Cluster analysis of risky behaviors among the youth in Western Iran: Determining correlates and comparing clusters based on severity of disability and attitude toward mental health help-seeking.

BACKGROUND AND AIMS: The objectives of the study were (i) cluster analysis of risky behaviors; (ii) determining correlates; and (iii) comparing clusters with regard to the attitude toward mental health help seeking. METHODS: The current cross-sectional study is a part of the first phase of the Persian Youth Cohort. From October 2014 to January 2017, 2990 individuals from Ravansar City in western Iran completed structured interviews and national and international standard questionnaires. The obtained data were analyzed using two-stage cluster analysis, multinomial logistic regression analysis, and Chi-square test. RESULTS: This model provided three distinct clusters: (i) low-risk group with mild distress, (ii) high-risk group with high distress, and (iii) violent group with medium distress. Some sociodemographic and lifetime psychiatric disorders were the correlates of unhealthy clusters (P < 0.05). Compared to the reference cluster, a higher number of members in unhealthy clusters were suffering from medium to severe disability. Nevertheless, the participants in these clusters were less inclined to mental health help seeking. CONCLUSIONS: More than half of the youth were suffering from suicidal and violent behaviors. Since high-risk participants are less inclined to mental health help seeking, the health policymakers can successfully utilize the results in planning general health programs.

Socioeconomic inequality in dental caries experience expressed by the significant caries index: cross-sectional results from the RaNCD Cohort Study.

INTRODUCTION: Socioeconomic inequality in dental caries among Iranian middle-aged adults remains largely unstudied. This study aimed to measure socioeconomic inequality in dental caries experience and to identify determinants of this inequality. MATERIALS AND METHODS: Data were obtained from the Ravansar Non-Communicable Diseases (RaNCD) Cohort Study. This cross-sectional analysis included 10,002 adults aged 35-65 years. Caries experience was dichotomised based on the decayed, missing and filled teeth (DMFT) of one-third of the population with the highest caries scores (i.e. significant caries index). Socioeconomic status (SES) was calculated using the principal component analysis. The concentration index (CI) was used to quantify the extent of socioeconomic inequality in dental caries experience. Decomposition analysis was conducted to quantify the contribution of each determinant to the observed inequality. RESULTS: The mean DMFT for all individuals was 16.1(SD 9.1). The CI of having significant dental caries was -0.236 (95% CI: -0.0259, -0.213), indicating that having significant dental caries was more concentrated among low-SES individuals. SES (65.6%), age group (24.7%) and female gender (3.7%) were found to have the largest percentage of contributions to the observed inequality in dental caries. CONCLUSION: This study indicates pro-rich inequalities in dental caries experience among middle-aged adults in Iran. The findings highlight the importance of early prevention of dental caries experience before it happens. To mitigate inequalities in dental caries experience, policy interventions should focus on females, older age groups, and low-SES individuals.

Socioeconomic-related inequalities in oral hygiene behaviors: a cross-sectional analysis of the PERSIAN cohort study.

BACKGROUND: Socioeconomic-related inequality in oral hygiene behaviors in Iran is poorly understood. This study aims to measure and decompose socioeconomic-related inequalities in oral hygiene behaviors among middle-aged and elderly adults in Iran. METHODS: A cross-sectional analysis was performed using data from the Prospective Epidemiological Research Studies in IrAN (PERSIAN), a large national cohort study. A total of 130,016 individuals aged 35 years and above from 17 cohort centers in Iran were included in the study. The normalized concentration index (Cn) was used to measure the magnitude of inequality in oral hygiene behaviors, i.e. brushing at least twice and flossing once daily, among middle-aged and elderly Iranian adults included in the cohort centers. Decomposition analysis was performed to quantify the contribution of each determinant to the observed inequality in oral hygiene behaviors. RESULTS: Totally, 65.5% of middle-aged and elderly adults brushed their teeth twice a day or more, 7.6% flossed at least once a day and 3.48% had both habits. The estimated Cn of the two habits combined, i.e. tooth brushing and dental flossing, for all provinces taken part in the PERSIAN cohort study was 0.399 (95% confidence interval [CI]: 0.383 to 0.417), indicating that the prevalence of the two habits combined is more concentrated among individuals with higher socioeconomic status. Inequality in oral hygiene behaviors was pro-rich in all cohort centers. The decomposition results suggested socioeconomic status as the main factor contributing to the overall inequality, followed by the level of education, and the province of residence. CONCLUSION: A low prevalence of oral hygiene behaviors among middle-aged and elderly Iranian adults was observed. There was also a pro-rich inequality in oral hygiene behaviors among middle-aged and elderly adults in all cohort centers. These results suggest an urgent need for targeted policy interventions to increase the prevalence of preventive oral hygiene behaviors among the poor and less-educated middle-aged and elderly adults in Iran.

Prevalence of Psychiatric Disorders and Associated Factors among the Youth in Ravansar, Iran.

BACKGROUND: Mental disorders contribute significantly to the burden of diseases in Iran. Therefore, the current study aims to assess the prevalence of psychiatric disorders and their associated factors among youth in Kermanshah province of Iran. METHODS: The current study is a part of the first phase of Ravansar Cohort (a part of the PERSIAN Youth Cohort) including 2991 participants aged 15 to 34 from Ravansar district in western Iran. Enrollment and data collection for this phase were performed from end April 2015 to early April 2017. The data were gathered using structured interviews and national and international standard questionnaires. Data analysis was carried out using multinomial logistic regression and chi-square test. RESULTS: The prevalence of any psychiatric disorder among the selected population was 31.3%. Major depressive disorder (MDD) (21.6%), followed by generalized anxiety disorder (GAD) (6.4%) and dysthymia (1.9%) were the most prevalent disorders among the study individuals. The prevalence of alcohol and opioid/stimulant use disorders was 4.6% and 5.1%, respectively. Moreover, there was significant relationship between location of residence (city or village) and marital status with prevalence of the disorders. CONCLUSION: Based on the results of the current study, it can be concluded that the prevalence of mental and psychiatric disorders among the youth in Ravansar district, western Iran is relatively high and needs specific plans and interventions to control it.

Measuring and Decomposing Socioeconomic Inequalities in Adult Obesity in Western Iran.

OBJECTIVES: Obesity is a considerable and growing public health concern worldwide. The present study aimed to quantify socioeconomic inequalities in adult obesity in western Iran. METHODS: A total of 10 086 participants, aged 35-65 years, from the Ravansar Non-communicable Disease Cohort Study (2014-2016) were included in the study to examine socioeconomic inequalities in obesity. We defined obesity as a body mass index ≥30 kg/m2 . The concentration index and concentration curve were used to illustrate and measure wealth-related inequality in obesity. Additionally, we decomposed the concentration index to identify factors that explained wealth-related inequality in obesity. RESULTS: Overall, the prevalence of obesity in the total sample was 26.7%. The concentration index of obesity was 0.04; indicating that obesity was more concentrated among the rich (p<0.001). Decomposition analysis indicated that wealth, place of residence, and marital status were the main contributors to the observed inequality in obesity. CONCLUSIONS: Socioeconomic-related inequalities in obesity among adults warrant more attention. Policies should be designed to reduce both the prevalence of obesity and inequalities in obesity by focusing on those with higher socioeconomic status, urban residents, and married individuals.

Cluster analysis of psychiatric profile, its correlates, and using mental health services among the young people aged 15-34: findings from the first phase of Iranian youth cohort in Ravansar.

PURPOSES: (1) Cluster analysis of psychiatric disorders and partitioning the youth; (2) determining socio-demographic correlates and parental histories for each one of the clusters; and (3) comparing clusters based on the extent and type of using psychotherapeutic services. METHODS: The current cross-sectional study is a part of the first phase of PERSIAN Youth Cohort. The sample of the study includes 2991 participants aged 15-34 (27 ± 5.1 years, 55.6% female) from Ravansar district in western Iran. Enrollment and data collection for this phase were performed from October, 2014 to January, 2017. The data were collected through structured interviews, including the Composite International Diagnostic Interview (CIDI; version 2.1), mental health-related Sheehan Disability Scale, and Service Use Questionnaire. The obtained data were analyzed using two-step cluster analysis, multinomial logistic regression, and Chi-square test. RESULTS: Our model proposed three clusters: a clinical cluster with significant mental disability; a healthy cluster with significant disability; and a healthy cluster with mild disability. There is a direct relationship between widow/divorced marital status and psychiatric maternal history with the clinical cluster (P < 0.05). Clinical and non-clinical clusters with medium to severe disability used services for mental health more often that the healthy cluster with mild functional disability (P < 0.05). CONCLUSIONS: The results of the study show that 28.7% of the youth in the general population of western Iran are suffering from psychiatric disorders and nearly two-thirds of the total population reported a medium-severe functional disability. Considering the wide range of mental disorders and the functional disability levels created by these disorders, cluster analysis could provide invaluable information regarding the partitioning of the youth population.