Development and Psychometric Properties of an Extended Theory of Planned Behavior Questionnaire for Childbearing Intentions and Behaviors in Iran / 가정의학회지

Background@#Childbearing is the most important determinant of population fluctuations, and its study is more important than other population phenomena. Owing to the lack of a valid questionnaire based on the extended theory of planned behavior, this mixed-method study was conducted to determine the validity and reliability of a questionnaire designed to examine related belief-based factors on the intention to bear children in Iranian society. @*Methods@#This study was conducted in two phases in Hamadan city, western Iran, in 2021. Phase 1 consisted of an extensive literature review and a qualitative study using a directed content analysis approach to generate an item pool. Psychometrics were measured in phase 2, including content, face, and construct validity. Reliability was assessed based on internal consistency and stability. The collected data were analyzed using IBM SPSS and AMOS ver. 24.0. @*Results@#Mean content validity ratio and content validity index were 0.7 and 0.85, respectively. Exploratory factor analysis of the 32 items identified an eight-factor solution. These factors jointly accounted for 79.1% of the observed variance in the outcome variables. Confirmatory factor analysis indicated a good fit for the data. The internal consistency based on Cronbach’s α was 0.85 (0.71–0.93). In addition, stability was confirmed using the test-retest method and intraclass correlation coefficient (0.74–0.94). @*Conclusion@#The designed questionnaire is a valid and reliable instrument for evaluating related belief-based factors on the intention and behavior of childbearing among married men and women in Iran.

The factors in older adults' health literacy in the field of physical activity: a qualitative study.

BACKGROUND: Older adults are one of the most vulnerable groups to the undesirable effects of low health literacy. Inadequate health literacy in older adults is associated with decreased physical activity, deviation from the path of health, and suffering from various diseases. Considering the role and importance of health literacy in promoting physical activity and improving health in older adults and the hypothesis that there are certain factors associated with health literacy in the field of physical activity, this study is aimed at understanding the factors related to older adults' health literacy about physical activity. METHODS: This study is a qualitative study on older adults 60 to 75 years old in retirement centers in Kermanshah, Iran, in 2020. Totally, 25 participants were recruited through purposeful sampling with maximum variation until data saturation. The data were collected through in-depth semi-structured interviews and analyzed using directed qualitative content analysis. RESULTS: By analyzing the manuscripts obtained from the interviews, 59 initial codes were extracted, which were reduced to 32 main codes after careful assessment. The main codes were grouped into 13 subcategories under 5 categories. Subcategories are the detected factors that are related to health literacy and categories are the five aspects of health literacy including access, reading skill, comprehension, evaluation and decision-making, and application of information. Health literacy was the main theme that encompassed the categories. CONCLUSION: This study provided a comprehensive understanding of beliefs, opinions and factors related to older adults' health literacy about physical activity. According to these findings, physical problems and diseases are not obstacles to making decisions and applying physical activity information in older adults who have a high understanding and proper evaluation of physical activity recommendations. Support, advertising, and organizational facilities are related to all dimensions of older adults' health literacy about physical activity, while socio-economic factors are related to the dimensions of access, comprehension, decision-making, and application of information. The factors related to older adults' health literacy about physical activity that were identified in this study, can be used by organizations that are responsible for policy-making, decision-making, and implementing physical activity promotion programs to improve the health in older adults.

Physical Activity Health Literacy in Iranian Older Adults: Development and Psychometric Testing.

Inadequate health literacy decreases physical activity. This study aimed to develop and examine psychometrics of physical activity health literacy in Iranian older adults. This methodological work was conducted in two phases. Phase 1 consisted of extensive studies review and qualitative study to extract and design the items. The psychometrics were measured in Phase 2 included content, faceconstruct validities, reliability, and stability. The collected data were analyzed in SPSS (version 25.0) and AMOS (version 24.0). The results of the exploratory factor analysis showed four factors- information evaluation, reading skill, perception, and decision making-and used information that explained 70.08% of the variance. The model's fitness was supported by confirmatory factor analysis. Internal consistency based on Cronbach's alpha was .89 with composite reliability >0.85. Stability was confirmed through the test-retest method and intraclass correlation coefficient (.89-1). Psychometrics of physical activity health literacy in Iranian older adults supported validity and reliability of the tool.

The Impact of Preventive Interventions on Intimate Partner Violence among Pregnant Women Resident in Hamadan City Slum Areas Using the PEN-3 Model: Control Randomized Trial Study / 가정의학회지

Background@#Intimate partner violence is a severe life-threatening criminal and public health problem affecting the well-being of individuals, families, and society. Planning interventions to reduce the burden of this persistent and criminal violence should be relevant culturally and socially. @*Methods@#In this randomized control trial, 150 pregnant women residing in slum areas of Hamadan were randomly assigned to two groups (intervention group: n=50 and control group: n=100). Interventional strategies included educating the victims based on local cultural norms, culturally sensitive individual and group counseling, and educating health care providers. Data were collected via face-to-face interviews at baseline and again at 3 months after the intervention. We used a paired t-test to evaluate the effect of the intervention by comparing changes in the outcomes measured. @*Results@#There were no statistically significant differences between the two groups at baseline in terms of sociodemographic characteristics. Post-test scores of knowledge (7.50±2.65 vs. 5.14±3.51, P=0.001), communication skills (18.38±4.25 vs. 16.2±3.83, P=0.04), and family support and social expectation of obedience (15.79±4.45 vs. 13.40±4.57, P=0.005) of the victims were statistically significantly higher in the experimental group compared to the control group. Moreover, physical (0.74±2.28 vs. 1.20±2.60, P=0.06), psychological (2.80±4.10 vs. 4.52±5.43, P=0.06), and sexual (0.11±0.58 vs. 0.61±1.22, P=0.04) violence reduced in the experimental group compared to the control group. @*Conclusion@#Culturally relevant interventions can reduce intimate partner violence.

Unintentional Injuries among the Elderly in Rural Areas and Their Related Behaviors / 가정의학회지

BACKGROUND: Although the role of unintentional injuries as a cause of death in adults is known, there is limited knowledge about such adults’ behaviors. This study aims to investigate the frequency of and factors affecting unintentional injuries among the elderly living in rural areas and their related behaviors. METHODS: A cross-sectional study was carried out in the rural areas of Hamadan County, Iran, in 2016. The sample consists of randomly selected 445 adults aged 60–75 years. Data collection was conducted through face-to-face interviews, using questionnaires. RESULTS: One hundred and forty-three participants (34.7%) experienced 166 injury occurrences. The injuries occurred more in females than in males. There were more mild and severe injuries (48.2% and 31.3%, respectively) than moderate ones (20.5%). The most frequent mechanism of injuries was accidental falls (64.5%). There was a significant relationship between using aid devices and injuries (P=0.001). Among the most applied injury preventive measures as reported by the elderly, crossing streets safely and the use of proper lighting at night had the highest percentages (81.5% and 69.7%, respectively). However, the use of protective handles and plastic flooring in bathrooms in order to prevent slipping had the lowest percentages (less than 1.0%). CONCLUSION: The injuries among the elderly in this study were important health concerns. Injury-related factors should be considered in the development of injury prevention programs.

The Association between Social Support and Happiness among Elderly in Iran / 가정의학회지

BACKGROUND: Elderly people's life is affected by multiple factors including social support, which is of the utmost importance. This study aimed to explore the association between social support and happiness as well as the impact of types of social support on happiness among elders. METHODS: This descriptive and analytical study was carried out on 411 elderly men and women referred to the retirement, cultural, and rehabilitation centers in Hamadan, west of Iran. Participants were selected by a multi-stage random sampling method. The research instrument included a questionnaire consisting of three parts: demographic information, the Oxford Argyle Happiness Inventory, and a Questionnaire derived from Social Support Theory. The questionnaire was completed through a self-report study. The collected data were analyzed using Pearson correlation coefficients, multiple linear regression, independent t-tests, and one-way analysis of variance in IBM SPSS Software ver. 22.0 (IBM Corp., Armonk, NY, USA). RESULTS: The mean for happiness was reported as 41.17±15.2. The values given for social support were 29.40±11.95 and for its dimensions were 7.53±3.89 and 13.70±4.90 for informational support and emotional support, respectively. Moreover, the mean value for appraisal support was 3.48±2.37 and was 4.70±2.56 for instrumental support. Multiple linear regression analysis revealed that social support and demographic variables could account for approximately 25% (R2=0.25) of changes in the variable of happiness. CONCLUSION: High social support could increase happiness among elders. The quality and quantity of social support can be taken into account as proper determinants and predictors of happiness among elders.