How did we protect children against COVID-19 in Iran? Prevalence of COVID-19 and vaccination in the socio-economic context of COVID-19 epidemic.

INTRODUCTION: The COVID-19 pandemic posed significant risks to children worldwide. This study aimed to assess the COVID-19 protection status of children and explored the relationship between household socio-economic status and COVID-19 morbidity and preventive measures, including vaccination and mask-wearing, in two cities in Iran. METHOD: A population-based cross-sectional study was conducted from July to October 2022 among 7 to 18-year-old children and their families in Tehran and Karaj. A total of 3,022 samples were selected using stratified multistage cluster sampling. Data were collected through interviews with children and adults, using questionnaires and was analyzed with Stata software version 14. RESULTS: The analysis focused on 2,878 children with a median age of 12. Over half (54%) reported that the pandemic negatively affected their family's financial status, with 45% describing its impact on children's needs as negative or very negative. Just under 50% of respondents consistently wore masks during the study period, and around 54% had received at least one dose of the COVID-19 vaccine. Reasons for not getting vaccinated included concerns about side effects, ineligibility for the target age group, and overcrowding at vaccination sites. The odds of not getting vaccinated were significantly lower for children aged 15-18, with boys more likely to refuse vaccination than girls. CONCLUSION: The financial impact of the pandemic in Iran affected families' ability to meet their children's needs. Moreover, low vaccination acceptance rates increased children's vulnerability to health problems and contributed to COVID-19 infections. Efforts should be made to increase vaccination acceptance, particularly among immigrant populations.

Life-time HIV testing among people who inject drugs in Iran: results from the National Rapid Assessment and Response survey.

Background: HIV testing is recommended for people who inject drugs (PWID). The aim of this study was to determine the prevalence of lifetime HIV testing among PWID and to better understand the predictors for HIV testing in a convenience sample across Iran. Materials and methods: This study is a secondary analysis of Iran's National Rapid Assessment and Response survey conducted between October 2016 and March 2017. Analysis includes the 999 people who reported injecting drugs across the capital cities of 21 provinces. Data were collected by using the venue-based application of the Time Location Sampling (TLS) frame. Chi-square tests were used to examine the difference between HIV testing across different quantitative variables. Logistic regression was used to determine the predictors of life-time HIV testing. Analysis was performed using STATA V.12 software with a significance level of 95%. Results: Most participants were male (n = 902, 93.50%), and over half (n = 555, 59.17%) were older than 35 years old. About one-third, (n = 326, 38%) of people interviewed were single and another one-third (n = 251, 29%) reported being divorced. Over two-thirds of participants (n = 678, 69.78%) in this study reported lifetime HIV testing. The results from a multiple variable logistic regression showed people with a university education were more likely to have been previously tested for HIV than illiterate people (OR = 18.87, 95%CI 2.85-124.6, value of p = 0.002). Those individuals who reported ever receiving methadone treatment were 2.8 times more likely to have been tested for HIV than individuals without methadone treatment experience (OR = 2.89, 95%CI 1.53-5.42, value of p < 0.001). Needle syringe sharing in last month, was negatively associated with life-time HIV testing (OR = 0.29, 95%CI 0.17-0.48, value of p < 0.001). Conclusion: Despite Iran's wide availability and access to counseling services for HIV testing in key populations, the proportion of PWID being tested for HIV could be improved. Developing effective strategies to increase people's understanding and awareness of the importance of and need for HIV prevention and familiarity with HIV testing sites is an essential step in increasing HIV testing for this population. Studies on more recent HIV testing are required to better assess and understand the frequency of HIV testing among PWID in Iran.

Main problems experienced by the neighbors of open drug scenes, Tehran, Iran: a mixed-method study.

BACKGROUND: Despite law enforcement and health interventions, open drug scenes have led to problems in many countries. The problems are, however, insufficiently explored. There are different types of drug scenes in Iran. This study aimed to explore the issues related to neighbors of one of the drug scenes in Tehran known as Farahzad. METHODS: Data were generated via semi-structured interviews in the first step of the current mixed-method study (2020-2021). Interviewees were people who use drugs (PWUDs), residents and business owners (N = 25). In the next step, a quantitative observation was conducted for eight days. The results were analyzed using conventional content analysis and descriptive statistics. RESULTS: The perceived problems were ambivalent attitudes about drug scene-related activities, violate of the territory of the self of the effected residents, and everyday concerns. The observation results indicated that men who use drugs are involved in drug scene-related activities more than women are. PWUDs try to hide their activities from the public view. Their efforts were considered "self-regulatory strategies" in the drug scene. CONCLUSIONS: Despite efforts of PWUDs to keep their activities invisible, drug scene-related issues are intolerable for neighbors. Neighbors and PWUDs have ambivalent attitudes. While they are concerned about the human rights of each other, drug scene-related activities have disturbed the neighbor's daily life and economic activities. Although law enforcement and harm reduction interventions reduce some of the problems, one of the approaches should be improving the coexistence between the neighbors and the residents of the drug scene to achieve broader and more sustainable compromises.

Face-to-face and Telespeech Therapy Services for Children during the COVID-19 Pandemic: A Scoping Review.

Objectives: There has been increased interest in using telepractice in clinical services during COVID-19. Using telepractice is little known in speech and language therapy. However, the parents and speech therapists were satisfied with this method. Therefore, this scoping review aims to compare tele speech therapy and face-to-face speech therapy during the COVID-19 pandemic and determine the efficacy of available telepractices in speech therapy. Materials & Methods: This scoping review was according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for scoping reviews (PRISMA-ScR) guideline. The authors systematically searched Web of Science, PubMed, and Scopus databases with specific eligibility criteria. The eligibility criteria were studies published from 1 January 2020 to 10 May 2023 from a peer-reviewed journal and written in English. In addition, the articles were about speech therapy in children during COVID-19. Results: Fifteen articles were included in this scoping review. Results showed that approximately all speech therapists used tele practice during the pandemic. Parents and students are satisfied with this method but have problems with it. On the other hand, some parents and SLPs preferred tele practice accompanied by face-to-face intervention. Furthermore, few studies determined the efficacy of tele practice with clear structural methods in specific populations. Conclusion: Although tele speech therapy is acceptable for providing speech and language therapy services to children with swallowing and communication disorder, speech-language therapists should increase their information and technology to achieve successful results. Moreover, parents must play an essential role in telepractice services to facilitate effective communication between clinicians and families.

Street Children in Iran: What Are Their Living and Working Conditions? Findings from a Survey in Six Major Cities.

Street children are among the most marginalized children, globally, who experience severe violations of their rights and face multiple deprivations. This study aimed to describe street children's characteristics and working conditions in Iran. METHOD: This cross-sectional rapid survey was conducted from March to May 2017 in six major cities in Iran. The sample group consisted of Iranian and non-Iranian girls and boys, aged 10 to 18, who worked on the streets for at least one month prior to the survey. Time-location based sampling was used. A total of 856 Children were randomly selected from 464 venues, including corners of streets, parks, metro gates, bus stations, shopping malls, and shopping centers frequented by street children. RESULTS: Findings showed that 90% of participants were boys, 60% were between 10 and 14 years old, almost 50% attended school, 12% were illiterate, and 32% had quit school. Children of Afghan nationality comprised 54% of the study participants, and the rest were Iranian. Of all participants, 85% resided with family or relatives. Most children (75.5%) worked more than 5 h daily, and vending (71.2%) and waste picking (16.1%) were common activities. Street children suffered, mainly, from harsh weather (22.7%), insults and beatings of everyday people (21%), starvation (20.7%), and police repression (15.4%). More than half of the study participants were not involved in intervention programs, and just 7% of them had attended any health education programs. CONCLUSION: Street children reported little to no service use, which may contribute to poor health. Street children require immediate attention to improve their wellbeing. Decision-makers and academicians should collaborate on intervention development research to design appropriate health and social interventions targeted at street children.

Prevalence and predictor factor of lifetime abortion in female sex workers in Iran: results of the national rapid assessment and response in 2017.

Female sex workers are at a high risk of abortion. This cross-sectional study included 855 female sex workers to determine the prevalence of lifetime abortion and its related factors. Logistic regression models were used to identify the factors related to lifetime abortion. The prevalence of lifetime abortion was reported at 40.8%. The chance of having a lifetime abortion was 7.8times higher in women aged >35years and 2.4times higher in financially dependent women. The high prevalence of lifetime abortion indicates that these women's health and fertility needs are not met.

Lifetime alcohol-use prevalence and correlated factors among street children in Iran.

BACKGROUND: Several studies on street children in Iran reported a high prevalence of alcohol consumption among this group. This study assessed the prevalence of lifetime alcohol use and correlated factors among street children in Iran. METHODS: We conducted a cross-sectional survey among 856 street children from six provinces of Iran. Behavioral data were collected by trained interviewers using a structured questionnaire. Our target outcome was lifetime alcohol use. We examined associations between individual variables and lifetime alcohol use using the chi-square. A multiple logistic regression model included variables with a p-value < .2. Lastly, we reported the adjusted odds ratio (an OR) point estimate and 95% confidence interval (95% CI) as the effect measure. RESULTS: Mean age and standard deviation (SD) of alcohol drinkers were 14.94 ± 2.16. Overall, 16.6% (CI95%: 14.38%, 19.55%) of participants reported lifetime alcohol use, and almost 60% of children reported alcohol use over three past months. In the final model, factors that were independently associated with alcohol use included the 15-18 age range (AOR 2.35, 95% CI 1.48-3.73), Iranian nationality (AOR 3.36, 95% CI 2.07-5.45), working longer than 5 years in the streets (AOR 2.90, 95% CI 1.72-4.88), father's drug use (AOR 1.93, 95% CI 1.22-3.01), and illiteracy (AOR 1.65, 95% CI 1.03-2.66). CONCLUSIONS: The results of the present study demonstrated that preventive plans for alcohol use among street children must be addressed using the services provided by governmental and nongovernmental organizations.

Iranian nongovernmental organizations' initiatives in COVID-19 pandemic.

BACKGROUND: With the outbreak of the COVID-19 virus crisis worldwide, including Iran, the need for corona prevention and treatment has become a national priority. With many businesses closed in the wake of COVID-19 and job losses and declining incomes, vulnerable individuals' and families' access to the minimum wage and healthcare facilities is falling, and their health is exposed to a great risk. In Iran, a significant number of vulnerable groups are supported by nongovernmental organizations (NGOs). This study is designed to understand the performance of NGOs after the onset of the COVID-19 crisis. MATERIALS AND METHODS: This study was carried out based on qualitative research between June and September 2020 in Tehran. This study was conducted using individual interviews with 33 managers and experts of 24 active NGOs providing services to vulnerable groups and a member of an NGO network. Data were analyzed using content analysis. RESULTS: Two main themes of service initiatives were extracted: (a) service initiatives to protect the target population against COVID-19 infection and its aftermath and (b) management initiatives to retain staff, finance, and adapt the organization to crisis situations. Service initiatives included five categories of health service initiatives, livelihood, employment, education, and leisure initiatives, while organizational management initiatives include human resource management, financial management, and communication with organizations. CONCLUSION: The COVID-19 breadth and its special features have set it apart from other crises and have led NGOs to work hard on several fronts to care for the most vulnerable people against the epidemic and its consequences and maintain the performance of their organizations. The unique role of cyberspace has made it one of the definitive pillars of the activities of NGOs, not only during the epidemic but also after its end.

Disaster Risk Reduction in Iranian Primary and Secondary School Textbooks: A Content Analysis.

OBJECTIVE: School textbooks have a significant role in transferring knowledge to the students and changing their behavior. This work aims to analyze school textbooks to find the representation of natural hazards in Iran, which is vital for supporting children in disaster situations. METHODS: In this study, a qualitative content analysis was used. Data were analyzed qualitatively by using MAXQDA 2018 software. For the 2019-2020 school year, 300 Iranian school textbooks in Persian language were collected. RESULTS: Findings of this work show that students receive information about disaster risk reduction (DRR) education through the primary and secondary grade levels in all 12 grades. The educational content covers various types of natural hazards, including geophysical, hydrological, climatological, meteorological, and biological disasters. In addition, the textbooks contain discussions about local hazards, causes and effects of disasters, and the disaster management cycle. CONCLUSIONS: The coverage of DRR and the relevant contents in school textbooks reveals that the discourse of natural hazards is important for Iranian authorities, especially in the education system. This study helps decision-makers and practitioners design more effective interventions to prepare children for disasters.

School-Based Education Programs for Preparing Children for Natural Hazards: A Systematic Review.

Schools have a significant role in disaster education to children. This study investigates the research works about school-based education programs in order to discover challenges and best practices. We conducted a systematic review of English language papers published in peer-review journals.The search identified 2577 publications and 61 articles meeting selection criteria and included in the review. Reviewed studies indicated that disaster education in schools is effective but yet insufficient in many countries. Lack of equipment, financial resources, policy gaps, and teachers' knowledge are common problems in programs. Main outcomes of this systematic review are showing methods used for health emergency preparedness of children of different ages and gender differences in school-based disaster preparedness, as well as the difference in their lifesaving skills in disasters.This study shows that some disaster education programs reported in the papers reviewed were not high-quality enough, which may lead to insufficient preparedness of children in disasters and consequently may put their health at risk, considering the increasing number of natural hazards.

Validation of the Persian version of the mental health literacy scale in Iran.

The present study was designed to validate an English version of the mental health literacy scale into Persian, in Iran. Statistical population consisted of all residents of 22 municipal districts of Tehran, Iran, in 2018. Multistage sampling methods were used (sample size = 1026). All participants filled the Mental Health Literacy scale; 12-item General Health Questionnaire; Multidimensional Health Locus of Control scale and a demographic checklist. Exploratory and confirmatory factor analysis, the intra-class correlation coefficient was used for analysing data. All analyses were run with SPSS and AMOS Graphics version 18. Exploratory factor analysis revealed five components (24 items) explaining 21.68%, 20.24%, 8.97%, 6.48% and 5.36% of the variance respectively (totally explained variance = 62.74%). Confirmatory factor analysis showed an acceptable goodness-of-fit (CMIN/DF = 3.19, GFI = 0.887, CFI = 0.893, IFI = 0.894, TLI = 0.877, RMSEA = 0.065). The values of Cronbach's alpha showed satisfactory internal consistency. Two clinical correlates of mental health literacy were investigated. The structure of the mental health literacy scale was to some extent different from the one in O'Connor et al. study, but it was consistent with the definition of MHL presented by Jorm et al. This is the first Persian version of the MHL in the general population in Iran and undoubtedly needs to be checked on more studies.

Indicators of Drug-Related Community Impacts of Open Drug Scenes: A Scoping Review.

INTRODUCTION: Places where people deal and/or use drugs publicly are known as open drug scenes (ODSs). Drug-related community impacts (DRCIs) refer to drug-related issues that negatively influence public and individual health, communities, businesses, and recreational and public space enjoyment. There are no well-established criteria for identification of DRCIs. We therefore performed a scoping review of literature to determine DRCIs indicators associated with ODSs. METHODS: The review was performed using the Preferred Reporting Items for Systematic Reviews and Meta-Analysis extension for scoping reviews (PRISMA-ScP). We searched English articles in PubMed, Scopus, Web of Science, and EMBASE databases from 1990 to 2021. The keywords were drug-related crime, drug-related offense, misconduct, social marginalization, homeless drug users, open drug scene, drug-related street disorder, public nuisance, and community impact. RESULTS: Sixty-four studies were identified. Twenty-five studies were included. Two studies (8%) were about drug-related public nuisance, 1 (4%) considered drug-related social problems, 2 (8%) focused on drug-related social disorder, and 18 studies (72%) discussed indicators of community impacts such as crime, drug-related litter, safety, noise, and drug use in public. Two studies (8%) included the frequency of drug use in ODSs. DISCUSSION: DRCI indicators are heterogenic, and various factors affect the indicators. The factors include social mores, political discourse, and historical approaches to dealing with and using drugs. Some societies do not tolerate the existence of ODSs. In contrast, many countries have adopted harm reduction programs to manage DRCIs. Identified DRCI indicators were drug using and dealing in public, drug-related litter, crime, drug-related loitering, street-based income generation activities, noise, and unsafety feelings in inhabitants. To solve the problems associated with DRCIs and to make a major change in ODSs, it is necessary to pay attention to the improvement of the economic conditions (e.g., employment opportunities), amendment (e.g., determine the limits of criminalization in drug use), and adoption of social policies (e.g., providing low-threshold and supportive services for homeless drug users).

HIV testing and its associated factors among street-based female sex workers in Iran: results of a national rapid assessment and response survey.

BACKGROUND: Female sex workers (FSWs) are at a disproportionate risk of sexually transmitted infections and they may face significant barriers to HIV testing. This study aimed to examine HIV testing prevalence and its associated factors among street-based FSWs in Iran. METHOD: A total of 898 FSWs were recruited from 414 venues across 19 major cities in Iran between October 2016 and March 2017. Eligible FSWs were women aged 18 years of age who had at least one commercial sexual intercourse in the previous year. HIV testing was defined as having tested for HIV in the lifetime. Bivariable and multivariable logistic regression were used to examine the correlates of HIV testing. We report adjusted odds ratios (aOR) and their 95% confidence intervals (CI). RESULT: Overall, 57.8% (95%CI: 20.0, 88.0) of participants reported having tested for HIV, and HIV prevalence among FSWs who tested for HIV was 10.3% (95%CI: 7.5, 13.0). The multivariable model showed that unstable housing (aOR: 8.86, 95%CI: 2.68, 29.32) and drug use (aOR: 3.47, 95%CI: 1.33, 9.06) were associated with increased likelihood of HIV testing. However, FSWs with a higher level of income were less likely to be tested for HIV (aOR: 0.09, 95%CI: 0.02, 0.43). CONCLUSION: Almost one in ten street-based FSWs had never tested for HIV. These findings suggest the need for evidence-based strategies such as outreach support and HIV self-testing to improve HIV testing in this marginalized population.

Child labor in Tehran, Iran: Abuses experienced in work environments.

BACKGROUND: Child labor is exploitative and harmful and deprives children of opportunities for a healthy life. Nonetheless, child labor is prevalent worldwide. Abusive working conditions are common, especially in developing countries. OBJECTIVE: This study was designed both to measure the prevalence of abuse in work environments and to identify possible risk and protective factors for such abuse in child laborers in Tehran, Iran. METHOD: The researchers conducted this cross-sectional study from September 2018 to May 2019 in Tehran and recruited 250 children from seven child labor support centers. RESULTS: The results demonstrated a relatively high rate of abuses experienced in work environments among Iranian child laborers: 77.6 % of children experienced at least one type of abuse, with emotional abuse (70.4 %) as the most frequently experienced abuse followed by neglect (52 %), physical abuse (5.8 %), and sexual abuse (3.6 %). Furthermore, living alone or with a single parent (OR = 3.15, CI 95 %: 1.33-7.45) was a risk factor, while working in home jobs (OR = 2.08, CI 95 %: 1.19-3.63), being male (OR = 0.19, CI 95 %: 0.06-0.55), and being older (OR = 0.32, CI 95 %: 0.17-0.60) were the protective factors of abuses experienced at work among child laborers. CONCLUSION: The findings of this study have implications for designing and implementing early interventions to provide less harmful work environments for child laborers. Further, advocacy efforts to prevent and eliminate child labor should be pursued.

Lifetime and past-month substance use and injection among street-based female sex workers in Iran.

BACKGROUND: Street-based female sex workers (FSWs) are highly at risk of HIV and other harms associated with sex work. We assessed the prevalence of non-injection and injection drug use and their associated factors among street-based FSWs in Iran. METHODS: We recruited 898 FSWs from 414 venues across 19 major cities in Iran between October 2016 and March 2017. Correlates of lifetime and past-month non-injection and injection drug use were assessed through multivariable logistic regression models. Adjusted odds ratios (AOR) and 95% confidence intervals (CI) were reported. RESULTS: Lifetime and past-month non-injection drug use were reported by 60.3% (95% CI 51, 84) and 47.2% (95% CI 38, 67) of FSWs, respectively. The prevalence of lifetime and past-month injection drug use were 8.6% (95% CI 6.9, 10.7) and 3.7% (95% CI 2.6, 5.2), respectively. Recent non-injection drug use was associated with divorced marital status (AOR 2.00, 95% CI 1.07, 3.74), temporary marriage (AOR 4.31 [1.79, 10.40]), had > 30 clients per month (AOR 2.76 [1.29, 5.90]), ever alcohol use (AOR 3.03 [1.92, 6.79]), and history of incarceration (AOR 7.65 [3.89, 15.30]). Similarly, lifetime injection drug use was associated with ever alcohol use (AOR 2.74 [1.20-6.20]), ever incarceration (AOR 5.06 [2.48-10.28]), and ever group sex (AOR 2.44 [1.21-4.92]). CONCLUSIONS: Non-injection and injection drug use are prevalent among street-based FSWs in Iran. Further prevention programs are needed to address and reduce harms associated with drug use among this vulnerable population in Iran.

Students' preparedness for disasters in schools: a systematic review protocol.

INTRODUCTION: Children are one of the most vulnerable groups in disasters. Improving students' knowledge and skills to prepare for disasters can play a major role in children's health. School as a place to teach children can make a significant contribution to provide the necessary skills. This study aims to identify the effects, strengths and weaknesses of interventions in schools to prepare children for disasters. METHODS AND ANALYSIS: We use Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines to develop a protocol for this systematic review. The included studies will report on the results of interventions targeting 'schoolchildren' defined as individuals between 4 and under 18 years old studying in schools. Different electronic databases will be used for a comprehensive literature search, including MEDLINE, Web of Science, CINAHL, PsycINFO, Cochrane Register of Controlled Trials and EMBASE to identify the records that match the mentioned inclusion criteria published till December 2020. The main search terms are 'disaster', 'preparedness', 'children' and 'school'. Four types of data will be extracted from the qualified studies including study characteristics (study design, year of publication and geographical region where the study was conducted), participant characteristics (sample size, age and gender), intervention characteristics (aim of intervention, intervention facilitators and barriers) and intervention outcomes. The quality appraisal of the selected papers will be conducted using Cochrane Collaboration's Risk of Bias for quantitative studies and Critical Appraisal Skills Programme checklist for qualitative studies. We use a narrative synthesis for this systematic review. The narrative synthesis refers to an approach to systematic reviews which focuses mostly on applying words and texts to summarise and explain findings. ETHICS AND DISSEMINATION: This paper is a part of a Ph.D. thesis of Hamed Seddighi at University of Social welfare and Rehabilitation Sciences with ethics code IR.USWR.REC.1399.008 approved by the Ethics Committee of the above-mentioned university. PROSPERO REGISTRATION NUMBER: CRD42020146536.

Contextual and Individual Determinants of Mental Health: A Cross-sectional Multilevel Study in Tehran, Iran.

OBJECTIVES: Our aim was to answer the following questions: (1) Can mental health variance be partitioned to individual and higher levels (e.g., neighborhood and district); (2) How much (as a percentage) do individual-level determinants explain the variability of mental health at the individual-level; and (3) How much do determinants at the neighborhood- or district-level explain the variability of mental health at the neighborhood- or district-level? METHODS: We used raw data from the second round of the Urban Health Equity Assessment and Response Tool in Tehran (in 2012-2013, n=34 700 samples nested in 368 neighborhoods nested in 22 districts) and the results of the official report of Tehran's Center of Studies and Planning (in 2012-2013, n=22 districts). Multilevel linear regression models were used to answer the study questions. RESULTS: Approximately 40% of Tehran residents provided responses suggestive of having mental health disorders (30-52%). According to estimates of residual variance, 7% of mental health variance was determined to be at the neighborhood-level and 93% at the individual-level. Approximately 21% of mental health variance at the individual-level and 49% of the remaining mental health variance at the neighborhood-level were determined by determinants at the individual-level and neighborhood-level, respectively. CONCLUSIONS: If we want to make the most effective decisions about the determinants of mental health, in addition to considering the therapeutic perspective, we should have a systemic or contextual view of the determinants of mental health.

Drug-related community issues and the required interventions in open drug scenes in Tehran, Iran: a qualitative study protocol.

BACKGROUND AND OBJECTIVES: Many low-income and middle-income countries experience problems with open drug scenes and drug-related community issues (DRCIs). These experiences occur in settings with varying levels of health and law enforcement initiatives, and accordingly a range of approaches are implemented to curb the problem. Most of the published literature stems from Western and high-income societies. With this concern, the present study aims to describe a planned project to explore DRCIs in the open drug scenes of Tehran, including its typology, and predisposing and reinforcing factors. In addition, the study attempts to investigate the perceptions with respect to the required interventions and barriers to their accessibility. METHODS: To this end, the current study focuses on the Farahzad drug scene due to its structure and the difficult access to the scene by harm reduction providers. Data collection techniques encompass field observation, indepth interview and focus group discussion. Further, semistructured interviews are conducted with people who use drugs and other key informants who are engaged at this drug scene, including business, community, voluntary and statutory stakeholders, for an average of 90 min (average of 45 min for each part of the study). Furthermore, as a complementary method, field observation is performed regarding the themes of DRCIs at this scene. Then, focus group discussions are held to further describe the themes of DRCIs as well as to explore the required interventions, for an average of 90 min. Finally, the results are evaluated using qualitative content analysis. ETHICS AND DISSEMINATION: Ethical approval for the study was obtained from the Ethics Committee of Iran University of Medical Sciences, Iran. Additionally, participants are to provide written informed consent. The findings of the study are expected to play a role in promoting the current intervention.

Population Size Estimates of Street Children in Iran: Synthesis of Multiple Methods.

We used four methods (direct count, indirect count, wisdom of the crowd, and unique object multiplier) to map and estimate the population size of street children in six major cities in Iran in 2017. In aggregate for the six cities, the number of street children was estimated at 5296 (interquartile range [IQR] 4122-7071) using the median of the four methods. This corresponds to a rate of 16.3 (IQR 12.5-24.5) per 10,000 children age 5-18 years old, or 3.2 (IQR 2.4-5.3) per 10,000 total population. The total number for street children in the country is estimated at 26,000 (IQR 20,239-34,719) children. Results can help policy-makers advocate for resources, plan programs, and evaluate the reach of programs for street children. The maps created through the course of the population size estimation exercise can also guide outreach efforts to provide street children with health and social welfare services.

Social Determinants of Positive Mental Health in Iranian Society: A Qualitative Approach.

BACKGROUND: Based on the World Health Organization definition, mental health is the absence of mental disorders and presence of positive mental health (PMH). As the social determinants of mental disorders and PMH are not the same in different cultures and in order to promote community mental health, social determinants of PMH should be identified, which is the aim of this study. METHODS: This was a qualitative study conducted in Tehran. Data were collected through eight focus group discussions with the general population aged between 30 and 60 years and ten semi-structured interviews with mental health professionals from Tehran. Data were analyzed through directional content analysis using Dedoose software. RESULTS: Fifty-one lay people and ten mental health professionals participated in this study. The process of content analysis resulted in two main themes: (a) structural determinants of PMH which consist of socioeconomic and political context and socioeconomic position and (b) intermediary determinants of PMH which consist of working condition, living condition, family factors, lifestyle, psychosocial factors, and health system. CONCLUSIONS: Improvement of living conditions, with emphasis on working conditions as one of the intermediary social determinants, will play an important role in promoting PMH.