Experiences of patient education among people affected by cardiovascular disease: a qualitative study based on Andragogy model.

BACKGROUND: Patient education is a key component of patient care, positively affecting health promotion and self-care ability. In this regard, an extensive body of research supports the use of the andragogy model in patient education. The study aimed to explore the experiences of people with cardiovascular disease in patient education. METHODS: This qualitative study involved 30 adult patients with cardiovascular disease who were hospitalized or had a history of hospitalization. They were purposively recruited with maximum variation from two large hospitals in Tehran, Iran. Data were gathered by conducting semi-structured interviews. Data collection was done by conducting semi-structured interviews. Then, the data were analyzed using directed content analysis and a preliminary framework based on six constructs of the andragogy model. RESULTS: Data analysis resulted in the development of 850 primary codes, which were reduced to 660 during data reduction. These codes were grouped into nineteen subcategories under the six primary constructs of the andragogy model, i.e., need-to-know, self-concept, prior experience, readiness for learning, orientation to learning, and motivation for learning. The most common problems in patient education were associated with self-concept, previous experience, and readiness for learning components. CONCLUSION: This study provides valuable information about the problems of patient education for adults with cardiovascular disease. Correction of the issues identified can improve care quality and patient outcomes.

The Role of the Health Belief Model in Explaining Why Symptomatic Iranian Women Hesitate to Seek Early Screening for Breast Cancer: a Qualitative Study.

Early detection of breast cancer (BC) is important to increase the likelihood of treatment and improve the quality of life and survival. The study explored why symptomatic women linger to seek early screening for BC diagnosis based on the health belief model (HBM). In this qualitative study, 20 participants were selected using the purposive sampling method (9 health professionals and 11 female patients BC). Data were collected using in-depth, semi-structured interviews in 2019. Transcribed interview data were analyzed using the directed content analysis informed by HBM. According to the participants' experiences, although most patients comprehended the extent of the disease, they did not see themselves at risk of BC. Some were not adequately aware of the benefits of early diagnosis and did not have the self-efficacy required for early presentation. The main barriers to the early presentation included lack of awareness, financial problems, embarrassment over the clinical examination, and inadequate access to specialized centers. According to HBM, while designing and implementing educational programs, it is recommended to focus on reinforcing perceived susceptibility, perceived benefits, and perceived self-efficacy, providing access to facilities, and removing possible barriers and cultural issues to encourage women for timely referral for BC screening.

Investigating the relationship between satisfaction of basic psychological needs, general health, and some background variables in the Iranian older adults: a cross-sectional study.

BACKGROUND: Promoting the health and mental health (MH) of the older adults making up a large part of the world's population in the coming years can provide the necessary conditions for their health and well-being of them. This study aimed to investigate the relationship between the satisfaction of basic psychological needs (BPNs), general health (GH), and some variables in Iranian older adults. METHODS: The present descriptive-correlational study was conducted on 780 older adults from Sarpol-e Zahab (Kermanshah) in 2019 including the study by multi-stage cluster random sampling. The data collection tool was BPNs satisfaction and GH questionnaire and a researcher-made questionnaire of individual and background information. Was used for data analysis using the SPSS version 16 program and descriptive statistics and tests Pearson correlation coefficient, chi-square test, independent-sample T-test, and multivariate linear regression. RESULTS: In the present study, participating a total of 780 older adult men aged 73.0 ± 29.32 years. There was a significant relationship between the satisfaction of BPNs and GH (p <  0.001). Also, 41% of the older adults were in poor GH and 30% were high in BPNs. Multiple logistic regression showed that the BPNs, age, income satisfaction, weather, and war zone were strong predictors of GH. the adjusted R2 value of 0.55 shows that the model described 55% of changes in the GH score. CONCLUSION: According to the findings of the study on the relationship between the satisfaction of BPNs and GH, providing insurance, social and economic support by developing health policies, creating supportive health environments, strengthening community action, and developing individual skills in the older adults can help improve their MH and that of the community.

Educational and ecological assessment for unintentional injuries among children under 7 years: directed qualitative research based on PRECEDE-PROCEED model.

BACKGROUND: Child injury is not seen as a new issue in medical science and public health; however, for years it has been either generally brushed aside or been conspicuously absent from the world health agenda. This study aims at investigating the factors leading to house injuries and attempts to highlight mothers' pivotal role to provide a safe place for children at home. METHODS: A qualitative research method was used. There were 29 interviews in total: 12 interviews with mothers, 9 with cure and prevention specialists and 8 with researchers. The data were gathered through semistructured interviews conducted in participants' workplaces namely universities, research centres, health centres and in some cases through telephone in 3 months from February 2021 to May 2021 in Tehran, Iran. The participants were selected through non-probability and purposive sampling. All of the recorded interviews and notes were accurately evaluated and data analysis was performed based on the content analysis. RESULTS: In this study, 29 participants' views were examined: 12 mothers (41.37%), 8 researchers (27.5%) and 9 treatment and prevention experts (31%). After the analysis of the interviews, 96 codes, 14 subcategories and 3 main categories were extracted. The main categories included the predisposing factors, reinforcing factors and enabling factors. The subcategories included perceived sensitivity, perceived susceptibility, health control centre, perceived benefits, observational or peripheral learning, social support, family support, abstract norms, valuing children's health, background factors, skills, rules and regulations, child's character traits and self-efficacy to overcome barriers. CONCLUSION: House injuries among children are a complicated and multifaceted issue that requires a comprehensive investigation to determine the contributing factors.

Effect of training based on health belief model and behavioral intention on improving dental and oral self-care behavior in 9-12-year-old Iranian female students.

BACKGROUND: Training dental and oral health behaviors by using appropriate training models and theories is an important issue in preventing dental and oral diseases. the present study aimed to investigate the effect of training based on the health belief model and behavioral intention on dental and oral health behaviors in female students aged 9-12 years old in the city of Rudsar, Guilan, Iran. METHODS: This research is an interventional study conducted on 84 female students aged 9-12 years old, who lived in the city of Rudsar (n = 42 in the control group and n = 42 in the interventional group) in 2019. The data collection tools included questions on demographic variables, structures of the health belief model (perceived sensitivity, perceived severity, perceived barriers and benefits, self-efficiency), behavioral intention, and performance. The questionnaire was completed before the intervention and 3 months after it by both groups. The intervention group received four 45-min sessions. The data were analyzed using SPSS 24, descriptive tests, independent sample t-test, pair sample t-test, and regression (P < 0.05). RESULTS: The mean age of the intervention and control groups was 10.88 ± 1.01 and 10.80 ± 1.01, respectively. The results showed that the average scores of all structures of the health belief model and behavioral intention in the intervention group significantly changed compared to the average scores obtained before the intervention (P < 0.05). Moreover, the average scores of perceived sensitivity (p < 0.009), perceived barriers (p < 0.007), self-efficiency (p < 0.001), and behavioral intention (p < 0.001) significantly changed after the intervention in both groups (p < 0.05). CONCLUSION: According to the results, the health belief model and the behavioral intention were effective in improving dental and oral health so that they can be applied to improving people's dental and oral health. It can also be used as a model to design, implement, and monitor medical health programs.

Design and psychometric properties of a questionnaire to assess gender sensitivity of perinatal care services: a sequential exploratory study.

BACKGROUND: Providing gender sensitive reproductive health service is recently emphasized by health organizations. This study aims to develop and assess psychometric properties of a questionnaire to assess gender sensitivity of perinatal care services (GS-PNCS) to be used by managers of perinatal services. METHODS: This study is a mixed sequential (Qualitative-Quantitative) exploratory study. In the qualitative phase, 34 participants were interviewed and the items were generated. To evaluate the validity; face, content and construct validity were assessed. The reliability was assessed by internal consistency and stability calculation. RESULTS: The content validity and reliability were demonstrated by S-CVR = 0.92 and S-CVI = 0.98, Cronbach's α = 0.880 and the ICC = 0.980 to 0.947. Exploratory factor analysis showed 8 factors which explained more than 52.53% of the variance. CONCLUSION: GS-PNCS is a valid and reliable questionnaire, with 49 items to assess gender sensitivity of perinatal care services and helps health care managers and planners to improve the quality of the services.

Identifying dimensions of empowerment in patients with inflammatory bowel disease: a qualitative study.

The role of patients' empowerment in enhancing the quality of life of chronic patients is undeniable and its importance in health policy making and health care is increasing day by day. However, no guidelines have been defined to empower people with inflammatory bowel disease (IBD). The purpose of this study was to identify the dimensions of IBD patients' empowerment. Semi-structured interviews were conducted with 26 participants who were purposefully selected from 2 IBD clinics in Tehran and Shiraz cities to gain diversity in the clinical and demographic characteristics. The data were analyzed based on the Granheim and Landman's content analysis method. According to the result of this study, the empowerment of IBD patients is composed of five dimensions including self-care, psychological coping with disease, social interaction skills, disease-specific health literacy and self-evaluation. The participants' most emphasis was on self-care and psychological coping dimensions. These findings can be used as a basis for educational interventions toward IBD patients' empowerment. More researches are needed to explore factors affecting the empowerment processes of IBD patients.

Systematic review of the tools of oral and dental health literacy: assessment of conceptual dimensions and psychometric properties.

BACKGROUND: This article aims to provide a description of conceptual dimensions and psychometric properties of the tools of oral and dental health literacy. METHODS: Two authors in this study conducted electronic searches in the Medline (via PubMed), and Embase databases to find relevant articles from 1990 to present day. Evaluation of the tools was carried out in two parts; general evaluation of the tools using skills introduced by Sørensen et al., and qualitative assessment of psychometric properties using COSMIN checklist. RESULTS: After reviewing 1839 articles on oral and dental health literacy and evaluating 33 full text articles for eligibility, 21 articles entered the study. The sample size varied from 20 to 1405 subjects and the items of each tool ranged from 11 to 99 items. Of the 21 tools examined, 16 tools were evaluated for word recognition. For the studies examined, the evaluation of COSMIN scores was often fair or good. Of the 21 tools examined, 9 tools at least in one dimension were in the category of "poor", 19 tools were in the category of "fair", 20 tools were in the category of "good", and 4 tools were in the category of "excellent" in at least one dimension. CONCLUSION: The findings of this study showed that some aspects of oral and dental health literacy are being ignored in the existing tools. Therefore, the authors of present study emphasize on the necessity to design and develop a comprehensive tool and take into account two characteristics of simplicity and briefness for international use.

How far are we from full implementation of health promoting workplace concepts? A review of implementation tools and frameworks in workplace interventions.

INTRODUCTION: Health promoting workplace frameworks provide a holistic view on determinants of workplace health and the link between individuals, work and environment, however, the operationalization of these frameworks has not been very clear. This study provides a typology of the different understandings, frameworks/tools used in the workplace health promotion practice or research worldwide. It discusses the degree of their conformity with Ottawa Charter's spirit and the key actions expected to be implemented in health promoting settings such as workplaces. METHOD: A comprehensive online search was conducted utilizing relevant key words. The search also included official websites of related international, regional, and national organizations. After exclusion, 27 texts were analysed utilizing conventional content analyses. RESULTS: The results of the analysis were categorized as dimensions (level or main structure) of a healthy or health promoting workplaces and subcategorized characteristics/criteria of healthy/health promoting workplace. DISCUSSION AND CONCLUSION: Our analysis shows diversity and ambiguity in the workplace health literature regarding domains and characteristics of a healthy/health promoting workplace. This may have roots in lack of a common understanding of the concepts or different social and work environment context. Development of global or national health promoting workplace standards in a participatory process might be considered as a potential solution.

Determinants of fruit and vegetable consumption among Tehranian adolescents: A qualitative research.

BACKGROUND: For effectively promoting fruit and vegetable consumption among adolescents, it is necessary to identify the determinants of intake. This qualitative research was conducted to explore the determinants of fruit and vegetable consumption among Tehranian adolescents in 2012. MATERIALS AND METHODS: The present qualitative study is aimed at identifying the determinants of fruit and vegetable consumption among Tehranian adolescents in 2012. Male and female students in the middle schools of Tehran, in the age range of 11-14 years, were used as the study population, which was selected by the convenience method. Semi-structured interactional interviews were used for data collection. Data was analyzed using the qualitative content analysis method. RESULTS: The availability and accessibility of fruits and vegetables in home, availability of unhealthy options in the environment, socioeconomic status, advertising about unhealthy options, subjective norms, reinforcement, and modeling were explored as environmental factors in this study. Also, individual factors were extracted as the second category that encompassed the subcategories including; preferences, knowledge, skill in preparing fruits and vegetables, outcome expectations, outcome expectancy, perceived susceptibility, and perceived seriousness. CONCLUSION: It is recommended that interventions have family-based designs as well as environmental policy-based (especially schools) ones. Meanwhile, families should be educated to adapt their children's sapour with tastes of fruits and vegetables during their childhood.

Physical Activity Promotion in Schools Using Theoretically Designed Mobile Phone Application.

Background: Regular physical activity for adolescents has many health benefits, many of which also affect adulthood. Physical activity is a behavior that requires planning and choosing an appropriate educational method, model, or theory. However, mobile phone applications are known as a suitable method to increase physical activity according to the guidelines. This study aims to increase physical activity in female students based on the theory of planned behavior using mobile phone applications. Methods: This quasi-experimental study was implemented on 220 high school students (110 people in each group). The samples were selected by a multi-stage cluster method and their information was collected by the International Physical Activity Questionnaire (IPAQ) and the Theory of Planned Behavior (TPB) questionnaire whose validity and reliability were confirmed. The intervention group received 8 sessions of education through a mobile phone application that was designed by the constructs of the theory of planned behavior. The samples were evaluated in three stages, through a pre-test, post-test, and two-month follow-up. Results: The results showed a significant difference in the post-test and two months after the intervention between intervention and control groups in terms of attitude, perceived behavioral control, intention, and physical activity. There was a significant difference between intervention and control groups in subjective norms in the post-test, but there was no significant difference in the two-month follow-up compared to the post-test (P = 0.08). Conclusions: An educational intervention based on the theory of planned behavior using mobile phone applications led to an increase in the physical activity of girl high school students. However, to determine the full effectiveness of this study, it is recommended to implement this intervention in all schools.

Accelerators/decelerators of achieving universal access to sexual and reproductive health services: a case study of Iranian health system.

BACKGROUND: At the 1994 International Conference on Population and Development (ICPD), held in Cairo, the global community agreed to the goal of achieving universal access to sexual and reproductive health (SRH) and rights by 2015. This research explores the accelerators and decelerators of achieving universal access to the sexual and reproductive health targets and accordingly makes some suggestions. METHOD: We have critically reviewed the latest national reports and extracted the background data on each SRH indicator. The key stakeholders, both national and international, were visited and interviewed at two sites. A total of 55 in-depth interviews were conducted with religious leaders, policy-makers, senior managers, senior academics, and health care managers. Six focus-group discussions were also held among health care providers. The study was qualitative in nature. RESULTS: Obstacles on the road to achieving universal access to SRH can be viewed from two perspectives. One gap exists between current achievements and the targets. The other gap arises due to age, marital status, and residency status. The most recently observed trends in the indicators of the universal access to SRH shows that the achievements in the "unmet need for family planning" have been poor. Unmet need for family planning could directly be translated to unwanted pregnancies and unwanted childbirths; the former calls for sexual education to underserved people, including adolescents; and the latter calls for access to safe abortion. Local religious leaders have not actively attended international goal-setting programs. Therefore, they usually do not presume a positive attitude towards these goals. Such negative attitudes seem to be the most important factors hindering the progress towards universal access to SRH. Lack of international donors to fund for SRH programs is also another barrier. In national levels both state and the society are interactively playing their roles. We have used a cascade model for presenting the barriers at the state levels from the strategic planning to implementation. Social factors are to be considered as a background for other factors at all stages. CONCLUSION: Accelerating universal access to SRH requires adequate funding, firm political commitment, creative programming, and the involvement of diverse actors, including faith-based, civil society, and private sector partners.

Assessing the method of providing health services to at-risk groups during natural events (earthquake): A systematic review.

Disasters create a large amount of human needs. Health services in natural disasters are considered the main factor of human survival. The present study was conducted to determine the method of providing health services to at-risk groups during natural events such as earthquakes in 2022. This systematic review was conducted based on English and Persian studies published in Web of Science, Google Scholar, Scopus, Science Direct, and PubMed databases, as well as internal databases including SID, Magiran in the fields of title, abstract, and keywords such as natural disaster, earthquake, health services, mental health services, psychosocial support system, nursing services, relief, mental and physical health, and its MeSH equivalents with all of the possible combinations. Finally, 11 studies were identified as eligible among the 48 ones found in the initial search. To examine the quality of studies, the Joanna Briggs Institute (JBI) and STROBE evaluation checklists were used. Based on the results, 1834 studies were found after screening and investigating the inclusion criteria, among which 237 and 1549 were excluded due to repetition and unrelated titles, respectively. Then, 48 studies remained after reviewing their abstracts, resulting in including 11 in English (N = 10) and Persian (N = 1) from different countries during 2003-2020. The reviewed studies included semi-experimental and experimental (N = 5) and descriptive ones (N = 6). A large number of studies (N = 21) were related to providing services in the event of multiple disasters and were excluded. About 92% (N = 10) of the studies were conducted in English and more than 90% were related to providing services after the earthquake including providing mental health services (N = 6), the cognitive behavioral intervention (N = 3), rapid assessment of needs (N = 1), as well as mental health services and disaster education (N = 1). The vast majority of studies demonstrated improvement in psychosocial functioning, facilitation of children's normal development, and successful adaptive functioning with an intervention. Based on the results, mental health training affects more when local people are trained to assess the victims based on mental and psychological status. Earthquake is regarded as an opportunity that allows professionals to discover and introduce intervention combination modules to provide mental health services while helping victims who need emotional support and comfort. However, various types of services should be provided, especially in earthquake-prone areas before and after the earthquake in order to achieve a life with fewer complications and a higher quality considering the amount of trouble created by such disaster as a special condition.

Behavioural and environmental risk factors for household injuries: semistructured interviews with health professionals and mothers in Iran.

BACKGROUND: Injuries are increasing global public health problems, causing disability and death among children. This has considerable financial, emotional and social effects on families and society. This study aimed to investigate the behavioural and environmental factors leading to unintentional home injuries and attempts to highlight the pivotal role of mothers' behaviour and performance to provide a safe place for children at home. METHODS: The current research is a qualitative study of a directed content analysis type. The data were gathered through semistructured interviews conducted in participants' workplaces, namely universities, research centres and health centres. In some cases, telephone interviews were conducted within 3 months, from February 2021 to May 2021 in Tehran, Iran. The participants were selected through non-probability and purposive sampling. All the recorded interviews and notes were accurately evaluated, and data analysis was performed based on the content analysis. There were 29 interviews in total: 12 interviews with mothers, 9 with treatment and prevention specialists, and 8 with researchers. RESULTS: A total of 66 factors, 6 subcategories and 2 main categories were extracted after analysing the interviews. The main categories included environmental and behavioural factors. The subcategories included house infrastructure, house equipment/furniture, children's equipment/furniture, provision of precarious conditions, access to hazardous substances and appliances, and unsafe arrangement of furniture. CONCLUSION: Despite the existing obstacles such as the long-term implementation, financial difficulties and overcomplicated policy-making process, health interventions can make it possible for mothers of children under the age of seven to adopt preventive measures through appropriately designed instructions and optimal use of existing facilities.

Hospital health literacy conceptual explanation: A qualitative content analysis based on experts and population perspectives.

BACKGROUND AND AIM: Given the complexities of the health care system and the importance of the subject and effects of health literacy in all aspects of care, defining specific health literacy in this context seems necessary. The purpose of this research was to explain the concept of hospital health literacy (HHL), its definition, and the related dimensions using the qualitative research method. MATERIALS AND METHODS: An exploratory qualitative design was used. Exploratory, open-ended, and face-to-face interviews based on the interview guide were used to elicit participants' perspectives between July 2021 and January 2022. By using the content analysis method, researchers coded transcripts and collated these codes into sub-categories and then merged them into the main category and explored the dimensions of the concept. RESULTS: A total of 23 service providers and 25 service recipients were included in the study. Analysis of qualitative data led to the identification of 6 categories and 25 sub-categories including cognitive literacy, functional (basic) literacy, communicative literacy, behavioral literacy, media literacy, and emotional literacy. CONCLUSION: The findings of the present study provide a deep understanding of the concept of HHL that could be applied to develop valid and reliable measurement tools for assessing HHL among a variety of populations. Also, it is hoped that the present attempt can be useful to guide future research and interventions as well as to provide a clear base for planning, implementing, and evaluating interventions aimed at promoting individuals' health literacy in health settings.

Developing and validating an instrument to assess women's empowerment in dealing with domestic violence in Iran: a mixed-methods study protocol.

INTRODUCTION: Despite the emphasis on empowerment in interventions supporting women against domestic violence and ending spousal abuse, there is still no standard and accurate instrument to evaluate women's empowerment in this field. This study proposes a protocol to fill this gap by developing and psychometrically testing a standardised instrument for assessing women's empowerment in dealing with domestic violence (WEDDV). METHODS AND ANALYSIS: This study will be conducted in Iran in a mixed method with a sequential exploratory design (qualitative-quantitative). In the first phase, qualitative methods will be used to generate items, rank and identify essential items for WEDDV conceptualisation. The data collection method in this phase includes semistructured face-to-face interviews with married women, a review of related literature, and a fuzzy Delphi method with participants with work experience and expertise about violence against women. Qualitative data analysis will be done using a content analysis strategy and MAXQDA 2020 software. In the second phase of the study, the psychometric properties of the instrument, including face, content and construct validity, and the instrument's reliability will be evaluated. Also, the psychometric features of the COSMIN checklist will be used in the design of this instrument. ETHICS AND DISSEMINATION: This study protocol has been approved by the Research Ethics Committee of Shahid Beheshti University of Medical Sciences with code (IR.SBMU.PHNS.REC.1400.011). The findings will be published in prestigious journals and presented at national and international conferences. We hope that these results can provide a practical framework for planning and organising domestic violence interventions for policy-makers, researchers and women's health and counselling service providers.

WHO-PEN intervention in Iran's health system based on 5As healthy lifestyle counseling model: A randomized-clinical trial.

BACKGROUND: Skill Training Intervention Based on the Healthy Lifestyle Counselling Module (5As model) in the Ira PEN Program. MATERIALS AND METHODS: This study was a randomized controlled trial in Iran. Participants were 184 health workers and 184 clients (92 in each study group). The training program entailed an online training course, educational video, and clip. The behavior related to a healthy lifestyle in clients was also followed-up 2 months later. Data were analyzed using SPSS 22 software. RESULTS: Based on the observations, significant improvement in lifestyle counseling skills among health workers in the intervention group compared to the control group in terms of healthy nutrition (P < 0.001), physical activity (P < 0.001), smoking cessation (P = 0.03), and withdrawal of alcohol consumption (P < 0.001) was observed. Also, lifestyle-related behaviors among clients in terms of healthy nutrition (P < 0.001), physical activity (P < 0.001), and withdrawal smoking (P < 0.001) increased significantly. Furthermore, waist circumference (P < 0.024) and BMI (P < 0.001) among clients were significantly reduced. CONCLUSION: The training program for health personnel in healthy lifestyle has a more effective role in changing people's behavior and prevention of noncommunicable risk factors. Healthy life style counselling in primary health cares may lead to control risk factors for Noncommunicable disease.

Adolescents diabetes awareness test (ADAT): Tool development and psychometrics evaluation research.

BACKGROUND: During the last two decades, several reports have indicated an increase in the number of type-2 diabetes among adolescents. Therefore, an assessment of adolescents' awareness of this disease deserves serious consideration. This study aims at designing a psychometric tool for assessing adolescents' awareness of type-2 diabetes. METHODS AND MATERIAL: In this methodological research, 770 students attending 10 middle schools (five girls "schools and five boys" schools) from Tehran participated in the study. The questionnaire was designed by examining the relevant literature and the existing questionnaires, as well as considering the research team's comments, and the initial pool of items with 57 questions was designed. Face validity, content validity, and construct validity were calculated to determine the validity of the instrument. Reliability was measured via internal consistency coefficient (ICC) and internal consistency reliability was measured with Cronbach Alpha. SPSS 16 was used for data analysis. RESULTS: The questionnaire was initially designed with 57 items. Based on the results of CVR and CVI, five questions were removed. The average CVR and CVI were 0.75 and 0.82, respectively. Following exploratory factor analysis, the 30 questions in the questionnaire were categorized into five dimensions: public awareness, symptoms, behavioral risk factors, long-term effects, and medium-term effects. The internal reliability was calculated for the whole questionnaire-ICC = 0.87 with a Cronbach alpha coefficient of 0.80. CONCLUSIONS: The resulting questionnaire on adolescents' awareness of type-2 diabetes, with 30 questions in five dimensions, can be employed by researchers for its high factor loading in factor analysis and its standard psychometric properties.

The effect of education based on health belief model on hand hygiene behavior in the staff of Tehran dentistry centers: A quasi-experimental intervention study.

Background and Aims: Considering the increasing prevalence of dental services in the community and the impossibility of identifying each infected patient, hand sanitation is the most critical factor in controlling infection in these centers. Therefore, this study aimed to determine the effect of educational intervention on the hand health behavior of the staff of Tehran dentistry clinics based on the health belief model (HBM). Methods: In this quasi-experimental study in 2017, 128 employees of the health centers were selected through a multistage sampling method and they were placed in two groups of intervention and control (each 64 people). The data was collected using a questionnaire devised by the researcher. The validity and reliability of the questionnaire were determined. The questionnaire consisted of demographics, knowledge, structures of the HBM, and behavior variables. Then, the intervention was administered based on HBM-based education. Data were analyzed by SPSS16 and independent t test, χ 2, and repeated measurement analysis of variance. Results: Before the intervention, the two intervention and control groups did not differ significantly in terms of demographic variables, mean scores of knowledge, constructs of HBM, and hand hygiene behavior (p > 0.05), while the intervention group was scored higher significantly compared to the control one after the intervention (p < 0.001). Conclusion: According to the findings, the HBM can be used as a framework for designing educational interventions to improve hand hygiene behavior to control infection in health centers.

A study of growth failure and its related factors in children from 0 to 2 years in Tehran, Iran.

In this study, we aimed to estimate the prevalence of growth failure and identify the risk factors for this health problem in infants under two years old in Tehran, Iran. Using a cluster sampling method, 2182 infants' health files were randomly selected from eight health centers in Tehran. Growth failure was defined as a decrease in a child's weight (minimum 50 grams) at each attendance compared to the previous evaluation. The prevalence rate was between 0.05% and 6.2% at the different measurements. The regression analysis revealed that the presence of diarrhea [odds ratio (OR): 4.01, 95% confidence interval (CI): (3.50, 4.60)], respiratory infections [OR: 4.95, 95% CI: (4.40, 5.57)] and urinary tract infections [OR: 6.35, 95%CI: (3.97, 10.18)], as well as discontinuation of breast-feeding [OR: 10.91, 95%CI: (7.82, 15.23)], teething [OR: 4.14, 95% CI: (3.61, 4.75)] and complementary feeding [OR: 9.58, 95% CI: (6.48, 14.18)] were the significant risk factors for growth failure. Generally, our study showed a high prevalence of growth failure in infants less than two years in Tehran. More efforts are needed for promoting the knowledge level of mothers and healthcare providers to control this health problem in Iran.