CONTEXT: Iran's culture and religion prohibit sexual contact prior to marriage. Due to the sensitivity of the topic, little is known about the sexual activity of unmarried adolescent males or about their knowledge of, and attitudes toward, sexuality and reproductive health. METHODS:A population-based study of 1,385 males aged 15-18 in Tehran was conducted using a self-administered questionnaire. Participants were questioned about their beliefs and knowledge regarding reproductive health, and asked whether they had engaged in sexual activity. Bivariate and multivariate analyses were performed to identify factors associated with sexual knowledge, attitudes and behavior.RESULTS: Twenty-eight percent of the sample reported having engaged in sexual activity. Sexual experience was associated with older age, access to satellite television, alcohol consumption and permissive attitudes toward sex. Substantial proportions of respondents held misconceptions regarding condoms, STIs and reproductive physiology. Attitudes toward premarital sex were more permissive among respondents who were older, were not in school, had work experience, had access to the Internet or satellite television, lived separately from their parents, or reported having used alcohol, cigarettes or drugs. CONCLUSION:The relatively high prevalence of sexual activity and the lack of knowledge regarding STIs and contraceptives pose a significant threat to the sexual and reproductive health of adolescent males in Iran. Programs are needed to provide adolescents with the information and skills to make safe sexual decisions.

BackgroundHealth literacy refers to personal competencies for the access to, understanding of, appraisal of and application of health information in order to make sound decisions in everyday life. The aim of this study was to develop and evaluate the psychometric properties of an instrument for the measurement of health literacy among adolescents (the Health Literacy Measure for Adolescents-HELMA).MethodsThis study was made up of two phases, qualitative and quantitative, which were carried out in 2012–2014 in Tehran, Iran. In the qualitative part of the study, in-depth interviews with 67 adolescents aged 15–18 were carried out in 4 high schools to generate the initial item pool for the survey. The content validity of the items was then assessed by an expert panel review (n = 13) and face validity was assessed by interviewing adolescents (n = 16). In the quantitative part of the study, in order to describe the psychometric properties of the scale, validity, reliability (internal consistency and test-retest) and factor analysis were assessed.ResultsAn item pool made up of 104 items was generated at the qualitative stage. After content validity was considered, this decreased to 47 items. In the quantitative stage, 582 adolescents aged 15–18 participated in the study with a mean age of 16.2 years. 51.2% of participants were females. In principal component factor analysis, 8 factors were loaded, which accounted for 53.37% of the variance observed. Reliability has been approved by α = 0.93 and the test-retest of the scale at two-week intervals indicated an appropriate stability for the scale (ICC = 0.93). The final questionnaire was approved with 44 items split into eight sections. The sections were titled: gain access to, reading, understanding, appraise, use, communication, self-efficacy and numeracy.ConclusionThe Health Literacy Measure for Adolescents (HELMA) is a valid and reliable tool for the measurement of the health literacy of adolescents aged 15–18 and can be used to evaluate different levels of functional, interactive, and critical health literacy in adolescents.

OBJECTIVES: This study was conducted to identify and characterize the barriers and motivations to physical activity (PA) for elderly adults in Iran and other countries.METHODS: We searched 6 databases (PubMed, Embase, Scopus, Web of Science, Magiran, and the Scientific Information Database) from 2000 to the November 2017, using “aged 60 and over,” “physical activity” or “exercise,” and “motivator” and “barrier” as keywords. Two reviewers independently performed the search, screening, and quality assessment of the studies.RESULTS: In total, 34 papers were finally included in the study. The most important barriers, based on the frequency of factors, included physical problems, having no companions, and physical barriers to walking. The motivators included improving one’s physical condition, being social, and suitability of the physical environment.CONCLUSIONS: Important motivators and barriers to PA were more closely related to intrapersonal factors than to the interpersonal and environmental domains. The barriers and motivators to PA in the elderly were not markedly different between Iran and other countries. Therefore, a general strategy could be designed to improve PA in the elderly.

Men's participation in perinatal care (PNC) is a promising strategy for improving maternal health. This study aimed to assess the educational needs of men for their participation in PNC. This is a qualitative research study using focus group discussions. These were performed with eight groups of men and women in selected hospitals of Shahid Beheshti Medical Science University, Iran. Data were analysed using qualitative content analysis methodology. The majority of participants gave the 'emotional support of women' as the most appropriate form of men's participation in PNC, and the 'long working hours of men' as the main barrier. The majority would prefer men's education to be about 'emotional support', 'physiological changes' and 'signs of risks' during pregnancy. The participants emphasized the need to consider couples' requirements when selecting the place, time and duration of education.

Background: It is believed that smoking is the gateway to use substances and illicit drugs. Due to an increase in smoking among students, we thought there is a need for more efficient ways to prevent smoking among the young and adolescents. Objectives: This study aimed to develop an extended version of the Health Belief Model (HBM) with elements of Health Literacy (HL) to assess whether an educational intervention could be effective in smoking prevention based on this new development in 2016. Methods: This was a quasi-experimental study performed on 130 students living in dormitories of Shahid Beheshti University of Medical Sciences in Tehran, Iran, who were recruited and assigned to experimental and control groups (each containing 65 students). The experimental group received 6 electronic educational sessions via telegram application while the control group received no intervention. The data were collected using a questionnaire containing items on HBM, smoking preventive behaviors, and a measure of HL (the HL inventory for adults-HELIA). The questionnaire was completed at three time-points: before, immediately and three months after the intervention. The significance level was set at 0.05. Results: Before the intervention, there was no significant difference in the demographic and background variables, the underlying level of knowledge, preventive behaviors, HL, and all the constructs of the model between the groups (P > 0.05). After the intervention, comparing two groups showed that the mean scores of knowledge, preventive behaviors, HL, and all components of the model changed significantly in the experimental group compared to the control group (P < 0.05). The mean and standard deviation of adoption of smoking preventive behaviors at the beginning of the study in smoking and non-smoking students in the