Background: Health-related quality of life (HRQoL) reflects individuals’ perceptions of their health and daily functioning and has become a widely used outcome measure in population health research. Objectives: This study investigated factors associated with changes in HRQoL between baseline assessment and the 5-year follow-up in an adult cohort. Methods: A population-based cohort study was conducted among 106 adults in Shiraz, Iran, who completed HRQoL assessments at baseline in 2019 and at the five-year follow-up in 2024. Participants were recruited using multistage cluster sampling. Data on HRQoL and demographic, socioeconomic, behavioral, and clinical characteristics were collected using the Persian version of the 36-Item Short Form Health Survey (SF-36) questionnaire, physical examinations, laboratory measurements, and self-reported information. Changes in HRQoL were calculated, and factors associated with these changes were examined using multivariable linear regression models. Results: Among the 106 participants included in the analysis, 59 were female. At baseline, participants had a mean age of 48.4 ± 12.1 years. Comparisons between baseline and follow-up assessments indicated that total HRQoL remained largely unchanged, and the observed increase in mean Mental Component Summary (MCS) was not statistically significant. In regression analyses, older age was associated with greater improvement in MCS (β = 0.48, P = 0.006). Compared with participants who remained married, those who remained single experienced greater declines in total HRQoL (β = −16.04, P = 0.01) and MCS (β = −15.88, P = 0.02). Supplementary insurance status was associated with changes in HRQoL. Compared with participants who remained insured, those who gained supplementary insurance had greater changes in total HRQoL, MCS, and the Physical Component Summary (PCS) (β = 17.55, P < 0.001; β = 14.27, P = 0.003; and β = 21.02, P < 0.001, respectively). Participants who remained uninsured also showed greater changes in MCS (β = 12.41, P = 0.01). Self-rated health status was also associated with changes in HRQoL, with better ratings corresponding to improvements in both total HRQoL (β = −3.59, P = 0.01) and MCS (β = −4.23, P = 0.005). Conclusions: Over the five-year follow-up period, overall HRQoL remained relatively stable. Although the mean MCS increased slightly, this change was not statistically significant. Age, marital status, supplementary insurance status, and self-rated health were associated with changes in HRQoL. To confirm these findings and improve understanding of the factors influencing changes in HRQoL over time, further long-term studies with larger and more diverse populations are warranted.
Background: Saliva is a vital bodily fluid that plays a key role in oral and dental health. Salivary pH reflects buffering capacity, which helps prevent bacterial colonization, and salivary viscosity is directly related to protein content. Changes in these properties can adversely affect oral and dental health. Objectives: This study aimed to compare mean salivary pH and viscosity between women taking oral contraceptive pills (OCPs) and those not taking OCPs. Methods: In this cross-sectional study, 41 women participated: 21 OCP users and 20 non-users. Participants were recruited from Mahmoud Abad Health Center and Tahune Health Center in Isfahan using convenience sampling. Inclusion criteria were an age of 25 - 35 years and, for OCP users, at least 6 consecutive months of low-dose contraceptive pill use (OVOSTOP®, Iran Hormone Factory, Iran). Women taking medications that interfere with OCPs and those with gingivitis or periodontitis were excluded. Samples were collected between 9 and 11 AM. Immediately after sampling, salivary pH and viscosity were measured using a digital pH meter and a calibrated thistle tube. Data were analyzed using SPSS version 23. The Kolmogorov-Smirnov test was used to assess normality, and mean saliva movement in the capillary tube and salivary pH were compared between groups using independent t tests. Results: The mean saliva movement in the thistle tube was 10.76 mm ± 0.9042 SD in OCP users and 11.77 mm ± 1.3553 SD in the control group; this difference was significant (P = 0.008). The mean pH was 7.2434 ± 0.5665 SD in the case group and 7.0335 ± 0.7049 SD in the control group; this difference was not statistically significant (P = 0.297). Conclusions: Salivary viscosity was higher in women taking oral contraceptives. Because these pills are used over prolonged periods, oral health may be affected; therefore, women taking oral contraceptives should be informed about potential oral health effects and appropriate preventive measures.
Background: Students may smoke cigarettes to alleviate stress and psychological pressure. Low self-efficacy and limited health literacy may increase their propensity for smoking. Objectives: This study aimed to evaluate the effectiveness of health belief model-based education in improving health literacy, self-efficacy, and attitudes toward smoking. Methods: This quasi-experimental study was conducted in 2025 among students at the University of Social Welfare and Rehabilitation Sciences. Using simple random sampling, 60 students were selected and randomly assigned to the control and intervention groups. A pre-test was administered, and participants completed questionnaires on health literacy, self-efficacy, and attitudes toward smoking. The health belief model intervention protocol was then delivered to the intervention group in eight 1.5-hour sessions, followed by a post-test. For ethical reasons, informed consent was obtained. Data were analyzed using SPSS version 21. The chi-square test was used for demographic variables; means and standard deviations were used for descriptive analysis of the study variables before and after the intervention; and one-way MANCOVA was used for inferential analysis. Results: In the pre-test, the mean ± SD values for attitudes toward smoking were 47.72 ± 6.76 and 46.03 ± 6.93, those for health literacy were 52.15 ± 9.41 and 50.73 ± 7.12, and those for self-efficacy were 31.38 ± 3.79 and 29.73 ± 2.15 in the control and intervention groups, respectively. In the post-test, the mean ± SD values for attitudes toward smoking were 45.91 ± 7.20 and 22.53 ± 5.84, those for health literacy were 51.92 ± 8.08 and 63.16 ± 8.31, and those for self-efficacy were 29.15 ± 4.86 and 55.53 ± 3.92 in the control and intervention groups, respectively. Education based on the health belief model reduced the mean positive attitude toward smoking (P = 0.016), increased the mean self-efficacy score (P = 0.018), and increased the mean health literacy score (P = 0.029) in the intervention group compared with the control group. Conclusions: Education based on the health belief model may lead to changes in attitudes toward smoking, health literacy, and self-efficacy. Therefore, it may be recommended as an educational program for selected students.
