The Effect of Web-based Family-centered Empowerment Program in Preventing the Risk Factors of Substance Abuse in Students' Parents; Application of the Health Promotion Model

The Effect of Web-based Family-centered Empowerment Program in Preventing the Risk Factors of Substance Abuse in Students' Parents; Application of the Health Promotion Model | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research The Effect of Web-based Family-centered Empowerment Program in Preventing the Risk Factors of Substance Abuse in Students' Parents; Application of the Health Promotion Model Seyed Mohsen Mehri, Masoumeh Hashemian, Hamid Joveini, Mohammad Hassan Rakhshani, and 2 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-88647/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract Background and aim: The age of onset of substance abuse among adolescents has recently decreased worldwide. Parents play an important role in preventing their children from drug abuse. This study aimed to investigate the effect of web-based family-centered empowerment program in preventing the risk factors of substance abuse in students' parents, using the health promotion model (HPM). Method: This interventional study was based on 118 parents of high school students in Sabzevar, Iran (2019). Multi-stage random sampling was used to divide the participants into the experimental (n=65) and control (n=65) groups. The data were collected through a researcher-made questionnaire based on Pender's HPM. A website was designed to perform all stages of the study. The web-based educational intervention was performed for the experimental group. Both groups completed the questionnaires 2 months after the educational intervention. The data were analyzed using t-test, paired t-test, regression, correlation, and analysis of variance. Results: There was a significant difference between the scores of prior related behavior, perceived benefits of action, activity-related effect, situational influences, competitors, and commitment in the parents of the experimental group compared to the control group after the educational intervention (p-value <0.05). Moreover, a significant difference was observed between preventive behaviors of substance abuse and the mean score of perceived barriers to action, perceived self-efficacy, interpersonal influences, and role model in the parents of the experimental group compared to the control group after the educational intervention (p-value <0.05). Conclusion: Overall, designing an educational intervention based on the constructs of Pender's HPM could be an effective strategy for promoting preventive behaviors of substance abuse in parents. Preventive Medicine Health Economics & Outcomes Research Web-based Empowerment Substance Abuse Health Promotion Model Parents 1. Introduction Ensuring, maintaining, and promoting people's health is not possible without empowering them to control their individual and social destiny, and health education is the starting point that ensures the empowerment of individuals and communities ( 1 ). Drug addiction has been recognized as one of the health, medical, and social problems of the present century ( 2 ), and it can be claimed that all societies are more or less involved with it ( 3 ). Drug abuse mostly begins among high school students; therefore, one of the most important ways to reduce drug abuse in adulthood is to control it in adolescence ( 4 ). Studies have shown that most adolescents start abusing drugs around the age of 12 or 13 ( 5 ). The World Drug Report 2018 showed that drug abuse and its health effects are higher among young people than older people. Most research studies have shown that the early years of adolescence (12–14 years) to its final years (17 − 15 years) is a critical risk period for substance abuse and it may reach its maximum among adults (18–25 years) ( 6 ). The prevalence of cannabis and amphetamine abuse in 13 to 15 years old students is, respectively, 3.5% and 3.3%, worldwide ( 7 ). According to the United Nations Office on Drugs and Crime (UNODC) in 2011, Iran has one of the highest rates of opioid use ( 8 ). Researchers believe that adolescents start using legal substances, such as cigarettes and then turn to illegal substances, such as alcohol, inhalants and marijuana ( 5 ). According to statistics provided by the Ministry of Education, there are at least 500,000 students at risk of addiction. Research studies conducted in Iran have shown that 25% of students in the country are prone to addiction and 5% of whom are addicted ( 9 ). Moreover, 4% of students under the age of 15 and 24.4% between the ages of 15 to 19 have started abusing drugs ( 10 , 11 ). Another study has reported a substance abuse rate of 5.7% among Iranian students ( 12 ). Over the past few years, the age of tendency to addiction has significantly decreased ( 13 )and this has caused a major concern among many families and policymakers; since, adolescents’ tendency to addiction not only causes the loss of human resources, but also causes irreparable harm to the society. In this regard, it is very important to pay attention to the adolescents of the society and especially the students ( 9 ). Students develop their behavior in socializing with their family and friends, and if family members are deviant, children will be affected. When an individual is more connected to the family, he/she is more dependent on the family, and as a result, family norms become more internalized. In preventing addiction, the family has a crucial role in satisfying needs as well as providing life and opportunities for future success for adolescents ( 14 ). The family, directly and indirectly, plays a very important role in the tendency of children and adolescents to abuse drugs ( 15 ). The goal of family-centered prevention programs is positive youth development by creating competent parents and family communication skills and behaviors that strengthen parent/child affection and dependency, effective supervision, and disciplinary skills, and effective communication ( 12 ). The web-based intervention was considered as an innovation to conduct the study that does not require a specific time or place and the installation of special software. Experiences of such interventions have shown that e-learning and web-based education can be well received by individuals, encouraging people to participate in health education programs ( 16 ). The results of the studies also have indicated the positive effects of the web-based family-centered educational-supportive program ( 17 ). 1.1. Theoretical framework There is strong evidence that family-centered skills and educational programs have a positive impact on participants ( 18 ). Increasing knowledge leads to behavior change ( 8 , 19 ); therefore, interventions should be designed to maintain healthy behavior among the public ( 20 ). There are various theories and models for planning to change unhealthy behaviors and promote health ( 21 ). One of the comprehensive and predictive models used to study health-promoting behaviors, which provides a theoretical framework to find the factors affecting these behaviors, is Pender’s health promotion model (HPM). In this model, the determinants of health-promoting behaviors include individual experiences and characteristics, Activity related effect and cognitions of behavior, and behavioral outcomes ( 22 ). In this model, activity-related effects, such as perceived benefits of action and perceived barriers to action, directly affect the behavior ( 23 ). Most researchers used this model to study behaviors leading to health promotion ( 11 , 24 ). Therefore, due to the importance of using this model in promoting healthy behaviors, this study aimed to investigate the effect of web-based family-centered empowerment program in preventing the risk factors of substance abuse in students' parents, using the HPM. 2. Materials And Method 2.1. The participants and area This interventional study was conducted in 2018 in Sabzevar, Iran. The target group included the parents of second period high school students in Sabzevar selected by multi-stage random sampling (n = 130) and divided into the experimental (n = 65) and control (n = 65) groups. The inclusion criteria included satisfaction and interest in participating in the study, having a smartphone or computer, having at least junior high school diploma, Internet access and the ability to use it. For sampling, Sabzevar city was divided into six districts. Then, two high schools for boys and girls were randomly selected from each district and then a list of classes was prepared in each school. After that, the students were randomly selected and in the next stage their parents were selected to participate in the study (according to the sample size and the inclusion criteria). The parents were given a voluntary informed consent form if they were interested in participating in the study, and if they were not interested, another parent was asked to participate until the target sample size was completed in that school. The exclusion criteria included dissatisfaction with continuing the collaboration and failure to study at least three educational items (this possibility was provided through the site setting). The researchers tried to keep the sample loss rate as low as possible by taking appropriate measures. However, 17 parents (control group) and 4 parents (intervention group) were excluded from the study in the post-test phase. 2.2. Measurement and tools The data collection tool was a researcher-made questionnaire based on Pender's HPM designed in three sections and finally with 112 questions. The first section was related to demographic questions (12 questions), the second section was related to questions of substance abuse preventive behaviors (12 questions) and the third section was related to Pender’s model constructs (88 questions). An example of the questions and its measurement scale is given in Table 1 . Table 1 The designed tool based on the HPM with the aim of preventing substance abuse Construct Question example Coding to analyze data Cronbach's alpha Demographic information Gender, number of children, educational status, occupation, and etc. Fits the question from 1 to … 0.740 Preventive behaviors How free is your adolescent to do his/her personal affairs? The 5-point Likert scale (from (1) very high to (5) very low 0.914 Prior behavior Which of the following behaviors have you done in the last three months? -Talking to your adolescent about his/her problems. The 2-point Likert scale (from (1) I have done to (2) I have not done 0.935 Perceived benefits of action To what extent do you think the following items can be achieved by empowering the family to prevent substance abuse in children? - Maintaining income and reducing family expenses. The 5-point Likert scale (from (5) very high to (1) very low 0.919 Perceived barriers to action In case of any of the following items, to what extent can they reduce your motivation to prevent substance abuse in your adolescent? - Lack of time and overwork. The 5-point Likert scale (from (5) very high to (1) very low 0.755 Perceived self-efficacy I think I can prevent substance abuse in my adolescent, even: - If I am away from my family. The 5-point Likert scale from (5) absolutely sure to (1) not at all sure 0.814 Activity related affect To what extent do your actions to prevent substance abuse in your adolescent make you feel the followings: - Feeling useful The 5-point Likert scale (from (5) to a great extent to (1) not at all) 0.733 Interpersonal influences To what extent do the following people expect and encourage you to prevent substance abuse in your adolescent? -My friends The 5-point Likert scale (from (5) to a great extent to (1) not at all) 0.966 Situational influences To what extent do the following facilities and situations enable you to prevent substance abuse in your adolescent more seriously? - Setting rules in the family The 5-point Likert scale (from (5) to a great extent to (1) not at all) 0.845 Competitors' demands and priorities To what extent do you prefer planning to prevent substance abuse in your adolescent to the following issues? - Socializing and having fun with friends and colleagues The 5-point Likert scale (from (5) to a great extent to (1) not at all) 0.892 Model To what extent do the following people are role models for you in preventing substance abuse? - My colleagues The 5-point Likert scale (from (5) to a great extent to (1) not at all) 0.740 Commitment to plan of action Choose the best response about yourself in the following sentences. - Preventing substance abuse in my adolescent is so important to me that I dedicate specific time to it. The 5-point Likert scale (from (5) strongly agree to (1) strongly disagree) 0.914 Then, 136 initial questions of the questionnaire were designed by reviewing various authentic scientific texts and studies. To confirm its face validity, it was then given to 10 parents and the ambiguous phrases and words reported by them in the questionnaire were removed or corrected. Then, the content validity was confirmed by a panel of experts (10 health education and addiction specialists) and thus, the content validity index (CVI) and content validity ratio (CVR) were measured. The CVR value for most questions was equal to one, indicating the high validity of the questionnaire and CVI was equal to 0.96, indicating the acceptable validity of the questionnaire. Cronbach's alpha was used to assess the reliability of the questionnaires. Alpha for questionnaire constructs was obtained between 0.740–0.966, indicating high internal consistency and desirability of the scale. Moreover, the construct validity was performed on 336 parents and was analyzed and confirmed by Lisrel software. The results showed a good model fit and good reliability of the questionnaire, which have been published in an article. Out of 136 questions, 24 questions were removed and the questionnaire was approved with 112 questions. Both groups completed the questionnaire at the beginning and 2 months after the educational intervention. 2.3. Designing website In order to conduct the study, a website was needed to complete the questionnaire and educational intervention. Given that, according to the searching, no website was found to meet the requirements of this study, a website and a research system were designed and programmed to conduct the web-based study ( www.mehritest.ir ). Usernames and passwords were created for the subjects, and all stages of the study (completing the consent form to participate in the study, conducting the pre-test, dividing the subjects into control and intervention groups, observing and studying educational media in the intervention group, conducting the post-test) were done using this website. Supporting and notifying was provided by SMS and telephone calls. There was also a guide to use the website and a contact us page on the website. 2.4. Educational intervention Considering the most important predictors of substance abuse preventive behaviors, obtained from analyzing the pre-test data and emphasizing them, 15 educational media (including one poster, 1 animation, 4 short films, and 9 illustrated educational texts in PDF format) were produced and uploaded in the website tutorial and provided to parents for 20 days with the possibility of saving. In designing the media with the help of relevant experts in the field of designing health messages, it was tried to observe the principles of designing media and have the necessary attractiveness to encourage the parents to study and be approved by professors. The media topics include substance abuse statistics among students, familiarity with effective and practical solutions to prevent substance abuse, preventive advice to parents, family and addiction prevention, the introduction of various drugs, addiction prevention in adolescents, self-efficacy, life skills, the way parents talk to their children, the role of parents in preventing substance abuse among their children, as well as parents and addiction prevention. In the designed website, only the intervention group members with their username and password could enter the education section and use its content. After studying or viewing any content, the parents confirmed their visits by checking confirmation. In the website management panel, the statistics of the users’ visits, studying and not studying tutorials were specified as a follow-up. The experimental group did not receive any intervention from the researcher and received the routine community education and the "student, parents, colleagues simultaneous empowerment plan" held in the education system regarding addiction prevention. 2.5. Data analysis The collected data were analyzed using SPSS 16 statistical software and the p-value < 0.05 was considered statistically significant. Descriptive statistics were used to compare demographic characteristics between the groups. The results showed that there was no statistically significant difference between the experimental and control groups regarding any of the demographic variables. Mean (standard deviation) or median (interquartile range) was used to describe the quantitative variables according to the conditions, and frequency report (percentage) was used for the qualitative variables. To compare the mean quantitative impacts between the two groups, t-test or its non-parametric equivalent, Mann-Whitney test, was used. Chi-square test or Fisher's exact test was used to compare the qualitative factors between the groups. The generalized linear model by GEE method was used to study the constructs during the design phase. 2.6. Ethical considerations This study was approved by the ethics committee of Sabzevar University of Medical Sciences with the code (IR.MEDSAB.REC.1397.096). In addition, a written consent form was obtained from all the parents before explaining the purpose of the study. 3. Results Both experimental and control groups were compared in terms of demographic variables at the beginning of the study in terms of similarity and significant differences (Table 2 ). In this study, 53.2% of the parents were fathers and 46.8% were mothers, 53.2% of whom had a son and 46.8% had a daughter. Table 2 Frequency of the parents’ demographic characteristics in the experimental and control groups before the intervention Variable Subgroup Control group Experimental group Total Other results N % N % N % Age 33 to 40 years 21 34.4 15 31.2 36 33.0 P = 0.412 df = 2 x 2 = 1.77 41 to 46 years 23 37.7 14 29.2 37 33.9 47 to 55 years 17 27.9 19 39.6 36 33.0 Number of children 1 to 2 children 42 68.9 24 50.0 66 60.6 P = 0.051 1df = 3.99 = x2 3 to 7 children 19 31.1 24 50.0 43 39.4 Gender Male 32 66.7 26 42.6 58 53.2 P = 0.010 df = 1 x 2 = 6.24 Female 16 33.3 35 57.4 51 46.8 Children’s gender Boy 23 47.9 35 57.4 58 53.2 P = 0.33 df = 1 x 2 = 0.96 Girl 25 52.1 26 42.6 51 46.8 Marital status Married 47 97.9 59 96.7 106 97.2 P = 1 df = 2 Fishers exact = 1.01 Divorced 0 0 1 1.6 1 0.9 Spouse has died 1 2.1 1 1.6 2 1.8 Educational status High school degree 13 27.1 17 27.9 30 27.5 P = 0.52 df = 2 x 2 = 1.31 Diploma and associate degree 25 52.1 26 42.6 51 46.8 Bachelor and higher 10 20.8 18 29.5 28 25.7 Spouse's educational level I do not have a spouse 1 2.1 2 3.3 3 2.8 P = 0.14 df = 3 Fishers exact= 5.14 High school degree 8 16.7 9 14.8 17 15.6 Diploma and associate degree 24 50.0 19 31.1 43 39.4 Bachelor and higher 15 31.2 31 50.8 46 42.2 Occupation Employee 19 39.6 33 54.1 52 47.7 P = 0.000 df = 2 x 2 = 15.23 Self-employed 22 45.8 8 13.1 30 27.5 Housewife/househusband 30 14.6 20 32.8 27 24.8 Variable name subgroup Control group Experimental group Total Control group N % N % N % Spouse’s occupation I do not have a spouse 1 2.1 2 3.3 3 2.8 P = 0.01 df = 3 Fishers exact= 10.21 Employee 15 31.2 26 42.6 41 37.6 Self-employed 8 16.7 20 32.8 28 25.7 Housewife/househusband 24 50.0 13 21.3 37 33.9 Family financial status Poor 0 0 1 1.6 1 9 P = 0.003 df = 2 Fishers exact= 10.06 Fair 39 81.2 32 52.5 71 65.1 Good 9 18.8 28 45.9 37 33.9 Children’s living status Living with parents 47 97.9 58 95.1 105 96.3 P = 1 df = 2 Fishers exact= 0.98 Living with father 0 0 1 1.6 1 0.9 Living with mother 1 2.1 2 3.3 3 2.8 Living with people other than parents and spouse 0 0 0 0 0 0 Type of school Boys high school 22 45.8 33 54.1 55 50.5 P = 0.39 df = 1 x 2 = 0.73 Girls high school 26 54.2 28 45.9 54 49.5 Prior to the intervention, the participants’ status regarding preventive behavior of substance abuse was not favorable (P-value = 0.385); however, it significantly increased after the intervention in the experimental group compared to the control group (P-value = 0.000). In evaluating regression analysis indices of HPM components before the intervention (Table 3 ), interpersonal influences (β = 0.41), perceived benefits of action (β = 0.40), and perceived self-efficacy (β = 0.37), and prior related behavior (β = 0.37) were the strongest predictors of the behavior. Perceived benefits of action and self-efficacy could predict 29% and 27% of the variance in substance abuse prevention behavior, respectively. Table 3 Regression analysis indices of HPM components before the intervention Construct Coefficient (B) standard error Standardized coefficient (β) P-value adjusted R2 Prior related behavior 0.82 0.22 0.37 0.000 0.24 Perceived benefits of action 0.46 0.10 0.40 0.000 0.29 Perceived barriers to action 0.01 - 0.04 0.02- 0.806 0.13 Perceived self-efficacy 0.23 0.05 0.37 0.000 0.27 Activity related affect 0.16 0.14 0.12 0.226 0.14 Interpersonal influences 0.37 0.08 0.41 0.000 0.28 Situational influences 0.44 0.12 0.32 0.001 0.23 Competitors' demands 0.004- 0.05 0.008 - 0.934 0.12 Model 0.33 0.11 0.28 0.004 0.20 Commitment to plan of action 0.57 0.16 0.32 0.001 0.23 Table 4 represented that in 9 variables of 10 constructs related to the health promotion model, no statistically significant difference was observed between the experimental and control groups before the intervention program. The results also showed that there was a significant difference between the scores of Prior related behavior, perceived benefits of action, Interpersonal influences, Situational influences, competitors and commitment in the parents of the experimental group compared to the control group after the educational intervention. Table 4 Comparison of mean difference and standard deviation of HPM constructs scores, before and two months after the educational intervention Behavior Before the Intervention Two months after the intervention P-value Intervention 3.91 ± 44.02 2.99 ± 45.84 0.010 Control 5.00 ± 43.27 3.87 ± 42.56 0.437 P-value 0.385 0.000 Prior related behavior Before the Intervention Two months after the intervention P-value Intervention 1.89 ± 9.13 1.47 ± 10.36 0.000 Control 2.15 ± 9.04 1.27 ± 9.44 0.18 P-value 0.76 0.002 Perceived benefits of action Before the Intervention Two months after the intervention P-value Intervention 3.74 ± 48.08 2.36 ± 50.46 0.000 Control 4.08 ± 48.19 4.01 ± 49.08 0.375 P-value 0.889 0.057 Perceived barriers to action Before the Intervention Two months after the intervention P-value Intervention 12.10 ± 28.41 4.70 ± 25.38 0.338 Control 8.74 ± 27.88 3.75 ± 26.21 0.591 P-value 0.511 0.494 Perceived self-efficacy Before the Intervention Two months after the intervention P-value Intervention 8.50 ± 36.11 2.69 ± 37.30 0.308 Control 5.51 ± 35.17 4.17 ± 36.19 0.084 P-value 0.543 0.022 Individual influencers Before Intervention Two months after the intervention P-value Intervention 3.22 ± 25.11 1.60 ± 28.21 0.000 Control 3.20 ± 25.58 1.98 ± 26.48 0.229 P-value 0.36 0.000 Interpersonal influences Before the Intervention Two months after the intervention P-value Intervention 5.23 ± 33.57 2.72 ± 34.43 0.425 Control 4.18 ± 32.33 3.73 ± 33.02 0.212 P-value 0.124 0.032 Situational influences Before the Intervention Two months after the intervention P-value Intervention 3.38 ± 33.85 2.44 ± 35.52 0.002 Control 3.08 ± 33.71 2.43 ± 34.19 .0194 P-value 0.589 0.005 Competitors Before the Intervention Two months after the intervention P-value Intervention 7.85 ± 24.18 5.38 ± 27.34 0.001 Control 9.90 ± 25.73 5.91 ± 25.85 0.932 P value 0.304 0.499 Model Before the Intervention Two months after the intervention P-value Intervention 4.16 ± 25.72 2.28 ± 26.26 0.656 Control 3.07 ± 24.17 3.10 ± 23.42 0.224 P-value 0.004 0.000 Commitment Before the Intervention Two months after the intervention P-value Intervention 2.77 ± 27.07 1.61 ± 28.26 0.007 Control 2.16 ± 26.54 3.23 ± 26.15 0.778 P-value 0.147 0.000 Evaluating the regression analysis indices of the effect of education on behavior and the HPM constructs (Table 5 ) indicated that education could increase the behavior score by 3.27. After behavior, the constructs of the model, commitment to plan of action, and activity-related affect had the highest score increase of 2.66, 2.02 and 1.40, respectively, after the educational intervention. Moreover, education had the most effect on constructs of model (β = 0.44), activity-related effect (β = 0.44), parents’ behavior (β = 0.43), and prior related behavior (β = 0.32). Table 5 Regression analysis indices of the effect of education on behavior and the HPM constructs Constructs Coefficient (B) Standard error Standardized coefficient (β) P-value Behavior 3.27 - 0.66 0.43 - 0.000 Prior related behavior 0.92- 0.27 0.32- 0.001 Perceived benefits of action 1.37 - 0.62 0.21 - 0.028 Perceived barriers to action 1.48 0.82 0.17 0.074 Perceived self-efficacy 0.50- 0.73 0.07 - 0.493 Activity related affect 1.74 - 0.34 0.44- 0.000 Interpersonal influences 1.40 - 0.62 0.21 - 0.025 Situational influences 1.38 - 0.46 0.27- 0.003 Competitors' demands 1.51 - 1.03 0.13 - 0.147 Model 2.66 - 0.52 0.44 - 0.000 Commitment to plan of action 2.02 - 0.42 0.38 - 0.000 4. Discussion The results of this study showed that the parents’ prior behavior and behavior was not favorable before the intervention. However, it was expected to be in a better position, given the importance of the issue. The results of this study are consistent with the studies of Yazdanpanah ( 25 ), Mazloomy Mahmoodabad ( 26 ), and Hossein Rezaei ( 27 ). The results showed that education could have the greatest effect on the behavior score, as well as the effect of the intervention on the experimental group, parents who had a girl, and in families where the child lives with parents. Improving the behavior after the intervention in the experimental group is in line with studies conducted by Khodaveisi ( 28 ), Taheri ( 29 ), Dehdari ( 30 ), and Khodaveisi ( 28 ). The results of this study and the conducted studies ( 31 )discuss the design and implementation of interventions to prevent substance abuse in comparison with the competitor’s preferences and demands, such as watching TV, using computer, and etc. The results indicated that after the intervention, the parents became more responsible for preventing substance abuse in their adolescents, and preferred this issue to watch TV, cyberspace, using the Internet, and relaxing. In this study, it was shown that in order to increase the preventive behavior of substance abuse by parents, perceived barriers to action should be reduced. Moreover, it can be concluded that adequate income and consequently, sufficient time for parents to take care of their children are necessary to improve the parents’ preventive behaviors, which is in line with the results of studies by Rahimi ( 30 )and Kamali ( 32 ). In this study, the child's residence in the dormitory, lack of knowledge about drugs, lack of time and overwork, when parents are away from the family and lack of authorities’ attention to the adolescents’ problems were the most important perceived barriers to action from the participants’ viewpoint. This result is in line with that of Kumpfer’s study, which reported lack of time and overwork as the main perceived barriers to action. Self-efficacy is a predictor of performance and people with a stronger sense of self-efficacy show greater effort, more seriousness, and longer endurance in acquiring new tasks compared to those with less self-efficacy ( 12 , 33 ). Therefore, by providing appropriate educational resources, experienced and caring counselors, as well as educational facilities in the place of residence, some barriers to prevent substance abuse can be removed. Hence, in designing educations and interventions, great attention should be paid to the individuals’ benefits from behavior change, self-efficacy and incentives. Brownson ( 34 ), Saelens ( 35 ), and Nikpour ( 36 )also reported the positive effect of environment and access to facilities on parents' preventive behavior. The results of the present study showed that there was a significant difference in the construct of perceived benefits of action in the experimental group after the intervention and the participants' knowledge about the benefits of substance abuse prevention increased, which is consistent with Mazloomy Mahmoodabad’s study ( 26 )and in contrary to Shokoohi’s study ( 37 )These changes can indicate the effectiveness of educational intervention to promote and identify the benefits and effects of parent’s behavior changes in preventing substance abuse in their children. Solhi and Banaye Jedd also stated an increase in the score of commitment construct after the intervention ( 38 , 39 ). In Mirkarimi’s study ( 40 ), the commitment construct was not one of the main influential constructs. Given that having a positive feeling about behavior increases the probability of doing and repeating, it is necessary to consider creating a positive feeling about regular preventive behaviors in order to increase the substance abuse preventive behavior in parents. The results showed that after the educational intervention, most parents would use every opportunity to plan to prevent substance abuse. The results of similar studies have shown that family interventions are the most effective prevention and treatment measures for drug abuse and other negative growth consequences in adolescents ( 33 , 41 ). Therefore, planning to empower the family to promote the status of substance abuse preventive behavior should be considered ( 42 ). The mentioned results indicate the effect of web-based family-centered empowerment program intervention on improving most HPM constructs. Given that these constructs are effective in improving the status of preventive behavior, their implementation and promotion can be effective in improving preventive behavior. 4.1. Limitations One of the limitations of the present study was that the studied subjects were only from a small geographical area in Iran, Sabzevar. Therefore, the participants were not good representatives of parents in Iran and other countries. It is suggested that a future study be conducted to determine whether or not educational programs reduce parent’s level of empowerment and prevention of substance abuse risk factors among students in other parts of Iran and the world. 5. Conclusion The results indicate the effectiveness of the educational program based on the constructs of Pender’s HPM in empowering parents to prevent substance abuse risk factors among students. Educational programs are effective strategies that help empower parents to deal more easily with the problems and barriers in preventing substance abuse. In addition to education, more measures are required to prevent substance abuse. In this regard, it is recommended to provide basic facilities and job opportunities by related organizations with sufficient income, develop sports facilities, establish regulations in the family, provide facilities for the child's education in residence, and pay attention to preventive behaviors as one of the important components of lifestyle change. Abbreviations HPM : health promotion model , Content validity ratio (CVR), content validity index (CVI). Declarations Ethics approval and consent to participate This study was approved by the ethics committee of Sabzevar University of Medical Sciences (code: IR.MEDSAB.REC.1399.007). All participants signed the consent form before beginning the study. Consent for publication Not Applicable Competing interests The authors declare that they not have any conflict of interest Availability of data and materials Not Applicable Funding This study was supported by Sabzevar University of Medical Sciences. Authors' contributions S.M.M and M.H contributed to the design of the study, was responsible for the management and retrieval of data, contributed to initial data analysis and interpretation, drafted the initial manuscript. H.J and M.H.R decided upon the data collection methods and responsible for the data analysis decisions. H.E.A conceptualized and designed the study, supervised all aspects of the study, critically reviewed and revised the manuscript, and approved the final manuscript as submitted. all authors read and approved the final manuscript Conflict of interest The authors do not declare any conflict of interest. Funds This study is extracted from the master's thesis approved by the Vice Chancellor for Research and Technology and with the support of Sabzevar University of Medical Sciences. References Zare Harofteh F, Bahrevar V, Madani SM. Are the musculoskeletal pains the most important health problem for employees of mellat bank? A cross sectional study in Yazd, Iran. International Journal of Musculoskeletal Pain Prevention. 2017;2(4):333–7. Martínez Loredo V, Fernández Hermida JR. Impulsivity-targeted selective preventive interventions and treatments in addictive behaviors. Revista de Psicología Clínica con niños y adolescentes. 2019. Toofani H, Javanbakht M. Comparison of coping styles and dysfunctional attitudes in substance abusers and control group. 2002. Rahimi Movaghar A, Shimi A. Substances use situation in Iranian students. Social Welfare Quarterly. 2006;19:9–29. Neinstein L. Understanding legal aspects of care. 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International Scholarly Research Notices. 2014;2014. Webster-Stratton C, Taylor T. Nipping early risk factors in the bud: Preventing substance abuse, delinquency, and violence in adolescence through interventions targeted at young children (0–8 years). Prevention science. 2001;2(3):165–92. Kaplan HI, Sadock BJ. Study guide and self-examination review for Synopsis of psychiatry and Comprehensive textbook of psychiatry. 2020. Jahedi N, Talepasan S, Rahimian-Bougar E. Validation of Partners' Checklist: Measurement of the Problems Experienced by Family Members of Drug Abusers. Research on Addiction. 2016;10(38):211–32. solati s. abedin zadeh mr, nikfarjam m, deris f. Relationship between substance abuse and mental disorders of family (2001). Journal of Shahrekord Uuniversity of Medical Sciences. 2004;6(2):1–8. Fonseca A, Alves S, Monteiro F, Gorayeb R, Canavarro MC. Be a Mom, a web-based intervention to prevent postpartum depression: results from a pilot randomized controlled trial. Behav Ther. 2020;51(4):616–33. Moeini M, Shafiei D. The Impact of a Web-based Family-oriented Supportive Education Program in Adherence to Treatment of The Heart Failure Patients after Discharge from Hospital; A Randomized Clinical Trial. Journal of Clinical Nursing Midwifery. 2019;7(4):286–95. Scheier LM, Hansen WB. Parenting and teen drug use: The most recent findings from research, prevention, and treatment: Oxford University Press; 2014. Jouhari Z, Pirasteh A, Davati A, Mohamadi J. The effect of educational intervention in volunteer’s earthquake knowledge in health centers of eastern Tehran. 2012. Hosseini H, Tari Marzabad A, Hassanpour-ezatti M. Introducing an Integro-Differential Equation Model for Spread of Addictive Drugs abuse. Research on Addiction. 2017;10(40):255–66. Hazavehei S, Shadzi S, Asgari T, Pourabdian S, Hasanzadeh A. The effect of safety education based on Health Belief Model (HBM) on the workers practice of Borujen industrial town in using the personal protection respiratory equipments. Iran Occupational Health Journal. 2008;5(1):21–30. Rahnavard Z, Zolfaghari M, Kazemnejad A, Hatamipour K. An investigation of quality of life and factors affecting it in the patients with congestive heart failure. Journal of hayat. 2006;12(1):77–86. Mazloomi SS, Saba MA, Morovati MA, Fallahzadeh H. The relation of knowledge, attitude and self-management behaviors in asthmatic patients with controlling asthma. Zahedan Journal of Research in Medical Sciences. 2012;14(1). Heydari A, Khorashadizadeh F. Pender’s health promotion model in medical research. studies. 2014;41:59. Yazdanpanah B, Safari M, Yosefi M, Angha P, Habibian M, Zandi K, et al. Effects of Community Based Educational Prevention Program of Drug Abuse in Reduction of High Risk Behavior. The Journal of Shahid Sadoughi University of Medical Sciences. 2010;18(3):191–8. Mazloomy Mahmoodabad SS, Khoshab S, Sohrabi Vafa F, Fallahzadeh H, Yassini Ardekani SM. The effect of health education based on health belief model on preventive actions of synthetic drugs dependence in male students of Kerman, Iran. Social Behavior Research Health. 2017;1(2):100–7. Hossein-Rezaei H, Mohammad-Alizadeh S. Parents’ Knowledge about the Symptoms of Substance Abuse: a Study on Parents of Students in Kerman High Schools and Secondary Schools. Journal of Kerman University of Medical Sciences. 2008;15(3):261–8. Khodaveisi M, Omidi A, Farokhi S, Soltanian AR. The effect of Pender’s health promotion model in improving the nutritional behavior of overweight and obese women. International journal of community based nursing midwifery. 2017;5(2):165. Sadeghmoghadam L, Tavakolizadeh J, Mazloum Shahri SB, Taheri M. Effectiveness of Pender's Health Promotion Model on Reducing Drivers High-risk Behaviors. Journal of Police Medicine. 2018;7(3):97–102. Dehdari T, Rahimi T, Aryaeian N, Gohari MR. Effect of nutrition education intervention based on Pender's Health Promotion Model in improving the frequency and nutrient intake of breakfast consumption among female Iranian students. Public Health Nutr. 2014;17(3):657–66. Teymouri P, Niknami S, Ghofranipour F. Effects of a school-based intervention on the basis of pender’s health promotion model to improve physical activity among high school girls. Armaghane danesh. 2007;12(2):47–59. Khosravan S, Alami A, Mansoorian MR, Kamali M. The Effect of Intervention Based on Pender’s Model of Health-Promoting Self-Care Behaviors in Women who are the Head of their Household. Nursing Midwifery Studies. 2016;5(4):-. Kumpfer KL, Alvarado R. Family-strengthening approaches for the prevention of youth problem behaviors. Am Psychol. 2003;58(6–7):457. Brownson RC, Baker EA, Housemann RA, Brennan LK, Bacak SJ. Environmental and policy determinants of physical activity in the United States. American journal of public health. 2001;91(12):1995–2003. Saelens BE, Sallis JF, Black JB, Chen D. Neighborhood-based differences in physical activity: an environment scale evaluation. American journal of public health. 2003;93(9):1552–8. Nikpour G. Drugs and drug policy in the Islamic Republic of Iran. Middle East Briefs. 2019;119:2–7. Shokoohi M, Jamshidimanesh M, Ranjbar H, Saffari M, Motamed A. The effectiveness of a model-based health education program on protective behavior against human papillomavirus in female drug abusers: a randomized controlled trial. HIV & AIDS Review International Journal of HIV-Related Problems.19(1):16–23. Solhi M, Ahmadi L, Taghdisi MH, Haghani H. The Effect of Trans Theoretical Model (TTM) on exercise behavior in pregnant women referred to dehaghan rural health center in. Iranian Journal of Medical Education. 2012;11(8):942–50. Banaye Jedd M, Babazadeh T, Hashemian Z, Moradi F, Ghavami Z. Cognitive-Behavioral Determinants of Oral Health in students: an Application of Pender's Health Promotion Model. Journal of Education Community Health. 2016;3(2):1–8. Kamal Mirkarimi S, Maghsoudloo M, Berdi Ozouni-Davaji R, Raeisi V, Charkazi A, Raeisi M. The determinants of hypertension and commitment to implementing a nutrition program: application of Pender health promotion model. Journal of Health Literacy. 2018;3(1):50–60. Kumpfer KL, Magalhães C, Xie J. Cultural adaptations of evidence-based family interventions to strengthen families and improve children's developmental outcomes. European Journal of Developmental Psychology. 2012;9(1):104–16. Vahedian-Shahroodi M, Amin-Shokravi F, Hidarnia A, Jabbari Nooghabid H. A Survey on the effects of the pender's Health Promotion Model on prediction of the employees' physical activity. Health Education Health Promotion. 2013;1(1):51–66. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-88647","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Research","associatedPublications":[],"authors":[{"id":3325179,"identity":"fb3e25f5-3fa6-4564-8dcd-4cffd8a9d743","order_by":0,"name":"Seyed Mohsen Mehri","email":"","orcid":"","institution":"Sabzevar University of Medical Sciences","correspondingAuthor":false,"prefix":"","firstName":"Seyed","middleName":"Mohsen","lastName":"Mehri","suffix":""},{"id":3325180,"identity":"04b884f2-dd32-41b0-bb69-30e1365c3c9d","order_by":1,"name":"Masoumeh Hashemian","email":"","orcid":"","institution":"Sabzevar University of Medical Sciences","correspondingAuthor":false,"prefix":"","firstName":"Masoumeh","middleName":"","lastName":"Hashemian","suffix":""},{"id":3325181,"identity":"98d376b6-898a-4771-b642-093502e5472d","order_by":2,"name":"Hamid Joveini","email":"","orcid":"","institution":"Sabzevar University of Medical Sciences","correspondingAuthor":false,"prefix":"","firstName":"Hamid","middleName":"","lastName":"Joveini","suffix":""},{"id":3325182,"identity":"e2546095-8572-42e9-b9de-36f6032f68ba","order_by":3,"name":"Mohammad Hassan Rakhshani","email":"","orcid":"","institution":"Sabzevar University of Medical Sciences","correspondingAuthor":false,"prefix":"","firstName":"Mohammad","middleName":"Hassan","lastName":"Rakhshani","suffix":""},{"id":3325183,"identity":"a78dc492-6677-4309-af07-0f7f8fcf598c","order_by":4,"name":"Abdolghader Assarroudi","email":"","orcid":"","institution":"Sabzevar University of Medical Sciences","correspondingAuthor":false,"prefix":"","firstName":"Abdolghader","middleName":"","lastName":"Assarroudi","suffix":""},{"id":3325184,"identity":"3404dc12-76bc-41ca-8113-526f3109f091","order_by":5,"name":"Hamideh Ebrahimi Aval","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAA10lEQVRIiWNgGAWjYBACAyBmBuIENgbGxgcMDAdI09JsQJoWIGaTIEqLudgBxseFe+zy+MQOt1Xz1NyR42dgfvjoBh4tlrMTmI1nPEsuZpNObLvNc+yZsWQDm7FxDj6H3U5gk+Y5wJzYBtbCdjhxwwEeNmkCWth/8xyoB2sp5vlHnBY2Zp4Dh8FamHnbiNKS2Cw948BxkJZmybl9h40lmwn6Jfng54ID1YnzZ6c//PDm22E5fvbmh4/xaWFgYGyAM5l4QCQzXuXoun+QonoUjIJRMApGDAAAOM1N5MD8N1UAAAAASUVORK5CYII=","orcid":"https://orcid.org/0000-0001-9890-4400","institution":"Sabzevar University of Medical Sciences","correspondingAuthor":true,"prefix":"","firstName":"Hamideh","middleName":"Ebrahimi","lastName":"Aval","suffix":""}],"badges":[],"createdAt":"2020-10-06 14:15:43","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-88647/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-88647/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":13604314,"identity":"343b0223-e702-43b2-9f03-94094c2d4943","added_by":"auto","created_at":"2021-09-17 05:59:21","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":410311,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-88647/v1/444d0eb2-c5a1-4878-bb6c-0ee0194cbd18.pdf"}],"financialInterests":"","formattedTitle":"The Effect of Web-based Family-centered Empowerment Program in Preventing the Risk Factors of Substance Abuse in Students' Parents; Application of the Health Promotion Model","fulltext":[{"header":"1. Introduction","content":" \u003cp\u003eEnsuring, maintaining, and promoting people's health is not possible without empowering them to control their individual and social destiny, and health education is the starting point that ensures the empowerment of individuals and communities (\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e). Drug addiction has been recognized as one of the health, medical, and social problems of the present century (\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e), and it can be claimed that all societies are more or less involved with it (\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e). Drug abuse mostly begins among high school students; therefore, one of the most important ways to reduce drug abuse in adulthood is to control it in adolescence (\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e). Studies have shown that most adolescents start abusing drugs around the age of 12 or 13 (\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e). The World Drug Report 2018 showed that drug abuse and its health effects are higher among young people than older people. Most research studies have shown that the early years of adolescence (12\u0026ndash;14\u0026nbsp;years) to its final years (17\u0026thinsp;\u0026minus;\u0026thinsp;15\u0026nbsp;years) is a critical risk period for substance abuse and it may reach its maximum among adults (18\u0026ndash;25\u0026nbsp;years) (\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e). The prevalence of cannabis and amphetamine abuse in 13 to 15\u0026nbsp;years old students is, respectively, 3.5% and 3.3%, worldwide (\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e). According to the United Nations Office on Drugs and Crime (UNODC) in 2011, Iran has one of the highest rates of opioid use (\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e). Researchers believe that adolescents start using legal substances, such as cigarettes and then turn to illegal substances, such as alcohol, inhalants and marijuana (\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e). According to statistics provided by the Ministry of Education, there are at least 500,000 students at risk of addiction. Research studies conducted in Iran have shown that 25% of students in the country are prone to addiction and 5% of whom are addicted (\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e). Moreover, 4% of students under the age of 15 and 24.4% between the ages of 15 to 19 have started abusing drugs (\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e, \u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e). Another study has reported a substance abuse rate of 5.7% among Iranian students (\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e). Over the past few years, the age of tendency to addiction has significantly decreased (\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e)and this has caused a major concern among many families and policymakers; since, adolescents\u0026rsquo; tendency to addiction not only causes the loss of human resources, but also causes irreparable harm to the society. In this regard, it is very important to pay attention to the adolescents of the society and especially the students (\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eStudents develop their behavior in socializing with their family and friends, and if family members are deviant, children will be affected. When an individual is more connected to the family, he/she is more dependent on the family, and as a result, family norms become more internalized. In preventing addiction, the family has a crucial role in satisfying needs as well as providing life and opportunities for future success for adolescents (\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e). The family, directly and indirectly, plays a very important role in the tendency of children and adolescents to abuse drugs (\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e). The goal of family-centered prevention programs is positive youth development by creating competent parents and family communication skills and behaviors that strengthen parent/child affection and dependency, effective supervision, and disciplinary skills, and effective communication (\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eThe web-based intervention was considered as an innovation to conduct the study that does not require a specific time or place and the installation of special software. Experiences of such interventions have shown that e-learning and web-based education can be well received by individuals, encouraging people to participate in health education programs (\u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e). The results of the studies also have indicated the positive effects of the web-based family-centered educational-supportive program (\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e).\u003c/p\u003e \u003cdiv id=\"Sec2\" class=\"Section2\"\u003e \u003ch2\u003e1.1. Theoretical framework\u003c/h2\u003e \u003cp\u003eThere is strong evidence that family-centered skills and educational programs have a positive impact on participants (\u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e). Increasing knowledge leads to behavior change (\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e, \u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e); therefore, interventions should be designed to maintain healthy behavior among the public (\u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e). There are various theories and models for planning to change unhealthy behaviors and promote health (\u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e). One of the comprehensive and predictive models used to study health-promoting behaviors, which provides a theoretical framework to find the factors affecting these behaviors, is Pender\u0026rsquo;s health promotion model (HPM). In this model, the determinants of health-promoting behaviors include individual experiences and characteristics, Activity related effect and cognitions of behavior, and behavioral outcomes (\u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e). In this model, activity-related effects, such as perceived benefits of action and perceived barriers to action, directly affect the behavior (\u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e). Most researchers used this model to study behaviors leading to health promotion (\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e, \u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e). Therefore, due to the importance of using this model in promoting healthy behaviors, this study aimed to investigate the effect of web-based family-centered empowerment program in preventing the risk factors of substance abuse in students' parents, using the HPM.\u003c/p\u003e \u003c/div\u003e "},{"header":"2. Materials And Method","content":"\u003cdiv id=\"Sec4\" class=\"Section2\"\u003e\n\u003ch2\u003e2.1. The participants and area\u003c/h2\u003e\n\u003cp\u003eThis interventional study was conducted in 2018 in Sabzevar, Iran. The target group included the parents of second period high school students in Sabzevar selected by multi-stage random sampling (n\u0026thinsp;=\u0026thinsp;130) and divided into the experimental (n\u0026thinsp;=\u0026thinsp;65) and control (n\u0026thinsp;=\u0026thinsp;65) groups. The inclusion criteria included satisfaction and interest in participating in the study, having a smartphone or computer, having at least junior high school diploma, Internet access and the ability to use it. For sampling, Sabzevar city was divided into six districts. Then, two high schools for boys and girls were randomly selected from each district and then a list of classes was prepared in each school. After that, the students were randomly selected and in the next stage their parents were selected to participate in the study (according to the sample size and the inclusion criteria). The parents were given a voluntary informed consent form if they were interested in participating in the study, and if they were not interested, another parent was asked to participate until the target sample size was completed in that school. The exclusion criteria included dissatisfaction with continuing the collaboration and failure to study at least three educational items (this possibility was provided through the site setting). The researchers tried to keep the sample loss rate as low as possible by taking appropriate measures. However, 17 parents (control group) and 4 parents (intervention group) were excluded from the study in the post-test phase.\u003c/p\u003e\n\u003c/div\u003e\n\u003cdiv id=\"Sec5\" class=\"Section2\"\u003e\n\u003ch2\u003e2.2. Measurement and tools\u003c/h2\u003e\n\u003cp\u003eThe data collection tool was a researcher-made questionnaire based on Pender's HPM designed in three sections and finally with 112 questions. The first section was related to demographic questions (12 questions), the second section was related to questions of substance abuse preventive behaviors (12 questions) and the third section was related to Pender\u0026rsquo;s model constructs (88 questions). An example of the questions and its measurement scale is given in Table\u0026nbsp;\u003cspan class=\"InternalRef\"\u003e1\u003c/span\u003e.\u003c/p\u003e\n\u003cdiv class=\"gridtable\"\u003e\n\u003ctable id=\"Tab1\" border=\"1\"\u003e\u003ccaption\u003e\n\u003cdiv class=\"CaptionNumber\"\u003eTable 1\u003c/div\u003e\n\u003cdiv class=\"CaptionContent\"\u003e\n\u003cp\u003eThe designed tool based on the HPM with the aim of preventing substance abuse\u003c/p\u003e\n\u003c/div\u003e\n\u003c/caption\u003e\n\u003cthead\u003e\n\u003ctr\u003e\n\u003cth align=\"left\"\u003e\n\u003cp\u003eConstruct\u003c/p\u003e\n\u003c/th\u003e\n\u003cth align=\"left\"\u003e\n\u003cp\u003eQuestion example\u003c/p\u003e\n\u003c/th\u003e\n\u003cth align=\"left\"\u003e\n\u003cp\u003eCoding to analyze data\u003c/p\u003e\n\u003c/th\u003e\n\u003cth align=\"left\"\u003e\n\u003cp\u003eCronbach's alpha\u003c/p\u003e\n\u003c/th\u003e\n\u003c/tr\u003e\n\u003c/thead\u003e\n\u003ctbody\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eDemographic information\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eGender, number of children, educational status, occupation, and etc.\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eFits the question from 1 to \u0026hellip;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e0.740\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003ePreventive behaviors\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eHow free is your adolescent to do his/her personal affairs?\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eThe 5-point Likert scale (from (1) very high to (5) very low\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e0.914\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003ePrior behavior\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eWhich of the following behaviors have you done in the last three months?\u003c/p\u003e\n\u003cp\u003e-Talking to your adolescent about his/her problems.\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eThe 2-point Likert scale (from (1) I have done to (2) I have not done\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e0.935\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003ePerceived benefits of action\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eTo what extent do you think the following items can be achieved by empowering the family to prevent substance abuse in children?\u003c/p\u003e\n\u003cp\u003e- Maintaining income and reducing family expenses.\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eThe 5-point Likert scale (from (5) very high to (1) very low\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e0.919\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003ePerceived barriers to action\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eIn case of any of the following items, to what extent can they reduce your motivation to prevent substance abuse in your adolescent?\u003c/p\u003e\n\u003cp\u003e- Lack of time and overwork.\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eThe 5-point Likert scale (from (5) very high to (1) very low\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e0.755\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003ePerceived self-efficacy\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eI think I can prevent substance abuse in my adolescent, even:\u003c/p\u003e\n\u003cp\u003e- If I am away from my family.\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eThe 5-point Likert scale from (5) absolutely sure to (1) not at all sure\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e0.814\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eActivity related affect\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eTo what extent do your actions to prevent substance abuse in your adolescent make you feel the followings:\u003c/p\u003e\n\u003cp\u003e- Feeling useful\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eThe 5-point Likert scale (from (5) to a great extent to (1) not at all)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e0.733\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eInterpersonal influences\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eTo what extent do the following people expect and encourage you to prevent substance abuse in your adolescent?\u003c/p\u003e\n\u003cp\u003e-My friends\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eThe 5-point Likert scale (from (5) to a great extent to (1) not at all)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e0.966\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eSituational influences\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eTo what extent do the following facilities and situations enable you to prevent substance abuse in your adolescent more seriously?\u003c/p\u003e\n\u003cp\u003e- Setting rules in the family\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eThe 5-point Likert scale (from (5) to a great extent to (1) not at all)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e0.845\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eCompetitors' demands and priorities\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eTo what extent do you prefer planning to prevent substance abuse in your adolescent to the following issues?\u003c/p\u003e\n\u003cp\u003e- Socializing and having fun with friends and colleagues\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eThe 5-point Likert scale (from (5) to a great extent to (1) not at all)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e0.892\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eModel\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eTo what extent do the following people are role models for you in preventing substance abuse?\u003c/p\u003e\n\u003cp\u003e- My colleagues\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eThe 5-point Likert scale (from (5) to a great extent to (1) not at all)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e0.740\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eCommitment to plan of action\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eChoose the best response about yourself in the following sentences.\u003c/p\u003e\n\u003cp\u003e- Preventing substance abuse in my adolescent is so important to me that I dedicate specific time to it.\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eThe 5-point Likert scale (from (5) strongly agree to (1) strongly disagree)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e0.914\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003c/tbody\u003e\n\u003c/table\u003e\n\u003c/div\u003e\n\u003cp\u003eThen, 136 initial questions of the questionnaire were designed by reviewing various authentic scientific texts and studies. To confirm its face validity, it was then given to 10 parents and the ambiguous phrases and words reported by them in the questionnaire were removed or corrected. Then, the content validity was confirmed by a panel of experts (10 health education and addiction specialists) and thus, the content validity index (CVI) and content validity ratio (CVR) were measured. The CVR value for most questions was equal to one, indicating the high validity of the questionnaire and CVI was equal to 0.96, indicating the acceptable validity of the questionnaire. Cronbach's alpha was used to assess the reliability of the questionnaires. Alpha for questionnaire constructs was obtained between 0.740\u0026ndash;0.966, indicating high internal consistency and desirability of the scale. Moreover, the construct validity was performed on 336 parents and was analyzed and confirmed by Lisrel software. The results showed a good model fit and good reliability of the questionnaire, which have been published in an article.\u003c/p\u003e\n\u003cp\u003eOut of 136 questions, 24 questions were removed and the questionnaire was approved with 112 questions. Both groups completed the questionnaire at the beginning and 2 months after the educational intervention.\u003c/p\u003e\n\u003c/div\u003e\n\u003cdiv id=\"Sec6\" class=\"Section2\"\u003e\n\u003ch2\u003e2.3. Designing website\u003c/h2\u003e\n\u003cp\u003eIn order to conduct the study, a website was needed to complete the questionnaire and educational intervention. Given that, according to the searching, no website was found to meet the requirements of this study, a website and a research system were designed and programmed to conduct the web-based study (\u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e\u003ca href=\"http://www.mehritest.ir\" target=\"_blank\"\u003ewww.mehritest.ir\u003c/a\u003e\u003c/span\u003e\u003c/span\u003e). Usernames and passwords were created for the subjects, and all stages of the study (completing the consent form to participate in the study, conducting the pre-test, dividing the subjects into control and intervention groups, observing and studying educational media in the intervention group, conducting the post-test) were done using this website. Supporting and notifying was provided by SMS and telephone calls. There was also a guide to use the website and a contact us page on the website.\u003c/p\u003e\n\u003c/div\u003e\n\u003cdiv id=\"Sec7\" class=\"Section2\"\u003e\n\u003ch2\u003e2.4. Educational intervention\u003c/h2\u003e\n\u003cp\u003eConsidering the most important predictors of substance abuse preventive behaviors, obtained from analyzing the pre-test data and emphasizing them, 15 educational media (including one poster, 1 animation, 4 short films, and 9 illustrated educational texts in PDF format) were produced and uploaded in the website tutorial and provided to parents for 20 days with the possibility of saving. In designing the media with the help of relevant experts in the field of designing health messages, it was tried to observe the principles of designing media and have the necessary attractiveness to encourage the parents to study and be approved by professors.\u003c/p\u003e\n\u003cp\u003eThe media topics include substance abuse statistics among students, familiarity with effective and practical solutions to prevent substance abuse, preventive advice to parents, family and addiction prevention, the introduction of various drugs, addiction prevention in adolescents, self-efficacy, life skills, the way parents talk to their children, the role of parents in preventing substance abuse among their children, as well as parents and addiction prevention.\u003c/p\u003e\n\u003cp\u003eIn the designed website, only the intervention group members with their username and password could enter the education section and use its content. After studying or viewing any content, the parents confirmed their visits by checking confirmation. In the website management panel, the statistics of the users\u0026rsquo; visits, studying and not studying tutorials were specified as a follow-up.\u003c/p\u003e\n\u003cp\u003eThe experimental group did not receive any intervention from the researcher and received the routine community education and the \"student, parents, colleagues simultaneous empowerment plan\" held in the education system regarding addiction prevention.\u003c/p\u003e\n\u003c/div\u003e\n\u003cdiv id=\"Sec8\" class=\"Section2\"\u003e\n\u003ch2\u003e2.5. Data analysis\u003c/h2\u003e\n\u003cp\u003eThe collected data were analyzed using SPSS 16 statistical software and the p-value\u0026thinsp;\u0026lt;\u0026thinsp;0.05 was considered statistically significant. Descriptive statistics were used to compare demographic characteristics between the groups. The results showed that there was no statistically significant difference between the experimental and control groups regarding any of the demographic variables. Mean (standard deviation) or median (interquartile range) was used to describe the quantitative variables according to the conditions, and frequency report (percentage) was used for the qualitative variables. To compare the mean quantitative impacts between the two groups, t-test or its non-parametric equivalent, Mann-Whitney test, was used. Chi-square test or Fisher's exact test was used to compare the qualitative factors between the groups. The generalized linear model by GEE method was used to study the constructs during the design phase.\u003c/p\u003e\n\u003c/div\u003e\n\u003cdiv id=\"Sec9\" class=\"Section2\"\u003e\n\u003ch2\u003e2.6. Ethical considerations\u003c/h2\u003e\n\u003cp\u003eThis study was approved by the ethics committee of Sabzevar University of Medical Sciences with the code (IR.MEDSAB.REC.1397.096). In addition, a written consent form was obtained from all the parents before explaining the purpose of the study.\u003c/p\u003e\n\u003c/div\u003e"},{"header":"3. Results","content":"\u003cp\u003eBoth experimental and control groups were compared in terms of demographic variables at the beginning of the study in terms of similarity and significant differences (Table\u0026nbsp;\u003cspan class=\"InternalRef\"\u003e2\u003c/span\u003e). In this study, 53.2% of the parents were fathers and 46.8% were mothers, 53.2% of whom had a son and 46.8% had a daughter.\u003c/p\u003e\n\u003cdiv class=\"gridtable\"\u003e\n\u003ctable id=\"Tab2\" border=\"1\"\u003e\u003ccaption\u003e\n\u003cdiv class=\"CaptionNumber\"\u003eTable 2\u003c/div\u003e\n\u003cdiv class=\"CaptionContent\"\u003e\n\u003cp\u003eFrequency of the parents\u0026rsquo; demographic characteristics in the experimental and control groups before the intervention\u003c/p\u003e\n\u003c/div\u003e\n\u003c/caption\u003e\n\u003ctbody\u003e\n\u003ctr\u003e\n\u003ctd rowspan=\"2\" align=\"left\"\u003e\n\u003cp\u003eVariable\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd rowspan=\"2\" align=\"left\"\u003e\n\u003cp\u003eSubgroup\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd colspan=\"2\" align=\"left\"\u003e\n\u003cp\u003eControl group\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd colspan=\"2\" align=\"left\"\u003e\n\u003cp\u003eExperimental group\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd colspan=\"2\" align=\"left\"\u003e\n\u003cp\u003eTotal\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd rowspan=\"2\" align=\"left\"\u003e\n\u003cp\u003eOther results\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eN\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e%\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eN\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e%\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eN\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e%\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd rowspan=\"3\" align=\"left\"\u003e\n\u003cp\u003eAge\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e33 to 40\u0026nbsp;years\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e21\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e34.4\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e15\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e31.2\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e36\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e33.0\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd rowspan=\"3\" align=\"left\"\u003e\n\u003cp\u003eP\u0026thinsp;=\u0026thinsp;0.412\u003c/p\u003e\n\u003cp\u003edf\u0026thinsp;=\u0026thinsp;2\u003c/p\u003e\n\u003cp\u003ex\u003csup\u003e2\u003c/sup\u003e\u0026thinsp;=\u0026thinsp;1.77\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e41 to 46\u0026nbsp;years\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e23\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e37.7\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e14\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e29.2\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e37\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e33.9\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e47 to 55\u0026nbsp;years\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e17\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e27.9\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e19\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e39.6\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e36\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e33.0\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd rowspan=\"2\" align=\"left\"\u003e\n\u003cp\u003eNumber of children\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e1 to 2 children\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e42\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e68.9\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e24\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e50.0\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e66\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e60.6\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd rowspan=\"2\" align=\"left\"\u003e\n\u003cp\u003eP\u0026thinsp;=\u0026thinsp;0.051\u003c/p\u003e\n\u003cp\u003e1df =\u003c/p\u003e\n\u003cp\u003e3.99\u0026thinsp;=\u0026thinsp;x2\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e3 to 7 children\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e19\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e31.1\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e24\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e50.0\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e43\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e39.4\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd rowspan=\"2\" align=\"left\"\u003e\n\u003cp\u003eGender\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eMale\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e32\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e66.7\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e26\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e42.6\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e58\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e53.2\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd rowspan=\"2\" align=\"left\"\u003e\n\u003cp\u003eP\u0026thinsp;=\u0026thinsp;0.010\u003c/p\u003e\n\u003cp\u003edf\u0026thinsp;=\u0026thinsp;1\u003c/p\u003e\n\u003cp\u003ex\u003csup\u003e2\u003c/sup\u003e\u0026thinsp;=\u0026thinsp;6.24\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eFemale\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e16\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e33.3\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e35\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e57.4\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e51\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e46.8\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd rowspan=\"2\" align=\"left\"\u003e\n\u003cp\u003eChildren\u0026rsquo;s gender\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eBoy\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e23\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e47.9\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e35\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e57.4\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e58\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e53.2\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd rowspan=\"2\" align=\"left\"\u003e\n\u003cp\u003eP\u0026thinsp;=\u0026thinsp;0.33\u003c/p\u003e\n\u003cp\u003edf\u0026thinsp;=\u0026thinsp;1\u003c/p\u003e\n\u003cp\u003ex\u003csup\u003e2\u003c/sup\u003e\u0026thinsp;=\u0026thinsp;0.96\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eGirl\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e25\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e52.1\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e26\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e42.6\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e51\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e46.8\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd rowspan=\"3\" align=\"left\"\u003e\n\u003cp\u003eMarital status\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eMarried\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e47\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e97.9\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e59\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e96.7\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e106\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e97.2\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd rowspan=\"3\" align=\"left\"\u003e\n\u003cp\u003eP\u0026thinsp;=\u0026thinsp;1\u003c/p\u003e\n\u003cp\u003edf\u0026thinsp;=\u0026thinsp;2\u003c/p\u003e\n\u003cp\u003eFishers exact =\u003c/p\u003e\n\u003cp\u003e1.01\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eDivorced\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e1\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e1.6\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e1\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.9\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eSpouse has died\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e1\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e2.1\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e1\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e1.6\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e2\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e1.8\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd rowspan=\"3\" align=\"left\"\u003e\n\u003cp\u003eEducational status\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eHigh school degree\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e13\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e27.1\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e17\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e27.9\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e30\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e27.5\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd rowspan=\"3\" align=\"left\"\u003e\n\u003cp\u003eP\u0026thinsp;=\u0026thinsp;0.52\u003c/p\u003e\n\u003cp\u003edf\u0026thinsp;=\u0026thinsp;2\u003c/p\u003e\n\u003cp\u003ex\u003csup\u003e2\u003c/sup\u003e\u0026thinsp;=\u0026thinsp;1.31\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eDiploma and associate degree\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e25\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e52.1\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e26\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e42.6\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e51\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e46.8\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eBachelor and higher\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e10\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e20.8\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e18\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e29.5\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e28\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e25.7\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd rowspan=\"4\" align=\"left\"\u003e\n\u003cp\u003eSpouse's educational level\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eI do not have a spouse\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e1\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e2.1\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e2\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e3.3\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e3\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e2.8\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd rowspan=\"4\" align=\"left\"\u003e\n\u003cp\u003eP\u0026thinsp;=\u0026thinsp;0.14\u003c/p\u003e\n\u003cp\u003edf\u0026thinsp;=\u0026thinsp;3\u003c/p\u003e\n\u003cp\u003eFishers exact=\u003c/p\u003e\n\u003cp\u003e5.14\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eHigh school degree\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e8\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e16.7\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e9\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e14.8\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e17\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e15.6\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eDiploma and associate degree\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e24\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e50.0\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e19\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e31.1\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e43\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e39.4\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eBachelor and higher\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e15\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e31.2\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e31\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e50.8\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e46\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e42.2\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd rowspan=\"3\" align=\"left\"\u003e\n\u003cp\u003eOccupation\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eEmployee\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e19\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e39.6\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e33\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e54.1\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e52\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e47.7\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd rowspan=\"3\" align=\"left\"\u003e\n\u003cp\u003eP\u0026thinsp;=\u0026thinsp;0.000\u003c/p\u003e\n\u003cp\u003edf\u0026thinsp;=\u0026thinsp;2\u003c/p\u003e\n\u003cp\u003ex\u003csup\u003e2\u003c/sup\u003e\u0026thinsp;=\u0026thinsp;15.23\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eSelf-employed\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e22\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e45.8\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e8\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e13.1\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e30\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e27.5\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eHousewife/househusband\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e30\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e14.6\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e20\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e32.8\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e27\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e24.8\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd rowspan=\"2\" align=\"left\"\u003e\n\u003cp\u003eVariable name\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd rowspan=\"2\" align=\"left\"\u003e\n\u003cp\u003esubgroup\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd colspan=\"2\" align=\"left\"\u003e\n\u003cp\u003eControl group\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd colspan=\"2\" align=\"left\"\u003e\n\u003cp\u003eExperimental group\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd colspan=\"2\" align=\"left\"\u003e\n\u003cp\u003eTotal\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd rowspan=\"2\" align=\"left\"\u003e\n\u003cp\u003eControl group\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eN\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e%\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eN\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e%\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eN\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e%\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd rowspan=\"4\" align=\"left\"\u003e\n\u003cp\u003eSpouse\u0026rsquo;s occupation\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eI do not have a spouse\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e1\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e2.1\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e2\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e3.3\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e3\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e2.8\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd rowspan=\"4\" align=\"left\"\u003e\n\u003cp\u003eP\u0026thinsp;=\u0026thinsp;0.01\u003c/p\u003e\n\u003cp\u003edf\u0026thinsp;=\u0026thinsp;3\u003c/p\u003e\n\u003cp\u003eFishers exact=\u003c/p\u003e\n\u003cp\u003e10.21\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eEmployee\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e15\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e31.2\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e26\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e42.6\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e41\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e37.6\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eSelf-employed\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e8\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e16.7\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e20\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e32.8\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e28\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e25.7\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eHousewife/househusband\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e24\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e50.0\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e13\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e21.3\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e37\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e33.9\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd rowspan=\"3\" align=\"left\"\u003e\n\u003cp\u003eFamily financial status\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003ePoor\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e1\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e1.6\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e1\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e9\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd rowspan=\"3\" align=\"left\"\u003e\n\u003cp\u003eP\u0026thinsp;=\u0026thinsp;0.003\u003c/p\u003e\n\u003cp\u003edf\u0026thinsp;=\u0026thinsp;2\u003c/p\u003e\n\u003cp\u003eFishers exact=\u003c/p\u003e\n\u003cp\u003e10.06\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eFair\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e39\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e81.2\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e32\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e52.5\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e71\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e65.1\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eGood\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e9\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e18.8\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e28\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e45.9\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e37\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e33.9\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd rowspan=\"4\" align=\"left\"\u003e\n\u003cp\u003eChildren\u0026rsquo;s living status\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eLiving with parents\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e47\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e97.9\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e58\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e95.1\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e105\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e96.3\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd rowspan=\"4\" align=\"left\"\u003e\n\u003cp\u003eP\u0026thinsp;=\u0026thinsp;1\u003c/p\u003e\n\u003cp\u003edf\u0026thinsp;=\u0026thinsp;2\u003c/p\u003e\n\u003cp\u003eFishers exact=\u003c/p\u003e\n\u003cp\u003e0.98\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eLiving with father\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e1\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e1.6\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e1\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.9\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eLiving with mother\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e1\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e2.1\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e2\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e3.3\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e3\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e2.8\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eLiving with people other than parents and spouse\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd rowspan=\"2\" align=\"left\"\u003e\n\u003cp\u003eType of school\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eBoys high school\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e22\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e45.8\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e33\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e54.1\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e55\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e50.5\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd rowspan=\"2\" align=\"left\"\u003e\n\u003cp\u003eP\u0026thinsp;=\u0026thinsp;0.39\u003c/p\u003e\n\u003cp\u003edf\u0026thinsp;=\u0026thinsp;1\u003c/p\u003e\n\u003cp\u003ex\u003csup\u003e2\u003c/sup\u003e\u0026thinsp;=\u0026thinsp;0.73\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eGirls high school\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e26\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e54.2\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e28\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e45.9\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e54\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e49.5\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003c/tbody\u003e\n\u003c/table\u003e\n\u003c/div\u003e\n\u003cp\u003ePrior to the intervention, the participants\u0026rsquo; status regarding preventive behavior of substance abuse was not favorable (P-value\u0026thinsp;=\u0026thinsp;0.385); however, it significantly increased after the intervention in the experimental group compared to the control group (P-value\u0026thinsp;=\u0026thinsp;0.000). In evaluating regression analysis indices of HPM components before the intervention (Table\u0026nbsp;\u003cspan class=\"InternalRef\"\u003e3\u003c/span\u003e), interpersonal influences (\u0026beta;\u0026thinsp;=\u0026thinsp;0.41), perceived benefits of action (\u0026beta;\u0026thinsp;=\u0026thinsp;0.40), and perceived self-efficacy (\u0026beta;\u0026thinsp;=\u0026thinsp;0.37), and prior related behavior (\u0026beta;\u0026thinsp;=\u0026thinsp;0.37) were the strongest predictors of the behavior. Perceived benefits of action and self-efficacy could predict 29% and 27% of the variance in substance abuse prevention behavior, respectively.\u003c/p\u003e\n\u003cdiv class=\"gridtable\"\u003e\n\u003ctable id=\"Tab3\" border=\"1\"\u003e\u003ccaption\u003e\n\u003cdiv class=\"CaptionNumber\"\u003eTable 3\u003c/div\u003e\n\u003cdiv class=\"CaptionContent\"\u003e\n\u003cp\u003eRegression analysis indices of HPM components before the intervention\u003c/p\u003e\n\u003c/div\u003e\n\u003c/caption\u003e\n\u003cthead\u003e\n\u003ctr\u003e\n\u003cth align=\"left\"\u003e\n\u003cp\u003eConstruct\u003c/p\u003e\n\u003c/th\u003e\n\u003cth align=\"left\"\u003e\n\u003cp\u003eCoefficient (B)\u003c/p\u003e\n\u003c/th\u003e\n\u003cth align=\"left\"\u003e\n\u003cp\u003estandard error\u003c/p\u003e\n\u003c/th\u003e\n\u003cth align=\"left\"\u003e\n\u003cp\u003eStandardized coefficient (\u0026beta;)\u003c/p\u003e\n\u003c/th\u003e\n\u003cth align=\"left\"\u003e\n\u003cp\u003eP-value\u003c/p\u003e\n\u003c/th\u003e\n\u003cth align=\"left\"\u003e\n\u003cp\u003eadjusted R2\u003c/p\u003e\n\u003c/th\u003e\n\u003c/tr\u003e\n\u003c/thead\u003e\n\u003ctbody\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003ePrior related behavior\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e0.82\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e0.22\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e0.37\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e0.000\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e0.24\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003ePerceived benefits of action\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e0.46\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e0.10\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e0.40\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e0.000\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e0.29\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003ePerceived barriers to action\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e0.01 -\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e0.04\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e0.02-\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e0.806\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e0.13\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003ePerceived self-efficacy\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e0.23\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e0.05\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e0.37\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e0.000\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e0.27\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eActivity related affect\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e0.16\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e0.14\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e0.12\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e0.226\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e0.14\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eInterpersonal influences\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e0.37\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e0.08\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e0.41\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e0.000\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e0.28\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eSituational influences\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e0.44\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e0.12\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e0.32\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e0.001\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e0.23\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eCompetitors' demands\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e0.004-\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e0.05\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e0.008 -\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e0.934\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e0.12\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eModel\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e0.33\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e0.11\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e0.28\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e0.004\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e0.20\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eCommitment to plan of action\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e0.57\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e0.16\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e0.32\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e0.001\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e0.23\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003c/tbody\u003e\n\u003c/table\u003e\n\u003c/div\u003e\n\u003cp\u003eTable\u0026nbsp;\u003cspan class=\"InternalRef\"\u003e4\u003c/span\u003e represented that in 9 variables of 10 constructs related to the health promotion model, no statistically significant difference was observed between the experimental and control groups before the intervention program. The results also showed that there was a significant difference between the scores of Prior related behavior, perceived benefits of action, Interpersonal influences, Situational influences, competitors and commitment in the parents of the experimental group compared to the control group after the educational intervention.\u003c/p\u003e\n\u003cdiv class=\"gridtable\"\u003e\n\u003ctable id=\"Tab4\" border=\"1\"\u003e\u003ccaption\u003e\n\u003cdiv class=\"CaptionNumber\"\u003eTable 4\u003c/div\u003e\n\u003cdiv class=\"CaptionContent\"\u003e\n\u003cp\u003eComparison of mean difference and standard deviation of HPM constructs scores, before and two months after the educational intervention\u003c/p\u003e\n\u003c/div\u003e\n\u003c/caption\u003e\n\u003ctbody\u003e\n\u003ctr\u003e\n\u003ctd rowspan=\"4\" align=\"left\"\u003e\n\u003cp\u003eBehavior\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eBefore the Intervention\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eTwo months after the intervention\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eP-value\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eIntervention\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e3.91\u0026thinsp;\u0026plusmn;\u0026thinsp;44.02\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e2.99\u0026thinsp;\u0026plusmn;\u0026thinsp;45.84\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.010\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eControl\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e5.00\u0026thinsp;\u0026plusmn;\u0026thinsp;43.27\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e3.87\u0026thinsp;\u0026plusmn;\u0026thinsp;42.56\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.437\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eP-value\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.385\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.000\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd rowspan=\"4\" align=\"left\"\u003e\n\u003cp\u003ePrior related behavior\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eBefore the Intervention\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eTwo months after the intervention\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eP-value\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eIntervention\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e1.89\u0026thinsp;\u0026plusmn;\u0026thinsp;9.13\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e1.47\u0026thinsp;\u0026plusmn;\u0026thinsp;10.36\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.000\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eControl\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e2.15\u0026thinsp;\u0026plusmn;\u0026thinsp;9.04\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e1.27\u0026thinsp;\u0026plusmn;\u0026thinsp;9.44\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.18\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eP-value\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.76\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.002\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd rowspan=\"4\" align=\"left\"\u003e\n\u003cp\u003ePerceived benefits of action\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eBefore the Intervention\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eTwo months after the intervention\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eP-value\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eIntervention\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e3.74\u0026thinsp;\u0026plusmn;\u0026thinsp;48.08\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e2.36\u0026thinsp;\u0026plusmn;\u0026thinsp;50.46\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.000\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eControl\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e4.08\u0026thinsp;\u0026plusmn;\u0026thinsp;48.19\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e4.01\u0026thinsp;\u0026plusmn;\u0026thinsp;49.08\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.375\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eP-value\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.889\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.057\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd rowspan=\"4\" align=\"left\"\u003e\n\u003cp\u003ePerceived barriers to action\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eBefore the Intervention\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eTwo months after the intervention\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eP-value\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eIntervention\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e12.10\u0026thinsp;\u0026plusmn;\u0026thinsp;28.41\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e4.70\u0026thinsp;\u0026plusmn;\u0026thinsp;25.38\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.338\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eControl\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e8.74\u0026thinsp;\u0026plusmn;\u0026thinsp;27.88\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e3.75\u0026thinsp;\u0026plusmn;\u0026thinsp;26.21\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.591\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eP-value\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.511\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.494\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd rowspan=\"4\" align=\"left\"\u003e\n\u003cp\u003ePerceived self-efficacy\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eBefore the Intervention\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eTwo months after the intervention\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eP-value\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eIntervention\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e8.50\u0026thinsp;\u0026plusmn;\u0026thinsp;36.11\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e2.69\u0026thinsp;\u0026plusmn;\u0026thinsp;37.30\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.308\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eControl\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e5.51\u0026thinsp;\u0026plusmn;\u0026thinsp;35.17\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e4.17\u0026thinsp;\u0026plusmn;\u0026thinsp;36.19\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.084\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eP-value\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.543\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.022\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd rowspan=\"4\" align=\"left\"\u003e\n\u003cp\u003eIndividual influencers\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eBefore Intervention\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eTwo months after the intervention\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eP-value\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eIntervention\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e3.22\u0026thinsp;\u0026plusmn;\u0026thinsp;25.11\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e1.60\u0026thinsp;\u0026plusmn;\u0026thinsp;28.21\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.000\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eControl\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e3.20\u0026thinsp;\u0026plusmn;\u0026thinsp;25.58\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e1.98\u0026thinsp;\u0026plusmn;\u0026thinsp;26.48\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.229\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eP-value\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.36\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.000\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd rowspan=\"4\" align=\"left\"\u003e\n\u003cp\u003eInterpersonal influences\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eBefore the Intervention\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eTwo months after the intervention\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eP-value\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eIntervention\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e5.23\u0026thinsp;\u0026plusmn;\u0026thinsp;33.57\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e2.72\u0026thinsp;\u0026plusmn;\u0026thinsp;34.43\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.425\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eControl\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e4.18\u0026thinsp;\u0026plusmn;\u0026thinsp;32.33\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e3.73\u0026thinsp;\u0026plusmn;\u0026thinsp;33.02\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.212\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eP-value\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.124\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.032\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd rowspan=\"4\" align=\"left\"\u003e\n\u003cp\u003eSituational influences\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eBefore the Intervention\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eTwo months after the intervention\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eP-value\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eIntervention\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e3.38\u0026thinsp;\u0026plusmn;\u0026thinsp;33.85\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e2.44\u0026thinsp;\u0026plusmn;\u0026thinsp;35.52\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.002\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eControl\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e3.08\u0026thinsp;\u0026plusmn;\u0026thinsp;33.71\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e2.43\u0026thinsp;\u0026plusmn;\u0026thinsp;34.19\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e.0194\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eP-value\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.589\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.005\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd rowspan=\"4\" align=\"left\"\u003e\n\u003cp\u003eCompetitors\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eBefore the Intervention\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eTwo months after the intervention\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eP-value\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eIntervention\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e7.85\u0026thinsp;\u0026plusmn;\u0026thinsp;24.18\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e5.38\u0026thinsp;\u0026plusmn;\u0026thinsp;27.34\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.001\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eControl\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e9.90\u0026thinsp;\u0026plusmn;\u0026thinsp;25.73\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e5.91\u0026thinsp;\u0026plusmn;\u0026thinsp;25.85\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.932\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eP value\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.304\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.499\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd rowspan=\"4\" align=\"left\"\u003e\n\u003cp\u003eModel\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eBefore the Intervention\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eTwo months after the intervention\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eP-value\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eIntervention\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e4.16\u0026thinsp;\u0026plusmn;\u0026thinsp;25.72\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e2.28\u0026thinsp;\u0026plusmn;\u0026thinsp;26.26\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.656\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eControl\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e3.07\u0026thinsp;\u0026plusmn;\u0026thinsp;24.17\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e3.10\u0026thinsp;\u0026plusmn;\u0026thinsp;23.42\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.224\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eP-value\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.004\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.000\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd rowspan=\"4\" align=\"left\"\u003e\n\u003cp\u003eCommitment\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eBefore the Intervention\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eTwo months after the intervention\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eP-value\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eIntervention\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e2.77\u0026thinsp;\u0026plusmn;\u0026thinsp;27.07\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e1.61\u0026thinsp;\u0026plusmn;\u0026thinsp;28.26\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.007\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eControl\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e2.16\u0026thinsp;\u0026plusmn;\u0026thinsp;26.54\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e3.23\u0026thinsp;\u0026plusmn;\u0026thinsp;26.15\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.778\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eP-value\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.147\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.000\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003c/tr\u003e\n\u003c/tbody\u003e\n\u003c/table\u003e\n\u003c/div\u003e\n\u003cp\u003eEvaluating the regression analysis indices of the effect of education on behavior and the HPM constructs (Table\u0026nbsp;\u003cspan class=\"InternalRef\"\u003e5\u003c/span\u003e) indicated that education could increase the behavior score by 3.27. After behavior, the constructs of the model, commitment to plan of action, and activity-related affect had the highest score increase of 2.66, 2.02 and 1.40, respectively, after the educational intervention. Moreover, education had the most effect on constructs of model (\u0026beta;\u0026thinsp;=\u0026thinsp;0.44), activity-related effect (\u0026beta;\u0026thinsp;=\u0026thinsp;0.44), parents\u0026rsquo; behavior (\u0026beta;\u0026thinsp;=\u0026thinsp;0.43), and prior related behavior (\u0026beta;\u0026thinsp;=\u0026thinsp;0.32).\u003c/p\u003e\n\u003cdiv class=\"gridtable\"\u003e\n\u003ctable id=\"Tab5\" border=\"1\"\u003e\u003ccaption\u003e\n\u003cdiv class=\"CaptionNumber\"\u003eTable 5\u003c/div\u003e\n\u003cdiv class=\"CaptionContent\"\u003e\n\u003cp\u003eRegression analysis indices of the effect of education on behavior and the HPM constructs\u003c/p\u003e\n\u003c/div\u003e\n\u003c/caption\u003e\n\u003cthead\u003e\n\u003ctr\u003e\n\u003cth align=\"left\"\u003e\n\u003cp\u003eConstructs\u003c/p\u003e\n\u003c/th\u003e\n\u003cth align=\"left\"\u003e\n\u003cp\u003eCoefficient\u003c/p\u003e\n\u003cp\u003e(B)\u003c/p\u003e\n\u003c/th\u003e\n\u003cth align=\"left\"\u003e\n\u003cp\u003eStandard error\u003c/p\u003e\n\u003c/th\u003e\n\u003cth align=\"left\"\u003e\n\u003cp\u003eStandardized coefficient (\u0026beta;)\u003c/p\u003e\n\u003c/th\u003e\n\u003cth align=\"left\"\u003e\n\u003cp\u003eP-value\u003c/p\u003e\n\u003c/th\u003e\n\u003c/tr\u003e\n\u003c/thead\u003e\n\u003ctbody\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eBehavior\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e3.27 -\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e0.66\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.43 -\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e0.000\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003ePrior related behavior\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.92-\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e0.27\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.32-\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e0.001\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003ePerceived benefits of action\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e1.37 -\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e0.62\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.21 -\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e0.028\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003ePerceived barriers to action\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e1.48\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e0.82\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.17\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e0.074\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003ePerceived self-efficacy\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.50-\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e0.73\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.07 -\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e0.493\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eActivity related affect\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e1.74 -\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e0.34\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.44-\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e0.000\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eInterpersonal influences\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e1.40 -\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e0.62\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.21 -\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e0.025\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eSituational influences\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e1.38 -\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e0.46\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.27-\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e0.003\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eCompetitors' demands\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e1.51 -\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e1.03\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.13 -\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e0.147\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eModel\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e2.66 -\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e0.52\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.44 -\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e0.000\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eCommitment to plan of action\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e2.02 -\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e0.42\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.38 -\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e0.000\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003c/tbody\u003e\n\u003c/table\u003e\n\u003c/div\u003e"},{"header":"4. Discussion","content":" \u003cp\u003eThe results of this study showed that the parents\u0026rsquo; prior behavior and behavior was not favorable before the intervention. However, it was expected to be in a better position, given the importance of the issue. The results of this study are consistent with the studies of Yazdanpanah (\u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e), Mazloomy Mahmoodabad (\u003cspan citationid=\"CR26\" class=\"CitationRef\"\u003e26\u003c/span\u003e), and Hossein Rezaei (\u003cspan citationid=\"CR27\" class=\"CitationRef\"\u003e27\u003c/span\u003e). The results showed that education could have the greatest effect on the behavior score, as well as the effect of the intervention on the experimental group, parents who had a girl, and in families where the child lives with parents. Improving the behavior after the intervention in the experimental group is in line with studies conducted by Khodaveisi (\u003cspan citationid=\"CR28\" class=\"CitationRef\"\u003e28\u003c/span\u003e), Taheri (\u003cspan citationid=\"CR29\" class=\"CitationRef\"\u003e29\u003c/span\u003e), Dehdari (\u003cspan citationid=\"CR30\" class=\"CitationRef\"\u003e30\u003c/span\u003e), and Khodaveisi (\u003cspan citationid=\"CR28\" class=\"CitationRef\"\u003e28\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eThe results of this study and the conducted studies (\u003cspan citationid=\"CR31\" class=\"CitationRef\"\u003e31\u003c/span\u003e)discuss the design and implementation of interventions to prevent substance abuse in comparison with the competitor\u0026rsquo;s preferences and demands, such as watching TV, using computer, and etc. The results indicated that after the intervention, the parents became more responsible for preventing substance abuse in their adolescents, and preferred this issue to watch TV, cyberspace, using the Internet, and relaxing.\u003c/p\u003e \u003cp\u003eIn this study, it was shown that in order to increase the preventive behavior of substance abuse by parents, perceived barriers to action should be reduced. Moreover, it can be concluded that adequate income and consequently, sufficient time for parents to take care of their children are necessary to improve the parents\u0026rsquo; preventive behaviors, which is in line with the results of studies by Rahimi (\u003cspan citationid=\"CR30\" class=\"CitationRef\"\u003e30\u003c/span\u003e)and Kamali (\u003cspan citationid=\"CR32\" class=\"CitationRef\"\u003e32\u003c/span\u003e). In this study, the child's residence in the dormitory, lack of knowledge about drugs, lack of time and overwork, when parents are away from the family and lack of authorities\u0026rsquo; attention to the adolescents\u0026rsquo; problems were the most important perceived barriers to action from the participants\u0026rsquo; viewpoint. This result is in line with that of Kumpfer\u0026rsquo;s study, which reported lack of time and overwork as the main perceived barriers to action.\u003c/p\u003e \u003cp\u003eSelf-efficacy is a predictor of performance and people with a stronger sense of self-efficacy show greater effort, more seriousness, and longer endurance in acquiring new tasks compared to those with less self-efficacy (\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e, \u003cspan citationid=\"CR33\" class=\"CitationRef\"\u003e33\u003c/span\u003e). Therefore, by providing appropriate educational resources, experienced and caring counselors, as well as educational facilities in the place of residence, some barriers to prevent substance abuse can be removed. Hence, in designing educations and interventions, great attention should be paid to the individuals\u0026rsquo; benefits from behavior change, self-efficacy and incentives. Brownson (\u003cspan citationid=\"CR34\" class=\"CitationRef\"\u003e34\u003c/span\u003e), Saelens (\u003cspan citationid=\"CR35\" class=\"CitationRef\"\u003e35\u003c/span\u003e), and Nikpour (\u003cspan citationid=\"CR36\" class=\"CitationRef\"\u003e36\u003c/span\u003e)also reported the positive effect of environment and access to facilities on parents' preventive behavior.\u003c/p\u003e \u003cp\u003eThe results of the present study showed that there was a significant difference in the construct of perceived benefits of action in the experimental group after the intervention and the participants' knowledge about the benefits of substance abuse prevention increased, which is consistent with Mazloomy Mahmoodabad\u0026rsquo;s study (\u003cspan citationid=\"CR26\" class=\"CitationRef\"\u003e26\u003c/span\u003e)and in contrary to Shokoohi\u0026rsquo;s study (\u003cspan citationid=\"CR37\" class=\"CitationRef\"\u003e37\u003c/span\u003e)These changes can indicate the effectiveness of educational intervention to promote and identify the benefits and effects of parent\u0026rsquo;s behavior changes in preventing substance abuse in their children.\u003c/p\u003e \u003cp\u003eSolhi and Banaye Jedd also stated an increase in the score of commitment construct after the intervention (\u003cspan citationid=\"CR38\" class=\"CitationRef\"\u003e38\u003c/span\u003e, \u003cspan citationid=\"CR39\" class=\"CitationRef\"\u003e39\u003c/span\u003e). In Mirkarimi\u0026rsquo;s study (\u003cspan citationid=\"CR40\" class=\"CitationRef\"\u003e40\u003c/span\u003e), the commitment construct was not one of the main influential constructs. Given that having a positive feeling about behavior increases the probability of doing and repeating, it is necessary to consider creating a positive feeling about regular preventive behaviors in order to increase the substance abuse preventive behavior in parents. The results showed that after the educational intervention, most parents would use every opportunity to plan to prevent substance abuse.\u003c/p\u003e \u003cp\u003eThe results of similar studies have shown that family interventions are the most effective prevention and treatment measures for drug abuse and other negative growth consequences in adolescents (\u003cspan citationid=\"CR33\" class=\"CitationRef\"\u003e33\u003c/span\u003e, \u003cspan citationid=\"CR41\" class=\"CitationRef\"\u003e41\u003c/span\u003e). Therefore, planning to empower the family to promote the status of substance abuse preventive behavior should be considered (\u003cspan citationid=\"CR42\" class=\"CitationRef\"\u003e42\u003c/span\u003e). The mentioned results indicate the effect of web-based family-centered empowerment program intervention on improving most HPM constructs. Given that these constructs are effective in improving the status of preventive behavior, their implementation and promotion can be effective in improving preventive behavior.\u003c/p\u003e \u003cdiv id=\"Sec12\" class=\"Section2\"\u003e \u003ch2\u003e4.1. Limitations\u003c/h2\u003e \u003cp\u003eOne of the limitations of the present study was that the studied subjects were only from a small geographical area in Iran, Sabzevar. Therefore, the participants were not good representatives of parents in Iran and other countries. It is suggested that a future study be conducted to determine whether or not educational programs reduce parent\u0026rsquo;s level of empowerment and prevention of substance abuse risk factors among students in other parts of Iran and the world.\u003c/p\u003e \u003c/div\u003e "},{"header":"5. Conclusion","content":" \u003cp\u003eThe results indicate the effectiveness of the educational program based on the constructs of Pender\u0026rsquo;s HPM in empowering parents to prevent substance abuse risk factors among students. Educational programs are effective strategies that help empower parents to deal more easily with the problems and barriers in preventing substance abuse. In addition to education, more measures are required to prevent substance abuse. In this regard, it is recommended to provide basic facilities and job opportunities by related organizations with sufficient income, develop sports facilities, establish regulations in the family, provide facilities for the child's education in residence, and pay attention to preventive behaviors as one of the important components of lifestyle change.\u003c/p\u003e "},{"header":"Abbreviations","content":"\u003cp\u003eHPM\u003cstrong\u003e:\u003c/strong\u003e health promotion model\u003cstrong\u003e, \u003c/strong\u003eContent validity ratio (CVR), content validity index (CVI).\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eEthics approval and consent to participate\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis study was approved by the ethics committee of Sabzevar University of Medical Sciences (code: IR.MEDSAB.REC.1399.007). All participants signed the consent form before beginning the study.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConsent for publication\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNot Applicable\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCompeting interests\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors declare that they not have any conflict of interest\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAvailability of data and materials\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNot Applicable\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFunding\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis study was supported by Sabzevar University of Medical Sciences.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthors' contributions\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eS.M.M and M.H contributed to the design of the study, was responsible for the management and retrieval of data, contributed to initial data analysis and interpretation, drafted the initial manuscript. H.J and M.H.R decided upon the data collection methods and responsible for the data analysis decisions. H.E.A conceptualized and designed the study, supervised all aspects of the study, critically reviewed and revised the manuscript, and approved the final manuscript as submitted. all authors read and approved the final manuscript\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConflict of interest\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors do not declare any conflict of interest.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFunds\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis study is extracted from the master's thesis approved by the Vice Chancellor for Research and Technology and with the support of Sabzevar University of Medical Sciences.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\u003cli\u003e\u003cspan\u003eZare Harofteh F, Bahrevar V, Madani SM. 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Zahedan Journal of Research in Medical Sciences. 2012;14(1).\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eHeydari A, Khorashadizadeh F. Pender\u0026rsquo;s health promotion model in medical research. studies. 2014;41:59.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eYazdanpanah B, Safari M, Yosefi M, Angha P, Habibian M, Zandi K, et al. Effects of Community Based Educational Prevention Program of Drug Abuse in Reduction of High Risk Behavior. The Journal of Shahid Sadoughi University of Medical Sciences. 2010;18(3):191\u0026ndash;8.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eMazloomy Mahmoodabad SS, Khoshab S, Sohrabi Vafa F, Fallahzadeh H, Yassini Ardekani SM. The effect of health education based on health belief model on preventive actions of synthetic drugs dependence in male students of Kerman, Iran. Social Behavior Research Health. 2017;1(2):100\u0026ndash;7.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eHossein-Rezaei H, Mohammad-Alizadeh S. Parents\u0026rsquo; Knowledge about the Symptoms of Substance Abuse: a Study on Parents of Students in Kerman High Schools and Secondary Schools. Journal of Kerman University of Medical Sciences. 2008;15(3):261\u0026ndash;8.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eKhodaveisi M, Omidi A, Farokhi S, Soltanian AR. The effect of Pender\u0026rsquo;s health promotion model in improving the nutritional behavior of overweight and obese women. International journal of community based nursing midwifery. 2017;5(2):165.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eSadeghmoghadam L, Tavakolizadeh J, Mazloum Shahri SB, Taheri M. Effectiveness of Pender's Health Promotion Model on Reducing Drivers High-risk Behaviors. 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Nursing Midwifery Studies. 2016;5(4):-.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eKumpfer KL, Alvarado R. Family-strengthening approaches for the prevention of youth problem behaviors. Am Psychol. 2003;58(6\u0026ndash;7):457.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eBrownson RC, Baker EA, Housemann RA, Brennan LK, Bacak SJ. Environmental and policy determinants of physical activity in the United States. American journal of public health. 2001;91(12):1995\u0026ndash;2003.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eSaelens BE, Sallis JF, Black JB, Chen D. Neighborhood-based differences in physical activity: an environment scale evaluation. American journal of public health. 2003;93(9):1552\u0026ndash;8.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eNikpour G. Drugs and drug policy in the Islamic Republic of Iran. Middle East Briefs. 2019;119:2\u0026ndash;7.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eShokoohi M, Jamshidimanesh M, Ranjbar H, Saffari M, Motamed A. The effectiveness of a model-based health education program on protective behavior against human papillomavirus in female drug abusers: a randomized controlled trial. HIV \u0026amp; AIDS Review International Journal of HIV-Related Problems.19(1):16\u0026ndash;23.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eSolhi M, Ahmadi L, Taghdisi MH, Haghani H. The Effect of Trans Theoretical Model (TTM) on exercise behavior in pregnant women referred to dehaghan rural health center in. Iranian Journal of Medical Education. 2012;11(8):942\u0026ndash;50.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eBanaye Jedd M, Babazadeh T, Hashemian Z, Moradi F, Ghavami Z. Cognitive-Behavioral Determinants of Oral Health in students: an Application of Pender's Health Promotion Model. Journal of Education Community Health. 2016;3(2):1\u0026ndash;8.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eKamal Mirkarimi S, Maghsoudloo M, Berdi Ozouni-Davaji R, Raeisi V, Charkazi A, Raeisi M. The determinants of hypertension and commitment to implementing a nutrition program: application of Pender health promotion model. Journal of Health Literacy. 2018;3(1):50\u0026ndash;60.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eKumpfer KL, Magalh\u0026atilde;es C, Xie J. Cultural adaptations of evidence-based family interventions to strengthen families and improve children's developmental outcomes. European Journal of Developmental Psychology. 2012;9(1):104\u0026ndash;16.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eVahedian-Shahroodi M, Amin-Shokravi F, Hidarnia A, Jabbari Nooghabid H. A Survey on the effects of the pender's Health Promotion Model on prediction of the employees' physical activity. Health Education Health Promotion. 2013;1(1):51\u0026ndash;66.\u003c/span\u003e\u003c/li\u003e\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":true,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"Web-based, Empowerment, Substance Abuse, Health Promotion Model, Parents","lastPublishedDoi":"10.21203/rs.3.rs-88647/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-88647/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003e\u003cstrong\u003eBackground and aim: \u003c/strong\u003eThe age of onset of substance abuse among adolescents has recently decreased worldwide. Parents play an important role in preventing their children from drug abuse. This study aimed to investigate the effect of web-based family-centered empowerment program in preventing the risk factors of substance abuse in students' parents, using the health promotion model (HPM).\u003c/p\u003e\u003cp\u003e\u003cstrong\u003eMethod:\u003c/strong\u003e This interventional study was based on 118 parents of high school students in Sabzevar, Iran (2019). Multi-stage random sampling was used to divide the participants into the experimental (n=65) and control (n=65) groups. The data were collected through a researcher-made questionnaire based on Pender's HPM. A website was designed to perform all stages of the study. The web-based educational intervention was performed for the experimental group. Both groups completed the questionnaires 2 months after the educational intervention. The data were analyzed using t-test, paired t-test, regression, correlation, and analysis of variance.\u003c/p\u003e\u003cp\u003e\u003cstrong\u003eResults:\u003c/strong\u003e There was a significant difference between the scores of prior related behavior, perceived benefits of action, activity-related effect, situational influences, competitors, and commitment in the parents of the experimental group compared to the control group after the educational intervention (p-value \u0026lt;0.05). Moreover, a significant difference was observed between preventive behaviors of substance abuse and the mean score of perceived barriers to action, perceived self-efficacy, interpersonal influences, and role model in the parents of the experimental group compared to the control group after the educational intervention (p-value \u0026lt;0.05).\u003c/p\u003e\u003cp\u003e\u003cstrong\u003eConclusion:\u003c/strong\u003e Overall, designing an educational intervention based on the constructs of Pender's HPM could be an effective strategy for promoting preventive behaviors of substance abuse in parents. \u003c/p\u003e","manuscriptTitle":"The Effect of Web-based Family-centered Empowerment Program in Preventing the Risk Factors of Substance Abuse in Students' Parents; Application of the Health Promotion Model","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2020-10-14 15:58:38","doi":"10.21203/rs.3.rs-88647/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"45645145-9bb2-437b-86ce-89b579b43d94","owner":[],"postedDate":"October 14th, 2020","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[{"id":781889,"name":"Preventive Medicine"},{"id":781890,"name":"Health Economics \u0026 Outcomes Research"}],"tags":[],"updatedAt":"2020-10-14T15:58:40+00:00","versionOfRecord":[],"versionCreatedAt":"2020-10-14 15:58:38","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-88647","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-88647","identity":"rs-88647","version":["v1"]},"buildId":"J0_U0BvcaRcwD8yVFaRlm","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}