Enhancing physical activity participation among female employees: evaluating the effectiveness of an educational intervention.

This paper evaluates the effectiveness of an educational intervention based on the transtheoretical model aimed at increasing physical activity (PA) participation among female employees in Bandar Abbas city (Iran) healthcare centers in December 2017 and August 2018. Using a semi-experimental interventional study design with a randomized and multi-stage method, 100 participants were included in both the intervention (n = 50) and control groups (n = 50). Data collection involved questionnaires assessing demographic information (age, gender, marital status and education), stages of change in PA behavior, Perceived Benefits, Barriers and Self-efficacy. The data were analyzed using SPSS-16, employing both descriptive (mean, SD, frequency, percentage) and inferential statistics (t-tests, chi-squared tests, etc.). Prior to the educational intervention, 19 participants (0.38%) in the intervention group engaged consistently in PA (stages 4-5). After 3 and 6 months of intervention, these numbers increased to 29 (0.58%) and 25 (0.50%), respectively. This improvement was statistically significant compared to the pre-intervention stage (P < 0.001). The findings highlight the importance of theory-based behavior change models and health education programs in promoting PA and combating sedentary lifestyles. Although focused on a specific population in Bandar Abbas, the intervention can serve as a model for similar programs targeting diverse social classes and populations.

Educational Intervention of Improve Student's Oral Health: A Systematic Review and Meta-Analysis School-Based.

Background: The present research aimed to assess the effects of oral health intervention programs at school level on students' oral hygiene in developing countries. To this aim, a systematic review and meta-analysis approach was employed. Methods: The present research was done by surfing electronic databases with MEDLINE Ovid (Embase Ovid, Scopus), Web of Science from 2000 to Mar 2020. The data were collected using a standard type of data collection including specific studies to observational ones, and the data entered RevMan 2014. The eligibility criteria were individually randomized controlled trials (RCTs) or cluster-RCTs including quasi-experimental papers with oral health interventions. The RevMan 2014 package was used for a meta-analysis done through random-effects models. Results: Meta-analyses revealed statistically significant divergences in terms of knowledge (SMD 3.31, 95% CI 2.52 to 4.11; I2 = 98; P<0.001), attitude (SMD 1.99, 95% CI 0. 43 to 3.54; I2 = 99; P<0.001), behavior (SMD 4.74, 95% CI 3.70 to 5.77; I2 = 99; P<0.001), plaque index (SMD -1.01, 95% CI -1.50 to -0. 51; I2 = 97; P<0.001) and Gingival index (SMD 0. 33, 95% CI -0. 36 to 1. 02; I2 = 98; P=0.34) in the case of students who received educational interventions versus those with ordinary care. Conclusion: The present findings attested to the effectiveness of the educational interventions in improving oral health knowledge, attitudes, behaviors, and so on which can presumably contribute to a better oral hygiene, lower incidence of oral diseases, and lower costs of the treatments imposed by oral diseases.

Explaining the concept of oral health literacy: Findings from an exploratory study.

OBJECTIVES: Identifying those with inadequate oral health literacy is difficult because little is known about its various multiple dimensions. Accordingly, the present research investigated dimensions of the concept using a qualitative approach. METHOD: Participants (n = 15) who met inclusion criteria (Including having expertise in the fields of general dental, social dental, and health education and health promotion and having at least 5 years of relevant working experience) were recruited by purposive sampling via the public health and dentistry faculty in Tehran between December 2018 and October 2019. Thematic analysis was used to assess the data. RESULTS: A total of 15 specialists (ranging in age from 28 to 61, mean 44) were included in the study. Their working experience averaged 15.5 years (SD = 7.7, Min = 6, Max = 30). Independent analysis of qualitative data by three researchers led to identification of seven themes and 18 sub-categories, including need perception (feeling the need and paying attention to meeting the need), emotional literacy (valuation of oral health, formation of personality and taking care of oral health), planning literacy (planning and goal-orientation), communicative literacy (choice in decision-making, interpersonal communication skill and claiming), behavioural literacy (self-care), cognitive literacy (knowledge, information comprehension, information use, and information analysis) and media literacy (the ability to use up-to-date technologies, the ability to search for and acquire the information, and judgment). CONCLUSIONS: Our findings provide insights into the dimensions of oral health literacy. It is hoped that these findings can be used to guide the development of interventions on OHL and that aspects of the concept can help to enhance levels of OHL and help to promote health at societal level.

Women's decision to adopt or not adopt cervical cancer screening: Application of precaution adoption process model as the theoretical framework.

BACKGROUND: The cancer is uncontrolled growth and spread of cells that affect almost all parts of the body. One of the most prevalent cancers in the female genital system is cervical cancer. The aim of present study was to determine the effect of educational intervention using the Precaution Adoption Process Model (PAPM) on cervical cancer screening behavior (Pap smear test) among women. MATERIALS AND METHODS: In this interventional study that was done in Karaj health centers (2016), women (aged 15-49 years) were in the third stage of behavior change process based on PAPM randomly assigned to experimental and control groups. The data collection tool was a PAPM-based questionnaire whose validity and reliability were confirmed. Gathered data were analyzed using statistical software SPSS 16 and statistical tests (t-test, repeated measures analysis of variance, and Wilcoxon, Chi-squared, Fisher's exact, and Mann-Whitney tests). RESULTS: The result showed that the stages of the decision-making process between the two groups were significantly different at the time immediately and 2 months after the intervention (P > 0.001). Also the results of the intervention based on the health belief model health belief model (HBM) components, regarding variables of knowledge, perceived susceptibility, perceived benefits, perceived barriers, and subjective norms, the mean scores in the experimental group were significantly different between the three sections before, immediately, and 2 months after the intervention (P > 0.001). CONCLUSIONS: This study provides hints how persons could be influenced to move from the "Deciding about action" positions into to the stages of decided to act, adoption, and maintenance for promoting cervical cancer screening behavior.

Maternal predictive factors for preterm birth: A case-control study in Southern Iran.

BACKGROUND: Preterm birth (PTB) is one of the most important factors that increase the risk of chronic diseases and postpartum death in infants. The aim of this study was to determine the maternal factors that affect the birth of preterm infants in the city of Bandar Abbas. MATERIALS AND METHODS: This is a case-control study that was performed on 400 preterm infants. Sampling was done by a simple method, and information was gathered by interviewing the mothers and their medical records. Data were collected by SPSS software version 16. To compare risk factors in the two groups, conditional logistic regression was used, and P < 0.05 was considered statistically significant. RESULTS: Results showed that factors such as type of delivery (odds ratio [OR] = 3.584, 95% confidence interval [CI]: 1.981-6.485), preeclampsia (OR = 2.688, 95% CI: 1.164-6.207), history of PTB (OR = 4.171, 95% CI: 1.483-11.728), premature rupture of membranes (OR = 3.273, 95% CI: 1.745-6.137), care during prenatal (OR = 0.334, 95% CI: 0.159-0.701), placental abruption (OR = 3.209, 95% CI: 1.209-8.519), placenta previa (OR = 9.333, 95% CI: 2.086-41.770), and cervical insufficiency (OR = 11, 95% CI: 1.381-87.641) were independent risk factors of preterm infant birth. CONCLUSIONS: The PTB risk is higher for women with cervical insufficiency, history of placenta previa, and history of preterm. Early recognition and management of these high-risk conditions among pregnant women may lead to a reduction in PTB rates.

Association between self-efficacy and general health: a cross-sectional study of the nursing population.

BACKGROUND: The present research aimed to explore the association of self-efficacy and general health among nurses. METHODS: This was a descriptive-analytical. A total of 470 nurses were selected through the stratified sampling method. To collect the required data, GSE-10 and GHQ-28 were used. Independent-sample T-test, Pearson correlation coefficient, Chi-squared test, and regression were also used to analyze the obtained data. RESULTS: The results reveal a statistically significant correlation between general health and self-efficacy (t=-6.72, p < .001). Among general health parameters, social functioning has significantly predicted self-efficacy. CONCLUSIONS: As shown in the present findings, an acceptable level of self-efficacy can positively affect all aspects of nurses' general health.

Structural Equation Modeling of the Spirituality and Self-efficacy Among College Students.

The present research is a descriptive analytical study which is conducted on 540 students. Multistage random sampling method was used. Data gathered by questionnaire consist of demographic factors and spirituality assessment questionnaire and self-efficacy questionnaire. Data were analyzed using statistical tests including t test, Chi-square, one-way ANOVA and correlation between variables through SPSS16 and EQS6.1 Software. Positive coefficients in regression equations showed positive relationship of spiritual capability (P < 0.001, r = 0.932) and spirituality with perceived self-efficacy (P < 0.001, r = 0.394) so that an increase in one of them will lead to increase in another one; this result is matched with research hypothesis. It is recommended to officials and managers of universities to create some mechanisms in order to improve and promote spirituality in university to promote self-efficacy of students and also to adopt a spiritual approach in curriculums of higher education.

Exploring determinants of hand hygiene among hospital nurses: a qualitative study.

BACKGROUND: The present research is a qualitative one aiming to determine factors affecting hand-hygiene behavior of the nursing staff in Shariati Hospital of Tehran, Iran. METHODS: This was a qualitative study performed using content analysis approach. Considering the aim of the study, 16 in-depth semi-structured interviews were held with the nursing staff of Shariati Hospital of Tehran University of Medical Sciences. A convenient sampling was performed and continued until data saturation and until no new codes and categories were obtained. Data were analyzed through a qualitative content analysis based on the Graham and landsman method. Directed qualitative content analysis was done in order to analyze the data. RESULTS: The results of this study revealed 3 main themes in the Theory of Planned Behavior (TPB) (attitude, subjective norms and perceived behavioral control) and 8 main themes in the outside the framework (environment, perceptions, life style, morality, education, organizational culture, salience and personality). CONCLUSION: Due to the other factors also found in this study, an integration of theories and models for designing of interventions is recommended to increase adherence to hand hygiene behavior.

Safe driving behaviors among taxi drivers: a predictive cross-sectional study based on the health belief model.

BACKGROUND: The purpose of this study was to predict safe driving behaviors among taxi drivers of Tehran based on the constructs of health belief model. METHODS: This descriptive-analytical study was performed on 450 taxi drivers in Tehran using multi-stage sampling. Data were analyzed through SPSS software version 18 using Pearson correlation coefficient and multivariate regression analysis. The P < 0.05 was considered statistically significant. RESULTS: Among the constructs of health belief model, perceived severity, perceived benefits and self-efficacy, had significant and direct relationship and perceived barriers had a significant and reverse relationship with safe driving behaviors. According to the results, the constructs of health belief model predicted 17.3% of safe driving behaviors. Self-efficacy was the strongest determinant of safety behaviors (0.362 CI 0.098-0.625). CONCLUSIONS: Increasing self-efficacy, reducing perceived barriers and highlighting benefits for the purpose of accepting safe behaviors can be considered as a principle in driving education and training. Also, increasing the perceived severity of adverse outcomes of RTAs and the susceptibility to these outcomes will lead to higher levels of safe driving behaviors.

Theoretically designed interventions for colorectal cancer prevention: a case of the health belief model.

BACKGROUND: According to the WHO, most chronic diseases, including cancer, can be prevented by identifying their risk factors such as unhealthy diet, smoking and physical inactivity. This research examined the effectiveness of a theory-based educational intervention on colorectal cancer-related preventive nutritional behaviors among a sample of organizational staff. METHODS: In this interventional study, 110 employees of Shahid Beheshti University of Medical Sciences were randomly divided into two groups (intervention and control) with cluster sampling. The data gathering tool was a researcher-made questionnaire containing two parts of 10-dimensional information and health belief model constructs. The educational intervention was conducted for 1 month and in four sessions in the form of classroom lecture, pamphlet, educational text messages via mobile phones and educational pamphlets through the office automation system. Two groups were evaluated in two stages, pre-test and post-test. Data were analyzed using SPSS-18 software, analysis of Covariance (ANCOVA) and independent t-test (intergroup comparisons). RESULTS: Two groups were evaluated for variables such as age, sex, education level and family history of colorectal cancer, and there was no significant difference between the two groups (P < 0.05). After the 2 months since intervention, except for the mean score of perceived barriers, which was not significant after intervention, the mean scores of knowledge, perceived susceptibility, perceived severity, perceived benefits, perceived self-efficacy, behavioral intention, and preventive behaviors were significantly increased after the intervention in the intervention group compared to the control group (P > 0.05). CONCLUSION: Implementation of educational intervention based on health belief model was effective for the personnel, and can enhance the preventative nutritional behaviors related to colorectal cancer.

Systematic review of the tools of oral and dental health literacy: assessment of conceptual dimensions and psychometric properties.

BACKGROUND: This article aims to provide a description of conceptual dimensions and psychometric properties of the tools of oral and dental health literacy. METHODS: Two authors in this study conducted electronic searches in the Medline (via PubMed), and Embase databases to find relevant articles from 1990 to present day. Evaluation of the tools was carried out in two parts; general evaluation of the tools using skills introduced by Sørensen et al., and qualitative assessment of psychometric properties using COSMIN checklist. RESULTS: After reviewing 1839 articles on oral and dental health literacy and evaluating 33 full text articles for eligibility, 21 articles entered the study. The sample size varied from 20 to 1405 subjects and the items of each tool ranged from 11 to 99 items. Of the 21 tools examined, 16 tools were evaluated for word recognition. For the studies examined, the evaluation of COSMIN scores was often fair or good. Of the 21 tools examined, 9 tools at least in one dimension were in the category of "poor", 19 tools were in the category of "fair", 20 tools were in the category of "good", and 4 tools were in the category of "excellent" in at least one dimension. CONCLUSION: The findings of this study showed that some aspects of oral and dental health literacy are being ignored in the existing tools. Therefore, the authors of present study emphasize on the necessity to design and develop a comprehensive tool and take into account two characteristics of simplicity and briefness for international use.

Protocol of the TOHLA instrument: A Test of Oral Health Literacy in Adults.

BACKGROUND: A proper measurement instrument is selected based on the suggested use of the instrument, the target concept of measurement, and features of measurement (e.g. internal consistency, reproducibility, content and construct validity, responsiveness, and interpretability). Concerning the design and features of measurement, there are not any adequately specific standards for instrumentation to measure oral health literacy (OHL). The present study proposes a protocol that attempts to fill this gap by introducing the psychometrics of a standard questionnaire which measures OHL. MATERIALS AND METHODS: The present research employs a methodological design and is carried out in Tehran, with data collected through interviews that are held face to face. The data collection procedure involves a review of the related literature, cognitive interviews, fuzzy Delphi Method, and focal groups with participants with OHL work experience for item generation. The target participants of this research are the Iranian adult population and experts working professionally in different health domains. For qualitative data analysis, the content analysis strategy and in the instrument Psychometrics COSMIN checklist will use. CONCLUSIONS: Achievement of the present research will be used to evaluate the capability of the Iranian adult population in searching, processing, and deciding on healthcare services. This instrument will focus on evaluating both clinical and nonclinical settings. The present research can vastly improve our knowledge of the state of OHL in the Iranian adult population.

Effectiveness of a health intervention based on WHO food safety manual in Iran.

BACKGROUND: Food safety manual was developed by the World Health Organization (WHO) to train professionals to reduce the burden of foodborne diseases as a global strategy. The present pioneering research aimed to explore the effectiveness of an intervention based on the manual of five keys to safer food by WHO in enhancing the knowledge, attitude and behavior of Iranian Female Community Health Volunteers (FCHVs). METHODS: In the present quasi-experimental research, FCHVs (n = 125) were selected and assigned to two groups, an intervention and a control. A modified version of the questionnaire based on WHO manual was used to measure knowledge, attitude and behavior of the sample. The questionnaire was first completed at the outset of the study (pre-test) and then once again in 2 months of the intervention (post-test). Face and content validity of the questionnaire was tested and confirmed. Cronbach's alpha was used to test the reliability of the questionnaire along with the test-retest method of testing reliability. The data entered SPSS16 for statistical analysis. To this aim, Chi-squared test, dependent and independent samples T-test, ANOVA and ANCOVA were run. Partial population attributable risks were calculated and corresponding 95% confidence intervals (95% CIs) were estimated using a bootstrap method. RESULTS: The two groups showed no statistically significant difference in the pretest (p > .05). In the post-test, the mean scores for all variables was higher in the intervention group than the control, and this difference between the two research groups was statistically significant (p < .001). When the volunteers were adjusted for age and experience in healthcare centers, the mean scores were significantly higher in the intervention group than the control (p < .001). CONCLUSION: It was revealed in the present study that the educational intervention based on five keys to food safety manual by WHO managed to improve participants' knowledge, attitude and behavior. Translation of the target guideline in future can be a great help to researchers in prospective research. TRIAL REGISTRATION: Retrospectively registered: Iranian Registry of Clinical Trials IRCT20160822029485N4, at 2020-03-16.

Behavioral approach to food consumption and waste production: A quasi-experimental study.

BACKGROUND: Approximately one third of the food produced in the world for human consumption was wasted. OBJECTIVES: This study aimed to determine the effect of intervention on behavior of food consumption and waste production in the restaurants of Shahid Beheshti University of Medical Sciences. MATERIALS AND METHODS: In this quasi-experimental study, 233 students of public health school were selected as intervention group, and 233 students of medical school were selected as control group. The food wastage was weighed in both "Sabz" and "Medical" restaurants for a week. Based on training needs of the samples, teaching methods and programs were implemented in the intervention group for a month. The clients of both restaurants were followed 4 weeks after the intervention. The food waste was weighed after 4 weeks. Data were analyzed using SPSS software version 16 and statistical tests (Wilcoxon, Chi-squared, McNemar, and Mann-Whitney tests). RESULTS: The results obtained from Wilcoxon test showed that, the means of awareness, attitude, and behavior were significantly improved after the intervention in the intervention and control groups (P < 0.001). After the intervention, according to the number of served foods, it was expected that the weight of food wastage to be 341.37 kg/week, but this figure was reduced to 224.98 kg/week after the intervention. CONCLUSIONS: This study has confirmed the effectiveness of implementation of interventions on enhancement of knowledge, attitude, and behavior of people about consumption of food and amount of wastage. The authors suggest that to investigate sustainability of effect of intervention on behavior of food consumption and wastage production, this study could be implemented in different and longer time intervals after the end of project.

The effect of educational intervention based on the theory of planned behavior and stages of change construct on women's physical activity.

BACKGROUND: Insufficient physical activity is a global health-care problem and is considered an independent risk factor for chronic diseases. The present research aimed to explore the effect of an educational intervention based on the theory of planned behavior (TPB) and stages of change on promoting women's physical activity. MATERIALS AND METHODS: This quasi-experimental research was conducted on 68 women who voluntarily visited the health-care centers of Mashhad. They were selected by randomized multistratified sampling method and were divided into two groups of intervention (n = 34) and control (n = 34). The data collection tools included a demographic information questionnaire, a questionnaire based on the TPB and stages of change, and the International Physical Activity Questionnaire. The data were statistically analyzed by SPSS software version 16 using descriptive statistics (frequency, percentage, mean, and standard deviation) and inferential statistics (paired t-test, correlation coefficient, and covariance). The significance level of P < 0.05 was considered in this study. RESULTS: No statistically significant difference was found between the intervention and control groups before the intervention in terms of the scores of the TPB constructs and physical activity (P > 0.05). However, after the educational intervention, a significant difference was observed in the mean scores of TPB constructs and physical activity (P < 0.05). In addition, no statistically significant difference was found in the stages of change between the two groups after the intervention. CONCLUSIONS: The results of this study pointed to the effectiveness of educational intervention and the necessity to use educational interventions to help adopt preventive behaviors. Therefore, the use of well-established educational models rather than conventional methods is recommended.

Barriers to research activities as perceived by medical university students: A cross-sectional study.

CONTEXT: The importance of research is revealed by the fact that the top seven science producing countries in the world are the same seven countries worldwide in terms of the research facilities. AIM: To explore the barriers to research activities among the students of the Hormozgan Medical University. SETTINGS AND DESIGN: A total of 400 students affiliated with the Hormozgan University of Medical Sciences participated in this cross-sectional study. METHODS: The sampling method was proportional stratified, and the data collection instrument was a tripartite questionnaire that comprised demographic information, personal barriers, and organizational barriers. STATISTICAL ANALYSIS: The data were statistically analyzed by the Statistical Package for the Social Sciences (SPSS) software (V.16.0, SPSS Inc., Chicago, IL, USA) using descriptive statistics as well as the independent sample t-test, one-way analysis of variance, and Pearson's correlation coefficient. The level of significance was set at P < 0.05. RESULTS: The most prevalent personal barriers were inadequate knowledge of research methodology (2.91±1.24) and inadequate skill in research conduction (2.89±1.36). In the realm of organizational barriers, limited access to information sources was the most prevalent barrier (2.75±2.27). The results showed that researcher students encounter more of the organizational barriers (56.13±13.90), whereas non-researcher students faced more of the personal barriers (53.80±10.95). CONCLUSION: Establishing access to high-speed Internet system, raising students' awareness of research methodology through workshops, encouraging and motivating students for research work, and using online sources can help in removing the barriers to research activities.

Oral and dental health care during pregnancy: Evaluating a theory-driven intervention.

OBJECTIVE: The present research aimed to investigate the effect of an educational intervention based on the health belief model in pregnant women visiting the healthcare centers in the west of Tehran in 2016. MATERIALS AND METHODS: The present experimental research was conducted on 135 pregnant women visiting the healthcare centers in the west of Tehran. The subjects were selected through a randomized multistratified sampling and were divided into an experimental and a control group. The collected data were then statistically analyzed in SPSS ver.16. To do so, descriptive statistics and inferential statistics were used including the independent-samples t-test, repeated-measures one-way ANOVA and paired-sample t-test. RESULTS: The present findings revealed a statistically significant difference between the experimental and control groups in terms of immediate post-test results including perceived sensitivity, severity, benefits, barriers, and self-efficacy along with awareness and performance constructs (p Ë‚ 0.001). Moreover, two months after the intervention, except for the perceived sensitivity construct (p = 0.088), the two groups diverged significantly in terms of the other constructs (p Ë‚ 0.001). CONCLUSIONS: The educational intervention driven by the health belief theory showed to be effective on pregnant women and can help to promote preventive behaviors of tooth decay.

Factors involved in selecting the birth type among primiparous women.

BACKGROUND: Mortality and disability rates were reported to be respectively 2-3 and 5-10 times higher in C-sections compared to Vaginal delivery. OBJECTIVES: This study was aimed to explore the factors involved in selecting the birth type among primiparous women. METHODS: The present cross-sectional research was conducted on 220 primiparous women, who visited the health-care centers of Bandar Abbas. They were recruited in their first trimester of pregnancy with a simple randomized clustering method. Data were collected in a researcher-designed questionnaire. Its validity was confirmed by a panel of experts and reliability was tested and approved through the test-retest method. Mean, standard deviation, independent sample t-test, and Chi-squared tests for data analysis were done by SPSS 16. P < 0.05 was considered statistically significant. RESULTS: The mean age of the participants was 27.40 ± 6.07 years. The main barriers to the choice of vaginal delivery were the fear of pain and fear of vaginal area tears and ruptures, fear of injury to fetus, and doctor's recommendation. A statistically significant correlation was observed between the age, education, employment, income, awareness, and the reasons for preferring surgical childbirth. CONCLUSIONS: To reduce the rate of unnecessary cesarean sections (C-section), the following recommendations are suggested: Reducing fear of pain in expectant mothers, modifying wrong beliefs about the culture of natural childbirth, increasing awareness of fewer adverse effects of vaginal delivery including the vaginal tears if the mother abides by all midwife(s) instructions during the delivery procedure, providing educational courses for the necessary movements during the delivery, decreasing surgeons' payment for C-section, and increasing payment for natural childbirth and implementing barriers for optional delivery to reduce the C-section.

Pregnant Women's Health Literacy in the South of Iran.

Objective: Investigate the health literacy of pregnant women in the south of Iran. Materials and methods: The present descriptive-analytical study was conducted on 775 pregnant women in the south of Iran (including Boushehr, Ahvaz, Zahedan and Bandar Abbas cities) through the clustering sample selection method. The data were collected through the Test of Functional Health Literacy in Adults: TOFHLA, and were analyzed statistically via SPSS 16 through independent-sample t-test and ANOVA. Results: The average age of the subjects was 31.89 ± 7.54 years. The results indicated that 15.5% of the subjects had an inadequate level of health literacy; 41.7% had a border-line level of health literacy, and 42.8% had an adequate level of literacy. Significant correlations were found between each of these variables and the subjects' level of health literacy: education, age, occupation and care provision during pregnancy (p ˂ 0.05). The highest mean score of health literacy belonged to Ahvaz while the lowest belonged to Boushehr. Conclusion: According to the results, the health literacy level of pregnant women in the target geographical areas showed to be inadequate or on a border-line. Moreover, subjects' education, age and occupation showed to be significantly correlated with health literacy. Therefore, promoting pregnant women's health literacy through simplifying health-related information, use of audio-visual media, improving communicative skills among the health staff and mothers can be effective.

Prediction of Birth Type Based on the Health Belief Model.

Objective: To anticipate the type of childbirth according to the health belief model. Materials and methods: The present cross-sectional research was conducted on 222 primiparous women visiting the healthcare center in Khorram Abad. A combination of simple randomization and clustering was used to do the sampling. The data collection instrument was a validated four-part questionnaire the first part of which contained demographic information. The second part was comprised of awareness questions while the third dealt with the constructs of the health belief model. The final part consisted of the behavioral intention derived from the logical action theory. SPSS 16 was used to statistically analyze the data and the significance level was set at p ˂ 0.05. Results: The average age of the participants was 27.40 ± 6.07 years. Intention to go for a vaginal birth showed to be significantly correlated with awareness, perceived sensitivity, intensity, barriers and benefits (p ˂ 0.001) as well as self-efficacy (p = 0.025). The best predictor of the type of childbirth turned out to be the perceived barriers (OR = 1.153, p ˂ 0.001) and only then awareness (OR = 1.108, p ˂ 0.001). Conclusion: Strategies to remove the barriers of preferring vaginal childbirth, raising women's awareness of the side effects of C-section and the benefits of vaginal birth, strategies to enhance women's beliefs in their capability of natural childbirth can be used to reduce the prevalence of unnecessary C-sections.