Determinants of preventive behavior against Covid-19 in secondary school students based on Health Belief Model (HBM): a structural equations modeling (SEM).

Measures such as education, improving knowledge, attitude and taking preventive action to protect against COVID-19 are vital strategies for prevention. The aim of this study was to determine the predictability of Health Belief Model (HBM) constructs in performing preventive behaviors against COVID-19 among secondary school students in Chabahar, Iran. In this cross-sectional-analytical study, 400 secondary school students of Chabahar city were investigated by simple random sampling. The data collection tool was a questionnaire including demographic characteristics, knowledge, behavior, and Health Belief Model constructs' questions. Exploratory Factor Analysis (EFA) was used to evaluate the validity of HBM constructs, and the structural equation modeling (SEM) method was used to evaluate the direct and indirect effects of the relationship between knowledge, HBM constructs, and preventive behavior against COVID-19 based on the conceptual model. Based on the results of the structural modeling, the direct effect of knowledge on the constructs of the health belief model was positive and significant (ß = 0.34, P-value < 0.001), and on the preventive behavior of students was insignificant (ß = 0.12, P-value = 0.07) while the indirect effect of knowledge through increasing the constructs of the HBM on student behavior was positive and significant (ß = 0.30, P < 0.001). The relationship between the constructs of the HBM constructs and student behavior was also positive and significant (ß = 0.89, P-value < 0.001).Due to the fact that knowledge and HBM structures played a role in predicting the adoption of preventive behavior from COVID-19, it is possible to design appropriate interventions to increase knowledge, sensitivity, perceived severity, and self-efficacy, in order to recover from COVID-19 by adopting preventive behaviors.

The Effect of an Educational Intervention Based on the Health Action Process Approach on Nurses' Communication Skills / Efecto de una intervención educativa basada en el enfoque del proceso de acción en salud sobre las habilidades comunicativas de las enfermeras / Efeito de uma intervenção educativa baseada na abordagem do processo de ação em saúde nas habilidades de comunicação do enfermeiro. Estudo quase experimental com grupo controle

Objective. This study aimed to the effects of the Health Action Process Approach (HAPA) in promoting the quality of nurses' communication skills among nurses. Methods.The present quasi-experimental research was conducted on 148 nurses (76 in the intervention and 72 in the control group) in Yazd province (Iran). In this study, the total number of nurses in one hospital was selected as the intervention group, while the nurses from another hospital were chosen as the control group. The participants were recruited from public hospitals in Ardakan and Meibod cities. The data collection instrument was a questionnaire based on the Health Action Process Approach (HAPA) Constructs and a communicative skill questionnaire. The data were collected from the two groups before, one month after, and four months after the intervention. The control group did not receive any educational training during the course of the study. Results. In the pretest, no statistically significant difference was found between the intervention and control groups regarding the behavioral stages of effective communication with patients. In the posttest, the mean task self-efficacy score was significantly increased in the intervention group compared to the control (p<0.001). The mean coping self-efficacy score was also significantly higher in the intervention group than the control in the posttest (p<0.001). Moreover, the mean coping planning score was significantly increased in the post-test intervention group(p<0.001). The mean communicative skill score was also significantly increased in the intervention group compared to the post-test control (p=0.03). Conclusion. The intervention used in the present study based on the target model (HAPA) significantly affected nurses' self-efficacy and communicative skills in the experimental group.

Objetivo. Evaluar el efecto del enfoque del proceso de acción sanitaria (Health Action Process Approach (HAPA), en inglés) en la promoción de la calidad de las habilidades de comunicación de las enfermeras. Métodos. La presente investigación cuasiexperimental se llevó a cabo con 148 enfermeras (76 en el grupo de intervención y 72 en el de control) de la provincia de Yazd (Irán). Los participantes fueron reclutados en los hospitales públicos de las ciudades de Ardakan y Meibod. El instrumento de recogida de datos fue un cuestionario basado en los constructos HAPA y un cuestionario de habilidades comunicativas. Se recogieron datos de los dos grupos antes, un mes después y cuatro meses después de la intervención. El grupo de control no recibió ninguna formación educativa durante el estudio. Resultados. En la preprueba, no se encontraron diferencias estadísticamente significativas entre los grupos de intervención y de control en cuanto a las etapas conductuales de la comunicación eficaz con los pacientes. En la prueba posterior, la puntuación media de autoeficacia en la tarea aumentó significativamente en el grupo de intervención en comparación con el grupo de control (p<0.001). La puntuación media de autoeficacia en el afrontamiento también fue significativamente mayor en el grupo de intervención que en el grupo de control en el postest (p<0.001). Además, la puntuación media en planificación del afrontamiento aumentó significativamente en el grupo de intervención después de la prueba (p<0.001). La puntuación media en habilidades comunicativas también aumentó significativamente en el grupo de intervención en comparación con el grupo de control después de la prueba (p=0.03). Conclusión.La intervención utilizada en el presente estudio basada en el modelo HAPA mejoró significativamente la autoeficacia y las habilidades comunicativas de las enfermeras del grupo experimental.

Objetivo. Avaliar o efeito da Abordagem do Processo de Ação em Saúde (HAPA) na promoção da qualidade das habilidades de comunicação dos enfermeiros. Métodos. A presente pesquisa quase-experimental foi realizada com 148 enfermeiros (76 no grupo de intervenção e 72 no grupo de controle) da província de Yazd (Irã). Os participantes foram recrutados em hospitais públicos nas cidades de Ardakan e Meibod. O instrumento de coleta de dados foi um questionário baseado nos construtos do HAPA e um questionário de habilidades de comunicação. Os dados foram coletados dos dois grupos antes, um mês depois e quatro meses após a intervenção. O grupo de controle não recebeu nenhum treinamento educacional durante o estudo. Resultados. No pré-teste, não foram encontradas diferenças estatisticamente significativas entre os grupos de intervenção e controle em termos de estágios comportamentais da comunicação eficaz com os pacientes. No pós-teste, a pontuação média de autoeficácia na tarefa aumentou significativamente no grupo de intervenção em comparação com o grupo de controle (p<0.001). A pontuação média de autoeficácia de enfrentamento também foi significativamente maior no grupo de intervenção do que no grupo de controle no pós-teste (p<0.001). Além disso, a pontuação média do planejamento de enfrentamento aumentou significativamente no grupo de intervenção após o pós-teste (p<0.001). A pontuação média em habilidades de comunicação também aumentou significativamente no grupo de intervenção em comparação com o grupo de controle no pós-teste (p=0.03). Conclusão. A intervenção usada no presente estudo com base no modelo HAPA melhorou significativamente a autoeficácia e as habilidades de comunicação dos enfermeiros do grupo experimental.

Investigation of environmental ethics, spiritual health, and its relationship with environmental protection behaviors in nursing students / Investigación sobre ética ambiental, salud espiritual y su relación con comportamientos de protección ambiental en estudiantes de enfermería / Pesquisa sobre ética ambiental, saúde espiritual e sua relação com comportamentos de proteção ambiental em estudantes de enfermagem

Objective.To investigate the relationship between environmental ethics, spiritual health, and environmental behavior among nursing students . Methods. In this cross-sectional study, 200 iranian students from the Chabahar Nursing School were selected using a simple random sampling method. The data collection tool included a questionnaire on demographic information, knowledge, attitudes and behaviors towards the environment, environmental ethics, and spiritual health. Partial least squares structural equation modeling (PLS-SEM) was utilized to evaluate the conceptual framework in this study. Results. The mean score for environmental ethics among nursing students was 65.73±10.61 out of 100. Most of the students (47%) had desirable environmental ethics. The knowledge structure (ß=0.46) predicted attitude. The attitude structure also predicted environmental behavior (ß=0.28) and spiritual health (ß=0.31). Ultimately, the results showed that spiritual health and environmental ethics predict environmental behavior directly and indirectly (p<0.001). Conclusion. Spiritual health and environmental ethics were strong predictors of environmental behavior. Therefore, it is necessary to take into account not only students' spiritual health but also their ethical behaviors to promote environmental protection behaviors in the future.

Objetivo. Investigar la relación entre la ética ambiental, la salud espiritual y el comportamiento ambiental entre los estudiantes de enfermería. Métodos. En este estudio transversal se seleccionaron 200 estudiantes iraníes de la Escuela de Enfermería de Chabahar mediante un método de muestreo aleatorio simple. La herramienta de recogida de datos incluía un cuestionario sobre información demográfica, conocimientos, actitudes y comportamientos hacia el medio ambiente, ética medioambiental y salud espiritual. Se utilizó el modelo de ecuaciones estructurales por mínimos cuadrados parciales (PLS-SEM) para evaluar el marco conceptual de este estudio. Resultados. La puntuación media en ética medioambiental entre los estudiantes de enfermería fue de 65.73±10.61 sobre 100. El 47% de los estudiantes tenían una ética medioambiental deseable. La estructura de conocimientos (0.46) predijo la actitud. La estructura de la actitud también predijo el comportamiento medioambiental (0.28) y la salud espiritual (0.31). En última instancia, los resultados mostraron que la salud espiritual y la ética medioambiental predicen el comportamiento medioambiental directa e indirectamente (p<0.001). Conclusión. La salud espiritual y la ética medioambiental fueron fuertes predictores del comportamiento medioambiental. Por lo tanto, es necesario tener en cuenta no sólo la salud espiritual de los estudiantes, sino también sus comportamientos éticos para promover conductas de protección del medio ambiente en el futuro.

Objetivo. Investigar a relação entre ética ambiental, saúde espiritual e comportamento ambiental entre estudantes de enfermagem. Métodos. Neste estudo transversal, 200 estudantes da Escola de Enfermagem de Chabahar (Irã) foram selecionados usando um método de amostragem aleatória simples. A ferramenta de coleta de dados incluiu um questionário sobre informações demográficas, conhecimento, atitudes e comportamentos em relação ao meio ambiente, ética ambiental e saúde espiritual. A modelagem de equações estruturais por mínimos quadrados parciais (PLS-SEM) foi usada para avaliar a estrutura conceitual deste estudo. Resultados. A pontuação média sobre ética ambiental entre os estudantes de enfermagem foi de 65.73±10.61 de um total de 100. 47% dos estudantes tinham uma ética ambiental desejável. A estrutura de conhecimento (0.46) previu a atitude. A estrutura da atitude também previu o comportamento ambiental (0.28) e a saúde espiritual (0.31). Por fim, os resultados mostraram que a saúde espiritual e a ética ambiental previram o comportamento ambiental direta e indiretamente (p<0.001). Conclusão. A saúde espiritual e a ética ambiental foram fortes preditores do comportamento ambiental. Portanto, é necessário considerar não apenas a saúde espiritual dos alunos, mas também seus comportamentos éticos, a fim de promover comportamentos de proteção ambiental no futuro.

Preventing falls of the elderly at home: Applying the precaution adoption process model.

BACKGROUND: Falling in the elderly causes a variety of issues such as dependence, decreased self-efficacy, depression and limitation in daily activities, hospitalization and imposition of costs on the individual and society. The aim of this study was to investigate the prevention of falls in the elderly at home by applying the Precaution Adoption Process Model. MATERIALS AND METHODS: In this quasi-experimental study, 200 elderly people participated, 100 of whom were in the intervention group and 100 in the control group. The sample was provided via stratified random sampling. The data collection instruments were a researcher-made questionnaire including demographic details, as well as the Precaution Adoption Process Model (PAPM) questionnaire. Educational intervention was performed during four 45-minute sessions, following which the data was analyzed through SPSS 20 software and was evaluated based on the Chi-squared, Mann-Whitney U, Wilcoxon, and Fisher's exact tests. RESULTS: Investigating the distribution of participants in the phases of the PAPM indicated that most participants of both the intervention and control groups were in the passive fall prevention phase before treatment. However, after the intervention, most participants of the intervention group were in the active phases of fall prevention, while there were not any significant changes in the control group. Moreover, comparing the mean of the structures of knowledge, sensitivity, severity, benefits, perceived self-efficiency, and the cues to action in terms of preventing falls after the intervention, showed a significant increase in these structures in the intervention group compared to the control group (P < 0.001). Eventually, the findings of the study showed a significant decrease in the percentage of falls of the participants of the intervention group compared to that of the control group after the intervention (P = 0.004). CONCLUSIONS: Educational intervention on the basis of the PAPM promoted the elderly precaution from passive phases to active phases of preventing falls, thereby resulting in a decrease in the number of falls of elderly people.

COVID-19 anxiety and quality of life among adolescent pregnant women: a cross-sectional study.

OBJECTIVES: To determine the relationship between the COVID-19 anxiety and the quality of life among adolescent pregnant women in Dashtiari city, Iran. METHODS: In this cross-sectional study, 216 adolescent pregnant women in Dashtiari city, Iran in 2021 who met the inclusion criteria participated in a multi-stage sampling. Data collection tools included: demographic information, COVID-19 Anxiety Scale and a questionnaire of quality of life. Finally, the obtained data were analyzed in SPSS software version 21 using descriptive, Chi-square, Tukey and logistic regression tests. RESULTS: The results showed that 74 (34.3%) adolescent pregnant women had weak COVID-19 anxiety, 23 (10.6%) had moderate COVID-19 anxiety and 119 (55.1%) had severe COVID-19 anxiety. The results also showed that gestational age (OR=2.2, p=0.03), history of COVID-19 infection among adolescent pregnant women (OR=1.6, p=0.02), history of family and friends (OR=1.7) (p=0.04), quality of life (OR=4.3, p=0.001), increases the probability of COVID-19 anxiety. CONCLUSIONS: Considering the psychological consequences of the post-COVID-19 era and the psychological events that occur in this period, by identifying and predicting these issues, strategies should be considered for optimal intervention and reduction of injuries in the post-crisis era.

Assessing the Effectiveness of COVID-19 Prevention Campaign in Health Volunteers of Urmia City.

Holding educational campaigns with the purpose of conveying message about one particular behavior in the target group, is one of the society-based educational strategies. This study aimed to investigate the efficiency of the Campaign of COVID-19 Prevention on Health Volunteers in Urmia. The present study was a semi-experimental research, in which the sampling was done in a census way with 200 people participated. In this study, which was done as pre- and posttest, the amount of knowledge, attitude and behavior of health volunteers were evaluated by the designed questionnaires. The campaign was held for 2 months, which has benefited from the five methods of pamphlet, banners, films, social networking sites, and educational classes. After the campaign, the knowledge level, attitude and behavior of Health Volunteers increased to 35.1%, 30.09%, and 29.2%, respectively, which was meaningful statistically. Holding the campaign can trigger positive changes in improving the knowledge, attitude, and behavior of health volunteers, leading to the prevention of a plethora of health problems in society.

The predictors of the intention to receive Covid-19 vaccine using the health belief model and theory of planned behavior in South Khorasan province.

BACKGROUND: Widespread vaccination coverage in the shortest time is one of the most effective ways for controlling the COVID-19 pandemic. Factors affecting people's intention to get the COVID-19 vaccine are of great importance. The present study aimed to investigate the predictors of the intention to receive the Covid-19 vaccine based on the constructs of the health belief model (HBM) and theory of planned behavior (TPB) in South Khorasan Province. MATERIALS AND METHODS: In this cross-sectional-analytical study, 320 people over 18 years in South Khorasan province were randomly selected by cluster sampling method in 2021. The data was collected by a researcher-made questionnaire, including demographic information (9 questions), and the constructs of the health belief model (19 questions), and the theory of planned behavior (13 questions), using the self-report method. Finally, data were analyzed using t-test, ANOVA, linear regression, and Pearson correlation tests. RESULTS: The mean age of the study participants was 36.57 ± 11.56 with a range of 18-66 years. In the regression model, perceived susceptibility (ß = 0.247, P = 0.003), perceived severity (ß = 0.247, P = 0.003) from HBM, attitude (ß = 0.247, P = 0.003), and perceived behavioral control (ß = 0.247, P = 0.003) from TPB were significant predictors of the intention to get the Covid-19 vaccine. The constructs of the two models were able to explain 33% of the variance of the intention to receive the Covid-19 vaccine. CONCLUSIONS: The study findings reveal that HBM and TPB can predict factors affecting an individual's intention to receive the vaccine. The results can be utilized to design interventions with the aim of increasing vaccine uptake.

Investigating the effect of teach-back method on improving the lifestyle of health ambassadors in Urmia.

BACKGROUND: Adopting a healthy lifestyle is necessary to maintain and promote health. The aim of this study was to determine the effect of teach-back method on improving the lifestyle of health ambassadors in Urmia. MATERIALS AND METHODS: In this quasi-experimental study, 200 health ambassadors were participated. The research sample was obtained using simple random sampling method. Data collection tool was a questionnaire including demographic characteristics and lifestyle standard. The educational intervention was performed in 4 sessions of 45 min based on the teach-back method. Data were collected through a lifestyle questionnaire before and 3 months after the educational intervention. Then, the data were analyzed by mean and standard deviation, independent t-test, paired t-test, and Chi-square test through SPSS 19. RESULTS: The results showed that 24% of the control group and 21% of the intervention group had a good lifestyle before the educational intervention. After the educational intervention 27% of the control group and 54% of the intervention group were in good lifestyle. The results also showed that the mean score of total lifestyle and all its dimensions in the intervention group increased compared to the control group after the educational intervention and the difference between the mean score of total lifestyle and all its dimensions in the intervention group after the intervention was significant (P < 0.05). CONCLUSIONS: Among health ambassadors, teach-back communication is more effective in improving the lifestyle. Therefore, it is suggested that this method must be used in designing training programs for health ambassadors.

Effectiveness of the application of an educational program based on the Health Belief Model (HBM) in Adopting Preventive Behaviors from Self-Medication among Women in Iran. A Randomized Controlled Trial / Eficacia de la aplicación de un programa educativo basado en el Modelo de Creencias sobre la Salud en la adopción de conductas preventivas de la automedicación entre las mujeres de Irán. Un ensayo controlado aleatorio / Eficácia da aplicação de um programa educativo baseado no Modelo de Crenças sobre Saúde na adoção de comportamentos preventivos de automedicação entre mulheres no Irã. Um ensaio clínico randomizado

Objective.To evaluate the effectiveness of the application of an educational program based on the Health Belief Model (HBM) in Adopting Preventive Behaviors from Self-Medication among Women in Iran. Methods. Interventional study with pre and post phases. 200 women referring to the health centers of Urmia were selected by simple random sampling, divided into two groups of treatment and control. Data collection instruments were researcher-devised questionnaire including the questionnaire of Knowledge of Self-medication, the Questionnaire of Preventive Behaviors from Self-medication, and the questionnaire of Health Belief Model. The questionnaires were assessed for expert validity and then, were checked for reliability. The educational intervention was conducted for the treatment group during four weeks four 45-minute sessions. Results.The average scores of knowledge, perceived susceptibility, perceived severity, perceived benefits, perceived barriers, cues to action, self-efficiency, and post-intervention performance in have increased in treatment group, comparing to the control group, All findings were statistically significant (p<0.05). Furthermore, social media, doctors, and disbelief in self-medication were more effective in increasing awareness and encouraging to have proper medication, also, the highest self-medication was in taking pain-relievers, cold tablets and antibiotics, which showed significant decrease in treatment group after the intervention. Conclusion.The educational program based onHealth Belief Modelwas effective in reducing the self-medication among the studied women. Furthermore, it is recommended to use social media and doctors to improve the awareness and motivation among people. Thus, applying the educational programs and plans according to the Health Belief Model can be influential in reducing the self-medication.

Objetivo. Evaluar la eficacia de la aplicación de un programa educativo basado en el Modelo de Creencias sobre la Salud (MCS) en la adopción de conductas preventivas de la automedicación entre las mujeres de Irán. Métodos. Estudio de intervención con evaluación pre y post. Se seleccionaron 200 mujeres que acudieron a los centros de salud de Urmia, a quienes se asignaron a los dos grupos de estudio (tratamiento y control) mediante un muestreo aleatorio simple. Para la recolección de la información se utilizaron los cuestionarios sobre: Conocimientos acerca de la automedicación, conductas preventivas de la automedicación y el modelo de creencias sobre la salud. Se evaluó la validez de los cuestionarios por parte de los expertos y luego se comprobó su confiabilidad. La intervención educativa se llevó a cabo para el grupo de tratamiento durante cuatro semanas con 1 sesión semanal de 45 minutos de duración.Resultados.Las puntuaciones medias de los conocimientos, la susceptibilidad percibida, la gravedad percibida, los beneficios percibidos, las barreras percibidas, las señales para la acción, la autoeficacia y el rendimiento posterior a la intervención aumentaron en el grupo de tratamiento en comparación con el grupo de control, y todos los resultados fueron estadísticamente significativos (p<0.05). Además, los medios de comunicación social fueron eficaces para aumentar la concienciación y animar a tener una medicación adecuada. La mayor automedicación fue en la toma de analgésicos, pastillas para el resfriado y antibióticos, que mostró una disminución significativa en el grupo de tratamiento después de la intervención. Conclusión. El programa educativo basado en el Modelo de Creencias de Salud fue eficaz para reducir la automedicación entre las mujeres estudiadas. Además, se recomienda utilizar los medios de comunicación social para mejorar la concienciación y la motivación de las personas.

Objetivo. Avaliar a eficácia da aplicação de um programa educativo baseado no Modelo de Crenças em Saúde (HCM) na adoção de comportamentos preventivos de automedicação entre mulheres no Irã. Métodos. Estudo de intervenção com pré e pós avaliação. Duzentas mulheres que frequentavam os centros de saúde de Urmia foram selecionadas e alocadas nos dois grupos de estudo (tratamento e controle) por meio de amostragem aleatória simples. Para a coleta de informações, foram utilizados os questionários sobre: Conhecimento sobre automedicação, comportamentos preventivos de automedicação e o modelo de crenças sobre saúde. A validade dos questionários foi avaliada pelos especialistas e, em seguida, verificada sua confiabilidade. A intervenção educativa foi realizada para o grupo de tratamento durante quatro semanas com 1 sessão semanal com duração de 45 minutos. Resultados.Os escores médios de conhecimento, suscetibilidade percebida, gravidade percebida, benefícios percebidos, barreiras percebidas, pistas para ação, autoeficácia e desempenho pós-intervenção aumentaram no grupo de tratamento em comparação com o grupo de intervenção. controle, e todos os resultados foram estatisticamente significativos (p<0.05). Além disso, as mídias sociais foram eficazes na conscientização e no incentivo à medicação adequada. A maior automedicação foi em uso de analgésicos, antissépticos e antibióticos, que apresentou diminuição significativa no grupo de tratamento após a intervenção. Conclusão.O programa educativo baseado no Modelo de Crenças em Saúde foi eficaz na redução da automedicação entre as mulheres estudadas. Além disso, recomenda-se o uso das mídias sociais para melhorar a conscientização e a motivação das pessoas.

Effectiveness of the application of an educational program based on the Health Belief Model (HBM) in Adopting.

OBJECTIVES: To evaluate the effectiveness of the application of an educational program based on the Health Belief Model (HBM) in Adopting Preventive Behaviors from Self-Medication among Women in Iran. METHODS: Interventional study with pre and post phases. 200 women referring to the health centers of Urmia were selected by simple random sampling, divided into two groups of treatment and control. Data collection instruments were researcher-devised questionnaire including the questionnaire of Knowledge of Self-medication, the Questionnaire of Preventive Behaviors from Self-medication, and the questionnaire of Health Belief Model. The questionnaires were assessed for expert validity and then, were checked for reliability. The educational intervention was conducted for the treatment group during four weeks four 45-minute sessions. RESULTS: The average scores of knowledge, perceived susceptibility, perceived severity, perceived benefits, perceived barriers, cues to action, self-efficiency, and post-intervention performance in have increased in treatment group, comparing to the control group, All findings were statistically significant (p < 0.05). Furthermore, social media, doctors, and disbelief in self-medication were more effective in increasing awareness and encouraging to have proper medication, also, the highest self-medication was in taking pain-relievers, cold tablets and antibiotics, which showed significant decrease in treatment group after the intervention. CONCLUSIONS: The educational program based on Health Belief Model was effective in reducing the self-medication among the studied women. Furthermore, it is recommended to use social media and doctors to improve the awareness and motivation among people. Thus, applying the educational programs and plans according to the Health Belief Model can be influential in reducing the self-medication.

Facilitators and barriers of herbal medicine use in diabetic patients: A qualitative study.

BACKGROUND: In several countries such as Iran, the use of complementary and alternative medical products like herbal medicine is growing. There is, however, a lack of research on the prospects of herbal medicine patrons regarding facilitators and herbal medicine use barriers. The aim of this study was to explain the facilitators and the barriers of herbal medicine use in type 2 diabetes mellitus (T2DM) patients. MATERIALS AND METHODS: Qualitative one-to-one in-depth interviews were conducted with patients with T2DM from the Yazd Diabetes Research Center, using a semi-structured guide. For the recruitment of T2DM participants who used herbal medicine beside conventional medicine, purposeful sampling was used. Analysis of the data was carried out using the steps proposed by Graneheim and Landman strategies. RESULTS: Sixteen patients were interviewed. There were 2 subjects (facilitators and barriers herbal medicine use), 8 categories, and 89 initial codes. The facilitators included individual preferences, preparation skills, and family support and the factors obstructing the use of herbal medicine included insufficient skills about preparing, lack of easy access to consumption, insufficient of efficacy of herbal medicine, and negative properties of herbal medicine and taking time in preparing herbal medicine. CONCLUSION: Although some people use herbal medicine, the interest in use of herbal medicine is limited because of inadequate awareness of the impact and usage them. Therefore, the use of effective strategy in the integration of herbal remedies with conventional medicine can promote well-being of patients.

Determinants of Sailors' Protective Behaviors in Fishing Spots against the Risks of Sunlight and Skin Cancer: A Qualitative Study in Iran.

INTRODUCTION: The growing rate of nonmelanoma skin cancer (NMSC) and melanoma has been a great challenge for global health system. The present research aims to determine sailors' protective behaviors against the risks of sunlight and skin cancer in Iran. MATERIALS AND METHODS: The present research was qualitative in type, and its data were collected from August to December 2019. To this aim, 23 participants were recruited with whom semistructured interviews were held. The data collection continued until data saturation, and the interviews were coded in MAXQDA 10. Conventional content analysis was used to analyze the qualitative data. RESULTS: Analysis of sailors' perceptions and experiences revealed 7 categories: protective behaviors, hard personal and familial conditions, social interactions, poor social support, feeling of satisfaction, self-care, and fear. CONCLUSION: Sailors are prone to skin cancer due to their specific work conditions. Perceptions and determinants of skin cancer and protective behaviors against sunlight were identified among sailors. Promotion of protective behaviors and beliefs that impeded preventive behaviors are among issues that require special attention.

The effect of theory - Based educational intervention on consumption of smokeless tobacco products by merchants' guilds.

BACKGROUND: Smokeless tobacco (SLT) products are highly addictive and contain at least 28 carcinogenic chemicals. The purpose of this study was to determine the effect of theory-based on the Transtheoretical Model of Behavior Change on consumption of SLT products by Merchants' Guilds in 2018. MATERIALS AND METHODS: The present quasi-experimental research was conducted over one intervention group. The research population consisted of all consumers of the SLT products among the merchants' guilds in Chabahar City, Iran in 2018. Data were gathered from 320 individuals by simple random sampling using a valid and reliable researcher-made questionnaire. The intervention program was designed based on the Transtheoretical Model of Behavior Change cognitive processes and lasted 6 months. After the intervention, the same questionnaires were administered among the participants. The data were analyzed by SPSS version 20 using the descriptive and analytical tests. RESULTS: In the preintervention phase, the participants' mean scores of the cognitive processes at the precontemplation, contemplation, and preparation stages were 29.16 ± 4.63, 25.07 ± 3.84, and 12.12 ± 1.63, respectively. At the postintervention phase, mean scores of the precontemplation, contemplation, and preparation stages reached to 40.5 ± 5.96, 38.8 ± 5.03, and 35.5 ± 4.23, respectively. Furthermore, the participants' mean sores at the action and maintenance stages were 36.4 ± 4.57 and 43.3 ± 3.29, respectively. According to the ANOVA, a significant relationship was found between cognitive processes at the preintervention phase and stages of change (P < 0.001). CONCLUSIONS: Individuals can improve from the precontemplation, contemplation, and preparation phases to the action and maintenance stages by attending based on Transtheoretical Model of Behavior Change educational interventions. It is suggested that the structure of this model be used to reduce high-risk behaviors in other occupations.

Effect of the Living Environment on falls among the Elderly in Urmia.

BACKGROUND: The living environment has an impact on the health of the elderly, and the safety of the house is one of the concerns of the elderly. Disregarding the safety concerns increases the falling. AIM: This research was conducted with the aim of influencing the living environment on falls among elderly people in Urmia city. METHODS: This is a cross-sectional (descriptive-analytic) study which 200 elderly people were selected by random cluster sampling. Data were collected by using a two-part questionnaire including demographic information, and home safety assessment checklist. Data were analysed by using chi-square test and logistic regression in SPSS v. 21 software. RESULTS: The incidence of falling in the elderly was 30%. There was a significant statistical association with age, sex, marital status and history of chronic disease. Results of logistic regression showed non-safe stairs (OR = 1.1, p = 0.002), unsafe toilet/bath (OR = 1.3, p = 0.001), unsafe bedrooms (OR = 1.7, p = 0.05) unsafe living room (OR = 1.4, p = 0.02) increase the falls in the elderly, as well as male gender (OR = 1.14, p < 0.001) and living with other people (OR = 0.19, p = 0.002) reduce the falls in the elderly. CONCLUSION: By identifying the risk factors of the physical space of the home, we can plan for implementing necessary interventions according to the risk factor or risk factors to prevent and reduce the falls in the elderly community.

Mother-Father Differences in Postnatal Psychological Distress and Its Determinants in Iran.

AIM: The aim of this study was to investigate the mother-father differences in Postnatal Psychological Distress (PPD) and its determinants among the parents with 8-weeks old children. MATERIALS AND METHODS: In this cross-sectional study, applying simple random sampling, 306 postnatal parents with an 8-weeks old infant in Saqqez County, Iran, were invited to answer the General Health Questionnaire-28 (GHQ-28) items through the telephone interview. Fifty-eight subjects declined to participate in the study (Response Rate = 81.04%). The data were analysed using the SPSS Statistics v. 21. RESULTS: About 16.9% of all the parents had PPD. The difference in the prevalence of PPD in three dimensions between the two groups were statistically significant (p < 0.01): social dysfunction (25.8% for fathers vs. 5.6% for mothers), somatic disorders (21% for fathers vs. 7.3% for mothers), and anxiety (21% for fathers vs. 6.5% for mothers). The mode of delivery of the mothers and the level of education, the number of children, monthly income, and being consent with pregnancy among the fathers were significant predictors for PPD. CONCLUSION: The level of PPD was more prevalent among the new fathers compared to the new mothers. Among the fathers, but not the mothers, socioeconomic characteristics were contributed to PPD. Considering the differences in risk factors for maternal and paternal PPD, our findings may help family health care providers and policymakers in designing gender-specific intervention programs and diagnosis tools aimed at PPD prevention among new parents.