Effect of Lifestyle Promotion in the PRECEDE-PROCEED model among pre-diabetic adults based on PERSIAN cohort study: a randomized controlled trial study.

Background: Diabetes is a chronic disease caused by impaired glucose metabolism. This study aimed to design and evaluate the effect of a lifestyle promotion program based on the PRECEDE-PROCEED model among pre-diabetic individuals. Methods: This randomized controlled trial evaluated the effect of a lifestyle promotion program using the PRECEDE-PROCEED model among pre-diabetic individuals in Hoveizeh city in 2019. The study collected information on the disease status and risk factors associated with non-communicable conditions from the website of Hoveizeh Cohort Study Center. The primary outcome of the study was the percentage of glycated hemoglobin (HbA1c) with a three-month follow-up. Results: A total of 240 individuals participated in the study. There was no significant difference in anthropometric characteristics between the intervention and control groups (P < 0.05). Initially, there was no significant difference in the mean HbA1c between the intervention and control groups (P = 0.97). However, after three months of intervention, a statistically significant difference was observed (P > 0.001). The results indicated an increase in the mean quality of life in the intervention group, but no significant difference was found between the two groups or before and after the intervention within each group (P < 0.05). Conclusion: The findings suggest that the PRECEDE-PROCEED model provides a suitable framework for training pre-diabetic individuals and patients with type 2 diabetes mellitus (T2DM) to promote self-care behaviors. Supplementary Information: The online version contains supplementary material available at 10.1007/s40200-023-01273-7.

A confirmatory factor analysis of the Iranian version of the interpersonal communication skills scale among healthcare professionals.

BACKGROUND: Identifying healthcare professionals' (HCPs) communication skills is crucial to improving patient outcomes. Iranian HCPs' interpersonal communication skills (ICS) were validated using a culturally appropriate and indigenous scale. MATERIALS AND METHODS: In November and December 2021, convenience sampling was used to collect data from 170 HCPs. Seven factors were covered by the questionnaire, which consisted of 30 items. In order to validate the scale, first- and second-order confirmatory factor analyses (CFA) were performed. Various indices were used during the CFA, including Goodness of Fit Index (GFI), Adjusted Goodness of Fit (AGFI), Comparative Fit Index (CFI), Normed Fit Index (NFI), Standardized Root Mean Square Residual (SRMR), and Root Mean Square Error of Approximation (RMSEA). The Fornell-Larcker Criterion was used to assess discriminant validity. We analyzed the data in Lisrel 8.8 and SmartPLS 3.2.8. RESULTS: According to the Q2-index obtained from the blindfold test, the model had 44% predictive power. First-order CFA results showed acceptable indices (χ2 = 767.17; DF = 375; CFI = 0.98; GFI = 0.82; AGFI = 0.80; NFI = 0.97; SRMR = 0.22; RMSEA = 0.068). Furthermore, the second-order measurement model demonstrated adequate and desirable fit indices (χ2 = 797.24; DF = 381; CFI = 0.98; GFI = 0.82; AGFI = 0.78; NFI = 0.97; SRMR = 0.059; RMSEA = 0.068). General and listening skills were ranked highest in the importance-performance map analysis (IPMA). CONCLUSION: HCPs could benefit from this scale as it can assist them in developing ICS. It is recommended that skills training programs be replicated among different populations to evaluate their effectiveness.

The COVID-19 pandemic: knowledge, attitudes and practices of coronavirus (COVID-19) among patients with type 2 diabetes.

BACKGROUND: It is necessary to evaluate COVID-19 data on Knowledge, Attitudes and Practices (KAP) to confirm effective protective practice and to reduce risk in society. Hence, the study was carried out to determine KAP towards COVID-19 and the factors associated with knowledge and practices among patients with type 2 diabetes (T2D). METHODS: In this cross-sectional (descriptive-analytical) study, 357 patients with diabetes in Izeh participated in the study. The sampling method used was convenience sampling method. Data collection tool was a researcher-made questionnaire of demographic information and KAP of patients with T2D in relation to the new coronavirus. The validity and reliability of the research tool was confirmed using the content validity and test-retest. Data analysis was done in Stata.14.2 and Smartpls 3.2.8 using descriptive and analytical statistical tests. RESULTS: The mean score of participants' KAP towards Covid-19 was 74.22 (16.30), 72.88 (14.87), and 70.51 (19.70), respectively. The lowest and the highest score of the patients' knowledge was in the field of transmission (56.60 (20.96)) and care and prevention of the COVID-19 (88.58 (21.88)), respectively. Residence was the most important factor predicting the practice of diabetic patients with an explanatory coefficient ([SMD 1.08 (95% CI 0.85 to 1.30), P < 0.001] and R2 = 0.87%). CONCLUSION: Despite the good level of KAP of people towards the COVID-19 disease, there were answers showing poor knowledge, incorrect beliefs and attitudes, and insufficient practice regarding different aspects of the COVID-19 in some cases in our study. Residence was a strong predictor of type 2 diabetes mellitus (T2DM) patients' practice in terms of protective behaviors against Covid-19. Hence, educational needs evaluation based on residence is recommended, especially in rural T2DM patients.

Oral Health-Related Quality of Life Among Narcotic and Stimulant Users Referred to Maintenance Methadone Therapy Centers in Ahvaz City: Iran.

Introduction: We aimed to assess quality of life related to oral health in narcotic or stimulant users those were referred to maintenance methadone therapy (MMT) centers in Ahvaz City, Iran. Methods: It was a cross-sectional study based on exploratory approach which has conducted on 187 narcotic and stimulant users in Ahvaz city; during 15th May till September 2020. Data was selected by available non-random sampling method. The data collection tools included the demographic variables and the standard OHIP-14 questionnaires. All tests were used as descriptive statistics, Kolmogorov-Smirnov tests, independent t-test, one-way analysis of variance. P-values of less than 0.05 was considered significant. Results: The mean and standard deviation of the participants' age was 36.03 ± 8.98 years. The quality-of-life scores related to oral health were totally 34.89 ± 6.50 as well as 37.37 and 33.96 in narcotic and stimulant users, respectively. The total quality of life related to OHIP-14 did not have a significant relationship with variables of age, life companions, level of education, number of children, economic status, employment status, insurance status, underlying disease, toothbrush use status, last dentist visit, and number of missing teeth (P > 0.05). However, a significant difference was found between the quality of life related to oral health based on the type of substance used (narcotic or stimulant), so that the mean quality of life related to oral health was higher in narcotic than stimulant users (P < 0.05). Conclusion: Quality of life related to OHIP-14 was more unfavorable in stimulant users than narcotic users. So, policy makers and authorities are required to focus their interventions and research programs to improve health-related quality of life in users, especially stimulant.

Designing a national model for assessment of nursing informatics competency.

BACKGROUND: Due to the need for informatics competencies in the field of nursing, the present study was conducted to design a psychometric instrument to determine the qualification of informatics competencies of employed nurses in educational care centers. METHODS: The questionnaire was made by reviewing existing scientific resources and assessment tools. Two hundred nurses were selected using simple random sampling. Structural equation modeling was used using the measurement model technique and the average variance was calculated. Linear structural relations (LISREL) software was used to test the assumptions and correlations of the model. RESULTS: Findings showed relatively good estimation in the fit of first-order measurement model. The informatics knowledge subscale with a determining rate of 0.90 had the greatest explanatory effect among the subscales and informatics skill with a determining rate of 0.67 and basic computer skill with a determining rate of 0.60 were observed. The second-order measurement model of fitness indicators showed that the three factors can well explain the multidimensional construct of informatics competency. CONCLUSIONS: The designed tool can be used to develop educational strategies in relation to nursing students in the field of informatics and prepare them in the rich environment of information technology, which can be helpful in training nursing instructors.

Improvement in oral health related quality of life among the elderly: a randomized controlled trial.

BACKGROUND: The present study was conducted to determine the impact of educational intervention based on adult learning theory on oral health related quality of life of the elderly. MATERIALS AND METHODS: This study (IRCT20120910010804N13) was performed with 92 elderly patients referred to the dental clinic of Ahvaz Jundishapur University of medical sciences. Participants were randomly divided into experimental and control groups. The data were gathered by a questionnaire with demographic variables, variables of oral health related quality of the elderly, and variables for assessing the effectiveness of adult learning theory. Following pre-test, educational programs were conducted for the interventional group. After 1 month, the questionnaire was again administered to both groups. Next, the results of pre-test and post-test were analyzed using SPSS-23 at a significance level of 0.05. RESULTS: Educational intervention was significant in terms of overall oral health related quality of life and the overall effectiveness score of adult learning theory (P < 0.001). There was a significant difference between the two groups in terms of the mean change score of three physical, psychosocial, and pain dimensions following the educational intervention (P < 0.001). CONCLUSION: Education based on adult learning theory is recommended for improving oral health related quality of life among the elderly. TRIAL REGISTRATION: Iranian Registry of Clinical Trials, IRCT20120910010804N13. Registered on 2018-12-16. https://www.irct.ir/trial/35239.

Evaluation of an educational intervention based on health belief model on beta thalassemia carrier and final suspects couples.

INTRODUCTION: Beta-thalassemia is the most severe form of thalassemia major in which where the person needs regular blood transfusions and medical cares. The genetic experiment of prenatal diagnosis (PND) has been effective in the diagnosis of fetus with thalassemia major. This study was aimed to evaluate educational interventions on perceived susceptibility, perceived severity, perceived benefits, perceived barriers, cues to action and self-efficacy in beta-thalassemia carriers and suspected couples on doing a PND genetic test in Andimeshk. MATERIALS AND METHODS: In this quasi-experimental study, 224 beta-thalassemia carriers and suspected couples were randomly assigned to intervention and control groups. The data were collected using a researcher-made validated questionnaire using the self-administrated method. Before the intervention, questionnaires for both groups were completed, and then, an educational intervention was done for the intervention group during a month in four sessions for 30 min. After 2 months, the questionnaire was completed again by both groups. Data were analyzed using SPSS software version 20. RESULTS: There was no significant difference in the mean score of health belief model (HBM) variables and behavior between intervention and control groups before intervention (P < 0.05). However, after the educational intervention, the significant statistical difference in the mean score of perceived sensitivity, perceived severity, perceived benefits, perceived barriers, guidance for action, self-efficacy, and behavior of PND ß-thalassemia genetic tests was observed between the intervention and control groups. (P < 0.001). CONCLUSION: Educational programs based on HBM can increase HBM constructs, behavior, and self-efficacy of beta-thalassemia carrier couples for doing beta-thalassemia PND.

Predicting high school students' health-promoting lifestyle: a test of the information, motivation, behavioral skills model.

Background and aim Expenditure on adolescents' health promotion is critical to enhancing quality of life and fundamental for the prosperity of countries. This study tried to investigate the relationships between information-motivation-behavioral skills (IMB) model constructs as predictors of high school student's health-promoting lifestyle (HPL) in Southwest Iran. Methods This cross-sectional descriptive-analytic study was conducted on 400 students in Southwest Iran. Sample size required for this study was obtained using Soper's structural equation modeling (SEM) calculator. The stratified random sampling method was used in this study. A path analysis was taken to evaluate the HPL main determinants utilizing SEM. Results Information only had a significant indirect relationship with adolescents' HPL. But, both motivation and behavioral skills constructs had significant direct and indirect relationship with adolescents' HPL. The behavioral skill construct was the most imperative predictor variable. In general, behavioral skills construct (75%), motivation (66%) and knowledge (50%) constructs had the highest impact on HPL. The IMB model was able to explain 71% of the variance in adolescents' HPL. Conclusion The findings of the study showed that the IMB model was appropriate for explaining adolescents' HPL. It is necessary that actions are taken to improve behavioral skills and promote adolescents' HPL.

Explaining Continuance Intention of Fruit and Vegetable Consumption among the Rural Elderly: An Application of the Expectancy Confirmation Model.

Background and Aim: Healthy aging is the permanent right of all people. Thus, the purpose of this work was to investigate the expectation confirmation model constructs on intention of continuing to consume fruit and vegetables among the rural elderly. Materials and Methods: This cross-sectional study was conducted on 332 elderly. The expectation confirmation model served as a theoretical framework. A random sampling was recruited. Data were collected through face-to-face visit in the second 6 months of 2016. The data were then analyzed using LISREL 8.5 and SPSS 16 software. Results: This model could explain 79% of intention to continue fruit and vegetable consumption. The usefulness and satisfaction had the most effect on the intention to continue the consumption of fruit and vegetables. Conclusion: Expectation confirmation model depicted a proper application in explaining the intention to continue the consumption of fruit and vegetables in the elderly. Since perceived benefits were the most important factor in determining the intention to continue F&V consumption in this study, it is required that policymakers utilize suitable efficient strategies to promote the perception of benefits of F&V consumption in the elderly by means of campaigns in the society, organizations, and families.

Impact of theory-based educational intervention on explaining preventive pediculosis infestation behavior among primary school students.

BACKGROUND: Despite the fact that improved health, social, and economic situations have significantly affected the reduction of its infestation, pediculosis is still spreading worldwide. AIM: This study is conducted to evaluate the explanatory power of health belief model constructs in adoption of preventive pediculosis infestation behavior in female primary school students. METHODS: This study involves two stages. First, a cross-sectional study was conducted. In the second stage, a quasi-experimental intervention was performed. One hundred eighty female elementary school students in Omidiyeh County were randomly selected in two 90-subject groups (experimental and control). Samples were matched in two groups in terms of demographic variables. A group of educational intervention was based on the most effective construct of the first stage; and the educational intervention of control group was based on the low-effective construct. The path analysis and LISREL 8.5 software was utilized to compare the fit and the variance cover percentage of adopting preventive pediculosis infestation behaviors. RESULTS: According to the pre-intervention findings, there was no significant difference between experimental and control groups in terms of factors affecting the adoption of preventive pediculosis infestation behavior. This model had a weaker fit in the experimental than the control group, but these indices had better status after intervention in the experimental than the control group. Meanwhile, the cover percentage of explained variance for the experimental group after educational intervention was higher than pre-intervention, but it was lower in the control group. Finally, health belief model constructs (including the knowledge, cue to action, perceived susceptibility and severity, perceived benefits and barriers, and self-efficacy) in the experimental group, had better fit after the educational intervention compared with pre-intervention. CONCLUSION: Efficiency of the health belief model was approved for adopting preventive pediculosis infestation behavior in female primary school students. The future intervention studies should utilize the structural equation modeling approach separately in experimental and control groups to compare the changes in behavior between different demographic groups in the field of pediculosis infestation behavior.

Intention of Continuing to use the Hospital Information System: Integrating the elaboration-likelihood, social influence and cognitive learning.

INTRODUCTION: Anticipating effective factors in information system acceptance by using persuasive messages, is one of the main issues less focused on so far. This is one of the first attempts at using the elaboration-likelihood model combined with the perception of emotional, cognitive, self-efficacy, informational and normative influence constructs, in order to investigate the determinants of intention to continue use of the hospital information system in Iran. METHODS: The present study is a cross-sectional survey conducted in 2014. 600 nursing staff were chosen from clinical sectors of public hospitals using purposive sampling. The questionnaire survey was in two parts: Part one was comprised of demographic data, and part two included 52 questions pertaining to the constructs of the model in the study. To analyze the data, structural equation model using LISREL 8.5 software was applied. RESULT: The findings suggest that self-efficacy (t= 6.01, ß= 0.21), affective response (t= 5.84, ß= 0.23), and cognitive response (t= 4.97, ß= 0.21) explained 64% of the variance for the intention of continuing to use the hospital information system. Furthermore, the final model was able to explain 0.46 for self-efficacy, 0.44 for normative social influence, 0.52 for affective response, 0.55 for informational social influence, and 0.53 for cognitive response. CONCLUSION: Designing the necessary mechanisms and effective use of appropriate strategies to improve emotional and cognitive understanding and self-efficacy of the nursing staff is required, in order to increase the intention of continued use of the hospital information system in Iran.

Factors predicting the physical activity behavior of female adolescents: a test of the health promotion model.

OBJECTIVES: Physical activity behavior begins to decline during adolescence and continues to decrease throughout young adulthood. This study aims to explain factors that influence physical activity behavior in a sample of female adolescents using a health promotion model framework. METHODS: This cross-sectional survey was used to explore physical activity behavior among a sample of female adolescents. Participants completed measures of physical activity, perceived self-efficacy, self-esteem, social support, perceived barriers, and perceived affect. Interactions among the variables were examined using path analysis within a covariance modeling framework. RESULTS: The final model accounted for an R(2) value of 0.52 for physical activity and offered a good model-data fit. The results indicated that physical activity was predicted by self-esteem (ß=0.46, p<0.001), perceived self-efficacy (ß=0.40, p<0.001), social support (ß=0.24, p<0.001), perceived barriers (ß=-0.19, p<0.001), and perceived affect (ß=0.17, p<0.001). CONCLUSIONS: The findings of this study showed that the health promotion model was useful to predict physical activity behavior among the Iranian female adolescents. Information related to the predictors of physical activity behavior will help researchers plan more tailored culturally relevant health promotion interventions for this population.

Reliability and Construct Validity of the Iranian Version of Health-promoting Lifestyle Profile in a Female Adolescent Population.

BACKGROUND: Health-promoting lifestyle is receiving increasing attention concerning its prominent role in healthcare. This study examined to adapt the health-promoting lifestyle profile II culturally and to assess its psychometric properties. METHODS: In this cross-sectional study, content validity was established using translation and back-translation procedures, pilot testing of the instrument, and getting views of the expert panel. Concurrent validity was estimated with Pearson's correlation between the HPLP II, the quality of life (SF-12), self-efficacy variables, and demographic variables. Construct validity was evaluated by confirmatory factor analysis (CFA). Sample size for CFA included 500 people. HPLP II reliability was estimated with Cronbach's alpha coefficients. RESULTS: The content validity Index (CVI) surpassed 0.80 for the HPLP II and for four subscales. The CFA four-factor model represented an acceptable fit. Their factor loadings was more than 0.40. Correlations between the HPLP II and the subscales were acceptable. The relationships between the HPLP II, self-efficacy, SF-12 domain scores, and demographic variables were also significantly positive. Cronbach's α coefficient was 0.86 for the HPLP II and for the subscales ranged from 0.70 to 0.77. CONCLUSION: The shortened HPLP II had satisfactory psychometric properties. The revised 34-item four-factor model had perfect fit. It can be used to measure health-promoting lifestyle in the Iranian female adolescents' population.

Predicting health-related quality of life by using a health promotion model among Iranian adolescent girls: a structural equation modeling approach.

Predicting the significant determinants of health-related quality of life through the application of structural equation modeling in adolescents has received little attention in the health education and health promotion literature. The purpose of this study was to investigate the relationships between self-efficacy, barriers, social support, health-promoting lifestyle, and health-related quality of life among Iranian adolescent girls. Pender's health promotion model guided this study. This was a cross-sectional survey of 500 students who were recruited in Kashan, Iran. Their health-related quality of life was measured by using the Short Form Health Survey. A path analysis was conducted to predict the health-related quality of life determinants. The results indicated that 71% of the variance in health-related quality of life could be predicted by the variables. The results affirmed that self-efficacy was the most significant predictor of the students' health-related quality of life. It was concluded that interventions that are aimed at improving self-efficacy can lead to the enhancement of health-related quality of life among adolescent girls in the developing country of Iran.