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Background: Following the active ageing model based on the Health, Lifelong Learning, Participation and Security pillars, this research has a twofold objective: i) to classify older adults according to active ageing profiles, taking into account the four pillars, and ii) to ascertain the relationship between the profiles and personal and contextual factors, as well as well-being and quality of life in old age. Methods: A study sample of 5,566 Spanish older adults who participated in wave 6 of the Survey of Health, Ageing and Retirement in Europe (SHARE) was included. Data were analysed in different steps applying several statistical analyses (Principal Component, Cluster, Discriminant, Multiple Correspondence and bivariate analysis with Pearson chi-square and ANOVA). Results: Five older adult profiles were obtained (I: with moderate activity; II: quasi-dependents; III: with active ageing-limiting conditions; IV: with diverse and balanced activity; V: with excellent active ageing conditions). The first three profiles were characterised by subjects with a high average age, low educational level, who were retired or housewives, and who perceived a moderate level of loneliness, satisfaction with the social network and quality of life, as well as having a larger family network, but living in small households or alone. In contrast, the latter two profiles showed better personal and contextual conditions, well-being and quality of life. Discussion and conclusions: The multidimensional approach to active ageing followed in this article has revealed the presence of several older adult profiles, which are confined to groups with better or worse active ageing conditions. In this context, if ageing is a process that reflects the previous way of life, intervention priorities will have to consider actions that promote better conditions during the life cycle. [ABSTRACT FROM AUTHOR]

Objective: The measurement of patient satisfaction is considered an essential outcome indicator to evaluate health care quality. Patient satisfaction is considered a multi-dimensional construct, which would include a variety of domains. Although a large number of studies have proposed scales to measure patient satisfaction, there is a lack of psychometric information on them. This study aims to describe the psychometric properties of the Primary Care Satisfaction Scale (PCSS) of the EUprimecare project.Design: A cross-sectional survey of patient satisfaction with primary care was carried out by telephone interview.Setting: Primary care services of Estonia, Finland, Germany, Hungary, Lithuania, Italy and Spain.Participants: A total of 3020 adult patients aged 18-65 years old attending primary care services.Method: Classic psychometric properties were analysed and Rasch analysis was used to assess the following measurement properties: fit to the Rasch model; uni-dimensionality; reliability; differential item functioning (DIF) by gender, age, civil status, area of residency and country; local independency; adequacy of response scale; and scale targeting.Results: To achieve good fit to the Rasch model, the original response scales of three items (1, 2 and 6) were rescored and Item 3 (waiting time in the room) was removed. The scale was uni-dimensional and Person Separation Index was 0.79, indicating a good reliability. All items were free from bias. PCSS linear measure displayed satisfactory convergent validity with overall satisfaction with primary care.Conclusions: PCSS, as a reliable and valid scale, could be used to measure patient satisfaction in primary care in Europe. [ABSTRACT FROM AUTHOR]

Introduction: Social relationships (SR) are an important aspect in the healthy ageing process. The study aimed to describe SR in over-50s in Spain and analyse their association with physical/emotional, functional and cognitive/sensory health variables., Methods: The study sample was formed by 5583 people representing the Spanish population aged 50 and over, who participated in the sixth wave of the Survey of Health, Ageing and Retirement in Europe (SHARE). The variables were divided into socio-demographic aspects and economic, health and SR aspects represented by the number of friends, family members and satisfaction with social network and the Revised UCLA loneliness scale. The health variables were grouped using a main component analysis. Multiple linear regressions were performed between the health components with socio-demographic and SR variables., Results: 67.26% of respondents said they did not feel lonely. The feeling of loneliness was the variable most closely related to the physical and emotional, functional and cognitive and sensory health components. The main SR variable associated to health components was the Revised UCLA Loneliness Scale (standardised beta, p < 0.001; p < 0.001; and p < 0.001, respectively). The number of family members in social network SR variable was also associated with the physical/emotional health (β = 0.09, p < 0.001) and cognitive/sensory ability (β = 0.10, p = 0.001) components., Conclusions: The main SR aspect that impacts health status was loneliness. The results of this study suggest the importance of developing public health policies oriented to promoting action on the SR characteristics that enhance older people's health., (© 2022. The Author(s).)

Background: Sexism results in a number of attitudes and behaviors that contribute to gender inequalities in social structure and interpersonal relationships. The objective of this study was to evaluate the effectiveness of Lights4Violence, an intervention program based on promoting health assets to reduce sexist attitudes in young European people., Methods: We carried out a quasi-experimental study in a non-probabilistic population of 1146 students, aged 12-17 years. The dependent variables were the difference in the wave 1 and wave 2 values in the subscales of the Ambivalent Sexism Inventory: benevolent sexism (BS) and hostile sexism (HS). The effect of the intervention was evaluated through linear regression analyses stratified by sex. The models were adjusted by baseline subscales scores, socio-demographic and psychological variables., Results: In girls, we observed a decrease in BS in the intervention group compared to the control group (β = - 0.101; p = 0.006). In the wave2,, BS decreased more in the intervention group compared to the control group in girls with mothers with a low level of education (β = - 0.338; p = 0.001), with a high level of social support (β = - 0.251; p < 0.001), with greater capacity for conflict resolution (β = - 0.201; p < 0.001) and lower levels of aggressiveness (β = - 0.232, p < 0.001). In boys, the mean levels of HS and BH decreased in wave 2 in both the control and intervention groups. The changes observed after the wave 2 were the same in the control group and in the intervention group. No significant differences were identified between both groups., Conclusions: The implementation of the Lights4Violence was associated with a significant reduction in BS in girls, which highlights the potential of interventions aimed at supporting the personal competencies and social support. It is necessary to reinforce the inclusion of educational contents that promote reflection among boys about the role of gender and the meaning of the attributes of masculinity., Trial Registration: Clinicaltrials.gov : NCT03411564 . Unique Protocol ID: 776905. Date registered: 26-01-2018., (© 2022. The Author(s).)

Background: Machismo and acceptance of violence (AV) against women are part of the social construction of hegemonic masculinity and are related to the risk of dating violence. This study aims to analyze the effectiveness of the Lights4Violence program in reducing machismo and AV in secondary school students from different European cities., Methods: Quasi-experimental longitudinal study using a convenience sample of 1,146 high school students from different European cities (12-17 years old) including 575 intervention group students (59.1% girls) and 571 control group students (62.7% girls). We performed linear regression models to identify the effect of the intervention, modelling the difference in means in machismo and AV (dependent variables) between wave-2 and wave-1., Results: An interaction was identified between the group variable and the empathy variable. In wave-2, girls with high empathy at baseline in the intervention group obtained lower mean AV scores (β: -0.131; p = 0.004). However, the boys in the intervention group (reference: control group) with low empathy at baseline registered a significant increase in the mean values of machismo (β: 0.247; p < 0.001)., Conclusion: The importance of empathy is shown in the effectiveness of interventions to reduce machismo and AV in adolescents. While the Lights4Violence program focuses on promoting healthy relationships, there were some controversial results. It is possible that some children, especially those with less empathy, may have felt "challenged" during the intervention and/or assessment. This suggests the need for the development of interventions that also consider psychological processes and integrate the promotion of positive expressions of masculinity., (© 2022. The Author(s).)

Purpose: To analyze the potential association between social support, experiences of violence, and sociodemographic characteristics of adolescents and the likelihood of acceptance of violence and machismo in different European countries., Methods: Cross-sectional design. We recruited 1,555 participants ages 13-16 from secondary schools in Alicante (Spain), Rome (Italy), Iasi (Romania), Matosinhos (Portugal), Poznan (Poland), and Cardiff (UK). We used linear regression models to identify how social support from teachers and parents, experiences of violence-dating violence, bullying, cyberbullying, abuse in childhood-and sociodemographic characteristics were associated with violent thinking, specifically: machismo and acceptance of violence. The analysis was stratified by sex., Results: Acceptance of violence was higher for those who had lower perceived social support from parents (β girls  = -154, p < .001; β boys  = -.114, p = .019) for both sexes. Perpetration of bullying and/or cyberbullying was associated with higher scores for machismo and acceptance of violence for both sexes (β girls  = .067, p = .035; β boys  = .225, p < .001; (β girls  = .118, p < .001; β boys  = .210, p < .001). Being the victim of dating violence, having suffered physical and/or sexual abuse in childhood, and lower perceived social support from teachers were associated with higher scores for both machismo and acceptance of violence. These associations differed between girls and boys., Conclusions: Machismo and acceptance of violence are widely present amongst adolescents in different European countries. Our results suggest the importance of providing educational/psycho-educational interventions with boys and girls to prevent these attitudes and, in turn, prevent interpersonal violence, including bullying and dating violence., (Copyright © 2020 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.)

Despite the efforts of recent decades to reduce gender inequality, sexism is still prevalent among adolescents. The objective of this study was to identify the main socioeconomic characteristics, personal experiences, resources, and competencies associated with sexism in a sample of adolescents from different European countries. Baseline data from the Lights4Violence project included 1555 students ages 12-17 from secondary schools in six European countries (Spain, Italy, Romania, United Kingdom, Portugal, and Poland). Linear regression models were carried out, stratified by sex for benevolent (BS) and hostile (HS) dimensions of the Ambivalent Sexism Inventory. The average age of the sample was 14.3 years (SD = 1.5), 59.3% were girls. Boys scored higher on the measure of sexism (mean BS = 29.7; HS = 29.1) than girls (BS = 27.5, HS = 23.0; p < .001). Girls whose mothers had a university degree reported lower BS (β = -0.113; p = .023) (reference: lower education). Girls who had experienced dating violence reported higher HS (β = .080; p = .010) than those who had never been in an intimate relationship. For both sexes, high aggressiveness was associated with high levels of HS, and high aggressiveness was related to high levels of BS in boys. High assertiveness was associated with high levels of BS in both sexes and with high levels of HS in boys. A high level of problem-solving ability was associated with lower HS in both sexes. The study reinforces the need to invest in school programs aimed at preventing dating violence and promoting positive youth development., (© 2021 Wiley Periodicals LLC.)

This study aimed to analyze the determinants of quality of life (QoL) in older people in three European countries (Portugal, Spain and Sweden). A sample of 7589 participants in waves 4 (2011) and 6 (2015) of the Survey on Health, Aging, and Retirement in Europe (SHARE) project, aged 50 and over and living in Portugal, Spain and Sweden, was included. The CASP-12 scale was used to measure QoL. A principal component analysis was performed to group preselected variables related to active and healthy ageing into the dimensions of health, social participation, and lifelong learning. A linear regression model was built using the change in CASP-12 scores over the 4-year follow-up as the dependent variable, including the interactions between country and each independent variable in the model. After four years, the average QoL increased in Portugal (difference = 0.8, p < 0.001), decreased in Spain (-0.8, p < 0.001), and remained constant in Sweden (0.1, p = 0.408). A significant country-participation component interaction ( p = 0.039) was found. In Spain, a higher participation (β = 0.031, p = 0.002) was related to a higher QoL improvement at 4 years, but not in Sweden or Portugal. Physical health and emotional components (β = 0.099, p < 0.001), functional ability (β = 0.044, p = 0.023), and cognitive and sensory ability (β = 0.021, p = 0.026) were associated with QoL changes over time in all countries. The country-specific associations between health, social participation and QoL should be taken into account when developing public health policies to promote QoL among European older people.

Dating violence (DV) among adolescents is a public health issue because of its negative health consequences. In this study, we aimed to analyse the prevalence and the psychosocial and socioeconomic risk and protective factors associated DV among male and female adolescents in Europe. It was performed a cross-sectional study based on a non-probabilistic sample of 1555 students aged 13-16 years (2018-2019). The global prevalence of DV victimization was significantly greater among girls than boys (girls: 34.1%, boys: 26.7%; p = 0.012). The prevalence of DV in both girls and boys was greater for those over age 15 (girls: 48.5% p < 0.001; boys: 35.9%; p = 0.019). There was an increased likelihood of DV victimization among girls whose fathers did not have paid employment ( p = 0.024), who suffered abuse in childhood, and reported higher Benevolent Sexism [PR (CI 95%): 1.01 (1.00-1.03)] and machismo [1.02 (1.00-1.05)]. In the case of boys, the likelihood of DV increased with abuse in childhood ( p = 0.018), lower parental support [0.97 (0.96-0.99)], high hostile sexism scores ( p = 0.019), lower acceptance of violence ( p = 0.009) and high machismo ( p < 0.001). Abuse in childhood was shown to be the main factor associated with being a victim of DV in both population groups, as well as sexism and machismo attitudes. These results may contribute to future DV prevention school programs for both, teenagers and children of elementary school ages.

The aim of the article is to show the role of school social support and school social climate in dating violence victimization prevention among adolescents in Europe. Study participants were students from secondary schools (age 13-16) in Spain, Italy, Romania, Portugal, Poland and UK. The analysis in this text concern student with dating experience ( n = 993) (57.2% of girls and 66.5% of boys). School social support was measured by School Social Climate, Factor 1 Scale (CECSCE) and by Student Social Support Scale (CASSS), subscales teachers and classmates. The association between school social support and different types of dating victimization (physical and/or sexual dating violence, control dating violence and fear) was measured by calculating the prevalence ratios and their 95% confidence intervals, estimated by Poisson regression models with robust variance. All the models were adjusted by country and by sociodemographic variables. The results show that the average values of all types of social support are significantly lower in young people who have suffered any type of dating violence or were scared of their partner. The likelihood of suffering physical and/or sexual dating violence decreased when school social support increased [PR (CI 95%): 0.96 (0.92; 0.99)]. In the same way, the likelihood of fear decreased when school social climate increased [PR (CI 95%): 0.98 (0.96; 0.99)].There is an association between school social support and school social climate and experiences of being victim of dating violence among adolescents in Europe. Our results suggest that in the prevention of dating violence building a supportive climate at schools and building/using the support of peers and teachers is important.

Purpose: Loneliness and social isolation have detrimental effects on health in old age; however, the prospective associations with quality of life (QoL) remain unclear. Furthermore, despite the existence of a European north-south gradient in the distribution of loneliness and social isolation, little is known whether the associations are context-specific. We investigated the relationships between loneliness, social isolation and QoL of older adults residing in the North (Sweden) and South (Spain) of Europe., Methods: Study sample consisted of 2995 Swedish and 4154 Spanish older adults who participated in waves six and seven of the Study on Health, Aging and Retirement in Europe (SHARE). Loneliness and social isolation were measured at the baseline, and QoL was measured at the baseline and follow-up using CASP-12. Prospective associations were assessed via multivariate linear regression., Results: In Sweden, subjects with higher vs. lower loneliness had 1.01 (95% CI: -1.55, -0.40) units lower QoL, while every standard deviation increase in social isolation was associated with a 0.27 (95% CI: -0.42, -0.09)-unit decrease in QoL. In Spain, every standard deviation increase in social isolation was associated with a 0.66 (95% CI: -1.11, -0.22)-unit decrease in QoL. The association was stronger in subjects aged ≤65 years old and those with no chronic diseases. The association with loneliness was not statistically significant in Spain., Conclusion: Loneliness and social isolation are prospectively associated with decreased QoL among older adults, yet the associations are contextually bound. Future interventions should target both exposures, among others, in order to increase QoL in this group.

The purpose of this study is to assess the psychometric properties of the Portuguese version of the Control, Autonomy, Self-realization, and Pleasure (CASP)-12 scale used in the Survey of Health, Aging and Retirement in Europe (SHARE) project. Data were obtained from a representative sample of 1666 people aged ≥50 years living in Portugal and participating in the SHARE wave 6. In addition to the CASP-12 scale, sociodemographic data and health status, activity limitation (GALI), depression (Euro-D) and satisfaction with life scores were collected. Data quality and acceptability, construct and structural validity and internal consistency of the CASP-12 scale were analyzed. A Rasch analysis was also performed. CASP-12 total score (mean: 33.3; standard deviation: 5.8, range: 12-48) correlated with Euro-D (-0.57) and with life satisfaction (0.52). Mean scores were significantly lower for women, people aged ≥75 years and those with activity limitations and worse health status ( p < 0.001). The confirmatory factor analysis showed good fit to the 4-factor model (root mean squared error of approximation (RMSEA): 0.07; comparative fit index (CFI): 0.90, χ 2 (48) = 444.59, p < 0.001), which was confirmed by Rasch analysis (χ 2 (36) = 10.089, p = 0.745, person separation index (PSI) = 0.722 for the 4-factor model). For domains, person separation index ranged 0.31-0.79 and Cronbach's alpha, 0.37-0.73. In conclusion, the Portuguese version of the CASP-12 scale presents some inadequacies in acceptability, internal consistency and structural validity.

Objectives: To describe and analyze whether a relationship exists between gender equality and political responses to gender violence (GV) against women with physical and/or sexual intimate partner violence (IPV) in the European Union (EU)., Methods: We analyzed a subsample of 39,269 ever-partnered women aged 18 and older from the violence against women survey (2012) of the EU Agency for Fundamental Rights. Outcome was last 12 months physical and/or sexual IPV. Multilevel Poisson regression models were used., Results: Current prevalence of IPV was 4.2%. Having suffered abuse by an adult before age 15 was the strongest associated factor for increasing the probability of suffering (PR: 2.9). Living in countries with higher gender equality, with anti-GV legislation prior to 2005, in countries where the state involved multiple actors in GV response and in countries with family policies included in the Anglo-Saxon, Eastern European and Southern European typologies (reference: Nordic), diminishes the women likelihood of suffering IPV., Conclusions: The response to IPV in the EU requires an integral approach that accounts for the efforts of multiple sectors as well as policies that reach greater levels of gender equality in the countries.