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Vahideh Termeh Zonouzy,1 Shamsaddin Niknami,1 Fazlollah Ghofranipour,1 Ali Montazeri2 1Department of Health Education and Promotion, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran; 2Population Health Research Group, Health Metrics Research Center, Iranian Institute for Health Sciences Research, ACECR, Tehran, Iran Background: Breast cancer is an important public health problem worldwide. This study aimed to assess the effectiveness of an educational intervention based on fear appeals using the extended parallel process model (EPPM) to improve attitudes, intention, and early breast cancer diagnosis in Iranian women.Methods: This was a cluster-randomized trial conducted in Tehran, Iran. A sample of women 40 years old and above was recruited and assigned either to intervention group or to control group. The intervention group received two pamphlets containing fear appeals specially designed for this study using the EPPM. The control group received nothing. The primary outcomes were changes in attitude, behavioral intention, and early breast cancer diagnosis. Participants responded to a questionnaire before intervention and at 3 months follow-up assessments. Independent t-tests and paired t-tests were used for comparison.Result: In all, 600 women were entered into the study (277 in the intervention group and 323 in the control group). Of these, 162 were lost to follow-up assessment. Thus, the analysis was restricted to those for whom both baseline and follow-up information was available (n=438). The mean age of participants was 53.2 (SD=9.45) years, and the mean year education of participants was 9.4 (SD=4.12) years. There were no significant differences between two groups regarding demographic variables. However, comparing outcome variables (attitude, intention, and early breast cancer diagnosis) at baseline and follow-up assessments, we found that the intervention group showed significant improvements in attitude and intention (P=0.01 and P=0.001, respectively), but no significant improvement was observed for early breast cancer diagnosis (P=0.78). The control group did not show any changes.Conclusion: The findings showed that fear appeals could not influence early breast cancer diagnosis among women. However, significant changes were observed for attitude and behavioral intention. Keywords: EPPM, breast cancer screening, women’s health, Iran

Occupational injuries have several psychological, economic, social, and institutional consequences. Agriculture is a high-risk industry, but occupational injuries are mainly rooted in the behavior of farmers. The present study was conducted using the qualitative approach and the grounded theory method. The study population included members of the Faculty of Agricultural Science and Occupational Health of the School of Medical Science, agricultural experts, occupational health experts, and farmers who were selected through snowball sampling in Kermanshah province in western Iran. The data was collected through interviews. The findings showed that cognitive, personal management, cultural, organizational and economic factors affect agricultural occupational health behavior. In the research model, healthy growers, healthy products, and healthy society were the consequences of the use of appropriate strategies for agricultural occupational health behavior. Designing a native model of healthy behavior to promote occupational health is a step towards reducing injuries among farmers. [ABSTRACT FROM AUTHOR]

Background and Aim: Cancer is the third cause of mortality in Iran, killing more than 30000 persons annually. The Motivation Theory is a useful approach for predicting and planning intervention programs to change behaviors related to cancer prevention and early detection. Considering the absence of a valid and reliable protection motivation theory questionnaire for cancer early detection in Iran, this study was conducted to design such a questionnaire and assess its psychometric properties in Yazd Materials and Methods: This was a cross-sectional study. A questionnaire was designed based on similar questionnaires currently in use and its validity and reliability were determined. The reliability coefficients were calculated by Cronbach α and intraclass correlation coefficients. To determine the validity of the scale, two methods were used, namely, face validity and content validity. Confirmation factor analysis was used to determine factorial validity using Amous 21 software. Results: The CVR for all items of the questionnaire, CVI, ICC and internal consistency of the questionnaire were found to be 1, 0.97-1.0, 0.71-0.98, and 0.65-0.93, respectively. The confirmation factor analysis revealed that the questionnaire fitted the Iranian population. The Cronbach alpha coefficient for the questionnaire constructs varied between 0.71-0.98 and 0.65- 0.93 Conclusion: The validity and reliability of the Persian version of PMT scale for cancer early detection are acceptable and suitable, so it can be used in similar research. [ABSTRACT FROM AUTHOR]

Objective: The objective of this study was to investigate the reliability and validity of the Iranian version of the Pediatric Quality of Life Inventory™ 4.0 (PedsQL™ 4.0) Generic Core Scales in adolescentsMethods: After linguistic validation, the Iranian version of the PedsQL™ 4.0 was completed by 848 healthy and 26 chronically ill adolescents aged 13-18 years and their parents.Results: The internal consistency as measured by Cronbach's alpha coefficients exceeded the minimum reliability standard of .70. No floor effects were observed. Ceiling effects detected ranged from 1.5% for adolescent self-report total scale score to 42.2% for self-report social functioning. All monotrait-multimethod correlations were higher than multitrait-multimethod correlations. The intraclass correlation coefficients (ICC) between adolescent self-report and parent proxy-report showed good to excellent agreement. Exploratory factor analysis supported mainly comparable results with the original US English dialect version. The results of the confirmatory factor analysis for 5-factor models for both self-report and proxy-report indicated acceptable fit for the proposed models. Regarding gender and health status, as hypothesized from previous studies, girls reported lower health-related quality of life than boys on the total score, physical and emotional functioning, and healthy adolescents reported significantly higher health-related quality of life than those with chronic illnesses.Conclusion: The findings support the initial reliability and validity of the Iranian version of the PedsQL™ 4.0 as a generic instrument to measure HRQOL of adolescents in Iran. [ABSTRACT FROM AUTHOR]

This study explored the relative effects of self-efficacy on oral contraceptive use among a sample of 352 Iranian married women aged 18-49 years. In structured interviews 5 variables based on the Steps to Behaviour Change model (knowledge, approval, intention, practice and advocacy) were assessed and correlated with measures of family planning self-efficacy and general self-efficacy. The results indicated that the 2 independent measures, when taken together, were more effective in predicting behavioural intentions for effective use of oral contraceptives, with family planning self-efficacy making the strongest contribution. It is suggested that self-efficacy intervention techniques will benefit oral contraceptive users in preventing unintended pregnancies. [ABSTRACT FROM AUTHOR]

A cluster random sample of 1073 students in the Islamic Republic of Iran (mean age 14.37 years) completed a self-report questionnaire consisting of an exercise measure, selected constructs of Pender's health promotion model and an assessment of stages of behaviour change in exercise. In multivariate discriminant analysis, exercise self-efficacy, perceived barriers to exercise, perceived benefits of exercise and exercise behaviour were significant predictors of the stage of exercise behaviour change for both female and male adolescents. The findings support the importance of self-efficacy for engaging in physical activity for both sexes of Iranian adolescents. The barriers faced by Iranian girls should be considered in interventions to increase physical activity rates. [ABSTRACT FROM AUTHOR]

Abstract Background Premenstrual disorders usually refer to premenstrual syndrome (PMS) and premenstrual dysphoric disorder (PMDD). This study was designed to evaluate health-related quality of life (HRQOL) in a sample of Iranian adolescents with premenstrual disorders. Methods This was a cross sectional study. A sample of adolescent schoolgirls aged between 14 and 19 years were included in the study. Premenstrual disorders were indicated according to the International Classification of Diseases (ICD-10) and the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV). Health-related quality of life was measured using the Short Form Health Survey (SF-36). The data were analyzed in a descriptive fashion and were compared among subgroups of the study sample. Results In all 602 female students were studied. All students reported at least one premenstrual symptom. Of these, 224 (37.2%) met the diagnostic criteria for premenstrual dysphoric disorder (PMDD). Comparing the SF-36 scores between female students with and without PMDD, it was found that there were significant differences between these two groups in all measures (P < 0.001) except for physical functioning (P = 0.274). These differences were more evident on role emotional, role physical, social functioning and bodily pain. Conclusion The study findings affirm the fact that adolescents with premenstrual disorders suffer from poor health-related quality of life. In order to improve quality of life in female adolescents appropriate support should be provided for this population especially for those who suffer from more severe premenstrual disorders.

Abstract Background This study carried out to develop a scale for assessing diabetic patients' perceptions about physical activity and to test its psychometric properties (The Physical Activity Questionnaire for Diabetic Patients-PAQ-DP). Methods An item pool extracted from the Theory of Planned Behavior literature was generated. Then an expert panel evaluated the items by assessing content validity index and content validity ratio. Consequently exploratory factor analysis (EFA) was performed to indicate the scale constructs. In addition reliability analyses including internal consistency and test-retest analysis were carried out. Results In all a sample of 127 women with diabetes participated in the study. Twenty-two items were initially extracted from the literature. A six-factor solution (containing 19 items) emerged as a result of an exploratory factor analysis namely: instrumental attitude, subjective norm, perceived behavioral control, affective attitude, self-identity, and intention explaining 60.30% of the variance observed. Additional analyses indicated satisfactory results for internal consistency (Cronbach's alpha ranging from 0.54 to 0.8) and intraclass correlation coefficients (ranging from 0.40 to 0.92). Conclusions The Physical Activity Questionnaire for Diabetic Patients (PAQ-DP) is the first instrument that applies the Theory of Planned Behavior in its constructs. The findings indicated that the PAQ-DP is a reliable and valid measure for assessing physical activity perceptions and now is available and can be used in future studies.

Abstract Background Since microvascular and macrovascular complications are reduced through strict glycemic control, this study carried out to identify the factors that affect glycemic control. Methods A cross-sectional design was carried out to examine the role of demographic, anthropometric, clinical and other relevant characteristics in a sample of 103 female diabetic patients in Tehran, Iran. Personal interviews were conducted to collect data. Then blood sampling collected and the patients were divided into two outcome groups (controlled and uncontrolled diabetes). The groups were compared on the basis of their characteristics using both univariate and multivariate analyses. Results In all 103 patients were entered into the study. The mean age of patients was 46.38 (SD = 11.42) years. Overall, the mean value of HbA1c for the whole sample was 7.5 (SD = 2.35) and 56.3% had HbA1c ≥ 7%. The findings obtained from univariate analysis revealed that there were no significant differences between controlled and uncontrolled patients. However, in multivariate analysis the waist circumference was found to be a significant predictor of increased level of HbA1c (OR = 1.04, 95% CI = 1-1.08, P = 0.04). Conclusions The findings suggest that increased level of HbA1c is associated with waist circumference that is a modifiable factor. It seems that physical activity might be a solution to overcome this health problem. A larger study to identify other factors also is recommended.

Abstract Background Extensive body of the literature reveals that proper use of helmets is an effective way to reduce the severity of injuries and fatalities among motorcyclists. However, many motorcyclists do not use safety helmet properly. This study aimed to empirically explore reactions of motorcyclists to the safety helmet laws, in Iran. Methods Qualitative data were collected via four focus groups and 11 in-depth interviews. Participants were 28 male motorcyclists who never used a safety helmet during rides, and 4 male police officers. All transcripts, codes and categories were read for several times to exhaust identifiable major themes. During this process data were reduced from text to codes and themes. Results Five major themes emerged from the data analyses, including themes related to the following: (1) circumventing or dodging police officers; (2) simulating a helmet wearing behavior; (3) accepting the probability of receiving a ticket; (4) taking advantage of the police neglect and carelessness; and (5) using a cheap or convenient helmet. Conclusion Our findings suggest certain levels of reckless driving among the participating motorcyclists in this study. They also point to a system of law enforcement that operates haphazardly and fails to consistently penalize those who deviate from it. Further studies are needed to investigate how "risks" are perceived and relate to "reactions", and how a 'culture of masculinity' may encourage risk tolerance and a disposition toward lawlessness and carelessness among male motorcyclists. Also, there is a need for the development and implementation of multidimensional interventions that would offer socio-culturally sensitive educational and motivational messages to the motorcyclists and the in-service traffic-enforcement officers in Iran.

Abstract Background The present study aimed at assessing the psychometric properties of psychosocial determinants of physical activity-related measures in Iranian adolescent girls. Methods Several measures of psychosocial determinants of physical activity were translated from English into Persian using the back-translation technique. These translated measures were administered to 512 ninth and tenth-grade Iranian high school students. Results The results of a series of factor analysis showed that the self-efficacy scale contained a single factor, the social support scale contained two factors: family support and friend support, the physical activity 'pros & cons' scale contained two factors: physical activity pros scale and physical activity cons scale, the change strategies scale contained a single factor, the environment scale also contained a single factor. Chronbach's alphas, mean inter-item correlations and test-retest coefficients showed that these solutions were reliable. Conclusions These preliminary results provide support for using the mentioned scales to measure psychosocial determinants of physical activity in Iranian adolescent girls.

Abstract Background Physical activity (PA) rates decline precipitously during the high school years and are consistently lower among adolescent girls than adolescent boys. Due to cultural barriers, this problem might be exacerbated in female Iranian adolescents. However, little intervention research has been conducted to try to increase PA participation rates with this population. Because PA interventions in schools have the potential to reach many children and adolescents, this study reports on PA intervention research conducted in all-female Iranian high schools. Methods A randomized controlled trial was conducted to examine the effects of two six-month tailored interventions on potential determinants of PA and PA behavior. Students (N = 161) were randomly allocated to one of three conditions: an intervention based on Pender's Health Promotion model (HP), an intervention based on an integration of the health promotion model and selected constructs from the Transtheoretical model (THP), and a control group (CON). Measures were administered prior to the intervention, at post-intervention and at a six-month follow-up. Results Repeated measure ANOVAs showed a significant interaction between group and time for perceived benefits, self efficacy, interpersonal norms, social support, behavioral processes, and PA behavior, indicating that both intervention groups significantly improved across the 24-week intervention, whereas the control group did not. Participants in the THP group showed greater use of counter conditioning and stimulus control at post-intervention and at follow-up. While there were no significant differences in PA between the HP and CON groups at follow-up, a significant difference was still found between the THP and the CON group. Conclusion This study provides the first evidence of the effectiveness of a PA intervention based on Pender's HP model combined with selected aspects of the TTM on potential determinants to increase PA among Iranian high school girls.

Abstract Background The purpose of the present study was to assess the validity and reliability of Form A of Multidimensional Health Locus of Control scales in Iran. Health locus of control is one of the most widely measured parameters of health belief for the planning of health education programs. Methods 496 university students participated in this study. The reliability coefficients were calculated in three different methods: test-retest, parallel forms and Cronbach alpha. In order to survey validity of the scale we used three methods including content validity, concurrent validity and construct validity. Results We established the content validity of the Persian translation by translating (and then back-translating) each item from the English version into the Persian version. The concurrent validity of the questionnaire, as measured by Levenson's IPC scale was .57 (P < .001), .49 (P < .01) and .53 (P < .001) for IPC, respectively. Exploratory principal components analysis supported a three-factor structure that items loading adequately on each factor. Moreover, the approximate orthogonal of the dimensions were obtained through correlation analyses. In addition, the reliability results were acceptable, too. Conclusion The results showed that the reliability and validity of Persian Form A of MHLC was acceptable and respectable and is suggested as an applicable criterion for similar studies in Iran.

Background: Environmental factors influence children's development. However, their impact on outdoor play among children from international settings remains understudied. This study examined associations between parent perceptions of environmental factors and outdoor play among an international sample of preschool-aged children., Methods: Data were sourced from the pilot phases of the SUNRISE International Study of Movement Behaviors in the Early Years. Parents completed a questionnaire about their child's outdoor play and environmental factors that influenced their child's participation in outdoor play in the past 3 days., Results: 1855 children from 19 countries (16 low- and middle-income countries) were examined. Heat (-25.6; 95% CI, -44.6 to -6.6), cold (-26.9; 95% CI, -45.9 to -8.4), and rain (-24.8; 95% CI, -43.3 to -6.6) were negatively associated with weekday outdoor play. Cold (-41.2; 95% CI, -62.4 to -20.0) and social instability (-40.7; 95% CI, -61.5 to -20.3) were negatively associated with weekend outdoor play. Playing at friend's or relative's homes (29.5 [95% CI, 18.6 to 40.5]; 37.9 [25.6 to 50.4]), greenspaces (23.1 [95% CI, 9.6 to 36.6]; 30.4 [95% CI, 15.1 to 45.8]), and on the street (41.4 [95% CI, 26.9 to 55.7]; 34.9 [95% CI, 18.2 to 51.3]) were associated with weekday and weekend day outdoor play, respectively. Playing on the family's property was also associated with weekend day outdoor play (25.5 [95% CI, 18.2 to 51.3])., Conclusions: The environmental context is important to consider when developing interventions to promote outdoor play in young children across diverse international settings. Future research from representative populations is needed to confirm these findings.

Study Objectives: To examine 1) multidimensional sleep profiles in pre-schoolers (3-6 years) across geocultural regions and 2) differences in sleep characteristics and family practices between Majority World regions (Pacific Islands, Sub-Saharan Africa, Eastern Europe, Northeast Asia, Southeast Asia, South Asia, the Middle East and North Africa, Latin America) and the Minority World (the Western world)., Methods: Participants were 3507 pre-schoolers from 37 countries. Nighttime sleep characteristics and nap duration (accelerometer: n=1950) and family practices (parental questionnaire) were measured. Mixed models were used to estimate the marginal means of sleep characteristics by region and examine the differences., Results: Geocultural region explained up to 30% of variance in sleep characteristics. A pattern of short nighttime sleep duration, low sleep efficiency, and long nap duration was observed in Eastern Europe, Northeast Asia, and Southeast Asia. The second pattern, with later sleep midpoints and greater night-to-night sleep variability, was observed in South Asia, the Middle East and North Africa, and Latin America. Compared to the Minority World, less optimal sleep characteristics were observed in several Majority World regions, with medium-to-large effect sizes (∣d∣=0.48-2.35). Several Majority World regions reported more frequent parental smartphone use during bedtime routines (Northeast Asia, Southeast Asia: 0.77-0.99 units) and were more likely to have electronic devices in children's bedroom (Eastern Europe, Latin America, South Asia: OR=5.97-16.57) and co-sleeping arrangement (Asia, Latin America: OR=7.05-49.86), compared to the Minority World., Conclusions: Pre-schoolers' sleep profiles and related family practices vary across geocultural regions, which should be considered in sleep health promotion initiatives and policies., (© The Author(s) 2024. Published by Oxford University Press on behalf of Sleep Research Society.)

Background: This study examined the proportion of Iranian children who met the World Health Organization (WHO) Guidelines for physical activity, sedentary behaviour and sleep for children under 5 years. Additionally, it investigated the feasibility and acceptability of the methods to be used in the SUNRISE study., Methods: This pilot study was conducted among 83 children aged 3 and 4 years in preschools and health care centres in Iran, in 2022. Physical activity, sedentary behaviour and sleep (ActiGraph wGT3x-BT); fine and gross motor skills (validated activities); and executive functions (the Early Years Toolbox) were assessed., Results: Only four (4.8%) children met all recommendations of the WHO guidelines. The proportion of children who met MVPA, TPA, screen time, restrained sitting and sleep were 44.6%, 38.6%, 19.3%, 38.6% and 65.1%, respectively. Fifty-two (62.6%) children wore the ActiGraph for at least three full days. A total of 97.6%, 95.1% and 91.5% of children completed anthropometric, EF and motor skill assessments, respectively., Conclusion: This pilot study was feasible and acceptable among Iranian children. Regarding the low proportion of children who met the WHO guidelines, it is recommended that long-term and practical strategies be developed to promote healthier lifestyles among preschool children in Iran., (© 2024 John Wiley & Sons Ltd.)

Introduction: Disaster relief volunteers must have certain psychological and cognitive characteristics. Therefore, the present study aimed to investigate the effectiveness of the training program on improving knowledge, functional skills, and attitude among disaster volunteers., Methods: A quasi-experimental study was conducted in 2023 in Iran, including an intervention and control group and follow-ups. Ninety health volunteers were randomly selected and divided into two groups of 45. The experimental group received the training program for an hour a week for three months. The control group received no intervention. The participants of both groups completed the disaster preparedness questionnaire at the pre-test, post-test, and one and three months after the intervention. Data was analyzed using SPSS "version 26" software in the methods section., Results: The intervention effect were significant in increasing the volunteers' functional skills ( F  = 3.75), knowledge ( F  = 166.50), and attitude ( F  = 1.74), all in ( p  = 0.001). According to the results, this effect was stable over time for functional skills ( F  = 1.83) and knowledge ( F  = 18.04) all in ( p  < 0.05)., Conclusion: Training programs can help improve skills, attitudes and knowledge in natural disaster volunteers. Researchers interested in the field of natural disaster relief, particularly health researchers, could consider further examining the aforementioned topics in their studies., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2024 Amini, Hidarnia, Ghofranipour and Motlagh.)

Background: This study aimed to examine the relationship between Self-Care, Self-Efficacy, and Health Deviation Self-Care Requisites in patients with type 2 diabetes based on Orem's Self-Care Theory., Methods: The research involved 341 patients with type 2 diabetes in Rasht, Iran, using a descriptive-analytical cross-sectional design. The data collection included questionnaires assessing Self-Care Behaviors, Self-Efficacy, and Health Deviation Self-Care Requisites based on Orem's model., Results: Demographic factors such as gender, marital status, employment, education, age, duration of disease, and oral treatment and insulin had no consistent effect on self-care behaviors. Self-efficacy was a key factor influencing Self-Care Behaviors in diabetic patients. There was a strong and direct correlation between Self-Care Behaviors and Self-Efficacy, indicating the role of individuals' confidence in managing diabetes. Health Deviation Self-Care Requisites had both positive and negative correlations with different domains of Self-Care Behaviors.The physical exercise construct of self-efficacy was the most significant predictor of Self-Care Behaviors., Conclusions: This study provides valuable insights into the complex relationship between Self-Care, Self-Efficacy, and Health Deviation Self-Care Requisites in patients with type 2 diabetes. The findings underscore the importance of addressing Self-Efficacy and specific self-care domains, such as physical activity and foot care, in diabetes management strategies. This research contributes to the existing knowledge base and may inform healthcare professionals and policymakers in developing targeted interventions to improve self-care practices in diabetic patients., (© 2024. The Author(s).)

Background: The prevalence of overweight and obesity among children has raised public health concerns. This study aimed to design and evaluate a behaviour change intervention program to promote weight management among Tehranian preschoolers., Methods: The PRECEDE-PROCEED model is one of the most popular models in health education used to develop and evaluate most educational interventions. In this one-group pre and post-pilot study, 13 mothers of preschoolers were recruited from preschools in Tehran (the capital of Iran), in August 2020. Mothers received a six-week educational intervention, including text messages and educational videos via WhatsApp, to increase their self-efficacy to overcome barriers changing their children's lifestyle. Mothers reported preschoolers' height and weight to assess Body Mass Index and filled out the Food Frequency Questionnaire, the Persian version of the children's health-related quality of life questionnaire, and demographic features. The "Children's physical activity and sedentary behaviors checklist," newly designed by the researchers, was also filled out by mothers. These behaviors were measured according to the minutes that children were involved in these activities in a day, and the days they spent in a week for them. All variables were measured at baseline, immediately after the intervention and three months later. Data analysis was performed using SPSS IBM statistics version 22. Friedman test was used to evaluate changes over time., Results: The findings demonstrated that the mean BMI z-score stayed steady between baseline, immediately after the intervention and after three months (P = 0.60). Besides, after three months, the intervention programme led to a decrease in soft drink consumption (P = 0.001), and an increase in parental perception of their child's general health (P = 0.05), the parental concern regarding their child's emotional and physical health (P = 0.002) and minutes of physical activity per day (P = 0.02). However, fruit intake decreased (P = 0.01), and simple sugar, such as cube, increased (P = 0.03)., Conclusion: Results from this study are promising but should be interpreted with caution and should be replicated on a larger scale and compared with a control group to evaluate whether effects are maintained in a larger sample., (© 2022. The Author(s).)

The current study aimed to understand the perceptions and experiences of Iranian parents and principals of preschool children on weight management based on the PRECEDE-PROCEED Model (PPM), a comprehensive structure for assessing health needs for designing, implementing, and evaluating health promotion, and other public health programs. PRECEDE provides a structure for planning a targeted and focused public health program, and PROCEED provides a structure for implementing and evaluating the program. Data were gathered from 17 preschoolers' parents and two principals using semi-structured interviews in the preschool setting in Tehran, the capital of Iran, in 2019. Data were analyzed manually through directed content analysis based on constructs in phases two and three of the PPM, simultaneously with data collection. This study identified genetic, behavioral (e.g., food preferences, physical activity, sedentary behaviors, the effect of parents', peers', principals' and teachers' behavior and also influence of grandparents' and neighbors' behaviors) and environmental (e.g., home, grandparents' home and preschool) factors from the epidemiological construct. Also, predisposing (e.g., child's attitude, parent's and principals' attitude, as well as parents' knowledge and parents' and principals' beliefs), enabling (e.g., parental skills and skills of the principals and teachers, rules and laws in the preschools, and availability), and reinforcing (e.g., family support and influences, teachers' encouragement and influences, and peers' influences) factors were identified from the educational and ecological construct. Additionally, "quality of child-parent relationship" was determined as a new factor affecting preschoolers' weight management promotion; however, it was not in the PPM. In the study, parents' and principals' experiences regarding preschoolers' weight management promotion confirmed the genetic, behavioral, environmental, predisposing, enabling and reinforcing factors of the PPM. "Quality of child-parent relationship" factor may be related to the culture and family relationship type of Iranian people, which is suggested to be investigated in future studies., Competing Interests: The authors have declared that no competing interests exist.

Background: This article reports the steps of an educational intervention, which is designed to change livestock breeders' preventive behavior in terms of vaccinating their livestock against brucellosis. The study has been conducted in a rural area in a country with the second highest brucellosis prevalence in the world., Methods: In a quasi-experimental study and applying PRECEDE-PROCEED model, 45 livestock breeders were trained through basket method, accompanied with constructive feedback from researchers and peers and a brief interactive lecture at the end. The livestock breeders' awareness, attitude and practice level in the intervention group was compared with those of other 45 livestock breeders in a control group, 1 and 6 months after the intervention. According to the results of the Rose Bengal tests (RBTs), as a rapid and simple screening test, the presence or absence of Brucella antibodies in the animals' serum was investigated., Results: Immediately and 1 month after the intervention, the mean scores of knowledge, awareness and practice of livestock breeders in the intervention group were significantly higher. Six months after the intervention, the results of the RBTs were positive in more livestock in the intervention group compared to the animals in the control group. The positive result of RBT after educational intervention, in livestock whose test results were negative immediately before intervention, accompanying the results of observation indicating a good general condition of livestock was considered as a probable evidence of the success of the educational intervention., Conclusion: The model-driven educational intervention could significantly increase livestock breeders' awareness, attitude and practice regarding prevention of brucellosis and vaccination of their livestock against brucellosis; however, a period of non-continuous reinforcement and gradual reduction of the number of the reinforcements by health educator workers is recommended in order to increase the maintenance of the learnt behavior., Trial Registration: Conducting this study was registered at Iranian Registry of Clinical Trials ( IRCT20180304038945N1 ). Registered 24 December 2018. The proposal was registered before enrollment of the first participant., (© 2021. The Author(s).)