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The association between vegetarianism and depression is still unclear. We aimed to investigate the association between a meatless diet and the presence of depressive episodes among adults.A cross-sectional analysis was performed with baseline data from the ELSA-Brasil cohort, which included 14,216 Brazilians aged 35 to 74 years. A meatless diet was defined from in a validated food frequency questionnaire. The Clinical Interview Schedule-Revised (CIS-R) instrument was used to assess depressive episodes. The association between meatless diet and presence of depressive episodes was expressed as a prevalence ratio (PR), determined by Poisson regression adjusted for potentially confounding and/or mediating variables: sociodemographic parameters, smoking, alcohol intake, physical activity, several clinical variables, self-assessed health status, body mass index, micronutrient intake, protein, food processing level, daily energy intake, and changes in diet in the preceding 6 months.We found a positive association between the prevalence of depressive episodes and a meatless diet. Meat non-consumers experienced approximately twice the frequency of depressive episodes of meat consumers, PRs ranging from 2.05 (95%CI 1.00-4.18) in the crude model to 2.37 (95%CI 1.24-4.51) in the fully adjusted model.The cross-sectional design precluded the investigation of causal relationships.Depressive episodes are more prevalent in individuals who do not eat meat, independently of socioeconomic and lifestyle factors. Nutrient deficiencies do not explain this association. The nature of the association remains unclear, and longitudinal data are needed to clarify causal relationship.

This is a cross-sectional study whose objective was to identify clustering of lifestyle behaviors among undergraduate nursing students to inform health promotion efforts and improve health outcomes later in life. All 353 undergraduate nursing students from the School of Nursing in a public university, Bahia, Brazil were invited to participate. The inclusion and exclusion criteria were according to the major project. Participants must be enrolled and attending the 1st to 10th semester, with a minimum age of 18 years. Participants were excluded if they had any physical disabilities that limited the collection of anthropometric measures or were completing an internship off-campus. A total of 286 undergraduate nursing students met the criteria and completed the survey. The questionnaires included standardized measures for demographic, academic, and lifestyle behaviors (e.g., tobacco use, alcohol use, physical activity level, sedentary behavior, and fruits and vegetables consumed). Latent class analysis was performed to identify any clustering of lifestyle behaviors. Descriptive analyses indicated that 3.1% of the students were smokers, 23.1% consumed alcohol, 34.3% were inactive, 85.0% were sedentary, and 80.8% did not consume recommended amounts of fruits and vegetables. Latent class analysis produced four distinct subtypes of health risk: (a) low-health risk (33.57%); (b) moderate-health risk (27.97%); (c) high-health risk (19.58%); and (d) very high-health risk (18.88%). Approximately 38.5% of students were in the very high or high-risk classes. The proportion of students with very high and high-health risks emphasizes the importance of health promotion programs for university nursing students.

For most individuals, changes occurring during the aging process may cause dissatisfaction and concerns regarding body image, with implications on quality of life (QoL). The aim of this study was to assess the contribution of sociodemographic and psychological variables and the type of anti-aging products/treatments on men's QoL, as well as to evaluate the moderating role of aging perceptions in the relationship between psychological morbidity and QoL. This study used a cross-sectional design and included a sample of 111 male participants who used anti-aging cosmetic products/aesthetic treatments. Participants were assessed on body image, self-esteem, psychological morbidity, aging perceptions, traits of perfectionism, and QoL. Results suggested that psychological morbidity and perceptions of the aging process as chronic negatively contributed to QoL, and emotional representations of aging moderated the relationship between psychological morbidity and QoL. According to the findings, psychological intervention programs to improve QoL should focus on men with higher levels of psychological morbidity and more negative emotional responses to the aging process., This research was conducted at the Psychological Research Centre (CIPsi/UM), School of Psychology, University of Minho, supported by the Foundation for Science and Technology (FCT) through the Portuguese State Budget (UIDB/01662/2020).

Introduction: Certain behaviors have been associated with health promotion, including mammography screening, in women worldwide. Objective: The objective of this study was to determine whether there is an association between the periodicity of mammography screening and healthy lifestyle behaviors in Brazilian women employed at a public university in Bahia, Brazil. Methods: A total of 635 women of 50–69 years of age at the time of the interview, from the Brazilian Longitudinal Study of Adult Health cohort who were resident in Bahia, participated in the study. Data were collected using a multidimensional questionnaire that included questions on participants’ sociodemographic characteristics and health-related behaviors (smoking, alcohol consumption, leisure-time physical activity and diet) and another questionnaire that dealt with risk factors and breast cancer screening. Measures of association were calculated using simple and multivariate logistic regression. Results: The practice of physical activity, not smoking, moderate alcohol consumption and a healthy diet were the health behaviors most adopted by the women who had last had a mammogram ⩽2 years previously (which is in line with the interval recommended by the Brazilian Ministry of Health). A statistically significant association was found between a lapse of ⩾3 years since last undergoing mammography screening and excessive alcohol consumption, while a borderline association was found between the same screening interval and leisure-time physical inactivity. Conclusion: There was an association between lifestyle risk behaviors and a longer time interval between mammography screenings. The present results contribute to the debate on the use of mammography, lifestyle behaviors and health promotion among women.

The objective of this study was to evaluate the efficacy of two psychosocial interventions (Didactic and ACCENT) on socio-cognitive risk factors, in vulnerable Mozambican women at risk for HIV/AIDS infection. The study design was a randomized controlled trial on Mozambican women at HIV/AIDS risk (n = 150). The participants were randomized into three groups: Didactic Intervention (experimental group), ACCENT intervention (experimental group), and control group. We used an adapted version of the Women's Health Questionnaire, which includes a series of scales and questionnaires assessing psychosocial relevant dimensions to female protection towards HIV/AIDS: HIV/AIDS knowledge, condom use negotiation self-efficacy, and perceived barriers against safer sex. Both interventions were equally effective in increasing HIV/AIDS knowledge. The ACCENT intervention was especially effective in promoting condom use negotiation self-efficacy and in decreasing perceived barriers against safer sex, essential variables for sexual protection. These results support the adaptation of Western interventions to the African context.

The objective of the present study was to evaluate the association between social position and anthropometric status in women and men Brazilian adult. This was a cross-sectional study that used baseline data collected from 2008 to 2010 for the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil, in Portuguese), in the six major Brazilian state capital cities. A total of 15,105 active and retired civil servants aged from 35 to 74 years. Two latent variables were defined by latent class analysis, social position and anthropometric status. Both constructs and the analyses were separately evaluated by sex. Associations were assessed using multivariate logistic regression analysis with adjustment for age, self-reported skin color/race, and marital status. Around 44% of the women and 26% of the men were classified as overweight or obese. Social position tended to be lower in women (43.2%) and higher among men (40.4%). Heavier women were more likely to be black and brown-skinned, whereas slimmer women were more likely to be white. After adjustment, women’s weight increased as social position decreased (OR = 1.52; 95%CI: 1.36-1.70), whereas in men weight decreased as social position decreased (OR = 0.87; 95%CI: 0.76-0.99). Social position affected the anthropometric status of women and men differently, with body patterns also being affected by ethnicity/skin color, showing the potentiality of taking the intersectional perspective when investigating the possible social determinants of the phenomenon. Resumo: O objetivo do estudo foi avaliar a associação entre posição social e o estado antropométrico em brasileiros adultos de ambos os sexos. O estudo transversal usou dados coletados entre 2008 e 2010 pelo Estudo Longitudinal de Saúde do Adulto (ELSA-Brasil), nas seis maiores capitais brasileiras. Um total de 15.105 funcionários públicos, ativos e aposentados, de ambos os sexos, entre 35 e 74 anos de idade. Duas variáveis latentes foram definidas pela análise de classes latentes: posição social e estado antropométrico. Os construtos e análises foram avaliados separadamente por sexo. As associações foram avaliadas com o uso de análise de regressão logística multivariada, ajustada para idade, cor/raça e estado civil. Em torno de 44% das mulheres e 26% dos homens foram classificados com sobrepeso ou obesidade. A posição social tendia a ser mais baixa nas mulheres (43,2%) e mais alta nos homens (40,4%). Houve uma proporção maior de mulheres com sobrepeso ou obesidade entre as pretas e pardas, e proporção maior de mulheres magras entre as brancas. Nas mulheres, após ajustes, o peso aumentava na medida em que a posição social diminuía (OR = 1,52; IC95%: 1,36-1,70), enquanto nos homens o peso diminuía junto com a diminuição da posição social (OR = 0,87; IC95%: 0,76-0,99). A posição social afetou de maneira diferente o estado antropométrico de mulheres e homens, com perfis corporais afetados também pela raça/cor da pele, indicando o potencial de levar em conta a perspectiva interseccional ao investigar os possíveis determinantes sociais do fenômeno. Resumen: El objetivo de este estudio fue evaluar la asociación entre posición social y estatus antropométrico de adultos brasileños de ambos sexos. Fue un estudio transversal, realizado usando datos de referencia recogidos entre 2008 y 2010, del Estudio Longitudinal Brasileño de Salud en Adultos (ELSA-Brasil), llevado a cabo en seis de las mayores capitales de estado brasileñas. Un total de 15.105 activos y jubilados, mujeres y hombres funcionarios públicos de 35 a 74 años de edad. Se definieron dos variables latentes mediante análisis de clases latentes: posición social y estatus antropométrico. Ambos constructos y análisis fueron evaluados separadamente por sexo. Las asociaciones fueron evaluadas usando una regresión logística multivariada con ajuste por edad, color de piel/raza autoinformado y estatus marital. Alrededor de un 44% de las mujeres y un 26% de los hombres fueron clasificados como con sobrepeso u obesos. La posición social tendió a ser más baja en mujeres (43,2%) y más alta entre hombres (40,4%). Las mujeres con más peso tenían más probabilidad de ser negras y mulatas/mestizas y las mujeres más delgadas tenían más probabilidad de ser blancas. En mujeres, tras el ajuste, se incrementó más el peso cuanto mayor decrecía la posición social (OR = 1,52; IC95%: 1,36-1,70), mientras en hombres el peso decrecía al igual que la posición social (OR = 0,87; IC95%: 0,76-0,99). La posición social afectó diferentemente al estatus antropométrico de mujeres y hombres, con los patrones corporales también estando afectados por etnicidad/color de piel, mostrando su potencialidad tomando en consideración la perspectiva transversal, cuando se está investigando los posibles determinantes sociales del fenómeno.

Background It has been estimated that over 50% of the premature deaths occurring in Western countries can be attributed to causes rooted in lifestyle. In turn, leading a healthy lifestyle has also been associated with a wide range of psychosocial factors. Today, it is known that these differ among men and women. The present article aimed to identify the psychosocial factors associated with healthy lifestyles in women from the ELSA-Brazil cohort, the largest study concerning adult health conducted in Brazil. Methods This cross-sectional study was conducted using ELSA-Brasil baseline data, collected between 2008-2010. All included individuals were aged between 35 and 74 years at the time of voluntary recruitment. The ELSA-Brasil cohort has 8,218 women, both currently working and retired, from six public higher education and research institutions. Data were collected using the ELSA-Brasil questionnaire, a multidimensional instrument encompassing a range of topics. The lifestyle indicator was constructed by summing the scores attributed to four different behaviors (smoking, excessive alcohol consumption, inadequate nutrition and insufficient physical activity). Results Among women of the ELSA-Brasil, the following factors are associated with a healthier lifestyle: an age of 50-59 years (OR = 1.41; IC95% 1.24-1.61); age 60 years or older (OR = 2.21; IC95% 1.79-2.72); race/skin color Asian (OR = 2.29; IC95% 1.57-3.36), white/Caucasian (OR = 1.57; IC95% 1.36-1.81) or mixed-race (OR = 1.24; IC95% 1.07-1.44); a high-school equivalent (secondary) level of education (OR = 1.31; IC95% 1.09-1.57) or university degree (tertiary) (OR = 1.89; IC95% 1.55-2.29); being retired (OR = 1.33; IC95% 1.12-1.59); the self-perception of health status as good/very good (OR = 1.27; IC95% 1.12-1.45). Conclusions These findings should contribute towards preventing chronic non-communicable in adult women in Brazil and in other similar settings. Key messages Socio-demografic factors, such as age, race, education and retirement, influence the lifestyle of Brazilian women. Psychological factors, such as self-perception of health status, influence the lifestyle of Brazilian women.

Background Negotiation self-efficacy is one of the main predictors of effective condom use. Therefore, it is essential to identify the factors that influence condom use negotiation self-efficacy in vulnerable women. The aim of this paper is to examine whether socio-demographic and marital factors, and perceived barriers against safer sex are associated with condom use negotiation self-efficacy among Mozambican women at sexual risk. Methods 173 women, patients at a Mozambican public Hospital and at risk for HIV infection, completed measures of sociodemographic and marital characteristics, perceived barriers against safer sex, and condom use negotiation self-efficacy. Measures included the Mozambican version of the “Women's Health Study Questionnaire”, which presented good psychometric properties in this sample. Results Demographic variables (age and education) explained 20% of the variance (ΔF(2, 170)=20.92, p Conclusions These results support an exploratory predictive model of condom use negotiation self-efficacy that can inform interventions directed at behavioral change among Mozambican women at sexual risk. Key messages Women who were younger, had a higher level of education, were single, and talked about AIDS, had higher levels of condom use negotiation self-efficacy. Women who had lower levels of perceived barriers, had higher levels of condom use negotiation self-efficacy.

This study aimed to investigate differences in health behaviors as a function of gender and sexual orientation in the ELSA-Brasil cohort. Data were collected using a multidimensional questionnaire on health-related behaviors. The sample consisted of 10,314 participants, each of whom was in a stable relationship. Individuals in same-sex relationships were more likely to smoke, to spend more of their leisure-time in front of a screen and to sleep longer. When the behaviors were analyzed as a function of sexual orientation and gender, women in heterosexual relationships were less likely to smoke or to drink in excess, got more hours of sleep and spent less leisure time in front of a screen. On the other hand, they were less likely to exercise. These findings should contribute towards preventing chronic diseases and promoting health in people with different sexual orientations in Brazil and in other similar settings.

This article aims to identify the psychosocial factors associated with self-perceived health status in the Brazilian elderly population and to present differences related to gender. The data were collected by questionnaire, including sociodemographic and behavioral questions, and scales for psychological dimensions. Self-perceived health status is related to level of education, physical activity, and self-efficacy in the total population. Regarding gender differences, self-rated health status among men is related to education level and self-efficacy and in women to level of education, physical activity, social support, and self-efficacy. These results can inform future health promotion interventions.

Heterosexual encounters remain the primary route for HIV transmission in Africa. Safer sex behaviour is not adopted by many women due to several social and psychological factors. This paper aims to identify socio- demographic, marital and psychosocial predictors associated with current sexual activity and condom use in Mozambican women at sexual risk for HIV/AIDS. Women (173), patients at a public hospital and at risk for HIV infection, completed measures of condom use negotiation self-efficacy, perceived barriers against safer sex, current sexual activity and condom use. Having more than 6 years of education and being younger and single were significant predictors for current sexual activity and condom use. Regarding psychosocial factors, talking about AIDS with partners, condom use negotiation self-efficacy and fewer perceived barriers to safer sex were significant predictors for current sexual activity (intention to use and buy/get condoms). Condom use negotiation self-efficacy is a significant predictor for condom use. These results should be considered in new HIV prevention intervention design in Mozambique.Keywords: HIV prevention, Mozambique, sexual behaviours, women’s health

Discrimination is detrimental to physical and mental health, particularly insofar as health-risk behaviors are concerned. Particular attention has been paid to excess alcohol consumption and smoking in view of the ready availability of these substances in Western societies.To determine whether an association exists between perceived discrimination and excess alcohol intake and smoking in women and men enrolled in the ELSA-Brasil cohort study.The sample included in the ELSA-Brasil cohort consisted of 15,105 civil servants. Data from waves 1 and 2 of the study were used. A multidimensional questionnaire was used to collect sociodemographic characteristics and evaluate perceived discrimination, alcohol consumption, and smoking.An association was found between excess alcohol intake and perceived discrimination only in the men, with this association remaining significant in the youngest age group, in university-educated individuals, and in the group classified as middle-class. An association was found between smoking and lifetime perceived discrimination in women, particularly in those ≥60 years of age, brown-skinned women, those who had completed elementary school, and those classified as upper social class. This same association was found in the men, mainly those of 50-59 years of age, white-skinned males, those who had completed high school, those with a university education, and those classified as upper social class. Conclusions/Importance: Investing in public health policies aimed at combating the different forms of discrimination would appear essential. Not only does discrimination contribute to social injustice, but it also encourages health-risk behaviors such as excess alcohol intake and smoking.

Various behaviors are considered health enhancing. Nevertheless, according to the current scientific literature, four health behaviors are considered particularly risky in view of their association with a group of chronic diseases: 1) smoking; 2) excessive alcohol consumption; 3) poor diet; and 4) lack of physical activity. Theoretically, it should be possible to make improvements to one’s health by maximizing the number of healthy behaviors and minimizing the unhealthy ones. However, in reality, the different behaviors interconnect to create more complex lifestyles. Therefore, the objective of this paper is to present the construction of a lifestyle indicator based on health behaviors selected in the ELSA-Brazil study. This indicator revealed two lifestyles: less healthy and healthier lifestyles. The model proved adequate and was confirmed using latent class analysis (LCA). Agreement was 83.2 between the indicator and the LCA results, with a kappa coefficient of 0.65. Women were more likely to have a healthier lifestyle than men, reinforcing the scientific consistency of the indicator, since this finding is in agreement with data from the scientific literature. The indicator created to define lifestyle was found to have scientific consistency and validity; therefore, its use can be recommended for future population-based studies concerning the promotion of health and healthy lifestyles.

O vírus da imunodeficiência humana/síndrome da imunodeficiência adquirida (VIH/Sida) e uma das principais ameaças à vida humana, sendo que a vulnerabilidade da mulher é incontestável, principalmente em contextos desfavorecidos. Na África subsaariana as mulheres são as mais afetadas pelo VIH/Sida, numa proporção de infeção 4 vezes maior do que nos homens. Assim, é necessário aumentar o conhecimento dos fatores psicossociais e sociocognitivos ligados ao género, cultura e biologia que colocam a mulher em maior risco para o VIH/Sida. A literatura sugere que fatores como a vitimização, características da relação, problemas de saúde mental, história de cárcere e prostituição, nível de conhecimentos sobre a doença, crenças e competências relacionadas com a prática do sexo seguro, e a autoeficácia exercem influência sobre os comportamentos sexuais de risco para a infeção pelo VIH. A compreensão e análise destes fatores são essenciais no planeamento de estratégias interventivas mais realistas. O presente artigo apresenta uma revisão da literatura acerca dos fatores psicossociais e sociocognitivos que vulnerabilizam a mulher para o VIH/Sida, particularmente a mulher africana. São também levantadas questões de investigação que decorrem da análise da literatura neste domínio., HIV/AIDS is a major threat to human life and the vulnerability of women is undeniable, especially in disadvantaged settings. In sub-Saharan Africa, women are the most affected by HIV/AIDS, in a proportion of infection four times higher than men. Therefore, it is of the utmost importance to increase knowledge of which psychosocial and socio-cognitive factors may be related to gender, culture and biology thus placing women at greater risk for HIV/AIDS. The literature suggests that factors such as victimization, characteristics of the relationship, mental health problems, history of prison and prostitution; knowledge about HIV, beliefs and skills related to safe sex practices, and self-efficacy influence sexual risk behaviors linked to HIV infection. Examining these factors is essential to plan more realistic intervention strategies. This paper presents a literature review on the psychosocial and socio-cognitive factors that contribute to women's vulnerability to HIV/AIDS, particularly African women. The paper also addresses research questions that stem from the review of the literature in this field.

Purpose: To analyze the factors associated with commuting by bicycling and walking in adult participants from ELSA-Brasil (Longitudinal Study of Adult Health). Design: Cross-sectional. Setting: Six teaching/research institutions throughout Brazil. Participants: A total of 15 105 civil servants. Measures: Commuting by bicycling and walking was analyzed using the long-form International Physical Activity Questionnaire. Analysis: A hierarchical model containing possible factors associated with commuting by bicycling and walking was constructed. Crude and adjusted odds ratios were calculated using multinomial logistic regression. Results: Considering the 2 forms of commuting, 66% of the participants were being considered inactive or insufficiently active. In women, being “heavier,” feeling unsafe practicing physical activity, and being a former smoker were factors negatively associated with commuting by bicycling and walking. In men, active commuting was less common among those who were overweight or had abdominal obesity, those with a negative perception of safety, and those reporting that there was nowhere suitable in the neighborhood to practice physical activity. Conclusion: Obesity and negative perceptions in the neighborhood are associated with inactive or insufficiently active commuting. The relevance of this finding for public health is reinforce developing policies aimed at promoting health in Brazil and in other countries with similar characteristics.

Women’s anatomy and physiology place them at a higher risk of contracting the human immunodeficiency virus (HIV) and other sexually transmitted infections (STIs) compared to men. In addition, certain cultural and social issues increase women’s vulnerability to STIs. This descriptive literature review analyzed the different problems comprising relationship contexts as factors involved in the promotion of sexual health and the prevention of STIs in women. Data were obtained from classic authors who reported on how gender roles and imbalances in male-female relationships interfere with the prevention of STIs in women. For this, a systematic search was made of databases included in the Biblioteca Cientifica Online (B-on). Based on the selected articles evaluated, relationship-associated factors such as gender power imbalance, negative attitudes regarding condom use, and poverty and financial inequalities, as well as inadequate communication between partners were found to place women at risk of acquiring STIs. Since factors within relationships may play a significant role in STI prevention in various ways, it is relevant to take relationship characteristics into consideration when designing interventions aimed at promoting sexual health and preventing HIV/AIDS and other STIs in women. STI prevention programs should target both sexes and should focus strongly on increasing women’s capacity to negotiate and communicate with their partners.

In a community, depression can affect 30% to 45% of the elderly people. The consequences of this disease in the third age are numerous and adverse. Many researches have reported that depression is associated with a set of psychosocial factors. In this context, the perceived social support and general self-efficacy occupy an important position. Hence, the aim of this study is to confirm if the perceived social support and the general self-efficacy are predictors of depression in Brazilian senior citizen patients of a Health Basic Unit. The sample comprised144 elderly people (M age=69.3; SD=6.61) of both genders. The data were collected through a questionnaire which included socio-demographic questions and scales for the studied psychosocial dimensions. The results showed that perceived social support and self-efficacy are predictors of depression in the studied Brazilian elderly. Future interventions under the scope of mental health promotion and depression prevention in elderly people must consider these determinants as a way to increase their efficacy.

In Mozambique, women are the most affected by HIV/AIDS. Self-efficacy is one of the main predictors of effective use of a condom. Therefore, it is essential to identify the factors that influence condom-use negotiation self-efficacy in vulnerable women. The aim of this paper is to identify socio-demographic, marital, and psychosocial factors associated with condom-use negotiation self-efficacy among Mozambican women at risk for HIV infection. Participants were women (173) who were patients at the Gynecology Department of the Central Hospital of Beira, Mozambique, and at risk for HIV infection. Women completed measures of condom-use negotiation self-efficacy, HIV prevention knowledge, and perceived barriers against safer sex. The results showed that demographic and marital variables are associated with condom-use negotiation self-efficacy, namely, those having more than 9 years of education, who are younger and not living with a partner, and who talk about AIDS with partners report higher condom-use negotiation self-efficacy. Regarding psychosocial factors, higher HIV prevention knowledge and fewer perceived barriers to safer sex predict higher condom-use negotiation self-efficacy. These results can contribute to sexual health promotion and HIV/AIDS prevention in Mozambican women because they identify at-risk groups and marital and psychosocial malleable factors that can be targeted in AIDS prevention among at-risk Mozambican women.

Objectives: To assess associations, both individually and in combination, between leisure-time physical activity and sedentary behavior, and cardiometabolic health. Methods: This cross-sectional study included 13,931 civil servants participating in the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil). Leisure-time physical activity was analyzed using the leisure-time domain of the long-form International Physical Activity Questionnaire, while questions related to cumulative sitting time and leisure-based screen time on a weekday and on one day on the weekend were used to establish sedentary behavior. Data analysis was performed using multivariate logistic regression. Results: Following adjustment for confounding variables, high levels of leisure-time physical activity and low levels of sedentary behavior were both associated with favorable cardiometabolic health markers in both genders. When these two factors were analyzed in conjunction, taking the combination of low levels of leisure-time physical activity and high levels of sedentary behavior as the reference, the inverse associations with cardiometabolic variables became even more significant. Conclusion: High levels of leisure-time physical activity and low levels of sedentary behavior were both inversely associated with the cardiometabolic variables analyzed; however, the two variables when evaluated in conjunction appear to produce more consistent associations, particularly when sedentary behavior is evaluated according to leisure-based screen time.

Special Issue: "Health promotion interventions" : 25th conference of the European Health Psychology Society, Crete, Greece, 20-24 September 2011

A presente investigacao objetivou aprofundar os conhecimentos acerca dos itinera- rios terapeuticos da populacao da Ilha de Mocambique. Assim, segundo Kleinman (1980), em qualquer sociedade, pode-se identificar tres setores interconectados de cuidado medicos: o setor popular, o setor folk ou do povo, e o setor profissional. Neste seguimento, procedeu-se a uma analise do discurso de diferentes entrevistados agentes, tais como, membros da populacao (beneficiarios dos varios setores e agentes do setor popular), uma enfermeira (agente do setor profissional), e uma curandeira (agente do setor folk), tentando assim expor a perspectiva de cada um destes intervenientes dos itinerarios terapeuticos da populacao da Ilha de Mocambique. Desta forma, foi possivel constatar-se a presenca de todos os setores de saude e os motivos pelos quais sao procurados

De acordo com o PNUD (2010), num universo de 169 países, Moçambique ocupa o 165º lugar relativamente aos índices de desenvolvimento humano. Entre 2004/2005 desenvolveu-se uma investigação, com uma amostra de 500 indivíduos, cujo objectivo passou por analisar alguns indicadores de saúde da população da Ilha de Moçambique e compará-los com os valores nacionais. Os resultados demonstraram que, em alguns aspectos, os valores da Ilha são mais desfavoráveis do que os nacionais, enquanto que noutros são mais elevados. Assim, no geral, considera-se que a Ilha não possui um nível de desenvolvimento humano alto, tal como era esperado. Ao nível da saúde, a população não acede às oportunidades nem aos instrumentos que a ajudariam a melhorar a sua qualidade de vida.The United Nations Development Program (PNUD) refers to Mozambique as occupying the 165th place in terms of human development, within a range of 169 countries (2010). A study was conducted between 2004/2005, based on a sample of 500 persons. The goal was to analyse selected health indicators within the Island of Mozambique’s population, in order to compare them with the national rates. The results show that, in some aspects, the Island’s rates are lower than the national ones. However, it was also observed that certain variables revealed a more favourable situation within the Island of Mozambique. Generally speaking, then, we may conclude that human development is a serious problem in the Island. Healthwise, the population lacks the opportunities, as well as the means to improve this situation.

ObjectivesIt has been estimated that over 50% of the premature deaths occurring in Western countries can be attributed to causes rooted in lifestyle. In turn, leading a healthy lifestyle has also been associated with a wide range of psychosocial factors. Today, it is known that these differ among men and women. The present article aimed to identify, from a gender-based perspective, the psychosocial factors associated with healthy lifestyles in the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil) cohort, the largest study concerning adult health conducted in Latin America to date.DesignThis cross-sectional study was conducted using ELSA-Brasil baseline data, collected between 2008 and 2010.SettingSix Brazilian public higher education and research institutions.ParticipantsThe ELSA-Brasil cohort consists of approximately 15 000 employees (8218 women and 6887 men), both currently working and retired.Main outcome measuresThe lifestyle indicator was constructed by summing the scores attributed to four different behaviours.ResultsThe women of the ELSA-Brasil cohort have healthier lifestyles than men. In women, strong associations were found between a healthy lifestyle and age 60 years or older, Asian race and university level of education or higher. In men, being 60 years or older, of Asian or Caucasian race, having a high-school equivalent level of education or higher, being retired, having a housekeeper, having a good or very good self-perception of health and being satisfied with body image were the psychosocial factors associated with leading a healthy lifestyle.ConclusionsThe factors that influenced healthy lifestyles were found to differ among men and women, a fact that must be addressed when developing programmes designed to promote health.

Tese de doutoramento em Psicologia (área de especialização em Psicologia da Saúde), A presente investigação teve como objectivo testar a eficácia de duas intervenções psicossociais direccionadas para a prevenção do VIH/SIDA e promoção da saúde em mulheres Moçambicanas em risco sexual: a intervenção Didáctica e a intervenção ACCENT (“Capacidade Acelerada para a Exposição ao Conflito e Treino de Negociação”). A primeira é de cariz individual e meramente informativa; a segunda, além de informação, integra o treino de competências psicossociais, em grupo. Adicionalmente, também se procurou identificar as variáveis psicossociais associadas a comportamentos de risco sexual (práticas sexuais seguras actuais e utilização do preservativo) na amostra total, no pré-teste. O plano da investigação é do tipo randomized controlled trial, em que se distribuiu aleatoriamente as participantes por três condições: grupo experimental de intervenção ACCENT, grupo experimental de intervenção didáctica e grupo de controlo (sem intervenção). Também é um estudo longitudinal, com quatro momentos de avaliação: pré-teste (antes da intervenção), pósteste (após a intervenção), seguimento 1 (um mês após a intervenção), e seguimento 2 (três meses após a intervenção). Trata-se ainda de um estudo correlacional, na medida em que se investiga a relação entre variáveis psicossociais e comportamentais. O estudo decorreu no Hospital Central da Beira, em Moçambique, com uma amostra de 173 mulheres, em risco para a infecção pelo VIH/SIDA de acordo com critérios previamente estabelecidos. O instrumento de avaliação utilizado foi o Questionário do Estudo sobre a Saúde das Mulheres Moçambicanas (Hobfoll et al., 2002; versão adaptada por McIntyre, Costa & Patrão, 2009). Foram analisadas as características psicométricas das escalas que constituem este questionário, na amostra em estudo. As variáveis de resultado estudadas foram as seguintes: auto-eficácia geral, auto-estima, depressão, percepção de perda de recursos, suporte social, conhecimentos acerca do VIH/SIDA, percepção de barreiras face ao sexo seguro, auto-eficácia na negociação do preservativo, práticas sexuais seguras actuais (intenção e compra de preservativos), e utilização do preservativo (no decorrer dos últimos quatro actos sexuais). A primeira hipótese previa melhores resultados, a curto prazo (após a intervenção), para os grupos de intervenção (Didáctica e ACCENT), em comparação com o Grupo de Controlo (sem intervenção). A segunda hipótese previa melhores resultados para o grupo ACCENT, em comparação com o Grupo Didáctico, a curto prazo (após a intervenção). A terceira hipótese previa a manutenção dos ganhos obtidos ao longo do tempo no seguimento de um e três meses, em ambas as intervenções. As análises exploratórias pretenderam identificar as variáveis psicossociais associadas aos comportamentos de risco (correlatos) no préteste. A hipótese 1 foi confirmada para a generalidade das variáveis em estudo, à excepção da auto-eficácia geral, da depressão, da auto-estima, do suporte social, do stress financeiro e relacionado com as condições domésticas, da auto-eficácia para o uso do preservativo, e da percepção de atitudes do parceiro como negativas. A hipótese 2, relativa à superioridade da intervenção ACCENT em relação à intervenção Didáctica, confirmou-se para todas as variáveis em estudo, excepto nos conhecimentos acerca do VIH/SIDA, em que ambas as intervenções foram igualmente eficazes. A hipótese 3 também se confirmou para os conhecimentos acerca da transmissão/contágio, os conhecimentos acerca da prevenção, a percepção de atitudes do parceiro como negativas, as práticas sexuais seguras actuais, e a utilização do preservativo nos últimos 4 actos sexuais, indicando manutenção dos ganhos nos seguimentos de 1 e 3 meses para ambas as intervenções. A hipótese 3 apenas se confirmou para o grupo ACCENT relativamente à percepção de barreiras face ao sexo seguro, à ausência de percepção de risco, às percepções negativas face ao sexo seguro e ao suporte social. Relativamente às análises exploratórias, verificou-se que as variáveis demográficas idade e escolaridade, e as maritais estado civil e conversar sobre SIDA com os parceiros são corrrelatos significativos das variáveis comportamentais. Foram correlatos psicossociais significativos a auto-eficácia para o uso do preservativo e a percepção de barreiras. Os conhecimentos acerca da prevenção e a percepção de barreiras associaram-se à autoeficácia para o uso do preservativo que foi o correlato mais importante do comportamento sexual seguro. Finalmente, foram apresentadas as limitações do estudo, assim como, as implicações dos resultados obtidos para investigações futuras e a prevenção do VIH/SIDA na mulher africana., The present study aimed to evaluate the effectiveness of two psychosocial interventions focused on HIV/AIDS prevention and sexual health promotion among at risk Mozambican women: Didactic intervention and ACCENT intervention (Accelerating Capacity for Conflict Exposure Negotiation Training).. The Didactic intervention was merely informative and individual, whereas the ACCENT intervention, besides the educational component, emphasized the training and development of psychosocial skills in a group setting. This study also aimed to identify psychosocial correlates of sexual risk behaviors (current safe sex practices and condom use) among the total sample, at pre-test. The study design is a randomized controlled trial, in which participants were randomly assigned to three conditions: the experimental group ACCENT intervention, the experimental group Didactic intervention, and the control group (no intervention). It is a longitudinal study because the participants were followed over time and evaluated at four time points: pre-test (prior to the intervention), post-test (after the intervention), follow-up 1 (one month after the intervention), and follow-up 2 (three months after the intervention). It is also a correlational study, since the association between psychosocial and behavioral variables is examined. The study was conducted at the Central Hospital of Beira in Mozambique, with a sample of 173 women considered to be at risk for HIV/AIDS according to previously determined criteria). The instrument used was the Mozambican Women’s Health Study Questionnaire (Hobfoll et al., 2002; adapted by McIntyre, Costa, & Patrão, 2009). We analyzed the psychometric characteristics of the scales that make up this questionnaire, in the Mozambican sample. The outcome variables studied were the following: general self-efficacy, self-esteem, depression, perceived loss of resources, social support, HIV/AIDS knowledge, perceived barriers against safer sex, self-efficacy in condom negotiation, current sexual activity (intention to use and buy condoms), and condom use (last four sexual encounters). The first hypothesis predicted better results for the intervention groups (Didactic and ACCENT) at post-testin comparison to the control group (no intervention). The second hypothesis predicted better results for the ACCENT intervention group in comparison to the Didactic intervention group, at posttest. The third hypothesis predicted that the gains at post-test would be maintained at 1 and 3 months after the interventions. The exploratory analyses aimed to identify which psychosocial variables were associated with sexual risk behaviours (correlates) at pre test. Hypothesis 1 was confirmed for the majority of the variables studied, except for general self-efficacy, depression, self-esteem, social support, financial and domestic stress, self-efficacy in condom negotiation, and perceived partner’s negative attitudes.. Hypothesis 2, concerning the comparison of the effectiveness of the ACCENT intervention and the Didactic intervention, was confirmed for all variables studied, except for HIV/AIDS knowledge, since both interventions were equally effective. Hypothesis 3 was confirmed for HIV/AIDS knowledge, perceived partner’s negative attitudes, current safe sex practices, and condom use in the past four sexual encounters, indicating that these gains were maintained at 1 and 3 month follow-ups, for both interventions. Hypothesis 3 was only confirmed for the ACCENT intervention in terms of the perception of barriers to safe sex and social support. Regarding the exploratory analyses, we found that the demographic variables age and education level, and the marital variables (marital status and talking about AIDS with partners) are significant correlates of the safe sex behaviors. Self-efficacy in condom negotiation, and perceived barriers against safer sex, were significant correlates of sexual behavior. The HIV prevention knowledge and the perceived barriers against safer sex were associated with self-efficacy in condom negotiation, which was the most important correlate of safe sex behavior. Finally, the limitations of the study were presented as well as the implications of the results for future research and the prevention of HIV/AIDS among African women.

A presente investigação objectivou conhecer o nível de conhecimentos da população da Ilha de Moçambique acerca da malária, uma das doenças que mais assola o país. Assim, e tendo em conta o cenário moçambicano, traçou-se um estudo explotarório, constituído por uma amostra de 500 indivíduos, de ambos os sexos, residentes nos vários bairros da Ilha. Em termos gerais, as pessoas inquiridas estão maioritariamente bem informadas acerca das características da doença, suas implicações e formas de prevenção. Mesmo assim, verificou-se que ainda existem pessoas mal informadas. Estes indivíduos, que apresentam um nível baixo de conhecimentos acerca da doença, embora em menor número, continuam a ter procedimentos pouco preventivos e a contribuir para o aumento de casos desta doença. Considera-se que os resultados deste estudo são um contributo para a definição dos elementos a priorizar nas acções de educação e promoção da saúde, especificamente no que se refere à malária. This research aims to investigate the level of knowledge of the population of Mozambique Island about malaria, one of the diseases that most affect the country. Against this background we have developed an exploratory study, constituted by a sample of 500 individuals of both sexes, residing in different districts of the island. Overall, the respondents are mostly well informed about the characteristics of the disease, its implications, and ways of prevention. Still, the Island has residents without information about malaria. These people, who have a low level of knowledge about the disease, although in smaller numbers, still perform little preventive procedures and contribute to the increase in cases of this disease. It is considered that the results of this study are a contribution to the definition of priority actions in the promotion of education and health, specifically with regard to malaria.