Discussion
otits, febrile convulsion, infection, Jalili, ’ middle-ear infection, middle-ear infection
CNS INFECTIONS, DISEASE, OTITIS MEDIA, AFEBRILE CONVULSION, INFECTION, COMPLICATIONS
To the authors’ knowledge, this study is one of the few online educational interventions based on the PRECEDE model on otitis media preventive behaviors in the children. Few documents have been published about this issue at the time of this study. The results of this study showed that the educational intervention based on PRECEDE model is effective on the knowledge, attitude, behavior, enabling factors, reinforcing factors and mothers preventive behaviors of infants’ middle-ear infection.The average behavior score of mothers regarding to middle-ear infection in the experimental group increased satisfactorily 3 months after the intervention. This finding is in line with the results of Kashfi et al.’s [After the intervention, the average score of mothers’ knowledge in the experimental group was improved. This improvement was due to the educating mothers about preventative behaviors of otitis media. Meanwhile, there were some text, audio and video messages, and picture for them, and these factors improved the knowledge of the mothers in the intervention group. This finding confirms the results of Saudi et al.’s study [One of the findings of this study is the increase of the average score of the attitude of the mothers in the experimental group after the educational intervention. This increase can be attributed to the promotion of the mothers’ attitudes about seriousness of otitis media and paying attention to its complications for children and the cost of treatment. In fact, researchers believe that having knowledge alone is not enough to take preventive behaviors. But mothers attitude towards a disease is an important factor in conducting preventive behaviors. In the present study, using group discussions by chat in WhatsApp social network and sharing experiences of mothers and motivating them to prevent the occurrence of otitis media infections in children and introducing the benefits of these behaviors and the complications due to the lack of this care, ultimately increased the attitude of mothers after the intervention. This finding confirms Jalili et al.’s study [Finding showed that in the experimental group, the average score of enabling factors increased significantly after the end of the educational intervention. In fact, this enhanced can be attributed to the training method based on PRECEDE model and effective role of virtual education containing educational videos and slides on the skills of performing preventive behaviors against middle-ear infection in infants and instruction how to access services and free information about it. This finding is in line with the results of Kashfi et al.’s study [Regarding the role of support from family, friends, spouse and health staff in the field of preventive behaviors of otitis media in infants, the average score of reinforcing factors in the experimental group increased from 3.3 to 3.9 after the educational intervention. This finding confirms the results of other studies about preventing febrile convulsion in children [In the present study, reinforcing factors such as health staff were influential in increasing the motivation of mothers to follow these individuals. Hence guidance from the health care providers in form of educational classes in health centers for prevent otits media infection in children will be very helpful. Therefore in this study, in order to increase the information of the influential people (family, friends and spouse), some of the materials of the educational booklets electronic, voiced PowerPoint, short educational messages, and educational photos were specifically designed on increasing the information of family and especially the spouse to be effective in adopting the behaviors by mothers. Finally raising knowledge as well as other constructs of PRECED model, including attitudes, enabling factors and reinforcing factors all led to increased skills and preventive behaviors by mothers.One of the implications of the present study for health planners and policy maker in health promotion is to produce standard educational content based on the needs assessment with theory center and use them by health planners with the aim of providing training by health personnel in health centers and doctors and nurses in pediatric in clinics.