Razi Journal of Medical Sciences

Background: All over the world, health is a prerequisite for sustainable development in which people's health plays a key role. In this regard, women's health is of particular importance because they make up half of the world's population and play a key role in family health and community development. Researchers believe that it is impossible to achieve global health promotion without women's health. Health and fair distribution among different sections of society have been a major issue for the World Health Organization and many other international agencies and researchers over the past two decades. As a result, women's health and its effective role in achieving the goals of reducing maternal mortality, gender equality and women's empowerment have attracted the attention of the United Nations and its member states. Women's health is one of the most important activities and goals of health systems in societies. It is also considered as a measure of the progress of countries. However, according to reports released by the United Nations, women's health is vulnerable and needs to be reconsidered by policymakers. According to the World Health Organization, chronic diseases account for 70% of all deaths in Iran. In Iran, the most common diseases are non-communicable diseases. These diseases account for 45% of diseases for both sexes (i.e 33% for men and 33% for women). Obesity and overweight, arterial hypertension, insufficient physical activity, hypercholesterolemia and addiction are among the five primary risk factors that account for the largest share of the disease. Osteoporosis, cardiovascular disease, high blood pressure and stroke causes one-third of all deaths in the world. Cardiovascular disease accounts for half of all deaths in women over the age of 50 in developed countries. 70 million women around the world have diabetes and are projected to double by 2025.  In 2007, The World Health Organization (WHO) reported that additional statement that countries should be presented with general goals and strategies for controlling and preventing non-communicable diseases, one of which was: It is important to note that more global efforts are needed to increase physical activity and a healthy lifestyle. Many diseases and conditions that cause premature death or disability in women can be prevented with mobility. Despite the importance and necessity of women's sports participation as a global rule, women's participation in sports activities is limited. More over the lack of gender equality in the provision of facilities that reduce the chances of participating in sports and serious physical injuries. Therefore, it seems that in order to achieve the development of women's sports, it is necessary to identify the main factors of women's development in the form of a native model to provide the grounds for its development as an important factor in health.
Methods: In this descriptive-correlational study, which was conducted with a structural equation model approach, 409 people including the Minister, Deputy Minister, Chief of Staff, Deputy Chief of Staff, General Director of the province, Deputy Minister of Women's Affairs in the Physical Education Organization, heads of federations Sports, vice presidents of federations, technical and sports deputies in the provinces, the head of the province's women's sports development, heads of sports boards of provinces across the country and sports management experts of the Islamic Republic of Iran were selected as the sample. The tools of this research included a researcher-made questionnaire, which used three methods to assess the psychometry of the questionnaire: question analysis, validation, reliability, and in order to determine the validity of the questionnaire, formal and content validity and factor structural validity were used. Two methods of exploratory and confirmatory factor analysis were used to determine the validity of the factor structure. To investigate the validity of the researcher-made questionnaire, the structural validity method (factor analysis) was used in the first stage. In the following, confirmatory factor analysis has been used to confirm the exploratory factor analysis. First, model fitness indicators were used to determine the confirmatory factor analysis and whether the data were appropriate for this pattern or model. Generally, the fit indices of the model represent the fit of the data with the model, so the factor analysis factor model of the present study was confirmed. To measure the internal stability of the questionnaire, Cronbach's alpha method was used at the level (p≤.05). Cronbach's alpha obtained as follows: coefficient for the whole questionnaire 0.931, for each component 0.907, for the environmental component 0.920, for the Organizational component and 0.804 for the behavioral component. After data collection, frequency, frequency percentage, mean and standard deviation were used as descriptive statistics to describe the research data. The tilt and elongation test were used to check the naturalness of the data.  The T-test was used to measure the effectiveness of each of the variables on the factors affecting the development of women's sports, the Friedman test used to evaluate the ranking of these factors and the measurement model used to examine each of the factors affecting the development of women's sports for health, as an inferential statistic. Using SPSS 20 and AMOS 20 software, all analyzes were performed at 95% confidence level.
Results: The results of the present study showed that each of the organizational, environmental and behavioral factors have a significant effect on the development of women's sports in the Islamic Republic of Iran as an important health factor (p<0.05). Additionally, the hypothetical research model on the development of women's sports in the Islamic Republic of Iran as an important factor of health has a favorable fit. More over, the coefficients of the measurement model related to the relationship between effective factors in the development of women's sports showed that: There is a two-way path between organizational factors and environmental factors, and this path is significant. There is a two-way path between environmental factors and behavioral factors, and this path is meaningful. There is a two-way path between organizational factors and behavioral factors, and this path is meaningful. The results also showed that there is no significant difference between the factors affecting the development of women's sports in the Islamic Republic of Iran as an important health factor and each of the factors has a relatively similar value for the development of women's sports in the Islamic Republic of Iran.
Conclusion: Generally, the results of the present study showed that each of the environmental organizational and behavioral factors, as an important factor in health, have a significant impact on the development of women's sports in the Islamic Republic of Iran. Therefore, it is suggested that in order to prevent and control non-communicable diseases in women, promote self-care culture, move to improve lifestyle and provide the necessary infrastructure for health development, officials demand attention to these factors in health and development of women's sports. One of the limitations of the present study is the distribution of positional positions of the respondents to the questions of the questionnaire, which therefore it is suggested that in future research, participants answer the questions of the questionnaire with the same organizational positions. But other limitations include the uncertainty of classifying responses in the Likert spectrum. Due to the uncertainty in the existing questionnaires, it is necessary to implement these factors according to the fuzzy sets.