Predictive factors of ergonomic behaviors based on social cognitive theory among women workers on assembly lines: application of Bayesian networks.

BACKGROUND: This study focuses on identifying the key factors associated with ergonomic behaviors (ERBE) among women workers on assembly lines (WwAL) to prevent musculoskeletal disorders (MSDs) caused by repetitive motions and unfavorable body postures. To achieve this objective, this study employed Bayesian networks (BN) analysis based on social cognitive theory (SCT). METHODS: A cross-sectional study was conducted to examine the predictive factors of ERBE among 250 WwAL from six different industries located in Neyshabur, a city in northeastern Iran. The study used a two-stage cluster sampling method for participant selection and self-report questionnaires to collect data on demographic characteristics, variables associated with SCT, ERBE, and the standard Nordic questionnaire. The collected data were analyzed using Netica and SPSS version 21, which involved statistical analyses such as independent t-tests, Pearson correlation, and ANOVA tests at a significance level of p < 0.05. BN analysis was conducted to identify the important factors that impact ERBE. RESULTS: The majority of individuals reported experiencing chronic pain in their back, neck, and shoulder areas. Engaging in physical activity, consuming dairy products, and attaining a higher level of education were found to be significantly associated with the adoption of ERBE p < 0.05. Among the various SCT constructs, observational learning, intention, and social support demonstrated the highest levels of sensitivity towards ERBE, with scores of 4.08, 3.82, and 3.57, respectively. However, it is worth noting that all SCT constructs exhibited a certain degree of sensitivity towards ERBE. CONCLUSIONS: The research findings demonstrate that all constructs within SCT are effective in identifying factors associated with ERBE among WwAL. The study also highlights the importance of considering education levels and variables related to healthy lifestyles when promoting ERBE in this specific population.

Effectiveness of a theory-based educational intervention on work-related musculoskeletal disorders preventive behaviors among assembly-line female workers: a study protocol for a randomized controlled trial.

BACKGROUND: The use of preventive behaviors of musculoskeletal disorders (MSDs) requires proper training, which leads to correct decisions regarding maintaining postures at work and performing stretching exercises. Due to very repetitive work, applying manual force, improper postures, and static contractions of proximal muscles, assembly-line female workers suffer from musculoskeletal pains. It is assumed that structured and theory-based educational intervention using a learning-by-doing (LBD) approach may increase the preventive behaviors against MSDs and reduce the consequences of these disorders. METHODS: This randomized controlled trial (RCT) will be conducted in three phases: phase 1: validation of the compiled questionnaire, phase 2: determining the social cognitive theory (SCT) constructs that predict the preventive behaviors of MSDs in assembly-line female workers, and phase 3: designing and implementing the educational theory. The educational intervention is based on the LBD approach, and the study population includes assembly-line female workers in electronic industries of Iran, who are randomly divided into two intervention and control groups. The intervention group received the educational intervention in the workplace and the control group does not receive any intervention. The theory-based educational intervention includes evidence-based information along with pictures, fact sheets, and published literature about a good posture at work and the need to perform proper stretching exercises. The educational intervention aims to improve the knowledge, skills, self-efficacy, and intention of assembly-line female workers to adopt preventive behaviors of MSDs. DISCUSSION: The present study will evaluate the effects of maintaining a good posture at work and performing stretching exercises on the adherence to preventive behaviors of MSDs among assembly-line female workers. The developed intervention is easily implemented and evaluated in a short period of time based on the improved score of the rapid upper limb assessment (RULA) method and the mean score of adherence to stretching exercises and can be provided by a health, safety, and environment (HSE) expert. TRIAL REGISTRATION: ClinicalTrials.gov IRCT20220825055792N1. Registered on 23 September 2022 with the IRCTID.

Understanding risk factors for musculoskeletal disorders in Iranian housewives: Development of a comprehensive health promotion behavior model.

BACKGROUND: Chronic musculoskeletal problems are a major source of disability, reduced productivity and poor quality of life. Prevalence of musculoskeletal disorders among Iranian housewives is particularly high. Understanding how housework causes the injuries, mobility restrictions and pain associated with musculoskeletal disorders is vital to developing health promotion behavior models to support intervention. The aim of this qualitative study was to explore the experiences of housewives with musculoskeletal disorders and, according to the risk factors identified, to develop a comprehensive behavior change framework to facilitate implementing a musculoskeletal health-promoting training intervention for women. METHODS: Twenty-four in-depth interviews were conducted with Iranian housewives aged 20-65 years experiencing musculoskeletal pain over a 13-month period from September 2020 to October 2021. The conventional content analysis approach was used to interrogate the data. The transcript of each interview was considered a unit of analysis, and data analysis was performed using MAXQDA2018 software. RESULTS: The analysis of the interview data provided 1432 meaning units. From these codes, a conceptual framework was developed. This comprehensive model is comprised of 24 subcategories, eight categories and three themes: Individual and social predictors of MSDs and their control, Risk factors for MSDs, and Prevention and treatment of MSDs. Altogether the developed conceptual framework specified the multiple risk factors for MSDs in housewives. The findings were aligned to various health promotion models, and it was seen that ecological models, especially the Theory of Triadic Influence, can be very helpful as a supportive roadmap to implementing multilateral interventions to improve the quality of life of housewives. CONCLUSIONS: This study developed an evidence based comprehensive model that identifies the individual, psychosocial, and cultural factors that influence the status of MSDs in women's domestic work to support the development and implementation of effective ergonomic interventions to manage potentials for MSDs.

Development and psychometric properties of the HBM-based substance abuse prevention questionnaire (HBM-SAPQA) among Afghanian students.

In Afghanistan, adolescents and young people are the most important at risk groups for substance abuse. Considering the importance of model-based interventions in this group, this study aims to design and validate a questionnaire based on the Health Belief Model (HBM) for assessing the beliefs of Afghan students regarding substance abuse prevention behavior. This study was conducted in two stages. In the first stage, the items of the questionnaire were designed by conducting a combined documentary literature review and qualitative study. In the next step, its psychometric properties were evaluated through qualitative and quantitative face and content validity (CVR & CVR) and structural validity (exploratory factor analysis). Finally, internal consisitency through Cronbach's alpha as well as reliability was assessed. To above steps, the SPSS version 18 was applied. 57 items were obtained for the questionnaire by performing a qualitative study and using existing scientific sources for literature review. In checking the face validity of the questionnaire items quantitatively (calculating the impact score), the impact score of all items was above 1.5. The CVR of each item was more than 0.8 and their CVI was more than 0.79. In EFA (using the information of 408 students with average age of 23 years old), the final model was confirmed with 38 related to the main HBM constructs in 5 factors, which covered about 40% of the variance. Acceptable values of Cronbach's alpha between 0.71 and 0.81 for all factors confirmed the reliability of the questionnaire. The HBM-SAPQA obtained the acceptable validity/reliability to apply the beliefs of Afghan students regarding substance abuse preventive behavior.

Promoting behavior-related low back health in nurses by in-person and social media interventions in the workplace.

BACKGROUND: Nurses are put at high risk of work-related low back pain due to the nature of their work. The aim of this study was to develop and evaluate intervention based on the PRECEDE-PROCEED Model on promoting behaviors of low back health via two educational approaches. METHODS: This study was a community randomized-controlled clinical trial. The educational content was developed with six modules: knowledge, attitude, self-efficacy, reinforcing factors, enabling factors, and behavior. Intervention was delivered by two modes: (1) in-person (n = 60) and (2) social media (n = 60). Data were evaluated by a self-designed questionnaire at baseline, 3, and 6 months. Baseline comparisons between groups were made with Mann-Whitney U Test and T-Test. Comparison of change scores between groups and two delivery types across the three time periods used the mixed between-within subject analysis of variance. RESULTS: A total of 120 nurses received the allocated intervention. All educational component scores increased at 3-months in both groups. At the 6-month follow-up scores increased for enabling factors and behavior in the intervention group, while in the control group all scores increased except for attitude. Based on Bonferroni Post hoc analysis social media was more effective in knowledge, self-efficacy, reinforcing factors, and behavior than the in-person intervention. CONCLUSION: An educational program for low back health based on the PRECEDE-PROCEED model proved effective at improving all components. However, social media was more successful than in-person in the maintenance of behavior over the long term. TRIAL REGISTRATION: IRCT20170313033054N2: 25-02-2018. https://www.irct.ir/trial/25598.

Educational intervention program based on health belief model and neck pain prevention behaviors in school teachers in Tehran.

BACKGROUND: Prevention of musculoskeletal disorders as one of the most common occupational health problems among the working population in both developed and developing countries is an important necessity and priority. The aim of this study was to evaluate the effectiveness of an educational intervention program based on the Health Belief Model (HBM) to increase awareness, perceived sensitivity, perceived severity, perceived benefits, and self-efficacy in adopting neck health-promoting behaviors in school teachers. METHODS: The present study was a quasi-experimental of the randomized clinical trial that was conducted for 6 months (December 2020 to July 2021). Participants were 146 junior high school teachers were selected from 26 schools through random sampling and divided into two groups of intervention and control. The data collection instrument was the self-design questionnaire and was completed in three points of time (before, immediately, and 3 months after the intervention). The data were analyzed by software version 24 SPSS. RESULTS: The results showed that awareness, perceived sensitivity, perceived severity, perceived benefits and barriers, and self-efficacy in adopting neck health-promoting behaviors in the intervention group increased in two points of time (immediately after the intervention and 3 months of follow-up) (P <  0.05). CONCLUSION: Designing and implementing an educational intervention based on HBM could affect in adopting neck health-promoting behaviors among teachers. TRIAL REGISTRATION: IRCT20210301050542N1, 16/03/2021 first registration has been approved in Iranian Registry of Clinical Trials at (16/03/2021).

Impact of El-Poems study: the e-learning for postural education in music students: a randomized controlled trial protocol.

BACKGROUND: Musculoskeletal pain (MP) has today intensified in a large proportion of music students in Iran. Poor posture while playing an instrument is thus assumed as a very significant risk factor affecting such a condition in this population. The present study aims to evaluate the impact of electronic learning (e-learning) for postural education to music students on posture behavior and MP (abbreviated as an El-Poems study). METHODS: This study is a matched-pair, two-arm, parallel randomized controlled trial (RCT). The participants, as the 7th-to-12th-grade music students, will be accordingly assigned to intervention (n = 204) and control (n = 204) groups, based on the inclusion and exclusion criteria. The postural education will be also presented through the web-based Student Education Network (with the acronym, SHAD) at the Tehran Conservatory of Music, Tehran, Iran. The intervention program consists of four sessions, using the Integrated Change (I-Change) model. It will be also implemented by a trained physical education instructor and a health educator. The content of the program includes raising awareness, building motivation, and developing skills. Besides, its components are comprised of specific proper postures viz. standing, sitting, lifting, carrying, and hand position while playing a musical instrument. The primary outcome is the MP that will be assessed by the Nordic Body Map (NBM) questionnaire and a numerical rating scale (NRS), and the secondary outcome is the posture behavior that will be evaluated objectively, using the Rapid Entire Body Assessment (REBA) tool. The data will be also collected at baseline and after a six-month follow-up. CONCLUSION: This RCT is an innovative study as a pioneer to represent the first attempt for web-based postural education as well as an attractive intervention to prevent MP in Iranian music students. TRIAL REGISTRATION: Current Controlled Trials IRCT20180528039885N2 . Prospectively registered on 11 September 2021.

Exploring nurses' experiences of social media and in-person educational interventions for professional development: a qualitative study.

BACKGROUND: Nurses play an important role in health promotion, prevention strategies, and care. Therefore, nurses need to obtain and update their knowledge and skills via appropriate strategies. This study aimed to explore nurses' experiences of receiving social media and in-person education to integrate the findings into practice. METHODS: This was a qualitative study using the directed content analysis approach. A sample of nurses with previous experiences of receiving social media and in-person education participated in the study. They were asked to express their experiences and indicate their preferences. The data were collected based on individual semi-structured interviews. RESULTS: In total 15 participants took part in the study with a mean age of 40.6 ± 8.93 years and work experiences of 15.3 ± 9.21 years. During the process of content analysis, three main themes emerged: Approaches to nursing education and its adoption in the health system, Achieving effectiveness and efficiency in nursing education, and Health care policy and facilitating pathways for nursing education. Participants indicated several barriers to attending an educational program, including motivation, workload, time and place, and hospital politics. CONCLUSION: Overall the findings suggest that regardless of any methods of education nurses cannot actively engage in the educational interventions while on duty. However, the findings suggest that nurses believe that the social media approach might be superior in reducing barriers and making the educational interventions work better.

Educational intervention for the prevention of occupational neck pain: protocol of randomized trial.

BACKGROUND: Neck pain is one of the most common work-related musculoskeletal disorders (WMSDs). It has important social and economic consequences such as reduced productivity due to absenteeism, leave, and early retirement and financial losses due to medical expenses for the workforce especially teachers. This study aims to evaluate whether a model-based social media intervention could change the high-risk behaviors that cause work-related neck pain among teachers. METHODS: This is a randomized controlled trial that will be done in three steps. The first stage is a qualitative study to obtain the items and areas of the researcher-made questionnaire based on the health belief model (HBM), the second stage is the psychometric evaluation of the questionnaire, and the third stage is designing and implementation of model-based educational intervention in social media context. The study population is teachers who working in junior high school in the 19th district of education minister in Tehran, Iran, which are randomly divided into two groups of intervention and control. The intervention group receives training packages on social media, and the control group does not receive any training. The educational intervention tries to improve the knowledge, attitude, skills, and self-efficacy in adopting neck pain prevention behaviors among teachers. The study will also assess whether the intervention can promote preventive neck pain behavior among teachers. DISCUSSION: Work-related neck pain can have a negative impact on teachers' health. This study is an attempt to investigate the impact of developed interventions in promoting preventive behavior regarding work-related neck pain through social media context. TRIAL REGISTRATION: Iranian registry of Clinical Trial (IRCT) IRCT20210301050542N1 . Registered on 16 March 2021 Ethics code: IR.MODARES.REC.1399.163.

Effects of School-Based Educational Program on Backpack Carrying Behavior in Teenage Students.

One of the most serious issues is the growing prevalence of backaches among adolescent students as a result of carrying backpacks. The purpose of this study was to examine the impact of an education program (remedial information) on the school backpack carrying habits of adolescent students. The study sample consisted of 138 adolescent students aged 12 to 16 from 4 schools who were randomly assigned to either the experimental (N = 69) or control (N = 69) groups. The experimental group was subjected to a 6-week education program consisting of 6 sessions, whereas the control group received no educational intervention. During the pre-test and 3 months after the intervention, participants completed a questionnaire. The results (healthy items) were as follows: (1) carry as little as possible, (2) carry a school backpack on both shoulders, and (3) use lockers or something similar. After a 3-month follow-up, healthy items in the experimental group improved, but no significant changes were observed in the control group. When compared to the baseline, the experimental group's healthy backpack usage habits improved significantly at the post-test (P = .001). The current study's findings show that school-based education interventions on backpack behaviors improve the school-bag carrying habits of adolescent students.

Study protocol for a randomized controlled trial to improve the quality of life of housewives with musculoskeletal disorders: a health promotion intervention based on a participatory ergonomic approach-the Housewives Ergonomic Intervention (HEI) trial.

BACKGROUND: A variety of household chores expose women to a variety of biomechanical and psychosocial risk factors. A result of this is many housewives with musculoskeletal disorders. Given the interactive effects of these risk factors, it is necessary to consider multiple strategies to mitigate their effects. Accordingly, the present study will investigate the impact of a health promotion training program based on a participatory ergonomic approach towards a reduction in the prevalence of musculoskeletal disorders and an improvement in the quality of life of housewives. METHODS: Iranian housewives aged 20-65 years currently attending a specialist health clinic due to a painful musculoskeletal complaint will be invited to join the study. Recruitment will continue until a sample of 160 women provides informed consent to participate. The study will be conducted using a mixed-methods protocol in two phases. In the first phase, psychosocial and biomechanical risk factors will be identified using a qualitative approach. In the next phase, the results from the qualitative approach will be used to develop a conceptual framework based on health promotion theories and an intervention program based on a participatory ergonomic approach designed. Participants will be randomly allocated into one of four groups: (1) biomechanical intervention group, (2) psychosocial intervention group, (3) multidisciplinary intervention group (both biomechanical and psychosocial intervention), and (4) a control group. Data will be collected using Rapid Entire Body Assessment (REBA), Visual Analog Scale (VAS), Work Ability Score (WAS), Hospital Anxiety and Depression Scale (HADS), and the 36-item Short-Form health survey (SF-36) at baseline in 3-month and 6-month follow-up assessments. The impact of the three interventions on musculoskeletal disorders, work ability, stress, and quality of life will then be evaluated. DISCUSSION: The study will provide a practical approach to reducing stress, reducing musculoskeletal disorders, enhancing the ability to work, and improving the quality of life of women with musculoskeletal disorders associated with housework. If the designed interventions in the present study are effective, they will have the great practical potential for generalization to all housewives. TRIAL REGISTRATION: ClinicalTrials.gov IRCT20200602047640N . Registered on 07 September 2020 with the IRCTID.

The effectiveness of social media and in-person interventions for low back pain conditions in nursing personnel (SMILE).

AIM: To compare two educational approaches to reduce low back pain in nurses. DESIGN: A community randomized controlled clinical trial. METHODS: Data were collected with two interventions and a control arm between August 2018 and January 2019. Participants were recruited from three hospitals. Hospital 1 received an in-person educational programme, Hospital 2 received via the website and Hospital 3 received nothing. Statistical analysis was carried out with a follow-up of 3 and 6 months. RESULTS: A total of 180 female nurses with low back pain participated in the study. Dimensions of the quality of life improved over 3 and 6 months, pain and disability decreased over 3 months in both intervention groups and over 6 months in the social media group. CONCLUSION: Two educational approaches can be effective in decreasing pain, disability and improving quality of life. However, the findings suggest that the social media approach was more successful over the long-term and might be a better way to present the programme.

Study of Adolescents' Puberty, Adolescence Training Program: The Application of Intervention Mapping Approach.

BACKGROUND: Adolescence is a significant period of life which is crucial for life long health. The purpose of the study was to develop a puberty intervention-training program using an intervention mapping approach (IMA). METHODS: The present study was a study protocol where IMA was used as a planning framework for developing a puberty intervention-training program (PITP). Six intervention mapping steps have been described in this protocol. As the first step, needs assessment was performed by reviewing the studies, qualitative evaluation, and interviews. In the second step, the matrix of change objectives was designed from the intersection of performance goals and determinants. Later on, after designing the program and planning the program implementation, the program evaluation plan was developed. RESULTS: IMA guided us in designing and implementing a control-oriented training program with the participation of the participants along with the definition of outcomes, performance goals and determinants, theoretical methods and practical applications, intervention program, implementation and step by step assessment. CONCLUSION: Intervention mapping is a control-oriented, systematic, participation-based approach to design and implement targeted and on-going health promotion programs.

Effects of educational program based on Precede-Proceed model in promoting low back pain behaviors (EPPLBP) in health care workers Shahid Beheshti University of medical sciences: randomized trial.

The PRECEDE-PROCEED model is an adaptable planning model that could be served in public health issues. The purpose of this study is to investigate the effects of an educational program based on Precede-Proceed model on promoting Low Back Pain (LBP) behaviors among health care workers (HCWs). This Double-blinded randomized trial study was conducted on 112 from 120 HCWs aged from 30 to 55 years The eligible HCWs were randomly divided to intervention group 1 (N = 38), respectively intervention group 2 and control group (N = 37) for which the Precede-Proceed - based educational program was implemented and control group (N = 37). The random multi-stage cluster sampling method was used to recruit HCWs. HCWs completed a self-reported questionnaire on their Low Back Pain Behaviors assessment questionnaire based on the Precede-Proceed Model and a visual analogue scale (VAS) was also used. The data were gathered at initial of the study, 6 and 12 months follow-ups from three groups and were analyzed through SPSS version 19. There was a significant interaction between the factors "group" and "test time" (p < 0.05, p < 0.001) of knowledge, perceived self-efficacy, and attitude, reinforcing factors, enabling factors, public health, quality of life and LBP preventive behaviors of the intervention group., although, no significant alternate became located in the mean score of above structures of the control group. The findings of the present study confirmed the effectiveness of the PRECEDE-PROCEED model-based educational program on preventing LBP by enhancing scores of model constructs. However, these results should be repeated in further studies to be able to apply this program in health system.

Correction to: Effectiveness of a theory-based back care intervention on spine-related behavior among pupils: a school-based randomised controlled trial (T-Bak study).

An amendment to this paper has been published and can be accessed via the original article.

Development and validation of an instrument of occupational low back pain prevention behaviours of nurse.

AIM: To develop and test the psychometric properties of occupational low back pain prevention behaviours questionnaire in nursing personnel. DESIGN: A qualitative and quantitative research design to develop and validate an instrument. METHODS: A qualitative study was conducted from May - October 2017 with 20 participants to generate an item pool. Then, content and face validity was carried out. Next, the questionnaire was distributed among a sample of nurses. In all, 150 nurses participated (mean age 34.1; SD 7.66 years) in the study. Exploratory factor analysis used to determine the factor structure of the questionnaire. Item-scale correlation matrix was provided to examine the construct validity. Internal consistency (Cronbach's alpha) was estimated to assess reliability and intraclass correlation coefficient was calculated to examine stability. RESULTS: Six factors with 30 items emerged from the exploratory factor analysis that jointly accounted for 67.9% of the variance observed. Item-scale correlation matrix showed satisfactory results lending support to construct validity of the questionnaire. The Cronbach's alpha coefficient for the whole scale showed excellent internal consistency (0.92), although this was not true for the knowledge subscale. The intraclass correlation coefficient with a 2-week interval also indicated that the questionnaire had satisfactory stability (0.97). CONCLUSION: This study provides initial support for reliability and validity of the Occupational Low Back Pain Prevention Behaviour Questionnaire. IMPACT: This study offers an instrument to assess low back pain preventive behaviours among nurses. The instrument is useful for nursing personnel and could be used in hospitals and healthcare settings to implement appropriate interventions.

Effectiveness of a theory-based back care intervention on spine-related behavior among pupils: a school-based randomised controlled trial (T-Bak study).

BACKGROUND: Children's health and welfare have a special place in research and policy in many countries. One of the most important concerns is the increasing rate of backache in children due to many of behavioral risk factors. The aim of this study was to evaluate the effectiveness of an educational program on promoting back-related behavior as well as knowledge, skills, beliefs, and self-efficacy among fifth grade girls. METHODS: The theory-based back care (T-Bak) study was a school-based randomised controlled trial (RCT) that assessed the effectiveness of developing a back care training program based on the social cognitive theory (SCT). A total of 104 schoolchildren aged 11 ± 1.0 years were assigned to intervention (n = 52) and control (n = 52) groups. The intervention group received six sessions training on proper lifting and carrying techniques, having proper posture during daily activities, and correct backpack wearing techniques with a 1-week interval while the control group received nothing. Then, the two groups were assessed for knowledge, skills, self-efficacy, beliefs, and behavior at four points in time: baseline, immediate, three and six-months post-intervention. The changes of the outcomes investigated using univariate repeated measures analysis of variance. Partial eta squared measure (ηp2) was used to calculate effect sizes. RESULTS: A positive change was found for the intervention group back-related behavior from baseline to immediate post-intervention and follow-ups (F = 78.865, p < 0.001, ηp2 = 0.22). Overall there were 36.4% improvement for knowledge (ηp2 = 0.21), 53.2% for the skills (ηp2 = 0.25), 19.5% for the self-efficacy (ηp2 = 0.11), and 25.6% for the beliefs (ηp2 = 0.14) scores from baseline to 6 months' follow-up assessments among the intervention group (p < 0.001). The results also showed a significant interaction effect between group and time. CONCLUSION: The T-Bak intervention was effective in improving back-related behavior in pupils. It is now available and could be evaluated further in back-care related studies. TRIAL REGISTRATION: Current Controlled Trials IRCT20180528039885N1, 30th Oct 2018, 'Prospectively registered'. https://www.irct.ir/trial/31534.

Educational needs assessment among 10-14-year-old girls about puberty adolescent health of Ardebil.

BACKGROUND: This study aimed to investigate the educational needs of 10-14-year-old girls about adolescent puberty health in Ardabil City in Iran, the matter of adolescent puberty health is one of the most important health priorities, especially for girls. METHODS: This cross-sectional descriptive-correlational study was performed on girl students through stratified-cluster sampling in Ardabil city. The data gathering tool was a self-reported researcher-designed questionnaire consisting of 10 demographic questions and 35 self-care questions in 5 domains of self-care awareness, self-efficacy, enablers, enhancers and behaviors, based on the reviewed articles and resources. Descriptive statistics and chi-square test, correlation coefficient and regression were used to analyze the quantitative data. RESULTS: The mean age of the girls was 12.98 ± 4.67. There was a significant relationship between the mother's level of education (p < 0.001) and students 'knowledge about puberty and between mother's age (p < 0.002) and students' awareness of self-care behaviors during adolescence. The results of this study showed that 73.8% of girls were aware of puberty and menstruation problems. About 74.3% of girls had poor self-efficacy. About 77% of female students in the study did not have access to the required educational resources and classes that are one of the most important enablers of behavior formation. Eighty-eight percent of the families did not talk about the hygiene practices related to their children. The most common source of information about maternal health related practices was from mothers (64.8%). Correlation test between adolescents' health behavior and awareness (r = 0.12 p < 0.007) and between self-efficacy and health behaviors (r = 0.14, p < 0.001) revealed significant and positive relationships. CONCLUSION: There is a need among adolescent girls for information about adolescent health and related health behaviors. Currently there is lack of adequate and accurate information. The role of mothers is the most important source of information for adolescent girls and educational approaches for mothers and adolescents should be designed.

Factors predicting the oral health behaviors of the Iranian students in the District 1 Tehran, Iran

Aim: The purpose of this examination is determining the predictors of oral health behaviors among Iranian students in district 1 Tehran based on the health belief model with added commitment to plan construct. Methods: This cross-sectional study was conducted on 351 four grade female students in the first district of Tehran, Iran in 2017. The multi­stage random cluster sampling method was used to recruit students. The inclusion criteria were being in four ­ graded level of elementary schools of the 1st district in Tehran, being female students aged between 9-11 years and being physically and psychologically healthy student. Logistic regression analysis was used to identify the variables that predict oral health behaviors. Results: Totally, (N= 31.8%) students reported that they were brushing less than twice a day and (N= 55.2% ) students claimed using of dental floss once a week or less than once a day. The results indicated that perceived self-efficacy (OR=1.46, 95% CI=0.57-3.78, P<0.001), commitment to plan (OR=1.13, 95% CI=1.04-1.23, P<0.001) and cues to action (OR=1.42, 95% CI=1.14­1.76, P=0.002) were the significant predicting variables of brushing twice a day, and use of dental floss once a day or more (OR=1.02, 95% CI=0.23-3.53, P=0.003). Conclusion: This study has shown the effectiveness of the health belief model with added commitment to plan construct to predict oral health behavior in female students. Thus, it seems that the model as a acceptable framework for designing training programs to improve oral health behavior in students

Designing and psychometric evaluation of Stretching Exercise Influencing Scale (SEIS).

OBJECTIVE: The lack of reliable and valid tools for assessing the factors that influence stretching exercises (SEs) among Iranian office employees is obvious. This study aimed to design and evaluate psychometric properties of this instrument. DESIGN: Cross-sectional study of psychometric properties. SETTING: Data were gathered from May to September 2017. PARTICIPANTS: Participants were 420 office employees who were working in 10 health centres affiliated to the Shahid Beheshti University of Medical Sciences in Tehran, Iran. PRIMARY OUTCOME MEASURES: The instrument was designed on the basis of the constructs of the health promotion model (HPM) and extant literature. Exploratory factor analysis (EFA), Cronbach's α and intraclass correlation coefficient (ICC) were employed to check the scale's psychometric properties. RESULTS: In total, 420 questionnaires were completed. The mean age of the office employees was 37.1±8.03 years. Among the 86 items, 77 items had significant item-to-total correlations (p<0.05). The results showed good internal consistency and reliability for the whole questionnaire and each domain. EFA results confirmed 53.32% of the total variance of the items yielded in 11 subscales. The ICC was acceptable (0.78, 95% CI 0.70 to 0.88). CONCLUSIONS: The Stretching Exercise Influencing Scale (SEIS) can be a reliable and valid instrument for measuring the factors that influence SEs among office employees. TRIAL REGISTRATION: IRCT20160824295512N1.