Journal of Education and Health Promotion

Abstract Objective: To investigate selected constructs of the transtheoretical model (TTM) of behavior
change regarding smoking behavior among people in the preparation stage, as well as
motivation for cessation and nicotine dependency. Methods: A convenience sample of 123
smokers, during between June to and September 2011, completed the Persian version of the
short form of a smoking questionnaire based on TTM, the Fagerstrom nicotine dependence
test, and the motivational test. Results: Motivation for cessation was great (16.35 ± 2.45). The
negative affects of self-efficacy were higher than those to other situations (4.02 ± 0.84). The
pros and cons of smoking were 2.69 ± 1.00 and 3.78 ± 0.78, respectively. Temptation was
influenced by nicotine dependency (P < 0.05). Early initiation of smoking was significantly
associated with severe nicotine dependency (P < 0.05). Conclusion: The results confirm the
role of temptation, increase in the cons, decrease in the pros, and nicotine dependency.

Abstract Introduction: The role of individual healthy behaviors like physical activity, nutrition and stress
management on reduction of rate of disease mortality and morbidity is well known. The aim of
this study is to determine healthy life style in teachers employed in district No.4 in Isfahan, Iran,
in 2010. Materials and Methods: The participants of this cross-sectional study were 96 teachers
in district No. 4, selected via random sampling method. The data collection was performed
using a questionnaire including demographic healthy lifestyle questions. Analysis of the data
was performed through Software SPSS version 18. Results: The mean age of the subjects was
40.26 ± 6.05 years and, BMI mean was 25.08 ± 3.20. 96.8% of them were married and 3.1%
also were single. 1% of the teachers had a weak lifestyle, 13.5%had moderate, 85.4% had a
good lifestyle. In terms of nutrition, 2% of the teachers had a weak lifestyle, 23% moderate,
74% good. 76% in terms of physical activity, 29.2% smoking and 21.9% stress had a weak
lifestyle. Conclusion: According to the results, planning for teachers in school for receiving
information about healthy lifestyle is important.

Abstract Background: Quality gap is the gap between client’s understanding and expectations. The
first step in removing this gap is to recognize client’s understanding and expectations of the
services. This study aimed to determine women’s viewpoint of quality gap in primary health
care centers of Isfahan. Materials and Methods: This cross-sectional study was conducted
on women who came to primary health care centers in Isfahan city. Sample size was 1280
people. Service Quality was used to collect data including tangible dimensions, confidence,
responsiveness, assurance and sympathy in providing services. Data were analyzed by t test
and chi square test. Results: The results showed that women had controversy over all 5
dimensions. The least mean quality gap was seen in assurance (-11.08) and the highest mean
quality gap was seen in tangible dimension (-14.41). The difference between women’s viewpoint
in all 5 dimensions was significant. (P < 0.05) Conclusion: Negative difference means clients’
expectations are much higher than their understanding of the current situation, so there is a
large space to improve services and satisfy clients.

Abstract Background: There are few diverse studies that have reported the case fatality rates of different
methods of suicide, none of them are originated from developing countries. The aim of the
present article is to report the case fatality rates of different methods of suicide in Ilam province
of Iran. Materials and Methods: Data on 611 cases of suicide and 1807 cases of deliberate
self harm (DSH) that were recorded in a comprehensive registry during 1995 through 2002
were analyzed for both genders together and for males and females, separately. Findings: For
both genders together, the two most fatal methods were hanging (75.4%) and self-immolation
(68.3%); for males, hanging (76.3%) and self-immolation (64.7%); and for females, firearms
(75%) and hanging (73.7%), respectively. The least fatal methods for both genders together and
for females and males separately were drug ingestion and cutting. Conclusion: The results of
present study, which for the first time has reported the case fatality rates of suicide methods in
a developing world, would not only help to better plan the local suicide prevention strategies
and clinical assessment of suicidal cases but to shed light on overall understanding of this
mysterious human phenomenon.

Abstract Introduction: Education is basically one of the Universities’ and faculties’ leading missions and
duties; its promoted quality will also lead to an elevated educational quality in the University. Teacher
assessment can be mentioned as essential for the success of the quality promotion process. This
article deals with the designing and evaluation of a teaching quality evaluation form for teachers,
from the Lorestan University of Medical Science students’ point of view. Methods: A two-stage,
cross-sectional study was conducted on 290 Lorestan University of Medical Science students.
First, evaluation priorities were extracted using the Delphi technique in the fifth section, including
teaching skills, communication skills, principles of training, and skills assessment. In the second
stage, as the priority and importance of each item was evaluated in the fourth Lickert option,
sampling was done in few stages. The study instrument was a questionnaire, which included six
areas. The first part of the questionnaire was made up of the demographic characteristics and the
second part included five evaluation areas that were obtained from the student. The collected data
were analyzed using statistical software SPSS-16 and chi-square test, Kruskal-Wallis test. Results:
In the areas of teaching skills, mastery of the course, individual characteristics, self-confidence,
communication skills, intimate relationship with students, educational principles, rules respecting
the beginning and end time of class, skill assessment, and an accurate comprehensive examination
at the end of the semester by the students, were chosen as the most important factors. There
were significant differences in the majority of expressed comments between the genders and
academic status (P < 0.05). Conclusion: Students can properly diagnose the essential factors
in teachers’ evaluation, but in item prioritizing they may be partly affected by some factors such
as gender, academic status, semester, and academic course.

Abstract Background: Communication is the most important part of any educational process, the aim
of which is to transfer or exchange ideas and thoughts. It would be provided appropriately if
academic members had the communication skills. Considering the important role of academic
members in the educational process, in this study, the knowledge, attitude and performance
of academic members of School of Health, Isfahan University of Medical Sciences, were
investigated with regard to effective communication skills. Materials and Methods: In this
descriptive–analytic study, all academic members of the School of Public Health, Isfahan
University of Medical Sciences, were studied during the second academic semester of 2006-
2007. The data were collected by a valid and reliable three-part questionnaire including
knowledge (8 questions and maximum score of 8), attitude (31 questions and maximum score
of 155) and observational communication skills checklist (20 questions and maximum score
of 20). The obtained data were analyzed by calculating central indices using SPSS software.
Findings: The mean knowledge score of studied people in terms of communicational skills,
attitude and performance were 4.1 out of 8, 114.4 out of 155 and 16.3 out of 20, respectively.
Conclusion: Although the information of the participants of this study in terms of communication
skills was not sufficient, they seemed to have a positive attitude and relatively acceptable
performance in communication skills.

Abstract Introduction: 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
bioenvironmental disasters. The aim of this study was to evaluate the health literacy of the
student of the Kerman Public Health School, about the management and recycling of solid
waste. 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
students in health related fields although confirm its necessity, but 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 Background: The purpose of this study was to assess nutritional intakes of female aerobic athletes
in two different socio-economic classes in city of Isfahan. Materials and Methods: The participants
of this analytical study were 99 female aerobic athletes aged between 15 and 50 years old who
were randomly sampled (50 females in low economic region and 49 females in high economic
region). The demographic details were collected by a questionnaire, and anthropometric indexes
including height, weight, and waste circumference were measured using a tape measure and a
scale. They filled out the 24-hour food recall questionnaire for two consecutive days in order to
obtain their nutritional information. To analyze the data, Nutritionist 4 and SPSS18 software were
used. Results: The means of energy intake in high and low regions were 1479.19 ± 561.86 and
1300.68 ± 498.354 kcal, respectively. There was no significant difference in terms of energy intake
between these two groups (P = 0.98). The means of protein intake in low and high socio-economic
classes were 17.41 ± 5.85 and 54.48 ± 6.62, respectively, and no significant differences were
observed between these two regions (P = 0/606). The means of carbohydrate intake were 61.85
± 9.76 and 54.48 ± 6.62 in the low and high socio-economic classes with a significant difference
between them (P < 0.001). The mean of carbohydrate intake in the low socio-economic class was
considerably higher than that in the high socio-economic class. The means of fat intake were 23.88
± 8.24% and 30.07 ± 6.68% in the low and high socio-economic classes, respectively, and the
means of fat intake in the high socio-economic region was significantly higher than that in the low
socio-economic region (P < 0/001). Conclusion: The findings of this study indicated that the intakes
of fat and carbohydrate were significantly different in the two different socio-economic regions in
city of Isfahan. This difference could be attributed to different food patterns in these two regions.

Abstract Introduction: Medical tourism is rapidly becoming a worldwide, multibillion-dollar industry.
Iran has a high potential for this industry. The purpose of this study was to examine the
medical tourism cluster, using Diamond Analysis tool. Materials and Methods: This study is
a descriptive, analytical and qualitative one. Thirty professionals and researchers in this field
were interviewed and official documents belonging to the Health ministry as well as tourism
organization and finally related literature were examined. The data was analyzed using content
analysis method. Results: Positive and negative parts of the medical tourism industry of Iran
were determined according to diamond of advantage. Conclusion: The strategic issues were
identified and a number of possible solutions for addressing them were recommended. More
and effective public-private participations, aggressive marketing, improving infrastructures, and
international accreditation of health care facilities and human resources development could
improve medical tourism industry in the country.

Abstract Introduction: Residents have an important role as teachers and need to know about teaching,
teaching methods and skills. In developed countries, “resident-as-teacher” programs have
been implemented progressively; but there is little information about this theme in developing
countries such as Iran. This study aimed to determine effects of “teaching method” workshop
on surgical residents’ teaching skills in Isfahan University of Medical Sciences. Materials and
Methods: In this quasi-experimental study, 18 residents in 1st, 2nd, and 3rd years of surgical
residency in Isfahan University of Medical Sciences have attended in a 10-hour workshop.
Two questionnaires (validity and reliability) was verified: Clinical teaching self-assessment and
clinical teaching evaluation was completed before and after the intervention (“teaching method”
workshop) by attending residents and rater interns, respectively. Paired-samples T-test was
used to analyze collecting data. Results: After intervention, Self-assessment mean scores were
increased in two categories: feedback from 3.34 to 3.94 (P = 0.011) and promoting self-directed
learning from 3.53 to 4.02 (P = 0.009); whereas, there was no significant differences in evaluation
mean scores. Conclusion: Statistical results from self-assessment and evaluation scores show
little improvement in residents’ teaching skills after the intervention, but residents assessed the
workshop as useful. Lack of motivation in interns and little reward for residents who attend in
educational activities could be responsible for these results. So, to promote role of residents’
as teachers, we offer revision in residency curriculum and residents’ formal duties as well as
designing educational programs in teaching theme based on our needs and resources.