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Background. Primary health care system provides appropriate prevention and primary mental care services for the rural population, but not in urban areas. Therefore, the Community Mental Health Center (CMHC) was developed to provide mental health services in urban areas. The present study aimed to outline the performance, achievements and challenges of CMHC in one of the main cities in north west of Iran. Methods. This was a case study with in-depth interview approach. The outcomes, implications, and challenges of CMHC in Tabriz city of Iran were evaluated from 2015 to 2019 using three methods: 1) in-depth interviews with two executive managers, 2) focus group discussion with managers and mental healthcare providers, and 3) collection of mental health care indicators which was collected from patient health records. After the final evaluations, the challenges and appropriate recommendations were presented for improving mental health services in urban areas. Results. A total of 17 specialists and general medical doctors collaborated in conducting the study. During the study, 1053 initial visits and/or screenings, and 2313 patients with psychological disorders were identified and recorded. Moreover, a total of 988 mental training sessions were held for patients and their families. Five main themes, including the necessity for establishment and objectives, implementation process, achievements, challenges, and recommendations, with many sub-themes were identified during in-depth interviews and focus group discussions. Conclusion. It seems that CMHC is an appropriate strategy and model for providing basic mental health services, especially in metropolitan cities. Longitudinal studies with a randomized controlled trial design as well as cost-effectiveness evaluation studies are required to confirm CMHC in the Iranian context.

Background and Objectives: Chronic diseases are the leading causes of death in many countries in the globe. Behavioral risk factors such as smoking, alcohol consumption and the lack of physical activity are the most important determinants of these diseases and mortality. The source of behavioral risk factors in chronic diseases are in childhood and adolescence. The aim of this study was to investigate the behavioral risk factors and pattern in adolescents in Tabriz city, northwest of Iran. Material and Methods: A total of 1517 high school students were recruited for this cross-sectional study in Tabriz city using cluster random sampling. The data were collected using Global School-based Student Health Survey tool introduced by the World Health Organization. Results: Five percent of students had smoked once or more within the last 30 days. Nearly, twenty percent of students had a previous experience of cigarette smoking. About one percent of the cases had experienced different forms of drug consumption. Our findings showed that 4.2 percent (CI: 3.1-5.2) had committed suicide at least once during the last year and 4.2 percent of the students had carried cold weapons with them at least once every week. Eighty percent never used bike for sports, work or leisure. More than 45 percent of the students had some training courses in the classroom on the prevention of HIV infection, and 41.9 percent had talked to their parents about this matter. Conclusion : Based on our findings, more educational courses are needed in schools. Multi-sectoral collaboration in education, health and policy-making would also have a key role to improve adolescent health status in the community.

Background: In recent years, suicide in Iran has become a growing concern. Although stressful life events (SLEs) are increasing as a global prevalence, suicide attempters (SAs) and the impact and association between suicide and SLEs are poorly understood. Objectives: This study aimed at examining the role and effect of SLEs in suicides and SAs. Methods: This descriptive-analytical study was performed during 2014 to 2016 based on 186 records (through random quota sampling) of suicidal behaviors (SBs), including 154 SAs and 32 suicide cases in Malekan County, East Azerbaijan, Iran. A valid semi-structured Life Event questionnaire (LEQ) with 43-items of common types of SLEs in the last year before SBs was used by trained interviewers through single sitting and face to face interviews. The point-biserial correlation and multiple logistic regression analysis were utilized to estimate the adjusted odds ratios and confidence intervals for suicide risk. Results: A significant correlation was found between SLEs scores and suicide (R = 0.739). Comparing SLEs types between the two groups of SAs and suicides, it was revealed that the highest odds ratios were related to financial problems (OR = 11.9; 95% CI = 4.00 - 35.85), early marriage (OR = 4.97; 95% CI = 1.68 - 14.65), exposure to new conditions (OR = 8.79; 95% CI = 1.3 - 59.22), and family conflicts (OR = 2.53; 95% CI = 1.23 - 6.53), respectively. Conclusions: SLEs are most strongly associated with committing suicide. Suicide determinants are different from SA. SLEs management by health systems is imperative to improve life skills in suicide prevention.

Background Physical inactivity and sedentary behaviour are the main risk factors for non-communicable diseases in all stages of life. However, there is a lack of reliable data regarding the recommended level of physical activity and its correlates related to physical inactivity and sedentary behaviour among school students in Iran. The aim of the present study was to report the prevalence and correlates of physical activity/inactivity and sedentary behaviour among Iranian high school adolescents. Methods The Global School-based Student Health Survey (GSHS) was used for data collection. Related data comprising socio-demographics, health risk behaviour and protective factors were obtained from 1517 high school students. Multivariate logistic regression was used to assess the association between relevant independent variables (e.g. gender) and the dependent outcome variable (physical inactivity/sedentary behaviour). Results The prevalence of recommended physical activity by WHO was 27.8%, physical inactivity 72.2% and sedentary behaviour 71.4%. Being female, being overweight or obese, walking/cycling to or from school on 1–4 days, sitting 3 or more hours/day (sedentary behaviour), insufficient vegetable intake, being bullied and lack of parental support, peer support and parental connectivity (protective factors) were positively associated with physical inactivity. On the other hand, walking/cycling to or from school on 5–7 days and inadequate fruit intake were negatively associated with physical inactivity. Walking/cycling to or from school on 1–4 days, being physically inactive, inadequate fruit intake and being bullied were positively associated with sedentary behaviour. Conclusion The prevalence of physical inactivity and sedentary behaviour was high in our studied sample. Interventions that address the issue of active school transport, sedentary behaviour, fruit and vegetable intake, family and peer support and bullying should be given more priority by the public health authorities.

Background: This study was conducted to estimate the prevalence of mental disorders in children and adolescents in east Azerbaijan, Tabriz, Iran. Methods: A total of 1036 children and adolescents between the ages of 6 - 18 were selected with cluster sampling in Tabriz city. Measurements of mental disorders were done according to the semi-structured K-SADS scale. Data were gathered by trained clinical psychologists and were analyzed by SPSS V. 16. The prevalence of mental disorders was presented with percent (95% CI) and the significance level was considered as 0.05. Results: The prevalence of any mental disorder in children and adolescents were 24.9%. The measure in boys and girls were 25.4 and 24.9, respectively. A total of 27.4% of 6 - 9 years old, 23.9% of 10 - 14 year olds, and 23.5% of 15 - 18 year olds had suffered from at least one mental disorder. The mostcommondisorders, respectively, were enuresis,ADHD, specific phobia, separation anxiety disorder. Panic disorder, social phobia, specific phobia, and agoraphobia occurred more in girls more than boys, while conduct disorder occurred more in boys. Conclusions: The results of this study showed that one in four children and adolescents had at least one mental disorder. Thus, considering the fact that the beginning of most mental disorders were not until adolescence years and continuation to adulthood, it is necessary that appropriate interventions were designedandexecuted.Wemustdefinecost effective services for early case findings and treatment of mental disorders in the regional health system.

Purpose The purpose of the present study was to determine the correlates of waterpipe (WP) smoking among 15–17-year-old high school students in Iran. Method Data were collected using the Global Youth Tobacco Survey (GYTS), a self-administrated questionnaire distributed to a representative sample of high school students aged 15–17 in the city of Tabriz. Current WP smoking was defined as past 30-day use, and ever WP smoking was defined as at least one or two lifetime puffs. Differences in WP use, knowledge, and attitudes were analyzed using chi-square and Fisher exact tests. Binary logistic regression estimated the association between relevant independent variables (e.g., age) and the dependent variables (current/ever WP smoking). Results Of 1517 students, 21.6 % (95 % confidence interval [CI] = 19.5, 23.8) were ever WP smokers, and 9.7 % (95 % CI = 8.2, 11.2) were current WP smokers. Of current WP smokers, 40.3 % have stated that they want to stop smoking now. Moreover, 14.1 % of non-WP smokers reported that they might enjoy smoking WP. Of current WP smokers, 49.0 % have smoked at cafés. Additionally, 95.3 % of current WP smokers reported that their age did not prevent them from being served a WP. Studying in high school third grade (adjusted odds ratios (AORs) = 1.70; 95 % CI [1.10, 2.63]), experience of cigarette smoking (AORs = 1.57; 95 % CI [1.12, 2.20]), and being prepared to accept a WP offered by close friends (AORs = 3.31; 95 % CI [2.17, 5.04]) were independently associated with ever WP smoking, and accepting a WP offered by close friends (AORs = 4.36; 95 % CI [2.69, 7.07]) and gender (female) (AORs = 0.45; 95 % CI [0.30, 0.70] were independently associated with current WP smoking. Conclusion Prevalence of current and ever WP smoking is high in Tabriz. There is an urgent need to design interventions in order to increase students’ and their parents’ awareness regarding the harmfulness of WP, and to establish legal measures to restrict adolescents’ access to WPs and tobacco in society. First online: 03 March 2016Erratum to: The Prevalence, Attitudes, and Correlates of Waterpipe Smoking Among High School Students in Iran: a Cross-Sectional StudyZiaei, R., Mohammadi, R., Dastgiri, S. et al. Int.J. Behav. Med. (2017) 24: 480. doi:10.1007/s12529-017-9631-xWOS: 000400775600008Scopus: 2-s2.0-85009895029 GSHS

Purpose: Global School-based Student Health Survey (GSHS) is a project supported by the World Health Organization to assess adolescent health-risk behaviours and protective factors. The present study reports test-retest and internal consistency reliability as well as Content Validity Index (CVI) for the Persian version of GSHS and Global Youth Tobacco Survey (GYTS) adapted for Iranian students. Methods: The original English GSHS, GYTS and Optional Shisha modules were translated and back-translated, pilot-tested, reformed and corrected for clarity. The back-translated and English versions were compared and the Persian version was then edited to reach consistency for two versions. In order to evaluate the performance of this measure for our study sample (n= 47), we examined its test-retest reliability, internal consistency, and correlation between total test and re-test scales score as well as CVI. Results: The internal consistency (Cronbach's alpha) for the whole GSHS Core modules was 0.69, and for Core-Expanded GSHS, GYTS and Optional Modules for Shisha was 0.90. Test-retest reliability varied between 0.51 and 1.00 for Core and 0.23 to 1.00 for Core-Expanded GYTS and Optional Modules of Shisha. Total test and re-test scales score for GSHS Core varied from 0.64 to 1.00, and for Core-Expanded GSHS, GYTS and Optional Modules of Shisha varied 0.67 to 0.91. Conclusion: The Persian version of GSHS Core, Core-Expanded and GYTS has acceptable reliability and validity, and can serve as a reliable instrument for Persian-speaking communities. Global School Based Student Health Survey