Development and psychometric testing of a new instrument to measure factors influencing women's breast cancer prevention behaviors (ASSISTS)

Background: Breast cancer preventive behaviors have an extreme effect on women's health. Despite the benefits of preventive behaviors regarding breast cancer, they have not been implemented as routine care for healthy women. To assess this health issue, a reliable and valid scale is needed. The aim of the present study is to develop and examine the psychometric properties of a new scale, called the ASSISTS, in order to identify factors that affect women's breast cancer prevention behaviors. Methods: A multi-phase instrument development method was performed to develop the questionnaire from February 2012 to September 2014. The item pool was generated based on secondary analyses of previous qualitative data. Then, content and face validity were applied to provide a pre-final version of the scale. The scale validation was conducted with a sample of women recruited from health centers affiliated with Tehran University of Medical Sciences. The construct validity (both exploratory and confirmatory), convergent validity, discriminate validity, internal consistency reliability and test-retest analysis of the questionnaire were tested. Results: Fifty-eight items were initially extracted from the secondary analysis of previous qualitative data. After content validity, this was reduced to 49 items. The exploratory factor analysis revealed seven factors (Attitude, supportive systems, self-efficacy, information seeking, stress management, stimulant and self-care) containing 33 items that jointly accounted for 60.62 % of the observed variance. The confirmatory factor analysis showed a model with appropriate fitness for the data. The Cronbach's alpha coefficient for the subscales ranged from 0.68 to 0.85, and the Intraclass Correlation Coefficient (ICC) ranged from 0.71 to 0.98; which is well above the acceptable thresholds. Conclusion: The findings showed that the designed questionnaire was a valid and reliable instrument for assessing factors affecting women's breast cancer prevention behaviors that can be used both in practice and in future studies

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

Measurement of the Constructs of Health Belief Model related to Self-care during Pregnancy in Women Referred to South Tehran Health Network

Background and Objective: Self-care activities during pregnancy can be effective in reducing adverse pregnancy outcomes. Health Belief Model (HBM) is one of the most applicable models in educational need assessment for planning and implementation of educational interventions. The purpose of this study was to measurement of the constructs of HBM related to self-care during pregnancy in women referred to South Tehran health network.Materials and Methods: In this cross-sectional study 270 pregnant women who referred to health centers of South Tehran Health Networks participated. Demographic, knowledge and attitude questionnaires based on constructs of HBM was used to measure the status of knowledge and attitude of women. Data were analyzed using statistical software SPSS18.Results: Results showed that 92.2% of women had the knowledge scores in good level. The scores of perceived severity, perceived self-efficacy and cues to action were in good level in almost of women but almost of women obtained weak point in perceived susceptibility, perceived benefits and barriersConclusion: HBM can be used as an appropriate tool for assessment the status of pregnant women in the field of self-care behaviors during pregnancy and planning and implementation of educational interventions.</p

The Role of Self-Efficacy in Perceived Sensitivity and Severity to COVID-19 Preventive Behaviors

Background and purpose: Self-efficacy is central to behavior, especially preventive behaviors of Coronavirus Disease 2019 (Covid-19). Identifying the factors that lead to increased self-efficacy in individuals can pave the way for necessary decisions to change the behavior of the society. This study aimed at determining the relationship between people’s self-efficacy and perceived severity and sensitivity to preventive behaviors of Covid-19 in Sari, Iran. Materials and methods: This descriptive-analytical study was performed in 268 patients attending certain health centers in Sari, 2020.The subjects were selected using convenience sampling. To collect the data, a researcher-made questionnaire was administered online consisting of three sections. Results: The mean age of the study population was 36.81±8.6 years and 17.5% of the patients were confirmed cases of Covid-19. Among the people studied, 81.3% used soap and water to disinfect their hands. There were significant correlations between self-efficacy and perceived severity (B: 0.163, CI 95%: 0.068-0.257) and perceived sensitivity (B: 0.164, CI 95%: 0.060-0.267). Perceived sensitivity and severity also predicted 10% of the variance in self-efficacy. Conclusion: Perceived severity and sensitivity to Covid-19 preventative behaviors could affect people’s self-efficacy

Determination of factors affecting relapse of vaginitis among reproductive-aged women: An experimental study

Introduction: Vaginitis is a common problem for women, especially in reproductive-aged women. It is a worldwide health problem with many side effects but could be prevented by a health-promoting lifestyle related to vagina health. The aim of this study was to determine the factors affecting relapse of vaginitis. Methods: In this experimental study, 350 reproductive-aged women with vaginitis were selected from 10 health centers in Kermanshah (Iran) during 2015 and were equally included in the intervention and control groups. To collect data, a researcher-created questionnaire, which included sociodemographic and health-promoting lifestyle questions, was used. The educational intervention was performed over 20 sessions, each lasting 25-35 minutes. An intervention group was educated by face-to-face education, pamphlets, phone contacts, text messages, and social media. Another group continued the routine clinic education and treatment without contacting the intervention group. Data were analyzed through chi-square and a logistics regression model using IBM-SPSS version 20. Results: The results of the study indicated a significant relation between sociodemographic characteristics such as women and their husbands’ literacy, job, family size, income, area for each member of family, tendency of pregnancy, body mass index (BMI), and caesarean experience (p<0.001) and vaginitis. In addition, significant relationships between health-promoting lifestyle dimensions and prevention of vaginitis were identified. Relapse after intervention in the intervention group was 27.7% and 72.3% in the control group. According to the logistic regression analysis, chance for relapse of vaginitis in the group that did not receive intervention was more than the same chance in the intervention group (OR=5.14). Conclusion: Health-promoting lifestyle intervention influences prevention of vaginitis. Health-promoting lifestyle, literacy promotion, prevention of caesarian, and obesity are beneficial to improvement in lifestyle dimensions associated with vagina health could be implemented as a successful prevention method. Therefore, it seems that applying a health-promoting lifestyle is essential for a healthy vagina and prevention of vaginitis

The effects of health promotion model-based educational program on self-care behaviors in patients undergoing coronary artery bypass grafting in Iran

Background and aim: Post-operative self-care behaviors, have positive effects on increase in adaptability, and reduce cardiac surgery patients’ disability. The present study is carried out aimed at determining the effect of education based on a health promotion model on the patients' self-care behaviors after coronary artery bypass surgery. Methods: This is a semi-experimental study carried out in Mazandaran (Iran) in 2016. Two hundred and twenty patients who participated in the study were selected using a simple random sampling method from a population of postoperative patients, and divided into control and experimental groups (110 patients in each) using block (AABB) randomization. Self-designed self-care questionnaires based on a health promotion model were distributed among the patients once before and three months after intervention. The data were analyzed by SPSS- 22, Chi-Square tests, Mann- Whitney and ANCOVA at the significance level of p<0.05. Results: The average score of total self-care behaviors in cardiac surgery patients was not significant between the two groups before education (p=0.065), but after training, a significant difference was observed between the two groups (p<0.001). The analysis of ANOVA with repeated measure indicated that following the intervention, significant difference was observed between the two groups in terms of improvement of self-care behaviors after excluding the effect of pre-test and controlling demographic and health-related characteristics. Conclusions: Developing and implementing a training program based on the health promotion model can enhance self-care behaviors and reduce the number of admissions in patients after cardiac surgery

The Effect of Education on Empowerment of Girls for the Prevention of Osteoporosis: A Randomized Clinical Trial

Background and Objectives: Osteoporosis is one of the disasters of the recent century. Given the greater involvement of women in all age groups, prevention of osteoporosis is essential in women. Individual empowerment is one of the strategies to prevent the growth of osteoporosis. In this research, the role of empowerment model-based education, was investigated in the prevention of osteoporosis in female students. &nbsp; Methods: In this controlled trial, the target community (before and after) included female students of Islamic Azad University, Shahrekord Branch. The sampling method was two-stage stratified random sampling and the sample size was determined (75 people for each) in intervention and control group. Data were collected using a demographic questionnaire and a researcher-made questionnaire on individual empowerment for the prevention of osteoporosis (before the intervention and 3 months after intervention). Statistical analysis was carried out by independent t-test, paired t-test and Chi-square. &nbsp; Results: In this study, there was a significant increase in the scores of the constructs of knowledge (p<0.001), attitude (p<0.001), self-efficacy (p=0.005) and life skills p=0.015), in the intervention group before and after the educational intervention, but in the control group, there was no significant increase in the constructs of knowledge (p=0.25), attitude (p=0.49), self-efficacy (p=0.18), and life skills (p=0.69) before and after the intervention. &nbsp; Conclusion: The results of this study showed the educational intervention based on self-empowerment model can be effective in the improvement of female students in the prevention of osteoporosis. &nbsp

Daughters at Risk of Female Genital Mutilation: Examining the Determinants of Mothers' Intentions to Allow Their Daughters to Undergo Female Genital Mutilation.

Female genital mutilation (FGM) is still a common practice in many countries in Africa and the Middle East. Understanding the determinants of FGM can lead to more active interventions to prevent this harmful practice. The goal of this study is to explore factors associated with FGM behavior among Iranian mothers and their daughters. Based on Ajzen's theory of planned behavior, we examined the predictive value of attitudes, subjective norms, perceived behavioral control and several socio-demographic variables in relation to mothers' intentions to mutilate their daughters. A paper-and-pencil survey was conducted among 300 mothers (mean age = 33.20, SD = 9.09) who had at least one daughter and who lived in Ravansar, a county in Kermanshah Province in Iran. Structural equation modeling was used to investigate the relationships among the study variables. Our results indicate that attitude is the strongest predictor of mothers' intentions to allow their daughters to undergo FGM, followed by subjective norms. Compared to younger mothers, older mothers have more positive attitudes toward FGM, perceive themselves as having more control over their behavior and demonstrate a greater intention to allow their daughter to undergo FGM. Furthermore, we found that less educated mothers and mothers living in rural areas had more positive attitudes toward FGM and feel more social pressure to allow FGM. The model accounts for 93 percent of the variance in the mothers' intentions to allow their daughters to undergo FGM. Intervention programs that want to decrease FGM might focus primarily on converting mothers' neutral or positive feelings toward FGM into negative attitudes and on alleviating the perceived social pressure to mutilate one's daughter. Based on our findings, we provide recommendations about how to curtail mothers' intentions to allow their daughters to undergo FGM

Effect of theory-based intervention to promote physical activity among adolescent girls: a randomized control trial

Background: Physical activity (PA) rates decline among most high school female students, and due to cultural restrictions, the reduction of physical activity might be exacerbated in female Iranian adolescents. Objective: To determine the effects of the physical activity education theory-based intervention to promote activity among adolescent girls. Methods: This randomized clinical trial was conducted at public high schools in Tehran, Iran, from September 2015 to July 2016 on 578 girls. The subjects were assigned randomly to two groups of experiment and control (n=289 per group). All participants in the experimental group received an educational program based on a modified TPB. Measures were assessed before and 6 months after the experiment. The data were analyzed using SPSS version 23. We used descriptive statistics, multilevel analysis, Likelihood Ratio (LR) test, P-value less than 0.05 were considered statistically significant. Results: Five hundred and seventy-eight participants with a mean age of 14.26±0.96 years were studied in two groups of experiment (n=289) and control (n=289). Moreover, adjusted for the baseline values, the mean of the scores of the knowledge (84.1±13.6), attitude (31.2±13.6), subjective norm (40.4±11.1), behavioral intention (34.3±14.7), perceived behavioral control (38.4±11.6), perceived parental control (42.9±14.2), behavioral (42.6±17.1) was significantly higher in the experiment group compared with the control group (p<0.001). Conclusions: The results of this study implicate that theory based educational intervention is considered to be more effective in improving physical activity in adolescents. This result can be used to increase adolescent’s health promotion. Trial registration: The trial was registered at the Iranian Registry of Clinical Trials (IRST) with the identification number: IRCT2015070623089N2. Funding: The authors received no financial support for the research from Kermanshah University of Medical Sciences