Document Type : Original Article


Department of Public Health, Khomein University of Medical Sciences, Khomein, Iran


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
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.


1. Fauci AS, Lane HC, Redfield RR. Covid‑19 — Navigating the
Uncharted. N Engl J Med 2020;382:1268–9.
2. Shanbehzadeh M, Kazemi‑Arpanahi H, Mazhab‑Jafari K,
Haghiri H. Coronavirus disease 2019 (COVID‑19) surveillance
system: Development of COVID‑19 minimum data set and
interoperable reporting framework. J Educ Health Promot
3. Daniel SJ. Education and the COVID‑19 pandemic. Prospects
4. Khlaif ZN, Salha S, Kouraichi B. Emergency remote learning
during COVID‑19 crisis: Students’ engagement. Educ Inf Technol
5. Wang G, Zhang Y, Zhao J, Zhang J, Jiang F. Mitigate the effects of
home confinement on children during the COVID‑19 outbreak.
Lancet 2020;395:945–7.
6. Tang S, Xiang M, Cheung T, Xiang Y‑T. Mental health and its
correlates among children and adolescents during COVID‑19
school closure: The importance of parent‑child discussion. J Affect
Disord 2021;279:353–60.
7. Sharfstein JM, Morphew CC. The urgency and challenge of
opening k‑12 schools in the fall of 2020. JAMA [2020;324:133.
8. Pattison KL, Hoke AM, Schaefer EW, AlterJ, Sekhar DL. National
Survey of School Employees: COVID‐19, school reopening, and
student wellness. J Sch Health 2021;91:376–83.
9. Viner RM, Bonell C, Drake L, Jourdan D, Davies N, Baltag V, et al.
Reopening schools during the COVID‑19 pandemic: Governments
must balance the uncertainty and risks of reopening schools
against the clear harms associated with prolonged closure. Arch
Dis Child 2021;106:111–3.
10. Handebo S, Adugna A, Kassie A, Shitu K. Determinants of
COVID‑19‑related knowledge and preventive behaviours among
students in reopened secondary schools: Cross‑sectional study.
BMJ Open 2021;11:e050189.
11. Jahromi V, Ghashghaei S, Sharifi N. Improvement of
osteoporosis‑related behaviors in female students based on trans
theoretical model. J Educ Health Promot 2020;9:221.
12. Fathian‑Dastgerdi Z, Khoshgoftar M, Tavakoli B, Jaleh M. Factors
associated with preventive behaviors of COVID‑19 among
adolescents: Applying the health belief model. Res Soc Adm
Pharm 2021;17:1786–90.
13. Selzler A‑M, Habash R, Robson L, Lenton E, Goldstein R,
Brooks D. Self‑efficacy and health‑related quality of life in chronic
obstructive pulmonary disease: A meta‑analysis. Patient Educ
Couns 2020;103:682–92.
14. Rafiola R, Setyosari P, Radjah C, Ramli M. The effect of learning
motivation, self‑efficacy, and blended learning on students’
achievement in the industrial revolution 4.0. Int J Emerg Technol
Learn 2020;15:71–82.
15. Tang MY, Smith DM, Mc Sharry J, Hann M, French DP. Behavior
change techniques associated with changes in postintervention and
maintained changes in self‑efficacy for physical activity: Asystematic
review with meta‑analysis. Ann Behav Med 2019;53:801–15.
16. Ramezani T, Sharifirad G, Rajati F, Rajati M, Mohebi S. Effect of
educational intervention on promoting self‑care in hemodialysis
patients: Applying the self‑efficacy theory. J Educ Health Promot
17. Alimohammadi L, Mirghafourvand M, Zarei F, Pirzeh R. The
effectiveness of group counseling based on Bandura’s self‑efficacy
theory on sexual function and sexual satisfaction in Iranian
newlywed women: A randomized controlled trial. Appl Nurs
Res 2018;42:62–9.
18. Kardong‑Edgren S. Bandura’s self‑efficacy theory… Something
is missing. Clin Simul Nurs 2013;9:e327–8.
19. Schunk DH, Pajares F. Self‑efficacy theory. Handb Motiv Sch
20. Tavafi M, Baghaei R. The effect of health habit‑based intervention
program on self‑care and self‑efficacy of nursing students. J Heal
Promot Manag 2019;7:53–61.
21. Elgzar WT, Al‑Qahtani AM, Elfeki NK, Ibrahim HA. COVID‑19
outbreak: Effect of an educational intervention based on health
belief model on nursing students’ awareness and health beliefs
at Najran University, Kingdom of Saudi Arabia. Afr J Reprod
Health 2020;24:78–86.
22. Solhi M, Abasi H, Hazavehei MM, Roshanaei G. Effect of
educational intervention on empowerment of high school student
in prevention of smoking. Razi J Med Sci 2014;21:52–63.
23. RakhshaniT, KashfiSM, MotlaghZ, Kohan N. Effect of educational
intervention based on self‑efficacy on health‑promoting behaviors
in high‑school girl students: A quasi‑experimental study. Int J
Pediatr 2020;8:12461–70.
24. Karimy M, Koohestani HR, Araban M. The association between
attitude, self‑efficacy, and social support and adherence to
diabetes self‑care behavior. Diabetol Metab Syndr 2018;10:86.
25. Evenson AL, Sanders GF. Educational intervention impact on
osteoporosis knowledge, health beliefs, self‑efficacy, dietary
calcium, and Vitamin D intakes in young adults. Orthop Nurs
26. Hatef M, Sharif Nia H, Mousavinasab N, Esmaeili R, Shafipour V.
Self‑efficacy and prediction of associated factors in patients with
chronic diseases. J Maz Univ Med Sci 2018;28:86–94.
27. Reisi M, Mostafavi F, Javadzade SH, Mahaki B, Sharifirad G.
Assessment of some predicting factors of self‑efficacy in patients
with type 2 diabetes. Iran J Endocrinol Metab 2015;17:44–52.