Iranian Journal of Public Health最新文献

Background: Digital health technologies are pivotal in delivering the WHO-recommended healthy lifestyle messages to reduce premature mortality associated with noncommunicable diseases (NCDs). However, evidence on effective strategies to promote healthy lifestyle behaviours among patients with limited health literacy remains insufficient. This review explores current digital health communication strategies that support healthy lifestyles in adults with NCDs and low health literacy.

Methods: A scoping review was conducted using Arksey and O'Malley's framework, focusing on adults with NCDs and limited health literacy, digital health communication strategies, and healthy lifestyle behaviours. Searches were performed across 14 electronic databases and bibliographies of relevant studies from Jan 2012 to Nov 2022. Only primary studies published in English were included. Findings were reported following the PRISMA Extension for Scoping Reviews guidelines.

Results: Overall, 12 studies involving 15,175 participants, predominantly from high-income countries, met the inclusion criteria. Five digital health communication strategies were identified: telecommunication-based coaching, mobile applications, text messaging programs, eHealth and web-based tools, and bundled or multimodal interventions. These strategies demonstrated positive impacts on supporting healthy lifestyle behaviours.

Conclusion: This review highlights the potential of diverse digital health communication strategies to enhance healthy lifestyle behaviours in adults with NCDs and limited health literacy. Tailoring these strategies to individual preferences is critical for optimizing outcomes. Further research is required to validate these findings, particularly in low- and middle-income countries.

Background: The PRECEDE-PROCEED Model (PPM) is a theoretical tool for comprehensively assessing population health priorities and practically guiding the planning, implementation, and evaluation of interventions. We aimed to analyze systematically the extent of PPM utilization in the development and evaluation of public health interventions and to appraise the effectiveness of PPM-based interventions.

Methods: PUBMED, Web of Science, ELSEVIER, EBSCO, and SCOPUS were systematically searched to identify relevant peer-reviewed studies from inception to June 2024. Data were extracted on study objectives, design, population, PPM utilization, interventions, and outcomes. Qualitative synthesis was performed to analyze how PPM was applied, to identify recurring themes, and to assess intervention effectiveness.

Results: A total of 54 studies were included, of which 51 reported effective outcomes. These studies spanned 11 domains including disease prevention and control, healthy behaviors, preventing domestic violence, and so on. Education and ecological assessment was most frequently adopted (96%) in the PRECEDE stage, and outcome assessment was most commonly adopted (94%) in the PROCEED phase. All studied interventions incorporated health education. Nine key intervention elements were identified including sustained implementation, adequate duration, multiple educational topics, diverse formats, social support, providing educational materials, participant interaction, intervention monitoring, and practice support. Participant interaction was most frequently utilized (85%), whereas practice support was least frequently used (54%).

Conclusion: Our findings highlight the importance of educational and ecological assessment in the PRECEDE stage and outcome evaluation in the PROCEDE phase for effective intervention design and assessment. Future PPM-based interventions should consider the nine identified core elements, with emphasis tailored to the specific health domain.

Background: Plastic pollution, particularly from polystyrene, has emerged as a serious environmental concern, prompting growing interest in its biodegradation. We investigated the potential of four chewing insects; meal-worm (Tenebrio molitor), superworm (Zophobas morio), American cockroach (Periplaneta americana), and cricket (Gryllus bimaculatus) to biodegrade polystyrene paper (PSP).

Methods: Using a randomized complete block design, four chewing insects were divided into two groups after 48-hour fasting with water. One group received PSP only; the other received PSP mixed with tapioca starch. Weight loss of PSP was recorded after 72 hours.

Results: Z. morio demonstrated the highest degradation efficiency for PSP (92.10%), followed by P. americana (32.17%). When tapioca starch was added, Z. morio remained the highest effective (95.45%), followed by T. molitor (59.15%). Supplementing starch significantly enhanced degradation rates (P < 0.05). Fourier Transform Infrared Spectroscopy (FTIR) and Scanning Electron Microscopy (SEM) revealed signs of depolymerization, oxidation, and surface cracking. FTIR indicated new functional groups of carbonyl (C=O, 1650 cm^-1) and hydroxyl (O-H, 3200-3550 and 3584-3700 cm^-1).

Conclusion: Certain chewing insects, especially Z. morio and T. molitor, possess strong potential for PSP degradation, likely aided by their gut microbiota. Notably, this study is the first to report PSP degradation by P. americana and G. bimaculatus. Further research is needed to explore the microbial mechanisms within insect guts that facilitate plastic biodegradation.

Background: We sought to analyze the impact of physical activity and exercise ability, measured with a pedometer, on obstetric and neonatal outcomes.

Methods: Women who engaged, Türkiye in exercise for 30 minutes or longer during pregnancy were classified as the exercise group, whereas those who did not exercise were classified as the control group. The exercise capacity of women was evaluated by a 6-minute walking test utilizing a step counter, and its correlation with pregnancy outcomes was established. Postpartum anxiety levels and satisfaction were evaluated on the first and eighth days postpartum.

Results: The exercise group exhibited a significantly increased step count and length, alongside a reduced incidence of pregnancy problems (P < .05). The duration of labor, initial breastfeeding time, and neonatal intensive care unit (NICU) requirements were significantly reduced in the exercise group (P < .05). A notable disparity was detected between the two groups for anxiety levels and satisfaction and postpartum depression (P < .05).

Conclusion: Regular physical activity throughout gestation positively influences pregnancy outcomes and maternal well-being, without inducing difficulties for either the mother or the infant.

Background: Family caregivers of stroke patients play a critical role in post-stroke recovery, yet they often face significant challenges, including physical and emotional stress, lack of knowledge, and limited access to resources. Mobile health (mHealth) apps offer a promising solution to support caregivers by providing education, task management, and mental health resources. However, gaps remain in understanding the effectiveness, functionalities, and limitations of these apps. This study aimed to 1) identify and categorize existing mHealth apps for family caregivers of stroke patients, 2) evaluate the effectiveness of these apps in supporting caregivers, and 3) analyze the gaps in current mHealth offerings to inform future app development.

Methods: A systematic literature review was conducted, analyzing 30 studies published between 2014 and 2024 from databases such as IEEE Xplore, Scopus, Web of Science, and PubMed. The studies were evaluated based on app functionality and effectiveness in caregiver support, and limitations were identified.

Results: The findings revealed a diverse range of mHealth apps offering functionalities such as caregiver education, rehabilitation guidance, task management, communication tools, and health monitoring. However, notable gaps were identified, including limited multi-functionality, insufficient support for caregiver well-being, a lack of customization for diverse needs, and minimal validation through rigorous trials.

Conclusion: While mHealth apps provide valuable tools for family caregivers of stroke patients, addressing the identified gaps is essential to maximize their impact. Future Development should focus on creating comprehensive, user-centered, and evidence-based apps that integrate education, mental health support, and task management.

Background: Atherosclerotic cardiovascular disease (ASCVD) remains a leading cause of global morbidity and mortality. This study assessed the 10-year ASCVD risk and evaluated 5-year follow-up outcomes among adults in the Sabzevar PERSIAN Cohort Center, northeast Iran.

Methods: Baseline data were collected in 2018, with follow-up completed in 2023. Risk factors including age, gender, blood pressure, cholesterol levels, smoking status, and diabetes were assessed. The 10-year ASCVD risk was calculated using the American College of Cardiology's risk estimator and categorized as low (<5%), borderline (5-7.4%), intermediate (7.5-19.9%), or high (≥20%). A Cox proportional hazards model evaluated the association between age, gender, diabetes, and ASCVD events.

Results: Among 2,871 participants, men had higher blood pressure, while women had higher levels of total cholesterol, HDL, and LDL (P < 0.05). Hypertension was more prevalent in men than in women (P < 0.001). Diabetes was present in 13.8% (n = 397) of participants, with no significant difference between men and women. The distribution of 10-year ASCVD risk was as follows: low (74.58%), borderline (9.3%), intermediate (13.96%), and high (2.16%). Men had a significantly higher ASCVD risk than women (P < 0.001). During the 5-year follow-up, 1.2% (n = 34) of participants experienced ASCVD events. In multivariable analysis, age (P < 0.001), male gender (P < 0.001), and diabetes (P = 0.013) were significant predictors of ASCVD events.

Conclusion: ASCVD risk estimation and early intervention, particularly for older adults and individuals with diabetes, are essential. These findings support targeted prevention efforts in northeast Iran and similar populations.

Background: Type 2 diabetes (T2D) imposes a growing economic burden in Indonesia, driven by rising prevalence and associated complications. This review synthesizes current evidence on the economic costs of T2D in Indonesia to inform policy decisions aimed at alleviating these financial impacts.

Methods: A systematic review was conducted using the PRISMA guidelines and the PICOS framework, analyzing studies from major databases including PubMed, ProQuest, EBSCO, ScienceDirect, and Google Scholar published from 2019-2025. Studies included addressed both direct costs and/or indirect costs related to T2D in Indonesia, and reported annual or monthly per-patient costs.

Results: Six studies were included in the analysis, representing a diverse geographical coverage and various healthcare facilities, with the majority being tertiary facilities. The average annual direct cost per patient with complications reached USD 1,607.7, compared to USD 427.3 for patients without complications, a difference of 3.8 times. Limited indirect cost data show USD 35.2 for patients with complications versus USD 20.5 for cases without complications. Hospitalization, medications, and medical procedures are the main cost drivers. Only three studies reported indirect costs, indicating a potential underestimation of the total economic burden.

Conclusion: T2D complications increase healthcare costs by nearly four times. These findings support a shift in policy towards prevention, expansion of screening through insurance, and strengthening of primary services. Standardized methodologies and the inclusion of indirect costs are needed for more accurate study comparisons and policy guidance.