مجله آموزش بهداشت و ارتقای سلامت ایران
سال هفتم شماره 2 (پیاپی 26، تابستان 1398)

Threatening 5%-10% of people over 65, Alzheimer’s disease (AD) is the most common type of dementia. Studies recommended the consumption of substances containing omega-3 as a way to prevent AD. The aim of present study was to determine factors related to consumption of omega-3 supplements based on the health belief model (HBM) constructs in order to prevent AD among the elderly. In this analytical cross-sectional study, 333 elderly, who referred to the healthcare centers of Tehran city in 2015-2016, were selected by stratified random sampling method. To be over 60 years old, absence of AD and consumption of omega-3 supplements during the past year, were set as the study entry criteria. Data were collected by a questionnaire developed based on HBM constructs after determining its validity and reliability were determined. The collected data were analyzed using SPSS 16. The highest calculated mean belonged to the Preventive behavior construct 48.6 (P< 0.001) followed by Perceived benefits 42.3 (P< 0.001). The lowest mean value was acquired by the construct of perceived barriers. This study showed that there existed some significant correlations of the behavior of omega-3 supplement consumption with the knowledge and constructs of susceptibility, severity and benefits perceived by the elderly studied. Considering the present study results showing significant relationship of omega-3 supplement consumption with knowledge and majority of HBM constructs, it is suggested that some elderly education interventions be designed and implemented to promote the behavior of AD prevention through strengthening the constructs of HBM.

Due to the limited individual approach to behavior change, health promotion researchers use community-based initiatives to understand the factors affecting physical activity and promote the health of citizens. Urban open spaces can facilitate participation in physical activity and the health of citizens. The aim of this study is to identify the indicators, attributes, and dimensions of health promotion of citizens. This study was conducted in the first half of 2017 using the Cochran systematic review protocol. In order to search for studies related to public open areas and mobility and health of citizens, a search strategy was used in scientific directories and Web of Science databases to search for Latin articles and to use the SID for Persian studies. Through applying Meta synthesis, the extracted indices were classified in terms of the attributes and dimensions of the environment protecting the citizens’ health. The result of this research showed that 65 papers were eligible for analysis. After Meta synthesis studies, 62 indicators, 11 attributes and 4 main dimensions related to health protection and health promotion areas were identified. They include: physical, semantic, functional, and social individual. Urban open spaces can be a safe environment for citizens’ health promotion activities. There should be aesthetics and green urban environments so that the citizens could safely and tranquilly carry out health promotion activities. These environments should be functionally and accessibly attractive and they should be a channel for citizens’ socialization.

Parents of children with developmental disabilities, particularly autism spectrum disorders (ASDs), are at risk for high levels of distress. The aim of this study was to evaluate effectiveness of acceptance and commitment therapy on psychological flexibility and Health Promotion among mothers with autistic children. This study was a quasi-experimental pretest - posttest with control group. The study population was consisted of all mothers with autistic children in Qom city at 2017. Study sample consisted of 30 (15 for each group) mothers that were selected by as a voluntary and randomly recruits to each groups. Instruments for gathering data were WHO quality of life questionnaire and Acceptance and Action Questionnaire- II. Data was analyzed by SPSS v21 using Covariance analysis test. Based on research findings, the acceptance and commitment therapy had significant impact on health promotion and psychological flexibility.  According to the findings of the study, acceptance- and commitment-based therapy is an applicable treatment intervention for health and quality of life of mothers with autistic children.

Health education and health promotion are considered an important source for economic, social and individual development. It is the governments’ important role to consider it as a crusial matter and all human beings need training to achieve this worthwhile goal, namely health. This study was carried out using content analysis “Shannon Entropy”. In this method data processing is done with a new look and both quantitative and qualitative content analysis. Entropy is an index to measure the uncertainty, and probability distribution. The content of the responsive design (text layout and healthcare reform basic education development plan) and twelve main dimensions and 58 sub-components of health education and health promotion were examined. Analizing the data of Shannon entropy analysis showed that the prevention of disease (32 cases) is the most frequent factor, and the least amount belonged to physical activity, mental health, prevention of high-risk behavior and disabilities with the frequency of 0. Studying the whole document of fundamental transformation, the component of the mental health (97 cases) is the most frequent, and the least frequent component was disability (0 cases). The results of the frequency of components have shown that the components of the health system do not have the normal distribution. Unfortunately, very little health education and health promotion are discussed in this document.

The review of literature suggests self-talk and self-control as effective methods for improving mental health and achievement of goals. Considering the importance of improving the level of self-efficacy of students, this study aimed to compare the effectiveness of positive self-talk and self-control training on self-efficacy of 10th high school female students. The present study is a semi-experimental design with pre-test post-test design with experimental and control groups. The research population is female students who study in 10th grade of the empirical sciences of public schools in Tehran’s 2nd district in 2017-2018. The sample size was 60 students who were selected by simple random and simple cluster sampling method, and they were randomly assigned into three groups of 20 subjects, two experimental groups (one self-talk and one self-control training group) and one control group. Each of the experimental groups was trained for 10 weeks. To measure self-efficacy, the general self-efficacy questionnaire of Sherer et al. (1982) was used. Data analysis was performed using SPSS 21 and one-way covariance analysis. The results indicated that positive self-talk and self-control training were effective on self-efficacy of students. Also, there is difference between effectiveness of these two methods on self-efficacy, and self-control training had greater effect on increasing self-efficacy (P<0/001). Regarding the effectiveness of positive self-talk and self-control training on general self-efficacy of students, it is desirable to conduct training courses on positive self-talk and emotional self-control in schools by counselors and therapists.

Multiple sclerosis is a chronic autoimmune disease affecting the central nervous system with unknown causes. Because of unpredictable nature, most patients have poor resilience. The purpose of this study was to determine the effectiveness of Cognitive-Behavioral Stress Management Training on increasing the resilience of women with Multiple Sclerosis. The design of this study was semi-experimental with pre-test, post-test and control group. The study population consisted of all female MS Patients who are member of Tehran MS Associations in 2017. The sample consisted of 30 cases, who were selected by volunteer sampling method and were placed by matching method in experimental and control groups. For collecting the data, Conner –Davidson Resilience scale designed in 2003 was used. The experimental group were trained by cognitive-behavioral stress management approach designed by Antoni, Ironson and Schneider in 2007. The control group received no intervention. The duration of the treatment sessions consisted of 8 sessions of 90 minutes, performed as a group once a week. Data were analyzed by repeated measurement analysis. Based on the results of the repeated measurement Analysis test, there was significant difference between the pre-test scores with post- test and follow up scores (P<0.001). Trainings presented in form of stress management in cognitive-behavioral approach with improving the resilience components which contains control, commitment & challenge with problems, have significant positive effects on increasing the resiliency of women with MS, therefore it can be used as a useful intervention to increase health and resilience of women with MS by therapists & counselors.

This study assessed the efficacy of Acceptance and Commitment Therapy (ACT) on weight loss and cognitive emotion regulation in obese people. To do this study, 29 obese people with BMI > 29.9 were selected by purposeful sampling at the beginning, who completed demographic questionnaire and emotional cognitive regulation questionnaire. The participants’ body mass index (BMI) was measured at the first meeting and at the end of the treatment. Participants were assigned into the intervention and the control groups. The intervention group participated in acceptance and commitment group therapy sessions for five months and at the end of the treatment sessions, they completed the questionnaires again. Statistical methods included Chi-square test, t-test for comparing two independent groups and analysis of covariance (P<0.01). The findings showed that the acceptance and commitment therapy can reduce BMI; it also reduces negative strategies and increases the positive strategies of emotional cognitive regulation (P<0.01).  The present study showed that the acceptance and commitment group therapy resulted in weight loss and improved emotion regulation in people with obesity. Therefore, it is recommended to use this therapeutic approach for obese individuals.

One of the major stressors for families, especially women, is a recurrent pregnancy loss that exposes them to many psychological problems. This research aimed to investigate the effectiveness of positivism training on rumination, body image and sexual satisfaction in women with recurrent pregnancy loss. This was a semi-experimental research with a pre-test and post-test design and an experimental and control group. Research population was women with recurrent pregnancy loss referring to Imam Khomeini (Rah) and Razi hospitals in Ahvaz city in spring of 2018. Sample research was 40 people that were selected by available sampling method and assigned into two equal groups. The experimental group was trained for 8 sessions of 90 minutes with positivism method and the control group didn’t receive any training. The groups completed the questionnaires of rumination, body image and sexual satisfaction in the pre-test and post-test stages. Data was analyzed by multivariate analysis of covariance method using SPSS 19. The findings showed that there was a significant difference between the experimental and control groups in terms of rumination, body image and sexual satisfaction. In the other words, positivism training led to a decrease in rumination and positive body image and sexual satisfaction in women with recurrent pregnancy loss (P<0/001). The results indicated the effect of positivism training in improving rumination, body image and sexual satisfaction in women with recurrent pregnancy loss. Therefore, counselors and therapists can use positivism training to intervention in the field of rumination, body image and sexual satisfaction.

one of the most common genital tract infections among women is vaginitis. It is a very serious issue due to its potential side effects for women. The aim of this study is to determine the effect of education based on the Theory of Planned Behavior, on preventive behaviors of vaginitis among Health Ambassadors in Maneh and Samalghan County. A semi-experimental interventional study was conducted using random sampling method among 80 health ambassadors in reproductive age of 18-49 years of selected comprehensive health centers in the city. Data gathering tool was a questionnaire designed based on the theory of planned behavior, the validity and reliability of which had been approved prior to the study and before and after educational intervention was completed by intervention and control groups.
The data were analyzed by SPSS 19 and using the statistical tests Kolmogorov Smirnov, Chi-square, T-test, Mann-Whitney. The results showed that the mean age of women was 30.86 ± 6.6 and the mean age of marriage was 18.24 ± 4.1. After the educational intervention, The mean score of knowledge, constructs of the theory of planned behavior (attitude, subjective norms, perceived behavioral control and behavioral intention), and vaginitis preventive behavior Increased in the intervention group significantly compared to the control group (P<0.001) The health education program designed based on the theory of planned behavior was effective in Promoting preventive behaviors of Vaginitis.

The aim of this study was to evaluate the constructs of protection motivation theory (PMT) for predicting seat-belt use in front seat passenger on urban transportation.  In this cross sectional study, 328 participants who traveled in urban streets during the past week as a front seat passenger during February to May 2018 were selected through multistage cluster sampling. A questionnaire including demographic characteristics, items related to PMT’s constructs, and seat-belt use behavior were used to collect data. Data were analyzed using SPSS 22.  In this study, 234 participants (71.3%) used seat-belts as front seat passenger of whom 27.7% (n=91) used seat-belt on mandatory law, and 43.6% (n=143) used seat-belts for personal safety. The predictors of using seat-belt were intention (P<0.001, Exp (B)= 1.28), self-efficacy (P=0.031, Exp(B)=1.09), perceived response costs (P =0.003, Exp(B)=0.88), perceived reward of unsafety behavior (P=0.005, Exp(B)=0.82). The predictors of using the seatbelt for safety were intention (P<0.001, Exp(B)= 1.41), perceived response costs (P<0.001, Exp (B)=0.82), perceived reward (P=0.003, Exp(B)=0.78). The predictors of using seat-belt as law forcing was the intention (P=0.005, Exp(B)= 1.20), self-efficacy (P<0.001, Exp(B)=1.18), perceived reward (P=0.011, Exp(B)=0.82).  In addition to the mandatory seat belt law which, through self-efficacy and reducing the rewards of not using the seat belt increases the seat-belt use, the convenience of the seat belt with two mechanisms for reducing the perceived barriers to seat belt and reducing the benefits and rewards of not using the seat belt in people with view of maintenance safety increases seat-belt use.

The aim of this study was to evaluate the rate of adverse experiences in childhood experiences (relational ACEs) in family and school settings, among university students, and investigate how they affect the students’ negative health outcomes including depression, anxiety, suicidal attitude, lifetime serious suicidal thought (LSST). In this study, 524 students aged 18-28 years were selected via multi-level sampling, from disciplines of humanities, engineering, and basic sciences at University of Tehran. Ethical considerations were approved by Ethical Committee of University of Tehran. HADS (≥8) for depression and anxiety, a researcher-made questionnaire for relational ACEs, and two single-questions for suicidal attitude and LSST, were employed. Analyzes were conducted using Exact Fisher’s test and binary logistic regression (univariate and multiple). 487 participants (59.2% females) with mean age of 20.66±1.42 were analyzed. Depression with 43.6% and anxiety with 69.6% were reported. Suicidal attitude with 39.8% and LSST with 37.9% were reported, both of which were significantly higher among females. Affected outcomes mainly included anxiety and suicide variables. Major influential relational ACEs included emotional abuse (mostly on anxiety, odds=2.21,95%CI=1.40-3.35), lack of love (mostly on anxiety, odds=2.01, 95%CI=1.22-3.31), neglect (mostly on anxiety, odds=1.93,95%CI=1.19-314; and LSST, odds=1.93, 95%CI=1.24-2.94), divorce/separation (mostly on suicidal attitude, odds=2.23, 95%CI=1.04-4.79), peer victimization (mostly on anxiety, odds=1.60,95%CI=0.95-2.69, P<0.10), and physical (mostly on suicidal attitude, odds=1.78,95%CI=1.07-2.97) and non-physical (mostly on anxiety, odds=2.61, 95%CI=1.39-4.88) sexual abuse. Female gender contributed to the increased impact of relational ACEs on the outcomes. Findings emphasized a need for longitudinal and epidemiological studies in the country. Further investigation on social-environmental determinants contributing to development of ACEs and maintaining the consequences are recommnded.

Extramarital Affairs, as a traumatic event, can endanger a couple’s marital life .This research has been designed and conducted in order to provide a predictive Causal model of the attitude of couples toward infidelity based on attachment styles and early maladaptive schemas, in addition to the mediating variable of marital intimacy, and love styles. Subjects include 650 married individuals (357 females and 293 males) living in Tehran in 2018 who were chosen using the convenience sampling method. Research data was gathered using Yung’s early maladaptive schemas questionnaires, attachment styles, love styles, marital intimacy and attitude toward infidelity. Data analysis was done using the path analysis method and the AMOS statistical software. Based on the direct effect of anxiety attachment, emotional deprivation, abandonment, social isolation, failure and vulnerability schemas on Eros love style, and the direct effect of anxiety attachment style and social isolation schema on Storge’s love style, were significant (P≤0/05). Also, emotional deprivation, vulnerability, self-sacrifice, and Eros, Storge and Agape love-making styles had a direct effect on marital intimacy (P≤0/05) and the direct effect of anxiety attachment, Storge love style, enmeshment, vulnerability, self-sacrifice schemas, and intimacy on marital infidelity were significant (P≤0/05). Based on the values of comparative, absolute and relative indices, the tested model had a favorable fit. Since marriage and choosing a partner are among the most important decisions in life, the necessity of studying these predictive variables in premarital and family counseling to identify individuals exposed to risk must be emphasized upon.