Journal of Education and Health Promotion

Abstract BACKGROUND: Voluntary counseling and testing (VCT) is one of the main efforts for the prevention
of high‑risk sexual behavior, including HIV/acquired immunodeficiency syndrome (AIDS). The aim of
this study was to determine cognitive determinants related to voluntary counseling and HIV testing
among Iranian adults based on the integrative model of behavioral prediction (IMBP).
MATERIALS AND METHODS: This cross‑sectional study was conducted in 2018 among Iranian
adults with high‑risk sexual behaviors, including drug abuse and unprotected sex, in western Iran.
A total of 300 adults were randomly selected to participate voluntarily in this study. Participants filled
out a self‑administered questionnaire, including the background data and IMBP constructs. Data were
analyzed by SPSS version 21, using statistical treatments, such as bivariate correlations, Chi‑square
test, t‑test, and logistic regression at a 95% significant level.
RESULTS: Almost 73.3% of the participants had a history of VCT. The highest probability of VCT
use was in participants who were in high level of VCT skills (odds ratio: 9.635; 95% confidence
interval [CI]: 3.255, 28.514]), following environmental constraints (odds ratio: 6.274; 95% CI: 2.166,
18.171). Furthermore, the IMBP constructs accounted for 85% of the variations in the outcome
measure of the VCT use intention.
CONCLUSIONS: Based on the result, it appears that the design and implementation of educational
programs to improve upon skills and environmental constraints toward VCT use among adults with
high‑risk behaviors could be useful to the promotion of VCT.

Abstract BACKGROUND: Hemodialysis patients experience many issues in self‑care behavior. Patients
require to control of manage the issue to improve the self‑care. Educational intervention to behavior
change can be effective on self‑care behavior. This study was conducted to investigate the effect of
an educational intervention, based on the self‑Efficacy theory on promoting self‑care in hemodialysis
patients.
MATERIALS AND METHODS: Seventy hemodialysis patients recruited in this study and divided
randomly into intervention group (n = 35) and control group (n = 35) with convenience sampling in
2016 from Qom city, Iran. Data were collected before and 3 months after education using demographic
questionnaire, self‑efficacy, a valid researcher‑made questionnaire regarding to awareness and
self‑care. The educational intervention was performed for the intervention group in 4 1‑h sessions
over 2 months. The data were analyzed through Paired t‑test, Independent t‑test, Chi‑square, and
Mann–Whitney at the significant level of 0.05.
RESULTS: While variables in two groups did not show significant difference before education (P > 0.05),
a significant increase was observed in variables of self‑efficacy (P < 0.001), awareness (P < 0.001),
and self‑care dimensions (P < 0.05) between two groups after 3 months education.
CONCLUSION: The results of this research suggested that employing educational programs based
on the self‑efficacy theory can lead to the improvement of the self‑care behaviors in hemodialysis
patients.

Abstract BACKGROUND: The educational environment has been confirmed as crucial factor for active
learning. Team‑based learning (TBL) is an interactive teaching method which improves students’
perceptions and performance.
OBJECTIVES: The comparison of the team‑based learning method through lecture‑based approach
on health education curriculum in public health students
METHODS: A quasi‑experimental study was conducted among 23 public health students of bachelor
degree and 14 public health students of associate degree to teach communication and Health
Education in Qom University of Medical Sciences from January 2015 to Jun 2016. Students of
bachelor degree selected TBL and students of associate degree preferred the traditional lecture‑based
method. In the current study, educational outcomes were defined as educational environment
and academic performance. At the last session of the semester, the educational environment and
academic performance of both groups were evaluated. Data were analyzed by SPSS version 20.0
using Chi‑square and Mann–Whitney test.
RESULTS: The mean and standard deviation of individual test score between the two groups showed
significant difference based on Mann–Whitney results (P = 0.036). The mean of final examination score
in TBL group was significantly higher than the traditional lecture group (P < 0.021, Mann–Whitney).
Our findings showed that in TBL group, 78.3% of students’ perceptions were in very favorable
condition while it was only 28.6% for students of the traditional method.
CONCLUSIONS: TBL method improves students’ perceptions about each area of educational
atmosphere and also provides opportunities to innovate which lead to active teamwork among
learners, and it can effectively enhance students’ academic performance.

Abstract BACKGROUND: Physically disabled people experience more restrictions in social activities than
healthy people, which are associated with lower level of well‑being and poor quality of life (QoL).
STUDY DESIGN: A cross‑sectional study was conducted
METHODS: This study was investigated on among 302 eligible physically disabled people. The
predictive role of the demographics and clinical characteristics, anxiety and depression, physical
activity, and self‑efficacy on the 36‑Item Short Form Health Survey (SF‑36) was examined.
STATISTICAL ANALYSIS USED: Statistical analysis used univariate and multivariate regression
models.
RESULTS: Gender, self‑reported physical activity levels, use of the disability aid tools, and depression
were significantly predictors of the physical component summary (PCS) (R2 = 0.20, P < 0.001). We
realized that anxiety, depression, and self‑efficacy could significantly predict the mental component
summary (MCS) (R2 = 0.43, P < 0.001).
CONCLUSIONS: Study results revealed that four and three variables could predict 20% and 43%
of PCS and MCS variations, respectively. These findings warranted the detection of QoL risk factors
and establishment of targeted interventions to optimize the health‑related QoL among physically
disabled people.
Keywords:

Abstract BACKGROUND: Social support is one of the most effective factors on the diabetic self‑care. This
study aimed to assess social support and its relationship to self‑care in type 2 diabetic patients in
Qom, Iran.
STUDY DESIGN: A cross‑sectional study was conducted on 325 diabetics attending the Diabetes
Mellitus Association.
METHODS: Patients who meet inclusion and exclusion criteria were selected using random sampling
method. Data were collected by the Summary of Diabetes Self‑Care Activities and Multidimensional
Scale of Perceived Social Support, with hemoglobin A1
C test. Data were analyzed using descriptive
statistics and independent t‑test, analysis of variance, Pearson correlation, and linear regression
test, using 0.05 as the critical significance level, provided by SPSS software.
RESULTS: The mean and standard deviation of self‑care and social support scores were
4.31 ± 2.7 and 50.32 ± 11.09, respectively. The mean level of glycosylated hemoglobin (HbA1
C) of
patients was 7.54. There was a significant difference between mean score of self‑care behaviors
and social support according to gender and marital status (P < 0.05). The regression analysis
showed that disease duration was the only variable which had a significant effect on the level
of HbA1
C (P < 0.001). Pearson correlation coefficient indicated that self‑care and social support
significantly correlated (r = 0.489, P > 0.001) and also predictive power of social support was 0.28.
Self‑care was significantly better in diabetics with HbA1
C ≤7%. Patients who had higher HbA1
C felt
less, but not significant, social support.
CONCLUSIONS: This study indicated the relationship between social support and self‑care behaviors
in type 2 diabetic patients. Interventions that focus on improving the social support and self‑care of
diabetic control may be more effective in improving glycemic control.