• Journal of Preventive Medicine and Public Health
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• v.54 no.3
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• pp.190-198
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• 2021

Objectives: Insufficient evidence exists regarding factors that affect screening adherence among people with a family history of diabetes, who comprise roughly half of all patients with diabetes. Therefore, we aimed to identify the determinants of diabetes screening adherence in adults with a family history of diabetes who had not yet been diagnosed with diabetes. Methods: This cross-sectional study was conducted at selected urban primary healthcare facilities in Tehran, Iran. The study population was clinically non-diabetic adults above 20 years of age with a family history of diabetes in at least 1 first-degree relative. All eligible people identified on randomly-selected days of the month were invited to join the study. Results: Among 408 participants, 128 (31.4%) had received a fasting blood glucose check during the last year. Using binary logistic regression, the independent predictors of screening adherence were knowledge of adverse effects of diabetes such as sexual disorders (odds ratio [OR], 3.05) and renal failure (OR, 2.73), the impact of family members' advice on receiving diabetes screening (OR, 2.03), recommendation from a healthcare provider to have a fasting blood glucose check (OR, 2.61), and intention to have a fasting blood glucose check within the next 6 months (OR, 2.85). Other variables that predicted screening adherence were age (OR, 1.05), job (being a housekeeper; OR, 3.39), and having a college degree (OR, 3.55). Conclusions: Knowledge of the adverse effects of diabetes, physicians' and healthcare providers' advice about the benefits of early disease detection, and family members' advice were independent predictors of screening adherence.

• Research in Community and Public Health Nursing
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• v.7 no.1
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• pp.118-128
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• 1996

The purpose of this study was examine the determinants of highschool students' health behavior. A convenient sample of 2nd grade highschool students (N=638) responded to self-report questionnaires. The IMCHB was then tested with data using SAS program by frequency, t-test, ANOVA, regression. The results were as follows 1. Health behaviors were found to be type of school specific. 2. From the general highschool's model, student's health affected health perception and mother's health and father's education affected self esteem among a set of background variables. Health perception and self-esteem are related to health behaviors. 16.8% of the varience in regular highschool student's health behavior are explained by health perception and self-esteem. 3. From the vocational highschool's model, 20.2% of health behavior varience was explained by self-esteem. Mothers' education, health perception and self esteem explained internal motivation. Student's health, internal motivation and self-esteem explained health perception. The results indicated that there was a relatively poor fit of the IMCHB to the highschool students' data.

• Membrane and Water Treatment
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• v.9 no.4
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• pp.273-278
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• 2018

Due to the lack of water in arid and semi-arid areas, reuse of wastewater can be a suitable way to compensate for water scarcity. Therefore, in this research, evaluation of the quality of wastewater of Kashan Treatment Plant to use for irrigation was studied. This descriptive cross-sectional study was conducted in 2016. pH, TSS, TDS, turbidity, COD, BOD5, Total Kjeldahl Nitrogen, Total Phosphorus, Total Coliform, fecal coliform, nematode eggs of inlet and outlet of wastewater treatment plant in Kashan were studied. Mean and standard deviation and wastewater quality parameters before and after treatment were tested with SPSS 22 (2014) software. The mean wastewater output of COD, BOD5, TSS, TDS and turbidity were respectively 86.6, 41.2, 11.11, 1095 mgL-1 and 17.5 NTU and the pH was equal to 7.22. Also, the average of Total Kjeldahl Nitrogen and phosphorus were 22.4 and 2.2 mgL-1 respectively. The mean of Total Coliform and fecal coliform were 225, 161 MPN / 100 ml respectively. In addition, no nematode eggs were found in final effluent. The results indicated that the treatment plants had a significant role in the control of microbial and organic pollution load of wastewater. Also, it is concluded that all parameters were in accordance with the standards of Iran's Department of Environment, so, it can be used for unrestricted irrigation.

• Journal of Preventive Medicine and Public Health
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• v.57 no.1
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• pp.65-72
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• 2024

Objectives: Protecting people against financial hardship caused by illness stands as a fundamental obligation within healthcare systems and constitutes a pivotal component in achieving universal health coverage. The objective of this study was to analyze the prevalence and determinants of catastrophic health expenditures (CHE) in Iran, over the period of 2013 to 2019. Methods: Data were obtained from 7 annual national surveys conducted between 2013 and 2019 on the income and expenditures of Iranian households. The prevalence of CHE was determined using a threshold of 40% of household capacity to pay for healthcare. A binary logistic regression model was used to identify the determinants influencing CHE. Results: The prevalence of CHE increased from 3.60% in 2013 to 3.95% in 2019. In all the years analyzed, the extent of CHE occurrence among rural populations exceeded that of urban populations. Living in an urban area, having a higher wealth index, possessing health insurance coverage, and having employed family members, an employed household head, and a literate household head are all associated with a reduced likelihood of CHE (p<0.05). Conversely, the use of dental, outpatient, and inpatient care, and the presence of elderly members in the household, are associated with an increased probability of facing CHE (p<0.05). Conclusions: Throughout the study period, CHE consistently exceeded the 1% threshold designated in the national development plan. Continuous monitoring of CHE and its determinants at both household and health system levels is essential for the implementation of effective strategies aimed at enhancing financial protection.

• Journal of Preventive Medicine and Public Health
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• v.46 no.6
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• pp.300-308
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• 2013

Objectives: The purpose of this study was to classify determinants of cost increases into two categories, negotiable factors and non-negotiable factors, in order to identify the determinants of health care expenditure increases and to clarify the contribution of associated factors selected based on a literature review. Methods: The data in this analysis was from the statistical yearbooks of National Health Insurance Service, the Economic Index from Statistics Korea and regional statistical yearbooks. The unit of analysis was the annual growth rate of variables of 16 cities and provinces from 2003 to 2010. First, multiple regression was used to identify the determinants of health care expenditures. We then used hierarchical multiple regression to calculate the contribution of associated factors. The changes of coefficients ($R^2$) of predictors, which were entered into this analysis step by step based on the empirical evidence of the investigator could explain the contribution of predictors to increased medical cost. Results: Health spending was mainly associated with the proportion of the elderly population, but the Medicare Economic Index (MEI) showed an inverse association. The contribution of predictors was as follows: the proportion of elderly in the population (22.4%), gross domestic product (GDP) per capita (4.5%), MEI (-12%), and other predictors (less than 1%). Conclusions: As Baby Boomers enter retirement, an increasing proportion of the population aged 65 and over and the GDP will continue to increase, thus accelerating the inflation of health care expenditures and precipitating a crisis in the health insurance system. Policy makers should consider providing comprehensive health services by an accountable care organization to achieve cost savings while ensuring high-quality care.

• Health Policy and Management
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• v.12 no.3
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• pp.99-111
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• 2002

This paper draws the determinants of National Health Expenditures(min) and collectivizes OECD countries which are positioned by same conditions using the decision tree analysis. Major findings are summarized as follows. We find that the power of influence of income level on NHE has been 58.35% in 1985, 65.37% in 1990, 66.90% in 1995, and 66.47% in 1997. The power of influence of public share in NHE has been on the increase during that period: 19.50% in 1985, 19.91% in 1990, 22.81% in 1995 and 26.88% in 1997. The two factors(income level, public share) tells for the most part of NHE: 77.85% in 1985, 85.28% in 1990, 89.71% in 1995, 93.35% in 1997. Our results support the hypothesis that NHE could be explained mostly by the income level and show that public share is negatively correlated with the growth of NHE.

• Research in Community and Public Health Nursing
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• v.25 no.4
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• pp.237-247
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• 2014

Purpose: The purpose of this study was to examine the social determinants of health (SDH) associated with health-related quality of life (HQOL) among the community-dwelling elderly, based on the conceptual framework of the Commission on Social Determinants of Health (CSDH). Methods: A survey was conducted with 199 elders aged 65 years or older sampled through convenient sampling. Data were collected through face to face interviews by trained interviewers using a structured questionnaire, which included scales of the residential area, social support, sense of community, social network, health behaviors, and HQOL. Data were analyzed by ANOVA and stepwise multivariate regression. Results: Major SDH affecting HQOL included the participants' residential area, sense of community, and health behavior. The HQOL of the elderly residing in the B area with a low rate of basic livelihood security recipients was higher than that of those residing in other areas. Conclusion: CSDH framework was useful to determine the factors associated with HQOL among the community-dwelling elderly. In addition to their health behavior, their sense of community was found to be a SDH of HQOL, indicating the need of health promotion programs tailored to the characteristics of residential areas and strategies to enhance involvement in community activities.

• Journal of Preventive Medicine and Public Health
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• v.40 no.6
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• pp.461-466
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• 2007

Objectives : The purpose of this study was to examine the determinants of sterilization in South Korea. Methods : This study was based on the data from the Korea National Fertility Survey carried out in the year 2000 by the Korea Institute of Health and Social Affairs. The subjects of the analysis were 4,604 women and their husbands who were in their first marriage, in the age group of 15-49 years. The data were analyzed by multiple logistic regression analysis. Results : Consistent with the findings of previous studies, the woman#s age and the number of total children increased the likelihood of sterilization. In addition, the year of marriage had a strong positive association with sterilization. Interestingly, the number of surviving sons tended to increase the likelihood of sterilization, whereas the woman#s education level and age at the time of marriage showed a negative association with sterilization. Religion, place of residence, son preference, and the husband#s education level, age and type of occupation were not significant determinants of sterilization. Conclusions : The sex of previous children and lower level of education are distinct determinants of sterilization among women in South Korea. More studies are needed in order to determine the associations between sterilization rate and decreased fertility.

• Korean Journal of Community Nutrition
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• v.6 no.1
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• pp.91-96
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• 2001

The purpose of this study was to identify the determinants of nutrition service utilization in health centers. Utilization of nutrition services for chronic discase were also investigated. Interview survey using questionnaire was conducted to collect the data required for analysis. The study subjects were 300 residents over 40 years of age, and 15 health workers representing health center service personnel in Kypnggi province. A wilcoxon 2-sample test and Kruskal-Wallis test were used to compare the distribution of health centers by health center characteristics and nutrition services. A chi-square test was used to test the association between service utilization and personal variables of the population. A multiple logistic regression analysis was used to measure the relative importance between the variables on service utilization. The results showed that only 10.0% of the study subjects used nutrition services provided by the health centers. Pilot project implementation and location of health centers, as well as educational level of the residents were significant factors influencing the utilization of the nutrition services provided by the health centers. Among the variables, pilot project implementation was the most important factor that influenced the nutrition service utilization in health centers.

• Korean Journal of Health Education and Promotion
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• v.22 no.3
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• pp.13-28
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• 2005

Objectives: The purpose of this paper is to describe the role for public education in mental health promotion, prevention of mental illness and treatment of mental disorders in Canada. Results: A brief history of the changing nature of the way we treat mental disorders in Canada argues for an increasingly critical role for public education. Furthermore, the new understanding of the role of social determinants in prevention of mental illness again necessitates a vital role for public education as the shift in focus moves from exclusively individual-focused health care treatments to creating supportive environments. The roles for mental health public education then become: advocacy for the social determinants of health approach, better understanding of the nature of mental health problems, useful information for self-management, and more knowledge about appropriate treatments. A brief discussion of the structure of the response in Canada provides an overview of national and provincial responsibilities in mental health care with a case study highlighting one community's response to addressing mental disorders. Conclusion : Finally, challenges regarding the most effective educators and the issue of professional expertise embedded in the status quo are discussed.