The transtheoretical model: Changes in health beliefs among female adolescents in Iran during 3 years

BACKGROUND: The present study aimed to track adolescents’ attitudes towards changes in their health behavior considering perceived benefit and barrier in different stages of physical activity during a three-year transitional period from junior high school to high school. METHODS: Data were collected amongst female adolescents in 2010 (n = 558) using random cluster sampling method, of whom 400 were provided by follow-up data in 2013. The stages of change and health beliefs regarding physical activity were measured using self-reported questionnaires. The research data were, then, analyzed in statistical analysis system (SAS), using inferential statistics. RESULTS: The baseline participants had a mean age of 14.28 ± 1.54 and at follow-up were 17.52 ± 1.82. At the baseline and follow-up, proportions of participants in pre-adaption and adaption stages were 26.7%-73.3% and 72.3%-27.7%, respectively. At baseline, pre-contemplators showed significantly lower positive attitude and greater agreement for most of the barrier items than those on other stages. In the baseline, female in action and maintenance stages endorsed greatest agreement for the barrier item i.e. having too much homework. In comparison to females, in the maintenance stage pre-contemplators were more likely to agree that a "not knowing how to do a certain type of exercise"(OR = 10.30, CI = 4.42-23.99). At the follow-up, in the pre-contemplators and maintenance stages, the greatest amount of agreement for the barrier item was "not enough time". CONCLUSION: This study revealed transition from junior high school to high school and showed lower physical activity in females. Consequently, perceived barriers increased and perceived benefits decreased in the transition from junior high school to high school.  

Relapse and Risk-taking among Iranian Methamphetamine Abusers ‎Undergoing Matrix Treatment Model

Background: This study investigated the correlation between risk-taking and relapse among methamphetamine (MA) abusers undergoing the Matrix Model of treatment. Methods: This cross-sectional study was conducted on male patients who were stimulant drug abusers undergoing the matrix treatment in the National Center for Addiction Research. A sampling was done using the availability method including 92 male patients. Demographic questionnaires and drug abuse related questionnaire were completed for each patient. Then, Bart’s balloon risk-taking test was administered to the patients. Findings: Participants had a mean age ± standard deviation (SD) of 27.59 ± 6.60 years with an age range of 17-29 years. Unemployment, unmarried status, criminal offense, and also addiction family history increased the probability of relapse. In addition, a greater adjusted score of the risk-taking test increased the odds of relapse by more than 97%. The simultaneous abuse of opium and stimulants compared to the abuse of stimulants only, revealed no statistically significant differences for relapse. Patients with higher risk-taking behavior had a more probability of relapse. Conclusion: This finding indirectly implies the usefulness of Bart’s risk-taking test in assessing risk-taking behavior in stimulant drug abusers

The transtheoretical model: Changes in health beliefs among female adolescents in Iran during 3 years

BACKGROUND: The present study aimed to track adolescents’ attitudes towards changes in their health behavior considering perceived benefit and barrier in different stages of physical activity during a three-year transitional period from junior high school to high school. METHODS: Data were collected amongst female adolescents in 2010 (n = 558) using random cluster sampling method, of whom 400 were provided by follow-up data in 2013. The stages of change and health beliefs regarding physical activity were measured using self-reported questionnaires. The research data were, then, analyzed in statistical analysis system (SAS), using inferential statistics. RESULTS: The baseline participants had a mean age of 14.28 ± 1.54 and at follow-up were 17.52 ± 1.82. At the baseline and follow-up, proportions of participants in pre-adaption and adaption stages were 26.7%-73.3% and 72.3%-27.7%, respectively. At baseline, pre-contemplators showed significantly lower positive attitude and greater agreement for most of the barrier items than those on other stages. In the baseline, female in action and maintenance stages endorsed greatest agreement for the barrier item i.e. having too much homework. In comparison to females, in the maintenance stage pre-contemplators were more likely to agree that a "not knowing how to do a certain type of exercise"(OR = 10.30, CI = 4.42-23.99). At the follow-up, in the pre-contemplators and maintenance stages, the greatest amount of agreement for the barrier item was "not enough time". CONCLUSION: This study revealed transition from junior high school to high school and showed lower physical activity in females. Consequently, perceived barriers increased and perceived benefits decreased in the transition from junior high school to high school

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

A school-based randomized controlled trial to improve physical activity among Iranian high school girls

Background: Physical activity (PA) rates decline precipitously during the high school years and are consistently lower among adolescent girls than adolescent boys. Due to cultural barriers, this problem might be exacerbated in female Iranian adolescents. However, little intervention research has been conducted to try to increase PA participation rates with this population. Because PA interventions in schools have the potential to reach many children and adolescents, this study reports on PA intervention research conducted in all-female Iranian high schools. Methods: A randomized controlled trial was conducted to examine the effects of two six-month tailored interventions on potential determinants of PA and PA behavior. Students (N = 161) were randomly allocated to one of three conditions: an intervention based on Pender's Health Promotion model (HP), an intervention based on an integration of the health promotion model and selected constructs from the Transtheoretical model (THP), and a control group (CON). Measures were administered prior to the intervention, at post-intervention and at a six-month follow-up. Results: Repeated measure ANOVAs showed a significant interaction between group and time for perceived benefits, self efficacy, interpersonal norms, social support, behavioral processes, and PA behavior, indicating that both intervention groups significantly improved across the 24-week intervention, whereas the control group did not. Participants in the THP group showed greater use of counter conditioning and stimulus control at post-intervention and at follow-up. While there were no significant differences in PA between the HP and CON groups at follow-up, a significant difference was still found between the THP and the CON group. Conclusion: This study provides the first evidence of the effectiveness of a PA intervention based on Pender's HP model combined with selected aspects of the TTM on potential determinants to increase PA among Iranian high school girls

Global, regional, and national cancer incidence, mortality, years of life lost, years lived with disability, and disability-Adjusted life-years for 29 cancer groups, 1990 to 2017 : A systematic analysis for the global burden of disease study

Importance: Cancer and other noncommunicable diseases (NCDs) are now widely recognized as a threat to global development. The latest United Nations high-level meeting on NCDs reaffirmed this observation and also highlighted the slow progress in meeting the 2011 Political Declaration on the Prevention and Control of Noncommunicable Diseases and the third Sustainable Development Goal. Lack of situational analyses, priority setting, and budgeting have been identified as major obstacles in achieving these goals. All of these have in common that they require information on the local cancer epidemiology. The Global Burden of Disease (GBD) study is uniquely poised to provide these crucial data. Objective: To describe cancer burden for 29 cancer groups in 195 countries from 1990 through 2017 to provide data needed for cancer control planning. Evidence Review: We used the GBD study estimation methods to describe cancer incidence, mortality, years lived with disability, years of life lost, and disability-Adjusted life-years (DALYs). Results are presented at the national level as well as by Socio-demographic Index (SDI), a composite indicator of income, educational attainment, and total fertility rate. We also analyzed the influence of the epidemiological vs the demographic transition on cancer incidence. Findings: In 2017, there were 24.5 million incident cancer cases worldwide (16.8 million without nonmelanoma skin cancer [NMSC]) and 9.6 million cancer deaths. The majority of cancer DALYs came from years of life lost (97%), and only 3% came from years lived with disability. The odds of developing cancer were the lowest in the low SDI quintile (1 in 7) and the highest in the high SDI quintile (1 in 2) for both sexes. In 2017, the most common incident cancers in men were NMSC (4.3 million incident cases); tracheal, bronchus, and lung (TBL) cancer (1.5 million incident cases); and prostate cancer (1.3 million incident cases). The most common causes of cancer deaths and DALYs for men were TBL cancer (1.3 million deaths and 28.4 million DALYs), liver cancer (572000 deaths and 15.2 million DALYs), and stomach cancer (542000 deaths and 12.2 million DALYs). For women in 2017, the most common incident cancers were NMSC (3.3 million incident cases), breast cancer (1.9 million incident cases), and colorectal cancer (819000 incident cases). The leading causes of cancer deaths and DALYs for women were breast cancer (601000 deaths and 17.4 million DALYs), TBL cancer (596000 deaths and 12.6 million DALYs), and colorectal cancer (414000 deaths and 8.3 million DALYs). Conclusions and Relevance: The national epidemiological profiles of cancer burden in the GBD study show large heterogeneities, which are a reflection of different exposures to risk factors, economic settings, lifestyles, and access to care and screening. The GBD study can be used by policy makers and other stakeholders to develop and improve national and local cancer control in order to achieve the global targets and improve equity in cancer care. © 2019 American Medical Association. All rights reserved.Peer reviewe

The effect of educational intervention based on an Ecological-social model on consuming fruit and vegetables in women in Ilam

Background: The effect of instructional models on the changing behavior of consuming fruit and vegetables in the prevention of diseases caused by consumption of foods including rice, contaminated with toxic metals, has not been investigated in Iran yet. Objective: To compare an Ecological-social model (ECO) group and Control group in increasing fruit and vegetable consumption. Methods: This research involved implementation of a six-month randomized controlled educational interventionist program into a group of Ecological-social framework along with a control group, totally summing up to 160 women between 18 and 50 years of age in Ilam, Iran in 2014. The questionnaire included knowledge, social support construct (immediate family, relatives, friends, colleagues and neighbors.) and fruit and vegetable intake in both groups before and after the intervention was examined. Data were analyzed by SPSS version 16 using the signed ranks test, and repeated measures analysis of variance analysis, and confidence interval of 95% were employed. Results: The results of the signed ranks test showed a significant increase in social support in the intervention group (p<0.001). This test showed a significant increase in fruit and vegetable consumption and a significant increase in the number of women using healthy rice (p<0.001), and a significant reduction in the number of women consuming unhealthy rice in the intervention group (p<0.001), that determines dietary intake improvement after the intervention compared with before the intervention (p<0.01). However, this improvement was not observed in the control group. Conclusions: The results showed that ECO plays an effective role in improving fruit and vegetable consumption in women. Therefore, this model was implemented as a health protocol through health-care centers to conduct the prevention of complications resulting from the use of food contaminated with toxic metals

Mediators of behavior change in two tailored physical activity interventions for adolescent girls

Objectives: It has been suggested that the lack of knowledge regarding the mechanisms responsible for behavior change may be responsible for the low levels of effectiveness in physical activity interventions among youth. While it is common for physical activity interventions to cite a theoretical framework, few test the validity of their constructs using an established mediation analysis technique. The purpose of this study was to identify mediators of physical activity behavior change in two tailored interventions for adolescent girls. Design: This study involved an experimental design. Methods: Participants (N=161) were randomly allocated to a control (CON) group, an intervention based on the Health Promotion (HP) Model or an intervention developed from the HP Model that included two processes from the Transtheoretical Model (THP). Both interventions included school-based education sessions, individual counseling sessions, and two physical activity sessions completed with the participants' mothers. Measures were assessed prior to the intervention, at post-intervention and at a 6-month follow-up. The following constructs were included in the mediation analyses: perceived benefits, perceived barriers, self-efficacy, exposure to models, social support, interpersonal norms, planning, stimulus control, and counterconditioning. Results: Perceived benefits, perceived barriers, self-efficacy, and commitment to planning satisfied the criteria for mediation in the THP intervention. Self-efficacy and commitment to planning were identified as mediators in the HP intervention. Conclusion: The results of this study provide evidence that both interventions were successful in increasing physical activity through changes in the theoretical constructs

Eeffect of life skills training on drug abuse preventive behaviors among university students

Background: Drug abuse is now-a-days one of the gravest social harms. Recent years have experienced a drastic rise in drug abuse among school and university students. Thus, the need for special attention to the issue is deemed important. The present study was conducted with the aim of assessing the impact of life skills training on promotion of drug abuse preventive behaviors. Methods: This field trial experimental study was conducted on 60 students of Gonabad Medical University selected through quota random sampling and assigned randomly into two Intervention and control groups. Data were collected through a questionnaire, including two sections of demographic information and drug abuse preventive behaviors. The questionnaire was first assessed as to its validity and reliability and then administered both before and after educational intervention and also as a follow-up 4 years after intervention - Data were then analyzed using t-tests and Chi-square. Results: Comparison of post-test mean scores of drug abuse preventive behaviors of both groups showed a significant difference (P < 0.01) which remained s[Table 4] years after intervention. There was a significant relationship between father ′ s educational level and drug abuse preventive behaviors (P < 0.01). Conclusions: Life skills′ training is effective in the promotion of drug abuse preventive behaviors of university students