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Background: Empowering adolescents to manage and reduce unhealthy behaviors and promote adaptive behaviors is a promising approach to promoting healthy behaviors. This review was an attempt to evaluate adolescent empowerment programs aimed at preventing and managing risky behaviors. Materials and Methods: This narrative review was conducted in 2023. The texts were reviewed in two sections: (1) a review of articles and books in databases and (2) a review of international websites. The keywords used to search for studies and programs included substance-related disorders, risky behaviors, empowerment, program, adolescent, suicide, and risky sexual behaviors. These keywords were individually searched in international databases such as “PubMed, Scopus, and Web of Science.” In the second section, a search was conducted on the websites of international organizations such as the World Health Organization (WHO). The inclusion criteria included having the full text of the original articles, articles in English, articles related to the development and evaluation of the effectiveness of empowerment programs, and the age range of adolescents. The texts that only had abstracts and were in non-English languages were excluded. Results: The programs designed to empower adolescents were in three areas: (1) community-based and peer-based programs, (2) family-based programs, and (3) comprehensive programs. Most programs focused on peer group participation and skill interventions. Conclusions: A powerful and effective empowering program for adolescents to prevent and control risky behaviors should be designed in the form of comprehensive programs in social, educational, economic, and health dimensions, and with the active engagement and participation of adolescents.

Abstract Background Rape, as an adverse incidence, leads to irreparable complications and consequences in women. Provision of health services to women survivors of rape requires catering for their real needs and identifying current deficits as well as barriers. The present study aimed to explore health system-related needs in women survivors of rape. Methods In the present qualitative study, the participants consisted of 39 individuals, including 19 women survivors of rape and 20 individuals with work experience in providing services to women survivors of rape. The participants were selected using the purposive sampling method with a maximum variation in Isfahan, Iran. Data were collected through in-depth interviews as well as field notes and were concurrently analyzed via conventional qualitative content analysis method. Results After analyzing the interviews, the health system-related needs of women survivors of rape were classified into two main categories: 1- The need for efficient medical care services with three sub-categories, namely “receiving services with respect for privacy and confidentiality”, “non-judgmental behavior and approach”, and “the need to receive empathy and the feeling of not being alone”, and 2- The need for desirable conditions and structure to provide services with two sub-categories, namely “the need to receive comprehensive and integrated services”, and “establishing specialized centers for providing services to survivors”. Conclusions Overall, explaining and highlighting the health system-related needs of women survivors of rape could provide a suitable basis for policy-making and planning according to their real needs. Receiving continuous services in separate centers with confidentiality and empathy could reduce the worries and concerns of women survivors of rape and help improve their health.

Abstract Introduction Screening is an effective method for preventing cervical cancer. The present study aimed to determine the predictability of cervical cancer screening using the information-motivation-behavioral skills (IMB) model, as this model can help understand the factors that influence health-related behaviors. Method The present cross-sectional study examined 310 women aged 20 to 60 in Isfahan, Iran, between 2020 and 2021. To this end, comprehensive health centers and gynecology clinics of hospitals were randomly selected by lot. Women who met the study’s inclusion criteria were selected via convenience sampling. An IMB skills questionnaire developed by researchers comprised the data collection tool. The data were analyzed using SPSS 22 software, descriptive and regression tests, and AMOS 24.0 software. Findings Approximately 18.1% of the participants had never undergone routine cervical cancer screening. The regression model results indicated that the model components accurately predicted regular cervical cancer screening (P

Abstract Background Endometriosis is a chronic disease affecting 6–10% of women worldwide. Sexual dysfunction has been reported in a significant percentage of these patients. Thus, the present study will be conducted to design, implement, and determine the effectiveness of an interventional program to improve the sexual function of women with endometriosis. Materials and methods This mixed-methods study will be carried out in three phases with a sequential exploratory approach. In the first phase (qualitative study) participants will be selected by purposive sampling in Isfahan, Iran. The data will be collected through in-depth interviews and field notes and analyzed using conventional content analysis. The interventional program will be designed in the second phase based on the results of the qualitative study and literature review and using the Delphi method and panel of experts. The interventional program will be implemented at the individual level in the third phase to investigate its effect on improving women’s sexual function. This phase includes quasi-experimental research, in which the pre- and post-intervention data will be collected from the intervention and control groups using the FSFI questionnaire and analyzed by descriptive and inferential statistical methods. Ultimately, a suitable interventional program will be presented by combining the data obtained in the qualitative and quantitative phases of the research. Conclusion Conducting the present study, along with the design and implementation of an appropriate, native, and culturally sensitive interventional program, can contribute to improving the sexual function of women with endometriosis and enhancing the quality of sexual relations between couples.

Abstract Background Having competence in initiating sexual interactions is one of the challenges of sexual health in any society. Given that the social, cultural, and religious background of some societies can prevent the acquisition of sexual competence in young women, this study will be done to design, implement, and determine the effectiveness of an intervention program to improve the sexual competence of young women on the eve of marriage. Methods The current research is a mixed-method study in a qualitative-quantitative sequence. In the first phase, a qualitative study will be conducted to explore the needs of sexual competence in young adult women about to get married and ways to improve it. Then, after the literature review and combining it with the results of the qualitative study, a draft of the intervention program will be developed. After reviewing the content of the program and validating it in the panel of experts, the final program will be developed. In the second phase, the effect of the program to promote the sexual competence of adult women about to get married will be determined in a quantitative study with a two-group quasi-experimental method. Discussion Providing a comprehensive and practical intervention program to promote sexual competence based on cultural, social, and religious background can help to improve the quality of sexual interactions of young women about to get married, reduce harm caused by lack of sexual competence, and ensure women’s sexual health.

Background & aim: As one of the most influential factors of marital life, sexual satisfaction can significantly lead to peace and compatibility of couples. The present study investigated the effect of Guided Imagery and Music (GIM) on the level of sexual satisfaction in women of reproductive age.Methods: In this parallel cluster-randomized trial which was conducted from Feb. 2019 to Apr. 2020, 72 women of reproductive age (two groups of 36 subjects) who had moderate or undesirable sexual satisfaction were sampled. The guided imagery music was presented for the intervention group for 6 weeks as twice a week. No intervention was performed for the control group. The data collection tool included fertility characteristics and Larson questionnaires, which was completed before, immediately and one month after the intervention. Data were analyzed by SPSS software (version 20) using independent t-test, chi-square, Mann-Whitney and variance analysis with repeated measurements.Results: There was no statistically significant difference between the two groups in the sexual satisfaction score before the intervention. The mean sexual satisfaction score in the intervention group had a statistically significant difference between the baseline (91.1±9.1), immediately after intervention (112±4.46) and one month later (102±9.24) (P< 0.001). However, there was no significant difference between the changes in the sexual satisfaction of women in the control group between three times.Conclusion: GIM technique improves women's sexual satisfaction. It is recommended to health care providers to use this behavioral technique to enhance the level of sexual satisfaction in women of reproductive age.

Abstract Background Rape is one of the principal forms of sexual violence leading to numerous psychological consequences for women. Providing effective psychological services to women survivors of rape requires identifying and considering their real needs. This study aimed to explore the psychological needs of women survivors of rape. Methods In this exploratory-descriptive qualitative study, the participants consisted of 19 women survivors of rape and 20 people with experience in providing services to survivors of rape, selected via purposive sampling method in Isfahan, Iran. In-depth individual semi-structured interviews and field notes were used to collect data, which were then analyzed using the conventional content analysis method. Results Based on the analysis of the interviews, the psychological needs of women survivors of rape were classified into three main categories: facing psychological problems, attention to emotional reactions, and the need to accept and adapt to reality. Conclusions The results revealed that women survivors of rape have different psychological needs. Thus, to meet these needs, supportive and psychological interventions can be considered at both individual and environmental levels. Also, eliminating gender stereotypes affecting the occurrence of rape in the dimensions of Iranian culture can lead to the liberation of the society from the culture of rape.

BACKGROUND: Cervical cancer screening is an effective and accessible method for preventing this cancer. However, low participation rates among women have been reported. Self-care is one of the solutions to improve access to health services. This study was conducted to determine the prediction of cervical cancer screening participation using self-care behaviors among women in Iran. MATERIALS AND METHODS: This cross-sectional study was conducted on 310 eligible women who were referred to comprehensive health centers and women’s clinics in teaching hospitals in Isfahan, Iran, from November 2020 to April 2021. Participants were enrolled using convenience sampling. The data collection tool included researcher-made questionnaires on personal and fertility characteristics, participation in cervical cancer screening, and self-care behaviors related to cervical cancer and its screening. Descriptive and inferential statistical methods were used for data analysis using the Statistical Package for the Social Sciences (SPSS) version 22 software. RESULTS: The results showed that the intention to undergo screening was low among individuals who had not undergone screening. Lack of awareness and not having enough time were the most common barriers to screening. The results of logistic regression analysis indicated that self-efficacy was the significant predictor of cervical cancer screening. With an increase in the self-care score, the 12% chance of doing a Pap smear increases significantly (P = 0.002). Furthermore, the results of multiple regression showed that with an increase in the self-care score, the chance of women who refer to screening every year, every 2–3 years, and every 4–5 years is increased to 25% (P = 0.001), 34% (P < 0.001), and 11% (P = 0.032), respectively, compared with non-referral. DISCUSSION: According to the results, self-care was a predictor of performing a Pap smear, and it was related to its regular performance of Pap smear too. Therefore, designing and implementing necessary interventions to increase self-care behaviors can improve women’s participation in cervical cancer screening and its regularity.

Abstract Legal abortion has adopted many beneficial measures to prevent the birth of fetuses with congenital anomalies and maintain the health of high-risk mothers. However, abortion has its own complications and, thus, most mothers need care in this regard. The aim of this study was to determine the effect of self-management model on behaviors related to the reproductive health of mothers after legal abortion. This clinical trial study was conducted on 72 women who had legal abortion with the permission from Isfahan forensic medicine. The intervention was conducted using the 5A self-management model. The control group received the usual health system cares. Data collection tool was a researcher-made questionnaire of behaviors related to reproductive health, which was completed before and two months after the intervention by the two groups. The total mean score of the behavior (P

BACKGROUND: Menopause is a natural event in women’s life that leads to physical, psychological, and social consequences. A fundamental health concern in postmenopausal women is problems with their sexual function. This study aims to design an interventional program to promote sexual function in postmenopausal women. MATERIALS AND METHODS: This sequential exploratory mixed methods study will be conducted in three phases. The first phase will be a qualitative study with a content analysis approach. The participants will be selected using a purposive sampling in Isfahan, Iran. The data will be collected through in-depth interviews and field notes and analyzed using conventional content analysis. In the second phase, the intervention will be designed and finalized to promote sexual function in postmenopausal women using the results of qualitative study and literature review, asking experts’ opinions, and holding specialized panels. In the third phase, the intervention will be implemented (in the form of a quasi-experimental study) and the effect of the intervention will be determined. In this phase, the data will be collected using the female sexual function index. Finally, an appropriate interventional program will be presented. CONCLUSION: It is hoped to promote sexual function in postmenopausal women by conducting this study and implementing an appropriate interventional program that is culturally sensitive. If it is proved that the intervention is effective, a basis for health policy–making to promote sexual health in postmenopausal women can be provided by presenting evidence and increasing the knowledge in this field of health.

Background: Rape is a serious global problem linked to long-term physical health complications in women. Women survivors of rape have different needs, the identification of which ensures optimal services and improves their health conditions. This study aimed to explore the needs of women survivors of rape through a narrative review. Materials and Methods: This review was conducted by searching databases of ISI Web of Science, Scopus, Science Direct, Cochrane, PubMed, Scientific Information Database (SID), the Iranian Magazine Database (Magiran), Iranian Research Institute for Information Science and Technology (IranDoc), Iranian Medical Articles Database (IranMedex), and the Google Scholar engine.All English and Persian articles published from January 2000 to August 2022 were searched using the keywords rape, sexual assault, sexual violence, victim, survivor, demands, and needs. Two independent researchers conducted all steps of article extraction and review to avoid possible bias, and a third person reviewed the articles in the case of disagreement between the two researchers. The final related articles were selected and evaluated using a pre-prepared checklist. Results: Out of 112 articles, 26 articles were selected for final evaluation. The needs of women survivors of rape were divided into six categories, including sociocultural, educational, legal and judicial, psychological, spiritual and religious, and healthcare. Conclusions: Women survivors of rape need survivor-centered, culturally appropriate services, necessitating careful planning and policymaking to address health and judicial issues from different dimensions considering their real-world needs.

Background: Delay in parenthood and the related consequences for health, population, society, and economy are significant global challenges. This study was conducted to determine the factors affecting delay in childbearing. Materials and Methods: This narrative review was conducted in February 2022 using databases: PubMed, Scopus, ProQuest, Web of Science, Science Direct, Cochrane, Scientific Information Database, Iranian Medical Articles Database, Iranian Research Institute for Information Science and Technology, Iranian Magazine Database, and Google Scholar search engine. The search terms used included “delayed childbearing,” “delayed parenthood,” “delayed fertility,” “delay of motherhood,” “parenthood postponement,” “deferred pregnancy,” “reproductive behavior,” and “fertility.” Results: Seventeen articles were selected for final evaluation. The factors were studied at micro and macro levels. The factors in micro level fell into two classes: personal and interpersonal. Personal factors included extension of women's education, participation in the labor market, personality traits, attitude and personal preferences, fertility knowledge, and physical and psychological preparation. The interpersonal factors included stable relations with spouse and other important people. The macro level included supportive policies, medical achievements, and sociocultural and economic factors. Conclusions: Policy-making and enforcement of interventions, such as improvement of the economic conditions, increased social trust, providing adequate social welfare protection, employment, and support of families using such strategies as creating family-friendly laws, taking into consideration the conditions of the country will reduce the insecurity perceived by the spouses and contribute to a better childbearing plan. Also, improving self-efficacy, increasing couples' reproductive knowledge and modifying their attitude can be helpful to better decision-making in childbearing.

BACKGROUND: Cervical cancer is one of the most common cancers in women. It is considered preventable due to the possibility of screening. The common barriers to cervical cancer screening include lack of knowledge, lack of time, and wrong beliefs. The use of e-Health technologies is one of the approaches for health promotion. The present study is aimed to the development of a mobile application for cervical cancer screening in women. MATERIALS AND METHOD: This is a multi-phase study. In the first step, a literature review will be conducted to examine factors related to cervical cancer screening and existing applications related to cervical cancer and its screening. Then, in the second step, a cross-sectional study will be conducted to investigate the factors related to cervical cancer screening in 246 women referred to comprehensive health centers and women’s clinics in teaching hospitals in Isfahan, Iran. The comprehensive health centers and women’s clinics in teaching hospitals will be randomly selected using a lottery method. Using convenience sampling, women who meet the inclusion criteria will be included in the study, provided they provide informed consent. The data will be collected using a questionnaire, and then the descriptive and inferential statistical tests and SPSS18 software will be used to analyze the data. In the third step, specialists (gynecologists, reproductive health specialists, and midwives) will prioritize the application content by filling out a questionnaire. Then, the research team will compile the application content draft, and this draft will be reviewed and approved by experts on the expert panel. The prototype of the application will be prepared, and experts will evaluate it in the fifth step. DISCUSSION: The results of this study will result in the development of applications for cervical cancer screening. The use of mobile applications can be useful in lifting some of the barriers to screening. Therefore, developing such applications may help improve cervical cancer screening.

Abstract Background Polycystic ovary syndrome (PCOS) is the most common endocrine disorder among women. Given the prevalence of this disease in adolescent girls as well as its serious physical, psychological, and social consequences, the present study aimed to explore the health system-related needs for healthy nutritional behaviors in adolescent girls with PCOS. Methods This qualitative content analysis was conducted in Shiraz, Iran between November 2016 and October 2017. Eighteen Adolescent girls with PCOS and 15 healthcare providers (midwives, gynecologists, nutritionists, and endocrinologists) were selected through purposeful sampling with maximum variation strategy. Data were collected through individual in-depth and semi-structured interviews, focus group discussions, and field note, and simultaneously analyzed using the conventional qualitative content analysis method. Results Three main categories that appeared included: 1) education and counseling on healthy nutrition and support for adolescent girls with PCOS with sub-categories of “empowering adolescent girls with PCOS to adopt healthy nutritional behaviors”, “providing services and education about healthy nutritional behaviors as a team”, and “the health team attention to the concerns of adolescent girls with PCOS and closely following the disease status, 2) solving communication problems with sub-categories of “proper interactions and building trust between health team members and adolescent girls” and “proper interactions between members of the health team”, and 3) developing the optimal structure for providing health services with sub-categories of “solving problems related to human resources, “promoting the position of health issues related to adolescent girls in the health system”, and “promoting policy-making in the field of nutritional health of adolescent girls”. Conclusions Based on the results of the present study, necessary measures should be taken to educate and advise on healthy nutrition, and to support adolescent girls with PCOS. The desired structure should also be developed to provide health services to these girls. By solving communication problems and building trust between the members of the health team and these girls, one can guide them to adopt healthy nutritional behaviors.

Introduction: Polycystic ovary syndrome is the most common endocrine disorder in women of childbearing age. Prevalence of this syndrome in adolescent girls has increased in recent years and unhealthy nutritional behaviors play an important role in the progression and complications of this syndrome. The present study was conducted aimed to explore individual components of nutritional behaviors in adolescent girls with this syndrome. Methods: This qualitative study was conducted with a content analysis approach in 2016-2017. Thirty-nine participants were selected through purposeful sampling method in gynecological clinics as well as offices of gynecologists and midwives in Shiraz. Data were gathered using individual in-depth interviews, focus group discussions and field notes. Data were analyzed using conventional qualitative content analysis. Results: In this study, 22 sub-categories and 8 main categories were obtained including: “having self-efficacy”, “impact of changes resulting from puberty and adolescence”, “prioritize academic success and promotion”, “experiences related to diet”, “awareness and attitude about the disease and related nutritional behaviors”, “have the knowledge to adopt healthy nutritional behaviors”, “emotional cravings for food”, and “amount of time available”. Conclusion: Different individual components affect the nutritional behaviors of adolescent girls with polycystic ovary syndrome. By identifying these components, policy makers and planners in the field of adolescent health can design various interventions in order to adopt healthy nutritional behaviors in these girls.

Abstract Introduction Breast cancer is one of the most prevalent cancers among women in Isfahan, Iran; however, its prevention is not desirable in this city. This disease poses several health, social and economic challenges for women. To promote women's self-care in breast cancer prevention, this study aims to design, implement and evaluate a self-care program among women in Isfahan through using a community-based participatory action research method. Methods The present study is based on a community-based participatory action research approach. In this study, the participatory action research includes four general phases of organizing, action planning, action, and rethinking. These phases are summarized as follows: In the organizing phase, the needs of the participants and the action research settings are examined. This means that the current situation is identified and the views of the process owners are assessed. In the action planning phase, using the results of the first phase, some strategies are designed to promote self-care behaviors in the prevention of breast cancer among women in Isfahan. In the implementation phase, the selected strategies are implemented with the help of the process owners. Finally, in the rethinking phase, the results of the implementation of the strategies are monitored and evaluated. This cycle continues until the intended results are achieved. Discussion Changing the role of individuals from a passive status to an aware and active status in the care process requires motivation, responsibility, and active participation of individuals in the disease control process. Moreover, many cultural and social factors affect the active participation of Iranian women. Therefore, individuals can be involved in promoting their health using a community-based participatory action research approach.

Abstract Background The transition to motherhood is associated with stress because of extensive and rapid changes to which women need to be able to adjust. To help women adjust to postpartum changes, their needs during this period must be identified. Therefore, the present qualitative study explored the needs of women for adjusting to postpartum changes. Methods In this study, 29 participants were selected through purposive sampling with maximum variation in Isfahan, Iran. Data was collected through in-depth individual interviews, daily notes, and field notes, and analyzed using conventional qualitative content analysis. Results Data analysis led to the emergence of 5 main categories: “the need to receive social support,” “the need to receive a sense of worth from the husband,” “the need to compensate and improve the situation,” “the need to create socio-cultural changes,” and “the need for training.” Conclusions According to the results of the study, in order to adjust to the changes in the postpartum period, and in addition to their efforts to compensate and improve the situation, women need to be supported by their husbands, family members and acquaintances, healthcare team, and society in various dimensions. Moreover, they should receive the information they need to turn the challenges of this period into an opportunity for growth.

Introduction: Hormonal changes during pregnancy affect the sleep-wake cycle and sleep structure and lead to sleep disorders. Ruminants and anxiety are two negative thoughts that can affect the quantity and quality of sleep and cause sleep disorders. Therefore, this study was conducted with aim to determine the relationship between disturbing thoughts (rumination, worry) and sleep quality of pregnant mothers.Methods: This cross-sectional descriptive study was performed in 2019 on 190 pregnant mothers referring to the health centers in Isfahan. Data collection tools were the questionnaires of ruminant, anxiety and sleep quality. Data were analyzed by SPSS software (version 22) and Spearman and regression tests. P

Background: Drug use is known as an important underlying factor in the occurrence of risky sexual behaviors. The present study was conducted to identify the factors associated with the involvement of women drug users in risky sexual behaviors. Materials and Methods: This review was conducted by searching databases of ISI Web of Science, Scopus, Science Direct, Cochrane, PubMed, Scientific Information Database (SID), the Iranian Magazine Database (Magiran), the Iranian Research Institute for Information Science and Technology (IranDoc), and the Iranian Medical Articles Database (IranMedex) and searching through the Google Scholar engine. All the articles published in English and Persian using the keywords including substance use, drug users, addiction, substance use disorders, substance-related disorders, sexual risks, high-risk sexual behavior, HIV risk behavior, unsafe sex, unprotected sex, and risky sex were searched from January 2000 to December 2020. After reviewing the articles, out of 110 articles, 21 articles were selected for final evaluation. Results: Factors related to the involvement of women drug users in risky sexual behaviors were divided into five categories: individual factors, factors related to drug use, inter-personal relationships, gender discrimination, and socio-economic factors. Conclusions: The results can be used in the field of women's social harms in finding strategies and designing the necessary interventions to prevent risky sexual behaviors in women drug users in different societies and cultural contexts. Also, the results can be used by all researchers who want to study the relationship between these factors and the involvement of women drug users in risky sexual behaviors.

Background: Health information-seeking behavior is directed by various factors. Understanding the motivations of pregnant women to obtain health information can facilitate evidence-based policy-making to enhance their health literacy. Therefore, this study was conducted to explore the motivations of pregnant women to seek health information. Materials and Methods: In this qualitative study with a content analysis approach, 39 participants, including pregnant women, midwives, and gynecologists in Isfahan city, Iran, were selected via purposive sampling with maximum variation strategy. Individual interviews, field notes, and daily notes were used to collect data, which was then analyzed using conventional qualitative content analysis. Results: Analysis of data resulted in one main category of “strive to protect the health of mother and fetus.” This main category consisted of four subcategories, including “increasing information related to maternal and fetal health,” “preventing recurring problems or causing complications in pregnancy,” “reducing worry about pregnancy problem,” and “receiving encouragement from the spouse, relatives, and healthcare providers.” Conclusions: According to the findings, pregnant women seek health information for a variety of reasons, including learning more about their own health and that of their fetus, preventing recurring problems or complications, alleviating concerns about pregnancy problems, and receiving encouragement from husbands, relatives, and healthcare providers. Thus, health professionals, midwives, and antenatal care providers should be aware of these issues and provide more evidence-based information to pregnant women at the time they require it.

Abstract Background Polycystic ovary syndrome is the most common endocrine disorder among adolescents and adults. Given the importance of healthy nutritional behaviors in management of this disease, the present study was conducted to determine the impact of an educational intervention program based on the theory of planned behavior on the nutritional behaviors of adolescents and young adults with polycystic ovary syndrome. Methods In this field trial study, 72 participants aged between 15 and 21 years old from four gynecology clinics in Shiraz, Iran, were assigned into the intervention and control groups. Educational intervention program was implemented based on the theory of planned behavior over 4 sessions during two weeks. The data collection tools were researcher-made questionnaires of demographic information, knowledge assessment, and assessment of theory of planned behavior constructs, as well as a questionnaire for assessing consumption of food groups, fast food, and snacks. The data were collected at two stages (once at baseline and once three months after the intervention), and then the changes in knowledge, attitude, subjective norms, the perceived behavioral control, behavioral intention, and nutritional behavior were analyzed using descriptive and inferential statistical methods (t-test, Chi-square, Mann- Whitney U, and Wilcoxon tests; as well as one- way ANOVA, repeated measures ANOVA, and ANCOVA, respectively). Results Statistically significant increases were observed in the mean scores of knowledge, attitude, subjective norms, the perceived behavioral control, behavioral intention, and nutritional behavior in the intervention group by passing three months from the intervention compared to the scores before the intervention (P 0.05). Moreover, the mean scores of knowledge, attitude, subjective norms, perceived behavioral control, behavioral intention, and nutritional behavior had no statistically significant difference before the intervention between the two groups; however, this was statistically significant by passing three months from the intervention (P

Abstract Background Sexual problems of intellectually disabled adolescents are associated with their inability to understand sexuality. Given the important role of parents in forming the attitude of their adolescents towards sexuality, the present study aimed to compare the effect of two educational interventions on mothers’ awareness, attitude and self-efficacy regarding sexual health care of intellectually disabled adolescent girls. Materials and methods This cluster randomized control trial was conducted in six intellectually disabled adolescent education centers in Isfahan, Iran in 2018. The centers were randomly assigned to intervention groups (group training and training through booklet) and control group. Mothers of educable intellectually disabled adolescent girls (n = 81) were entered into the three groups using convenience sampling and their awareness, attitude and self-efficacy regarding sexual health care of adolescent girls were assessed using questionnaires before and after the educational intervention. Data were analyzed using descriptive and inferential statistical methods. Results The mean score of mothers’ awareness, attitude and self-efficacy in each of the “group training”, “training through booklet group” and “control group” was significantly different after the intervention compared to before the intervention (p 0.05). Conclusion Implementation of the group training intervention for mothers of intellectually disabled adolescent girls in comparison with training through booklet was associated with a greater increase in their awareness, attitude and self-efficacy regarding sexual health care of adolescent girls. Therefore, group training is suggested as a suitable way to educate mothers about sexual health care of intellectually disabled adolescent girls. Trial registration IRCT, IRCT20160224026756N5. Registered 22 June 2018, https://en.irct.ir/user/trial/31704/view .

Abstract Background Numerous changes occur in different aspects of women’s lives in the postpartum period. Women’s adjusting with problems and taking advantage of this opportunity can develop their personality. In this regard, accurate knowledge of their experiences and feelings is necessary to help them to benefit from this period. Therefore, the present study aimed to explore the experiences related to postpartum changes in women. Methods In the present qualitative study, 23 participants, including women of childbearing age who gave birth and healthcare providers (midwives and obstetricians) in Isfahan, Iran were selected using purposive sampling with a maximum variation strategy. Data were collected through in-depth semi structured interviews, field notes, and daily notes, and simultaneously analyzed using the conventional qualitative content analysis. Results The data analysis results led to the extraction of three main categories including “feeling of decreased female attractiveness” (with two sub-categories of “ feeling of decreased beauty” and “feeling of decreased sexual function”), “feeling of insolvency and helplessness” (with two sub-categories of “physical burnout”, and “mental preoccupations”) and “beginning a new period in life” (with three sub-categories of “changing the meaning of life”, “feeling of maturity” and “deepening the communication”). Conclusions Findings of this study can provide a good context for designing interventions to improve the women’s quality of life by explaining and highlighting their experiences in the postpartum period. In this regard, providing sufficient empathy, social and psychological support from family members (especially husband), performing appropriate educational interventions and also regular assessment of women’s psychological state by healthcare providers in postpartum period can reduce their concerns and help to improve their health.

Background: Diagnosing congenital fetal anomalies before birth is considered an emotionally devastating experience. To facilitate the process of compatibility with this event, healthcare providers should determine various needs of these women. The present study was conducted to explore the informational and educational needs of women who have experienced pregnancy termination because of fetal anomalies. Materials and Methods: The present study was a qualitative content analysis. Forty participants (women, their spouses, and healthcare providers) in Rasht city, Iran, were selected using purposive sampling method with maximum variety and their data were gathered using in-depth interviews and field notes. Data were analyzed using conventional qualitative content analysis with Graneheim and Lundman approach. Results: After analyzing the text of the interviews, the informational and educational needs of women who have experienced pregnancy termination because of fetal anomalies were categorized in three main categories of “receiving information tailored to the client's circumstances,” “learning life skills to cope,” and “getting prepared for the next pregnancy.” Conclusions: The results, by exploring and magnifying the informational and educational needs of these women, could present an appropriate context for providing principal care and cultural-based interventions with an emphasis on comprehensive education and counseling. Also, proper implementation of the process of obtaining informed consent from the women to terminate the pregnancy is essential. These could facilitate the conditions for their return to normal life and ultimately promote their health.

Abstract Background Men’s participation in perinatal care is one of the key factors in promoting maternal and neonatal health. The effects of various methods of training on men’s knowledge and attitude about participation in perinatal care can be different. So, this study aimed to compare the effect of two methods of training on men’s knowledge and attitude about participation in perinatal care. Methods This cluster randomized control trial was conducted in three midwifery clinics in Tabriz, Iran between May and August 2018. Each clinic was randomly assigned to intervention (group- based training along with text messaging and CD- based training) and control groups. Seventy-five men were enrolled in three groups and evaluated for their knowledge and attitude about participation in perinatal care. Before and 3 months after the intervention, a researcher-made questionnaire was completed by the participants. Data were analyzed using descriptive and inferential statistics (paired t-test, one-way ANOVA, ANCOVA, chi-square, Kruskal-Wallis and Fisher exact tests). Results The mean (SD) score of men, s knowledge and attitude about participation in perinatal care had a significant increase in group- based training along with text messaging after the intervention compared to the score of before the intervention (p

Abstract Background In order to provide appropriate and adequate care to women who have experienced termination of pregnancy due to fetal anomalies, the health needs of this group should be assessed. Considering the lack of information about the care and services required by these women in Iran, this study was conducted with the aim of exploring the needs related to the health system in women with experience of pregnancy termination due to fetal anomalies. Methods This study was conducted with a qualitative approach. 40 participants were selected through purposive sampling, and the data were collected through in-depth semi structured interviews and field notes, and analyzed using conventional qualitative content analysis. Results After analyzing the texts, the needs related to the health system in women with experience of pregnancy termination due to fetal anomalies were categorized in the three main categories: “efficient treatment team”, “optimal organizational structure in providing services” and “financial support for families”. Conclusions The findings of the present study by exploring and highlighting the needs related to the health system in different dimensions in women with experience of pregnancy termination due to fetal anomalies can be helpful for designing and providing basic and comprehensive care programs.

Abstract Background Pregnancy termination due to fetal anomalies has many psychological consequences for women. Providing appropriate and desirable care to this group of women and their families plays an important role in the process of coping with this crisis. The aim of the present study was to explore the psychological experiences of women with pregnancy termination due to fetal anomalies. Methods This was a qualitative content analysis study. 40 participants were selected through purposeful sampling with maximum variation and data were collected through in-depth individual interviews, field notes, and analyzed using the conventional qualitative content analysis method simultaneously. Results After analyzing the interview transcripts, the psychological experiences of women with pregnancy termination due to fetal anomalies were classified into two main categories: “emotional reactions coinciding with the diagnosis of fetal anomalies” (consisting of two sub-categories of “disbelief and denial of fetal anomalies” and “feelings of sadness and anger”) and “ psychological problems following pregnancy termination” (consisting of two sub-categories of “ feeling helpless, fearful, anxious, and depressed” and “feeling conscience-stricken, and guilty”). Conclusion According to findings of the present study, exploring and highlighting the experiences of women with pregnancy termination due to fetal anomalies in the psychological dimension can provide a deeper understanding of the needs of these women for providing optimal care at different times and ultimately promote their psychological health.

Abstract Background Polycystic ovary syndrome (PCOS) is a hormonal disorder in women of reproductive age. It seems that over the recent years, PCOS has augmented in adolescent girls due to unhealthy food habits and obesity. So, the present study was conducted to explore the food habits in overweight and obese adolescent girls with PCOS. Methods In the present qualitative study, 33 participants were selected using a purposive sampling method. Data were collected through individual in-depth interviews, focus group discussions (FGDs), and field notes. These data were analyzed through the use of conventional qualitative content analysis. Results Three main categories were extracted: First, the high consumption of unhealthy food had three sub-categories: “high consumption of fatty and salty foods”, “high consumption of unhealthy snacks”, and “high consumption of sugar-rich foods”. Second, low consumption of healthy food had three sub-categories: “low consumption of dairy products”, “low consumption of fiber-rich foods”, and “low consumption of meat, beans, fish and seafood” Third, inappropriate behavioral habits had three sub-categories: “lack of concentration and consumption of large meals”, “inappropriate dietary and physical activity patterns”, and “skipping the meals and going on arbitrary diets”. Conclusion This research through presenting an image of food habits in overweight and obese adolescent girls with PCOS is able to help for designing the necessary interventions to change the food habits, control the symptoms and complications of PCOS, and finally, improve the reproductive health of these girls.

Abstract Background Drug use is an important underlying factor in risky sexual behaviors. Risky sexual behaviors can lead to STIs and HIV/AIDS, especially in women. For better understanding of the relationship between drug use and risky sexual behaviors in women, it is necessary to identify the process of the formation of these behaviors that is a multidimensional process influenced by multiple socio-cultural factors. Therefore, the present study aims to explore the process of risky sexual behaviors formation in women drug users. Methods This is a grounded theory qualitative study with Corbin and Strauss approach. The participants of the study are women drug users with risky sexual behaviors who, using purposeful sampling method, will be selected from the Counseling and Harm Reduction centers for vulnerable women, the Drug Rehabilitation centers affiliated to the Isfahan University of Medical Sciences, Therapeutic Community Rehabilitation centers, Drop in Centers affiliated to the Welfare Organization, Medium-term Residential centers (women’s camps), and Women’s Empowerment centers in Isfahan, Iran. Sampling will continue using snowball method and the strategy of maximum variation in terms of the age, occupation, education, duration of the drug use, and type of the drug. During the sampling process, theoretical sampling will gradually replace purposeful sampling, so that sampling will proceed based on the emergence of the theory and for understanding of the concept and, then, the next participants will be selected. Sampling will continue until data saturation is reached. Data will be collected using individual semi-structured in-depth interviews, observation, field notes, and memo writing. Data will be coded as they are collected, and the analysis will be performed at three levels of open, axial, and selective coding and based on the constant comparative analysis. The four criteria of credibility, dependability, transferability and confirmability will be used to ensure the trustworthiness of the data. Discussion The findings of the present study are expected to provide a better understanding of the process of risky sexual behaviors formation in women drug users. The findings may also lead to the identification of the barriers and factors contributing to the formation of such behaviors and, finally, will promote the reproductive and sexual health of these women. This study can also provide the guide and the ground for designing and conducting further studies in the related areas through using various qualitative and quantitative methods.

Background: Postpartum period is associated with stress and pressure, and the woman must adjust herself to these changes. This study aimed to review the factors affecting women's adjustment to postpartum changes in conducted studies. Materials and Methods: This review was conducted by searching databases such as ISI Web of Science, Science Direct, Scopus, Cochrane, PubMed and Scientific Information Database (SID), Iranian Medical Articles Database (IranMedex), Iranian Research Institute for Information Science and Technology (IranDoc), and the Iranian Magazine Database (MagIran), as well as searching through Google Scholar (as a Web search engine) in December 2019. Publications from July 2004 to October 2019 were reviewed and limited to Persian and English. The keywords used included “Postpartum”, “Women's needs”, “Adjustment” and “Coping”. After reviewing the articles, out of 60 original articles, 17 articles were selected for final evaluation. Results: Factors affecting adjustment to postpartum changes were divided into personal and social factors. Personal factors included previous experiences, coping styles and strategies, personality traits, self-efficacy and awareness, and social factors included family and relatives, healthcare providers, cultural context, and laws and regulations. Conclusions: Adjustment to postpartum changes depends on the personal and social factors that can interact with each other. Women's awareness enables them to use positive coping strategies in this critical situation. Educating women's spouse and family members can contribute to increase the women's social support. Additionally, the law support guarantees the implementation of many interventions in promoting the mother's health.

Background: Polycystic Ovary Syndrome (PCOS) is one of the most common endocrine disorders in the women of reproductive age. In addition to multiple physical problems, this syndrome has many psychological manifestations. Thus, the present research was conducted aimed at investigating the psychological experiences of the adolescent girls with PCOS. Materials and Methods: This research was conducted using the qualitative content analysis method. A total of 18 adolescent girls with PCOS and 15 healthcare providers were selected by the purposive sampling method. The data were collected through in-depth interviews, focus group discussions, and field notes, which were analyzed using the conventional content analysis method. Results: After analyzing, three main categories and seven subcategories were extracted. First, the psychological experiences related to the disease symptoms had three subcategories: “psychological experiences related to hirsutism, alopecia, and acne,” “psychological experiences related to obesity,” and “psychological experiences related to menstrual disorders.” Second, the psychological experiences related to disease complications had two subcategories: “psychological experiences related to infertility” and “psychological experiences related to disease progression.” Third, the psychological experiences related to treatment of the disease had two subcategories: “psychological experiences related to prolongation of the treatment and uncertain fate of the disease” and “psychological experiences related to the complications of the medical treatment.” Conclusions: Results of the study showed that adolescent girls with PCOS were exposed to multiple concerns endangering their psychological health. Therefore, it is recommended to provide adequate and appropriate information about the disease and its consequences, as well as psychosocial supports and regular assessment of psychological state by the team of healthcare providers in the adolescent girls with PCOS.

Background: Intellectually disabled persons, as compared with normal people, experience different changes during the adolescence period including the appearance of secondary sexual characteristics. However, owing to their low intelligence quotient, these changes are usually accompanied by more problems and challenges. The present study was conducted to determine the experiences of parents regarding the sexual and reproductive health of educable intellectually disabled adolescent girls. Materials and Methods: This qualitative study was carried out on 52 participants (adolescent girls, parents, teachers, healthcare providers, and managers) who were selected via purposeful sampling in Isfahan between July 2016 and April 2017. Data were collected through semi-structured interviews, focus group discussions and field notes, and analyzed using conventional content analysis. Results: Five sub-categories were extracted: “unawareness about sexual needs of the adolescent girl and her potential vulnerability,” “inappropriate actions in directing the sexual behaviors of the adolescent,” “insufficient supervision and care over the adolescent's sexual health,” “inappropriate actions toward marrying off the adolescent,” and “inappropriate actions regarding the menstrual and genital health” which formed the main category of “parents' inefficiency in maintaining adolescent girls' sexual and reproductive health.” Conclusions: Based on the results, parents face different challenges about the sexual and reproductive health of intellectually disabled adolescent girls. Hence, empowering the parents especially mothers through teachers and healthcare providers with the knowledge and skills to maintain the sexual and reproductive health of intellectually disabled adolescent girls would make them emboldened to find the ability to protect themselves in different situations.

BACKGROUND: Rape can lead to various physical and psychological consequences. Thus, survivors should receive immediate interventions and need-based care. The present study aims to design and psychometric evaluation of needs in women survivors of rape. MATERIALS AND METHODS: This mixed methods study is conducted using a sequential exploratory approach. In the first phase, the participants (women survivors of rape and healthcare providers) are selected through purposive sampling in Isfahan. Data are collected through in-depth semi-structured interviews and field notes and are analyzed using conventional qualitative content analysis. The draft of the questionnaire is prepared based on the findings of the qualitative phase and literature review. Then, the face validity, content validity, and reliability of the questionnaire are assessed. Construct validity is assessed using the exploratory factor analysis through a descriptive cross-sectional study on women survivors of rape in the quantitative phase. Using a convenience sampling method, the data are collected in the research environment and analyzed via descriptive and inferential statistical methods. Cronbach's alpha coefficient is used to assess the internal correlation of the questionnaire. CONCLUSION: The valid and reliable questionnaire that is developed in this study can be used by planners to provide services and care according to the needs of women survivors of rape.

BACKGROUND: Breast cancer is the most common type of cancer and the second leading cause of death among women. Religion and spiritual behaviors are effective strategies for maintaining human health. The aim of this study was to determine the relationship between religious orientation and spiritual intelligence with general health dimensions in women with breast cancer. MATERIALS AND METHODS: The present study is a correlational study that was performed on 50 women with breast cancer referred to medical centers affiliated to Isfahan University of Medical Sciences in 2020. Data were collected through questionnaires of religious orientation, spiritual intelligence, and general health. Data were analyzed by Spearman and regression tests. RESULTS: The results showed that religious orientation had a significant positive relationship with the overall score of general health, but the components of religious orientation had a significant negative relationship with the number of components of public health (p < 0.05). Spiritual intelligence also had a significant positive relationship with general health. However, the number of components of spiritual intelligence has a significant negative relationship with the number of components of general health (p < 0.05). CONCLUSION: Considering the relationship between religious orientation and spiritual intelligence with public health and considering educational programs based on spiritual intelligence and religious orientation in this group of people can be an important step in promoting their general health.

The COVID-19 pandemic has had considerable consequences in many areas of life, including the social area and childbearing plans. The present narrative review aimed to examine the childbearing decisions and its related factors during the COVID-19 pandemic. This review was conducted by searching in scientific databases, including Web of Science, Science Direct, Google Scholar, Scopus, Cochrane, PubMed, ProQuest, Scientific Information Database (SID), Iranian Research Institute for Information Science and Technology (IranDoc) and Iranian Journal Database (Magiran) in June 2022. The search resulted in 111 sources, of which 16 were in line with the research objective. Couples have mainly cancelled or delayed their previous plans related to childbearing decisions. There are two groups of direct and indirect factors related to childbearing decisions during the COVID-19 pandemic: The former includes (1) well-being-related factors such as economic conditions, interpersonal relationships and gender roles in terms of task division; and (2) health-related factors, including health emergencies and physical and psychological health. The latter includes factors such as social distancing and social media. Based on the results, governments should facilitate childbearing by adjusting existing policies, addressing economic insecurity and protecting the livelihoods of those affected by the crisis. Health policymakers and planners must also prioritize women's access to reproductive health services in a safe environment while promoting equity in access. It is also necessary to promote the quality and quantity of indirect care and virtual counseling based on the needs of women in crisis.

Introduction: Youths are considered as a susceptible group in terms of engagement in pre-marital sexual relationships. Therefore, this study was conducted to explain factors protecting youths in engagement in pre-marital sexual relationships. Method: This qualitative study was performed on 30 youths as well as 17 other participants (other than the youths) living in Isfahan in 2013. Data were collected through semi-structured interviews. Data were analyzed using qualitative conventional content analysis. Results: After data analysis, two themes including "having a strong and secure personality" and "obeying the religious beliefs and principles" were obtained. Conclusion: According to the results, having a healthy personality and obeying religious beliefs play an outstanding role in protecting youths in engagement in pre-marital sexual relationships? The results of this study can pave the way toward interventions for internalizing religious values as well as developing healthy personality in youth, which help their sexual health promotion.

Abstract Background Appropriate health information seeking behavior can play an effective role in self-care and promotion of women’s quality of life during pregnancy. However, different barriers can impede pregnant women while accessing health information. The aim of this research was to explain challenges to access health information during pregnancy. Methods The present qualitative study was carried out on 28 participants who were selected using the purposeful sampling technique. Data were collected through in-depth interviews, field notes, and daily notes; data were analyzed using conventional content analysis. Results The main barriers to access health information during pregnancy were as follows: many duties of women at home as well as out-of-home education and employment, inability to make distinction between correct and incorrect information, insufficient interactions between women and healthcare providers, failure to access to various information resources, common complaints of pregnancy, and stress and anxiety of confronting the problems during pregnancy. Conclusion Based on the results, pregnant women experienced personal, social, and structural barriers when accessing health information. Therefore, policymakers and health planners should remove the barriers, encourage self-care, and enhance the quality of life for pregnant women, thus, promoting their health status in the end.

Abstract Background Extensive application of screening tests for early diagnosis of fetal abnormalities would justify support for women who are facing pregnancy termination due to fetal abnormalities. Considering the lack of available information regarding supportive sources for these people, the present study was conducted to determine the supportive needs of women who have experienced pregnancy termination due to fetal abnormalities. Methods The present research was a qualitative study. The participants were selected using a purposeful sampling method with maximum variation. Data were collected through in-depth personal interviews and taking of field notes and were analyzed simultaneously using conventional content analysis. Results The main categories that appeared in the present study included “support from the husband” with sub-categories of “mental support and necessary accompaniments”, “participating in planning for future pregnancy” and “financial support to pay the costs of diagnosis and follow-up”, “support from the family and friends” with sub-categories of “helping in taking care of other children”, “help in performing daily activities” and “empathy, companionship and necessary support to maintain mental peace” and finally “support from peers” with sub-categories of “communicating with the peers and receiving information from them” and “creating a sense of confidence and hopefulness”. Conclusions Results of the present study, by determining and highlighting the supportive needs of women who have experienced pregnancy termination due to fetal abnormalities, could be an appropriate basis for providing effective strategies to improve constant participation of the husbands, family members and the peers along with other professional care.

Abstract Background The role of men’s participation in prenatal, delivery and postpartum care is very important, well defined and cannot be over emphasized. Very few studies exist about men’s role in promoting the health of the mother and barriers to their participation in perinatal care in Iran; hence, the present study was conducted to determine the barriers to men’s participation in perinatal care. Methods The present qualitative study was carried out on 45 participants who were selected employing purposeful sampling technique. Data were collected through in-depth semi-structured interviews, focused group discussions and field notes. Data were analyzed using conventional content analysis. Results After data analysis, four main categories extracted were: “cultural barriers”, “personal and interpersonal barriers”, “health system-related barriers” and “socio-economic barriers”. Conclusion The results of this study, by presenting the barriers to and challenges for men’s participation in perinatal care, could be helpful in designing culture-based strategies to overcome these barriers and improve men’s participation.

Background: Breastfeeding is an important issue in postpartum period and critical to the infant's health, but childbirth interventions such as childbirth analgesia may affect the onset and duration of the process. This study aimed to determine the status of breastfeeding in women receiving epidural analgesia. Materials and Methods: This cohort study was conducted on 393 mothers in the postpartum period that had vaginal delivery with or without using epidural analgesia (with their own choice) between December 2017 and September 2018. After selecting the convenient samples, the researcher-made outcome breastfeeding checklists were completed in selected hospitals in Isfahan, Iran, Within 24 hours and 4 weeks after delivery. Data were analyzed using statistical methods (Independent t test, Mann-Whitney, ANCOVA, and Chi-square). The significance level of the tests was less than 0.05. Results: According to the results, most of the subjects in the two groups began breastfeeding during the first hour after childbirth. There was no significant difference between the two groups in the beginning of breastfeeding while controlling the number of labors. There was no significant difference between the two groups in comparison to the type of milk given to the infant Within 24 hours after birth and 4 weeks after birth, either. There was no significant difference between the two groups in comparison to breastfeeding problems at either time. Conclusions: According to the results, saying that there is no negative effect by epidural analgesia on the breastfeeding process, using this analgesia is recommended to promote natural childbirth.

Background: Pregnancy termination due to fetal anomalies is associated with emotional, psychological, and social injuries for women. Determining the needs of women with these experiences is the key for programming to provide high quality and desirable care. Hence, the present study was conducted to determine the needs of women who have experienced pregnancy termination due to fetal anomalies. Materials and Methods: The present literature review was conducted in March 2018 by searching databases such as Irandoc, SID, MagIran, Iranmedex, Cochrane, Science Direct, ISI Web of science, PubMed, Google Scholar, and Scopus. The used keywords for the search included “fetal anomalies,” “pregnancy termination due to fetal anomalies,” “therapeutic abortion,” “need assessment,” and “care program.” Publication date was restricted to 2004–2017, and publication language was restricted to English and Farsi. Article search was conducted by two independent reviewers, and all of the studies were evaluated by these two individuals. The searches resulted in finding 88 articles related to the subject from which 16 articles that had more appropriately covered the topic were selected for the present study. Results: From the results, the needs of these women could be categorized into two groups of “needs related to the care system” and “needs related to the husband, family members, friends, and peers.” Conclusions: Considering that women who have experienced pregnancy termination due to fetal anomalies have different needs, educating healthcare providers and husbands, family members, friends, and peers for providing comprehensive care tailored to the needs of these individuals seems necessary.

Background: Sexual problems could cause severe personal discomfort and affect interpersonal relationships. Considering that selection of appropriate methods has an important role in success of the education, this study was conducted to compare the effects of two methods of group education and peer education on sexual dysfunction of menopausal women. Materials and Methods: In this randomized controlled trial, 108 menopausal women were allocated into three groups in the health centers of Isfahan, Iran. After educating four menopausal women, educational sessions were conducted by them for the participants (36 women) in the peer groups. Two educational sessions were conducted by the researcher in the group education. The control group received no intervention. Before and 1 month after the intervention, female sexual function index was completed by the participants. Data were analyzed using descriptive and inferential statistics (one-way analysis of variance, paired t-test, Chi-square, Kruskal–Wallis, and Post hoc LSD test). Results: The total mean score of sexual function and its domains in the peer education and group education groups was significantly higher than the control group after the intervention (F2, 93= 23.52, p < 0.001); but the difference between the peer education group and the group education group was not statistically significant. Conclusions: Both methods of peer education and group education have been effective in improving the sexual function of menopausal women. So, considering the advantages of peer education such as its low cost, affordability, and no need to train specialized individuals, its implication in educational programs for menopausal women is recommended.

Abstract Background Polycystic ovarian syndrome (PCOS) is the most common endocrine disorder among women. Inappropriate eating behaviors are some of the most important risk factors for obesity in all age groups. Therefore, performing comprehensive culturally sensitive interventions for modification of eating behaviors as a useful affordable strategy seems necessary. So, this study aims to present a comprehensive interventional program for promoting eating behaviors in adolescent girls with PCOS. Methods This study has a sequential exploratory mixed methods design including three sequential phases. The researcher represents eating behaviors among adolescent girls with PCOS using a qualitative approach. In the onset of the second phase, a comprehensive interventional program for promoting eating behaviors is designed for adolescent girls with PCOS. In this regard, in addition to qualitative studies, some related papers and texts are used. The suggested program of expert panel is approved based on prioritization guidelines. Then, in the third phase and after different stages of finalization of the program, its affectability is evaluated regarding improvement of eating behaviors in adolescent girls with PCOS. Discussion Results of the present mixed methods study, by presenting an interventional culturally sensitive program for promoting eating behaviors in adolescent girls with PCOS, lead to the improvements of the health of young girls. If this program works, it can become one of the leading education guidelines for eating behaviors in adolescent girls with PCOS. Trial registration IRCT20160224026756N6. Registered 18 Aug 2018.

Objective: Pregnant women need health information to ensure their health and to have a healthy delivery. Therefore, equipping them with adequate information can bring desired health outcomes for them and their fetus. The present study was conducted to explore health information needs of women during pregnancy. Materials and methods: The present research was a qualitative study. Thirty-nine participants (pregnant women, midwives, and obstetricians) were selected through purposeful sampling in Isfahan from June to November 2016. Data were collected through in-depth face-to-face semi-structured interviews, daily notes and field notes. Results: Data analysis led to emergence of ten sub-categories including: "common complaints during pregnancy", "problems and complications in pregnancy", "factors affecting fetal health", "proper nutrition and take supplements during pregnancy", "sex during pregnancy", "exercise during pregnancy", "diagnostic tests in pregnancy", "fetal growth and development", "types of childbirth and preparation for delivery" and "baby care and breastfeeding" and finally the main category was the "health information needs". Conclusion: Regarding the health information requests of pregnant women, their needs should be identified and taken into consideration when planning educational programs for this group of women.

BACKGROUND: One of the most basic life events is fertility or reproduction, which, although known as a social phenomenon, is a complex and multidimensional concept with economic, cultural, political, and religious significance. The present study aims to explain the pattern of childbearing behaviors in couples. MATERIALS AND METHODS: This study is a focused ethnographic qualitative research. Participants of this study will be 20–35 years old couples who, using purposeful sampling method, will be selected from comprehensive health centers, ultrasound centers, laboratories, premarital counseling centers, offices of obstetricians and midwives, universities, shopping centers, cinemas, parks, restaurants, and entertainment centers in Isfahan, Iran. Sampling will continue considering the strategy of maximum variation in terms of age, occupation, education, and economic status until data saturation is reached. Data will be collected through semi-structured and in-depth individual interviews, focus group discussions, observation, field notes, daily notes, and document analysis. Simultaneous with data collection, the data will be analyzed using the thematic analysis method based on Braun and Clarke's approach. CONCLUSION: This present study is expected to lead to a deep understanding and identification of the attitudes, beliefs, and values of couples with regard to childbearing. Moreover, by understanding the pattern of childbearing behaviors of couples, useful information will be provided to the policymakers and planners for effective planning in the field of healthy childbearing. The findings can also be used in reproductive health counseling for newly married couples and community-based interventions.

Abstract Background Protection and promotion of sexual health is of great importance for educable intellectually disabled adolescent girls; since they are prone to high risk sexual vulnerabilities and consequences, such as unwanted pregnancy, sexually transmitted infections, and acquired immune deficiency syndrome. Although the rights of intellectually disabled adolescents have been emphasized through the recent years, their sexual health care is still a challenge for parents, teachers, caregivers, and service providers. This study aims to present a comprehensive sexual health care program for educable intellectually disabled adolescent girls. Methods This study is carried out by an exploratory sequential mixed qualitative-quantitative methods approach including three sequential phases. The researcher represents sexual health state of educable intellectually disabled adolescent girls using a qualitative approach. In the onset of the second phase, a comprehensive sexual health care program is designed for educable intellectually disabled adolescent girls. In this regard, in addition to qualitative studies, some related papers and texts are used. The suggested program of expert panel is approved based on prioritization guidelines. Then, in the third phase and after different stages of finalization of the program, its affectability is evaluated regarding improvement of sexual health state of educable intellectually disabled adolescent girls. Discussion It is expected that from the results of the present mixed methods study, by presenting a comprehensive sexual health program for educable intellectually disabled adolescent girls, lead to improvements in the sexual health of these girls. Moreover, it wants to reduce risky sexual behaviors, sexual abuse and harassment, and their consequences in adolescent girls in order to improve sexual health state of the society. If this program works, it can become one of the leading education and care guidelines for sexual health care of intellectually disabled adolescent girls. Trial registration IRCT20160224026756N5. Registered 22 June 2018.

Abstract Background The inclusion of fathers’ participation during the perinatal period is an important strategy for improving mothers’ health. No studies have yet been conducted in Iran to explain the concept, obstacles and facilitators of fathers’ participation during the perinatal period. Thus, this study will be carried out to provide a comprehensive interventional program for promoting fathers’ participation in the perinatal care. Methods This study is a sequential exploratory (qualitative – quantitative) mixed methods design that consists of three consecutive phases. In this study, following a qualitative approach, the researchers will explain the concept, obstacles, facilitators and strategies related to promoting fathers’ participation in perinatal care. In the second phase, researchers will design an appropriate and comprehensive interventional program for promoting fathers’ participation in perinatal care by using the results of the qualitative phase and literature reviews. The proposed interventional program is designed by a panel of experts based on prioritization guidelines and will be finalized for execution. In the third stage, the effectiveness of interventional program on the awareness, attitude and practice of fathers about participation in perinatal care will be investigated in a semi-experimental study. Discussion It is expected that from the results of the present mixed methods study, by presenting an interventional culturally sensitive program which is appropriate for the conditions of the society for expectant fathers, the participation of fathers in the perinatal period will increase and thus lead to improvements in the health of the mother and the infant. If this interventional program is effective, it could be included in the perinatal health care guidelines. Trial registration IRCT20160224026756N4 Registered 27 May 2018.

Abstract Background The participation of the father during the perinatal period is an important strategy for improving the mother’s health. Very few studies exist about the father’s role in promoting the health of the mother in Iran; thus, the present study was conducted to examine the role of fathers in perinatal care. Methods The present study was a qualitative research. Participants were selected using purposeful sampling with maximum variation and the data was collected through in-depth interviews, focus group discussions and field notes. The data was analyzed using conventional content analysis. Results After data analysis, the main categories extracted were: “help in maintaining the health of the mother and fetus”, “emotional support of mother”, “comprehensive participation of father in married life”, “preparing for safe delivery” and “postpartum support”. Conclusions The results of the present study provide different perspectives on the participation of fathers when designing culture-based intervention for their participation in perinatal care.

Background: In recent years, the Internet has become one of the most popular sources of health information for users, and pregnant women are no exception. This study aimed to investigate Internet usage among pregnant women for achieving health information on the finding of related studies. Materials and Methods: This review study was conducted by searching databases such as IranMedex, Magiran, Scientific Information Database, Irandoc, PubMed, Science Direct, Cochrane, Google Scholar, and Scopus in December 2016. Restrictions were placed on publication to within 16 years and language of publication was restricted to English and Persian. Keywords used in the search included information-seeking behavior, information-seeking, information needs, access to information, pregnancy, and pregnant women. Results: This search resulted in 106 related publications and among them sixteen articles met inclusion criteria. This review showed that the use of the Internet by pregnant women was driven by information needs, ease, and speed of access and finding people with the same situation. Fetal development, symptoms, and complications of pregnancy, prenatal tests and nutrition, activities during pregnancy, and stages of delivery were the most often mentioned topics of interest. The benefits of internet use include reduced anxiety, personal support, creating an emotional connection and an increased confidence. Conclusions: Health providers must have sufficient ability for interpreting the achieved information from the Internet and should allocate efficient amount of time for discussing information-seeking manners with pregnant women. Furthermore, they must try to respond to the doubts of pregnant women and provide valid and reliable online educational resources.