1. Introduction
Adolescence is an important period of life; it is the period of transition between childhood and adulthood that begins with puberty. This period is the beginning of physical, psychological and social changes and is the period of preparation for fulfilling great responsibilities such as family, social, cultural, and economic issues in adulthood. Paying attention to the health of adolescents is one of the Millennium Development Goals and one of the missions of the member of the World Health Organization. Evidence shows that 70% of deaths in adulthood are the result of behaviors in adolescence, and preventing the formation of these behaviors requires the design and implementation of goal-based programs. Adolescent health planning to achieve an acceptable level of health and prevention of waste of capital should be based on attention to all aspects of health and needs assessment. Adolescents’ needs are different from other age groups due to their personality and physiological changes. It is very important to pay attention to gender differences in the needs assessment of adolescents, since studies have shown that adolescent girls and boys have different health needs that their needs definitely need to be assessed separately. In order to have proper planning in the field of adolescents, it is necessary to have information about their health needs because understanding these needs can reduce health risks and develop health services. This study aims to investigate health needs of adolescent boys in Iran and its related factors.

2. Materials and Methods
In this cross-sectional analytical study, participants were 352 boys studying in the first and second year of high school in the fields of mathematics, experimental sciences, humanities, and technical sciences public, non-profit, and gifted & talented schools in Rasht, Iran. The sampling method was random multi-stage cluster sampling. The data collection tool in this study was a questionnaire consisting of two parts. The first part surveys demographic information and the second part was the Male Adolescent Health Needs-Assessment Scale developed by Zare et al. It has 49 questions in 4 areas: physical health needs (12 items), mental health needs (20 items), social health needs (13 items) and sexual health needs (4 items) of adolescent boys. The items are rated on a 5-point Likert scale from 1 to 5. Data analysis was carried out using descriptive (Mean, standard deviation, median, minimum and maximum) and inferential statistics (regression analysis to determine factors related to boys’ health needs) in SPSS v.16 software.

3. Results
The age range of participants was 12-18 years (Mean±SD age = 14.96 ±1.72 years). The majority of participants were studying in public high schools (41.8%) in the field of experimental sciences (25.3%) and were in the first year of high school (50.5%). Their mean scores of health needs in physical, sexual, psychological and social needs are presented in Table 1.

Regression analysis results showed that the physical health need of participants had a statistically significant relationship with the type of study school (P = 0.001). Participants in non-profit and gifted & talented schools had greater physical health needs than those in public schools. Sexual health needs had a statistically significant relationship with age (P= 0.002), study in non-profit (P= 0.015) and gifted & talented (P = 0.001) schools, having mothers with high school diploma (P= 0.025) and university degree (P = 0.033) and with mothers being employed (P = 0.005). Participants at younger ages, enrolled in gifted & talented and nonprofit schools, having mothers with high school and university education, and with employed mothers with had higher sexual health needs. Mental health needs had a statistically significant relationship with the variables of study in a non-profit school (P = 0.009), being the third child (P= 0.048), having employed (P = 0.021) and self-employed father (P = 0.032) and having mother being worker (P = 0.022). The boys attending nonprofit schools had lower mental health needs. Third-born boys had better mental health needs. Those whose fathers were employed or self-employed had more mental health needs. Finally, the social health need of participants had a statistically significant relationship with the type of study school (P = 0.001). Participants in non-profit and gifted & talented schools had greater physical health needs than those in public schools.

4. Discussion and Conclusion
Sexual health need of adolescent boys in Iran requires more attention followed by social, physical, and mental health needs. One of the limitations of this study was the inability to consider the health needs of a large number of adolescents due to cultural differences in different parts of Iran. It is necessary to conduct more studies in this filed. Other limitation was the sensitive age of adolescents, which made it difficult to gain their trust to answer the questions. The researcher, by introducing himself and saying his working conditions, gained their trust.

Ethical Considerations
Compliance with ethical guidelines
This study was approved by the Ethics Committee of the Guilan University of Medical Sciences (Code: IR.GUMS.REC.1398.206). All ethical principles are considered in this article. The participants were informed about the purpose of the research and its implementation stages. They were also assured about the confidentiality of their information and were free to leave the study whenever they wished, and if desired, the research results would be available to them.

Funding
The paper was extracted from the PhD. dissertation of the first author at the Student Research Center, School of Nursing and Midwifery, Guilan University of Medical Sciences, Rasht.

Authors' contributions
Conceptualization, resources, supervision: Amir Mohammad Safardoost, Zahra Bostani Khalesi; Research: Amir Mohammad Safardoust; Original draft-writing, review and editing: Zahra Bustani Khalsi; Methodology, funding acquisition: All authors.

Conflicts of interest
The authors declared no conflict of interest.

Acknowledgements
The authors would like to thank the Vice-Chancellor for Research of Guilan University of Medical Sciences and the participants for their cooperation.

Refrences

1. Dick B, Ferguson BJ. Health for the world’s adolescents: A second chance in the second decade. Journal of Adolescent Health. 2015; 56(1):3-6. [DOI:10.1016/j.jadohealth.2014.10.260]
2. Hatami H, Razavi M, Eftekhar Ardebili H, Majlesi F. Persian textbook of public health. 4^th ed. Tehran: Arjomand; 2017.
3. World Health Organization. Health for the world’s adolescents: a second chance in the second decade: Summary. Geneva: World Health Organization; 2014. https://apps.who.int/iris/handle/10665/112750
4. Mokdad AH, Forouzanfar MH, Daoud F. Global burden of diseases, injuries, and risk factors for young people’s health during 1990-2013: A systematic analysis for the global burden of disease study 2013. Lancet. 2016; 387(10036):2383-401. [DOI:10.1016/S0140-6736(16)00648-6]
5. UNICEF: For every child. Adolescents overview [Internet]. 2019 [Updated 2019 October]. Available from: https://data.unicef.org/topic/adolescents/overview/
6. Balocchini E, Chiamenti G, Lamborghini A. Adolescents: which risks for their life and health? Journal of Preventive Medicine and Hygiene. 2013; 54(4):191-4. [PMCID]
7. Vogel JP, Pileggi-Castro C, Chandra-Mouli V, Pileggi VN, Souza JP, Chou D, et al. Millennium development goal 5 and adolescents: looking back, moving forward. Archives of Disease in Childhood. 2015; 100(S1):S43-7. [DOI:10.1136/archdischild-2013-305514]
8. United Nations Population Fund. International conference on population and development program of action. New York, NY: UNFPA; 1994. http://www.unfpa.org/publications/international-conference-population-and-development-programme-action
9. AlBuhairan FS, Tamim H, Al Dubayee M, AlDhukair S, Al Shehri S, Tamimi W, et al. Time for an adolescent health surveillance system in Saudi Arabia: findings from “Jeeluna”. Journal of Adolescent Health. 2015; 57(3):263-9. [DOI:10.1016/j.jadohealth.2015.06.009]
10. Harris SK, Aalsma MC, Weitzman ER, Garcia-Huidobro D, Wong C, Hadland SE, et al. Research on clinical preventive services for adolescents and young adults: Where are we and where do we need to go? Journal of Adolescent Health. 2017; 60(3):249-60. [DOI:10.1016/j.jadohealth.2016.10.005]
11. Tsai MC, Chou YY, Lin SJ, Lin SH. Factors associated with adolescents’ perspectives on health needs and preference for health information sources in Taiwan. Archives of Disease in Childhood. 2015; 98(1):9-15. [DOI:10.1136/archdischild-2012-301629]
12. Alexander SC, Fortenberry JD, Pollak KI, Bravender T, Davis JK, Østbye T, et al. Sexuality talk during adolescent health maintenance visits. JAMA Pediatrics. 2014; 168(2):163-9. [DOI:10.1001/jamapediatrics.2013.4338]
13. Kågesten A, Parekh J, Tunçalp O, Turke S, Blum RW. Comprehensive adolescent health programs that include sexual and reproductive health services: a systematic review. American Journal of Public Health. 2014; 104(12):e23-36. [DOI:10.2105/AJPH.2014.302246]
14. Salam RA, Das JK, Lassi ZS, Bhutta ZA. Adolescent health interventions: Conclusions, evidence gaps, and research priorities. Journal of Adolescent Health. 2016; 59(4S):S88-92. [DOI:10.1016/j.jadohealth.2016.05.006]
15. Moghadam Tabrizi F, Zamani S . [A survey on the health cocern of adolescent 15- 18 years old in zanjan (Persian)]. the Journal of Urmia Nursing and Midwifery faculty. 2016; 14(4):335-42. https://www.sid.ir/en/journal/ViewPaper.aspx?id=532656
16. Zare E, Simbar M, Shahhosseini Z, Alavi Majd H. Design and psychometric properties of male adolescent health needs-assessment scale. International Journal of Community Based Nursing and Midwifery. 2016; 4(4):297-308. [PMCID]
17. Amin A, Kgesten A, Adebayo E, Chandra-Mouli V. Addressing gender socialization and masculinity norms among adolescent boys: Policy and programmatic implications. Journal of Adolescent Health. 2018; 62(3S):S3-5. [DOI:10.1016/j.jadohealth.2017.06.022]
18. Zare E, Simbar M, Shahhosseini Z, Alavi Majd H. The priorities of Iranian male adolescents health needs. American Journal of Men's Health. 2017; 11(4):1255-9. [DOI:10.1177/1557988317693346]
19. Simbar M, Alizadeh S, Hajifoghaha M, Golezar S. [Review of Iranian adolescents’educational needs for sexual and reproduvtive health (Persian)]. Journal of Isfahan Medical School. 2017; 34(412):1563-72. https://www.sid.ir/en/journal/ViewPaper.aspx?ID=532654
20. Banaei M, Simbar M, Ghasemi V, Nazem H. Barriers of adolescents’ access to reproductive and sexual health services in Iran: A systematic review. International Journal of Pediatrics. 2019; 7(12):10505-22. [DOI: 10.22038/IJP.2019.42108.3543]
21. Salam RA, Faqqah A, Sajjad N, Lassi ZS, Das JK, Kaufman M, et al. Improving adolescent sexual and reproductive health: A systematic review of potential interventions. Journal of Adolescent Health. 2016; 59(4S):S11-28. [DOI:10.1016/j.jadohealth.2016.05.022]
22. Motlagh ME, Rejaei L, Jonidi-Jafari A, Ardalan G, Dorouzi J, Sartipizadeh M, et al. [Priorities in health education needs of youth based on needs assessment stakeholder involvement, in areas covered by the health departments of Iran university of medical sciences (Persian)]. Journal of Education and Community Healthh. 2016; 3(1):51-7. [DOI:10.21859/jech-03017]
23. Bohman H, Låftman SB, Päären A, Jonsson U. Parental separation in childhood as a risk factor for depression in adulthood: A community-based study of adolescents screened for depression and followed up after 15 years. BMC psychiatry. 2017; 17(1):117. [DOI:10.1186/s12888-017-1252-z]
24. Modiri F, Safiri k, Mansourian F. [A study on social health and its effective factors (Persian)]. Quarterly Journal of Social Development. 2016; 12(2):7-28. [DOI:10.22055/QJSD.2018.13506]
25. Richter M, Körholz D. The social dimension of adolescent health: Challenges for paediatric research and practice. Klinische Pädiatrie. 2015; 227(4):193-8. [DOI:10.1055/s-0035-1549976]