Iranian Journal of

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Background & Objectives: Ecstasy is a methamphetamine derivative becoming increasingly popular throughout the world, particularly among adolescents and young adults. Iran, situated between eastern and western societies, can serve as a significant source of information on ecstasy use and on the users' profile. The purpose of this study was to determine the prevalence of ecstasy use and high-risk behavior among high school students in Lahidjan.
Methods: We conducted a cross-sectional study of a representative sample drawn from high school students of Lahidjan in 2005, using multi-stage stratified random sampling. The study questionnaire was administered to 2345 students in grades 8 through 12. The questionnaire was adapted from that used in "Monitoring the future" projects in the United States and ESPAD (The European School Survey Project on Alcohol and other Drugs). It included questions on demographic characteristics, family profile, social contacts, school life and the use of drugs. Data analysis was done with the SPSS software (version11.5), using χ2 tests and logistic regression methods.
Results: Of the 2345 students selected for the study, 2328 (92%) responded. Of these, 1327 (57.8%) were males and 970 (42.2%) were females. Lifetime prevalence of ecstasy use was 2.4% (55 students) 31 subjects had used ecstasy within the past month and 24 students reported using the substance in the preceding year. Ninety-two subjects (4.2%) had experience with other drugs. In χ2 tests, ecstasy use was significantly associated with gender, use of other substances, cigarette smoking, partying with friends, family structure and poor school performance in the past. There was no association with age, type of school (private or public) or the family's education level. In logistic regression, factors influencing ecstasy use were the use of other drugs, cigarette smoking and partying with friends (p< 0.0001).
Conclusions: Ecstasy use appears to be a serious problem in high schools. Whatever the causes behind the rise in ecstasy use, personalized and informative educational interventions should be organized in all schools.

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Background & Objectives: Malnutrition is widely regarded as one of the factors affecting quality of life. The adverse effects of malnutrition have been documented in various age groups. School problems, learning difficulties, humiliation and teasing from peers are some of the most common complications of obesity and excessive thinness. The goal of this study was to determine the BMI and some of the factors affecting it in the students of Dezfool.
Methods: In a cross-sectional study and using random cluster sampling, 5726 students from 39 clusters were selected and anthropometric measurements were performed in the schools and under standard conditions. Cases of obesity and thinness were identified using BMI percentiles for age and sex (NCHS). A Body Mass Index above the 95th and below the 5th percentile was defined as obesity and thinness respectively.
Results: This study involved the participation of 5508 students (96.2%). The prevalence of thinness was 33% (1716) with a 95% confidence interval of 27.3%-38.8%. The prevalence of obesity was 2.6% (157) with a 95% confidence interval of 1.7%-3.4%. There was no significant difference between the prevalence of obesity or thinness between the two sexes (P>0.05). The prevalence of obesity and thinness significantly increased and decreased respectively with aging (P<0.05).
Conclusions: Malnutrition among the students in Dezfool predominantly takes the form of thinness, while obesity is not a serious problem in this population overall, these findings indicate poor nutritional status. High-risk groups have been identified and they must become the target of interventions by the Health and Education Ministries.

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Background & Objectives: The youth group is more prone to HIV infection. Education is a cornerstone to prevention. This study was conducted to compare the efficacy of peer education and traditional lectureship and distribution of pamphlet on high school students.
Methods: 1500 female high school students, third graders, were selected based on stratified random sampling studying in 21 high schools in Kermanshah. In each high school, 73 third grades were selected as the sample of the study. We designed a questionnaire as an assessment tool for interventions. Peer education was done by 502 students, and AIDS awareness pamphlet was distributed on 500 students, and the rest of students were attended a one-day workshop which was ran by a female physician in their high school.
Results: The mean average age was 16.78 (SD= ± 0.7) years. The mean scores of pretest and post-test in each groups were statistically significant different (P=0.0001). Mean score of difference in workshop by female physician was greater than peer education group, 10.7 and 8.8, respectively. The group whome received their knowledge about AIDS by pamphlet obtained the least mean score than other groups and this was statistically significant (P=0.0001).
Conclusions: The findings of this study indicate that educating students by general practitioners is more effective way to increase students’ knowledge about prevention of AIDS.

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Background & Objectives: Cytomegalovirus (CMV) is a one the cause of congenital illness and disability, including hearing loss and mental retardation. CMV is a herpesvirus which establishes a persistent life-long infection. Since the prevalence of antibodies against the virus varies in different geographical areas in the world, we decided to identify the seroepidemiology of CMV infection.
Methods: A descriptive study was conducted among 360 volunteer asymptomatic healthy female students in Islamic Azad University of Kazeroun. The men age of subjects was 20.8 years. For serological studies five (ml) of blood sample was collected and the serum was isolated by centrifugation. Enzyme linked immunosorbent assay (ELISA) was used for determination of immunoglobulin G (IgG) and immunoglobulin M (IgM) antibodies of CMV. Finally the results were analyzed by statistical methods.
Results: Overall, CMV-IgG antibody was positive in 340 persons (94.4%) out of 360 subjects and they have a previous infection. However, Only four persons (1.1 %) were determined to have IgM antibody. Also we couldn’t find any significant difference concerning their fields of study and their residency (p>0.05).
Conclusions: With considering the high rat of CMV infection rate in young female, it is suggested to have appropriate preventive programs for women particular in susceptible groups.

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Background & Objectives: Food security (access to safe, nutritious, affordable food) is one of the important determinants of health status in human life. Since monitoring and assessing of associated factors to food security are essential for health planning, this study has tried to determine household food security status and food consumption amongst high school student families in Esfahan, Iran.
Methods: This cross-sectional study was conducted in autumn 2008 on 580 high school 14-17y students of Esfahan, Iran using a systematic cluster sampling. Food security and food frequency questionnaire were completed by interviewing mothers and students.
Results: The prevalence of household food insecurity was estimated as 36.6% (95%CI: 33-40%). Household food insecurity was positively associated with frequency of some food group intakes among students, including bread macaroni potato legume and eggs (P<0.05). In addition, negative associations were observed between food insecurity and frequency of other food group intakes including rice, red meat, sausage and hamburger, poultry, fish, green vegetables, root and bulb(colored) vegetables, melons, banana, pineapple, coconut, mango, apple, orange, milk, and yogurt (P<0.05).
Conclusion: The results of this study indicate that food insecurity is prevalent among (students) households in Esfahan. In addition, students living in food-insecure households more frequently consumed cheap foods containing high energy per kilogram. Therefore, appropriate nutritional programs should be designed to improve the quality of household food consumption.

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مقدمه و اهداف: در اغلب موارد دانشجویان پرستاری در بالین مورد خشونت فیزیکی و کلامی قرار می‌گیرند. اگر چه در مطالعات قبلی خشونت علیه پرستاران مورد بررسی قرار گرفته است ولی با این حال توجه بسیار کمی به بررسی خشونت نسبت به دانشجویان پرستاری شده است. هدف از این مطالعه تعیین شیوع و ابعاد خشونت محل کار نسبت به دانشجویان پرستاری در محیط بالینی است.
روش کار: در این مطالعه توصیفی، 271 دانشجوی پرستاری با روش سرشماری شرکت کردند. اطلاعات با استفاده از پرسشنامه‌ای که با روش اعتبار محتوا و آزمون و آزمون مجدد مورد پایایی و روایی قرار گرفت، جمع‌آوری گردید.
نتایج: به طور کلی به ترتیب 9/74 % و 38/7% از دانشجویان سابقه خشونت کلامی، فیزیکی را در طی سال گذشته داشتند. اکثر خشونت‌های فیزیکی توسط بیماران صورت گرفته بود در حالی که بیشتر خشونت کلامی توسط همراهان بیمار صورت گرفته بود. به ترتیب بیشترین پاسخ به خشونت کلامی و فیزیکی این واکنش بود که "متقابلاً داد و بیداد کردم" و "به مربی یا مافوق خود گزارش دادم". از دیدگاه دانشجویان پرستاری شایع‌ترین عامل مساعدکننده خشونت محل کار، کمبود آگاهی مردم در خصوص وظایف دانشجو در بیمارستان‌ها بود. بین جنس و ترم تحصیلی دانشجویان با خشونت رابطه معنی داری یافت نشد.
نتیجه‌گیری: دانشجویان پرستاری اغلب در محیط کارآموزی مورد خشونت قرار می‌گیرند. باید راه‌های پیشگیری از خشونت و همچنین نحوه واکنش به خشونت به دانشجویان پرستاری آموزش داده شود و این مباحث در سرفصل درسی دانشجویان پرستاران گنجانده شود.

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Background & Objectives: Nursing and midwifery students are at risk needlestick/sharps injuries (NSIs/Sis). Actual number of NSIs/SIs among students due to insufficient reporting it is not clear in Iran. The aim of this study was to explore the barriers of not reporting of NSIs/SIs among nursing students.
Methods: This descriptive cross-sectional study was conducted in Arak University of Medical Sciences in 2009. 207 and 68 nursing and midwifery students were participated in study, respectively. A questionnaire, consisting two sections of demographic information and questions about exposure to (NSIs/SIs) and frequency and barrier reporting of NSIs/SIs, was completed by students.
Results: According to the findings, 43% and 20.5% of nursing and midwifery students had experienced at least one contaminated NSIs/Sis in the past 12 months. Only 44.9 % (n=40) and 50% (n=7) of the nursing and midwifery who had experienced NSIs/Sis in the previous year, were reported all exposures to NSIs/Sis, respectively. The most important the reasons for not reporting injuries consisted of low probabilities of the infection risk of the injury source, not familiar with reporting process and fear of decreasing evaluation score.
Conclusion: NSIs/SIs and non-reporting of NSIs/SIs were highly prevalent in nursing and midwifery students. More education programs should be directed at students to increase their awareness of about NSIs/SIs. Also nursing and midwifery student’s instructors should give positive responses to nursing students for reporting NSIs/SIs.

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Background & Objectives: Sleep quality is an important factor in student life and affects in their learning process. Sleep problems are related to increased health concerns, irritability, depression, fatigue, attention and concentration difficulties, along with poor academic performance. The aim of this paper is to conduct a survey based on a questionnaire that would characterize the quality of sleep in students living in dormitories of Tehran University of Medical Sciences (TUMS).
Methods: We conducted a cross-sectional study using the stratified random sampling approach on 277 students residing in dormitories in Tehran. A demographic questionnaire and Pittsburgh Sleep Quality Index (PSQI) were used for data collection.
Results: Mean (CI) of PSQI in students was 8.57 (8.10- 9.04). Using the cut-off score of 6 for the PSQI global score, 73.3% (68.1%-78.5%) of students were described as poor sleeper. Female students had a worse quality of sleep compared to male. The mean duration of sleep in students was 5:15´± 105´ (hours). This was significantly higher in male students than female students. There were no significant relationships between demographic variables such as age, academic level, marital status and family income with and quality of sleep.
Conclusion: This study showed that poor sleep quality is prevalent among students living in dormitories of TUMS. Therefore it is necessary to provide effective educational interventions for this group in order to improve the quality of sleep.

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Background & Objectives: One of the most common anxiety disorders in children is separation anxiety disorder (SAD). The purpose of the present study was to investigate the epidemiology of separation anxiety disorder in Isfahan primary school male student.
Methods: The present study was a descriptive study. The statistical population was all the male students from 7 to 9 years old, studying in second and third grades in primary schools of Isfahan. The sample of study consisted of 1514 male student, who were selected randomly by multi-stage sampling method. The instruments of this study consisted of the Separation Anxiety Disorder Scale, Spence Children's Anxiety Scale and Clinical Interview. Data obtained were analyzed by using descriptive statistics and chi-square and logistic regression.
Results: The findings showed that the rate of separation anxiety disorder in male (7 to 9 year- old student) was %6/93. SAD were more common in 7 years old (7.4%). Children having record of hospitalization, immigration, single-parent households and close relatives of mortality had a higher rate of separation anxiety disorder.
Conclusion: This study shows that separation anxiety disorder among primary school male students is significantly high. Therefore it is important to consider the potential utility of early anxiety prevention/intervention programs, especially for children at this age group.

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Background & Objectives: There is increasing evidence that self-medication is a widely prevalent practice in many developing countries. It seems a special significance issues among medical students as they are the future medical practitioners. The objective of this study was to assess the level of self-medication and its related factors amongst medical students in Tehran University of Medical Sciences.
Methods: A cross-sectional questionnaire-based study was conducted among the 600 students of Tehran University of medical science in 2011 year.
Results: The frequency of self-medication in students was 35.7 percent. This was more common in females rather than males. Some reasons for seeking self-medication included Previous illness experience (51/9%), easily access to medications (28/5%) and feeling not important of illness (22/9%).
Conclusion: Our study shows that self-medication is common among medical students in Tehran. In this situation, it is necessary for faculties to create awareness and educate theses students regarding advantages and disadvantages of self-medication.

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Background & Objectives: Smoking is a global problem and is the most important cause of death due to non- communicable diseases. This study was conducted to evaluate smoking and its correlates in male students in South Khorasan.

Methods: This descriptive-analytical study was undertaken in South Khorasan on high school male students. A sample of 2371 cases was selected through cluster multi stage sampling. The data was collected through a structured questionnaire and analyzed by SPSS software using chi-square and logistic regression tests.

Results: The prevalence of smoking was 12.3 per cent (285 cases).The most important motivating factors for smoking for the first time were curiosity, joy. The most important predictors of smoking were hookah consumption, the presence of a smoker in or outside the living place, and a negative attitude to smoking. Working father and education regarding smoking risks were preventive factors.

Conclusion: Special education and public awareness about the risks of smoking and establishment of consultation centers for adolescents can be major steps toward the prevention and control of smoking among students.

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Background and Objectives: One of the most common anxiety disorders in children is social anxiety disorder (SAD). The purpose of the present study was to investigate the epidemiology and clinical characteristics of social anxiety disorder in students in Kermanshah, Iran.

Methods: The present study was a cross-sectional study. The statistical population was all school students aged 13-17 years old in the secondary schools of Kermanshah. According to Krejcie and Morgan Table and multi-stage cluster sampling, 760 students were selected who completed a questionnaire on demographic variables as well as the Social Anxiety Scales for Children and Adolescents (SAS-CA). The data were analyzed using descriptive statistics, chi-square test, and logistic regression analysis with the SPSS-19 software. P values≤0.05 were considered significant.

Results: The results showed that the prevalence of social anxiety disorder in the whole population was 80.18%. The prevalence was higher in female students than male students. The severity of social anxiety disorder was moderate in 12.25%, severe in 4.90%, and very severe in 1.70% of the students. Parental education, parental occupation, number of family members, average household income, and family history of psychiatric disorders had a significant relationship with the prevalence of SAD in students (P<0.05) but this relationship was not significant for the mode of delivery (P>0.05).

Conclusion: This study shows that the prevalence of social anxiety disorder is significantly high among middle school students. Therefore, it is important to consider early anxiety prevention/intervention programs, especially for children in this age group.

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Background and Objectives: Food-borne diseases are serious problems in public health. Since the outbreaks can be prevented, we need to take action in the prevention of such infection. On 28 June, 2014 cases of gastroenteritis occurred in students living in dormitories of a medical university; therefore, this study aimed to investigate the outbreak of gastroenteritis to determine its risk factors.
Methods: This case - control study was performed to evaluate students. A total of 70 patients with gastroenteritis in the outbreak of 16 June 2014 were selected. A total of 70 students without any gastrointestinal complaints in the weeks before the outbreak were also selected as the control group using convenient sampling.
Results: The results of this study provided 4 main themes (challenges of access to the data of the surveillance system, challenges of access to the data of national surveys and ordered projects, challenges of access to the data of electronic health records, and challenges of access to confidential data) and 15 sub-themes.
Conclusion: According to the results, having lunch prepared by the university on 16 June was the likely cause of the outbreak on 17 June in student living in dormitories. Hygiene in cooking and food storage, especially in public places such as schools and universities are important in the prevention of food-borne outbreaks.

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Background and Objectives: Academic failure is of paramount importance for medical students because it might lead to a decline in scientific level of the community of physicians in the future. This study was conducted to investigate the predictors of academic failure in medical students of Lorestan University of Medical Sciences using classification tree. 
 
Methods: In this cohort study, academic records of all medical students of Lorestan University of Medical Sciences during the academic years of 1999-2008 were selected by census and were followed up until September 2016. Academic failure was defined as having at least one of the components of appropriate grade point average, prolonged graduation, academic probation, dropout, expulsion, and any failure in ccomprehensive exams and the CART classification tree was adopted using the SPSS 22 software to predict it.
 
Results: The cumulative incidence of academic failure was 26.4% and the most prevalent components were prolonged graduation (21.7%) and academic probation (15.0%). The probability of academic failure was 0.449 in subjects taking guest courses, 0.220 in subjects with no history of guest courses admitted to courses with less than 40 students and admission quotas of zone 1 or 3, and 0.456 in subjects with no history of guest courses admitted to courses with more than 40 students and males.
 
Conclusion: With respect to identifying the predictors of academic failure, it is suggested that these students be referred to consulting centers of the university or educational supervisors’ moreover, the regulations of taking guest courses in other universities should be revised.

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Background and Objectives: The Problematic Internet Use Questionnaire (PIUQ) is a scale for evaluating the adverse effects of high Internet usage. It was adopted into Persian in a previous study. The factorial structure of the adopted version was different from the original English version. The purpose of this study was to determine the factorial structure of the Persian version of the Problematic Internet Use Questionnaire.
 
Methods: In this methodologic study, sampling was carried out in students of Iran University of Medical Sciences, University of Tehran, and Sharif University of Science and Technology. A total of 428 students completed the Problematic Internet Use Questionnaire. Exploratory factor analysis was performed using SPSS. Confirmatory factor analysis was carried out using AMOS. The reliability of the Scale was determined using Cronbach’s alpha coefficient (α=0.89).
 
Results: Exploratory factor analysis showed four factors including online preoccupation, adverse effects, social interactions, and excessive use. The mean ± SD of the domains was 2.12±0.81, 2.01±0.86, 2.18±0.85 and 2.39±0.97 for online preoccupation, adverse effects, social interactions, and excessive use, respectively.
 
Conclusion: The exploratory and confirmatory factor analysis showed that the Persian version of the Problematic Internet Use Questionnaire had a relatively similar structure with the English version. One dimension of the questionnaire was split to two new dimensions. This questionnaire can be a useful tool for measuring problematic behaviors related to the excessive use of the Internet.

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Background and Objectives: Iran has carried out a series of surveys based on the Global school-based student health survey (GSHS) referred to as the CASPIAN. The aim of this paper was to compare the methodology and tools of CASPIAN surveys and to propose recommendations and suggestions for future implementations.
 
Methods: The data of this systematic review study were gathered from the World Health Organization (WHO) documentations, international databases including Pubmed, EMBASE, Scopus, GoogleScholar, and ScienceDirect, and national databases including Magiran, SID, and Irandoc. The search was conducted in both English and Persian (for the time period from 2003 to 2018). The time and place of the study, target population, questionnaire(s), sample size, and sampling method were compared between the surveys.
 
Results: Five rounds of CASPIAN survey were conducted in Iran from 2003 to 2015. The surveys had two sets of questionnaires for students and parents. In all five rounds, sampling methods and questionnaires were similar in the core and differed in some details that were added selectively in each round. The questionnaires were designed based on the GSHS and the WHO stepwise approach to non-communicable disease risk factor surveillance (STEPS) programs.
 
Conclusion: Considering the small variation in each series and compliance with the global model, it is suggested that the next CASPIAN survey be conducted according to the previous series in accordance with the standards presented in the global model in recent years in a reasonable interval from the 2015 survey.

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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.
 

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Background and Objective: The aim of this research is validation of questionnaire of covid-19 social effects (SISQ) on Iranian students.
 
Methods: The current study is a descriptive-analytic validation-type study and its statistical population was consisted of students of University of Tehran who 300 of them took part in this research voluntarily. After study of content validity, exploratory and confirmatory factor analysis was used to study construct validity and Cronbach Alfa and cluster correlation coefficients were utilized to study the reliability; for further study on main variables of research, Pearson correlation and T tests were used; analyses were conducted by SPSS25 and AMOS26 softwares.
 
Results: In study of validity of seventh item questionnaire, based on professors’ opinion, it was out of content validity (cvr= 0.16); in exploratory factor analysis, four social distance, social acceptance, social information and social anxiety factors were extracted which expressed 57.99 percent variance of questionnaire; results of confirmatory factor analysis confirmed the 4-factor model after adding and omitting processes (RMSEA= 0.05, CFI= 0.93, IFI= 0.93, p= 0.09, x2= 85.26), Cronbach Alfa and interclass correlation coefficients were equal to 0.8 for the final questionnaire; correlation of all items with the total mark was positive and meaningful and the values varied from 0.49 to 0.65. Average (standard deviation) of studied people’s age was 24.07 (6.27) year.
 
Conclusion: 14-item questionnaire of covid-19 social effects on students has acceptable validity and reliability.Further studies in other populations are suggested.

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Background and Objectives: One of the most important issues in public health is violence, which affects people around the world. Therefore, a qualitative study was conducted to explain the consequences of student violence.
 
Methods: This study was part of a qualitative exploratory sequential study conducted in Ruodsar in 2017. This study was carried out using conventional qualitative content analysis method. The data were collected through 50 individual in-depth interviews using purposive sampling. Data analysis was done using the Landman and Grahaim method.
 
Results: Data analysis in the first phase of research resulted in the extraction of 98 initial codes, two subcategories and one main category. At the end of this stage, the consequences of adult violence according to the findings were as follows: "The harmful consequences of violence are conceptual, dynamic, and multidimensional. The harmful consequences of violence point to changes that occur within the violent person or the people around them after the violence, which are divided to interpersonal and intrapersonal consequences.
 
Conclusion: The present study revealed some new dimensions of the concept of harmful consequences of violence, especially in student girls. This definition is based on the Iranian context and culture. Violence prevention requires attention to these dimensions at different interpersonal and the intrapersonal levels.

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Background and Objectives: Physical activity is one of the most important components of life. The aim of this study was to evaluate the physical activity level of primary school students in Bushehr in 1398.
 
Methods: In this cross-sectional descriptive-analytical study, the research population included all elementary school students in Bushehr. Four hundred and six students were selected using multi-stage random sampling. The Physical Activity Questionnaire for Children, which is a valid and reliable scale, was used to collect the data. Independent t test, one-way analysis of variance, Pearson correlation coefficient and multiple linear regression model were used for data analysis. Data was analyzed using the SPSS software version 20.
 
Results: The mean score of physical activity was 3.27±0.84. There was a significant relationship between demographic factors (parents’ education level, participant’s education level and BMI) and physical activity. Students whose parents had higher levels of education were more likely to engage in physical activity and people who were obese had less physical activity.
 
Conclusion: The students' physical activity was moderate. Given that there is a direct link between physical inactivity and increased prevalence of overweight and obesity, it is important to pay attention to the lifestyle of people, especially children and adolescents who are in the learning age. Therefore, more attention should be paid to improving the level of physical activity in students through education and building a culture.