Mahdi Moshki

The effect of educational intervention on prevention of postpartum depression: an application of health locus of control

AIMS AND OBJECTIVES To assess the effectiveness of application of health locus of control in pregnant women for prevention of postpartum depression in Iran. BACKGROUND Nearly 10-15% of women suffer postnatal depression by the end of the second week after delivery, which creates problems in caring for the child that may affect childs future learning and concentration. DESIGN Pre-post experimental design. METHODS Two hundred and thirty volunteer women were randomly divided into experimental and control groups. The data collection tools included a demographic questionnaire, the Multidimensional Health Locus of Control Scale and the Edinburg Depression Scale. Based on the associations found in the pretest, intervention programme was planned and carried out in the focused group discussion method. Data were collected after the end of scheduled sessions, immediately and one month later. The data were analysed with SPSS-16 using statistical methods including anova, chi-square test, Students t-test and paired t-test. RESULTS Chance health locus of control significantly reduced and internal health locus of control significantly increased, immediately after intervention. Also, a month after intervention, a significant difference was observed between the two groups in reducing postpartum depression. CONCLUSIONS The planned participatory intervention led to empowerment and increased awareness and internalisation of health control beliefs and less tendency towards external health control beliefs, especially chance, improvement in general health leading to improved psychological health for prevention of postpartum depression in mothers. RELEVANCE TO CLINICAL PRACTICE Clinicians might assess chance and internal health locus of control to identify the women at risk of developing depression during their pregnancy and to develop prevention and treatment plans.

Effect of Precede–Proceed Model on Preventive Behaviors for Type 2 Diabetes Mellitus in High-Risk Individuals

This study sought to assess the effect of precede–proceed model on preventive behaviors for type 2 diabetes mellitus (DM) in high-risk individuals. In this semi-experimental study, 164 high-risk individuals for type 2 DM were selected and were randomly divided into two groups of intervention and control (n = 85). Educational intervention was performed as a single session face-to-face instruction for 1.5 hr for the intervention group participants. Data were collected before (baseline) and immediately and 1 month after the intervention in the two groups. The mean score of predisposing (knowledge) factors (p = .001), reinforcing factors (p = .001), and enabling factors (p = .02) were significantly different at baseline and 1 month after the intervention in the intervention group compared with the control group (p < .05). A significant improvement occurred in the nutritional habits of high-risk participants in the intervention group at 1 month after the intervention compared with controls (p = .001). The precede–proceed model can be effective for promoting the preventive behaviors for type 2 DM in high-risk individuals.

Facilitator Psychological Constructs for Mammography Screening among Iranian Women

BACKGROUND While many researchers often use a theoretical framework for mammogram repeat interventions, it seems they do not apply an identified mediation analysis method. The aim of this study was to determine the mediators of mammogram replication behavior in two tailored interventions for non-adherent Iranian women. MATERIALS AND METHODS A sample population of 184 women over 50 years old in Sanandaj, Iran, was selected for an experiment. Participants were randomly allocated into one of the three conditions: 1) an intervention based on the Health Belief Model (HBM) 2) an intervention based on an integration of the HBM and selected constructs from the Theory of Planned Behavior (TPB), and 3) a control group. Constructs were measured before the intervention, and after a 6-month follow-up. RESULTS Perceived self-efficacy, behavioral control, and subjective norms were recognized as mediators in the HBM and selected constructs from the TPB intervention. Perceived susceptibility, severity, barriers, self-efficacy and behavioral control met the criteria for mediation in the HBM intervention. CONCLUSIONS This study was successful in establishing mediation in a sample of women. Our findings enrich the literature on mammography repeat, indicating key intervention factors, and relegating redundant ones in the Iranian populations. The use of strategies to increase mammography repeat, such HBM and TPB constructs is suggested to be important for maintaining a screening behavior, once the behavior has been adopted.

Efficacy of Peer Education for Adopting Preventive Behaviors against Head Lice Infestation in Female Elementary School Students: A Randomised Controlled Trial

Background Pediculosis is a common parasitic infestation in students worldwide, including Iran. This condition is more prevalent in populous and deprived communities with poor personal hygiene. This study sought to assess the efficacy of peer education for adopting preventive behaviors against pediculosis in female elementary school students based on the Health Belief Model (HBM). Methods A total of 179 female fifth grade students were selected using multistage random sampling and were randomly allocated to control and intervention groups. A standard questionnaire was designed and administered to collect baseline information. An educational intervention was then designed based on the conducted needs assessment. The educational program consisted of three sessions, held by peers for the intervention group. The questionnaire was re-administered one month after the intervention. Independent and paired t-test, Pearson’s correlation coefficient, and regression analysis were applied as appropriate. Results The two groups had no significant differences in the scores of knowledge, HBM constructs, or behavior before the intervention. After the intervention, however, the mean scores of all parameters significantly improved in the intervention group. Conclusion Peer education based on HBM is an effective strategy to promote preventive behaviors against pediculosis in among fifth grade female elementary school students in Iran.

Relationships among depression during pregnancy, social support and health locus of control among Iranian pregnant women.

Background: Prenatal depression is a significant predictor of postpartum depression and is detrimental to fetal development. Aim: To examine whether depression during pregnancy is associated with social support and health locus of control (HLC). Method: Data were collected from a sample of 208 Iranian pregnant women using a demographic questionnaire, the Edinburgh Postnatal Depression Scale, the multidimensional HLC Scale and the social support appraisals. Results: Depression was experienced by 37% of participants. Overall, women reported higher level of family support (6.88 ± 1.15) than other supports (6.87 ± 1.29). Protective supports from other resources (6.87 ± 1.29) were higher than those from friends (5.94 ± 1.5). Internal, powerful others and chance beliefs had the highest mean scores. Social support and chance HLC significantly influenced the proposed mediator (depressive mood) in the linear regression model. Bivariate analysis showed significant associations between social support (friend, family and others) and depressive mood. Internal HLC had a significant association with social support and powerful others HLC. However, Pearson correlation coefficient was not significant between depressive mood and all dimensions of HLC. Conclusion: Clinicians could assess social support and chance HLC to identify and treat women at risk of prenatal depression. By providing support during pregnancy, depression levels in women and its effects on the fetus may be decreased, which could prevent postpartum depression.

Educational intervention to improve oral health beliefs and behaviors during pregnancy: a randomized-controlled trial.

BACKGROUND Oral and dental health is one of the most important aspects of public health, which becomes more important during pregnancy. Health education may effectively prevent a considerable percent of oral and dental diseases. OBJECTIVE This study was designed to evaluate the effects of an oral and dental health educational intervention during pregnancy on the beliefs and behaviors of pregnant women on oral and dental health. PARTICIPANTS AND METHODS In this randomized-controlled clinical trial, 160 pregnant women were allocated randomly to intervention and control groups (80 in each group). The intervention group received six education sessions over 3 weeks on oral health issues, whereas the control group received no education. Beliefs and behaviors of pregnant women on oral health were evaluated before, immediately, and 2 months after the educational intervention using a self-administered questionnaire containing 13 Likert scale belief statements and nine practice items. RESULTS There were no significant differences in the scores of behaviors between the two groups, whereas the scores of beliefs of the educated group were lower than the controls at baseline. The scores of beliefs and behaviors were significantly higher in the educated group than the controls immediately and 2 months after the education program (P<0.05). CONCLUSION AND RECOMMENDATIONS The results of the present study indicated the positive effects of oral health training during pregnancy in promoting the beliefs and behaviors of pregnant women on oral health. More attention to oral and dental education programs is recommended during pregnancy.

The prediction of postpartum depression: The role of the PRECEDE model and health locus of control

Background: The main purpose of this study was to investigate the effect of the PRECEDE model and health locus of control (HLC) on postpartum depression. This study used the path analysis to test the pattern of causal relations through the correlation coefficients. Materials and Method: The participants included 230 pregnant women in the north-east of Iran who were selected by convenience sampling. To analyze data, Pearson correlation and path analysis were applied to examine the relationships between variables using SPSS 20 and LISREL 8.50software. Results: The result of path analysis showed that a positive correlation exists between predisposing (knowledge, internal HLC, powerful others HLC, chance HLC) enabling and reinforcing factors with postpartum depression by GHQ score (GFI = 1, RSMEA = 000). Conclusion: The current study supported the application of the PRECEDE model and HLC in understanding the promoting behaviors in mental health and demonstrated their relationships with postpartum depression.

A Predictive Model of Apartment-Living Based on Socio-Economic and Demographic Factors With Health-Based Approach in Iran

Objective: Due to importance and progressive growth of apartment-living phenomenon in the world today, it is essential to survey the different dimensions of this modern lifestyle. The aim of this study is to predict rate of apartment-living based on the different predicted variables of socio-economic and demographic factors with approach to different health aspects. Methods: A descriptive- analytic study was carried out between 600 apartment and 800 non-apartment residents in the Shiraz (Southern Region of Iran) through multi-stage cluster sampling during the year 2011. The statistical analysis was performed on the obtained data using multi-variable logistic regression as well as ANOVA analysis. Result: The rate for apartment-living in above 30 years old age group was 8.31 times more than 15-30 years old, 9.6 times more in employed vs. unemployed; 6.57 and 9.49 times more in families with average and high monthly incomes, respectively, vs. family with low monthly income; 8.73 times more in owner sub-group vs. renter sub-group; and 1.30 times more in people living lonely than those living with family. People living in an apartment are in poor health status considering physical, mental and social aspects. Conclusion: Based on the results, it is very important that policy makers in urban areas consider the determinative role of socio-economic and demographic factors, which are involved in selecting apartment-living lifestyle by urban residents and also are effective on health.

Effectiveness of the teach-back method in improving self-care activities in postmenopausal women

Introduction Menopause is a physiological process during which women can improve their quality of life by taking proper self-care measures. Performing self-care requires proper and effective training. The present study was conducted to investigate the effect of self-care training programs based on the teach-back method on the self-care status in postmenopausal women. Material and methods The present clinical trial was conducted in 2016 in Gonabad, in the east of Iran. Eighty postmenopausal women, whose last menstrual period was 1-5 years earlier, were randomly allocated to an intervention group (n = 40) and a control group (n = 40). The intervention group attended four 45-minute sessions of a training program based on the teach-back method on the principles of self-care during menopause, whereas the control group received no training. Knowledge and self-care status were assessed in all subjects before and one month after implementing the training program. The data were analysed in SPSS-20. P < 0.05 was set as the level of statistical significance. Results Before the intervention, no significant differences were observed between the two groups in terms of demographic variables, including age, occupation, level of education, and the time elapsed since the last menstrual period (p > 0.05). No significant differences were observed between the two groups also in terms of the score of knowledge about menopause and self-care practice before the intervention (p > 0.05). The mean scores of knowledge and self-care were found to be significantly higher in the intervention group compared to those in the controls one month after the intervention (p < 0.0001 and p = 0.001, respectively). Statistically significant differences were observed between the two groups in terms of the change scores of knowledge and self-care practice before and one month after the intervention (p < 0.05). Conclusions The results showed that the self-care education program based on the teach-back method improves the self-care activities in postmenopausal women. It is therefore recommended that healthcare providers apply this method in menopausal care training programs.

The effectiveness of a group-based educational program on the self-efficacy and self-acceptance of menopausal women: A randomized controlled trial

ABSTRACT This study aimed to assess the effectiveness of a group-based educational training on the self-efficacy and self-acceptance of Iranian menopausal women using the PRECEDE–PROCEED model. This Randomized Controlled Trial (RCT) was conducted on 80 menopausal women in the age range of 47–55 years residing in the northeast of Iran. The participants were divided randomly into a test group (n = 40) and a control group (n = 40). We found that designing and implementation of a group-based educational training according to the PRECEDE–PROCEED model can significantly enhance the knowledge and performance of the test group with regard to self-efficacy and self-acceptance.