Prediction of cervical cancer screening: application of the information-motivation-behavioral skills model.

INTRODUCTION: Screening is an effective method for preventing cervical cancer. The present study aimed to determine the predictability of cervical cancer screening using the information-motivation-behavioral skills (IMB) model, as this model can help understand the factors that influence health-related behaviors. METHOD: The present cross-sectional study examined 310 women aged 20 to 60 in Isfahan, Iran, between 2020 and 2021. To this end, comprehensive health centers and gynecology clinics of hospitals were randomly selected by lot. Women who met the study's inclusion criteria were selected via convenience sampling. An IMB skills questionnaire developed by researchers comprised the data collection tool. The data were analyzed using SPSS 22 software, descriptive and regression tests, and AMOS 24.0 software. FINDINGS: Approximately 18.1% of the participants had never undergone routine cervical cancer screening. The regression model results indicated that the model components accurately predicted regular cervical cancer screening (P < 0.00). Path analysis revealed that information (ß = 0.05, P = 0.002), motivation (ß = 0.187, P = 0.026), and behavioral skills (ß = 0.95, P < 0.001) were directly associated with regular cervical cancer screening. Furthermore, behavioral skills had the greatest direct effect on regular cervical cancer screening. DISCUSSION AND CONCLUSION: The results demonstrated that the IMB model accurately predicted cervical cancer screening. Therefore, it is possible to improve cervical cancer screening in women by designing and implementing interventions based on this model's components, particularly those that improve behavioral skills.

A qualitative study on the health system-related needs in women survivors of rape.

BACKGROUND: Rape, as an adverse incidence, leads to irreparable complications and consequences in women. Provision of health services to women survivors of rape requires catering for their real needs and identifying current deficits as well as barriers. The present study aimed to explore health system-related needs in women survivors of rape. METHODS: In the present qualitative study, the participants consisted of 39 individuals, including 19 women survivors of rape and 20 individuals with work experience in providing services to women survivors of rape. The participants were selected using the purposive sampling method with a maximum variation in Isfahan, Iran. Data were collected through in-depth interviews as well as field notes and were concurrently analyzed via conventional qualitative content analysis method. RESULTS: After analyzing the interviews, the health system-related needs of women survivors of rape were classified into two main categories: 1- The need for efficient medical care services with three sub-categories, namely "receiving services with respect for privacy and confidentiality", "non-judgmental behavior and approach", and "the need to receive empathy and the feeling of not being alone", and 2- The need for desirable conditions and structure to provide services with two sub-categories, namely "the need to receive comprehensive and integrated services", and "establishing specialized centers for providing services to survivors". CONCLUSIONS: Overall, explaining and highlighting the health system-related needs of women survivors of rape could provide a suitable basis for policy-making and planning according to their real needs. Receiving continuous services in separate centers with confidentiality and empathy could reduce the worries and concerns of women survivors of rape and help improve their health.

A comprehensive interventional program to improve the sexual function of women with endometriosis: a mixed-methods protocol study.

BACKGROUND: Endometriosis is a chronic disease affecting 6-10% of women worldwide. Sexual dysfunction has been reported in a significant percentage of these patients. Thus, the present study will be conducted to design, implement, and determine the effectiveness of an interventional program to improve the sexual function of women with endometriosis. MATERIALS AND METHODS: This mixed-methods study will be carried out in three phases with a sequential exploratory approach. In the first phase (qualitative study) participants will be selected by purposive sampling in Isfahan, Iran. The data will be collected through in-depth interviews and field notes and analyzed using conventional content analysis. The interventional program will be designed in the second phase based on the results of the qualitative study and literature review and using the Delphi method and panel of experts. The interventional program will be implemented at the individual level in the third phase to investigate its effect on improving women's sexual function. This phase includes quasi-experimental research, in which the pre- and post-intervention data will be collected from the intervention and control groups using the FSFI questionnaire and analyzed by descriptive and inferential statistical methods. Ultimately, a suitable interventional program will be presented by combining the data obtained in the qualitative and quantitative phases of the research. CONCLUSION: Conducting the present study, along with the design and implementation of an appropriate, native, and culturally sensitive interventional program, can contribute to improving the sexual function of women with endometriosis and enhancing the quality of sexual relations between couples.

Endometriosis is a chronic disease in women of reproductive age. The negative impact of endometriosis on intimate relationships and sexual function has been reported in a significant number of women with this disease. The results of this study offer a rich source of information for the required interventions to promote the sexual and reproductive health of women with endometriosis. This study is a sequential exploratory (qualitative­quantitative) mixed methods design that consists of three consecutive phases. In this study, following a qualitative approach, the researchers will explain the experiences of women with endometriosis of sexual function and the appropriate strategies to improve the sexual function of these women. In the second phase, the researcher will design an appropriate interventional program for to improving the sexual function of women with endometriosis by using the results of the qualitative phase and literature reviews. The purposed interventional program is designed using the Delphi method and panel of experts and will be finalized for execution. In the third stage, the effectiveness of interventional program on the sexual function of women with endometriosis will be investigated in a quasi-experimental study. Therefore, it is expected that conducting a mixed method study by presenting an interventional culturally sensitive program can contribute to improving the sexual function of women with endometriosis and enhancing the quality of sexual relations between couples.

Development, implementation, and evaluation of the effectiveness of an intervention program to improve the sexual competence of young adult women about to get married: a protocol study.

BACKGROUND: Having competence in initiating sexual interactions is one of the challenges of sexual health in any society. Given that the social, cultural, and religious background of some societies can prevent the acquisition of sexual competence in young women, this study will be done to design, implement, and determine the effectiveness of an intervention program to improve the sexual competence of young women on the eve of marriage. METHODS: The current research is a mixed-method study in a qualitative-quantitative sequence. In the first phase, a qualitative study will be conducted to explore the needs of sexual competence in young adult women about to get married and ways to improve it. Then, after the literature review and combining it with the results of the qualitative study, a draft of the intervention program will be developed. After reviewing the content of the program and validating it in the panel of experts, the final program will be developed. In the second phase, the effect of the program to promote the sexual competence of adult women about to get married will be determined in a quantitative study with a two-group quasi-experimental method. DISCUSSION: Providing a comprehensive and practical intervention program to promote sexual competence based on cultural, social, and religious background can help to improve the quality of sexual interactions of young women about to get married, reduce harm caused by lack of sexual competence, and ensure women's sexual health.

Preparing young people to start safe and satisfactory sexual behaviors and as a result to acquire sexual competence can play an important role in ensuring their sexual health. But in some countries, talking about sexual issues is a cultural and religious taboo. Given that Lack of sexual competence is associated with negative consequences, the present study aims to design, implement, and determine the effectiveness of a program to promote sexual competence in young adult women who are about to get married. In the first phase, to identify the needs of acquiring sexual competence and to explore the strategies for improving sexual competence, a qualitative study will be conducted with a content analysis approach. Individual interviews will be conducted with women aged 18 to 25 about to get married, the teachers of pre-marriage classes, midwives, gynecologists, reproductive health specialists, psychiatrists, and psychologists who work in the field of sexual health. Based on the findings of this phase and after reviewing the literature, an intervention program to improve sexual competence in young adult women will be designed and prepared. After the experts approve the intervention program, in the second phase, a quantitative study will be conducted to determine the effect of the intervention program on improving the sexual competence of young adult women about to get married.

Identifying women's needs to adjust to postpartum changes: a qualitative study in Iran.

BACKGROUND: The transition to motherhood is associated with stress because of extensive and rapid changes to which women need to be able to adjust. To help women adjust to postpartum changes, their needs during this period must be identified. Therefore, the present qualitative study explored the needs of women for adjusting to postpartum changes. METHODS: In this study, 29 participants were selected through purposive sampling with maximum variation in Isfahan, Iran. Data was collected through in-depth individual interviews, daily notes, and field notes, and analyzed using conventional qualitative content analysis. RESULTS: Data analysis led to the emergence of 5 main categories: "the need to receive social support," "the need to receive a sense of worth from the husband," "the need to compensate and improve the situation," "the need to create socio-cultural changes," and "the need for training." CONCLUSIONS: According to the results of the study, in order to adjust to the changes in the postpartum period, and in addition to their efforts to compensate and improve the situation, women need to be supported by their husbands, family members and acquaintances, healthcare team, and society in various dimensions. Moreover, they should receive the information they need to turn the challenges of this period into an opportunity for growth.

Health system-related needs for healthy nutritional behaviors in adolescent girls with polycystic ovary syndrome (PCOS): a qualitative study in Iran.

BACKGROUND: Polycystic ovary syndrome (PCOS) is the most common endocrine disorder among women. Given the prevalence of this disease in adolescent girls as well as its serious physical, psychological, and social consequences, the present study aimed to explore the health system-related needs for healthy nutritional behaviors in adolescent girls with PCOS. METHODS: This qualitative content analysis was conducted in Shiraz, Iran between November 2016 and October 2017. Eighteen Adolescent girls with PCOS and 15 healthcare providers (midwives, gynecologists, nutritionists, and endocrinologists) were selected through purposeful sampling with maximum variation strategy. Data were collected through individual in-depth and semi-structured interviews, focus group discussions, and field note, and simultaneously analyzed using the conventional qualitative content analysis method. RESULTS: Three main categories that appeared included: 1) education and counseling on healthy nutrition and support for adolescent girls with PCOS with sub-categories of "empowering adolescent girls with PCOS to adopt healthy nutritional behaviors", "providing services and education about healthy nutritional behaviors as a team", and "the health team attention to the concerns of adolescent girls with PCOS and closely following the disease status, 2) solving communication problems with sub-categories of "proper interactions and building trust between health team members and adolescent girls" and "proper interactions between members of the health team", and 3) developing the optimal structure for providing health services with sub-categories of "solving problems related to human resources, "promoting the position of health issues related to adolescent girls in the health system", and "promoting policy-making in the field of nutritional health of adolescent girls". CONCLUSIONS: Based on the results of the present study, necessary measures should be taken to educate and advise on healthy nutrition, and to support adolescent girls with PCOS. The desired structure should also be developed to provide health services to these girls. By solving communication problems and building trust between the members of the health team and these girls, one can guide them to adopt healthy nutritional behaviors.

Exploring the experiences related to postpartum changes: perspectives of mothers and healthcare providers in Iran.

BACKGROUND: Numerous changes occur in different aspects of women's lives in the postpartum period. Women's adjusting with problems and taking advantage of this opportunity can develop their personality. In this regard, accurate knowledge of their experiences and feelings is necessary to help them to benefit from this period. Therefore, the present study aimed to explore the experiences related to postpartum changes in women. METHODS: In the present qualitative study, 23 participants, including women of childbearing age who gave birth and healthcare providers (midwives and obstetricians) in Isfahan, Iran were selected using purposive sampling with a maximum variation strategy. Data were collected through in-depth semi structured interviews, field notes, and daily notes, and simultaneously analyzed using the conventional qualitative content analysis. RESULTS: The data analysis results led to the extraction of three main categories including "feeling of decreased female attractiveness" (with two sub-categories of " feeling of decreased beauty" and "feeling of decreased sexual function"), "feeling of insolvency and helplessness" (with two sub-categories of "physical burnout", and "mental preoccupations") and "beginning a new period in life" (with three sub-categories of "changing the meaning of life", "feeling of maturity" and "deepening the communication"). CONCLUSIONS: Findings of this study can provide a good context for designing interventions to improve the women's quality of life by explaining and highlighting their experiences in the postpartum period. In this regard, providing sufficient empathy, social and psychological support from family members (especially husband), performing appropriate educational interventions and also regular assessment of women's psychological state by healthcare providers in postpartum period can reduce their concerns and help to improve their health.

Assessing the impact of an educational intervention program based on the theory of planned behavior on the nutritional behaviors of adolescents and young adults with PCOS in Iran: a field trial study.

BACKGROUND: Polycystic ovary syndrome is the most common endocrine disorder among adolescents and adults. Given the importance of healthy nutritional behaviors in management of this disease, the present study was conducted to determine the impact of an educational intervention program based on the theory of planned behavior on the nutritional behaviors of adolescents and young adults with polycystic ovary syndrome. METHODS: In this field trial study, 72 participants aged between 15 and 21 years old from four gynecology clinics in Shiraz, Iran, were assigned into the intervention and control groups. Educational intervention program was implemented based on the theory of planned behavior over 4 sessions during two weeks. The data collection tools were researcher-made questionnaires of demographic information, knowledge assessment, and assessment of theory of planned behavior constructs, as well as a questionnaire for assessing consumption of food groups, fast food, and snacks. The data were collected at two stages (once at baseline and once three months after the intervention), and then the changes in knowledge, attitude, subjective norms, the perceived behavioral control, behavioral intention, and nutritional behavior were analyzed using descriptive and inferential statistical methods (t-test, Chi-square, Mann- Whitney U, and Wilcoxon tests; as well as one- way ANOVA, repeated measures ANOVA, and ANCOVA, respectively). RESULTS: Statistically significant increases were observed in the mean scores of knowledge, attitude, subjective norms, the perceived behavioral control, behavioral intention, and nutritional behavior in the intervention group by passing three months from the intervention compared to the scores before the intervention (P < 0.001). However, these differences were not statistically significant in the control group (P > 0.05). Moreover, the mean scores of knowledge, attitude, subjective norms, perceived behavioral control, behavioral intention, and nutritional behavior had no statistically significant difference before the intervention between the two groups; however, this was statistically significant by passing three months from the intervention (P < 0.001). CONCLUSION: Considering the effect of an educational intervention program based on the theory of planned behavior on creating healthy nutritional behaviors in adolescents and young adults with polycystic ovary syndrome, it is recommended to use it in order to improve the nutritional health of them. TRIAL REGISTRATION: IRCT, IRCT20160224026756N6. Registered 18 Aug 2018, https://en.irct.ir/user/trial/32693/view.

Comparing the effect of two educational interventions on mothers' awareness, attitude, and self-efficacy regarding sexual health care of educable intellectually disabled adolescent girls: a cluster randomized control trial.

BACKGROUND: Sexual problems of intellectually disabled adolescents are associated with their inability to understand sexuality. Given the important role of parents in forming the attitude of their adolescents towards sexuality, the present study aimed to compare the effect of two educational interventions on mothers' awareness, attitude and self-efficacy regarding sexual health care of intellectually disabled adolescent girls. MATERIALS AND METHODS: This cluster randomized control trial was conducted in six intellectually disabled adolescent education centers in Isfahan, Iran in 2018. The centers were randomly assigned to intervention groups (group training and training through booklet) and control group. Mothers of educable intellectually disabled adolescent girls (n = 81) were entered into the three groups using convenience sampling and their awareness, attitude and self-efficacy regarding sexual health care of adolescent girls were assessed using questionnaires before and after the educational intervention. Data were analyzed using descriptive and inferential statistical methods. RESULTS: The mean score of mothers' awareness, attitude and self-efficacy in each of the "group training", "training through booklet group" and "control group" was significantly different after the intervention compared to before the intervention (p < 0.05). The mean score of mothers' awareness and self-efficacy after the intervention in the "group training" was higher than the "control group" and "training through booklet group" (p < 0.001). The mean score of mothers' awareness and self-efficacy after the intervention in the "training through booklet group" was higher than in "control group" (p = 0.005, p = 0.02). Also, after the intervention, the mean score of mothers' attitude in the "group training" was higher than the "control group" and the "training through booklet group" (p < 0.001), but there was no significant statistical difference between the mean score of mothers' attitude in "control group" and "training through booklet group" (p > 0.05). CONCLUSION: Implementation of the group training intervention for mothers of intellectually disabled adolescent girls in comparison with training through booklet was associated with a greater increase in their awareness, attitude and self-efficacy regarding sexual health care of adolescent girls. Therefore, group training is suggested as a suitable way to educate mothers about sexual health care of intellectually disabled adolescent girls. Trial registration IRCT, IRCT20160224026756N5. Registered 22 June 2018, https://en.irct.ir/user/trial/31704/view .

A qualitative study exploring the needs related to the health system in women with experience of pregnancy termination due to fetal anomalies in Iran.

BACKGROUND: In order to provide appropriate and adequate care to women who have experienced termination of pregnancy due to fetal anomalies, the health needs of this group should be assessed. Considering the lack of information about the care and services required by these women in Iran, this study was conducted with the aim of exploring the needs related to the health system in women with experience of pregnancy termination due to fetal anomalies. METHODS: This study was conducted with a qualitative approach. 40 participants were selected through purposive sampling, and the data were collected through in-depth semi structured interviews and field notes, and analyzed using conventional qualitative content analysis. RESULTS: After analyzing the texts, the needs related to the health system in women with experience of pregnancy termination due to fetal anomalies were categorized in the three main categories: "efficient treatment team", "optimal organizational structure in providing services" and "financial support for families". CONCLUSIONS: The findings of the present study by exploring and highlighting the needs related to the health system in different dimensions in women with experience of pregnancy termination due to fetal anomalies can be helpful for designing and providing basic and comprehensive care programs.

Comparing the effect of group- based training along with text messaging and compact disc- based training on men's knowledge and attitude about participation in perinatal care: a cluster randomized control trial.

BACKGROUND: Men's participation in perinatal care is one of the key factors in promoting maternal and neonatal health. The effects of various methods of training on men's knowledge and attitude about participation in perinatal care can be different. So, this study aimed to compare the effect of two methods of training on men's knowledge and attitude about participation in perinatal care. METHODS: This cluster randomized control trial was conducted in three midwifery clinics in Tabriz, Iran between May and August 2018. Each clinic was randomly assigned to intervention (group- based training along with text messaging and CD- based training) and control groups. Seventy-five men were enrolled in three groups and evaluated for their knowledge and attitude about participation in perinatal care. Before and 3 months after the intervention, a researcher-made questionnaire was completed by the participants. Data were analyzed using descriptive and inferential statistics (paired t-test, one-way ANOVA, ANCOVA, chi-square, Kruskal-Wallis and Fisher exact tests). RESULTS: The mean (SD) score of men, s knowledge and attitude about participation in perinatal care had a significant increase in group- based training along with text messaging after the intervention compared to the score of before the intervention (p < 0.001, p = 0.005, respectively), but the mean (SD) score of men, s knowledge and attitude had not a significant increase in CD- based training and control group after the intervention compared to the score of before the intervention. The mean (SD) score of men,s knowledge and attitude about participation in perinatal care in group- based training along with text messaging were significantly higher than in CD- based training (p < 0.001, p = 0.039, respectively) and control group (p = 0.001, p = 0.021, respectively) after the intervention, respectively. However, the mean (SD) score of men, s knowledge and attitude in CD- based training were not significantly different from the control group after the intervention. CONCLUSION: Group- based training along with text messaging was more effective in improving the knowledge and attitude of men about participation in perinatal care compared to CD- based training. So, its implication in educational programs for the men is recommended. TRIAL REGISTRATION: IRCT, IRCT20160224026756N4 . Registered 27 May 2018.

Food habits in overweight and obese adolescent girls with Polycystic ovary syndrome (PCOS): a qualitative study in Iran.

BACKGROUND: Polycystic ovary syndrome (PCOS) is a hormonal disorder in women of reproductive age. It seems that over the recent years, PCOS has augmented in adolescent girls due to unhealthy food habits and obesity. So, the present study was conducted to explore the food habits in overweight and obese adolescent girls with PCOS. METHODS: In the present qualitative study, 33 participants were selected using a purposive sampling method. Data were collected through individual in-depth interviews, focus group discussions (FGDs), and field notes. These data were analyzed through the use of conventional qualitative content analysis. RESULTS: Three main categories were extracted: First, the high consumption of unhealthy food had three sub-categories: "high consumption of fatty and salty foods", "high consumption of unhealthy snacks", and "high consumption of sugar-rich foods". Second, low consumption of healthy food had three sub-categories: "low consumption of dairy products", "low consumption of fiber-rich foods", and "low consumption of meat, beans, fish and seafood" Third, inappropriate behavioral habits had three sub-categories: "lack of concentration and consumption of large meals", "inappropriate dietary and physical activity patterns", and "skipping the meals and going on arbitrary diets". CONCLUSION: This research through presenting an image of food habits in overweight and obese adolescent girls with PCOS is able to help for designing the necessary interventions to change the food habits, control the symptoms and complications of PCOS, and finally, improve the reproductive health of these girls.

Psychological experiences of women with pregnancy termination due to fetal anomalies: a qualitative study from the perspective of women, their spouses, and healthcare providers in Iran.

BACKGROUND: Pregnancy termination due to fetal anomalies has many psychological consequences for women. Providing appropriate and desirable care to this group of women and their families plays an important role in the process of coping with this crisis. The aim of the present study was to explore the psychological experiences of women with pregnancy termination due to fetal anomalies. METHODS: This was a qualitative content analysis study. 40 participants were selected through purposeful sampling with maximum variation and data were collected through in-depth individual interviews, field notes, and analyzed using the conventional qualitative content analysis method simultaneously. RESULTS: After analyzing the interview transcripts, the psychological experiences of women with pregnancy termination due to fetal anomalies were classified into two main categories: "emotional reactions coinciding with the diagnosis of fetal anomalies" (consisting of two sub-categories of "disbelief and denial of fetal anomalies" and "feelings of sadness and anger") and " psychological problems following pregnancy termination" (consisting of two sub-categories of " feeling helpless, fearful, anxious, and depressed" and "feeling conscience-stricken, and guilty"). CONCLUSION: According to findings of the present study, exploring and highlighting the experiences of women with pregnancy termination due to fetal anomalies in the psychological dimension can provide a deeper understanding of the needs of these women for providing optimal care at different times and ultimately promote their psychological health.

The process of risky sexual behaviors formation in women drug users: a protocol for a grounded theory study.

BACKGROUND: Drug use is an important underlying factor in risky sexual behaviors. Risky sexual behaviors can lead to STIs and HIV/AIDS, especially in women. For better understanding of the relationship between drug use and risky sexual behaviors in women, it is necessary to identify the process of the formation of these behaviors that is a multidimensional process influenced by multiple socio-cultural factors. Therefore, the present study aims to explore the process of risky sexual behaviors formation in women drug users. METHODS: This is a grounded theory qualitative study with Corbin and Strauss approach. The participants of the study are women drug users with risky sexual behaviors who, using purposeful sampling method, will be selected from the Counseling and Harm Reduction centers for vulnerable women, the Drug Rehabilitation centers affiliated to the Isfahan University of Medical Sciences, Therapeutic Community Rehabilitation centers, Drop in Centers affiliated to the Welfare Organization, Medium-term Residential centers (women's camps), and Women's Empowerment centers in Isfahan, Iran. Sampling will continue using snowball method and the strategy of maximum variation in terms of the age, occupation, education, duration of the drug use, and type of the drug. During the sampling process, theoretical sampling will gradually replace purposeful sampling, so that sampling will proceed based on the emergence of the theory and for understanding of the concept and, then, the next participants will be selected. Sampling will continue until data saturation is reached. Data will be collected using individual semi-structured in-depth interviews, observation, field notes, and memo writing. Data will be coded as they are collected, and the analysis will be performed at three levels of open, axial, and selective coding and based on the constant comparative analysis. The four criteria of credibility, dependability, transferability and confirmability will be used to ensure the trustworthiness of the data. DISCUSSION: The findings of the present study are expected to provide a better understanding of the process of risky sexual behaviors formation in women drug users. The findings may also lead to the identification of the barriers and factors contributing to the formation of such behaviors and, finally, will promote the reproductive and sexual health of these women. This study can also provide the guide and the ground for designing and conducting further studies in the related areas through using various qualitative and quantitative methods.

Barriers to men's participation in perinatal care: a qualitative study in Iran.

BACKGROUND: The role of men's participation in prenatal, delivery and postpartum care is very important, well defined and cannot be over emphasized. Very few studies exist about men's role in promoting the health of the mother and barriers to their participation in perinatal care in Iran; hence, the present study was conducted to determine the barriers to men's participation in perinatal care. METHODS: The present qualitative study was carried out on 45 participants who were selected employing purposeful sampling technique. Data were collected through in-depth semi-structured interviews, focused group discussions and field notes. Data were analyzed using conventional content analysis. RESULTS: After data analysis, four main categories extracted were: "cultural barriers", "personal and interpersonal barriers", "health system-related barriers" and "socio-economic barriers". CONCLUSION: The results of this study, by presenting the barriers to and challenges for men's participation in perinatal care, could be helpful in designing culture-based strategies to overcome these barriers and improve men's participation.

Supportive needs of women who have experienced pregnancy termination due to fetal abnormalities: a qualitative study from the perspective of women, men and healthcare providers in Iran.

BACKGROUND: Extensive application of screening tests for early diagnosis of fetal abnormalities would justify support for women who are facing pregnancy termination due to fetal abnormalities. Considering the lack of available information regarding supportive sources for these people, the present study was conducted to determine the supportive needs of women who have experienced pregnancy termination due to fetal abnormalities. METHODS: The present research was a qualitative study. The participants were selected using a purposeful sampling method with maximum variation. Data were collected through in-depth personal interviews and taking of field notes and were analyzed simultaneously using conventional content analysis. RESULTS: The main categories that appeared in the present study included "support from the husband" with sub-categories of "mental support and necessary accompaniments", "participating in planning for future pregnancy" and "financial support to pay the costs of diagnosis and follow-up", "support from the family and friends" with sub-categories of "helping in taking care of other children", "help in performing daily activities" and "empathy, companionship and necessary support to maintain mental peace" and finally "support from peers" with sub-categories of "communicating with the peers and receiving information from them" and "creating a sense of confidence and hopefulness". CONCLUSIONS: Results of the present study, by determining and highlighting the supportive needs of women who have experienced pregnancy termination due to fetal abnormalities, could be an appropriate basis for providing effective strategies to improve constant participation of the husbands, family members and the peers along with other professional care.

Challenges to access health information during pregnancy in Iran: a qualitative study from the perspective of pregnant women, midwives and obstetricians.

BACKGROUND: Appropriate health information seeking behavior can play an effective role in self-care and promotion of women's quality of life during pregnancy. However, different barriers can impede pregnant women while accessing health information. The aim of this research was to explain challenges to access health information during pregnancy. METHODS: The present qualitative study was carried out on 28 participants who were selected using the purposeful sampling technique. Data were collected through in-depth interviews, field notes, and daily notes; data were analyzed using conventional content analysis. RESULTS: The main barriers to access health information during pregnancy were as follows: many duties of women at home as well as out-of-home education and employment, inability to make distinction between correct and incorrect information, insufficient interactions between women and healthcare providers, failure to access to various information resources, common complaints of pregnancy, and stress and anxiety of confronting the problems during pregnancy. CONCLUSION: Based on the results, pregnant women experienced personal, social, and structural barriers when accessing health information. Therefore, policymakers and health planners should remove the barriers, encourage self-care, and enhance the quality of life for pregnant women, thus, promoting their health status in the end.

Participation of father in perinatal care: a qualitative study from the perspective of mothers, fathers, caregivers, managers and policymakers in Iran.

BACKGROUND: The participation of the father during the perinatal period is an important strategy for improving the mother's health. Very few studies exist about the father's role in promoting the health of the mother in Iran; thus, the present study was conducted to examine the role of fathers in perinatal care. METHODS: The present study was a qualitative research. Participants were selected using purposeful sampling with maximum variation and the data was collected through in-depth interviews, focus group discussions and field notes. The data was analyzed using conventional content analysis. RESULTS: After data analysis, the main categories extracted were: "help in maintaining the health of the mother and fetus", "emotional support of mother", "comprehensive participation of father in married life", "preparing for safe delivery" and "postpartum support". CONCLUSIONS: The results of the present study provide different perspectives on the participation of fathers when designing culture-based intervention for their participation in perinatal care.

A comprehensive sexual health care program for educable intellectually disabled adolescent girls: protocol for a mixed methods study.

BACKGROUND: Protection and promotion of sexual health is of great importance for educable intellectually disabled adolescent girls; since they are prone to high risk sexual vulnerabilities and consequences, such as unwanted pregnancy, sexually transmitted infections, and acquired immune deficiency syndrome. Although the rights of intellectually disabled adolescents have been emphasized through the recent years, their sexual health care is still a challenge for parents, teachers, caregivers, and service providers. This study aims to present a comprehensive sexual health care program for educable intellectually disabled adolescent girls. METHODS: This study is carried out by an exploratory sequential mixed qualitative-quantitative methods approach including three sequential phases. The researcher represents sexual health state of educable intellectually disabled adolescent girls using a qualitative approach. In the onset of the second phase, a comprehensive sexual health care program is designed for educable intellectually disabled adolescent girls. In this regard, in addition to qualitative studies, some related papers and texts are used. The suggested program of expert panel is approved based on prioritization guidelines. Then, in the third phase and after different stages of finalization of the program, its affectability is evaluated regarding improvement of sexual health state of educable intellectually disabled adolescent girls. DISCUSSION: It is expected that from the results of the present mixed methods study, by presenting a comprehensive sexual health program for educable intellectually disabled adolescent girls, lead to improvements in the sexual health of these girls. Moreover, it wants to reduce risky sexual behaviors, sexual abuse and harassment, and their consequences in adolescent girls in order to improve sexual health state of the society. If this program works, it can become one of the leading education and care guidelines for sexual health care of intellectually disabled adolescent girls. TRIAL REGISTRATION: IRCT20160224026756N5 . Registered 22 June 2018.

A comprehensive interventional program for promoting father's participation in the perinatal care: protocol for a mixed methods study.

BACKGROUND: The inclusion of fathers' participation during the perinatal period is an important strategy for improving mothers' health. No studies have yet been conducted in Iran to explain the concept, obstacles and facilitators of fathers' participation during the perinatal period. Thus, this study will be carried out to provide a comprehensive interventional program for promoting fathers' participation in the perinatal care. METHODS: This study is a sequential exploratory (qualitative - quantitative) mixed methods design that consists of three consecutive phases. In this study, following a qualitative approach, the researchers will explain the concept, obstacles, facilitators and strategies related to promoting fathers' participation in perinatal care. In the second phase, researchers will design an appropriate and comprehensive interventional program for promoting fathers' participation in perinatal care by using the results of the qualitative phase and literature reviews. The proposed interventional program is designed by a panel of experts based on prioritization guidelines and will be finalized for execution. In the third stage, the effectiveness of interventional program on the awareness, attitude and practice of fathers about participation in perinatal care will be investigated in a semi-experimental study. DISCUSSION: It is expected that from the results of the present mixed methods study, by presenting an interventional culturally sensitive program which is appropriate for the conditions of the society for expectant fathers, the participation of fathers in the perinatal period will increase and thus lead to improvements in the health of the mother and the infant. If this interventional program is effective, it could be included in the perinatal health care guidelines. TRIAL REGISTRATION: IRCT20160224026756N4 Registered 27 May 2018.