Community health assessment: Knowledge, attitude and practice of women regarding water-pipe smoking in Bandar Abbas

Graphical abstract

To diagnose the problem, for creating action plan, the present cross sectional study was conducted on 205 women aged over 18 randomly selected from Green-tree region in suburb of Bandar Abbas city Trial registration: No applicable Ethics: No applicable

Protocol data
Community health assessment with public participation can provide better understanding the needs of society, researchers and health professionals [1][2][3][4][5].
The assessment results showed that community health concerns and priorities of the community members may be different from what health systems report. Operational plans based on diagnostic problems in the community, for education, policy and health interventions could improve public health and enhance the performance of people. The implementation of the public health assessment process, leading to increased participation of people in their health and prevention programs are guaranteed to run properly.

Materials and methods
This study is conducted in the form of a community evaluation project in Block 6 of Green Tree neighborhood in the north eastern part of Bandar Abbas City, Hormozgan Province. The model used in this study is based on the community evaluation pattern used in the School of Public Health, Tehran University of Medical Sciences [6,7], to evaluate different communities based on the localized pattern [8] of Evaluation of the North Carolina Health Administration Society [9][10][11].
According to this pattern, community evaluation consists of eight phases, in which phases one to seven contribute to problem identification and prioritization, and phase eight deals with developing an operational plan to solve the problems. In phase one, the community evaluation team, consisted of one epidemiologist as the guide, one person responsible for coordinating with the administrations and residents in the region, and two secretaries for interview meetings. The primary data were collected in the second phase during group focused discussion sessions, brain storming and individual interviewing in Shahid Takhty's Health Center, the schools and mosques in the neighborhood, teachers, residents and trusties in the region.
Data gathering, summarizing and interpreting the primary and secondary data obtained from other organizations was done in the third phase. Analyzing the data obtained from phases two and three, aiming to acquire a fundamental understanding of the demographic features, major health risks and the existing problems was done in the fourth phase, and totally 67 problems were extracted as a result. Oral and written report of the evaluation process of the beneficiaries in society was done in the fifth phase to involving more people in the evaluation process. In the sixth phase, prioritizing the problems identified in the previous phases was done in a collaborative meeting, in presence of the evaluation team, health professionals, the mosque liturgist, board of trustees, and the trusties in the neighborhood, using Hanlon method [12].
Scoring the problems listed based on health importance, the extent and feasibility of addressing the problem was done by assigning 1-10 to each problem, and the first 10 problems, having the highest score, were selected as the high priority problems in the community under study (Table 1).
Finally, the problem "high prevalence of water-pipe in women" was selected among the list, which had operational, educational, and intervention feasibility. The current field study, aiming to identify this problem in Block 6 of Green Tree neighborhood in Bandar Abbas was conducted by developing a proposal entitled "Investigating the knowledge, attitude, and practices of over 18-years old women   Documentary report on the evaluation process, along with all findings, to the society members is done in the seventh phase, which, in turn, results in developing an operational plan for the society in the eighth phase for high priority problems. To run this cross-sectional study, 206 women over 18-years old, residing in Block 6 of Green Tree neighborhood, were selected randomly ( Table 2).
The study used the researcher-made survey questionnaire as a principal tool for gathering data. The questionnaire included 5 sections: demographic information, knowledge, attitude, practices, and life satisfaction questions [13,14]. The questioners completed the questionnaire. The content validity of the questionnaire was verified using the experts' attitude, and the questions' reliability in each field was verified using the primary studies (Cronbach's alpha = 0.79).
The data analysis was performed in two descriptive and analytical parts. Mean value, standard deviation, and relative frequency indices were used in the descriptive part, while Chi-square test and linear regression models were used in the analytical part. The outcome variables in this study (knowledge, attitude, and practices) were divided from the mean value to two parts: higher than mean and lower than mean (Table 3); two-state variables were used as outcome for further analysis. Statistical analyses were done using SPSS software, version 24.

Conflicts of interest
Authors have no conflicts of interest.