{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T21:09:28Z","timestamp":1792012168277,"version":"4.4.0"},"reference-count":61,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2023,10,24]],"date-time":"2023-10-24T00:00:00Z","timestamp":1698105600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100003329","name":"Ministerio de Econom\u00eda y Competitividad","doi-asserted-by":"publisher","award":["1380358"],"award-info":[{"award-number":["1380358"]}],"id":[{"id":"10.13039\/501100003329","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100023561","name":"Ministerio de Universidades","doi-asserted-by":"publisher","award":["FPU20\/01567"],"award-info":[{"award-number":["FPU20\/01567"]}],"id":[{"id":"10.13039\/501100023561","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Public Health"],"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>To determine whether the different pelvic floor disorders are associated with changes in perceived quality of life (QoL), globally and in its sub-dimensions.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>An observational study was conducted with women in Spain between 2021 and 2022. Information was collected using a self-developed questionnaire on sociodemographic data, employment, history and health status, lifestyle and habits, obstetric history, and health problems. The SF-12 questionnaire was used to assess quality of life. The Pelvic Floor Distress Inventory (PFDI-20) was used to assess the presence and impact of pelvic floor problems, and includes the POPDI-6 subscales for prolapse, CRADI- 8 for colorectal symptoms, and UDI-6 for urinary symptoms. Crude (MD) and adjusted mean differences (aMD) were estimated with their respective 95% confidence intervals (CI).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Thousand four hundred and forty six women participated in the study with a mean age of 44.27 (SD = 14.68). A statistical association was observed between all the pelvic floor disorders and QoL, overall and in all its dimensions (<jats:italic>p<\/jats:italic> &amp;lt;<jats:italic>0<\/jats:italic>.001), in the bivariable analysis. The lowest scores were observed in the emotional component. After adjusting for confounding factors, the pelvic floor disorders in general (aMD \u22120.21, 95% CI: \u22120.23 to \u22120.20), the impact of uterine prolapse symptoms (aMD \u22120.20, 95% CI: \u22120.27 to \u22120.12), the colorectal-anal symptoms (aMD \u22120.15, 95% CI: \u22120.22 to \u22120.09), and urinary symptoms (aMD \u22120.07, 95% CI: \u22120.13 to \u22120.03) was negatively associated on the score on the SF-12 questionnaire (<jats:italic>p<\/jats:italic> &amp;lt;<jats:italic>0<\/jats:italic>.05).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Women who have a pelvic floor dysfunction, symptoms of pelvic organ prolapse, colorectal-anal symptoms, or urinary symptoms, have a worse perceived quality of life in all dimensions. Prolapse symptoms have the biggest impact, and the emotional component of QoL is the most affected sub-domains.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fpubh.2023.1180907","type":"journal-article","created":{"date-parts":[[2023,10,25]],"date-time":"2023-10-25T09:30:05Z","timestamp":1698226205000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":56,"title":["Influence of pelvic floor disorders on quality of life in women"],"prefix":"10.3389","volume":"11","author":[{"given":"Roc\u00edo Adriana","family":"Peinado Molina","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antonio","family":"Hern\u00e1ndez Mart\u00ednez","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sergio","family":"Mart\u00ednez V\u00e1zquez","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Juan Miguel","family":"Mart\u00ednez Galiano","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2023,10,24]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"141","DOI":"10.1097\/AOG.0000000000000057","article-title":"Prevalence and trends of symptomatic pelvic floor disorders in US women","volume":"123","author":"Wu","year":"2014","journal-title":"Obstet Gynecol."},{"key":"B2","doi-asserted-by":"publisher","first-page":"143","DOI":"10.4103\/GMIT.GMIT_7_19","article-title":"Current treatments for female pelvic floor dysfunctions","volume":"8","author":"Hong","year":"2019","journal-title":"Gynecol Minim Invasive Ther."},{"key":"B3","doi-asserted-by":"publisher","first-page":"27","DOI":"10.1186\/s12905-022-01609-0","article-title":"Prevalence of pelvic floor dysfunction: a Saudi national survey","volume":"22","author":"Al-Badr","year":"2022","journal-title":"BMC Womens Health."},{"key":"B4","unstructured":"Dysfunction of pelvic and sexual floor in women125\n            P\u00e9rez RodriguezNM\n            Mart\u00ednez TorresJC\n            Garc\u00eda DelgadoJ\u00c1\n            Rodr\u00edguez AdamsEM\n            Rodr\u00edguez LaraH\n          Invest Medicoquir.112019"},{"key":"B5","doi-asserted-by":"publisher","first-page":"527","DOI":"10.1016\/j.ogc.2019.04.010","article-title":"Pelvic floor disorders","volume":"46","author":"Good","year":"2019","journal-title":"Obstet Gynecol Clin North Am."},{"key":"B6","doi-asserted-by":"publisher","first-page":"e0172054","DOI":"10.1371\/journal.pone.0172054","article-title":"Female reproductive factors are associated with objectively measured physical activity in middle-aged women","volume":"12","author":"Laakkonen","year":"2017","journal-title":"PLoS ONE."},{"key":"B7","doi-asserted-by":"publisher","first-page":"334","DOI":"10.1002\/nau.24563","article-title":"Depression, anxiety, and stress in women with urinary incontinence with or without myofascial dysfunction in the pelvic floor muscles: a cross-sectional study","volume":"40","author":"Reis","year":"2021","journal-title":"Neurourol Urodyn."},{"key":"B8","doi-asserted-by":"publisher","first-page":"299","DOI":"10.1111\/ggi.13618","article-title":"Effect of pelvic floor dysfunction on sexual function and quality of life in Chinese women of different ages: an observational study","volume":"19","author":"Zhu","year":"2019","journal-title":"Geriatr Gerontol Int."},{"key":"B9","doi-asserted-by":"publisher","first-page":"1872","DOI":"10.1177\/0898264318799223","article-title":"Urinary incontinence is associated with physical performance decline in community-dwelling older women: results from the international mobility in aging study","volume":"31","author":"Corr\u00eaa LC de","year":"2019","journal-title":"J Aging Health."},{"key":"B10","doi-asserted-by":"publisher","first-page":"588","DOI":"10.1016\/j.ajog.2019.11.1285","article-title":"Pelvic organ prolapse surgery and quality of life\u2014A nationwide cohort study","volume":"222","author":"Mattsson","year":"2020","journal-title":"Am J Obstet Gynecol"},{"key":"B11","doi-asserted-by":"publisher","first-page":"621","DOI":"10.1016\/j.gastrohep.2010.07.003","article-title":"Calidad de vida en pacientes con incontinencia fecal y su relaci\u00f3n con la gravedad de la misma","volume":"33","author":"Ciriza","year":"2010","journal-title":"Gastroenterol Hepatol."},{"key":"B12","doi-asserted-by":"publisher","first-page":"10","DOI":"10.1590\/s1980-220x2016032603266","article-title":"Impacto dos tipos de incontin\u00eancia urin\u00e1ria na qualidade de vida de mulheres","volume":"51","author":"Saboia","year":"2017","journal-title":"Revista da Escola de Enfermagem da USP."},{"key":"B13","doi-asserted-by":"publisher","first-page":"887","DOI":"10.1007\/s00192-020-04410-5","article-title":"Health-related quality of life in parous women with pelvic organ prolapse and\/or urinary incontinence in Bangladesh","volume":"32","author":"Imoto","year":"2021","journal-title":"Int Urogynecol J."},{"key":"B14","doi-asserted-by":"publisher","first-page":"1087","DOI":"10.1007\/s00192-021-04725-x","article-title":"Interventional treatment for myofascial pelvic floor pain in women: systematic review with meta-analysis","volume":"32","author":"Frederice","year":"2021","journal-title":"Int Urogynecol J."},{"key":"B15","doi-asserted-by":"publisher","first-page":"102032","DOI":"10.1016\/j.jogoh.2020.102032","article-title":"Importance of a pelvic floor lifestyle program in women with pelvic floor dysfunctions: a pilot study","volume":"50","author":"Blanchard","year":"2021","journal-title":"J Gynecol Obstet Hum Reprod."},{"key":"B16","doi-asserted-by":"publisher","first-page":"127","DOI":"10.1067\/mob.2003.548","article-title":"The functional and psychosocial impact of fecal incontinence on women with urinary incontinence","volume":"189","author":"Fialkow","year":"2003","journal-title":"Am J Obstet Gynecol."},{"key":"B17","doi-asserted-by":"publisher","first-page":"95","DOI":"10.1186\/s12905-018-0585-1","article-title":"One in five women suffer from pelvic floor disorders in Kersa district Eastern Ethiopia: a community-based study","volume":"18","author":"Dheresa","year":"2018","journal-title":"BMC Womens Health."},{"key":"B18","doi-asserted-by":"publisher","first-page":"551","DOI":"10.1017\/S0033291798006667","article-title":"Development of the world health organization WHOQOL-BREF quality of life assessment","volume":"28","year":"1998","journal-title":"Psychol Med"},{"key":"B19","doi-asserted-by":"publisher","first-page":"411","DOI":"10.1016\/j.aprim.2008.10.019","article-title":"La calidad de vida relacionada con la salud","volume":"41","author":"Liz\u00e1n Tudela","year":"2009","journal-title":"Aten Primaria."},{"key":"B20","doi-asserted-by":"publisher","first-page":"1517","DOI":"10.4067\/S0717-95022013000400059","article-title":"Calidad de vida relacionada con salud: una variable resultado a considerar en investigaci\u00f3n cl\u00ednica","volume":"31","author":"Manterola D","year":"2013","journal-title":"Int J Morphol."},{"key":"B21","doi-asserted-by":"publisher","first-page":"202004023","DOI":"10.4321\/S1135-57272020000100011","article-title":"Calidad de vida relacionada con la salud y h\u00e1bitos de vida: diferencias entre adolescentes migrantes y aut\u00f3ctonos","volume":"94","author":"Jim\u00e9nez Boraita","year":"2020","journal-title":"Rev Esp Salud Publica."},{"key":"B22","doi-asserted-by":"publisher","first-page":"675","DOI":"10.1016\/j.soc.2018.05.008","article-title":"Health-related quality of life","volume":"27","author":"Sitlinger","year":"2018","journal-title":"Surg Oncol Clin N Am."},{"key":"B23","doi-asserted-by":"publisher","first-page":"1078","DOI":"10.1097\/01.mlr.0000182493.57090.c1","article-title":"Self-reported health status of the general adult US population as assessed by the EQ-5D and health utilities index","volume":"43","author":"Luo","year":"2005","journal-title":"Med Care."},{"key":"B24","doi-asserted-by":"publisher","first-page":"1171","DOI":"10.1097\/MLR.0b013e3181354828","article-title":"Mode of administration is important in us national estimates of health-related quality of life","volume":"45","author":"Hanmer","year":"2007","journal-title":"Med Care."},{"key":"B25","doi-asserted-by":"publisher","first-page":"1162","DOI":"10.1097\/MLR.0b013e31814848f1","article-title":"US norms for six generic health-related quality-of-life indexes from the national health measurement study","volume":"45","author":"Fryback","year":"2007","journal-title":"Med Care."},{"key":"B26","doi-asserted-by":"publisher","first-page":"1115","DOI":"10.1007\/s11136-010-9673-x","article-title":"Gender differences in health-related quality-of-life are partly explained by sociodemographic and socioeconomic variation between adult men and women in the US: evidence from four US nationally representative data sets","volume":"19","author":"Cherepanov","year":"2010","journal-title":"Qual Life Res."},{"key":"B27","doi-asserted-by":"publisher","first-page":"2367","DOI":"10.1016\/j.socscimed.2006.06.017","article-title":"Gender differences in health-related quality of life among the elderly: the role of objective functional capacity and chronic conditions","volume":"63","author":"Orfila","year":"2006","journal-title":"Soc Sci Med."},{"key":"B28","doi-asserted-by":"publisher","first-page":"143","DOI":"10.1186\/1477-7525-8-143","article-title":"Health status of the advanced elderly in six european countries: results from a representative survey using EQ-5D and SF-12","volume":"8","author":"K\u00f6nig","year":"2010","journal-title":"Health Qual Life Outcomes."},{"key":"B29","doi-asserted-by":"publisher","first-page":"68","DOI":"10.1186\/s12955-016-0471-1","article-title":"The impact of health literacy and life style risk factors on health-related quality of life of Australian patients","volume":"14","author":"Jayasinghe","year":"2016","journal-title":"Health Qual Life Outcomes."},{"key":"B30","doi-asserted-by":"publisher","first-page":"890","DOI":"10.1249\/01.MSS.0000126778.77049.76","article-title":"Associations between physical activity dose and health-related quality of life","volume":"4","author":"Brown","year":"2004","journal-title":"Med Sci Sports Exerc."},{"key":"B31","doi-asserted-by":"publisher","first-page":"45","DOI":"10.2147\/DMSO.S34835","article-title":"Impact of physical activity and bodyweight on health-related quality of life in people with type 2 diabetes","volume":"303","author":"Eckert","year":"2012","journal-title":"Diabetes Metab Syndr Obes."},{"key":"B32","doi-asserted-by":"publisher","first-page":"10243","DOI":"10.1007\/s00520-022-07429-0","article-title":"Sleep and health-related quality of life in women following a cancer diagnosis: results from the Women's Wellness after Cancer Program in Australia","volume":"30","author":"Edmed","year":"2022","journal-title":"Support Care Cancer."},{"key":"B33","doi-asserted-by":"publisher","first-page":"101","DOI":"10.1016\/j.srhc.2015.01.005","article-title":"Health-related quality of life five years after birth of the first child","volume":"6","author":"Carlander","year":"2015","journal-title":"Sex Reprod Healthcare."},{"key":"B34","doi-asserted-by":"publisher","first-page":"324","DOI":"10.3390\/jcm8030324","article-title":"Quality of life of women after giving birth: associated factors related with the birth process","volume":"8","author":"Mart\u00ednez-Galiano","year":"2019","journal-title":"J Clin Med."},{"key":"B35","doi-asserted-by":"publisher","first-page":"726","DOI":"10.1157\/13121076","article-title":"Interpretaci\u00f3n de los cuestionarios de salud SF-36 y SF-12 en Espa\u00f1a: componentes f\u00edsico y mental","volume":"130","author":"Vilagut","year":"2008","journal-title":"Med Clin."},{"key":"B36","doi-asserted-by":"publisher","first-page":"704","DOI":"10.1111\/j.1600-0412.2012.01396.x","article-title":"Pelvic organ prolapse contributes to sexual dysfunction: a cross-sectional study","volume":"91","author":"Athanasiou","year":"2012","journal-title":"Acta Obstet Gynecol Scand."},{"key":"B37","doi-asserted-by":"publisher","first-page":"281","DOI":"10.1016\/j.ejogrb.2013.07.006","article-title":"Cultural adaptation and validation of the Pelvic Floor Distress Inventory short form (PFDI-20) and Pelvic Floor Impact Questionnaire short form (PFIQ-7) Spanish versions","volume":"170","author":"S\u00e1nchez-S\u00e1nchez","year":"2013","journal-title":"Eur J Obstet Gynecol Reprod Biol."},{"key":"B38","doi-asserted-by":"publisher","first-page":"48","DOI":"10.1016\/S1138-6045(07)73665-1","article-title":"El Cuestionario Internacional de Actividad F\u00edsica. Un instrumento adecuado en el seguimiento de la actividad f\u00edsica poblacional Revista Iberoamericana de Fisioterapia y","volume":"10","author":"Mantilla Toloza","year":"2007","journal-title":"Kinesiolog"},{"key":"B39","doi-asserted-by":"publisher","first-page":"929","DOI":"10.1007\/s00296-014-2960-z","article-title":"Reliability and validity of the Spanish version of the Pittsburgh sleep quality index (PSQI) in patients with fibromyalgia","volume":"34","author":"Hita-Contreras","year":"2014","journal-title":"Rheumatol Int."},{"key":"B40","doi-asserted-by":"publisher","first-page":"1155","DOI":"10.1093\/sleep\/29.9.1155","article-title":"Recommendations for a standard research assessment of insomnia","volume":"29","author":"Buysse","year":"2006","journal-title":"Sleep."},{"key":"B41","doi-asserted-by":"publisher","first-page":"2657","DOI":"10.1007\/s00192-021-04748-4","article-title":"Pelvic floor distress inventory (PFDI)\u2014systematic review of measurement properties","volume":"32","author":"de Arruda","year":"2021","journal-title":"Int Urogynecol J."},{"key":"B42","doi-asserted-by":"publisher","first-page":"272","DOI":"10.13109\/zptm.2020.66.3.272","article-title":"Validierung der Messung gesundheitsbezogener Lebensqualit\u00e4t mittels des Short-Form-Health-Survey-12 (SF-12 Version 20) in einer deutschen","volume":"66","author":"Drixler","year":"2020","journal-title":"Normstichprobe Z Psychosom Med Psychother."},{"key":"B43","doi-asserted-by":"publisher","first-page":"343","DOI":"10.1111\/j.1467-842X.2002.tb00182.x","article-title":"The SF-12 in the Australian population: cross-validation of item selection","volume":"26","author":"Sanderson","year":"2002","journal-title":"Aust N Z J Public Health."},{"key":"B44","doi-asserted-by":"publisher","first-page":"12","DOI":"10.1111\/nmo.14511","article-title":"Spanish translation and validation of a hybrid, health-related quality of life questionnaire for chronic esophageal conditions: NEQOL-S","volume":"3","author":"Oleas","year":"2022","journal-title":"Neurogastroenterol Motil."},{"key":"B45","doi-asserted-by":"publisher","first-page":"8325","DOI":"10.1038\/s41598-022-12043-5","article-title":"Spanish cross-cultural adaptation and validation of the Australian pelvic floor questionnaire in running women","volume":"12","author":"Molina-Torres","year":"2022","journal-title":"Sci Rep."},{"key":"B46","doi-asserted-by":"publisher","first-page":"81","DOI":"10.29063\/ajrh2020\/v24i1.8","article-title":"Association between non-competitive physical exercise and menstrual disorders","volume":"24","author":"Peinado-Molina","year":"2020","journal-title":"Afr J Reprod Health"},{"key":"B47","doi-asserted-by":"publisher","first-page":"518","DOI":"10.21037\/apm-20-2462","article-title":"Cross-sectional study on the SF-36, the general self- efficacy, the social support, and the health promoting lifestyle of the young elderly in a community in Shanghai","volume":"10","author":"Zhu","year":"2021","journal-title":"Ann Palliat Med."},{"key":"B48","doi-asserted-by":"publisher","first-page":"1515","DOI":"10.1007\/s11136-013-0586-3","article-title":"comparison of SF-36 summary measures of physical and mental health for women across the life course","volume":"23","author":"Mishra","year":"2014","journal-title":"Qual Life Res."},{"key":"B49","doi-asserted-by":"publisher","first-page":"30","DOI":"10.1186\/s12905-017-0387-x","article-title":"Quality of life of breast and cervical cancer survivors","volume":"17","author":"Huang","year":"2017","journal-title":"BMC Womens Health."},{"key":"B50","doi-asserted-by":"publisher","first-page":"120","DOI":"10.1186\/1471-2458-9-120","article-title":"Role of educational level in the relationship between Body Mass Index (BMI) and health-related quality of life (HRQL) among rural Spanish women","volume":"9","author":"Garc\u00eda-Mendiz\u00e1bal","year":"2009","journal-title":"BMC Public Health."},{"key":"B51","doi-asserted-by":"publisher","first-page":"175","DOI":"10.1186\/s12916-014-0175-5","article-title":"Weight loss required by the severely obese to achieve clinically important differences in health-related quality of life: 2-year prospective cohort study","volume":"12","author":"Warkentin","year":"2014","journal-title":"BMC Med."},{"key":"B52","doi-asserted-by":"publisher","first-page":"2717","DOI":"10.1007\/s10067-019-04613-2","article-title":"Prevalence of comorbidities and their associations with health-related quality of life and healthcare expenditures in patients with rheumatoid arthritis","volume":"38","author":"An","year":"2019","journal-title":"Clin Rheumatol."},{"key":"B53","doi-asserted-by":"publisher","first-page":"21","DOI":"10.1097\/NCC.0000000000001070","article-title":"Ruiz-de-Alegr\u00eda B, L\u00f3pez-Vivanco G, Garc\u00eda-Vivar C, Iraurgi I. Differences in quality of life and emotional well-being in breast, colon, and lung cancer patients during outpatient adjuvant chemotherapy: a longitudinal study","volume":"4","author":"Ulibarri-Ochoa","year":"2022","journal-title":"Cancer Nurs."},{"key":"B54","doi-asserted-by":"publisher","first-page":"8411","DOI":"10.3390\/ijerph17228411","article-title":"Quality of life in a cohort of 1078 women diagnosed with breast cancer in spain: 7-year follow-up results in the MCC-Spain study","volume":"17","author":"Alonso-Molero","year":"2020","journal-title":"Int J Environ Res Public Health"},{"key":"B55","doi-asserted-by":"publisher","first-page":"79","DOI":"10.1093\/sleep\/zsw079","article-title":"Changes in sleep duration, quality, and medication use are prospectively associated with health and wellbeing: analysis of the UK household longitudinal study","volume":"40","author":"Tang","year":"2017","journal-title":"Sleep"},{"key":"B56","doi-asserted-by":"publisher","first-page":"492","DOI":"10.3390\/brainsci11040492","article-title":"The relationship between physical activity, self-perceived health, and cognitive function in older adults","volume":"11","author":"Dost\u00e1lov\u00e1","year":"2021","journal-title":"Brain Sci."},{"key":"B57","doi-asserted-by":"publisher","first-page":"1","DOI":"10.2478\/v10001-006-0005-x","article-title":"Physical activity and self-perceived health status","volume":"19","author":"Kaleta","year":"2006","journal-title":"Int J Occup Med Environ Health."},{"key":"B58","doi-asserted-by":"publisher","first-page":"101081","DOI":"10.1016\/j.ssmph.2022.101081","article-title":"Evaluating clinical and demographic influences on health perception: a translation of the SF-12 for use with NHANES","volume":"18","author":"Covert","year":"2022","journal-title":"SSM Popul Health."},{"key":"B59","doi-asserted-by":"publisher","first-page":"1292","DOI":"10.4067\/S0034-98872021000901292","article-title":"Calidad de vida en personas mayores con depresi\u00f3n y dependencia funcional: validez del cuestionario SF-12","volume":"149","author":"Lera","year":"2021","journal-title":"Rev Med Chil."},{"key":"B60","doi-asserted-by":"publisher","first-page":"291","DOI":"10.1016\/j.genhosppsych.2012.12.004","article-title":"Anxiety treatment improves physical functioning with oblique scoring of the SF-12 short form health survey","volume":"35","author":"Niles","year":"2013","journal-title":"Gen Hosp Psychiatry."},{"key":"B61","doi-asserted-by":"publisher","first-page":"E141","DOI":"10.36076\/ppj.2014\/17\/E141","article-title":"Prevalence of chronic pelvic pain among women: an updated review","volume":"17","author":"Ahangari","year":"2023","journal-title":"Pain Physician."}],"container-title":["Frontiers in Public Health"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fpubh.2023.1180907\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,10,25]],"date-time":"2023-10-25T09:30:09Z","timestamp":1698226209000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fpubh.2023.1180907\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,10,24]]},"references-count":61,"alternative-id":["10.3389\/fpubh.2023.1180907"],"URL":"https:\/\/doi.org\/10.3389\/fpubh.2023.1180907","relation":{},"ISSN":["2296-2565"],"issn-type":[{"value":"2296-2565","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,10,24]]},"article-number":"1180907"}}