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      Introducing a new measure for assessing self-efficacy in response to air pollution hazards for pregnant women

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          Abstract

          A self-efficacy instrument should be condition-specific. There are several instruments for measuring self-efficacy, but none are air pollution-specific. This study aimed to develop a self-efficacy measure for assessing pregnant women’s responses to air pollution hazards. A random sample of pregnant women aged between 18 and 35 years attending three prenatal care centers were entered into the study. Prenatal care centers randomly selected from a list of centers located in different geographical regions of Tehran, Iran. After careful consideration and performing content and face validity, a 4-item measure was developed and participants completed the questionnaire. Reliability was estimated using internal consistency and validity was assessed by performing confirmatory factor analysis (CFA) and known group comparison. In all 200 eligible pregnant women were studied. The mean age of participants was 26.9 (SD = 4.8) years and it was 27.9 (SD = 9.1) weeks for gestational age. The findings showed almost perfect results for both content validity ratio (CVR = 1) and content validity index (CVI = 1). The confirmatory factor analysis indicated a good fit to the data, and known group comparison revealed satisfying results. Internal consistency as measured by the Cronbach’s alpha coefficient was found to be 0.74. In general, the findings suggest that this new generated scale is a reliable and valid specific measure of self-efficacy in response to air pollution hazards for pregnant women. However, further studies are needed to establish stronger psychometric properties for the questionnaire.

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          Most cited references23

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          The global burden of disease due to outdoor air pollution.

          As part of the World Health Organization (WHO) Global Burden of Disease Comparative Risk Assessment, the burden of disease attributable to urban ambient air pollution was estimated in terms of deaths and disability-adjusted life years (DALYs). Air pollution is associated with a broad spectrum of acute and chronic health effects, the nature of which may vary with the pollutant constituents. Particulate air pollution is consistently and independently related to the most serious effects, including lung cancer and other cardiopulmonary mortality. The analyses on which this report is based estimate that ambient air pollution, in terms of fine particulate air pollution (PM(2.5)), causes about 3% of mortality from cardiopulmonary disease, about 5% of mortality from cancer of the trachea, bronchus, and lung, and about 1% of mortality from acute respiratory infections in children under 5 yr, worldwide. This amounts to about 0.8 million (1.2%) premature deaths and 6.4 million (0.5%) years of life lost (YLL). This burden occurs predominantly in developing countries; 65% in Asia alone. These estimates consider only the impact of air pollution on mortality (i.e., years of life lost) and not morbidity (i.e., years lived with disability), due to limitations in the epidemiologic database. If air pollution multiplies both incidence and mortality to the same extent (i.e., the same relative risk), then the DALYs for cardiopulmonary disease increase by 20% worldwide.
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            The use of theory in health behavior research from 2000 to 2005: a systematic review.

            Theory-based health behavior change programs are thought to be more effective than those that do not use theory. No previous reviews have assessed the extent to which theory is used (that is, operationalized and tested) in empirical research. The purpose of this study was to describe theory use in recent health behavior literature and to assess the proportion of research that uses theory along a continuum from: informed by theory to applying, testing, or building theory. A sample of empirical research articles (n = 193) published in ten leading public health, medicine, and psychology journals from 2000 to 2005 was coded to determine whether and how theory was used. Of health behavior articles in the sample, 35.7% mentioned theory. The most-often-used theories were The Transtheoretical Model, Social Cognitive Theory, and Health Belief Model. Most theory use (68.1%) involved research that was informed by theory; 18% applied theory; 3.6% tested theory; and 9.4% sought to build theory. About one third of published health behavior research uses theory and a small proportion of those studies rigorously apply theory. Patterns of theory use are similar to reports from the mid-1990s. Behavioral researchers should strive to use theory more thoroughly by applying, testing, and building theories in order to move the field forward.
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              Ambient Air Pollution and Low Birth Weight in Connecticut and Massachusetts

              Background Several studies have examined whether air pollution affects birth weight; however results vary and many studies were focused on Southern California or were conducted outside of the United States. Objectives We investigated maternal exposure to particulate matter with aerodynamic diameter < 10, < 2.5 μm (PM10, PM2.5), sulfur dioxide, nitrogen dioxide, and carbon monoxide and birth weight for 358,504 births in Massachusetts and Connecticut from 1999 to 2002. Methods Analysis included logistic models for low birth weight (< 2,500 g) and linear models with birth weight as a continuous variable. Exposure was assigned as the average county-level concentration over gestation and each trimester based on mother’s residence. We adjusted for gestational length, prenatal care, type of delivery, child’s sex, birth order, weather, year, and mother’s race, education, marital status, age, and tobacco use. Results An interquartile increase in gestational exposure to NO2, CO, PM10, and PM2.5 lowered birth weight by 8.9 g [95% confidence interval (CI), 7.0–10.8], 16.2 g (95% CI, 12.6–19.7), 8.2 g (95% CI, 5.3–11.1), and 14.7 g (95% CI, 12.3–17.1), respectively. Lower birth weight was associated with exposure in the third trimester for PM10, the first and third trimesters for CO, the first trimester for NO2 and SO2, and the second and third trimesters for PM2.5. Effect estimates for PM2.5 were higher for infants of black mothers than those of white mothers. Conclusions Results indicate that exposure to air pollution, even at low levels, may increase risk of low birth weight, particularly for some segments of the population.
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                Author and article information

                Contributors
                Journal
                J Environ Health Sci Eng
                J Environ Health Sci Eng
                Journal of Environmental Health Science and Engineering
                BioMed Central
                2052-336X
                2013
                8 July 2013
                : 11
                : 16
                Affiliations
                [1 ]Department of Health Education, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran
                [2 ]Department of Environmental Health Engineering, Faculty of Health, Shaheed Beheshti University of Medical Sciences, Tehran, Iran
                [3 ]Department of Biostatistics, Hospital Management Research Center, School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, Iran
                [4 ]Prochange Behavior System, West Kingston, USA
                [5 ]Department of Gynecology, Faculty of Medical Sciences, Baqiyatallah University of Medical Sciences, Tehran, Iran
                [6 ]Mental Health Research Group, Health Metrics Research Center, Iranian Institute for Health Sciences Research, ACECR, Tehran, Iran
                Article
                2052-336X-11-16
                10.1186/2052-336X-11-16
                3776291
                24491221
                a2453f4a-ad41-4a61-bb1c-cd7f8eba0712
                Copyright ©2013 Araban et al.; licensee BioMed Central Ltd.

                This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 13 January 2013
                : 6 July 2013
                Categories
                Research Article

                air polltion,confirmatory factor analysis,iran,pregnant women,reliability,self-efficacy,validity

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