The effect of web-based family-centered empowerment program in preventing the risk factors of substance abuse in students' parents; application of the health promotion model.

BACKGROUND: The age of onset of substance abuse among adolescents has recently decreased worldwide. Parents play an important role in preventing their children from drug abuse. This study aimed to investigate the effect of web-based family-centered empowerment program in preventing the risk factors of substance abuse in students' parents, using the health promotion model (HPM). MATERIAL AND METHODS: This interventional study was based on 118 parents of high school students in Sabzevar, Iran (2019). Multi-stage random sampling was used to divide the participants into the experimental (n = 65) and control (n = 65) groups. The data were collected through a researcher-made questionnaire based on Pender's HPM. A website was designed to perform all stages of the study. The web-based educational intervention was performed for the experimental group. Both groups completed the questionnaires 2 months after the educational intervention. The data were analyzed using t-test, paired t-test, regression, correlation, and analysis of covariance. RESULTS: There was a significant difference between the scores of prior related behavior, perceived benefits of action, activity-related effect, situational influences, competitors, and commitment in the parents of the experimental group compared to the control group after the educational intervention (P-value < 0.05). Moreover, a significant difference was observed between preventive behaviors of substance abuse and the mean score of perceived barriers to action, perceived self-efficacy, interpersonal influences, and role model in the parents of the experimental group compared to the control group after the educational intervention (P-value < 0.05). CONCLUSION: Overall, designing an educational intervention based on the constructs of Pender's HPM could be an effective strategy for promoting preventive behaviors of substance abuse in parents.

The effect of empowerment program to reduce Sugar Consumption based on the Multi-Theory Model on Body Mass Index and abdominal obesity in Iranian women.

BACKGROUND: Considering the prevalence of overweight and abdominal obesity in middle-aged women, this study was conducted to determine the effect of empowerment program to reduce sugar consumption based on the Multi-Theory Model (MTM) on Body Mass Index (BMI) and abdominal obesity in women aged 30-60 in Joven. METHODS: This quasi-experimental study (include descriptive and interventional sections) was conducted on the Joven city, Khorasan Razavi province, Iran country from October 2020 to August 2021. Sampling was performed as a multi-stage cluster. First, a descriptive study was performed among 400 women, and then 128 people who were eligible to enter the interventional phase of the study were selected. In the control group, 63 people and in the intervention group, 65 people were eligible to enter the study. The educational intervention was performed in five 60-minute sessions for groups of 12 people. The instruments included the demographic questionnaire, sugar consumption checklist and researcher-made questionnaire based on MTM constructs. Before the intervention, one, three and six months after the intervention, the questionnaire was completed by both intervention and control groups also measurement of waist circumference and BMI were performed using standard instruments. The obtained data were analyzed by SPSS 17. RESULTS: After the educational intervention, there was a significant difference between the intervention and control groups in all the MTM constructs. Also, six months after the educational intervention, BMI, waist circumference and amount of consumption of sugary substances decreased significantly in the intervention group (p < 0.05). CONCLUSION: Educational intervention based on the MTM can be effective in reducing the consumption of sugary substances and shaping behaviors related to healthy lifestyle in women.

The relationship between readiness for treatment of substance use and self-efficacy based on life skills.

Substance use is a social harm. Promoting substance users readiness for treatment of substance use with a non-medical approach is important besides the medical approach. The current study aimed to determine the relationship between readiness for treatment of substance use and self-efficacy based on life skills. In this descriptive-analytical study, a number of 118 substance users in Hamadan city (Iran) were participated. The data collection tools were Stages of Change Readiness and Treatment Eagerness Scale (SOCRATES) and Drug Avoidance Self-Efficacy Scale (DASES). Analytical and descriptive tests were used for data analysis, at 95% significant level, using Statistical Package for the Social Sciences 16. The results of this study showed that the readiness for treatment of substance use had a significant relationship with the self-efficacy includes assertiveness and communication (Df:1; Pvalue<0.05). Self-efficacy based on life skills can be used to promote substance users readiness for treatment of substance use in educational interventions.

A protocol of comprehensive assessment of exposure to greenspace in school children.

Evidence on a comprehensive greenspace exposure assessment on primary school children is scarce yet. Therefore, we aimed to assess a comprehensive greenspace exposure on primary school children and their behavioral function. We assessed different aspects of exposure to greenspace as well as behavioral function in 704 primary school children in Sabzevar, Iran, during the COVID-19 pandemic (i.e., 22 September 2020 to 10 March 2021). The greenspace indicators were including Normalized Difference Vegetation Index (NDVI) in 100, 300 and 500m buffers around children's homes based on Landsat 8 images with 30 × 30 m resolution, residential proximity to green space based on the Euclidean distance of the geocoded residential address to (i) the nearest green space of any area and (ii) the nearest green space with an area of at least 5000m2 (i.e., major green space) based on land use map of the study area, time spent in public and private green spaces, number of plant pots at home and visual access to greenspace based on a prepared questionnaire. The behavioral development of primary school children was assessed using a Persian online validated version of the Strengths and Difficulties Questionnaire (SDQ) filled by parents.

Development and Validation of an Instrument to Measure Parental Factors Related to Substance Use Prevention in Adolescents.

BACKGROUND: The average age of using illicit drugs for the first time in adolescents has decreased in Iran over the past years. Studies show that family and environment play a notable role in keeping adolescents away from substances. AIMS: The present study is an attempt to develop and validate a model-based questionnaire to measure parental factors related to substance use prevention in adolescents. METHODS: This methodological study was carried out on 336 parents of high school students in Sabzevar- Iran, in 2018. The first draft of the questionnaire, including 136 items, was developed based on the constructs of the Health Promotion Model (HPM) using similar questionnaires, literature review, and interviewing 9 qualified experts. The validity of the questionnaire was measured through face validity (qualitative and quantitative), content validity (qualitative and quantitative), and construct validity (confirmatory factor analysis). The reliability of the questionnaire was measured by internal consistency and test-retest reliability. SPSS ver. 16 and LISREL ver. 8.2 software was used for statistical analysis. RESULTS: Throughout the validation process, 35 items were omitted, and the final version of the questionnaire consisting of 101 items was developed. The overall content validity ratio was 0.81, which indicates the proper and understandable content of the items. The overall content validity index was 0.96, which indicates excellent expert validity. The Cronbach's alpha coefficient of the questionnaire was 0.85 (constructs range= 0.73-0.96), and the intraclass correlation coefficient of the questionnaire was 0.78 (constructs range= 0.46-0.91), which indicates that the questionnaire has good internal consistency and test-retest reliability. Further, the confirmatory factor analysis yielded an appropriate fit for the model (RMSEA= 0.069, χ2/df= 2.77, GFI= 0.60, AGFI= 0.83, CFI= 0.83, NNFI= 0.83). CONCLUSION: The validity and reliability of the HPM-based questionnaire were supported. Therefore, the questionnaire can be used by health educators and health policymakers in empowerment programs for parents to improve their behavioral skills concerning the prevention of substance use in their adolescents.

Prioritizing the health education needs based on community participation: AHP method.

INTRODUCTION: The identification of health education needs through the community results in targeted services and health promotion. Prioritizing these needs, in addition to identifying the desired health system based on the needs of the community, is required for the optimal allocation of resources. Therefore, this study was conducted with the aim prioritizing the health educational needs of Sabzevar-Iran community. MATERIALS AND METHODS: This study was a two-step mix study. In the first stage, the qualitative method of the main themes of health educational needs of Sabzevar society was determined. Then, the questionnaire was prepared by a paired scale (36 questions) and quantitative method was used to prioritize the main themes with Analytic Hierarchy Process (AHP) software. The random sampling method was used in this study and data analysis was performed using Expert Choice software using AHP method. RESULTS: Social problems with 0.206, contagious diseases with 0.205, nutrition with 0.161, and public health with 0.132 were in the first to fourth grades of health educational needs in Sabzevar city and environmental health, health management, noncontagion diseases, elderly, and occupational health were in the fifth to ninth grades. The consistency index in this study was 0.08, although the adjustment index is <0.1 good and acceptable. CONCLUSION: Social problems are the first priority of Sabzevar society, which require appropriate training.

Health literacy and its associated demographic factors in 18-65-year-old, literate adults in Bardaskan, Iran.

AIMS: Improvement of general health literacy is one of the ways to achieve the desired public health condition. To this end, the first step is to determine the health literacy level and its associated demographic factors in individuals. SETTINGS AND DESIGN: This study was a cross-sectional, descriptive-analytic survey conducted on 700 adults (age range: 18-65 years) in Bardaskan, Iran. The required samples were selected via random cluster sampling method. SUBJECTS AND METHODS: The demographic questionnaire was used to collect sociodemographic information. The Health Literacy for Iranian Adults questionnaire was used to determine the level of health literacy in participants. STATISTICAL ANALYSIS: Data analysis was conducted using SPSS software version 20 through descriptive and inferential statistics. Results were considered statistically significant at P ≤ 0.05. RESULTS: A total of 700 participants with a mean (standard deviation) age of 31.25 (9.32) years participated in this study. The primary sources of health information were physicians and health staff (50.9%) followed by the Internet (19.7%). The health literacy level of 18.1% of the participants was inadequate, 27.7% was marginal, 39.4% was adequate, and 14.7% was excellent. The mean overall scores of health literacy and its subscales were within the adequate range (66.1-84.0). The relationships of health literacy level with age, education, marital status, occupational status, and history of disease were statistically significant (P < 0.001). CONCLUSION: It seems necessary to design and implement a variety of educational programs to improve the general health literacy of the citizens of Bardaskan. Educational programs need to focus on groups with higher priority such as elderly people, individuals with lower educational levels, widows/widowers and divorced/separated individuals, unemployed and retired individuals, homemakers, and individuals with a history of disease.

Farsi Version of the Mammography Self-efficacy Scale for Iranian Women.

BACKGROUND: Self-efficacy is a crucial factor in adopting mammography behavior. A reliable and valid instrument is necessary to measure self-efficacy among Iranian women. OBJECTIVE: The aim of this study is to translate the original version of Champion's Mammography Self-efficacy Scale into Farsi and then to estimate the Farsi version's reliability and validity. METHODS: In a cross-sectional study, 200 women 40 years or older who were referred to health centers in Iran were invited to complete the related questionnaires during an interview. Cronbach's α coefficients and item-total correlations were measured to evaluate the reliability of the scales. Content and face validities were evaluated using the opinions of a panel of experts, and construct validity was estimated through applying confirmatory factor analysis. Logistic regression and χ tests were used to estimate theoretical relationships. RESULTS: In terms of reliability, the internal consistency α was .904 and the test-retest reliability correlation over a 4-week period was 0.624. With regard to the confirmatory factor analysis, the proportion of χ to degrees of freedom was 0.394, giving a P value of .852 and a root-mean-square error of approximation less than 0.001 with confidence intervals of less than 0.001 and 0.018, with a comparative fit index of 1, normed fit index of 0.999, relative fit index of 0.993, and incremental fit index of 1. CONCLUSION: The items that form the self-efficacy measurement scale in the Farsi version are highly reliable and valid. IMPLICATIONS FOR PRACTICE: Healthcare professionals and nursing health communities may apply the instrument to determine women's self-efficacy and to plan appropriate educational interventions, aiming at promoting women's mammography behavior.

Farsi version of the multidimensional health locus of control and God locus of health control scales: validity and reliability study among Iranian women with a family history of breast cancer.

OBJECTIVE: To determine the Persian version's reliability and validity of the Multidimensional Health Locus of Control and God Health Locus of Control scales among women with family history of breast cancer. METHODS: The cross-sectional study was conducted in Sabzevar, Iran, in 2012. It randomly selected women with family members affected by breast cancer. Predesigned questionnaires were completed through interviews. Content and face validity was evaluated using the opinions of a panel of experts, and construct validity was confirmed by applying confirmatory factor analysis.The instruments' reliability was assessed using Cronbach's alpha and test-retest reliability. RESULTS: There were 200 women in the study with their age ranging between 18 and 69 years and revealed the following; root mean square error of approximation for Multidimensional Health Locus of Control Scale = 0.013, and God Locus of Health Control Scale = 0.077; comparative fit index = 0.999, 0.998; incremental fit index = 0.999, 0.998;Tucker-Lewis fit index = 0.998, 0.998; and normed fit index = 0.983, 0.997 respectively. Cronbach's alpha was 0.61 for Internal Health Locus of Control, 0.8 for Chance Health Locus of Control, 0.68 for Power Health Locus of Control and 0.9 for God Locus Health Control. CONCLUSION: The Persian version of the subscales supported the main version.

Intimate partner violence in the eastern part of Iran: a path analysis of risk factors.

Intimate partner violence against women is a widespread phenomenon that is the cause of many deleterious health and social consequences. This study examines the impact of some risk factors on partner violence in the eastern region of Iran, using path analysis. The study used a population-based cross sectional study design. In this study, 251 married women who were referred to the health centers were selected through a proportionally stratified and randomized sampling method. Domestic violence was measured using Conflict Tactics Scale and the socio-demographic variable was assessed by a self-report questionnaire. Bayesian Structural Equation Modeling was used for evaluating the overall path analysis and the direct and indirect p-value was estimated by Bootstrap method. AMOS and SPSS software were used to analyze data. The prevalence of overall violence was 78.1%, with 37.8% and 0.8% of women reporting minor and severe violence, respectively, and 39.8% reporting both severe and minor forms of violence. Psychological violence was the most common type of violence reported (66.5%). The model showed that husbands' drug abuse and women's higher level of education compared to their husbands were the first and second most important factors that significantly and directly influenced the violence. The women's attitude, however, had the least effect on the violence. The findings indicated that higher educated women and women with addicted husbands were more likely to experience violence. Treating the drug abuse disorders, especially mental disorders, using behavioral couple's therapy, as well as modifying certain traditional and cultural biases against women's empowerment are suggested.