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.

Factors that influence dietary behavior toward iron and vitamin D consumption based on the theory of planned behavior in Iranian adolescent girls.

BACKGROUND: The impact of iron and vitamin D supplements among adolescent is not well understood. The prevalence of supplement use, and the behavioral intentions of adolescents was studied to better understand the data on supplement intake. We used the theory of Planned Behavior (TPB) to explore the determinants that influence supplement intake, and its potential constructs to examine determinants that influence dietary supplement behavior towards the use of iron and vitamin D supplements amongst a sample of Iranian schoolgirl. METHODS: This was a cross-sectional study of 485 adolescent girls aged 12-17 years. Multiple analytical models including hierarchical regression and structural equation modeling (SEM) were used to examine the association between TPB constructs and adolescent's behavioral intentions to consume dietary supplements. RESULTS: Based on the results of SEM, constructs of TPB and knowledge were found to predict 74% of the variation in the behavioral intentions of the schoolgirls. SEM indicated that perceived behavioral control (PBC) and knowledge had significant associations with intention behaviors to take nutritional supplements. CONCLUSION: TPB and its constructs were used to establish the determinants of iron and vitamin D intake among schoolgirls in Iran. This outcome indicates that efforts to promote behavioral intentions through targeting subjective norms, attitude, and PBC may promote supplement use.

A modified persian version of the self-stigma of depression scale among the Iranian population: a methodological study in 2023.

INTRODUCTION: This cross -sectional research evaluated the psychometric properties of the Self-Stigma of Depression Scale (SSDS) among Iranian people. METHODS: This methodological study was conducted among 881 people in 2023, Iran. The method of proportional stratified sampling was used to select participants. To evaluate the validity, face, content, construct, convergent, and discriminant were evaluated. The reliability of SSDS was assessed with the McDonald's omega coefficient, Cronbach α coefficient, and test- retest (Intraclass Correlation Coefficient). RESULTS: In confirmatory factor analysis, the factor loading of all items of SSDS was more than 0.5, and two items had low factor loading. After deleted these items, goodness of fit indexes (such as GFI = 0.945, RMSEA = 0.067, AGFI = 0.917, CFI = 0.941, RFI = 0.905) confirmed the final model with 14 items and four factors of social inadequacy (3 items), help-seeking inhibition (4 questions), self-blame (3 questions), and shame (4 questions). In the reliability phase, for all items of SSDS, Cronbach α coefficient was 0.850, the McDonald omega coefficient was 0.853, and the intraclass correlation coefficient was 0.903. CONCLUSION: The Persian form of SSDS was approved with 14 items and four factors: social inadequacy, help-seeking inhibition, self-blame, and shame. This tool can be used to check the status of self-stigmatization of depression in different groups.

Effect of an educational intervention based on self-efficacy theory and health literacy skills on preventive behaviors of urinary tract infection in pregnant women: A quasi-experimental study.

OBJECTIVE: The impact of self-efficacy and health literacy skills on pregnant women's adherence to urinary tract infection (UTI) preventive behaviors is inadequately investigated. Thus, the present study explored whether an educational intervention based on self-efficacy and health literacy skills managed to improve UTI preventive behaviors among pregnant women. METHODS: A quasi-experimental study was conducted from January to July 2021 among pregnant women residing in Mashhad, Iran. To this aim, 110 pregnant women at a gestational age of 12-18 weeks were randomly assigned to a control (n = 55) and an intervention group (n = 55) and completed all questionnaires during the intervention and the 3-month follow-up. The intervention group received the full training program, comprising six 2-hourly training sessions. RESULTS: Most women were from low-income families (69.1%), were housewives (74.5%) with high school education or lower (63.6%). The theory-based intervention had a significant effect (P < 0·05) on UTI preventive behavior outcomes (i.e., clothing habits, nutrition, urination, health, and sexual behaviors) in the intervention group compared with the control group after intervention, and in their variation from baseline to follow-up in all scores. CONCLUSIONS: An educational intervention based on health literacy skills and self-efficacy could be an effective theory-based intervention to improve UTI preventive behaviors and reduce recurrent UTI and complications.

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.

Quality of life and life satisfaction among university students: Exploring, subjective norms, general health, optimism, and attitude as potential mediators.

OBJECTIVE: This study aims to examine the association of quality of life (QOL) with life satisfaction, subjective norms, general health, optimism, and attitude among university students. PARTICIPANTS: Respondents include 632 university students (Mage=21.36, SD = 2.86). METHODS: This cross-sectional study was conducted on university students in Torbat Heydariyeh, Iran. Several statistical models were tested, including hierarchical regression and path analysis, to examine the direct or indirect association between a set of important variables. RESULTS: According to the results of path analysis, constructs of subjective norms, general health, positive attitude, optimism, and life satisfaction were significant predictors of students' QOL. Compared with other constructs, general health status (p < 0.001, R2 = 0.548) and life satisfaction (p < 0.001, R2 = 0.253) showed the strongest association with QOL. CONCLUSIONS: The results indicate that efforts to improve life satisfaction by targeting general health, subjective norms, optimism, and attitudes may provide promising ways to improve QOL.

Iranian healthcare professionals' knowledge, attitudes, and use of complementary and alternative medicine: a cross sectional study.

BACKGROUND: The present study aims to investigate the knowledge, attitude, and performance of Iranian Healthcare Professionals (HP) about Complementary and Alternative Medicine (CAM) modalities. METHODS: This cross-sectional study was carried out on 210 HP in 2019. Samples were selected from healthcare centers, clinics, and hospitals using census sampling. Data collection tools included demographic information, attitude, knowledge, and the amount of use of CAM modalities. Data analysis was performed using SPSS ver. 24. RESULTS: In this study, the response rate was 85.3% (n=209). A majority of respondents had a positive attitude toward CAM (n=166, 79%), but their level of knowledge was limited (n=154, 73.6%). The most commonly used CAM modalities were herbal medicine (93.2%), exercise therapy (75.4%), and hydrotherapy (75.2%), respectively, and the least commonly used ones were magnetic therapy (2.9%) and hypnosis (4.8%). The most important reasons for the use of CAM modalities by HP included fewer side effects than medical treatments (57.4%), its lowest cost than medical treatments (34.9%), non-serious disease with no need for referral to a clinic (32.1%), and its more convenient access than medical treatments (30.6%). The results showed that there was a significant relationship between the education level and the use of CAM modalities (p<0.05). There was also a significant relationship between the suggestion of CAM modalities and the amount of use of these modalities, and those who used these modalities would also have recommended them to their clients more frequently (p<0.05). CONCLUSION: The results showed that most of HP used at least one of the CAM modalities and had a positive attitude towards CAM. As the level of knowledge was limited, training courses should be implemented to increase health practitioner's level of knowledge on CAM.

The study of eye care behaviors in patients with type 2 diabetes.

INTRODUCTION: The purpose of present study was to investigate eye care behaviors based on the BASNEF model and Health Locus of Control (HLOC) in patients with type 2 diabetes(T2D). METHODS: This cross-sectional analytical study was carried out on 150 patients with T2D in Iran in 2019. The subjects were selected using simple random sampling. The data collection tools included demographic, eye self-care behavior inventory based on BASNEF model and health locus of control whose validity and reliability were confirmed. Data analysis was carried out using Independent samples-t test ANOVA, and linear regression in SPSS ver. 24. RESULT: The results of linear regression showed that knowledge, attitude, subjective norms, enabling factors, internal HLOC, chance HLOC and external HLOC were able to predict 17% of intention to eye self-care behaviors (P < 0.001) and attitude was the strongest construct in predicting intention of eye care behavior in patients with T2D (P < 0.05). In this study, most people had internal HLOC and mean (± SD) of their internal construct was 27.42(± 2.73). Also, the enabling factors construct showed a significant correlation with the internal HLOC (r = 0.283) and behavioral intention (r = 0.348) (P < 0.001). CONCLUSION: The results of this study showed that attitude and enabling factors are effective constructs in predicting the intention to perform preventive behaviors of ocular complications in T2D patients. Therefore, it is recommended to organize training classes, access resources, and educational information, facilitate access to physicians for eye examinations, create new skills for care and prevention of ocular complications.

Organizing framework to investigate associations between diabetes knowledge, health literacy, and self-care behaviors in patients with type 2 diabetes based on the extended parallel process model.

OBJECTIVE: The mechanisms underlying the relations between diabetes self-care behaviors, cognition, and social factors are still equivocal, and it is unclear how diabetes knowledge and health literacy is associated with self-care behaviors. Here, we tested a hypothetical path model linking diabetes self-care behaviors to knowledge, health literacy, and constructs of the extended parallel process model (EPPM) to understand potential predictors that may influence patients' self-care behavior with type 2 diabetes. METHODS: A cross-sectional study was conducted, and 404 patients with type 2 diabetes were recruited from healthcare centers in Khaf, Iran. Diabetes self-care behaviors were indicated by, glucose self-control, foot care, physical activity, medications, smoking, and a healthy diet. The main data collection instruments in this study were the Health Literacy for Iranian Adults questionnaire (HELIA), diabetes knowledge, and self-care behavior based on the EPPM questionnaires. RESULTS: The results from path modeling indicated that perceived susceptibility, efficacy, self-efficacy, knowledge, and health literacy were significant (p < 0.05) predictors for diabetes self-care behaviors and path model accounted for 32% of the total variance. CONCLUSION: Based on the results, key constructs of EPPM, diabetes knowledge, and health-related literacy are empirically supported diabetes self-care behaviors. These factors could apply to health professionals for developing educational intervention programs to facilitate a physically active lifestyle.

Ergonomic factors of school bags and their adaptation to the weight of students.

BACKGROUND: Students use a school bag to carry their school supplies which may not have the required standards and ergonomic factors. OBJECTIVE: This study was aimed to examine the ergonomic factors of schoolbags and their adaptation to the weight of elementary school students. METHODS: This cross-sectional study was carried out on 721 primary schoolchildren. To collecting data a checklist, which its final version was approved by the experts, was designed by researchers. Data were analyzed by using SPSS ver. 22 and Chi-square test, One-Way ANOVA, and univariate and multivariate logistic regression models. RESULTS: In this study, about 90.1% of students used a backpack to carry their items and most students carried backpacks with a weight up to 10% of their body weight. In 43.5% of the students, waist width was appropriate with backpack width at the bottom, and in 96.6% shoulder width was appropriate with backpack width at the top. Multivariate logistic regression showed that girls in compared to boys were more likely tolerated ratio of backpack weight to body weight, and also had more likely proportion of waist width and the backpack width at the bottom. The grades of the first, second, and fourth used more heavy backpacks. Students who their mothers were employee compared to housewives, carried heavier backpacks and had more likely proportion of waist width and the backpack width at the bottom. As the mother's age increased, the proportion of waist width and the backpack width at the bottom is diminished. CONCLUSION: The schoolbags weight of many students was more than the standard weight, and their schoolbags did not have the required standards. Educational interventions can increase the knowledge of students and parents about the ideal weight of a schoolbag and the criteria for choosing a proper school bag.

Epidemiology of Suicide/Suicide Attempt and Its Association with Individual, Family, and Social Factors in Eastern Part of Iran: A Historical Cohort Study.

BACKGROUND: Suicide/suicide attempt, as a major public health problem, has been included among anti-social behaviors. We aimed to investigate the epidemiology of suicide and some associated individual, family, and social factors. METHODS: A historical cohort study was conducted among all cases (748 persons) reports related to suicide/suicide attempt that register in hospital reporting system and health care center in Gonabad and Bajestan, Iran, from 2009 to 2014. The required data were extracted through a checklist. Descriptive (mean and standard deviation) and analytic statistics (t-test, Chi-square, and logistic regression) applied to analyzed data. All data were analyzed using SPSS software. RESULTS: Of the 748 reported suicide attempters, 17 cases (2.3%) had completed suicide. The annual average incidence rate of suicide was 110.03 per 100,000 populations. The mean age of suicide attempt had significantly decreased during the time (P=0.007). Furthermore, a significant association was observed between outcome of suicide and place of residence (P=0.019), history of physical illnesses (P=0.002), and method of suicide (P=0.001). CONCLUSION: Due to trend of age among suicide attempters, considering intervention programs of suicide prevention for school pupils and university students especially individuals residing in rural areas, as well as individuals suffering from physical illness would be effective to reduce the rate of suicide.

Health literacy, knowledge and self-care behaviors to take care of diabetic foot in low-income individuals: Application of extended parallel process model.

AIM: This study has been conducted with the aim of determining the relationship between health literacy, knowledge and self-care behaviors to take care of the diabetic foot in low-income individuals, based on the extended parallel process model (EPPM). METHODS: This cross-sectional study was conducted on 400 patients with type II diabetes referred to the Diabetes Clinic, using a random sampling method and using standard questionnaires. In this study, the constructs of knowledge, EPPM (perceived sensitivity, perceived severity, response efficacy, self-efficacy), and health literacy were significantly related to self-care behaviors (p < 0.05). RESULTS: Based on the linear regression results, the constructs of knowledge, health literacy, and constructs of EPPM were able to account for 43% of the variance to perform diabetic foot self-care behaviors. The maximum impact was related to the constructs of health literacy and self-efficacy (p < 0.001). CONCLUSION: Based on these results, levels of knowledge and health literacy of patients were very poor overall, and the self-care behaviors were not appropriate. On the other hand, considering the great impact of health literacy in performing self-care behaviors, it is suggested that educational courses be held in this regard and proper strategies are employed to enhance the health literacy of diabetic patients.

Perceptions and personal use of Complementary and Alternative Medicine (CAM) by Iranian health care providers.

PURPOSE: Aim of this study was to determine the perceptions about and personal use of CAM by health care providers. METHODS: A cross-sectional survey was carried out on 320 health care providers, who were selected by census method. RESULTS: 86.6% of the subjects reported that they had used at least one or more CAM. The most commonly used CAM was prayer (65.6%). There was a significant relationship between sex and all the five factors of attitude. The highest mean score of attitude was related to Factor 1 (attitude toward the desirability of CAIM therapies). Based on the results of univariate logistic regression, there was a significant association between the use of complementary medicine and education level. CONCLUSION: Based on the results it seems that this group can play an effective role in providing the appropriate information for the community and prevent the unnecessary use of CAM.