Enhancing physical activity participation among female employees: evaluating the effectiveness of an educational intervention.

This paper evaluates the effectiveness of an educational intervention based on the transtheoretical model aimed at increasing physical activity (PA) participation among female employees in Bandar Abbas city (Iran) healthcare centers in December 2017 and August 2018. Using a semi-experimental interventional study design with a randomized and multi-stage method, 100 participants were included in both the intervention (n = 50) and control groups (n = 50). Data collection involved questionnaires assessing demographic information (age, gender, marital status and education), stages of change in PA behavior, Perceived Benefits, Barriers and Self-efficacy. The data were analyzed using SPSS-16, employing both descriptive (mean, SD, frequency, percentage) and inferential statistics (t-tests, chi-squared tests, etc.). Prior to the educational intervention, 19 participants (0.38%) in the intervention group engaged consistently in PA (stages 4-5). After 3 and 6 months of intervention, these numbers increased to 29 (0.58%) and 25 (0.50%), respectively. This improvement was statistically significant compared to the pre-intervention stage (P < 0.001). The findings highlight the importance of theory-based behavior change models and health education programs in promoting PA and combating sedentary lifestyles. Although focused on a specific population in Bandar Abbas, the intervention can serve as a model for similar programs targeting diverse social classes and populations.

Mono and polycyclic aromatic hydrocarbons in waterpipe wastewater: Level and ecotoxicological risk assessment.

Increasing of tobacco consumption around the world has led to the production of a large volume of waterpipe wastewater that enter the environment (e.g., coastal areas)and threaten aquatic creatures. However, until now, no research has been carried out on the amounts of monocyclic and polycyclic aromatic hydrocarbons (PAHs) in hookah wastewater. In the current study, the levels of PAHs and BTEX compounds in waterpipe wastewater resulting from the use of different tobacco brands were determined and their eco-toxicological effects were also evaluated. The mean levels of Æ©PAHs in waterpipe wastewater of Al Tawareg, Al-Fakher, Nakhla, Tangiers and traditional tobacco brands samples were 3.48 ± 1.65, 3.33 ± 1.52, 3.08 ± 1.25, 2.41 ± 0.87 and 0.70 ± 0.13 µg/L, respectively. The mean levels of Æ©BTEX in waterpipe wastewater of Al Tawareg, Al-Fakher, Nakhla, Tangiers and traditional tobacco brands samples were also 2.53 ± 0.61, 2.65 ± 0.78, 2.51 ± 0.72, 2.35 ± 0.56, and 0.78 ± 0.12 µg/L, respectively. The maximum level of PAHs and BTEX compounds in all brands/flavors samples were for naphthalene (Naph) and toluene, respectively. The concentrations of some PAHs (fluoranthene (Flrt), anthracene (Ant), benzo(b)fluoranthene (BbF), benzo(b)fluoranthene (BkF), benzo (g,h,i)perylene (BghiP) and dibenzo (a, h) anthracene (DahA)) and BTEX compounds (benzene) in the waterpipe wastewater samples were more than recommended guidelines and standards by the international reputable organizations such as World Health Organization (WHO) for water quality. Waterpipe wastewater can be introduced as an important origin for the release of these dangerous contaminants into the environmental matrixes. Therefore, more stringent regulations should be considered for the safe disposal of such hazardous wastes including waterpipe wastewater.

Assessing the risk of metabolic syndrome and diabetes in relation to Hookah smoking: Evidence from a cohort study in Southern Iran.

Background: Hookah smoking has pointedly increased worldwide and could have different harmful health effects. However, long term hookah smoking effects on chronic diseases has not been well studied. This study was aimed to investigate the relationship between hookah smoking with metabolic syndrome and diabetes. Methods: In this prospective study, the baseline data from 3695 participant (35-70 years old) of Bandar-e-Kong cohort study in Hormozgan province, Iran were used. In this study, data were collected through the questionnaires designed in the Kong cohort study and 25 mm of blood sample. All analyses were performed using SPSS version 27.0 and the ggplot2 package in RStudio version 2023.06.1 + 524. p < 0.05 was considered a significant difference. Results: The prevalence of hookah smoking was 17.3% in total. Also, the prevalence of metabolic syndrome, diabetes, hypertension, and dyslipidemia were 35.6, 15.2, 31.2, and 78.0%, respectively. Our results showed that there were statistically significant relationship between hookah smoking and metabolic syndrome, hypertension and diabetes (p < 0.05). In the case of dyslipidemia, hookah smoking was also associated with increase in dyslipidemia (p < 0.05). Conclusions: More evidence is needed to understand the mechanism of hookah smoking and these health effects. As well as, health education and increasing public awareness about the health effects of hookah smoking and implementation of smoking prohibition policies are highly recommended.

The effectiveness of a theory -based health education program on waterpipe smoking cessation in Iran: one year follow-up of a quasi-experimental research.

BACKGROUND: The present research aimed to determine the effect of an educational intervention based on the extended theory of planned behavior (ETPB) on waterpipe (WT) smoking cessation in women. METHODS: The present quasi-experimental had a pre-test, post-test design with 3, 6 and 12 months follow-ups was conducted in Bandar Abbas city, south of Iran in December 2021-March 2023. A total of 448 women over the age of 15 (224 in the intervention group (IG), 224 in the control group (CG)), using a two-stage cluster sampling method participated. The educational intervention focused on WT smoking cessation implemented in 14 sessions. The educational methods in the training sessions were lectures, collaborative discussions, Q&As, brainstorming, role plays, and peer education. The main outcome was WT cessation behavior. Repeated measures ANOVA tests and post hoc were run to compare the IG and CG at baseline in terms of demographic variables, t-test and chi square test, and in the four points of time of data collection. The data were analyzed in Stata14. A p-value < 0.05 was considered as statistically significant. RESULTS: The mean and standard deviation of WT cessation behavior and all ETPB constructs in the IG was significantly higher than the CG. After the educational intervention, in the IG, the perceived behavioral control, attitude, subjective norm, intention and knowledge increased, and the weekly smoking and WT smoking habit decreased (P < 0.001). The CG did not have any significant change in other variables except for the increased knowledge score. During the 12-month follow-up, the cessation rate was 43.81% (P = 0.645) in the IG and 7.45% in the CG (P = 0.081). CONCLUSIONS: The educational intervention positively affected WT smoking reduction and cessation in women through influencing the ETPB constructs. It is strongly recommended to design theory-based interventions beyond the individual level with an emphasis on interpersonal relationships to facilitate WT cessation as far as possible.

Determinants of Adherence to Treatment in Type 2 Diabetic Patients: A Directed Qualitative Content Analysis Based on Pender's Health Promotion Model.

Adherence to the treatment of type 2 diabetes (T2D), which includes the use of prescribed drugs, following a healthy diet, and adopting a physically active lifestyle, is important to control the disease and improve the patients' quality of life. The present study aimed to explain the determinants of adherence to treatment in patients with T2D based on Pender's Health Promotion Model (HPM). The present research used a qualitative content analysis and was based on Pender's HPM. The data were collected through in-depth semi-structured interviews with 20 T2D patients using a purposive sampling in Bandar Abbas, southern Iran. Maximum variation was considered in terms of gender, age, history of diabetes, type of drug used, education, and occupation. The data collection continued until data saturation. At the same time, the collected data were analyzed using the directed content analysis. MAXQDA 10 was used to manage codes and facilitate data analysis. The data analysis led to the extraction of 10 categories and 19 subcategories as the determinants of adherence to the treatment of T2D patients. The participants shared their experiences about personal characteristics and their ecological environment, specific cognition and emotions, and the behavioral results and experience as the determinants of adherence to T2D treatment. The categories extracted from this study in the form of HPM constructs provided a framework to explain treatment adherence. This information can help policy makers and planners in designing future programs.

First report on BTEX leaching from waterpipe tobacco wastes (WTWs) into aquatic environment.

Waterpipe tobacco wastes (WTWs) may contain considerable levels of hazardous contaminants such as BTEX (benzene, toluene, ethylbenzene, o-xylene, and m/p-xylene). However, no research has been carried out on BTEX levels in WTWs and the release of these pollutants into the water environment. This research examined the levels of BTEX in WTWs of flavored/local tobacco and also the release rate of these toxins into three kinds of water, including seawater (SW), tap water (TW), and distilled water (DW) with different leaching times (15, 30 min, 1.2, 4, 8 h, and 1, 2, and 4 days). The mean contents of BTEX in WTW samples of Al-Mahmoud, Al-Fakher, Mazaya, Al-Ayan brands, and local tobacco samples were 17.0 ± 4.14, 19.1 ± 4.65, 19.6 ± 4.19, 18.8 ± 4.14, and 3.16 ± 0.63 µg/kg, respectively. The mean BTEX levels in flavored tobacco samples were considerably greater than that of local tobacco (p < 0.05). The WTWs leaching experiments showed that the levels of BTEX ranged from 5.26 to 6.12, 5.02-5.60, and 3.83-5.46 µg/L in DW, TW, and SW, respectively. All target compounds were found for all exposure times in DW, TW, and SW samples. After adding sodium azide as an antibacterial agent to water samples (simulating biodegradation processes), higher levels of BTEX compounds were detected in SW. Further research is needed to address the potential environmental hazards due to WTWs leaching into aquatic environments.

Smoking waterpipe, cigarette, and heart disease: a cross-sectional analysis of baseline data from the Kong Cohort Study in the South of Iran.

Previous studies have shown the association between smoking and increased risk of cardiovascular diseases, but long-term effects of waterpipe use are unknown and more research is needed. The present study explored the relationship between cigarette and waterpipe smoking and heart disease in southern Iran. This cross-sectional study used the basic data of Bandar Kong Cohort Study (KCS) to test the relationship between waterpipe and cigarette smoking and heart disease in 4009 participants. A multivariate binary logistic regression was run to estimate adjusted odds ratios (ORs) in SPSS 16. The prevalence of tobacco use was 27.7%. The frequency of heart disease was 7.8% percent (n = 314). There was a statistically significant relationship between cigarette smoking and heart disease (OR = 2.11; 95% CI:1.41-3.16). In individuals who only smoked waterpipes, the odds of heart disease were higher than non-smokers. This relationship was not statistically significant (OR = 1.25, 95% CI:0.88-1.78). In those who smoked cigarettes and waterpipe at the same time, the odds of heart disease were higher than non-smokers (OR = 1.42; 95% C.I: 0.83-2.59). In general, cigarette smoking increases the risk of heart disease. As well as waterpipe smoking was associated with heart disease. However, this association was not statistically significant. More studies are required to validate the association between waterpipe smoking and heart disease. Also, waterpipe use was more common at younger ages, and on the other hand, heart diseases have a long latent period, so in this age group, high incidence of heart disease is likely in the future.

The role of intrapersonal and interpersonal factors in waterpipe cessation: a case-control study.

BACKGROUND: The prevalence of waterpipe smoking among women in southern Iran is significantly higher than women in other regions of Iran. We aimed to explore the effect of several demographic factors, knowledge, attitude, self-efficacy and social norms on a successful cessation of waterpipe smoking in the marginalized women of Bandar Abbas city, in the south of Iran. METHODS: This case-control study was conducted in 2022 among 731 women (246 subjects who successfully quit waterpipe smoking in the case group and 485 who smoked waterpipe in the control group). A cluster sampling method was used to collect the required data through face-to-face interviews and a researcher-made questionnaire. The questionnaire consisted of demographic information, behavioral information about waterpipe smoking and knowledge, attitude, self-efficacy and social norms. The data were analyzed in STATA 14 using univariate and multivariate regression analyses. RESULTS: The mean and standard deviation of age was 39.24 ± 11.93 and 37.18 ± 13.57 in the control and case groups, respectively. With an increase of one score in social norm (OR: 1.046), the odds of cessation were increased for 4%. With an increase of one score in self-efficacy (OR: 1.152), the odds of cessation were increased for 15%. With an increase of one score in knowledge (OR: 1.064), the odds of cessation were increased for 6%. With an increase of one score in attitude (OR: 1.215) the odds of cessation were increased for 21%. CONCLUSION: The present findings revealed personal and interpersonal influential factors in successful waterpipe cessation. Women's knowledge can be increased and their attitude can be changed. Important people in women's lives can be influenced to, consequently, affect women positively and improve their self-esteem.

Oral health and smoking in Bandare-Kong cohort study: a cross-sectional population-based study (findings from PERSIAN cohort study).

Considering the harmful effects of smoking on oral and dental health, our aim was to investigate the oral and dental health status of people in the city of Bandare-Kong, Iran, and its relationship to smoking. This cross-sectional population-based study used baseline data from the Bandare-Kong Cohort Study. A total of 4063 participants aged 35-70 years were included in this study. Using Stata17 software, negative binomial regression was employed to identify factors related to the decayed, missing, and filled teeth (DMFT) index. The association between smoking status and DMFT was assessed by the adjusted incidence rate ratio (IRR). Of the 4063 participants, 987 (24.29%) used cigarettes, hookahs, or both. The mean ± standard error (SE) DMFT index in all subjects was 11.08 ± 0.15; it was 14.17 ± 0.53 for cigarette smokers and 12.39 ± 0.37 for hookah users (p < 0.001). After adjusting for other variables, the rate of DMFT for cigarette smokers was 0.33 (IRR: 1.33; 95% confidence interval [CI]: 1.22, 1.44), which was higher than for those who did not use cigarettes. The rate of DMFT for those who used cigarettes, hookahs, or both was 0.11 (IRR: 1.11; 95% CI: 1.05, 1.18), which was also higher than for those who did not smoke. Cigarette smoking is a risk factor for oral health complaints. Although the rate of DMFT was increased in hookah smokers, it was not a predictor of dental problems. However, we suggest that hookah use be included in educational policies to control oral and dental diseases.

Predictive power of PEN-3 cultural model in cervical cancer screening among women: a cross- sectional study in South of Iran.

BACKGROUND: Cervical cancer (CC) can be prevented through early detection facilitated by screening as well as an early diagnosis and effective treatment of the precancerous lesions. The present research aimed to determine the predictors of cervical cancer screening (CCS) based on the PEN-3 model constructs. METHODS: A cross-sectional study was conducted between September 2021- March 2022 with 840 women aged 15-49 in the city of Bandar Abbas, in the south of Iran, using a cluster sampling. The participants completed a valid and reliable self-administered questionnaire in person. The questionnaire included demographic characteristics, knowledge toward CC and the constructs of the PEN-3 model toward CCS. A multivariable logistic regression was used to determine the relationship and predictive power of model constructs with behavior as an outcome variable. The data were statistically analyzed in STATA14.2. The p-value < 0.05 was considered statistically significant. RESULTS: A total of 810 questionnaires were analyzed (with a return of 95.63%). The mean and standard deviation of the participants' age was 30.97 ± 5.80 years. Pearson correlation coefficient analysis of all constructs and CCS behavior was statistically significant (P-value < 0.05). The multivariable logistic regression analytic results were enablers toward CCS (coefficient: 0.275) and Nurturers toward CCS (coefficient: 0.182), perceptions toward CCS (coefficient: 0.077) and knowledge toward CC (coefficient: 0.048, marginal significant) were predictors of CCS behavior. For the internal validity of the designed prediction model, a sample of 1000 was selected using the bootstrap sample replacement method which demonstrated the accuracy of the model PEN-3 is about 75% in predicting CCS behavior. CONCLUSIONS: The results of the present research showed that personal factors such as perceptions and interpersonal factors such as enablers and nurturers toward CCS can predict CCS behavior. Therefore, in order to increase the acceptance of CCS in women, a set of intrapersonal and interpersonal factors should be taken into account.

A predictive model of waterpipe smoking cessation among women in southern Iran: application of the theory of planned behavior.

BACKGROUND: Today, waterpipe (WT) smoking is a rising issue worldwide, and has taken a significant and growing share of tobacco consumption in the world. Present study aimed to explore the predictors of WT cessation in the light of the theory of planned behavior (TPB). METHODS: This cross-sectional analytical study was conducted in 2021-2022 using a multi-stratified cluster sampling on 1,764 women in Bandar Abbas, southern Iran. Data were collected through a reliable and valid questionnaire. The three-part questionnaire includes demographic information, behavioral information of WT smoking, and the constructs of the TPB along with an additional habit construct. Multivariate logistic regression analysis was run to model the predictor constructs of WT smoking. The data were analyzed statistically in STATA14.2. RESULTS: With an increase in one attitude score, the odds of cessation increased by 31% (p < 0.001). Also, with an increase of one score in knowledge, the odds of cessation are increased by 0.05% (0.008). With an increase of one score for intention, the odds of cessation are 26% (0.000). in social norms, the odds of cessation are 0.02% (0.001). With an increase of one score in perceived control, the odds of cessation increased by 16% (0.000) and inhabit score, the odds of cessation decrease by 37% (0.000). In the model where the habit construct was present, the accuracy, sensitivity, and pseudo R2 indices were 95.69%, 77.31%, and 65%, respectively and after removing the habit construct, the so-called indices changed to 90.7%, 50.38% and 0.44%, respectively. CONCLUSIONS: The present research confirmed the effectiveness of the TPB model in predicting waterpipe cessation behavior. The knowledge obtained from this research can help develop a systematic and effective intervention to facilitate waterpipe cessation. Focusing on the habit variable can play a critical role in waterpipe cessation in women.

Predictors of hospital length of stay and mortality among COVID-19 inpatients during 2020-2021 in Hormozgan Province of Iran: A retrospective cohort study.

Background and Aims: About one-fifth of patients with COVID-19 need to be hospitalized. Predicting factors affecting the hospital length of stay (LOS) can be effective in prioritizing patients, planning for services, and preventing the increase in LOS and death of patients. The present study aimed to identify the factors that predict LOS and mortality in COVID-19 patients in a retrospective cohort study. Methods: A total of 27,859 patients were admitted to 22 hospitals from February 20, 2020 to June 21, 2021. The data collected from 12,454 patients were screened according to the inclusion and exclusion criteria. The data were captured from the MCMC (Medical Care Monitoring Center) database. The study tracked patients until their hospital discharge or death. Hospital LOS and mortality were assessed as the study outcomes. Results: As the results revealed, 50.8% of patients were male and 49.2% were female. The mean hospital LOS of the discharged patients was 4.94. Yet, 9.1% of the patients (n = 1133) died. Among the predictors of mortality and long hospital LOS were the age above 60, admission to the ICU, coughs, respiratory distress, intubation, oxygen level less than 93%, cigarette and drug abuse, and a history of chronic diseases. Masculinity, gastrointestinal symptoms, and cancer were the effective variables in mortality, and positive CT was a factor significantly affecting the hospital LOS. Conclusion: Paying special attention to high-risk patients and modifiable risk factors such as heart disease, liver disease, and other chronic diseases can diminish the complications and mortality rate of COVID-19. Providing training, especially for those who care for patients experiencing respiratory distress such as nurses and operating room personnel can improve the qualifications and skills of medical staff. Also, ensuring the availability of sufficient supply of medical equipment is strongly recommended.

Educational Intervention of Improve Student's Oral Health: A Systematic Review and Meta-Analysis School-Based.

Background: The present research aimed to assess the effects of oral health intervention programs at school level on students' oral hygiene in developing countries. To this aim, a systematic review and meta-analysis approach was employed. Methods: The present research was done by surfing electronic databases with MEDLINE Ovid (Embase Ovid, Scopus), Web of Science from 2000 to Mar 2020. The data were collected using a standard type of data collection including specific studies to observational ones, and the data entered RevMan 2014. The eligibility criteria were individually randomized controlled trials (RCTs) or cluster-RCTs including quasi-experimental papers with oral health interventions. The RevMan 2014 package was used for a meta-analysis done through random-effects models. Results: Meta-analyses revealed statistically significant divergences in terms of knowledge (SMD 3.31, 95% CI 2.52 to 4.11; I2 = 98; P<0.001), attitude (SMD 1.99, 95% CI 0. 43 to 3.54; I2 = 99; P<0.001), behavior (SMD 4.74, 95% CI 3.70 to 5.77; I2 = 99; P<0.001), plaque index (SMD -1.01, 95% CI -1.50 to -0. 51; I2 = 97; P<0.001) and Gingival index (SMD 0. 33, 95% CI -0. 36 to 1. 02; I2 = 98; P=0.34) in the case of students who received educational interventions versus those with ordinary care. Conclusion: The present findings attested to the effectiveness of the educational interventions in improving oral health knowledge, attitudes, behaviors, and so on which can presumably contribute to a better oral hygiene, lower incidence of oral diseases, and lower costs of the treatments imposed by oral diseases.

Utilization of cervical cancer screening services and its associated factors in Iran: a case-control study.

BACKGROUND: Considering the high incidence rate of cervical cancer (CC) in Iran, screening is an effective way of reducing the impact of the disease due to early detection. Thus, the recognition of the factors affecting the use of cervical cancer screening (CCS) services is essential.The present study aimed to determine the associated factors of CCS in women living in the suburbs of Bandar Abbas in the south of Iran. METHODS: The present case-control study was conducted between January and March 2022 in the suburban areas of Bandar abbas. Two hundred participants were assigned to the case group and 400 participants were assigned to the control group. A self-constructed questionnaire was used to collect the data. This questionnaire contained demographic information, reproductive information, knowledge of CC, knowledge of CCS and access to the screening. Univariate and multivariate regression analyses were run to analyze the data. The data were analyzed in STATA 14.2 at a significance level of p < 0.05. RESULTS: The mean and standard deviation of participants' age in the case group was 30.33 ± 4.892, and in the control group was 31.35 ± 6.149. The mean and standard deviation of knowledge in the case group was 10.21 ± 1.815 and in the control group was 7.24 ± 2.447. The mean and standard deviation of access was 43.72 ± 6.339 in the case and 37.17 ± 4.828 in the control group. The results of multivariate regression analysis showed the following factors increased the odds of CCS: knowledge (OR medium = 18.697, OR high = 13.413), access (OR medium = 4.028, OR high = 8.126), being married (OR = 3.193), being educated (OR diploma = 2.587, OR university degree = 1.432), middle and high SES (OR Middle = 6.078, OR Upper = 6.608), and not smoking (OR = 1.144). Also, women's reproductive status, including history of sexually transmitted diseases (OR = 2.612), use of oral contraceptives (OR = 1.579), sexual hygiene (OR = 8.718). CONCLUSIONS: In the light of the present findings, it can be concluded that besides increasing suburban women's knowledge, their access to screening facilities should be improved. The present findings showed the need to remove the barriers to CCS in women of low SES to increase the rate of CCS. The present findings contribute to a better understanding of factors involved in CCS.

Perceived stress among older adults during COVID-19 outbreak: A cross-sectional study in Southern Iran.

Background and Aims: The stress associated with the coronavirus disease 2019 (COVID-19) pandemic significantly affects people's lives, especially older adults. The present study aimed to identify risk factors leading to the perceived stress associated with COVID-19 among the adults over 60 years old of Southern Iran. Methods: This cross-sectional study was conducted in December 2021 in Bandar Abbas among older adults. The COVID-PSS-10 (Perceived Stress Scale) questionnaire was distributed among the older adults receiving healthcare services from health centers in Bandar Abbas selected through a convenient sampling method. Then, answers to the questions resulted in the score (without units). Results: A total number of 456 participants between 60 and 90 years with an average age of 64 ± 5.12 years took part in this study. The mean ± SD score of total perceived stress was 16.45 ± 8.36 (the mean score of stress was 10.30 ± 6.16 and coping was 6.15 ± 3.83). Of the total, 129 participants (28.28%) were grouped as the high-stress group. Results showed that the 70-79 years age group had higher odds of belonging to the stressed group than the 60-69 years age group (odds ratio = 2.336). Moreover, participants with a diploma were 57% more stressed than illiterate participants. The latter perceived less stress and had lower odds of belonging to the high-stress group. The employed were 61% less likely to be categorized in the stressed group than the unemployed. Among women, 43% were less likely than men to be in the high-stress group. Conclusion: As the present findings showed, the risk factors of perceived stress induced by COVID-19 are old age, low education, unemployment, and masculinity. Therefore, planning to improve stress-coping skills such as entertainment, strengthening social relationships, physical activity, and the peace of mind of this population are suggested under the supervision of geriatric specialists and psychiatrists.

Increasing cervical cancer screening in Iran: effectiveness of a theory-based educational intervention.

PURPOSE OF STUDY: The high mortality rate of cervical cancer in developing countries is mainly related to inefficient screening programs. The aim of the present study was, thus, to determine the effect of an educational intervention based on BASNEF (Belief, Attitudes, Subjective Norms, and Enabling Factors) model on increasing the rate of cervical cancer screening (CCS) in Bandar Deir in the south of Iran. METHODS: A quasi-experimental educational intervention was made with 202 women participants (101 in the intervention group (IG) and 101 in the control group (CG)) in 2019-20. The sampling was convenience in type. The data were collected using a reliable and valid tripartite questionnaire (demographic information, knowledge, BASNEF constructs). A total number of 14 training sessions were held each taking 60 min, at two levels, personal and interpersonal (for family members, health workers and healthcare givers). Finally, there was a three-month follow-up held in December 2021. RESULTS: After the training, a statistically significant difference was found between the IG and CG in all model constructs (p < 0.001). Before the intervention, in the IG, the personal health score was 4.35 ± 2.52, which was increased to 5.25 ± 0.753 after the training (p < 0.001). However, in the CG, the difference was not statistically significant (p < 0.030). 63.4% of women in the IG and 32.7% in the CG performed the CCS and the between-group difference was statistically significant (p < 0.001). Attitude, enabling factors and behavioral intention were the main predictors of CCS. CONCLUSION: The present findings showed though the training intervention based on the BASNEF model had limited resources and was run in a short time, it managed to motivate women to perform the CCS. It could maximally remove barriers at both personal and interpersonal levels and suggest strategies in the light of these barriers to achieve a successful screening program.

Cervical cancer is the fourth most prevalent fatal cancer among women on a global scale, and is one of the few cancers that can be prevented through screening. The high mortality rate of cervical cancer in developing countries, including Iran, has been largely attributed to inefficient screening programs. In developing countries cervical cancer screening programs are far from qualified. Yet, theory-based educational interventions can play an important role in promoting CCS behavior. Therefore, the present study was designed to determine the effect of an educational intervention based on the Beliefs, Attitudes, Subjective Norms and Enabling Factors (BASNEF model on increasing CCS in women in the south of Iran. BASNEF model includes beliefs about behavioral outcomes, attitudes toward behavior, subjective norms and enabling factors. The most significant construct in BASNEF model is the behavior change. Beliefs and attitudes are influenced by culture, values, traditions, education, media, and personal experiences. Subjective norms include family, society, social media, and peer pressure. Enabling factors include income, women's status, time, and skills. This model can be proposed as a new educational method. A quasi-experimental two-group (pretest­posttest) study was conducted in 2019­2020 on 202 women (101 in the intervention group, and 101 in the control group). In the intervention group, 14 training sessions (10 at the personal level and 4 at the interpersonal level) were held between 40 and 60 min' long. In the control group, 1 training session was held in 6 groups of 15­20. It was 60 min' long. The follow-up was held three months after the intervention. The results showed that the educational intervention, by affecting the BASNEF constructs, significantly affected women's CCS behavior. Maximizing barriers at both personal and interpersonal levels and suggesting strategies based on these barriers can help achieve a successful screening program. In particular, we call for the implementation of goal-oriented training programs according to health education and health promotion models to increase the rate of CCS behavior.

COVID-19 and hookah smoking cessation among women in Southern Iran: A cross-sectional study.

Hookah smoking does not only transmit COVID-19 but also intensifies the symptoms of the disease. Thus, the present research aimed to explore the association between COVID-19 and hookah cessation among female smokers. The institutional-based cross-sectional study was conducted nine months after the onset of the COVID-19 pandemic. Face-to-face interviews were held between November 2020 and January 2021 to explore the pattern of hookah smoking among 561 female hookah smokers in Bandar Abbas in the south of Iran. The daily, weekly and monthly rates of hookah smoking showed a statistically significant decrease in the during COVID-19 era (p < .001). Thirteen percent of women managed to cease hookah smoking successfully during the pandemic. The odds ratio of hookah cessation was higher in single women (95% CI 1.09-5.23) as well as women with a high socioeconomic status (SES) (95% CI 4.28-24.01). It was also higher among women who initiated hookah smoking at an older age (95% CI 29-68) and among those with no hookah smoking family member (95% CI 301- 943). Fear of COVID-19 infection was the leading factor involved in hookah cessation or reduction. Entertainment was the leading barrier to successful hookah cessation behavior. It is believed that COVID-19 has directly and indirectly contributed to the reduced or ceased hookah smoking behavior. One of the reasons for the reduction of hookah smoking was the fear of aggravated symptoms and reasons for cessation included closure of coffee shops and removal of all hookahs from the city.

The effect of a theory-based educational program on southern Iranian prisoners' HIV preventive behaviors: a quasi-experimental research.

BACKGROUND: The present research explored the effect of an educational program based on the health belief model (HBM) on prisoners' HIV preventive behaviors in the south of Iran. METHODS: The present quasi-experimental research was conducted in 2019-20 on 280 prisoners, 140 in the control group (CG) and 140 in the intervention group (IG). The sampling was simple randomized. The data were collected using a questionnaire in two parts, one exploring the demographic information and the other the HBM constructs. The final follow-up was completed 3 months after the educational intervention (8 sessions long) in November 2020. RESULTS: After the intervention, statistically significant between-group differences were found in the healthy behavior score and all HBM constructs except for the perceived barriers (p < 0.001). Perceived severity and susceptibility were found to be the strongest predictors of HIV preventive behaviors. CONCLUSION: The educational intervention showed to positively affect the adoption of preventive behaviors mediated by the HBM constructs. To remove barriers to HIV preventive behaviors or any other healthy behavior, researchers are suggested to develop multi-level interventions (beyond the personal level) to gain better findings.