Objective(s): Health Insurance Literacy (HIL) is the knowledge, ability, and confidence of people to find and evaluate information about Insurance plans, choose the best plan and how to use it. This study was conducted to examine the level of HIL among the insured person of the Iran Health Insurance Organization in Tehran. Methods: This cross-sectional study was conducted in 2023 with the participation of 309 insured person. The data were collected using a 27-item questionnaire that included three dimensions of access, Insurance terms, and performance skills. The validity and reliability of the questionnaire were confirmed. Data analysis was performed in SPSS.24 using T-test and One-way ANOVA. Results: The mean score for access was 8.5±1.91, Insurance terms 10.21±2.46 and performance skill was 22.94±3.23. The overall mean HIL score was 41.64±6.22. The HIL status of 60% of the insured person was intermediate and 40% was low. The mean score of HIL was higher among people living in the northern region, those covered by the special diseases fund, those with a monthly less income, and those without supplementary Insurance. The HIL level was also higher among people whose source of Insurance information was friends and acquaintances (P<0.05). Conclusion: The majority of people had relatively low levels of HIL. Knowing the level of HIL and the factors that influence it can guide policy makers in developing educational interventions to remove barriers and improve HIL. Educational interventions through public media such as television, short videos on the websites and applications of Insurance organizations and social media, and the provision of Insurance information on waiting room monitors in medical centers are suggested to improve HIL.

Background and Aim: The purpose of the research is to investigate the factors affecting the model of Health, safety and environmental (HSE) risk Literacy. Organizations can’t work without without Healthy and safe employees. Health Literacy deals with the issue of whether a person meets the complex requirements of promoting and maintaining Health in modern society. Methods: The researcher has analyzed the results and findings of previous researchers by applying a systematic and meta- combination approach and by performing the 7 steps of the Sandelowski and Barroso method; he has identified the effective factors. Among 556 articles, 55 articles were selected based on the CASP method, and the validity of the analysis was confirmed with the Kappa coefficient value of 0.711. In this context, in order to measure reliability and quality control, the transcription method was used, and its value was identified for the indicators identified at the level of excellent agreement. The results of data analysis collected in MAXQDA software led to the identification of 84 primary codes in 16 categories in 5 dimensions. Results: Finally, five dimensions of planning, concepts of Literacy development, implementation of education, evaluation and revision were identified as influencing dimensions of Health, safety and environmental risk Literacy. Conclusion: Organizations can focus on these factors in order to improve the Literacy of HSE risks as one of the preventive and improving decision- making factors among their employees. What can be inferred from the categories and dimensions is the impossibility of balanced and proportional promotion of HSE risk Literacy in an organization by one person and one department and even the organization itself alone. Improving the Literacy of HSE risks requires the attention and assistance of extra-organizational, organizational and individual factors. Please cite this article as: Yari A, Shobeiri SM, Rezaei M, Hamidieh A. Factors Affecting Health, Safety and Environmental Risk Literacy Promotion Model. Irtiqa Imini Pishgiri Masdumiyat. 2023;11(1):40-57. Doi: 10.22037/iipm.v11i1.41735

Background: Health Insurance Literacy is a nascent concept that has emerged mainly after the implementation of the law known as Obamacare in the United States. This study seeks to identify the themes of Health Insurance Literacy in Iranian society. Methods: The study approach is qualitative. Data were collected using nine semistructured interviews, ten focal group meetings with the presence of 86 experts of an Insurance organization and a specialized meeting with fifteen academic experts, from September to December 2018 at the organization's location. MAX QDA10 software was used to organize the data. Qualitative data analysis was performed using continuous comparison analysis and in the form of directional qualitative content analysis based on the conceptual model (Paez et al 2014). Coding was performed independently by two researchers and then collected. Results were reviewed by an external observer. Finally, in a specialized meeting with the participation of representatives of specialized (groups secretaries) and academic experts (participants in the initial interviews), the findings of the study were re-examined and confirmed. Results: By reviewing the collected texts, 264 initial codes, 21 components, 10 subthemes, and five themes were extracted. Based on the conceptual model of the study, the data were organized in three axes. In the knowledge axis, the themes of Health Insurance knowledge (including Health Insurance knowledge and attitude toward Health Insurance) and awareness of insured rights and assignments (including insured assignments and insured rights), in the axis of skill, themes of information search and services (including information acquisition and service search) and utilization of Insurance coverage (including receiving Insurance coverage and benefiting from benefits), and in the axis of self-confidence, the theme of self-efficacy (including Timely decision making and environmental awareness) have been identified. Conclusion: Health Insurance Literacy for Iranian society, instead of being able to choose the type of Insurance, focuses on its application in improving decision-making behavior and seeking insured treatment in the Health market.

2Objective(s): The purpose of this study was to develop and validate Health Insurance Literacy assessment tool in Iran. Methods: A cross-sectional descriptive study was conducted with the aim of standardizing the Iranian tool for measuring Health Insurance Literacy. The items of the tool were extracted from a qualitative study based on Paez et al. model. A total of 219 patients of a general medical center in southwest of Iran were randomly selected to participate in the study. Content validity was assessed estimating CVR and CVI and face validity was performed by a panel of experts. Structural validity was evaluated using the exploratory factor analysis. To measure reliability, we used Cronbach's alpha. Results: The findings of the study showed a 7-factor solution accounting for 66% of variance observed. Also a high internal consistency between the items was estimated (Cronbach's alpha=0.85) . All study constructs showed a positive and significant correlation with the main variable. Conclusion: The Iranian tool for measuring Health Insurance Literacy as a valid and reliable tool can be used in Iran. This tool can be used in assessing the needs of interventions to empower the insured regarding how to apply Insurance coverage in the Health market.

Introduction: One of the main characteristics of a hospital information system (HIS) is confidentiality. Studies have shown that the security requirements on electronic Health records are not fully met in Iran.This study was conducted to determine the percentage of HIPAA (Health Insurance portability and accountability act) security safeguard application in university hospitals of Shiraz University of Medical Sciences in 2010.Methods: This was a cross-sectional descriptive study. The study population included university hospitals of Shiraz University of Medical Sciences equipped with HIS. Data were collected by a checklist through interview with the IT authorities of the hospitals. The checklist was in accordance with HIPAA security standard rules. Tool validity was checked by the content validity method. Data were analyzed using descriptive statistics.Results: The risk management and data backup plan, two out of seven required administrative security safeguards (i.e. risk analysis, risk management, sanction policy, information system activity review, data backup plan, disaster recovery plan, and emergency mode operation plan), were fully applied in all the hospitals. Both of two required physical security safeguards, disposal and media reuse, were applied in the majority of the hospitals. Of the two required technical security safeguards, unique user identifications, and emergency access procedure were applied only in one of the hospitals.Conclusion: Operational planning must be implemented in order to increase the application of required administrative security safeguards. Full application of the required physical security safeguards, which are close to reach, and the required technical security safeguards could be the main steps in promoting security of the HIS.