Mother's milk-mother's gift: Mobile-based training to increase self-efficacy of nursing women during postpartum and puerperium: A quasi-experimental study.

BACKGROUND: The World Health Organization recommends exclusive breastfeeding for 6 months followed by continued breastfeeding with complementary food up to 2 years of age or beyond. This study aimed to investigate the effect of mobile -based education on the self-efficacy of lactating women in the postpartum period. METHODS: A quasi-experimental study was carried out in 2018 in Shirvan, Iran among 69 postpartum women. Participants were assigned to intervention (n = 33) and control (n = 36) groups on the first day after delivery by random allocation. Intervention group received the mobile-based training for 4 weeks in the form of text messages, photos, video clips, and audio files. The control group received routine hospital care and training. Data were collected on demographic characteristics, delivery information, and the breastfeeding self-efficacy. Self-efficacy was measured in two groups at three time points; the first day after delivery, 4 weeks after delivery and 8 weeks after delivery. FINDINGS: The mean and standard deviation of breastfeeding self-efficacy score was higher in the intervention than control group 4 weeks (155.30 ± 10.93 vs 132.52 ± 19.70, P < 0.001) and 8 weeks after delivery (160.18 ± 11.33 vs 132.30 ± 24.09, P < 0.001). Compared to the control group, the rate of exclusive breastfeeding in the intervention group was significantly higher 4 and 8 weeks after the delivery (Pall < 0.05). DISCUSSION: The findings from this study showed a substantial increase in breastfeeding self-efficacy and exclusive breastfeeding in the group who received training through mobile-based education compared to the group that received routine care. APPLICATION TO PRACTICE: Mobile-based breastfeeding education might be a promising strategy to increase breastfeeding self-efficacy. It is suggested that midwives include the design of mobile-based educational programs as part of their educational strategies and use the advantages of this educational method during pregnancy and after childbirth. TRAIL REGISTRATION: This article has been registered in Iran's Clinical Trial Center with the code: 2 N20171024036972 IRCT.

Comparison of associated factors of domestic violence against women by their husbands based on demographic characteristics and life skills in Iran.

BACKGROUND: In recent decades, the prevention of domestic violence against women (DVAW) has been considered a priority for women's health in many countries. Identifying factors related to DVAW by their husbands or intimate partner can promise prevention and decrease in prevalence. The objective of this study was to examine and compare associated factors of domestic violence based on demographic characteristics and some life skills. MATERIALS AND METHODS: This cross-sectional study was conducted in Abadan, Iran. 640 couples completed questionnaires including demographic characteristics, communication skills, anger management, and problem-solving skill. In addition, women completed the questionnaire on domestic violence. Data were analyzed using descriptive statistics (t-test and one-way analysis of variance) and multiple linear regression. RESULTS: Approximately 57% of the women in this study have been subjected to psychological violence in their lifetime by their husbands. The result of multiple regression indicated that demographic characteristics had a very small contribution to explaining domestic violence (R 2= 0.03) and only the education level of women was identified as a key predictor of domestic violence. The result of multiple regression based on life skills among couples demonstrated that communication skills and anger management of couples were inversely and significantly associated with domestic violence and these variables explained 51% of the variance in domestic violence. CONCLUSIONS: Empowering couples with anger management and communication skills can play an important role in decreasing domestic violence. Therefore, developing and planning educational interventions by policymakers and health care providers seems necessary for couples.

Effects of the COVID-19 pandemic on lifestyle among Iranian population: A multicenter cross-sectional study.

Background: Quarantine, an unpleasant experience, was implemented in many countries to limit the spread of Coronavirus disease 2019 (COVID-19), which it could associated whit lifestyle changes. The present study aimed to determine the changes in Iranian's lifestyle during COVID-19 pandemic. Materials and Methods: In the present cross-sectional study, 2710 Iranian people completed an online researcher-made questionnaire asking lifestyle regarding COVID-19, which includes five sections about physical activity, stress and anxiety, nutrition habit, sleep disorders, and interpersonal relationship in addition to demographic data from January to February 2021, using the multistage cluster sampling method. Results: The participants' mean age was 33.78 ± 11.50 years and 68.3% of them were female. Traveling, sightseeing, and family visits have been eliminated from 91%, 83.5%, and 77.5% of participants' lives, respectively. There were increase in stress level (P < 0.001), weight of the participants (P < 0.001), sleep problems (P < 0.001), and healthier foods (P < 0.001) but decrease in interpersonal communication (P < 0.001) and the amount of physical activity (P < 0.001). Conclusion: In summary, this study indicates some changes in lifestyle of Iranian people, including changes in some eating practices, physical activity, social communication, and sleeping habits during the pandemic. However, as the COVID-19 pandemic is ongoing, a comprehensive understanding of these behaviors and habits can help develop interventions to mitigate the negative lifestyle behaviors during COVID-19 pandemic.

The effect of price on cigarette consumption, distribution, and sale in Tehran: a qualitative study.

BACKGROUND: Appropriate increases in tobacco taxes and prices are an essential component of comprehensive tobacco control strategies. This study investigates factors related to the use, sale, and distribution of cigarettes in Iran, focusing on the relationship between cigarette price and its consumption. METHODS: This interview-based qualitative study was conducted among 20 participants, including cigarette smokers, retail shop owners, large-scale distributors, and an expert in tobacco control research. RESULTS: Seven themes were extracted from participant interviews, including the type and price of cigarette, the best time to sell cigarettes, profits from the sale of cigarette, affordability, rise in cigarette price and smokers' reaction to it, lobbying and black-market sales of cigarettes, and the sale and distribution of cigarettes across the country. Although the price of cigarettes in Iran has shown some increases in the past decade, the timing of these increases are not predictable and the limited amount of these increases has not reduced the use of cigarettes. Following a price increase, consumers are more likely to switch from buying packets to single cigarettes, or buy a less expensive brand, then to quit. Moreover, increases in prices may encourage smokers and sellers to buy a large number of cigarettes and store them for a rainy day. Another adverse effect may be increased smuggling of illicit cigarettes to balance the pressure caused by rising prices. CONCLUSIONS: Our findings highlight two important aspects concerning cigarette pricing in Iran. First is the change in the type of purchase from the whole box of cigarettes to the single stick cigarette or swapping to less expensive cigarettes. Second, increase in cigarette price (either through taxing or regular increases) could be offset by flooding smuggled cigarettes into the market. Therefore, in addition to raising cigarette prices, reducing cigarette consumption rates in Iran requires the development and effective implementation of regulatory policies to control cigarette smuggling, reduce purchasing, and subsequently curb the use of this leading cause of premature morbidity and mortality.

Prevalence and Type Distribution of Human Papillomavirus Recovered from the Uterine Cervix of Nigerian Women: A Systematic Review and Meta-Analysis

Background: Infection with an oncogenic type of human papillomavirus is a prerequisite for the development of precancerous cervical lesions and its subsequent progression to cervical cancer. With an alarming increase in the detection of other suspicious papillomavirus genotypes in both healthy and women with cervical lesions, there is a need for comprehensive data on cervical papillomavirus infection to address cervical cancer and other associated disease burden, especially in Sub-Sarahan Africa, where the bulk of the problem exists. The present study was conducted to develop comprehensive data on the prevalence and circulating genotypes of human papillomavirus in various risk categories in Nigeria. Methods: A systematic review and meta-analysis of peer-reviewed publications on cervical papillomavirus infection were performed. Relevant data were extracted from eligible studies published in PubMed, Web of Science, Embase, Scopus, and Google Scholar, from inception to July 31, 2019. The random-effect model was used to estimate the pooled prevalence. We identified 327 potential studies and pooled data from 18 studies, involving 5697 women aged 15-86 years. Results: The overall pooled prevalence of cervical papillomavirus infection was 42% (95%CI: 30-54%) in the general population and 37% (95%CI: 25-50%) among women living with HIV/AIDS, with the predominance of genotypes 16, 18, 31, 35, 52, 58 and 45. The highest prevalence was observed in teenagers and young adults and the second peak in women 50 years and above. Conclusion: The prevalence of cervical human papillomavirus infection is cumulatively high in Nigeria and HIV is a strong co-factor. We, therefore, strongly recommend the co-screening of human papillomavirus and cervical cancer and integration of the intervention strategy into the existing HIV-care guideline in Nigeria.

A Qualitative Study of Factors Influencing the Onset of Hookah Smoking among Iranian Men with Turkmen Ethnicity.

INTRODUCTION: Hookah smoking has grown considerably among Iranian Turkmen in the past two decades. The reasons for this increase in the consumption of hookah are unclear. Therefore, this study was conducted with the aim of determining the factors related to the start of hookah smoking in men with Turkmen ethnicity. METHODS: This qualitative study was conducted between February 2018 and June 2018 in Turkmen cities of Golestan provinces in Iran. The study participants included 26 male Turkmen water pipe smokers with various ages, occupation, and education level. Study data were collected through semi-structured individual interview and the results were analyzed in August 2018 by content analysis. Data management was done by software, MAXQDA version 10. RESULTS: In this study, 26 hookah smoker men with the age range of 20-45 years were interviewed. The age of the participants at the time of starting hookah consumption varied from 14 to 25 years. On the basis of qualitative data, the reasons for the start of hookah smoking in male Turkmen were classified into three main categories: (1) individual (curiosity and sense of adulthood, fewer perceived risks compared with other substances and hookah's sensory attractions); (2) interpersonal (hookah-smoking friends and consumption of hookah by family members); and (3) societal (blaming unemployed people in small neighborhoods, cultural influence, more social acceptance compared with other substances, and easy access to hookah). CONCLUSION: Individual, interpersonal, and societal factors play important role in the start of hookah smoking among male Turkmens. Developing health policies based on the above factors can be effective in adopting hookah prevention and control strategies. Moreover, future studies could be developed with the goal of discovering ways to solve the problem of unemployment and plan for developing recreational activities in this area to prevent initiation of hookah smoking especially among youth.

Intention to quit water pipe smoking among Iranian women: a qualitative directed content analysis.

BACKGROUND: Water-pipe smoking is the most common type of tobacco used among Iranian women. The aim of this study was to explain women's perceptions of their intention for quitting water-pipe smoking based on the theory of planned behavior. METHODS: The study was a qualitative content analysis which was carried out over 4 months in 2016 in Tehran-Iran. The participants were 26 women ages 18 to 45-years-old who smoked water-pipe and were selected through snowball sampling. The study was performed in hookah cafes, parks, and homes. The data were collected through individual interviews. The interviews were open-ended questions based on the theory of planned behavior. Directed content analysis was used to analyze the data. RESULTS: Findings showed that women did not intend to quit water-pipe in that time. Main contributing factors influencing not having intention of cessation were positive attitude and false beliefs toward hookah smoking, as well as having peers and family members who smoked water-pipe or approved its use. Although most females realized the obstacles associated with hookah cessation, they believed that quitting water-pipe smoking was up to them and could control more barriers. CONCLUSION: Social pressure, positive attitude and false beliefs towards hookah smoking, as well as external and internal obstacles diminished women 's intention for cessation. Therefore, it is recommended to apply the theory of planned behavior into behavior change interventions in order to increase the intention to quit water-pipe smoking.

Persistent use of hookah smoking among Iranian women: A qualitative study.

INTRODUCTION: Hookah smoking is the most common method of tobacco smoking among Iranian women and its rate has significantly increased over the past few decades. This study aimed to explore reasons behind persistent use of hookah smoking among Iranian women. METHODS: This qualitative study was conducted from December 2014 to March 2016. Participants were 38 Iranian women living in Tehran, the capital of Iran. They were hookah smokers at the time of this study or at least had a history of its use. Data were collected using semi-structured face-to-face interviews and were analyzed using the qualitative content analysis method. RESULTS: The main factors for persistent use of hookah smoking from the perspective of women were entertainment, a pretext to gather with old friends and family members, and a method for the creation of social networks. Hookah smoking has been described as entertainment and fun. CONCLUSIONS: Strategies aimed to curb the social issue of hookah smoking by women need to focus on the provision of appropriate entertainment methods with the consideration of advantages, such as gathering with friends and family members and consolidating relationships.

Factors contributing to nass consumption among Iranian Turkmen: A qualitative study.

INTRODUCTION: Nass is a smokeless tobacco product. Iranian Turkmen have a long history of nass consumption. However, the factors contributing to nass consumption among Iranian Turkmen are not known. The purpose of the present study is to examine the factors contributing to nass consumption among Iranian Turkmen. METHODS: This qualitative study was conducted between January and March 2016 in four Turkmen cities of Golestan province in Iran. Participants included 34 male Turkmen nass consumers. Data were collected through individual and group interviews and were analyzed by content analysis. Data management was done by qualitative data analysis software MAXQDA, Version 10. RESULTS: The results of data analysis revealed the following as the main reasons for nass consumption by the study population: 1) cultural, social, and environmental facilitators, 2) nass was considered as an alternative to cigarette smoking, 3) nass was believed to intensify the effects of opium and other drugs, 4) specific occupations and circumstances, and 5) beliefs related to nass. CONCLUSIONS: Cultural and historical backgrounds, convenient access to nass at a very low price, curiosity, emulation, and peer pressure were the main factors driving nass consumption among Iranian Turkmen. Various beliefs, such as the idea that nass intensifies the effects of opium and alcohol, calms the nerves, and helps individuals quit smoking were also found to contribute to this phenomenon. Finally, individuals in certain lines of work, such as fishing, driving combines, and military service, were more likely to consume nass.

Perception of Iranian Mothers About Oral Health of Their School-Children: A Qualitative Study.

OBJECTIVES: Oral health is an important aspect of general health and well-being for children. Understanding the viewpoint of mothers about children's oral health provides a basis for the development of interventions to improve oral care and disease prevention. The purpose of this study was to explore the perception of Iranian mothers regarding the oral health of their children. MATERIALS AND METHODS: This descriptive qualitative study was the first phase of an exploratory mixed method design and collected data from April to May 2015 in Tehran, Iran. The qualitative data were collected through seven focus group discussions and three semi-structured interviews. The participants were 58 Iranian women who had a first grader. Data were analyzed using conventional content analysis. RESULTS: The main themes identified from the data were: (I) the definition of oral health, (II) the importance of maintaining oral health and dental treatment, (III) the effect of nutrition on children's oral health, (IV) the role of oral health behaviors, (V) the causes of dental caries and malocclusion/crowding, (VI) the symptoms and causes of gum disease, (VII) the causes of halitosis. CONCLUSIONS: According to the mothers' perception, the main factors influencing children's oral health were: nutrition and oral health behaviors such as daily tooth brushing and flossing. The results of this study can be used to develop a model of oral health education and a prevention program for improving oral health among Iranian school-children.

Health Promoting Lifestyle and its Determinants Among University Students in Sabzevar, Iran.

BACKGROUND: Healthy lifestyle is a major strategy to promote current and subsequent health status. The aim of this study was to assess the status of health-promoting the lifestyle and its determinants among students. METHODS: A stratified random sample of 500 students in a university in the city of Sabzevar, Iran participated in this cross-sectional study. Health-promoting lifestyle was measured using Walker's health-promoting lifestyle profile II. RESULTS: There was a significant correlation between all domains of health-promoting the lifestyle. The highest score among the domains was for an interpersonal relationship (70.8%), and the lowest score was for nutrition (53.6%), and physical activity (53.4%). Significant differences were found in physical activity by gender (P ≤ 0.05). There were significant differences in health responsibility, spiritual growth and body mass index by marital status (P < 0.01). CONCLUSIONS: Since one out of five students in this study were overweight/obese, health program planning to promote lifestyle, especially physical activity and nutrition among students is recommended. Our findings may be helpful for faculty administrators, curriculum planners, and health educators in designing guidelines to structuralize a healthier campus and to develop health promotion programs supporting healthy choices among students.