Development and application of a fuzzy occupational health risk assessment model in the healthcare industry.

BACKGROUND: Hazards of the workplace and their impacts on the healthcare industry affect the quality of patient care and safety and impose high costs on the healthcare industry. Occupational health in this industry requires proper identification of hazards and managing the related risks. In this study, the researchers attempted to develop an easy-to-use and high applicability occupational health risk assessment model with a fuzzy approach to evaluate risks more precisely. METHODS: In this study, a fuzzy inference system (FIS) was designed and applied to develop a risk assessment model. CONCLUSIONS: This study showed that the developed model could be applied as a practical model for evaluating occupational health risks. The weight of each risk criterion was used to calculate the risk level by adopting a fuzzy approach. The risk assessment results construed using the fuzzy set theory provided a broad picture of risks and could work adequately in the presence of inaccurate and insufficient data to calculate the risk. This model calculates risk levels and provides us with the dispersion and distribution of the calculated value of the risk number.

A predictive model of genital warts preventive behaviors among women in the south of Iran: application of health belief model.

BACKGROUND: Genital wart (GW) is known as an infectious disease. Besides the infection, it is associated with a higher risk of cervical neoplasia and cancer in the infected population. The present research aimed to explore the predictors of GW preventive behaviors based on the health belief model (HBM). METHODS: The present analytical and cross-sectional research was conducted in 2019 among 720 women between 15 and 49 years of age in Bandar Abbas in the south of Iran. The sample was selected in a multi-stratified clustering method. The participants responded to a reliable and valid researcher-made questionnaire which explored demographic information, knowledge-related items and the model constructs. A multivariate linear regression analysis was run to determine the predictors of adopting GW preventive behaviors. A path analysis was also run to test the direct and indirect effects of the model constructs on the dependent variable. RESULTS: The mean and standard deviation of participants' age was 30.43 ± 8.697 years. As Pearson's correlation coefficients showed, knowledge (r = 0.197, p < 0.001), perceived susceptibility (r = 0.434, p < 0.001), severity (r = 0.463, p < 0.001) and self-efficacy (r = 0.434, p < 0.001) were significantly correlated with the adoption of GWs preventive behaviors. Multiple linear regression analysis showed that self-efficacy (B = - 0.010, p < 0.001), perceived susceptibility (B = 0.070, p < 0.001) and severity (B = 0.078, p < 0.001) were the predictors of GW preventive behaviors. Path analysis showed that perceived susceptibility, severity and self-efficacy directly affected healthy behaviors while perceived benefits and barriers indirectly affected the preventive behaviors. CONCLUSIONS: The present findings help to promote knowledge of the predictors of GW preventive behaviors. HBM can be a useful theoretical framework to evaluate the preventive behavior of the disease and help to reduce the rate of sexually-transmitted infections including GW.

Using intervention mapping for hookah smoking cessation: a quasi-experimental evaluation.

BACKGROUND: The present study aimed to evaluate the results of a theory-based and systematic intervention on Hookah Tobacco Smoking (HTS) cessation in women local to Bandar Abbas, Iran. METHODS: In the present quasi-experimental research, we used an intervention mapping approach to develop, implement, and evaluate an education and training course as our intervention. Applying the results of a systematic review and two prior local qualitative studies, we identified six HTS determinants and set goals for the intervention. We selected 212 eligible women through systematic stratified random sampling and enrolled them in control and intervention groups. The course was presented to the intervention group in 17 sessions for four months. The educational material was developed to address the goals of the intervention, improve HTS determinants, and change the HTS behavior. We used a questionnaire to collect data on participants' characteristics, HTS behavior, and detailed determinants of HTS in the control and intervention groups at the beginning of the study, at the end of the intervention, and at three- and six- months follow-up. All work done in the study was guided by ethical considerations. RESULTS: The results showed no significant difference between women enrolled in control and intervention groups regarding participants' characteristics and HTS behavior. At baseline, there were no differences between groups for six determinants of HTS (knowledge, attitude, social norms, self-efficacy, habit, and intention). At the end of the intervention and at three and six months follow-up, the women in the intervention group had significantly better results in all six domains, compared with those in the control group. The rate of HTS abstinence at the end of the intervention and at the three- and six-month follow-ups was 61.3%, 48.5%, and 45.5% for the intervention and 16%, 14.4%, and 10% for the control groups, respectively. CONCLUSIONS: HTS is a complicated behavior, and its cessation is hard. However, Intervention Mapping (IM) can be a powerful integrative, purposeful, theory-based, and participation-based method to reduce or cease HTS. This method should be tested in other settings. TRIAL REGISTRATION: IRCT20190126042494N1, Registered 3.3.2019. https://en.irct.ir/trial/37129.

The effectiveness of a model-based health education program on genital warts preventive behaviors: a quasi-experimental study.

BACKGROUND: Genital warts (GWs) are highly prevalent among Iranian women. GWs are not only highly infectious but are also followed by severe adverse effects, including the development of cervical cancer. Therefore, the present study aimed to explore the effect of an educational intervention based on the health belief model (HBM) on the adoption of GWs preventive behaviors by married women in Bandar Abbas, a city in the south of Iran. METHODS: A quasi-experimental intervention was conducted between 2019 and 2020 among 150 women participants (75 as the intervention and 75 as the control group). The sampling method was multi-stage clustering. The required data was collected using a reliable and valid tripartite questionnaire which explored demographic information, awareness, and HBM constructs. A total number of 15 educational sessions were held, each 90 min long. The control group received only one 90-min session. The final follow-up was completed three months after the intervention in November 2020. RESULTS: The two research groups had no statistically significant differences in terms of awareness, perceived susceptibility, severity, benefits, barriers, and self-efficacy before the intervention (in the pre-test) (p > .05). After the educational intervention, the two groups showed statistically significant differences in all constructs except for the perceived benefits (p < .001). In the intervention group, in the pretest (before the intervention), the behavior score was 2.77 ± 2.59, which was increased to 3.73 ± .52 after the intervention (p < .001). In the control group, however, the difference was not statistically significant (p = 0.227). CONCLUSION: The present findings showed that the educational intervention based on the HBM can improve the prevalence of GWs preventive behaviors in women. This education should be provided by experts at regular intervals in all healthcare centers.

Maternal predictive factors for preterm birth: A case-control study in Southern Iran.

BACKGROUND: Preterm birth (PTB) is one of the most important factors that increase the risk of chronic diseases and postpartum death in infants. The aim of this study was to determine the maternal factors that affect the birth of preterm infants in the city of Bandar Abbas. MATERIALS AND METHODS: This is a case-control study that was performed on 400 preterm infants. Sampling was done by a simple method, and information was gathered by interviewing the mothers and their medical records. Data were collected by SPSS software version 16. To compare risk factors in the two groups, conditional logistic regression was used, and P < 0.05 was considered statistically significant. RESULTS: Results showed that factors such as type of delivery (odds ratio [OR] = 3.584, 95% confidence interval [CI]: 1.981-6.485), preeclampsia (OR = 2.688, 95% CI: 1.164-6.207), history of PTB (OR = 4.171, 95% CI: 1.483-11.728), premature rupture of membranes (OR = 3.273, 95% CI: 1.745-6.137), care during prenatal (OR = 0.334, 95% CI: 0.159-0.701), placental abruption (OR = 3.209, 95% CI: 1.209-8.519), placenta previa (OR = 9.333, 95% CI: 2.086-41.770), and cervical insufficiency (OR = 11, 95% CI: 1.381-87.641) were independent risk factors of preterm infant birth. CONCLUSIONS: The PTB risk is higher for women with cervical insufficiency, history of placenta previa, and history of preterm. Early recognition and management of these high-risk conditions among pregnant women may lead to a reduction in PTB rates.

Barriers to using a helmet among motorcyclist students: a qualitative study.

BACKGROUND: Helmet use rates among motorcyclists are low and various factors are involved. Therefore, the present study aimed to investigate the factors affecting the use of helmet in motorcycle students in Iran (Bandar Abbas city) in 2019. METHODS: The research was qualitative and data were collected through individual interviews and observations and were interpreted by content analysis method. Participants were 15 motorcyclist students studying in public health (6), nursing (4), dentistry (2), medicine (1), health education (1) and biochemistry (1). They were purposefully included in the study and sampling continued until data saturation. The main tool for data collection was deep semi-structured interviews with open answers which lasted for 20 to 60 minutes. Finally, 15 interviews were collected in this study. RESULTS: The five main categories (economic, family, socio-cultural, individual, and riding rules) were extracted from the data that each had a subclass. CONCLUSIONS: Different factors in micro and macro dimensions play a role in the use of helmets among motorcyclists. Consideration of these factors by the relevant organizations in the field of traffic can increase the use of helmets.

Association between self-efficacy and general health: a cross-sectional study of the nursing population.

BACKGROUND: The present research aimed to explore the association of self-efficacy and general health among nurses. METHODS: This was a descriptive-analytical. A total of 470 nurses were selected through the stratified sampling method. To collect the required data, GSE-10 and GHQ-28 were used. Independent-sample T-test, Pearson correlation coefficient, Chi-squared test, and regression were also used to analyze the obtained data. RESULTS: The results reveal a statistically significant correlation between general health and self-efficacy (t=-6.72, p < .001). Among general health parameters, social functioning has significantly predicted self-efficacy. CONCLUSIONS: As shown in the present findings, an acceptable level of self-efficacy can positively affect all aspects of nurses' general health.

What are the intervention goals of women's hookah cessation? A systematic, evidence-based and participatory study.

This Study was designed to answer the question: what are the intervention goals of women for ceasing to smoke. The present research was part of a larger study and was a pioneering systematic research conducted between September 23, 2018 and September 26, 2019 through an intervention mapping in southern Iran among professional hookah Smoking (HS) women. In order to know more about the HS among women, the behavioral and environmental correlates of HS/cessation and the determiners or fundamental causes of these factors were extracted via a systematic review and a local qualitative study. As the results revealed, the expected outcomes of the educational program concerning hookah cessation were achieved. As the realization of these outcomes requires certain changes to the behavioral and environmental dimensions, in the next step, the intervention goals of hookah cessation were identified. As the results showed, four behavioral factors involved in the unhealthy HS behavior were individual HS, Being in the Company of hookah smokers, Visiting tempting and contaminated places and Physical and mental dependence on HS (habit), In addition, four effective environmental factors were found at different interpersonal, organizational, community and policy levels. These include, respectively: recommendation and motivation for cessation by influential figures, care providers' poor inadequate knowledge and skill, Easy acceptance of hookah in society, and the lack of effective rules. Knowledge, awareness, social norms, Motivation to comply, skill and self-efficacy, habit, were among the determining factors of hookah cessation. Employment of a systematic is based on evidence and cooperation and is guided by a assessing the needs of the target population. Such a method can suggest more purposive and relevant intervention goals so as to cease HS. The aim would be to intervene in the purposes of the above-mentioned change, as compared in predetermined interventions, and increase the chances of HS cessation among women.

Predictors of hookah smoking frequency among women in the South of Iran: A cross-sectional study.

The prevalence of hookah smoking has grown over the past decades in Iran especially in the south of the country. This study aimed to determine the behavioral and socio-demographic predictors of the hookah smoking frequency among women in southern Iran. This research was conducted on 400 women hookah smokers selected through multi-stage sampling method. Data were collected from October 2018 to September 2019 using a questionnaire guided by literature. Ordinal logistic regression analysis was run to determine the influential behavioral and socio-demographic predictors involved in the frequency of hookah smoking. Variables with a P-value of less than 0.05 in the final fitting model were associated with the outcome variable (frequency of hookah smoking per day1 = once a day, 2 = twice a day, 3 = three times a day, 4 = more than three times a day). We found that the longer duration of hookah smoking, family usage of hookah smoking, beginning to smoke hookah with peers, absence of either parent in family (single-parent families and a lack of prior intention to cease smoking), ever-married women and low socio-economic status (SES) predicted the frequency of hookah smoking. To prevent the behavior and make effective interventions to reduce hookah smoking, policy-makers should stay focused on factors other than internal motivations. Focus on the companies surrounding women smokers, quitting the habit of hookah smoking and effective interventions to decrease one's intention to smoke hookah can help reduce such unhealthy behaviors.

Safe driving behaviors among taxi drivers: a predictive cross-sectional study based on the health belief model.

BACKGROUND: The purpose of this study was to predict safe driving behaviors among taxi drivers of Tehran based on the constructs of health belief model. METHODS: This descriptive-analytical study was performed on 450 taxi drivers in Tehran using multi-stage sampling. Data were analyzed through SPSS software version 18 using Pearson correlation coefficient and multivariate regression analysis. The P < 0.05 was considered statistically significant. RESULTS: Among the constructs of health belief model, perceived severity, perceived benefits and self-efficacy, had significant and direct relationship and perceived barriers had a significant and reverse relationship with safe driving behaviors. According to the results, the constructs of health belief model predicted 17.3% of safe driving behaviors. Self-efficacy was the strongest determinant of safety behaviors (0.362 CI 0.098-0.625). CONCLUSIONS: Increasing self-efficacy, reducing perceived barriers and highlighting benefits for the purpose of accepting safe behaviors can be considered as a principle in driving education and training. Also, increasing the perceived severity of adverse outcomes of RTAs and the susceptibility to these outcomes will lead to higher levels of safe driving behaviors.

Predictors of Hookah Smoking among Women in Bandar Abbas, Southern Iran: A Cross-Sectional Study Based on the Intervention Mapping Protocol.

Background: The purpose of this study was to determine the predictors of hookah smoking (HS) among professional HS women in Bandar Abbas, southern Iran using intervention mapping protocol. Methods: The present cross-sectional study is part of a larger study, which was conducted on 332 HS women using a multistage (clustered and randomized) process. Data were collected from October 2018 to August 2019 using a researcher-made questionnaire. Results: Mean age of the participants was 36.1 ± 13.3 years. Ordinal regression model, after the control of confounding variables, showed that attitudes, self-efficacy, habits, and intention were the most important predictors of HS behavior in women (OR = 1.14). The prevalence of HS was 1.76 times higher in women who did not want to quit hookah. Knowledge and Social norms were not associated with the HS behavior. Conclusions: According to the present findings, changing or eliminating women's positive attitude toward HS is deemed possible through reducing the social acceptance of HS in enculturating the negative attitude in society, enhancing women's self-efficacy via purposeful and specific education on resisting hookah temptation, unraveling all factors involved in habit formation and adjusting these factors through long-term interventions and timely interventions to affect intention to consumption before the actual occurrence of behavior (HS).

An intervention development for cessation of hookah smoking among Iranian women: study protocol for a systematic and theory-based approach to intervention design.

BACKGROUND: Hookah smoking is an emerging global health issue, especially in Eastern Mediterranean region; and accordingly, women are at the center of this issue as they have a more positive attitude towards hookah smoking. Also, the rate of hookah smoking is increasing at a faster rate among women compared to men. The aim of the present study will be systematically designing and implementing an educational intervention program for hookah smoking cessation among 15 years old women and older in the Iranian southern city of Bandar Abbas. METHODS: We will use intervention mapping methodology for designing the study. Due to the breadth of factors affecting hookah smoking and the complexity of hookah cessation, we will initially conceptualize hookah smoking cessation program as a set of purposeful activities designed to stop the hookah smoking. In the first step (need assessment), the environmental and behavioral factors related to hookah smoking/cessation and the determinants of these factors will be determined by systematic review and local qualitative study. Then, based on the results of the first step, the behavioral and environmental goals of hookah smoking cessation will be identified. In the second step, the practical goals will be determined for each of the behavioral and environmental outcomes; and then, the logic and matrix of change objectives will be designed using the determinants extracted from the previous step. The products of the second step will be the intervention goals. In the third step, theoretical and practical methods affecting each of the intervention goals will be identified. In the fourth step, contents of educational program for hookah cessation will be produced. The fifth step will be about planning to implement the program. In the sixth step, the effectiveness of designed program will be evaluated in a quasi-experimental intervention. DISCUSSION: Appropriate development and successful implementation of a hookah cessation intervention requires a systematic and theory-based approach. We believe that using Intervention Mapping (IM) as the guiding methodology will make it possible to address complexities of developing an intervention program. Also, reflections on the quasi-experimental research and describing the context and executed methods of implementation would contribute to the development of IM and the knowledge needed for the implementation of program. Trial registration IRCT20190126042494N1, Registered 3.3.2019. https://en.irct.ir/trial/37129.

Explaining the determinants of hookah consumption among women in southern Iran: a qualitative study.

BACKGROUND: The prevalence of hookah consumption has been on the increase in Iran over the past two decades. This rate is higher among women than men in the south of Iran than other geographical areas. The purpose of this study was to explain the determinants of hookah consumption among indigenous women of Bandar Abbas city, southern Iran. METHODS: This is the first qualitative study with the conventional content analysis approach that has examined the factors affecting the consumption of hookah at all ecological levels in 2018-2019. Participants, with a maximum variation in terms of age, education, occupation, hookah consumption and geographical areas of the city, were selected purposefully to take part in a semi-structured interview. The data were recorded, typed and analyzed according to the framework of the ecological model of health promotion at five levels (intrapersonal, interpersonal, organizational, social and political). The interview continued until data saturation. MAXQDA software version 10 was used for data management. RESULTS: Interviews were conducted with 56 participants (21 female hookah smokers, 15 female ex- smokers, and 20 experienced experts). A total of eight main categories were extracted from the data including; positive attitude towards hookah consumption, psychosocial needs, sensory charms of hookah, individual factors, family factors, cultural-environmental backgrounds, social-political backgrounds, and economic challenges. CONCLUSIONS: The results indicated the extensive influence of internal and external factors on the consumption of hookah. In order to successfully reduce the consumption of hookah, it is essential to consider intrapersonal, interpersonal, organizational, social and political factors.

Barriers to research activities as perceived by medical university students: A cross-sectional study.

CONTEXT: The importance of research is revealed by the fact that the top seven science producing countries in the world are the same seven countries worldwide in terms of the research facilities. AIM: To explore the barriers to research activities among the students of the Hormozgan Medical University. SETTINGS AND DESIGN: A total of 400 students affiliated with the Hormozgan University of Medical Sciences participated in this cross-sectional study. METHODS: The sampling method was proportional stratified, and the data collection instrument was a tripartite questionnaire that comprised demographic information, personal barriers, and organizational barriers. STATISTICAL ANALYSIS: The data were statistically analyzed by the Statistical Package for the Social Sciences (SPSS) software (V.16.0, SPSS Inc., Chicago, IL, USA) using descriptive statistics as well as the independent sample t-test, one-way analysis of variance, and Pearson's correlation coefficient. The level of significance was set at P < 0.05. RESULTS: The most prevalent personal barriers were inadequate knowledge of research methodology (2.91±1.24) and inadequate skill in research conduction (2.89±1.36). In the realm of organizational barriers, limited access to information sources was the most prevalent barrier (2.75±2.27). The results showed that researcher students encounter more of the organizational barriers (56.13±13.90), whereas non-researcher students faced more of the personal barriers (53.80±10.95). CONCLUSION: Establishing access to high-speed Internet system, raising students' awareness of research methodology through workshops, encouraging and motivating students for research work, and using online sources can help in removing the barriers to research activities.

Factors associated with hookah smoking among women: A systematic review.

INTRODUCTION: The present study aimed to determine factors associated with hookah smoking among women on a global scale based on a systematic review of related literature. Intervention Mapping was the guiding framework for this review. METHODS: Searches were performed in Web of Science, PubMed, Iranian databases, Elsevier, Embase, Scopus, Medline, Google Scholar, and the World Health Organization (WHO) website, using keywords related to hookah and associated terms. Studies in English or Persian, published between 1990 and 2018, were included in this review if they were available in full text and had a target population of women. Determinants of hookah smoking at the intrapersonal, interpersonal, institutional/organizational, community, and political levels, were extracted. RESULTS: Positive attitude, social-psychological needs, low perceived risk, social-cultural acceptance of hookah, easy access and lack of laws were among the reasons given for consuming hookah. Because hookah smoking is a multifactorial issue, the qualitative method alone was not sufficient to identify the determinants of hookah smoking among women. The opinions of experts in the field of smoking control had been largely neglected in the obtained studies, and most quantitative studies lacked a theoretical framework. CONCLUSIONS: To reduce the rate of hookah consumption, actions to be taken include changing women's positive attitude toward hookah, learning to resist friends' pressure to smoke, highlighting the unpleasantness of hookah smoking by segregating places with transparent walls within public places, showing in the virtual world that hookah smoking is socially unacceptable, limiting access to hookah tobacco products, and effectively implementing rules that restrict hookah smoking in public places.

Factors involved in selecting the birth type among primiparous women.

BACKGROUND: Mortality and disability rates were reported to be respectively 2-3 and 5-10 times higher in C-sections compared to Vaginal delivery. OBJECTIVES: This study was aimed to explore the factors involved in selecting the birth type among primiparous women. METHODS: The present cross-sectional research was conducted on 220 primiparous women, who visited the health-care centers of Bandar Abbas. They were recruited in their first trimester of pregnancy with a simple randomized clustering method. Data were collected in a researcher-designed questionnaire. Its validity was confirmed by a panel of experts and reliability was tested and approved through the test-retest method. Mean, standard deviation, independent sample t-test, and Chi-squared tests for data analysis were done by SPSS 16. P < 0.05 was considered statistically significant. RESULTS: The mean age of the participants was 27.40 ± 6.07 years. The main barriers to the choice of vaginal delivery were the fear of pain and fear of vaginal area tears and ruptures, fear of injury to fetus, and doctor's recommendation. A statistically significant correlation was observed between the age, education, employment, income, awareness, and the reasons for preferring surgical childbirth. CONCLUSIONS: To reduce the rate of unnecessary cesarean sections (C-section), the following recommendations are suggested: Reducing fear of pain in expectant mothers, modifying wrong beliefs about the culture of natural childbirth, increasing awareness of fewer adverse effects of vaginal delivery including the vaginal tears if the mother abides by all midwife(s) instructions during the delivery procedure, providing educational courses for the necessary movements during the delivery, decreasing surgeons' payment for C-section, and increasing payment for natural childbirth and implementing barriers for optional delivery to reduce the C-section.

Fish consumption based on transtheoretical model among housewives.

BACKGROUND: Consuming fish plays a key role in human health and prevention of diseases. The aim of this study was using transtheoretical model to analyze the trend of fish consumption among women. MATERIALS AND METHODS: In this descriptive-analytic research, 383 housewives who referred to health centers in Bandar Abbas were selected through a stratified sampling method. Data were collected by a questionnaire to determine fish consumption based on transtheoretical model and analyzed by using SPSS software version 19.0. with the significance level of P < 0.05. RESULTS: Nearly 11.7% of the patients were found to be at the precontemplation stage; 3.9% were at the contemplation stage; 13.6% were at the preparation stage; 7.3% showed to be at the action stage, and 63.4% were at the maintenance stage. The results showed a significant relation of the constructs of the model with the stages of change of consuming one or two meals of fish a week. Moving through the stages of change from the precontemplation stage to maintenance stage was accompanied by an increase in decisional balance, self-efficacy, and processes of change (P < 0.05). CONCLUSION: It is suggested that in designing educational interventions in the light of this model, more emphasis is placed on perceived benefits and self-efficacy. The processes of change are advised to be used more often, and perceived barriers to fish consumption need to be reduced as far as possible.

Pregnant Women's Health Literacy in the South of Iran.

Objective: Investigate the health literacy of pregnant women in the south of Iran. Materials and methods: The present descriptive-analytical study was conducted on 775 pregnant women in the south of Iran (including Boushehr, Ahvaz, Zahedan and Bandar Abbas cities) through the clustering sample selection method. The data were collected through the Test of Functional Health Literacy in Adults: TOFHLA, and were analyzed statistically via SPSS 16 through independent-sample t-test and ANOVA. Results: The average age of the subjects was 31.89 ± 7.54 years. The results indicated that 15.5% of the subjects had an inadequate level of health literacy; 41.7% had a border-line level of health literacy, and 42.8% had an adequate level of literacy. Significant correlations were found between each of these variables and the subjects' level of health literacy: education, age, occupation and care provision during pregnancy (p ˂ 0.05). The highest mean score of health literacy belonged to Ahvaz while the lowest belonged to Boushehr. Conclusion: According to the results, the health literacy level of pregnant women in the target geographical areas showed to be inadequate or on a border-line. Moreover, subjects' education, age and occupation showed to be significantly correlated with health literacy. Therefore, promoting pregnant women's health literacy through simplifying health-related information, use of audio-visual media, improving communicative skills among the health staff and mothers can be effective.

Prediction of Birth Type Based on the Health Belief Model.

Objective: To anticipate the type of childbirth according to the health belief model. Materials and methods: The present cross-sectional research was conducted on 222 primiparous women visiting the healthcare center in Khorram Abad. A combination of simple randomization and clustering was used to do the sampling. The data collection instrument was a validated four-part questionnaire the first part of which contained demographic information. The second part was comprised of awareness questions while the third dealt with the constructs of the health belief model. The final part consisted of the behavioral intention derived from the logical action theory. SPSS 16 was used to statistically analyze the data and the significance level was set at p ˂ 0.05. Results: The average age of the participants was 27.40 ± 6.07 years. Intention to go for a vaginal birth showed to be significantly correlated with awareness, perceived sensitivity, intensity, barriers and benefits (p ˂ 0.001) as well as self-efficacy (p = 0.025). The best predictor of the type of childbirth turned out to be the perceived barriers (OR = 1.153, p ˂ 0.001) and only then awareness (OR = 1.108, p ˂ 0.001). Conclusion: Strategies to remove the barriers of preferring vaginal childbirth, raising women's awareness of the side effects of C-section and the benefits of vaginal birth, strategies to enhance women's beliefs in their capability of natural childbirth can be used to reduce the prevalence of unnecessary C-sections.

The effect of an instructional program based on health belief model in decreasing cesarean rate among primiparous pregnant mothers.

INTRODUCTION: Although cesarean section has saved many mothers' and infants' lives, the problem is in its increasing prevalence. According to recent statistics, the current rate of cesarean in Iran is in fact 3-4 times as more than the standard rate defined by WHO. Therefore, the present study is aimed to estimate the effect of an instructional program based on health belief model on reducing cesarean rate among primiparous pregnant women. MATERIALS AND METHODS: In this semi-experimental research, 60 primiparous women who had visited Bandar Abbas Healthcare Centers were selected as the subjects. They were in their 26-30(th) week of pregnancy. They were selected in a multi-stage cluster sampling method (a combination of clustering and simple randomization), and were divided into two groups, subjects and control group. The data were gathered using a valid and reliable questionnaire. The instructional intervention was done after the completion of the pretest questionnaire based on the sub-constructs of the health belief model in six instructional sessions. 1 month after the intervention, posttest questionnaires were completed by the subjects in both groups. The data were analyzed using descriptive statistics, standard deviation, independent t-test, and paired t-test. The significance level was set at <0.05. RESULTS: Two groups had a significant difference between awareness score, perceived sensitivity, intensity, benefits, barriers, self-efficacy, and the performance (P < 0.001). In the experimental group, nine subjects (30%) had a natural delivery. CONCLUSION: According to the findings of the current research, an instructional program illuminated (designed) by the health belief model can significantly influence pregnant women's awareness, intention, and choice of delivery type.