Design and usability evaluation of a mobile application for self-care among Iranian adolescents.

BACKGROUND: Mobile phones can be an ideal platform to engage adolescents to maintain, improve, and promote self-care. Therefore, the current study aims to design and evaluate the usability of a mobile application for self-care in adolescents with a user-centered approach. METHODS: The current applied developmental study was done in four steps. The first step, polling and examining opinions was conducted through in-depth semi-structured interviews, with the aim of user-centered mobile application design with the involvement of 30 participants. The second step, extracting and compiling the educational content related to the main themes of the self-care app, was obtained from national and international guidelines and instructions, including the World Health Organization, the Center for Disease Control and Prevention, the Ministry of Health and Medical Education, etc. In the third step, the initial version of the mobile application was developed. In the fourth step, app usability was evaluated by 30 participants from the target group, 2 weeks after using the app, using the MAUQ questionnaire. RESULTS: In the first step, 789 codes, 12 sub-categories, and 3 categories were extracted. These codes were used in the design of the mobile application. In the second step, educational information was prepared and arranged in 5 sections (physical activity, nutrition, personal hygiene, risky behaviors and safety and events) in the form of text, images and short videos. In the third step, the mobile application was designed based on step 1 and 2. This application operates in online mode and under the Android operating system. the initial version of the mobile application was developed using JavaScript and Typescript programming languages in a Visual Studio Code environment. In the fourth step, the participants the overall level of usability of the application as very good with an average of 6.28 ± 0.55. The highest average score was given to the user interface and satisfaction with an average score of 6.43 ± 0.58. CONCLUSIONS: The "My-Care" app is a collaboratively designed smartphone app for adolescents that targets 5 dimensions of physical self-care. This app has the potential to teach, assess, and promote self-care among adolescents.

Diabetes-related instrument to assess preventive behaviors among adolescents (DIAPBA): a tool development and psychometric research.

BACKGROUND: Type 2 diabetes is a chronic but preventable disease that is on the rise among adolescents. Evaluating adolescents' behavior and planning to prevent it require a valid and reliable instrument. This study aims at designing a psychometric instrument to measure adolescents' behavior with respect to type-2 diabetes. RESEARCH DESIGN AND METHODS: In this methodological research, 770 students (adolescent boys and girls aged 13-15 years) participated through multistage sampling. The Inclusion criteria were: junior high school students, students' willingness for participation and not suffering from type-1 or type-2 diabetes. The questionnaire was designed by examining the relevant literature and the existing questionnaires as well as considering the research team's comments. The validity of the study was determined through face validity and content validity both quantitatively and qualitatively. The construct validity was determined through exploratory and confirmatory factor analysis. Reliability was measured via intraclass consistency coefficient (ICC) and internal consistency reliability was measured by Cronbach Alpha. SPSS 16 and Eq. 6.1 were used for data analysis. RESULTS: At first, a list of 47 initial items was designed and compiled, and after by removing similar (10 questions) or inappropriate sentences (12 questions), a draft questionnaire with 25 questions was designed. No items were removed in the face validity phase. Based on exploratory factor analysis, the number of items in the questionnaire was reduced to 20 items and was categorized in five dimensions of stress management, healthy food/healthy diet, unhealthy food/unhealthy diet, high-risk behavior, and self-care. The results of confirmatory factor analysis confirmed the model. The internal consistency coefficient was confirmed measuring Cronbach Alpha at 0.70 with ICC = 0.80. CONCLUSION: The questionnaire designed has standard psychometric properties to assess adolescents' behavior with respect to type-2 diabetes prevention. The reliability and the validity of the questionnaire as well as its general structure were confirmed.

Enhancing physical activity participation among female employees: evaluating the effectiveness of an educational intervention.

This paper evaluates the effectiveness of an educational intervention based on the transtheoretical model aimed at increasing physical activity (PA) participation among female employees in Bandar Abbas city (Iran) healthcare centers in December 2017 and August 2018. Using a semi-experimental interventional study design with a randomized and multi-stage method, 100 participants were included in both the intervention (n = 50) and control groups (n = 50). Data collection involved questionnaires assessing demographic information (age, gender, marital status and education), stages of change in PA behavior, Perceived Benefits, Barriers and Self-efficacy. The data were analyzed using SPSS-16, employing both descriptive (mean, SD, frequency, percentage) and inferential statistics (t-tests, chi-squared tests, etc.). Prior to the educational intervention, 19 participants (0.38%) in the intervention group engaged consistently in PA (stages 4-5). After 3 and 6 months of intervention, these numbers increased to 29 (0.58%) and 25 (0.50%), respectively. This improvement was statistically significant compared to the pre-intervention stage (P < 0.001). The findings highlight the importance of theory-based behavior change models and health education programs in promoting PA and combating sedentary lifestyles. Although focused on a specific population in Bandar Abbas, the intervention can serve as a model for similar programs targeting diverse social classes and populations.

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.

A theory-driven organ donation campaign: a field intervention among university students in Iran.

Background: This study conducted an empirical evaluation of an intervention derived from the theory of planned behavior (TPB) aimed at implementing a health campaign among medical students at Shahid Beheshti University of Medical Sciences. Methods: In this interventional study, a valid and reliable TPB-based questionnaire was administered before launching a health campaign titled "Organ Donation=Life Donation" among 260 medical students. The campaign was structured around nine steps: situation analysis, goal identification, target audience identification, strategy development, tactics establishment, media selection, timetable creation, budget planning, and program evaluation. Two months after the campaign, participants completed a posttest and were offered an organ donation card. Data analysis was conducted using SPSS ver. 16, employing descriptive statistics (frequency and percentage) and tests such as the Kolmogorov-Smirnov test and the paired-samples t-test. Results: All participants adopted more prodonation stances across all constructs measured, both immediately and 2 months after exposure to the health campaign, compared to their pretest scores. These results indicate that the health campaign had a significant impact on psychological variables such as attitudes (P<0.001), subjective norms (P<0.001), and perceived behavioral control (P<0.038), as well as on the actual acceptance of an organ donor card. Conclusions: Effective health education and promotion interventions, including health campaigns, are essential to encourage the use of organ donation cards. Additionally, current experiences indicate that the TPB serves as a suitable theoretical framework for designing organ donation interventions.

Test of Oral Health Literacy in Adults (TOHLA): development and psychometric evaluation of a new scale.

This study aimed to develop and rigorously evaluate the Test of Oral Health Literacy in Adults (TOHLA) for the Iranian population, addressing the limitations of existing oral health literacy (OHL) measurement instruments and contributing to the literature on OHL assessment. The development of the TOHLA involved a qualitative approach, which included a comprehensive literature review and semi-structured interviews with a panel of 15 experts from diverse fields and 22 Iranian adults aged 18 to 64 years. The instrument was designed with 48 items categorized into four domains: cognitive skill, communication skill, media skill, and functional skill. Content validity was established through expert input and content validation indices. Construct validity was supported by factor analysis, and concurrent validity was assessed by comparing TOHLA scores with demographic variables. Internal consistency and test-retest reliability analyses were performed to assess the instrument's reliability. The psychometric evaluation of the TOHLA demonstrated strong content validity, construct validity, concurrent validity, internal consistency, and test-retest reliability. The instrument exhibited a high level of internal consistency, with a Cronbach's alpha coefficient of 0.81 for the entire scale. Test-retest reliability was satisfactory, with an intraclass correlation coefficient (ICC) of 0.83. Concurrent validity analysis showed statistically significant associations between OHL scores and demographic variables, supporting the instrument's overall performance. The TOHLA overcomes the weaknesses observed in existing instruments and offers a comprehensive tool with strong psychometric properties to assess the OHL of the Iranian adult population. Researchers, policymakers, and healthcare providers can utilize the TOHLA to address oral health challenges and enhance overall oral health outcomes among Iranian adults.

Design and evaluation of mobile application for adolescents' self-care: protocol for a randomized controlled field trial.

BACKGROUND: Adolescence is a critical stage for the development of self-care. Many adolescents use mobile apps to monitor and improve their health. Health information technology plays a significant role in the field of self-care. This article provides a protocol for a study to design and evaluate mobile applications for adolescent self-care. METHODS: The present research is a combination of applied development study, methodological, and intervention experimental. This study will be done in three stages: The first stage is the design and evaluation of a mobile application for adolescent self-care. The second stage is, designing and evaluating the psychometric properties of the "Questionnaire for Measuring Adolescent Self-Care Performance." This questionnaire will be used before and after using the application in the third stage. The third stage is determining the effectiveness of self-care interventions based on mobile applications among adolescents. The target group will be adolescents aged 10-19 from the schools of Amol City. In the first stage, the opinions of 30 people adolescents, parents, and experts will be used. In the second stage, the number of samples will be 10 times the number of items in the questionnaire. In the third stage, 50 people will be in the intervention group and 50 people will be in the control group. Descriptive statistics will be used for data analysis. Between-group and intra-group comparisons will be calculated about quantitative variables, independent t-test and paired t-test, and analysis of variance. The chi-square test and Fisher's exact test will be used in SPSS 16 software to test the homogeneity of qualitative variables between the two groups. DISCUSSION: In the first stage, based on the opinions received from the target group, a user-centered educational application for self-care of adolescents will be designed. In the second stage, after determining the validity and reliability, a questionnaire will be designed to measure the self-care performance of adolescents. In the third stage, using an intervention study for 3 months, the effectiveness of the training will be determined through the designed application. Our findings are scheduled for a full analysis, with expectations that analyses will be completed by September 2023.

A school-based randomized controlled field trial to improve Beliefs About Obese Persons (BAOP) and Attitudes Towards Obese Persons (ATOP) among adolescents.

OBJECTIVES: A negative attitude towards obesity may lead to stigma and thus lower self-esteem in people with obesity of any society. The purpose of this study was to assess the impact of a school-based randomized controlled field trial on female adolescents' attitudes and beliefs towards people with obesity. METHODS: This experimental study was conducted among 124 middle school students (control group=62, intervention group=62). Using a cluster random sampling method, four schools were chosen and randomly assigned to intervention and control groups. The data collection tool was the Attitudes Toward Obese Persons (ATOP) and Beliefs About Obese Persons (BAOP) scales, which were used after validity and reliability processes. The intervention program was developed and implemented following pretest, responses analysis, and educational needs assessment in two sessions (180 min). The follow-ups were performed immediately and two months after the intervention. Data were analyzed by SPSS version 16.0 using independent t-test, chi-square test, repeated measures ANOVA, and ANCOVA at the significance level of 0.05. RESULTS: The mean BAOP scores of each group before, immediately and two months after the intervention were significantly different between (p<0.001). There was no significant difference between the mean ATOP and BAOP scores of the two groups before, immediately, and two months after the intervention (p>0.001). CONCLUSIONS: It seems that beliefs and attitudes regarding obesity as well as discriminatory perceptions towards people with obesity have high firmness and resistance and require innovative and appropriate interventions.

ChecKAP: A Checklist for Reporting a Knowledge, Attitude, and Practice (KAP) Study.

INTRODUCTION: The Knowledge, Attitudes, and Practices (KAP) model is a foundational tool in public health research. KAP surveys play a vital role in this process by gauging a population's current level of knowledge about a specific health issue. Rigorous evaluation is essential for ensuring the validity and reliability of KAP studies. Therefore, in this study, a comprehensive checklist for reporting Knowledge, Attitude, and Practices (KAP) Studies was developed. METHODOLOGY: This study was conducted using a systematic six-step roadmap. A comprehensive review of available relevant quality assessment tools led to the development of specific new items. An expert panel reviewed the initial draft, and after corrections were made, the second draft was finalized and subjected to psychometric analysis by experts. RESULTS: The development of ChecKAP (Checklist for Reporting Items for Knowledge, Attitude, and Practice) represents a significant contribution to KAP studies. The final tool consists of 46 items across 8 fields: title (1 item), abstract (6 items), keywords (1 item), introduction (6 items), method (11 items), findings (7 items), discussion (15 items), and conclusion (1 item). CONCLUSION: ChecKAP assesses the inherent complexity of KAP research methods and ensures consistent reporting. It fills an important gap in the KAP research literature and serves a dual purpose. First, it acts as a quality assessment tool for reviewers, enabling them to evaluate the methodological rigor and clarity of submitted manuscripts. Second, it serves as a guideline for authors, promoting a more systematic and transparent approach to reporting.

Test of Oral Health Literacy in Adults (TOHLA): development and psychometric evaluation of a new scale

Abstract This study aimed to develop and rigorously evaluate the Test of Oral Health Literacy in Adults (TOHLA) for the Iranian population, addressing the limitations of existing oral health literacy (OHL) measurement instruments and contributing to the literature on OHL assessment. The development of the TOHLA involved a qualitative approach, which included a comprehensive literature review and semi-structured interviews with a panel of 15 experts from diverse fields and 22 Iranian adults aged 18 to 64 years. The instrument was designed with 48 items categorized into four domains: cognitive skill, communication skill, media skill, and functional skill. Content validity was established through expert input and content validation indices. Construct validity was supported by factor analysis, and concurrent validity was assessed by comparing TOHLA scores with demographic variables. Internal consistency and test-retest reliability analyses were performed to assess the instrument's reliability. The psychometric evaluation of the TOHLA demonstrated strong content validity, construct validity, concurrent validity, internal consistency, and test-retest reliability. The instrument exhibited a high level of internal consistency, with a Cronbach's alpha coefficient of 0.81 for the entire scale. Test-retest reliability was satisfactory, with an intraclass correlation coefficient (ICC) of 0.83. Concurrent validity analysis showed statistically significant associations between OHL scores and demographic variables, supporting the instrument's overall performance. The TOHLA overcomes the weaknesses observed in existing instruments and offers a comprehensive tool with strong psychometric properties to assess the OHL of the Iranian adult population. Researchers, policymakers, and healthcare providers can utilize the TOHLA to address oral health challenges and enhance overall oral health outcomes among Iranian adults.