ARTICLE INFO

Article Type

Original Research

Authors

Bashirian   S. (1)
Mahmoodi   H. (2)
Barati   M. (*1)
Mohammadi   Y. (3)






(1) Social Determinants of Health Research Center, Hamadan University of Medical Sciences, Hamadan, Iran
(2) Public Health Department, Health Faculty, Hamadan University of Medical Sciences, Hamadan, Iran
(3) Modeling of Noncommunicable Diseases Research Center, Hamadan University of Medical Sciences, Hamadan, Iran

Correspondence

Address: Health Faculty, Hamadan University of Medical Sciences, Shaheed Fahmideh Street, Hamadan, Iran.
Phone: +98 (81) 38381795
Fax: +98 (81) 38380509
barati@umsha.ac.ir

Article History

Received:  February  3, 2019
Accepted:  May 14, 2019
ePublished:  September 21, 2019

BRIEF TEXT


Planning to reduce the production and supply of hookah and tobacco can be a positive step to reducing the hookah and tobacco consumption in the community.

... [1-5]. Epidemic problems of hookah smoking is increasing worldwide and its death toll is projected to rise to 3 million by 2030, with the developing country contributing more than one million to this death [6]. … [7-9]. Unfortunately, hookahs and tobacco are now widely available in public places and in grocery stores, as well [10]. … [11-17]. The results of other studies also show the effectiveness of the theory of planned behavior (TPB) in predicting high risk behaviors [18-18]. TPB can also play a role in enhancing individual and social capacity to participate in community health provision [19]. … [20-22].

The aim of the present study was to determine the effectiveness of educational programs on decreasing intention of hookah and tobacco supply among the handlers of public places and food centers in Arak city, Iran based on the TPB.

This research is a quasi-experimental study with the pretest-posttest method and the control group.

The present research was carried out among 102 handlers of public places and food centers of Arak city with active records in health centers distributing hookah or tobacco in 2017.

Sample size was estimated 42 subjects, according to the Hazrat et al. study [23] and considering the mean performance score of 28 in the test group and 24 in the control as well as the standard deviation of 5, alpha of 0.05 and 95% power that with the probability of a 20% drop, the sample size eventually increased to 51.

Educational content was provided by pamphlet, booklet, poster and educational CD based on the educational needs of the pre-test phase and the proposed training program consisted of four 60-minute sessions by lectures, group discussions, brainstorming and Q&A sessions and was administered to the test group. Evaluation of the educational intervention was done two months after the end of educational intervention and data were collected in two groups at posttest. Information was completed by written questionnaires using self-report method. Questionnaires consisted of two sections: demographic information and constructs of TPB. The questionnaires used in the studies by Bashirian et al. [16] and Barati et al. [12] were used to design and construct the questionnaire regarding variables of the TPB. Cronbach's alpha for the questions was 0.85 for attitude, 0.88 for abstract norms, 0.71 for perceived behavioral control and 0.95 for behavioral intention. The collected data were analyzed by SPSS 16 software using independent T-test, paired t-test, chi-square and McNemar tests.

The age range of the participants ranged from 20 to 68 years. There was no statistically significant difference between the two groups in terms of demographic variables (p> 0.05). The two groups only showed a statistically significant difference in terms of history of hookah and tobacco supply (p = 0.002; Table 1).After the educational intervention, a significant difference was observed between the mean scores of the constructs, including attitude, abstract norms, perceived behavioral control and intention to reduce hookah and tobacco supply (p <0.001; Table 2).In addition, the difference between the mean score of constructs, including positive attitude toward reducing hookah and tobacco supply, abstract norms of encouraging reducing hookah and tobacco supply, perceived behavioral control and intention to reduce hookah and tobacco supply was significantly different between experimental and control groups after educational intervention (p <0.001; Table 3).The highest effect size of educational intervention was related to the intention to reduce hookah supply with effect size of 25.1% (Table 4).

Various studies have shown that one of the most important preventive measures against tobacco risks is to modify people's attitudes [24]. The results of the present study showed that the mean score of positive attitude toward reduction of hookah and tobacco supply after intervention in the experimental group was significantly higher than the control group. This finding is consistent with the results of other study on tobacco prevention [24, 25]. … [26-29]. The results of this study indicated the success of the training program in increasing the mean score of perceived behavioral control in comparison with the control group, which is consistent with the results of other studies on tobacco prevention [30, 31]. … [32-34].

Implementation of similar training programs with regard to effective target groups in reducing the production and supply of hookah and tobacco in other regions is recommended.

The limitations of the present study were as follows: using self-report method, time limit for data collection after training and bias due to the lack of true responses because of observation measures by supervisory agencies and the economic benefits of tobacco handlers.

The educational interventions based on the theory of planned behavior are effective to reduce the supply of hookah and tobacco among the handlers of public places and food centers.

We would like to acknowledge and appreciate the staff of the Deputy of Health of the University of Medical Sciences, Markazi Province as well as all the public and food handlers involved in this study.

None declared.

None declared.

This article is extracted from a dissertation approved by the Research Council of Hamadan University of Medical Sciences (960115133) supported by of the Social Determinants of Health Research Center.

TABLES and CHARTS

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