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Prenatalna / postnatalna intervencija koja uključuje proaktivnu telefonsku podršku i pisane materijale provedena je na uzorku od 400 žena iz Splitsko-dalmatinske županije u Hrvatskoj a kojima je ovo prva trudnoća. Žene su randomizirane u tri grupe intervencija (IS), aktivna kontrolna (AKS) i standardna kontrolna skupiina (SKS) od studenog 2013. do prosinca 2016. Primarni ishod bio je isključivo dojenje (EBF) s 3 mjeseca. Sekundarni ishodi bili su poteškoće s dojenjem, stavovi prema hranjenju dojenčadi, samoučivkovitost dojenja i stope dojenja s 3 i 6 mjeseci. Od 400 žena, 45 (11%) se izgubilo tijekom praćenja, a konačne analize provedene su na 129 (IS), 103 (AKS) i 123 (SKS) sudionice. Stope EBF s 3 mjeseca bile su značajno veće za IS (OR 4,6, 95% CI 2,7 do 8,1; EBF 81%) kao i sa 6 mjeseci (OR 15,7, 95% CI 9,1 do 27,1; EBF 64%) u usporedbi s SKS (EBF 47% sa 3 mjeseca, a 3% u 6 mjeseci). Viši postoci zabilježeni su i za AKS nakon 3 mjeseca (OR 2,2, 95% CI 1,3 do 3,8, EBF 68%) i 6 mjeseci (OR 2,3, 95% CI 1,4 do 3,9, EBF 16%). Ispitanice IS-a zabilježile su najveći porast pozitivnog stava prema dojenčadi, u usporedbi s početnom vrijednosti, i značajno veću samoučinkovitost dojenja. Ispitanice SKS imale su znatno veće poteškoće s dojenjem, u dobi od 3 i 6 mjeseci, u usporedbi s AKS i IS. Tiskani materijali za dojenje i proaktivna telefonska podrška žena na kojima je ovo prva trudnoća pokazali su učinkovitim sredstvom za povećanje stope dojenja, smanjenje poteškoća s dojenjem i poboljšanje samoučinkovitosti i stava prema prehrani dojenčadi., An antenatal/postnatal intervention involving proactive telephone support and written materials was conducted among primiparas. 400 women, from the Split-Dalmatia County, Croatia, were randomised between November 2013 and December 2016 into three groups: intervention (IG), active control (ACG) and standard care (SCG). Primary outcome was exclusive breastfeeding (EBF) at 3 months. Secondary outcomes included breastfeeding difficulties, attitudes towards infant feeding, breastfeeding self-efficacy and social support. Practice staff were blinded to group allocation. Of 400 women, 45 (11%) were lost to follow-up, and final analyses were conducted on 129 (IG), 103 (ACG) and 123 (SCG) participants. EBF rates at 3 months were significantly higher for the IG (OR 4.6, 95% CI 2.7 to 8.1; EBF 81%) as well as at 6 months (OR 15.7, 95% CI 9.1 to 27.1; EBF 64%) compared to SCG (EBF 47% at 3 months, and 3% at 6 months). Higher rates were also observed for the ACG at 3 months (OR 2.2, 95%CI 1.3 to 3.8, EBF 68%) and 6 months (OR 2.3, 95%CI 1.4 to 3.9, EBF 16%). Participants in the IG had the highest increase in positive attitudes towards infant feeding, in comparison to baseline, and significantly higher breastfeeding self-efficacy. Participants in SCG experienced significantly more breastfeeding difficulties, both at 3 and 6 months, in comparison to AC and IGs. Written breastfeeding materials and proactive telephone support among primiparas are an effective means of increasing breastfeeding rates, decreasing breastfeeding difficulties and improving self-efficacy and attitudes towards infant feeding.

Prenatalna / postnatalna intervencija koja uključuje proaktivnu telefonsku podršku i pisane materijale provedena je na uzorku od 400 žena iz Splitsko-dalmatinske županije u Hrvatskoj a kojima je ovo prva trudnoća. Žene su randomizirane u tri grupe intervencija (IS), aktivna kontrolna (AKS) i standardna kontrolna skupiina (SKS) od studenog 2013. do prosinca 2016. Primarni ishod bio je isključivo dojenje (EBF) s 3 mjeseca. Sekundarni ishodi bili su poteškoće s dojenjem, stavovi prema hranjenju dojenčadi, samoučivkovitost dojenja i stope dojenja s 3 i 6 mjeseci. Od 400 žena, 45 (11%) se izgubilo tijekom praćenja, a konačne analize provedene su na 129 (IS), 103 (AKS) i 123 (SKS) sudionice. Stope EBF s 3 mjeseca bile su značajno veće za IS (OR 4,6, 95% CI 2,7 do 8,1; EBF 81%) kao i sa 6 mjeseci (OR 15,7, 95% CI 9,1 do 27,1; EBF 64%) u usporedbi s SKS (EBF 47% sa 3 mjeseca, a 3% u 6 mjeseci). Viši postoci zabilježeni su i za AKS nakon 3 mjeseca (OR 2,2, 95% CI 1,3 do 3,8, EBF 68%) i 6 mjeseci (OR 2,3, 95% CI 1,4 do 3,9, EBF 16%). Ispitanice IS-a zabilježile su najveći porast pozitivnog stava prema dojenčadi, u usporedbi s početnom vrijednosti, i značajno veću samoučinkovitost dojenja. Ispitanice SKS imale su znatno veće poteškoće s dojenjem, u dobi od 3 i 6 mjeseci, u usporedbi s AKS i IS. Tiskani materijali za dojenje i proaktivna telefonska podrška žena na kojima je ovo prva trudnoća pokazali su učinkovitim sredstvom za povećanje stope dojenja, smanjenje poteškoća s dojenjem i poboljšanje samoučinkovitosti i stava prema prehrani dojenčadi. An antenatal/postnatal intervention involving proactive telephone support and written materials was conducted among primiparas. 400 women, from the Split-Dalmatia County, Croatia, were randomised between November 2013 and December 2016 into three groups: intervention (IG), active control (ACG) and standard care (SCG). Primary outcome was exclusive breastfeeding (EBF) at 3 months. Secondary outcomes included breastfeeding difficulties, attitudes towards infant feeding, breastfeeding self-efficacy and social support. Practice staff were blinded to group allocation. Of 400 women, 45 (11%) were lost to follow-up, and final analyses were conducted on 129 (IG), 103 (ACG) and 123 (SCG) participants. EBF rates at 3 months were significantly higher for the IG (OR 4.6, 95% CI 2.7 to 8.1; EBF 81%) as well as at 6 months (OR 15.7, 95% CI 9.1 to 27.1; EBF 64%) compared to SCG (EBF 47% at 3 months, and 3% at 6 months). Higher rates were also observed for the ACG at 3 months (OR 2.2, 95%CI 1.3 to 3.8, EBF 68%) and 6 months (OR 2.3, 95%CI 1.4 to 3.9, EBF 16%). Participants in the IG had the highest increase in positive attitudes towards infant feeding, in comparison to baseline, and significantly higher breastfeeding self-efficacy. Participants in SCG experienced significantly more breastfeeding difficulties, both at 3 and 6 months, in comparison to AC and IGs. Written breastfeeding materials and proactive telephone support among primiparas are an effective means of increasing breastfeeding rates, decreasing breastfeeding difficulties and improving self-efficacy and attitudes towards infant feeding.

AIM: This study aimed to determine the attitudes of adolescents towards sexual health and to assess their understanding of contraception use and knowledge about sexually transmitted infections in three ethnically different areas of Croatia and Bosnia and Herzegovina. METHODS: A total of 146 adolescent high school students between 17 and 19 years of age from three different cities were enrolled in this cross- sectional study. The participants completed two anonymous questionnaires: one that measured attitudes towards safe sex practice and another that measured contraception and general sexual health knowledge. RESULTS: Shame was identified as the main factor why adolescents did not seek information about sexual health and contraception. On average, respondents correctly answered only 35% of questions regarding sexual health. Adolescents from East Mostar, with a predominantly Bosniak population, had more positive attitudes towards safe sex and showed less contraception knowledge in comparison to their colleagues from two cities in Croatia. LIMITATIONS: Our study design might be burdened by socially desirable reporting and other biases inherent to the survey design. CONCLUSION: Adolescents from Croatia and Bosnia and Herzegovina, countries that experienced war and are still undergoing post-communist socio- economic transition, generally did not have adequate knowledge with respect to safe sex lifestyles. Respondents had major problems identifying sexually transmitted infections and their knowledge about contraception was insufficient. IMPLICATIONS FOR NURSING AND HEALTH POLICY: Providing care for adolescent populations should address specificities in local ethnical and socio-economical circumstances. There is a need for further studies to determine social, cultural and religious factors influencing the knowledge and attitudes towards sexual health in order to provide most effective interventions for specific adolescent populations.

Zdravstveno prosvjećivanje adolescenata o spolno prenosivim bolestima