Factors Influencing Health Promoting Behaviours in Women of Reproductive Age in Iran: Based on Pender’s Health Promotion Model

INTRODUCTION: Health promotion behaviours are considered as preventives of non-communicable diseases and key determinants of maintaining and improving the health status. AIM: This study aimed to investigate and identify effective factors on health-promoting behaviours based on Pender model in women of reproductive age from February to April 2017, in Savojbolagh, Iran. METHODS: This cross-sectional study is conducted on 240 women aged between 15 to 49 years in Savojbolagh, Iran, in 2017. The questionnaire consisted of several items, including socio-demographic characteristics, health-promoting lifestyle profile-II (HPLP-II), self-efficacy, social support and constructs of Pender’s health promotion model. SPSS-18 software has been applied for statistical analysis. RESULTS: The mean age of the women was 31.10 ± 7.29 years. Total HPLP-II score was 106.64 ± 11.93. The highest and the lowest mean in the subscales were belonged to nutrition and physical activity, respectively. According to the bivariate analysis, the total HPLP-II score is significantly related to prior health-related behaviour (p = 0.000). There was a statistically significant relationship between stress management and the variables including perceived benefits, perceived barriers, prior health-related behaviour, situational influences, commitment to a plan of action (p < 0.05). Also, health responsibility had a statistically significant relationship with self-efficacy (p < 0.05). CONCLUSION: According to our results, it can be inferred that there is a problem with the HPBs of women. Considering that health-promoting behaviours like physical activity had a low score, it is a necessity to plan and perform interventions for improving health promotion behaviours

Impacts of Urban Traffic and Transport on Social Determinants of Health from the Perspective of Residents and Key Informants in Sanandaj, Iran: A Qualitative Study

Background and Objective: Traffic and transport, as a political and social phenomenon, play an important role in the quality and socioeconomic structure of a society. This phenomenon constitutes one of the foundations of modern urban life and social needs of populations. Regarding this, the present study was performed to investigate the impacts of urban traffic and transport on the social determinants of health (SDH) based on the viewpoints of urban residents and key informants in Sanandaj, Iran. Materials and Methods: This qualitative study was conducted on 22 urban residents and 8 key informants selected through purposive sampling technique. The data were analyzed through conventional content analysis approach. Data collection was conducted using four focus group discussions (FGDs) (including 22 residents) and eight in-depth interviews. MAXQDA10 was applied for the purpose of data management. Results: The SDHs that were negatively affected by Sanandaj urban traffic and transport included socio-cultural (e.g., recreation and free times, daily work trends, safety of within-city commuting, tobacco use, and education) and environmental factors (e.g., vegetation, antiquities, noise pollution, urban aesthetic status, and environment, and soil, food, and water status). Conclusion: Urban traffic/transport stakeholders, health policy makers, and health professionals in Iran should pay much more attention to the impacts of urban traffic/transport plans on health and its determinants. It seems necessary to comprehensively assess urban traffic/transport on health status and its determinants in Iran

Breast cancer-preventive behaviors: exploring Iranian women’s experiences

BACKGROUND: Breast cancer-preventive behaviors are critical for community and women’s health. Although many studies have addressed women’s knowledge and attitudes toward breast cancer, little information is available about their experiences of breast cancer preventive behaviors. This study aimed to explore the experiences of Iranian women regarding preventive behaviors. METHODS: This was a qualitative study. A sample of Iranian women aged 30 years and over was selected purposefully. Data collected through focus group and semi-structured audiotaped interviews and were analyzed by conventional content analysis. RESULTS: The following five main themes emerged from the analysis: attitude toward breast cancer and preventive behaviors, stress management, healthy lifestyle, perceived social support and individual/environmental barriers. The findings showed that women were highly motivated to preventive behaviors of breast cancer but faced considerable challenges. CONCLUSIONS: The findings indicated that increased awareness, positive attitudes, stronger motivational factors, and fewer barriers toward preventive behaviors are most important parameters that might encourage women to practice breast cancer-preventive behaviors

تاثير آموزش بر توانمندى رابطان مركز بهداشت شرق تهران در مورد مهارت هاى ارتباطى زوجين

Background and Aims: Communication and relationship skills in people’s lives, especially in the context of marriage are important as the other aspects of the marriage are over. Previous studies have shown that couples improve communication skills, increase intimacy in their marriage and will reduce conflicts. The main objective of this program is to use an active education system to upgrade the knowledge and strengthenskills of health Volunteers. This study aimed to determine the effect of education on couples’ communication skills ability in East Tehran Health Center volunteers.Materials and Methods: This research is a quasi-experimental study in which 112 people from the health care facility in East Tehran Center were selected randomly and studied as a sample in two different test and control groups. At the first meeting the questionnaires were distributed and completed between both groups. The results were analyzed based on experimental programs using methods including role playing,and group discussion for 4-weeks training. A month after the questionnaires were completed and returned byboth groups the results were analyzed using descriptive and experimental methods including Wilcoxon and Mann-Whitney tests at a significance level (p <0.05).Results: Statistical analysis showed a significant difference in the mean scores of empowerment before and after in group. Also significant differences were found in empowerment scores in the area of cognitive distortions, listening, anger management and problem solving(p<0.001) and the problem solving skillsshowed the greatest increase. Conclusion: Holding communication skills trainings would have potential impacts on health and is desirable, therefore, it is recommended to perform educational programs to empower volunteers’ ability.زمينه و هدف: ارتباط و مهارت هاى ارتباطى در زندگى انسان ها، به خصوص در زندگى زناشويى اهميت فراوان دارد و مانند بسترىاست كه ساير ابعاد زندگى زناشويى را در بر مى گيرد. در مطالعات قبلى ثابت شده است كه آموزش مهارت هاى ارتباطى در زوجين ،موجب كاهش تعارضات زناشويى و افزايش صميميت در آنان مى گردد. هدف اصلي اجراي برنامه رابطين بهداشتي، ارتقاء آگاهي ودانش آنان با استفاده از يك نظام آموزش فعال و مطلوب و تقويت نمودن مهارت هاى آنان مي باشد. مطالعه حاضر با هدف تعيين اثرآموزش روي توانمندي رابطين مركز بهداشت شرق تهران در مورد مهارتهاي ارتباطي زوجين است. مواد و روش ها: پژوهش حاضر از نوع مطالعات نيمه تجربى است كه در آن 112 نفر از رابطان بهداشتى مركز بهداشت شرق تهراندر دو گروه آزمون و كنترل، به صورت تصادفى انتخاب و مورد مطالعه قرار گرفتند. در ابتدا پرسشنامه ها بين هر دو گروه توزيع وتكميل گرديد ونتايج آن مورد تجزيه و تحليل قرار گرفت و براساس آن برنامه مداخله آموزشي با استفاده از روش هاى ايفاى نقش وبحث گروهى به صورت 4 هفته براى گروه آزمون برگزار گرديد. يك ماه بعد پرسشنامه ها براي هر دو گروه مجددا تكميل شد و نتايج با استفاده از روش های آمار توصیفی و آزمون های ناپارامتری ویلکاکسون و من ویتنی در سطح معنی داری مورد تجزیه و تحلیل قرار گرفت. يافته ها: نتايج آناليز آمارى تفاوت معنادارى در ميانگين نمرات توانمندى قبل و بعد از آزمون نشان داد. هم چنين تفاوت معنادارى درميانگين نمرات توانمندى قبل و بعد از آزمون در مورد مهارت هاى تحريف شناختى، گوش دادن، حل مسئله و مديريت خشم مشاهده شد. نتيجه گيري: برگزارى آموزش مهارت ارتباطى تاثير مطلوبى بر توانمندى رابطان بهداشت دارد، لذا ارائه برنامه هاى آموزشى در راستاىتوانمندى رابطان پيشنهاد مى شود

The effect of psychosocial factors and patients’ perception of tuberculosis treatment non-adherence in Addis Ababa, Ethiopia

Background: Although there are several studies reported on factors affecting tuberculosis (TB) treatment non-adherence, there is information gap on psychosocial and patients’ perceptions aspects. Therefore, this study was aimed to investigate the effect of psychosocial factors and patients’ perceptions on TB treatment non-adherence in Ethiopia.Methods: A cross sectional study was conducted in Addis Ababa from May to December, 2014. Thirty one health facilities were randomly selected and 698 TB patients, who had been on treatment, were enrolled consecutively using patient registration number. Structured questionnaire was used to collect data on demographics, knowledge, psychological distress, alcohol use, tobacco smoking and six HBM domains. Treatment adherence level was the main outcome variable, and it measured using visual analog scale. Statistical Package for Social Sciences version 20 was used for data analysis.Results: Non-adherence level within last one month prior to the study was 19.5%. After controlling for all potential confounding variables, Antiretroviral Therapy (ART) status (Adjusted Odds Ratio (AOR) = 1.79, 95% Confidence interval (CI) (1.09 -2.95)), alcohol use (AOR = 2.11, 95% CI (1.33-3.37)), economic status (AOR = 0.53, 95% CI (0.33-0.82)), perceived barriers (AOR = 1.21, 95% CI (1.10-1.47)) and psychological distress (AOR = 1.83, 95% CI (1.47-2.29)) were independently associated with TB treatment non-adherence.Conclusion: ART status, economic status, alcohol use, perceived barrier and psychological distress are the major areas that need to be targeted with health promotion intervention to enhance TB treatment adherence.Keywords: Treatment Non-adherence, Determinants of treatment non-adherence, Health Belief Model, Tuberculosi

Effective Factors of the Healthy Nutritional Behavior Based on the Application of Social Cognitive Theory among 13-15-Year-Old Students

Background: There is a rapid spurt in non-communicable diseases because of some significant changes in nutrition patterns around the globe. Controlling the main risk factors, namely lack of physical activity and smoking, might decrease more than 50% of the deaths and disabilities caused by these factors. This study aimed to investigate the effective factors of healthy food behavior based on the application cognitive social theory to 13 to 15-year- old students. Materials and Methods: This cross-sectional study was performed on 330 students aged 13–15 years, in Zarrin- Dasht County, Fars Province, south of Iran who were randomly selected from public schools assigned to the study in 2016. The data gathering tools were demographic questionnaire, a researcher-made questionnaire of social cognitive theory (outcome expectations, outcome values, self-efficacy, social support, and self-regulation), and another questionnaire on nutritional behavior. Questionnaires were completed by students. For analyzing data, the SPSS-22 software, multiple regression, and correlation tests were used.   Results: 330 students aged 13–15 years with seventh, eighth and ninth educational grade participated in this study. Among different constructs of social cognitive theory, outcome expectations (P=0.001), social support (P=0.005), and self-regulation (P=0.001), have made significant contribution to the explanation of the variance of appropriate nutritional behavior among the students. In total, these variables account for approximately 63% of the variance of nutritional behaviors. Conclusion According to the results of this study outcome expectations, social support, and self-regulation might be effective in designing educational interventions to achieve healthy food behavior in students

The Exploration of Protective factors on prevention working children’s substance abuse

BackgroundChild labor is one of the challenges among most big cities in the world. In recent years, substance abuse among working, and street children has become a common phenomenon. Thus, in the present study, the protective factors affecting the prevention of substance abuse among Iranian working children were identified by using the social-ecological approach.Materials and MethodsThe participants included Seventeen 8-15-year-old children who were the members of Imam Ali and Ilia non-governmental organizations (NGOs). Semi-structured in-depth interview interviews were used for data collection. Purposive sampling began in December 2015 and continued till data saturation in June 2016. Data were analyzed based on qualitative content-oriented analysis.ResultsDifferent protective factors were identified and classified at five levels of the social-ecological model. Four classes (belief, knowledge, attitude, skill) at the personal level, two classes (family and relatives) at the interpersonal level, two classes (governmental organizations and non-governmental organizations) at the organizational level, the class of living environment at the community level , and two classes (supportive policies and restrictive policies) at the public policies level were considered.ConclusionThe protective factors affecting the prevention of substance abuse are related to personal, household, social, organizational, and public policy factors. Thus, personal and social empowerment, social participation and capacity building seem necessary to strengthen the protective factors which play a significant role in the prevention of substance abuse among Iranian working children

Development and Psychometric Properties of Risk and Protective Factors of Substance Use ‎Scale in Iran: An Application of Social Development Model

Background: Substance use is a growing public health problem among adolescents. In the lack of a valid and reliable instrument based on social development model (SDM), this study aimed to develop risk and protective factors of substance use scale based on SDM to determine risk and protective factors influencing substance use among adolescents. Methods: A total of 235 male students from 9th and 10th grade (14-18 years old) of public high schools in Kerman, Iran, selected through multistage cluster sampling. Items pool extracted from the literature and focus groups with male adolescents. Face validity of the questionnaire assessed for readability and clarity of items. Then, an expert panel evaluated the items for content validity. Consequently, construct validity of questionnaire confirmed through exploratory factor analysis (EFA). Known group validity is determined by the degree to which the instrument shows different scores between two groups of those who had an experience in drug use and those who did not have such an experience. In addition, reliability assessed via internal consistency and test-retest. Results: About 10 factor solution (containing 38 items) emerged as a result of EFA entitled adolescent’s “beliefs on hookah and alcohol,” “bonding to parents,” “family rules on substance use,” “drug resistance skills,” “adolescent’s beliefs on hard drugs,” “situational perception on hookah and alcohol,” “rules of school,” “situational perception on hard drugs,” “attachment to school,” and “perceived opportunity at school.” The first four emerged factors explained 46% of the total variance observed. Among these factors, adolescent’s beliefs on hookah and alcohol explained a more than 25.3% of the total variance. Results indicated satisfactory internal consistency (Cronbach¢s alpha ranging from 0.71 to 0.85) and intra-class correlation coefficients (ICC) (ranging from 0.48 to 0.81). Conclusion: The risk and protective factors of substance use questionnaire are the first instrument based on the SDM. The findings showed that this questionnaire is a valid and reliable instrument for assessing determinants of substance use which can be used by researchers and policymakers in preventive initiatives

Development and psychometric properties of social exclusion questionnaire for Iranian divorced women

Background: Divorce, especially in women, could be assessed from socio-cultural perspective as well as psychological viewpoint. This assessment requires cultural adopted as well as valid and reliable questionnaire. This study aimed to develop and assess the psychometric properties of a questionnaire in order to address social consequences in Iranian divorced women.Methods: This was an exploratory mixed method study conducted during 2012 to 2014. According to the grounded theory approach in the first phase, social exclusion was extracted as a core of understanding process in participants. Based on, 47 preliminary generated items reliability and validity were assessed. In the second phase, the divorced women were recruited from a safe community center in Tehran through convenience sampling.Results: Exploratory factor analysis conducted on the questionnaires of 150 divorced women with mean age 41.76±8.49 yr, in that, indicated five dimensions, discriminative marital status, economic dependence on marital status, exclusionary marital status, and traumatic marital status health risks and, frightening marital status that jointly accounted for the 64% of the variance observed. An expert panel approved the face and content validity of the developed tool. The Cronbach’s alpha coefficient and the Intra-class Correlation Coefficient were found to be 0.70 and 0.85, respectively.Conclusion: The present study provided a valid and reliable measure as Social Exclusion Questionnaire in Iranian divorced women (SEQ-IDW) to address social post-divorce consequences, which might help to improve women’s social health