Mahmoud Tavousi

The 12-item medical outcomes study short form health survey version 2.0 (SF-12v2): a population-based validation study from Tehran, Iran

BackgroundThe SF-12v2 is the improved version of the SF-12v1. This study aimed to validate the SF-12v2 in Iran.MethodsA random sample of the general population aged 18 years and over living in Tehran, Iran completed the instrument. Reliability was estimated using internal consistency and validity was assessed using known-groups comparison and convergent validity. In addition the factor structure of the questionnaire was extracted by performing both exploratory and confirmatory factor analyses (EFA and CFA).ResultsIn all, 3685 individuals were studied (1887male and 1798 female). Internal consistency for both summary measures was satisfactory. Cronbachs α for the Physical Component Summary (PCS-12) was 0.87 and for the Mental Component Summary (MCS-12) it was 0.82. Known-groups comparison showed that the SF-12v2 discriminated well between men and women and those who differed in age and educational status (P < 0.05). Furthermore, as hypothesized the physical functioning, role physical, bodily pain and general health subscales correlated higher with the PCS-12, while the vitality, social functioning, role emotional and mental health subscales correlated higher with the MCS-12. Finally the exploratory factor analysis indicated a two-factor structure (physical and mental health) that jointly accounted for 59.9% of the variance. The confirmatory factory analysis also indicated a good fit to the data for the two-latent structure (physical and mental health).ConclusionAlthough the findings could not be generalized to the Iranian population, overall the findings suggest that the SF-12v2 is a reliable and valid measure of health related quality of life among Iranians and now could be used in future health outcome studies. However, further studies are recommended to establish its stability, responsiveness to change, and concurrent validity for this health survey in Iran.

The School Anxiety Scale-Teacher Report (SAS-TR): translation and psychometric properties of the Iranian version

BackgroundThe School Anxiety Scale-Teacher Report (SAS-TR) was designed to assess anxiety in children at school. The SAS-TR is a proxy rated measure and could assess social anxiety, generalized anxiety and also gives a total anxiety score. This study aimed to translate and validate the SAS-TR in Iran.MethodsThe translation and cultural adaptation of the original questionnaire were carried out in accordance with the published guidelines. A sample of students participated in the study. Reliability was estimated using internal consistency and test-retest analysis. Validity was assessed using content validity. The factor structure of the questionnaire was extracted by performing both exploratory and confirmatory factor analyses.ResultsIn all 200 elementary students aged 6 to 10 years were studied. Considering the recommended cut-off values, overall the prevalence of high anxiety condition in elementary students was found to be 21 %. Cronbachs alpha coefficient for the Iranian SAS-TR was 0.92 and intraclass correlation coefficient (ICC) was found to be 0.81. The principal component analysis indicated a two-factor structure for the questionnaire (generalized and social anxiety) that jointly accounted for 55.3 % of variances observed. The confirmatory factory analysis also indicated a good fit to the data for the two-latent structure of the questionnaire.ConclusionIn general the findings suggest that the Iranian version of SAS-TR has satisfactory reliability, and validity for measuring anxiety in 6 to 10 years old children in Iran. It is simple and easy to use and now can be applied in future studies.

Iranian Health Literacy Questionnaire (IHLQ): An Instrument for Measuring Health Literacy in Iran

Background: Promoting Health Literacy (HL) is considered as an important goal in strategic plans of many countries. In spite of the necessity for access to valid, reliable and native HL instruments, the number of such instruments in the Persian language is scarce. Moreover, there is no good estimation of HL status in Iran. Objectives: The aim of this study was to provide a valid, reliable and native instrument to measure and monitor community HL in Iran and also, to provide an estimation of HL status in two Iranian provinces. Patients and Methods: By applying the multistage cluster sampling, 1080 respondents (540 from each gender) were recruited from Kerman and Mazandaran provinces of Iran, from February to June 2014 to participate in this cross-sectional study. The development of the Iranian Health Literacy Questionnaire (IHLQ) was initiated with a comprehensive review of the literature. Then, face, content and construct validity as well as reliability were determined. Results: Internal consistency and test-retest reliability (ICC) of the factors was in the range of 0.71 to 0.96 and 0.73 to 0.86, respectively. In order to construct validity, Exploratory Factor Analysis (EFA) Kaiser-Meyer-Olkin (KMO) = 0.95 and Bartlett’s test result of 3.017 with P < 0.001) with varimax rotation was used. Optimal reduced solution, including 36 items and seven factors, was found in EFA. Five of the factors identified were reading/comprehension skills, individual empowerment, communication/decision-making skills, social empowerment and health knowledge. Conclusions: It was concluded that IHLQ might be a practical and useful tool for investigating HL for Persian language speakers around the world. Since HL is dynamic and its instruments should be regularly revised, further studies are recommended to assess HL with application of IHLQ to detect its potential imperfections.

Substance use avoidance among Iranian male adolescents: a comparison of three versions of the theory of reasoned action

Abstract The theory of reasoned action (TRA) is one of the most common models in predicting health-related behaviors and is used more often in health education studies. This study aimed to add two control constructs (perceived behavioral control – PBC and self-efficacy – SE) to the TRA and compare them using the structural equation modeling (SEM) for substance use avoidance among Iranian male adolescents in order to find out which model was a better fit in predicting the intention. This was a cross-sectional study carried out in Tehran, Iran. Data were collected from a random sample of high school male students (15–19 years of age) using a questionnaire containing items related to the TRA plus items reflecting two additional constructs (SE and PBC). In all, 433 students completed the questionnaires. The results obtained from SEM indicated a better fit to the data for the TRA with SE compared to the TPB (TRA with PBC) and TRA (χ2/df=2.55, RMSEA=0.072, CFI=0.96, NFI=0.94, NNFI=0.95, SRMR=0.058). Comparing SE and PBC, the results showed that self-efficacy was a better control construct in improving the TRA and predicting substance use avoidance intention (41%). The TRA with SE had a better model fit than TPB and the original version of the TRA.