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Abstract Introduction Menopause is a natural phase in a woman’s life, but the quality of life and health of postmenopausal women are often compromised by unhealthy lifestyles. Therefore, it is crucial to identify the factors that influence their well-being. The main objective of this study is to explore the barriers to a healthy lifestyle among Iranian postmenopausal women. Methods Qualitative exploratory research was conducted among postmenopausal women aged 45–65 years in three different health centers located in urban areas with varying economic level in a central city of Iran. These areas represented upscale, downtown, and downscale areas with different economic statuses (wealthy, relatively wealthy, and less wealthy). Nine focus group discussions were held, focusing on managing menopausal symptoms, physical activity, and healthy nutrition. Each topic was discussed separately in a different health center, with 10 women participating in each session. Data analysis was conducted using Graneheim and Lundman’s method. Results The study revealed a prominent theme, “perceived lack of behavioral control as a barrier to a healthy lifestyle in post-menopause.” Two categories, “False attitudes” and “Perceived inability to engage in behavior,” were derived from 26 codes related to managing menopausal symptoms. Furthermore, a category, “Perceived inability to engage in behavior,” was formed from 11 to 13 codes related to physical activity and healthy nutrition, respectively. The theme highlighted that the perceived lack of behavioral control prevented the women from adopting a healthy lifestyle. Conclusion Improving perceived behavioral control through the modification of attitudes and abilities is essential for maintaining a healthy postmenopausal lifestyle.

Background: Alcohol consumption, as a high-risk behaviour of adolescents, is a problematic challenge in health system around the globe. Iran, as an Islamic country, has been faced with this issue despite strict religious norms and heavy laws and punishment, especially after the fundamental 1979 revolution. This study aimed to analyze and use theoretical model to identify the factors influencing the intention not to drink alcohol among adolescents in southern Iran.Methods: The cross-sectional study was conducted in mid- 2020 in southern Iran. The data were collected using available samples from among 763 tenth grade adolescents who visited health canters to receive health services upon entering school. Kolmogorov-Smirnov, Shapiro-Wilk test, independent sample t-test, and binary logistic regression (P

Abstract Background Menopausal women should learn self-care practices to enjoy a healthy lifestyle, positive health behaviors, and health status. In addition, the lack of self-care knowledge can lead to unhealthy attitudes and lifestyles, resulting in many complications. Improved self-care knowledge can foster positive attitudes, leading to healthier lifestyles as a beneficial cycle. However, menopausal women have limited knowledge about self-care and evaluation tools. Therefore, this study aimed to develop and investigate the validity and reliability of the Women’s Self-care Knowledge and Attitude Questionnaire (WSKAQ) in Iranian menopausal women. Methods This cross-sectional study was conducted on 249 menopausal women, aged between 45 and 65 years and at least one year post-menopause, with a minimum literacy level of elementary education. Validation properties included construct validity, exploratory (EFA), and discriminant validity. Reliability was further established through Cronbach’s α and McDonald’s Omega. PASS 15 and SPSS 27 software were used to select centers, calculate sample size and analyze the data, respectively. Results The initial stage of construct validity involved the Kolmogorov–Smirnov test and EFA, resulting in a 6-item self-care knowledge subscale, 47.29% of the total data variance, and 7-item self-care attitude subscale, 55.50% of the total data variance. Independent t-test indicated that menopausal women with education level equal to or higher than diploma have significantly higher self-care attitude scores than those with lower than diploma (p = 0.007). Additionally, significant correlations were observed between self-care knowledge and attitude (r:0.30). Cronbach’s α and McDonald’s Omega coefficients of the 13-item WSKAQ were 0.77 and 0.78, respectively. Conclusions Based on the results, the WSKAQ, consisting of 13 items, was validated and reliable for assessing the self-care knowledge and attitude of Iranian menopausal women.

Abstract The current study aimed to assess the impact of combined interventions including mindfulness and self-regulation on self-neglect and self-regulation among Iranian older adults with type 2 diabetes. This was a three-arm cluster randomized controlled trial study conducted among 135 older diabetic patients in Shiraz, Iran. Three urban healthcare centers (clusters) were randomly assigned to three study groups. The intervention groups received either a Self-Regulation-based Intervention Program (SRIP) or a Combined Mindfulness and Self-Regulation Intervention Program (CMSRIP), while the control group received routine care and COVID-19 prevention training. These training programs, which consisted of text and video-based content, were conducted over 24 weeks using WhatsApp as a mobile-based communication platform. Outcomes were measured using the Elder Self-Neglect Scale and Short-Form Self-Regulation Questionnaire at baseline, week 4, and week 16 post-intervention, with data analysis conducted using SPSS 20 software. The CMSRIP led to significantly greater improvement in the score of self-regulation (χ2 = 73.23, P-Value =

Abstract Purpose This review seeks to examine the current state of postpartum social support and psychosocial conditions among women around the world, as well as explore the relationship between these factors. Additionally, it aims to propose a logical framework for enhancing postpartum social support and psychosocial conditions in this population. Methods Following the development of a search strategy, two databases, PubMed and Science Direct, were searched for studies published between January 2019 and May 2023. The search was conducted throughout the entire month of May 2023. The risk of bias in the included cross-sectional studies was assessed using the Newcastle–Ottawa Quality Assessment Scale, which was adapted for this specific study design. To determine if the main objective of the cross-sectional studies was to investigate the relationship between social support and postpartum psychosocial conditions, a review was conducted based on the AMSTAR checklist, PRISMA checklist and PRISMA flow diagram. Data extraction was performed with the consensus of two authors, and a narrative synthesis approach was chosen for data synthesis, following the guidelines provided by the Centre for Reviews and Dissemination (CRD). Results Eleven cross-sectional studies were included in the final analysis. Our findings revealed that all reviewed studies provided evidence of a positive association between social support and healthy psychosocial conditions in postpartum period. However, due to the absence of standardized measurement indicators to identify and compare the outcomes of various studies, there was a need to develop a conceptual framework that could enhance our understanding of the postpartum psychosocial condition including anxiety, depression, unfavorable quality of life and social support status up to 24 month after child birth. This framework aimed to incorporate childbirth and motherhood as "stressful events," while considering social support as a crucial "coping resource." Furthermore, it acknowledged empowerment, help-seeking behavior, and peer support as important "coping actions," alongside implementing client-centered interventions. Lastly, it recognized postpartum mental health and optimal quality of life as significant "effects" of these factors. Conclusions The proposed conceptual framework could define postpartum women’s health as “the ability to adapt and self-manage.”

Background: Nowadays, children and teenagers easily access computer games while parents are unaware of the dangers posed by excessive use of these games. The present study investigated the effect of educational intervention based on the theory of planned behavior (TPB) on primary school boys’ aggression levels. Methods: This research was a randomized controlled trial. The sample size was determined to be 180 considering a confidence interval of 95% and test power of 90% (group 1=90, group 2=90). The sampling environment was a multi-stage cluster with four primary schools from two education districts in Shiraz City, Iran in 2013. The participants were evaluated once before the intervention and then one week and one month after the educational intervention. We used the aggression checklist (12 items) and a researcher-made questionnaire according to TPB theory, which has suitable validity and reliability. The data were analyzed using SPSS software, version 19. Results: There was no difference between the two groups before the intervention. After the education program, the 4 constructs of TPB, including attitude, perceived behavioral control, behavioral intentions, and behavior, increased in the intervention group compared to the control group (P

IntroductionSexual harassment is a significant problem in workplaces all over the world. Women's reactions to sexual harassment are influenced by various factors. The aim of the current study was to investigate how women respond sexual harassment in the retail clothing industry.MethodsIn-depth face-to-face interviews were conducted with 16 women aged 23–44 years (mean 29.18 years) employed for at least 3 years in clothes shops in Shiraz, Iran. A grounded theory approach was used to analysis the data and raise hypotheses.ResultsThe main perpetrators of sexual harassment for female saleswomen were male customers. The women experienced conflict-induced stimulation (core phenomenon) when they were faced with sexual harassing behaviors (causal conditions). Such stimulation prompted three types of coping strategies: silence, avoidance, or confrontation. Intervening factors like the characteristics of the Iranian society (including family mores, state-imposed hijab regulations, patriarchal culture, educational system, and regulatory monitoring) and contextual factors (including individual and environmental factors and particularly employer expectations) were found to influence the selection of strategies used as well as their potential consequences in challenging situations.ConclusionThe current study used a grounded theory approach to produce an explanatory storyline that can be tested. Sexual harassment induces conflict-induced stimulation and responses are influenced by intervening conditions, contextual factors, selected strategies, and the perceived consequences of the response. The findings of the grounded theory study suggest that there are negative consequences, particularly in terms of lack of employer support and losing one's job, shame, and family disapproval which act as barriers for female saleswomen to counteracting sexual harassment from male customers. Such an understanding can also be applied to develop educational policies to support women as well as ameliorate the prevalence of this essentially illegal problem.

Mindful self-care is a valuable activity that contributes to old people’s independence and self-control and its development is in line with the duties of social workers. This study aimed to validate the mindful self-care scale (MSCS) for Iranian old people and was performed on old people living in the community of Shiraz, Iran. This cross-sectional study was conducted on old people living in the community who met the inclusion criteria in Shiraz, Iran. After linguistic validation of the Persian version of MSCS with 36 items, face, and content validity were determined. Then the first part of construct validity was conducted using a kurtosis test, and exploratory factor analysis with the first sample ( n = 250). After selecting the appropriate items, confirmatory factor analysis was assessed with the second sample ( n = 250). Scale reliability was also evaluated. The optimal cut-off points were obtained by calculating the area under the curve (AUC). SPSS version 23 was used for further data analysis, while confirmatory factor analysis was conducted using AMOS version 24. Exploratory factor analysis loaded only 24 items with four factors. The modified second-order confirmatory factor analysis model displayed a good fit (RMSEA = 0.04; CFI = 0.90; GFI = 0.90). Cronbach’s alpha coefficient of MSCS with 24 items was .94. The cut-off points were 38, 11, 23, and 17 for factors of resilience, goal achievement, supportive relationship, and self-care respectively, and 90 for the whole instrument. The study found that the MSCS short form with 24 items is valid and reliable in the Iranian elderly population, making it an effective tool for mental self-care screening and a practical tool for social workers. However, the study recommends repeating the study in other cities of Iran to generalize the findings.

Introduction. Retirement resources are considered one of the key determinants of well-being and coping with the challenging situations of retirement courses. Therefore, due to the lack of a valid questionnaire for research and practice at the national level as well as international comparisons, this study was conducted to translate the original retirement resources inventory into Persian and assess the validity and reliability of the Persian version. Materials and Methods. The research employed a cross-sectional descriptive methodological approach, beginning with translating the questionnaire into Persian. Psychometric properties were evaluated through face, content, construct validity, and reliability tests. 335 participants were involved in assessing construct validity, while 30 participants contributed to the internal consistency test, and 20 took part in the test-retest reliability test. Data analysis was performed using SPSS Version 26 and AMOS 24 software. Results. The exploratory factor analysis (EFA) revealed eight components with eigenvalues greater than 1, accounting for 46.68% of the variance, with no questions being removed. Confirmatory factor analysis (CFA) indicated that all items had a factor loading above 0.3, resulting in a final model with 35 items and eight factors, supported by fit indices (χ2/df = 1.95, TLI: 0.87, IFI = 0.88, RMSEA = 0.05, GFI: 0.85). Reliability measures showed Cronbach’s alpha coefficients ranging from 0.71 to 0.83 and an intraclass correlation coefficient (ICC) of 0.93. Conclusion. The study concludes that the Persian version of the RRI, encompassing 35 items across eight dimensions, is a valid and reliable tool for the Iranian retiree population. This validated inventory can be utilized in future national and international studies, particularly experimental ones, to develop well-being and retirement adjustment programs, thereby aiding in understanding and supporting Iranian retirees.

Background. The Health Locus of Control (HLC) serves as a mediator between an individual’s behaviors and health status, influenced by various cultural, environmental, and situational factors. Its measurement reflects health beliefs and attitudes, ultimately leading to healthy behaviors. Menopause is a significant phenomenon in women’s lives, often resulting in a wide range of symptoms and health issues. Therefore, the perception of HLC plays a crucial role in promoting healthy behaviors and managing menopausal symptoms. This study aimed to assess the validity and reliability of the Persian version of the short form Multidimensional Health Locus of Control Scale (MHLC) in Iranian menopausal women and explore its interrelationships. Methods. A cross-sectional study was conducted with 271 menopausal women from September to November 2023. Psychometric properties such as construct validity (confirmed through confirmatory factor analysis), convergent validity (evaluated using average variance extracted), and internal consistency (assessed by Cronbach’s alpha, composite reliability and rho_A factor) were examined. Discriminant validity was determined using the Fornell–Larcker criterion. Reliability was further established through Cronbach’s alpha and McDonald’s Omega coefficients. The predictive relevance of the model and associations between constructs were analyzed using various statistical measures. Data analysis was conducted using SPSS v.27 and Smart PLS 3.0 software. Limitations of this study include that it was conducted in urban health centers, only women with at least primary education were included, and reliance on self-reported data. Results. The initial stage of construct validity involved the Kolmogorov–Smirnov test, with confirmatory factor analysis demonstrating a good model fit. Significant correlations were found between internal health control and factors related to doctors and other people, indicating that internal health control directly influences these factors in managing menopausal symptoms and health problems. Cronbach’s alpha and McDonald’s Omega coefficients for the 13-item MHLC-C scale were satisfactory (0.81 and 0.72, respectively). Conclusions. The Persian version of the 13-item MHLC-C has been validated as a reliable tool for assessing the health locus of control in Iranian menopausal women. Internal health control was found to significantly impact perceptions related to doctors and other people, highlighting its importance in managing menopausal symptoms effectively.

IntroductionThe highest incidence of overweight among adults is found among women, predominantly middle-aged women. While it has been demonstrated that being overweight increases mortality by compromising physical and mental health, it also imposes substantial costs on the healthcare system. Lack of physical activity is a primary contributing factor to becoming overweight. The majority of inactive adults are women, particularly middle-aged women. Consequently, this study investigated the training program for overweight women based on the health belief model (HBM) and social support approach.MethodsA randomized, controlled trial involving 73 overweight middle-aged women (control group: 37, intervention group: 36) was conducted using simple random sampling. The intervention group participated in six 120-min sessions per week for 6 weeks of a training program based on HBM and social support through physical activity, group discussion, role play, and media. Data were collected using the Physical Activity Questionnaire (IPAQ), Bandura’s Exercise Self-Efficacy Scale (Bandura’s ESE), and a researcher-made questionnaire before and 4 weeks after the training. The collected data were analyzed using descriptive and inferential statistics via SPSS 27 software. p-values

Background: Breast cancer is one of the most prevalent cancers among women worldwide. The phe scale is the first credible measurement tool to delve into critically ill patients’ experiences and emotional state and detect their level of engagement in the treatment and care process. However the Persian version of the scale needs to be further investigated. Accordingly, the present study aimed to evaluate the psychometric features of the patient health engagement scale (phe s) in Iranian patients suffering from breast cancer.Methods: This is a cross-sectional study. The sample size was estimated by multiplying the total number of items by ten. The sample size was estimated for this 5-item scale 128 breast cancer patients who referred to a specialized clinic in 2020. Content validity and reliability analysis were performed, and the data were analyzed using IBM SPSS26 software and R content validity package.Results: The ordinal alpha of thesample was 0.626, indicating an acceptable internal consistency. The analysis of the rash model revealed an acceptable infit and outfit MNSQ (685-932). The polychoric correlation coefficient within the items was 46, representing a moderate correlation. All the factor loadings had a high value (0>60), thereby confirming the single dimensionality of the scale.Conclusion: The phe scale has favorable reliability and validity to assess the patients’ emotional adjustment and their engagement in their health and self-management before designing and implementing any intervention.

Background: The aim of this study was to examine the effect of a volunteer-led food safety training program based on social cognitive theory on behaviors and their determinants among community women.Methods: This is a single-blinded randomized controlled trial conducted in 8 urban health centers in Marvdasht city, southern Iran. 60 volunteers and 502 women who were selected through multi-stage cluster random sampling method participated in the study. A 4-session food safety training program was implemented for health volunteers in the experimental group (n=30). They then trained the women in the experimental group (n=260) in their local community for a month. Data were collected using validated questionnaires in the group of volunteers before and one week after the intervention and in the group of women before and one month after the intervention. Data were entered in SPSS software version 22 and analyzed using Chi-Square and comparisons between the two groups were conducted by ANCOVA. P

Abstract The aim of this study was to examine the effectiveness of a stress management educational intervention programme based on the Transactional Model of Stress and Coping (TMSC) among industrial workers. Participants were 106 employees of a power plant in Iran, randomly assigned into an intervention group and a control group. The intervention comprised active and participatory methods to enhance employees coping skills and it was delivered in six face-to-face sessions. Data was collected using the Ways of Coping Questionnaire, the Multidimensional Scale of Perceived Social Support, the Perceived Stress Scale, and the Spiritual Well-Being Scale at baseline and three months after the intervention. We found mean scores of distancing, self-controlling, seeking social support, escape-avoidance, planned problem-solving, positive reappraisal, total coping skills, perceived social support, and spiritual well-being significantly differed at follow-up compared to baseline in the intervention group, but not in the control group. There was also a significant difference in the mean score of perceived stress between the two groups. We conclude that the educational intervention based on the TMSC was effective in improving coping skills and reducing perceived stress. We suggest that interventions based on the TMSC model can be supportive in workplaces where job stress is common.

Abstract The cumulative effects of adversity and unhappiness affect life satisfaction and quality of life in the growing older adult population. Most of the interventions aimed at improving the health and quality of life of older adults have adopted a problem-oriented or weakness-focused approach. However, a positive or strengths-focused approach can also have a virtuous but more effective capacity to contribute to the well-being and life satisfaction of older adults. Therefore, the present study was conducted to investigate the effect of positive thinking training on improving resilience and life satisfaction among older adults. A randomized controlled trial was conducted on 100 older adults with simple random sampling. The intervention group received 90-min weekly sessions for eight weeks on positive thinking training through written homework for reflection, group discussion, and media. The data were collected using Ingram and Wisnicki Positive Thinking Questionnaire, Connor-Davidson Resilience Scale, and Tobin Life Satisfaction Questionnaire at baseline and one week and two months after the training. The collected data were analyzed using descriptive and inferential statistics in SPSS software 26. P values below 0.05 were considered statistically significant. Positive thinking training led to better thinking (p

Abstract Introduction Girls can use their mother’s emotional, informational and behavioral support to perform healthy behaviors due to their constant access to their mothers. This study aimed to evaluate the effect of role modeling and maternal support in the family to improve healthy behaviors and perceived Family Health Climate (FHC) in female students. Methods In this educational quasi-experimental study, 261 female students (133 in the intervention group and 128 in the control group) and 223 mothers (109 intervention and 114 control) were selected using the cluster multi-stages sampling method and entered the study. Participants (intervention and control groups) completed the FHC scale at three stages (before intervention, immediately after the intervention, and 2 months after intervention). A training program that comprised 12 sessions for students and six sessions for their mothers using collaborative learning techniques and printed materials was conducted with the experimental group. Also after completing the questionnaire in the follow-up phase, pamphlets and educational videos were given to the control group. Data were analyzed using SPSS20 via a chi-square test, independent t-test, and Repeated Measures ANOVA at a significance level of 0.05. Results Before the intervention, there was no significant difference between demographic variables and the score of the FHC scale in both groups (p

Abstract Background The workplace has been identified as a key determinant of health status. There is evidence of innumerable health problems among employees, particularly healthcare workers. Against this background, a holistic-systemic approach together with a good theoretical framework is required to reflect on this issue, and to support the design of effective interventions to promote the health and wellbeing of the given population. The present study aims to evaluate the effectiveness of an educational intervention in improving resilience, social capital, psychological wellbeing, and health-promoting lifestyle in healthcare workers, utilizing the Social Cognitive Theory integrated into the PRECEDE-PROCEED model. Methods This randomized controlled trial will be performed on a large sample of the employees working in two healthcare centers in the city of Shiraz, Iran. The study will proceed with the healthcare workers of one city being given the educational intervention and the healthcare workers of the other city serving as a control group. Using a census method, all healthcare workers in the two cities will be informed of the trial and its purpose, and then invitations to join the study will be issued. The minimum sample size required has been calculated as 66 individuals in each healthcare centers. Recruitment to the trial will by systematic random sampling of eligible employees who submit an expression of interest in joining the trial, and subsequently give informed consent. Data will be collected through a self-administered survey instrument at three stages: at baseline, and both immediately and three months after the intervention. The experimental group members should participate in at least eight of the ten weekly educational sessions of the intervention and complete the surveys in the three stages. There is no educational intervention for the control group, and they simply experience some routine programs, and complete the surveys at the same three timepoints. Discussion The findings will provide evidence for the possible effectiveness of a theory-based educational intervention to improve resilience, social capital, psychological wellbeing, and health-promoting lifestyle among healthcare workers. If the educational intervention is found to be effective, then its protocol will be exploited in other organizations to boost resilience. Trial registration IRCT20220509054790N1.

Introduction The changes that retirees experience during their retirement years will challenge their ability to cope, potentially endangering their health and quality of life. This study aims to design and evaluate a theory-based health promotion programme to improve retirees’ psychological well-being and quality of life.Methods and analysis This mixed-method, non-blinded study uses an embedded design. The purposive sampling method will be employed for the qualitative aspect of the study. Qualitative data will be collected at baseline, focusing on retirement adjustment, through semistructured, in-depth individual interviews and focus group discussions. The data will be analysed using Graneheim and Lundman’s qualitative content analysis method. A pre–post test controlled group design will be conducted for the quantitative part of the study. A sample size of 80 is estimated for both the intervention and control groups. Systematic sampling and the block randomisation method will be employed for sampling. The training programme in the intervention group will consist of eight 60 min sessions and environmental support, implemented after assessing the research environment and obtaining approval from the relevant officials. A brief training programme unrelated to the intervention group’s focus (home safety) will be implemented for the control group. Quantitative measures will be collected in both groups at baseline, 3 months and 6 months after the intervention. These measures will include self-administered questionnaires covering demographic variables, retirement adjustment, retirement resources, quality of life, coping methods, spiritual well-being and psychological well-being. Analytical statistics will be performed using the generalised linear model, with p values≤0.05 considered significant.Ethics and dissemination This protocol has received approval from the ethics committee of Shiraz University of Medical Sciences. The research findings will be disseminated through peer-reviewed manuscripts, presentation in abstracts at National and International Scientific Conferences, and data sharing among researchers.Trial registration number IRCT20180516039690N2.

Background: COVID-19 epidemic in Iran has imposed a heavy social, economic, political, and psychosocial burden and caused devastating social problems. On the other hand, it has also led to promising social cohesion. This study aimed to explore the community-wide changes following the COVID-19 pandemic and to understand how these changes may affect the Iranian community.Methods: This qualitative study used the grounded theory approach and conducted from May 2020 to March 2021 at Shiraz University of Medical Sciences, Shiraz, Iran. Adopting a purposive sampling approach, 15 faculty members in different fields participated in this study, and 17 interviews were performed.Results: This study indicated that the core phenomenon in the social change process was “struggling for survival and livelihood”. Therefore, people tried to identify and choose strategies to deal with or repel COVID-19 disease as a life-threatening situation. A set of contextual factors influenced their choice. The media and the performance of organizations as intervening conditions also played an important role in this process. Finally, this complex process led to constructive and destructive outcomes in society.Conclusion: The COVID-19 epidemic caused various multifaceted social changes in the Iranian community. Some social consequences were constructive and contributed to community development, while others jeopardized community development goals. Therefore, the paradigm model developed in this study can help policymakers and social planners develop programs to promote community health.

Background: Regarding demographic, socio-economic differences, and some other infrastructural factors, there are concerns about the access to and use of mobile health technology. This study aims to identify the facilitators and barriers to the use of mobile health from the perspective of users.Methods: In this qualitative meta-synthesis, electronic databases were systematically searched. Studies included qualitative investigations published by 30th of December 2020 that examined the facilitators or barriers to using mobile health from the users’ point of view. The Critical Appraisal Skills Program checklist was used to evaluate the quality of each study. A steady comparison process has been used to identify similar structures in several studies that have been summarized in thematic constructs.Results: Six factors were identified as barriers and seven factors as facilitators. Barriers included difficulty in use, inaccessibility, uselessness or inapplicability, lack of adequate skills, communication barriers, and security concerns; facilitating factors included motivational factors, documentation, degree of ease, provider credibility and source of information, perceived usability, social-cultural appropriateness, and perceived benefits.Conclusion: The findings of this study provide a good basis for information and communication technology practitioners as well as health care services to improve access to and use of mobile health technology by adopting appropriate policies for infrastructure development and social empowerment. Further research focusing on technological, demographic, and geriatrics aspects is suggested.

Abstract Background Uncontrolled diabetes is an important public health problem that endangers the quality of life of patients. Promoting self-management through well-planned training is an essential strategy to control diabetes effectively. This study aimed to examine the effects of a training program based on social cognitive theory (SCT) on self-management behavior, glycemic index, and quality of life among patients with type 2 diabetes mellitus. Methods This is a quasi-experimental study with a pretest–posttest design. The statistical population included 106 adults with type 2 diabetes mellitus assigned to the intervention and control groups [n1 = n2 = 53], who received services from two urban health centers. A multi-method, SCT-based training program consisting of six 60–80-min sessions was run, followed by 2–3 follow-up home visits [once a month for each participant] for the intervention group. The data were collected before and three months after the intervention and were analyzed in SPSS 19. Results Before the intervention, there was no significant difference between the two groups regarding the main variables. After the intervention, there was a significant increase in the intervention group's mean scores of knowledge, self-efficacy, social support, outcome expectations, self-regulation, self-management behavior, glycemic index, and quality of life. There were no significant changes in these constructs in the control group after the intervention. The regression analysis results indicated that social cognitive theory and self-management could explain the variance in quality of life [adjusted R-squared = 0.476]. Conclusions The findings support the effectiveness of the multi-method, SCT-based educational intervention in improving self-management behaviors, glycemic index, and quality of life among patients with type 2 diabetes mellitus. It is suggested that the quality of type 2 diabetes care programs should be promoted. However, further research is needed to evaluate the long-term outcomes.

Abstract Introduction Women heads of households (widows or divorcees) are vulnerable groups in society who face various psychological problems and have less resilience than other women. Therefore, the present study was conducted to determine the effectiveness of resilience educational intervention on the psychological capital of poor widows in Fasa city, south Iran. Materials and Methods In this quasi-experimental study, 120 widows covered by Imam Khomeini Relief Foundation were selected by a simple random sampling method based on a random Efron algorithm (Efron coin) and randomly assigned into two interventions and control groups (60 people each) in the second half of 2021. About 8 training sessions on resilience and psychological capital were held for the experimental group through training clips, audio transmissions, and podcasts. Data were collected using demographic characteristics forms, widowers' resilience assessment questionnaires, and Luten's psychological capital scale for testing and control before and two months after the intervention. Data were analyzed with Chi-square test, independent and paired t-test using SPSS V. 26 software. Results There were differences between the two groups at pretest in demographic variables and psychological capital and its subscales, and resilience and its subscales (P ≥ 0.05).. But two months after the educational intervention, a statistically significant increase was observed in the experimental group in these variables compared to the control group (p

Background: Increased proportion of the retired population and the occurrence of retirement syndrome may significantly affect the Quality of life (QoL) and the well-being of older people. Therefore, the present study was conducted to examine the effect of training intervention on retirement syndrome and QoL among retired older men in Safashahr, Iran, in 2019. Methods: Using a randomized block design, the quasi-experimental study was conducted on 140 retired men with retirement syndrome. The subjects’ average age was 61.24±1.36 years. The older people were selected by purposive sampling and then randomly assigned to an experimental group (n=70) and a control group (n=70). The intervention comprised five 90-minute sessions of the practical training course of exercises for over 45 days in the experimental group. The study outcomes, such as retirement syndrome and QoL, were measured before, immediately after, and two months after the intervention. The study data were analyzed using SPSS Statistics 25, independent sample t-tests, Chi-square tests, and repeated measure ANOVA. The significance level was set at 0.05. Results: Based on the average score of retirement syndrome (< 0.001) and its subscales, such as helplessness and failure (HF) (p< 0.001), feeling of old and idle (FOI) (

Background: One of the most challenging aspects of today's technology is mobile social networking which has had a different effect on the health and social life of individuals. The goal of this study was to investigate the relationship between the use of mobile-based social networks and general health. Methods: This analytical and cross-sectional correlation study was done on 295 staff of Bushehr University of Medical Sciences in 2018 -2019. The data was collected using the general health and social networking addiction questionnaires. A random sampling method was used to select the participants. Descriptive statistics, T-test, one-way ANOVA and Pearson correlation coefficient were used for data analysis via the SPSS V. 24 software. Results: Of two hundred ninety-five participants 153 (51.7%) were male and 142 (48.3%) were female. The mean age of the participants was 36.32±6.61years. There is a statistically significant relationship between mean score of social network addiction with demographic characteristics of sex, marital status. There is also a significant relationship between the level of general health and marital status and the amount of daily use of social networking. There is a direct and significant relationship between the amount of use of social networks and general health (P

Objective To assess the impact of family social support (FSS) on postpartum quality of life (PQOL). Methods This analytical cross-sectional study enrolled postpartum women and asked them to complete the PQOL and FSS questionnaire (FSSQ) between October 2021 and February 2022 in three urban health centres in Shiraz, Iran. Pearson correlation coefficient analysis and multiple regression were used to determine the relationship between the FSS and PQOL variables. Structural equation modelling was used to determine the relationship pathways of the impact of FSS on PQOL. Results A total of 240 women were enrolled in the study. The mean ± SD scores of PQOL and FSSQ were 61.63 ± 9.59 and 69.80 ± 11.19, respectively. Family support seeking (7.95) and emotional support seeking (−6.80) were two factors affecting PQOL. Conclusion Women should be empowered to seek support through education and actions from health workers, especially nurses and midwives, during routine regular prenatal care.

Objectives: Older people have a fear of falling, which is far more difficult than falling itself. We measured the extent of this feeling using a short and valid Falls Efficacy Scale-International (FES-I) 7-item questionnaire for the aging community in Iran. Methods: The present psychometric work deals with outlining the validation and translation of FES-I (short version) among 9117 Persian-speaking elderly people with a mean age of 70.2±8.3 years (54.1% female and 45.9% male) in July 2021. Investigations were performed on confirmatory factor analysis, exploratory factor analysis, internal consistency, and construct validity along with test-retest reliability, receiver operating characteristic analysis, inter-rater, and convergent validity. Results: 72.4% of the subjects were living alone, 92.9% required support in activities of daily living , and 93.0% experienced falling in the past two years. A one-factor solution was assigned by exploratory factor analysis for FES-I. Thus, this model was proved by the confirmatory factor analysis with valid fit indices. Based on Cronbach’s alpha, intra-cluster correlation coefficient, and McDonald’s omega (≥ 0.80), internal consistency was confirmed. The exact cut-off value was represented by the receiver operating characteristic analysis for male/female and between with/without fear of falling among older samples with higher measures of specificity and sensitivity. Moreover, a significant effect of age, aging in place, loneliness, hospitalization rate, frailty, and sense of anxiety (effect size ≥ 0.80, p ≤ 0.05) on fear of falls was detected using analysis of variance.Conclusions: The psychometric properties of the original scale were preserved by the Persian version of FES-I seven items as a self-reported measure of fear of falling. It could be assuredly a measure in both community and clinical settings. The possible uses and limitations of the Iranian FES-I were also discussed.

Background: The content of nutrition education and the process of behavioral change should be designed based on the principles of educational for achieving behavioral goals. This systematic study aimed to evaluate the effectiveness of nutrition interventions designed mainly by health educational and promotional theory and models. Methods: The PubMed, Science Direct, Scopus, and Cochrane databases were searched using the following keywords “nutrition behavior” or “food behavior” or “dietary behavior” and “model” or “theory” and “intervention” or “predict” from 2013 up to April 2018 in English Language. Results: Regarding the inclusion criteria, 25 interventional studies were assessed of 3090 primary screened investigations. Social Cognitive Theory, Empowerment model, Theory of Planned Behavior, and Health Belief Model were mostly used in the investigated studies. Most target groups in these studies were school students and women. In the field of constructs, self-efficacy and attitude mainly applied in studies seem to be the most important for researchers. In the field of educational methods, group educational methods in the forms of lectures, group discussions, and brainstorming were mainly applied by researchers. Conclusion: To change eating behaviors, the study framework, duration of training, and correct training method should be designed according to the target group as well as appropriate theory and models

Background: Decreasing and preventing isolation and social loneliness among the elderly are important fields for policymaking and action commitment in social health. Evidence shows that the nature and spectrum of an individual’s social network including the quality and quantity of social relations and contact frequency can affect the old people’s health considerably. Social participation leads to a decrease in mortality and depression and improves people’s cognitive function. Since few interventions on assessment of the effect of social participation on old people’s loneliness have been done, this study was conducted to determine the impact of the educational program of social participation on the feeling of loneliness. Methods: This is a quasi-experimental study based on convenience sampling method, on 239 elderly people aged ≥60 years living in rural regions of Baiza. The intervention was held for the intervention group during five weeks through five 60-80 minute educational sessions. The data were collected by CCHS-SP and UCLA Loneliness Feeling Questionnaires before and after the intervention in the experiment and control groups. The data were analyzed usingSPSS (version19). Results: The significance level was assumed 0.05 in statistical analysis. After one month of educational intervention program, the mean score of social participation increased in the intervention group from 6.17±3.86 to 17.98±3.84 after the intervention. The findings showed a remarkable improvement in loneliness feeling scores of the mentioned group form 62.24±.7.53 to 28.86±6.88 after the intervention (p

BackgroundSchools are ideal for promoting the mental health of school-age children, but the teachers' current knowledge is insufficient to play an influential role in mental health services at schools. Fortunately, however, teachers have a high sense of responsibility, interest, and talent to receive knowledge and the ability to participate in this field. This study aimed to examine whether a protocol focused on the role of teachers could identify, guide, and care for school-age children with behavioral and mental health problems.MethodThe current research was a “before and after” pilot quasi-experimental study conducted in three elementary, secondary, and high schools. The main intervention consisted of a 5-h workshop based on a ready-to-use booklet for teachers conducted separately in each school. A total of 58 teachers and 872 school-age children were included using a judgmental sampling technique.ResultsThe pre-and post-workshop mean scores of teachers' knowledge about common mental disorders in school-age children were 6.21 ± 4.58 and 12.50 ± 7.27, respectively. According to the Strengths and Difficulties Questionnaire (SDQ), the teachers made 127 referrals, of whom 102 school-age children had problems. Consultants diagnosed 114 school children who reflected 90% of all teachers' recommendations needing psychological care and counseling. Finally, only 50 diagnosed school-age children were followed up and attended therapy sessions at counseling centers. The sensitivity and specificity of this brief intervention in detecting school-age children with psychological problems were respectively 80.3 and 98.0%.ConclusionsThis study's results support teacher empowerment training's effectiveness in identifying and guiding school-age children needing mental health care. Psychological counseling programs in schools in various quantitative and qualitative dimensions, including responding to school-age children's needs and psychological problems, should be adequately evaluated, and appropriate measures should be taken to promote mental health services. Collaboration between health systems and the education department will increase the effectiveness of mental health programs' promotion and drug abuse prevention. These pilot data lead the way to designing scientifically sound follow-up studies that will concretely ascertain the benefit of this program.

The aim of this study was to examine the validity and reliability of the Persian version of the Short Form Self-Regulation Questionnaire (SSRQ) among Iranian community-dwelling older adults and to determine its optimal cutoff point. In Shiraz, Iran, a cross-sectional study of 500 older adults ≥ 60 years was conducted in two steps. The forward–backward method was used for translation. Psychometric properties, such as the face and content validity, based on the point of view of experts, construct validity based on exploratory factor analysis (EFA) and confirmatory factor analysis (CFA), convergent validity by assessing the relationship with the Generalized Self-Efficacy Scale (GSE-10), and reliability based on Cronbach’s α were examined. A receiver operating characteristic curve (ROC) was plotted to confirm the cutoff point. Validity of both the face and the content was confirmed. The first stage of construct validity was performed using the kurtosis test and the EFA, and finally, only 20 items in four subscales were loaded with 76.34% of the total variance. The CFA indicated a good fit to the data (root mean square error of approximation (RMSEA) = 0.059; comparative fit index (CFI) = 0.92; and goodness of fit index (GFI) = 0.89). Cronbach’s α coefficient of the SSRQ-20 increased to 0.87. A significant positive correlation was found between the SSRQ-20 and the GSE-10 (r = 0.44), indicating acceptable convergent validity. The optimal cutoff score for differentiating older adults in terms of self-regulation was 71. This study demonstrates that the Persian version of the SSRQ, which contains 20 items, is a valid and reliable tool for assessing self-regulation in Iranian community-dwelling older adults.

Objectives: The increasing trend in aging population raises the need to pay attention to the daily activities of the elderly and their social support as an effective factor in promoting their health. This study aims to investigate the correlation of perceived social support and demographic variables with the Activities of Daily Living (ADL) in older adults living in rural communities in Iran. Methods & Materials: This is a descriptive-analytical study with cross-sectional design conducted on 430 elderly people aged ≥60 years living in a rural community in Iran (Bayza county located 45 km away from Shiraz city) who were selected using a convenience sampling method. Procidano & Heller’s Perceived Social Support - Family Scale (PSS-Fa) and the ADL scale for the elderly were used for data collection. The ADL questionnaire’s internal consistency by calculating Cronbach’s alpha coefficient was obtained 0.96. The PSS-Fa with a Cronbach’s alpha coefficient ranging from 0.88 to 0.91 has acceptable internal consistency. The reliability of its Persian version using Cronbach’s alpha coefficient was obtained 87%. Data were analyzed in SPSS V. 25 software using multivariate ANOVA and regression analysis. Results: The mean±SD age of the participants was 69.67±7.067 years. The mean score of PSS-Fa and the ADL scale was reported 16.55± 5.16 and 55.10±3.07, respectively. Perceived social support, education and age had significant effect correlation with the ability to perform ADL in the elderly (P0.05). The age factor was inversely correlated with the ability to perform ADL; hence, the independence of older adults decreases with the increase of age. Conclusion: Many demographic variables and social support affect the ability to perform ADL in the elderly. Social support can be used as a social investment to improve the quality of life of the elderly. Therefore, considering that one of the duties of health care providers is to improve the health status of the elderly, it is necessary for health care providers to increase social support and maintain and promote a healthy and active life for them through educational programs and periodic physical examinations.

Objective: Caregiving burden is defined as a specific level of pressure and problems expressed by caregiver or family, which involves a range of psychological, emotional, social and economic problems. Further, satisfaction is described as the level of the mental happiness, self-confidence and usefulness sensed by caregiver about his/her own caregiving behaviour. The present study aimed to assess the psychometric properties of the Persian version of caregiving satisfaction (SCR) and caregiving burden of grandchildren scales (BCR) among grandparent population by considering the lack of a Persian tool for their measurement. Method: This cross-sectional, descriptive-analytic study was conducted on 70 grandparents who were selected through convenience sampling among the individuals referred to the healthcare centres of five southern cities in Iran Shiraz, Sepidan, Fasa, Jahrom, and Borazjan from April to August, 2019. The questionnaires were filled out by individual interview with participants and the data were analysed through explanatory and confirmatory factor analyses and ROC curve, using SPSS 25 and Amos 21. Results: Two factors were extracted in each questionnaire (Regarding each questionnaire, happiness and responsibility in individual and social satisfaction in caregiving burden were extracted through explanatory factor analysis), representing 78.1 and 75.1% of total variance, respectively. The Cronbach's coefficients alpha related to these subscales were obtained as 0.709-0.859 by indicating an acceptable internal consistency. Conclusion: The Persian version of these questionnaires had appropriate validity and reliability required for measuring satisfaction and caregiving burden of grandchildren among Iranian grandparents and can be used in day care and healthcare centres.

Introduction: One of the main challenges of Methadone Maintenance treatment (MMT) centers is the patients’ non-adherence to treatment process in tempting situations. This study was conducted to validate the Persian version of one of the valid questionnaires on situational drug use temptation. Methods: A cross‑sectional study was carried out on 150 men referring to MMT centers in Shiraz, Iran, in 2019. Data were collected using a self-administered questionnaire containing demographic data and Persian version of drug use temptation questionnaire with 20 items. The content validity was assessed by 15 psychiatrists and health education and promotion experts based on the Lawshe criteria. The reliability of the questionnaire was determined using Cronbach’s alpha. The construct validity was evaluated by exploratory Principal Component Analysis (PCA) and confirmatory factor analysis. Data were analyzed using SPSS 24 and Amos 24. Results: Overall, 141 individuals completed the questionnaire (response rate: 94%). The mean and standard deviation of the participants' age were 37±7. The Kaiser–Meyer–Olkin test of sampling was adequate (KMO 0.913) and the Bartlett test of sphericity was significant (Chi-square 1847.65; p= 0.001). Four factors were extracted and two items were not included in any of the factors. Goodness of fit indices of structural equation model, i.e. Chi2, Chi2/df, and RMSEA were ​​ 158.504, 1.22 and 0.04, respectively, which indicated the acceptable fitness of the model. Conclusion: The Persian version of the questionnaire of temptation to use drugs is suitable for use among the Iranian population.

Introduction: Promoting self-care practice, as a critical strategy for enhancing the quality of life in patients with Multiple Sclerosis (MS) is a challenging issue. This study aimed to propose a model of health-promoting self-care behaviors in MS patients. Methods: In this cross-sectional study, 200 patients with MS, who had referred to the Hospital for Special Diseases in Kerman City, Iran, were chosen. The main data collection instruments were the multiple sclerosis knowledge questionnaire, the Rosenberg self-esteem scale, multiple sclerosis self-efficacy scale, questionnaire of perceived barriers and benefits of self-care behaviors, social support, the health promotion lifestyle profile II, and resilience and sense of coherence scale. Data analysis was conducted in SPSS V. 22 and AMOS18 software. The Structural Equation Modeling (SEM) was also used for further analysis of data Results: The model explained 82% of variance in Health-Promoting self-care Behavior (HPB). The results of the final model obtained from the SEM showed that self-efficacy (β=0.53, SE=0.04, P= 0.007), self-esteem (β=0.39, SE=0.04, P=0.005), social support (β=0.36, SE=0.04, P=0.009), sense of coherence (β=0.34, SE=0.07, P=0.006), resilience (β=0.33, SE=0.07, P=0.018), and perceived benefits (β=0.25, SE=0.05, P=0.009) had a positive and significant relationship with HPB. Conclusion: The self-care empowerment model in patients with MS presented in this study can be used as a framework for designing health promotion interventions to improve the quality of life of patients with MS.

Background: The evidence suggests nutrition style as a key determinant of health. On the other hand, nutrition literacy is a key determinant of nutrition decisions and behaviors. This study aimed to develop and validate an inventory in order to predict nutrition literacy promoting behavior based on the theory of planned behavior (TPB) in the youth. Methods: In this cross-sectional study, 203 students (100 females and 103 males) were selected using the randomized cluster method from dormitories in Shiraz University of Medical Sciences. They were supposed to complete Nutrition Literacy Promoting Behavior based on TPB (TPB-NLPB) questionnaire. The tool was developed using relevant scientific literature and its validity was confirmed by the experts’ panel (n = 6). The instrument includes four subscales: attitude toward behavior, subjective norm, perceived behavioral control, and behavioral intention. The reliability and validity of the instrument were assessed by exploratory and confirmatory factor analysis and Cronbach’s alpha coefficient. Results: The coefficients of Cronbach’s alpha (α = 0.87), Guttmann method (λ1 = 0.84 to λ6 = 0.91), and convergent validity (0.74) were estimated (P < 0.01). The exploratory factor analysis demonstrated five factors, which clarified 64.91% of the scale’s variance. Second-order confirmatory factor analysis pointed out that the factor was well matched up onto the principal factor. Consequently, the five-factor model was appropriate for the data using fit index techniques for adjusting the scale. Conclusions: The results confirmed the well-adjusted reliability and psychometric properties of the TPB-NLPB and its usefulness for the relevant studies.

Background. The World Health Organization (WHO) has considered type 2 diabetes mellitus (T2DM) a major global health challenge because of its high prevalence worldwide. T2DM can affect patients’ personal, social, and economic statuses. On the other hand, due to the increasing prevalence of T2DM, Quality of Life (QOL) has received more attention in recent years. Objective. The present study was conducted to investigate the relationships between QOL and physical activity level, body mass index, fasting blood sugar, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, triglyceride, total cholesterol, HbA1c, and systolic and diastolic blood pressure among Iranian patients with uncomplicated T2DM. Methods. This cross-sectional study was conducted on 135 participants selected through consecutive sampling. The study data were collected using International Physical Activity Questionnaire and Short-Form Health Survey Questionnaire. Then, the data were entered into the SPSS ver. 28 software, and Pearson’s correlation was used to measure the correlation between the variables. Linear regression was also employed. The significance level was set at 0.05. Results. The significant association was observed between gender (p=0.007), HDL level (p=0.02), and gender-adjusted physical activity (p=0.002) with QOL. Conclusions. Due to the association between physical activity and HDL level with QOL in patients with uncomplicated T2DM, they should be given the necessary training to improve their physical activity and regulate HDL level. Also, empowering them in this matter improves their QOL.

Background. Providing better care and encouraging behaviors promoting health are effective measures to manage breast cancer patients. The present research was conducted to carry out an intervention based on the PHE model to promote physical activity, distress management, social support, and quality of life in breast cancer patients. Methods. This randomized control trial study was conducted on 123 women with breast cancer and their caregivers (group 1=61 and group 2=62). Subjects entered the study from the oncology ward of a specialized clinic in Shiraz, Iran. The education was done through clips, pamphlets, and lectures in 8 sessions with a duration of 15 to 25 minutes. A posttest was carried out in the both groups in 2 times (the end and 3 months) after intervention. The SPSS25 software was used to analyze the data. Results. The mean and SD of age of group 1 were (45.77±8.84) and control group 2 (45.58±77.64). The fiding showed a significant difference between the mean scores of distress management, social support, physical activity, and cancer self-efficacy in group 1 vs. group 2 after intervention (P

Background and Objective: The current evidences have indicated that the prevalence of smoking cigarette and waterpipe has an ascending trend among the university students since their first year of study. The present study aimed to evaluation of explanation of the BASNEF model on smoking waterpipe among the university students. Materials and Methods: This cross-sectional study was conducted on 462 students selected by proportional stratified random sampling. The study data were collected using demographic questionnaire and researcher-made questionnaire based on the “BASNEF” model. The collected data were then entered into the SPSS statistical software (v. 19) and analyzed using descriptive statistics, Pearsons correlation coefficient and Regression analysis. Results: The prevalence rates of smoking cigarette and waterpipe were 11.7% and 16.6%, respectively. The results showed no significant difference in using cigarette or waterpipe by gender(p

Introduction: The role of fathers in adolescents’ health is regarded as less important than mothers. This necessitates considering their role more than before. The present study was conducted to investigate the associations between high school students’ demographic profile and their general health with the fatherhood characteristics of their fathers. Methods: This descriptive-analytical and cross-sectional investigation was conducted among 604 girl and boy students in 2015 in Shiraz (Iran). The data collection tools included two self-administered questionnaires and a General Health Questionnaire (GHQ). Two self-administered questionnaires consisted of 5 demographic and 16 fatherhood characteristics questions. They were selected through a simple random sampling method, and the data were analyzed by Pearson correlation and descriptive statistics. The significance level was considered as 5%. Results: The findings showed that 495 students (46.90% girls and 53.10 boys) participated in the present study. They also demonstrated that 382 students were between 15-17 years old (79.20%) and 113 of them (20.80) aged about 18-19. There was significant associations between the mean scores of students general health and some of their fatherhood characteristics (P value=0.01). Some of their demographic information was also correlated to their general health significantly. The mean scores of fatherhood characteristics and students’ general health were, in turn, 38.56 (SD=14.6) and 44.99 (SD=9.69). Conclusion: This study demonstrated the role of fathers in their offspring’s health status. It makes it necessary to educate fathers and reinforce their capabilities to promote their children’s health.

Background: Despite the key role of nutrition literacy and behavior in health, evidence suggests a low adherence to healthy nutritional behaviors. We sought to determine the influence of a group-based interactive training program on nutrition-related literacy, knowledge and behavior of students. Methods: Two-hundred and three undergraduate students were enrolled by multi-stage cluster sampling and were randomly divided into two groups of intervention (n=106) and control (n=97). Four questionnaires measured the demographic variables, nutrition-related literacy, knowledge, and behavior. The educational intervention was performed as workshop using a new educational style. Results: There was no significant difference between the two groups regarding demographic variables. After educational intervention, a significant increase was found in the mean scores of nutrition literacy from 22.20±3.85 to 31.95±2.19, nutrition knowledge from 54.23±1.80 to 77.06±7.20, and nutritional behavior from 52.32±16.54 to 67.52±19.69 (p

Background: Nutrition literacy is a key determinant of nutrition decision and behavior. This study investigated the psychometric properties of the Persian version of Nutrition Literacy Inventory (NLI-28) among university students. Methods: In a cross-sectional study, 203 students (101 women and 102 men) were enrolled through a randomized cluster sampling method from the four dormitories of Shiraz University of Medical Sciences. The instrument was prepared through a translation and back-translation process and it was used as a self-administered inventory. The NLI-28 included three subscales i.e. functional nutrition literacy, interactive nutrition literacy, and critical nutrition literacy. The reliability and validity of the instrument were assessed by using exploratory and confirmatory factor analysis (CFA) and Cronbach’s alpha coefficient. Results: Mean of content validity ratio (CVR) for essential criterion, means of content validity index (CVI) for simply criterion, clarity criterion, and relevance criterion were obtained as 0.89, 0.9, 0.96, and 0.98, respectively. The coefficients of Cronbach’s alpha (α=0.87), convergent validity (0.74), divergent validity (-0.11), and criterion validity (0.73) were estimated (p

Introduction: Social participation is considered one dimension and also determinant of quality of life. The level of social participation of the elderly is influenced by various components such as socio-economic and demographic factors. The present study aimed to assess the relationship between social participation, quality of life, and some socio-economic factors in community dwelling elderly in Kerman, Iran. Methods: This cross-sectional study was conducted on 250 communities dwelling old people in Kerman in 2017 selected through random sampling. The data were collected using researcher-made Social Participation questionnaire and WHOQOL-BREF questionnaires. The data were analyzed using Pearson’s correlation coefficient, t-test, one-way ANOVA, and linear regression analysis. Results: The results revealed the participants’ mean score of social participation was above fifty. Social participation was significantly associated with age (p < 0.001), marital status (p = 0.004), education level (p < 0.001), and occupation (p = 0.021). A significant direct correlation was also observed between social participation and quality of life (p < 0.001), and social participation determined 21 % of variance of life quality score (p < 0.001). Conclusion: With the increase in social participation of the elderly, their quality of life improves. Establishing nongovernmental organizations, charities, and associations for retirement and aging can increase the level of social participation of the elderly.

Objective: Since prisoners may acquire AIDS and transmit HIV because of highly risky behaviors, implementation of educational and therapeutic programs is important in decreasing the prevalence of AIDS and transmission of HIV. This study was conducted to recognize different types of interventions and compare their effectiveness regarding prevention of AIDS and its control in prisons. Methods: The ISI, PubMed, Google Scholar, databases were searched with use of “AIDS,” “prison,” “HIV,” and “incarceration” as keywords from January 2000 to March 2017, with access to free full text and English language as limitations. Related articles, including observational, epidemiological, case, and interventional studies, were extracted and those inconsistent with the study’s goals were excluded. Results: Forty-three studies were finally selected. The effectiveness of interventions related to AIDS prevention and control in prisons was studied. Conclusion: It seems that theory-based studies conducted with stakeholders participation and evaluated summatively are more successful, because they give a sense of ownership. In addition, considering prison as a setting can lead to more success of these programs.

This systematic review aimed to investigate the types and characteristics of effective interventions when improving the independence of the elderly during activities of daily living. After developing a search strategy, the various databases, including PubMed, Scopus, Cochrane Library, Science Direct, Proquest, and Embase, were searched up to October 16, 2019. The Review Manager 5.1 software was used to determine the risk of bias. The randomized clinical trials were reviewed to find if their interventions' main goal was to improve the elderly's independence in activities of daily living. Data were extracted independently by two authors. Eight randomized controlled trials were included in the final analysis. Three types of interventions were identified and categorized as cognitive training, physical exercises, and multicomponent interventions. All reviewed studies provided evidence of the effectiveness of interventions in improving older people's ability to perform the activities of daily living. However, the lack of uniform measurement indicators to identify and compare the most effective interventions forced us to develop a conceptual framework for designing future interventional research. This conceptual framework included designing tailored interventions, creating an age-friendly environment as well as financial, psychological, and social support. The proposed conceptual framework can also help develop future systematic reviews focusing on a particular intervention type.

Introduction: End-stage renal disease (ESRD) is an advanced stage of chronic kidney disease requiring hemodialysis (HD). The long-term efficacy of HD in ESRD patients highly depends on treatment adherence. Objectives: This study aimed to validate the health action process approach (HAPA) questionnaire to predict treatment adherence in HD patients. Patients and Methods: This cross-sectional study was conducted in teaching hospitals in Shiraz during 2018. A total of 220 patients with ESRD under HD were selected using convenience sampling method. Furthermore, the validity, clarity, and comprehensiveness of the questionnaire were validated by a group of patients and experts. Then the exploratory factor analysis (EFA) was performed, and the reliability was determined using Cronbach’s alpha. Internal consistency was assessed using test-retest method (one-month interval) and calculating intra-class correlation coefficient (ICC) index. Results: Content validity index (CVI) and content validity ratio (CVR) were obtained 0.98 and 0.95 respectively indicating adequate content validity. Six constructs (risk perception, action self-efficacy, behavioral intention, planning, maintenance self-efficacy and recovery self-efficacy) were extracted using EFA. These constructs explained 51.4% of total variance. The Cronbach’s alpha of different constructs ranged from 0.68 to 0.82. Furthermore, the ICC ranged from 0.67 to 0.78 indicating an acceptable internal consistency. Conclusion: The HAPA questionnaire is a valid and reliable tool for assessing treatment adherence in HD patients. Further studies are recommended on larger sample sizes and other Iranian populations.

Background and objective: Physical activity is an important behavior to reduce the risk of non-communicable diseases. Providing the context for physical activity in the workplace in addition to promoting the employees' physical and mental health has significant economic benefits for organizations. We conducted the present study using a social marketing model to explain the determinants of a Workplace Health Promotion in promoting physical activity among employees of government organizations in Yasuj, Iran.Materials and methods: The present study was qualitative research with directed content analysis based on the social marketing model. Thirty-three employees of government organizations in Yasuj were included in the study using the purposive sampling method. The data collection method included semi-structured interviews and observation. Data analysis was performed manually and by the qualitative content analysis method. The implementation data were systematically sorted and analyzed and classified into five steps.Results: Organizational structure, organizational policies, and a supportive interpersonal climate were extracted and categorized as characteristics of workplace health promotion programs from participant interviews. In addition to participants' emphasis on receiving information from reputable sources, virtual communication networks such as WhatsApp and real communication networks such as physicians and specialists were their preferred media for education and information.Conclusion: Due to the complexity of workplace, diversity, and multiplicity of factors and determinants of physical activity, the findings of the present study will be a basis for designing an appropriate and effective intervention and organizational changes to promote physical activities among employees in the future.

Purpose. Due to the use of different methodologies, tools, and measurements, the positive or negative impact of Internet use on human life quality is accompanied by a series of ambiguities and uncertainties. Therefore, in this study, a systematic review and meta-analysis are conducted regarding the effect of Internet addiction on the quality of life. Methods. A systematic search of resources was conducted to investigate the effect of Internet addiction on the quality of life. The databases of PubMed, Cochrane Library, Scopus, Web of Science, Embase, and Science Direct were searched from January 1980 to July 2020. The articles were screened by two researchers in multiple levels in terms of the title, abstract, and full-text; then, final studies that met the inclusion criteria were retrieved and included in the study. Results. After searching the previously mentioned international databases, 3863 papers were found, 18 of which we included in the final analysis. Surveys indicated that people who had a high Internet addiction received lower scores of quality of life than those who were normal Internet users (OR = 2.45, 95% CI; 2.31–2.61, p

Background. Despite the availability of various guidelines, rules, and strategies, hand hygiene adherence rates among healthcare workers are reported significantly lower than expected. The aim of this meta-analysis is to determine the most effective interventions to improve hand hygiene and to develop a logic model based on the characteristics of the most effective interventions. Methods. A literature search was conducted on PubMed, ProQuest, Web of Knowledge, Scopus, Cochrane Library, and ScienceDirect databases up to December 21, 2019, with no time limit. Randomized clinical trials which had designed interventions to improve hand hygiene were reviewed. Data were extracted independently by two authors. All statistical analyses were performed using Comprehensive Meta-Analysis (CMA) software (version 2.0). A random-effects model was used to estimate odds ratios. Results. Although 14 studies were initially reviewed, only 12 studies entered the meta-analysis, since they had identified percentage rates of hand hygiene compliance. The most effective intervention (odds ratio 18.4, 95% CI (13.6–24.8)) was a multilevel strategy that influenced the determinants of hand hygiene behavior at individual, interpersonal, and organizational levels. Following this, a theory-driven logic model was mapped out to promote hand hygiene, based on situational analysis. Conclusion. This study suggests that designing integrated interventions based on a multilevel socioecological approach has the greatest potential to improve hand hygiene compliance in healthcare workers. The logical model proposed in this study can thus provide a useful guide for designing and conducting future experimental research.