Examining the effectiveness of a training program on improving knowledge, functional skills, and attitude in natural disaster volunteers.

Introduction: Disaster relief volunteers must have certain psychological and cognitive characteristics. Therefore, the present study aimed to investigate the effectiveness of the training program on improving knowledge, functional skills, and attitude among disaster volunteers. Methods: A quasi-experimental study was conducted in 2023 in Iran, including an intervention and control group and follow-ups. Ninety health volunteers were randomly selected and divided into two groups of 45. The experimental group received the training program for an hour a week for three months. The control group received no intervention. The participants of both groups completed the disaster preparedness questionnaire at the pre-test, post-test, and one and three months after the intervention. Data was analyzed using SPSS "version 26" software in the methods section. Results: The intervention effect were significant in increasing the volunteers' functional skills (F = 3.75), knowledge (F = 166.50), and attitude (F = 1.74), all in (p = 0.001). According to the results, this effect was stable over time for functional skills (F = 1.83) and knowledge (F = 18.04) all in (p < 0.05). Conclusion: Training programs can help improve skills, attitudes and knowledge in natural disaster volunteers. Researchers interested in the field of natural disaster relief, particularly health researchers, could consider further examining the aforementioned topics in their studies.

International study of 24-h movement behaviors of the early years (SUNRISE): A pilot study from Iran.

BACKGROUND: This study examined the proportion of Iranian children who met the World Health Organization (WHO) Guidelines for physical activity, sedentary behaviour and sleep for children under 5 years. Additionally, it investigated the feasibility and acceptability of the methods to be used in the SUNRISE study. METHODS: This pilot study was conducted among 83 children aged 3 and 4 years in preschools and health care centres in Iran, in 2022. Physical activity, sedentary behaviour and sleep (ActiGraph wGT3x-BT); fine and gross motor skills (validated activities); and executive functions (the Early Years Toolbox) were assessed. RESULTS: Only four (4.8%) children met all recommendations of the WHO guidelines. The proportion of children who met MVPA, TPA, screen time, restrained sitting and sleep were 44.6%, 38.6%, 19.3%, 38.6% and 65.1%, respectively. Fifty-two (62.6%) children wore the ActiGraph for at least three full days. A total of 97.6%, 95.1% and 91.5% of children completed anthropometric, EF and motor skill assessments, respectively. CONCLUSION: This pilot study was feasible and acceptable among Iranian children. Regarding the low proportion of children who met the WHO guidelines, it is recommended that long-term and practical strategies be developed to promote healthier lifestyles among preschool children in Iran.

Erratum: Determinants of health volunteer training in natural hazard management in Iran.

[This corrects the article DOI: 10.4102/jamba.v15i1.1384.].

Interplay of self-care, self-efficacy, and health deviation self-care requisites: a study on type 2 diabetes patients through the lens of Orem's self-care theory.

BACKGROUND: This study aimed to examine the relationship between Self-Care, Self-Efficacy, and Health Deviation Self-Care Requisites in patients with type 2 diabetes based on Orem's Self-Care Theory. METHODS: The research involved 341 patients with type 2 diabetes in Rasht, Iran, using a descriptive-analytical cross-sectional design. The data collection included questionnaires assessing Self-Care Behaviors, Self-Efficacy, and Health Deviation Self-Care Requisites based on Orem's model. RESULTS: Demographic factors such as gender, marital status, employment, education, age, duration of disease, and oral treatment and insulin had no consistent effect on self-care behaviors. Self-efficacy was a key factor influencing Self-Care Behaviors in diabetic patients. There was a strong and direct correlation between Self-Care Behaviors and Self-Efficacy, indicating the role of individuals' confidence in managing diabetes. Health Deviation Self-Care Requisites had both positive and negative correlations with different domains of Self-Care Behaviors.The physical exercise construct of self-efficacy was the most significant predictor of Self-Care Behaviors. CONCLUSIONS: This study provides valuable insights into the complex relationship between Self-Care, Self-Efficacy, and Health Deviation Self-Care Requisites in patients with type 2 diabetes. The findings underscore the importance of addressing Self-Efficacy and specific self-care domains, such as physical activity and foot care, in diabetes management strategies. This research contributes to the existing knowledge base and may inform healthcare professionals and policymakers in developing targeted interventions to improve self-care practices in diabetic patients.

Determinants of health volunteer training in natural hazard management in Iran.

Both natural and man-made dangers cause bodily harm, as well as social, economic and environmental harm. In order to minimise the complications of these threats, proper training and preparedness are crucial. The purpose of this study was to look at the factors that affect how well-trained healthcare volunteers are for natural hazards in Iran. Using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses approach, a systematic review of literature on the factors influencing the training of healthcare volunteers in natural hazard published between 2010 and 2020 was conducted. The Google Scholar search engine, PubMed (Medline and Central), Science Direct and Web of Science databases were searched using both individual and combined key phrases. The Strengthening the Reporting of Observational studies in Epidemiology checklist was used to select and evaluate 592 observational and quasi-experimental articles. Finally, the study comprised 24 papers that satisfied the research criteria and made good use of good technique, sample size and adequate tools for validity and reliability. The most useful variables for disaster preparedness were job self-efficacy, strategic decision-making and quality of work-life, job performance, job motivation, knowledge, awareness and health literacy. Contribution: To avoid calamity, a thorough training program is required. Therefore, the most crucial objectives for health education specialists are to identify the factors that determine disaster preparedness, train volunteers and provide fundamental techniques to reduce natural dangers.

An internet-based educational intervention for mothers targeting preschoolers' weight management promotion (PWMP): a pilot study.

BACKGROUND: The prevalence of overweight and obesity among children has raised public health concerns. This study aimed to design and evaluate a behaviour change intervention program to promote weight management among Tehranian preschoolers. METHODS: The PRECEDE-PROCEED model is one of the most popular models in health education used to develop and evaluate most educational interventions. In this one-group pre and post-pilot study, 13 mothers of preschoolers were recruited from preschools in Tehran (the capital of Iran), in August 2020. Mothers received a six-week educational intervention, including text messages and educational videos via WhatsApp, to increase their self-efficacy to overcome barriers changing their children's lifestyle. Mothers reported preschoolers' height and weight to assess Body Mass Index and filled out the Food Frequency Questionnaire, the Persian version of the children's health-related quality of life questionnaire, and demographic features. The "Children's physical activity and sedentary behaviors checklist," newly designed by the researchers, was also filled out by mothers. These behaviors were measured according to the minutes that children were involved in these activities in a day, and the days they spent in a week for them. All variables were measured at baseline, immediately after the intervention and three months later. Data analysis was performed using SPSS IBM statistics version 22. Friedman test was used to evaluate changes over time. RESULTS: The findings demonstrated that the mean BMI z-score stayed steady between baseline, immediately after the intervention and after three months (P = 0.60). Besides, after three months, the intervention programme led to a decrease in soft drink consumption (P = 0.001), and an increase in parental perception of their child's general health (P = 0.05), the parental concern regarding their child's emotional and physical health (P = 0.002) and minutes of physical activity per day (P = 0.02). However, fruit intake decreased (P = 0.01), and simple sugar, such as cube, increased (P = 0.03). CONCLUSION: Results from this study are promising but should be interpreted with caution and should be replicated on a larger scale and compared with a control group to evaluate whether effects are maintained in a larger sample.

Understanding the perceptions of parents and preschool principals on the determinants of weight management among Iranian preschoolers: A directed qualitative content analysis.

The current study aimed to understand the perceptions and experiences of Iranian parents and principals of preschool children on weight management based on the PRECEDE-PROCEED Model (PPM), a comprehensive structure for assessing health needs for designing, implementing, and evaluating health promotion, and other public health programs. PRECEDE provides a structure for planning a targeted and focused public health program, and PROCEED provides a structure for implementing and evaluating the program. Data were gathered from 17 preschoolers' parents and two principals using semi-structured interviews in the preschool setting in Tehran, the capital of Iran, in 2019. Data were analyzed manually through directed content analysis based on constructs in phases two and three of the PPM, simultaneously with data collection. This study identified genetic, behavioral (e.g., food preferences, physical activity, sedentary behaviors, the effect of parents', peers', principals' and teachers' behavior and also influence of grandparents' and neighbors' behaviors) and environmental (e.g., home, grandparents' home and preschool) factors from the epidemiological construct. Also, predisposing (e.g., child's attitude, parent's and principals' attitude, as well as parents' knowledge and parents' and principals' beliefs), enabling (e.g., parental skills and skills of the principals and teachers, rules and laws in the preschools, and availability), and reinforcing (e.g., family support and influences, teachers' encouragement and influences, and peers' influences) factors were identified from the educational and ecological construct. Additionally, "quality of child-parent relationship" was determined as a new factor affecting preschoolers' weight management promotion; however, it was not in the PPM. In the study, parents' and principals' experiences regarding preschoolers' weight management promotion confirmed the genetic, behavioral, environmental, predisposing, enabling and reinforcing factors of the PPM. "Quality of child-parent relationship" factor may be related to the culture and family relationship type of Iranian people, which is suggested to be investigated in future studies.

Application of the PRECEDE -PROCEED model in prevention of brucellosis focused on livestock vaccination process.

BACKGROUND: This article reports the steps of an educational intervention, which is designed to change livestock breeders' preventive behavior in terms of vaccinating their livestock against brucellosis. The study has been conducted in a rural area in a country with the second highest brucellosis prevalence in the world. METHODS: In a quasi-experimental study and applying PRECEDE-PROCEED model, 45 livestock breeders were trained through basket method, accompanied with constructive feedback from researchers and peers and a brief interactive lecture at the end. The livestock breeders' awareness, attitude and practice level in the intervention group was compared with those of other 45 livestock breeders in a control group, 1 and 6 months after the intervention. According to the results of the Rose Bengal tests (RBTs), as a rapid and simple screening test, the presence or absence of Brucella antibodies in the animals' serum was investigated. RESULTS: Immediately and 1 month after the intervention, the mean scores of knowledge, awareness and practice of livestock breeders in the intervention group were significantly higher. Six months after the intervention, the results of the RBTs were positive in more livestock in the intervention group compared to the animals in the control group. The positive result of RBT after educational intervention, in livestock whose test results were negative immediately before intervention, accompanying the results of observation indicating a good general condition of livestock was considered as a probable evidence of the success of the educational intervention. CONCLUSION: The model-driven educational intervention could significantly increase livestock breeders' awareness, attitude and practice regarding prevention of brucellosis and vaccination of their livestock against brucellosis; however, a period of non-continuous reinforcement and gradual reduction of the number of the reinforcements by health educator workers is recommended in order to increase the maintenance of the learnt behavior. TRIAL REGISTRATION: Conducting this study was registered at Iranian Registry of Clinical Trials ( IRCT20180304038945N1 ). Registered 24 December 2018. The proposal was registered before enrollment of the first participant.

Cross-sectional examination of 24-hour movement behaviours among 3- and 4-year-old children in urban and rural settings in low-income, middle-income and high-income countries: the SUNRISE study protocol.

INTRODUCTION: 24-hour movement behaviours (physical activity, sedentary behaviour and sleep) during the early years are associated with health and developmental outcomes, prompting the WHO to develop Global guidelines for physical activity, sedentary behaviour and sleep for children under 5 years of age. Prevalence data on 24-hour movement behaviours is lacking, particularly in low-income and middle-income countries (LMICs). This paper describes the development of the SUNRISE International Study of Movement Behaviours in the Early Years protocol, designed to address this gap. METHODS AND ANALYSIS: SUNRISE is the first international cross-sectional study that aims to determine the proportion of 3- and 4-year-old children who meet the WHO Global guidelines. The study will assess if proportions differ by gender, urban/rural location and/or socioeconomic status. Executive function, motor skills and adiposity will be assessed and potential correlates of 24-hour movement behaviours examined. Pilot research from 24 countries (14 LMICs) informed the study design and protocol. Data are collected locally by research staff from partnering institutions who are trained throughout the research process. Piloting of all measures to determine protocol acceptability and feasibility was interrupted by COVID-19 but is nearing completion. At the time of publication 41 countries are participating in the SUNRISE study. ETHICS AND DISSEMINATION: The SUNRISE protocol has received ethics approved from the University of Wollongong, Australia, and in each country by the applicable ethics committees. Approval is also sought from any relevant government departments or organisations. The results will inform global efforts to prevent childhood obesity and ensure young children reach their health and developmental potential. Findings on the correlates of movement behaviours can guide future interventions to improve the movement behaviours in culturally specific ways. Study findings will be disseminated via publications, conference presentations and may contribute to the development of local guidelines and public health interventions.

Evaluating the Consistency Between Conceptual Frameworks and Factors Influencing the Safe Behavior of Iranian Workers in the Petrochemical Industry: Mixed Methods Study.

BACKGROUND: Unsafe worker behavior is often identified as a major cause of dangerous incidents in the petrochemical industry. Behavioral safety models provide frameworks that may help to prevent such incidents by identifying factors promoting safe or unsafe behavior. We recently conducted a qualitative study to identify factors affecting workers' unsafe behaviors in an Iranian petrochemical company. OBJECTIVE: The aims of this study were to (1) conduct a review of the relevant research literature between the years 2000 and 2019 to identify theoretical models proposed to explain and predict safe behavior in the workplace and (2) to select the model that best reflects our qualitative findings and other evidence about the factors influencing safe behaviors among petrochemical workers. METHODS: This research used mixed methods. Initially, we conducted a qualitative study of factors that Iranian petrochemical workers believed affected their safety behavior. Four themes emerged from the semistructured interviews: (1) poor direct safety management and supervision; (2) unsafe workplace conditions; (3) workers' perceptions, skills, and training; and (4) broader organizational factors. Electronic databases, including PubMed, Embase, Scopus, Google Scholar, EBSCOhost, and Science Direct, were then searched for eligible studies on models to explain and predict safe behaviors, which were published between the years 2000 and 2019. Medical subject headings were used as the primary analytical element. Medical subject headings and subheadings were then extracted from the literature. One researcher conducted the search and 3 researchers performed screening and data extraction. Then, constructs described in each study were assessed to determine which were the most consistent with themes derived from our qualitative analysis. RESULTS: A total of 2032 publications were found using the search strategy. Of these, 142 studies were assessed and 28 studies met the inclusion criteria and were included in the review. The themes identified in the qualitative study most closely matched 3 scales included in Wu et al's model that measured safety behavior and performance, safety leadership, and safety climate in petrochemical industries. Poor direct safety management and supervision matched with safety leadership and its subscales; unsafe workplace conditions matched with safety climate and its subscales; workers' perceptions, skills, and training matched with safety performance and its subscales; and broader organizational factors matched with some subscales of the model. CONCLUSIONS: This is the first literature review to identify models intended to explain and predict safe behavior and select the model most consistent with themes elicited from a qualitative study. Our results showed that effective safety leadership and management and safety climate and culture systems are the most frequently identified factors affecting safe behaviors in the petrochemical industry. These results can further help safety researchers and professionals design effective behavior-based safety interventions, which can have a more sustainable and persistent impact on workers' safety behaviors. TRIAL REGISTRATION: Iranian Registry of Clinical Trials IRCT20170515033981N2; https://www.irct.ir/trial/26107. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): RR2-10.1186/s12889-019-7126-1.

Design and validation of brucellosis prevention questionnaire focused on animal vaccination.

BACKGROUND: The inadequate awareness of livestock breeders on brucellosis transmission, as well as their improper knowledge about preventing brucellosis is considered as one of the important barriers to animal vaccination against brucellosis. The present study aimed to design and validate a brucellosis prevention questionnaire focused on animal vaccination. The valid questionnaire was used to design, implement, and evaluate an interventional training program. METHOD: A brucellosis prevention questionnaire (BPQ) was developed in the exploratory psychometric study. In addition, face-to-face interviews were conducted to formulate its initial items, the results of which were merged with those obtained from literature review. Further, the face, content, and construct validity of the questionnaire were assessed by co-operating livestock breeders, veterinarians, and health educationists. The impact score (IS), and content validity ratio (CVR) and index (CVI) of the items were calculated, and the construct validity of the questionnaire was evaluated through factor analysis. Furthermore, the reliability of the results related to the questionnaire was measured by using Cronbach's alpha, intra-class correlation coefficient (ICC), and composite reliability, as well as the standard error of measurement (SEM). RESULTS: The questionnaire was finalized with 53 items and its validity was confirmed by CVI (0.90), CVR (0.74), and IS (4.30). Additionally, the items were loaded into three constructs of awareness, attitude, and practice. Further, the predictive power of awareness, attitude, and practice was determined as 43.43, 15.81, and 15.78%, respectively. Furthermore, the fitness of the proposed model among the constructs was confirmed by the root mean square error of approximation (RMSEA) < 0.08, as well as normed chi-square (× 2/ df) < 5.0, comparative fit index (CFI) ≥ 0.90, and Tucker- Lewis index (TLI) ≥ 0.9. CONCLUSION: The brucellosis prevention questionnaire represented acceptable psychometric properties. The factors influencing the preventive behavior of livestock breeders can be identified by applying the questionnaire, and co-operating veterinarians and educational planners.

Factors associated with unsafe work behaviours in an Iranian petrochemical company: perspectives of workers, supervisors, and safety managers.

BACKGROUND: The petrochemical industry is hazardous, in part because of the inherently dangerous nature of the work conducted, and incidents frequently result in significant financial and social losses. The most common immediate cause of incidents and injuries in this industry is unsafe worker behaviour. Identifying the factors encouraging unsafe work behaviours is the first step in taking action to discourage them. The aim of this study was to (a) explore workers', supervisors' and safety managers' attitudes and perceptions of safety in a petrochemical company in Iran, and (b) identify the factors that discourage safe work behaviours. METHODS: A qualitative study was conducted by applying the steps described by Graneheim and Lundman (2004). Twenty participants were recruited from an Iranian petrochemical company using a multi-stage approach, with initial purposive sampling followed by snowball sampling to enhance recruitment. Individual face-to-face and semi-structured interviews were conducted to gain an in-depth understanding of factors acting as barriers to safe behaviour. The interviews were recorded and transcribed in Persian and then translated into English. Conventional content analysis was performed. RESULTS: The main themes emerging from the interviews were: (i) poor direct safety management and supervision; (ii) unsafe workplace conditions; (iii) workers' perceptions, skills and training; and (iv) broader organisational factors. CONCLUSIONS: The findings give insights into practical organisational measures that can be implemented by management to promote workers' commitment to safety and engage in safe behaviours in their workplace. TRIAL REGISTRATION: Iranian Registry of Clinical Trials: IRCT20170515033981N2 . Retrospectively registered 19 June 2018.

Evaluating the impact of HBM-based education on exercise among health care workers: the usage of mobile applications in Iran.

BACKGROUND: Mechanical life made us witness the growing increase of chronic diseases despite the prominent scientific developments in the field of health, treatment and control. The aim of this study was to evaluate the impact of educational intervention based on Health Belief Model (HBM) using mobile applications (Telegram messenger) on doing exercise among the health care workers of Ilam university of medical sciences in 2017. METHODS: In this interventional study, 114 people working in Ilam University of medical sciences participated in two groups of intervention and control (employed at two different cities) after providing the informed consent form. HBM-ISCS questionnaire was used to collect the required data and its reliability was approved using Cronbach's alpha. Descriptive statistics, chi square, t test, repeated measures ANOVA (RMANOVA) and structural equation model (SEM) were used. RESULTS: Half of the participants were men, 58.77% of them were undergraduate. The mean and SD of their age was 37.61 ± 4.88 years. Based on the results of the repeated measures analysis of variance test (before and after the intervention) in the intervention group, there were significant difference in all of the HBM constructs (perceived barriers was excepted), daily and weekly exercises, blood biochemical markers of the participants (P > 0.05). The above changes were not significant in the control group (P ≥ 0.05). CONCLUSION: Exercise is closely related to the beliefs of people, so implementing educational interventions based on Telegram messenger with emphasis on health beliefs and using HBM can lead to have exercise. Therefore, this application can be a suitable tool to deliver trainings, especially when holding in-person classes is difficult.

The postpartum depression literacy scale (PoDLiS): development and psychometric properties.

BACKGROUND: Maternal mental health including postpartum mental health is essential to women's health. This study aimed to develop a specific measure for assessing postpartum depression literacy and consequently evaluate its psychometric properties among a sample of perinatal women. METHODS: This investigation was composed of two studies: developing the measure, and evaluating of psychometric properties of the developed questionnaire. In development stage an item pool was created. Then, based on definition of mental health literacy and preliminary screening, an initial questionnaire was developed. The content and face validity of the questionnaire were then assessed. In the second study psychometric properties of the questionnaire were examined. Overall 692 perinatal women with the mean age of 27.63 years (ranging from 17 to 43) participated in the study. RESULTS: In all an item pool of 86 items was generated. Of these, 31 items were removed and the remaining 55 items subjected to content and face validity and further 16 items removed. In the second stage a 39-item questionnaire namely the Postpartum Depression Literacy Scale (PoDLis) was evaluated. In principal component factor analysis, 31 items were loaded indicating a 7-factor solution for the questionnaire. The factors designated the following constructs: ability to recognize postpartum depression, knowledge of risk factors and causes, knowledge and belief of self-care activities, knowledge about professional help available, beliefs about professional help available, attitudes which facilitate recognition of postpartum depression and appropriate help-seeking, and knowledge of how to seek information related to postpartum depression. Finally performing the confirmatory factor analysis, the Postpartum Depression Literacy Scale with 31 items was supported for the structures suggested by theoretical model and findings from the exploratory factor analysis. The Cronbach's alpha coefficient for the scale was .78 and it ranged from .70 to .83 for each factor lending support to the internal consistency of the questionnaire. CONCLUSION: The findings suggest that the Postpartum Depression Literacy Scale (PoDLiS) is a reliable and valid instrument for measuring the postpartum depression literacy and now can be used in studies of mental health literacy in women.

Development of Psychometric Properties of Farmers' Occupational Health Behavior Questionnaire for Iranian Farmers.

Background: Agriculture is one of the most dangerous industries throughout the world, and its risk level is dictated by several determinants whose real weights are often unknown. Objective: The present work aims to develop psychometric properties of farmers' occupational health behavior questionnaire for Iranian farmers. Methods: In this qualitative-quantitative study, the items of the instrument were derived from the qualitative phase. Face validity, content validity, reliability, and consistency methods were applied. Construct validity was estimated by the exploratory factor analysis. Results: Eleven factors with factor loads of >0.501 were extracted as the main factors. They altogether captured about 58.97% of the variance of factors affecting farmers' occupational health behavior. The reliability of the instrument was confirmed as its Cronbach's alpha was in the range of 0.72-0.93. Conclusion: Given the complicated nature of occupational health behaviors among farmers, it is imperative to measure the factors influencing these behaviors precisely. Therefore, the development of a proper instrument can be very crucial in identifying influential factors. The findings showed that the developed instrument was optimally reliable and valid.

A randomised controlled trial of an educational intervention to promote safe behaviours in petrochemical workers: a study protocol.

BACKGROUND: The worldwide concern about safety has created a need for new and effective strategies to improve safety in the workplace. Based on reported studies, approximately 90% of workplace accidents are due to unsafe behaviour and human error. Therefore, the most important strategy in reducing the rate of these accidents is training workers regarding safe behaviour and avoiding human error. There is limited research on understanding the barriers to promoting safe behaviour amongst petrochemical workers. This paper presents a protocol for an intervention study, using training sessions in combination with an educational software (application). The intervention aims to both promote workers' safe behaviour and reduce the rate of occupational accidents. METHODS: One hundred seventy-six workers will be recruited to this study from an Iranian petrochemical industry. The study is Mixed Methods Research (MMR) which will be carried out in two phases. In the first phase, using a qualitative approach, in-depth interviews will identify the causes of unsafe behaviour in the petrochemical industry. In the second phase, models of safe behaviour used in workplaces and the petrochemical industry will be investigated. The findings of the first phase will be matched with the constructs of these models to produce a well-suited conceptual model. Questionnaires and an educational intervention will be designed based on the results of the two phases. The workers will receive training interventions using direct methods, involving training sessions and workshops, and in an indirect method for which educational software will be designed. A randomised controlled trial (RCT) will assess comparability between the intervention group and the control group at baseline, after the intervention, and at a three-month follow up. DISCUSSION: This research will provide a practical approach for promoting safe behaviours and reducing occupational hazards amongst industrial workers. TRIAL REGISTRATION: Iranian Registry of Clinical Trials: IRCT20170515033981N2 . Registered 19 June 2018.

Inconsistent Mammography Perceptions and Practice among Women of Over 40 Years in Iran

Objective: This paper aims to report the relationship between perceptions of mammography and screening practices. Methods: This cross-sectional study was conducted between May and September 2017, involving 400 women of over 40 years old, who was referred to as urban health centers in Tehran, Iran. The subjects were selected by multi-stage cluster sampling. Women with inconsistent mammography perceptions and practices were identified the Pros and Cons of mammography behavior for perceptions and Transtheoretical model (TTM) stage of adoption for prior and intended screening practices. The research instrument included a self-administered questionnaire and data were analyzed using descriptive statistics and measures of central tendency, and the chi-square, T-tests, and correlation regression analysis. Results: The average age participant was 45.6±5.4. Consistent with the TTM and pros and cons of mammography, women in action tended to have more positive perceptions of mammography than women in pre-contemplation or contemplation (mean decisional balance: action= 16.8; SD, 1.4; contemplation=1.8; SD, 0.48; precontemplation= SD, 1.4;0.56; p<0.001). Conclusion: results of the current study indicate there are inconsistent mammography perceptions and practice among women in Iran, then we recommend that future intervention, consider setting factors in addition to standard perceptions focused counseling.

Farmers' Preventive Behavior Analysis Against Sunlight Using the Health Belief Model: A Study from Iran.

Agriculture is one of the major sources of employment and income in many countries, especially in developing countries. Farmers are exposed to numerous harmful factors such as sunlight and ultraviolet radiation. These factors contribute to multiple diseases including skin cancer. The aim of this study was to analyze the farmer's preventive behavior against sunlight using the Health Belief Model (HBM). This descriptive study was conducted by survey methodology and a questionnaire. The population of the research was composed of farmers in Kermanshah Province (N = 126,900). The sample size was determined as 382 farmers using the Krejcie and Morgan table. The validity of the questionnaire was confirmed by relevant professors and experts, and the reliability was confirmed through a pilot study and the calculation of Cronbach's alpha coefficient, which was estimated at 0.70-0.83. Findings showed that the HBM structures had a significant effect on the farmer's preventive behavior, so that the perceived barriers, susceptibility, severity, benefits, self-efficacy, and cues to action have the strongest impact on the farmer's preventive behavior against sunlight. The results illustrated that components of the HBM were appropriate predictors for farmers' preventive behavior against sunlight.

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.

Factors Affecting Self-Care Performance in Adolescents with Type I Diabetes According to the PEN-3 Cultural Model.

BACKGROUND: Adolescence is the most difficult period to control and manage type 1 diabetes (T1D), and various perceptions, enablers, and nurturers influence self-care behaviors in these patients. OBJECTIVES: The purpose of this study was to identify factors affecting self-care performance in adolescents with T1D, according to the PEN-3 cultural model. METHODS: In this study, in-depth interviews were conducted initially with 26 participants, and one group discussion was held with 13 participants. Assessment domains of the PEN-3 model (key influence on health behaviors and impact of behavior on health) guided the analysis of qualitative study and focus group data. Finally, the data were classified to a 3 × 3 table, based on the PEN-3 model. RESULTS: The most common positive PEN included awareness of self-care behaviors, attitude towards the disease, impact of spirituality on self-care, easy access to needed medical services, and maternal support. The negative PEN included attitude of patients and parents towards reasons of becoming sick (why me), awareness about the disease and its causes, low self-efficacy, limited training, high cost of blood glucose test strips, lack of educational therapeutic curricula based on spirituality, ignoring the role of spirituality in treatment and self-care, and conflict between parents and patients. CONCLUSIONS: The results of this study can be used to guide the development of cultural group therapy interventions aimed at increasing adherence to self-care behaviors among Iranian adolescents with T1D.