@2024 Afarand., IRAN

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ISSN: 2383-2150    Journal of Education and Community Health 2020;7(3):161-168

Background
…[1]. Head lice infestation is commonly known as Pediculosis. Infection with head lice spread directly through contact with infected people and indirectly through contact with the personal belongings of an infected person [2].
Previous Studies
…[3-11]. Studies on the causes of treatment resistance and treatment failure of head lice have shown that based on the ideas of many mothers, head lice can be prevented only by observing personal hygiene and using personal belongings. Also, mothers' awareness level about lice infestation is low. Feelings of shame and embarrassment at the attitudinal level are the barriers that can affect the incompleteness of treatment. In terms of performance, most mothers performed the treatment only once [12, 13]. According to studies, a previous and current history of head lice infestation can also be considered as effective factors in the success or failure of treatment. Sometimes the disease source or the person who is infected is still between people and the family, and is not well treated and cleansed and needs family treatment [6, 14]. …[15]. It seems that training interventions based on standard educational models can be effective in improving and accelerating the treatment of Pediculosis and preventing the spread of treatment-resistant cases. One of the standard training models is the Health Belief Model, which is especially useful for designing programs to prevent disease and behavior change in the short term [16]. …[17-19].
Aim(s)
The aim of this study was to investigate the effect of educational intervention based on the Health Belief Model on the success rate of a head lice treatment in treatment-resistant cases.
Research type
This research is a quasi-experimental study.
Research society, place and time
This study was carried out on mothers, whose children infected with head lice and had been treated for more than two weeks but their treatment has failed, in Qom city in 2019.
Sampling method and number
The sample size was determined to be 60 people in each group using MedCalc 19.4.1 software and considering confidence interval of 95%, α=0.05, β=0.2, reading power of 80% and also the rate of infestation elimination in the two groups equal to 85% and 100%, respectively, and by calculating the rate of statistical drop (10%), 140 people were determined as the sample size. Samples were selected by the available sampling method and were divided into two intervention and control groups (n=70 in each group) by the block randomization [20]. Inclusion criteria included conscious written consent to participate in the study by the subjects and exclusion criteria were also unwilling to participate in research and self-reporting of pediculosis infestation.
Used devices&materials
The data collection instrument was a researcher-made questionnaire consisting of two parts; the first part was about demographic and contextual information and the second part was about measuring the constructs of the Health Belief Model. Content validity and Cronbach's alpha test were used to evaluate the scientific validity and the reliability of the internal stability of the questionnaire, respectively. Before the training intervention, both groups completed the pre-test of the questionnaire. Then, for the intervention group, three 75-minute training sessions were performed through lectures and group discussions during a month (one training session every 10 days). The educational content was prepared in the form of pamphlets and slides (Table 1).Also in training sessions, use of Permethrin shampoo [21], Lindane lotion, or Dilice solution (Dilice 4% Anti Lice Lotion 60ml), combing for 25 minutes after each use of lotions mentioned by considering scientific recommended treatment methods in scientific sources. It should be emphasized that during two weeks after starting treatment, mothers should have careful and daily monitoring of their children's hair. 2 months after the intervention, post-test questionnaires were completed by the subjects in both groups to assess the success rate of head lice infestation treatment in both intervention and control groups. Data were analyzed by paired Chi-square and T-tests, using SPSS 16 software.
Findings by Text
There was a statistically significant difference between the two groups in terms of education level and employment status (p=0.001), but no significant difference was observed in terms of other demographic variables (p>0.05; Table 2).There was no significant difference between the two groups in terms of mean scores of the model constructs except the knowledge structure, before the training intervention (p>0.05), but a significant difference was observed between the two groups in the constructs of knowledge, perceived intensity, perceived sensitivity, perceived benefits and self-efficacy, after the intervention (p<0.05). The mean scores of awareness, perceived sensitivity, perceived intensity, perceived benefits and self-efficacy in the intervention group increased significantly (p<0.05). However, there was no significant change in the perceived barriers structure in the intervention group after training (p>0.05). There was no significant difference in the control group (p>0.05; Table 3).In the intervention group, 40.0% of the subjects believed that the staff of the health centers could provide the most help to mothers in the treatment of lice infection, while in the control group the mothers believed that most guidance was provided by their spouses and relatives (35.7%, Table 4).Regarding the success rate of treatment in both groups, all 70 cases in the intervention group (100%) were successfully treated after the intervention, but among 70 cases of the control group, only 13 subjects (18.6%) were successfully treated and 57 cases (81.4%) did not succeed in their treatment. Therefore there was a statistically significant difference between the two groups in terms of the success rate of lice infection treatment (p=0.001).
Main comparison to the similar studies
In the awareness structure, the results of this study are consistent with the study of Daneshvar et al. [1]. Findings of this study are consistent with the studies of motevali Haghi et al. [22], Zareban et al. [23], Daneshvar et al. [1] and Morvati et al. [24] intending to evaluate a health training program to reduce head lice infestation among school students. After the educational intervention, improving the mean score of perceived sensitivity in the intervention group was a good sign of the effect of training intervention on increasing the perceived sensitivity in the intervention group. The results are in accordance with the findings of Morvati et al. [24], Panahi et al. [25] and Moshki et al. [26]. In terms of perceived intensity, the results of this structure were in accordance with the findings of the study of Daneshvar et al. [1], Moshki et al. [26] and Sajadi Hazawei & Shamsi [27]. The findings of this study in terms of the perceived benefits are consistent with the results of the studies of Daneshvar et al. [1], Morvati et al. [24] and Moshki et al. [26], but it is not accordance with the study of Panahi et al. [25]. Its possible reasons can be include differences in the items such as sample size, geographical status, target group type, and used instrument. There was no statistically significant difference in mothers' perceptions of barriers to the successful treatment of Pediculosis in both groups before and after the educational intervention. The findings of this study were in accordance with the study of Morvati et al. [24], while in the study of Panahi et al. [25], Daneshvar et al. [1], Moshki et al. [26] and Khakshour & Peyman [28], an educational intervention was able to reduce the existing obstacles. Also, increase of self-efficacy in the intervention group after the training program was statistically significant, which was in accordance with the results of the study of Daneshvar et al. [1] and Moshki et al. [26].
Suggestions
Use of the Health Belief Model is suggested to increase the success rate in the treatment of head lice infested people, who their treatment has failed after two weeks.
Limitations
According to scientific research, no study was found to compare the success rate of treatment, which can be considered as one of the limitations of this study. Also, given that the issue of self-reporting behavior was one of the limitations of this study, therefore as a strength of the study, a memorandum between schools and health centers was used in order to minimize the percentage of statistical drop and ease of access to groups.
Conclusions
Educational intervention based on the Health Belief Model has a positive effect on the success rate of head lice infection in treatment-resistant cases.
Acknowledgments
This article is retrieved from researches approved by Qom University of Medical Sciences and is written with the code of 97941. We would like to thank the responsible expert of the Diseases Unit of Qom Health Center and professors of the Epidemiology and Biostatistics Departments and Department of Public Health, Faculty of Health, Qom University of Medical Sciences, for cooperation in the implementation of the project, also, the Vice Chancellor for Research of Qom University of Medical Sciences to facilitate the approval process and financial support.
Conflict of interest
There is no conflict of interest.
Ethical Permissions
This study was approved by the Ethics Committee of Qom University of Medical Sciences with the ethics code of IR.MUQ.REC.1397.101.
Funding Sources
This study was funded by the Vice Chancellor for Research of Qom University of Medical Sciences.

TABLES and CHARTS

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