Gender-based differences in cognitive needs of Iranian rural health workers to perform osteoporosis prevention educational programs: an application of health belief model

ABSTRACT

Rural health workers play a detrimental role in implementing rural osteoporosis prevention programs. To successfully implement such programs, addressing their gender-based cognitive needs seems to be necessary. Our aim in the present study was to investigate gender-based differences in determinants of educating rural communities on osteoporosis prevention among Iranian rural health workers (RHWs) applying the health belief model (HBM). In this cross-sectional study, conducted in 2017, 280 RHWs were recruited to participate in the study, through random sampling. An HBM-based researcher-made questionnaire was developed to collect data. Face, content, construct and convergent validity and reliability of the scales were approved. After splitting data by gender, hierarchical linear regression was used to investigate the predictors of RHWs’ performance on osteoporosis prevention education programs (OPEPs). In Confirmatory Factor Analysis (CFA), the measurement model was found to be with a good fit to the data in the assumed model (χ2 [466] = 999.466, p < 0.001, CFI = 0.921, NFI = 0.821, TLI = 0.913, RMSEA = 0.048[0.043–0.054]). Among male RHWs, perceived barriers (p < 0.01), knowledge (p < 0.05) and the mean distance of health house from the marginal villages (p < 0.05) were significant predictors of the RHWs’ performance on OPEPs (cumulative adjusted R² = 0.790). Among female RHWs, perceived barriers (p < 0.01), self-efficacy (p < 0.05) and cues to action (p < 0.05) were significant predictors of the outcome variable (cumulative adjusted R² = 0.404). The findings of the present study are informative for the development of targeted interventions aimed at fostering RHWs’ performance on OPEPs.

KEYWORDS:

• Rural health workers
• osteoporosis
• education
• prevention
• health belief model

Authors Contributions

H.N. A.L. and A.N. collected the initial data. H.N., A.N., S.S., M.A. and A.L. were involved in the conception of the study, performed the analyses and drafted the manuscript. H.H., H.N., A.L. and H.M. were involved in the interpretation of the results from the analyses. S.S. and A.L. assisted in drafting and revising the manuscript.

Acknowledgments

The authors thank the initial research team who provided us with the data.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. Ethical approval was provided by the Research Committee in Tabriz University of Medical Sciences (Ethics Code: IR.TBZMED.REC.1396.795).

Informed consent

Informed consent was obtained from all individual participants included in the study.

Disclosure statement

Haidar Nadrian, Ahmad Nejati, Arman Latifi, Mehran Aghemiri, Hossein Hajizadeh, Hassan Mahmoodi, Shayesteh Shirzadi and Haleh Heizomi declare that they have no conflict of interest.

Additional information

Funding

The author(s) received no financial support for the research, authorship, and/or publication of this article.