shayesteh shirzadi

We developed a protocol for a health literacy promotion program (HeLPP) to promote self-care behaviors and quality of life (QOL) among T2DM patients in Chaldoran County, Iran. To develop the educational program, we primarily conducted a behavioral and educational assessment on the pre-test data collected from the participants. In this paper, we report a summary of the protocol and the primary results of the pre-test findings.  The HeLPP protocol is naturally developed for a randomized controlled trial with Solomon four-group design. Developing the HeLPP, we will conduct it for both test groups. To plan the HeLPP and to find the main predictors of self-care behaviors and QOL, we firstly conducted a cross-sectional study (as a needs assessment phase). So, applying simple random sampling, data on 160 patients were collected and analyzed. The validated scales (Health Literacy Questionnaire (HLQ), Self-care activities scale, and Diabetes QOL Brief Clinical Inventory) were used to collect data. The mean age of participants was 61.08 ± 11.35. The most significant determinants of self-care behaviors were understanding (β: 0.26), reading skills (β: 0.23), and knowledge (β: -0.19). Self-care behaviors (β: 0.29) and decision-making (β: 0.28) were significant predictors of QOL.  Considering the predicting role of understanding, reading skills, and decision-making for self-care behaviors and QOL of the rural T2DM patients, the focus of HeLPP should be on clear communication, goal-setting, and teach back strategies. The developed protocol seems to be helpful in promoting the outcome variables of the study.

One of the factors influencing the modification of menopausal symptoms is healthpromoting behaviors (HPBs). Nevertheless, women do not have sufficient knowledge about HPBs and do not earn the required information and training in this field. The current study was thus performed to study the relationship between HPBs and menopausal symptoms (MSs) among Iranian postmenopausal women (PMW).

Using stratified random sampling, this current cross-sectional study was carried out on 300 PMW covered by Neyshabur healthcare centers in 2022. Data gathering was conducted using three questionnaires: demographic characteristics, health-promoting lifestyle profile-II (HPLP- II), and menopause rating scale (MRS). Pearson correlation test and stepwise regression analysis were used for analyzing data by SPSS v. 22, and the significance level was less than 0.05.

The mean age and menopausal age of participants were 56.4 (4.1) and 49.4 (3.3), respectively. There was a significant negative statistical relationship between the total score of HPBs and its subscales and MSs (P < .05). Physical activity, spiritual growth, and having chronic diseases were found to be independent predictors of MSs.

Based on the findings, there was an adverse correlation between HPBs and MSs in the women who participated in the study. Executing educational programs focusing on maintaining and promoting a healthy lifestyle can reduce MSs; as a result, increasing overall women’s quality of life.

 Proper elucidation of medication non-adherence reasoning especially in older adults might pave the way for an auspicious therapeutic outcome. The main aim of this study was to develop and psychometrically test the Medications Non-adherence Reasoning (MedNARS) questionnaire for application in research and probably practice settings.

 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.

 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).

 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.

Our objective was to determine the frequency of inadequate functional health literacy (FHL) among adult Kurd population, and infer the contribution index of sociodemographic factors for FHL across gender.  In this cross-sectional study, multistage cluster sampling was employed to recruit 1000 people older than 18 years from 38 urban and 14 rural healthcare centers in Sanandaj, Iran. Data on FHL was collected from May to July 2019, through face-to-face interviews by using the validated Persian version of the Test of functional health literacy in adults (TOFHLA). The concentration index method was used to measure inequality in FHL.  Overall, 869 respondents (response rate: 86.9%) with a mean age of 33.68 (±13.0) completed the TOFHLA questionnaire. The average TOFHLA score was 51.9, which was 52.2 (±0.46) among males and 50.7 (±0.40) among females, p<0.001. Among females, the place of residence, monthly income, age, education level, and being head of the household contributed to 43%, 32%, 13%, 11.5%,  and 11% of FHL inequality, respectively. While, among males, the place of residence (45.2%), household size (15.1%), and monthly income (13.5%) contributed most to inequality in FHL.  FHL has disparities by gender and location. Males and rural people are at particular risk for poor FHL. For ease and better resolution of poor FHL, each population, gender, and area type should be considered as a stand-alone, which may help in identifying tailored interventions for males and females with low levels of FHL.

  The changing nature of work in today's world has caused a large number of people to be engaged in sedentary jobs. In such cases, lack of physical activity can lead to non-communicable diseases and increase morbidity and mortality. The purpose of this study was to provide a step-by-step descriptive design, implementation, and evaluation of a physical activity promotion program in the workplace using an intervention mapping approach.

Methods and Materials:

 In this study, evidence-based and theory-based intervention design, guided by the steps of an intervention mapping approach, to promote physical activity in the workplace is described.

Physical activity intervention was performed based on workplace as well as individual and interpersonal, environmental, and organizational goals. Interventions include using the Ministry's gym for all employees, consulting with sports experts and instructors, increasing the Ministry's sport administration programs, holding a cultural festival for the participation and cooperation of all managers, employees and their families, photography, and painting competitions, and helping physical activity assistants for follow-up and feedback. Communication channels included posters, pamphlets, labels, motion graphics, stands, booklets, and movies.

Intervention mapping ensures transparency of all components of the intervention and provides a systematic, theory-based, and evidence-based approach to interventions development in the sedentary behavior changes among employees.

Self-medication is one of the chief health problems and educational programs on its prevention are very important. An educational program can be considered effective, if it can make the necessary changes in participants’ knowledge and behavior. The aim of this study was to evaluate the educational prevention program of self-medication in women using the Kirkpatrick model.
This evaluation study was carried out on 88 women. The cluster sampling method was used. The data collection tools consisted of the Dundee Ready Educational Environment Measure (ýDREEM) and a researcher-made questionnaire based on the Kirkpatrick model, the validity and reliability of which were measured. The experimental group attended the educational program for 1 month. The effectiveness rate of the course was calculated based on significant differences in learning, reaction, and behavior scores of the case and control groups during the pre-test and post-test. The collected data were analyzed in SPSS statistical software using descriptive and analytical statistical tests.
The mean scores of desirability rate of participants’ reactions in terms of students’ perception of learning environment, students’ academic self-perception, students’ social self-perception, students’ perception of atmosphere, and students’ perception of teachers were 44.81 ± 7.06, 31.50 ± 4.11, 22.50 ± 3.54, 43.10 ± 7.46, and 41.37 ± 5.20, respectively. After the educational intervention, t-test results showed a significant difference between the experimental and control groups in mean score of knowledge change and attitude change in the second evaluation level, and also between mean score of behavior change in the third level (P According to the Kirkpatrick model, the educational prevention program of self-medication resulted in favorable outcomes in the three evaluated levels of reaction, learning, and behavior, and showed satisfactory efficiency.

Adolescence is a critical stage of growth and development. That is associated with changes in body shape and appearance. Issues such as irregular menstrual periods, amenorrhea, and menstrual cycle are major issues in women's health. The purpose of this study was to examine the determinants of physical puberty health based on the Health Belief Model (HBM) among female adolescents.
This analytical cross sectional study was conducted in welfare boarding centers in Tehran, Iran. Data were collected in 2011 by a structured and valid questionnaire. Total 61 female adolescents (age range: 12-19 yrs) participated in this study from welfare boarding centers in Iran, Tehran, by using convenience sampling method. The questionnaire consisted of demographic characteristics, health belief model constructs and physical puberty health behaviors gathered by using interview. A series of univariate general linear models were used to assess the relationship between puberty health and health belief model constructs.
According to the results of this study there were positive significant relationships between perceived susceptibility, perceived benefits, perceived barriers, cues to action and increased puberty health in female adolescents (p Based on the results of the study to improve the physical Puberty health behaviors of female adolescents should make them aware of the benefits of health behaviors, and remove or reform the perceived barriers of health behaviors. Also, the appropriate information resources should be introduced for obtaining information about puberty health.

The puberty as a stage of life is an important developmental process. Teen girls have numerous health care needs and their specific aspects should be considered.. In this study we applied explanatory model to determine the role of health belief model constructs on physical puberty health among teen girls.. This correlational cross-sectional study was conducted in 2011, and attempted to determine the total, indirect and direct effects of health belief model construct on physical puberty health behaviors. The population studied included 61 girls aged from 12 to 19 years from welfare boarding centers in Iran (Tehran), and selected by convenience sampling method. Data on demographic characteristics, health belief model constructs and physical puberty health behaviors were collected using an interview-based questionnaire, and analyzed by structural equation modeling.. The perceived variables such as susceptibility, severity, benefits, barriers and cues to action showed their direct effects on physical puberty health behaviors. Also perceived benefits affected physical puberty health behaviors indirectly through perceived susceptibility. The total effect of perceived benefits on physical puberty health behaviors was 0.292. There are positive significant relationships between perceived susceptibility, perceived benefits, perceived barriers and physical puberty health behaviors as well as path coefficient. SE for each of them were, (0.27 (0.11)), (0.32 (0.09)) and (0.2 (0.06)), respectively.. Since benefits of physical puberty health behavior were the most important predictor of this puberty health behavior, it is concluded that increasing the benefits along with improving each of the perceived susceptibility, severity, barriers and cues to action can lead to increasing physical puberty health behavior and health promotion..

PRECEDE model is the most appropriate model for planning in health education and promotion. The aim of this study is the effect of educational intervention based on PRECEDE model on the regular physical activity among elderly people. In this study, 80 elderly people were selected based on inclusion criteria and randomly assigned in experimental and control groups. Educational program for regular physical activity was designed with considering predisposing, enabling, reinforcing factors that are effective for regular physical activity in elderly people. Before educational intervention, questionnaires completed by the participants and then experimental group received the educational intervention. After one month of intervention the questionnaires were filled again and collected data was analyzed with SPSS-21, t-test and Chi-Square and ANOVA. Mean to 25, self- efficacy of 9.62 to 13.97), reinforcing factor (6.22 to 8.32) and enabling factor (8.37 to 16.67) in experimental group in signiticant level. Education was effective on predisposing,enabling and reinforcing factors that are effective for regular physical activity in elderly people. By using Educational diagnosis phase of PRECEDE model we can plan various educational programs for encouraging elderly people for doing regular physical activity.

Focus group discussion is a research methodology in which a small group of participants gather to discuss a specified topic or an issue to generate data. Menstrual prob-lems are a major cause of morbidity for women. This study mainly aims to determine the impact health education based on focus group discussion on promotion Hygienic practices during menstrua-tion of female adolescents welfare boarding centers of Tehran city. This is a quasi-experimental intervention study، conducted Female adoles-cents inhabitant welfare boarding centers of Tehran city. All eligible persons were selected (n=61). Data collection tool was a questionnaire including demographic information، performance regarding pubertal physical health and that completed before training and one month after training by inter-view. Educationalinterventionwasimplementedin3 months. Data was analyzed by statistical methods (Paired T Test and Kalmogorov– Smiranov Test) using SPSS16 software. After educational intervention the mean scores of Hygienic practices during menstruation increased from 12/114/43 to 16/502/79 based on Statistical test was significant (P<0/001). After training through group discussion Increased Hygienic practices during menstrua-tion، so this method can be used in education to girls during puberty.

Increasing elderly population has increased attention to improve quality of life in elderly people. This paper aimed to study the effect of educational intervention based on the PRECEDE model to promote quality of life in elderly. In this experimental study, 80 elderly people were randomly divided into two intervention and control groups. Planning of educational program was performed according to the PRECEDE model. Before implementing the program, Quality of life questionnaire and a self-designed and standard questionnaire according to the PRECEDE Model were filled in both groups. Both groups were followed up one month after the intervention and previous questionnaires were filled again. Collected data was analyzed using paired T-test, independent sample T-test, one way ANOVA, Chi-square and ANCOVA by SPSS-21 software. Through health promotion intervention, the mean score of quality of life increased from 76.77±13.23 to 82.87±12.25. There was a significant difference between the total score of quality of life of intervention and control groups (P=0.031). In addition, findings showed a significant difference in physical, mental, environmental and social dimensions before and after the intervention (P<0.05). Using the PRECEDE model could help to identify influential factors on quality of life in elderly and developing effective educational programs.

Puberty as a stage of life is an important developmental process. Teen girls have numerous health care needs and their specific issues should be considered. This study mainly aimed to determine the impact of education based on health belief model on promotion of physical puberty health among female teenagers who were residents in welfare boarding centers in Tehran city.

It was a quasi-experimental intervention study, conducted in welfare boarding centers of Tehran city among inhabitant girls with 12 to 19 years old. All eligible persons were selected (n=61). Data collection tool was a questionnaire including demographic information, health belief components, physical function during menstruation, completed before and one month after training by interview. Educational intervention was implemented in 3 months. Data was analyzed by Wilcoxon statistical test using SPSS16 software.

After educational intervention, perceived severity (p<0.001), perceived susceptibility (p<0/001), perceived barriers (p<0.001), perceived benefits (p<0.001), and physical function during menstruation were significantly different.

Educational intervention improved girl's perceptions and performance. Thus, health belief model should be used for puberty health education planning in female adolescents.