Journal of Education and Health Promotion

Abstract BACKGROUND: Breast cancer is the most prevalent cancer and a major cause of mortality among
women. Breast self‑examination (BSE) is a key technique for early diagnosis of breast cancer,
which, along with lifestyle changes, can alleviate the risk of mortality. This study aimed to examine
the effect of self‑care training programs on lifestyle change and BSE of immigrant Afghan women
residing in Iran.
MATERIALS AND METHODS: In this quasi‑experimental study, 140 immigrant Afghan women visiting
health‑care centers in Shiraz (Iran) were selected via convenience sampling during 2019–2020. The
data were collected using a lifestyle questionnaire, a demographic information checklist, and a BSE
checklist. Following the pretest, the experimental group received three sessions of self‑care training
and took the posttest 2 months after the intervention. The control group did not receive any intervention,
but took the same posttest 2 months after the pretest. Data analysis was performed using paired and
independent t‑test and Chi‑squared test in Statistical Package for the Social Sciences (SPSS) 22.
RESULTS: The post‑intervention level of knowledge and performance of the experimental group
significantly increased in terms of a healthy lifestyle (P < 0.001) and performance of BSE (P < 0.001)
compared to the control group. The intervention also had a significant positive effect (P < 0.000) on
all dimensions of lifestyle.
CONCLUSION: Self‑care training for lifestyle and BSE can promote the prevention and early diagnosis
of breast cancer in immigrant Afghan women who have limited access to health care.

Abstract BACKGROUND: Adopting a healthy lifestyle is necessary to maintain and promote health. The aim
of this study was to determine the effect of teach‑back method on improving the lifestyle of health
ambassadors in Urmia.
MATERIALS AND METHODS: In this quasi‑experimental study, 200 health ambassadors were
participated. The research sample was obtained using simple random sampling method. Data
collection tool was a questionnaire including demographic characteristics and lifestyle standard. The
educational intervention was performed in 4 sessions of 45 min based on the teach‑back method.
Data were collected through a lifestyle questionnaire before and 3 months after the educational
intervention. Then, the data were analyzed by mean and standard deviation, independent t‑test,
paired t‑test, and Chi‑square test through SPSS 19.
RESULTS: The results showed that 24% of the control group and 21% of the intervention group
had a good lifestyle before the educational intervention. After the educational intervention 27% of
the control group and 54% of the intervention group were in good lifestyle. The results also showed
that the mean score of total lifestyle and all its dimensions in the intervention group increased
compared to the control group after the educational intervention and the difference between the
mean score of total lifestyle and all its dimensions in the intervention group after the intervention
was significant (P < 0.05).
CONCLUSIONS: Among health ambassadors, teach‑back communication is more effective in
improving the lifestyle. Therefore, it is suggested that this method must be used in designing training
programs for health ambassadors.

Abstract BACKGROUND: Breast cancer (BC) is the most common cause of cancer‑related deaths in women
globally. Currently, many machine learning (ML)‑based predictive models have been established to
assist clinicians in decision making for the prediction of BC. However, preventing risk factor formation
even with having healthy lifestyle behaviors or preventing disease at early stages can significantly
lead to optimal population‑wide BC health. Thus, we aimed to develop a prediction model by using a
genetic algorithm (GA) incorporating several ML algorithms for the prediction and early warning of BC.
MATERIAL AND METHODS: The data of 3168 healthy individuals and 1742 patient case records
in the BC Registry Database in Ayatollah Taleghani hospital, Abadan, Iran were analyzed. First, a
modified hybrid GA was used to perform feature selection and optimization of selected features.
Then, with the use of selected features, several ML algorithms were trained to predict BC. Afterward,
the performance of each model was measured in terms of accuracy, precision, sensitivity, specificity,
and receiver operating characteristic (ROC) curve metrics. Finally, a clinical decision support system
based on the best model was developed.
RESULTS: After performing feature selection, age, consumption of dairy products, BC family history,
breast biopsy, chest X‑ray, hormone therapy, alcohol consumption, being overweight, having children,
and education statuses were selected as the most important features for prediction of BC. The
experimental results showed that the decision tree yielded a superior performance than other ML
models, with values of 99.3%, 99.5%, 98.26% for accuracy, specificity, and sensitivity, respectively.
CONCLUSION: The developed predictive system can accurately identify persons who are at elevated
risk for BC and can be used as an essential clinical screening tool for the early prevention of BC and
serve as an important tool for developing preventive health strategies.

Abstract BACKGROUND: Lifestyle and nutritional transitions in the society driven by globalization have led
to the rising burden of cholelithiasis. The present study was done to assess the impact of lifestyle,
stress, menstrual pattern, and cardiometabolic risk factors on young females with cholelithiasis.
MATERIALS AND METHODS: A hospital‑based case–control study was conducted on young females
of 18–45 years. Cases and age‑matched controls were compared on their lifestyle parameters like
demography, marital status, occupation, educational status, family income, stress along with menstrual
pattern, cardiometabolic parameters like anthropometric measures, blood pressure (BP), fasting
blood sugar (FBS), and lipid profile. Chi‑square test and unpaired t‑test were used for the analysis
of data using SPSS software, and P < 0.05 was considered statistically significant.
RESULTS: The majority of the cases were from rural areas, married, homemakers leading a
comparatively sedentary lifestyle consuming more red meat, less literate, and belonged to a lower
economic group with significantly more stress compared to controls. The age of menarche, neither the
regularity nor irregularity of the menstrual cycle (regular cycle 21–35 days), showed any difference,
but cases had significantly more pregnancies and usage of oral contraceptives compared to controls.
Waist–height ratio, systolic BP, FBS, triglyceride, low‑density lipoprotein (LDL), and very low-density
lipoprotein (VLDL) were significantly higher in cases. Cases had a 14.4 times more risk of developing
metabolic syndrome when compared with controls.
CONCLUSION: Married, rural, less literate Indian women leading a sedentary lifestyle, consuming
more of red meat, and soft drinks with increased psychosomatic stress are more prone to develop
cholelithiasis. Women who use hormonal contraceptives have increased occurrence of cholelithiasis
and they were more prone to develop metabolic syndrome. The need for the hour is health education,
to implement simple lifestyle changes, thereby decreasing the incidence of cholelithiasis in young
females.

Abstract BACKGROUND: This study aimed to investigate the effect of educational intervention based on the
Pender’s health promotion model (HPM) on lifestyle and self‑efficacy of the patients with diabetic
foot ulcer.
MATERIALS AND METHODS: In this clinical trial conducted in 2019, 74 patients based on
inclusion criteria were selected through convenience sampling and allocated to two groups of
intervention (n = 37) and control (n = 37) using the randomized permuted block method. In this
study, Demographic characteristics and localized Diabetes Foot Care Self‑Efficacy Scale and
Health‑Promoting Lifestyle Profile Questionnaire for diabetic foot care were completed by two groups.
The obtained data were analyzed using SPSS 16 and through descriptive and comparative statistics,
independent t‑test, paired t‑test, and ANCOVA.
RESULTS: After the intervention, the mean score of the intervention group significantly increased
in all lifestyle dimensions (P < 0.001). Furthermore, the mean score of self‑effcacy increased in the
intervention group after the intervention (P < 0.001). Comparing the change in the mean scores of
lifestyle and self‑efficacy in both the groups 50 days after the intervention, an increase was observed
in the mean scores of self‑efficacy (P < 0.001) as well as those of lifestyle and its dimensions in the
intervention group compared to those in the control group (P < 0.001).
CONCLUSION: Educational intervention based on the Pender’s HPM can promote the self‑efficacy,
lifestyle, and its dimensions in the patients with diabetic foot ulcers. The results of this study can be
used in educational interventions aiming at patients with diabetic foot ulcers to change their lifestyle
and improve their self‑efficacy.

Abstract BACKGROUND: Patient education is a key factor in promoting the health of people with acute
coronary syndrome (ACS), and the effective use of technology can play an important role in this
regard. This study aimed to determine the effectiveness of education using media messages on the
lifestyle of patients with ACS.
MATERIALS AND METHODS: The present clinical trial was conducted on 91 cases with ACS
admitted to the cardiac ward of Afshar Hospital in Yazd, Iran, during 2018–2019, who were randomly
assigned to control and intervention groups. The former only was provided with routine training before
discharge, while the latter, in addition to routine training before discharge, received education on
social networking and sending text/visual messages. At baseline and 3 months after the intervention,
the Walker’s Lifestyle Questionnaire was completed. The independent t‑test, paired t‑test, and
Chi‑square test were employed for data analysis.
RESULTS: The average lifestyle value of the intervention group was significantly higher compared
with the control group after the intervention (P ˂ 0.001). Moreover, the lifestyle score was significantly
different pre‑ and post‑intervention in the intervention group (P ˂ 0.001).
CONCLUSIONS: Education using media messages is useful to promote the lifestyle in cases with
ACS, which seems effective in planning the follow‑up for these patients.

Abstract BACKGROUND: Lifestyle can play an important role in controlling type II diabetes (T2D), and a
high‑risk lifestyle can exacerbate its effects. The aim of this study was to compare the effectiveness
of motivational interviewing with self‑development education on T2D patients’ lifestyle.
MATERIALS AND METHODS: This was a quasi‑experimental study in 2017–2018. The design was
pretest–posttest with an active comparison group. The population of this study was T2D patients of
Firouzgar and Imam Reza Hospitals in Tehran. Using targeted sampling, 80 patients were selected and
randomly assigned into experimental and comparison groups. The instrument was a tool for assessing
lifestyle determinants in T2D patients (determinants of lifestyle behavior questionnaire) based on the
theory of planned behavior. Intervention program was initially performed, and motivational interviewing
was conducted on Firouzgar Hospital’s patients for 10 sessions while self‑development education
was conducted on Imam Reza Hospital’s patients for 10 sessions (active comparison group). To
analyze the data, independent t‑test and Chi‑square test were used.
RESULTS: The results showed that the patients who received motivational interviewing had significant
improvement in their lifestyles with a 95% confidence level at P = 0.042, compared to the patients
who had been trained with self‑development education.
CONCLUSION: Motivational interviewing improves the lifestyle of T2D patients compared to
self‑development education. It is recommended that motivational interviewing be used to help the
rehabilitation of these patients. This method helps patients control their blood sugar while improving
their lifestyle.

Abstract BACKGROUND: Gestational diabetes is one of the most common metabolic diseases during
pregnancy. The risk of a lifestyle role in the prevention of metabolic syndrome in women with a history
of gestational diabetes has now been identified. The present study was performed to investigate the
relationship between lifestyle and metabolic syndrome in women with a history of gestational diabetes.
MATERIALS AND METHODS: The present study was a retrospective case–control study that was
performed on 90 women (45 women with a history of gestational diabetes and 45 women without a
history of gestational diabetes) in Kerman health centers 5 years after delivery in 2020. Data were
collected using a demographic questionnaire and a standardized Walker lifestyle Health promoting
Lifestyle profile II questionnaire. The reference laboratory was also used to perform the experiments.
SPSS21 software and Spearman’s and Chi‑square tests were used to analyze the data.
RESULTS: The mean age was 35.67 in the case group and 34.27 in the control group (P = 0.230).
Lifestyle did not show any difference between the two groups (P = 0.058). However, metabolic
evaluation was different in the two groups (P = 0.030). Furthermore, the results of Spearman’s test
to examine the relationship between lifestyle and other variables studied showed that in the case
group (P = 0.075) and in the control group (P = 0.819) there was no relationship between lifestyle
and metabolic assessments 5 years after delivery.
CONCLUSIONS: In case group women, it is possible to prevent the progression to type 2 diabetes
and disturb the metabolic assessment by teaching a healthy lifestyle and timely follow‑up after
delivery. A history of gestational diabetes can be one of the causes of type 2 diabetes and metabolic
syndrome. Getting training to change your lifestyle during pregnancy and postpartum can reduce the
incidence of gestational diabetes and type 2 diabetes. Screening pregnant women during childbirth
is a good opportunity to diagnose diabetes early and predict it in the coming years.

Abstract BACKGROUND: Lifestyle training is of a key important in adolescent age for better life in the future.
Healthy lifestyle in adolescents can management of any disease such as diabetes and polycystic
ovarian syndrome (PCOS). Schools can provide an important environment to identify and change
the lifestyle of students. The aim of this protocol is designing and evaluating the effectiveness of
school‑based lifestyle training program improving the PCOS of adolescents.
MATERIALS AND METHODS: A cluster‑randomized controlled trial will be conducted to examine
the effectiveness of school‑based lifestyle training program in 16 to 18 years old adolescent girls.
The healthy lifestyle program will be designed by modification of behavioral habit, dietary intake,
and physical activity and educated in eight sessions for adolescents and one session for parents in
the intervention groups with sixty participants.
RESULTS: Changes in primary and secondary outcomes in PCOS and healthy adolescents
before and after intervention in the intervention and control groups will be analyzed for evaluation
effectiveness by one‑way ANOVA or other nonparametric equivalents.
CONCLUSION: The current study will provide information on the effectiveness of school‑based
lifestyle training programs for adolescents. With increasing numbers of PCOS at risk for long‑term
and/or late effects of treatment and other chronic diseases, efforts for promoting the healthy lifestyle
of this important group are urgently needed. This lifestyle program may provide valuable information
relating to the development of other healthy lifestyle interventions for PCOS and result in appropriate
behavior change and self‑management strategies.

Abstract BACKGROUND: Primary osteoporosis is a common complication of aging and menopause. The
negative effects of osteoporosis in the coming years will increase by increasing life expectancy and
population aging. The purpose of this research was to compare health‑promoting lifestyle and quality
of life in postmenopausal women with and without primary osteoporosis.
MATERIALS AND METHODS: This cross‑sectional analytical research was conducted on 445
postmenopausal women aged 50–65 selected by simple random sampling in Tabriz health centers
from September 2018 to July 2019. Data collection instruments included demographic, midwifery,
anthropometric, health‑promoting lifestyle profile II and menopausal quality‑of‑life questionnaire
questionnaires, and serum test checklist (25‑hydroxy vitamin D, complete blood count/diff,
thyroid‑stimulating hormone, fasting blood sugar, Calcium, and Phosphor). Dual‑energy X‑ray
absorptiometry method was used to measure bone density. Data were analyzed using SPSS/23
through descriptive and inferential statistics such as Chi‑square, independent t‑test, Mann–Whitney,
and multiple regression.
RESULTS: The mean score of lifestyle was 141.2 ± 21.9 in normal and 127.2 ± 25.4 in osteoporosis
group, and differences were statistically significant in total score (P < 0.001) and all subdomains.
The mean score of quality of life was 3.9 ± 1.2 in the normal and 4.5 ± 1.4 in the osteoporotic group.
The differences were significant in total score (P < 0.001) and all subdomains except for sexual
function subdomain (P = 0.064). Logistic regression adjusted for confounders indicated by one unit
increase in total lifestyle score, the odds of primary osteoporosis reduced by 2.2% (adjusted odds
ratio [0.95% confidence interval]: 0.978 [0.963–0.994], P = 0.006).
CONCLUSION: To prevent of primary osteoporosis and improve the quality of life of postmenopausal
women, it seems that education and implementation of health‑promoting lifestyle are essential. The
research findings can be used to plan for health care in middle and old ages.

Abstract INTRODUCTION: A person with colostomy or ileostomy undergoes a comprehensive treatment
with a wide range of adjustments which affect the individual’s social and psychological functioning.
Quality of life (QOL) is a subjective feeling which includes physical, social, psychological, and spiritual
domains of an individual that can be affected by a stoma.
AIM: This study is aimed at identifying the QOL and impact of stoma on their lifestyle pattern among
ostomates attending stoma outpatient department of gastroenterology department of a government
tertiary care center in South India during 2018.
METHODS: A descriptive study using a cross‑sectional survey design was conducted among 55
ostomates, following consecutive sampling technique. The data were collected using a City of Hope
QOL Questionnaire for Ostomy patients which had QOL Assessment Questions from four subdomains
including physical, psychological, social, and spiritual aspects. This tool also had open‑ended
questions on lifestyle assessment components.
RESULTS: 63.6% of the participants had colostomy; 72.7% of the stomas were due to cancer. The
mean QOL score of the participants was 4.13 ± 1.07. The ostomates scored relatively well in both
physical (5.68 ± 1.76) and spiritual (4.32 ± 1.36) domains, but the sociological (2.85 ± 1.3) domain score
was very low. Permanent ostomates scored significantly higher than the temporary ostomates (P = 0.04).
CONCLUSION: The QOL score of ostomates was less than the scores reported in the Western
population and living with stoma significantly alters their lifestyle. Therefore, follow‑up services and
counseling services to the ostomates by the health‑care professionals are needed.

Abstract BACKGROUND AND AIM: Full health is one of the basic human rights and requires a healthy lifestyle.
Public continuous education, especially among the students who are a great target group and the
future of the country, is the best way to modify lifestyle. Therefore, the present study was conducted
with the aim of analyzing the factors affecting the prevention of non communicable diseases from
studentsʼ viewpoints in Isfahan in the academicyear of 2016–2017.
METHODS: This study was carried out through the qualitative approach and conventional content
analysis method. Participants included 27 students who were selected by convenient and purposeful
sampling method with maximum variation. Method of data collection was semi structured interviews
with sound recordings with note–taking, and data analysis method was inductive content analysis.
RESULTS: After removing repetitive codes and merging the similar ones, 1237 codes were obtained
from interviews that were placed in 7 main categories and 18 subcategories. The main categories
included “grand health policy‑makings,ˮ “the role of the educational system in promoting health,ˮ
“schools and healthy nutrition models,ˮ “schools and sports and physical activity development,ˮ
“informal learning,ˮ “preventive strategies in health promotion,ˮand “lifestyle modification.ˮ
CONCLUSION: It seems that controlling and improving the factors affecting lifestyle and making
school education more effective are the main factors that influence the efficacy of preventive
educational programs of non communicable diseases.

Abstract BACKGROUND: Over the last decades, childhood obesity has become a worldwide epidemic health
problem. Identifying the barriers to a healthy lifestyle among children and adolescents is necessary for
further effective intervention to prevent overweight and obesity. This study aims to assess the barriers
to healthy lifestyle habits, including physical activity (PA), eating, and sleep among adolescents from
the perspective of their parents.
METHODS: In this cross‑sectional study, the parents of obese and overweight middle school students
were enrolled. Data were collected using a questionnaire about barriers of healthy nutrition and PA.
RESULTS: Overall, 172 parents completed the questionnaire. Lack of access to affordable facilities
for PA, lack of access to the appropriate place for PA, and lack of sufficient information on how to
do or increase PA were the main barriers to PA. The barrier factors for healthy eating were media
advertisement of unhealthy foods, lack of motivation to use healthy nutrition, and lack of adequate
information about healthy eating. Regarding poor sleep, lack of knowledge about the benefits of sleep,
prolonged watching television, and late sleep time of family members were reported as the main
barriers. These findings were not statistically different according to the family socioeconomic level.
CONCLUSION: Our findings propose that for improving healthy lifestyle in obese children and
adolescents, access to facilities, and appropriate places for PA should be provided at the community
level. Moreover, training parents and students about healthy lifestyle behaviors is necessary for
families of all socioeconomic levels.

Abstract BACKGROUND: Many of the problems caused by aging can be delayed and the health of the elderly
maintained by improving and applying a healthy lifestyle during old age. Therefore, the researcher
has designed and implemented a study aimed “compare the impact of group motivational interviews
with multimedia education on improving lifestyle in the elderly.”
METHODS: This study is triple blind before and after clinical trial was performed on three groups of
thirty (n = 90) of the elderly with mean age 63.41 ± 6.88 who were members of the elderly centers
of Tehran city neighborhoods with average to unfavorable lifestyle score. The first test group was
subjected to group motivational interviewing during five sessions. The second test group was subjected
to distant multimedia training. No training was given to the third group as the control group. After
3 months, the lifestyle questionnaire was completed in three groups. The results were analyzed
by these techniques as statistical tests such as mean, standard deviation, relative frequency, and
absolute frequency were used. The inferential statistical tests such as paired t‑test and one‑way
ANOVA were used, respectively, to compare the pre‑ and post‑mean scores and in each group and
compare the mean scores of lifestyle dimensions in three groups.
RESULTS: Both motivational interviewing and multimedia education have been effective in changing
the lifestyle of the elderly, but according to the findings, motivational interviewing has a greater impact
on elderly lifestyle. The total lifestyle score in four areas such as nutrition, self‑care, mental health,
and physical activity was significantly different in the three groups after the intervention (P < 0.001).
CONCLUSIONS: Each educational program can somehow improve behavioral skills in individuals.
Effective teaching methods should address the learning difficulties and inability to learn during the
aging period. The results of this study can be a step toward the elaboration of strategies for education
and promotion of healthy lifestyle in the elderly.

Abstract INTRODUCTION: Health needs a lifestyle upgrade. Lifestyle is important because it affects the quality
of life and the diseases’ prevention. This study aimed to investigate the lifestyle and its relationship
with health‑care value of mid‑aged women.
METHODS: This descriptive‑analytic study was conducted on 287 middle‑aged women in Isfahan
in 2016. Samples were randomly selected among the centers as well as from those referring
to comprehensive urban health centers. Walker’s Health‑Promoting Lifestyle Profile II and a
researcher‑made health‑care value questionnaire were provided to mid‑aged women. Data were
analyzed using descriptive statistics, Pearson’s correlation coefficient tests, and multiple linear
regression (MLR) analysis.
RESULTS: The average health value score in women was 59.6 and the total lifestyle score was
57.9 out of 100, which is in the semi‑desirable range. The highest score among the lifestyle domains
was related to the interpersonal relationship (67.6) and the lowest score was related to physical
activity (39.4). Pearson’s correlation coefficient showed that there is a direct relation between the
health value score and the total score of lifestyle and all its domains (P < 0.001). MLR model showed
that the areas of responsibility (P < 0.001), interpersonal relationships (P < 0.001), and physical
activity (P = 0.01) have the highest predictive value for the health value score among the different
domains of lifestyle score.
CONCLUSION: Lifestyle and health value of mid‑aged women in Isfahan are in the semi‑desirable
range and lifestyle has a direct relationship with health value. Therefore, lifestyle enhancement can
enhance the health value and take steps to improve health in the community.

Abstract INTRODUCTION: In recent decades, the focuses of health studies were mostly in middle‑aged
women, and few studies have investigated the lifestyle of women after delivery. The aim of this
study was to determine the effects of both self‑efficacy and perceived barriers on Iranian women
health‑promoting lifestyle (HPL) in the first 1 year after childbirth.
MATERIALS AND METHODS: Using a cross‑sectional design, 310 women at first‑year postpartum
were surveyed in Zanjan (Iran) in 2016. The proportionate stratified random sampling method was
carried out to select a participant. HPL has assessed with HPL profile II questionnaire. Self‑efficacy
was assessed using self‑rated abilities for health practices scale. Perceived barriers were assessed
by Barriers to Health‑promoting Activities for Disabled Person scale. A meditational model was used
to examine whether perceived barriers mediates between perceived self‑efficacy and HPL.
RESULTS: The participants mean age was 29.82 (5.1) years, 53.9% were primiparous, and most
of them were homemakers (82.9%). The mean total score of HPL was 2.50 (0.29). The relationship
between HPL and self‑efficacy was mediated by perceived barriers partially.
DISCUSSION: Self‑efficacy, not only promotes women’s HPL but also indirectly affect the women’s
lifestyle by reducing perceived barriers.

Abstract AIM: This study aims to assess the association of sugary foods and drinks consumption with behavioral
risk and oral health status of 12‑ and 15‑year‑old government school children in Udaipur.
MATERIALS AND METHODS: A descriptive cross‑sectional study was conducted among of
12‑ and 15‑year‑old government schoolchildren of Udaipur. A survey pro forma designed based on
HBSC (Health behaviour in School‑aged Children) study protocol and WHO Oral Health Assessment
Form for Children (2013) was used. Chi‑Square test, Independent Sample t‑test, and Multinomial
Logistic Regression analysis were used with 95% confidence interval and 5% significance level.
RESULTS: Out of 710 participants, 455 (64.1%) were males and 255 females (35.9%). Majority of
15 years age (57.3%) consumed more soft drinks than 12‑year‑old. Males showed a comparatively
greater tendency to have sugar sweetened products than females. The decayed, missing, and filled
teeth (dmft) and DMFT scores were relatively higher for subjects who consumed sugary substances
more than once/day than who had less than once/day. Gingivitis was associated with high sugar diet.
CONCLUSION: Sugary foods and drinks consumption is significantly associated with behavioral
habits of children and is a clear behavioral risk for oral health.

Abstract INTRODUCTION: Cardiovascular diseases are the leading cause of death all over the world. Lifestyle
can have an important role not only in reducing risk factors but also in the prevention and treatment
of coronary heart diseases. The aim of this study was to examine the relationship between clinical
parameters and various aspects of patients’ lifestyles according to the severity of their coronary
artery stenosis.
MATERIALS AND METHODS: This study was a descriptive, analytic study carried out on 220 patients
undergoing coronary angiography at Mazandaran Heart Center. Based on the angiography results,
patients were divided into two groups: artery stenosis > 50% (110 cases) and < 50% (110). Patients’
lifestyles were evaluated using health‑promoting behavior questionnaire. Blood pressure and
triglyceride, low‑density lipoprotein, high‑density lipoprotein, cholesterol, and fasting blood sugar
were also measured. After collecting data, SPSS 21 software, Chi‑square test, t‑test, and multiple
linear regression were used for analysis of the data.
RESULTS: The results showed that in patients with positive angiographic data, there is a significant
correlation between clinical parameters and dimensions of health‑promoting behavior (P < 0.05).
CONCLUSION: Given the impact of clinical parameters on various aspects of lifestyle, it seems
that by teaching the different aspects of lifestyle (such as having a healthy diet consisting of fresh
fruits and vegetables, reducing intake of saturated fat, physical activity and regular exercise, stress
management, and blood pressure control) to patients with a positive angiographic result, we can
improve their lifestyles by means of improving clinical parameters.

Abstract Background: Lifestyle affects people’s health and life length, however, no sufficient studies
have been done on the effect of lifestyle on middle‑ageing, as the transitional period from
adulthood to old‑ageing, this study has been conducted to study the effect of educational
intervention on health promoting lifestyle of middle‑aged women in Lenjan city of Isfahan
Province, Iran. Methods: This quasi‑experimental study was conducted on 88 middle‑aged
women were selected through randomized sampling from two health centers in Lenjan, and
then were categorized into experimental and control groups. To collect data, a researcher‑made
demographic and life style questionnaire was used. The educational intervention was performed
in five sessions. Data were collected from both groups in two stages: Before the intervention
and 3 months after the education. Data were analyzed with using SPSS‑20 and P < 0.05 were
considered statistically significant. Results: The results showed that educational program had a
positive significant effect on increasing the mean scores in the intervention group, considering
the physical activity, mental health, and interpersonal relationship, P < 0.001. However, regarding
the nutrition, the mean increase was not significant (P = 0.113). Conclusion: According to the
findings, it is evident that educational intervention is beneficial for various aspects of middle‑aged
women’s lifestyle. Therefore, applying a healthy lifestyle seems essential for having a healthy
aging period, and educational intervention can be effective.

Abstract Type-2 diabetes is a major, non-communicable disease with increasing prevalence at a global
level. Type-2 diabetes results when the body does not make enough insulin or the body cannot
use the insulin it produces. Type-2 diabetes is the leading cause of premature deaths. Improperly
managed, it can lead to a number of health issues, including heart diseases, stroke, kidney
disease, blindness, nerve damage, leg and foot amputations, and death. Type-2 diabetes or
adult-onset diabetes is most common type of diabetes, usually begins when a person is in
his or her mid-50s, but diabetes is not inevitable. Minor changes in your lifestyle can greatly
reduce your chances of getting this disease. Therefore, in order to prevent this condition, action
should be taken regarding the modifiable factors that influence its development-lifestyle and
dietary habits. However, with proper testing, treatment and lifestyle changes, healthy eating as
a strategy, promote walking, exercise, and other physical activities have beneficial effects on
human health and prevention or treatment of diabetes, promoting adherence to this pattern is
of considerable public health importance.