Original Article

Effectiveness of a Social Cognitive Theory Intervention on Promoting Personal Protective Equipment (PPEs) Use among Iranian Aluminum Company Workers


Workers in industrial workplaces are at increased risk of developing, occupational hazards, work-related accidents, and diseases. Personal Protective Equipment use (PPE) may protect the user against accident or safety risks in the working environment. Educational interventions may improve knowledge and practice related to prevention, but little is known about their knowledge and exposure prevention. This study was aimed to determine the effect of educational intervention based on social cognitive theory (SCT) on knowledge and (PPEs) use among Iranian workers of Aluminum Company (IRALCO).  This parallel randomized trial was conducted in a sample of 188 workers who were randomly assigned as the intervention (n=94) and a control (n=94) groups. The intervention group received an educational intervention of six sessions lasting 45-60 minutes augmented with the electronic-learning whereas; the control group attended a routine education program of the company. A researcher-made questionnaire based on SCT constructs and a practice/checklist was used to collect data at baseline and six months after the intervention. Mann-Whitney Test and Wilcoxon Signed Ranks Test analysis were used for data analysis using SPSS version 24.0. P<0.05 was considered statistically significant. After the intervention, knowledge, practices (checklist) items, and all SCT constructs (except emotional adaptability (P= 0.077) revealed significant differences in the intervention group (P≤0.001) whereas in the control group were no significant differences (P>0.05). This study indicated that the application of educational intervention based on SCT constructs can reflect a positive impact on knowledge and appropriate use of PPEs to reduce occupational-related injuries. This theory is a recommended method to improve workers’ personal protective behaviors.

1. Hämäläinen P, Takala J. Kiar TB. Global Estimates of Occupational Accidents and Work-related Illnesses, World Congress on Safety and Health at Work,. 3-4 September 2017. Singapore.
2. Vahedian Shahroodi M, Mohammadi, A, Tehrani H. A review of studies in the field of knowledge and safe behaviors of workers in Iran. Journal of Health Literacy. 2016:1(1): 25-38.

3. Wright T, Adhikari A, Yin J, Vogel R, Smallwood S, Shah G. Issue of compliance with use of personal protective Equipment among wastewater workers across the southeast region of the United States. Int J Environ Res Public Health. 2019. 5; 16(11). pii: E2009. DOI: 10.3390/ijerph16112009.
4. Flynn MA, Keller B, DeLaney SC. Promotion of alternative-sized personal protective Equipment. J Safety Res. 2017; 63:43-46. DOI: 10.1016/j.jsr.2017.08.004.

5. Shamsi M, Shams M, Nilipour Tabatabaei A. Attitude and behaviors related to using personal protective equipment: Audience analysis to design a behavior change intervention for employees in constructing underground stations in Esfahan. Iran Occupational Health. 2013; 10 (3):20-28.
URL: http://ioh.iums.ac.ir/article-1-760-en.html
6. Vanderhoof W. How to get workers to wear it. Occup Health Saf. 2004; 73(12):42-44.
7. Kiani F, Samavatyan H, Poorabdian S, Mansournejad Z, Jafari E. Effectiveness of a safety training course in changing employees' attitude toward safety issues and its dimensions: a pathological study. SJSPH. 2011; 9 (2) :53-68. [In Persian].
URL: http://sjsph.tums.ac.ir/article-1-53-en.html
8. O'Connor T, Flynn M, Weinstock D, Zanoni J Occupational safety and health education and training for underserved populations. New Solut. 2014; 24(1):83-106. DOI: 10.2190/NS.24.1.d.
9. Syron LN, Bovbjerg VE, Mendez-Luck CA, Kincl LD. Safety and Health Programs in Alaska's Seafood Processing Industry: Interviews with Safety and Health Managers. J Agro medicine. 2019; 24(4):449-461.
DOI: 10.1080/1059924X.2019.1639578.
10. Taghdisi MH, Madadzadeh N, Shadzi SH, Hassanzadeh A. Effects of Education Interventions on the Coke workers' Immune Performances on Baznef Model Basis at Isfahan Melting Factory, 2005. sjimu. 2008, 16(3): 1-10. [In Persian].
11. Balkhyour MA, Ahmad I, Rehan M. Assessment of personal protective Equipments use and occupational exposures in small industries in Jeddah: Health implications for workers. Saudi J Biol Sci. 2019; 26(4):653-659. DOI: 10.1016/j.sjbs.2018.06.011
12. Amidi Mazaheri M, Heydarnia AR, Ghofranipour FA, Shafiei A. The effect of theory-based intervention on promote workers’ safe behavior in Isfahan steel company. Journal of Isfahan medical school (I.U.M.S). 2010, 27(102):798-808. [In Persian].
13. Schroer S, Haupt J,Pieper C. Evidence-based lifestyle interventions in the workplace-an overview. Occupational Medicine. Narnia. 2014, 64(1):8-12.
DOI: 10.1093/occmed/kqt136.
14. Van Wier MF, Ariëns GA, Dekkers JC, Hendriksen IJ, Pronk NP, Smid T, van Mechelen W. ALIFE@Work: a randomized controlled trial of a distance counselling lifestyle programme for weight control among an overweight working population. BMC Public Health. 2006 May 24; 6: 140. DOI:10.1186/1471-2458-6-140
15. Van Wier, MF, Ariëns GAM, Dekkers JC, Hendriksen IJM, Smid T, Mechelen WV. Phone and e-mail counselling are effective for weight management in an overweight working population: a randomized controlled trial. BMC Public Health. 2009; 9(1): 6. DOI: 10.1186/1471-2458-9-6.
16. JangY, Yoo H. Self-management programs based on the social cognitive theory for Koreans with chronic disease: A systematic review’, Contemporary Nurse Routledge. 2012; 40(2):147–159.
DOI: 10.5172/conu.2012.40.2.147.
17. Hatchett A, Hallam JS, Ford, MA. Evaluation of a social cognitive theory-based email intervention designed to influence the physical activity of survivors of breast cancer’, Psycho-Oncology. 2013; 22(4):829–836. DOI: 10.1002/pon.3082
18. Dennis EA, Potter KL, Estabrooks PA, Davy BM. Weight Gain Prevention for College Freshmen: Comparing Two Social Cognitive Theory-Based Interventions with and without Explicit Self-Regulation Training’, Journal of Obesity. Hindawi Publishing Corporation Journal of Obesity. 2012; 1–10. DOI: 10.1155/2012/803769.
19. Stajkovic AD, Luthans F. Social cognitive theory and self-efficacy: Going beyond traditional motivational and behavioral approaches. Organizational Dynamics. Pergamon, 1998; 26 (4): 62-74. DOI: 10.1016/S0090-2616(98)90006-7.
20. Sharma M. Theoretical foundations of health education and health promotion. World Headquarters Jones & Bartlett Learning, third edition, USA, 2016.
21. Lubans DR, Plotnikoff RC, Morgan PJ, Dewar D, Costigan S, Collins CE. Explaining dietary intake in adolescent girls from disadvantaged secondary schools. A test of Social Cognitive Theory. Appetite. 2012; 58(2):517-24.
DOI: 10.1016/j.appet.2011.12.012.
22. Lawshe CH. A quantitative approach to content validity. Personnel Psychology. John Wiley & Sons, Ltd .1975, 28(4), pp. 563–575.
DOI: 10.1111/j.1744-6570. 1975.
23. Pazargadi M, Ashktorab T, Alavimajd H, Khosravi S. Developing an Assessment Tool for Nursing Students` General Clinical Performance. Iranian Journal of Medical Education. 2013; 12 (11) :877-887
URL: http://ijme.mui.ac.ir/article-1-2182-en.html
24. Honda H, Iwata K. Personal protective equipment and improving compliance among healthcare workers in high-risk settings. Curr Opin Infect Dis. 2016; 29(4):400-6.
DOI: 10.1097/QCO.0000000000000280.
25. Umoren Q, Ekanem US, Johnson OE, Olugbemi MO. An assessment of the effect of health education on the use of personal protective Equipments among small scale welders (panel beaters) in Akwa Ibom state, Nigeria’, International Journal of Community Medicine and Public Health. 2016; 3(11):3220-3228.
DOI: 10.18203/2394-6040.ijcmph20163940.
26. Adewoye KR, Awoyemi AO, Babatunde OA, Atoyebi OA, Salami SK, Issa FY. Effect of health education intervention on the knowledge and use of personal protective Equipments among small scale electric arc welders in Ilorin, Nigeria. Indian J Occup Environ Med. 2014; 18(1):3-8.
27. Ezeugwu L, Aguwa EN, Arinze-Onyia SU, Okeke TA. Health education: Effect on knowledge and practice of workplace personal hygiene and protective measures among woodworkers in Enugu, Nigeria. Niger J Clin Pract. 2017; 20(7):867-872.
DOI: 10.4103/njcp.njcp_258_16).
28. Shojaei S, Tavafian SS, Jamshidi A R, Wagner J, Sepahvandi MR. Social Cognitive Theory-Based Intervention and Low Back Pain among Health Care Workers in Qom Hospitals of Iran. International Journal of Musculoskeletal Pain prevention. 2017; 2(1): 193-201.
29. Duncan-Whaley DO. Effect of Nutrition and Physical Activity Counseling on Knowledge and Behavior of Elementary Students in a Rural, Coastal Community. Master thesis of Science in Nursing, 2005.
30. Shirvani H, Sanaeinasab H, Tavakoli R, Saffari M, Khalaji K, Me’mar S. The Effect of a Social Cognitive Theory-based Educational Intervention on the Physical Activity of Female Adolescents. Iran J Health Educ Health Promot. 2017; 4(4):309-318.
DOI: 10.18869/acadpub.ihepsaj.4.4.309). [In Persian].
31. Navidian A, Rostami Z, Rozbehani N. Effect of motivational group interviewing-based safety education on Workers' safety behaviors in glass manufacturing. BMC Public Health. 2015 19; 15: 929. DOI: 10.1186/s12889-015-2246-8.
32. Abbasian F, Omidvar N, Bondarianzadeh D, Rashidkhani B, Shakibazadeh E, Hashemi B. Effect of a School-based Intervention Based on Social Cognitive Theory on Fruit and Vegetable Consumption in Middle School Students in Tehran. Hayat. 2012; 17 (4) :73-84 URL: http://hayat.tums.ac.ir/article-1-48-en.html[In Persian].
33. Hashemi B, Omidvar N, Bondarianzadeh D, Shakibazadeh E, Rashidkhani B, Abbasian F. Effect of a Family-Based Intervention Based on Social–Cognitive Theory on Fruit and Vegetable Intake of Middle School Female Students in a District of Tehran. Hakim Health Sys Res. 2012; 15 (1) :44-52
URL: http://hakim.hbi.ir/article-1-970-en.html[In Persian].
34. Poddar KH, Hosig KW, Anderson-Bill ES, Nickols-Richardson SM, Duncan SE. Dairy intake and related self-regulation improved in college students using online nutrition education. J Acad Nutr Diet. 2012; 112(12):1976-86.
DOI: 10.1016/j.jand.2012.07.026.
35. Taymoori P, Niknami SH, Tanya Berry T, Lubans D, Ghofranipour F, Kazemnejad A. A school-based randomized controlled trial to improve physical activity among Iranian high school girls. International Journal of Behavioral Nutrition and Physical Activity. 2008; 5(1):18.
DOI: 10.1186/1479-5868-5-18.
36. Peyman N, Ezzati Rastegar KH. Effect of an educational program on job tension management in nurses, based on self-efficacy theory. Modern Care Journal. 2012; 9 (33) :1-9.
37. Pirasteh A, Asghari A, Faghihzadeh S, Ghofranipour F. Development and validation of psychosocial determinants measures of physical activity among Iranian adolescent girls. BMC Public Health. 2008; 8(1): 50.
DOI: 10.1186/1471-2458-8-150.

38. Stacey FG, James EL, Chapman K, Lubans DR. Social cognitive theory mediators of physical activity in a lifestyle program for cancer survivors and carers: findings from the ENRICH randomized controlled trial. Int J Behav Nutr Phys Act. 2016 Apr 14; 13:49.
DOI: 10.1186/s12966-016-0372-z.
39. Chan SY. Social cognitive theory based physical activity intervention targeting non-working time physical activity of workers with intellectual disabilities’, Open Access Theses and Dissertations. 2014. Available at: https://repository.hkbu.edu.hk/etd_oa/53 (Accessed: 13 June 2019).
40. Lubans, D,Sylva K. Controlled Evaluation of a Physical Activity Intervention for Senior School Students: Effects of the Lifetime Activity Program. Journal of Sport and Exercise Psychology. 2006; 28(3):252-268.
DOI: 10.1123/jsep.28.3.252.
41. Quach T, Von Behren J, Tsoh J, Reynolds P, Fu L, Nguyen T, Le M, Nguyen TT. Improving the knowledge and behavior of workplace chemical exposures in Vietnamese-American nail salon workers: a randomized controlled trial. Int Arch Occup Environ Health. 2018; 91(8):1041-1050. DOI: 10.1007/s00420-018-1343-2.
IssueVol 11 No 3 (2019) QRcode
SectionOriginal Article(s)
Knowledge Personal Protective Equipment (PPE) Social Cognitive Theory (SCT) Occupational Health Iranian Aluminum Company Worker

Rights and permissions
Creative Commons License This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
How to Cite
Yaghoti HR, Tol A, Mazloumi A, Sadeghi R, Rahimi Foroushani A, Ghaderi A. Effectiveness of a Social Cognitive Theory Intervention on Promoting Personal Protective Equipment (PPEs) Use among Iranian Aluminum Company Workers. Int J Occup Hyg. 2019;11(3):187-199.