Improving dental-oral health learning in students using a mobile application ("My tooth"): A controlled before and after study.

OBJECTIVES: Tooth decay is one of the most common problems amongst students. Despite considerable educational interventions, it is still very prevalent. The aim of this study was to compare the effect of a dental-oral health mobile educational application with the common dental-oral health education amongst elementary school students. METHODS: This interventional study was carried out on 158 girl students in the age range of 10-12 years in Mobarakeh City, Iran. The participants were categorized into the intervention and control groups and investigated in the academic year of 2018-2019. The research tool was a researcher-made questionnaire with confirmed validity and reliability. Initially, all students completed the questionnaires. Later, the intervention group members were trained using dental-oral health mobile educational application and control group received the common dental-oral health educations in lectures and demonstrations. Two months after the last intervention, the same questionnaire was completed and data were analysed by SPSS software. RESULTS: Before the intervention, the mean score of behaviour was 13.69 ± 3.89 and 13.93 ± 3.02 (of 21) for the intervention and control groups. At this phase, the difference between the two groups was not significant in the studied dimensions (p > 0.05). After the intervention, mean scores of the intervention group increased significantly with regard to all variables (p < 0.05). CONCLUSIONS: Findings of this study confirmed the positive effect of learning through mobile applications on increasing the students' knowledge, attitude and performance regarding dental-oral health education.

Fear of abortion and emotional divorce in women with minor thalassemia: a population-based study in Yazd, Iran.

BACKGROUND: Thalassemia is the most common genetic disorder in humans that can be controlled and treated by, premarital screening, prenatal diagnosis and abortion. Aortion can be a critical issue for many families based on the cultural and religious backgrounds and have different consequences for couples, such as emotional divorce. Therefore, the present study aimed to investigate the association between fear of abortion and emotional divorce in women with minor thalassemia in Yazd City, Iran. MATERIALS AND METHODS: This retrospective study was conducted on 61 women with minor thalassemia (case group) and 100 healthy women (control group), who referred to health centers in Yazd. The census sampling was applied to select the case group and multistage (cluster andsimple) random sampling was adopted to select the control group. Data were collected using Gutman Emotional Divorce Questionnaire and a researcher made scale for measuring fear of Abortion. Data were analyzed by SPSS using descriptive statistics and chi-square, independent t-test, Pearson correlation, and linear regression. RESULTS: The mean scores of emotional divorce (6.62 vs. 4.26) and fear of abortion (25.85 vs. 17.4) were higher in the case than control group (P ˂ 0.01). There was a positive and significant correlation between fear of abortion and emotional divorce in the case (P ˂ 0.05, r = 0.275) and control (P ˂ 0.05, r = 0.570) groups. Fear of abortion in the case group predicted 25% of the variance in emotional divorce. CONCLUSION: Given the high level of fear of abortion in women with minor thalassemia and its effect on increasing the emotional divorce, designing and implementing psychological interventions with ongoing follow-up are recommended for thalassemia carrier couples.

The predictors of the intention to receive Covid-19 vaccine using the health belief model and theory of planned behavior in South Khorasan province.

BACKGROUND: Widespread vaccination coverage in the shortest time is one of the most effective ways for controlling the COVID-19 pandemic. Factors affecting people's intention to get the COVID-19 vaccine are of great importance. The present study aimed to investigate the predictors of the intention to receive the Covid-19 vaccine based on the constructs of the health belief model (HBM) and theory of planned behavior (TPB) in South Khorasan Province. MATERIALS AND METHODS: In this cross-sectional-analytical study, 320 people over 18 years in South Khorasan province were randomly selected by cluster sampling method in 2021. The data was collected by a researcher-made questionnaire, including demographic information (9 questions), and the constructs of the health belief model (19 questions), and the theory of planned behavior (13 questions), using the self-report method. Finally, data were analyzed using t-test, ANOVA, linear regression, and Pearson correlation tests. RESULTS: The mean age of the study participants was 36.57 ± 11.56 with a range of 18-66 years. In the regression model, perceived susceptibility (ß = 0.247, P = 0.003), perceived severity (ß = 0.247, P = 0.003) from HBM, attitude (ß = 0.247, P = 0.003), and perceived behavioral control (ß = 0.247, P = 0.003) from TPB were significant predictors of the intention to get the Covid-19 vaccine. The constructs of the two models were able to explain 33% of the variance of the intention to receive the Covid-19 vaccine. CONCLUSIONS: The study findings reveal that HBM and TPB can predict factors affecting an individual's intention to receive the vaccine. The results can be utilized to design interventions with the aim of increasing vaccine uptake.

Impact of education on interdental cleaning behaviour based on the transtheoretical model.

PURPOSE: To determine the impact of education on stages of change of behaviour in Iranian senior high school students for interdental cleaning based on the transtheoretical model. MATERIALS AND METHODS: This experimental study took place from April to November 2010. 306 students were selected by multistage cluster sampling and placed into two groups: control (153 students) and intervention (153 students). Appropriate instruments and the intervention programme were designed with the purpose of improving stages of interdental cleaning behaviour, perceived benefits and self-efficacy, as well as reducing perceived barriers and gingival index (GI). The impact of the intervention programme was assessed after 24 weeks and the GI of each student was recorded for both groups before and after intervention. The data were analysed using SPSS software and the chi-square, t test, ANOVA, paired t test, Mann-Whitney U-test and sign test. RESULTS: The intervention had a significant, positive impact on improvement of the stages of interdental cleaning behaviour, increase in self-efficacy, perceived benefits, decrease in perceived barriers and improvement of GI (P < 0.001). After the intervention, the average grades of self-efficacy, perceived barriers and perceived benefits in the control group vs the intervention group were significantly different (P < 0.001 to 0.01). CONCLUSION: The programme was found to positively influence the stages of change and potential indicators of interdental cleaning behaviour and GI. It is suggested that this model be used for interventions in the other population groups.

Comparison of the Effect of Traffic Park-Based and School-Based Educational Interventions on Safe Road Crossing in Yazd Elementary School Students.

INTRODUCTION: Traffic accidents are one of the most important health problems that cause many deaths every year. Scientific-practical interventions are needed to prevent traffic accidents. This study aimed to compare the effectiveness of traffic-based and school-based interventions on the safe road crossing in Yazd elementary school students. METHODS: This interventional study was conducted on 132 students (66 males and 66 females) in two groups of school-based and traffic park-based intervention. A questionnaire was used to determine the safe crossing behavior score. Then, an educational intervention was administered to both groups. Two months after the intervention, safe crossing behavior was evaluated in both groups. Finally, the data were analyzed using SPSS software version 22. RESULTS: In both groups, the score of safe crossing behavior was significantly increased after the intervention. The school-based group had significantly better behaviors compared to the traffic park-based group (P=0.001). There was a significant difference in the mean score of behavior between males and females and the intervention had a greater effect on female students (P=0.017). CONCLUSION: Educational interventions and especially school-based intervention can be effective in improving the students' safe crossing behaviors.

Psychometric Properties of the Mobile Health Literacy Scale in the Workers of an Automotive Metal Sheet Factory in Shahrekord, Iran.

BACKGROUND: Mobile health (mHealth) literacy refers to the ability to use mobile devices to search, find, understand, evaluate, and use health information to identify or solve a health problem. Health literacy skills are important for improving health information interventions and it will not be possible to investigate this skill unless a valid and reliable tool is developed. OBJECTIVE: This study aimed to investigate the psychometric properties of the Persian version of the mHealth Literacy Scale in the workers of an automotive metal sheet factory in Shahrekord, Iran. METHODS: After forward and backward translation of the scale and ensuring the accuracy of the translation, qualitative face validity was examined by an expert panel and quantitative face validity by 10 workers using the item impact score. Content validity index (CVI) and content validity ratio were investigated by seven experts on health education. To investigate construct validity, the scale was completed by 200 workers. One-factor and two-factor structures of the measure were studied using confirmatory factor analysis and the reliability was evaluated using Cronbach's alpha coefficient. KEY RESULTS: The CVI for each of the three parameter (relevance, clarity, simplicity) was rated 0.75 to 1 for each item. Confirmatory factor analysis showed that the one-factor model had a better fit to the data than the two-factor model [goodness of fit index = 0.985(>0.90), comparative fit index = 0.999 (>0.90), Tucker-Lewis index = 0.996 (>0.90), normed fit index = 0.994(>0.90), root mean square error of approximation = 0.038(< 0.08)]. Furthermore, the scale had an acceptable internal consistency (Cronbach's alpha = 0.964). CONCLUSION: The Persian version of mHealth Literacy Scale has satisfactory reliability and validity and could be used as an effective tool to evaluate mHealth literacy among Iranian workers. [HLRP: Health Literacy Research and Practice. 2022;6(4):e257-e261.] Plain Language Summary: This cross-sectional study was conducted on 200 workers of an automotive metal sheet factory in southwest Iran to investigate the psychometric properties of the Persian version of the mHealth Literacy Scale. The results demonstrated that one-factor structure was more appropriate for evaluating mHealth literacy among Iranian workers.

Nutrition literacy and its related demographic factors among workers of Taraz Steel company, Chaharmahal and Bakhtiari, Iran.

Background: Nutrition is critical to prevent some chronic diseases. Nutrition literacy refers to ability to gain, understand and evaluate nutrition facts to choose appropriate foods. Nutrition literacy has recently drawn the attention of professionals with respect to health promotion. The purpose of this study was to investigate nutrition literacy and potentially related demographic factors among workers of a steel company in Chaharmahal and Bakhtiari province, southwest Iran. Methods: In this descriptive-analytical study in 141 workers of Taraz Steel company in 2021, participants were selected by convenience sampling and a self-report nutrition literacy scale nativized to Iranians was used to collect data. Data were analyzed by SPSS 22 using Mann-Whitney U test, Kruskal-Wallis test and Spearman's correlation coefficient. Results: About 75% of workers had adequate nutrition literacy and around 24% inadequate nutrition literacy. The highest percentage of mean score was obtained for determination of food groups (85.4%) and the lowest for calculation of food units (47%). The mean score of nutrition literacy was significantly higher in people with higher education (P = 0.020). Also, people with adequate monthly salary attained a higher mean score on determination of food groups (P = 0.021) and higher overall nutrition literacy (P = 0.003) compared to other people. No relationship was observed between nutrition literacy and body mass index as well. Conclusion: Most workers have adequate nutrition literacy but their scores on calculation of food units are relatively low. It is essential for policymakers to collect information on the level of nutrition literacy in different populations, especially Iranian workers, to reduce the prevalence of nutrition-related chronic diseases.

Design and psychometric evaluation of schools' resilience tool in Emergencies and disasters: A mixed-method.

BACKGROUND: In addition to their educational role, resilient schools have a good capacity in response to disasters. Due to the large student population, the schools can be a safe and secure environment during disasters, in addition to maintaining their performance after. Given the role and importance of the schools, the impact of culture and environment on resilience, without any indigenous and comprehensive tool for measuring the resilience in Iran, the study aimed to design and psychometrically evaluate the measurement tools. METHOD: This study was conducted using a mixed-method sequential explanatory approach. The research was conducted in two main phases of production on items based on hybrid model and the psychometric evaluation of the tool. The second phase included validity (formal, content and construction) and reliability (multiplex internal similarity, consistency and reliability). RESULT: The integration of systematic and qualitative steps resulted in entering 91 items into the pool of items. After formal and content validity, 73 items remained and 44 were omitted in exploratory factor analysis. A questionnaire with 5 factors explained 52.08% of total variance. Finally, after the confirmatory factor analysis, the questionnaire was extracted with 29 questions and 5 factors including "functional", "architectural", "equipment", "education" and "safety". Internal similarity and stability in all factors were evaluated as good. CONCLUSION: The result showed that the 29-item questionnaire of school resilience in emergencies and disasters is valid and reliable, that can be used to evaluate school resilience. On the other hand, the questionnaire on assessment of school resilience in disasters enables intervention to improve its capacity.

Operational Strategies for Establishing Disaster-Resilient Schools: A Qualitative Study.

INTRODUCTION: Resilient schools can warranty students' health and survival at disasters. It is obligatory that schools be prepared for natural challenges through local programs. Considering the great population of students, disaster-resilient schools can be a safe and suitable environment for students at the time of disaster. OBJECTIVE: This study aims to identify certain operational strategies for establishing schools resilient to natural disasters. METHOD: This qualitative study was based on conventional content analysis. Using purposive sampling method, 24 experts in the fields of health in disasters, construction engineering, psychology, teaching, and administrative management participated in the study. Maximum variation sampling continued until data saturation was achieved. The data collected via unstructured interviews were analyzed with Graneheim and Lundmen's conventional content analysis. RESULTS: Content analysis resulted in four main categories as operational strategies for establishing disaster-resilient schools including: 1) "construction and non-construction optimization", with four subcategories of construct risk management, optimization of construct architecture and physical structure, correct construct localization, and promotion of non-construct safety, 2) "promotion of organizational coordination and interactions" with two subcategories, namely improvement in intra-organizational communication and improvement in extra-organizational communication, 3) "improvement in education" with three subcategories of holding educational courses for families and students, holding educational courses for managers and personnel, and holding simulated exercises, and 4) "process promotion" with four subcategories of increased preparedness, correct planning, creation of organizational structure, and rehabilitation facilitation. CONCLUSION: Various factors affecting schools' response to disasters form operational strategies to establish disaster-resilient schools. These strategies influence pre- and post-disaster preparedness. Awareness of these components followed by preparedness prior to disasters can save students' lives, improve school performance after disasters, and aid in establishing disaster-resilient schools as safe lodgings.

Assessment of school resilience in disasters: A cross-sectional study.

BACKGROUND AND OBJECTIVES: School resilience is defined as risk-reducing strategies used to create a safe environment for students when faced natural disasters. Resilient schools, in addition to their educational role, provide a suitable capacity for responding to disasters and rehabilitation after the incidence. This study determined the level of disaster resilience of schools in Yazd, central Iran. MATERIALS AND METHODS: This is a descriptive-analytic study conducted among 400 schools and 367 participants in Yazd, 2018. To collect data, we used the school resilience in disasters questionnaire (α =0.95 and intraclass correlation coefficient = 0.97 [95% confidence interval: 0.96-0.98]) containing 48 questions. We also analyzed the gleaned data through the Pearson correlation coefficient, one-way ANOVA, and independent t-test. RESULTS: The total score of school disaster resilience was 153.30 ± 29.57. In these schools, the function had the highest (47.76 ± 13.96), and safety had the lowest (6.74 ± 3.18) score among all areas of school disaster resilience. There was a positive significant correlation between total resilience and areas of function, education, structural, nonstructural, architecture, commute routes, safety, location, and equipment (P < 0.001). Location had the smallest (r = 0.424) and function had the greatest (r = 0.854) correlation with total resilience. CONCLUSION: It can help the school management board in assessing the level of resilience of their school and determining the priorities for disaster risk reduction. Awareness of the status of resilience can help policy-makers and experts create an effective program for increasing resilience.

Awareness of the effect of fluctuations in female sex hormone levels on periodontal health among obstetricians.

Background: Changes in women's hormonal levels in different periods of their lives, such as puberty, menses, pregnancy, menopause and oral contraceptive use, affect periodontal health. Periodontal status has been associated with adverse pregnancy outcomes. Subsequently, it is important for obstetricians to be aware of the effects of hormones on women's oral health. The current study assessed obstetricians' awareness about the effect of female sex hormones on periodontium in Yazd in 2016. Methods: A cross-sectional study was conducted using a self-administered, structured questionnaire. Prior to the study, a questionnaire was pre-tested and validated (ICC=0.89). The questionnaire was randomly distributed among 40 obstetricians in Yazd. Data were analyzed with chi-squared test, t-test and ANOVA and Spearman's correlation coefficient, using SPSS 18. Results: There were no significant relationships between awareness level and the age (P=-0.252), years of practice and experience (P=-0.030) or practicing in public medical centers (P=0.121). Conclusion: As women have special periodontal health care considerations due to fluctuations in the levels of their sex hormones, this study suggests that promotion of oral health awareness among obstetricians is necessary to improve women's overall health, especially during pregnancy.

Determinants of Cancer Early Detection Behaviors:Application of Protection Motivation Theory.

BACKGROUND: Cancer is account for 13% of all deaths around the world and is the third cause of mortality in Iran. More than one third of these cases are pre-ventable and about 33% are curable with early detection. The aim of this study was to determine the predictors of cancer early detection (CED) behaviors applying Protection Motivation Theory (PMT). METHODS: In this cross-sectional study, cluster sampling method was employed to recruit 260 individuals of above 20 years old in Yazd, Iran and a researcher designed questionnaire was completed through interviews for each of the respondents. PMT theoretical variables and CED behaviors were the basis of data collection procedure. RESULTS: Participants acquired 64.47% of the protection motivation, 30.97% of the passive and 45.64% of the active behaviors? possible scores. Theory constructs predicted 19.8%, 15.6% and 9.6% of the variations for protection motivation, passive and active behavior respectively. Protection motivation was responsible for 3.6% of passive and 8% of active behaviors? variations. CONCLUSION: Considering the scarceness of CED behaviors and the applicability of PMT in predicting these behaviors, utilization of the PMT?s constructs in any interventional programs to accelerate CED behaviors could be an alternate methodological choice in the cancer control initiatives.

Determination of preventive behaviors for pandemic influenza A/H1N1 based on protection motivation theory among female high school students in Isfahan, Iran.

INTRODUCTION: Influenza A/H1N1 pandemic has recently threatened the health of world's population more than ever. Non-pharmaceutical measures are important to prevent the spread of influenza A/H1N1 and to prevent a pandemic. Effective influenza pandemic management requires understanding of the factors influencing preventive behavioral. This study reports on predictors of students' preventive behaviors for pandemic influenza A/H1N1 using variables based on the protection motivation theory (PMT). MATERIALS AND METHODS: In a cross-sectional study, multiple-stage randomized sampling was used to select 300 female students in Isfahan who completed a questionnaire in December 2009. Data were collected using a self-report questionnaire based on PMT. The statistical analysis of the data included bivariate correlations, Mann-Whitney, Kruskal-Wallis, and linear regression. RESULTS: The mean age of participants was 15.62 (SE = 1.1) years old. Majority of participants were aware regarding pandemic influenza A/H1N1 (87.3%, 262 out of 300). Results showed that, protection motivation was highly significant relationship with preventive behavior and predicted 34% of its variance. We found all of the variables with the exception of perceived susceptibility, perceived severity, and response cost were related with protection motivation and explained 22% of its variance. CONCLUSION: Promotion of students' self-efficacy, and intention to protect themselves from a health threat should be priorities of any programs aimed at promoting preventive behaviors among students. It is also concluded that the protection motivation theory may be used in developing countries, like Iran, as a framework for prevention interventions in an attempt to improve the preventive behaviors of students.

Determinants of oral health behaviors among high school students in Shahrekord, Iran based on Health Promotion Model.

PURPOSE: This paper reports on predictors of students' oral health behaviors, using variables based on the Health Promotion Model in an attempt to identify influential variables that may be addressed through intervention efforts. METHODS: A non-probability sample of 300 high school students was recruited from 4 high schools in Shahrekord City, Iran. The study took place between January and March of 2008. Appropriate instruments were used to measure the variables of interest. The statistical analysis of the data included bivariate correlations, t-test, one-way ANOVA and linear regression. RESULTS: The cognition variables - perceived self-efficacy, perceived benefits, perceived barriers and activity-related affects, and commitment to a plan of Oral health behaviors, were significantly related to oral health behaviors among the respondents. A negative association was found between oral health behaviors and perceived barriers. Interpersonal influences, such as modeling and norms, and situational influences were found to be significantly related to increased oral health behaviors. All of the Health Promotion Model variables were statistically significant predictors of oral health behaviors, and accounted for 65.1% of the variation. CONCLUSION: Promotion of interpersonal modeling and the students' perceived self-efficacy should be priorities of any programs aimed at promoting oral health behaviors among students. It is also concluded that the Health Promotion Model may be used in developing countries, like Iran, as a framework for planning intervention programs in an attempt to improve the oral health behaviors of students.