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Objectives: The Assessment of Life Habits (LIFE-H) is a well-known questionnaire used to evaluate participation. The aim of this study was to determine the reliability and validity of the Turkish version of the LIFE-H in children with Cerebral Palsy (CP). Patients and Methods: The study included 450 children with CP between the ages of 2-18 years old. The internal consistency and testretest reliability of the LIFE-H were calculated. The construct validity of the LIFE-H was determined with the Pediatric Evaluation of Disability Inventory (PEDI) domains and Pediatric Outcome Data Collection Instrument (PODCI) subscales. Results: The mean age of the children was 8.37±5.13 years (42.4% female, 57.6% male). The internal consistency of the LIFE-H was determined to be acceptable for all categories (Cronbach alpha:0.794-0.999). The test-retest reliability values were found to be of good to excellent reliability (ICC:0.804-0.999). The correlation between the LIFE-H total scores, PODCI subscales and PEDI domains was determined as acceptable (rho between 0.538-0.894) except for the Pain/Comfort, Happiness subscales of the PODCI (rho:0.240 – 0.479). Conclusions: It was determined that the Turkish LIFE-H had acceptable internal consistency, good test-retest reliability and satisfactory construct validity. Turkish LIFE-H is an appropriate tool to assess the participation of children and adolescents with CP.

Giriş:Adolesanlardaki sağlıklı yaşam becerileri ile okul başarısı, sosyodemografik özellikler ve aile tutumunun ilişkisini değerlendirmek için bu çalışmanın yapılması planlanmıştır. Gereç ve Yöntem:Araştırma bir lisede 8-15.12.2017 tarihlerinde arasında yapılmıştır. Evrenini lisenin 10. Sınıf öğrencileri oluşturmaktadır. (n=374) . 349 öğrenciye ulaşılmış (%93,3) ve kesitsel tipte epidemiyolojik bir araştırma yapılmıştır. Değişkenler; sosyodemografik özellikler, ailenin sağlığı geliştirme davranışları, Adolesanların Sağlığı Geliştirme Ölçeği (Adolescent Health Promotion Scale-AHPS)(40 soru), vücut kitle indeksleri(Z-skorlaması), okul başarısı, anne-babaları hakkındaki vücut algıları, cep telefonu, bilgisayar ve TV başında geçirilen süredir.Bulgular:Araştırmada erkek öğrencilerin bilgisayar/tablet kullanma ve televizyonu izleme süresi kızlardan daha fazladır. Ayrıca kız öğrenciler erkek öğrencilere göre daha başarılı çıkmıştır. Adolesan Sağlığını Geliştirme Ölçeği puanları ile yapılan değerlendirmede toplam puanda, yaşam memnuniyeti, sağlık sorumluluğu, stres yönetimi ve sosyal destek alt başlıklarında iki saatten az kullananların iki saatten fazla kullananlara göre daha fazla puan aldığı görülmektedir. Okul not ortalaması 85 puan altında olanlar 85 puan üstü olanlara göre ölçek toplam puanı, yaşam memnuniyeti ve sağlık sorumluluğu başlıklarında daha düşük puan elde etmiştir. Sağlık sorumluluğu, egzersiz ve stres yönetimi alanlarında anneleri sigara içmeyenlerin içenlere göre daha yüksek puan elde ettikleri görülmüştür. Ayrıca toplam puan, ve tüm alt gruplarında babaları sigara içmeyenler içenlere göre daha yüksek puan almıştır.Tartışma: Adolesan dönemde sağlığı geliştiren davranışların geliştirilmesi için cep telefonu ve bilgisayar/tablet kullanım süreleri azaltılmalı, kız öğrenciler için beslenme ve egzersiz konularında, erkek öğrenciler için ise yaşam memnuniyeti ve sağlık sorumluklarında destekleyici çalışmalar yapılmalıdır. Ayrıca sağlıklı yaşam davranışları geliştirilirse okul başarılarının da artabileceği göz önünde bulundurulmalıdır.

In 2015-2017, the fourth round of the World Health Organization (WHO) European Childhood Obesity Surveillance Initiative (COSI) was conducted in 36 countries. National representative samples of children aged 6–9 (203,323) were measured by trained staff, with similar equipment and using a standardized protocol. This paper assesses the children's body weight status and compares the burden of childhood overweight, obesity, and thinness in Northern, Eastern, and Southern Europe and Central Asia. The results show great geographic variability in height, weight, and body mass index. On average, the children of Northern Europe were the tallest, those of Southern Europe the heaviest, and the children living in Central Asia the lightest and the shortest. Overall, 28.7% of boys and 26.5% of girls were overweight (including obesity) and 2.5% and 1.9%, respectively, were thin according to the WHO definitions. The prevalence of obesity varied from 1.8% of boys and 1.1% of girls in Tajikistan to 21.5% and 19.2%, respectively, in Cyprus, and tended to be higher for boys than for girls. Levels of thinness, stunting, and underweight were relatively low, except in Eastern Europe (for thinness) and in Central Asia. Despite the efforts to halt it, unhealthy weight status is still an important problem in the WHO European Region. The authors gratefully acknowledge support from a grant from the Russian Government in the context of the WHO European Office for the Prevention and Control of NCDs. Data collection in the countries was made possible through funding from the following: Albania: WHO through the Joint Programme on Children, Food Security and Nutrition “Reducing Malnutrition in Children,” funded by the Millennium Development Goals Achievement Fund, and the Institute of Public Health; Austria: Federal Ministry of Social Affairs, Health, Care and Consumer Protection, Republic of Austria; Bulgaria: Ministry of Health, National Center of Public Health and Analyses, WHO Regional Office for Europe; Croatia: Ministry of Health, Croatian Institute of Public Health and WHO Regional Office for Europe; Czechia: Ministry of Health of the Czech Republic, grants AZV MZČR 17-31670 A and MZČR – RVO EÚ 00023761; Cyprus: not available; Denmark: Danish Ministry of Health; Estonia: Ministry of Social Affairs, Ministry of Education and Research (IUT 42-2), WHO Country Office, and National Institute for Health Development; Finland: Finnish Institute for Health and Welfare; France: Santé publique France, the French Agency for Public Health; Georgia: WHO; Greece: International Hellenic University and Hellenic Medical Association for Obesity; Hungary: WHO Country Office for Hungary; Ireland: Health Service Executive; Italy: Ministry of Health and Italian National Institute of Health; Kazakhstan: Ministry of Health of the Republic of Kazakhstan and WHO Country Office; Kyrgyzstan: World Health Organization; Latvia: Ministry of Health, Centre for Disease Prevention and Control; Lithuania: Science Foundation of Lithuanian University of Health Sciences and Lithuanian Science Council and WHO; Malta: Ministry of Health; Montenegro: WHO and Institute of Public Health of Montenegro; North Macedonia: funded by the Government of North Macedonia through National Annual Program of Public Health and implemented by the Institute of Public Health and Centers of Public Health in the country. WHO country office provided support for training and data management; Norway: Ministry of Health and Norwegian Institute of Public Health; Poland: National Health Programme, Ministry of Health; Portugal: Ministry of Health Institutions, the National Institute of Health, Directorate General of Health, Regional Health Directorates and the kind technical support from the Center for Studies and Research on Social Dynamics and Health (CEIDSS); Romania: Ministry of Health; Russian Federation: WHO; San Marino: Health Ministry, Educational Ministry, Social Security Institute and Health Authority; Serbia: World Health Organization (Ref. File 2015-540940); Slovakia: Biennial Collaborative Agreement between WHO Regional Office for Europe and Ministry of Health SR; Slovenia: Ministry of Education, Science and Sport of the Republic of Slovenia within the SLOfit surveillance system; Spain: Spanish Agency for Food Safety and Nutrition (AESAN); Sweden: Public Health Agency of Sweden; Tajikistan: WHO Country Office in Tajikistan and Ministry of Health and Social Protection; Turkmenistan: WHO Country Office in Turkmenistan and Ministry of Health; Turkey: Turkish Ministry of Health and World Bank. info:eu-repo/semantics/publishedVersion

To investigate the effects of fatigue, gross motor function, and gender on participation in life situations of school-aged children with cerebral palsy (CP) from a parental perspective.The study included 209 children with CP aged between 5 and 13 years (mean age, 8.06 ± 2.41 years; girls, 45.5%) and their parents. Fatigue, gross motor function, and participation status were evaluated with the Pediatric Quality of Life (PedsQL), Gross Motor Function Classification System (GMFCS), and the Assessment of Life Habits (Life-H) questionnaire, respectively. The effects of fatigue, gross motor function, and gender on participation were investigated with linear regression analysis.According to parental reports, 79.9% of the children had fatigue. Children in all GMFCS levels experienced fatigue. Fatigue and GMFCS levels were dependent variables, and therefore only simple linear regression analyses were performed. Fatigue explained 38-43% of the variances in daily activities, social roles, and total Life-H scores, while gross motor function explained 48-65% of the variances in scores (p 0.001). Gender had no effect on participation scores (p 0.05).More than two thirds of the school-aged children with CP had fatigue. Fatigue and poor gross motor function had a negative effect on participation in daily activities and social roles.

Introduction:Obesity is a growing public health concern with increasing prevalence in the world. It is aimed to investigate the relationship between socio-demographic features, dietary habits, physical activity level and body mass index (BMI) of the officers and contracted staff between the ages of 18- 64 working in administrative units of a university and some factors affecting these relationships.Methods:The population of this cross-sectional study consists of officers and contracted staff working at a university campus. The data were evaluated by using SPSS 20.0 program. Descriptive statistics, chi-square test and three different binary logistic regressions were conducted in the study.Results:The mean age of the employees was 36.4±8.23 years and 67.4% of the participants were male. Half of the participants had bad dietary habits, 15.8% of the participants were physically “active” and 68.2% were overweight and obese. Being male and the importance given to health (good and above) were found to be protective factors against the bad dietary habits. Low educational level (1.88) and being married (2.32) were the risk factors for bad dietary habits. Males (2.78), married participants (1.94), participants with good and above importance given to health (1.62) and participants working as a contracted staff (2.68) were found to be physically more active. Being male (2.16), having children (2.32) and being physically active (1.78) were found to be risk factors for overweight and obesity.Conclusion:It was found that there were differences in nutrition, physical activity and obesity among university staff with different social structures. Awareness of BMI values, healthy nutrition and physical activity levels should be increased in the intervention programs aimed at changing the lifestyle of individuals working in different statuses in the society.

Obesity, peer bullying and self-esteem are important public health problems in adolescent age group in Turkey as well as in the world. This study aims to investigate bilateral and tripartite relations of obesity, peer bullying and self-esteem. The universe of this cross-sectional study was middle school students in Ankara; 1955 student were reached in 42 schools determined by systematic sample method. Data was collected under observation with the questionnaire including anthropometric measurements (BMI-z-score), self-esteem scale and peer bullying. Written permission was given by the Ethical Committee at the University. We reached 1955 students (975 girls; 877 boys). The average of age was 12.84±0.59. The prevalence of overweight was 15.0% and obesity 7.2%. The percentage of low self-esteem was found as 45.4%. Frequencies of physical bullying-bully subgroup was 36.7%, verbal 51.4% and emotional 35.2%; the percentages of bullying-victim subgroups were found as 41.9%, 49.7% and 19.5%, respectively. A strong relationship was between obesity and physical bullying-victim without grouping for self-esteem (p = 0.03). Obesity was associated with low self-esteem without physical or emotional bullying (p = 0.02; p = 0.03). Low self-esteem was related with all types of bullying (p Prevention of peer bullying, fighting with obesity are important topics to protect adolescent mental health, improve school health. More effective studies should be conducted in this field, intervention programs have holistic approach should be developed at countries levels and global level. Key messages The holistic approach always highlighted from Sustainable Development Goals to Astana has a great importance in improving physical, mental and social health of adolescent in schools. Obesity, peer bullying and self-esteem are important issues affecting physical, social and mental health in adolescence in whole world.

Amaç: Bir üniversitede görev yapan 18-64 yaş arasındaki personelin beslenme okuryazarlığı (BOY), beslenme alışkanlıkları ve ilişkili olan bazı sosyodemografik özelliklerinin belirlenmesi amaçlanmıştır. Gereç ve Yöntem: Kesitsel nitelikteki araştırmanın evrenini bir üniversiteye bağlı farklı yerleşkelerde çalışan personel oluşturmaktadır. Çalışmanın verileri, tanımlayıcı özellikler, yetişkinlerde beslenme okuryazarlığı değerlendirme aracı (YBOYDA) ölçeği ve beslenme alışkanlıkları puanlaması soru formu ile 2015 yılı içerisinde toplanmıştır. Örneklem seçilmemiştir, çalışanların %85,9’una ulaşılmıştır (n=476). Verilerin değerlendirilmesi SPSS 20.0 paket programı kullanılarak yapılmıştır. Verilerin özetlenmesinde tanımlayıcı istatistikler, gruplar arası karşılaştırmalarda ki-kare testi ve ileri analiz için ikili lojistik regresyon kullanılmıştır. Bulgular: Araştırma kapsamındaki çalışanların %67,4’ü erkek olup, yaş ortalaması 36.4±8.23 yıldır. Katılımcıların %32.1’i yeterli beslenme okuryazarlığı düzeyine, %8,4’ü iyi beslenme alışkanlığına sahiptir. Yetersiz beslenme okuryazarlığına BOY’a sahip olma ilkokul ve ilköğretim kurumlarından mezun olanlarda üniversite ve üstü mezuniyeti olanlara göre 5.85 kat (%95 GA: 3.12-10.97), bekârlarda evlilere göre 2.53 kat %95 GA:1.11-5.75) daha yüksektir. Kadınlarda ve evlilerde beslenme alışkanlıkları daha kötüdür [sırasıyla; (OR:1.702, %95 GA: 1.10-2.61) (OR=2.45, %95 GA:1.28-1.33]. Beslenme alışkanlıkları ise kadınlarda ve evlilerde daha kötüdür (sırasıyla: OR=1.70, %95 GA: 1.10-2.61 ve OR=2.45, %95 GA:1.28-1.33). Buna karşın beslenme alışkanlığıyla beslenme okuryazarlığı arasında anlamlı bir ilişki saptanamamıştır. Sonuç: Yetişkinlere yönelik sağlık eğitimi programlarında, beslenme okuryazarlığı düzeylerinin değerlendirilmesi ve yükseltilmesine özel müdahalelere gereksinim bulunmaktadır.

Objective: This study was conducted to investigate lead exposure awareness of families with children aged 0-6, who applied to a district polyclinic. Method: The research was carried out in Hüseyin Savaş district clinic between the 11th-21st of October, 2016. Amongst all the parents who applied to the polyclinic over the given time period, a questionnaire was administered to 101 parents who volunteered to participate. The questionnaire was created by using the literature and was administered through the face-to-face survey application technique. Results: It was determined that 86.1% of the participants did not have sufficient knowledge of lead poisoning. The mean score on the lead poisoning prevention awareness scale was lower for mothers with a high school education, when compared to those with university degrees. Furthermore, the mean score for prevention awareness was higher for respondents living in the centre of the province, compared to those from peripheral villages and towns. In addition, participants with higher economic status perceptions were found to be more knowledgeable than those with moderate perceptions. Conclusion: More education for parents, caregivers and children about lead exposure will raise awareness about the issue.

Objective: Chronic Health Conditions (CHC) and problems among adolescents have recently become more frequent. CHC may have an influence on their perception of quality of life and self-efficacy. This research aimed to compare quality of life and self-efficacy among adolescents with CHC and without CHC. Methods: The research was conducted with 778 adolescents from a high school. Students were asked as follows: “Have you had any health condition which requires a doctor supervision and/or which requires continuous medication (pills, injection, oral or nasal usage) at least for 6 months or more?” All students completed the Self - Efficacy Questionnaire for Children (SEQ-C) and Pediatric Quality of Life Inventory (PedsQL). Results: All diseases declared by the students are accepted as chronic health conditions. The frequency of having chronical health condition is 19.5% among the high school students. PedsQL for adolescents with CHC were significantly lower compared to those without CHC (p0.05). Conclusion: It has been observed that the PedQL of students with chronic health problems was negatively affected as a result of our work. Lower QoL associated with school functioning of adolescents with chronic health problems suggests the importance of school-related factors (friends, teachers and physical structure) in the intervention of improving quality of life.

Background/aim: Body esteem BE is defined as the self-evaluation of one's own body or appearance. The Body Esteem Scale for Adolescents and Adults BESAA consists of three subscales: BE-appearance, BE-weight, and BE-attribution. Though initially developed for adolescents and adults, the use of the scale has recently increased in health-related research on children. This study aimed to assess the validity and reliability of the Turkish version of the BESAA for children. Materials and methods: The participants in the study were 4th grade children aged 9-10 years in Ankara, Turkey. The validity of the scale was evaluated through exploratory and confirmatory factor analyses. Internal consistency and test-retest reliability were assessed using Cronbach's alpha and Spearman's rho correlation coefficient, respectively. Results: The Turkish version of the BESAA for children includes BE-weight, BE-appearance, and BE-attribution subscales. The scale demonstrated good model fit statistics chi-square/df = 3.41, P < 0.001 and good internal consistency for BE-weight α = 0.85 , BEappearance α = 0.76 , and BE-attribution α = 0.69 . According to our findings, test-retest reliability of the three subscales was in the moderate/acceptable range for children r = 0.57-0.68, P < 0.01 . Conclusion: The Turkish version of the BESAA can be used to measure BE in terms of appearance, weight, and attribution in children

Background/aim: To determine risk factors of overweightness/obesity in children aged 0-5 years in the Turkish population.Materials and methods: We made advanced analysis using the Turkey Demographic Health Survey (TDHS) 2013 female database, in which data from children aged under five years and their mothers are included. Analyses were performed using weight for height index data. The children were divided into two groups by age as 0-23 months and 24-59 months.Results: The analysis comprised 2196 children aged under 5 years. Several factors were associated with an increase in overweightness/obesity of children aged under 5 years. Overweight/obesity in children aged 0-23 months was associated with several factors such as age (12-23 months) (OR: 2.89 CI: 1.62-5.13), high birth weight (OR: 2.36 CI: 1.26-4.44), maternal obesity (OR: 2.09 CI: 1.33-3.27), and maternal smoking (OR: 2.07, CI: 1.28-3.33). Overweightness/obesity in children aged 24-59 months was associated with several factors such as education level of the mother (OR: 2.27, CI: 1.08-4.75), consanguineous marriage (OR: 2.86, CI: 1.83-4.47), and which region of Turkey the family lives in (OR: 2.79, CI: 1.53-5.08).Conclusion: Our results from the TDHS 2013 showed several risk factors of children overweight/obesity. Determining obesity risk factors, monitoring obese children/adults, and providing a multidisciplinary approach to the treatment and prevention of obesity will be useful for the future.

Amac: Turkiye’de 1996 yilinda kamuda, otobuslerde ve bazi ic mekânlarda sigara icim yasagi baslamis, 2008 yilinda yasak kapsami genisletilmistir. Kanunun uygulanmasi sirasinda evde sigara icme yuzdesi azalmistir, ancak evlerde pasif sigara icilmesi hala ulkedeki cocuklar icin bir halk sagligi sorunudur. Bu calismada, cocuklarin evlerde sigara dumanindan pasif etkilenimlerini belirlemek amaclanmistir. Gerec ve Yontemler: Bu tanimlayici calisma, 11-21.01.2016 tarihleri arasinda Antalya Ataturk Devlet Hastanesi Huseyin Savas Semt Poliklinigine basvuru yapan 0-11 yas arasi cocugu olan (n=524) 113 anne-baba uzerinde yapilmistir. Arastirma verilerinin toplanmasinda arastirmacilar tarafindan olusturulan bir form kullanilmistir. Bulgular: Misafirin evde sigara icmek icin katilimcilarin % 17.7’sinin izin istemedigi, %23’unun bazen izin istedigi saptanmistir. Katilimcilarin % 66.4’unun i zinsiz sigara icen misafiri uyardigi ve %69.9’unun cocuklarinin herhangi bir sekilde (bazen, genellikle ve her zaman) sigara dumanina maruz kaldigi bulunmustur. Katilimcilar, sigara icilmesi ile ilgili aile kurallarinin oldugunu (% 66.4) ve evde yasayan aile bireylerinin evin hemen her mekâninda sigara ictigini bildirmislerdir. Onlarin bildirimine gore, evde sigara icen annelerin orani % 80.0, babalarin orani % 76.5'tir (p

Objective: Chronic Health Conditions (CHC) and problems among adolescents have recently become more frequent. CHC may have an influence on their perception of quality of life and self-efficacy. This research aimed to compare quality of life and self-efficacy among adolescents with CHC and without CHC. Methods: The research was conducted with 778 adolescents from a high school. Students were asked as follows: “Have you had any health condition which requires a doctor supervision and/or which requires continuous medication (pills, injection, oral or nasal usage) at least for 6 months or more?” All students completed the Self - Efficacy Questionnaire for Children (SEQ-C) and Pediatric Quality of Life Inventory (PedsQL). Results: All diseases declared by the students are accepted as chronic health conditions. The frequency of having chronical health condition is 19.5% among the high school students. PedsQL for adolescents with CHC were significantly lower compared to those without CHC (p0.05). Conclusion: It has been observed that the PedQL of students with chronic health problems was negatively affected as a result of our work. Lower QoL associated with school functioning of adolescents with chronic health problems suggests the importance of school-related factors (friends, teachers and physical structure) in the intervention of improving quality of life. Amaç: Son yıllarda ergenlerde kronik sağlık sorunu sıklığının arttığı tespit edilmiştir. Ergenlerin bu dur um ile başa çıkmaya çalışırken yaşam memnuniyetinin de etkileneceği düşünülmüştür. Çalışmamızda kronik sağlık sorunu olan ve olmayan ergenlerin yaşam kalitesi ve öz-yeterlilik durumlarının karşılaştırılması amaçlanmıştır. Yöntemler: Araştırma 778 kişinin katıldığı lise öğrencileri ile yapılmıştır. Öğrencilere demografik sorularla birlikte “Son 6 ay, ya da daha uzun süre doktor takibinde olmanızı gerektiren ve/veya devamlı ilaç (hap, iğne, ağızdan veya burundan hava uygulaması gibi) kullanmanızı gerektiren bir sağlık sorununuz var mı? ( varsa lütfen hastalığın adını yazınız)” sorusu yöneltilmiştir. Bu soruya birden fazla cevap verebilecekleri belirtilmiştir. Sorunun devamında “Pediyatrik Yaşam Kalitesi Ölçeği” ve “Çocuklar İçin Öz-Yeterlilik Ölçeği”ni doldurmaları istenmiştir. Bulgular: Öğrenciler tarafından belirtilen tüm hastalıklar kronik sağlık sorunu olarak kabul edilmiştir. Çalışmada verilen cevaplar doğrultusunda öğrencilerin %19,5’inde kronik sağlık sorunu tespit edilmiştir ve yaş ortalaması 16,44±1,10 bulunmuştur. Kronik sağlık sorunu bulunmayan ergenlerin yaş ortalaması ise 16,22±1,10’dir. Kronik sağlık sorunu bulunanlarda toplam yaşam kalitesi (p0.05). Sonuç: Çalışmamızın sonucunda kronik sağlık sorunu olan ergenlerin yaşam kalitesinin olumsuz etkilendiği görülmüştür. Kronik sağlık sorunu bulunan ergenlerin, okul işlevselliği ile ilgili yaşam kalitesinin düşük olması ise yaşam kalitesinin iyileştirilmesi müdahalesinde okul ile ilişkili faktörlerin (arkadaş, öğretmen ve fiziki yapı) önemini ortaya koymuştur.

Background The “Call to a Healthy Lifestyle” study was initiated in 2013 as part of a bilateral agreement signed between the Institute of Public Health of Hacettepe University and the Ministry of Labor of the Republic of Turkey. It aims at promoting a healthy lifestyle among the staff of the Ministry and creating a “model” for other institutions to emulate. Methods This is a cross-sectional study that was designed …

To evaluate the health-related quality of life of women living in Van city center by SF-36 and its association with the women's characteristics. Materials and methods: The women (n = 1527) answered a questionnaire through a face-to-face interview, and some measurements were made. The variations of physical component score (PCS) and mental component score (MCS) of SF-36 were investigated by non-parametric tests, and by linear regression analysis. Results: The percentage of early marriages among married women was 55.6. Number of pregnancies per married woman was 4.5 ± 2.8, the lowest mean in vitality (44.0 ± 20.6) and the highest mean in physical functioning (73.2 ± 28.2) components of SF-36. The women's means on PCS was 43.7 ± 11.4, and on MCS was 37.2 ± 8.9. In regression analysis, the age of marriage, the number of live births, and presence of still birth-spontaneous miscarriage, and BMI were associated with PCS; the age of marriage, smoking cigarette, physical exercise and BMI were associated with MCS. Conclusion: Policies to improve the status of women and interventions for reproductive health and for promotion of healthy behavior are needed to enhance the HRQOL of women living in the city of Van.