This descriptive-correlational study was conducted on the students of KUMS (n=4,200), and 360 students (180 females and 180 males) were selected via stratified random sampling after segregation based on their school and gender. Data were collected using the standard questionnaire by Milfort, Duckitt, and Wagner (2010), 17. which has been previously used in Iran 18. Data analysis was performed in SPSS version 21 using linear regression analysis and Pearson s correlation-coefficient.

According to the descriptive results, 50% of the subjects (n=180) were female, and the remaining were male. In terms of education level, 44% of the participants (n=159) had a BSc, and the majority of the subjects (22%) were from the School of Nursing and Midwifery (Table 1).

The mean score of ERBs was 63.67±4.88, and the mean scores of environmental attitude and environmental knowledge were 25.79±4.08 and 18.62±1.99, respectively. Table 2

Our findings were indicative of an insignificant correlation between the environmental knowledge and environmental behaviors of the students (r=0.07; P=0.20). On the other hand, a positive, significant correlation was denoted between the environmental attitude and environmental behaviors of the participants (r=-0.54; P <0.001) table 3

We applied linear regression analysis to evaluate the correlations between the students’ environmental behaviors and variables of gender, attitude, knowledge, education level, and medical school. In the first stage, we investigated the correlations between the independent variables and the dependent variable, and the effects of these variables were also adjusted by multivariate analysis in case of a significant correlation. According to the multivariate linear regression analysis and the univariate analysis, the students’ environmental behaviors was significantly correlated with the variables of gender, attitude, education level, and medical school (P <0.05). The effects of these variables were modified by multivariate analysis.

After the modification of the gender variable, the significant associations remained between the environmental behavior scores and variables of attitude and education level, and the environmental behavior scores of the medical and dental students were 4.91 and 7.18 units higher compared to the students with an associate degree (reference category) (Table 4). In addition, a significant correlation was denoted between the students’ environmental behaviors and their attitude, so that a one-unit increase in the environmental attitude score increased the environmental behavior score by 0.97 units (Table 4). According to the regression model, these variables explained approximately 35% of the variance of the students’ environmental behavior score (dependent variable). Table 4

The present study aimed to evaluate ERBs in medical students by assessing two important components of environmental knowledge and attitude, which affect environmental behavior. The obtained results showed significant correlations between the students environmental behaviors and their knowledge and awareness. Accordingly, increased environmental knowledge and awareness was associated with more environmentally conscious behaviors in the students, as well as their higher inclination toward environmental protection. In addition, the correlation-coefficient between the environmental attitude and environmental behaviors of the students was positive and moderate. Moreover, significant associations were denoted between the mentioned variables. In this regard, our findings are in line with the results obtained by Wee et al. (2017), Ahmad et al. (2015), Tam and Chan (2017), Rodriguez-Barreiro et al. (2013), and Molina et al. (2013) 89101112.

Inconsistent with our findings, Akomolafe (2011) evaluated the influential factors in the environmental education of 539 students, reporting an unfavorable attitude toward environmental issues in the sample population. Moreover, parental gender and education level and educational institution had no impact on the environmental behaviors of the students 19 The discrepancy between these findings might be due to the fact that people s behaviors toward environmental protection cannot be predicted through the mere understanding of their accepted environmental values, as well as environmental knowledge and attitudes. Therefore, an assessment of other social and environmental factors is required to identify citizens environmental behaviors. Some researchers believe that novel environmental approaches are primarily beneficial for determining our attitude toward the environment and may also create a situation where meaningful environmental behaviors could be tracked 20

According to the results of the present study, the correlation-coefficient between the environmental awareness (knowledge) and environmental behaviors of the students was rather weak, yet positive. Furthermore, no significant correlation was observed between the two variables, which is incongruent with the results obtained by Mifsud (2012) 8, Roczen et al. (2013) 9, Disa et al. (2011) 10, and Molina et al. (2013) 21. On the other hand, our findings are in line with the results obtained by Kumar (2013) Sanjay 21 and Reyes et al. (2010) 22 Kumar Sanjay (2013) evaluated the environmental knowledge of rural people in the Hamirpur region (India), reporting that the environmental knowledge of the participants was low, and there were several barriers to making relevant information available to this community. In the mentioned research, the subjects seemed to have a certain level of environmental awareness, while they did not exhibit any environmental behaviors. In the study by Reyes et al. (2010) regarding local environmental knowledge and education, no significant association was denoted between local and academic knowledge. Therefore, education in this field seemed necessary, and it was concluded that learning could lay the foundation for proenvironmental behaviors.

A possible explanation of the mentioned findings is that the behaviors in the field of environmental protection cannot be predicted through the mere knowledge of the type of environmental values acknowledged by individuals or their environmental knowledge and attitudes. Therefore, an assessment of other social and environmental factors is required to identify the environmental behaviors of citizens. It is likely that the physical characteristics of the natural environment where individuals interact in their daily lives and their attitude toward these places may influence their attitudes and behaviors toward the environment. In general, increased environmental knowledge could change their attitude and performance, thereby leading to effectual environmental policies. On the other hand, the need to recognize the views and assess the general knowledge of the community members about environmental issues is due to the fact that the knowledge and attitude of individuals affect their behaviors in multiple cases 23. Furthermore, the general knowledge and attitudes of the public toward the environment lay the foundation for enhancing the impact of these variables on the practices in this regard 24. Therefore, the way we treat planet Earth and its resources will have a profound effect on the climate. If the required actions are not taken, negative environmental changes can severely damage the environment and lower the quality of life of human communities.

One of the most important institutions affecting this issue is higher education since evaluating the most important problems and challenges regarding students' environmental attitude include the tendency to subjectivism and moving away from objectivity, lack of assurance of fairness in the evaluation, and lack of guaranteed security about the results of the evaluation reports of students 25. Higher education could obtain environmental information and promote critical and independent thinking in the community 26.

Given the poor environmental knowledge of students, it is recommended that proper solutions be devised in this regard, such as holding environmental camps for cleaning the environment, visiting protected and deteriorated natural resources, holding ceremonies such as planting trees in universities on the occasion of arbor day, discussing environmental issues in the form of influential posters/images, preparing movies/brochures about the environment and presenting them to students, encouraging students to separate garbage in the dormitory, creating and strengthening environmentally-friendly student organizations, holding courses/workshops about the environment, implementing competitions in the field of environment among students, and printing/publishing magazines to raise the environmental awareness of students.