Health Promotion Perspectives
Year:2020 | Volume:10 | Issue:3|Papers Count:17

Dear Editor, “ From black death to corona virus: a brief history of quarantines” ; “ Iran’ s coronavirus outbreak is bizarrely reminiscent of the black death” ; “ Learn from history: black death killed millions of people” ; “ Black death offers lessons for dealing with covid-19 outbreak” . This is just a glimpse at the headlines of some famous papers regarding the outbreak of the novel coronavirus disease of 2019 (COVID-19) highlighting the importance of this crisis as a global warning. On January 31, 2020, the WHO announced the outbreak of COVID-19 as a public health emergency worldwide. 1 High virulence of the pathogen, its rapid transmissibility, and the potential for environmental contamination are important characteristics of COVID-19, reaffirming the need for special attention. During this pandemic, serious considerations have been given to the high-level quarantine in most countries battling with COVID-19...

Dear Editor, Vietnam, a middle-income country with more than 96 million population, has mobilized the entire political system in the country to implement a proactive and comprehensive campaign to fight the Coronavirus disease 2019 (COVID-19) pandemic. Employing the principle “ Early detection, strict quarantine, isolation as well as an active treatment” , Vietnam has achieved initial success in containing the spread of the disease. 1 As of April 26, 2020, the number of confirmed COVID-19 cases was 270, 225 recoveries and no deaths...

The issue of indoor air quality (IAQ) concerns 64 million students across Europe, but it is still a neglected topic, although it impacts both their health and learning outcomes. Classroom microclimate is the first key factor determining a healthy or unhealthy school environment, and it is influenced by ventilation, temperature and humidity rate. Classrooms are usually crowded, overheated and poorly ventilated, thus resulting in possible increases of carbon dioxide (CO2), that can cause several problems when its concentrations exceed the value of 0. 15 percentage volume of CO2 (1500 ppm) or even at lower levels (1000 ppm). CO2 can also arise from outside the school, being widely produced by combustion of fossils or road traffic. Anthropogenic activities are responsible for the emission of nitrogen dioxide (NO2) and polycyclic aromatic hydrocarbons (PAH) too, which represent other possible external contaminants potentially impairing IAQ. Further dangerous exposures for students’ health are those related to natural emission of gas Radon, which typically accumulates in poorly ventilated classrooms, and volatile organic compounds (VOCs, released by building materials, paints, furnishings, detergents), while chemicals substances (i. e. cyanoacrylate, lead, cadmium, nickel) might be contained in school materials. Finally, particulate matters (PM2. 5 and PM10) originating from road traffic, domestic heating or industrial activities represent additional possible contaminants impacting schools’ air quality. Poor IAQ might result in mild adverse events (i. e. headaches, nausea etc. ) or cause respiratory problems. More frequently, IAQ affects students’ attention and their school performances, as widely documented by many studies. Standardized tests administered to pupils exposed to poor IAQ (to assess reading and mathematical abilities) systematically result in worse outcomes compared to students staying in healthy classroom environments. In this paper, we present recommendations of UNESCO Chair on Health Education and Sustainable Development and Italian Society of Environmental Medicine (SIMA) to ensure an optimal IAQ at school, including some post-COVID-19 issues.

Background: Failed attempts to improve the delivery of healthcare to communities show distinct flaws that have a higher impact during a major incident or disaster (MID). This study evaluates the concept of surge capacity, which intends to achieve a balance between the needs and resources in affected areas by providing staff, stuff, structure, and system. Methods: A systematic literature review was performed according to the PRISMA statement and by using PubMed, Scopus, and Google Scholar, and related keywords. Results: There were limited publications about flexible surge capacity (FSC). However, the sum of data obtained indicated the need for flexibility in expanding major incidents or disasters, demanding new resources, which may neither be available on time nor reachable due to infrastructural damage. Conclusion: FSC is a novel concept based on international guidelines. It refers to the extra and adjustable human and material resources that can be mobilized by activating nonprofessional but educated staff and different but accepted facilities in a fast, smooth, and productive way. Public health and public education play an essential role in obtaining such flexibility.

Background: Chronic pain is commonly associated with anxiety and depression, making it more challenging to be managed. Psychological interventions are suggested for such complicated issues which are well evident in the United States and Europe. However, generalizing the evidence to Iranian population – as a Middle Eastern society – might be questionable. We aimed to synthesize our evidence on the effectiveness of these interventions among Iranian populations. Methods: This was a systematic review and meta-analysis. Persian and English literature were searched through Iran-doc, Elm-net, and PubMed until March 2019 using the following terms (or its Persian synonyms): chronic pain; persistent pain; chronic fatigue; fibromyalgia; neuropath*; LBP; irritable bowel; CFS; psycho*; cogniti*; acceptance; meaning; mindfulness; relaxation; biopsychosocial; rehabilitation; educat*. Eligible trials were randomized trials that evaluated the effectiveness of psychological interventions on Iranian adults with chronic pain. No setting restriction was considered. Risk of bias for each trial was assessed, and the random-effect model was used to pool summary effect across trials. Results: In all 30 eligible RCTs, the risk of bias for randomization was low except for one study. The pooled standardized mean difference (SMD) for depression and anxiety were 1. 33 (95% CI:-1. 42 to-0. 68) and 1. 25 (95% CI:-1. 55 to-0. 96), respectively. Conclusion: This study suggests that psychological interventions are highly effective in reducing depression and anxiety in Iranian patients with chronic pain, compared to what observed in the U. S. and European studies. However, there are still some methodological issues to be addressed. Future research should focus on high-quality trials with considerations on the methodological issues reported in the present study.

Background: Part of the role of the media is to report any issue affecting the society to the masses. Coronavirus has become an issue of transnational concern. The importance of the media in the coverage of coronavirus disease 2019 (COVID-19) in Nigeria and its implications among Nigerian populace cannot be overestimated. This study evaluates how Nigerian media depict the coronavirus pandemic and how the depictions shape people’ s perception and response to the pandemic. Methods: The study employed a quantitative design (newspaper content analysis and questionnaire). The content analysis examines the nature of media coverage of coronavirus in Nigeria and China using four major national newspapers (The Sun, The Vanguard, The Guardian and The Punch). The period of study ranged from January 2020 to March 2020. A total of 1070 newspaper items on coronavirus outbreak were identified across the four newspapers and content-analysed. Results: The finding shows that the coverage of the pandemic was dominated by straight news reports accounting for 763 or (71. 3%) of all analysed items. This was followed by opinions 169 (15. 8%), features 120 (11. 2%) and editorials 18 (1. 7%) respectively. The Punch 309 (28. 9%) reported the outbreak more frequently than The Sun 266 (24. 9%), The Guardian 258 (24. 1%) and Vanguard 237 (22. 1%). Finding further suggests that the framing pattern adopted by the newspapers helped Nigerians to take precautionary measures. Conclusion: Continuous reportage of COVID-19 has proved effective in creating awareness about safety and preventive measures thereby helping to ‘ flatten the curve’ and contain the spread of the virus. However, the newspapers should avoid creating fear/panic in reporting the pandemic.

Background: African American men have poorer health outcomes compared to their white counterparts despite medical advancements and early detection of diseases. The purpose of this study was to determine to what extent the constructs of the multi theory model (MTM) explain the intention for initiation and sustenance of the consumption of fruits and vegetables among African American adult men in Mississippi. Methods: Using a cross-sectional design a valid and reliable paper survey was administered during November and December of 2019. The target population for the study consisted of African American adult men (18 or older) that had not consumed recommended levels of fruits and vegetables within 24 hours of taking the questionnaire. A convenience quota sample of African American men from select barbershops in Jackson, Mississippi, were asked to complete the 40-item questionnaire on preventive health screening behavior (n = 134). Results: The mean total number of fruits and vegetables consumed by participants within 24 hours of the taking the survey was 1. 63 (SD =1. 47). The mean intention to initiate consuming 5 or more cups of fruits and vegetables per day score was 2. 13 (SD=1. 17) as measured on a 5-point scale (0-4). Behavioral confidence (β = 0. 495, P < 0. 0001), and changes in physical environment (β = 0. 230, P < 0. 0001) accounted for 40. 8% of the variance in predicting the intention to initiate behavioral change regarding the daily consumption of fruits and vegetables. Practice for change (β = 0. 462, P < 0. 001) and emotional transformation (β = 0. 215, P < 0. 0001) accounted for 37. 5% of the variance in the intention to sustain fruits and vegetables consumption behavior. Conclusion: Based on data found in the study, MTM appears to predict the intention to initiate and sustain fruit and vegetable intake of African American men. Further research studies of suitable interventions to target African American men are needed.

Background: There is no validated instrument for Persian-speaking students to apply the socialecological resilience theory (SERT), which emphasizes the ecological resources for developing resilience. The study aimed at developing the student social-ecological resilience measure (Student-SERM) in Iran’ s context. Methods: Three separate samples of undergraduates participated in this mixed-methods research from the University of Tehran, Iran. Phase-1 qualitatively explored the resilience features in the university setting, to devise the university-specific subscale (USS). Phase-2 piloted the construct validity and reliability of the Student-SERM in 242 undergraduates, who also completed Depression, Anxiety, and Stress Scale (DASS-21). Phase-3, as a cross-validation study, investigated 487 undergraduates, who completed the refined Student-SERM, Hospital Anxiety and Depression Scale (HADS), and three indices screening academic performance, loneliness, and suicide acceptability. Exploratory factor analysis (EFA) and confirmatory factor analysis (CFA), Pearson’ s correlation, and Cronbach’ s alpha were performed. Results: Phase-1 yielded nine items for USS. In phase-2, EFA indicated the construct validity of the main 20-item measure (RMSEA=0. 06 and SRMR=0. 04) and the nine-item USS (RMSEA = 0. 07 and SRMR = 0. 04), and the reliability and convergent/divergent validity were confirmed. In phase-3, EFA (RMSEA = 0. 07 and SRMR = 0. 04) and CFA (RMSEA = 0. 07, CFI = 0. 89, TLI = 0. 87, and SRMR = 0. 07) in two separate subsamples and CFA (RMSEA = 0. 06, CFI = 0. 92, TLI = 0. 90, and SRMR = 0. 06) in the total sample indicated the construct validity of the refined Student-SERM, including family, peer, culture, growth, and USS subscales. The reliability and convergent/ divergent validity were also reconfirmed. Conclusion: The Student-SERM incorporates ecological resources, accounting for the students’ resilience. Since the resilience process involves a return to healthy functioning after adversity, further research can examine the application of Student-SERM in high-risk student populations.

Background: Mammography screening tends to reduce mortality rate through early detection. One of the barriers to mammography screening is fear of negative appearance evaluation (FNAE). This study investigated the impact of internal health locus of control, breast cancer worries and age on the relationship between FNAE and attitude towards mammography. Methods: A cross-sectional, questionnaire-based survey design was used. Samples were Iranian women, living in Iran, aged at least 30 years old, without any history of cancer, and had not performed mammography previously based on self-report. In total, 823 samples were collected through conducting an online survey from April to June 2016. The questionnaire consisted of several instruments including attitude toward breast cancer screening procedures scale, FNAE scale, the internal dimension of the multidimensional health locus of control, and two items to measure breast cancer worry. Using covariance-based structural equation modeling the model was tested. Results: The interaction of FNAE with internal health locus of control (β =-0. 128, P < 0. 05, CI:-0. 200,-0. 056), breast cancer worry (β = 0. 090, P < 0. 05, CI:-0. 162,-0. 017), and age (β =-0. 095, P < 0. 05, CI =-0. 163,-0. 026) was significant. The three tested moderators dampened the positive relationship between FNAE and negative attitude towards mammography. Conclusion: More information about the screening procedure should be given to women to overcome their fear. The findings indicate the need for interventions seeking to shift women’ s health locus of control from external to internal. Women with low level of cancer worry need more attention.

Background: The purpose of this study was to explore the associations between personality traits and dieting self-efficacy as well as health behaviors among emerging adult women. Methods: In this cross-sectional study, the sample consisted of 161 participants in age from 19 to 25 years, who were administered the NEO-Five-Factor Inventory, the Health Behaviors Inventory (HBI), and the Dieting Self-Efficacy Scale (DIET-SE). Results: Our findings indicated that personality traits explained both health behaviors and dieting self-efficacy (F = 6. 21, df = 5, 155, P < 0. 001, F = 6. 42, df = 5, 155, P < 0. 001, respectively). Neuroticism (B =-0. 45, P < 0. 01) and agreeableness (B = 0. 39, P < 0. 01) were investigated as significant predictors of females’ health behaviors, whereas extraversion (B =-0. 40, P < 0. 001), agreeableness (B = 0. 20, P < 0. 05), and conscientiousness (B = 0. 33, P < 0. 01) were related to dieting self-efficacy. In addition, the results suggested the mediational effect of dieting selfefficacy in the relationship between personality traits (i. e., consciousness and agreeableness) and general health behaviors. Conclusion: The role of personality traits for dieting self-efficacy as well as physical health among emerging adult women was confirmed. As dieting self-efficacy turned out to be a mediation factor, the findings may be used in psychoeducation for patients.

Background: This study aimed to find possible spatial variation in children’ s weight disorders and in predicting the spatial distribution. Methods: The study population of this ecological study consisted of 7-18-year-old students living in 30 provinces of Iran. We used Besag, York and Mollie (BYM) model, a Bayesian model, to study the relative risk (RR) of underweight and excess weight (overweight and obese). The model was fitted to data using OpenBUGS (3. 2. 1) software. Results: The highest RR of underweight was found in southeastern provinces. Whereas, the highest RR of excess weight was documented in northern, northwestern and capital provinces. Sistan-Balouchestan (RR=1. 973; Bayesian confidence interval [BCI]: 1. 682, 2. 289), Hormozgan (RR=1. 482; BCI: 1. 239, 1. 749), South Khorasan (RR=1. 422; BCI: 1. 18, 1. 687) and Kerman (RR=1. 413; BCI: 1. 18, 1. 669) had the highest RR of underweight. Mazandaran (RR=1. 366; BCI: 1. 172, 1. 581), Gilan (RR=1. 346; BCI: 1. 15, 1. 562), Tehran (RR=1. 271; BCI: 1. 086, 1. 472) and Alborz (RR=1. 268; BCI: 1. 079, 1. 475) provinces are high risk regions for excess weight. Conclusion: The significant variations in geographical distribution of weight disorders are because of various sociodemographic and ethnic differences. The current findings should be considered in health policy making in different regions of the country.

Background: Equitable promotion of health indicators requires cooperation among different sectors more than ever. The “ Health in All Policies” (HiAP) approach contributes to this process through strengthening intersectoral collaboration. To implement this approach at a national scale, indicators of health-oriented performance from various organizations, and their measurement methods, need to be precisely defined. The aim of present study was to design a toolkit for implementing HiAP in Iran. Methods: A review of literature and documents, as well as conducting semi-structured interviews and focus group discussions were undertaken to collect data for this qualitative study. Content analysis was applied to the collected data and the results were placed in three categories: criteria, sub-criteria and indicators; implementation processes; and implementation requirements. Results: The toolkit aims to achieve various objectives, including intersectoral excellence and the systematic development of intersectoral collaboration. In the process section, reports on measures taken by organizations are assessed by a three-member audit committee. The top three organizations, in terms of intersectoral cooperation in achieving public health goals, are introduced in a Health Week. Requirements for success in achieving the HiAP approach include financial resources to implement the HiAP, a database, an electronic method for submitting reports, training courses, monitoring and annual reporting of relevant indicators, and formulating regulations in order to assess organizations. Conclusion: Justification and training in various organizations to support the implementation of health-oriented measures, providing an annual ranking of organizations, and encouraging the organizations can contribute to the institutionalization of the toolkit through the Supreme Council for Health and Food Security. It is recommended that a Secretariat of Sustainable Development to be established under the Plan and Budget Organization (PBO) of the Islamic Republic of Iran to monitor portfolio indicators.

Background: The Personal Wellbeing Index-Adults (PWI-A) is the most widely used instrument for measuring subjective-quality of life (QoL). The current study seeks to investigate the construct validity and reliability of the Arabic version of the PWI-A on adults with bilateral hearing impairment by comparing the single-factor solution with the two-factor solution. Methods: A cross-sectional study was conducted at the Audio-Vestibular Medicine Unit of Alexandria University from July-2017 to January-2018. A total of 205 adults were interviewed to measure the subjective-QoL using the PWI-A instrument. Internal consistency was determined using both Cronbach’ s alpha and composite reliability (CR). Validity was assessed by construct validity, including ordinal regression, ordinal exploratory factor analysis (OEFA), and ordinal confirmatory factor analysis (OCFA). Results: The first four items of the PWI-A which are: satisfaction with living standard, health, achievements, and relationships were the most important indicators of subjective-wellbeing (Part r2 0. 0547, 0. 0324, 0. 0361, and 0. 0225, respectively). OEFA suggested that the two-factor model contributes better than the single-factor model. OCFA validated this suggested solution; (two-factor: RMSEA = 0. 084 (90% CI = 0. 01-0. 14); CFI = 0. 964; AIC = 52. 64; single-factor: RMSEA = 0. 119 (90% CI = 0. 07-0. 17); CFI = 0. 922; AIC = 62. 77). Good internal consistency was also presented (two-factor: Cronbach’ s alpha = 0. 719, 0. 693; single-factor: Cronbach’ s alpha = 0. 750). Conclusion: The Arabic version of the PWI-A is a multidimensional scale that consists of two dimensions: the first is related to subjective-QoL, and the second is related to satisfaction with the community. Thus, it is recommended to use the short version of the PWI-A with only four items to measure subjective-QoL, as it achieved sufficient reliability and construct validity.

Background: This study examines the global media framing of coronavirus disease 2019 (COVID-19) to understand the dominant frames and how choice of words compares in the media. Periods of health crisis such as the outbreak of coronavirus pandemic add to the enormous burden of the media in keeping people constantly informed. Extant literature suggests that when a message is released through the media, what matters most is not what is said but how it is said. As such, the media could either mitigate or accentuate the crisis depending on the major frames adopted for the coverage. Methods: The study utilises content analysis. Data were sourced from LexisNexis database and two websites that yielded 6145 items used for the analysis. Nine predetermined frames were used for the coding. Results: Human Interest and fear/scaremongering frames dominated the global media coverage of the pandemic. We align our finding with the constructionist frame perspective which assumes that the media as information processor creates ‘ interpretative packages’ in order to both reflect and add to the ‘ issue culture’ because frames that paradigmatically dominate event coverage also dominate audience response. The language of the coverage of COVID-19 combines gloom, hope, precaution and frustration at varied proportions. Conclusion: We conclude that global media coverage of COVID-19 was high, but the framing lacks coherence and sufficient self-efficacy and this can be associated with media’ s obsession for breaking news. The preponderance of these frames not only shapes public perception and attitudes towards the pandemic but also risks causing more problems for those with existing health conditions due to fear or panic attack.

Background: In the United States, only about 15% of individuals meet daily fruit intake recommendations of 2 cups per day and only 10% meet the vegetable intake recommendations of 3 cups per day. African American women are a high-risk group. In this study, a fourth-generation multi-theory model (MTM) of health behavior change was used to design and evaluate a Sisters Adding Fruits and Vegetables for Optimal Results (SAVOR) intervention for AA women. Methods: The study utilized a randomized controlled trial (RCT) with measurements taken at pretest, posttest (after the three-week intervention) and follow-up (at the end of eight weeks). SAVOR (n=26) was compared to an equivalent knowledge-based intervention (n=28). Process evaluation was done for program fidelity and satisfaction. A validated 38-item self-reported questionnaire was used to measure changes in MTM constructs and past 24-hour consumption of fruits and vegetables. Results: The SAVOR intervention resulted in improvement of mean consumption of fruits and vegetables in the experimental group from pre-test (2. 78) to posttest (4. 77) to recommended levels at follow-up (5. 04) while in the comparison group they remained at around 3 (P < 0. 0001) Statistically significant changes (P < 0. 05) were noted for all MTM constructs except for participatory dialogue. Conclusion: The SAVOR intervention was found to be efficacious and established the robustness of MTM. SAVOR can be replicated for future effectiveness trials.

Background: Climate change is one of the most critical threats to our society. The purpose of this cross-sectional study was to describe the content of the most viewed climate change videos on YouTube. Methods: The term “ climate change” was used to search on YouTube to garner a sample of the 100 most widely-viewed videos. Videos in a language other than English, or considered irrelevant, were excluded. Using a fact sheet from National Aeronautics and Space Administration, content categories were created and successively coded. Results: The mean number of views for the 100 videos evaluated was 231, 140. 2 views (SD= 718, 399. 5) and the mean length was 12. 1 minutes (SD= 24. 1). Most videos were uploaded by a news source (77. 0%), included a belief that climate change is happening (77. 0%), and mentioned the impact of climate change on the environment (71. 0%). Only one-third of the videos mentioned how to prevent climate change (33. 0%). More than half focused on a specific environment and, of those, 47. 2% specifically focused on cities. Compared to videos that did not focus on a specific environment, the videos with an environmental focus were more often intended for adults (87. 3% vs. 53. 3%, P ≤ 0. 001). Conclusion: This study highlights the need for climate change YouTube videos intended for youth. Targeting youth may lead to engagement of younger generations in climate change discourse and inspire climate action. Further research is needed to determine the effectiveness of YouTube as a platform for educational videos on climate change.

Background: The media plays as an important role in delivering information about emergent issues, such as the Eastern equine encephalitis virus (EEEV) outbreak of 2019. As such, there has been an increase in news coverage of vector-borne disease coverage due to a rise in emerging or re-emerging arboviruses. Methods: The purpose of this study was to describe the content of news clips related to the recent (2019) EEEV outbreak in the United States. Results: Only 3 of the important topics identified were mentioned in a majority of the 110 videos analyzed. These topics were, mosquito mentioned as transmitter, prevention by repellent/ pesticide, and geography. Thus, many aspects of EEEV were lacking in coverage. Conclusion: A priority for public health professionals should be to engage in discourse with news media to assure that information disseminated via news channels is not vague or misleading.