Global research consistently identifies significant disparities in the diagnosis of Autism Spectrum Disorder (ASD), strongly associated with family socioeconomic status and geographic location. However, such data from low-resource settings like Bangladesh is critically lacking. This case-control study aimed to characterize the socioeconomic and geographic profiles of children clinically diagnosed with ASD at a major tertiary centre in Bangladesh. The study was conducted at Department of Pediatrics, Mymensingh Medical College & Hospital, Bangladesh; Institute of Pediatric Neurodisorder and Autism (IPNA), BMU; Institute of Child and Mother Health (ICMH), Dhaka, Bangladesh from June 2021 to May 2022, enrolling 25 children with ASD and 25 typically developing controls aged 3-16 years. Data on key demographic indicators, including parental education, family income, place of birth and residence characteristics, were collected through parental interviews. Statistical analyses revealed profound disparities. Children with ASD were significantly more likely to come from families with higher parental education (Fathers: 80.0% vs. 16.0%; Mothers: 76.0% vs. 12.0%), higher monthly family income (92.0% vs. 44.0%) and an urban birthplace (80.0% vs. 32.0%). Furthermore, residence near a high-traffic road was a strongly associated environmental factor (92.0% vs. 44.0%). These findings highlight significant inequities in the pathway to an ASD diagnosis in Bangladesh, which are likely driven by differential access to specialized healthcare, varying levels of parental awareness and the urban concentration of diagnostic services rather than causal risk factors. The results underscore an urgent public health imperative: to develop and implement equitable strategies that enhance ASD awareness, decentralize diagnostic capabilities and ensure that all children in Bangladesh, irrespective of their socioeconomic background or place of residence, have an equal opportunity for timely identification and support.

Socioeconomic status (SES) is associated with adolescents' cognitive and academic outcomes, yet most research has focused on household SES in high-income countries. This study examined linear and canonical associations between family- and school-level disadvantage and cognitive-academic performance in 1296 Chilean adolescents (aged 10-14). Linear mixed models estimated associations between SES and continuous cognitive and academic scores, while canonical correlation analysis (CCA) characterized multivariate SES-cognition-achievement patterns. Findings showed that attending schools with a mid- or low School Vulnerability Index (SVI) was associated with higher scores in memory and problem solving (β = 4.3-7.4), whereas SVI was not related to grades; in contrast, parental university education and higher household income were linked to higher cognitive scores (β = 2.9-5.0) and better grades across subjects (β = 0.12-0.45). CCA identified two globally significant covariation modes. The first mode (r = 0.40) captured a broad socioeconomic dimension, driven primarily by family income and parental education, which correlated with generalized cognitive and academic performance. A second mode (r = 0.25) captured secondary variance in selected academic subjects and inhibitory control. However, individual SES indicators did not reach statistical significance on this component. These findings suggest a shared socioeconomic gradient driven predominantly by family resources underlies adolescent cognitive and academic outcomes. Alongside this global trend, school vulnerability is primarily linked to specific cognitive functions and family socioeconomic status is pervasively associated with academic achievement. Mitigating educational disparities would therefore benefit from multi-level policies targeting both environments. SUMMARY: A shared socioeconomic gradient driven by family resources underlies adolescent cognitive and academic outcomes. School vulnerability associates specifically with targeted cognitive functions. Family socioeconomic status pervasively associates with broad academic achievement. Effective mitigation of educational disparities involves targeting both home and school contexts.

Swimming lessons are an effective drowning prevention strategy, yet uptake remains socially patterned. Socio-structural factors such as parent age, sex and family income may shape parents' decisions to enrol their children in swimming lessons. According to the Theory of Planned Behaviour (TPB), people's beliefs, reflected in their attitudes, subjective norms and perceived control, drive health-related intentions. Socio-structural characteristics may therefore influence parents' intentions indirectly by shaping these underlying beliefs. This study examined an untested pathway, assessing whether socio-structural factors shape parents' beliefs and, in turn, their intentions to enrol children in swimming lessons. Parents (N = 323) of primary school-aged children without prior formal lessons completed an online survey. Latent variable structural equation modelling in R (Lavaan) tested direct and indirect relationships between socio-structural factors, TPB constructs and intention. The model demonstrated good fit. Parent age predicted attitudes, subjective norms and perceived control. Sex directly predicted intention, while income predicted perceived control. All three TPB constructs significantly predicted intention, mediating the effects of age and income. The model explained 70% of variance in intention. Parents' intention to enrol their children in swimming lessons is shaped indirectly by socio-structural characteristics through belief-based TPB constructs. This highlights the importance of integrating structural determinants into social cognition models to better understand inequities in preventive health behaviours. SO WHAT?: Strengthening positive attitudes, supportive social norms and parental confidence, while reducing financial and structural barriers to participation, may improve equitable access to swimming lessons and contribute to drowning prevention.

The Supplemental Security Income (SSI) program remains an important source of financial support for low-income families of children, adolescents, and young adults with disabilities. In most states, SSI eligibility also qualifies children for the state Medicaid program, providing access to health care services. The Social Security Administration (SSA), which administers the SSI program, considers a child disabled under SSI if there is a medically determinable physical or mental impairment or combination of impairments that results in marked and severe functional limitations. The impairment(s) must be expected to result in death or have lasted, or be expected to last, for a continuous period of at least 12months. The income and assets of families of children with disabilities are also considered when determining financial eligibility. When an individual with a disability becomes an adult at age 18, the SSA considers only the individual's income and assets. The SSA considers an adult disabled if there is a medically determinable impairment (or combination of impairments) that prevents substantial gainful activity for at least 12 continuous months. SSI benefits are important for youth with disabilities who are transitioning to adulthood. The purpose of this statement is to provide updated information about SSI medical and financial eligibility criteria and the disability determination process. Although pediatricians do not make the determination for SSI eligibility, this statement discusses the pediatrician's role in alerting families to the possibility of SSI support, connecting families to resources to assist in the application process, and providing timely documentation required for the application.

This study shows how deep-rooted inequalities-shaped by where a child is born, their family's income, and their mother's education-restrict access to essential services for early development. Using data from the National Survey on Childhood Malnutrition (ENDI), we use the Human Opportunity Index (HOI) and Shapley decomposition to assess disparities in healthcare, water, and sanitation in Ecuador. Although overall averages for services like prenatal care and immunization are high, children with chronic malnutrition (stunting) face much less access and greater inequality. The largest gaps are in access to safely managed drinking water and sanitation, where both coverage and equity remain low, particularly among stunted children. Geographic location is the main predictor of inequality, followed by economic status and maternal education. This study provides transferable insights to inform equitable public health policies in similar contexts worldwide.

Medical specialty choice shapes both physician identity and healthcare systems. Specialty choices are influenced not only by academic interest and aptitude but also by gender norms and socioeconomic pressures. While these dynamics are well documented in high income settings, fewer studies examine how perceived gender roles and income expectations jointly influence specialty preferences in LMICs contexts. This sequential mixed methods study combined a cross-sectional online survey with semi structured interviews. The quantitative phase included 155 medical students (response rate 79.5%) and examined associations between demographic characteristics and specialty preferences. The qualitative phase comprised 34 interviews purposively sampled across all five cohorts. Interview data were analyzed thematically using Braun and Clarke's six step framework, following an inductive and reflexive approach guided by Social Cognitive Career Theory to explore how students understood and negotiated gender norms, income potential, and workload intensity. Quantitative analysis showed no statistically significant associations between income-based specialty preference and gender, GPA, family income, hometown, or high school background (all p > 0.05). High income specialties were selected by 60 students (39%), low-income specialties by 26 (17%), and other fields by 69 (44%), with similar gender distribution across these groups (p = 0.81). In contrast, qualitative analysis revealed pronounced gendered patterns. Many female students chose specialties they perceived as low intensity, often citing anticipated caregiving responsibilities and work life balance concerns as reasons for avoiding surgery, emergency medicine, and other high intensity fields. Male students frequently reported social and familial pressure to pursue prestigious or high-income specialties, prioritizing financial stability and provider roles even when these conflicted with personal interests. Across both genders, themes highlighted the centrality of perceived income, prestige, mentorship inequities, and cultural narratives of sacrifice in shaping career compromises. Specialty choice among medical students in LMICs reflects not only personal interest but also structural inequities linked to gender norms and income expectations. Although quantitative analysis of demographic factors did not independently predict specialty preferences, qualitative findings revealed powerful social pressures that shape career compromises. Targeted, gender sensitive career counselling, equitable mentorship, and financial support are needed to enable students to choose specialties that align with their values and competencies.

Purpose: This study examines management competencies, career attitudes, leadership preferences, and long-term life purpose orientations among Generation Z students in the Indian higher education context. It also explores whether demographic factors influence these dimensions and whether they are interrelated. Methodology: A quantitative and exploratory research design was adopted. Data were collected through a structured online questionnaire from 478 students enrolled in intermediate, undergraduate, and postgraduate programs across India. Descriptive statistics, independent samples t-tests, one-way ANOVA and Chi-square tests were used for data analysis. Findings: The results indicate that Generation Z students report generally high levels of management competencies, particularly in time management and coordination, while adaptability and balancing personal and academic responsibilities were comparatively lower. Selected career attitudes including work–life balance, financial independence, and career stability, differed significantly across schooling background. Family income and academic stream influenced specific management competencies and career attitudes. In terms of leadership, students showed a strong preference for transformational, servant, and autonomy-supportive leadership styles, whereas authoritarian leadership was least preferred. Leadership preferences were largely consistent across demographic groups; however, long-term life purpose orientations varied significantly with family income, highlighting the role of socio-economic background in shaping students aspirations. Practical Implications: The findings suggest that higher education institutions should place greater emphasis on developing adaptability, work–life balance skills, and collaborative competencies, while also considering students’ diverse socio-economic backgrounds in employability and leadership development initiatives. Originality: The study offers a student-centric and context-sensitive perspective by integrating management competencies, career attitudes, and leadership preferences within a single framework in the Indian higher education context.

Abstract Building on the findings from previous studies, the purpose of this study was to understand whether area-level median household income ( MHI ) and median family income ( MFI ) estimates would capture the same dimension of area-based socioeconomic status ( SES ) at multiple census geographic levels as the composite measures derived from five area-based indices developed in the United States. Area-based socioeconomic data at the census tract, ZIP code tabulation area, county, core-based statistical area, micropolitan statistical area, metropolitan statistical area, and state levels were obtained from the US Census Bureau’s website. Consistent across multiple census geographic levels, area-level MHI and MFI were very strongly and positively correlated with one another and were also strongly or very strongly correlated, either positively or negatively, with five composite measures. Taken together, either area-level MHI or MFI may be used to capture a change from lowest to highest SES areas at multiple census geographic levels.

To facilitate the vocational rehabilitation of colorectal cancer patients, more information is needed on the influencing factors related to the quality of work life of colorectal cancer patients after their return to work. This study examines the Quality of Working Life (QWL) among the patients with colorectal cancer (CRC) survivors after returning to work and identifies influencing factors. A cross-sectional study from January to May 2023 followed 290 CRC survivors from a Chinese hospital's oncology outpatient department. The General Questionnaire, Quality of Working Life Questionnaire for Cancer Survivors (QWLQ-CS), Simplified Coping Style Questionnaire, and the Social Support Revalued Scale were used for data collection. Descriptive statistics, T-tests, ANOVA, correlation, and multiple linear regression analyses were conducted with the Statistical Package for the Social Science (SPSS) version 25.0. The QWL score of CRC survivors was (67.72 ± 12.21). Factors such as the per capita monthly family income, medical payment method as self-employment, basic medical insurance system for urban residents, stoma status, positive coping strategies, passive coping strategies, and social support utilization emerged as significant QWL determinants, while passive coping strategies was inversely related to QWL. CRC survivors have greater room for improvement in their work life (QWL) after returning to work. To enhance their reintegration and QWL, healthcare professionals should implement individualized interventions that reflect the various challenges these individuals face. It is important to provide special attention to colorectal cancer survivors who pay for their medical care directly, have residential health insurance, have an ostomy, or have a per capita family income of less than 281⁄ per month, as they tend to report worse levels of quality of work life. Clinical personnel should rapidly detect these risk factors and offer the required assistance and resources to ensure that these patients are adequately prepared to resume employment and enhance their overall quality of work life.

Congenital infections, often asymptomatic for both mother and fetus, can affect neurodevelopment. This study aimed to analyze neurodevelopmental outcomes and associated risk factors in preterm children with and without congenital STORCH infections. A case-control study was conducted, with children assessed longitudinally. A retrospective case-control study was conducted including 248 preterm children. The control group showed higher cognitive and language scores than the STORCH case-group. The STORCH case-group had a significant decline in cognitive scores from 6 to 18 months (p<0.05), although their motor scores improved from 6 to 24 months (p<0.05). Risk factors for neurodevelopment in the STORCH case-group included APGAR, NICU seizures and stay, familyincome, sepsis, and twin birth (beta 0.27-0.49). For the control-group, risk factors included NICU seizures and stay, APGAR, family income, sepsis, mechanical ventilation, maternal education, and bronchopulmonary dysplasia (beta 0.12-0.31). Children with STORCH infections showed poorer cognitive and language development. Early prevention of STORCH infections is crucial to prevent negative developmental outcomes.

ABSTRACTBackgroundAnemia is a worldwide public health problem, affecting more than half of schoolchildren in developing countries. The prevalence of anemia has been studied in various communities in Ethiopia. However, data on schoolchildren in Mattu town have been lacking.ObjectiveThis study aimed to determine the prevalence and associated factors of anemia among schoolchildren attending a public primary school in Mattu town, southwest Ethiopia.MethodsA school‐based cross‐sectional study recruited 317 children aged 7–14 years in 2024. Sociodemographic and socioeconomic data were collected via questionnaires. Blood analyses were performed for complete blood count, red blood cell morphology, malaria, and intestinal parasites. Data analysis was conducted using SPSS version 23, with logistic regression used to identify factors associated with anemia at p value < 0.05.ResultA total of 330 schoolchildren were included in the study, with a 96.1% response rate. The overall prevalence of anemia in this study was 33 (10.4%, 95%CI: 7.27%, 14.31%). Mild anemia was found in 69.7% of cases, and females comprised 53.3% of participants, with a mean age of 11.1 years (SD ± 1.798). The factors significantly associated with anemia included mothers with no formal education (AOR = 5.02, 95% CI: 1.75–14.39), male gender ((AOR = 3.15, 95% CI: 1.20–8.28)), low family income (AOR = 4.71, 95% CI: 1.75–12.68), intestinal parasitic infection (AOR = 4.48, 95% CI: 1.77–11.37), and a habit of consuming coffee or tea with meals (AOR = 3.96, 95% CI: 1.55–10.11).ConclusionThis study found a mild prevalence of anemia among schoolchildren in Mattu town. Anemia was associated with low maternal education, low family income, male sex, and intestinal parasitic infections. Targeted interventions such as health education, deworming programs, and awareness of tea/coffee consumption with meals are recommended to improve child health outcomes.

Background: malnutrition in throughout early childhood remains the important health problem in Iraq and it’s a disorder which arises when a child consumes insufficient or excessive amount of one or more of the nutrients, significantly leading to health problems. Aim :To estimate the prevalence of malnutrition and its contributed socio-demographic, economic, and health-related factors among children under six years attending a major hospital outpatient department in Sulaymaniyah, Iraq. Methods: A cross-sectional study was conducted in hospital setting between March 2025 to July 2025. A systematic random sample of 420 child-caregiver pairs was selected. Information were collected using structured questionnaire and anthropometric measurements. The nutritional status was categorised based on WHO Growth Standards. Bivariate and multivariate logistic regression analyses was carried out to estimate factors associated with malnutrition . Results: Any malnutrition (stunting, wasting, or underweight) was 30.7%. Stunting was most commonly observed (14.8%), then underweight (11.7%) and wasting (7.9%). On bivariate analysis, low family income (p=0.024) was significantly associated with malnutrition (χ²=9.48). Multivariate analysis confirmed low income as the strongest predictor. Children from families earning &lt;300,000 IQD/month (aOR=2.22, 95% CI: 1.05–4.73) and 500,000–800,000 IQD/month (aOR=2.46, 95% CI: 1.15–5.28) had significantly higher odds of malnutrition versus the highest income group.Health and dietary factors were not significant independent predictors. Conclusion: Malnutrition is a potential public health problem in this population, with stunting being the primary concern. Socioeconomic status, not health or dietary practices, is the fundamental determinant. Effective interventions must therefore extend beyond nutritional education to include robust economic support and poverty alleviation programs to address the root causes.

Unpacking the heterogeneity of AI literacy among nursing undergraduates: A latent profile analysis.

The COVID-19 pandemic disrupted daily behaviours. We compared the annual change in obesity prevalence before and during the pandemic in children and parents. Participants were recruited from TARGet Kids! in Canada and followed prospectively. Each participant had at least one body mass index (BMI) measure before and during the pandemic. Marginal logistic models with piecewise functions were used to estimate adjusted odds ratios (aORs) for the association between year and obesity prevalence before (2015-2020) and during the pandemic (2020-2023). Among children (n = 1,163), in the 5years pre-pandemic, the average annual increase in the odds of obesity was 18% per year (aOR = 1.18, 95%CI 1.02-1.36).This increased substantially early in the pandemic (aOR = 2.17, 95%CI 1.45-3.25), and during the second year of the pandemic it decreased (aOR = 0.66, 95%CI 0.46-0.93). Among parents (n = 653), pre-pandemic there was an annual increase in the odds of obesity (aOR = 1.27, 95%CI 1.12-1.42) but this plateaued during the early (aOR = 0.79, 95%CI 0.50-1.25) and later pandemic periods (aOR = 1.08, 95% CI:0.81-1.43). Increases in child obesity during the pandemic were greatest among lower income families and younger children. Obesity prevalence among children rose significantly early in the COVID-19 pandemic and waned in the second year but remained higher than pre-pandemic levels.Clinical Trial Registration: www.clinicaltrials.gov, ID NCT01869530.

Introduction: Obesity is a nutritional disease, one of the most significant of the 21st century, that has grown to epidemic proportions. Overweight and obesity, once considered a problem in high-income countries, now affect low and middleincome countries, especially in urban areas. Overweight and obesity rates among children and adolescents are constantly rising. Aims of the Study: to assess the incidence and associative factors of obesity among adolescent in selected schools of Pimpri Chinchwad municipal corporation area, Pune. Methodology: The study adopted an exploratory approach with a cross-sectional design to assess the incidence and associative factors of obesity among adolescents in selected schools of Pimpri Chinchwad, Pune. A total of 200 adolescents (12–18 years) were selected using simple random sampling. Data were collected using a structured interview schedule and anthropometric measurements to calculate BMI. The tool included demographic data and factors such as dietary pattern, activity pattern, and personal and family history. A pilot study was conducted to test feasibility. Data were analysed using descriptive and inferential statistics. Results: Most adolescents were aged 14–16 years, with nearly equal gender distribution and majority being Hindu, nonvegetarian, and from nuclear families. Among 200 adolescents, 45.5% were normal weight and 7.5% were obese, with higher obesity in girls. Dietary habits, physical inactivity, and stress showed significant association with obesity. Family income and religion were also significantly related, with higher BMI seen in higher income groups. Conclusion: The study concludes that obesity among adolescents is present at a notable level, with significant association to dietary habits, physical inactivity, stress, family income, and religion. Early identification and lifestyle modifications are essential to prevent and control obesity among adolescents.

Background. Human papillomavirus (HPV) is a prevalent sexually transmitted infection and major cause of cervical and anogenital cancers. This study aimed to assess parental knowledge, vaccine hesitancy, and health beliefs concerning HPV infection and vaccination. Methods. This cross-sectional study was conducted using convenience sampling among parents of adolescents aged 9-18 attending outpatient clinics at a tertiary hospital. The study collected sociodemographic characteristics and used the Health Belief Model Scale for HPV Infection and Vaccination to assess health beliefs, in order to identify factors associated with parental perceptions and vaccination attitudes. Results. A total of 320 parents participated in the study; 82.8% were mothers. Self-reported HPV infection was low (1.9%), and only 3.4% of parents and 2.8% of their children had been vaccinated. Awareness about HPV infection was 75%, and that of the HPV vaccine was 67.2%. However, only 30% of parents were willing to vaccinate their children, while 47.5% were uncertain. The most commonly reported barriers were lack of awareness (33.9%) and concerns about side effects (26.4%). Higher parental education, family income, and prior HPV knowledge were positively associated with both awareness and willingness to vaccinate children, whereas having multiple adolescents was associated with increased vaccine hesitancy. Conclusion. Parental awareness of HPV infection and vaccination was 75% and 67.2%, respectively, while vaccination rates among adolescents were very low. Higher parental education, income, and prior HPV knowledge were associated with favorable perceptions of vaccination. Addressing knowledge gaps and reducing perceived barriers through educational interventions may help increase HPV vaccination uptake among adolescents.

BackgroundInfertility affects millions globally, and while assisted reproductive technology (ART) has become a cornerstone of its treatment, there is limited research on how Lebanese women perceive these services. This study aims to fill the gap by assessing each of the knowledge, attitudes, and expectations of Lebanese women experiencing difficulty conceiving towards ART.MethodsA cross-sectional study was conducted between June and September 2024, involving 346 Lebanese women from two fertility centers in Beirut. Participants were selected by simple random sampling to complete the questionnaire through individual interviews. Descriptive and bivariate analyses were performed, and generalized linear models were used to explore the associated factors of knowledge, attitudes, and expectation scores.ResultsThe results showed that 56.4% of participants had good knowledge, 54.9% had positive attitudes, and 73.7% exhibited high expectations. The generalized linear models revealed that previous ART use (β = 0.151), receiving ART information from a doctor (β = 0.064), female age (β = 0.005), and physical exercise (β = 0.119) were linked to higher knowledge, while higher family income (β = −0.133), history of immunodeficiency (β = −0.275), living in centers (β = −0.066), were linked to lower knowledge. For attitudes, residing in South Lebanon (β = 6.136), having a history of ovarian cyst removal (β = 2.065), receiving ART information from a doctor (β = 1.151) and female age (β = 0.120) were linked to positive attitudes, while living in centers (β = −1.835), having a regular menstrual period (β = −1.521) were linked to lower attitudes. For the expectations, female hormonal disorder (β = 2.758) was significantly associated with higher expectations, while advanced female age (β = −0.768) was associated with lower expectations.ConclusionThis study identifies associated factors influencing knowledge, attitudes, and expectations toward ART. To optimize these aspects, interventions should focus on effective education, personalized treatments, reducing barriers, and providing psychological support to improve women’s reproductive health. Further research is needed to explore these factors in the broader population.

This study aimed to determine the prevalence and risk factors associated with Toxoplasma gondii infection in blood donors from the Brazilian Semiarid region, and to explore its implications for transfusion safety. Samples were collected from 646 donors at blood donation centers in the states of Ceará and Paraíba. Serological diagnosis was performed using BIOLISA TOXOPLASMOSE ELISA kits for anti-T. gondii IgM and IgG antibodies, and molecular diagnosis was conducted by conventional PCR targeting a 529-bp noncoding repetitive fragment. Epidemiological questionnaires on variables associated with infection were administered, and statistical analysis was performed in univariate and multivariate stages, using multiple logistic regression. Among the 646 donors, 43.4% (281/646) were positive for anti-T. gondii IgG antibodies, 0.3% (2/646) for IgM antibodies, and none tested positive by PCR. In the univariate analysis, age, family income, educational level, salad washing practices, water source, raw milk consumption, and duration as a donor were significantly associated, whereas in the multivariate analysis only "age" and "salad washing practices" remained significant. A substantial IgG seroprevalence was observed among blood donors in the Brazilian Semiarid. The low IgM frequency, concurrent IgG positivity, and negative PCR results are consistent with a low transfusion risk in the region. However, these findings should be interpreted cautiously, as negative PCR results do not completely rule out the presence of circulating parasites. Age was identified as a risk factor, whereas proper salad washing showed a protective effect.

Women, especially in urban marginalized areas, face a set of challenges and limitations in the field of health promotion. Considering the key role of women in family and community health, and their vulnerability in marginalized conditions, this study aimed to examine health-promoting lifestyle in women living in urban marginalized areas, to identify their needs and provide a foundation for designing evidence-based interventions and effective policies to improve women's health. This cross-sectional, descriptive-analytical study was conducted in 2025 on 295 women living in a suburban area of Mashhad, northeastern Iran, using multi-stage sampling. After ethical approval and written informed consent, participants completed a demographic questionnaire and the Health-Promoting Lifestyle Profile II (HPLP-II), whose Persian version has confirmed validity and reliability in Iran (Cronbach's alpha = 0.82). Data were analyzed in SPSS version 25 using descriptive and analytical statistics including Kruskal-Wallis, Mann-Whitney U, and Spearman correlation tests with a significance level of p < 0.05. The mean age of the women was 37.25 ± 10.63 years and mean total health-promoting lifestyle score was 127.87 ± 26.91, with the highest mean score in the spiritual growth dimension (26.02 ± 5.58). Analyses showed a significant inverse relationship between age, number of children, BMI, and lifestyle score (P < 0.05), and lower lifestyle scores among women with chronic diseases such as hypertension and hyperlipidemia (P < 0.05). A significant increase in lifestyle score with higher family income (P < 0.05), and differences in mean lifestyle scores based on marital status and educational level (P < 0.05). The findings indicate that the overall level of health-promoting lifestyle among women living in marginalized areas is moderate and associated with various individual and social factors. These findings suggest that improving women's health in such settings requires attention to both personal behaviors and broader economic and educational contexts. Further studies are recommended to design and assess interventions that effectively address these factors.

Breast cancer is a leading cause of cancer-related deaths worldwide, with most cases in Bangladesh diagnosed at advanced stages due to limited awareness and late detection. While breast self-examination (BSE) is a simple, cost-free method for early detection, its practice among adolescents remains poorly understood. This study aims to explore breast cancer knowledge, BSE practices, and barriers among adolescent girls in a semi-urban area, addressing a critical gap in early prevention efforts. A cross-sectional study was carried out with 384 adolescent girls from four renowned schools in a semi-urban area of Dhaka, Bangladesh. Participants were sampled at school from January to April 2025. Proportionate stratified random sampling was conducted to determine the study sample from each school. A validated semi-structured self-reported questionnaire was employed to collect data from participants during the survey period. Among the participants, only 45.3% had heard of BSE and just 4.6% reported ever practicing it. Overall, breast cancer knowledge was low, with a mean score of 9.49 out of 31 (30.6%). Regression analyses indicated that higher breast cancer knowledge scores were significantly associated with having a science academic background (β = 1.82, p < 0.01), higher family income (β = 1.14, p < 0.05), and prior BSE practice (β = 2.36, p < 0.001). A strong positive correlation was observed between overall knowledge and BSE practice (r = 0.54, p = 0.001). Students from the science section were significantly more likely to practice BSE than those from the humanities section (OR = 9.47, 95% CI: 1.21–73.89, p = 0.032). Participants who received BSE information from health workers were approximately nine times more likely to practice BSE than those who did not (OR = 9.62, 95% CI: 2.30–40.20, p = 0.002). The study demonstrates critically low levels of breast cancer knowledge and BSE practice among adolescent girls, with knowledge strongly influencing practice. These findings underscore the need for culturally appropriate, school-based educational interventions to improve awareness, promote early detection behaviors, and potentially reduce future breast cancer morbidity and mortality in Bangladesh.