Measuring Subjective Happiness by Newly Developed Scale in Tehran, Iran

Background: Happiness as one of the main positive health indicators has drawn more attention in recent years among policy makers and health system managers. There are few studies performed to measure happiness in population-based settings in Iran. In response to this need, our study tends to assess Iranians subjective happiness in Tehran, Capital city of Iran.Materials and Methods: Present study was conducted in Tehran, Capital of Iran, with more than 7 Million populations in January 2013, using a two-step approach. In first step c conceptual framework of Iranians’ happiness was developed. In the second phase of study, a survey recruiting 700 participants was conducted. Stratified cluster sampling method was employed. Participants were recruited from all the 22 municipal divisions of Tehran as strata, proportional to the population size and its gender and age distribution. Happiness was measure by a 40-item questionnaire with scores ranged among 40 to 200.Results: Conceptual framework of Iranians’ happiness based on reviewed documents and consensus building process was the product of first step. At second step, from a pool of 700 persons, 696 (97%) agreed to participate and filled out the questionnaire completely.  The mean of happiness score was 143.9 (95% confidence interval, 142.5 to 145.4). The results show that the happiness score of jobless people (135.1, 95%CI: 128.1-142.0) and widowed singles (126.6, 95%CI: 113.0-140.2) were significantly lower than other corresponding groups. There was no significant association between gender, age group, educational level as determinants and happiness.Conclusion: Happiness level of Tehranians is somewhat higher than the moderate level. This finding is consistent with findings of other conducted studies in country. However, it is not consistent with some of international reports of happiness, For instance, Happy Planet Index. Due to inadequate information, it is necessary to conduct more research to measure subjective happiness and its determinants, specially, in a nation-wide approach

Does health-related quality of life predict injury event?

Background: Unintentional injury is a leading threat to children's health. Some human ‎factors have been determined as predictor of unintentional injury. Association ‎between Health-Related Quality of Life (HRQOL) as a human factor and unintentional ‎injuries is unclear. The objective of study is to examine the association between ‎HRQOL and unintentional injuries among primary school children. Methods: This study was a cross-sectional conducted in Ahwaz, a city in Iran. ‎Overall, 3375 children aged 6-10 years were randomly selected from primary school. ‎HRQOL was measured by 56 items taken from seven domains of Netherlands ‎Organization for Applied Scientific Research Academic Medical Center (TNO AZL) ‎child quality of life (TACQOL) parent form. Parents were interviewed to collect ‎information about incidence, cause and a brief description of injury within the past 12 ‎months prior to the study.‎ Results: The response rate was 3375 of 3792 (89%). There was a significant trend ‎for increasing occurrence of injury with decreasing of HRQOL score (P= Sig). ‎Adjusted OR for injury was significantly higher in very low (2.38, 95% CI: 1.45-‎‎3.86), low (2.18, 95% CI: 1.34-3.56), and medium (1.73, 95%CI: 1.06-2.83) ‎HRQOL groups compared to reference group (very high HRQOL). The median of total ‎HRQOL (P= Sig) and all its domains (P=0.017) (except autonomous functioning) ‎was lower in injured group compared to uninjured one.‎ Conclusions: This study found an association between HRQOL and unintentional ‎injury among primary school children. This is a preliminary finding and further ‎investigations with a well-defined analytical design are needed.

Indicators of children’s social health: development a conceptual framework to assess equity

Background: Social health is important to be assessed as a dimension of health. In this study we tried to determine areas and sub-areas of children social health indicators.  Methods: In a structured way, we reviewed the main social health databases and documents since 1995, both Iranian and international were reviewed to develop conceptual framework and to extract indicators.  Results: According to reviewed documents, indicators of social health were categorized into four groups. In first category indicators are related to system capacities such as facilities and institutions, financial, and human resources. Social system functions are classified as group two. The main subcategories of social health functions are policy development and enforcement, social marketing, community organizing, coalition building and collaboration, education, case management, screening, surveillance, and investigation. In group three, named as social factors, the main determined areas are life skills, early child development, family functioning, and social networks. Indicators related to social outcomes are categorized as group four. The main related positive social outcomes are social wellbeing and happiness and the main negative outcomes are physical health outcome (injuries, infectious diseases, etc.), mental health outcomes, development and learning outcomes, risky behaviors, academic outcomes, and legal outcomes.  Conclusion: Our recommended model develops a conceptual framework for child social health indicators. This framework and extracted indicators can be used to compare different populations to assess inequity for evidence based policy making and to implement proper interventions

Developing national framework of monitoring and evaluation of non-communicable diseases control and prevention: an experience from Iran

Background: Islamic Republic of Iran, as a country has undergone dramatic and rapid demographical and economic transition leading to increase mortality and morbidity of Non-Communicable Diseases (NCDs). Furthermore, the prevalence of risk factors of NCDs is at alarming range for the population. In response to this challenge, a number of different high level policies have been developed dealing with NCDs, directly or indirectly. However, the fragmentation of policies makes monitoring of NCDs control difficult. Therefore, the aim of the present study was to develop a comprehensive framework for monitoring and evaluating of NCDs control and prevention.  Methods: A qualitative approach with content analysis method was conducted. Components of NCDs monitoring and evaluation framework were extracted and adaptation of components based on requirements of Iran’s health system was made.    Results: Based on the proposed framework, the three main components of NCDs surveillance are as follows; 1) monitoring outcomes (morbidity and mortality); 2) monitoring risk factors; and 3) assessing health care system response, which includes national capacity to prevent NCDs.  Conclusion: The developed framework is a political tool to strengthen activities to control and prevention of NCD and making more effective inter-sectorial collaboration

Institutional health promotion standards in school of medicine at Shahid Beheshti University of Medical Sciences according to medical students' opinions in 2020

Background: Health promotion in occupational and educational environments contributes to the improvement and higher efficiency of the people affected by them. The health status of medical students as future providers of health services has great importance. This study aimed to evaluate health promotion standards in the school of medicine at Shahid Beheshti University of Medical Sciences. Methods: This cross-sectional study evaluated health promotion standards of school of medicine using a questionnaire filled out by medical students in 2020. The validity and reliability of the questionnaire were confirmed. The questionnaire measured health promotion standards in the fields of healthy nutrition, facilities for proper physical activity, providing a healthy environment for students, adequate education for health promotion and disease prevention. Analytical and statistical tests were performed using IBM SPSS 23 software. Results: Among 340 medical students participated in the study 31.8 percent were in the basic sciences grade, 26.5 percent were stagers, and 41.8 percent were interns. The mean score of all questions among different grades was 1.11 (SD=0.33), 0.97 (SD=0.43), and 0.93 (SD=0.34), respectively (on a scale of 0-3). A significant difference was reported in the comparison of "basic sciences versus stagers (PV=0.011)" and "basic sciences versus interns (PV<0.01) ". the mean score of questions overall was 1.00 (SD=0.37). Conclusion: Based on findings, health promotion in the school of medicine at Shahid Beheshti University of Medical Sciences was in the medium range, which demonstrates the need for future policies that lead to a more efficient health-promoting environment

Measuring self-rated social health of Iranians: a population based survey in three cities

Abstract:Background and objectives: Social health as third dimension of health, along with physical and mental health, has drawn more attention in recent years among policy makers and health system managers. No other study, to our knowledge, has documented measuring individual-level social health in Iran. In response to this need, our study tends to assess Iranians self-rated social health through conducting a survey in 3 cities of Iran. Methods: We conducted a survey using cross sectional method in three cities of Iran included people more than 18 years old. We use a random sample size of 800 people. The scale provides a total score of social health and three sub-scores. Total score was calculated by summing all 33 items, so the range was between 33 to 165, considering that higher score indicating better social health. Psychometric parameters of scale were acceptable. To interpret scores, respondents were categorized into five ordered groups as quintiles for amount of social health. To compare social health scores in different demographic groups multiple linear regression was employed to interpret association between demographic variables and social health score. Results: From a pool of 800 persons, 794 (99%) agreed to participate and filled out the questionnaire completely.  The mean of self-rated social health score was 105.0 (95% confidence interval, 103.8 to 106.2). 50% of participants had medium level of social health. social health score was higher for those who live in Urmia as a small city in comparison with big cities- Tehran and Isfahan (P V< 0.001) and was lower for unemployed people (PV= 0.029). There was no association between social health score and other factors such as sex, age and educational level (PV>0.05) Conclusion:This study may be considered as the first step in evidence-based policy-making in the field of social health in Iran. Certainly, it is necessary to conduct more studies to measure social health and its determinants in a nation-wide approach

Measuring Self-perceived Social Health of Iranians; Finding from Iran Social Health Survey

Background: The novelty of the study is to measure self-perceived social health of Iranians as one of the main dimensions of health.Materials and Methods: This cross-sectional study was conducted in all provinces of Iran in September 2014 with 10500 participants to measure self-perceived social health on a scale from 33 to 165 arranged in three areas; family, friends and relatives, and community. Area of "family" was measure in a range from 6 to 30; area of "friends and relatives" was from 9 to 45; and area of "community" was from 19 to 95. The psychometrics of scale was examined in separate previous study.Results: From a total of 10500 participants, 10244 fulfilled questionnaire (Response rate= 97.6%). 49.2% of participants were male. Mean of the total social health score was 99.91; area of "family" was 22; area of "friends and relatives" was 27.6; and area of "community" was 51.2. The main factors negatively influences on social health were low house size, unemployment, being divorced or widow and being at the age of 18-30. There was no significant relationship between social health score and educational level.Conclusion: It is magnificently attained that standardized social health rate in the present study was 3.9% lower than the rate has been estimated in comparison to similar previously conducted study in three big cities of Iran, two years earlier. Area of "community" is also the main accountant for this drop. To continue monitoring the social health of Iranians, we recommend conducting the next rounds every 3-5 years

Self-assessment of clinical competence on sexual health by Iranian medical interns: a framework for curriculum revision

Background: The sexual medicine education in medical faculties has been a challenging issue worldwide in recent decades. Most of medical students are dissatisfied for their sexual health education which indicates an emergent need for curriculum revision. The nobility of the study was to reveal medical students' competency gaps on sexual medicine.Methods: This cross-sectional study was conducted at a large, public medical school, topped the national ranking for its excellence in education. The target population was medical interns in their 6th and 7th year of their course. With a census sampling approach, all eligible students were included. To develop the questionnaire, the framework of ESSM (European Society for Sexual Medicine) syllabus of sexual medicine 2012 was employed after being examined by an expert panel to meet the criteria of content coverage. Recruiting 10 participants, a pilot was conducted to assess the criterions of validity and reliability. Finally a 35 item questionnaire was developed including three domains; "male sexual problems", "female sexual problems" and "common to both sexes sexual problems” with 17, 9, and 9 items, respectively. Students were asked to answer each item in a five-level Likert scale. The total score was standardized to convert scores to a range of 0-100 making it easy to interpret. In addition, a single question on the general competency was asked. Analytical statistics were used appropriate to data type and distribution (t test, one-way ANOVA). Study protocol was approved by research executive and ethics board of the institution.Results: 152 of 260 eligible students participated, with mean age of 25.0 (SD=2.3), of whom 54% were females. The standardized total competency score was 22.3 (95% CI: 20.4-24.2). Regarding to not only total but also different domains scores, there was no significant difference in different grades (PV>0.05). The female students' competency was significantly higher in the domain of "female sexual problems" and "common sexual problems, but not in the domain of "male sexual problems". None of the interns believed that they are competent enough to manage patients with sexual problems by themselves.Conclusions: We magnificently attained that medical students' clinical competency on sexual medicine is poor. Medical education system of Iran would not be able to deal with this challenge unless it provides with a comprehensive curriculum revision

Protocol Design for Large–Scale Cross–Sectional Studies of Surveillance of Risk Factors of Non–Communicable Diseases in Iran: STEPs 2016

INTRODUCTION: The rise in non-communicable diseases (NCDs) has gained increasing attention. There is a great need for reliable data to address such problems. Here, we describe the development of a comprehensive set of executive and scientific protocols and instructions of STEPs 2016. METHODS/DESIGN: This is a large-scale cross-sectional study of Surveillance of Risk Factors of NCDs in Iran. Through systematic proportional to size cluster random sampling, 31,050 participants enrolled in three sequential processes, of completing questionnaires; physical measurements, and lab assessment. RESULTS: Out of 429 districts, samples were taken from urban and rural areas of 389 districts. After applying sampling weight to the samples, comparing the distribution of population and samples, compared classification was determined in accordance with the age and sex groups. Out of 31,050 expected participants, 30,541 participant completed questionnaires (52.31% female). For physical measurements and lab assessment, the cases included 30,042 (52.38% female) and 19,778 (54.04% female), respectively. DISCUSSION: There is an urgent need to focus on reviewing trend analyses of NCDs.To the best of our knowledge, the present study is the first comprehensive experience on systematic electronic national survey. The results could be also used for future complementary studies