Authors
Abstract
INTRODUCTION: Internet addiction refers to the excessive use of the internet that causes mental,
social, and physical problems. According to the high prevalence of internet addiction among university
students, this study aimed to determine the effect of an educational intervention on preventive
behaviors of internet addiction among Tehran University of Medical Sciences students.
MATERIALS AND METHODS: This study was a quasi‑experimental study conducted among female
college students who live in the dormitories of Tehran University of Medical Sciences. Two‑stage
cluster sampling was used for selection of eighty participants in each study groups; data were
collected using “Young’s Internet Addiction” and unstructured questionnaire. Validity and reliability
of unstructured questionnaire were evaluated by expert panel and were reported as Cronbach’s
alpha. Information of study groups before and 4 months after the intervention was compared using
statistical methods by SPSS 16.
RESULTS: After the intervention, the mean scores of internet addiction, perceived barriers
construct, and the prevalence of internet addiction significantly decreased in the intervention group
than that in the control group and the mean scores of knowledge and Health Belief Model (HBM)
constructs (susceptibility, severity, benefits, self‑efficacy) significantly increased.
CONCLUSIONS: Education based on the HBM was effective on the reduction and prevention of
internet addiction among female college students, and educational interventions in this field are
highly recommended.
Keywords
1. Young KS. Internet addiction a new clinical phenomenon and its
consequences. Am Behav Sci 2004;48:402-15.
2. Razieh J, Ghasempoor A, Ajdari Z, Sadeghigooghari N. The
relationship between Internet addiction and anxiety in the
universities students. Interdiscipl J Contemp Res Bus 2012;4:942-9.
3. Mishra S, Draus P, Goreva N, Leone G, Caputo D. The impact
of internet addiction on university students and its effect on
subsequent academic success: A survey based study. Issues Inf
Syst 2014;15:344-52.
4. Miller MA. Internet Technologies Handbook: Optimizing the IP
Network. 1st ed. United States of America: John Wiley and Sons;
2005.
5. Sato T. Internet addiction among students: Prevalence and
psychological problems in Japan. JMAJ 2006;49:279-83.
6. Baladehi MS, Hassanzadeh R, Dousti Y. Prediction of health
behaviors of students in terms of internet. IJSBAR 2015;4:448-54.
7. Omoyi AD, Momoh M. Time management of internet dependency
among university students and its impact on academic
performance. Eur J Bus Manage 2013;5:200-8.
8. Koc M. Internet addiction and psychopathology. Turk Online J
Educ Technol 2011;10:143-8.
9. Conrad P, Bandini J, Vasquez A. Illness and the internet: From
private to public experience. Health (London) 2016;20:22-32.
10. Conrad P, Stults C. The Internet and the experience of illness. In:
Bird C, Conrad P, Fremont A, Timmermans S, editors, Handbook
of Medical Sociology. 6th ed. Nashville, Tennessee: Vanderbilt
University Press; 2010. p. 179-91.
11. Stats I. Internet World Stats 2014: Usage and Population Statistics.
Retrieved from Internet World Stats; 2014. Available from: http://
www internet world stats com/stats htm. [Last accessed on
2015 Oct 02].
12. Naffise M, Mohammad A, Ahmad PB, Omid R, Ayatollahi A,
Reza B, et al. The prevalence of Internet addiction among the
students of Rafsanjan University of Medical Sciences. ASEAN J
Psychiatry 2013;14:109-16.
13. HasanzadehR, Beydokhti A, Zadeh FD. The prevalence of internet
addiction among university students: A general or specific
problem. J Basic Appl Sci Res 2012;2:5264-71.
14. Ghasemzadeh L, Shahraray M, Moradi A. The study of degree of
prevalence to internet addiction and its relation with loneliness
and self esteem in high schools students of Tehran. J Educ
2007;23:41-68.
15. Khatib Zanjani N, Agah Heris M. The Prevalence of Internet
Addiction among the Students of Payam Noor University,
Semnan Province. Magazine of E-learning Distribution in
Academy 2014; 5:1-7.
16. Kiany T, Fallahi Khoshknab M, Dalvandi A, Hosaini M,
Nourozi K. Internet addiction and its related factors among
nursing students in Tehran University of Medical Sciences in
2013. Journal of Nursing Education 2014; 2:50-62.
17. Gonzalez NA. Internet addiction disorder and its relation to
impulse control. [Dissertation] USA: Texas University, Collage
of Psychology; 2008. p. 6-25.
18. Widyanto L, Griffiths M. “Internet addiction”: A critical review.
Int J Ment Health Addict 2006;4:31-51.
19. Cao F, Su L. Internet addiction among Chinese adolescents:
Prevalence and psychological features. Child Care Health Dev
2007;33:275-81.
20. Niemz K, Griffiths M, Banyard P. P revalence of pathological
Internet use among university students and correlations with
self-esteem, the General Health Questionnaire (GHQ), and
disinhibition. Cyberpsychol Behav 2005;8:562-70.
21. Ekinci O, Celik T, Savas N, Toros F. Association between
internet use and sleep problems in adolescents. Archives of
Neuropsychiatry 2014;51:122-8.
22. Yeon Soo K, Sung Byuk K, In Kyung J, Yun Sook L, Jung Hyun K.
The effects of Internet addiction on the lifestyle and dietary
behavior of Korean adolescents. Nutr Res Pract 2010;4:51-7.
23. Musa MA, Majid V. Study of the relationship between internet
addiction and anxiety: Determination of the extent of internet
addiction and anxiety among Iranian students. J Appl Environ
Biol Sci 2014;4:201-9.24. Anderson KJ. Internet use among college students: An exploratory
study. J Am Coll Health 2001;50:21-6.
25. Bloch J. Student/teacher interaction via email: The social context
of Internet discourse. J Second Lang Writ 2002;11:117-34.
26. Shojaei Zadeh D, Changizi M, Sadeghi R. The effect of education
about addiction through health belief model(HBM) on knowledge
and perceptions of high school students in Shadegan. J Sci Todays
World 2014;3:240-4.
27. Kapahi A, Ling CS, Ramadass S, Abdullah N. Internet addiction
in Malaysia causes and effects. iBusiness 2013;5:72-6.
28. Akin A, Iskender M. Internet addiction and depression, anxiety
and stress. Int Online J Educ Sci 2011;3:138-48.
29. Lashgarara B, Taghavi Shahri M, Maheri AB, Sadeghi R. Internet
addiction and general health of dormitory students of Tehran
University of Medical Sciences in 2010. SJSPH 2012;10:67-76.
30. Jafary Nodoushan M, Jafary Nodoushan K, Mirizadeh M,
Ahmari Tehran H, Norouzinejad G, Sadeghi Yekta T, et al.
The survey of correlation between internet addiction and
general health status among the students of Qom University of
Medical Sciences in 2010-2011, Qom, Iran. Qom Univ Med Sci J
2012;6:86-90.
31. Dadipoor S, Zara F, Abdolrezaei Zarandi F, Ghanbarnejad A,
Hassanzadeh R, Safari Moradabadi A. Investigate internet
addiction and effective factors among students in Hormozgan
University of Medical Sciences. J Health Syst Res 2014;10:469-79.
32. Bahrami A. Addiction and Process of Prevention. 1st ed. Tehran:
Samt Inc.;2004.
33. Griffin KW, Botvin GJ. Evidence-based interventions for
preventing substance use disorders in adolescents. Child Adolesc
Psychiatr Clin N Am 2010;19:505-26.
34. Modeste N, Tamayose T. Dictionary of Public Health Promotion
and Education: Terms and Concepts. 2st ed. United States of
America: John Wiley and Sons; 2004.
35. Jackson C. Behavioral science theory and principles for practice
in health education. Health Educ Res 1997;12:143-50.
36. Dizaji MB, Taghdisi MH, Solhi M, Hoseini SM, Shafieyan Z,
Qorbani M, et al. Effects of educational intervention based on
PRECEDE model on self care behaviors and control in patients
with type 2 diabetes in 2012. J Diabetes Metab Disord 2014;13:72.
37. Armitage CJ, Conner M. Social cognition models and health
behaviour: A structured review. Psychol Health 2000;15:173-89.
38. Maheri AB, Hamid Joveini H, Bahrami MN, Sadeghi R. The study
of the effects of internet addiction on healthy lifestyle in students
living in the dormitories of Tehran University of Medical Sciences,
2012. RJMS 2013;20:10-9.
39. Van Rooij AJ, Prause N. A critical review of “Internet addiction”
criteria with suggestions for the future. J Behav Addict
2014;3:203-13.
40. Mirzaei Alavijeh M, Jalilian F, Zinat Motlagh F,
Mazloomy Mahmodabad S, Zolghadr R, Hatamzadeh N.
Effectiveness of drug abuse preventative intervention among
Iranian Medical College Students based on the theory of planned
behavior. Health Educ Health Promot 2015;2:41-52.
41. Sarna LP, Bialous SA, Kraliková E, Kmetova A, Felbrová V,
Kulovaná S, et al. Impact of a smoking cessation educational
program on nurses’ interventions. J Nurs Scholarsh 2014;46:314-21.
42. Strøm HK, Adolfsen F, Fossum S, Kaiser S, Martinussen M.
Effectiveness of school-based preventive interventions on
adolescent alcohol use: A meta-analysis of randomized controlled
trials. Subst Abuse Treat Prev Policy 2014;9:48.
43. Mohammadizeidi E, Pakpour A. Effectiveness of an educational
intervention based on theory of planned behavior to reduce
intentions to smoke among secondary school students. J Res
Health 2013;3:504-13.
44. Lin P, Simoni JM, Zemon V. The health belief model, sexual
behaviors, and HIV risk among Taiwanese immigrants. AIDS
Educ Prev 2005;17:469-83.
45. Wong LP, AbuBakar S. Health beliefs and practices related
to dengue fever: A focus group study. PLoS Negl Trop Dis
2013;7:e2310.
46. Allahverdipour H, Bazargan M, Farhadinasab A, Hidarnia A,
Bashirian S. Effectiveness of skill-based substance abuse
intervention among male adolescents in an Islamic country: Case
of the Islamic Republic of Iran. J Drug Educ 2009;39:211-22.
47. Rahnavard Z, Mohammadi M, Rajabi F, Zolfaghari M. An
Educational intervention using health belief on smoking
preventive behavior among female teenagers. Journal of Hayat
2011;17:15-26.
48. Li K, Kay NS. Correlates of cigarette smoking among male Chinese
college students in China – A preliminary study. Int Electron J
Health Educ 2009;12:59-71.
49. Reisi M, Javadzade SH, Shahnazi H, Sharifirad G, Charkazi A,
Moodi M. Factors affecting cigarette smoking based on
health-belief model structures in pre-university students in
Isfahan, Iran. J Educ Health Promot 2014;3:23.
50. Rakhshani F, Esmaeili AB, Charkazi AB, Haftsavar M, Shahnazi H,
Esmaeili AJ. Effect of education on smoking prevention in
students of Zahedan. J Health Syst Res 2009;6:267-75.
51. Johari M, Eslami AA, Alahverdipoor H, Hasanzade A, Farid F.
Factors related to adopting healthy behaviors by patients with
tuberculosis in Isfahan: Application of health belief model. J Educ
Health Promot 2014;3:86.
52. Whitehead D, Russell G. How effective are health education
programmes – Resistance, reactance, rationality and risk?
Recommendations for effective practice. Int J Nurs Stud
2004;41:163-72.
53. Koch J. The role of exercise in the African-American woman with
type 2 diabetes mellitus: Application of the health belief model.
J Am Acad Nurse Pract 2002;14:126-9.
54. Daniel M, Messer LC. Perceptions of disease severity and barriers
to self-care predict glycemic control in Aboriginal persons with
type 2 diabetes mellitus. Chronic Dis Can 2002;23:130-8.
55. Brown SA. Measuring perceived benefits and perceived barriers
for physical activity. Am J Health Behav 2005;29:107-16.
56. Lajunen T, Räsänen M. Can social psychological models be used
to promote bicycle helmet use among teenagers? A comparison
of the health belief model, theory of planned behavior and the
locus of control. J Safety Res 2004;35:115-23.
consequences. Am Behav Sci 2004;48:402-15.
2. Razieh J, Ghasempoor A, Ajdari Z, Sadeghigooghari N. The
relationship between Internet addiction and anxiety in the
universities students. Interdiscipl J Contemp Res Bus 2012;4:942-9.
3. Mishra S, Draus P, Goreva N, Leone G, Caputo D. The impact
of internet addiction on university students and its effect on
subsequent academic success: A survey based study. Issues Inf
Syst 2014;15:344-52.
4. Miller MA. Internet Technologies Handbook: Optimizing the IP
Network. 1st ed. United States of America: John Wiley and Sons;
2005.
5. Sato T. Internet addiction among students: Prevalence and
psychological problems in Japan. JMAJ 2006;49:279-83.
6. Baladehi MS, Hassanzadeh R, Dousti Y. Prediction of health
behaviors of students in terms of internet. IJSBAR 2015;4:448-54.
7. Omoyi AD, Momoh M. Time management of internet dependency
among university students and its impact on academic
performance. Eur J Bus Manage 2013;5:200-8.
8. Koc M. Internet addiction and psychopathology. Turk Online J
Educ Technol 2011;10:143-8.
9. Conrad P, Bandini J, Vasquez A. Illness and the internet: From
private to public experience. Health (London) 2016;20:22-32.
10. Conrad P, Stults C. The Internet and the experience of illness. In:
Bird C, Conrad P, Fremont A, Timmermans S, editors, Handbook
of Medical Sociology. 6th ed. Nashville, Tennessee: Vanderbilt
University Press; 2010. p. 179-91.
11. Stats I. Internet World Stats 2014: Usage and Population Statistics.
Retrieved from Internet World Stats; 2014. Available from: http://
www internet world stats com/stats htm. [Last accessed on
2015 Oct 02].
12. Naffise M, Mohammad A, Ahmad PB, Omid R, Ayatollahi A,
Reza B, et al. The prevalence of Internet addiction among the
students of Rafsanjan University of Medical Sciences. ASEAN J
Psychiatry 2013;14:109-16.
13. HasanzadehR, Beydokhti A, Zadeh FD. The prevalence of internet
addiction among university students: A general or specific
problem. J Basic Appl Sci Res 2012;2:5264-71.
14. Ghasemzadeh L, Shahraray M, Moradi A. The study of degree of
prevalence to internet addiction and its relation with loneliness
and self esteem in high schools students of Tehran. J Educ
2007;23:41-68.
15. Khatib Zanjani N, Agah Heris M. The Prevalence of Internet
Addiction among the Students of Payam Noor University,
Semnan Province. Magazine of E-learning Distribution in
Academy 2014; 5:1-7.
16. Kiany T, Fallahi Khoshknab M, Dalvandi A, Hosaini M,
Nourozi K. Internet addiction and its related factors among
nursing students in Tehran University of Medical Sciences in
2013. Journal of Nursing Education 2014; 2:50-62.
17. Gonzalez NA. Internet addiction disorder and its relation to
impulse control. [Dissertation] USA: Texas University, Collage
of Psychology; 2008. p. 6-25.
18. Widyanto L, Griffiths M. “Internet addiction”: A critical review.
Int J Ment Health Addict 2006;4:31-51.
19. Cao F, Su L. Internet addiction among Chinese adolescents:
Prevalence and psychological features. Child Care Health Dev
2007;33:275-81.
20. Niemz K, Griffiths M, Banyard P. P revalence of pathological
Internet use among university students and correlations with
self-esteem, the General Health Questionnaire (GHQ), and
disinhibition. Cyberpsychol Behav 2005;8:562-70.
21. Ekinci O, Celik T, Savas N, Toros F. Association between
internet use and sleep problems in adolescents. Archives of
Neuropsychiatry 2014;51:122-8.
22. Yeon Soo K, Sung Byuk K, In Kyung J, Yun Sook L, Jung Hyun K.
The effects of Internet addiction on the lifestyle and dietary
behavior of Korean adolescents. Nutr Res Pract 2010;4:51-7.
23. Musa MA, Majid V. Study of the relationship between internet
addiction and anxiety: Determination of the extent of internet
addiction and anxiety among Iranian students. J Appl Environ
Biol Sci 2014;4:201-9.24. Anderson KJ. Internet use among college students: An exploratory
study. J Am Coll Health 2001;50:21-6.
25. Bloch J. Student/teacher interaction via email: The social context
of Internet discourse. J Second Lang Writ 2002;11:117-34.
26. Shojaei Zadeh D, Changizi M, Sadeghi R. The effect of education
about addiction through health belief model(HBM) on knowledge
and perceptions of high school students in Shadegan. J Sci Todays
World 2014;3:240-4.
27. Kapahi A, Ling CS, Ramadass S, Abdullah N. Internet addiction
in Malaysia causes and effects. iBusiness 2013;5:72-6.
28. Akin A, Iskender M. Internet addiction and depression, anxiety
and stress. Int Online J Educ Sci 2011;3:138-48.
29. Lashgarara B, Taghavi Shahri M, Maheri AB, Sadeghi R. Internet
addiction and general health of dormitory students of Tehran
University of Medical Sciences in 2010. SJSPH 2012;10:67-76.
30. Jafary Nodoushan M, Jafary Nodoushan K, Mirizadeh M,
Ahmari Tehran H, Norouzinejad G, Sadeghi Yekta T, et al.
The survey of correlation between internet addiction and
general health status among the students of Qom University of
Medical Sciences in 2010-2011, Qom, Iran. Qom Univ Med Sci J
2012;6:86-90.
31. Dadipoor S, Zara F, Abdolrezaei Zarandi F, Ghanbarnejad A,
Hassanzadeh R, Safari Moradabadi A. Investigate internet
addiction and effective factors among students in Hormozgan
University of Medical Sciences. J Health Syst Res 2014;10:469-79.
32. Bahrami A. Addiction and Process of Prevention. 1st ed. Tehran:
Samt Inc.;2004.
33. Griffin KW, Botvin GJ. Evidence-based interventions for
preventing substance use disorders in adolescents. Child Adolesc
Psychiatr Clin N Am 2010;19:505-26.
34. Modeste N, Tamayose T. Dictionary of Public Health Promotion
and Education: Terms and Concepts. 2st ed. United States of
America: John Wiley and Sons; 2004.
35. Jackson C. Behavioral science theory and principles for practice
in health education. Health Educ Res 1997;12:143-50.
36. Dizaji MB, Taghdisi MH, Solhi M, Hoseini SM, Shafieyan Z,
Qorbani M, et al. Effects of educational intervention based on
PRECEDE model on self care behaviors and control in patients
with type 2 diabetes in 2012. J Diabetes Metab Disord 2014;13:72.
37. Armitage CJ, Conner M. Social cognition models and health
behaviour: A structured review. Psychol Health 2000;15:173-89.
38. Maheri AB, Hamid Joveini H, Bahrami MN, Sadeghi R. The study
of the effects of internet addiction on healthy lifestyle in students
living in the dormitories of Tehran University of Medical Sciences,
2012. RJMS 2013;20:10-9.
39. Van Rooij AJ, Prause N. A critical review of “Internet addiction”
criteria with suggestions for the future. J Behav Addict
2014;3:203-13.
40. Mirzaei Alavijeh M, Jalilian F, Zinat Motlagh F,
Mazloomy Mahmodabad S, Zolghadr R, Hatamzadeh N.
Effectiveness of drug abuse preventative intervention among
Iranian Medical College Students based on the theory of planned
behavior. Health Educ Health Promot 2015;2:41-52.
41. Sarna LP, Bialous SA, Kraliková E, Kmetova A, Felbrová V,
Kulovaná S, et al. Impact of a smoking cessation educational
program on nurses’ interventions. J Nurs Scholarsh 2014;46:314-21.
42. Strøm HK, Adolfsen F, Fossum S, Kaiser S, Martinussen M.
Effectiveness of school-based preventive interventions on
adolescent alcohol use: A meta-analysis of randomized controlled
trials. Subst Abuse Treat Prev Policy 2014;9:48.
43. Mohammadizeidi E, Pakpour A. Effectiveness of an educational
intervention based on theory of planned behavior to reduce
intentions to smoke among secondary school students. J Res
Health 2013;3:504-13.
44. Lin P, Simoni JM, Zemon V. The health belief model, sexual
behaviors, and HIV risk among Taiwanese immigrants. AIDS
Educ Prev 2005;17:469-83.
45. Wong LP, AbuBakar S. Health beliefs and practices related
to dengue fever: A focus group study. PLoS Negl Trop Dis
2013;7:e2310.
46. Allahverdipour H, Bazargan M, Farhadinasab A, Hidarnia A,
Bashirian S. Effectiveness of skill-based substance abuse
intervention among male adolescents in an Islamic country: Case
of the Islamic Republic of Iran. J Drug Educ 2009;39:211-22.
47. Rahnavard Z, Mohammadi M, Rajabi F, Zolfaghari M. An
Educational intervention using health belief on smoking
preventive behavior among female teenagers. Journal of Hayat
2011;17:15-26.
48. Li K, Kay NS. Correlates of cigarette smoking among male Chinese
college students in China – A preliminary study. Int Electron J
Health Educ 2009;12:59-71.
49. Reisi M, Javadzade SH, Shahnazi H, Sharifirad G, Charkazi A,
Moodi M. Factors affecting cigarette smoking based on
health-belief model structures in pre-university students in
Isfahan, Iran. J Educ Health Promot 2014;3:23.
50. Rakhshani F, Esmaeili AB, Charkazi AB, Haftsavar M, Shahnazi H,
Esmaeili AJ. Effect of education on smoking prevention in
students of Zahedan. J Health Syst Res 2009;6:267-75.
51. Johari M, Eslami AA, Alahverdipoor H, Hasanzade A, Farid F.
Factors related to adopting healthy behaviors by patients with
tuberculosis in Isfahan: Application of health belief model. J Educ
Health Promot 2014;3:86.
52. Whitehead D, Russell G. How effective are health education
programmes – Resistance, reactance, rationality and risk?
Recommendations for effective practice. Int J Nurs Stud
2004;41:163-72.
53. Koch J. The role of exercise in the African-American woman with
type 2 diabetes mellitus: Application of the health belief model.
J Am Acad Nurse Pract 2002;14:126-9.
54. Daniel M, Messer LC. Perceptions of disease severity and barriers
to self-care predict glycemic control in Aboriginal persons with
type 2 diabetes mellitus. Chronic Dis Can 2002;23:130-8.
55. Brown SA. Measuring perceived benefits and perceived barriers
for physical activity. Am J Health Behav 2005;29:107-16.
56. Lajunen T, Räsänen M. Can social psychological models be used
to promote bicycle helmet use among teenagers? A comparison
of the health belief model, theory of planned behavior and the
locus of control. J Safety Res 2004;35:115-23.
)