Psychometric evaluation of a new instrument to hookah tobacco smoking-related factors in the Iranian female university students based on the Extended Parallel Process Model.

BACKGROUND: The higher prevalence of hookah tobacco smoking (HTS) has become worrisome in women. Thus, it is essential to identify and measure the perceptions associated with this unhealthy behavior as well as the type of response to risk messages to design the effective programs. This study aimed to psychometric evaluation of a new instrument, named the Extended Parallel Process Model-Hookah Tobacco Smoking Questionnaire (EPPM-HTSQ), for female university students. MATERIAL AND METHODS: This methodological study was conducted in 2019-2020 in central and western Iran. The first version of the instrument was developed with 97 items. Face, Content, and construct validity methods were used to assess the EPPM-HTSQ validity. The data viability for factorability was guided through Kaiser-Meyer-Olkin (KMO) measure of sample adequacy (Values >0.7) and Bartlett's test of Sphericity (P < 0.05). The Exploratory Factor Analysis (EFA) method with varimax rotation and SPSS software was performed to identify the main factors of the questionnaire and interpretable factors. The internal consistency and external reliability were determined. The test-retest was used for evaluating the stability of tools. RESULTS: During the assessment of the face and content validity 71 items remained in the questionnaire. EFA led to the extraction of nine dimensions: "Focusing on superior rewards," "Response Efficacy," "Perceived physical threat," "Perceived social threat," "Self-efficacy," "Fear control," "Attitude," "Fear," and "Intention" Kaiser-Meyer-Olkin (KMO) test (0.957) and Bartlett's test (P < 0.001). Cronbach's alpha (0.871-0.951) and ICC (0.985-0.998) were approved for scale dimensions. CONCLUSION: Important findings of the present study were the development and validation of the EPPM-HTSQ for measuring EPPM variables in relation to HTS; introducing a new variable "focusing on superior rewards"; as well as, the new classification of the concept of "perceived threat." The final version of the EPPM-HTSQ is a valid and reliable tool, but it is suggested to be re-evaluated in other studies with different populations and sample sizes.

Sociocultural factors contributing to waterpipe tobacco smoking among adolescents and young adult women: a qualitative study in Iran.

Purpose: Waterpipe tobacco smoking (WTS) is currently a serious and growing public health threat in the world, especially in adolescents and young women. The aim of the study was to explore sociocultural factors contributing to WTS among adolescents and young adult women in Iran. Methods: This qualitative study was conducted from August 2017 to January 2019 in Isfahan and Hamadan cities, Iran; it included 13-30-year-old females with experience of WTS. For data collection, in-depth semi-structured personal interviews were conducted at participants' preferred time and place. Concurrent with data collection, data were analysed through conventional content analysis. Results: The study participants described the various sociocultural factors contributing to WTS. These factors were categorized into four following main categories: waterpipe glamorization by its producers and sellers, media advertisement or silence, common sociocultural traditions, and governmental policies and regulations. Conclusion: A wide range of sociocultural factors affects WTS among Iranian adolescents and young adult women. Therefore, interdisciplinary multidimensional strategies are needed for WTS management and prevention among these at-risk groups. Public education, strict supervision of tobacco import, export, and selling, ample employment opportunities for young people and effective leisure time management are essential to reduce WTS.Abbreviation WTS: Waterpipe Tobacco Smoking; MPOWER: Monitor tobacco use and prevention policies, Protect people from tobacco smoke, Offer help to quit tobacco use, Warn about the dangers of tobacco, Enforce bans on tobacco advertising, promotion and sponsorship, Raise taxes on tobacco.

An Examination of the Past Behaviour-Intention Relationship in the Case of Brushing Children's Teeth.

PURPOSE: The present study sought to apply the expanded theory of planned behaviour (TPB) to the prediction of mothers' intention to brush their children's teeth and examine the mediating role of the variables of the TPB on the relationship between past behaviour and the intention. MATERIALS AND METHODS: This cross-sectional study was carried out among 211 mothers with children ages 2 to 5 years. Participants completed measures of the TPB (i.e. attitude, subjective norm, perceived control and intention) and past behaviour in relation to brushing. Regression analyses were conducted to explore the predictors of mothers' intention. Mediation was assessed using Preacher and Hayes' INDIRECT.SPSS macro. RESULTS: The TPB explained 25% of the variance in brushing intention, with attitude, subjective norms and perceived behavioural control making significant contributions. Past behaviour explained an additional 3% of the variance in intention. Analysis showed that TPB variables only partially mediate the effect of past behaviour on intention. CONCLUSIONS: Our findings revealed that mothers' intention to brush their children's teeth is under the control of both past behaviour and psychological factors. Accordingly, interventions to improve children's toothbrushing should focus on the motivational (e.g. attitude) as well as the habitual determinants (e.g. environmental cues). However, given the low explanatory power of our model, it may be necessary to incorporate other psychological and environmental variables into an explanation of the mothers' intention to brush their children's teeth.

Evaluation of an oral health intervention among mothers of young children: a clustered randomized trial.

BACKGROUND: Oral health education for the mothers of very young children is important in reducing the risk of early childhood caries. This study aimed to evaluate the impact of an oral health intervention among mothers of 1-2 years old children. METHODS: This cluster randomized controlled trial (2012) was conducted among ninety mothers of 1-2 year old children. The setting of study was 10 child day-care centers out of 18 in Hamadan, western Iran. Day-care centers were randomly allocated into two groups: an intervention group (5 day-care centers, 45 mothers) and a control group (5 day-care centers, 45 mothers). Intervention consisted of three sessions, a booklet, and mobile phone text-message reminders. The primary outcome was change in cleaning the children' teeth, while the secondary outcomes were changes in Theory of Planned Behavior (TPB) cognitions. Questionnaires at baseline, 10 days, and 3 months assessed intervention effects. Data were analyzed using SPSS v.16. T tests, chi- square, and logistic and linear generalized estimating equations (GEE) regression were used to test intervention impact. RESULTS: At 10-day assessment, mothers in intervention group reported a significant difference in knowledge (P=0.001), attitude (P=0.004), perceived behavioral control (P=0.008), and cleaning of children's teeth (P=0.011). Also, at 3-month assessment compared to control group, the mothers in intervention group significantly improved in scores of knowledge (P=0.001), attitude (P=0.001), perceived behavioral control (P=0.001), and cleaning of children's teeth (P=0.001). However, the effect sizes were small to medium and ranged from 0.1 to 0.4 for all cognitions except knowledge (effect size>0.70). Generalized estimating equations (GEE) showed that score of attitude and perceived behavioral control of intervention group improved between the two post-test assessments. CONCLUSIONS: A brief multicomponent theory-based intervention among mothers of 1-2 years old children was effective moderately in improving cognitions and self-reported cleaning children's teeth.