farzad jalilian

Disorders related to the quality and quantity of sleep are among the most important issues of old age. In this regard, the present study aimed to determine the efficacy of an educational program based on the theory of planned behavior for the improvement of sleep hygiene behaviors in the elderly.

This semi-experimental study with efficacy intervention was performed on 60 elderly people in Hamadan City, Iran who were divided into the intervention (n=30) and control (n=30) groups. Development, implementation, and evaluation of the intervention program were carried out based on needs assessment by using the theory of planned behavior and intervention mapping approach. The data collected before and two months after the implementation of the program were analyzed in SPSS software (version 16).

The average scores for attitude, perceived behavior control, and intention significantly increased in the intervention group after the implementation of the program (P<0.05). The estimated effect sizes, based on Cohen's d index, were moderate for attitude (0.7) and perceived behavioral control (0.6), and very large for intention (0.83). However, the estimated effect sizes for subjective norms (0.16) and sleep hygiene behaviors (0.06) were low.

The results were promising in terms of enhancing the intention to engage in sleep hygiene behaviors following the implementation of the program. This suggests that the theory of planned behavior can serve as a useful framework for the development, implementation, and evaluation of programs aimed at the improvement of sleep hygiene behaviors among older adults.

One of the most important strategies recommended to prevent the recurrence of kidney stones is to consume enough water (2 to 2.5 liters per day), which can prevent the recurrence of kidney stones in about 50 to 60 percent. The purpose of this study was to determine the cognitive determinants of water consumption among patients with kidney stones based on the PRECEDE model.

The present study was a descriptive analytical study that was conducted as an convenience sampling among 214 patients with kidney stones referred to Imam Reza Hospital in Kermanshah. The measurement tool was a written questionnaire based on the educational and ecological evaluation step of the PRECEDE model. Data were analyzed using descriptive statistics (prevalence, percentage, mean, standard deviation) and analytical statistics (independent t-test, Pearson correlation and logistic regression) in SPSS version 16 software.

The mean age of respondents was 46.6 years [SD: 14.01], ranged from 17 to 73 years. 13% of patients reported that they consume more than two liters of water per day. Perceived self-efficacy (OR=1.313) and perceived barriers (OR=0.715) regarding water consumption were stronger predictors for water consumption of more than 2 liters per day among patients.

Paying attention to improving patients' self-efficacy and also reducing their perceived barriers regarding water consumption in the design of educational interventions can lead to beneficial results in order to improve water consumption and consequently prevent and reduce the recurrence of kidney stones among these patients.

Detecting and diagnosing it early can greatly reduce the mortality rate. The aim of the present study was to determine the efficacy of the prostate cancer screening promotion program based on the health action process approach (HAPA) in men aged 50 to 69 years in Kermanshah using a Smartphone application.

The present study was a quasi-experimental study that was conducted in two intervention and control groups (40 people each) in 2023. Information was collected using a questionnaire. The obtained information was analyzed in SPSS software version 16.

After the program was implemented, a significant difference was seen in the average scores of action self-efficacy (P < 0.001), intention (P < 0.001), action planning (P = 0.005), coping planning (P = 0.042), coping self-efficacy (P = 0.012), recovery self-efficacy (P < 0.001) and self-monitoring (P = 0.016) between the intervention and control groups. The effect size for risk perception, outcome expectancies, action self-efficacy, intention, action planning, coping planning, coping self-efficacy, recovery self-efficacy and self-monitoring are 0.44, 0.43, 0.97, 0.77, 1.12, 0.46, 0.58, 0.92 and 0.55 were estimated, respectively.

The use of Smartphone applications program based on the HAPA can provide valuable insights in enhancing the acceptance of prostate cancer screening tests. It is recommended to utilize these applications for the development and implementation of men's health promotion programs.

The  Capability, Opportunity, and Motivation Behaviour (COM-B) model is widely used to explain behavior. In this survey, we examined how well the COM-B model could predict the likelihood of Iraqi Kurdish individuals getting vaccinated against COVID-19.

An online cross-sectional survey was developed to explain the COVID-19 vaccine uptake based on COM-B components. Non-probability sampling was used to collect data from 970 Kurdish people in Said Sadiq, Kurdistan Region, Iraq. Data were analyzed in SPSS software (version 16) using bivariate correlation and logistic regression statistical tests.

The mean age of respondents was 32.68 years [95% CI: 31.95, 33.40], ranging from 18-72 years. Based on the results,  46.3% (420/907) of participants had received the COVID-19 vaccine at least once. Older age (OR: 1.021 and P=0.016), government job (OR: 1.691 and P<0.001), a positive family history of COVID-19 (OR: 1.764 and P=< 0.001), physical capability (OR: 1.877 and P<0.001), and automatic motivation (OR: 1.069 and P=0.016) had significant effects on COVID-19 vaccine uptake.

We have found evidence supporting the use of the COM-B model for developing programs aimed at increasing COVID-19 vaccination uptake. To develop effective interventions, it is important to prioritize activities that enhance physical capability and automatic motivation.

Skin cancer is one of the most common cancers. Numerous studies have shown the positive effect of using sunscreen creams in preventing skin cancer. The purpose of this study was to determine the inequality in the use of sunscreen cream.

This cross-sectional study was conducted among adults in Kermanshah city. Data was collected using questionnaire by interview. Concentration index and curve were used to quantify and analyze inequality in sunscreen use. The results of adjusted odds ratio and decomposition analysis for sunscreen use were also estimated.

14.39% used sunscreen. The ratio of use in men was 5.65% and in women was 21.72%. The concentration index for sunscreen use (P<0.001) was 0.344, which indicates the greater concentration of sunscreen use among the rich. The rich groups are 3.72 times more likely to use sunscreen than the poor, and people in the middle class are also 1.48 times more likely to use sunscreen. The highest share of participation in the creation of inequality in sunscreen consumption was achieved by the socio-economic status variable with 61.26%, education level with 13.23% and age with 13.02%.

The focus of health promotion interventions should target groups with low socio-economic status. Men and less educated people should be prioritized in the development and implementation of interventions.

Minthodes oramanatae Gilasian & Ziegler sp. nov. is described as new to science from western province of Kermanshah, Iran. This species is separated from other Minthodes species by its shiny black abdomen, narrow frons, long postpedicel, presence of basal scutellar marginal setae, short petiole of wing cell r4+5 and absence of marginal setae on abdominal tergite 2. Photographs of the male habitus and terminalia are given. The comparison of the morphological characters of M. oramanatae Gilasian & Ziegler sp. nov. with its closely related species M. atra (Kugler, 1971) and M. rossica (Mesnil, 1963) is provided. Photographs of the habitus and male terminalia of M. atra are presented for the first time. The identification key to the Iranian Minthodes species is provided.

Cervical cancer is a significant public health concern and has caused numerous unfortunate deaths. The Pap smear (PS) test is a widely-recognized and affordable screening technique used to detect cervical cancer at an early stage.

This study aimed to investigate the inequality in cervical cancer screening uptake.

This cross-sectional research was conducted on 774 married 30–37 women selected by multi-stage cluster sampling. They were living in Kermanshah City, Iran, in 2019. Their socioeconomic status was evaluated using the principal component analysis (PCA) and was shown by the index and curve of concentration of socioeconomic inequality in PS. The obtained data were analyzed using the chi-square, t-test, logistic regression, and compensation statistical tests.

The mean age of participants was 45.42±10.66 years. About 43.9% of women had education levels under a diploma. Also, 89.3% of women were married, and 58.1% had already done a PS test at least once. In addition, 26.5% of women had a regular PS test uptake. The concentration index for PS test uptake was 0.062 (P=0.115). Education level (OR=1.181, 95% CI; 1.022, 1.364, P=0.024) and a positive family history of cervical cancer (OR=3.591, 95% CI; 1.811, 7.120, P=0.001) had significant impacts on regular PS uptake.

A person’s level of education and family history of cervical cancer were the most critical factors for getting regular PS test uptake. Furthermore, the concentration index showed that the frequency of PS test uptake was slightly higher in the rich group. Focusing interventions on less educated and disadvantaged women may provide useful insights to promote PS test uptake, thereby reducing inequalities. Moreover, using fear appeal strategies to promote PS test uptake may be beneficial.

 Mental health help-seeking is the initial step in evaluating one's mental state, receiving an accurate diagnosis and professional intervention for mental health problems.

 The current study aimed to determine the mental health help-seeking attitudes of older adults in Kermanshah.

 This descriptive cross-sectional research study was conducted in 2022 among 538 individuals aged 60 and above who were beneficiaries of the pension funds in Kermanshah, Iran. The samples were selected by multi-stage cluster sampling. Data were collected through interviews with older adults using a standardized questionnaire. The collected data were analyzed using SPSS software version 16.

 The mean age of respondents was 66.01 ± 4.09, ranging from 60 to 75 years. About 39% (210 people) of older adults had positive mental health help-seeking attitudes, and 61% (328 people) had negative mental health help-seeking attitudes. The positive mental health help-seeking attitudes were higher in older adults with higher educational levels (P < 0.001) and better economic status (P = 0.029).

 The majority of the older adults had a negative attitude towards mental health help-seeking, highlighting the importance of interventions to improve elderly attitudes toward mental health help-seeking.

Bladder cancer is one of the most common malignancies of the urinary system. An important source of health disparities is related to early cancer detection strategies. The present study aimed to determine the inequality in bladder cancer screening uptake.

The current cross-sectional study was conducted on 1,760 subjects from the urban population over 30 in Kermanshah. The adjusted odds ratio was used to show the relationship between bladder cancer screening uptake and different subgroups. The concentration index and concentration curve were used to quantify and analyze inequality in bladder cancer screening uptake.

The history of bladder cancer screening uptake was 1.02% (1.18% in men and 0.88% in women). The mean age of bladder cancer screening uptake was 56.18 years (standard deviation 12.60 years). The highest percentage of bladder cancer diagnostic test uptake pertained to participants who had a positive family history of bladder cancer (23.33%). The concentration index for bladder cancer screening uptake was estimated at 0.238 (P<0.073). The adjusted odds ratio demonstrated that the wealthy group had 10.25 times as many bladder cancer screening uptake as the poor participants.

The odds ratio of bladder cancer screening uptake in the rich group was more than 10 times that of the participants in the poor group. Health resources should be directed to help reduce disparities and provide services to those most in need.

OrganizationalCommitment(OC) isanattitude or orientationtowardthe organization that connects the individual’s identity to the organization.

This study aimed to determine the OC level of Kermanshah University of Medical Sciences (KUMS) faculty members.

This cross-sectional study was conducted among 177 faculty members of KUMS in western Iran. The samples were randomly selected among faculty members. The data were collected by self-reporting using a standard Balfour and Whechler questionnaire and analyzed in SPSS software version 16 using t-tests and Pearson correlations.

The mean score of OC was 28.12 (SD: 4.82), ranging from 9 - 45. There was no significant difference between gender and OC (P = 0.239). OC had a positive and significant correlation with age (r = 0.192 & P = 0.011). The relationship between job history and OC was positive but insignificant (r = 0.147 & P = 0.057).

According to the OC score, emphasizing the subjects and areas of OC can effectively increase faculty members’ dedication to the university

The increasing incidence of chronic kidney disease around the world highlights the need for more attention and appropriate actions to enhance therapeutic outcomes and improve patients’ quality of life. This study aimed to evaluate the efficacy of a program to promote medication adherence among hemodialysis patients using the Capability, Opportunity, and Motivation-Behavior (COM-B) model.

The present study was a quasi-experimental interventional study conducted on 140 chronic kidney patients referred to the Dialysis ward of Imam Reza Hospital (Kermanshah, Iran) divided into two groups of 70 patients as intervention and control during 2021. The program was developed by conducting a needs assessment based on the COM-B model and evaluating it in two stages, before and three months after the implementation. Data were collected by a questionnaire based on the COM-B model and analyzed using the SPSS software (version 16).

After the implementation of the program, the components of capability and medication adherence behavior had a significantly higher average rank in the intervention group. The effect sizes of the intervention components, including capability, opportunity, motivation, and medication adherence behavior, were calculated to be 0.69, 0.19, 0.23, and 0.43, respectively.

Considering the effect sizes of each component, especially behavior, it seems that the developed program based on the COM-B model has enough efficiency and that the employed model is effective for developing programs to promote medication adherence.

Internalized stigma (IS) is defined as negative stereotypes people hold about themselves and have accepted them. The purpose of this study was to determine IS among HIV/AIDS patients in Kermanshah, Iran.

This cross-sectional research was conducted on 200 HIV/AIDS patients in the Behavioral Diseases Counseling Center of Kermanshah University of Medical Sciences, Kermanshah, Iran, in 2021. The required data were collected using a questionnaire and holding an interview. The gathered data were analyzed in SPSS-16 software using one-way analysis of variance, independent samples t-test, and bivariate correlation tests.

The average overall score of IS was obtained at 5.65 (score range: 0 to 6). The mean internalized stigma score was slightly higher among male patients, single individuals, those with primary education, unemployed patients, and those with poor economic status; however, it was not statistically significant.

It can be concluded that IS highly prevalent among HIV/AIDS patients in Kermanshah. Comprehensive interventions among patients are needed to reduce stigma.

Mobile technologies and devices effectively maintain health and well-being is a promising opportunity for health policymakers and relevant stakeholders.

The current study aimed to evaluate a mhealth program to promote smoking prevention behaviors among university students in northern Iraq. The integrative model of factors influencing smoking behavior (IMFISB) was used as a theoretical framework.

This quasi-experimental research study was conducted on 150 Kurdish students of Raparin University in northern Iraq. University students were randomly divided into intervention (n = 75) or control (n = 75) groups. The mhealth theory-based intervention program was evaluated using the mobile application (Avoid Smoking) in eight sessions. The data was collected using a questionnaire before and two months after the program’s implementation and analyzed in SPSS software version 16.

The effect size was estimated as "small" for belief, value, and family pressure. The effect size was estimated as “medium" for knowledge, attitude, peer pressure, self-image, and intention. The average response for smoking prevention behaviors was 15.17, which significantly increased to 16.88 after program implementation among the intervention group (P < 0.001), and the effect size was estimated to be "medium" for smoking prevention behaviors.

Based on the results, smoking prevention interventions can be effective among students using mobile health evidence-based interventions.

Control of Type 2 Diabetes Mellitus (T2DM) is influenced by lifestyle. The aim of this research was to determine the predictors of treatment adherence behaviors among T2DM based on Social Cognitive Theory (SCT).

This descriptive-analytical research was done among 500 T2DM patients in Tehran during 2021. Simple random sampling was performed among patients based their medical records in the Diabetes Control Clinic of Tehran's District Five. The data collection tools were written questionnaire based on the SCT determinants. Data were analyzed using descriptive statistics (frequency, percentage, mean, standard deviation) and analytical statistics (Pearson's correlation and linear regression) in SPSS software version 16.

The mean score of treatment adherence behaviors was 56.34 [SD: 10.41], ranged from 16 to 80. The outcome expectations, perceived self-efficacy, and social support accounted for 43% of the variation in the outcome measure of the treatment adherence behaviors. Self-efficacy was the strongest predictor (Beta = 0.430 and P<0.001). Increasing age (ß= -0.126 and P= 0.004), insulin treatment (ß= -0.250 and P<0.001) and smoking (ß= -0.146 and P= 0.001) conversely and having health insurance (ß= 0.181 and P<0.001) were positively predictive of treatment adherence behaviors.

The development, implementation and evaluation of educational interventions based on SCT with emphasis on promoting perceived self-efficacy can lead to useful findings in promoting treatment adherence behaviors among T2DM patients.

Developing a valid and reliable questionnaire is an essential step in field studies. The present study aimed to evaluate the psychometric properties of the socio-cognitive determinants of water intake questionnaire behaviors among patients with kidney stones in the west of Iran.

Construct items were elicited from interviewing patients with kidney stones, experts, and socio-cognitive items pool-related similar questionnaires. Internal consistency, as well as face, content, and construct validity, were evaluated. Data were analyzed in SPSS (version 20.0). Based on Eigenvalues of ≥ 1.00 and factor loadings of ≥ 0.40, five determinants were extracted.

The calculated Kaiser-Meyer-Olkin (KMO) value was 0.697. The socio-cognitive determinants of water intake questionnaires were found to have acceptable internal consistency (Cronbach alpha of determinants between 0.65-0.85), and the theoretical assumptions for face, content, and construct validities were confirmed. The Intra-class Correlation Coefficient (ICC) of socio-cognitive determinants was high (ICC between 0.810 - 0.911). In general, the five studied socio-cognitive determinants explained 73.83% of the variance in the proposed model.

The socio-cognitive determinants of the water intake questionnaire were revealed to have an acceptable psychometric evaluation. The questionnaire could be used to predict or explain water intake behavior in order to develop programs to increase water intake behavior among patients with kidney stones.

Self-efficacy is an individual's belief in their capacity to reach specific goals and is an important basis for behavior. Mothers play a decisive role in children's Oral Health (OH). The aim of this study was to determine the maternal self-efficacy in OH care of preschool children.

This descriptive-analytical research was conducted among 652 women with 3 to 6-year-old children in Kermanshah city in 2019. The participants were selected using simple random sampling from among the mothers who referred to health centers. The data was collected by a self-reporting written questionnaire.

Family economic status (ß = 0.179 and P < 0.001), and mother education (ß = 0.104 and P = 0.032) were predictors of maternal self-efficacy in OH care of children. Mothers received about half of the score of the self-efficacy questionnaire. Maternal self-efficacy in OH care was lower when they felt stress, depression, and anxiety.

Mothers obtained about half of the score of the self-efficacy questionnaire. The necessity of developing and implementing interventions to improve maternal self-efficacy in OH care is felt, especially for mothers with lower education and Families with a weaker economic status.

Breast cancer is the most common cancer among Iranian women. Numerous studies have shown the positive effect of screening behaviors in reducing breast cancer mortality. The aim of this study was to determine the level of inequality in breast cancer screening tests uptake (breast self-exam (BSE), clinical breast exam (CBE), and mammography) in western Iran.

This cross-sectional study was performed among 907 women aged 30 and older in Kermanshah. Data were collected using a questionnaire through interviews. The concentration index and concentration curve were used to quantify and analyze inequality in breast cancer screening (SBE, CBE, and mammography). Crude and adjusted odds ratios were used to assess the relationship of each of the three screening behaviors with different subgroups.

The history of SBE, CBE, and mammography were 28.22%, 18.85%, and 17.75%, respectively. The concentration curve was calculated to be 0.268 (P < 0.001) for SBE, 0.126 (P < 0.001) for CBE, and 0.066 (P = 0.166) for mammography.

The focus of health promotion interventions should be on groups of low socioeconomic status. The development of public awareness-raising campaigns, especially for less educated women, can lead to favorable results in reducing inequality in breast cancer screening test uptake.

Spatial distribution of the English grain aphid, Sitobion avenae (F.), was studied in wheat fields of Mahidasht, Kermanshah province and Sequential sampling models with fixed precision level were prepared for its monitoring. Sampling was conducted during five years. At each sampling date, 100 tillers were randomly visited. The mean range of population density in wheat field was 0.39-34.01 aphids/ tiller. Taylor's Power Law parameters were used to preparing sampling models according to Green (1970). Spatial distribution was determined as cumulative. Sample size decreased with increasing aphid population density in sampling models. In research precision level of (0.1), the sample size required at the highest average population density observed in the field (34.01/ tiller) was 136, which in precision level proposed for integrated pest management (0.25) reduced to 22 tillers. Overall, due to the large sample size at the precision level of 0.1, the model prepared at the precision level of integrated pest management (0.25) was recommended for monitoring S. avenae. The recommended model can reduce sample size more than six times at different densities in comparison to the sequential sampling model at the precision level of 0.1.

 Hepatitis B (HB) is one of the important common occupational diseases, and health care workers are one of the most at-risk groups. The current study aimed to investigate the best psycho-social predictors of HB preventive behaviors among nurses by using the theory of planned behavior (TPB).

 The current research was a cross-sectional study. An anonymous self-reported scale according to the TPB determinants was distributed among 330 nurses in Kermanshah, and 299 (90.6%) questionnaires were returned. Nurses were randomly selected among different teaching hospitals in Kermanshah in 2016. Data were analyzed by SPSS version 16 using Pearson correlation, one-way analysis of variance, independent samples t test, and linear regression tests.

 The mean score for the HB preventive behaviors was 3.14±1.45 ranging from 1 to 5. The TPB determinants accounted for 21% of the variance in nurses’ HB preventive behaviors. Attitude and perceived behavior control (PBC) were the best determinants of performing HB preventive behaviors. Furthermore, higher education level, gender (female), and family history of HB were effective in the higher score of HB prevention behaviors (P<0.001).

 In developing programs and policies to prevent HB among nurses in Iran, attitude and PBC should be considered. These findings may guide HB interventions to improve the capacity to seek HB preventive behaviors.

Spiritual intelligence (SI) is a combination of many factors such as the capacity for transcendence, transcendental awareness, recognition of spiritual beings, and the use of spiritual resources to solve problems. This study aims to determine the SI of students in Kermanshah University of Medical Sciences (KUMS) and its relationship with demographic and educational factors.

This descriptive-analytical study that was conducted on 318 students of KUMS in Kermanshah, Iran in 2017 who were selected using a random sampling method. The data were collected using a self-report questionnaire. Data were analyzed in SPSS software, version 16.

The Mean±SD of SI was 102.53±22.53. The students obtained 70.7% of the maximum obtainable score for SI. In overall, 75 students (25.3%) had low SI, 213(72%) had moderate SI, and 8(2.7%) had high SI. Older age had a significant relationship with SI (P=0.033).

Most of students in KUMS have moderate SI. It can be improved by educational interventions.

Adherence to the regular medication has an important role in controlling and treatment of AIDS. The aim of the present research was to develop, implement, and evaluation of an interventional program to promote medication adherence among AIDS patients referred to Behavioral Diseases Counseling Centers in Kermanshah by using the I-Change model.

The present research was a quasi-experimental interventional efficacy study among a total of 150 AIDS patients in Kermanshah, 2021 who were randomly selected and assigned to intervention and control (each, n = 75) groups. The intervention development was based on the I-Change model needs assessment and intervention mapping approach, the collected data was evaluated before and three months after the implementation intervention. Data were analyzed by SPSS-16.

The mean age of patients was 39.11 [SD: 6.07], ranging from 22 -51 years. After implementing the intervention in the intervention group, the mean score of regular medication adherence behaviors (P <0.001, d= 0.48) and knowledge (P = 0.028, d= 0.31) was significantly higher and the perceived barrier (P = 0.020, d= 0.35) was lower than in the control group.

I-Change model can be used as a basis for the development of interventional programs to improve medication adherence among AIDS patients.

The false chinch bugs, Nysius cymoides (Spinola) (Hem., Lygaeidae) is a polyphagous and cosmopolitan distributed and it causes damage as the most important pest in canola fields in Kermanshah province in the recent years. In the present study, population fluctuations and spatial distribution of the pest were investigated in canola fields of Kermanshah province during 2020 and 2021 years. The results of this study showed that the first group of the false chinch bugs populations in 2020 and 2021 were observed on the 8 and 11th of April, respectively.The second population peak of the pest in 2020 and 2021 with an average of 372.22 ± 66.31 and 126.45 ± 4.58 was obtained on 22 and 19th June, respectively. The highest population density of nymphs in 2020 and 2021 with an average of 1263.50 ± 125.19 and 206.00 ± 3.91 was obtained on 23th June. The results of spatial distribution showed that in 2020, the spatial distribution of males, females and adults of the N. cymoides was recognized as aggregated based on Taylor’s power law method and as random based on Iwao’s patchiness regression method. In general, the results of this study showed that N. cymoides had two population peaks. Also, based on goodness of fit, the Iwao’s patchiness method was more suitable than the Taylor’s power law method for estimating the spatial distribution of the pest.

Sleep quality and quantity disorders are among the most important problems in old age. Healthy sleep behaviors are among the best ways to deal with sleep disorders among the elderly. This study aimed to determine the socio-cognitive determinants predicting healthy sleep behaviors among the elderly who had been referred to the retirement centers in Hamadan, Iran.

This cross-sectional study was performed among 288 elderly people who had been referred to the retirement centers in Hamadan, Iran in 2020, and were selected through stratified random sampling. Data were collected online using a self-administered questionnaire with items on demographic characteristics and the theory of planned behavior (TPB) constructs. Data were analyzed by SPSS software (version 16) using Pearson correlation, independent t test, one-way ANOVA, and linear regression tests at the significance level of 0.05.

The mean (±standard deviation) age of respondents in this study was 67.2 (±6.3) years. Perceived behavior control (β=0.409), attitude (β=0.251), and subjective norms (β=0.205) were stronger predictors of healthy sleep behavior intention among the elderly, respectively; collectively, they accounted for 28.5% of the variation in sleep health behavior intention. Behavioral intention (β=0.429) and perceived behavioral control (β=0.167) were also predictors of healthy sleep behaviors among the elderly. There was a statistically significant relationship between the educational level and healthy sleep behaviors (P<0.05).

It seems that the development and implementation of educational programs based on the TPB for the improvement of attitudes, subjective norms, and perceived behavior control can play an effective role in promoting healthy sleep behaviors and sleep quality among the elderly.

Today, it is essential that new technologies such as Smartphone’s and their tools, such as applications, be considered in the design of health interventions. The purpose of this study was to determine the efficiency of educational intervention on promoting communication skills among students using the m-health approach based on theory of planned behavior.

We conducted a quasi-experimental intervention study among 160 university students in Kermanshah University of Medical Sciences (KUMS) during 2020. Data were measured using a self-report questionnaire based on theory of planed behavior constructs. Results were measured at the beginning and two months after the intervention. Data were analyzed by SPSS version 16 using chi-square, Independent Samples t-test, and paired sample t-test.

The mean age of students was 21.88 years [SD: 2.51]. Our findings showed the efficiency of the intervention in increasing the scores of attitude (32.05 increased to 32.76; P=0.005), subjective norms (12.19 increased to 12.40; P=0.038), and behavioral intention (10.32 increased to 11.95; P<0.001) towards learning communication skills in the intervention group. Also, the estimated effect sizes for attitude, subjective norms, and intention were 0.48, 0.23, and 0.72, respectively.

We have shown that the tested m-Health program has been effective in promoting attitudes, subjective norms and intentions to learn communication skills. Given the availability of this technology, it seems that it can lead to useful findings in promoting youth health.