Development, Validation, and Cross Cultural Adoption of Persian Version of Behavioral Risk Factor Tool.

Background: One of the most crucial objectives of policymakers is to enhance the population's overall health. Establishing a surveillance system is a way to achieve this goal. The Behavioral Risk Factor Surveillance System (BRFSS) is a national system that collects data on the health-related behaviors of the United States residents using the Behavioral Risk Factor Questionnaire (BRFSSQ). This survey is aimed at reducing risk behaviors and their consequences. Regarding the fact that the cultural environment within each country may affect how behaviors are assessed, this study aimed to develop a Persian version, cross-cultural adaptation, and assess the validity and reliability of the PBRFSSQ. Methods: In this cross-sectional study, 250 individuals were enrolled using the stratified sampling method between August 2022 and April 2023. Six steps of translation and test method proposed by Sousa et al was used. Content and face validity were calculated. Also, the Cronbach's alpha and test-retest were computed. Results: Of all participants, 54.5% were male and aged 30 to 65 years old (69%). The Scale Content Validity Index was equal to 0.95. The Intra class Correlation Coefficient (ICC) was computed as 0.86, 0.88, and 0.87 for the core, optional, and total components, respectively. Furthermore, the Cronbach's alpha coefficient of 0.85 was obtained overall. Conclusion: This tool was highly valid and reliable for assessing risky behaviors among the Iranian general population.

Familial aggregation of traffic risky behaviours among pedestrians: a cross-sectional study in northwestern Iran.

OBJECTIVE: This study aims to assess the familial aggregation of traffic risky behaviours among pedestrians and describe the sociodemographic profile of pedestrians in northwestern Iran. METHODS: A cross-sectional study was conducted among 933 pedestrians in 2023. Participants were selected using stratified random sampling. Traffic risky behaviour was measured using a validated instrument among heads of households and their first relatives. The generalised estimating equations were computed to estimate the adjusted OR and 95% CI for familial aggregation of traffic risky behaviours. RESULTS: Of the total sample, 52.2% and 27.7% of the participants were male and aged 41-50, respectively. The majority of respondents were categorised in middle socioeconomic class (36.9%). The OR for familial aggregation of traffic risky behaviours was 1.42 (95% CI 1.07 to 1.89), indicating that the presence of traffic risky behaviours in at least one family member increased the likelihood of similar behaviour in other members. Fathers showing violation behaviours were associated by 1.98-fold increase in violation behaviours among their offspring. Similarly, the existence of violation behaviour in one sibling increased the odds of violation behaviour among other siblings (OR 1.99, 95% CI 1.18 to 3.73). CONCLUSIONS: This study revealed the familial aggregation of traffic risky behaviours of pedestrians, with father-offspring and sibling aggregations emerging as prominent components of familial aggregation. The findings suggested that family-based prevention programmes may yield greater effectiveness than individual-based approaches. As such, implementing targeted interventions focusing on family might have a substantial impact on reducing pedestrian traffic risky behaviours.

Prevalence of Asthma in East Azerbaijan Adult Population and Its Determinants Factors: A Cross-Sectional Study from the Northwest of Iran.

Background: Asthma is one of the most common chronic respiratory diseases. It is estimated that more than 400 million people will suffer from it by 2025. This study aims to determine the prevalence of asthma in East Azerbaijan and investigate the association between asthma and some environmental and demographic factors. Materials and Methods: This is a cross-sectional study based on a major Lifestyle Promotion Project (LPP) conducted in the districts of East Azerbaijan, including 2641 participants aged 15 to 65 years of the general population selected through probability proportional to size (PPS) multistage stratified cluster sampling. We used the World Health Survey questionnaire about doctor-diagnosed asthma to determine the prevalence of asthma. Age, smoking status, physical activity level, socioeconomic variables such as job and education level, and body mass index (BMI) were used as covariates in regression models. A questionnaire was used to obtain socio-demographic information and smoking status. The short form of the International Physical Activity Questionnaire was used to estimate the level of physical activity (IPAQ). Results: The mean age of participants was 40.9 ± 12.05 years including 1242 (47 %) males and 1399 (53 %) females. The prevalence of asthma was 3.3 %. The frequency of smokers was significantly higher in the asthmatic group compared with the non-asthmatic group (OR=2.33 [1.76-3.31]; p=0.03). There was no significant association between asthma and other demographic and lifestyle characteristics. Obesity has also played a significant role in the development of asthma. Conclusion: According to the results of this study, obesity and smoking have played a significant role in the development of asthma but there is no statistically significant relationship between socioeconomic and demographic factors.

Prevalence of metabolic syndrome in East Azerbaijan-Iran and its determinants factors.

Introduction: Metabolic syndrome (MetS) is a prevalent metabolic disorder with increasing prevalence attributed to extended life expectancy. This study aims to investigate MetS prevalence and its determinants in the East-Azerbaijan population. Methods: Conducted as a cross-sectional study within the East Azerbaijan region, this research is based on a major Lifestyle Promotion Project. The study encompasses 700 participants aged 15 to 65 years, representing the general population and selected using probability proportional to size multistage stratified cluster sampling. MetS diagnoses were conducted using the adult Panel III criteria. Data on socio-demographics, smoking status, and physical activity levels were collected through questionnaires. Results: Among participants, the mean age was 42.4±12.38 years, and the mean body mass index was 27.69±4.94 kg/m2. The MetS group exhibited higher mean age and body mass index compared to the non-MetS group (P<0.001). The prevalence of MetS in the population was 34.2%, with higher rates in females (37.1%) compared to males (30.5%), though this difference wasn't statistically significant (P=0.11). Notably, a substantial distinction was observed between the two groups regarding education levels (P<0.001). Conclusion: The study reveals a significant association between increasing age and higher prevalence of MetS. Furthermore, lower educational levels were linked to an elevated prevalence of MetS. While other socio-demographic factors didn't demonstrate statistically significant relationships, these findings emphasize the importance of targeted interventions and education in mitigating MetS risks.

A qualitative study on human resources for primary health care in Iran.

BACKGROUND: According to World Bank Group report, while Primary Health Care (PHC) services in Iran were appropriate to the needs of the population in the late 1970s and 1980s, the changing burden of diseases and shifting demand patterns have rendered the existing PHC system no longer suitable to meet current and emergent needs. Based on previous studies, one of the main PHC challenges in Iran relates to human resources issues. METHODS: This study was conducted in 2012 at 3 scales of local (Tabriz city), provincial (East Azerbaijan), and national levels. Two qualitative methods were used in the study: free-focus group discussions and in-depth interviews. Framework analysis was used to analyze collected data. Categories of analysis were developed using framework analysis approach, and main themes were emerged. RESULTS: Four themes were developed and finalized out of focus group discussions and interviews: availability of health workers in PHC, competency, PHC health workers' motivation, and PHC managerial issues. CONCLUSION: Based on findings and issues discovered in this study, several suggestions can be made, including development, implementation, and evaluation of needs assessment strategies for various vocational posts, promotion of educational courses and PHC-based training, strengthening of relationships and coordination between practical and scientific bodies, application of incentive programs in PHC, and strengthening of system management capacity through use of qualified managers.

Health promoting hospitals in Iran: Persian translation, cultural adaptation, content and face validation of selfassessment form of the standards of health promoting hospitals affiliated to the World Health Organization.

Background: According to the World Health Organization, hospitals should assess their internal wards to improve health promotion services using self-assessment tools. To achieve this goal, standards of health promoting hospitals have been developed by the World Health Organization, and measurable elements and indicators have been defined to facilitate the practical application of these standards in planning, implementation, and evaluation of health promotion in hospitals. Moreover, a form has been developed for this self-assessment. Considering linguistic and cultural differences in various countries, standards must be written in equivalent texts and, then, their content and face validity should be examined. Performing this process in a systemic and scientific way can guarantee that the same tools have been used, and thus the results obtained from different hospitals are comparable. Methods: After the preparation phase (considering research aim, obtaining permission from the original designers, and determining the time), the following activities were done: translating the form from its original language to the target language, combining and compiling initial translations to a single translation, reversing the final version of the translation from the target language to the original language, obtaining cognitive information, revising and concluding, and determining the content and face validity of the translated form and final report. After filling in the form, face validity was calculated using impact score formula. Content validity was measured using content validity ratio (CVR) and content validity index (CVI). Results: After calculating the impact score, all 40 items showed a high impact score greater than 1.5, representing the fact that all items are important. The minimum value of CVR for each of the 40 items was estimated to be 0.64; CVI of all items was greater than 0.79. Conclusion: Given the input of the standards of health promoting hospitals affiliated to the World Health Organization in National Accreditation of Iranian hospitals, the form was translated and found to be valid according to content and face validity and is available in Persian to be used in Iranian hospitals (Appendix 1).

Suicidal ideation and its correlates among high school students in Iran: a cross-sectional study.

BACKGROUND: Globally, the second leading cause of death among adolescents is suicide and in middle-income countries adolescents' suicidal ideation is a neglected public health area. The present study was conducted to determine the prevalence and correlates of suicidal ideation among 15-17-year-old high school students in Iran. METHODS: Self-administered, Global School-based Student Health Survey (GSHS) questionnaires were distributed to a representative sample (N =1517) of high-school students aged 15-17 in the city of Tabriz. Multivariate logistic regression was used to assess the association between relevant independent variables (e.g. gender) and the dependent outcome variable (suicidal ideation in the past 12 months). RESULTS: Overall, 62 (4.1%, 95% CI= 3.1, 5.2) of 1,517 students had thoughts of suicide. Three hundred and thirteen (20.6%, 95% CI= 18.6, 22.7) students reported being bullied in the previous 30 days. In addition, 134 (8.8%, 95% CI= 7.5, 10.3) students reported having been sexually abused. Being worried that they could not eat or did not feel hungry (Adjusted Odds Ratio (AOR) = 4.15; 95% Cl [1.71, 10.07]; current cigarette smoking (AOR = 3.00; 95% CI [1.69, 5.30]; thinking about using alcohol or other drugs (AOR = 4.28; 95% CI [2.41, 7.59]; and being sexually abused (AOR = 2.63; 95% CI [1.32, 5.24]) were all factors positively associated with suicidal ideation. CONCLUSION: The prevalence of suicidal ideation was lower in our school students than in earlier studies. Interventions that address the issue of current cigarette smoking, worries, thinking about using alcohol or other drugs and sexual abuse should be given more priority by the public health authorities.

Epidemiology of congenital hypothyroidism in Markazi Province, Iran.

OBJECTIVE: The aim of this study was to investigate the epidemiology of congenital hypothyroidism (CH) among newborns in Markazi Province, Iran. METHODS: This cross-sectional study was conducted from 2006 to 2012. Blood samples were taken between 3 to 5 days after birth from the heel. Thyroid stimulating hormone (TSH) was tested using the enzyme-linked immunosorbent assay method and was employed as the screening test. Newborns with abnormal screening results (TSH >5 mIU/L) were re-examined. The data were analyzed using SPSS. RESULTS: A total of 127 112 infants were screened. Of these, 51.2% were male and 48.8% were female. The coverage rate of the screening program was 100%. Of 6102 recalled subjects (re-call rate 4.8%), 414 cases with CH were detected, yielding a CH prevalence of 1:307 (female:male ratio 1:0.95). The prevalence of permanent and transient CH was 1:581 and 1:628, respectively. CONCLUSION: This study reveals that the prevalence of CH is higher compared to worldwide levels. Comprehensive and complementary studies for recognizing related risk factors should be a priority for health system research in this province.

Neonatal screening for congenital hypothyroidism in East Azerbaijan, Iran: the first report.

OBJECTIVES: To investigate the prevalence of congenital hypothyroidism (CH) among neonates in East Azerbaijan, Iran. METHODS: A cross-sectional study conducted from 2009 to 2010. Most heel blood samples were taken between three and seven days of birth. Thyroid stimulating hormone (TSH) was tested using the enzyme-linked immunosorbent assay method. Neonates with abnormal screening results (TSH>20 mIU/L, T4<6.5 mg/dL) were re-examined. Data were analysed using SPSS software. RESULTS: A total of 62,459 infants were screened. Of 1562 re-called subjects (re-call rate 2.5%), 94 cases with CH were detected, yielding a CH prevalence of 1:666 (female:male ratio 1:1.4). CONCLUSION: The prevalence of CH in East Azerbaijan province is higher in comparison with worldwide levels. These results emphasize the importance of the neonatal screening programme.