The Impact of Safe Community Program on safety promotion among motorcyclists in Iran with focus on helmet usage

Background: Injuries to motorcyclists are an important public health problem. Motorcycles' riders and pillions have the highest public health burden in terms of disability adjusted life years (DALY) lost. Many countries are facing the problem of a rapidly growing motorcyclists' death. This is important for us because the motorcycle fleet in Iran is rising quickly. These series of studies conducted to assess and evaluate the impact of safe community program on motorcyclist's safety in Islamic Republic of Iran. Methods: Two cross sectional observations were conducted in 14 cities (5 safe community practicing and 9 safe community non practicing cities) independently on 2005 and 2007. 10% of registered motorcycles were observed and interviewed (n=1114 in each observation). Results: results revealed that 87.9% used motorcycle for the commercial purposes. All motorcyclists were male, mostly aged 18-29 years old. Death rate significantly rose from 122 to 254 per 100000 motorcyclists in Fars province since first observation (p < 0.0001). Helmet usage rate was constant (13%). Recorded crashes increased from 16.4% to 23.1% in safe community setting (p < 0.0001). 11% carried more than one pillion. Heat disturbances, embarrassment, hearing blockage, and neglecting were the most mentioned excuses for not using helmet. Law enforcement, public education, accessible to helmet on discount rate, new legislation and finally access to new designed helmet were the most suggestions made by motorcyclists to promote helmet usage. No significant effect was noticed between two settings. Interventions were not constant in safe community cities. Community involvement into the safe program could ensure sustainability of initiatives. Conclusion: Motorcyclists' death rate is high among the young adult male of 19-39 in both communities in Iran. A positive outcome was detected at the beginning of safe community program on knowledge, attitude and behaviour of motorcyclists' riders and preventive effect on death rate. As the time passes, this effect drops and no significant effect was noticed between the two settings. This suggests that the process of interventions must be constant

Socio-demographic determinants of obesity indexes in Iran:findings from a nationwide STEPS survey

Background: Overweight and obesity are considered as non-communicable diseases (NCDs)risk factors with increasing prevalence worldwide. This nationwide study aimed to determine the socio-demographic determinants of obesity indexes in Iran. Methods: This cross-sectional study was conducted based on data from the sixth round of nationwide Stepwise approach to surveillance (STEPS) survey in the 31 provinces of Iran in 2011. A total of 9878 people aged ≥20 years were selected using a multi-stage cluster sampling method. Data were collected through three steps questionnaire including ecological, physical and biochemical measurements. We assessed body mass index (BMI), waist circumference(WC) and waist-hip ratio (WHR) as the main indicators of obesity. Results: In this study, the weighted prevalence of overweight and obesity were 34.5% (95% CI:33.6, 35.5) and 21.5% (95% CI: 20.7, 22.3), respectively. The mean ± standard deviation (SD)of BMI among men and women were 25.4±4.4 and 26.9±5.2 kg/m2 respectively. Older age,living alone, having lower education level, being housewife or retired were associated with overweight and obesity (P<0.05). Urbanization was positively associated with BMI and WC.Being obese or overweight was associated with having a history of type 2 diabetes mellitus (T2DM), hypertension (HTN) and cardiovascular diseases (CVDs). Conclusion: The prevalence of overweight in this study was less than global rate while it was vice versa for obesity prevalence. Some socio-demographic characteristics were identified as determinants of obesity which should be considered for planning preventive and control action plans

Development and psychometric evaluation of data collection tools for Iranian integrated road traffic injury registry: Registrar-station data collection tool

Background: Comprehensive and accurate data are fundamentally needed for effective management of road traffic injuries (RTIs). Existing sources of RTI reports have a huge underestimation and inaccuracy at some levels. The aim of this study was to develop and validate the registrar-station data collection tool as a part of the Iranian Integrated Road Traffic Injury Registry (IRTIR). Materials and Methods: This study was conducted in Tabriz University of Medical Sciences in 2018. A data collection tool was developed to be used by the registrar for inpatient section of IRTIR by information retrieved from the literature review and road traffic experts' need assessment. The content validity of the preliminary tool was assessed. The feasibility of the tool was tested in two regional referral injury hospitals. Intra- and inter-rater reliability of the tool was evaluated using the individual/absolute intra-class correlation coefficient (ICC) and Kappa. Validity was revisited after 1 year of the pilot study. Results: The registrar-station data collection tool of IRTIR included 53 items, in five categories. Content validity was approved (modified content validity index was 0.8-1 and content validity ratio was one for all items). ICC was >0.6 for all items, and kappa index ranged between 0.69 and 0.92. The nurse data collection tool of IRTIR was applicable in the pilot phase. Conclusions: The Registrar-Station data collection tool of IRTIR was confirmed as a valid and reliable tool for inpatient traffic injuries as a part of the Iranian IRTIR

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

The Iranian blood pressure measurement campaign, 2019: study protocol and preliminary results

Purpose Hypertension is one of the most important risk factors for premature mortality and morbidity in Iran. The objective of the Iranian blood pressure (BP) measurement campaign was to identify individuals with raised blood pressure and providing appropriate care and increase the awareness among the public and policymakers of the importance of tackling hypertension. Methods The campaign was conducted in two phases. The first (communication) phase started on May 17th (International Hypertension Day). The second phase started on June 8th, 2019, and lasted up to July 7th during which, blood pressures were measured. The target population was Iranians aged >= 30 years. Participants voluntarily referred to health houses in rural and health posts and comprehensive health centers in urban areas in the setting of the Primary Health Care network. Additionally, over 13,700 temporary stations were set up in highly visited places in urban areas. Volunteer healthcare staff interviewed the participants, measured their BP, and provided them with lifestyle advice and knowledge of the risks and consequences of high blood pressure. They referred participants to physicians in case their BP was high. Participants immediately received a text message containing the relevant advice based on their measured BP and their past history. Results Blood pressure was measured for a total of 26,678,394 participants in the campaign. A total of 13,722,148 participants (51.4%) were female. The mean age was 46 +/- 14.1 years. Among total participants, 15,012,693 adults (56.3%) with no past history of hypertension had normal BP, 7,959,288 participants had BP in the prehypertension range (29.8%), and finally, 3,706,413 participants (13.9%) had either past medical history of hypertension, used medications, or had high BP measured in the campaign. Conclusion The campaign was feasible with the objective to increase the awareness among the public and policymakers of the importance of tackling hypertension in Iran