Type 2 Diabetes Health Literacy Assessment Tool: Translation and Psychometric Evaluation of the Iranian Version.

Background: Adequate health literacy can lead to self-care behaviors among patients with type 2 diabetes (T2D). Although there is an instrument for measuring the health literacy of patients with diabetes, there is no Persian version of the instrument in Iran. Objectives: The aim of this study was to translate the Chinese Health Literacy Scale for Diabetes (CHLSD) and evaluate the psychometric parameters of the Iranian version. Methods: In this methodological study, using a standard forward-backward translation procedure, the original English language version of the questionnaire was translated into Persian. Face and content validity steps were performed for psychometric measurements. To perform construct (convergent) validity, a cross-sectional study was carried out with the participation of T2D patients admitted to the diabetes clinic (aged over 25 years old). To test the reliability, internal consistency was assessed by Kuder-Richardson (K-R) coefficient, and a test-retest was performed by Spearman correlation coefficient. Results: A total of 283 patients with T2D (mean age: 52.4 years and standard deviation: 11.5) were included in the study. The factor loadings of the variables were checked by calculating the correlation value of the characteristics of a construct with that construct, whose value was greater than 0.4. The K-R coefficients for the whole instrument and its four subscales (remembering, application, analysis, and comprehension) were 0.8, 0.71, 0.73, 0.87, and 0.89, respectively. Re-testing of the instrument with an interval of two weeks indicated the acceptable stability of the instrument (ICC ≥ 0.8). Conclusions: Our findings showed that the Iranian version of CHLSD is a valid and reliable instrument for measuring the health literacy in patients with diabetes.

Predictors of Physical Activity among Adolescent Girl Students Based on the Social Cognitive Theory.

BACKGROUND: The importance of increasing adolescence girl's level of physical activity is recognized as a priority for having a healthy lifestyle. However, adolescent girls especially Iranian, are at high risk for physical inactivity. Social Cognitive Theory (SCT) is a successful theory to explain physical activity behavior. The aim of this study was to determine the predictors of physical activity based on the SCT. METHODS: This cross-sectional study was conducted among 400 adolescent girls (15-16 yr old) in Tehran, Iran (2013). The participants were randomly chosen with multistage sampling. The SCT constructs consisted of self-efficacy, self-regulation, social support, outcome expectancy, and self-efficacy to overcoming impediments. Statistical analysis was carried out applying SPSS: 16, LISREL 8.8. Stepwise regression was used to test predictors of behavior. Pearson correlation was assessed. RESULTS: Self efficacy to overcoming impediments was the main construct to predict physical activity (Beta=0.37). Other determinants were self-efficacy (Beta=0.29), family support (beta=0.14), outcome expectancy (beta=0.13), friend support (beta=0.12), and self-regulation (beta=0.11), respectively. In general, the SCT questionnaire determined 0.85 variation of physical activity behavior. All of the constructs had direct significant relation to physical activity behavior (P<0.001). CONCLUSIONS: The constructs of SCT provide a suitable framework to perform promoting physical activity programs and self-efficacy to overcoming impediments and self-efficacy are the best predictors of physical activity in adolescent girls.

Correlates of mammography utilization among working Muslim Iranian women.

Most countries in Middle East have been successful in establishing and furthering basic facilities for screening, diagnosis, and treatment of breast cancer. The rate of compliance with mammography screening, however, remains well below North American and Western European countries. We utilized the Health Belief Model (HBM) to explore factors associated with mammography screening behavior among a sample of 320 Muslim women aged > or = 35. Carrying out this cross-sectional study, we found that screening behavior was associated with older age, higher perceived benefit of breast cancer screening, and lower perceived barrier. Additionally, we demonstrate the importance of religious beliefs in influencing mammography screening behavior and explaining the link between religious involvement and mammography behavior.

Risk-taking behaviors among motorcyclists in middle east countries: a case of islamic republic of Iran.

OBJECTIVE: Injuries caused by motor vehicle crashes in Middle Eastern countries are among the highest in the world. In Iran, road traffic crashes are the second most common cause of mortality. Particularly, motorcycle-related injuries among men are the second most common type of traffic-related crash in this country. This study used qualitative research methods to elicit and explore the personal experiences of Iranian motorcyclists in respect to factors that facilitate their engagement in risk-taking behaviors within the PRECEDE (predisposing, reinforcing, and enabling constructs in educational diagnosis, and evaluation) framework. METHODS: Focus groups, in-depth interviews, and field observation were conducted among motorcyclists, pillion passengers, and police officers. RESULTS: Our data show that being young and single, living in lower socioeconomic conditions, and suffering from poor physical health and daily stress influence risk-taking behaviors. Additionally, lack of defined traffic rules and regulations, the availability and accessibility of motorcycles among unlicensed underaged persons, the cost-effectiveness of motorcycle transportation, unsafe roads and a lack of special pathways for motorcycles, and aggressive car and van/truck drivers are among the enabling factors that provoke risk-taking behavior. Finally, the participants verified that the enjoyment of motorcycling reinforced their decision to continue engaging in risky behaviors, and being penalized for disobeying traffic laws prevented them from further risk-taking behaviors. CONCLUSION: Enabling and reinforcing factors to reduce risk-taking behaviors among motorcyclist could include (1) promoting smart driving practices among motorcyclists; (2) training pediatricians and emergency physicians to deliver brief motivational interventions to their young patients to avoid risky behaviors while riding; (3) training traffic enforcement officers to appreciate the value of providing consistent law enforcement services; (4) enhancing local efforts to increase the number of pathways for motorcyclists and improve the condition of deteriorated roads; (5) revising legislation and policies in association with motorcycle ownership among underaged and unlicensed individuals; (6) limiting an excessive number of passengers (particularly children) and cargo on motorcycles; and (7) identifying solutions to reduce the negative attitudes of car drivers toward motorcyclists and increase systematic compliance of traffic laws by motorcyclists and car drivers.

A home-based, transtheoretical change model designed strength training intervention to increase exercise to prevent osteoporosis in Iranian women aged 40-65 years: a randomized controlled trial.

Physical activity (PA) helps to prevent osteoporosis, but older women are often sedentary. This study used a pre-post randomized controlled design to evaluate a 12-week exercise education intervention program based on the stages of change (SoC) and processes of change from the transtheoretical change model (TTM) to improve adherence with strength and balance training recommendations at levels sufficient to prevent osteoporosis in Iranian women aged 40-65 years. The home-based exercise prescription consisted of strength and balance training that was progressive, individually tailored and included a walking program. Individuals in the training group (n=61) had a positive, significant progression in psychological SoC (P<0.001), whereas no progression in stages occurred in the control group (n=55). After the intervention, the training group demonstrated significant improvements in PA, lower body muscle strength, static and dynamic balance, with no significant changes in the control group. These results support the applicability of the TTM for a PA intervention and indicate that this training program is very effective in improving balance and lower body strength in older women.