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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.

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Background: Although compliance with all self-care behaviors is necessary for successful management of diabetes, patients with diabetes often refuse favorable self-care. This article is aimed to test the effects of a theory-related intervention to conduce self-aid adherence and metabolic curb in patients having type-2 diabetes. Methods: In this randomized controlled trial, 80 patients suffering from type-2 diabetes were arbitrarily allotted to intervention and control group. The intervention group attended six sessions in a batch and one-on-one consultation and received an education on self-efficacy and outcome expectations on improving the strategies. Self-efficacy, outcome expectations, self-care behaviors and HbA1c were measured and compared in two groups in the starting, after three and six-months of the interventions. "Intention to treat" analysis was used. Data were analyzed using t test and ANOVA for repeated measures. Results: Mean score of self-efficacy, outcome expectations and self-care behaviors revealed significant differences between two groups in the results of three and six months after the intervention (P < 0.01). A major fall in HbA1c was noted in the intervention group. The mean scores of the HbA1c showed a significant difference between two groups, six months after the intervention (P < 0.05). After the intervention diet, physical activity and foot care improved significantly in the intervention group (P < 0.001). No significant improvement occurred in self-monitoring of blood glucose and medication adherence between two groups after the intervention Conclusion: It is concluded that implementing educational interventions based on the self-efficacy model and related strategies can be effective for patients with type-2 diabetes and is recommended to be used for patient education in the field of metabolic control.

Purpose:Despite the importance of patients believes as one of the most important predictors of treatment adherence behavior, it is rarely considered in numerous studies. Then the current survey was aimed to develop and study the beliefs about medicines questionnaire (BMQ) in patients with hypertension.Materials and Methods:The BMQ developed by Horn and et al. was used in the current study. This questionnaire included 18 questions in both public and private beliefs regarding drug. Face and content validity of the tool was investigated using expert’s panel. In final, aforementioned tool was tested in 612 participants. To explore structure validity and internal consistency, exploratory and confirmatory factor analysis and alpha coefficient was conducted. To evaluate the final validity of instrument, the mean score of the beliefs about medicines of patients with appropriate medication adherence were compared to patients without medication adherence.Results:The mean age of patients was 44.08 ± 10.38 years. Women were 314 of participants. Calculated face validity by the impact score for each item indicated that all the items of the questionnaire had the impact score of more than 1.5. In total, all items had scored higher than 0.79 by considering 18 items for content validity. The average of content validity index for the questionnaire was 0.93. Load of factors were in the range of 0.51 to 0.79. Four items explained % 57 of the total variance. Comparison of all instrument items in the two groups showed that patients with good adherence had higher score in 15 items (% 83 of all items).Conclusion:The findings suggested that the BMQ in patients with hypertension as a valid and reliable instrument can be used to evaluate the patients’ medication adherence.

Background:Colorectal cancer is one of the most important and most common cancers and the second leading cause of cancer deaths worldwide. Every year, nearly 1 million new cases of colorectal cancer are recognized around the world and nearly half of them lose their lives due to the disease. The statistics reveal shocking incidence and mortality from colorectal cancer, therefore secondary prevention of this cancer is important and research has shown that by early diagnosis 90% of patients can be treated. Among the colorectal cancer screening tests, fecal occult blood test (FOBT) takes the priority because of its convenience and also low cost. But due to various reasons, the participation of people in this screening test is low. The goal of this study is to assess the factors that affect participation of population at average risk in colorectal cancer screening programs, based on health belief model structures.Materials and Methods:A cross-sectional survey of 196 individuals, more than 50 years old, was conducted in Isfahan. Ninety-eight people of the target group were selected from laboratories while they came there for doing FOBT test; the method of sampling in this group was random sampling. The method of data collection in the other 98 individuals was by home interview and they were selected by cluster sampling. The questionnaire used was based on health belief model to assess the factors associated with performing FOBT. The data collected were analyzed using descriptive and inferential statistical methods.Results:The mean score of knowledge in the first group was 48/5 ± 11/7 and in the second group was 36/5 ± 19/3. Individuals in the first group were more likely to be married, had more years of schooling, and better financial status. There were significant relationships between knowledge (P<0.001), perceived susceptibility (P<0.001), perceived severity (P<0.001), perceived barriers (P<0.001), and self-efficacy (P<0.001) in the two groups. There was no significant association between the perceived benefits in the two groups. Those people who have had FOBT test in last year in each group reported better score of Health Belief Model model structures.Conclusion:According to this study, it seems that there is an urgent need to pay more attention to this disease and its prevention through screening. With a better understanding of factors affecting the test, it can be a useful step to reduce the rate of death and costs, and improve the community health outcomes.

BackgroundThe prevalence of consuming fast foods and non-nutritious snacks is progressively increasing among adolescents. This study aimed to explore factors behind snack consumption at school among Iranian high-school students.MethodsThis descriptive qualitative study was conducted in 2017 in four boys’ and four girls’ high-schools located in Isfahan, Khorramabad, and Tehran, Iran. Data were collected through 42 in-depth semi-structured interviews and four focus groups with male and female students, their parents, and their school teachers and administrators. The conventional content analysis approach was used for data analysis. Trustworthiness was applied to the study through prolonged engagement, maximum variation sampling, and member checking techniques.ResultsFactors behind students’ snack consumption came into two main groups, namely influential behaviors, and influential emotions and perceptions. Influential behaviors included the behaviors of students, their family members, peers, school administrators, and snack sellers. Moreover, influential emotions and perceptions included positive and negative feelings towards healthy snacks, fear over the consequences of unhealthy snacks, and perceived positive outcomes of healthy snacks.ConclusionsStudents’ snack consumption at school is affected not only by their own behaviors, emotions, and perceptions, but also by significant others’ behaviors and environmental factors. School administrators need to make environmental modifications to turn school environment into a pleasant place for healthy snack consumption and make healthy snack consumption a pleasurable experience for students.