Journal of Education and Health Promotion

Abstract BACKGROUND: Coronavirus disease‑2019 (COVID‑19) pandemic can aggravate the health
problems in slum areas. The present study intends to examine the challenges of health protection of
slum’s residences during the COVID‑19 pandemic with the Social Determinants of Health perspective,
in Kerman city in Iran.
MATERIALS AND METHODS: The present study was a qualitative content analysis. Data were
collected by purposeful sampling in‑depth and semi‑structured interviews with 16 people. The
interviews were conducted (from October to December 2020) with the local representatives of the
slum’s residents, health‑care workers, managers of facilitation offices, and welfare social service
centers that are located in slum areas (Interview’s guide is attached). The textual material from
the interviews was entered into the MAXQDA software and directed content analysis was used to
analyze the data.
RESULTS: Data analysis led to the identification of 4 categories (Sociocultural, Situational,
Economical, and Physical environment) and 12 subcategories: Sociocultural: lack of awareness,
begging culture, low trust in disease control programs, low bottom‑up planning, and increasing
violence; Situational: decreasing donors’ activities and canceling important meetings; Economical:
unemployment, decreasing in income, and increasing limitations of many institutions in providing
resources; and Physical environment: inadequate space and inappropriate conditions in some houses
and alleys for people protection against Corona viruses.
CONCLUSIONS: Slum residents have faced many challenges during the COVID‑19 pandemic.
These challenges can affect the health of slum and other urban dwellers. Multidisciplinary thinking
and actions are needed. Increase awareness and engagement slum residents in control disease
programs should be considered.

Abstract BACKGROUND AND AIM: Some people exposed to disasters will suffer from acute stress
disorder (ASD) due to the negative consequences of these disasters. Evaluating this disorder at a
large scale requires a credible and standardized tool. Therefore, the current study aims to investigate
the psychometric properties of the ASD questionnaire for people exposed to Kerman earthquake.
METHODS: This is a descriptive‑tooling study, conducted on 435 men and women older than 18 years
living in earthquake‑affected areas of Kerman Province (Kouh‑e‑Banan). The study was carried out
using the Persian translating of the English version of the Diagnostic and Statistical Manual of Mental
Disorders, Fifth Edition ASD questionnaire on accessible individuals living in temporary residence
tents in two initial and final stages and different stages of validity and reliability evaluation was carried
out. The findings were analyzed using descriptive statistics and Pearson’s correlation coefficient.
RESULTS: During the evaluation of content validity, no questions were eliminated. To carry out
factor analysis, sampling competence, and suitability of sample size were confirmed through
Kaiser–Meyer–Olkin and Bartlett’s tests. In the factor analysis stage, 14 items in three factors were
defined. The factors were included reexperiencing and analysis, arousal (continuous irritability), and
avoidance factors which together explained 59.43% of percentage distribution. In the next stage
of evaluating divergent validity, the results indicated a significant and inverse correlation between
ASD score and quality of life score (r = −0.43, P = 0.002) of the participants, while there was also
a positive and significant correlation between ASD score and general health disorder score of
the participants (r = 0.47, P < 0.0001). The reliability of the questionnaire was investigated using
Cronbach’s alpha, and inner class correlation coefficient was calculated to be 0.9.
CONCLUSIONS: The tool investigated in this study has suitable validity and reliability and is effective
for use by psychologists and relief workers for necessary interventions and prevention of ASD in
disasters.

Abstract INTRODUCTION: Health services utilization is a complex behavioral phenomenon affected by
multiple factors including availability, distance, cost and quality of health services as well as personal
attitudes, cultural beliefs, and socioeconomic characteristics. This study aimed to assess the status
of health‑care utilization among dwellers of slums in one of the Iran’s big cities.
METHODS: This was a cross‑sectional study in which 559 slums people were selected using a
random clustered sampling method. Data on health services utilization were collected using health
equity assessment and response tool questionnaire. Data analysis was performed using descriptive
statistics and logistic regression analysis through SPSS ver. 22.
RESULTS: In this study, 42.5% (238) people who required outpatient services. 21% (118) of them
were able to use them. Furthermore, among the families, who needed outpatient services during the
past month, 15% (38) were able to use the services for at least once. Regarding inpatient services,
62% (349) of people needed hospitalization, of which 31% (175) were able to be hospitalized.
Age (P = 0.2), gender (P = 0 <001), marital status (P = 0 <001), income status (P = 0.1), and
education (P = 0.21) determined utilization of outpatient services; however, inpatient services
utilization was affected by age (P = 0.03), gender (P = 0.02), marital status (P = 0 <001), and income
status (P = 0.32). The final model of multiple regression showed that, there was a relationship between
age (odds ratio [OR] =1.7, confidence interval [CI] 95% = 0.47–0.88), marital status (OR = 2.78, CI
95% = 0.64–1.2), and the use of inpatient services.
CONCLUSION: The utilization of health services in slum areas is not desirable. As it was showed
that the utilization of health services in slums people is a multifactorial event; thus, proper planning
and policy for this increasingly demand are essential.

Abstract BACKGROUND: Young people’s attitudes toward marriage have been undergone changes in
recent years and it seems to be contradicting in the struggle between conservative and modern
liberal attitudes. The purpose of this study was to evaluate the attitude of new grooms toward intact
hymen in Kerman.
MATERIALS AND METHODS: This cross‑sectional study has been conducted on 790 new grooms
in Kerman, Iran. In this study, we examined the attitudes in two aspects of sexual norm and personal
attitude toward premarital relationships in new grooms. The sampling method was purposive sampling
and the data were analyzed using t‑test and analysis of variance.
RESULTS: The results of this study have showed a more conservative sexual attitude toward
the sexual norms of premarital sex. The average score of the participants in the sexual norm and
personal attitude was, respectively 15.86 and 48.15, indicating that their conservative views have
been overcome. Most of the samples (90%) have believed in required preserving virginity before
marriage, and 82% believed in virginity as the most valuable asset of the girls. In this study, the
conservative attitudes of men were inversely related with their age and were directly related with
perceived sexual norm and the level of affinity to religious affairs.
CONCLUSION: According to the results of this study, conservative attitudes toward premarital
relationships are predominating in new grooms, but this is not generalized. The conservative attitude
of new grooms may have harmful effects on their interpersonal behaviors after marriage, which
requires purposeful training.

Abstract Introduction: The increasing trend in waste production and its improper disposal in the
environment have led to mismanagement of national resources and hazards to the natural
environment. Therefore the recycling of solid waste can help prevent economic and
bioenvironmental disasters. The aim of this study was to evaluate the health literacy of the
student of the Kerman Public Health School, about the management and recycling of solid
waste. Methods: This was a cross-sectional study and the target population was all of the
students of the Kerman Public Health School (421 students), in five fields. A questionnaire
including demographic and health literacy questions was distributed among the students.
Results: The male students answered the questions significantly more than female students
(P < 0.001). The Environmental Health students acquired a higher score than all other
students and health literacy significantly increased as the student’s studying degree promoted
(P < 0.001). Also as the number of trimesters increased, health literacy significantly increased
(P < 0.001). The parents’ education, the family income and number of people in the family had
no significant effect on health literacy. All students believed recycling is important and more than
50% had acquired their knowledge from their academics. Conclusion: This survey showed that
students in health related fields although confirm its necessity, but need more education in health
literacy as they are supposed to be the promoters of public health in the society in the near future.

Abstract Background: The increasing trend in waste production and its improper disposal in the environment
have led to mismanagement of national resources and hazards to the natural environment.
Therefore, the recycling of solid waste can help prevent economic and bio‑environmental disasters.
The aim of this study was to evaluate the health literacy of the students of the Kerman Public Health
School about the management and recycling of solid waste. Materials and Methods: This was a
cross‑sectional study and the target population was all of the students of the Kerman Public Health
School (421 students) in five fields. A questionnaire including demographic and health literacy
questions was distributed among the students. Results: The male students answered the questions
significantly more than female students (P<0.001). The Environmental Health students acquired
a higher score than all other students and health literacy significantly increased as the student’s
studying degree promoted (P<0.001). Also, as the number of trimesters increased, health literacy
significantly increased (P<0.001). The parents’ education, the family income, and number of people
in the family had no significant effect on health literacy. All students believed recycling is important
and more than 50% had acquired their knowledge from their academics. Conclusion: This survey
showed that although students in health‑related fields confirm the necessity of recycling solid waste,
they still need more education in health literacy as they are supposed to be the promoters of public
health in the society in the near future.