Maria Cecília Formoso Assunção

Universidade Federal de Pelotas, São Francisco de Paula, Rio Grande do Sul, Brazil

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Publications (58)70.76 Total impact

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    ABSTRACT: To assess the prevalence of sexual initiation until the age of 14 years old, as well as sociodemographic and behavioral factors. In 2008, 4,325 from the 5,249 adolescents of the 1993 birth cohort in Pelotas, Rio Grande do Sul, were interviewed. Sexual initiation was defined as the first intercourse up to the age of 14 years old. The information was obtained by interviewing adolescents in their houses, during the 2008 follow-up. The analyzed variables were: skin color, asset index, maternal and adolescents' schooling, experimental use of tobacco and alcohol, drunkenness episode, use of any illicit drug, illegal drug use by friends and involvement in fights during the past year. Use of condoms and contraceptive methods, number of partners and the age of sexual initiation were also analyzed. The prevalence of sexual initiation by the age of 14 was of 18.6%. Lower schooling, asset index and maternal education were related to higher prevalence of sexual initiation until the age of 14, as well as being male or being born to adolescent mothers. Sexual intercourse was also related to the behavioral variables analyzed. Among adolescent girls who had intercourse up to the age of 14, 30% did not use contraception and 18% did not use condoms in the last sexual intercourse. Boys reported a higher number of sexual partners than girls. The results suggest a relationship between sexual intercourse (≤ 14 years) and some health-risk behaviors. The non-use of condoms and contraceptives may make them vulnerable to experiencing unwanted situations. Education and sociocultural strategies for health should be implemented from the beginning of adolescence.
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    ABSTRACT: Background: Maternal smoking during pregnancy is associated with short-term and also long-term harmful effects on offspring. Objective: The aim of this study is to evaluate the associations of maternal smoking during pregnancy with offspring bone health at 18 years old, and the role of birth weight and contemporaneous height, weight and body mass index (BMI) in this association. Data from the 1993 Pelotas Birth Cohort were analyzed using path analysis stratified by sex. Adolescents at 18 years old (N = 1512 males, 1563 females). DXA-determined total body bone mineral density (BMD) and bone mineral content (BMC) were assessed at 18 years old. Results: Each additional cigarette smoked during pregnancy was associated with a lower BMC by -4.20 g in males (95% CI -8.37; -0.05), but not in females [-2.22 g (95% CI -5.49; 1.04)]; weaker inverse associations were observed for BMD. This inverse association was explained by the influence of maternal smoking on birth weight and contemporaneous anthropometry, particularly height. A 1 kg higher birth weight was associated with a higher BMC by around 144 g in males and by around 186 g in females, and also with a higher BMD by around 0.019 g/cm(2) in males and by around 0.018 g/cm(2) in females, respectively. Conclusions: Lifecourse analysis using path models has enabled to evaluate the role of mediators in the associations of maternal smoking during pregnancy and birth weight with bone mass in the offspring, thus generating improved understanding of the etiology of bone health and the importance of early life experiences. (C) 2014 The Authors. Published by Elsevier Ireland Ltd. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
    Early Human Development 12/2014; 90(12). DOI:10.1016/j.earlhumdev.2014.08.024 · 1.93 Impact Factor
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    ABSTRACT: OBJECTIVE: To analyze physical activity during adolescence in participants of the 1993 Pelotas Birth Cohort Study, Brazil. METHODS: Data on leisure time physical activity at 11, 15, and 18 years of age were analyzed. At each visit, a cut-off point of 300 min/week was used to classify adolescents as active or inactive. A total of 3,736 participants provided data on physical activity at each of the three age points. RESULTS: A significant decline in the proportion of active adolescents was observed from 11 to 18 years of age, particularly among girls (from 32.9% to 21.7%). The proportions of girls and boys who were active at all three age points were 28.0% and 55.1%, respectively. After adjustment for sex, economic status, and skin color, participants who were active at 11 and 15 years of age were 58.0% more likely to be active at 18 years of age compared with those who were inactive at 11 and 15 years of age. CONCLUSIONS: Physical activity declined during adolescence and inactivity tended to track over time. Our findings reinforce the need to promote physical activity at early stages of life, because active behavior established early tends to be maintained over time.
    Revista de Saúde Pública 12/2014; 48(6):925-930. DOI:10.1590/S0034-8910.2014048005313 · 1.22 Impact Factor
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    ABSTRACT: Previous studies have suggested an association between maternal smoking during pregnancy and asthma symptoms such as wheezing during childhood. However, few have evaluated this association in adolescence, especially in populations with high prevalence of wheezing as in Brazil. Using the 1993 Pelotas birth cohort, a longitudinal study set in southern Brazil of 5249 urban live births, we aimed to evaluate the association between maternal and the partner's smoking during pregnancy and wheezing at 11 and 15 years of age. We evaluated smoking during pregnancy using number of cigarettes/day, and our main outcomes were as follows: wheezing in the last year and number of wheezing crises, at both 11 and 15 years of age, as well as persistent wheezing (having crises at 11 and 15 years of age) and medical asthma diagnosis at age 15. In addition, other socio-demographic variables were included as possible confounders and mediators of this association. We used Poisson regression models to evaluate crude and adjusted associations. Of the 5249 live births in 1993, 87.5% and 85.7% were followed-up to 11 and 15 years of age, respectively. Maternal smoking during pregnancy showed a dose-response association with number of wheezing crises at age 15 (P=0.023), presence of persistent wheezing (P=0.034) and asthma diagnosis (P=0.023). Partner's smoking was not associated with any wheezing variables. Maternal smoking during pregnancy appears to exert an effect on respiratory morbidity of adolescents, evaluated by wheezing symptoms.
    Journal of Developmental Origins of Health and Disease 11/2014; DOI:10.1017/S2040174414000555 · 0.77 Impact Factor
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    ABSTRACT: To evaluate the longitudinal association between physical activity behavior at 11 years of age and the incidence of mental health problems from 11 to 15 years of age.
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    ABSTRACT: Purpose Most children live in low- and middle-income countries (LMICs), many of which have high levels of violence. Research in high-income countries (HICs) shows that childhood behaviour problems are important precursors of crime and violence. Evidence is lacking on whether this is also true in LMICs. This study examines prevalence rates and associations between conduct problems and hyperactivity and crime and violence in Brazil and Britain. Methods A comparison was made of birth cohorts in Brazil and Britain, including measures of behaviour problems based on parental report at age 11, and self-reports of crime at age 18 (N = 3,618 Brazil; N = 4,103 Britain). Confounders were measured in the perinatal period and at age 11 in questionnaires completed by the mother and, in Brazil, searches of police records regarding parental crime. Results Conduct problems, hyperactivity and violent crime were more prevalent in Brazil than in Britain, but nonviolent crime was more prevalent in Britain. Sex differences in prevalence rates were larger where behaviours were less common: larger for conduct problems, hyperactivity, and violent crime in Britain, and larger for nonviolent crime in Brazil. Conduct problems and hyperactivity predicted nonviolent and violent crime similarly in both countries; the effects were partly explained by perinatal health factors and childhood family environments. Conclusions Conduct problems and hyperactivity are similar precursors of crime and violence across different social settings. Early crime and violence prevention programmes could target these behavioural difficulties and associated risks in LMICs as well as in HICs.
    Social Psychiatry and Psychiatric Epidemiology 10/2014; 50(4). DOI:10.1007/s00127-014-0976-z · 2.58 Impact Factor
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    ABSTRACT: Objective: Estimate the prevalence of dental caries based on clinical examinations and self-reports and compare differences in the prevalence and effect measures between the two methods among 18-year-olds belonging to a 1993 birth cohort in the city of Pelotas, Brazil. Method: Data on self-reported caries, socio-demographic aspects and oral health behaviour were collected using a questionnaire administered to adolescents aged 18 years (n = 4041). Clinical caries was evaluated (n = 1014) by a dentist who had undergone training and calibration exercises. Prevalence rates of clinical and self-reported caries, sensitivity, specificity, positive and negative predictive values, absolute and relative bias, and inflation factors were calculated. Prevalence ratios of dental caries were estimated for each risk factor. Results: The prevalence of clinical and self-reported caries (DMFT>1) was 66.5% (95% CI: 63.6%-69.3%) and 60.3% (95% CI: 58.8%-61.8%), respectively. Self-reports underestimated the prevalence of dental caries by 9.3% in comparison to clinical evaluations. The analysis of the validity of self-reports regarding the DMFT index indicated high sensitivity (81.8%; 95% CI: 78.7%-84.7%) and specificity (78.1%; 95% CI: 73.3%-82.4%) in relation to the gold standard (clinical evaluation). Both the clinical and self-reported evaluations were associated with gender, schooling and self-rated oral health. Clinical dental caries was associated with visits to the dentist in the previous year. Self-reported dental caries was associated with daily tooth brushing frequency. Conclusions: Based on the present findings, self-reported information on dental caries using the DMFT index requires further studies prior to its use in the analysis of risk factors, but is valid for population-based health surveys with the aim of planning and monitoring oral health actions directed at adolescents.
    PLoS ONE 09/2014; 9(9):e106382. DOI:10.1371/journal.pone.0106382 · 3.53 Impact Factor
  • Bruna Celestino Schneider, Suele Manjourany Silva Duro, Maria Cecília Formoso Assunção
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    ABSTRACT: This paper is the result of a cross-sectional population-based study that evaluated individuals aged 20 or more living in the urban area of Pelotas in the state of Rio Grande do Sul and sought to describe the frequency of meat consumption and the habit of eating meat with an excess of fat. It evaluated the consumption over the past year of red meat (including bone, steak and ground beef), white meats (chicken and fish) and viscera and processed meats. Of the 2,730 people interviewed, 99.1% (CI95% 98.7 - 99.5) consumed some type of meat over the past year, while around 32% reported daily consumption. The prevalence of consumption of red meat (99.3% CI95% 98.9 - 99.6) and white meat (99.4% CI95% 99.1 - 99.7) was similar. Chicken was the meat most consumed by interviewees (98.0% CI95% 97.4 - 98.5), while viscera were the least consumed (59.1% CI95% 56.4 - 61.7). The processed meats consumed by 85.5% (CI95% 83.7 - 87.2) of the respondents, presented the highest prevalence of daily consumption (16.6%). Meats with excess of fat were consumed by 52.3% (CI95% 49.8 - 54.8) of adults, especially men and people of lower education and economic status.
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    ABSTRACT: To investigate the association between dental caries and obesity, evaluated by air displacement plethysmography, among 18-year-old adolescents from a birth cohort in the city of Pelotas, Brazil.
    Community Dentistry And Oral Epidemiology 05/2014; DOI:10.1111/cdoe.12109 · 1.80 Impact Factor
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    ABSTRACT: Association between three physical activity (PA) measurements throughout adolescence and bone density at 18 years of age was investigated. PA was associated with both lumbar spine and femoral neck bone mineral density (BMD) in early adulthood independent of type of PA used in the analysis. The results were more consistent in boys. This study amis to evaluate if PA during adolescence could influence BMD later in life. A population-based birth cohort study was carried out. PA was assessed at 11 and 15 years of age by questionnaire and included sports performed while BMD (lumbar spine and femoral neck) was measured by dual-energy X-ray absorptiometry at 18 years. A peak strain score was generated based on ground reaction forces of different PA. PA was measured as peak strain score, peak strain score multiplied by minutes/week and minutes/week. Unadjusted and adjusted analyses were performed using linear regression. Overall, 3,811 adolescents were studied (1,866 boys and 1,945 girls). The peak strain score at 11 and 15 years was associated with lumbar and femoral neck BMD at 18 years in boys. Among girls, high-impact PA at 11 years was positively associated with lumbar and femoral BMD (p = 0.01; p < 0.001). After adjusted analysis, weekly minutes of PA at 11 years were not associated with lumbar spine but were associated with femoral neck BMD (p < 0.001); at 15 years, weekly minutes of PA were positively associated with BMD at both sites. Regardless of PA status at 11 years of age, attaining the recommendations of PA (300 min/week) at 15 years appears to be important for BMD at 18 years in both sites in boys and girls. The results Appeared to be more consistent in boys. PA during adolescence was positively associated with both lumbar spine and femoral neck BMD in early adulthood independent of type of PA used in the analysis.
    Osteoporosis International 04/2014; 25(8). DOI:10.1007/s00198-014-2715-4 · 4.04 Impact Factor
    This article is viewable in ResearchGate's enriched format
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    ABSTRACT: To estimate the point prevalence of self-medication among adolescents aged 18 years and to evaluate the type of drugs used (either over-the-counter or prescription drugs) and socioeconomic, health-related, and behavioral correlates of self-medication. This cross-sectional study used data from the 1993 Pelotas (Brazil) Birth Cohort Study. Data were obtained through the administration of a questionnaire to adolescents aged 18 years. The outcome variables were point prevalence of medicine use and self-medication collected by self-report. The independent variables studied were gender, continuous medicine use, socioeconomic status, schooling, self-rated health, body mass index, and physical activity levels. Medicines were classified into therapeutic groups according to the Anatomical Therapeutic Chemical classification system. A total of 4,106 adolescents were interviewed. The point prevalence of medicine use was 41.1% (95% confidence interval [CI] 39.6-42.6), and the proportion of self-medication among medicine users was 65.1% (95% CI 62.8-67.4). The point prevalence of self-medication was 26.7% (95% CI 25.4-28.1), and it was higher among female adolescents, those more educated, and those who rated their health as poor. Out of the drugs used for self-medication (58% of all drugs used), 1,003 (78.7%) were nonprescription drugs and 271 (21.3%) were prescription drugs. The most frequently used drugs for self-medication were analgesics (56.1%), systemic antihistamines (7.4%), and anti-inflammatory and antirheumatic products (7.1%). A high point prevalence of self-medication was found among adolescents, which is particularly concerning due to high use of prescription drugs for self-medication. Interventions are needed to promote rational use of medicines in this population.
    Journal of Adolescent Health 04/2014; 55(2). DOI:10.1016/j.jadohealth.2014.02.010 · 2.75 Impact Factor
  • Bruna Celestino Schneider, Suele Manjourany Silva Duro, Maria Cecília Formoso Assunção
    Ciência & Saúde Coletiva 01/2014; 19(8):3583-3592. DOI:10.1590/1413-81232014198.11702013 · 0.40 Impact Factor
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    ABSTRACT: Purpose To estimate the point prevalence of self-medication among adolescents aged 18 years and to evaluate the type of drugs used (either over-the-counter or prescription drugs) and socioeconomic, health-related, and behavioral correlates of self-medication. Methods This cross-sectional study used data from the 1993 Pelotas (Brazil) Birth Cohort Study. Data were obtained through the administration of a questionnaire to adolescents aged 18 years. The outcome variables were point prevalence of medicine use and self-medication collected by self-report. The independent variables studied were gender, continuous medicine use, socioeconomic status, schooling, self-rated health, body mass index, and physical activity levels. Medicines were classified into therapeutic groups according to the Anatomical Therapeutic Chemical classification system. Results A total of 4,106 adolescents were interviewed. The point prevalence of medicine use was 41.1% (95% confidence interval [CI] 39.6–42.6), and the proportion of self-medication among medicine users was 65.1% (95% CI 62.8–67.4). The point prevalence of self-medication was 26.7% (95% CI 25.4–28.1), and it was higher among female adolescents, those more educated, and those who rated their health as poor. Out of the drugs used for self-medication (58% of all drugs used), 1,003 (78.7%) were nonprescription drugs and 271 (21.3%) were prescription drugs. The most frequently used drugs for self-medication were analgesics (56.1%), systemic antihistamines (7.4%), and anti-inflammatory and antirheumatic products (7.1%). Conclusions A high point prevalence of self-medication was found among adolescents, which is particularly concerning due to high use of prescription drugs for self-medication. Interventions are needed to promote rational use of medicines in this population.
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    ABSTRACT: This study aimed to describe dietary patterns and to investigate associations with demographic and socioeconomic factors among children one to six years of age in the city of Pelotas, Rio Grande do Sul State, Brazil. Pearson correlation was used to group different foods. Dietary patterns were constructed using principal components analysis (PCA). Associations were established with the Kruskal Wallis test (α = 0.05). The study evaluated 667 children. Five dietary patterns were identified: "vegetables", "traditional" (bread, butter/margarine, rice/pasta, coffee, sugar), "sweets and sausages", "snacks" (dairy products, chocolate, cookies, and juice), and "fruits". Children of mothers with more schooling and higher income showed greater adherence to "vegetables" and "fruits". The "traditional" pattern was more common in children of mothers with less education and lower family income. The "vegetables" and "traditional" patterns showed greater variance. Families' socioeconomic status played a key role in determining children's dietary patterns.
    Cadernos de saúde pública / Ministério da Saúde, Fundação Oswaldo Cruz, Escola Nacional de Saúde Pública 12/2013; 29(12):2416-26. · 0.83 Impact Factor
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    ABSTRACT: Prenatal cigarette smoke exposure may have adverse psychological effects on offspring. The objective was to assess the association between parental smoking during pregnancy and offspring happiness at age 18, as well as depression. Participants were part of a birth cohort study in Pelotas, Brazil (5,249 participants). Happiness was measured by the Subjective Happiness Scale, a Likert-like scale with four questions generating a score from 1 to 7, with ≥ 6 indicating "happiness". Depression was measured using the Mini International Psychiatric Interview. About one third of mothers reported having smoked during pregnancy and 4.6% reported smoking 20 or more cigarettes a day. The prevalence of happiness was 32.2% (95% CI 30.8; 33.7), depression 6.8% (95% CI 6.1; 7.6), and simultaneous happiness and depression less than 1%. The prevalence of offspring happiness decreased as smoking in pregnancy increased, even after control for confounding variables, showing an OR = 0.79 [95% CI 0.55; 1.13]. The opposite happened to depression; the prevalence of offspring depression increased as smoking in pregnancy increased (<20 cigarettes/day OR = 1.38 [95% CI 1.03; 1.84] and ≥20 cigarettes/day OR = 2.11[95% CI 1.31; 3.40]. Smoking by the partner was associated with decreased offspring happiness after adjustment for confounders, but did no show association with offspring depression. Offspring were less likely to be happy and more likely to be depressed if their mother smoked during pregnancy, and less likely to be happy if their father smoked during mother's pregnancy. Although we can not affirm that this is a "causal pathway", public policies to reduce smoking in pregnancy could improve the health of the offspring in the short and long term.
    PLoS ONE 11/2013; 8(11):e80370. DOI:10.1371/journal.pone.0080370 · 3.53 Impact Factor
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    ABSTRACT: This study evaluated the association between obesity and emotional and behavioral difficulties in adolescents. We studied 4,325 individuals 11 to 15 years of age who were members of the 1993 birth cohort in Pelotas, Rio Grande do Sul State, Brazil. Information on body mass index (BMI), maternal assessment of the adolescents' emotional and behavioral health (Strengths and Difficulties Questionnaire - SDQ), and sociodemographic and behavioral characteristics were used. Gender-stratified analyses were conducted with simple and multivariate linear regression. In the adjusted analysis, obesity only correlated with total SDQ scores in boys. Among the latter, teenage obesity was associated with higher scores on the subscale of relational problems with peers. Given current knowledge on the future implications of obesity and mental health and in dealing with adolescents, studies on gender differences in adolescence may contribute to understanding such associations.
    Cadernos de saúde pública / Ministério da Saúde, Fundação Oswaldo Cruz, Escola Nacional de Saúde Pública 09/2013; 29(9):1859-66. · 0.83 Impact Factor
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    Patricia Abrantes Duval, Denise Halpern-Silveira, Maria Cecilia Formoso Assunção
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    ABSTRACT: The aim of this study was to analyze the effect of lifestyle counseling on metabolic syndrome (MetS) prevalence in the short term. This was a before-after study design conducted in a nutrition outpatient clinic. Participants were adults presenting with MetS according to the International Diabetes Federation criteria. In the study 109 individuals (mean age 41 ± 9.6 years old) were included, the majority women (82,6%). Participants received individualized dietary prescription guidelines for healthy eating and were encouraged to perform physical activity. After five months, a decrease of 21.5% in the prevalence of MetS (p<0,001) was observed Significant mean reductions (p<0,001) in bodyweight (3.5 ± 3.4 Kg), waist circumference (4.0 ± 4.0 cm), triglycerides (33.8 ± 69.6 mg/dl) and fasting glucose we observed (6.6 ± 18.3 mg/dl), while HDL cholesterol showed an increase (2.6 ± 6.1mg/ dl, p<0,001). We conclude that lifestyle counseling consisting of individualized nutritional guidance through a balanced diet, physical activity promotion and change in lifestyle can reduce the prevalence of MetS in the short term.
    Revista Chilena de Nutricion 09/2013; 40(3):216-223. DOI:10.4067/S0717-75182013000300002
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    ABSTRACT: Early childhood nutritional factors can play a crucial role in the development of body composition in later phases of life. A systematic literature review was conducted to identify studies on the association between early nutritional determinants and fat-free mass in adulthood. The PubMed and Virtual Health Library electronic databases were used. Nine articles were included after a peer review of the 576 references initially found, published from 2003 to 2009, with healthy subjects and longitudinal analysis. Birth weight and birth length and variations across childhood were strong predictors of fat-free mass at later ages. The studies showed that higher birth weight and greater weight gain in early childhood were associated with greater fat-free mass in adulthood. However, the available data are limited and inconclusive in relation to eating in early childhood as a predictor of fat-free mass at later ages.
    Cadernos de saúde pública / Ministério da Saúde, Fundação Oswaldo Cruz, Escola Nacional de Saúde Pública 04/2013; 29(4):639-53. DOI:10.1590/S0102-311X2013000400003 · 0.83 Impact Factor
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    ABSTRACT: The aim of this study was to characterize the methodology of data collection on physical activity using accelerometry in two birth cohorts (2004 and 1993) in Pelotas, Rio Grande do Sul State, Brazil, at the 6-7 and 18-year follow-up visits, respectively. During visits to the study headquarters for a health evaluation, cohort subjects received the accelerometer to be worn on the wrist for 5 to 8 days, after which the device was retrieved at their homes. Genea and GENEActiv triaxial estimators of gravity (g) acceleration were employed. Accelerometry data were collected from 3,331 children (93.7% of those included in follow-up) and 3,816 adolescents (99% of those in follow-up). The study characterizes the data collection methodology in more than 7,000 individuals and discusses issues in its implementation. It thus provides a methodological framework aimed at helping to plan future population-based studies with the use of such technology and to improve understanding of physical activity in the context of epidemiological studies.
    Cadernos de saúde pública / Ministério da Saúde, Fundação Oswaldo Cruz, Escola Nacional de Saúde Pública 03/2013; 29(3):557-65. DOI:10.1590/S0102-311X2013000300013 · 0.83 Impact Factor
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    ABSTRACT: PurposeTo track the use of medicine and self-medication from infancy to adolescence.Methods All newborns in the city of Pelotas, Brazil, were monitored and enrolled in the 1993 Pelotas (Brazil) Birth Cohort Study. Subsamples of the cohort were visited at 1, 3, and 6 months and at 1 and 4 years of age. At 11 and 15 years of age, all cohort members were sought. In each of these visits, information on medicine use in the 15 days before the interview was collected. Two outcomes were analyzed: prevalence of medicine use and prevalence of self-medication.ResultsPrevalence of medicine use in the first year of life ranged from 52.0% to 68.6%. From 4 to 15 years of age, the prevalence decreased, ranging from 30.9% to 37.2%. At age 15, girls presented a 33% higher prevalence of medicine use than boys. The proportion of self-medication ranged from 12.4% to 29.0% and was higher in girls aged 11 and 15 years than boys of the same age. In all follow-up periods, use of medicines was significantly higher among children who used medicines in the earlier period. Prevalence of self-medication was higher among those who were self-medicated in the previous periods.Conclusions Tracking studies are important to public health because they can predict future behavior by analyzing past behavior, thus helping in designing preventive actions. In this study, previous use of medicines predicts future use, thus creating an opportunity to plan actions that promote the rational use of medicines.
    Journal of Adolescent Health 12/2012; 51(6):S11–S15. DOI:10.1016/j.jadohealth.2012.06.027 · 2.75 Impact Factor