مجله آموزش بهداشت و ارتقای سلامت ایران
سال پنجم شماره 4 (پیاپی 20، زمستان 1396)

Iron deficiency is the most common nutritional problem in the world and is one of the main cause of anemia, especially in girls. The aim of this study was to evaluate the educational intervention program based on Health Belief Model (HBM) to increase preventive manners against iron-deficiency.
Material and This quasi-experimental study was conducted on 128 female students of high schools in the second grade Friedan city in 2015. They were randomly divided into intervention and control groups. The data gathering tool was a questionnaire including demographic characteristics, HBM constructs and health performance questionnaires which were used after confirmation of validity and reliability of the tool. The data were analyzed using descriptive statistics, paired and independent t-test in SPSS 22 software.
Before training, there was not a significant difference in the mean scores of the health belief model constructs and health function between two groups, (p > 0.05). But three months after intervention, the mean scores of perceived susceptibility, severity, benefits, barriers, perceived self-efficacy, practice guidance and health performance were significantly different between two groups (p Education based on HBM has been effective in promoting the preventive behaviors of iron deficiency anemia, therefore this model can be used as a framework for designing and performing education interventions to prevent iron deficiency anemia.

The Tobacco use is recognized as a global health problem. Considering the high prevalence of hookah consumption among college students and its risks and negative consequences on the human health, this study aimed to investigate the factors related to hookah consumption among college students of Asad abad city base on the theory of planned behavior (TPB).
This cross-sectional study was carried out on 400 students of Asad abad universities between 2015 and 2016. The method was multi-stage sampling and the questionnaires were completed as a self-report. The data-gathering tools consisted of a questionnaire based on the TPB construct and demographic variables. The data were analyzed by SPSS-16 software with linear and logistic analysis.
The mean age of participants was [3/3 ± 72/22] years, the results showed that the prevalence of hookah consumption was 32% among students. In addition, among the variables of planned behavior theory, perceived behavioral control and positive attitude towards the most powerful consumption, the predictors had the intention to use a hookah. In total, 78.5% of the behavioral intention variance was explained by the constructs of TPB. Behavioral intention (ß =0/489) was better predictive for manner camped to perceived behavioral control (ß =0/115).
Considering the effectiveness of the planned behavior theory to predict the hookah consumption, it seems that this theory can be used for planning to prevent the hookah and interventions among students. Training including all aspects affecting drug compliance is necessary.

The high prevalence of obesity is a serious health problem around the world, there are some variables can cause increase of overweight. The present study aimed to investigate the role of health-oriented lifestyle and health locus of control in preventing this disease .
This descriptive-cross sectional study was conducted during the first six months of 2014 and the statistical population consisted of all female and male overweight patients with the range of 15-67 years old from Imam Khomeini hospital in Tehran. 300 individuals were selected using purposeful sampling method and by calculating Body Mass Index (BMI), two groups were divided into overweight (BMI= 25-29.9) and without overweight (BMI=18.5-24.9) groups. Data were collected applying health-oriented lifestyle and health locus of control questionnaires and analyzed by logistic regression in SPSS 24 software.
The results of this study indicated a correct prediction that 87% and 74% of people had normal-weight and overweight respectively. The complete model was significantly reliable (P≥0/001, df = 21 and chi-square= 141/61) and totally %82 of the predictions were correct.
Health-oriented lifestyle and health locus of control are capable of being an overweight prediction, and it can be said that by changing the individuals’ lifestyle and regulating the source of health control, the risk of overweight will be reduced.

LBP is one of the most important health problems and the main cause of people's disability in most countries that has reached a stage of the epidemic. The aim of this study was to evaluate the effect of six-weeks aquatic exercise on pain, disability, static balance and function of the trunk and pelvic girdle muscles in women with chronic low back pain.
The statistical population of this study were selected among 20 to 40 year old woman who referred to orthopedic clinics in Hamadan. This is a semi-experimental research. A total of 24 female patients with chronic low back pain were involved in the study and randomly were divided into two groups of 12 individuals: experimental and control groups. The tools for measuring the data were 2 standard questionnaires including Quebec Pain and Oswestry Disability, and also Stork Equilibrium, Seats Up Test, Sorensen Test, and Scott Test. The experimental group performed a six-week training protocol (three sessions per week), and during this period, the control group did not perform any practice. Evaluation and measurements were performed before and after the intervention. In order to analyze the data, using SPSS 19, dependent and independent t-test were used at a significant level of 0.05.
The results of t-test showed that the experimental group had significantly improved dependent variables (p The results of this study demonstrated that the aquatic therapy protocol used in this study can be an effective therapeutic method to improve the physical condition, health, pain, disability, and patients’ balance.

Type 2 diabetes is one of the most important public health challenges. Self-efficacy and health literacy play a key role in self-care for diabetic patients. The aim of this study was to determine the effect of training based on self-efficacy theory on health literacy, self-care behaviors and self-efficacy in patients with type 2 diabetes.
This quasi-experimental study was conducted on 70 patients with type 2 diabetes that were randomly divided into two groups of experimental and control. Data were evaluated with standard questionnaires including TOHFLA, SDSCA, CIDS. The educational programs were implemented for the experimental group, then after the intervention, the results were analyzed by SPSS16 software.
Before the intervention, the two groups did not show a significant different in terms of mean scores for self-efficacy (t=0.29, P=0.77), self-care behavior (t=0.42, p= 0.67) and health literacy scores (t=0.38, p=0.69). However, after the educational intervention, the mean scores of the test group increased and both groups indicated a significant difference in mean scores of self-efficacy (t=0.099, p=0.001), self-care behavior (t=3.13, p=0.003) and health literacy scores (t=2.66, p=0.01).
The results of this study showed that educational intervention based on self-efficacy theory is effective to improve self-efficacy and health literacy in diabetic patients. Therefore, the use of self-efficacy strategies is recommended for control programs in health care among diabetic people.

Pap smear test is a cervical cancer screening tool that plays an important role in the early detection, prevention and delay of progression of the cervical disorder. Therefore, this study aimed to determine the effect of educational intervention on performing pap smear in women of Fasa city.
This quasi-experimental study were performed on 160 women referred to Fasa Health Centers (80 individuals in experimental and 80 in the control group) in 2015. The data collection tools were demographic questionnaires, Knowledge and performance questionnaires and HBM constructs in the field of pap smear which was completed before and two months after the intervention. The educational program for the test group was conducted during 5 sessions in a discussion group with the presentation of educational pamphlets. The findings were analyzed by SPSS 22 software at the significance level of P The mean scores of awareness and HBM model constructs (susceptibility, severity, benefit and perceived barriers) were significantly increased in the experimental group compared to the control group after the intervention (P Improving the performance of the Pap smear tests in women support the implementing a training program and taking advantage of the health belief model for cervical cancer screening.

Type 2 diabetes is the most common chronic disease that makes a lot of restrictions for patients and their families. Therefore, improving the psychological characteristics of these people has been considered by many therapists. The present research aimed to determine the impact of acceptance and commitment group therapy on hardness and perceived stress coefficient in patients with type 2 diabetes.
This experimental study was a pre-test and post-test design with a control group. The statistical population of this research included all patients with type 2 diabetes who referred to health care centers of Ahvaz city in 2015. Totally 30 patients were selected by convenience sampling method and randomly divided into two equal groups. The experimental group received 8 sessions of 90 minutes by group therapy approach based on acceptance and commitment. Groups completed the perceived stress and hardness coefficient questionnaires. Data were analyzed using multivariate analysis of covariance method.
The findings showed that there was a significant difference between the experimental and control groups in the variables of perceived stress and hardness coefficient. In the other words, the acceptance and commitment group therapy method significantly increased the hardness factor and decreased perceived stress among patients with type 2 diabetes.
Considering the effect of group therapy based on acceptance and commitment on perceived stress and hardness, it is suggested counselors and therapists use this mentioned method to increase the hardness factor and reduce perceived stress in patients with type 2 diabetes.

Global changes have created new health challenges specifically in hospitals. In the new perspective, nowadays hospitals are the best places for health promotion and preventive services. The present study aimed to evaluate the performance of general educational hospitals of Mashhad University of Medical Sciences based on the standards of health promoting hospitals.
The present study was a descriptive – analytic and the data collection tool was a World Health Organization questionnaire regarding the standards of health promoting hospitals. To fill in the questionnaires, a team of main members of the hospitals was formed and standards assessment criteria were determined, then the questionnaires were completed by each team member. The data analysis was performed by SPSS software through statistical indicators (mean, SD), t-test and paired t-test.
The results were identified by five categories of activities based on the standards of health promotion hospitals. Regarding standards, the highest score was related to patient’s information and therapeutic interventions (78) and the lowest was for managerial policies (51.1). In total, all hospitals were in the same situation to perform the standards of health promotion hospitals, with a mean score of 63.80%.
It seems that some activities related to the health-promoting hospitals (HPS) are being carried out in hospitals. Therefore, for improving the quality of health services, encouraging policymakers and healthcare managers to create consistent policies will have an effective role to improve the status of hospitals.

Back ground and Considering the most important factor in the control of diabetes is self-care behaviors and since improving self- care behaviors is the first step to help patients for better control and management of their disease. Therefore this research was conducted with the title of “determination of effective factors on self -care behaviors in diabetic women referring to Mashhad health centers”.
In this cross-sectional study, 300 women with type 2 diabetes who referred to public health centers were selected in the city of Mashhad by multistage cluster method. Data gathering tools were a summary of self-care behaviors by Toobert and his colleagues. The data analysis was done by SPSS software version 21and data were analyzed using descriptive statistics, Pearson, independent T-test, ANOVA and Spearman tests. Level of significance was considered 0.05 in all tests. In all tests, a significant level of 0.05 was considered.
The mean score of patient’s self -care was 42.72 ± 9.90 and their self -care status was moderate. The self-care score behavior showed a significant statistical relationship with level of education, high income and training of patients (p According to the results of this research, the important factors, such as educational level, economic status and previous knowledge of the patient play a significant role in the realization of self-care behaviors. Therefore, in order to promote self-care behaviors of patients, first of all, health educators should identify the mentioned factors, then make a plan and educational interventions.

Achieving old age is one of the major advances in human life, but reducing in physical activity, especially balance walking, and cognitive impairment including problems in the elderly are associated with physical, psychological and social consequences. The purpose of this study was to investigate the effect of a training protocol on cognition and physical health status in elderly women living in elderly care centers.
In this quasi-experimental study, 24 elderly women with a healthy cognitive status (mean age, 72.40±6.05 years; weight, 62.66±4.55 kg) in an elderly care center were randomly divided into two groups of intervention and control. The intervention group used a 12-weeks course of combined training (cognitive-motor). Berg Balance Scale (BBS), Timed up and Go test (TUG), Functional Reach Test (FRT) and Mini-Mental State Examination (MMSE) were taken before and after the intervention.
The findings showed an improvement in the results of the FRT test (p=0.002), BBS test (p=0.001), TUG test (p=0.001) and MMSE test (p=0.011) in the intervention group.
The results showed that cognitive-motor training program can be effective to improve motor performance especially balance and cognitive factors in elderly women. It seems that this type of activity is a beneficial training method for maintaining motor function and reduction the speed of mental function of the elderly people.

Traffic jams and transportation are an important part of the spectrum socioeconomic and environmental factors outside the health system with impacts on health. The aim of this study was to explain the residents’ viewpoints about the impacts of urban traffic on their physical health in Sanandaj.
The study was carried out qualitatively with content analysis method in 2014. Twenty-two residents of the city were selected as participants who were interviewed in a Focus Group Discussions (FGDs) (4 sessions) and in-depth individual interviews (8 sessions), respectively. A purpose-based sampling method was used in this study. The MAXQDA10 software was applied to facilitate the coding and categorizing the data.
Based on the viewpoints of the participants, urban traffic jams has two direct and indirect negative impacts on physical health. The direct effects cause premature aging, excessive fatigue, and mental illness and make some problems in the musculoskeletal system, digestive system, nervous system, respiratory system, cardiovascular system. The indirect influences include pure reliance on the car, accidents, traffic congestion and air pollution.
Healthcare researchers and urban traffic policymakers should design comprehensive studies to assess the impacts of urban traffic jams and transportation on community health. Therefore, they would be able to investigate the impacts on the health of individuals after the enactment of each law and planning and to implement community-based health promoting strategies in the society.

Ellis rational emotive behavioral therapy (REBT) has been approved as a way to decrease some health problems. Therefore, it may be effective in promoting health. Therefore, this study aimed to investigate the effectiveness of REBT on the health.
the research is a quasi-experimental with pre-test and post-test design. The statistical population included 650 experts working in Iran Khodro Diesel Company. 60 people were selected using random sampling method and were randomly divided into two groups. The general health questionnaire was used as a measurement tool. At first, this questionnaire was in the pre-test and the experimental group received Ellis method. Then the test was implemented in two further stages of post-test and follow-up. Data were analyzed using SPSS-16 software and variance test (ANOVA).
The results of the analysis showed that using Ellis health method and social functioning subscales, anxiety and depression have improved in the experimental group compared to the control group (0/88, 0/04) (P Therefore, it can be stated that Ellis method has been fruitful on the improvement of mental health and its subscales, and it is recommended that courses such as Ellis intervention program can be held in work environments.

Considering the importance of the role of nurses in increasing the individuals’ health, family, and society, the present study was conducted to investigate the relationship between perception of social support and tendency of using psychotropic substances in nurses.
The statistical population of this descriptive-correlational study consisted of all nurses of hospitals in Kermanshah (2016). 341 nurses were selected using cluster sampling method and the data-gathering tools was the multi-dimensional scale of social support perception (Zimat et al. 1988) and questionnaire (Bahremand and colleagues, 2014) was applied for the tendency of using psychotropic substances. Data were analyzed by SPSS-22 software, Pearson correlation, and regression analysis tests.
The results of the research showed that there was a significant relationship between the components of the perception of social support and the general score of the tendency toward psychotropic substances. These relationships were meaningful in level (P Therefore, it can be concluded that the subscales of the perception of social support can predict the tendency of using psychotropic substances.