Journal of Education and Health Promotion

Abstract BACKGROUND: The expansion of pregnancy‑related mobile applications has led to an increase
in the usage of these applications by Iranian women, which has the potential to have a long‑term
impact on women’s pregnancy health and, as a result, community health. The goal of this research
was to investigate the state of pregnancy‑related mobile applications in Iran.
MATERIALS AND METHODS: This was a descriptive‑applied research approach which was
conducted in 2020. One hundred and fifty‑seven pregnancy apps from different Iranian mobile app
markets were installed and were examined in terms of the resources used and their validity, subject
distribution, participation of obstetricians in the app development, apps volume, rank acquired by
users and distribution of apps according to the developers. The relationship between the number of
resources used and user rankings was also tested.
RESULTS: A total of 157 apps were categorized into 12 subject categories based on their content.
Only 1.3% of the apps were developed with the participation of obstetricians. Only 5% of the apps
had used reliable information resources. Furthermore, the number of resources referenced in the
studied apps did not have a significant relationship with star ratings (r = 0.03, P = 0.64), according
to the Pearson correlation test.
CONCLUSION: Iranian mobile applications in the field of pregnancy have grown significantly in
terms of quantity, subject diversity, and user acceptance; however, the credibility of the information
in these apps cannot be validated. This serves as a reminder to users to exercise caution while
using such apps.

Abstract BACKGROUND: Social participation and group interaction are the basic and expected indicators of
serving in the job of the faculty. Some improvements are needed for universities and professors in
this area, which they can be better identified by studying the main beneficiaries. In this regard, this
study was aimed to identify strategies to increase social capital and interaction of medical universities’
faculty members.
MATERIALS AND METHODS: This qualitative study which was a qualitative content analysis type
was performed on 22 faculty members of Isfahan, Mashhad, Tabriz, Iran, Army, Shahrekord, Sabzevar,
Arak, and Khomein universities through semi‑structured interviews and purposive sampling. Data
were analyzed using qualitative content analysis.
RESULTS: According to finding, in order to improve the social interactions of medical universities’ faculty
members, there were 2 factors and 8 main categories including organizational factors (“organizational
dynamics,” “organizational security,” “standardization of selection and evaluation,” “value creation,”
and “establishing a compensation system”) and individual social factors (“education and social
programs,” “personal skills and beliefs promotion,” and “personality and learning”).
CONCLUSIONS: The obtained strategies in this study to improve social capital and group interactions
and group participation of medical universities’ faculty members can be planned and implemented
by managers and can be used for faculty members themselves.

Abstract BACKGROUND AND AIM: Given the growing trend of aging and the limited resources of the health
system, the lack of long‑term prior government planning, and reduced growth of the productive force
of society, identifying strategies for planning and action to deal with future aging is very important.
In this regard, the study was conducted to identify strategies for dealing with the aging population
from the perspective of health system experts.
METHODS: The qualitative content analysis study was performed on 29 Iranian male and female
experts in the aging and health scope from Isfahan, Tehran, Tabriz, and Babol who purposefully
participated in the semi‑structured interview. Data were classified by qualitative content analysis.
RESULTS: Two concepts emerged according to the participated experts’ opinions, regarding the
strategies of the Iranian health system in dealing with future aging: “executive policy” strategies,
including “design, planning and implementation,” “evaluation and standardization,” “strengthening
demand‑driven” and “modeling national and international experiences,” “preventive policies”
strategy, which includes “Focus on prevention,” “Focus on values and competencies,” “Educational
empowerment,” “Knowledge‑based empowerment,” “Empowerment of age‑related groups,”
“Economic empowerment,” and “Social support.”
CONCLUSION: The diversity and breadth of the mentioned strategies indicate the necessity
of comprehensive readiness and adaptation of health services to the elderly conditions and
characteristics. Purposeful planning and timely implementation of programs and policies to better
address the health system with future aging will be possible by using practical strategies.

Abstract Today, the ability of the organizations to successfully knowledge management and sharing can 
help them in better performance. Effective knowledge sharing (KS) in the clinical context provides 
better clinical decisions and improves the quality of care services. This systematic review will be 
conducted to identify the factors related to the clinical KS (CKS). This systematic literature review will 
be conducted to search the published documents about the affecting factors on the (clinical) KS. To 
this end, PubMed, Scopus, Web of Science, ProQuest, Cochrane, Embase, SID, Magiran, IranDoc, 
and ISC will be thoroughly assessed with considered keywords and search strategy. No time limit 
will be considered and all relevant documents published will be evaluated until the start date of the 
search. To the best of our knowledge, no systematic review study has been conducted on the factors 
related to CKS and our research will try to comprehensively extract the effective factors in this topic. 
Identifying the factors affecting CKS will lead to transparency in the exchange and interpretation of 
clinical knowledge in clinical care delivery and making the best clinical decisions as well as improving 
the quality of clinical care. It will also provide a condition to facilitate the delivery of more effective 
clinical education for policymakers in the field of clinical education.

Abstract BACKGROUND: Pregnancy causes a set of complex physiological and psychological changes that 
affect marital relationships. Mindfulness is a form of meditation that can promote person’s performance 
and perception of sexual relationships. The present study aimed to determine the effect of mindfulness 
on sexual desire and sexual satisfaction in primigravida pregnant women.
MATERIALS AND METHODS: The present study is a quasi‑experimental that has investigated 
on 72 primigravida pregnant women. The samples were selected randomly and assigned to 
experimental and control groups. The experimental group received six 90‑min sessions of mindfulness 
intervention, and the control group received the educational pamphlet. The female sexual function 
index (FSFI) was filled by the subjects of the two groups in three stages of before the intervention, a
week, and a month after the intervention. Data analysis was done by SPSS20 (Statistics 20 software;
SPSS Inc., Chicago, IL, USA) at the significance level of 0.05.
RESULTS: According to the statistical tests, there was no significant difference between the two
groups in terms of demographic characteristics and pregnancy information. The findings suggest
no significant difference between the mean pretest and posttest score of sexual desire in the two
groups (P > 0.05). However, the two groups were significantly different in terms of the mean score
of sexual satisfaction before and after the intervention (P<0.05).
CONCLUSION: By increasing the concentration on the present moment and avoiding judgment,
mindfulness can increase sexual satisfaction. However, sexual desire can be affected by various
factors such as the cultural context, the quality of marital relationships, and the pregnancy hormonal 
changes that can influence the sexual response.

Abstract BACKGROUND AND AIM: To answer the society’s health‑care needs related to social determinants
of health (SDH), higher education system must be responsive in training knowledgeable students and
faculty members. Therefore, this study was carried out to determine the responsiveness of higher
education system in relation to the SDH.
METHODS: This is a content analysis study carried out using qualitative approach. Semi‑structured
interviews were used to gain access to the knowledge of experts in the fields of health care, education,
and SDH. Sampling was carried out until data saturation was achieved during which 15 experts were
selected using purposeful sampling method with highest possible variety. Data were categorized
using qualitative content analysis approach.
RESULTS: In total, 11 themes and 43 categories of codes were identified in semi‑structured
interviews with experts. A total of two approaches were identified for the training of responsive
students including educational–research approach and cultural–social approach; five approaches
were identified for the development of faculty members including cognitive development, executive
development, evaluation, promotion and incentives, and revisions; two approaches were identified for
provision of theoretical and practical education including education in a real and active environment
and structural education; and finally, two approaches were identified for evaluation of students and
faculty members in regard to their responsiveness to society’s health needs and SDH including
content and operational approaches.
CONCLUSION: In general, the results of the current study indicate the need for the higher education
system to use educational, research, and society‑based approaches in real and social environments
along with an incentive system and use of evaluation for responsiveness to society’s health needs
and SDH. These results can be useful for the health‑care system and the higher education system.

Abstract BACKGROUND AND AIM: Considering the important role of universities in advancing educational,
social, cultural, economic, and political affairs and given the significant and effective role of social
determinants of health (SDH) in personal and social life, this study aimed to design a preliminary
questionnaire to assess the awareness and attitude of students and professors of relevant medical
sciences departments toward the SDH.
METHODS: This is a descriptive survey study of the instrumentation type and is done on the
students and professors of Isfahan and Kashan medical sciences universities in 2019. The
content and face validity of the questionnaire were assessed. Cronbach’s alpha coefficient and
the correlation coefficient for each question as well as the total score of the questionnaire were
reported for this attitude measurement questionnaire. The difficulty coefficient, optimum difficulty
level, discrimination coefficient, and the relevant variance were calculated for every question in the
awareness measurement questionnaire.
RESULTS: The internal consistency of the questionnaire for the awareness toward the SDH for 15
questions was 0.742. This consistency was acceptable for 18 questions in the attitude measurement
questionnaire after omitting two questions with not appropriate distinguishing ability. The difficulty
level of the questions was relatively high.
CONCLUSION: Given that no tool was observed in the search strategy to measure the SDH,
therefore, the design and psychometrics of such a tool can be used to measure the awareness and
attitude of the target audiences; since this tool had an acceptable validity and reliability at its initial
stages, researchers are suggested to apply it for standardization in different academic societies.

Abstract BACKGROUND AND AIM: Some people exposed to disasters will suffer from acute stress
disorder (ASD) due to the negative consequences of these disasters. Evaluating this disorder at a
large scale requires a credible and standardized tool. Therefore, the current study aims to investigate
the psychometric properties of the ASD questionnaire for people exposed to Kerman earthquake.
METHODS: This is a descriptive‑tooling study, conducted on 435 men and women older than 18 years
living in earthquake‑affected areas of Kerman Province (Kouh‑e‑Banan). The study was carried out
using the Persian translating of the English version of the Diagnostic and Statistical Manual of Mental
Disorders, Fifth Edition ASD questionnaire on accessible individuals living in temporary residence
tents in two initial and final stages and different stages of validity and reliability evaluation was carried
out. The findings were analyzed using descriptive statistics and Pearson’s correlation coefficient.
RESULTS: During the evaluation of content validity, no questions were eliminated. To carry out
factor analysis, sampling competence, and suitability of sample size were confirmed through
Kaiser–Meyer–Olkin and Bartlett’s tests. In the factor analysis stage, 14 items in three factors were
defined. The factors were included reexperiencing and analysis, arousal (continuous irritability), and
avoidance factors which together explained 59.43% of percentage distribution. In the next stage
of evaluating divergent validity, the results indicated a significant and inverse correlation between
ASD score and quality of life score (r = −0.43, P = 0.002) of the participants, while there was also
a positive and significant correlation between ASD score and general health disorder score of
the participants (r = 0.47, P < 0.0001). The reliability of the questionnaire was investigated using
Cronbach’s alpha, and inner class correlation coefficient was calculated to be 0.9.
CONCLUSIONS: The tool investigated in this study has suitable validity and reliability and is effective
for use by psychologists and relief workers for necessary interventions and prevention of ASD in
disasters.

Abstract INTRODUCTION: This study aimed to predict health information‑seeking behavior (HISB) components
based on health anxiety among users of public libraries.
MATERIALS AND METHODS: This research was a descriptive‑correlational study. The statistical
population consisted of users of public libraries. Data collection tools included the HISB questionnaire
and the Short Form of Health Anxiety Inventory (SHAI).
RESULTS: The results indicated that health anxiety was a significant predictor of the components
of HISB. The illness likelihood had a direct relationship with the components of the need for health
information and the purposefulness of health information seeking, and it was inversely related to
barriers to obtaining health information. In addition, the preoccupation with illness was directly related
to the components of the need for health information, the diversity of health information sources, the
time of referring to health information sources, the purposefulness of health information seeking, and
evaluation of reasons for referring to the library.
CONCLUSION: Among the components of health anxiety, preoccupation to the disease has the
highest role in the emergence of users’ information‑seeking behavior.

Abstract INTRODUCTION: Reviewing articles are one of the most important methods for maintaining and
improving the scientific quality of research outputs, especially in the field of health and medicine,
and are often accompanied with various challenges.
AIM: The current study was carried out to Health Promotion in the Review Process of the Health
Scientific Journals according to Explanation of Experts.
MATERIALS AND METHODS: This study has a qualitative approach and was carried out using
the content analysis method. Data were gathered through semi‑structured interviews with experts
with direct and related experiences with health scientific journals including editors in chief, internal
managers, editorial boards, authors’ council and members of national journal commission with at
least 2 years of continuous related work experience in journals and review of at least 10 articles.
Sampling was carried out using purposeful snowball sampling, and data were analyzed using content
analysis method. Lincoln and Guba tests were used to determine the validity and reliability of the
analysis based on the following four criteria – credibility, transferability, certainty, and verifiability.
RESULTS: Experts’ opinions were categorized based on criteria for reviewer selection with three
dimensions of technical expertise, ethical behavior, and orientation and order; reviewer selection
methods including emphasis on others and emphasis on self; and review problems in the Iranian
Health Science and Research Journals including incentive system, reviewer characteristics, and
structural problems.
CONCLUSION: Findings of the current study are usable for all Iranian Health Scientific Journals,
editors, editors in chief, and internal managers as well as lawmakers in the area of scientific research.

Abstract AIM AND BACKGROUND: Social anxiety can interfere with performance and academic success in
students. One of the third‑generation treatments for social anxiety is acceptance and commitment
therapy. Therefore, the current study aims to determine the effectiveness of acceptance and
commitment group therapy on social anxiety of female dormitory residents of Isfahan University of
Medical Sciences.
METHODS: This was a semiempirical study with pre‑ and posttest conducted on 71 female students
living in the dormitory of Isfahan University of Medical Sciences. The study was carried out in five
training sessions using the Liebowitz Social Anxiety Scale and second version of acceptance and
commitment scale whose validity and reliability were confirmed. Data were analyzed using Student’s
t‑test.
RESULTS: The findings showed that acceptance and commitment group therapy has affected the
social anxiety in female dormitory residents of Isfahan University of Medical Sciences (P < 0.0001).
CONCLUTIONS: The findings of this study can be used by student deputies of universities,
consultation centers, as well as counselors and psychologists to improve the conditions for students.

Abstract AIM AND BACKGROUND: Women are among vulnerable groups and susceptible to mental
health problems during any disaster. Therefore, the current study aims to identify the mental health
information needs of women during disasters.
METHODS: This is a qualitative study carried out using content analysis method through
semi‑structured interviews with 27 participants in cities of Tehran, Isfahan, and Mashhad during the
year 2018.
RESULTS: The summary of the findings indicated 8 components and 25 subcomponents for health
information needs of women during disasters. These information needs included primary needs and
secondary needs such as psychological, social, cultural, support and rescue, policy‑making, media
coverage, and environmental needs.
CONCLUSION: The findings of this study can be used by authorities and policy‑makers during
disasters and rescue efforts for the female population and can help improve the general health
status of the society.

Abstract AIM AND BACKGROUND: Given the fact that immune system is greatly affected by people’s
emotional characteristics and since these characteristics are mainly formed through interactions
with one’s parents, this study aims to determine the relation between personality characteristics and
disorders of multiple sclerosis (MS) patients and their parents.
METHODS: This is an applied, descriptive study on 88 MS patients and 63 parents who had visited
two physiotherapy clinics in Tehran between January and August 2016. Participants who met the
inclusion criteria were selected using convenient sampling method. After acquiring their consent,
participants were asked to fill the millon personality questionnaire. Gathered data were analyzed using
Pearson and Spearman tests. R statistical software was also used to draw histogram of the data.
RESULTS: The most common personality disorder in MS patients includes histrionic personality
disorder while the most common problems among their parents included histrionic personality
disorder and obsessive character traits. There was also a direct, significant relation between histrionic
personality disorder and narcissistic traits in parents and patients.
CONCLUSIONS: Due to unknown nature and progress of MS, studying personality characteristics
of patients and their parents can help determine better treatment methods along with advances in
neurological treatments.

Abstract INTRODUCTION: Patients undergoing hemodialysis have a low level of health and mindfulness
technique in mind‑body medicine is used to help patients with chronic illness. Therefore, this clinical
trial was conducted to determine the effect of the mindfulness program on the general health of
patients undergoing treatment with hemodialysis.
METHODS: Sixty hemodialysis patients were selected through the convenient method and randomly
divided into experimental and control groups. Both groups completed demographic information
questionnaire and general health questionnaire. Then, the experimental group received 8 sessions of
mindfulness training and the control group received 8 sessions of education in relation to end‑stage renal
disease and hemodialysis. Educational sessions were performed for both groups in the second 30 min
after hemodialysis for 1 h in six individual sessions and two 1.5 h group sessions. Immediately after
and 1 month after the intervention, the General Health Questionnaire was completed by both groups.
RESULTS: Analysis of the findings showed no significant differences between the mean score
of general health disorder and its subscales before the intervention in to two groups (P > 0.05).
Nevertheless, after intervention in the experimental group, the mean of general health disorder score
decreased from 44.17 ± 12.32 to 21.9 ± 6.4 and 1 month after the intervention, the mean score
of this score was 23.6 ± 6.2. The mean score of physical symptoms, anxiety and sleep disorder,
social functioning deficiency, and depression were also significantly lower in the experimental group
immediately after intervention and 1 month after the intervention; however, there were no significant
differences between the mean of this score immediately and 1 month after the intervention. In addition,
the mean score of general health disorder changes immediately and 1 month after the intervention
in the experimental group was significantly more than the control group. In the control group, there
was no significant difference between the mean score of general health disorder and its subscales
before, immediately, and 1 month after the intervention (P > 0.05).
CONCLUSIONS: The results of this research showed that mindfulness has been effective in reducing
physical and anxiety symptoms, sleep disorder, social dysfunction, and depression symptoms.
Therefore, the use of mindfulness as a complementary treatment can improve the general health
level in these patients.

Abstract AIM AND BACKGROUND: Mental health and empowerment are two of the women’s essential
needs. These two related concepts play an important role in women’s lives. Therefore, this study
aimed to investigate empowerment of women and its relation with mental health problem prevention
during difficult situations.
METHODS: This qualitative study was conducted through semi‑structured interviews with 33 experts
in the fields of psychology, social sciences, women studies, medicine and crisis management
specialists using snowball sampling in cities of Tehran, Isfahan, Tabriz, and Mashhad during the year
1395 (March 2016–March 2017). Samples were selected heterogeneously. The interview transcripts
and codes were presented to the participants, and structural analysis was used for data evaluation.
RESULTS: The factors related to empowerment of women with consideration to their mental health
were determined based on Longew theory and interviews and include: welfare (primary needs
(biological and security) and developmental needs (social needs and dignity), access (facilities and
values), knowledge (about inequalities and rights), participation (in politics, decision‑making and
society), and control (implementation and institutionalization of the above‑mentioned needs).
CONCLUSIONS: The indicators determined in this study show that empowerment has an important
role in determining women’s real position in society. Since women make up half of the population and
affect society as a whole, the advantages of empowerment of women will be felt in the entire society.

Abstract BACKGROUND: Bibliotherapy is defined as using dynamic interaction along with reading a book in
order to help the people to increase their cognitive understanding. This study aims to investigate the
effect of bibliotherapy on the psychological capital of the employees of the Department of Management
and Medical Informatics of Isfahan University of Medical Science.
MATERIALS AND METHODS: This is an applied study using a semi‑empirical method. The
statistical population consists of all nonfaculty employees of the target department (70 people).
Twenty eight people were randomly selected and divided into experiment and control groups and
answered the psychological capital questionnaire. The data gathering tool was the psychological
capital questionnaire of Luthans. The experiment group underwent six 2‑h sessions of bibliotherapy
where the control group underwent no interference. Both groups answered the questionnaire again
1‑month after the final bibliotherapy session. The information was analyzed using descriptive
(average and frequency distribution) and analytical (independent t‑test, paired t‑test, Chi‑square
test, and Mann–Whitney U‑test) with the help of SPSS 20 software.
RESULTS: The findings showed no meaningful distinction average scores of the physiological capital
of both groups before interference. However, the average physiological capital score and an average
score of each factor in the experiment group was meaningfully higher than that of the control group
after the bibliotherapy sections.
CONCLUSION: The results showed that bibliotherapy is a suitable method for increasing the
psychological capital of the employees of different organizations which will in turn provide both the
employees themselves and the organization with material and spiritual gains.

Abstract Background: Considering the increasing importance of emotional intelligence (EI) in different
aspects of life, such as academic achievement, the present survey is aimed to predict academic
performance of medical students in the comprehensive examination of the basic sciences, according
to the indices of emotional intelligence and educational status. Materials and Methods: The present
survey is a descriptive, analytical, and cross‑sectional study performed on the medical students
of Isfahan, Tehran, and Mashhad Universities of Medical Sciences. Sampling the universities was
performed randomly after which selecting the students was done, taking into consideration the
limitation in their numbers. Based on the inclusion criteria, all the medical students, entrance of
2005, who had attended the comprehensive basic sciences examination in 2008, entered the
study. The data collection tools included an Emotional Intelligence Questionnaire (standardized in
Isfahan), the average score of the first to fifth semesters, total average of each of the five semesters,
and the grade of the comprehensive basic sciences examination. The data were analyzed through
stepwise regression coefficient by SPSS software version 15. Results: The results indicated
that the indicators of independence from an emotional intelligence test and average scores of
the first and third academic semesters were significant in predicting the students’ academic
performance in the comprehensive basic sciences examination. Conclusion: According to the
obtained results, the average scores of students, especially in the earlier semesters, as well as
the indicators of independence and the self‑esteem rate of students can influence their success
in the comprehensive basic sciences examination.

Abstract Background: The issue of students’ academic failure is one of the most important educational,
economic, and social issues. Cognizance of the factors related to academic downfall is so efficient
in its prevention and control and leads to protecting governmental assets and labor force. In
order to achieve this goal, this study intends to determine the predictive factors of the students’
academic performance in Isfahan University of Medical Sciences in terms of their personality profile,
mental health, and their demographic characteristics. Materials and Methods: This study was a
descriptive‑correlation study on 771 students who entered Isfahan University of Medical Sciences
between 2005 and 2007. The information was gathered through using the students’ educational and
clinical files (for measuring personality characteristics and mental health) and SAMA Software (To
get the mean scores). Minnesota Multiphasic Personality Inventory short form and General Health
Questionnaire were used for collecting clinical data. The data were analyzed using SPSS 15(stepwise
regression coefficient, variance analysis, Student’s t‑test, and Spearman correlation coefficient).
Result: The results showed that the aforementioned students obtained a normal average for their
personality profile and mental health indicators. Of all the reviewed variables, education, age, gender,
depression, and hypochondria were the predictive factors of the students’ educational performance.
Conclusion: It could be concluded that some of the personality features, mental health indicators,
and personality profile play such a significant role in the students’ educational life that the disorder
in any of them affects the students’ educational performance and academic failure.

Abstract Introduction: Bibliotherapy is a supplement, simple, inexpensive and readily available
method to treat the diseases that is performed with cooperation of librarians and
psychologists or doctors. The aim of this study is the investigation of group bibliotherapy’s
effect on the self‑esteem of the female students of Isfahan University of Medical Sciences
Living in Dormitory in 2012. Materials and Methods: The present study is an interventional
semi‑experimental study with pre test and post test and control group. The statistical
population of study consisted of 32 female students who reside in Isfahan University
of Medical Sciences dormitories which control and case groups and the students were
divided randomly between these two groups. Data was collected by Cooper Smith
Self‑esteem questionnaire scale (Cronbach’s alpha: 0.85). Two groups were examined
by the questionnaire in pre test. Case group received group bibliotherapy for 2 month
(8 sessions of 2 hours), while the control group received no training at all. Then, 2 groups
were assessed in post test after 1 month. Descriptive statistics (means and frequencies
distribution) and inferential statistics (independent t‑ test, paired t‑ test and mann whitney)
were used and data was analyzed by SPSS20 software. Results: The findings showed that
group bibliotherapy had positive and significant effect on general, family, professional and
total self esteem of female students living in dormitories, but it had no effect on their social
self esteem. Conclusion: Group bibliotherapy can increase female students’ self‑esteem
levels. On the other hand, conducting these studies not only can improve mental health of
people, but can also improve their reading habits.