@2024 Afarand., IRAN

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ISSN: 2383-2150    Journal of Education and Community Health 2015;1(4):32-42

Background
… [1-11]. School accidents include accidents which happen during school activities inside and outside the school in school time such as on the way to school.
Previous Studies
Paying attention to deaf and hard-of-hearing students because of deprivation from hearing as one of the most important syntonic senses, evolution of mental processes and disposition to the danger of injuries caused by accidents are so important[12]. … [13] Health Belief Model is an individual model studying health behavior and includes perceived susceptibility, perceived severity, perceived benefits, perceived barriers, self-efficacy and cues to action. Training programs based on this model focus on the changing of persons` attitude and their beliefs to do preventive and healthy behaviors [14].
Aim(s)
The current study was concluded with the aim of evaluating preventive training program from injuries caused by school accidents in deaf and hard-of-hearing high school students in Hamedan based on Health Belief Model.
Research type
This study is an intervention quasi-experimental one.
Research society, place and time
50 deaf and hard-of-hearing students of Hamedan high schools were under study from 24th of February in 2014 to 9th of June in 2014.
Sampling method and number
Sampling is done based on census method.
Used devices&materials
The used instrument in this study is a pre-designed questionnaire by Rezapuret al. [15] that has 10 questions about demographic characteristics of individuals 9 four-option knowledge questions with the minimum score of zero and maximum score of nine. Question related to the constructs of Health Belief Model were in form of six options with Likert scale including 5 questions of perceived susceptibility with the minimum score of 5 and maximum score of 30, 5 questions of perceived severity with the minimum score of 5 and maximum score of 30, 4 questions of perceived benefits with the minimum score of 4 and maximum score of 24.7 questions of perceived barriers with the minimum score of 7 and maximum score of 42, 7 questions of cues to action with the minimum score of 5 and maximum score of 42, and 6 questions of self-efficacy with the minimum score of 6 and maximum score of 36, as well as 17 questions related to predictive behaviors of injuries caused by accidents with the yes-no choices with the minimum score of zero and maximum score of 17.One was given to the correct behavior and zero to wrong behavior. It is worth mentioning that at the end all scores were scaled from 100. This questionnaire had been designed for normal students and as this study was conducted on deaf and hard-of-hearing students, to verify the reliability of the questionnaire again, it was handed to 30 students and it was evaluated by intrinsic parallelism and Alpha coefficient. The reliability of the questions of knowledge, perceived susceptibility, perceived severity,perceived barrier, cues to action, self-efficacy, and predictive behavior from injury were 0.68, 0.66, 0.68, 0.66, 0.69, 0.69, 0.85, and 0.65 respectively. To avoid the impurity of the data, 23students of one gender (girls) were chosen randomly as an intervention group and 27 students of other gender were considered as control group. It should be explained that before intervention, the difference in the mean score of knowledge, the model constructs, and preventive behavior of injury between two genders was not significant. Considering the few number of the target society and the use of census method, all participants in pre-test took part in intervention study. The results showed that there was a relationship between knowledge and all factors of health belief model, except the perceived susceptibility with students' behaviors and perceived benefits was a better predictor for behaviors(p=0.046). Knowledge level was58%; perceived susceptibility rate was 40.53; perceived severity was 40.53; perceived benefits was 31.58; perceived barriers was 69.52; guide for action was 34.19, self-efficacy was 33.05 andbehavior was 83.05. Considering the amounts and the relationship between the constructs, the content was designed as a training booklet with the title of "preventing the injuries caused by accident" by research group with opinions of experts in health education and upgrading health and safety using validate scientific sources. Considering the different training methods in this special group of students, two days before the start of the training classes, the training booklets were handed to each student of the group and they were emphasized to study it in two days. Then three 40-minute training sessions were held in following days every other day for intervention students (23 people) by the researcher at school considering constructs of health belief model. In case of becoming absent, the training topic was given to the student the day after. In order to increase the ability of making relationship with deaf and hard-of-hearing students, the trainers were asked to help. Accordingly, the research group used more effective training methods that required less hearing sense. Including the used methods were practiced shows, playing roles, sign language, lecture, questioning and answering, picture, slide, training manual. As an example teaching the right way of going up and down of stairs, students were directed to the school hallway and this behavior was showed by using the fences as a help and speed control using the practical showing method and body language. A training session for parents and another one for justification and harmony for school teachers of this school as guidance were held. In order to follow up and review the presented subjects, a 40 minutes training session was held a month after the last session. Due to the sameness of presenting methods in these schools to deaf and hard-of-hearing students and considering their active presence and same feedback in training process, there were deaf and hard-of-hearing students in these classes at the same time. A month after holding, following and reviewing, a post-test was taken from two groups of intervention and control by using a questionnaire. Statistical analysis: Data was analyzed using the 16 version of SPSS statistical software and based on statistical Chi-square, Fisher, paired t-test and independen t-t test. Meaningful level was considered less than 0.05 for all tests.
Findings by Text
According to Table 1, the age of most of the students in control and intervention groups (respectively 63% and 39%) was from 16 to 19 (p=0.268) and mostly were living in the city (p=0.094). In addition, results showed that most students of both groups were in second grade of high school (p=0.393) and had family with 4 and 5 members (p=0.723). Most students were the second child of the family (p=0.523).Most of the parents in both groups had a degree less than diploma (p=0.112) and (p=0.748). Most mother in both groups were homemakers (p= 0.645) and fathers were workers (p=0.737). Regarding the injury history of students, results showed that 29.6% of control group and 18.5% on intervention group had a minor injury history (injuries leads to home remedies) during last year (p= 0.283). The participants of the study included deaf students (respectively 29.5 and 26% in control and intervention group) and hard-of-hearing (respectively 70.5 and 74% in control and intervention group) (p=0.781). Generally based on the results of the study, there was not meaningful difference between two groups in demographic variables. As the results of Table 2 shows, there was not any statistically significant difference before intervention on studied variables in both control and intervention groups and both groups were same in pre-intervention level in mentioned variables. According to this table. The paired t-test states a meaningful difference between mean knowledge results, perceived severity, perceived benefits, self- efficacy, cues to action and preventive measures in intervention group before and after training intervention (p<0.05). This is, while, in control group no significant difference was observed except in the construct of self-efficacy (p> 0.05). Before training intervention, the most important cues to action included the health centers staff and PE teachers, but after intervention, it was changed to teachers and parents.
Main comparison to the similar studies
… [15]. The gain results of this study were similar to the results of Ebrahimi et al. [16] and Cheraghiet al. study [17]. … [18]. Lack ofdifference in the mean results of perceived susceptibility is also ween in the study conducted by of Honewinkel and Asshoer[19] but it was not in harmony with the results of Ebrahimi et al. study [16] and Cheraghiet al. [17]. … [20, 21] the training based on useful safety behaviors using suitable training method can be the reason of this increase. The gained results from the studies by Karimi et al. [22], Orougiet al. [23] and Kadry et al. [24] also support these results. … [25-30].
Suggestions
Presenting training programs similar to this study in all schools related to deaf and hard-of-hearing students of the country is recommended.
Limitations
Of limitation of this study, it can be referred to the use of auto reporting method to gather data including data related to students' behaviors. Other limitation of the study was limited number of students in the research society i.e., the target group were totally studying in the two schools (one school for girls, and one school for boys).
Conclusions
Training intervention based on health belief model can upgrade preventive measures from injuries caused by school accidents in deaf and hard-of-hearing students.
Acknowledgments
The authors send their appreciation to the educational department officials, management, vice chancellor and all teachers of both schools related to deaf,and participated students in the study.
Conflict of interest
Non-declared
Ethical Permissions
At the beginning of the study, a permission form was filled out by parents.Participated students of the current study were justified about the method of doing the study, confidentiality of the information and the purpose of doing this study, and they were entered the study in case of consent agreement.
Funding Sources
This study is the result of a MA thesis on health teaching by the first author (FatemehVejdani-Aram) in the Hamedan University of Medical Sciences that was approved in research council of this university (Project no.: 930126275).

TABLES and CHARTS

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