Physical Activity Promotion in Schools Using Theoretically Designed Mobile Phone Application.

Background: Regular physical activity for adolescents has many health benefits, many of which also affect adulthood. Physical activity is a behavior that requires planning and choosing an appropriate educational method, model, or theory. However, mobile phone applications are known as a suitable method to increase physical activity according to the guidelines. This study aims to increase physical activity in female students based on the theory of planned behavior using mobile phone applications. Methods: This quasi-experimental study was implemented on 220 high school students (110 people in each group). The samples were selected by a multi-stage cluster method and their information was collected by the International Physical Activity Questionnaire (IPAQ) and the Theory of Planned Behavior (TPB) questionnaire whose validity and reliability were confirmed. The intervention group received 8 sessions of education through a mobile phone application that was designed by the constructs of the theory of planned behavior. The samples were evaluated in three stages, through a pre-test, post-test, and two-month follow-up. Results: The results showed a significant difference in the post-test and two months after the intervention between intervention and control groups in terms of attitude, perceived behavioral control, intention, and physical activity. There was a significant difference between intervention and control groups in subjective norms in the post-test, but there was no significant difference in the two-month follow-up compared to the post-test (P = 0.08). Conclusions: An educational intervention based on the theory of planned behavior using mobile phone applications led to an increase in the physical activity of girl high school students. However, to determine the full effectiveness of this study, it is recommended to implement this intervention in all schools.

Assessing the method of providing health services to at-risk groups during natural events (earthquake): A systematic review.

Disasters create a large amount of human needs. Health services in natural disasters are considered the main factor of human survival. The present study was conducted to determine the method of providing health services to at-risk groups during natural events such as earthquakes in 2022. This systematic review was conducted based on English and Persian studies published in Web of Science, Google Scholar, Scopus, Science Direct, and PubMed databases, as well as internal databases including SID, Magiran in the fields of title, abstract, and keywords such as natural disaster, earthquake, health services, mental health services, psychosocial support system, nursing services, relief, mental and physical health, and its MeSH equivalents with all of the possible combinations. Finally, 11 studies were identified as eligible among the 48 ones found in the initial search. To examine the quality of studies, the Joanna Briggs Institute (JBI) and STROBE evaluation checklists were used. Based on the results, 1834 studies were found after screening and investigating the inclusion criteria, among which 237 and 1549 were excluded due to repetition and unrelated titles, respectively. Then, 48 studies remained after reviewing their abstracts, resulting in including 11 in English (N = 10) and Persian (N = 1) from different countries during 2003-2020. The reviewed studies included semi-experimental and experimental (N = 5) and descriptive ones (N = 6). A large number of studies (N = 21) were related to providing services in the event of multiple disasters and were excluded. About 92% (N = 10) of the studies were conducted in English and more than 90% were related to providing services after the earthquake including providing mental health services (N = 6), the cognitive behavioral intervention (N = 3), rapid assessment of needs (N = 1), as well as mental health services and disaster education (N = 1). The vast majority of studies demonstrated improvement in psychosocial functioning, facilitation of children's normal development, and successful adaptive functioning with an intervention. Based on the results, mental health training affects more when local people are trained to assess the victims based on mental and psychological status. Earthquake is regarded as an opportunity that allows professionals to discover and introduce intervention combination modules to provide mental health services while helping victims who need emotional support and comfort. However, various types of services should be provided, especially in earthquake-prone areas before and after the earthquake in order to achieve a life with fewer complications and a higher quality considering the amount of trouble created by such disaster as a special condition.

Adolescents diabetes awareness test (ADAT): Tool development and psychometrics evaluation research.

BACKGROUND: During the last two decades, several reports have indicated an increase in the number of type-2 diabetes among adolescents. Therefore, an assessment of adolescents' awareness of this disease deserves serious consideration. This study aims at designing a psychometric tool for assessing adolescents' awareness of type-2 diabetes. METHODS AND MATERIAL: In this methodological research, 770 students attending 10 middle schools (five girls "schools and five boys" schools) from Tehran participated in the study. The questionnaire was designed by examining the relevant literature and the existing questionnaires, as well as considering the research team's comments, and the initial pool of items with 57 questions was designed. Face validity, content validity, and construct validity were calculated to determine the validity of the instrument. Reliability was measured via internal consistency coefficient (ICC) and internal consistency reliability was measured with Cronbach Alpha. SPSS 16 was used for data analysis. RESULTS: The questionnaire was initially designed with 57 items. Based on the results of CVR and CVI, five questions were removed. The average CVR and CVI were 0.75 and 0.82, respectively. Following exploratory factor analysis, the 30 questions in the questionnaire were categorized into five dimensions: public awareness, symptoms, behavioral risk factors, long-term effects, and medium-term effects. The internal reliability was calculated for the whole questionnaire-ICC = 0.87 with a Cronbach alpha coefficient of 0.80. CONCLUSIONS: The resulting questionnaire on adolescents' awareness of type-2 diabetes, with 30 questions in five dimensions, can be employed by researchers for its high factor loading in factor analysis and its standard psychometric properties.

Developing and validating an instrument to assess women's empowerment in dealing with domestic violence in Iran: a mixed-methods study protocol.

INTRODUCTION: Despite the emphasis on empowerment in interventions supporting women against domestic violence and ending spousal abuse, there is still no standard and accurate instrument to evaluate women's empowerment in this field. This study proposes a protocol to fill this gap by developing and psychometrically testing a standardised instrument for assessing women's empowerment in dealing with domestic violence (WEDDV). METHODS AND ANALYSIS: This study will be conducted in Iran in a mixed method with a sequential exploratory design (qualitative-quantitative). In the first phase, qualitative methods will be used to generate items, rank and identify essential items for WEDDV conceptualisation. The data collection method in this phase includes semistructured face-to-face interviews with married women, a review of related literature, and a fuzzy Delphi method with participants with work experience and expertise about violence against women. Qualitative data analysis will be done using a content analysis strategy and MAXQDA 2020 software. In the second phase of the study, the psychometric properties of the instrument, including face, content and construct validity, and the instrument's reliability will be evaluated. Also, the psychometric features of the COSMIN checklist will be used in the design of this instrument. ETHICS AND DISSEMINATION: This study protocol has been approved by the Research Ethics Committee of Shahid Beheshti University of Medical Sciences with code (IR.SBMU.PHNS.REC.1400.011). The findings will be published in prestigious journals and presented at national and international conferences. We hope that these results can provide a practical framework for planning and organising domestic violence interventions for policy-makers, researchers and women's health and counselling service providers.

The effect of education based on health belief model on hand hygiene behavior in the staff of Tehran dentistry centers: A quasi-experimental intervention study.

Background and Aims: Considering the increasing prevalence of dental services in the community and the impossibility of identifying each infected patient, hand sanitation is the most critical factor in controlling infection in these centers. Therefore, this study aimed to determine the effect of educational intervention on the hand health behavior of the staff of Tehran dentistry clinics based on the health belief model (HBM). Methods: In this quasi-experimental study in 2017, 128 employees of the health centers were selected through a multistage sampling method and they were placed in two groups of intervention and control (each 64 people). The data was collected using a questionnaire devised by the researcher. The validity and reliability of the questionnaire were determined. The questionnaire consisted of demographics, knowledge, structures of the HBM, and behavior variables. Then, the intervention was administered based on HBM-based education. Data were analyzed by SPSS16 and independent t test, χ 2, and repeated measurement analysis of variance. Results: Before the intervention, the two intervention and control groups did not differ significantly in terms of demographic variables, mean scores of knowledge, constructs of HBM, and hand hygiene behavior (p > 0.05), while the intervention group was scored higher significantly compared to the control one after the intervention (p < 0.001). Conclusion: According to the findings, the HBM can be used as a framework for designing educational interventions to improve hand hygiene behavior to control infection in health centers.

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.

Hospital health literacy conceptual explanation: A qualitative content analysis based on experts and population perspectives.

BACKGROUND AND AIM: Given the complexities of the health care system and the importance of the subject and effects of health literacy in all aspects of care, defining specific health literacy in this context seems necessary. The purpose of this research was to explain the concept of hospital health literacy (HHL), its definition, and the related dimensions using the qualitative research method. MATERIALS AND METHODS: An exploratory qualitative design was used. Exploratory, open-ended, and face-to-face interviews based on the interview guide were used to elicit participants' perspectives between July 2021 and January 2022. By using the content analysis method, researchers coded transcripts and collated these codes into sub-categories and then merged them into the main category and explored the dimensions of the concept. RESULTS: A total of 23 service providers and 25 service recipients were included in the study. Analysis of qualitative data led to the identification of 6 categories and 25 sub-categories including cognitive literacy, functional (basic) literacy, communicative literacy, behavioral literacy, media literacy, and emotional literacy. CONCLUSION: The findings of the present study provide a deep understanding of the concept of HHL that could be applied to develop valid and reliable measurement tools for assessing HHL among a variety of populations. Also, it is hoped that the present attempt can be useful to guide future research and interventions as well as to provide a clear base for planning, implementing, and evaluating interventions aimed at promoting individuals' health literacy in health settings.

WHO-PEN intervention in Iran's health system based on 5As healthy lifestyle counseling model: A randomized-clinical trial.

BACKGROUND: Skill Training Intervention Based on the Healthy Lifestyle Counselling Module (5As model) in the Ira PEN Program. MATERIALS AND METHODS: This study was a randomized controlled trial in Iran. Participants were 184 health workers and 184 clients (92 in each study group). The training program entailed an online training course, educational video, and clip. The behavior related to a healthy lifestyle in clients was also followed-up 2 months later. Data were analyzed using SPSS 22 software. RESULTS: Based on the observations, significant improvement in lifestyle counseling skills among health workers in the intervention group compared to the control group in terms of healthy nutrition (P < 0.001), physical activity (P < 0.001), smoking cessation (P = 0.03), and withdrawal of alcohol consumption (P < 0.001) was observed. Also, lifestyle-related behaviors among clients in terms of healthy nutrition (P < 0.001), physical activity (P < 0.001), and withdrawal smoking (P < 0.001) increased significantly. Furthermore, waist circumference (P < 0.024) and BMI (P < 0.001) among clients were significantly reduced. CONCLUSION: The training program for health personnel in healthy lifestyle has a more effective role in changing people's behavior and prevention of noncommunicable risk factors. Healthy life style counselling in primary health cares may lead to control risk factors for Noncommunicable disease.

The Role of the Health Belief Model in Explaining Why Symptomatic Iranian Women Hesitate to Seek Early Screening for Breast Cancer: a Qualitative Study.

Early detection of breast cancer (BC) is important to increase the likelihood of treatment and improve the quality of life and survival. The study explored why symptomatic women linger to seek early screening for BC diagnosis based on the health belief model (HBM). In this qualitative study, 20 participants were selected using the purposive sampling method (9 health professionals and 11 female patients BC). Data were collected using in-depth, semi-structured interviews in 2019. Transcribed interview data were analyzed using the directed content analysis informed by HBM. According to the participants' experiences, although most patients comprehended the extent of the disease, they did not see themselves at risk of BC. Some were not adequately aware of the benefits of early diagnosis and did not have the self-efficacy required for early presentation. The main barriers to the early presentation included lack of awareness, financial problems, embarrassment over the clinical examination, and inadequate access to specialized centers. According to HBM, while designing and implementing educational programs, it is recommended to focus on reinforcing perceived susceptibility, perceived benefits, and perceived self-efficacy, providing access to facilities, and removing possible barriers and cultural issues to encourage women for timely referral for BC screening.

Behavioural and environmental risk factors for household injuries: semistructured interviews with health professionals and mothers in Iran.

BACKGROUND: Injuries are increasing global public health problems, causing disability and death among children. This has considerable financial, emotional and social effects on families and society. This study aimed to investigate the behavioural and environmental factors leading to unintentional home injuries and attempts to highlight the pivotal role of mothers' behaviour and performance to provide a safe place for children at home. METHODS: The current research is a qualitative study of a directed content analysis type. The data were gathered through semistructured interviews conducted in participants' workplaces, namely universities, research centres and health centres. In some cases, telephone interviews were conducted within 3 months, from February 2021 to May 2021 in Tehran, Iran. The participants were selected through non-probability and purposive sampling. All the recorded interviews and notes were accurately evaluated, and data analysis was performed based on the content analysis. There were 29 interviews in total: 12 interviews with mothers, 9 with treatment and prevention specialists, and 8 with researchers. RESULTS: A total of 66 factors, 6 subcategories and 2 main categories were extracted after analysing the interviews. The main categories included environmental and behavioural factors. The subcategories included house infrastructure, house equipment/furniture, children's equipment/furniture, provision of precarious conditions, access to hazardous substances and appliances, and unsafe arrangement of furniture. CONCLUSION: Despite the existing obstacles such as the long-term implementation, financial difficulties and overcomplicated policy-making process, health interventions can make it possible for mothers of children under the age of seven to adopt preventive measures through appropriately designed instructions and optimal use of existing facilities.

Effect of training based on health belief model and behavioral intention on improving dental and oral self-care behavior in 9-12-year-old Iranian female students.

BACKGROUND: Training dental and oral health behaviors by using appropriate training models and theories is an important issue in preventing dental and oral diseases. the present study aimed to investigate the effect of training based on the health belief model and behavioral intention on dental and oral health behaviors in female students aged 9-12 years old in the city of Rudsar, Guilan, Iran. METHODS: This research is an interventional study conducted on 84 female students aged 9-12 years old, who lived in the city of Rudsar (n = 42 in the control group and n = 42 in the interventional group) in 2019. The data collection tools included questions on demographic variables, structures of the health belief model (perceived sensitivity, perceived severity, perceived barriers and benefits, self-efficiency), behavioral intention, and performance. The questionnaire was completed before the intervention and 3 months after it by both groups. The intervention group received four 45-min sessions. The data were analyzed using SPSS 24, descriptive tests, independent sample t-test, pair sample t-test, and regression (P < 0.05). RESULTS: The mean age of the intervention and control groups was 10.88 ± 1.01 and 10.80 ± 1.01, respectively. The results showed that the average scores of all structures of the health belief model and behavioral intention in the intervention group significantly changed compared to the average scores obtained before the intervention (P < 0.05). Moreover, the average scores of perceived sensitivity (p < 0.009), perceived barriers (p < 0.007), self-efficiency (p < 0.001), and behavioral intention (p < 0.001) significantly changed after the intervention in both groups (p < 0.05). CONCLUSION: According to the results, the health belief model and the behavioral intention were effective in improving dental and oral health so that they can be applied to improving people's dental and oral health. It can also be used as a model to design, implement, and monitor medical health programs.

World health organization-package of essential noncommunicable disease intervention in iran's health system based on 5As healthy lifestyle counseling model: A randomized-controlled trial protocol.

BACKGROUND: The Iran Package for Essential Noncommunicable Disease (Ira-PEN) program has been established since 2018 with the aim of controlling and caring of noncommunicable diseases (NCDs) as well as their underlying causes in Iran. In this study protocol, a healthy lifestyle module will be used for the first time in Iran, which was recommended in 2018 by the World Health Organization to train health workers. This module relies on the 5As model, a training intervention design, then, implement, evaluate, and present the results to the managers and decision makers of the Ira-PEN program. MATERIALS AND METHODS: This study will be performed in 2 stages, including 2 steps per stage. The first stage involves designing the 2 steps and validation of the healthy lifestyle counseling skills tool. The tool will encompass a health counseling evaluation checklist and a counseling assessment questionnaire according to the counseling recipients. The second stage also entails 2 steps; designing a training program for health workers in the field of healthy lifestyle counseling based on the Oles-Cement model followed by implementation and evaluation. CONCLUSIONS: The training program and the results obtained in this study will be presented to the managers and decision makers of both the Ira-PEN program and NCDs control in Iran, and it is suggested to enhance the training program, network, and educational curriculum of health workers in providing healthy lifestyle counseling to play a more effective role in changing the public behavior toward a healthy lifestyle and preventing the risk factors of NCDs.

Designing and psychometric assessment of the scale of factors influencing HPV vaccine uptake behaviors in young adults.

BACKGROUND: In order to increase HPV vaccination, it is necessary to identify the factors influencing vaccination behavior among different cultures and the young adult populations. To evaluate the factors influencing HPV vaccine uptake behaviors, valid, reliable, and culture-compatible scales are required. This study was conducted with the aim of designing and psychometric assessment of the scale of factors influencing HPV vaccine uptake behaviors in Young Adults (FI(HPV)VUBYA) in Iran. METHODS: The present study was carried out in a mixed-method in two steps: (a) Generating items using a qualitative study and literature review and (b) Reducing items by psychometric assessment of the designed scale. The initial set of items (N = 80) was prepared based on a qualitative study and literature review. A total of 400 young adults participated in online data collection from November 2019 to February 2020. The validity (face, content, and construct) and reliability (internal consistency and stability) of the scale were evaluated. RESULTS: The exploratory factor analysis (EFA) revealed that the scale has 7 factors, explaining 57.84% of the total extracted variance. There was also a knowledge factor that EFA did not analyze, but its validity and reliability were evaluated with 7 other factors. The results of confirmatory factor analysis showed a good model fit. Convergent and divergent validity of the scale was accepted for all factors. Good reliability was also reported for the scale. CONCLUSION: FI(HPV)VUBYA 8-factor scale has good validity and reliability among young Iranian adults. Due to its appropriate psychometric properties, this scale can be used on this population in future studies.

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.

Investigating the relationship between satisfaction of basic psychological needs, general health, and some background variables in the Iranian older adults: a cross-sectional study.

BACKGROUND: Promoting the health and mental health (MH) of the older adults making up a large part of the world's population in the coming years can provide the necessary conditions for their health and well-being of them. This study aimed to investigate the relationship between the satisfaction of basic psychological needs (BPNs), general health (GH), and some variables in Iranian older adults. METHODS: The present descriptive-correlational study was conducted on 780 older adults from Sarpol-e Zahab (Kermanshah) in 2019 including the study by multi-stage cluster random sampling. The data collection tool was BPNs satisfaction and GH questionnaire and a researcher-made questionnaire of individual and background information. Was used for data analysis using the SPSS version 16 program and descriptive statistics and tests Pearson correlation coefficient, chi-square test, independent-sample T-test, and multivariate linear regression. RESULTS: In the present study, participating a total of 780 older adult men aged 73.0 ± 29.32 years. There was a significant relationship between the satisfaction of BPNs and GH (p <  0.001). Also, 41% of the older adults were in poor GH and 30% were high in BPNs. Multiple logistic regression showed that the BPNs, age, income satisfaction, weather, and war zone were strong predictors of GH. the adjusted R2 value of 0.55 shows that the model described 55% of changes in the GH score. CONCLUSION: According to the findings of the study on the relationship between the satisfaction of BPNs and GH, providing insurance, social and economic support by developing health policies, creating supportive health environments, strengthening community action, and developing individual skills in the older adults can help improve their MH and that of the community.

The Concept of Social Health From an Iranian Perspective: A Qualitative Exploration.

Objective: As one of the health aspects, social health is less well-known than physical and mental aspects. In order to better understand this aspect and considering the importance of social context in its conceptualizing, the present study was performed aiming at explaining the social health and identification of its various aspects in the perspective of Iranian adults. Methodology: The present study was conducted in 2021 with a qualitative approach and with the participation of Iranian adults and social health professionals. Data were collected through semi-structured interviews with 36 participants who were selected by purposive sampling. The obtained data were analyzed using qualitative (conventional) content analysis and Granheim and Lundman method in the MAXQDA-2020. Guba and Lincoln criteria were observed to evaluate the quality of research results. Results: Using data analysis, 3 main categories and 17 subcategories were obtained, including: (1) Conceptual scope of social health (social health as social capital, social health as mental health, social health as moral health), (2) Characteristics of social health (biologic, continual, acquired, evolutionary, relative), and (3) Social health dimensions (openness to interactions, social adaptability, social dutifulness, social self-esteem, mutual trust, communicational capability, social optimism, enjoying social support, public-oriented personality). Conclusion: Since social health has a conceptual scope, it is important to try to strengthen and reproduce the dimensions of social health and at the same time use planning, policymaking and appropriate interventions to improve and to promote the dimensions of social health.

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.

Priorities for a gender-sensitive sexually transmitted infections and human immunodeficiency virus (STIs/HIV) services: An exploratory mixed methods study.

Background and Aim: Providing gender-sensitive health services is emphasized by the World Health Organization. This study aimed to assess and prioritize the needs for the gender-sensitive sexually transmitted infections/human immunodeficiency viruses (STIs/HIV) prevention services by a valid and reliable questionnaire. Methods: This was an exploratory mixed methods sequential study in Shiraz Iran 2019. The first phase was a qualitative study on 37 providers and managers of the services who were recruited using the purposive and then snowball sampling method. In the second phase, following the content analysis of the qualitative data and a review of related literature, a questionnaire was developed and its psychometric properties were evaluated. Then, in the third phase, the questionnaire was used to assess and prioritize the needs through a quantitative descriptive cross-sectional study on all 290 providers of STI/HIV prevention services affiliated with Shiraz University of Medical Sciences. Results: The finding of the qualitative phase showed gender-sensitive STI/HIV prevention services should provide gender-sensitive care and education by the trained personnel and manages with appropriate facilities and equipment. Providing these services also requires supportive policies, intersectoral cooperation, and community capacitation. In the second phase, a questionnaire was developed with 63 items. Assessment of psychometric properties of the questionnaire demonstrated the scale content validity index and ratio (S-CVI = 0.98 and S-CVR = 0.87, respectively), as well as the reliability of the questionnaire (internal consistency = 0.972 and intracluster correlation coefficient = 0.910). Results of the third descriptive phase of the study demonstrated the highest priorities for gender-sensitive education (92.01 ± 11.76%) and care services (92.11 ± 12.04%), respectively. Conclusions: To improve the quality of the services, a gender-based education and care process, as well as a gender-sensitive structure, including gender-sensitive personnel, facilities, and management are necessary. Recognizing and meeting the needs for gender-sensitive services will improve the quality of the services.

Strategies for Improving Participation in Human Papillomavirus Vaccination Among Young Adults in the Capital of Iran: A Qualitative-Exploratory Study.

Background: Different strategies can promote healthy behaviors. Although the human papillomavirus (HPV) vaccine is very important due to its effect in reducing cervical cancer, the behavior of HPV vaccination is low among young adults in Iran. Therefore, this study aimed to determine strategies for improving HPV vaccination among young adults. Methods: The present study was conducted with a qualitative content analysis method. The participants were 30 health professionals and young adults in Tehran city who were selected using purposive and snowball sampling. The data were collected through semistructured interviews and analyzed by Graneheim and Lundman's approach. Results: In total, two categories were identified: (1) access to services: access to the vaccine, vaccine insurance coverage; (2) educational coverage: subgroup training, educational content, time for training, educational channels, education strategies, and educational conditions. Conclusions: This is the first study conducted to determine strategies for improving HPV vaccination in Iran. The policymakers and planners, schools, and health centers are recommended to use the strategies obtained from this study to increase HPV vaccine imports, as well as increase the community members' knowledge and acceptance of the HPV vaccine.

Concordance of the cardiovascular patient education with the principles of Andragogy model.

BACKGROUND: Patient education is a critical aspect of patient care and is considered a vital part of self-care (especially in patients with cardiovascular disease (CVD)) and health promotion. The literature supports incorporating the principles of the andragogy model (adult learning) into patient education. This study aimed to determine the concordance of the CVD patient education with the principles of the andragogy model. METHODS: This cross-sectional survey was conducted on 384 adult CVD patients from 2 selected hospitals of Tehran. The sampling method was convenient, and the data collection tool was a researcher-made questionnaire based on the principles of the andragogy model. Data were analyzed using SPSS16 statistical software. RESULTS: The mean age of the patients was 55.69 ± 13.01 years old. Frequency of distribution of the patients who, in total, selected the items of 4 or 5 for respecting the principles of andragogy model was as follows: 68.16% for the motivation, 66.29% for the need, 66.03% for the orientation, 54.16% for the experiences, 51.55% for the self-concept, and 44.65% for the readiness principle. Also, three principles of motivation (77.37) need (74.97), and orientation (74.78) had the highest mean, respectively, in terms of adhering to this model. But the most common problems in patient education were related to the principles of readiness (64.35), self-concept (68.19), and experiences (77.71) with the lowest mean. CONCLUSIONS: The findings of this study provided valuable information on the flaws in patient education, including ignoring and disrespecting the principles of adult education. Correcting these detected defects and providing feedback to health professionals can improve the quality of patient education programs and patient satisfaction. Also, it empowers healthcare providers, patients, and families through effective education strategies.