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This randomized clinical trial examined the efficacy of a designed educational program versus oral drug treatment in Iran. A total of 197 patients with chronic low back pain were randomized into either intervention group (n = 97) receiving a five 2 hour– session educational program followed by continued monthly booster sessions and telephone counseling plus medication or to control group (n = 100) receiving just medication. At baseline and 3 months of follow up, participants completed demographic characteristic questionnaires as well as three other questionnaires including Short – form General Health Survey (SF-36 item), Quebec Disability Scale (QDS) and Ronald – Morris Disability Questionnaire (RDQ). Data were analyzed by SPSS 18. The two groups were comparable at baseline in terms of all baseline characteristics and the mean scores of the scales. However, after three months, the intervention group was significantly different from control group in all subscales of SF-36, QDS and RDQ (P values < 0.05). Furthermore, this study showed a statistically significant difference between two groups (P< 0.05) in terms of mean difference scores for SF -36, RDQ and QDS over time. The findings revealed that the designed educational program could improve all quality of life domains and reduce disability in chronic low back pain patients during a period of 3 months.

Background: Back pain is one of the most important public health problems that is on the rise among the schoolchildren’s population. The aim of this study was to determine cognitive factors related to back care-related behavior based on the social cognitive theory (SCT) among female schoolchildren. Methods: A cross-sectional study was directed among 5th-grade female students through a convenience method. Structured questionnaire data were collected from 610 students attending public elementary schools in Tehran, Iran from October 2018 to March 2019. The initial model was formulated based on the SCT. Based on these data, the hypothesized model was confirmed via a structural equation modeling analysis using SPSS (version 24.0) and LISREL (version 8.80). Results: The skills (r=0.73, t-value=13.42), self-efficacy (r=0.87, t-value=15.51), and expectation beliefs (r=0.61, t-value=6.68) were verified as key cognitive factors that cause a back behavior. Finally, various indicators such as comparative fit index, normed fit index, and root mean squared error of approximation demonstrated the fitness of the models (P

Background Nurses are put at high risk of work-related low back pain due to the nature of their work. The aim of this study was to develop and evaluate intervention based on the PRECEDE-PROCEED Model on promoting behaviors of low back health via two educational approaches. Methods This study was a community randomized-controlled clinical trial. The educational content was developed with six modules: knowledge, attitude, self-efficacy, reinforcing factors, enabling factors, and behavior. Intervention was delivered by two modes: (1) in-person (n = 60) and (2) social media (n = 60). Data were evaluated by a self-designed questionnaire at baseline, 3, and 6 months. Baseline comparisons between groups were made with Mann-Whitney U Test and T-Test. Comparison of change scores between groups and two delivery types across the three time periods used the mixed between-within subject analysis of variance. Results A total of 120 nurses received the allocated intervention. All educational component scores increased at 3-months in both groups. At the 6-month follow-up scores increased for enabling factors and behavior in the intervention group, while in the control group all scores increased except for attitude. Based on Bonferroni Post hoc analysis social media was more effective in knowledge, self-efficacy, reinforcing factors, and behavior than the in-person intervention. Conclusion An educational program for low back health based on the PRECEDE-PROCEED model proved effective at improving all components. However, social media was more successful than in-person in the maintenance of behavior over the long term. Trial registration: IRCT20170313033054N2: 25-02-2018.https://www.irct.ir/trial/25598

Background Prevention of musculoskeletal disorders as one of the most common occupational health problems among the working population in both developed and developing countries is an important necessity and priority. The aim of this study was to evaluate the effectiveness of an educational intervention program based on the Health Belief Model (HBM) to increase awareness, perceived sensitivity, perceived severity, perceived benefits, and self-efficacy in adopting neck health-promoting behaviors in school teachers. Methods The present study was a quasi-experimental of the randomized clinical trial that was conducted for 6 months (December 2020 to July 2021). Participants were 146 junior high school teachers were selected from 26 schools through random sampling and divided into two groups of intervention and control. The data collection instrument was the self-design questionnaire and was completed in three points of time (before, immediately, and 3 months after the intervention). The data were analyzed by software version 24 SPSS. Results The results showed that awareness, perceived sensitivity, perceived severity, perceived benefits and barriers, and self-efficacy in adopting neck health-promoting behaviors in the intervention group increased in two points of time (immediately after the intervention and 3 months of follow-up) (P Conclusion Designing and implementing an educational intervention based on HBM could affect in adopting neck health-promoting behaviors among teachers. Trial registration IRCT20210301050542N1, 16/03/2021 first registration has been approved in Iranian Registry of Clinical Trials at (16/03/2021).

Aims: This study will be done to evaluate the effectiveness of a designed educational intervention program in adopting knee prevention behaviors in women with knee osteoarthritis in Yasouj, Iran. Method and Materials: This research is a mix method study that has 3 phases. The 1st stage is an observational checklist regarding risky behaviors of common daily activities will be provided based on literature review and interview with related specialists. In 2end stages of doing risky behaviors will be determined through interviews with women suffering from knee osteoarthritis. The third stage of this study will be a semi experimental study in which the designed educational intervention program will be tested. This study will be conducted on eligible 100 women with knee osteoarthritis referred to the orthopedic clinic of Yasouj city in south of Iran. These women will be randomly divided into intervention and control groups, each one with 50 participants. Just intervention group will be educated with intervention program The data collection instruments will be demographic profile questionnaire, Visual Analog Scale (VAS), self-efficacy questionnaire, Western Ontario and McMaster Universities osteoarthritis Index (WOMAC) questionnaire, muscle strength test and a checklist of protective behaviors. Data will be collected before and six months after the intervention of both groups and analyzed by software version 24 SPSS. Conclusion: This study will determine that the designed educational program could be effective in improving the knee protective behaviors and consequently may be resulted in increased knee muscle strength, decreased knee pain and manage the problems caused by knee osteoarthritis. &nbsp

Aim To compare two educational approaches to reduce low back pain in nurses. Design A community randomized controlled clinical trial. Methods Data were collected with two interventions and a control arm between August 2018 and January 2019. Participants were recruited from three hospitals. Hospital 1 received an in‐person educational programme, Hospital 2 received via the website and Hospital 3 received nothing. Statistical analysis was carried out with a follow‐up of 3 and 6 months. Results A total of 180 female nurses with low back pain participated in the study. Dimensions of the quality of life improved over 3 and 6 months, pain and disability decreased over 3 months in both intervention groups and over 6 months in the social media group. Conclusion Two educational approaches can be effective in decreasing pain, disability and improving quality of life. However, the findings suggest that the social media approach was more successful over the long‐term and might be a better way to present the programme.

Background: Neck pain is a common problem among teachers. This study aimed to develop and evaluate an instrument for measuring occupational neck pain preventive behaviors among teachers. Method: In order to develop a neck pain preventive behavior this study was conducted in December 2020 in two phases: qualitative, and quantitative. In qualitative phase a purposeful sample of teachers were interviewed to generate an item pool. Then content validity and face validity were performed to provide a provisional version of the questionnaire. In the next stage, to evaluate the psychometric properties of the questionnaire, a cross sectional study was conducted. In total, 146 teachers participated in this study (with a mean age 36.7; SD 8.92 years). The questionnaire was distributed among a sample of teachers. Exploratory factor analysis was used to obtain the factor structure of the questionnaire. The item-scale correlation matrix was examined to further evaluate the validity of the questionnaire. Internal consistency (Cronbach's alpha) was calculated to assess reliability and intra class correlation coefficient (ICC) to assess stability.Results: Based on analysis of the exploratory factor, 8 factors with 43 substances, that together accounted for 65,25% variances were obtained. Also, the correlation matrix in the case scale to establish the validity of the questionnaire showed satisfactory results. The results of face validity showed that 4 factors were not approved and were removed from the questionnaire. Reliability evaluation with internal consistency method (Cronbach's alpha) showed excellent compatibility (0.87). The intra class correlation reliability assessment showed that the questionnaire has satisfactory stability (ICC) (0.92).Conclusion: This study provides the reliability and validity for the Occupational Pain Neck Preventive Behaviors Questionnaire. The questionnaire evaluates occupational neck pain prevention behaviors among teachers and possibly is useful for using in other settings.

Back pain is considered as a public health problem and it may be predictive of adult disability, and is on the rise among the schoolchildren population. The aim of this study was to explore the association between back pain, posture habits and individual factors (knowledge, self-efficacy, beliefs, and behavior) among schoolchildren. A self-reported questionnaire was used to collect the demographics characteristics, individual factors, posture habits, and back pain. Chi-square test and binary logistic regression analyses were used to examine the association between variables. Among 610 pupils, the prevalence of back pain was 23.6% (n = 144). There were 530 (86.9%) pupils that indicated that they had carried the school backpack of ideal posture. There were significant relationships between the sitting at work on the computer (p = 0.006, OR = 1.66, 95% CI = 1.11-2.49) and on a chair (p = 0.021, OR = 1.61, 95% CI = 1.01 - 2.57) habits with back pain respectively. Self-efficacy significantly associated with back pain (p = 0.001). Similarly, individual factors significantly associated with posture habits. The findings suggest that back care educational programmes are needed to address individual factors in order to promote proper posture habits and reduce backache.

BackgroundThis study aimed to investigate the educational needs of 10–14-year-old girls about adolescent puberty health in Ardabil City in Iran, the matter of adolescent puberty health is one of the most important health priorities, especially for girls.MethodsThis cross-sectional descriptive-correlational study was performed on girl students through stratified-cluster sampling in Ardabil city. The data gathering tool was a self-reported researcher-designed questionnaire consisting of 10 demographic questions and 35 self-care questions in 5 domains of self-care awareness, self-efficacy, enablers, enhancers and behaviors, based on the reviewed articles and resources. Descriptive statistics and chi-square test, correlation coefficient and regression were used to analyze the quantitative data.ResultsThe mean age of the girls was 12.98 ± 4.67. There was a significant relationship between the mother’s level of education (p p p p ConclusionThere is a need among adolescent girls for information about adolescent health and related health behaviors. Currently there is lack of adequate and accurate information. The role of mothers is the most important source of information for adolescent girls and educational approaches for mothers and adolescents should be designed.

Background: Neck pain is one of the most common work-related musculoskeletal disorders (WMSDs). Which has important social and economic consequences such as reduced productivity due to absenteeism, leave and early retirement and financial losses due to medical expenses for the workforce, especially teachers, and is a serious problem among teachers. This study aims was to evaluate whether a theory-based intervention social media could change the high-risk behaviors that cause to job-related neck pain among teachers.Methods: This is a community-randomized controlled trial that will be done in three steps. The stages of the study include: The first stage is a qualitative study to obtain the items and areas of the researcher-made questionnaire based on the health belief model (HBM), the second stage is the psychometric evaluation of the questionnaire and the third stage is the design and implementation of model-based educational intervention in social media. The study population is middle school teachers in the 19th district of Tehran, which are randomly divided into two groups of intervention and control. The intervention group receives training packages on social media and the control group does not receive any training. The intervention tries to improve the knowledge, attitude, skills and self-efficacy in adopting neck pain prevention behaviors among teachers. The study will also assess whether the intervention can reduce disability caused by neck pain among teachers.Discussion: Job-related neck pain can have a negative impact on teachers' health. This study is an attempt to investigate the impact, development and implementation of interventions in reducing job-related neck pain on social media.Trial registration number: IRCT20210301050542N1Registered on 16 March 2021 in IRCT (Iranian registry of Clinical TrialEthics Code: IR.MODARES.REC.1399.163

Background: Development and psychometrics of a questionnaire for preventive occupational pain behaviors in teachers.Quantitative and qualitative research plan in tool development and validation.Method: A qualitative study was conducted in December 2020 with 25 participants to obtain the initial information of the questionnaire. Then content validity and face validity were performed. In the next stage, a questionnaire was distributed among the sample of teachers. In total, 146 teachers participated in this study (with a mean age 36.7; SD 8.92 years). Exploratory factor analysis was used to obtain the factor structure of the questionnaire. The correlation matrix in the case scale has been used to evaluate the validity of the structure. Internal stability (Cronbach's alpha) was calculated to assess reliability and internal correlation coefficient to assess stability.Results: Based on analysis of the exploratory factor, 8 factors with 43 substances, that together accounted for 65,25% variances were obtained. Also, the correlation matrix in the case scale to establish the validity of the questionnaire showed satisfactory results. The results of face validity showed that 4 factors were not approved and were removed from the questionnaire. Reliability evaluation with internal consistency method (Cronbach's alpha) showed excellent compatibility (0.87). The Intraclass correlation reliability assessment showed that the questionnaire has satisfactory stability (ICC) (0.92).Conclusion: This study provides the reliability and validity of the Occupational Pain Neck Preventive Behaviors Questionnaire. This study provides an instrument for evaluating occupational neck pain prevention behaviors among teachers. The instrument is useful for teachers and staff of administrative units and healthcare settings to implement appropriate interventions.

Background Neck pain is one of the most common work-related musculoskeletal disorders (WMSDs). It has important social and economic consequences such as reduced productivity due to absenteeism, leave, and early retirement and financial losses due to medical expenses for the workforce especially teachers. This study aims to evaluate whether a model-based social media intervention could change the high-risk behaviors that cause work-related neck pain among teachers. Methods This is a randomized controlled trial that will be done in three steps. The first stage is a qualitative study to obtain the items and areas of the researcher-made questionnaire based on the health belief model (HBM), the second stage is the psychometric evaluation of the questionnaire, and the third stage is designing and implementation of model-based educational intervention in social media context. The study population is teachers who working in junior high school in the 19th district of education minister in Tehran, Iran, which are randomly divided into two groups of intervention and control. The intervention group receives training packages on social media, and the control group does not receive any training. The educational intervention tries to improve the knowledge, attitude, skills, and self-efficacy in adopting neck pain prevention behaviors among teachers. The study will also assess whether the intervention can promote preventive neck pain behavior among teachers. Discussion Work-related neck pain can have a negative impact on teachers’ health. This study is an attempt to investigate the impact of developed interventions in promoting preventive behavior regarding work-related neck pain through social media context. Trial registration Iranian registry of Clinical Trial (IRCT) IRCT20210301050542N1. Registered on 16 March 2021 Ethics code: IR.MODARES.REC.1399.163

Background: According to the studies conducted, adolescence and its related health issues are of the most significant issues. The purpose of the study was to develop a Musculoskeletal Health intervention-training program using intervention mapping approach (IMA).Methods: The present study was a study protocol where IMA was used as a planning framework for developing musculoskeletal Health intervention-training program. Six intervention mapping steps were completed in the study. As the first step, needs assessment was performed by reviewing the studies, qualitative evaluation and interviews. In the second step, matrix of change objectives was designed. Later on, after designing the program and planning the program implementation, the program evaluation plan was developed.Results: IMA guided us in designing and implementing a control-oriented training program with the participation of the participants along with the definition of outcomes, performance goals and determinants, theoretical methods and practical applications, intervention program, implementation and step by step assessment.Conclusion: Intervention mapping is a participation-based approach to design and implement promotion programs.

Musculoskeletal Diseases (MSDs) is the most common occupational health problem affecting work and each day in workplace employees which are growing in Iran. This study aimed to Identification of the factors predicting the Stretching Exercise (SE) Behavior among Office employees with reinforcing and developing the performance of the Health Promotion Model (DHPM) in Shahid Beheshti University of Medical Sciences (SBUMS) of Iran. This cross-sectional study, data were collected a questionnaire-based on HPM for SE behaviors and Self Regulation, Counter-conditioning, and Stimulus control questionnaire (DHPM) From eligible 430 office employees working in comprehensive service centers for urban-rural health affiliated to SBUMS, selected by Multistage cluster sampling from May to Sep 2017. All structures were examined as predicting factors to decide whether or not they affect the likelihood of the prevalence of SE behavior. The data were analyzed using Confirmatory Factor Analysis the method by Amos software 22 and regression analysis with SPSS 19 software. Totally 420 office employees with mean age of 37.1±8.03 years old took part in the study. The effects of the validity of two versions of HPM (RMSEA= 0.067, x2/df=2.98, GFI&CFI=0.90) and DHPM in confirmatory factor analysis confirmed that i¬tness Indexes of the DHPM (RMSEA= 0.059, x2/df=2.38, GFI&CFI=0.98) were better. Regression analysis reflected that the coverage ratio of SE behavior variance of the DHPM is more than the HPM. This study showed that perceived barriers to action could prevent the studied participants from engaging in stretching exercise. Perceived self-efficacy, Commitment to a plan of action, interpersonal influences, and Stimulus control were significant predictors for SE behavior.

Objective (s): The present study aimed to identify and describe the perceived risk of occupational low back pain and contributing factors among nursing personnel. Methods: This qualitative study was conducted on a sample of nurses with at least one-year experience in a hospital. Focused group discussions and semi-structured interviews were conducted using the PRECEDE-PROCEED model as a framework. Then, they were transcribed and analyzed using content analysis. Results: In all 12 nursing personnel were interviewed. Predisposing factors were extracted from the sub-themes (feeling of risk, perception of the severity of the risk, self-efficacy, perception of the value of health) and reinforcement factors from sub-themes (the role of colleagues in the workplace, physical and mental benefits, economic interests). Two sub-themes (facilitators and organizational barriers) were identified in relation to managerial and enabling factors. Conclusion: The analysis showed that occupational low back pain affects the individual, social and occupational life of nurses. Therefore, working conditions, mental conditions, and rules governing the hospital should be scrutinized to insure that nursing professionals maintain good health.

Background: Physical activity affects office employees in achieving a healthy lifestyle and preventing diseases such as Musculoskeletal Diseases (MSDS). Combining sports such as stretching exercises in healthy lifestyle programs is one of the most important decisions to prevent such disease.Purpose: This study aimed to predict factors of interpersonal and situational influences for stretching exercise (SE) among office employees at Shahid Beheshti University of Medical Sciences.Methods: A cross-sectional study was conducted among 420 office employees recruited by multi-stage cluster sampling. Self-administered questionnaires of SE and interpersonal and situational influences based on Pender’s Health Promotion Model, as well as socio-demographic data, were used in this study. The collected data were analyzed using Spearman correlation and logistic regression tests.Results: Results showed that among 420 participants, the scores of interpersonal and situational influences, and SE were 4.6±11.52, 4.5±14.21, and 2.48±17.64, respectively. There was a significant relationship between interpersonal influence and SE (r=0.54; p0.05), and interpersonal influences were a strong predictor for SE behavior.Conclusion: This study showed that the office employees who were more interpersonal influencers were more likely to do stretching exercise behavior. Therefore, interpersonal factors could be used as an educational principle in facilitating admission behavior of SE regarding Pender’s Model.

Background: According to the studies conducted, teenage and its related health issues are of the most significant issues. The purpose of the study was to develop a Musculoskeletal Health intervention-training program using intervention mapping approach (IMA)for teenagers 12 to 14 years old.Methods: The present study is a study protocol where IMA has been used as a planning framework for developing musculoskeletal Health intervention-training program. Six intervention mapping steps have been completed in the study. As the first step, needs assessment has been performed by systematic review and qualitative evaluation . In the second step, matrix of change objectives was designed. Later on, after designing the program and planning the program implementation, the program evaluation plan was developed.Results: IMA guided us in designing and implementing a control-oriented training program with the participation of the participants along with the definition of outcomes, performance goals and determinants, theoretical methods and practical applications, intervention program, implementation and step by step assessment.Conclusion: Intervention mapping is a participation-based approach to design and implement promotion programs.

Background: Interpersonal influences are critical key points for stretching exercise predicting. In Iran, there's no measure to observe interpersonal Influences amongst workplace office employees. Objective: The purpose of this study was to investigate the short form psychometrics of Interpersonal Influences scale for Stretching Exercise predicting among based on Health Promotion Model (HPM) With Added Constructs. Methods: By multistage cluster sampling method, this cross-sectional study was done among 385 office employees were selected from the Health networks at Shahid Beheshti University of Medical Sciences of Iran (SBUMS). Results: The EFA is shown via the principle component approach one factor with 77% cumulative variance and Kaiser-Mayer-Olkin (KMO) became 90.7%; p -value< 0.001. This was the good fit index in Confirmatory Factor Analysis (CFA). Also With the help of Construct validity, factor was explanted. Within the CFA area, Root Mean Square Error of Approximation (REMSEA) result display= 0.059, Goodness of Fit Index (GFI) = 0.966, Adjusted Goodness of Fit Index (AGFI) = 0.985 confirmed with Cronbach’s alpha (α = 0.834%) and [ (ICC) =0.79 95% Confidence ICCnterval (CI) (0.58, 0.84)]. Conclusion: This study generated a Persian-language version of the Interpersonal Influences scale among the office employees Based on the of HPM.

Background: Sedentary occupations frequently expose employees to prolonged periods with poor posture, which has been considered as the cause of musculoskeletal disorder. Objectives: The study set out to identify the related factors of a taking healthy sitting posture in office workers. Methods: This qualitative study aimed to use the theoretical domains framework (TDF) to investigate perceived determinants to taking a proper sitting posture in office workers. Semi-structured interviews with 25 office workers according to purposive sampling was conducted with a convenience sample of university office workers in Iran. Recorded interviews were transcribed into MAXQDA version 10. Directed content analysis and framework analysis were used for drawing the 12 domains of the TDF. Results: Explored themes were mapped onto the TDF domains, including skills, knowledge, behavioral regulation, goals, environmental context and resources, social influences, beliefs about capability, intentions, emotion, beliefs about consequences, memory, and attention and reinforcement. Conclusions: This study is a theoretical starting point in making structured interventions to change improper sitting posture among office workers. Also, the identified factors provide organizational managers with a wide list of factors by which they can encourage their employees to use proper postures in the workplace, leading to a significant reduction in job absenteeism and insurance fees associated with health problems. In addition, this study enriches the literature by providing additional empirical evidence for the TDF theory.

Background: According to the studies conducted, adolescence and its related health issues are of the most significant issues. The purpose of the study was to develop a Musculoskeletal Health intervention-training program using intervention mapping approach (IMA).Methods: The present study was a study protocol where IMA was used as a planning framework for developing musculoskeletal Health intervention-training program. Six intervention mapping steps were completed in the study. As the first step, needs assessment was performed by reviewing the studies, qualitative evaluation and interviews. In the second step, matrix of change objectives was designed. Later on, after designing the program and planning the program implementation, the program evaluation plan was developed.Results: IMA guided us in designing and implementing a control-oriented training program with the participation of the participants along with the definition of outcomes, performance goals and determinants, theoretical methods and practical applications, intervention program, implementation and step by step assessment.Conclusion: Intervention mapping is a participation-based approach to design and implement promotion programs.

Background Nurses play an important role in health promotion, prevention strategies, and care. Therefore, nurses need to obtain and update their knowledge and skills via appropriate strategies. This study aimed to explore nurses’ experiences of receiving social media and in-person education to integrate the findings into practice. Methods This was a qualitative study using the directed content analysis approach. A sample of nurses with previous experiences of receiving social media and in-person education participated in the study. They were asked to express their experiences and indicate their preferences. The data were collected based on individual semi-structured interviews. Results In total 15 participants took part in the study with a mean age of 40.6 ± 8.93 years and work experiences of 15.3 ± 9.21 years. During the process of content analysis, three main themes emerged: Approaches to nursing education and its adoption in the health system, Achieving effectiveness and efficiency in nursing education, and Health care policy and facilitating pathways for nursing education. Participants indicated several barriers to attending an educational program, including motivation, workload, time and place, and hospital politics. Conclusion Overall the findings suggest that regardless of any methods of education nurses cannot actively engage in the educational interventions while on duty. However, the findings suggest that nurses believe that the social media approach might be superior in reducing barriers and making the educational interventions work better.

Background Adolescence is a significant period of life which is crucial for life long health. The purpose of the study was to develop a puberty intervention-training program using an intervention mapping approach (IMA). Methods The present study was a study protocol where IMA was used as a planning framework for developing a puberty intervention-training program (PITP). Six intervention mapping steps have been described in this protocol. As the first step, needs assessment was performed by reviewing the studies, qualitative evaluation, and interviews. In the second step, the matrix of change objectives was designed from the intersection of performance goals and determinants. Later on, after designing the program and planning the program implementation, the program evaluation plan was developed. Results IMA guided us in designing and implementing a control-oriented training program with the participation of the participants along with the definition of outcomes, performance goals and determinants, theoretical methods and practical applications, intervention program, implementation and step by step assessment. Conclusion Intervention mapping is a control-oriented, systematic, participation-based approach to design and implement targeted and on-going health promotion programs.

Background Back pain is an important public health problem and the leading cause of adult disability worldwide and is rising among schoolchildren populations. Despite numerous studies reporting on back care interventions in pediatric population; there is currently no existing theory-based instrument to assess impact and outcome of these programs. This paper reports on development and psychometric testing of a theory based back-care behavior instrument for use among elementary schoolchildren. Methods This was a three-phases study that included the following steps: a) a literature research to review existing instruments that assess healthy spine-related behavior in elementary schoolchildren; b) development of a new instrument namely the Back-care Behavior Assessment Questionnaire (BABAQ) based on the Social Cognitive Theory and existing instruments, and c) conducting a cross sectional study to test psychometric properties of the BABAQ by estimating the content validity ratio (CVR), the content validity index (CVI), performing confirmatory factor analysis (CFA), reliability analysis, and convergent validity as estimated by the Average Variance Extracted (AVE). Results First, a questionnaire (the BABAQ) was developed. It contained of 49 items tapping into 5 pre-defined constructs (skills, knowledge, self-efficacy, expectation beliefs, and behavior). Then, 610 fifth-grade female schoolchildren were entered into a cross sectional study and they completed the BABAQ. The CVR and the CVI of the questionnaire was found to be ≥0.54 and > 0.7, respectively. The CFA confirmed the five constructs and showed good fit for the data. The intraclass correlation (ICC) and the Cronbach’s alpha coefficients for the BABAQ were 0.84 (P Conclusion The findings suggest that the Back-care Behavior Assessment Questionnaire (BABAQ) is a valid instrument for measuring healthy spine-related behaviors among schoolchildren.

Background: Addiction in Afghanistan, as the largest opium producer in the world, is relatively high, and limited studies have indicated that the youth, especially students are the majority of the addicted cases in this country. Objectives: This quasi-experimental study aimed at designing and evaluating the effect of educational intervention based on the Health Belief Model (HBM) on drug abuse prevention among the students of Khatam Al-Nabieen University in Afghanistan. Methods: In this quasi-experimental study, 120 students of Khatam Al-Nabieen University residing in Ghazni city, Afghanistan, were randomly divided into two groups of the intervention and control (60 students per group). The HBM-based educational intervention was performed for the intervention group. The data in both groups were collected and evaluated at four time points, including before intervention, and immediately, 3, and 6 months after the intervention using a valid researcher-made questionnaire. Results: Although there was no significant difference between the mean score of the HBM constructs (P > 0.05) before the intervention, the results of repeated measures ANOVA showed significant differences in the intervention group in HBM constructs and also intention toward substance abuse preventive behavior (P < 0.001). There were significant inter- and intra-group differences, as well as the group-time interaction in all HBM constructs mean scores (P < 0.001). Also, as the valuable finding, the preventive behavioral intention significantly (P < 0.001) improved following a 3- and 6-month follow-up in the intervention group (17.63 ± 1.34 and 17.66 ± 1.42, respectively) compared with the control group (10.95 ± 1.33 and 10.87 ± 1.22, respectively). Conclusions: The results showed that the HBM-based educational program by preventing substance abuse can help students adopt proper behaviors.

Background In Afghanistan, adolescents and young people are the most important at risk groups for substance abuse. Considering the importance of model-based interventions, this study aims to design and validate a questionnaire based on the Health Belief Model (HBM) for assessing the beliefs of Afghan students regarding substance abuse prevention behavior. Methods This study was conducted in two stages. Firstly, the items of the questionnaire were designed by conducting a combined documentary literature review and qualitative study. In the next step, its psychometric properties were evaluated through qualitative and quantitative formal validity (calculation of impact score), qualitative and quantitative content validity - Content Validity Ratio (CVR) and Content Validity Index (CVI)- and structural validity through Factor Explanatory Analysis (FEA). Finally, consistency compatibility through Cronbach’s alpha as well as reliability (internal correlation) test re-test were assessed. To above steps, the SPSS version 18 was applied. R esults 74 items were obtained for the questionnaire by performing a qualitative study and using existing scientific sources for literature review. In the study of formal validity of quantitative items, the effect coefficient of all above 1.5 was calculated. The CVR of each item was more than 0.8 (mean 0.93), and their CVI was more than 0.79. In this stage, 12 items related to cues to action hanged to 1 item with 12 options so all 63 remained items were retained in the questionnaire. In FEA 40 items related to main constructs of HBM were assessed by which, by eliminating 2 items, structural validity was confirmed for 38 items in 5 factors and covering about 40% of the variance for EFA 408 students with average age of 23 years old were assessed. In the internal compatibility process, the acceptable values ​​of Cronbach's alpha between 0.71 and 0.81 were calculated for all factors. Test re test approved to assess reliability of the instrument. Conclusion The HBM-SAPQA tool obtained the acceptable validity/reliability to apply the beliefs of Afghan students regarding substance abuse preventive behavior. Although the result of this study showed, this questionnaire has good validity and reliability, but this result should be confirmed in future studies.

Background: Nurses are put at high risk of work-related low back pain (LBP) due to the nature of their work. There is wide scientific evidence that the incidence and prevalence of LBP in nurses is high. Therefore, promoting behaviors for low back health in nurses is essential. The aim of this study was to develop and evaluate a theory-based educational intervention on promoting behaviors of low back health via in-person and social media education among nursing personnel with LBP. Methods: The educational content was developed with six modules: knowledge, attitude, self-efficacy, reinforcing factors, enabling factors and behavior. Evaluation of the content was undertaken in nurses, mean age 36.50 ± 5.79 years, with LBP recruited to a community randomized controlled trial with two modes of delivery: in-person (n=60) and social media (n=60). Data were collected with a self-designed questionnaire at baseline, 3 and 6 months. Baseline comparisons between groups were made with Mann-Whitney U Test for non-normal data and T-Test for normal data. Comparison of change scores between groups and two delivery types across the three time periods used the mixed between-within subject analysis of variance. Results: A total of 120 nurses received the allocated intervention and completed the baseline and follow-up questionnaires. The results indicated there were no significant statistical differences between two delivery types in the variables at the baseline (p > .05). All educational component scores increased at 3-months in both groups. At the 6-month follow-up scores increased for enabling factors and behavior in the in-person group, while in the social media group all scores increased except for attitude. Based on Bonferroni Post hoc analysis there was the difference between the delivery types; social media was more effective in knowledge (p = .01), self-efficacy (p = .03), reinforcing factor (p = .05) and behavior (p = .001) than the in-person intervention. Conclusion: An educational program for low back health was developed based on the PRECEDE-PROCEED model and proved effective at improving knowledge, attitude, self-efficacy, reinforcing factors, enabling factors and behavior. However, delivery via social media was more successful than in-person in the maintenance of behavior over the long-term.

Aim: Oral hygiene must start at a young age. Childhood is the perfect time to start the conversion of knowledge into creative thinking and subsequent health care activity. This study aimed to measure the constructs of the Health Belief Model (HBM) in relation to the oral health practice of female students in Tehran.Methods: A cross-sectional descriptive study was conducted on 416 grade five female students of elementary schools in the school year of 2016-2017 in Tehran, Iran. Data were collected using an author-designed questionnaire based on the constructs of the HBM. The validity of the questionnaire was confirmed using face validity while its reliability was approved using Cronbach’s alpha statistics. Data were analyzed using Pearson's correlation and regression analysis at 0.05 level of significance.Findings: According to the findings, the mean age of the participants was 10.88±0.628 years. Pearson's correlation showed that four the HBM constructs of Self-efficacy, Cues to action, Perceived benefits, Perceived barriers were significant predictors for oral health practices (P < 0.05). In addition, the variables of knowledge and socio– economic conditions (mother's educational level, father's educational level, mother's job, father's job and family income) had significant relationship with performance (P < 0.05).Conclusion: Our study shows that for improving the beliefs related with oral health behaviors, designing educational programs with emphasis on increasing self-efficacy and perceived benefits, and overcoming the barriers to promote oral health behaviors is essential.

Study DesignClinical trial.PurposeTo evaluate the effectiveness of a multidisciplinary group-based intervention on improving pain and disability among Iranian nurses with chronic low back pain in Tehran, Iran.Overview of LiteratureAlthough low back pain (LBP) is one of the most important health problems, the challenge remains on how to find an effective intervention to reduce pain and related disabilities.MethodsOverall, 136 eligible nurses with chronic mechanical LBP were classified into two groups. The intervention group (n=66 participants) participated in a physiotherapy educational program (for 120 minutes) plus a health educational program based on predictive constructs of the social cognitive theory (for 120 minutes). These interventions were delivered by a physiotherapist and a health education specialist. The control group (n=70 participants) participated in a physiotherapy educational program (for 120 minutes). Disability rate, pain severity, and back pain prevention behavior were measured initially and at 3- and 6-month follow-up visits using the visual analogue scale, Roland-Morris Disability, and Nursing Low Back Pain Preventive Behaviors Questionnaire. Data were analyzed by SPSS ver. 16.ResultsThere were statistically significant differences between the two groups in the main outcome measures immediately after the educational program and at 3- and 6-month follow-up visits. Preventive behaviors of participants in the intervention group were improved at 3- and 6- month follow-up visits (ppConclusionsThis study showed that a multidisciplinary educational program intervention can be an effective approach for reducing LBP and related disabilities among nurses.

Study DesignInterventional research with a 6-month follow-up period.PurposeWe aimed to establish the effectiveness of a multidisciplinary workplace intervention on reduction of work-related low back pain (WRLBP), using ergonomic posture training coupled with an educational program based on social cognitive theory.Overview of LiteratureWRLBP is a major occupational problem among healthcare workers, who are often required to lift heavy loads. Patient handling is a particular requirement of nurse aides, and has been reported as the main cause of chronic WRLBP.MethodsWe included 125 nursing assistants from two hospitals affiliated to Qom University of Medical Sciences from May to December 2015. There was an intervention hospital with a number of 63 nursing assistants who received four multidisciplinary educational sessions for 2 hours each plus ergonomic posture training over two days and a control hospital with a number of 62 nursing assistants who didn't receive educational intervention about low back pain. The outcomes of interest were reductions in WRLBP intensity and disability from baseline to the follow up at 6 months, which were measured using a visual analog scale and the Quebec Disability Scale. Descriptive and analytical statistics were used to analyze the data.ResultsThe comparison tests showed significant change from baseline in reduction of WRLBP intensity following the multidisciplinary program, with scores of 5.01±1.97 to 3.42±2.53 after 6 months on the visual analog scale in the intervention group (pp=0.07).ConclusionsWe showed that our multidisciplinary intervention could reduce the intensity of WRLBP among nurse aides, making them suitable for implementation in programs to improve WRLBP among nursing assistants working in hospitals.

Objectives: Smoking is a serious, highly prevalent health problem worldwide. This paper aimed to evaluate the effects of an educational program on quitting smoking among automobile workers in Bam, Iran. Patients and Methods: In this interventional study, one hundred male automobile workers were randomly allocated to the intervention (N = 50) and control group (N = 50) at automobile manufacturing factory in Bam, Iran in 2017. Just the intervention group participated in an educational program. The short form of Transtheoretical Model (TTM) questionnaire and also Fagerstrom Test for Nicotine Dependence (FTND) were used. Chi-square test was used to compare the categorical variables and repeated measure ANOVA was utilized to compare parametric variables between the two groups. Results: Totally 50 participants in each group of the intervention (mean age = 30.90 ± 4.22) and control (mean age = 31.44 ± 3.55) groups completed the study. The mean scores for the decisional-balance in the control versus intervention group, immediately after the intervention, 3, and 6-month follow-up were 22.73 ± 2.28 vs. 18.68 ± 2.20, 21.96 ± 2.19 vs. 18.20 ± 2.08, and 22.18 ± 2.40 vs. 18.62 ± 1.97, respectively. The mean scores in the control versus intervention group for temptation were 32.30 ± 5.10 vs. 20.72 ± 3.01, 31.88 ± 5.09 vs. 24.04 ± 3.05, and 32.58 ± 4.72 vs. 24.08 ± 2.65, respectively; and for the processes of change were 70.96 ± 6.27 vs. 58.68 ± 5.89, 71.50 ± 6.88 vs. 60.48 ± 6.37, and 72.30 ± 6.66 vs. 63.02 ± 6.38, respectively. The mean scores of change in the intervention group compared to the control group at 6 months after the intervention compared to baseline were significant in terms of decisional balance (3.96 vs. -0.42; P < 0.001); situational temptation (-9.7 vs. -1.34, P < 0.001), and process of change (-6.22 vs. 1.64, P < 0.001). Conclusions: This study revealed that the designed educational program could be effective in quitting smoking among automobile factory workers through decreasing temptation and increasing decisional balance and process of change.

Aim: The purpose of this examination is determining predictors to oral health behaviors predict in Iranian students in district 1 Tehran based on the health belief model with added commitment to plan construct. Methods: This cross-sectional study were randomly selected conducted on 351 eligible four grade female students in the first district of Tehran, Iran in 2017. The random Multi‑stage random cluster sampling method was used to recruit students. The inclusion criteria were being graded, four female students (aged 9-11 years), or education at the fourth grade of one of the elementary schools studied in the first district of Tehran and, The health of the student from a physical and psychological of view. Logistic regression analysis was used to identify the variables that predict oral health behaviors. To assess the predictors of oral health behaviors, all the expanded Health Belief Model constructs with the construct of “Commitment to Plan of Action” from “Health Promotion Model were examined as risk factors to see if they influence on the probability of brushing behavior and dental floss behavior occurrence and were interpreted through odds ratio (OR). SPSS version 19 was used to analyze the data. Results: Totally 308 four grade female students with mean age of 9.32 ± 0.81 years old took part in the study. The total 31.8% of the students reported that they were brushing behavior less than twice a day and 55.2% students claimed, use of dental floss behavior once a week or less than once a day. The results indicated that perceived self-efficacy (OR=1.46, 95% CI=0.57-3.78, P

Aim To develop and test the psychometric properties of occupational low back pain prevention behaviours questionnaire in nursing personnel. Design A qualitative and quantitative research design to develop and validate an instrument. Methods A qualitative study was conducted from May - October 2017 with 20 participants to generate an item pool. Then, content and face validity was carried out. Next, the questionnaire was distributed among a sample of nurses. In all, 150 nurses participated (mean age 34.1; SD 7.66 years) in the study. Exploratory factor analysis used to determine the factor structure of the questionnaire. Item-scale correlation matrix was provided to examine the construct validity. Internal consistency (Cronbach's alpha) was estimated to assess reliability and intraclass correlation coefficient was calculated to examine stability. Results Six factors with 30 items emerged from the exploratory factor analysis that jointly accounted for 67.9% of the variance observed. Item-scale correlation matrix showed satisfactory results lending support to construct validity of the questionnaire. The Cronbach's alpha coefficient for the whole scale showed excellent internal consistency (0.92), although this was not true for the knowledge subscale. The intraclass correlation coefficient with a 2-week interval also indicated that the questionnaire had satisfactory stability (0.97). Conclusion This study provides initial support for reliability and validity of the Occupational Low Back Pain Prevention Behaviour Questionnaire. Impact This study offers an instrument to assess low back pain preventive behaviours among nurses. The instrument is useful for nursing personnel and could be used in hospitals and healthcare settings to implement appropriate interventions.

Background Low back pain in nursing profession remains an important health issue. This study aims to assess whether a theory based interactive social media intervention could change job-related risk behaviors among nursing personnel. Methods This is a community-randomized controlled trial. Three settings of hospitals will randomly be assigned to the study arms: Intervention setting 1 receiving an in-person educational package; intervention setting 2 receiving the same material a web-based; and a control setting receiving nothing. The intervention would contain materials related to occupational risk behaviors and will try to promote the knowledge, attitude, skill, and self-efficacy of nurses on low back pain preventive behaviors. The primary outcome will be reduction in low back pain. The study also will assess whether the intervention could reduce pain-related disability and improve the quality of life. Discussion Occupational low back pain among nurses could adversely affect both patients and nurses’ health. This study is an attempt to see if social media could play a role to guide the development and implementation of future interventions.

Background: Occupational back pain is the most prevalent health problem among nurses that needs to be assessed by a valid and multi-factorial questionnaire. The purpose of the present study was to design and develop an instrument for assessing job-related back pain prevention behaviors among nursing professionals. Methods: First an item pool of 49 items was generated. Then, content and face validity was carried out. Consequently, a cross-sectional study was conducted in Mazandaran, Iran. The questionnaire was distributed among a sample of nurses working in hospitals affiliated to Mazandaran University of Medical Sciences. Exploratory factor analysis was used to determine the factor structure of the questionnaire. Item-scale correlation matrix employed to examine the construct validity. The Cronbach’s alpha was estimated to assess the reliability and the intraclass correlation coefficient was calculated to examine stability. Results: In all 155 nurses participated in the study. The mean age of respondents was 34.1 (SD = 7.66) years, and 83.2% were female. Six factors with 30 items emerged from the exploratory factor analysis: knowledge, attitude, self-efficacy, reinforcing factors, enabling factors and behavior that jointly accounted for %66.5 of variance observed. Item-scale correlation matrix showed satisfactory results lending support to construct validity of the questionnaire. The Cronbach’s alpha coefficient showed excellent internal consistency (alpha=0.92). The intraclass correlation coefficient with 2-weeks interval also indicated that the questionnaire has satisfactory stability (ICC = 0.97). Conclusions: The findings showed that the Occupational Back Pain Prevention Behavior Questionnaire is a reliable and valid instrument for measuring occupational back pain prevention behaviors among nurses. Keywords: Occupational Back Pain, Prevention behaviors, Psychometric evaluation, PRECEDE-PROCEED model, Nurse

espanolAntecedentes: los empleados de oficina de todas las edades corren el riesgo de contraer enfermedades no transmisibles, como los trastornos musculoesqueleticos (TME) debido a la inactividad fisica. El comportamiento del ejercicio de estiramiento (SE) podria ayudar a los empleados de oficina a prevenir los TME. Esta investigacion tuvo como objetivo estudiar los predictores de SE entre los empleados de oficina que trabajan en la Universidad de Ciencias Medicas Shahid Beheshti (SBUMS) de Iran a traves de un modelo de promocion de la salud (HPM). Metodos: en el presente estudio, 430 empleados de oficina elegibles fueron seleccionados al azar. Para evaluar los predictores de SE, todos los constructos de HPM se examinaron como factores de riesgo para determinar si influyen en la probabilidad de ocurrencia de comportamiento de SE y se interpretaron a traves de odds ratio (OR). SPSS version 19 se utilizo para analizar los datos. Resultados: un total de 420 empleados de oficina con una edad media de 37,1 ± 8,03 anos participaron en el estudio. Este estudio demostro que las barreras percibidas para la accion podrian evitar que los participantes se involucren en SE (OR [IC 95%]: 0.875 [0.815-0.939], p Conclusiones: Este estudio mostro que los empleados de la oficina que tenian mas confianza y estaban comprometidos con un plan de accion, y percibian menos barreras, tenian mas probabilidades de participar en el comportamiento de SE. EnglishBackground: Office employees of all ages are at risk for non-communicable diseases such as musculoskeletal disorders (MSDs) due to physical inactivity. Stretching exercise (SE) behavior could help office employees prevent MSDs. This research aimed to study the predictors of SE among office employees working in Shahid Beheshti University of Medical Sciences (SBUMS) of Iran through a health promotion model (HPM). Methods: In the present study, 430 eligible office employees were randomly selected. To assess the predictors of SE, all the HPM constructs were examined as risk factors to determine whether they influence the probability of SE behavior occurrence and were interpreted through odds ratio (OR). SPSS version 19 was used to analyze the data. Results: A total of 420 office employees with mean age of 37.1 ± 8.03 years took part in the study. This study showed that perceived barriers to action could prevent participants from engaging in SE (OR [95% CI]: 0.875 [0.815-0.939], p 2019;71:178-85)

Introduction : Dental caries and obesity are multifactorial diseases with diet being a common contributory factor. Many studies have reported varied outcomes about the association between dental caries and body mass index. But, there is no published study that investigates this association among female students in Tehran. The main aim of this study was to examine the relationship between dental caries and body mass index (BMI) in a sample of female students in Tehran. Methods : In this cross‑sectional study, 416 students aged between 10 to 12 years was examined for dental caries using WHO standard diagnostic criteria. The Decayed, missing and flled of permanent teeth (DMFT) were recorded. The student’s weight and height were measured by two trained examiner and their BMI were calculated. BMI‑for‑age and dental caries categories were analyzed with Pearson correlation coeffcient, Chi‑square, and t ‑tests using SPSS computer software. Results : The mean DMFT score and BMI of the study population was 1.03 ± 1.41 and 18.11 ± 3.33 respectively. The fndings showed that 58.9% of the children had a normal weight, 27.9% were overweight, 10.3% were obese, and only 2.9% of the students were thin when they were compared with WHO standard of BMI for children with the same age. The respective mean DMFT values for BMI groups (thin, normal, overweight and obese) were 1.25, 0.73, 1.42, and 1.65, respectively. There was a signifcant association ( P < 0.05) between dental caries and high BMI. Conclusions : This study demonstrated a signifcant association between caries frequency with high body mass index. For these reasons, the evaluation of nutritional status in students should be implemented in control programs for dental caries both on the community, schools, and individual levels. Keywords : Body mass index, children, dental caries

Mohammad Hossein Delshad,1 Sedigheh Sadat Tavafian,1 Anoshirvan Kazemnejad2 1Department of Health Education and Health Promotion, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran; 2Department of Biostatistics, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran Introduction: Health Promotion Model (HPM) is one comprehensive model by which health behavior predicting factors could be determined.Purpose: This study aimed to investigate the effects of a designed interventional program based on HPM on promoting stretching exercise (SE) behavior among office employees.Patients and methods: This interventional designed study was carried out on 87 office employees who were working in the three health networks affiliated to Shahid Beheshti University of Medical Sciences in Tehran, Iran. These participants were randomly divided into intervention group (N=44) who complied with educational program based on HPM and control group (N=43) who did not receive the program. The data were collected through a demographic questionnaire and a researcher-made questionnaire based on HPM at three times of baseline, 3- and 6-month follow-ups and analyzed using SPSS version 19.Results: Totally, 40 office employees with mean age of (37.70±7.40) in intervention and 37 ones with mean age of (35.97±7.34) in control group were assessed. At baseline, both groups were the same regarding the HPM constructs of perceived barriers, perceived self-efficacy, commitment to plan, and interpersonal influences (P>0.05). However, following intervention, there was a significant difference between two groups during 6-month follow-up in all these predictor factors (P

Background and Objectives: Back pain is the most common pain in pregnancy. This research aimed at exploring the influence of exercise program training on behavior change that leads to back pain prevention in pregnant females. Materials and Methods: This research was semi-experimental with pretest-post-test and control group research method, and included 120 pregnant females that referred to the Karaj Health Center. These females were selected randomly and divided to 2 groups, including control (60 persons) and intervention (60 persons). The research used 3 tools, the demographical questionnaire, Visual Analogue Scale (VAS), and awareness and attitude questionnaire, in order to specify back pain preventive behavior. Data were then analyzed using SPSS 21 with the paired t-test, Mann-Whitney, and Tukey tests. Results: There were significant differences between average awareness, attitude and preventive behaviors, and rate of back pain in the third trimester of pregnancy in the intervention group before and after the intervention (P >0.05). Also, there was a significant difference in the mentioned items between the intervention and control groups (P >0.05). Conclusions: This research showed that the training intervention could improve awareness, attitude, and behavior of pregnant females in back pain prevention.

The PRECEDE-PROCEED model is an adaptable planning model that could be served in public health issues. The purpose of this study is to investigate the effects of an educational program based on Precede-Proceed model on promoting Low Back Pain (LBP) behaviors among health care workers (HCWs). This Double-blinded randomized trial study was conducted on 112 from 120 HCWs aged from 30 to 55 years The eligible HCWs were randomly divided to intervention group 1 (N = 38), respectively intervention group 2 and control group (N = 37) for which the Precede-Proceed - based educational program was implemented and control group (N = 37). The random multi-stage cluster sampling method was used to recruit HCWs. HCWs completed a self-reported questionnaire on their Low Back Pain Behaviors assessment questionnaire based on the Precede-Proceed Model and a visual analogue scale (VAS) was also used. The data were gathered at initial of the study, 6 and 12 months follow-ups from three groups and were analyzed through SPSS version 19. There was a significant interaction between the factors “group” and “test time” (p < 0.05, p < 0.001) of knowledge, perceived self-efficacy, and attitude, reinforcing factors, enabling factors, public health, quality of life and LBP preventive behaviors of the intervention group., although, no significant alternate became located in the mean score of above structures of the control group. The findings of the present study confirmed the effectiveness of the PRECEDE-PROCEED model-based educational program on preventing LBP by enhancing scores of model constructs. However, these results should be repeated in further studies to be able to apply this program in health system., Occupational health; Health profession; Rehabilitation; Physical activity; Public health; Quality of Lifel PRECEDE-PROCEED model; LBP, Preventive behavior, Attitude, Enabling factors, Reinforcing factors.

Background: False beliefs and fear of movement are common among patients with chronic low back pain (CLBP). Objectives: The current study aimed at changing the relaxation behaviors (RB) of patients with chronic low back pain based on educational programs through the Theory of Reasoned Action. Methods: The current experimental study was conducted from May to Nov 2016 on patients with chronic low back pain referred to pain clinics in Yazd, Iran. Through random blocking of every two participants, two groups were formed; the intervention (N = 43) group received educational programs based on the theory of reasoned action plus physician visits, and the control group (N = 45) received just physician visits. Results: The mean age of intervention and control groups was 40.14 ± 6.8 and 38.33 ± 5.46 years, respectively. The mean score of RB in the intervention group improved from 4.58 ± 1.73 at baseline to 4.51 ± 1.69 and 3.02 ± 1.64 at three- and six-month follow-up times, while in the control group the changes were from 2.84 ± 1.62 at baseline to 3.49 ± 1.16 and 3.20 ± 1.42 at the same follow-up times; the changes were significant (P = 0.04). Conclusions: The educational programs of the current study could be recommended to change the beliefs of patients with chronic low back pain about the relaxation behaviors.

Background: Situational temptations are important key points for smoking cessation. However, temptation to engage in smoking across different situations is yet challenging. In Iran, there is no measurement to assess situational temptations among workers. Objectives: The current study aimed at psychometrically evaluating the short form of situational temptations scale for smoking cessation based on transtheoretical model. Methods: By stratified random sampling method, 218 male current smoking automobile factory workers were selected and assessed through the short form of situational temptation scale. Exploratory factor analysis (EFA), confirmatory factor analysis (CFA), and Cronbach’s alpha were applied. Results: The mean age of the workers was 30.52 ± 6.66 years. CVI and CVR of each question were > 0.71. The result of EFA with principal component approach showed 1 factor with 45% cumulative variance and KMO was 91%, which were the good fit index in CFA. In the area of CFA, the result showed REMSEA = 0.006, GFI = 0.973, AGFI = 0.955; P value = 0.452, which were the good fit index in CFA. The reliability was also confirmed with Cronbach’s alpha (α = 80.1%). Conclusions: The current study approved the short form of situational temptation scale for smoke cessation. However, to ensure a reliable/valid instrument to realize smoking behaviors, doing more researches are recommended.

Introduction: Sexual health educationcan enable the people to improve their sexual behaviors. This study aimed to examine the impact of sexual education program on improving sexual behavior among married women in Southern Tehran. Methods &Materials: This semi-experimental study was conducted on 130 women took part in two groups of intervention and control (each one 65 individuals). The intervention group complied with two 180 -minute training sessions. Data were gathered from two groups at initial of the study and 3- month follow up through demographic questionnaire and scale of women sexual function and were analyzed with independent and paired T tests. Findings: Totally 65 women took part with mean age of 35.6 ± 7.75 and 35.15± 6.85 in two groups of intervention and control respectively. At first, there were no significant differences between two groups in terms of demographic characteristics and score of sexual function scale. However, after three months the sexual behaviors of intervention group (28.14 ± 3.44 were significantly much better than control group 22.79 ± 6.60 (p

Background: One of the many tasks of rural health houses (HHs) is to provide health education for rural clients. Objectives: The purpose of this study was to assess the conditions and responsibilities of HHs regarding health education. Methods: Through systematic random sampling, 1600 HHs were selected during April-September 2011. Besides the characteristics of HHs, type of training, audience groups, time of education, number of participants, and reasons for educational classes were requested in a written format from the selected HHs. Data were analyzed using Excel 2007 and SPSS version 16. Results: In total, 21.9% of HHs had no group education within the first 5 months. Most education was related to the field of reproductive health, followed by intestinal diseases. The largest target group included mothers eligible for family planning. The mean duration of education was 33.6 minutes per week. Based on the findings, 55% of training was conducted due to provincial health priorities. Conclusions: Although cardiovascular diseases, road traffic accidents, and cancers are the major causes of mortality in Iran, most education concentrated on reproductive health, as well as mother and child health. Therefore, modifications in educational methods and planning are necessary.

BACKGROUND Self-efficacy is a crucial factor in adopting mammography behavior. A reliable and valid instrument is necessary to measure self-efficacy among Iranian women. OBJECTIVE The aim of this study is to translate the original version of Champion's Mammography Self-efficacy Scale into Farsi and then to estimate the Farsi version's reliability and validity. METHODS In a cross-sectional study, 200 women 40 years or older who were referred to health centers in Iran were invited to complete the related questionnaires during an interview. Cronbach's α coefficients and item-total correlations were measured to evaluate the reliability of the scales. Content and face validities were evaluated using the opinions of a panel of experts, and construct validity was estimated through applying confirmatory factor analysis. Logistic regression and χ tests were used to estimate theoretical relationships. RESULTS In terms of reliability, the internal consistency α was .904 and the test-retest reliability correlation over a 4-week period was 0.624. With regard to the confirmatory factor analysis, the proportion of χ to degrees of freedom was 0.394, giving a P value of .852 and a root-mean-square error of approximation less than 0.001 with confidence intervals of less than 0.001 and 0.018, with a comparative fit index of 1, normed fit index of 0.999, relative fit index of 0.993, and incremental fit index of 1. CONCLUSION The items that form the self-efficacy measurement scale in the Farsi version are highly reliable and valid. IMPLICATIONS FOR PRACTICE Healthcare professionals and nursing health communities may apply the instrument to determine women's self-efficacy and to plan appropriate educational interventions, aiming at promoting women's mammography behavior.

Aim: Despite the evidence suggesting the positive impact of the immediate mother-newborn Skin-to-Skin Contact (SCC), it has not yet been adopted to use for healthy newborn in Iran. No study has explained the reasons. This study aimed to survey midwives' opinions about the predisposing factors in SCC at birth in Tehran hospitals in 2014.Method: The samples, in this cross sectional descriptive study, were 292 midwives who worked in labour wards, and a multi- stage cluster sampling was applied. First we applied stratified and simple random approaches. Then they were classified into educational, social security, and private groups. Data collection instrument was a self- developed questionnaire consisting of 9 demographic characteristics and 38 items concerning the predisposing factors in SCC. We applied face/content validity and item impact method for the instrument's validity. For assessing the internal consistency of the instrument, Cronbach's alpha coefficient was used. All statistical analyses were performed using the SPSS-18.Findings: The findings showed that 95.5% of the midwives possessed good knowledge of SSC, 93.2% had positive attitudes, 96.6% believed in SSC effects, and 94.9% had a good self-efficacy perception. The Cronbach‟s alpha coefficient of the 38-item instrument showed excellent internal consistency (α=0.88), and it was valid and reliable to measure predisposing factors in SSC.Conclusion: The knowledge and attitudes of conducting SSC at birth were evaluated at “good” and “positive”, respectively. Therefore, we suggest further analytic studies to determine how these factors could affect on midwife behaviour.

Aim: This is a cross- sectional study to assess low back pain preventive behaviors among Iranians nursing aides who provide direct patient care in hospitals. Musculoskeletal disorders (MSDs) comprise significant occupational injuries and disabilities within the nursing profession. Studies show that implementing a safe patient handling can prevent low back pain among nursing aides. Methods: This study was conducted in Qom (Iran) in 2015 with a sample of 452 eligible nursing aides working in six educational hospitals affiliated with Qom University of Medical Sciences. Data were collected by a researcher-developed questionnaire with 29 questions in two sections of demographic questions (17 items), and low back pain preventive behaviors were adopted from the Occupational Safety and Health Administration (OSHA) guidelines for nurses (12 items). Findings: Totally, 452 nursing aides suffering from chronic low back pain participated in the study, which included 289 males (63.9%) and 163 females (36.6%) with mean age of 37.71 (SD = 8.3) years. The mean score of applying low back pain preventive behaviors was 32.9 ± 7.7. Fifty nine participants (13.1%) had poor behavior scores, 251 participants (55.5 %) obtained average scores, and 142 participants (31.4 %) achieved acceptable scores due to their preventive behaviors. The majority of the studied nursing aides (68.6%) did not consistently perform safe patient handling. Conclusion: This study showed that most nursing aides had low preventive behaviors regarding maintaining their body mechanics. Thus, evaluating the causes of failing to do safe behaviors /safe patient handling is strongly recommended in Iran.

Background Pregnant women and their fetus belong to a sensitive group in response to air pollution hazards. The aim of this study was to evaluate the effectiveness of a theory-based educational program to change pollution exposure behavior in pregnant women. Methods In this randomized controlled trial, pregnant women attending a prenatal clinic in Tehran, Iran were selected and randomized into the experimental and control groups. The inclusion criteria were age between 18 and 35 years, having a history of pregnancies without adverse outcomes and not suffering from chronic diseases. Data collected at baseline and 2-month follow-up. At baseline face-to-face interviews were conducted using a valid and reliable questionnaire including items on demographic characteristics, stages of change, self-efficacy, decisional balance and practice regarding air pollution preventive behaviors. The intervention composed of three parts: motivational interviewing, a booklet and daily small message service (SMS). The control group received no intervention except receiving usual care. Follow-up data were collected after the intervention. Data were analyzed performing t-test, Mann–Whitney U test, and chi-squared. Results In all the data for 104 pregnant women (53 in the intervention and 51 in the control group) were analyzed. The mean age of participants was 27.2 (SD = 4.11) years and it was 22.89 (SD = 8.75) weeks for gestational age. At baseline there were no significant statistical differences between intervention and control groups on the study measures while we found significant group differences in terms of stages of change, self-efficacy, perceived benefits and practice regarding air pollution preventive behaviors at follow-up assessment (P

Aim: The objective of this study was to determine the relationship between chronic mechanical low back pain and work-related risky behaviors of nurses at hospitals in Tehran. Methods: In order to determine the relationship between chronic mechanical low back pain and work-related risky behaviors of nurses, a cross-sectional was conducted among nurses in general hospitals in Tehran- Iran from April 17, 2014 to July 16, 2014. Five hundred eligible nurses, who were working in the different wards of under study hospitals, were included in this study. A researcher- designed 50 - item questionnaire was used to collect data. The Cronbach’s alpha coefficient (alpha=0.91), and test-retest evaluation (ICC=0.94) of the scale confirmed reliability of the questionnaire. Data were analyzed using SPSS.v16 through descriptive and analytic tests. P-value < 0.05 was considered significant in both analyses. Findings: In total, five hundred nurses with mean age of 37.71+ 6.75 years took part in the study. 168 nurses (33.6%) were male and 332 nurses were (64.4%) female. The majority of nurses who were working more than 15 years (75%) were suffering from low back pain. Low back pain was more prevalent among female nurses (68%) compared to male nurses (32%). Most participants believed that excessive physical tension and hard work at their worksite were the causes of their chronic low back pain. There were no significant differences between two genders in this regard (P>0.5). In contrast with men, the majority of females (N= 222, 66.8%) believed that psychological tensions at work have been the reasons for their chronic low back pain. Conclusion: Iranian nurses believed that work – related physical and psychosocial factors could result in low back pain.