Knowledge, attitudes and practices of Iranian people about food safety and hygiene during covid-19 pandemic.

AIM: The objective of this study was to develop a cultural adopted questionnaire for evaluation of knowledge (K), attitude (A) and practice (P) of Iranian population toward food safety during Covid-19. METHODS: The study is based on an online questionnaire that filled by 712 Iranians over 16 years old. Exploratory factor analysis (EFA), confirmatory factor analysis (CFA) and reliability assessment were performed. The construct validity of A and P determined by EFA and confirmed by CFA. Difficulty index was used for K. RESULTS: The reliability score of questionnaire was satisfactory. The three items of K-A-P questionnaire were significantly associated with the total score of questionnaire. The KAP questionnaire regarding food safety in covid-19 consisted of 27 items multidimensional scale with strong psychometric features. The respondent showed a satisfactory level of KAP during covid-19 pandemics. CONCLUSION: The KAP questionnaire regarding food safety in covid-19 is a valid and reliable tool for measurement of knowledge, attitude and practice of people regarding food safety in covid-19.

Status of Iranian schools' psycho-social environment: cultural adaptation and validation of the Persian version of the W.H.O profile to create Child-Friendly Schools.

BACKGROUND: Creating an environment for emotional and social well-being is an important responsibility of Health-Promoting and Child-Friendly Schools. Thus, the present study aimed to assess cultural adaptation and validation of the Persian version of the Psycho-Social Environment (PSE) Profile. The second purpose of this study was to survey the psycho-social environment of schools among a local sample of Iranian school staff. METHODS: This study was conducted in two phases, including cultural adaptation and validation of a culturally adapted scale. The cultural adaptation process followed the procedure suggested by Beaton et al. Then, the culturally adapted scale was administered to a local sample of Iranian school staff including managers (21.9%), teachers (57.4%), support staff (4%), and other school staff (16.7%) in a cross-sectional study. The participants' mean age was 39.98 ± 8.11 years and they were mostly female (62.8%). The psychometric properties of the culturally adapted version of the questionnaire were tested using a confirmatory factor analysis (n = 265), and a test of internal consistency. Finally, the status of schools' psycho-social environment was assessed using descriptive and analytical statistics. RESULTS: Confirmatory factor analysis indicated an overall good fit for the 7-factor profile (χ2/df: 1.906, PNFI: 0.62, TLI: 0.78, CFI: 0.79, RMSE: 0.059). The test of internal consistency showed an acceptable reliability (α = 0. 98). CONCLUSIONS: The Persian version of the PSE profile was culturally adapted for use in Iranian schools. Certainly, this culturally adapted version of PSE profile could be useful to determine the school psycho-social environment and to make any changes that can promote a friendly school climate for all participants, and to enhance learning and development.

Effects of the COVID-19 pandemic on lifestyle among Iranian population: A multicenter cross-sectional study.

Background: Quarantine, an unpleasant experience, was implemented in many countries to limit the spread of Coronavirus disease 2019 (COVID-19), which it could associated whit lifestyle changes. The present study aimed to determine the changes in Iranian's lifestyle during COVID-19 pandemic. Materials and Methods: In the present cross-sectional study, 2710 Iranian people completed an online researcher-made questionnaire asking lifestyle regarding COVID-19, which includes five sections about physical activity, stress and anxiety, nutrition habit, sleep disorders, and interpersonal relationship in addition to demographic data from January to February 2021, using the multistage cluster sampling method. Results: The participants' mean age was 33.78 ± 11.50 years and 68.3% of them were female. Traveling, sightseeing, and family visits have been eliminated from 91%, 83.5%, and 77.5% of participants' lives, respectively. There were increase in stress level (P < 0.001), weight of the participants (P < 0.001), sleep problems (P < 0.001), and healthier foods (P < 0.001) but decrease in interpersonal communication (P < 0.001) and the amount of physical activity (P < 0.001). Conclusion: In summary, this study indicates some changes in lifestyle of Iranian people, including changes in some eating practices, physical activity, social communication, and sleeping habits during the pandemic. However, as the COVID-19 pandemic is ongoing, a comprehensive understanding of these behaviors and habits can help develop interventions to mitigate the negative lifestyle behaviors during COVID-19 pandemic.

Assessment of attitudes toward functional foods based on theory of planned behavior: validation of a questionnaire.

BACKGROUND: The objectives of this study are to construct a cultural adopted questionnaire for evaluation of consumer's attitudes toward functional foods among Iranian's population according to Theory of Planned Behavior (TPB) and to investigate the attitudes toward vitamin enriched foods (VEF). METHODS: Participants were students of Birjand University of Medical Sciences (BUMS). Exploratory factor analysis (EFA), Confirmatory Factor Analysis (CFA) and reliability assessment were performed. The construct validity of questionnaire determined by EFA and confirmed by CFA. RESULTS: The overall Cronbach's alpha of questionnaire was 0.78. The three domains of TPB model were significantly associated with the total score of attitude toward functional foods questionnaire (AFFQ). Attitudes and subjective norms could successfully predict the consumption of VEF (p < 0.023 and p < 0.001, respectively), but perceived control construct could not perform the prediction (p < 0.219). CONCLUSION: AFFQ is a valid and reliable instrument to measure the attitudes of consumers toward consumption of functional foods in Iran.

Consumption status of functional drinks based on the theory of planned behavior and the stages of change model in female employees.

This study aimed to determine the consumption status of functional drinks based on the theory of planned behavior and the Stages of Change Model. This study was conducted on 536 female employees of Birjand offices in 2022. The data was collected by using the functional food questionnaire and was analyzed using SPSS with significance level of P < 0.05. The largest number of people consume probiotic drinks (buttermilk, kefir, etc.) were in the maintenance stages (31.2%) and who consume milk fortified with vitamin D were in the contemplation stage (37.3%). The mean score of the participants in the subscales of attitude, behavioral control, and subjective norm was 17.69 ± 3.05, 16.83 ± 2.88, 21.73 ± 4.33, respectively. The mean score of the attitude and subjective norm regarding the consumption of all drinks had a significant relation with the stages of change model (p < 0.05). The results of this study showed that the most drinks that female employees consumed regularly were probiotic drinks, while they did not intend to use functional juices (pre-contemplation stage). Therefore, it seems that this theory can be used as a framework in designing educational programs in order to increase the consumption of functional foods and improve women's health.

Is the Theory of Planned Behavior a good model for predicting salt consumption behavior in pregnant women? A structural equation modeling approach.

BACKGROUND: Non-communicable illnesses are the leading reason for wide-reaching death. Reducing the burden of these illnesses is one of the significant objectives of the World Health Organization's action plan. In this respect, reducing salt consumption is one of the most cost-effective public health interventions. The present study aimed to adjust the Theory of Planned Behavior (TPB) in expecting salt consumption behavior in pregnant women visiting the health centers in Birjand. MATERIALS AND METHODS: In this cross-sectional study, 273 pregnant women who visited the health centers in Birjand were selected through Quota sampling method. The data were collected using a self-administered questionnaire based on the TPB constructs. The data analysis was done in SPSS 19 and AMOS 24. RESULTS: The mean age of participants was 27.33 ± 5.77 years, and their mean gestational age was 12.67 ± 4.11 weeks. The mean score of attitude construct was 86.54 ± 8.50, subjective norm construct 36.59 ± 4.47, perceived behavioral control construct 41.63 ± 7.01, intention construct 16.01 ± 2.65 and behavior construct 19.86 ± 2.57. There was a statistically significant relationship between attitude construct (p < 0.001), perceived behavioral control (p < 0.001), and intention (p < 0.001) with salt consumption behavior (p < 0.05). The goodness of fit indices showed a proper fit of data (χ2/df = 1.94, PNFI = 0.6, TLI = 0.9, CFI = 0.9 and RMSE = 0.06). CONCLUSION: The results of this study showed that the TPB is an appropriate model for reviewing the behavior of salt consumption. Hence, this model offers a suitable basis for designing an educational intervention to regulate the quantity of salt consumed by pregnant women and; thus, its usage in health promotion programs is suggested.

The effect of educational intervention based on self-efficacy theory on pregnancy anxiety and childbirth outcomes among Iranian primiparous women.

BACKGROUND: Pregnancy anxiety is associated with a diverse birth outcomes. Mothers' education could have a critical role in increasing their self-efficacy to defeat their anxiety and improve pregnancy and child birth outcomes. The study was conducted to examine the effect of intervention based on self-efficacy theory on pregnancy anxiety and child birth outcomes. MATERIALS AND METHODS: The study was conducted as a quasi-experimental design on 60primiparous women (26-28 weeks) in Birjand (East Iranian province) from May to September 2017, who were randomly divided into intervention and control groups. The intervention group received 8 sessions of 90-min educational intervention based on self-efficacy theory strategies besides the routine prenatal care. Vanden Bergh's pregnancy anxiety questionnaire and checklist of pregnancy and delivery outcomes were used for data collection. RESULTS: The level of pregnancy anxiety was similar in both groups before the intervention, but immediately and 1 month after the intervention, the mean score of pregnancy anxiety significantly reduced in the intervention group and significantly increased in the control group (P < 0.001). There was a significant difference in mean neonatal weight (P < 0.001) between the two groups. Emergency and elective cesarean section were significantly lower in the intervention group compared to the control group (P < 0.001), but there were no significant differences in the frequency of preterm delivery between two groups (P < 0.05). CONCLUSION: The results provide support for the effectiveness of intervention based on self-efficacy theory in reducing pregnancy anxiety and enhancing positive pregnancy outcomes. Hence, theory-based educational interventions may serve as a cost-effective and noninvasive approach to reduce pregnancy anxiety in Iran.

Healthy Beliefs regarding Breast Cancer Screening in Iranian Women Health Volunteers: A Path Analysis.

BACKGROUND: In Iran, 82% of breast cancer cases are diagnosed in late stages, resulting in low survival rates. In the present study, the Stages of Change Theory and Health Belief Model were used as theoretical frameworks for assessing Women Health Volunteer readiness to act on different breast cancer screening behaviors. METHODS: A total of 1,410 Women Health Volunteers were enrolled in this cross-sectional study. The breast self-examination (BSE) and mammography stages of change were measured independently. A standardized questionnaire based on the Health Belief Model was used to assess their beliefs about breast cancer screening methods. A path analysis using PASW SPSS ver. 18.0 (SPSS Inc., Chicago, IL, USA) was used to test the effects of individual beliefs on breast cancer screening stages of change. RESULTS: Most participants were classified in the pre-contemplation stage of breast cancer screening behaviors. Perceived barriers, benefits, and susceptibility emerged as BSE stages of change predictors. No beliefs were significant mammography stages of change predictors. CONCLUSION: Iranian Women Health Volunteers had a very low adherence to common BSE and mammography practices. Healthy beliefs have a strong association with the stages of change for performing BSE, but not for mammography. The impact of health beliefs on an individual's readiness to act on different breast cancer screening methods may vary with respect to the type of screening method.

The effect of educational intervention based on theory of planned behavior and self-regulatory strategies on the social vitality of women employee.

BACKGROUND: Social vitality is one of the most important social indicators to develop a sense of public satisfaction. The aim of this study was to investigate the effect of educational intervention based on theory of planned behavior (TPB) and self-regulatory strategies on the social vitality of women employee. MATERIALS AND METHODS: In this randomized controlled field trial study, 66 women employees of Birjand University of Medical Sciences (Iran) were selected including intervention (n = 31) and control (n = 35). Data were collected by standard Oxford Happiness Questionnaire and a researcher-made questionnaire based on TPB which its the validity and reliability were confirmed. The educational intervention consisted of 5 sessions based on the constructs of the TPB and self-regulatory strategies which were to the interventional group. Data analysis was performed using the Chi-square, Fisher's exact test, independent t-test, repeated measures ANOVA, and Bonferroni post hoc test at a significance level of <0.05. RESULTS: The mean age of women in the intervention and control group was 37.1 ± 9.3 and 36.2 ± 7.6 years (P = 0.67). Model constructs and happiness scores were homogeneous (P > 0.05) before the intervention, in two group of study, but after attitude (P = 0.016), subjective norm (P = 0.029), perceived behavior control (P = 0.01), intention (P = 0.006), and happiness score (P < 0.001) had a significant increase in the intervention group. In the control group, only a significant difference occurred over time in the happiness rate (P = 0.031). CONCLUSIONS: The results of the present study showed the effectiveness of educational intervention on the social vitality of women employees. Therefore, TPB is recommended to use in interventions to promote social vitality.

Predictors of Colorectal Cancer Screening Participation in Southern Khorasan (Iran).

PURPOSE: Colorectal cancer is one of the most important common malignancies; therefore, timely screening for colorectal cancer can lead to early diagnosis and long survival for patients. The purpose of this study was to investigate the related factors in fecal occult blood test for screening of colorectal cancer based on health belief model constructs in high-risk population in east of Iran. METHODS: This cross-sectional study was performed on 475 people over 40 years old in Birjand (East of Iran) who were selected by multi-stage sampling. A valid and reliable questionnaire was used for data collection. Data were analyzed using logistic regression test in the SPSS software version 19s. RESULTS: In this study, 480 subjects were included in the final analysis, 331 (69%) were male, and the rest of them were female. Mean age of the participants was 55.12 with the standard deviation of 10.04. Of those studied population, 8.3% performed screening tests for early detection of colorectal cancer, and 15% intended to do so. There was a significant relationship between gastrointestinal disease history and perceived self-efficacy and test performance. In addition, significant relationship was observed between perceived self-efficacy in male participants and intention to do test (p < 0.05). CONCLUSION: Perceived self-efficacy was the most salient predictor of the probability of undergoing fecal occult blood testing as well as the history of the test. Promoting perceived self-efficacy is very important in the process of promoting colorectal cancer screening behaviors. Therefore, it is recommended that when designing educational interventions, consideration should be given to enhancing the perceived self-efficacy of at-risk individuals to overcome the barriers for performing fecal occult blood testing.

The effect of educational intervention based on the health belief model on osteoarthritis-preventive behaviors in middle-aged women.

BACKGROUND AND AIM: Arthritis is the most common type of arthritis in people over 40 years. This study aimed to determine the effect of an educational intervention on the prevention of arthritis among middle-aged women using the health belief model. MATERIALS AND METHODS: This was a randomized controlled field trial. The study population was women aged 29-59 years who referred to health centers in Birjand. Seventy-three women were selected by a systematic random sampling method and were randomly divided into intervention (n = 36) and control (n = 37) groups. The data collection tool was a researcher-made questionnaire. Data were analyzed using the Chi-square test, Fisher's exact test, t-test, repeated-measures ANOVA, and Bonferroni post hoc test. As for the cases where the data were not normally distributed, the Friedman nonparametric test, Mann-Whitney U-test, and Wilcoxon post hoc tests were used. RESULTS: In the intervention group, the mean score of knowledge, perceived susceptibility, severity, benefits, self-efficacy, and behavior significantly increased, and the mean score of perceived barriers significantly decreased after the intervention (≤0.001). In the control group, there were significant differences in the mean scores of perceived susceptibility, perceived severity, perceived self-efficacy, and performance after an intervention (P ≤ 0.001). However, this increase was significantly higher in the intervention group than in the control group. CONCLUSION: Based on the present study and according to the positive impact of the educational intervention based on the health belief model on the prevention of arthritis, it is recommended to use this theory in educational programs to prevent arthritis.

Developing and Validating the Functional, Communicative, and Critical Health Literacy Questionnaire among the Iranian General Population.

OBJECTIVES: Many scales have been developed to assess health literacy. These scales have been developed extensively in clinical populations in developed countries. Our study describes the process of development and validation of the Health Literacy Questionnaire to measure health literacy in the general Iranian population. METHODS: We followed the scale development process outlined by Schwab in 1980. After a comprehensive review of the research published on Nutbeam's definition of health literacy and its measurement, two focus groups were considered to generate a pool of items. We then assessed the face validity and content validity of the items. The final version of the questionnaire was subject to independent exploratory and confirmatory factor analysis. The internal consistency of the questionnaire was evaluated using Cronbach's alpha. Finally, construct validity was assessed using bivariate analysis between the total scores on the scale and theoretically relevant variables. RESULTS: The results of exploratory factor analysis revealed a three-factor 14-item structure for the scale. Confirmatory factor analysis provided a good statistical and conceptual fit for the data. The analysis of the internal consistency of the scale was satisfactory (α = 0.798). Further, health literacy was significantly associated with participants' age, educational level, self-rated household income, smoking history, self-rated health, and self-rated health literacy. CONCLUSIONS: The results we obtained indicate that this newly constructed health literacy tool is highly valid and reliable. Prospective studies are required to evaluate the predictive validity of the scale with regard to health outcomes.

Cognitive predictors of cervical cancer screening's stages of change among sample of Iranian women health volunteers: A path analysis.

INTRODUCTION: The uptake of Pap smear among Iranian women is low, resulting in a high rate of casualties from cervical cancer in Iran. The present study used the Health Belief Model (HBM) and the Stages of Change theory as theoretical frameworks for understanding the predictors of the behaviour of Iranian Women Health Volunteers (WHVs) with respect to cervical cancer screening. METHODS: Data from the 1,253 WHVs were analyzed using path analysis to assess the effects of cognitive factors (including knowledge, perceived susceptibility to cervical cancer, perceived severity of cervical cancer, Pap smear benefits, Pap smear barriers, and Pap smear self-efficacy) on the stages of change for Pap-smear behaviour. RESULTS: The majority of the respondents (71.5%) reported that they had not taken previous Pap smear tests; only 3% had received a regular Pap test. The perceived benefits to cervical cancer screening, the perceived barriers to cervical cancer screening, and the perceived self-efficacy to perform cervical cancer screening emerged as the predictors of cervical cancer screening's stages of change; perceived threat to cervical cancer, however, did not. DISCUSSION: Uptake of regular cervical screening for Iranian WHVs was very low. Different interventions, such as media campaigns and educational interventions could provide an opportunity to improve women's knowledge on cervical cancer and Pap test benefits, address any misconceptions or fears about the procedure of the Pap test, and finally increase the cervical screening uptake by Iranian women.

Cultural Adaptation and Psychometric Properties of the Persian Version of the Circumstances, Motivation, and Readiness Scale.

BACKGROUND: Treatment motivation has always been an important issue in substance abuse treatment. In recent decades, several instruments have been developed to measure this concept. OBJECTIVES: In this study, cultural adaptation and psychometric properties of the Persian version of the circumstances, motivation and readiness scale (CMR) are illustrated in a sample of Iranian addicts. MATERIALS AND METHODS: The translation process followed Beaton et al.'s (2000) guideline for the cross-cultural adaptation of self-administered questionnaires, including the steps of translation, synthesis, back translation, expert committee review, and pre-testing. The final version of the Persian CMR was assessed for internal consistency and construct validity (n = 203). RESULTS: There was one eliminated item in the cross-cultural adaptation process. Also, four items that had low correlation with the total score were excluded from the questionnaire during the initial analysis. Using the remaining items, Principle axis factoring with Promax rotation was performed and three factors, circumstance, motivation, and readiness, were identified. The secondary order three factor model provided a good statistical and conceptual fit for the data. Internal consistency met the criterion for a reliable measure (Cronbach's alpha = 0.840). The α range for these identified factors was 0.597 to 0.837. CONCLUSIONS: Although the CMR was originally designed for use in TC treatment, this study suggests that it is also applicable, with some modifications, in short-term residential camps. Also, it is concluded that the Persian translation of the CMR can be applied for studies among Persian addicts.

Factors affecting quality of life in postmenopausal women, Isfahan, 2011.

CONTEXT: Various studies have shown that quality of life in women after menopause undergoes radical changes. Several factors such as psycho-social factors are associated with the quality of life during menopausal period. AIMS: The present study surveyed the factors associated with quality of life of postmenopausal women in Isfahan, based on Behavioral Analysis Phase of PRECEDE model. SETTINGS AND DESIGN: This cross-sectional study was conducted through stratified random sampling among 200 healthy postmenopausal women in Isfahan in 2011. SUBJECTS AND METHODS: Data were collected by two valid and reliable questionnaires (one to assess the quality of life and the other to survey the factors associated with the Behavioral Analysis Phase of PRECEDE model). Data analysis was performed using SPSS software (version 18) and analytical and descriptive statistics. RESULTS: Pearson correlation indicated a positive and significant correlation between the quality of life and attitude toward menopause, perceived self-efficacy, and enabling and reinforcing factors, but there was no significant relationship between the quality of life and knowledge about menopause. Also, the quality of life in postmenopausal women had significant correlation with their age, education level, marital status, and employment status. CONCLUSION: Based on the present study, attitude, perceived self-efficacy, perceived social support, and enabling factors are associated with the quality of life in postmenopausal women. So, attention to these issues is essential for better health planning of women.