Stages of dairy product consumption among Iranian female high school students based on transtheoretical model: The case of osteoporosis prevention.

Background: As nutritional needs increase in adolescence, dairy consumption can play a key role in health and disease prevention; however, unfortunately, inadequate consumption of milk and dairy products has often been reported in adolescents. Aim: The purpose of this study was to investigate the relation between decisional balance, self-efficacy, and the processes of change with the stages of change for dairy consumption in female high school students in Shaft county located in the west of Gilan Province, Iran. Methods: A total of 385 female high school students in Shaft County were studied through the census method in 2019. The data collection instrument was a valid and reliable questionnaire consisting of demographic information, stages of change and items of transtheoretical model constructs including the processes of change (cognitive process: consciousness-raising, dramatic relief, self-reevaluation, environmental reevaluation, and social liberation; behavioral process: self-liberation, counter conditioning, reinforcement management, stimulus control and helping relationships), decisional balance and self-efficacy. Data were analyzed using SPSS 21 software. Results: A total of 208 (54%), 53 (13.8%), 56 (14.5%), 32 (8.3%) and 36 (9.4%) students were in the pre-contemplate, contemplation, preparation, action and maintenance stages, respectively. As the subjects progressed through the stage of change for dairy consumption, an increase in the mean score of self-efficacy, decisional balance, and processes of change was observed (P < 0.01). Conclusion: The constructs of the transtheoretical model should be considered in designing educational interventions to promote dairy consumption with regard to the stage of change for dairy consumption in the subjects.

Development and Psychometric Properties of the Mental Health Literacy Questionnaire (MHLQ) Among Young Iranian Soldiers.

Background: Prevention of the incidences of mental disorders, psychological problems, or their rapid diagnosis is an important issue that has led to the creation of a mental health literacy concept and the development of standard tools for evaluating them. This study is the first step in the designing and psychometrics of the Mental Health Literacy Questionnaire (MHLQ) in Iran. The purpose of this study was to design the psychometric properties of the MHLQ in soldiers. Methods: This study is a methodological study that was designed in three phases: 1) Designing the instrument, 2) Assessing the items, and 3) Psychometric assessment. This study was conducted during 2017-2018, and the soldiers were selected by using a convenience sampling method from different garrisons of Tehran, Iran. To evaluate the content validity of the questionnaire 10 experts, to evaluate the face validity 9 soldiers, and for the pilot study 103 soldiers formed the sample size. Finally, construct validity was assessed among 251 soldiers. Results: In the first phase, 78 items were collected and designed. Then, based on the experts' opinions and preliminary studies, the items were reduced to 52 in the "Assessing the items phase" and then to 42 items in the psychometric phase. In the third phase, 31 items remained in the final version. The CVR and CVI scores of the 52 items were 0.91 and 0.94, respectively. Exploratory factor analysis revealed a 4-factor structure with 31 items of special value that were higher than five that accounted for 55.04 of the total scale variance. The fit indices values indicated that the model is fit for the data. In the total scale, the test-retest reliability and Cronbach's alpha were 0.81 and 0.76, respectively. Conclusion: The MHLQ of soldiers has appropriate psychometric properties and can be considered as a suitable tool for evaluation and screening as well as a basis for educational and research interventions.

Prevalence and related factors of intimate partner violence among married women in Garmsar, Iran.

BACKGROUND: Intimate partner violence (IPV) is the most common type of domestic violence often used by men against their wives. Due to the destructive and widespread social and health consequences of IPV, the present study aimed to investigate the prevalence and related factors of IPV among married women in Garmsar, Iran. METHODS: Using multi-stage clusters sampling method, this cross-sectional study included 400 married women in Garmsar, Iran. The data collection process was conducted during October and December 2019 using a researcher-made questionnaire. The content validity of the questionnaire was confirmed using content validity ratio (CVR) and content validity index (CVI) indicators (0.85 and 0.88, respectively). Also, the reliability was confirmed by examining the internal consistency and obtaining a score of 0.93 for Cronbach's alpha. Descriptive and analytical statistics were performed using t-test, analysis of variance (ANOVA), and Tukey's post-hoc test. RESULTS: Most participants were in the age range of 20-40 years (mean age: 34.9 years). The overall exposure of women to IPV was 56.11%. In addition, the most prevalent types of IPV included legal (24%), social (24%), financial (22%), verbal (16%), physical (13%), emotional (12%), and sexual (11%). The effective factors on the prevalence of IPV included number of children, education level, occupation, and age (P less than 0.05). CONCLUSIONS: We witnessed that women living in Garmsar faced different types of IPV and their overall exposure to this phenomenon was higher than the national and global average. To resolve the problem, the following measurements are recommended: a careful investigation of the reasons for the spread of IPV, implementing interventions based on reliable evidence, and serious cooperation of the experts and relevant governmental and non-governmental institutions, particularly citizens.

Evaluation of psychometric properties of the maastricht upper extremity questionnaire (MUEQ) in iranian computer users.

BACKGROUND: Measurement of the essential risk factors for work-related musculoskeletal disorders is a fundamental step in predicting the problem and identifying high-risk individuals. In this regard, Maastricht upper extremity questionnaire (MUEQ) has not been validated in Iran. This study aimed to develop a valid and reliable Persian version of MUEQ. MATERIALS AND METHODS: In this descriptive study, the computer users employed in a governmental informatics administration in Tehran, Iran, were included during the end of 2018 and early 2019. Face and content validity of the MUEQ was conducted, and a six-part questionnaire was provided. The reliability of the questionnaire was obtained using Cronbach's α and test-retest. Concurrent validity was assessed with Nordic Musculoskeletal Questionnaire (NMQ). Exploratory and confirmatory factor analysis, comparison test of independent mean, internal consistency coefficient, test-retest, and Pearson correlation were carried out using the AMOS and SPSS 22 software. RESULTS: Participants consisted of 282 computer users (110 males) with a mean age of 35.17 ± 7.65 years. The mean duration of computer use in a working day was 6.68 ± 2.10 h with a range of 1-12 h. The most prevalent symptoms were existed in the neck (39.1%), back (31.0%), and lower back (30.3%) areas. KMO test and Bartlett's test of sphericity showed that a significant correlation existed among questions. Cronbach's alpha coefficient of the questionnaire varied from 0.61 to 0.83 and test-retest coefficient was higher than 0.7. Correlation coefficient was between NMQ and body posture (r = 0.23, P = 0.004) and between NMQ and work environment (r = 0.28, P = 0.000). Evaluations related to the construct validity and concurrent validity demonstrated that the questionnaire has acceptable construct validity. Six factors of the MUEQ in Root Mean Squared Error Approximation (RMSEA) index (0.062) were acceptable and satisfactory in Parsimony Comparative Fit Index (PCFI), Comparative Fit Index (CFI), Normed Fit Index (NFI), and Parsimony Goodness of Fit Index (PGFI) (0.732, 0.8000, 0.680, and 0.680, respectively). CONCLUSIONS: The Persian version of the MUEQ represented a satisfactory validity and reliability and was suitable for computer users in the assessment of their risk factors of musculoskeletal complaints.

Community readiness for collecting stray dogs in Aradan County: a quantitative-qualitative study.

BACKGROUND: Paying more attention to free-roaming dogs' population control seems to be necessary because of public health and environmental problems. The present study used the community readiness model to determine the readiness of Aradan County in terms of collecting stray dogs. METHODS: This study is a quantitative-qualitative research study conducted in Aradan County in Semnan Province of Iran. The semi-structured questionnaire uses the six dimensions of the Community Readiness Model as guideline, with 36 items used for the interview. The interviews lasted 45 to 100 minutes with 11 key members including the governor, prefect, mayor's assistant, city council chairman, key trustees, officials responsible for environmental health network, officials responsible for environmentalism of the city, and governors of a rural district. In quantitative part two, assessors read the interviews carefully and assigned scores based on the rating-scale form suggested by the guideline itself for scoring each dimension. A qualitative directed content analysis with deductive approach was used for analyzing the collected qualitative data. RESULTS: The study involved 11 key members of Aradan County, all of whom were male. Most of the participants were over 40 years old and with five years of work experience (73.6 %). The mean score of each six dimensions in Aradan County were: Community efforts (4.78), Community knowledge of efforts (4.28), Leadership (4.90), Community climate (4.38), Community knowledge about the issue (4.20) and Resources related to the issue (3.29) respectively. Community readiness in Aradan County and Aradan City was generally estimated to be in the preplanning stage, whereas vague public awareness was found in the rural areas. In the qualitative part, 870 initial open codes, 589 refund codes, 19 subcategories and 6 themes emerged, including (a) community efforts, (b) community knowledge of the efforts (c) leadership, (d) community climate, (e) community knowledge of the issue, and (f) resources related to the issue. CONCLUSIONS: For improving the process of collecting the stray dogs, it is necessary to focus on holding educational sessions for the public to increase their partnership and justify the responsible organizations' activities to collaborate and provide the necessary financial resources.

Factors Associated with Tobacco Use among Iranian Adolescents: An Application of Protection Motivation Theory.

BACKGROUND: Tobacco use is a significant predisposing factor to many diseases. Protection motivation theory is a well-suited theory, since fear can motivate individuals to change their unhealthy behaviors. OBJECTIVE: This study was conducted to examine the associations between the constructs of this theory with intention and tobacco use behavior. METHOD: The present cross-sectional study was conducted in Noshahr, Iran. The participants were 440 high school boys selected using a stratified random sampling in 2016. A questionnaire about tobacco use based on protection motivation theory was developed and its validity and reliability were assessed. The questionnaire included the demographic information, the constructs of theory, and tobacco use behavior. Structural equation modeling was used to test the associations between the constructs with intention and tobacco use. RESULTS: The variables of perceived vulnerability (ß = 0/137, P < 0.001), fear (ß = 0/149, P < 0.001), self-efficacy (ß = 0/249, P < 0.001), perceived intrinsic reward (ß = -0.285, P < 0.001), threat appraisal (ß = -0.25, P < 0.001), and coping appraisal (ß = 0.358, P < 0.001) had direct effect and are significant with intention. Moreover, perceived vulnerability (ß = -0.158, P < 0.001), fear (ß = -0.172, P < 0.001), self-efficacy (ß = -0.288, P < 0.001), perceived intrinsic reward (ß = 0.329, P < 0.001), threat appraisal (ß = 0.265, P < 0.001), and coping appraisal (ß = -0.379, P < 0.001) affected tobacco use indirectly through intention and were significantly associated with behavior. Also, intention had direct effect and is significant with tobacco use (ß = -1.156, P < 0.001). CONCLUSIONS: The protection motivation theory provides a useful framework for investigating factors of tobacco use among male students. Future tobacco prevention interventions should focus on increasing the vulnerability and fear, decreasing intrinsic reward, and improving self-efficacy to reduce tobacco use.

The effect of motivational interviewing-based intervention using self-determination theory on promotion of physical activity among women in reproductive age: A randomized clinical trial.

BACKGROUND: Physical activity (PA) prevents chronic diseases. Self-determination theory (SDT) provides a useful framework to understand the nature of motivational interviewing (MI). OBJECTIVE: This study aimed to determine the effect of MI-based intervention using SDT on the promotion of PA among women in reproductive age. METHODS: Seventy women in reproductive age were selected by clustering sampling method for this randomized controlled trial. The questionnaire included the variables of physical fitness test, SDT, and global physical activity questionnaire (GPAQ). The validity of the questionnaires was approved using content validity ratio (CVR) and index (CVI). The reliability and internal consistency of the questionnaires and measures was approved using test-retest method and Cronbach's alpha test, respectively. The intervention group (n=35) received four MI sessions through theory and one standard education session about PA. The control group (n=35) received a standard education session about PA. RESULTS: Four months after the intervention, an increase in the mean scores of total PA (p<0.001, ES=4.77), physical fitness tests including flexibility (p<0.001, ES=1.59), muscular endurance (p<0.001, ES=2.0), cardiorespiratory endurance (p<0.001, ES=0.51), and a decrease in mean scores of agility test (p<0.001, ES= - 0.51) and sedentary behavior (p<0.01, ES=- 0.74) was observed in the intervention group compared to the control group. The intervention group reported an increase in the scores of intrinsic motivation (p<0.001, ES=3.34), identified regulation (p<0.001, ES= 1.28), perceptions of competence (p<0.001, ES=0.81) and autonomy (p<0.001, ES=2.01), enjoyment (p<0.001, ES=0.98) and health motives (p<0.01, ES=0.19), health care climate (p<0.001, ES=4.6), and a decreased score of external regulation (p<0.01, ES=-0.55) and amotivation (p<0.01, ES= -0.56) over time, compared to the control group. CONCLUSION: MI-based intervention using SDT was effective on the promotion of PA. TRIAL REGISTRATION: The Trial was registered at the Iranian Registry of Clinical Trial (http://www.irct.ir) with the Irct ID: IRCT2015101924592N1.

Alexander Technique Training Coupled With an Integrative Model of Behavioral Prediction in Teachers With Low Back Pain.

BACKGROUND: Individuals suffering from chronic low back pain (CLBP) experience major physical, social, and occupational disruptions. Strong evidence confirms the effectiveness of Alexander technique (AT) training for CLBP. OBJECTIVES: The present study applied an integrative model (IM) of behavioral prediction for improvement of AT training. METHODS: This was a quasi-experimental study of female teachers with nonspecific LBP in southern Tehran in 2014. Group A contained 42 subjects and group B had 35 subjects. In group A, AT lessons were designed based on IM constructs, while in group B, AT lessons only were taught. The validity and reliability of the AT questionnaire were confirmed using content validity (CVR 0.91, CVI 0.96) and Cronbach's α (0.80). The IM constructs of both groups were measured after the completion of training. Statistical analysis used independent and paired samples t-tests and the univariate generalized linear model (GLM). RESULTS: Significant differences were recorded before and after intervention (P < 0.001) for the model constructs of intention, perceived risk, direct attitude, behavioral beliefs, and knowledge in both groups. Direct attitude and behavioral beliefs in group A were higher than in group B after the intervention (P < 0.03). CONCLUSIONS: The educational framework provided by IM for AT training improved attitude and behavioral beliefs that can facilitate the adoption of AT behavior and decreased CLBP.

Evaluation of Transtheoretical Model-Based Family Education Among Females of Zahedan (Southeast of Iran).

BACKGROUND: It cannot be denied that many improvements in female and child health have been achieved worldwide through international family planning programs. More than half of the females (57%) with unintended pregnancy admitted that they had not used birth control the month before conception. OBJECTIVES: The aim of this study was to promote family planning practice among females of Zahedan (southeast of Iran) through the transtheoretical model (TTM). PATIENTS AND METHODS: The current quasi-experimental study was conducted on 96 eligible females, who were allocated either to the case or the control group and were selected from homes in the border of Zahedan city (southeast of Iran) during 2010. Convenience sampling by door-to-door visits was used for finding eligible cases. A TTM-based self-administrated family planning questionnaire was used for data collection. Participants in the intervention group received education in two groups, based on their stage of change: precontemplation, contemplation, preparation, action, maintenance, and all groups were followed for three months. RESULTS: The result of the chi-square test did not show any significant difference in the stage of change: precontemplation, contemplation, preparation, action, maintenance before education between the control and intervention groups (P = 0.55). After education, subjects in the intervention group moved forward through stage of change and got at least one step closer to the family planning behavior., with this change being significant (P < 0.001), while the movement of participants through stage of change not being significant in control group (P = 1). The results of statistical tests illustrated that the mean knowledge of the intervention group was 7.5 ± 7.1 versus 0.5 ± 4 for the control group (P < 0.001), mean of attitude of the intervention group was 5.5 ± 5.41 versus 0.09 ± 2.04 for the control group (P < 0.001), and practicing family planning methods (P < 0.007) in the intervention group was higher than the control group after education based on TTM. CONCLUSIONS: According to this study, the educational plan based on TTM was effective in changing knowledge, attitude, and practice and directing females towards taking action. Moreover, self-efficacy, perceived barriers and benefits are factors that affect the use of family planning methods.