Journal of Education and Health Promotion

Abstract BACKGROUND: Cardiovascular diseases (CVDs) are among the most important causes of premature 
death, disability, disease burden, and increasing the cost of healthcare worldwide. Having an overview 
of service utilization can help policymakers to plan more effective use of those services and to cut 
costs. Thus, this study aims to determine the amount of use as well as the cost of various outpatient 
diagnostic procedures for CVDs in Isfahan province of Iran from 2011 to 2017.
MATERIALS AND METHODS: This descriptive study used insurance claim data (time period: 
2011–2017) from Health Insurance Organization in Isfahan province to determine the amount of 
use and the cost of various outpatient diagnostic procedures for CVDs. Afterward, based on these 
data, the use and the cost of various outpatient diagnostic procedures for CVDs were estimated for 
the total population of Isfahan province. The list of outpatient diagnostic procedures for CVDs was 
carefully chosen according to experts’ opinions.
RESULTS: The use and the cost of outpatient diagnostic procedures for CVDs have drastically 
increased in the study period (2011–2017). Since 2011, the number of procedures and their related 
costs have increased 6.6 and 30.76 times (11.74 times, adjusted with PPP conversion factor), 
respectively. Per capita use (per thousand people) was 18.75 in 2011, reaching 116.51 in 2017. 
Per capita cost (per thousand people) was 1,887,660 IRR (355 PPP$) in 2011, reaching 54,660,365 
IRR (3920 PPP$) in 2017. The highest cost and use were related to echocardiography and 
electrocardiography, respectively. A notable increase has been observed in the share of radionuclide 
myocardial perfusion scan and analysis of pacemakers and ICDs of the total cost.
CONCLUSIONS: The use of outpatient diagnostic procedures for CVDs has drastically increased 
during the studied period. Consequently, the cost borne by the health system and the patients have 
notably increased. This may be because of the increase in the incidence and prevalence of CVDs 
during the study period. Greater access to related health services can be mentioned as another reason 
for this increase. Further research is needed to explain all potential reasons and their importance, 
which can provoke a suitable health policy reaction.

Abstract INTRODUCTION: Responsibility in the higher educational system requires the universities to be
sensitive on students’ needs and expectations. The purpose of the present study was to examine the
educational service quality among health information technology (HIT) students in Isfahan University
of Medical Science based on the SERVQUAL model.
METHODS: This was a descriptive cross‑sectional study and carried out at the Management and
Medical Information Sciences faculty of IUMS in 2018. Sixty‑eight undergraduate and postgraduate
students of HIT participated in this study. For collecting data, the standard SERVQUAL questionnaire
was used. The collected data were analyzed using SPSS version 20 software in descriptive level.
RESULTS: Findings showed that there was a positive gap in overall dimensions of educational
services quality (mean discrepancy of expectations and perceives). Most mean of service gap was
contributed to responsiveness dimension 1.06 (0.98 standard deviation [SD]), following that empathy
1.04 (0.97 SD), assurance 1.00 (0.83 SD), reliability 0.83 (0.76 SD), and the least gap was seen
intangibles 0.61 (1.02 SD).
CONCLUSION: According to the current gaps in all quality dimensions, as well as high amount of
expectations in comparison with students’ perception, it is required to evaluate higher education
quality through implementing students’ knowledge skill and creative abilities. Therefore, to improve
the quality of educational services at the Faculty of Management and Medical Information, all
dimensions, especially the responsiveness dimension, should be considered.

Abstract BACKGROUND: To increase the utilization of preventive dental care, it is essential to improve
the knowledge and attitude of parents about such cares. The aim of this study was to evaluate
the knowledge, attitude, and practice of school children’s parents toward fissure sealant (FS) and
professional fluoride therapy in Isfahan.
MATERIALS AND METHODS: In this cross‑sectional study, school children’s parents (n = 637) were
selected based on proportional cluster sampling. A valid and reliable questionnaire was designed,
including demographic section, questions about parents’ experience and their knowledge and attitude
about professional fluoride and FS therapy. Data were analyzed by ANOVA, regression, Chi‑square,
and correlation coefficient tests.
RESULTS: The means of total knowledge and knowledge about fluoride therapy and FS were 5.9 ± 4.1
out of 19, 3.3 ± 2.0 out of 9 and 2.6 ± 2.7 out of 10, respectively. The mean of attitude was 33.7 ± 5.8.
The mean of knowledge toward FS therapy was significantly higher in academically educated
parents (P = 0.023). The mean of total knowledge among those who received their knowledge by their
dentist was also significantly higher than that of other resources such as mass media (P = 0.003).
Total knowledge was positively correlated with attitude (P < 0.001, coefficient = 0.5). Of participants,
10.4% (54) and 23.2% (124) had the experience of FS and fluoride therapy, respectively.
CONCLUSION: Based on the low level of knowledge regarding professional preventive care in this
study and the effectiveness of knowledge acquired through dentists and mass media consultations,
it might be effective to require them to consider such training more seriously.

Abstract BACKGROUND: Preconception care is a set of interventions that aim to identify and repair the factors
that can affect the outcome of pregnancy. The aim of this study was to determine the prevalence of
receiving preconception care, its relation with recipients’ individuality, fertility, and determining the
reason for lack of checkup.
MATERIALS AND METHODS: This was a descriptive cross‑sectional study that was conducted based
on simple stratified random quota sampling on 702 women who gave birth in hospitals of Isfahan (Iran)
from April to June in 2016. The tool of collecting data was researcher‑made questionnaire. The data
were analyzed by the SPSS software version 18 using the mean, standard deviation, relativity, and
independent Chi‑square tests.
RESULTS: The results showed that 47.7% of participants had received preconception care. There
was a significant relationship between educational levels, income, wanted pregnancy, number of
pregnancies, and previous individual delivery with preconception care (P <   0/05). The main reason
for the lack of preconception care was unplanned pregnancy.
CONCLUSIONS: Results of this study indicated that the quantity of preconception care is not
desirable. Therefore, notifying and sensitizing women of childbearing age is essential to refer to
service centers and receiving preconception care and planning to present it to all eligible women
before pregnancy care. The main causes of the lack of preconception care can be adjusted through
health programs.

Abstract Background: Healthy nutrition particularly the energy intake and the essential nutrients in
female students is very important. This study aims to assess micro- and macronutrient intakes
in female students of Isfahan University of Medical Sciences, Iran. Materials and Methods:
This cross-sectional study involved 100 female students aged between 18 and 25 years in
2008–2009. Anthropometrics measures were performed and two 24-hours food recalls were
used to collect the dietary information and were analyzed using food processor 2 and compared
with the dietary reference intakes (DRIs) 2008. Findings: As many as 61.1% of subjects resided
in dormitories; 12.7% were married. Prevalence of overweight or obesity and abdominal obesity
in the subjects studied were 6.9% and 46.1%, respectively. The mean (±SD) systolic blood
pressure was 105.2 ± 15.6 mmHg and the diastolic was 62.2 ± 10.4 mmHg. Totally, 3.9% of
the subjects had hypertension. Food intake analysis indicated that B12, folate, magnesium,
potassium, and calcium were below the recommended level, and vitamin C, E, pantothenic
acid, B1
, B3
, phosphate, and zinc were above, and energy intake, macronutrient, vitamin A,
pyridoxine, iron, and selenium were, in general, adequate. Conclusion: The findings of the
study indicated that macronutrients intake was appropriate, but the problem mainly existed
in the consumption of micronutrients. It is recommended to increase the intakes of important
food groups such as dairy, vegetable, and fruit that are proper sources of micronutrients, and
it is also suggested to improve strategies and the competence in this area of nutrition.