Search Results (474)

Background: Street sex workers (SSWs) experience some of the highest levels of health inequality in the UK, yet face persistent barriers to accessing NHS healthcare. These barriers are shaped by structural disadvantage, stigma, and the complex realities of their lives. Despite significant health needs, engagement with services remains low, and existing models of care often fail to accommodate the lived experiences of this population. Aims: This study explores how SSWs access, experience, and navigate NHS healthcare. It aims to understand the barriers and enablers of access, identify areas for improvement, and offer recommendations to inform the development of more inclusive service provision. Methods: An ethnographic approach was undertaken within a South Yorkshire charitable organisation. Data collection involved participant observation and an arts-based scrapbook intended to facilitate trauma-informed, flexible engagement. Thematic analysis was used to analyse the data, organised around a dynamic, processual approach using the candidacy framework. Findings: Barriers to care were present across all stages of healthcare engagement, including minimisation of health needs, administrative exclusion, lack of continuity, and stigma from professionals. Participants frequently described systems as inaccessible. Key enablers included supportive organisational staff and consistent, trusted relationships with specific providers. Areas for Improvement and Recommendations: Findings highlight the need to simplify registration processes, provide in-person options, and reduce reliance on digital communication. Greater continuity of care and gender-sensitive, trauma-informed approaches were consistently requested. Services should not be evaluated solely by uptake but by how well they accommodate marginalised users. Healthcare settings that prioritise safety, trust, and consistency were shown to improve engagement. SWs spoke of the work of accessing care, which for many was too hard to gain. Conclusions: SSWs are not disengaged from healthcare but are routinely excluded by systems that fail to meet their needs. Service redesign must begin from the realities of those who are most marginalised, through co-production, to reduce health inequity and build meaningful access. Full article

Background: Healthcare workers (HCWs) have experienced sustained occupational exposure to SARS-CoV-2 throughout the COVID-19 pandemic. While infection prevention and control (IPC) practices have been widely implemented, limited prospective data exist on how occupational exposure risk and adherence to protective practices evolve over time, particularly beyond the acute phases of the pandemic. This study aimed to prospectively assess occupational and community exposure risk to COVID-19 among HCWs and to evaluate temporal changes in adherence to IPC practices during routine care and aerosol-generating procedures. Methods: A prospective observational study was conducted among HCWs from four public hospitals in the region of Thessaly, Greece. Eligible participants were HCWs who reported contact with suspected or confirmed COVID-19 cases. The data were collected at baseline (January–March 2022) and at a six-month follow-up using the World Health Organization’s “Risk Assessment and Management of Exposure of Health Care Workers in the Context of COVID-19” questionnaire. The instrument captured demographic characteristics, professional roles, occupational and community exposure, and adherence to IPC practices. Results: A total of 203 HCWs participated in the study. The overall proportion of HCWs reporting occupational exposure was 72.9% in both assessments. Among HCWs with occupational exposure (n = 148), the proportion classified as high-risk showed a statistically significant increase from 76% (95% CI: 0.6951–0.8320) at baseline to 88% (95% CI: 0.8258–0.9310) at follow-up (p = 0.010). This shift reflects a substantial effect size, with the odds of high-risk classification being more than double at follow-up (OR = 2.24). Nurses consistently demonstrated higher risk compared with physicians. The overall use of personal protective equipment remained high. However, adherence to several IPC practices declined over time, including removal and replacement of PPE according to protocol and frequent decontamination of high-touch surfaces. Conclusions: Occupational exposure risk among HCWs remained substantial and increased over time despite stable occupational exposure estimates. The observed decline in adherence to key IPC measures highlights the need for continuous monitoring and reinforcement of protective practices in healthcare settings. Full article

Groundwater heavy metal contamination (GHMC) has drawn significant attention in China over recent decades due to industrialization. However, effective monitoring and early warning remain global challenges because of the limited understanding of heavy metal behavior in groundwater. This study conducts a detailed comparative analysis of heavy metals and conventional indicators using a long-term, high-frequency online monitoring program. Groundwater online monitoring is an automated system for real-time, continuous collection, and transmission of indicators via sensors and IoT platforms. Conventional indicators refer to the priority parameters used to assess basic water quality, hydrological characteristics and health risks in routine monitoring. Nineteen heavy metals and ten conventional indicators were monitored simultaneously, generating approximately 1.6 million data points over three years. The time series data show that online monitoring effectively captures abnormal changes in heavy metal levels. Abnormal heavy metal fluctuations appear as sharp, isolated spikes lasting at least several hours, while conventional indicators exhibit high-amplitude variations lasting over 30 h—indicating that heavy metal changes are harder to detect in a timely manner. Long-term comparisons also reveal low consistency between heavy metals and conventional indicators, supporting the need for independent heavy metal monitoring. In contrast, strong consistency among heavy metals suggests opportunities to streamline monitoring by selecting representative elements. Monitoring frequency optimization shows that daily measurement is sufficient for heavy metals, which is slightly more frequent than the typical three-day interval for most conventional indicators. Long-term data enable reliable early warnings for both indicator types, with predictions closely matching field observations. However, heavy metal alerts are shorter and less frequent than those for conventional indicators. Integrating both types into a unified early warning system enhances its comprehensiveness, accuracy and timeliness. This study provides a solid scientific foundation for efficient GHMC monitoring and early warning in groundwater in areas under the influence of industrial activities. Full article

Background: South Africa faces the world’s highest HIV burden, disproportionately affecting women, alongside rising Type 2 Diabetes (T2D). Weight gain associated with preferred dolutegravir (DTG)-based antiretroviral therapy may worsen obesity and T2D risk. This process evaluation explored the implementation of a 12-month time-restricted eating (TRE) intervention for weight management in women with HIV and overweight/obesity in Khayelitsha, Cape Town. Methods: Using the RE-AIM framework, the study investigated the implementation journey. Data were collected from three groups: RCT participants, healthcare workers (n = 21), and fieldworkers (n = 3). Methods included structured informal interviews with TRE participants throughout the intervention and semi-structured in-depth interviews (IDIs) with a subset (n = 19) at 12 months. IDIs and focus group discussions were conducted with healthcare staff. Results: Implementation faced significant contextual challenges, including high food insecurity, economic constraints, and high crime levels. Cultural norms around food hospitality also posed barriers. Despite this, TRE was highly feasible and acceptable. Participants reported positive behavioural changes, establishing eating routines and consuming healthier foods. Perceived health benefits included improved appetite control, wellbeing, sleep, and weight management. Key facilitators were the intervention’s flexibility and, importantly, the non-judgmental, empathetic support from fieldworkers, which drove engagement and retention. Healthcare workers expressed willingness to integrate TRE into existing HIV counsellor-led services, and nearly all participants desired to continue TRE post-intervention. Conclusions: This process evaluation demonstrates that TRE is a contextually suitable and acceptable intervention from an implementation perspective. Its success in practice, however, depends on mitigating complex multi-level barriers through a flexible program design and high-quality, relationship-focused support integrated into existing healthcare infrastructure. Trial registration: PACTR202302484999720, 8 February 2023. Full article

Background: Childhood obesity is a growing public health concern globally and is associated with a wide spectrum of comorbidities, including sleep-disordered breathing (SDB). SDB remains under-recognized in pediatric population with obesity, particularly in Middle Eastern settings, despite its significant impact on cognitive, behavioral, and metabolic health. Objectives: To assess the prevalence of SDB among children with obesity aged 6–12 years attending King Faisal University polyclinics in Saudi Arabia and to identify key demographic and anthropometric predictors, with particular emphasis on the mediating role of neck circumference. Methods: A cross-sectional study was conducted involving 130 children with obesity aged 6–12 years. Data collection included sociodemographic characteristics, anthropometric measurements (BMI percentile, neck and waist circumference), and screening for SDB using the validated Arabic version of the Pediatric Sleep Questionnaire Sleep-Related Breathing Disorder (PSQ-SRBD) scale. Logistic regression and mediation analyses were performed to examine associations and pathways between obesity parameters and SDB risk. Results: Of the 130 participants, 37.7% screened positive for SDB risk. SDB prevalence was higher among males and older children. Neck circumference and BMI percentile were independently associated with SDB risk, with neck circumference mediating the relationship between BMI and SDB. The mediation model indicated that increased BMI contributes to SDB risk both directly and indirectly through increased neck circumference. Conclusion: SDB is highly prevalent among obese Saudi children, and neck circumference is a significant mediator of risk. Incorporating SDB screening and neck circumference measurements into routine pediatric obesity care can facilitate early detection and management. These findings support the need for integrated, multidisciplinary approaches to improve pediatric health outcomes. Full article

Dengue and chikungunya are endemic arboviral diseases in many low- and middle-income countries, often co-circulating and presenting with overlapping symptoms that hinder early diagnosis. Timely differentiation is critical, especially in resource-limited settings where laboratory testing is unavailable. We developed and evaluated machine-learning (ML)- and deep-learning (DL) models to classify dengue, chikungunya, and discarded cases using a large-scale, real-world dataset of over 6.7 million entries from Brazil (2013–2020). After applying the Synthetic Minority Oversampling Technique (SMOTE) to address class imbalance, we trained six ML models and one artificial neural network (ANN) using only demographic, clinical, and comorbidity features. The Random Forest model achieved strong multi-class classification performance (Recall: 0.9288, the Area Under the Curve (AUC): 0.9865). The ANN model excelled in identifying chikungunya cases (Recall: 0.9986, AUC: 0.9283), suggesting its suitability for rapid screening. External validation confirmed the generalizability of our models, particularly for distinguishing discarded cases. Our models demonstrate high-accuracy in differentiating dengue and chikungunya using routinely collected clinical and epidemiological data. This work supports the development of Artificial Intelligence-powered decision-support tools to assist frontline healthcare workers in under-resourced settings and aligns with the One Health approach to improving surveillance and diagnosis of neglected tropical diseases. Full article

Background and objectives: Low bone mineral density (BMD) is a recognized complication in people living with HIV (PLHIV) that remains under-addressed, particularly in Malaysia. Known contributing factors for low BMD include advanced age, HIV infection itself, and prolonged use of anti-retroviral therapy (ART), particularly tenofovir-based regimens. There are limited data on the burden of low BMD in the HIV population in Malaysia. This study aimed to determine the prevalence of low BMD among men living with HIV on tenofovir disoproxil fumarate (TDF) and to identify the possible associated factors compared to a group of healthy individuals matched for age and ethnicity. Methods: This is single-center cross-sectional study involved 112 men (56 HIV-positive individuals and 56 uninfected individuals matched for age and ethnicity) who underwent dual-energy X-ray absorptiometry (DXA) scans of the femoral neck and lumbar spine. Sociodemographic, clinical lifestyle, and laboratory data, including FRAX scores for those aged more than 40 years old, were collected. Results: The prevalence of low BMD at the femoral neck in HIV-infected men on tenofovir disoproxil fumarate was significantly higher compared to healthy individuals (32.1% vs. 16.1%; p < 0.05). Low BMD prevalence at the lumbar spine was higher in the HIV group (8.9% vs. 3.6%; p = 0.463) but was not statistically significant. Older age and low body mass index (BMI) were found to be significantly associated with reduced BMD in HIV patients. Chronic kidney disease stage 2 and 3a was linked with low femoral neck BMD. HIV-related factors (duration of illness, duration of ART exposure, and CD4+ counts) showed no significant associations to low BMD. The 10-year risk of major osteoporotic and hip fractures estimated by the FRAX tool was low in both groups, and no participant exceeded the recommended intervention threshold. Conclusions: Men with HIV on tenofovir disoproxil fumarate have a higher prevalence of low BMD, particularly at the femoral neck. Traditional risk factors were more closely associated with low BMD compared to HIV-related factors and specific markers, supporting the need for routine bone health screening and preventive strategies in this population. Full article

Background: Spondyloarthritis (SpA) typically develops before 40 years of age, but increasing life expectancy has led to a growing number of cases in older adults. It is well known that age at onset may influence disease presentation, comorbidities, and patient outcomes. Objectives: To assess whether age at onset influences SpA clinical presentation. Methods: We analyzed clinical, demographic, clinimetric, and imaging data in 272 SpA patients, grouped by onset age: early (≤40, n = 119), intermediate (41–59, n = 127), and late (≥60, n = 26). All patients had a minimum follow-up duration of 12 months. Their epidemiologic, clinic, and clinimetric data were collected, as well as patient-reported outcome measures (PROs) [Patient Global Assessment (PGA), Health Assessment Questionnaire (HAQ), FACIT-Fatigue (FACIT-F), SHORT-FORM 36 (SF-36), Hospital Anxiety and Depression Scale (HADS), Work Productivity and Activity Impairment Questionnaire (WPAI), CSI (Central Sensitization Inventory), and Psoriatic Arthritis Impact of Disease (PsAID) questionnaire]. In univariate analyses, differences in categorical variables across onset groups were assessed using Fisher’s exact test; for continuous variables, between-group comparisons were performed using the Mann–Whitney U test (two-tailed) or the Kruskal–Wallis test, as appropriate, with Bonferroni correction for post hoc analyses. Multivariable regression models were subsequently fitted, adjusting for sex, diagnosis, and disease duration. For binary outcomes, multivariable logistic regression models were used, while multivariable linear regression models (ANCOVA) were applied for continuous outcomes. The overall association between onset group and each outcome was formally tested using likelihood ratio tests, comparing models including the onset variable with nested models excluding it. A p-value < 0.05 was considered statistically significant. Results: Patients’ mean age was 60.0 ± 13.7 years; 55.9% of them were males; and there were 188 cases (69.1%) of psoriatic arthritis (PsA) and 84 cases (30.9%) of ankylosing spondylitis (AS). In early-onset patients, inflammatory back pain (IBP) was more frequent, whereas late-onset patients more often presented with joint swelling. A family history of SpA and psoriasis was less common in late-onset forms. Comorbidities, including osteoporosis, osteoarthritis, hypertension, hyperuricemia, and diabetes, were more prevalent in older-onset patients, resulting in a higher overall comorbidity burden in Groups 2 and 3. Patient-reported outcomes were largely similar across age groups, although work activity limitation was more pronounced in younger patients. Conclusions: Age at onset seems to influence SpA phenotypes: early-onset could favor axial involvement, while late-onset may associate with peripheral arthritis. Late-onset forms are associated with a more severe comorbidity burden, in particular for cardiovascular risk factors. Lung involvement proved to be more prevalent with respect to the general population, so it should be checked in the routinary assessment of SpA patients. These findings suggest that rheumatologists could tailor their routine assessments based on patients’ age at disease onset. Interestingly, work productivity seems more impacted in early-onset patients. All these points highlight the importance of age at disease onset in SpA, guiding toward personalized medicine in terms of follow-up, therapy, and more holistic patient management. Full article

Background/Objectives: Adequate hydration is essential for health; however, water consumption behaviors are influenced not only by physiological needs but also by hydration knowledge and perceptions of drinking water quality. Empirical evidence examining these factors in Eastern European populations remains limited. This study aimed to assess hydration knowledge, water consumption patterns, and attitudes toward drinking water quality among adults in Romania, and to examine their associations with daily water intake and water source preferences. Methods: A cross-sectional study was conducted between November 2024 and November 2025 among adults residing in Romania. Data were collected from 165 participants using an anonymous, self-developed, paper-based questionnaire administered in person to adult patients attending routine visits in four primary care clinics in Arad, Romania, using a convenience sampling approach. The questionnaire assessed sociodemographic characteristics, hydration knowledge, water consumption behaviors, and attitudes toward drinking water quality. Descriptive statistics, chi-square tests, correlation analyses, and multivariable linear and logistic regression models were applied to identify factors associated with daily water intake, adequate hydration (≥2 L/day), and bottled water consumption. Results: Hydration knowledge was moderate overall and was significantly associated with education level and gender. Higher hydration knowledge was positively correlated with daily water intake (r = 0.21, p = 0.006) and was independently associated with higher intake and adequate hydration (OR = 1.28, 95% CI: 1.10–1.49; p = 0.002). Greater trust in tap water was also positively associated with daily intake (r = 0.27, p = 0.001) and adequate hydration (OR = 1.31, 95% CI: 1.12–1.54; p < 0.001). Lower trust in tap water and stronger beliefs regarding bottled water were significant predictors of bottled water use as the primary drinking water source. Education level emerged as a consistent predictor across multiple hydration-related outcomes. Conclusions: Hydration knowledge and perceptions of drinking water quality are key, modifiable factors associated with water consumption behaviors. Educational strategies integrated into primary care and transparent communication regarding tap water safety may support adequate and sustainable hydration among adults. Full article

Background: Vaccines save lives, but only if they are available at health facilities for administration. Stockouts occur for various reasons, including inaccurate forecasting and resupply calculations. Population-based forecasts are typically used for immunization programs, yet they are often based on inaccurate population estimates. This retrospective study analyzed available routine facility-level data from two districts in Mozambique to provide insights for improved supply chain management, including resupply decisions, at the facility level. Methodology: Data from August to October 2023 were collected and analyzed for wastage rate, session cohort, and forecast accuracy. Results: The results show that district-level wastage rates are nominally different from globally acceptable standards, while being significantly different at the facility level. Analysis also showed divergence of vaccination doses provided to a session cohort during the month-long periods that appear to be correlated with periods of stockout. Using population-based forecasting for resupply methodology consistently undersupplied facilities by 20% (ranging from 5 to 41% across 16 facilities), while using the number of doses of administered BCG as a proxy for the population oversupplied by 12% (ranging from 1% underforecast and 28% overforecast), with tighter variance. Conclusions: Despite limitations due to the availability and quality of data, the results suggest an opportunity to shift from a traditional population-based approach to forecasting and resupply decisions, leveraging existing data systems, applying tailored wastage rates, and adjusting inventory management policies to ensure vaccine availability. Full article

Background/Objectives: Institutional catering serves vulnerable populations, including schoolchildren. Surfaces in food preparation environments are key control points for food safety and reservoirs and transmission routes for antimicrobial-resistant (AMR) bacteria. This study characterized the hygienic status of food-contact surfaces (FCS) and non-food-contact surfaces (NFCS) in Hungarian school kitchens, identified contamination hotspots, and examined how routine monitoring can support AMR prevention. Methods: We retrospectively analyzed routine environmental hygiene monitoring records from 96 school kitchens (2019–2024). In total, 8412 swab samples were collected, 8407 had quantifiable counts, 6233 from FCS (e.g., plates, trays, boards, utensils), and 2174 from NFCS (e.g., sinks, fridges, workers’ hands). Total aerobic mesophilic counts were measured with a redox-potential method and expressed as CFU/100 cm²; 250 CFU/100 cm² (2.4 log₁₀) was the hygienic threshold. Results: Overall, 12.4% of surfaces exceeded the threshold. Non-food-contact surfaces were more likely to be non-compliant than food-contact surfaces (OR 2.77, 95% CI 2.43–3.17; p < 0.001). Hotspots included transport-container lids (67.2% non-compliant; OR 43.82), sink basins (32.8%; OR 10.46), and cutting boards (21.6%; OR 5.89). Seasonally, non-compliance was highest in summer (16.5%) and lowest in winter (9.0%; p < 0.001). Conclusions: Multi-year monitoring revealed substantial contamination concentrated in a few hotspots that, within a One Health framework—which recognizes the interconnectedness of human, animal, and environmental health—may represent environmental reservoirs and cross-contamination nodes relevant to AMR prevention. Targeted optimization of cleaning and disinfection for these surfaces, combined with trend analysis of indicator data and periodic AMR-focused environmental sampling, could reduce foodborne and AMR-related risks in public catering. Full article

Family caregivers provide up to 90% of care in Alberta’s communities and play an essential role in sustaining the province’s health and social care systems, yet they remain under-recognized and insufficiently supported. To address this gap, we co-designed the Alberta Family Caregiver Strategy and Action Plan (2024–2025), a provincial framework developed through participatory research and collective impact methods. Guided by principles of co-production, equity, and lived experience, the project engaged over 500 stakeholders, including caregivers, healthcare providers, educators, employers, and policymakers, through Phase 1 interviews (health/community leaders, n = 44; Family and Community Support Services (FCSS), n = 47; navigation experts, n = 9), Phase 2 co-design team consultations, and Phase 3 sector roundtables (n = 52). Using reflexive thematic analysis, we identified four foundational caregiver strategies, Recognition, Partnership, Needs Assessment, and Navigation, and four enabling conditions: Education, Workplace Supports, Policy and Research and Data Infrastructure. These elements were synthesized into an eight-priority Alberta Caregiver Strategy and Action Plan Framework, a practical way to connect validated priorities with coordinated, measurable implementation across settings. Participants emphasized four key enablers essential to making caregiver inclusion more feasible and sustainable: education, workplace supports, policy infrastructure, and research and evaluation. Findings highlight strong cross-sector consensus that caregiver inclusion must be embedded into routine practice, supported by consistent policy, and reinforced through provincial coordination with local adaptation. The Alberta Family Caregiver Strategy provides a practical, evidence-informed plan for transforming fragmented supports into a coherent, caregiver-inclusive ecosystem that strengthens both caregiver well-being and system sustainability. Full article

Background/Objectives: This study aimed to describe changes in physical performance and nutritional status among frail adults at risk of falls receiving muscle-targeted oral nutritional supplementation (MT-ONS) as part of routine clinical care. Methods: A prospective, open-label, single-centre, uncontrolled, descriptive study was conducted in a real-world clinical setting. Patients ≥ 70 years attending an outpatient fall clinic were consecutively recruited and assessed at baseline and after at least 90 days of MT-ONS (100% whey protein enriched with leucine and vitamin D), provided as part of a comprehensive care plan including exercise recommendations, medication review, and home adaptation advice. Sociodemographic, physical performance [Short Physical Performance Battery (SPPB)], nutritional status [Mini Nutritional Assessment-Short Form, (MNA^®-SF)], walking ability [Functional Ambulation Categories (FACs)], number of falls, muscle strength (dynamometry), body composition (Tanita), health-related quality-of-life (SF-12), functional capacity (Barthel Index), and adherence data were collected. Statistics analyses were descriptive and exploratory. Results: Twenty-six participants were assessed (58% women, age: 82.1 ± 5.4 years). Mean SPPB score increased from 7.3 (±3.6) to 8.0 (±4.0) (p = 0.3). At baseline, 35% were malnourished, 42% at risk of malnutrition, and 23% well-nourished. After ≥90 days of MT-ONS, 4% were malnourished, 54% at risk, and 42% well-nourished. The number of falls decreased from 1.2 falls/month (±0.9) to 0.2 falls/month (±0.3, p < 0.0001). Favourable changes in physical performance were positively correlated with improvements in nutritional status (p = 0.03). Adherence was high (92%), largely attributed to pleasant taste (71%) and smell (58%) and positive health perceptions (58%). Conclusions: In routine clinical practice, frail adults at risk of falls who received MT-ONS, 100% whey protein enriched with leucine and vitamin D for ≥90 days, as part of a comprehensive care plan improved their physical performance and nutritional status and reduced the number of falls. These findings should be interpreted as preliminary. Full article

Background/Objectives: Child undernutrition remains a major public health in Djibouti, yet conventional anthropometric indicators may underestimate its true burden by failing to capture overlapping forms of malnutrition. The Composite Index of Anthropometric Failure (CIAF) provides a more comprehensive assessment by identifying children experiencing one or multiple anthropometric deficits. This study aimed to estimate the prevalence and determinants of undernutrition among children under five years of age in Djibouti using the CIAF. Methods: This study is a secondary analysis of data from the nationally representative 2023 Multisectoral Survey conducted in Djibouti. A cross-sectional design with a two-stage stratified cluster sampling method was used to collect data on a national random sample (n = 2103) of children aged 6–59 months. Standardized anthropometric measurements were used to derive conventional indicators (stunting, wasting, and underweight) and the CIAF. Binary logistic regression analyses were performed to identify factors associated with anthropometric failures, adjusting for child, household, and contextual characteristics. Results: Based on conventional indicators, 23.4% of children were stunted, 20.0% were underweight, and 9.9% were wasted. Using the CIAF, 36.9% of children experienced at least one anthropometric failure, including 18.8% with multiple concurrent failures. Boys, children aged 6–47 months, those living in nomadic households, and those residing in specific regions had significantly higher risks of undernutrition. Socioeconomic indicators and household food security were not independently associated with undernutrition after adjustment. Conclusions: More than one-third of children under five in Djibouti experience undernutrition when assessed using the CIAF, revealing a substantial hidden burden not captured by conventional indicators alone. Incorporating the CIAF into routine nutrition surveillance could improve identification of vulnerable children and support more targeted, context-specific interventions. Full article

Background/Objectives: Childhood overweight and obesity are influenced by family-level behaviors related to nutrition, physical activity, and daily routines. This study aimed to In contrast to screen time family nutrition and physical activity practices for overweight and obesity among children aged 6–17 years in Türkiye. Methods: A cross-sectional study was conducted with 214 children recruited from a community setting. Sociodemographic data and anthropometric measurements were collected, and family practices were assessed using the Family Nutrition and Physical Activity Scale–Turkish version (FNPA-TR). Binary logistic regression analyses were performed separately for overweight and obesity outcomes. Results: Healthier beverage choices were the only significant predictor of overweight, reducing the odds by 62%. Obesity was predicted by three FNPA domains: family meal frequency, family eating habits, and screen time. Frequent family meals and healthier eating habits were associated with lower obesity risk, whereas higher screen exposure increased the likelihood of obesity. Conclusions: Beverage choices, family meal patterns, eating habits, and screen exposure emerged as key behavioral predictors of unhealthy weight status in children. These findings highlight key family-centered prevention targets for pediatric nursing and public health, including promoting healthy beverage consumption, strengthening structured family eating routines, and reducing screen exposure in children. Full article