Public Health最新文献

{"title":"Age at menarche by birth cohort: A pooled analysis of half a million women in Asia","authors":"","doi":"10.1016/j.puhe.2024.09.020","DOIUrl":"10.1016/j.puhe.2024.09.020","url":null,"abstract":"<div><h3>Objectives</h3><div>To evaluate changes in the age at menarche in Asian populations.</div></div><div><h3>Study design</h3><div>Retrospective cohort study.</div></div><div><h3>Methods</h3><div>We included 548,830 women from six countries in Asia. The data were sourced from 20 cohorts participating in the Asia Cohort Consortium (ACC) and two additional cohort studies: Japan Multi-institutional Collaborative Cohorts (J-MICC), and Japan Nurse Health Study (JNHS) with data on age at menarche. Joinpoint regression was used to evaluate changes in age at menarche by birth year and by country.</div></div><div><h3>Results</h3><div>The study includes data from cohorts in six Asian countries namely, China, Iran, Japan, Korea, Malaysia and Singapore. Birth cohorts ranged from 1873 to 1995. The mean age of menarche was 14.0 years with a standard deviation (SD) of 1.4 years, ranged from 12.6 to 15.5 years. Over 100 years age at menarche showed an overall decrease in all six countries. China showed a mixed pattern of decrease, increase, and subsequent decrease from 1926 to 1960. Iran and Malaysia experienced a sharp decline between about 1985 and 1990, with APC values of −4.48 and −1.24, respectively, while Japan, South Korea, and Singapore exhibited a nearly linear decline since the 1980s, notably with an APC of −3.41 in Singapore from 1993 to 1995.</div></div><div><h3>Conclusions</h3><div>Overall, we observed a declining age at menarche, while the pace of the change differed by country. Additional long-term observation is needed to examine the contributing factors of differences in trend across Asian countries. The study could serve as a tool to strengthen global health campaigns.</div></div>","PeriodicalId":49651,"journal":{"name":"Public Health","volume":null,"pages":null},"PeriodicalIF":3.9,"publicationDate":"2024-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142378482","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Validation of the Spanish version of the Health Literacy Survey (HLS19-Q12) in secondary care specialty consultations","authors":"","doi":"10.1016/j.puhe.2024.09.022","DOIUrl":"10.1016/j.puhe.2024.09.022","url":null,"abstract":"<div><h3>Objectives</h3><div>This study sought to validate the HLS₁₉-Q12 in Spain and in the Spanish language, as well as describe the sociodemographic profile and the general health literacy of the study population.</div></div><div><h3>Study design</h3><div>Descriptive cross-sectional.</div></div><div><h3>Methods</h3><div>Factor analysis and Cronbach's alpha were used to validate the Spanish version of the HLS₁₉-Q12. Health literacy scores and associated categories were calculated using the scale factsheet, and the patient population sociodemographic profile was determined using frequency analysis.</div></div><div><h3>Results</h3><div>The HLS₁₉-Q12 used in Spain in the Spanish language was found to be both valid and reliable (Cronbach's alpha = 0.87). The sociodemographic profile was primarily male and aged, and the majority of patients were of Spanish origin and had diabetes. General patient health literacy was limited, with 60% of participants having general health literacy categorized as inadequate or problematic, and 40 % sufficient or excellent.</div></div><div><h3>Conclusions</h3><div>This study validated the HLS₁₉-Q12 in Spain, created a sociodemographic profile of the sample population, and calculated their health literacy scores. This contribution provides another valuable validated tool and associated data to the increasingly important field of health literacy.</div></div>","PeriodicalId":49651,"journal":{"name":"Public Health","volume":null,"pages":null},"PeriodicalIF":3.9,"publicationDate":"2024-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142378484","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exploring under-five mortality disparities: a comparative analysis of rural and urban areas in Punjab-Pakistan, using Multiple Indicator Cluster Survey data","authors":"","doi":"10.1016/j.puhe.2024.08.011","DOIUrl":"10.1016/j.puhe.2024.08.011","url":null,"abstract":"<div><h3>Objectives</h3><div>Child health is a social and economic development indicator. Pakistan is one of the countries with a high rate of under-five mortality. This research aims to examine several demographic, geographical, socioeconomic, health-related, and environmental factors related to under-five mortality in both rural and urban areas of Punjab, Pakistan.</div></div><div><h3>Study design</h3><div>This is a cross-sectional study.</div></div><div><h3>Methods</h3><div>We used data from the Multiple Indicator Cluster Survey 2017-18 of children aged between 0 and 59 months (<em>n</em> = 39,024), steered by the Punjab Bureau of Statistics. Children who died before reaching the age of five were considered as outcome variables. The bivariate relationship of the outcome variable with each socio-economic, demographic, health-seeking, and environmental variable is estimated with a <em>P</em>-value of &lt;0.01. We used logistic regression analysis separately. Inclusive descriptive statistics were used for the detailed analysis, i.e., compare means, cross-tabulations, independent sample t-tests, and comparison across rural–urban areas<strong>.</strong></div></div><div><h3>Results</h3><div>Results showed that in the mother-level variables, mother education plays a substantial role in reducing mortality; the higher the level of education, the lower the mortality rate.</div></div><div><h3>Conclusion</h3><div>The study revealed that improving drinking water sources, such as tap and bottled water, can reduce the incidence of mortality, particularly in low-income households. Therefore, interventions targeting children are likely to be most effective for reducing the under-five mortality rate in Pakistan.</div></div>","PeriodicalId":49651,"journal":{"name":"Public Health","volume":null,"pages":null},"PeriodicalIF":3.9,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142367210","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Conventional cytology scheme: adherence and associated factors","authors":"","doi":"10.1016/j.puhe.2024.08.025","DOIUrl":"10.1016/j.puhe.2024.08.025","url":null,"abstract":"<div><h3>Objectives</h3><div>This study analyzed adherence rates to conventional cytology and associated factors in a cohort of women at a health service provider institution in Medellin, Colombia.</div></div><div><h3>Study design</h3><div>Observational cohort study with repeated measures.</div></div><div><h3>Methods</h3><div>Clinical and sociodemographic data were obtained from databases for screenings between January 2018 and December 2022. Adherence, defined as undergoing 1, 2, or 3 cytology tests according to national guidelines, was the outcome. Statistical analysis involved a Poisson model with robust errors to identify factors associated with adherence.</div></div><div><h3>Results</h3><div>In total, 26,445 women were included, with a median age of 25 years (IQR: 22–27). Adherence rate was 20.4%. Having just high school education (RR = 0.51; 95% CI: 0.49–0.55), a history of pregnancy (RR = 0.63; 95% CI: 0.54–0.75), and a history of sexually transmitted infections (RR = 0.88; 95% CI: 0.78–0.99) decreased adherence. Conversely, the human papillomavirus (HPV) vaccination history increased adherence (RR = 2.11; 95% CI: 1.60–2.80).</div></div><div><h3>Conclusion</h3><div>It is vital to monitor cytology programs to improve demand-induced and spontaneous consultations. Diligent follow-up, focusing on patients with factors linked to low adherence, along with appointment reminders, can enhance adherence to the screening protocol.</div></div>","PeriodicalId":49651,"journal":{"name":"Public Health","volume":null,"pages":null},"PeriodicalIF":3.9,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142359574","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Caregiver's intention and uptake of influenza vaccination for children in Australia before and after introduction of free vaccination","authors":"","doi":"10.1016/j.puhe.2024.08.022","DOIUrl":"10.1016/j.puhe.2024.08.022","url":null,"abstract":"<div><h3>Objectives</h3><div>To investigate the change between 2017 and 2023 in caregiver-reported intention to vaccinate children aged 6 months-5 years against influenza and compare this to vaccine uptake in Australia, following the COVID-19 pandemic and the free influenza vaccine policy for young children by different states and territories since 2018 and nationally in 2020.</div></div><div><h3>Study design</h3><div>Retrospective data analysis.</div></div><div><h3>Methods</h3><div>A retrospective data analysis was conducted using the Royal Children's Hospital National Child Health Poll data. The data were collected through online cross-sectional surveys of Australian caregivers' intention to vaccinate their children against influenza in 2017 and 2023. The proportion of parents who intended to vaccinate their children against influenza was weighted to reflect Australia's population distribution. We compared this to National Centre for Immunisation Research Surveillance (NCIRS) data on the percentage (%) of children registered as actually having had the influenza vaccine in 2017 and 2023.</div></div><div><h3>Results</h3><div>In children aged five years and under, an increase in intention to vaccinate of 34.7 percentage points from 27.4% (weighted, <em>n</em> = 307/1050) in 2017 to 62.1% (weighted, <em>n</em> = 457/743) in 2023 was observed. We compared intention with the NCIRS influenza vaccine uptake data, which recorded an increased uptake for children under five years of 23.3 percentage points from 6.2% in 2017 to 28.2% in 2023.</div></div><div><h3>Conclusions</h3><div>Between 2017 and 2023, there was a substantial increase in caregiver intention to vaccinate children against influenza, during which the national free influenza vaccine policy for young children was enacted and the COVID-19 pandemic began. There is a substantial gap between the intention to vaccinate and actual uptake of influenza vaccination, warranting further investigation into the barriers behind vaccination, beyond that of cost.</div></div>","PeriodicalId":49651,"journal":{"name":"Public Health","volume":null,"pages":null},"PeriodicalIF":3.9,"publicationDate":"2024-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142358680","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Factors influencing the first dose of measles vaccination uptake in 42 low- and middle-income countries","authors":"","doi":"10.1016/j.puhe.2024.09.017","DOIUrl":"10.1016/j.puhe.2024.09.017","url":null,"abstract":"<div><h3>Objectives</h3><div>Vaccination against measles still stands as a highly impactful public health strategy for mitigating childhood morbidity and mortality. Relatively poor immunization coverage among children has been observed in low and middle-income countries (LMICs). Our study intended to determine socio-demographic factors associated with the 1st dose of measles vaccination among South Asian (SA) and SubSaharan African (SSA) countries children.</div></div><div><h3>Study design</h3><div>This was a cross-sectional study.</div></div><div><h3>Methods</h3><div>This study utilized demographic and health survey data from 42 low-and middle-income countries (LMICs) in SA and SSA. The children's dataset yielded 255,775 children between the ages of 12 and 59 months. The independent predictors were determined by using crude and adjusted odds ratios with 95% confidence intervals (CI).</div></div><div><h3>Results</h3><div>The prevalence of first-dose measles-immunized children was 55.5% for the selected LMICs. The multivariable analysis for combined regions (SA and SSA) showed that parents with a higher level of education, rich wealth quintile, mothers with media access, mothers with more than four antenatal care (ANC) visits and baby postnatal check-up (PNC) within two months were significantly associated with the first dose of measles vaccination among children.</div></div><div><h3>Conclusion</h3><div>The first dose measles immunization coverage in the selected LMICs was considerably low. To boost the uptake of childhood measles vaccination, public health interventions particularly need to focus on children born to uneducated parents, poor families, and those who have not used health services (ANC and PNC). Financial funding is crucial for establishing mobile vaccination clinics to improve immunization rates among the impoverished.</div></div>","PeriodicalId":49651,"journal":{"name":"Public Health","volume":null,"pages":null},"PeriodicalIF":3.9,"publicationDate":"2024-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142327196","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sexual and gender-based violence among adolescents and young adults in refugee settlements and host communities: A case of Palorinya Refugee Settlement in Obongi District, Uganda","authors":"","doi":"10.1016/j.puhe.2024.09.014","DOIUrl":"10.1016/j.puhe.2024.09.014","url":null,"abstract":"<div><h3>Objective</h3><div>This study established the prevalence and correlates of Sexual and Gender-Based Violence (SGBV) among adolescents and young adults aged 13–24 in refugee and host communities in Obongi District of Uganda as of June 2022.</div></div><div><h3>Study design</h3><div>The study was cross-sectional and the participants were adolescents (13–19 years) and young adults (20–24 years) in both refugee and host communities.</div></div><div><h3>Methods</h3><div>Using a stratified sampling technique 801 participants were identified in the settlement's five zones and interviewed using a semi-structured questionnaire. The main outcome of interest was the experience of SGBV in previous 12 months and factors associated with it were determined using modified Poisson multivariable regression analysis technique.</div></div><div><h3>Results</h3><div>Most of the respondents (82.7 %) perceived SGBV occurred in their community and 13.6 % reported that they had experienced it in the previous 12 months. However, less than half (48 %) of those who experienced it reported the incident to the police or other authorities. Factors significantly associated with SGBV were being female (APR = 1.70, 95 % CI: 1.08–2.70), attaining vocational/tertiary education (APR = 2.18, 95 % CI: 1.02–4.69), being married [monogamous marriage (APR = 2.64, 95 % CI: 1.53–4.55), polygamous marriage (APR = 3.58, 95%CI: 1.86–6.89)], and being Ugandan (APR = 2.20, 95 % CI: 1.33–3.63).</div></div><div><h3>Conclusion</h3><div>The findings highlight a concerning prevalence of SGBV among adolescents and young adults within both refugee and host communities, compounded by substantial under-reporting to authorities. Urgent attention is needed to implement targeted interventions that prioritize the protection of women, married individuals, and Ugandan households in and around settlements, while also providing comprehensive support for survivors. Further research should be conducted to explore the connection between tertiary education and SGBV to inform prevention strategies.</div></div>","PeriodicalId":49651,"journal":{"name":"Public Health","volume":null,"pages":null},"PeriodicalIF":3.9,"publicationDate":"2024-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142324152","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Socioeconomic patterns in indoor environment in Denmark: cross-sectional studies from 2000 and 2021","authors":"","doi":"10.1016/j.puhe.2024.08.024","DOIUrl":"10.1016/j.puhe.2024.08.024","url":null,"abstract":"<div><h3>Objectives</h3><div>To examine changes and socioeconomic patterns in indicators of a poor indoor environment in 2000 and 2021.</div></div><div><h3>Study design</h3><div>Cross-sectional data from the Danish Health and Morbidity Survey in 2000 and 2021.</div></div><div><h3>Methods</h3><div>The study included 27,068 participants. Indicators of indoor environment (annoyances from mould, temperature, draught, traffic and neighbour noise, and presence of water damage) were obtained from questionnaires (2021) and partly by interview (2000). Socioeconomic status included home ownership, educational level, and household income. The degree of social inequality in the indoor environment was estimated using the concentration index of inequality.</div></div><div><h3>Results</h3><div>The prevalence of annoyances due to draught, temperature, and noise increased significantly from 2000 to 2021 (e.g., temperature 5.9%–25.1%, odds ratio (OR) 6.72, 95% confidence interval (CI) 6.12–7.38), whereas the prevalence of water damage decreased (17.7%–13.8%, OR 0.85, 95% CI 0.76–0.96). No difference was seen in annoyances due to mould (3.1% in 2000 and 2.5% in 2021, OR 0.90, 95% CI 0.69–1.17). Social inequality was present for thermal conditions, annoyances due to noise and presence of water damage when assessed by income but not by educational level. Conditions were more prevalent among individuals with low income in both 2000 and 2021.</div></div><div><h3>Conclusions</h3><div>The proportion of individuals reporting a poor indoor environment due to thermal conditions and noise increased in the period 2000–2021. Social inequality was observed in all indicators of a poor indoor environment for household income, whereas the inequality was less pronounced when assessed by educational level.</div></div>","PeriodicalId":49651,"journal":{"name":"Public Health","volume":null,"pages":null},"PeriodicalIF":3.9,"publicationDate":"2024-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142327195","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Individual- and community-level predictors of healthcare-seeking behaviour for acute respiratory tract infections among children under five in 29 low- and middle-income countries: a multilevel analysis","authors":"","doi":"10.1016/j.puhe.2024.08.028","DOIUrl":"10.1016/j.puhe.2024.08.028","url":null,"abstract":"<div><h3>Objectives</h3><div>This study aimed to identify the individual- and community-level determinants of mothers’ healthcare-seeking behaviour for children under the age of 5 years with acute respiratory infection (ARI) symptoms in low-and middle-income countries (LMICs).</div></div><div><h3>Study design</h3><div>Nationally representative Demographic and Health Survey datasets from 29 LMICs were used.</div></div><div><h3>Methods</h3><div>The study included 16,893 children aged under 5 years with ARI symptoms in the 2 weeks prior to the survey. A multilevel logistic regression model was used to examine associations between individual- and community-level factors with health-seeking behaviour for ARIs. The adjusted odds ratio (AOR) along with 95% confidence intervals (CIs) were reported as a measure of association.</div></div><div><h3>Results</h3><div>The overall prevalence of healthcare-seeking behaviour for ARIs among children under 5 years in LMICs was 58.83% (95% CI: 58.08, 59.57). Findings showed that mothers with primary or higher education (AOR = 1.20; 95% CI: 1.08, 1.33), and those residing in rich households (AOR = 1.32; 95% CI: 1.18, 1.48), attending antenatal care (ANC) visits (AOR = 1.53; 95% CI: 1.31, 1.79) and delivering at a healthcare facility (AOR = 1.28; 95% CI: 1.16, 1.41) were more likely to seek healthcare for ARIs. A higher level of community maternal education (AOR = 1.44; 95% CI: 1.24, 1.68) was positively associated with seeking healthcare for ARIs, while a higher level of community poverty (AOR = 0.83; 95% CI: 0.72, 0.96) was negatively associated with healthcare seeking for ARIs.</div></div><div><h3>Conclusions</h3><div>This study revealed that mothers’ healthcare-seeking behaviour for ARIs was closely linked to modifiable risk factors, including maternal education, household wealth, use of maternal health services (e.g., ANC), as well as community poverty and literacy levels. Future interventions should consider these modifiable risk factors when developing strategies to improve child health outcomes in LMICs.</div></div>","PeriodicalId":49651,"journal":{"name":"Public Health","volume":null,"pages":null},"PeriodicalIF":3.9,"publicationDate":"2024-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142327194","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Abuse and neglect as indicators of unhealthy behaviours among 15-year-old schoolchildren in Albania","authors":"","doi":"10.1016/j.puhe.2024.09.019","DOIUrl":"10.1016/j.puhe.2024.09.019","url":null,"abstract":"<div><h3>Objective</h3><div>We assessed the independent associations of lifetime child abuse and neglect indices with behavioural characteristics of children.</div></div><div><h3>Study design</h3><div>A cross-sectional study was conducted in Albania in 2022.</div></div><div><h3>Methods</h3><div>Participants consisted of a nationwide representative sample of 1877 schoolchildren aged 15 years (55 % girls; response: 96 %). Data on lifetime child abuse and neglect were collected, along with behavioural factors and sociodemographic characteristics. Binary logistic regression was used to assess the independent associations of child abuse and neglect with behavioural factors of schoolchildren.</div></div><div><h3>Results</h3><div>Irrespective of sociodemographic characteristics, lifetime physical abuse was positively related to lifetime smoking (OR = 1.8, 95%CI = 1.4–2.3), lifetime alcohol consumption (OR = 2.4, 95%CI = 1.9–2.9), and breakfast skipping (OR = 1.3, 95%CI = 1.0–1.6). Furthermore, positive independent factors associated with emotional abuse included lifetime alcohol intake (OR = 1.7, 95%CI = 1.3–2.1) and breakfast skipping (OR = 1.4, 95%CI = 1.0–1.8). Additionally, positive factors associated with lifetime emotional neglect consisted of lifetime smoking (OR = 2.2, 95%CI = 1.6–3.0) and alcohol intake (OR = 2.0, 95%CI = 1.5–2.6), and a lower fruit consumption (OR = 1.7, 95%CI = 1.3–2.3). Positive factors associated with lifetime sexual abuse included lifetime alcohol consumption (OR = 2.4, 95%CI = 1.4–4.1) and especially smoking (OR = 4.3, 95%CI = 2.6–7.3). Also, lifetime witnessing of family violence was positively related to lifetime smoking (OR = 2.7, 95%CI = 1.8–4.1) and alcohol intake (OR = 1.7, 95%CI = 1.2–2.6).</div></div><div><h3>Conclusions</h3><div>We evidenced strong and consistent links between child maltreatment indices and unhealthy behavioural practices among 15-year-old children in Albania. These findings underscore the potential impact of early trauma on developmental trajectories. The association between child abuse and the adoption of detrimental behaviours highlights the urgent need for comprehensive support and intervention strategies to break the cycle of harm.</div></div>","PeriodicalId":49651,"journal":{"name":"Public Health","volume":null,"pages":null},"PeriodicalIF":3.9,"publicationDate":"2024-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142324151","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}