What sources do adolescents turn to for information about their health concerns?

BACKGROUND: Adolescents are developmentally normatively interested in information about sexuality and other health-related issues. In the absence of available health programming, identifying the sources of information that youth are currently accessing will help adolescent health researchers understand where youth 'are,' thereby informing where and how future interventions can be targeted. This is particularly important in resource-limited settings, such as Iran, where funding for public health programming is scant. This study aimed to examine primary and preferred sources of adolescents' health information queries and identify health topics in which they are most interested. METHODS: In 2011, a random sample of 915 adolescents, aged 14-18 years, completed anonymous, self-administered questionnaires. RESULTS: Mothers (51.11%) and same-sex friends (40.11%) were both the primary as well as the preferred source of health information for adolescents. More than one in three adolescents identified media information sources, including books (39.6%) and the Internet (37.9%), as their primary and preferred sources. The most common topic adolescents sought information about was sexuality issues. Younger adolescents preferred receiving information from parents, whereas older adolescents preferred friends as sources for information [X2=9.3, p=0.009]. No age differences were noted in using media sources (p>0.05). CONCLUSIONS: These findings indicate future interventions should integrate some if not all of these sources [both people (mothers, same-sex friends) and media (books, the Internet)] to deliver evidenced-based health information.

Parents as Teachers: Mothers' Roles in Sexual Abuse Prevention Education in Gorgan, Iran.

BACKGROUND: Parents play an important role in protecting their children from sexual abuse. Mothers, in particular, play key roles in the sexual socialization of their children and in educating their children about child sexual abuse (CSA). OBJECTIVES: The purpose of this study was to determine whether preschool girls in Gorgan (a city in northern Iran) could learn personal safety skills when taught by their mothers. PARTICIPANTS AND SETTING: Fifty-six participants (mother-daughter pairs) were recruited from patients visiting health centers. Mean age of girls was 6.34 years. METHODS: Girls were pretested using Persian versions of the Personal Safety Questionnaire and 'What If' Situations Test, randomly assigned to either a mother-taught program or wait-list control, and post-tested. Mothers assigned to the education group participated in a two-hour workshop on preventing CSA and were given the Body Safety Training workbook to teach their daughters. Following the one-week training by their mothers, children in both groups were post-tested and follow-up tested one month later. RESULTS: Children taught by their mothers demonstrated significant increases in knowledge about sexual abuse and higher levels of personal safety skills compared to controls, and these gains were maintained at the one-month follow-up. CONCLUSION: Results suggest that mothers can effectively teach their young daughters personal safety skills. Difficulties female children have in recognizing appropriate-touch requests are discussed and compared to results in other developing countries. Advantages of home-based instruction for young children are described and suggestions for increasing parent participation are offered.

Exploring the relationship between health concerns and high-risk behaviours in Medical Sciences' students.

Aim: The need to cope with life concerns may drive an individual to resort to high-risk behaviours. This study aimed to determine the relationship between health concerns and high-risk behaviours. Design: A cross-sectional study. Methods: We sampled 926 Medical Sciences' students from the North of Iran from September-December 2017 using the stratified sampling method. Results: The most and less common high-risk behaviour was physical inactivity (97.5%) and high-risk sexual behaviour (15.7%), respectively. In multivariate logistic regression analysis, participants' concerns about human sexuality (AOR: 1.39; CI: 1.22, 1.57), injury prevention and control (AOR: 1.12; CI: 1.01, 1.20), nutrition (AOR: 1.13; CI: 1.02, 1.26) and emotional health (AOR: 1.08; CI: 1.02, 1.15) increased the odds of risky behaviours. Among Medical Sciences' students, health concerns are linked with risky behaviours. The result of this study can be used to develop relevant interventions targeting mental health to reduce risky behaviour among youth.

"Konkoor Giant", a narrative of high school female students from Gorgan, Iran.

Background The university entrance exam or Konkoor is a determining event for the Iranian adolescents and their families. It is considered as the most important opportunity for adolescents for creating their ideal futures. Hence, regarding the importance of this exam and its accompanying pressures during the critical and stressful adolescence period, this study describes adolescents' perspective about what make them worried about the university entrance exam. Methods This study is based on responses of 500 high school female students to an open-ended question completed in their class. In total 482 adolescents wrote down their answers. Using quantitative content analysis, these statements were analyzed. Results The findings showed that three categories including "individual" category (87.90%) with three subcategories; Konkoor's outcome, readiness for Konkoor, self-blame, and "family" category (7.12%) with three subcategories; consequences of failure, family expectations, family conflicts, and "religious- socioeconomic" category (4.98%) with three subcategories; religion, financial status, educational policies as the main adolescents concern sources about the university entrance exam. Conclusion Considering the high concerns of female adolescents about the university entrance exam and the pressures that they receive from their families, society, and even themselves, modifying the educational policies, applying some measures to promote knowledge, and gaining required skills to deal with different aspects of such concerns are necessary for adolescents and their parents.

Influencing factors on high-risk sexual behaviors in young people: an ecological perspective.

Background In recent years, high-risk sexual behaviors due to their negative consequences both for the individual and society have received more attention than other high-risk behaviors. Objective The aim of this study was to review the influencing factors of high-risk sexual behaviors among young people from an ecological point of view. Methods This review was conducted through searching databases including PubMed, Web of Science, Scopus, Google Scholar and the Cochrane Library with keywords such as sexual risk-taking behavior, high-risk sex, unprotected sex and unsafe sex. The relevant papers published between 1995 and 2016 were extracted. After reviewing the abstract and full text of the articles, 45 papers were used to write this article. Results From an ecological theory approach, factors which influence high-risk sexual behaviors are divided into three categories - the microsystem, the mesosystem and the macrosystem. The microsystem includes factors such as age, gender, race, marital status, place of residence, religion, level of education, personality traits, psychological problems, childhood experiences, body image and coincidence of high-risk behaviors; the mesosystem includes factors such as family structure, peers and sex education; in the macrosystem, the impact of culture and traditions of the society, economic status and the media are presented. Conclusion Given that high-risk sexual behaviors often have multiple causes, it seems that health policymakers must consider multi-dimensional interventions to influence high-risk sexual behaviors based on the ecological approach.

Health concerns of adolescents in Tehran, Iran.

BACKGROUND: Adolescent health concerns are an important source of information that should be considered when planning school and community health promotion policies, programs and services. Adolescence is a critical period of human development and the health concerns of adolescents can point to important issues that may be eclipsed by epidemiologic and other clinical sources of information. This study aimed to assess the health concerns of adolescents living in Tehran, Iran and to examine associations between selected demographics and the health concerns reported by participants. METHODS: This study was a population-based cross-sectional survey in 2011. Data were collected from a stratified random cluster sample of 915 adolescents, aged 14-18 years, living in Tehran, using the Persian version of the Adolescent Health Concern Inventory (AHCI-P). The data were analyzed using the χ2, Mann-Whitney and Kruskal-Wallis tests and logistic regression analysis. RESULTS: The mean numbers of health concerns in girls and boys were 48 (±27.6) and 44.5 (±27.4) respectively. The highest ranking health concern subscale for both girls and boys was The Future, and "being successful" was endorsed as the most prominent concern in the subscale. Female (OR: 1.42, CI 95%: 1.08-1.87), mother's educational level (OR: 2.23, CI 95%: 1.07-4.65) and living in northern (OR: 1.76, CI 95%: 1.13-2.74) and western (OR: 2.02, CI 95%: 1.30-3.16) regions of Tehran were significant predictors of a higher level of health concerns. CONCLUSION: Findings can be used to inform school and public health promotion policies, programs and supportive services designed to improve the overall health and well-being of adolescents.

Health concerns of Iranian adolescents: protocol for a mixed methods study.

BACKGROUND: Adolescents have particular health and developmental needs that suggest they should neither be treated as older children nor younger adults. OBJECTIVES: The aim of this paper is to report the protocol for a mixed methods study that set out to investigate the health concerns of Iranian adolescents and their sources of health information with the goal of identifying suitable strategies to address their health concerns. MATERIALS AND METHODS: This mixed methods study consists of an explanatory sequential design to be conducted in two phases. The first phase was a population-based cross-sectional survey of 915, 14-18 year old adolescents who were selected by stratified cluster random sampling method from the 22 main municipal sectors of Tehran, Iran. They completed a series of self-administered questionnaires which were analyzed using quantitative approaches. The second phase was a qualitative study in which adolescents were selected using purposeful sampling for individual in-depth semi-structured interviews on the basis of the quantitative findings from the first phase. These data, together with a literature review and data obtained through nominal group technique, would then be used to in the development of strategies to reduce adolescents' health concerns. RESULTS: The findings of this mixed methods sequential explanatory study are expected to provide unique information about the health concerns of Iranian adolescents and their sources of information, which to date have received little attention. CONCLUSIONS: These data will provide a rich source of information that can be used by intervention programs, health professionals and policy makers in addressing the health concerns of adolescents, with the goal of facilitating a successful passage to adult life.

Psychometric properties of the adolescent health concern inventory: the persian version.

OBJECTIVE: It is important to consider the health concerns of adolescents before developing and implementing public health promotion or health education curriculum programs aimed at ameliorating priority health problems experienced by adolescents. The aim of this study was to test the psychometric properties of the original Adolescent Health Concern Inventory (AHCI) for use with an Iranian population. METHODS: This was a methodological study in which 50 adolescents with age range of 14-18 years were selected using convenience sampling. The translation and cultural adaptation process of The AHCI followed recognized and established guidelines. The face and content validity was established by analyzing feedback solicited from teenagers and professionals with expertise in health, sociology and psychology. Reliability was examined using test-retest and Cronbach's alpha for internal consistency reliability. Kappa and McNemar tests were used to examine test-retest reliability for each item. RESULTS: Minor cultural differences were identified and resolved during the translation process and determining the validity of the checklist. Results from Kappa and McNemar tests indicate a high degree of test-retest reliability. Internal consistency reliability as measured by Cronbach's alpha for the subscales were between 0.68 and 0.87 with total instrument reliability of 0.96 indicating considerable overall reliability. CONCLUSION: The Persian version of the AHCI appears valid and reliable. Hence, it can be used for filling a gap in identifying the adolescents' health concerns in the research and community settings and school health education programs in Iran to design appropriate interventions.

Heterotopic pregnancy following ovulation induction by Clomiphene and a healthy live birth: a case report.

INTRODUCTION: A heterotopic pregnancy is defined as the presence of a combined intrauterine and ectopic pregnancy. Its estimated incidence is accepted as between 1/7000 and 1/30,000 pregnancies. It is also reported to be as high as 1% after the use of assisted reproductive technology, but Clomiphene Citrate which increases the rate of twinning, could be associated with a heterotopic pregnancy rate of 1/900, which is much less than using assisted reproductive technology. Heterotopic pregnancies are diagnostic and therapeutic challenges for obstetricians. If they continue without diagnosis, a life-threatening situation may occur even when surgical intervention with laparotomy is performed. CASE PRESENTATION: We present the case of a 22-year-old Iranian woman who developed a simultaneous extra -and intrauterine pregnancy after the induction of ovulation with Clomiphene. In this case, there was a delay in the detection of the ectopic pregnancy component resulting in an emergency laparotomy being performed. Fortunately after the laparotomy, the intrauterine pregnancy was not affected and it progressed satisfactorily until 37 weeks. A healthy male baby was delivered by caesarean section. CONCLUSION: This case suggests that a heterotopic pregnancy must always be considered in patients presenting with pelvic pain even in a confirmed intrauterine pregnancy, particularly after the induction of ovulation by Clomiphene Citrate or assisted reproductive technology. Every clinician treating women of reproductive age should keep this diagnosis in mind. It also demonstrates that early diagnosis is essential in order to salvage the intrauterine pregnancy and avoid maternal morbidity and mortality.