masoumeh dejman

Currently, in addition to the undeniable impact of cultural factors on mental health problems’ diagnosis and treatment methods, the use of rapid, short, and intervention-based instruments can be effective in the accurate diagnosis of mental health problems, especially in the health system of developing countries.

This study aimed to validate an instrument developed for screening patients with common mental health problems using item response theory (IRT).

The study was conducted in Semnan province (with Persian ethnicity), Iran, from August 2017 to February 2018. A 101-item tool consisted of district common mental health problems (i.e., depression, anxiety, and obsession), along with a functional checklist. The development of the instrument involved a pilot study and psychometric testing. The IRT-based analysis was used as the item-reduction method to evaluate the shortened tool as an appropriate screening tool. The participants were healthy individuals and patients with depression, anxiety, and obsessive-compulsive disorder (OCD). The data were analyzed using Stata software (version 15.1).

The study participants were 160 individuals (58.2% male) with a mean age of 36.3 ± 11.2 years. All item impact factors were within the range of 1.8 - 5. The mean values of clarity, simplicity, relevance, and scale-level content validity index/averaging calculation method of the instrument were 96.73 ± 0.70, 97.64 ± 0.61, 98.2 ± 1.9, and 97.09 ± 0.63, respectively. Cronbach’s alpha and internal consistency coefficient were 0.88 and 0.7. Moreover, 13, 5, and 12 items were excluded using IRT from depression, anxiety, and OCD dimensions based on the threshold criteria, respectively.

Iranian screening tools for mental health problems can provide qualified information with the least error and the most precision in appropriate early diagnosis and decrease the burden of mental health problems in the national healthcare system.

The hot line services were developed in response to the perceived need for 24‑hour help services in crises ranging from suicide to unwanted pregnancy. This study is aimed at analyzing the strengths, weaknesses, challenges, and suggestions of improving the performance of the help centers from the perspective of key stakeholders.

We conducted a qualitative study to elicit the key informants’ opinion regarding the performance of Iranian hot‑lines. All the conversations were audio‑recorded with the permission of the participants. To reach the saturation limit, the number of interviews was completed in the saturation of data. Data was gathered from 15 individual in‑depth interviews. Collecting and analyses of data was based on content analysis through which simultaneously during texts open coding, main concepts were extracted and then in axial coding similar concepts were categorized.

According to the study results, there is no specific and independent system for assessing the hot‑ lines. One of the major weaknesses was the lack of standard protocols. Most participants believed that most of these guidelines came from the general principles of counseling and are not standard. As another point, the existence of referral services is one of the main problems of counseling lines. The most important suggestion from the majority of experts were the development of services and modification of their investments.

The findings, in addition to providing the applied data for policy‑making in the health system, will significantly contribute to the creation of scientific, technical, and skillful personnel in the community of researchers.

To test whether gender moderates the effects of baseline depressive symptoms and chronic medical conditions (CMCs) on risk of receiving subsequent psychiatric diagnosis among
older adults.

Data came from ten waves of the Health and Retirement Study, a nationally representative longitudinal study. We followed 9794 individuals older than 52 years without any diagnosed psychiatric disorder at baseline for up to 18 years. Baseline depressive symptoms and CMC were the predictors, time to receiving an emotional diagnosis was the outcome, baseline
demographics and socioeconomics were controls, and gender was the moderator. We used Cox proportional hazards models for data analysis.

In the pooled sample, female gender increased the effect of baseline depressive symptoms (hazard ratio [HR], 1.58; 95% confidence interval [CI], 1.26–2.00) and reduced the effect of baseline CMC (HR, 0.78; 95% CI, 0.63–0.97) on time to receiving a psychiatric diagnosis. Among men, baseline depressive symptoms (HR, 2.36; 95% CI, 1.87–2.97) increased and baseline CMC (HR, 0.81; 95% CI, 0.69–0.95) decreased time to receiving a psychiatric diagnosis. Among women, depressive symptoms (HR, 1.49; 95% CI,
1.21–1.83) but not CMC (HR, 1.06; 95% CI, 0.91–1.23) were associated with time to receiving a psychiatric diagnosis over time.

Men and women differ in how depressive symptoms and CMC influence their risk of receiving a psychiatric diagnosis over time. Depressive symptoms are more salient promotor for men than women while CMC is only a barrier for men.

To address the disproportionate burden of poor mental health among women, we present a community based participatory research (CBPR) model used to develop a women’s mental health promotion program for Iranian women.

This is a multi‑phase interventional study using a CBPR approach among married women age 18–65 living in Tehran. First, participants described the process of women’s mental health. Subsequent steps involved participatory needs assessment, priority setting, intervention design, and evaluation. Finally, a conceptual model of women’s mental health promotion was developed.

Seeking comfort” emerged as the core process in women’s mental health. To promote mental health, women prioritized training on coping mechanisms to deal with stress. Women receiving this training used more problem‑based coping methods and reported a higher quality of life than the comparison group.

The resulting conceptual model illustrates the utility of using a CBPR approach to develop women’s mental health promotion programs.

Depression is a major public health concern that accounts for a high global disease burden.

The aim of this study, developing a depression inventory for screening the Fars ethnicity in Iran.

The research was carried out using a combined (multi-stage) method in the Persian ethnicity between April 2016 and March 2017. Individual interviews were conducted in Tehran, Iran, with depressed patients, the patients’ relatives or friends and key informants. In the next stage, a 28-item tool was designed. The face, content, criterion and construct validity (confirmatory factor analysis) of the designed tool were assessed in order to determine its validity. Data were analyzed by Amos 24 and spss16.

This study was conducted on 150 individuals, 55% female and 45% male, selected from the general public through convenience sampling with a mean age of 35.28±12. 38. The impact score for all the items was between 1.8 and 5, CVR was between 0.7 and 1 for all the items and S-CVI/Ave was 97.09 ± 0.63. Based on the results of the confirmatory factor analysis, all the components were approved as factors used to screen for depression. The model fit coefficients, the CMIN/DF was calculated as 1.93. NFI, CFI and GFI were 0.70, 0.54 and 0.73 respectively. For reliability, Cronbach’s alpha was calculated as 0.88 with an internal consistency coefficient that is 0.7.

This depression screening tool for the Fars ethnicity was designed based on the Fars ethnicity and the Iranian culture and appears to be an appropriate tool due to its good reliability, validity, simplicity and applicability in different situations.

Substance abuse has always been one of the major health concerns in Iran. Substance abuse during adolescence has a range of negative consequences for the individual. Earlier studies in Iran mainly focus on the epidemiology of substance abuse among adolescents and few studies have focused on its underlying factors. This study was aimed to explain the family factors underlying the development of a tendency for substance abuse among adolescents. This is a qualitative study, and the conventional content analysis method was used. The participants consisted of 12 people who were selected using purposeful sampling method. They were the adolescents in Tehran Province Youth Detention Center in Iran with previous or current experience of substance abuse in the age range of 15 - 19 years old. Data were collected through in-depth interviews. The interviews were transcribed verbatim and the data were analyzed using qualitative content analysis. Four themes were obtained based on the research goal: Paternal role, maternal role, discipline methods, and family function. The paternal role consisted of three categories of insufficient paternity, passive paternity, and lack of paternity. The maternal role was comprised of incompetent maternity, and lack of maternity. The discipline methods were composed of three categories of punitive discipline, enhancing affection, and inadequate supervision. Finally, the family function referred to a blaming and unsupportive family. Substance abuse prevention programs for vulnerable teenagers will have better outcomes by involving their parents, particularly their fathers. Also, it seems the mental health and addiction policymakers need to prioritizing family education as one of the most important substance abuse prevention strategies in vulnerable adolescents.

Depression is one of the most important mental disorders affecting 350 million people in the world. The aim of this study was to explore the similarities and differences in the symptoms and experiences of depression in cities representing the Fars, Turk, and Kurd ethnic groups of Iran. A qualitative study was implemented in three ethnic groups in Iran between April 2016 and March 2017 using individual interviews with 44 depressed patients, 20 people of their relatives, and three key informants in Tehran (Fars), Tabriz (Turk), and Sanandaj (Kurd) cities. The data were analyzed using directed content analysis. The analysis of the data led to the extraction of four main themes, including cognitive, behavioral, physical, and emotional/motivational symptoms. The study findings would help to explore various expressions of depression and provide a multidimensional construct to develop the culturally specific measurement of depression in three different ethnic groups.

Objectives Mental health problems are prevalent especially in women all over the world. These problems have adverse effects on various aspects of life. Interventional programs to mental health promotion related to sociocultural structure and it is needed to know the coping mechanisms and mental health promotion strategies and it is the aim of this study.
Methods This is a qualitative study. The relevant data were collected by in-depth interviews with 15 married women (18-65 years old) in Tehran. Then the obtained data were investigated through content analysis.
Results Married women used four strategies to cope with the stress and promote the mental health status: a) strengthening the spiritual aspects, b) learning the skills of stress management, positive thinking, self-controlling and problem solving, c) seeking help, and d) setting their priorities setting and avoid daily boring tasks.
Conclusion Teaching coping mechanisms based on problem-solving techniques is essential for mental health promotion in married women.

Aim: The aim of this study was to evaluate the relationship of prisoners’ demographic features in 7 provinces of Iran with their crime type and level.
This descriptive study was performed in all 2200 newcomer prisoners of 7 great prisons of Iran (Zahedan¡ Urmia¡ Kermanshah¡ Karaj¡ Bandar Abbas¡ Yazd and Gorgan) during January and February 2009. The analysis of personal properties (age¡ level of education¡ unemployment¡ poverty and place of residence) of prisoners was done in the framework of structuralism and functionalism using SPSS 19 software.
Increasing the age and level of education of prisoners was inversely related to crimes¡ especially theft¡ which was the most frequent among the crimes¡ and only a direct relation to fraud was observed. The amount of crime and its re-engagement with the level of education and income was inversely related and was directly related to urbanization and intercourse. Traffic accidents and accidents with urbanization had a direct relationship with the reverse and fraudulent and drug trafficking¡ as well as the history of their repetition with urbanization.
Demographic factors such as age¡ education¡ and low income play a significant role in committing crimes¡ especially robbery. Also¡ the location agent is also linked to crime types¡ so that drug addiction¡ drug trafficking and fraud and repeat offenders are more likely to occur in the city¡ and driving accidents and accidents and repeat offenses in villagers.

The aim of this study was to understand the experience and meaning of life in children with cancer that in this article present the god concept as one of its themes.
Current study is a qualitative descriptive phenomenological research. The sample includes 7 children with cancer selected using convenience sampling based on the most heterogeneity of samples. They were deeply interviewed. Data were analyzed using Colaizze method.
Based on the analysis of the data, ''the belief in God as being superior", was extracted as one of the main themes. This theme includes two sub-themes: 1) Faith in God and His satisfaction, and 2) Life as a context of divine testing.
Belief in God, play an important role in understanding the meaning of life and the formation of a positive orientation to life in children with cancer. The findings of this study can be used as a conceptual base for explaining the concepts in other research and/or for designing interventional models for this kind of children.

Although the association between major depressive disorder (MDD) and low self-esteem is well established, we do not know if race and ethnicity modify the magnitude of this link.
Using a nationally representative sample of adults in the United States, we explored whether or not race alters the association between MDD and self-esteem.
Data came from the National Survey of American Life (NSAL), a nationally representative household survey with 3,570 African Americans (Blacks) and 891 Non-Hispanic Whites. Low self-esteem (Rosenberg Self-Esteem Scale) was the dependent variable, MDD (Composite International Diagnostic Interview) was the independent variables, gender, age and educational level were controls, and race was the focal moderator. Logistic regressions were used for data analysis.
In the pooled sample, MDD and low self-esteem showed reciprocal associations, above and beyond all covariates. Our model showed significant interaction between race and MDD, suggesting a stronger association between MDD and self-esteem among Blacks compared to Whites. We could find such interactions among men but not women.
Depression and low self-esteem are more strongly linked among Blacks than Whites, particularly among men. It is not clear whether depression leaves a larger scar on self-esteem for Blacks or that Blacks are more vulnerable to the effect of low self-esteem on depression.

HIV/AIDS is one of the diseases which not only makes threats to physical health, but also, due to the negative attitudes of people and the social stigma, affects the emotional and social health of patients. The aim of this study was to identify the psychological, social, and family problems of people living with HIV/AIDS (PLWHA) in Iran. In this qualitative study, we used purposive sampling to enroll PLWHA, their families, and physicians and consultants in two cities of Kermanshah and Tehran. Each group of PLWHA, their families, physicians, and consultants participated in two focus group discussions (FGDs), and a total of eight FGDs were conducted. Six interviews were held with all key people, individually. Based on the views and opinions of various groups involved in the study, the main problems of PLWHA were: Ostracism, depression, anxiety, a tendency to get revenge and lack of fear to infect others, frustration, social isolation, relationship problems, and fear due to the social stigma. Their psychological problems included: Marriage problems, family conflict, lack of family support, economic hardships inhibiting marriage, and social rejection of patient’s families. Their family problems were: Unemployment, the need for housing, basic needs, homelessness, and lack of social support associations. It seems that the identification and focusing on psychological, social, and family problems of affected people not only is an important factor for disease prevention and control,but also enables patients to have a better response to complications caused by HIV/AIDS.

Stressful life events during pregnancy are associated with adverse consequences for mother and newborn. The purpose of this study was to understand the effects of stressful life events during pregnancy on low-birth-weight newborn according to social determinants of health.
This study was the second part of a large research project. The main study was conducted using case-control design. Samples were recruited in four stages by selecting 750 mothers with newborns weighing less than 4000 gr using multistage sampling method. The data about women’s lifestyle during pregnancy was collected using a questionnaire which was developed using inductive and deductive approaches based on social determinants of health. This study assessed stressful life events during pregnancy using 18 items.
Findings: The average of stressful life events number and the total score of this domain were different between two groups (p The stressful life events can influence fetal growth independently. Although receiving health care during pregnancy (the biological dimension), has an important influence, the role of stress, the related factors and the coping methods should be considered.

In recent years, there has been an increasing interest in performing research on drug use and sex work among at-risk women. Although there is a well-documented literature of the initial reasons associated with drug use and sex work among women, there is, however, a paucity of information in this area in Iran. This study aimed to explore the initial reasons associated with drug use and sex work in a group of female treatment seekers, who presented health-related risk behaviors, in Tehran, Iran. Patients and Thisqualitative study enrolled a total of 65 at-risk women, from five women-specific drug clinics, who participated in the study in 2011. Individual in-depth interviews were conducted. Focus group interviews were conducted with 10 key informants. All interviews were audio-taped and thematically written. The recorded data were analyzed using ATLASti qualitative research software version 10. The median age of the sample was 34 years. In addition, 44.6% of subjects were opiate users, and 55.4% were users of opiates and methamphetamine. Sex work was the main source of income for almost half of the sample. The most frequently reported reasons, associated with initial drug use, were extrinsic motivations, including the drug-using family, friends or social networks. Intrinsic motivations, including curiosity and individual willingness to use drugs, were other initial reasons. The most frequently reported reasons, associated with initial sex work, included the need to purchase drugs and financial problems. The study findings demonstrated a number of reasons associated with initial drug use and sex work. The role of sex work in providing drugs necessitates education and prevention. Special treatment programs should be implemented to prevent sex work among at-risk women in Iran.

Working in Street as a part of Child Labor is a Global problem. Several studies have focused on familial factors of child labor in Iran. This study is going to present the issue of child labor and its risk factors and impacts on street children in Tehran. This study used rapid assessment and response method in 1391-92 in Tehran. Samples were recruited from street children in Tehran as well as from key informants in field of child labor. Data was gathered through literature review, qualitative interviews using Focus Group Discussion with 13 groups of street children, in-depth individual interview with 16 experts, and interview with 286 street children using structured questionnaires in 128 venues in Tehran. Qualitative data were analyzed by content analysis and quantitative data was analyzed statistically using Chi square tests. Findings showed that earning money to support family financially was the main reason for children being worked in the streets (75.3%). In accessibility to formal education for Afghan children, family conflicts such as violence, drug use and different cultural attitudes between children and parents were considered as other reasons on becoming street children in different ethnic groups. Children were at risk of multiple physical, sexual, and mental health problems specially violence in their homes and streets. As a conclusion, although economic problems have main role in becoming a street child, but it is not an unique reason. Therefore, in planning for street children, other substantial factors should be considered. Besides, future studies are recommended to be concentrated on child laboring in other places than streets.

Contextual factors such as ethnicity, gender, place, and their intersections determine the social condition that populations and individuals live in. As a result, environmental stressors that shape exposures, and also resilience and vulnerabilities are specific to the population. This emphasizes the role of the intersection of such contextual factors in studying psychosocial causes of depression. The aim of this case study is to review the role of war related stress as a unique environmental cause of depression among Kurdish women who live in the Middle East. First, we reviewed the literature on the direct effects of ethnicity, gender, place, and their intersections on depression. Then we discussed the contextual (indirect) effects of these factors in modifying the effect of (resilience and vulnerability to) risk factors of depression. Then we reviewed the evidence highlighting the role of war related stress as a unique social cause of depression among Kurd women. We hope this paper provides an example of how social causes of depression depend on intersections of ethnicity, gender, and place. We argue that depression should be seen as a condition, with population specific causes and consequences. We also believe that ethnicity, gender, and place help clinicians and public health officials to better approach depression within populations. Contextual factors should not be undermined in approaching depression across population groups. In this view, context not only determines the exposure to the risk and protective factors, it also changes the vulnerability and resilience to them. Thus we need to better understand how ethnicity, gender, place, and their intersections modify separate, additive, and multiplicative effects of risk and protective factors on depression.

Children, who work or live at streets, are one of the HIV high risk groups in Iran, with no comprehensive preventive programs. This study intended to assess substance use among street children in Tehran, Capital of Iran.
This paper is a part of comprehensive rapid assessment and response (RAR) research on street children in Tehran in 2012-13. Data were collected by interview using questionnaires. Two hundred and seventy 289 street children were selected by time-location sampling in Tehran.
From the total of 259 street children, 59.4% were Iranian and 74% were boys. Prevalence of drug use among street children was 25.6%.  The prevalence of smoking, drug abuse and also drinking alcohol were 8.9% among boys and 1.4% among girls.20.8%, 17.3% and 6.9% of the street children had at least used cigarette, alcohol and drugs once in their lives respectively. There was a significant relationship between consumption of alcohol and other substances among street children with higher age, type of occupation and leaving home experience.
Comprehensive preventive programs targeting street children is recommended to be started at lower ages, with the main focus on young boys among street children. In addition family intervention and improvement of children’s lifestyle could be a main strategy for drug use prevention among this population.

Mental health is an essential component for positive adaptation that enables people to cope with adversity to achieve their full potential and humanity. In this study, using a community based approach, the social determinants of mental health in Iranian women were extracted; and in addition, priority setting for interventional programs according to analytical framework of WHO was implemented. This study was a community based participatory research (CBPR) in district 22 of Tehran (Iran). The target group was married females with age range of 18-65 years. In this study, mental health priorities were extracted by qualitative methods according to Essential National Health Research model (ENHR) and the analytical framework of WHO. Data analysis was done based on content analysis by the open code 3.6 software. In the quantitative phase, according to secondary data, 1144 individuals (560 females and 584 males) were selected, of whom 41 percent had impaired mental health based on General Health Questionnaire (GHQ) (P<0.05). According to the qualitative phase, the first mental health priority in socioeconomic level was lack of insurance for unattended families, it was unemployment in differential exposure level and it was lack of knowledge and skills related to dealing with stress in the differential vulnerability level; in differential outcome and consequence levels, the priorities were lack of free counseling centers in the study area and lack of facilities for mental health rehabilitation. Providing training courses to improve the skills to deal with stress is considered one of the most important interventions for mental health promotion in women.

Children who work or live in the streets are one of the high-risk groups for HIV. The high population of street children and lack of comprehensive intervention programs for them increase their risk for HIV in Iran. This study intended to explore the situation of drug abuse in street children in Tehran، the capital city. This paper reports part of a comprehensive rapid assessment and response (RAR) research project on street children in Tehran during 2012-13. Data were collected by interviewing subjects using questionnaires. The sample size was 289 street children selected by time-location sampling in Tehran. Data showed that about 25. 6% of the street children had had some history of cigarette smoking، alcohol abuse، and/or drug abuse. Most of them were boys aged 15-18 years. The prevalence rate of cigarette and/or hubble-bubble smoking، alcohol consumption and drug abuse during the preceding 6 months 12. 1%، 11% and 6. 9%، respectively. Significant associations were found between alcohol consumption and drug abuse on the one hand and the children’s age، type of occupation and home-leaving experience on the other. Further analysis of the data showed that the main reason for drug abuse was curiosity (56. 6%)، followed by mere enjoyment (39. 6%) and leisure (35. 8%). It can be concluded that drug abuse among street children is highly associated with gender، age، alcohol consumption، cigarette smoking and leaving home experience. Therefore، it is recommended to start drug abuse prevention programs at lower ages، with particular emphasis on boys. In addition، family intervention and improvement of children’s lifestyle aiming at preventing home-leaving could be a main strategic plan for reducing drug abuse among street children.

HIV/AIDS has been concentrated among injecting drug users in the country. This study aimed to investigate and identify health and treatment needs of people living with HIV/AIDS in Iran. This qualitative study was conducted in 2012 in Iran. The study groups consisted of experts, practitioners, and consultants working with People Living with HIV/AIDS and their families. Data was collected through Focus Group Discussions and deep interviews. Data were analyzed using content analysis method. The findings of this study included the needs of people living with HIV/AIDS, which were classified in three main categories. The first category was prevention and counseling services with several sub-groups such as education and public and available consultation, distribution of condoms to vulnerable groups, increasing counseling centers in urban areas, providing appropriate psychological and supportive counseling, and family planning services. The second category included diagnostic and treatment services and had several sub-groups such as full retroviral treatment, Tuberculosis treatment and continuing care, providing care and treatment for patients with hepatitis, and providing dental services. The third category included rehabilitation services and had some sub-categories such as home care, social and psychological support, nutritional support, and empowering positive clubs. This study puts emphasis on making plans based on the priorities to meet the needs of people living with HIV/AIDS in Iran.

The aim of the present study was to investigate the views of policy makers and key persons about national AIDS control politics. This qualitative study used purposive sampling. To collect data, the perspectives of six experts about AIDS were inspected. Framework analysis was used to analyze the data. The results of this study showed that beside the strengths there are also significant weaknesses in making the policies, administering the existing policies, executing the programs in organizations, and planning new policies to control AIDS; hence these problems and weaknesses must be identified to achieve the main goals of AIDS control program. AIDS is not only a health problem but a social, economical and cultural problem, which requires more attention from authorities and related organizations for developing and implementing policies in accordance with international guidelines. To achieve Millennium development goals (MDGs) in the context of AIDS it is essential for policy makers and key figures to consider more effective activities and measures in their agenda.

Disclosure of HIV is important for improving self-care behaviors, psychological well-being, commitment to the treatment, and reducing risk of transmission. One of the major benefits of disclosure is social support, which is an essential resource for effective coping with HIV infection. However, receiving any social support requires disclosing of HIV status. This study aimed to determine the disclosure of HIV status and its related factors such as social support in addition to demographic and disease characteristics among people living with HIV in Iran.Patients and This cross-sectional study, using simple random sampling, was carried out on 175 people with HIV/AIDS who referred to Behavioral Counseling Centers. The self-administrated, Norbeck Social Support Questionnaire was used to measure social support. Disclosure of HIV status was assessed with an investigator-designed questions. Multiple logistic regression analysis with backward Likelihood Ratio method was applied to identify the adjusted odds ratio between disclosure as dependent variable and demographic variables, social support as independent variables. Participants were often disclosed their HIV status to family members. But there were differences about disclosure of HIV status within the context of the family. Family members were perceived as more supportive. Multiple logistic regression analysis demonstrates that the gender (adjusted OR = 0.181; 95% CI. 068-0.479), CD4 cell count (adjusted OR = 0.997; 95% CI 0.994-0.999), route of transmission (injection-drug user [adjusted OR = 9.366; 95% CI 3.358-26.123] and other routes [tattooing, mother to child, dental services, etc.], [adjusted OR = 3.752; 95% CI 1.157-12.167]), and functional support variable (adjusted OR = 1.007; 95% CI 1.001-1.013) remained in the model as significant predictors for disclosure. The results of this study regarding disclosure of HIV status and its relations to social support and some demographic variables can provide an understanding based on the evidence for promotion of knowledge and coping interventions about people living with HIV/AIDS and their perceived social support status.

Community‑based health programs (CBHPs) with participatory approaches has been recognized as an important tool in health promotion. The goal of this study was to understand the nature of participation practice in CBHP and to use the data to advocate for more participation‑friendly policies in the community, academy and funding organizations. In this qualitative study, 13 CBHPs, which were active for last 5 years have been assessed using semi‑structural in‑depth interviews with programs principal and managers and focus group discussions with volunteers and service users. Data analysis was based on the deductive‑inductive content analysis considering the participatory approaches in these programs. The results show that, the main category of participation was divided to community participation and intersectional collaboration. The community participation level was very different from “main,” “advisory” or “supporting” level. The process of recruitment of volunteers by the governmental organization was centralized and in non‑governmental organizations was quite different. According to respondents opinion, financial and spiritual incentives especially tangible rewards, e.g., learning skills or capacity building were useful for engaging and maintaining volunteers’ participation. For intersectional collaboration, strong and dedicated partners, supportive policy environment are critical. It seems that maintaining partnership in CBHP takes considerable time, financial support, knowledge development and capacity building.

Pasteur Institute of Iran was established in 1919 with the aim to produce vaccines and prevent communicable diseases in Iran. Over time، their activities extended into areas of research، education and services. Naturally، such a vast development begs establishment of a comprehensive management and monitoring system. With this outlook، the present study was carried out with the aim to design a performance assessment model for Pasteur Institute of Iran that، in addition to determining evaluation indicators، it could prepare the necessary grounds for providing a unified assessment model for the global network of the Pasteur Institutes. This study was designed and performed in 4 stages: first; design of indicators and determining their scores. Second; editing indicators according to the outcome of discussions and debates held with members of Research Council of Pasteur Institute of Iran. Third; implementation of a pilot model based on the Institute’s activities in 2011. Fourth; providing the pilot model feedback to the stakeholders and finalizing the model according to an opinion survey. Based on the results obtained، the developed indicators for Pasteur Institute of Iran evaluation were designed in 10 axes and 18 sub-axes، which included 101 major and 58 minor indicators. The axes included governance and leadership، resources and facilities، capacity building، knowledge production and collaborations، reference services، economic value of products and services، participation in industrial exhibitions، status of the institute، satisfaction and institute’s role in health promotion. The indicators presented in this article have been prepared based on the balance in the Institute’s four missions، to provide the basis for assessment of the Institute’s activities in consecutive years، and possibility of comparison with other institutes worldwide.

In Iran, more than 25% of women suffer from mental disorders. Mental disorders and subclinical problems are associated with socioeconomic problem. At the community level, mental health promotion can reduce social damage. The aim of this study as a part of community based mental health promotion intervention was to explore how mental health in Iranian women is viewed. According to a qualitative method in 2012, participants were selected by purposeful sampling from married women 18 to 65 years who are residents in Tehran. Fifteen in depth individual interviews were conducted with regard to the concept of mental health, causal pathway and help-seeking behavior according to explanatory model. Mental health was perceived as the same of emotional well-being. It conceptualized not only lack of mental disorder but also sense of satisfaction and healthy functioning. According to participant`s view, the causal pathway of mental health problems were classified to individual, familial and social factors. Physical and behavioral problems were related to individual factor, Lack of marital adjustment was one of the most important issues in familial item and in social factor, cultural context and socio- economic problems were extracted. In help seeking process, all of the participants believed that the religion has important effect in mental health. Marital adjustment is an important stage in process of mental health in women.