Psychometric assessment of the Persian adaptation of the attitudes toward seeking professional psychological help scale-short form.

BACKGROUND AND PURPOSE: Mental health disorders are a growing concern worldwide, with a significant impact on public health. Understanding attitudes toward seeking professional psychological help is essential in addressing these issues. In the Iranian context, there is a need for a reliable tool to measure these attitudes. This study aims to assess the validity and reliability of the Persian Adaptation of the Attitudes Toward Seeking Professional Psychological Help Scale-Short Form (ATSPPH-SF). MATERIALS AND METHODS: A cross-sectional study was conducted in May 2023, utilizing a convenience sampling method with 1050 participants aged 10 to 65 years in Iran.The ATSPPH-SF questionnaire, consisting of 10 items and 2 subscales, was employed. The questionnaire underwent translation and cultural adaptation, and its validity was assessed through qualitative face and content validities. Confirmatory factor analysis (CFA) was used to evaluate construct validity. Reliability was assessed using McDonald's omega coefficient and Cronbach's alpha coefficient. Data collection was conducted through an online survey. RESULTS: The CFA results indicated a two-factor structure for the ATSPPH-SF, with one factor representing openness to seeking treatment for emotional problems and the other factor reflecting the value and need for seeking treatment. The model demonstrated acceptable fit indices. Both McDonald's omega coefficient and Cronbach's alpha coefficient suggested good internal consistency for the scale. The mean total score for the ATSPPH-SF was 21.37 (SD = 5.52), indicating the reliability and validity of the scale for the Iranian population. CONCLUSION: This study confirms the suitability of the short-form ATSPPH-SF with 10 items and 2 subscales as a valid and reliable tool for assessing attitudes toward seeking professional psychological help in the Iranian population. With no prior appropriate instrument available, this scale fills a crucial gap. It can be employed to measure attitudes among various demographic groups, aiding in the design of targeted interventions to enhance mental health literacy and reduce the stigma associated with seeking professional psychological help in Iran.

The effect of web-based educational interventions on mental health literacy, stigma and help-seeking intentions/attitudes in young people: systematic review and meta-analysis.

OBJECTIVES: This study aims to provide a systematic review and meta-analysis of the literature on The Effect of Web-Based Educational Interventions on Mental Health Literacy, Stigma and Help-seeking intentions/attitudes in young people. METHODS: Articles in English published between April 1975 and February 2023 were retrieved from seven databases, leading to a total of 2023 articles identified. RESULTS: 20 studies were included after applying exclusion criteria, 10 of which were eligible for meta-analysis. Results showed that web-based educational interventions had a significant positive effect on mental health literacy knowledge (SMD = 0.70, 95% CI = [0.16, 1.25]), but not on stigma (SMD = -0.20, 95% CI = [-0.48, 0.08]) or help-seeking intentions/attitudes (SMD = 0.48, 95% CI = [-0.50, 1.46]). CONCLUSION: This study reviewed and analyzed the effect of web-based educational interventions on mental health literacy, stigma, and help-seeking intentions/attitudes among young people. The results showed that web-based educational interventions improved mental health literacy knowledge, but not stigma or help-seeking outcomes. The study suggested several recommendations to enhance the effectiveness of web-based educational interventions on stigma and help-seeking outcomes, such as using more rigorous designs and methods, more comprehensive and multifaceted interventions, more tailored and targeted interventions, and more collaborative and participatory approaches. The study concluded that web-based educational interventions may have a greater impact on reducing stigma and promoting help-seeking among young people, which may ultimately lead to better mental health outcomes and well-being for this population.

Social media and mental health in students: a cross-sectional study during the Covid-19 pandemic.

BACKGROUND: Social media causes increased use and problems due to their attractions. Hence, it can affect mental health, especially in students. The present study was conducted with the aim of determining the relationship between the use of social media and the mental health of students. MATERIALS AND METHODS: The current cross-sectional study was conducted in 2021 on 781 university students in Lorestan province, who were selected by the Convenience Sampling method. The data was collected using a questionnaire on demographic characteristics, social media, problematic use of social media, and mental health (DASS-21). Data were analyzed in SPSS-26 software. RESULTS: Shows that marital status, major, and household income are significantly associated with lower DASS21 scores (a lower DASS21 score means better mental health status). Also, problematic use of social media (ß = 3.54, 95% CI: (3.23, 3.85)) was significantly associated with higher mental health scores (a higher DASS21 score means worse mental health status). Income and social media use (ß = 1.02, 95% CI: 0.78, 1.25) were significantly associated with higher DASS21 scores (a higher DASS21 score means worse mental health status). Major was significantly associated with lower DASS21 scores (a lower DASS21 score means better mental health status). CONCLUSION: This study indicated that social media had a direct relationship with mental health. Despite the large amount of evidence suggesting that social media harms mental health, more research is still necessary to determine the cause and how social media can be used without harmful effects.

The impact of gender patient-physician concordance on interpersonal processes of care and patients' outcomes in the diabetes care setting.

OBJECTIVE: To investigate whether patient-physician gender concordance influences the patient's perceptions of interpersonal processes of care and patient outcomes in Muslim patients with diabetes. METHODS: We conducted a cross-sectional telephone survey involving 4152 randomly selected patients using electronic diabetes records. Outcome measures included perceptions of interpersonal processes of care, adherence to medications, and HbA1c. Linear mixed regression models were used to explore the associations between the outcome variables and patient gender and gender concordance. RESULTS: The best processes of care were observed consistently for female concordant dyads. In adjusted mixed models, lower Hurried Communication was associated with female concordant (-0.91, p < 0.001) and female physician-male patient dyads (-0.82, p = 0.007). Higher Elicited Concerns was associated with female concordant (0.65, p = 0.003) and female physician-male patient dyads (0.59, p = 0.013). Higher Explained Results and Compassionate/Respectful were associated with female concordant dyads (0.83, p < 0.001, and 0.55, p = 0.010 respectively). Lower HbA1c was independently linked with female concordant dyads (-0.84, p < 0.001). CONCLUSION: This study highlights the importance of female gender concordance on perceptions of interpersonal processes of diabetes care and glycemic control. PRACTICE IMPLICATIONS: Strengthening physicians' communication skills with female patients should be taken into consideration.

Comorbidities in Patients with Lichen Planopilaris: A Case-Control Study.

Introduction: Lichen planopilaris (LPP) is a lymphocyte-mediated type of scarring alopecia and considered to have autoimmune etiology. Studies about systemic comorbid conditions are limited. Our goal is to identify the prevalence of medical comorbidities in patients with LPP. Methods: In a retrospective case-control study, the medical records of 208 LPP patients and 208 controls were reviewed for existing comorbidities such as thyroid diseases, cardiovascular disorders, hypertension, hyperlipidemia, and lupus erythematous. Results: Hyperlipidemia was found in 41.8% of all patients with LPP and in 17.3% of controls (p value <0.001, OR = 4.167). Chances of hypertension and cardiovascular disorders were lower in the LPP group in comparison to controls (p value = 0.009). Thyroid disorders were more prevalent in LPP patients, but the difference was not statistically significant (p value = 0.277). Conclusion: Our study further emphasizes that LPP patients should be screened for medical comorbidities, especially lipid profile abnormalities.

Exploring the influence of scheduled meetings on physiological indicators of hospitalized patients satisfaction facing acute myocardial infarction in the intensive care unit.

BACKGROUND: Satisfaction of patients is among the top priorities of health-care providers. Meeting with families is essential for patients who are admitted to various wards, although it has been restricted for many reasons such as its impact on physiologic indicators. This present research study aimed to exploring the influence of scheduled meetings on physiological indicators of hospitalized patients satisfaction facing acute myocardial infarction in the intensive care unit. MATERIALS AND METHODS: This study was a nonrandomized clinical trial with a control group conducted in the cardiac care unit ward of Hamadan's Ekbatan Hospital. Sixty patients with acute myocardial infarction were chosen through convenient sampling and assigned to intervention (planned meeting) and control (routine meeting) groups in a nonrandomized manner. Data were collected by a researcher-made questionnaire of patient satisfaction and the observatory checklist of physiologic indicators and then analyzed in IBM SPSS Statistics v23. RESULTS: The total mean score of satisfaction did not significantly differ between the two groups (P = 0.921). The satisfaction of patients for "the conduct of visitors" was significantly higher in the intervention group (P = 0.005). During the study, no meaningful difference was found between the two groups for physiologic indicators (P > 0.05), while these indicators, except for blood O2 saturation, were meaningfully increased in the control group during routine meetings (P < 0.05). CONCLUSION: Planned meetings did not promote total satisfaction of patients with meetings, but improved some aspects of satisfaction, such as the conduct of visitors. The planned meeting is recommended as an alternative for a routine meeting, as it did not affect the physiologic indicators of patients in the intervention group.

Validity and reliability of the Persian version of the exercise self-efficacy scale in people with multiple sclerosis.

BACKGROUND: Exercise self-efficacy has been identified as one of the primary determinants of physical activity in people with multiple sclerosis (MS). Therefore, assessment of exercise self-efficacy is important to be measured with valid and reliable scale to provide tailored interventions. MATERIALS AND METHODS: The English version of the exercise self-efficacy scale was translated into Persian using a forward-backward translation approach. Factorial validity was conducted using the expletory factor analysis (EFA) and the confirmatory factor analysis (CFA). In addition, construct validity was performed using convergent and known-group validity. Reliability was evaluated by internal consistency and test-retest reliability. Participants were recruited from two hospitals (MS clinics). RESULTS: Expletory factor analysis identified a single factor structure which explained 64.7% variance in exercise self-efficacy scale (EXSE). CFA supported a single factor structure with a good model fit. Average variance extracted = 0.60 and composite reliability = 0.93 values confirmed the convergent validity. The known-group validity was verified with significant differences between subgroups. The Cronbach's alpha coefficient = 0.93 and intraclass correlation coefficient = 0.85 supported reliability of EXSE scale. CONCLUSIONS: Our findings provided sufficient evidence of validity and reliability for EXSE scale in people with MS. This measure can utilize by researchers and health-care providers in studies and clinical practice as a robust measure to assess exercise self-efficacy and to develop interventions in people with MS.

Determinants of physical activity in women with multiple sclerosis based on theory of planned behavior.

Background: In recent decades, the scientific evidence has demonstrated that regular physical activity (PA) provides abundant physiological and psychological benefits in people with multiple sclerosis (MS). However, most persons with MS are physically inactive. This study examined determinants of PA based on the theory of planned behavior (TPB) among women with MS. Method: Participants (178)-completed measures included Godin Leisure-Time Exercise and TPB questionnaires. Descriptive statistics and hierarchical linear regression were analyzed using IBM SPSS. Result: Most participants were homemaker and the mean age was 34.2 years. The mean of PA was 11.6 ± 7.9 and only 10% of participants had sufficient amount of PA. The result of hierarchical linear regression indicated that attitude (ß = 0.27; P < 0.05), subjective norm (ß = 0.18; P < 0.05), and perceived behavioral control (ß = 0.44; P < 0.05) explained 58% variance in exercise intention. Intention (ß = 0.20; P < 0.05) and other variables explained 18% variance in PA. Conclusion: Our findings indicate that constructs of TPB could be used in behavioral interventions by health-care providers for increasing PA among women with MS.

Assessing quality of life in patients with autoimmune bullous diseases using the Persian version of Treatment of Autoimmune Bullous Disease Quality of Life questionnaire finds similar effects in women as men.

In autoimmune bullous diseases (AIBDs), autoantibodies loosen molecular adhesions in the skin and/or mucosa and lead to blisters and erosions. Immunosuppressive drugs reduce mortality of the AIBD; therefore, patients will have to live longer with comorbidities. Objective: This study aims to determine the quality of life of AIBD patients undergoing systemic treatment while investigating the survey's relationship with various factors. Methods: In this 2-step cross-sectional study, we initially included 53 consecutive pemphigus patients to investigate reliability and validity of the Persian version of Treatment of Autoimmune Bullous Disease Quality of Life (TABQOL) questionnaire. Then, we conducted the study on 119 AIBD patients, currently under treatment at an AIBD clinic in Iran. Results: The mean TABQOL score for our patients was 13.87 ± 7.51. The highest TABQOL was for epidermolysis bullosa acquisita (24 ± 8.485) followed by pemphigus foliaceus (20.5 ± 14.181) and the lowest for pemphigus vulgaris (13.24 ± 6.54). There was no significant difference between patients' TABQOL scores and their gender, history of rituximab injection, and disease severity scores. We only found a positive correlation between TABQOL and prednisolone dose. Conclusion: Treatments of AIBD considerably impact the quality of life of patients and an impairment in quality of life is correlated to higher doses of prednisolone.

Type 2 Diabetes Burden and Diabetes Distress: The Buffering Effect of Patient-centred Communication.

OBJECTIVES: Our aim in this study was to assess the moderating role of patient-centred communication as a source of social support in the relationship between burden of diabetes and diabetes distress. METHODS: Individuals with type 2 diabetes (N=1,267) completed validated tools of diabetes distress and multiple aspects of patient-centred communication. A path approach was used to evaluate the moderating role of patient-centred communication in the relationship between diabetes burden, as indicated by prescription of insulin and presence of complications, and distress. RESULTS: Lower Hurried Communication, higher Elicited Concerns/Responded, higher Explained Results/Medications, greater Patient-centred Decision-making and Compassionate/Respectful were significantly associated with lower distress after controlling for burden. Hurried Communication, Explained Results/Medications and Patient-centred Decision-making moderated the relation between insulin and diabetes distress. CONCLUSIONS: Our findings support the stress-buffering hypothesis of patient-centred communication and imply that aspects of patient-centred communication may protect against diabetes-related distress.

Strategies and experiences for sand and dust storm adaptation: A qualitative study in Iran.

BACKGROUND AND PURPOSE: Sand and Dust storms (SDS) are meteorological hazards that are increasing due to climate change. Mitigation and adaptation are two main strategies that help to deal with this global concern. In the recent decades, Iran has been prone to SDS. Therefore, this study was conducted in 2018 in order to explore the SDS adaptation experiences and strategies in the Iranian community. METHODS: Using content analysis approach and purposive sampling, three groups (including 14 experts, 8 authorities, and 23 individuals) were selected. Data were collected through semi-structured interviews. Data analysis was performed using Graneheim and Lundman's method. Finally, Gaba and Lincoln's scientific criteria were used for data validity. RESULTS: Two major categories emerged from the analysis. The first category was related to the adaptation experiences and included two subcategories: "citizens' experiences" and "experts'/ authorities' experiences". The second was related to SDS adaptation strategies and included five subcategories: "educational development", "public participation", "inter-sectorial coordination", "institutional development", and "environment preservation". CONCLUSIONS: Identifying the experiences and strategies that are implemented by a community to adapt to SDS is the core stone for developing a comprehensive local and national adaptation plan. This study suggests strategies and action plans for SDS adaptation that can be used in policy making.

Patient-physician interpersonal processes of care at the time of diabetes treatment intensification and their links to patient outcomes.

OBJECTIVE: To investigate how patient-physician interpersonal processes of care are related to levels of diabetes-related distress, diabetes medication-taking behavior, and HbA1c during conversations with patients about intensifying medication. METHODS: We randomly recruited 1270 patients from diabetes specialty clinics in Tehran, Iran who were taking an additional oral diabetes medication or starting insulin during the prior 3 months. This interviewer-administered cross-sectional survey assessed multiple aspects of patient-physician interpersonal processes, diabetes-related distress, and diabetes medication-taking. Clinical history and HbA1c were collected from electronic medical records. Regression estimates and Structural Equation Modeling were used to test associations. RESULTS: Some communication scales indicated a significant relationship with total diabetes distress (P < 0.001). Diabetes medication-taking was associated with less diabetes distress (adjusted odds ratio [aOR]=0.45, P < 0.001), lower Hurried Communication (aOR=0.72, P = 0.013), higher Elicited Concerns (aOR=1.30, P = 0.012), and higher Explained Results (aOR=1.41, P < 0.001) scores. SEM analyses showed medication-taking behavior was associated with a 0.68 decrease in HbA1c. Hurried Communication and diabetes distress were directly associated with HbA1c. CONCLUSION: Aspects of patient-physician interpersonal processes at the time of intensifying diabetes treatment may be related to experiencing less distress, effective medication-taking, and improved HbA1c. PRACTICE IMPLICATIONS: The results are intended to inform communication strategies that physicians might incorporate into practice.

Patient-physician communication in the context of diabetes care: Adaptation and assessment of psychometric properties of a Persian version of the interpersonal process of care survey (P-IPC).

AIMS: To examine the psychometric characteristics and explore the preliminary validity of the Persian version of the Interpersonal Processes of Care Survey (P-IPC) to assess patient-physician communication in the context of diabetes care. METHODS: After adapting, translating, examining content validity, and pretesting the questionnaire, it was administered to 300 patients with diabetes. Confirmatory factor analysis identified the factor structure (scales). Variability, item-scale correlations, reliability, and construct validity of the final scales were examined. RESULTS: Factor analysis supported the hypothesized second-order factor model with 27 of the 29 items:11 first-, and 7 second-order common factors. Scale scores were calculated for the 7 second-order factors. Internal-consistency reliability for the 7 scales ranged from 0.60 to 0.90 and 2-week test-retest correlations ranged from 0.89 to 0.96. The communication and interpersonal style domains of the P-IPC demonstrated high ceiling effects suggesting good patient-physician communication. The P-IPC scales differentiated between patients in the language-concordant and language-discordant groups, and patterns of correlations with three patient satisfaction measures corresponded to hypotheses. CONCLUSION: The P-IPC includes all of the second-order scales identified in the original IPC. Evidence of its reliability and validity suggest it can be useful for assessing patient-physician communication in the context of diabetes care.

Likelihood of Breast Screening Uptake among Reproductive-aged Women in Ethiopia: A Baseline Survey for Randomized Controlled Trial.

BACKGROUND: Breast cancer is the most devastating public health problem affecting women in developed and developing world. Therefore, this study was aimed to assess the likelihood of taking breast self-examination as a breast screening behavior among reproductive age women. METHODS: A community based cross-sectional study was conducted on 810 reproductive-age women. Intervieweradministered questionnaires were used to collect data. Study participants were selected using systematic sampling method. Data were analyzed using SPSS version 24.0. RESULTS: The likelihood of performing breast self-examination was 54.3%. However, the comprehensive knowledge of the participants was 11.5%. As independent predictors, perceived severity of breast cancer [AOR (95%CI) = 2.05 (1.03 to 1.07)] and self-efficacy [AOR (95%CI) = 2.97(0.36-0.99)] were positively associated with the likelihood of performing breast self-examination whereas districts [AOR (95%CI) = 0.58 (0.37 to 0.91)] and place of residence [AOR (95%CI) = 0.69 (0.51 to 0.93)] were negatively associated with the likelihood of performing breast selfexamination. The HBM Model explained 64.2% of the variance in this study. CONCLUSION: Although the likelihood of performing breast selfexamination was relatively good, the comprehensive knowledge of the women was very low. Therefore, breast cancer screening education must address knowledge and socio-cultural factors that influence breast screening through awareness creation using appropriate behavioral change communication strategies.

The association of resilience with health-related quality of life (HRQoL) in adolescent students.

OBJECTIVES: Identifying the factors associated with HRQoL in adolescents is a prerequisite of interventions aimed at improving the overall quality of life and health status among them. Studies have identified many factors associated with HRQoL in different populations; however, very little is known about the role of resilience on HRQoL in adolescent students. SUBJECTS: This cross-sectional study was conducted on 1500 high school students (750 boys and 750 girls) in Tehran. The subjects were selected through the cluster and multistage sampling methods. METHODS: The data collection tool included three questionnaires; a demographic information questionnaire, the Health-Related Quality of Life Questionnaire (KIDSCREEN-27), and the Children and Youth Resilience Measurement (CYRM-28). Data were analyzed with SPSS 23 software. Regression analysis was performed to determine the association of resilience with HRQoL. RESULTS: The mean score of overall health-related quality of life and overall resilience were 57.51 ± 15.03 and 98.35 ± 16.48, respectively. Individual sub-scale (ß = 0.402, p < 0.001), caregiver sub-scale (ß = 0.279, p < 0.001) and context sub-scale (ß = 0.122, p < 0.001) of resilience were, respectively, the positive and significant predictors of HRQoL in students. The resilience sub-scales explained 49% of the total variance of HRQoL, and the individual sub-scale was the strongest predictive factor for HRQoL in students. CONCLUSION: It is recommended to incorporate resilience training programs into the regular school education in order to improve the quality of life and health of students in all high schools and educational centers of the country.

Knowledge, attitude, and practice among mothers about newborn care in Sindh, Pakistan.

BACKGROUND: Each year nearly 7.7 million children under five years die around the world; out of which approximately 3.1 million of the newborns die during the neonatal period and almost all these (99%) deaths occur in the developing countries. According to the World Health Organization's estimation neonatal deaths account for 45% of the under-five deaths. More than one-third of these deaths occur in the first 24 h of birth, whereas three-quarter of the neonatal deaths takes place in the first seven days of birth. The purpose of this study is to assess the knowledge, attitude, and practices (KAP) among mothers about newborns' care and its related factors in district Badin Sindh province of Pakistan. METHODS: A community-based cross-sectional study was conducted from July 2017 to August 2017 to assess the Knowledge, Attitude, and Practices (KAP) in mothers regarding newborn care. A structured questionnaire was administered, after pretest, for data gathering through face to face interview. All survey participants were identified using multi-stage cluster sampling. A scoring system was used to calculate the level of KAP among participants. Independent sample t-test, ANOVA, and GLM were applied to identify the statistical difference between the means of various groups. RESULT: A total of 518 survey participants were interviewed. Among the study sample, more than half of the newborns were bathed within six hours of delivery. Around 50% started breastfeeding after 1 h of birth. A substantial proportion (45%) of mothers gave pre-lacteal feeding and 44.8% of them did not feed colostrum to their newborns. Among those who administered pre-lacteal to their newborn babies included animal/formula milk (15.4%), honey (24.5%) and fresh butter/ghee (5.2. %). Mothers with no education had less significant KAP score about newborn care as compared to those who had higher education (p < 0.05). CONCLUSION: This study revealed that high-risk factors such as immediate bathing, application of traditional substances on the cord, delayed initiation of breastfeeding, discarding colostrum and giving pre-lacteal feed to newborns were highly prevalent. This requires urgent attention of Maternal, Newborn and Child Health (MNCH) programs and health care delivery system to prevent harmful care practices and adopt healthy practices especially in the rural settings.

Assessing the impact of an educational intervention program on sexual abstinence based on the health belief model amongst adolescent girls in Northern Ghana, a cluster randomised control trial.

BACKGROUND: Adolescent pregnancy is a worldwide problem because of its health, social, economic and political repercussions on the globe. Even though the rates of adolescent pregnancy have declined over the decade, there is still unacceptably high rates especially in lower and middle-income countries including Ghana. Although the problem has been widely investigated, there is little information on the effectiveness of different methods to improve adolescent sexual abstinence based on theoretical models. This study is aimed to assess an educational intervention program on sexual abstinence based on the Health Belief Model (HBM) among adolescent girls in Northern Ghana. METHODS: A cluster randomized control trial was conducted in Ghana from April to August 2018. Participants within the ages of 13-19 years were enrolled voluntarily from six randomly selected Senior High Schools (3 for intervention and 3 for control). A total of 363 adolescent were enrolled. A self-structured questionnaire was administered to both groups of participants at baseline and endpoint of the study. Control participants received their normal classes whiles the intervention group additionally received comprehensive sexuality education for 1 month. Qualified midwives conducted the health education program. At least two sessions were conducted for each participating class weekly. The lessons focused on perceived susceptibility, perceived severity of adolescent pregnancy, perceived benefits, perceived barriers to adolescent pregnancy prevention, personal and family values, perceived self-efficacy and knowledge of contraceptives. Educational strategies such as discussions, demonstrations, role-play and problem solving techniques were used to deliver the lessons. Sexual abstinence was the outcome variable of the study and it was measured after 3 months of the intervention. Binary logistic regression was used to assess the impact of the intervention on sexual abstinence practice. RESULTS: At baseline, there was no difference between control and intervention groups. The mean score of Knowledge and attitude for control were (58.17 and 139.42) and intervention (60.49 and 141.36) respectively. Abstinence practice was 69.4% for control and 71.6% in the intervention group. However, after the intervention, the mean score of knowledge and attitude for control were (87.58 and 194.12) respectively. Sexual abstinence in the control was 84.4% and intervention was 97.3% respectively. The educational interventions resulted in a significant difference in sexual abstinence between intervention and control groups (OR = 13.89, 95% Confidence Interval (2.46-78.18, P < 0.003). CONCLUSION: Educational intervention, which was guided by HBM, significantly improved sexual abstinence and the knowledge of adolescents on pregnancy prevention among the intervention group. Provision of comprehensive sex education guided by behavioural theories to adolescents at Senior High Schools in Ghana is recommended. TRIAL REGISTRATION: This trial was retrospectively registered in Protocol Registration and Results System (PRS) with trial number NCT03384251 .

Application of Kingdon and Hall Models to Review Environmental Sanitation and Health Promotion Policy in Ethiopia: A Professional Perspective as a Review.

BACKGROUND: In the world, many countries, including Ethiopia, are framing policies to roll back the problem of the sanitation. For this, the Kingdon and Hall models are the two distinct models formed to articulate the policy agenda to the health problem. The Kingdon model includes problem, policy and politics streams whereas the Hall model includes legitimacy, feasibility and support of the health policies. Therefore, this review aims to integrate the two models with diseases prevention and health promotion policies of Ethiopia. METHODS: We used the existing frameworks of the models as a guiding principle. Then, we applied the frameworks of the two models as an important consideration to interlink policy agenda to a given health problem. We also described the existing scientific literature about the sanitation and health promotion. After thoroughly reviewing, possible policy inputs and country setups were included with a brief discussion by comparing different kinds of literatures. RESULTS: The two models are recognized as an opportunity to get an essential sanitation policy. The government settled and has closed links to the new innovation as an emerged discourse. Therefore, the two model streams came together for setting sanitation problem on the policy agenda. The technical feasibility, public acceptability and congruence with existing values were all judged to be favorable. CONCLUSION: The integration of policies within the policy frameworks has very important outputs in various countries. Therefore, the field specialists should figure out the problem of policy integration through policy evaluation researches.

How do reproductive age women perceive breast cancer screening in Ethiopia? A qualitative study.

BACKGROUND: Breast cancer remains one of the deadliest non-communicable diseases in the world. In Ethiopia, breast cancer accounts for 33.4% of total cancer diagnosis in women. OBJECTIVE: This study aims to explore perception about breast screening behavior among reproductive age women. METHODS: This qualitative study was conducted as a baseline to identify gaps to design interventions that will enhance breast screening uptake among reproductive age women. Six focus group discussions and 9 in-depth interviews were conducted with women and health workers respectively. Semi-structured questions were used. Data analysis was analyzed by Atlas.ti. 7 and the ideas were put in direct quotation and narration. RESULTS: Lack of awareness is the preceding problem for self-susceptibility to breast cancer as well as for having breast screening. Majority of women thought that the cause of breast cancer was a sin (supernatural power). Self-efficacy and cues to action were the most important correlates of the perception owing to fear of socio-cultural stigma and discrimination. CONCLUSION: All health belief model constructs identified a critical problem for adaptation of behavior. Therefore, this gives the opportunity to design and develop community-based intervention and explore new intervention mechanism with an accurate method.

Conceptual definition and framework of climate change and dust storm adaptation: a qualitative study.

Climate Change Adaptation (CCA) is a complex, multi-disciplinary, and culture-dependent concept. This study aims to explore a conceptual definition, the subjective framework of CCA including its domains, attributes, and consequences. The approach of qualitative conventional content analysis was considered for the explanation of the subjective concept, and at the same time as the collection process, data analysis was performed using Zhang and Wildemuth's method. The interview method was semi-structured and sampling was targeted and with maximum diversity. The interview was conducted with 22 qualified experts. The accuracy and validity of the data were ensured using Guba and Lincoln scientific accuracy criteria. Six main categories including "sustainability, productivity, stability, empowerment, transformation, and flexibility" were conceptualized in the theme of adaptation characteristics. "Sustainable development, life improvement, response coordination and integration, creativity and innovation, resilience promotion, vulnerability reduction, effective management, and independence" were the main categories in the theme of the adaptation consequences. According to the results, the following conceptual-functional definition can be presented for adaptation to climate change: "CCA refers to the ability of system instability, sustainability, empowerment, productivity, flexibility, and transformation to climate change through the optimal use of resources, resistance, and coping, capacity building and opportunity creation". This definition is conceptual, it means that includes the main features of climate-adaptation and is also functional that is, includes adaptation strategies for climate change.