Introduction: Different groups of population vary in whether and how often they seek help from health care providers. Determination of such intergroup differences in health care utilization contributes to identification of disparities in access to care. Andersen’s model of health care utilization (commonly used for exploring patients’ behaviors) was chosen as the theoretical basis for this study.

Objective: To identify groups of individuals who are more likely to seek medical attention in Russia and to establish differences in their preference between public and private health care providers.

Materials and methods: Statistical regression analysis was applied to public health survey data collected in 2022. The sample of 2,150 respondents was representative for the adult population of Russia.

Results: Every four out of five respondents sought medical help (79.0 %) in the previous year. Two third of them reported going to a private provider at least once (65.3 %) over the previous year. Being female, younger, married, with higher education, employed, having monthly incomes over 20 thousand rubles, rating their own health as bad were associated with being more likely to seek medical assistance. The first four characteristics of the respondents listed above and belonging to the highest income group (earning more than 60 thousand rubles monthly) were also found to be associated with higher probability of utilizing paid services.

Conclusions: This study revealed no differences in access to care between the respondents living in cities of different sizes; rather, such differences were associated with the employment status and income of the participants.

Introduction: Vaccination is the most efficient and cost-effective way to prevent infectious diseases. In recent years, despite the proven positive role of vaccination, there has been an ambiguous attitude towards ongoing vaccination campaigns in the world.

Objective: To test and validate the proprietary method of establishing personal levels of vaccination adherence.

Materials and methods: The authors have elaborated a method of assessing vaccination adherence using a specially developed questionnaire consisting of four groups (scales) and including 36 both direct and indirect statements related to immunization and serving as indicators. In April–June 2023, we conducted a questionnaire-based survey of 300 people aged 19 to 75 years. The respondents were asked to rate their level of agreement with the statements using the Likert scale. Each indicator was a value calculated for a particular respondent, expressed in points. The scoring was done manually or automatically. The data were then analyzed in SPSS Statistics 23.0 using methods of correlation analysis and descriptive statistics.

Results: The vaccination adherence level was moderate in 179 (59.7 %), low in 9 (3.0 %), and high in 112 (37.3 %) respondents. The Spearman’s rank correlation analysis revealed statistically significant correlations between the responses and the actual level of commitment to vaccination. Our method has demonstrated compliance with standard requirements for internal consistency, factor validity of scales, and statistical significance of test parts (Cronbach’s α-coefficient = 0.830; the factor analysis allowed us to distinguish four components).

Conclusion: Testing and subsequent validation of the own method have made it possible to determine the level of vaccination adherence as moderate as the questionnaire scales correspond to significant factors influencing the choice of a behavioral strategy. This method can be recommended both for research purposes and for practical application in healthcare institutions.

Introduction: The COVID-19 pandemic has had an ambiguous effect on the physical activity of the population. On the one hand, there was a decrease in physical activity of citizens due to restrictive measures. On the other hand, the epidemiological situation has forced people to pay more attention to their health, including physical activity.

Objective: To describe changes in physical activity of the working-age population of Russia related to the COVID-19 pandemic and to assess health effects of physical activity in Russians during the pandemic.

Materials and methods: The empirical basis of the study was the data on the working Russian population aged 18 to 64 years collected within the Russian Monitoring of Economic Situation and Health of the Population by the Higher School of Economics during four rounds: a “pre-pandemic” period including rounds 27 and 28 in October 2018 to January 2020, and a “pandemic” period including rounds 29 and 30 from October 2020 to January 2022. The data was analyzed using the SPSS Statistics.

Results: We established that 26 % of the population were engaged in physical activity in 2019, and in 2021 this proportion increased to 31 %. The Russians who had exercised before the pandemic increased their physical activity, and the number of “inactive” citizens decreased from 728 to 707 people. During the COVID-19 pandemic, physical activity of moderate intensity gained popularity. Thus, the share of people engaged in walking increased by 7 %.

Conclusions: Physical activity of the able-bodied population of Russia increased during the COVID-19 pandemic, but it still does not comply with the recommendations of the World Health Organization.

Introduction: Behavioral models of a healthy lifestyle emerge at school age and determine the health status in adulthood. Schools are considered the best environment for building commitment to a healthy lifestyle.

Objective: To assess adherence to a healthy lifestyle in rural schoolchildren before and after preventive intervention.

Materials and methods: Students attending six schools in the Bekovsky district of the Penza Region were anonymously surveyed twice using the international Health Behavior in School-aged Children questionnaire. In the years 2015 and 2022, 617 and 596 fifth to eleventh graders aged 11 to 17 were interviewed, respectively. We have developed a method for integral assessment of the commitment of children and adolescents to a healthy lifestyle, based on the cumulative adherence of schoolchildren to its six components with four options of adherence distinguished. The adherence index is defined as the proportion of people committed to a specific number of healthy lifestyle components out of the total number of respondents and is expressed as a percentage.

Results: Prior to preventive intervention in health education started in 2009, 12.7 % of boys and 7.2 % of girls in grades 5 to 8 and 28.1 % of male and 16.4 % of female ninth to eleventh graders smoked or tried to smoke. During the first phase of the intervention (2008–2015), a significant reduction in the number of smoking schoolchildren was achieved. As a result of the second stage of intervention launched in the district schools in 2015, we observed an increase in the number of daily fruit eaters (OR: 1.45; 95 % CI: 1.06–1.99) and a decrease in the number of smokers (OR: 0.22; 95 % CI: 0.07–0.66) and alcohol drinkers (OR: 0.25; 95 % CI: 0.08–0.76) among 11–14-year-old schoolchildren. Among schoolchildren aged 15–17, we detected an increase in the number of those eating fruit (OR: 0.049; 95 % CI: 1.49–1.06) and vegetables (OR: 1.78; 95 % CI: 1.16–2.73) on a daily basis, having sufficient physical activity (OR: 1.9; 95 % CI: 1.26–2.87), neither smoking (OR: 0.45; 95 % CI: 0.21–0.96) nor drinking alcohol (OR: 0.29, 95 % CI: 0.11–0.8). The index of adherence to healthy lifestyle among students in grades 5–8 increased from 1.54 (95 % CI: 0.8; 2.28) in 2015 to 3.98 % (95 % CI: 2.76; 5.2) (p < 0.05) in 2022, and from 1.76 (95 % CI: 1.21; 2.31) to 1.83 (95 % CI: 1.21; 2.45) among the ninth to eleventh graders.

Conclusions: A two-stage preventive intervention in health education in rural schools realized without additional expenditures contributed to raising commitment to a healthy lifestyle among students in grades 5–8.

Background: At present, diagnostics of premorbid conditions in medical college students is of particular importance owing to the extensive use of modern educational equipment, technologies and materials.

Objective: To assess the functional status of first to third-year medical college students majoring in orthopedic dentistry.

Materials and methods: In April–May 2023, we conducted a cross-sectional study of 182 male students of the medical college at the Volgograd State Medical University, all majoring in orthopedic dentistry. The subjects were divided into three observation cohorts consisting of 66 first-year college students (mean age: 18.29 ± 0.11 years), 60 second-year students (19.84 ± 0.20 years), and 56 third-year students (20.66 ± 0.24 years). We established their heart rate variability and analyzed integrative indicators of functioning of the regulatory systems with a focus on adaptive capacities according to the method by R.M. Baevsky. The functional state of the central nervous system of the students was assessed using variational chronoreflexometry.

Results: We observed balanced heart rate regulation (type 1) in most subjects (73 %). At the same time, by the final year of study the number of students with excessive sympathicotonic reaction was found to increase. Some young men showed an increase in the activity of regulatory systems above normal values. Suboptimal activity of the autonomic nervous system can reduce its efficiency and induce rapid CNS fatigue, which was confirmed by the results of variational chronoreflexometry.

Discussion: We revealed a slight tension of regulatory systems having no adverse health effects in the male students. Yet, excessive sympathicotonic reaction noted in the third-year students indicated predisposition to disruption of mechanisms of adaptive capacity in some young men. Optimization of schoolwork pressure is one of the measures of preventing further negative changes in the functional status of student youth. The assessed score of schooling intensity of future dental technicians was 3.1.

Conclusions: Our findings show that the study load causes increasing tension of the regulatory systems of the body.

They justify the importance of improving the curriculum and developing a set of targeted measures for an increase in functional reserves of medical college students majoring in orthopedic dentistry.

Introduction: Digitalization of education, which has been widely implemented in Russia since 2015, has made it possibleto provide distance learning for schoolchildren and students during the COVID-19 pandemic. The results of assessingindicators of the functional state of schoolchildren and students in this mode of education showed the possibility of such negative consequences as increased fatigue, complaints related to the musculoskeletal system, pronounced manifestationsof computer vision syndrome and stress.

Objective: To assess age and sex-specific patterns of adaptation of high school children, students of vocationalschools and universities to distance learning.

Materials and methods: We conducted an anonymous online survey of high school children in the cities of Moscowand Omsk (n = 91) and students of a college and a university in Omsk (56 and 43 young people, respectively) using aspecially developed questionnaire containing 36 questions about health status and well-being after online classes andfinishing homework, duration of leisure-time Internet use, and lifestyle. We evaluated indicators of well-being, complaintsof fatigue, headaches, irritability, pain associated with the musculoskeletal system, manifestations of computer visionsyndrome, other complaints occurring during e-learning and doing homework. The analysis of data on 190 subjects wascarried out using online calculators for estimating statistical criteria using generally accepted statistical methods. Theresults of descriptive statistics were presented as arithmetic means (M) and their standard errors (±m). We used theStudent’s and Fischer’s criteria and estimated values of relative health risks (RR), their confidence intervals and theetiological fraction (EF, %).

Results: We found that distance learning increased the prevalence of complaints of fatigue, headaches, irritability,neck and back pain after online classes and especially homework. We established sex-specific differences in health effectsof the total academic load. Young women were more vulnerable than young men. In schoolgirls, risks of headaches afteronline classes were statistically significant compared to those after homework (RR = 3.4; 95 % CI = 1.37–8.45) with a veryhigh degree of correlation (EF = 70.6 %). Irritability after classes was also more frequent in girls. Female vocational schoolstudents had higher rates of severe fatigue after classes compared to male students (RR = 2.77; 95 % CI = 1.07–7.16).

They were also more likely to complain of pain in the right wrist. Female university students had even more pronounced sex-specific differences in vulnerability compared to their male peers in terms of fatigue after school and homework, pain in neck (RR = 8.05; 95 % CI = 1.24–52.4) and back (RR = 3.83; 95 % CI = 1.22–12.1) after finishing homework. We observed that leisure and lifestyle of all the students were characterized by excess use of the Internet, reduced sleep duration, and low physical activity.

Conclusions: There are significant differences in the lifestyle and reactions of girls and boys to the academic load in the course of distance learning. Our findings show that e-learning can negatively affect students’ well-being, contributing to complaints typical of computer visual syndrome and disorders of the musculoskeletal system. We have obtained evidence proving the necessity to regulate the total load of digital education in order to attenuate its adverse health effects in modern adolescents and young people, especially females.

Introduction: Much attention has been paid to the problem of sleep disorders in young people recently. Medical university students are at higher risk for sleep disturbances potentially leading to decreased attention, poor personal well-being and academic performance, since their schoolwork pressure is higher than that of students of other universities.

Objective: To study the prevalence of sleep disorders among medical university students.

Materials and methods: In fall 2022, we conducted an anonymous questionnaire-based survey of 680 students of the Smolensk State Medical University using the Pittsburgh Sleep Quality Index (PSQI) to assess the quality of sleep and sleep disorders in the randomly selected representative sample. Statistical data analysis was carried out in Microsoft Excel.

Results: Poor sleep quality was established in 75.9 % of the medical students surveyed. The mean sleep duration was estimated to be 6 hours and 12 minutes. Maximum disorders were found in the subjective assessment of sleep quality in 3.5 % of the respondents; in sleep delay – in 3.1 %; in sleep duration – in 7.2 %; in sleep efficiency – in 1.5 %; in the use of sleeping medication – in 5.3 %; and in daytime dysfunction – in 17.4 % of the examined. We observed poor sleep quality in all the subjects but noted that sleep disorders were more common in the second and third-year students.

Conclusions: Sleep disorders in student youth include problems with the quality, schedule and duration of sleep and daytime dysfunction. They are more frequent in junior students. Female students are at higher risk. Awareness of sleep disturbances students are experiencing and appropriate preventive measures can help maintain not only high academic performance, but also physical and mental health.

Introduction: The prevalence of childhood overweight and obesity demonstrates a significant increase. Social factors can contribute to the risk of these medical conditions, which determines the relevance of their consideration for the development of appropriate comprehensive measures for prevention.

Objective: To study the social and health profile of rural and urban school pupils in order to establish factors contributing to overweight and obesity among children and adolescents.

Materials and methods: We analyzed data of a questionnaire-based survey of 2,159 schoolchildren aged 7 to 17 years living in the city of Novosibirsk and the Novosibirsk Region. The survey was conducted in accordance with the program recommended by the Federal Service for Surveillance on Consumer Rights Protection and Human Wellbeing for studying nutrition of schoolchildren within the framework of the National Demography Project in May 2020.The statistical analysis was performed in Excel and Statistica 10.0 using parametric methods, correlation and regression analyses. Differences were considered statistically significant at p < 0.05.

Results: We found that the proportion of overweight children was 24.6 % and 25.2 % among urban and rural schoolchildren, respectively; 24.2 % of the children were brought up in single-parent families and 20.0 % – in low-income families. We established a strong correlation between overweight in both parents and that in children, in fathers and children (r = 0.88, p ≤ 0.05 and r = 0.76, p ≤ 0.05, respectively), and a moderate correlation between overweight in mothers and in children (r = 0.54, p ≤ 0.05). We also revealed a statistically significant correlation between the lack of higher education in parents and overweight in children (r = 0.63, p ≤ 0.05).

Conclusion: Our findings have served as the basis for developing a model for prevention of overweight and obesity and its implementation in the family and school environment.

Background: A healthy balanced diet is the basis for maintaining health at any age. Identification of causes of violations in organization of nutrition of preschoolers remains relevant, since the breach of fundamental principles of healthy eating aggravates negative trends in children’s health.

Objective: To compare actual feeding of children attending two preschools using a single menu.

Materials and methods: In spring–summer 2022, we carried out a comparative analysis of the diet of 99 children aged 3 to 6 years attending two kindergartens using methods of estimation and portion weighing. In total, we examined 20,700 portions and took 41,580 weight measurements. Food intake was then estimated both per child and per preschool. To establish the quality of meals served, we conducted a questionnaire-based survey of parents; the questionnaire was approved by the Local Ethics Committee of the Novokuznetsk State Institute of Advanced Medical Training – Branch of the Russian Medical Academy of Continuous Professional Education (protocol No. 1 of January 14, 2020).

Results: Weighing of the food set showed that actual consumption of food products differed from that specified in the menu. The diet was imbalanced. Natural food standards were met in both preschools only for cereals and legumes (95–100 %), juices and fruits (100 %). Deficit of bread ranged from 8 to 28 % of the recommended consumption rate, and that of potatoes and vegetables was 14 %. Significant differences between the weights of food products actually consumed and listed on the menu were found for vegetables, potatoes, by-products, fish, cheese, and cottage cheese. The total caloric value of the rations was 6–12 % lower while the protein content was 8 to 18 %, fat content – 7 to 16 %, and that of carbohydrates – 5 to 11 % lower than declared.

Conclusions: Weighing provides more accurate data on children’s nutrient intake in preschools. Nutrition information given in the menus is overestimated by 6 to 15 % on the average. The parent survey showed that children did not eat some of the dishes from the preschool menu at home, so it was more difficult to adapt them to the proposed diet.

Introduction: To date, the issue of participant interaction in the diagnostic and therapeutic process is extremely relevant for improving the effectiveness of preventing healthcare-associated infections and combating antibiotic resistance.

Objective: To optimize approaches to the interaction of participants in the diagnostic and treatment process in order to perfect the system of preventing healthcare-associated infections (HAIs) and combating antibiotic resistance.

Materials and methods: This paper presents a retrospective epidemiological analysis of the causative agents of HAIs in puerperas and newborns with multiple resistances to antibacterial drugs (multiple drug resistance (MDR) and extensive drug resistance (XDR)) in three maternity hospitals from three constituent entities of the Russian Federation in 2019–2021. We also applied sociological, statistical, analytical, and organizational experiment methods in the research.

Results: We analyzed resistance indices of strains isolated from mothers and newborns in 2019–2021 and identified key interventions to reduce the number of HAIs and antibiotic resistance rates. We also defined daily doses of antibacterial drugs per hospital bed day in three constituent entities of the Russian Federation using the example of participants of he Pilot Project implemented in 2019–2021. A scheme of optimal interaction between participants in the diagnostic and treatment process is proposed, which allows solving the problems of antibiotic resistance and the prevalence of HAIs.

Conclusion: Constant and effective interaction of all participants in the diagnostic and treatment process, openness in providing data, the possibility of using special programs for prevention, improving the skills of medical personnel and identifying difficulties that impede HAI prevention, will influence the spread of antibiotic resistance and improve measures aimed at solving these important tasks.