Decisional Balance Inventory (DBI) adolescent form for smoking : psychometric properties of the Persian version

Abstract Background One effective model for studying cigarette smoking cessation is the transtheoretical model (TTM). In order to assess to what degree interventions can make variations in individuals’ behavior, several questionnaires have been developed based on the TTM. This study aims to describe the development of the Persian version of the Decisional Balance Inventory (DBI) for smoking cessation in Iran and to evaluate its psychometric properties. Design and methods The forward-backward technique was used to translate the DBI from English into Persian. After linguistic validation and a pilot test among 30 male smoking young adults, a cross-sectional study was performed, and psychometric properties of the Persian version of the DBI were assessed. Using a convenience sampling method, 120 male smokers between 16 and 24 years of age were recruited from three factories in Nowshahr, Iran. In order to assess the reliability of the DBI, internal consistency and test–retest methods were performed. Additionally, face and content validity were assessed, and the construct validity of the DBI was calculated by performing both exploratory and confirmatory factor analysis. Data were analyzed using SPSS and AMOS. Results The mean age of the sample (n = 120) was 20.19 (SD = 2.13) years. The mean scores for the content validity index (CVI) and the content validity ratio (CVR) were .94 and .89, respectively. The results of exploratory factor analysis (EFA) showed a three-factor solution for the DBI that accounted for 55.4% of observed variance. The results achieved from the confirmatory factor analysis (CFA) displayed that the data fit the model: the relative chi-square (×2/df) = 1.733 (p < .001) and the root mean square error of approximation (RMSEA) = .07 (90% CI = .05–.105). All comparative indices of the model including GFI, AGFI, CFI, NNFI, and NFI were more than .80 (.87, .83, .91, .89, and .81, respectively). The Cronbach’s alpha ranged from .78 to .83, indicating an acceptable reliability. Furthermore, the intraclass correlation coefficient (ICC) ranged from .72 to .89, confirming a satisfactory result. Conclusions The results from the present study indicate that the Persian version of the DBI has good psychometric properties and is suitable to measure smoking behaviors among Iranian adolescent and young adult smokers. Consequently, the instrument could be used in planning cigarette smoking cessation interventions among Iranian adolescents and young adults

Exploring breast cancer preventive lifestyle and social support of Iranian women : a study protocol for a mixed-methods approach

Abstract Background It is widely accepted that a healthy lifestyle may decrease the probability of developing cancer. This study aimed to describe a study protocol that makes it possible to explore preventive health lifestyles of Iranian women and their received social support for the purpose of developing cultural strategies to increase breast cancer prevention. Methods A mixed-methods study will be accomplished in two sequential parts. First, a cross-sectional study will be conducted in which 2,250 Iranian women are recruited by using a random multistage cluster sampling of 20 health care centers. Structured face-to-face interviews will be conducted to obtain information on the participants’ health lifestyle and perceived social support. Data will be analyzed using both multivariate regression and structural equation modeling techniques. Then, a qualitative study will be conducted among employed women using a purposive sampling design. Data will be collected by means of focus groups and semi-structured interviews and will be analyzed using a conventional content analysis approach. The results of the quantitative and qualitative study will be used to develop breast cancer preventive strategies. Discussion Researchers need to acquire knowledge regarding the lifestyle and perceived social support of Iranian women that will foster culturally competent approaches to promote healthy lifestyles to develop breast cancer preventive strategies. Examining breast cancer preventive lifestyles provides valuable information for designing applicable intervention programs for improving women’s health

Psychometric properties of the Persian version of the Cancer attitude inventory

Background: The Cancer Attitude inventory (CAI) was developed to measure attitudes toward cancer. The aim of the present study was to describe the development of the Persian version of the CAI and to evaluate its psychometric properties in an Iranian sample. Methods: The forward-backward method was used to translate the CAI scale from English into Persian. After linguistic validation and a pilot check, a cross-sectional study was performed and psychometric properties of the Iranian version of the questionnaire were assessed. The scale validation was conducted with a convenience sample of 820 laypeople. Construct validity was assessed through both exploratory factor analysis (EFA) and confirmatory factor analysis (CFA). Internal consistency was assessed through Cronbach's alpha analysis and test-retest analysis. Results: Five factors were identified in CAI: isolation, helplessness, fear of consequence, belief of control and independence, and fear of death. The results achieved from the CFA displayed that the data fit the model: the relative chi-square (x2/df)= 2.98 (p <.001), and the root mean square error of approximation (RMSEA) =.07 (90% CI =.06-.07). All comparative indices of the model had scores greater than.80, demonstrating a good fit to the data. Cronbach's Alpha and the intra-class correlation coefficient (ICC) were .97, which is well above the acceptable threshold. Conclusions: The results indicate that the Persian version of the CAI is practical, reliable and valid. Consequently, the instrument could be used in plans to create positive attitudes about cancer control and treatment among Persian people

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

Exploring Iranian women’s perceptions and experiences regarding cervical cancer-preventive behaviors

Abstract Background Preventive behaviors regarding cervical cancer are essential for women’s health. Even though many studies have addressed women’s knowledge and attitudes toward cervical cancer, little information is available about their experiences of cervical cancer-preventive behaviors. Thus, the aim of this study is to explore the perceptions and experiences of Iranian women regarding cervical cancer-preventive behaviors. Methods This study used a qualitative approach and was conducted in Zanjan, Iran. Participants included 27 women, aged 20–60 years, with no previous history of cervical cancer symptoms or diagnosis. Data were obtained through semi-structured in-depth interviews and focus group discussions. Inductive qualitative content analysis was employed to converge and compare themes through participant data. Results The following six main themes emerged from the analysis: attitudes toward cervical cancer and preventive behaviors, preventive behaviors’ concept, self-care, religion and culture, perceived social support, and awareness about cervical cancer and preventive behavior. The findings revealed that several women had misconceptions about cervical cancer and were even superstitious about the causes of it. Fear, shame, and embarrassment were reasons for not undertaking cervical cancer screening. Cervical cancer was also linked to worries about decreased marital satisfaction, sexuality, and femininity. However, religion was considered a positive factor to conducting cancer-preventive behaviors. Conclusions This study showed that improving knowledge about the causes of cervical cancer, increasing awareness of the potential consequences of it, and creating positive attitudes toward screening behavior might encourage Iranian women to perform cervical cancer-preventive behaviors

Perceived barriers to methadone maintenance treatment among Iranian opioid users

Abstract Background Opioid use is a severe problem in Iran. Despite methadone maintenance treatment (MMT) programs being one of the most important treatment strategies for reducing individual and public harms associated with opioid use, a large proportion of Iranian patients refuse to participate in such treatment programs. Methods The present study aims to explore the beliefs and attitudes toward MMT programs of opioid-dependent patients who were participating or had participated in methadone therapy. In-depth interviews were conducted with 23 opioid users between 27 and 58 years of age from Kurdistan provinces. Results Overall, six themes were discovered to be key barriers relating to methadone treatment, including financial barriers related to methadone treatment, lack of awareness about methadone treatment, negative attitudes regarding using methadone, worries about methadone’s side effects, social stigma ascribed to methadone therapy, and systemic barriers to methadone treatment. Conclusion Our study revealed that the cost of treatment is a major obstacle to attending and continuing at MMT programs and that addicts and their families are not always accurately informed about the duration of MMT programs and the side effects of methadone treatment

Understanding the relapse process : exploring Iranian women’s substance use experiences

BackgroundRelapse is one of the main challenges that must be tackled in the drug addiction treatment. Different factors contribute to the relapse process but it remains unclear how relapse occursin women. Describing the relapse phenomenon in women might be of interest to practitioners and academics. The aim of this study was to explore the relapse experiences of Iranian women with a substance use disorder.MethodsQualitative in-depth interviews were conducted with women with a substance use disorder. The interviews contained open-ended questions regarding relapse experiences during previous treatment. Interviews were digitally recorded. Data were analyzed using the content analysis method.ResultsIn total, 20 women who use drugs took part in the study. The mean age of the women was 34.57 (age range=9.6years), and the minimum age of participants was 23years. The following five main themes were explored: socioeconomic backgrounds, physical complications of drug withdrawal, psychological burden of drug withdrawal, family atmosphere, and cultural factors. The findings highlighted the different treatment needs in women with a substance use disorder.ConclusionsBased on the interviews, it seems necessary to develop female-specific comprehensive treatment programs by putting more emphasis on pain treatment intervention, relapse prevention, the diagnosis and treatment of mental disorders, couples counseling, and financial support. Furthermore, policymakers should be committed to providing a nonjudgmental social environment to remove or reduce stigma of women with drug use problems