Journal of School of Public Health and Institute of Public Health Research

Effect of the Intervention Based on New Communication Technologies and the Social-Cognitive Theory on the Lifestyle of the Employees with Overweight and Obesity

Hasan Eftekhar

Background and Aim: This study was conducted to evaluate the effect of an intervention based on modern communication technologies and the social cognitive theory on the lifestyle of the government employees in the City of Hamadan, Iran in 2014.

Materials and Methods: A randomized control trial [IRCT2014083118989N1] was conducted including a total 435 employees with overweight or obesity. They were divided into a control group receiving no education and two intervention (experimental) groups (IG1 and IG2) receiving a 6-month education under the title of “lifestyle program”. The educational intervention was “telephone-assisted” in IG1 and “web-assisted” in IG2. Six and nine months after the intervention the lifestyle and changes in in the constructs of the social-cognitive theory were determined and compared between the experimental and control groups. Data were collected and analyzed using SPSS-20.

Results: In both intervention groups, the lifestyle program resulted in promoting lifestyle status from “Good” to “Very good” (p=0.001). The intervention in the telephone-assisted group led to increases in the mean scores of the constructs of self-efficacy, environment, outcome expectations, and outcome expectancies, while in the web-assisted intervention group increases were observed only in the mean scores of the constructs of self-efficacy and outcome expectancies (p<0.05).

Conclusion: The results of the present study confirm the effectiveness of a lifestyle intervention based on modern communication technologies and the social-cognitive theory.

The Prevalence of Anemia Among Pregnant Women in Iran (2005-2016): A Systematic Review and Meta-Analysis Study

Kourosh Sayehmiri

Background and Aim: Anemia in pregnant women is a common disease in developing countries, the prevalence ranging between 35% and 100%. Based on a systematic review in 2005 anemia prevalence among Iranian pregnant women was estimated to be 12.4%. The objective of the present systematic review and meta-analysis was to determine anemia prevalence among Iranian pregnant women between 2005 and 2016.

Materials and Methods: This systematic review, using standard key words, included databases Magiran, Iranmedex, IranDoc, SID, Medlib, Scopus, PubMed, ScienceDirect, Cochran, Embase, Springer, Web of Science, and Online Library Wiley, as well as the Google Scholar search engine of for the period 2005-2016. All the reviewed papers meeting the inclusion criteria were included in the study. Data were analyzed using the random effect model based on meta-analyses, the software being Stata Ver.11.1.

Result: Twenty-five studies with a total sample of 56610 pregnant women met the inclusion criteria. The prevalence of anemia was estimated to be 17% (95% CI: 14-20). The highest (23%) and lowest (12%) prevalence rates were observed in the center and west of the country, respectively. The prevalence was estimated to be 21% in urban areas and 8% in the rural areas.

Conclusion: The prevalence of anemia in Iranian pregnant women has increased over the last 11 years. Therefore, appropriate intervention programs must be implemented in premarital counseling and pregnancy clinics.

The Survey of Performance Supervision Board New System Hospitals Administration Alan in Selected Training Hospitals of Isfahan: A Qualitative Study

Mohammad reza Tavakoli

Background and Aim: In 1995 the new plan (system) of hospital administration plan/scheme (fee for service) was communicated. According to this plan a proportion (percentage) of the hospital income would be allocated to the hospital staff as a fee for service; the remaining would, after deducting other expenditures, be allocated for the autonomy of the hospital. Based on the plan/scheme, the Supervisory Board will consist of two main committees, namely, the High Supervisory Board and the Supervisory Board for the Centers (hospitals). The main objective of this study was to evaluate the performance of the Supervisory Board in the new system of hospital administration plan in selected teaching hospitals of Esfahan, Iran in 2014.

Materials and Methods: This was a qualitative research. Eleven individuals were selected by targeted sampling and interviewed using semi-structured interviews. The thematic analysis method was used to analyze the data.

Result: Based on the thematic analysis results, the main source of weakness in the underlying and structural factors (developing programs and the implementation phase) was the Hospital Administration Supervisory Board in the new system.

Conclusion: It can be concluded that the most notable findings in this study are weaknesses in the underlying and structural factors (developing the program) and weak underlying and structural factors (implementation of the program). The findings will help health policy-makers to develop suitable strategies and a plan of action to minimize weaknesses of the new fee for service scheme/plan.

The Factorial Structure of Subjective Well-Being Questionnaire in Adolescent of Qom City

Afzal Akbaribalootbangan

Background and Aim: The present research aimed to study the psychometric characteristics of a subjective well-being questionnaire among high school students.

Materials and Methods: This was a descriptive correlational study. A total of 400 high school students (200 boys and 200 girls) in the City of Ghom, Iran were selected by multistage cluster sampling. Data were collected using the Oxford subjective well-being and happiness inventory questionnaire. Factor analysis and Cronbach's alpha coefficient and the Pearson correlation test were used to analyze the data.

Results: Factor analysis showed that the scale was saturated with four factors. In addition, Pearson correlation test indicated that subjective well-being was positively associated (p < 0.01) with happiness (r=0.27), discipline (r=0.11) and academic achievement (r=0.28). Also the reliability of the subjective well-being questionnaire using Cronbach's alpha was found to be 0.87 for the total scale and 0.69, 0.85, 0.73 and 0.78 for the subscales school connectedness, joy of learning, educational purpose and academic efficacy, respectively; these findings indicate that the tool used was quite good and reliable.

Conclusions: Based on the findings is concluded that the Persian version of the subjective well-being questionnaire is an acceptable tool to determine the psychometric characteristics of high school students and can be used as a valid instrument in psychological research.

Effect of Intervention Counseling 5A Step Method Based on the Structure on Stage of Change to Promote Physical Activity Female Employees in Mashhad Factories Industrial

Fatemeh Sedghi

Background and Aim: One of the most important health problems in the modern society is reduced appropriate physical activity by people. The five-step counselling process, which is composed of five essential principles in health counselling, can help to improve health behaviors, such as physical activity, in different individuals. The aim of this study was to determine the effect of an educational intervention using the five-step counseling process based on the stage of change construct on physical activity promotion in female-employees working in Toos Industrial State factories, Mashad, Iran.

Materials and Methods: This was a controlled intervention study including 76 women working in the Mashad industrial estate factories, Iran, divided into an experimental (n=36) and a control (n=40) group. Data were collected using the standard Marcus Physical Activity Stages of Change Questionnaire and the International Physical Activity Questionnaire (IPAQ), which measures physical activity at three levels of light, moderate and severe, and analyzed using the SPSS software; a P<0.05 was considered to indicate statistical significance.

Results: The results showed that there were no statistically significant differences before the consultation intervention between the two study groups as regards the stage of change and level of physical activity (p>0.05). Further analysis of the data revealed that the intervention had caused increases in both the physical activity and stage of change (P<0.05).

Conclusion: Based on the findings, it is concluded that the five-step counselling process is effective in promoting physical activity and can be used as an appropriate strategy by health professionals in the health-service delivery centers and organizations to promote the health behaviors of people.

Quality of Life Among Behvarzs in Qazvin Province

Maryam Sabaghian

Background and Aim: The quality of life of community health workers (Behvarzes) is of special importance since they are in direct contact with the community offering health services to individuals and families. The objective of this study was to assess the quality of life of Behvarzes in Qazvin Province, Iran.

Materials and Methods: This cross-sectional study included 406 male- and female-Behvarzes working in the health houses in Qazvin Province, Iran. Data were collected using the World Health Organization Quality of Life questionnaire (WHOQOL-BREF). The questionnaire was distributed in the Behvarzes’ monthly refresher training sessions and completed by them (self-administrated). Data were analyzed using SPSS version17.

Result: The average age of the participants was 35.4± 6.3 years. Analysis of the data showed the means of quality of life scores for physical, psychological, social and environment domains to be 50.81%, 53.00%, %53.96 and %35.7, respectively. In all domains, the score of quality of life for the Behvarzes with a high education level was significantly higher than those of others (p<0.001). In addition, marital status was significantly associated with the quality of life

in all the domains (p<0.001) except in the environment domain (p=0.16).

Conclusion: The result of this study show that the quality of life of health workers (Behvarzes) is medium. Considering the importance of their work and the services they offer to the community, attempts should be made to improve their quality of life.

In Vivo Comparative Study of Antimalarial Activity of Hydro-Alcoholic Extract of Crocus sativus (Stigma) with Chloroquine

Mostafa Ghanadian

Background and Aim: Medicinal plants provide an excellent source of drugs and new drug combinations, including the basis for the development of drug resistance to common anti-malarial treatments. In this study we investigated and compared the effect of an alcoholic extract of saffron and its constituents with that of chloroquine on malaria in mice.

Materials and Methods: A total of 65 male mice similar as regards gender, weight and age were randomly divided into 13 groups of 5 each. Eleven of the groups were infected with Plasmodium berghei and treated with saffron extract and its constituents and chloroquine based on the proposed method of Ryley and Petrs. Upon detecting the parasite in peripheral blood of the infected mice, they were treated with an aqueous, alcoholic or ethyl acetate solution at a dose of 350, 700 or 1050 mg/kg body weight (BW), chloroquine at a dose of 20mg/kg BW, and an iron chelator (50mg/kg BW). The solutions with the most effective concentrations were determined. Oral treatment at every stage lasted for up to 4 days. Parasite reduction in the groups treated with the extract was determined on days 4 and 7 and compared with that in the control, placebo and chloroquine groups. The Group 13 mice had no parasite injection and received no drug and were kept in the animal house only to control accidental death.

Results: Data analysis (t-test; SPSS) showed the most effective concentrations to be 700mg/kg ethyl acetate solution and 350 and 700mg/kg saffron extract, causing a significant reduction of parasitemia in the infected mice on day 7 (p<0.05).

Conclusion: The findings of this study indicate the potential effect of the alcoholic extract of saffron on Plasmodium berghei and, therefore, should receive proper attention.

The Comparison of Executive Functions in the Brain of Who that Returns to Addiction and no Return

Baharak Fakhim yousefnia

Background and Aim: Both the cognitive and functional processes in an individual can be influenced directly by the central nervous system. Considering the widespread use of narcotics, an exact knowledge of the different dimensions of addiction and its relationship with the brain executive functions can help find strategies for its treatment and promote effectiveness of current intervention programs and optimization of functional activities and, ultimately, promotion of well-being and psychological dimensions in these patients. The purpose of this study was to compare the brain executive functions in two groups of addicts ─ those who have and those have not resumed using narcotics.

Materials and Methods: The study population consisted of all the male-addicts consulting the addiction recovery/treatment centers in Tehran in 2013, who had used the narcotic methamphetamine (glass) in the past and had taken action to quit, as well as those who had, after quitting, resumed using narcotics. The sample in each group included 30 male-addicts who had given their consent. They were selected by the available sampling method. Diagnosis of addiction and classification of mental disorders in the subjects was based on a). the Diagnostic and Statistical Manual of Mental Disorders, 4th Edition, Text Revision (DSM-IV-TR), and b). assessment by specialists in the addiction recovery centers. The “Wisconsin Card" and "Stroop test" were used to collect data, and one-way analysis of variance test (ANOVA) was used for data analysis.

Results: The results indicated that executive functions of the brain as regards design flexibility, response inhibition, and conceptualizing addiction, as well as its general executive functioning, were weaker in the groups who had resumed addiction.

Conclusion: Based on the findings it can be concluded that narcotics can weaken the brain executive functions in addicts and make them lose hope for any improvement. The findings support results of previous work reported in the literature; however, further research is needed in this area to make it possible to draw definitive conclusions.