1 2345-346X Iranian Journal of Health Education and Health Promotion 651 Explanation of Pap Smear Preventive Behavior among Women Based on Health Belief Model: A Qualitative Study Bahmani Afshin b Rahmani Khaled c Ahmadian Farzaneh d Alizadeh Zainab e Akhtar Bahieh f b Kurdistan University of Medical Sciences. Sanandaj,iran. c Epidemiology, Dep. of Epidemiology, School of Health, ShahidBeheshti University of Medical Sciences, Tehran, Iran. d Kurdistan University of Medical Sciences. Sanandaj,iran. e Kurdistan University of Medical Sciences. Sanandaj,iran. f Kurdistan University of Medical Sciences. Sanandaj,iran. 1 6 2017 5 1 5 14 27 09 2016 22 02 2017 Background and objective: Cervical cancer is one of the most prevalent cancers among women. Although Pap smear test is an effective screening program, it is not conducted very frequently. This study aimed to recognize the determinants affecting women's participation in Pap smear test screening, with a qualitative approach, based on the health belief model (HBM). Materials and methods: This was a qualitative research, based on thematic analysis, conducted in 2015. Participants were 30 rural women who participated in this study voluntarily in Sarvabad County in Kurdestan Province in Iran. Purposive sampling was used to recruit participants and sampling continued until data saturation. Semi-structured interviews were used to collect the data. Data were analyzed using thematic analysis. Results: Based on participants’ perception, more of the women believed that they were not at risk for cervical cancer; however, they perceived the severity of the disease. Some of them did not have an adequate understanding of the test benefits. They pointed to financial difficulties, fear of test result and lack of awareness are the main barriers in taking Pap smear test. Conclusion: Several factors affect women's participation in screening and Pap smear test. These factors include the components of social, economic, cultural, attitudes, individual beliefs, lack of awareness, fear, etc. Findings of this study could help health administers and planners in designing and implementing interventional programs such as theory-based educational programs,  face-to-face educational classes, expert advice and speech of clergy people and influential community people to increase women’s participation in Pap smear test screening program. Paper Type: Research Article.
564 Concepts and Indexes of Elder Abuse: The Conceptual Framework for Applied Studies in the Field of Elder Abuse Estebsari Fatemeh g Mostafaei Davood h Khalifehkandi Zahra Rahimi i Estebsri Kimia j Taghdisi Mohammad Hossain k g Shahid Beheshti University of Medical Sciences h Shahid Beheshti University of Medical Sciences i Iran University of Medical Sciences(IUMS j Lorestan University of medical science k Iran University of Medical Sciences(IUMS 1 6 2017 5 1 15 19 29 05 2016 01 11 2016 Background and Objectives: Due to physiological and anatomical changes elders are more susceptible and exposed to numerous dangers including elder abuse.  Elder abuse is a complex issue; so that it is mentioned as one of the indirect predictors of death which it is hard to assess. The objective of this study was to make researchers become familiar with the concepts, types and indexes of elder abuse. To reach a uniform concept towards this issue will help to make more cohesive actions to track and reduce cases of elder abuse. Results: Different definitions of elder abuse and a variety of elder abuse, indicators and behaviors associated with each type of harassment was offered. The first and most important step in dealing with a phenomenon is to become familiar with the concepts and terminology position. conclusion: Based on the findings of this study, uniform concepts in the field of elder abuse and its different variety will help policy makers and planners have access to the uniform concept in this field. In addition, it is used in setting policy and related policies for the elderly to pay special attention to elder abuse as a specialized subject. Paper type: Review Article. 459 The Impact of Applying the Breast Crawl (TBC) with other Educational Strategies on Breastfeeding Self-Efficacy after the First Breastfeeding among Primiparous Women in Dezful Abdollahipour Fereshteh l Nouhjah Sadigheh Latifi Seyed Mahmood Araban Marzieh o l Ahvaz Jundishapur University of Medical Science o Social Determinants of Health Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran 1 6 2017 5 1 20 32 29 11 2015 30 10 2016 Background and objective: Breastfeeding self-efficacy could be a strong predictive factor in breastfeeding. The aim of this study was to compare the impact of breastfeeding self-efficacy applying TBC (crawling baby to the mother’s breast) and other self-efficacy promoting strategies after the first breastfeeding in primiparous women admitted to the maternity ward of Ganjavian hospital in the city of Dezful, Khuzestan Province, Iran. Materials and methods: In this quasi-experimental study, the sample size was 120 primiparous pregnant women admitted to the maternity ward of Ganjavian hospital in Dezful. Eligible individuals with consent were enrolled in the study. Participants completed a five-part pre-test questionnaire prior to childbirth. After childbirth, subjects were randomly divided into two intervention groups and one control group. Post-test was taken by breastfeeding self-efficacy questionnaire during the first 24 hours after delivery. For data analysis, descriptive statistics and ANOVA were used through SPSS 16. Significant correlation was considered as p < 0.05. Results: Breastfeeding self-efficacy scores increased in all three groups. But only the intervention group based on educational strategies showed a statistically significant compared to the control group (p = 0.039). The breast crawl (TBC) group showed no statistically significant (p = 0.076) compared with other groups (p = 0.990). Conclusion: Due to the many advantages of TBC, besides educating based on self-efficacy promoting strategies, TBC is also recommended for primiparous Paper type: Research Article. 488 Effects of Nutrition Education on Anthropometric Indices, Biochemical and Sonographic Findings of Patients with Non-alcoholic Fatty Liver Disease (NAFLD) Tehrani Masoumeh p Baji Zahra Shakerinejad Ghodratollah Hajinajaf Saeedeh Jarvandi Farzaneh Saki Maryam p ACECR-Khuzestan ACECR-Khuzestan ACECR-Khuzestan ACECR-Khuzestan ACECR-Khuzestan ACECR-Khuzestan 1 6 2017 5 1 33 42 10 01 2016 24 09 2016 Background and objective: Nonalcoholic fatty liver disease (NAFLD) is one of the most common liver disease. It occurs most commonly among obese and overweight people. This study was performed to determine the effect of nutrition education on anthropometric indices, biochemical and sonographic findings in patients with NAFLD Referring to Khuzestan Diet Therapy clinic, Academic Center for Education, Culture and Research (ACECR), Branch of Khuzestan, in Ahvaz, Iran. Materials and methods: This study was a before and after interventional study carried out on 30 NAFLD patients. Selected variables were evaluated at the time before and after three month intervention by nutrition education for patients. SPSS 19 and statistical tests, including descriptive, paired samples t-test and non-parametric sign test was used to analysis the data. Results: The average age of the patients were 44.8 ± 11.2 years. Anthropometric indices decreased significantly after three months nutrition education intervention (p< 0.001). Hepatic enzymes and lipid profiles declined at the end of intervention in which it was only statistically significant about ALT and AST (p< 0.001). Sonographic findings of patients indicated a significant reduction in severity and grade of disease after intervention. Conclusion: Nutrition education could affect the anthropometric and biochemical indices and improve the liver function of NAFLD patients. Paper type: Research Article. 539 The Relationship Between Demographic Factors and Marital Satisfaction of Couples Intended to Divorce Referred to Family Judicial Complex in Borujerd County Ghofranipour Fazlollah Aminshokravi Farkhondeh Torkashvand Roya School of Medical Sciences, Tarbiat Modares University School of Medical Sciences, Tarbiat Modares University School of Medical Sciences, Tarbiat Modares University 1 6 2017 5 1 43 50 11 04 2016 30 01 2017 Background and objective:  Marital satisfaction is affected by many factors among which the safe and pleasurable marital relationships are the most important one. In Iran, marital satisfaction involves socio-cultural obstacles as well as the limiting policies which make research difficult. Therefore, adequate information is not available in the area. The aim of this research was to determine marital satisfaction level among the couples who intended to separate from each other and its association with some demographic factors. Materials and methods: This descriptive-correlation study was conducted in 2015 through Black size Randomization among 130 couples intended to divorce referred to the family judicial complex in Borujerd County, Iran. ENRICH and demographic questionnaires were used for data collection and were analyzed through SPSS21. Results: Marital satisfaction of 51% of women and 57% of men were low. The results also showed that there was a statistically significant association between marital satisfaction and the following factors: age difference of couples (p = 0.000), duration of married life (p = 0.048), education (p= 0.035) and income (p =0.041) and age difference of women (p = 0.000), marital type (p = 0.839), education (p = 0.045), but there was no statistically significant association between marital satisfaction and other factors tested in this study. Conclusion: According to the results, practical strategies to improve couple's awareness about marital satisfaction and its vital influences on marital satisfaction is recommended. Further studies are needed to be done in order to provide research-based information in this field. Paper type: Research Article. 586 Decision Making in Health Education and Health Promotion Interventions Using the Evidential Reasoning Approach Ebrahimnia Mehdi Akhoundi Ali Rouhollahi Mahboubeh Taghdisi Alireza Baqiyatallah University of Medical Sciences School of Civil Engineering, University of Tehran School of Environmental Engineering, University of Tehran , Islamic Azad University, Research Branch 1 6 2017 5 1 51 57 03 07 2016 17 01 2017 Decision making in health education and health promotion is often faced with problems that are affected by different factors simultaneously. In this case, researchers have to deal with multi-criteria decision-making problems. Considering the fact that many factors have an effect on the decisions that are to be made in health education and health promotion, using a method that can deal with both qualitative and quantitative criteria and data with a degree of uncertainty is highly beneficial. The evidential reasoning approach is a multi-criteria decision-making method that can be used to select the most preferable option, based on comments from different experts. The benefits of this method are the ability to receive and use data in different formats with or without uncertainty. Thereby resulting in more reliable and sophisticated answer than many other multi-criteria decision-making methods.  Paper type: Review Article. 806 Relationship of Perceived Benefits and Perceived Barriers with Regular Physical Activity Among Employees of Mashhad University of Medical Sciences Vafaee-Najar Ali Ebrahimipour Hosein Behzad Fatemeh Tehrani Hadi Mashhad University of Medical Sciences Mashhad University of Medical Sciences Mashhad University of Medical Sciences Mashhad University of Medical Sciences 1 6 2017 5 1 58 64 19 12 2016 07 04 2017 Background and objective: The development of technology in many developed communities has resulted in sedentary living and the appearance of many non-infectious diseases. In order to solve this problem and change the activity patterns, the factors affecting the physical activity should be clarified. This study tried to determine the benefits and perceived barriers of regular physical activities of the employees. Materials and methods: In this cross-sectional study, 117 employees of health center in Kalat, in Razavi Khorasan Province in Iran, affiliated with Mashhad University of Medical Sciences (MUMS), were studied in 2012-2013. In order to gather the data, a standard questionnaire of perceived benefits and barriers of physical activity was used. The data were analyzed using SPSS 16. Results: The average age of the employees were 34.09 ± 8.08 years and 66 of them (56.4%) were female. Overall, 34.2% of the employees had regular physical activity- 53% of male and 20% of female ones. The mean of perceived benefit scores was 100.3. ±1.4 and the mean of perceived barrier scores was 25.9±6.14. There was a significant relationship between physical activity and the age (p < 0.01) as well as the level of education (p < 0.01) but the presence or absence of physical activity had no significant relationship with the perceived benefits (p =0.58). Conclusion: Lack of adequate facilities for physical activities such as being far away, time-consuming and tiring due to exercise were the barriers for doing physical activities and some other factors like being interested in the exercises motivate the employees to do the physical activities. Paper Type: Research Article. 593 The Effect of Training Program Based on Health Belief Model Developed by the Fear of Self-Care Behavior and Hba1c Levels in Patients with Type 2 Diabetes Porgholmi Morteza Farmanbar Rabiollah Kasmaei Parisa Omidi Saeed Guilan University of Medical Sciences Guilan University of Medical Sciences Guilan University of Medical Sciences Guilan University of Medical Sciences 1 6 2017 5 1 65 72 16 07 2016 30 01 2017 Background and objective: Diabetes is a serious and a chronic disease. With proper training diabetes can be prevented up to 80%. Therefore, patients with diabetes should be trained in terms of self-care due to the reason that the most important factor of treating diabetes and health care is the patient. This study aimed to determine the effect of training program based on Health Belief Model developed with the fear of self-care behavior and HbA1c levels in patients with type II diabetes in urban-rural health centers in the city of Rasht. Material and Methods: This is a randomized controlled trial study. The study population were 84 patients with type II diabetes covered by Rasht health centers. They were randomly divided into two groups of intervention (n = 42) and control (n = 42). Data were gathered through constructs of Health Belief Model developed with the fear of self-care behavior and HbA1c levels before and three months after the test. Control group was not intervened. But the test group were under intervention with 6 sessions of 30-45 minutes, based on pre-tests, using mixed teaching methods such as: speech, discussion, question and answer, role playing with a teaching aid like pamphlets, posters and instructional videos. To analyze the data, descriptive statistics (measures of dispersion and central tendency), chi-square, t-tests and paired t-test was used through SPSS 21. Results: After intervention, the mean HbA1c in the intervention group were significantly different. However, the mean HbA1c in the control group was not significant. The average grade was increased in the experimental group after the intervention, while in the control group this difference was not significant. And the average score of self-care behavior in the experimental group before and three months after the intervention, there was a statistically significant difference (p = 0.001). But this difference was not significant in the control group. Conclusion: A detailed training program based on health belief model to increase perceived susceptibility and severity among patients and perceived benefits, and remove perceived barriers with enhancing self-efficacy as well as self-care behaviors in patients and reduction in hemoglobin A1c with type II diabetes is very beneficial. Paper Type: Research Article.