BACKGROUND: In chronic diseases such as osteoporosis, understanding the factors that improve prevention, such as health literacy (HL), is essential in reducing the incidence of these diseases. This study aimed to determine the association between HL and adoption of osteoporosis-preventive behaviors among students in Qazvin. SUBJECTS AND METHODS: This is a cross-sectional study in which 375 female students (aged 15–18 years) at high schools (grades 10 th , 11 th , and 12 th ) in Qazvin city were selected, in 2019. Sampling method was multistage. To collect data, the standardized questionnaire for measuring HL in adolescents (health literacy measure in adolescents), in addition to another questionnaire for assessing osteoporosis-preventive behaviors, was used. Data were analyzed using SPSS 22 by descriptive statistics and logistic regression. The association considered significant when P < 0.05. RESULTS: The mean scores of adoption of osteoporosis-preventive behaviors and HL were 22.43 ± 5.60 and 70.84 ± 12.58, respectively. Logistic regression showed that there was a significant association between the adoption of osteoporosis-preventive behaviors and HL ( P = 0.001). In addition, the association between the adoption of osteoporosis-preventive behaviors and age was also significant ( P = 0.048 and odds ratio = 3.35). CONCLUSIONS: Young students and those of low HL showed less adoption of osteoporosis-preventive behaviors. Therefore, it is necessary to pay more attention to design educational programs that may raise the knowledge and awareness of those students about such these diseases, mainly prevention.

BACKGROUND: Health literacy plays an important role in adopting preventive behaviors. Considering the relatively high prevalence of breast cancer in women, this study aimed to assess the association between health literacy and adopting the preventive behavior of breast cancer in Iran. METHODS: This was a descriptive, cross-sectional study, in which 375 female students at Imam Khomeini International University in Qazvin in the academic year of 2018–2019 were selected through a stratified random sampling method. Demographic and background questionnaire, the standard questionnaire of Health Literacy for Iranian Adults in addition to another questionnaire for measuring breast cancer preventive behaviors, were used for collecting data. Data were analyzed using SPSS 22 using descriptive statistics and logistic regression. RESULTS: The mean of the breast cancer preventive behaviors and health literacy were 8.92 ± 1.82 out of 16 and 70.80 ± 12.49 out of 100. Regression results showed that there was a statistically significant association between the adoption of breast cancer preventive behaviors and physical activity ( P < 0.001) and health literacy ( P < 0.018). Accordingly, the chance for adopting the preventive behaviors in good level among students with rare and without physical activity was 0.105 and 0.100 times, respectively, more than students who had been doing physical activity on a daily basis. Moreover, the same chance among students with adequate and very adequate health literacy was 1.802 and 2.169 times more than students with inadequate health literacy. CONCLUSION: The results indicated that students with lower levels of health literacy and less physical activity had shown less tendency to adopt preventive behaviors of breast cancer. Therefore, special attention should be paid to health literacy (HL), particularly physical activity, application of health information, and assessment in students when designing educational programs to prevent breast cancer.

Background The health belief model (HBM) is effective in preventing osteoporosis and promoting health literacy (HL). In this regard, there are some critical points such as the role of HL in preventing osteoporosis, adoption of preventive behaviors, adoption of behaviors, including physical activity, and the role of health volunteers in transmitting health messages to the community. Considering the aforesaid points this study was performed among the health volunteers aimed to determine the effect of educational intervention based on integrated HBM with HL on walking and nutrition behaviors to prevent osteoporosis. Materials and methods In this quasi-experimental intervention study, 140 health volunteers (70 people in each of the two intervention and control groups) were enrolled in the study using multi-stage random sampling, in 2020. The members of the intervention group received e-learning through social media software, 4 times during 4 weeks (once a week) and were provided with educational booklets and pamphlets. Data collection tools included demographic and background questionnaires; standard questionnaire based on the HBM, awareness, and walking and nutrition behaviors to prevent osteoporosis; and HELIA questionnaire to measure HL. These questionnaires were completed in two stages, before and 3 months after the intervention. The educational intervention in this study was sent to the intervention group in 4 stages. The collected data were analyzed using proportional tests (paired t-test, Wilcoxon test, independent t-test, Mann-Whitney test) and SPSS software version 23. Results The mean and standard deviation related to the score of adoption of nutrition behaviors at the beginning of the study in the intervention group was 5.398 ± 1.447, which changed to 8.446 ± 1.244 after 3 months, indicating a significant increase in the adoption of such behaviors (P = 0.009). In the control group, the mean and standard deviation of the scores of adoption of nutrition behaviors changed from 5.451 ± 1.222 to 6.003 ± 1.005, which was not statistically significant (P = 0.351). Also, the mean and standard deviation related to the scores of adoption of walking behavior at the beginning of the study in the intervention group was 8.956 ± 0.261, which changed to 13.457 ± 0.587 after 3 months, indicating a significant increase in the adoption of such behaviors (P < 0.001). In the control group, the mean and standard deviation related to the scores of the adoption of walking behavior changed from 8.848 ± 0.353 to 9.025 ± 0.545, which was not statistically significant (P = 0.211). Prior to the intervention, there was no significant difference between two groups regarding the variables of demographic and background, knowledge, all constructs of the model, HL, and adoption of walking and nutrition behaviors (P > 0.05). After the intervention, the comparison of the two groups showed that there was a significant change in the mean scores of awareness, all constructs of the model, HL, and adoption of preventive behaviors in the intervention group than the control group (P < 0.05). Conclusion The educational intervention based on an HBM integrated with HL was effective and acceptable in correcting and promoting walking and nutrition behaviors to prevent osteoporosis among health volunteers. Therefore, it can be said that the intervention implemented was in line with the developed model used.