Health literacy among Iranian adults: findings from a nationwide population-based survey in 2015.

BACKGROUND: Health literacy is one of the most important determinants of noncommunicable diseases prevention. Health literacy is associated with elevated risks for poorer access to care, adverse health outcomes, and increased hospitalization and health costs. AIMS: This study aimed to determine the level of health literacy among the general adult population in the Islamic Republic of Iran. METHODS: Using a cross-sectional study during 2014-2015 with a multistage cluster sampling approach, we administered a pilot-tested standardized questionnaire to assess different domains of health literacy (i.e., reading, comprehension, communication/decision-making and Interpretation/judgment skills, individual and social empowerment, health information access and health information use) among 8439 (3935 males) individuals aged 18-60 years. Data were collected through face-to-face interviews. Descriptive statistics and multivariable linear regression method using SPSS (20) were applied to identify the factors associated with health literacy among Iranian adults. RESULTS: The mean health literacy level was 10.2±3.8 (out of 20). Only 18% (95% confidence interval [CI]: 17.15-18.78) of the participants had adequate health literacy, while 45.7% (95% CI: 44.64-46.78) had inadequate, and the 36.3% (95% CI: 35.21-37.33) had moderate health literacy. In the adjusted linear regression model, education level (the smallest ß = 4.35, P < 0.001), age (ß = 0.01, P = 0.002), female sex (ß = 0.45, P < 0.001), residency in rural areas (ß = 0.26, P < 0.001) and having permanent job (ß = 1.03, P < 0.001) were significantly associated with more health literacy. CONCLUSION: Our findings highlighted that the Iranian adult population has an insufficient level of health literacy, which calls for comprehensive education planning to improve the levels, with special attention to certain subpopulations (e.g. illiterate populations) and domains (e.g. individual empowerment).

Factors in relation with fatigue and illness perception in patients with myocardial infarction and the changes in fatigue due to intervention on illness perception: Research design, methodology, and preliminary results.

BACKGROUND: In physical diseases including cardiovascular diseases (CVDs), illness perception (IP) plays an important role in illness outcomes. Fatigue is a major bothersome symptom after myocardial infarction (MI). This manuscript presents the research design, methodology, and primary findings of a study on factors in relation with fatigue and IP in patients with MI, and changes in fatigue after intervention on IP. METHODS: 241 patients with MI who experienced a first-time acute MI (AMI) participated in this study in 2016-2017. During hospitalization, the demographic and clinical information of participants were collected. After four months, the information regarding fatigue, IP, coping with stress, type D personality, perceived social support (PSS), and locus of control of the participants was collected at their houses. About one year later, based on the results of phase one of the study, a psychoeducation course was conducted for 35 of the patients as intervention group while 36 patients were supervised as control group. Two months later, the role of IP in fatigue changes of the participants was assessed. RESULTS: 155 (65%) of the patients had positive family history of coronary heart disease (CHD). 103 (43%) were cigarette smokers, 100 (43.5%) had high blood cholesterol, and 72 (30%) had sedentary life style before MI. CONCLUSION: The overview of the factors related to fatigue and IP of the patients with MI could help the care teams to provide better care in the recovery period of the illness.

Development and psychometric properties of a self-regulation scale about leisure time physical activity in Iranian male adolescents.

BACKGROUND: Self-regulation is one of the current psychological concepts that have been known as a determinant of leisure time physical activity. Due to cultural and social diversity in different societies and age groups, application of specific questionnaires is essential to perform investigations about physical activities. The aim of this study is development and evaluation of psychometric properties of a self-regulation questionnaire about leisure time physical activity in Iranian male adolescents. MATERIALS AND METHODS: This cross-sectional study was conducted in 2013, and data of 603 male students from 12 high schools in Isfahan were collected. A comprehensive literature review and similar questionnaire review were conducted and 25 items were selected or developed to measure self-regulation. Comprehensibility of items was evaluated in a pilot study and an expert panel evaluated face and content validity. Exploratory factors analysis (EFA) was used for evaluation of construct validity and extraction of sub-constructs of self-regulation. Leisure time physical activity was assessed using International Physical Activity Questionnaire (IPAQ). RESULTS: The mean age of the participants was 16.3 years (SD =1.0) and the range was 15-19 years. Cronbach's α coefficient of the questionnaire in the pilot and main study was 0.84 and 0.90, respectively. EFA resulted in four sub-constructs including "enlistment of social support", "goal setting", "self-construction", and "self-monitoring", which explained 63.6% of the variance of self-regulation. CONCLUSIONS: Results of this investigation provide some support to the validity and reliability of the 16-item questionnaire of self-regulation abut leisure time physical activity in the target group.

A self-efficacy questionnaire regarding leisure time physical activity: Psychometric properties among Iranian male adolescents.

BACKGROUND: Attention to different aspects of self-efficacy leads to actual evaluation of self-efficacy about physical activity. This study was carried out in order to design and determine psychometric characteristics of a questionnaire for evaluation of self-efficacy about leisure time physical activity (SELPA) among Iranian adolescent boys, with an emphasis on regulatory self-efficacy. MATERIALS AND METHODS: This descriptive-analytic study was conducted in 734 male adolescents aged 15-19 years in Isfahan. After item generation and item selection based on review of literature and other questionnaires, content validity index (CVI) and content validity ratio (CVR) were determined and items were modified employing the opinions of expert panel (N = 10). Comprehensibility of the questionnaire was determined by members of target group (N = 35). Exploratory factors analysis (EFA) was operated on sample 1 (N 1 = 325) and confirmatory factors analysis (CFA) on sample 2 (N 2 = 347). Reliability of SELPA was estimated via internal consistency method. RESULTS: According to EFA, barrier self-efficacy and scheduling self-efficacy are the two main aspects of SELPA with the total variance of 65%. The suggested model was confirmed by CFA and all fitness indices of the corrected model were good. Cronbach's alpha was totally estimated as 0.89 and for barrier and scheduling self-efficacy, it was 0.86 and 0.81, respectively. CONCLUSIONS: The results provide some evidence for acceptable validity and reliability of SELPA in Iranian adolescent boys. However, further investigations, especially for evaluation of predictive power of the questionnaire, are necessary.

Developing an appropriate model for self-care of hypertensive patients: first experience from EMRO.

BACKGROUND: Cardiovascular diseases (CVDs) constitute 53% of deaths above the age of 30; 54% of these deaths are attributed to high blood pressure. Coronary artery disease (CAD) is the main cause of mortality in the world. Hypertension accounts for 13% of mortalities and 6% of morbidities and is one of the main risk factors that cause loss of healthy life years. Blood pressure is not optimally controlled even among those who are aware of their disease. Previous studies showed that apart from pharmacological treatment, lifestyle improvement can also play a significant role in the prevention of high blood pressure CVDs. Self-care among them has been addressed in several previous studies. There are few self-care programs in Iran, but no study has been conducted on blood pressure. METHODS: In this study the primary model is designed and then revised, and in the pilot study the feasibility of the project was approved and the final model presented. RESULTS: The current project proposes a model for self-care of hypertensive patients and their families, and is based on education of health care providers and patients in such a way that patients can control their illness. CONCLUSION: The model can be implemented at a national scale.

Needs assessment of health education in health-networks of the Isfahan province of Iran, 2005-2006.

An essential element of a successful educational system is evidence concerning the core educational needs of the system. This descriptive study used the consent-based technique of needs assessment to determine health educational needs and priorities within such education in 21 district health networks of the Isfahan province of Iran. This study was conducted in the Isfahan province from March 2005 to December 2006 among health experts of the Isfahan provincial health center and the following three groups in district health networks: health experts at headquarters; health workers delivering health services; and people in the community covered by these networks. Health education needs and priorities of the Isfahan provincial health authority at the district health networks were determined. While the first priority of headquarter experts and field workers was mental health and family planning, respectively, the first priority of people in the community in most districts was nutrition. The findings showed that in most districts there are differences in viewpoints between health workers, health experts and service users regarding health educational needs and priorities within the needs.