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In Afghanistan, adolescents and young people are the most important at risk groups for substance abuse. Considering the importance of model-based interventions in this group, this study aims to design and validate a questionnaire based on the Health Belief Model (HBM) for assessing the beliefs of Afghan students regarding substance abuse prevention behavior. This study was conducted in two stages. In the first stage, the items of the questionnaire were designed by conducting a combined documentary literature review and qualitative study. In the next step, its psychometric properties were evaluated through qualitative and quantitative face and content validity (CVR & CVR) and structural validity (exploratory factor analysis). Finally, internal consisitency through Cronbach’s alpha as well as reliability was assessed. To above steps, the SPSS version 18 was applied. 57 items were obtained for the questionnaire by performing a qualitative study and using existing scientific sources for literature review. In checking the face validity of the questionnaire items quantitatively (calculating the impact score), the impact score of all items was above 1.5. The CVR of each item was more than 0.8 and their CVI was more than 0.79. In EFA (using the information of 408 students with average age of 23 years old), the final model was confirmed with 38 related to the main HBM constructs in 5 factors, which covered about 40% of the variance. Acceptable values of Cronbach's alpha between 0.71 and 0.81 for all factors confirmed the reliability of the questionnaire. The HBM-SAPQA obtained the acceptable validity/reliability to apply the beliefs of Afghan students regarding substance abuse preventive behavior.

Background: One of the most prevalent musculoskeletal diseases (MSDs) is knee osteoarthritis (KO), which results in patients experiencing significant pain, decreased function and range of motion, lower income, decreased social contact, and ultimately diminished quality of life. This study sought to evaluate the risk factors for knee osteoarthritis in women between the ages of 40 and 55 because several studies have shown that KO is frequent among these females. Methods: One hundred of the 198 individual who were randomly chosen for this descriptive-analytical study were eligible and included because they met the inclusion criteria. The amount of protective behavior was assessed using a 38-item self-design checklist. Knee function and pain intensity were assessed using the Western Ontario and McMaster Universities Arthritis Index (WOMAC) and the visual analog scale (VAS). In addition, a muscle strength assessment and a self-efficacy questionnaire were applied. Using SPSS version 24, analytical tests were run on the collected data. Results: This study showed there is a significant relationship between knee osteoarthritis and various factors such as age, body mass index, educational status, other diseases (blood pressure and diabetes), muscle strength, daily housewives’ performance, knee-protective behaviors, and self-efficacy in the field of knee-protective behaviors (P < 0.05 in all instances). Conclusion: Providing educational and training programs for women to prevent knee osteoarthritis is highly advised since, as this study's findings showed, the majority of risk factors linked to knee discomfort from osteoarthritis can be managed.

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

Background Chronic musculoskeletal problems are a major source of disability, reduced productivity and poor quality of life. Prevalence of musculoskeletal disorders among Iranian housewives is particularly high. Understanding how housework causes the injuries, mobility restrictions and pain associated with musculoskeletal disorders is vital to developing health promotion behavior models to support intervention. The aim of this qualitative study was to explore the experiences of housewives with musculoskeletal disorders and, according to the risk factors identified, to develop a comprehensive behavior change framework to facilitate implementing a musculoskeletal health-promoting training intervention for women. Methods Twenty-four in-depth interviews were conducted with Iranian housewives aged 20–65 years experiencing musculoskeletal pain over a 13-month period from September 2020 to October 2021. The conventional content analysis approach was used to interrogate the data. The transcript of each interview was considered a unit of analysis, and data analysis was performed using MAXQDA2018 software. Results The analysis of the interview data provided 1432 meaning units. From these codes, a conceptual framework was developed. This comprehensive model is comprised of 24 subcategories, eight categories and three themes: Individual and social predictors of MSDs and their control, Risk factors for MSDs, and Prevention and treatment of MSDs. Altogether the developed conceptual framework specified the multiple risk factors for MSDs in housewives. The findings were aligned to various health promotion models, and it was seen that ecological models, especially the Theory of Triadic Influence, can be very helpful as a supportive roadmap to implementing multilateral interventions to improve the quality of life of housewives. Conclusions This study developed an evidence based comprehensive model that identifies the individual, psychosocial, and cultural factors that influence the status of MSDs in women’s domestic work to support the development and implementation of effective ergonomic interventions to manage potentials for MSDs.

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

Objective (s): Neck pain is one of the most common musculoskeletal disorders associated with work that leads to important social and economic consequences such as reduced productivity due to absenteeism, early leave and retirement, missed working days, financial loss. Due to medical expenses and poor work ethic due to discomfort when working in the workforce, especially teachers. The aim of this study was to identify and explain the causes of occupational neck pain and promote preventive behaviors based on the health belief model in teachers. Methods: The was a qualitative study using the directed content analysis approach by telephone interviews with 25 high school teachers working Tehran, Iran, in 2020. Teachers were selected based on simple random sampling. Interview questions were designed based on the constructs of the health belief model and the information was analyzed using MAXQDA software. Results: Based on the health belief model the following factors including awareness, sensitivity and perceived severity, perceived benefits and barriers, cues to action and self-efficacy emerged as effective factors causing occupational neck pain in teachers. Conclusion: Teachers expressed a number of reasons for neck pain experiencing. Due to the important role of teachers in educating children, adolescents and young people, their health should be considered a priority.

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

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

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

Background Musculoskeletal pain (MP) has today intensified in a large proportion of music students in Iran. Poor posture while playing an instrument is thus assumed as a very significant risk factor affecting such a condition in this population. The present study aims to evaluate the impact of electronic learning (e-learning) for postural education to music students on posture behavior and MP (abbreviated as an El-Poems study). Methods This study is a matched-pair, two-arm, parallel randomized controlled trial (RCT). The participants, as the 7th-to-12th-grade music students, will be accordingly assigned to intervention (n = 204) and control (n = 204) groups, based on the inclusion and exclusion criteria. The postural education will be also presented through the web-based Student Education Network (with the acronym, SHAD) at the Tehran Conservatory of Music, Tehran, Iran. The intervention program consists of four sessions, using the Integrated Change (I-Change) model. It will be also implemented by a trained physical education instructor and a health educator. The content of the program includes raising awareness, building motivation, and developing skills. Besides, its components are comprised of specific proper postures viz. standing, sitting, lifting, carrying, and hand position while playing a musical instrument. The primary outcome is the MP that will be assessed by the Nordic Body Map (NBM) questionnaire and a numerical rating scale (NRS), and the secondary outcome is the posture behavior that will be evaluated objectively, using the Rapid Entire Body Assessment (REBA) tool. The data will be also collected at baseline and after a six-month follow-up. Conclusion This RCT is an innovative study as a pioneer to represent the first attempt for web-based postural education as well as an attractive intervention to prevent MP in Iranian music students. Trial registration Current Controlled Trials IRCT20180528039885N2. Prospectively registered on 11 September 2021

Objective (s): Low back pain is a common disorder of spine. One of the most important concerns is the increasing rate of low back pain in schoolchildren that might predict adult disability. The purpose of this study was to explain the structural relationship between low back pain and spine-related behavior among pupils via structural equation modeling based on social cognitive theory (SCT). The hypothesized model included skills, knowledge of spine care principals, self-efficacy, and expectation beliefs as independent variables, and spine-related behavior as a dependent variable. Methods: We collected data from 204 students attending public elementary schools using a structured questionnaire in Tehran, Iran from October 2018 to March 2019. The hypothesized model was examined via a structural equation modeling (SEM) analysis using SPSS, version 24.0, and LISREL, version 8.80. Results: The effect of skills, knowledge, self-efficacy and beliefs on spine-related behavior was 0.73 (t-value=13.09), 0.42 (t-value=6.71), 0.87 (t-value=16.67), and 0.55 (t-value=4.95) respectively. In addition, various indicators, such as Comparative Fit Index (CFI), Normed Fit Index (NFI), χ2/df, and Root Mean Squared Error of Approximation (RMSEA) showed the good fitness of the models. Conclusion: The results revealed that the pupils who had more confident, skills, expectation beliefs, and knowledge were more likely to perform proper spine-related behavior. In this regard, school-based low back pain prevention interventions should be addressed using key cognitive factors that consider the potential change strategies.

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

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

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

For downloading the full-text of this article please click here. Background and Objective: Spirituality in job is a new topic but with a limited theoretical-scientific development in organizational literature. The importance of this issue and its impact on work efficiency call for a proper instrument for evaluation purposes. Longevity and incomprehensiveness of some of the questionnaires motivated the authors to provide an Intercultural Translation and psychometric analysis of the standard comprehensive instrument of Spirituality at Work. Methods: In this cross-sectional descriptive study, English version of Spirituality at Work scale, adopted from Val Kinjersk’s study, was used as the main instrument. An attempt was made to complete English-to-Persian translation as well as to provide cultural conformities using the Wild pattern and recursive translation method and retranslation phases, respectively. Afterwards, face validity was performed based on 10 experts’ views and 18 accessible samples and then reliability and validity of the questionnaire were examined and internal correlation was determined in a cross-sectional study on 393 health workers. Construct validity was assessed with a sample size of 268 people through factor analysis. In this study, all the ethical considerations have been observed and no conflict of interest was reported by the authors. Results: To determine construct validity, principal components analysis was performed using Varimax rotation method, in which 70.31% of total variance was explained by two factors. Its face validity was also desirable. In assessing the questionnaire’s reliability using internal consistency method, Cronbach’s alpha coefficient was found to be 96%, which ranged from 78% to 91% for the subscales. There was a high correlation among subscales of this questionnaire (0/82-0/97). Conclusion: The questionnaire had good consistency and the high correlation between the subscales is indicative of a god cultural consistency in translation of the questionnaire. The questionnaire of Spirituality at Work, which aimed at assessing the experience of spirituality in job based on individuals’ experience of spirituality and workplace morale has proper construct validity and face validity.For downloading the full-text of this article please click here. Please cite this article as: Shojaei S, Tavafian SS, Wagner J, Jamshidi AR, Mohammadi-Valadani A. An Intercultural Translation and Psychometric Analysis of 18-item Spirituality at Work Questionnaire. Pizhūhish dar dīn va salāmat. 2020; 5(4): 114-126. https://doi.org/10.22037/jrrh.v5i4.22349

Background:Situational influences can facilitate or impede stretching exercise behaviours. However, since there is no measurement to assess situational influences among office employees, it might be difficult to understand the role of situational influences on stretching exercises. The current study aimed to evaluate the psychometric characteristics of Short Form of Situational influences Scale for predicting Stretching Exercise among office employers based on the Health Promotion Model (HPM). Method: By multistage cluster sampling method, this cross-sectional study was conducted among 385 office employees selected from the health networks at Shahid Beheshti University of Medical Sciences of Iran (SBUMS) who were assessed through the Short Form of Situational influences Scale. Exploratory factor analysis (EFA), confirmatory factor analysis (CFA), and Cronbach’s alpha were employed. Results: The mean age of the office employees was 39.4±7.76 years. Content Validity Index (CVI) and Content Validity Ratio (CVR) of each question were greater than 0.79. The result of EFA with principal component analysis showed one factor (Situational influences) with 43.6% cumulative variance and KMO with 90.4% (P < 0.001). This was a good fit index in CFA. The reliability of the questionnaire was confirmed through acceptable Cronbach’s alpha (α = 0.79). Regarding CFA, the result showed REMSEA = 0.048, GFI = 0.978, AGFI = 0.986 confirmed with Cronbach’s alpha (α = 79 %) and ICC =0.71 95% CI (0.69, 0.79). Conclusion: The current study revealed that the Short Form of Situational influences Scale for Stretching Exercise is a valid instrument. Therefore, it can be used as a reliable and valid instrument to investigate Stretching Exercise behaviours among office employers.

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

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

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

BackgroundA variety of household chores expose women to a variety of biomechanical and psychosocial risk factors. A result of this is many housewives with musculoskeletal disorders. Given the interactive effects of these risk factors, it is necessary to consider multiple strategies to mitigate their effects. Accordingly, the present study will investigate the impact of a health promotion training program based on a participatory ergonomic approach towards a reduction in the prevalence of musculoskeletal disorders and an improvement in the quality of life of housewives.MethodsIranian housewives aged 20–65 years currently attending a specialist health clinic due to a painful musculoskeletal complaint will be invited to join the study. Recruitment will continue until a sample of 160 women provides informed consent to participate. The study will be conducted using a mixed-methods protocol in two phases. In the first phase, psychosocial and biomechanical risk factors will be identified using a qualitative approach. In the next phase, the results from the qualitative approach will be used to develop a conceptual framework based on health promotion theories and an intervention program based on a participatory ergonomic approach designed. Participants will be randomly allocated into one of four groups: (1) biomechanical intervention group, (2) psychosocial intervention group, (3) multidisciplinary intervention group (both biomechanical and psychosocial intervention), and (4) a control group. Data will be collected using Rapid Entire Body Assessment (REBA), Visual Analog Scale (VAS), Work Ability Score (WAS), Hospital Anxiety and Depression Scale (HADS), and the 36-item Short-Form health survey (SF-36) at baseline in 3-month and 6-month follow-up assessments. The impact of the three interventions on musculoskeletal disorders, work ability, stress, and quality of life will then be evaluated.DiscussionThe study will provide a practical approach to reducing stress, reducing musculoskeletal disorders, enhancing the ability to work, and improving the quality of life of women with musculoskeletal disorders associated with housework. If the designed interventions in the present study are effective, they will have the great practical potential for generalization to all housewives.Trial registrationClinicalTrials.govIRCT20200602047640N. Registered on 07 September 2020 with the IRCTID.

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

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

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

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

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

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

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

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

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

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

An amendment to this paper has been published and can be accessed via the original article.

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

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

Background Children’s health and welfare have a special place in research and policy in many countries. One of the most important concerns is the increasing rate of backache in children due to many of behavioral risk factors. The aim of this study was to evaluate the effectiveness of an educational program on promoting back-related behavior as well as knowledge, skills, beliefs, and self-efficacy among fifth grade girls. Methods The theory-based back care (T-Bak) study was a school-based randomised controlled trial (RCT) that assessed the effectiveness of developing a back care training program based on the social cognitive theory (SCT). A total of 104 schoolchildren aged 11 ± 1.0 years were assigned to intervention (n = 52) and control (n = 52) groups. The intervention group received six sessions training on proper lifting and carrying techniques, having proper posture during daily activities, and correct backpack wearing techniques with a 1-week interval while the control group received nothing. Then, the two groups were assessed for knowledge, skills, self-efficacy, beliefs, and behavior at four points in time: baseline, immediate, three and six-months post-intervention. The changes of the outcomes investigated using univariate repeated measures analysis of variance. Partial eta squared measure (ηp2) was used to calculate effect sizes. Results A positive change was found for the intervention group back-related behavior from baseline to immediate post-intervention and follow-ups (F = 78.865, p p2 = 0.22). Overall there were 36.4% improvement for knowledge (ηp2 = 0.21), 53.2% for the skills (ηp2 = 0.25), 19.5% for the self-efficacy (ηp2 = 0.11), and 25.6% for the beliefs (ηp2 = 0.14) scores from baseline to 6 months’ follow-up assessments among the intervention group (p Conclusion The T-Bak intervention was effective in improving back-related behavior in pupils. It is now available and could be evaluated further in back-care related studies. Trial registration Current Controlled Trials IRCT20180528039885N1, 30th Oct 2018, ‘Prospectively registered’. https://www.irct.ir/trial/31534

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

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

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

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

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

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

Compliance with preventive behaviors is essential to control hypertension among suffered patients. This study aimed to assess the effect of a designed educational program on nutrition behaviors among patients with primary hypertension referring to the hospitals in Qazvin, Iran. In this study, a number of 68 eligible patients suffering from primary hypertension was recruited from an intervention hospital (N=34) and a control hospital (N=34). Before the intervention, data on demographic characteristics and main variables including knowledge, attitudes, self-efficacy, and behaviors of the participants were gathered through the questionnaires. Then, the intervention group was provided by the educational program. The same data were collected 4 weeks after the intervention. The mean age was 53.59±7.33 for the intervention group and 52.15±8.68 for the control group. The two groups were equal in terms of all demographic and main variables except for attitude before the intervention. The results showed all variables such as knowledge, attitude, self-efficacy, and behavior were improved in the intervention group compared to the control group. In conclusion, this study verified the educational program could improve knowledge, attitudes, self-efficacy as well as behaviors regarding nutrition behaviors among patients suffering from hypertension.

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

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