Academic Impact Evaluation in National Health Research System: Toward Public Health Promotion

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Help Seeking Behaviors During COVID 19 Pandemic in Iran: A Qualitative Study

Background: With rapid outbreak of coronavirus disease 2019 (COVID-19), due to high transmission, long incubation, rapid spread and lack of definitive treatment of disease, extensive efforts were simultaneously made to identify the transmission chain and ways to control the disease.Aim: This study aimed to accurately identify help seeking behaviors during Covid-19 pandemic.Method: This qualitative study was performed based on explanatory model of Kleinman’s theory and through semi-structured interviews with 15 individuals who were confirmed as COVID-19 cases in Tehran. Interviews were conducted by telephone, digitally recorded and transcribed verbatim and analyzed via directional content analysis based on Graneheim and Lundman. Help seeking behaviors in different levels were extracted by purposive sampling approach.Results: Three main categories were extracted including popular, professional and folk sectors in help seeking behaviors. In popular sector, four levels were extracted consisting of individual, familial, social and community. In individual level, phone consultation and self-medication were two main subcategories. In familial level, conflict of expectation and the key role of wife in Covid-19 management were expressed. In social level, three subcategories included donors / charity, media and social media. Community level had one subcategory named ethical commitment. In professional sector, three subcategories were extracted including training, medical insurance and emergency services. In folk sector, the majority of participants believed that Covid-19 is God's punishment for people's sins.Implications for Practice: Exploring help-seeking behaviors at different levels can help the national health system to better control COVID-19 pandemic and provide preventive services

Establishing research impact assessment in Iran: The first report from a non-high-income country

Background This study presents the first report on research impact assessment (RIA) in non-high-income countries, undertaken as a pilot initiative in 2021. Within it, we aimed to explore the feasibility of employing the ‘payback’ model for evaluating the impact of health research and enhancing the accountability of universities. We focussed on three key impact domains: ‘production of decision support documents and knowledge-based products,’ ‘implementation of research results,’ and ‘health and economic impact.’ Methods We adopted a case study approach to assess the impact of 5334 health research projects conducted by researchers from 18 universities from 2018 to 2020. Researchers were required to submit evidence related to at least one of the specified impact domains; six scientific committees verified and scored claimed impacts at the national level. Results Only 25% of the assessed projects achieved impact in at least one domain, with the production of decision support documents and knowledge products being the most reported impact. Notably, economic impact was verified in only three projects, indicating room for improvement in this area. Technology research exhibited the highest acceptance rate of claimed impact, suggesting a positive correlation between technology-focused projects and impactful outcomes. Conclusions This study demonstrates the feasibility of employing a case study approach and the ‘payback’ model to evaluate the impact of health research, even within the constraints of a moderately equipped research infrastructure. These findings underscore the potential of integrating RIA into the governance of health research in Iran and other non-high-income countries, as well as the importance of using RIA to assess the accountability of health research systems, guide the allocation of research funding, and advocate for the advancement of health research. The study sets a precedent for future assessments in similar contexts and contributes to the ongoing global dialogue on the societal impact of health research

Scientific Authority in Iranian Pharmaceutical Sciences Research Centers: The Results of a Decade Research Evaluation: Scientific Authority in Pharmaceutical Research Center

The scientific authority refers to social power of scientific knowledge, in different sciences.  The aim of this study is to present the role of Iranian pharmaceutical research centers in scientific authority based on research evaluation for a decade. Iranian pharmaceutical research centers with more than one year of activity from 2013 to 2022 were assessed based on the intervention model of evaluation system. Three domains including stewardship, knowledge production and research impact with 20 indicators have been used in this process. 36 pharmaceutical sciences research centers (PhRCs) related to 23 universities of Medical Sciences (UMSs) were evaluated for a decade. The mean and standard deviation (SD) of age of the research activities in PhRCs was 12.2 ± 8.60. The ratio of faculty member to research center was 10.5. The total number of published articles was 20166 and 70% of which were indexed in ISI –WOS.34.2% and 21.7% of them were published in the first quantile journals and with international collaboration respectively. Based on research ranking, the first three centers were Tabriz Applied Pharmaceutical Science Research Center, Mashhad Pharmaceutical Sciences Research Center and Tabriz Pharmaceutical Nanotechnology research center. Mission oriented research activities in Iranian pharmaceutical research centers may lead them in achieving scientific authority

Psychometric Study Using Item Response Theory of an Instrument Developed for Assessment of Iranian Mental Health Problems

Background: Currently, in addition to the undeniable impact of cultural factors on mental health problems’ diagnosis and treatment methods, the use of rapid, short, and intervention-based instruments can be effective in the accurate diagnosis of mental health problems, especially in the health system of developing countries. Objectives: This study aimed to validate an instrument developed for screening patients with common mental health problems using item response theory (IRT). Methods: The study was conducted in Semnan province (with Persian ethnicity), Iran, from August 2017 to February 2018. A 101-item tool consisted of district common mental health problems (i.e., depression, anxiety, and obsession), along with a functional checklist. The development of the instrument involved a pilot study and psychometric testing. The IRT-based analysis was used as the item-reduction method to evaluate the shortened tool as an appropriate screening tool. The participants were healthy individuals and patients with depression, anxiety, and obsessive-compulsive disorder (OCD). The data were analyzed using Stata software (version 15.1). Results: The study participants were 160 individuals (58.2% male) with a mean age of 36.3 ± 11.2 years. All item impact factors were within the range of 1.8-5. The mean values of clarity, simplicity, relevance, and scale-level content validity index/averaging calcu-lation method of the instrument were 96.73 ± 0.70, 97.64 ± 0.61, 98.2 ± 1.9, and 97.09 ± 0.63, respectively. Cronbach’s alpha and internal consistency coefficient were 0.88 and 0.7. Moreover, 13, 5, and 12 items were excluded using IRT from depression, anxiety, and OCD dimensions based on the threshold criteria, respectively. Conclusions: Iranian screening tools for mental health problems can provide qualified information with the least error and the most precision in appropriate early diagnosis and decrease the burden of mental health problems in the national healthcare system

Positive Mental Health from the perspective of Iranian society: A qualitative study [version 1; referees: 2 approved]

Background: According to the World Health Organization, mental health relates, not only to the absence of mental disorder, but also to Positive Mental Health. Studies have shown that promoting positive mental health, not only reduces the prevalence and incidence of mental disorders, but also affects the process of treatment and reduces related burden. However, this concept has different interpretations in different cultures, and in many societies, mental health is still considered the absence of mental illness. Thus, the present study was conducted to provide an in-depth understanding of Iranian adults` perspective towards the concept of positive mental health. Materials and Methods: In the present qualitative study, eight focus group discussions (6 to 8 adults in each session) were held consisting of 30 to 60 year-old men and women from Tehran. Data were analyzed in "DeDoose" qualitative software using content analysis. Results: According to the data obtained, participants found no difference between positive mental health and mental health, mostly equating it to the absence of mental disorders and having positive energy, peace in and satisfaction with life. According to the results, positive mental health has four domains of emotional/psychological, spiritual, social, and life skills. Conclusion: Understanding an individual’s positive mental health concepts culturally and providing appropriate community based programs can significantly promote the mental health of the community

Positive Mental Health from the perspective of Iranian society: A qualitative study [version 2; referees: 2 approved]

Background: According to the World Health Organization, mental health relates, not only to the absence of mental disorder, but also to Positive Mental Health. Studies have shown that promoting positive mental health, not only reduces the prevalence and incidence of mental disorders, but also affects the process of treatment and reduces related burden. However, this concept has different interpretations in different cultures, and in many societies, mental health is still considered the absence of mental illness. Thus, the present study was conducted to provide an in-depth understanding of Iranian adults` perspective towards the concept of positive mental health. Materials and Methods: In the present qualitative study, eight focus group discussions (6 to 8 adults in each session) were held consisting of 30 to 60 year-old men and women from Tehran. Data were analyzed in "DeDoose" qualitative software using content analysis. Results: According to the data obtained, participants found no difference between positive mental health and mental health, mostly equating it to the absence of mental disorders and having positive energy, peace in and satisfaction with life. According to the results, positive mental health has four domains of emotional/psychological, spiritual, social, and life skills. Conclusion: Understanding an individual’s positive mental health concepts culturally and providing appropriate community based programs can significantly promote the mental health of the community

Strengths, Weaknesses, and Strategies in Improving the Help-Seeking Behaviors in COVID-19 Pandemic: An Experience from Iran

Background: Currently, coronavirus disease 2019 (COVID-19) pandemic is recognized as a major threat to human public health. Obviously, accurate and in-depth identification of patients’ help-seeking behavior not only explains the process but also is able to identify the related factors, challenges, strengths, and weaknesses, and depicts participants' expectations for optimization and improvement. Methods: This qualitative study was conducted based on content analysis and through individual interviews (in person and by phone) with people with a history of COVID-19 disease until data saturation was reached between June and September 2020 in Tehran, Iran. Findings: In this study, 15 in-depth individual interviews were conducted. Strengths, weaknesses, and strategies to improve the help-seeking behavior were extracted in four levels: individual, family, social, and health system. The most important strengths were self-care (individual level), empathy of family members (family), charitable activities (social), and human resources (health system). The most important weaknesses in these levels included lack of attention to health protocols, lack of requirements for full quarantine, economic problems, and lack of proper monitoring by the health system. Conclusion: The most important and key element to improve the help-seeking behavior is human resources and promoting the individual capabilities in various aspects

Determining the effectiveness of cognitive behavioral therapy interventions based on the transdiagnostic approach in the treatment of common mental health problems : Presenting an experience from the Islamic Republic of Iran

Introduction: There is growing support to develop transdiagnostic approaches that provide new insights into mental health problems and cut across the existing traditional diagnostic boundaries all over the world. The present study was conducted to test the transdiagnostic cognitive behavioral therapy (TCBT) approach in treating patients with common mental health problems and evaluate its effectiveness compared to the current treatment settings of the healthcare system. Methods: A randomized controlled trial was conducted in Semnan Province, north of Iran. The study took pace in urban health centers. A sample of 520 Iranian adults, tested as positive on the Kessler Psychological Distress Scale, were enrolled. Participants who received a score above the cut-off point in any of the three mental health disorders (depression, anxiety, or obsessive compulsive disorder [OCD]) based on the locally validated study instrument were randomly allocated to the study. The intervention group received TCBT during eight sessions provided by trained general health service providers without previous mental health training; the standby control group received Mental Health Services as Usual (MHSU). The post-test interviews were conducted using the study instrument after the completion of both group treatments. Results: A total of 459 individuals (87.8% female) ultimately entered the study. The withdrawal rate was 24% (53 participants in the TCBT and 56 in the MHSU). Reduction in depression, anxiety, and OCD symptoms was significant within each group and when comparing TCBT and MHSU (mean difference). Conclusion: This trial recommends that the transdiagnostic CBT approach can be effective in improving common mental health problems and functions among individuals by trained general healthcare providers in the primary healthcare system. The results can be more useful in decision making when defining the process of providing mental healthcare in the National Primary Healthcare System