International Journal of Preventive Medicine
Volume:5 Issue: 12, Dec 2014

As the first experience of substance abuse often starts in adolescence, and studies have shown that drug use is mainly related to cigarette and alcohol consumption, an initial exploration of substance abuse prevalence, including cigarette and alcohol, seems to be the first step in preventing and controlling drug consumption. This study aimed to explore studies on drug use among high school students by investigating articles published in the past decade in Iran. In this study, the databases inside the country were used to access articles related to substance abuse by students during 2001–2011, among which 7 articles on 14–19 years old high school students were studied. The seven studied articles showed that the highest drug use prevalence pertained to cigarette and hookah, followed by alcohol, opium, ecstasy, hashish and heroin. Opium and heroin use in Kerman city were, respectively, about 4 and 5 times of their use in other studied cities. Drug use is relatively high in the adolescent and effective group of the society, which requires particular attention and prompt and immediate intervention.

Although the overwhelming majority of Iranian adolescents are well‑adjusted, a substantial group exhibits high levels of maladjustment and deficient functioning. Escalation of criminal violence among the youth population has become a major public policy issue and a serious public health problem. In reviewing a 10‑year literature, this article aimed to describe and propose primary assumptions regarding the correlates of aggressive and violent behaviors in Iranian adolescents and youth. Bibliographic databases such as PubMed and Google Scholar along with Iranian databases including PubMed, IranMedex, Magiran, Irandoc, Psychoinfo, and Emrofor Scientific Information Database, and Magiran constituted the databases which we searched for the relevant literature. Overall 98 articles met the inclusion criteria, allowing us to initiate the discussion. Reportedly, prevalence of violence and aggression among the Iranian adolescents and youth ranged from 30% to 65.5% while males being 2½ times more affected than females. The role of gender, family environment, family size, socioeconomic status, and victimization in perpetuating the circumstances was apparent. Relatively high prevalence of violence and aggression among Iranian youth and adolescents is a warning sign and a great challenge to the social system. Reviewed studies suffer from certain methodological and conceptual limitations. Undertaking community‑based studies to estimate the actual extent of the problem is warranted.

Violence is a global issue that has received considerable attention during recent years. Available research has suggested various factors, mostly family and social factors, to possibly affect violence. As previous studies have not examined the relationship between these factors and violent behaviors in adolescents, this study aimed to assess the relationship between environmental factors and violence in adolescents. This descriptive, correlational research used cluster sampling to select 5500 adolescent students from Isfahan Province (Iran). Data were collected through a 21-item researcher-made questionnaire. The questionnaire was modified according to the relevant experts’ opinions and had Cronbach’s alpha of 0.82. The collected data were analyzed by applying multiple regression analysis in SPSS (SPSS Inc., Chicago, IL, USA). Most participants (89.1%) lived in urban areas and about half (49.8%) of them were female. Linear regression test showed violent behaviors to have significant, inverse relationships with love and affection in the family (β = −0.097; P < 0.001) and watching drama and comedy movies (β = −0.128; P < 0.001 and β = −0.032; P = 0.030, respectively). There were significant, direct relationships between violent behaviors in adolescents and aggressive behaviors in the family (β =0.099; P < 0.001) and watching crime, police, and action movies (β =0.129; P < 0.001, detective movies β =0.043; P < 0.001, and β =0.061; P < 0.001, respectively). However, the incidence of violent behaviors was not significantly related with the effects of peers and presence of sports facilities. Our findings confirmed love and affection and healthy pastime (e.g. watching comedy and drama movies) in the family to reduce violent behaviors in adolescents. In contrast, aggressive behaviors in the family, watching crime, police, and action movies were found to increase violent behaviors in adolescents.

Since correlations have been found between body composition and physical activity in different parts of the world, inactivity and poor physical condition likely contributes main factors in childhood obesity. This study was implemented to determine the relationship between cardiovascular fitness and body‑composition in a group of Iranian middle school students. In this descriptive study, subjects comprised of 12,946 students (10,531 girls and 2,415 boys aged 11–13 years) in the city of Isfahan. Height, weight, body‑fat percent, body mass index, and cardiovascular fitness of the aforesaid students were measured by valid tests. This study showed that fat percentage and aerobic fitness (VO2 max) of girls were 24.73%, and 29.5 (ml/kg/min) and boys19.32% and 36.4 (ml/kg/min) respectively. Results also revealed that there was a negative significant correlation between fat percent and aerobic fitness of boys (r = −0.81), and girls (r = −0.77) respectively. To conclude, this study signifies that fat percentage augmentation leads to a decrease in aerobic fitness of children. Thus, fat percentage can be associated with different chronic diseases such as cardiovascular ones.

In the past two decades, physical activity has decreased during both childhood and adolescence, and particularly adolescence. It seems that schools are attractive settings in which to implement interventions designed in order to promote physical activity in children; but in Iranian students, few studies have evaluated the effects of such interventions on overweight and obese children. The aim of this study was to evaluate the effects of a short‑term school‑based physical activity on obesity and aerobic fitness in 12–14 years aged girls. This is a study with single group pretest and posttest design, in which 129 middle school girls in city of Isfahan were assessed based on preventive plan of inactivity in children at the Provincial Health Office. Variables, including weight, height, body mass index (BMI), waist‑hip ratio (WHR), body fat percentage and aerobic power of subjects were measured using valid tests. This study showed that subjects’ body fat percentage changed about 3.6% (37.74% pretest vs. 36.39% posttest), VO2 max changed 7.43% (29.72 pretest vs. 31.93 posttest), WHR changed 1.12% (0.89 pretest vs. 0.88 posttest), whereas BMI was changed 1.65% (27.80 pretest vs. 27.34 posttest). Findings also revealed that there were significant differences between fat percent, (P = 0.001) and VO2 max (P = 0.001) of subjects, but there was no difference between BMI of them in pre‑ and post‑tests (P = 0.361). These results suggest that even a short‑term exercise intervention may lead to positive changes in body fat percentage, WHR and aerobic fitness of overweight children. Therefore, school‑based physical activity interventions can be an effective preventive strategy to control obesity and overweight in students.

Some local governments have implemented strategies to increase physical activity as a way to control obesity in children, but in Iranian students few studies have evaluated the effects of such interventions on overweight and obese children. The aim of this study was to evaluate the effects of a short‑term school‑based physical activity on obesity and cardiovascular fitness in 12-‑14-‑year-‑old boy students. This study showed an intervention effect on some health‑related fitness factors in students. A number of 127 boy students aged 12–14 years, in the city of Isfahan, based on preventive plan of inactivity in children at the provincial Health office selected randomly as subjects. Measurement variables include; weight, height, body mass index (BMI), waist‑hip ratio (WHR), body‑fat percent and aerobic power of subjects measured by valid tests. This study revealed that body‑fat percentage of this students changed near to 17.84% (42.25% pretest vs. 34.71% posttest), WHR 0.44%, (0.915 pretest vs. 0.911 posttest), VO2 max changed 8.54% (27.84 pretest vs. 30.22 posttest) whereas BMI was changed 2.61% (26.81 pretest vs. 26.03 posttest). Results also revealed that there were significant differences between fat percent, (P = 0.001) and VO2 max (P = 0.001), but there was no difference between BMI of subjects in pre and posttests (P = 0.452). Findings of this study signify that an implementation of short‑term intervention components in the school system may have a beneficial effect on body‑fat percentage and cardiovascular fitness of overweight/obese children.

Childhood obesity is a worldwide major public health problem in both developed and developing countries. The purpose of this study was to determine the prevalence of obesity and overweight in 12-14-year-old students in the city of Isfahan. This study was conducted among 10,531 girls and 2415 boys aged 12–14 years in the city of Isfahan. Percentage of children in the corresponding body mass index (BMI) categories for overweight and obesity (specified by the Centers for Disease Control and Prevention criteria percentiles) were assessed, based on preventive plan of inactivity in children and youth of Isfahan province. Findings revealed that prevalence of overweight in children varied by age from 15.3% to 26.9% in boys and 12.9% to 29.9% in girls, and prevalence of obesity varied from 14.8% to 33.7% and 15% to 29.9% in boys and girls, respectively. Percentile norms for BMI of subjects were computed based on sex categories. To conclude, results of the study revealed that subjects have approximately the same percentage of overweight/obesity compared to other children have been studied; however, in comparison to previous studies, a higher rate was witnessed in grade 8 boy students. These situations indicate that there are needs to implement some intervention programs, as well as management policies.

Considering the importance of anger, aggression, violence and other misbehaviours in schoolchildren education, the present study was conducted to evaluate the knowledge and practice of students in Isfahan province regarding violence, in order to figure out the required interventions for violence‑reduction. In a survey during 2008-‑2009, 5500 junior and senior high school students of Isfahan province were assessed in a multistage sampling process to determine their level of knowledge about various types of violent behaviors, causes of violence, its consequences, and preventive behaviors. Validity and reliability of the data collection tool (questionnaire) were assessed. The study revealed that the mean scores of violent behaviors knowledge, knowledge of violent behavior outcomes, and knowledge of violence preventive behaviors, were 6.6 ± 2.1, 5.5 ± 1.9, and 4.7 ± 1.3, respectively. Sources of violent behaviors in 92% of urban students and 89% of rural students were personal reasons and family behaviors, and 85% of urban and 88% of rural students considered mass media and computer games blameworthy, and the differences were statistically significant in all cases (P < 0.0001). In terms of practice, overall, 69.7% of girls and 84.2% of boys had violent behaviors. Physical and verbal violence were 31.3% and 40.7%in girls, and 66% and 52.8% in boys, respectively (intersexes P values were P < 0.001 and P = 0.7 respectively, and intra‑sex P value was P < 0.0001). Results showed that girls and city dwellers were more aware of recognizing violent behaviors, outcomes, and causes, compared with boys and villagers, and in terms of general practice, violence was observed among boys more than girls. Further complementary studies in this area seem required.

Present study aimed to evaluate the prevalence of grades of nutritional status comprising underweight, normal weight, overweight, and obesity as well as other measurable anthropometric indicators of body mass index (BMI) in regard to gender, educational level, and living area among students settled in Isfahan province. This cross‑sectional study was conducted on a sample of 4700 individuals (2349 females and 2351 males) being from 9 to 15 years old, while they were students of either primary school or junior high school. Random cluster method was applied in both urban (84%) and rural (16%) areas of Isfahan province. BMI values were measured and then categorized using reference growth charts from the Centers for Disease Control and Prevention (CDC 2000). Weight‑for‑age and stature‑for‑age indices were assessed as well in accordance with CDC growth charts. The overall prevalence of underweight, overweight, and obesity was 13.9, 10.4, and 5.7%, respectively. Boys and students of urban areas showed a higher tendency of obesity and overweight in comparison with girls and rural students respectively. Furthermore, rural students had poorer status in both weight‑for‑age and stature‑for‑age indices. In addition, educational level was the only statistically efficacious factor. This study and previous ones demonstrated that children and adolescents’ nutritional status, which strongly affect general health status of individuals, should receive more exquisite attention.

School provides a set of condition which is very important determinant for student smoking behavior. This study aims at exploring the association of the school environment on Iranian middle and high school students smoking. A self‑administered anonymous questionnaire was circulated among 5500 randomly selected students with 98.3% response rate. The questionnaire asked on demographic information, student smoking status, and their perception on the school environment. School environment factor was consist of teacher smoking, implementation of smoke‑free policy at school, student adherence to this policy, student perception of school personnel attitude and attention on smoking and finally receiving information on smoke‑related issues via teachers. Analyses were performed with SPSS software using Chi‑square and multiple logistic regression. Boys with higher level of witness to teachers smoking had higher odds of being smoking (odds ratio [OR] =1.62, 95% confidence interval [CI] =1.17, 2.25); significant relationship was seen between boy’s perception regarding school anti‑smoking rules and their smoking (OR = 1.40, 98% CI 1.12, 1.75); fewer concern of school personnel on student smoking behavior was correlated to boys smoking behavior (OR = 1.31, 98% CI 1.06–1.63). Among girls, only higher perceived teacher smoking (OR = 2.59, 95% CI = 1.04, 6.44) was associated with their smoking. Teachers have a crucial role in student smoking; therefore, they strategies must be taken to persuade the student, school staff, and students to adhere free‑smoking policies in and out of school.

Considering the problem of drug abuse in Iran especially in adolescents and the youth, recent alterations in drug abuse rate and its trend, the necessity to have local information about this problem, applied research has a determining role in management of this problem and making proper decisions. Therefore, the current study was conducted to develop a questionnaire to assess the status of drug abuse among high school students of Isfahan Province, Iran. This cross‑sectional study was conducted out in 2009 in 20 cities of Isfahan Province. A researcher‑made questionnaire was developed to determine knowledge, attitude, and practice of high school students regarding addictive drugs and their associated causes. This was accomplished by recruiting 7137 students who were selected by multistage random cluster sampling. The designed questionnaire identified the status quo of drug abuse according to age, gender, and different cities of Isfahan Province. We also accessed information about the type of abused drug, the most common causes of drug abuse for the first time, the most important causes of drug abuse, mean age of abusers and mean age at the first abuse, common time and locations of drug abuse, and the most common routes of drug abuse according to gender as well as urban and rural areas of Isfahan Province. Reliability of the questionnaire, based on the calculated Cronbach’s alpha coefficient, was 77% considering a cut‑off point of 0.07. According to the obtained results, the designed questionnaire is capable to assess the drug abuse status among high school students of Isfahan Province. Regarding the importance of teenage years in forming the future behaviors of adolescents and the opportunities provided at schools, it is prudent to pay more attention to interventions in this age group in order to increase their knowledge and correct their attitude toward illegal drugs and strengthening their confidence in this regard. These interventions can have an important role in decreasing the rate of drug abuse in this age group and consequently in the whole community.

It can be concluded from the existing theories that parental education status, by affecting socioeconomical status of families, can impact the incidence of violent behaviors in teenagers. Therefore, this study was conducted aiming at investigating the relationship between parental education and teenagers’ knowledge of violent behaviors and their incidences. For this cross‑sectional, descriptive‑correlational study, a sample of 5500 teenager students from Isfahan province were selected by random cluster sampling and responded to a 61‑item questionnaire. The data collected from by questionnaire was analyzed by Spearman’s statistical correlation and multiple regression methods. Most of the students under study (89.1%) were living in cities and the rest were rural dwellers. In terms of gender, female to male ratio was approximately equal (49.8% vs. 50.2%). The statistical results showed that there is a significant positive relationship between practice and knowledge (R = 0.092 and P = 0.00), but there is no significant relationship between parental education and practice and there is a significant relationship between parental education and knowledge (Mothers’ education P = 0.00 and R = 0.121 and fathers’ education P = 0.00 and R = 0.109). Moreover, there was a positive significant relationship between teenagers’ knowledge of violence consequences (P = 0.005 and B = 0.048) violent behavior causes (P = 0.00 B = 0.085) and methods of preventing violent behaviors (P = 0.00 and B = 0.085) with teenagers’ practice. Based on the results of the present study that indicates teenagers are less aware of the consequences of violent behavior compared to other subscales of knowledge, it is better that teenagers’ education about the violent behaviors are more about the consequences of violent behavior rather than its definitions. Moreover, parental education is related to teenagers’ knowledge of the violent behavior so it is better that in various grades more comprehensive and suitable information regarding violent behaviors be presented.

Adolescents are being threatened by several accidents because of entering the new world of adulthood, separation from families, a greater presence in community individually, the lack of knowledge of rules and risk‑taking spirit of adolescents, and events. The contribution of these damages and their related costs are higher in developing and low‑income countries. The current study was conducted for proper planning focused on reducing accidents that have the highest incidence, evaluating school events, determining the place and time that most accidents happened to students and determining the body part injured. A cross‑sectional study using a multistage cluster sampling was conducted on 6933 students 11–14 years old (middle school) in 2009–2010 in Isfahan Province. The data were collected through observation and a researcher‑made questionnaire and then entered into the EPi6 software, and analyzed by the SPSS 11.5 software and the statistical test of Chi‑square. The findings showed that 49.9% of students were girls (n = 3462) and 50.1% (n = 3471) were boys, 84.5% of students (n = 5860) were living in urban areas and 15.5% of students (n = 1073) were living in rural areas. Frequency distribution of incidents was 53.9% (3739 cases) at school and 10.6% (732 cases) on the commuting route. The most injured body part was hand with 1018 cases (18.5%) and foot with 1267 cases (23.1%), and mostly they were injured in boys. The findings showed that a high percentage of students were injured at school, where the first step to prevent the incidence of such preventable incidents at school is to secure workshop environments and school yards.

Population growth and use of the car in daily life entails new incidents and accidents everyday. Adolescents’ entering the new world of adults, their insufficient knowledge of rules, and high‑risk behaviors expose them to more risks. Accordingly, a study was conducted with the aim to evaluate the status of preventive behaviors in traffic accidents in boy and girl junior high school students in Isfahan regarding vehicle use. A descriptive‑analytical cross‑sectional study was conducted on 7000 junior high school boy and girl students from 20 towns in Isfahan Province using multi‑stage cluster sampling method in 2009–2010. A researcher‑made questionnaire was used as data collection tool, which evaluated students’ practice and preventive behaviors with 21 questions, each examining students’ practice in accidents and incidents that may occur in school and on the way to school. Data were analyzed with Epi 6 and SPSS software using t‑test and Chi‑square test. Girls comprised 49.9% of students and 50.1% were boys, 84% lived in urban areas and 15.5% in rural areas. The frequency of an accident location was school in 53.9% with 3739 cases and on the way to school in 10.6% with 732 cases. Mean practice score of preventive behaviors in traffic accidents involving cars, taxi, and school bus (72.6 ± 17.52 girls, 72.7 ± 18.31 boys, P = 0.88), motorbike (79.1 ± 14.048 girls, 74.1 ± 19.73 boys, P < 0.001), bicycle (71.4 ± 16.56 girls, 68.5 ± 14.69 boys, P = 0.152), bus and minibus (91.8 ± 13.16 girls, 87 ± 18.65 boys, P < 0.001), crossing the street (30.5 ± 26.67 girls, 32.7 ± 28.03 boys, P = 0.003), and skating (60.6 ± 29.103 girls, 61.2 ± 26.84 boys, P = 0.927). Results indicate that girls have better preventive practices than boys in use of motorbikes, buses, and minibuses. According to the results obtained, the majority of students walk to school and have the lowest practice score in this respect. It is recommended that as the first step, students be given necessary road traffic rules training, particularly how to cross the street.

Although nutritional status of children and adolescents is of great concern various interventions and modifications aiming at promotion of healthy eating behaviors have limited impact due to insufficient understanding of dietary habits between different age groups and genders. The aim of this study in not only evaluation of nutritional knowledge, practice, and dietary habits of primary school and junior high school students in Isfahan province, but also this research explore crucial differences regarding gender and living area of the above‑mentioned population in Iran. This cross‑sectional study was conducted on 4700 primary school and junior high school pupils in Isfahan province. Data were collected through standard 24‑h recall food frequency questionnaire and researcher‑designed questionnaire. Independent t‑test was applied for comparison of mean values of total units of consumed food materials. Qualitative variables were compared by using the Chi‑square test. Data were analyzed by ACCESS 2010 and SPSS 18 software. Nutritional knowledge of female pupils and junior high school students was higher than their male and elementary school students respectively; still, theses superiorities did not lead to higher practice score. Bread and cereals group received daily intakes in accordance with food and drug administration (FDA) recommendations. Indeed, vegetables, milk, and dairy products, as well as meat daily intakes, were lower than the FDA recommendation, whereas fats, oils, and sugars intakes were higher. In comparison to females, male participants had significantly lower consumption of vegetables and fruits whilst they had a higher intake of carbohydrates, fats, and meats. Our results showed that adolescents failed to meet sufficient nutritional requirements, and they had an imbalanced diet, which was considerably low in several essential nutrients and high in some food materials.