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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]

Background: To address the disproportionate burden of poor mental health among women, we present a community based participatory research (CBPR) model used to develop a women's mental health promotion program for Iranian women. Methods: This is a multi-phase interventional study using a CBPR approach among married women age 18-65 living in Tehran. First, participants described the process of women's mental health. Subsequent steps involved participatory needs assessment, priority setting, intervention design, and evaluation. Finally, a conceptual model of women's mental health promotion was developed. Results: "Seeking comfort" emerged as the core process in women's mental health. To promote mental health, women prioritized training on coping mechanisms to deal with stress. Women receiving this training used more problem-based coping methods and reported a higher quality of life than the comparison group. Conclusions: The resulting conceptual model illustrates the utility of using a CBPR approach to develop women's mental health promotion programs. [ABSTRACT FROM AUTHOR]

Background: Depression is a major public health concern that accounts for a high global disease burden. Objectives: The aim of this study, developing a depression inventory for screening the Fars ethnicity in Iran. Methods: The research was carried out using a combined (multi-stage) method in the Persian ethnicity between April 2016 and March 2017. Individual interviews were conducted in Tehran, Iran, with depressed patients, the patients' relatives or friends and key informants. In the next stage, a 28-item tool was designed. The face, content, criterion and construct validity (confirmatory factor analysis) of the designed tool were assessed in order to determine its validity. Data were analyzed by Amos 24 and spss16. Results: This study was conducted on 150 individuals, 55% female and 45% male, selected from the general public through convenience sampling with a mean age of 35.28±12. 38. The impact score for all the items was between 1.8 and 5, CVR was between 0.7 and 1 for all the items and S-CVI/Ave was 97.09±0.63. Based on the results of the confirmatory factor analysis, all the components were approved as factors used to screen for depression. The model fit coefficients, the CMIN/DF was calculated as 1.93. NFI, CFI and GFI were 0.70, 0.54 and 0.73 respectively. For reliability, Cronbach's alpha was calculated as 0.88 with an internal consistency coefficient that is 0.7. Conclusions: This depression screening tool for the Fars ethnicity was designed based on the Fars ethnicity and the Iranian culture and appears to be an appropriate tool due to its good reliability, validity, simplicity and applicability in different situations. [ABSTRACT FROM AUTHOR]

Background: Positive Mental Health (PMH) enables people to cope with the common stresses of life and adversity to achieve their full potential and humanity. In many communities, promoting PMH via prioritized interventions has been considered as a key component of public health policies to optimize mental well-being. Objective: To set the priorities of interventional programs of Iranian PMH promotion according to the World Health Organization (WHO) Priority Public Health Condition (PPHC) analytical framework. Methods: This qualitative study was implemented in 2017 in Tehran, Iran and had two main phases. In a qualitative needs-assessment phase, needs of the community's PMH were collected through eight focus group discussions with a general population aged 30 to 60 years-old. In a priority-setting phase, the priorities of PMH were extracted through an expert panel consisting of mental health professionals and policy makers. Data gathering was implemented based on purposeful sampling according to inclusion criteria. Data were analyzed based on directional content analysis using Dedoose software version 7.6.6. Results: Fifty-one people and ten mental health professionals and policymakers participated in this study. The process of data analyzing, categorized PMH needs in 4 main categories, 15 subcategories and 46 codes. The four categories were financial security, social security, healthy lifestyle and promoting psychological factors. In the expert panel, first, the indicators of PMH priority setting were determined and then based on the priority public health condition analytical framework of the World Health Organization, the most important of PMH priority in each level was indicated as "creating job positions" in socioeconomic level, "providing proper working conditions" in differential exposure, "promoting practical life skills training" in the differential vulnerability, "easy and affordable access to mental health services" in differential healthcare outcome. Conclusion: Appropriate policymaking and regulation at national level regarding employment, promoting working conditions, and reducing unemployment, promote community PMH as well as expanding accessible and affordable mental health services in the national healthcare system and empowering the community through providing practical life skill courses. [ABSTRACT FROM AUTHOR]

Background: Research centers, defined as organized research units having research as their primary mission, are positioned as an organizational solution to tighten the knowledge to do gap in health research system (HRS). Therefore, this study aims to explore the roles of medical research centers (MRCs) in promoting HRS. Methods: In this cross-sectional study, we reviewed the evaluation results of research performance of MRCs from 2001 to 2014. Data of evaluation indicators (in knowledge production and capacity building domains) were gathered and finally compared for these years. Results: In the mentioned period, the number of medical research centers has grown by more than 11 folds. In the domain of knowledge production, the total number of published articles and published articles in ISI, Web of Science per researcher rose from 0.5 and 0.05 to about 3.5 and 1.2, respectively. The number of indexed articles in scientific international databases has increased more than 66 times and the total number of citations of MRCs' articles has increased to more than 80 000. In the domain of capacity building, the trend of workshops and held congresses is ascending. Conclusion: MRCs are well empowered in knowledge production in national HRS. [ABSTRACT FROM AUTHOR]

Background: Research evaluation is a systematic and objective process to measure relevance, efficiency and effectiveness of research activities, and peer review is one of the most important tools for assessing quality of research. The aim of this study was introducing research evaluation indicators based on peer reviewing. Methods: This study was implemented in 4 stages. A list of objective-oriented evaluation indicators were designed in 4 axes, including; governance and leadership, structure, knowledge production and research impact. Results: The top 10% medical sciences research centers (RCs) were evaluated based on peer review. Adequate equipment and laboratory instruments, high quality research publication and national or international cooperation were the main strengths in medical sciences RCs and the most important weaknesses included failure to adhere to strategic plans, parallel actions in similar fields, problems in manpower recruitment, knowledge translation & exchange (KTE) in service providers and policy makers' levels. Conclusion: Peer review evaluation can improve the quality of research. [ABSTRACT FROM AUTHOR]

Background: In recent years, international ranking systems have been used by diverse users for various purposes. In most of these rankings, different aspects of performance of universities and research institutes, especially scientific performance, have been evaluated and ranked. In this article, we aimed to report the results of research ranking of Iranian universities of medical sciences (UMSs) based on some international indicators in 2015. Methods: In this study, after reviewing the research indicators of the majority of international ranking systems, with the participation of key stakeholders, we selected eight research indicators, namely research output, high-quality publications, leadership, total citations, citations per paper in 2015, papers per faculty member and h-index. The main sources for data gathering were Scopus, PubMed, and ISI, Web of Science. Data were extracted and normalized for Iranian governmental UMSs for 2015. Results: A total of 18023 articles were indexed in 2015 in Scopus with affiliations of UMSs affiliation. Almost 17% of all articles were published in top journals and 15% were published with international collaborations. The maximum h-index (h-index = 110) belonged to Tehran University of Medical Sciences. The average paper per faculty member was 1.14 (Max = 2.5, Min = 0.13). The mean citation per published articles in Scopus was 0.33. Conclusion: Research ranking of Iranian UMSs can create favorable competition among them towards knowledge production. [ABSTRACT FROM AUTHOR]

Objective: Mental health is an essential component for positive adaptation that enables people to cope with adversity to achieve their full potential and humanity. In this study, using a community based approach, the social determinants of mental health in Iranian women were extracted; and in addition, priority setting for interventional programs according to analytical framework of WHO was implemented. Method: This study was a community based participatory research (CBPR) in district 22 of Tehran (Iran). The target group was married females with age range of 18-65 years. In this study, mental health priorities were extracted by qualitative methods according to Essential National Health Research model (ENHR) and the analytical framework of WHO. Data analysis was done based on content analysis by the open code 3.6 software. Results: In the quantitative phase, according to secondary data, 1144 individuals (560 females and 584 males) were selected, of whom 41 percent had impaired mental health based on General Health Questionnaire (GHQ) (P<0.05). According to the qualitative phase, the first mental health priority in socioeconomic level was lack of insurance for unattended families, it was unemployment in differential exposure level and it was lack of knowledge and skills related to dealing with stress in the differential vulnerability level; in differential outcome and consequence levels, the priorities were lack of free counseling centers in the study area and lack of facilities for mental health rehabilitation. Conclusion: Providing training courses to improve the skills to deal with stress is considered one of the most important interventions for mental health promotion in women. [ABSTRACT FROM AUTHOR]

Background: Community-based health programs (CBHPs) with participatory approaches has been recognized as an important tool in health promotion. The goal of this study was to understand the nature of participation practice in CBHP and to use the data to advocate for more participation-friendly policies in the community, academy and funding organizations. Methods: In this qualitative study, 13 CBHPs, which were active for last 5 years have been assessed using semi-structural in-depth interviews with programs principal and managers and focus group discussions with volunteers and service users. Data analysis was based on the deductive-inductive content analysis considering the participatory approaches in these programs. Results: The results show that, the main category of participation was divided to community participation and intersectional collaboration. The community participation level was very different from "main," "advisory" or "supporting" level. The process of recruitment of volunteers by the governmental organization was centralized and in non-governmental organizations was quite different. According to respondents opinion, financial and spiritual incentives especially tangible rewards, e.g., learning skills or capacity building were useful for engaging and maintaining volunteers' participation. For intersectional collaboration, strong and dedicated partners, supportive policy environment are critical. Conclusions: It seems that maintaining partnership in CBHP takes considerable time, financial support, knowledge development and capacity building. [ABSTRACT FROM AUTHOR]

BACKGROUND: Priority setting is one of the major issues in the health research system and no health system can afford to pay for every research they want to do, particularly in developing countries, so we decided to set the national main areas of the health research priorities. METHODS: In this study, according to Essential National Health Research (ENHR) strategy and with cooperation of all the Iranian universities of medical sciences and other stakeholders, the national health research priorities were extracted. RESULTS: The number of research priorities collected from the universities of medical sciences was 6723. Seventeen percent of the research priorities were related to basic science, 78 percent applied science, and 5 percent were related to developmental type. According to epidemiological classification, 50% of the research priorities were in descriptive form. In this process, 9 main extracted areas consist of communicable diseases, non-communicable disease, Health System Research, pharmaceutical sciences and Industry, basic science, traditional medicine and herbal medicine, nutrition, environmental health, and dentistry. And then for each area, five main projects were defined. CONCLUSIONS: In the Health Research System, the participatory priority setting is the main function based on needs assessment. [ABSTRACT FROM AUTHOR]

Background: Based on the World Health Organization definition, mental health is the absence of mental disorders and presence of positive mental health (PMH). As the social determinants of mental disorders and PMH are not the same in different cultures and in order to promote community mental health, social determinants of PMH should be identified, which is the aim of this study. Methods: This was a qualitative study conducted in Tehran. Data were collected through eight focus group discussions with the general population aged between 30 and 60 years and ten semi-structured interviews with mental health professionals from Tehran. Data were analyzed through directional content analysis using Dedoose software. Results: Fifty-one lay people and ten mental health professionals participated in this study. The process of content analysis resulted in two main themes: (a) structural determinants of PMH which consist of socioeconomic and political context and socioeconomic position and (b) intermediary determinants of PMH which consist of working condition, living condition, family factors, lifestyle, psychosocial factors, and health system. Conclusions: Improvement of living conditions, with emphasis on working conditions as one of the intermediary social determinants, will play an important role in promoting PMH. [ABSTRACT FROM AUTHOR]

Background and Objectives: Depression is one of the most important mental disorders affecting 350 million people in the world. The aim of this study was to explore the similarities and differences in the symptoms and experiences of depression in cities representing the Fars, Turk, and Kurd ethnic groups of Iran. Methods: A qualitative study was implemented in three ethnic groups in Iran between April 2016 and March 2017 using individual interviews with 44 depressed patients, 20 people of their relatives, and three key informants in Tehran (Fars), Tabriz (Turk), and Sanandaj (Kurd) cities. The data were analyzed using directed content analysis. Results: The analysis of the data led to the extraction of four main themes, including cognitive, behavioral, physical, and emotional/ motivational symptoms. Conclusions: The study findings would help to explore various expressions of depression and provide a multidimensional construct to develop the culturally specific measurement of depression in three different ethnic groups. [ABSTRACT FROM AUTHOR]

Background: During the last 3 decades, Iran has experienced a rapid population growth and at the same time the health of Iranian people has improved greatly. This achievement was mainly due to training and availability of health manpower, well organized public health network and medical science and research improvement. In this article, we aimed to report the relevant data about the medical science and research situation in Iran and compare them with other countries. Methods: In this study, after reviewing science development and research indicators in medical sciences with participation of key stakeholders, we selected 3 main hybrid indexes consisting of "Research and Development (R&D) expenditures," "Personnel in Science and Technology sector" and "knowledge generation" for evaluation of medical science and research situation. Data was extracted from reliable databases. Results: Over the past decade, Iran has achieved significant success in medical sciences and for the first time in 2015 based on Scopus index, Iran ranked first in the number of published scientific papers and number of citations in the region and among all Islamic countries. Also, 2% of the world's publications belong to Iran. Regarding innovation, the number of Iranian patents submitted to the United States Patent and Trademark Office (USPTO) was 3 and 43 in 2008 and 2013, respectively. In these years, the number of personnel in science and technology sectors including post graduate students, researchers and academic members in universities of medical sciences (UMSs) have increased. The female students in medical sciences field account for about twothirds of all students. Also, women comprise about one-third of faculty members. Since 5 years ago, Iran has had growth in science and technology parks. These achievements were attained in spite of the fact that research spending in Iran was still very low (0.5% of gross domestic product [GDP]) due to economic hardships and sanctions. Conclusion: Medical science and research development has been at least partially due to health technological development, training and availability of health manpower and improvement of overall health status in Iran compared to other Islamic countries. [ABSTRACT FROM AUTHOR]

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]

Background: Researchers, practitioners, and policymakers call for updated valid evidence to monitor, prevent, and control of alarming trends of health problems. To respond to these needs, health researches provide the vast multidisciplinary scientific fields. We quantify the national trends of health research outputs and its contribution in total science products. Methods: We systematically searched Scopus database with the most coverage in health and biomedicine discipline as the only sources for multidisciplinary citation reports, for all total and health-related publications, from 2000 to 2014. These scientometrics analyses covered the trends of main index of scientific products, citations, and collaborative papers. We also provided information on top institutions, journals, and collaborative research centers in the fields of health researches. Results: In Iran, over a 15-year period, 237,056 scientific papers have been published, of which 81,867 (34.53%) were assigned to health-related fields. Pearson's Chi-square test showed significant time trends between published papers and their citations. Tehran University of Medical Sciences was responsible for 21.87% of knowledge productions share. The second and the third ranks with 11.15% and 7.28% belonged to Azad University and Shahid Beheshti University of Medical Sciences, respectively. In total fields, Iran had the most collaborative papers with the USA (4.17%), the UK (2.41%), and Canada (0.02%). In health-related papers, similar patterns of collaboration followed by 4.75%, 2.77%, and 1.93% of papers. Conclusions: Despite the ascending trends in health research outputs, more efforts required for the promotion of collaborative outputs that cause synergy of resources and the use of practical results. These analyses also could be useful for better planning and management of planning and conducting studies in these fields. [ABSTRACT FROM AUTHOR]

Background: Factors affecting social health, especially in young adults, are among the most important research priorities. Knowledge of social factors affecting young adults' health will lead to understand them in the social context. The present study is aimed to explain the perspective of young adults on social factors affecting health. Methods: In the present qualitative content analysis study, semi-structured open interviews were conducted through targeted sampling of young volunteers aged 18-30 who were selected from Tehran Province. Interviews were recorded, transcribed, and analyzed. The inclusion criteria for participants were willingness to participate in the study and ability to express their personal experiences. Twenty-one data were collected through collection was done with individual in-depth interviews. Results: Using this qualitative approach, the present study was conducted to identify factors affecting social health from the perspective of young adults. The analysis led to the extraction of three main categories, each with two or three subcategories: expectations regarding the community, expectations regarding the family, and expectations regarding infrastructures. Conclusions: Our findings shown that social support considered as effective elements in providing social health of young adults. The evidence on controlling factors should be considered in promoting the social health of specific target groups. The results of the present study could be used for better planning of interventions in youth social health domains. [ABSTRACT FROM AUTHOR]

BACKGROUND: Student counseling centers are responsible for physical, mental and social health of university students. Therefore, this study was conducted to assess the key stakeholders' opinions on different aspects of the activities performed in these centers. METHODS: This qualitative study used focus group discussion. Key stakeholders including university students and key informants from nine randomly selected medical universities participated in the study. After data saturation, thematic analysis was conducted. Themes were drawn out through constant comparative method. RESULTS: Based on 243 extracted codes and through comparative analysis, four categories were determined, namely students' need for students counseling centers, successes and limitations of student counseling centers, student counseling services priorities, and suggestions for service promotion. CONCLUSIONS: According to stakeholders' opinions, youth participation in needs assessment and priority setting processes in real-based situations leads to better performance of counseling services. Empowering the counselors is another point required for better outcomes. In addition, strategic planning and monitoring, along with evaluation of programs, could promote the provided services. [ABSTRACT FROM AUTHOR]