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A number of studies claim that tobacco control (TC) regulations are associated with reductions in smoking-related hospitalisation rates, but very few have estimated the impact of TC laws (TCL) at both countrywide and regional levels, and none of them have studied the impact of TCL in relation to compliance with TC regulations. This study evaluates the effects of Russian TCL on hospital admission (HA) rates for pneumonia countrywide and in 10 Russian regions and the extent of these effects in connection with the compliance with TCL. Methods: HA rates for pneumonia from 2005–2019 were analysed to compare the periods before and after the adoption of TCL in 2013. An interrupted time series design and a Poisson regression model were used to estimate the immediate and long-term effects of TCL on pneumonia annual hospitalisation rates after the TCL adoption, compared with the pre-law period. The 10 Russian regions were compared using the TCL implementation scale (TCIS) developed on the basis of the results of the Russian TC policy evaluation survey; Spearman’s rank correlation and linear regression models were employed. Results showed a 14.3% reduction in HA rates for pneumonia (RR 0.88; p = 0.01) after the adoption of TCL in Russia with significant long-term effect after 2013 (RR 0.86; p = 0.006). Regions with better enforcement of TCL exhibited greater reductions in pneumonia HA rates (rsp = −0.55; p = 0.04); (β = −4.21; p = 0.02). Conclusions: TCL resulted in a sustained reduction in pneumonia hospitalisation rates, but these effects, varying by region, may depend on the scale of the TCL enforcement.

Introduction. The health status of the population and the economic development of the country are interrelated. The economic costs of compensatory payments associated with an increase in the incidence of diseases among company employees are constantly growing. The indirect costs of employers related to the health of employees are made up of absenteeism and presenteeism of employees. Determining the prevalence of frequency and level of presenteeism and the costs associated with it requires a special approach. The aim is to present the experience of adapting the tool for measuring the level of presenteeism among employees of the Russian Federation. Materials and methods. In 2020, experts from the NMRC TPM developed a set of tools (a questionnaire for employers and a questionnaire for employees). The 5-block employee questionnaire includes a translated and adapted version of the Stanford Presenteeism Scale. This unit assesses the degree of decline in productivity due to health conditions and, accordingly, when planning health promotion programs, calculate the opportunities to reduce presenteeism and increase productivity. Results. As a result, 553 completed questionnaires were received from employees. Among the interviewed employees, there were 33.5% of men (n = 187), the average age was 39.8 10.7 years, the average age of women was 42.6 11.1 years. Mostly employees had an average level of presenteeism (n=271, 57.3%), while low and high levels were observed in 41.2% (n=196) and 1.5% (n=6), respectively. The average level of presenteeism was in 96 men (59.9%) and 175 women (55.9%). Presenteeism is most prevalent among employees aged 40 to 49 (33.2%, n=157), and least prevalent among employees over 60 (5.7%, n=27). The minimum level of presenteeism was observed among technical specialists (6.1%, n=29), as well as among managers (10.1%, n=48). Conclusions. The Stanford Presenteeism Scale is characterized by conciseness, multiplicity, ease of obtaining and interpreting the results, which ensures the reliability of its application and allows us to recommend using the SPS for real practice. This paper describes the process of adaptation of the Stanford scale of presenteeism for Russian workers, in particular, the choice of this scale for adaptation in Russia is explained.

BACKGROUND: Asthma and obesity have a close relationship: obesity is a risk factor for asthma, the link of its pathogenesis, a predictor of heavier flow and the worst control. One of the priorities of non-drug therapy of asthma is the fight against overweight. Preventive counseling allows doctors to teach patients the principles of a healthy lifestyle, including controlling body weight. There is no domestic population-based research that reflects the coverage of overweight persons with asthma of the counseling on weight loss in various socio-demographic groups. Thus our study is actual. AIMS: Determine socio-demographic factors of overweight patients with bronchial asthma living in Russian urban areas associated with receiving counseling on weight loss. MATERIALS AND METHODS: This study was based on a cross-sectional population-based study Know Your Heart (20152018, Arkhangelsk, Novosibirsk, n=4504). For this research, we selected overweight patients with asthma (n=167). We applied the CHAID (Chi-Squared Automatic Interaction Detection) decision tree to identify socio-demographic factors associated with receiving weight loss counseling. CHAID method allows for the automated classification of the sample and the detection of relationships between the predictors and the analyzed outcome. RESULTS: The probability of obtaining counseling on weight loss increased by 1.39 times among retired women with obesity compared with the coverage level of counseling in the studied sample as a whole (61.7%). Among the men, the probability of obtaining counseling on weight loss increased 1.27 times in the presence of obesity. Reducing the likelihood of getting counseling both among women (1.39 times compared with the general indicator) and among men (2.2 times compared with the general indicator) was noted if their weight corresponded to the category of the excess body (BMI 25.029.9). CONCLUSION: 61.7% of the overweight urban population of two regions of Russia with asthma received counseling on weight loss. Groups of overweight patients with asthma, which are statistically significantly less often obtaining counseling on weight loss: persons with BMI 25.029.9, regardless of gender, and non-retired women with BMI 30.0. The decision tree developed by us will allow allergists-immunologists and doctors of related specialities to be wary of patients from the population groups identified in the study where the activity of conducting preventive counseling is reduced. In turn, this will increase the coverage of preventive counseling for patients with bronchial asthma and, as a result, will contribute to improving asthma control.

Introduction: Good sleep is an important determinant of health. Poor sleep quality is associated with poor health outcomes. Restrictive measures introduced due to the COVID-19 pandemic in the spring 2020 have led to unprecedented changes in human lives worldwide warranting research on different aspects of the influence of restrictive measures on human health and behavior. Aim: To study associations between the restrictive measures during COVID-19 pandemic and sleep characteristics in Russia. Moreover, we studied factors associated with changes in sleep patterns. Methods: We conducted a national online survey between 26 April 2020 and 6 June 2020 when the tightest measures were in place. Eligible participants included all Russian adults aged 18 years and over. The questionnaire contained 31 items and included mostly close-ended questions. Sleep quality was assessed before the COVID-19 pandemic and in the last 7 days during the study period. The respondents were asked to determine whether they were getting enough sleep, whether they had trouble falling asleep, and whether they woke up earlier than they wanted. Results: In spring 2020, 2 432 individuals from 62 regions of Russia completed web-based questionnaires. Most of them were from the Republic of Tatarstan (n = 804), Irkutsk (n = 474), Sakhalin (n = 225) and Tver regions (n = 152). For most of the respondents, the sleep characteristics analyzed in the study did not change. Negative changes in comparison with the period before the pandemic were noted a fifth of respondents while positive changes were reported by by 12-30 %. A third of respondents (30.3%) reported that the number of days without getting enough sleep decreased , ranging from 13.8 % in Sakhalin Oblast to 56.9 % in Tver Oblast. Adherence to the self-isolation regimen (OR = 2.15, 95 % CI 1.62-2.86), the presence of children (OR = 0.7, 95 % CI 0.59-0.84) and living in rural areas (OR = 1.58, 95 % CI 1.26-1.98) were the main correlates of sleep problems. Conclusion: Most of responders did not report changes in sleep quality. However, substantial regional differences were identified. identification of characteristics associated with negative sleep changes may contribute to development of targeted measures to mitigate the negative impact of the COVID-19 pandemic.

Aim. To study the effects of diet optimization and weight loss on the dynamics of metabolic syndrome and cardiovascular risk factors in women with overweight and obesity in six-month dietary counseling and remote monitoring.Material and Methods. A balanced caloric restriction by 240–250 kcal a day on average was recommended to 119 women with overweight and obesity. Actual nutrition was evaluated using special computer software “1C Nutrition Evaluation”.Results. The study showed a significant nutritional imbalance with a relatively high consumption of fats (40.4%) and low consumption of carbohydrates (39.6%), mainly due to the low consumption of starch. On the contrary, the consumption level of monoand disaccharides (20.9%) was twice as high as recommended (10%) by the World Health Organization (WHO). Dietary restriction and nutritional optimization led to a significant decrease in the values of body weight, body mass index, waist circumference, blood pressure, and lipid metabolism. As a result, the risks and probability of metabolic syndrome and cardiovascular diseases decreased.Conclusion. Correction of eating habits allowed to establish a rational and balanced approach to dietary energy restriction and nutritional structure optimization. Achieved weight loss was associated with normalization of parameters of abdominal obesity, blood pressure, and lipid metabolism. Six-month dietary intervention in women promoted control of risk factors for metabolic syndrome and cardiovascular diseases. The results of the study may be used to improve the personalized technology of distant preventive counseling in primary health care aimed at weight loss to achieve both primary and secondary prophylactics of metabolic syndrome and chronic non-infectious diseases.

Objective To describe total pre-hospital delays (symptom onset to admission), patient delay (symptom onset to calling for help), and transport delay (calling for help to admission) experienced by patients with acute coronary syndrome (ACS) in Russia and to identify factors associated with longer delays. Methods A prospective observational cohort study of ACS patients with myocardial infarction recruited in both PCI and non-PCI hospitals across 13 regions and multiple levels of the health system in Russia. Results Median total pre-hospital delays in our study was 5.1 hours, median patient delay was 1.5 hours and median transport delay was 2.1 hours. Patient delay did not differ by age and sex, although having a STEMI and certain symptom presentations, including severe pain, reduced delays. Transport delays were markedly reduced in those transported by Emergency Medical Services (EMS) and taken directly to the hospital of definitive treatment (rather than one closer but unable to offer Percutaneous coronary intervention (PCI)). Whilst transport delays were reduced in those using EMS, just half of patients using EMS had a transport delay of less than 2 hours (first medical contact to admission). Among all patients taken directly to hospital by EMS, 70% were STEMI patients. Of these STEMI patients, 78% had a transport delay of 2 hours or more. Among these patients, only 16.0% received thrombolysis in the ambulance. As expected, regional differences were apparent with all types of delay, with greatest variation found in transport delays. Conclusions Delays are currently longer than the ESC guidelines for STEMI patients and other severe cases., Reducing patient delay will reduce overall delays. Transport delays are inevitable in many regions of Russia but better triage of patients, increased use of EMS, and early thrombolysis in EMS, particularly for STEMI patients facing excessive transport delays, will reduce delays and buy time before PCI.

Introduction: Protecting and promoting health of employees through the implementation of measures to correct risk factors in the workplace is an important mechanism for achieving the strategic goal of increasing healthy life expectancy. Aim: To develop and pilot a package of tools for planning and implementing workplace well-being programs. Methods: In 2019, the federal project "Strengthening Public Health" was launched, within the framework of which model corporate programs were developed and published, including measures aimed at correcting smoking, poor nutrition, insufficient physical activity, psycho-emotional overstrain and excessive alcohol consumption. A set of tools has been developed to facilitate the development and implementation of workplace well-being programs, maximally focused on the needs of a particular enterprise. The set of tools include a questionnaire for the employer and a questionnaire for employees. Results: The set of tools has been tested by mailing to the chief freelance specialists in medical prevention of 28 regions of the Russian Federation, who responsible for the implementation of workplace well-being programs in the regions. Five hundred and eighty-eight completed questionnaires were received (among them 35 from employers, and 553 from employees). The analysis of the piloting results allowed us to make a number of adjustments to the questionnaires and confirm the importance of studying workers' presentiment in planning workplace well-being programs. The improved questionnaires are available online at https://atriya.gnicpm.ru/ . Conclusion: We developed the set of instruments which must be useful for implementation of the workplace well-being programs. Surveys of employers contribute to obtaining a snapshot of the attitudes and priorities of employers in the region to plan targeted measures to stimulate the implementation of workplace well-being programs at the regional level. Questionnaires for employees can be used for an indepth assessment of the priorities on the concrete workplace and development of a targeted program to the needs of a particular enterprise.

Several medications have been suspected to contribute to the etiology of inflammatory bowel disease (IBD). This study assessed the association between medication use and risk of developing IBD using the Prospective Urban Rural Epidemiology (PURE) cohort.This was a prospective cohort study of 133,137 individuals between the ages of 20-80 from 24 countries. Country-specific validated questionnaires documented baseline and follow-up medication use. Participants were followed prospectively at least every 3 years. The main outcome was development of IBD, including Crohn's disease (CD) and ulcerative colitis (UC). Short-term (baseline but not follow-up use) and long-term use (baseline and subsequent follow-up use) were evaluated. Results are presented as adjusted odds ratios (aOR) with 95% confidence intervals (CI).During a median follow-up of 11.0 years [interquartile range (IQR) 9.2-12.2], there were 571 incident IBD cases (143 CD and 428 UC). Incident IBD was significantly associated with baseline antibiotic [aOR: 2.81 (95% CI: 1.67-4.73), p=0.0001] and hormonal medication use [aOR: 4.43 (95% CI: 1.78-11.01), p=0.001]. Among females, previous or current oral contraceptive use was also associated with IBD development [aOR: 2.17 (95% CI: 1.70-2.77), p0.001]. NSAID users were also observed to have increased odds of IBD [aOR: 1.80 (95% CI: 1.23-2.64), p=0.002], which was driven by long-term use [aOR: 5.58 (95% CI: 2.26-13.80), p0.001]. All significant results were consistent in direction for CD and UC with low heterogeneity.Antibiotics, hormonal medications, oral contraceptives, and long-term NSAID use were associated with increased odds of incident IBD after adjustment for covariates.

The World Health Organization released new guidelines on physical activity and sedentary behaviour in November 2020. This commentary summarises these guidelines, including the new elements. An evaluation of the guidelines for each specific sub-population is provided. Finally, as the author group includes physical activity researchers from four continents, we provide recommendations on how to support the implementation of the new guidelines.

To date, few data on how the COVID-19 pandemic and restrictions affected children’s physical activity in Europe have been published. This study examined the prevalence and correlates of physical activity and screen time from a large sample of European children during the COVID-19 pandemic to inform strategies and provide adequate mitigation measures. An online survey was conducted using convenience sampling from 15 May to 22 June, 2020. Parents were eligible if they resided in one of the survey countries and their children aged 6–18 years. 8395 children were included (median age [IQR], 13 [10–15] years; 47% boys; 57.6% urban residents; 15.5% in self-isolation). Approximately two-thirds followed structured routines (66.4% [95%CI, 65.4–67.4]), and more than half were active during online P.E. (56.6% [95%CI, 55.5–57.6]). 19.0% (95%CI, 18.2–19.9) met the WHO Global physical activity recommendation. Total screen time in excess of 2 h/day was highly prevalent (weekdays: 69.5% [95%CI, 68.5–70.5]; weekend: 63.8% [95%CI, 62.7–64.8]). Playing outdoors more than 2 h/day, following a daily routine and being active in online P.E. increased the odds of healthy levels of physical activity and screen time, particularly in mildly affected countries. In severely affected countries, online P.E. contributed most to meet screen time recommendation, whereas outdoor play was most important for adequate physical activity. Promoting safe and responsible outdoor activities, safeguarding P.E. lessons during distance learning and setting pre-planned, consistent daily routines are important in helping children maintain healthy active lifestyle in pandemic situation. These factors should be prioritised by policymakers, schools and parents. HIGHLIGHTS: To our knowledge, our data provide the first multi-national estimates on physical activity and total screen time in European children roughly two months after COVID-19 was declared a global pandemic. Only 1 in 5 children met the WHO Global physical activity recommendations. Under pandemic conditions, parents should set pre-planned, consistent daily routines and integrate at least 2-hours outdoor activities into the daily schedule, preferable on each day. Schools should make P.E. lessons a priority. Decision makers should mandate online P.E. be delivered by schools during distance learning. Closing outdoor facilities for PA should be considered only as the last resort during lockdowns.

Introduction: Excessive salt intake (ESI) is a well-established risk factor of chronic non-communicable diseases (NCDs). Russia is among the countries with the high salt consumption. Population-based strategies to reduce salt intake have a potential for significant contribution to reduce the burden of NCDs. Modeling studies to justify the need and quantify the potential of these measures have been performed in several countries, but the evidence from Russia is still scarce. Aim: To forecast the efficiency of selected population-based prevention strategies to reduce salt intake in Russia. Methods: Potential efficiency of two population-based strategies was assessed. Introduction of the national excise tax on sodium used for industrial food production was the first strategy. The second strategy was a long term health literacy mass-media campaign aimed to reduce salt intake combined with a voluntary reduction in salt content in processed foods by manufacturers. Russia-specific impact of ESI on NCDs and population attributive risk (PAR) were calculated using previously assessed economic burden (EB) of ESI. The prediction period was 15 years. The changes in PAR after the introduction of population-based prevention strategies and changes in the EB of selected NCDs were calculated. Results: The first and the second programmed had a potential to reduce ESI prevalence by 2.99 % and 7.49 %, respectively. The corresponding numbers of prevented cases of NCDs were 23 352 and 57 874. Avoided direct medical costs exceeded 390 million rubles for the first strategy and over 969 million rubles for the second. The cumulative economic effect over 15 years was 4.10 billion rubles for the introduction of the new tax while the predicted cumulative economic effect of the second programme was 9.9 billion rubles. Conclusions: Although the population-based prevention strategies selected for this study have not yet been implemented in Russia, both have a significant potential to reduce the burden of NCDs and have substantial economic efficiency.

The large number of patients worldwide infected with the SARS-CoV-2 virus has overwhelmed health-care systems globally. The Anti-Coronavirus Therapies (ACT) outpatient trial aimed to evaluate anti-inflammatory therapy with colchicine and antithrombotic therapy with aspirin for prevention of disease progression in community patients with COVID-19.The ACT outpatient, open-label, 2 × 2 factorial, randomised, controlled trial, was done at 48 clinical sites in 11 countries. Patients in the community aged 30 years and older with symptomatic, laboratory confirmed COVID-19 who were within 7 days of diagnosis and at high risk of disease progression were randomly assigned (1:1) to receive colchicine 0·6 mg twice daily for 3 days and then 0·6 mg once daily for 25 days versus usual care, and in a second (1:1) randomisation to receive aspirin 100 mg once daily for 28 days versus usual care. Investigators and patients were not masked to treatment allocation. The primary outcome was assessed at 45 days in the intention-to-treat population; for the colchicine randomisation it was hospitalisation or death, and for the aspirin randomisation it was major thrombosis, hospitalisation, or death. The ACT outpatient trial is registered at ClinicalTrials.gov, NCT04324463 and is ongoing.Between Aug 27, 2020, and Feb 10, 2022, 3917 patients were randomly assigned to colchicine or control and to aspirin or control; after excluding 36 patients due to administrative reasons 3881 individuals were included in the analysis (n=1939 colchicine vs n=1942 control; n=1945 aspirin vs 1936 control). Follow-up was more than 99% complete. Overall event rates were 5 (0·1%) of 3881 for major thrombosis, 123 (3·2%) of 3881 for hospitalisation, and 23 (0·6%) of 3881 for death; 66 (3·4%) of 1939 patients allocated to colchicine and 65 (3·3%) of 1942 patients allocated to control experienced hospitalisation or death (hazard ratio [HR] 1·02, 95% CI 0·72-1·43, p=0·93); and 59 (3·0%) of 1945 of patients allocated to aspirin and 73 (3·8%) of 1936 patients allocated to control experienced major thrombosis, hospitalisation, or death (HR 0·80, 95% CI 0·57-1·13, p=0·21). Results for the primary outcome were consistent in all prespecified subgroups, including according to baseline vaccination status, timing of randomisation in relation to onset of symptoms (post-hoc analysis), and timing of enrolment according to the phase of the pandemic (post-hoc analysis). There were more serious adverse events with colchicine than with control (34 patients [1·8%] of 1939 vs 27 [1·4%] of 1942) but none in either group that led to discontinuation of study interventions. There was no increase in serious adverse events with aspirin versus control (31 [1·6%] vs 31 [1·6%]) and none that led to discontinuation of study interventions.The results provide no support for the use of colchicine or aspirin to prevent disease progression or death in outpatients with COVID-19.Canadian Institutes for Health Research, Bayer, Population Health Research Institute, Hamilton Health Sciences Research Institute, and Thistledown Foundation.For the Portuguese, Russian and Spanish translations of the abstract see Supplementary Materials section.

Digital, Background: Effective treatments for COVID-19 are urgently needed, but conducting randomized trials during the pandemic has been challenging.Methods: The Anti-Coronavirus Therapy (ACT) trials are parallel factorial international trials that aimed to enroll 3500 outpatients and 2500 inpatients with symptomatic COVID-19. The outpatient trial is evaluating colchicine vs usual care, and aspirin vs usual care. The primary outcome for the colchicine randomization is hospitalization or death, and for the aspirin randomization, it is major thrombosis, hospitalization, or death. The inpatient trial is evaluating colchicine vs usual care, and the combination of rivaroxaban 2.5 mg twice daily and aspirin 100 mg once daily vs usual care. The primary outcome for the colchicine randomization is need for high-flow oxygen, need for mechanical ventilation, or death, and for the rivaroxaban plus aspirin randomization, it is major thrombotic events, need for high-flow oxygen, need for mechanical ventilation, or death. Results: At the completion of enrollment on February 10, 2022, the outpatient trial had enrolled 3917 patients, and the inpatient trial had enrolled 2611 patients. Challenges encountered included lack of preliminary data about the interventions under evaluation, uncertainties related to the expected event rates, delays in regulatory and ethics approvals, and in obtaining study interventions, as well as the changing pattern of the COVID-19 pandemic. Conclusions: The ACT trials will determine the efficacy of antiinflammatory therapy with colchicine, and antithrombotic therapy with aspirin given alone or in combination with rivaroxaban, across the spectrum of mild, moderate, and severe COVID-19. Lessons learned from the conduct of these trials will inform planning of future trials., Contexte : Il est urgent de mettre au point des traitements efficaces contre la COVID-19, mais il n’est pas facile de realiser des essais à repartition aleatoire dans un contexte pandemique.Methodologie : Les essais internationaux factoriels ACT (Anti-Coronavirus Therapy) avaient un objectif d’inscription de 3 500 patients externes et de 2 500 patients hospitalises presentant une COVID-19 symptomatique. L’essai mene auprès de patients externes visait à evaluer la colchicine par rapport aux soins habituels, et l’aspirine par rapport aux soins habituels. Le paramètre d’evaluation principal au terme de la repartition aleatoire des patients etait l’hospitalisation ou le decès dans le groupe traite par la colchicine, et la thrombose majeure, l’hospitalisation ou le decès dans le groupe traite par l’aspirine. L’essai mene auprès de patients hospitalises visant à evaluer la colchicine par rapport aux soins habituels, et un traitement associant le rivaroxaban à 2,5 mg deux fois par jour et l’aspirine à 100 mg une fois par jour par rapport aux soins habituels. Le paramètre d’evaluation principal au terme de la repartition aleatoire des patients etait le recours à l’oxygenotherapie à haut debit ou à la ventilation mecanique ou le decès dans le groupe traite par la colchicine, et la survenue de manifestations thrombotiques majeures, le recours à l’oxyg enotherapie à haut debit ou à la ventilation m ecanique ou le decès dans le groupe traite par l’association rivaroxaban-aspirine. Resultats : À la fin de la periode d’inscription, le 10 fevrier 2022, 3 917 patients externes et 2 611 patients hospitalises formaient la population des essais. Certains aspects se sont reveles problematiques, notamment le manque de donnees preliminaires sur les interventions à evaluer, les incertitudes liees aux taux d´evenements prevus, les retards touchant les approbations reglementaires et ethiques et les interventions de recherche, de même que l’evolution de la pandemie de COVID-19. Conclusions : Les essais ACT d etermineront l’efficacite du traitement anti-inflammatoire par la colchicine et du traitement antithrombotique par l’aspirine, administree seule ou en association avec le rivaroxaban, contre la COVID-19 legère, moderee ou sevère. Les leçons tirees de ces essais orienteront la planification d’essais ulterieurs., Ciencias Médicas y de la Salud

High salt intake is an important risk factor for cardiovascular diseases (CVD), closely related to the level of blood pressure in the population. The purpose of the review: to study population-based interventions for CVD prevention, aimed at reducing salt intake; to assess the potential for their implementation in the Russian Federation. We presented population-based strategies for dietary salt intake reduction used in different countries. The main components of strategies aimed to correct this risk factor in the Russian Federation were identified. The main components of the population-based approach to reducing salt intake are: determining population salt consumption, identifying sources of salt in the diet, monitoring of salt content in products, engaging with the food industry, consumer awareness campaigns, changes in product labeling, tax measures. An integrated approach to the problem is the most successful. Measures which were highly effective have not yet been fully implemented in the Russian Federation. At the moment, taxation of high-salt foods and tax subsidies for healthy food are not applied. Food manufacturers are not sufficiently involved - there are no legislatively introduced measures to reduce salt through food reformulation. Firstly it has to be applied to diet-forming products that are consumed daily, such as bakery and dairy products, and meat products.

Aim. To analyze hospital admission and ambulatory care of the patients with arterial hypertension (AH) in federal districts and regions from the perspective of the WHO concept of diseases, which can be treated in ambulatory settings (ambulatory care sensitive conditions, ACSC).Material and methods. For analysis we used data from annual forms of federal statistical monitoring (12 and 14), which includes data on hospital admissions with hypertension in federal districts and separate regions in 2017. Hypertension included diseases characterized by raised blood pressure, ICD10: I10-I13.Results. We performed the analysis of 12 and 14 forms per districts and regions of the Russian Federation. Regions with increased hospitalization rates and an increased ratio of the hospitalizations to number to outpatients visits were identified. High variability of these indicators was observed both among both between regions and federal districts. The values of the ratio indicator vary from 0.0131 in the Nizhny Novgorod Region to 0.0234 in the Chechen Republic. The average value of the ratio in the federal district varies from 0.032 in the Volga Federal District to 0.119 in the North Caucasus Federal District. In the North Caucasus and Far East Federal District the value of the indicator is significantly higher than in other districts.Conclusion. Assessing diseases which can be treated in ambulatory setting scan be one of the tools for evaluating the quality of medical care in primary care facilities. However, before including ACSC as an indicator of the quality of health care delivery, a deeper understanding of the reasons that can impact its rates is required.

Background: The prevalence of obesity in Russia has increased sharply since the mid-1990s. Interestingly, the prevalence of obesity in Japan is lower than in many Western countries. Japan has implemented different types of weight control programs using a smart device to monitor patients remotely. New health promotion methods from Japan are now being used in Russia. The Russian-Japanese “Tackle Obesity and Metabolic Syndrome Outcome by Diet, Activities and Checking Body Weight Intervention” (RJ-TOMODACHI) study aims to evaluate a preventive intervention using Japanese health monitoring technology in reducing excess body weight, compared with standard care, in Russia. Methods and Results: The trial is a single-center, 3-armed, parallel group randomized controlled trial conducted among overweight/obese adults. It has been designed to compare the effectiveness of 2 newly developed interventions against standard care for 6 months. Participants in the low- and high-intensity intervention groups will have 3 and 6 consultations over the study period, respectively. In all, 260 adults were screened at baseline; 65 did not participate in the trial for various reasons. The remaining 195 people were randomized into 3 groups (high-intensity intervention, n=73, low-intensity, n=73; standard care group, n=49). Conclusions: The trial protocol has been designed so that the methodology can be adapted for use in Russia.

Russia belongs to countries with a high prevalence of arterial hypertension (AH), which is the main cause of premature death in the Russian population. The level of blood pressure (BP) is controlled in less than a third of patients, which may be due to poor adherence to medical recommendations and irregular medication. The manuscript provides a review of studies evaluating the effectiveness of measures to improve adherence to antihypertensive therapy (AHT).Aim. To prepare a systematic review of Russian studies to assess the effectiveness of measures to increase adherence to AHT, to determine/describe the main directions of the intervention and the methodological level.Material and methods. The search for full-text articles on adherence to AHT published in Russian in the period from 2000 to 2019 was carried out in the main Russian and international electronic databases eLIBRARY.ru, Embase, Russian Medicine, MEDLINE. Of the 563 publications found, 20 were included in the review.Results. In 14 studies, adherence was assessed using the 4-item Morisky Medication Adherence Scale (MMAS-4), other studies used bespoke questionnaires or pill counts. Two studies examined factors associated with adherence. The observation period was up 6 weeks to 12 months, the number of participants is 30-2435 people. A higher adherence was noted in women, people over 50 years old, with higher education, working, with concomitant diabetes mellitus and a history of myocardial infarction. Patient education was effective interventions to improve adherence (in particular, in studies, improvement on the MMAS-4 from 1.8 to 3.9 points, p=0.0002 or from 2.80 to 3.79 points, pConclusion. The most effective ways to improve adherence are patient education and the use of drugs fixed combinations. In most studies, subjective methods of adherence assessing were used.

Unhealthy diet is associated with high morbidity and mortality from chronic non-communicable diseases (NCDs) which in turn are associated with high economic costs. A significant proportion of these costs is attributed to insufficient fresh fruits and vegetables in the diet worldwide with large country-to-country variation warranting research in various settings including Russia. The aim: to assess the economic burden of insufficient consumption of fruits and vegetables in Russia in 2016 due to their contribution to the development of major NCDs. Methods: The calculation was made using population attributive risk for the development of cardiovascular diseases, type 2 diabetes and cancer from meta-analyses and the data on the prevalence of fruits and vegetables consumption and the abovementioned diseases in the Russian population. The economic costs from the main NCDs were calculated using the human capital method. The share of health care system costs and economic losses due to morbidity and mortality from NCDs associated with fruits and vegetables underconsumption was assessed. Results: The contribution of insufficient consumption of fruits and vegetables to the morbidity and mortality from cardiovascular diseases, coronary heart disease and stroke were 5 % each (95 % CI: 3.0-6.2), 5% (95 % CI: 3.7-6.2) and 10 % (95 % CI: 4.9-15.9), respectively. Corresponding proportions for lung cancer was 8.9 % (95 % CI: 3.7-14.4). The economic burden associated with this risk factor, amounted more than 134 billion rubles (95 % CI: 78.8-173.3 billion rubles), 0.16 % of GDP of the Russian Federation in 2016. Indirect losses due to premature mortality (86 %) prevailed in the structure of the economic burden. Conclusions: The high prevalence of fruits and vegetables underconsumption in Russia and its significant contribution to the morbidity and mortality from NCDs are associated with significant economic costs from this risk factor.

Aims To adapt and validate the Alcohol Use Disorders Identification Test (AUDIT) for use in the Russian Federation and countries with Russian-speaking populations by: 1) Operationalizing alcohol use patterns to allow for the best identification of hazardous use patterns in the Russian context. 2) Determining the best cut-off values for brief advice/interventions in primary healthcare settings. 3) Determining the best cut-off values for potential alcohol use disorders. Methods Systematic review of past use and validation of the Russian-language AUDIT. Interviews to be conducted with experts to identify problems encountered in the use of existing Russian-language AUDIT versions. A pilot study using a revised translation of the Russian-language AUDIT that incorporates country-specific drinking patterns in the Russian Federation. Results and Conclusions The systematic review identified over 60 different Russian-language AUDIT versions without systematic validation studies. The main difficulties encountered with the use of the AUDIT in the Russian Federation were related to the lack of: a concept and definition for a standard drink; low-risk drinking guidelines/thresholds and inclusion of the specific drinking pattern of episodic heavy drinking. A revised version of the Russian-language AUDIT was created based on the pilot studies, and was validated in primary healthcare facilities in all regions in 2019/2020., Short Summary To introduce the Alcohol Use Disorders Identification Test (AUDIT) into primary healthcare settings in the Russian Federation, consultations with experts and several initial studies were conducted to adapt the instrument. This article presents the final instrument and the steps taken to construct it. It also presents the design of the validation study to determine alcoholic intake thresholds for appropriate interventions.

The prevalence of hypertension in the Russian Federation (RF) has been growing in recent years, which causes significant socio-economic burden. Aim . To evaluate economic burden of hypertension in the RF in 2016 including direct costs and economic losses caused by decreased labor efficiency. Material and methods . The calculation included the prevalence of hypertension in the RF and the relative risk of hypertension for cardiovascular diseases (CVD) (including stroke and coronary heart disease), chronic obstructive pulmonary disease (COPD), type 2 diabetes mellitus (DM2), cancer of the trachea, bronchi and lungs, breast and prostate. The calculation included Russian statistics on noncommunicable diseases (NCD) for 2016. Statistical analysis – calculations were performed by Microsoft Excel 10.0 Results . Population attributable risk (PAR) of hypertension in mortality from all CVDs was 34%, in morbidity – 30%, including PAR in mortality from coronary heart disease and stroke 38% and 60%, respectively; the same in morbidity – 28% and 14%, respectively. For DM2 PAR in mortality was 1%, in morbidity – 18%. For COPD PAR in morbidity was ≈24%. PARs in morbidity and mortality for lung, bronchi and trachea cancer were ≈12%, for prostate cancer ≈3%, and for breast cancer 6%. Direct medical costs associated with the analyzed NCDs exceeded 84 billion rubles, direct non-medical costs – over 1.5 billion rubles. In the structure of economic burden, the main part was associated with gross domestic product (GDP) losses due to premature mortality due to hypertension. Conclusion . The total economic burden associated with hypertension in 2016 amounted to 869936 million rubles that corresponded to 1% of Russian GDP.

Aim: to study the impact of anti-smoking measures within the Federal Law N 15-FL on the number of hospitalization of patients with acute cardiovascular conditions in the Samara and Arkhangelsk Regions and the Chuvash Republic. Methods: Monthly hospitalization rates for acute myocardial infarction and unstable angina were analyzed usinginterrupted time series by means of the STATA 15.0 software package, which includes the ITS module in three regions of the Russian Federation from 01.01.2012 to 31.12.2017, and by gender (men and women) and age (0-59 years and 60 years and older). Results. Reduction in hospital incidence after each stage of the anti-tobacco policy was obwerved in two of the three regions. In the Samara Region we observed a reductionby 16.3 % in 2013 and by 18.4 % in 2014 for unstable angina and by 10.6 % in 2013 and by 10.5 % in 2014 for acute myocardial infarction, respectively. In the Arkhangelsk Region the number of hospitalizations decreased by 14.3 % in 2013 and by 14.4 % in 2014 for unstable angina, and by 7.5 % in 2013 and by 7.7 % in 2014 for acute myocardial infarction. No significant decrease was observed in the Chuvash Republic. Gender stratification revealed a decrease in the hospital incidence of acute myocardial infarction and unstable angina in women in the Samara and Arkhangelsk Regions, and in men - only in the Samara region. The percentage of reduction in unstable angina was higher than in the acute myocardial infarction. An analysis of age groups in the Samara Region showed a decrease in the number of hospitalizations for acute myocardial infarction and unstable angina in both age groups, and in the Arkhangelsk Region only in people over 60 years of age. Conclusions: anti-tobacco legislation introduced in Russia in 2013 and 2014 is likely to have contributed to a decrease in the number of hospitalizations for acute cardiovascular diseases, but the effect varied across genders and age-groups.

Aim. To analyze the associations of health care system resources utilization and temporary disability (TD) with the main cardiovascular risk factors (RF) at the population and individual level in working age population based on ESSE-RF study data.Material and methods. The analysis was based on ESSE-RF study data. Standard epidemiological survey methods and evaluation criteria were used. Analysis of probability and number of outpatient visits, hospitalizations, ambulance calls and TD was conducted by using hurdle model. Hypertension, obesity, hypercholesterolemia, hyperglycemia and tobacco consumption were independent variables.Results. A total of 21923 individuals aged 25-64 years were included: men – 8373 (38%) and women – 13550 (62%). The probability of outpatient visits significantly determined in group with tobacco consumption and with hypercholesterolemia for men, and for women – in the smoking group, with obesity and with hyperglycemia. Numbers of outpatient visits has doubled for patient with hyperglycemia. The numbers of outpatient visits were higher among women smokers compared to non-smokers. Chance to be hospitalized significantly associate with smoking, obesity, hypercholesterolemia for men and with obesity, hyperglycemia – for women. Hypercholesterolemia was associated with a smaller number of inpatient treatment cases among men. The probability of ambulance calls increased for smoking men, for male group with hypertension, hypercholesterolemia, obesity and with hyperglycemia, at the same time, the likelihood increased in female group with hypertension, hyperglycemia, smoking and with obesity. In addition, numbers of ambulance calls were higher in 1.55 times for women with obesity (pConclusion. So, there is a significant association of probability of using and consumption level of healthcare recourse with the RF depending on the type of medical care, sex and RF.

Aim. To evaluate the structure of multimorbidity, outcomes and the potential effect of dapagliflozin in patients with a combination of cardiovascular disease (CVD) and type 2 diabetes in Russian clinical practice.Material and methods. The data of 10 registries with the inclusion of 22957 people, including 4370 with type 2 diabetes in 6 regions of the Russian Federation, were analyzed. Scenarios for reducing mortality from all and cardiovascular causes and hospitalizations for CVD were simulated among groups of patients with diabetes combined with myocardial infarction (MI) and diabetes combined with heart failure with reduced ejection fraction (HFrEF) based on data from the Federal Registry of diabetes, the RECVASA and REGION registries, relative risks associated with analyzed adverse events from the DECLARE study.Results. When analyzing the data of all 22957 patients with CVD included in the registries, it was found that the proportion of patients with comorbid diabetes was on average 19.0%. Of the various diagnoses of CVD, the combination with diabetes was most often recorded in patients that had MI – 2.0%, stroke – 22.5% and heart failure – 24.0%. In the RECVASA registry (Ryazan) for 4 years of follow-up of 699 patients with a combination of CVD and diabetes mortality from all causes was 20.9%, and from cardiovascular causes – 15.6%. The simulated number of potentially prevented cardiovascular deaths with dapagliflozin taking in patients with diabetes combined with MI for 4 years in Russia will be 39124, and 37440 cardiovascular hospitalizations. The number of potentially preventable deaths from all causes among patients with diabetes combined with HFrEF will be 4543, cardiovascular deaths in 1995, and the number of prevented cardiovascular hospitalizations will be 7072.Conclusion. According to data from the registries of CVD patients in 6 regions of the Russian Federation, it was revealed that in real clinical practice the proportion of people with comorbid diabetes averaged 19% both at the outpatient and hospital stages. These subgroups of multimorbid patients have both the highest risk of developing fatal and non-fatal cardiovascular complications, and the largest number of indications for prescribing drugs that affect the prognosis due to effects on both CVD and diabetes.

As per data provided by the WHO, about one third of death cases due to cancer are caused by risk factors that can be modified. Also, according to data provided by several authors, 4 modifiable risk factors cause 70% of malignant neoplasm cases that could have been prevented. Malignant neoplasms occupy the 2nd rank place in mortality structure in the Russian Federation. A significant share of analyzed malignant neoplasms can potentially be prevented provided that risk factors are corrected; therefore, investments into prevention should be a core in any activity aimed at public health improvement. Our goal was to evaluate economic losses that occurred due to most common oncologic diseases related to behavioral risk factors among population in Russia in 2016 (including costs borne by the public healthcare and losses in the economy). Our analysis comprised direct expenses borne by the public healthcare or, in other words, money spent on oncologic diseases treatment, direct funds allocated to pay disability allowances and temporary disability payments as well as indirect losses in the economy associated with untimely deaths and disability among employable population. Aggregated economic losses that occurred due to 10 most common malignant neoplasms included into our analysis amounted to 241.3 billion rubles or 0.3% of the country GDP in 2016. Direct expenses accounted for 71.7% of the total losses while GDP losses caused by untimely deaths and disability amounted to 28.3%. The highest direct expenses borne by the public healthcare were due to colorectal cancer (52 billion rubles) and cancer in the trachea, bronchial tubes, and lungs (50 billion rubles). Our data indicate it is necessary to invest into oncologic diseases prevention and treatment. These investments can produce a significant economic effect in long-term period thus making for economic growth.

Aim. To study the prevalence of familial hypercholesterolemia (FH), the characteristics of the clinical features and treatment of the disease in selected regions of the Russian Federation, this article describes the design and initial characteristics of patients included in the study.Material and methods. The study participants were selected among those included in the study “Epidemiology of cardiovascular risk factors and diseases in the regions of the Russian Federation” (ESSE-RF) in different regions of the Russian Federation. The study included individuals with lowdensity lipoprotein cholesterol (LDL-C) levels >4.9 mmol/l or LDL-C levels >1.8 mmol/l, but ≤4.9 mmol/l during statin therapy, according to the data obtained in the ESSE-RF study. These persons are invited for examination and questioning by experts in the field of FH diagnostics. On the basis of the survey data and provided medical documentation, the following information is collected: age, sex, smoking status, presence of hypertension, history of coronary artery disease, stroke, atherosclerosis of cerebral and peripheral arteries, LDL-C level, type, volume and duration of lipid-lowering therapy throughout life, presence and dates of secondary causes of hyperlipidemia, information about the family history of development of early cardiovascular diseases and atherosclerotic diseases, increased levels of LDL-C in relatives of the 1st and 2nd degree of kinship. All patients are examined for the presence of tendon xanthomas (Achilles, metacarpal, elbow, knee tendons) and Corneal arcus. During the visit, blood is taken for subsequent biobanking, measurement of current blood lipid levels, elimination of secondary forms of hypercholesterolemia (for subsequent determination of liver enzymes, thyroid stimulating hormone) and genetic testing. The diagnosis of FH is based on Dutch Lipid Clinical Network Criteria (DLCN). Besides, all participants in the study are tested for compliance with the diagnosis of FH according to Simon Broome criteria. All patients with a definite or probable diagnosis of FH according to DLCN or Simon Broome criteria are subjected to ultrasound examination of carotid, femoral arteries and heart and molecular genetic testing for LDLR, APOB and PCSK9 gene variants.Results. Out of 16 360 participants of the ESSE-RF study in 10 regions, 1787 people (10,9%) met the criteria for inclusion in this study. Among them, men accounted for 35.4%, of which 1150 (7%) patients had a LDL-C level >4.9 mmol/l and 637 (3,9%) had a LDL-C level from 1,81 mmol/l to 4.9 mmol/l during lipid-lowering therapy. When compared to the original cohorts of participants from the 10 regions as compared to 3 previously surveyed regions and selected sub-groups within these cohorts we observed significant differences in several parameters such as age, total cholesterol level, triglycerides, LDL-C, the frequency of cardiovascular diseases, that may indicate regional differences in FH prevalence.Conclusion. The analysis of clinical data of the participants of the ESSE-RF study shows that more than 10% of individuals require an additional examination to verify the FH diagnosis, and regional differences in the FH prevalence are possible.

ObjectivesWe used the WHO draft nutrient profile model (NPM) to evaluate baby foods targeted at infants and young children (IYC) aged 6–36 months in the Russian Federation to assess their suitability for marketing.DesignA cross-sectional study in Moscow (Russian Federation).SettingNutrition information of baby food was primarily collected from retailer websites, with some complementary data from physical stores. Both specialist stores for IYC and general supermarkets were included.ParticipantsTwo hundred and thirty baby food products targeted to IYC were selected. Breastmilk substitutes and products targeted at children over 3 years old were excluded.Main outcome measuresPer cent of missing nutrition data, per cent of products with added sugar or sweetener and exceeded sodium or salts, per cent of products marketed as suitable for IYC under 6 months.ResultsMost products were ‘ready-to-eat’, including fruit (n=42, 18.5%) and vegetable (n=29, 12.8%) purees, meat, fish or cheese purees (n =26, 11.5%); ‘dry or instant cereal/starchy foods’ (n=27, 11.9%), including predominantly dry cereals, ‘juices and other drinks’ (n=26, 11.5%). 95% (n=219/230) of products were missing total sugar information, 78% (n=180/230) were missing either sodium or salt, and 25% (n=57/230) were missing total fat. Among products with sugar and sodium information, 41% (n=94/230) included added sugar or sweeteners, and 48% (n=24/50) exceeded the NPM sodium threshold. 40% of products (n=92/230) were marketed as suitable for IYC aged under 6 months.ConclusionBaby foods marketed for IYC showed a high per cent of missing nutrition information and disparity with WHO’s guidelines for complementary feeding, age of introduction, sugar and salt content. Stronger regulation is needed in this area to minimise higher risk of non-communicable diseases (NCDs) in later life.

Intensive investigation of cardiovascular disease (CVD) risk factors (RFs), both traditional (smoking, dyslipidemia, diabetes, etc.) and non-traditional, which are a component of the so-called exposome, as well as their non-drug and drug correction provide wide prospects for effective cardiovascular prevention. Prevention becomes the dominant trend in cardiology and in medicine in general. The aim of the article was to describe cardiovascular prevention in young, middle, elderly and senile age. Due to the multifaceted nature of cardiovascular RFs, an integrated biopsychosocial approach, individual and population-based prevention, cumulative risk assessment of all CVDs, intersectoral collaboration and the involvement of decision-makers, are key to the success and effectiveness of prevention measures. It is important to note that, on the one hand, preventive measures should be started as early as possible due to cumulative effect of RFs, on the other hand, most of the preventive interventions for CVD are extremely relevant at all life stages.

Introduction 24-hour movement behaviours (physical activity, sedentary behaviour and sleep) during the early years are associated with health and developmental outcomes, prompting the WHO to develop Global guidelines for physical activity, sedentary behaviour and sleep for children under 5 years of age. Prevalence data on 24-hour movement behaviours is lacking, particularly in low-income and middle-income countries (LMICs). This paper describes the development of the SUNRISE International Study of Movement Behaviours in the Early Years protocol, designed to address this gap. Methods and analysis SUNRISE is the first international cross-sectional study that aims to determine the proportion of 3- and 4-year-old children who meet the WHO Global guidelines. The study will assess if proportions differ by gender, urban/rural location and/or socioeconomic status. Executive function, motor skills and adiposity will be assessed and potential correlates of 24-hour movement behaviours examined. Pilot research from 24 countries (14 LMICs) informed the study design and protocol. Data are collected locally by research staff from partnering institutions who are trained throughout the research process. Piloting of all measures to determine protocol acceptability and feasibility was interrupted by COVID-19 but is nearing completion. At the time of publication 41 countries are participating in the SUNRISE study. Ethics and dissemination The SUNRISE protocol has received ethics approved from the University of Wollongong, Australia, and in each country by the applicable ethics committees. Approval is also sought from any relevant government departments or organisations. The results will inform global efforts to prevent childhood obesity and ensure young children reach their health and developmental potential. Findings on the correlates of movement behaviours can guide future interventions to improve the movement behaviours in culturally specific ways. Study findings will be disseminated via publications, conference presentations and may contribute to the development of local guidelines and public health interventions. Funding Agencies|American Council on Exercise, USA; Beijing Health System High Level Talents Training Project, China [2015-3-88]; Biomedical Research Foundation, Dhaka, Bangladesh [BRF-19-01]; Canadian Institutes of Health Research Frederick Banting and Charles Best Canada Graduate Scholarship (CGS-M)Canadian Institutes of Health Research (CIHR); Canadian Institutes of Health Research Planning and Dissemination GrantCanadian Institutes of Health Research (CIHR) [155265]; Civilian Research Development Foundation (CRDF) Global [OISE-20-66864-1]; Department of National Planning and Monitoring, PNG Government [02704]; Early Start, University of Wollongong, Australia; Faculty of Health Sciences at the University of the Witwatersrand, Johannesburg, South Africa; Fogarty International Center (FIC) of the National Institutes of Health [D43 TW010137]; Geran Universiti Penyelidikan (GUP), Universiti Kebangsaan Malaysia [GUP-2018-142]; Global Challenges Program, University of Wollongong, Australia [888/006/497]; Harry Crossley Foundation, South Africa; National Institute of Education-Ministry of Education, Singapore [OER 04/19 TWP]; Pham Ngoc Thach University of Medicine, Vietnam [1319/QD-TDHYKPNT]; Sasakawa Sports Research Grant, Sasakawa Sports Foundation, Japan [190A2-004]; Stella de Silva Research grant from Sri Lanka College of Paediatricians, Sri Lanka; The DST-NRF Centre for Excellence in Human Development at the University of Witwatersrand, Johannesburg, South Africa; International Society of Behavioral Nutrition and Physical Activity, Pioneers Program (ISBNPA-2021); The University Research Coordination Office of the De La Salle University, Philippines [29 IR S 3TAY192021]; Universidad de La Frontera Research Directorate, Chile [DI20-0093, DFP19-0012, DI20-1002]; WHO European Office for Prevention and Control of Noncommunicable Diseases

Introduction The Russian Federation reported one of the largest number of COVID-19 infections. Major restrictions (social distancing, travel bans, event cancellation, changes to work practices) were introduced on the 28th March 2020 with the level of restrictions varied depending on the epidemiology of the virus from region to region. Purpose is to estimate the impact of COVID-19 on sleep among adults in Russia. Methods The NMRC TPM conducted a national online-survey ‘Study of the impact of restrictions on physical activity of the population in self-isolation due to COVID-19'. Data were collected during the period of tightest restriction through the country between 26 April 2020 and 6 June 2020. A link on the online survey was distributed through the regional center of public health. Sleep quality was assessed by comparing the period before the COVID-19 and the last 7 days. Results In spring 2020, 2432 completed questionnaires from 62 regions of Russia were received. There was a predominance of female respondents (86.6%), the average age was 33.6±14.9 years and 38.2±13.1 years for men and women, respectively. The majority of completed questionnaires were received from the Republic of Tatarstan (n = 804), Irkutsk (n = 474), Sakhalin (n = 225) and Tver regions (n = 152). Compare pre-COVID to during COVID there was a significant decline in the number of days per week participants reported not getting enough sleep (3.21±2.44 to 2.86±2.57; p < 0.001) and participants also reported an increase in the number of days per week they had trouble falling asleep (1.70±2.24 to 2.13±2.48; P < 0.001). The number of days participants waking up earlier than wanted before and during the pandemic has not changed (2,6 Đ, 2,59 (p < 0,5)). Conclusions Effective health promotion strategies directed at adopting or maintain positive health related behaviors such as targeted social media messaging and balanced media reporting, should be used to maintain healthy sleep during these unprecedented times. Key messages Changes in sleep quality during COVID-19 identified as a result of the online-survey ‘Study of the impact of restrictions on physical activity of the population in self-isolation due to COVID-19'. Effective health promotion strategies directed at adopting or maintain positive health related behaviors should be used to maintain healthy sleep during COVID-19 pandemic.