A comprehensive scoping review of global educational strategies and outcomes in aedes-borne disease control.

BACKGROUND: Aedes mosquito is the primary vector of emerging or re-emerging arboviruses that threaten public health worldwide. Many efforts have been made to develop interventions to control the Aedes mosquito. This scoping review was conducted to identify the nature and scope of educational interventions to prevent and control diseases transmitted through the Aedes mosquito. The findings can be used to evaluate, compare, and develop appropriate control strategies. METHODS: The present scoping review was conducted in 2023 and used Arksey and O'Malley's approach, which involves five key stages. To search for academic papers, PubMed, Web of Science, Scopus and ScienceDirect databases were used with a combination of keywords about Aedes mosquitoes, educational interventions, and disease prevention and control. The search was not limited by the publication date, yet only included studies published in English. Studies were included that reported the educational interventions about Aedes mosquito control at the community or organizational level. The screening of papers was done based on the PRISMA-ScR guideline. Excel 2019 was used for data analysis. RESULTS: Initially, 3,172 papers were extracted, and after screenings and reviews, a total number of 45 final papers were selected. The studies focused on educational interventions. Twenty interventional studies were at the organizational level and 25 at the community level. The latter was the most commonly used strategy. Interventions using educational approaches have achieved sustainable results. Out of the forty-five studies, twenty-one were assessed to have a low risk of bias. CONCLUSIONS: The present scoping review evaluates the effectiveness of educational interventions at various community levels for controlling Aedes-borne diseases, emphasizing the need for multidisciplinary collaboration. Controlling Aedes mosquitoes using education and attracting the community's participation is an effective approach to reduce diseases transmitted through Aedes. The development of education at different levels of the community, such as educational and occupational environments, can play a role in the effectiveness of societal education and can be more cost-effective. Maintaining the effect of this approach is challenging because it requires multi-sector and multidisciplinary team participation and active community engagement over the long term. Further research is required to explore the removal of barriers to the implementation of educational interventions and the consistency of effects.

Psychometrics properties of type 2 diabetes treatment adherence questionnaire (DTAQ): a study based on Pender's health promotion model.

BACKGROUND: Management of type 2 diabetes (T2D) as a chronic disease requires treatment adherence such as controlling the blood glucose level and adopting a healthy lifestyle. The present study aimed to develop and psychometrically evaluate a questionnaire based on the Pender's Health Promotion Model (HPM) to measure treatment adherence and the associated factors among T2D patients. METHODS: The present study was conducted in qualitative and the quantitative phases between March 2022 and March 2023. The participants were T2D patients visiting Shahid Mohammadi hospital Diabetes Clinic in Bandar Abbas in the south of Iran. The first draft of items was extracted from the qualitative phase. The present study used interviews with T2D patients, item construction, validity and reliability evaluation of the instrument, and the relevant statistical analyses. It emphasized the significance of content, face, and construct validity, along with reliability testing using Cronbach's alpha and test-retest method. Data were analyzed using SPSS software, V16 and AMOS, V23. RESULTS: A 97-item questionnaire was developed through the qualitative phase and, after content validity, it was reduced to 86 items. Five items were removed in face validation, and after the test-retest method, 79 items were retained. The confirmatory factors analysis confirmed a 65-item model with appropriate fitness of data. Cronbach's alpha coefficient showed an acceptable reliability of the diabetes treatment adherence questionnaire (α = 0.92). CONCLUSION: The questionnaire developed based on the HPM model provides a standard and comprehensive measurement of the degree of adherence to treatment and the associated factors among Iranian T2D patients. This is especially valuable in the Iranian healthcare context, where effective management of chronic diseases such as diabetes is of a top priority. Questionnaires can help identify barriers and facilitators of treatment adherence to inform systematic and goal-oriented interventions. The proposed questionnaire had good psychometric properties, and can be used as a valid and practical instrument to measure the factors related to treatment adherence behaviors.

A health promotion model-based intervention to enhance treatment adherence in patients with type 2 diabetes.

BACKGROUND: The present study aimed to determine the effect of an intervention based on Pender's health promotion model (HPM) on treatment adherence in patients with type 2 diabetes (T2D). METHODS: The present quasi-experimental study with a 3-month follow-up was conducted in Bandar Abbas, a city in the south of Iran in 2023. The intervention group (IG) with a total number of 95 T2D patients was selected from Hormuz diabetes clinic and the control group (CG) with 95 T2D patients was selected from comprehensive health centers through a clustering sampling method. The educational intervention was implemented in 10 sessions to improve patients' treatment adherence. The teaching methods in training sessions were lectures, joint discussions, Q&A, role-play and peer training. The participants were evaluated using a researcher-made questionnaire including the constructs of Pender's HPM about T2D treatment adherence, hemoglobin A1C (HbA1C), and BMI. Independent-samples t-test, paired-samples t-test, covariance analysis and stepwise regression analysis were used. Data analysis was done in SPSS 26. FINDINGS: Three months after the intervention, in comparison to the CG, the mean and standard deviation of treatment adherence benefits (p = 0.002), treatment adherence self-efficacy (p = 0.010), treatment adherence related affect (p = 0.001), interpersonal influences (p = 0.012), commitment to plan of action (p < 0.001), treatment adherence behavior (p = 0.022), treatment adherence experiences (p = 0.001) was higher in the IG. The mean and standard deviation of situational influences (p < 0.001), immediate competing demands and preferences (p = 0.018) were lower than the CG. The results obtained from the analysis of covariance proved the effectiveness of the intervention in the constructs of Pender's HPM and HbA1C in participants of the IG (p < 0.001). The regression analysis showed, after the intervention, for every 1 unit of change in commitment to behavior planning, action related affect and perceived self-efficacy, compared to before the intervention, there were 0.22 units, 0.16 units and 0.26 units of change in the behavior score in the IG. CONCLUSION: The findings proved the effectiveness of the educational intervention in improving the constructs in Pender's HPM and the blood sugar level of T2D patients. As the results of the educational intervention showed, the use of a suitable educational approach as well as the development of appropriate educational content for the target population can significantly improve the treatment adherence behavior. TRIAL REGISTRATION: This study is registered on the Iranian Registry of Clinical Trials (IRCT20211228053558N1: https://www.irct.ir/trial/61741 ) and first release date of 17th March 2022.

A qualitative exploration of experts' views about multi-dimensional aspects of hookah smoking control in Iran.

BACKGROUND: The related literature has primarily addressed cigarette smoking control. It seems that researchers have failed to explore the determinants of hookah smoking (HS) control. In an attempt to fill this gap, the present study explores experts' views about aspects of HS control in Bandar Abbas, a city in the south of Iran. METHODS: The present qualitative study, conducted in 2022 and 2023, used a content analysis. To this aim, 30 experts in tobacco prevention and control were invited to participate in the research. Twenty seven accepted the invitation. In-depth, semi-structured, and face-to-face interviews were held with the experts. A purposive sampling was used and the data collection continued until data saturation. The interviews lasted between 18 and 65 min. MAXQDA 10.0 was used for data management and analysis. RESULTS: The expert interviewees had a mean age of 44.77 ± 6.57 years and a mean work experience of 18.6 ± 6.8 years. A total number of six main categories were extracted from the data, including usin influential figures to control HS, controlling HS by alternative activities, changing beliefs and attitudes toward HS, taking administrative and regulatory measures, and facilitating HS cessation. CONCLUSION: This qualitative study explored the multifaceted ways people adopt to quit HS. Using influential figures to control hookah smoking, promoting alternative activities as a means of control, changing beliefs and attitudes, enforcing administrative regulations, and facilitating quit attempts all play an important role in tackling the prevalence of hookah smoking. These findings emphasize the importance of a comprehensive and multifaceted approach to integrate various interventions to effectively address hookah smoking behavior.

Assessing the risk of metabolic syndrome and diabetes in relation to Hookah smoking: Evidence from a cohort study in Southern Iran.

Background: Hookah smoking has pointedly increased worldwide and could have different harmful health effects. However, long term hookah smoking effects on chronic diseases has not been well studied. This study was aimed to investigate the relationship between hookah smoking with metabolic syndrome and diabetes. Methods: In this prospective study, the baseline data from 3695 participant (35-70 years old) of Bandar-e-Kong cohort study in Hormozgan province, Iran were used. In this study, data were collected through the questionnaires designed in the Kong cohort study and 25 mm of blood sample. All analyses were performed using SPSS version 27.0 and the ggplot2 package in RStudio version 2023.06.1 + 524. p < 0.05 was considered a significant difference. Results: The prevalence of hookah smoking was 17.3% in total. Also, the prevalence of metabolic syndrome, diabetes, hypertension, and dyslipidemia were 35.6, 15.2, 31.2, and 78.0%, respectively. Our results showed that there were statistically significant relationship between hookah smoking and metabolic syndrome, hypertension and diabetes (p < 0.05). In the case of dyslipidemia, hookah smoking was also associated with increase in dyslipidemia (p < 0.05). Conclusions: More evidence is needed to understand the mechanism of hookah smoking and these health effects. As well as, health education and increasing public awareness about the health effects of hookah smoking and implementation of smoking prohibition policies are highly recommended.

The effectiveness of a theory -based health education program on waterpipe smoking cessation in Iran: one year follow-up of a quasi-experimental research.

BACKGROUND: The present research aimed to determine the effect of an educational intervention based on the extended theory of planned behavior (ETPB) on waterpipe (WT) smoking cessation in women. METHODS: The present quasi-experimental had a pre-test, post-test design with 3, 6 and 12 months follow-ups was conducted in Bandar Abbas city, south of Iran in December 2021-March 2023. A total of 448 women over the age of 15 (224 in the intervention group (IG), 224 in the control group (CG)), using a two-stage cluster sampling method participated. The educational intervention focused on WT smoking cessation implemented in 14 sessions. The educational methods in the training sessions were lectures, collaborative discussions, Q&As, brainstorming, role plays, and peer education. The main outcome was WT cessation behavior. Repeated measures ANOVA tests and post hoc were run to compare the IG and CG at baseline in terms of demographic variables, t-test and chi square test, and in the four points of time of data collection. The data were analyzed in Stata14. A p-value < 0.05 was considered as statistically significant. RESULTS: The mean and standard deviation of WT cessation behavior and all ETPB constructs in the IG was significantly higher than the CG. After the educational intervention, in the IG, the perceived behavioral control, attitude, subjective norm, intention and knowledge increased, and the weekly smoking and WT smoking habit decreased (P < 0.001). The CG did not have any significant change in other variables except for the increased knowledge score. During the 12-month follow-up, the cessation rate was 43.81% (P = 0.645) in the IG and 7.45% in the CG (P = 0.081). CONCLUSIONS: The educational intervention positively affected WT smoking reduction and cessation in women through influencing the ETPB constructs. It is strongly recommended to design theory-based interventions beyond the individual level with an emphasis on interpersonal relationships to facilitate WT cessation as far as possible.

Relationship between self-efficacy and adherence to antiretroviral therapy in HIV/AIDS patients: An analytical cross-sectional study in southern Iran.

Background and Aims: The human immunodeficiency virus (HIV) infection, also known as acquired immunodeficiency syndrome (AIDS), is spreading rapidly in the world, especially in developing countries, and is considered a serious health threat. This study aimed to assess the relationship of adherence antiretroviral therapy (ART) and self-efficacy among people living with HIV. Methods: This cross-sectional study was conducted in March-July 2022 at the Center for Behavioral Diseases in Bandar Abbas. A total number of 208 HIV patients treated with ART entered the study after voluntarily signing an informed letter of consent. The data collection instrument was the adherence to ART questionnaire with the six subscales and the General Self-Efficacy Scale-17 (GSE-17) general self-efficacy questionnaire. Multivariate regression analysis was used to test the relationship among the variables. Results: The participants' mean age was 41.7 ± 8.2 years. Self-efficacy was positively correlated with adherence ART. With every one score of increased self-efficacy, MA increased for 0.85 score (p < 0.001) and medical challenges have the strongest correlation (r = 0.27) with self-efficacy. The multivariable regression analysis showed that moderate and high socioeconomic status (SES) each improved MA for 18 and 22 units, respectively, compared to poor SES. Alcohol consumption reduced MA for 11 units. Conclusion: This study proved the positive relationship of self-efficacy in adherence to ART in HIV patients. The insights offered by this research can help develop a systematic and effective intervention to promote MA in HIV patients. SES and alcohol consumption significantly affect MA.

Determinants of Adherence to Treatment in Type 2 Diabetic Patients: A Directed Qualitative Content Analysis Based on Pender's Health Promotion Model.

Adherence to the treatment of type 2 diabetes (T2D), which includes the use of prescribed drugs, following a healthy diet, and adopting a physically active lifestyle, is important to control the disease and improve the patients' quality of life. The present study aimed to explain the determinants of adherence to treatment in patients with T2D based on Pender's Health Promotion Model (HPM). The present research used a qualitative content analysis and was based on Pender's HPM. The data were collected through in-depth semi-structured interviews with 20 T2D patients using a purposive sampling in Bandar Abbas, southern Iran. Maximum variation was considered in terms of gender, age, history of diabetes, type of drug used, education, and occupation. The data collection continued until data saturation. At the same time, the collected data were analyzed using the directed content analysis. MAXQDA 10 was used to manage codes and facilitate data analysis. The data analysis led to the extraction of 10 categories and 19 subcategories as the determinants of adherence to the treatment of T2D patients. The participants shared their experiences about personal characteristics and their ecological environment, specific cognition and emotions, and the behavioral results and experience as the determinants of adherence to T2D treatment. The categories extracted from this study in the form of HPM constructs provided a framework to explain treatment adherence. This information can help policy makers and planners in designing future programs.

Smoking waterpipe, cigarette, and heart disease: a cross-sectional analysis of baseline data from the Kong Cohort Study in the South of Iran.

Previous studies have shown the association between smoking and increased risk of cardiovascular diseases, but long-term effects of waterpipe use are unknown and more research is needed. The present study explored the relationship between cigarette and waterpipe smoking and heart disease in southern Iran. This cross-sectional study used the basic data of Bandar Kong Cohort Study (KCS) to test the relationship between waterpipe and cigarette smoking and heart disease in 4009 participants. A multivariate binary logistic regression was run to estimate adjusted odds ratios (ORs) in SPSS 16. The prevalence of tobacco use was 27.7%. The frequency of heart disease was 7.8% percent (n = 314). There was a statistically significant relationship between cigarette smoking and heart disease (OR = 2.11; 95% CI:1.41-3.16). In individuals who only smoked waterpipes, the odds of heart disease were higher than non-smokers. This relationship was not statistically significant (OR = 1.25, 95% CI:0.88-1.78). In those who smoked cigarettes and waterpipe at the same time, the odds of heart disease were higher than non-smokers (OR = 1.42; 95% C.I: 0.83-2.59). In general, cigarette smoking increases the risk of heart disease. As well as waterpipe smoking was associated with heart disease. However, this association was not statistically significant. More studies are required to validate the association between waterpipe smoking and heart disease. Also, waterpipe use was more common at younger ages, and on the other hand, heart diseases have a long latent period, so in this age group, high incidence of heart disease is likely in the future.

The role of intrapersonal and interpersonal factors in waterpipe cessation: a case-control study.

BACKGROUND: The prevalence of waterpipe smoking among women in southern Iran is significantly higher than women in other regions of Iran. We aimed to explore the effect of several demographic factors, knowledge, attitude, self-efficacy and social norms on a successful cessation of waterpipe smoking in the marginalized women of Bandar Abbas city, in the south of Iran. METHODS: This case-control study was conducted in 2022 among 731 women (246 subjects who successfully quit waterpipe smoking in the case group and 485 who smoked waterpipe in the control group). A cluster sampling method was used to collect the required data through face-to-face interviews and a researcher-made questionnaire. The questionnaire consisted of demographic information, behavioral information about waterpipe smoking and knowledge, attitude, self-efficacy and social norms. The data were analyzed in STATA 14 using univariate and multivariate regression analyses. RESULTS: The mean and standard deviation of age was 39.24 ± 11.93 and 37.18 ± 13.57 in the control and case groups, respectively. With an increase of one score in social norm (OR: 1.046), the odds of cessation were increased for 4%. With an increase of one score in self-efficacy (OR: 1.152), the odds of cessation were increased for 15%. With an increase of one score in knowledge (OR: 1.064), the odds of cessation were increased for 6%. With an increase of one score in attitude (OR: 1.215) the odds of cessation were increased for 21%. CONCLUSION: The present findings revealed personal and interpersonal influential factors in successful waterpipe cessation. Women's knowledge can be increased and their attitude can be changed. Important people in women's lives can be influenced to, consequently, affect women positively and improve their self-esteem.

Oral health and smoking in Bandare-Kong cohort study: a cross-sectional population-based study (findings from PERSIAN cohort study).

Considering the harmful effects of smoking on oral and dental health, our aim was to investigate the oral and dental health status of people in the city of Bandare-Kong, Iran, and its relationship to smoking. This cross-sectional population-based study used baseline data from the Bandare-Kong Cohort Study. A total of 4063 participants aged 35-70 years were included in this study. Using Stata17 software, negative binomial regression was employed to identify factors related to the decayed, missing, and filled teeth (DMFT) index. The association between smoking status and DMFT was assessed by the adjusted incidence rate ratio (IRR). Of the 4063 participants, 987 (24.29%) used cigarettes, hookahs, or both. The mean ± standard error (SE) DMFT index in all subjects was 11.08 ± 0.15; it was 14.17 ± 0.53 for cigarette smokers and 12.39 ± 0.37 for hookah users (p < 0.001). After adjusting for other variables, the rate of DMFT for cigarette smokers was 0.33 (IRR: 1.33; 95% confidence interval [CI]: 1.22, 1.44), which was higher than for those who did not use cigarettes. The rate of DMFT for those who used cigarettes, hookahs, or both was 0.11 (IRR: 1.11; 95% CI: 1.05, 1.18), which was also higher than for those who did not smoke. Cigarette smoking is a risk factor for oral health complaints. Although the rate of DMFT was increased in hookah smokers, it was not a predictor of dental problems. However, we suggest that hookah use be included in educational policies to control oral and dental diseases.

Predictive power of PEN-3 cultural model in cervical cancer screening among women: a cross- sectional study in South of Iran.

BACKGROUND: Cervical cancer (CC) can be prevented through early detection facilitated by screening as well as an early diagnosis and effective treatment of the precancerous lesions. The present research aimed to determine the predictors of cervical cancer screening (CCS) based on the PEN-3 model constructs. METHODS: A cross-sectional study was conducted between September 2021- March 2022 with 840 women aged 15-49 in the city of Bandar Abbas, in the south of Iran, using a cluster sampling. The participants completed a valid and reliable self-administered questionnaire in person. The questionnaire included demographic characteristics, knowledge toward CC and the constructs of the PEN-3 model toward CCS. A multivariable logistic regression was used to determine the relationship and predictive power of model constructs with behavior as an outcome variable. The data were statistically analyzed in STATA14.2. The p-value < 0.05 was considered statistically significant. RESULTS: A total of 810 questionnaires were analyzed (with a return of 95.63%). The mean and standard deviation of the participants' age was 30.97 ± 5.80 years. Pearson correlation coefficient analysis of all constructs and CCS behavior was statistically significant (P-value < 0.05). The multivariable logistic regression analytic results were enablers toward CCS (coefficient: 0.275) and Nurturers toward CCS (coefficient: 0.182), perceptions toward CCS (coefficient: 0.077) and knowledge toward CC (coefficient: 0.048, marginal significant) were predictors of CCS behavior. For the internal validity of the designed prediction model, a sample of 1000 was selected using the bootstrap sample replacement method which demonstrated the accuracy of the model PEN-3 is about 75% in predicting CCS behavior. CONCLUSIONS: The results of the present research showed that personal factors such as perceptions and interpersonal factors such as enablers and nurturers toward CCS can predict CCS behavior. Therefore, in order to increase the acceptance of CCS in women, a set of intrapersonal and interpersonal factors should be taken into account.

A predictive model of waterpipe smoking cessation among women in southern Iran: application of the theory of planned behavior.

BACKGROUND: Today, waterpipe (WT) smoking is a rising issue worldwide, and has taken a significant and growing share of tobacco consumption in the world. Present study aimed to explore the predictors of WT cessation in the light of the theory of planned behavior (TPB). METHODS: This cross-sectional analytical study was conducted in 2021-2022 using a multi-stratified cluster sampling on 1,764 women in Bandar Abbas, southern Iran. Data were collected through a reliable and valid questionnaire. The three-part questionnaire includes demographic information, behavioral information of WT smoking, and the constructs of the TPB along with an additional habit construct. Multivariate logistic regression analysis was run to model the predictor constructs of WT smoking. The data were analyzed statistically in STATA14.2. RESULTS: With an increase in one attitude score, the odds of cessation increased by 31% (p < 0.001). Also, with an increase of one score in knowledge, the odds of cessation are increased by 0.05% (0.008). With an increase of one score for intention, the odds of cessation are 26% (0.000). in social norms, the odds of cessation are 0.02% (0.001). With an increase of one score in perceived control, the odds of cessation increased by 16% (0.000) and inhabit score, the odds of cessation decrease by 37% (0.000). In the model where the habit construct was present, the accuracy, sensitivity, and pseudo R2 indices were 95.69%, 77.31%, and 65%, respectively and after removing the habit construct, the so-called indices changed to 90.7%, 50.38% and 0.44%, respectively. CONCLUSIONS: The present research confirmed the effectiveness of the TPB model in predicting waterpipe cessation behavior. The knowledge obtained from this research can help develop a systematic and effective intervention to facilitate waterpipe cessation. Focusing on the habit variable can play a critical role in waterpipe cessation in women.

Socio-personal factors affecting adherence to treatment in patients with type 2 diabetes: A systematic review and meta-analysis.

PURPOSE: The purpose of study was to identify the socio-personal factors affecting adherence to the treatment of patients with type 2 diabetes. METHODS: Cross-sectional articles were extracted from databases such as Web of Science, PubMed, Elsevier. A meta-analysis was performed using integrated odds ratios (OR) and 95% confidence interval (CIs) for age, BMI, depression, educational level, gender, employment status, marital status, smoking status. STATA 12.0 was used to estimate pooled RR in definite subgroups. The quality of the studies included was evaluated using the STROBE checklist. RESULTS: Thirty-one studies out of 7407 extracted articles were finally selected for the meta-analysis. The results showed that younger people had a 17% higher risk than older people, smokers had a 22% higher risk than non-smokers, and the employed had a 15% higher risk of non-adherence to treatment. CONCLUSION: In conclusion, older age, smoking and employment can lead to non-adherence to T2D treatment. Interventions are suggested to be made besides common health care considering the socio-personal features on type 2 diabetes patients' treatment adherence.

Utilization of cervical cancer screening services and its associated factors in Iran: a case-control study.

BACKGROUND: Considering the high incidence rate of cervical cancer (CC) in Iran, screening is an effective way of reducing the impact of the disease due to early detection. Thus, the recognition of the factors affecting the use of cervical cancer screening (CCS) services is essential.The present study aimed to determine the associated factors of CCS in women living in the suburbs of Bandar Abbas in the south of Iran. METHODS: The present case-control study was conducted between January and March 2022 in the suburban areas of Bandar abbas. Two hundred participants were assigned to the case group and 400 participants were assigned to the control group. A self-constructed questionnaire was used to collect the data. This questionnaire contained demographic information, reproductive information, knowledge of CC, knowledge of CCS and access to the screening. Univariate and multivariate regression analyses were run to analyze the data. The data were analyzed in STATA 14.2 at a significance level of p < 0.05. RESULTS: The mean and standard deviation of participants' age in the case group was 30.33 ± 4.892, and in the control group was 31.35 ± 6.149. The mean and standard deviation of knowledge in the case group was 10.21 ± 1.815 and in the control group was 7.24 ± 2.447. The mean and standard deviation of access was 43.72 ± 6.339 in the case and 37.17 ± 4.828 in the control group. The results of multivariate regression analysis showed the following factors increased the odds of CCS: knowledge (OR medium = 18.697, OR high = 13.413), access (OR medium = 4.028, OR high = 8.126), being married (OR = 3.193), being educated (OR diploma = 2.587, OR university degree = 1.432), middle and high SES (OR Middle = 6.078, OR Upper = 6.608), and not smoking (OR = 1.144). Also, women's reproductive status, including history of sexually transmitted diseases (OR = 2.612), use of oral contraceptives (OR = 1.579), sexual hygiene (OR = 8.718). CONCLUSIONS: In the light of the present findings, it can be concluded that besides increasing suburban women's knowledge, their access to screening facilities should be improved. The present findings showed the need to remove the barriers to CCS in women of low SES to increase the rate of CCS. The present findings contribute to a better understanding of factors involved in CCS.

Perceived stress among older adults during COVID-19 outbreak: A cross-sectional study in Southern Iran.

Background and Aims: The stress associated with the coronavirus disease 2019 (COVID-19) pandemic significantly affects people's lives, especially older adults. The present study aimed to identify risk factors leading to the perceived stress associated with COVID-19 among the adults over 60 years old of Southern Iran. Methods: This cross-sectional study was conducted in December 2021 in Bandar Abbas among older adults. The COVID-PSS-10 (Perceived Stress Scale) questionnaire was distributed among the older adults receiving healthcare services from health centers in Bandar Abbas selected through a convenient sampling method. Then, answers to the questions resulted in the score (without units). Results: A total number of 456 participants between 60 and 90 years with an average age of 64 ± 5.12 years took part in this study. The mean ± SD score of total perceived stress was 16.45 ± 8.36 (the mean score of stress was 10.30 ± 6.16 and coping was 6.15 ± 3.83). Of the total, 129 participants (28.28%) were grouped as the high-stress group. Results showed that the 70-79 years age group had higher odds of belonging to the stressed group than the 60-69 years age group (odds ratio = 2.336). Moreover, participants with a diploma were 57% more stressed than illiterate participants. The latter perceived less stress and had lower odds of belonging to the high-stress group. The employed were 61% less likely to be categorized in the stressed group than the unemployed. Among women, 43% were less likely than men to be in the high-stress group. Conclusion: As the present findings showed, the risk factors of perceived stress induced by COVID-19 are old age, low education, unemployment, and masculinity. Therefore, planning to improve stress-coping skills such as entertainment, strengthening social relationships, physical activity, and the peace of mind of this population are suggested under the supervision of geriatric specialists and psychiatrists.

Application of Pender's health promotion model for type 2 diabetes treatment adherence: protocol for a mixed methods study in southern Iran.

BACKGROUND: Type 2 diabetes (T2D) mellitus treatment as a chronic disease requires adequate adherence to treatment including controlling blood glucose levels and lifestyle management. The aim of this study is to investigate the factors affecting of adherence to T2D treatment from the perspective of patients and design an intervention program based on Pender's health promotion model (HPM) to increase T2D treatment adherence in Bandar Abbas, a city located in the south of Iran. METHODS: This mixed method study will consist of qualitative stage, questionnaire design and a randomized, open-label, parallel-group interventional study based on HPM in southern Iran. Sampling for qualitative stage will continue until reaching the saturation. In the intervention stage, participants will be 166 T2D patients referring to the Bandar Abbas Diabetes Clinic will be randomized into intervention and control groups (allocation 1:1). After identifying the factors affecting adherence to treatment in T2D patients by qualitative study and literature review, a questionnaire based on HPM will be designed. In the next stage, 10 sessions of intervention for the intervention group will be designed. To evaluate the effect of the intervention, intervention and control groups will be tested for hemoglobin A1c (HbA1c) before and 3 months after the intervention. DISCUSSION: This designed study is a program for improving treatment adherence in T2D based on the HPM model and contributes to a better understanding of effective factors in adherence to treatment in T2D patients. The results of this project can be used for macro-diabetic planning. TRIAL REGISTRATION: This study is registered on the Iranian Registry of Clinical Trials (IRCT20211228053558N1: https://www.irct.ir/trial/61741 ) and first release date of 17th March 2022.

Explaining the factors affecting women's life during COVID-19 lockdown: A qualitative study among women in Southern Iran.

Background: The long-term impact of COVID-19 on women's health can cause serious damage to the family and society. Aim: To explain the factors affecting women's life during COVID-19 lockdown in Southern Iran. Methods: In this qualitative study, 20 women who referred to Bandar Abbas health care centers were interviewed and semi-structured interviews continued until data saturation. Results: Data were extracted into seven categories as follows: socio-family influence, occupational challenges, financial concern, leisure time, access to services, psychological reactions, and physical problems. Conclusion: We conclude that, lockdown had effects on women's life in terms of psychological, social, economic, and family relationships. Learning risk management skills can help manage these effects.

Quality of life and its related psychological problems during coronavirus pandemic.

BACKGROUND: The prevalence of coronavirus disease 2019 (COVID-19) has endangered the psychological health of individuals. This study aimed to assess the quality of life and its related psychological problems during COVID-19 pandemic. METHODS: In this cross-sectional study, 559 citizens above the age of 16 years, in Isfahan and Bandar Abbas cities in Iran were selected with a convenient sampling method. An online questionnaire was used to collect the data, which consisted of five sections: demographic information, short health anxiety inventory (SHAI), perceived stress scale (PSS), world health organization quality of life questionnaire (WHOQOL-BREF) and Padua inventory. Data were analyzed using statistical tests including t-test, path analysis and structural equation modeling (SEM) using SPSS 24 and Amos 21 statistical software. RESULTS: A total of 559 subjects with the mean age of 37.34 ± 11.19 years participated in this study. Most of the participants were female (78.5%), married (71.6%) and employed (40.9%). The majority of them also had a bachelor's degree (42.9%). There were significant negative correlations between perceived helplessness (r = -.597, p = .000), perceived stress (r = -.715, p = .000), risk of disease (r = -.302, p = .000), negative effect of disease (r = -.424, p = .000), health anxiety (r = -.366, p = .000), contamination obsessions (r = -.187, p = .000) and washing compulsions (r = -.193, p = .000) with quality of life. On other hand, significant positive correlation was found between perceived self-efficacy (r = .665, p = .000) and quality of life. CONCLUSIONS: According to our findings, health anxiety, perceived stress and obsessive-compulsive disorder were negatively affected psychological health during COVID-19 which in turn decreased quality of life. Therefore, we suggest considering prevention and treatment of theses psychological problems to diminish the risk of reduced quality of life during COVID-19 global pandemic crisis.