Development of an Instrument to Measure Dietary Supplement Health Literacy.

BACKGROUND: Health literacy is one of the important social determinants of health. OBJECTIVE: The aim of this study was to develop an instrument to measure Dietary Supplement Health Literacy (DSHL) of Iranian women. METHODS: In this psychometrics study, an initial nine-factor instrument was developed. Face validity and content validity of the instrument were evaluated. The factor structure of the instrument was explored by the Exploratory Factor Analysis (EFA) among 400 women taking Dietary supplement. Confirmatory Factor Analysis (CFA) was done to determine the underlying factor structure of the instrument in this population. The internal and external reliability of the instrument was evaluated. KEY RESULTS: According to expert panel opinions, 16 items were deleted. The results of the EFA showed that the Kaiser-Meyer-Olkin and Bartlett's test of sphericity were significant. EFA showed that 30 items could be grouped into nine factors that accounted for 60.84% of the variance. Since two items in the ability to actively engage with health care providers factor were loaded in factor 1, this factor was labeled Engaging in receiving informational supports from health care providers. In addition, one item of the dimension was loaded in factor 3. Given that the one item of factor 5 and 1 item of factor 6 were loaded in a new factor 9, this factor was labeled Applying information to decision-making. The CFA indicated that the nine-factor structure of the DSHL instrument had a poor fit. To modify indices, factor 9 with 2 items and 1 item of factor 6 were deleted. The Cronbach's alpha and intraclass correlation coefficient of the instrument were acceptable. Finally, a 27-item instrument with 8 dimensions was confirmed. CONCLUSIONS: The results of the study showed that the instrument developed was a valid tool for identifying the DSHL of Iranian women. [HLRP: Health Literacy Research and Practice. 2022;6(2):e159-e166.] Plain Language Summary: This study sought to develop and validate a multidimensional instrument to measure the health literacy of Iranian women about dietary supplements that was performed from July 2019 to May 2020 in Iran. Findings showed that the 30-item instrument developed in this study is a valid instrument to be used for identifying the health literacy of Iranian women about dietary supplements.

The determinants of anti-diabetic medication adherence based on the experiences of patients with type 2 diabetes.

BACKGROUND: The purpose of this study is to explain the experiences of patients with type 2 diabetes (T2DM) about medication adherence. METHOD: A qualitative content analysis study was conducted at the Institute of Endocrinology and Metabolism Research and Training Center of Firoozgar Academic Hospital, affiliated to Iran University of Medical Sciences in Tehran, Iran during April-June 2017. Twenty-six semi-structured in-depth interviews were conducted with diabetic patients and their families. The participants were asked about their experiences of medication adherence. After the first round of the interviews, content analysis of data started and continued up to the data saturation. RESULTS: Four main themes including perceived barriers (with 6 subthemes including inadequate knowledge, situational influences, inadequate perceived threat about diabetes, treatment characteristics, personality traits and medication cost), perceived social support (with 3 subthemes including family, doctor and community supports), medication beliefs (with 3 subthemes including belief in the effectiveness of treatment, belief in the more effectiveness of complementary therapies than medication use and prioritizing the use of the pills instead of the insulin injection) and cues to action (with 2 subthemes including internal and external cues to action) emerged as the experiences of the participants in terms of anti-diabetic medications adherence which should be considered in developing medication adherence interventions for the patients with T2DM. CONCLUSION: The patients with T2DM had more barriers for regular drugs consumption. They had incorrect beliefs about anti-diabetic drugs. In addition, they were in need of abroad support community, surroundings and also health professionals. Health systems should consider medication adherence training to be added to the treatment protocols of the diabetic patients.

Prevention of Esophageal Cancer: Experience of an Educational Campaign for Reducing Hot Tea Consumption in Iran.

BACKGROUND: Given the association between drinking hot tea and the risk of esophageal squamous cell carcinoma, this study was designed to determine the effectiveness of an educational campaign based on the Theory of Planned Behavior (TPB) in reducing hot tea consumption among a sample of Iranian female students. MATERIALS AND METHODS: In this quasi-experimental study, 130 primary-school female students in Salas Babajani, Kermanshah, Iran were randomly selected. A two-month campaign based on TPB constructs was developed and conducted for the intervention group. Combined mass media approaches (such as posters, pamphlet, and brochure) with small group and individual activities were used to transfer the campaign messages. Also, five 40-minute instructional sessions for the students and one session for their parents and teachers were held. The hot tea consumption, attitude, subjective norms, perceived behavioral control and no intention to drink hot tea were variables which were measured at baseline and again after 4 weeks. RESULTS: There was a significant improvement in the perceived behavioral control and intention to drink no hot tea variables in the intervention group as compared to the control group following the campaign. In addition, significant reductions were found for the hot tea consumption and favorable attitude toward drinking hot tea in the intervention group as compared to the control group. CONCLUSIONS: Conducting educational campaigns based on TPB variables may reduce hot tea consumption among Iranian students.

Effects of progressive muscular relaxation training on quality of life in anxious patients after coronary artery bypass graft surgery.

BACKGROUND & OBJECTIVE: Evidences suggest that relaxation therapy may improve psychological outcomes in heart patients. We evaluated the effect of progressive muscular relaxation (PMR) training in decreasing anxiety and improving quality of life among anxious patients after coronary artery bypass graft surgery (CABG). METHODS: This study was an open uncontrolled trial. The sample included 110 anxious patients referred to the cardiac rehabilitation clinic of Tehran Heart Center, Tehran, Iran, during six weeks after coronary artery bypass graft (CABG). Patients were allocated to receive both exercise training and lifestyle education plus relaxation therapy (relaxation group; n=55) or only exercise training beside lifestyle education (control group or the recipient of usual care group; n=55). Duration of the relaxation therapy was 6 wk and in the case of usual care was 8 wk. Both the groups were followed up one month after completion of intervention. Anxiety and quality of life in the two treatment groups were compared. RESULTS: There were no significant differences in overall QOL, state anxiety and trait anxiety scores between the two groups before intervention. Significant reductions in state anxiety (P<0.01) and trait anxiety (P<0.01) levels were observed in relaxation group after intervention compared to control group. Women had high state anxiety and a low quality of life than men in the two groups before intervention. After intervention, there was no difference between men and women in the relaxation group. INTERPRETATION & CONCLUSION: Our findings show that progressive muscular relaxation training may be an effective therapy for improving psychological health and quality of life in anxious heart patients.