Afarand Scholarly Publishing Institute Health Education and Health Promotion 2588-5715 14 1 2026 04 22 Effectiveness of the COM-B Model Application in Hypertension Management; a Systematic Review 1 8 28501 10.58209/hehp.14.1.1 EN A. Abidah Faculty of Nursing, Airlangga University, Surabaya, Indonesia T. Sukartini Department of Advanced Nursing, Faculty of Nursing, Airlangga University, Surabaya, Indonesia H. Mariyanti Department of Basic Nursing, Faculty of Nursing, Airlangga University, Surabaya, Indonesia Journal Article 2026 04 22 Aims: This systematic review aims to identify the effectiveness of the COM-B-based intervention model on hypertension management behavior and to explore the barriers and facilitators of COM-B interventions in changing hypertension behavior. Information & Methods: This systematic review uses the PRISMA guide. The databases of Scopus, PubMed, ProQuest, and Web of Science were searched from January 2015 to April 2025. The search strategy uses keywords and Boolean operators. The selection of articles is based on the research's inclusion and exclusion criteria. This study used the Joanna Briggs Institute Critical Appraisal Checklist to assess the quality of the included studies. Findings: Twelve studies involving 1,961 participants from China, the United States, Uganda, Nepal, India, and Ghana were included. 5 quantitative articles showed that COM-B-based interventions had clinical significance in terms of blood pressure values and behavioral significance, including blood pressure control, self-management, dietary patterns, and others. 7 qualitative articles report on barriers and facilitators to behavior change, including low health literacy, medical costs, pill fatigue, and social factors. Meanwhile, facilitators of behavior change are family support, interactive education, and treatment facilities such as digital reminders. Conclusion: The COM-B model is effectively used to evaluate barriers and facilitators to the performance of health behaviors. Identified barriers and facilitators can be used to develop COM-B-based behavior change interventions. Behavioral changes are evident in the results of COM-B-based intervention research, which significantly influence clinical outcomes.

https://hehp.modares.ac.ir/article_28501_65378614c4adbc65cc1643a8bd221e59.pdf

Afarand Scholarly Publishing Institute Health Education and Health Promotion 2588-5715 14 1 2026 01 01 Knowledge, Attitudes, and Practices of Nurturing Care in Indonesian Mothers of Acutely Ill Children Under Five Years Old 9 18 28503 10.58209/hehp.14.1.9 EN F. Haryanti Department of Pediatric and Maternity Nursing, Faculty of Medicine, Public Health, and Nursing, University of Gadjah Mada, Yogyakarta, Indonesia I. Parmawati Department of Pediatric and Maternity Nursing, Faculty of Medicine, Public Health, and Nursing, University of Gadjah Mada, Yogyakarta, Indonesia A. Sandhi Department of Pediatric and Maternity Nursing, Faculty of Medicine, Public Health, and Nursing, University of Gadjah Mada, Yogyakarta, Indonesia I. Rahmat Department of Pediatric and Maternity Nursing, Faculty of Medicine, Public Health, and Nursing, University of Gadjah Mada, Yogyakarta, Indonesia A.B. Agustin Department of Pediatric and Maternity Nursing, Faculty of Medicine, Public Health, and Nursing, University of Gadjah Mada, Yogyakarta, Indonesia C.I. Putri Department of Pediatric and Maternity Nursing, Faculty of Medicine, Public Health, and Nursing, University of Gadjah Mada, Yogyakarta, Indonesia T.M.N. Izati Department of Pediatric and Maternity Nursing, Faculty of Medicine, Public Health, and Nursing, University of Gadjah Mada, Yogyakarta, Indonesia A. Akhmadi Department of Mental Health and Community Nursing, Faculty of Medicine, Public Health, and Nursing, University of Gadjah Mada, Yogyakarta, Indonesia Journal Article 2026 04 22 Aims: Nurturing care during episodes of acute illness is essential to support optimal child development, yet the delivery remains poorly studied in Indonesia. The objective of this study was to determine maternal knowledge, attitudes, and practices related to nurturing care among mothers of acutely ill children under 5 years old in Indonesia. Instrument & Methods: It is a descriptive, cross-sectional study conducted in November 2024 at Banguntapan II PHC. One hundred and four mother-child pairs were studied using systematic random sampling. Information was gathered through validated questionnaires on knowledge, attitudes, and practices. Descriptive statistics, Pearson correlation, and ANOVA test were performed. Findings: The knowledge (8.35±1.83) and attitudes (95.64±3.36) of mothers were high regarding nurturing care. Practice scores, however, were significantly lower (58.56±7.19), indicating a significant knowledge-practice disparity. Correlation analysis revealed a moderate positive relationship between knowledge and attitudes (r=0.557), but no significant correlations were found between knowledge-practices or attitudes-practices. Notably, no statistically significant differences were observed across demographic factors, including age, occupation, education level, or family income. Conclusion: These results highlight key areas for targeted interventions, particularly in nutritional and early stimulation activities and in child safety practices during periods of illness, to support optimal development.

https://hehp.modares.ac.ir/article_28503_3bb7e223dd6fe07da16874517cf3fa54.pdf

Afarand Scholarly Publishing Institute Health Education and Health Promotion 2588-5715 14 1 2026 01 01 Validation of Mobile Application Usability Questionnaire for Evaluation of Usability of the Mommy-Be Application in Indonesia 19 27 28504 10.58209/hehp.14.1.19 EN A. Syam Department of Public Health, Faculty of Health, Mega Buana University, Palopo, Indonesia F. Fadli Department of Public Health, Faculty of Health, Mega Buana University, Palopo, Indonesia A. Syam Department of Management, Faculty of Business, Ciputra University, Makassar, Indonesia A.R. Amelia Department of Public Health, Faculty of Public Health, Universitas Muslim Indonesia, Makassar, Indonesia A. Toaha Health Polytechnic of the Ministry of Health, Balikpapan, Kalimantan Timur, Indonesia Journal Article 2026 04 22 Aims: Mobile health (mHealth) applications have emerged as an effective approach to supporting maternal breastfeeding health. However, adopting these applications often faces challenges in terms of usability and user satisfaction. This study aimed to adapt and validate the Malay-language version of the Mobile Application Usability Questionnaire (MAUQ) for the Mommy-Be application in Indonesia. Instrument & Methods: This research uses a descriptive, quantitative design with a Confirmatory Factor Analysis (CFA) to test the instrument's validity. A total of 386 breastfeeding mothers in Makassar City, South Sulawesi, participated in a two-week trial of the application, who were invited via social media applications at each primary health service. Findings: A CFI value of 0.548 and a TLI of 0.477 indicated a less-than-ideal model fit. After removing items with high Modification Indices (MIs), the second model showed a significant improvement, with a CFI of 0.972, a TLI of 0.966, and an RMSEA of 0.062. Conclusion: These results highlight the importance of adapting instruments to the local context and technical conditions of the application. The results of this study are expected to support the development of health applications better aligned with local users' needs.

https://hehp.modares.ac.ir/article_28504_ceee632a967af1be6e1c0a29e21bb1c5.pdf

Afarand Scholarly Publishing Institute Health Education and Health Promotion 2588-5715 14 1 2026 04 22 Alcohol Misuse Prevention Campaign for Parents of 3-7 Years Old Children in Kerman Province, Iran 29 35 28502 10.58209/hehp.14.1.29 EN V.R. Borhaninejad Social Determinants of Health Research Center, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran A. Iranpour “HIV/STI Surveillance Research Center” and “WHO Collaborating Center for HIV Surveillance, Institute for Futures Studies in Health”, Kerman University of Medical Sciences, Kerman, Iran A. Bahramnejad Neuroscience Research Center, Kerman University of Medical Sciences, Kerman, Iran S. Alizadeh Social Determinants of Health Research Center, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran Journal Article 2026 04 22 Aims: Childhood is considered the most appropriate stage for behavioral interventions, as children have not yet established stable behavioral patterns. Implementing educational interventions at this age can instill healthy behaviors and prevent risky behaviors in adulthood. Accordingly, the present study was conducted to implement a campaign to prevent alcohol misuse among parents of children aged 3-7 years in Kerman Province, Iran. Instrument & Methods: This study was conducted with 500 participants in the pre-test and 497 in the post-test between November 2023 and January 2024 in Kerman. Sampling was conducted randomly. An educational package was uploaded for 10 days on the domestic messaging platform Eitaa. Data were collected before and after the campaign using a researcher-designed questionnaire on knowledge and attitudes. Statistical analyses were performed using SPSS software. Findings: Most parents were in the 29-59-year age group. After the campaign, the mean knowledge score regarding alcohol misuse in children improved significantly (p<0.001), whereas the attitude score did not. Conclusion: The intervention increases parental knowledge about alcohol and substance misuse, but doesn’t change their attitudes.

https://hehp.modares.ac.ir/article_28502_a472370cd24972948ca543bcb05a29b2.pdf

Afarand Scholarly Publishing Institute Health Education and Health Promotion 2588-5715 14 1 2026 01 01 Modeling a Job Demands-Resources Framework in Indonesian Primary Healthcare; a Structural Equation Modeling-Partial Least Squares Analysis 37 43 28505 10.58209/hehp.14.1.37 EN R. Rahman Department of Management Science, Halu Oleo University, Kendari, Indonesia P. Patwayati Department of Management, Faculty of Economics and Business, Halu Oleo University, Kendari, Indonesia L.H. La Hatani Department of Management, Faculty of Economics and Business, Halu Oleo University, Kendari, Indonesia S.W. Maharani Department of Management, Faculty of Economics and Business, Halu Oleo University, Kendari, Indonesia Journal Article 2026 04 22 Aims: Primary health care requires personnel with strong psychological resources to maintain optimal performance. Grounded in the Job Demands-Resources model, this study examines the mediating role of work engagement in the relationship between personal resources—self-efficacy, resilience, and optimism—and healthcare professionals’ performance. Instrument & Methods: This study employed an explanatory cross-sectional design. Data were collected from 292 primary healthcare professionals using a Likert-scale questionnaire and proportional stratified random sampling. Structural relationships and mediation effects were analysed using Structural Equation Modeling-Partial Least Squares (SEM-PLS) with SmartPLS 4, assessing both measurement and structural models. Findings: Personal resources significantly influenced work engagement, with optimism (β=0.430), self-efficacy (β=0.318), and resilience (β=0.161) showing positive effects. Work engagement had a strong and significant effect on performance (β=0.699). Direct effects of optimism and resilience on performance were not significant. However, mediation analysis revealed significant indirect effects of optimism (β=0.301), self-efficacy (β=0.222), and resilience (β=0.113) on performance through work engagement. Conclusion: The findings indicate that personal resources primarily enhance performance through work engagement. Strengthening psychological resources and fostering supportive work environments are essential strategies for improving performance in primary health care settings.

https://hehp.modares.ac.ir/article_28505_1a95a34d609c80482beaf440a005e271.pdf

Afarand Scholarly Publishing Institute Health Education and Health Promotion 2588-5715 14 1 2026 01 01 Influence of Patient Conditions and Health Service Providers on Indonesian Patients' Experience 45 51 28506 10.58209/hehp.14.1.45 EN R.I. Suranto Department of Hospital Administration, Faculty of Public Health, Hasanuddin University, Makassar, Indonesia S.A. Pasinringi Department of Hospital Administration, Faculty of Public Health, Hasanuddin University, Makassar, Indonesia F. Rivai “Department of Hospital Administration, Faculty of Public Health” and “Hasanuddin University Hospital”, Hasanuddin University, Makassar, Indonesia H.A. Hamzah “Department of Hospital Administration, Faculty of Public Health” and “Hasanuddin University Hospital”, Hasanuddin University, Makassar, Indonesia I. Irwandy “Department of Hospital Administration, Faculty of Public Health” and “Hasanuddin University Hospital”, Hasanuddin University, Makassar, Indonesia Journal Article 2026 04 22 Aims: Patient experience is a key indicator for assessing hospital service quality. Although Primaya Inco Sorowako Hospital has achieved A-level accreditation with a patient satisfaction rate above 90%, several complaints persist about long waiting times, unclear explanations from staff, and complex administrative procedures. These issues indicate the need to evaluate factors influencing patient experience. To analyze the influence of patient conditions and healthcare service providers on patient experience at Primaya Inco Sorowako Hospital, both directly and through the mediation of healthcare service providers. Instrument & Methods: This cross-sectional study was conducted among patients who had completed their visit at Primaya Inco Sorowako Hospital, Indonesia, during 2024 (3771 individuals) and were able to provide informative responses. The sample size was calculated to be 349 respondents. Data were collected using a closed-ended questionnaire with a 4-point Likert scale and analyzed using univariate, bivariate, and multivariate methods. Findings: Patient conditions and healthcare service providers significantly affect patient experience. The most influential factors were healthcare responsiveness and quality, emphasizing the importance of timeliness, effective communication, and provider attentiveness to patient needs. Conclusion: Patient experience at Inco Sorowako Hospital is influenced by factors in both the Patient and Health Provision dimensions.

https://hehp.modares.ac.ir/article_28506_4b777618f85e4ce92de27c69a6cc104c.pdf

Afarand Scholarly Publishing Institute Health Education and Health Promotion 2588-5715 14 1 2026 01 01 Effects of Nature-Based Educational Therapy on Treatment Adherence and Exercise Capacity in Ischemic Heart Disease Patients 53 59 28453 10.58209/hehp.14.1.53 EN E. Karazhian Department of Medical-Surgical Nursing, Faculty of Nursing and Midwifery, Mashhad University of Medical Sciences, Mashhad, Iran N. Davoudi Hasanabad Department of Medical-Surgical Nursing, Faculty of Nursing and Midwifery, Mashhad University of Medical Sciences, Mashhad, Iran S.A. Ebrahimi Department of Orthopedic Surgery, Faculty of Medicine, Iran University of Medical Sciences, Tehran, Iran S. Nazemi Department of Cardiovascular Diseases, Razavi Hospital, Mashhad, Iran S.R. Mazlom Department of Medical-Surgical Nursing, Faculty of Nursing and Midwifery, Mashhad University of Medical Sciences, Mashhad, Iran Journal Article 2026 04 22 Aims: This study evaluated the effect of nature-based therapy on treatment adherence and exercise capacity in patients with ischemic heart disease. Materials & Methods: This randomized controlled clinical trial was conducted on 58 patients who were randomly assigned to the intervention and control group (n=29 per group). The intervention group participated in a structured nature-based educational program that included guided walking, group discussions, relaxation techniques, and exercise sessions conducted in a natural environment. The control group received routine face-to-face education. Treatment adherence was assessed using the eight-item Morisky Medication Adherence Scale, and exercise capacity was evaluated using the six-minute walk test before and after the intervention. Secondary physiological outcomes, including blood pressure, heart rate, respiratory rate, and oxygen saturation, were also measured. Analysis of covariance was used to compare post-intervention outcomes between groups while adjusting for baseline values. Findings: After adjusting for covariates, treatment adherence was significantly higher in the intervention group than in the control group (p<0.01). Exercise capacity was also significantly greater in the intervention group than in the control group (p<0.001). Furthermore, the intervention group showed significant improvements in physiological parameters, including lower systolic and diastolic blood pressure, reduced heart rate, and improved oxygen saturation compared with the control group (p<0.05). Conclusion: Nature-based therapy significantly improves treatment adherence, exercise capacity, and physiological outcomes in patients with ischemic heart disease in the short term.

https://hehp.modares.ac.ir/article_28453_8e9f22434774cce976973717448380b4.pdf

Afarand Scholarly Publishing Institute Health Education and Health Promotion 2588-5715 14 1 2026 01 01 Effect of COVID-19 Pandemic-Related Post-Traumatic Stress Disorder on the Quality of Nurses' Work Life 61 67 28451 10.58209/hehp.14.1.61 EN F. Hosseini Social Determinants of Health Research Center, Research Institute for Prevention of Non-Communicable Diseases, Qazvin University of Medical Sciences, Qazvin, Iran F. Hashemi Department of Surgical Technology, Faculty of Paramedical, Qazvin University of Medical Sciences, Qazvin, Iran A. Shafiei Department of Surgical Technology, Faculty of Paramedical, Qazvin University of Medical Sciences, Qazvin, Iran A. Salavatian Social Determinants of Health Research Center, Research Institute for Prevention of Non-Communicable Diseases, Qazvin University of Medical Sciences, Qazvin, Iran Journal Article 2026 04 22 Aims: Post-traumatic stress disorder is a psychological condition that can affect individuals during large-scale crises, such as the coronavirus pandemic. This study aimed to investigate the effect of COVID-19-related post-traumatic stress disorder on the quality of nurses’ work life. Instrument & Methods: This cross-sectional descriptive-analytical study was conducted between September 2022 and March 2023 among nurses working in hospitals affiliated with Qazvin University of Medical Sciences, located in northwest Iran. Through convenience sampling, 261 nurses were enrolled. Data were collected using the demographic and professional characteristics form, the Post-Traumatic Stress Disorder Symptoms Scale, and the Quality of Nurses’ Work Life (QNWL) questionnaire. Data analysis was performed using SPSS 20, applying descriptive statistics and inferential tests, including the Mann-Whitney U test, Kruskal-Wallis test, analysis of variance, and Spearman’s correlation coefficient. A significance level of p<0.05 was considered. Findings: The mean age of the participants was 35.19±7.75 years. The mean post-traumatic stress disorder score was 45.96±20.21, and the mean quality of nurses’ work life score was 128.17±27.73. Significant relationships were observed between employment status and work shift with the quality of nurses’ work life (p<0.05). Additionally, gender and marital status were significantly associated with post-traumatic stress disorder scores (p<0.05). Conclusion: Both post-traumatic stress disorder symptoms and the quality of nurses’ work life are at moderate levels among the nurses.

https://hehp.modares.ac.ir/article_28451_92b11f86a8c3f4e663ef070a822e1d2b.pdf

Afarand Scholarly Publishing Institute Health Education and Health Promotion 2588-5715 14 1 2026 01 01 Effect of Self-Efficacy-Based Intervention on Stress, Anxiety, Depression, and Quality of Life in Heart Failure Patients 69 75 28448 10.58209/hehp.14.1.69 EN A. Asri Community and Family Nursing Department, Panrita Husada College of Health Sciences, Bulukumba, Indonesia A. Suswani Community and Family Nursing Department, Panrita Husada College of Health Sciences, Bulukumba, Indonesia S. Safruddin Community and Family Nursing Department, Panrita Husada College of Health Sciences, Bulukumba, Indonesia M. Muriyati Medical Surgical Nursing Department, Panrita Husada College of Health Sciences, Bulukumba, Indonesia A.B. Aszrul Community and Family Nursing Department, Panrita Husada College of Health Sciences, Bulukumba, Indonesia Journal Article 2026 04 22 Aims: Heart failure is a major global public health problem. This study aimed to assess the effect of a self-efficacy-based nursing intervention on stress, anxiety, depression, and quality of life in patients with heart failure. Materials & Methods: This quasi-experimental study was conducted involving 252 participants, with 126 assigned to the intervention group and 126 to the control group, at community cardiology centers in South Sulawesi, Indonesia. The intervention group participated in a twelve-week structured program centered on knowledge, motivation, and self-monitoring, based on Bandura’s self-efficacy theory. Psychological distress, quality of life, and functional independence were evaluated at baseline and during the intervention. Findings: Participants in the intervention group showed significant reductions in stress (p=0.001), anxiety (p<0.001), and depression (p=0.010) compared to the control group. Quality of life improved in physical (median 63.00), psychological (median=69.00), and social (median=69.00) domains. Functional independence showed a significant increase (p=0.002). Conclusion: The self-efficacy-based nursing intervention significantly decreases psychological distress and improves quality of life in patients with heart failure.

https://hehp.modares.ac.ir/article_28448_8e14f4de91da22108a5247cc18253a0a.pdf

Afarand Scholarly Publishing Institute Health Education and Health Promotion 2588-5715 14 1 2026 01 01 Digital Literacy and Health Service Effectiveness in Kendari City 77 82 28449 10.58209/hehp.14.1.77 EN J. Jumakil Department of Biostatistics and Health Information System, Faculty of Public Health, University of Halu Oleo, Kendari, Indonesia S. Suhadi Department of Health Policy Administration, Faculty of Public Health, University of Halu Oleo, Kendari, Indonesia L.A. Kalza Department of Health Policy Administration, Faculty of Public Health, University of Halu Oleo, Kendari, Indonesia M.B. Yahya Department of Health Policy Administration, Faculty of Public Health, University of Halu Oleo, Kendari, Indonesia M. Wahida Department of Health Policy Administration, Faculty of Public Health, University of Halu Oleo, Kendari, Indonesia M.J. Ihsani Department of Health Policy Administration, Faculty of Public Health, University of Halu Oleo, Kendari, Indonesia Journal Article 2026 04 22 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.

https://hehp.modares.ac.ir/article_28449_7faf67c63084cf8345243e912885f1a5.pdf

Afarand Scholarly Publishing Institute Health Education and Health Promotion 2588-5715 14 1 2026 01 01 E-Health Literacy and Its Relationship with Self-Care Behaviors among Iranian Hypertensive Patients 83 90 28454 10.58209/hehp.14.1.83 EN Sh. Shirzadi .“Noncommunicable Diseases Research Center” and “Department of Public Health, Faculty of Health and Paramedicine, Neyshabur University of Medical Sciences, Neyshabur, Iran Z. Arab Borzu Department of Biostatistics and Epidemiology, Faculty of Health, Zahedan University of Medical Sciences, Zahedan, Iran M. Taziki Students Research Committee, Neyshabur University of Medical Sciences, Neyshabur, Iran S. Safari Students Research Committee, Neyshabur University of Medical Sciences, Neyshabur, Iran N. Golghandashti Students Research Committee, Neyshabur University of Medical Sciences, Neyshabur, Iran Sh. Jahanfar Department of Public Health and Community Medicine, Tufts School of Medicine, Boston, USA Journal Article 2026 04 22 Aims: E-health literacy is correlated with health-related behaviors, suggesting it can act as a mediator in the process by which health-related information leads to changes in health-related behaviors. This study aimed to investigate e-health literacy and examine the relationship between e-health literacy and self-care behaviors in hypertensive patients. Instrument & Methods: This cross-sectional study was conducted in 2024 among 240 hypertensive patients covered by the healthcare centers of Neyshabur City, Iran. Participants were selected using a stratified random sampling method. Data were gathered using a demographic characteristics questionnaire, the Hypertension Self-Care Profile, and the Electronic Health Literacy Scale. The collected data were analyzed using multiple linear regression with SPSS 22. Findings: The mean age of the respondents was 41.10±5.69 years. The mean of diabetes self-care activities was 47.1±8.5, and the mean e-health literacy was 21.3±6.6. Most diabetics had low e-health literacy, with 179 (74.6%) falling into this category. After adjusting for having a blood pressure measuring device at home and sleep status, e-health literacy (B=0.313, SE=0.092, p<0.05) was the statistically significant independent factor associated with self-care activities of hypertensive patients. Conclusion: Implementing educational programs focused on promoting e-health literacy increases the self-care activities of hypertensive patients, thereby enhancing the patient’s overall quality of life.

https://hehp.modares.ac.ir/article_28454_0334bbbe24552d27a5c4c2dcc41570c3.pdf

Afarand Scholarly Publishing Institute Health Education and Health Promotion 2588-5715 14 1 2026 01 01 Relationship between Fertility Knowledge, General Health Literacy, and Reproductive Health Literacy among Iranian Medical Students 91 98 28450 10.58209/hehp.14.1.91 EN M. Rostami Varnousfaderani “Student Research Committee” and “Department of Epidemiology, Faculty of Public Health and Safety”, Shahid Beheshti University of Medical Sciences, Tehran, Iran Z. Khoshnazar Student Research Committee, Shahid Beheshti University of Medical Sciences, Tehran, Iran F. Mohammadjani Student Research Committee, Saveh University of Medical Sciences, Saveh, Iran F. Fotovvati Student Research Committee, Saveh University of Medical Sciences, Saveh, Iran F. Ghafoori Department of Reproductive Health, Saveh University of Medical Sciences, Saveh, Iran K. Hosseini Clinical Research and Development Center of the Kamali Hospital, Alborz University of Medical Sciences, Karaj, Iran P. Hosseini Koukamari Social Determinants of Health Research Center, Saveh University of Medical Sciences, Saveh, Iran Journal Article 2026 04 22 Aims: This study aimed to examine the association between fertility knowledge, general health literacy, and reproductive health literacy among female students at Saveh University of Medical Sciences. Instrument & Methods: This descriptive-analytical cross-sectional study was conducted in 2025 on 208 female medical sciences students. Data collection tools included the Cardiff Fertility Knowledge Scale , the Short Form Health Literacy for Iranian Adults, and the Women’s Reproductive Health Literacy Questionnaire. Data were analyzed using SPSS 24. For inferential analysis, Spearman’s correlation and backward linear regression were employed. Findings: The mean age of participants was 22.34±3.27 years. The mean fertility knowledge score was 7.68 out of 13, while the mean scores for general health literacy and reproductive health literacy were 74.07 and 73.54 out of 100, respectively. A significant positive correlation was observed between fertility knowledge and both general health literacy (r=0.401, p<0.001) and reproductive health literacy (r=0.386, p<0.001). Regression analysis revealed that general health literacy (P=0.003) and reproductive health literacy (P=0.007) were significant positive predictors of fertility knowledge. Conclusion: Fertility knowledge among female university students is moderate and influenced by both general and reproductive health literacy.

https://hehp.modares.ac.ir/article_28450_7fa37b4aadce3de52314aa3ff5c6673d.pdf

Afarand Scholarly Publishing Institute Health Education and Health Promotion 2588-5715 14 1 2026 01 01 Impact of the Teach-Back Method on Self-Care Behaviors in Hemodialysis Patients in Indonesia 99 105 28452 10.58209/hehp.14.1.99 EN W. Trisnaningtyas Nursing Department, Ministry of Health Polytechnic, Surakarta, Indonesia N.K. Wulandari Nursing Department, Ministry of Health Polytechnic, Surakarta, Indonesia Sh. Metasari Nursing Department, Ministry of Health Polytechnic, Surakarta, Indonesia S. Sawab Nursing Department, Ministry of Health Polytechnic, Surakarta, Indonesia Journal Article 2026 04 22 Aims: Self-care is essential for improving clinical outcomes among hemodialysis patients. However, limited health literacy often hinders patients’ ability to meet treatment demands. This research aimed to examine the efficacy of the teach-back technique as a health education strategy in promoting self-care behaviors among individuals receiving hemodialysis treatment in Indonesia. Materials & Methods: This quasi-experimental study was conducted with 158 hemodialysis patients recruited from two tertiary hospitals in 2025. Participants were assigned to the intervention and control groups (79 per group). Data were collected through a researcher-constructed questionnaire assessing sociodemographic and clinical characteristics, along with the established Self-Care Agency Scale (SCAS). Statistical analyses were performed using SPSS 21, applying the Chi-square test, and independent t-tests. Findings: No notable disparities were observed between the groups at the initial assessment (p > 0.05). Following a two-month period, the experimental group exhibited markedly elevated self-care scores across all domains—namely, medication adherence (p=0.007), self-monitoring (p=0.0001), dietary management (p=0.0001), personal hygiene (p=0.009), and psychological well-being (p=0.0001)—compared with the control group. Conclusion: The teach-back technique is effective in bolstering self-care abilities among individuals receiving hemodialysis.

https://hehp.modares.ac.ir/article_28452_8ce72432c3ae3826e43979bd3e800bbd.pdf

Afarand Scholarly Publishing Institute Health Education and Health Promotion 2588-5715 14 1 2026 01 01 The Influence of Life Skill Education (Lse) Strategies In Pulmonary Tuberculosis Patients On Prevention Of Household Contact Infringement In North Sumatra 28447 EN Asriwati Amirah Teguh Suharto Nur Aini Rara Jaka Desy Neni Ekowati Krisna Dona BR Sembiring Azniah Syam Melyana Malik Journal Article 2026 04 22 In Indonesia, pulmonary tuberculosis remains a public health problem because it is the country with the second-highest number of TB cases in the world. Pulmonary TB primarily affects the productive age group and tends to spread to household contacts, particularly vulnerable groups such as children from low socioeconomic backgrounds. Purpose of this study is to develop a life skills education model for TB patients, utilizing an effective Life Skills Education strategy to prevent TB transmission, particularly among household contacts. Materials & Methods using Quantitative research with a quasi-experimental design, utilizing a two-group pre-test and post-test design for the intervention and control groups to assess the effect of the Life Skill Education strategy on the prevention of transmission to household contacts through the implementation of life skills education for TB patients. The study population consisted of all TB patients in the North Sumatra region. The sample consisted of 127 patients in urban areas and 126 patients in rural areas. The non-parametric-Friedman test was used to examine changes in knowledge, attitudes, and actions towards preventing TB transmission among household contacts. Meanwhile, the Mann-Whitney test was used to compare scores between groups. The results All results were statistically significant (p<0.05). The conclusion showed that health education using the lecture method with the LSE module could improve knowledge, attitudes, and actions in both urban and rural areas. It is recommended that health workers provide counseling using the LSE module more practically to prevent household transmission, as part of the TB Elimination Program by 2030.

https://hehp.modares.ac.ir/article_28447_6246bbd28be0b22ff440cc5413329f36.pdf

Afarand Scholarly Publishing Institute Health Education and Health Promotion 2588-5715 14 1 2026 01 01 Perspectives of faculty members on the use of artificial intelligence chatbots in medical education and research: a qualitative study 28455 EN R. Abjar Z. Nouri Khaneghah L. Sadati S.M. Hosseini Gh. Ramezani Journal Article 2026 04 22 Aims: The effective adoption of artificial intelligence in medical academia critically depends on faculty perspectives as the primary stakeholders. Therefore, this study was conducted with the aim of elucidating the Perspectives of faculty members regarding the use of artificial intelligence Chatbots in the medical education and research. Methods: The present study is a qualitative research using a content analysis approach. Data were collected through semi-structured interviews with eighteen faculty members. Sampling continued purposively and via snowball sampling until data saturation was reached. The interviews were analyzed using the conventional content analysis method by Graneheim and Lundman. The rigor of the findings was ensured using Lincoln and Guba's criteria. Result: The findings were organized into three main categories: [1] "Practical Application Domains of AI Tools," which included the sub-categories of content creation and instructional design, academic research support and production, and therapeutic application; [2] "Identified Benefits and Challenges for AI Tools," comprising the sub-categories of ethical and security concerns, educational and pedagogical concerns for student learning, technical and infrastructural limitations, and perceived advantages and opportunities; and [3] "Prerequisites and Enablers for Effective AI Tools Use," covering the sub-categories of competency development and foundational attitudes and systemic support. Conclusion: The results of this study indicate that faculty members widely utilize chatbots for content creation, article writing, and disease diagnosis and that they can help accelerate educational and research processes. However, challenges such as filtering and data validity exist and should be addressed. The effective utilization of these technologies requires appropriate training.

https://hehp.modares.ac.ir/article_28455_1fd6b8f9b13318adc358fca5d1ea1b5b.pdf

Afarand Scholarly Publishing Institute Health Education and Health Promotion 2588-5715 14 1 2026 01 01 Organizational Determinants of Health Worker Performance in a Decentralized Health System: The Selective Mediating Role of Quality of Work Life 28591 EN M. Yuda Pratama I. Yustina N. Nurmaini Z. Zulkarnain G. Silaban E. Mutiara N.L. Lubis S. Sumardiyono Journal Article 2026 02 02 Aims: to analyze whether QWL (Quality of Work Life) consistently mediates organizational commitment, healthy work environment, motivational climate, career development, and health worker job performance in decentralized primary care systems. Materials & Methods This paper adopted an explanatory quantitative research study approach, referring to the validated metrics measured organizational commitment, workplace quality, motivation, career progression, QWL, and job performance involved 320 Aceh, Indonesia, local government primary health care workers. Indirect and direct variable links were examined using PLS-SEM. Findings QWL significantly mediates the effects of inspiring environment and career development on work performance (β = 0.272; p = 0.001), but not organizational commitment or health. Many organizational elements affect work performance without QWL. Finally, QWL cannot explain all organizational and job scenarios. Psychological and structural factors impact decentralized health system employee performance, requiring workforce management beyond QWL growth. Conclusion: Work-life quality boosts health professionals' performance in decentralized health systems, although its mediating effect varies by organization. QWL selectively mediated motivating environment and career growth on work performance, but not organizational commitment or health.

https://hehp.modares.ac.ir/article_28591_6e117946c3865270453226df079b8d5f.pdf

Afarand Scholarly Publishing Institute Health Education and Health Promotion 2588-5715 14 1 2026 01 01 The Effect of JUMINTEN TABAH Model as an Effort to Prevent Anemia among Adolescent Girls 28592 EN W. Triana I. Imelda Journal Article 2026 02 09 Objektive: This study evaluated the effectiveness of the JUMINTEN TABAH model in improving anemia prevention knowledge, compliance with IFA consumption, and hemoglobin levels among adolescent girls. Methods: A quantitative quasi-experimental study with a nonequivalent control group pretest–posttest design was conducted from January to August 2025 in several public senior high schools in Muaro Jambi District, Jambi Province, Indonesia. A total of 100 adolescent girls aged 15–18 years were recruited and allocated into intervention and control groups. The intervention group received the JUMINTEN TABAH model, which consisted of scheduled weekly consumption of IFA tablets every Friday, health education using a pocket book, a Friday calendar as a reminder tool, and peer mentoring and monitoring by Youth Red Cross (PMR) cadres, supported by complementary activities. The control group received routine school health education and IFA distribution. Data were collected using structured questionnaires and hemoglobin measurements. Statistical analyses included paired and independent tests as well as effect size estimation. Results: The intervention group showed a significant increase in knowledge and compliance behavior after the intervention (p < 0.001), while changes in the control group were not statistically significant. Improvements in knowledge and compliance were significantly higher in the intervention group compared to the control group (p < 0.001), with large effect sizes, indicating a strong impact of the intervention. Conclusion: The JUMINTEN TABAH model is effective in improving knowledge and compliance with IFA tablet consumption among adolescent girls and has the potential to support anemia prevention programs in school settings.

https://hehp.modares.ac.ir/article_28592_d6df8e50c3cc76ab487e51448cc1c57f.pdf

Afarand Scholarly Publishing Institute Health Education and Health Promotion 2588-5715 14 1 2026 01 01 Digital Transformation in Indonesia’s Primary Healthcare: Navigating Regulatory Pressure and Perceived Threats in Electronic Medical Records Adoption 28593 EN M. Ghozali C.K. Dewi Journal Article 2026 02 15 Aims: This study explore the dynamics of Electronic Medical Records (EMRs) adoption and use in primary healthcare facilities in Indonesia. It specifically examines the role of regulatory pressure and perceived technological threats within the framework of mandatory national health policies. Material and Methods: A multisite cross-sectional survey was conducted among 688 healthcare workers from 27 community health centers in Bantul Regency, Indonesia. The study utilizes an analytical framework incorporating regulatory pressure, perceived threat, performance expectancy, effort expectancy, facilitating conditions, behavioral intention, and actual use, analyzed through structural equation modeling. Findings: The analysis reveals that perceptions of utility, ease of use, and organizational support play a vital role in shaping the intention to adopt EMRs. Regulatory pressure emerges as a primary driver that shapes facility readiness and practitioners’ psychological response, directly strengthening behavioral intention. Notably, actual system usage is driven by the synergy between regulatory mandates and institutional readiness. Conclusion: Successful digital transformation in primary healthcare requires coherence among regulatory enforcement, institutional readiness, and the adaptive responses of healthcare workers to technological change.

https://hehp.modares.ac.ir/article_28593_c57d4c50a6b5969e1244e60155863090.pdf

Afarand Scholarly Publishing Institute Health Education and Health Promotion 2588-5715 14 1 2026 01 01 Dental Prosthetic Status, Needs, and Oral Frailty in Aging Population: Insights from a Cross-Sectional Study 28643 EN Reda Abdelrahman Ahmed Mahdy Department of Gerontological Nursing, Faculty of Nursing, Zagazig University, Zagazig, Egypt. Esmail Ahmed Abdel-Gawwad Department of Removable Prosthodontics, Faculty of Dental Medicine, Al-Azhar University, Cairo, Egypt. Mostafa I. Fayad Department of Substitutive Dental Science, College of Dentistry, Taibah University, Madinah, Saudi Arabia. Safia Gomaa Mohammed Department of Gerontological Nursing, Faculty of Nursing, Zagazig University, Zagazig, Egypt. Journal Article 2025 12 18 Aims This study’s objective is to evaluate the current status of dental prosthetics, identify prosthetic needs, and the prevalence of oral frailty within the geriatric population in Egypt. Instrument & Methods The study recruited 258 community-dwelling adults aged 60 years or older from residential homes in Al-Sharkia Governorate, Egypt. Collected data included demographic information, medical history, oral hygiene, prosthetic status and needs, and scores on the Oral Frailty Index-8 (OFI-8). Statistical analyses, including chi-square tests, t-tests, and multinomial logistic regression, were utilized to evaluate the associations among prosthetic status, prosthetic needs, and oral frailty. Findings The analysis revealed that a very high percentage (79.8%) of participants were at an elevated risk for oral frailty. More than half the participants needed prosthetic rehabilitation, but many did not have access to suitable dental care. Factors including advanced age, chronic diseases, cigarette smoking, and poor oral hygiene were significantly linked to increased prosthetic needs. In contrast, place of residence and income level were not found to be significant predictors. Conclusion This study underscores the high prevalence of oral frailty and substantial unmet prosthetic needs among older adults in Egypt. The findings emphasize the need for comprehensive geriatric dental care that incorporates prosthetic treatment. Such interventions are vital for preventing the progression of oral frailty and preserving quality of life in this aging population.

https://hehp.modares.ac.ir/article_28643_cfcb7077d0bda605e84974ded63d24c1.pdf