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.

Development and validation of a health belief model based instrument for measuring factors influencing exercise behaviors to prevent osteoporosis in pre-menopausal women (HOPE).

BACKGROUND: The health belief model (HBM) is the most commonly used conceptual framework for evaluating osteoporosis health belief and behaviors. The purpose of this study was to develop and evaluate the psychometric properties of a health belief model based questionnaire for exercise behavior for preventing osteoporosis among women aged 30 years and over. METHODS: This was a cross sectional study of a convenience sample of women aged 30 years and over in Tehran, Iran using a theory-based instrument (HOPE). The instrument contained 39 items covering issues relate to osteoporosis prevention behavior. In this methodological study, exploratory and confirmatory factor analyses were used for psychometric evaluation. The Cronbach's alpha coefficient and Intraclass Correlation Coefficient (ICC) was used to evaluate the reliability of the scale. RESULTS: In all 240 women participated in the study. The mean age of participant was 39.2 ± 7.8 years. The initial analysis extracted nine factors for the questionnaire that jointly accounted for 66.5% of variance observed. Confirmatory factor analysis showed that the data obtained was fit with Health Belief Model (HBM) and self-regulation construct (X2 = 1132.80, df = 629, P < 0.0001, CFI = 0.94, GFI = 0.91, RMSEA = 0.05 and SRMR = 0.06). The Cronbach's alpha coefficient for the subscales ranged from 0.72 to 0.90 and Intraclass Correlation Coefficient (ICC) ranged from 0.71 to 0.98; well above acceptable thresholds. CONCLUSIONS: The HOPE was found to be appropriate instrument for measuring health belief and self-regulation for prevention of osteoporosis.

The transtheoretical model (TTM) questionnaire for smoking cessation: psychometric properties of the Iranian version.

BACKGROUND: The transtheoretical model (TTM) is a common framework for studies of smoking cessation. Using the TTM, several instruments were developed to measure to what extent interventions could make changes in people's behavior. The current study aimed to test the validity and reliability of the Persian version of a TTM based questionnaire for smoking cessation in Iran. METHODS: This was a cross-sectional validation study among adult male smokers using the TTM Questionnaire. Backward-forward procedure was applied to translate the questionnaire from English into Persian (the Iranian language). The confirmatory factor analyses were performed to test validity. The internal consistency and stability of the questionnaire was examined using Cronbach's alpha coefficient and Intraclass Correlation Coefficient (ICC). RESULTS: In all 150 male smokers were entered into the study. The mean age of participants was 36.51 ± 7.94 years. The results obtained from confirmatory factor analysis revealed that the data was fit to the model: the goodness of fit index (GFI) = 0.92; the comparative fit index (CFI) = 0.91; the root mean square error of approximation (RMSEA) = 0.065 (95% CI = 0.063-0.067), and the relative chi-square (x²/df) = 1.87, p < 0.001. The Cronbach's alpha ranged from 0.60 to 0.84 indicating an acceptable result. Also Intraclass Correlation of Coefficient (ICC) ranged from 0.61 to 0.83 corresponding to a satisfactory finding. CONCLUSION: The current study provided psychometric evidence for an appropriate, reliable, and valid tool to determine smoking behaviors among Iranian adult smokers. Indeed the findings from this study could be applied in designing smoking cessation interventions in Iran.

Promoting sexual abstinence intention among female university students: A quasi-experimental study.

BACKGROUND: The effectiveness of a theory-based educational intervention on intension for sexual abstinence among female university students was evaluated. MATERIALS AND METHODS: Female students were recruited from humanity sciences department through cluster sampling. Educational intervention was applied for four 90-min sessions and by application of cognitive theories during 4 weeks. RESULTS: One hundred and nine female students with mean age of 20.74 ± 1.57 years took part in the study. Despite the similarity of two groups of intervention (n = 53) and control (n = 59) at baseline, there were significant differences between the two groups in mean scores of the variables, knowledge (4.62 ± 1.38 vs. 3.53 ± 1.61), perceived susceptibility (14.05 ± 1.51 vs. 12.37 ± 2.11), and perceived benefits (28.41 ± 2.14 vs. 27.51 ± 3.05), at follow-up time after 3 months (P < 0.05). Additionally, these variables were observed with improvement over 3 months in the intervention group (P < 0.05). However, this study showed no significant effect on the behavior intention and self-efficacy. CONCLUSION: This study showed that educational intervention could improve knowledge, perceived benefits, and self-efficacy of the female students regarding HIV/AIDS.

Development and psychometric properties of a new social support scale for self-care in middle-aged patients with type II diabetes (S4-MAD).

BACKGROUND: Social support has proved to be one of the most effective factors on the success of diabetic self-care. This study aimed to develop a scale for evaluating social support for self-care in middle-aged patients (30-60 years old) with type II diabetes. METHODS: This was a two-phase qualitative and quantitative study. The study was conducted during 2009 to 2011 in Tehran, Iran. In the qualitative part, a sample of diabetic patients participated in four focus group discussions in order to develop a preliminary item pool. Consequently, content and face validity were performed to provide a pre-final version of the questionnaire. Then, in a quantitative study, reliability (internal consistency and test-retest analysis), validity and factor analysis (both exploratory and confirmatory) were performed to assess psychometric properties of the scale. RESULTS: A 38-item questionnaire was developed through the qualitative phase. It was reduced to a 33-item after content validity. Exploratory factor analysis loaded a 30-item with a five-factor solution (nutrition, physical activity, self monitoring of blood glucose, foot care and smoking) that jointly accounted for 72.3% of observed variance. The confirmatory factor analysis indicated a good fit to the data. The Cronbach's alpha coefficient showed excellent internal consistency (alpha=0.94), and test-retest of the scale with 2-weeks intervals indicated an appropriate stability for the scale (ICC=0.87). CONCLUSION: The findings showed that the designed questionnaire was a valid and reliable instrument for measuring social support for self-care in middle-aged patients with type II diabetes. It is an easy to use questionnaire and contains the most significant diabetes related behaviors that need continuous support for self-care.

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.

Facilitators, Barriers, and Structural Determinants of Physical Activity in Nulliparous Pregnant Women: A Qualitative Study.

Aims & Backgrounds. Reduced physical activity in pregnant women is highly stemmed from their misconceptions and attitudes during pregnancy. This study is aimed at recognizing the facilitators, barriers, and structural factors that influence activity among pregnant women. Participants & Methods. This qualitative study was conducted from January to June 2020 in nulliparous pregnant women. Forty participants selected randomly from the Pounak Health Center of Tehran City, Iran, answered open-ended questions about the obstacles that deprived them of physical activity during pregnancy. Data were analyzed by MAXQDA 12 software. Findings. 620 primary codes, 42 secondary codes, 11 subthemes, and 6 themes were extracted. These themes were divided into the PEN-3 categories: facilitators, barriers, and structural factors. The nurture factors as facilitators had communication and support from others as subthemes. Barriers consisted of sociocultural (participate in pregnancy class with a companion, social beliefs, and culture of poverty), socioeconomic (financial problems), and individual factors (physical, psychoemotional, and spiritual dimensions), and structural factors consisted of environmental (equipment) and organizational (possibilities in health centers) factors. Conclusion. Lack of awareness and misinformation, accessibility obstacles, and economic problems are the worst physical activity barriers during pregnancy. Being among other pregnant women and the physicians' recommendations are the best facilitators of physical activity during pregnancy.

Measuring the Structures of the Health Belief Model Integrated with Health Literacy in Predicting University Students' Adoption of Smoking Preventive Behaviors.

Objectives: One of the priorities of public health in reducing smoking is to prevent young people from becoming smokers. Health literacy (HL), smoking, and preventive behaviors are related. Moreover, HL has a potential impact on strengthening the Health Belief Model (HBM). Considering the high prevalence of smoking among university students, the current study was conducted to measure the structures of the HBM integrated with HL in predicting university students' adoption of smoking preventive behaviors. Methods: This was a cross-sectional descriptive study. Three hundred and forty dormitory students of Shahid Beheshti University of Medical Sciences (Teheran, Iran) in 2016, were selected through single-stage cluster sampling for the study. The data gathering tool was a researcher-made questionnaire based on the HBM and the HL inventory for adults (HELIA). The data were analyzed using the SPSS software version.16. Results: The multiple regression analysis showed that the application of health information from five dimensions of HL, perceived susceptibility, self-efficacy, and decision-making dimensions were the predictors of smoking prevention. Also, the structures of this integrated model were able to anticipate 36.5% of the behavioral changes. Conclusion: The HBM integrated with HL can be used as an appropriate framework for designing educational programs to encourage university students to adopt smoking preventive behaviors.

Development and psychometric properties of a belief-based Physical Activity Questionnaire for Diabetic Patients (PAQ-DP).

BACKGROUND: This study carried out to develop a scale for assessing diabetic patients' perceptions about physical activity and to test its psychometric properties (The Physical Activity Questionnaire for Diabetic Patients-PAQ-DP). METHODS: An item pool extracted from the Theory of Planned Behavior literature was generated. Then an expert panel evaluated the items by assessing content validity index and content validity ratio. Consequently exploratory factor analysis (EFA) was performed to indicate the scale constructs. In addition reliability analyses including internal consistency and test-retest analysis were carried out. RESULTS: In all a sample of 127 women with diabetes participated in the study. Twenty-two items were initially extracted from the literature. A six-factor solution (containing 19 items) emerged as a result of an exploratory factor analysis namely: instrumental attitude, subjective norm, perceived behavioral control, affective attitude, self-identity, and intention explaining 60.30% of the variance observed. Additional analyses indicated satisfactory results for internal consistency (Cronbach's alpha ranging from 0.54 to 0.8) and intraclass correlation coefficients (ranging from 0.40 to 0.92). CONCLUSIONS: The Physical Activity Questionnaire for Diabetic Patients (PAQ-DP) is the first instrument that applies the Theory of Planned Behavior in its constructs. The findings indicated that the PAQ-DP is a reliable and valid measure for assessing physical activity perceptions and now is available and can be used in future studies.

Determinants of glycemic control in female diabetic patients: a study from Iran.

BACKGROUND: Since microvascular and macrovascular complications are reduced through strict glycemic control, this study carried out to identify the factors that affect glycemic control. METHODS: A cross-sectional design was carried out to examine the role of demographic, anthropometric, clinical and other relevant characteristics in a sample of 103 female diabetic patients in Tehran, Iran. Personal interviews were conducted to collect data. Then blood sampling collected and the patients were divided into two outcome groups (controlled and uncontrolled diabetes). The groups were compared on the basis of their characteristics using both univariate and multivariate analyses. RESULTS: In all 103 patients were entered into the study. The mean age of patients was 46.38 (SD = 11.42) years. Overall, the mean value of HbA1c for the whole sample was 7.5 (SD = 2.35) and 56.3% had HbA1c > or = 7%. The findings obtained from univariate analysis revealed that there were no significant differences between controlled and uncontrolled patients. However, in multivariate analysis the waist circumference was found to be a significant predictor of increased level of HbA1c (OR = 1.04, 95% CI = 1-1.08, P = 0.04). CONCLUSIONS: The findings suggest that increased level of HbA1c is associated with waist circumference that is a modifiable factor. It seems that physical activity might be a solution to overcome this health problem. A larger study to identify other factors also is recommended.

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.

Muslim breast cancer survivor spirituality: coping strategy or health seeking behavior hindrance?

We explored the role of religiosity and spirituality on (i) feelings and attitudes about breast cancer, (ii) strategies for coping with breast cancer, and (iii) health care seeking behaviors among breast cancer survivors in Iran. We conducted in-depth semistructured interviews with 39 breast cancer survivors. We found that spirituality is the primary source of psychological support among participants. Almost all participants attributed their cancer to the will of God. Despite this, they actively have been engaged with their medical treatment. This is in surprising contrast to Western cultures in which a belief in an external health locus of control diminishes participation in cancer screening, detection, and treatment. These findings can help researchers to provide a framework for the development of appropriate and effective culturally sensitive health interventions.

Motorcyclists' reactions to safety helmet law: a qualitative study.

BACKGROUND: Extensive body of the literature reveals that proper use of helmets is an effective way to reduce the severity of injuries and fatalities among motorcyclists. However, many motorcyclists do not use safety helmet properly. This study aimed to empirically explore reactions of motorcyclists to the safety helmet laws, in Iran. METHODS: Qualitative data were collected via four focus groups and 11 in-depth interviews. Participants were 28 male motorcyclists who never used a safety helmet during rides, and 4 male police officers. All transcripts, codes and categories were read for several times to exhaust identifiable major themes. During this process data were reduced from text to codes and themes. RESULTS: Five major themes emerged from the data analyses, including themes related to the following: (1) circumventing or dodging police officers; (2) simulating a helmet wearing behavior; (3) accepting the probability of receiving a ticket; (4) taking advantage of the police neglect and carelessness; and (5) using a cheap or convenient helmet. CONCLUSION: Our findings suggest certain levels of reckless driving among the participating motorcyclists in this study. They also point to a system of law enforcement that operates haphazardly and fails to consistently penalize those who deviate from it. Further studies are needed to investigate how "risks" are perceived and relate to "reactions", and how a 'culture of masculinity' may encourage risk tolerance and a disposition toward lawlessness and carelessness among male motorcyclists. Also, there is a need for the development and implementation of multidimensional interventions that would offer socio-culturally sensitive educational and motivational messages to the motorcyclists and the in-service traffic-enforcement officers in Iran.

An educational intervention based on the extended parallel process model to improve attitude, behavioral intention, and early breast cancer diagnosis: a randomized trial.

Background: Breast cancer is an important public health problem worldwide. This study aimed to assess the effectiveness of an educational intervention based on fear appeals using the extended parallel process model (EPPM) to improve attitudes, intention, and early breast cancer diagnosis in Iranian women. Methods: This was a cluster-randomized trial conducted in Tehran, Iran. A sample of women 40 years old and above was recruited and assigned either to intervention group or to control group. The intervention group received two pamphlets containing fear appeals specially designed for this study using the EPPM. The control group received nothing. The primary outcomes were changes in attitude, behavioral intention, and early breast cancer diagnosis. Participants responded to a questionnaire before intervention and at 3 months follow-up assessments. Independent t-tests and paired t-tests were used for comparison. Result: In all, 600 women were entered into the study (277 in the intervention group and 323 in the control group). Of these, 162 were lost to follow-up assessment. Thus, the analysis was restricted to those for whom both baseline and follow-up information was available (n=438). The mean age of participants was 53.2 (SD=9.45) years, and the mean year education of participants was 9.4 (SD=4.12) years. There were no significant differences between two groups regarding demographic variables. However, comparing outcome variables (attitude, intention, and early breast cancer diagnosis) at baseline and follow-up assessments, we found that the intervention group showed significant improvements in attitude and intention (P=0.01 and P=0.001, respectively), but no significant improvement was observed for early breast cancer diagnosis (P=0.78). The control group did not show any changes. Conclusion: The findings showed that fear appeals could not influence early breast cancer diagnosis among women. However, significant changes were observed for attitude and behavioral intention.

A school-based randomized controlled trial to improve physical activity among Iranian high school girls.

BACKGROUND: Physical activity (PA) rates decline precipitously during the high school years and are consistently lower among adolescent girls than adolescent boys. Due to cultural barriers, this problem might be exacerbated in female Iranian adolescents. However, little intervention research has been conducted to try to increase PA participation rates with this population. Because PA interventions in schools have the potential to reach many children and adolescents, this study reports on PA intervention research conducted in all-female Iranian high schools. METHODS: A randomized controlled trial was conducted to examine the effects of two six-month tailored interventions on potential determinants of PA and PA behavior. Students (N = 161) were randomly allocated to one of three conditions: an intervention based on Pender's Health Promotion model (HP), an intervention based on an integration of the health promotion model and selected constructs from the Transtheoretical model (THP), and a control group (CON). Measures were administered prior to the intervention, at post-intervention and at a six-month follow-up. RESULTS: Repeated measure ANOVAs showed a significant interaction between group and time for perceived benefits, self efficacy, interpersonal norms, social support, behavioral processes, and PA behavior, indicating that both intervention groups significantly improved across the 24-week intervention, whereas the control group did not. Participants in the THP group showed greater use of counter conditioning and stimulus control at post-intervention and at follow-up. While there were no significant differences in PA between the HP and CON groups at follow-up, a significant difference was still found between the THP and the CON group. CONCLUSION: This study provides the first evidence of the effectiveness of a PA intervention based on Pender's HP model combined with selected aspects of the TTM on potential determinants to increase PA among Iranian high school girls.

Improving safe street-crossing behaviors among primary school students: a randomized controlled trial.

Background: Child pedestrian injury is a global public health concern. Our aim in the present study was to investigate the effects of active learning-based educational intervention on street-crossing behavior among male primary school students in Mehriz county, Iran. Methods: In this randomized controlled trial, 90 first grade elementary school students(experiment = 50, control group = 48) participated. The "ASSURE Model" was applied to design the template of this active learning-based educational program, which was implemented for the experiment group in eight sessions. Behaviors of the students about ''looking for vehicles on the street'', "being cautious of dangers'' and ''crossing from safe places'' were observed and documented in actual traffic environments before, 1 week, and 6 months after intervention. Results: One week and 6 months after the intervention, the experiment group's performance in all 3 behaviors were significantly improved (P < 0.001). Distraction-adjusted differences in the mean scores of behaviors between the experiment (Mean = 2.62) and control (Mean = 3.19)groups before and 6 months after intervention (Mean in experiment groups = 6.3, Mean in control group = 4.24) were also statistically significant (P < 0.001). Conclusion: Our educational intervention was found to be helpful in promoting the street crossing behaviors of primary school-aged children. School healthcare professionals may apply active learning education as the core category of their interventional programs to promote street-crossing behaviors among primary school students.

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.

Factors Associated with Anger among Male Adolescents in Western Iran: An Application of Social Cognitive Theory.

INTRODUCTION: Anger can be defined a natural emotional response that is gradually formed to protect us in dealing with threats, damages, assaults, and failures; while hatred is a change of attitude which is built following the persistence of anger towards a subject or an individual. One of the main reasons of adolescents' reference to the counseling centers is their anger accompanied by violence. OBJECTIVE: This study aims to determine the social cognitive factors associated with anger among a population of adolescents in the west of Iran based on the social cognitive theory. METHODOLOGY: Samples were selected based on multi-stage cluster sampling. Method including the first and the second-grade male high school students from Ilam town (N=360). The Spielberger's anger questionnaire (STAXI 2) and a self-designed questionnaire based on Bandura's social cognitive theory were employed as the data collection instruments in the present study. RESULTS: Of the selected population, 200 students were the first-grade and 160 students were the second-grade students. 135 students were the first child of the family, 150 students were the second or the third birth, and 75 students were the fifth or above in their families. Descriptive tests and correlation analysis were used to conduct the statistical analysis. Although there was a significant and inverse relationship between all the components of the theory and anger, the strongest relationship was seen in self-efficacy (-0.585) and the weakest relationship was seen in modeling (-0.297). DISCUSSION & CONCLUSION: If was concluded that helping people to know their abilities and have a better personal judgment in this case, can influence their anger control. In addition, the process of stress management can effectively increase an individual's emotional coping.

The effect of self-care education program on reducing HbA1c levels in patients with type 2 diabetes.

BACKGROUND: Diabetes as the most common diseases caused by metabolic disorders is an important global challenge. This is a disease that requires lifelong self-care because self-care and improved quality of life is cost effective. This study is aimed to determine the impact of self-care education program on reducing HbA1c, type 2 diabetic patients and was conducted in Zahedan. MATERIALS AND METHODS: This is an experimental study done on 138 diabetic female patients in Zahedan city, in 2011 (1390). This sampling method of patients was based on inclusion and exclusion criteria of the Diabetes Center, at Hazrat Ali Asghar Hospital (AS) in Zahedan. Samples were divided randomly in to two groups: 69 cases and 69 controls. Data collected included validity and reliability confirmed questionnaire. Checklist was based on patients 'performance of reporting and (HbA1c) testing. Before the educational intervention, the checklist of questions for recording the (HbA1c) test for both the groups were completed, and study samples received 5 sessions of education (with the group discussion and film show) for a month. However, the control group received only routine training. Three months after the educational intervention, both groups completed the questionnaire and the check list and data using SPSS software and the appropriate tests were analyzed. RESULTS: Findings showed that the mean domain scores of area of knowledge, attitude and practice educational groups, were recorded as (46.6 ± 8.57, 46.5 ± 0.86 and 29.06 ± 10.02), respectively. And after education scores of knowledge, attitude and practice were recorded as (52.80 ± 2.20, 12.98 ± 1.02 and 39.69 ± 4.74), respectively, and in study group significant difference (P < 0/001) was seen. CONCLUSION: Self-care training in striation leads to improve knowledge, attitude and self-care performance of the study samples and also improves the average (HbA1c). Because it seems to increase the active participation of learners in their care that they have experienced with this training method and their motivation enhanced them to learn better self-care. So this type of care education should be given to the attention of nurses and healthcare's staff.

Sexual behavioral abstine HIV/AIDS questionnaire: Validation study of an Iranian questionnaire.

BACKGROUND: This study was designed to assess the validity and reliability of the designed sexual, behavioral abstinence, and avoidance of high-risk situation questionnaire (SBAHAQ), with an aim to construct an appropriate development tool in the Iranian population. MATERIALS AND METHODS: A descriptive-analytic study was conducted among female undergraduate students of Tehran University, who were selected through cluster random sampling. After reviewing the questionnaires and investigating face and content validity, internal consistency of the questionnaire was assessed by Cronbach's alpha. Explanatory and confirmatory factor analysis was conducted using SPSS and AMOS 16 Software, respectively. RESULTS: The sample consisted of 348 female university students with a mean age of 20.69 ± 1.63 years. The content validity ratio (CVR) coefficient was 0.85 and the reliability of each section of the questionnaire was as follows: Perceived benefit (PB; 0.87), behavioral intention (BI; 0.77), and self-efficacy (SE; 0.85) (Cronbach's alpha totally was 0.83). Explanatory factor analysis showed three factors, including SE, PB, and BI, with the total variance of 61% and Kaiser-Meyer-Olkin (KMO) index of 88%. These factors were also confirmed by confirmatory factor analysis [adjusted goodness of fitness index (AGFI) = 0.939, root mean square error of approximation (RMSEA) = 0.039]. CONCLUSION: This study showed the designed questionnaire provided adequate construct validity and reliability, and could be adequately used to measure sexual abstinence and avoidance of high-risk situations among female students.