Journal of Education and Health Promotion

Abstract BACKGROUND: Sexually transmitted infections (STIs) have always been considered as a health
problem in the world. Also, vulnerable women (addicts, jail breakers, and prostitutes) are at the highest
risk. According to the World Health Organization’s (WHO) approach, the only effective way to prevent
and control this disease is public health education, and high‑risk and vulnerable groups should be
prioritized in educational programs. The aim of the study was to investigate the effect of health belief
model (HBM)‑based education on changing the behaviors related to STIs in vulnerable women.
MATERIALS AND METHODS: The present study is an intervention (field trial) study in vulnerable
women. Convenience sampling method was used in this study and the sample size was determined
to be 84 subjects. Through tossing a coin, the social support center was selected as the intervention
group and the drop‑in center as the control group. Quantitative data analysis was performed, and
descriptive and inferential statistical methods were used.
RESULTS: The mean scores of perceived threat, perceived benefits, perceived barriers, and
perceived self‑efficacy and changes in performance between the three measurement stages, as
well as changes in the scores of perceived threat, perceived benefits, perceived barriers, and
perceived self‑efficacy over three measurement times were significantly different between the two
groups (interaction) (P < 0.001). The mean score of performance 3 months after the intervention
was significantly higher than before the intervention (P = 0.001).
CONCLUSIONS: The present study confirmed the effectiveness of the HBM in promoting behavioral
modifiers that lead to STIs. Therefore, educational interventions with emphasis on understanding
the threats, benefits, barriers, and self‑efficacy and, ultimately, performance improvement in relation
to STIs are recommended.

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: Breast cancer is the most common type of cancer among women and it is the
second leading cause of mortality among cancers in women and a major health issue in developed
countries. Although there are simple and effective screening methods, just minority of women use
them. Given the high prevalence of breast cancer in Isfahan women and the low prevalence of
screening behavior, the present study aimed to determine the impact of theory‑based educational
intervention on breast self‑examination (BSE) behavior and mammography.
MATERIALS AND METHODS: The present experimental study was conducted on 93 women referred
to comprehensive health centers in Isfahan through convenience sampling, and by this way 46 women
were included in the control group and 47 in the intervention group. Data collection was done by
a valid and reliable questionnaire. Furthermore, educational interventions were performed for the
intervention group in three sessions. Furthermore, the data were completed in the intervention group
before, immediately after, and 3 months after intervention and before and 3 months after intervention
in the control group. The data were analyzed by SPSS (16); and paired t‑test and repeated measure
test were used for analysis in the intervention group and also independent t‑test and paired t‑test
were employed to analyze data of the control group.
RESULTS: The results showed significant changes in perceived benefit constructs (P = 0.023),
knowledge (P < 0.001), self‑efficacy (P < 0.001), and behavioral intention regarding BSE (P = 0.035)
in the intervention group over time, but changes were not significant in both perceived susceptibility
and severity in the intervention group. As far as mammography behavior is concerned, only the
perceived benefit construct in the intervention group had significant changes. In terms of the screening
behavior, only BSE behavior significantly changed before and after intervention.
CONCLUSION: The study showed that theory‑based education by applying of constructs such
as perceived benefits and self‑efficacy and intention for BSE model could promote breast cancer
screening behavior such as BSE. Therefore, it is suggested that health educators utilize educational
texts based on these constructs to increase their influence on individuals via screening behavior
for breast cancer.

Abstract AIMS: Although chronic diseases are the most common and expensive health problems, they are
preventable too. Nurses play a key role in the care of these patients. One of the important roles
of nurses is consultation role. Due to the high impact of nurse consultant role on health promotion
and also the fact that this role is not fully understood in Iran, this study aims at clarifying the role of
nurse consultant.
MATERIALS AND METHODS: This is a qualitative study with content analysis approach conducted
through semi‑structured interviews in Isfahan University of Medical Sciences from April to December
2017. A total of 35 participants (11 patients, 9 nurses, 6 faculty members, 4 postgraduate students,
and 5 nursing managers) were included in the study. Sampling was done based on purposive sampling
method, and participants were asked to express their opinions about nurse consultant.
RESULTS: In this article, we discussed the following three categories and seven subcategories: (1)
nursing consultation as a treatment facilitator (nursing consultation as a way to reduce the treatment
course, nursing consultation as a way to reduce complications, and nursing consultation as a way
to reduce costs); (2) professional performance in nursing consultation (nursing consultation based
on problem‑solving and evidence‑based practice and management and teamwork in nursing
consultation); and (3) prerequisites for the nursing consultation role (supporting nurses and introducing
the role in decision‑making units and creating demand).
CONCLUSION: Nursing consultation has an essential role in patient health promotion. Therefore, it
is better that nurses and other health‑care team should be familiar with this vital role.

Abstract INTRODUCTION: Barriers to medication adherence in patients with hypertension can have significant
differences that made researchers confute to conclude that medication adherence is required to
be more explored, and then, beneficial interventions develop to decrease these barriers. Thus, the
current study was aimed to identify barriers to adherence in Iranian society.
MATERIALS AND METHODS: A qualitative content analysis was carried out. Participants were as
follow: Patients with hypertension who had clinic records in the health centers of Isfahan University of
Medical Science. Purposive sampling method was conducted and continued until data saturation, as
well. Semi‑structured interview was selected as the best‑qualified technique to select data. Data were
analyzed using qualitative content, constant comparative analysis, and MAXQDA (Ver 10) software.
RESULTS: After study and separation of basic concepts, 1620 basic codes were extracted from
interviews. Classes were made based on codes and after multiple reviews, summarizing as well
as similarity. Primary themes were identified using more explorations and comparison of classes.
Based on the nature, the conceptual themes were named. These themes include (1) environmental
challenges of life, (2) incompatibility of patients; (3) forget to take medicine, and (4) inefficient
recommendations of family.
CONCLUSION: Findings revealed that barriers to patient adherence to the treatment had four
dimensions that may be likely useful for managers and planners in the health field to plan and intervene
regarding medication adherence as the most critical preventing factor for patients with hypertension.

Abstract BACKGROUND: This study was aimed at developing and studying the scale of self‑efficacy in
adherence to treatment in Iranian patients with hypertension.
METHODS: A mix‑method study was conducted on the two stages: in the first phase, a qualitative
study was done using content analysis through deep and semi‑structured interviews. After data
analysis, the draft of tool was prepared. Items in the draft were selected based on the extracted
concepts. In the second phase, validity and reliability of the instrument were implemented using a
quantitative study. The prepared instrument in the first phase was studied among 612 participants. To
test the construct validity and internal consistency, exploratory factor analysis and Cronbach’s alpha
were used, respectively. To study the validity of the final scale, the average score of self‑efficacy in
patients with controlled hypertension were compared with patients with uncontrolled hypertension.
RESULTS: In overall, 16 patients were interviewed. Twenty‑six items were developed to assess
different concepts of self‑efficacy. Concept‑related items were extracted from interviews to study
the face validity of the tool from patient’s point of view. Four items were deleted because scored
0.79 in content validity. The mean of questionnaire content validity was 0.85. Items were collected
in two factors with an eigenvalue >1. Four items were deleted with load factor <0.4. Reliability was
0.84 for the entire instrument.
CONCLUSION: Self‑efficacy scale in patients with hypertension is a valid and reliable instrument that
can effectively evaluate the self‑efficacy in medication adherence in the management of hypertension.

Abstract Background: The higher prevalence rate of influenza A among adolescence emphasizes the
importance of preventative strategies among this age group of population. The aim of this study
was to evaluate the preventive behaviors of high school students regarding type A influenza,
in Shahrekord, Iran. Materials and Methods: In this cross-sectional study, 313 high school
students were enrolled. Preventive behaviors of influenza A was evaluated by components of
the Health Belief Model (HBM), using a questionnaire which its reliability was verified through
a pilot study (alpha score 0.8). Data analysis was done by descriptive statistics, independent
t-test and Pearson correlation coefficient. Findings: Mean age of the students was 16.31 years.
Knowledge, perceived severity and perceived barriers were in the modest level among the
students. The highest scores were related to perceived susceptibility (75.4%) and perceived
benefit (55.6%). Mass media was the main source of their information regarding influenza A.
Conclusion: Considering the findings of this study and the relation between HBM components
and the preventive behaviors of students, it seems that using HBM could be useful in improving
preventive behaviors of influenza A among the studied population.