Sh Hasanzadeh, H Sadeghi Bazargani , M Hashemiparast, M Asghari Jafarabadi ,
Volume 15, Issue 4 (1-2020)
Abstract
Background and Objectives: The aim of this study was to determine the predictability of the PLS-SEM model for injuries resulting in hospitalization in motorcyclists using a mediator variable in a case-control study.
Methods: In this case-control study, 300 cases and 156 controls were randomly selected from 150 clusters using random cluster sampling. The data were collected using the motorcycle riding behavior (MRB) questionnaire, adult attention deficit hyperactivity disorder (ADHD) questionnaire (subscales) and a checklist containing motorcycle related variables.
Results: The motorcycle riding behavior, adult ADHD, motorcycling related variables and some demographic variables were found to be the predictors of injury. There were significant positive relationships between injury and motorcycling related variables (B=0.20, P=0.001) and ADHD (B=0.33, P=0.001), between MRB and motorcycling related variables (B=0.51, P=0.001) and ADHD (B=0.52, P=0.001), and between ADHD and motorcycling related variables (B=0.39, P=0.001).
Conclusion: Considering the more accurate results of PLS-SEM, the intervention programs should especially address those who have hyperactive children, those who use the cellphone while riding, and those who ride in dark hours of the night.
M Rezaei, N Fakhri, S Shahsavari, F Rajati,
Volume 15, Issue 4 (1-2020)
Abstract
Background and Objectives: Gestational Diabetes Mellitus (GDM) is the most common metabolic disorder in pregnancy. In case of early detection, some of its complications can be prevented. The aim of this study was to investigate early prediction of GDM by logistic regression (LR), discriminant analysis (DA), decision tree (DT) and perceptron artificial neural network (ANN) and to compare these models.
Methods: The medical files of 420 pregnant women (2010-12) in Kermanshah health centers were evaluated using convenience sampling. Demographic data, pregnancy-related variables, lab tests results, and a diagnosis of GDM according to a fasting blood sugar level of 92 or more were collected from their files. After fitting the four models, the performance of the models was compared and according to the criteria of accuracy, sensitivity and specificity (based on the ROC curve), the superior model was introduced.
Results: Following the fitting of LR, DA, DT and perceptron ANN models, the following results were obtained. The accuracy of the above models was 0.81, 0.83, 0.78 and 0.83, respectively, the sensitivity of the models was 0.50, 0.63, 0.58 and 0.58, the specificity of the models was 0.96, 0.93, 0.87 and 0.94, and the area under the ROC curve was 0.86, 0.78, 0.73 and 0.87, respectively.
Conclusion: In predicting and categorizing the presence of GDM, the ANN model had a lower error rate and a higher area under the ROC curve compared to other models. It can be concluded that this model offers better predictions and is closer to reality than other models.
M Asghari Jafarabadi , L Karimi, F Rahimi Bashar , A Vahedian Azimi ,
Volume 15, Issue 4 (1-2020)
Abstract
Background and Objectives: Progressive muscle relaxation (PMR) training as part of an educational program for patients involved in pathologic and physiological events (PPE) can have important physiological and psychological benefits for the patients, and can affect various dimensions of their lives including the quality of life. This systematic review and meta-analysis was conducted to determine the effect of PMR on the quality of life of patients involved in PPE.
Methods: Through searching the words “PMR” and “quality of life (QOL)” in Persian databases including SID, MagIran, IranMedex, and IranDoc and international databases including Google Scholar, Scopus, PubMed, Web of Science, ProQuest, and ScienceDirect, all studies published on the effect of PMR on the QOL were extracted. The methodological quality of the papers was examined using Cochrane risk of bias. Data analysis was carried out using a random-effects model and heterogeneity was assessed by I2. The data were analyzed using the STATA software version 14.0.
Results: Of 495 studies, only 10 explored the effect of PMR on the QOL of patients. The pooled mean of the QOL and all dimensions were statistically significant, including physical functioning (0.339), physical role limitation (0.378), bodily pain (0.341), general health (0.598), social functioning (0.873), mental health (0.736), emotional role limitation (0.791), vitality (0.706), total physical dimensions (0.652), total mental dimensions (1.316), and total QOF score (0.480). Only one study had a low risk of bias.
Conclusion: Implementation of PMR has a significant effect on the quality of life of patients involved in PPE. PMR is recommended to improve the QOL of the patients.
E Ghaderi, Gh Moradi, S Sharafi, Kh Rahmani, Sh Ahmadi, B Mohsenpour, M Nasehi,
Volume 15, Issue 4 (1-2020)
Abstract
Background and Objectives: Over the past decades, the Iran’s anti-tuberculosis campaign has become highly structured and many achievements have been made. The purpose of this study was to describe the characteristics of the TB surveillance system and its components in the Islamic Republic of Iran.
Methods: The data of this study were obtained from the surveillance system of the Center for Communicable Disease Control, a review of the records, documents, books and published articles, and also interviews with process owners and experts of TB surveillance during 2017-2019.
Results: Case finding and treatment and follow-up of TB patients and their household contacts are done In the TB surveillance system. The implementation of the DOTS, (DIRECTLY OBSERVED TREATMENT SHORT-Course) is a major component of the TB surveillance system. Patient registration is done in an online application, which allows extracting and reporting the important indicators of the program. In this surveillance system, there is a special sensitivity to the treatment of patients, so the incidence of multi drug-resistant TB in the country is lower than that of the neighbors. The presence of regional laboratories that cover the entire region of the country is one of the strengths of the TB surveillance program in Iran.
Conclusion: Despite budget problems, the anti-TB program in Iran has many achievements. However, new strategies need to be considered to reduce the incidence of TB.
N Moghimi, Gh Moradi, Sh Amiri, A Saeedi,
Volume 16, Issue 1 (6-2020)
Abstract
Background and Objectives: Rheumatoid arthritis is a chronic, progressive disease of the joints that presents with articular and systemic symptoms. The purpose of this study was to determine the quality of life in patients with rheumatoid arthritis and its relationship with body mass index.
Methods: This descriptive-analytical study was performed in 195 patients with rheumatoid arthritis in Tohid Hospital, Sanandaj, Iran. The data collection tool was a questionnaire including demographic and clinical characteristics. The SF-36 instrument was used to evaluate the quality of life.
Results: In the study, 40% of men and 58% of women had a disease severity higher than 2.6 according to the Disease Activity Score 28. There was a significant difference in all dimensions of quality of life including physical function, energy / fatigue and general health between men and women (P <0.05). All dimensions of quality of life were inversely correlated with BMI. There was a significant relationship between the disease severity and each of the dimensions of pain, general health and general changes (P <0.05).
Conclusion: Quality of life in patients with rheumatoid arthritis is correlated with body mass index and severity of rheumatoid arthritis; therefore, it seems that health policy makers or clinical practitioners need to pay more attention to these two factors to increase the patients’ quality of life.
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Volume 16, Issue 1 (6-2020)
Abstract
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M Etemadi, A Olyaeemanseh, Mm Tadayon, E Rostami, M Shiri, Aa Fazaeli , Mj Kabir, A Mehrabi Bahar, A Vosough Moghadam ,
Volume 16, Issue 1 (6-2020)
Abstract
Background and Objectives: The study aimed to analysis the psychometric properties of the health system resilience scale, assessing it and to introduce a conceptual model for qualitative analysis of Iran health system in the face of the civid-19 crisis.
Methods: In this Mixed-method study, the determination of face and content validity was performed using 8 experts. The structure validity was investigated in a cross-sectional study through an electronic survey of 178 actors in the Iran health system. Resilience has been assessed in five dimensions using 5point Likert scale.
Results: The percentage mean score of the Iranian health system resilience in the face of the Covid19 crisis was 41/08 and in the moderate level. The percentage mean score (standard deviation) for 5 dimension include awareness 39/2 (21), diversity 38/7 (21), self-regulation 36 (20/6), integration 39/9 (21/5) and adaptation 41/2 (21/8). Confirmatory factor analysis indicated the appropriate fit of the information with the five-component structure.
Conclusion: The maximum score of resilience dimension belongs to adaptation and the lowest to the self-regulation indicating that it requires interventions to involve the private sector, and to design a new delivery system for crisis situations. The questionnaire can be used as a standard instrument for assessing the health system resilience.
B Moatamedizadeh, H Ansari, A Payandeh, Sm Tabatabae, A Ramazanpouramirdehi,
Volume 16, Issue 1 (6-2020)
Abstract
Background and Objectives: In addition to effective treatment, tuberculosis recurrence is a very important challenge regarding the treatment of this infection. This study was conducted to evaluate the risk factors associated with tuberculosis recurrence.
Methods: In this nested case-control study, 202 tuberculosis patients with recurrence and 202 matched controls in terms of age, sex and place of residence were studied. The cases and controls were selected from a cohort of tuberculosis patients in Sistan and Baluchestan province between 2011 and 2018. The data were collected using interviews and patients’ records. The independent t-test, chi-square and multiple conditional logistic regression were used to analyze the data.
Results: The drug abuse history (OR=6.1), 3+ smear positive (OR=3.03), chest X-ray suggestive of tuberculosis (OR=4.9), drug resistance (OR=7.3), low socioeconomic status (OR=3.9), weight loss (OR=3.1), chest pain (OR=3.2), history of digestive disease (OR=22.1), smoking (OR=6.1), and imprisonment (OR=3.7) significantly increased the chance of recurrence among tuberculosis patients (p<0.05). On the other hand, the chance of recurrence was significantly lower in patients with coughs (OR=0.29) and a small family size (OR=0.28).
Conclusion: According to the results, tobacco use, drug use, low socio-economic status, life conditions, and disease conditions are the most important determinants of tuberculosis recurrence. In general, epidemiologic factors related to tuberculosis recurrence are not similar in different regions; therefore, educational programs for patients and their families and prevention methods should be considered based on related factors in different regions.
E Mostafavi, Gh Moradi, Kh Rahmani, F Jahanbakhsh, S Eybpoosh, M Keypour, E Ghaderi, H Erfani, K Hajibagheri, M Zeinali, M Khodabandehloo, M Shirzadi,
Volume 16, Issue 1 (6-2020)
Abstract
Background and Objectives: The purpose of this study was to present a summary of the rabies surveillance program in humans in the country, its achievements and its strengths and weaknesses.
Methods: This study was a review of the country's plan for surveillance and control of rabies in humans. The sources of information included the data, reports, documents, and published guidelines. The viewpoints of stakeholders and experts were also reviewed in this study.
Results: Since rabies is a zoonotic disease, its effective management requires a good collaboration between several organizations. Moreover, because Iran is located in an endemic region, there is a need for the development of regional and international cooperation for the success of disease prevention, control and management. Animal services for biting and rabies control are provided free of charge in more than 700 centers in the country. Major achievements of the program include timely preventive treatment for animal bite cases, knowledge of the geographical distribution of the disease, identification of high-risk provinces, and decreasing the percentage of human deaths.
Conclusion: The program has performed well for rabies secondary prevention. Some aspects of the program, however, still need to be improved, including improvement of educational programs targeting general population and high-risk groups, animal bite prevention, vaccination of domestic dogs, controlling the population of stray dogs, rabies control in wild animals, and proper waste collection and disposal.
M Saberi, M Hosseinpour , A Khaleghnejad Tabari, H Soori, Mr Maracy,
Volume 16, Issue 1 (6-2020)
Abstract
Background and Objectives: Congenital anomalies are also known as birth defects and congenital disorders. Congenital anomalies occur in about 3-7% of the newborn babies worldwide. The purpose of this study was to determine the incidence of congenital anomalies and their determinants in hospitals affiliated with Isfahan University of Medical Sciences in 1395.
Methods: This cross-sectional study was conducted in all infants born in 1395. The data were analyzed with the SPSS software version 20 using Binary logistic regression.
Results: Of 5455 births in Isfahan hospitals, 121 neonates were diagnosed with major congenital anomalies. The total incidence of major congenital anomalies was 2.2 per 100 births. The results showed a statistically significant relationship between maternal blood group, consanguinity, sex and height of infant with congenital anomalies in newborns (P <0.05). Moreover, 26.7% of all abnormalities were related to limbs and the lowest percentage was related to genetic abnormalities, digestive system, anus, and spine with an incidence of 0.7% for each.
Conclusion: More attention should be paid to premarital genetic counseling in order to identify the consanguinity factor as a risk factor for genetic abnormalities. Moreover, pregnant women should be educated about the timely intake of micronutrients to control abnormalities.
S Rahmani, M Karami, , M Adabi, A Doosti Irani,
Volume 16, Issue 1 (6-2020)
Abstract
Background and Objectives: After the introduction of the pneumococcal vaccine, an increase has been observed in the disease due to nonspecific stereotypes of the vaccine. This study was conducted to determine the spatial distribution of pneumococcal vaccine coverage and common stereotypes of streptococcus pneumonia after vaccine introduction in the vaccine recipient countries.
Methods: The Web of Sciences, Medline, and Scopus were searched using a designed search strategy. Studies that reported the prevalence of the stereotypes of streptococcus pneumonia and replacement of the stereotypes were included. In addition, the coverage of pneumococcal vaccination in the countries was extracted from the reports of the World Health Organization. The spatial distribution of vaccine recipient countries and vaccination coverage were determined using the ArcGIS 10.6.1.
Results: Of 6989 retrieved references, 325 studies were included. The highest proportion of vaccine recipient countries were in the African, European and Western Pacific regions. The vaccination coverage increased up to 2017 in the vaccine recipient countries. The common specific vaccine serotypes after the introduction of vaccine were 19A, 5, 3, 14, 19F, 7F, 23F, 6B. In addition, common nonspecific vaccine serotypes were 11A, 15A/B, 8, and 12F.
Conclusion: The results indicated pneumococcal vaccination is not included in the immunization program in many countries. In addition, common serotypes after vaccine introduction of include 19A, 5, 3, 14, 19F, 7F, 23F, 6B. Therefore, it is recommended the health policymakers have a plan for pneumococcal vaccine introduction based on the pattern of the commonly detected stereotypes.
M Amini, A Kazemnejad, F Zayeri, A Amirian, N Kariman,
Volume 16, Issue 1 (6-2020)
Abstract
Background and Objectives: Gestational diabetes mellitus (GDM) is a medical problem in pregnancy, and its late diagnosis can cause adverse effects in the mother and fetus. The purpose of this research was to estimate the accuracy parameters of a biomarker for early prediction of gestational diabetes in the absence of a perfect reference standard test.
Methods: This study was conducted in 523 pregnant women who presented to Mahdieh Hospital and Taleghani Hospital affiliated with Shahid Beheshti University of Medical Sciences, Tehran, Iran 2017-2018. As a predictor for detecting GDM, beta- human chorionic gonadotropin (β-hCG) measurements were recorded during 14-17th weeks’ gestation in a checklist. The Bayesian latent variable model was used to estimate the sensitivity, specificity, and area under receiver operating characteristic curve (AUC). Bayesian parameter estimation was calculated using the R2OpenBUGS package in R version 3.5.3.
Results: The median gestational age was 33 years. In the absence of a perfect reference test, the applied model had a sensitivity, specificity, and AUC of 78% (95% credible interval (CrI): 0.66-0.83), 83% (95% CrI: 0.74-0.89), and 0.72 (95% CrI: 0.64-0.88) for β-hCG, respectively.
Conclusion: According to the results of this study, β-hCG may be an acceptable biomarker for early diagnosis of diabetes in pregnant women in the absence of a perfect reference test.
M Karami, Kh Rahmani, Gh Moradi, Mm Gouya, A Sabouri , K Entezar Mahdi , Gh Kamali, Sm Zahraei,
Volume 16, Issue 1 (6-2020)
Abstract
Background and Objectives: Elimination and eradication of measles requires designing and implementing an enhanced surveillance system. The purpose of this study was to review the measles surveillance system in Iran.
Methods: The data of this study were obtained from the surveillance system of the Center for Communicable Disease Control; a review of the records, documents, books, and published articles; and interviews with process owners and experts of measles surveillance in 2017-2019.
Results: Iran has a surveillance plan to eliminate the measles. The current design for suspected cases of measles in Iran is a case-based surveillance system, in which for each identified case with fever and maculopapular rashes, some activities such reporting, laboratory confirmation, clinical and epidemiological investigation and case registration in individual forms are done.
Conclusion: Complete surveillance of cases suspicious of measles and high coverage of vaccination in children less than 2 years in a cohesive surveillance system and rapid response to the outbreak have led to lack of occurrence of indigenous measles in Iran. Although the current status of the measles surveillance system in Iran seems to be favorable, since Iran is at the stage of measles elimination, it is essential to increase the sensitivity of the reporting system for suspected cases of measles and to maintain the status of vaccine coverage to save elimination status.
S Aghamohamadi, A Khosravi, E Kazemi, A Atefi,
Volume 16, Issue 1 (6-2020)
Abstract
Background and Objectives: A large proportion of the data of cause of death is registered in hospitals in Iran. Assessment of the death data can help to identify the problems of cause of death registration system and improve it. Therefore, this study was conducted to review the quality of cause of death registration in Iranian hospitals in 2016.
Methods: All hospital deaths in 2016 were reviewed and classified by age group and sex using the Ministry of Health’s death registration system. Analysis of Causes of National Deaths for Action (ANACONDA) was used to evaluate the quality of the data of cause of death.
Results: About 24% of the recorded hospital deaths were assigned to garbage code categories. The highest percentage of this group was seen in the age group over 70 years old and the highest percentage of well-defined causes of death was seen in the age group below one year. Moreover, among the five groups of garbage code causes of death, the group with insufficient details of the cause of death based on ICD classification had the highest percentage in all age groups.
Conclusion: Since a substantial proportion of the causes of deaths registered in the Iranian hospitals are categorized in the garbage code categories and cannot be used for planning and health policy making, it is necessary to design a comprehensive plan to implement interventions such as implementation of process evaluation programs and training programs for physicians and coders.
H Choobineh, Gh Danesh, N Mansouri, M Najafi Majareh , F Shahbazi, Ss Hashemi Nazari ,
Volume 16, Issue 2 (8-2020)
Abstract
Background and Objectives: The purpose of this study was to investigate the status of HSE indices in a number of organizations affiliated with Tehran Municipality.
Methods: In this cross-sectional study, the study population included all organizations affiliated with Tehran Municipality HSE performance was assessed through an 18-item checklist. The content validity of this checklist was examined by obtaining the opinions of experts in the field. The data of this study were analyzed using the SPSS software version 22.
Results: The results of this study showed that three organizations, namely Suburbs Bus Company, Urban Planning Organization, and Terminals and Parks Organization had the best HSE performance with indexes of 63.6%, 57.485 and 52.59%, respectively. Among the 18 items of HSE performance, the HSE policy had the highest score (68.6%).
Conclusion: Based on the findings of this study, the value of the HSE index was not complete in any of the fields. The results of this study showed that although the foundation of the HSE system was implemented in many units of Tehran Municipality, it is still a long way before the desired point is reached. Therefore, it is necessary to formulate and implement appropriate action plans and to evaluate the effectiveness of control measures to improve the HSE indicators.
Mm Gouya, Sm Zahraei, Gh Moradi, M Karami, S Mahmodi, Sh Shah Mahmoodi , E Ghaderi, F Kaveh, A Norouzinejad , K Hajibagheri, Kh Rahmani,
Volume 16, Issue 2 (8-2020)
Abstract
Background and Objectives: : According to the global strategy for polio eradication, targeted surveillance of the disease is one of the main tasks of the health system. The purpose of this study was to review the status and surveillance of poliomyelitis/acute flaccid paralysis (AFP) in Iran.
Methods: The present study was a review on the processes, structures and achievements of the poliomyelitis/AFP surveillance system in Iran during 2017-2019. The data of this study were obtained from the surveillance system of the Center for Communicable Disease Control; a review of the records, documents, books and published articles; and interviews with process owners and experts of poliomyelitis/AFP surveillance.
Results: The polio eradication program in Iran is based on the action plan of the World Health Organization that was introduced initially in 1988. Currently, the surveillance system of AFP is active at three levels: country, university, and city. The number of poliomyelitis cases in the country decreased from 50 cases per year in 1985 to zero in 2001, and Iran has been a polio-free country since 2001. The final report on polio eradication in Iran was approved by the regional commission on polio detection in April 2006.
Conclusion: The surveillance system of AFP has had a proper effectiveness throughout the country. Maintaining this situation in the country requires an increase in the sensitivity of the surveillance system of the disease, regular monitoring of vaccine coverage, strict implementation of international health regulations, especially on the eastern borders of the country, and providing technical assistance to neighboring countries.
E Abdalmaleki, Zh Abdi, M Gohrimehr, R Alvandi, S Riazi Isfahani , E Ahmadnezhad ,
Volume 16, Issue 2 (8-2020)
Abstract
Background and Objectives: One of the data sources for monitoring the progress towards Sustainable Development Goals and Universal Health Coverage (UHC) is household surveys such as Multiple Indicator Cluster Survey (MICS) and Demographic and health Survey (DHS). This study was conducted to assess the implementation of these surveys in the Eastern Mediterranean Region (EMR) to evaluate the experience of Iran in conducting these surveys and to propose one of them as the best option for implementation in Iran.
Methods: In this review article, by reviewing the databases of the relevant organizations, the implementation history, instructions, protocols, and the generated indicators of these two surveys were assessed.
Results: So far, 26 standard DHS and 56 standard MICS have been implemented in the EMR. Iraq implemented the highest number of MICS and Egypt carried out the highest number of DHS. In the global reports, no DHS/MICS surveys were conducted in Iran after 2000 However, according to the official reports, Iran conducted two rounds of a survey called MIDHS (a combination of DHS and MICS) in 2010 and 2015.
Conclusion: The EMR has performed well in implementing these surveys. According to the findings, DHS is more suitable for Iran. However, right now, what is important is not to decide which survey to be conducted. Considering the international commitments for monitoring the progress towards UHC, it is important to conduct either one in 2020 in Iran.
M Hadian, M Tajvar, Ms Yekani Nejad , M Arab,
Volume 16, Issue 2 (8-2020)
Abstract
Background and Objectives: The main purpose of this study was to compare the predictive power of the Inequality-adjusted Human Development Index (IHDI) with the Human Development Index (HDI) with regard to the share of deaths caused by Non-Communicable Diseases (NCD) among all deaths in the world and Iran.
Methods: The data required for this cross-sectional ecological study were extracted from the reports of the United Nations Human Development Program and the WHO in 2015. Pearson correlation test was used to investigate the correlation of HDI and IHDI with the share of deaths caused by NCDs and linear regressions models were used to determine the associations of IHDI and HDI with the dependent variable.
Results: At a significant level of P<0.01, the dependent variable showed a strong positive correlation with HDI (0.892) and IHDI (0.899). Simple linear regression showed that HDI alone predicted the dependent variable well (Adj.R2=0.794, P<0.001).However, according to the multivariate linear regression model, when IHDI and HDI were included in the model, IHDI was able to predict the dependent variable well (Adj.R2=0.809, P=0.001), while the relationship between HDI and the dependent variable was no longer significant.
Conclusion: Although HDI alone is an important predictor of NCD status, it loses its influence in the presence of IHDI. Therefore, in addition to HDI, IHDI that illustrates the impact of inequality on human development can provide more information on the status of deaths caused by NCDs.
A Mehri, M Yaseri, D Rahimi, S Nejat,
Volume 16, Issue 2 (8-2020)
Abstract
Background and Objectives: Self-confidence is an individual characteristic in students that enables them to have a positive or realistic view of themselves. The purpose of present study was to evaluate the validity and psychometric properties of the Self-confidence Questionnaire (PEI)
Methods: This cross-sectional study was conducted on 100 students of four medical universities. Validation of this questionnaire included the steps of translation, content validity, face validity, repeatability and internal consistency.
Results: The mean age of the participants in this study was 32.1 (SD = 5.5) years. The majority of the students were postgraduate students (47%) and the least (11%) were undergraduate students. The results of this study showed that the overall relevancy and clarity of the questions were 92% and 83%, respectively. The percentage of agreement on overall comprehensiveness was 100%. Cronbach's alpha coefficient and interclass correlation coefficient were higher than 0.7 in all domains. The ICC of each question was also between 0.72 and 0.98.
Conclusion: Based on the results of this study, the Persian version of the PEI questionnaire has an appropriate reliability for use in the student population of Iranian universities.
F Amini, A Abadi, M Namdari, Z Ghorbani, S Azimi,
Volume 16, Issue 2 (8-2020)
Abstract
Background and Objectives: Cancer is a complex disease with a lengthy and expensive course of treatment that causes many problems for the community. Knowledge of oral cancer plays an important role in early diagnosis. The aim of this study was to determine the level of knowledge about the symptoms and risk factors of oral cancer and assess the related factors.
Methods: In this study, 671 parents of primary school children were randomly selected from primary schools in four districts of Tehran. The participants were asked to answer questions related to demographic characteristics and knowledge of the risk factors and symptoms of oral cancer. Data analysis was done using Poisson regression model and multi-level Poisson regression model using SPSS and STATA software. The AICI Akaike Information Criterion (AIC) was applied to evaluate the models.
Results: The mean score of knowledge was 3.7 with a standard deviation of 6.7. Among the studied variables, female gender, advanced age, a higher SES score, and a higher welfare index had positive effects on oral cancer knowledge (P <0.05).
Conclusion: The results of this study showed that demographic, social and economic factors of parents were effective on oral cancer. It can be statistically concluded that a multilevel Poisson regression model is more suitable for analyzing this data.
