Explaining the perspective of people living with HIV on health-promoting behaviours based on Pender's model: A directed content analysis.

AIM: Health-promoting behaviours are an important challenge in people living with HIV (PLHIV). Knowing PLHIV's perspective can be helpful for more effective health-promoting behaviour planning. Therefore, the present study aims to explain PLHIV's perspective on health-promoting behaviours based on Pender's health-promotion model. DESIGN: A qualitative study with a directed content analysis approach. METHODS: Altogether, 17 PLHIV referring to the Behavioural Diseases Consultation and Control Center in Tehran, Iran and were selected through purposive sampling. The data were collected through semi-structured individual interviews and the results were analysed through directed content analysis based on Pender's model. Data management was done by MAXQDA V10. RESULTS: Data analysis led to the extraction of 396 codes in 35 subcategories and 15 main categories in 6 constructs of Pender's model, including the perceived benefits (health assurance and optimal disease control), perceived barriers (insufficient knowledge and awareness, lack of motivation, adverse outcomes of the disease and socioeconomic status), perceived self-efficacy (endeavouring to have a healthy lifestyle, responsibility for one's health and that of others), activity-related affect (positive and negative feelings), the interpersonal influences (family, friends and relatives and social media) and situational influences (the resources available to the community and community's culture). PATIENT OR PUBLIC CONTRIBUTION: In this study, the contribution of PLHIV was used and their perspectives were surveyed. The findings of this study can help policymakers and planners formulate health policies to select the most appropriate strategies and approaches to promoting effective healthy behaviours among PLHIV.

"Applying Intersectionality in designing and implementing health interventions: a scoping review".

BACKGROUND: Given the potential of intersectionality to identify the causes of inequalities, there is a growing tendency toward applying it in the field of health. Nevertheless, the extent of the application of intersectionality in designing and implementing health interventions is unclear. Therefore, this study aimed to determine the extent to which previous studies have applied intersectionality and its principles in designing and implementing health interventions. METHODS: The title and abstract of the articles which were published in different databases e.g. PubMed, Web of Science, Proquest, Embase, Scopus, Cochrane, and PsychInfo were screened. Those articles that met the screening criteria were reviewed in full text. The data about the application of principles of intersectionality, according to the stages heuristic model (problem identification, design & implementation, and evaluation), were extracted through a 38-item researcher-made checklist. RESULTS: Initially, 2677 articles were found through reviewing the target databases. After removing the duplicated ones and screening the titles and abstracts of 1601 studies, 107 articles were selected to be reviewed in detail and 4 articles could meet the criteria. The most frequently considered intersectionality principles were "intersecting categories" and "power", particularly at the stages of 'problem identification' as well as 'design & implementation'. The results showed that "multilevel analysis" principle received less attention; most of the studies conducted the interventions at the micro level and did not aim at bringing about change at structural levels. There was a lack of clarity regarding the attention to some of the main items of principles such as "reflexivity" as well as "social justice and equity". These principles might have been implemented in the selected articles; however, the authors have not explicitly discussed them in their studies. CONCLUSIONS: Given the small number of included studies, there is still insufficient evidence within empirical studies to show the implication of intersectionality in designing and conducting health interventions. To operationalize the intersectionality, there is a need to address the principles at various stages of health policies and interventions. To this end, designing and availability of user-friendly tools may help researchers and health policymakers appropriately apply the intersectionality.

How to increase community participation capacity in food environment policymaking: Results of a scoping review.

Background: Food environment plays a major role in health outcomes. A growing interest in community-based participatory research (CBPR) has led to its application in the improvement of the food environment. This scoping review aims to compile and map the literature and identify key strategies used for increasing community participation capacity in the food environment policymaking process. Methods: The scoping review of peer-reviewed articles on community participation and food environment policymaking followed the framework suggested by Arksey and O'Malley (2005). Scopus, PubMed, and Web of Science were searched. A charting table was developed to extract the key information of each identified study. A directed content analysis approach was used to assign retrieved codes into categories proposed by Foster-Fishman. Results: A total of 28 studies were included in this review. Most studies used the CBPR approach to involve the community at least in the problem identification step of the policymaking process (n=12) and 7 studies reported their involvement in all the steps of policymaking. In 15 out of 28 studies, the level of community participation was at "involvement" and in 8 studies it was at "empowerment". Strategies for increasing relational capacity, member capacity, programmatic capacity, and organizational capacity of community participation were reviewed. Conclusion: To improve food environment using the community-participation approach, identifying different strategies and adjusting them based on the social and political context of each society is of high importance.

Health literacy among Iranian adults: findings from a nationwide population-based survey in 2015.

BACKGROUND: Health literacy is one of the most important determinants of noncommunicable diseases prevention. Health literacy is associated with elevated risks for poorer access to care, adverse health outcomes, and increased hospitalization and health costs. AIMS: This study aimed to determine the level of health literacy among the general adult population in the Islamic Republic of Iran. METHODS: Using a cross-sectional study during 2014-2015 with a multistage cluster sampling approach, we administered a pilot-tested standardized questionnaire to assess different domains of health literacy (i.e., reading, comprehension, communication/decision-making and Interpretation/judgment skills, individual and social empowerment, health information access and health information use) among 8439 (3935 males) individuals aged 18-60 years. Data were collected through face-to-face interviews. Descriptive statistics and multivariable linear regression method using SPSS (20) were applied to identify the factors associated with health literacy among Iranian adults. RESULTS: The mean health literacy level was 10.2±3.8 (out of 20). Only 18% (95% confidence interval [CI]: 17.15-18.78) of the participants had adequate health literacy, while 45.7% (95% CI: 44.64-46.78) had inadequate, and the 36.3% (95% CI: 35.21-37.33) had moderate health literacy. In the adjusted linear regression model, education level (the smallest ß = 4.35, P < 0.001), age (ß = 0.01, P = 0.002), female sex (ß = 0.45, P < 0.001), residency in rural areas (ß = 0.26, P < 0.001) and having permanent job (ß = 1.03, P < 0.001) were significantly associated with more health literacy. CONCLUSION: Our findings highlighted that the Iranian adult population has an insufficient level of health literacy, which calls for comprehensive education planning to improve the levels, with special attention to certain subpopulations (e.g. illiterate populations) and domains (e.g. individual empowerment).

A social network analysis on immigrants and refugees access to services in the malaria elimination context.

BACKGROUND: There has been significant progress in eliminating malaria in Iran. The aim of this study is to investigate the structure of inter-organizational collaboration networks in the field of unauthorized immigrants and refugees access to services in order to eliminate malaria. METHODS: This study employed social network analysis, in which nodes represented stakeholders associated with providing access of immigrants and refugees to services in the field of malaria elimination, and ties indicated the level of collaboration. This study adopted socio-centric analysis and the whole network was studied. In this regard, 12 districts of the malaria-endemic area in Iran were selected. Participants included 360 individuals (30 representatives of the organization/group in each district). The data were gathered by interview, using the levels of collaboration scale. UCINET 6 was used for data analysis. The indices of density, centralization, reciprocity, and clustering were investigated for each twelve network and at each level of collaboration. RESULTS: The average density of the networks was 0.22 (SD: 0.04). In districts with a high incidence of imported malaria, the values of network density and centralization were high and the networks comprised of a larger connected component (less isolated clusters). There were significant correlations between density of network (r = 0.66, P = 0.02), degree centralization (r = 0.65, P = 0.02), betweenness centralization (r = 0.76, P = 0.004), and imported malaria cases. In general, the degree centrality and betweenness centrality of the organizations of health, district governor, and foreign immigrants' affairs were higher. In all networks, 60% of the relationships were bilateral. At a higher level of collaboration, the centralization declined and reciprocity increased. The average of betweenness centralization index was 22.76 (SD = 3.88). CONCLUSIONS: Higher values of network indices in border districts and districts with more cases of imported malaria, in terms of density and centralization measures, can propose the hypothesis that higher preparedness against the issue and centralization of power can enable a better top-down outbreak management, which needs further investigations. Higher centrality of governmental organizations indicates the need for involving private, non-governmental organizations and representatives of immigrant and refugee groups. Recognition of the existing network structure can help the authorities increase access to malaria prevention, diagnosis, and treatment services among immigrants and refugees.

How to utilize tacit knowledge in health organizations: An Iranian perspective.

Background: Studies show that 90% of an organization's knowledge is embedded and synthesized in its employees' minds. Thus, when employees leave the organization or their positions change, their valuable knowledge, skills, and experiences are lost, however, if used properly, tacit knowledge can be a source of innovation and competitive advantage in an organization. This study aimed at exploring the methods for sharing and utilizing tacit knowledge in health organizations. Methods: In this study, qualitative approach was adopted to explore ways of utilizing tacit knowledge in health organizations. Tacit knowledge experts, who had published at least one relevant article, conducted 17 individual and 2 group interviews. Purposeful sampling was used to select the participants. Methods for sharing and utilizing tacit knowledge were explored by holding in-depth semi-structured interviews. Data were analyzed using thematic analysis. Results: The results were summarized into 5 categories and 18 themes. The categories included 'identification of different dimensions of organizational knowledge', 'prerequisites of tacit knowledge utilization', 'defining the process of tacit knowledge utilization', 'converting tacit to explicit knowledge', and 'converting tacit to tacit knowledge'. Participants believed that the process of converting tacit to explicit knowledge was a cyclical process that included the understanding the existing situation and detecting knowledge entry points, identifying knowledge items and harvesting them, assessment, codification, and standardization, entry into knowledge repository, and updating. Conclusion: Our results revealed that health organizations need the prerequisites of tacit knowledge sharing to acquire the capacity to utilize this kind of knowledge. Because the themes extracted in this study are rarely used in health organizations, the results will be helpful in guiding the development of knowledge utilization strategies and planning in these organizations.

HOSPITAL-BASED HEALTH TECHNOLOGY ASSESSMENT IN IRAN.

BACKGROUND: Hospitals with health technology assessment (HTA) programs have reported its positive effects on the management of resources and costs. This study aimed to identify the barriers faced by hospital-based HTA (HBHTA) in Iran by inductive content analysis of stakeholders' and decision-makers' points of view. METHODS: The key individuals and organizations that could provide rich, relevant, and diverse data in response to the research question were purposively selected for the interviews and focus group discussion. RESULTS: Twelve stakeholders from seven public hospitals participated in the interviews. Another eighteen stakeholders from twelve HBHTA-related organizations took part in the focus group discussion. Most of the hospitals' senior management team did not feel the need for HBHTA and believed that in Iran a systematic process like HTA faces many challenges. CONCLUSIONS: The stakeholders participating in this study highlighted the significance of certain points that needed to be addressed before establishing HBHTA in Iran.

Environmental risk factors contributing to traffic accidents in children: a case-control study.

The aim of this study is to identify environmental risk factors related to road accidents in children of Tehran. This case-control study was performed in 2013. The cases were injured pedestrians aged 5-15 who were admitted to major hospitals supervised by Tehran University of Medical Sciences. The sample size for the cases was 273 and for the control group was 546. For the completeness of the clusters, 7 extra persons in case (total = 280) and 14 persons (total = 560) in control group were included. The interference of confounding variables assessed through forward conditional logistic regression. Result shows occurrence of traffic accidents was significantly associate with the width of the alleys or (<5 m: OR = 8.4, 95% CI: 3.3-21.5; 5-8 m: OR = 4.7, 95% CI: 1.8-12.2), distance from home to school((<100 m: OR = 1.7, 95% CI: 1.0-2.8), existence of parking lot (OR = 1.5, 95% CI: 1.0-2.3), traffic congestion (OR = 4.1, 95% CI: 2.6-6.4), traffic speed (OR = 2.1, 95% CI: 1.3-3.2) and existence of pedestrian bridges(OR = 4.2, 95% CI: 2.6-6.8). In the light of the important role of environmental factors in the occurrence of child traffic accidents, alleviating structural risk factors in addition to education and enforcement need more systematic efforts and planning by policymakers and urban planners to attain pedestrian safety goals.

Life Satisfaction Index among Elderly People Residing in Gorgan and Its Correlation with Certain Demographic Factors in 2013.

BACKGROUND: Aging is a universal phenomenon that will present itself as a dominant social and welfare challenge. AIM: This study was to examine life satisfaction among people residing in Gorgan and its correlation with certain demographic factors in 2013. METHODS: A total of 250 elder people were selected for the study through the convenience sampling during 4 months. Data collected through life satisfaction index-A (LSIA). This instrument consists of 5 subscales, including, zest for life, resolution and fortitude, congruence between desired and achieved goals, positive self-concept and mood tone. The Multiple Linear Regression analysis was used in order to determine factors influencing the overall LSIA. RESULTS: The overall LSIA score was 22.1 ± 7.5 with the maximum and minimum mean scores pertaining to the resolution and fortitude (6.1 ± 2.5) and the positive self-concept (3.1 ± 1.2) subscales, respectively. Level of education, type of living and gender were variables influencing the overall LSIA (P<0.05). CONCLUSION: Given the overall LSIA, it appears that future plans for this age group should be seriously revised along with cultural plans for promoting reverence for old age in the general public.

Effectiveness of Community Participation in Earthquake Preparedness: A Community-Based Participatory Intervention Study of Tehran.

OBJECTIVE: The aim of this study was to evaluate the effectiveness of a community-based participatory intervention on earthquake preparedness in Tehran. METHODS: This community-engaged research was conducted during 2011 to 2013. An intervention and a control neighborhood were chosen through systematic cluster sampling. In the intervention group 305 households and in the control group 314 households were sampled for pre- and post-assessment surveys. A participatory intervention was designed on the basis of consultation with the community advisory board and was implemented by trained volunteers. Changes in outcome variables in the intervention and control groups were detected in terms of knowledge, attitude, and practice. Pearson chi-square tests and covariance regression were used to evaluate the effectiveness of the intervention. RESULTS: The results showed that the frequency of earthquake experience in the intervention and control groups was 69.2% and 79.0%, respectively. Moreover, the mean difference scores in knowledge, attitude, and practice in the intervention and control groups before and after the intervention were significant (P<0.001). CONCLUSIONS: A participatory intervention effectively improved disaster preparedness at a community level. To ensure sustainability, the participatory approach should be integrated into public health disaster planning.

Spatial Factors Affecting the Frequency of Pedestrian Traffic Crashes: A Systematic Review.

CONTEXT: Considering the importance of pedestrian traffic crashes and the role of environmental factors in the frequency of crashes, this paper aimed to review the published evidence and synthesize the results of related studies for the associations between environmental factors and distribution of pedestrian-vehicular traffic crashes. EVIDENCE ACQUISITION: We searched all epidemiological studies from 1966 to 2015 in electronic databases. We found 2,828 studies. Only 15 observational studies out of these studies met the inclusion criteria of the study. The quality of the included studies was assessed using the strengthening the reporting of observational studies in epidemiology (STROBE) checklist. RESULTS: A review of the studies showed significant correlations between a large number of spatial variables including student population and the number of schools, population density, traffic volume, roadway density, socio-economic status, number of intersections, and the pedestrian volume and the dependent variable of the frequency of pedestrian traffic crashes. In the studies, some spatial factors that play an important role in determining the frequency of pedestrian traffic crashes, such as facilities for increasing the pedestrians' safety were ignored. CONCLUSIONS: It is proposed that the needed research be conducted at national and regional levels in coordination and cooperation with international organizations active in the field of traffic crashes in various parts of the world, especially in Asian, African and Latin American developing countries, where a greater proportion of pedestrian traffic crashes occur.

Spatial analysis to identify high risk areas for traffic crashes resulting in death of pedestrians in Tehran.

Background: More than 20% of deaths from traffic crashes are related to pedestrians. This figure in Tehran, the capital of Iran, reaches to 40%. This study aimed to determine the high-risk areas and spatially analyze the traffic crashes, causing death to pedestrians in Tehran. Methods: Mapping was used to display the distribution of the crashes. Determining the distribution pattern of crashes and the hot spots/ low-risk areas were done, using Moran's I index and Getis-Ord G, respectively. Results: A total of 198 crashes were studied; 92 of which, (46.4%) occurred in 2013 to 2014 and other 106 cases (63.6%) occurred in 2014 to 2015. The highest and the lowest frequency of crashes was related to January (26 cases) and June (10 cases), respectively. One hundred fifty- eight cases (79.8%) of crashes occurred in Tehran highways. Moran's index showed that the studied traffic crashes had a cluster distribution (p<0.001). Getis- Ord General G index indicated that the distribution of hot and cold spots of the studied crashes was statistically significant (p<0.001). Conclusion: The majority of traffic crashes causing death to pedestrians occurred in highways located in the main entrances and exits of Tehran. Given the important role of environmental factors in the occurrence of traffic crashes related to pedestrians, identification of these factors requires more studies with casual inferences.

The effect of exercise therapy on cognitive functions in multiple sclerosis patients: A pilot study.

BACKGROUND: The positive impacts of exercise therapy on patients' cognitive problems still remain unknown. This study was a pilot intervention to examine the effects of combined exercise on the cognitive problems of patients with multiple sclerosis (MS) in Iranian MS Society over 2012 to 2013. METHODS: This quasi-experimental research was carried out in the form of a pretest/posttest study. Forty two patients with MS were selected from those visiting the rehabilitation center of Iranian MS Society, using non-probability convenience sampling. The Expanded Disability Status Scale (EDSS) of each patient was recorded before the intervention and Brief Repeatable Battery of Neuropsychological (BRB-N) test was administered before and after the intervention. The data were analyzed using the analytical tests such as Wilcoxon test. RESULTS: Of 21 participants, 17 subjects (82%, n=14) female with mean (±SD) age of 37 (±9.98) years and mean (±SD) EDSS of 2.35 (±0.90) completed all stages of the study. Changes in long-term storage and permanent long-term retrieval of information after the intervention were statistically significant (p<0.001). In addition, the change in the average of total delay after the intervention was also significant by 1.11 (p<0.001). CONCLUSION: Our study confirmed the possibility of change in the cognitive abilities of MS patients through physical interventions. This finding emphasizes the necessity of more clinical examinations and increases the hopes for new rehabilitation methods for the disorder.

Development and Psychometric Properties of Risk and Protective Factors of Substance Use Scale in Iran: An Application of Social Development Model.

BACKGROUND: Substance use is a growing public health problem among adolescents. In the lack of a valid and reliable instrument based on social development model (SDM), this study aimed to develop risk and protective factors of substance use scale based on SDM to determine risk and protective factors influencing substance use among adolescents. METHODS: A total of 235 male students from 9th and 10th grade (14-18 years old) of public high schools in Kerman, Iran, selected through multistage cluster sampling. Items pool extracted from the literature and focus groups with male adolescents. Face validity of the questionnaire assessed for readability and clarity of items. Then, an expert panel evaluated the items for content validity. Consequently, construct validity of questionnaire confirmed through exploratory factor analysis (EFA). Known group validity is determined by the degree to which the instrument shows different scores between two groups of those who had an experience in drug use and those who did not have such an experience. In addition, reliability assessed via internal consistency and test-retest. FINDINGS: About 10 factor solution (containing 38 items) emerged as a result of EFA entitled adolescent's "beliefs on hookah and alcohol," "bonding to parents," "family rules on substance use," "drug resistance skills," "adolescent's beliefs on hard drugs," "situational perception on hookah and alcohol," "rules of school," "situational perception on hard drugs," "attachment to school," and "perceived opportunity at school." The first four emerged factors explained 46% of the total variance observed. Among these factors, adolescent's beliefs on hookah and alcohol explained a more than 25.3% of the total variance. Results indicated satisfactory internal consistency (Cronbach¢s alpha ranging from 0.71 to 0.85) and intra-class correlation coefficients (ICC) (ranging from 0.48 to 0.81). CONCLUSION: The risk and protective factors of substance use questionnaire are the first instrument based on the SDM. The findings showed that this questionnaire is a valid and reliable instrument for assessing determinants of substance use which can be used by researchers and policymakers in preventive initiatives.

Are people in Tehran prepared for the family physician program?

BACKGROUND: Upon successful experiences of family physician program in the rural regions, Iranian Ministry of Health and Medical Education (MOHME) made a decision to expand this program to urban areas. For this reason a pilot program were designated and some cities have been selected to determine dos and don'ts of performing family physician program in the cities. Various studies were published during this period demonstrating the advantages and disadvantages of family physicians' care in these cities. After this process in 2012 and 2013 MOHME announced implementation of family physician program in Tehran. Our study investigated public attitudes, knowledge and practice about the newly introduced program. METHODS: This cross-sectional study was performed in Tehran during November to December 2012. A telephone survey was carried out using the Random Digit Dialing (RDD) method and data was gathered by a researcher designed questionnaire. A total of 386 residents aged 18 years and over participated in the study. To compare the differences between various groups' knowledge scores data were analyzed performing Chi-square test, t-test, ANOVA, and logistic regression by SPSS software version 17, to find factors that affected individuals' agreement with the program. RESULTS: Among all samples 214(57.4%) knew about the program and almost 120(85.1%) of these aware people were planning to participate in the program. Television and Radio were the major information resources. After adjusting for Educational status, Access to Internet and Socio Economic Status(SES) those people who didn't have any kind of health coverage systems(Health insurance) were most likely to accept the program and agree with that[OR= 2.38(1.05-5.38)]. CONCLUSIONS: The fact that despite low levels of information, most of aware people intend to enroll in the new program reveals that expanding informative programs would bring more participation and involvement among community.

The effect of health promoting intervention on healthy lifestyle and social support in elders: a clinical trial study.

BACKGROUND: Many of the problems pertaining to old age originate from unhealthy lifestyle and low social support. Overcoming these problems requires precise and proper policy-making and planning. OBJECTIVES: The aim of the current research is to investigate the effect of health promoting interventions on healthy lifestyle and social support in elders. PATIENTS AND METHODS: This study was conducted as a clinical trial lasting for 12 months on 464 elders aged above 60 years who were under the aegis of health homes in Tehran, Iran. Participants were selected through double stage cluster sampling and then divided into intervention and control groups (232 individuals in each). Tools for gathering data were a demographic checklist and two standard questionnaires called Health-Promoting Lifestyle Profile version 2 and personal resource questionnaire part 2. Data were analyzed using descriptive and analytical tests including paired t test, analysis of covariance (ANCOVA) and Pearson correlation coefficient. RESULTS: The average age of elders in this study was 65.9 ± 3.6 years (ranging between 60 and 73 years old). Results showed that the differences between the mean post-test scores of healthy lifestyle and its six dimensions as well as perceived social support and its five dimensions in the control and intervention groups were statistically significant (P value < 0.0001). CONCLUSIONS: Aging is an inevitable stage of life. However, effective health promoting interventions can procrastinate it, reduce its consequences and problems, and turn it into a pleasant and enjoyable part of life.

Investigation of relationship between social capital and quality of life in multiple sclerosis patients.

BACKGROUND: A large portion of existing medical research on Multiple Sclerosis patients focuses more on predicting medical variables (such as diagnosis, treatment) and individual variables such as the onset of disease, gender, etc., rather than broader socio-contextual factors. So that, here has yet been no study investigating factors such as social capital in Multiple Sclerosis patients. AIM: The purpose of this study is determining the relation between social capital and quality of life in Multiple Sclerosis patients who referred to Iran Multiple Sclerosis Society in 2012. METHOD: This cross-sectional study was conducted on 172 patients visiting Iran Multiple Sclerosis Society (Tehran) during 10 months via convenience samplings and face to face interviews. Tools for collecting data included World Bank's social capital integrated questionnaire (SC-IQ) and Multiple Sclerosis Quality of Life (MSQOL) -54. RESULTS: The average age of patients was 34/8 ± 9/6. The analysis of the six dimensions of social capital questionnaire showed that the highest average score belonged to membership in groups and networks (63/3 ± 15/3) and the lowest one was about trust and solidarity (44/3 ± 13/7).The results of the regression model showed that there is a statistical significant and positive relation between social capital and quality of life (P > 0.0001). CONCLUSION: Since the present study has been conducted for the first time in this vulnerable subpopulation of patients, its results can provide invaluable information regarding the quality of life and at the same time present hypotheses about the contributing factors.

Physical activity in Iranian older adults who experienced fall during the past 12 months.

BACKGROUND: Physical activity may have several benefits for elderly people. However, the risk of falling might prevent this population from showing interest in physical activity. This research was aimed to explore facilitators and barriers to physical activity in older persons who have experienced at least one fall in the past 12 months. METHODS: This cross sectional study was conducted in 2010-2011, in Tehran, Iran. Using a multistage sampling method a group of elderly people entered into the study. A multi-section questionnaire was used to collect data on demographic information, physical activity level, and different determinants that might influence physical activity. Several statistical tests including linear regression were used to analyze the data. RESULTS: In all, 180 old people from 40 elderly centers (49 men and 131 women) took part in the study. The mean age of participants was 65.9 ± 6.1 years. The result indicated that most participants experienced two or more falls during the last year (54.5%). Those who had more falls significantly scored lower on the Physical Activity Scale for Elderly (p < 0.0001). 'Keeping in touch with friends' was the most important advantage cited by participants for performing physical activity. The results obtained from linear regression analysis showed that 'perceived benefits' was the only significant factor that associated with physical activity (ß = 1.03, p < 0.001). CONCLUSION: The findings suggest that perceived benefits could facilitate physical activity among elderly regardless of number of falls, self-reported health and daily living activities. However, we observed inverse association between number of falls and physical activity. Indeed the findings suggest that we should reinforce benefits exist when designing programs to increase physical activity among elderly population.

Ethical Considerations of Community-based Participatory Research: Contextual Underpinnings for Developing Countries.

BACKGROUND: The nature of community-based participatory research (CBPR) poses distinctive ethical challenges. In the absence of organized guidelines, a remarkable amount of researchers' time and energy will be spent tackling these ethical challenges. The study aimed to explore ethical issues and principles potentially arising when conducting CBPR. METHODS: This qualitative study conducted in CBPR Center of Tehran University of Medical Sciences. Required data were gathered through systematic literature review and semi-structured interviews. Representatives of community, academia, and nongovernmental organizations (NGOs) participated in our study. Ten interviews with representatives of partner organizations, four group interviews with academic staff, and four with representatives of community were conducted. Repeated thematic analysis was used to elicit ethics-related overarching themes from transcribed interviews. As recommendations, these themes were then organized into a set of CBPR-related ethical issues and principles. RESULTS: Four CBPR ethical guidelines (including 173 articles) were selected from a systematic review. Overarching themes relating to ethical principles which emerged from interviews were as follows: Trust, transparency and accountability, equity and inclusion, power imbalance, tolerance and conflict management, and attention to cultural sensitivity. Practical principles that emerged included: Consensus rather than informed consent, ownership of data and research achievements, and sustainability and maintenance of relationships. According to findings and in comparison to international guidelines, the present study put more emphasis on cultural sensitivity and sustainability as CBPR ethical tangles. CONCLUSIONS: Community-based participatory research ethical challenges are of the same kind in most parts of the world. However, some discrepancies exist that calls for local scrutiny. Future use and critic of current explored ethical issues and principles are highly encouraged.

The impact of educational intervention based on empowerment model in preventing violence against women.

BACKGROUND: One of the most obvious forms of violence in today's society is violence against women. In Iran, along with other countries, violence against women has become a problematic issue. OBJECTIVES: The present research aims to investigate the impact of educational intervention based on empowerment model in preventing violent behaviors against women. PATIENTS AND METHODS: The present study is an intervention research done through the random selection of 91 women under the aegis of Imam Khomeini Relief Foundation in Gorgan. Tools for data gathering included demographics checklist, Rosenberg Self-Esteem, general self-efficacy, awareness and attitude questionnaires. Three ninety-minute educational sessions were held for each group to enhance their awareness, change their attitudes, and train them life skills to increase self-esteem so that they can express their vicarious experiences to increase their self-efficacy toward violent behavior. Following the post-test, data were analyzed with SPSS software (version 20). Tests for analyzing data included descriptive and analytical tests (chi-square, Pearson's correlation, independent samples t-test, One-way ANOVA and paired t test). RESULTS: Results indicated that the frequency of domestic violence against participating women was significant after educational intervention, as compared to pre-intervention period. Paired t-test showed that average scores of awareness, attitude, self-esteem, and self-efficacy constructs, and total power were statistically higher after educational intervention as compared to the period prior to intervention. CONCLUSIONS: As one of the manifestations and the moving force of empowerment, education is the first major strategy in codifying, designing, and implementing empowerment programs. For women to be empowered, the active participation of all people in education is required.