مجله آموزش بهداشت و ارتقای سلامت ایران
سال سوم شماره 4 (پیاپی 12، زمستان 1394)

The idea of health promoting hospitals (HPHs) was developed for the first time at the World Summit on Health Promotion in 1986 by the World Health Organization (WHO). According to this idea, hospitals as well as patients, have a significant role in promoting public health in general and promoting the health of its clients and employees. In the health promoting hospitals approach, hospitals are among the best settings to deliver health promotion and prevention services. Therefore, its most important mission is to change the treatment-based approach to a health-centered approach. Health Promoting Hospitals seek to institutionalize the concept of prevention and health promotion among employees, the empowerment of patients in hospitals and the good interaction of hospitals with its community. This approach will result in the improvement of the quality of services provided to the people and communities.

Fish consumption plays an important role in human health and prevention of disease. This study was aimed to determine the tendency to fish consumption based on the constructs of the Transtheoretical Model (TTM) in women referred to Health Centers of Bandar Abbas.
In this analytical-descriptive study, 383 women who referred to Health Centers of Bandar Abbas recruited through cluster sampling. Data were collected using a questionnaire which consisted of two sections, namely, demographic characteristics and structures of TTM. Data were analyzed by SPSS 19 and one-way ANOVA and linear trends as statistical tests.
11.7% of participants were in the precontemplation stage, 3.9% in the contemplation stage, 13.6% in the preparation stage, 7.3% in the action stage, and 63.4% in the maintenance stage. The results of the one-way ANOVA test showed a significant association between constructs of TTM and stages of change, so that with progress of individuals from pre-contemplation stage to the maintenance stage, the decisional balance, self-efficacy and processes of change were increased (p Regarding the significant association between decisional balance, self-efficacy and processes of change with the stages of change for fish consumption, designing and implementation of educational programs toward reinforcing the TTM constructs for attaining the action and maintenance in fish consumption is suggested.

Adolescence is the most dangerous of lifetime regarding the onset of substance abuse and education is one of the most important methods to prevent this problem. The purpose of this study was to determine the impact of an educational intervention in the prevention of substance abuse among adolescents in Qazvin city using the theory of planned behavior (TPB).
This study was a quasi-experimental study. With multi-stage sampling method, 216 students participated in the experimental and control groups. Five focus group discussions (including 8-15 members) were presented to the experimental group mainly based on role-playing, brain storming and group discussions methods. Self-reporting questionnaires were used for data collection consisted of demographic questions, attitudes, subjective norms, perceived behavioral control, intention and preventive behavior with 5-point Likert response options. Reliability and validity of the questionnaires was confirmed by Cronbach's alpha and test-retest coefficient. The data collected before and 2 months after training were analyzed with SPSS 20 and Chi-square, pair and independent t-test, and Fisher's exact test.
The mean scores of attitude (from 26.3±17.4 to 45.7±21.6), subjective norms (from 20.4±14.6 to 33.4±15.2), perceived behavioral control (from 36.6±20.9 to 58.4±27.3), intention (from 6.24±2.2 to 11.4±3.8) and addiction related preventive behavior (from 24.11±9.5 to 40.6±13.7) were significantly improved after educational intervention among the experimental group (p TPB provides an appropriate framework for designing educational interventions to prevent substance abuse among adolescents and its application in health promotion programs in schools and prevention of substance abuse is recommended.

Indeed the development of health promotion programs in the community would result in ineffective solutions if social and cultural backgrounds are not considered. Therefore, this study was conducted to assess the level of social health and factors influencing the staff employees of the Ministry of Health and Medical Education in Iran.
The study was a descriptive- analytical one in which 257 employees of the Ministry of Health and Medical Education in Iran were selected by stratified random sampling. In order to measure the social health of the employees, Keyes social health questionnaire was used. This questionnaire measured five social health components- social cohesion, social prosperity, social acceptance, participation and social adaptation. The data analysis was conducted using Non-parametric correlation (c2) and Kendall's test by SPSS 20 with the significance level of 0.05.
Most of the participants (51.7%) had medium social health, and 17.8% had low social health. There was a significant correlation between social health and gender, education and accommodations (p Health system will have a good performance if the issues and needs of employees are considered in designing and managing it. The results of this study showed the importance of health education and health promotion intervention in the field of social health among staff, especially the staff of the Ministry of Health and Medical Education in Iran.

As recycling is a reasonable method for preserving the environment, this study attempted to discuss the empowerment of elementary students to perform source recycling in Maragheh city.
This was an intervention study. Four schools were selected randomly among Maragheh city elementary schools; 206 students as the experimental group and 207 were selected as a control group. After the trainings in 7 sessions in a classroom using teaching methods such as discussion, showing cartoons, role playing, storytelling, computer game were used and 8 promotional programs like recycling entertainments, crafts, recycling road games and Recycling Day was also implemented. All the students started to separate wastes while school. Some students, as green protectors, guided the students. A work report form was used to collect the data, confirmed by experts, was filled out by the two groups of students within 3 weeks before and after training. The report discussed their environmental activities. Data obtained were analyzed by Chi-Square test by SPSS 16.
After the intervention, the recycling activity in the test group was 38.8%. There was a significant difference in recycling and environmental activities of the test and control groups (p Results showed that education in empowering students was effective in improving waste separation behavior.

Health education tries to provide an opportunity for people to find necessary information and skills to make high quality decisions. One of the important steps for educational planning is selection of interventions that have most returns. The aim of this study was to prioritize health education methods through Analytical Hierarchy Process (AHP) and Goal Programming (GP) techniques.
This was a quantitative-qualitative and applied study. The sample consisted of all 12 city health centers in Markazi Province, Iran. Through Focus Group Discussions (FGDs), the main criteria of health education techniques were identified and prioritized through AHP technique. Then, using WinQSB software and GP program, the best combination of health education methods was determined.
Cost, access, acceptability, feasibility and effectiveness were identified as the main criteria for selection of health education methods. Prioritized training methods include, in order, were: group education (44.4%), face-to-face education (23%), distribution of pamphlets and brochures (10%), health education films (9%), sending educational SMS (7%), seminars (4%), TV education (1%), educational exhibitions (1%), role playing (0.5%) and educational rallies(0.10%).
Methods of group education, face-to-face education, distribution of pamphlets and brochures and showing health educational films have a significant returns than other methods in terms of cost saving, meeting educational needs, target group access to educational methods, popularity and feasibility.

Adolescents and youth are the most vulnerable groups concerning tobacco use. The present study was performed to determine predictors of intention and preventive behaviors of tobacco use among students based on the theory of planned behavior (TPB) constructs.
An analytic, cross-sectional study was conducted among 200 students of Gonabad University of Medical Sciences in 2013. Stratified sampling was used to select the participants. In order to collect the data, a validated and reliable questionnaire was designed based on the TPB. Participants fill out the questionnaire in a self-reporting form. Data were entered in SPSS 20 and analyzed by descriptive and analytic statistics, Spearman’s correlation coefficient and logistic regression model.
The students’ attitude and perceived behavioral control predicted 41% of the variations of their behavioral intention. Meanwhile, the perceived behavioral control could predict 32% of the participants’ behavioral variation. There were significant correlations between the participants’ attitude and their behavioral intention, the participants’ perceived behavioral control and their behavioral intention, as well as between perceived behavioral control of the students and their behavior of tobacco use (p The students’ perceived behavioral control would be a strong predictor for their intention to use tobacco and the students’ preventative performance of tobacco use.

Meta-cognitive therapy and educating components of spiritual intelligence were two important methods in treating anxiety disorders. This study was aimed to investigate the effect of meta-cognitive therapy and educating components of spiritual intelligence in decreasing the symptoms of generalized anxiety disorder among students.
This was a quasi-experimental study with a pre-test and post-test design. The statistical population included all students with generalized anxiety disorder that referred to counseling centers of Islamic Azad University, Mashhad branch in the year 2013. Totally 45 students were selected through available sampling method and randomly assigned to three groups. The experimental groups were educated for ten 70-minute sessions by meta-cognitive therapy and components of spiritual intelligence; the control group did not receive any treatment. For collecting data all groups completed the Cattell generalized anxiety questionnaire as a pre-test and a post-test. Data were analyzed with SPSS 19 and by univariate analysis of covariance (UNCOVA).
Both methods of meta-cognitive therapy and educating component of spiritual intelligence significantly led to the decrease of generalized anxiety disorder symptoms of students. Also, the findings showed there wasn’t any significant differences between meta-cognitive therapy and education component of spiritual intelligence methods in decreasing the symptoms of generalized anxiety disorder of students.
Meta-cognitive therapy and educating the component of spiritual intelligence methods were equally effective in decreasing the generalized anxiety disorder of students. Therefore, counselors and therapists can use the mentioned methods in treating generalized anxiety of students.

Family is the smallest part of the society that constitute the main pillars of a couple. Therefore, to have a healthy society, healthy families, we need to have a healthy couple. The aim of this study was to predict the Islamic marital satisfaction based on the quality of life among married students.
This study was a correlation one. The statistical population of the study was 400 married students of the Allameh Tabatabai University and Imam Hossain (AS) University in 2014. From the 400 samples, 200 men and 200 women were selected by convenience sampling. To collect data, short form of the Islamic Marital Satisfaction Questionnaire and WHO Quality of Life-BREF (WHOQOL-BREF) questionnaire were used. The data were analyzed through regression using SPSS 18.
The Results of regression analysis revealed that among four components of quality of life, mental quality of life (p According to The results of the regression tables, psychological and social components of quality of life of their ability to predict marital satisfaction.

Cardiovascular disease is the most common cause of death and a major cause of disability in many countries, including Iran. To reduce the effects of heart attacks and their complications, lifestyle and behavioral modification is needed. In this study, the theory of planned behavior was used to find out if an educational intervention could change the lifestyle of patients with myocardial infarction and how much is its effectiveness.
This was a randomized controlled trial conducted on 80 patients with myocardial infarction who live in the city of Bandar Abbas, Iran. The patients were divided into two groups by random allocation- intervention and control group. Those who were in the intervention group participated in 4 educational sessions (at 50 minutes a session, one session per week) in accordance with the theory of planned behavior. A questionnaire consisting of 3 parts was used to gather the data: demographics, Health Promoting Lifestyle Profile (HPLP II), and a researcher-made scale based on constructs from the theory of planned behavior. Content validity was used for validation and the reliability was assessed using Cronbach's alpha test, and the test-re-test. The questionnaire was completed three times through interview: before the intervention, one month and three months after the intervention. Data were analyzed using Chi-square, RMANOVA, and multiple linear regression.
The mean age of the participants was 51.5 7 ±7.70 years; 67% were male. One month and three months after the intervention, a significant improvement in the lifestyle of the intervention group compared with the control group was seen (p 0.001>). Also, based on the constructs of the theory (attitudes, subjective norms, perceived behavioral control, behavioral intention and behavior) one month and three months after the intervention, there were considerable increases in the mean scores of the intervention group than the control group (p 0.001>).
The educational program designed based on a theoretical foundation is useful to change attitudes, subjective norms, perceived behavioral control and behavioral intention for a healthy lifestyle among patients with myocardial infarction. It also may improve all aspects of lifestyle in such patients. Therefore, assessing the effectiveness of these theory-based educational interventions may be suggested to improve the lifestyle among other patients.

Crimean-Congo Hemorrhagic fever (CCHF) is a viral zoonosis transmitted by ticks. Determining the predictors of preventive behaviors of this disease and designing a structured educational intervention has an important role in promoting the health of all people who are directly or indirectly exposed to this dangerous disease, including ranchers and their families. The aim of this study was to determine the preventive behavior predictors in ranchers in Zabol.
In this cross-sectional study, 200 rural ranchers by a multi-stage sampling method randomly were selected and surveyed. The data were collected via a multi-section questionnaire that was developed based on the health belief model and its validity and reliability was confirmed by experts and Cornbrash’s alpha coefficient (α= 0.72). The data were analyzed in SPSS 16 using descriptive and analytic statistics (percentage, mean, Pearson Correlation coefficient and linear regression test).The significant level was set at 0.05.
91.5%, 46.5% and 31.5% of participants, respectively, were male, illiterate and rancher and over about 50% of them had butchered an animal in the past. Results also showed that preventive behaviors of CCHF have a positive significant association with perceived benefit and perceived self-efficacy, and also results of linear regression test showed that self-efficacy forecasted 11% of behavior variances in participants.
Maintaining and improving the ranchers health against the risk of CCHF in tropical regions, particularly in the Sistan region in Sistan and Bloochestan province is an educational urgency and interventions based on the health belief model should emphasize more on the self-efficacy and perceived susceptibility.

According to the importance of effective social factors on health, in this study a model of the relation between socioeconomic status, perceived stress, social support and domestic violence with women’ depression in reproductive age in Tehran the year of 2014 was tested.
This sectional descriptive-correlative study was performed on 1053 women referred to the medical centers affiliated to Shahid Beheshti University of Medical Sciences. The participants were selected through multi-stage random sampling. For collecting the data, demographic and socio-economic status, perceived stress, perceived social support, domestic violence and Beck depression questionnaires were used. The data were analyzed using SPSS 19 & Lisrel 8.8 software.
Results showed that 49.7% of women had mild to severe degree of depression. The average stress score of perceived stress was 23.22±8.34, and most of them (43.1%) had moderate of social support. 70% had good socioeconomic status. 41.1% were taken domestic violence. The final path model fitted well (GFI=1; RMSEA=0.08) and showed that socioeconomic status had direct (β=- 0.20) and indirect effect (β= - 0.07251), perceived stress had direct effect (β=0.16), social support had direct(β=- 0.22) and indirect effect (β=- 0.0672), domestic violence had direct effect (β=0.20) on depression, and in the overall effect social support had the most effects on depression (β= -0.2872).
According to the relation between all variables that investigated with depression of women, screening of these factors for prevention and diagnosis of depression in order to promote mental health and early intervention is recommended.