Trajectories of Breastfeeding-Related Thoughts and Attitudes Among Low-Income Smoke-Exposed Pregnant Women: A Latent Class Growth Analysis.

BACKGROUND: Psychosocial predictors of breastfeeding and changes in those factors during pregnancy, along with the relationship of those changes with both breastfeeding and smoke use and exposure, are not well explored. RESEARCH AIM: The aim of this study was to identify distinct trajectories of psychosocial determinants of breastfeeding and smoking in pregnant women. METHODS: We used a longitudinal study design and data from a randomized controlled trial conducted among smoke-exposed pregnant women and their infants. Participants were recruited early in pregnancy and were surveyed at ≤ 16 and 32 weeks gestation, delivery, 3 and 6 months postpartum for breastfeeding intentions, initiation, continuation, and smoke use and exposure. Psychosocial variables associated with breastfeeding were measured at baseline and 32 weeks gestation using the Mitra index, a structured questionnaire that assesses barriers and facilitators of breastfeeding intentions. Latent class growth analysis was performed using Mitra scores to identify distinct subgroups of participants with different trajectories. Sociodemographic characteristics, breastfeeding, and tobacco smoke use and exposure were compared across classes. RESULTS: Three or four trajectories were identified for each of the six Mitra scores. Trajectories for all Mitra scores were associated with breastfeeding intention and initiation. Overall, Mitra, knowledge, self-efficacy, social support, and time barrier classes all differed by tobacco smoke use or exposure. CONCLUSION: Trajectories of breastfeeding knowledge, self-efficacy, social support, and time to breastfeed/social barriers are associated with tobacco smoke use and exposure during pregnancy. Encouragement to breastfeed and to cease and avoid tobacco smoke should start early in pregnancy, focusing on these determinants to improve health outcomes.

Public perception of new plant breeding techniques and the psychosocial determinants of acceptance: A systematic review.

Advancements in New Plant Breeding Techniques have emerged as promising tools for enhancing crop productivity, quality, and resilience in the face of global challenges, such as climate change and food security. However, the successful implementation of these techniques relies also on public acceptance of this innovation. Understanding what shapes public perception and acceptance of New Plant Breeding Techniques is crucial for effective science communication, policymaking, and the sustainable adoption of these innovations. The objective of this systematic review was to synthesize existing research on the public perception of New Plant Breeding Techniques applied to food crops and explore the psychosocial determinants that influence acceptance. Twenty papers published between 2015 and 2023 were included on various New Plant Breeding Techniques and their reception by the general public. Determinants affecting the acceptance of food crops derived from New Plant Breeding Techniques were categorized into six areas: sociodemographic factors, perceived benefits and risks, attitudes toward science, communication strategies, personal values, and product characteristics.

Understanding of perinatal mental health and its psychosocial determinants through Ukrainian women's experience.

INTRODUCTION: Perinatal mental health defines new mothers, their families, and the social, emotional, and cognitive development of their children. The factors contributing to Ukrainian mothers' mental health are not well-defined in the literature. This study aims to explore how Ukrainian women understand mental health and its psychosocial determinants through their perinatal experience. METHODS: This qualitative analysis is part of a larger mixed-methods study exploring perinatal mental health in Ukraine. Five online focus groups (n=30) with Ukrainian mothers of children aged 0-5 years were conducted in June-July 2020. The participants were selected from a pool of 1634 women who completed an online questionnaire and agreed to participate in further research. Informed consent was obtained. The data collected from the focus groups were transcribed verbatim and analyzed thematically using Dedoose software. RESULTS: The study identified two themes. The first theme was: 'Understanding perinatal mental health through women's experience', which covers five subthemes. The second theme was 'Psychosocial determinants of maternal mental health', which includes six subthemes. Overall, women's feelings of guilt, blame, and shame during their perinatal journey are influenced by socio-cultural factors and can lead to mental health problems and reluctance to seek proper help. CONCLUSIONS: The study has identified some factors that can contribute to the enhancement of mental health and well-being of mothers in Ukraine during their perinatal journey. Negative emotions such as guilt, blame, and shame can have a significant impact on their ability to seek the necessary support, and should be addressed by midwives and other healthcare professionals.

Evaluating and Enhancing an Educational Intervention to Reduce Smallholder Farmers' Exposure to Pesticides in Uganda Through a Digital, Systematic Approach to Behavior Change: Protocol for a Cluster-Randomized Controlled Trial.

BACKGROUND: Smallholder farmers receive educational interventions on safe pesticide handling by governmental agencies, industries, or nongovernmental organizations to reduce exposure risks. However, existing educational interventions have limited effects on changing behaviors. Targeting psychosocial determinants of behavior change in educational interventions through theory- and evidence-based approaches may enhance their effectiveness. OBJECTIVE: We aim at describing the intervention development and study design of a 3-arm cluster-randomized controlled trial to assess the effects in improving safe pesticide handling and reducing pesticide exposure of (1) an existing educational intervention and (2) a newly developed SMS text messaging intervention based on the Risks, Attitudes, Norms, Abilities, and Self-regulation (RANAS) behavior change approach. METHODS: We enrolled 539 Ugandan smallholder farmers in 12 clusters (subcounties). The clusters, each with 45 farmers, were randomly allocated to one of the three arms: (1) educational intervention, (2) educational intervention+RANAS-based SMS text messages, or (3) control group. The educational intervention comprised a 2-day workshop that targeted multiple aspects of safe pesticide handling, whereas the SMS text messages targeted the use of personal protective equipment (PPE) and were based on the RANAS approach. For intervention development in this study, this approach includes identifying psychosocial determinants of PPE use at baseline and selecting behavior change techniques to target them in SMS text messages. The primary outcomes of the study are (1) pesticide knowledge, attitude, and practice scores indicating performance throughout the educational intervention; and (2) frequency of PPE use. Secondary outcomes are the RANAS-based behavioral determinants of PPE use, the frequency of glove use, algorithm-based pesticide exposure intensity scores, and signs and symptoms of pesticide poisoning. The outcomes were assessed in structured interviews before the intervention (baseline) and at the 12-month follow-up. The effect of the interventions among the arms will be analyzed using the intervention arms and baseline measures as predictors and the follow-up measures as outcomes in linear multivariable mixed models including the clusters as random effects. The mediating psychosocial determinants of the interventions will be assessed in multiple mediation models. RESULTS: The study was conducted from 2020 to 2021-baseline interviews were conducted in October 2020, and the educational intervention was delivered in November 2020. The RANAS-based SMS text messages were developed based on the baseline data for relevant behavioral determinants of PPE use and sent between February 2021 and September 2021. Follow-up interviews were conducted in October 2021. Overall, 539 farmers were enrolled in the study at baseline; 8.3% (45/539) were lost to follow-up by the end of the study. CONCLUSIONS: This study will contribute to a better understanding of the effectiveness and behavior change mechanisms of educational interventions by using an experimental, cluster-randomized study design to improve pesticide handling among smallholder farmers. TRIAL REGISTRATION: International Standard Randomised Controlled Trial Number (ISRCTN) 18237656; https://doi.org/10.1186/ISRCTN18237656. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/55238.

Multiple long-term conditions, loneliness and social isolation: A scoping review of recent quantitative studies.

BACKGROUND: Multiple long-term conditions (MLTC), loneliness and social isolation are common in older adults. Recent studies have explored the association of MLTC with loneliness and social isolation. This scoping review aimed to map this current evidence and identify gaps in the literature. METHODS: A scoping review was conducted following the PRISMA guidelines for scoping reviews. Ovid Medline, Embase, CINAHL, The Cochrane Library, PsycInfo, and Bielefeld Academic Search Engine were searched for studies published between January 2020-April 2023. Quantitative studies, published in any language, that assessed the association of MLTC with loneliness and/or social isolation were included. RESULTS: 1827 records were identified and screened. Of these, 17 met inclusion criteria. Most studies were cross-sectional and based on older adults. Studies were conducted in Europe, the US, Canada, and low- and middle-income countries. Ten studies focused on the association between MLTC and loneliness, six assessed the association between MLTC and social isolation and one examined associations with both loneliness and social isolation. Most studies reported a significant cross-sectional association of MLTC with loneliness, but there was weaker evidence for a longitudinal association between MLTC and loneliness and an association between MLTC and social isolation. Studies were heterogenous in terms of measures and definitions of loneliness/social isolation and MLTC, confounders adjusted for, and analytical models used, making comparisons difficult. CONCLUSIONS: Further population-based longitudinal studies using consistent measures and methodological approaches are needed to improve understanding of the association of MLTC with both loneliness and social isolation.

Psychosocial Determinants of Sleep Behavior and Healthy Sleep Among Adolescents: A Two-Wave Panel Study.

To date, it remains unknown which psychosocial determinants identified by several leading behavior change theories are associated with different sleep parameters among adolescents. Therefore, this study investigates whether changes in knowledge about healthy sleep, attitude toward healthy sleep and going to bed on time, self-efficacy to engage in healthy sleep behavior, perceived parental and peer norms, perceived barriers (e.g., worrying, fear of missing out), and perceived support (e.g., bedtime rules, encouragement) related to healthy sleep are associated with changes in adolescents' sleep duration on school days and free days and sleep quality over a period of 1 year. Two-wave data of 1648 Flemish adolescents (mean age = 15.01, SD = 0.65, 46.3% female) were analyzed using linear models. Increased levels of parental social support, positive attitude towards and perceived advantages of healthy sleep, norm-knowledge, and perceived peer behavior were associated with sleep duration, with parental social support having the strongest association. Increased levels of perceived barriers were associated with decreased levels of sleep quality parameters, and increased levels of self-efficacy, positive attitude, and parental modeling were associated with improved sleep quality parameters, with perceived barriers having the strongest association. The current results indicate that behavior change theories are useful in the context of adolescent sleep behavior and suggest that perceived parental support (i.e., bedtime rules) and perceived barriers are most strongly associated with adolescents' sleep duration and/or quality.

Psychosocial determinants of sexual health in newly married couples: a protocol for a mixed-methods study.

BACKGROUND: Regarding psychosocial factors affecting sexual health and in most cultures, healthy and pleasurable sexual relations are valued in the family context, the present study aims to identify the psychosocial determinants of sexual health in newly married couples. METHODS: The present mixed-methods study will be conducted in three phases. The first phase will be carried out qualitatively based on which psychosocial determinants of the sexual health of newly married couples will be extracted. In the second phase, questionnaire items of psychosocial determinants of sexual health in newly married couples will be compiled, and face validity (quantitative and qualitative), content validity (quantitative and qualitative), and reliability of the questionnaire will be evaluated. In the third phase, which will be the quantitative phase of the study, the construct validity of the questionnaire will be assessed by analyzing the main items. Moreover, at this stage, the relationship between the extracted psychosocial determinants and the sexual health of newly married couples will be investigated. DISCUSSION: By explaining the psychosocial determinants of sexual health in newly married couples, it is possible to identify key variables for designing interventions that improve the sexual health of this group, based on their cultural sensitivities.

Determinants of Willingness to Undergo Lung Cancer Screening among High-Risk Current and Ex-smokers in Sabah, Malaysia: A Cross-Sectional Pilot Study.

BACKGROUND: Attitudes towards smoking, lung cancer screening, and perceived risk of lung cancer have not been widely studied in Malaysia. The primary objective of this study was to describe the factors affecting the willingness of high-risk current smokers and ex-smokers to undergo low-dose computed tomography (LDCT) screening for lung cancer. METHODS: A prospective, cross-sectional questionnaire study was conducted in current smokers or ex-smokers aged between 55 and 80 years at three hospitals in Kota Kinabalu, Sabah, Malaysia. The questionnaire recorded the following parameters: perceived lung cancer risk; Prostate Lung Colon Ovarian Cancer 2012 risk prediction model excluding race and ethnicity predictor (PLCOm2012norace); demographic characteristics; psychosocial characteristics; and attitudes towards lung cancer and lung cancer screening. RESULTS: A vast majority of the 95 respondents (94.7%) indicated their willingness to undergo screening. Stigma of lung cancer, low levels of knowledge about lung cancer symptoms, concerns about financial constraints, and a preference for traditional medication were still prevalent among the respondents, and they may represent potential barriers to lung cancer screening uptake. A desire to have an early diagnosis (odds ratio [OR], 11.33; 95% confidence interval [CI], 1.53 to 84.05; p=0.02), perceived time constraints (OR, 3.94; 95% CI, 1.32 to 11.73; p=0.01), and proximity of LDCT screening facilities (OR, 14.33; 95% CI, 1.84 to 111.4; p=0.01) had significantly higher odds of willingness to undergo screening. CONCLUSION: Although high-risk current smokers and ex-smokers are likely to undergo screening for lung cancer, several psychosocial barriers persist. The results of this study may guide the policymakers and clinicians regarding the need to improve lung cancer awareness in our population.

Model of psychosocial determinants of health in processes of social exclusion.

The substantial increase in the number of families facing social exclusion in Europe and its direct relationship with health inequities is a challenge for studies approaching the social determinants of health and policies dealing with welfare and social inclusion. We start from the premise that reducing inequality (SDG10), has a value and contributes on other goals such as improving health and well-being (SDG3), ensuring quality education (SDG4), promoting gender equality (SDG5) and decent work (SDG8). In this study, we identify disruptive risk factors and psychological and social well-being factors that influence self-perceived health in trajectories of social exclusion. The research materials used a checklist of exclusion patterns, life cycles and disruptive risk factors, Goldberg's General Health Questionnaire (GHQ-12), Ryff's Psychological Well-being (PWB) Scale and Keyes' Social Well-being Scale. The sample consists of 210 people (aged between 16 and 64 years): 107 people in a situation of social inclusion and 103 people in a situation of social exclusion. The data treatment involved statistical analysis, including correlation study and multiple regression analysis, aimed at developing a model of psychosocial factors that may act as health modulators, considering social factors as predictors in the regression model. The results showed that individuals in the sample, in a situation of social exclusion, have a greater accumulation of disruptive risk factors, and these are related to having fewer psychosocial and cognitive resources to cope with stressful situations: less self-acceptance, less mastery of the environment, less purpose in life, less level of social integration and social acceptance. Finally, analysis showed that in the absence of social integration and purpose in life, self-perceived health statuses decline. This work allows us to use the model obtained as a basis for confirming that there are dimensions of psychological and social well-being that should be considered stress-buffering factors in trajectories of social exclusion. These findings can help design psychoeducational programs for prevention and intervention with the aim of improving psychological adjustment and health states, as well as to promote proactive and reactive policies to reduce health inequalities.

Evaluating the childcare needs of cancer patients undergoing radiation therapy.

PURPOSE: About one-fifth of newly diagnosed cancer patients are parents to young children. These patients are at higher risk of psychosocial stress and inability to attend treatment due to having to balance their own healthcare needs with childcare duties. This study aims to explore the impact of childcare on cancer parents and elicit their perspectives on potential supports. The results could help inform the implementation of suitable childcare programs to remove this barrier in accessing care. METHODS: Patients at a large Canadian cancer treatment center were screened by oncologists for having minor children at home. Secure electronic surveys were then distributed to consenting participants. Domains surveyed included patient demographics, childcare burden, impact on treatment, and preference for childcare supports. RESULTS: The mean age of correspondents was 43.9 (range 33-54), 46 patients (92%) were female, and breast cancer was the most common primary tumor. The median number of children per correspondent was two, and their mean age was 8.4. Balancing childcare with cancer treatment had a significant impact on self-reported stress levels for most correspondents. Twenty (40%) participants had to reschedule and 7 (14%) participants missed at least one appointment due to childcare conflicts. During the COVID-19 pandemic, access to childcare resources decreased while childcare responsibilities increased. Three-quarters of correspondents reported that a flexible childcare would make it easier for them to adhere to appointment schedules. CONCLUSION: Childcare is a significant psychosocial barrier for patients accessing cancer care. Our results indicate that most parents undergoing treatment may benefit from hospital-based childcare services.

Prevalence and Psychosocial Correlates of Diabetes Mellitus in South Africa: Results from the South African National Health and Nutrition Examination Survey (SANHANES-1).

In South Africa, there are a limited number of population estimates of the prevalence of diabetes and its association with psychosocial factors. This study investigates the prevalence of diabetes and its psychosocial correlates in both the general South African population and the Black South African subpopulation using data from the SANHANES-1. Diabetes was defined as a hemoglobin A1c (HbA1c) ≥6.5% or currently on diabetes treatment. Multivariate ordinary least squares and logistic regression models were used to determine factors associated with HbA1c and diabetes, respectively. The prevalence of diabetes was significantly higher among participants who identified as Indian, followed by White and Coloured people, and lowest among Black South Africans. General population models indicated that being Indian, older aged, having a family history of diabetes, and being overweight and obese were associated with HbA1c and diabetes, and crowding was inversely associated with HbA1c and diabetes. HbA1c was inversely associated with being White, having higher education, and residing in areas with higher levels of neighborhood crime and alcohol use. Diabetes was positively associated with psychological distress. The study highlights the importance of addressing the risk factors of psychological distress, as well as traditional risk factors and social determinants of diabetes, in the prevention and control of diabetes at individual and population levels.

Psychosocial Factors Predict Mask-Wearing: A Longitudinal Study Across 3 Phases of the COVID-19 Pandemic.

Determinants of mask-wearing during a pandemic range from the personal to the political. Using a repeated measures design, we examined psychosocial predictors of self-reported mask-wearing 3 times during the early stage of the COVID-19 pandemic. Participants completed surveys at baseline (summer 2020), 3 months (fall 2020), and 6 months (winter 2020-2021). The survey assessed the frequency of mask-wearing and psychosocial predictors from various theories, including fear of COVID-19, perceived severity, perceived susceptibility, attitude, health locus of control, and self-efficacy. Results indicated that the strongest predictors of mask-wearing varied as a function of the stage in the pandemic. In the earliest phase, fear of COVID-19 and perceived severity were the strongest predictors. Three months later, attitude was the strongest predictor. Finally, another 3 months later, self-efficacy became the strongest predictor. Overall, the results suggest that the primary determinants of a novel protective behavior shift over time and with increased familiarity.

Psychosocial determinants, adherence to health policies, and support searching in adults in Córdoba city, Argentina, under pandemic context / Determinantes psicosociales, adherencia a políticas de salud y búsqueda de apoyo en adultos de la ciudad de Córdoba, Argentina, en contexto de pandemia.

Introduction: Pandemics throughout human history have caused global crises. Given their multifactorial impact, they generate changes in the functioning of the health pole, in the adaptation of the health system, the economy of nations, in political decision-making, and lifestyles. At the individual level, changes in behavior, emotions, thoughts, and quality of life in its many aspects (physical, psychological, social, and environmental) are glimpsed. Materials and method: With a quantitative approach of cross-sectional ex post facto design, and exploratory scope, the psychosocial and sociodemographic aspects related to adherence to health policies and the search for support were investigated in the adult population of the city of Córdoba (20 to 60 years). 704 people were surveyed, to whom the perceived stress questionnaire (pss-10), a sociodemographic questionnaire, and a questionnaire carried out with an ad hoc modality were applied. Results and Conclusions: Age, sex, schooling, health history, psychiatric/psychological history, and having relatives/partners belonging to a risk group; they presented an association with respect to adherence to health policy regulations; fear of getting infected; help/support seeking; and perceived stress. This research aims to be a starting point to promote local studies that investigate adherence to health policy regulations necessary to cope with the spread of a disease worldwide with the fewest possible adverse reactions.

Introducción: A lo largo de la historia de la humanidad las pandemias han sido causantes de crisis globales. Dado su impacto multifactorial, generan modificaciones en el funcionamiento del polo sanitario, en la adaptación del sistema de salud, la economía de las naciones, en la toma de decisiones políticas, y estilos de vida. A nivel individual se vislumbran modificaciones en el comportamiento, emociones, pensamientos, y la calidad de vida en sus múltiples vertientes (física, psicológica, social, y ambiental). Materiales y método: Con un enfoque cuantitativo de diseño ex post facto transversal, y alcance exploratorio se indagaron los aspectos psicosociales y sociodemográficos relacionados a la adhesión de las políticas sanitarias y la búsqueda de apoyo en población adulta de la ciudad de Córdoba (20 a 60 años). Se encuestó a 704 personas a las cuales se les aplicó el cuestionario de estrés percibido (pss- 10), un cuestionario sociodemográfico, y un cuestionario realizado con  modalidad ad hoc. Resultados y conclusiones: La edad, el sexo, escolaridad, antecedentes de salud, antecedentes psiquiátrico/psicológicos y tener familiares/pareja perteneciente a grupo de riesgo; presentaron asociación respecto a la adherencia a la normativa político sanitaria; miedo a contagiarse; búsqueda de ayuda/apoyo; y estrés percibido. La presente investigación pretende ser un puntapié inicial para promover estudios locales que indaguen la adherencia a las normativas políticas sanitarias necesarias para sobrellevar la propagación de una enfermedad a nivel mundial con las menores reacciones adversas posibles.

Ocular trauma, visual acuity related to time of referral and psychosocial determinants, during COVID­19 pandemic: A prospective study.

The aim of the present study was to explore the associations between visual outcomes of ocular injury patients in a tertiary hospital unit with clinical and demographic variables and to evaluate the psychosocial impact of the injury on the patients. An 18-month prospective study of 30 eye-injured adult patients was conducted in the General University Hospital of Heraklion, Crete, a tertiary referral hospital. All severe eye injury case information was prospectively collected between February 1, 2020 and August 31, 2021. Best corrected visual acuity (BCVA) was labelled not poor (>0.5/10 or >20/400 on the Snellen scale, <1.3 in LogMAR scale) and poor (≤0.5/10 or ≤20/400 on the Snellen scale, ≥1.3 on the LogMAR equivalent). Data regarding participants' perceived stress levels, by using Perceived Stress Scale 14 (PSS-14), were collected prospectively, one year after study end. Out of 30 ocular injury patients selected, 76.7% were men and most of them were self-employed and private or public sector workers (36.7%). Not poor final BCVA was related to not poor initial BCVA [odds ratio (OR) 1.714; P=0.006]. No statistical associations were found between visual outcome and demographic or clinical factors, but not poor final BCVA was associated with improved self-reported psychological condition of the sufferers, as examined by a questionnaire sheet developed to collect information for study purpose (8.36/10 vs. 6.40/10; P=0.011). No patient reported job loss or changed work status following the injury. Not poor initial BCVA was a significant predictor for not poor final visual outcomes (OR 1.714; P=0.006). Patients with not poor final BCVA expressed higher levels of positive psychology (8.36/10 vs. 6.40/10; P=0.011) and less fear of eye injury repetition (64.0 vs. 100.0%; P=0.286). Not poor final BCVA was associated with low PSS-14 scores one year after study end (77.3 vs. 0.0%, P=0.003). Collaboration between ophthalmologists, mental health professionals and primary care team may be important in order to help patients to cope with the psychosocial burden sequel to eye trauma.

Duration of the patient interval in breast cancer and factors associated with longer delays in low-and middle-income countries: A systematic review with meta-analysis.

OBJECTIVE: Breast cancer survival is lower in low- and middle-income countries (LMICs) partially due to many women being diagnosed with late-stage disease. The patient interval refers to the time elapsed between the detection of symptoms and the first consultation with a healthcare provider and is considered one of the core indicators for early diagnosis and treatment. The goal of the current research was to conduct a meta-analysis of the duration of the patient interval in LMICs and investigate the socio-demographic and socio-cultural factors related to longer delays in presentation. METHODS: We conducted a systematic review with meta-analysis (pre-registered protocol CRD42020200752). We searched seven information sources (2009-2022) and included 50 articles reporting the duration of patient intervals for 18,014 breast cancer patients residing in LMICs. RESULTS: The longest patient intervals were reported in studies from the Middle East (3-4 months), followed by South-East Asia (2 months), Africa (1-2 months), Latin America (1 month), and Eastern Europe (1 month). Older age, not being married, lower socio-economic status, illiteracy, low knowledge about cancer, disregarding symptoms or not attributing them to cancer, fear, negative beliefs about cancer, and low social support were related to longer delays across most regions. Longer delays were also related to use of alternative medicine in the Middle East, South-East Asia, and Africa and distrust in the healthcare system in Eastern Europe. CONCLUSIONS: There is large variation in the duration of patient intervals across LMICs in different geographical regions. Patient intervals should be reduced and, for this purpose, it is important to explore their determinants taking into account the social, cultural, and economic context.

Design and validation of theory-based perceptions concerning the physical literacy questionnaire for pregnant women (P2LQ-PW).

BACKGROUND: There is evidence that physical literacy plays an essential role in understanding the importance of maintaining appropriate physical activity and thereby preventing illnesses during pregnancy. The present study aimed to design and validate a physical literacy questionnaire focused on pregnant women. METHODS: In this exploratory psychometric study, theory-based perceptions concerning the physical literacy questionnaire for pregnant women were designed. Face-to-face interviews were conducted to develop the initial items. The findings from the interviews were merged with the literature review. The content, construct, and face validity was assessed by the participation of midwives, health educationists, and pregnant women. The content validity ratio, content validity index, and impact score of the items were calculated. The construct validity of the questionnaire was calculated through confirmatory and exploratory factor analysis. The reliability of the questionnaire was calculated by the standard error of measurement, intra-class correlation coefficient, composite reliability, and Cronbach's alpha. RESULTS: The highest score was seen in the knowledge subscale and the value of Cronbach's alpha for the subscales was 0.89 to 0.97, and the value of ICC was 0.76 to 0.89. The correlation according to the opinion of experts was satisfactory in all items of the questionnaire. The minimum loading factor for varimax rotation in the knowledge subscale was 0.41, the attitude was 0.56, the nurture factor was 0.38, and enabling factor was 0.27. The compatibility of the model among the constructs was confirmed by the normed chi-square (χ2/ df) < 5.0, comparative fit index ≥0.90, Tucker-Lewis index ≥0.9, and root mean square error of approximation < 0.08. CONCLUSION: The physical literacy questionnaire for pregnant women is the first tool based on the PEN-3 model that other researchers can use to collect data and conduct educational interventions to change physical literacy behavior among Persian women during pregnancy.

Psychosocial Determinants of Hand Hygiene, Facemask Wearing, and Physical Distancing During the COVID-19 Pandemic: A Systematic Review and Meta-analysis.

BACKGROUND: Hand hygiene, facemask wearing, and physical distancing play a crucial role in the prevention of the COVID-19 pandemic. Identifying the key psychosocial determinants of these precautionary behaviors contributes to effective intervention and policymaking for COVID-19 and future pandemics. PURPOSE: This study aimed to systematically review and meta-analyze available evidence on psychosocial determinants of the general population's practice of three precautionary behaviors, based on the Risk, Attitudes, Norms, Abilities, and Self-regulation (RANAS) framework. METHODS: Literature was identified by searching seven databases and relevant review papers. Observational and experimental studies targeting the general population (≥18 years) published between January 2020 to September 2021 were included. Pooled effect sizes were calculated with the inverse-variance method using random-effects models. RESULTS: A total of 51 studies (64 samples) were included in the qualitative synthesis, of which 30 studies (42 samples) were included in the meta-analysis. RANAS-based constructs including knowledge, pros attitudes, and perceived norms were identified as significant determinants of all three behaviors in the meta-analysis. Perceived susceptibility and cons attitudes showed no significant associations with any behaviors. Perceived severity, perceived control, self-efficacy, and behavioral intention were significantly associated with one or two behaviors. Country (western vs. eastern hemispheres) significantly moderated the effects of certain risk and ability factors. CONCLUSIONS: More research is needed with respect to the intention-behavior relationship, self-regulatory and reflexive factors of precautionary behaviors, as well as the exploration of the potential moderating effect of sociodemographic factors.

Identifying the psychosocial factors affecting the practice of three precautionary behaviors (hand hygiene, facemask wearing, and physical distancing) contributes to effective intervention and policymaking for the COVID-19 and future pandemics. Given the lack of summarized evidence, we conducted a systematic review and meta-analysis. Through seven databases and relevant review papers, we summarized the research findings of 51 observational studies that targeted the general population (≥18 years) and were published between January 2020 and September 2021. We found that (a) more knowledge, positive behavioral attitudes, and better compliance with the norms were associated with better practices of all three precautionary behaviors; (b) perceived susceptibility to the disease and negative behavioral attitudes were not associated with any precautionary behaviors; (c) higher levels of perceived disease severity, perceived behavioral control, self-efficacy, and behavioral intention were associated with better practices of one or two behaviors. In addition, we found that country (western vs. eastern hemispheres) differed in the relationship between psychosocial factors and behavioral practices. Specifically, both the association of perceived susceptibility with hand hygiene and the association of perceived severity with physical distancing were stronger among western populations. In contrast, the contribution of self-efficacy on the practice of physical distancing was stronger among eastern populations.

Psychosocial determinants of the intention and self-efficacy to attend antenatal appointments among pregnant adolescents and young women in Cape Town, South Africa: a cross-sectional study.

BACKGROUND: Antenatal care is imperative for adolescents and young women, due to their increased risk of pregnancy-related complications. Evidence on the psychosocial determinants of antenatal attendance among this vulnerable group is lacking. This study assessed the relevance of the psychosocial sub-determinants of intention and self-efficacy to attend antenatal appointments among pregnant adolescents and young women in Cape Town, South Africa; with a view to informing behaviour change interventions. METHODS: Pregnant women and girls aged 13-20 years were recruited to complete a cross-sectional questionnaire assessing their pregnancy experiences, pregnancy-related knowledge and psychosocial determinants related to antenatal care seeking. Confidence Interval Based Estimation of Relevance (CIBER) analysis was used to examine the association of the psychosocial sub-determinants with the intention and self-efficacy to attend antenatal appointments, and to establish their relevance for behaviour change interventions. The psychosocial sub-determinants comprised knowledge, risk perceptions, and peer, partner, family and individual participant attitudes. RESULTS: The mean gestation age of participants (n=575) was 18.7 weeks, and the mean age was 18 years. Risk perceptions of experiencing preeclampsia and heavy bleeding during pregnancy or childbirth if clinic appointments are not attended had moderate mean scores and were positively correlated with intention and self-efficacy, which makes them relevant intervention targets. Several family, peer, partner and individual participant attitudes that affirmed timely appointment attendance had strong positive associations with intention and self-efficacy but their mean score were already high. CONCLUSIONS: Given the high means of the family, peer, partner and individual participant attitudes, the relevance of these attitudinal items as intervention targets was relatively low. Further studies are recommended to assess the relevance of these sub-determinants in similar populations.