Health warning messages on cigarette packs: how young smokers process it

Background: One of the major smoking prevention strategies has been to educate the public and increase people’s awareness, using health warning messages. However, many young people continue smoking without paying attention to health risk messages on cigarette packets in Iran. Hence, this study was conducted to examine the processing route of anti-smoking messages and influencing cognitive factors by using the Elaboration Likelihood Model. Study design: A case-control study. Methods: The non-probability sample for the cross-sectional study consisted of 387 tobacco smokers in the age range of 18 to 30 years old. This study was conducted between July and November of 2018 in Tabriz, Iran. A researcher-designed questionnaire was used for the purpose of data collection. No causal inferences were drawn due to the non-experimental nature of the study. Results: It was found that tobacco smokers often processed the health warning messages through the central route. Perceived severity, smoking abstinence self-efficacy, and psychological dependence were predictors of message processing through the central route. The results supported the conceptual model of cognitional predictors of the processing route. Conclusions: To design and execute effective health warning messages to quit smoking, it is recommended to consider cognitive factors as a means to enhance critical thinking about the content of the health warning message. &nbsp

Recess Activity and General Health Status among Iranian Elementary Schools’ Pupils

Background: Regular and daily physical activity during childhood and at school is one of the important part of requirements of normal growth, development and well-being. To achieve physical activity promotion among school child aged population recess as outside of class time efforts is scheduled and allows students to engage in physical and social activities. The purpose of the present study was to assess recess activities as well as status of physical activities among a sample of Iranian students at the pri¬mary schools.Methods: This cross-sectional study was performed in four randomly se¬lected schools from a list of 26 elementary schools in March, 2012 in the city of Shahindej, located in North-west of Iran. Participants were 439 (10–12 years) elementary schools’. Physical activity level by self-reporting, mental health using the parent-completed Child Health Questionnaire, and happiness was assessed using a Persian translated version of the Subjective Happiness Scale. Hierarchical logistic regression analysis was applied in two steps using the enter method to analyze data in the SPSS version 17.Results: Backward logistic regression analysis showed that gender of the parent who answered the study questions, father’s education, educational grade of children, BMI, physical function, physical health, health status of the children and family function were significantly related to the children’s physical activity level.Conclusion: Promoting parents’ awareness and schools’ staff about im¬portance of physical activities especially in recess times must be an impor¬tant part of school and community mental health promotion programs

“It’s beyond the pale to smoke hookah”: perceptions of Iranian adolescents on social unacceptability of hookah smoking

The present study aimed to explore the perceptions of high school students on Social Unacceptability (Arabic/Persian term = Qabahat) of Hookah Smoking (SUoHS). In this qualitative study, 31 student adolescents in Tabriz, Iran, were invited to participate in semi-structured individual interviews and focus group discussions (FGDs). Data were analyzed using interpretative thematic analysis. The unacceptability of hookah smoking was viewed at the “disreputability of hookah smoking and hookah smokers”. The students also explained SUoHS in the “incivility of hookah smoking and smokers in the society”, “disrespectfulness of hookah smokers and their families”, and “the consequences of hookah smoking”. The SUoHS is rooted from the social values and norms within communities. To decrease hookah smoking levels among adolescents, school health nursing interventions should be tailored to bridge the gap between their recognition of SUoHS and subsequent behavior change through creating group dynamics highlighting the domains of social unacceptability of the behavior

Socioeconomic Status and Coronary Heart Disease

Background: Iran has undergone a remarkable demographic transition over the last threedecades. Socioeconomic status (SES) indicators including education, income, and occupationare associated with coronary heart disease (CHD) risk factors, morbidity, and mortality. Theaim of the present study was to describe demographic and socioeconomic characteristics, theirassociation to the diseases, and to explore the predictive risk of CHD in Tabriz, the fourthlargest city in Iran and the capital of East Azerbaijan Province.Methods: This cross-sectional descriptive study was carried out to explore and analyze thecurrent SES status of CHD patients. The study was conducted in Tabriz and all patients(n=189) refereed to the Central Referral Hospital for cardiac patients (Shahid Madani Hospital)from 2009 to 2010 were considered. A researcher structured questionnaire with 15 questionswas used to collect data. Descriptive statistics were used to describe the basic SES featuresof the CHD patients and data analysis was done using SPSS ver. 16.Results: Less educated participants were more susceptible to CHD. Regarding to occupationalstatus, housewives and retired men were in higher risk of CHD than the rest of the people.Studied patients also reported to be mostly from urban areas that were living in apartmentcomplexes.Conclusion: In line with some international research evidence the study results suggested thatpeople from lower/middle social classes were in greater CHD risk than higher social classes.This epidemic might be halted through the promotion of healthier lifestyles and the support ofenvironmental and policy changes

Development of a Hookah Smoking Obscenity Measurement Scale for Adolescents

Background: The worldwide trend of hookah use among adolescents is increasing, and literature shows arelationship between obscenity and adolescents’ tendency toward hookah smoking. As there is a lack ofappropriate instruments to measure the obscenity of hookah smoking, in the present study, we aimed todevelop an instrument to measure hookah smoking obscenity among adolescents.Methods: In this methodological study, a sequential exploratory design was used to conduct the study fromFebruary 2017 to July 2018 on adolescents in Tabriz, Iran. In the qualitative phase, we conducted semistructured individual interviews (with 18 students) and a focus group discussion (FGD) (with 13 students) toexplain the concept of obscenity and develop the items of hookah smoking obscenity scale (HSOS). We thenexamined the psychometric properties of the HSOS based on face, content, construct and predictive validitiesas well as internal consistency and repeatability.Findings: The HSOS was developed with 21 items based on the results of qualitative data analysis. Applyingconfirmatory factor analysis (CFA), the χ2/degree of freedom (df) ratio was found to be 3.792 for the fourfactor structure of the questionnaire and the fit indices of this structural model were satisfactory. The valuesof Cronbach’s alpha and the intraclass correlation coefficient (ICC) for the constructs in the HSOS ranged0.81-0.93 and 0.79-0.92, respectively.Conclusion: We found the HSOS with a good level of fit indices, validity, and reliability. The HSOS may beapplied by school healthcare providers and health practitioners to find valid and reliable data on theobscenity of hookah smoking when developing hookah smoking prevention/cessation interventions amongadolescents

Development and Psychometric Properties of a Condom Use and Its Cognitive Determinants Questionnaire (CUCDQ)

AIM: The aim of this study was to assess the psychometric properties of Condom Use and its Cognitive Determinants Questionnaire (CUCDQ) among married women in Tabriz, Iran.MATERIALS AND METHODS: In this cross-sectional study, applying multistage cluster sampling 388 married women were recruited to participate in the study. A comprehensive literature review was conducted to develop CUCDQ. Face, content, and construct validity, as well as reliability, were investigated.RESULTS: Principal component factor analysis with varimax rotation demonstrated a six factors structure as the best solution [Bartlett’s Test of Sphericity (Approx. Chi-Square= 4193.07, df= 780, p<0.001); KMO= 0.815] which explained 43.13% of all the variance between the items. CUCDQ represented a proper validity, reliability, simplicity and functionality.CONCLUSION: CUCDQ may be helpful for family health care providers and family planning decision makers in precise assessing the behavioural, psychological, and educational factors related to condom use. This scale may be useful in a various range of studies including family planning or STIs prevention studies in different communities. Future research is recommended to assess the different dimensions of the tool in different communities

Psychometric Properties of the Lasher and Faulkender Anxiety about Aging Scale (AAS) among Iranian Older Adults

Abstract: (1) Background: The older adult population of society is exposed to multiple stressors daily, such as the loss of loved ones, dysfunctional mobility, financial dependence, and suffering from numerous chronic illnesses. The present study aimed to assess the psychometric properties of the Anxiety about Aging Scale among older adults in Iran. (2) Methods: A sample of 703 communitydwelling older adults was recruited and screened using a standardized tool. The mean age of participants was 69.4 � 8.1 years. The majority of participants were male (59.2%), married (66.6%), and illiterate (79.7%). A ‘forward-backward’ translation method was used in developing the Iranian version of the AAS for assessing the psychometric properties among older adults. Confirmatory factor analysis (CFA) and the Rasch model were used for construct validity. (3) Results: Applying CFA indicated that the model’s four original factors are the best solution, representing 55% of the total variance. The result of the CFA showed that this four-factor model had a good fit for the data. The findings were also confirmed by Rasch analysis. (4) Conclusions: The Persian version of the AAS is valid and reliable for measuring aging anxiety among Iranian older adults

Medications Non-adherence Reasoning Scale (MedNARS): Development and psychometric properties appraisal

Background: Proper elucidation of medication non-adherence reasoning especially in older adults might pave the way for an auspicious therapeutic outcome. The main of this study was to develop and psychometrically test the Medications Non-adherence Reasoning (MedNARS) questionnaire for application in research and probably practice settings. Methods: A mixed methods design was utilized to develop the MedNARS. The item pool was mainly generated based on a qualitative query and literature review. The expert panel approved version of the MedNARS was psychometrically assessed on a convenience sample of 220 older patients with chronic disease. The internal consistency, test-retest reliability, content and face validity of the scale were appraised and its construct validity was assed using exploratory and confirmatory factor analyses. Results: A nine-item version of the MedNARS was drafted based on the classical item analysis procedures and its estimated internal consistency measure of the Cronbach’s alpha (0.85) and test-retest reliability (0.96) were in the vicinity of acceptable range. The exploratory factor analysis (EFA) output revealed a unidimensional structure for the MedNARS and the conducted confirmatory factor analysis (CFA) indicated an acceptable data fit for the extracted one-factor model. The goodness of fit indices were as the followings: χ2 /df=1.63(90% CI: 0.02 to 0.11), root mean squared error of approximation (RMSEA)=(0.07), comparative fit index (CFI)=0.95, Tucker–Lewis index (TLI)=0.93 and standardized root mean squared residual (SRMSR)=(0.05). Conclusion: The study findings were indicative of MedNARS’s applicability and feasibility for use in assessment of medication non-adherence reasoning among the elderly patients with chronic diseases. The MedNARS as a brief and elder-friendly instrument can be applied both in research and practice settings to enhance efficiency, safety, and health outcomes of the therapeutic recommendations

Substance abuse behaviors among university freshmen in Iran: a latent class analysis

OBJECTIVES Substance abuse behaviors among university freshmen in Iran are poorly understood. This study aimed to identify, for the first time, subgroups of university freshmen in Iran on the basis of substance abuse behaviors. Moreover, it examined the effects of socio-demographic characteristics on membership in each specific subgroup. METHODS Data for the study were collected cross-sectionally in December 2013 and January 2014 from 4 major cities in Iran: Tabriz, Qazvin, Karaj, and Khoramabad. A total of 5,252 first-semester freshmen were randomly selected using a proportional cluster sampling methodology. A survey questionnaire was used to collect data. Latent class analysis (LCA) was performed to identify subgroups of students on the basis of substance abuse behaviors and to examine the effects of students’ socio-demographic characteristics on membership in each specific subgroup. RESULTS The LCA procedure identified 3 latent classes: the healthy group; the hookah experimenter group; and the unhealthy group. Approximately 82.8, 16.1, and 2.1% of students were classified into the healthy, hookah experimenter, and unhealthy groups, respectively. Older age, being male, and having a family member or a close friend who smoked increased the risk of membership in classes 2 and 3, compared to class 1. CONCLUSIONS Approximately 2.1% of freshmen exhibited unhealthy substance abuse behaviors. In addition, we found that older age, being male, and having a close friend or family member who smoked may serve as risk factors for substance abuse behaviors

Correlates of video games playing among adolescents in an Islamic country

<p>Abstract</p> <p>Background</p> <p>No study has ever explored the prevalence and correlates of video game playing among children in the Islamic Republic of Iran. This study describes patterns and correlates of excessive video game use in a random sample of middle-school students in Iran. Specifically, we examine the relationship between video game playing and psychological well-being, aggressive behaviors, and adolescents' perceived threat of video-computer game playing.</p> <p>Methods</p> <p>This cross-sectional study was performed with a random sample of 444 adolescents recruited from eight middle schools. A self-administered, anonymous questionnaire covered socio-demographics, video gaming behaviors, mental health status, self-reported aggressive behaviors, and perceived side effects of video game playing.</p> <p>Results</p> <p>Overall, participants spent an average of 6.3 hours per week playing video games. Moreover, 47% of participants reported that they had played one or more intensely violent games. Non-gamers reported suffering poorer mental health compared to excessive gamers. Both non-gamers and excessive gamers overall reported suffering poorer mental health compared to low or moderate players. Participants who initiated gaming at younger ages were more likely to score poorer in mental health measures. Participants' self-reported aggressive behaviors were associated with length of gaming. Boys, but not girls, who reported playing video games excessively showed more aggressive behaviors. A multiple binary logistic regression shows that when controlling for other variables, older students, those who perceived less serious side effects of video gaming, and those who have personal computers, were more likely to report that they had played video games excessively.</p> <p>Conclusion</p> <p>Our data show a curvilinear relationship between video game playing and mental health outcomes, with "moderate" gamers faring best and "excessive" gamers showing mild increases in problematic behaviors. Interestingly, "non-gamers" clearly show the worst outcomes. Therefore, both children and parents of non-game players should be updated about the positive impact of moderate video gaming. Educational interventions should also be designed to educate adolescents and their parents of the possible harmful impact of excessive video game playing on their health and psychosocial functioning.</p