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Abstract Background Knowledge is sparse concerning injuries affecting rural populations in low and middle-income countries in general and in Iran in particular. This study documents the incidence and characteristics of severe injuries affecting rural people in the Iranian district of Twiserkan and it investigates these people's suggestions for injury prevention and control. Methods An interview-based investigation was undertaken that comprised all unintentional injuries leading to hospitalization (more than 6 hours) or death that had occurred within a twelve month period and that were identified in the files of the 62 "health houses" of the Twiserkan district. For each case, semi-structured interviews were conducted at the households of the injured people (134 injuries affecting 117 households were identified). Results The incidence rates of fatal and non-fatal injuries were respectively 4.1 and 17.2 per 10 000 person-years and, as expected, men were more affected than women (77.6% of all injury cases). Traffic injuries (in particular among motorcyclists) were as common as home-related injuries but they were far more fatal. Among common suggestions for prevention, people mentioned that the authorities could work on the design and engineering of the infrastructure in and around the village, that the rural health workers could contribute more with local information and education and that the people themselves could consider behaving in a safer manner. Conclusion Not only domestic injuries but also those in traffic are an important cause of severe and fatal injury among rural people. Health workers may play an important role in injury surveillance and in identifying context-relevant means of prevention that they or other actors may then implement.

Objective: Road traffic injuries (RTIs) have been identified as a major public health problem worldwide. Motorcyclists are one of the most vulnerable groups in terms of injuries and fatalities in road traffic crashes. Not using a helmet and head and neck injuries are the main causes of death and disability among them. This study explores barriers and facilitators of helmet use among motorcyclists., Methods: A qualitative approach to conventional content analysis was employed in this research. The purposive sampling method, with maximum diversity, was used to select participants among motorcyclists and traffic police officers in Qom City, Iran. To collect data and reach data saturation, 41 face-to-face semistructured interviews with 29 motorcyclists and 12 traffic police officers were conducted using the interview guide., Results: The mean and standard deviation of age were 32.6 ± 8.6 for the motorcyclist group and 34 ± 7.9 for the police group. Through qualitative data analysis, the codes were extracted from the collected data and categorized into 2 categories including barriers and facilitators. In the category of barriers 5 subcategories were identified including nonadherence to the helmet law, unpleasant feeling, psychological characteristics, economic factors, and helmet quality. In the category of facilitators, 3 subcategories were identified including education and information campaigns, encouragement and increase motivation, and policymaking and legislative measures., Conclusion: Police supervision and law enforcement can be effective in improving the behavior of helmet use. Also, to create and increase the motorcyclists' motivation to use helmets, economic and cultural incentives and social participation can be used to facilitate acceptance of the law regarding helmet use. Furthermore, quality improvement of helmets to remove barriers and physical problems such as heat, visual and auditory restrictions, head movement restrictions, and weight can be very useful. The findings of this study can help to develop more appropriate and context-based interventions to increase helmet use and therefore to prevent RTIs in the community.

Road traffic injuries (RTIs) are a significant cause of death and disability among young people worldwide. Programs that use injury prevention strategies have been shown to effectively reduce the number of injuries. This systematic review aims to present the available evidence on the effectiveness of intervention programs in preventing RTIs among adolescents and young adults. Articles were identified and retrieved from databases including PubMed, Embase, Web of Science, Scopus, Science Direct, Magiran, SID, and Iran Medex. Two reviewers independently screened the articles. Articles published from the first year of publication until January 2018 that met the eligibility criteria were included in the review. These articles covered randomized controlled trials, pretest/post-test interventions, and controlled pretest/post-test interventions aimed at reducing RTIs among adolescents and young people aged 12-26 years. The framework, provided by Murphy and Haddon, were used to categorize the interventions. According to this framework, the interventions were categorized into five groups including education/behavior change, incentive, engineering/technology, legislation/enforcement, and multifaceted programs. The methodological quality of the studies was assessed using the Effective Public Health Practice Project. Of the initial 3165 findings, 13 studies met the inclusion criteria. Eleven of these studies used educational/behavioral approaches, while two employed multifaceted programs. In the educational/behavioral approach, participants' behaviors were considered as outcome variables. Only one of these studies was not successful. Multifaceted interventions were successful in changing behaviors. No studies were found on the effectiveness of other interventions. Eight studies were assessed as having moderate quality. The systematic review shows that educational/behavioral strategies and multifaceted programs are effective in reducing RTIs among young adults and adolescents. However, there is a lack of studies on other potential interventions. The quality of the included studies was moderate, suggesting a need for more rigorous research.

Background: Measuring socioeconomic status (SES) as an independent variable is challenging, especially in epidemiological and social studies. This issue is more critical in large-scale studies on the national level. The present study aimed to extensively evaluate the validity and reliability of the Iranian SES questionnaire., Methods: This psychometric, cross-sectional study was conducted on 3000 households, selected via random cluster sampling from various areas in East Azerbaijan province and Tehran, Iran. Moreover, 250 students from Tabriz University of Medical Sciences were selected as interviewers to collect data from 40 districts in Iran. The construct validity and internal consistency of the SES questionnaire were assessed using exploratory and confirmatory factor analyses and the Cronbach's alpha. Data analysis was performed in SPSS and AMOS., Results: The complete Iranian version of the SES questionnaire consists of 5 factors. The Cronbach's alpha was calculated to be 0.79, 0.94, 0.66, 0.69, and 0.48 for the occupation, self-evaluation of economic capacity, house and furniture, wealth, and health expenditure, respectively. In addition, the confirmatory factor analysis results indicated the data's compatibility with the 5-factor model (comparative fit index = 0.96; goodness of fit index = 0.95; incremental fit index = 0.96; root mean square error of approximation = 0.05)., Conclusion: According to the results, the confirmed validity and reliability of the tool indicated that the Iranian version of the SES questionnaire could be utilized with the same structure on an extensive level and could be applicable for measuring the SES in a broader range of populations., Competing Interests: The authors declare that they have no competing interests., (© 2024 Iran University of Medical Sciences.)

Background: The rate of seat belt use in rural societies is less than in urban societies. The present study aimed to determine the effect of demographic and traffic-related variables on seat belt use among rural non-drivers based on the theory of planned behavior (TPB)., Methods: This study was conducted among 450 non-drivers in the rural areas of Hashtroud district in Iran. For collection of data, a questionnaire containing questions about demographic characteristics and general information on traffic-related behaviors of non-drivers, and questions on seat belt use based on constructs of the TPB was used., Results: The lowest seat belt use rate was for non-drivers that sit in the rear seat of a car on rural roads (22.4 % never, 14.4 % always). Also, the rate of seat belt use among parents of participants on rural roads was lower than on city roads. Adherence to traffic rules and having training about seat belt use had significant effects on the construct of TPB, including attitude, subjective norms, perceived behavioral control, behavioral intention, and behavior of seat belt use. With increasing age, subjective norms about seat belt use have improved. The attitude toward seat belt use among females was better than males., Conclusions: The result indicated that most of rural non-drivers did not adhere to traffic rules. Adherence to the traffic rules and having training on seat belt use had a significant impact on seat belt use behavior. Training seat belt use especially by parents could be effective in improving seat belt use.

Background: Substance abuse is the actual psychosocial harm, especially in young people confronted with content marketing in nowadays media environment, a risk factor for experiencing substance abuse. Based on the literature review, education designed based on the cognitive-behavioral model and planning models, such as using a social marketing framework, is the most effective method to prevent addictive substance abuse. Also, media literacy related to substance abuse and the prototype willingness model is considered a new integrated approach to present the intervention measures' desired results., Methods: The present study evaluates an intervention program based on media literacy on substance abuse prevention among students using an integrated social marketing approach. This study aims to complete the SMART model's sixth and seventh stages, implementing intervention and evaluation. Participants will be students of Hamadan University, Iran. Randomization will occur at the university and school levels, and gathered data will appear at two-time (i.e., pre-test and three months follow-up). Intervention group students will obtain both substance abuse prevention education and substance abuse media literacy (SAML) education between pre-test and 3 months post-test. Students in the delayed intervention will be given this education after study accomplishment; this group will receive their regular courses except for substance abuse prevention and media literacy titles during education intervention. The outcome variables are intentions and substance abuse behavior based on prototype willingness and substance abuse media literacy., Discussion: Evaluation of Substance abuse prevention and substance abuse media literacy education must be careful to ensure that they effectively enable people, especially in youth in the new media ecology and unique "Infomedia" ecosystems, in the current digital society. The SAML education plan's evaluation has the first web-based education program in universities. No prior research has psychometrically considered SAML in students in the SMART model's sixth and seventh stages., Trial Registration: IRCT20200914048719N1 . Registered on June 30, 2021., (© 2022. The Author(s).)

Background: Road traffic injuries (RTIs) are one of the most critical factors that endanger human health. More specifically, head and neck injuries are the main causes of deaths and disabilities among motorcyclists. This study aimed to investigate the predictive factors of helmet use behavior among motorcyclists based on the theory of planned behavior (TPB)., Study Design: This study followed the cross-sectional design., Methods: This study was conducted on randomly selected 730 motorcyclist employees in Qom, Iran, in 2021. The data collection tool was a self-administered researcher-made questionnaire, including items on demographic characteristics, history of RTIs, and constructs of TPB. Data were analyzed using descriptive summary statistics, analysis of variance, independent samples t test, Pearson correlation coefficient, and structural equation modeling (SEM)., Results: In this study, only 9.8% of the participants reported that they always used a helmet while riding a motorcycle. About 60% reported a history of a motorcycle crash, and 11.5% had a history of head injuries. The direct effect of attitude, subjective norms, and perceived behavioral control on the intention to use a helmet were statistically significant, explaining 59% of the variation in behavioral intention (intention to use a helmet) (R 2 =0.59). Moreover, perceived behavioral control and behavioral intention had significant effects on helmet use behavior (R 2 =0.26)., Conclusion: The prevalence of helmet use among the studied population was very low. Moreover, TPB was useful in identifying the determinants of behavior and especially behavioral intention of helmet use among motorcyclists., (© 2022 The Author(s); Published by Hamadan University of Medical Sciences. 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.)

Road traffic injuries (RTIs) are a serious public health problem and are an important cause of disability and death worldwide. A significant proportion of traffic injuries and fatalities are among pedestrians. Reviewing and evaluating related interventions can be a practical step to implementing appropriate methods to prevent RTIs among pedestrians, a highly vulnerable group of road users., The search of articles was conducted in the electronic databases of Scopus, PubMed, ISI, Safety Lit, and CDC. Other papers were also reviewed using forward citation and backward citation. The search strategy was for studies examined from the first years of database creation until January 10, 2021, in all languages in journals with matched judgment according to the type of population, type of interventions, comparators, and results. Joanna Briggs Institute (JBI) checklists were used to determine articles' quality and assess possible biases depending on the type of study., The initial search resulted in finding 16,272 abstracts. Finally, 25 studies, including 17 randomized clinical trials (RCTs) studies, seven studies pretest/post-test interventions (PPI), and one study controlled pretest/post-test interventions (cPPI) met the inclusion criteria. Among these preventive interventional studies, 20 studies were conducted in high-income countries, three were in lower middle-income countries, one study was in upper middle-income country, and only one study was conducted in a low-income country. Most interventional studies in the field of prevention of RTIs (15 studies) had an educational/behavioral approach, designed to change pedestrian behavior and the use of this approach was also effective in improving pedestrian behavior. The legislation/law enforcement approach was used in one study and two studies used an engineering/technology approach. In studies with an engineering approach after engineering reforms, pedestrian injuries in children decreased by 37.5%. In seven studies, multifaceted interventions were used. The interventional studies that used this approach were able to improve pedestrian safe behavior., The majority of studies were based on educational/behavioral approaches and pedestrians' behavior improved notably. In addition, the majority of interventional studies were conducted in countries with high income levels. Therefore, programming for preventive interventions to attenuate RTIs is highly important in low/middle-income countries to reduce the risk of injury to vulnerable road users. These findings can be applied by policy-makers to develop educational, engineering, environmental, and law enforcement interventions and attenuate injuries sustained by pedestrians.

Breast cancer is one of the most common diseases of women, which can increase the survival of patients with its early diagnosis. Despite the existence of relatively sensitive methods of early detection of breast cancer, such as mammography, statistics show that a small number of women perform mammography according to the recommended clinical guidelines. Using the health belief model, this study aims to determine the factors affecting mammography among women teachers in Hamedan., Methods: This study was conducted on 458 female teachers aged 40 years and older of Hamadan city, in western part of Iran, during October to December of 2019. The participants were asked about the factors affecting mammography based on the health belief model. Questionnaires were completed by self-reported method and analyzed by SPSS software at 95% confidence interval., Results: The average age of the study participants was 46±4.1 years. Among the participants, about 41.5% had performed mammography at least once. In univariate analysis, the constructs of the health belief model generally predicts performing mammography between 35 and 49 percent. In multivariate analysis, age 46 to 50 years, having supplementary insurance, history of breast disease, perceived barriers with odds ratio of 3.4, 3.4, 10.6 and .89, respectively, were significantly related to mammography., Conclusions: Female teachers over 45 years of age with a history of breast disease, if they do not have financial or other barriers to do mammography, perform breast cancer screening.

Objective: The present study aimed to determine the predictors of drug use among students based on the Extended Prototype willingness model (EPWM)., Methods: This cross-sectional study was performed at Hamadan universities. The participants were selected via multi-stage sampling. Finally, out of 721 students participated. The questionnaire consisted of four sections: (a) socio-demographic characteristics, (b) Questionnaire about the prototype willingness model constructs, (c) Questionnaire about the status of drug use behavior, (d) Substance Abuse Media Literacy (SAML) scale. Data were analyzed using a structural equations partial least squares confirmatory composite approach and SPSS-23., Results: The mean age of students was of 23.47 ± 4.14 years. Based on results, behavioral willingness (β = 0.420, t-value = 9.010, p < 0.001) and behavioral intention (β = 0.291, t-value = 6.957, p < 0.001) significantly predicted drug use. The presented results of analysis, 66% of the variance of the drug use, 62% of the variable of the behavioral willingness, and 56% of the behavioral intention could be explained by the EPWM., Conclusion: The present study demonstrated that EPWM could predict drug use in students. Therefore, designing and implementing educational and promotional intervention programs to reduce behavioral willingness and increase students' skills in substance abuse media literacy is necessary to prevent drug use behavior., (© 2022. The Author(s).)

Background: There is no official and representative information on certain health-risk behaviors in Iran. This national survey was performed to determine the prevalence of five high-risk behaviors among the adult population and underlying factors., Methods: This cross-sectional study was performed in 23 provinces of Iran in 2019 involving 10,957 participants. The following five risky behaviors were evaluated: (a) using illicit drugs in the past month, (b) drinking alcohol in the past month, (c) having extramarital sex in the past year, (d) having suicidal thoughts in the past month, (e) and attempting suicide in the past year. The logistic regression model was used for analyses and associations were reported using odds ratio (OR) with its 95% confidence interval (CI)., Results: The prevalence of health-risk behaviors was as follows: illicit drug use 10.4%, drinking alcohol 16.8%, extramarital sex 9.9%, suicidal thoughts 8.8%, and suicide attempt 5.4%. Almost 27.6% of the participants were involved in at least one risky behavior. There was a strong association between illicit drugs use and male gender 2.51 (2.11-2.98) and using psychiatric medications 2.96 (2.46-3.55); between drinking alcohol and male gender 2.23 (1.93-2.58); between extramarital sex and divorced/widowed status 2.43 (1.72-3.44) and having an intimate friend of the opposite sex 3.75 (3.13-4.51); between suicidal thoughts and using psychiatric medications 2.23 (1.83-2.72); between suicide attempt and a history of running away from home 2.10 (1.64-2.68)., Conclusion: More than one-fourth Iranian adult population is involved in at least one risky behavior. Engaging in any risky behavior may increase the possibility of engaging in other high-risk behaviors., Competing Interests: Conflict of interest The authors have no conflict of interest to declare., (Copyright © 2022 Ebrahimi et al. Published by Tehran University of Medical Sciences.)

Background: Road traffic crashes (RTCs) and its associated injuries are one of the most important public health problems in the world. In Iran, RTCs rank second in terms of mortality. To address this issue, there is a need for research-based interventions. Prioritizing researches using a variety of approaches and frameworks to determine the most effective interventions is a key nodal point in the RTCs' research policy planning cycle. Thus, this study aims to generate and prioritize research questions in the field of RTCs in Iran., Methods: By adapting the Child Health and Nutrition Research Initiative (CHNRI) method, this study engaged 25 prominent Iranian academic leaders having role in setting Iran's long-term road safety goals, a group of research funders, and policymakers. The experts' proposed research questions were independently scored on a set of criteria: feasibility, impact on health, impact on the economy, capacity building, and equity. Following the prioritization of Research Questions (RQs), they were all classified using the 5 Pillar frameworks., Results: In total, 145 Research Questions were systematically scored by experts against five criteria. Iran's top 20 road traffic safety priorities were established. The RQs related to "road safety management" and "road and infrastructure" achieved a high frequency., Conclusions: The top 20 research questions in the area of RTCs in Iran were determined by experts. The majority of these RQs were related to "road safety management". The results of this study may contribute to the optimal use of resources in achieving long-term goals in the prevention and control of road traffic crashes and its related injuries. Considering these RQs as research investment options will improve the current status of Road Traffic Injuries (RTIs) at a national level and further advance toward compliance with international goals. If these research priorities are addressed, and their findings are implemented, we can anticipate a significant reduction in the number of crashes, injuries, and deaths., Competing Interests: Competing interests: The authors completed the ICMJE Unified Competing Interest Form (available upon request from the corresponding author), and declare no conflicts of interest., (Copyright © 2022 by the Journal of Global Health. All rights reserved.)

Background: Burns are one of the most important childhood injuries that can be controlled and prevented. Mothers play an important role in preventing child burns. Health education and promotional theories facilitate a precise recognition of the behavioral factors in mothers that help preventing burn injury in their children. Burns in children under five years old and the factors in prevention of burn by their mothers were examined using PRECEDE Model. The study environment was rural and urban areas of Kermanshah, Iran., Methods: This cross-sectional study was conducted on 330 mothers in urban and rural areas of Kermanshah County in the west of Iran. The participants were randomly selected among mothers who had at least one child younger than five years old. Data was collected through interviewing the mothers using a valid and reliable questionnaire. The questionnaire included questions on demographic characteristics, PRECEDE Model, and history of burn. The data were analyzed using SPSS-16., Results: The mean age of the mothers in urban areas (29.33 ± 5.987) was higher than that of those in rural areas (28.77 ± 6.236). More than 90% of the mothers were housewives, both in urban and rural areas. The rate of a history of burn in rural children under the age of five (8.3%) was greater than that in urban children (5.2%). Most of the burn cases in urban areas were mild whereas those in rural areas were moderate. The majority of burn cases had happened at home in children 1-3 years' age range; this rate was higher in boys. The majority of burns cases had happened when the child was playing (urban: 64.3%, rural: 100%). In addition, liquids and hot objects were the main causes of the burns (urban: 78.5%, rural: 100%). Among the constructs of PRECEDE models in the urban areas, knowledge (P < 0.001), attitudes (P = 0.027), and environmental factors (P = 0.03) had a significant relationship with burn-preventive behaviors in mothers. In addition, in the rural areas, attitudes (P = 0.038) had a significant relationship with burn-preventive behaviors in mothers., Conclusion: Burn was an important injury in the study population, especially in the rural areas. The PRECEDE model can help us to identify the factors in burn injuries in children and the preventive behaviors in mothers. The findings can be used to develop preventive interventional programs to better protect this vulnerable group in society., (Copyright © 2021 Elsevier Ltd and ISBI. All rights reserved.)

Background: Road Traffic Injuries (RTIs) are the important causes of unintentional injuries and deaths. In this respect, seat belt wearing is an influential factor in reducing the mortality and severity of road traffic injuries. The rate of seat belt use among is lower adolescents, compared to adults. The present study aimed to investigate the influential factors on seat belt-weraing behavior among adolescent students as car occupants based on the Theory of Planned Behavior (TPB)., Study Design:   A cross-sectional design., Methods: This study was conducted among 952 adolescent students studying in grades 7, 8, and 9 in the schools of Tabriz, Iran, in the 2019-20 academic year. A researcher-made questionnaire was designed based on TPB for data collection, the validity and reliability of which have been confirmed., Results: The results indicated that the rate of seat belt use in the front seat inside the city was lower than that outside the city. Regarding TPB constructs, perceived behavioral control (β=0.137; 95% CI: 0.006-0.013; P<0.001), subjective norm (β=0.313; 95% CI: 0.021-0.032; P<0.001), and attitude (β=0.322; 95% CI: 0.034-0.053; P<0.001) had a significant and positive relationship with the intention of seat belt-wearing behavior. Moreover, the behavioral intention (β=0.571; 95% CI: 0.62-0.64; P<0.001) had a significantly positive relationship with seat belt-wearing behavior., Conclusion: The Theory of Planned Behavior is appropriate to determine predictor factors of seat belt-weraing behavior among adolescent students as car occupants. In addition, the results of the present study may provide a theoretical basis for policy-making to improve adolescent students' seat belt use.

Background: Intimate partner violence is a severe life-threatening criminal and public health problem affecting the well-being of individuals, families, and society. Planning interventions to reduce the burden of this persistent and criminal violence should be relevant culturally and socially., Methods: In this randomized control trial, 150 pregnant women residing in slum areas of Hamadan were randomly assigned to two groups (intervention group: n=50 and control group: n=100). Interventional strategies included educating the victims based on local cultural norms, culturally sensitive individual and group counseling, and educating health care providers. Data were collected via face-to-face interviews at baseline and again at 3 months after the intervention. We used a paired t-test to evaluate the effect of the intervention by comparing changes in the outcomes measured., Results: There were no statistically significant differences between the two groups at baseline in terms of sociodemographic characteristics. Post-test scores of knowledge (7.50±2.65 vs. 5.14±3.51, P=0.001), communication skills (18.38±4.25 vs. 16.2±3.83, P=0.04), and family support and social expectation of obedience (15.79±4.45 vs. 13.40±4.57, P=0.005) of the victims were statistically significantly higher in the experimental group compared to the control group. Moreover, physical (0.74±2.28 vs. 1.20±2.60, P=0.06), psychological (2.80±4.10 vs. 4.52±5.43, P=0.06), and sexual (0.11±0.58 vs. 0.61±1.22, P=0.04) violence reduced in the experimental group compared to the control group., Conclusion: Culturally relevant interventions can reduce intimate partner violence.

Background: Behavior change interventions in tackling road traffic injuries are a public health concern. Thus, this interventional research was to survey the effect of safe traffic behaviors among male students in Hamadan, Iran, utilizing theory of planned behavior., Methods: In this quasi-experimental study, 204 students were randomly selected through multistage sampling from male high school students of Hamadan city, west-central of Iran, and non-randomly allocated to control and intervention groups (102 students in every group). The self-administrate questionnaire was used for data collection in this research. Frequency (percentage) and mean (SD) were used for description. Cronbach alpha coefficient, content validity ratio (CVR) and content validity index (CVI) were used for psychometric evaluation of questionnaire and paired/independent sample t-test was used for data analysis. All statistical analyses were done in SPSS 19 and significant level was considered 0.05., Results: In both groups, more than 50 % of students walked to school. The two study groups were homogeneous in terms of confounding variables (p >  0.05). The validity of the questionnaire was confirmed and the total Cronbach's alpha value was equal to 0.97. There was no significant difference in the score of safe traffic behaviors between the two groups before the intervention (p >  0.05). But after the intervention, the score in the intervention group was significantly increased (p < 0.05). Intragroup comparison also showed that only in the intervention group the score was significantly changed (p < 0.05)., Conclusion: Theory of planned behavior is a suitable conceptual framework for planning the interventions to increase safe traffic behaviors in students., (© 2021. The Author(s).)

Intimate partner violence (IPV) occurs in all settings, especially in poor neighborhoods. It is considered to be a serious public health concern with serious consequences in the short and long term for abused women because of distinct barriers in obtaining support sources. Therefore this cross-sectional study focuses on the prevalence and the determinants of IPV among pregnant women residents in poor neighborhoods. Overall, 63.8% experienced at least one type of IPV. Also, educational status, family's monthly income, husband's employment status, and having a smoker husband were found to be important predictors of IPV against pregnant women. A better understanding of social determinants of violence can help decision-makers in developing effective policies. It is crucial to prioritize the poor neighborhoods for future interventions to reduce IPV imposed during pregnancy., (© Copyright 2021 Springer Publishing Company, LLC.)

Background: Musculoskeletal pains are among evident health problems in children and adolescents. Backpack carrying behaviors and the sitting postures are among behavioral factors associated with musculoskeletal pain in schoolchildren. Therefore, this study aims to identify the factors related to these important musculoskeletal behaviors, using Health Promotion Models., Methods: In this cross-sectional study, a questionnaire was created based on PRECEDE Model and Health Belief Model and was administered to 673 Iranian students, whom were selected randomly from elementary schools of Hamadan, Iran, in 2018., Results: The findings of the study revealed that proper sitting postures and backpack carrying were 42 and 33%, respectively. The findings also showed that predisposing factors including perceived susceptibility (p < 0.05, β = 0.219), perceived severity (p < 0.05, β = 0.166), perceived barriers (p < 0.05, β = - 0.191), perceived self-efficacy (p < 0.05, β = 0.188) and also enabling factors (p < 0.05, β = 0.329) were significantly related to sitting behaviors. Moreover, backpack carrying behaviors had significant relationships with predisposing factors of perceived susceptibility (p < 0.05, β = 0.198), perceived barriers (p < 0.05, β = - 0.258), perceived self-efficacy (p < 0.05, β = 0.185) and reinforcing factors (p < 0.05, β = 0.208)., Conclusions: It seems necessary for future preventive programs to take factors of musculoskeletal pains among children and adolescents into account.

Background: Hospital staffs are at high risk of Novel Coronavirus (2019-nCoV preventive behaviors play a peculiar role in the reduction of the incidence and mortality of this infection. Therefore, the present study aimed to assess the prevention behaviors of COVID-19 among health staff based on the Extended Parallel Model (EPPM) in western Iran., Study Design: It was a cross-sectional study. ., Methods: The present study was performed in the west of Iran in April 2020. In total, 1,664 cases were enrolled in this study via multi-stage sampling. The data were collected using a questionnaire, including the demographic characteristics of participants and EPPM constructs. All analyses were conducted in Stata software (version 14) at a 5% significant level., Results: As evidenced by the obtained results,  1,523 (91.53%), 1,226 (73.68%), 1,526 (91.71%), 893 (53.67%), and 862 (51.86%) of health staff wear gloves, use masks, avoid contact with others, maintain a good distance from other people, and wash their hands frequently with water and soap, respectively. In terms of using gloves and avoiding contacts with others, participants with high perceived threat had higher odds of observing health behaviors (OR= 3.14, 95% CI: 2.08, 4.73; P<0.001) and (OR= 3.1, 95% CI: 2.04, 4.69; P<0.001), respectively. In all categories of EPPM, the participants with high efficacy had higher odds of exhibiting health behaviors, compared to those with low efficacy (P<0.001)., Conclusion: The results of the present study demonstrated that  health workers are expected to be at the highest level of threat and efficiency. Moreover, the findings emphasized the effectiveness of the recommended strategies in the prevention of COVID-19 disease.

Background: Physical inactivity is one of the major risk factors for non-communicable diseases. This systematic review and meta-analysis aimed to assess the effects of educational interventions on promoting regular physical activity in adolescent weight management programs., Methods: The relevant studies indexed in Embase, Web of Science, Scopus, and ProQuest databases were searched using keywords namely "Physical Activity, Adolescent, Weight Management, Body Mass Index (BMI), Randomized Controlled Trials, and Clinical Trial." Up to the end of March 2020, two authors independently screened the papers, extracted data, and assessed the methodological quality of the studies using Effective Public Health Practice Project (EPHPP) tool., Results: Out of 12,944 initial studies, 14 met the inclusion criteria after screening the titles, abstracts, and full texts of the papers. The participants in these studies were aged between 6 and 18 years, and 13 studies included participants from both sexes. Moreover, eight of them were performed as a controlled clinical trial. The overall estimate of the difference showed that the interventions improved weight loss which is a statistically significant finding. The participants in the intervention group had a weight loss of 1.02 kg compared to the control group at a 95% confidence interval (- 4.794-0.222)., Conclusion: Published longitudinal data indicated that physical activity declines over the transition from adolescence to adulthood. Using the results of the study, policy-makers can design educational interventions using educational models and patterns., Systematic Review Registration: PROSPERO registration number: CRD42020173869.

Background: This survey was conducted to determine the level of aggression among the Iranian adult population and underlying predisposing factors., Study Design: A cross-sectional study., Methods: This cross-sectional study included 10,957 participants, involving 23 out of the 31 provinces of Iran in 2019. The outcome of interest was aggression, evaluated by the Buss & Perry aggression questionnaire. The association between aggression and 34 demographic, behavioral, social, and cultural characteristics was assessed using simple and multiple linear regression., Results: The overall mean (SD) score of aggression was 77.10 (22.53). Based on the severity of aggression, the participants were categorized into four groups as follows: 2,464 (23.1%) nonaggressive, 4,692 (43.9%) mild, 3,071 (28.8%) moderate, and 454 (4.2%) severe aggressive. Aggression was more likely to occur in people with the following characteristics: younger ages, having several siblings, lower ranks of birth, having an intimate friend of the opposite sex, having an aggressive father/mother, history of parental divorce, interest in watching action/porn movies, listening to music, history of escape from home/school, using neuropsychiatric drugs, using illicit drugs, history of suicidal thoughts/attempt, and family conflict and hostility. Aggression was less likely to occur with the following characteristics: reading, regular physical exercise, the ability to control anger, regular prayer, adherence to avoid lying, respect to other people's rights, sexual satisfaction, and attachment to parents., Conclusion: A majority of the population has some degree of aggression. Aggression is a multifactorial behavior corresponding with several demographical, social, cultural, and religious factors, some of which back to early childhood events.

Objective: Pedestrians are road users vulnerable to traffic injuries and fatalities. This study aimed to develop and validate a pedestrian behavior questionnaire to be used in Iran., Methods: In this cross-sectional study, the initial questionnaire was designed based on the evaluation of previous studies conducted world-wide or in Iran. The initial pack included 127 items. After the assuring the face validity of the questionnaire, 27 experts' opinions in the field of traffic was obtained for assessing/ improving the content validity. To test the reliability of the questionnaire, the test-retest method and internal consistency assessment were used. To evaluate the structural validity, the Exploratory Factor Analysis (EFA) using the principal component and the Varimax rotation was applied., Results: After completing the face validity and after summarizing the experts' suggestions, 12 questions were deleted. By calculating the content validity ratio and coefficient, 20 and 17 were removed. Also, the average content validity coefficient regarding relevancy, clarity and overall average were 0.86, 0.88, and 0.87, respectively. The Cronbach's alpha coefficient was 0.84. In the last stage and according to the results of the factor analysis, five factors violations, distraction, positive behaviors (group1), positive behaviors (group2) and Aggressive behaviors) were identified from the 29-items questionnaire, which explained 98% of the total variance., Conclusion: Considering the necessity of using a verified and validated tool for planning and evaluating effective interventions for pedestrians is inevitable. The tool designed in the study was found to be valid and reliable for use to measure pedestrian's behavior and planning to modify high-risk behaviors and enhance safe pedestrian behaviors., Competing Interests: The authors have no conflicts of interest with respect to this manuscript., (Journal compilation © 2020 Trauma Research Center, Shiraz University of Medical Sciences.)

Objective: Road traffic injuries (RTIs) are recognized as one of the most important causes of morbidity and mortality throughout the world, especially in developing countries. Human behavior is reportedly one of the critical factors in the occurrence of such injuries. The purpose of this study is to evaluate the correlation of abnormal driving behaviors with the frequency and severity of RTIs among drivers in Hamadan, west of Iran., Methods: The present cross-sectional study was conducted on 800 people driving, who were selected by multistage cluster sampling technique. Data were collected using a three-part self-administered questionnaire including demographic, social and driving characteristics; the Manchester driver behavior questionnaire (DBQ); as well as information on a history of the occurrence of the injuries caused by the crashes and the severity of them. Data were statistically analyzed using numerical indices, linear regression analysis, Pearson correlation, ordinal logistic regression model and multinomial logistic regression., Results: The highest and lowest mean percentages of abnormal driving behavior were related to unintentional violations (19.13) and Lapses (16.44), respectively. "Changing radio stations and listening to music while driving", "overtaking a driver who drives slowly", and "unintentionally exceeding the speed limit" were the three highest behaviors associated with road traffic injuries, with the mean and standard deviation of (1.93 ± 1.4), (1.90±1.4), (1.58±1.3), respectively. Age, gender, educational level, driving experience and driving hours during the day were significantly associated with DBQ dimensions and severity of road traffic injuries., Conclusions: The results of this study showed that socio-demographic characteristics were significantly correlated with driving behavior. In addition, driving behaviors were correlated with traffic crashes and the resulting injuries. The findings of this study can be utilized to develop driving behavior interventions among the drivers., Competing Interests: The authors have declared that no competing interests exist.

Background and Aim: Fire is one of the major dangers that cause many casualty, injuries and property damages every year worldwide. Most of these losses occur in low- and middle-income countries. Exploring the stakeholders experience is a great source for understanding factors affecting the prevention of fires and its related injuries. The purpose of this study then is understanding the perception of safety from fire related injuries in residential inhabitants of buildings in Iran., Methods: This study was conducted using conventional content analysis during December 2016 to December 2017. In total, 25 interviewees were selected through purposive sampling among experienced/or knowledgeable participants. Data was collected employing semi-structured interviews. The data analysis process was based on the Lundman & Graneheim method and their recommendations., Findings: The six categories including: safe building against fire, fire safety regulations, safety-friendly people, effective relief organizations, safe urban structure and economic and financial capacity was extracted., Conclusion: Fire safety in residential buildings with the demanding people for safety is ensured that having such city requires multidisciplinary function with a holistic approach. Further investigation to explore the process of fire safety for residential buildings is recommended., Competing Interests: Declaration of Competing Interest They have no conflict of interest., (Copyright © 2020. Published by Elsevier Ltd.)

Background: The Theory of Planned Behavior (TPB) is proposed to predict behavioral intention. We conducted this study aimed to investigate the effects of Suicidal Ideation (SI) and constructs of TPB on suicidal intention., Methods: This cross-sectional study was conducted with 923 married women selected by multi-stage sampling method from Gilan-e Gharb County, the west part of Iran, in 2018. Data gathering tools were a questionnaire on demographic characteristics, the Beck Scale for Suicidal Ideation, and a four-part questionnaire based on constructs of TPB, including Attitude, Subjective Norms, Perceived Behavioral Control (PBC), and Intention. Data were analyzed by SPSS 19 and AMOS using Structural Equation Modeling (SEM)., Results: Out of 923 participants, 345 women (37.4%) had some degree of suicidal ideation. The mean score of suicidal ideation in all of participants was 5.98 ± 7.79, while in the 345 individuals with suicidal ideation was 15.53 ± 3.65. Suicidal ideation had the strongest positive total effect on suicide intent, while PBC and attitude had the negative effect on suicide intent., Conclusions: Since suicidal ideation had the strongest direct effect on suicidal intent, it is suggested that this variable be used for risk assessment in all suicide prevention programs and counseling measures be implemented to reduce suicidal thoughts. Also, undesirable attitudes toward suicide and perceived behavioral control on suicide intention can be considered and emphasized in planning future interventions.

Background: Earthquakes are one of the most destructive natural disasters in which many people are injured, disabled, or died. Iran has only 1 % of the world's population, but the percentage of its earthquake-related deaths is absolutely higher. Therefore, this study aimed to determine the level of earthquake preparedness of households and its predictors using the Health Belief Model (HBM)., Methods: This observational descriptive and analytical study was conducted on 933 households in Hamadan province, located in the west of Iran, in 2019. Multi-stage cluster random sampling was used for selecting the participants. The inclusion criteria were being at least 18 years old and being able to answer the questions. A questionnaire was used for data collection including earthquake preparedness, awareness of earthquake response, predictors of earthquake preparedness based on the HBM, and demographic information. Analysis of variance, independent t-test, and a linear regression model was used., Results: The mean age of participants was 38.24 ± 12.85 years. The average score of earthquake preparedness was low (approximately 30%). There was a significant relationship between earthquake preparedness and gender (P < 0.001), homeownership (P < 0.001), marriage status (P < 0.001), education (P < 0.001), and previous earthquake experience (P < 0.001). Regarding the HBM constructs, perceived benefits (P < 0.001), cues to action (P < 0.001), and self-efficacy (P < 0.001) were significant predictors of earthquake preparedness., Conclusions: Earthquake preparedness was insufficient. Besides, perceived benefits, cues to action, and self-efficacy were predictors of earthquake preparedness. These predictors can be taken into account, for designing and implementing related future interventions.

Background: Sleep quality is one of the main human factors related to urban road traffic crashes. This study aimed at determining the relationship between sleep quality and road traffic crashes in urban drivers., Methods: This correlational study was conducted in Hamadan, a city located in the western part of Iran. The study samples consisted of 309 Hamadan drivers (i.e., 103 with road traffic crashes (RTCs) and 206 without RTCs), who were referred to police centers to change or renew their driving licenses. The data collection tool was a two-part questionnaire including demographic information and the Pittsburgh Sleep Quality Index (PSQI). The questionnaire was filled out in a self-administered manner. Statistical analysis was done using the SPSS-16 software and applying logistic regression, Fisher's exact test, and Chi-square test., Results: The comparison of sleep quality scores between two groups, using the adjusted logistic regression test, showed a statistically significant difference between them (P = 0.019). This means that the sleep quality of drivers without RTCs was 1.8 times better than drivers with RTCS (OR=1.8; 95% CI, 1.1 - 3.07)., Conclusions: There was a significant association between poor sleep quality and the occurrence of RTCS in urban drivers. As a result, it is recommended paying more attention to the sleep quality of urban drivers to prevent and control RTCs.

Objectives: This study investigated the prevalence of low back pain (LBP) and its risk factors among elementary-school students., Methods: In this cross-sectional study, 693 elementary students from Hamadan city, western Iran, were selected by multistage stratified cluster sampling. Data were collected through interviews using questionnaires. Posture and psychosocial elements were assessed using the observational Rapid Upper Limb Assessment (RULA) checklist and the standard Strengths and Difficulties Questionnaire, respectively. Penalized logistic regression with the group smoothly-clipped absolute deviation regularization method was used for variable selection and data analysis (α=0.05). The chi-square test was also used., Results: In total, 26.6% of the students (7-12 years old) reported LBP in the last month. Older age (odds ratio [OR], 3.08; 95% confidence interval [CI], 1.80 to 5.26), watching TV for more than 3 hours a day (OR, 2.62; 95% CI, 1.46 to 4.68), very short seat backrests (OR, 3.08; 95% CI, 1.61 to 5.90), excessively curved seat backrests (OR, 4.36; 95% CI, 2.08 to 9.13), very short desks (OR, 3.44; 95% CI, 1.61 to 7.35), a family history of LBP (OR, 2.49; 95% CI, 1.58 to 3.91), carrying a school bag on one shoulder (OR, 1.91; 95% CI, 1.03 to 3.54), and RULA scores of 3 (OR, 2.26; 95% CI, 1.13 to 4.50) or 4 (OR, 2.85; 95% CI, 1.37 to 5.91) were associated with LBP., Conclusions: A high prevalence of LBP was found among elementary-school students. This study underscores the importance of recognizing vulnerable children and teenagers and developing interventional health promotion programs to prevent LBP based on an appropriate consideration of its contributory factors.

Intimate partner violence occurs in all settings. In this paper the authors describe socio-cultural factors affecting intimate partner violence against pregnant women in suburban Hamadan.The PEN-3 model was utilized by semi-structured interviews with 18 pregnant women. According to women, cultural perceptions (patience in case of facing violence, faith in fate and normalization of violence), enablers (communication skills, economic status, and availability of legal support), and nurturers (family support and social expectation of obedience to men) were found to be important factors that influence violence.A better understanding of the cultural perceptions can help decision-makers in identifying the cultural appropriateness of interventions.

Background: Violence among adolescents is a global public health concern. There is limited evidence on the effectiveness of anti-bullying interventions in Iran. Weaimed to examine the effectiveness of social cognitive theory (SCT)-based intervention on reducing bullying and victimization in elementary school students., Study Design: A randomized controlled trial., Methods: Eight elementary schools (consisted of 280 students in 5th and 6th grade) from deprived and semi-deprived areas of Kermanshah (west of Iran) were randomly assigned to intervention and control group from 2018 to 2019. Anti-bullying training content appropriate for SCT and sociocultural characteristics were provided to the intervention group including students, parents, teachers and school staff. The measures included SCT constructs, bullying, victimization, and social competence of students., Results: At baseline participants of two groups were homogenous in terms of demographic factors except for the type of living with the parent (P=0.040) and outcome variables including SCT constructs and bullying behaviors. The interventions significantly improved SCT constructs, reduced bullying and victimization and increased social competence in the intervention group compared to the control group (P<0.001). The difference between outcome expectations in both groups was not significant (P=0.137)., Conclusion: Interventions based on sociocultural characteristics and focuses on SCT theory reduce bullying and victimization behavior. Given the effectiveness and feasibility of these interventions, this theory can be effective to break the bullying cycle and improve social competence.

Background: Neck and shoulder pain is relatively common among children and teenagers and has a negative impact on their physical and psychological health. This study was carried out to assess the prevalence of neck and shoulder pain among elementary school students, and to investigate the relationship between this pain and its risk factors., Methods: In this cross-sectional study, 693 elementary school students aged 7 to 12 years from Hamadan city, located in western Iran, were selected through the multistage cluster random sampling method. Data were collected through interviews and questionnaires. For the social and psychological variables, the parent version of the Strengths and Difficulties Questionnaire (SDQ) was used. For assessing each student's posture, an observational checklist, the Rapid Upper Limbs Assessment (RULA), was used. The data was analyzed using the unadjusted (univariate) and adjusted (multivariate) logistic regression., Results: The prevalence of the neck pain was slightly higher than that of shoulder pain. The prevalence reported over a month was 35.8 and 30.9% for neck and shoulder pain, respectively. The logistic regression analyses showed that, very high desk height (odds ratio (OR) =1.96, 95% confidence interval CI: 1.02-3.74), backward seat pan inclination (OR = 2.10, 95% CI: 1.37-3.24), forward seat pan inclination (OR = 3.12, 95% CI:1.46-6.68), difficulty in viewing the board (OR = 2.54, 95% CI: 1.10-5.84), too much homework (OR = 2.59, 95% CI: 1.49-4.51), RULA score at level III (OR = 2.88, 95% CI:1.64-5.05), and RULA score at level IV (OR = 3.12, 95% CI: 1.72-5.63) increased the risk of neck pain independently. On the other hand, sitting on desk and seat (OR = 0.59, 95% CI: 0.39-0.91) and laying position for doing homework (OR = 0.53, 95% CI: 0.34-0.81) reduced the related risk. Very short desk height (OR = 2.41, 95% CI: 1.26-4.61) and too much homework (OR = 1.94, 95% CI: 1.10-3.42) increased the risk of shoulder pain., Conclusion: The elementary school students reported a high prevalence of shoulder and neck pain. This study found that improper sitting positions, as well as physical factors such as the school furniture, too much homework, and difficulty in viewing the classroom board, were associated with pain. Proper interventions considering the risk factors assessed in this study, are suggested.

Background: Road traffic injuries (RTIs) are important health problems and increasing knowledge on their prevention-related issues can be credible. This study aims to assess beliefs and performances of students to prevent road traffic injuries and their related factors, using Health Belief Model (HBM)., Methods: This cross-sectional study carried out on a random sample of 500 fourth and fifth grades students of elementary schools in Hamadan city, west of Iran. The data gathering tool was a self-administered questionnaire designed on the basis of HBM constructs and also the knowledge and performance of the students in relation to prevent RTIs. To increase the accuracy of this study, the students' road-crossing behaviors were observed in a simulated street in the school, using an observation checklist. Data were analyzed by SPSS 16., Results: The mean age of the participants was 10.51±0.50. About preventing RTIs, the mean scores of the students' knowledge was 64.139, and regarding HBM constructs, the mean scores of their perceived susceptibility, perceived severity, perceived benefits, perceived barriers and self-efficacy were 82.817, 82.453, 82.451, 89.917, 84.343 and 91.250, respectively. The mean score of the students' self-reported performances about traffic injury prevention was 48.750 and the mean score of their observed road-crossing behavior in the simulated street was 45.000. The final model of multiple linear regressions showed that the students' sex (p=0.001), their knowledge (p less than 0.001), perceived susceptibility (p=0.002), perceived barriers (p=0.032), self-efficacy (p=0.001), and their observed road-crossing behaviors (p=0.019) predict the students' self-reported injury prevention performances., Conclusions: Regarding prevention of RTIs, knowledge and performance of the studied students are undesirable. The study findings can help designing more appropriate prevention programs for them.

Farmers in developing countries use harmful pesticides while taking few or no protective measures. There is limited evidence on factors affecting their safety measures. The objective of this study was to identify the underlying factors influencing farmers' protective behaviors (PBs) and use of personal protective equipment (PPE) during the exposure to pesticides. From April to August 2017, a descriptive study was conducted in Twiserkan County in western Iran among 474 farmers from 104 villages. A questionnaire was developed to measure demographic characteristics and factors suggested in integrated agent-centered (IAC) framework. The questionnaire was validated in terms of content validity through expert reviews and tested for reliability in a group of farmers. Data were collected by face-to-face interviews with farmers. Physiological arousal (β = .154, p < .05), intention (β = .345, p < .05), habit (β = .188, p < .05), and contextual factors (β = .101, p < .05) had a significant and positive impact on farmers engaging in pesticide PBs. Among the assessed factors, only physiological arousal (β = .122, p < .05) and habit (β = .646, p < .05) were found to have a significant and positive effect on the use of PPE, but the intention (β = -.039, p > .05) and contextual factors (β = -.009, p > .05) had no significant relation with the use of PPE. The results of this study identified determinants of farmers' safety measures. Our results suggest that the IAC framework could serve as a guide to developing a more effective intervention for safety measures of Iranian farmers.

Background: Aggression is the most significant psychopathological risk factor. It is a multifaceted construct and can affect students' social, mental and physical health. The present study was conducted to investigate factors associated with aggression among elementary school girls and boys using the theoretical framework of Social Cognitive Theory in Kermanshah city, Iran., Methods: The cross-sectional study was conducted on 900 students, including 445 girls and 455 boys, 563 parents and 104 elementary school teachers in the fourth, fifth and sixth educational grades in Kermanshah city in 2018. The proportionate stratified random sampling was used. The Adolescent Peer Relations Instrument (APRI) was used to measure aggression. To measure the variables of social cognitive theory, a researcher-made questionnaire was used. Data analysis was conducted using descriptive and inferential statistics via the SPSS software., Results: It was showed that 29% and 10% of the students had moderate and high levels of aggression, respectively. Also, 30.6% of them were moderate victims and 45.6% were intense victims. Self-efficacy (p less than 0.001), perceived social norms (p=0.011), observational learning (p less than 0.001), outcome expectations (p=0.027), outcome expectancies (p=0.028) and per-ceived situational (p less than 0.001) were reported as the significant predictors of aggressive behaviors in the students based on the Social Cognitive Theory constructs. In total, they explained for 37.3% of changes in aggressive behaviors. Parents' knowledge (p=0.005), parents' attitude (p=0.012), teachers' attitude (p less than 0.001), and teachers' self-efficacy (p=0.021) had statistically significant relationships with aggression in the students., Conclusions: Aggression among children and adolescents is getting alarmingly prevalent. The Social Cogni-tive Theory is the appropriate framework for the prediction of aggression behaviors in children and adolescents. Therefore, designing and implementing educational interventions based on this theory can help with the management of aggression in children and adolescents.

Background: Organ donation is a life-saving process for patients suffering from an advanced organ failure. A disparity between donated organs and required organs for transplantation is one of the major problems in Iran. Since personal attitudes about organ donation is a main factor influencing willingness to donate organ, the present study sought to provide a deeper understanding of the attitudes of university students in Iran regarding organ donation., Methods: This qualitative study was conducted in 2016. Semi-structured interviews were held for collecting data from eighty five students from various universities in Hamadan city, Iran. Using a purposive sampling method, the students were selected based on the maximum variation. The content analysis method was used for data analysis by the research team and criteria for the study's rigor was considered., Results: Overall, the students had positive attitudes toward organ donation by brain-dead patients. Nevertheless, not of them stated that they would become an organ donor. During the data analysis, 376 primary codes, 13 categories, and 6 themes were developed. Themes were "cognitive readiness", "mediators of decision making", "beliefs and motivations", "interactions with the health system", "dependency", and "integrity of the body". Also, thirteen sub-themes were developed., Conclusion: Many factors influence the students' attitudes toward organ donation. Identification and explanation of these factors can help healthcare managers and policymakers for planning and improving the organ donation culture in the society.

Farmers are among the most common work groups at risk of skin cancer. The protection motivation theory has been widely accepted as a framework for predicting health related behaviors. This study was conducted to determine the role of factors preventing skin cancer among farmers in Eslamabad-e Gharb district, Iran, using the protection motivation theory. In this descriptive study, 280 farmers living in this district were studied from May to June 2017. Using cluster random sampling methods, health houses where farmers received health care were selected. Each farmer within the selected health house was then enrolled into the study using simple random sampling. Data were collected by interview using an author-developed questionnaire. The questionnaire ascertained demographic information and constructs of the protection motivation theory. Almost half of the farmers had a history of sunburn (56.4%). With regard to prevention, a small proportion reported using sunscreen (8.6%), hats (3.2%), gloves 3.9%, sunglasses 4.6%, and protective clothing 15.4%. The results of regression analyses showed that with one unit of increase in the scores of self-efficacy to adopt prevention behavior and perceived protection motivation resulted in an increase in the mean score of the "protective" behavior by 0.26 and 0.20, respectively. Working conditions among farmers place them at great risk and skin cancer prevention is essential. Intervention and prevention programs should fully identify the determinants of skin cancer prevention in farmers; in addition, the identified effective factors must be taken into account when designing and implementing appropriate interventions.

Background: Although the role of unintentional injuries as a cause of death in adults is known, there is limited knowledge about such adults' behaviors. This study aims to investigate the frequency of and factors affecting unintentional injuries among the elderly living in rural areas and their related behaviors., Methods: A cross-sectional study was carried out in the rural areas of Hamadan County, Iran, in 2016. The sample consists of randomly selected 445 adults aged 60-75 years. Data collection was conducted through face-to-face interviews, using questionnaires., Results: One hundred and forty-three participants (34.7%) experienced 166 injury occurrences. The injuries occurred more in females than in males. There were more mild and severe injuries (48.2% and 31.3%, respectively) than moderate ones (20.5%). The most frequent mechanism of injuries was accidental falls (64.5%). There was a significant relationship between using aid devices and injuries (P=0.001). Among the most applied injury preventive measures as reported by the elderly, crossing streets safely and the use of proper lighting at night had the highest percentages (81.5% and 69.7%, respectively). However, the use of protective handles and plastic flooring in bathrooms in order to prevent slipping had the lowest percentages (less than 1.0%)., Conclusion: The injuries among the elderly in this study were important health concerns. Injury-related factors should be considered in the development of injury prevention programs.

The researchers conducted this study as a phenomenological research to understand the individual and social factors related to attempted suicide phenomenon among women of Gilan-e Gharb. Participants of the study are comprised of 17 women survivors of attempted suicide selected by purposive sampling or snowball method. To gather the data, we conducted semi-structured interviews in face-to-face and audio-recorded methods from February to April 2017. Researchers transcribed verbatim and analyzed the content of the interviews thematically. The main issues in this study were three main themes including the "personal factors", "social factors", and "other issues related to attempted suicide" with seven sub-themes. We concluded that both personal and social factors contribute to the suicide attempts in female subjects. Also, we found that the majority of participants did not want to die by the attempted suicide.

Although acute pesticide poisoning (APP) is known to be a major health concern among farmers in developing countries, knowledge of its prevalence and risk factors is limited. The purpose of this study was to investigate the prevalence and a broad range of potential work-related risk factors of APP among Iranian farmers and farm workers. This cross-sectional study was conducted in rural areas of the Twiserkan County in Iran. In this study, there were 474 farmers and farm workers who had used pesticide 1 week before data collection. Participants were selected from 104 villages. Data were gathered using a questionnaire and analyzed using STATA (version 14.2 SE). Binary logistic regression and multinomial logistic regression were employed. The results of this study showed that 286 (60.3%) farmers and farm workers who applied pesticides suffered from work-related APP. Most frequent APP symptoms were runny nose (29.8%) and headache (25.1%). Five risk factors were identified, including annual income ( p < 0.05), number of farming years (odds ratio (OR) = 0.31), number of spraying years (OR = 2.40), place of pesticide storage (OR = 2.69), and type of sprayer ( p < 0.05). The results of this study indicated that APP is prevalent among the studied farmers. Some work-related factors play an important role in APP among Iranian rural farmers. In addition, the magnitude of these risk factors differed significantly by severity of acute and somatic pesticide poisoning.

This cross-sectional study was conducted in rural areas of Twiserkan (Toyserkan) County, in Iran, to assess factors associated with home-related injuries among under-five-year children and their mothers' care regarding injury prevention. Mothers who had their under-five-year-old children injured within a 12-month period were identified from recorded information in Twiserkan Health Center. Then, data were gathered using pre-tested questionnaire and through interview with injured children's mothers. The questions were about characteristics of the children's injuries and their mothers' care regarding injury prevention, using PRECEDE (Predisposing, Reinforcing, and Enabling Constructs in Educational/Environmental Diagnosis and Evaluation) model with focus on knowledge and attitude; enabling and reinforcing factors; and mothers' preventive behaviours. The study results showed that 197 out of 210 total identified mothers took part in the study. The reported injuries were 11.68%, 39.09%, and 49.24%, respectively, for severe, moderate, and mild cases. Fall was the most frequent injury with 35%. Among PRECEDE model constructs, there was a statistically significant correlation between mothers' knowledge and injury severity among children. Home-related injuries are an important health problem among study population and their prediction and prevention are necessary. Enhancement of mothers' knowledge can be helpful to improve child injury prevention.