Validity and reliability of the Evidence Utilisation in Policymaking Measurement Tool (EUPMT).

BACKGROUND: As a well-known theory in studying the effective factors on behaviour, the theory of planned behaviour (TPB) is frequently used in evaluating the health behaviour of people and healthcare providers, but rarely applied in studying the behaviour of health policymakers. The aim of the present study is to design and validate a TPB-based measurement tool for evidence utilisation in health policymaking (the EUPMT) through a mixed approach using confirmatory factor analysis. METHODS: The study population consisted of all the specialised units and their employees in the five deputies of Iran's Ministry of Health and Medical Education in 2013. All those eligible were invited to participate in the study, which comprised 373 persons. The reliability of the EUPMT was determined through test-retest and internal consistency. Additionally, its validity was determined by face, content, convergent, discriminant and construct validities. SPSS-20 and LISREL-8.8 were employed to analyse the data. To assess the fitness of the measurement models, three groups of indices were used, i.e. absolute, relative and parsimonious. RESULTS: The content and face validities of the tool were 83% and 67%, respectively. Cronbach's alpha of different constructs ranged from 0.7 to 0.9. In the test-retest method, the intra-class correlations were between 0.75 and 0.87. Confirmatory factor analysis showed that the penta-factorial structure of the experimental data had acceptable fitness with the TPB (GFI = 0.86, NFI = 0.94, RSMEA = 0.075). CONCLUSION: TPB is able to explain the behaviour of evidence utilisation in health policymaking. The finalised TPB-based tool has relatively good reliability and validity to assess evidence utilisation in health policymaking. The EUPMT can be applied to determine the status quo of evidence utilisation in health policymaking, whilst designing interventions for its improvement and assessing their outcomes.

'Linking research to action' in Iran: two decades after integration of the Health Ministry and the medical universities.

OBJECTIVE: To examine the impact of integration of the Iranian Health Ministry and medical universities, which took place in 1985, on 'linking research to action'. STUDY DESIGN: A qualitative study including 18 in-depth interviews and 10 focus group discussions with different stakeholders ranging from researchers, policy makers and service providers in medical and non-medical groups. METHODS: A thematic framework was used to identify various positive and negative aspects of the integration on 'linking research to action' to date. RESULTS: The positive influences on universities that have been established since integration and/or in the peripheral provinces are more prominent. Distribution of health manpower in various parts of the country has almost unanimously been stated as a positive aftermath. On the other hand, the negative influence most agreed upon was the deviation of larger universities from their main commitment of knowledge production, due to overindulgence in service delivery. CONCLUSIONS: Before making any decisions about changing the current structure of the health-research system, the country's national innovation system should be defined. This is because national research problems are not confined to integration and health research, and cover more general aspects. Therefore, any change in integration and health research should be considered secondary to the latter.

Analysis of smoking behaviour among Iranian population: a cohort and period analysis.

BACKGROUND: The patterns of smoking in ageing cohorts are important to public health authorities. The aim of this study is to describe the patterns of smoking among Iranian population. METHODS: Data from cross-sectional surveys of Health and Disease Survey (HDS) in Iran were utilized. Smoking was categorized as no smoker, light smoker (less than 10 cigarettes a day), moderate smokers (10 to 20 cigarettes a day), and heavy smoker (more than 20 cigarettes a day). Age group cohorts were constructed by following each age group to the next age group in two consecutive surveys. The change in smoking behavior was express as the difference of smoking prevalence and 95% confidence interval around the difference were constructed. Three birth cohorts of 1930, 1960, and 1975 were constructed among smoker and their age at initiation of smoking were assessed for the three cohorts. RESULTS: Smoking was more prevalent among age group 25-39 in males and age group 40-60 in females. Smoking prevalence increased in all categories of smoking behavior among male cohort of 15-25 year age-group and stayed stable afterward up to their 40's. After age 40, the prevalence of smoking decreased in heavy smokers and stayed stable in light and moderate smokers. A different pattern was seen among female smokers. Age at initiation of smoking decreased in the last decades. Among the male birth cohort of 1930, just 32.6% of smokers started smoking before age 20 compared with 48.7% in birth cohort of 1975, P value < 0.0001. Similar pattern was seen among the female smokers. CONCLUSIONS: The pattern of smoking in Iranian population high lights the fact that smoking behavior is highly age dependent.