BackgroundPregnant women and their fetus belong to a sensitive group in response to air pollution hazards. The aim of this study was to evaluate the effectiveness of a theory-based educational program to change pollution exposure behavior in pregnant women.MethodsIn this randomized controlled trial, pregnant women attending a prenatal clinic in Tehran, Iran were selected and randomized into the experimental and control groups. The inclusion criteria were age between 18 and 35 years, having a history of pregnancies without adverse outcomes and not suffering from chronic diseases. Data collected at baseline and 2-month follow-up. At baseline face-to-face interviews were conducted using a valid and reliable questionnaire including items on demographic characteristics, stages of change, self-efficacy, decisional balance and practice regarding air pollution preventive behaviors. The intervention composed of three parts: motivational interviewing, a booklet and daily small message service (SMS). The control group received no intervention except receiving usual care. Follow-up data were collected after the intervention. Data were analyzed performing t-test, Mann–Whitney U test, and chi-squared.ResultsIn all the data for 104 pregnant women (53 in the intervention and 51 in the control group) were analyzed. The mean age of participants was 27.2 (SD = 4.11) years and it was 22.89 (SD = 8.75) weeks for gestational age. At baseline there were no significant statistical differences between intervention and control groups on the study measures while we found significant group differences in terms of stages of change, self-efficacy, perceived benefits and practice regarding air pollution preventive behaviors at follow-up assessment (P < 0.05).ConclusionThe findings indicated that the TTM-based intervention was effective in increasing air pollution preventive behaviors among pregnant women. This study provided a framework to modify some psychosocial determinants of air pollution preventive behavior other than knowledge using constructs of Transtheoretical model of behavior change, additionally results suggests the importance of education and makes enlightenment of the air pollution risk knowledge accelerate.Trial registration IRCT2012091010804N1

A self-efficacy instrument should be condition-specific. There are several instruments for measuring self-efficacy, but none are air pollution-specific. This study aimed to develop a self-efficacy measure for assessing pregnant women’s responses to air pollution hazards. A random sample of pregnant women aged between 18 and 35 years attending three prenatal care centers were entered into the study. Prenatal care centers randomly selected from a list of centers located in different geographical regions of Tehran, Iran. After careful consideration and performing content and face validity, a 4-item measure was developed and participants completed the questionnaire. Reliability was estimated using internal consistency and validity was assessed by performing confirmatory factor analysis (CFA) and known group comparison. In all 200 eligible pregnant women were studied. The mean age of participants was 26.9 (SD = 4.8) years and it was 27.9 (SD = 9.1) weeks for gestational age. The findings showed almost perfect results for both content validity ratio (CVR = 1) and content validity index (CVI = 1). The confirmatory factor analysis indicated a good fit to the data, and known group comparison revealed satisfying results. Internal consistency as measured by the Cronbach’s alpha coefficient was found to be 0.74. In general, the findings suggest that this new generated scale is a reliable and valid specific measure of self-efficacy in response to air pollution hazards for pregnant women. However, further studies are needed to establish stronger psychometric properties for the questionnaire.

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Background: Epidemiological studies have reported associations between elevated air pollution and autism spectrum disorders (ASD). However, we hypothesized that exposure to air pollution that mimics real world scenarios, is a potential contributor to ASD. The exact etiology and molecular mechanisms underlying ASD are not well understood. Thus, we assessed whether changes in OXTR levels may be part of the mechanism linking PM 2.5 /gaseous pollutant exposure and ASD. The current in-vivo study investigated the effect of exposure to fine particulate matter (PM 2.5) and gaseous pollutants on ASD using behavioral and molecular experiments. Four exposure groups of Wistar rats were included in this study: 1) particulate matter and gaseous pollutants exposed (PGE), 2) gaseous pollutants only exposed (GE), 3) autism-like model (ALM) with VPA induction, and 4) clean air exposed (CAE) as the control. Pregnant dams and male pups were exposed to air pollutants from embryonic day (E0) to postnatal day (PND21). Results: The average ± SD concentrations of air pollutants were: PM 2.5 : 43.8 ± 21.1 μg/m 3 , CO: 13.5 ± 2.5 ppm, NO 2 : 0.341 ± 0.100 ppm, SO 2 : 0.275 ± 0.07 ppm, and O 3 : 0.135 ± 0.01 ppm. The OXTR protein level, catalase activity (CAT), and GSH concentrations in the ALM, PGE, and GE rats were lower than those in control group (CAE). However, the decrements in the GE rats were smaller than other groups. Also in behavioral assessments, the ALM, PGE, and GE rats demonstrated a repetitive /restricted behavior and poor social interaction, but the GE rats had weaker responses compared to other groups of rats. The PGE and GE rats showed similar trends in these tests compared to the VPA rats. Conclusions: This study suggested that exposure to ambient air pollution contributed to ASD and that OXTR protein may serve as part of the mechanism linking them.

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