Impact of health literacy and illness perception on medication adherence among older adults with hypertension in Iran: a cross-sectional study.

Background: Adherence to medication is an essential factor in controlling and reducing the side effects of non-communicable diseases, particularly hypertension. Medication adherence varies in older adults due to the effects of various factors. The research aimed to examine the determinants of medication adherence among older adults with hypertension. Methods: This cross-sectional study was performed among 300 people aged 60 years or older referring to health centers in Sarab, Iran, between February and May 2023. To collect data, valid and reliable tools were applied. Results: There was a significant association between age groups, level of education, and monthly income status with adherence to medication (p-value <0.05). According to the results of hierarchical regression, demographic variables collectively explained 3.2% of the variance in adherence to therapeutic regimens (p-value = 0.143). The inclusion of illness perception at step 2, along with demographic variables, led to a further significant increase in 9.6% of the variance (p-value <0.001). In the final step, health literacy dimensions were added, which explained an additional 8.7% of the variance (p-value <0.001). In total, demographic variables, illness perception, and HL dimensions explained 21.5% of the variance in adherence to therapeutic regimens. Conclusion: According to the results, demographic variables, illness perception, and HL dimensions were the main determinants of medication adherence among older adults. Health educators should focus on creating interventions that improve medication adherence by addressing illness perception and health literacy dimensions in this particular population.

Barriers to COVID-19 vaccine uptake: classification and the role of Health Literacy and Media Literacy.

Background: Vaccination is one of the most influential and cost-effective health interventions for preventing and reducing COVID-19 diseases. Unfortunately, the majority of the world's population is deprived of vaccination. Health Literacy (HL) and Media Literacy (ML) are essential to the COVID-19 vaccination. The present study investigates the barriers to COVID-19 vaccine uptake, focusing on classification and the roles of HL and ML. Methods: A cross-sectional study was conducted among people 18-65 years old in Sarab City, located in East Azerbaijan, Iran, between September to October 2020. Multistage cluster sampling was employed to recruit 298 people from Health Care Services Centers (HCCs). Results: The results of this research demonstrated that about 32.6% of participants reported that they have fully injected COVID-19 vaccines. Also, HL was positively associated with ML (r = 0.214, p < 0.05). Barriers of COVID-19 vaccine uptake were classified into personal, interpersonal, group and organizational, society and decision-making factors. Besides, barriers to the COVID-19 vaccine were significantly correlated with HL (r = -0.298, p < 0.05) and ML (r = 0.266, p < 0.05). Additionally, in the hierarchical regression model, demographic characteristics accounted for 8.2% of the variation in barriers to the COVID-19 vaccine (F = 4.34; p = 0.001), that monthly income (ß = -0.237; p < 0.05) and marriage statues (ß = 0.131; p < 0.05) were statistically associated with low barriers. HL as predictor variables explained an additional 14.4% of variation in barriers of COVID-19 vaccine (F = 53.84; p < 0.001) and ML explained an extra 9.2% of the variation (F = 38.83; p < 0.001). In total, demographic characteristics, HL dimensions and ML were able to explain 31.8% of the variation in barriers to COVID-19 vaccine. Conclusions: According to the findings, various strategies are needed to increase the COVID-19 vaccination uptake. This is due to the fact that barriers to COVID-19 vaccination uptake are multifactorial. These facts can help health policymakers and healthcare providers design media-based interventions to reduce barriers to COVID-19 vaccination uptake among adults. Enhancing vaccine HL and ML for adults and improving vaccine confidence are of high priority.

COVID-19 vaccine hesitancy: A Systematic review of cognitive determinants.

Background: Although mass vaccination is considered one of the most effective public health strategies during the pandemic, in the COVID-19 era, many people considered vaccines unnecessary and, or doubted the effectiveness of the COVID-19 vaccine. This review aimed to tabulate cognitive causes of COVID-19 vaccination hesitancy, which may help public health policymakers overcome the barriers to mass vaccinations in future pandemics. Methods: For this systematic review, studies pertaining to COVID-19 vaccine hesitancy published up to June 2022 were retrieved from six online databases (Cochrane Library, Google Scholar Medline through PubMed, Scopus, and Web of Science). Inclusion criteria were the studies conducted on people who had a delay in accepting or refusing COVID-19 vaccines, reported the impact of cognitive determinants on vaccine hesitancy, and were written in English in the timeframe of 2020-2022. Results: This systematic review initially reviewed 1171 records. From these 91 articles met the inclusion criteria. The vaccination hesitation rate was 29.72% on average. This systematic review identified several cognitive determinants influencing vaccination hesitancy. Lack of confidence and complacency were the most frequent factors that predicted vaccine hesitancy. Conclusion: The identified prevailing cognitive determinants for COVID-19 vaccine hesitancy indicated that using initiative and effective communication strategies would be a determinant factor in building people's trust in vaccines during the pandemic and mass vaccinations.

The Role of Perceived Social Support on Quality of Life in People with Cardiovascular Diseases.

Background: Cardiovascular Diseases (CVDs) are one of the major causes of hospitalization and mortality worldwide. Strengthening perceived social support and quality of life can reduce these problems. This study aimed to describe the role of perceived social support on cardiovascular patients' quality of life. Methods: This cross-sectional study was conducted from September 2020 to February 2021. We selected 150 cardiovascular patients through convenience sampling. The questionnaires included: the Persian version of the WHOQOL-BREF, Perceived Social Support, and demographic variables. Hierarchical linear regression was used to explore the association between perceived social support and quality of life. Data were analyzed by SPSS version 21.0 software. A P-value less than 0.05 is considered statistically significant. Results: The demographic variables could predict 12.2% of the variance of quality of life in the first step. In the second step, after adjusting control variables and dimensions of social support, the predictability increased to 29% of the variance with the addition of variables. All dimensions of social support, excluding tangible assets support, were significant predictors of quality of life and monthly income status. Self-esteem support (ß= 0.387) was the strongest predictor of quality of life in cardiovascular patients. Conclusions: Patients with higher perceived social support have a better quality of life than the other patients. Perceived social support is one of the strategies that can be utilized to improve quality of life and overcome disease in cardiovascular patients.

Correlates of Older Adults' E-Health Information-Seeking Behaviors.

INTRODUCTION: The Internet is an important source for health information and a medium for older adults' empowerment in health decision-making and self-caring. Therefore, we aimed to identify the potential motivators and probable barriers of e-health information-seeking behaviors (e-HISB) among older Iranian adults. METHODS: A cross-sectional study assessed the usefulness of self-efficacy, perceived encouragement, positive attitude toward e-HISB, perceived usefulness, challenges of being visited by physicians, and perceived barriers in predicting e-HISB in a sample of 320 older adults in Tabriz, Iran. RESULTS: The self-efficacy for online information seeking, positive attitude toward e-HISB, and perceived usefulness increased the odds of e-HISB by 12.00%, 24.00%, and 15.00%, respectively. In addition, e-health literacy, conflicting information, distrust of online information, and web designs that were not senior-friendly were the major barriers to e-HISB. DISCUSSION/CONCLUSION: The theoretical and practical implications of the motivators and barriers of e-HISB can be instrumental in designing and executing programs aimed at improving e-health literacy among older adults especially during the COVID-19 pandemic.

Health warning messages on cigarette packs: how young smokers process it.

One of the major smoking prevention strategies has been to educate the public and increase people's awareness, using health-warning messages. However, many young people continue smoking without paying attention to health risk messages on cigarette packets in Iran. Hence, this study was conducted to examine the processing route of anti-smoking messages and influencing cognitive factors based on the Elaboration Likelihood Model. This cross-sectional study was correlational in nature. The non-probability sample consisted of 387 tobacco smokers in the age range of 18 to 30 years old. The study was conducted between July and November of 2018 in Tabriz, Iran. A researcher-designed questionnaire was used for the purpose of data collection. No causal inferences were drawn due to the non-experimental nature of the investigation. It was found that tobacco smokers often processed the health warning messages through the central route. Perceived severity, smoking abstinence self-efficacy, and psychological dependence were predictors of message processing through the central route. The results supported the conceptual model of cognitional predictors of the processing route. To design and execute effective health warning messages to quit smoking, it is recommended to consider cognitive factors as a means to enhance critical thinking about the content of the health-warning message.

Theory-based E-health literacy interventions in older adults: a systematic review.

BACKGROUND: e-health literacy can facilitate the uptake of benefits of health for older adults. In this review, we aimed to tabulate the types and outcomes of the theory-based e-health interventions that had been applied to improve the e-health literacy of older adults. METHODS: In this systematic review, theory-based e-health literacy interventions that published up to April 2020 were retrieved from several online electronic databases, including Medline via PubMed, Cochrane Library, ProQuest, and EMBASE. The published papers were included in this study, if the study had been conducted on older adults, a theory-based intervention aimed at promoting e-health literacy, and had been written in English language in the timeframe of 2008-2020. RESULTS: A total of 1658 records were identified initially, of which, 12 articles met the inclusion criteria. The systematic review identified the using of variety of intrapersonal, interpersonal, and societal level conceptual models in enhancing of e-health literacy in older adults, and the concept of self-efficacy was applied in the most of interventions as the main conceptual theoretical framework. CONCLUSIONS: Despite the paucity of conceptual models, which are specifically designed for e-health literacy interventions, based on our findings, we recommend self-efficacy as a powerful concept that can play an important role in improving e-health literacy in older adults.

What psycho-social factors determine intimate partner violence of men against women? A social cognitive theory-based study.

Despite the multidimensionality of intimate partner violence (IPV) against women, there is a lack of research on the perspectives of men toward the phenomenon. Our aim in this cross-sectional study was to examine the predictability of social cognitive theory in explaining men's violent behaviors against women. We find among a sample of 576 Iranian married men showed a reciprocal determinism between outcome expectancy, attitude toward IPV, and observational learning in formation of men's IPV against women. Therefore, the interactive associations of cognitive and environmental factors, as a comprehensive approach, should be considered while studying the determinants of IPV against women among men.

A socio-cognitive inquiry of excessive mobile phone use.

OBJECTIVES: The study examined the predictive ability of selected demographic and socio-psychological characteristics in explaining excessive mobile phone use (EMPU) behavior and problematic use in a sample of university students on the basis of the social cognitive theory. METHODS: The sample consisted of 476 randomly selected university students in Tabriz, Iran. The study was cross-sectional in nature. A researcher-designed questionnaire was used for the purpose of data collection. No causal inferences were drawn due to non-experimental nature of the study. RESULTS: It was found that having boyfriend/girlfriend increases the likelihood of EMPU while self-efficacy to avoid EMPU decreases it. Self-efficacy to avoid EMPU, self-regulation, observational learning, self-control, and attitude toward EMPU were predictors of mobile phone problematic use. The results provided a proper fit for a conceptual model of reciprocal determinism. CONCLUSION: Although social cognitive constructs may predict mobile phone problematic use, they are not useful in predicting the behavior of EMPU.