Workplace interventions for increasing physical activity in employees: A systematic review.

BACKGROUND: There is scattered evidence of the impact of workplace interventions in improving employees' physical activity. This systematic review was performed to evaluate the strategies of workplace interventions and their effectiveness, as reported in primary studies. METHOD: Primary experimental trials, both randomized controlled trials (RCTs) and non-RCTs, which examined interventions to increase healthy adult employees' physical activity were included in this review. Studies in English or Persian published between 2009 and 2019 with access to full text of resources were considered. Google Scholar, PubMed, Web of Science, Scopus and Cochrane Library, ProQuest (Thesis) and World Health Organization Clinical Trial Registration Databases and Persian databases such as SID, Magiran, IranMedex, Irandoc were searched. All the stages of review were conducted based on PRISMA. RoB and ROBINS-I were used to assess the risk of bias of the primary studies. RESULTS: Thirty-nine studies, with a total of 18 494 participants, met the inclusion criteria. Of these, 22 were RCTs, 17 were non-RCTs. Effective interventions were reported in 15 RCTs and 14 non-RCTs. Four main strategies of interventions were identified, consisting of motivation and support; monitoring and feedback; information and education; and activity. Thirteen different behavior change techniques (BCT) were identified with self-determination theory (SDT) being the most frequent behavior change theory used. CONCLUSION: It seems that a multi-strategy intervention that one of the strategies of which is physical activity in the workplace (Activity), the use of behavioral change theories, especially SDT, may be indicative of a more effective intervention. It is recommended that BCTs be considered when designing physical activity interventions.

Pattern of body mass index, chronic diseases, and physical component of quality of life in a population in North of Iran: A latent class analysis.

Background: Due to the rise of non-communicable diseases (NCDs) and lifestyle changes, this study aimed at determining the subclasses of Iranian adults based on body mass index, some NCDs, and status of physical component of quality of life. Methods: A total of 5207 participants of Amol cohort study were studied in this study. Latent class analysis (LCA) was used to determine the best model with the minimum AIC or BIC. Results: We decided that the 6 latent classes model was the best model. The first class described 35.1% of the participants and was characterized by individuals with no disease status. The sixth class described 0.7% of the individuals and was characterized by individuals exhibiting high probability of body mass index (BMI) equal or more than 25, kidney inadequacy, hypertension, and moderate physical component of quality of life status. Conclusion: This study showed the pattern of body mass index, chronic diseases, and physical component of quality of life. Our findings demonstrated that some risk factors and non-communicable diseases tend to accumulate in some classes, especially classes 5 and 6, and thus the risk of developing these diseases rises along with increase in their clustering abilities. These results point out the critical importance of designing specific preventive interventional programs for these stratums of individuals.

Economic Effects of 1978 Tabas Earthquake (Iran).

BACKGROUND: Natural disasters are one of the most important adverse health events. The earthquake that happened in the city of Tabas in 1978 was ranked third in terms of number of deaths caused by natural disasters over the past 100 years in Iran. This study was aimed to evaluate the economic and human capital consequences of earthquake in Tabas district. METHODS: We used a two percent random sample of Iran Census Dataset from 2006 to run a difference-in-difference study. The difference-in-difference methodology was used to evaluate (1) the mean changes in variables including years of schooling and wealth; (2) the odds changes in primary school completion and literacy of people born (5 or 10 years) post-event versus (5 or 10 years) pre-event in Tabas compared with the same values for those born in the same period of time in the control districts. RESULTS: Differential increase in years of schooling for being born 10 years after the earthquake versus in 10 years before earthquake in Tabas was one-third of a school year less than in the control districts. There were 89.5% and 65.4% decrease in odds that an individual is literate, and 0.26 and 0.104 average decrease in the SES index for those born in Tabas in periods of 5 and 10 years, respectively, compared with control districts. CONCLUSION: Tabas earthquake had negative long-term effects on human capital and wealth. This study can help official authorities to promote educational and economic plans and to implement comprehensive reforms in earthquake-stricken areas.

The trend of national and subnational burden of maternal conditions in Iran from 1990 to 2013: the study protocol.

BACKGROUND: It is widely accepted that maternal mortality is a proxy for maternal health status. Maternal deaths only represent the top of the iceberg; morbidity due to maternal causes apart from maternal mortality, poses a huge burden on women's families. There is an excessive need to widen the research on maternal morbidity. Here, we explain the framework of our study on maternal conditions and their burden in Iran as a part of the National and Sub-national Burden of Diseases (NASBOD) study. METHODS: A systematic search will be carried out for both published and unpublished data on maternal mortality and morbidity reported between 1985 and 2013. Data collected through systematic review and those obtained from national and sub-national surveys will be extracted in a data set. Two statistical models will be applied: Bayesian Autoregressive Multi-level models and Spatio-Temporal Regression models. Models will be used to overcome the problem of data gaps across provinces, years and age groups. DISCUSSION: In order to control and manage maternal conditions and to make more efficient and cost-effective policies, there is an excessive need for data on the burden of such diseases. There are a few sub-national analyses of the burden of disease. In the current study, burden of maternal conditions will be assessed at national and sub-national levels in Iran between 1990 and 2013.  The results of this study are undoubtedly required to provide comprehensive information at the national and provincial levels to administer interventions more effectively, since the priority based policies need regional assessments and comparisons.

Inpatient data, inevitable need for policy making at national and sub-national levels: a lesson learned from NASBOD.

BACKGROUND: Estimating burden of disease, injuries and risk factors is crucial for health policy decision making. The Burden of Diseases (BoD) studies provide data about the magnitude and distribution of health problems among the population at national and sub-national levels. The BoD studies are designed to use secondary data for estimating prevalence and incidence of diseases, injuries and risk factors. However, due to the scarcity of data sometimes it becomes unavoidable to collect data from medical records. Among all needed source of data, including surveys, registries, censuses, inpatient and outpatient data, hospital data are an essential source for BoD studies. Hospital Data Survey (HDS) aims to estimate the prevalence and incidence of diseases and injuries that led to admission to hospitals. This paper aims to describe the required steps for data gathering, sampling, analytical methods, and other needed procedures for HDS. STUDY DESIGN: The designed questionnaire includes demographic data, current health status, diseases, injuries and co-morbidities with their ICD10 codes, curative procedures, and treatment. A pilot study was conducted on 302 medical records from 6 hospitals to evaluate the validity and reliability of the questionnaire. Sampling frame was designed and probability proportional was used after being tested in the pilot study. In the next step, we will collect 367500 medical files from 863 hospitals (0.5% of all inpatient records in hospitals from1996 - 2013). The HDS is the first national study in Iran that is gathering data through an online-offline web-based system based on electronic version of the questionnaire which makes the process of data cleaning and analyses more comfortable.