Current Trends in Adolescent Health. In: Diclemente RJ, Hansen WB, Ponton LE, editors. Handbook of Adolescent Health Risk Behavior. Boston: Springer US; 1996. pp. 5-34. [DOI: 10.1007/978-1-4899-0203-0_2]

Underage drinking among Asian American and Pacific Islander adolescents

This study assessed the prevalence of alcohol abuse and dependence rates among four major ethnic groups of Hawai'i and examined the relationship among risk factors, protective factors, and demographic variables related to underage drinking. A total of 196 students were administered the Diagnostic Interview Schedule for Children, the American Drug and Alcohol Survey, and the Prevention Planning Survey. Drinking rates for Native Hawaiian students were significantly higher than those for Japanese and Caucasian students. Multiple logistic regression models accounted for 49% of the variance for any alcohol use. Ethnic group differences were found when data were disaggregated for Asian and Pacific Islander students.

Substance use in Portuguese and Spanish adolescents: highlights from differences, similarities and moderating effects

Many behaviors with lasting health impact are initiated in adolescence. Substance use is one such behavior. To analyse the factors involved in adolescent substance use among Portuguese and Spanish boys and girls, an explanatory model was developed using structural equations modelling. The model proposes that the impact of social contexts (family, friends, classmates and teachers) on substance use (tobacco, alcohol and illicit drugs) is mediated by perceptions of well-being (psychological symptoms, well-being and school satisfaction). Data on 1589 Portuguese (mean age = 13.27, SD = .59) and 4191 Spanish adolescents (mean age = 13.21; SD = .47) who took part in the HBSC/WHO survey were analysed. The model fits the data of each country (CFI > .90; RMSEA < .03) and the majority of the relationships proposed in the model have been as expected for both samples. The relations with a major effect, for both countries, were: the negative effect of family on psychological symptoms and the positive effect of family on subjective well-being; the negative effect of classmates on psychological symptoms; the positive effect of teachers on school satisfaction; the effect of psychological symptoms (negative) and school satisfaction (positive) on well-being; the negative effect of school satisfaction on tobacco and alcohol use; and the positive effect of tobacco on alcohol use, and alcohol use on cannabis. For each of the dependent factors studied (tobacco, alcohol and illicit drugs), the levels of explained variance varied between 9% (for tobacco use) and 46% (for alcohol use). Some non-invariant paths were obtained in country comparisons, controlling for gender. In multivariate analyses the paths from tobacco use to cannabis and from alcohol to cannabis were significant, but much stronger for Spanish girls than Portuguese girls.

Alcohol use and abuse in adolescence: proposal of an alternative analysis

BACKGROUND

A national, representative, school-based sample of Portuguese youths was used to examine the prevalence of alcohol use in this population and to analyse differences between demographic variables such as gender and age, as well as to propose a statistical procedure that optimally quantifies categorical variables.

METHODS

Data on 6109 state school students from Portugal, in the 6th, 8th and 10th grades, aged 11-18, who participated in the 2002 (Health Behaviour in School-aged Children/WHO) survey of adolescent health, were analysed. Adolescents aged between 11 and 14 were placed in the younger group, and those 15-18 years old were placed in the older group. Optimal scaling was used to optimize the computation of factor scores, which were subsequently submitted to multiple regression analysis in order to analyse the impact of gender and age on alcohol use.

RESULTS

The results of this study show that the majority of Portuguese school-aged adolescents attending regular school at 6th, 8th and 10th grades do not drink alcoholic beverages (beer, wine or spirits) on a regular basis (at least once a month). However, about 8% of these adolescents do drink beer, 3% do drink wine and 12% do drink spirits on a regular basis. With regard to age and gender, about a quarter of the older boys stated that they drink beer or spirits regularly. The multiple regression analysis showed that age and gender had a significant impact on alcohol use.

CONCLUSION

Alcohol - in particular spirits - is a substance used by some Portuguese adolescents. Alcohol use and abuse is more frequent in boys and increases with age. The importance of these findings for health promotion strategies is discussed.

School-based youth health nurses: roles, responsibilities, challenges, and rewards

A case study and focus-group discussions were conducted with 10 youth health nurses (nurses) employed in the recently introduced School-Based Youth Health Nurse Program (SBYHNP) to identify their roles, responsibilities, and professional development needs. Major roles are support, referral, health promotion, and marketing. Clients include high school students, teachers, and parents; the majority of whom are female and aged 13-16 years. Health issues addressed during individual consultations are predominantly psychosocial but also include medical, sexual health and sexuality issues, health surveillance, and risk-taking behaviors. Nurses also provide clients with health information and promote enhanced personal skill development during these consultations. Health promotion strategies undertaken by nurses were predominantly health education and health information displays. Nurses reported marketing their role and function within the school to be an essential and often difficult aspect of their role. Professional development through the SBYHNP was excellent; however, there was concern relating to the availability of future educational opportunities. The SBYHNP provides nurses with a new, challenging, autonomous role within the school environment and the opportunity to expand their role to incorporate all aspects of the health-promoting schools' framework.

Family-level impact of the CHAMP Family Program: a community collaborative effort to support urban families and reduce youth HIV risk exposure

This article presents family-level results from an ongoing study examining the impact of the CHAMP (Chicago HIV prevention and Adolescent Mental health Project) Family Program, a family-based HIV preventative intervention meant to reduce the amount of time spent in situations of sexual possibility and delay initiation of sexual activity for urban youth in the 4th and 5th grades living in neighborhoods with high rates of HIV infection. The CHAMP Family Program has been developed, delivered, and overseen by a collaborative partnership, consisting of community parents, school staff, community-based agency representatives, and university-based researchers. Design of the program was informed by input from this collaborative partnership, child developmental theory of sexual risk, and empirical data gathered from the targeted community. This article presents findings that suggest CHAMP Family Program impact on family communication, family decision-making, and family-level influences hypothesized to be related to later adolescent HIV risk. Implications for future family-based HIV prevention research are discussed here.

CORRELATES AND PREDICTORS OF RISKY SEXUAL PRACTICES AMONG A MULTI-RACIAL/ETHNIC SAMPLE OF UNIVERSITY STUDENTS

This research identifies the correlates and predictors of risky sexual behaviors among an ethnically diverse multiethnic sample of college students attending a large state university in the southeastern U.S. (N=338). Nine risk and five protective factors served as independent! predictive factors in the analyses. The dependent variable was scores on a risky sexual behaviors scale. Six of the nine risk factors and four of the five protective factors were significantly correlated with scores on the risky sexual behaviors scale. Regression analyses identified six significant predictors of risky sexual practices: number of partners in last six months; religious values; condom attitudes; age at first sex; binging on alcohol; and residential locus. These terms explained 29.4% of the total variance in risky sexual behavior scores. Implications for prevention programs and future research are noted.

Without parental consent: conducting research with homeless adolescents

ISSUES AND PURPOSE

To identify the ethical and legal implications of conducting research with homeless adolescents and to discuss guidelines for conducting research without parental consent.

CONCLUSIONS

Ethical principles of capacity, risk, postponement, and truthful disclosure within the context of the rights of minors to consent to healthcare treatment form the basis of the argument for allowing adolescents to consent to participate in research without parental consent when there is minimal risk or when such consent could place them at increased risk for harm.

PRACTICE IMPLICATIONS

Adolescents who are the target population for clinical research or who are intended recipients of nursing care should be involved in setting priorities, purposes, and protocols. Parents and other adults from their communities should be included in developing strategies to protect their confidentiality and privacy while helping them achieve autonomy in making informed health-related decisions.

Religion's role in promoting health and reducing risk among American youth

Although past research has long documented religion's salutary impact on adult health-related behaviors and outcomes, relatively little research has examined the relationship between religion and adolescent health. This study uses large, nationally representative samples of high school seniors to examine the relationship between religion and behavioral predictors of adolescent morbidity and mortality. Relative to their peers, religious youth are less likely to engage in behaviors that compromise their health (e.g., carrying weapons, getting into fights, drinking and driving) and are more likely to behave in ways that enhance their health (e.g., proper nutrition, exercise, and rest). Multivariate analyses suggest that these relationships persist even after controlling for demographic factors, and trend analyses reveal that they have existed over time. Particularly important is the finding that religious seniors have been relatively unaffected by past and recent increases in marijuana use.

Health-related, help-seeking behaviors in female Mexican-American adolescents

PURPOSE

To explore and describe the health-related, help-seeking behaviors of young female Mexican-American adolescents.

DESIGN

Qualitative exploratory-descriptive design using focus groups.

SETTING

Community recreation centers.

PARTICIPANTS

18 female Mexican-Americans ages 10-16 years residing in a South Central state.

MAIN OUTCOME MEASURES

A demographic information form and semi-structured interview designed for the study.

RESULTS

Subjects described two themes of help-seeking behaviors: seeking help for physical health problems and preventive healthcare from formal sources (i.e., community health clinics, family physicians, and public schools), and seeking help for concerns about pubertal development and pregnancy from informal sources (i.e., their mothers, aunts, sisters, and friends).

CONCLUSION

While young, female Hispanic adolescents may seek help from formal sources for preventive healthcare services and physical health problems not related to sexuality, they tend to seek help from informal sources for psychosocial and sexuality issues. Community-based interventions should be developed that focus on the importance of this pattern of help-seeking behaviors for young female Hispanics.

Health risks of homeless adolescents. Implications for holistic nursing

Although the exact number of homeless adolescents is unknown, it is estimated that this population may exceed 2 million. Literally living on the streets, homeless youth are at risk for a variety of physical, psychosocial, and spiritual health problems. Many engage in "survival sex," exchanging sexual favors for necessities of food, clothing, and shelter. Such risky sexual behaviors make them vulnerable to sexually transmitted diseases, including human immunodeficiency virus (HIV) and acquired immunodeficiency syndrome (AIDS), and unintended pregnancies. Many have serious, diagnosable mental health problems, whereas others suffer various consequences of substance abuse. There is a need for comprehensive and holistic health care services, for which the majority of homeless youth have very limited access. Holistic nursing can provide creative interventions for thus vulnerable population.