A Study on Perceived Discrimination from Implementation of the Health Reform Program among Employees of Training Organizations in Rafsanjan City, 2015

Background: After security, the second most important human need is health and the healthcare reform plan is a program for improving health services. The purpose of this study was to investigate the social consequences of implementing the health system reform plan in Rafsanjan, with emphasis on the feeling of discrimination among employees of the educational organizations of this city. Methods: In this descriptive and analytical cross-sectional study, 362 employees of the educational organizations were selected through stratified random sampling in 2015. A researcher-made questionnaire with 21 questions was used to measure the variables. One-way analysis of variance and Pearson correlation coefficient were used for statistical analysis and data analysis was performed through SPSS version 20. Results: 63% of the staff of educational institutions perceived discrimination in the health system reform plan at an intermediate level. The staff of the Education Department with mean score of 59.0 had the most and Vali -ye-Asr University employees with mean score of 44.9 had the least perceived discrimination from the implementation of the health system reform program. Among job categories, teachers with mean score of 56.5 had the most and physicians with mean score of 45.1 had the least perceived discrimination from the implementation of the health system reform plan. Increased health costs was associated with increased perceived discrimination while higher socioeconomic status and care services was associated with decreased perceived discrimination. Conclusion: The results of this study showed that the implementation of the health system reform plan has led to different levels of discriminatory perception among staff of educational institutions

The Effect of Educational Intervention based on the Health Belief Model on Diabetes Screening Behavior in over 30 Years Old men in Shahr-e-Babak

Background: Diabetes is one of the major health problems in the world and half of the affected patients are unaware of it. The aim of this study was to determine the effect of the Health Belief Model on the behavior of male subjects attending diabetes screening. Methods: This interventional study was performed on 180 men over 30 years of age. The intervention group (90 ones) underwent educational intervention conducted over four 60-minute sessions. Data were collected using a questionnaire (including 51 questions) filled out through direct interview before the intervention and two months after that. Fisher's exact test, Wilcoxon and Mann-Whitney tests were used for data analysis. Results: After the intervention, knowledge scores increased in both intervention and control groups. This was due to the implementation of routine training at the centers. But, significant increase in the attitudes and practice was observed only in the intervention group. Also, perceived benefits, perceived barriers, and cues to action, after the intervention, showed significant increase in the intervention group compared with the control group (P <0.001). Conclusion: Health Belief Model was effective in education of people over 30 years old for participating in diabetes screening programs. Therefore, it is recommended to use this model alongside traditional methods

The Effect of Educational Intervention Based on the Health Belief Model on Medication Adherence among Patients with Diabetes Referred to a Diabetes Center in Zarand, Kerman

Background: Medication adherence in patients with diabetes is one of the main factors in diabetic patients care. The aim of this study was to investigate the effect of educational intervention based on the Health Belief Model (HBM) on medication adherence in patients with diabetes referred to a diabetes center in Zarand, Iran, in 2014. Methods: This quasi-experimental study was performed on 100 patients with diabetes. The patients were divided into two groups (intervention and control). Data were collected using a researcher-made questionnaire including demographic variables, constructs of HBM, and the Morisky self-report questionnaire. The intervention group were divided into 5 groups including 8-12 patients, and according to the HBM, education was performed in four 60-90 minute sessions during one month. One month after the intervention, data were collected again and analyzed using descriptive statistics, linear regression, and Mann–Whitney U test. Results: There was a significant difference in mean score of knowledge, perceived susceptibility, perceived severity, perceived benefits, perceived barriers, perceived efficacy, and cues to action between intervention and control groups after the intervention. Medication adherence was significantly related to the level of education (P=0.006). Among constructs of HBM, perceived self-efficiency was the strongest predicting factor (P=0.03). After the intervention, the mean scores of perceived sensitivity (P<0.001), perceived severity (P<0.001), perceived benefits (P<0.001), perceived barriers (P<0.001), perceived self-efficiency (P<0.0001), cue to action (P<0.0001), and medication adherence (P<0.0001) increased significantly. Conclusion: Education based on the HBM was effective in increasing adherence to medical instructions in patients with type 2 diabetes

Breast Self – examination Predictors based on Precede Model: a study on female active health volunteers in Zarand City

Background & Objectives: Breast cancer is still the most common malignancy leading to women mortality worldwide and late diagnosis of breast cancer is still one of the main causes of death in affected women. One of the ways of early detection of breast cancer is breast self – examination. The aim of this study was to determine predicting factors of breast self - examination in female active health volunteers of Zarand/ Iran based on Precede model. Methods: In this descriptive- analytical study, all participants of active heath volunteer program in health centers of zarand (110 women) were recruited. Data were collected using a researcher – made questionnaire consisted of two sections of demographic information and constructs of Precede model. Data were analyzed through SPSS22 and by using descriptive statistics (distribution and central tendency, frequency and percent) and analytic statistics (logistic regression). Results: Mean age of participants was 37.76 ± 9.75 years and 81.8 % of them were married. Among Precede constructs, predisposing factors (self-efficacy: OR=1.46 and knowledge: OR=1.30) had the highest predicting role. Performing breast self - examination showed significant relationship with level of education (OR=0.01), family history of breast cancer (OR=0.02) and marital status (OR=0.04). Conclusion: Since predisposing factors were the most important predicting factors for breast - self-examination, in planning health education programs, more attention should be paid to improving women's self - efficacy and increasing their awareness about breast self – examination. Key¬words: Breast Self - Examination, Precede Model, Predicting, Health Volunteers Citation: Khaleghi Mahani H, Fadakar MM, Ahmadi Tabatabaei SV, Mirzai M, Poursharifei A. Breast Self – examination Predictors based on Precede Model: a study on female active health volunteers in Zarand City. Journal of Health Based Research 2017; 3(1): 71-85

The Effect of Educational Intervention based on the theory of planned behavior on Nutritional Behavior with Regard to Cardiovascular Diseases among Health Volunteers

Background: We sought to evaluate the effect of educational intervention based on the theory of planned behavior (TPB) on nutritional behaviors in relation to the cardiovascular disease (CVD) among health volunteers. Methods: In this quasi-experimental study, the participants included 128 active health volunteers. To conduct the study, 65 and 63 participants were randomly assigned into the intervention and control groups, respectively. Data were collected before and six weeks after the intervention using a validated researcher-made questionnaire. The questionnaire consisted of demographic variables, knowledge questions, and TPB constructs. Data were analyzed by Chi-square, t-test, Mann-Whitney U, and Wilcoxon test. Results: No significant difference was observed between the intervention and control groups with regard to the demographic characteristics, knowledge mean scores, and TPB constructs at the beginning of the study. However, the mean scores of knowledge, attitude, subjective norms, perceived behavioral control (PBC), and nutritional behavior increased significantly (P &lt; 0.001, P &lt; 0.001, P = 0.018, P = 0.007, and P &lt; 0.001, respectively) in the intervention group six weeks after the beginning of study. Significant differences were observed in nutritional performance of the intervention group, in other words the nutritional behavior of the intervention group members changed during the intervention. Conclusion: The PBC was the strongest construct in attitude. To optimize nutritional interventions in preventing the CVD, TPB should be implemented in educational interventions.</jats:p

Association of Urban Liveability with Cancer Incidence in Iran: A Nationwide Ecological Study

Background: Urban liveability is a multidimensional concept associated with many domains of human health. Objectives: This study aimed at investigating the association between urban liveability and cancer incidence in Iran. Methods: The data of provincial-level urban liveability were obtained from reliable sources. The data of cancer incidence were inquired from the population-based cancer registry of the Iranian Ministry of Health and Medical Education in 2016. Urban liveability scores were determined in all provinces of Iran by utilizing the global liveable city index (GLCI) method. Negative binomial Poisson regression was used to examine the relationship between urban liveability and cancer incidence. Results: Provinces with a higher urban liveability had a higher likelihood of cancer incidence. Higher economic score was significantly associated with higher incidence in colorectal (IRR = 1.49, P = 0.005), liver (IRR = 1.48, P = 0.002), leukemia (IRR = 1.39, P = 0.005), lung (IRR = 1.39, P = 0.039), breast (IRR = 1.38, P = 0.011), and prostate cancers (IRR = 2.11, P &lt; 0.001). Also, provinces with higher environmental friendliness and sustainability had significantly more stomach (IRR = 1.53, P = 0.004), colorectal (1.79, P &lt; 0.001), lung (IRR = 1.43, P = 0.014), and prostate (IRR = 1.50, P = 0.032) cancer incidence. Provinces with higher political governance had significantly more breast cancer (IRR = 1.34, P = 0.002) and leukemia (IRR = 1.30, P = 0.016) incidence rates. Conclusions: Along with the development of urban liveability, the incidence of cancers is increasing in Iran. Cancer control strategies should be implemented especially in settings with higher urbanization.</jats:p

Investigating the relationship between high-risk behaviors and mental health in adolescents in Rabor city, Iran.

Abstract Introduction: The present study was conducted to investigate the relationship between high-risk behaviors (HRB) and mental health in adolescents in Rabor.Methods: The present study was a cross-sectional analytical study that was performed on 334 girle and boy students aged 12-18 years in Rabor city in 2021. In this study, adolescents answered high risk behaviors and mental health questionnaire. Data were analyzed using SPSS software version 26. Results: In this study, the mean age was 15/25 ± 1/78. The findings indicate that smoking and hookah use were higher in boys than girls. Among the demographic variables, age and level of education had a positive and significant relationship with HRB and mental health (p&lt;0/05), The mean score of total mental health for all subjects was 12/83±10/82. The variables of age, sex, marital status of parents, number of children in the family, educational level, smoking, hookah and alcohol have been determined as influential and facilitating factors in HBR of adolescents. Fathers literacy was considered as a facilitator and age variables, alcohol consumption and parents' marital status were considered as deterrents to mental health. Conclusion: The present study showed that male gender is one of the risk factors for alcohol, smoking and other substances, tendency to high-risk sexual behaviors, depression and suicide in adolescents. Among the determinants of tendency to HRB in adolescents, psychological variables are of particular importance at the individual, social and family levels. Good mental health can improve quality of life, while poor mental health can make it worse.</jats:p

Breast Self – examination Predictors based on Precede Model: a study on female active health volunteers in Zarand City

Background & Objectives: Breast cancer is still the most common malignancy leading to women mortality worldwide and late diagnosis of breast cancer is still one of the main causes of death in affected women. One of the ways of early detection of breast cancer is breast self – examination. The aim of this study was to determine predicting factors of breast self - examination in female active health volunteers of Zarand/ Iran based on Precede model. Methods: In this descriptive- analytical study, all participants of active heath volunteer program in health centers of zarand (110 women) were recruited. Data were collected using a researcher – made questionnaire consisted of two sections of demographic information and constructs of Precede model. Data were analyzed through SPSS22 and by using descriptive statistics (distribution and central tendency, frequency and percent) and analytic statistics (logistic regression). Results: Mean age of participants was 37.76 ± 9.75 years and 81.8 % of them were married. Among Precede constructs, predisposing factors (self-efficacy: OR=1.46 and knowledge: OR=1.30) had the highest predicting role. Performing breast self - examination showed significant relationship with level of education (OR=0.01), family history of breast cancer (OR=0.02) and marital status (OR=0.04). Conclusion: Since predisposing factors were the most important predicting factors for breast - self-examination, in planning health education programs, more attention should be paid to improving women's self - efficacy and increasing their awareness about breast self – examination. Keywords: Breast Self - Examination, Precede Model, Predicting, Health Volunteers Citation: Khaleghi Mahani H, Fadakar MM, Ahmadi Tabatabaei SV, Mirzai M, Poursharifei A. Breast Self – examination Predictors based on Precede Model: a study on female active health volunteers in Zarand City. Journal of Health Based Research 2017; 3(1): 71-85

The Indicators and Methods used for Measuring Urban Liveability: A Scoping Review

Abstract Purpose Livability is a multi-dimensional and hierarchical concept which consists of various criteria and sub-criteria and may be evaluated in different ways. The aim of this study was to systematically review indicators and methods used for the evaluation of urban liveability in literature. Methods The five-stage methodological framework of Arksey and O'Malley was used to conduct this scoping review. A systematic search of electronic databases, including Scopus, Medline (via PubMed), EMBASE, Web of Science and Ebsco was done until May 29, 2019. Web searching, searching reference lists and hand searching was also conducted to retrieve more relevant articles. Two reviewers screened the papers for eligibility based on the inclusion criteria and extracted their key data and reported them descriptively. Results Sixty seven (67) out of 3599 papers met the selection criteria. This review showed 5 distinct domains considered to be important components of liveability. The domains were Economical, Environmental, Institutional, Social, and Governance (Political). The most important indices which were frequently applied in various studies were Environmental friendliness and Sustainability, Socio-Cultural Conditions and Economic Vibrancy and Competitiveness. We also identified 10 different methodologies used for assessing urban liveability. Conclusion This paper discusses and summarizes the latest indicators and methods used for determining urban liveability. The information offered in the review can help future investigators measure urban liveabilty more systematically than before.</jats:p