The effect of intervention programs on road traffic injury prevention among adolescents and young people: a systematic review

Road traffic injuries (RTIs) are a significant cause of death and disability among young people worldwide. Programs that use injury prevention strategies have been shown to effectively reduce the number of injuries. This systematic review aims to present the available evidence on the effectiveness of intervention programs in preventing RTIs among adolescents and young adults. Articles were identified and retrieved from databases including PubMed, Embase, Web of Science, Scopus, Science Direct, Magiran, SID, and Iran Medex. Two reviewers independently screened the articles. Articles published from the first year of publication until January 2018 that met the eligibility criteria were included in the review. These articles covered randomized controlled trials, pretest/post-test interventions, and controlled pretest/post-test interventions aimed at reducing RTIs among adolescents and young people aged 12-26 years. The framework, provided by Murphy and Haddon, were used to categorize the interventions. According to this framework, the interventions were categorized into five groups including education/behavior change, incentive, engineering/technology, legislation/enforcement, and multifaceted programs. The methodological quality of the studies was assessed using the Effective Public Health Practice Project. Of the initial 3165 findings, 13 studies met the inclusion criteria. Eleven of these studies used educational/behavioral approaches, while two employed multifaceted programs. In the educational/behavioral approach, participants' behaviors were considered as outcome variables. Only one of these studies was not successful. Multifaceted interventions were successful in changing behaviors. No studies were found on the effectiveness of other interventions. Eight studies were assessed as having moderate quality. The systematic review shows that educational/behavioral strategies and multifaceted programs are effective in reducing RTIs among young adults and adolescents. However, there is a lack of studies on other potential interventions. The quality of the included studies was moderate, suggesting a need for more rigorous research.

Evaluation of a web-based randomized controlled trial educational intervention based on media literacy on preventing substance abuse among college students, applying the integrated social marketing approach: a study protocol

BACKGROUND

Substance abuse is the actual psychosocial harm, especially in young people confronted with content marketing in nowadays media environment, a risk factor for experiencing substance abuse. Based on the literature review, education designed based on the cognitive-behavioral model and planning models, such as using a social marketing framework, is the most effective method to prevent addictive substance abuse. Also, media literacy related to substance abuse and the prototype willingness model is considered a new integrated approach to present the intervention measures' desired results.

METHODS

The present study evaluates an intervention program based on media literacy on substance abuse prevention among students using an integrated social marketing approach. This study aims to complete the SMART model's sixth and seventh stages, implementing intervention and evaluation. Participants will be students of Hamadan University, Iran. Randomization will occur at the university and school levels, and gathered data will appear at two-time (i.e., pre-test and three months follow-up). Intervention group students will obtain both substance abuse prevention education and substance abuse media literacy (SAML) education between pre-test and 3 months post-test. Students in the delayed intervention will be given this education after study accomplishment; this group will receive their regular courses except for substance abuse prevention and media literacy titles during education intervention. The outcome variables are intentions and substance abuse behavior based on prototype willingness and substance abuse media literacy.

DISCUSSION

Evaluation of Substance abuse prevention and substance abuse media literacy education must be careful to ensure that they effectively enable people, especially in youth in the new media ecology and unique "Infomedia" ecosystems, in the current digital society. The SAML education plan's evaluation has the first web-based education program in universities. No prior research has psychometrically considered SAML in students in the SMART model's sixth and seventh stages.

TRIAL REGISTRATION

IRCT20200914048719N1 . Registered on June 30, 2021.

Factors Associated With Anabolic Steroids Use in Bodybuilding Athletes Based on the Theory of Planned Behavior

Background: Athletes’ use of androgenic-anabolic steroids (AASs) is a significant health problem. This study aimed to determine factors associated with AAS in male bodybuilders by applying the theory of planned behavior (TPB). Methods: Using a multistage random sampling procedure, this descriptive-analytical cross-sectional study was performed on 429 athletes participating in gyms in Qom, Iran, in 2019. The data collection tool was a questionnaire, including demographic information and questions related to TPB constructs. Data were analyzed by descriptive statistics, Chi-square test, logistic regression, and linear regression using SPSS software, version 16. Results: The results demonstrated that 188 (48.2%) athletes had a history of AAS use. The attitude (β=0.39), subjective norm (β=0.26), and perceived behavioral control (β=-0.36) predicted 38% of the variance of intention to AAS use. Further, behavioral intention was the statistically significant predictor of AAS use among the studied athletes (OR=0.83, 95% CI: 0.78-0.87). Variables such as having friends (OR=2.06, 95% CI: 1.28-3.30) or a sports coach using AAS (OR=3.1, 95% CI: 1.58-6.42) and having a history of supplementation use (OR=5.8, 95% CI: 2.65-12.8), along with age (OR=4.3, 95% CI: 0.35-53.6) had a significantly predictive role in using AAS. Conclusion: The findings revealed that nearly half of the studied athletes had a history of using AAS and supplements. TPB is applicable to identify the determinants of beliefs, intention, and behavior to use AAS among athletes. These findings can be useful in designing appropriate programs to prevent AAS use.

Prediction of Helmet Use Behavior among Motorcyclists Based on the Theory of Planned Behavior

BACKGROUND

Road traffic injuries (RTIs) are one of the most critical factors that endanger human health. More specifically, head and neck injuries are the main causes of deaths and disabilities among motorcyclists. This study aimed to investigate the predictive factors of helmet use behavior among motorcyclists based on the theory of planned behavior (TPB).

STUDY DESIGN

This study followed the cross-sectional design.

METHODS

This study was conducted on randomly selected 730 motorcyclist employees in Qom, Iran, in 2021. The data collection tool was a self-administered researcher-made questionnaire, including items on demographic characteristics, history of RTIs, and constructs of TPB. Data were analyzed using descriptive summary statistics, analysis of variance, independent samples t test, Pearson correlation coefficient, and structural equation modeling (SEM).

RESULTS

In this study, only 9.8% of the participants reported that they always used a helmet while riding a motorcycle. About 60% reported a history of a motorcycle crash, and 11.5% had a history of head injuries. The direct effect of attitude, subjective norms, and perceived behavioral control on the intention to use a helmet were statistically significant, explaining 59% of the variation in behavioral intention (intention to use a helmet) (R2=0.59). Moreover, perceived behavioral control and behavioral intention had significant effects on helmet use behavior (R2=0.26).

CONCLUSION

The prevalence of helmet use among the studied population was very low. Moreover, TPB was useful in identifying the determinants of behavior and especially behavioral intention of helmet use among motorcyclists.

Factors Associated with Breast Cancer Mammographic Screening Behavior among Iranian Women

Breast cancer is one of the most common diseases of women, which can increase the survival of patients with its early diagnosis. Despite the existence of relatively sensitive methods of early detection of breast cancer, such as mammography, statistics show that a small number of women perform mammography according to the recommended clinical guidelines. Using the health belief model, this study aims to determine the factors affecting mammography among women teachers in Hamedan.

METHODS

This study was conducted on 458 female teachers aged 40 years and older of Hamadan city, in western part of Iran, during October to December of 2019. The participants were asked about the factors affecting mammography based on the health belief model. Questionnaires were completed by self-reported method and analyzed by SPSS software at 95% confidence interval.

RESULTS

The average age of the study participants was 46±4.1 years. Among the participants, about 41.5% had performed mammography at least once. In univariate analysis, the constructs of the health belief model generally predicts performing mammography between 35 and 49 percent. In multivariate analysis, age 46 to 50 years, having supplementary insurance, history of breast disease, perceived barriers with odds ratio of 3.4, 3.4, 10.6 and .89, respectively, were significantly related to mammography.

CONCLUSIONS

Female teachers over 45 years of age with a history of breast disease, if they do not have financial or other barriers to do mammography, perform breast cancer screening.

Interventions to prevent road traffic injuries among pedestrians: a systematic review

Road traffic injuries (RTIs) are a serious public health problem and are an important cause of disability and death worldwide. A significant proportion of traffic injuries and fatalities are among pedestrians. Reviewing and evaluating related interventions can be a practical step to implementing appropriate methods to prevent RTIs among pedestrians, a highly vulnerable group of road users.

The search of articles was conducted in the electronic databases of Scopus, PubMed, ISI, Safety Lit, and CDC. Other papers were also reviewed using forward citation and backward citation. The search strategy was for studies examined from the first years of database creation until January 10, 2021, in all languages in journals with matched judgment according to the type of population, type of interventions, comparators, and results. Joanna Briggs Institute (JBI) checklists were used to determine articles' quality and assess possible biases depending on the type of study.

The initial search resulted in finding 16,272 abstracts. Finally, 25 studies, including 17 randomized clinical trials (RCTs) studies, seven studies pretest/post-test interventions (PPI), and one study controlled pretest/post-test interventions (cPPI) met the inclusion criteria. Among these preventive interventional studies, 20 studies were conducted in high-income countries, three were in lower middle-income countries, one study was in upper middle-income country, and only one study was conducted in a low-income country. Most interventional studies in the field of prevention of RTIs (15 studies) had an educational/behavioral approach, designed to change pedestrian behavior and the use of this approach was also effective in improving pedestrian behavior. The legislation/law enforcement approach was used in one study and two studies used an engineering/technology approach. In studies with an engineering approach after engineering reforms, pedestrian injuries in children decreased by 37.5%. In seven studies, multifaceted interventions were used. The interventional studies that used this approach were able to improve pedestrian safe behavior.

The majority of studies were based on educational/behavioral approaches and pedestrians' behavior improved notably. In addition, the majority of interventional studies were conducted in countries with high income levels. Therefore, programming for preventive interventions to attenuate RTIs is highly important in low/middle-income countries to reduce the risk of injury to vulnerable road users. These findings can be applied by policy-makers to develop educational, engineering, environmental, and law enforcement interventions and attenuate injuries sustained by pedestrians.

Can substance abuse media literacy increase prediction of drug use in students?

Objective

The present study aimed to determine the predictors of drug use among students based on the Extended Prototype willingness model (EPWM).

Methods

This cross-sectional study was performed at Hamadan universities. The participants were selected via multi-stage sampling. Finally, out of 721 students participated. The questionnaire consisted of four sections: (a) socio-demographic characteristics, (b) Questionnaire about the prototype willingness model constructs, (c) Questionnaire about the status of drug use behavior, (d) Substance Abuse Media Literacy (SAML) scale. Data were analyzed using a structural equations partial least squares confirmatory composite approach and SPSS-23.

Results

The mean age of students was of 23.47 ± 4.14 years. Based on results, behavioral willingness (β = 0.420, t-value = 9.010, p < 0.001) and behavioral intention (β = 0.291, t-value = 6.957, p < 0.001) significantly predicted drug use. The presented results of analysis, 66% of the variance of the drug use, 62% of the variable of the behavioral willingness, and 56% of the behavioral intention could be explained by the EPWM.

Conclusion

The present study demonstrated that EPWM could predict drug use in students. Therefore, designing and implementing educational and promotional intervention programs to reduce behavioral willingness and increase students’ skills in substance abuse media literacy is necessary to prevent drug use behavior.

High-Risk Behaviors and Associated Factors among Iranian Adult Population: A National Survey

BACKGROUND

There is no official and representative information on certain health-risk behaviors in Iran. This national survey was performed to determine the prevalence of five high-risk behaviors among the adult population and underlying factors.

METHODS

This cross-sectional study was performed in 23 provinces of Iran in 2019 involving 10,957 participants. The following five risky behaviors were evaluated: (a) using illicit drugs in the past month, (b) drinking alcohol in the past month, (c) having extramarital sex in the past year, (d) having suicidal thoughts in the past month, (e) and attempting suicide in the past year. The logistic regression model was used for analyses and associations were reported using odds ratio (OR) with its 95% confidence interval (CI).

RESULTS

The prevalence of health-risk behaviors was as follows: illicit drug use 10.4%, drinking alcohol 16.8%, extramarital sex 9.9%, suicidal thoughts 8.8%, and suicide attempt 5.4%. Almost 27.6% of the participants were involved in at least one risky behavior. There was a strong association between illicit drugs use and male gender 2.51 (2.11-2.98) and using psychiatric medications 2.96 (2.46-3.55); between drinking alcohol and male gender 2.23 (1.93-2.58); between extramarital sex and divorced/widowed status 2.43 (1.72-3.44) and having an intimate friend of the opposite sex 3.75 (3.13-4.51); between suicidal thoughts and using psychiatric medications 2.23 (1.83-2.72); between suicide attempt and a history of running away from home 2.10 (1.64-2.68).

CONCLUSION

More than one-fourth Iranian adult population is involved in at least one risky behavior. Engaging in any risky behavior may increase the possibility of engaging in other high-risk behaviors.

Setting research priorities to achieve long-term national road safety goals in Iran

Background

Road traffic crashes (RTCs) and its associated injuries are one of the most important public health problems in the world. In Iran, RTCs rank second in terms of mortality. To address this issue, there is a need for research-based interventions. Prioritizing researches using a variety of approaches and frameworks to determine the most effective interventions is a key nodal point in the RTCs' research policy planning cycle. Thus, this study aims to generate and prioritize research questions in the field of RTCs in Iran.

Methods

By adapting the Child Health and Nutrition Research Initiative (CHNRI) method, this study engaged 25 prominent Iranian academic leaders having role in setting Iran’s long-term road safety goals, a group of research funders, and policymakers. The experts' proposed research questions were independently scored on a set of criteria: feasibility, impact on health, impact on the economy, capacity building, and equity. Following the prioritization of Research Questions (RQs), they were all classified using the 5 Pillar frameworks.

Results

In total, 145 Research Questions were systematically scored by experts against five criteria. Iran's top 20 road traffic safety priorities were established. The RQs related to “road safety management” and “road and infrastructure” achieved a high frequency.

Conclusions

The top 20 research questions in the area of RTCs in Iran were determined by experts. The majority of these RQs were related to “road safety management”. The results of this study may contribute to the optimal use of resources in achieving long-term goals in the prevention and control of road traffic crashes and its related injuries. Considering these RQs as research investment options will improve the current status of Road Traffic Injuries (RTIs) at a national level and further advance toward compliance with international goals. If these research priorities are addressed, and their findings are implemented, we can anticipate a significant reduction in the number of crashes, injuries, and deaths.

The Impact of Preventive Interventions on Intimate Partner Violence among Pregnant Women Resident in Hamadan City Slum Areas Using the PEN-3 Model: Control Randomized Trial Study

BACKGROUND

Intimate partner violence is a severe life-threatening criminal and public health problem affecting the well-being of individuals, families, and society. Planning interventions to reduce the burden of this persistent and criminal violence should be relevant culturally and socially.

METHODS

In this randomized control trial, 150 pregnant women residing in slum areas of Hamadan were randomly assigned to two groups (intervention group: n=50 and control group: n=100). Interventional strategies included educating the victims based on local cultural norms, culturally sensitive individual and group counseling, and educating health care providers. Data were collected via face-to-face interviews at baseline and again at 3 months after the intervention. We used a paired t-test to evaluate the effect of the intervention by comparing changes in the outcomes measured.

RESULTS

There were no statistically significant differences between the two groups at baseline in terms of sociodemographic characteristics. Post-test scores of knowledge (7.50±2.65 vs. 5.14±3.51, P=0.001), communication skills (18.38±4.25 vs. 16.2±3.83, P=0.04), and family support and social expectation of obedience (15.79±4.45 vs. 13.40±4.57, P=0.005) of the victims were statistically significantly higher in the experimental group compared to the control group. Moreover, physical (0.74±2.28 vs. 1.20±2.60, P=0.06), psychological (2.80±4.10 vs. 4.52±5.43, P=0.06), and sexual (0.11±0.58 vs. 0.61±1.22, P=0.04) violence reduced in the experimental group compared to the control group.

CONCLUSION

Culturally relevant interventions can reduce intimate partner violence.

Prediction of Seat Belt Use Behavior among Adolescents Based on the Theory of Planned Behavior

BACKGROUND

Road Traffic Injuries (RTIs) are the important causes of unintentional injuries and deaths. In this respect, seat belt wearing is an influential factor in reducing the mortality and severity of road traffic injuries. The rate of seat belt use among is lower adolescents, compared to adults. The present study aimed to investigate the influential factors on seat belt-weraing behavior among adolescent students as car occupants based on the Theory of Planned Behavior (TPB).

STUDY DESIGN

  A cross-sectional design.

METHODS

This study was conducted among 952 adolescent students studying in grades 7, 8, and 9 in the schools of Tabriz, Iran, in the 2019-20 academic year. A researcher-made questionnaire was designed based on TPB for data collection, the validity and reliability of which have been confirmed.

RESULTS

The results indicated that the rate of seat belt use in the front seat inside the city was lower than that outside the city. Regarding TPB constructs, perceived behavioral control (β=0.137; 95% CI: 0.006-0.013; P<0.001), subjective norm (β=0.313; 95% CI: 0.021-0.032; P<0.001), and attitude (β=0.322; 95% CI: 0.034-0.053; P<0.001) had a significant and positive relationship with the intention of seat belt-wearing behavior. Moreover, the behavioral intention (β=0.571; 95% CI: 0.62-0.64; P<0.001) had a significantly positive relationship with seat belt-wearing behavior.

CONCLUSION

The Theory of Planned Behavior is appropriate to determine predictor factors of seat belt-weraing behavior among adolescent students as car occupants. In addition, the results of the present study may provide a theoretical basis for policy-making to improve adolescent students' seat belt use.

Effect of educational intervention on safe traffic behaviors of high school male students in Iran, using the theory of planned behavior: a quasi-experimental study

BACKGROUND

Behavior change interventions in tackling road traffic injuries are a public health concern. Thus, this interventional research was to survey the effect of safe traffic behaviors among male students in Hamadan, Iran, utilizing theory of planned behavior.

METHODS

In this quasi-experimental study, 204 students were randomly selected through multistage sampling from male high school students of Hamadan city, west-central of Iran, and non-randomly allocated to control and intervention groups (102 students in every group). The self-administrate questionnaire was used for data collection in this research. Frequency (percentage) and mean (SD) were used for description. Cronbach alpha coefficient, content validity ratio (CVR) and content validity index (CVI) were used for psychometric evaluation of questionnaire and paired/independent sample t-test was used for data analysis. All statistical analyses were done in SPSS 19 and significant level was considered 0.05.

RESULTS

In both groups, more than 50 % of students walked to school. The two study groups were homogeneous in terms of confounding variables (p >  0.05). The validity of the questionnaire was confirmed and the total Cronbach's alpha value was equal to 0.97. There was no significant difference in the score of safe traffic behaviors between the two groups before the intervention (p >  0.05). But after the intervention, the score in the intervention group was significantly increased (p < 0.05). Intragroup comparison also showed that only in the intervention group the score was significantly changed (p < 0.05).

CONCLUSION

Theory of planned behavior is a suitable conceptual framework for planning the interventions to increase safe traffic behaviors in students.

Prevalence of Intimate Partner Violence Among Pregnant Women in the Poor Neighborhoods of Hamadan, Iran

Intimate partner violence (IPV) occurs in all settings, especially in poor neighborhoods. It is considered to be a serious public health concern with serious consequences in the short and long term for abused women because of distinct barriers in obtaining support sources. Therefore this cross-sectional study focuses on the prevalence and the determinants of IPV among pregnant women residents in poor neighborhoods. Overall, 63.8% experienced at least one type of IPV. Also, educational status, family's monthly income, husband's employment status, and having a smoker husband were found to be important predictors of IPV against pregnant women. A better understanding of social determinants of violence can help decision-makers in developing effective policies. It is crucial to prioritize the poor neighborhoods for future interventions to reduce IPV imposed during pregnancy.

Identification of factors related to behaviors associated with musculoskeletal pain among elementary students

BACKGROUND

Musculoskeletal pains are among evident health problems in children and adolescents. Backpack carrying behaviors and the sitting postures are among behavioral factors associated with musculoskeletal pain in schoolchildren. Therefore, this study aims to identify the factors related to these important musculoskeletal behaviors, using Health Promotion Models.

METHODS

In this cross-sectional study, a questionnaire was created based on PRECEDE Model and Health Belief Model and was administered to 673 Iranian students, whom were selected randomly from elementary schools of Hamadan, Iran, in 2018.

RESULTS

The findings of the study revealed that proper sitting postures and backpack carrying were 42 and 33%, respectively. The findings also showed that predisposing factors including perceived susceptibility (p < 0.05, β = 0.219), perceived severity (p < 0.05, β = 0.166), perceived barriers (p < 0.05, β = - 0.191), perceived self-efficacy (p < 0.05, β = 0.188) and also enabling factors (p < 0.05, β = 0.329) were significantly related to sitting behaviors. Moreover, backpack carrying behaviors had significant relationships with predisposing factors of perceived susceptibility (p < 0.05, β = 0.198), perceived barriers (p < 0.05, β = - 0.258), perceived self-efficacy (p < 0.05, β = 0.185) and reinforcing factors (p < 0.05, β = 0.208).

CONCLUSIONS

It seems necessary for future preventive programs to take factors of musculoskeletal pains among children and adolescents into account.

COVID-19 Prevention Behaviors among Health Staff: Data from a Large Survey in the West of Iran

Background: Hospital staffs are at high risk of Novel Coronavirus (2019-nCoV preventive behaviors play a peculiar role in the reduction of the incidence and mortality of this infection. Therefore, the present study aimed to assess the prevention behaviors of COVID-19 among health staff based on the Extended Parallel Model (EPPM) in western Iran.

Study design: It was a cross-sectional study.

Methods: The present study was performed in the west of Iran in April 2020. In total, 1,664 cases were enrolled in this study via multi-stage sampling. The data were collected using a questionnaire, including the demographic characteristics of participants and EPPM constructs. All analyses were conducted in Stata software (version 14) at a 5% significant level.

Results: As evidenced by the obtained results, 1,523 (91.53%), 1,226 (73.68%), 1,526 (91.71%), 893 (53.67%), and 862 (51.86%) of health staff wear gloves, use masks, avoid contact with others, maintain a good distance from other people, and wash their hands frequently with water and soap, respectively. In terms of using gloves and avoiding contacts with others, participants with high perceived threat had higher odds of observing health behaviors (OR= 3.14, 95% CI: 2.08, 4.73; P<0.001) and (OR= 3.1, 95% CI: 2.04, 4.69; P<0.001), respectively. In all categories of EPPM, the participants with high efficacy had higher odds of exhibiting health behaviors, compared to those with low efficacy (P<0.001).

Conclusion: The results of the present study demonstrated that health workers are expected to be at the highest level of threat and efficiency. Moreover, the findings emphasized the effectiveness of the recommended strategies in the prevention of COVID-19 disease.

Effect of interventions based on regular physical activity on weight management in adolescents: a systematic review and a meta-analysis

BACKGROUND

Physical inactivity is one of the major risk factors for non-communicable diseases. This systematic review and meta-analysis aimed to assess the effects of educational interventions on promoting regular physical activity in adolescent weight management programs.

METHODS

The relevant studies indexed in Embase, Web of Science, Scopus, and ProQuest databases were searched using keywords namely "Physical Activity, Adolescent, Weight Management, Body Mass Index (BMI), Randomized Controlled Trials, and Clinical Trial." Up to the end of March 2020, two authors independently screened the papers, extracted data, and assessed the methodological quality of the studies using Effective Public Health Practice Project (EPHPP) tool.

RESULTS

Out of 12,944 initial studies, 14 met the inclusion criteria after screening the titles, abstracts, and full texts of the papers. The participants in these studies were aged between 6 and 18 years, and 13 studies included participants from both sexes. Moreover, eight of them were performed as a controlled clinical trial. The overall estimate of the difference showed that the interventions improved weight loss which is a statistically significant finding. The participants in the intervention group had a weight loss of 1.02 kg compared to the control group at a 95% confidence interval (- 4.794-0.222).

CONCLUSION

Published longitudinal data indicated that physical activity declines over the transition from adolescence to adulthood. Using the results of the study, policy-makers can design educational interventions using educational models and patterns.

SYSTEMATIC REVIEW REGISTRATION

PROSPERO registration number: CRD42020173869.

The Epidemiology of Aggression and Associated Factors among Iranian Adult Population: A National Survey

Background: This survey was conducted to determine the level of aggression among the Iranian adult population and underlying predisposing factors.

Study design: A cross-sectional study.

Methods: This cross-sectional study included 10,957 participants, involving 23 out of the 31 provinces of Iran in 2019. The outcome of interest was aggression, evaluated by the Buss & Perry aggression questionnaire. The association between aggression and 34 demographic, behavioral, social, and cultural characteristics was assessed using simple and multiple linear regression.

Results: The overall mean (SD) score of aggression was 77.10 (22.53). Based on the severity of aggression, the participants were categorized into four groups as follows: 2,464 (23.1%) nonaggressive, 4,692 (43.9%) mild, 3,071 (28.8%) moderate, and 454 (4.2%) severe aggressive. Aggression was more likely to occur in people with the following characteristics: younger ages, having several siblings, lower ranks of birth, having an intimate friend of the opposite sex, having an aggressive father/mother, history of parental divorce, interest in watching action/porn movies, listening to music, history of escape from home/school, using neuropsychiatric drugs, using illicit drugs, history of suicidal thoughts/attempt, and family conflict and hostility. Aggression was less likely to occur with the following characteristics: reading, regular physical exercise, the ability to control anger, regular prayer, adherence to avoid lying, respect to other people's rights, sexual satisfaction, and attachment to parents.

Conclusions: A majority of the population has some degree of aggression. Aggression is a multifactorial behavior corresponding with several demographical, social, cultural, and religious factors, some of which back to early childhood events.

Safety concept of fire related injuries in inhabitants of residential buildings in Iran: A qualitative study

BACKGROUND AND AIM

Fire is one of the major dangers that cause many casualty, injuries and property damages every year worldwide. Most of these losses occur in low- and middle-income countries. Exploring the stakeholders experience is a great source for understanding factors affecting the prevention of fires and its related injuries. The purpose of this study then is understanding the perception of safety from fire related injuries in residential inhabitants of buildings in Iran.

METHODS

This study was conducted using conventional content analysis during December 2016 to December 2017. In total, 25 interviewees were selected through purposive sampling among experienced/or knowledgeable participants. Data was collected employing semi-structured interviews. The data analysis process was based on the Lundman & Graneheim method and their recommendations.

FINDINGS

The six categories including: safe building against fire, fire safety regulations, safety-friendly people, effective relief organizations, safe urban structure and economic and financial capacity was extracted.

CONCLUSION

Fire safety in residential buildings with the demanding people for safety is ensured that having such city requires multidisciplinary function with a holistic approach. Further investigation to explore the process of fire safety for residential buildings is recommended.

Factors associated with preventive behaviours of COVID-19 among hospital staff in Iran in 2020: an application of the Protection Motivation Theory

This study was conducted to predict the preventive behaviours of healthcare workers (HCWs) towards COVID-19 based on the Protection Motivation Theory (PMT). This cross-sectional and analytical study was conducted on 761 HCWs in Hamadan, Iran, using multi-stage random sampling. The preventive behaviours against COVID-19 among HCWs were assessed at a relatively desirable level. Based on the PMT, threat and coping appraisal were predictors of protection motivation to conduct COVID-19 preventive behaviours (P<0.001). The intention was also predictive of COVID-19 preventive behaviours (P<0.001). Consideration of personnel's self-efficacy and their knowledge regarding the effectiveness of protective behaviours in designing staff training programmes are recommended.

Risk factors for low back pain among elementary school students in western Iran using penalized logistic regression

OBJECTIVES

This study investigated the prevalence of low back pain (LBP) and its risk factors among elementary-school students.

METHODS

In this cross-sectional study, 693 elementary students from Hamadan city, western Iran, were selected by multistage stratified cluster sampling. Data were collected through interviews using questionnaires. Posture and psychosocial elements were assessed using the observational Rapid Upper Limb Assessment (RULA) checklist and the standard Strengths and Difficulties Questionnaire, respectively. Penalized logistic regression with the group smoothly-clipped absolute deviation regularization method was used for variable selection and data analysis (α=0.05). The chi-square test was also used.

RESULTS

In total, 26.6% of the students (7-12 years old) reported LBP in the last month. Older age (odds ratio [OR], 3.08; 95% confidence interval [CI], 1.80 to 5.26), watching TV for more than 3 hours a day (OR, 2.62; 95% CI, 1.46 to 4.68), very short seat backrests (OR, 3.08; 95% CI, 1.61 to 5.90), excessively curved seat backrests (OR, 4.36; 95% CI, 2.08 to 9.13), very short desks (OR, 3.44; 95% CI, 1.61 to 7.35), a family history of LBP (OR, 2.49; 95% CI, 1.58 to 3.91), carrying a school bag on one shoulder (OR, 1.91; 95% CI, 1.03 to 3.54), and RULA scores of 3 (OR, 2.26; 95% CI, 1.13 to 4.50) or 4 (OR, 2.85; 95% CI, 1.37 to 5.91) were associated with LBP.

CONCLUSIONS

A high prevalence of LBP was found among elementary-school students. This study underscores the importance of recognizing vulnerable children and teenagers and developing interventional health promotion programs to prevent LBP based on an appropriate consideration of its contributory factors.

The effects of suicidal ideation and constructs of theory of planned behavior on suicidal intention in women: a structural equation modeling approach

BACKGROUND

The Theory of Planned Behavior (TPB) is proposed to predict behavioral intention. We conducted this study aimed to investigate the effects of Suicidal Ideation (SI) and constructs of TPB on suicidal intention.

METHODS

This cross-sectional study was conducted with 923 married women selected by multi-stage sampling method from Gilan-e Gharb County, the west part of Iran, in 2018. Data gathering tools were a questionnaire on demographic characteristics, the Beck Scale for Suicidal Ideation, and a four-part questionnaire based on constructs of TPB, including Attitude, Subjective Norms, Perceived Behavioral Control (PBC), and Intention. Data were analyzed by SPSS 19 and AMOS using Structural Equation Modeling (SEM).

RESULTS

Out of 923 participants, 345 women (37.4%) had some degree of suicidal ideation. The mean score of suicidal ideation in all of participants was 5.98 ± 7.79, while in the 345 individuals with suicidal ideation was 15.53 ± 3.65. Suicidal ideation had the strongest positive total effect on suicide intent, while PBC and attitude had the negative effect on suicide intent.

CONCLUSIONS

Since suicidal ideation had the strongest direct effect on suicidal intent, it is suggested that this variable be used for risk assessment in all suicide prevention programs and counseling measures be implemented to reduce suicidal thoughts. Also, undesirable attitudes toward suicide and perceived behavioral control on suicide intention can be considered and emphasized in planning future interventions.

Earthquake preparedness of households and its predictors based on health belief model

Background

Earthquakes are one of the most destructive natural disasters in which many people are injured, disabled, or died. Iran has only 1 % of the world’s population, but the percentage of its earthquake-related deaths is absolutely higher. Therefore, this study aimed to determine the level of earthquake preparedness of households and its predictors using the Health Belief Model (HBM).

Methods

This observational descriptive and analytical study was conducted on 933 households in Hamadan province, located in the west of Iran, in 2019. Multi-stage cluster random sampling was used for selecting the participants. The inclusion criteria were being at least 18 years old and being able to answer the questions. A questionnaire was used for data collection including earthquake preparedness, awareness of earthquake response, predictors of earthquake preparedness based on the HBM, and demographic information. Analysis of variance, independent t-test, and a linear regression model was used.

Results

The mean age of participants was 38.24 ± 12.85 years. The average score of earthquake preparedness was low (approximately 30%). There was a significant relationship between earthquake preparedness and gender (P < 0.001), homeownership (P < 0.001), marriage status (P < 0.001), education (P < 0.001), and previous earthquake experience (P < 0.001). Regarding the HBM constructs, perceived benefits (P < 0.001), cues to action (P < 0.001), and self-efficacy (P < 0.001) were significant predictors of earthquake preparedness.

Conclusions

Earthquake preparedness was insufficient. Besides, perceived benefits, cues to action, and self-efficacy were predictors of earthquake preparedness. These predictors can be taken into account, for designing and implementing related future interventions.

The relationship between sleep quality and road traffic crashes of urban drivers in Hamadan, Iran

Background:

Sleep quality is one of the main human factors related to urban road traffic crashes. This study aimed at determining the relationship between sleep quality and road traffic crashes in urban drivers.

Methods:

This correlational study was conducted in Hamadan, a city located in the western part of Iran. The study samples consisted of 309 Hamadan drivers (i.e., 103 with road traffic crashes (RTCs) and 206 without RTCs), who were referred to police centers to change or renew their driving licenses. The data collection tool was a two-part questionnaire including demographic information and the Pittsburgh Sleep Quality Index (PSQI). The questionnaire was filled out in a self-administered manner. Statistical analysis was done using the SPSS-16 software and applying logistic regression, Fisher’s exact test, and Chi-square test.

Results:

The comparison of sleep quality scores between two groups, using the adjusted logistic regression test, showed a statistically significant difference between them (P = 0.019). This means that the sleep quality of drivers without RTCs was 1.8 times better than drivers with RTCS (OR=1.8; 95% CI, 1.1 - 3.07).

Conclusions:

There was a significant association between poor sleep quality and the occurrence of RTCs in urban drivers. As a result, it is recommended paying more attention to the sleep quality of urban drivers to prevent and control RTCs.

The Effect of an Anti-Bullying Intervention on Male Students' Bullying-victimization Behaviors and Social Competence: A Randomized Controlled Trial in Deprived Urban Areas

BACKGROUND

Violence among adolescents is a global public health concern. There is limited evidence on the effectiveness of anti-bullying interventions in Iran. Weaimed to examine the effectiveness of social cognitive theory (SCT)-based intervention on reducing bullying and victimization in elementary school students.

STUDY DESIGN

A randomized controlled trial.

METHODS

Eight elementary schools (consisted of 280 students in 5th and 6th grade) from deprived and semi-deprived areas of Kermanshah (west of Iran) were randomly assigned to intervention and control group from 2018 to 2019. Anti-bullying training content appropriate for SCT and sociocultural characteristics were provided to the intervention group including students, parents, teachers and school staff. The measures included SCT constructs, bullying, victimization, and social competence of students.

RESULTS

At baseline participants of two groups were homogenous in terms of demographic factors except for the type of living with the parent (P=0.040) and outcome variables including SCT constructs and bullying behaviors. The interventions significantly improved SCT constructs, reduced bullying and victimization and increased social competence in the intervention group compared to the control group (P<0.001). The difference between outcome expectations in both groups was not significant (P=0.137).

CONCLUSION

Interventions based on sociocultural characteristics and focuses on SCT theory reduce bullying and victimization behavior. Given the effectiveness and feasibility of these interventions, this theory can be effective to break the bullying cycle and improve social competence.

Neck and shoulder pain among elementary school students: prevalence and its risk factors

Background

Neck and shoulder pain is relatively common among children and teenagers and has a negative impact on their physical and psychological health. This study was carried out to assess the prevalence of neck and shoulder pain among elementary school students, and to investigate the relationship between this pain and its risk factors.

Methods

In this cross-sectional study, 693 elementary school students aged 7 to 12 years from Hamadan city, located in western Iran, were selected through the multistage cluster random sampling method. Data were collected through interviews and questionnaires. For the social and psychological variables, the parent version of the Strengths and Difficulties Questionnaire (SDQ) was used. For assessing each student’s posture, an observational checklist, the Rapid Upper Limbs Assessment (RULA), was used. The data was analyzed using the unadjusted (univariate) and adjusted (multivariate) logistic regression.

Results

The prevalence of the neck pain was slightly higher than that of shoulder pain. The prevalence reported over a month was 35.8 and 30.9% for neck and shoulder pain, respectively. The logistic regression analyses showed that, very high desk height (odds ratio (OR) =1.96, 95% confidence interval CI: 1.02–3.74), backward seat pan inclination (OR = 2.10, 95% CI: 1.37–3.24), forward seat pan inclination (OR = 3.12, 95% CI:1.46–6.68), difficulty in viewing the board (OR = 2.54, 95% CI: 1.10–5.84), too much homework (OR = 2.59, 95% CI: 1.49–4.51), RULA score at level III (OR = 2.88, 95% CI:1.64–5.05), and RULA score at level IV (OR = 3.12, 95% CI: 1.72–5.63) increased the risk of neck pain independently. On the other hand, sitting on desk and seat (OR = 0.59, 95% CI: 0.39–0.91) and laying position for doing homework (OR = 0.53, 95% CI: 0.34–0.81) reduced the related risk. Very short desk height (OR = 2.41, 95% CI: 1.26–4.61) and too much homework (OR = 1.94, 95% CI: 1.10–3.42) increased the risk of shoulder pain.

Conclusion

The elementary school students reported a high prevalence of shoulder and neck pain. This study found that improper sitting positions, as well as physical factors such as the school furniture, too much homework, and difficulty in viewing the classroom board, were associated with pain. Proper interventions considering the risk factors assessed in this study, are suggested.

Investigating the effective factors of near-drowning experience in junior high school students of Guilan Province, Iran: a theory-based study

Background:

Drowning is one of the most important causes of deaths from injuries in the world, and among adolescents. Although drowning is one of the major public health threats, it can be prevented by knowing its effective factors. Purposes: This study aims to investigate the effective factors of near-drowning in junior high school students, based on Theory of Planned Behavior.

Methods:

This cross-sectional study was conducted in 2018 in Guilan province, north of Iran. Of the seven coastal cities, three cities were randomly selected as samples. The data gathering tool was a researcher-made questionnaire including questions about demographic variables, knowledge and constructs of the Theory of Planned Behavior (attitude, subjective norms, perceived behavioral control, intention and behavior) and near-drowning. After confirming the validity and reliability, students completed the questionnaire. 734 students were randomly selected using multi-stage cluster sampling. Data were analyzed using logistic regression, linear regression and SPSS-16 software.

Results:

21.1% of the students had near-drowning experience. 59.4% of the injuries were occurred in the sea and the rest of them were in pool, river, dam, pond, bathtub, well and canal. Most of the injuries were occurred at 4-8p.m (35.5%). Near-drowning following swimming (41.3%), playing and recreation (23.9%), and diving (12.3%) were the most common mechanisms. Logistic regression showed a significance between sex (p = 0.000), father s education (p = 0.005), place of residence (p = 0.000), swimming skills (p = 0.003), intention (p = 0.020) and near-drowning. Also linear regression revealed a significant relationship between attitude and drowning prevention behaviors (p = 0.018).

Conclusions:

In the studied population, the near-drowning rate is high. Considering most of the injuries occurred in the sea following swimming, accurate knowledge of all effective factors of near-drowning will help design appropriate interventions to prevent drowning in adolescents, including beach safety, setting time for swimming in the sea and swim training.

Keywords:

Drowning; Injury Prevention; Safety promotion; Health promotion

Beliefs and performances of elementary school students to prevent road traffic injuries, using Health Belief Model: a study from Hamadan, Iran

BACKGROUND

Road traffic injuries (RTIs) are important health problems and increasing knowledge on their prevention-related issues can be credible. This study aims to assess beliefs and performances of students to prevent road traffic injuries and their related factors, using Health Belief Model (HBM).

METHODS

This cross-sectional study carried out on a random sample of 500 fourth and fifth grades students of elementary schools in Hamadan city, west of Iran. The data gathering tool was a self-administered questionnaire designed on the basis of HBM constructs and also the knowledge and performance of the students in relation to prevent RTIs. To increase the accuracy of this study, the students' road-crossing behaviors were observed in a simulated street in the school, using an observation checklist. Data were analyzed by SPSS 16.

RESULTS

The mean age of the participants was 10.51±0.50. About preventing RTIs, the mean scores of the students' knowledge was 64.139, and regarding HBM constructs, the mean scores of their perceived susceptibility, perceived severity, perceived benefits, perceived barriers and self-efficacy were 82.817, 82.453, 82.451, 89.917, 84.343 and 91.250, respectively. The mean score of the students' self-reported performances about traffic injury prevention was 48.750 and the mean score of their observed road-crossing behavior in the simulated street was 45.000. The final model of multiple linear regressions showed that the students' sex (p=0.001), their knowledge (p less than 0.001), perceived susceptibility (p=0.002), perceived barriers (p=0.032), self-efficacy (p=0.001), and their observed road-crossing behaviors (p=0.019) predict the students' self-reported injury prevention performances.

CONCLUSIONS

Regarding prevention of RTIs, knowledge and performance of the studied students are undesirable. The study findings can help designing more appropriate prevention programs for them.

Beliefs and performances of elementary school students to prevent road traffic injuries, using Health Belief Model: a study from Hamadan, Iran

BACKGROUND

Road traffic injuries (RTIs) are important health problems and increasing knowledge on their prevention-related issues can be credible. This study aims to assess beliefs and performances of students to prevent road traffic injuries and their related factors, using Health Belief Model (HBM).

METHODS

This cross-sectional study carried out on a random sample of 500 fourth and fifth grades students of elementary schools in Hamadan city, west of Iran. The data gathering tool was a self-administered questionnaire designed on the basis of HBM constructs and also the knowledge and performance of the students in relation to prevent RTIs. To increase the accuracy of this study, the students' road-crossing behaviors were observed in a simulated street in the school, using an observation checklist. Data were analyzed by SPSS 16.

RESULTS

The mean age of the participants was 10.51±0.50. About preventing RTIs, the mean scores of the students' knowledge was 64.139, and regarding HBM constructs, the mean scores of their perceived susceptibility, perceived severity, perceived benefits, perceived barriers and self-efficacy were 82.817, 82.453, 82.451, 89.917, 84.343 and 91.250, respectively. The mean score of the students' self-reported performances about traffic injury prevention was 48.750 and the mean score of their observed road-crossing behavior in the simulated street was 45.000. The final model of multiple linear regressions showed that the students' sex (p=0.001), their knowledge (p less than 0.001), perceived susceptibility (p=0.002), perceived barriers (p=0.032), self-efficacy (p=0.001), and their observed road-crossing behaviors (p=0.019) predict the students' self-reported injury prevention performances.

CONCLUSIONS

Regarding prevention of RTIs, knowledge and performance of the studied students are undesirable. The study findings can help designing more appropriate prevention programs for them.

Utilizing the PEN-3 model to identify socio-cultural factors affecting intimate partner violence against pregnant women in Suburban Hamadan

Intimate partner violence occurs in all settings. In this paper the authors describe socio-cultural factors affecting intimate partner violence against pregnant women in suburban Hamadan.The PEN-3 model was utilized by semi-structured interviews with 18 pregnant women. According to women, cultural perceptions (patience in case of facing violence, faith in fate and normalization of violence), enablers (communication skills, economic status, and availability of legal support), and nurturers (family support and social expectation of obedience to men) were found to be important factors that influence violence.A better understanding of the cultural perceptions can help decision-makers in identifying the cultural appropriateness of interventions.

Aggression and its predictors among elementary students

Background:

Aggression is the most significant psychopathological risk factor. It is a multifaceted construct and can affect students’ social, mental and physical health. The present study was conducted to investigate factors associated with aggression among elementary school girls and boys using the theoretical framework of Social Cognitive Theory in Kermanshah city, Iran.

Methods:

The cross-sectional study was conducted on 900 students, including 445 girls and 455 boys, 563 parents and 104 elementary school teachers in the fourth, fifth and sixth educational grades in Kermanshah city in 2018. The proportionate stratified random sampling was used. The Adolescent Peer Relations Instrument (APRI) was used to measure aggression. To measure the variables of social cognitive theory, a researcher-made questionnaire was used. Data analysis was conducted using descriptive and inferential statistics via the SPSS software.

Results:

It was showed that 29% and 10% of the students had moderate and high levels of aggression, respectively. Also, 30.6% of them were moderate victims and 45.6% were intense victims. Self-efficacy (p less than 0.001), perceived social norms (p=0.011), observational learning (p less than 0.001), outcome expectations (p=0.027), outcome expectancies (p=0.028) and per-ceived situational (p less than 0.001) were reported as the significant predictors of aggressive behaviors in the students based on the Social Cognitive Theory constructs. In total, they explained for 37.3% of changes in aggressive behaviors. Parents’ knowledge (p=0.005), parents’ attitude (p=0.012), teachers’ attitude (p less than 0.001), and teachers’ self-efficacy (p=0.021) had statistically significant relationships with aggression in the students.

Conclusions:

Aggression among children and adolescents is getting alarmingly prevalent. The Social Cogni-tive Theory is the appropriate framework for the prediction of aggression behaviors in children and adolescents. Therefore, designing and implementing educational interventions based on this theory can help with the management of aggression in children and adolescents.

Individual and social factors related to attempted suicide among women: A qualitative study from Iran

The researchers conducted this study as a phenomenological research to understand the individual and social factors related to attempted suicide phenomenon among women of Gilan-e Gharb. Participants of the study are comprised of 17 women survivors of attempted suicide selected by purposive sampling or snowball method. To gather the data, we conducted semi-structured interviews in face-to-face and audio-recorded methods from February to April 2017. Researchers transcribed verbatim and analyzed the content of the interviews thematically. The main issues in this study were three main themes including the "personal factors", "social factors", and "other issues related to attempted suicide" with seven sub-themes. We concluded that both personal and social factors contribute to the suicide attempts in female subjects. Also, we found that the majority of participants did not want to die by the attempted suicide.

Which Factors Influence Farmers’ Use of Protective Measures During Pesticides Exposure?

Farmers in developing countries use harmful pesticides while taking few or no protective measures. There is limited evidence on factors affecting their safety measures. The objective of this study was to identify the underlying factors influencing farmers’ protective behaviors (PBs) and use of personal protective equipment (PPE) during the exposure to pesticides. From April to August 2017, a descriptive study was conducted in Twiserkan County in western Iran among 474 farmers from 104 villages. A questionnaire was developed to measure demographic characteristics and factors suggested in integrated agent-centered (IAC) framework. The questionnaire was validated in terms of content validity through expert reviews and tested for reliability in a group of farmers. Data were collected by face-to-face interviews with farmers. Physiological arousal (β = .154, p < .05), intention (β = .345, p < .05), habit (β = .188, p < .05), and contextual factors (β = .101, p < .05) had a significant and positive impact on farmers engaging in pesticide PBs. Among the assessed factors, only physiological arousal (β = .122, p < .05) and habit (β = .646, p < .05) were found to have a significant and positive effect on the use of PPE, but the intention (β = –.039, p > .05) and contextual factors (β = –.009, p > .05) had no significant relation with the use of PPE. The results of this study identified determinants of farmers’ safety measures. Our results suggest that the IAC framework could serve as a guide to developing a more effective intervention for safety measures of Iranian farmers.

Unintentional Injuries among the Elderly in Rural Areas and Their Related Behaviors

BACKGROUND

Although the role of unintentional injuries as a cause of death in adults is known, there is limited knowledge about such adults' behaviors. This study aims to investigate the frequency of and factors affecting unintentional injuries among the elderly living in rural areas and their related behaviors.

METHODS

A cross-sectional study was carried out in the rural areas of Hamadan County, Iran, in 2016. The sample consists of randomly selected 445 adults aged 60-75 years. Data collection was conducted through face-to-face interviews, using questionnaires.

RESULTS

One hundred and forty-three participants (34.7%) experienced 166 injury occurrences. The injuries occurred more in females than in males. There were more mild and severe injuries (48.2% and 31.3%, respectively) than moderate ones (20.5%). The most frequent mechanism of injuries was accidental falls (64.5%). There was a significant relationship between using aid devices and injuries (P=0.001). Among the most applied injury preventive measures as reported by the elderly, crossing streets safely and the use of proper lighting at night had the highest percentages (81.5% and 69.7%, respectively). However, the use of protective handles and plastic flooring in bathrooms in order to prevent slipping had the lowest percentages (less than 1.0%).

CONCLUSION

The injuries among the elderly in this study were important health concerns. Injury-related factors should be considered in the development of injury prevention programs.

Skin Cancer Preventive Behaviors in Iranian Farmers: Applying Protection Motivation Theory

Farmers are among the most common work groups at risk of skin cancer. The protection motivation theory has been widely accepted as a framework for predicting health related behaviors. This study was conducted to determine the role of factors preventing skin cancer among farmers in Eslamabad-e Gharb district, Iran, using the protection motivation theory. In this descriptive study, 280 farmers living in this district were studied from May to June 2017. Using cluster random sampling methods, health houses where farmers received health care were selected. Each farmer within the selected health house was then enrolled into the study using simple random sampling. Data were collected by interview using an author-developed questionnaire. The questionnaire ascertained demographic information and constructs of the protection motivation theory. Almost half of the farmers had a history of sunburn (56.4%). With regard to prevention, a small proportion reported using sunscreen (8.6%), hats (3.2%), gloves 3.9%, sunglasses 4.6%, and protective clothing 15.4%. The results of regression analyses showed that with one unit of increase in the scores of self-efficacy to adopt prevention behavior and perceived protection motivation resulted in an increase in the mean score of the "protective" behavior by 0.26 and 0.20, respectively. Working conditions among farmers place them at great risk and skin cancer prevention is essential. Intervention and prevention programs should fully identify the determinants of skin cancer prevention in farmers; in addition, the identified effective factors must be taken into account when designing and implementing appropriate interventions.

Acute pesticide poisoning and related factors among farmers in rural Western Iran

Although acute pesticide poisoning (APP) is known to be a major health concern among farmers in developing countries, knowledge of its prevalence and risk factors is limited. The purpose of this study was to investigate the prevalence and a broad range of potential work-related risk factors of APP among Iranian farmers and farm workers. This cross-sectional study was conducted in rural areas of the Twiserkan County in Iran. In this study, there were 474 farmers and farm workers who had used pesticide 1 week before data collection. Participants were selected from 104 villages. Data were gathered using a questionnaire and analyzed using STATA (version 14.2 SE). Binary logistic regression and multinomial logistic regression were employed. The results of this study showed that 286 (60.3%) farmers and farm workers who applied pesticides suffered from work-related APP. Most frequent APP symptoms were runny nose (29.8%) and headache (25.1%). Five risk factors were identified, including annual income ( p < 0.05), number of farming years (odds ratio (OR) = 0.31), number of spraying years (OR = 2.40), place of pesticide storage (OR = 2.69), and type of sprayer ( p < 0.05). The results of this study indicated that APP is prevalent among the studied farmers. Some work-related factors play an important role in APP among Iranian rural farmers. In addition, the magnitude of these risk factors differed significantly by severity of acute and somatic pesticide poisoning.

Effect of Educational Program, Based on PRECEDE and Trans-Theoretical Models, on Preventing Decline in Regular Physical Activity and Improving it among Students

BACKGROUND

Adolescents especially middle school girls do not follow 60 min of regular physical activity (RPA), recommended by WHO, and endure physical activity decline. Using theory-based interventional program, considering the age of decline in RPA, seems to be effective. The aim of this study was to determine the effects of educational program, based on PRECEDE and Trans-Theoretical models, on preventing decline in RPA and improving it among 7th grade girl students.

STUDY DESIGN

Randomized controlled trial.

METHODS

This study was conducted on 7th grade girl students in Hamadan, west of Iran from 2015-16. Participants were divided into intervention (N=179) and control (N=165) groups by random assignment. Physical activity questionnaire for adolescents and the model-based questionnaire were used before and after intervention. Intervention included two months education and six months follow up. The effects of intervention were determined by statistical test and analysis of covariance using SPSS version 16.

RESULTS

The higher change in the mean scores was observed in self-efficacy (0.86), counter condition (0.66) and helping relationship (0.57) in the intervention group (P≤0.001). In addition, a significant difference (P ≤0.001) was observed between the two groups 6 months after the intervention in all constructs of model. The mean score of doing physical activity in the intervention group increased from 2.50 to 3.17 that it was differed significantly from the control group (P≤0.001).  CONCLUSIONS: School based intervention using PRECEDE and Trans-Theoretical models might prevent girl students' RPA decline and improve their RPA.

Effect of a model-based educational program for mothers, on home-related injury prevention among under-five-year children in rural Twiserkan, Iran

Afshari M, Moghimbeigi A, Hazavehei SMM, Rezapur-Shahkolai F. Effect of a model-based educational program for mothers, on home-related injury prevention among under-five-year children in rural Twiserkan, Iran. Turk J Pediatr 2017; 59: 648-656. Children under 5 years of age are most vulnerable in terms of home-related injuries. As a majority of these injuries are predictable and preventable, it is important to design preventive intervention programs that can be utilized as models of health education. The aim of this study was to determine the effect of an educational program, using the PRECEDE model, for rural mothers, on home-related injury prevention among under-five-year old children. This quasi-experimental study was conducted on 72 mothers, with at least one under-five-year old child, in the rural areas of Twiserkan (Toyserkan) County in Iran. The intervention and control groups (36 participants in each), were interviewed in pre/post-test study by trained interviewers, using the questionnaire. The intervention group participated in four educational sessions. The questionnaire included the questions on demographic information, mothers` beliefs and caring in relation to child-injury prevention, based on the PRECEDE model and focusing on predisposing factors (knowledge and attitudes), enabling factors; reinforcing factors; and mothers` preventive behaviors. According to the results of the study, the mean scores of predisposing factors (knowledge), enabling and reinforcing factors and also mothers` behaviors on injury prevention, did not have significant differences between two groups before intervention, whereas they had significant differences after intervention. This study showed that the educational program, using the PRECEDE model, can be effective on promoting knowledge and performances of mothers in relation to home-related injury prevention among their under-five-year old children.

Home-related injuries among under-five-year children and mothers' care regarding injury prevention in rural areas

This cross-sectional study was conducted in rural areas of Twiserkan (Toyserkan) County, in Iran, to assess factors associated with home-related injuries among under-five-year children and their mothers' care regarding injury prevention. Mothers who had their under-five-year-old children injured within a 12-month period were identified from recorded information in Twiserkan Health Center. Then, data were gathered using pre-tested questionnaire and through interview with injured children's mothers. The questions were about characteristics of the children's injuries and their mothers' care regarding injury prevention, using PRECEDE (Predisposing, Reinforcing, and Enabling Constructs in Educational/Environmental Diagnosis and Evaluation) model with focus on knowledge and attitude; enabling and reinforcing factors; and mothers' preventive behaviours. The study results showed that 197 out of 210 total identified mothers took part in the study. The reported injuries were 11.68%, 39.09%, and 49.24%, respectively, for severe, moderate, and mild cases. Fall was the most frequent injury with 35%. Among PRECEDE model constructs, there was a statistically significant correlation between mothers' knowledge and injury severity among children. Home-related injuries are an important health problem among study population and their prediction and prevention are necessary. Enhancement of mothers' knowledge can be helpful to improve child injury prevention.

Effect of educating mothers on injury prevention among children aged <5 years using the Health Belief Model: a randomized controlled trial

OBJECTIVES

To assess the effect of the Health Belief Model (HBM) on the education of mothers for promoting safety and preventing injury among children aged <5 years.

STUDY DESIGN

Randomized controlled trial.

METHODS

This study was conducted in Hamadan City, West Iran in 2012. One hundred and twenty mothers participated in this study, divided into intervention and control groups (60 mothers in each group). The intervention group participated in an educational programme consisting of four 1-hour sessions twice per week. The education programme was based on the HBM. The participants of both groups were evaluated before the intervention and two months after the intervention using a questionnaire. The validity and reliability of the questionnaire were tested with a pilot study. The questionnaire consisted of three parts: demographic characteristics; knowledge, practices and HBM constructs (perceived sensitivity, perceived severity, perceived benefits, perceived barriers, cues to action and self-efficacy); and history of recent injuries to the child. Student's t-test was used to compare the mean differences, and P < 0.05 was considered to indicate significance.

RESULTS

None of the 120 participants dropped out of the study. The mean differences in knowledge, perceived susceptibility, perceived severity, perceived benefits, perceived barriers, cues to action, self-efficacy and practices after the intervention, between the two groups, were 3.98, 3.57, 3.97, 1.57, -7.08, 0.82, 2.95 and 2.47, respectively. All differences were statistically significant (P = 0.001).

CONCLUSIONS

Educational programmes based on the HBM can be used as an effective approach in planning and developing preventive programmes for injury prevention and safety promotion in children aged <5 years.

Factors associated with mothers' beliefs and practices concerning injury prevention in under five-year children, based on health belief model

BACKGROUND

Injuries are the first leading but predictable, avoidable and preventable cause of death among under five-year children worldwide. The present study aimed to identify the factors associated with mothers' beliefs and practices concerning injury prevention in under five-year children.

METHODS

This cross-sectional study was conducted from August to October 2011 in Hamadan County, the west of Iran, enrolling 580 mothers with at least one under five-year child. The data collection instrument was a questionnaire including 85 questions regarding demographic characteristics; knowledge; practices; Health Belief Model (HBM) constructs; and history of injury occurrence among the children. The reliability of the questionnaire was evaluated by a pilot study using Cronbach's alpha coefficient. Data had been collected through interview with mothers, by trained interviewers.

RESULTS

Almost 22.59% of mothers reported at least one injury in their under five-year children. Of 131 injuries occurred, 85 cases were mild, 23 cases were moderate, and 23 cases were severe. About 52.67% of injuries occurred in boys, 37.41% in less than one-year children, 73.28% at home, and 61.07% when the children were playing game. Fall (24.28%), burn (20.61%) and poisoning (14.50%) were the common causes of injuries. There was a positive correlation between mothers' practices and knowledge, perceived benefits, cues to action and self-efficacy and a negative correlation between mothers' practices and perceived susceptibility, severity, and barriers.

CONCLUSION

Knowledge, perceived severity, perceived barriers, cues to action, and self-efficacy of mothers toward the injuries in children were among the most important predictive constructs, which may be used for planning educating programs.