Developing a pilot study protocol and lessons from Iran for the integrated and repeated public health surveillance
Yosra Azizpour1,2, Reyhaneh Ehsani3, Keyvan Karimi2
1Occupational Sleep Research Center, Baharloo Hospital, Tehran University of Medical Sciences, Tehran, Iran.
Background:
This study aims to design a cost-benefit Integrated and Repeated Public Health Surveillance System (IRPHS) to monitor key health indicators, identify emerging health concerns, and support community health interventions through the provision of timely and systematic data for informed policymaking.
Methods:
This study introduced a novel framework for public health surveillance in Iran by integrating multidisciplinary indicators into a single, telephone-based platform. Using structured consensus across 32 expert panels, remote-friendly and policy-relevant indicators were identified and operationalized. The measurement tool underwent rigorous face and content validation involving subject-matter experts and community representatives. The survey protocol incorporated a nationally trusted phone infrastructure (4030 line), stratified sampling, and adaptive outreach strategies, creating a scalable model. Further innovation included real-time supervision mechanisms, enhancing data accuracy, population representativeness, and implementation feasibility in resource-limited settings.
Results:
A total of 110 validated indicators were identified across nine key public health domains: service receipt, non-communicable diseases (NCDs), communicable diseases, behavioral risk factors (including smoking, nutrition, and physical activity), dentistry, health of males and females, health literacy, psychological disorders, and population characteristics. Data were collected through 75 structured questions during a pilot study involving 1,311 individuals aged 18 and above from southern Tehran. The mean age of participants was 39.7 years (standard error [SE]: 0.43), with 50.63% males [95% confidence interval (CI): 47.66, 53.60].
Conclusions:
The IRPHS framework shows promise for national scale-up and integration into routine public health monitoring for timely and localized policy response.
Supplementary Information:
The online version contains supplementary material available at 10.1007/s40200-025-01698-2.
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