ARTICLE INFO

Article Type

Original Research

Authors

Joghataei   Z. (1)
Peyman   N. (*2)
Noori   R. (3)
Esmaily   H. (4)
Moradi   M. (5)






(*2) “Department of Health Education and Health Promotion, Faculty of Health” and “Social Determinants of Health Research Center”, Mashhad University of Medical Sciences, Mashhad , Iran
(1) Department of Health Education and Promotion, School of Health, Mashhad University of Medical Sciences, Mashhad, Iran
(3) Department of Community Health Nursing, Faculty of Nursing, Gonabad University of Medical Sciences, Gonabad , Iran
(4) “Biostatistics Department, Public Health Faculty”, “Social Determinants of Health Research Center”, Mashhad University of Medical Sciences, Mashhad, Iran
(5) Social Development and Health Promotion Research Center, Gonabad University of Medical Sciences, Gonabad , Iran

Correspondence

Article History

Received:  February  17, 2020
Accepted:  July 1, 2020
ePublished:  December 20, 2020

BRIEF TEXT


The important problem in public health is external parasites that despite the progress of medical sciences are considered as the health problem threatening public health [1]. The head lice are one of these external parasites, which belongs to the order Anoplura.

... [3-5]. According to the World Health Organization, the prevalence of lice in Iran is between 6 and 30% [6]. ...[7-11]. Although schools have the necessary factors for the prevalence of lice, they have the necessary factors for the prevalence of lice too. Schools are the most suitable places for training to control and prevent pediculosis [12], and people should understand that head lice infection can be controlled and prevented with health training [10]. Training Healthy Behaviors Leads to replacing wrong behaviors with right ones. ...[13]. Selecting a model for health training is the first step in the process of any training program [14]. One of these models is the Health Belief Model and emphasizes that changes in people's attitudes will lead to changes in their behavior [15]. The Health Belief Model is a comprehensive model that plays an effective role in disease prevention. The key assumption in this model is that disease-preventative behaviors are based on individuals' beliefs [14]. ...[16]. Social media and mobile messengers can help people quickly get the knowledge and information they need. As well as they can improve learning in health training programs due to easy and fast access, instant feedback, facilitating interaction and communication between people, the possibility of sharing information with others, and providing multiple resources. …[17,18].

This research aimed to determine the effect of education based on health belief model on the promotion of pediculosis-preventing behaviors in female students using social media messengers.

This research is a quasi-experimental study.

The study was carried out on all female students of middle schools in Bojnourd city in 2018.

This study carried out between 150 people as the sample study (75 objects in the intervention group and 75 objects in the control group) considering similar researches [19], the standard formula for mean comparing, 95% confidence level, 90% test power, and the probability of sample drop. The sampling method was random and clustered. In the first step between 12 girls' high school, two schools were randomly selected, and then among the students of each school, the number of objectives was randomly selected according to the sample size.

The data collection tool was a 4-part questionnaire. The first part of the questionnaire included demographic information and the second part included 9 questions about students' awareness of head lice, the ways of transmission, and the ways to prevent the disease. In the third section, 5 questions are posed for each construct of the Health Belief Model, including perceived sensitivity, perceived severity, perceived barriers, perceived benefits, and self-efficacy. The fourth part of the questionnaire was related to preventive behaviors. For investigating the validity of the research tool, the questionnaires were sent to 10 experts in the field of school health training and their opinions were asked to determining the content and face validity of the questionnaire. The content validity ratio and content validity index were 0.79 and 0.81, respectively. The reliability of the research tool was confirmed using completing the questionnaires by 50 students of the schools except for the objectives in the intervention and control groups. Cronbach's alpha coefficient of awareness questions, perceived sensitivity, perceived intensity, perceived benefits, perceived barriers, practice guidance, self-efficacy, and behavior structures were 0.79, 0.81, 0.78, 0.78, 0.86, 0.89, 0.84, and 0.93, respectively. After obtaining a license from North Khorasan University of Medical Sciences and the education department of Bojnourd city, explaining the goals, and the way of program implementation for the studied schools, the researcher entered the schools, and introduced himself/ herself to the students and explained the goals of the study for them. If they agreed to participate in the study, they completed the questionnaires in accordance with ethical standards and confidentiality of information. After expressing their consent to participate in the study, they completed the questionnaires in accordance with ethical standards and confidentiality of information. After conducting the pre-test and compiling the training content, the intervention and control group were formed according to the list of students and the mobile number that they mentioned in the questionnaire about access to the social network messengers. The training program was conducted for 2 weeks, 3 days each week by uploading videos and training materials. The questionnaires were completed by the students immediately after the educational intervention and again 3 months later. 5 questionnaires of the control group were deleted from the study due to incompleteness. SPSS 20 software was used for data analysis. Data analysis was performed using descriptive and inferential statistical tests (Mann-Whitney U, analysis of variance, Chi-square, and Fisher's exact tests).

The data, obtained from completed questionnaires by 145 objectives, were analyzed (n=75 in the intervention group, n=70 in the control group). The results of the Mann-Whitney U test showed that there was no significant difference between students in terms of age (p=0.514), number of family members (p=0.192), number of combs per week (p=0.178) (Table 1). According to Fisher's exact test, there was no significant difference between the intervention and control groups in terms of infection history (p=0.992) (Table 1). we found that there was an interaction in the awareness, sensitivity, perceived barriers, perceived benefits, and self-efficacy indicators through analysis of duplicate data between time factor and the group (p<0.05). Therefore, the changes in these indicators have been compared between the intervention and control groups. According to table 2 and using the Mann-Whitney U test, there was a significant difference between the two groups in terms of awareness index immediately after the intervention compared to before the intervention (p<0.001). Therefore, that awareness index increased by 4 units in the intervention group, and one unit in the control group. Also, the changes in the intervention increased by 4 units in the intervention group and 2 units in the control group 3 months after the intervention, which was a statistically significant difference (p<0.002).In the intervention group the changes in the perceived sensitivity index increased by 3 units immediately after the intervention, whereas there was no increase in changes of this index in the control group, which was statistically significant (p<0.001). Also, the changes increased by 3 units in the intervention group and 2 units in the control group 3 months after the intervention, which was also significant (p<0.001). There was a significant difference between the two groups in terms of changes in the perceived barrier index, immediately after the intervention (p<0.001); so that, in the intervention group, the changes increased by 3 units and in the control group, no increase was observed. Also, the changes increased by 3 units in the intervention group and decreased by 0.5 units in the control group, 3 months after the intervention, which was a statistically significant difference (p<0.001). The observed changes in the perceived benefit index immediately and 3 months after the intervention compared to before the intervention were significantly different in the two groups (p<0.001) so that in the intervention group it increased by 2 units, and in the control group it did not increase. There was a significant difference in self-efficacy index between the two groups immediately after the intervention (p<0.001) so that in the intervention group there was an increase of 1 unit, and no increase was observed in the control group. In addition, the changes increased by 2 units in the intervention group 3 months after the intervention, whereas it did not increase in the control group, which was statistically significant (p=0.001; Table 2).By controlling the confounding variables of parental occupation and parental education and controlling structures before the intervention, the results of the study showed that the perceived severity score in the intervention group increased by 3.29 and 2.75 units compared to the control group immediately and 3 months after the intervention, which was also significant (p<0.001). Also, the score of the practice guidance structure in the intervention group increased by 1.94 and 2.54 immediately and 3 months after the intervention, respectively, compared to the control group, which was significant (p<0.001).

The aim of this study was to determine the effect of training on the promotion of pediculosis prevention behaviors in female students based on the Health Belief Model using social media messengers. The results showed that there was a significant difference in the changes of the awareness index between the intervention and control groups immediately and 3 months after training which is in line with the results of some studies such as Khadem al-Husseini et al. [20], considering that their model and training method are similar to this study. Haqqani et al. [21], in their research, showed that education by use of short message service increases the awareness of pregnant women. However, in a study in which web-based education was performed via email using the Health Belief Model, no significant difference in knowledge was observed after the intervention in the two groups [22]. The results showed that there was no significant difference in the perceived sensitivity index between the two groups before the intervention, while a significant difference was observed between the two groups after the training, immediately and 3 months after the intervention. Kapik & Gozum [22], in a study, concluded that this educational method increases the perceived sensitivity among individuals. The results showed that the score of perceived severity increased in the intervention group immediately and 3 months after the training of pediculosis prevention behaviors, which is statistically significant. In the study of Morvati et al. [23], the results showed that the mean score of perceived intensity in the intervention group increased significantly compared to the control group and it is consistent with the results of this study. The changes ratio in the perceived barriers index was significant in the intervention group compared to the control group immediately and 3 months after the training. The results of several studies are in line with this study [13, 20]. Heydari & Norouzi [24] in a study conducted that training using the multimedia method and sending text messages, significantly reduced the mean scores of perceived barriers in the intervention group compared to the control group and it is in accordance with the results of the present study. In the study by Kapik & Gozum [22], the results showed that training based on the Health Belief Model significantly reduces perceived barriers to prostate cancer screening. There was a significant difference in the structural changes of the perceived benefits between the control and intervention groups immediately and 3 months after the intervention. Rahmani et al. [25], in a study, resulted that the training program using social media messengers was effective in increasing the perceived benefits in pregnant women after 24 weeks, which is similar to the results of this study. In addition, the results of the study of Khadem al-Husseini et al. [20] showed that the mean score of perceived benefits increased significantly in the intervention group compared to the control group immediately and 3 months after training. Therefore, the results of the study are consistent with the present study. The results showed that the practice guidance score for surgery increased in the intervention group compared to the control group immediately and 3 months after training the pediculosis preventative behaviors, which is statistically significant. In the study of Baji et al. [13], it was also shown that training based on the Health Belief Model significantly increased the scores of the practice guidance structure in the intervention group compared to the control group. Based on the results, the changes in the self-efficacy structure were significant in the intervention group compared to the control group immediately and 3 months after the training. The results of the study of Karimian et al. [26] are in line with the results of the present study. However, in the study of Rahmani et al. [25], it was shown that education based on a para-theoretical model using social media messengers has not been effective in increasing the self-efficacy of pregnant women to reduce gingivitis. Educational intervention based on the Health Belief Model using social network messengers significantly increased the behavior score in the intervention group compared to the control group immediately after the training. Tajri et al. [27], in the research, concluded that the virtual social network services and SMS can be used as new and effective methods in shaping proper nutritional behaviors and these results are in line with the results of the present study. Also, in the studies of Khadem al-Husseini et al. [20] and Morwati et al. [23], it was shown that training is effective in promoting health behaviors based on the Health Belief Model using social networks messengers.

It is recommended that further research be conducted on all students at other levels of study using other media.

The findings of the study were only related to female students, and it was not possible to compare the two genders. Also, some students couldn't attend training sessions because of limited access to the Internet and social media messengers prevented. These objectives were contacted later to make sure they attended the program and studied the material.

Training using the Health Belief Model promoted the level of awareness as well as model constructs about pediculosis preventative behaviors in female students.

We would like to thank all the students and their families and the education officials of Bojnourd city and all those who helped us in carrying out this research.

This article is the result of a research project with the code of 980388 approved by Mashhad University of Medical Sciences.

This study is approved by the Research Ethics Committee of Mashhad University of Medical Sciences (code R.MUMS.REC.1398.217).

This research has been financially supported by the Research assistant of Mashhad University of Medical Sciences.

TABLES and CHARTS

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CITIATION LINKS

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