Exploring Attitudes Toward "Sugar Relationships" Across 87 Countries: A Global Perspective on Exchanges of Resources for Sex and Companionship.

The current study investigates attitudes toward one form of sex for resources: the so-called sugar relationships, which often involve exchanges of resources for sex and/or companionship. The present study examined associations among attitudes toward sugar relationships and relevant variables (e.g., sex, sociosexuality, gender inequality, parasitic exposure) in 69,924 participants across 87 countries. Two self-report measures of Acceptance of Sugar Relationships (ASR) developed for younger companion providers (ASR-YWMS) and older resource providers (ASR-OMWS) were translated into 37 languages. We tested cross-sex and cross-linguistic construct equivalence, cross-cultural invariance in sex differences, and the importance of the hypothetical predictors of ASR. Both measures showed adequate psychometric properties in all languages (except the Persian version of ASR-YWMS). Results partially supported our hypotheses and were consistent with previous theoretical considerations and empirical evidence on human mating. For example, at the individual level, sociosexual orientation, traditional gender roles, and pathogen prevalence were significant predictors of both ASR-YWMS and ASR-OMWS. At the country level, gender inequality and parasite stress positively predicted the ASR-YWMS. However, being a woman negatively predicted the ASR-OMWS, but positively predicted the ASR-YWMS. At country-level, ingroup favoritism and parasite stress positively predicted the ASR-OMWS. Furthermore, significant cross-subregional differences were found in the openness to sugar relationships (both ASR-YWMS and ASR-OMWS scores) across subregions. Finally, significant differences were found between ASR-YWMS and ASR-OMWS when compared in each subregion. The ASR-YWMS was significantly higher than the ASR-OMWS in all subregions, except for Northern Africa and Western Asia.

Socioeconomic inequalities in psychosocial well-being among adolescents under the COVID-19 pandemic: a cross-regional comparative analysis in Hong Kong, mainland China, and the Netherlands.

BACKGROUND: Despite evidence on socioeconomic inequalities in psychosocial well-being of adolescents under the COVID-19 pandemic, the explanatory factors and their potential variations across contexts remained understudied. Hence, this cross-regional study compared the extent of inequalities and the mediating pathways across Hong Kong, Mainland China, and the Netherlands. METHODS: Between July 2021 and January 2022, 25 secondary schools from diverse socioeconomic background were purposively sampled from Hong Kong, Zhejiang (Mainland China), and Limburg (the Netherlands). 3595 junior students completed an online survey during class about their socioeconomic position, psychosocial factors, and well-being. Socioeconomic inequalities were assessed by multiple linear regressions using the Slope Index of Inequality (SII), whereas the mediating pathways through learning difficulty, overall worry about COVID-19, impact on family' financial status, resilience, trust in government regarding pandemic management, and adaptation to social distancing were examined by mediation analyses moderated by regions. RESULTS: The adverse psychosocial impact of COVID-19 was stronger in the Netherlands and Hong Kong compared with Mainland China. The greatest extent of socioeconomic inequalities in the change in psychosocial well-being was observed among students in the Netherlands (SII = 0.59 [95% CI = 0.38-0.80]), followed by Hong Kong (SII = 0.37 [0.21-0.52]) and Mainland China (SII = 0.12 [0.00-0.23]). Learning difficulty and resilience were the major mediators in Mainland China and Hong Kong, but to a lesser extent in the Netherlands. CONCLUSION: Socioeconomic inequalities in psychosocial well-being were evident among adolescents under the pandemic, with learning difficulty and resilience of students as the key mediators. Differences in the social contexts should be considered to better understand the variations in inequalities and mediating pathways across regions.

Individual Differences in How Desirable People Think They Are as a Mate.

Mate value is an important concept in mate choice research although its operationalization and understanding are limited. Here, we reviewed and evaluated previously established conceptual and methodological approaches measuring mate value and presented original research using individual differences in how people view themselves as a face-valid proxy for mate value in long- and short-term contexts. In data from 41 nations (N = 3895, Mage = 24.71, 63% women, 47% single), we tested sex, age, and relationship status effects on self-perceived mate desirability, along with individual differences in the Dark Triad traits, life history strategies, peer-based comparison of desirability, and self-reported mating success. Both sexes indicated more short-term than long-term mate desirability; however, men reported more long-term mate desirability than women, whereas women reported more short-term mate desirability than men. Further, individuals who were in a committed relationship felt more desirable than those who were not. Concerning the cross-sectional stability of mate desirability across the lifespan, in men, short- and long-term desirability rose to the age of 40 and 50, respectively, and decreased afterward. In women, short-term desirability rose to the age of 38 and decreased afterward, whereas long-term desirability remained stable over time. Our results suggest that measuring long- and short-term self-perceived mate desirability reveals predictable correlates.

Healthcare workers' delivery of adolescent responsive sexual and reproductive healthcare services: an assessment in Plateau state, Nigeria.

BACKGROUND: Adolescents should have access to high quality and responsive sexual and reproductive health, however, it is unclear to what extent the national policy on health and development of adolescent is implemented by health care workers in Plateau State. This study assessed the general availability of sexual and reproductive health services, the delivery of responsive adolescent sexual and reproductive health services and health care worker?s understanding of what constitutes adolescent responsive sexual and reproductive health services. METHODS: Using a cross sectional design, we interviewed 409 health care workers selected through a multistage sampling technique, across six Local Government Areas of Plateau State, Nigeria using an interviewer-administered survey questionnaire. RESULTS: The most available sexual and reproductive health services was antenatal and delivery care (69.2%), contraception 25.9% and 14.9% reported post abortion care. Only 1.2% indicated the availability of the four recommended essential sexual and reproductive health services (counselling/information provision, provision of contraceptives, testing/treatment for sexually transmitted infection (STI) /HIV and post abortion care) in their facilities. Little over half (58.4%) felt their facilities were adequate in meeting the sexual and reproductive health needs of adolescent and this was associated with delivery of post abortion care (AOR=3.612; CI=1.886-6.917; p = .001) and providing sexual and reproductive health services to adolescents without parental consent (AOR=3.612; CI=1.886-6.917; p = .001). Most health care workers had poor understanding of adolescent responsiveness of sexual and reproductive health services, understanding better among health workers who provided services without parental consent and in a separate room for privacy and confidentiality. CONCLUSION: We conclude that adolescent sexual and reproductive health services is not yet as stipulated in the national policy in Plateau State, Nigeria and in general, health workers have poor understanding of what it means to provide adolescent-responsive services.

Nutritional changes during the COVID-19 pandemic: a rapid scoping review on the impact of psychological factors.

COVID-19 and the resulting measures to curb the spread of the virus have significantly changed our lives, including our nutritional choices. In this rapid scoping review an overview is provided of what psychological factors may be associated with peoples' eating behaviour during COVID-19 restrictions. Relevant literature was identified using PubMed, PsycInfo, CINAHL and MEDLINE databases from 2019 onwards. For included studies, information on study characteristics, eating behaviours, and psychological factors were extracted. 118 articles were included, representing 30 countries. Findings indicated that most people consumed more and unhealthy food in times of COVID-19 restrictions, while some consumed less but often for the wrong reasons. Several psychological factors, related to (1) affective reactions, (2) anxiety, fear and worriers, (3) stress and (4) subjective and mental wellbeing were found to be associated with this increase in food consumption. These outcomes may help to be better inform future interventions, and with that, to be better prepared in case of future lockdown scenarios.

The role of psychosocial variables in breast self-examination practice: Results from focus group discussions in Surabaya, Indonesia.

INTRODUCTION: Breast cancer is a global life-threatening disease. Breast self-examination (BSE) followed by timely diagnosis and treatment is a viable screening method for populations with limited health care access such as Indonesia. Knowledge of the beliefs underlying BSE could benefit the development of future health education efforts to promote BSE and breast cancer awareness among Indonesian women, with the ultimate aim to achieve early detection and promote long-term survivals. The purpose of this study was to explore the underlying beliefs of BSE among women in Surabaya, Indonesia in accordance with the reasoned action approach (RAA) framework. Moreover, we investigated what these women considered an effective approach to improve breast awareness and promote BSE in their social networks. METHOD: The participants included 62 women aged 18-55 (M = 32,9) in Surabaya, Indonesia who were divided into nine focus groups. Directed content analysis was employed to analyze the data. RESULTS: Six psychosocial determinants of performing BSE emerged from the analysis: knowledge, attitude and beliefs, risk perception, norms, perceived behavior control, and intention. Furthermore, the participants identified face-to-face meetings with visual media and healthcare professionals as effective channels to enhance breast awareness. CONCLUSION: This study sheds light on the application of the RAA for BSE, and reveals the importance of face-to-face meetings involving healthcare professionals and women's social networks for breast education.

Breast self-examination as a route to early detection in a lower-middle-income country: assessing psychosocial determinants among women in Surabaya, Indonesia.

BACKGROUND: Breast cancer has become a public health concern in Indonesia. Regular breast self-examination (BSE) is considered an important first step for its early detection, especially in countries with limited healthcare access, as it is the case in Indonesia. This study aimed to confirm and assess the psychosocial determinants of intention to perform BSE and BSE performance. METHODS: The cross-sectional study was conducted on 204 women aged 18-65 years in Surabaya, Indonesia. A 64-item survey was conducted, included variables from the Reasoned Action Approach, and the Health Belief Model, presented questions about demographics, breast cancer knowledge, and behavior related to BSE. RESULTS: Most women (72.5%) expressed intention to perform BSE; however, only 7.8% and 2.9% performed BSE per week and per month, respectively, in the past year. Breast cancer knowledge and attitudes towards BSE were uniquely associated with BSE performance. Perceived behavioral control (PBC) and BSE attitudes were unique correlates of intention. Perceived benefits and barriers and subjective norms were significantly associated with intention and BSE behavior in bivariate analyses. CONCLUSIONS: Breast screening education should incorporate strategies for improving attitudes towards BSE, PBC, and breast cancer knowledge with perceived benefits and barriers and subjective norms as relevant targets.

Social Emotional Learning and the promotion of equal personal relationships among adolescents in Panama: a study protocol.

Adolescents in Panama face multiple barriers that affect their health, such as high rates of teenage pregnancy, increased human immunodeficiency virus (HIV) infections and sexual violence. Equal relationships between women and men are likely to reduce such risks. Here, we suggest that the school-based enhancement of Social and Emotional Learning core competencies-awareness of self and others, positive attitudes and values, responsible decision-making, and social interaction skills-could foster positive changes in behaviors between boys and girls, specifically through a focus on equal roles, equal rights in relationships and nonviolent problem solving. This paper, using the Intervention Mapping Protocol, describes the process of development of, and planning surrounding the implementation and evaluation of the program 'Me and My new World', a Social Emotional Learning intervention for middle school students (12-15 years old) in Panama. Program development was based on a needs assessment (Araúz Ledezma et al. (2020) Behavioural and environmental influences on adolescent decision making in personal relationships: a qualitative multi-stakeholder exploration in Panama. Health Education Research, 35, 1-14.) and a literature review of theory- and evidence-based Social and Emotional Learning (SEL)-programs. Intervention outcomes, performance objectives and change objectives of the intervention were identified. The practical applications of different theory-based methods allowed for contextual considerations that could potentially influence the expected behavioral outcomes of the intervention. Teachers were the implementers of the program, and during development, implementation, and evaluation, the roles, opinions, and teaching methods of all stakeholders were recognized. We conclude that Intervention Mapping allows for the analysis of multiple factors influencing the development and implementation of Social Emotional Learning programs promoting equal relationships among adolescents in a developing country, with a special consideration of culture, educational systems, and policies, from a capability development perspective.

Violence typologies and sociodemographic correlates in South African adolescents: a three-wave cross-sectional study.

BACKGROUND: Violence victimisation and violence perpetration may co-occur in adolescents. Understanding the sociodemographic correlates of the independent and joint profiles of victimisation and perpetration may inform preventive interventions. This study examined the associations of sociodemographic factors with four violence typologies, namely, 1) non-involvement in both victimisation and perpetration, 2) victims only, 3) perpetrators only, and 4) victim-perpetrators. Trends in the prevalence of the four violence typologies over the three survey years were also examined. METHODS: We used data from the three nationally representative South African Youth Risk Behaviour Surveys conducted in 2002, 2008, and 2011 and included a multi-ethnic sample of adolescents (n = 30,007; boy: 46.9%, girls: 53.1%; M age = 16 years, SD = .06). RESULTS: The sample consisted of 8030 (30.8%) adolescents who had non-involvement in both victimisation and perpetration, 8217 were victims only (29.8%), 2504 were perpetrators only (9.0%), and 7776 were victim-perpetrators (24.6%). Logistic regression analyses showed that being a girl increased the odds of non-involvement (OR: 1.47, 99% CI: 1.36-1.58) and being victims only (OR: 1.90, 99% CI: 1.76-2.05). Being a boy increased the odds of being perpetrators only (OR: 0.42, 99% CI: 0.37-0.47) and victim-perpetrators (OR: 0.51, 99% CI: 0.47-0.55). Adolescents who did not have an absent mother had higher odds of non-involvement (OR: 0.78, 99% CI: 0.62-0.97). Lower monthly allowance increased the odds of victimisation only (OR: 0.99, 99% CI: 0.97-1.00), whereas higher monthly allowance increased the odds of perpetration only (OR: 1.05, 99% CI: 1.03-1.08). Trend analysis showed that between 2002 to 2011, there was an increase in the prevalence of non-involvement in adolescents (p < .001), a decrease in the prevalence of victims only (p < .05) and victim-perpetrators (p < .001), and no changes in the prevalence of perpetrators only (p > .05). CONCLUSIONS: Sociodemographic factors are uniquely associated with different violence typologies suggesting the need for tailored interventions to target adolescents with differed risks to violence victimisation and perpetration. Strengthening family relations, particularly between mother and child, may protect adolescents from the experiences of victimisation and perpetration.

Behavioural and environmental influences on adolescent decision making in personal relationships: a qualitative multi-stakeholder exploration in Panama.

Adolescents in Panama face multiple challenges to their sexual health, rights and well-being such as high rates of teenage pregnancy (∼30% of all pregnancies), increased HIV infections and sexual violence. In the absence of sufficient evidence-based data and an ongoing debate in Panamanian society about how to approach adolescents' health problems, the aim of this qualitative study was to explore the perceptions and attitudes of different societal actors, namely governmental employees, NGO employees, academics, members from religious groups, teachers and parents. We conducted in-depth interviews (N = 34) which focused on the behavioural and environmental factors considered to influence adolescents' decision making with regard to love, friendships and family relations. Furthermore, we explored how these stakeholders viewed the role of the education system, and the potential of including social-emotional learning (SEL) in the curriculum to provide skills and capacities, which could encourage adolescents to make better decisions and improve their well-being, in general but also in the context of sexual behaviours. Analysis revealed five central themes, i.e. perceptions towards gender roles and equality, adolescents' love (sexual) relationships, capacity needs regarding prevention of risk behaviours and the role of education, comprehensive sexuality education in schools and the potentiality of SEL in the education system. The findings of the study can enhance understanding on the views of stakeholders regarding the factors influencing adolescents' decision making, as well as regarding the possibilities of introducing SEL in the Panamanian educational curriculum.

Determinants of breast self-examination practice among women in Surabaya, Indonesia: an application of the health belief model.

BACKGROUND: Breast cancer has become one of the most common causes of mortality among Indonesian women. Many women in Indonesia present with late-stage breast cancer, negatively affecting prognosis and treatment outcomes. Better prognosis of breast cancer will be achieved if it is diagnosed in an earlier stage, thus efforts to detect breast cancer earlier are important. Breast Self-Examination (BSE) is considered as an important first step to encourage women to actively be responsible for their own health, especially for women in low-and middle-income countries with limited resources and access to other forms of preventive healthcare (e.g., screening programs). The present study aimed to predict BSE practice among women in Surabaya, Indonesia using the Health Belief Model (HBM). METHODS: This investigation was a cross-sectional survey which was distributed among 1967 women aged 20-60 years. The Indonesian version of Champion's Health Belief Model Scale (I-CHBMS) was used to explain self-reported BSE practice. Logistic regression analysis was used to examine the association of HBM variables with BSE practice. RESULTS: 44.4% of the respondents indicated they had performed BSE. Further, the results indicated that the HBM variables were significantly associated with BSE practice. Specifically, higher perceived benefits and self-efficacy, lower perceived barriers and less cues to action were unique correlates of BSE practice. The result also showed that perceived severity and susceptibility were not associated with BSE practice. CONCLUSION: This study indicated that several HBM constructs significantly associated with BSE practice among Indonesian women, suggesting that BSE health education programs should emphasize the perceived benefits of BSE, focus on increasing women's self-efficacy to address and overcome perceived barriers in performing BSE, and help them in identifying personally relevant cues to action.

Exploring the Perceived Effectiveness of Applied Theater as a Maternal Health Promotion Tool in Rural Zambia.

In the current study, we aimed (a) to extend the previous research conducted in Kalomo District on the psychosocial factors that influence women's intention to utilize maternal health care services (MHS) and (b) to explore community members' perceptions of the use of a theater-based health promotion program to positively influence these factors among pregnant women. Semistructured, in-depth interviews were conducted with 44 respondents, and confirmed the importance of knowledge, perceived behavioral control, attitudes, social norms, and risk perception as influences on women's health care utilization. The majority of respondents were positive about the use of theater interventions in improving maternal health care-seeking behavior. The behavior change methods proposed to incorporate in theater plays were seen as appropriate and useful to convey health-related information in theater plays, in particular if the main character was an identifiable role model. Discussion focuses on the unique contributions and possibilities of utilizing theater in (maternal) health promotion.

Personal and environmental factors associated with the utilisation of maternity waiting homes in rural Zambia.

BACKGROUND: Although the association between the presence of maternity waiting homes (MWHs) and the personal and environmental factors that affect the use of MWHs has been explained in qualitative terms, it has never been tested in quantitative terms. The aim of this study was to test the association between the presence of MWHs and personal and environmental factors that affect the use of MWHs. METHODS: A cross-sectional study was conducted using an interviewer-administered questionnaire from 1st July to 31st August, 2014 among 340 women of reproductive age in 15 rural health centres in Kalomo district, Zambia. Tests of association (chi square, logistic regression analysis, odds ratio) were conducted to determine the strength of the association between the presence of MWHs and personal and environmental factors. Differences between respondents who used MWHs and those who did not were also tested. RESULTS: Compared to respondents from health centres without MWHs, those from centres with MWHs had higher odds of expressing willingness to use MWHs (adjusted odds ratio [aOR] = 4.58; 95% confidence interval [CI]:1.39-15.17), perceived more benefits from using a MWH (aOR =8.63; 95% CI: 3.13-23.79), perceived more social pressure from important others to use MWH (aOR =27.09; 95% CI: 12.23-60.03) and higher personal risk from pregnancy and childbirth related complications (aOR =11.63; 95% CI: 2.52-53.62). Furthermore, these respondents had higher odds of staying at a health centre before delivery (aOR =1.78; 95% CI: 1.05-3.02), giving birth at a health facility (aOR = 3.36; 95% CI: 1.85-6.12) and receiving care from a skilled birth attendant (aOR =3.24; 95% CI: 1.80-5.84). In contrast, these respondents had lower odds of perceiving barriers regarding the use of MWHs (aOR =0.27; 95% CI: 0.16-0.47). Factors positively associated with the use of MWHs included longer distances to the nearest health centre (p = 0.004), higher number of antenatal care (ANC) visits (p = 0.001), higher proportions of complications during ANC (p = 0.09) and women's perception of benefits gained from staying in a MWH while waiting for delivery at the health centre (p = 0.001). CONCLUSION: These findings suggest a need for health interventions that focus on promoting ANC use, raising awareness about the risk and severity of pregnancy complications, promoting family and community support, and mitigating logistical barriers.

Increasing utilisation of skilled facility-based maternal healthcare services in rural Zambia: the role of safe motherhood action groups.

BACKGROUND: Community-centred health interventions, such as Safe Motherhood Action groups (SMAGs), have potential to lead to desired health behavioural change and favourable health outcomes. SMAGs are community-based volunteer groups that aim to reduce critical delays that occur at household level with regard to decision-making about seeking life-saving maternal care at health facilities. The aim of this study was to explore perspectives, roles, achievements and challenges of the SMAG programme in Kalomo, Zambia. METHODS: In-depth interviews (IDIs) were conducted in 7 health centres in Kalomo district between 1st April and 20th May, 2015 with 46 respondents comprising 22 SMAG members, 5 headmen, 10 mothers, 3 husbands, 5 nurses, and 1 district maternal and child health coordinator. Perspectives on the selection, training, roles, achievements and challenges of the SMAG programme were explored. RESULTS: Respondents were aware of the presence, selection, training and roles of the SMAG members and had a positive attitude towards the programme. They believed that the SMAG programme led to an increase in women's risk perception about pregnancy and childbirth-related complications. Further, participants believed that the programme resulted in increased utilisation of facility-based antenatal, delivery and postnatal care, and improvement in maternal and newborn health outcomes. However, various challenges affected implementation of the SMAG programme. Among these were insufficient material and financial support to the programme, lack of refresher training for SMAG members, poor quality of care in health care facilities due to a lack of maternity waiting homes, low staffing levels in health facilities, the poor state and small size of the labour wards, and lack of equipment to handle obstetric emergencies. CONCLUSION: The SMAG programme has potential to be an important community intervention for increasing utilisation of facility-based skilled care and improving maternal and newborn health outcomes.

Reasons for home delivery and use of traditional birth attendants in rural Zambia: a qualitative study.

BACKGROUND: Despite the policy change stopping traditional birth attendants (TBAs) from conducting deliveries at home and encouraging all women to give birth at the clinic under skilled care, many women still give birth at home and TBAs are essential providers of obstetric care in rural Zambia. The main reasons for pregnant women's preference for TBAs are not well understood. This qualitative study aimed to identify reasons motivating women to giving birth at home and seek the help of TBAs. This knowledge is important for the design of public health interventions focusing on promoting facility-based skilled birth attendance in Zambia. METHODS: We conducted ten focus group discussions (n = 100) with women of reproductive age (15-45 years) in five health centre catchment areas with the lowest institutional delivery rates in the district. In addition, a total of 30 in-depth interviews were conducted comprising 5 TBAs, 4 headmen, 4 husbands, 4 mothers, 4 neighbourhood health committee (NHC) members, 4 community health workers (CHWs) and 5 nurses. Perspectives on TBAs, the decision-making process regarding home delivery and use of TBAs, and reasons for preference of TBAs and their services were explored. RESULTS: Our findings show that women's lack of decision- making autonomy regarding child birth, dependence on the husband and other family members for the final decision, and various physical and socioeconomic barriers including long distances, lack of money for transport and the requirement to bring baby clothes and food while staying at the clinic, prevented them from delivering at a clinic. In addition, socio-cultural norms regarding childbirth, negative attitude towards the quality of services provided at the clinic, made most women deliver at home. Moreover, most women had a positive attitude towards TBAs and perceived them to be respectful, skilled, friendly, trustworthy, and available when they needed them. CONCLUSION: Our findings suggest a need to empower women with decision-making skills regarding childbirth and to lower barriers that prevent them from going to the health facility in time. There is also need to improve the quality of existing facility-based delivery services and to strengthen linkages between TBAs and the formal health system.

Improving access to skilled facility-based delivery services: Women's beliefs on facilitators and barriers to the utilisation of maternity waiting homes in rural Zambia.

BACKGROUND: Maternity waiting homes (MWHs) are aimed at improving access to facility-based skilled delivery services in rural areas. This study explored women's experiences and beliefs concerning utilisation of MWHs in rural Zambia. Insight is needed into women's experiences and beliefs to provide starting points for the design of public health interventions that focus on promoting access to and utilisation of MWHs and skilled birth attendance services in rural Zambia. METHODS: We conducted 32 in-depth interviews with women of reproductive age (15-45 years) from nine health centre catchment areas. A total of twenty-two in-depth interviews were conducted at a health care facility with a MWH and 10 were conducted at a health care facility without MWHs. Women's perspectives on MWHs, the decision-making process regarding the use of MWHs, and factors affecting utilisation of MWHs were explored. RESULTS: Most women appreciated the important role MWHs play in improving access to skilled birth attendance and improving maternal health outcomes. However several factors such as women's lack of decision-making autonomy, prevalent gender inequalities, low socioeconomic status and socio-cultural norms prevent them from utilising these services. Moreover, non availability of funds to buy the requirements for the baby and mother to use during labour at the clinic, concerns about a relative to remain at home and take care of the children and concerns about the poor state and lack of basic social and healthcare needs in the MWHs--such as adequate sleeping space, beddings, water and sanitary services, food and cooking facilities as well as failure by nurses and midwives to visit the mothers staying in the MWHs to ensure their safety prevent women from using MWHs. CONCLUSION: These findings highlight important targets for interventions and suggest a need to provide women with skills and resources to ensure decision-making autonomy and address the prevalent gender and cultural norms that debase their social status. Moreover, there is need to consider provision of basic social and healthcare needs such as adequate sleeping space, beddings, water and sanitary services, food and cooking facilities, and ensuring that nurses and midwives conduct regular visits to the mothers staying in the MWHs.

Understanding the psychosocial and environmental factors and barriers affecting utilization of maternal healthcare services in Kalomo, Zambia: a qualitative study.

This qualitative study aimed to identify psychosocial and environmental factors contributing to low utilization of maternal healthcare services in Kalomo, Zambia. Twelve focus group discussions (n = 141) and 35 in-depth interviews were conducted in six health centre catchment areas. Focus group discussions comprised women of reproductive age (15-45 years), who gave birth within the last year; in-depth interviews comprised traditional leaders, mothers, fathers, community health workers and nurse-midwives. Perspectives on maternal health complications, health-seeking behaviour and barriers to utilization of maternal healthcare were explored. Most women showed insight into maternal health complications. Nevertheless, they started antenatal care visits late and did not complete the recommended schedule. Moreover, most women gave birth at home and did not use postnatal care. The main reasons for the low utilization were the low perceived quality of maternal healthcare services in clinics (negative attitude), negative opinion of important referents (subjective norms), physical and economic barriers such as long distances, high transport and indirect costs including money for baby clothes and other requirements. To improve, our findings suggest need for an integrated intervention to mitigate these barriers. Our findings also suggest need for further research to measure the elicited beliefs and determine their relevance and changeability.

Personal and environmental predictors of the intention to use maternal healthcare services in Kalomo, Zambia.

Low maternal healthcare service utilization contributes to poor maternal and new born health outcomes in rural Zambia. The purpose of this study was to identify important factors influencing women's intention to use these services in Kalomo, Zambia. An interviewer-administered questionnaire was used to collect data from 1007 women of reproductive age (15-45 years) from 13 rural health centres with the lowest service utilization rates in the district. Questions included measures of (past) healthcare seeking behaviour, psychosocial variables (attitude, perceived social norms, perceived behavioural control), logistical barriers (e.g., distance to the clinic) and sociodemographic variables (e.g., age, income and education level). Overall, our findings showed that most respondents had high intention to use healthcare services. Intention was positively associated with attitude, personal norms, behavioural control, education and income levels. Conversely, intention was negatively related to perceived social norms, age and distance. Multivariate regression analysis showed that, together, these variables accounted for 41.8% of the variance in intention, with perceived behavioural control being the strongest predictor of intention, followed by geographical distance and perceived social norms. These findings suggest that public health programmes mitigating these important factors are likely to motivate pregnant women to use maternal healthcare services.

Emotion in Motion: Weight Bias Internalization, Exercise Avoidance, and Fitness-Related Self-Conscious Emotions.

Weight bias internalization (WBI), the process of internalizing negative attitudes and stereotypes towards overweight individuals, significantly impacts self-worth and health behaviors, such as exercise avoidance. In the current study, we focused on the mediating role of fitness-related self-conscious emotions, particularly shame and guilt. A cross-sectional study involving 150 self-described overweight Dutch women (age M = 49.63 ± 10.72) was conducted online. Participants completed measures assessing weight bias internalization, exercise avoidance, and body/fitness-related self-conscious emotions. Data were analyzed using linear regression and mediation analysis, controlling for age, BMI, and exercise frequency. The results show that weight bias internalization, guilt-free shame, and shame-free guilt uniquely predict exercise avoidance. Guilt-free shame partially mediated the relationship between weight bias internalization and exercise avoidance, indicating that increased internalized weight bias led to higher levels of guilt-free shame, which in turn contributed to exercise avoidance. Shame-free guilt did not act as a unique mediator. These findings underscore the importance of addressing weight bias internalization and fitness-related self-conscious emotions, particularly guilt-free shame, in interventions targeting exercise avoidance among overweight individuals. Strategies promoting self-compassion and reducing shame may prove beneficial in improving exercise behaviors and overall well-being.

Social Media as Input for Recruiment: Does Women's Relationship History Affect Candidate Evaluations?

We examine whether information about a female candidate's relationship history, obtained from social media profiles, affects evaluations of her suitability for a student union board position. Moreover, we investigate whether it is possible to mitigate any bias against women with multiple partners by providing information about the origins of prejudice. We utilized a 2 (relationship history: multiple vs. one partner(s)) X 2 (mitigating information: explaining prejudice against promiscuous women vs. explaining prejudice against outgroups) experimental design across two studies. Participants were female students (Study 1: n = 209 American students; Study 2; n = 119 European students), who indicated whether they would hire the applicant for a job, and evaluated this applicant. Results show that generally, participants tended to evaluate the candidate with multiple partners less positively than the candidate with only one partner: They were less likely to hire her (Study 1), evaluated her less positively (Study 1), and considered her less of a fit with the organization (Study 1 and 2). The results regarding providing additional information were not consistent. Our findings suggest that private social media information can influence applicant evaluations and hiring decisions, and therefore organizations should be careful when utilizing social information in recruitment processes.