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Background: As a public health emergency, coronavirus disease 2019 (Covid-19) is a threat to our future; therefore, appropriate health system responsiveness (HSR), as an important criterion, is of crucial importance. This study aimed to evaluate the different dimensions of responsiveness of healthcare centers, both public and private, providing COVID-19 services in Tehran. Methods: Following a cross-sectional design, this study was conducted in Tehran (the capital city of I.R. Iran) from May to November 2020. Data were collected using the World Health Organization (WHO) questionnaire on responsiveness. Two hundred questionnaires were filled out through face-to-face or phone call interviews in two public and private hospitals (100 in each) providing Covid-19 services. Participants were selected using the convenience sampling technique among all those who received Covid-19 services during the past six months in the city of Tehran. Results: The mean age of participants was 45.9 ± 15.9 and 51.5% were female. On an average, 52.6% of the respondents evaluated at least one dimension of responsiveness as appropriate and/or strongly appropriate. Communication obtained the highest score (58.2%), followed by confidentiality (56.5%), dignity (56%), and prompt attention (52%). Meanwhile, autonomy and choice were evaluated as poor (moderate, weak, and strongly weak) by 63.5 and 52.5% of respondents. There was no significant association between the type of healthcare center (i.e., public or private) and responsiveness (p-value = 0.896). However, there was a significant difference between gender (p-value = 0.036) and education level (p-value = 0.014) with responsiveness. According to the respondents, prompt attention and choice were the most and least important dimensions, respectively. Conclusions: Evaluation of HSR in the era of COVID-19 not only provides a tool for qualitative assessment of services but also plays an important role in providing feedback to policymakers to adopt effective policies. [ABSTRACT FROM AUTHOR]

Introduction: There is growing support to develop transdiagnostic approaches that provide new insights into mental health problems and cut across the existing traditional diagnostic boundaries all over the world. The present study was conducted to test the transdiagnostic cognitive behavioral therapy (TCBT) approach in treating patients with common mental health problems and evaluate its effectiveness compared to the current treatment settings of the healthcare system. Methods: A randomized controlled trial was conducted in Semnan Province, north of Iran. The study took pace in urban health centers. A sample of 520 Iranian adults, tested as positive on the Kessler Psychological Distress Scale, were enrolled. Participants who received a score above the cut‐off point in any of the three mental health disorders (depression, anxiety, or obsessive compulsive disorder [OCD]) based on the locally validated study instrument were randomly allocated to the study. The intervention group received TCBT during eight sessions provided by trained general health service providers without previous mental health training; the standby control group received Mental Health Services as Usual (MHSU). The post‐test interviews were conducted using the study instrument after the completion of both group treatments. Results: A total of 459 individuals (87.8% female) ultimately entered the study. The withdrawal rate was 24% (53 participants in the TCBT and 56 in the MHSU). Reduction in depression, anxiety, and OCD symptoms was significant within each group and when comparing TCBT and MHSU (mean difference). Conclusion: This trial recommends that the transdiagnostic CBT approach can be effective in improving common mental health problems and functions among individuals by trained general healthcare providers in the primary healthcare system. The results can be more useful in decision making when defining the process of providing mental healthcare in the National Primary Healthcare System. [ABSTRACT FROM AUTHOR]

Background: Currently, in addition to the undeniable impact of cultural factors on mental health problems' diagnosis and treatment methods, the use of rapid, short, and intervention-based instruments can be effective in the accurate diagnosis of mental health problems, especially in the health system of developing countries. Objectives: This study aimed to validate an instrument developed for screening patients with common mental health problems using item response theory (IRT). Methods: The study was conducted in Semnan province (with Persian ethnicity), Iran, from August 2017 to February 2018. A 101-item tool consisted of district common mental health problems (i.e., depression, anxiety, and obsession), along with a functional checklist. The development of the instrument involved a pilot study and psychometric testing. The IRT-based analysis was used as the item-reduction method to evaluate the shortened tool as an appropriate screening tool. The participants were healthy individuals and patients with depression, anxiety, and obsessive-compulsive disorder (OCD). The data were analyzed using Stata software (version 15.1). Results: The study participants were 160 individuals (58.2% male) with a mean age of 36.3±11.2 years. All item impact factors were within the range of 1.8 - 5. The mean values of clarity, simplicity, relevance, and scale-level content validity index/averaging calculation method of the instrument were 96.73 ± 0.70, 97.64 ± 0.61, 98.2 ± 1.9, and 97.09 ± 0.63, respectively. Cronbach's alpha and internal consistency coefficient were 0.88 and 0.7. Moreover, 13, 5, and 12 items were excluded using IRT from depression, anxiety, and OCD dimensions based on the threshold criteria, respectively. Conclusions: Iranian screening tools for mental health problems can provide qualified information with the least error and the mostprecision in appropriate early diagnosisanddecrease the burden of mental health problems in the national healthcare system. [ABSTRACT FROM AUTHOR]