homamodin javadzade

Osteoarthritis (OA) is a prevalent joint condition that significantly reduces individuals’ quality of life. Effective preventive behaviors can help mitigate the occurrence of OA, and understanding the factors influencing these behaviors is crucial. Health literacy has been identified as a significant factor affecting various health outcomes; however, limited information is available regarding its association with arthritis prevention behaviors. This study aimed to assess the predictive role of functional, communicative, and critical health literacy in adopting arthritis prevention behaviors among middle-aged women.

This cross-sectional descriptive-analytical study was conducted in 2023 on a randomly selected sample of 519 women aged 30-59 years, affiliated with the Borazjan Comprehensive Healthcare Center. Data were collected using the Functional, Communicative, and Critical Health Literacy (FCCHL) questionnaire and an OA preventive behaviors survey. Data were analyzed using R version 3.3.4 through multiple regression and descriptive statistical methods. Furthermore, a significant level of P<0.05 was considered statistically significant.

The mean age of the participants was 41.85±8.01 years, ranging from 30 to 59 years. Among the health literacy dimensions, the highest and lowest average scores were assigned to critical and functional dimensions, respectively. Multiple regression analysis revealed that among the cognitive variables, joint pain (P=0.001, β=0.106), and among the domains of health literacy, critical health literacy (P<0.001, β=0.258) were significant predictors of OA preventive behaviors.

This study highlights the importance of considering critical health literacy levels among women and the intensity of joint pain when designing educational programs for preventing OA among middle-aged women. These findings underscore the need for targeted interventions to enhance health literacy and alleviate joint pain to promote effective arthritis prevention behaviors.

The use of digital games is highly prevalent among adolescents and can adversely affect their physical and mental health. The aim of this study was to determine the predictors of the stages of change in problematic digital games in high school students using a transtheoretical model.

This descriptive-analytical cross-sectional study was performed on 703 high school students in Bushehr 2020. A valid and reliable researcher-made questionnaire was performed for data gathering and analyzed using SPSS ver. 22 by descriptive indices, one-way ANOVA, chi-square, and rank ordered logistic regression.

According to the results, self-efficacy, dramatic relief and social freedom were the predictors of the change stages of reducing and quitting digital games. This means that girls and students with higher self-efficacy (P = 0.037, OR = 1.054), have a better chance of being in higher stages of change and by increasing a unit of dramatic relief score (P = 0.025, OR = 1.09) and social freedom (OR = 1.135, P <0.001), the chances of individuals to be in the upper stages of change increased.

It seems that the design of educational interventions based on self-efficacy variables and taking into account the change processes of dramatic relief and social freedom, which increase the chances of people to be placed in higher stages of change, in reducing the behavior of digital games of students, especially for boys will be effective.

Diabetes Self‑Management Education and Support (DSMES) as a framework focuses on seven self‑care behaviors. Moreover, technology‑assisted self‑care education is increasingly suggested for patients with Type 2 Diabetes Mellitus (T2DM). Therefore, we examined the effect of a web‑based program on self‑care behaviors and glycated hemoglobin values in patients with diabetes mellitus. 

This randomized controlled clinical trial was conducted at Alzahra Hospital in Isfahan, Iran, between April and November 2020 and included 70 patients with T2DM. Data were collected using a questionnaire that included a demographic information section and a diabetes self‑management section with 21 questions on a Likert scale. Fasting blood samples (2.50 ml) were collected before and after the interventions to measure HbA1c levels. The study intervention involved a web‑based program that included multimedia educational content (such as videos, lectures, educational motion graphics, text files, posters, and podcasts) presented in seven sections based on DSMES over a 21‑day period with monitoring by an instructor.

The mean scores for healthy eating (F = 3.48, p = 0.034) and medication adherence (F = 6.70, p < 0.001) significantly increased in the interventional group, while the mean scores for being active, monitoring, reducing risks, problem‑solving, and healthy coping did not significantly change. Additionally, the mean differences in HbA1c values significantly improved in the interventional group compared to the control (F = 5,1, p = 0.026).

A web‑based program in accordance with DSMES improved HbA1c levels and increased scores for healthy eating and medication adherence in patients with T2DM. However, further research with larger sample sizes and qualitative interviews is needed.

Healthcare workers, who work at the frontline of providing health services, are at risk of occupational stress due to several conditions. Therefore, the present study was conducted to determine the effects of virtual training based on Bandura's self-efficacy theory on occupational stress of healthcare workers in Bushehr, Iran.

This semi-experimental study was conducted on 63 healthcare workers in Bushehr city in 10 comprehensive healthcare centers randomly selected as intervention and control centers (n=5 each). The intervention group received four sessions of virtual training based on self-efficacy theory in the form of a webinar, while the control group received no training. The information of the studied subjects was collected using a questionnaire consisting of four sections, namely demographic information assessment, self-efficacy assessment, and occupational stress assessment before, two weeks, and one month after the educational intervention. The data were analyzed using SPSS software version 24.

In general, knowledge and self-efficacy increased in the intervention group after training, and changes in knowledge and self-efficacy were significantly different between the two groups during the study period (P<0.001). In the intervention group, occupational stress improved two weeks and one month after training, compared to the pre-training period, whereas in the control group, although the changes were significant, these changes manifested as an increase in stress intensity. There was a significant difference in occupational stress changes between the two groups during the study period (P<0.001), and the condition improved in the intervention group.

The results of this study suggested that virtual stress management education based on self-efficacy theory could increase knowledge levels and self-efficacy and improve occupational stress in healthcare workers.

Hookah, as a traditional method of smoking, is widely used in Iran, especially in Bushehr province. It is essential to identify the most important determinants of modifying hookah smoking behavior. This study aimed to investigate the predictors of the stages of change in quitting hookah smoking in 15-60-year-old individuals in Bushehr province, southern Iran, based on the transtheoretical model (TTM).   This descriptive-analytical study was conducted on 1173 Hookah smokers in Bushehr province. The samples were selected by two-stage random sampling from 10 cities. Data were collected using a valid and reliable questionnaire consisting of 5 sections (demographic characteristics, stages of change, processes of change, decisional balance, and self-efficacy). Data were analyzed by R version.3.3.1 using analysis of variance and ordinal logistic regression at a significant level of 0.05.  The data revealed 82% of the participants were in the preparatory phase (55.3% in pre-contemplation and 26.7% in contemplation stages). Marital status, family members smoking hookah, cigarette smoking, level of education, number of family members, number of quitting attempts, self-efficacy, self-reevaluation, counter-conditioning, reinforcement management, and stimulus control were predictors of quitting hookah smoking. Given that most study participants were in the inactive stages of quitting hookah smoking, it seems necessary to design and implement behavioral interventions based on the predictive TTM constructs in this population.

Although no definitive cure has been discovered for AIDS yet, this disease can be controlled with early diagnosis and current medications Therefore, the present study was conducted to determine the effect of a web-based educational intervention according to the health belief model on HIV testing in Bushehr marriage volunteer couples.

The present study was a quasi-experimental study done on 122 couples who volunteered for marriage (61 couples in the intervention group and 61 couples in the control group) referred to the Nabi Akram Center in Bushehr. The control group received training and routine services, and the intervention group, received a web-based multimedia intervention based on Health Belief Model in addition to the above services. The data were collected by a questionnaire consisting of three sections of demographic knowledge, Health Belief Model constructs, and items for measuring behavior. After data collection, the analysis was performed by STATA software ver.15. The significance level of statistical tests was considered 0.05.

In the intervention group, there was a statistically significant difference between awareness and all constructs except perceived intensity before and after the intervention (P<0.001), while in the control group, no statistically significant difference was seen in any of the variables after the intervention (P>0.001). Changes in the mean scores of awareness and all constructs between the two groups during the study period had a statistically significant difference and were higher in the intervention group (P<0.001). Regarding HIV testing, there was a statistically significant difference between the two intervention and control groups after the educational intervention and HIV testing was significantly higher in the intervention group.

Web-based education, according to the health belief model, is effective and can be used to encourage young couples to test for AIDS for early diagnosis.

 Health literacy (HL) is a factor with significant impact on the quality of communication between healthcare providers and clients and the outcomes of healthcare services. The aim of the study was to evaluate healthcare providers’ HL-related knowledge, attitude, and practice.

 This cross-sectional descriptive study was conducted in 2019–2020. Participants were all eligible healthcare providers in all eleven urban healthcare centers in Shahrekord, Iran. A demographic questionnaire and a researcher-made HL-related knowledge, attitude, and practice questionnaire were used for data collection and the SPSS software (v. 18.0) was used for data analysis.

 The mean scores of participants’ HL-related knowledge, attitude, and practice were 39.62±14.23, 37.54±16.56, and 56.54±19.19, respectively. There was a significant positive correlation between the mean scores of HL-related attitude and practice (P=0.001).

 Healthcare providers may have poor HL-related knowledge and attitude and moderate HL-related practice. Therefore, in-service educational programs are recommended to improve their HL-related knowledge, attitude, and practice.

The World Health Organization considers preventive behaviors, which are influenced by several factors, the most important factor in breaking the COVID-19 transmission chain. Therefore, the present study aimed to determine the predictors of COVID-19 preventive behaviors based on an extended pattern of health beliefs in adults.

The present study is a descriptive-analytical cross-sectional study performed on 900 adults. The sample was selected through convenience sampling from the statistical population of Salamooz website users. In this study, information was collected using a researcher-made questionnaire consisting of four sections (demographic characteristics, health belief model constructs, perceived social support, and COVID-19 preventive behaviors) and statistically analyzed using the SPSS software (version 24).

Among the studied variables, age (P<0.001, B=0.04), sex (P<0.001, B=1.33), history of COVID-19 (P=0.001, B=-0.75), perceived sensitivity (P=0.007, B=0.13), perceived barriers (P<0.001, B=-0.24), perceived self-efficacy (P< 0.001, B=0.16), family social support (P<0.001, B=0.13), and friends social support (P=0.021, B=0.06) were predictors of COVID-19 preventive behaviors. These constructs were able to predict 29% of changes in COVID-19 preventive behaviors. Among them, perceived barriers were the strongest predictor of preventive behaviors.

Based on the predictors of COVID-19 preventive behaviors, it is suggested that policymakers, officials, and planners in the process of implementing behavioral change to improve COVID-19 preventive behaviors form strategies to increase mental sensitivity. In particular, they can use the risk of illness and inform families, as well as individuals, to improve their supportive role and self-efficacy to reduce barriers to performing preventive behavior.

Dyslipidemia is one of the major causes of cardiovascular disease (CVD); however, it can be prevented and controlled via observing and adherence to a diet. This study aimed at determining the effect of nutrition education based on BASNEF model on decreasing blood lipid profile.  This clinical trial study was conducted on 150 people with a high blood lipid profile who referred to Shahrekord laboratories in 2020. The samples were randomly divided into intervention and control groups. In order to measure blood lipids such as high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), triglyceride (TG), and total cholesterol (TC), 15 mL of venous blood samples were collected after 12 hours fasting before the intervention and again 2 months after the intervention. The intervention group received nutrition education based on BASNEF model, and the collected data were analyzed using SPSS version 20 software.  There was no significant difference between the two groups in terms of demographic variables. TG levels in the intervention group decreased significantly after the intervention (P < 0.001). In addition, TC and LDL levels decreased significantly in the intervention group after the intervention (P < 0.001), while the level of HDL index in the intervention group increased significantly after the intervention. Nonetheless, there was no significant difference in these indices in the control group after the intervention (P > 0.05).  The significant decrease in blood lipids after a short period indicates the effect of nutrition education based on BASNEF model and adherence to proper diet on controlling blood lipids. Therefore, recommending people to adhere to a proper diet can help raise people’s nutritional awareness and reduce blood lipids.

This study was conducted with the aim of comparision study of the effect of educational intervention based on health belief model using two methods of web-based multimedia education and booklet on adherence to mammography in women 40 years and older in Bushehr.

This study is a quasi-experimental study that was performed on 126 women 40 years and older (three groups, each consisting of 42 people). Educational content was designed based on the Health Belief Model. Data gathered by questionnaire before and two months after the educational intervention and, were analyzed using chi-square test and repeated measures analysis of variance in SPSS v.22.

after Intervention, comparison of the three groups showed that the mean score of knowledge in both Web-Based and booklet groups increased compared to the control group. Perceived benefit, susceptibility, perceived severity and health motivation also increased significantly after intervention in the web-based intervention group, but no significant change was observed in control groups. Perceived barriers also decreased in the web-based group after intervention. Adhering to mammography in the web-based intervention after training was significantly higher than the booklet and control group.

The results of this study showed that educational intervention based on psychological structures and web-based can be useful in improving women's beliefs about mammography behavior and promoting their behavior. It seems that the use of web-based teaching methods is more acceptable and effective than previous methods such as booklets. Therefore, designing studies using modern web-based educational methods is suggested.

Nomophobia is defined as the fear of being out of mobile phone contact and is considered a phobia of the modern age. The current study explored the effectiveness of the medical Librarian's web-based educational program on optimal use of smartphones among students with nomophobia based on self-efficacy theory.

This semi-experimental study applied random controlled clinical trial and before-after Design groups with a follow-up method. The population included all students of Bushehr University of Medical Sciences. Of the population, 98 students with high score nomophobia were selected as a sample. They were divided into two groups, control, and intervention, randomly. The intervention group received a web-based educational program, plus an electronic pamphlet. Data were collected in two steps. SPSS software was used to analyze data.

The results indicated that the nomophobia score in an intervention group reduced significantly (P<0.001), just two weeks after the intervention (54.1±16.20) in comparison to the before (78.3±22.11). Also, the average score of self-efficacy increased remarkably (P<0.001), after the intervention (36.3±4.20) than before (30.8±4.79). The score of nomophobia and self-efficacy showed a significant difference between the control and intervention groups.

Health-based educations, especially web-based educations, can be considered a good solution during the pandemics for target audiences. The useful web-based educational program could have improved the recognition of the students toward nomophobia and increase their self-efficacy.

The present study aimed to investigate the relationship between self-efficacy, decision-making balance, and change processes with stress management in middle-aged women.

This cross-sectional study was performed in 2019 on 600 middle-aged women covered by Bushehr Comprehensive Health Services Centers. The method of sampling was stratified. Data was gathered by demographic questionnaire and TTM based questionnaire, including self-efficacy, decisional balance (perceived barriers and benefits), processes of change, and stage of changes. Data were analyzed using ANOVA and Tukey post hoc test in SPSS 20 software.

The lowest and highest mean stress management scores were in the women in pre-contemplation (13.64±3.79) and maintenance (22.58±4.10), respectively. The mean score of self-efficacy in the women during the stages of change from pre-contemplation (15.71±6.80) to maintenance (33.06±5.09) was upward, and this average score in the stages of pre-contemplation, contemplation, and preparation was significantly lower than the stages of action and maintenance (p<0.001). Regarding processes of change, consciousness-raising, dramatic relief, environmental reevaluation, self-evaluation, social liberation, self-liberation, stimulus control, counter conditioning, helping relationships, and reinforcement management are significantly lower pre-contemplation and contemplation than action and maintenance (p<0.001).

The results indicate the importance of TTM constructs in advancing individuals to higher levels of change. Based on this, it is recommended to design and implement educational interventions based on TTM to improve stress management behaviors.

Lack of attention to health literacy by health professionals in relation to clients affects the quality and success of health services. The present study aimed to investigate the knowledge and practice of health care providers in Bushehr City, Iran, regarding health literacy and applying its related strategies in the process of communication with patients.

This was a cross-sectional descriptive-analytic study done on 91 health care careers in Bushehr. The samples were entered using a census method, and a researcher-made questionnaire was used to assess the level of knowledge and practice of healthcare providers about health literacy and applying related strategies in communication and education to clients. Data were analyzed using descriptive and inferential statistics via SPSS software.

The level of knowledge of health care providers was weak about health literacy and its related strategies, and the status of performance and application of health literacy strategies in the process of communication and education to the clients was generally moderate. Health care providers with lower age (P = 0.022), less work experience (P = 0.009), contracted employment status (P = 0.008), and higher education level (P = 0.026) had better knowledge about the health literacy. Health care providers with higher levels of knowledge about health literacy strategies also had better performance in using these strategies in practice (P = 0.017).

Health care providers' knowledge about health literacy is weak, and there is moderate performance in applying health literacy strategies in the process of communication and education to the clients. Since health care providers who have a better understanding of health literacy strategies, use health literacy strategies more than others do; therefore, training courses is necessary to empower health care providers with the concept of health literacy and its effective role in patient education.

Health literacy and health-promoting behaviors are among the most important determinants of health. This study aimed to evaluate the relationship between health literacy and the status of health-promoting behaviors in Shahrekord adults. 

Materials & Methods:

This study was performed on 384 adults who referred to healthcare centers in Shahrekord in 2018 using cluster sampling. Data were collected using functional, communication, and critical health literacy questionnaires and health promotion lifestyle scale. In addition, data analysis was performed in SPSS version 18 using descriptive and analytical statistics (e.g., Pearson’s correlation coefficient and one-way ANOVA). Notably, a P-value of less than 0.05 was considered statistically significant.

In this study, the participants obtained low mean health literacy (functional: 49.19±54.15, communication: 53.45±15.89 and critical: 50.86±17.88) and health-promoting behaviors scores. In the target group, the highest and lowest scores obtained were related to the dimensions of spiritual growth and self-fulfillment (46.50±14.86) and physical activities (24.16±26.49), respectively. The results were indicative of a relationship between functional, communication, and critical health literacy and dimensions of health-promoting behaviors in the participants (P<0.05).

According to the results of the study, more attention must be paid to health literacy and health-promoting behaviors in healthcare plans and policies. Therefore, it is recommended that the increase and improvement of these factors be prioritized in this regard.

Adolescents who have overweight and obesity face many physical and psychological problems and this condition may extend to adult life. The aim of this study was to compare factors related to health promotion lifestyle based on Pender Health Promotion Model (HPM) among high school students with and without overweight and obesity. Materials and Methods This was a comparative cross-sectional study conducted on high school students in Deyyer city, Bushehr province, Iran. 353 students (180 students with overweight and obesity and 173 without overweight and obesity) were studied. The data collection tool consisted of three sections (baseline characteristics, HPM constructs and Health-Promoting Lifestyle Profile II). Data were analyzed using SPSS software version 22.0.

The mean score of health promoting lifestyle behaviors in spiritual-growth (p<0.029), responsibility (p<0.02), stress-management (p<0.002), physical-activity (p<0.001), healthy-eating (p<0.002), in students with overweight and obesity were significantly lower than those without overweight and obesity. According to the results of regression analysis, predictors of health promoting lifestyle between two groups of students were different. The only predictor construct of healthy lifestyle in adolescents without overweight and obesity was perceived self-efficacy (p<0.001), and in students with overweight and obesity in addition to perceived self-efficacy (p=0.030), perceived barriers (p=0.015), also predicted students' health promoting lifestyle.

The results of this study showed that students with overweight and obesity had a poor health promoting lifestyle compared to those without overweight and obesity. In general, to improve the health-promoting lifestyle, implementation of educational interventions based on the HPM with emphasis on self-efficacy for normal weight students and self-efficacy and perceived barriers constructs for obese and overweight students are recommended.

Self-medication is a high prevalent behavioral choice that may lead to serious consequences. it is necessary to identify the factors that influence and modify this behavior. In this regard, this study aimed to investigate the role of psychological factors and health literacy on self-medication behavior in adults in Bushehr province.

This is a cross-sectional descriptive-analytic study that was conducted on 1013 persons referred to Bushehr comprehensive health centers. The subjects were selected through convenience sampling and completed demographic, knowledge, psychological constructs of health belief model, health literacy, and self-medication questionnaires. Data were analyzed using independent t-test, chi-square and logistic regression models in SPSS software version 22.

Based on the results, occupational status, insurance coverage, knowledge, perceived susceptibility, perceived severity and critical health literacy were predictors of self-medication behavior. According to the results, laborers and retirees were less likely to self-medicate than the unemployed as well as those who were not covered by insurance in comparison to those who were covered by the insurance services. Other results also showed that subjects with higher knowledge and perceived susceptibility had a 1.34- and 1.77-times higher odds of self-medication, respectively. Individuals with higher perceived severity and higher critical health literacy were less likely to practice self-medication.

Improving health insurance coverage and attention to occupation and knowledge, as well as modifying perceived susceptibility and severity beliefs, beside the considering and promoting critical health literacy can be effective in modifying self-medication behavior in individuals.

The skills that are required for understanding and applying health information to everyday life have been conceptualized as health literacy. Limited health literate people have more health problems, given that health promoting behaviors can play a protective role for people's health, therefore, the purpose of this study was to determine the relationship between health literacy and health promoting behaviors.   In this cross-sectional study, 402 individuals over 18 years of age referred to the health centers (in the city of Bushehr, south of Islamic Republic of Iran), completed the (FCCHL) scales for assessing health literacy, (HPLP II) for assessing health promoting behaviors and a demographic questionnaire. The sampling method in this study was two-stage cluster sampling. Multiple regression model was performed in the analysis using R software (version 3.3.2) to predict health literacy outcome.   Functional, communicative and critical health literacy were related to some aspects of health-promoting behaviors but not to all. All the health literacy subscales were significant predictors of health responsibility and none of them predict interpersonal relations.   Health literacy plays an important role in successful health-promoting lifestyle behaviors, but the impact differs by context. These findings can be used in planning and the implementation of educational interventions to improve healthy lifestyles.

Health literacy is an important element in the ability of a woman to engage in activities that promote her and her family and her children’s health. The pregnant women’s health literacy, can improve the quality of prenatal care, affect the outcome of pregnancy and in addition to the health of the baby. Understanding the most important factors affecting the health literacy of pregnant women is very important. Therefore, the present study aimed to determine the relationship between health literacy level and socioeconomic status of pregnant women in Bushehr city. In this descriptive cross-sectional study, 100 primigravid women referred to the comprehensive health centers of Bushehr city were selected randomly. Health information literacy questionnaire (FCCHL) and socioeconomic status questionnaire (SES) were used to collect information. Data were analyzed by SPSS v.22 software. The mean age of participants was 26.96 ± 4.84. The highest level of health literacy was in the functional and the lowest score in the critical domain. Employed pregnant women had better communicational (p=0.002, z= -3.12) and critical health literacy (p=0.006, z=-2.938). There was a direct and significant correlation between socioeconomic status and critical health literacy (p = 0.04, r = 0.206). It seems in women with lower socioeconomic status due to lack of the job, low income and other affecting factors, the acquisition of skills related to health literacy, especially critical health literacy is denied. This could be a threat to their health. Therefore, it is necessary to pay attention to women with low socioeconomic status in order to improve their health literacy or provide health services and education appropriate to their level of health literacy.

Although exclusive breastfeeding (EBF) is highly emphasized by the experts, nulliparous women do not adhere to this behavior at a desirable level. Since it seems that mothers’ beliefs and values play an important role in their adherence to these behaviors, the present study, aimed to perform a careful analysis of the behavior and evaluation of factors associated with the EBF in nulliparous women referring to healthcare centers in Bushehr using theory of planned behavior.
This is a cross-sectional study, which was conducted on 400 nulliparous mothers with children less than six-months who referred to healthcare centers in Bushehr, Iran. Stratified random-sample was used and data were collected using a researcher-made questionnaire and were later analyzed using statistical tests, including Pearson, Spearman, linear regression and logistic regression in SPSS version 22.0 Software.
The results showed that 62.5% of infants were exclusively breast-fed. Variables such as infant' gender, father's occupation and type of pregnancy were significantly related with EBF behavior. Constructs, including attitude (P The theory of planned behavior is an appropriate framework to identify factors associated with the EBF behavior among nulliparous Iranian mothers. Therefore, designing interventions based on this theory seems to have the potential to improve the EBF practice.

Undoubtedly, proper nutrition has important role in safeguarding the individual from many diseases, especially chronic ones, and increasing ones physical and intellectual efficiency. Considering the importance of nutrition education to school-age kids, this research was done with the purpose of determining the effect of nutrition education on the knowledge, attitude, and performance of female students at primary school about junk food consumption.

This is an experimental intervention study in Shahr-e-kord city about the reduction of junk foods consumption in 2011. Seventy-two primary girl students were randomly divided into 2 groups, experimental (36) and controls (36). Before of the educational program, self-administrative questionnaire and FFQ (Food Frequency Questionnaire) questionnaire were filled out for both the groups. The self-administrative questionnaire was completed 3 times (before, immediately, and 2 months after education), and FFQ questionnaire was completed 2 times (before and 2 months after education) by students. After pre-test, 4 educational session classes in experimental group were performed. Finally, data were collected and analyzed by SPSS 16 computer software.

Demographic variables of the studied population in 2 groups were similar. Before intervention, there were no significant differences regarding the knowledge, attitude, and performance in 2 groups (P > 0/05). After intervention, there were significant differences in the levels of knowledge, attitude, and performance between experimental and control groups (P < 0.001).

According to the results, intervention has positive impact on pattern of nutrition, and it can be concluded that intervention is effective on increasing or improving the knowledge, attitude, and performance of the students.

Diabetes is a chronic disease that can cause severe complications such as cardiovascular disease, blindness and kidney failure. Given the importance of self-care in diabetic patients, and considering that inadequate health literacy is a serious barrier for the management of diabetes that can affect patient's participation in self-care, Therefore this study aimed to assess the status of health literacy in patients with type 2 diabetes in three domains of functional, communicative and critical and Determine the factors associated with self-care behaviors in these patients. A cross-sectional study on 187 diabetic patients referred to Hazrat Ali diabetes clinic in Isfahan. The samples were selected by randomly Convenience sampling method. The level of health literacy and Status of self-care behaviors in patients was assessed by a standardized questionnaire (FCCHL) and (DMSES) respectively. Collected data were analyzed Using the ANOVA, t-independent, Pearson correlation coefficient at SPSS v.21 statistical software. The mean age of the study population was 57.40 ± 11.07. Average health literacy score and self-care behaviors of the participants were 2.28± 0.57 and 3.84 ± 1.56 respectively. There was significant relationship between total health literacy, communicational and critical health literacy with self-care behaviors. There was no significant relationship between functional health literacy and self-care behaviors. Communicational health literacy was associated with diet, physical activity, blood glucose monitoring and foot care. Critical health literacy was associated with physical activity, blood glucose monitoring, foot care, and taking medication. There was no significant relationship between Communicational health literacy and taking medication and also between critical health literacy and diet. Considering that communication and critical health literacy was associated with the self-care of patients with diabetes so Emphasis and consideration should primarily be given on skills related to these domains of health literacy. Since that Patients’ functional HL capabilities that was associated with basic skills in reading and writing was not related to self-care, therefore assessment of education levels alone in the clinical setting is not recommended.

Colorectal cancer is one of the most common cancers and second leading cause of cancer deaths worldwide. Every year nearly one million new cases of colorectal cancer are recognized around the world and nearly half of them lose their lives due to the disease. Researches shown that in early diagnosis of this cancer 90% of patients can be treated. The fecal occult blood test (FOBT) because of its low cost and simplicity has priority over other screening methods. The goal of this study was assessing the perceived barriers that affecting participating in colorectal cancer screening programs in moderate risk population. A case-control survey of 196 individuals over 50 years old was conducted in Esfahan. 98 of the target group were selected from laboratories while they came for doing FOBT test (Group A). The other 98-Individuals (Group B) were selected with cluster sampling by home interview. The Standardized questionnaire containedquestions about perceived barriers associated with performing FOBT. Collected data were analyzed using descriptive and inferential statistics methods using SPSS v14. The mean score of perceived barriers in the first group was 40.9 and in the other group was 56.54 (p<0.001). Also all those people that performed FOBT in last year reported less perceived barrier (p<0.001). Lack of awareness, not being in priority, fear of cancer detection and lack of physician recommendation were some of barriers in non-referred to laboratory group. According to this study, a better understanding of barriers affecting the test performance, removing the barriers can be a useful step to increase rate of early detection and reduce rate of death, costs, and improve community health outcomes.

health literacy is ameasure of individual’s ability to read، comprehend، and act on medicalinstructions. Individuals with limited health literacy have less healthknowledge، lower use of preventive services، delayed diagnoses، worseself-management skills and incur higher health care costs. Older adults are oneof the most important at risk group. Health promoting behaviors in older adultshave Potential impact on their health، quality of life and reduce the costsrelated to health care. So the purpose of this study was to assess healthliteracy level in older adults and to investigate the Relationships betweenhealth literacy and health promoting behaviors. A cross-sectional surveyof 354 older adults was conducted in Isfahan. The method of sampling wasclustering. Health literacy was measured using the Test of Functional HealthLiteracy in Adults (TOFHLA). Data collected using home interviewing. For data analyzingwas used SPSS 18 and descriptive statistics and One Way ANOVAs and k squaredtests. Approximately 79. 6% of adults were found tohave inadequate health literacy. They tended to be older، have fewer years ofschooling، lower household income، and being female. Individualswith inadequate health literacy were more likely to report limitations inactivity and less consumption of fruit and vegetables (p<0. 001). Nosignificant association was found between health literacy and smoking status. Low health literacy isvery prevalent in older adults so it indicates the importance of healthliteracy issue in health promotion. Therefore with simple educational materialsand effective interventions for low health literacy group we can improve healthpromotion in society and mitigate the adverse health effects of low healthliteracy.