اکرم کریمی شاهنجرینی

The purpose of this study was to investigate the role of spiritual well-being and demographic characteristics in signing the donor card.

This cross-sectional study was conducted in Hamadan in 2018. Six hundred employees from 57 offices (out of 60) were selected using a random sampling method. Data gathering was carried out using a self-administered questionnaire. The data were analyzed using logistic regression analysis using SPSS version 22.

The participants’ mean±SD age was 39.5±7.0. About 20% (n=120) of employees had a donor card and 41.7% (n=250) of them were being a blood donors. About 56 percent than half of them were categorized as having high spiritual health. Among the interpersonal and mass media sources, employees obtained more information from friends (n=181, 30.2%) and TV (n=482, 80.3%), respectively. The results of logistic regression showed that being female (AOR=1.80; 95% CI=1.12-2.87), fewer children (1 child: AOR=1.99; 95% CI=1.15-3.43 & no child: AOR=2.94; 95% CI=1.48-5.84), being blood donor (AOR=2.40; 95% CI=1.50-3.85), and higher spiritual heath (AOR=1.01; 95% CI=1.00-1.03) were significantly predicted to sign donor card.

This study provides evidence about the importance of spiritual well-being and demographic predictors of organ donor cards. These predictors can be helpful for the development and implementation of interventions related to increasing the sign donor card.

Early childhood development is one of the priority areas of social determinants of health. A wide range of factors influence a childchr('39')s development. This study aimed to investigate the factors associated with developmental delay in children under 5 years.

This study was a case-control study that conducted from April to August 2019 in Hamadan city. 462 children under 5 years and their mothers participated (231 children that have a developmental delay in the case group and 231 healthy children in the control group). The risk factors assessed were demographic characteristics, mothers’ awareness, and childhood developmental care. The data analysis were performed using Logistic Regression by Stata11 software and a significant level of 5% was considered.

The results showed that there were statistically significant relation between the developmental delay with mothers’ age (OR=1.04, 95%CI:1.00-1.08), history of child hospitalization (OR=2.57, 95%CI:1.63-4.05), tobacco use by parents (OR=2.09, 95%CI:1.20-3.64), and mothers’ awareness (OR=0.44, 95%CI:-0.25-0.82).

Mothers with children under 5 years need to be educated on various aspects of development and caregiving behaviors that protect their children from developmental delays, and the Identify these factors can help planners to reduce developmental delays and their effects.

Health workers are at high risk of novel coronavirus (Covid-19) and preventive behaviors play an important role in reducing the incidence and deaths of this infection. Therefore, the aim of the present study was to investigate COVID-19 Preventive Behaviors and its Related Beliefs among Health Workers of Hamadan province using the Extended Parallel Process Model (EPPM).

This cross-sectional descriptive study was conducted on 950 health workers in Hamadan, in 2020 who were selected by multistage random sampling method. The data were collected using a questionnaire including demographic information and EPPM constructs. Data were analyzed in STATA 14 using descriptive statistics and Pearson correlation test.

Behaviors of avoiding contact with others and frequent hand washing with soap and water with 97.8% and 95.3%, respectively, had the highest frequency among health personnel. The condition of EPPM constructs was evaluated at a relatively favorable level. Also, 46.0% of health personnel were involved in the risk perception process.

It is necessary to improve the level of perceived self-efficacy of employees and also to emphasize the effectiveness of the recommended strategies in the prevention of Covid-19 disease.

Colorectal cancer is one of the most preventable cancers. Regular screening behaviors play an important role in reducing the incidence and deaths of this cancer. Therefore, in the present study we aimed to determine the factors associated with intention to perform fecal occult blood test (FOBT) among medical professionals using the protection motivation theory (PMT).

This descriptive-analytical study was conducted on 240 employees aged over 50 years in Hamadan University of Medical Sciences in 2018 using multistage random sampling. The data were collected using a questionnaire including demographic information and PMT constructs. Data were analyzed using SPSS software version 16. Chi-square and linear regression tests were used as appropriated.

In this study, 22.8% of the participants reported a history of FOBT. There was a significant correlation between the referring to the doctor for intestinal disease and performing FOBT (p < 0.05). Based on the PMT, perceived self-efficacy (β = 0.439) and response efficiency (β = 0.48) were predictive of protection motivation (intention) to conduct FOBT. In total, different structures of the PMT explained 24.6% of the variation of intention changes (R2 = 0.226).

Due to the low frequency of screening behavior among staff, the emphasis on the importance of early diagnosis of cancer is necessary. Also, consideration of perceived self-efficacy and the effectiveness of screening behaviors in designing staff training programs are recommended for increasing the intention to perform screening behaviors.

Incomplete adherence to iron supplementation consumption program is one of the main causes of iron deficiency anemia during pregnancy. The purpose of this study was to investigate the effect of educational intervention on promoting adherence to different aspects of iron supplementation consumption program in pregnant women.

This semi-experimental study with pretest-posttest design with control group was conducted among 100 pregnant women during 16-20 weeks of pregnancy who referred to two health centers in Asadabad, Hamadan in 2017. The subjects were selected using random sampling method and randomly divided into intervention and control groups (50 people in each group). The training program was presented to the intervention group in the form of text messages along with pictures, self-monitoring and a phone call. Blood parameters were measured by blood tests and other variables were evaluated using a questionnaire. Data were analyzed by SPSS 21 software using Chi-square test, independent t-test and paired t-tests.

Intervention could make a significant difference in the behavior of mothers in both groups regarding iron supplementation consumption with vitamin C sources (p<0.001). However, despite the improvement of iron supplementation consumption behavior, lack of simultaneous iron supplementation consumption with calcium sources and observation of the distance between tea drinking and supplement consumption, the difference between the two groups was not significant. The mothers of the two groups also had a significant difference in the amount of ferritin (p=0.003).

The intervention program designed based on the protection motivation theory is effective in promoting adherence to the iron supplementation consumption plan and reducing anemia in pregnant women.

Pregnancy is the most significant stage of a woman's life which is accompanied with increased nutritional needs. This study aims to determine the effect of training program on the base of social cognitive theory constructs in order to improve nutritional behavior among pregnant women.
This quasi-experimental study was conducted on 96 pregnant women in three zones of Tabriz city in 2015. In every zone, one health center was randomly assigned as intervention group and the other as control group (n=48 per group). Training program was applied on intervention groups for two months. Data were collected using a self-administered questionnaire with items on the social cognitive theory constructs and nutritional behavior questionnaire which was completed before and two months after intervention. Data was analyzed through SPSS-20 software by using independent t-test, paired t-test, chi-square, McNemar and fisher exact test.
Results showed that scores of knowledge, outcome expectancy, expectations, self-efficacy, social support, self–regulations, reciprocal determinism and nutritional behaviors were increased significantly in the experimental group (P Implementation of educational intervention based on Social Cognitive Theory structures can be an effective role in modifying pregnant mother's nutritional behavior.

Unhealthy snacks consumption has an important role in childhood obesity. The aim of this study was to evaluate the effect of an educational intervention for mothers on the consumption of healthy snacks in children aged 1-5 years using social cognitive theory.
Methods & Materials: This quasi-experimental study was (IRCT2013062912456N2) conducted on 126 mothers who had children 1-5 years old in 2013. The mothers were selected from Hamadan health centers and divided into two groups of intervention and control. The intervention consisted of four sessions, a booklet, a short video, and 6 written messages. The constructs of SCT and food consumption frequency were assessed at baseline, 10 days after the last session and 2-months after the intervention. The data were analyzed by Chi-square test, independent t-test, repeated measures and covariance analysis using SPSS software version 16.
At baseline, the two groups were similar in the demographic characteristics, the constructs of SCT, and unhealthy snacks consumption frequency (P>0.05). Considering that the interaction effects of group and time in the repeated measurement analysis of variance were significant, the means of two groups were compared at each stage using independent t test and significant differences between the two groups were observed at two stages after the intervention.
This intervention had a positive effect on the consumption of healthy snacks. Therefore, SCT and the implemented procedure could be used to develop interventions to modify snack consumption patterns in children.

Oral health behaviors of pregnant women are important due to their effects on mother and child’s health. The objective of this study was to investigate dental care and its related barriers among pregnant women in Hamadan city, Iran.
This cross-sectional study was carried out on 280 pregnant women in Hamadan city in 2012. We used stratified cluster sampling to select the subjects and a researcher-made questionnaire was used. The questionnaire included demographic information, common dental problems, visit of a dentist during pregnancy and tooth brushing, as well as the perceived barriers of these two behaviors. The reliability and validity of the tool were evaluated using estimates of internal consistency and the opinions of a panel of experts, respectively. Data were analyzed in SPSS-16 using logistic regression test.
The mean age of pregnant women was 27.2 ± 4.88 years. Tooth brushing after each meal and use of mouthwash rates were 12% and 20%, respectively. Half of the participants had not seen a dentist during their current pregnancy. The most important barriers to brush twice a day were impatience and lack of energy. Dental visit barriers were cost, low priority, and stress related to dentistry. Factors associated with no dental visit included poor economic status (P= 0.011) and working outside of home (P= 0.045).
Given the important adverse outcomes associated with poor oral health on mothers and babies, interventions to reduce the barriers of dental cares are crucial.

Low levels of medication adherence in patients with type 2 diabetes is one of the greatest challenges in the treatment and control of diabetes, this study was designed to determine medication adherence and its related factors in patients with type II diabetes in 2015.
In this cross-sectional study, a total of 300 patient's records with type 2 diabetes in the health centers of Tuyserkan city were randomly selected. Data collection instrument was self-made questionnaire which consisted of factors related to medication adherence questionnaire and medication adherence questionnaire. Questionnaires were completed after Confirmed validity and reliability, by questioning and interviews. To analyze the data, descriptive and inferential statistics (T-test, ANOVA, Simple and multiple linear regression) were applied, using spss software, version 19.
26.3% of patients were male and 73.7% were female. Also, 65% of patients were illiterate, 24% of patients had some degree of symptoms, 59.4% of patients had poor medication adherence. There were a significant relationship between age, education, patient care and treatment expenditure, health care team and health system, therapy-related factors and condition-related factors, beliefs about illness, efficacy, concerns about drugs with medication adherence (P This study showed that medication adherence in diabetes patients are not suitable and individual, economical and social factors affect on it.Therefore, the role of these factors must be considered when designing intervention programs.

Students are one of the vulnerable groups to injuries. The deaf and hard of hearing students may also be more vulnerable due to their disability. This study was conducted through the developing, implementing and evaluating an educational program on school injury preven-tion among high school deaf and hard of hearing students, using Health Belief Model. This Quasi-experimental study was conducted among all deaf and hard of hearing students in Hamadan city of Iran, who were studied in two their related special schools, in 2014. They were randomly divided into two experimental (n=23) and control (n=27) groups. Data were collected via questionnaire including questions on demographics, Health Belief Model constructs and students’ knowledge and preventive behaviors. Questionnaires were filled out, through interview in both groups, before and two months after the intervention. The intervention included a designed booklet and five educational sessions. Data was analyzed by Paired T-test, independent T-test, Chi-Square and Fisher Test using SPSS-16. The findings revealed that after educational intervention, the mean scores of the student's knowledge (P=0.002), preventive behaviors (P=0.001) constructs of Health Belief Model, including perceived severity (P=0.001), perceived benefits (P=0.001), self-efficacy (P=0.001) and cues to action (P=0.001) were significantly improved in experimental group, comparing with control group. The results of the study showed that an educational intervention based on the Health Be-lief Model can improve school injury preventive behaviors among deaf and hard of hearing students.

Despite associating regular breakfast consumption habits with a range of health benefits، the rate of skipping the meal is high. The present study was conducted to determine the factors associated with breakfast consumption among female students of Hamadan University of Medical Sciences based on the Social Cognitive Theory (SCT). The present cross-sectional study was carried out on 423 female students in different faculties of Hamadan University of Medical Sciences. Participants were selected through multistage random sampling. The frequency of breakfast consumption and SCT variables، including knowledge، hope، outcome expectancies، observational learning، social support and self-efficacy، was measured using a self-administered questionnaire. Data were analyzed in SPSS-16 using the chi-square test، the correlation test and the linear regression analysis. 24% of the students stated that they always ate breakfast. 10% of the students skipped breakfast. On average، the students ate breakfast 4. 2 times a week. Self-efficacy (p<0. 001) and social support (p<0. 001) were good predictors of breakfast consumption in the students. These two variables were able to predict 64% of the variance in breakfast habits. The results show that self-efficacy and social support should be targeted in the design of interventions intending to increase breakfast consumption among female university students.

There has been growing interest in adolescents’ emotional intelligence and strengthening their various skills including effective and efficient communication. Therefore، this study sought to investigate the relationship between emotional intelligence and communication skills of high school students in Hamadan، Iran based on the theory of social support. This descriptive-analytical study was conducted in 2014. Multistage sampling was performed to select 497 students from high schools of Hamadan. The subjects completed a questionnaire containing items on communication skills، emotional intelligence، and social support. The collected data were analyzed using Pearson’s correlation test، Spearman’s correlation test، t-test، and analysis of variance in SPSS-18. There was a significant relationship between emotional intelligence and communication skills of the participants. The students had a moderate level of communication skills. In general، girls enjoyed higher levels of communication skills، emotional intelligence، and social support (except appraisal support) compared to boys. Moreover، constructs of social support were significantly related with emotional intelligence and communication skills. According to our findings، educational interventions and training packages for students، parents، and schoolteachers are required to improve the students’ emotional intelligence and communication skills.

There is evidence that snacks provide a significant part of daily energy and nutrients in children. Choosing healthy snacks for children can contribute to a healthy diet. The purpose of this study was to identify predictors of healthy snacks choice by mothers using the Social Cognitive Theory (SCT). In this cross-sectional study, 398 mothers of a 1-5 year old child were selected using cluster sampling among 12 health centers in Hamedan city. The participants completed self-report measures of background information, SCT constructs, and a food frequency questionnaire. According to the Content Validity Ratio (CVA), Content Validity Index (CVI), and Cronbach's alpha, the questionnaires were reliable and valid. The collected data were analyzed using SPSS software (version, 15) and based on Chi-squared, ANOVA and linear regression tests. Statistical significance was defined as P < 0.05. The findings of this study showed that availability, outcome expectancy, and self- efficacy were the significant predictors of mothers’ healthy snacks choice. These factors together explained 14.5% of the variance of this behavior. In the development and implementation of snacking education interventions for mothers, proper methods to change availability, outcome expectancy, and self- efficacy should be considered.

Despite the decline of infant mortality in recent years, this problem is still in health care system in society. Identification of factors affecting infant mortality enables the health systems to design effective interventions. This study aimed to identify factors that contribute to infant mortality in high-risk pregnancies. This study was a cross-sectional study in which neonatal deaths in 2011, were investigated in Tuyserkan City. Data were collected primarily through city family health unit and then the checklist of care records and medical records were collected from newborns died. In this study, the influence of risk factors for pregnancy and newborn mortality by categories of mothers in both groups were free of risk factors and risk factors. The data were analyzed using Stata 11. In this study, the higher risk of gestational were for ages greater than 35 years and more than four times (16.1%). Among the variables examined, only the method of delivery and prematurity in infants without risk factors was different between the two groups of high-risk mothers. Significantly greater risk of cesarean delivery in women without risk factors was maternal (p=0.03). The most important underlying cause of death was premature infants (60.09%). Special attention is required during preconception, pregnancy and postpartum care for mothers at risk or high risk, especially since it is mandatory according to the country's health system. Moreover, providing quality health education and counseling to couples counseling and genetic testing can be effective in reducing infant mortality.

The most unwanted pregnancy occurs while couples used less effective contraceptive method. The purpose of this study was determine effectiveness of educational program to persuade couples for choosing more and the most effective contraceptive methods based on BASNEF model. This experimental study carried out on 120 couples using less effective contraception referred to health centers in 2011 and 2012 in Hamadan. 6 health centers with the most unwanted pregnancy randomly divided to intervention and control groups. Then 60 couples as intervention group randomly were selected from 3 health centers and from 3 health centers 60 couples as control group were participated. Pre-test was done by using a questionnaire in both groups and specific education was performed in the intervention group based on BASNEF model. After 6 weeks, post test filled in both groups and the results were analyzed by SPSS 16. The results showed that there were significant mean differences for knowledge, beliefs, attitude, subjective norms, intention and enabling factors. Finally, in interventional group 55.5 percent of couples were using more and the most effective contraception. Educational program based on BASNEF model to persuade couples for using more effective contraception had been effective.

Fast-food consumption among Iranian families appears to be increasing proba-bly due to urbanization, popularization of western-style diets and increased women's labor force participation. Few theory-based investigations have assessed the determinants of fast food consumption. Therefore, the aim of this study was to determine the predictors of fast food consumption, based on the social cognitive theory (SCT) among women referred to health centers in Hamadan, Western of Iran. This cross-sectional study was conducted using structured self-administered questionnaires on 384 women referred to 10 health centers in Hamadan city, Western of Iran. Health center was considered as a sampling unit and systematic random sampling method was applied to select health centers. Participants filled a questionnaire con-taining SCT constructs, an eight-item food frequency questionnaire, and demographic charac-teristics. Data was analyzed by independent T-test, one-way ANOVA, and multiple linear re-gression using SPSS-16. The model could explain 21% of the variance in frequency of fast food consumption. Outcome expectations (p=0.04) and availability (p<0.001) were the significant predictors. The career status of women was the only related demographic characteristic (p<0.001). Interventions aimed to change outcome expectations and introducing nutritious alternatives to fast food could be promising to decrease the rate of fast-food consumption.

Although tooth decay is a preventable disease، it is one of the most common childhood diseases that influences on children ''s health. Caring behaviors have a significant effect on prevalence of this disease. The objective of this study was to investigate the tooth decay status of 2 -5 year children and the role of their mother''s’ caring behaviors. This was a cross-sectional study of 211 children aged 2-5 years and their mothers in Hamadan، Iran. Mothers completed questions about their own oral self- care and their children’s oral caring behaviors. Clinical examination of children’ oral health was carried by a trained dentist. Dental carrier was observed in 83% of the children. There was a relationship between mothers’ and children’s dental visit. The perceived barriers explained 14% of the variance in mothers’ caring behaviors. In policy setting on oral health of children more emphasis should be placed on mothers’ own oral health behaviors and improving mothers’ skills to remove barriers of caring behaviors.

To evaluate the sleep quality of bus drivers and its relationship with several factors. Participants included 238 bus drivers were selected using a non-probability convenience sampling. We measured the Pittsburgh Sleep Quality Index (PSQI), a self-report measure of sleep quality, and age, duration of deriving and consumption of tea and smoking. The results showed that 85% of bus drivers have unfavorable sleep quality. Multiple regression analyses have shown that duration of deriving seemed to influence patient's sleep quality. Health education regard the quality of sleep and legal supervision to prevent the overloading of shift work of bud drivers may be helpful in decrees the road crashes incidence.

Regarding the importance of determining the determinants of diabetes self-care, this study aimed to examine two major determinants of self-care activities, i.e. perceived barriers, and perceived self-efficacy among type two diabetic patients in Tehran, Iran. Methods & Materials: In this cross-sectional study, 128 patients were recruited to the study using convenience sampling. The validated diabetes instruments were completed by the patients. The included participants aged older than 18 years. Data were analyzed using bivariate correlation and path analysis. The mean score of the perceived barriers and perceived self-efficacy were 3.05 and 2.18, respectively. The maximum score of self-care was 4.18. There was a positive correlation between self-efficacy and the self-care (r=0.22; P<0.01). Positive correlations were also found between education with self-efficacy and self-care (r=0.28; P<0.05), (r=0.29; P<0.05). There was a negative correlation between perceived barriers and self-care behaviors (r=-0.68; P<0.000). Using serial multiple regressions and path analysis, we had a final model (RMSEA=0.05; GFI=0.95; CFI=0.98; P=0.44; and Chi-Square=26.5). This model showed that perceived barriers were the strongest predictor for self-care behaviors. Perceived barriers mediated the effect of self-efficacy on the self-care behaviors. The intervention efforts that address the studied determinants related to self-care behavior could potentially impact type two diabetic patient's self-care activities. These determinants should be mentioned in the program developing

The increasing consumption of junk foods by adolescents is associated with adverse health consequences. The purpose of this study was to identify determinants of unhealthy snack consumption among female adolescents using an integrative method based on the theory of planned behavior. The sample included 90 female adolescents aged 12-15 years, from 2 guidance schools in Tehran, selected by systematic sampling. In the qualitative phase of the study, which was of a phenomenology type, the data were collected through 9 focus group discussions. After obtaining parental consent, in each discussion session a moderator followed a topic outline developed based on the theory of planned behavior (TPB). Data analysis was done using the framework method. The quantitative phase consisted of a cross-sectional study on 790 female adolescents aged 12-15 years old from 10 schools, selected using a randomized stratified cluster sampling method. Data on social cognition (based on TPB) and food consumption (using a 48-item food frequency questionnaire) were collected and analyzed using the multiple regression method. In both phases of the study there was a broad range of factors, some of them contradicting each other, influencing selection of snacks by the adolescents. Taste was identified as the most important factor influencing their attitude towards junk foods consumption. The major predictors of behavior of the adolescents were found to be easy access to junk foods, personal taste preferences, peer pressure, media advertisements, and low price of unhealthy snacks (p<0.05). The most influential individuals in snack choice, based on the qualitative phase findings, were peers, while quantitative findings identified parents as the most influential. Applying an integrative approach provided a comprehensive insight into the underlying factors of junk food consumption by adolescents. Intervention programs with due consideration of these factors can help reduce unhealthy snack food consumption in this vulnerable group.