Social capital and physical activity among Croatian high school students.

OBJECTIVE: To examine factors associated with regular physical activity in Croatian adolescents. STUDY DESIGN: A cross-sectional survey among high school students was carried out in the 2013/14 school year. METHOD: A survey was conducted among 33 high schools in Zagreb City, Croatia. Participants were students aged 17-18 years. The dependent variables were regular moderate to vigorous physical activity (MVPA) and overall physical activity measured by the short version of International Physical Activity Questionnaire and defined as 60 min or more of daily physical activity. The independent variables included family, neighborhood, and high school social capital. Other study covariates included: socio-economic status, self-rated health, psychological distress and nutritional status. The associations between physical activity and social capital variables were assessed separately for boys and girls through multiple logistic regression and inverse probability weighting in order to correct for missing data bias. RESULTS: A total of 1689 boys and 1739 girls responded to the survey. A higher percentage of boys reported performing regular vigorous and moderate physical activity (59.4%) and overall physical activity (83.4%), comparing with the girls (35.4% and 70%, respectively). For boys, high family social capital and high informal social control were associated with increased odds of regular MVPA (1.49, 95%CI: 1.18 - 1.90 and 1.26, 95%CI: 1.02 - 1.56, respectively), compared to those with low social capital. For girls, high informal social control was associated with regular overall physical activity (OR 1.38, 95% CI: 1.09 - 1.76). CONCLUSION: High social capital is associated with regular MVPA in boys and regular overall activity in girls. Intervention and policies that leverage community social capital might serve as an avenue for promotion of physical activity in youth.

Effectiveness of an integrative health-care model for climacteric-stage women.

OBJECTIVES: To evaluate an integrative health-care model (IHCM) with an empowerment approach for self-care in terms of improving health-related quality of life (HR-QoL) and lifestyle. METHODS: We conducted a field trial with one intervention (IHCM) and one comparison group receiving usual care (UC), with ex ante and ex post measurements. The IHCM was provided for 3 months to each woman in the first group, with follow-up of both groups at 3 and 6 months. The differences in differences estimator was used to assess the effect of intervention, adjusting for clinically important covariates in the framework of a generalized linear regression model. RESULTS: A total of 380 women (IHCM 190 and UC 190) participated in the study. The differences in differences estimator between IHCM and UC for aerobic physical activity was 81 and 87 min/week at 3 and 6 months, respectively; for consumption of dairy products, fruit and vegetables the estimator was 4.8, 6.6 and 9.4 servings per week respectively at 3 months, and 3.9, 6.3 and 9.7 servings at 6 months. The effect of IHCM on HR-QoL at 3 months was greater for the domains of vasomotor, somatic symptoms and sleep problems (11.7, 10.0 and 13.2 points, respectively); at 6 months the differences of major positive change were observed in the domains of memory/concentration, vasomotor symptoms and sleep problems (12.2, 10.4 and 10.8 points, respectively). CONCLUSION: The results support the importance of patient-centered health care during the climacteric stage, within integrative care programs with an empowerment approach.

Toward healthy aging through empowering self-care during the climacteric stage.

BACKGROUND: While they progress through the climacteric stage, women often develop physical and psychological health needs, calling for innovative health-care services that can be translated into preventive programs and empowerment towards self-care. OBJECTIVE: To identify the changes in women's discourse regarding their concerns and needs about the climacteric stage and self-care after they had participated in an integrative women-centered health-care model with empowerment for self-care. METHODS: Women's narratives during counseling group sessions were analyzed using qualitative inductive thematic analysis. RESULTS: A total of 121 women between 45 and 59 years of age participated. At the beginning of the counseling group sessions, we identified the following themes: (1) Lack of information about changes during the climacteric stage and self-care; (2) Tradition: the climacteric stage as a taboo subject; (3) Life's changes and transitions: the complexity of the climacteric experience; (4) Stigma of menopause; (5) Relationship between the traditional gender role and the lack of self-care. At the end of the counseling group sessions, the themes were: (1) The climacteric as a natural stage; (2) Expectations for old age; (3) Empowerment and the change of awareness for self-care; (3) De-medicalization of the climacteric; (4) The richness of group work; (5) Empowerment as motivation to convey acquired knowledge. CONCLUSION: Women in the climacteric stage require more information about their physical, psychological and social needs, as well as the potential impact on their health during old age. Empowerment during the climacteric can contribute to improving the perception about this stage as well as the importance of self-care.