Predictors of performing preventive behaviors against affliction with COVID-19 based on vaccination: An application of the health belief model.

BACKGROUND: Nowadays, the COVID-19 pandemic has become one of the greatest global threats to human communities. Presently, the most important solution to deal with this pandemic is to fully comply with health protocols along with general vaccination. Given the increased vaccination rate in the community and the change in the thought of some people in the field of durable immunity and changing health behaviors, the present study determined the predictors of preventive behaviors against affliction with COVID-19 in two vaccinated and non-vaccinated groups based on the health belief model in the Iranian population aged 15-65 years. MATERIALS AND METHODS: This descriptive-analytical study was conducted cross-sectionally in 2022. A sample size of 500 Yazdi citizens was selected using the convenience non-random sampling method using the contact numbers received from the SIB system of the Iranian health deputy. They were examined online in two vaccinated and unvaccinated groups. The instrument used was Delshad Noghabi et al.'s questionnaire which was based on the health belief model. Due to the adjustment of the questionnaire according to the target group, its validity and reliability were re-checked and confirmed. Data were analyzed with SPSS22 using descriptive and analytical statistics, t-test, and linear regression. RESULTS: Based on the findings of the study, a significant difference was observed between the three variables of income level (P = 0.019), smoking (P <0.001), and employment status (P = 0.025) in two vaccinated and unvaccinated groups at the level of preventive behaviors. Besides, the constructs of perceived sensitivity (P <0.001), perceived benefits (P <0.001), action guide (P <0.001), and self-efficacy (P = 0.018) significantly predict preventive behaviors, so that the predictive value of perceived benefits (ß =3.67) was more than other variables. CONCLUSION: To prevent diseases, it is very important to increase people's awareness and information (self-efficacy) about the use of vaccination and pay attention to individual demographic characteristics in vaccination programs. Also, perceived sensitivity, perceived benefits, action guidelines, and perceived self-efficacy can be considered as important factors in determining people's willingness to be vaccinated. Therefore, education and information programs should be focused on these factors to increase people's willingness to be vaccinated.

Prevalence of premature ovarian insufficiency (POI) and its relationship with female reproductive factors in Iranian women: a cross-sectional study from the Persian (Shahedieh) cohort data.

BACKGROUND: In premature ovarian insufficiency, the cessation of menstruation, and cessation of ovarian function occurs before the age of 40, and this phenomenon is associated with many complications and problems for women. Since several factors can affect this situation, this study was conducted to determine the relationship between fertility history, and premature ovarian failure. METHODS: This cross-sectional study was conducted on the data of the first phase of cohort study, which was a sample of 10,000 people from an Iranian adult population (age: 35-70 years). 1276 women were included who naturally experienced menopause from this population. They were separated into three groups based on the age of menopause: premature ovarian failure for those who reached menopause before the age of 40, early menopause for those who reached menopause between the ages of 40 and 45, and natural menopause for those who reached menopause at or after the age of 45. The demographic and fertility characteristics of two groups of women, one with premature ovarian failure and the other with early menopause, were compared with a group of women experiencing normal menopause. The comparison was based on frequency and percentage. Moreover, the odds ratio (OR) of these two groups compared to normal group was crudely calculated, and adjusted based on age at the time of the interview using a logistic regression model. SPSS 23 software was used to fit models and calculations. RESULTS: The prevalence of premature ovarian failure was 3%. The likelihood of premature ovarian failure decreases as the number of live births rises. The risk is considerably higher for births ranging from zero to three children compared to those with more than four. Increased duration of breastfeeding is associated to a reduced risk of premature ovarian failure compared to the spontaneous occurrence (OR = 0.98, 95% CI (0.97, 0.99)). This relationship is maintained even after adjusting for age (OR = 0.98, 95% CI (0.97, 0.99). CONCLUSION: Based on the results of present study, it can be concluded that the factor of the number of births, and the duration of breastfeeding affect reducing the occurrence of POI, therefore, in health and treatment programs and policies, encouragement to have children, which is now part of the policies population of Iran, and the importance, and benefits of breastfeeding for mother and baby should be emphasized more.

Impact of social and cultural factors on incidence, transmission and control of Coronavirus disease in Iran: a qualitative study.

INTRODUCTION: COVID-19 pandemic has had mixed reactions from nations, people and governments about ways to cope with, prevent and control the disease. The current study identifies social, cultural and policy factors affecting the incidence and control of Coronavirus disease in Iran. METHODS: A qualitative study consists of content analysis as well as the views of 20 experienced and knowledgeable subjects specialized in social and cultural health management. The data were gathered using three semi-structured interviews and then continued by 17 semi-structured interviews. Data analysis was done using Graneheim approach. After each interview, the recorded audio files transcript and reviewed. Then codes extracted and divided to categories and sub-categories. RESULTS: There are distinct social and cultural factors in coping with Coronavirus disease. These consisted of three categories of governance, individual and community related factors. A total of 17 subcategories and 215 primary codes that were extracted from the text of interviews as variables of the study and in relation to the research question. Ten subdomains of governance including vaccination, political issues, knowledge, support services, administrative services, transportation, health and treatment, culturalization, legislation and, managerial and financial policies impacted the spread and mitigation of the pandemic at various levels. CONCLUSION: The management of pandemics requires a comprehensive capacity for identifying and determining social and cultural criteria. A healthy partnership between governments and the community may be required to remove unnecessary obstacles that hinder public health attempt to alleviate the risk. The obtained criteria and indicators from this study may be utilized by policy makers in an attempt to strengthen protocols for mitigating pandemics. Further studies may be warranted to confirm these findings.

The effect of educational support intervention including peer groups for infant care on the growth rates of infants, breastfeeding self-efficacy and quality of life of their mothers in Iran: study protocol.

BACKGROUND: Mothers' knowledge about the infant's problems and will provide the necessary care can increase the mother's confidence in providing care for her infant and eliminate misconceptions in primiparous mothers. The present study will be conducted to evaluate the effect of educational support intervention including peer groups for infant care on the growth rates of infants, breastfeeding self-efficacy and quality of life of their mothers in Iran. METHODS: This quasi-experimental study is an educational support intervention protocol for infant care which will be conducted in two phases. The educational support program will be designed in the first phase. The program includes educational sessions on breastfeeding, growth and development of infants and care for children under 1 year of age in a virtual group where a physician, a nurse, a midwife and a healthcare provider are also present. Using the opinions of the experts, the peer group will discuss various points and the research team will finalize the program based on priorities. The second phase of the educational intervention will be conducted experimentally as a pretest-posttest design for the intervention and control groups. DISCUSSION: The present study will provide useful protocol about the effect of educational support intervention for infant care and the sharing of peer group experiences on infants' growth rates, breastfeeding self-efficacy, and quality of life of their mothers. The current educational package not only combines virtual education and peer experiences in strengthening the education of mothers, but also it can improve mothers' physical and mental health and reduce medical costs by using telephone follow-up in supporting of the mothers of infants. TRIAL REGISTRATION: Registration of this randomized control trial has been completed with the Iranian Registry of Clinical Trials, IRCT20210913052457N1, registered 9/10/2021, https://www.irct.ir/trial/59093 .

Mothers' knowledge about the infant's problems and provide the necessary care can increase the mother's confidence in providing care for her infant and eliminate misconceptions in primiparous mothers. This quasi-experimental study is an educational support intervention protocol for infant care that will be conducted in two phases. The educational support program will be designed in the first phase. The program includes educational sessions on breastfeeding, growth and development of infants and cares for children under one year of age in a virtual group where a physician, a nurse, a midwife and a healthcare provider are also present. Using the opinions of the experts, the peer group will discuss various points and the research team will finalize the program based on priorities. The second phase of the educational intervention will be conducted experimentally as a pretest­posttest design for the intervention and control groups. The present study will be conducted to evaluate the effect of educational support intervention including peer groups for infant care on the growth rates of infants, breastfeeding self-efficacy and quality of life of their mothers in Iran.

Predictors of regular physical activity behavior and quality of life in post-menopausal Iranian women based on the multi-theory model.

This research aims to identify the predictive factors related to the initiation and sustaining of regular physical activity behaviors and their influence in adapting to menopausal symptoms. The study uses the multi-theory model (MTM) as the conceptual framework. The descriptive cross-sectional research was conducted on 200 post-menopausal women aged 45-55 years. All participants were referred to health centers, where they completed a three-part questionnaire involving: demographic information, a questionnaire on the influence of regular physical activity on the onset and sustaining of menopause using the MTM, and a standard questionnaire of menopausal quality of life. Data were collected, managed, and analyzed using SPSS 20 and AMOS 23 software. This study reveals that behavioral confidence and changes in the physical environment with coefficients of 0.55 and 0.14 respectively had a direct and significant impact on the initiation of regular physical activity-related behaviors during menopause. The construct of participatory dialogue had no significant impact on the initiation of regular physical activity-related behaviors and menopause. Regarding the sustainability of regular physical activity, the emotional transformation construct with a coefficient of 0.73 and change in social environment construct with a coefficient of 0.11 directly and significantly impact keeping regular physical activity behaviors due to menopause. Therefore, interventions based on the MTM can prove very useful for this specific population. In addition, the use of constructs validated by this study will especially be useful in producing evidence-based intervention for the target population.

Effect of the fourth generation multi-theory model intervention on the quality of life in Iranian postmenopausal women: A randomized controlled trial.

OBJECTIVES: Menopause is a natural part of women's lives and is associated with a series of complications that can impair their quality of life. This study was conducted to determine the effect of specific educational interventions on the quality of life among postmenopausal women. METHODS: This randomized controlled trial was conducted on 80 menopausal women who met the inclusion and exclusion criteria and were selected through the multi-stage stratified random sampling method. The participants were randomly allocated to either the control or intervention group (40 per group). The intervention comprised 5 × 45-min educational sessions based on the Multi-Theory Model on the predetermined days of the week. The scores of the quality of life level were collected at baseline, immediately, and 3 months after the intervention using the Menopause-Specific Quality of Life questionnaire (MENQOL). The control group received a health advice. RESULTS: Analysis of variance of repeated measures showed a significant interaction between time and intervention. The comparison between the mean score of quality of life of the "before," "immediately after intervention," and "3 months after the intervention" showed a significant difference between the two groups. The intervention group quality of life improved significantly as the intervention went on compared to the control group. CONCLUSION: Structured simple educational programs based on the Multi-Theory Model could be used as a simple and noninvasive intervention that help menopausal women improve their quality of life through menopausal symptoms relief. Further interventions with larger trials may be required to confirm these findings.

The prevalence of preventive behaviors and associated factors during the early phase of the COVID-19 pandemic among Iranian People: Application of a Health Belief Model.

INTRODUCTION: Coronavirus disease 2019 (COVID-19) has developed into a severe public health concern. The present study was aimed to evaluate the related preventive behaviors to COVID-19, and associated factors among Iranians based on the constructs of the Health Belief Model (HBM). METHODS: This cross-sectional study was conducted between March and April 2020 among Iranians. Data of 1,020 people were collected by a self-administered questionnaire based on the constructs of HBM and also a demographics questionnaire. Simple and multivariable linear regression models were used to determine the predictors of preventive behaviors concerning COVID-19. A P-value of less than 0.05 was considered significant. RESULTS: The mean score of preventive behaviors concerning COVID-19 was 4.27 (standard deviation = 0.60). 40.6% (95% CI: 38.6-43.7%), and 56.5% (95% CI: 53.4-59.5%) of the participants exhibited a high, and moderate level of preventive behaviors, respectively. 75.1% of the participants would always/often wear face masks out home or in crowded places. The most common preventive behaviors were using of personal belongings in the workplace or at home (96.1%) and staying at home except for very necessary or for work (92.9%). Results showed that all six HBM constructs, i.e., perceived susceptibility (B = 0.07, P < 0.001), perceived severity (B = 0.08, P < 0.001), perceived benefits (B = 0.25, P < 0.001), perceived barriers (B = -0.12, P = 0.001), cues to action (B = 0.07, P < 0.001), and self-efficacy (B = 0.26, P < 0.001) were significant predictors of related preventive behaviors to COVID-19. Female gender was another predictor of preventive behaviors (B = 0.18, P < 0.001). CONCLUSIONS: This study demonstrated the effectiveness of HBM constructs in predicting COVID-19 preventive behaviors. Therefore, the model as a framework for designing training programs for improving health behaviors among Iranians during the COVID-19 pandemic seems to be helpful.

Predictors in Initiating and Maintaining Nutritional Behaviors to Deal With Menopausal Symptoms Based on Multi-Theory Model.

This cross-sectional study was conducted in 2019 on 204 postmenopausal women aged 45-55 years who referred to Yazd health centers to determine the predictors in initiating and sustaining nutritional behaviors to deal with menopausal symptoms based on the multi-theory model (MTM). The participants were required to complete the demographic information questionnaire and a researcher-made questionnaire over the effective nutritional behaviors in menopause based on the MTM. The data were summarized and analyzed using SPSS 18 and AMOS23 by running descriptive indicators and path analysis. Behavioral confidence (ß = 0.61, P < 0.001) had a higher predictive power in initiating a nutritional behavior compared to the changes in the physical environment (ß = 0.13, P < 0.05) and participatory dialogue (ß = 0. 10, p < 0.05). Among the behavior-related constructs, only emotional transformation (ß = 0.78, P < 0.001) could predict the behavioral sustaining. A positive and significant association was observed between nutritional behavior sustaining and quality of life (ß = -0.41, P < 0.001). The MTM is an appropriate model for predicting the initiation and sustaining of the nutritional behaviors in dealing with menopause. The behavioral confidence, changes in physical environment, and participatory dialogue constructs played a significant role in predicting the initiation of behavior. The emotional transformation construct was also an important predictor in maintaining nutritional behaviors to deal with menopausal symptoms. So, future researchers are recommended to conduct MTM-based investigations according to the predictive constructs among menopausal women.

Readability and suitability assessment of educational materials in promoting the quality of life for postmenopausal women.

INTRODUCTION: Educational materials are frequently used by health providers to inform postmenopausal women about menopause acceptance behavior. However, little attention has been paid to the readability and suitability of these educational materials. The study aimed to determine the readability and suitability of educational materials in promoting the quality of life for postmenopausal women. MATERIAL AND METHODS: Multiple instructional materials and books were used for the design and preparation of educational materials and were then tailored to the target group. Readability was measured by using the readability assessment of materials (RAM); and suitability was determined by the suitability assessment of materials (SAM) that considers characteristics such as content, graphics, layout/topography, and cultural appropriateness. Twenty reviewers, including 10 postmenopausal women, 5 postmenopausal women family members, and 5 health experts scored the educational materials. RESULTS: The mean readability score ±standard deviation (SD) of the educational materials was10 ±1.6 and 8 ±1.4, for the pamphlet and daily activities' booklets, respectively, which were increased to 14 ±0.6 and, 16 ±1.3, after tailoring the content. The average SAM scores before and after tailoring the content were 45% for the pamphlet, which was increased to 81%; 45% for the daily activities' booklets, which was increased to 86%. The increase in all scores was significant (p < 0.001). The final tailored educational material was rated "superior media" on the SAM ratings. CONCLUSIONS: Given that most of the printed materials are suitable for people with higher education levels, health providers are strongly advised to prepare simple and understandable education materials that may increase the likelihood of consumer perception and recall.

Effects of an educational intervention based on the multi-theory model on promoting the quality of life in postmenopausal women: a protocol.

INTRODUCTION: Menopause is associated with symptoms and complications that can affect women's quality of life. Therefore, acceptance of the symptoms and complications can improve quality of life during this period. In this regard, the purpose of this study was to design an educational program based on the multi-theory model (MTM) to deal with complications of the menopausal period and improve the women's quality of life. MATERIAL AND METHODS: In designing this study, four phases are considered. In the first phase, the questionnaire of menopausal symptom acceptance behaviors will be designed based on the MTM using literature review and a panel of experts' viewpoints. The validity and reliability of the questionnaire will be confirmed at this stage. In the second phase, a descriptive study will be conducted by administering the questionnaire designed in the first phase along with the Menopause-Specific Quality of Life questionnaire. The third phase includes the curriculum design based on the findings of the descriptive study, investigations of various studies, and viewpoints of the experts' panel. Therefore, the main components of the intervention will be identified. These components will determine the influential constructs of the MTM according to the descriptive research. Later, the related interventions and messages will be produced and designed from different sources. Intervention strategies will include group discussion, lectures, confidence-building skills, movie screenings, role play, preparation of daily activities booklets for postmenopausal women, and training classes for husbands and children to improve social support for women. The interventions, contents, and messages designed with the presence of health professionals and members of the target community will be pre-tested by examining factors such as audience perception of the message, appropriateness of the education to the audience's literacy and culture, as well as attractiveness, credibility, and acceptance of the materials. Finally, the fourth phase will be the implementation of the pre-test/post-test educational intervention using the intervention and control groups. RESULTS AND CONCLUSIONS: The present study provides good information about the needs and strategies to enhance the quality of life in postmenopausal women by utilizing a menopausal acceptance training program. Therefore, designing a program to increase the menopausal acceptance in postmenopausal women can be effective in improving the quality of life and reducing the treatment and medical care costs.

The Effect of Husbands' Education Regarding Menopausal Health on Marital Satisfaction of Their Wives.

OBJECTIVES: Marital satisfaction has an important effect on people's mental health. Due to the increasing average age and life expectancy of Iranian women, obtaining knowledge about sexual aspects of post-menopause women for partners can improve their health and quality of life. This study aimed to determine the effect of education for the husbands regarding menopause on marital satisfaction of their wives. METHODS: This randomized controlled trial was conducted on 100 women aged 45 to 55 years old and their husbands in Yazd in 2014. Subjects were randomly assigned to intervention group (50 couples) and control group (50 couples). The data gathering tools included two questionnaires, the first one contained questions about demographic information of women and men, and the other one was used to assess knowledge and practice in men about menopause and Enrich marital satisfaction. The second questionnaire was applied twice; before intervention and two months after that. In the intervention group an educational program in the form of three 60-minute sessions were conducted using speech, but the control group received no training. Analysis was performed through the statistical SPSS software, paired t-test, t-test and chi-square. RESULTS: In the intervention group, two months after the educational program the knowledge of menopausal health and women's marital satisfaction scores increased significantly (P<0.001). But there was no significant difference in control group. CONCLUSIONS: Training menopausal health to husbands can increase women's marital satisfaction in the period of menopausal transition. Therefore, designing and implementing educational programs for husbands is recommended.

The effects of menopausal health training for spouses on women's quality of life during menopause transitional period.

OBJECTIVE: Spouses' support during menopausal transition has an important role for improving the quality of life in postmenopausal women. Since the first step in providing support is having adequate knowledge, this study aimed to investigate the effects of an educational program on menopause health for spouses on women's quality of life during the menopausal transition. METHODS: This clinical trial was conducted in Yazd, Iran. A hundred healthy women aged 45 to 60 years were recruited by random sampling. The spouses in the intervention group (n = 50) attended three training sessions about the management and health of menopausal transition. The spouses in the control group (n = 50) did not receive any intervention. Knowledge and performance about menopausal health were assessed in all spouses before and 3 months after intervention. All women were assessed by the Menopause Rating Scale, and the Menopause Quality of Life questionnaire before and 3 months after educational intervention. Analyses were carried out using SPSS 16 software. The level of significance was set at P less than 0.05. RESULTS: The knowledge and performance of spouses in the intervention group were significantly higher 3 months after intervention (P < 0.0001). The quality of life in women in the intervention group was higher 3 months after intervention (P < 0.0001). The mean scores of psychological and physical domains were significantly lower in the intervention group (P = 0.002 and P = 0.001, respectively). CONCLUSIONS: The training of menopausal health for spouses improves the quality of life in women during menopausal transition. We suggest integrating such educational programs in menopausal management programs.