Health behavior-related indicator of lifestyle: application in the ELSA-Brasil study

[Body image perception, socioeconomic characteristics, and lifestyle in women participating in ELSA-Brasil in Bahia, Brazil]

Body image distortion is an alteration in the perception of the body that can have repercussions on health. This study aims to estimate the prevalence of body image accuracy and distortion among women participating in the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil) living in Bahia State, Brazil, and to investigate associations with socioeconomic characteristics, lifestyle, and gynecological care seeking. A total of 609 women aged 50 to 69 years participated in the study, who answered face-to-face questionnaires from 2012 to 2014. The Stunkard silhouette scale was used to investigate accurate or distorted perception for more or less weight. The relative risk ratio (RR) was calculated by multinomial logistic regression using Stata 13. Most participants have an accurate perception of their own bodies (53.7%). Among those with distorted perception, there is a tendency to distort towards less weight (38.1%). In the multinomial regression analysis, the variables race/skin color and education remained associated with the distortion towards underweight. The race/skin color variable was positively associated with the distortion towards underweight among Mixed-race women (RR = 1.89; 95%CI: 1.13-3.16) and black (RR = 2.10; 95%CI: 1.25-3.55), while the education variable among those with up to high school education (RR = 1.65; 95%CI: 1.18-2.33). There were no associations with the other variables or with distortion for more weight. The results contribute to explaining the relationships between body image perception and socioeconomic factors, revealing that women of different races/skin colors and varying educational levels are influenced in different ways by social discourses, impacting the perception of their body image.

Factors Associated with Avoiding Referrals by Dental Teleconsulting Sessions in Brazil

This cross-sectional analytical study assessed the frequency of avoided referrals of primary care to other care levels by dental teleconsulting and its association with individual and contextual variables using a multilevel approach. It appraised asynchronous dental teleconsulting sessions from the secondary database of the Monitoring and Evaluation System of the Telehealth Results during 2020, during the COVID-19 pandemic. The outcome was "whether referral to secondary care was avoided". Individual variables were related to teleconsulting and professionals that requested it: sex, dental specialty, and dentistry field. Contextual variables were related to each municipality that requested responses: Municipal Human Development Index, oral health teams (OHTs) in primary health care coverage, dental specialty centers coverage, illiteracy rate, Gini index, longevity, and per capita income. A descriptive analysis was made using the Statistical Package for the Social Sciences. Hierarchical Linear and Nonlinear Modeling software was used to perform multilevel analyses to assess the association of individual and contextual variables with avoiding patient referral to other care levels. Most teleconsulting sessions avoided patient referral to other care levels (65.1%). Contextual variables explained 44.23% of the variance in the outcome. Female dentists were more likely to avoid patient referrals than male dentists (OR = 1.74; CI = 0.99-3.44; p = 0.055). In addition, an increase of one percentage point in OHT/PHC coverage of municipalities increased the likelihood of avoiding patient referral by 1% (OR = 1.01; CI = 1.00-1.02; p = 0.02). Teleconsulting sessions efficiently avoided patient referral to other care levels. Both contextual and individual factors were associated with avoided referrals by teleconsulting sessions.

Negative Self-Assessment of Health in Women: Association with Sociodemographic Characteristics, Physical Inactivity and Multimorbidity

Introduction: Women present a higher prevalence of negative self-assessment of health (NSAH) when compared to men. However, there is a gap in the literature of factors associated with NSAH in women from developing countries such as Brazil. In addition, few studies have assessed the magnitude of the association between multimorbidity and NSAH in this population. Thus, the aim of this study was to evaluate the association between NSAH and sociodemographic characteristics, lifestyle and multimorbidity in women from the Midwest region of Brazil. Methods: A study based on data from the National Health Survey, a household survey that investigated health situation, lifestyle and risk factors for chronic diseases in the adult population of Brazil, was held. Sampling was performed in multiple stages. The selected women answered a standardized questionnaire on sociodemographic data, self-assessment of health and potential determinants. Poisson regression was used to analyze the association between NSAH and sociodemographic characteristics, lifestyle and multimorbidity. A significance level of 0.05% was established. Results: The study included 4233 women. The prevalence of NSAH found was 6.0% (95% Confidence Interval [95% CI]: 5.1–7.0%). There was an association between NSAH and advancing age, low schooling, physical inactivity and multimorbidity. Furthermore, there was an association between NSAH and diseases/disorders such as chronic back pain, systemic arterial hypertension, mental disorders, depression, cardiovascular diseases, stroke, cancer, hypercholesterolemia and diabetes mellitus. Conclusion: The prevalence of NSAH was low. A strong association was found between this variable and multimorbidity. In addition, increased age, low schooling and physical inactivity were predictors of NSAH in women.

Healthy lifestyle behaviors and the periodicity of mammography screening in Brazilian women

Introduction:

Certain behaviors have been associated with health promotion, including mammography screening, in women worldwide.

Objective:

The objective of this study was to determine whether there is an association between the periodicity of mammography screening and healthy lifestyle behaviors in Brazilian women employed at a public university in Bahia, Brazil.

Methods:

A total of 635 women of 50–69 years of age at the time of the interview, from the Brazilian Longitudinal Study of Adult Health cohort who were resident in Bahia, participated in the study. Data were collected using a multidimensional questionnaire that included questions on participants’ sociodemographic characteristics and health-related behaviors (smoking, alcohol consumption, leisure-time physical activity and diet) and another questionnaire that dealt with risk factors and breast cancer screening. Measures of association were calculated using simple and multivariate logistic regression.

Results:

The practice of physical activity, not smoking, moderate alcohol consumption and a healthy diet were the health behaviors most adopted by the women who had last had a mammogram ⩽2 years previously (which is in line with the interval recommended by the Brazilian Ministry of Health). A statistically significant association was found between a lapse of ⩾3 years since last undergoing mammography screening and excessive alcohol consumption, while a borderline association was found between the same screening interval and leisure-time physical inactivity.

Conclusion:

There was an association between lifestyle risk behaviors and a longer time interval between mammography screenings. The present results contribute to the debate on the use of mammography, lifestyle behaviors and health promotion among women.

Perfil alimentar e inatividade física em mulheres universitárias na cidade de Brasília

Resumo Objetivo Analisar a associação entre perfil alimentar, atividade física e estado nutricional entre mulheres universitárias. Método Estudo transversal com 1500 mulheres. O questionário abordava questões sobre a vigilância de fatores de risco e proteção para doenças crônicas. As associações foram analisadas pelo teste qui-quadrado e análise de correspondência múltipla. Resultados Das 1500 mulheres, 64,3% tinham entre 20 e 29 anos. Aquelas fisicamente ativas consumiram mais frutas (p<0,01), salada (p<0,01) e vegetais/verduras (p<0,01), enquanto as fisicamente inativas consumiram mais refrigerantes (p<0,01), carne com gordura visível (p=0,03) e leite com gordura (p=0,04). As mulheres fisicamente inativas também apresentaram maior prevalência de diabetes mellitus (p<0,01), colesterol elevado (p<0,01) e dislipidemia (p=0,04). Conclusão e implicação para a prática As universitárias apresentaram comportamentos de risco a sua saúde, onde o consumo de álcool, baixo consumo de alimentos saudáveis e a alta prevalência de inatividade física contribuíram para o aumento dos fatores de risco para doenças crônicas. Ações preventivas com a participação de uma equipe multidisciplinar ajudará na melhora da saúde no ambiente acadêmico.