Document Type : Original Article

Authors

Social Determinants of Health Research Center, Isfahan University of Medical Sciences, Isfahan, Iran

Abstract

BACKGROUND AND AIM: Considering the important role of universities in advancing educational,
social, cultural, economic, and political affairs and given the significant and effective role of social
determinants of health (SDH) in personal and social life, this study aimed to design a preliminary
questionnaire to assess the awareness and attitude of students and professors of relevant medical
sciences departments toward the SDH.
METHODS: This is a descriptive survey study of the instrumentation type and is done on the
students and professors of Isfahan and Kashan medical sciences universities in 2019. The
content and face validity of the questionnaire were assessed. Cronbach’s alpha coefficient and
the correlation coefficient for each question as well as the total score of the questionnaire were
reported for this attitude measurement questionnaire. The difficulty coefficient, optimum difficulty
level, discrimination coefficient, and the relevant variance were calculated for every question in the
awareness measurement questionnaire.
RESULTS: The internal consistency of the questionnaire for the awareness toward the SDH for 15
questions was 0.742. This consistency was acceptable for 18 questions in the attitude measurement
questionnaire after omitting two questions with not appropriate distinguishing ability. The difficulty
level of the questions was relatively high.
CONCLUSION: Given that no tool was observed in the search strategy to measure the SDH,
therefore, the design and psychometrics of such a tool can be used to measure the awareness and
attitude of the target audiences; since this tool had an acceptable validity and reliability at its initial
stages, researchers are suggested to apply it for standardization in different academic societies.

Keywords

1. Lucyk K, McLaren L. Taking stock of the social determinants of
health: A scoping review. PLoS One 2017;12:e0177306.
2. Solar O, Irwin A. A conceptual framework for action on the social
determinants of health. Social Determinants of Health Discussion
Paper 2 (Policy and Practice). ISBN 978 92 4 150085 2 and
73 pages. Available from: https://www.who.int/sdhconference/
resources/ConceptualframeworkforactiononSDH_eng.pdf. [Last
accessed on 2020 Jan 31].
3. Islam MM. Social determinants of health and related inequalities:
Confusion and implications. Front Public Health 2019;7:11.
4. CSDH. Closing the Gap in a Generation: Health Equity through
Action on the Social Determinants of Health. Final Report of the
Commission on Social Determinants of Health. Geneva: World
Health Organization; 2008.
5. Hunter K, Thomson B. A scoping review of social determinants
of health curricula in post‑graduate medical education. Can Med
Educ J 2019;10:e61‑71.
6. Andermann A, CLEAR Collaboration. Taking action on the social
determinants of health in clinical practice: A framework for health
professionals. CMAJ 2016;188:E474‑83.
7. Afeiche M, Peterson KE, Sánchez BN, Schnaas L, Cantonwine D,
Ettinger AS, et al. Windows of lead exposure sensitivity,
attained height, and body mass index at 48 months. J Pediatr
2012;160:1044‑9.
8. Lidsky TI, Schneider JS. Lead neurotoxicity in children: Basic
mechanisms and clinical correlates. Brain 2003;126:5‑19.
9. Lanphear BP, Kahn RS, Berger O, Auinger P, Bortnick SM,
Nahhas RW. Contribution of residential exposures to asthma in
us children and adolescents. Pediatrics 2001;107:E98.
10. An K, Salyer J, Brown RE, Kao HF, Starkweather A, Shim I.
Salivary biomarkers of chronic psychosocial stress and CVD risks:
A systematic review. Biol Res Nurs 2016;18:241‑63.
11. BingenheimerJB, Brennan RT, Earls FJ. Firearm violence exposure
and serious violent behavior. Science 2005;308:1323‑6.
12. Pollack CE, Cubbin C, Ahn D, Winkleby M. Neighbourhood
deprivation and alcohol consumption: Does the availability of
alcohol play a role? Int J Epidemiol 2005;34:772‑80.
13. Marco CA, Wolfson AR, Sparling M, Azuaje A. Family
socioeconomic status and sleep patterns of young adolescents.
Behav Sleep Med 2011;10:70‑80.
14. Gordon‑Larsen P, Nelson MC, Page P, Popkin BM. Inequality in
the built environment underlies key health disparities in physical
activity and obesity. Pediatrics 2006;117:417‑24.
15. Cummins S, Macintyre S. Food environments and
obesity‑neighbourhood or nation? Int J Epidemiol 2006;35:100‑4.
16. Matthews KA, Gallo LC, Taylor SE. Are psychosocial factors
mediators of socioeconomic status and health connections? A
progress report and blueprint for the future. Ann N Y Acad Sci
2010;1186:146‑73.
17. Evans GW, Schamberg MA. Childhood poverty, chronic
stress, and adult working memory. Proc Natl Acad Sci U S A
2009;106:6545‑9.1.
18. Chuang YC, Cubbin C, Ahn D, Winkleby MA. Effects of
neighbourhood socioeconomic status and convenience store
concentration on individual level smoking. J Epidemiol
Community Health 2005;59:568‑73.
19. Aluko OO, Adebayo AE, Adebisi TF, Ewegbemi MK, Abidoye AT,
Popoola BF. Knowledge, attitudes and perceptions of occupational
hazards and safety practices in Nigerian healthcare workers. BMC
Res Notes 2016;9:71.
20. Hu P, Huang W, Bai R, Zhang F, Sharma M, Shi Z, et al.
Knowledge, attitude, and behaviors related to eating out among
university students in China. Int J Environ Res Public Health
2016;13. pii: E696.
21. El‑Nmer F, Salama AA, Elhawary D. Nutritional knowledge,
attitude, and practice of parents and its impact on growth of their
children. Menoufia Med J 2014;27:612‑6.
22. Al‑Haqwi AI, Tamim H, Asery A. Knowledge, attitude and
practice of tobacco smoking by medical students in Riyadh, Saudi
Arabia. Ann Thorac Med 2010;5:145‑8.
23. Soleymani L, Najafpour Boushehri S, Tahmasbi R. Knowledge,
attitude and practice declaration of elderly in Ahram city toward
nutrition behavior in 2013. Iran South Med J 2015;18:370‑82.