Browsing by Author "Djikanovic, Bosiljka (33567801400)"

Background: Health literacy is an important determinant of health. This concept is under-researched in the Republic of Srpska, Bosnia and Herzegovina. Objectives: To assess health literacy and its association with sociodemographic variables, self-perception of health and the presence of chronic conditions in primary healthcare setting. Methods: In May 2016, a cross-sectional study was executed in two primary healthcare centres. Out of approximately 1500 patients who visited both health centres during four consecutive days, about 800 were eligible. Of these, 110 patients agreed to complete the translated Short Test of Functional Health Literacy in Adults (S-TOFHLA). The influence of demographic, social, economic, and health characteristics (independent variables) on the S-TOFHLA score (dependent variable) was assessed by multiple logistic regression analysis. Results: One questionnaire was incomplete and therefore 109 questionnaires were analysed. Inadequate, marginal, and adequate health literacy were present in 19 (17.4%), 16 (14.7%) and 74 (67.9%) respondents. Adequate health literacy was found predominantly among respondents younger than 55 years and those with a high level of education. Regression analyses showed that low level of education (OR: 5.3), age 55 years and over (OR: 3.9), living in a rural area (OR: 3.7) and having three or more chronic diseases (OR: 2) were independently associated with inadequate or marginal health literacy. Conclusion: In this study performed in two primary healthcare centres in the Republic of Srpska, Bosnia and Herzegovina, low health literacy was associated with low level of education, older age, living in a rural area, and having more chronic diseases. © 2019, © 2019 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group.

There is an error in the Acknowledgment statement. The correct number for project number is 175042. The authors apologize for this error and state that this does not change the scientific conclusions of the article in any way. The original article has been updated. © 2021 Stamenkovic,Matejic, Djikanovic and Bjegovic-Mikanovic.

Background: The prevalence of unhealthy lifestyles and preventable chronic diseases is high. They lead to disabilities and sickness absence, which might be reduced if health promotion measures were applied. Therefore, we developed the PerfectFit health promotion intervention with a "blended care"-approach, which consists of a web-based health risk assessment (HRA) including tailored and personalized advice, followed by motivational interviewing (MI). We hypothesize that adding MI to a web-based HRA leads to better health outcomes. The objective is to describe the design and baseline characteristics of the PerfectFit study, which is being conducted among employees with high cardiovascular risk in the military workforce, the police organization and an academic hospital. Methods: PerfectFit is a cluster randomized controlled trial, consisting of two arms. Based on cardiovascular risk profiling, done between 2012 and 2014, we included employees based on one or more risk factors and motivation to participate. One arm is the 'limited' health program (control) that consists of: (a) an HRA as a decision aid for lifestyle changes, including tailored and personalized advice, and pros and cons of the options, and (b) a newsletter every 3 months. The other arm is the 'extensive' program (intervention), which is additionally offered MI-sessions by trained occupational physicians, 4 face-to-face and 3 by telephone, and is offered more choices of health promotion activities in the HRA. During the follow-up period, participants choose the health promotion activities they personally prefer. After six and twelve months, outcomes will be assessed by online questionnaires. After twelve months the cardiovascular risk profiling will be repeated. The primary outcome is self-reported general health. Secondary outcomes are self-reported work ability, CVD-risk score, sickness absence, productivity loss at work, participation in health promotion activities, changes in lifestyle (smoking, alcohol consumption, physical activity, stress management) and body mass index. Furthermore, a process evaluation and an economic analysis will be performed. Discussion: Additional coaching using MI is expected to be a key factor for success of the web-based HRA in employees with increased cardiovascular risk. This "blended care"-approach may be an essential strategy for effective health promotion activities. Trial registration: Dutch Trial Register by registration number NTR4894, 14/11/2014. © 2015 Kouwenhoven-Pasmooij et al.

Background Unwanted pregnancies are still common in Central and Eastern European countries, including Serbia. Little is known about the use of contraception in different ethnic groups. This research was undertaken to investigate the use of contraception between Roma and non-Roma women in Serbia and factors associated with it. Methods Data from the 2010 Multiple Indicator Cluster Survey (MICS4) conducted in Serbia were used. This research included 1082 Roma and 2145 non-Roma women aged 15-49. Univariate and multivariate logistic regression analyses were used to analyze socio-demographic factors associated with the use of contraception in both population groups. Results Roma women use any type of contraception more often than non-Roma women. However, Roma women rely more on traditional and unsafe methods such as withdrawal and lactational amenorrhea method, but significantly less on modern methods such as pill, condom and intrauterine device. Place of living (region) is also associated with contraceptive usage. Conclusions Inequalities in the use of contraception between Roma and non-Roma women exist. Promoting modern methods of contraception and education about the importance of the use of contraception should be in the focus of national health policies and strategies related to reproductive health to reduce these inequalities. ©The Author 2014.

Background: This study aimed to identify factors associated with intimate partner violence against women living in Belgrade, Serbia. Method A cross-sectional, population based household survey was conducted in Belgrade as part of the WHO Multi-country Study on Women's Health and Domestic Violence, using a standard questionnaire. Face-to-face interviews were conducted with 1456 women aged 15-49 years. Data used in this study were from a subset of 886 women who ever cohabited with their male intimate partners. The association between various factors at individual and relationship levels and reported physical or sexual partner violence, or both, was assessed by univariate and multivariate logistic regression analysis. Results Multivariate logistic regression modelling revealed that partner violence was significantly associated with a number of factors relating to the male partner: dally alcohol consumption (AOR 4.25, 95% Cl 1.78 to 10.11), having affairs (AOR 3.97, 95% Cl 1.62 to 9.57), fighting with other men (AOR 3.62, 95% Cl 1.91 to 6.88), his mother having experienced spousal abuse (AOR 2.71, 95% Cl 1.40 to 5.23) and he himself being beaten as a child (AOR 3.14, 95% Cl 1.48 to 6.63). Among the factors related to the women, only forced or unwanted first sexual intercourse was independently associated with exposure to partner violence (AOR 2.50, 95% Cl 1.05 to 5.96). Conclusion The majority of factors associated with intimate partner violence related to the male partner; in particular his childhood experiences of violence in his own family. Long-term violence prevention programmes should target boys growing up in families with domestic violence.

Objectives The aims of this study were to estimate the level of knowledge, attitudes, and intentions about human papillomavirus (HPV) infection and HPV vaccine among gynecologists and to explore predictors of gynecologists' intention to recommend the HPV vaccine. Method This research was conducted between April and June 2014 among all gynecologists working at women's health departments in all primary health centers in Belgrade, the capital of Serbia, using a specially designed questionnaire. Results The response rate was 88.2%. The knowledge of gynecologists was estimated as average. The most frequently reported obstacles to HPV vaccination was the financial concern (59.8%). More than two thirds of the gynecologists were willing to recommend the vaccine (68.4%). The factors associated with the gynecologists' intention to recommend the vaccine included their positive attitudes toward boys' vaccination (odds ratio [OR], 8.96; 95% confidence interval [CI], 2.85-28.16), negative attitudes toward frequent changes the recommendations (OR, 0.31; 95% CI, 0.10-0.93), and beliefs that the vaccine application would decrease condom usage (OR, 0.31; 95% CI, 0.06-0.68). Conclusions The findings provide an important insight into the current point of view of the gynecologists, which confirms that the better the knowledge of HPV and vaccine, the higher the likelihood of recommending it. © Lippincott Williams & Wilkins.

Health literacy (HL) has become an important area of research. The aim of this study was to evaluate the HL of primary healthcare patients in the Republic of Srpska (RS), Bosnia and Herzegovina (B&H) and to identify socioeconomic and health factors associated with HL. This cross-sectional study among 768 patients was conducted in two healthcare centres between March and May 2017, using the Short Test of Functional Health Literacy in Adults (S-TOFHLA). Analysis was done using descriptive and inferential statistics (a chi-squared test and logistic regression). Inadequate and marginal HL was found in 34,6% of respondents. Socioeconomic and self-reported health factors were significantly related to HL. An age of 55 years and over (OR 1.02), living in a rural environment (OR 2.25), being divorced (OR 3.32), being insufficiently physically active (OR 1.29), having poor income (OR 1.96), having more than three chronic diseases (OR 1.94), and poor health (OR 1.59) were significantly corelated with inadequate and marginal HL. The results of our study indicate that a low level of HL is related to the elderly, having a divorce, having a rural residence, poor income, having more than three chronic diseases, poor health, and insufficient physical activity. Further evaluation, monitoring, and activities to improve HL are of great importance for patients’ health outcomes. © 2019 by the authors. Licensee MDPI, Basel, Switzerland.

Health literacy (HL) has become an important area of research. The aim of this study was to evaluate the HL of primary healthcare patients in the Republic of Srpska (RS), Bosnia and Herzegovina (B&H) and to identify socioeconomic and health factors associated with HL. This cross-sectional study among 768 patients was conducted in two healthcare centres between March and May 2017, using the Short Test of Functional Health Literacy in Adults (S-TOFHLA). Analysis was done using descriptive and inferential statistics (a chi-squared test and logistic regression). Inadequate and marginal HL was found in 34,6% of respondents. Socioeconomic and self-reported health factors were significantly related to HL. An age of 55 years and over (OR 1.02), living in a rural environment (OR 2.25), being divorced (OR 3.32), being insufficiently physically active (OR 1.29), having poor income (OR 1.96), having more than three chronic diseases (OR 1.94), and poor health (OR 1.59) were significantly corelated with inadequate and marginal HL. The results of our study indicate that a low level of HL is related to the elderly, having a divorce, having a rural residence, poor income, having more than three chronic diseases, poor health, and insufficient physical activity. Further evaluation, monitoring, and activities to improve HL are of great importance for patients’ health outcomes. © 2019 by the authors. Licensee MDPI, Basel, Switzerland.

Objective: The aim of this study was to determine the perceptions and attitudes of health professionals toward violence against women in intimate relationships, and to discuss them as opportunities and barriers for improving health professionals' response. Methods: Six focus groups were conducted with 71 health professionals employed in the public primary health care centers in Belgrade (Serbia). The data were analyzed according to the direct approach of the qualitative content analysis. Results: Findings suggest that the majority of health professionals perceive IPV as an unjustifiable act. They showed an understanding for women; see their role as providing support to women and collaborating with other institutions. They are willing to help, but do not know how. However, some health professionals appeared to be judgmental in terms of what preceded violence, and would insist on extracting a woman's disclosure that violence had occurred. As barriers, they emphasized the lack of training and specific education on IPV, a weak support network, and overall social insecurity. Conclusion: There is a gap between health professionals' willingness to help and resources needed, along with prejudice and interrogative attitudes. Barriers appeared at individual, organizational and societal levels. Practice implications: Proper education and protocols are priorities in strengthening health professionals' response to IPV. © 2009 Elsevier Ireland Ltd.

Objectives: The prevalence of smoking is very high in Serbia. A wide range of tobacco control measures and activities have been undertaken to encourage smoking cessation, but it is not known whether smokers in Serbia are willing to quit, and if inequalities exist between them. This study analysed intentions to quit smoking, using the Stages of Change Model, among a population of current and/or former adult smokers in Serbia, and compared socio-economic and demographic characteristics. Study design: Cross-sectional study on a nationally representative population sample, using data from the 2006 National Health Survey. The sample consisted of 5905 current or former daily smokers. Methods: Logistical regression analysis was used to identify associations between socio-economic and demographic characteristics of former/current smokers, and their stage of change in terms of smoking (precontemplation, contemplation, preparation, action, maintenance and termination). Results: More than one-fifth (22%) of current smokers did not intend to quit smoking (precontemplation stage). Women were twice as likely to contemplate quitting compared with men [odds ratio (OR) 2.08, 95% confidence interval (CI) 1.68-2.58]. However, women were less successful in quitting smoking (termination stage) than men (OR 0.64, 95% CI 0.52-0.79). In addition to gender, educational inequalities in intentions to quit smoking were identified; less-educated individuals were less willing to quit smoking (preparation and action stages) regardless of their socio-economic status or chronic disease status. Conclusion: Tobacco control interventions should be sensitive to gender and educational inequalities in quitting smoking. © 2012 The Royal Society for Public Health.

Introduction: The outbreak of the disease caused by the novel coronavirus, SARS-CoV-2 named COVID-19 has spread throughout the world. The number of registered cases is increasing and almost no country or territory worldwide has been without any COVID-19 patient. The aim of this study was to examine the level of knowledge on the SARS-COv-2 and COVID-19 among medical students and to explore the differences in attitudes, practices and fear of COVID-19 among students with sufficient and students with insufficient knowledge. Methodology: The cross-sectional study among the 1,722 medical students was conducted through an online platform of the Faculty of Medicine, University of Belgrade. The instrument used was a questionnaire with sections on socio-demographic characteristics, knowledge, attitudes and practices towards COVID-19 and the Fear of COVID-19 scale. Results: Total of 1576 (91.50%) students were in the sufficient knowledge group. The multivariate logistic regression analysis showed that there was a significant association between the sufficient knowledge on COVID-19 and female sex (OR = 1.70, 95% CI = 1.18-2.45), age (OR = 1.10, 95% CI = 1.02-1.18), considering the preventive measures enforced in Serbia as good (OR = 2.57, 95% CI = 1.18-5.56), wearing the surgical mask outside of the household in the past 14 days (OR = 1.87, 95% CI = 1.22-2.87) and score on Fear of COVID-19 scale (OR = 0.94, 95% CI = 0.91-0.98). Conclusions: Medical students showed good knowledge of COVID-19 and could be a part of the promotion of health education messages as a part of preventive measures. Copyright © 2021 Terzic-Supic et al. This is an open-access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Introduction: The outbreak of the disease caused by the novel coronavirus, SARS-CoV-2 named COVID-19 has spread throughout the world. The number of registered cases is increasing and almost no country or territory worldwide has been without any COVID-19 patient. The aim of this study was to examine the level of knowledge on the SARS-COv-2 and COVID-19 among medical students and to explore the differences in attitudes, practices and fear of COVID-19 among students with sufficient and students with insufficient knowledge. Methodology: The cross-sectional study among the 1,722 medical students was conducted through an online platform of the Faculty of Medicine, University of Belgrade. The instrument used was a questionnaire with sections on socio-demographic characteristics, knowledge, attitudes and practices towards COVID-19 and the Fear of COVID-19 scale. Results: Total of 1576 (91.50%) students were in the sufficient knowledge group. The multivariate logistic regression analysis showed that there was a significant association between the sufficient knowledge on COVID-19 and female sex (OR = 1.70, 95% CI = 1.18-2.45), age (OR = 1.10, 95% CI = 1.02-1.18), considering the preventive measures enforced in Serbia as good (OR = 2.57, 95% CI = 1.18-5.56), wearing the surgical mask outside of the household in the past 14 days (OR = 1.87, 95% CI = 1.22-2.87) and score on Fear of COVID-19 scale (OR = 0.94, 95% CI = 0.91-0.98). Conclusions: Medical students showed good knowledge of COVID-19 and could be a part of the promotion of health education messages as a part of preventive measures. Copyright © 2021 Terzic-Supic et al. This is an open-access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Objectives: This study aimed to identify to what extent negative attitudes towards intimate partner violence against women are present among young women and men living in Serbia, in Roma and non-Roma settlements. Methods: We used the data from the 2010 Multiple Indicator Cluster Survey conducted in Serbia, for the respondents who were 15–24 years old. Regression analyses were used to examine the association between judgmental attitudes, socio-demographic factors and life satisfaction. Results: In Roma settlements, 34.8% of men and 23.6% of women believed that under certain circumstances men are justified to be violent towards wives, while among non-Roma it was 5.6 and 4.0%, respectively. These negative attitudes were significantly associated with lower educational level, lower socio-economic status and being married. In multivariate model, in both Roma and non-Roma population women who were not married were less judgmental, while the richest Roma men were least judgmental (OR 0.40, 95% CI 0.18–0.87). Conclusions: Violence prevention activities have to be focused on promoting gender equality among youth in vulnerable population groups such as Roma, especially through social support, strengthening their education and employment. © 2017, Swiss School of Public Health (SSPH+).

Introduction: The aim of this paper is to present an experience from the School of Medicine (University of Belgrade, Serbia) in restructuring of study programs to be compliant with Bologna standards and European best practices in public and community health. We devised the new module with the idea to implement both the concept of patient-centered medicine and community-based learning activity, in the pre-clinical phase of medical education. It emphasis importance of social determinants of health, community activities on health promotion, early contacts with patients, developing communication skills and introduction of primary health care settings Method: All participants of overall four generations of this curriculum (students, patients and physicians) were asked to evaluate their participation in the module, using three types of self-administered questionnaires. Results: Overall 1529 students (response rate 74.1%), 1011 patients (response rate 57.2%) and 118 physicians (response rate 69.5%) had participated in this evaluation. One-way analysis of variance (ANOVA) demonstrated significantly higher satisfaction of patient with the participation in the new module (4.48), than the students (3.90) and physicians (4.08) (F=69.882, p = 0.000). Conclusion: The satisfaction of patients enrolled in this module encourages us to continue. Broadening of medical training to primary health care and other "non-medical" community settings enabled students to get insight into the different social determinants of health. However, the instructors need to improve the student's understanding and devotion for this conception.

Background: Exclusive breastfeeding is essential for early childhood development, although the use of adaptive milk formulas instead of breastfeeding is widespread nowadays. This study aimed to examine the prevalence of exclusively breastfed infants under the age of 6 months in non-Roma and Roma population and factors associated with this practice. Materials and Methods: This study is a secondary analysis of the Serbian Multiple Indicator Cluster Survey investigating non-Roma and Roma infants under the age of 6 months. The study included mothers of 321 non-Roma and 164 Roma infants younger than 6 months. Univariate and multivariate logistic regression served to analyze factors associated with the practice of exclusive breastfeeding in both populations. Results: The prevalence of exclusive breastfeeding was almost the same among mothers in both non-Roma and Roma population (13.3 vs. 13%, p = 0.910). Exclusive breastfeeding was significantly more often (p < 0.001) among wealthier women, women whose newborns were over 2,500 g on birth, multipara, and women who had not established menstrual cycle among both populations. Living outside the capital significantly diminishes the chance for exclusively breastfed infants in the non-Roma community (Vojvodina: OR 0.16, CI 95% 0.03–0.92; eastern Serbia: OR 0.02, CI 95% 0.01–0.35) as well as living in the rural area (urban: OR 10.35, CI 95% 1.94–55.28). Unexpectedly, in the non-Roma population, not staying in the same room with the newborn in the maternity ward increases the chance for the baby to be exclusively breastfed (OR 7.19, CI 95% 1.80–28.68). The same pattern has been observed in Roma population. Non-Roma mothers multipara are more likely to exclusively breastfeed their children than primipara (OR 7.78, CI 95% 1.09–20.93), while among Roma mothers, the inverse association has been found although not significant (OR 0.42, CI 95% 0.14–1.23). Attending a childbirth preparation program more than 18 times increases the chances of infants being exclusively breastfed (OR 18.65, CI 95% 1.34–53.67). In the Roma population, there was no single woman that attended a childbirth preparation program. Conclusion: The pattern of exclusive breastfeeding significantly differs between non-Roma and Roma populations. Preventive work should have focus on strengthening support to mothers and medical staff in maternity wards. © Copyright © 2020 Stamenkovic, Matejic, Djikanovic and Bjegovic-Mikanovic.

Objective The present study aimed to identify the role of mother's education in the nutritional status of children aged 2-5 years in Serbia. Design Nationally representative population-based study. Age- and gender-specific BMI percentiles of children were analysed. In accordance with the WHO growth reference, children with BMI less than the 5th percentile were considered undernourished. Logistic regression was used to calculate the association between mother's education and other socio-economic determinants as possible confounders. Setting UNICEF's fourth Multiple Indicator Cluster Survey, conducted in both Roma and non-Roma settlements in Serbia. Subjects Children (n 2603) aged 2-5 years (mean age 3·05 years). Results Less than 5 % of children aged 2-5 years were undernourished. There were significantly more undernourished children among the Roma population, in the capital of Serbia and among those whose mothers were less educated. There were statistically significant differences according to mother's education in all socio-economic characteristics (ethnicity, area, region of living and wealth index). Mother's level of education proved to be the most important factor for child's nutritional status; place of living (region) was also associated. Conclusions Mother's education is the most significant predictor of children's undernutrition. It confirms that investment in females' education will bring benefits and progress not only for women and their children, but also for society as a whole. © The Authors 2016.

Objective The present study aimed to identify the role of mother's education in the nutritional status of children aged 2-5 years in Serbia. Design Nationally representative population-based study. Age- and gender-specific BMI percentiles of children were analysed. In accordance with the WHO growth reference, children with BMI less than the 5th percentile were considered undernourished. Logistic regression was used to calculate the association between mother's education and other socio-economic determinants as possible confounders. Setting UNICEF's fourth Multiple Indicator Cluster Survey, conducted in both Roma and non-Roma settlements in Serbia. Subjects Children (n 2603) aged 2-5 years (mean age 3·05 years). Results Less than 5 % of children aged 2-5 years were undernourished. There were significantly more undernourished children among the Roma population, in the capital of Serbia and among those whose mothers were less educated. There were statistically significant differences according to mother's education in all socio-economic characteristics (ethnicity, area, region of living and wealth index). Mother's level of education proved to be the most important factor for child's nutritional status; place of living (region) was also associated. Conclusions Mother's education is the most significant predictor of children's undernutrition. It confirms that investment in females' education will bring benefits and progress not only for women and their children, but also for society as a whole. © The Authors 2016.

Women who have experienced intimate partner violence use health care services more often than non-abused women, but it is unclear what they expect from physicians in relation to their intimate partner violence experience. In this study the authors explored whether women in Serbia expect physicians to help them after having experienced intimate partner violence, what kind of help the women expected, and if none, why none is expected. The authors of this study conducted structured interviews with 120 women who visited six primary healthcare centres. Quantitative data were analyzed using descriptive statistics, while qualitative data were analyzed applying content analyses. The majority of women (81.7%) expected healthcare professionals to help them in the event of intimate partner violence, mainly through giving advice, information, contacting other institutions, services, and providing understanding and support. Fewer women expected help in the form of documenting violence and contacting police. Only a minority (8.3%) did not expect help, noting that intimate partner violence is beyond the scope of healthcare professionals' interest or competencies, and/or that violence was a private problem, while 10% were unsure about the role of physicians in the case of intimate partner violence. The majority of women in this study expected help with intimate partner violence. Physicians should be aware of these expectations and how to provide support to women experiencing intimate partner violence. © 2011 Copyright Taylor and Francis Group, LLC.