Health Education and Health Promotion

Abstract Aims: The optimization of services, such as online registration and virtual consultations is hampered by low levels of digital literacy. The purpose of this study was to investigate how digital literacy affects the community health center’s ability to provide quality medical care.
Instrument & Methods: This quantitative and explanatory study was conducted on 224 samples. Purposive sampling was used at the community health center, whereas proportionate random sampling techniques were used at the research location to determine the number of respondents at each community health center. A questionnaire was used to gather data, which was then administered to Kendari City health center officers.
Findings: The effectiveness of healthcare was positively and significantly affected by digital literacy (p=0.0001). Community health center policies had a positive and significant impact on digital literacy (p=0.011), while digital infrastructure had a positive and significant impact (p=0.016).
Conclusion: Digital literacy significantly improves service effectiveness.

Abstract Aims: This study aimed to examine the relationship between perceived social support and the university-to-work transition among graduates of the School of Health.
Instrument & Methods: This descriptive-analytical cross-sectional study was conducted on 227 graduates of the School of Public Health, Qazvin University of Medical Sciences, in the fields of public health, environmental health engineering, occupational health engineering, and health services management over three consecutive years (2023-2025). Data were collected via an online questionnaire developed using the Porsline platform, including demographic and educational parameters, the Multi-Dimensional Scale of Perceived Social Support, and University-To-Work Transition Scale. Analyses were performed using independent t-tests, Pearson correlation coefficients, ANOVA, and multivariate regression in SPSS version 25.
Findings: The mean age of the students was 22.89±1.04 years; 75.4% were female, 24.6% were male, and 45.6% were relatively satisfied with their field of study. Pearson correlation analysis revealed significant positive associations between university-to-work transition and the four transition competencies—concern (r=0.77, p=0.0001), curiosity (r=0.80, p=0.0001), confidence (r=0.74, p=0.0001), and control (r=0.75, p=0.0001)—as well as perceived social support from significant others (r=0.13, p=0.037). Multiple regression indicated that field of study, satisfaction with the field, family financial status, and perceived support from significant others accounted for 15% of the variance in university-to-work transition.
Conclusion: Strengthening transition competencies and social support, along with field alignment and finances, can improve graduates’ readiness for the university-to-work transition and their employment outcomes.

Abstract Aims: Women are more likely to use herbal medicine than men. Considering the importance of women’s health, particularly during reproductive age, which is a crucial time for healthy life cycles, the aim of this study was to determine the predictors of herbal medicine use among reproductive-age Iranian women based on the socio-ecological model.
Instrument & Methods: This cross-sectional study included 190 reproductive-age Iranian women from Jahrom city, selected using multi-stage sampling. The data collection tool was a researcher-developed questionnaire comprising demographic information and the constructs of the socio-ecological model. Backward multiple logistic regression was used to identify predictors of herbal medicine use. Data analysis was performed using SPSS version 25.
Findings: The mean age of the participants was 33.84±9.66 years. Interpersonal factors (OR=1.30, p<0.001) and public policy factors (OR=1.20, p=0.01) could explain 38% of the variance in herbal medicine use.
Conclusion: Herbal medicine use among reproductive-age women is related to psychological and demographic factors, and interpersonal factors are the strongest predictor of herbal medicine use.

Abstract Aims: Today, people often prefer electronic communication over traditional methods. In fact, the post-COVID-19 era has seen an increase in health consciousness, leading individuals to share various types of health information online, extending beyond their immediate acquaintances. Therefore, this research aimed to investigate the impact of health literacy on electronic word of mouth among Malaysian internet users in disseminating health information, with a focus on socio-demographic comparisons.
Instrument & Methods: This cross-sectional descriptive study involved 400 respondents, utilizing proportionate quota sampling as the sampling technique. A total of 100 samples were collected from each region of Peninsular Malaysia (Central, Southern, Northern, and East Coast), who completed a self-administered questionnaire consisting of 56 items. This instrument was adapted from a well-established Electronic Word of Mouth Questionnaire and the New Short-Form Health Literacy Instrument.
Findings: The three domains of health literacy explained electronic word of mouth effectively among respondents who were male, aged 41 to 50 years, with secondary education, and self-employed. However, stronger influences of health literacy domains on electronic word of mouth were observed among respondents who were female, aged 18 to 30 years, had a bachelor’s degree, and were currently not employed.
Conclusion: Gender, age, highest education, and occupation are influential factors of health literacy.

Abstract Aims: This study aimed to analyze the perceptions and readiness of health profession students regarding interprofessional education within the Indonesian context.
Participants & Methods: This study employed a concurrent mixed-methods design involving 190 health profession students from three study programs (medicine, nursing, and pharmacy) at Universitas Airlangga Hospital. Quantitative data were collected using the validated Readiness for Interprofessional Learning Scale and analyzed using SPSS 25. Meanwhile, qualitative data were obtained through in-depth (one-on-one) interviews and analyzed thematically.
Findings: There was a significant increase in students’ Readiness for Interprofessional Learning Scale scores before and after participating in interprofessional education (p<0.05), indicating enhanced readiness for interprofessional learning. Thematic analysis revealed four main themes, including interprofessional education is seen as an engaging and beneficial activity, interprofessional education broadens cross-professional perspectives, each profession brings a unique point of view, and cultural values, such as sungkan (reluctance), gotong royong (mutual cooperation), and professional stereotypes influence interactions in interprofessional education activities.
Conclusion: IPE enhances students’ interprofessional understanding, communication, and confidence in applying collaborative values in future practice.

Abstract Aims: This study aimed to determine the correlation between health-promoting hospitals’ standards and nurses’ caring behaviors.
Instrument & Methods: This correlational study was conducted on 228 nurses working in hospitals affiliated with Birjand University of Medical Sciences in 2021 in Birjand, Iran. The research instruments included the demographic characteristics checklist, the Caring Behavior Inventory, and the World Health Organization’s Health Promotion Standards Adherence Scale.
Findings: There was a significant positive correlation between the total score of health-promoting hospital standards and the total score of nurses’ caring behaviors from the perspective of nurses (p<0.001, r=0.494). Likewise, there was a significant positive correlation between all dimensions of health-promoting hospitals’ standards and all dimensions of nurses’ caring behaviors (p<0.001).
Conclusion: Hospitals enhance nurses’ caring behavior by following health-promoting hospital standards and fostering a positive work environment with improved inter-professional relationships.

Abstract Aims: The identification of factors that affect health literacy in the elderly will aid in designing interventions aimed at promoting health literacy by focusing on these factors. Therefore, the present aimed to determine the relationship between health literacy and financial literacy among the elderly.
Instrument & Methods: This cross-sectional study was conducted on 295 elderly in Urmia, Iran, who were selected using a multi-stage cluster sampling method in 2022. The data collection tools included a demographic information form, the Health Literacy for Iranian Adults Questionnaire, and the Financial Literacy Questionnaire. Data were analyzed using SPSS version 16, employing the Kolmogorov-Smirnov test, independent t-test, one-way ANOVA, and Pearson correlation coefficient.
Findings: The mean health literacy score of the elderly participants was 64.38 out of 100, indicating a not very sufficient level. Additionally, the mean financial literacy score was 47.84 out of 100, reflecting a low level of financial literacy. A positive and significant correlation was found between financial literacy and health literacy (p<0.001, r=0.60).
Conclusion: There are low levels of both financial literacy and health literacy among the elderly in Urmia, and financial literacy and health literacy are positively correlated.

Abstract Aims: Electronic health records play a crucial role in modern healthcare by providing users and healthcare providers with comprehensive medical information. However, the implementation of EHR systems involves a complex balance of advantages and challenges. This study examined the strengths, weaknesses, potential benefits, and challenges related to the implementation of electronic health records.
Instrument & Methods: This cross-sectional survey was conducted from May to September 2023, involving 63 electronic health record managers and 110 practitioners from health centers in Mazandaran province. A purposive sampling technique was employed, utilizing a specially designed questionnaire to evaluate different aspects of electronic health records, including their strengths, limitations, potential benefits, and possible risks. The data analysis included a combination of descriptive and analytical statistics.
Findings: The participants had an average age of 40.48±9.14 years. Electronic health record managers highlighted the rapidity and effectiveness of information access, as well as the smooth exchange of electronic data, as major advantages of electronic health record implementation. Noted weaknesses included a heavier workload for healthcare providers and inadequate equipment for EHR functionality. The potential for achieving system integration and improving access to health sector statistics was identified. Nevertheless, there were concerns regarding the security of patient information and difficulties in developing and implementing appropriate software.
Conclusion: The success of electronic health record implementation depends on a thorough understanding of its various aspects, including strengths, weaknesses, threats, and opportunities.

Abstract Aims: The increased recognition of the significance of occupational safety and health in the workplace has attracted increasing attention in the field of public health. This study aimed to analyze recent trends in prioritizing worker safety, health, and well-being in the workplace, focusing on the connections between occupational safety and health and public health.
Information & Methods: This systematic review employed a combined approach using the preferred reporting items for systematic reviews and meta-analyses model along with an analysis tool, VOSviewer, for a systematic review of the literature. The research process involved identifying search topics and pertinent keywords (such as occupational safety, health, well-being, and public health) and conducting a systematic literature search in the Scopus and SciSpace databases
Findings: A shift in awareness regarding occupational risks and their impact on mental and physical health was indicated. Moreover, the study underscored the significance of integrating occupational health with public health.
Conclusion: The safety, health, and well-being of workers significantly influence not only individuals but also the overall welfare of society.

Abstract Aims: The elderly population, both globally and in Iran, is increasing. The well-being of the elderly is a crucial aspect of health. This study aimed to examine the impact of social cognitive determinants on the healthy lifestyle of older adults.
Instrument & Methods: This cross-sectional study was conducted in 2021, involving 455 elderly in Rasht City, Guilan Province. Data on demographic characteristics, lifestyle information, and constructs of the social cognitive theory were collected.
Findings: The majority of participants had an average lifestyle. Among the various components, prevention received the highest score for a healthy lifestyle among the elderly, while physical activity received the lowest score. Among the constructs of the social cognitive theory, outcome expectancies had the highest mean score, while self-efficacy had the lowest mean score. The correlation analysis revealed significant and direct relationships between the constructs of the cognitive theory and healthy lifestyle scores among the elderly. Awareness, self-regulation, social support, and outcome expectations significantly predicted lifestyle behavior.
Conclusion: The social cognitive theory holds predictive value for understanding the lifestyle of older adults.

Abstract Aims: The current study aimed to investigate the impact of an educational intervention focusing on positive emotions and anger management on fostering positive emotions, mitigating negative emotions and anger, enhancing emotional regulation, and improving the mental and physical health of teachers.
Materials & Methods: The current research employed a quasi-experimental design with pre-test, post-test, and a two-month follow-up. The statistical population comprised 420 elementary school teachers in the 5th district of Isfahan City in 2021, from which 40 individuals were selected as participants using convenience sampling. They were then divided into two groups; one receiving training on cultivating positive emotions and managing anger, and a control group. Participation was voluntary. Data was collected using a 50-item scale assessing positive and negative emotions, anger management, emotional regulation, mental health, and physical health of teachers. Data analysis was conducted using univariate analysis of variance. A follow-up test to assess the intervention’s impact on fostering positive emotions and anger management was conducted after two months.
Findings: The educational intervention on positive emotions and anger management improved mental health, emotion regulation, and physical health, increased the level of positive emotions, and decreased the level of negative emotions of teachers.
Conclusion: Implementing training focused on cultivating positive emotions and managing anger, rooted in the principles of positive psychology, enhances and boosts emotional regulation, as well as the mental and physical well-being of teachers.

Abstract Aims: Healthcare workers are crucial in the healthcare sector, and understanding their educational prerequisites is of paramount importance. This study employed interpretive structural modeling to develop a comprehensive framework for elucidating these prerequisites in Iran.
Participants & Methods: We engaged 27 participants, including academic staff from the Universities of Medical Sciences and managers from the health and treatment network in Iran. Data were collected through self-administered questionnaires. The identified educational needs underwent validation using the Lawshe content validity index, resulting in a substantial content validity ratio (CVR) of 98%. Interpretive structural modeling was then applied to categorize and prioritize these educational needs.
Findings: The study unveiled nine essential educational needs for healthcare workers in Iran, covering domains, including effective communication skills, internet resource utilization, responsibility, work ethics, healthcare-related laws and regulations, decision-making and problem-solving abilities, teamwork, legal and ethical principles, management skills, and specialized healthcare knowledge, of which communication skills, internet resource utilization, responsibility, and work ethics emerged as the most influential factors.
Conclusion: This research offers valuable insights for the improvement of healthcare worker education and training programs in Iran.

Abstract Aims: Individuals with substance use disorder often struggle with chronic and recurrent episodes, experiencing a lack of control over their behaviors and significant disruptions in motivation. This study investigated the relationship between anxious attachment, family well-being, and addiction susceptibility among university students with the mediating role of cognitive emotion regulation.
Instrument & Methods: This study utilized structural equation modeling, a widely recognized multivariate correlation method, to examine the relationship between various factors in the context of addiction susceptibility. The target population for this study comprised students from the Islamic Azad University of Ahvaz. Through convenience sampling, a sample of 300 students was selected. All participants completed the Potential Addiction Scale, Experience in Close Relationships Scale, Family-of-Origin Scale, and Cognitive Emotion Regulation Scale. The collected data underwent statistical analysis using SEM, revealing a well-fitted model.
Findings: Anxious attachment and family health significantly influenced participants' inclination toward addiction (p<0.001). These effects were directly and indirectly observed, mediated by cognitive emotion regulation (p<0.001).
Conclusion: Reducing addiction tendencies in young individuals can be achieved through training families and university students on cultivating secure attachment styles, employing adaptive cognitive regulation strategies, and promoting overall family health.

Abstract Aims: Knowledge and skills significantly affect the learning performance of vocational students. However, adding ability without enhancing memory can reduce learning effectiveness, which ultimately affects learning performance. This study was done to investigate the effect of learning engagement and self-confidence on learning performance, mediated by repetition of educational materials. The goal is to improve the learning process and increase students' memory retention during exams.
Participants & Methods: This study was conducted on 179 respondents from health vocational schools to analyze knowledge, skills, and expertise after learning using four variables: learning engagement, self-confidence, repetition strategy, and learning performance from August to December 2022.
Findings: The results indicated that learning engagement and self-confidence directly affected learning performance. The Repetition strategies mediated the relationship between learning engagement and self-confidence with learning performance.
Conclusion: Therefore, implementing rehearsal strategies for students is essential in the learning process to establish optimal learning performance. Repetition strategies can help students maintain and strengthen their memory, leading to better exam performance and educational evaluations.

Abstract Aims: Evaluating diabetics’ health-promoting behaviors is an essential part of nursing care. This study aimed to examine the relationship between health-promoting behaviors and perceived social support from the family in patients with type 2 diabetes.
Instrument & Methods: This was a descriptive cross-sectional study. The data were collected from a foundation university hospital in Tabriz, Iran. The sample consisted of 183 type 2 diabetes patients. Data were collected using the Perceived Social Support from Family and Health-Promoting Behaviors scales.
Findings: The average score of social support was 15.07±6.74 (range: 0 to 20), and the average score of health-promoting behaviors was 49.62±17.74 (range: 0 to 112). There was a significant and positive correlation between the scores of health-promoting behaviors and perceived social support (r=0.28, p<0.001). We predicted the changes in health-promoting behaviors based on the regression analysis of the changes in perceived social support from the family (B=0.563).
Conclusions: Family social support affects health-promoting behaviors in type 2 diabetes patients, and should be considered during interventions to improve health-promoting behaviors by nurses and other healthcare providers. We suggest other descriptive correlational studies with a higher sample size and interventional studies on this subject.

Abstract Aims: This study aimed to analyze the effect of knowledge on the application of clean and healthy living behavior through perceived susceptibility in the prevention of AIDS.
Participants & Methods: Using quantitative research, we examined the possible causality between certain factors possibly causing the studied symptoms. The statistical population was 290 people living in Wakatobi Regency, of whom 166 people were considered as samples using the Lemeshow formula. Descriptive and inferential analyses were performed using path analysis, t-test, and normality tests.
Findings: Based on the results of the path analysis, the path coefficient value of the knowledge to perceived susceptibility was 0.177 with a t-value of 7.762 > 1.974 and a p-value of < 0.005. Thus, it can be concluded that knowledge has a positive and significant effect on clean and healthy living behavior in the community.
Conclusion: The results showed that knowledge about the dangers of smoking had a significant effect on fostering clean and healthy behavior (PHBS) through perceived susceptibility.

Abstract Aims: A healthy lifestyle reduces the mortality from diseases such as cardiovascular diseases and diabetes mellitus. This study aimed to assess the effectiveness of an online health and well-being program in improving physical activity, nutrition, and sleep in college students.
Materials & Methods: The present study utilized a quantitative methodology, mainly a two-group pretest-posttest design on 178 college students. The experimental group received three months of a health and well-being program while the control resumed their daily activities. The participants answered an adapted online questionnaire divided into socio-demographic and physical activity, nutrition, and sleep data. Data were analyzed using SPSS 27 software.
Findings: In both experimental and control groups, the participants’ physical activity in a day was at an average level. Moreover, the frequency of eating nutritious foods in a week was at an average level for both groups. In terms of hours of sleep per night, the total pretest and posttest mean scores for the experimental and control groups indicated that the participants’ hours of sleep per night are at a below-average level. In terms of physical activity, nutrition, and hours of sleep per night, there was no statistically significant difference between the pretest and posttest for both groups (p>0.05).
Conclusion: There is no evidence of a significant difference between college students' physical activity, nutrition, and sleep after the online health well-being program.

Abstract Aims: The article’s purpose was to consider the problematic issues of forming an understanding of such concepts as health, pain, and suffering.
Information & Methods: A set of general scientific and special methods was used in work: dialectical, dogmatic, hermeneutics, comparative legal method, statistic, and sociological method.
Findings: Considered the category of "health" in various humanities and compared the characteristics of "physical pain" and "physical and moral suffering" as possible consequences of criminal offenses that harm the health of the individual.
Conclusion: The research of such problematic issues allowed to development of a unified approach to the understanding of such concepts as “health”, “pain” and “suffering” this, in turn, will make it possible to unify legislation in this area.

Abstract Aims: One of the most common problems in the world is the growing aging population. The present study was examined the age-friendly city of Tehran based on indicators from the elders perspective
Instrument & Methods: This cross-sectional study was examined four indicators of the age-friendly city of Tehran from the perspective of the elderly (n=418) in 2018. The data collection tool was the World Health Organization (WHO)’s questionnaire of age-friendly city indicators: Social Participation, Civic-Participation and Employment, Respect and Social Inclusion, and the Communication and Information index. Statistical analysis was performed using SPSS 18 on the collected data, assuming a significance level of <0.05.
Findings: The mean age of the elderly was 66.86±6.31 years. Comparing the means of the age-friendly city indicators revealed the social participation index mean of 35.0, the civic participation and employment index mean of 18.9, respect and social inclusion mean of 18.2, and the communication and information mean of 24.5.
Conclusion: Tehran metropolitan is only able to fulfill the basic needs of the elderly and is far from being the ideal situation and cannot achieve active aging for its people.

Abstract Aims: Health-promoting behaviors have a major role in healthcare. The present study was conducted to assess health-promoting behaviors and its related factors in Iranian female household heads based on Pender's model.
Materials & Methods: The present cross-sectional study recruited 106 female household heads selected according to census sampling from Gonabad Health Centers, eastern Iran, from January to August in 2015. Data were collected using the Health-Promoting Lifestyle Profile-II (HPLP-II) and a researcher-made cognitive and emotional factors questionnaire based on Pender's model. Data were analyzed by SPSS 16, using descriptive and analytical tests, including ANOVA and independent student t-test.
Findings: Participants' statistical mean age was 40.16±7.21 years, and most of them (61 women, 57.5%) were widowed and the rest were divorced. The statistical mean score of health-promoting behaviors was 123.16±20.42, in moderate level, and showed significant relationships with cognitive and emotional factors of self-efficacy, barriers, and interpersonal relationships (p<0.05). Among health-promoting behaviors, spiritual growth had the highest Statistical mean score (24.91±5.3), and physical activity (12.83±3.5) and stress management (17.83±3.9) the lowest mean score.
Conclusion: Health-promoting behaviors in Iranian female household heads need improvement. The results can be used by these women and the healthcare system to identify related factors and develop interventions for modifying health-promoting lifestyles.

Abstract Aims: Oral and dental problems are among the most common diseases in the world. The aim of this research was to determine the effect of an education program designed based on the health belief model on improving the behaviors preventing oral and dental problems in the 7th-grade students.
Materials & Methods: This semi-experimental study was conducted on 7th-grade female students in Qom in 2016. The samples were selected via multistage sampling method. Using the list of students, a total of 100 students were selected of each school. The participants were divided into two groups include the intervention and control groups, there were 50 people in each groups. Before the intervention, a standardized questionnaire based on the health belief model was distributed in both groups. Then the educational content which had been already prepared was presented to cases in five sessions via different methods. Data were analyzed using independent t-test, chi-square, paired t-test and SPSS 20 software.
Findings: After the intervention, the constructs of Knowledge (p<0.001), perceived susceptibility (p=0.001), perceived severity (p=0.01), perceived barriers (p=0.02), and perceived self-efficacy (p<0.001) had significantly changed in the intervention group, as compared with the time before the intervention.
Conclusion: Health belief model has an impact on student's knowledge and perception of oral health and it can be used to increase students' Knowledge and understanding in order to promote their oral and dental health.

Abstract Aims: In Iran, safety and health education in agriculture such as the industrial sector has not been taken into account, and most farmers are not covered by professional health. The aim of this study was to assess the farmers’ awareness about occupational safety and health and factors affecting it.
Instruments & Methods: The population of the present descriptive correlational study included 140 households from farmers based on the simple random sampling method in 2014, in Mahidasht, Kermanshah Province, Iran. A researcher-made questionnaire was used as a research instrument and its validity was confirmed by the panel of experts and its reliability was confirmed by Cronbach's alpha coefficient. The data were analyzed by SPSS 23, using multiple stepwise regression and Pearson correlation test.
Findings: Most of the farmers had a negative attitude towards the observance of occupational health issues. The mean awareness had a significant correlation with social status (r=0.47; p=0.001), satisfaction of the agriculture as an occupation (r=0.51; p=0.0001), attitude (r=0.37; p=0.012) and, economic status (r=0.42; p=0.005). In the first step, the social status and satisfaction of the agriculture as an occupation predicted 66.9% of variance of awareness. In the second step, social status and satisfaction of the agriculture as an occupation as well as attitude predicted 53.3% of variance of awareness, and in the third step, by adding economic status to the previous variables; all variables predicted 51.2% of variance of awareness.
Conclusion: The level of farmers’ awareness about occupational safety and health is moderate. Social status, attitude, and economic status affect the farmers’ awareness about occupational safety and health.

Abstract Aims: Drug abuse among college students continues as a major public-health concern. Theory-driven research is necessary to address and find causes. The current research investigates the utility of Theory of Planned Behavior (TPB) in designing and implementing a drug abuse educational prevention program among medical college students. Methods: This quasi-experimental study was conducted among 120 college students in two groups: experimental and control, who were randomly enrolled at the baseline survey. We used a questionnaire, which included three sections of background data (11 questions), knowledge about the side effects of drug abuse questionnaire (16 questions), and TPB-based questionnaire (20 questions). Educational planning was based on active learning with using group discussion, printed leaflet, and audio-visual CD. The participants were followed up after 2-month intervention. Data were analyzed by the SPSS software version 16 using appropriate statistical tests such as stepwise multiple logistic regressions and t-test. Findings: Almost 6.7% of the participants had a history of drug abuse. The three predictors of 1) attitude, 2) subjective norms, and 3) perceived behavioral control accounted for 48 % of the variation in the outcome measure of the intention to drug abuse. There was a significant improvement in average response for knowledge about the side effects of drug abuse and TPB variables among the students who were under intervention (P < 0.05). Conclusions: Designing intervention to reduce positive attitude and subjective norms toward drug abuse among college students could be useful to substance abuse prevention.