Background and Objectives Action research has become popular in health system research and problem solving. The aim of this study was to introduce the concepts and applications of action research in health system. Material and Methods This study reviewed the related documents and literatures in Persian and English Language by comprensive search in web-based resources. Results This study compares the Simmons model and other methods and provides a successful model for the use of pilot research in the health system. Conclusion This study recommends utilization of action research in solving health system problems in practice and also for learning in environment. Extended Abstract Background and Objectives Many experts believed that classic research methods have not been sufficient to help solve numerous problems faced by the health system. Thus, researchers have developed a new approach to this problem called "action research."The results of various studies in different countries have confirmed positive effects of this type of study in improving the performance of the health system. The aim of this study was to introduce the concepts and applications of action research in improving the performance of the health system. Material and Methods The present study is a revie of the existing documents and literature. Relevant books and websites were searched through to find various approaches and methods of action research. In order to review action research studies conducted in the field of health and other sectors, valid Persian and English electronic references were reviewed by using the keywords "action research", "health system" and "health" in 2020. At first, definitions and key concepts of action research in the health system were discussed, then the model introduced by Simmons in 1995 for action research, as a comprehensive model, was described and examples of action research studies conducted worldwide, were provided. Results In action research, the researcher with the participation of stakeholders identifies the problems in the system and collects information to solve the problems. Then, in accordance with the conditions of the organization and the solutions provided, the researcher tries to improve the performance. Finally, the results of interventions are evaluated. For this reason, action research is known as a method to improve performance and quality. The Simmons model includes subject identification, data collection, planning, implementation, evaluation and feedback. By summarizing the information obtained, the following steps can be suggested for conducting successful action research in health system: determining the subject of the research, describing the current situation, collecting information, analyzing and interpreting data, selecting and implementing a new solution, collecting information, evaluating the impact of the new action and determining its validity, revising and presenting the final report. Action research includes looking (gathering information and describing the current situation), thinking (discovering what is happening, interpreting it and explaining why and how) and acting (planning, implementing and evaluating). FOCUS PDCA is a proposed model for action research. This model includes 9 steps: finding a problem, organizing the research team, clarifying the process, understanding the causes of change, selecting an item to improve, planning, doing, checking and acting. Conclusion One of the most important reasons for the success of and attention to action research is the inadequacy of traditional research in answering basic questions and problems in the field of health, and the reason for this inefficiency is the gap between traditional research and the needs of the health system, a weakness that can be properly addressed by action research. Finally, it is recommended that if health managers are looking to promote standards and improve the health system in practice and in their specific situation, it is better to continue action research. Since action research is one of the most practical and basic types of research that provides realprospects to promote standards and improve the health system by analyzing the existing issues and problems and taking action to solve them. Practical implications of research Action research is one of the most central and basic types of research that provides the ground for raising standards and improving the health system by analyzing existing issues and problems and taking action to address them. Ethical considerations In selecting sources, extracting and also in reporting the content of sources and studies, the principle of fidelity and ethical principles have been observed. Conflict of interest The authors of the article declare that there is no conflict of interest for the authors of the article. Acknowledgement The authors of the article thank the Vice Chancellor for Research and Technology of Tabriz University of Medical Sciences for approving and financially supporting this study in the form of project number IR.TBZMED.REC.1397.154.

Background: This study has been conducted to analyze the processes, models, and policies to assess fitness to drive and improving driving in the elderly in the world. Methods: The Arkesy and O’Malley frameworks were employed. Articles with at least one aspect of driving eligibility in the elderly were included. Expected data were collected using appropriate keywords from PubMed, Web of Science, Scopus, Embase, IranDoc, SID, and MagIran. Data were analyzed using the Content Analysis method. Results: Out of 675 records, 24 papers and reports were included in the study that all of them were High-Income Countries (HICs). Among the studies that referred to the baseline age, the highest frequency was 70 yr old (4 studies). Vision assessment was the main item to judge driving fitness (mentioned in 75% of the studies). The in-person (5 studies) was the most common method of renewal. General practitioners were the principal performers to measure driving fitness (7 studies). Thirteen studies referred to the road tests as part of the driver's license renewal process. In most all reports and papers, there were policies on empowering the elderly driver, including providing safe driving tips, optional driving skills tests, holding retraining courses, etc. The most frequently supporting policies included introducing alternative transportation. Conclusion: Most HICs have worthwhile experience in measuring and improving the fitness to drive in the elderly and enforce different laws according to social and political conditions. Utilizing these experiences by considering economic and social differences can be useful and practical for middle and low-income countries.

Introduction: Safety has been neglected in primary health care (PHC). A review of the literature shows that a comprehensive and specific framework to assess the safety of the service recipients (SRs) in PHC has not yet been developed. Therefore, this study aimed to design and validate a framework for assessing the safety of SRs in PHC. Methods: This study is a qualitative study with a grounded theory approach that was designed and conducted in 2020 in the Vice-Chancellor for Health of Tabriz University of Medical Sciences. The present study was conducted in three stages: conducting a comprehensive literature review, consulting 15 experts and officials of the country and the province, and conducting two stages of the Delphi technique with the participation of 23 experts. Content analysis was used to analyze the data. Results: In the literature review phase, 114 criteria were identified from 16 references. Finally, 71 criteria, in 6 main areas and 20 sub-areas, were identified for assessing the safety of SRs in PHC. The main areas include management and leadership (26 criteria), process management (8 criteria), SRs' safety audit (15 criteria), human resources (5 criteria), SRs and community participation (5 criteria), and occupational safety (12 criteria). Conclusion: In this study, a comprehensive and systematic framework and criteria for measuring the safety of SRs in PHC were designed and validated, which can be used by policymakers and officials of PHC.

Background: Several countries in the world have distinct policies and frameworks to assessment and promote fitness to drive in the elderly. Accordingly, this study has been conducted to analyze the processes, models, and policies to assessment fitness to drive and improving driving in the elderly in the world.Method: Expected data were collected using keywords older, old, elderly, aging, ageing, senior, polic*, process, programme, plan, guideline, framework, driving capacity, driving eligibility, safe drive, fitness to drive, renewal driving license, commercial driver, driving qualification, driving ability, driving evaluation, driving assessment and their Persian equivalents from various English-language databases included: PubMed, Web of Science, Scopus, Embase, and Persian-language databases Included: IranDoc, SID, and MagIran. In this study, the Arkesy and O’Malley frameworks were employed.Results: Eventually, 24 papers and reports were included in the study. Vision assessment was the main item to judge the fitness to drive in the elderly, followed by driving assessment, cognitive assessment, and motor assessment. The in-person, postal, and online renewal of license were the most common method of renewal. General practitioners were the principal performers to measure driving fitness. In most all reports and papers, there were policies on empowering the elderly driver, including providing safe driving tips, optional driving skills tests, holding retraining courses, and so on. The most significant supporting policies included introducing alternative transportation to preserve the independence of the elderly. This study explained that clinical assessment is normally performed in drivers older than 75 years old to diagnose disorders and treat and prevent them in distinct time periods.Conclusion: Most high-income countries have worthwhile experience in measuring and improving the fitness to drive in the elderly and enforce different laws according to environmental, social, and political conditions. Utilizing these experiences by considering economic and social differences can be useful and practical for middle and low-income countries.

No abstract