Tarbiat Modares University (TMU) Health Education and Health Promotion 2588-5715 12 4 2025 07 13 Effect of Vaginismus-Specific Schema Therapy and Conventional Schema Therapy on Sexual Self-Assertiveness & Self-Esteem in Women with Vaginismus Disorder 553 560 2561 10.58209/hehp.12.4.553 EN R. Kakavand Department of Psychology, Isfahan (Khorasgan) Branch, Islamic Azad University, Isfahan, Iran F. Khayatan Department of Psychology, Isfahan (Khorasgan) Branch, Islamic Azad University, Isfahan, Iran M. Golparvar Department of Psychology, Isfahan (Khorasgan) Branch, Islamic Azad University, Isfahan, Iran Journal Article 2025 07 13 Aims: Vaginismus disorder is the second most common sexual dysfunction in women, and it is a significant issue in the lives of those affected. This disorder has unfortunate and destructive consequences for the individual’s health, the family unit, and the couple’s intimacy. This study aimed to compare vaginismus-specific schema therapy with conventional schema therapy in terms of their effects on sexual self-assertiveness and self-esteem in women with vaginismus disorder. Materials & Methods: This quasi-experimental research employed a pre-test, post-test, and follow-up design, including a control group. The statistical population consisted of women with vaginismus disorder who were referred to the obstetrics and gynecology clinic of Payambaran Hospital in Tehran, Iran, in 2021, of whom 45 individuals were selected using a purposive sampling method, and were randomly assigned to three groups through a simple lottery method (n=15 per group). The Persian version of Halbert’s Sexual Self-Assertiveness Questionnaire and the Female Sexual Self-Esteem Inventory (SSEI-W) developed by Zeanah and Schwarz were used. The two experimental groups received treatment in ten sessions, each lasting 90 minutes, while the control group did not receive any intervention. Data were analyzed by repeated-measures ANOVA and Bonferroni’s post-hoc test using SPSS 22. Findings: Both vaginismus-specific schema therapy and conventional schema therapy were effective in increasing sexual self-assertiveness (Eta=0.83) and self-esteem (Eta=0.94) in women with vaginismus disorder compared to the control group (p=0.001). A comparison of the mean differences between the two intervention groups and the control group revealed that vaginismus-specific schema therapy was more effective in improving self-assertiveness and sexual self-esteem in women than conventional schema therapy (p=0.001). Conclusion: Vaginismus-specific schema therapy for vaginismus enhances sexual self-assertiveness and self-esteem among women with vaginismus by helping them identify their problems.

https://hehp.modares.ac.ir/article_2561_59eb5dd36914c29b299c84b7ddaf08ec.pdf

Tarbiat Modares University (TMU) Health Education and Health Promotion 2588-5715 12 4 2025 07 13 Teacher-Parent Collaboration; Enhancing Education for Children with Intellectual Disabilities 561 569 2562 10.58209/hehp.12.4.561 EN F. Qorib Department of Communication Science, Faculty of Social and Political Science, University of Tribhuwana Tunggadewi, Malang, Indonesia R.P. Nurdiarti Department of Communication Science, Faculty of Communication and Multimedia, University of Mercubuana Yogyakarta, Yogyakarta, Indonesia F. Septiani Department of Communication Science, Faculty of Communication and Multimedia, University of Mercubuana Yogyakarta, Yogyakarta, Indonesia R. Setiawan Department of Public Administration, Faculty of Social and Political Science, University of Bandar Lampung, Bandar Lampung, Indonesia Journal Article 2025 07 13 Aims: This research investigates how therapeutic communication, supported by teacher-parent collaboration, enhances the social, emotional, and academic development of children with intellectual disabilities at SLB Bina Siwi, Indonesia. Participants & Methods: A qualitative approach was used, with purposive sampling selecting 5 teachers from a total of 11 and 3 parents from 5. Criteria for selecting teachers included a minimum of three years of experience and diverse educational backgrounds. Data were gathered through in-depth interviews and a 3-month observation period. Snowball sampling was employed to ensure data saturation and capture diverse perspectives. Findings: The study found that therapeutic communication plays a core role in improving the social and emotional development of children with intellectual disabilities. Teachers using empathetic and adaptive communication observed increased engagement among students. Parents who actively collaborated with teachers reported improved confidence in supporting their children’s education at home, which further aids children’s adaptation to challenges in both environments. Conclusion: Therapeutic communication is crucial in educating children with intellectual disabilities, with strong teacher-parent collaboration being key to its success.

https://hehp.modares.ac.ir/article_2562_dbab2adc8f9d078009ee3fa810bea142.pdf

Tarbiat Modares University (TMU) Health Education and Health Promotion 2588-5715 12 4 2025 07 13 Evaluating Health Promotion Standards in Educational Hospitals Affiliated with North Khorasan University of Medical Sciences 571 579 2563 10.58209/hehp.12.4.571 EN H. Namdar Ahmadabad Vector-borne Diseases Research, Center, North Khorasan University of Medical Sciences, Bojnurd, Iran R. Rajabzadeh Department of Midwifery, School of Medicine, North Khorasan University of Medical Sciences, Bojnurd, Iran S.H. Hosseini Department of Health Education and Health Promotion, School of Health, North Khorasan University of Medical Sciences, Bojnurd, Iran A. Jafarimoghadam Vice-Chancellor of Treatment Affairs, North Khorasan University of Medical Sciences, Bojnurd, Iran Journal Article 2025 07 13 Aims: Health promotion standards focus on the needs of patients and their companions, serving as the foundation for fostering a healthy lifestyle for both patients and society. The present study aimed to determine the state of health promotion standards in educational hospitals affiliated with North Khorasan University of Medical Sciences using both internal and external evaluation methods. Instrument & Methods: In this cross-sectional descriptive-analytical study, six educational hospitals affiliated with the North Khorasan University of Medical Sciences were recruited through census sampling. The World Health Organization’s self-assessment tool for health promotion in hospitals, which had been previously translated, localized, and validated, was used to collect data. This internal evaluation tool includeed four standards (management policy and program, health promotion of patients and families, health promotion of staff, and health promotion of hospitals and their surroundings) and 67 substandards. The internal evaluation team was selected from experienced hospital staff, while the external evaluation team was selected from the research team. They scored the status of each substandard from one to ten based on observations, documents, and interviews. Findings: The internal evaluations revealed that hospitals made significant progress in health promotion standards, with a total average score of 7.05±2.25. The total average score of the external evaluation was 5.44±2.04, indicating that most evaluated hospitals were in the moderate stage of progress. In both internal and external evaluation results, the highest average score was related to the standard for health promotion of patients and families, while the lowest total average score was associated with the standard for health promotion of staff. Conclusion: Educational hospitals affiliated with the North Khorasan University of Medical Sciences exhibit progress in health promotion but need improvement, particularly in staff health promotion.

https://hehp.modares.ac.ir/article_2563_dbd22ba3bd0df8f385bdac3e9f8be207.pdf

Tarbiat Modares University (TMU) Health Education and Health Promotion 2588-5715 12 4 2025 07 13 Stunting Incidence Based on Socio-Demographic Determinants, Family Food Security, and Maternal Digital Parenting 581 588 2564 10.58209/hehp.12.4.581 EN M.K. Alwi Faculty of Public Health, University Muslim Indonesia, Makassar, Indonesia Y. Yusriani Faculty of Public Health, University Muslim Indonesia, Makassar, Indonesia P. Purnawansyah Faculty of Ilmu Komputer, University Muslim Indonesia, Makassar, Indonesia Journal Article 2025 07 13 Aims: Toddlers are one of the groups vulnerable to malnutrition, often associated with prolonged deficiencies in protein and energy. Stunting is a chronic malnutrition issue that results in a child failing to grow adequately compared to others in the same age range. From 2019 to 2022, there were 80 villages identified as stunting loci in Maros Regency, spread across 23 sub-districts, including the Marusu Health Center work area. Factors contributing to stunting include mothers’ knowledge and behavior, poor feeding attitudes, and economic challenges. The purpose of this research was to analyze the connections between knowledge, attitudes, actions, family support, the role of cadre integrated health posts, food resilience, digital parenting, and the cultural practices of mothers with toddlers in the Marusu Health Center area. Instrument & Methods: This quantitative cross-sectional study was conducted on 341 mothers of toddlers selected using the total sampling technique. Data collection involved a combination of interviews, observations, and questionnaires. The analysis process involved three techniques, including univariate analysis, bivariate analysis, and multivariate analysis. Findings: None of the investigated factors exhibited a statistically significant correlation with stunting in the Marusu Health Center area. The Chi-Square test showed no significant relationships between knowledge (p=0.805), maternal attitudes (p=0.942), maternal practices (p=0.726), family support (p=0.942), the role of health service post cadres (p=1.000), food security (p=0.632), digital parenting (p=0.378), and cultural factors (p=0.812). Conclusion: There is no statistically significant relationship between knowledge, attitudes, actions, family support, the role of integrated service post, food security, digital parenting, and cultural influences and the incidence of stunting in the Marusu Health Center region.

https://hehp.modares.ac.ir/article_2564_8169e05e2a0debcb15458f2cc1eff0ea.pdf

Tarbiat Modares University (TMU) Health Education and Health Promotion 2588-5715 12 4 2025 07 13 Socio-Psychological Predictors of Students' Preventive Behaviors Against Pediculosis; the Health Belief Model Approach 589 596 2565 10.58209/hehp.12.4.589 EN E. Shafei Department of Public Health, School of Public Health and Safety, Shahid Beheshti University of Medical Sciences, Tehran, Iran S. Rakhshanderou Department of Public Health, School of Public Health and Safety, Shahid Beheshti University of Medical Sciences, Tehran, Iran M. Ghaffari Department of Public Health, School of Public Health and Safety, Shahid Beheshti University of Medical Sciences, Tehran, Iran H. Hatami Department of Public Health, School of Public Health and Safety, Shahid Beheshti University of Medical Sciences, Tehran, Iran Journal Article 2025 07 13 Aims: Head lice infestation is a common and significant health issue among students and in school settings. It is particularly more prevalent in children aged 5-13 years. This study aimed to investigate the determinants of preventive behaviors against pediculosis based on the theoretical framework of the health belief model among students in the urban areas of Heris County. Instrument & Methods: This descriptive-analytical correlational study was conducted with 1,000 students in urban schools in Heris County, East Azerbaijan. Data were collected through a census of all fourth and fifth-grade students in elementary schools. The research instrument was a questionnaire designed based on the health belief model, which had been validated, and its reliability was confirmed in previous studies. After the students completed the questionnaires, the data were analyzed using SPSS 16 by ANOVA and multiple linear regression. Findings: Fourth-grade students demonstrated higher awareness (p=0.027) compared to fifth-grade students. Perceived susceptibility (p=0.001) and perceived barriers (p=0.004) were significantly (p=0.0001) higher in individuals with no history of pediculosis infestation compared to those with a history of pediculosis infestation. Except for the perceived severity construct, all components of the health belief model had a significant correlation with preventive behaviors against pediculosis. Furthermore, awareness (p=0.0001), self-efficacy (p=0.0001), perceived barriers (p=0.0001), gender (p=0.0001), and maternal education (p=0.024) were identified as key predictors of these behaviors, and these parameters collectively accounted for 21.5% of the variance in behavior changes (R2=0.215). Conclusion: Awareness, self-efficacy, and perceived barriers play a significant role in adopting preventive behaviors against pediculosis infestation.

https://hehp.modares.ac.ir/article_2565_e6acf4b0f69f6f6e60e9a815938aa1ff.pdf

Tarbiat Modares University (TMU) Health Education and Health Promotion 2588-5715 12 4 2025 07 13 Effect of the Lazarus' Transactional Model-Based Intervention on Stress Control and Coping in Patients with Type 2 Diabetes 597 603 2566 10.58209/hehp.12.4.597 EN M.R. Miraki “Department of Health Education and Health Promotion, School of Health” and “Student Research Committee”, Rafsanjan University of Medical Sciences, Rafsanjan, Iran M. Nasirzadeh Department of Health Education and Health Promotion, School of Health, Rafsanjan University of Medical Sciences, Rafsanjan, Iran A.R. Sayadi “Department of Psychiatric Nursing, School of Nursing and Midwifery” and “Social Determinants of Health Research Center”, Rafsanjan University of Medical Sciences, Rafsanjan, Iran M. AbdolKarimi “Department of Health Education and Health Promotion, School of Health” and “Geriatric Care Research Center”, Rafsanjan University of Medical Sciences, Rafsanjan, Iran Journal Article 2025 07 13 Aims: One of the effective factors in preventing the complications of diabetes is stress management. The purpose of this study was to evaluate the effect of an intervention based on Lazarus’ Transactional Model on the level of stress in patients with type 2 diabetes. Materials & Methods: This quasi-experimental study was conducted among 80 patients with type 2 diabetes. Stress levels, coping methods, and hemoglobin A1C were evaluated before the intervention and three months afterward. In the intervention group, five training sessions were held based on the strategies outlined in the model. The data were analyzed using analysis of variance, Pearson’s correlation coefficient, and analysis of covariance. Findings: The perceived stress score in the intervention group decreased after the intervention. The results of the Pearson correlation test indicated a negative and significant relationship between the stress score and confrontive and optimistic coping strategies. Additionally, there was a positive and significant relationship between the stress score and methods of emotional adaptation and fatalism (p<0.001). Analysis of covariance revealed that, after adjusting for group effects, the intervention had a significant impact on the use of adaptive methods and stress levels (p<0.001). Conclusion: Training and interventions aimed at utilizing coping approaches based on Lazarus’ Transactional Model of stress and adaptation is effective in controlling and reducing stress in patients with type 2 diabetes.

https://hehp.modares.ac.ir/article_2566_42fe880812925e520249e808937738d2.pdf

Tarbiat Modares University (TMU) Health Education and Health Promotion 2588-5715 12 4 2025 07 13 Health-Promoting Hospitals’ Standards and Their Correlation with Nurses’ Caring Behaviors 605 610 2567 10.58209/hehp.12.4.605 EN M. Esmaeelzadeh Student Research Committee, Birjand University of Medical Sciences, Birjand, Iran M. Pirani Hashemi Nezhad Hospital, Mashhad University of Medical Sciences, Mashhad, Iran M. Bahrami Department of Nursing, Faculty of Nursing and Midwifery, Birjand University of Medical Sciences, Birjand, Iran M. Soleimanian Asl Student Research Committee, Birjand University of Medical Sciences, Birjand, Iran H. Sabeghi Department of Nursing, Faculty of Nursing and Midwifery, Birjand University of Medical Sciences, Birjand, Iran Journal Article 2025 07 13 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.

https://hehp.modares.ac.ir/article_2567_dda04f9d634145a9c68d5dfe53b21272.pdf

Tarbiat Modares University (TMU) Health Education and Health Promotion 2588-5715 12 4 2025 07 13 Quality of Life in Children with Attention-Deficit/Hyperactivity Disorder; Influencing Factors and Parental Perspectives 611 616 2568 10.58209/hehp.12.4.611 EN A. Massoodi Social Determinants of Health Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran S.M. Zavarmousavi Department of Psychiatry, Shafa Hospital, Guilan University of Medical Sciences, Rasht, Iran S. Moudi Social Determinants of Health Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran E. Alinejad Student Research Committee, Babol University of Medical Sciences, Babol, Iran H. Gholinia Ahangar Clinical Research Development Unit of Rouhani Hospital, Babol University of Medical Sciences, Babol, Iran Journal Article 2025 07 13 Aims: Attention-deficit/hyperactivity disorder affects approximately 5.3% of children globally, causing significant functional challenges. This study examined the relationship between parental stress-coping strategies and the quality of life in children with this disorder. Instrument & Methods: In this cross-sectional analysis, 220 children with attention-deficit/hyperactivity disorder (aged 8 to 12 years) and their parents were selected from medical centers affiliated with Babol University of Medical Sciences in 2023. Diagnoses were confirmed by a child and adolescent psychiatrist using DSM-5 criteria. Parents completed the Coping Inventory for Stressful Situations-Short Form, while the children's quality of life was assessed using the Pediatric QoL Inventory. Findings: Children rated their quality of life and its specific aspects higher than their parents did. A significant difference was observed only in the emotional coping strategy within the emotional functioning domain, where children in the high-quality-of-life group reported better scores (p=0.017). Other dimensions and coping strategies did not show statistically significant differences (p>0.05). Furthermore, from the parents' perspective, no significant associations were found between stress-coping strategies and their children's quality of life across any dimension (p>0.05). Conclusion: Parental coping strategies, particularly those involving emotional support, play a key role in shaping the emotional experiences of children with ADHD.

https://hehp.modares.ac.ir/article_2568_48c3ec5c3a93a9e294a8a6392ccedeb4.pdf

Tarbiat Modares University (TMU) Health Education and Health Promotion 2588-5715 12 4 2025 07 13 Village Midwife Performance in Maternal and Child Health Services in Jambi Province, Indonesia 617 622 2569 10.58209/hehp.12.4.617 EN R. Ruwayda Department of Public Health, Faculty of Public Health, University of Indonesia, Jakarta, Indonesia S.P. Hastono Department of Public Health, Faculty of Public Health, University of Indonesia, Jakarta, Indonesia K.N. Siregar Department of Public Health, Faculty of Public Health, University of Indonesia, Jakarta, Indonesia E. Martha Department of Public Health, Faculty of Public Health, University of Indonesia, Jakarta, Indonesia L. Nurdini Department of Public Health, Faculty of Public Health, University of Indonesia, Jakarta, Indonesia Journal Article 2025 07 13 Aims: The study aimed to analyze the determinants of village midwife performance in maternal and child health services. Instrument & Methods: This quantitative study employed a cross-sectional design. The population consisted of all village midwives in Muaro Jambi Regency, Jambi Province, with a sample of 171 midwives providing maternal and child health services. This study was conducted over a period of three months, from January to March 2024, with the data collection phase occurring between February and March 2024. The inclusion criteria required participants to have more than two years of experience as village midwives. The dependent parameter was the performance of the midwives in improving maternal and child health, while the independent parameters were supervision, training, and attitude. Findings: 101 midwives (59.8%) had never attended training, while 139 (81.3%) had received training, and 119 midwives (69.9%) exhibited a predominantly positive attitude. The significant parameters associated with the performance of village midwives in the univariate analysis were age, education level, length of service, incentives outside salary (all with p-value=0.0001), and supervision within the past year (p-value=0.001). In the multivariate analysis, the significant parameters were age (p-value=0.035) and education level (p-value=0.037). Conclusion: Considering the age and education level of midwives in the implementation and socialization of the Maternal and Child Health program enhancing the performance of village midwives is crucial.

https://hehp.modares.ac.ir/article_2569_02f657d55eaf1c4840ce8d66fcdaf90c.pdf

Tarbiat Modares University (TMU) Health Education and Health Promotion 2588-5715 12 4 2025 07 13 An Educational Intervention Model to Improve Hypertension Self-Management in the Elderly 623 635 2570 10.58209/hehp.12.4.623 EN E. Roza Department of Public Health Sciences, Faculty of Mathematics and Natural Sciences Education, Jambi of University, Jambi, Indonesia M. Rusdi Department of Chemistry Education, Faculty of Teacher Training and Education, Jambi of University, Jambi, Indonesia G. Guspianto Department of Public Health Sciences, Faculty of Medicine and Health Sciences, Jambi of University, Jambi, Indonesia M.H.E. Hasibuan Department of Chemistry Education, Faculty of Teacher Training and Education, Jambi of University, Jambi, Indonesia Journal Article 2025 07 13 Aims: This systematic review aimed to evaluate the effectiveness of educational interventions designed to improve hypertension self-management among elderly populations. Information & Methods: This review was conducted in accordance with the PRISMA 2020 guidelines. Eligible studies were selected based on the PICOS framework and included randomized controlled trials, quasi-experimental studies, and pre-post designs published between 2000 and 2024. Six electronic databases (PubMed, Scopus, Web of Science, ScienceDirect, JSTOR, and Cochrane Library) were systematically searched. The quality of the studies was assessed using the Critical Appraisal Skills Program, and the Risk of Bias tool was utilized to evaluate bias in randomized studies. Findings: This review included 15 studies, primarily randomized controlled trials, with sample sizes ranging from 20 to 253 participants. The educational interventions significantly enhanced self-management in elderly individuals with hypertension. Interventions, such as mobile application-based support, face-to-face group education, and telephone-based guidance led to improvements in key outcomes, including blood pressure control, medication adherence, and lifestyle modifications. These programs also increased participants’ knowledge and self-efficacy in managing their condition. Notably, interventions targeting adherence to the dietary approach to stop hypertension diet demonstrated significant improvements in both dietary habits and physical activity, contributing to better overall hypertension management. Conclusion: Educational and self-management interventions, particularly those integrating digital tools, effectively improve hypertension management in older adults.

https://hehp.modares.ac.ir/article_2570_852c44ddce7e0c7e4c64d86147300831.pdf

Tarbiat Modares University (TMU) Health Education and Health Promotion 2588-5715 12 4 2025 07 13 Educational Interventions Targeting Anxiety Reduction in the Prenatal Period 637 647 2571 10.58209/hehp.12.4.637 EN Y. Aryani Department of Midwifery, Riau Ministry of Health Polytechnic of Health, Riau, Indonesia D.N. Lilis Department of Midwifery, Jambi Ministry of Health Polytechnic of Health, Jambi, Indonesia R. Hairunisyah Department of Midwifery, Ministry of Health Polytechnic of Health, Palembang, Indonesia Journal Article 2025 07 13 Aims: Educational interventions have emerged as a promising avenue for reducing prenatal anxiety, offering a structured approach to inform and empower expectant mothers. However, previous reviews have been limited by a narrow focus and inconsistent methodologies, necessitating a comprehensive evaluation of various educational approaches. This systematic review aimed to evaluate the effectiveness of different educational interventions in reducing prenatal anxiety. Information & Methods: A literature search was conducted involving five databases, including PubMed, Scopus, CINAHL, PsycINFO, and the Cochrane Library. Study quality and risk of bias were assessed independently by the authors using the CASP and RoB2 tools. The initial database query yielded 2,565 articles, of which only 16 studies met the inclusion criteria for data extraction and analysis. Findings: Educational interventions, such as mindfulness-based approaches, antenatal education programs, and lifestyle-based strategies were effective in reducing prenatal anxiety. Mindfulness techniques and psychoeducation significantly improved maternal self-efficacy and emotional regulation. Antenatal education programs and lifestyle interventions reduced anxiety related to childbirth and enhanced coping strategies. Additionally, culturally tailored and digital interventions showed promise, although challenges in user engagement and interactivity were identified. Conclusion: Diverse educational interventions effectively reduce prenatal anxiety.

https://hehp.modares.ac.ir/article_2571_283085d30e10513624c8cece7993f4de.pdf

Tarbiat Modares University (TMU) Health Education and Health Promotion 2588-5715 12 4 2025 07 13 Predicting and Classifying the Perceptions of Learning Needs Importance in Cancer Patients; a Machine Learning Approach 649 660 2572 10.58209/hehp.12.4.649 EN O. Ayaad Quality and Accreditation Department, Sultan Qaboos Comprehensive Cancer Care and Research Centre (SQCCCRC), University Medical City, Muscat, Oman R. Ibrahim Quality and Accreditation Department, Sultan Qaboos Comprehensive Cancer Care and Research Centre (SQCCCRC), University Medical City, Muscat, Oman Kh. AlBaimani Sultan Qaboos Comprehensive Cancer Care and Research Centre (SQCCCRC), Muscat, Oman M.M. AlGhaithi Quality and Accreditation Department, Sultan Qaboos Comprehensive Cancer Care and Research Centre (SQCCCRC), University Medical City, Muscat, Oman Z.G. Sawaya Nursing Department, Sultan Qaboos Comprehensive Cancer Care and Research Centre (SQCCCRC), University Medical City, Muscat, Oman N.S. AlHasni Nursing Department, Sultan Qaboos Comprehensive Cancer Care and Research Centre (SQCCCRC), University Medical City, Muscat, Oman H.S. AlAwaisi Nursing Department, Sultan Qaboos Comprehensive Cancer Care and Research Centre (SQCCCRC), University Medical City, Muscat, Oman A.S. AlFahdi Holistic Care Department, Sultan Qaboos Comprehensive Cancer Care and Research Centre (SQCCCRC), University Medical City, Muscat, Oman B. Al Faliti Quality and Accreditation Department, Sultan Qaboos Comprehensive Cancer Care and Research Centre (SQCCCRC), University Medical City, Muscat, Oman B.M. Salman Pharmacy Department, National Hematology and Bone Marrow Transplant Center, University Medical City, Muscat, Oman Journal Article 2025 07 13 Aims: Artificial intelligence (AI) and machine learning (ML) are revolutionizing healthcare by enhancing the prediction of learning needs and enabling tailored educational interventions for patients and staff. This study explores the application of AI and ML models to predict learning needs from the patient's perspective. Instruments & Methods: Three ML models (Linear Regression, Random Forest, and Gradient Boosting) were trained on health literacy, demographic, and treatment data from 218 cancer patients at Sultan Qaboos Comprehensive Cancer Center. Evaluation metrics included Mean Absolute Error (MAE), Root Mean Squared Error (RMSE), R2 Score, and Area Under the Curve (AUC). Classification models (Random Forest, Gradient Boosting, Decision Tree, and Extra Trees) were assessed for accuracy, precision, recall, F1-score, and AUC in categorizing learning needs. Findings: Gradient Boosting had the best predictive performance (MAE:0.0534, RMSE: 0.0788, R²:0.9844, AUC:0.96), followed by Random Forest (AUC:0.93). Linear Regression was less effective (AUC: 0.85). Key predictors included literacy level in chemotherapy, hormonal therapy, and treatment experiences, while demographic factors had minimal impact. For classification, Gradient Boosting and Decision Tree models achieved the highest accuracy (96.51%) and AUC (0.96). Random Forest showed 94.19% accuracy, while Extra Trees had 90.70%, indicating variability in model performance. Conclusion: AI and ML, particularly Gradient Boosting, demonstrate strong potential in predicting and categorizing learning needs.

https://hehp.modares.ac.ir/article_2572_c0e90532fb42ac6de18e25e95db73047.pdf

Tarbiat Modares University (TMU) Health Education and Health Promotion 2588-5715 12 4 2025 07 13 Physicians’ and Nurses’ Attitudes, Awareness, Knowledge, and Skill in Telemedicine 661 674 2573 10.58209/hehp.12.4.661 EN F. Dahmardeh Kemmak “Department of Health Information Technology, School of Paramedical and Rehabilitation Sciences” and “Student of Research Committee”, Mashhad University of Medical Sciences, Mashhad, Iran M. Sarbaz Department of Health Information Technology, School of Paramedical and Rehabilitation Sciences, Mashhad University of Medical Sciences, Mashhad, Iran S.F. Mousavi Baigi “Department of Health Information Technology, School of Paramedical and Rehabilitation Sciences” and “Student of Research Committee”, Mashhad University of Medical Sciences, Mashhad, Iran P. Marouzi Department of Health Information Technology, School of Paramedical and Rehabilitation Sciences, Mashhad University of Medical Sciences, Mashhad, Iran M. Sheykhotayefeh Department of Health Information Technology, School of Paramedical and Rehabilitation Sciences, Mashhad University of Medical Sciences, Mashhad, Iran Kh. Kimiafar Department of Health Information Technology, School of Paramedical and Rehabilitation Sciences, Mashhad University of Medical Sciences, Mashhad, Iran Journal Article 2025 07 13 Aims: This systematic review aims to examine physicians’ and nurses’ attitudes, knowledge, awareness, and skill in telemedicine technology. Information & Methods: Studies were extracted from the PubMed, Embase, Scopus, and Web of Sciences databases in March 2023, following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Cross-sectional studies examining physicians’ and nurses’ attitudes, awareness, knowledge, and skill in telemedicine were considered as the inclusion criteria. A similar checklist was used for data extraction, and Joanna Briggs Institute’s (JBI) critical appraisal checklist specific for cross-sectional studies was employed to assess the quality of the entered studies to this research. Findings: A total of 13 studies with the inclusion criteria were entered into the study. Seven studies (54%) examined health specialists’ attitudes and revealed their proper and promising attitudes toward telemedicine. Among five studies probing their participants’ awareness of telemedicine, three reported high awareness, while two had documented moderate levels of awareness. On the other hand, among ten studies investigating telemedicine knowledge, seven had reported high, one moderate, and two low telemedicine knowledge. Three studies evaluated telemedicine skillfulness and reported moderate (two studies) and low (one study) skill levels of their participants. Conclusion: Health specialists hold positive and promising attitudes toward telemedicine. Telemedicine awareness, knowledge, and skill among health professionals are above-moderate and desirable.

https://hehp.modares.ac.ir/article_2573_60519c3dd22587d6de04d5f1e28bd41d.pdf

Tarbiat Modares University (TMU) Health Education and Health Promotion 2588-5715 12 4 2025 07 13 Impact of Tele-Nursing on Adherence to Treatment Regimen and Quality of Life in Pediatric Patients Undergoing Heart Transplantation Surgery 675 682 2574 10.58209/hehp.12.4.675 EN S.M. Hosseini Moghadam “Student Research Committee” and “Department of Pediatric Nursing, School of Nursing and Midwifery”, Shahid Beheshti University of Medical Sciences, Tehran, Iran M. Babaie Department of Anesthesiology, School of Allied Medical Sciences, Alborz University of Medical Sciences, Karaj, Iran M. Nourian Department of Pediatric Nursing, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran M. Mahdavi Heart Research Center, Shaheed Rajaie Cardiovascular Medical and Research Center, Tehran, Iran M. Nasiri Department of Biostatistics, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran M. Varzeshnejad Department of Pediatric Nursing, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran Journal Article 2025 07 13 Aims: Heart transplantation significantly alters the lifestyle and quality of life of children and adolescents post-surgery. These patients must strictly adhere to their treatment regimens to maintain graft viability and achieve better adaptation. Enhancing the quality of life in pediatric heart transplant recipients is a critical responsibility of nurses. This study aimed to evaluate the impact of a tele-nursing supportive educational program on treatment adherence and quality of life in children aged 12-18 years. Materials & Methods: This quasi-experimental study with a single-group design without a control group was done on 41 pediatric patients who were referred to a specialized hospital for heart transplantation in Tehran in 2022. Participants were selected through census sampling and received education via communication platforms, such as WhatsApp, Skype, and Telegram, as chosen by the patients and their parents. The program spanned eight weeks, during which data were collected using a socio-demographic questionnaire, the Pediatric Quality of Life Inventory for Cardiac Problems, and the Modanloo Medication Adherence Scale. Pre- and post-test results were analyzed using SPSS version 16. Findings: There was a significant improvement in the mean quality of life score and its dimensions (p=0.001), as well as the medication adherence score and its dimensions (p=0.001) after the implementation and follow-up of the intervention program. Conclusion: Tele-nursing interventions offer an effective and accessible approach to enhancing treatment adherence and improving the quality of life for pediatric heart transplant recipients.

https://hehp.modares.ac.ir/article_2574_8f125da0b3432ed853c0b6f7ee5aaa6b.pdf

Tarbiat Modares University (TMU) Health Education and Health Promotion 2588-5715 12 4 2025 07 13 Examining the Attitude, Knowledge, and Awareness of Professionals Toward Telerehabilitation 683 694 2575 10.58209/hehp.12.4.683 EN R. Norouzi Aval “Department of Health Information Technology, School of Paramedical and Rehabilitation Sciences” and “Student Research Committee”, Mashhad University of Medical Sciences, Mashhad, Iran Kh. Kimiafar Department of Health Information Technology, School of Paramedical and Rehabilitation Sciences, Mashhad University of Medical Sciences, Mashhad, Iran M. Sarbaz Department of Health Information Technology, School of Paramedical and Rehabilitation Sciences, Mashhad University of Medical Sciences, Mashhad, Iran S.F. Mousavi Baigi “Department of Health Information Technology, School of Paramedical and Rehabilitation Sciences” and “Student Research Committee”, Mashhad University of Medical Sciences, Mashhad, Iran Journal Article 2025 07 13 Aims: Telerehabilitation is a branch of telemedicine and an emerging method of providing rehabilitation services through information and communication technology between patients and healthcare providers. This systematic review aimed to examine healthcare professionals' attitudes, knowledge, and awareness of telerehabilitation. Information & Methods: A systematic search was conducted without a time limit in PubMed, Embase, Scopus, and Web of Science databases on May 27, 2024. We followed the PRISMA guidelines for reporting evidence from the studies included in this systematic review. Titles and abstracts were independently screened based on eligibility criteria. A checklist was used for data extraction. The Joanna Briggs Institute Critical Appraisal Checklist for analytical cross-sectional studies was used to assess the quality of the studies included in this review. Findings: A total of 33 eligible articles were identified through this review. Out of these, 25 studies investigated healthcare professionals' attitudes toward telerehabilitation. Additionally, 15 studies evaluated the knowledge of healthcare professionals regarding telerehabilitation, while 10 studies explored their awareness of telerehabilitation. Conclusion: All health professionals have a positive and promising attitude toward the use of telerehabilitation, but half of the specialists have insufficient knowledge and limited experience in telerehabilitation.

https://hehp.modares.ac.ir/article_2575_fecf2c550171d3195c879d115440ae45.pdf

Tarbiat Modares University (TMU) Health Education and Health Promotion 2588-5715 12 4 2025 07 13 Role of Cardio-Vascular Risk Assessment in Educational Intervention Based on Health Belief Model for Medical Adherence in Patients with Hypertension 695 702 2576 10.58209/hehp.12.4.695 EN F. Malekzadeh Student Research Committee, Bushehr University of Medical Sciences, Bushehr, Iran R. Tahmasebi Department of Epidemiology and Biostatistics, Faculty of Health, Bushehr University of Medical Sciences, Bushehr, Iran A. Noroozi Department of Health Education and Promotion, Faculty of Health, Bushehr University of Medical Sciences, Bushehr, Iran Journal Article 2025 07 13 Aims: Hypertension is a critical health condition requiring consistent medical adherence to prevent complications. This study aimed to evaluate the effects of a cardiovascular risk assessment and an educational intervention grounded in the Health Belief Model (HBM) on medication adherence among patients with hypertension. Materials & Methods: A semi-experimental study was conducted with three groups: a combined risk assessment and education group, a risk assessment-only group, and a control group, each consisting of 40 patients. Cardiovascular risk was individually assessed in both intervention groups using the Framingham model, with risk categories (low, moderate, high) explained to personalize the intervention and enhance perceived susceptibility. Additionally, patients in the combined intervention group received an educational booklet structured around HBM components. All participants completed questionnaires measuring knowledge, HBM constructs, the Morisky Medication Adherence Questionnaire, and treatment compliance (measured by the ratio of consumed to prescribed medications) at baseline and after three months. Data analysis was performed using SPSS software version 26. Findings: The three groups were demographically comparable. Over time, the combined intervention group showed significant improvements in all HBM constructs. The risk assessment-only group demonstrated improvements in perceived barriers, perceived benefits, self-efficacy, and awareness. Both intervention groups exhibited enhanced treatment compliance and medication adherence compared to the control group. Conclusion: The combined educational and risk assessment intervention proved more effective in improving awareness and strengthening HBM constructs than risk assessment alone.

https://hehp.modares.ac.ir/article_2576_ef1e491a766ce3127556063d49bc2f98.pdf

Tarbiat Modares University (TMU) Health Education and Health Promotion 2588-5715 12 4 2025 07 13 Relationship between Health Literacy and Financial Literacy in the Elderly 703 711 2577 10.58209/hehp.12.4.703 EN M. Maheri Department of Public Health, School of Public Health, Urmia University of Medical Sciences, Urmia, Iran M. Ghesmati Department of Community Medicine, School of Medicine, Urmia University of Medical Sciences, Urmia, Iran J. Amirzadeh-Iranagh Department of Public Health, School of Public Health, Urmia University of Medical Sciences, Urmia, Iran Journal Article 2025 07 13 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.

https://hehp.modares.ac.ir/article_2577_74934548253bcab8490ebd74afed7031.pdf

Tarbiat Modares University (TMU) Health Education and Health Promotion 2588-5715 12 4 2025 07 13 Perceived Stress and Eating Disorders in Iranian Nurses 713 719 2578 10.58209/hehp.12.4.713 EN S.H. Hosseini Department of Health Education and Promotion, Faculty of Health, North Khorasan University of Medical Sciences, Bojnurd, Iran R. Rajabzadeh Department of Community Medicine, Faculty of Medicine, Sabzevar University of Medical Sciences, Sabzevar, Iran R. Alizadeh Faculty of Public Health, North Khorasan University of Medical Sciences, Bojnurd, Iran Z.S. Sangsefidi Department of Nutrition, Faculty of Public Health, North Khorasan University of Medical Sciences, Bojnurd, Iran Journal Article 2025 07 13 Aims: Stressful conditions can lead to increased emotional and mental distress. This study aimed to evaluate perceived stress and eating disorders among a sample of Iranian nurses. Instrument & Methods: This cross-sectional study was conducted on 149 nurses from hospitals in Bojnurd City, Iran. Eating disorders and perceived stress were assessed using the valid Persian version of the Eating Disorders Scale and the valid Persian version of the Perceived Stress Scale, respectively. Findings: The nurses exhibited moderate to high levels of perceived stress. Overall eating disorder and anorexia nervosa scores were higher among single individuals compared to married ones. Overall eating disorder scores were elevated in individuals without personal experiences of illness or without experiences of losing family members due to illness, while bulimia scores were higher in nurses who had experienced the loss of family members due to illness compared to those without such experiences. Significant correlations were observed between the overall eating disorder (r=0.20, p=0.01) and anorexia nervosa (r=0.38, p<0.001) and physical activity level and age. Conclusion: The nurses demonstrate moderate to high levels of perceived stress, and their overall eating disorder is significantly correlated with their physical activity level and age.

https://hehp.modares.ac.ir/article_2578_9457fc28ceb408103e13533e4a5b6bd1.pdf

Tarbiat Modares University (TMU) Health Education and Health Promotion 2588-5715 12 4 2025 07 13 Predictors of Waste Separation Behavior and Behavioral Intention in Housewives 721 726 2579 10.58209/hehp.12.4.721 EN Z.S. Asadi Department of Community Medicine, Faculty of Medicine, AJA University of Medical Sciences, Tehran, Iran A.H. Sharifi Department of Community Medicine, Faculty of Medicine, Tehran University of Medical Science, Tehran, Iran K. Naddafi Department of Environmental Health Engineering, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran G. Amani Department of English Language Teaching, Faculty of Literature and Humanities, Ilam University, Ilam, Iran N. Abdi Department of Nursing, Faculty of Nursing and Midwifery, Kurdistan University of Medical Sciences, Sanandaj, Iran Journal Article 2025 07 13 Aims: Waste separation behavior is beneficial for implementing waste management, recycling, and financial savings. The present study aimed to identify the predictors of waste separation behavior and behavioral intention based on the integrated behavioral model among housewives in Tehran. Instrument & Methods: This descriptive cross-sectional study was conducted on 326 housewives in an institutional district located in the northern part of Tehran in 2023. Data collection was carried out using a developed questionnaire based on the integrated behavioral model. Findings: The mean age of the study participants was 38.96 years. Waste separation behavior, environmental factors, and normative beliefs significantly influenced the behavioral intention score for waste separation (p<0.0001). The levels of increase for the aforementioned factors were reported as 0.655, 0.101, and 0.204, respectively (R2=0.569). Additionally, the history of waste separation training (p<0.0001) and the spouses’ educational level (p=0.003) were found to significantly affect the behavioral intention score for waste separation, with levels of increase reported as 0.786 and 0.275, respectively (R2=0.203). Conclusion: The housewives’ behavior and their behavioral intention regarding waste separation largely depend on the history of waste separation training at the source and on environmental factors.

https://hehp.modares.ac.ir/article_2579_5b168fdba5ee5ea262cc2d4c0b457697.pdf

Tarbiat Modares University (TMU) Health Education and Health Promotion 2588-5715 12 4 2025 07 13 Program Based on Risk Perception Theories for the Prevention of Common Non-Communicable Disease 727 734 2580 10.58209/hehp.12.4.727 EN N. Alizadeh Health Education and Promotion Group, Science and Research Branch, Islamic Azad University, Tehran, Iran D. Shojaeizadeh Health Education and Promotion Group, Science and Research Branch, Islamic Azad University, Tehran, Iran Z. Jalili Health Education and Promotion Group, Science and Research Branch, Islamic Azad University, Tehran, Iran L. Jahangiry Tabriz Health Services Management Research Center, Tabriz University of Medical Sciences, Tabriz, Iran Journal Article 2025 07 13 Aims: This study was designed to evaluate the impact of an educational intervention grounded in risk perception theories aimed at the prevention and management of common non-communicable diseases in an urban population. Materials & Methods: The study employed a semi-experimental design with two groups (intervention and control), utilizing a pre- and post-test approach. It incorporated protection motivation theory and the health belief model within an urban population in Hashtruod, focusing on non-communicable disease prevention and care in 2023. The participant population consisted of 426 individuals, with 213 assigned to the intervention group and 213 to the control group, all randomly selected from the comprehensive health centers in Hashtrood. A questionnaire assessing personal risk perception regarding non-communicable diseases was used, which included five dimensions: Perceived sensitivity, perceived barriers, perceived benefits, perceived self-efficacy, and behavioral intentions to change. The educational intervention, designed to enhance personal risk perception, was implemented over two sessions within a two-week period for the intervention group. Findings: The intervention based on risk perception theories significantly improved the intervention group's perceived sensitivity, perceived severity, perceived benefits, self-efficacy, and guidance for action. Conclusion: An educational intervention based on the health belief model and protection motivation theory effectively enhanced awareness constructs, behavioral intentions, perceived sensitivity, perceived severity, perceived benefits, perceived barriers, self-efficacy, response self-efficacy, and guidance for adopting healthy behaviors.

https://hehp.modares.ac.ir/article_2580_17b3c7061788dbe82de5abe9f6fe22b3.pdf