Evaluation of Mackey Childbirth Satisfaction Rating Scale in Iran: What Are the Psychometric Properties?

Background: With the integration of the evaluation of patient satisfaction in the overall assessment of healthcare services, authorities can be assured about the alignment of these services with patient needs and the suitability of care provided at the local level. Objectives: This study was conducted in 2013 in Zahedan, Iran, in order to assess the psychometric properties of the Iranian version of the mackey childbirth satisfaction rating scale (MCSRS). Patients and Methods: For this study, a methodological design was used. After translating the MCSRS and confirming its initial validity, the questionnaires were distributed among women with uncomplicated pregnancies and no prior history of cesarean section. The participants had given birth to healthy, full-term, singletons (with cephalic presentation) via normal vaginal delivery at hospitals within the past six months. Cronbach’s alpha and test-retest (via the intraclass correlation coefficient) were applied to analyze the internal consistency and reliability of the scale. Moreover, the validity of the scale was tested via exploratory factor analysis, confirmatory factor analysis, and convergent validity. Results: The MCSRS consists of six subscales. Through the process of validation, two partner-related items (“partner” subscale) of the scale were excluded due to cultural barriers and hospital policies. Cronbach’s alpha for the total scale was 0.78. It ranged between 0.70 and 0.86 for five subscales, and was 0.31 for the “baby” subscale. Factor analysis confirmed the subscales of “nurse,” “physician,” and “baby,” which were identified in the original scale. However, in the translated version, the “self” subscale was divided into two separate dimensions. The six subscales explained 70.37% of the variance. Confirmatory factor analysis indicated a good fitness for the new model. Convergent validity showed a significant correlation between the MCSRS and the SERVQUAL scale (r = 0.72, P < 0.001). Moreover, the Farsi version of the MCSRS showed excellent repeatability (r = 0.81 - 0.96 for individual subscales and r = 0.96 for the entire scale). Conclusions: The study findings indicated the Farsi version of the MCSRS is a reliable and valid instrument. However, according to the reliability assessment and factor analysis, the “baby” and “self” subscales need further revisions

Reliability of a tool for measuring theory of planned behaviour constructs for use in evaluating research use in policymaking

<p>Abstract</p> <p>Background</p> <p>Although measures of knowledge translation and exchange (KTE) effectiveness based on the theory of planned behavior (TPB) have been used among patients and providers, no measure has been developed for use among health system policymakers and stakeholders. A tool that measures the intention to use research evidence in policymaking could assist researchers in evaluating the effectiveness of KTE strategies that aim to support evidence-informed health system decision-making. Therefore, we developed a 15-item tool to measure four TPB constructs (intention, attitude, subjective norm and perceived control) and assessed its face validity through key informant interviews.</p> <p>Methods</p> <p>We carried out a reliability study to assess the tool's internal consistency and test-retest reliability. Our study sample consisted of 62 policymakers and stakeholders that participated in deliberative dialogues. We assessed internal consistency using Cronbach's alpha and generalizability (G) coefficients, and we assessed test-retest reliability by calculating Pearson correlation coefficients (<it>r</it>) and G coefficients for each construct and the tool overall.</p> <p>Results</p> <p>The internal consistency of items within each construct was good with alpha ranging from 0.68 to alpha = 0.89. G-coefficients were lower for a single administration (G = 0.34 to G = 0.73) than for the average of two administrations (G = 0.79 to G = 0.89). Test-retest reliability coefficients for the constructs ranged from <it>r </it>= 0.26 to <it>r </it>= 0.77 and from G = 0.31 to G = 0.62 for a single administration, and from G = 0.47 to G = 0.86 for the average of two administrations. Test-retest reliability of the tool using G theory was moderate (G = 0.5) when we generalized across a single observation, but became strong (G = 0.9) when we averaged across both administrations.</p> <p>Conclusion</p> <p>This study provides preliminary evidence for the reliability of a tool that can be used to measure TPB constructs in relation to research use in policymaking. Our findings suggest that the tool should be administered on more than one occasion when the intervention promotes an initial 'spike' in enthusiasm for using research evidence (as it seemed to do in this case with deliberative dialogues). The findings from this study will be used to modify the tool and inform further psychometric testing following different KTE interventions.</p

The effect of different cardiovascular risk presentation formats on intentions, understanding and emotional affect: a randomised controlled trial using a web-based risk formatter (protocol)

Background The future risk of heart disease can be predicted with increasing precision. However, more research is needed into how this risk is conveyed and presented. The aim of this study is to compare the effects of presenting cardiovascular risk in different formats on individuals' intention to change behaviour to reduce risk, understanding of risk information and emotional affect. Methods/design A randomised controlled trial comprising four arms, with a between subjects design will be performed. There will be two intervention groups and two control groups. The first control comprises a pre-intervention questionnaire and presents risk in a bar graph format. The second control presents risk in a bar graph format without pre-intervention questionnaire. These two control groups are to account for the potential Hawthorne effect of thinking about cardiovascular risk before viewing actual risk. The two intervention groups comprise presenting risk in either a pictogram or metonym format (image depicting seriousness of having a myocardial infarction). 800 individuals' aged between 45 and 64 years, who have not been previously diagnosed with heart disease and have access to a computer with internet, will be given a link to a website comprising a risk calculator and electronic questionnaires. 10-year risk of having a coronary heart disease event will be assessed and presented in one of the three formats. A post-intervention questionnaire will be completed after viewing the risk format. Main outcome measures are (i) intention to change behaviour, (ii) understanding of risk information, (iii) emotional affect and (iv) worry about future heart disease. Secondary outcomes are the sub-components of the theory of planned behaviour: attitudes, perceived behavioural control and subjective norms. Discussion Having reviewed the literature, we are not aware of any other studies which have used the assessment of actual risk, in a trial to compare different graphical cardiovascular risk presentation formats. This trial will provide data about which graphical cardiovascular risk presentation format is most effective in encouraging behaviour change to reduce cardiovascular risk. Trial registration Current Controlled Trials ISRCTN9131931

SEISMIC EVALUATION OF AN EXISTING OVERPASS STEEL BRIDGE BY TIME HISTORY ANALYSIS FOR ITS RETROFIT DESIGN

The Thirteenth East Asia-Pacific Conference on Structural Engineering and Construction (EASEC-13), September 11-13, 2013, Sapporo, Japan

Evaluating the impact of HBM-based education on exercise among health care workers: the usage of mobile applications in Iran

Background Mechanical life made us witness the growing increase of chronic diseases despite the prominent scientific developments in the field of health, treatment and control. The aim of this study was to evaluate the impact of educational intervention based on Health Belief Model (HBM) using mobile applications (Telegram messenger) on doing exercise among the health care workers of Ilam university of medical sciences in 2017. Methods In this interventional study, 114 people working in Ilam University of medical sciences participated in two groups of intervention and control (employed at two different cities) after providing the informed consent form. HBM-ISCS questionnaire was used to collect the required data and its reliability was approved using Cronbach's alpha. Descriptive statistics, chi square, t test, repeated measures ANOVA (RMANOVA) and structural equation model (SEM) were used. Results Half of the participants were men, 58.77 of them were undergraduate. The mean and SD of their age was 37.61 +/- 4.88 years. Based on the results of the repeated measures analysis of variance test (before and after the intervention) in the intervention group, there were significant difference in all of the HBM constructs (perceived barriers was excepted), daily and weekly exercises, blood biochemical markers of the participants (P > 0.05). The above changes were not significant in the control group (P >= 0.05). Conclusion Exercise is closely related to the beliefs of people, so implementing educational interventions based on Telegram messenger with emphasis on health beliefs and using HBM can lead to have exercise. Therefore, this application can be a suitable tool to deliver trainings, especially when holding in-person classes is difficult

Effect of perceived barriers and self-efficacy on daily exercise among employees using HBM

Aims This study aimed to determine the relationship between the constructs of Health Belief Model (HBM) and doing daily exercise to prevent cardiovascular diseases (CVDs) among the employees of Ilam University of medical sciences in Iran. Instrument & Methods About 294 employees of Ilam University of medical sciences participated in this cross-sectional study after providing a written consent form in 2017. The tool to collect data was an HBM-ISCS questionnaire, which was applied. Eventually, the obtained data were analyzed using SPSS 16 and logistic regression. Findings The results showed that 72.4 of participants did not exercise daily, and the Mean±SD of their daily exercise was 8.08±1.51min. Logistic regression showed that the possibility of daily exercise per unit of increase in perceived barriers decreased by about 10, while every unit of increase in the self-efficacy score resulted in the possibility of 1.12 times more doing daily exercise. The possibility of doing daily exercise among men was 2 times more than in women, and among the personnel of financial/administrative department, it was about 2.5 times more than in the employees of health care department. Accordingly, the possibility of doing exercise decreased by about 8 per unit of increase in work experience. Conclusion The amount of doing daily exercise among the participants of this study was low, and implementing interventions commensurate with the results of this study and based on HBM can be effective in improving the amount of doing daily exercise in them. © 2021, the Authors | Publishing Rights, ASPI

Explaining the concept of maternal health information verification and assessment during pregnancy: a qualitative study

BACKGROUND: Pregnant women use information sources for their own health and health of their children. However, despite the importance of trusting the information sources, pregnant women may not have the ability to verify the maternal health information, which could have negative consequences for their health. The purpose of this study was to explain the concept of maternal health information verification and assessment in pregnant women according to their experiences and perception. METHODS: This is a qualitative study that was conducted in 2017 in Tehran, Iran. The participants in this study consisted of 19 pregnant women who were selected by purposeful sampling. To collect data, semi-structured, in-depth and face to face interviews were conducted with participants and continued until saturation of data. Conventional content analysis method was used to analyze the data and to identify concepts and synthesize them into general classes. MAXQDA software version 10 was used to manage the data. RESULTS: In the process of data analysis, the concept of verification and assessment of maternal health information in pregnancy was explained in two main categories, including "Validity of information resources" and "Reliance on information resources." The category of Validity of information resources had two subcategories of valid and invalid sources, and the main category of Reliance on information resources had two subcategories of indicators of assurance, and confusion and trying to obtain assurance. CONCLUSION: The results indicated that pregnant women used various sources and indicators, as well as different evaluation methods to obtain information and verify it, especially when they are confused. Thus, health authorities and healthcare professionals should provide appropriate programs to familiarize mothers with credible sources, train pregnant women on standards and practices for judging the accuracy of information, and create a safe margin of information

Development and psychometric properties of maternal health literacy inventory in pregnancy

BACKGROUND: Pregnancy is one of the most sensitive and important stages of women's life. Maternal health literacy is the key to achieving a healthy pregnancy. It also affects pregnancy outcomes by improving the quality of health care in this period. The aim of this study was to develop and evaluate the psychometric properties of maternal health literacy inventory in pregnancy (MHELIP). METHODS: This sequential, exploratory and mixed study was carried out in two parts (qualitative study and psychometric evaluation of the tool) in Tehran in 2016-18. The first part involved a qualitative content analysis with a traditional approach using in-depth, semi-structured and personal interviews with 19 eligible pregnant women. Then, the pool of items extracted from the qualitative part was completed by reviewing the existing literature and tools. In the second part, the overlapping items were summarized and the tool was validated. In order to evaluate the construct validity, a cross-sectional study was conducted with the participation of 320 pregnant women. Data analysis was performed by SPSS-19 software using exploratory factor analysis and reliability tests (Cronbach's alpha and ICC). RESULTS: Findings of qualitative part produced a pool of 120 items that reached to 124 items after reviewing the literature. After confirming face and content validity by calculating CVI and CVR for each item, 53 items remained in the pool. Finally, the results of exploratory factor analysis confirmed a tool with 48 items in four factors, explaining 46.49 of the variance of total variables of the tool. Reliability of the tool was approved by Cronbach's alpha = 0.94 and test-retest with 2-weeks intervals, indicating an appropriate stability for the scale (ICC = 0.96). Finally, the tool was finalized with 48 items in 4 dimensions, including "Maternal Health Knowledge", "Maternal Health Information Search", "Maternal Health Information Assessment" and "Maternal Health Decision Making and Behavior". CONCLUSION: The designed tool is a multidimensional, reliable and validated scale for assessing maternal health literacy during pregnancy. This tool can be used to evaluate different aspects of maternal health literacy in pregnant women, which was prepared based on their experiences during a qualitative study

Determining Health Literacy Level and Its Related Factors Among Pregnant Women Referred to Medical and Health Centers of Tehran in 2019: A Cross-sectional Study

Background: The ability to acquire, process, and understand health information to make informed decisions about health is de-fined as health literacy. A low level of health literacy disrupts women’s ability to understand and use health information in order to take appropriate and timely measures during pregnancy. Objectives: Due to the importance of health literacy during pregnancy and its direct impact on fetal health, this study was conducted to determine the level of health literacy and its related items among the pregnant women referred to medical and health centers in Tehran. Methods: This descriptive-analytical study was conducted on 270 pregnant women referred to the medical and health centers of Tehran in 2019. The participants in this study were selected by the mixed sampling method (cluster and random methods to select health centers and the convenience method to select participants). Data collection tools included a questionnaire for demographic and midwifery characteristics and a specialized questionnaire for maternal health literacy in pregnancy (MHELIP). Data analysis was performed by SPSS-19 software. Results: The mean age of the participants was 28.16 ± 5.70 years, and the mean gestational age was 24.50 ± 9.25 weeks. The mean score of health literacy among pregnant women was 63.14 ± 9.63, and 48.9 of them had limited (inadequate and insufficient) health literacy. The results showed positive correlations between the total score of health literacy and the demographic variables of age (P = 0.025), education (P = 0.003), and income (0.008), but no significant relationship was found between the mean total score of health literacy and employment status (P = 0.614) or parity (P = 0.614). Conclusions: It was found that limited health literacy had a high prevalence among pregnant women. Given the importance of pregnancy, it seems necessary for healthcare policymakers to design programs to promote women’s health literacy during preg-nancy. © 2021, Author(s)

Iranian Health Literacy Questionnaire (IHLQ): An Instrument for Measuring Health Literacy in Iran

BACKGROUND: Promoting Health Literacy (HL) is considered as an important goal in strategic plans of many countries. In spite of the necessity for access to valid, reliable and native HL instruments, the number of such instruments in the Persian language is scarce. Moreover, there is no good estimation of HL status in Iran. OBJECTIVES: The aim of this study was to provide a valid, reliable and native instrument to measure and monitor community HL in Iran and also, to provide an estimation of HL status in two Iranian provinces. PATIENTS AND METHODS: By applying the multistage cluster sampling, 1080 respondents (540 from each gender) were recruited from Kerman and Mazandaran provinces of Iran, from February to June 2014 to participate in this cross-sectional study. The development of the Iranian Health Literacy Questionnaire (IHLQ) was initiated with a comprehensive review of the literature. Then, face, content and construct validity as well as reliability were determined. RESULTS: Internal consistency and test-retest reliability (ICC) of the factors was in the range of 0.71 to 0.96 and 0.73 to 0.86, respectively. In order to construct validity, Exploratory Factor Analysis (EFA) Kaiser-Meyer-Olkin (KMO) = 0.95 and Bartlett's test result of 3.017 with P < 0.001) with varimax rotation was used. Optimal reduced solution, including 36 items and seven factors, was found in EFA. Five of the factors identified were reading/comprehension skills, individual empowerment, communication/decision-making skills, social empowerment and health knowledge. CONCLUSIONS: It was concluded that IHLQ might be a practical and useful tool for investigating HL for Persian language speakers around the world. Since HL is dynamic and its instruments should be regularly revised, further studies are recommended to assess HL with application of IHLQ to detect its potential imperfections