Validation and evaluation of school-based mental health literacy training program "The Guide Cymru" in Iranian adolescent students aged 13-15: study protocol.

BACKGROUND: Schools are an ideal setting for enhancing mental health literacy, a crucial strategy for improving adolescents' mental health knowledge and attitudes and promoting help-seeking. "The Guide Cymru" program is an adaptation of the mental health literacy program" The Guide" that was developed in Canada. The program will be culturally adapted for 13- to 15-year-old Iranian adolescent students in the first secondary schools. METHODS: In this randomized controlled trial, using the stratified random sampling procedure, the whole eighth and ninth grade student body (aged 13 to 15) from Sirjan City's first secondary schools will be included in the study. Twenty first secondary schools will be randomly assigned to one of two groups: control or intervention. Finally, 562 students and 40 teachers will participate in the research. The tools of mental health literacy scale (MHLs), mental health general knowledge and attitudes related to mental disorders/illnesses are employed in this study. DISCUSSION: This trial aims to be to explore whether "The Guide Cymru", a mental health literacy program offered to students as part of the school curriculum, can decrease the stigma associated with mental health and promote help-seeking behaviors among students.

Prevalence of premature ovarian insufficiency (POI) and its relationship with female reproductive factors in Iranian women: a cross-sectional study from the Persian (Shahedieh) cohort data.

BACKGROUND: In premature ovarian insufficiency, the cessation of menstruation, and cessation of ovarian function occurs before the age of 40, and this phenomenon is associated with many complications and problems for women. Since several factors can affect this situation, this study was conducted to determine the relationship between fertility history, and premature ovarian failure. METHODS: This cross-sectional study was conducted on the data of the first phase of cohort study, which was a sample of 10,000 people from an Iranian adult population (age: 35-70 years). 1276 women were included who naturally experienced menopause from this population. They were separated into three groups based on the age of menopause: premature ovarian failure for those who reached menopause before the age of 40, early menopause for those who reached menopause between the ages of 40 and 45, and natural menopause for those who reached menopause at or after the age of 45. The demographic and fertility characteristics of two groups of women, one with premature ovarian failure and the other with early menopause, were compared with a group of women experiencing normal menopause. The comparison was based on frequency and percentage. Moreover, the odds ratio (OR) of these two groups compared to normal group was crudely calculated, and adjusted based on age at the time of the interview using a logistic regression model. SPSS 23 software was used to fit models and calculations. RESULTS: The prevalence of premature ovarian failure was 3%. The likelihood of premature ovarian failure decreases as the number of live births rises. The risk is considerably higher for births ranging from zero to three children compared to those with more than four. Increased duration of breastfeeding is associated to a reduced risk of premature ovarian failure compared to the spontaneous occurrence (OR = 0.98, 95% CI (0.97, 0.99)). This relationship is maintained even after adjusting for age (OR = 0.98, 95% CI (0.97, 0.99). CONCLUSION: Based on the results of present study, it can be concluded that the factor of the number of births, and the duration of breastfeeding affect reducing the occurrence of POI, therefore, in health and treatment programs and policies, encouragement to have children, which is now part of the policies population of Iran, and the importance, and benefits of breastfeeding for mother and baby should be emphasized more.

Exploring Barriers and Facilitators of Inter-Organizational Management in Response to Mass Casualty Traffic Incidents: A Qualitative Study.

OBJECTIVE: To investigate and understand the current status of inter-organizational management in relief organizations as well as the relief organizations personnel behavior when facing mass traffic incidents (MCTI). The inter-organizational barriers and facilitators are also discussed in response to MCTI management and in order to help direct future actions to improve pre-hospital emergency services. METHODS: The current qualitative study was performed through face-to-face, semi-structured interviews with 31 individuals from pre-hospital emergency services authorities and personnel, Red Crescent and Yazd, Kohgiluyeh and Boyer-Ahmad, Fars, and Qom provinces police. These provinces were selected by purposive sampling in 2018-2019. The conventional content analysis method was applied to analyze the data in this research. RESULTS: Three main categories and 14 subcategories were determined. The categories are including relief organizations coordination (having four subcategories: independent relief organizations, interdepartmental services integration, insufficient knowledge of organizations about one other, and performance based on job descriptions), resource and infrastructure management (having four subcategories: adverse information management, proper information management, lack of medical resources and capacities considered, and upgrading of medical resources and capacities considered), and response management of relief organizations (having six subcategories: incomplete assessment, improving the quality of assessment, weakness in establishing scene security, scene security management, poor response, and cooperation in response). CONCLUSION: Relief organizations need to perform under a unified command. It has inter-organizational cooperation and provide integration of interdepartmental services in order to manage responsiveness at the scene. It also prevents an independent, chaos, and inability of the injured to properly understand and needs in MCTI.

Exploring the nutritional beliefs of pregnant women in Yazd city.

INTRODUCTION: During the pregnancy, a woman as a healthy person grows another human being in her body and needs more cares due to changes in psychological and physical needs. This study aimed to explore the nutritional beliefs of pregnant women in Yazd city. METHODS: This was a qualitative study conducted with a conventional content analysis approach. A total of 12 participants were selected from women referred to the community health centers in Yazd, Iran, by the purposeful sampling method. Data were collected through recorded semi-structured interviews that were transcribed verbatim and analyzed by the Lundman and Granheim's content analysis method. RESULTS: In this study, after analyzing the data, 10 main categories and 26 subcategories were extracted. The codes were 446 cases with no overlap, which was reduced after careful review and integration of similar items. Topics of categories included: The concept of nutrition during pregnancy, Nutrition limitations during pregnancy, Myths about food during pregnancy, Doubts about nutrition during pregnancy, Pregnancy food style, Sources of nutritional information in pregnancy, Positive Consequences of Healthy Nutrition in Pregnancy, Consequences of inappropriate pregnancy nutrition, Religious Beliefs in Pregnancy Nutrition, social support. CONCLUSION: The results indicated that the women were committed to their own nutritional beliefs that derive from their culture and this study provided a clear picture of the cultural beliefs of Yazdi women regarding pregnancy nutrition. According to the results, it is necessary to design the education process based on the culture of the community in order for that process to be effective.

Iranian Women's Breast Health-Seeking Behaviors: Husband's Role.

BACKGROUND: Breast cancer has become the most common cancer among Yazdi women in Iran. Thus, it is necessary to encourage these women to participate in breast health-seeking behaviors. In this regard, husbands can play an effective role. OBJECTIVE: The aim of this study was to explore women's perceptions about the effect of their husband's role on breast health-seeking protection motivation. METHODS: This study used a directed qualitative content analysis approach based on the Protection Motivation Theory. Participants were selected using purposive sampling; in-depth semistructured interviews with 14 Yazdi women were completed. RESULTS: One major category named "motivator role of husband" emerged from the analysis. The following subcategories underlying this category were "indifference and a lack of support as long as the women can continue with expected duties," "what women want for support," "facilitating and restrictive factors of husband's supportive role," "public health education needed," and "husband's agreement with preventive actions." CONCLUSIONS: Voluntary participation in breast health-seeking behaviors is a culturally sensitive topic. The qualitative methodology allowed this sensitive topic and its different aspects to be explored. The findings indicated that the major source of support for women was their husband's behavior toward breast health-seeking actions. Family cohesion and love among couples were identified as strong determinant factors pertaining to husband's supportive behaviors. IMPLICATIONS FOR PRACTICE: The study findings provided deeper understanding about the effective factors related to a husband's role in motivating a wife to practice breast cancer prevention. These new findings are relevant for health educators and practitioners to develop culturally based interventions.

The Effect of Telephone Counseling and Education on Breast Cancer Screening in Family Caregivers of Breast Cancer Patients.

BACKGROUND: Breast cancer is the most common form of malignancy among females. Family history is a key risk factor for breast cancer. Breast cancer screening practices are vital in patients with family history of breast cancer. Telephone counseling and education may be appropriate for improved breast cancer screening. This study was done to determine family caregiver patients' knowledge of risk factors for breast cancer and practice of breast cancer screening and also to assess the effect of telephone counseling and education on mammography screening. METHODS: This study was a community-based trial. The participants of the study were 90 caregivers who were randomly divided into an experimental group, telephone counseling and education, and a control group. The intervention group received counseling and education phone calls. A three-section questionnaire was responded and filled out through telephone interviews with the participants. The collected data were analyzed with SPSS18, using descriptive and inferential statistics. RESULTS: The results showed that 88.9% of the participants did not know when to do breast self-exam (BSE). Mammography was performed by the participants before and after the telephone counseling in intervention group (P<0.00), which were 13.3% and 77.8% respectively). Moreover, the major cause of failure to participate in mammography was lack of enough knowledge in 73.3% of the participants. CONCLUSION: This study concluded that knowledge and practice on breast cancer screening in family caregiver of breast cancer patients was low. Telephone counseling and educating may provide a suitable technique for earlier detection of breast cancer in family caregivers of breast cancer patients and it can influence the decision making regarding mammography screening among 40-year-old or older women. Trial Registration Number: 2017052316870N3.

Response costs of mammography adherence: Iranian women's perceptions.

BACKGROUND: Mammography as the most common secondary prevention method has known to be helpful in detecting breast cancer at the early stages. Low level of participation among women toward mammography uptake due to cultural beliefs is a great concern. This study aimed at exploring the perceptions of women about response costs of mammography adherence (MA) in Yazd, Iran. METHODS: A qualitative study using semi-structured interviews was performed. Fourteen women,one oncology nurse, and a breast cancer survivor were purposefully interviewed. Interviews were transcribed verbatim and analyzed by directed content analysis method based on protection motivation theory (PMT). RESULTS: One main theme was emerged from the analysis namely called "response costs".Two main categories were also emerged from the data; (1) psychological barriers with six subcategories including "embarrassment," "worry about being diagnosed with cancer," "preoccupation with underlying disease," "misconception about mammography," "need for an accompanying person," and "internalizing the experiences of the others," and (2) maladaptive coping modes which encompassed three subcategories: "religious faith," "fatalism," and"avoidance and denial." CONCLUSION: Useful information was provided about the response costs of mammography utilization based on the perceptions of women. Cognitive barriers may be decreased by conducting modifications in women's awareness and attitude toward MA as well as changing the national health system infrastructures. Incorporating religious and cultural belief systems into MA educational programs through motivational messages is recommended.