Document Type: Original Articles


1 Department of Community Health Nursing, Fatemeh (P.B.U.H) Faculty of Nursing and Midwifery, Shiraz University of Medical Sciences, Shiraz, Iran;

2 Cardiovascular Research Center, Shiraz University of Medical Sciences, Shiraz, Iran


Background: Urinary tract infection (UTI) is one of the most  common infections seen in all age and both sex groups which frequently occur among adolescent and young women. UTIs are the second most common cause of emergency department attendance for adolescents. Considering the importance of promoting preventive behaviors of UTI, we aimed to evaluate the effect of peer education based on health belief model (HBM) on preventive behaviors of UTI among first-grade high school female students.Methods: In this quasi-experimental study, we recruited 168 first-grade high school girl students who were assigned into intervention (n=84) and control (n=84) groups. Data were collected using an HBM questionnaire which was designed by the researcher based on the review of the literature; before, immediately after and one month after the intervention. A total of 12 students in the intervention groups were selected as peer educator and attended two 2-hour training sessions for one week and were trained by the researcher. Afterwards, the trained peers taught the learned materials to their peers in two 1-hour sessions for two weeks through conferences and question-andanswer sessions. Data were analyzed by SPSS18 using t test and RMANOVA. The significance level was set at <0.05.Results: The results showed that the mean scores of knowledge, HBM constructs and p reventive behaviors related to UTI significantly increased in the participants of intervention group immediately after and one month after the intervention.(P<0.001)Conclusion: Peer education based on HBM seem to promote preventive behaviors related to UTI and reduce the risk of the disease among students.Trial Registration Number: IRCT201404167531N5


  1. Javaheri Tehrani F, Nikpour S. The effect of education
  2. based on health belief model on preventive behaviors of
  3. urinary tract infections (UTI) among married women
  4. referred to Tehran selected hospitals. Preventive Care
  5. in Nursing and Midwifery 2012; 3(1): 1-11. [in persian]
  6. Wein AJ, Kavoussi LR, Novick AC, Partin AW, Peters
  7. CA. Campbell-Walsh Urology. 10ed: Elsevier Saunders;
  8. : 257-85.
  9. Hocken berry MJ, Wilson O. Wong’s Nursing Care of
  10. Infants & Children. 9ed: Elsevier Mosby; 2011: 1140.
  11. M. FAV. Recurrent urinary tract infections. Best Practice
  12. & Research Clinical Obstetrics and Gynaecology 2005;
  13. (6): 861-73.
  14. Mc Aninch JW, Lue TF. Smith & Tanagho’s General
  15. Urology. 18ed: Mc Graw Hill LANGE; 2013: 197-205.
  16. Bonny AE, Brouhard BH. Urinary tract infections
  17. among adolescents. Adolescent Medicine Clinics 2005;
  18. (1): 149-61.
  19. Goolsby MJ. Urinary tract infection. J Am Acad Nurse
  20. Pract 2001;13(9): 395-8.
  21. Hashemiparast M, Shojaezade D, Dehdari T, Gohari M.
  22. Design and evaluation of educational interventions on
  23. the health belief model to promote preventive behaviors
  24. of urinary tract infection in mothers with children less
  25. than 6 years. Razi Journal of Medical Sciences 2013;
  26. (110): 8-22. [in persian].
  27. Tabrizian L, Nikpour S, Masroorroodsari D, Haghani
  28. H. Individual risk factors of urinary tract infection
  29. in married women. Iran Nursing 2003; 16(35): 20-4.
  30. [in persian]
  31. Taghdisi M, Nezhad Sadeghi E. The effect of health
  32. education based on health belief model on behavioral
  33. promotion of urinary infection prevention in pregnant
  34. women. Journal of Research & Health Promot Pract
  35. ; 2(1): 126-36. [in persian].
  36. Burleigh AE, Benck SM, McAchran SE, Reed
  37. JD, Krueger CG, Hopkins WJ. Consumption of
  38. sweetened, dried cranberries may reduce urinary
  39. tract infection incidence in susceptible women – a
  40. modified observational study. Nutrition journal 2013;
  41. (139): 2-7.
  42. Haji Amini Z, Rajayi M, Razaghi M, Ebadi A, Sadeghi
  43. M, Alaf Javadi M, et al. Prevalence & risk factors of
  44. urinary tract infection in girl students. kowsarMedical Journal 2006; 11(1): 91-9. [in persian]
  45. Hooton TM. Recurrent urinary tract infection in
  46. women. Int J Antimicrob Agents 2001; 17(4): 259-68.
  47. Nasiri Amiri F, Hasanjani Roshan M, Haji Ahmadi M,
  48. Akbarzade Pasha Z. The effect of health behavior on
  49. UTI incidence in pregnant women in Babol . Journal
  50. of Babol University of Medical Sciences 2006; 8(2):
  51. -62. [in Persian]
  52. Smeltzer SC, Bare B, Hinkle JL, Cheever KH. Brunner
  53. and Suddarth’s textbook of medical - surgical nursing
  54. ed. Philadelphia: Wolter Kluwer /Lippincott
  55. Williams and Willkins; 2010: 1359-65.
  56. Saffari M, Shojaeizadeh D, Ghofranpour F, Heydarnia
  57. A, Pakpour A. Health Education & Promotion
  58. Theories,Models,Methods: Sobhan; 2009: 11. [in
  59. persian]
  60. Rosenstock IM. The health belief model & preventive
  61. health behavior. Health education monographs 1974;
  62. (4): 354-86.
  63. Allender JA, Rector C, Warner K. Community health
  64. nursing(promoting & protecting the public’s health).
  65. ed: wolterskluwer/lippincott williams & wilkin;
  66. : 318.
  67. Pender N, Murdaugh C, Parsons M. Health promotion
  68. in nursing practice. 5 ed. USA: Pearson prentice hall;
  69. p 38.
  70. Lotfi Mainbolagh B, Rakhshani F, Zareban I,
  71. Montazerifar F, Alizadeh Sivaki H, Parvizi Z . T he
  72. effect of peer education based on health belief model on
  73. nutrition behaviors in primary school boys. J Research
  74. Health 2012; 2(2): 214-25. [in persian]
  75. Turner G, Shepherd J. A method in search of a theory:
  76. peer education and health promotion. Health Educ Res
  77. ; 14(2): 235-47.
  78. Gozum S, Karayurt O, Kav S, Platin N. Effectiveness
  79. of peer education for breast cancer screening and health
  80. beliefs in eastern Turkey. Cancer Nurs 2010; 33(3):
  81. -20.
  82. Akbarzadeh M, Zangi Abadi M, Motahari M, Tabatabai
  83. H. Comparison the effects of BSE education on
  84. knowledgeand attitudes of Student by peers and health
  85. staff. Iranian Journal of Medical Education 2009; 8(2):
  86. -203. [in persian]
  87. Noori Sistani M, Merghati K hoi E , Taghdisi M H.
  88. Promoting Knowledge, Attitude and Practices (KAP)
  89. of the Mothers in their Girls’ Pubertal Health Based on
  90. Peer Education Approach. Journal of Babol University
  91. of Medical Sciences 2010; 11(6): 9-33. [in persian]
  92. Kargar M, Jamali Moghadam N, Moattari M, Fallah
  93. Zadeh MH, Pourahmad S. The Effect of Education
  94. by Peers and Health Personnel on the Osteoporosis
  95. Knowledge and Health Beliefs in Adolescents with
  96. Nephrotic Syndrome. IJCBNM 2013;1(3): 137-46.
  97. Zahedian nejadi A. The effect of peer education on the
  98. knowledge of female high school students about stress
  99. management. Iran,Shiraz: Shiraz university of medical
  100. sciences; 2008. [in persian]
  101. Merakou K, Kourea-Kremastinou J. Peer education
  102. in HIV prevention: an evaluation in schools. The
  103. European Journal of Public Health 2006; 16(2): 128-32.
  104. Jahanfar S, Lye MS, Rampal L. A randomised controlled
  105. trial of peer-adult-led intervention on improvement
  106. of knowledge, attitudes and behaviour of university
  107. students regarding HIV/AIDS in Malaysia. Singapore
  108. Med J 2009; 50(2): 173-80.
  109. Venmans LMAJ, Gorter KJ, HAK E, RUTTEN GEHM.
  110. Short-Term Effects of an Educational Program on
  111. Health-Seeking Behavior for Infections in Patients
  112. With Type 2 Diabetes. Diabetes Care 2008; 31(3): 402-7.
  113. Sharifi-rad G, Hazavei M, Hasan- zadeh A, Daneshamouz
  114. A. The effect of health education based on health
  115. belief model on preventive actions of smoking in grade
  116. one, middle school students. Journal of Arak university
  117. of medical sciences 2007; 10(1): 1-8. [in persian]
  118. Motamedi N, Hejazi SH, Hazavei SMM, Zamani AR,
  119. Saberi S, Rahimi E. Effect of education based on
  120. Health Belief Model on promoting preventive behavior
  121. of coetaneous leishmaniasis. Journal of Military
  122. Medicine 2010; 11(4): 231-6. [in persian]