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.

Health beliefs on type 2 diabetes: a methodological research for development and psychometric evaluation of "DIABA" (Diabetes-related Instrument to Assess Beliefs of Adolescents) health beliefs on type 2 diabetes.

BACKGROUND: Several reports have shown an increase in the number of type-2 diabetics among adolescents creating an extra burden for this age group. However, there is no instrument assessing adolescents' attitude toward this disease. This study aims at designing a psychometric tool for assessing adolescents' health beliefs regarding type-2 diabetes. RESEARCH DESIGN AND METHODS: In this methodological research, 770 boy and girl adolescents (between 13 and 15) from Tehran 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 extensive literature review and the related existing questionnaires, as well as considering the research team's comments. The validity of the questionnaire was determined through face and content validity. The construct validity was determined through exploratory and confirmatory factor analysis. Reliability was measured via internal consistency coefficient (ICC) and internal consistency reliability was measured by Cronbach Alpha. SPSS 16 and EQS6.1 were used for data analysis. RESULTS: The pool of questions had 57 items, and by removing similar (23 questions) or inappropriate sentences (8 questions), a draft questionnaire with 26 questions was designed. No items were removed in the face validity phase. Based on the results of CVR and CVI, six items and 4 items in the exploratory factor analysis were removed. Finally, a questionnaire with 16 items in 4 dimensions of perceived self-efficacy, behavioral beliefs, perceived susceptibility and perceived severity was obtained. The results of confirmatory factor analysis confirmed the model. The internal consistency coefficient was confirmed measuring Cronbach Alpha at 0.78 and ICC = 0.73. CONCLUSION: The questionnaire designed can be employed as a reliable and valid instrument to assess the psychological perceptions and health beliefs of adolescents with respect to type-2 diabetes.

Experiences of patient education among people affected by cardiovascular disease: a qualitative study based on Andragogy model.

BACKGROUND: Patient education is a key component of patient care, positively affecting health promotion and self-care ability. In this regard, an extensive body of research supports the use of the andragogy model in patient education. The study aimed to explore the experiences of people with cardiovascular disease in patient education. METHODS: This qualitative study involved 30 adult patients with cardiovascular disease who were hospitalized or had a history of hospitalization. They were purposively recruited with maximum variation from two large hospitals in Tehran, Iran. Data were gathered by conducting semi-structured interviews. Data collection was done by conducting semi-structured interviews. Then, the data were analyzed using directed content analysis and a preliminary framework based on six constructs of the andragogy model. RESULTS: Data analysis resulted in the development of 850 primary codes, which were reduced to 660 during data reduction. These codes were grouped into nineteen subcategories under the six primary constructs of the andragogy model, i.e., need-to-know, self-concept, prior experience, readiness for learning, orientation to learning, and motivation for learning. The most common problems in patient education were associated with self-concept, previous experience, and readiness for learning components. CONCLUSION: This study provides valuable information about the problems of patient education for adults with cardiovascular disease. Correction of the issues identified can improve care quality and patient outcomes.

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.

Peer-led theoretically Desinged HIV/AIDS prevention intervention among students: a case of health belief model.

BACKGROUND & AIM: HIV/AIDS is one of the most dangerous viruses known in the world. In addition, considering its fatality rate and high cost of care, it is a serious threat to the health and economy of social communities. Adolescents are one of the high-risk groups. One of the most effective ways to prevent this disease is to promote healthcare, raise awareness, and change health-related beliefs and attitudes. This study aims at determining the effect of peer education, based on the health belief model, on the preventative measures against AIDS adopted by girls. METHODS & MATERIALS: In this empirical-interventionist study two schools were randomly selected, one of which was considered as the intervention group and the other as the control group. The classes were also randomly selected and 80 students from each school took part in the project following the entry criterion. A questionnaire with acceptable validity and reliability was used to collect data. In this study a few bright students were chosen as peer educators after being trained. The intervention group (N = 80) received 4 sessions of 60-min education through training, lectures, question and answer, and group discussion, But the control group received no instruction. The posttest was administered two months after the treatment. The data was fed into the SPSS 16. Finally, T-test, Chi-Square, and ANCOVA were employed to analyze the data. RESULTS: The average scores obtained from the intervention group and the control group were not significantly different in terms of awareness level, perceived susceptibility, perceived severity, perceived benefits, perceived barriers, perceived self-efficacy, behavioral intention, and behavior in baseline (P>0.05). Two months after the intervention there was a significant increase in the average scores of all the variables in the experimental group (P > 0.05). However, there was no significant change in the scores of the control group (P > 0.05). CONCLUSION: Following a health belief model focusing on peer eduaction among high school girls, the intervention eduaction can affect awareness level, susceptibility, severity, benefits, perceived barriers, perceived self-efficacy, behavioral intention, and finally avoidance of high-risk behavior.

Design and validation of theory-based perceptions concerning the physical literacy questionnaire for pregnant women (P2LQ-PW).

BACKGROUND: There is evidence that physical literacy plays an essential role in understanding the importance of maintaining appropriate physical activity and thereby preventing illnesses during pregnancy. The present study aimed to design and validate a physical literacy questionnaire focused on pregnant women. METHODS: In this exploratory psychometric study, theory-based perceptions concerning the physical literacy questionnaire for pregnant women were designed. Face-to-face interviews were conducted to develop the initial items. The findings from the interviews were merged with the literature review. The content, construct, and face validity was assessed by the participation of midwives, health educationists, and pregnant women. The content validity ratio, content validity index, and impact score of the items were calculated. The construct validity of the questionnaire was calculated through confirmatory and exploratory factor analysis. The reliability of the questionnaire was calculated by the standard error of measurement, intra-class correlation coefficient, composite reliability, and Cronbach's alpha. RESULTS: The highest score was seen in the knowledge subscale and the value of Cronbach's alpha for the subscales was 0.89 to 0.97, and the value of ICC was 0.76 to 0.89. The correlation according to the opinion of experts was satisfactory in all items of the questionnaire. The minimum loading factor for varimax rotation in the knowledge subscale was 0.41, the attitude was 0.56, the nurture factor was 0.38, and enabling factor was 0.27. The compatibility of the model among the constructs was confirmed by the normed chi-square (χ2/ df) < 5.0, comparative fit index ≥0.90, Tucker-Lewis index ≥0.9, and root mean square error of approximation < 0.08. CONCLUSION: The physical literacy questionnaire for pregnant women is the first tool based on the PEN-3 model that other researchers can use to collect data and conduct educational interventions to change physical literacy behavior among Persian women during pregnancy.

Design, implementation, and evaluation of a PRECEDE-PROCEED model-based intervention for oral and dental health among primary school students of Rafsanjan city: a mixed method study.

BACKGROUND: Oral and dental health has a significant impact on public health as well as the quality of life among individuals and families. This study aims to design, implement, and evaluate an intervention based on the PRECEDE-PROCEED model for oral and dental health among primary school students in Rafsanjan city, Southern Iran. METHODS: According to the nature of the model and with the focus group discussion and interview methods, in phases 1 to 4 (PRECEDE), predisposing, enabling, and reinforcing factors related to oral health were identified. The training program was designed and consisted of six sessions for students (250 students) with a brushing session, three sessions for parents, and two sessions for teachers. Process evaluation and the effect of the program on behavioral and factors affecting oral health were evaluated (PROCEED). RESULTS: In the qualitative section, seven predisposing factors, five enabling factors, and two reinforcing factors were identified. A training program based on the PRECEDE-PROCEED model was found to be effective in increasing the mean scores of the above constructs and the students' brushing behavior (P < 0.001). CONCLUSION: Based on the model planning phases, the factors affecting the brushing behavior of children aged 6-12 years were identified. The educational program has had a significant effect on improving the scores of predisposing, enabling and reinforcing factors and children's brushing behavior.

Structural Equation Modeling of the Spirituality and Self-efficacy Among College Students.

The present research is a descriptive analytical study which is conducted on 540 students. Multistage random sampling method was used. Data gathered by questionnaire consist of demographic factors and spirituality assessment questionnaire and self-efficacy questionnaire. Data were analyzed using statistical tests including t test, Chi-square, one-way ANOVA and correlation between variables through SPSS16 and EQS6.1 Software. Positive coefficients in regression equations showed positive relationship of spiritual capability (P < 0.001, r = 0.932) and spirituality with perceived self-efficacy (P < 0.001, r = 0.394) so that an increase in one of them will lead to increase in another one; this result is matched with research hypothesis. It is recommended to officials and managers of universities to create some mechanisms in order to improve and promote spirituality in university to promote self-efficacy of students and also to adopt a spiritual approach in curriculums of higher education.

Effectiveness of a health intervention based on WHO food safety manual in Iran.

BACKGROUND: Food safety manual was developed by the World Health Organization (WHO) to train professionals to reduce the burden of foodborne diseases as a global strategy. The present pioneering research aimed to explore the effectiveness of an intervention based on the manual of five keys to safer food by WHO in enhancing the knowledge, attitude and behavior of Iranian Female Community Health Volunteers (FCHVs). METHODS: In the present quasi-experimental research, FCHVs (n = 125) were selected and assigned to two groups, an intervention and a control. A modified version of the questionnaire based on WHO manual was used to measure knowledge, attitude and behavior of the sample. The questionnaire was first completed at the outset of the study (pre-test) and then once again in 2 months of the intervention (post-test). Face and content validity of the questionnaire was tested and confirmed. Cronbach's alpha was used to test the reliability of the questionnaire along with the test-retest method of testing reliability. The data entered SPSS16 for statistical analysis. To this aim, Chi-squared test, dependent and independent samples T-test, ANOVA and ANCOVA were run. Partial population attributable risks were calculated and corresponding 95% confidence intervals (95% CIs) were estimated using a bootstrap method. RESULTS: The two groups showed no statistically significant difference in the pretest (p > .05). In the post-test, the mean scores for all variables was higher in the intervention group than the control, and this difference between the two research groups was statistically significant (p < .001). When the volunteers were adjusted for age and experience in healthcare centers, the mean scores were significantly higher in the intervention group than the control (p < .001). CONCLUSION: It was revealed in the present study that the educational intervention based on five keys to food safety manual by WHO managed to improve participants' knowledge, attitude and behavior. Translation of the target guideline in future can be a great help to researchers in prospective research. TRIAL REGISTRATION: Retrospectively registered: Iranian Registry of Clinical Trials IRCT20160822029485N4, at 2020-03-16.

Theoretically designed interventions for colorectal cancer prevention: a case of the health belief model.

BACKGROUND: According to the WHO, most chronic diseases, including cancer, can be prevented by identifying their risk factors such as unhealthy diet, smoking and physical inactivity. This research examined the effectiveness of a theory-based educational intervention on colorectal cancer-related preventive nutritional behaviors among a sample of organizational staff. METHODS: In this interventional study, 110 employees of Shahid Beheshti University of Medical Sciences were randomly divided into two groups (intervention and control) with cluster sampling. The data gathering tool was a researcher-made questionnaire containing two parts of 10-dimensional information and health belief model constructs. The educational intervention was conducted for 1 month and in four sessions in the form of classroom lecture, pamphlet, educational text messages via mobile phones and educational pamphlets through the office automation system. Two groups were evaluated in two stages, pre-test and post-test. Data were analyzed using SPSS-18 software, analysis of Covariance (ANCOVA) and independent t-test (intergroup comparisons). RESULTS: Two groups were evaluated for variables such as age, sex, education level and family history of colorectal cancer, and there was no significant difference between the two groups (P < 0.05). After the 2 months since intervention, except for the mean score of perceived barriers, which was not significant after intervention, the mean scores of knowledge, perceived susceptibility, perceived severity, perceived benefits, perceived self-efficacy, behavioral intention, and preventive behaviors were significantly increased after the intervention in the intervention group compared to the control group (P > 0.05). CONCLUSION: Implementation of educational intervention based on health belief model was effective for the personnel, and can enhance the preventative nutritional behaviors related to colorectal cancer.

Exploring determinants of hand hygiene among hospital nurses: a qualitative study.

BACKGROUND: The present research is a qualitative one aiming to determine factors affecting hand-hygiene behavior of the nursing staff in Shariati Hospital of Tehran, Iran. METHODS: This was a qualitative study performed using content analysis approach. Considering the aim of the study, 16 in-depth semi-structured interviews were held with the nursing staff of Shariati Hospital of Tehran University of Medical Sciences. A convenient sampling was performed and continued until data saturation and until no new codes and categories were obtained. Data were analyzed through a qualitative content analysis based on the Graham and landsman method. Directed qualitative content analysis was done in order to analyze the data. RESULTS: The results of this study revealed 3 main themes in the Theory of Planned Behavior (TPB) (attitude, subjective norms and perceived behavioral control) and 8 main themes in the outside the framework (environment, perceptions, life style, morality, education, organizational culture, salience and personality). CONCLUSION: Due to the other factors also found in this study, an integration of theories and models for designing of interventions is recommended to increase adherence to hand hygiene behavior.

Systematic review of the tools of oral and dental health literacy: assessment of conceptual dimensions and psychometric properties.

BACKGROUND: This article aims to provide a description of conceptual dimensions and psychometric properties of the tools of oral and dental health literacy. METHODS: Two authors in this study conducted electronic searches in the Medline (via PubMed), and Embase databases to find relevant articles from 1990 to present day. Evaluation of the tools was carried out in two parts; general evaluation of the tools using skills introduced by Sørensen et al., and qualitative assessment of psychometric properties using COSMIN checklist. RESULTS: After reviewing 1839 articles on oral and dental health literacy and evaluating 33 full text articles for eligibility, 21 articles entered the study. The sample size varied from 20 to 1405 subjects and the items of each tool ranged from 11 to 99 items. Of the 21 tools examined, 16 tools were evaluated for word recognition. For the studies examined, the evaluation of COSMIN scores was often fair or good. Of the 21 tools examined, 9 tools at least in one dimension were in the category of "poor", 19 tools were in the category of "fair", 20 tools were in the category of "good", and 4 tools were in the category of "excellent" in at least one dimension. CONCLUSION: The findings of this study showed that some aspects of oral and dental health literacy are being ignored in the existing tools. Therefore, the authors of present study emphasize on the necessity to design and develop a comprehensive tool and take into account two characteristics of simplicity and briefness for international use.

Evaluation of Health Belief Model-Based Intervention on Breast Cancer Screening Behaviors among Health Volunteers.

Breast cancer is the most common cancer and the second leading cause of death among women. Regarding the lack of knowledge about the cause of breast cancer and considering the fact that all women are prone to this disease, training on methods of early diagnosis to reduce its complications is of great importance. Thus, this study aimed to determine the effect of education based on the health belief model on breast cancer screening behaviors in health volunteers of health centers in Isfahan. In this experimental study, 480 healthy volunteers were randomly divided into two groups: the case (n = 240) and control (n = 240). The training program was designed according to health belief model structures. Before the training interventional program, the Champion standard questionnaire and functional checklist were completed for both groups. A standard questionnaire was completed during three stages (before, immediately after, and 2 months after the training). The experimental group received the educational intervention during eight sessions, and the collected data was eventually analyzed using the SPSS statistical software version 16 with relevant statistical tests. Participation of all individuals in the present research was voluntary and with informed consent. The results showed that mean scores of knowledge, perceived susceptibility, severity, benefits, barriers, self-efficacy, and behavioral intention related to breast self-examination (BSE) and mammography in the intervention group significantly increased compared with those of the control group immediately after and 2 months after educational intervention. There was a significant difference between groups in BSE skill 2 months after the intervention, but there was no significant difference between the two groups in BSE behavior and mammography 2 months after the intervention. The results confirmed the efficiency and effectiveness of an educational intervention based on the health belief model on improving factors affecting breast cancer screening behaviors.

Oral and dental health care during pregnancy: Evaluating a theory-driven intervention.

OBJECTIVE: The present research aimed to investigate the effect of an educational intervention based on the health belief model in pregnant women visiting the healthcare centers in the west of Tehran in 2016. MATERIALS AND METHODS: The present experimental research was conducted on 135 pregnant women visiting the healthcare centers in the west of Tehran. The subjects were selected through a randomized multistratified sampling and were divided into an experimental and a control group. The collected data were then statistically analyzed in SPSS ver.16. To do so, descriptive statistics and inferential statistics were used including the independent-samples t-test, repeated-measures one-way ANOVA and paired-sample t-test. RESULTS: The present findings revealed a statistically significant difference between the experimental and control groups in terms of immediate post-test results including perceived sensitivity, severity, benefits, barriers, and self-efficacy along with awareness and performance constructs (p Ë‚ 0.001). Moreover, two months after the intervention, except for the perceived sensitivity construct (p = 0.088), the two groups diverged significantly in terms of the other constructs (p Ë‚ 0.001). CONCLUSIONS: The educational intervention driven by the health belief theory showed to be effective on pregnant women and can help to promote preventive behaviors of tooth decay.

Determinants of fruit and vegetable consumption among Tehranian adolescents: A qualitative research.

BACKGROUND: For effectively promoting fruit and vegetable consumption among adolescents, it is necessary to identify the determinants of intake. This qualitative research was conducted to explore the determinants of fruit and vegetable consumption among Tehranian adolescents in 2012. MATERIALS AND METHODS: The present qualitative study is aimed at identifying the determinants of fruit and vegetable consumption among Tehranian adolescents in 2012. Male and female students in the middle schools of Tehran, in the age range of 11-14 years, were used as the study population, which was selected by the convenience method. Semi-structured interactional interviews were used for data collection. Data was analyzed using the qualitative content analysis method. RESULTS: The availability and accessibility of fruits and vegetables in home, availability of unhealthy options in the environment, socioeconomic status, advertising about unhealthy options, subjective norms, reinforcement, and modeling were explored as environmental factors in this study. Also, individual factors were extracted as the second category that encompassed the subcategories including; preferences, knowledge, skill in preparing fruits and vegetables, outcome expectations, outcome expectancy, perceived susceptibility, and perceived seriousness. CONCLUSION: It is recommended that interventions have family-based designs as well as environmental policy-based (especially schools) ones. Meanwhile, families should be educated to adapt their children's sapour with tastes of fruits and vegetables during their childhood.

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.

Requirements and Key Features of a Mobile Application for Adolescent Self-Care From a Stakeholders Perspective: A Qualitative Study.

Adolescence is characterized by many changes and these changes differentiate adolescents' self-care needs. The use of smartphones and tablets to provide healthcare services has expanded, and the user-centered design could help to create mobile applications based on users' needs. Therefore, the present study aimed to identify the data requirements and key features of mobile application for adolescent self-care from a stakeholder perspective. This study was conducted with a qualitative approach to identify the key features of mobile application for adolescent's self-care as well as educational content axes for five component of self-care using conventional and directed content analysis respectively. From 3 sub-groups 30 participants were selected based on purposive sampling with maximum variety and sampling was performed until data saturation. Data were collected through in-depth semi-structured interviews. Participants' informed consent was obtained before the interview. The interview lasted 20-40 min and MAXQDA software version 10 was used for data analysis. In this study, four criteria of acceptability, reliability, transferability, and validity proposed by Guba and Lincoln were used to evaluate and validate the data. After conducting the interviews, 789 initial codes, 12 sub-categories, and 3 categories (app view, app content architecture, app self-care content) were emerged, which reflects the key features of a mobile application and the necessary educational content. The research findings could provide a guide for future mobile application development considering the viewpoints of health professionals, content, and software experts. Addressing the features and requirements in practice could lead to designing efficient and effective mobile applications.

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.

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.