Health Education and Health Promotion
Volume:11 Issue: 2, Spring 2023

The phenomenon of infodemic, characterized by the rapid dissemination of misinformation, disinformation, and misconceptions, poses significant threats to public health, social cohesion, and trust in institutions. This letter explores the role of metaphors in contributing to misconceptions and provides insights into effective infodemic management strategies. Metaphors, while powerful tools for simplification and understanding, can unintentionally perpetuate misconceptions. In an infodemic context, carefully crafted metaphors can be harnessed to combat misinformation, but caution must be exercised to avoid reinforcing misconceptions or oversimplifying complex topics. In conclusion, effective infodemic management necessitates leveraging metaphors thoughtfully and engaging experts from diverse fields. By implementing evidence-based strategies and integrating AI responsibly, society can better combat misinformation and promote accurate understanding during an infodemic.

Approximately 49% of pregnancies in adolescents aged 15-19 years are mistimed. Significantly in Jambi City, this trend has increased. It reflects adolescents lack of understanding about healthy living, the risks of sexual relations, and the rejection of unwanted relationships. This study aimed to determine the effect of counseling using videos and leaflets on adolescents' knowledge about the impact of mistimed pregnancy.

This quasi-experimental study, with a pre-test and post-test with a control group design, was conducted from January to June 2021 in the work area of the Penyengat Olak Public Health Center, Jambi City, Indonesia. Ninety-six adolescents participated in the study and were divided into groups with video intervention and leaflet education, totaling 48 adolescents each. Research data were analyzed using the analysis of covariance test.

A significant increase was observed in student's knowledge after education using videoeo media, with a different mean score of 36 (p=0.001). Also, there was a significant increase in student's knowledge after receiving an education using leaflet media, with a different mean score of 24 (p=0.001).

Education using video media is more effective than leaflet media in increasing adolescents' knowledge about mistimed pregnancy.

Premarital screening is a procedure to assess health status before entering the marital stage. In Indonesia, this examination has not been fully optimized for controlling catastrophic diseases, including genetic diseases. This study aimed to determine the relationship between knowledge, attitudes, and behavior toward premarital genetic screening in non-medical and health students.

This cross-sectional descriptive study was conducted on 400 non-healthcare students from the southern region of Central Java, who were selected using a simple random sampling method. The knowledge, attitudes, and behaviors toward premarital genetic screening were measured using questionnaires. The chi-square test was used to look for relationships between variables.

The knowledge level in 55.5% of respondents was sufficient, in 42.5% was poor, and in 2% was good. Most respondents (57.3%) had a positive attitude. The majority of the respondents exhibited a positive attitude toward all indicators, except for actively seeking information. 355 respondents (88.75%) displayed positive behavior toward premarital genetic screening, while the 45 respondents (11.25%) exhibited negative behavior. There was no significant relationship between knowledge with attitude and behavior (p>0.05), but a significant relationship was observed between attitude and behavior (p=0.021).

There is no relationship between knowledge and attitude. However, the study found a relationship between attitudes and behaviors toward premarital and genetic screening in non-health students.

Because low levels of maternal knowledge can cause stunting, developing an education system and web-based stunting anticipation system is needed to increase mothers' ability to improve stunting prevention efforts. This study aimed to evaluate the effectiveness of the Education System and Stunting Anticipation on mothers' knowledge, attitudes, and practices in preventing stunting in Pekanbaru City.

This research adopted a quantitative analytic approach using a quasi-experimental pre-and post-test design with controls. The study was conducted in the working area of Rejosari Health Center for the intervention group and Sapta Taruna Health Center for the control group from April to July 2022. There were 148 mothers in each group. The intervention group received exposure to the Education System and Anticipation of Stunting. The Wilcoxon and Mann-Whitney tests were used to analyze data.

Before the intervention, the mean ranks of knowledge, attitude, and practice were 27.47, 51.39, and 30.88, respectively. After the intervention, the mean ranks of knowledge, attitude, and practice reached 71.50, 61.46, and 35.54, respectively. The increase in scores in the intervention group was significantly higher than the control group (p<0.001).

Implementing the Stunting Education and Anticipation System effectively increases mothers' knowledge, attitudes, and practices in stunting prevention.

Electrocardiography is a common non-invasive diagnostic tool used to evaluate the heart's electrical and muscular processes. Every nurse must understand the fundamental electrocardiogram rhythms. This study aimed to assess nurses’ knowledge of electrocardiogram interpretation at Al-Hussein Teaching Hospital in Al-Samawa City.

This descriptive study was carried out on nurses at Al-Hussein Teaching Hospital in Al-Samawa City, Iraq, from 1st December 2022 to 30th February 2023. Fifty nurses were selected by a purposive sampling (non-probability) method. A researcher-made questionnaire was designed to collect data. This questionnaire consisted of two sections. The first section was related to demographic information, and the second section had 15 self-report questions to measure the knowledge level of nurses. Data were analyzed using SPSS 24.0 software.

Most of the nurses were women (64.0%) and in the age group of 25-29 years (36.0%), and more than half of them were married (74.0%). Most nurses graduated from the institute (42.0%), and the total years of service of 40% were 1-10 years. The nurses' knowledge regarding electrocardiogram Interpretation was at a poor level.

The knowledge of electrocardiogram interpretation in Al-Hossein Teaching Hospital in Al-Samawa City is at a poor level.

Nurses are more susceptible to low back pain rather than other Healthcare workers. The present study aimed to assess nurses' knowledge and practice toward the prevention of low back pain related to work and to find out the association between nurses' knowledge and practice with their demographic characteristics.

This descriptive analysis study was conducted on nurses at Al-Diwaniya Teaching Hospital, Diwaniyah City, Iraq, from 1 March 2022 until 30 October 2022. Fifty nurses were selected by a purposive sampling (non-probability) method. Data were collected using a self-administered questionnaire regarding nurses' knowledge of prevention low back pain related to work and an observational checklist to assess nurses’ practice. Data were analyzed using a Chi-square test by SPSS 23 software.

The majority of nurses (60.0%) had a fair level of knowledge, and the mean score of nurses' knowledge was 0.48±0.21. Also, 50.0% of nurses had a low level of practice, and the mean score of nurses' practice was 1.75±0.45. There was a significant relationship between nurses' knowledge and education level (p=0.003). However, there was a significant relationship between nurses' practice and gender, education level, years of experience in nursing, and the workplace in hospital (p<0.05).

Most of the nurses in Al-Diwaniya Teaching Hospital, have a fair level of knowledge and a low level of practice in the prevention of low back pain related to work.

The aim of this study was to evaluate the relationship between exercise and mental health and provide insights and problem-solving plans regarding this relationship.
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This research used a combination of experimental, correlational, and qualitative approaches by measuring the level of physical activity and mental health in the studied population and assessing the relationship between these two variables through correlational studies. The used tools were the Sports and Physical Activity Questionnaire Mental Health Questionnaire, Sports Assessment Scale, and physiological tests. Data were analyzed by Pearson correlation coefficient, regression analysis, and t-test using SPSS 21 software.

There was a strong positive relationship between the level of physical activity and mental health evidenced by the Pearson correlation coefficient of 0.893 and the linear regression equation value of 0.749. T-test values obtained from the two groups with different levels of physical activity were statistically significant (p=0.05).

Exercise has a positive impact on mental health and can help reduce the risk of mental disorders. Regular exercise can improve psychological well-being and reduce stress. Exercise is also associated with improved physical fitness and better sports achievements. Further studies are needed to identify the types and intensities of the most effective exercise in improving mental and physical health.

Considering the importance and effectiveness of disease prevention awareness campaigns in healthcare and their limited use in Iran and worldwide, more widespread implementation of these campaigns could have significant positive impacts on public health outcomes. The aim of this study was to evaluate the effectiveness of disease prevention awareness campaigns.

For this literature review, we conducted a systematic search of papers published on disease prevention awareness campaigns between 2010 and 2022, in both Persian and English. We limited our search to papers with full text available and searched across multiple credible scientific databases, including ScienceDirect, PubMed, Scopus, Google Scholar, SID and Magiran. We excluded papers that did not align with our research objectives.

Out of the 44 papers searched on disease prevention awareness campaigns, 18 relevant papers were selected and their results were investigated, of which two cases were in Persian and 16 in English. Most areas used in the awareness campaigns were related to diseases, such as acute coronary syndrome, diabetes, cancers, sexually transmitted diseases, and infectious diseases. The results of this study suggested the effectiveness of organizing awareness campaigns in preventing diseases.

The evidence suggests that awareness campaigns have had a positive impact on reducing the risk of disease and preventing its development. Therefore, it is important to make concerted efforts to develop effective and appropriate awareness campaigns for all individuals at risk.

Health literacy is considered a fundamental ability needed when making difficult health-related decisions. Also, people with nutrition literacy can convert nutrition messages into knowledge and tend to make healthier eating choices. This systematic review aimed to summarize the literature on nutrition and health literacy to enhance the medical students’ knowledge about the importance of health and nutrition literacy.
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In this study systematic review, research articles published in English were reviewed using relevant terms in PubMed, CINAHL, Web of Science, EMBASE, Scopus, and CINAHL databases. The articles were selected based on the inclusion and exclusion criteria, repetition, purpose, and relevance to the topic. Furthermore, the “Consensus-based Standards for the selection of health Measurement Instruments” checklist was used to select and evaluate the reviewed articles.

A total of 2978 articles were reviewed. Ultimately, 15 articles were approved and included in the study. Six studies were conducted on nursing students, six were on students of pharmacy and other clinical fields, and three studies examined medical students. The average nutrition and food literacy scores were sufficient, whereas the nutrition knowledge score was moderate.

In the reviewed studies, nutrition literacy is evaluated to be at a low to medium level. Most students have insufficient nutrition knowledge.

Substance abuse in adolescents is caused by many factors, including family conflicts, negative parenting models, and family estrangement. The aim of this study was to determine the relationship between resilience and family functioning with drug use risk behavior among adolescents in Limo District, Depok city, Indonesia.
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This descriptive correlational study with a cross-sectional approach was conducted on adolescents aged 10-15 years who lived in Limo District, Depok, Indonesia. 315 adolescents were selected by simple random sampling method. Walsh Family Resilience Questionnaire was used to measure family resilience, and Family Assessment Device was used to measure family functioning. Data analysis was performed using chi-square test and logistic regression analysis.

Family resilience (p=0.011) and family functioning (p=0.001) were significantly related to drug use risk behavior. Adolescents whose families have poor resilience are 1.694 times more likely to engage in risky drug behaviors than adolescents whose families have good resilience. Also, adolescents who have poor-functioning families are 2.054 times more at risk of risky drug behaviors than adolescents whose families function well.

Adolescents whose families have low resilience and whose families have poor functioning are 60.7% more likely to exhibit drug use risk behavior.

Electronic health can lead to health preservation and promotion using information and communication technologies to receive and record accurate data, appropriate storage, and retrieval, as well as the health information management approach. The present systematic review aimed to assess the E-health application during the COVID-19.
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The present systematic review was done based on PRISMA protocols. The study data were retrieved using the E-health and COVID-19 keywords in the related studies from August 4, 2021, in PubMed, Scopus, Magiran, and Sid databases. Moreover, the inclusion criteria were original research studies that used E-health to manage patients with COVID-19.

A total of 10 articles were included in the study, 40% of which focused on the impact of E-health on reducing fear and anxiety caused by COVID-19, 30% on the E-health in early diagnosis and progression of the disease, 10% on the E-health application in the field of prevention, 10% on E-health in the field of disease control, and 10% on E-health for quick investigations of the disease process and access new medical information. The used technologies included virtual training through WhatsApp video calling, Instagram, iGap and Telegram voice and text messaging, artificial intelligence, and data mining techniques.

E-health tools played a prominent role during the COVID-19 in the prevention, diagnosis, control, and fear reduction of coronavirus disease. Various practical strategies such as financing, implementation and legal requirements can be considered to effectively use the capabilities of eHealth tools in disease management.

This study aimed to determine the effectiveness of digital pocketbooks and animated videos about the danger signs of pregnancy in women in the third trimester of pregnancy at the Kebon IX Health Center, Jambi City, Indonesia.
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This pre-experimental study used a two-group pre-test post-test design involving 120 women in their third trimester of pregnancy referring to the Kebon IX Health Center, Jambi City, Indonesia. The dependent variable was knowledge, while the independent variable was health education using animated videos and E-books about the danger signs of pregnancy. Statistical analysis was done using SPSS 16 by the Wilcoxon test.

The pre-test knowledge level of most of the subjects in the animated video media group was at a good level (50%), and after the intervention (post-test), it increased to 100%. The pre-test knowledge level of most of the subjects in the E-book group was at a good level (66.7%), and after the intervention (post-test), it increased to 100%. There were differences in the level of knowledge of pregnant women before and after the intervention using animated videos and E-books (p-value <0.001).

Animated videos and E-books can increase the knowledge of women in the third trimester of pregnancy about the danger signs of pregnancy.

Knowledge and skills significantly affect the learning performance of vocational students. However, adding ability without enhancing memory can reduce learning effectiveness, which ultimately affects learning performance. This study was done to investigate the effect of learning engagement and self-confidence on learning performance, mediated by repetition of educational materials. The goal is to improve the learning process and increase students' memory retention during exams.
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This study was conducted on 179 respondents from health vocational schools to analyze knowledge, skills, and expertise after learning using four variables: learning engagement, self-confidence, repetition strategy, and learning performance from August to December 2022.

The results indicated that learning engagement and self-confidence directly affected learning performance. The Repetition strategies mediated the relationship between learning engagement and self-confidence with learning performance.

Therefore, implementing rehearsal strategies for students is essential in the learning process to establish optimal learning performance. Repetition strategies can help students maintain and strengthen their memory, leading to better exam performance and educational evaluations.

Although the Internet has greatly benefited our daily lives, over usage of it can lead to addiction, which can negatively impact our life. This study aimed to assess the impact of digital addiction on emotional status of female high school students.
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This descriptive correlational study was conducted in Baghdad Governorate from December 1st, 2022 to April 5th, 2023. 360 female high school students were selected using simple random sampling method. Data were collected using a questionnaire whose validity was confirmed by experts, and a pilot study confirmed the reliability of the results. This questionnaire had a total of 25 questions to measure digital addiction and 21 questions to measure mental health. Through the interview, data were gathered, and descriptive and inferential statistical analysis were used to analyze the data.

The majority of respondents are female pupils in grades 4, with a mean age of 16.55±1.08 years. 49.7% of the high school pupils reported a high degree of addiction, and 50.6% had a moderate level of emotional status. The amount of time spent using devices during the week (β=-0.218; p=0.0001), the amount of time spent using devices on the weekend (β=0.137; p=0.019), and digital addiction (β=0.282; p=0.0001), all predicted emotional status.

Emotional status is predicted by the time of device use during the week, the amount of device use on the weekends, and digital addiction.

Teachers often encounter work-related challenges that can compromise their mental health. We used a dual-factor model to evaluate the relationship between the meaning of work and teachers’ mental health. Mental health is defined as a high level of psychological well-being and a low level of psychological distress.
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This qualitative study involved a survey completed by 261 elementary school teachers in East Java, Indonesia, and five teacher interviews. Data were collected through documentation, interviews, and a Mental Health Scale, and data analysis was performed through descriptive and thematic analysis.

Many problems of teachers in performing their duties and teachers' inability to interpret their behavior have caused the level of mental health to decrease.

Our results contribute to a better understanding of teacher challenges that can affect overall mental health and provide useful strategies to improve teaching conditions.

As one of the primary causes of confusion and decline in mental health, stress can be the source of considerable negative effects on student performance. The present study aimed to investigate the effectiveness of stress management training in academic optimism and hope of university entrance exam applicants.
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This was a quasi-experimental study based on a pretest-posttest design with a follow-up. The statistical population consisted of all university entrance exam applicants in Ahvaz, Iran, in 2022. Thirty applicants, who met the inclusion criteria, were selected as the sample using convenience sampling and randomly assigned to the treatment and control groups (15 participants per group). The participants in the treatment group attended eleven 120-minute sessions of cognitive-behavioral stress management (CBSM) training program, whereas those in the control group received no intervention. The Academic Optimism Scale and Adult Hope Scale were used to collect data. Data were analyzed using descriptive statistics (mean and standard deviation) and inferential statistics (analysis of covariance).

The results showed that the stress management training program improved the academic optimism (F=117.24, P=0.001) and hope (F=66.33, P=0.001) of the participants in the treatment group.

It can be concluded that stress management training in stressful situations, such as the university entrance exam can boost candidates' academic optimism and hope.

Evaluating diabetics’ health-promoting behaviors is an essential part of nursing care. This study aimed to examine the relationship between health-promoting behaviors and perceived social support from the family in patients with type 2 diabetes.
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This was a descriptive cross-sectional study. The data were collected from a foundation university hospital in Tabriz, Iran. The sample consisted of 183 type 2 diabetes patients. Data were collected using the Perceived Social Support from Family and Health-Promoting Behaviors scales.

The average score of social support was 15.07±6.74 (range: 0 to 20), and the average score of health-promoting behaviors was 49.62±17.74 (range: 0 to 112). There was a significant and positive correlation between the scores of health-promoting behaviors and perceived social support (r=0.28, p<0.001). We predicted the changes in health-promoting behaviors based on the regression analysis of the changes in perceived social support from the family (B=0.563).

Family social support affects health-promoting behaviors in type 2 diabetes patients, and should be considered during interventions to improve health-promoting behaviors by nurses and other healthcare providers. We suggest other descriptive correlational studies with a higher sample size and interventional studies on this subject.

This study aimed to analyze the effect of knowledge on the application of clean and healthy living behavior through perceived susceptibility in the prevention of AIDS.
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Using quantitative research, we examined the possible causality between certain factors possibly causing the studied symptoms. The statistical population was 290 people living in Wakatobi Regency, of whom 166 people were considered as samples using the Lemeshow formula. Descriptive and inferential analyses were performed using path analysis, t-test, and normality tests.

Based on the results of the path analysis, the path coefficient value of the knowledge to perceived susceptibility was 0.177 with a t-value of 7.762 > 1.974 and a p-value of < 0.005. Thus, it can be concluded that knowledge has a positive and significant effect on clean and healthy living behavior in the community.

The results showed that knowledge about the dangers of smoking had a significant effect on fostering clean and healthy behavior (PHBS) through perceived susceptibility.

Research capacity building and self-efficacy are essential skills for medical students that greatly help them to participate in research. The present study aimed to investigate the relationship between academic stress and research self-efficacy in medical students through the mediating role of research spirit.
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This descriptive-correlational study used path analysis to examine the relationships between the variables. The statistical population was all postgraduate medical students in Ilam in the academic year 2022-2023, of whom 301 students were selected using convenience sampling. They completed the Research Self-Efficacy Scale, the Academic Stress Scale, and the Research Spirit Questionnaire. Evaluation of the proposed model was done using path analysis.

There was a negative correlation between academic stress and research spirit (p<0.001). There was a significant positive correlation between research spirit and research self-efficacy (p<0.001), whereas there was no significant correlation between the direct path of academic stress to research self-efficacy. Also, there was a significant correlation between the indirect path connecting academic stress and research self-efficacy through research spirit (p<0.01).

Based on the results, the proposed model shows a good fit and is a major step toward identifying factors influencing research self-efficacy among medical students.

Cardiac arrest is a sudden cessation of heart function and results in death if not immediately assisted with Cardiac Pulmonary Resuscitation (CPR). Chances of survival increase if immediately assisted CPR by people around or bystanders. There is a need to increase the quantity and quality of CPR bystanders through CPR education and training using application media that can be used anytime and anywhere. This study was done to determine the effect of CPR training using the SI-Hajar app on the knowledge and skills of teenagers about CPR.
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This study used a quasi-experimental design with a pre-and post-test approach to CPR training using the Si-Hajar app. Samples were taken by purposive sampling from 40 teenagers in Lubuklinggau City Juni in December 2021. CPR knowledge was measured from knowledge about out-of-hospital hospital cardiac arrest (OHCA), which was measured using a questionnaire. Skill was measured by how the subject performed CPR using a CPR standard checklist regarding operating procedures.

After the implementation of the Si-Hajar app, we found a statistically significant difference in knowledge and skill scores between the Si-Hajar and control (P<0.001 for both) groups. There was a correlation between group intervention and knowledge (p=0.001), but there was no correlation between knowledge and the history of cardiac arrest (p=0.0761) and willingness to perform CPR (p=0.0585). Regarding the CPR skill, there was a correlation between group intervention and skill (p=0.001), but there was no correlation between skill and the history of cardiac arrest and willingness to perform CPR.

Using the Si-Hajar app has a significant effect on the knowledge and skills of teenagers in OHCA knowledge and CPR management.

Today, obesity and associated hypertension are among the main health threats and risk factors for the occurrence of many diseases in most developed and developing countries. The present study aimed to determine the predictors of physical activity among a sample of overweight male employees of Urmia offices in the light of the Health Belief Model (HBM).
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In this descriptive-analytical study, 467 overweight male employees of offices in Urmia City were included between November and March 2021 using simple random sampling. The data collection instrument was a questionnaire consisting of four sections: demographic features, knowledge questions, HBM constructs, and performance-related questions. Data analysis was performed by SPSS 18 using descriptive and inferential statistics.

 The results showed statistically significant differences between overweight male employees who engaged in standard physical activities and those who did not, in terms of the mean score of perceived susceptibility (p<0.022), perceived severity (p<0.04), perceived barriers (p<0.001), and perceived self-efficacy (p<0.001) concerning the hypertension prevention behavior. However, this difference was not statistically significant for the perceived benefits construct (p=0.221). Logistic regression analysis results showed that perceived barriers and self-efficacy were significant predictors of physical activity.

The HBM constructs can predict physical activity behavior in hypertension. However, more research is needed to confirm other predictors of related behaviors in employees.

The present study aimed to investigate the relationship between the Nurse Competency Predicting Scale (NCPS) scores and those of the Principles and the course of Techniques of Nursing Procedures (PTNPs), particularly its theoretical and practical units, among nursing students.
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This cross-sectional study was conducted on the new entrance nursing students at the Guilan University of Medical Sciences. In total, 175 nursing students were recruited by the census method. Then, the NCPS was completed online, and the data analysis was performed using the Pearson correlation coefficient, ANOVA, and t-test by SPSS 21.  

The mean NCPS score of the students was 73.14±10.23. A statistically significant relationship was observed between the nursing students’ paramedic clinical experience, reason for choosing nursing as their field of study, interest in studying nursing, desire to work in the nursing profession, and intention of doing a PhD degree and their NCPS scores (p<0.05). However, there was no statistically significant relationship between the NCPS scores and scores of the course of PTNPs, and the first internship scores (p>0.05).

The capacity to acquire NC among the new entrance nursing students is at a high level. Here, the students with the intention of doing a PhD, and a history of paramedic clinical experience, interested in studying nursing and working in the nursing profession reported a higher NC. Considering these key factors during university admissions can be suggested to strengthen NC in the nursing profession.

The World Health Organization recommends preventive behaviors despite the approval of several vaccines to control COVID-19. Mass media and digital technologies also play an important role in addressing public health issues. This study aimed to investigate the protection motivation theory constructs by COVID-related information channels on protective behaviors against COVID-19 in southwestern Iran.
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In this cross-sectional descriptive study from July to August 2021, 255 patients referred to urban health centers were included by simple random sampling. Data were analyzed by SPSS 24 software using correlation and regression tests.

32.2% of the participants received COVID-19 information through radio, TV, and satellite, and 30.6% through WhatsApp and Telegram social networks. Awareness predicted 11% of protective behavior (p<0.001; R=0.118; β=0.343). Protective motivation (behavioral intention) predicted 49.5% of behavior (p<0.001; R=0.495; R2=0.487).

Using protection motivation theory by information channels facilitates preventive behavior against COVID-19.