Journal of School of Public Health and

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Background and Aim: Cardiovascular diseases (CVDs) are a major cause of death worldwide. The objective of this study was to determine the most important behavioral (inadequate nutrition, low physical activity, smoking and alcohol consumption) and non-behavioral (stress, high blood sugar, dyslipidemia, hypertension and obesity) risk factors for CVD among CVD patients hospitalized in Kermanshah Heart Hospital. This was a needs assessment study aiming at designing interventions for reducing CVD risk factors.
Materials and Methods: In this cross-sectional study 402 CAD patients (60.4% males and 39.6% females) were selected by consecutive sampling from among those hospitalized in Imam Ali Hospital for the first time. Data were collected using the Iranian version of WHO Stepwise questionnaire and the patients’ files and analyzed using the SPSS-16 software.
Results: The mean (±SD) age of the patients was 54.2 (±8.8) years. About 73% of them had a poor diet and 46.5% had low physical activity; in addition, 36% of the men had consumed alcohol in the previous year and 26.1% were smokers. Non-behavioral risk factors were quite common too. The proportions of the patients suffering from diabetes, hypertension and overweight-plus-obesity and abdominal obesity were 49.3%, 48.0%, 54.7% and 61.0%, respectively. Finally, 43.3% of the patients had high stress, 31.0% were hypertriglyceridemic and in another 21% hypercholesterolemia was seen.
Conclusion: Based on the findings it can be concluded that, as compared to other risk factors, imbalanced nutrition was more prevalent common among the patients. Another major risk factor was obesity, particularly abdominal obesity. In addition, blood glucose disorders were more common than dyslipidemia.
 

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Background and Aim: Developing appropriate programs for community problem solving and community development and prosperity will be possible only after realistic identification of the community’s problems. Community health assessment is a process by which researchers and community members understand the health care system and community concerns through data collection and analysis, determining strengths and weaknesses and defining the community’s resources and demands. Basmenj is a town located 10 kilometer from the metropolitan City of Tabriz, Iran and on the verge of adjoining this metropolis. This paper reports results of the community assessment of this town.
Materials and Methods: This study was conducted in autumn 2017. The methodology used for community assessment was based on the eight-stage model of North Carolina. In the first seven stages the Basmenj community problems were identified and prioritized, followed, in the eighth stage, by developing an action plan for solving the problems in order of priority.
Results: Approximately 100 different problems were identified at the end of the first stage. Based on the Hanlon classification model, the top prioritized problems of the region were found to be, in that order, youth addiction, urban trashes, stray dogs, environmental pollution caused by Pars Color Company, narrowness of the main street, inner-city livestock farming, early marriage among girls, wastewater problems, youth unemployment, and high consumption and self-administration of anti-biotics.
From among these problems, the urban trashes problem was studied briefly. Factors playing a role in its causation were found to be as follows: lack of waste reduction and waste sorting programs, low citizens’ knowledge about trash gathering, absence of an appropriate urbane wastewater system, and, finally, lack of participation of citizens and the private sector in trash gathering and burying
Conclusion: A wide range of social, cultural and economic problems was identified.  The top priority was found to be focusing on problems related to urban trashes. However, it should be noted that solving all the community problems identified requires the co-operation and support of all the governmental organizations, as well as involvement of the community at large.

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Background and Aim: Although staying at home seems to be the best way to reduce the risk of Covid 19 virus and stay safe from it, the home has physical and psychological effects on people, especially vulnerable populations. Polycystic Ovary Syndrome (PCOS) is one of the most common endocrine disorders in women which, in addition to many physical problems, it has many psychological manifestations. Thus, the present research was conducted to determine the effect of home-made aerobic activity on the psychological state of adolescent girls with PCOS in home quarantine conditions.
Materials and Methods: In this 12-week study a sample of 40 adolescent girls with PCOS participated ─ 20 in the intervention, and 20 in the control, group, the intervention group performing home-based aerobic training for the whole period. In both groups anxiety and depression, as well as body image concern were determined at the beginning and at the end of the period, using the Hospital Anxiety and Depression and Littleton Body Image Concern questionnaires, respectively; so was body composition by weight and height. The data were analyzed using the SPSS-22 software, the statistical tests being the Kolmogorov-Smirnov test and Analysis of covariance.
Results: Before the intervention, the experimental and control groups did not differ significantly as regards anxiety, depression, body image concern and body composition (p> 0.05). Further analysis of the data revealed significant differences between the two groups regarding these variables (p = 0.001) at the end of the period.
Conclusion: Supervised aerobic exercise in the home has a favorable effect on the psychological state of adolescent girls with PCOS and can be recommended as a safe therapy for these patients in corona conditions.

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Background and Aim: The promotion of the health of the members of a society is based on the assessment of the situation of that society. This study was conducted in the Soufian district of Shabestar city with the aim of identifying and prioritizing its problems and needs with the direct participation of the people.
Materials and Methods: This was a cross-sectional study conducted in the Sufian District of Shabestar city in 2019, the methodology used being based the 8-phases model of North Carolina. The community health assessment was performed in 8 phases. The first seven phases included identifying and prioritizing the problems of the District, and the eighth was developing operational plans to solve its priority problems.
Results: A total of 23 different problems were identified. Prioritizing the problems according to the Hanlon method showed the ten main and priority problems to be, in a descending order, as follows: marriage of girls at an early age (21.01), excessive use of chemical fertilizers in farmlands (20.89), lack of social security clinics (20.51), unemployment (20.38), severe air pollution caused by incineration of industrial waste (20.01), accumulation of municipal waste in the city (19.89), high hardness of city water (19.76), lack of property deeds (19.63), lack of a specific unit in the industrial town to separate waste (19.38), and lack of a gas supply to Mehr Housing and lack of asphalted roads (19.28). Marriage of girls at an early age was identified as the main problem and with the first priority, and a general preliminary study was done on it; it was found that in about 43% of all marriages registered between 2014 and the first half of 2021 the ages of girls were under 18 years. Factors causing and increasing marriage of girls at an early age were identified to be as follows: low awareness of girls' families and girls themselves of the consequences of early marriage, social acceptance of early marriage in the area and low parental literacy.
Conclusion: In this study a wide range of social, cultural, economic and health problems were identified in the population studied. Marriage of girls at an early age is an important social problem with serious undesirable consequences. In an attempt to solve this problem it is essential to consider, in addition to legal and legislative strategies and actions, appropriate scientific, social, cultural and economic strategies and applied research.
 

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Background and Aim:  The health, safety and environment (HSE) system is an integrated system that tries to create a healthy, pleasant and lively environment with no accidents, damages and injuries by converging and synergizing human resources, facilities and equipment. The purpose of the present study was to investigate the validation of the revised scale of HSE performance.
Materials and Methods: This was a descriptive and analytical research conducted using the psychometric method. The statistical population included all workers of the steel companies in Kerman Province, Iran in 1400. Using the cluster sampling method based on psychometric criteria a sample of 100 was selected for the convergent validity and a sample of 578 for the construct validity section. Data were collected through two scales of HSE performance and job stress (Cohen et al., 1983). Content validity, convergent validity and factor analysis methods were used to check the validity of the scale. The reliability of the scale was checked using the internal homogeneity and classification reliability (dividing in 2 haves).  The SPSS version 22 software was used for data analysis.
Results: Confirmatory factor analysis confirmed the six-factor model. The questionnaire was used along with the 35-item occupational stress questionnaire of Cohen et al. (1983) which had good reliability and validity. The alpha coefficient obtained for the whole scale was 0.79, and for the subscales as follows: resilience 0.93, demand 0.90, role 0.93, control 0.85, support 0.72 and relationships 79.0. In addition, the reliability coefficient of the scale was also calculated using the classification method. The classification coefficient for the first and second halves of the data was 0.87 and 0.62, respectively, the correlation between the two halves being 0.248. These findings indicated a favorable internal consistency coefficient for the HSE performance scale (P<0.001).
Conclusion: According to the findings obtained based on the HSE validation, which showed that the fit of the model is high and also that the evaluation of HSE performance has a great role in the health of employees, more attention should be paid to the establishment and implementation of HSE management in Kerman steel companies.
 

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Background and Aim: Assessment of disease risk with the ultimatevaim of implementing preventive strategies in the workplace is a necessity. This study was conducted to assess the risk of COVID-19 in hospital occupational groups in Saghez city, Iran.
Materials and Methods: This cross-sectional study was conducted in 2021 among three hospital occupational groups (total sample size = 300) in Saghez city, Iran, including physicians and nurses, as well as laboratory, administrative, financial, radiology and general service personnel, using the COVID-19 rapid risk analysis technique. Data were collected using a valid questionnaire based on the Likert scale and analysed (to determine acceptable, tolerable and intolerable risks) using the descriptive and inferential methods, the software used being SPSS-26.
Results: As regards the probability variable, the highest probability of occurrence of COVID-19 was related to the general service and administrative-financial occupational groups with an average of 1.6 and 1.5, respectively. The level of attitude was generally good and excellent. The analysis of the severity of the outcome variable was at a critical level in the physicians group (42.5) and at a catastrophic level in the other groups. In total, all occupations were rated at an unacceptable risk level (H), the general service and administrative-financial occupational groups being at a higher risk than other groups. There were statistically significant differences between the types of occupation on the one hand and the variables studied, as well as the individual characteristics and COVID-19 morbidity on the other hand.
Conclusion: Considering the high risk of occurrence of COVID-19 among the hospital professionals it is essential to develop and implement plans aiming at preventing and reducing the disease risk in them.
 

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Background and Aim: Social health is one of the most basic criteria of social well-being and an effective factor in improving the quality of life of any society. .In Iran, the Office of Mental Health, Social Health and Addiction (OMSHA) is responsible for planning, implementing, monitoring and evaluating social health programs. The purpose of this research was to criticize and assess the contents of the social health component of the primary health care (PHC) system in an attempt to revise the contents.
Materials and Methods: The method used in this study was the deconstruction method. The research environment was all the contents of the social health component provided by OMSHA, and in order to obtain precise data the entire statistical population was taken as the study sample.
Results: In general, data analysis indicated the following: inappropriate screening, cultural adaptation, unidimensionality, role and responsibility adaptation, the preference of treatment to prevention, updating, comprehensiveness and adequacy of basic contents, and comprehensiveness and adequacy of practical suggestions.
Conclusion: It can be concluded that revision of the contents of the social health component of the Office of Mental health, Social Health and Addiction is a necessity in order to improve the delivery of mental health services..
 

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Background and purpose: The purpose of this research was to  write a critical review of the available service packages in the Mental and Social Health and Addiction Office (MSHAO) of the Ministry of Health and Medical Education in the areas of drugs, alcohol and tobacco, which are currently used in the primary health care system. The content analysis method was used to extract the specialists’ critiques.
Materials and Methods: Initially the MSHAO sent 1362 pages of information in the form of 47 files to researchers to be reviewed. The files were classified, eliminating/removing additional, unrelated and duplicated items; finally 840 pages in 29 files were studied and carefully examined. Then, seven experts in the field of addiction were asked to criticize the packages, using the content analysis method to extract the experts' critiques.
Results: The findings showed that comprehensive information about drugs, alcohol and tobacco addiction is provided to the clients. However, based on a critical review of the existing packages four main critiques were extracted, namely, sources/references, epidemiology, incompatibility of Iranian-Islamic culture, and technical-specialist issues. In addition, criticisms were also extracted in the following areas/services: the number of files and the variety of interventions, editing and writing problems, interventions and discussions with inappropriate in-text sources/citations, some old sources/references (published in 2013 and 2014), old interventions, lack of appropriate compatibility with the culture of the Islamic society of Iran, and direct translation of some parts of the original texts and documents of international meetings/gatherings.
Conclusion: Despite the efforts of the Mental and Social Health and Addiction Office to cover the needs of the majority of people referring to the primary care system, it seems that the high number of interventions and additional information can cause confusion of/for the physician, mental health care provider, family health care provider, general health care provider and other relevant individuals. It is, therefore, suggested that some packages be merged with each other, duplicate items be removed and specific sections be added, some packages be fundamentally revised based on the suggested items, and updated packages be developed with due consideration of  to the culture of the Iranian society.
 

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Background and Aim: This study aimed to assess and prioritize the health needs of a community served by the Imamzadeh Ghasem Health Center in Tehran city, Iran.
Materials and Methods: This study was conducted based on the North Carolina model for comprehensive community health assessment. General information and available facilities were extracted from secondary sources, while insights into specific community needs were gathered through interviews with 76 individuals representing diverse demographics. The assessment was made by secondary data analysis and direct interviews.
Finally, the prioritization of health needs of the community was based on a scoring system based on severity, extent, and ease of being solved.
Results: The findings revealed that sewage problems, construction issues and waste management were considered to be the primary health concerns in the region. Comparative analysis with the situation in other regions in Iran emphasizes the unique challenges faced by the community in the present study.
Conclusion: The prioritized health issues highlight the community's urgent needs, requiring targeted interventions. Proposed solutions include legal measures, public education and municipal interventions to address the sewage, construction and waste management problems.