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Introduction and Objectives: Health care providers need a high level of communication skills in dealing with pediatric patients and their carers. The objective of this project was to evaluate current practice and implement best practices promoting health care provider communication with pediatric patients and carers in a children's hospital in Tabriz, Iran., Methods: This project used the JBI Model of Evidence-Based Healthcare, which guided the conceptualization of evidence implementation, context analysis, project implementation, and evaluation of outcomes using evidence-based quality indicators. An audit and feedback strategy was adopted to measure baseline compliance with best practices, develop strategies to address areas of non-compliance, and conduct a final audit to measure any changes in compliance. Four criteria were developed for the baseline and follow-up audits. Criteria 1 and 2 were evaluated using a sample of 30 health care providers, while Criteria 3 and 4 were evaluated using a sample of 80 pediatric patients and carers., Results: All four criteria improved at the end of the project. Criterion 1 (health care staff receive communication skills training) had the highest mean score at baseline and follow-up (63% and 83%, respectively). Criterion 2 (implementation of local strategies by health care organizations) increased from 45% to 55%. However, this rate of improvement was the lowest of all the criteria. Criterion 3 (pediatric patients receive relevant education) improved from low to moderate, rising from 18% to 49%. A more significant improvement was noted for Criterion 4 (parents receive relevant education), which rose from 19% to 56%., Conclusions: The strategies implemented in this project successfully improved health care provider communication with pediatric patients and their carers. To ensure project sustainability, repeat audits will be conducted after 3, 6, and 12 months., Spanish Abstract: http://links.lww.com/IJEBH/A199., Competing Interests: The authors declare no conflicts of interest., (Copyright © 2024 JBI. Unauthorized reproduction of this article is prohibited.)

Background: In light of the multi-faceted challenges confronting health systems worldwide and the imperative to advance towards development goals, the contribution of health policy graduates is of paramount importance, facilitating the attainment of health and well-being objectives. This paper delineates a set of core skills and competencies that are requisite for health policy graduates, with the objective of preparing these graduates for a spectrum of future roles, including both academic and non-academic positions., Methods: The study was conducted in three phases: a scoping review, qualitative interviews and the validation of identified competencies through brainstorming with experts. In the initial phase, a scoping review was conducted on the databases. The following databases were searched: PubMed, Scopus, Web of Science and Google Scholar search engine. Additionally, the WebPages of universities offering health policy programmes were manually searched. In the second phase, 36 semi-structured interviews were conducted with students, graduates and distinguished academics from Iran and other countries. These interviews were conducted in person or via email. In the third phase, the draft version of the competencies and their associated learning objectives, derived from the preceding stages, was subjected to independent review by an expert panel and subsequently discussed. In light of the expert panel's findings, the authors undertook a subsequent revision of the list, leading to the finalization of the core competencies through a process of consensus., Results: In the scoping review phase, the analysis included six studies and nine university curricula. The results of the scoping review could be classified into five domains: health system understanding, health policy research, knowledge translation, multidisciplinary work and knowledge of public health. In the second phase, six core competencies were extracted from the interviews and combined with the results of the first phase, which were then discussed by the expert panel at the third phase. The final five core competencies, derived from the brainstorming session and presented in no particular order, encompass health policy research, policy analysis, educational competencies, decision-making and multidisciplinary work., Conclusions: It is essential that the curriculum is appropriate and contextually tailored, as this is crucial to foster multi-dimensional competencies that complement the specific disciplines of future health policy scholars. These scholars must possess the ability to genuinely serve their health systems towards achieving health-system goals and sustainable development., (© 2024. The Author(s).)

Background: A better understanding of health system performance requires evaluating achievements and challenges, thereby providing a basis for effective reforms. This systematic review aims to investigate the challenges and weaknesses of leadership and governance-related health policies in Iran., Methods: In this qualitative systematic review, we followed the instructions of the Joanna Briggs Institute (JBI). It encompassed qualitative studies assessing challenges and weaknesses of leadership and governance-related health policies. Thematic synthesis was conducted in three stages to identify common themes., Results: The primary database search yielded 1890 records, of which 152 were fully assessed, resulting in the inclusion of 57 studies in this review. Thematic synthesis produced 157 structured codes and identified 11 main descriptive themes of challenges in leadership and governance-related health policies. These themes included hospital autonomy policy, challenges to the entire health system, governance of medical universities, healthcare payment systems, sustainable universal health insurance coverage, informal payments, insurance systems, induced demand, strategic purchasing of health services, the family physician program, family physician and rural health insurance programs, and primary healthcare human resources., Conclusion: The identified challenges underscore the urgent need for strategic reforms and interventions to overcome the complex issues plaguing the healthcare system. By addressing these challenges, policymakers and top healthcare managers might ensure that the population have access to high-quality care in a more responsive healthcare system., (© 2024 The Author(s). This is an open-access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.)

The total fertility rate in Iran has declined to below replacement level recently, and a new approach has been taken to tackle this issue. Thus, this study aimed to identify the involved stakeholders and their characteristics in the new population policy change in Iran. We employed a qualitative approach using the purposive sampling of key informants and the identification of relevant documents. The main stakeholders were divided into seven key groups: religious, political, governmental, professional, international sectors, media, and nongovernmental organizations. In addition, there was no centralized, clear, and comprehensive mechanism to guide the activities of stakeholders to coordinate and bring the total fertility rate to the replacement level in Iran. Despite the importance of the new population policy in Iran, in recent years, we still experience dispersion and inconsistency among various actors in this area. It is imperative to go through a consensus and coalition at macro-level authorities alongside evidenced-based population policymaking., (© 2022. The Author(s).)

Introduction: The first case of the novel coronavirus disease (COVID-19) in Iran was officially announced on February 19, 2020, in Qom city. The prevalence of COVID-19 is higher among frontline healthcare workers (HCWs) due to their occupational exposure., Objective: The aim of this evidence implementation project was to improve the protection of nurses against COVID-19 in the emergency department of a teaching hospital in Tabriz, Iran., Methods: A clinical audit was undertaken using the JBI Practical Application of Clinical Evidence System (JBI PACES) tool. Ten audit criteria, representing the best practice recommendations for the protection of HCWs in the emergency department were used. A baseline audit was conducted, followed by the implementation of multiple strategies. The project was finalized with a follow-up audit to evaluate changes in practice., Results: The baseline audit results showed that the compliances for four (out of ten) audit criteria (criteria 4, 7, 8 and 9), were under 75%, which indicated poor and moderate compliance with the current evidence. After implementing plans such as running educational programs and meetings, major improvement was observed in 3 criteria, criterion 4 was improved from low to excellent (41-81%), criterion 7 was promoted from low to moderate (30-62%), criterion 8 was not promoted considerably (22-27%) and criterion 9 was improved from moderate to excellent (70-84%)., Conclusion: The results of the audit process increased COVID-19 protection measures for nurses in the emergency department. It can be concluded that educational programs and tools, such as face-to-face training, educational pamphlets, workshops and meetings can facilitate the implementation of evidence into practice., (Copyright © 2022 JBI. Unauthorized reproduction of this article is prohibited.)

Background: Gastrointestinal cancers continue to claim the lives of thousands of individuals. Fortunately, primary prevention, which focuses on interventions to change unhealthy lifestyle behaviors, can lessen the negative effects and decrease the economic burden of these cancers. The purpose of this paper is to assess the likelihood of adopting gastrointestinal cancer prevention policies through the lens of Kingdon's theory of agenda setting., Methods: A qualitative study was conducted using document review and face-to-face interviews with 22 key informants from different stages of the policymaking process of gastrointestinal cancer prevention program in Iran. We used purposive sampling. Our analysis of documents and interview were guided based on Kingdon's multiple streams (problem stream, policy stream, and political stream)., Results: Based on the results of this study the important factors of problem stream are as below. The high cost of gastrointestinal cancer diagnostic services dramatically affect patient's financial affordability to essential cancer-related services. Consequently, most of the cancers show distant metastasis at the time of diagnosis, imposing catastrophic expenses to patients, society, and the health systems. In the policy stream, participants mentioned the importance of the cancer registry system in the country that provides a clear source of information for decision-makers to plan for early diagnostic services. Under the political stream, the national and international supports provide a favorable climate for this issue., Conclusion: Now that a window of opportunity for gastrointestinal cancer prevention policymaking is created, there is a need for greater efforts to strengthen the inter-sectoral collaboration. The presence of the policy entrepreneurs during this period can press for policy change, however, actors need political support from the highest level of the governance to push this issue on the agenda., Policy Summary: This paper is seeking to have impact on the policies related to prevention of gastrointestinal cancers in Iran., (Copyright © 2020 Elsevier Ltd. All rights reserved.)

Background: Gastrointestinal cancers in Iran are among the major non-communicable diseases with a considerable burden on the health system. Changes in lifestyles as well as environmental factors have resulted in the emergence of these cancers., Objective: To elicit and quantitatively verify experts' opinions regarding the potential public health impact, feasibility, economic impact, and budgetary impact of gastrointestinal cancer prevention policies in Iran., Methods: Sixteen experts from Iran were recruited in an email-based, two-round Delphi study. In each round, a questionnaire of policy options for preventing gastrointestinal cancers, which adhered to the new policy framework of the World Cancer Research Fund International, was given to participants. In the first round, experts were asked to provide opinions for and against the policy options. The second round evaluated the policy options for their public health impact, feasibility, economic impact, and budgetary impact., Results: A total of 32 policy options were organized based on three domains: health-enhancing environments, system changes, and behavior change communications. Of the 32 policy options, there were consensus in 31 (96%) and 30 (93%) options for public health impact and feasibility, respectively. On study completion, experts reached a consensus in 29 of 32 (90%) policy options for economic impact; only on 26 (81%) of these policy options did participants reached consensus for budgetary impact., Conclusion: Findings indicated that although nearly all policy options reached a consensus for their public health impact, some options are not feasible or do not appear to have an economic rationale for being implemented. Moreover, it is crucial to take into account the inter-sectoral collaboration between health and non-health sectors. Findings from this study can be helpful for health policymakers in identifying support for evidence-informed approaches regarding gastrointestinal cancer prevention.

Introduction: Parents of infants admitted to hospital have high information needs. A good educational program will improve the outcomes and communication needs of these parents. Results from some studies have shown that patient education in Iran is inappropriate and should be improved., Objectives: The aim of this evidence implementation project was to evaluate the current practice and implement the best practice related to promoting patient education in a children's hospital in Tabriz, Iran., Methods: A clinical audit was undertaken using the Joanna Briggs Institute Practical Application of Clinical Evidence System tool. Eight audit criteria that represent the best practice recommendations for patient education were used. A baseline audit was conducted followed by implementing multiple strategies, and the project was finalized with a follow-up audit to determine a change in practice., Results: Significant improvements in the follow-up audit in comparison with the baseline audit were as follows: evaluation of patient learning has been undertaken to determine met and unmet needs (from 65 to 77%); patients' learning needs, readiness to learn, and their learning style have been assessed before the implementation of an educational initiative (from 55 to 66%); and educational resources in different formats (e.g., written handouts, brochures, and links to online materials) are available in the ward (from 33 to 77%). Strategies that were implemented to achieve change in practice included conducting workshops and conferences, determining a trained nurse as responsible for educating parents, training in discharge time, the presentation of educational films daily, conducting group training, and installing related posters in the department and patient's room. The other five criteria were less compliant with best practice in the follow-up audit rather than the baseline audit; however, all of them except one (Criterion 3) were still up to 75% compliant, which is considered excellent by the audit team., Conclusion: The follow-up audit results indicated an improvement in providing parental education. It can be concluded that these interventions can facilitate the implementation of evidence into clinical practice., (Copyright © 2021 JBI. Unauthorized reproduction of this article is prohibited.)

Introduction: Informed consent is a continuous and dynamic process. It is a crucial part of healthcare procedures that becomes more complex in a pediatric clinical practice, where parents must make decisions for their children., Objectives: The aim of this implementation project was to evaluate the current practice and implement the best practice related to obtaining informed consent in a children's hospital in Tabriz, Iran., Methods: A clinical audit was undertaken using the JBI Practical Application of Clinical Evidence System (JBI PACES) tool. Five audit criteria representing the best-practice recommendations for informed consent were used. A baseline audit was conducted, followed by the implementation of multiple strategies. The project was finalized with a follow-up audit to determine change in practice., Results: The compliance rate of all criteria improved from baseline to follow-up audit. Criteria 1 (obtaining informed consent prior to all nursing procedures) and 5 (provision of information related to the necessity of the treatment) reached 97% compliance in the follow-up cycle. Criterion 4 (provision of information related to the nature and effect of the treatment) achieved 74% compliance. Both criteria 2 and 3 (provision of information related to alternative treatments and consequences of refusing treatment) reached 57% in the follow-up cycle. To improve compliance, meetings were organized with the heads of departments, nurses and residents regarding informed consent. Also, staff were encouraged to report cases where informed consent was not obtained., Conclusion: The audit results indicated an improvement in obtaining informed consent in the included departments. The interventions that were employed can facilitate the implementation of evidence into clinical practice.

Background: A huge number of people living with HIV/AIDS lives in developing countries. Thus, strengthening health systems in these countries is a prerequisite for improving disease prevention and care. After three decades of HIV/AIDS policy-making in Iran, conducting a comprehensive analysis on the policy process seems to be essential. In the present study, we aimed to analyse the HIV/AIDS policy-making process in Iran from 1986 to 2016., Methods: This was a theory-based, multi-method and retrospective study. Interviewing of key informants and review of policy documents were concurrently conducted to identify and include further key informants (39 participants) and documents in the study. Framework analysis was used to analyse data., Results: The mean age of participants working in HIV/AIDS policy-making was of 48 years and participants had a mean of 14 years of working experience. Findings were categorized as contextual factors, content of HIV/AIDS policies, actors involved in the policy process, and evidence use in the policy process. Contextual effective factors on the HIV/AIDS policy-making process were categorized into five major themes, namely situational factors, structural-managerial factors, socioeconomic factors, political and legal factors, and international factors. The HIV/AIDS phenomenon in Iran was identified to be deeply rooted in the culture and traditions of society. The HIV/AIDS policy content has, recently, been crystallized in the national strategic plans and harm reduction policies of the country. The policy process has been conducted with a solely governmental top-down approach and is now suffering from poor evidence and lack of sufficient consideration of contextual factors., Conclusions: There is a great need for change in the approach of government towards the issue and to increase the participation of non-governmental sectors and civil society in the policy process.