A community based intervention to modify preventive behaviors of cutaneous leishmaniasis in children: a randomized controlled trial based on PRECEDE PROCEED model.

OBJECTIVES: Iran ranks among the top six countries globally with a significant incidence of Cutaneous Leishmaniasis (CL). Using planning models is one community-based intervention to promote preventive behaviors. The purpose of our study was to evaluate the effectiveness of the PRECEDE-PROCEED model (PPM) in modifying preventive behaviors related to CL in children through mother training in a community intervention. METHODS: A randomized controlled trial based on the PPM model was conducted on 168 mothers (intervention (n = 84) and control group (n = 84) with 10 years old children in the rural areas of Iran. Mothers from 7 village areas were randomly allocated to the intervention (2 village) and control groups (5 village). The intervention group received a program comprising eight 90-minute training sessions and environmental interventions. In this study, we utilized the PPM as a framework to design the questionnaires on Leishmaniosis prevention behavior. Participants in both groups completed the questionnaires at baseline (before the intervention), immediately after the intervention, and at the 2-month follow-up. Analysis of the data was conducted utilizing SPSS20, with statistical significance set at p < 0.05. RESULTS: Compared to the control group, the intervention group showed significant increases in knowledge, enabling factors, reinforcing factors, attitude, and preventive behaviors related to Cutaneous Leishmaniasis over time from baseline to follow-up (P < 0.001). No significant differences (P > 0.05) were observed in the alterations of the PPM construct, knowledge, and preventive behaviors within the control group from pre-intervention to follow-up. CONCLUSIONS: Community (education and environmental) intervention based on PPM is feasible and acceptable to modify preventive behaviors of Cutaneous Leishmaniasis in children by increasing a mother's knowledge and attitude as well as changing enabling and reinforcing factors. TRIAL REGISTRATION: IRCT20160619028529N8.

Perceptions and determinants of oral health care among Iranian pregnant women: a qualitative study.

OBJECTIVES: This study aimed to gain a comprehensive understanding of the determinants that influence oral healthcare behaviours among Iranian pregnant women. STUDY DESIGN: Qualitative study. SETTING: Comprehensive health service centres. PARTICIPANTS: A sample consisting of all people involved in the process of oral care during pregnancy, 18 pregnant women, 7 midwives/healthcare workers, 3 supervisors of prenatal care services and 3 dentists) were purposefully sampled in terms of demographic characteristics. METHODS: The qualitative content analysis study conducted 31 semistructured individual interviews in 2022, utilising MAXQDA V.10. RESULTS: The participants identified 3 main categories and 11 subcategories: individual and physiological determinants (care needs, perceived importance, motivation, oral health literacy and inherent pregnancy limitations), organisational determinants (costs, access to equipment and services, review of service delivery process and professional behaviour) and social-cultural determinants (educational services and support from family and friends). CONCLUSIONS: The results can be used in interventions to improve oral healthcare for pregnant women. This study highlights the importance of addressing individual, organisational and social-cultural determinants to improve oral healthcare during pregnancy.

The influence of emotional intelligence on academic stress among medical students in Neyshabur, Iran.

BACKGROUND: Although, several novel strategies related to coping with stress dominate the possible vicissitudes that may occur, academic stress and its mental and physical outcomes remain a serious public concern among college students. Available data on how/where intervention-based novel strategies and emotional intelligence skills can influence students' ability to deal with stress and crisis situations is still unclear. This study aims to investigate the effectiveness of an educational intervention based on emotional intelligence on the level of academic stress components among Iranian medical students. METHODS: This research has been done in two descriptive and quasi-experimental sections in the academic year 2018-2019. To determine the effect of emotional intelligence components on stress levels, this descriptive study was performed on 200 students. Then, a quasi-experimental study was then conducted to determine the impact of an emotional intelligence component-based educational intervention on academic stress-coping skills. Data were collected through a personal information questionnaire, Bradbury and Graves's emotional intelligence questionnaire, and Gadzella's academic stress questionnaire. RESULTS: Most of the participants were female (72.3%) married (72%), non-native (62.1%), and second or third academic years (78.5%). The mean number of academic years of employment was 9.5. The mean age of students were 23 ± 3.5 years old. Intervention based on emotional intelligence significantly (p < 0.05) improved students' emotional intelligence skills and decreased their academic stress and reactions to stressors in the intervention group. CONCLUSION: It appears that emotional intelligence training is a feasible and highly acceptable way to develop coping skills with academic stress; therefore, such training is essential to be considered as part of university education to improve students' education quality and their skills to study without academic stress.

Translation and localization the Persian version of diabetes distress scale among type 2 diabetes.

INTRODUCTION: The aimed of this psychometric cross-sectional research was translation and localization the Persian version of diabetes distress scale in type 2 diabetes. METHODS: This psychometric cross-sectional research was translation and localization the Persian version of diabetes distress scale among 1028 type 2 diabetes in Mashhad city, Iran, 2022. Cluster sampling method was used for selection the participants. The validity and reliability of diabetes distress scale designed and evaluated by Polonsky was assessed in this study. The validity of diabetes distress scale was evaluated by face validity, content validity, and structural validity. Twenty-six type 2 diabetes were selected for evaluation the reliability of scale. RESULTS: The factor loading of all questions of diabetes distress scale were more than 0.4 and the results of goodness-of-fit indexes showed acceptable values (for example: RMSEA = 0.076, IFI = 0.909, AGFI = 0.819, PNFI = 0.758). Cronbach's alpha coefficient, McDonald omega coefficient and Intraclass Correlation Coefficient (ICC) showed a value of 0.950, 0.955, and 0.903, respectively for all items of diabetes distress scale. Cronbach's alpha coefficient, McDonald omega coefficient and ICC showed a value of 0.914, 0.917, and 0.893, respectively for Core Level of Distress (8 items). Also, Cronbach's alpha coefficient, McDonald omega coefficient, and ICC showed a value of 0.920, 0.928, and 0.884, respectively for all factors of Sources of Distress (21 items). CONCLUSION: The Persian form of diabetes distress scale with 29 items and two parts of Core Level of Distress with 8 items and Sources of Distress with 21 items and 7 factors (Hypoglycemia with 3 items, Long-term Health with 3 items, Healthcare Provider with 3 items, Interpersonal Issues with 3 items, Shame/Stigma with 3 items, Healthcare Access with 3 items, and Management Demands with 3 items) is a good scale to evaluation the status of diabetes distress in Iranian type 2 diabetes.

Exploring the conceptual framework of a health-promotion faculty from the perspective of members: a qualitative study.

OBJECTIVES: Understanding the concepts and structures of health promotion in the faculty from the perspective of its members. STUDY DESIGN: Qualitative study. SETTINGS: Faculties of Medical Sciences University. PARTICIPANTS: A sample of four main groups in the faculty (students, faculty members, staff and managers) were purposively sampled for demographic characteristics and their views on the concepts of health promotion. METHODS: A descriptive qualitative study using thematic analysis of content was conducted. Data were obtained using semistructured interviews and then analysed thematically. MAXQDA V.10 software was used to organise and code the imported interview transcripts. RESULTS: Three main categories of management policy, environmental structure and executive strategies were identified as health-promotion structures in the faculty based on the views of the interviewees. CONCLUSION: The inclusion of a health-promotion approach in university policies requires administrators' commitment to health promotion and the participation of all members and partners inside and outside the faculty to identify health needs and engagement in programmes.

Exploration factors on smoking among female adolescents based on the viewpoints of Iranian adolescent girls.

BACKGROUND: In recent years, the prevalence of smoking in women has increased significantly. This study aimed to explain the effective factors in the tendency to smoke in female adolescents, employing a qualitative method of content analysis in Mashhad, Iran. METHODS: The data for this conventional content analysis were obtained by conducting semi­structured interviews with 20 female adolescent smokers. For open coding, integrating codes, creating main category and subcategories, and extracting quotation associated with codes and subcategories, MAXQDA software version 10 was used. RESULTS: Based on the results of the study, one main category and six subcategories were identified to influence the decision to smoke. The main category was interconnection of psychological and gender experiences. The subcategories included self-management weakness, ignoring the side effects, gender orientation, negative psychological experiences, the attraction of cigarettes, and positive psychological experiences. CONCLUSION: Psychological and gender factors play an important role in initiating people's behavior and tendency to smoke and smoking prevention programs in educational settings need to focus efforts around what is known about young women smokers.

Exploration the role of social, cultural and environmental factors in tendency of female adolescents to smoking based on the qualitative content analysis.

BACKGROUND: The aim of this study was to explain the socio-cultural and environmental factors of smoking tendency in female adolescents. METHODS: This qualitative content analysis study was conducted among Iranian female adolescents in Mashhad, Iran. The data was collected through semi-structured interviews with 20 female smokers. The duration of each interview varies from 30 to 70 min. Data collection and management of data were done using MAXQADA software version 10. RESULTS: In exploration the effective socio-cultural and environmental factors in the tendency of female adolescents to smoking, six subcategories of role modeling of friends, membership in groups, parenting patterns, family modeling, the predisposing community, and the negative impact of the media were extracted. CONCLUSIONS: The results obtained in this study indicated that there is a need to formulate policies and adopt environmental and social laws to reduce smoking. The results also showed the effective role of parents in improving personal skills, creating a stress-free environment in the family, and controlling adolescent behavior. Therefore, it is necessary to pay attention to all social and cultural aspects in order to make the smoking prevention programs.

Design and evaluation of psychometric properties of cigarette smoking tendency questionnaire for female adolescents (CTQFA).

BACKGROUND: The tendency of women to smoke has increased in recent years and the prevalence of smoking among women is increasing. The purpose of this study was to design and evaluation the psychometric properties of the smoking tendency questionnaire for Iranian female adolescents. METHODS: This cross-sectional study was performed on 604 female adolescents in Iran in 2021. The bank of questions was designed based on the qualitative study concepts and review of the literature. To perform the psychometric evaluation, steps such as face validity (qualitative), content validity (qualitative and quantitative) and construct validity (confirmatory factor analysis) were performed. The reliability of the instrument was assessed using McDonald's omega coefficient and Cronbach's alpha coefficient. RESULTS: Based on the results of psychometrics (face, content, and construct validity), the number of questions was reduced from 102 to 52, and 50 questions were removed. Finally, a questionnaire with 52 questions and 5 subscales of the tendency to experience smoking (14 items), re-experience smoking (8 items), cigarette dependence (9 items), intention to quit smoking (9 items), and smoking cessation (12 items) was approved. The content validity ratio (CVR) and content validity index (CVI) for all questions were 0.770 and 0.938, respectively. The Cronbach's alpha and McDonald's omega coefficients for all questions were 0.903 and 0.904, respectively. CONCLUSION: Based on the results of this questionnaire, 52 questions, and 5 subscales can be used to assess the tendency of female adolescents to cigarette smoking.

National, regional, and global prevalence of cigarette smoking among women/females in the general population: a systematic review and meta-analysis.

BACKGROUND: This systematic and meta-analysis review aimed to provide an updated estimate of the prevalence of ever and current cigarette smoking in women, in geographic areas worldwide, and demonstrate a trend of the prevalence of smoking over time by using a cumulative meta-analysis. METHODS: Following PRISMA guidelines, we conducted a systematic review and meta-analysis of studies published on the prevalence of ever and current cigarette smoking in women. We searched PubMed, Web of Science (ISI), Scopus, and Ovid from January 2010 to April 2020. The reference lists of the studies included in this review were also screened. Data were reviewed and extracted independently by two authors. A random effects model was used to estimate the pooled prevalence of ever and current cigarette smoking in women. Sources of heterogeneity among the studies were determined using subgroup analysis and meta-regression. RESULTS: The pooled prevalence of ever and current cigarette smoking in women was 28% and 17%, respectively. The pooled prevalence of ever cigarette smoking in adolescent girls/students of the school, adult women, pregnant women, and women with the disease was 23%, 27%, 32%, and 38%, respectively. The pooled prevalence of ever cigarette smoking in the continents of Oceania, Asia, Europe, America, and Africa was 36%, 14%, 38%, 31%, and 32%, respectively. CONCLUSIONS: The prevalence of cigarette smoking among women is very high, which is significant in all subgroups of adolescents, adults, and pregnant women. Therefore, it is necessary to design and implement appropriate educational programs for them, especially in schools, to reduce the side effects and prevalence of smoking among women.

Comprehensive overview of computer-based health information tailoring: a systematic scoping review.

OBJECTIVES: To explore the scope of the published literature on computer-tailoring, considering both the development and the evaluation aspects, with the aim of identifying and categorising main approaches and detecting research gaps, tendencies and trends. SETTING: Original researches from any country and healthcare setting. PARTICIPANTS: Patients or health consumers with any health condition regardless of their specific characteristics. METHOD: A systematic scoping review was undertaken based on the York's five-stage framework outlined by Arksey and O'Malley. Five leading databases were searched: PubMed, Scopus, Science Direct, EBSCO and IEEE for articles published between 1990 and 2017. Tailoring concept was investigated for three aspects: system design, information delivery and evaluation. Both quantitative (ie, frequencies) and qualitative (ie, theme analysis) methods have been used to synthesis the data. RESULTS: After reviewing 1320 studies, 360 articles were identified for inclusion. Two main routes were identified in tailoring literature including public health research (64%) and computer science research (17%). The most common facets used for tailoring were sociodemographic (73 %), target behaviour status (59%) and psycho-behavioural determinants (56%), respectively. The analysis showed that only 13% of the studies described the tailoring algorithm they used, from which two approaches revealed: information retrieval (12%) and natural language generation (1%). The systematic mapping of the delivery channel indicated that nearly half of the articles used the web (57%) to deliver the tailored information; printout (19%) and email (10%) came next. Analysis of the evaluation approaches showed that nearly half of the articles (53%) used an outcome-based approach, 44% used process evaluation and 3% assessed cost-effectiveness. CONCLUSIONS: This scoping review can inform researchers to identify the methodological approaches of computer tailoring. Improvements in reporting and conduct are imperative. Further research on tailoring methodology is warranted, and in particular, there is a need for a guideline to standardise reporting.

Applying a health action model to predict and improve healthy behaviors in coal miners.

INTRODUCTION: One of the most important ways to prevent work-related diseases in occupations such as mining is to promote healthy behaviors among miners. This study aimed to predict and promote healthy behaviors among coal miners by using a health action model (HAM). METHOD: The study was conducted on 200 coal miners in Iran in two steps. In the first step, a descriptive study was implemented to determine predictive constructs and effectiveness of HAM on behavioral intention. The second step involved a quasi-experimental study to determine the effect of an HAM-based education intervention. This intervention was implemented by the researcher and the head of the safety unit based on the predictive construct specified in the first step over 12 sessions of 60 min. The data was collected using an HAM questionnaire and a checklist of healthy behavior. RESULTS: The results of the first step of the study showed that attitude, belief, and normative constructs were meaningful predictors of behavioral intention. Also, the results of the second step revealed that the mean score of attitude and behavioral intention increased significantly after conducting the intervention in the experimental group, while the mean score of these constructs decreased significantly in the control group. CONCLUSION: The findings of this study showed that HAM-based educational intervention could improve the healthy behaviors of mine workers. Therefore, it is recommended to extend the application of this model to other working groups to improve healthy behaviors.

Digital Media-based Health Intervention on the promotion of Women's physical activity: a quasi-experimental study.

BACKGROUND: Technological advances have caused poor mobility and lower physical activity among humankind. This study was conducted to assess the impact of a digital media-based (multi-media, internet, and mobile phone) health intervention on promotion of women's physical activity. METHODS: In this quasi-experimental study, 360 women were divided into case and control groups. The digital media-based educational intervention was conducted in two months in the case group electronically, using mail and Internet and telephone platforms. Physical activity was measured using International Physical Activity Questionnaire (IPAQ) that estimated women's physical activity rate in the previous week. Data was analyzed using descriptive and analytical statistics (ANOVA, chi-square, paired and independent t-tests) using SPSS 20. RESULTS: The mean score of knowledge, attitude and level of physical activity in the control group were not significantly different before and after the intervention. While in the case group, this difference before and after the intervention was significant (p < 0.001), and mean scores of the above-mentioned factors increased after the intervention. CONCLUSIONS: Using innovative and digital media-based health education can be effective in improving health-based behavior such as physical activity. Therefore, it seems necessary to develop user-based strategies and strengthen the behavioral change theories and hypotheses based on digital media for effective influence on behavior. TRIAL REGISTRATION: Iranian Registry of Clinical Trials (IRCT), IRCT20160619028529N5 . Registered December 24, 2017 [retrospectively registered].

Comprehensive overview of computer-based health information tailoring: a scoping review protocol.

INTRODUCTION: Tailoring health information to the needs of individuals has become an important part of modern health communications. Tailoring has been addressed by researchers from different disciplines leading to the emergence of a wide range of approaches, making the newcomers confused. In order to address this, a comprehensive overview of the field with the indications of research gaps, tendencies and trends will be helpful. As a result, a systematic protocol was outlined to conduct a scoping review within the field of computer-based health information tailoring. METHODS AND ANALYSIS: This protocol is based on the York's five-stage framework outlined by Arksey and O'Malley. A field-specific structure was defined as a basis for undertaking each stage. The structure comprised three main aspects: system design, information communication and evaluation. Five leading databases were searched: PubMed, Scopus, Science Direct, EBSCO and IEEE and a broad search strategy was used with less strict inclusion criteria to cover the breadth of evidence. Theoretical frameworks were used to develop the data extraction form and a rigorous approach was introduced to identify the categories from data. Several explanatory-descriptive methods were considered to analyse the data, from which some were proposed to be employed for the first time in scoping studies. ETHICS AND DISSEMINATION: This study investigates the breadth and depth of existing literature on computer-tailoring and as a secondary analysis, does not require ethics approval. We anticipate that the results will identify research gaps and novel ideas for future studies and provide direction to combine methods from different disciplines. The research findings will be submitted for publication to relevant peer-reviewed journals and conferences targeting health promotion and patient education.

Design, Implementation, and Evaluation of Self-Describing Diabetes Medical Records: A Pilot Study.

BACKGROUND: Each patient's medical record consists of data specific to that patient and is therefore an appropriate source to adapt educational information content. OBJECTIVES: This study aimed to design and implement an information provision system based on the medical records of diabetic patients and to investigate the attitudes of users toward using this product. METHODS: The study was organized into three phases: need analysis, design and implementation, and final evaluation. The aim of the need analysis phase was to investigate the questioning behavior of the patient in the real-world context. The design and implementation phase consisted of four stages: determining the minimum dataset for diabetes medical records, collecting and validating content, designing and implementing a diabetes electronic medical record system, and data entry. Evaluating the final system was done based on the constructs of the technology acceptance model in the two dimensions of perceived usefulness and perceived ease of use. A semistructured interview was used for this purpose. RESULTS: Three main categories were extracted for the patient's perceived usefulness of the system: raising the self-awareness and knowledge of patients, improving their self-care, and improving doctor-patient interaction. Both patients and physicians perceived the personalized sense of information as a unique feature of the application and believed that this feature could have a positive effect on the patient's motivation for learning and using information in practice. Specialists believed that providing personal feedback on the patient's lab test results along with general explanations encourages the patients to read the content more precisely. Moreover, accessing medical records and helpful notes was a new and useful experience for the patients. CONCLUSIONS: One of the key perceived benefits of providing tailored information in the context of medical records was raising patient awareness and knowledge. The results obtained from field observations and interviews have shown that patients were ready to accept the system and had a positive attitude when it was put into practice. The findings related to user attitude can be used as a guideline to design the next phase of the research (ie, investigation of system effectiveness on patient outcomes).

The effect of social class on the amount of salt intake in patients with hypertension.

Reducing salt intake is a factor related to life style which can influence the prevention of blood pressure. This study was conducted to assess the impact of social class on the amount of salt intake in patients with hypertension in Iran. This was an observational on the intake of salt, as estimated by Kawasaki formula in a sample from Iranian population, stratified for social background characteristics. The finding in general was that the estimated salt intake was somewhat higher in subjects from a lower social background, while the opposite was true for lipid levels (LDL and HDL cholesterol). There was also a significant correlation between salt intake and the level of systolic blood pressure, but not the level of diastolic blood pressure. Considering high salt intake (almost double the standard amount in Iran), especially in patients with low-social class and the effects of salt on human health, it is suggested to design and perform suitable educational programs based on theories and models of health education in order to reduce salt intake.