JOURNAL OF SCHOOL OF PUBLIC HEALTH AND INSTITUTE OF PUBLIC HEALTH RESEARCH
Year:2011 | Volume:9 | Issue:2|Papers Count:11

Background and Aim: Visceral leishmaniasis is a systemic parasitic disease with a high fatality rate in under-5-year-old children. The disease is endemic in some parts of Iran, particularly in the north-west region. In 2001 a visceral leishmaniasis (VL) surveillance system was established for children aged £12 years in the primary health system in Meshkin-Shahr District, Ardebil Province, situated in the north-west of Islamic Republic of Iran.Materials and Methods: All cases with clinical signs and symptoms of VL and confirmed positive by the direct agglutination test (DAT) were referred for physical examination and treatment.Results: The mean annual incidence of VL decreased significantly from 1.88 per 1000 children before (1985-2000), to 0.77 per 1000 child population after (2001-07), the intervention. In the control area with no surveillance, it increased from 0.11 to 0.23 per 1000.Conclusion: Early detection of VL using serological tests and timely treatment of cases can decrease the mortality and morbidity rates of VL in endemic areas.

Background and Aim: Priority setting is one of the most important issues in health research systems. No national health system can afford to finance all research projects proposed by researchers, especially in developing countries. Therefore, we decided to set the main national health research priorities in Iran using the Essential National Health Research (ENHR) method.Materials and Methods: All of the Iranian universities of medical sciences and other stakeholders collaborated in this study. The methodology for research priority setting was based on needs assessment and ENHR. Results: The total number of research priorities gathered from universities of medical sciences was 6723. The proportions of topics related to basic science, applied and development subjects were 17%, 78% and 5%, respectively. Further analysis of the data showed that almost half (46.3%) of the research priorities were descriptive, 36.0% analytical, and 17.6% interventional. The research priorities were divided into 9 main areas, namely, communicable diseases, noncommunicable diseases, health system research, pharmaceutical sciences and industrial pharmacy, basic science, traditional and herbal medicine, nutrition, environmental health, and dentistry.Conclusion: Up to now the common procedure for research priority setting has been, with a top-to-bottom approach, managed by a limited number of researchers and experts, while in the method presented in this paper a bottom-to-top approach is used, which is more effective.

Background and Aim: In social marketing, the common techniques of commercial marketing are used to increase the chances of acceptability of an idea or action by the target group. In this study, we determined the impact of an intervention based on social marketing to reduce risky driving behaviors among taxi drivers in Tehran.Materials and Methods: This was a quasi-experimental study, consisting of a quantitative and a qualitative part, on taxi-drivers in 2 regions (an intervention and a control groups) in the City of Tehran. Based on a formative research approach, the components of social marketing, namely, the product (reminder message for concentrating on avoidance of two target behaviors, tailgating and not driving between lines), price, place and promotion were determined. An 8-week educational program was implemented, the components being installation of stickers before the driver's eyes, distributing a pamphlet, and transferring messages through taxi route supervisors as opinion leaders. After six weeks, risky driving behaviors were assessed by checklists and compared.Results: The intervention resulted in statistically significant reductions in the two target behaviors in the intervention group as compared with the control group. Furthermore, logistic regression showed that the odds ratio for avoiding both behaviors increased significantly in the intervention group. Conclusion: Determining specific target groups, designing interventions based on actual needs and wants of the target group, and focusing on the factors influencing the behavior market are the basic elements of social marketing. Due consideration of these elements when designing behavioral interventions would lead to reductions in risky driving behaviors.

Background and Aim: Experience at the national and international levels shows that internal evaluation, especially at the level of academic departments, can play a critical role in warranting having a university with high standards. The objectives of the present research project were to determine (a). the quality of the structural elements of the Epidemiology and Biostatistics Department (EBD) School of Public Health, Tehran University of Medical Sciences, and (b). The strengths, weaknesses, opportunities and threats, on the basis of which action could be taken to improve the quality of activities in the Department.Materials and Methods: The study was conducted with the collaboration of the head and faculty members, all of the students (residents, Ph.D. and M.S. students), and the graduates, of the EBD. Nine variables were studied, namely, 1). Aims and objectives, 2). Organizational and management structure, 3). Faculty members, 4). Students, 5). Teaching and learning process, 6). Courses and curricula, 7). Graduates, 8). Research and educational facilities and equipment, and 9). Research activities of the faculty members. First the initial weight of the 9 variables were determined by opinion poll carried out among all the faculty members of EBD. Then unrelated data were identified through proper tests and omitted and the final weights extracted. The tools used to collect the data included interview, observation, and 7 self-prepared questionnaires and 2 check lists. Results: The mean score for the 9 factors studied was 59.8%, the range being between 37.0% (for objectives and mission) and 72.0% (for graduates).Conclusion: The graduate domain is one of the key areas in internal evaluation of the Department of Epidemiology and Biostatistics. On the other hand, the lower score for objective and aims domain implicates the need for future intervention in this domain.

Background and Aim: Millions of occupational accidents and disease cases are reported from work places annually causing considerable human and financial damages. Safety training is globally considered the best strategy to mitigate these damages. In this project a safety attitude questionnaire was used to obtain the required information. The questionnaire contained items about 13 relevant variables: job conscientiousness, fatalism, leadership, safety consciousness, role overload, work pressure, job safety perception, supervisor safety perception, coworker safety perception, management safety perception, safety program and policies perception, interpersonal conflicts at work, and job involvement.Materials and Methods: A total of 204 individuals (101 in the control and 103 in the experiment group) in the Isfahan Steel Company completed the safety attitude questionnaire. This was followed by a 4-hour safety training course attended by the experimental group. After 30 days both the experimental and control group completed the questionnaire again. Descriptive statistics and covariate analysis were used the compare the data between the 2 groups.Results: Safety training in the workplace influenced positively the general attitude of the personnel towards safety issues. Further analysis of the data revealed that the training affected statistically significantly only safety consciousness, leadership, and management safety perception.Conclusion: Assessment of safety attitude in the workplace and its dimensions can be used to identify those areas of safety training that need more attention and a better design.

Background and Aim: Community assessment is a process by which a clear picture of the community assets, strengths, resources, and needs is obtained with active participation of the community itself, followed by prioritization of the community needs and formulating strategies and programs to solve the problems. This study was conducted to identify and prioritize problems and needs of the Azerbaijan Borough in Tehran city, Iran, with active participation of the people.Materials and Methods: This study was conducted to determine the attitudes and beliefs of the community members about their community needs and problems. The study was based on a model designed in North Carolina, US. In this model, the assessment process is performed in eight steps. In the first seven steps problems are identified and prioritized, and in step 8 a plan of action is developed to deal with the problem selected.Results: A total of 40 problems were identified and divided into several groups. The most important problems were as follows: social problems, environmental health problems, educational and cultural problems, civil rights and urban services, distribution and use of drugs, lack of family counseling centers, shortage of parks and playgrounds for neighborhood children, lack of supervision by municipal contractors on urban cleaning, and lack of mental health services specially for the elderly.Conclusion: Several types of problems, including health, as well as non-health - social, cultural and economic - problems were identified. Community assessment provides an appropriate opportunity for active participation of community members and makes available sufficient information for sound decision-making. Thus, community assessment can be regarded as a suitable technique for identifying and prioritizing community needs.

Background and Aim: Many studies show that the only way to control diabetes and prevent its debilitating complications is continuous self-care. This study aimed to determine factors affecting self-care behavior of diabetic women in Khoy City, Iran based the extended theory of reasoned action (ETRA).Materials and Methods: A sample of 352 women with type 2 diabetes referring to a Diabetes Clinic in Khoy City in West Azarbaijan Province, Iran participated in the study. Appropriate instruments were designed to measure the relevant variables (diabetes knowledge, personal beliefs, subjective norm, self-efficacy and behavioral intention, and self-care behavior) based on ETRA. Reliability and validity of the instruments were determined prior to the study. Statistical analysis of the data was done using the SPSS-version 16 software.Results: Based on the data obtained, the proposed model could predict and explain 41% and 26.2% of the variance of behavioral intention and self-care, respectively, in women with type-2 diabetes. The data also indicated that among the constructs of the model perceived self-efficacy was the strongest predictor for intention for self-care behavior. This construct affected both directly and indirectly self-care behavior. The next strongest predictors were attitudes, social pressures, social norms, and intervals between visiting patients by the treating team.Conclusion: The proposed model can predict self-care behavior very well. Thus, it may form the basis for educational interventions aiming at promoting self-care and, ultimately, controlling diabetes.

Background and Aim: This paper reports on the predictors of high school students' oral health behaviors (OHBs) based on the Pender's Health Promotion Model (HPM) in an attempt to identify effective factors that may be addressed through intervention efforts.Materials and Methods: A multistage cluster sample of 403 high school students were recruited from 8 high schools in Marivan County, Iran. The study was conducted between April and July, 2010. Appropriate instruments were used to measure the relevant variables. The statistical analysis of the data included bivariate correlations, t-test, one-way ANOVA and linear regression.Results: All HPM variables (perceived self-efficacy, perceived benefits and barriers, activity-related affects, interpersonal and situational influences and commitment to a plan of OHBs) were significantly related to OHBs among the respondents (p<0.01), and a negative association was found between OHBs and perceived barriers (p<0.01). All HPM variables were statistically significant predictors of OHBs and accounted for 42.2% of the variance.Conclusion: Promotion of interpersonal influences and the students' perceived self-efficacy and also commitment to a plan of action should be priorities of any program aimed at promoting OHBs among students. School health care providers should suggest strategies to overcome the barriers of performing OHBs, rather than noting the benefits of these behaviors.