Knowledge, attitude, self-efficacy and estimation of frequency of condom use among Iranian students based on a crosswise model

Functionality of the Crosswise Model for Assessing Sensitive or Transgressive Behavior: A Systematic Review and Meta-Analysis

Tools for reliable assessment of socially sensitive or transgressive behavior warrant constant development. Among them, the Crosswise Model (CM) has gained considerable attention. We systematically reviewed and meta-analyzed empirical applications of CM and addressed a gap for quality assessment of indirect estimation models. Guided by the PRISMA protocol, we identified 45 empirical studies from electronic database and reference searches. Thirty of these were comparative validation studies (CVS) comparing CM and direct question (DQ) estimates. Six prevalence studies exclusively used CM. One was a qualitative study. Behavior investigated were substance use and misuse (k = 13), academic misconduct (k = 8), and corruption, tax evasion, and theft (k = 7) among others. Majority of studies (k = 39) applied the "more is better" hypothesis. Thirty-five studies relied on birthday distribution and 22 of these used P = 0.25 for the non-sensitive item. Overall, 11 studies were assessed as high-, 31 as moderate-, and two as low quality (excluding the qualitative study). The effect of non-compliance was assessed in eight studies. From mixed CVS results, the meta-analysis indicates that CM outperforms DQ on the "more is better" validation criterion, and increasingly so with higher behavior sensitivity. However, little difference was observed between DQ and CM estimates for items with DQ prevalence estimate around 50%. Based on empirical evidence available to date, our study provides support for the superiority of CM to DQ in assessing sensitive/transgressive behavior. Despite some limitations, CM is a valuable and promising tool for population level investigation.

The Effect of ACT on Self-Esteem and Self-efficacy of Women with Breast Cancer in Iran

Background:

Today, breast cancer is the second major cause of cancer deaths in women.

Objective:

The present study aimed to determine the effect of acceptance and commitment therapy (ACT) on self-esteem and self-efficacy of cancer adaptation behaviors in women.

Methods:

The present study was a randomized educational trial (IRCT Registration number: IRCT2016100430140N1) based on intervention and control groups including 30 patients with breast cancer who were referred to Cancer comprehensive center of Imam Khomeini Hospital in Sari 2017. The intervention group participated in ACT sessions for 8 weeks held as 8 sessions. In the control group, there was no intervention and only chemotherapy was carried out. Self-esteem and self-efficacy of cancer adaptation behaviors were assessed using Rosenberg Self-esteem Scale and Cancer Behavior Inventory before and after the intervention and one month later. Data analysis was tested by repeated measurement, ANOVA and Tukey post-hoc tests.

Results:

The mean of self-esteem before and after intervention and one month later was 13.46 ± 1.12, 16.86 ± 0.91, 15.86 ± 0.99 in ACT group, and 14 ± 1, 14.40 ± 0.98, 14.20 ± 1.08 in the control group, respectively (F(2,27)=11.90, P=0.001). The mean of self-efficacy of cancer adjustment behaviors before and after the intervention and one month later was 104.40 ± 20.19, 218.20 ± 15.32, 214.86 ± 16.97 in ACT group, and 96.86 ± 15.04, 97.06 ± 18.61, 94.53 ± 14.69 in the control group, respectively (F(2,27)=8.26, P=0.001).

Conclusion:

This counseling approach can be used as an easy, non-invasive and helpful method to increase self-esteem and self-efficacy among patients for adaptation to cancer.

Comprehensive analysis of the HIV/AIDS policy-making process in Iran

Background

A huge number of people living with HIV/AIDS lives in developing countries. Thus, strengthening health systems in these countries is a prerequisite for improving disease prevention and care. After three decades of HIV/AIDS policy-making in Iran, conducting a comprehensive analysis on the policy process seems to be essential. In the present study, we aimed to analyse the HIV/AIDS policy-making process in Iran from 1986 to 2016.

Methods

This was a theory-based, multi-method and retrospective study. Interviewing of key informants and review of policy documents were concurrently conducted to identify and include further key informants (39 participants) and documents in the study. Framework analysis was used to analyse data.

Results

The mean age of participants working in HIV/AIDS policy-making was of 48 years and participants had a mean of 14 years of working experience. Findings were categorized as contextual factors, content of HIV/AIDS policies, actors involved in the policy process, and evidence use in the policy process. Contextual effective factors on the HIV/AIDS policy-making process were categorized into five major themes, namely situational factors, structural-managerial factors, socioeconomic factors, political and legal factors, and international factors. The HIV/AIDS phenomenon in Iran was identified to be deeply rooted in the culture and traditions of society. The HIV/AIDS policy content has, recently, been crystallized in the national strategic plans and harm reduction policies of the country. The policy process has been conducted with a solely governmental top-down approach and is now suffering from poor evidence and lack of sufficient consideration of contextual factors.

Conclusions

There is a great need for change in the approach of government towards the issue and to increase the participation of non-governmental sectors and civil society in the policy process.

Multiple sensitive estimation and optimal sample size allocation in the item sum technique

For surveys of sensitive issues in life sciences, statistical procedures can be used to reduce nonresponse and social desirability response bias. Both of these phenomena provoke nonsampling errors that are difficult to deal with and can seriously flaw the validity of the analyses. The item sum technique (IST) is a very recent indirect questioning method derived from the item count technique that seeks to procure more reliable responses on quantitative items than direct questioning while preserving respondents' anonymity. This article addresses two important questions concerning the IST: (i) its implementation when two or more sensitive variables are investigated and efficient estimates of their unknown population means are required; (ii) the determination of the optimal sample size to achieve minimum variance estimates. These aspects are of great relevance for survey practitioners engaged in sensitive research and, to the best of our knowledge, were not studied so far. In this article, theoretical results for multiple estimation and optimal allocation are obtained under a generic sampling design and then particularized to simple random sampling and stratified sampling designs. Theoretical considerations are integrated with a number of simulation studies based on data from two real surveys and conducted to ascertain the efficiency gain derived from optimal allocation in different situations. One of the surveys concerns cannabis consumption among university students. Our findings highlight some methodological advances that can be obtained in life sciences IST surveys when optimal allocation is achieved.