An application of social marketing for promoting HIV testing in Iran.

BACKGROUND: It has been estimated that 60,000 Iranians have been infected with HIV/AIDS and only 36% of them are aware of their status. This study aimed to design, implement and evaluate a social marketing campaign to promote HIV testing in Boyer-Ahmad County, Kohgiluyeh, and Boyer-Ahmad Province, southwest of Iran. MATERIALS AND METHODS: This study was a quasi-experimental pretest-posttest without a control group, developed based on a social marketing assessment and response tool. To design the intervention formative research was conducted, comprised of four focus group discussion sessions with 42 participants of the target community along with seven in-depth semi-structured personal interviews with health care providers involved in the HIV/AIDS Program. Data analysis was done manually using content analysis and the main content was formulated for the campaign. Afterward, the slogan and messages of the campaign were developed. The campaign's materials including banners, posters, pamphlets, referral forms, and short messages were designed, pretested, and revised. Ultimately, the campaign was conducted for one month in October 2019. To determine the effectiveness of the campaign, the rate of referrals to the Center for Behavioral Health Counseling Services (CBHCS), for three months before and after the campaign, was compared. RESULTS: Qualitative findings identified that the majority of the interviewees mentioned that the main reasons for the low rate of referrals to get tested for HIV were lack of awareness and information about HIV/AIDS and its diagnosis as well as the free and confidential tests available from the CBHCS. Moreover, the stigma associated with HIV/AIDS was another important reason for low referrals for testing. The rate of referrals for HIV testing in the three months leading up to the campaign was 18, 32, and 23 people, and three months after the campaign was 64, 81, and 44 individuals; respectively. The results of the multivariate analysis demonstrated that the campaign had increased the rates of referrals for HIV testing through its significant influence on females, and individuals with academic degrees. CONCLUSION: It can be concluded that the social marketing campaign was successful in persuading people to get tested for HIV.

Exploration roles and responsibilities of trade unions in preventing and responding to emergencies against epidemics: The case of COVID-19.

BACKGROUND AND AIM: The coronavirus disease 209 (COVID-19) pandemic has been affecting various strata of society including different guilds. Each of these segments has its role to play in controlling epidemics. Accordingly, this study aimed to explore trade unions' roles and responsibilities in the prevention and emergency response to epidemic, including the COVID-19 pandemic. MATERIALS AND METHODS: The present qualitative research was conducted using directed content analysis. Participants were selected by a purposeful sampling method. Data were collected through semistructured interviews and field notes and validated through Lincoln and Guba's (1985) evaluative criteria. Data were analyzed by MAXQDA software. RESULTS: Data analysis, constant comparison, and class integration provided a total of seven main themes, which were extracted into four domains of Plan, Implementation, Review, and Action. The main themes were categorized into the dimensions of each domain, so that the Plan domain included three dimensions of union/guild contexts, leadership and staff participation, and planning. The Implementation domain included two dimensions of support and operations. The Assessment domain had a performance evaluation dimension, and the Action domain was made up of an improvement dimension. CONCLUSION: Relying on their organizational and social capacities, trade unions can facilitate the leadership and participation of employees and communities for appropriate policies and making resilient decisions to control epidemics and other roles and responsibilities related to health.

Designing a Social Marketing-Based Intervention to Promote Sun-protective Behaviors among Urban Adolescent Boys: A Study Protocol.

Background: Skin cancer is one of the most preventable diseases. The purpose of this study is to describe a social marketing-based intervention design protocol to promote sun-protective behaviors among adolescent boys living in urban areas in Yasuj, south west of Iran. Methods: This study will be conducted based on six specific steps including a qualitative study, a systematic review, development of appropriate tools, a cross-sectional study, intervention designing, and a feasibility study. The main objective of the qualitative study is to elicit the views and opinions of adolescent boys, their parents, and teachers about sun-protective behaviors. In the second step, factors affecting sun-protective behaviors will be reviewed systematically. Based on the findings of the first and second steps, an appropriate model/theory of behavior change will be selected, and a standardized questionnaire will then be developed. In the fourth step, a cross-sectional survey will be conducted using the developed questionnaire to assess current sun-protective behavior practices. Results: Findings of the first to fourth stages will provide a comprehensive picture of the issue and the affecting factors. During the fifth step, the structure and the content of the intervention package, as well as educational and promotional materials, will be developed and pre-tested. Finally, in the sixth step, a feasibility study will be conducted. Conclusion: This study will provide practical information on the achieving of content and construct of a community-based social marketing intervention. This protocol reports on how to achieve audience-oriented insights for designing a tailored intervention aimed at promoting sun-protective behaviors among adolescent boys using social marketing.

Insights for speed management among Iranian drivers: a social marketing formative research study.

BACKGROUND: Road traffic crashes are among the leading causes of death and disability in the world, particularly in low and middle-income countries. This study aimed at to conduct a social marketing formative research to inform the development of a campaign to manage driving speed on the intercity roads of Iran. METHODS: To carry out the social marketing formative research, a qualitative and quantitative study were conducted. Also, a literature review of the speed management strategies was carried out and an analysis of traffic accident data and speeding violations was performed in selected provinces during 2019 and 2020. RESULTS: Based on the findings of the qualitative study, perceived sense of lack of speed control, poor monitoring system, and law enforcement are the main reasons drivers exceed the speed limit. They mostly suggest using punitive levers and more stringent law enforcement practices for speed management. Literature reviews also confirm that to successfully develop an effective speed management plan a set of measures should be implemented together, including road safety engineering, raising awareness, social marketing strategies, and finally strict law enforcement. The overriding findings of the formative research revealed that to persuade Iranian drivers to respect the speed limit, the messages of the campaign should focus on strict law enforcement in the selected corridors. CONCLUSIONS: In the minds of the Iranian audience, strict law enforcement is of paramount importance for a speed management strategy to work; hence it should be taken into consideration when tailoring the campaign messages. From the findings of the present study, it can be concluded that to manage speed on intercity routes in Iran, a social marketing campaign is needed to encourage compliance with speed limits.

The Iranian National Blood Pressure Measurement Campaign: What Do the Process and Output Evaluation say?

BACKGROUND: The Iranian National Blood Pressure Measurement Campaign (INBPMC) was conducted all over the country to raise awareness in different groups of people regarding the importance of blood pressure and persuading them to manage their blood pressure. The present research aimed at assessing the process and output of this campaign. METHODS: For process evaluation, 31 universities/faculties were selected. Experts from the Ministry of Health and Medical Education assessed the documentation of the campaign implementation using the designed checklist. The output was assessed by including 8274 people and through a telephone survey using the designed instructions. RESULTS: The response rate of the telephone interviews was 82.74% (8274 people). It was found that 79% of the selected groups were aware of the INBPMC. Among them, 64% remembered the messages, 99% of the participants who remembered the messages agreed with those messages, and 89% of the participants who agree with the messages went for a measurement of their blood pressure. In the telephone interviews, 30% of the participants stated that they were diagnosed with hypertension, 97% of these participants received the required consultations for subsequent care, and 86% of them went to the health service centers to receive care. The process evaluation of the INBPMC indicated that the universities of medical sciences obtained 97% of the score of the checklist. CONCLUSION: The INBPMC was successful and accomplished its objectives.

Development and application of a tool to measure hearing health literacy of young people in the Islamic Republic of Iran.

BACKGROUND: A reliable and valid tool to assess hearing health literacy in Iranian young people is lacking. AIMS: This study aimed to develop a tool to assess the hearing health literacy of young people in the Islamic Republic of Iran and to use the tool to determine the hearing health literacy of a sample of Iranians aged 12-25 years. METHODS: A questionnaire was designed with three skill sections: obtaining health information, evaluating this information and applying it to benefit health. The validity and reliability of the tool were determined. Cluster sampling was used to select 50 urban clusters across the country from which 5000 Iranians aged between 12-25 years old were selected to complete the questionnaire. RESULTS: The final questionnaire had 22 items with scores ranging from 22 to 44. The Cronbach alpha was 0.65, and content validity ratio and index were 0.92 and 0.82, respectively. Of the 5000 questionnaires completed, 4890 were included in the analysis. The mean (standard deviation (SD)) age of the participants was 17 (SD 3) years and 45.9% were males. The mean score on the tool was 30.81 (SD 3.75), indicating inadequate health literacy (score 22-36). Only 137 (2.8%) participants had adequate health literacy (score 37-44). Statistically significant differences in mean hearing health literacy were seen for sex, age, years of education, occupation, marital status and income (P < 0.05). CONCLUSIONS: Given the low level of hearing health literacy in Iranian young people, programmes to improve the ear and hearing health literacy are urgently needed.

Using Social Marketing to Reduce Intention of Cesarean Section in Iranian Women.

INTRODUCTION: In Iran, the rate of cesarean section is three times more than the acceptable rate considered by the World Health Organization. This study aimed at reducing the selection of cesarean section by primigravida through an intervention based on social marketing in Boyer-Ahmad County, Iran, 2015. METHODS: In this field trial, 39 of primigravida women were identified and selected as a target group. Formative research (a quantitative survey and a qualitative study) was done to achieve the social marketing mix. The tailored intervention was developed based on the findings of formative research. The intervention was implemented for one month for pregnant women who had cesarean section intention. Their intention for the cesarean section was studied again one month after the implementation of the intervention. The effectiveness of the intervention was evaluated by the proportion test. RESULTS: The average age of the women was 25.82. All of the women 38.5 percent had a diploma degree and lower than and 61.5 percent had a university degree. Before the intervention, 39 women intended to do Cesarean. The intention of 30 pregnant women was changed significantly one month after the intervention. CONCLUSION: The study showed the effectiveness of an intervention based on consumer-oriented social marketing theory and could be used to reduce Cesarean intention. More studies about related factors of vaginal delivery selection especially from behavioral intention up to behavior are suggested.

Using Social Marketing to Reduce Salt Intake in Iran.

Objectives: WHO has recommended that the average salt intake must be <5 grams per day. However, people consume salt much more in many countries. In this study, we design and implement an intervention based on social marketing model to reduce salt consumption in Yasuj, Iran. Materials and Methods: This study employed a quasi-experimental pretest-posttest with control group design which consisted of a formative research (qualitative-quantitative) and an interventional phase. To collect the qualitative data, six focus group discussions by participating of 66 people were established. The qualitative data were analyzed manually using directed content analysis. In quantitative study, 166 people aged 25-50 years completed a KAP questionnaire, and their average salt intake was determined through measuring sodium in their urine sample. By analyzing the data, marketing mix components were determined for designing an intervention. An educational package (including posters for installing in the kitchen, pamphlets, phone counseling, four educational classes, and brief interventions done by physicians and other health personnel) focused on reducing salt intake and using alternatives was developed. For one month, program was implemented for intervention group. Two months later, KAP survey and measuring the urine sodium were repeated for intervention and control groups. The data was compared for two groups, before and after the intervention by using independent t-test, paired t-tests and repeated measures ANOVA. Results: The qualitative findings showed that most participants agreed that the salt intake was high in Iran. Most of them recommended home-based and family-driven strategies to reduce salt intake, offered using healthier alternatives for salt, and recognized physicians and health care providers in healthcare facilities as the most important to encourage people to reduce salt intake. After the intervention, the mean and standard deviation of KAP were improved significantly in intervention group. The mean salt intake decreased significantly by 3.01 ± 2.38 in the intervention group and repeated measures ANOVA showed significant change over time (P < 0.001) and a significant difference between two groups (P = 0.04). Also, the interaction between time and group was significant (P = 0.001). Conclusion: The mean salt intake among the study population was approximately three times more than the level recommended by the WHO. The social marketing-based intervention succeeded in reducing the salt intake of the study subjects by ~3 grams on average.