Design and evaluation of two educational media in the form of animation and games to promote the cutaneous leishmaniasis prevention behaviors in adolescent female.

BACKGROUND: Cutaneous leishmaniasis (CL) has social and psychological effects on different groups, especially adolescents and young girls in 98 countries of the world, in addition to the economic burden. Therefore, it is necessary to apply effective methods for CL prevention. In this study, educational messages were designed based on Extended Parallel Process Model in both forms of animation and game, whose effect on the cutaneous leishmaniasis prevention behaviors was evaluated in adolescent female students.  METHODS: This experimental study was carried out from January to September 2021 on 275 adolescent female students in Isfahan province, Iran. Cluster sampling method was used, and then the students were randomly divided into three groups, namely animation education, game education, and control groups. The educational intervention was performed with two new media in the form of animation and games. The data collected before and two months after the education through a valid and reliable researcher-made questionnaire were analyzed in SPSS24 software using statistical tests of ANOVA, Chi-square, paired t and analysis of covariance (ANCOVA). RESULTS: The mean age of the participants was 14.07 ± 0.94. The mean scores of behavior in the animation group (60.60 ± 23.00), the game group (61.70 ± 22.05), and the control group (66.13 ± 24.62) were not significantly different prior to the education. However, after the education, there was a significant difference between the animation (80.66 ± 17.62) and game groups (82.58 ± 19.07) and the control group (69.79 ± 23.29) (P < 0.001). The mean scores of model constructs following the intervention (susceptibility, severity, response efficacy, and perceived self-efficacy) significantly increased in the animation and game groups compared to that in the control group (P < 0.05). CONCLUSION: The results showed that if educational programs contain a combination of threat and efficiency messages, CL-preventive behaviors in adolescents increase. Providing similar educational content with both game and animation methods indicated that both methods had an almost same effect. Although animation production is more costly, it has the advantage of being used in periods and for other adolescents.

Development and psychometric assessment of cutaneous leishmaniasis prevention behaviors questionnaire in adolescent female students: Application of integration of cultural model and extended parallel process model.

BACKGROUND: Cutaneous Leishmaniasis (CL) is an important public health issue in at least 83 countries, including Iran. Individuals' behavior modification is believed to be one of the best ways for CL prevention. However, no comprehensive questionnaires have been psychoanalyzed for identification of CL prevention behaviors and its numerous associated factors, as well as the impact of educational messages. Thus, the present study was conducted to develop and psychometrically assess CL prevention behaviors questionnaire in female students. METHODS: The present study was performed from October 2020 to May 2021 by developing a preliminary questionnaire based on integration of Cultural Model and Extended Parallel Process Model. The questionnaire was completed online by 460 adolescent female students living in endemic areas of Isfahan, Iran. Exploratory factor analysis was performed using SPSS 24 to ensure the construct validity. Internal reliability was assessed via Cronbach's alpha and external reliability was determined using the test-retest method based on the intraclass correlation coefficient (ICC) index. RESULTS: The first version of the questionnaire contains 110 items, out of which 82 remained according to content validity ratio (CVR) and content validity index (CVI) criteria. Afterwards, 11 items were removed due to low factor load in the construct validity process using the factor analysis technique. Ultimately, a 71-items questionnaire was developed and 12 factors were extracted from it. According to Cronbach's alpha index, the internal reliability for the questionnaire was 0.877 and the ICC index calculated the external reliability as 0.833. CONCLUSIONS: Integration of a Cultural Model with individual model was used for the first time to measure the factors related to CL prevention behaviors in this questionnaire; owing to the strength of the factor structure and appropriate psychometric properties, the questionnaire is applicable in the evaluation process of educational interventions concerning CL prevention, especially in female students.

Behaviors and Perceptions Related to Cutaneous Leishmaniasis in Endemic Areas of the World: A Review.

The investigation of perceptions and behaviors associated with cutaneous leishmaniasis (CL) in different societies has indicated that mere attention to biological and medical aspects is not enough to prevent and control diseases and it is necessary to know the disease-associated behaviors and beliefs. The present study aimed to answer a question: what are the behaviors and perceptions associated with cutaneous leishmaniasis in endemic regions of the world?. This study is a review of the articles published on CL from January 2010 to January 2021, on the International databases Science Direct, Scopus and PubMed. We utilized the terms cutaneous leishmaniasis, in combination with some keywords, including belief, perceptions, knowledge, attitude, practices, prevention, and behavior. Non-original studies, including editorials, reviews, prefaces, brief communications, and letters to the editor, CL epidemiological articles, pre-published articles that has not been peer reviewed, and articles that not provide complete findings on CL-related perceptions and behaviors were excluded from the present paper. After screening, 25 articles from 17 regions of the world were included in the study. The results depicted a novel classification of behaviors and perceptions related to CL prevention and control. Two positive and negative categories of perceptions and behaviors were discovered. Positive perceptions and behaviors were classified into five categories, including: 1- good awareness, 2- perceived susceptibility, 3- perceived severity, 4- perceived response efficiency, and 5- appropriate behaviors. Furthermore, negative perceptions and behaviors were classified into four categories: 1- poor awareness 2- misconceptions (A. About the disease vector B.about the cause of the disease, C. about the consequences of the disease and the treatment process), 3- perceived barriers (A. in prevention, B. in medical treatment), and 4- misbehaviors (A. negligence, B. local and traditional behavioral patterns). In most endemic parts of the world, misconceptions are probably the leading cause of several misbehaviors in dealing with CL. It seems that providing educational programs to strengthen positive beliefs and correct negative beliefs are rooted in the studies in different countries and could be useful for improving the relevant behaviors and ultimately, taking a step towards the prevention and control of CL.

Role of self-efficacy, outcome expectation, and outcome expectancy in promoting oral health behaviors in adolescent girls.

INTRODUCTION: Oral health is a very important issue for different groups, especially adolescents. Social cognitive theory seeks to describe and promote people's health behaviors in a variety of ways. The aim of this study was to determine the role of self-efficacy, outcome expectation, and outcome expectancy in promoting oral health behaviors in adolescent girls in Shahrekord. METHODS: The present study was performed as an intervention in junior high schools in Shahrekord (school year: 2018-2019). Using cluster sampling method, a total of eighty adolescent girls studying in Shahrekord public schools were selected and randomly divided into two groups of intervention and control. A researcher-made questionnaire was used to collect data on demographic variables, outcome expectation, and outcome expectancy constructs. In addition, a checklist was used to assess the status of oral health among the participants. Education for the experimental group was held in four sessions, each lasting 50-60 min. The data required for the study were collected in three stages: before the intervention, immediately after, and 2 months after the intervention. Using SPSS statistical software version 18, the collected data were analyzed through paired t-test and analysis of variance via repeating the observations. RESULTS: There was no significant difference between the two groups in terms of demographic variables. Before the intervention, there was no significant difference between the two groups in terms of the mean scores of outcome expectation, outcome expectancy, and self-efficacy; however, after the intervention, there was an increase in the scores of the experimental group (P < 0.001). Two months after training, there was also a significant increase in the mean score of oral health behavior in the experimental group (P < 0.001). CONCLUSION: Training based on perceived self-efficacy, outcome expectation, and outcome expectancy played an important role in creating the desired attitude toward oral health-promoting behavior among students.

Comparing the impact of educational messages based on an extended parallel process model on solid waste separation behaviors in female students: A four-group randomized trial.

BACKGROUND: The increase in non-separated solid waste is a threat to environmental health. People may be motivated to reduce the destructive effects of waste accumulation in the environment by receiving educational messages and learning the proper methods of waste separation. This study aimed to determine the effect of educational messages on waste separation in dormitory students based on Extended Parallel Process Model (EPPM). METHODS: This randomized controlled trial was performed on 320 students categorized into four groups from October to December 2019. After installing waste separation tags on separate containers, three types of messages were presented to encourage and educate waste separation in the following four groups: threat messages; efficacy messages; threat/efficacy messages; and control group. Data were collected prior to and one week after training by a self-reported valid and reliable questionnaire. They were analyzed in SPSS21. RESULTS: In the efficacy group and threat/efficacy group, not only the mean scores of "perceived threat associated with non-segregation and waste accumulation", "attitude" and "intention" but also the mean score of "efficacy" and "waste separation behavior" were improved (P < 0.05). In both groups, the mean score of "perceived barriers" for waste separation was lower than the other two groups (P < 0.001). DISCUSSION: Use of efficacy-based massages alone or in combination with the threat component was proposed to promote waste separation. No specific study has documented the effectiveness of messages based on EPPM on solid waste separation behaviors. The current study highlighted the effectiveness of using EPPM to promote waste-separation behavior in practice, not in theory.

Development and psychometric evaluation of waste separation beliefs and behaviors scale among female students of medical sciences university based on the extended parallel process model.

BACKGROUND: The increasing production of un-recycled waste is a great threat to public health. Therefore, assessment and measurement of people's beliefs and perceptions with regard to these threats can contribute to the development of suitable educational messages promoting waste separation behaviors. This study aimed to carry out the scale development and psychometric evaluation of behaviors and beliefs associated with waste separation among female students. METHOD: This methodological research was performed in 2019. The primary questionnaire was developed based on the assessment of waste separation beliefs and behaviors based on the extended parallel process model. Afterwards, to confirm the content and face validity of the research tool, the opinions of 14 faculty members and certain students were asked for, respectively. In order to assess the construct validity of the questionnaire, exploratory factor analysis was performed based on the data collected from 386 female students in Isfahan University of Medical Sciences, Iran. The internal and external reliability of the tool was determined through estimating Cronbach's alpha and test-retest based on intraclass correlation (ICC) index, respectively. RESULTS: The mean age and academic semester of the students were 22 ± 1.9 years and 5.58 ± 2.6, respectively. The primary version of the questionnaire was designed with 65 items; one item was omitted during the content validity process. Construct validity with factor analysis technique yielded nine dimensions including 64 items with a factor loading above 0.3. The overall reliability of the research tool was confirmed at Cronbach's alpha of 0.87. Furthermore, the ICC of the entire questionnaire was 0.89. CONCLUSION: According to the results of the study, the final 64-item questionnaire could be used by various researchers to assess waste separation beliefs and behaviors considering suitable psychometric features.