Community readiness for collecting stray dogs in Aradan County: a quantitative-qualitative study.

BACKGROUND: Paying more attention to free-roaming dogs' population control seems to be necessary because of public health and environmental problems. The present study used the community readiness model to determine the readiness of Aradan County in terms of collecting stray dogs. METHODS: This study is a quantitative-qualitative research study conducted in Aradan County in Semnan Province of Iran. The semi-structured questionnaire uses the six dimensions of the Community Readiness Model as guideline, with 36 items used for the interview. The interviews lasted 45 to 100 minutes with 11 key members including the governor, prefect, mayor's assistant, city council chairman, key trustees, officials responsible for environmental health network, officials responsible for environmentalism of the city, and governors of a rural district. In quantitative part two, assessors read the interviews carefully and assigned scores based on the rating-scale form suggested by the guideline itself for scoring each dimension. A qualitative directed content analysis with deductive approach was used for analyzing the collected qualitative data. RESULTS: The study involved 11 key members of Aradan County, all of whom were male. Most of the participants were over 40 years old and with five years of work experience (73.6 %). The mean score of each six dimensions in Aradan County were: Community efforts (4.78), Community knowledge of efforts (4.28), Leadership (4.90), Community climate (4.38), Community knowledge about the issue (4.20) and Resources related to the issue (3.29) respectively. Community readiness in Aradan County and Aradan City was generally estimated to be in the preplanning stage, whereas vague public awareness was found in the rural areas. In the qualitative part, 870 initial open codes, 589 refund codes, 19 subcategories and 6 themes emerged, including (a) community efforts, (b) community knowledge of the efforts (c) leadership, (d) community climate, (e) community knowledge of the issue, and (f) resources related to the issue. CONCLUSIONS: For improving the process of collecting the stray dogs, it is necessary to focus on holding educational sessions for the public to increase their partnership and justify the responsible organizations' activities to collaborate and provide the necessary financial resources.

Intention to quit water pipe smoking among Iranian women: a qualitative directed content analysis.

BACKGROUND: Water-pipe smoking is the most common type of tobacco used among Iranian women. The aim of this study was to explain women's perceptions of their intention for quitting water-pipe smoking based on the theory of planned behavior. METHODS: The study was a qualitative content analysis which was carried out over 4 months in 2016 in Tehran-Iran. The participants were 26 women ages 18 to 45-years-old who smoked water-pipe and were selected through snowball sampling. The study was performed in hookah cafes, parks, and homes. The data were collected through individual interviews. The interviews were open-ended questions based on the theory of planned behavior. Directed content analysis was used to analyze the data. RESULTS: Findings showed that women did not intend to quit water-pipe in that time. Main contributing factors influencing not having intention of cessation were positive attitude and false beliefs toward hookah smoking, as well as having peers and family members who smoked water-pipe or approved its use. Although most females realized the obstacles associated with hookah cessation, they believed that quitting water-pipe smoking was up to them and could control more barriers. CONCLUSION: Social pressure, positive attitude and false beliefs towards hookah smoking, as well as external and internal obstacles diminished women 's intention for cessation. Therefore, it is recommended to apply the theory of planned behavior into behavior change interventions in order to increase the intention to quit water-pipe smoking.

Factors Associated with Tobacco Use among Iranian Adolescents: An Application of Protection Motivation Theory.

BACKGROUND: Tobacco use is a significant predisposing factor to many diseases. Protection motivation theory is a well-suited theory, since fear can motivate individuals to change their unhealthy behaviors. OBJECTIVE: This study was conducted to examine the associations between the constructs of this theory with intention and tobacco use behavior. METHOD: The present cross-sectional study was conducted in Noshahr, Iran. The participants were 440 high school boys selected using a stratified random sampling in 2016. A questionnaire about tobacco use based on protection motivation theory was developed and its validity and reliability were assessed. The questionnaire included the demographic information, the constructs of theory, and tobacco use behavior. Structural equation modeling was used to test the associations between the constructs with intention and tobacco use. RESULTS: The variables of perceived vulnerability (ß = 0/137, P < 0.001), fear (ß = 0/149, P < 0.001), self-efficacy (ß = 0/249, P < 0.001), perceived intrinsic reward (ß = -0.285, P < 0.001), threat appraisal (ß = -0.25, P < 0.001), and coping appraisal (ß = 0.358, P < 0.001) had direct effect and are significant with intention. Moreover, perceived vulnerability (ß = -0.158, P < 0.001), fear (ß = -0.172, P < 0.001), self-efficacy (ß = -0.288, P < 0.001), perceived intrinsic reward (ß = 0.329, P < 0.001), threat appraisal (ß = 0.265, P < 0.001), and coping appraisal (ß = -0.379, P < 0.001) affected tobacco use indirectly through intention and were significantly associated with behavior. Also, intention had direct effect and is significant with tobacco use (ß = -1.156, P < 0.001). CONCLUSIONS: The protection motivation theory provides a useful framework for investigating factors of tobacco use among male students. Future tobacco prevention interventions should focus on increasing the vulnerability and fear, decreasing intrinsic reward, and improving self-efficacy to reduce tobacco use.

Health promoting hospitals in Iran: Persian translation, cultural adaptation, content and face validation of selfassessment form of the standards of health promoting hospitals affiliated to the World Health Organization.

Background: According to the World Health Organization, hospitals should assess their internal wards to improve health promotion services using self-assessment tools. To achieve this goal, standards of health promoting hospitals have been developed by the World Health Organization, and measurable elements and indicators have been defined to facilitate the practical application of these standards in planning, implementation, and evaluation of health promotion in hospitals. Moreover, a form has been developed for this self-assessment. Considering linguistic and cultural differences in various countries, standards must be written in equivalent texts and, then, their content and face validity should be examined. Performing this process in a systemic and scientific way can guarantee that the same tools have been used, and thus the results obtained from different hospitals are comparable. Methods: After the preparation phase (considering research aim, obtaining permission from the original designers, and determining the time), the following activities were done: translating the form from its original language to the target language, combining and compiling initial translations to a single translation, reversing the final version of the translation from the target language to the original language, obtaining cognitive information, revising and concluding, and determining the content and face validity of the translated form and final report. After filling in the form, face validity was calculated using impact score formula. Content validity was measured using content validity ratio (CVR) and content validity index (CVI). Results: After calculating the impact score, all 40 items showed a high impact score greater than 1.5, representing the fact that all items are important. The minimum value of CVR for each of the 40 items was estimated to be 0.64; CVI of all items was greater than 0.79. Conclusion: Given the input of the standards of health promoting hospitals affiliated to the World Health Organization in National Accreditation of Iranian hospitals, the form was translated and found to be valid according to content and face validity and is available in Persian to be used in Iranian hospitals (Appendix 1).

The effect of maternal employment on the elementary and junior high school students' mental health in Maku.

BACKGROUND & OBJECTIVE: Most experts view the childhood period as a foundation for shaping the individuals' fundamental future characteristics and behaviors. They believe that parents' personality and behavior quality exert a greater effect on the development of a child's personality than other factors. Given the mothers' role in children's mental health and considering the fact that children are a nation's future makers, the present study was designed to investigate the impact of maternal employment on students' mental health in Maku. MATERIALS & METHODS: The present study is descriptive and cross-sectional, and the population of the study encompasses all students in the fifth, sixth, and seventh grades (n=583) who are studying in 2013-2014 academic year in Maku. General Heath Questionnaire was employed for gathering data, and the SPSS software was used for analyzing the data. FINDINGS: The results of the study indicated that there was a significant difference between the mental health problems, somatic problems, social functioning, anxiety, and depression of the students with employed and non-employed mothers. In other words, the students with non-working mothers experienced greater mental disorders than those with working mothers. CONCLUSION: According to the findings of this study, it can be concluded that children with working mothers showed a better mental health than non-working mothers' children.

Behavioral determinants of cardiovascular diseases risk factors: A qualitative directed content analysis.

BACKGROUND: The PRECEDE model is a useful tool for planers to assess health problems, the behavioral and environmental causes of the problems, and their determinants. This study aims to understand the experiences of patients and health care providers about the behavioral causes of cardiovascular diseases (CVDs) risk factors and their determinants. METHODS: This qualitative study utilized content analysis approach based on the PRECEDE model. The study was conducted for over 6 months in 2012 at the diabetes units of health centers associated with Alborz University of Medical Sciences, which is located in Karaj, Iran. Data were collected using individual semi-structured interviews with 50 patients and 12 health care providers. Data analysis was performed simultaneously with data collection using the content analysis directed method. RESULTS: Stress, unhealthy eating, and physical inactivity were the behaviors, which predict the risk factors for CVD. Most of the patients considered stress as the most important underlying cause of their illness. In this study, 110 of the primary codes were categorized into seven subcategories, including knowledge, attitude, perceived susceptibility, severity, perceived benefits, barriers, and self-efficacy, which were located in the predisposing category of the PRECEDE model. Among these determinants, perceived barriers and self-efficacy for the mentioned behaviors seemed to be of great importance. CONCLUSION: Identifying behavioral determinants will help the planners design future programs and select the most appropriate methods and applications to address these determinants in order to reduce risky behaviors.

Environmental determinants of cardiovascular diseases risk factors: a qualitative directed content analysis.

BACKGROUND: Cardiovascular diseases (CVDs) are the number one cause of death in the world. In most analyses of health problems, environment plays a significant and modifiable role in causing the problem either directly or indirectly through behavior. OBJECTIVES: This study aims to understand the patients and healthcare providers' experiences about the environmental determinants of CVD risk factors based on the Precede Model. PATIENTS AND METHODS: This qualitative study conducted over six months in 2012 at Diabetes Units of Health Centers associated with Alborz University of Medical Sciences and Health Services which is located in Karaj, Iran. The data were collected based on individual semi-structured interviews with 50 patients and 12 healthcare providers. Data analysis was performed simultaneous with data collection using the content analysis directed method. RESULTS: Lack of behaviors like stress control, healthy eating and physical activity were the roots of the risk factors for CVD. The environmental factor is one of the barriers for conducting these behaviors. The environmental barriers included of structural environment including "availability and accessibility of health resources", "new skills", and "law and policies" which are located in enabling category and social environment including "social support", "motivation to comply" and "consequences of behavior" which are located in reinforcing category. The most barriers to performing health behaviors were often structural. CONCLUSIONS: The environmental factors were barriers for doing healthy behaviors. These factors need to be considered to design health promotion interventions. Policymakers should not only focus on patients' education but also should provide specific facilities to enhance economic, social and cultural status.

The effects of an educational program based on PRECEDE model on depression levels in patients with coronary artery bypass grafting.

BACKGROUND: Depression is among the most important barriers to proper treatment ofcardiac patients. It causes failure in accepting their conditions, decreases their motivation infollowing the therapeutic recommendations, and thus negatively affects their functionality andquality of life. The present study aimed to investigate the effects of an educational programbased on Predisposing, Reinforcing, Enabling Constructs in Educational Diagnosis andEvaluation (PRECEDE) model on depression level in coronary artery bypass grafting (CABG)surgery patients. METHODS: This was a quasi-experimental study in which 54 post-bypass surgery patients ofIsfahan Cardiovascular Research Center were investigated. The patients were randomly dividedinto two groups of intervention and control. The data was collected using two questionnaires.Primarily, the cardiac depression scale was used to measure the degree of depression followedby PRECEDE model-based educational questionnaire to identify the role of the educationalintervention on patients. The PRECEDE model-based intervention composed of 9 educationalsessions per week (60-90 minutes each). The patients were followed up for two months postintervention. RESULTS: Following the educational intervention, mean scores of predisposing, enabling,and reinforcing factors, and self-helping behaviors significantly increased in the interventiongroup compared to the control group (P < 0.001). In addition, a significant difference in meanscores of depression was observed between the two groups following the educationalintervention (P < 0.001). CONCLUSION: The findings of the current study confirmed the practicability and effectivenessof the PRECEDE model-based educational programs on preventing or decreasing depressionlevels in CABG patients.