Background and Aim: Digital technology has profoundly transformed way of life, making the ability to access and understand information through modern technologies increasingly important—especially for older adults. This study aims to assess e-Health Literacy among Iranian older adults in 2025. Materials and Methods: This cross-sectional study was conducted between 2024 and 2025 among 420 older adults attending comprehensive health service centers affiliated with Shahid Beheshti University of Medical Sciences in Tehran. Participants were enrolled using a multi-stage random sampling method. Inclusion criteria were age ≥ 60 years, Iranian nationality, literacy and ability to complete the questionnaire, willingness to participate, having a household file in the covered health centers, and absence of cognitive impairment at the time of the study. Older adults with incomplete questionnaire responses were excluded. Data were collected using the standardized e-Health Literacy Scale (eHEALS), with scores ranging from 8 to 40. Statistical analyses were performed using independent t-tests and ANOVA in SPSS version 16. Findings: The mean e-Health Literacy score was 17.88 ± 7.60, which was below the acceptable level. Higher e-Health Literacy was observed among younger older adults aged 60–64 years, those who were married, employed, and had higher educational attainment (P < 0.001). In addition, better economic status, daily Internet use, and higher skills in using digital devices were significantly associated with higher e-Health Literacy levels (P < 0.001). Although men showed a higher mean score than women, no statistically significant association was found between gender and e-Health Literacy (P = 0.270). Conclusion: The level of e-Health Literacy among older adults was below average and unacceptable, representing an unfavorable status for this vulnerable and growing group. This attempt, by providing valuable data, can be a suitable scientific basis for designing targeted interventions to promote e-Health Literacy in older adults.
Introduction: Iran’s declining fertility rate from 3.95 in 1990 to 1.36 during 2020–2025 has recently raised demographic and socioeconomic concerns. Educational interventions based on the Theory of Planned Behavior (TPB) can promote intentions for timely preconception care (PCC). Thus, this study evaluated such an intervention among couples with delayed subsequent childbearing. Methods: Using a pre-test/post-test design, this quasi-experimental study was conducted in Jiroft, Iran in 2024. Married couples with one child experiencing delayed subsequent childbearing were recruited from eight healthcare centers randomly assigned to the intervention or control groups (n=56 couples each). The intervention group participated in eight weekly, 60-minute educational sessions based on the TPB, targeting attitudes, subjective norms, and perceived behavioral control toward PCC. The outcomes were measured using a validated questionnaire, assessing intention to engage in PCC. Finally, data were analyzed using paired and independent t-tests and ANCOVA to evaluate intervention effects. Results: At baseline, participants in the intervention group exhibited moderate-to-low PCC-related scores across awareness (mean±SD: 11.94±2.13), attitude (37.13±4.10), subjective norms (25.96±3.54), perceived behavioral control (19.04±2.08), and behavioral intention (11.13±1.23). Following the structured educational intervention, the intervention group demonstrated statistically significant and clinically meaningful improvements in all outcomes. Awareness increased by an average of 4.03 points to 15.98±1.01, and attitude improved by 4.33 points to 41.46±3.70. Moreover, subjective norms, perceived behavioral control, and behavioral intention rose by 1.75 points to 27.71±3.46, 3.33 points to 22.37±1.70, and 2.77 points to 13.90±0.89, respectively (all paired P<0.001). These enhancements, absent or minimal in the control group, highlight the efficacy of the intervention in substantially elevating knowledge, positive attitudes, perceived social influence, behavioral control, and intentions toward PCC. Conclusion: The educational TPB-based intervention could significantly improve PCC-related factors and intentions among women with one child and delayed pregnancies. These findings support using theory-driven programs to enhance reproductive health and promote informed childbearing decisions.
Introduction: The prevalence of hypertension (HTN) increases with age. This study evaluated the effectiveness of a home visit program integrated with primary health care (PHC) in improving physical activities in the elderly with HTN. Methods: This randomized controlled trial was conducted on 108 hypertensive elderly participants in Khorramabad from May to October 2023. They were selected using stratified, multi-stage cluster sampling, and the intervention was designed based on the Health Belief Model. The primary outcome was the change in physical activity, measured by the Physical Activity Scale for the Elderly. The data were analyzed by SPSS 19 using an independent t-test, the Mann-Whitney test, ANOVA, and the generalized estimating equations model. Results: In the final analysis of 90 individuals, the integrated home visit program within the PHC structure could significantly increase the likelihood of engaging in overall physical activity (OR=1.84; 95% CI: 1.27-2.66; P=0.001) and leisure-time physical activity (OR=1.81; 95% CI: 1.15-2.85; P=0.01) compared to the control group. Based on the analysis of factors associated with the primary outcome, higher education (OR=1.85, 95% CI: 1.3-3.4, P=0.012), home ownership (OR=6.9, 95% CI: 2.88.1-16.73, P=0.001), and having health insurance (OR=1.75, 95% CI: 1.26-2.42, P=0.001) were independently associated with increased odds of achieving a clinically considerable improvement in leisure-time activity. Conclusion: Overall, integrating a home visiting program into the PHC structure noticeably improved overall physical activity levels among older adults with HTN. Therefore, it is suggested that this model be used to improve physical activity in this population. Trial Registration: Identifier: IRCT20180721040540N4; https://irct.behdasht.gov.ir/user/ trial/45393/view (Registration date 2020-05-21).
Introduction: Artificial Intelligence (AI) is increasingly applied in healthcare as it helps healthcare workers to improve the quality of care. Medical students should prepare themselves with the competence to properly and ethically use AI, especially in areas with socioeconomic challenges and limited educational resources. This study assessed medical students’ current readiness in healthcare in Sumatra. Methods: This cross-sectional study was conducted on medical students in Sumatra from November 2024 to February 2025. AI readiness was evaluated using the MAIRS-MS questionnaire. Data were analyzed using chi-square for bivariate tests and multivariate logistic regression to identify significant predictors of readiness. Results: Overall, 1,053 respondents from 22 universities in Sumatra were included in this study. Nearly 74.7% lacked formal AI training, and 90.9% relied on general tools like ChatGPT. The overall AI readiness mean was 74.36 (±14.03). Students received the highest score in ethics (10.96±2.46) and ability (28.20±5.57), but the lowest score in cognition (24.48±5.92). Prior AI training was the primary predictor for overall readiness (OR=1.90; 95% CI: 1.44–2.61). Coding experience significantly boosted cognitive readiness (OR=1.84; 95% CI: 1.33–2.54), while public university affiliation was strongly associated with higher vision (OR=2.20; 95% CI: 1.70–2.86) and ethical readiness (OR=2.10; 95% CI: 1.63–2.72). Conclusion: Medical students in Sumatra revealed moderate-to-high readiness, particularly in ethics and technical interest, yet lacked foundational cognitive proficiency. Structured curricula, hands-on practice, and early programming exposure are essential. Formal AI training is the key predictor to bridge this "literacy paradox" and ensure effective, ethical clinical integration.
Introduction: Tuberculosis (TB), caused by a single infectious agent, is the second leading cause of death worldwide, following coronavirus disease 2019, resulting in almost twice as many deaths as HIV/AIDS. Over 10 million people continue to develop TB annually. Thus, this review aimed to explore the treatment adherence in patients with TB and identify the key barriers affecting their adherence to therapy. Methods: This integrative review utilized Joanna Briggs Institute reporting guidelines for scoping reviews. Researchers completed literature searches across PubMed, ProQuest, Scopus, CINAHL, Cochrane, and Garuda databases to find English and Bahasa Indonesian full texts published from 2013 to 2023. In addition, the review followed the Whittemore and Knafl framework and employed the Critical Appraisal Prospective Study Instrument for quality control. Results: The results of 13 studies examining treatment adherence, barriers, and the role of health workers in TB revealed that individuals, service policies, and comorbidities affect TB treatment adherence. Moreover, treatment barriers were primarily caused by a lack of social support, drug side effects, economic factors, and low levels of knowledge. Nonetheless, health workers contributed to improving TB treatment adherence through supervising medication intake, providing education and counseling, and collaborating with their coworkers. Conclusion: Our findings demonstrated the importance of understanding medication adherence, barriers, and the role of health workers in integrative care of TB patients.
