Journal of Preventive Medicine and Public Health

Brief Report

Drug Prescription Indicators in Outpatient Services in Social Security Organization Facilities in Iran: Afsoon Aeenparast, Ali Asghar Haeri Mehrizi, Farzaneh Maftoon, Faranak Farzadi; J Prev Med Public Health. 2024;57(3):298-303. Published online April 4, 2024; DOI: https://doi.org/10.3961/jpmph.23.424

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Objectives
The aim of this study was to estimate drug prescription indicators in outpatient services provided at Iran Social Security Organization (SSO) healthcare facilities.
Methods
Data on all prescribed drugs for outpatient visits from 2017 to 2018 were extracted from the SSO database. The data were categorized into 4 main subgroups: patient characteristics, provider characteristics, service characteristics, and type of healthcare facility. Logistic regression models were used to detect risk factors for inappropriate drug prescriptions. SPSS and IBM Modeler software were utilized for data analysis.
Results
In 2017, approximately 150 981 752 drug items were issued to outpatients referred to SSO healthcare facilities in Iran. The average number of drug items per outpatient prescription was estimated at 3.33. The proportion of prescriptions that included an injection was 17.5%, and the rate of prescriptions that included an antibiotic was 37.5%. Factors such as patient sex and age, provider specialty, type of facility, and time of outpatient visit were associated with the risk of inappropriate prescriptions.
Conclusions
In this study, all drug prescription criteria exceeded the recommended limits set by the World Health Organization. To improve the current prescription patterns throughout the country, it would be beneficial to provide providers with monthly and annual reports and to consider implementing some prescription policies for physicians.

Summary

Key Message
In present research all drug prescriptions in Iran Social Security outpatient facilities were assessed. In all 45,312,540 studied prescriptions, the average number of drug items per prescriptions was 3.33 items. 17.5% of prescriptions contained injection and 37.5% contained antibiotic. Patient sex and age, provider specialty, type of facility were associated with the risk of inappropriate prescriptions. It seems that correct policy making and proper supervision alongside health education will be core basis for improving drug prescription and use.

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A Cross-Sectional Investigation on Drug-Drug Interactions in Prescriptions of Pediatric Outpatient Clinics at a Referral Center in Southern Iran
Sara Asadi, Omid Moradi, Hossein Amini, MReza Goodarzian, Maryam Babaei, Maral Goodarzian
Journal of Comprehensive Pediatrics.2024;[Epub] CrossRef

Original Articles

Patterns of Health-related Quality of Life in Men Who Inject Drugs: A Survey in Southeast Iran: Marzieh Nojomi, Maysam Rezapour, Neda Soleimanvandi Azar, Mehdi Darabi, Mehran Asadi-Aliabadi; J Prev Med Public Health. 2024;57(2):148-156. Published online February 23, 2024; DOI: https://doi.org/10.3961/jpmph.23.379

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Abstract Summary PDF: Objectives
Understanding patterns of quality of life in people who inject drugs (PWID) can help healthcare providers plan and manage their health problems in a more focused manner. Therefore, the current study aimed to identify patterns of health-related quality of life in PWID in southeast Iran.
Methods
This cross-sectional study was conducted in southeast Iran on men who had injected drugs at least once during the last year. We used convenience sampling in 2 drop-in centers and venue-based sampling at 85 venues. Demographic characteristics, high-risk behaviors, and health-related quality of life were evaluated using the 5-level EQ-5D version (EQ-5D-5L) questionnaire. Latent profile analysis was used to identify patterns of quality of life.
Results
This study enrolled 398 PWID, who had a mean age of 34.1±11.4 years. About 47.9% reported a prison history in the last 10 years, 59.2% had injected drugs in the last month, and 31.6% had a history of sharing syringes. About 46.3% reported having 2 or more sexual partners in the last 6 months, and 14.7% had a history of sex with men. Out of the 5 EQ-5D-5L profiles, the fifth profile had the most people (36.6%). Most variations in quality of life were related to pain and discomfort.
Conclusions
We showed that the pain and discomfort dimension of EQ-5D-5L had more variation in PWID. This finding will be useful for allocating appropriate interventions and resources to promote health-related quality of life in this population.; Summary

Key Message
People who Inject drugs, as an at-risk population in physical and mental disorders, need support to reduce harm. This study found that the health-related quality of life of these people is affected more by the pain and discomfort dimension. This can be caused by their social exclusion and marginalization. Hence, regular planning is necessary to organize the health status of these people. Due to the hard-to-reach nature of this population, special arrangements such as utilizing peer groups may be effective to provide them with services.

Prevalence and Determinants of Catastrophic Healthcare Expenditures in Iran From 2013 to 2019: Abdoreza mousavi, Farhad lotfi, Samira Alipour, Aliakbar Fazaeli, Mohsen Bayati; J Prev Med Public Health. 2024;57(1):65-72. Published online November 25, 2023; DOI: https://doi.org/10.3961/jpmph.23.291

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Abstract Summary PDF

Objectives
Protecting people against financial hardship caused by illness stands as a fundamental obligation within healthcare systems and constitutes a pivotal component in achieving universal health coverage. The objective of this study was to analyze the prevalence and determinants of catastrophic health expenditures (CHE) in Iran, over the period of 2013 to 2019.
Methods
Data were obtained from 7 annual national surveys conducted between 2013 and 2019 on the income and expenditures of Iranian households. The prevalence of CHE was determined using a threshold of 40% of household capacity to pay for healthcare. A binary logistic regression model was used to identify the determinants influencing CHE.
Results
The prevalence of CHE increased from 3.60% in 2013 to 3.95% in 2019. In all the years analyzed, the extent of CHE occurrence among rural populations exceeded that of urban populations. Living in an urban area, having a higher wealth index, possessing health insurance coverage, and having employed family members, an employed household head, and a literate household head are all associated with a reduced likelihood of CHE (p<0.05). Conversely, the use of dental, outpatient, and inpatient care, and the presence of elderly members in the household, are associated with an increased probability of facing CHE (p<0.05).
Conclusions
Throughout the study period, CHE consistently exceeded the 1% threshold designated in the national development plan. Continuous monitoring of CHE and its determinants at both household and health system levels is essential for the implementation of effective strategies aimed at enhancing financial protection.

Summary

Key Message
• The aim of this study was to analyze the prevalence and determinants of catastrophic health expenditures (CHE) in Iran. • Catastrophic health expenditures (CHE) are used for monitoring financial protection within health systems. • The World Health Organization defines CHE as out-of-pocket payments for healthcare that exceed 40% of a household’s capacity to pay. • In Iran, the prevalence of CHE increased from 3.60% in 2013 to 3.95% in 2019. • Continuous monitoring of CHE and its determinants is essential for implementing effective strategies aimed at enhancing financial protection.

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An analysis of financial protection and financing incidence of out-of-pocket health expenditures in Kazakhstan from 2018 to 2021
Askhat Shaltynov, Yulia Semenova, Madina Abenova, Assel Baibussinova, Ulzhan Jamedinova, Ayan Myssayev
Scientific Reports.2024;[Epub] CrossRef

Epidemiology of Suicide by Hanging in Fars Province, Iran (2011-2019): A Population-based Cross-sectional Study: Leila Moftakhar, Alireza Mirahmadizadeh, Sanaz Amiri, Fariba Rezaei, Habibollah Azarbakhsh; J Prev Med Public Health. 2023;56(3):264-271. Published online April 20, 2023; DOI: https://doi.org/10.3961/jpmph.22.519

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Abstract PDF

Objectives
Hanging is a common method of attempted suicide. This study investigated the epidemiological profile of attempted and completed suicides by hanging in southern Iran.
Methods
This cross-sectional study was performed on 1167 suicide attempts by hanging between 2011 and 2019. All data related to suicide attempts by hanging were collected from the Fars Suicide Surveillance System. The trends in suicide cases and the mean age of attempted and completed suicides were plotted. The chi-square test was used to identify suicide-related factors. Crude rates of incidence, mortality, and standardized fatality during the study period were calculated. Finally, logistic regression was used to identify the predictors of death in individuals who attempted suicide.
Results
The mean age of those who attempted suicide was 33.21±16.82 years; the majority were male (80.5%). The rate of attempted and completed suicide by hanging were 3.50 and 2.79 per 100 000 people, respectively. The case-fatality rate was calculated as 79.34%. The results of our study indicated an increasing trend in suicide attempts by hanging. The likelihood of death was 2.28 times higher in individuals with a previous history of suicide attempts and 1.85 times higher in those with a psychological disorder.
Conclusions
The findings of this study suggest an increasing trend in attempted and completed suicide by hanging, especially among individuals with a history of suicide attempts and psychological disorders. It is necessary to take action to reduce the rate of suicide attempts and identify the underlying causes of suicide attempts by hanging.

Summary

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Assessing the knot in a noose position by thyrohyoid and cervical spine fracture patterns in suicidal hangings using machine learning algorithms: A new insight into old dilemmas
Aleksa Leković, Arso Vukićević, Slobodan Nikolić
Forensic Science International.2024; 357: 111973. CrossRef

Adverse Events Following Immunizations in Infants Under 1 Year of Age in Lorestan Province, Western Iran: Anbari khatereh, Ghanadi Koruosh, Toulabipour Alireza, Jamebozuorghi Daryuosh, Baharvand Parastoo; J Prev Med Public Health. 2023;56(2):172-179. Published online March 14, 2023; DOI: https://doi.org/10.3961/jpmph.22.540

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Abstract PDF: Objectives
Vaccination is an important intervention for preventing disease and reducing disease severity. Universal vaccination programs have significantly reduced the incidence of many dangerous diseases among children worldwide. This study investigated the side effects after immunization in infants under 1 year of age in Lorestan Province, western Iran.
Methods
This descriptive analytical study included data from all children <1 year old in Lorestan Province, Iran who were vaccinated according to the national schedule in 2020 and had an adverse event following immunization (AEFI). Data were extracted from 1084 forms on age, sex, birth weight, type of birth, AEFI type, vaccine type, and time of vaccination. Descriptive statistics (frequency, percentage) were calculated, and the chi-square test and Fisher exact test were used to assess differences in AEFIs according to the abovelisted variables.
Results
The most frequent AEFIs were high fever (n=386, 35.6%), mild local reaction (n=341, 31.5%), and swelling and pain (n=121, 11.2%). The least common AEFIs were encephalitis (n=1, 0.1%), convulsion (n=2, 0.2%), and nodules (n=3, 0.3%). Girls and boys only showed significant differences in mild local reactions (p=0.044) and skin allergies (p=0.002). The incidence of lymphadenitis (p<0.001), severe local reaction (p<0.001), mild local reaction (p=0.007), fainting (p=0.032), swelling and pain (p=0.006), high fever (p=0.005), and nodules (p<0.001) showed significant differences based on age at vaccination.
Conclusions
Immunization is a fundamental public health policy for controlling vaccine-preventable infectious diseases. Although vaccines such as the Bacillus Calmette-Guérin vaccine, oral poliovirus vaccine, and pentavalent vaccine are well-researched and reliable, AEFIs are inevitable.; Summary

Adapting the Community Readiness Model and Validating a Community Readiness Tool for Childhood Obesity Prevention Programs in Iran: Mahdieh Niknam, Nasrin Omidvar, Parisa Amiri, Hassan Eini-Zinab, Naser kalantari; J Prev Med Public Health. 2023;56(1):77-87. Published online January 10, 2023; DOI: https://doi.org/10.3961/jpmph.22.409

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Abstract PDF Supplementary Material

Objectives
It is critical to assess community readiness (CR) when implementing childhood obesity prevention programs to ensure their eventual success and sustainability. Multiple tools have been developed based on various conceptions of readiness. One of the most widely used and flexible tools is based on the community readiness model (CRM). This study aimed to adapt the CRM and assess the validity of a community readiness tool (CRT) for childhood obesity prevention programs in Iran.
Methods
A Delphi study that included 26 individuals with expertise in 8 different subject areas was conducted to adapt the CRM into a theoretical framework for developing a CRT. After linguistic validation was conducted for a 35-question CR interview guide, the modified interview guide was evaluated for its content and face validity. The quantitative and qualitative analyses were performed using Stata version 13 and MAXQDA 2010, respectively.
Results
The Delphi panelists confirmed the necessity/appropriateness and adequacy of all 6 CRM dimensions. The Persian version of the interview guide was then modified based on the qualitative results of the Delphi study, and 2 more questions were added to the community climate dimension of the original CRT. All questions in the modified version had acceptable content and face validity. The final CR interview guide included 37 questions across 6 CRM dimensions.
Conclusions
By adapting the CRM and confirming linguistic, content, and face validity, the present study devised a CRT for childhood obesity prevention programs that can be used in relevant studies in Iran.

Summary

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Improving community readiness among Iranian local communities to prevent childhood obesity
Mahdieh Niknam, Nasrin Omidvar, Hassan Eini-Zinab, Naser Kalantari, Keyvan Olazadeh, Parisa Amiri
BMC Public Health.2023;[Epub] CrossRef

Social Contact Patterns Associated With Tuberculosis: A Case-control Study in Southwest Iran: Neda Amoori, Bahman Cheraghian, Payam Amini, Seyed Mohammad Alavi; J Prev Med Public Health. 2022;55(5):485-491. Published online September 30, 2022; DOI: https://doi.org/10.3961/jpmph.22.335

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Objectives
Tuberculosis (TB) is a major public health concern worldwide. Social contact patterns can affect the epidemiology and risk of airborne diseases such as TB. This study was designed to investigate the social contact patterns associated with TB.
Methods
In this case-control study, groups of participants with and without TB were matched by age and sex. Participants reported the nature, location, frequency, and average duration of social contacts over 1 month. The duration and number of social and spatial contacts were compared between groups using the chi-square test and the t-test. Odds ratios (ORs) with 95% confidence intervals (CIs) were used to quantify the relationship between social contact time and TB status. Data were analyzed using Stata version 11 statistical software. A p-value of <0.05 was considered to indicate statistical significance.
Results
In this study, 80 patients with TB and 172 control participants were included, and a total of 3545 social contacts were registered. Social contact with family members (OR, 1.72; 95% CI, 1.10 to 2.40), contact with a person with TB (OR, 1.53; 95% CI, 1.16 to 2.01), and contact at the participant’s home (OR, 1.42; 95% CI, 1.19 to 1.82) were significantly associated with TB status.
Conclusions
The duration of long-term social contact, rather than the number of contacts, may be the main contact-related factor associated with TB transmission in this population. The focus of contact-tracing efforts should be on finding and treating both family members and long-term contacts in non-household settings.

Summary

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Collaboration and involvement of village heads, public health officer, and village midwives in improving adherence of tuberculosis patients
Nixson Manurung, R. Hamdani Harahap, Fazidah A. Siregar, Lita Sri Andayani
Clinical Epidemiology and Global Health.2024; 26: 101528. CrossRef
Trends and risk factors for drug-resistant tuberculosis among children in Sichuan, China: A 10-year retrospective analysis, 2013–2022
Maoying Li, Bin Deng, Yuhong Huang, Qiong Li, Jing Han, Shenjie Tang, Lei Chen
Medicine.2024; 103(15): e37643. CrossRef
Coping efforts made: Psychological burden of people living with tuberculosis due to social stigma in society. A qualitative phenomenology study
Abd Nasir, Intan Idiana Hassan, Anwar Ma’ruf, Novianto Edi Suharno, Sianiwati Goenharto, Cucuk Rahmadi Purwanto, Anestasia Pangestu Mei Tyas, I. Marion Sumari-de Boer
PLOS ONE.2024; 19(7): e0303331. CrossRef
Investigating the intensity of social contacts associated with tuberculosis: a weighted networks model
Neda Amoori, Payam Amini, Bahman Cheraghian, Seyed Mohammad Alavi
BMC Pulmonary Medicine.2023;[Epub] CrossRef

The Effect of an Empowerment Program on the Health-promoting Behaviors of Iranian Women Workers: A Randomized Controlled Trial: Fatemeh Noori, Zahra Behboodimoghadam, Shima Haghani, Shahzad Pashaeypoor; J Prev Med Public Health. 2021;54(4):275-283. Published online June 24, 2021; DOI: https://doi.org/10.3961/jpmph.21.088

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Abstract PDF

Objectives
The workplace is an ideal place for encouraging health-promoting behaviors. Therefore, the aim of the present study was to determine the effect of an empowerment program on the health-promoting behaviors of women workers.
Methods
This randomized clinical trial was conducted with 80 women workers employed at a food packaging facility in 2020. The subjects were selected using convenience sampling and were classified into intervention and control groups using block randomization. An empowerment program for women workers was conducted across 6 sessions based on an empowerment model. Data collection tools included a demographic questionnaire and the Health Promoting Lifestyle Profile-II, which participants completed both before the program and 8 weeks after the last session. Data analysis was performed in SPSS version 16 using descriptive analysis and inferential statistics.
Results
There were no significant differences between the 2 groups in various health-promoting behaviors before the program. However, the intervention group’s scores for nutrition (34.92±1.09 vs. 27.87±4.23), physical activity (24.40±2.94 vs. 17.40±5.03), stress management (26.35±2.60 vs. 23.05±4.27), spiritual growth (34.02±3.00 vs. 30.22±5.40), interpersonal relationships (30.82±2.38 vs. 27.60±4.61), and health responsibility (31.60±2.71 vs. 28.22±4.59) were significantly higher than the control group’s 8 weeks after the program had ended. Moreover, there was a significant difference in the total score of health-promoting behaviors for the intervention group compared to the control group (179.00±9.22 vs. 151.42±20.25, p=0.001).
Conclusions
An empowerment program for women workers led to significant improvements in the health-promoting behaviors of the participants. Similar programs can ultimately improve women’s health in the workplace.

Summary

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Participatory Approaches in the Context of Research Into Workplace Health Promotion to Improve Physical Activity Levels and Reduce Sedentary Behavior Among Office-Based Workers: Scoping Review
Aidan John Buffey, Christina Kate Langley, Brian P Carson, Alan E Donnelly, Jon Salsberg
JMIR Public Health and Surveillance.2024; 10: e50195. CrossRef
Effectiveness of Multicomponent Interventions and Physical Activity in the Workplace to Reduce Obesity: A Systematic Review and Meta-Analysis
M. Rocío Jiménez-Mérida, Manuel Vaquero-Abellán, José M. Alcaide-Leyva, Vanesa Cantón-Habas, Elena Raya-Cano, Manuel Romero-Saldaña
Healthcare.2023; 11(8): 1160. CrossRef

Daytime Napping and Nighttime Sleep During Pregnancy and Preterm Birth in Iran: Farnaz Shaliha, Maryam Mozaffari, Faeze Ramezani, Hamideh Hajnasiri, Farnoosh Moafi; J Prev Med Public Health. 2021;54(3):182-189. Published online March 31, 2021; DOI: https://doi.org/10.3961/jpmph.20.372

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Abstract PDF

Objectives
This study investigated the relationship between sleep quality during pregnancy and preterm birth.
Methods
This longitudinal study was conducted between August 2018 and May 2019. The participants were 150 pregnant women who had been referred to 7 healthcare centers in the city of Qazvin, Iran and met the inclusion criteria. The Petersburg Sleep Quality Index, the Epworth Sleepiness Scale, and 2 questions about daytime sleep status and a demographic questionnaire were administered at 14-18 weeks and 28-32 weeks of gestation. Data were analyzed using the Mann-Whitney test, the Fisher exact test, and univariate and multivariable logistic regression.
Results
In the present study, poor sleep quality affected 84.7% of the participants at 14-18 weeks and 93.3% at 28-32 weeks of gestation. The final model for preterm birth prediction incorporated age and the Petersburg Sleep Quality Index score in the second and third trimesters. Preterm birth increased by 14% with each unit increase in age. With each unit increase in the Petersburg Sleep Quality Index score in the second and third trimesters, preterm birth increased by 42% and 28%, respectively, but the p-values of these factors were not significant.
Conclusions
Although a significant percentage of pregnant women had poor sleep quality, no significant relationship was found between sleep quality during pregnancy and preterm birth.

Summary

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Development, validation, and reliability of the Chrononutrition Profile Questionnaire-Pregnancy (CPQ-P)
Ee Yin Kok, Satvinder Kaur, Nurul Husna Mohd Shukri, Nurliyana Abdul Razak, Masaki Takahashi
BMC Pregnancy and Childbirth.2024;[Epub] CrossRef
Association between sleep quality with maternal and neonatal outcomes during the covid-19 pandemic
Maryam Akbari, Sara EsmaeilzadehSaeieh, Malihe Farid, Arman Shafiee, Mahmood Bakhtiyari, Touran Bahrami Babaheidari, Mansoureh Yazdkhasti
BMC Pregnancy and Childbirth.2024;[Epub] CrossRef
Sleep duration, napping behaviors and restless legs syndrome during pregnancy and the trajectories of ultrasonographic measures of fetal growth: Findings from the NICHD Fetal Growth Studies–Singletons
Muzi Na, Samidha Sudhakar Shetty, Xiaoyue Niu, Stefanie N. Hinkle, Cuilin Zhang, Xiang Gao
Sleep Health.2024; 10(4): 462. CrossRef
Managing Maternal Fatigue During Childbirth: A Systematic Review
Kunnikar Chaisitsanguan, Puangpaka Kongwattananon, Dawn Hawthrone
Current Women s Health Reviews.2023;[Epub] CrossRef
Studying the Sleep Quality of First Pregnant Women in the Third Trimester of Pregnancy and Some Factors Related to It
Moude Liu, Qin Tang, Qing Wang, Weixi Xie, Jinbao Fan, Siyuan Tang, Wei Liu, Yingjun Zhou, Xu Deng
Journal of Integrative Nursing and Palliative Care.2022; 1(1): 18. CrossRef

The Burden of Stroke in Kurdistan Province, Iran From 2011 to 2017: Shahram Moradi, Ghobad Moradi, Bakhtiar Piroozi; J Prev Med Public Health. 2021;54(2):103-109. Published online February 1, 2021; DOI: https://doi.org/10.3961/jpmph.20.335

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Abstract PDF

Objectives
The aim of this study was to calculate the burden of stroke in Kurdistan Province, Iran between 2011 and 2017.
Methods
Incidence data extracted from the hospital information system of Kurdistan Province and death data extracted from the system of registration and classification of causes of death were used in a cross-sectional study. The World Health Organization method was used to calculate disability-adjusted life years (DALYs).
Results
The burden of stroke increased from 2453.44 DALYs in 2011 to 5269.68 in 2017, the years of life lost increased from 2381.57 in 2011 to 5109.68 in 2017, and the years of healthy life lost due to disability increased from 71.87 in 2011 to 159.99 in 2017. The DALYs of ischaemic stroke exceeded those of haemorrhagic stroke. The burden of disease, new cases, and deaths doubled during the study period. The age-standardised incidence rate of ischaemic stroke and haemorrhagic stroke in 2017 was 21.72 and 20.72 per 100 000 population, respectively.
Conclusions
The burden of stroke is increasing in Kurdistan Province. Since health services in Iran are based on treatment, steps are needed to revise the current treatment services for stroke and to improve the quality of services. Policy-makers and managers of the health system need to plan to reduce the known risk factors for stroke in the community. In addition to preventive interventions, efficient and up-to-date interventions are recommended for the rapid diagnosis and treatment of stroke patients in hospitals. Along with therapeutic interventions, preventive interventions can help reduce the stroke burden.

Summary

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The incidence, mortality and disease burden of cardiovascular diseases in China: a comparative study with the United States and Japan based on the GBD 2019 time trend analysis
Menglan Zhu, Wenyu Jin, Wangbiao He, Lulu Zhang
Frontiers in Cardiovascular Medicine.2024;[Epub] CrossRef

Household Overcrowding in Iran, a Low-middle-income Country: How Major of a Public Health Concern Is It?: Leila Jansar Hosseini, Ali Hussein Samadi, Abraha Woldemichael, Masoumeh Najaf Gharebelagh, Satar Rezaei, Enayatollah Homaie Rad; J Prev Med Public Health. 2021;54(1):73-80. Published online January 11, 2021; DOI: https://doi.org/10.3961/jpmph.20.568

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Objectives
Household overcrowding (HC) can contribute to both physical and mental disorders among the members of overcrowded households. This study aimed to measure the status of HC and its main determinants across the provinces of Iran.
Methods
Data from 39 864 households from the 2016 Iranian Household Income and Expenditures Survey were used in this study. The Equivalized Crowding Index (ECI) and HC index were applied to measure the overcrowding of households. Regression models were estimated to show the relationships between different variables and the ECI.
Results
The overall, urban, and rural prevalence of HC was 8.2%, 6.3%, and 10.1%, respectively. The highest prevalence of HC was found in Sistan and Baluchestan Province (28.7%), while the lowest was found in Guilan Province (1.8%). The number of men in the household, rural residency, the average age of household members, yearly income, and the household wealth index were identified as the main determinants of the ECI and HC.
Conclusions
The study demonstrated that the ECI and HC were higher in regions near the borders of Iran than in other regions. Therefore, health promotion and empowerment strategies are required to avoid the negative consequences of HC, and screening programs are needed to identify at-risk families.

Summary

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Future scenarios of palliative care in health system of Iran: a multi-method study
Salman Barasteh, Akram Parandeh, Maryam Rassouli, Rohallah Zaboli, Amir Vahedian Azimi, Morteza Khaghanizadeh
Frontiers in Public Health.2024;[Epub] CrossRef
Social determinants of health and diabetes: Results from a cohort study in Iran
SeyedJalal Hashemi, Mehrnoosh Jasemzadeh, Nader Saki, Bahman Cheraghian, Sara Sarvandian, Ali Montazeri, Maedeh Raeisizadeh, Marzieh Araban
Asian Journal of Social Health and Behavior.2023; 6(2): 86. CrossRef
Inadequate housing and pulmonary tuberculosis: a systematic review
Ju-Yeun Lee, Namhee Kwon, Ga-yeon Goo, Sung-il Cho
BMC Public Health.2022;[Epub] CrossRef

Exploring Reproductive Health Education Needs in Infertile Women in Iran: A Qualitative Study: Zohreh Khakbazan, Raziyeh Maasoumi, Zahra Rakhshaee, Saharnaz Nedjat; J Prev Med Public Health. 2020;53(5):353-361. Published online July 14, 2020; DOI: https://doi.org/10.3961/jpmph.20.056

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Objectives
An inadequate understanding of infertility can affect individuals’ self-efficacy and ability to perform self-care; thus, reproductive health education is an important part of infertility treatment. The present qualitative study aimed to explore the experiences and educational needs of infertile women with regard to reproductive health.
Methods
In this qualitative study, we utilized a content analysis approach. Purposive sampling was performed to ensure maximum diversity. In total, 23 individual interviews were conducted with 20 Iranian women with infertility and 3 key informants between July 2018 and February 2019 in northern Iran. Data were collected through in-depth, semi-structured interviews. Data analysis was performed using a conventional content analysis approach.
Results
Reproductive health education needs were identified by analyzing interview data from 4 main categories: familiarity with the fertility process and preparation for pregnancy, recognition of infertility and expectations around seeking treatment, recognition of preventive actions associated with reproductive health, and correction of false beliefs. Recognizing the causes of infertility and understanding the different approaches to infertility treatment are among the most important educational needs of infertile women. The potential for neglect of health-related issues due to concerns about fertility and the maternal experience necessitates education about preventive measures for cervical cancer, breast cancer, and sexually transmitted infections. Correcting misconceptions, including those related to contraceptives and traditional medicine, can also help promote reproductive health.
Conclusions
In infertile women, the educational needs associated with reproductive health are multifaceted. Satisfying these needs can help achieve optimal treatment results and promote reproductive health.

Summary

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The impact of stigma on mental health and quality of life of infertile women: A systematic review
Yue Xie, Yue Ren, Changmin Niu, Ying Zheng, Ping Yu, Lin Li
Frontiers in Psychology.2023;[Epub] CrossRef
Women's experience of infertility & treatment – A silent grief and failed care and support
Shereen Assaysh-Öberg, Catrin Borneskog, Elin Ternström
Sexual & Reproductive Healthcare.2023; 37: 100879. CrossRef
Effect of Teach-back and Douyin platform short video health education in women receiving infertility treatment
Qin Lin, Haiyan Zhou, Jijun Wu, Pei Chen, Yanping Niu, Weiwei Fang, Ling Li, Ling Peng, Mengxue Fu
DIGITAL HEALTH.2023;[Epub] CrossRef
Study of Reproductive Health Literacy and Its Related Factors in Infertile Women
Z Rakhshaee, B Kamranpour
Journal of Health and Hygiene.2023; 14(4): 466. CrossRef
Women’s Attempts Related to Complementary and Alternative Medicine Use in Infertility Causes and Diagnosis: A Narrative Inquiry
Mohsen Azimi-Nezhad, Malihe Noori Sistani, Mohammad Vahedian-Shahroodi
Community Health Equity Research & Policy.2022; 42(3): 291. CrossRef

Educational Intervention Based on the Health Belief Model to Modify Risk Factors of Cardiovascular Disease in Police Officers in Iran: A Quasi-experimental Study: Mohsen Saffari, Hormoz Sanaeinasab, Hassan Jafarzadeh, Mojtaba Sepandi, Keisha-Gaye N. O'Garo, Harold G. Koenig, Amir H. Pakpour; J Prev Med Public Health. 2020;53(4):275-284. Published online June 18, 2020; DOI: https://doi.org/10.3961/jpmph.20.095

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Objectives
Police officers may be at a greater risk for cardiovascular disease (CVD) than the general population due to their highstress occupation. This study evaluated how an educational program based on the health belief model (HBM) may protect police officers from developing CVD.
Methods
In this single-group experimental study, 58 police officers in Iran participated in a 5-week intervention based on HBM principles. Outcomes included changes in scores on an HBM scale, time spent on moderate to vigorous physical activity (International Physical Activity Questionnaire), body mass index (BMI), blood lipid profile, blood glucose, and blood pressure. The intervention consisted of 5 HBM-based educational sessions. Follow-up was conducted at 3 months post-intervention. The paired t-test was used to examine differences between baseline and follow-up scores.
Results
All aspects of the HBM scale improved between baseline and follow-up (p<0.05), except the cues to action subscale. Self-efficacy and preventive behaviors improved the most. BMI decreased from 26.7±2.9 kg/m² at baseline to 25.8±2.4 kg/m² at follow-up. All components of the lipid profile, including triglycerides, cholesterol, high-density lipoprotein, and low-density lipoprotein, showed significant improvements post-intervention. Blood glucose and blood pressure also decreased, but not significantly. Nearly 25% of participants who were not physically active at baseline increased their physical activity above or beyond the healthy threshold.
Conclusions
A relatively brief educational intervention based on HBM principles led to a significant improvement in CVD risk factors among police officers. Further research is needed to corroborate the effectiveness of this intervention.

Summary

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Factors Affecting Breast Self-examination Behavior Among Female Healthcare Workers in Iran: The Role of Social Support Theory: saeed bashirian, Majid Barati, Leila Moaddab Shoar, Younes Mohammadi, Mitra Dogonchi; J Prev Med Public Health. 2019;52(4):224-233. Published online June 26, 2019; DOI: https://doi.org/10.3961/jpmph.18.277

8,705 View
344 Download
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Abstract PDF Supplementary Material

Objectives
In women, breast cancer is the most common cancer and the leading cause of cancer death. Screening tests are the basis for early diagnosis. In Iranian women, the mortality rate of breast cancer is high due to insufficient screening examinations and delayed visits for care. Therefore, this study aimed to determine the factors affecting breast self-examinations among Iranian women employed in medical careers.
Methods
This cross-sectional study included 501 women working in the medical professions at Hamadan University of Medical Sciences in western Iran in 2018. The subjects were selected by stratified random sampling. Data were collected using a researcher-developed, self-report questionnaire that contained demographic information and questions based on protection motivation theory and social support theory. Descriptive data analysis was conducted using SPSS version 23 and model fitting with PLS version 2.
Results
The mean age of the participants was 37.1±8.3 years, and most of the women (80.4%) were married. Most women had a bachelor’s degree (67.5%). The findings of this study showed that the coping appraisal construct was a predictor of protection motivation (β=0.380, p<0.05), and protection motivation (β=0.604, p<0.05) was a predictor of breast self-examination behavior. Additionally, social support theory (β=0.202, p<0.05) had a significant positive effect on breast self-examination behavior.
Conclusions
The frequency of practicing self-examinations among women employees in the medical sector was low; considering the influence of social support as a factor promoting screening, it is necessary to pay attention to influential people in women’s lives when designing educational interventions.

Summary

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Measuring and decomposing socioeconomic inequality in catastrophic healthcare expenditures in Iran: Satar Rezaei, Mohammad Hajizadeh; J Prev Med Public Health. 2019;52(4):214-223. Published online June 14, 2019; DOI: https://doi.org/10.3961/jpmph.19.046

6,934 View
217 Download
16 Crossref

Abstract PDF

Objectives
Equity in financial protection against healthcare expenditures is one the primary functions of health systems worldwide. This study aimed to quantify socioeconomic inequality in facing catastrophic healthcare expenditures (CHE) and to identify the main factors contributing to socioeconomic inequality in CHE in Iran.
Methods
A total of 37 860 households were drawn from the Households Income and Expenditure Survey, conducted by the Statistical Center of Iran in 2017. The prevalence of CHE was measured using a cut-off of spending at least 40% of the capacity to pay on healthcare services. The concentration curve and concentration index (C) were used to illustrate and measure the extent of socioeconomic inequality in CHE among Iranian households. The C was decomposed to identify the main factors explaining the observed socioeconomic inequality in CHE in Iran.
Results
The prevalence of CHE among Iranian households in 2017 was 5.26% (95% confidence interval [CI], 5.04 to 5.49). The value of C was -0.17 (95% CI, -0.19 to -0.13), suggesting that CHE was mainly concentrated among socioeconomically disadvantaged households in Iran. The decomposition analysis highlighted the household wealth index as explaining 71.7% of the concentration of CHE among the poor in Iran.
Conclusions
This study revealed that CHE is disproportionately concentrated among poor households in Iran. Health policies to reduce socioeconomic inequality in facing CHE in Iran should focus on socioeconomically disadvantaged households.

Summary

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