BackgroundThere has been significant progress in eliminating malaria in Iran. The aim of this study is to investigate the structure of inter-organizational collaboration networks in the field of unauthorized immigrants and refugees access to services in order to eliminate malaria.MethodsThis study employed social network analysis, in which nodes represented stakeholders associated with providing access of immigrants and refugees to services in the field of malaria elimination, and ties indicated the level of collaboration. This study adopted socio-centric analysis and the whole network was studied. In this regard, 12 districts of the malaria-endemic area in Iran were selected. Participants included 360 individuals (30 representatives of the organization/group in each district). The data were gathered by interview, using the levels of collaboration scale. UCINET 6 was used for data analysis. The indices of density, centralization, reciprocity, and clustering were investigated for each twelve network and at each level of collaboration.ResultsThe average density of the networks was 0.22 (SD: 0.04). In districts with a high incidence of imported malaria, the values of network density and centralization were high and the networks comprised of a larger connected component (less isolated clusters). There were significant correlations between density of network (r = 0.66, P = 0.02), degree centralization (r = 0.65, P = 0.02), betweenness centralization (r = 0.76, P = 0.004), and imported malaria cases. In general, the degree centrality and betweenness centrality of the organizations of health, district governor, and foreign immigrants’ affairs were higher. In all networks, 60% of the relationships were bilateral. At a higher level of collaboration, the centralization declined and reciprocity increased. The average of betweenness centralization index was 22.76 (SD = 3.88).ConclusionsHigher values of network indices in border districts and districts with more cases of imported malaria, in terms of density and centralization measures, can propose the hypothesis that higher preparedness against the issue and centralization of power can enable a better top-down outbreak management, which needs further investigations. Higher centrality of governmental organizations indicates the need for involving private, non-governmental organizations and representatives of immigrant and refugee groups. Recognition of the existing network structure can help the authorities increase access to malaria prevention, diagnosis, and treatment services among immigrants and refugees.Electronic supplementary materialThe online version of this article (10.1186/s12936-018-2635-4) contains supplementary material, which is available to authorized users.

Background:Many of the problems pertaining to old age originate from unhealthy lifestyle and low social support. Overcoming these problems requires precise and proper policy-making and planning.Objectives:The aim of the current research is to investigate the effect of health promoting interventions on healthy lifestyle and social support in elders.Patients and Methods:This study was conducted as a clinical trial lasting for 12 months on 464 elders aged above 60 years who were under the aegis of health homes in Tehran, Iran. Participants were selected through double stage cluster sampling and then divided into intervention and control groups (232 individuals in each). Tools for gathering data were a demographic checklist and two standard questionnaires called Health-Promoting Lifestyle Profile version 2 and personal resource questionnaire part 2. Data were analyzed using descriptive and analytical tests including paired t test, analysis of covariance (ANCOVA) and Pearson correlation coefficient.Results:The average age of elders in this study was 65.9 ± 3.6 years (ranging between 60 and 73 years old). Results showed that the differences between the mean post-test scores of healthy lifestyle and its six dimensions as well as perceived social support and its five dimensions in the control and intervention groups were statistically significant (P value < 0.0001).Conclusions:Aging is an inevitable stage of life. However, effective health promoting interventions can procrastinate it, reduce its consequences and problems, and turn it into a pleasant and enjoyable part of life.

Background Given the potential of intersectionality to identify the causes of inequalities, there is a growing tendency toward applying it in the field of health. Nevertheless, the extent of the application of intersectionality in designing and implementing health interventions is unclear. Therefore, this study aimed to determine the extent to which previous studies have applied intersectionality and its principles in designing and implementing health interventions. Methods The title and abstract of the articles which were published in different databases e.g. PubMed, Web of Science, Proquest, Embase, Scopus, Cochrane, and PsychInfo were screened. Those articles that met the screening criteria were reviewed in full text. The data about the application of principles of intersectionality, according to the stages heuristic model (problem identification, design & implementation, and evaluation), were extracted through a 38-item researcher-made checklist. Results Initially, 2677 articles were found through reviewing the target databases. After removing the duplicated ones and screening the titles and abstracts of 1601 studies, 107 articles were selected to be reviewed in detail and 4 articles could meet the criteria. The most frequently considered intersectionality principles were “intersecting categories” and “power”, particularly at the stages of ‘problem identification’ as well as ‘design & implementation’. The results showed that “multilevel analysis” principle received less attention; most of the studies conducted the interventions at the micro level and did not aim at bringing about change at structural levels. There was a lack of clarity regarding the attention to some of the main items of principles such as “reflexivity” as well as “social justice and equity". These principles might have been implemented in the selected articles; however, the authors have not explicitly discussed them in their studies. Conclusions Given the small number of included studies, there is still insufficient evidence within empirical studies to show the implication of intersectionality in designing and conducting health interventions. To operationalize the intersectionality, there is a need to address the principles at various stages of health policies and interventions. To this end, designing and availability of user-friendly tools may help researchers and health policymakers appropriately apply the intersectionality.

Background: Health literacy is one of the most important determinants of noncommunicable diseases prevention. Health literacy is associated with elevated risks for poorer access to care, adverse health outcomes, and increased hospitalization and health costs. Aims: This study aimed to determine the level of health literacy among the general adult population in the Islamic Republic of Iran. Methods: Using a cross-sectional study during 2014-2015 with a multistage cluster sampling approach, we administered a pilot-tested standardized questionnaire to assess different domains of health literacy (i.e., reading, comprehension, communication/decision-making and Interpretation/judgment skills, individual and social empowerment, health information access and health information use) among 8439 (3935 males) individuals aged 18-60 years. Data were collected through face-to-face interviews. Descriptive statistics and multivariable linear regression method using SPSS (20) were applied to identify the factors associated with health literacy among Iranian adults. Results: The mean health literacy level was 10.2±3.8 (out of 20). Only 18% (95% confidence interval [CI]: 17.15-18.78) of the participants had adequate health literacy, while 45.7% (95% CI: 44.64-46.78) had inadequate, and the 36.3% (95% CI: 35.21-37.33) had moderate health literacy. In the adjusted linear regression model, education level (the smallest β = 4.35, P < 0.001), age (β = 0.01, P = 0.002), female sex (β = 0.45, P < 0.001), residency in rural areas (β = 0.26, P < 0.001) and having permanent job (β = 1.03, P < 0.001) were significantly associated with more health literacy. Conclusion: Our findings highlighted that the Iranian adult population has an insufficient level of health literacy, which calls for comprehensive education planning to improve the levels, with special attention to certain subpopulations (e.g. illiterate populations) and domains (e.g. individual empowerment).