Health Promotion Perspectives
Volume:2 Issue: 2, Dec 2012

As the effects of demographic transition are realised around the world، many in-dustrial societies are facing the effects of a baby boom generation، increased life expectancies، decreased birth rates and recent changes to retirement legislation with the result that older work ers are set to comprise a greater proportion of the labour force. This paper reviews the evidence for the physical and cognitive factors that characterise an ageing workforce in manufacturing. From an ergonomics and human factors (E/HF) pers pective، characteristics of manufacturing tasks and the effects of ageing provide an insight into how the industry will have to adapt to support the user needs of the older worker in the future. The approach taken is drawn from Ilmarinen’s framework of age، experience، and work performance، from which specific E/HF issues are explored. There would appear to potential to support physical decline in older workers within manufacturing jobs through increased mechanisation and automation; however، those factors associated with cognitive human factors are less clear. Increased mechanisation and automation can place greater loads and demands on the older worker where cognitive decline is more subtle and varied between workers. Using historical and contemporary findings and the relationship between age، experience، and work performance is redrawn to include both cognitive skills and physical attributes to provide recommendations for future job design and worker needs.

The workshop that this paper reports, held in Iran in May of 2011, at the 1st Interna tional and 4th National Congress on Health Education and Promotion, had three main objec tives: 1) to introduce participants to the knowledge translation (KT) concept, along with its models and methods; 2) to enhance participants’ knowledge of how KT could apply to public health education and promotion; and 3) to learn from different participating stakeholder groups about the factors that facilitate or impede effective KT in public health education and promotion in Iran. The workshop consisted of three components: introducing the KT concept, assessing the KT capacity of participants, and facilitating a discussion of the important contextual factors that promote and impede effective KT. Of the 26 individuals from across the country participat ing in the workshop, 17 took part in a KT capacity assessment activity. They classified them selves into one of the following three stakeholder groups: administrators and policymakers (n=6), practitioners (n=2), and researchers (n=9). There were different capacities for KT across the three stakeholder groups. The re-ported challenges for effective KT include “lack of resources and funding”; “lack of time”; “poor quality of relationships and lack of trust between health policymakers, administrators, re-searchers, and clinicians”; “inadequate skills possessed by healthcare professionals and adminis-trators for assessment and adaptation of research findings”; and “poor involvement of commu-nity partners in the research process.” There is a great need to develop effective strategies to overcome the reported barri ers for effective KT.

People''s behaviors and intentions about healthy behaviors depend on their beliefs, values, and knowledge about the issue. Various models of health education are used in deter mining predictors of different healthy behaviors but their efficacy in cultural behaviors, such as water saving behaviors, are not studied. The study was conducted to explain water saving beha viors in Yazd, Iran on the basis of Health Belief Model and Reasoned Action Theory. The cross-sectional study used random cluster sampling to recruit 200 heads of households to collect the data. The survey questionnaire was tested for its content validity and reliability. Analysis of data included descriptive statistics, simple correlation, hierarchical multiple regression. Simple correlations between water saving behaviors and Reasoned Action Theory and Health Belief Model constructs were statistically significant. Health Belief Model and Reasoned Action Theory constructs explained 20.80% and 8.40% of the variances in water saving beha-viors, respectively. Perceived barriers were the strongest Predictor. Additionally, there was a sta tistically positive correlation between water saving behaviors and intention. In designing interventions aimed at water waste prevention, barriers of water saving behaviors should be addressed first, followed by people''s attitude towards water saving. Health Belief Model constructs, with the exception of perceived severity and benefits, is more powerful than is Reasoned Action Theory in predicting water saving behavior and may be used as a framework for educational interventions aimed at improving water saving behaviors. Key words: Predictor, water saving behaviors, Health Belief Model, Reasoned Action Theory

This study was conducted to assess the nutritional status in Iranian major depres sive disorder patients. We also determined the relationship between nutrients intake with depres sion severity. Seventy major depressive patients were selected randomly from outpatient depressive subjects, referred to Razi Psychiatry Hospital in Tabriz, Iran in 2007. Dietary intakes were rec orded and compared with dietary reference intakes (DRIs). Definition of the disease and its se verity were according to DSM-IV-TR and Hamilton Depression Rating Scale, respectively. Nu tritionist III program, Chi-square, correlation and t-test were used for data analyses. Demo graphic, clinical and laboratory data were analyzed using SPSS software for windows (ver sion13.0). According to dietary analysis, 11.4% and 55% of patients had dietary protein and energy deficiency, respectively. 97.1% and 95.7% of patients had less folate and B12 intakes than recom mended dietary allowances. The mean (Mean ± SD) for plasma folate and B12 was 5.18±6.11 ng/ml and 389.05±346.9 pg/ml, respectively. Low plasma folate and B12 was observed in 51.4% and 50.0 % of patients, respectively. There was no significant relationship between blood folate and B12 levels with depression severity. Similarly, nutrients intake had no effect on depression se verity. Low plasma concentrations and low dietary intakes of folate and B12 are common among Tabrizian depressive patients. It seems that nutritional intervention for increasing folate and vitamin B12 intake must be considered as health promotive and preventative program for patients suffering from depression disorders.

Prescription drug abuse in Southwest Virginia is a serious problem affecting indi-viduals, families, and communities. The aim of this study was to characterize and understand the extent of the prescription drug abuse problem in Southwest, Virginia as well as the dynamics that surround that abuse. More specifically, the study focused on learning the extent of the problem along with which prescription drugs are typically used prior to entering treatment, reasons for prescription drug and methadone abuse, and the sources for prescription drug use, misuse and abuse. Mixed methodology was employed which included surveying methadone clinic con-sumers at two treatment clinics in Southwest, Virginia and seven focus field interviews of key community stakeholders. The extent of prescription drug abuse is high and that the demographics of prescription drug users are getting younger and now involve more males than females. Oxycodone, hydroco done, methadone, and morphine were the most commonly used drugs prior to enrollment in the clinics with over one-half of methadone-maintained consumers reporting that they had abused benzodiazepines along with opioids. Focus groups and clinic consumer data highlighted the key etiological factors in prescription drug abuse: use (due to workforce related injuries) turning to abuse, wanting to get high, overprescribing and physician issues, lack of information, and cultural acceptance of drug taking as problem solving behavior. The two most common sources for the abused prescription drugs were physicians and street dealers. A constellation of conditions have led to the epidemic of prescription drug abuse in Southwest Virginia, including poverty, unemployment and work-related injuries, besides, public health education programs on the dangers of prescription opiate misuse and abuse are urgently needed.

The issue of knowledge on school backpacks among parents has received little attention. The objectives of this study were to assess school backpack carriage and its consistency with parents’ knowledge about children friendly school backpacks. This was a randomized cross-sectional study. Totally 307 elementary school children and 250 parents were recruited to assess parental knowledge about standard school backpacks in 2010. Data collection were carried out on an unscheduled day in order to, children and their par ents prepared school backpacks based on their own previous habits and behaviors. All statistical analyses were performed using version 16.0 of the statistical software package SPSS Approximately, 132 (51.6%) of the parents were not aware of the recommended weight limit for carrying school backpacks and 144 (56.3%) were not aware that the size of the backpack must be proportionate to the upper back region. Significant difference was found for the mean score of awareness of a safe and standard school backpack between fathers and mothers: fathers had more knowledge about school backpack carriages in comparison with mothers (P<0.001). Children, parents and teachers should be educated about the characteristics of a standard backpack, different strategies. Parents are the best advocates for safety promotion and should represent the group most likely to help to significantly reduce backpack related injuries among school children by selecting safe school backpacks, supervising school backpack carrying and checking backpack weights.

Considering the significant role of consumers’ awareness about food labels in making healthy food choices, this study was designed to assess the knowledge, attitude and prac tice of university students about food labeling. In this cross-sectional study, 332 students aged 18-25 yr in five different academic majors (including Nutrition, Public Health, Health Services Administration, Paramedical and En gineering) were asked to complete an approved questionnaire contained fifteen questions. The chi-square test was applied to examine the differences across various major groups. 89.2% of the students believed that food labels had effect on nutritional awareness. 77.4% were agreed with the usefulness of the food labels and 79.2% did not feel that nutrition claims on food label were truthful. For 84% of students, the expiry date and storage conditions information were the most important informational cues to appear on the food labels. From 47.6% of students who reported the use of nutrition facts label in their often or always shopping; only 32.3% used the information on labels to fit the food into their daily diet. Surprisingly, fatty acids were the least noteworthy items (1.9%) on nutrition facts labels. Regarding students’ major, there was significant difference in their knowledge, attitude and practice about truth of the nutri tion claims, using food labels and importance of health claims (P<0.05). Food labels were more useful tools for students and had an effect on their nutri-tional awareness. Designing and implementation of the educational programs in order to increase the level of knowledge about food labels is suggested.

Vitamin A deficiency is an important dietary deficiency in the world. Thus, the ne cessity of screening for deficient populations is obvious. This paper introduces a fast, cheap and relatively reliable method called “dried blood spot” (DBS) method in screening the deficient populations. The validity of this method for retinol measurement was investigated. The “precision” and “agreement” criteria of the DBS method were assessed. The preci sion was calculated and compared with those of plasma using F-test. The agreement was eva luated using Bland-Altman plot. The imprecision of retinol measurements in dried spots was not significantly different from those of the control (plasma). A good correlation coefficient (r2=0.78) was obtained for dried spots’ retinol measurements versus plasma’s retinol analysis (P < 0.01). Paired t-test showed no significant difference between the DBS and retinol methods on a group level. Imprecision of DBS measurement was acceptable, compared to that of the plasma method. The difference be tween these two methods was not statistically significant on a group level. Application of DBS standard samples, in which a part of the plasma was replaced with the artificial plasma, was shown to be a reliable calibration mean for retinol measurements in DBS samples. Retinol in dried spots was stable for 90 days. Overall, the DBS method provided a precise measurement of retinol, showing results that were comparable with the measurement of retinol in plasma.

Employees can be counseled on how they feel about their job. If any particular dimension of their job is causing them dissatisfaction, they can be assisted to appropriately change it. In this study, we investigated the factors affecting job satisfaction from the perspective of employees working in the health system and thereby a quantitative measure of job satisfaction. Using eight focus group discussions (n=70), factors affecting job satisfaction of the employees were discussed. The factors identified from literature review were categorized in four groups: structural and managerial, social, work in it-self, environmental and welfare factors. The findings confirmed the significance of structural and managerial, social, work in it-self, environmental and welfare factors in the level of job satisfaction. In addition, a new factor related to individual characteristics such as employee personal characteristics and development was identified. In order to improve the quality and productivity of work, besides, structural and managerial, social, work in it-self, environmental and welfare factors, policy makers should be taken into account individual characteristics of the employee as a factor affecting job satisfaction.

Polycystic ovary syndrome (PCOS) is a common endocrine disorder associated with increased risk of cardiovascular disease. The purpose of this study was to investigate the ef fects of omega-3 fatty acids on serum paraoxonase 1 activity and lipids ratios in polycystic ovary syndrome. This double-blind randomized controlled clinical trial was conducted on 64 PCOS pa tients with 20-35 years old. Thirty two of the subjects had taken 4 g/day omega -3 fatty acids and 32 patients were given placebo for 8 weeks. Fasting blood samples, anthropometric measure ments and dietary intakes were collected at the beginning and the end of the study. Serum total cholesterol, triglyceride, and HDL-C were measured using the enzymatic methods. LDL-C con centration was calculated by the Friedewald formula and arylesterase activity of serum PON1 was measured. Data were analyzed using SPSS software. Omega-3 fatty acids significantly decreased TC/HDL-C and LDL-C/HDL-C ratios (P = 0.009 for both) and significantly increased serum PON1 activity (P = 0.048) compared with placebo. Changes in TG/HDL-C ratio were not statistically significant in omega-3 fatty acids group at the end of the study in comparison to placebo group. Reduction in TC/HDL-C, LDL-C/HDL-C and TG/HDL-C ratios and increase in serum PON1 activity were also significant in omega-3 fatty acids group at the end of the study compared with baseline values (P <0.001, P < 0.001, P = 0.004, and P = 0.001, respectively). Omega-3 fatty acids may decrease the risk for cardiovascular disease through the improvement in paraxonase-1 activity and reduction in some lipids ratio in PCOS women.

The main objective of this study was characterization of selected heavy metals concentrations (Lead, cadmium, copper, zinc, nickel and chromium) in groundwater used for ir-rigation in Tabriz City''s countryside. After consulting with the experts of agriculture department and site survey, 38 irriga-tion water samples were taken from different farms (34 wells) without primary coordination with farm owners. All of samples were acidified to achieve pH≈2 and then were concentrated from 10 to 1 volume. The concentrations of Cd, Pb, Cu, Cr, Ni, and Zn in the samples (totally 228) were determined with a flame atomic absorption spectrophotometer. In none of 38 farms, irrigation with surface runoff and industrial wastewater was ob-served. The average concentrations of Cd, Pb, Cu, Cr, Ni, and Zn in the irrigated water were de termined 6.55, 0.79, 16.23, 3.41, 4.49, and 49.33µg/L, respectively. The average and even maxi mum concentrations of heavy metals in the irrigation water at the studied area were less than toxicity threshold limits of agricultural water. Currently, not using of surface runoff and industrial wastewater as irrigation water by farmers indicates that the controlling efforts by authorities have been effective in the area. Water used for irrigation of the farms and groundwater of the studied area are not polluted with heavy metals and there is no risk from this viewpoint in the region.

Abnormal homeostasis of iron such as deficiency or overload is associated with the pathogenesis of cardiovascular disease (CVD). Another risk factor for CVD is obesity whose added predictive ability to iron status has been assessed by few study. This study aimed to eva luate the effect of adding anthropometric indices to a model based on iron status as risk factors of CVD. This cross-sectional study included 140 adult women aged 18-50 years randomly se-lected from Sheikhorrais Clinic that is one of the Tabriz University sub-specialized clinics in 2011. Anthropometric indices, carotid intima-media thickness (CIMT) and body iron status were measured by standard protocol, non-invasive ultrasound and concentrations of serum iron, ferri tin, TIBC (Total iron Binding Capacity) and complete blood cell counts (CBC), respectively. In tegrated discriminatory improvement index (IDI) and net reclassification improvement index (NRI) were used as the measures of added predictive ability of anthropometric measures to the iron statues. IDI (SE) after adding Waist Circumference (WC), Waist to Heap Ratio (WHR), Waist to Height Ratio (WHtR), Body Mass Index (BMI) and Body fat (%) to base model was 0.12 (0.028), 0.09 (0.026), 0.12 (0.028), 0.07 (0.022) and 0.10 (0.026) respectively. The NRI (SE) was 0.10 (0.065) for WC, 0.03 (0.058) for WHR, 0.07 (0.067) for WHtR, 0.05 (0.067) for BMI, and 0.08 (0.064) for Body fat. Anthropometric indices could significantly add to the predictive ability of the iron statues, with highest IDI when WC and WHtR were added to the base model. It suggests that by adding WC and WHtR to the iron status lead us to a more optimal model for predicting the ini tial stage of atherosclerosis.

The aims of this study were to determine the effect of different brewing times and diluting on oxalate content of loose-packed black teas consumed in Tabriz, Iran. The oxalate content of black teas after brewing for 5, 10, 15, 30, 60 minutes was measured in triplicate by enzymatic assay. In order to attain the most acceptable dilution of tea infusions, tea samples which were brewed for 15, 30 and 60 minutes were diluted two (120 ml), three (80 ml) and four (60 ml) times respectively. There was a stepwise increase in oxalate concentrations associated with increased brewing times (P< 0.001) with oxalate contents ranging from 4.4 mg/240 ml for the 5 min to 6.3 mg/240 ml for 60 min brewing times, respectively. There were significant differences between the mean oxalate content of different dilutions after brewing for 15, 30 and 60 minutes (P< 0.001). The oxalate content of Iranian consumed black tea after different brewing times and different dilution was below the recommended levels. Therefore, it seems that consumption of black tea several times per day would not pose significant health risk in kidney stone patients and susceptible individuals.

Managers in the hospital should have enough managerial skill to be coordinated with the complex environment. Defining a competency framework assessment for hospital man-agement will help to establish core competencies for hospital managers. The aim of this study was to develop concrete and suitable performance assessment criteria using expert''s view. In this qualitative study in total, 20 professionals participated in the interview and Fo cus Group Discussions (FGD). Two of informants were interviewed and 18 professionals par ticipants in three focus group discussions. Discussions and interviews were well planned, the FGD environments were suitable and after interviews completion the notes were checked with participant for completeness. Thematic analysis method was used for the analysis of qualitative data. Findings from 3 FGDs and 2 semi structured interviews done with 20 professionals were categorized accordance to themes. The findings were classified in 7 major and 41 sub themes. The major themes include competency related to planning, organization and staff per-formance management, leadership, information management, and clinical governance and per-formance indicators. All participants had hospital administration experience; so their explanation impor tant in identifying the criteria and developing hospital managers’ performance assessment tool. In addition to professional perspectives and studies done in other countries, in order to design this kind of tools, it is necessary to adopt the obtained findings to the local hospital conditions.

The objective of the current study was to assess the effects of royal jelly supple-mentation on body weight, total daily energy and macronutrients intakes in type2 diabetic fe-males. In this randomized clinical trial, fifty female volunteers with type2 diabetes were as-signed into the supplemented (n=25) and placebo (n=25) groups, given a daily dose of 1000 mg royal jelly soft gel or placebo, for 8 weeks, respectively. Before and after the intervention, body weight and height of subjects were measured and body mass index was calculated. Dietary intake of patients was assessed using 24-hour food recall questionnaire for three non consecutive days (including 1 weekend day) and analyzed with Nutritionist IV software. The normally distributed data were compared using paired and independent t-tests, where appropriate. Royal jelly supplementation significantly (P<0.01) decreased the mean body weight (72.45±4.42 vs. 71.00±6.44 kg) while it increased insignificantly in placebo group (73.02±6.44 vs 73.52±6.80 kg). Royal jelly supplementation resulted in significant decrease of mean daily total energy (P<0.01) and carbohydrate (P<0.01) intakes, while in placebo group the mean daily total energy and fat intakes were increased significantly (P<0.05). Supplementation with royal jelly may be beneficial in weight management of di-abetic patients.

The objective of this research was to investigate the kinetic behavior of the biofil tration process for the removal of styrene. A three stage compost based biofilter was inoculated with thickened activated sludge. The reaction order rate constants were obtained from continuous experiments and used as the specific growth rate for the Monod equation. The measured concentration profiles show a linear dependence on the bed height in the biofilter at higher loadings, such as 75 and 45 g m-3 h-1. This is the condition of reaction limitation for a reaction with zero-order kinetics. From the experimental data, maximum elimination capac ity (ECmax) was estimated to be 44, 40 and 26 g m-3 h-1 at empty bed retention times (EBRTs) of 120, 60 and 30 s, respectively. However, at lower loadings, the measured concentration profile of the biofilter is one of exponential increase, which is the condition of both reaction and diffusion limitations for a reaction with zero-order kinetics. Maximum elimination capacities found from the experimental results were the same as Monod model predictions. Both the experimental re sults and the model predictions showed the influence of EBRT on the removal rate of styrene, particularly for the highest loading rate. In terms of the practical applications of the proposed models have the advantage of being simpler than Monod kinetics and Monod kinetics requires a numerical solution.

Vegetables play an important role in human nutrition. Nitrate content is a signifi-cant quality criterion to determine characteristic of vegetables. About 80% of nitrate intake in human is from vegetables and fruits. High dietary intake of nitrate is seen as an undesirable be-cause of its association with gastric cancer and infantile methemoglobinemia. Varzeghan, North western Iran is one of the cities with high Age-standardized incidence rates (ASR) of gastric can cer in Iran. Currently, in Varzeghan there is no available and accurate information describing ni trate concentration as one of the important risk factors of vegetables for human consumption. In this cross sectional study totally 11 types of vegetables (cabbage, lettuce, spinach, parsley, coriander, dill, leek, fenugreek, tarragon, fumitory and mint) from several different green grocery of Varzeghan were collected in spring (April) and autumn (November and December) 2011 and their nitrate contents were analyzed. Mean nitrate contents at the above noted fresh vegetables were 161, 781, 83, 707, 441, 501, 1702, 684, 805, 772 and 191 mg NO3-kg-1 respectively. In none of the 11 fresh vegetables nitrate content were not more than established limitations. Nitrate concentrations were below of others reported at different countries. The mean concentration of nitrate at all vegetables in autumn was higher than in spring significantly.

The present study was conducted to scrutinize Public- Private Partnership (PPP) models in public hospitals of different countries based on performance indicators in order to se-lect appropriated models for Iran hospitals. In this mixed (quantitative-qualitative) study, systematic review and expert panel has been done to identify varied models of PPP as well as performance indicators. In the second step we prioritized performance indicator and PPP models based on selected performance indicators by Analytical Hierarchy process (AHP) technique. The data were analyzed by Excel 2007 and Expert Choice11 software’s. In quality – effectiveness area, indicators like the rate of hospital infections (100%), hospital accidents prevalence rate (73%), pure rate of hospital mortality (63%), patient satisfaction percentage (53%), in accessibility equity area indicators such as average inpatient waiting time (100%) and average outpatient waiting time (74%), and in financial – efficiency area, indicators including average length of stay (100%), bed occupation ratio (99%), specific income to total cost ratio (97%) have been chosen to be the most key performance indicators. In the pri oritization of the PPP models clinical outsourcing, management, privatization, BOO (build, own, operate) and non-clinical outsourcing models, achieved high priority for various performance in dicator areas. This study had been provided the most common PPP options in the field of public hospitals and had gathered suitable evidences from experts for choosing appropriate PPP option for public hospitals. Effect of private sector presence in public hospital performance, based on which PPP options undertaken, will be different.

Carpet weaving operations usualy involve poor working conditions that can lead to the development of musculoskeletal disorders (MSDs). This study investigated MSDs among car pet weavers in relation to working conditions from workers'' view in Tabriz City, Northwest Iran. This cross-sectional and descriptive study was conducted in city of Tabriz, Iran. Data were col lected using interviews and questionnaires. The study population consisted of 200 randomly selected healthy weavers from twenty five active carpet weaving workshops. The results showed a high prevalence of musculoskeletal problems among the study population. The most commonly affected body areas were neck, lower back, ankles/feet, hands/wrists, upper back, shoulders and knees, respectively. More than half of the weavers were not satisfied with the thermal con dition, noise level and cleanliness of the air in the workshops. The result indicated a significant relation ship between upper back symptoms and daily working time and between lower back symptoms and the numbers of rows of knots woven in a day. Weavers'' satisfaction with hand tools shape and thermal condi tion of the workshops were associated with lower back symptoms, whereas satisfaction with weaving looms were associated with upper back complaints. The poor working condition of hand-woven carpet workshops such as environmental con ditions and work station design and tools should be the subject of ergonomics interventions.

There is little information on the detailed patterns of cervical screening uptake in older migrant women in Australia. This linkage study was performed to assess cervical screening participation in older migrants. We linked year 2000-2001 records for 14,228 Middle Eastern/Asian-born women 40-64 years of age, and an age and area matched random sample of 13,939 Australian-born women in the New South Wales (NSW) Admitted Patients Data Collection (APDC), which records country of birth, to screening register records. Screening behaviour after 1st July 2001 was assessed in women without a recorded prior cervical abnormality Compared to Australian-born women, women born in South Central Asia had a lower screening participation rate (odds ratio for being screened at least once within a 3 year period 0.78, 95% CI 0.70-0.88). However, participation appeared relatively higher (17%-25%) in women born in the Middle East or other parts of Asia. Screening increased with increasing socioeconomic status (SES) in Australian-born women, but this trend was not observed in the migrant women. When we broadly corrected for hysterectomy, the apparent excess of screening in women from the Middle East and other parts of Asia was substantially eliminated and in contrast, the apparent deficiency in screening in women from South Central Asia increased. Older women from the Middle East, and North East and South East Asian countries appeared to have similar overall screening participation to that of Australian-born women. Women from South Central Asia appeared less likely than Australian-born women to participate in cervical screening at the recommended interval.

Iran started a new public-private partnership model in form of health coopera tives which is somehow different from other types of health cooperatives throughout the world. In this study we compared the performance and quality of health services in public health cen ters (PHCs) and cooperative health centers (CHCs). In this comparative study performance quality of two cohorts of public and coopera tive health centers were compared in several health service delivery programs over the time pe riod of 2001- 2002. Screening program: the rate of visited population during screening program was higher in CHCs. Maternal health care program: In some of studied programs CHCs had better results. Child health care: Most indicators were better or similar in CHCs. School health program and Health education: All indices were better or similar in CHCs. Environmental health: population based positive function was not significantly different for the population covered by CHCs compared to population covered by PHCs. Management: Client and staff satisfaction as well as participation and attitudes of personnel towards management was better in CHCs. Mean annual cost per capita of the covered population by PHCs was higher. CHCs as a public private partnership model in Iran may deliver preventive health care services as effective as PHCs in many fields and even better in some areas.