Behavioral Factors Research Articles

Human connection with nature improves wellbeing and pro-environmental behavior: A literature review

Given the world's continuous environmental concerns, there is a need for increased participation in nature protection. The ecological crisis of the last decade on Earth has become one of the causes of the rupture of society's relationship with nature. Such relationships can predict diverse attitudes, concerns, intentions, and pro-environmental behavior (PEB). A systematic literature review (SLR) aims to compare, study, and analyze journal articles that relate to issues related to nature as a major factor in pro-environmental behavior. The results of selecting articles indexed by SCOPUS found as many as 1716 publications. The 50 open-access publications of articles were chosen based on specific criteria and further examined to identify eight final articles that align with the Inclusion of Nature in Self (INS) scale. Pro-environmental behavior strengthens human relationships with nature and encourages a sense of ownership and involvement with the environment. Pro-environmental behavior refers to behaviors that are beneficial to the environment, such as supporting conservation policies, recycling, and participating in nature. Research using INS scale, which focuses on connections with nature, still has significant potential and should persist in making contributions to science and humanity.

Summary Measure of Health-Related Quality of Life and Its Related Factors Based on the Chinese Version of the Core Healthy Days Measures: Cross-Sectional Study.

The core Healthy Days measures were used to track the population-level health status in the China Chronic Disease and Risk Factor Surveillance; however, they were not easily combined to create a summary of the overall health-related quality of life (HRQOL), limiting this indicator's use. This study aims to develop a summary score based on the Chinese version of the core Healthy Days measures (HRQOL-5) and apply it to estimate HRQOL and its determinants in a Chinese population. From November 2018 to May 2019, a multistage stratified cluster survey was conducted to examine population health status and behavioral risk factors among the resident population older than 15 years in Weifang City, Shandong Province, China. Both exploratory factor analyses and confirmatory factor analyses were performed to reveal the underlying latent construct of HRQOL-5 and then to quantify the overall HRQOL by calculating its summary score. Tobit regression models were finally carried out to identify the influencing factors of the summary score. A total of 26,269 participants (male: n=13,571, 51.7%; mean age 55.9, SD 14.9 years) were included in this study. A total of 71% (n=18,663) of respondents reported that they had excellent or very good general health. One summary factor was extracted to capture overall HRQOL using exploratory factor analysis. The confirmatory factor analysis further confirmed this one-factor model (Tucker-Lewis index, comparative fit index, and goodness-of-fit index >0.90; root mean square error of approximation 0.02). Multivariate Tobit regression analysis showed that age (β=-0.06), educational attainments (primary school: β=0.72; junior middle school: β=1.46; senior middle school or more: β=2.58), average income (≥¥30,000 [US $4200]: β=0.69), physical activity (β=0.75), alcohol use (β=0.46), self-reported disease (β=-6.36), and self-reported injury (β=-5.00) were the major influencing factors on the summary score of the HRQOL-5. This study constructs a summary score from the HRQOL-5, providing a comprehensive representation of population-level HRQOL. Differences in summary scores of different subpopulations may help set priorities for health planning in China to improve population HRQOL.

Sexual behavior and personal initiative to take the HIV test among men who have sex with men in Semarang, Indonesia.

The HIV test is an important strategy for HIV prevention and treatment, starting from screening individuals who are unaware of being infected with HIV and requiring antiretroviral therapy. Information about sexual behavior factors related to HIV testing initiatives among MSM in Indonesia is still limited. Previous studies only showed the correlation of various sexual behavior variables with the decision whether to obtain an HIV test or not; but did not learn whether the HIV testing was obtained due to personal initiative or invited by others. This research can be used as a reference for developing an HIV testing program based on sexual behavior variables. This research aims to study the sexual behavior factors related to the personal initiative on taking the HIV test among men who have sex with men (MSM). We used cross-sectional study among 300 MSM who had an HIV test. This research found that homosexual orientation was negative factor related to the personal initiative for obtaining an HIV test. Sexual behavior among MSM is correlated with the personal initiative to take HIV testing. Further investigation should emphasize among homosexuals because they do not have the initiative to take an HIV test.

Socio-economic inequalities in the use of flu vaccination in Europe: a multilevel approach

BackgroundThe European-wide statistics show that the use of flu vaccination remains low and the differences between countries are significant, as are those between different population groups within each country. Considerable research has focused on explaining vaccination uptake in relation to socio-economic and demographic characteristics, health promotion and health behavior factors. Nevertheless, few studies have aimed to analyze between-country differences in the use of flu vaccination for the EU population. To address this gap, this study examines the socio-economic inequalities in the use of influenza vaccination for the population aged 15 years and over in all 27 EU Member States and two other non-EU countries (Iceland and Norway).MethodsUsing data from the third wave of European Health Interview Survey (EHIS) 2019, we employed a multilevel logistic model with a random intercept for country, which allows controlling simultaneously the variations in individuals’ characteristics and macro-contextual factors which could influence the use of flu vaccination. In addition, the analysis considers the population stratified into four age groups, namely adolescents, young adults, adults and elderly, to better capture heterogeneities in flu vaccination uptake.ResultsThe main findings confirm the existence of socio-economic inequalities between individuals in different age groups, but also of significant variation between European countries, particularly for older people, in the use of influenza vaccination. In this respect, income and education are strong proxy of socio-economic status associated with flu vaccination uptake. Moreover, these disparities within each population group are also explained by area of residence and occupational status. Particularly for the elderly, the differences between individuals in vaccine utilization are also explained by country-level factors, such as the type of healthcare system adopted in each country, public funding, personal health expenditure burden, or the availability of generalist practitioners.ConclusionsOverall, our findings reveal that vaccination against seasonal influenza remains a critical public health intervention and bring attention to the relevance of conceiving and implementing context-specific strategies to ensure equitable access to vaccines for all EU citizens.

The faces of Long-COVID: interplay of symptom burden with socioeconomic, behavioral and healthcare factors.

The long-term effects of COVID-19 (Long COVID) include 19 symptoms ranging from mild to debilitating. We examined multidimensional correlates of Long COVID symptom burden. This study focused on participants who reported having had COVID in Spring 2023 (n = 656; 85% female, mean age = 55, 59% college). Participants were categorized into symptom-burden groups using Latent Profile Analysis of 19 Long-COVID symptoms. Measures included demographics; quality of life and well-being (QOL); and COVID-specific stressors. Bivariate and multivariate associations of symptom burden were examined. A three-profile solution reflected low, medium, and high symptom burden, aligning with diagnosis confirmation and treatment by a healthcare provider. Higher symptom burden was associated with reporting more comorbidities; being unmarried, difficulty paying bills, being disabled from work, not having a college degree, younger age, higher body mass index, having had COVID multiple times, worse reported QOL, greater reported financial hardship and worry; maladaptive coping, and worse healthcare disruption, health/healthcare stress, racial-inequity stress, family-relationship problems, and social support. Multivariate modeling revealed that financial hardship, worry, risk-taking, comorbidities, health/healthcare stress, and younger age were risk factors for higher symptom burden, whereas social support and reducing substance use were protective factors. Long-COVID symptom burden is associated with substantial, modifiable social and behavioral factors. Most notably, financial hardship was associated with more than three times the risk of high versus low Long-COVID symptom burden. These findings suggest the need for multi-pronged support in the absence of a cure, such as symptom palliation, telehealth, social services, and psychosocial support.

Alcohol consumption among older adults in the United States amidst the COVID-19 pandemic: an analysis of the 2017-2021 Behavioral Risk Factor Surveillance System.

Alcohol consumption is responsible for numerous life-threatening diseases, including liver cirrhosis, heart disease, and various cancers. During the pandemic, alcohol-related deaths increased from 2019 to 2021, topping out at approximately 108,000 deaths related to alcohol. This trendalso introduced the question whether heavy alcohol consumption and binge drinking increased during the pandemic, particularly in those 65 and older. The objective of this study is to determine whether heavy alcohol consumption and binge drinking increased during the pandemic in older adults in the United States. We performed a cross-sectional analysis of the Behavioral Risk Factor Surveillance System (BRFSS) to determine whether rates of overall alcohol consumption, heavy consumption, or binge drinking deviated from 2017 through 2021. We utilized chi-square tests to determine changes in rates over the included years. Our findings show that the overall rate of alcohol use in populations 65 and older from 2017 through 2021 wasapproximately 42.1 %, which peaked in 2017 at 43.7 % and declined each year, resulting in the lowest rate (41.3 %) in 2021 (χ 2 =8.96, p<0.0001). Binge and heavy drinking rates were 5.1 % and 4.2 % overall during this time frame, respectively, and the annual changes were not statistically significant. The impact of COVID-19 on the drinking behavior of older US adults was minimal in terms of binge orheavy drinking, although the overall rates of alcohol consumption among this group declined. Reports among other US age groups showed increased consumption and deaths from alcohol use. Future research is needed to determine the causes for the overall decrease in consumption or adaptive measures that this group may have taken, which led tominimal changes in binge or heavy drinking in contrast toyounger populations.

Behavioral Insights Into Investment Decision-Making: Evidence From the Nepal Stock Exchange

This paper provides a reliable foundation for investigating how people's behaviors influence investment decisions. The study surveyed 286 individual investors who participated in the Nepal Stock Exchange, employing a purposive sampling procedure and self-administered structured Likert scale questionnaire. The results indicate that behavioral factors, including stock affordability, information availability, third-party opinions, and herding effect, significantly influence individual investors’ rationality in making investment decisions. The study concludes that in a developing and expanding environment, factors such as disposable income, market trends, and external opinions notably shape investment decisions when individuals choose to invest in the stock market. The alignment of our findings with existing literature reinforces the robustness of our results. The implications of these findings extend to investors, financial advisors, and policymakers alike. Recognizing the influence of behavioral factors can aid in developing strategies to promote informed decision-making and mitigate the adverse effects of herding behavior.

Prevalence and determinants of risky behaviors: a comprehensive review of substance use and sexual risk behaviors among adolescents in the United States

Adolescents are often the most vulnerable to risky behaviors due to their quest for independence, experimentation, and identity development, resulting in deep-rooted patterns that affect health across the life course. This review examines the prevalence and determinants of substance use and sexual risk behaviors among adolescents in the United States. A systematic search of peer-reviewed literature published between 1980-2023 was conducted using multiple databases. Studies focusing on U.S. adolescents aged 12-19 and reporting on prevalence or associated factors of substance use (alcohol, tobacco, marijuana, or any illicit drugs) or sexual risk behaviors (early sexual initiation, multiple partners, or inconsistent condom use) were included. The review synthesized data from 40 studies meeting inclusion criteria. Results indicate concerning rates of substance use and sexual risk-taking, with variations by demographic factors. Alcohol and marijuana use were most prevalent, reported by 30-40% of adolescents. Nearly half of high school students reported having sexual intercourse, with 40% not using condoms consistently. Prevalence was generally higher among older adolescents, sexual minorities, and some racial minority groups. Key determinants of risk behaviors were reviewed based on socioecological models including individual, interpersonal, community and societal factors. The review highlights the multilevel nature of influences on adolescent risk behaviors. Findings underscore the need for tailored interventions addressing multiple determinants. Particular attention to vulnerable groups such as African American Adolescents and social determinants of health inequities is warranted. More research on risk and protective factors and effective interventions is needed. This synthesis can inform the development of evidence-based policies and programs to reduce substance use and sexual risk behaviors among U.S. adolescents.

A novel prediction model for the probability of aggressive behavior in patients with mood disorders: Based on a cohort study

BackgroundAccurately predicting the probability of aggressive behavior is crucial for guiding early intervention in patients with mood disorders. MethodsCox stepwise regression was conducted to identify potential influencing factors. Nomogram prediction models were constructed to predict the probabilities of aggressive behavior in patients with mood disorders, and their performance was assessed using consistency index (C-index) and calibration plots. ResultsResearch findings on 321 patients with mood disorders indicated that being older (HR = 0.92, 95% CI: 0.86–0.98), single (HR = 0.11, 95% CI: 0.02–0.68), having children (one child, HR = 0.07, 95%CI: 0.01–0.87; more than one child, HR = 0.33, 95%CI: 0.04–2.48), living in dormitory (HR = 0.25, 95%CI: 0.08–0.77), non-student (employee, HR = 0.24, 95% CI: 0.07–0.88; non-employee, HR = 0.09, 95% CI: 0.02–0.35), and higher scores in subjective support (HR = 0.90, 95% CI: 0.82–0.99) were protective factors. On the contrary, minorities (HR = 5.26, 95% CI: 1.23–22.48), living alone (HR = 4.37, 95% CI: 1.60–11.94), having suicide history (HR = 2.51, 95% CI: 1.06–5.95), and having higher scores in EPQ-E (HR = 1.04, 95% CI: 1.00–1.08) and EPQ-P (HR = 1.03, 95% CI: 1.00–1.07) were identified as independent risk factors for aggressive behavior in patients with mood disorders. The nomogram prediction model demonstrated high discrimination and goodness-of-fit. ConclusionsA novel nomogram prediction model for the probability of aggressive behavior in patients with mood disorders was developed, effective in identifying at-risk populations and offering valuable insights for early intervention and proactive measures.

Multi-dimensional predictors of first drinking initiation and regular drinking onset in adolescence: A prospective longitudinal study

Early adolescent drinking onset is linked to myriad negative consequences. Using the National Consortium on Alcohol and NeuroDevelopment in Adolescence (NCANDA) baseline to year 8 data, this study (1) leveraged best subsets selection and Cox Proportional Hazards regressions to identify the most robust predictors of adolescent first and regular drinking onset, and (2) examined the clinical utility of drinking onset in forecasting later binge drinking and withdrawal effects. Baseline predictors included youth psychodevelopmental characteristics, cognition, brain structure, family, peer, and neighborhood domains. Participants (N=538) were alcohol-naïve at baseline. The strongest predictors of first and regular drinking onset were positive alcohol expectancies (Hazard Ratios [HRs]=1.67–1.87), easy home alcohol access (HRs=1.62–1.67), more parental solicitation (e.g., inquiring about activities; HRs=1.72–1.76), and less parental control and knowledge (HRs=.72–.73). Robust linear regressions showed earlier first and regular drinking onset predicted earlier transition into binge and regular binge drinking (βs=0.57–0.95). Zero-inflated Poisson regressions revealed that delayed first and regular drinking increased the likelihood (Incidence Rate Ratios [IRR]=1.62 and IRR=1.29, respectively) of never experiencing withdrawal. Findings identified behavioral and environmental factors predicting temporal paths to youthful drinking, dissociated first from regular drinking initiation, and revealed adverse sequelae of younger drinking initiation, supporting efforts to delay drinking onset.

Adult vaccination coverage in the United States: A database analysis and literature review of improvement strategies

ABSTRACT Despite vaccines being instrumental in reducing vaccine-preventable disease, adult vaccination rates in the United States (US) are below optimal levels. To better understand factors affecting vaccination rates, we analyzed trends in adult vaccination coverage using data from the Behavioral Risk Factor Surveillance System (BRFSS) and conducted a targeted literature review (TLR) on interventions to improve adult vaccination rates in the US. Both the BRFSS analysis and the TLR focused on influenza; pneumococcal disease; tetanus and diphtheria or tetanus, diphtheria, and acellular pertussis; herpes zoster; and human papillomavirus vaccination for US adults aged 18–64 years. The TLR additionally included hepatitis A and hepatitis B vaccination. Vaccination coverage rates (VCRs) and changes in VCRs were calculated using the 2011–2019 BRFSS survey data. For the TLR, the MEDLINE and MEDLINE In-Process databases were searched for articles on vaccination interventions published between January 2015 and June 2021. The BRFSS analysis showed that changes in VCRs were generally modest and positive for most states over the study period. The TLR included 32 articles that met the eligibility criteria; intervention strategies that improved adult vaccination outcomes incorporated an educational component, vaccination reminders or reinforcement at the point of care, or authorized non-clinician members of the healthcare team to vaccinate. Furthermore, interventions combining more than one approach appeared to enhance effectiveness. The strategies identified in this TLR will be valuable for policymakers and stakeholders to inform the development and implementation of evidence-based policies and practices to improve adult vaccination coverage.

An Exploration of Unique Mental Health Challenges and Resilience Factors within the LGBTQ+ Community: A Systematic Review

Mental health challenges in the LGBTQ+ community pressing issues as it impact the overall health status. Despite the concerns raised on the discrimination, bias and stereotypes, new challenges arise, implicating challenges to the health sector. The present review of evidence focuses on the resilience factors and the unique mental health challenges faced by members of the LGBTQ+ community. The Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) were used to identify, select, appraise and synthesize evidence in the present review, whereas the Sample, phenomenon of Interest, Design, Evaluation and Research type (SPIDER) protocol guided the selection of eligible studies to be reviewed. The Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach was used to rate the certainty of evidence about the unique mental health challenges and resilience factors within the lesbian, gay, bisexual, transgender, queer, intersex, and asexual (LGBTQ+) community. Initial article search was limited to English publications and performed on electronic databases, including Google Scholar, ProQuest, PubMed, and Web of Science. The Cochrane risk of bias assessment tool was used to examine the risk of bias in the individual studies. Risk of bias assessment was performed on the domains, including due to the randomization process, bias due to deviations from intended interventions, bias due to missing outcome data, bias in the measurement of the outcomes, bias in the selection of the reported result, and the overall risk of bias, reflecting the overall risk of bias of the included studies. A qualitative synthesis of results was considered in the present systematic review. The evidence was contrasted and compared against the existing knowledge and theoretical orientation. The present review found that poor dissemination of interventions and implementations are unique mental health challenges among the LGBTQ+ community. The poor implementation and dissemination of interventions substantiate psychological distress, anxiety, depression, and suicidal thoughts and deteriorates quality of life. The web or internet-based implementation of cognitive behavioral therapy emerged as effective resilience factor in the management of mental conditions among members of the LGBTQ+ community. Keywords: LGBTQ+, mental health, treatment, cognitive behavioral therapy, resilience factors, anxiety, depression, and interventions

Behavioral preferences and contract choice in the residential solar PV market

AbstractGreater adoption of renewable energy technologies by households is a key component of decarbonization and energy transition goals. Although existing literature has examined how sociodemographic characteristics, “green” preferences, and peer effects impact adoption of new energy technology, the role of behavioral preferences has not been adequately studied. In this paper, we examine the effect of two types of behavioral preferences, namely the degree of risk tolerance (risk preference) and attitude toward delayed reward (time preference) on the contract decision to lease or own a solar photovoltaic (PV) system. We develop a theoretical framework to show that the effect of risk and time preferences on the relative utilities from the two contracts is monotonic: Lower risk aversion and lower discount rate (more patience) imply a higher chance of solar PV ownership. To test these predictions empirically, we first estimate preference parameters (risk aversion and discount rate) from laboratory data collected from solar PV adopters. We then combine the parameter estimates with data on actual solar PV contract choice to examine the relationship between solar PV adopters' time and risk preferences and their lease‐versus‐own choice. Our regression results confirm that less risk averse individuals have a higher tendency to choose the ownership option, whereas more patient individuals are (weakly) more likely to own their solar PV systems. These findings contribute to a greater understanding of the role of behavioral factors in household decisions related to energy technologies.

Understanding the psychological and behavioral factors influencing picky eating in preschool-aged children

Eating choices in preschool children are shaped by various psychological and behavioral factors. Key influences include the child's natural temperament, with traits such as sensory sensitivity and food neophobia playing an important role. Parental eating practices, including modeling healthy eating behaviors and creating a positive mealtime environment, have a significant impact on children's eating patterns. Family dynamics, such as parental pressure or restrictions, can exacerbate selective eating behavior. In addition, early experiences with a variety of foods and repeated exposure to new foods are also important in shaping a child's acceptance of varied foods. Interventions that emphasize a non-coercive and supportive approach, encourage repeated exposure to a variety of foods, and foster a positive mealtime atmosphere are critical to reducing picky eating behavior. By understanding these factors, parents and caregivers can better address and manage picky eating, encourage healthier eating habits, and support preschoolers' overall growth and well-being.

Sociodemographic Determinants of Extreme Heat and Ozone Risk Among Older Adults in 3 Sun Belt Cities.

Vulnerable populations across the United States are frequently exposed to extreme heat, which is becoming more intense due to a combination of climate change and urban-induced warming. Extreme heat can be particularly detrimental to the health and well-being of older citizens when it is combined with ozone. Although population-based studies have demonstrated associations between ozone, extreme heat, and human health, few studies focused on the role of social and behavioral factors that increase indoor risk and exposure among older adults. We conducted a household survey that aimed to understand how older adults are affected by extreme heat and ozone pollution inside and outside of their homes across Houston, Phoenix, and Los Angeles. We examine contributing factors to the risk of self-reported health effects using a generalized linear mixed-effects regression model of telephone survey data of 909 older adults in 2017. We found an increased occurrence of self-reported symptoms for extreme heat with preexisting respiratory health conditions and a lack of air conditioning access; self-reported ozone symptoms were more likely with preexisting respiratory health conditions. The risk of heat-related symptoms was slightly higher in Los Angeles than Houston and Phoenix. We found several demographic, housing, and behavioral characteristics that influenced the risk of heat- and ozone-related symptoms. The increased risk among older adults based on specific social and behavioral factors identified in this study can inform public health policy and help cities tailor their heat and ozone response plans to the specific needs of this vulnerable population.

Cancer History and Social Support Impact Colorectal Cancer Screening Utilization by Race/Ethnicity.

This study examined the association between cancer history, social support, and up to date colorectal cancer (CRC) screening among four racial/ethnic groups. We conducted a cross-sectional analysis using data on respondents aged 45-75 years from the 2022 Behavioral Risk Factor Surveillance System. Our outcome of interest was CRC screening and exposures of interest were race/ethnicity, cancer history, and social support. Weighted multivariable logistic regression was performed. Among 73,869 adults, the CRC screening rate was 66.8% with the highest rate in non-Hispanic (NH) Whites (72.2%) and the lowest in Hispanics (52.6%). Screening rates were higher in adults with a cancer history (81.9%) and those having social support (69%). Hispanic adults with a cancer history had lower screening use (50.9% vs. 77.4% in no cancer history group; p-value <0.001). Regardless of race/ethnicity, adults without social support had lower screening utilization (p-value<0.05). In effect modification, NH White adults who reported no cancer history and lack of social support were 12% less likely to have CRC screening than those with social support but without cancer history (OR,0.88;95% CI, 0.79-0.98). Similar results were observed among Hispanic adults without a cancer history and social support, with 37% less likely to have CRC screening than those with social support but no cancer history (OR,0.63;95% CI, 0.42-0.93). NH White and Hispanic adults without a cancer history and limited social support were less likely to have CRC screening uptake. By implementing culturally tailored interventions that address social support needs, greater CRC screening compliance may be increased among these populations.

Utilization of Data Visualization Tools to Inform Decision-Making Among Health Managers in Selected Counties, in Kenya

The study aimed to investigate the factors influencing the utilization of data visualization tools among County and Sub County Health Managers in eight selected counties in Kenya. The research focused on how individual characteristics, technological, organizational, and behavioral factors impact the use of these tools in decision-making. The mixed methods approach included quantitative data from structured questionnaires and qualitative data from interviews. Out of the targeted 160 respondents, 149 participated, giving a response rate of 93%. Data were analyzed using SPSS version 26 for quantitative analysis and thematic content analysis for qualitative data. The findings revealed that all four factors significantly influence decision-making. Individual characteristics had a positive correlation coefficient of 0.504, technological factors 0.784, organizational factors 0.776, and behavioral factors 0.404, all statistically significant. The study showed that 82.3% of the variance in data visualization tool utilization could be explained by these factors. The regression analysis demonstrated positive relationships between each factor and the use of data visualization tools. The study concluded that individual characteristics, such as training, significantly influence decision-making and recommended further training for healthcare managers in advanced data analysis, epidemiology, data presentation, interpretation, data mining, modeling, GIS, monitoring, evaluation, data analytics, and predictive analysis.

The Perception and Roles of School Mental Health Professionals Regarding School Bullying (Suluk Audwani) in Oman: A Qualitative Study in an Urban Setting.

With increasing mental health risks among school populations and prevalent bullying, school mental health professionals (SMHP) are crucial globally. This study explores the perspectives of SMHP on bullying in Omani schools, focussing on definitions, types, current practices, and future strategies. Involving 50 Omani SMHP from Muscat Governorate with at least three years of experience, data was collected through structured interviews and analyzed using Braun and Clarke's six-step thematic analysis. Six key themes emerged: The definition of bullying, its components, common types, current anti-bullying practices, challenges, and future suggestions. Bullying, termed "سلوكعدواني" (Suluk Audwani), meaning aggressive behavior, includes five components: perpetrators, victims, harmful behavior, spectators, and psychosocial factors. Verbal bullying, physical bullying, and cyberbullying are common and vary by age. SMHP frequently employ awareness-raising and psychological first aid. Challenges include resistance from students and parents and institutional barriers. In the future, SMHP will emphasize greater awareness to effectively address Suluk Audwani. Oman has adopted international best practices to recruit SMHP. SMHP's perspectives on Suluk Audwani reflect both their training and Omani cultural influences. Future research should explore various social strata to improve evidence-based understanding and prevention of Suluk Audwani.

Prevalence and associated factors of myopia among adolescents aged 12–15 in Shandong Province, China: a cross-sectional study

Myopia is a growing concern worldwide, especially among adolescents. This study aimed to investigate the prevalence and associated factors of myopia in adolescents aged 12–15 in Shandong Province, China. This cross-sectional study adhered to the Strengthening the Reporting of Observational Studies in Epidemiology guidelines and involved stratified random cluster sampling of 128,678 students from 186 middle schools across 17 cities in Shandong Province. Data collection was conducted from March to April 2024. We excluded students with organic eye diseases, abnormal binocular vision functions, or a history of eye injuries or surgeries. Myopia was assessed using the standard logarithmic visual acuity chart and autorefractor without inducing ciliary muscle paralysis. A comprehensive questionnaire survey was conducted to gather demographic characteristics and daily life behaviors. With the chi-squared test for univariable analysis and multivariable logistic regression for identifying significant factors. This study included 126,375 participants, with a gender distribution of 51.02% male and 48.98% female. The overall prevalence of myopia was 71.34%. Higher prevalence was observed in girls (72.26%) compared to boys (70.45%), and the prevalence increased with age, peaking at 73.12% in 15-year-olds. Urban residents had a higher prevalence (71.86%) than rural (70.39%). Factors such as increased frequency of eye usage while lying down or leaning forward, frequent use of eyes while walking or riding in a car, prolonged screen time, and extended homework duration were associated with higher odds of developing myopia. Conversely, higher frequency of outdoor exercise, maintaining proper posture during reading and writing, greater distance from eyes to screen, and longer sleep duration were associated with lower odds. Additionally, female gender, older age, urban residence, and parental history of myopia increased the risk. The high prevalence of myopia among adolescents in Shandong Province was influenced by a combination of demographic, behavioral, and environmental factors. The study highlighted the importance of lifestyle modifications, such as increasing outdoor activities and maintaining proper visual habits, limiting the duration of screen exposure and homework sessions, and extending sleep duration, to mitigate the risk of developing myopia. These findings underscored the need for targeted public health interventions and educational campaigns to address this significant public health issue.

Socio-cultural and Environmental Risk Factors for Leprosy in Jaffna District, Sri Lanka

This study was conducted to determine the socio-cultural and environmental risk factors of leprosy in Jaffna. A case-control study was conducted in dermatology clinic, teaching hospital, Jaffna from July 2015 to July 2016. All 97 cases and 291 controls by systematic sampling were recruited using interviewer-administered questionnaire.The mean age of cases was 41 (SD=21) and control was 48 (SD=20). Of 97 cases, 54.6 %( n=53) males; 99 %( n=96) Tamils; 79.4 %( n=77) Hindus; 60 %( n=59) above secondary education. Of 291 controls, 42.3 %( n=123) were males; 99.3 %( n=289) Tamils; 85.6 % (n=249) Hindus; 78.4 % ( n=225) above secondary education.Socio demographic factors (12 variables), house and environmental factors (11 variables), and behavioral factors (18 variables) were included in bivariate analysis and many were found to be significantly (p&lt;0.05) associated with leprosy. Marital status, displacement, monthly income, presence of BCG scar, firewood as cooking fuel, and hunting reptiles were not found to be associated with leprosy. Multiple logistic regression analysis showed significant association between leprosy and - crowded household [OR4.5, (1.5-13.6)], non-availability of drinking water within 30 minutes walking [OR15.1, (2.3-98.3)], environment with shrub [OR2.9, (1.4-6.1)], exposure to shrub [OR2.7, (1.2-5.9)], exposure to leprosy patient [OR10.6, (4.1-27.5)], exposure to fishing [OR4.5, (1.5- 13.6)], visits to leprosy affected area [OR10.8, (4.7-24.5)] and unavailability of safe water source [OR3.3, (1.2- 9.1)]. In addition to the well-known risk factors environment-related risk factors, especially exposure to jungle/shrubs could play a role in the transmission of leprosy.