مجله آموزش بهداشت و ارتقای سلامت ایران
سال دوازدهم شماره 1 (پیاپی 45، بهار 1403)

Despite fundamental advancements in the understanding of health and the new strategy of the World Health Organization in enhancing the health of the individual, organization, and society, health education and promotion is a relatively new major in Iranian medical and health science. However, it has not yet been introduced as a specialist major at various levels. This research aims to investigate the challenges of educational quality and the position of health promotion and education.

The current study employs a qualitative research with a structured content analysis approach. In this research, 24 health education and health promotion specialists, and graduates were chosen using a purposive sampling method From September2022 to May 2023. Using semi-structured interviews, different people’s perspectives on the challenges of health education promotion were investigated, and After 22 interviews, no new code was extracted, but two more interviews were recorded to make sure, and sampling continued until data saturation (24 interviews). The collected data were analyzed using the Graneheim and Lundman approach.

The challenges of the major of health education promotion from the perspective of the research participants include two main components: 1) scientific capacities (with sub-components of improving the curriculum and empowerment of professors and students) and 2) structural capacities (with sub-components of creating a position for the major of health education and promotion and determining the organizational level of employment).

According to the findings, the quality of health education and health promotion may be enhanced by upgrading the curriculum, elevating professors, and providing a space for the major. In this respect, introducing the major at various levels of society can be useful in attracting motivated and talented people to study at higher levels and training scientifically and ethically outstanding professors in this major. As a result, to adapt to the aims of health education promotion and to apply it and the way professors teach, it is suggested to implement a broad curriculum reform and hold meetings with policymakers to expose the area to decision-making levels.

Socialization is a critical organizational process that significantly contributes to effectively adapting personnel into a new organization and playing a suitable role according to the Ottawa Charter, which is one of its important areas for promoting health, developing people's skills, and also reorienting health care services. This study aims to identify the influential factors that contribute to the organizational socialization process among employees inside the health system of Iran.

The current study is an exploratory sequential mixed-method that was conducted in 2022 among managers and personnel of the health system in Tabriz, Iran. The qualitative phase of the study employed a content analysis methodology, wherein a purposive sample technique was utilized to pick 16 managers and staff from the health system. During the quantitative phase, a study was devised and executed utilizing the Delphi technique to thoroughly assess and finalize the components derived from the initial stage. The third part of the study involved a cross-sectional examination employing a descriptive-analytical methodology to assess the indicated parameters. A total of 333 health system employees and administrators were surveyed using a questionnaire.

Organizational socialization of health system employees can be improved through increased awareness of employees, organizational planning, recruitment and retention of talented personnel, performance evaluation of employees, alignment of individual and organizational values, and increased organizational commitment. The results of structural equation modeling showed that organizational planning, employee awareness, individual-organizational values, recruitment and retention of talented staff, and increased organizational commitment had a significant effect on organizational socialization of the healthcare system employees by 9%, 13%, 15%, 11%, and 14%, respectively.

Socialization, as one of the most important organizational processes, can help managers and policymakers to facilitate and plan the process of empowering the employees and reorienting health-oriented processes based on health promotion approaches.

Accountability and social commitment is one of the philosophical approaches of universities, which focuses more on the responsibility of universities in serving the society. The purpose of this research is to identify the skills expected by the society from the graduates of the master's degree in health education and health promotion in order to increase the level of social accountability. 

This qualitative study was conducted with the quantitative content analysis method at Ahvaz University of Medical Sciences. The statistical population of this research was all the students and graduates of the master's degree in health and the staff in charge of the health education unit in the sub-category of health department, who were invited to the study by available sampling method. The data collection method was a structured interview.

This research was conducted with the participation of 19 health education graduates and experts with an average age of 39 years and an average work experience of 14 years. 105 needs and skills of a health education and health promotion expert in the form of four main categories including; The required skills of a health education and health promotion expert in the workplace, useful skills for the workplace that are taught in the university, skills expected in the workplace and expectations from the educational system to increase responsiveness to the needs of society were presented.

There is a gap between the skills taught at the university level and the job needs of graduates of this field, and most of this difference is estimated for practical skills. Also, in order to improve responsiveness to the needs of employees and ultimately the needs of the society, the scientific and practical support of health education experts is needed for the workers in the work environment, which requires close interaction of the health department with the health faculty.

Theory-based educational interventions are a logical approach in order to improve pro-environmental behaviors. This study was conducted with the aim of investigating the effectiveness of the educational intervention based on the extended theory of planned behavior on pro-environmental behaviors in residents of Qazvin city.

Using a multi-stage random sampling method, 120 citizens referring to Qazvin health care centers participated in a quasi- experimental study in 2022-2023. Targeted educational content was provided through what’s APP and online training (4 sessions) in the form of lectures and group discussions along with educational pamphlets and text messages for the experimental group. Data were collected before and 3 months after the Theory based education using demographic questionnaires, Pro-environmental Knowledge, moral commitment, Self- identity, TPB subscales, and pro-environmental behavior questionnaires, and were analyzed with SPSS 25.0 software and chi-square, independent and paired T-tests, ANOVA and ANCOVA were analyzed.

The mean of pro-environmental awareness (from 5.2±1.3 to 10.9±2.1), attitude (from 17.5±2.5 to 34.7±6.1), subjective norms (from 8.9±1.8 to 14.9±1.3), self-identity (from 8.8±1.7 to 12.7±2.1), moral commitment (from 10.9±1.4 to 15.0±2.1), behavioral control (from 15.7±1.6 to 24.9±3.5) and behavioral intention (from 7.4±2.2 to 11.2±9) significantly improved in the experimental group after theory based education (P<0.001). Also, the mean of pro-environmental behaviors improved significantly after controlling the effect of the pre-test variable in the experimental group (36.4±9.5 to 52.2±8.7, P<0.001).

The implementation of educational interventions based on the extended theory of planned behavior can encourage pro-environmental behaviors in citizens by improving psychological factors.

The high prevalence of caesarean section is a global health concern, especially in Iran. Considering the possibility of complications caused by cesarean section and the importance of identifying the development process of this delivery method, the present research was conducted with the aim of determining the factors influencing the behavioral intention and the choice of the type of delivery by pregnant women of Bojnord city based on the theory of planned behavior.

The current cross-sectional study was conducted in 2021 on 369 pregnant women first abdomen who referred to comprehensive health centers in Bojnurd city. The sampling method was multi-stage. The data collection tool was a questionnaire based on the theory of planned behavior. The data were analyzed by SPSS 21 software by using t-test, Mann-Whitney, and Chi-square tests. 

72.6% of the participants wanted to give birth naturally and 27.4% had a cesarean birth. People who intended to have a natural birth significantly had better knowledge, a more positive attitude towards natural birth, and a better perceived behavioral control (P<0.001). The two constructs of attitude (β=-0.234) and perceived behavioral control (β=-0.215) had the most negative and significant predictors of the behavioral intention to perform cesarean delivery (P<0.001). The results of the subjective norms showed that the doctor's opinion and the mass media had the greatest and least influence on the choice of the type of delivery in pregnant women, respectively. The constructs of the theory of planned behavior together predicted 17.2 of the variance of natural childbirth intention in pregnant women.

The theory of planned behavior can be effective by identifying the factors of pregnant women's intention in choosing natural delivery. It is suitable with training and interventions to reduce the rate of cesarean section for pregnant women using this theory.

suicide of soldiers is a type of multi-dimensional behavioral damage that several factors are involved in its occurrence. The present study was conducted with the aim of explaining the structural relationships between mental health and cohesion of family relationships through organizational factors on the tendency of soldiers to commit suicide.

This research is a correlational and descriptive-analytical study. The population includes all the soldiers serving in the Iranian police force in 1400-1401 with a simple random sampling and a multi-stage cluster according to Cochran's formula, with a volume of 1000 people. The data were obtained from Goldberg and Hiller (1979) 28-GHQ mental health questionnaires, Joyner et al.'s (2009), family cohesion (2009) and researcher-made organizational factors questionnaires, and the method of confirmatory factor analysis model for the default model was checked by Spss16 and Amos24.

The proposed model has an acceptable fit. Mental health (P=0.022, B=-0.227) and the cohesion of family relationships (P=0.001, B=-0.157) have a significant inverse relationship with the tendency to commit suicide with the mediation of organizational factors. Mental health variables, family cohesion and organizational factors are simultaneously able to explain 25.3% of the variance of suicide tendency and mental health, and family cohesion is able to explain 16.2% of organizational factors.

mental health and the cohesion of family relationships strengthened through positive organizational factors lead to a correct understanding of service conditions and reduce the tendency to commit suicide among soldiers.

Today, identifying the factors affecting the preventive behaviors and control of the Covid-19 disease as a global crisis is the main need of all societies.  But in order to achieve this goal, a valid and reliable tool is needed to measure people's performance to prevent Corona .As a result, the current research was conducted with the aim of designing and psychometrically analyzing the questionnaire of preventive behaviors against Corona.

This descriptive study was conducted in 1400 and 1401.  First, a questionnaire of preventive behaviors against corona was designed with 48 questions, and then two quantitative and qualitative methods were used to determine the face validity of the questionnaire. Also, content validity was examined in both quantitative and qualitative ways. Then factor analysis was conducted with a sample of 220 people. Cronbach's alpha was used to determine the internal consistency of the questionnaire, and the test and retest method was used to evaluate the stability. The data was analyzed based on SPSS software and statistical tests.

The total face validity score was 5/75. Cronbach's alpha coefficient for all constructs was reported to be higher than 0/7 and the intragroup correlation coefficient (ICC) value of the questionnaire obtained from the test-retest with a two-week interval, with a 95% confidence interval, was 0/812, which indicates the reliability of the instrument.  In total, based on exploratory factor analysis, 6 factors were extracted. As a result, this scale has 6 subscales: regulation of leaving home and shopping, respiratory transmission cycle, social responsibility, principles of hand hygiene, nutritional hygiene and social distancing regulations; which explain 64/98% of the total variance.

The results of the study showed that the desired face validity of the questionnaire indicates the ease of understanding the items and their existential necessity from the point of view of the target community. The appropriate values of content validity, including the content validity index and the content validity ratio, also show that, from the point of view of experts, the questionnaire can measure what it should measure. Factor analysis also confirmed the correlation of the subscales with the whole instrument and the appropriate construct validity of the instrument. It also showed high values of internal homogeneity and stability of the designed questionnaire. In the Corona crisis and the period after it, as well as the possible outbreak of similar diseases in the future health service providers as well as policy makers in this area can use this questionnaire to check people's health behaviors and use its results in the design and implementation of preventive and care protocols.

Stress is one of the major problems in life and occupation is one of the most important factors that cause it. This study aimed to investigate the effect of educational intervention based on virtual social networks on occupational stress among employees of Tehran University of Medical Sciences.

The present semi-experimental study was conducted among 122 employees of Tehran University of Medical Sciences, who were randomly assigned to intervention (n=59) and control (n=63) groups, in 2022. The data collection tool was questionnaires of job stress and knowledge, attitude, and practice regarding stress, which were completed before and two months after the educational intervention. The training program was implemented virtually for the intervention group within a month with the methods of educational videos, audio files, images, and text messages. The data were analyzed by SPSS 16 software using independent t-test, paired t-test and ANCOVA.

There was no significant difference in the average score of knowledge, attitude, and performance between the two intervention and control groups before the intervention, but two months after the educational intervention, by adjusting the effect of pre-test scores, the average score of knowledge, attitude and practice in the intervention group increased significantly. (P<0.001). The average occupational stress score in the intervention group decreased from 118.26 to 117.20, which was significant compared to the control group (P<0.001).

Considering the effectiveness of educational intervention based on virtual social networks on increasing knowledge, attitude, and practice regarding stress as well as management of occupational stress, it is recommended to design and implement educational interventions using modern technologies and virtual spaces to improve mental health in the workplaces.