title: An investigation on the effect of Health Belief Model-based education on refusal skills in high risk situations among female students.
abstract: BACKGROUND
  Various studies show an association between lack of social skills in adolescents and the future incidence of behavioral disorders. If girls, as future mothers, lack adequate health, awareness, self confidence and social skills, they may act as a source of many social problems. Therefore, the present study has tried to educate this group on one of the most essential social skills, refusal skill in high risk situation.
  
  
  METHODS
  This is a field quasi experimental study conducted on 145 female students in middle schools in Arak, Iran in 2010-2011. The schools were randomly selected. The subjects were selected through systematic random sampling from the schools' log book. The data were collected by questionnaires containing personal and familial characteristics, three health belief model structures, and behavioral intention in high risk situations. The data were analyzed by descriptive statistical tests (frequency distribution, mean, SD) and inferential tests of repetitive variance analysis and T-test through SPSS.
  
  
  RESULTS
  In the present study, repetitive variance analysis showed that education by use of a health belief model had a positive effect on refusal skills in high risk situations as well as perceived barriers (p = 0.007), self-efficacy (p = 0.015), behavioral intention (p = 0.048) after educational intervention in the study group, but not on perceived benefits (p = 0.180).
  
  
  CONCLUSIONS
  The results showed that education significantly increased refusal skills in high risk situations in the study group through the health belief model. With regard to the results, it is essential to equip the students with preventive behaviors to guarantee their physical, emotional and social health.
authors.affiliation: Nursing and Midwifery Care Research Center, Department of Midwifery, School of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran.
authors.forename: Khadijeh
authors.initials: K
authors.lastname: Boroumandfar
authors.forename: Fatemeh
authors.initials: F
authors.lastname: Shabani
authors.forename: Mohtasham
authors.initials: M
authors.lastname: Ghaffari
keywords: Education; behavioral intention; health belief model; refusal skills in high risk situations