Correlates of screen-based behaviors among adults from the 2019 Brazilian National Health Survey.
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ABSTRACT:
SUBMITTER: Silva DR
PROVIDER: S-EPMC8672534 | biostudies-literature |
REPOSITORIES: biostudies-literature
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Project description:ObjectivesThe Brazilian Family Health Strategy (FHS) is strongly associated with better health system performance, but there are no nationally-representative data examining individual-level primary care experiences in the country. Here, we examine reports of primary care experiences among adults with different forms of healthcare coverage (FHS, "traditional" public health posts, and private health plans).MethodsData are from the 2019 National Health Survey that included a shortened version of the Primary Care Assessment Tool (PCAT). PCAT questions were administered to a subsample of randomly-selected adults who had a doctor visit within the past 6 months and sought care in a primary care setting (9677 respondents). We used linear regression to examine the association between type of healthcare coverage and PCAT scores adjusted for sex, age, socioeconomic status, health status, geographic region and state of residence.ResultsPrimary care experiences in the sample of Brazilians who had a doctor visit 6 months prior to the survey averaged a modest PCAT score of 57 out of 100. Regression models show that users of the FHS had superior primary care experiences, but with large variations across Brazilian regions and states. Individuals selected to respond to the PCAT questions were more likely to be female, older, and poorer, and to be in worse health than the general population.ConclusionsBrazil's FHS is associated with modest, but higher-reported primary care experiences than both traditional public health posts and those who have a private health plan. Future iterations of the PCAT module could enhance generalizability by including individuals who had a doctor visit in the past 12 (instead of 6) months.
| S-EPMC9173631 | biostudies-literature
Project description:BackgroundLittle is known about the presence of two or more chronic conditions (multimorbidity) on tooth loss between adults and older adults. Understanding the mechanisms of multimorbidity on tooth loss is essential to inform policy development. This study aims to investigate the association between multimorbidity and severity of tooth loss in Brazilian adults and older adults.MethodsWe analysed data from a nationally representative sample of 88,531 Brazilian individuals aged 18 and over who participated in the 2019 Brazilian Health Survey. Tooth loss was the outcome by two different classifications: functional dentition (lost 1-12 teeth) and severe tooth loss (lost 23-32 teeth). The presence of multimorbidity was the main exposure and based on 13 self-reported doctor-diagnosed chronic diseases that were further categorised into two groups, i.e., ≥2 or ≥ 3 comorbidities. Sociodemographic covariates included sex, age, race, income, level of education and tobacco smoking and geographic region of residency. Multivariate logistic regression models estimated the OR (Odds Ratios) and 95%CI of the associations between multimorbidity and tooth loss.ResultsFor 65,803 adults (aged 18 to 59), the presence of multimorbidity (≥2) was associated with 32% higher odds of having severe tooth loss (95% CI, 1.17; 1.49) and 33% lower odds of having functional dentition (95% CI, 0.60; 0.75). For the 22,728 older adults (aged 60 and older), multimorbidity (≥2) was associated with a 17% higher odds of severe tooth loss (95% CI, 1.06; 1.29) and 23% lower odds of having functional dentition (95% CI 0.70; 0.85). The sensitivity analysis, excluding hypertension, confirmed our findings.ConclusionsBrazilian adults and older adults with multimorbidity are more likely to have severe tooth loss and less likely to have functional dentition.
| S-EPMC8691078 | biostudies-literature
Project description:IntroductionAccess to medicines is a challenge, especially in developing countries, highlighting the need of population-based research to evaluate access and related factors.ObjectiveThis study aimed to assess access to medicines and identify associated factors using data from the 2019 Brazilian National Health Survey (PNS).MethodsThis population-based cross-sectional study used data from the 2019 PNS and considered access to prescription medicines as the primary outcome. The sample included 24,753 individuals aged 15 years or older who looked for medical care in the last 15 days and received a medicine prescription. Andersen's behavioral model was used to select independent variables. After descriptive analysis, a multinomial logistic regression multilevel analysis was performed using the independent variables with a significance level lower than 0.20 in the bivariate analysis.ResultsThe lowest chances of getting access to medicines were observed in individuals aged between 40 and 59 years, women, with complete middle and high school, with lower-income families, who attended public services, with worse self-assessed health, and those who looked for health care for disease prevention and health promotion.ConclusionsAccess to medicines among the Brazilian population is associated with social, economic, and health perception factors. Our findings may update and guide the development of public policies on medication and pharmaceutical care, facilitating medication purchases by the care user and promoting health equity.
| S-EPMC9858017 | biostudies-literature
Project description:This study aimed to identify Brazilian dietary patterns and their associations with health, lifestyle and sociodemographic characteristics. Data from the Brazilian National Health Survey conducted in 2013 were used. A questionnaire was applied containing 22 items related to dietary consumption. Dietary patterns were determined through factor analysis (FA). Poisson regression models, with robust variance, were used to identify associations between dietary patterns and independents variables. Statistical significance was defined as p-value<0.05. Data were analysed for 60,202 adults (estimated population size: 146,308,458). FA identified three dietary patterns: healthy, protein, and western. The younger age group (18-24 years) had a lower adherence to the healthy pattern (PR:0.53; 95%CI:0.49-0.58) and greater adherence to the protein (PR:1.52; 95%CI:1.42-1.62) and western (PR:1.80; 95%CI:1.68-1.93) patterns compared to the elderly (?60 years). Women had a greater association with the healthy pattern (PR:1.32; 95%CI:1.28-1.38) and lower association with the protein pattern (PR:0.80; 95%CI:0.77-0.82) compared to men. Illiterate participants showed lower adherence to the healthy (PR:0.58; 95%CI:0.53-0.63) and western (PR:0.54; 95%CI:0.48-0.62) patterns compared to those with higher educational levels. Smokers had lower adherence to the healthy (PR:0.76; 95%CI:0.71-0.81) and higher adherence to the protein (PR:1.14; 95%CI:1.11-1.19) patterns compared to non-smokers. Participants with poor/very poor self-rated health status had a lower adherence to the healthy (PR:0.79; 95%CI:0.73-0.86) and western (PR:0.81; 95%CI:0.73-0.89) patterns compared to those in a very good/good self-rated health status. Multimorbidity was positively associated with the healthy pattern (PR:1.18; 95%CI:1.11-1.26) and inversely associated with the protein pattern (PR:0.88; 95%CI:0.80-0.96) compared to participants without comorbidities. We suggest that strategies to promote healthy eating should consider health, lifestyle and sociodemographic characteristics in the Brazilian population.
| S-EPMC7886222 | biostudies-literature
Project description:IntroductionCriminal legal system (CLS) exposed adults experience higher rates of substance use, substance use disorder (SUD), and overdose. As most CLS exposed adults are not incarcerated, it is important to focus on CLS exposure across the carceral continuum.MethodsThis research used pooled data from adult respondents (N = 206,314) in the National Survey on Drug Use and Health (2015-2019). Survey weighted descriptive statistics and Poisson regression were used to estimate prevalence of polysubstance use (i.e., concurrent use) across CLS exposure types (i.e., arrest, probation, parole), identifying relevant correlates.ResultsThe prevalence of polysubstance use was higher among CLS exposed adults, and nearly two-thirds of CLS exposed adults who used multiple types of substances indicated having an SUD. Comparing CLS exposure types, polysubstance use was less likely among adults on probation (IRR=0.89, 95%CI=0.84,0.94) or parole (IRR=0.82, 95%CI=0.76,0.87) compared to those arrested. Polysubstance use was also more likely among adults on probation (IRR=1.09, 95%CI =1.01,1.17) compared to those on parole. While some characteristics (i.e., age, ethnicity, SUD) were consistently associated with polysubstance use across types of CLS exposure, other characteristics (i.e., sexual identity, marital status, suicidal ideation) were not.ConclusionsThere is heterogeneity in health risks as a function of CLS exposure type. Further research is needed to identify causal mechanisms and differences based on demographic characteristics. Given high levels of polysubstance use across CLS exposure types, a shift towards a more comprehensive approach in substance use epidemiology may facilitate building an evidence-base to maximize treatment related interventions to reduce polysubstance-involved overdoses.
| S-EPMC10862373 | biostudies-literature
Project description:ObjectivesTo assess the prevalence of and factors associated with the lifetime medical diagnosis of depression in Brazil.DesignPopulation-based, cross-sectional study.SettingAnalysis of data from the 2019 Brazilian National Health Survey.Participants90 846 individuals aged ≥15 years were included.Outcome measureThe self-reported medical diagnosis of depression at some point in one's life was the main outcome. Prevalence ratios (PRs) with 95% CIs were calculated by Poisson regression with robust variance. The independent variables included the geographical area of residence, sociodemographic characteristics, current smoking status, alcohol abuse, daily screen time, and the presence of physical disorders and mental health comorbidities.ResultsThe self-reported lifetime prevalence of medical diagnosis of depression was 9.9% (95% CI 9.5% to 10.2%). The probability of having received a medical diagnosis of depression was higher among urban residents (PR 1.23; 95% CI 1.12 to 1.35); females (2.75; 2.52 to 2.99); those aged 20-29 years (1.17; 0.91 to 1.51), 30-39 years (1.73; 1.36 to 2.19), 40-49 years (2.30; 1.81 to 2.91), 50-59 years (2.32; 1.84 to 2.93) and 60-69 years (2.27; 1.78 to 2.90) compared with those under 20 years; white-skinned people (0.69 (0.61 to 0.78) for black-skinned people and 0.74 (0.69 to 0.80) for indigenous, yellow and brown-skinned people compared with white-skinned people); those with fewer years of education (1.33(1.12 to 1.58) among those with 9-11 years, 1.14 (0.96 to 1.34) among those with 1-8 years and 1.29 (1.11 to 1.50) among those with 0 years compared with those with ≥12 years of education); those who were separated/divorced (1.43; 1.29 to 1.59), widowed (1.06; 0.95 to 1.19) and single (1.01; 0.93 to 1.10) compared with married people; smokers (1.26; 1.14 to 1.38); heavy screen users (1.31; 1.16 to 1.48) compared with those whose usage was <6 hours/day; those with a medical diagnosis of a physical disorder (1.80; 1.67 to 1.97); and individuals with a medical diagnosis of a mental health comorbidity (5.05; 4.68 to 5.46).ConclusionThis nationwide population-based study of self-reported lifetime medical diagnosis of depression in Brazil showed that the prevalence was almost 10%. Considering the current Brazilian population, this prevalence corresponds to more than 2 million people who have been diagnosed with depression at some point in their lives.
| S-EPMC9723899 | biostudies-literature
Project description:BackgroundDental health is often neglected by the majority of the population and has contributed to the global burden of oral diseases. We assessed awareness, utilization and barriers to seeking oral health care among adults in Nebbi District, Uganda.MethodsA community-based, cross sectional study was conducted in the central division, Nebbi District in Uganda among adults between the age of 18 years or older. An interviewer-administered, semi-structured questionnaire was used for data collection on socio-demographic characteristics, oral health awareness, oral health utilization, associated factors and barriers.ResultsA total of 400 adults with a median age of 32 years (interquartile range 24-43) years were enrolled. More than half (57.5%, n = 230) of the participants were female. Participants identified smoking (42.8%, n = 171) and consumption of sugary foodstuffs (29.0%, n = 116) as risk factors for oral disease. Not brushing was also identified by 260 participants (65.0%) as the cause of tooth decay and 95.8% (n = 383) believed brushing one's teeth could prevent tooth decay. Of the 51.5% (n = 206) who had experienced a toothache or discomfort 12 months prior to the study but only about half (52%, n = 106) had sought healthcare from a dental clinic or facility. About 89.5% (n = 94) of the participants were able to see a dentist during their last visits. Dental carries (76.6%, n = 70) and gum bleeding (14.9%, n = 14) were the most frequent reasons for visiting a dental clinic, and 73.7% (n = 70) had their tooth extracted. Barriers to seeking oral healthcare were cost of treatment (47.5%, n = 190), and long waiting time (18.5%, n = 74). The odds of seeking oral healthcare was 2.8-fold higher in participants who were being married (Odds ratio (OR): 2.8, 95% CI 1.3-6.3, p = 0.011) and 3.5-fold higher among housewives (COR: 3.5, 95% CI 1.1-11.4, p = 0.040).ConclusionAbout half of the participants had sought healthcare following a dental condition. Cost of treatment seems to be an important factor affecting utilization of oral health services. Optimization of costs, and creating awareness regarding benefits of utilizing preventive dental services are recommended.
| S-EPMC8447567 | biostudies-literature
Project description:Low fruit and vegetable (FV) intake is a leading risk factor for chronic disease globally as well as in the United States. Much of the population does not consume the recommended servings of FV daily. This paper describes the development of psychosocial measures of FV intake for inclusion in the U.S. National Cancer Institute's 2007 Food Attitudes and Behaviors Survey.This was a cross-sectional study among 3,397 adults from the United States. Scales included conventional constructs shown to be correlated with fruit and vegetable intake (FVI) in prior studies (e.g., self-efficacy, social support), and novel constructs that have been measured in few- to- no studies (e.g., views on vegetarianism, neophobia). FVI was assessed with an eight-item screener. Exploratory factor analysis, Cronbach's alpha, and regression analyses were conducted.Psychosocial scales with Cronbach's alpha ≥0.68 were self-efficacy, social support, perceived barriers and benefits of eating FVs, views on vegetarianism, autonomous and controlled motivation, and preference for FVs. Conventional scales that were associated (p<0.05) with FVI were self-efficacy, social support, and perceived barriers to eating FVs. Novel scales that were associated (p<0.05) with FVI were autonomous motivation, and preference for vegetables. Other single items that were associated (p<0.05) with FVI included knowledge of FV recommendations, FVI "while growing up", and daily water consumption.These findings may inform future behavioral interventions as well as further exploration of other potential factors to promote and support FVI.
| S-EPMC4338082 | biostudies-other
Project description:BackgroundManagement of cardiovascular risk factors (high cholesterol, diabetes, and hypertension) should start by implementing a healthy lifestyle. Whereas lifestyle recommendations are provided irrespective of the patient's socio-economic status has not been recently assessed in the Brazilian population.AimsTo assess the preventive measures against cardiovascular risk factors according to educational level and income in the Brazilian population.MethodsSurvey data of the 2019 Brazilian National Health Survey (PNS). The PNS is a nationwide household-based survey carried out by the Brazilian Ministry of Health. The PNS included face-to-face interviews and collected information on lifestyle management of high cholesterol, diabetes, and hypertension by a healthy diet, an adequate weight, exercise, and quitting smoking. The participant's educational level and income (in multiples of the basic salary per capita) was collected.ResultsOf the 88,052 participants included, 13,151 (14.9%), 6,986 (7.9%) and 22,516 (25.6%) reported being diagnosed with high cholesterol, diabetes, or hypertension, respectively. Dietary recommendations were the most frequently provided (94.5%, 94.6% and 88.1% for high cholesterol diabetes, and hypertension, respectively), while recommendations to quit smoking to current smokers were the least frequently provided (74.9%, 85.8% and 81.1% for high cholesterol, diabetes, and hypertension, respectively). After multivariable adjustment, participants with a higher educational level or a higher income had a higher likelihood of reporting receipt lifestyle recommendations for high cholesterol or hypertension, while no associations were found for most recommendations for diabetes.ConclusionBetter-educated, wealthier Brazilians report receiving more lifestyle recommendations regarding high cholesterol and hypertension management more frequently than lower-educated or with low-income.
| S-EPMC10728434 | biostudies-literature
Project description:BackgruoundWe evaluated the prevalence and management of diabetes mellitus (DM) in elderly Korean patients based on data from the Korea National Health and Nutrition Examination Survey (KNHANES).MethodsA total of 3,068 adults aged 65 years and older (19.8% of total population) were analyzed using KNHANES from 2019 to 2020. Prevalence, awareness, treatment, and control rates, and comorbidities were analyzed. Lifestyle behaviors and energy intake were also measured.ResultsThe prevalence of DM and prediabetes was 29.6% and 50.5%, respectively. The awareness, treatment and control rates were 76.4%, 73.3%, and 28.3%, respectively. The control rate was 77.0% if A1C <7.5% criteria was used. The mean A1C value of individuals with known DM was 7.1%, and 14.5% of the known DM patients had A1C ≥8.0%. Abdominal obesity, hypertension, and hypercholesterolemia were combined with DM in 63.9%, 71.7%, and 70.7%, respectively, and the rate of integrated management was 36.0% (A1C <7.5% criteria). A total of 40.1% of those with DM walked regularly. The percentage of energy intake from carbohydrates was higher in those with DM than in those without DM (P=0.044), while those of fat (P=0.003) and protein (P=0.025) were lower in those with DM than in those without DM in women.ConclusionIn 2019 to 2020, three of 10 adults aged 65 years and older in Korea had DM, and approximately 70% of them had comorbidities. A strategy for more individualized comprehensive care for the elderly patients with DM is urgently needed.
| S-EPMC10555543 | biostudies-literature