Gender Differences in Relations among Perceived Family Characteristics and Risky Health Behaviors in Urban Adolescents

Dual alcohol and cannabis use in male and female adolescents: Relationships with family variables

Family dynamics influence adolescents' use of alcohol and other substances, such as cannabis. The aim of this study was to understand the relationship between family variables and alcohol use, dual use of alcohol and cannabis, and non-use in adolescents according to sex. A cross-sectional study was conducted. The sample comprised 879 adolescents (56.4 % boys; M(SD)age = 14.25 (1.88) years). Multinomial regression analysis showed that for boys, the presence of family conflict increased the likelihood of being an alcohol (OR = 1.19) and dual (OR = 1.23) user rather than a non-user. For girls, communication reduced the probability of being an alcohol user (OR = 0.88), and the presence of consequences for breaking rules reduced the probability of being a dual user rather than a non-user (OR = 0.83) or an alcohol user (OR = 0.84). These findings highlight the importance of family prevention of adolescents' substance use, bearing in mind the participants' sex.

The impact of a parent-based prevention intervention on Mexican-descent youths' perceptions of harm associated with drug use: Differential intervention effects for male and female youths

Parent training (PT) interventions reduce the likelihood of youth problematic behaviors, including drug use. However, the dissemination of culturally adapted PT interventions in low-income Latina/o immigrant communities remains scarce. In this selective prevention study, we examined the extent to which exposure to CAPAS-Youth, a culturally adapted version of the PT intervention known as GenerationPMTO^© , resulted in increased adolescent perception of harm associated with use of alcohol and other drugs. In a randomized controlled trial with 71 Latina/o immigrant families (95% of parents self-identified as Mexican origin, n = 98), 37 families were allocated to the CAPAS-Youth intervention condition versus wait-list control (n = 34 families). According to adolescents' reports at intervention completion, significant increased levels of perceived harm associated with drug use were found for female youths, but not for males. Differential results indicate the importance of tailoring PT prevention interventions according to youths' sex differences (i.e., males vs. females).

Relationships of familial sexual stigma and family support with internalized homonegativity among lesbian, gay and bisexual individuals: The mediating effect of self-identity disturbance and moderating effect of gender

Background

The mediators of the association between familial attitudes toward sexual orientation and internalized homonegativity among lesbian, gay, and bisexual (LGB) individuals have not been well examined.

Methods

A cross-sectional survey study was carried out to examine the (i) associations of familial sexual stigma and family support with internalized homonegativity among young adult LGB individuals in Taiwan, and (ii) mediating effect of self-identity disturbance and the moderating effect of gender. Self-identified LGB individuals (N = 1000; 50% males and 50% females; mean age = 24.6 years) participated in the study. Familial sexual stigma, family support, self-identity disturbance, and internalized homonegativity were assessed. Structural equation modeling was used to examine relationships between the variables.

Results

The results indicated that familial sexual stigma was directly associated with increased internalized homonegativity, and indirectly associated with increased internalized homonegativity via the mediation of self-identity disturbance among LGB individuals. Family support was indirectly associated with decreased internalized homonegativity via the mediation of low self-identity disturbance. The direct association between family support and internalized homonegativity was only found among lesbian and bisexual women but not among gay and bisexual men.

Conclusions

Program interventions for familial sexual stigma, family support, and self-identity disturbance are warranted to help reduce internalized homonegativity among LGB individuals.

Gender Differences in the Psychosocial Determinants Underlying the Onset and Maintenance of Alcohol Use Disorder

A large number of different mechanisms have been linked to Alcohol Use Disorder (AUD), including psychosocial, neurocognitive, affective, and neurobiological factors. Gender has been shown to impact the presentation and progression of AUD; yet, little work has been done to parse the different mechanisms underlying AUD within the lens of gender differences. A review of the literature on adolescence revealed that psychosocial factors, in particular lack of family social support and interactions with peers, drive the onset of alcohol use more strongly in girls relative to boys. However, research done on gender differences in disease progression in adults remains limited. Our gender-specific analysis of the mechanisms underlying AUD in adults revealed that lack of social support was causally linked to negative affect, mental health symptoms, and AUD symptom severity in women, but not men. These novel results suggest that psychosocial factors may play a gender-specific role not only in the onset of use in adolescence, but also in the maintenance of addiction in adults. If confirmed, this suggests the need for investigating gender-specific recovery trajectories. In this perspective piece, we review the literature regarding gender differences in the onset and maintenance of AUD and present original data that support unique risk factors in women.

Parenting practices and oral health behaviors of children in rural Egypt: gender differences in a household survey

Background

Parenting practices influence children’s health and development. The current study aimed at assessing gender differences in children’s perception of the parenting practices of both parents, and in the association between children’s oral health behaviors and parenting practices.

Methods

A cross-sectional household survey of 6–12 year old children was conducted in a rural area in Northwestern Egypt in 2019. Clinical examination assessed caries and gingivitis. The Alabama Parenting Questionnaire assessed parenting practices in five domains (positive parenting, involvement, inconsistent disciplining, poor monitoring and corporal punishment) and the World Health Organization questionnaire assessed oral health behaviors including sugar consumption and daily toothbrushing. Sugar consumption was the dependent variable in linear regression and daily toothbrushing was the dependent variable in logistic regression. Parenting practices were the explanatory variables adjusting for confounders. Effect modification by child gender was assessed.

Results

The response rate was 94.1% (n = 433), mean age = 9.9 years, 44.1% boys, 17.8% with daily toothbrushing and mean sugar consumption score = 3.4/8. Girls perceived more mothers’ positive parenting than boys (mean = 14.15 and 13.46) and boys perceived more poor monitoring and corporal punishment. Boys and girls differed in the association between sugar consumption and fathers’ inconsistent disciplining, poor monitoring (P = 0.004 and 0.02) and mothers’ corporal punishment (P = 0.02), and also daily toothbrushing and mothers’ involvement, positive parenting (P = 0.05 and 0.02), fathers’ positive parenting (P = 0.02), mothers’ inconsistent discipling and poor monitoring (P = 0.01 and 0.04).

Conclusions

There were differences between boys and girls in perceiving mothers’ and fathers’ parenting practices and in the association between these parenting practices and toothbrushing and sugar consumption.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12903-022-02054-z.

Parental support and monitoring as associated with adolescent alcohol and tobacco use by gender and age

BACKGROUND

Parental support (PS) and parental monitoring (PM) are known protective factors against adolescent substance use (SU). However, little is known about whether PS and PM may affect SU outcomes differently by gender and age. This study examined the relationship between PS and PM and adolescent SU, specifically alcohol and tobacco use, stratified by gender and age group.

METHODS

Middle and high school students (n = 2351, 48.5% Female) completed surveys of self-reported SU, perceived PS and PM, and socioeconomic background. Age group was defined dichotomously as grade 7-8 Middle school and grade 9-10 High school students. PS and PM were each measured using previously validated tools. SU was measured by lifetime and past 30 days cigarette/alcohol use. One-way ANOVA and binary logistic regression models were completed. Odds ratios and means were reported.

RESULTS

PS and PM were significantly and negatively related to all outcome variables regardless of gender and age group. Mean differences in PS and PM were insignificant between age groups. Between genders, PM scores were significantly higher for girls (14.05) compared to boys (13.48) (p < 0.01). Odds Ratios of all four SU types (for alcohol and tobacco use) increased with higher age group, with ORs ranging from 1.45-2.61 (p < .05).

CONCLUSIONS

PS and PM were protective against SU for all participants, consistent with previous literature. Girls reported greater parental monitoring than boys, irrespective of age-group. While girls experienced higher levels of monitoring, they did not report lower SU than boys. This suggests that monitoring girls more closely than boys appears unnecessary in preventing adolescent SU. Finally, PS was a more significant factor in preventing SU for older adolescents (high school aged group) than for younger adolescents, irrespective of gender suggesting that PS may be more impactful and important as adolescents age. As children mature, particularly from middle school to high school, PS may play a larger role in preventing SU for older adolescents compared to younger ones.

Family Strengths and Latinx Youth Externalizing Behavior: Modifying Impacts of an Adverse Immigration Environment

In recent years, the federal administration has ramped up efforts to curb and enforce immigration laws, in essence redefining how immigration, particularly in the Latinx population, is viewed and dealt with in the United States. The aim of the present study was to examine Latinx family strengths in relation to youth externalizing behavior, considering the modifying impacts of the current anti-immigration environment. Data were drawn from a study of 547 mother-adolescent dyads. Adolescents were 12.80 years old (SD = 1.03) on average and 55% female; 88% were U.S. born. Adolescents completed measures of family strengths, including parental behavioral control, parental support, and respeto. They also reported on their own externalizing behavior. Mothers completed a measure of their affective and behavioral responses to immigration actions and news. Results showed that in families of mothers who reported adverse responses to the immigration context, parental behavioral control, parental support (boys only), and respeto were more strongly related to youth behavior. Results align with the family compensatory effects model, in which strengths at the family level help to offset adversities outside the home. Discussion focuses on ways to support families in establishing and maintaining high levels of protective processes and on the need to challenge anti-immigration rhetoric, practices, and policies that undermine healthy youth development in the Latinx population.

Gender stigma awareness is associated with adolescent risky health behaviors

Objectives

Although racial stigma in school is associated with adolescent risky health behaviors, there are no studies investigating how gender stigma relates to adolescent risky health behaviors among low-income, minority youth. We sought to determine whether gender stigma awareness is associated with adolescent risky health behaviors (delinquency, fighting, and substance use) and whether this association is mediated by school disengagement (low perceived teacher support, low school engagement, cutting classes, and breaking school rules) among low-income, minority students.

Methods

We analyzed cross-sectional survey data, collected from 2017 to 2019, from 412 high school students. Multi-level logistic regressions tested whether gender stigma awareness was associated with delinquency, fighting, and substance use, controlling for covariates, baseline behaviors, and clustering within schools. Mediation analyses tested whether school disengagement (low school engagement, perceived teacher support, cutting class, and breaking school rules) mediated these associations. Secondary analyses explored whether associations differed for male versus female, high-performing versus low-performing, and Latinx versus non-Latinx students.

Results

In this predominantly Latinx (83%) sample, gender stigma awareness was associated with delinquency (AOR = 1.48, P< 0.001) and fighting (AOR = 1.15, P< 0.001). School engagement, perceived teacher support, breaking school rules, and cutting classes mediated 42.7% of the association between gender stigma awareness and delinquency and 65.42% of the association between gender stigma awareness and fighting. Gender stigma awareness was also associated with substance use for low-performing (AOR = 1.68, P = 0.003) and non-Latinx adolescents (AOR = 3.80, P = 0.03). School disengagement did not mediate the association between gender stigma awareness and substance use for non-Latinx students but mediated 50% of this association for low-performing students.

Conclusions

Gender stigma awareness is associated with adolescent risky health behaviors. A decreased sense of acceptance in the school community and increased school misbehavior may mediate these associations. School environments that value and accept all students may better support adolescent health.

Assessment of Family, Peers, and Externalising Behaviour Dimensions in Adolescence: The Proposal of a Comprehensive Instrument (FPEB)

In the context of externalising behaviour problems, risk factor research (RFR) focuses on risk and protective factors of juvenile delinquency, which can pertain to individual, system, and societal levels. Several instruments aiming at measuring these factors have been developed, but a comprehensive research tool is missing. The aim of the present study was to develop and validate a questionnaire, the "Family, Peers, and Externalising Behaviour in adolescence" (FPEB) as a tool for assessing adolescents' tendency of externalising behaviour, the quality of relation with their parents, and peer-relations. FPEB was administered to 835 Italian students (36.8% males, age M = 13.81, SD = 1.54) together with the Moral Disengagement questionnaire to test concurrent validity. Data about socio-demographics and school performance were also collected. An EFA (Promax rotation, subsample A, n = 444) resulted in a four-factor structure that was corroborated by a CFA (subsample B, n = 388). The factors were "externalising behaviour" (var 13.16%), "peer relations difficulties" (var 11.10%), "Family conflict" (var 8.32%), and "lack of family negotiation" (var 7.11%) and showed good internal consistency (all α ≥ 0.65). There were differences between males and females in the correlational patterns of the four factors. The FPEB factors also showed good concurrent validity: two of the four factors ("lack of family negotiation" and "externalising behaviour") and the total score of the scale correlated with the "Moral disengagement scale", whereas peer relation difficulties did not. Further analyses also showed gender differences (except for "peer relations difficulties") and an association between students' school performance and "externalising behaviour", "family conflict", and the total FPEB scores. We concluded that the FPEB is a tool that is potentially useful to assess risk and protective factors and to plan targeted interventions (focusing on the specific area). Limitations and suggestions for further improvements are also discussed.

Reducing HIV/STI Risk Among Adolescents Aged 12 to 14 Years: a Randomized Controlled Trial of Project Prepared

Despite calls for evidence-based HIV/STI prevention programs for youth aged 12 to 14 transitioning to adolescence, few effective programs exist. In a two-group intent-to-treat randomized trial in the Bronx, NY, 397 participants were randomly assigned to Project Prepared or an attention control, TEEN. Participants completed surveys at baseline, 6 months, and 12 months. Prepared had two components, an 11-session program and a 3-week internship. Content covered sexual risk behavior, social cognitions, gender norms, relationships, and resilience. TEEN built communication skills and had the same intensity and structure as Prepared but no sexual content. In both, boys and girls were trained together in mixed groups of ~ 11 teens. Primary outcomes were HIV knowledge, self-efficacy, condom outcome expectancy, and behavioral intentions. Secondary outcomes were relationship expectations and endorsement of risky gender norms. Generalized estimating equation analyses showed youth randomized to Prepared had significant improvements compared to TEEN at T2 in HIV knowledge, sexual self-efficacy, and outcome expectancy for condom use. At T3, there were significant differences favoring Prepared in outcome expectancy for condom use, sexual self-efficacy, and intention for partner communication about HIV/AIDS or STIs. Analyses by gender showed program effects in both boys (intention to talk to a partner about condom use, abstinence self-efficacy, sexual self-efficacy, and condom outcome expectancy) and girls (gender norms, and abstinence outcome expectancy). Prepared effectively reduced risk in young adolescents. ClinicalTrials.gov ID: NCT01880450, Protocol ID: 2008-551.

Alcohol consumption in early adolescence: Associations with sociodemographic and psychosocial factors according to gender

Introduction

Early alcohol consumption can irreversible damage the adolescents’ brain and may affect their quality of life. In order to better prevent such a deleterious behaviour, knowing its determinants is needed. So far, only few studies among adolescents aged <15 years exist, of which the majority failed to include gender differences. Therefore, the aim of this study was to investigate whether gender differences in the association between alcohol use and sociodemographic and psychosocial characteristics among 10-14-year olds exist.

Methods

Data came from the 2018 Health Behaviour in School-Aged Children (HBSC) study conducted in French-speaking schools of Belgium. The sample analysed here comprised 4,364 10-14-year olds from the Walloon Region. Associations of the recent alcohol consumption (at least one glass during the past month) with sociodemographic and psychosocial characteristics were estimated using gender-stratified multivariable logistic regression modelling.

Results

Prevalence of early alcohol consumption was 14% (boys: 16%; girls: 12%). Migration status and family affluence scale (FAS) were associated with early alcohol consumption only in boys. Second-generation immigrant boys (vs. natives: OR = 0.66 [0.47–0.92]) and boys from “low” FAS families (vs. “high”: OR = 0.56 [0.32–0.98]) or “medium” FAS (vs. “high”: OR = 0.63 [0.43–0.92]) were less likely to have consumed alcohol in the past month. In both genders, alcohol consumption was positively associated with age and inversely associated with school satisfaction and family support. No association was observed with family structure, peer support and life satisfaction in the multivariable models.

Conclusion

Our findings showed that gender differences may exist in the determinants of alcohol consumption among young adolescents. They will contribute to the development of public health policies and actions for the most vulnerable adolescents, which should take gender differences into account.

Parents Matter: Associations Between Parent Connectedness and Sexual Health Indicators Among Transgender and Gender-Diverse Adolescents

CONTEXT

Transgender and gender-diverse youth experience significant health disparities across numerous domains of health, including sexual health. Among general populations, parent connectedness has been strongly associated with youth sexual health.

METHODS

The relationships between parent connectedness and sexual health indicators were investigated among 2,168 transgender and gender-diverse youth who participated in the 2016 Minnesota Student Survey, a statewide population-based survey of ninth- and 11th-grade students. Multivariate logistic regression models, stratified by sex assigned at birth, tested associations between parent connectedness-youth's perceptions of parent caring and parent-youth communication-and eight sexual health indicators: ever having had sex, having multiple sexual partners in the past year, pregnancy involvement, substance use at last sex, partner communication about STI prevention, partner communication about pregnancy prevention, condom use at last sex and pregnancy prevention methods at last sex.

RESULTS

The level of parent connectedness was inversely associated with ever having had sex, regardless of sex assigned at birth (odds ratios, 0.6-0.8). Although level of connectedness was inversely associated with having multiple sexual partners in the past year and pregnancy involvement among transgender and gender-diverse youth assigned male at birth (0.6-0.7), these relationships were nonsignificant among transgender and gender-diverse youth assigned female at birth. Further differences in associations between parent connectedness and four sexual risk-reduction behaviors were found between youth assigned male at birth and those assigned female.

CONCLUSIONS

As with other populations, parent connectedness promotes sexual health among transgender and gender-diverse youth and may provide a point of intervention.

Parental protective and risk factors regarding cannabis use in adolescence: A national sample from the Chilean school population

Background: Research has increased our understanding of the parental factors associated with the initiation and development of cannabis use disorder in adolescents, but few studies about this have been performed in middle- or low-income countries.

Objective: First, to examine whether perceived past parental drug use, parental monitoring, and attitude toward adolescent cannabis use are associated with general and problematic cannabis use in Chilean adolescents. Second, to explore whether perceived past parental drug use weakens the associations of protective factors with general and problematic adolescent cannabis use.

Methods: Regression analyses were performed on cross-sectional data from a multistage probabilistic sample stratified by clusters (municipalities, school and grade) of 43,060 students (47% male, mean age 15.5 years) from grades 8 to 12, which was collected from the Chilean National School Survey on Drug Use (2013).

Results: Perceived past parental drug use increased the likelihood of adolescent cannabis use in general, but not its problematic use. Parental monitoring of adolescents' whereabouts and parental opposition to adolescent cannabis use decreased the likelihood of adolescent cannabis use in general, as well as problematic use. Perceived past parental drug use only interacted with parental monitoring of school activities.

Conclusions: In line with research from the United States, the Netherlands and Spain, parental monitoring of adolescents' whereabouts and a strong parental opposition to cannabis use appear to be protective factors, irrespective of past parental use. However, the effectiveness of monitoring adolescents' school activities seems to decrease when parents are perceived as having used drugs in the past.

Prevalence of Elevated Alanine Aminotransferase by Diagnostic Criterion, Age, and Gender among Adolescents

Background

Serum alanine aminotransferase (ALT) activity was measured not only to detect liver disease, but also to monitor overall health. The purpose of this study was to obtain the prevalence of elevated ALT levels among adolescents.

Methods

In a school-based cross-sectional study, a representative sample was analyzed from 9 middle and high schools in Shenzhen, China, during 2017 to 2018. Elevated ALT was defined as diagnostic criterion I (>30 U/L for boys and >19 U/L for girls) and diagnostic criterion II (>40 U/L).

Results

From the adolescent population, a total of 7281 students (boys, 4014, and girls, 3267) aged from 10 to 17 years were collected. The prevalence of elevated ALT was 7.11% (6.88% for boys and 7.41% for girls) by criterion I and 2.72% (3.96% for boys and 1.19% for girls) by criterion II. Based on the Shenzhen census and Chinese national census population, the adjusted prevalence of elevated ALT was 7.65% (boys 7.19% and girls 8.21%) and 6.79% (boys 6.07% and girls 7.56%) by criterion I and 2.85% (boys 4.20% and girls 1.16%) and 2.43% (boys 3.49% and girls 1.29%) by criterion II. For age, the overall trends were increasing progressively, regardless of the use of diagnostic criteria for an elevated ALT activity.

Conclusions

This study supplements the gap that the prevalence of elevated ALT levels differed in gender, age, and criteria among adolescents of Shenzhen. We should take the prevalence as a predictor and continue to play a warning and preventive role in preparation for further intervention.

Association of Family Member Detention or Deportation With Latino or Latina Adolescents' Later Risks of Suicidal Ideation, Alcohol Use, and Externalizing Problems

IMPORTANCE

Policy changes since early 2017 have resulted in a substantial expansion of Latino or Latina immigrants prioritized for deportation and detention. Professional organizations, including the American Academy of Pediatrics, American Medical Association, and Society for Research in Child Development, have raised concerns about the potentially irreversible mental health effects of deportations and detentions on Latino or Latina youths.

OBJECTIVE

To examine how family member detention or deportation is associated with Latino or Latina adolescents' later mental health problems and risk behaviors.

DESIGN, SETTING, AND PARTICIPANTS

Survey data were collected between February 14 and April 26, 2018, and between September 17, 2018, and January 13, 2019, and at a 6-month follow-up from 547 Latino or Latina adolescents who were randomly selected from grade and sex strata in middle schools in a suburban Atlanta, Georgia, school district. Prospective data were analyzed using multivariable, multivariate logistic models within a structural equation modeling framework. Models examined how family member detention or deportation within the prior 12 months was associated with later changes in suicidal ideation, alcohol use, and clinical externalizing symptoms, controlling for initial mental health and risk behaviors.

EXPOSURE

Past-year family member detention or deportation.

MAIN OUTCOMES AND MEASURES

Follow-up reports of suicidal ideation in the past 6 months, alcohol use since the prior survey, and clinical level of externalizing symptoms in the past 6 months.

RESULTS

A total of 547 adolescents (303 girls; mean [SD] age, 12.8 [1.0] years) participated in this prospective survey. Response rates were 65.2% (547 of 839) among contacted parents and 95.3% (547 of 574) among contacted adolescents whose parents provided permission. The 6-month follow-up retention rate was 81.5% (446 of 547). A total of 136 adolescents (24.9%) had a family member detained or deported in the prior year. Family member detention or deportation was associated with higher odds of suicidal ideation (38 of 136 [27.9%] vs 66 of 411 [16.1%]; adjusted odds ratio, 2.37; 95% CI, 1.06-5.29), alcohol use (25 of 136 [18.4%] vs 30 of 411 [7.3%]; adjusted odds ratio, 2.98; 95% CI, 1.26-7.04), and clinical externalizing behaviors (31 of 136 [22.8%] vs 47 of 411 [11.4%]; adjusted odds ratio, 2.76; 95% CI, 1.11-6.84) at follow-up, controlling for baseline variables.

CONCLUSION AND RELEVANCE

This study suggests that recent immigration policy changes may be associated with critical outcomes jeopardizing the health of Latino or Latina adolescents. Since 95% of US Latino or Latina adolescents are citizens, compromised mental health and risk behavior tied to family member detention or deportation raises concerns regarding the association of current immigration policies with the mental health of Latino and Latina adolescents in the United States.

Assessing the Validity of the Quartile Risk Model of Dissociation for Predicting Deliberate Self-Harm

Deliberate self-harm (DSH) involves a physical act with the intent of harming the self. There are many precipitants to this behavior, with dissociation receiving increasing attention. The current study examined the quartile risk model for predicting deliberate self-harm, which proposes that four quadrants of dissociation (low normative, high normative, low clinical, and high clinical) represent varying levels of risk for engagement in DSH. The model posits that quadrants one and three (low normative, low clinical), protect against engagement in deliberate self-harm. Quadrants two and four (high normative, high clinical), represent an increased risk of engaging in DSH. The current study also investigated the association between shame and deliberate self-harm. College students (n = 247) completed measures assessing trait dissociation, state and trait shame, and deliberate self-harm. Results did not support the quartile risk model, rather they suggested a general increasing level of deliberate self-harm with heightened dissociation. Furthermore, trait shame was significantly associated with deliberate self-harm. Significantly more state shame was found to occur before engaging in deliberate self-harm relative to after. Results suggest shame and dissociation are related to increased DSH.

Relationship between perception of emotional home atmosphere and fruit and vegetable consumption in European adolescents: results from the I.Family survey

OBJECTIVE

Consumption of fruits and vegetables (F&V) among adolescents falls below recommendations in many Western countries. The impact of social and emotional aspects of family life on adolescent dietary behaviour may contribute to this, yet remains under-investigated. The present study examines the association between adolescents' perceptions of emotional home atmosphere (EHA) and their F&V consumption frequency.

DESIGN

An FFQ was used to assess F&V consumption frequency. EHA was assessed by an eight-item measure with three subscales: perceived home warmth, strictness and relational tension. EHA subscales were used as binary variables: a score equal to or above the median value was considered as a higher perception, while a score below the median was considered as a lower perception of the EHA in question. Country differences in meeting the European 5-a-day recommendations were described. Further, the association between EHA and F&V consumption frequency was investigated using multiple linear regression.

SETTING

Regional examination centres in eight European countries.

PARTICIPANTS

Adolescents (n 3196) aged 12-18 years.

RESULTS

The mean F&V consumption frequency was 3·27 (sd 2·84) times/d. Only 16·1 % of boys and 18 % of girls in our study sample met the recommendation of five F&V daily. After controlling for age, sex, education level of the parents and country of origin, perceived home warmth was associated with a 16 (95 % CI 9, 22) % higher F&V consumption frequency (P < 0·001).

CONCLUSIONS

F&V consumption frequency was suboptimal in the survey areas. Interventions targeting perceived warmth as a component of EHA could potentially have a positive effect on adolescents' dietary behaviour.

Determinants of risky sexual practice, drug abuse and alcohol consumption in adolescents in Iran: a systematic literature review

Background

Evidence shows that the prevalence of risky sexual practice, drug abuse, and alcohol consumption behaviors in low and middle income countries such as Iran is not in a favorable condition. Preventive programs against these behaviors in Iran are very rare, and the results are unclear, which may be due to the lack of deeply and systematically understanding of the determinants of these behaviors. Evidence suggests that these behaviors are coincidence. So all of these behaviors were examined together. The present study was conducted aiming at determining the reasons for the occurrence of these behaviors among 15–19-year-old adolescents in Iran.

Methods

The Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines were followed to review published and unpublished studies in Iran. The databases used were Scopus, PubMed, Web of Science, and Cochrane Library. The query terms were “Synthetic Drug” OR “Designer Drug”, AND Adolescents OR Teenagers OR Juvenile, AND Iran. The Joanna Briggs Institute Critical Appraisal Checklist was employed for critical appraisal. The quantitative studies using the regression model to analyze the factors affecting these behaviors were studied as the form of the theme. For analyzing the data, narrative synthesis and thematic analysis were used.

Results

Twelve studies were meticulously reviewed. The findings were classified into five main themes (including individual, family, friends, school, and community) and 26 sub-themes. The most frequent main theme and sub-themes were respectively Family, Higher age, Male gender, Weak religious beliefs, Low self-esteem, Anti-social behaviors in family, Mother’s employment, Parenting style, Poor intimacy of parents, Absence of parents, Peer pressure, and Lack of appropriate recreation. No primary study has referred to the political, economic, or policy factors affecting such behaviors.

Conclusions

The most identified sub-themes belong to family factors. Iran is a country with ideology of Islam; however, being Muslim does not guarantee adherence to all Islamic guidelines. So being Muslim is not a good reason to prevent these behaviors. Iran needs precise policy making in this area through considering family structure. It is also suggested that primary studies referring to the political, economic, or policy factors affecting such behaviors should be carried out.

Adolescent-to-Parent Violence and Family Environment: The Perceptions of Same Reality?

The use of several sources of information (parents and children) is scarce in family studies. Child-to-parent violence (CPV) is still considered the most hidden and stigmatized form of family violence. One objective of this study was to analyze the prevalence of child-to-parent violence and perceptions of family environment as a function of the informant (parent or child), child's sex, and parents' sex in a community population. The study also aimed to analyze the predictive power of family conflict and aggressive family discipline in child-to-parent violence depending on the informant. A sample of 586 adolescents (49% boys, aged between 12 and 18) and their parents (40%) participated in the study. The Family Environment Scale and the Conflict Tactics Scales were administered. Results showed good consistency between adolescent reports and parent reports for physical CPV, but adolescents perceived worse family environments than their parents. Multiple regression models revealed that aggressive family discipline and family are important risk factors for CPV. Early intervention to prevent CPV is recommended, focused on promoting family relationships and avoiding harsh discipline practices. It is important that parents are able to ask for help when they need it.

Perceived family relationship quality and use of poly-tobacco products during early and late adolescence

BACKGROUND

The role of family relationship in adolescent use of emerging tobacco products, which have become increasingly popular, is unknown. We examined the associations of perceived family relationship quality with current use of poly-tobacco products including cigarettes, electronic cigarettes (e-cigarettes), waterpipe and smokeless tobacco in adolescents.

METHODS

Data from a representative sample of 42,250 US grade 7-12 equivalent students (mean ± SD age 14.6 ± 1.9 years; 51.3% boys) from 75 randomly selected secondary schools in Hong Kong (2012-13) were analysed. Logistic regressions yielded adjusted odds ratios (AORs) for current (past 30-day) use of cigarettes, e-cigarettes, waterpipe, smokeless tobacco and poly-tobacco (≥2 products) in relation to perceived family relationship quality, adjusted for age, sex, perceived family affluence, parental education, family structure, parental and sibling smoking and secondhand smoke exposure at home. Subgroup analyses were conducted to compare the associations in early (aged ≤14 years) versus late (>14) adolescents.

RESULTS

The odds of current use increased with worse perceived family relationship quality with AORs (95% confidence interval) of up to 2.92 (2.32-3.68) for cigarettes, 7.28 (4.71-11.2) for e-cigarettes, 5.04 (3.44-7.40) for waterpipe, 8.09 (4.87-13.4) for smokeless tobacco and 5.25 (3.45-8.01) for poly-tobacco products use (all P for trend <.001). The associations for all tobacco use outcomes were stronger in early than late adolescents (all P for interaction <.001).

CONCLUSIONS

Dose-response relationships were found between negatively perceived family relationship quality and current poly- and individual tobacco product use by Hong Kong Chinese secondary students. The associations were stronger for alternative tobacco products and in early adolescents.