Journal of School of Public Health and

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Diabetes is a chronic disease of lifelong duration, and its management requires a fundamental change in the patient’s lifestyle. The aim of this study was to evaluate the efficacy of a health education program on the knowledge, behavior, HBA1c and health related quality of life of diabetic patients after following the patients’ participation in the program. The study population consisted of type 2 diabetic patients attending at Bandar Abbas diabetic clinic. Eighty patients were randomly selected and they were randomly assigned to two groups, 40 to the intervention and 40 to the control group. At the initial visit and 4 months after education, knowledge and behavior were assessed by questionnaire HBA1c measured by colorimetric method and health-related quality of life assessed by means of WHOQOL-BREF questionnaire. The education sessions for intervention group were held at diabetic clinic. The 40 patients that assigned to the control group gave the appropriate consent and completed questionnaires at baseline and after 4 months. The intervention group had statistically significant increase in the mean of knowledge score from 6.7 to 15.8(p=0.000), physical health from 64.7 to 77.2 (p=0.000) and psychological health from 56 to 71.4(p=0.000) and had statistically significant reduction in the mean of HBA1c from 9.4 to 8.2 (p= 0.000).Also the intervention group had statistically significant increase in self-monitoring blood glucose, weight monitoring, exercise and diet. Patients in control group showed no significant changes in the outcomes measured except for knowledge.

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Background and Aim: The role of fresh water snails as the intermediary host in transmitting parasitic infestations in man and animals is well known. In Iran, urinary schistosomisasis is known to be endemic in the Khuzestan Province, south-west of the country. Considering the Egyptian experience concerning the negative effects of Aswan Dam construction on expanding the prevalence of human bilharziasis, the possible role of huge agro-industrial sugar-cane projects on eliminating schistosomiasis in the only known endemic province of Khuzestan in Iran came to our attention. The main objective of this study was to identify the species of fresh water snails in a vast area under cultivation of sugar cane in Khuzestan province, S.W. Iran.

Methods and Materials: Thirty locations (points) under cultivation of sugar-cane in the area were selected for snail collection. In the selected localities there existed drains, canals, ditches, and water stands. Preliminary identification of snails was performed at the time of collection. A more complete taxonomical study was made after the samples were transferred to the laboratory of Dezful Health Research station.

Results: The total number of snails collected was 3825 snails, and seven different species were identified: Physa sp . (29%), Gyraulus sp. (19%), Melanoides sp. (16%), Bellamya sp. (14%), Melanopsis sp. (12%), L. gedrosiana, (7%)L. truncatula(2%). No Bulinus truncatus was seen .

Conclusion: Most of these snails are capable of getting involved in the life cycle of some zoonotic helminth parasites, e.g., Fasciolid and Heterophyd. These findings are encouraging. However, in order to avoid any possible undesirable effects on the public's health, constant monitoring, as well as annual malacological surveys, is essential.

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Background and Aim: In social marketing, the common techniques of commercial marketing are used to increase the chances of acceptability of an idea or action by the target group. In this study, we determined the impact of an intervention based on social marketing to reduce risky driving behaviors among taxi drivers in Tehran.

Materials and Methods: This was a quasi-experimental study, consisting of a quantitative and a qualitative part, on taxi-drivers in 2 regions (an intervention and a control groups) in the City of Tehran. Based on a formative research approach, the components of social marketing, namely, the product (reminder message for concentrating on avoidance of two target behaviors, tailgating and not driving between lines), price, place and promotion were determined. An 8-week educational program was implemented, the components being installation of stickers before the driver's eyes, distributing a pamphlet, and transferring messages through taxi route supervisors as opinion leaders. After six weeks, risky driving behaviors were assessed by checklists and compared.

Results: The intervention resulted in statistically significant reductions in the two target behaviors in the intervention group as compared with the control group. Furthermore, logistic regression showed that the odds ratio for avoiding both behaviors increased significantly in the intervention group. 

Conclusion: Determining specific target groups, designing interventions based on actual needs and wants of the target group, and focusing on the factors influencing the behavior market are the basic elements of social marketing. Due consideration of these elements when designing behavioral interventions would lead to reductions in risky driving behaviors.

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Background and Aim: Many studies show that the only way to control diabetes and prevent its debilitating complications is continuous self-care. This study aimed to determine factors affecting self-care behavior of diabetic women in Khoy City, Iran based the extended theory of reasoned action (ETRA).

Materials and Methods: A sample of 352 women with type 2 diabetes referring to a Diabetes Clinic in Khoy City in West Azarbaijan Province, Iran participated in the study. Appropriate instruments were designed to measure the relevant variables (diabetes knowledge, personal beliefs, subjective norm, self-efficacy and behavioral intention, and self-care behavior) based on ETRA. Reliability and validity of the instruments were determined prior to the study. Statistical analysis of the data was done using the SPSS-version 16 software.

Results: Based on the data obtained, the proposed model could predict and explain 41% and 26.2% of the variance of behavioral intention and self-care, respectively, in women with type-2 diabetes. The data also indicated that among the constructs of the model perceived self-efficacy was the strongest predictor for intention for self-care behavior. This construct affected both directly and indirectly self-care behavior. The next strongest predictors were attitudes, social pressures, social norms, and intervals between visiting patients by the treating team.

Conclusion: The proposed model can predict self-care behavior very well. Thus, it may form the basis for educational interventions aiming at promoting self-care and, ultimately, controlling diabetes.

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Background and aim: Delivery or parturition is the peak of a woman’s pregnancy period, accompanied with birth of one or more babies. Unfortunately, Cesarean section, despite its probable undesirable health and economic consequences, has become more and more common. Considering that the goal of health education is behavior change in people, the objective of this study was to investigate the role of health volunteers in educating mothers consulting the health care centers in Ardabil in the area of choice of delivery method based on the Behavioral Intention Model (BIM).
Materials and Methods: In this experimental study, 140 primaparous mothers in Ardabil city in the seventh month of pregnancy were selected by systematic random sampling and divided into a case and a control group, and a written pretest was given to both groups. Education based on the BIM was imparted to the case group. One month after delivery, both groups were post-tested. The data on awareness, attitude, results evaluation and practice were analyzed using the Wilcoxon, Mann Whitney-U and Chi-square tests.
Results: The findings revealed statistical differences between the case and control groups after intervention with regard to awareness, evaluation of results and attitude (p<0.001). However, behavioral intention did not change (p=0.106).
Conclusion: Although health volunteers' participation results in an increase in knowledge and promotes attitude and evaluation of behavioral results in pregnant women, it does not change their behavioral intention. It is suggested to conduct similar studies for comparative purposes involving other trainers, such as physicians and nurses in other cities, using other educational models and methods.

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Background and Aim: Diabetes mellitus (DM) is one of the most common public health problems worldwide. Diabetic foot as a late complication of DM imposes high physical and emotional costs to the patients. The purpose of this study was to determine the effect of an educational program based on the Health Belief Model (HBM) on diabetic foot care in type-2 DM patients.
Materials and Methods: Ninety seven (female=57, male=40) type-2 diabetes patients, randomly divided into two groups ̶ and intervention (n = 47) and a control group (n = 50) ̶   participated in this study. Using questionnaires data were collected, initially and 3 months after the educational intervention, on demographic characteristics, awareness and the HBM constructs. The intervention group participated in 3 educational sessions during the3-month period. The data were analyzed by SPSS 20, the statistical test being Shapiro-Wilk, Chi-Square, Wilcoxon, McNemar tests and paired T-Test.
Results: There were no statistically significant differences before the intervention between the experimental and control groups with respect to the mean scores of knowledge and HBM’s components (perceived susceptibility, severity, benefits and barriers, as well as self-efficacy and self-care). The intervention improved the scores significantly in the experimental groups (p<0.05), while there were no significant changes in the control group scores (p>0.05). 
Conclusion: This study shows that type-2 diabetic patients need to learn how to take care of their feet and that implementing educational programs based on the Health Belief Model can be effective in this regard.
 

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Background and Aim: Observance of the principles of infection control in dentistry is the basis of preventing the transmission of dangerous diseases such as AIDS, hepatitis and preventing the spread of diseases in the community. In view of the importance of dentistry education in the field of observance of the principles of infection control, the aim of this study was to determine the effect of educational intervention on infection control among dental students of Shahid Beheshti University of Medical Sciences.
Materials and Methods: The present study is a pre and post interventional study that the number of samples is 75 dental students referred to Endodontics Department of Shahid Beheshti University of Medical Sciences for endodontic treatment and radiotherapy of teeth during treatment in the academic year of 95-96 that were selected by available sampling method and after determining the sample size, a researcher-made questionnaire was prepared based on the Health Belief Model and verified in terms of validity and reliability, and completed in two stages before and after training with a 3 month interval. Three training sessions were conducted in this study for 15-30 minutes during the course of one month as group training and question and answer. During these meetings, students were given useful materials about infection control in dentistry, pathogenic microorganisms, transmission methods, and infection control guidelines in dentistry radiology. The data gathering tool was a questionnaire based on Health Belief Model. after data collection, spss21 software was used to analyze them. Non-parametric Kolmogorov-Smirnov tests, paired t-test and non-parametric Wilcoxon test were used for statistical analysis of the 0/05 significance level before and after the knowledge and structures of the health belief model.
Results: The results of statistical analysis showed that 62.7% of the participants were female students and 89.3% of single students, and the participants in the study were from 8,9,11 terms. The results of this study showed that the mean and standard deviation of knowledge and performance scores of students toward infection control before training were 11.48 ± 2.23 and 5.48 ± 0. 93, respectively, and after the training were increased to 14.75±0.57 and 9.36 ± 0.91. This difference was statistically significant by doing paired t-test (p  the comparison of the mean and standard deviation of the scores of other aspects of the health belief model regarding infection control among dentistry students also showed a significant increase.
Conclusion:  According to the results, it can be concluded that education based on the health belief model has been effective in controlling infection in dentistry students.

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Background and Aim: Primary health care is a holistic approach that aims to maximize people's health and well-being as quickly as possible in their immediate living environment. The primary health care system is the first point of contact of the people with the health system. Therefore, increasing its resilience will play a significant role in controlling and managing pandemics. This research aimed to identify strategies to strengthen the resilience of the primary health care system in the Covid-19 pandemic.

Materials and Methods: This study was conducted using the scoping review method. Using appropriate keywords search was done on the subject of the study in PubMed, Web of Science, Scopus, SID, Iranmedex and Magiran databases and Google and Google Scholar search engines. Finally, after screening and reviewing the titles, abstracts and texts of the retrieved documents, 36 articles were selected and strategies to strengthen the resilience of the primary health care system in the Covid-19 pandemic were extracted from them.
Results: A total of 48 strategies/solutions were extracted to strengthen the resilience of the primary health care system, categorized into 6 groups, namely, governance and leadership, financing, human resources, medicines and equipment, health information systems, and health service delivery. Among the most frequently solutions mentioned were the following: Dynamic and accountable leadership, using valid research evidence in policy-making, contingency planning, increasing inter-sectoral cooperation, advocacy for health policies, community involvement, sustainable financing, recruiting additional staff and training and supporting them, providing sufficient stocks of medicines and diagnostic kits, developing and modernizing public health information systems, facilitating people's access to health centers, continuing to provide health services, and increasing the community’s health literacy.
Conclusion: The structural and process components of the primary health care system including "governance and leadership", "financing", "staff", "equipment, vaccines and medicines", "information" and "health care delivery" should be strengthened in a coordinated manner in the primary health care system to be prepared for future epidemics.