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

Comparison of the Level of Satisfaction of Service Recipients Between Government and Outsourced Health Posts Under Coverage of South Tehran Health Center

Zahra Beigom Seyed Aghamiri

Background and Aim: The District Health Network is based on the principles of equity, appropriate technology, inter-sectoral collaboration and public participation. Measuring patient satisfaction is one of the basic criteria in determining the quality of care services. The purpose of this study was to compare the level of satisfaction of service recipients between government and non-government health posts in the south of Tehran in 2021.
Materials and Methods: This was a cross-sectional, descriptive and analytical study. A two-part researcher-developed questionnaire was used to collect data. The first part included items related to demographic characteristics of the clients, insurance status, geographical location and type of health post, appointment system and frequency of visits, and the second part contained questions on the type and level of satisfaction with the services provided.
Results: In the governmental health posts, the clients were mostly satisfied with, in a decreasing order, vaccination services, post-vaccination education, waiting time and physical space. In the outsourced posts, post-vaccination care education, under-one year old child care, vaccination and a sense of responsibility obtained, in an increasing order, the highest scores of satisfaction. Further analysis of the data showed the clients’ least satisfaction with youth and middle-aged care in governmental posts and youth care in outsourced posts.
Conclusion: Continuous and frequent measurement of satisfaction and developing timely interventions based on the results obtained will help greatly promotion of the quality of health services.

Strengthening Primary Health Care System Resilience in Covid-19 Pandemic: A Scoping Review

Tina Taherkhani

Background and Aim: Primary health care is a holistic approach that aims to maximize people's health and well-being as quickly as possible in their immediate living environment. The primary health care system is the first point of contact of the people with the health system. Therefore, increasing its resilience will play a significant role in controlling and managing pandemics. This research aimed to identify strategies to strengthen the resilience of the primary health care system in the Covid-19 pandemic.

Materials and Methods: This study was conducted using the scoping review method. Using appropriate keywords search was done on the subject of the study in PubMed, Web of Science, Scopus, SID, Iranmedex and Magiran databases and Google and Google Scholar search engines. Finally, after screening and reviewing the titles, abstracts and texts of the retrieved documents, 36 articles were selected and strategies to strengthen the resilience of the primary health care system in the Covid-19 pandemic were extracted from them.
Results: A total of 48 strategies/solutions were extracted to strengthen the resilience of the primary health care system, categorized into 6 groups, namely, governance and leadership, financing, human resources, medicines and equipment, health information systems, and health service delivery. Among the most frequently solutions mentioned were the following: Dynamic and accountable leadership, using valid research evidence in policy-making, contingency planning, increasing inter-sectoral cooperation, advocacy for health policies, community involvement, sustainable financing, recruiting additional staff and training and supporting them, providing sufficient stocks of medicines and diagnostic kits, developing and modernizing public health information systems, facilitating people's access to health centers, continuing to provide health services, and increasing the community’s health literacy.
Conclusion: The structural and process components of the primary health care system including "governance and leadership", "financing", "staff", "equipment, vaccines and medicines", "information" and "health care delivery" should be strengthened in a coordinated manner in the primary health care system to be prepared for future epidemics.

Predictors of Nutrition Awareness and Behaviors and Physical Activity in Fifth Grade Elementary School Students in Ghods City

Roya Sadeghi

Background and Aim: Physical activity and nutrition are important topics in adolescent health. This study aimed to determine the predictors of nutritional knowledge, behaviors, and physical activity in fifth-grade elementary school female students
Materials and Methods: This cross-sectional descriptive-analytical study was performed on 480 female students in the fifth grade of the elementary school in Gods city in 2020-2021 by cluster random sampling. Data were collected using a researcher-made questionnaire two-part questionnaire of contextual questions and questions about knowledge, nutritional and physical activity, virtual in the Shad messenger. The content validity ratio and content validity index was used to determine validity, and the intra-cluster correlation index to determine the reliability, of the questionnaire. In data analysis, descriptive statistical tests, Pearson

correlation coefficient, and multiple regression analysis were performed using SPSS 27.
Results: The results of multiple regression analysis showed the effect of nutritional knowledge variables on nutritional behavior (p <0.001, β = 0.159) and physical activity knowledge on nutritional behavior (p = 0.008, β = 0.120) if the Physical activity knowledge variable was not effective on physical activity behavior and also nutritional knowledge variable had no effect on physical activity behavior.
Conclusion: Increasing knowledge of nutrition and physical activity improves students' nutritional behavior, but this increase in knowledge does not affect physical activity behavior. The sedentary lifestyle and the presence of the Covid-19 pandemic appear to have significantly reduced physical activity. By increasing knowledge, nutritional behavior and physical activity can be improved to some extent

The Impact of Institutional Quality, Air Pollution and Health Expenditures on Health: A Panel Threshold Approach

Seyed Mohammad Seyedi

Background and Aim: In addition to health costs, institutions are a factor influencing directly and indirectly the promotion of health in a country. Air pollution, the main cause of which is the industry and in the control and reduction of which the governments have an important role, is another important factor affecting the health situation in a country. This paper reports the results of a study on the health impact of institutions, considering health costs and air pollution.
Materials and Methods: The impact of institutions on health in 38 developing countries during the period 2006-2018 was determined using the threshold panel method, health proxy life expectancy index and good governance index as the quality of institutions and explanatory variables of misery, per capita income, health costs and happiness. Based on the CO₂ threshold variable, the sample was divided into two homogeneous regimes and the model was obtained with EVIEWS (10) and Stata (15) software packages.
Results: The findings indicate that the governance index and happiness in both regimes are significantly positive. Health costs in the upper group were found not to be significant and in the lower group to have little effect on health. In addition, income was significant in both regimes, though with little effect. Finally, the misery index was also found to be significant, but its coefficient in the lower group was not in line with the relevant theories.
Conclusion: Based on the findings of this study, institutions in developing countries play a major role and form a causal chain among other sectors which are very important in promoting health of the populations. Therefore, in order to promote health in these countries policies should be designed and implemented for institutional improvements.

Management of Fire Crisis in Oil Refineries Using Drone Technology: A Case Study in the Lavan Oil Refinery

Zahra Abedi

Background and Aim: Due to the design features, facilities and the presence of crude oil materials or refined products from crude oil, the refining industry is prone to major accidents such as fire and explosions, which cause a lot of damages and losses. On the other hand, due to the development of intelligent technologies and drones (remote-controlled birds) and the widespread use of these technologies in various industries, the use of these new technologies in the oil and gas industry is inevitable. This case study was conducted with the aim of utilizing drone technology in fire crisis management in oil refineries in the Lavan Oil Refinery, Iran.
Materials and Methods: Data were collected using qualitative methods and literature review by combining keywords such as refinery, fire and explosion and drone, as well as holding semi-structured interviews with 15 informed and experienced persons from among refinery personnel. In order to identify internal strengths (S) and weaknesses (W) and external opportunities (O) and threats (T) the gathered data were analyzed using the basic SWOT model.
Results: Analysis of the data show the following strategies to be the results of the external threats and opportunities and internal strengths and weaknesses: Strength/Opportunity (SO), Strength/Threat (ST), Weakness / Opportunity (WO) and Weakness/Threat (WT).
Conclusion: The use of drones for monitoring (finding the location and source of fire), identifying (determining the exact location and extent of the fire), confronting and controlling (relief and rescuing, saving the lives of firefighters, firefighting) in the Iranian oil industry requires making changes in the capacity and levels of technology and the equipment and manpower. Making these changes requires the support of managers and personnel of the oil industry in order to use this new technology and make it operational. In this way, fire crisis management in refineries can be implemented by using drone technology.

Predicting the Tendency of the University Students to Addiction: The Role of Initial Maladaptive Schemas and Emotion Cognitive Regulation

Hossein Torkmani

Background and Aim: Considering the harms and dangers of addiction and the fact that many people are trapped in it every day, it is important to identify the variables that affect it. The aim of this study was to predict the tendency to addiction among university students based on initial maladaptive schemas and cognitive emotion regulation.
Materials and Methods: This was a cross-sectional descriptive-analytical study. The statistical population consisted of all the 3548 students of Gonbad Kavous Payame-Noor University in the academic year 2019-20, from among whom a sample of 384 students was selected using the one-stage cluster random sampling method. The data collection tools were the following 3 questionnaires: early maladaptive schema (Young, 2005), cognitive emotion regulation (Garnefski & Kraaij, 2001) and addiction tendency (Wade and Butcher, 1992). Pearson correlation coefficient and multiple linear regression were used to analyze the data using the SPSS software version 22 at a statistical significance level of 0.05.
Results: Data analysis showed correlations between addiction and the following variables: excessive ringing in the ears (r = 0.491, p = 0.001), being guided by others (r = 0.523, p = 0.001), disturbed constraints (0.001 >, r = 0.426 p), impaired function (r = 0.389, p = 0.001), discontinuation (r = 0.406, p <0.001) and cognitive emotion regulation (p> 475, <0.001). 0r =). In addition, the results of multiple linear regression analysis showed the following: excessive ringing (β= 0.203, p = 0.001), being guided by others (β= 0.274, p = 0.001), disturbed constraints (β= 0.261, p = 0.001), impaired function (β= 0.229, p = 0.001), discontinuation (β= 0.193, p <0.001) and cognitive emotion regulation (β= 0.315, p = 0.001).
Conclusion: Based on the findings of this study, the average tendency to addiction among university students can be predicted by changing the initial maladaptive schemas and improving the cognitive emotional regulation.

The Needs of Self-Care and Community Mental Health Education

Zahra Validabady

Background and Aim: Among the valuable developments in the primary health care system has been the special attention paid to the issue of mental health and the addition of a self-care program for community mental health education. However, no integrated measures have been taken in relation to the needs of service recipients, educational priorities and the required facilities. This study was conducted to explain the priorities of this program in primary health care centers affiliated to Iran University of Medical Sciences, Tehran, Iran.
Materials and Methods: This was a qualitative study with a content analysis approach. The sample consisted of 12 stakeholders selected by purposive sampling with maximum diversity. Data were collected through in-depth and semi-structured interviews and a modified checklist of the Community Health Needs Assessment Program and analyzed using the Granheim and Landman approach.
Results: Based on data analysis, the needs were grouped into two main categories, namely, the needs of service providers and the needs of service recipients. The service providers’ needs included continuous coordination with non-health sectors, a virtual education and information system and continuous training and educational supervision, as well as appropriate space, facilities and equipment, while the of needs of service recipients were classified based on services needed for age groups, namely, services for children, adolescents and young people, adult and middle-aged, elderly and others.
Conclusion: Identifying needs can lead to the optimal use of limited resources aiming at imparting applied education and training. The results of this research can be an effective step towards expansion based on the needs for mental health education and a great help in achieving the goals of this program in primary health care centers. Based on the results it is recommended to plan personnel training and revise the services based on the identified needs in order to increase the effectiveness of this program.

Covid-19 in Iran: A Qualitative Study of the Experiences of Health Care Workers

Ali siamiaghdam

Background and Aim: With the rapid spread of Covid-19 around the world, the exposure of health care workers to the disease has increased. The study aimed to investigate the personal and professional experiences of health care workers during the outbreak of coronavirus in hospitals in Tehran, Iran.
Materials and Methods: This qualitative study included health care workers in the main Covid-19 units in Shahid-Beheshti University of Medical Sciences hospitals in Tehran, Iran conducted using the content analysis method in 2021. The sample was selected by purposeful sampling, using the snowball method. Data were collected through semi-structured interviews and, after extracting the items, analyzed using the MAXQDA 10 software.
Results: After coding a total of 236 main codes were extracted and divided into 10 main categories and 30 subcategories. Four main themes were identified: "Personal experience of health care workers", "Professional experience of health care workers", "Challenges of working in the field of Covid-19" and "Strategies to deal with Covid-19".
Conclusion: Due to the increasing psychological pressure on health care workers, it seems that planning psychological counseling and providing welfare facilities for them can be useful in reducing their mental stress. In addition, it is recommended to hold training and maneuvering courses at times of crisis and provide the necessary equipment, as well as take action for continuous supervision and monitoring to improve the working conditions of health workers.