ABSTRACT
BACKGROUND: Insufficient physical activity (IPA) is one of the leading causes of premature mortality through the increased burden of non-communicable diseases. From 1990 to 2017, the percentage of low physical activity attributable disability-adjusted life years (DALY) increased globally by 1.5 times and 2-fold in Iran, causing more than 1.2 million deaths worldwide and 18,000 deaths in Iran in 2017. Reports suggest that Iran, a developing middle-income country, suffers from a high level of IPA. Socioeconomic and cultural alterations along with the country's developments expose the population to IPA risk. We aimed to describe IPA prevalence in Iran's adult population, categorized by demographics, geographical region, and activity domains to assess the present pattern of physical inactivity and its domains in the country. METHODS: In 2016, in order to represent Iran's adult population, adult participants (n: 30541) from 30 provinces were selected using systematic proportional to size cluster sampling. Physical activity (PA) was assessed via the Global Physical Activity Questionnaire, calculating the Metabolic Equivalent of Task (MET) value in minutes per week for work, recreation, and transport domains. Insufficient physical activity (IPA) was defined according to WHO's recommendation (less than 600 METs per week). Adjusted odds ratios of IPA associates for sociodemographic, lifestyle related variables, and metabolic risk factors were reported. RESULTS: A high prevalence of IPA was seen in the total population (54.7%, 95%CI: 54.0-55.3) with a considerable difference between the two genders (males: 45.3% (95%CI: 44.3-46.3); females: 61.9% (95%CI: 61.0-62.7)). Work-related activity was the domain with the greatest percentage of total PA, whereas, both genders lacked recreational activities. In our findings, being female, a housekeeper, younger and living in urban areas were significantly associated with higher levels of IPA. Moreover, insufficient fruit and vegetable consumption, lack of alcohol consumption, having a personal vehicle, and finally, having a medical history of diabetes were significantly associated with the presence of IPA in our population. Among the study population, 33.6% (95%CI: 33.0-34.2) had at least 4 h of sedentary behavior in a typical day. CONCLUSIONS: Widespread IPA among the Iranian adult population is of major concern. In our findings, we observed a considerable gap in the prevalence and pattern of IPA between the two genders. Additionally, IPA was associated with living in urban areas, unhealthy lifestyle habits and a history of other metabolic risk factors. Thus, a prompt initiative for population-specific actions should be taken.
Subject(s)
Exercise , Population Surveillance , Adolescent , Adult , Aged , Female , Humans , Iran , Life Style , Male , Middle Aged , Risk Factors , Sedentary Behavior , Sex Factors , Surveys and Questionnaires , Young AdultABSTRACT
BACKGROUND: The most recent emerging infectious disease, coronavirus disease 2019 (COVID-19), is pandemic now. Iran is a country with community transmission of the disease. Telehealth tools have been proved to be useful in controlling public health disasters. We developed an online self-screening platform to offer a population-wide strategy to control the massive influx to medical centers. METHODS: We developed a platform operating based on given history by participants, including sex, age, weight, height, location, primary symptoms and signs, and high risk past medical histories. Based on a decision-making algorithm, participants were categorized into four levels of suspected cases, requiring diagnostic tests, supportive care, not suspected cases. We made comparisons with Iran STEPs (STEPwise approach to Surveillance) 2016 study and data from the Statistical Centre of Iran to assess population representativeness of data. Also, we made a comparison with officially confirmed cases to investigate the effectiveness of the platform. A multilevel mixed-effects Poisson regression was used to check the association of visiting platform and deaths caused by COVID-19. RESULTS: About 310 000 individuals participated in the online self-screening platform in 33 days. The majority of participants were in younger age groups, and males involved more. A significant number of participants were screened not to be suspected or needing supportive care, and only 10.4% of males and 12.0% of females had suspected results of COVID-19. The penetration of the platform was assessed to be acceptable. A correlation coefficient of 0.51 was calculated between suspected results and confirmed cases of the disease, expressing the platform's effectiveness. CONCLUSION: Implementation of a proper online self-screening tool can mitigate population panic during wide-spread epidemics and relieve massive influx to medical centers. Also, an evidence-based education platform can help fighting infodemic. Noticeable utilization and verified effectiveness of such platform validate the potency of telehealth tools in controlling epidemics and pandemics.
Subject(s)
COVID-19 , Male , Female , Humans , COVID-19/diagnosis , COVID-19/epidemiology , COVID-19/prevention & control , SARS-CoV-2 , Iran/epidemiology , Pandemics/prevention & control , HospitalsABSTRACT
BACKGROUND: To achieve Sustainable Development Goal 3.6 in Iran, we need to have a comprehensive understanding of the distribution of risky behaviours regarding road-traffic injuries at national and sub-national levels. Little is known about the road-use vulnerability patterns of road-traffic injuries in Iran. The aim of this study is to describe the prevalence of self-reported human risk factors in road-traffic injuries using the findings from a large-scale cross-sectional study based on the World Health Organization's stepwise approach to surveillance of non-communicable diseases (STEPs). METHODS: A cross-sectional survey study in 2016 assessed the road-use pattern and prevalence of risky behaviours of people more than 18 years old. In this study, we planned to recruit 31 050 individuals as a representative sample at national and provincial levels. In practice, 30 541 individuals (3105 clusters) from urban and rural areas of Iran were selected. Basic socio-demographic data, major behavioural risk factors such as seatbelt and helmet non-compliance, drunk driving and occupant in a car with a drunk driver were assessed through baseline interviews gathered through an Android tablet-based questionnaire. RESULTS: The overall prevalence of seatbelt and helmet compliance was 75.2% (95% confidence interval: 74.7-75.7) and 13.9% (13.4-14.5), respectively, at the national level. The prevalence of risk-taking behaviours such as drink driving was 0.5% (0.4-0.6) and for being an occupant in a car with a drunk driver was 3.5% (3.2-3.8). At the provincial level, the highest age-standardized prevalence of seatbelt compliance (89.6%) was almost 1.5 times higher than the lowest provincial prevalence (58.5%). In 63% of provinces, the lowest prevalence of seatbelt compliance was observed among people aged 18-24 years old. CONCLUSIONS: In Iran, existing disease-prevention and health-promotion programmes should be expanded to target vulnerable subgroups that have more prevalent human risk factors for road-traffic injuries. Further research is required to investigate the context-specific proximal human risk factors and vulnerability patterns in Iran.