Comprehensive Health Center Research Articles

The Effect of Self-Care Training on Blood Sugar Control, HbA1C Level, and Life Quality of Diabetic Patients in Birjand, East of Iran: A Randomized Clinical Trial Study

Background As one of the most important public health problems worldwide, diabetes is closely linked with patients' lifestyles. The optimal approach to treating diabetes is to prevent it. Our aim in this study was to assess the impact of self-care behaviors on quality of life, blood sugar control, and HbA1C level in patients with type 2 diabetes. Methods This randomized clinical trial examined 100 diabetic women referred to Ghadir Comprehensive Health Center in Birjand in 2019. A 5 cc fasting blood sample was taken from each participant. The participants were randomly assigned to experimental and control groups. For the experimental group, a 10-session self-care training workshop was held. Baseline and postintervention fasting blood glucose, HbA1C level, and life quality of the two groups were assessed and compared six months after the intervention. Data were analyzed in SPSS (16). Results In the experimental group, the mean serum HbA1C level decreased from the baseline 7.5 ± 1.5 to 6.3 ± 1.0 (P < 0.001). Fasting blood sugar in the intervention group decreased from 136.3 ± 43.5 to 127.3 ± 22.9, but the reduction was not significant (P=0.322). The mean scores of the quality of life (P=0.002) and the visual analogue scale (P < 0.001P < 0.001) in the experimental group increased significantly compared to the control group. Conclusion Self-care training for diabetic women had positive effects on both life quality and disease control. Therefore, it is recommended that self-care training be delivered and taken more seriously by physicians and health care providers in addition to drug therapy.

Medication Adherence and its Related Factors in Patients with Type 2 Diabetes

Background: One of the public health challenges in the worldwide is diabetes, and adherence to treatment is crucial. Adherence to treatment can help reduce the complications of the disease. Therefore, this study was performed to evaluate the status of adherence to treatment among patients with type 2 diabetes in Khorramabad. Materials and Methods: In this cross-sectional study, 392 men and women with type 2 diabetes referred to comprehensive health centers in Khorramabad between May and August 2016 were studied. Demographic questionnaire and Morisky Medication Adherence Scale (MMAS-8) were used to collect data. Version 22 SPSS and descriptive analysis were used to analyze the data. Significance level in the present study was less than 0.05. Descriptive tests, Chi-square, Fisher's exact test, and independent t-test were used. Results: The mean age of study participants was 56.03 ± 10.91. 68.9% (270 people) were women and 31/1% (122 people) were men. According to the score obtained from the Morisky questionnaire, a total of 219 patients (55/9%) followed the desired treatment and 173 (44/1%) followed the unfavorable treatment. There was a significant relationship between patients' adherence to treatment with the variables of gender, marital status, educational status, and their monthly income. No statistically significant between age and employment status with adherence to treatment were observed. Conclusion: Findings of this study showed that adherence to treatment among patients with type 2 diabetes in Khorramabad is in a good level. Health policy makers should strive to ensure that all patients adhere to their treatment process with easy access to services and reduced costs.

Knowledge of postpartum depression among mothers at immunisation clinics in Mushin, Nigeria

Background Postpartum depression is the most common psychological disorder affecting women during the postpartum period, yet this condition often goes undiagnosed. Studies show that the onset of postpartum depression can occur at any time following delivery, up to three months postpartum; in some cases, up to a year postpartum. This study aimed to assess knowledge of postpartum depression in mothers attending immunisation clinics at selected primary healthcare centres in Mushin, Nigeria. This study will help identify areas for improvement in educating women on postpartum depression, leading to early identification, treatment and reduced cases of the illness. Methods This was a descriptive quantitative study using multistage sampling to select participants from two purposively selected comprehensive health centres. Simple random sampling was used to select 240 mothers to participate in the study, who were given self-structured questionnaires on sociodemographic data and knowledge of postpartum depression. Data were analysed using the Statistical Package for Social Sciences version 22. Descriptive statistics were used to present demographic variables and objectives. Inferential statistics, the chi-square test, was used to test hypotheses at P&lt;0.005. Results The majority of participants (60.8%) had poor knowledge of postpartum depression. There is a statistically significant relationship between age and knowledge of postpartum depression (P=0.000). There is no significant relationship between education level and knowledge of postpartum depression. Conclusions The majority of women in this study had poor knowledge of postpartum depression. To tackle this, midwives should aim to reinforce health education on mental and emotional health and assess the emotional and mental health status of women during the antenatal and postpartum periods. It is also key for midwives to refer women on time if they suspect postpartum depression.

Paternal adaptation and related factors in Iranian fathers.

ObjectiveAlthough fathers are an essential element in family health, they are often overlooked by the healthcare system and are not given enough information on how to care for their infants and spouses. In this regard, understanding the characteristics or predictors of paternal adaptation might help healthcare providers design and implement interventions to foster paternal adaptation. The present study looked into paternal adaptation and related factors in Iranian fathers.MethodsThis cross-sectional study included 298 fathers seen at 41 comprehensive healthcare centers in Rasht. The sampling method was stratified and each comprehensive health center was considered as a separate group. We measured paternal adaptation using the standardized paternal adaptation questionnaire (PAQ) with 38 items and five domains.ResultsThe results indicated that paternal adaptation scores were statistically different based on child age, length of marriage, and history of miscarriage (p<0.05). Father age presented a significant inverse correlation with the adaptation score, with lower paternal adaptation scores observed in older fathers (r=-0.115, p=0.048).ConclusionsThe most significant factors related to paternal adaptation were history of miscarriage, satisfaction with family wellbeing welfare and income level, nationality of the father, maternal age, and satisfaction with married life.

Improving the Quality of Geriatric Care for the Healthy Elderly in a Comprehensive Health Centers in Iran

Objectives: In the geriatric care provided in health centers, the healthy elderly are neglected. This qualitative study aims to improve the quality of geriatric care for the healthy elderly. Methods &amp; Materials: This community-based participatory study was conducted from 2016 to 2018 with the participation of 11 healthcare providers, 54 older people and 54 family members in Shahid Motahari Comprehensive Health Center in Mashhad, Iran. The mean age of healthcare providers was 32.4±2.7 years with a work experience 8.3 years. The mean age of the elderly was 64.3±3.9 years. Data were collected using the SERVQUAL questionnaire and interviews, focus group discussions, and field note taking. After identifying the problems through interviews with 8 personnel and 19 older people, group discussion sessions were held to design the change programs. After implementing the change programs, 30 interviews were conducted with the participants and comparisons were made before and after the programs. Descriptive statistics was used to analyze the qualitative data, and descriptive statistics and paired t-test were used to analyze the quantitative data. Results: The mean total score of service quality according to the elderly and their families in the pre-intervention stage was 63.02±9.46 and 61.83±9.05, respectively. These values reached 130.09±14.75 and 122.65±13.56 in the post-intervention stage, and this difference was statistically significant (P=0.001). The presented dynamic care model was able to improve geriatric care for the healthy elderly in the comprehensive health center by modifying the attitude, skills and empowerment of staff. Conclusion: The dynamic care model can improve the quality of geriatric services for the healthy elderly with features such as active, participatory, continuous, comprehensive and supportive care. It can be used in other health centers.

Relationship between Cognitive-Behavioral Processes and Stages of Change in Nutrient Use in Overweight Women Referring to Health Centers in Isfahan.

Background:The positive impact of post-needs assessment training on the correction of eating habits is remarkable. The aim of present study was to determine the relationship between cognitive-behavioral processes and stages of change in nutrient use in overweight women referring to health centers in Isfahan.Materials and Methods:The present study was a cross-sectional study conducted in 2017 during a three-month period. Using systematic random sampling, 260 overweight women referring to Isfahan comprehensive health centers were chosen. Data collection was performed by a four-part researcher-made questionnaire including demographic information form, stages of change of behavior, cognitive and behavioral processes questionnaire, and standard 168-item Food Frequency Questionnaire. After confirming its validity and reliability, it was completed by the researcher. Data were then entered N4 software perfect and analyzed using descriptive and analytical tests (ANOVA and Bonferroni Post-Hoc).Results:59.30% of the subjects were in an inactive and 40.70% in an active phase. There was a significant difference with respect to different stages of change and the use of all behavior change processes (F4= 11.42, p < 0.001). The rate of using cognitive and behavioral processes increased during the nutrient change behavior (p < 0.001).Conclusions:The results of the study showed that moving away from pre-contemplation stage to maintenance phase increases the rate of using these processes that is due to the stability and improvement of changed behavior. Therefore, health plans should be designed based on the stage of the target group.

The effects of educational intervention on breast self-examination and mammography behavior: Application of an integrated model.

BACKGROUND:Breast cancer is the most common type of cancer among women and it is the second leading cause of mortality among cancers in women and a major health issue in developed countries. Although there are simple and effective screening methods, just minority of women use them. Given the high prevalence of breast cancer in Isfahan women and the low prevalence of screening behavior, the present study aimed to determine the impact of theory-based educational intervention on breast self-examination (BSE) behavior and mammography.MATERIALS AND METHODS:The present experimental study was conducted on 93 women referred to comprehensive health centers in Isfahan through convenience sampling, and by this way 46 women were included in the control group and 47 in the intervention group. Data collection was done by a valid and reliable questionnaire. Furthermore, educational interventions were performed for the intervention group in three sessions. Furthermore, the data were completed in the intervention group before, immediately after, and 3 months after intervention and before and 3 months after intervention in the control group. The data were analyzed by SPSS (16); and paired t-test and repeated measure test were used for analysis in the intervention group and also independent t-test and paired t-test were employed to analyze data of the control group.RESULTS:The results showed significant changes in perceived benefit constructs (P = 0.023), knowledge (P < 0.001), self-efficacy (P < 0.001), and behavioral intention regarding BSE (P = 0.035) in the intervention group over time, but changes were not significant in both perceived susceptibility and severity in the intervention group. As far as mammography behavior is concerned, only the perceived benefit construct in the intervention group had significant changes. In terms of the screening behavior, only BSE behavior significantly changed before and after intervention.CONCLUSION:The study showed that theory-based education by applying of constructs such as perceived benefits and self-efficacy and intention for BSE model could promote breast cancer screening behavior such as BSE. Therefore, it is suggested that health educators utilize educational texts based on these constructs to increase their influence on individuals via screening behavior for breast cancer.

Evaluating the related factors to health-improvement style and the value of health among middle aged women referring to comprehensive health centers of Isfahan in 2016

Introducction. The present study was conducted to evaluate the related factors to health-improvement lifestyle and value of health among middle aged women. Material and Methods: The present study was a descriptive-correlational research that was conducted with participation of 278 middle aged women who referred to the health centers of Isfahan and were selected randomly in 2016. Data were collected using demographic characteristics questionnaire, Walker's Health Promoting Lifestyle Profile II (HPLPII) and a researcher-made questionnaire for the value of health that were completed by the participants. Data were analyzed using SPSS software with Pearson correlation coefficient test, linear regression analysis, Mann-Whitney test and Wilcoxon test. Results: According to the results of the present study there was a direct relation between the score of value of health and the total score of lifestyle and the scores all of its domains (p &lt; 0.05). There was a significant relation between the employment of middle aged women and the domains of personal relationships and spiritual growth lifestyle and also between background diseases and physical stress and stress management of the health-improvement lifestyle (p &lt; 0.05). Also a significant relation was observed between the age of the middle aged women and the value of health and the domain of responsibility of the heath-improvement lifestyle (p &lt; 0.05). Conclusions: To enhance the level of the health-improvement and value of health lifestyles among this group of women it is necessary to pay attention to matters such as support, facilitation and personal-social factors in the healthcare programs for these women.

Medication adherence in HIV-positive pregnant women on antiretroviral therapy attending antenatal clinics in Ado metropolis, south-west Nigeria: A multicentre study

Background. Adherence to antiretroviral therapy (ART) and optimal viral suppression are crucial to the prevention of mother-to-child transmission (PMTCT) of HIV/AIDS. Objective. To determine adherence to ART and associated factors in Ado-Ekiti, Nigeria. Methods. A cross-sectional multicentre study was conducted among 170 HIV-positive pregnant women attending antenatal clinics of Ekiti State University Teaching Hospital and the Comprehensive Health Centre in Ado-Ekiti. Data collected using a semi-structured questionnaire were analysed with SPSS. Descriptive statistics, univariate and logistic regression were performed to determine factors associated with good adherence. Results. Using the pill count method and the Morisky Medication Adherence Scale-8 (MMAS-8), the prevalence of good adherence was 73.5% and 75.3%, respectively. Women with higher education were three times more likely to practise good adherence than those with little or no formal education (adjusted odds ratio (aOR)=3.03; 95% confidence interval (CI) 1.23 - 5.79; p =0.043) and those employed were four times more likely to practise good adherence (aOR=4.13; 95% CI 1.83 - 8.15; p =0.02). Also, partner disclosure, treatment support and use of ARVs for prevention of mother-to-child transmission (PMTCT) were indications of women three times more likely to practise good adherence ((aOR=2.53; 95% CI 0.99 - 5.80; p =0.035); (aOR=2.15; 95% CI 0.77 - 4.15; p =0.014) and (aOR=3.15; 95% CI 0.93 - 6.21; p =0.035)). Forgetfulness, busy schedule and stigmatisation were reasons given for non-adherence. Conclusions. The majority of the women had good adherence. However, counselling on adherence and partner disclosure should be sustained to ensure full benefits of PMTCT.

A Students’ Health Centre Design for Qatar

Introduction: School health services have the purpose of ensuring that all students are ready to learn by ascertaining that they are in good health. More than 2.3 billion school-aged children have been reported to spend a third of their days in the school environment1. Such findings underscore the need to establish school health centers (SHCs) that exclusively promote students’ physical, social, and psychological health of school children, yet currently non-existent in the State of Qatar. Aim: The present paper aims to propose the establishment of SHCs in Qatar, and to envision the impact of these comprehensively and uniquely designed Student Health Care Centers (SHCs) for school children health and wellbeing in Qatar. Student’s Health Center Design: Qatar prioritizes student’s health as part of its high-quality health care services. Qatar’s student health will benefit from establishment of comprehensive school health center services. Recommendation: This paper presents an SHC design that may be used in the State of Qatar. Identical SHC design may be applied in other countries also to improve the health, and quality of life among school children by creating a platform for rendering multidisciplinary health care services and health promotion to school children.

Status of Food Security in Kerman, Iran During the COVID-19 Pandemic

Background and Aim: Food security at individual, family, national, regional and global levels can be achieved when all people at all times have physical and economic access to adequate and healthy food to meet their nutritional needs and priorities for a healthy and active life. This study aims to investigate the status of food security and its related socioeconomic factors in households during the Coronavirus Disease 2019 (COVID-9) pandemic in Kerman, Iran. Methods &amp; Materials: This descriptive cross-sectional study was conducted on 500 households selected randomly from five comprehensive health centers in five districts of Kerman city in Iran. A demographic/socioeconomic questionnaires and the Persian version of the 18-item USDA Household Food Security Survey (HFSS) were used for collecting data. Ethical Considerations: All ethical principles are considered in this article. The participants were informed about the purpose of the research and its implementation stages. They were also assured about the confidentiality of their information and were free to leave the study whenever they wished, and if desired, the research results would be available to them. Results: There was a significant relationship between the socioeconomic factors (household size, house size, and number of amenities) and the food security. There correlation between the household size and food security was positive (R= 0.142, P&lt;0.001), while the correlation of house size (R= -0.093, P&lt;0.005) and number of amenities (R= -0.73, P&lt;0.001) with food security was negative. Conclusion: By increasing the awareness of people and improving their economic situation, it is possible to improve the food security situation of households in Kerman city.

Effect of education based on the health belief model on earthquake preparedness in women

Earthquake as a health risk affects human health all around the world. Iran is located in an earthquake-prone area; however, Iranian people do not demonstrate appropriate preparedness for earthquakes. Women play a critical role in earthquake risk reduction. Earthquake education programs are of great significance in preparing women and their families. The behavioral theory-based education can be an effective framework for facilitating earthquake preparedness. This study aimed to determine the effect of education based on the health belief model (HBM) on earthquake preparedness in women living in Hamadan City, Iran. The study presented the results of a quasi-experimental study on 120 women (60 women in an experimental group and 60 women in a control group) admitted to comprehensive health centers, who were selected using the multi-stage random sampling method. Earthquake preparedness was assessed with a researcher-made HBM questionnaire and a checklist before and two months after HBM-based education in three 45–60 min sessions. The collected data was analyzed using Independent samples t-test, Paired samples t-test, and ANCOVA. The results showed that after HBM-based education, the scores of awareness, HBM constructs, namely perceived susceptibility, perceived servility, perceived benefits, perceived self-efficacy constructs (except for cues to action), and earthquake preparedness increased in the intervention group compared to the control group (P < 0.001). Given the positive impact of HBM-based education on awareness, most of the HBM constructs, and earthquake preparedness, HBM-based education should be applied with more focus on cues to action for earthquake preparedness.

Oral Health Knowledge, Attitudes, and Practices of People with Diabetes in South of Tehran, Iran

Objective: This study assesses the oral health knowledge, attitudes, care practices, and related underlying factors of people with diabetes. Materials and Methods: In a descriptive cross-sectional study using a random sampling method, 201 patients who referred to five comprehensive health centers in the South of Tehran,Iran, participated. A previously published questionnaire was used, and its reliability and validation analyses were performed. There were 31 Open-Ended, Closed-Ended, and Likert scale questions, including 26 on key underlying factors, one with 13 parts in oral health knowledge, one with nine parts related to oral health attitudes, and three on care practices. Data were entered into SPSS software version 24, and descriptive statistics and regression were used to analyze and report the results. Results: The mean age of participants was 49 years (σ=7.6), and males accounted for 58.2% of the study population. 37.48% of the patients had poor oral health knowledge, whereas 61.76% of them reported average care practices, with 68.29% above average attitudes. Among the study population, only 33.3% brushed more than once per day. 35.8% considered bleeding gums while brushing unacceptable, and 42.3% reported gums swelling and redness as signs of disease. Over half of respondents (52.2%) strongly supported the idea of keeping their natural teeth as long as possible, while 41.8% were only agreed. On the other hand, patients with a higher level of education scored better in knowledge, attitudes, and care practices (p-value&lt;0.05). Conclusion: As the knowledge, care practices, and to some extent attitudes of people with diabetes toward their general oral health were unsatisfactory, an appropriate training program should be developed to warn diabetic patients of the importance of oral health and its two-way impact on diabetes.

Incidence Of Enteropathogenic Escherichia Coli Among Infants At Eleyele Comprehensive Health Centre, Ile-Ife

Abstract Introduction/Objective This work was carried out to find the incidence of enteropathogenic Escherichia Coli in children below five years of age who complained of having diarrhea at Eleyele Comprehensive Health Centre, Obafemi Awolowo University Teaching Hospital Complex, Ile-Ife. Methods All specimen were cultured as routinely done in Bacteriology Laboratory in Obafemi Awolowo University Teaching Hospital for stool samples. Colonies of lactose fermenters were processed after overnight incubation at 37°c. Non lactose fermenter colonies were discarded. Out of 200 colonies isolates on MacConkey Agar, there were 150 lactose fermenters and these were all processed. Biochemical examination on sugars, for the production of acid and gas, indole production, motility, citrate utilization, voges-prokauer and Methyl red tests. Results Out of 150 strains, only 80 strains obeyed IMVic ++ -- reactions. These were serotyped to know the enteropathogenic strains. From the result obtained, 23 strains reacted positively with polyvalent antisera (Polyvalent 2, 3, 4 antisera) out of which 13 strains gave a positive reaction with corresponding monovalent antisera. 5 strains from polyvalent 2 antisera, 5 strains from polyvalent 3 antisera, and 3 strains from polyvalent 4 antisera. In close study of this work, total percentage of female with Diarrhea cases were 44.5% total percentage of male with diarrhea cases were 55.5%. Out of these 80, Escherichia coli were isolated, from these 13 enteropathogenic Escherichia coli strains were isolated (16.25%). Patient with age group below 2 years gave 9 strains 69.2%, 2-3 years gave 2 strains (15.4%), 3-4 years gave 1 strain (7.7%) and 4-5 years gave 1 strain (7.7%). Also close examination of result revealed that male children had the greater percentage of Enteropathogenic infection with 8 strains out of the 13 strains serotyped (61.5%) and female children with 5 strains (38.5%). Conclusion Escherichia coli remain an important cause of infant diarrhea. Although epidemics of infant diarrhea caused by enteropathogenic Escherichia coli have almost disappeared from the developed countries, it is still very common in developing countries. The relative importance of enteropathogenic Escherichia coli as a cause of infant diarrhea need to be reassessed and new diagnostic techniques will also help to simplify this task.

The effects of the Fordyce’s 14 fundamentals for happiness program on happiness and caregiver burden among the family caregivers of patients with epilepsy: A randomized controlled trial

BackgroundCaregiving to patients with epilepsy (PWE) is often very stressful for family caregivers and puts a heavy caregiver burden (CB) on them. The aim of this study was to evaluate the effects of Fordyce’s fourteen Fundamentals for Happiness Program on happiness and CB among the family caregivers of PWE. MethodsThis randomized controlled trial was conducted on seventy family caregivers of PWE. Participants were purposively recruited from the Comprehensive Health Center in Shahrekord, Iran, and randomly allocated to either an intervention or a control group. Participants in the control group received conventional health-related educations in four one-hour group sessions, while participants in the intervention group received the Fordyce’s fourteen Fundamentals for Happiness Program in eight one-hour group sessions. Happiness and CB in both groups were assessed at three time points, namely before, immediately after, and two months after the intervention. Data were analyzed using the SPSS program (v. 18.0). FindingsThere were no significant differences between the control and the intervention groups regarding participants’ demographic characteristics and their pretest mean scores of happiness and CB (P > 0.05). The mean scores of happiness and CB in the control group did not significantly change (P > 0.05), while the mean score of happiness significantly increased and the mean score of CB significantly decreased in the intervention group across the three measurement time points (P < 0.05). Consequently, the mean score of happiness in the intervention group was significantly greater than the control group and the mean score of CB in the intervention group was significantly less than the control group at both posttests (P < 0.01). ConclusionThe Fordyce’s fourteen Fundamentals for Happiness Program is effective in significantly increasing happiness and reducing CB among the family caregivers of PWE. Healthcare providers and policy makers can use this program to reduce problems among these family caregivers.

Retaining VA Women’s Health Primary Care Providers: Work Setting Matters

When an experienced provider opts to leave a healthcare workforce (attrition), there are significant costs, both direct and indirect. Turnover of healthcare providers is underreported and understudied, despite evidence that it negatively impacts care delivery and negatively impacts working conditions for remaining providers. In the Veterans Affairs (VA) healthcare system, attrition of women's health primary care providers (WH-PCPs) threatens a specially trained workforce; it is unknown what factors contribute to, or protect against, their attrition. Based on evidence that clinic environment, adequate support resources, and workload affect provider burnout and intent to leave, we explored if such clinic characteristics predict attrition of WH-PCPs in the VA, to identify protective factors. This analysis drew on two waves of existing national VA survey data to examine predictors of WH-PCP attrition, via logistic regression. All 2,259 providers from 140 facilities VA-wide who were WH-PCPs on September 30, 2016. The dependent variable was WH-PCP attrition in the following year. Candidate predictors were clinic environment (working in: a comprehensive women's health center, a limited women's health clinic, a general primary care clinic, or multiple clinic environments), availability of co-located specialty support resources (mental health, social work, clinical pharmacy), provider characteristics (gender, professional degree), and clinic workload (clinic sessions per week). Working exclusively in a comprehensive women's health center uniquely predicted significantly lower risk of WH-PCP attrition (adjusted odds ratio 0.40; CI 0.19-0.86). A comprehensive women's health center clinical context may promote retention of this specially trained primary care workforce. Exploring potential mechanisms-e.g., shared mission, appropriate support to meet patients' needs, or a cohesive team environment-may inform broader efforts to retain front-line providers.

Pregnant Women’s Knowledge and Beliefs About Voluntary HIV Counseling and Testing in Birjand in 2018: An Assessment Using Health Belief Model

Background: Pregnant women are at increased risk of HIV acquisition, whose rapid diagnosis not only saves the lives of the mother and fetus and prevents the infection of the husband, but also prevents the transmission of the virus to other people in the community. Objectives: In this line, this study aimed to assess pregnant women’s knowledge and beliefs in Birjand about voluntary HIV counseling and testing based on health belief model constructs. Methods: In this descriptive-analytical study, 238 pregnant women referring to Birjand comprehensive health centers (CHC) in 2018 are studied. Participants were selected using multi-stage random sampling. First, Birjand was divided into four districts as north, south, east, and west. Then, one health center and one CHC were selected from each district. Data were collected using a researcher-made questionnaire consisting of demographic information, knowledge, model constructs, and behavior, whose validity and reliability were determined. Data were analyzed using SPSS19 and independent t-test and one-way ANOVA. Results: The mean age of participants was 28.3 + 5.1 years. Mean score of knowledge, susceptibility, severity, benefits, barriers and perceived self-efficacy were 5.9 + 3.6, 8.9 + 2.21, 23.7 + 4.7, 34.7 + 4.2, 28.2 + 5.9, and 24.5 + 7.3 respectively and behavior was determined to be 5%. Knowledge was evaluated to be poor in 1.7%, moderate in 51.7%, and good in 46.6%. There was a significant negative relationship between barriers and all model constructs (P &lt; 0.05) and a significant positive relationship between knowledge with perceived susceptibility (r = 0.15) and guidance for action (r = 0.2), susceptibility with perceived severity (r = 0.23). Conclusions: This study showed the insufficiency of pregnant women’s knowledge about the importance of HIV screening. Therefore, it is recommended to use the Health Belief model in CHC to improve the knowledge, attitude, and practice of this target group.

Health care services utilization in a comprehensive health centre, in a rural community of South-South, Nigeria

2021; 2: 1, 2, 3.

Expected Outcomes from Family Medicine Specialized Graduates in Iranian Health System from the Viewpoints of Stakeholders: A Qualitative Study

Background and Objectives: The purpose of training and applying family physicians in the health system is to optimize rating the services and referral system. The purpose of this study was to explanation of the expected outcomes of family medicine graduates from the viewpoints of professors, assistants and senior managers of the health system and its comparison with the defined consequences in the curriculum of this major at Tabriz University of Medical Sciences. Material and Methods: This is a qualitative study with the content analysis approach. Sampling method is non-random and purposive. Three focus group discussions and six semi-structured interviews conducted with 31 participants, including three groups of professors, assistants and senior managers of the health system by FGD method and also including 25 participants and 6 individuals were used for individual interview. Interviews continued until data saturation. Content analysis method used for data analysis. Results: After conceptualizing, extracting and coding themes into 56 themes, the findings were categorized into three general themes: Occupational status (such as: Conscientious physician, policy maker, supervisor or provider), job duties (Education, research, management, consulting and visit) and employment outcomes (such as: Cost reduction, unnecessary refer and population health promotion). Conclusion: The use of specialist family physicians in positions such as the physician in charge of the health complex and service provision in comprehensive health centers can have outcomes such as appropriating referrals, reducing costs and preventing overuse, and reducing the workload of levels 2 and 3.

Adult mental health centre – A case study report from Slovenia

Abstract Issue There are two main public mental health problems in Slovenia: suicide and harmful alcohol consumption. The average suicide rate (25 per 100.000 people) is above the European average. There are substantial differences in the accessibility of mental health services and socio-economic and demographic differences within individual geographical areas. To address those challenges the establishment of comprehensive and accessible mental health centres within local environments were planned. Description of the Problem First ten adult mental health centres (AMHC) were established last year, one covering population of approximately 80.000 people. The implementation process is well established, while the evaluation process has just begun and assessment of characteristics of the population covered by one of the first AMHC serves as the basis. Results There were 74 people in medical treatment in one of the rural AMHC in Slovenia in 2019, mostly women (68.9%) and older people (x ̅=61.9). The income of people included is very low (x ̅=523 EUR). The number of hospitalisations were higher before inclusion (x ̅=1.2 before; x ̅=0.2 after). Beside regular treatment patients receive non-pharmacological therapies such as health education (90.5%) and occupational therapy (47.3%). Within first patients’ assessment mostly the physical health needs, psychological distress, daytime activities and safety to self were not met, which changes after the second assessment (p &amp;lt; 0.05, t &amp;gt; 2.000). Lessons Multiple needs of the patients seem to be well addressed through comprehensive, multidisciplinary team work and intersectoral collaboration at local level (e.g. with social work centres, family physicians, non-governmental services). Key messages Patients’ needs are well addressed through patient-centred approach at local level. Comprehensive, multidisciplinary team work and intersectoral collaboration at local level can address multiple needs of the patients.