Objective: To evaluate the effectiveness of wearable device interventions (eg, Fitbit) to improve physical activity (PA) outcomes (eg, steps/day, moderate to vigorous physical activity [MVPA]) in populations diagnosed with cardiometabolic chronic disease. Data Source: Based on Preferred Reporting Items for Systematic Reviews and Meta-Analyses, an electronic search of 5 databases (Medline, PsychINFO, Scopus, Web of Science, and PubMed) was conducted. Study Inclusion and Exclusion Criteria: Randomized controlled trials (RCTs) published between January 2000 and May 2018 that used a wearable device for the full intervention in adults (18þ) diagnosed with a cardiometabolic chronic disease were included. Excluded trials included studies that used devices at pre-post only, devices that administered medication, and interventions with no prospective control group comparison. Data Extraction: Thirty-five studies examining 4528 participants met the inclusion criteria. Study quality and RCT risk of bias were assessed using the Cochrane Collaboration Tool. Data Synthesis: Meta-analyses to compute PA (eg, steps/day) and selected physical dispersion and summary effects were conducted using the raw unstandardized pooled mean difference (MD). Sensitivity analyses were examined. Results: Statistically significant increases in PA steps/day (MD ¼ 2592 steps/day; 95% confidence interval [CI]: 1689-3496) and MVPA min/wk (MD ¼ 36.31 min/wk; 95% CI: 18.33-54.29) were found for the intervention condition. Conclusion: Wearable devices positively impact physical health in clinical populations with cardiometabolic diseases. Future research using the most current technologies (eg, Fitbit) will serve to amplify these findings.

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Purpose Reducing informal payments (IPs) for health services has always been a top priority for health policymakers all over the world. As the newest attempts to reduce IPs, Iran’s Government applied a set of reforms in the health care system in 2014 called “Health Sector Evolution Plan” (HSEP). The purpose of this paper is to investigate the prevalence and nature of IPs one year after implementing this plan. Design/methodology/approach This descriptive and cross-sectional study was a nationwide survey on Iran's health sector informal payments carried out in 2016. To do this, a sample of 1,112 Iranain households was selected from all over the country using a multistage cluster-stratified sampling method. The prevalence and nature of IPs were determined through conducting face-to-face interviews using a standard questionnaire. Findings One year after implementing the HSEP, about 27.7 percent of sampled Iranians had at least one experience of IPs for health services. The prevalences of compulsory and voluntary IPs were 21.4 and 11.5 percent, respectively. IPs were reported by 26.1 and 12.5 percent in the inpatient and outpatient services, respectively. Originality/value According to the results, compulsory IPs are still prevalent in both the outpatient and inpatient services of Iran’s health system and it seems that the HSEP has not been completely successful in achieving the goal of eradicating IPs. It can be said that the HSEP has been the first step toward eradicating IPs in Iran and should not be the last one. The study provides useful results of the prevalence and nature of IPs after implementing the HSEP, which should be considered in designing the next steps.

Objective To assess existing evidence on the effects of COVID‐19 on healthcare workers (HCWs) using the health‐related productivity loss approach. Methods A systematic search of online databases including PubMed, Scopus, Ovid, Web of Science, and EMBASE was conducted up to 25 August 2020. Following two screening stages, studies related to the effects of COVID‐19 on healthcare workers were included in the study. Results 82 studies were included in the analysis. The COVID‐19 related death rate among HCWs ranged from 0.00‐0.7%, while the positive test incidence varied between 0.00 and 24.4%. 39 evidences assessed psychological disorders. A wide range of psychological disorders observed among HCWs: 5.2 to 71.2% in anxiety, 1.00 to 88.3% in stress, 8.27 to 61.67% in insomnia, and 4.5 to 50.4% in depression. Conclusions The early evidence suggests that healthcare workers are one of the most vulnerable groups when it comes to positive COVID‐19 infection, mortality, and mental illness.

Introduction: Informal payments are a serious obstacle to equitable access and universal health coverage in developing countries. This study aimed to identify the most important factors affecting health informal payments in Iran. Methodology: The cross-sectional and descriptive-analytical study was carried out on a study population of all Iranians who, at least once over the past year (i.e. 2017), had received healthcare services and were exposed to paying health informal payments. A sample of 1477 households was selected using a multi-stage stratified-cluster sampling method. The required data were collected using a researcher-made questionnaire and completed by face-to-face interviews with the heads of households. The main factors affecting the odds of making informal payments were identified using the Ordered Logistic Regression model. Results: Having basic health insurance coverage, awareness of health insurance entitlements, education, perceived behavioral control, and the pattern of health service utilization had, respectively, the highest effects on the odds of making informal payments for healthcare. The odds of making informal payments for patients with no awareness of the health insurance entitlements were 3.5, 3.6, and 6.7 times more than those with low, medium, and high awareness, respectively (Odds Ratio = 3.58, 3.69, 6.74; P < 0.001). Conclusion: The health policymakers, in addition to improving service financing, should plan to increase patients' awareness, correct their false beliefs, change their attitudes, and improve social participation regarding health informal payments in order to reduce such transactions.