Journal of Education and Health Promotion

Abstract Emotions are universal in academic and clinical settings. A student is likely to hope for success,
maybe be worried about failure, or may feel comfortable after an exam. These feelings undoubtedly
affect his/her motivation, effort, academic performance, and progress. This study aimed to investigate
the role of emotion in the learning and performance of medical students and its mechanism. This
study was a scoping review conducted in 2022 to examine the role of emotions in medical education.
The three databases PubMed, ERIC, and Science Direct and the search engine Google Scholar
were searched using the following keywords: “emotion,” “medical student,” “teaching,” “learning,”
and “medical education.” English articles published from 2010 to 2022 were reviewed, and finally,
34 articles that met the inclusion criteria were reviewed. Review of the selected articles showed that
there was a significant relationship between the cognitive system and emotions in the brain. The
conceptual framework of the relationship between cognition and emotion can be explained in the
form of dimensional and discrete views of emotions and based on cognitive load theory. Emotions
affect cognition with the four mechanisms of memory, cognitive resources, cognitive strategies,
and motivation and can be effective in learning self‑regulation, clinical reasoning, and academic
achievement of medical students. Emotions in medical education is a double‑edged sword. In other
words, it is highly recommended to divide emotions into activating and inactivating, instead of dividing
them into positive and negative ones. In this context, medical educators can use the positive aspects
of nearly all emotions to improve the quality of their teaching.

Abstract BACKGROUND: Academic stress is a common experience among university students. It can affect
the body composition of the students through behavioral changes, which further affect their physical
activity level (PAL). Musculoskeletal disorders could arise from the interaction of these factors. This
study aimed to determine the relationship between PAL, academic stress, selected anthropometric
indices, and the development of MSDs among a selected Nigerian population.
MATERIALS AND METHODS: This was a cross‑sectional study of 256 (129 females and 127 males)
undergraduates of the University of Nigeria, Enugu Campus aged 15–30 years using Student’s
Stress Inventory to evaluate academic stress, the short‑form of the International Physical Activity
Questionnaire to determine the PAL, and a Standard Nordic Musculoskeletal Questionnaire to
assess MSDs.
RESULTS: The results showed a high PAL with the male students having more PAL (61.4%) than
female students. Secondly, the prevalence of MSDs among the population was high (66.02%)
and the students faced moderate academic stress with the prevalence being more among the
female students (75.2%). A significant difference was observed between academic stress and the
development of MSDs (P = 0.009).
CONCLUSION: This study’s findings support the hypothesis that increased academic stress and low
level of physical activity are linked to increased risks of MSDs among students. Thus, it is warranted
that the University curriculum is re‑adjusted and incorporate public enlightenment programs on
possible causes and prevention of musculoskeletal disorders, stress management, and coping
strategies.

Abstract BACKGROUND: The COVID‑19 pandemic has become a major problem for education systems. This
study was conducted to investigate the effect of educational intervention based on the self‑efficacy
theory of high‑school students in adopting preventive behaviors of COVID‑19.
MATERIAL AND METHODS: This quasi‑experimental study was performed on Hazrat Zahra and
Shahed high‑school students in Jahrom (southern Iran) in 2021. In total, 160 students (80 each in
the intervention group and the control group) were selected by multistage random sampling. Data
collection tools included a demographic information questionnaire and self‑efficacy in adopting
preventive behaviors from COVID‑19 researcher‑made questionnaire. Questionnaires were completed
by all participants before and 3 months after the educational intervention. The educational intervention
was performed for 6 weeks by using an educational program based on Bandura self‑efficacy theory.
The intervention was performed during 12 sessions of face‑to‑face training in the classroom (two 1‑h
sessions per week), distributing educational packages and sending educational videos through
cyberspace. Data were analyzed using Chi‑square test, independent t test, paired t test, and linear
regression.
RESULTS: After the educational intervention, a significant difference was observed in the intervention
group before and after the educational intervention (P = 0.018) and between the intervention and the
control groups (P = 0.001) in the self‑efficacy in adopting preventive behaviors from COVID‑19 score.
Also, the average self‑efficacy score of students increased with an increase in parental education
level and a history of COVID‑19 in family members.
CONCLUSION: Educational intervention based on self‑efficacy theory was shown as an effective
method to improve students’ self‑efficacy in adopting preventive behaviors from COVID‑19.

Abstract BACKGROUND: Medical education is competitive across the globe. The long duration of the medical
and paramedical courses and exposure to clinical settings potentially causes mental health issues.
The aim of this study was to estimate the prevalence of depression, anxiety and stress among
undergraduate students in a private medical college in South India.
MATERIALS AND METHODS: This cross‑sectional study was conducted among paramedical and
medical students at a private medical college hospital and research center in South India in the
year 2021. The required sample size was calculated as 783 with an expected prevalence of 53%,
95% confidence interval (CI), design effect 2.0, and non‑response of 10%. The study participants
were selected based on simple random sampling. After obtaining informed consent, the data was
collected using an email questionnaire. Standard data collection tools such as the Perceived Stress
Scale (PSS); and the Depression, Anxiety and Stress Scale ‑ 21 (DASS‑21) questionnaire were
used. The investigator computed the odds ratio (OR) and adjusted odds ratio (aOR) with a 95% CI.
RESULTS: Out of 1200 students, 1015 (85%) responded to the email questionnaire. Among them, 639
were females (63%), and 925 were paramedics (91%). Prevalence of depression, anxiety and stress
were 59%, 43% and 11%, respectively. Almost 95% of students experienced moderate‑to‑severe
stress in the last one month. Prevalence was higher among females and students of medical
courses. Students of final year of college (aOR = 2.0; 95% CI = 1.2–3.5) and students of medical
course (aOR = 1.5; 95% CI = 1.1–2.4) were independently associated with stress among the study
participants.
CONCLUSION: There is high prevalence of depression, anxiety and stress among medical college
students in south India. The final year of study and medical course were independently associated
with higher stress than others. We recommend periodic assessment of mental health status and
additional mental health care for final year students and medical students.

Abstract BACKGROUND: One of the main tasks of educational institutions, in addition to developing students’
professional competencies, is to develop decision‑making and problem‑solving skills, which are
themselves influenced by critical thinking that should be developed by instructors at the university.
The aim of this study was to compare the level of critical thinking skills in students and faculties of
Ahwaz Jundishapur University of Medical Sciences.
MATERIALS AND METHODS: In this cross‑sectional descriptive study, the sample consisted of
81 medical students and 52 faculty members of the medical school who were teaching and studying
in 2021. The research method was descriptiveanalytical and the data collection tool was the California
Critical Thinking Questionnaire Form B. SPSS‑18 software and t‑test were used to analyze the data.
RESULTS: The mean score of students’ critical thinking skills was 12.49 ± 4.43 and that of faculties
was 12.44 ± 3.76 and no significant difference was observed between the scores of the two
groups (P = 0.94).
CONCLUSION: The findings of the study show that the level of critical thinking skills in both faculties
and students is below the standard and poor. The results of the study indicate the weakness of critical
thinking in students and faculties in all dimensions, which indicates the need to teach critical thinking
skills at the university level. Therefore, educational planners and faculty officials should pay more
attention to developing critical thinking skills in their educational programs.

Abstract BACKGROUND: Coronavirus disease (COVID‑19) causes significant psychological distress among
nursing students. College‑bound nursing students might have preferred different types of coping
strategies to deal with psychological distress. This study aims to measure the psychological distress
and role of coping styles to mediate the stress level among the baccalaureate nursing students amid
the COVID‑19 pandemic.
MATERIAL AND METHODS: A cross‑sectional online survey was conducted in December 2020 at
a nursing college attached to a tertiary care teaching hospital, North India. Nearly 251 baccalaureate
nursing students completed the Impact of Event Scale‑Revised (IES‑R) and Coping Orientation to
Problems Experienced Inventory (Brief‑COPE) scale to report their psychological distress and coping
styles, respectively. Chi‑square test, independent sample t‑test followed by binary and multivariable
regression were used to identify the factors associated with distress in students during the pandemic.
RESULTS: Students’ mean age was 22.22 ± 1.24 years. The mean IES‑R was 19.59 ± 12.45 in
nursing students. Psychological distress found a significant association with age (P = 0.022), academic
class (P = 0.016), travel history (P = 0.034), and being positive reverse transcription–polymerase
chain reaction (RT‑PCR) for COVID‑19 status of self (P = 0.018) and family members in the medical
profession (P = 0.013). In binary logistic regression, stress level found a significant association with
first‑year academic level (OR: 3.250, 95% CI: 1.429–7.390, P = 0.005) and family members in the
medical profession (OR: 4.44, 95% CI: 1.019–19.382, P = 0.047). Adaptive coping styles were more
frequently preferred than maladaptive coping styles (54% vs 41%). Adaptive (r = 0.295, P < 0.001)
and maladaptive coping (r = 0.403, P < 0.001) shows a significant positive relationship with stress
in students, respectively.
CONCLUSIONS: Coronavirus pandemic causes significant distress among nursing students. Students
were able to manage stress using acceptance and religious/spiritual coping strategies. During the
pandemic, stress management to support mental health is highly recommended.

Abstract BACKGROUND: The impact of Coronavirus Disease‑19 on peoples’ life has become evident.
Recently, sport activities are important in improving individual health and their well‑being. The aim of
this study is to investigate the effect of using mobile phone fitness applications on some characteristics
of physical fitness and psychological well‑being of female university students.
MATERIALS AND METHODS: A descriptive study design was implemented using a survey which
was adapted to collect data from a sample of 50 female participants within the age of 18 to 19 years.
As for the results, the participants indicated that they used physical fitness application by smart
phone regularly during COVID‑19.
RESULTS: The results also illustrate that there was a significant difference on the study variables
based on the study groups and test time. The study results extend literature concerning sport activities
participation and promoting positive well‑being during COVID‑19 pandemic.
CONCLUSION: The study indicated a significant difference of the application on physical fitness
and psychological well‑being among the participants. Based on the results, the study recommended
to organize several sport activities among students and encourage them to use smart phones for
positive purposes. Finally, practical implications are outlined.

Abstract BACKGROUND AND AIM: Vaccination has been appraised to be one of the most significant public 
health achievements in human history. However, in countries like Nigeria, vaccine hesitancy is a 
public health challenge that has consistently forestalled concerted efforts made by health authorities 
to curb the spread of communicable diseases such as COVID‑19. To improve COVID‑19 vaccine 
acceptance via targeted interventions, it is imperative to examine the public’s perception. Thus, 
this study aims to evaluate vaccine hesitancy among university students in Southwestern Nigeria.
MATERIALS AND METHODS: The study utilized a descriptive cross‑sectional design. 
A self‑administered questionnaire was administered to a total of 366 respondents who were recruited 
using the convenience sampling technique and snowball approach. Data were entered and analyzed 
using SPSS.
RESULTS: The majority of the respondents were over 18 years (88%) and were between their first 
and third years (81%). Over a tenth of the respondents reported having at least a loved one that 
had tested positive for the virus, while only 88% believed the virus is real. Furthermore, only 17% 
of the students had a positive attitude toward the vaccine. Although 90% of the respondents were 
aware of the administration of COVID‑19 vaccine in Nigeria, only around a quarter were willing to take 
the vaccine, while 5.5% had been vaccinated. The major reasons for COVID‑19 vaccine hesitancy 
highlighted by the respondents were concerns about vaccine side effects (21.3%), lack of trust in the 
authorities (26.5%), vaccine efficacy (13.1%), and diverse mystical possibilities (39.1%).
CONCLUSION: The results indicate that a significant communication gap exists between the 
respondents and local health authorities. To enhance the acceptance of COVID‑19 vaccines, extensive 
and targeted health promotion campaigns are required to allay specific concerns raised by the public.

Abstract BACKGROUND: Students’ perception of their academic environment has a substantial influence
on their actions, academic accomplishments, satisfaction, goal attainment, and behavior. The study
was carried out to evaluate the perception of academic environment in physiotherapy students, and
to identify the specific domains which could act as predictors of academic performance.
MATERIALS AND METHODS: This descriptive, cross-sectional research was conducted
over 12 months using total population sampling. Three hundred and forty-three (139 postgraduate
and 204 final year) final year and postgraduate physiotherapy students from five colleges of
Mumbai and Navi Mumbai, who conformed to the inclusion benchmarks, participated in the study.
Perception of educational environment was evaluated using Dundee Ready Education Environment
Measure (DREEM). Academic performance was evaluated using the percentage obtained in the
last university examination. Data were entered in MS Excel (©Microsoft, USA) and converted to
Stata Version 15.1© StataCorp, College Station, for further analysis. The mean values and standard
deviations for perception of educational environment were calculated and linear regression models
were used to conduct multivariate analysis for each item in the questionnaire.
RESULTS: The mean total DREEM score of physiotherapy students was 129.97 ± 22.72. Students
whose Students’ Academic Self‑perception scores were in the “Feeling more on the positive side”
category showed a 4.17 point increase in percentage scores as compared with those who reported
feeling like a total failure/had many negative aspects to their academic self‑perception (95% confidence
interval [CI]: 2.46, 5.89; P < 0.001). Students whose Students’ Perception of Learning (SPoL) scores
were in the “Teaching highly thought of” category showed a 2.75 point increase in percentage scores
as compared with those who viewed teaching poorly/negatively (95% CI: 0.44, 5.06; P = 0.02).
CONCLUSION: Physiotherapy students had a “more positive than negative” view of the academic
environment; however, a few “problematic areas” need to be remediated. Efforts to improve students’
academic self-perception may improve their academic performance since this was the strongest
predictor of their academic performance, followed by total DREEM scores and SPoL.

Abstract BACKGROUND: The exponential increase of cases and the emergence of the new COVID‑19
variants continue to be a challenge. It remains crucial to assess whether or not minimum health
standards against COVID‑19 are consistently followed. This study determined the higher education
students’ practice of protective measures against COVID‑19 of more than a year into the pandemic.
MATERIALS AND METHODS: A questionnaire web survey, cross‑sectional study was conducted
among higher education students (n = 2309) of a public university in the Philippines. Data were
analyzed using the SPSS software.
RESULTS: Results indicated that students generally had a high practice of COVID‑19 preventive
measures. However, only 45.9% always practice physical distancing measures, and only 35.9%
always seek information related to COVID‑19 after more than a year into the pandemic. Female,
married, graduate level, with a monthly family income of PHP 10,000 and above, and personal
knowledge of someone who tested for COVID‑19 had a significantly higher practice of COVID‑19
protective measures. Older age, higher general self‑reported health status, and higher intention
to comply with recommended protective health behaviors were significantly correlated with higher
practice of preventive measures against COVID‑19.
CONCLUSION: After more than a year of being into the pandemic, students still practice preventive
health behaviors, however, this is not done consistently. As the pandemic is still not over in the country
and many parts of the world, continuous monitoring and a reminder to practice minimum protective
health protocols are needed to mitigate and prevent the spread of COVID‑19.

Abstract BACKGROUND: Intellectual property rights (IPRs) are increasingly becoming significant for
sustainable growth of today’s knowledge‑based society. An inappropriate knowledge regarding IPR
can fail to reserve rights for one’s intellectual creation. Hence this study was planned with an aim to
assess knowledge, awareness, and practices regarding intellectual property rights in India amongst
the health-care professionals in Belagavi city.
MATERIALS AND METHODS: A descriptive cross‑sectional study was conducted among the
postgraduate students and faculty of six health‑care professional institutions in Belagavi, Karnataka.
A total of 724 responses were recorded using convenient sampling. Data was collected using
self‑administered validated questionnaire which included demographic details and total 20 questions
pertaining to knowledge, awareness, and practices regarding IPR. Two‑point Likert scale was used.
Descriptive statistics, Mann–Whitney U‑test, and Chi‑square test were applied.
RESULTS: A total of 724 responses were recorded, 411 from postgraduate students and 313 from
faculty of 6 health‑care professional institutions. It was observed that 24.3% and 39.3% of postgraduate
students and faculty participants, respectively, had maximum knowledge while 35.5% of faculty and
27.5% of postgraduate students had maximum awareness regarding IPR in India. Only 17.6% and
10.2% of faculty and postgraduate students had previously attended workshops on IPR.
CONCLUSION: The present study identified that both faculty and postgraduate students of health‑care
profession have less knowledge and awareness regarding IPR. However, both knowledge and
awareness regarding IPR were better among faculty when compared to postgraduate students.
Thus, the academic community requires a higher level of sensitization and exposure to IPR in India.

Abstract INTRODUCTION: With the unintended closure of classrooms following the outbreak of COVID‑19, the 
virtual education method is used as an alternative to face‑to‑face education. Virtual education is one 
of the important factors in promoting the learning of medical students and has many benefits such as 
increasing the ability of critical thinking, problem‑solving skills, and self‑directed learning. However, 
critically examining students’ perceptions of e‑learning can help improve quality and better planning.
MATERIALS AND METHODS: This research was a qualitative study. Twelve students were enrolled 
in the study based on purposive sampling. Data were collected using in‑depth semi‑structured 
interviews in 2020. All interviews were recorded and then transcribed and analyzed using a continuous 
comparison and conventional content analysis approach.
RESULTS: Data analysis revealed four main themes and ten subthemes. The main themes included 
“student concern,” “teacher barriers,” “technology weakness,” and “asynchronous virtual learning 
flexibility.”
CONCLUSION: Asynchronous e‑learning in the COVID‑19 outbreak had its advantages and 
disadvantages. By analyzing students’ perceptions in this field, some better designs and planning 
can be done to increase the quality of education.

Abstract BACKGROUND: Human papillomavirus (HPV) infection is the major risk factor for cervical 
cancer (CC) in women of reproductive age. Despite advances in treatment and prevention of CC by 
HPV vaccination, very few women utilize them because of a lack of awareness about HPV.
MATERIALS AND METHODS: We conducted this cross‑sectional study among Health Professions 
Students (HPS) at King Saud Bin Abdul Aziz University for Health Sciences, Jeddah. Data were 
collected using a predesigned and validated study questionnaire to assess the knowledge, attitude, 
and perception of HPS toward HPV.
RESULTS: A total of 580 HPS responded to the survey; 128 (22.1%) were male, while 452 (77.9%) 
were female with the mean age ± standard deviation 20.36 ± 1.74 years. There was no significant 
difference between males and females related to screening of HPV and CC (82.8%; 82.3%). 
A minority (30.3%) of participants thought that HPV infection leads to CC, while 38.3% did not know 
about it. Furthermore, knowledge about HPV screening and vaccination was poor.
CONCLUSIONS: Students from the college of medicine had more knowledge and awareness 
about HPV (34.9%, P < 0.001). Thus, it is important to implement effective education programs, 
curricular activities, and awareness campaigns for health professions to augment the learning 
process effectively.

Abstract BACKGROUND: Urinary tract infections (UTIs) are more common in females than males and 
predominantly based on their unhealthy practices in their day to day lives. This study is trying to 
assess the occurrence of UTI and strategies used by female student to prevent UTI.
MATERIALS AND METHODS: A cross‑sectional descriptive study carried out in a tertiary care 
teaching institute. A total of 338 conveniently selected B. Sc. Nursing and MBBS Medical students 
were surveyed. The data were collected by using a pretested, a self‑structured questionnaire 
related to occurrence and practices to prevent UTI along with necessary demographic details. 
Descriptive (frequency, percentage, mean and standard deviation) and inferential (Chi‑square test) 
statistics was used to compute the data.
RESULTS: The result of this study shows that 10.05% female students reported of having UTI. The 
proportion was higher in nursing students (67.6%) than medical (32.4%) but did not show a significance 
difference (P = 0.61). Age, duration of hostel life, and marital status were significantly associated 
with the status of UTI (P = 0.001). To prevent UTI, students were using commercial product with 
Tea Tree Oil, soap, drinking 3–4 l water/day, increased frequency of peri‑wash during menstruation 
period, and use of Citrus Fruits. The use of western toilet was also significantly associated with 
status of UTI (P = 0.04).
CONCLUSION: The occurrence of UTI was more among nursing students. Most of the perineal 
hygienic practices by the female students were associated with occurrence of UTI; hence, it is 
necessary to emphasize on preventive practices to minimize re‑occurrence.

Abstract BACKGROUND: One of the most important clinical teaching keys is the use of new evaluation that 
plays an essential role in strengthening the quality level of clinical skills students. Hence, the aim 
of this study was to determine the effect of smartphone clinical skills recording in the labor ward on 
satisfaction of midwifery students.
MATERIALS AND METHODS: This is a quasi‑experimental study that was conducted on 60 midwifery 
students in the 8th semester was selected through the convenience sampling method. Clinical 
skills of labor ward recorded by two methods groups (smartphone and traditional). The satisfaction 
questionnaire was completed before and after by the two groups. Data were analyzed using the 
descriptive and inferential statistics through the SPSS version 22 software.
RESULTS: Independent t‑test showed that the satisfaction scores before intervention in both 
smartphone and traditional groups were not statistically significant (P = 0.126), whereas there was 
a significant difference between two groups after intervention (P = 0.002).
CONCLUSION: The use of smartphone techniques in the labor ward can be effect in clinical skills 
recording among midwifery students.

Abstract BACKGROUND: The current pandemic associated with SARS‑CoV‑2 has negatively influenced 
several activities, including teaching in Operative Dentistry. The aim of this study was to evaluate 
the influence of knowledge in Operative Dentistry on undergraduate students’ perception related to 
personal life and return to clinical practices classes during pandemic.
MATERIALS AND METHODS: The present research was a cross‑sectional, observational, and 
qualitative survey. The 16‑item based questionnaire was sent to undergraduate students in 2020, 
which were divided into two groups, according to the Operative Dentistry knowledge: G1‑not started 
clinical practice; G2‑already started or completed clinical practice. Questions were focused on the 
impact of the pandemic in relation to their personal lives and return to clinical practice classes. 
Chi‑square association test was performed using the SigmaPlot 12.0 software (P ≤ 0.05).
RESULTS: The response rate was 55.5% for G1 and 44.4% for G2. Regarding the questions related 
to personal life, G1 demonstrated higher percentages of fear of contracting the virus during theoretical 
classes. Same observations were found when students answered about their fear of contracting 
coronavirus during the clinical practice classes. However, G2 presented the highest agreement 
responses for the preparedness feeling to return to theoretical classroom, clinical practice classes, 
and the possibility of applying online learning.
CONCLUSIONS: In general, students’ knowledge had little influence on perception of personal life. 
However, students who have more knowledge in operative dentistry presented more security about 
returning to clinical classes.

Abstract BACKGROUND: Ineffective health communication could cause the increase of COVID‑19 cases 
in Indonesia. Medical students can involve in efforts in health communication on social media to 
positively impact prevention behaviors during a pandemic. This study aims to identify and analyze 
medical students’ and internship doctors’ perceptions toward health communication related to 
COVID‑19 through social media.
MATERIALS AND METHODS: A mixed method with exploratory sequential used. A qualitative study 
was done using phenomenology approach through deep and semi‑structured interviewing. After data 
analysis, the draft of the instrument prepared. Items in the draft selected based on the respondents’ 
answer. Then, a quantitative cross‑sectional study was used. The data obtained from 399 medical 
students and doctors at a University in Indonesia using Google Form on October 14 to October 20, 2020 
through media social. Data were analyzed using Pearson Correlation and Chi‑square (alternative: Fisher’s 
exact test) and logistic regression analysis with P < 0.05 and 95% confidence interval, respectively.
RESULTS: Based on interview, respondents communicate health on social media because the 
condition of COVID‑19 in Indonesia is dangerous, feel vulnerable to COVID‑19, understand the 
benefits, obligations, or responsibilities as a candidate and/or medical personnel and believe they
can create content/find valid sources. Meanwhile, the perception of limited knowledge is their biggest
obstacle in conducting health communication. There were a relationship between gender (P = 0.028, 
PR = 0.657), perceived severity (P = 0.044, PR (Prevalence Ratio) =4.844 [0.725–32,354]), perceived 
susceptibility (P = 0.005, PR = 1.803 [1.182–2.750]), perceived barrier (P < 0.001, PR = 2.543 [1.908–
3.388]), and self‑efficacy (P = 0.012, PR = 1.810 [1.120–2.926]) with health communication behavior. 
The perceived barrier (P < 0.001, RR = 4.278 [2.709–6.754]) and perceived susceptibility (P = 0.004, 
PR = 2.304 [1.302–4.077]) were the most influenced behavior.
CONCLUSIONS: This study showed that perceived severity, perceived susceptibility, perceived 
barrier, and self‑efficacy are predictor factors of health communication behavior related to COVID‑19
on social media with perceptions of susceptibility and perceived barriers as the most influential
variables. It is necessary to provide communication learning on social media as effectively and 
applied directly to reduce perceived barriers and increase self‑efficacy.

Abstract BACKGROUND: Noncommunicable diseases (NCDs) may be influenced by lifestyle behavior,
acquired during transition in student life at university. Health is a major concern globally. The
developing counties are facing a double burden of disease, both communicable and NCD. This
study is aimed to assess the lifestyle and its associated factors that can affect the health status of
medical and nursing students.
MATERIALS AND METHODS: A community‑based cross‑sectional study was conducted among
medical and nursing students of Sasaram, Bihar, by universal sampling. The study population
consisted of 303 medical and 233 nursing students. The 536 students in the study, included 195
from rural areas and 341 from urban areas. Simple Lifestyle Indicator Questionnaire was used and
Chi‑square statistics was computed to determine the association of demographic variables with
lifestyle behavior using Epi InfoTM 7 analysis software.
RESULTS: Mean age and body mass index were 21 ± 2.59 years and 22.12 ± 3.77, respectively.
After statistical analysis utilizing the Chi‑square test, it was shown that the difference was found to
be nonsignificant (P > 0.05) in all the following variables, such as gender, age, marital status except
in designation, and alcohol and tobacco intake which showed the difference to be highly significant.
CONCLUSIONS: The maximum number of students in the study population showed intermediate
healthy lifestyle (57.1%), despite being the upcoming health‑care providers of future. Fruits were
rarely present in diet in 82%, no physical activity in 21.2%, and tobacco and alcohol were consumed
by 11.7% and 13%, respectively. Targeted intervention for healthy diet, physical activity, stress,
tobacco, and alcohol reduction can lead to healthy lifestyle. Independence and autonomy gained in
the transition phase in student life needs guided supervision to raise responsible adults. It may help
to assist or to plan accordingly in future to improve lifestyle of the students.

Abstract BACKGROUND: Happiness is one of the main components of mental health that plays an important
role in promoting people’s health. This study aimed to investigate the status of happiness in students
of Iran University of Medical Sciences and its relationship with students’ attitudes toward the field of
education and the future of career in 2017.
MATERIALS AND METHODS: This cross‑sectional study was performed on 500 students of Iran
University of Medical Sciences The data collection tool was a questionnaire consisting of three
parts: demographic information, Oxford Happiness Inventory; A questionnaire was used to measure
students’ attitudes about their career future, which was completed by students of Iran University
of Medical Sciences. In order to analyze the data, SPSS software version 24 and descriptive and
analytical statistics were used.
RESULTS: Findings showed that 72% of students had a good level of happiness. There is also a
significant relationship between happiness and attitude toward the field of study. According to the
results, there is a significant relationship between the career future and the amount of happiness.
There was a significant relationship between gender and happiness
CONCLUSION: The study findings show that, by planning correctly in determining the fields of
education and ensuring the future of the job, happiness can be improved among students. Therefore,
it is recommended that the authorities take the students with the correct needs assessment in the
field of business education in the field of study.

Abstract BACKGROUND: Obesity and overweight in children and adolescents have become a global problem
in recent years. Adolescence increases the likelihood of obesity in adulthood and associated illnesses.
Nowadays, health literacy is one of the greatest determinants of the health. This study was conducted
to evaluate the correlation between body mass index (BMI) and health literacy in high school students.
MATERIALS AND METHODS: In this descriptive‑analytical study, 430 high school students were
enrolled in a multi‑stage random method in Yazd city in the center of Iran. The data were collected
through The Health Literacy Measure for Adolescents and calculate BMI with measurement of
height and weight of adolescents. The data were then analyzed using SPSS 25 and descriptive and
inferential statistics (Chi‑square and multivariate regression).
RESULTS: The results showed that the mean score of BMI (21.76 ± 3.76) was in a normal range.
The score of health literacy was at the borderline level (58.44 ± 13.79). BMI was not significantly
correlated with health literacy (P = 0.09). BMI was significantly different in terms of age, high school
grade, school type, and health status. School type and health status predict 37% of the variance of
BMI (R2 = 37%) and the best predictor was health status (P < 0.05).
CONCLUSIONS: The results of the present study showed that BMI was not correlated with health
literacy and student health literacy was at the borderline level. It is necessary to carry out further
studies on the causes and facilitators and the barriers to increasing health literacy. Furthermore,
educational interventions are needed to prevent the increase of BMI in adolescents and identify
determining factors.

Abstract BACKGROUND: The nationwide coronavirus (COVID‑19) pandemic and ensuing lockdown has
enforced institutions crosswise India to provisionally close to inhibit the spread of the virus and
started online learning for students. To measure the level of satisfaction of nursing students with
online learning and to identify the barriers which restrict to online learning.
MATERIALS AND METHODS: The current study adopted quantitative research approach with an
online survey research design and carried out during May–June 2020. Participants were selected
through a web‑based survey (Google form), in which 219 students enrolled. Self‑structured
questionnaire with the Likert scale was used to measure the level of satisfaction of nursing students
with online learning and identify the barriers which restrict online learning. The descriptive and
inferential statistics were used for the analysis in which 219 participants were enrolled in the study
of data with IBM SPSS version 20.
RESULTS: Majority of student’s participants 148 (67.57%) were extremely satisfied with online
learning. The findings suggest that the highest barriers which restrict to online learning among
nursing students is low voice and language clarity (2.16 ± 0.593), physical health barriers such as
eye strain (2.43 ± 0.613), reliability and connectivity problem (2.26 ± 0.534). Among all demographic
data, age is significantly associated with the level of satisfaction of online learning.
CONCLUSIONS: The study data indicated that maximum students were extremely satisfied the with
online learning and among barriers which effect online learning is low voice and language clarity,
reliability and connectivity problem, physical health barriers such as eye strain.

Abstract BACKGROUND: Globally, depression is one of the leading causes of illness and disability among
adolescents, and suicide is the third leading cause of death among the young and adolescents.
Since we have limited data on the prevalence of psychological distress among the youth of India,
our aim was to estimate the prevalence of psychological distress, anxiety, and depression among
students of professional colleges.
MATERIALS AND METHODS: This study was conducted in Visakhapatnam, Andhra Pradesh (India).
A total of 502 apparently healthy students have participated in this study. Data were collected from
243 medical students, 119 engineering students, 103 dental students, and 36 nursing students.
A pretested, prevalidated, and structured Kessler’s Psychological Distress Scale (K10) was used for
the assessment of mental health among students. This is a self‑administered questionnaire‑based
cross‑sectional study. Microsoft Office Excel was used for data storage and tabulation. Mean,
standard deviation, Chi‑square test, Mann–Whitney U‑test, and Kruskal–Wallis test were used to
find the association difference between various parameters using SPSS 22 software.
RESULTS: Out of 502 students, 34.7% of students were found to have normal mental health, 135
students were having mild mental problems, and 116 and 77 had moderate and severe mental illness,
respectively. Out of 197 males, 66 were normal, 61, 46, and 24 had mild, moderate, and severe
mental problems, respectively. Out of 305 females, only 108 were found to be normal.
CONCLUSION: Male students were found to have higher prevalence of mental abnormalities.
A significant higher prevalence of depression is seen in day‑scholars compared to hostellers. Nursing
students are having significantly higher prevalence of depression and nonpsychotic mental illness
as compared to dental, engineering, and medical students. Medical students are having the lowest
rate of depression than other nonmedical professional subjects.

Abstract BACKGROUND AND AIM: Parasitology course is one of the basic science courses in the educational
curriculum for medical students. Since the integration of basic and clinical sciences has helped
students better understand the basic science course content, the aim of the present study was to
determine the effect of integration of basic and clinical aspects of a specific topic in a parasitology
course on medical students learning.
MATERIALS AND METHODS: A randomized controlled trial was conducted on 110 undergraduate
fifth‑semester medical students from April to July 2018. The students were randomly divided into two
groups, based on student identification number: Intervention and control groups. The topic selected
for this study from the parasitology course was “cutaneous leishmaniasis.” At the beginning of the
program, a dermatologist presented the clinical aspects of the topic to the intervention group. Then,
a parasitologist delivered a traditional lecture about the basic aspects of the topic to both groups.
The students’ scores on questions related to cutaneous leishmaniasis in the final exam were used
as a measure of learning and teaching outcomes. A questionnaire that consisted of seven items and
three open‑ended questions was used based on the objectives of the randomized controlled trial.
Statistical analysis was performed by SPSS software.
RESULTS: Based on the result of the final examination, there was no significant difference in
the learning rate of students between the intervention and control groups (P ≥ 0.05). According
to students’ comments, the teaching of clinical science alongside basic science increased the
importance of the topic and the students’ interest in basic science. Most students agreed that this
method prepares them for their clinical years.
CONCLUSION: Many medical students believe that the content of many basic science courses are
forgotten in the future. Therefore, basic science education alongside clinical science presentations
are suggested.

Abstract BACKGROUND: Motivation and desire are the main psychological factors associated with regular
breakfast consumption among elementary students. The purpose of this study was to assess the
readiness of students to regular breakfast consumption.
MATERIALS AND METHODS: This research was cross‑sectional study; 300 students participated
who were selected based on cluster sampling from elementary schools in different parts of Ardabil
and were interviewed using a motivational questionnaire according to SOC model. The acquired
data was then analyzed by ANOVA and linear regression.
RESULTS: Cognitive processes of change such as social liberation (β = 0.31, α = 0.001) and
self‑reevaluation (β = 0.13, α = 0.04) and self‑efficacy (β = 0.44, α = 0.001) played a significant role
in motivating students to move from the inactive stage to preparation stage.
CONCLUSION: By understanding the motivational factors of regular breakfast consumption, a regular
program can be implemented to increase breakfast consumption and ensure the health of students
and help them to grow in learning ability and abstract thinking.

Abstract BACKGROUND: Todays, human lifestyle has faced significant changes, and this lifestyle has
caused health problems. The increase of smoking, among young people, is one of the risk factors
and incorrect lifestyle factors. The present study will design an educational campaign intervention
based on the protection motivation theory (PMT) on smoking preventive behaviors in students.
MATERIALS AND METHODS: In designing this study, five phases are considered. (1) needs
assessment and determination of the current situation are considered. In this phase, the required
communication is established to form a planning team with key and influential people and experts, (2)
tool design, (3) educational intervention (educational campaign) is designed. Some individuals will
be selected and trained as facilitators to start entering the target population, have a better access
to the target group, and implement the interventions in the target group. (4) the implementation of
the educational plan, in which the designed educational intervention (educational campaign) will
be implemented on the students of the studied universities. (5) the educational evaluation, which
will be conducted 2 months after the intervention of the educational campaign. The posttest will be
based on before and after the implementation of the educational campaign. In the prevention of the
second type in smoking students, the salivary cotinine levels of smoking students will be measured
and comparisons will be made before and after educational using appropriate statistical tests.
RESULTS: The present study addresses the needs and strategies for smoking prevention using a
training campaign based on the PMT and web .
CONCLUSION: Designing a campaign which will lead to smoking preventive behaviors causes
lifestyle changes, prevent health problems such as cancer, cardiovascular diseases, and other
chronic diseases, reduce treatment costs, and increase life expectancy.