Journal of Education and Health Promotion

Abstract

Abstract Background: Asthma is the most prevalent disease during childhood, known as the most important
reason for children’s disability adolescences truancies, thanks to their hospitalization and as a result
intensification of disease symptom. Material and methods: The present study is quasi-experimental
kind, implemented with two groups. Sampling method was straightforward. 80 student’s secondgrade high school students constitute participants. Both groups were homogenized considering
age, gender, education, and parent’s vocation. First of all, a letter agreement was received from
students. Then, the knowledge and accomplishment of students were measured by means of
relevant questionnaire and checklist in advance of educational intervention. In the next step, during
4 sessions, educational content specified beforehand was presented to students via interview,
lecture, group discussion, and display methods. The knowledge and accomplishment of both
groups’ students was measured through questionnaire and checklist. Finally, the data was analyzed
by SPSS 16 and statistical test of t-paired, independent-t, man-Whitney, and ANOVA. Results: The
finding demonstrated that group’s student accomplishment registered 91.8 ± 1.3 while being
2.2 ± 0.6 before holding session. In addition, their knowledge increased significantly, registering
99.6 ± 1.2 while it had measured as 1.3 ± 0.3 before sessions. The results of paired t-test indicated
that the average of difference between knowledge and accomplishment grades of two groups
was significant (P<0.05). Conclusions: Regarding the finding of the present study and the fact
that asthma is on the rise resulting in an increase in truancies as well as stressing the efficacy of
training peers suffering from the disease, the implementation of the curriculum could be necessary.

Abstract Introduction: Ecstasy consumption has increased 70% worldwide, and its use is currently
outweighed heroin and cocaine. Conducted survey found that students more than other
groups used ecstasy pills. Ecstasy usage has recently augmented in students. Therefore,
this study aims to determine practice of Isfahan University of Medical Science students
about using ecstasy based on health belief model in 2011. Materials and Methods: A crosssectional study was conducted on 267 students of Isfahan University of Medical Science.
Data were collected by a validated and reliable questionnaire in 3 parts (demographic
information, H.B.M constructs, and practice). To analyze, SPSS software (ver.18) and statistical
test including T-Test and Kruskal-Wallis were used. Results: The mean score of age was
20.95 ± 1.61 years, and 39.3% of men and 90.6% of women were single. 2.2% of students
have used ecstasy pills. The mean score of H.B.M constructs was perceived susceptibility
(72.75 ± 19.68), perceived severity (84.58 ± 16.98), and perceived benefits (80.43 ± 23.49).
The finding presented that there was significant differences between the using ecstasy and
perceived severity and perceived benefits (P ≤ 0.001), but there was no significant statistical
relationship between the using ecstasy and perceived susceptibility and perceived barriers
(P = 0.076, P = 0.554). In terms of cues to action, students suggested that radio and TV are
most significance cues. Conclusion: According to results, to prevent ecstasy usage among
Isfahan University of Medical Science students based on health belief model, we should
improve perceived susceptibility. Besides, radio and TV rules as the most important cues
should not also be denied. Moreover, newly identified susceptibility indicates the need for
quantitative research and behavioral trials.

Abstract Background: Health literacy is a measure of an individual’s ability to read, comprehend, and act on
medical instructions. Limited health literacy can reduce the adults’ ability to comprehend and use
basic health-related materials, such as prescription, food labels, health education pamphlets, articles,
appointment slips, and health insurance plans, which can affect their ability to take appropriate and
timely health care action. Nowadays, low health literacy is considered a worldwide health threat. So,
the purpose of this study was to assess health literacy level in older adults and to investigate the
relationships between health literacy and health status, health care utilization, and health preventive
behaviors. Materials and Methods: A cross-sectional survey of 354 older adults was conducted
in Isfahan. The method of sampling was clustering. Health literacy was measured using the Test of
Functional Health Literacy in Adults (TOFHLA). Data were collected using home interviewing. Health
status was measured based on self-rated general health. Health care utilization was measured
based on self-reported outpatient clinic visits, emergency room visits, and hospitalizations, and
health preventive behaviors were measured based on self-reported preventive health services
use. Results: Approximately 79.6% of adults were found to have inadequate health literacy. They
tended to be older, had fewer years of schooling, lower household income, and were females.
Inadequate health literacy was associated with poorer general health (P < 0.001). Health literacy
level was negatively associated with outpatient visits (P = 0.003) and hospitalization (P = 0.01).
No significant association was found between health literacy level and emergency room utilization.
Self-reported lack of PSA (Prostate-Specific Antigen) test (P < 0.001) and fecal occult blood test
(FOBT; P = 0.003) was higher among individuals with inadequate health literacy than those with
adequate health literacy. No significant association was found between health literacy level and
mammogram in the last 2 years. Conclusion: Low health literacy is more prevalent in older adults.
It indicates the importance of health literacy issue in health promotion. So, with simple educational
materials and effective interventions for low health literacy group, we can improve health promotion
in the society and mitigate the adverse health effects of low health literacy.

Abstract Introduction: Environmental natural radiation measurement is of great importance and interest
especially for human health. The induction of genetic disorder and cancer appears to be the most
important in an exposed population. Materials and Methods: Measurements of background
gamma rays were performed using a mini-rad environmental survey meter at 25 different
locations around the city of Kermanshah (a city in the west of Iran). The measurements were
also performed at two different time of day one in the morning and the other in the afternoon.
At each location and time measurements were repeated for five times and the mean was
considered as the background dose at that location. Results and Discussions: Comparison
between the measured results in the morning and afternoon has not shown any significant
difference (P > 0.95). The maximum and minimum obtained results were 2.63 mSv/y and
1.49 mSv/y, respectively. From the total measurements at 25 sites mean and SD background
radiation dose to the population is 2.24 ± 0.25 mSv. Conclusion: The mean radiation dose
to the population is about 2.5 times of the world average total external exposure cosmic rays
and terrestrial gamma rays dose reported by UNSCEAR.

Abstract Abstract
Background: Obesity is growing rapidly in our country. Nutrition is an important issue of obesity.
The aim of this study was to determine the association between fruit and vegetable intake
with the waist circumference and the body mass index (BMI) among young female university
students. Materials and Methods: This cross-sectional study was conducted on 236 healthy
female university students aged between 18 and 30 years old, who were selected randomly
from the students of Isfahan University of Medical Sciences, Iran. A previously validated semiquantitative food frequency questionnaire was used to assess the entire dietary component
intake. Physical activity was assessed by daily recording of the physical activities. Findings: The
prevalence of obesity, central adiposity and overweight was 1.7, 0.9 and 8.1%, respectively. The
mean value of BMI and the waist circumference was 21.54 kg/m2
 and 70.37 cm, respectively.
There was an inverse correlation between the fruit and vegetable intake and body weight (r =
-0.1, P = 0.03) as well as BMI (r = -0.1, P = 0.04) and also there was an inverse correlation
between the fruit intake and body weight (r = -0.1, P = 0.01) and BMI (r = -0.1, P = 0.01).
There was no significant correlation between fruit and vegetable as well as fruit or vegetable
separately with the waist circumference. Conclusion: There were significant correlations
between fruit and also fruit and vegetable and body weight and BMI among female university
students. There was no significant correlation between fruit and vegetable as well as fruit or
vegetable separately with waist circumference.

Abstract Introduction: Diabetes is one of the chronic diseases that have been considered by policy makers.
Diabetes causes premature mortality, disability and sometimes irreversible problems. Although it
is under consideration of doctors, there is no study about the role of the socioeconomic status of
the patient in control of diabetes in our society. The main purpose of this research is to explore
relationship between socioeconomic status and control of diabetes. Materials and Methods:
320 diabetic patients were randomly chosen from specialized clinic of Dr. Gharazy hospital. The
element was questionnaire which its reliability was calculated according to coefficients Cronbach’s
alpha (r = .078). The patients’ two previous sessions’ blood sugar level and also their HbA1C
were studied via referring to their medical records. Then the patients were categorized into
successful and unsuccessful groups in controlling the diabetes. Their socioeconomic status was
analyzed through SPSS software. Results: The findings show that there is a direct relationship
between socioeconomic status and control of diabetes. The better socioeconomic status is the
better diabetes has been controlled. Conclusion: In order to control diabetes, taking drugs and
patients’ socioeconomic status should be take into consider and social screening is essential.

Abstract ABSTRACT
Context: Damages and loss of life sustained during an earthquake results from falling structures
and flying glass and objects. To address these and other problems, new information technology
and systems as a means can improve crisis management and crisis response. The most
important factor for managing the crisis depends on our readiness before disasters by useful
data. Aims: This study aimed to determine the Earthquake Information Management System
(EIMS) in India, Afghanistan and Iran, and describe how we can reduce destruction by EIMS
in crisis management. Materials and Methods: This study was an analytical comparison in
which data were collected by questionnaire, observation and checklist. The population was
EIMS in selected countries. Sources of information were staff in related organizations, scientific
documentations and Internet. For data analysis, Criteria Rating Technique, Delphi Technique
and descriptive methods were used. Results: Findings showed that EIMS in India (Disaster
Information Management System), Afghanistan (Management Information for Natural Disasters)
and Iran are decentralized. The Indian state has organized an expert group to inspect issues
about disaster decreasing strategy. In Iran, there was no useful and efficient EIMS to evaluate
earthquake information. Conclusions: According to outcomes, it is clear that an information
system can only influence decisions if it is relevant, reliable and available for the decisionmakers in a timely fashion. Therefore, it is necessary to reform and design a model. The model
contains responsible organizations and their functions.

Abstract Introduction: Universities provide different facilities for talented students. The aim of this research
was to comparatively examine the rate of satisfaction among the talented students with the services
offered to them at different Iranian universities. Methods: This was a survey study in which a
researcher-made questionnaire was used to collect the data. The statistical population of this
research consisted of all the talented students at four universities who had been admitted at these
universities from 2003 to 2009. Using the formula, the total number of samples was estimated to
be approximately 328. Results: The research findings indicated that the talented students did
not have satisfaction with the educational situation, and no statistically significant difference was
observed among the different universities with regard to this issue. Conclusion: According to the
findings it is suggested that universities offer more financial facilities for research, and attending
conferences, and provide rich-content and valuable classes, and active and creative teaching
methods. It is also proposed that educational workshops on detecting talented students and the
manner of dealing with them be convened for faculty members.

Abstract Purpose: Outsourcing in healthcare is a cost-effective strategy that can lead to increase services
quality. The aim of this study was to determine the types of services that have been outsourced
in educational hospitals in Isfahan and to investigate managers’ view about the impact of
Outsourcing. Design/Methodology/Approach: A descriptive-survey study carried out in 2010.
Our samples consisted of 100 educational hospital and treatment deputy senior managers of
Isfahan University of Medical Sciences and 53 usable questionnaires were received. Survey
instrument main points were the extent to which educational hospital outsource services and the
impact of Outsourcing. Reliability and validity of the questionnaire have been verified. Data are
analyzed with SPSS18 software. Findings: The results for medical-diagnostics services showed
physiotherapy, radiology, and ultrasound that have the highest rate (33%) of being outsourced.
Between logistic and administrative activities, housekeeping, and facility engineering maintenance
services are the highest rate of outsourced (100%) and green space, CSR, laundry, and medical
records are the lowest rate of outsourced (16%). In managers’ view, in relation to advantages
of outsourcing, pay more attention to internal and external customers in private sector (57.2%)
was the highest. In relation to disadvantages of outsourcing, costs increase for the patients
(45.6%) was the highest. In relation to barriers of outsourcing, forgetting the goal of outsourcing
(efficiency) (60.6%) was the highest. Conclusion: Finally, managers’ views about outsourcing
in health services organizations were rather acceptable, but in their views, there are barriers in
implementation of outsourcing and they are focused on removing the barriers before outsourcing.
Fundamental infrastructure developments as making competing market, promoting of cultures,
education, modifying the management attitude and approach, and establishing incentive policies
are emphasized for successful implementation of outsourcing.

Abstract Background: Today, the challenges of quality improvement and customer focus as well as systems
development are important and inevitable matters in higher education institutes. There are some
highly competitive challenges among educational institutes, including accountability to social needs,
increasing costs of education, diversity in educational methods and centers and their consequent
increasing competition, and the need for adaptation of new information and knowledge to focus
on students as the main customers. Hence, the purpose of this study was to determine the rate
of costumer focus based on Isfahan University of Medical Sciences students’ viewpoints and to
suggest solutions to improve this rate. Materials and Methods: This was a cross‑sectional study
carried out in 2011. The statistical population included all the students of seven faculties of Isfahan
University of Medical Sciences. According to statistical formulae, the sample size consisted of
384 subjects. Data collection tools included researcher‑made questionnaire whose reliability was
found to be 87% by Cronbach’s alpha coefficient. Finally, using the SPSS statistical software and
statistical methods of independent t‑test and one‑way analysis of variance (ANOVA), Likert scale
based data were analyzed. Results: The mean of overall score for customer focus (student‑centered)
of Isfahan University of Medical Sciences was 46.54. Finally, there was a relation between the
mean of overall score for customer focus and gender, educational levels, and students’ faculties.
Researcher suggest more investigation between Medical University and others. Conclusion: It is
a difference between medical sciences universities and others regarding the customer focus area,
since students’ gender must be considered as an effective factor in giving healthcare services quality.
In order to improve the customer focus, it is essential to take facilities, field of study, faculties, and
syllabus into consideration.

Abstract Background: The increasing trend in waste production and its improper disposal in the environment
have led to mismanagement of national resources and hazards to the natural environment.
Therefore, the recycling of solid waste can help prevent economic and bio‑environmental disasters.
The aim of this study was to evaluate the health literacy of the students of the Kerman Public Health
School about the management and recycling of solid waste. Materials and Methods: This was a
cross‑sectional study and the target population was all of the students of the Kerman Public Health
School (421 students) in five fields. A questionnaire including demographic and health literacy
questions was distributed among the students. Results: The male students answered the questions
significantly more than female students (P<0.001). The Environmental Health students acquired
a higher score than all other students and health literacy significantly increased as the student’s
studying degree promoted (P<0.001). Also, as the number of trimesters increased, health literacy
significantly increased (P<0.001). The parents’ education, the family income, and number of people
in the family had no significant effect on health literacy. All students believed recycling is important
and more than 50% had acquired their knowledge from their academics. Conclusion: This survey
showed that although students in health‑related fields confirm the necessity of recycling solid waste,
they still need more education in health literacy as they are supposed to be the promoters of public
health in the society in the near future.

Abstract Objective: To investigate selected constructs of the transtheoretical model (TTM)
of behavior change regarding smoking behavior among Iranian male students.
Materials and Methods: A convenience sample of 578 smokers and ex‑smokers from six
universities during December 2009 to June 2010 completed three Persian versions of the short
form smoking questionnaire based on TTM, developed by Prochaska, Velicer, and Diclemente.
Data were analyzed using SPSS 15. Frequency analysis was conducted to demographic
variables. Stages’ differences were assessed with analysis of variance (ANOVA) followed by
post‑hoc multiple comparisons with Tukey’s honestly significant difference (HSD) test. Alpha
levels were set at P<0.05. Results: More than half of the subjects were in contemplation stage.
The pros of smoking among subjects in the precontemplation stage were significantly higher
than those of subjects in the preparation and maintenance stages. Meanwhile; the pros of
smoking ratings were significantly higher for the contemplation and preparation stages than
for the maintenance stage. Significant mean differences in cons of smoking behavior emerged
across the stages of change. However, pros and cons of smoking in the action stage were not
significantly different than other stages of change. In line with self‑efficacy/temptation construct,
the result showed that positive social efficacy, negative affect efficacy, and habit strength were
significantly different between the stages of change. Conclusion: The results provide support to
the advantages of increased self‑efficacy and the role of decisional balance for the intervention
program development for smoking cessation.

Abstract Background: Effective safety education can prevent many occupational accidents. To educate
the public about safety effectively, determinants of safe behavior must be addressed. Personality
constructs are among the most important determinants of safe behavior. One of the personality
constructs that has been studied recently in relation to accidents is locus of control. The main
aim of this study was designing, validating, and determining the reliability of safety locus of
control scale. Materials and Methods: This study was a descriptive, cross‑sectional study. The
“forward–backward” procedure was applied to translate safety locus of control scale (Jones
and Becker 1985) from English to Persian. To determine the scientific validity of the scale , face
validity and content validity by expert judgments were used. Internal consistency was determined
using Cronbach’s α‑coefficient. Questionnaires were distributed to a group of 400 workers from
different parts of Isfahan Steel Company. Finally, 317 workers completed the questionnaires.
Exploratory factor analysis was performed with software SPSS13, and confirmatory factor
analysis was performed with software LISREL8.8. Results: The exploratory factor analysis
results revealed that the three components of the items can be extracted from the scale including
internal control (4 questions), environmental and equipment control (4 questions), and chance
and fate (4 questions). Confirmatory factor analysis using maximum likelihood estimation results
indicated that the data had good fit with three‑component scale and fit indices were acceptable:
c2
∕df=3.96, df=41, c2
=120.59, RMSIA=0.080, 95% Confidence Interval=0.64–0.097, CFI=0.96,
GFI=0.94, AGFI=0.89. The internal control components and equipment and environmental
control were negatively correlated with each other (P≤0.05, r=−0.41). Also, a weak correlation
between chance and fate and environmental and equipment control was seen (P≤0.05, r=0.31).
Conclusion: In most studies, designing a scale and determining its validity and reliability is
costly and time consuming. The available reliable and valid scale leads to reduced costs and
accelerated research. In other words, duplication will be avoided. The scale obtained in this study
can be used in safety and industrial psychology research.