School-based intervention on behavioral intention of adolescents regarding healthy diet in India.

Introduction: Adolescence is a distinctive period of life when intense physical, psychological, and cognitive development occurs. A healthy diet helps prevent various forms of malnutrition and non-communicable diseases (NCDs) like diabetes, heart disease, stroke, and cancer. The current study aimed to assess the change in behavioral intentions (measured based on the TPB) toward healthy dietary practices through health promotion intervention among adolescents studying in selected schools in an urban area of West Bengal, India. Methods: The current study was a non-randomized controlled interventional study conducted among adolescents in either seventh, eighth, ninth, or tenth grades and aged between 12 and 16 years. Two-step cluster analysis with maximum likelihood estimation identified the intenders of a healthy diet. The intervention effect was measured using Relative Risk (RR) for being in the higher intention cluster through Generalized Linear Model (GLM) with a log-linear link under Poisson distribution assumptions and robust standard errors. A P-value of 0.05 or lesser was considered statistically significant. Results: There was no statistically significant difference in the mean score of "Attitude" in both groups. The mean score of "Subjective Norm" among the intervention group increased after intervention, and the difference was statistically significant. The mean score of "Perceived behavioral control" in the intervention group increased after the intervention, but the difference was statistically not significant. The intervention group's post-intervention proportion of intenders increased, and the difference was statistically significant. The relative risk of becoming an intender for healthy diet consumption in the Intervention group compared to the Control group was 2.07 (1.44-2.97). Conclusions: The intervention package effectively brought about a positive change in behavioral intention toward healthy dietary practices among adolescents. Model-based and construct-oriented intervention packages can be adopted in school-setting to promote behavioral intention toward a healthy diet.

Perceived behavioral control regarding regular physical activity and healthy diet: An observational study among school-going adolescents in an urban area of West Bengal, India.

BACKGROUND: Healthy children are the foundation for a healthy and developing nation. Perceived behavioral control (PBC), comprising control belief and perceived power, is a person's perception of the ease or difficulty of performing the behavior of interest. For facilitating regular physical activity and regular healthy dietary practices among the adolescents, PBC is an important construct to develop and implement appropriate interventions. The aim is to assess PBC to perform regular physical activity and regular healthy dietary practices and measure their statistical relationship among the school-going adolescents in an urban area in West Bengal. MATERIALS AND METHODS: A school-based cross-sectional study was conducted among 251 adolescents aged 12-16 years after taking consent and assent for participation in the study. Data were collected with self-administered questionnaire on sociodemographic variables and the two domains of PBC, i.e., control beliefs and perceived power, related to regular physical activity and regular healthy dietary practices. Each PBC total score was calculated by multiplying control belief score and perceived power score for each respondent. Partial correlation coefficient was calculated between regular healthy dietary practices and regular physical activity. RESULTS: Among the total 251 responses analyzed, 34.7% and 27.5% students belonged to age group 14 and 15, respectively. It was observed that the mean (± standard deviation) score of PBC regarding regular healthy dietary practices was 100.7 (±27.7) and for regular physical activity was 106.0 (±21.4). The correlation between PBC of regular healthy dietary practices and regular physical activity was 0.421 and was statistically significant. CONCLUSION: In case PBC score over any behavior is higher, behavioral intention and ultimately chances of performing that particular behavior increases. Designing appropriate school-based health promotion strategies can lead to healthier children fostering regular healthy dietary practices and regular physical activity in their homes and communities.

Gender inequalities in prevalence, pattern and predictors of multimorbidity among geriatric population in rural West Bengal.

Context: Multimorbidity is considered as a priority for global health research. It is defined as the coexistence of two or more chronic health conditions in an individual. It is increasingly being recognized as a major concern for primary care physicians due to its huge impact on individual, family, and societal level. Aim: The aim of this study was to find the quantum of gender-related inequalities and determinants of multimorbidity among the elderly people in a rural part of West Bengal. Materials and Methods: This is a cross-sectional study carried out among 246 elderly people (60 years and above) in a community setting from Oct 2017 to Sep 2018. Logistic regression analysis was done to find out the predictors of multimorbidity. Data were analyzed using the SPSS software (version 16.0. Chicago, SPSS Inc.). Results: Approximately 82% of the study subjects were suffering from multi-morbidity with a significant difference between males (80.9%) and females (88.5%). In binary logistics, people of both the genders aged >70 years, who had less than primary level education, had more than three children, whose source of income was from their children (sons/daughters), were dependent on others for daily routine were at high risk of being multimorbid; whereas depression was a significant predictor of multimorbidity in females and not in males. In multivariable analysis, age remained the only significant predictor for both the gender and for females; depression remained significant after adjusting with significant variables in binary logistics. Conclusion: Morbidity screening at each visit, individual as well as family counseling and lifestyle modifications help to cope with the rising burden of multimorbidity at the primary care level. More insight into the epidemiology of multi-morbidity is necessary to take steps to prevent it, lower its burden and align health-care services as per needs.

A cross-sectional study on assessment of perceived threat to cervical cancer using health belief model among women in a slum area of Kolkata.

BACKGROUND: Despite the implementation of various cervical cancer preventive strategies by the Government of India, there is a scarcity of knowledge and consequent low utilization of cervical cancer screening services among women in India. This contributes to the burden of cervical cancer among Indian women. This study was conducted to assess perceived threat-regarding cervical cancer among women and to identify its explanatory factors in a slum area of Kolkata. MATERIALS AND METHODS: A cross-sectional study was conducted among 192 adult women from May to September 2019 in Kolkata. The multistage sampling technique was used using a structured schedule. Perceived threat to cervical cancer was measured using a composite score including perceived susceptibility and perceived severity constructs of the health belief model. Data were analyzed by descriptive statistics and multivariable logistic regression model using SPSS software version 16. RESULTS: Overall, 22.9% of the participants had satisfactory levels of perceived threat to cervical cancer. Statistically significant association was found between unsatisfactory levels of perceived threat with reproductive age group (adjusted odds ratio [AOR] = 3.01; P = 0.036), education level up to primary (AOR = 2.89; P = 0.026), and unsatisfactory knowledge (AOR = 2.94; P < 0.001) among respondents. The multivariable regression model was of good fit. CONCLUSION: The study population had very unsatisfactory levels of perceived threat to cervical cancer. Thus, to increase cervical cancer screening uptake among women, it is necessary to tailor robust behavior change communication campaigns to increase the perception of susceptibility and severity, thereby increasing the perception of threat of cervical cancer among women.

Elder abuse and its predictors: a cross-sectional study in a rural area of West Bengal, eastern part of India.

BACKGROUND: Elder abuse is an important public health problem hidden from public view in spite of its detrimental effect on physical and mental health. In the last three decades, there is responsiveness toward abuse of children and spouses worldwide but even today abuse and neglect of aged people seem to be the matter of least concern. This study aims to reveal the magnitude of elder abuse and its predictors. METHODS: This is a cross-sectional study carried out in a community setting among elderly people (60 years and older) from October 2015 to September 2017 in a rural area of West Bengal, eastern part of India. Elder abuse was elicited by questions adapted from the Actual Abuse Tool. Data were analysed using SPSS (version 16.0). Logistic regression analysis was performed to reveal the factors associated with elder abuse. RESULTS: The study found that 25.6% of the respondents had experienced abuse, psychological abuse being the commonest type. Disability was the most common perceived risk for abuse. Univariate logistic regression showed higher age (70 years and older), female gender, who were Scheduled caste, living in a nuclear family, having more than three children, financially and functionally dependent, who was suffering from depression and multimorbidity had increased odds of being abused. In multivariable logistic regression, people aged above 70 years, living in a nuclear family and dependent for instrumental activities of daily living remained significant predictors of abuse. CONCLUSION: Around one in four of the respondents was abused in a 1 year duration which implies the urgent need for action. Routine screening for elder abuse at ground level and abuse prevention campaigns can be an important measure to alleviate this hidden problem. Also, there is a need to explore culturally specific forms of elder abuse to provide an age-friendly environment.