The efficacy of theory driven treatment adherence promotion program among type 2 diabetic patients: application of intervention mapping and mHealth.

Background: Mobile health interventions (mHealth) may improve health-related lifestyle behaviors and disease management. Successful management of diabetes is patient-centered responsibility. The aim of this research was to determine the efficacy of the theory driven program of promoting treatment adherence in type 2 diabetes (T2DM) patients based on mHealth. Methods: This quasi-experimental research was conducted on 70 T2DM patients in Tehran, Iran. Participants were randomly divided into intervention (n = 35) or control (n = 35) groups. The data collection tool was a questionnaire based on some of constructs Social Cognitive Theory (SCT) which elicit from formative evaluation. The SCT theory-based intervention program was developed, implemented, and evaluated based on Intervention Mapping (IM) as a framework in 8 sessions using online WhatsApp application. The data was collected through by online interviews before and one month after the implementation of the program and analyzed in SPSS version 16. Results: After the implementation of the program, a significant increase in self-efficacy (P = 0.009), outcome expectations (P < 0.001), and also diabetes treatment adherence behaviors (P = 0.024) were indicated in the intervention group. The estimated effect sizes for self-efficacy, outcome expectations, social support, and diabetes treatment adherence behaviors were 0.78, 0.06, 0.07, and 0.62, respectively. Conclusion: Estimated effect size of the implemented intervention was evaluated as "large" effect for diabetes treatment adherence behaviors. Findings indicated the usefulness and efficacy of the mHealth educational program based on SCT constructs and the IM approach in treatment adherence behaviors promotion among T2DM patients in Iran. Supplementary Information: The online version contains supplementary material available at 10.1007/s40200-023-01291-5.

Socio-Economic Status and Clinical Breast Examination Screening Uptake: Findings from the First Cohort Study among Iranian Kurdish Women.

Clinical Breast Examination (CBE) is utilized as a screening modality in many low income countries without widespread mammography capability. The aim of the current study was to evaluate the impact of socio-economic status (SES) on CBE screening rates in Iranian Kurdish women. A cross-sectional study was conducted in the western region of Iran. A sample of 5,289 Iranian Kurdish women aged 35-65 years old was analyzed. Data were collected from July 2014 to September 2018. The Concentration Index-CI and Concentration Curve were used to estimate the socioeconomic inequalities in CBE rate. The analysis of data was done by STATA software (Version 14). 12.3% of the women had received CBE at least once. CBE rates in the 46-50 age group were higher than in other age groups (OR = 2.06; 95% CI = 1.56-2.71). Women with 6-9 years of education had higher odds ratio of receiving CBE (OR = 1.41; 95% CI = 1.02-1.94). Women living in rural areas were less likely to have received CBE compared to those living in urban areas (OR=0.54; 95% CI = 0.42-0.61). The overall concentration index for receipt of CBE was 0.188. In countries without widespread mammography programs, strategies for the promotion of CBE should focus on the lower SES population.
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Information Needs Assessment among Parents of Children with Cancer.

Background: Parents of children with leukemia should be receiving an extensive amount of information about the care of their child; the aim of this study was to determine the parents' information needs of children with leukemia. Methods: A cross-sectional study design was used to describe medical, physical, mental and lifestyle information needs among parents of children with leukemia. 209 parents of children diagnosed with leukemia in the west of Iran, during winter 2018, voluntarily participated in individual interviews. Data were analyzed by SPSS version 16 using t-test, One-way ANOVA and bivariate correlations statistical tests at 95% significant level. Results: The mean age of participants was 39.45 years [95% CI: 38.35, 40.55], ranged from 27 to 58 years. Participants achieved 55.6% score of information needs. There was a significant relationship between higher education level (P< 0.001), better economic status (P=0.008) and more family size member (P=0.003) with information needs. Conclusion: Findings suggest that parents of children with leukemia need the information to learn how to take care of their childhood and could be useful for guiding implementers to planning and implement effective programs to promotion information of parents towards children with cancer.

Locus of Control or Self-Esteem; Which One is the Best Predictor of Academic Achievement in Iranian College Students.

BACKGROUND: Self-esteem and behavioral consequences, which are due to external or internal locus of control, are effective on academic achievement of students. OBJECTIVES: The aim of this study was to determine the prediction of locus of control and self-esteem in academic achievement among the students. MATERIALS AND METHODS: This cross-sectional study was conducted on 300 college students in Kermanshah University of Medical Sciences in 2014. Data collection tools were in three sections: demographic, Rotter internal-external locus of control scale and Coopersmith self-esteem inventory. Data were analyzed using the SPSS software version 21. RESULTS: Results showed that 29.8% and 76.2% of the participants had internal locus of control, and high self-esteem, respectively. There was a significant correlation between self-esteem, locus of control and academic achievement of the students. Self-esteem accounted for 39.5% of the variation in academic achievement. CONCLUSIONS: It seems that interventions to increase self-esteem among student can help improve academic achievement among them.

Fitness Intention and Its Relationship With Eating Attitudes: A Cross-Sectional Study of Iranian Female Medical College Students.

BACKGROUND: Fitness is a very important goal among young adults that may lead to eating disorders. OBJECTIVES: The aim of this study was to identify the factors influencing fitness intention based on the theory of planned behavior (TPB) and its relationship to eating attitudes. MATERIALS AND METHODS: A cross-sectional study was conducted among 231 female college students during the winter of 2012. Participants were randomly selected in proportion to their distribution among the different faculties at Hamadan University of Medical Sciences. A structured questionnaire was applied for collecting data and data was analyzed by SPSS version 21 using a T-test, ANOVA, bivariate correlations, and linear regression at a 95% significant level. RESULTS: Nearly 21.6% of the participants had abnormal eating attitudes. The TPB variables accounted for 40% of the variation in fitness intention. Bivariate correlations indicated a positive correlation between fitness intention and eating attitude (r = 0.417, P < 0.05). CONCLUSIONS: Based on our results, it seems that designing and implementing educational programs to reduce positive attitudes and encourage subjective norms toward fitness may be useful for preventing abnormal eating attitudes.

Satisfaction of Iranian Medical Universities' faculty members towards holding Shahid Motahari Annual Educational Festival.

INTRODUCTION: Shahid Motahari Annual Educational Festival aims to improve the quality of medical education in the Islamic Republic of Iran, and has held since 2008. The present study was performed to determine the satisfaction level of Iranian medical universities' faculty members about holding Shahid Motahari Annual Educational Festival during the past six years, from 2008 to 2014. METHODS: This cross-sectional study was conducted on 473 faculty members (FMs) including deputies and educational administrators, managers, and faculty members of medical education development centers, members of scientific committees, and faculty members who participated in Shahid Motahari Festival from 42 medical sciences universities in Iran. Data collection instruments were two reliable and valid questionnaires on the background and also participants' satisfaction towards Shahid Motahari Educational Festival. Data were analyzed using SPSS Software, version 14. RESULTS: Among all participants, 30 FMs (6.3%) were educational deputies, 36 FMs (7.6%) managers of medical education development centers, 226 FMs (56.2%) members of scientific committees, 29 FMs (6.1%) members of the national committees, 343 FMs (27.5%) attendees, and 264 FMs (55.8%) had participated for retraining. The total satisfaction level of the participants was 73.3% which shows a good satisfaction level. CONCLUSION: The results identified the main important strength points such as "proposals' review process at the country level" and weakness points such as "organizing the festival".