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Choy CC, Simi S, Soti-Ulberg C, Naseri T, Salinas YD, Hawley NL. Noncommunicable disease risk behaviors and protective factors among children in Samoa: Retrospective trend analysis of global school-based health surveys in 2011 and 2017. PLOS GLOBAL PUBLIC HEALTH 2024; 4:e0003315. [PMID: 38861507 PMCID: PMC11166286 DOI: 10.1371/journal.pgph.0003315] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/04/2024] [Accepted: 05/16/2024] [Indexed: 06/13/2024]
Abstract
Pacific Island countries experience a high prevalence of noncommunicable diseases (NCDs), which may be prevented by reducing risk behaviors and strengthening protective factors in childhood and adolescence. To better inform preventative interventions, our objective was to use publicly available data from the Global School-based Student Health Survey (GSHS), to provide cross-sectional and trend estimates for the prevalence of NCD risk and protective factors among school-aged children in 2011 and 2017 in Samoa. Two waves of cross-sectional data included 4,373 children (51.98% female), with a median age of 15 years, who were mainly in school years 9-10 in Samoa. Retrospective analyses were adjusted for the GSHS multistage stratified cluster sample design. Weighted prevalences of overweight/obesity, dietary behaviors, physical activity, and sedentary behavior, oral and hand hygiene, emotional and mental health, and community protective factors were reported by study year. Logistic regressions were fitted to assess differences in the prevalence of risk and protective factors, adjusted for age group, sex, and school year. In 2011 and 2017, the prevalence of overweight/obesity remained consistently high in females (59.12% and 64.29%, p = 0.428) and increased from 44.21% to 53.65% in males (p = 0.039). Time spent sitting for long periods, smoking cigarettes, using other tobacco products, and drinking alcohol were lower in 2017 compared to 2011 (all p<0.05). Many children reported experiencing bullying (33.27% for females and 59.30% for males in 2017), while physical fighting was common among males (73.72% in 2011 and 57.28% in 2017). The high prevalence of obesity and related NCD risk factors require urgent public health action in Samoa. Alongside the continued reduction of tobacco and alcohol use, emotional and mental wellness should be prioritized in interventions and programs to promote healthy behaviors and lifestyle changes starting in childhood.
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Affiliation(s)
- Courtney C. Choy
- Department of Chronic Disease Epidemiology, Yale School of Public Health, New Haven, Connecticut, United States of America
| | | | | | - Take Naseri
- Ministry of Health, Motootua, Apia, Samoa
- Department of Epidemiology, School of Public Health, Brown University, Providence, Rhode Island, United States of America
| | - Yasmmyn D. Salinas
- Department of Chronic Disease Epidemiology, Yale School of Public Health, New Haven, Connecticut, United States of America
| | - Nicola L. Hawley
- Department of Chronic Disease Epidemiology, Yale School of Public Health, New Haven, Connecticut, United States of America
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Dong C, Chen H, Li Y, Sun Y, Pan Y, Xu Q, Sun H. Patterns of Health-Risk Behaviours and Their Associations With Anxiety and Depression Among Chinese Young Adults by Gender: A Latent Class Analysis. Psychol Rep 2024:332941241258922. [PMID: 38842056 DOI: 10.1177/00332941241258922] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/07/2024]
Abstract
This study investigated gender differences in health-risk behaviour patterns among young adults and assessed the associations of anxiety and depression with these patterns. A cross-sectional survey was conducted with 1740 young Chinese adults aged 18-24 years. Latent class analysis (LCA) and multinomial logistic regression were conducted to identify the clusters of health-risk behaviours and their associations with anxiety and depression. Three common patterns were found for both genders: physical inactivity, substance use, and insufficient fruit intake (5.7% for males [M] and 11.6% for females [F]); a sedentary lifestyle only (48.4% for M and 48.9% for F); and a sedentary lifestyle, substance use, and an unhealthy diet (7.6% for M and 20.0% for F). Additionally, two additional unique patterns were found: physical inactivity and unhealthy diet in males (38.3%) and physical inactivity and insufficient fruit intake in females (19.6%). Sociodemographic variables exert different effects on health-risk behaviour patterns as a function of gender. Lower anxiety levels (odds ratio [OR]: 0.892; 95% confidence interval [CI]: 0.823-0.966) and greater depression levels (OR: 1.074; 95% CI: 1.008-1.143) were associated with a sedentary lifestyle, substance use, and unhealthy diet class only in female young adults compared with a sedentary-only class. These findings underscore the need for the implementation of targeted interventions based on gender differences.
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Affiliation(s)
- Chaoqun Dong
- School of Nursing, Wenzhou Medical University, Wenzhou, China
| | - Hua Chen
- School of Nursing, Peking University, Beijing, China
| | - Yi Li
- Medical Informatics Center, Institute of Advanced Clinical Medicine, Peking University, Beijing, China
| | - Yumei Sun
- School of Nursing, Peking University, Beijing, China
| | - Yinzhu Pan
- School of Nursing, Wenzhou Medical University, Wenzhou, China
| | - Qiongying Xu
- School of Nursing, Wenzhou Medical University, Wenzhou, China
| | - Hongyu Sun
- School of Nursing, Peking University, Beijing, China
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O'Dean S, Sunderland M, Newton N, Gardner L, Teesson M, Chapman C, Thornton L, Slade T, Hides L, McBride N, Kay-Lambkin FJ, Allsop SJ, Lubans D, Parmenter B, Mills K, Spring B, Osman B, Ellem R, Smout S, McCann K, Hunter E, Catakovic A, Champion K. The Health4Life e-health intervention for modifying lifestyle risk behaviours of adolescents: secondary outcomes of a cluster randomised controlled trial. Med J Aust 2024; 220:417-424. [PMID: 38613175 DOI: 10.5694/mja2.52279] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2023] [Accepted: 10/17/2023] [Indexed: 04/14/2024]
Abstract
OBJECTIVES To investigate the effectiveness of a school-based multiple health behaviour change e-health intervention for modifying risk factors for chronic disease (secondary outcomes). STUDY DESIGN Cluster randomised controlled trial. SETTING, PARTICIPANTS Students (at baseline [2019]: year 7, 11-14 years old) at 71 Australian public, independent, and Catholic schools. INTERVENTION Health4Life: an e-health school-based multiple health behaviour change intervention for reducing increases in the six major behavioural risk factors for chronic disease: physical inactivity, poor diet, excessive recreational screen time, poor sleep, and use of alcohol and tobacco. It comprises six online video modules during health education class and a smartphone app. MAIN OUTCOME MEASURES Comparison of Health4Life and usual health education with respect to their impact on changes in twelve secondary outcomes related to the six behavioural risk factors, assessed in surveys at baseline, immediately after the intervention, and 12 and 24 months after the intervention: binge drinking, discretionary food consumption risk, inadequate fruit and vegetable intake, difficulty falling asleep, and light physical activity frequency (categorical); tobacco smoking frequency, alcohol drinking frequency, alcohol-related harm, daytime sleepiness, and time spent watching television and using electronic devices (continuous). RESULTS A total of 6640 year 7 students completed the baseline survey (Health4Life: 3610; control: 3030); 6454 (97.2%) completed at least one follow-up survey, 5698 (85.8%) two or more follow-up surveys. Health4Life was not statistically more effective than usual school health education for influencing changes in any of the twelve outcomes over 24 months; for example: fruit intake inadequate: odds ratio [OR], 1.08 (95% confidence interval [CI], 0.57-2.05); vegetable intake inadequate: OR, 0.97 (95% CI, 0.64-1.47); increased light physical activity: OR, 1.00 (95% CI, 0.72-1.38); tobacco use frequency: relative difference, 0.03 (95% CI, -0.58 to 0.64) days per 30 days; alcohol use frequency: relative difference, -0.34 (95% CI, -1.16 to 0.49) days per 30 days; device use time: relative difference, -0.07 (95% CI, -0.29 to 0.16) hours per day. CONCLUSIONS Health4Life was not more effective than usual school year 7 health education for modifying adolescent risk factors for chronic disease. Future e-health multiple health behaviour change intervention research should examine the timing and length of the intervention, as well as increasing the number of engagement strategies (eg, goal setting) during the intervention. TRIAL REGISTRATION Australian New Zealand Clinical Trials Registry: ACTRN12619000431123 (prospective).
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Affiliation(s)
- Siobhan O'Dean
- Matilda Centre for Research in Mental Health and Substance Use, University of Sydney, Sydney, NSW
| | - Matthew Sunderland
- Matilda Centre for Research in Mental Health and Substance Use, University of Sydney, Sydney, NSW
| | - Nicola Newton
- Matilda Centre for Research in Mental Health and Substance Use, University of Sydney, Sydney, NSW
| | - Lauren Gardner
- Matilda Centre for Research in Mental Health and Substance Use, University of Sydney, Sydney, NSW
| | - Maree Teesson
- Matilda Centre for Research in Mental Health and Substance Use, University of Sydney, Sydney, NSW
| | - Cath Chapman
- Matilda Centre for Research in Mental Health and Substance Use, University of Sydney, Sydney, NSW
| | - Louise Thornton
- Matilda Centre for Research in Mental Health and Substance Use, University of Sydney, Sydney, NSW
| | - Tim Slade
- Matilda Centre for Research in Mental Health and Substance Use, University of Sydney, Sydney, NSW
| | - Leanne Hides
- Centre of Youth Substance Abuse, University of Queensland, Brisbane, QLD
- University of Queensland, Brisbane, QLD
| | - Nyanda McBride
- National Drug Research Institute, Curtin University, Perth, WA
| | - Frances J Kay-Lambkin
- Priority Research Centre for Brain and Mental Health, University of Newcastle, Newcastle, NSW
| | - Steve J Allsop
- National Drug Research Institute, Curtin University of Technology, Perth, WA
| | | | | | - Katherine Mills
- Matilda Centre for Research in Mental Health and Substance Use, University of Sydney, Sydney, NSW
| | - Bonnie Spring
- Northwestern University, Evanston, United States of America
| | - Bridie Osman
- Matilda Centre for Research in Mental Health and Substance Use, University of Sydney, Sydney, NSW
| | | | - Scarlett Smout
- Matilda Centre for Research in Mental Health and Substance Use, University of Sydney, Sydney, NSW
| | - Karrah McCann
- Matilda Centre for Research in Mental Health and Substance Use, University of Sydney, Sydney, NSW
| | - Emily Hunter
- Matilda Centre for Research in Mental Health and Substance Use, University of Sydney, Sydney, NSW
| | | | - Katrina Champion
- Matilda Centre for Research in Mental Health and Substance Use, University of Sydney, Sydney, NSW
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Li X, Dessie Y, Mwanyika-Sando M, Assefa N, Millogo O, Manu A, Chukwu A, Bukenya J, Patil R, Zou S, Zhang H, Nurhussien L, Tinkasimile A, Bärnighausen T, Shinde S, Fawzi WW, Tang K. Co-occurrence of and factors associated with health risk behaviors among adolescents: a multi-center study in sub-Saharan Africa, China, and India. EClinicalMedicine 2024; 70:102525. [PMID: 38533342 PMCID: PMC10963189 DOI: 10.1016/j.eclinm.2024.102525] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/08/2023] [Revised: 02/18/2024] [Accepted: 02/20/2024] [Indexed: 03/28/2024] Open
Abstract
Background Despite lifelong and detrimental effects, the co-occurrence of health risk behaviors (HRBs) during adolescence remains understudied in low- and middle-income countries. This study examines the co-occurrence of HRBs and its correlates among adolescents in sub-Saharan Africa, China, and India. Methods A multi-country cross-sectional study was conducted in 2021-2022, involving 9697 adolescents (aged 10-19 years) from eight countries, namely Burkina Faso, China, Ethiopia, India, Ghana, Nigeria, Tanzania, and Uganda. A standardized questionnaire was administered to examine five types of HRBs - physical inactivity, poor dietary habits, smoking, alcohol consumption, and risky sexual behavior. Latent class analysis was employed to identify clustering patterns among the behaviors, and logistic regression was used to identify the correlates of these patterns. Findings Three clusters of HRBs were identified, with Cluster 1 (27.73%) characterized by the absence of any specific risky behavior, Cluster 2 (68.16%) characterized by co-occurrence of physical inactivity and poor dietary habits, and Cluster 3 (4.11%) characterized by engagement in smoking, alcohol consumption, and risky sexual behavior. Relative to Cluster 1, being in Cluster 2 was associated with being female (aOR 1.20, 95% CI 1.09-1.32), not enrolled in education (aOR 0.84, 95% CI 0.71-0.99), and not engaged in paid work (aOR 1.23, 95% CI 1.08-1.41). Compared with those Cluster 1, adolescents in Cluster 3 were less likely to be female (aOR 0.41, 95% CI 0.32-0.54), be engaged in paid work (aOR 0.54, 95% CI 0.41-0.71), more likely to be older (aOR 7.56, 95% CI 5.18-11.03), not be enrolled in educational institution (aOR 1.74, 95% CI 1.27-2.38), and more likely to live with guardians other than parents (aOR 1.56, 95% CI 1.19-2.05). Interpretation The significant clustering patterns of HRBs among adolescents in sub-Saharan Africa, China, and India highlights the urgent need for convergent approaches to improve adolescent health behaviors. Early life and school-based programs aimed at promoting healthy behaviors and preventing risky and unhealthy behaviors should be prioritized to equip adolescents with the tools and skills for lifelong well-being. Funding Fondation Botnar (Grant #INV-037672) and Harvard T.H. Chan School of Public Health, partially funded this study.
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Affiliation(s)
- Xuan Li
- Vanke School of Public Health, Tsinghua University, China
| | - Yadeta Dessie
- College of Health and Medical Sciences, Haramaya University, Ethiopia
| | | | - Nega Assefa
- College of Health and Medical Sciences, Haramaya University, Ethiopia
| | | | - Adom Manu
- Department of Population, Family, and Reproductive Health, University of Ghana, Ghana
| | - Angela Chukwu
- Department of Statistics, University of Ibadan, Nigeria
| | | | | | - Siyu Zou
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, United States of America
| | - Hanxiyue Zhang
- Vanke School of Public Health, Tsinghua University, China
| | - Lina Nurhussien
- Department of Global Health and Population, T. H. Chan School of Public Health, Harvard University, United States of America
| | | | - Till Bärnighausen
- Department of Global Health and Population, T. H. Chan School of Public Health, Harvard University, United States of America
- Heidelberg Institute of Global Health, Heidelberg University, Heidelberg, Germany
| | - Sachin Shinde
- Department of Global Health and Population, T. H. Chan School of Public Health, Harvard University, United States of America
| | - Wafaie W. Fawzi
- Department of Global Health and Population, T. H. Chan School of Public Health, Harvard University, United States of America
| | - Kun Tang
- Vanke School of Public Health, Tsinghua University, China
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da Silva AG, Souza JB, Gomes CS, da Silva TPR, Gomide Nogueira de Sá ACM, Malta DC. Multiple behavioral risk factors for non-communicable diseases among the adolescent population in Brazil: the analysis derived from the Brazilian national survey of school health 2019. BMC Pediatr 2024; 24:122. [PMID: 38360574 PMCID: PMC10868108 DOI: 10.1186/s12887-024-04601-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/28/2023] [Accepted: 01/29/2024] [Indexed: 02/17/2024] Open
Abstract
BACKGROUND Health risk behaviors often emerge or intensify during adolescence and tend to co-occur, exposing individuals to an even greater risk for the development of non-communicable diseases (NCDs). The likelihood of exhibiting multiple health risk factors also increases throughout life and is associated with sociodemographic characteristics contributing to their escalation and severity. In this context, the objective of this study was to analyze the association between sociodemographic characteristics and multiple behavioral risk factors for non-communicable diseases among the adolescent population in Brazil. METHODS This cross-sectional study utilized data from the Brazilian National Survey of School Health 2019. The sample comprised 121,580 adolescents aged 13 to 17. The analyzed variables included irregular intake of fruits and vegetables, regular consumption of soft drinks and treats, insufficient physical activity, sedentary lifestyle, cigarette smoking, and alcohol consumption. To analyze MBRFs, a classification ranging from zero to five was created, and associations were estimated using Odds Ratio (OR) with the respective 95% confidence interval (CI). The Backward method was employed for the multivariate regression model, utilizing ordinal logistic regression. RESULTS Adolescents without behavioral risk factors for NCDs constituted only 3.9% (95% CI 3.7-4.1). The most prevalent categories were two and three MBRFs, accounting for 28.3% (95% CI: 27.7-28.8) and 27.0% (95% CI: 26.5-27.5), respectively. Adolescents aged 16 and 17 (ORadj: 1.39; 95% CI: 1.32-1.48), residing in the Brazilian Southeast (ORadj: 1.66; 95% CI: 1.52-1.81), and those reporting poor or very poor self-rated health (ORadj: 2.05; 95% CI: 1.87-2.25) were more likely to exhibit multiple behavioral risk factors. Conversely, male adolescents (adjusted OR: 0.65; 95% CI: 0.62-0.69), those of mixed race (adjusted OR: 0.92; 95% CI: 0.87-0.97), and residents of rural areas (adjusted OR: 0.76; 95% CI: 0.70-0.84) were less likely to manifest MBRFs for NCDs. CONCLUSION The majority of adolescents displayed MBRFs for NCDs, positively associated with age, region, and perceived health status. This underscores the necessity for healthcare promotional interventions throughout the life cycle, as these behaviors may persist into adulthood.
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Affiliation(s)
- Alanna Gomes da Silva
- Graduate Program in Nursing, Department of Maternal-Infant and Public Health Nursing, Federal University of Minas Gerais (UFMG), Avenida Professor Alfredo Balena, 190, Bairro Santa Efigênia, Belo Horizonte, 30130-100, Minas Gerais, Brazil.
| | - Juliana Bottoni Souza
- Faculty of Medicine, Graduate Program in Public Health, Federal University of Minas Gerais (UFMG), Belo Horizonte (MG), Brazil
| | - Crizian Saar Gomes
- Faculty of Medicine, Graduate Program in Public Health, Federal University of Minas Gerais (UFMG), Belo Horizonte (MG), Brazil
| | - Thales Philipe Rodrigues da Silva
- Federal University of São Paulo, Paulista School of Nursing, Rua Napoleão de Barros,754, Bairro Vila Clementino, São Paulo, 04023-062, Brazil
| | | | - Deborah Carvalho Malta
- School of Nursing, Graduate Program of the School of Nursing, Department of Maternal-Infant and Public Health Nursing, Federal University of Minas Gerais, Belo Horizonte (MG), Brazil.
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Glaser M, Green G, Barak S, Bord S, Levi S, Jakobovich R, Dunsky A, Zigdon A, Zwilling M, Tesler R. The effects of the Friendship Online Intervention Program on physical activity, substance abuse, psychosomatic symptoms, and well-being among at-risk youth. J Adolesc 2024; 96:251-265. [PMID: 37985148 DOI: 10.1002/jad.12272] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Revised: 10/26/2023] [Accepted: 11/05/2023] [Indexed: 11/22/2023]
Abstract
INTRODUCTION At-risk youth are those who are currently or potentially exposed to physical, mental, or emotional danger. The Friendship Online Intervention Program (FOIP) was created to encourage physical activity (PA) and reduce risky behavior among vocational secondary-school youth in Israel. We wanted to evaluate the effect of FOIP on PA, substance abuse, and psychological factors, including psychosomatic symptoms and well-being. METHODS From October 2021 to June 2022, nonrandom sampling was employed to select at-risk youth from vocational secondary schools for participation in the FOIP. Before and after the intervention, questionnaires were administered to the intervention and control groups. The effects of FOIP were evaluated by univariate and multivariable analyses. RESULTS The intervention (n = 103) and control (n = 77) groups showed similar levels of PA, cigarette smoking, and alcohol consumption at the beginning of the study. At follow-up, the intervention group showed a 57% increase in PA versus no change for the control group and decreased levels of smoking compared to the control group (p < .001). Similarly, in the intervention group, the number of psychosomatic symptoms decreased (effect size = 1.68) and life satisfaction increased (effect size = 0.86). Group assignment (intervention or control group) significantly predicted PA level, cigarette smoking, psychosomatic symptoms, and life satisfaction (adjusted R2 = .46, .20, .08, and .28, respectively) with participants in the intervention group showing more favorable results compared with the control group. CONCLUSIONS FOIP was effective in increasing PA and decreasing risky behaviors among youth. FOIP may help at-risk youth build resilience and promote their physical and mental health.
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Affiliation(s)
- Michal Glaser
- Department of Health Systems Management, Ariel University, Ariel, Israel
- Health Promotion Research Center, Ariel University, Ariel, Israel
| | - Gizell Green
- Department of Nursing, Faculty of Health Sciences, Ariel University, Ariel, Israel
| | - Sharon Barak
- Department of Nursing, Faculty of Health Sciences, Ariel University, Ariel, Israel
- Department of Pediatric Rehabilitation, Sheba Medical Center at Tel Hashomer, Ramat-Gan, Israel
| | - Shiran Bord
- The Max Stern Yezreel Valley College, Jezreel Valley, Israel
| | - Sharon Levi
- School of Public Health, University of Haifa, Haifa, Israel
| | - Ronit Jakobovich
- Department of Health Promotion, Tel Aviv University, Tel Aviv, Israel
| | - Ayelet Dunsky
- School of Human Movement and Sport Sciences, Wingate Institute Academic College, Netanya, Israel
| | - Avi Zigdon
- Department of Health Systems Management, Ariel University, Ariel, Israel
| | - Moti Zwilling
- Department of Economics and Business Administration, Ariel University, Ariel, Israel
| | - Riki Tesler
- Department of Health Systems Management, Ariel University, Ariel, Israel
- Health Promotion Research Center, Ariel University, Ariel, Israel
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Mandic S, Khan A, García Bengoechea E, Coppell KJ, Spence JC, Smith M. Physical activity, screen time and dietary behaviours in New Zealand adolescents prior to and following the onset of the COVID-19 pandemic. BMC Public Health 2024; 24:188. [PMID: 38229064 PMCID: PMC10790521 DOI: 10.1186/s12889-024-17688-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2023] [Accepted: 01/05/2024] [Indexed: 01/18/2024] Open
Abstract
BACKGROUND Insufficient physical activity, high screen time, and unhealthy dietary patterns among adolescents may have worsened during the pandemic, but data are lacking. This study compared physical activity, screen time and fruit and vegetable intake in adolescents from Dunedin, New Zealand, 5-6 years before (Study 1) and during (Study 2) the COVID-19 pandemic. METHODS Adolescents completed an online survey as part of the Built Environment and Active Transport to School (BEATS) studies in 2014/2015 (Study 1; n = 1,266; age: 15.3 ± 1.4 years; 54.6% female) and 2021/2022 (Study 2; n = 819; age: 15.2 ± 1.4 years; 47.4% female). The proportion of adolescents meeting guidelines for physical activity (≥ 60 min/day of moderate-to-vigorous physical activity), outside school screen time (≤ 2 h/day) and fruit and vegetable intake (> 1 serving/day for both fruit and vegetables) was calculated. Data were analysed using multivariable linear and logistic regression modelling. RESULTS Few adolescents met recommended health behaviour guidelines. Compared to Study 1, significantly greater proportions of adolescents at Study 2 met guidelines for physical activity (16.7% vs. 23.1%; p < 0.001) and outside school screen time (13.3% vs. 18.3%; p < 0.001) while fruit and vegetable intake was not different (29.6% vs. 27.0%; p = 0.322). Compared to Study 1, average outside school screen time at Study 2 was lower on both weekdays (5.0 ± 2.9 vs. 4.6 ± 2.9; p < 0.001) and weekend days (6.9 ± 3.5 vs. 6.1 ± 3.6 h/day; p < 0.001). Reported frequency of consuming sweets was higher and soft drinks lower at Study 2 versus Study 1. CONCLUSIONS Despite observed higher levels of physical activity and lower levels of outside school screen time during the pandemic compared to the pre-pandemic levels, few adolescents met health behaviour guidelines at both time points. Therefore, comprehensive health promotion that aims to improve physical activity levels, screen time and dietary patterns for adolescents is still necessary to prevent chronic health conditions adulthood.
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Affiliation(s)
- Sandra Mandic
- AGILE Research Ltd, Wellington, New Zealand.
- School of Sport and Recreation, Faculty of Health and Environmental Sciences, Auckland University of Technology, Private Bag 92006, Auckland, 1142, New Zealand.
- Centre for Sustainability, University of Otago, Dunedin, New Zealand.
| | - Asaduzzaman Khan
- School of Health and Rehabilitation Sciences, Faculty of Health and Behavioural Sciences, University of Queensland, Brisbane, Australia
| | - Enrique García Bengoechea
- Physical Activity for Health Research Cluster, Health Research Institute, Department of Physical Education and Sport Sciences, University of Limerick, Limerick, Ireland.
- Research and Innovation Unit, Sport Ireland, Dublin, Ireland.
| | - Kirsten J Coppell
- Department of Medicine, University of Otago, Wellington, New Zealand
- Nelson Marlborough Institute of Technology, Nelson, New Zealand
| | - John C Spence
- Faculty of Kinesiology, Sport, and Recreation, University of Alberta, Edmonton, Canada
| | - Melody Smith
- School of Nursing, Faculty of Medical and Health Sciences, The University of Auckland, Auckland, New Zealand
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Zapico AG, Aparicio-Ugarriza R, Quesada-González C, Gómez SF, Wärnberg J, Medrano M, Gusi N, Aznar S, Marín-Cascales E, González-Valeiro MA, Serra-Majem L, Pulgar S, Tur JA, Segu M, Fíto M, Homs C, Benavente-Marín JC, Sánchez-Gómez J, Jiménez-Zazo F, Alcaraz PE, Sevilla-Sánchez M, Herrera-Ramos E, Bouzas C, Sistac C, Schröder H, Gesteiro E, González-Gross M. Lifestyle behaviors clusters in a nationwide sample of Spanish children and adolescents: PASOS study. Pediatr Res 2023; 94:2077-2084. [PMID: 37454185 DOI: 10.1038/s41390-023-02710-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/07/2022] [Revised: 05/29/2023] [Accepted: 06/08/2023] [Indexed: 07/18/2023]
Abstract
BACKGROUND Youth is a vulnerable period. To classify lifestyle behaviors and its relationship with health-related outcomes of Spanish children and adolescents. METHODS Cross-sectional study including 3261 children aged 7.5-17.5 y (52.8% females). Physical activity (PA), screen-time, sleep time, adherence to Mediterranean diet (MD), weight status (WS) by validated methods. Cluster analysis was run considering chronological age. RESULTS Six clusters were identified: C1: high screen time, low adherence to MD and sleep time (n = 431,13.20%); C2: high WS, medium adherence to MD,high sleep time, and low screen time (n = 466,14.30%); C3: young group with low screen time and high PA, adherence to MD and sleep (n = 537,16.40%); C4: worst profile regarding adherence to MD, PA, WS and sleep time (n = 609,18.70%); C5: low screen time and PA, high sleep time (n = 804,24.70%); C6: high PA and screen time, low WS (n = 414,12.70%). Mean absolute values were statistically different among PA levels, screen and sleep time, adherence to MD, age, and WS (all p < 0.001). CONCLUSIONS The most prevalent pattern was low levels of PA, MD, and screen time, and high sleep time. The second most prevalent was characterized by very low levels of PA, sleep time, and adherence to MD, and high screen time, and WS in adolescents. IMPACT STATEMENT The main identified lifestyle behavior was poor physical activity, low adherence to Mediterranean Diet and high screen and sleep time. Children should increase physical activity levels, adherence to Mediterranean diet, decrease screen and sleep the appropriate hours per day. Families, schools, and medical communities must work together to gloss over present and future diseases. Sleep time had not been previously included in cluster analysis with physical activity, sedentary behaviors, obesity, and nutritional status, thus the present data open a new perspective in Spanish population. Health policies should focus on promoting physical activity, Mediterranean diet, adequate sleep and reducing screen time.
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Affiliation(s)
- Augusto G Zapico
- ImFINE Research Group. Department of Health and Human Performance, Universidad Politécnica de Madrid, Madrid, Spain.
- Department of Language, Arts and Physical Education, Universidad Complutense de Madrid, Madrid, Spain.
| | - Raquel Aparicio-Ugarriza
- ImFINE Research Group. Department of Health and Human Performance, Universidad Politécnica de Madrid, Madrid, Spain
- Biomedical Research Center on Physiopathology of Obesity and Nutrition (CIBEROBN), Institute of Health Carlos III, Madrid, Spain
| | - Carlos Quesada-González
- ImFINE Research Group. Department of Health and Human Performance, Universidad Politécnica de Madrid, Madrid, Spain
- Departamento de Matemática Aplicada a las Tecnologías de la Información y la Comunicación, Universidad Politécnica de Madrid, 28031, Madrid, Spain
| | - Santiago Felipe Gómez
- Gasol Foundation, Sant Boi de Llobregat, Spain
- Biomedical Research Networking Center on Epidemiology and Public Health studies (CIBERESP), Institute of Health Carlos III, Madrid, Spain
- Hospital del Mar Medical Research Institute (IMIM), Barcelona, Spain
- Nursing and Physiotherapy Department, University of Lleida, Lleida, Spain
| | - Julia Wärnberg
- Biomedical Research Center on Physiopathology of Obesity and Nutrition (CIBEROBN), Institute of Health Carlos III, Madrid, Spain
- EpiPHAAN Research Group. Faculty of Health Sciences, University of Málaga-Institute of Biomedical Research of Malaga (IBIMA), Málaga, Spain
| | - María Medrano
- ELIKOS group, Institute for Innovation & Sustainable Development in Food Chain (IS-FOOD). CIBEROBN, ISCIII Navarra, Public University of Navarra, Navarra, Spain
| | - Narcís Gusi
- Physical Activity and Quality of Life Research Group (AFYCAV), Faculty of Sport Sciences, Universidad de Extremadura, Cáceres, Spain
| | - Susana Aznar
- PAFS Research Group, Faculty of Sports Sciences, University of Castilla-La Mancha, Toledo, Spain
- Biomedical Research Networking Center on Frailty and Healthy Aging (CIBERFES). Institute of Health Carlos III, Madrid, Spain
| | - Elena Marín-Cascales
- Research Center for High Performance Sport, Catholic University of Murcia, Murcia, Spain
- Faculty of Sport Sciences, UCAM, Catholic University of Murcia, Murcia, Spain
| | | | - Lluís Serra-Majem
- Biomedical Research Center on Physiopathology of Obesity and Nutrition (CIBEROBN), Institute of Health Carlos III, Madrid, Spain
- Research Institute of Biomedical and Health Sciences (IUIBS), University of Las Palmas de Gran Canaria, Las Palmas, Spain
- Preventive Medicine Service, Centro Hospitalario Universitario Insular Materno Infantil (CHUIMI), Canarian Health Service, Las Palmas, Spain
| | - Susana Pulgar
- Regional Unit of Sports Medicine, Municipal Sports Foundation of Avilés, Asturias, Spain
| | - Josep A Tur
- Biomedical Research Center on Physiopathology of Obesity and Nutrition (CIBEROBN), Institute of Health Carlos III, Madrid, Spain
- Research Group of Community Nutrition & Oxidative Stress, University of the Balearic Islands-IUNICS & Health Research Institute of the Balearic Islands (IDISBA), Palma de Mallorca, Spain
| | | | - Montserrat Fíto
- Biomedical Research Center on Physiopathology of Obesity and Nutrition (CIBEROBN), Institute of Health Carlos III, Madrid, Spain
- Hospital del Mar Medical Research Institute (IMIM), Barcelona, Spain
| | - Clara Homs
- Gasol Foundation, Sant Boi de Llobregat, Spain
- GRoW, Global Research on Wellbeing, Blanquerna School of Life Sciences, University Ramon Llull, Barcelona, Spain
| | - Juan Carlos Benavente-Marín
- EpiPHAAN Research Group. Faculty of Health Sciences, University of Málaga-Institute of Biomedical Research of Malaga (IBIMA), Málaga, Spain
| | - Jesús Sánchez-Gómez
- Physical Activity and Quality of Life Research Group (AFYCAV), Faculty of Sport Sciences, Universidad de Extremadura, Cáceres, Spain
| | - Fabio Jiménez-Zazo
- PAFS Research Group, Faculty of Sports Sciences, University of Castilla-La Mancha, Toledo, Spain
| | - Pedro E Alcaraz
- Research Center for High Performance Sport, Catholic University of Murcia, Murcia, Spain
- Faculty of Sport Sciences, UCAM, Catholic University of Murcia, Murcia, Spain
| | | | - Estefanía Herrera-Ramos
- Research Institute of Biomedical and Health Sciences (IUIBS), University of Las Palmas de Gran Canaria, Las Palmas, Spain
| | - Cristina Bouzas
- Biomedical Research Center on Physiopathology of Obesity and Nutrition (CIBEROBN), Institute of Health Carlos III, Madrid, Spain
- Research Group of Community Nutrition & Oxidative Stress, University of the Balearic Islands-IUNICS & Health Research Institute of the Balearic Islands (IDISBA), Palma de Mallorca, Spain
| | | | - Helmut Schröder
- Biomedical Research Networking Center on Epidemiology and Public Health studies (CIBERESP), Institute of Health Carlos III, Madrid, Spain
- Hospital del Mar Medical Research Institute (IMIM), Barcelona, Spain
| | - Eva Gesteiro
- ImFINE Research Group. Department of Health and Human Performance, Universidad Politécnica de Madrid, Madrid, Spain
| | - Marcela González-Gross
- ImFINE Research Group. Department of Health and Human Performance, Universidad Politécnica de Madrid, Madrid, Spain
- Biomedical Research Center on Physiopathology of Obesity and Nutrition (CIBEROBN), Institute of Health Carlos III, Madrid, Spain
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9
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Cini KI, Wulan NR, Dumuid D, Nurjannah Triputri A, Abbsar I, Li L, Priambodo DA, Sameve GE, Camellia A, Francis KL, Sawyer SM, Patton GC, Ansariadi A, Azzopardi PS. Towards responsive policy and actions to address non-communicable disease risks amongst adolescents in Indonesia: insights from key stakeholders. THE LANCET REGIONAL HEALTH. SOUTHEAST ASIA 2023; 18:100260. [PMID: 38028160 PMCID: PMC10667299 DOI: 10.1016/j.lansea.2023.100260] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Revised: 07/02/2023] [Accepted: 07/21/2023] [Indexed: 12/01/2023]
Abstract
Background Non-communicable diseases (NCDs) such as cancer, diabetes, heart disease, mental disorder and chronic lung conditions are the leading cause of death and disability in Indonesia. Adolescence is when risks for NCDs emerge and it is also an important life stage for intervention, yet young people are often at the margins of NCD policy and actions. This study aimed to understand how policies and actions should address NCD risks (tobacco smoking, inadequate physical activity, and diet) for adolescents in Indonesia, and how young people can be meaningfully involved. Methods Qualitative in-depth interviews over videoconference (n = 21) were conducted in English or Bahasa with stakeholders in Indonesia. Participants included policymakers, implementation partners, and advocates who were focused on adolescent health or NCDs. Interviews were recorded, transcribed, translated, and thematically analysed using NVivo12. Findings were disseminated to participants for validation and feedback. Youth participants (n = 7) attended an additional workshop and considered recommendations and actions arising from this research. Findings Participants identified that government and non-government organisations are acting on NCDs in Indonesia, but few of the existing initiatives target adolescents, and adolescent services rarely addressed NCD risks. Participants also felt that policies to protect adolescents from NCD risks (i.e., smoke-free areas in public) were not always enforced. For programs or initiatives focused on adolescent health, those that had engaged adolescents as co-creators and leaders were perceived to be more successful. As such, participants recommended more meaningful engagement of young people, including young people's leadership of initiatives. Additional recommendations included the need for intersectoral engagement and a 'whole-of-government' approach to prevention given the complex determinants of NCD risks, and the need for evidence-based actions that are underpinned by quality data to enable monitoring of progress. Interpretation There is a recognised need to strengthen policies and actions to address NCD risks amongst adolescents in Indonesia. Meaningful youth engagement that allows young people to take the lead, intersectoral actions, and evidence-based data driven responses were key strategies identified. Funding UNICEF East Asia and Pacific Regional Office.
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Affiliation(s)
- Karly I. Cini
- Global Adolescent Health Group, Maternal Child and Adolescent Health Program, Burnet Institute, Melbourne, Australia
- Centre for Adolescent Health, Murdoch Children's Research Institute, Melbourne, Australia
- Department of Paediatrics, Faculty of Medicine, Dentistry, and Health Sciences, University of Melbourne, Melbourne, Australia
| | - Nisaa R. Wulan
- Global Adolescent Health Group, Maternal Child and Adolescent Health Program, Burnet Institute, Melbourne, Australia
| | - Dorothea Dumuid
- Alliance for Research in Exercise, Nutrition and Activity (ARENA), Allied Health & Human Performance, University of South Australia, Australia
| | - Alifah Nurjannah Triputri
- Centre for Epidemiology and Population Health Studies, Faculty of Public Health, Hasanuddin University, Makassar, Indonesia
| | - Iffat Abbsar
- Centre for Adolescent Health, Murdoch Children's Research Institute, Melbourne, Australia
- Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Australia
| | - Luo Li
- Centre for Adolescent Health, Murdoch Children's Research Institute, Melbourne, Australia
- Department of Paediatrics, Faculty of Medicine, Dentistry, and Health Sciences, University of Melbourne, Melbourne, Australia
| | - Diandra A. Priambodo
- Centre for Adolescent Health, Murdoch Children's Research Institute, Melbourne, Australia
- Faculty of Medicine, University of Indonesia, Jakarta, Indonesia
| | | | | | - Kate L. Francis
- Centre for Adolescent Health, Murdoch Children's Research Institute, Melbourne, Australia
- Department of Paediatrics, Faculty of Medicine, Dentistry, and Health Sciences, University of Melbourne, Melbourne, Australia
| | - Susan M. Sawyer
- Centre for Adolescent Health, Murdoch Children's Research Institute, Melbourne, Australia
- Department of Paediatrics, Faculty of Medicine, Dentistry, and Health Sciences, University of Melbourne, Melbourne, Australia
| | - George C. Patton
- Centre for Adolescent Health, Murdoch Children's Research Institute, Melbourne, Australia
- Department of Paediatrics, Faculty of Medicine, Dentistry, and Health Sciences, University of Melbourne, Melbourne, Australia
| | - Ansariadi Ansariadi
- Centre for Epidemiology and Population Health Studies, Faculty of Public Health, Hasanuddin University, Makassar, Indonesia
| | - Peter S. Azzopardi
- Global Adolescent Health Group, Maternal Child and Adolescent Health Program, Burnet Institute, Melbourne, Australia
- Centre for Adolescent Health, Murdoch Children's Research Institute, Melbourne, Australia
- Department of Paediatrics, Faculty of Medicine, Dentistry, and Health Sciences, University of Melbourne, Melbourne, Australia
- Adolescent Health and Wellbeing Program, Telethon Kids Institute, Adelaide, South Australia, Australia
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10
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Gaube S, Walton K, Kleine AK, Däumling S, Rohrmeier C, Müller S, Bonrath E, Schneider-Brachert W. Examining outpatients' hand hygiene behaviour and its relation to COVID-19 infection prevention measures. J Hosp Infect 2023; 141:55-62. [PMID: 37634601 DOI: 10.1016/j.jhin.2023.08.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2023] [Revised: 08/03/2023] [Accepted: 08/10/2023] [Indexed: 08/29/2023]
Abstract
BACKGROUND The increasing demand for outpatient care is associated with a higher risk of infection transmission in these settings. However, there is limited research on infection prevention and control practices in ambulatory clinics, and none focuses on patients. AIM To examine outpatients' hand hygiene behaviours, their determinants, and their associations with other infection prevention measures during the COVID-19 pandemic. METHODS We observed the hand hygiene behaviour of one cohort of patients in one outpatient clinic and surveyed a separate sample in five clinics about their hand hygiene practice in outpatient facilities. A questionnaire based on the Theoretical Domains Framework (TDF) was used to examine predictors of the behaviour. Moreover, patients indicated their compliance with COVID-19 infection prevention measures, vaccination status, disease risk perception, and vaccine hesitancy. FINDINGS Observed hand hygiene rates among 618 patients were low (12.8%), while 67.3% of the 300 surveyed patients indicated sanitizing their hands upon entering the clinic. The TDF domains 'memory, attention, and decision processes' and 'emotions' significantly predicted both current (today's) and general hand hygiene behaviour in outpatient clinics. Hand hygiene behaviour and compliance with COVID-19 infection prevention showed a positive association; however, no significant connection was found with patients' vaccination status, suggesting different behavioural motivators. CONCLUSION Hand hygiene among outpatients should be improved through interventions focusing on helping patients remember to clean their hands. More research on infection prevention in outpatient facilities is needed to ensure patient safety.
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Affiliation(s)
- S Gaube
- Global Business School for Health, University College London, London, UK.
| | - K Walton
- Department of Infection Prevention and Infectious Diseases, University Hospital Regensburg, Regensburg, Germany
| | - A-K Kleine
- LMU Center for Leadership and People Management, LMU Munich, Munich, Germany
| | - S Däumling
- Department of Infection Prevention and Infectious Diseases, University Hospital Regensburg, Regensburg, Germany
| | - C Rohrmeier
- Faculty of Medicine, University of Regensburg, Regensburg, Germany; HNO-Gemeinschaftspraxis, Straubing, Germany
| | - S Müller
- Clinic and Polyclinic for Oral and Maxillofacial Surgery, University Hospital Regensburg, Regensburg, Germany; MKG-Praxis im Turm, Straubing, Germany
| | - E Bonrath
- Praxis für Chirurgie & Handchirurgie, Regensburg, Germany
| | - W Schneider-Brachert
- Department of Infection Prevention and Infectious Diseases, University Hospital Regensburg, Regensburg, Germany
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11
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Somta S, Völker M, Widyastari DA, Mysook S, Wongsingha N, Potharin D, Katewongsa P. Willingness-to-pay in physical activity: how much older adults value the community-wide initiatives programs? Front Public Health 2023; 11:1282877. [PMID: 38026321 PMCID: PMC10644721 DOI: 10.3389/fpubh.2023.1282877] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2023] [Accepted: 10/16/2023] [Indexed: 12/01/2023] Open
Abstract
Background Previous studies have shown insufficient physical activity (PA) as a significant global health concern and a major risk factor for non-communicable diseases (NCDs). Community-wide initiatives in physical activity (CWIPA) is considered as a best-buy for Community-wide initiatives in physical activity (CWIPA) is considered as a best-buy for NCDs prevention. However, assessment regarding resource allocation and cost-effectiveness of existing programs is lacking. This study investigated local residents' willingness-to-pay (WTP) for community PA programs in Southern Thailand. Methods The contingent valuation method (CVM) using the payment card approach was employed to elicit the WTP of 472 residents aged 45 years and over in selected provinces in which community PA programs had been implemented. Respondents were asked to indicate their WTP for the continuous offering of free CWIPA by choosing how much they were willing to pay from eight bid-value options, payable through their monthly electricity bill. Results The mean WTP of Thai older adults was found to be 72 baht/month ($2/month) or 868 baht/year ($25/year). This indicated the maximum amount an older person was willing to pay for any community-based PA program. More than half the sample (54.2%) chose zero as their answer, while there was a fairly large variation in other levels of WTP. The WTP was lower among older respondents and those who resided in rural areas but was higher among those with a history of participation in an organized PA program. Conclusion The level of WTP can be interpreted as an indicator of community satisfaction with CWIPA. That finding can be used as evidence for the government and policy makers in allocating resources and designing future CWIPA. A variety of organized PA programs should be offered to all community members to ensure inclusivity and also to provide equal access for senior citizens.
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Affiliation(s)
- Sittichat Somta
- Thailand Physical Activity Knowledge Development Centre (TPAK), Salaya, Nakhon Pathom, Thailand
| | - Marc Völker
- Institute for Population and Social Research, Mahidol University, Salaya, Nakhon Pathom, Thailand
| | | | - Sirinapa Mysook
- Sisaket Provincial Public Health Office, Mueang, Sisaket, Thailand
| | - Narakorn Wongsingha
- Thailand Physical Activity Knowledge Development Centre (TPAK), Salaya, Nakhon Pathom, Thailand
| | - Danusorn Potharin
- Thailand Physical Activity Knowledge Development Centre (TPAK), Salaya, Nakhon Pathom, Thailand
| | - Piyawat Katewongsa
- Institute for Population and Social Research, Mahidol University, Salaya, Nakhon Pathom, Thailand
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12
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Tegegne TK, Islam SMS, Maddison R. Longitudinal patterns of lifestyle risk behaviours among UK adults with established cardiovascular disease: a latent transition analysis. Front Cardiovasc Med 2023; 10:1116905. [PMID: 37731520 PMCID: PMC10507625 DOI: 10.3389/fcvm.2023.1116905] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2023] [Accepted: 08/21/2023] [Indexed: 09/22/2023] Open
Abstract
Background People with cardiovascular disease (CVD) need to engage in healthy lifestyle behaviours. However, there is a gap in identifying longitudinal patterns of change in lifestyle behaviours among people with CVD. This study aimed to identify clustering of lifestyle risk behaviours and their 4 ± year changes among UK adults with CVD, and to determine the associated factors. Methods We used the UK Biobank data collected at two time points (2006-2010/baseline data = T0 and 2014+/third visit data = T4). Six key lifestyle risk behaviours were assessed: smoking, high alcohol intake, poor fruit and vegetable consumption, physical inactivity, poor sleep balance (<7 or >8 h/night) and prolonged sitting. A random intercept latent transition analysis was performed to identify patterns of lifestyle risk behaviours at T0 and their changes from T0 to T4. Results We included 5,304 participants with CVD whose data on lifestyle risk behaviours were collected at two-time points. Alcohol intake and current smoking were 75.7% and 5.4% at baseline, respectively, and 67.4% and 3.0% at follow-up. Three latent classes emerged: Latent class (LC) 1-"high alcohol intake, poor sleep balance and poor fruit and vegetable intake", LC2-"high alcohol intake and poor fruit and vegetable intake", and LC3-"high alcohol intake". Most adults remained in the same LC over the 4 + years (range: 83.9%-100.0%). After 4 + years, 3.5% from LC3 and 10.4% from LC2 at baseline moved into LC1. The odds of transitioning to LC2 relative to staying in LC1 and LC3 were 2.22 and 4.13 times higher for males than for females, respectively. A single-year increase in participants' age was associated with a 1.16 times increase in the odds of moving to LC1 relative to staying in LC2. Conclusion People with CVD did not show improvement in lifestyle risk behaviours, and interventions targeting multiple lifestyle risk behaviours are needed to improve CVD.
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Affiliation(s)
- Teketo Kassaw Tegegne
- Institute for Physical Activity and Nutrition, Deakin University, Geelong, VIC, Australia
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13
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Dalene KE, Lergenmuller S, Sund ER, Hopstock LA, Robsahm TE, Nilssen Y, Nystad W, Larsen IK, Ariansen I. Clustering and trajectories of key noncommunicable disease risk factors in Norway: the NCDNOR project. Sci Rep 2023; 13:14479. [PMID: 37660221 PMCID: PMC10475033 DOI: 10.1038/s41598-023-41660-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2023] [Accepted: 08/29/2023] [Indexed: 09/04/2023] Open
Abstract
Noncommunicable diseases (NCDs) are a leading cause of premature death globally and have common preventable risk factors. In Norway, the NCDNOR-project aims at establishing new knowledge in the prevention of NCDs by combining information from national registries with data from population-based health studies. In the present study, we aimed to harmonize data on key NCD risk factors from the health studies, describe clustering of risk factors using intersection diagrams and latent class analysis, and identify long-term risk factor trajectories using latent class mixed models. The harmonized study sample consisted of 808,732 individuals (1,197,158 participations). Two-thirds were exposed to ≥ 1 NCD risk factor (daily smoking, physical inactivity, obesity, hypertension, hypercholesterolaemia or hypertriglyceridaemia). In individuals exposed to ≥ 2 risk factors (24%), we identified five distinct clusters, all characterized by fewer years of education and lower income compared to individuals exposed to < 2 risk factors. We identified distinct long-term trajectories of smoking intensity, leisure-time physical activity, body mass index, blood pressure, and blood lipids. Individuals in the trajectories tended to differ across sex, education, and body mass index. This provides important insights into the mechanisms by which NCD risk factors can occur and may help the development of interventions aimed at preventing NCDs.
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Affiliation(s)
- Knut Eirik Dalene
- Department of Chronic Diseases, Norwegian Institute of Public Health, PO Box 222, 0213, Oslo, Skøyen, Norway.
| | - Simon Lergenmuller
- Department of Registration, Cancer Registry of Norway, PO Box 5313, 0304, Oslo, Majorstuen, Norway
| | - Erik R Sund
- Department of Public Health and Nursing, Norwegian University of Science and Technology, Oslo, Norway
- Levanger Hospital, Nord-Trøndelag Hospital Trust, Levanger, Norway
| | - Laila A Hopstock
- Department of Health and Care Sciences, UiT The Arctic University of Norway, Oslo, Norway
| | | | - Yngvar Nilssen
- Department of Registration, Cancer Registry of Norway, PO Box 5313, 0304, Oslo, Majorstuen, Norway
| | - Wenche Nystad
- Department of Chronic Diseases, Norwegian Institute of Public Health, PO Box 222, 0213, Oslo, Skøyen, Norway
| | - Inger Kristin Larsen
- Department of Registration, Cancer Registry of Norway, PO Box 5313, 0304, Oslo, Majorstuen, Norway
| | - Inger Ariansen
- Department of Chronic Diseases, Norwegian Institute of Public Health, PO Box 222, 0213, Oslo, Skøyen, Norway
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14
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Alosaimi N, Sherar LB, Griffiths P, Pearson N. Clustering of diet, physical activity and sedentary behaviour and related physical and mental health outcomes: a systematic review. BMC Public Health 2023; 23:1572. [PMID: 37596591 PMCID: PMC10436445 DOI: 10.1186/s12889-023-16372-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2023] [Accepted: 07/24/2023] [Indexed: 08/20/2023] Open
Abstract
BACKGROUND Physical activity (PA), sedentary behaviour (SB) and diet play an important role in the physical and mental health of young people. Understanding how these behaviours cluster, and the impact of clusters on health is important for the development of public health interventions. This review examines the prevalence of clusters of PA, sedentary time, and dietary behaviours, and how clusters relate to physical and mental health indicators among children, adolescents and young adults. METHODS Electronic (PubMed, Web of Science and Scopus) and manual searches were conducted for articles that were (i) observational studies including children, adolescents and/or young adults aged 5-24 years, (ii) examined the 'patterning', 'clustering', or 'co-existence' of each of PA, dietary behaviour and SB, and (iii) published in English up to and including July 2022. In addition to information on clustering, data on physical and mental health outcomes were extracted where reported. Included studies were assessed using the Cochrane risk of bias for observational studies. A narrative synthesis was conducted due to high heterogeneity. This review was registered with PROSPERO (CRD42021230976). RESULTS Forty-nine cross-sectional studies and four prospective cohort studies from eighteen countries reporting data from 778,415 individual participants were included. A broad range of clusters (n = 172) were found (healthy, unhealthy, and mixed). Mixed clusters were common (n = 98), and clusters of high diet quality, low PA and high SB were more prevalent in girls, while mixed clusters of high PA, high SB and low diet quality were more prevalent in boys. Unhealthy clusters comprising low moderate to vigorous PA, low consumption of fruits and vegetables, and high screen time were prevalent, particularly in those from lower socioeconomic status families. Compared to those with healthy behavioural clusters, those with unhealthy and mixed clusters had a higher adiposity, higher risk of cardiovascular disease, poorer mental health scores, and lower cardiorespiratory fitness. CONCLUSIONS PA, SB and diet cluster in healthy, unhealthy and mixed patterns in young people that differ across sociodemographic characteristics. Unhealthy clusters are associated with poorer health outcomes. Intervention strategies targeting un-clustering multiple unhealthy behaviours should be developed and evaluated for their impact on health outcomes.
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Affiliation(s)
- Noura Alosaimi
- School of Sport, Exercise & Health Sciences, Loughborough University, Epinal Way, Loughborough, LE11 3TU, Leicestershire, UK.
| | - Lauren B Sherar
- School of Sport, Exercise & Health Sciences, Loughborough University, Epinal Way, Loughborough, LE11 3TU, Leicestershire, UK
- National Institute for Health Research (NIHR) Leicester Biomedical Research Centre, Leicester, UK
| | - Paula Griffiths
- School of Sport, Exercise & Health Sciences, Loughborough University, Epinal Way, Loughborough, LE11 3TU, Leicestershire, UK
| | - Natalie Pearson
- School of Sport, Exercise & Health Sciences, Loughborough University, Epinal Way, Loughborough, LE11 3TU, Leicestershire, UK
- National Institute for Health Research (NIHR) Leicester Biomedical Research Centre, Leicester, UK
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15
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Almas A, Iqbal R, Ghani A, Samad Z, Sabir S, Kazmi K. School Health Education Program in Pakistan (SHEPP): findings from a feasibility trial in pre-adolescent school children from a lower middle-income country. Pilot Feasibility Stud 2023; 9:123. [PMID: 37461089 PMCID: PMC10351151 DOI: 10.1186/s40814-023-01344-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2022] [Accepted: 06/16/2023] [Indexed: 07/20/2023] Open
Abstract
BACKGROUND The school environment plays an essential role in promoting health education and physical activity for children and adolescents. We aim to assess the feasibility of threefold health education program in children and its potential efficacy on physical activity and diet and cardiometabolic risk factors including blood pressure, body mass index (BMI), and waist circumference. METHODS The SHEPP was a parallel group feasibility intervention trial conducted in two schools over 23 months. All children aged 9-11 years enrolled in the schools were included. The SHEPP intervention comprised of health education on healthy lifestyle and physical activity sessions for children, training of teachers, and awareness sessions for parents conducted over 10 months. One school received the intervention of SHEPP while the other school continued routine activity. The primary outcome was the feasibility of SHEPP in terms of recruitment, retention, and treatment fidelity. Secondary outcomes were physical activity levels, dietary intake (of fruits and vegetables), and cardiometabolic risk factors (blood pressure, BMI, and waist circumference (WC)). RESULTS A total of 1280 preadolescent children were assessed for eligibility and 1191 were found eligible. The overall recruitment n (%) was 982/1191(82.5%) with 505(51.4) from SHEPP intervention school and 477(48.6) in routine activity school. The overall retention rate n (%) at 10-month follow-up was 912/982(92.8), with 465/505(92) in SHEPP intervention school and 447/477(93.7) in routine activity school. In treatment fidelity, 132/144(92) %). Physical activity sessions and all (100%) health education sessions were conducted for each of the twelve classes. Mean (SD) Seven-day Physical activity increased by 134 (196) min in the SHEPP intervention school v 29.8(177) in the routine activity school (P value < 0.001) from baseline to follow-up. Overall, there was an increase in vegetable intake (> 3 serving /day) in SHEPP intervention school of 5.5 to 21.4% from baseline to follow-up compared to 7.5 to 14.9% in routine activity school. The mean change (SD) in systolic blood pressure was 1.3(12) mmHg, 2.2(19.0) mm Hg in in diastolic blood pressure, - 0.09(5.4) kg/m2 in BMI and 6.2 cm in waist circumference in the intervention arm versus - 3.4(11.1) mm Hg in SBP, - 4.3(9.9) mm Hg in DBP, - 0.04((4.6) kg/m2 in BMI, and 3.8 cm in WC in the control arm. CONCLUSION We found that intervention using SHEPP is feasible in schools and may help children to adopt a healthy lifestyle as they age by increasing physical activity. However, the potentially beneficial effect on diet, MI, and BP needs further exploration and a longer follow-up, more specifically at the juncture of teenage and adulthood. TRIAL REGISTRATION NCT03303287.
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Affiliation(s)
- Aysha Almas
- Department of Medicine, Aga Khan University, Karachi, Pakistan.
| | - Romaina Iqbal
- Department of Community Health Sciences, Aga Khan University, Karachi, Pakistan
| | - Abdul Ghani
- Institute of Public Health, Quetta, Pakistan
| | - Zainab Samad
- Department of Medicine, Aga Khan University, Karachi, Pakistan
| | - Sania Sabir
- Department of Medicine, Aga Khan University, Karachi, Pakistan
| | - Khawar Kazmi
- National Institute of Cardiovascular Diseases, Karachi, Pakistan
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Vakili M, Mirzadeh M, Mirzaei M, Modarresi M, Raei R, Karimi R, Aghakoochak A, Imani AA. Sex differences in high-risk health behaviors among school-going adolescents in Yazd, Iran; a cross-sectional study. Heliyon 2023; 9:e16404. [PMID: 37303572 PMCID: PMC10250580 DOI: 10.1016/j.heliyon.2023.e16404] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2022] [Revised: 05/14/2023] [Accepted: 05/15/2023] [Indexed: 06/13/2023] Open
Abstract
Objective Adolescents are exposed to a wide range of high-risk health behaviors. This study aimed to investigate the high-risk health behaviors of adolescents in an Iranian adolescent population and gender differences. Method This cross-sectional descriptive study recruited high school students in Yazd city in center of Iran. Schools were randomly selected. In each school, all selected classes were included. Sampling in each class was census. The study investigated self-reported high-risk health behaviors. Students completed the Global School-based Student Health Survey (GSHS), an anonymous, validated questionnaire. Results 2420 students participated in this study (52.5% male). The age range was 12-19 years. Daily consumption of ≥1 serving of fruit and vegetables per day was reported by 77.4% and 49.5% of respondents, respectively. Adequate physical activity was reported by only 18.4% of adolescents, and significantly less frequently by girls than boys (p < 0.001). 11.8% were current smokers (M/F ratio: 2.6), and 20.5% (M/F ratio: 1.5) were ever used hookah. The prevalence of ever alcohol and substance abuse was 15.5% and 8.8%, respectively. The prevalence of tobacco and substance use was significantly higher in participants' boys than in girls (p < 0.001). Males were over twice more likely to report frequent fighting in the past 12 months than girls. Overall, girls reported more parental supervision than boys (82.1% vs. 73.4%) and parental monitoring (90.6% vs. 86.8%), while boys reported higher levels of awareness over leisure activities than girls (65.8% vs. 58.4%). Conclusions High-risk health behaviors are more common in boys than girls. Health policymakers should use these results in prioritizing and designing health interventions to promote youth health. Further studies are recommended to identify the factors influencing the prevalence of these behaviors.
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Affiliation(s)
- Mahmood Vakili
- Health Monitoring Research Center, School of Medicine, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Mahboobahsadat Mirzadeh
- Department of Internal Medicine, School of Medicine, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Mohsen Mirzaei
- Accident Prevention and Crisis Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Mozhgan Modarresi
- Yazd Cardiovascular Research Center, School of Medicine, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Reihaneh Raei
- Health Monitoring Research Center, School of Medicine, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Reihaneh Karimi
- Health Monitoring Research Center, School of Medicine, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Arezoo Aghakoochak
- Health Monitoring Research Center, School of Medicine, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
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Castro O, Mair JL, Salamanca-Sanabria A, Alattas A, Keller R, Zheng S, Jabir A, Lin X, Frese BF, Lim CS, Santhanam P, van Dam RM, Car J, Lee J, Tai ES, Fleisch E, von Wangenheim F, Tudor Car L, Müller-Riemenschneider F, Kowatsch T. Development of "LvL UP 1.0": a smartphone-based, conversational agent-delivered holistic lifestyle intervention for the prevention of non-communicable diseases and common mental disorders. Front Digit Health 2023; 5:1039171. [PMID: 37234382 PMCID: PMC10207359 DOI: 10.3389/fdgth.2023.1039171] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2022] [Accepted: 04/06/2023] [Indexed: 05/28/2023] Open
Abstract
Background Non-communicable diseases (NCDs) and common mental disorders (CMDs) are the leading causes of death and disability worldwide. Lifestyle interventions via mobile apps and conversational agents present themselves as low-cost, scalable solutions to prevent these conditions. This paper describes the rationale for, and development of, "LvL UP 1.0″, a smartphone-based lifestyle intervention aimed at preventing NCDs and CMDs. Materials and Methods A multidisciplinary team led the intervention design process of LvL UP 1.0, involving four phases: (i) preliminary research (stakeholder consultations, systematic market reviews), (ii) selecting intervention components and developing the conceptual model, (iii) whiteboarding and prototype design, and (iv) testing and refinement. The Multiphase Optimization Strategy and the UK Medical Research Council framework for developing and evaluating complex interventions were used to guide the intervention development. Results Preliminary research highlighted the importance of targeting holistic wellbeing (i.e., both physical and mental health). Accordingly, the first version of LvL UP features a scalable, smartphone-based, and conversational agent-delivered holistic lifestyle intervention built around three pillars: Move More (physical activity), Eat Well (nutrition and healthy eating), and Stress Less (emotional regulation and wellbeing). Intervention components include health literacy and psychoeducational coaching sessions, daily "Life Hacks" (healthy activity suggestions), breathing exercises, and journaling. In addition to the intervention components, formative research also stressed the need to introduce engagement-specific components to maximise uptake and long-term use. LvL UP includes a motivational interviewing and storytelling approach to deliver the coaching sessions, as well as progress feedback and gamification. Offline materials are also offered to allow users access to essential intervention content without needing a mobile device. Conclusions The development process of LvL UP 1.0 led to an evidence-based and user-informed smartphone-based intervention aimed at preventing NCDs and CMDs. LvL UP is designed to be a scalable, engaging, prevention-oriented, holistic intervention for adults at risk of NCDs and CMDs. A feasibility study, and subsequent optimisation and randomised-controlled trials are planned to further refine the intervention and establish effectiveness. The development process described here may prove helpful to other intervention developers.
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Affiliation(s)
- Oscar Castro
- Future Health Technologies, Singapore-ETH Centre, Campus for Research Excellence and Technological Enterprise (CREATE), Singapore, Singapore
| | - Jacqueline Louise Mair
- Future Health Technologies, Singapore-ETH Centre, Campus for Research Excellence and Technological Enterprise (CREATE), Singapore, Singapore
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore
| | - Alicia Salamanca-Sanabria
- Future Health Technologies, Singapore-ETH Centre, Campus for Research Excellence and Technological Enterprise (CREATE), Singapore, Singapore
| | - Aishah Alattas
- Future Health Technologies, Singapore-ETH Centre, Campus for Research Excellence and Technological Enterprise (CREATE), Singapore, Singapore
| | - Roman Keller
- Future Health Technologies, Singapore-ETH Centre, Campus for Research Excellence and Technological Enterprise (CREATE), Singapore, Singapore
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore
| | - Shenglin Zheng
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore
| | - Ahmad Jabir
- Neuroscience and Mental Health, Lee Kong Chian School of Medicine, Nanyang Technological University Singapore, Singapore, Singapore
| | - Xiaowen Lin
- Neuroscience and Mental Health, Lee Kong Chian School of Medicine, Nanyang Technological University Singapore, Singapore, Singapore
| | - Bea Franziska Frese
- Future Health Technologies, Singapore-ETH Centre, Campus for Research Excellence and Technological Enterprise (CREATE), Singapore, Singapore
- Centre for Digital Health Interventions,Institute of Technology Management, University of St. Gallen, St. Gallen, Switzerland
| | - Chang Siang Lim
- Future Health Technologies, Singapore-ETH Centre, Campus for Research Excellence and Technological Enterprise (CREATE), Singapore, Singapore
| | - Prabhakaran Santhanam
- Centre for Digital Health Interventions, Department of Management, Technology, and Economics, ETH Zurich, Zurich, Switzerland
| | - Rob M. van Dam
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore
- Department of Exercise and Nutrition Sciences, Milken Institute School of Public Health, George Washington University, Washington DC, DC, United States
| | - Josip Car
- Centre for Population Health Sciences, LKCMedicine, Nanyang Technological University, Singapore, Singapore
- Department of Primary Care and Public Health, School of Public Health, Imperial College London, London, United Kingdom
| | - Jimmy Lee
- Neuroscience and Mental Health, Lee Kong Chian School of Medicine, Nanyang Technological University Singapore, Singapore, Singapore
- Research Division, Institute of Mental Health, Singapore, Singapore
- North Region & Department of Psychosis, Institute of Mental Health, Singapore, Singapore
| | - E Shyong Tai
- Future Health Technologies, Singapore-ETH Centre, Campus for Research Excellence and Technological Enterprise (CREATE), Singapore, Singapore
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Elgar Fleisch
- Future Health Technologies, Singapore-ETH Centre, Campus for Research Excellence and Technological Enterprise (CREATE), Singapore, Singapore
- Centre for Digital Health Interventions,Institute of Technology Management, University of St. Gallen, St. Gallen, Switzerland
| | - Florian von Wangenheim
- Future Health Technologies, Singapore-ETH Centre, Campus for Research Excellence and Technological Enterprise (CREATE), Singapore, Singapore
- Centre for Digital Health Interventions, Department of Management, Technology, and Economics, ETH Zurich, Zurich, Switzerland
| | - Lorainne Tudor Car
- Neuroscience and Mental Health, Lee Kong Chian School of Medicine, Nanyang Technological University Singapore, Singapore, Singapore
- Department of Primary Care and Public Health, School of Public Health, Imperial College London, London, United Kingdom
| | - Falk Müller-Riemenschneider
- Future Health Technologies, Singapore-ETH Centre, Campus for Research Excellence and Technological Enterprise (CREATE), Singapore, Singapore
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore
- Digital Health Center, Berlin Institute of Health, Charite University Medical Centre Berlin, Berlin, Germany
| | - Tobias Kowatsch
- Future Health Technologies, Singapore-ETH Centre, Campus for Research Excellence and Technological Enterprise (CREATE), Singapore, Singapore
- Centre for Digital Health Interventions, Department of Management, Technology, and Economics, ETH Zurich, Zurich, Switzerland
- Institute for Implementation Science in Health Care, University of Zurich, Zurich, Switzerland
- School of Medicine, University of St. Gallen, St. Gallen, Switzerland
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Zambrano Bermeo RN, Estrada Gonzalez C, Guerra EDPH. Influence of Personal Factors on Health-Promoting Behavior in College Students: A Structural Equation Modeling Approach. J Multidiscip Healthc 2023; 16:1259-1270. [PMID: 37179974 PMCID: PMC10167957 DOI: 10.2147/jmdh.s401870] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2022] [Accepted: 03/14/2023] [Indexed: 05/15/2023] Open
Abstract
Purpose This study aimed to determine how personal factors influence health-promoting behavior in university students using a structural equation modeling approach guided by the Health Promotion Model. Patients and Methods An analytical cross-sectional study was conducted. The study included 763 health science students from four universities in Cali, Colombia, who answered a questionnaire on personal factors and Health Promoting Lifestyle Profile II, Spanish version, which was validated in the study population. The direct and indirect relationships between personal factors and health-promoting behaviors were assessed using structural equation modeling. Data analysis was performed using descriptive statistics and structural equation modeling. Results A significant relationship was noted between the biological and psychological personal factors of the measurement model (p < 0.05). Psychological personal factors (self-esteem and perceived health status) positively influence health promoting behavior in university students (Hypothesis 2). It's not possible to demonstrate that health promoting behavior is positively influenced by personal biological factors (Hypothesis 1) and by personal sociocultural factors (Hypothesis 3). Conclusion There is a need for interventions that help improve the health-promoting lifestyle profile and are focused on enhancing the self-esteem and perceived health status of university students.
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Collins S, Hoare E, Allender S, Olive L, Leech RM, Winpenny EM, Jacka F, Lotfalian M. A longitudinal study of lifestyle behaviours in emerging adulthood and risk for symptoms of depression, anxiety, and stress. J Affect Disord 2023; 327:244-253. [PMID: 36754097 DOI: 10.1016/j.jad.2023.02.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/04/2022] [Revised: 01/28/2023] [Accepted: 02/01/2023] [Indexed: 02/08/2023]
Abstract
BACKGROUND Little research has examined how lifestyle behaviours cluster together to contribute to mental health outcomes. The current study aimed to identify latent classes of emerging adult lifestyle behaviours (diet, physical activity, sedentary time, smoking, alcohol, cannabis, and other drug use) at age 20 years and their associations with depression, anxiety, and stress symptoms at age 22 and 27 years. METHODS Participants were 616 emerging adults enrolled in the Raine Study. Lifestyle classes at baseline were identified using latent class analysis. Longitudinal associations between latent class membership and risk of depression, anxiety, and stress symptoms were examined using logistic regression models. RESULTS Three lifestyle classes were identified: Class 1 (healthier pattern, n = 399 [64.8 %]), Class 2 (predominantly female, high substance-use, low physical activity pattern, n = 121 [19.6 %]), and Class 3 (predominantly male, high substance-use, poor diet pattern, n = 96 [15.6 %]). Following adjustment, Class 2 were at a higher risk of depression, anxiety, and stress symptoms at age 22 years, and a higher risk of anxiety and stress symptoms at age 27 years, compared to Class 1. LIMITATIONS This study was limited by reliance on self-report data, lack of available indicators for parental socioeconomic status, and some measurement inconsistencies across variables. Adherence to lifestyle clusters over time was not assessed. CONCLUSIONS Latent classes of lifestyle behaviours were identified among emerging adults, and differences in mental health outcomes were found among the classes at two prospective time points. Future research and prevention strategies for common mental disorders should target emerging adults and focus on lifestyle patterns.
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Affiliation(s)
- Sam Collins
- Deakin University, The Institute for Mental and Physical Health and Clinical Translation (IMPACT), Food & Mood Centre, School of Medicine, Barwon Health, Australia.
| | - Erin Hoare
- Deakin University, The Institute for Mental and Physical Health and Clinical Translation (IMPACT), Food & Mood Centre, School of Medicine, Barwon Health, Australia
| | - Steven Allender
- Deakin University, Institute for Health Transformation, Global Obesity Centre, School of Health and Social Development, Australia
| | - Lisa Olive
- Deakin University, The Institute for Mental and Physical Health and Clinical Translation (IMPACT), School of Medicine, Barwon Health, Australia; Deakin University, Centre for Social and Early Emotional Development, School of Psychology, Australia
| | - Rebecca M Leech
- Deakin University, The Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Geelong, Australia
| | | | - Felice Jacka
- Deakin University, The Institute for Mental and Physical Health and Clinical Translation (IMPACT), Food & Mood Centre, School of Medicine, Barwon Health, Australia
| | - Mojtaba Lotfalian
- Deakin University, The Institute for Mental and Physical Health and Clinical Translation (IMPACT), School of Medicine, Barwon Health, Australia
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20
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Shi Y, Shi M, Liu C, Sui L, Zhao Y, Fan X. Associations with physical activity, sedentary behavior, and premenstrual syndrome among Chinese female college students. BMC Womens Health 2023; 23:173. [PMID: 37041480 PMCID: PMC10091683 DOI: 10.1186/s12905-023-02262-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2022] [Accepted: 03/07/2023] [Indexed: 04/13/2023] Open
Abstract
PURPOSE Premenstrual syndrome refers to a set of distressing symptoms experienced before the menstrual flow, which can affect female students' behavior, cognitive abilities, mental health status, and academic performance. Identifying modifiable risk factors is essential to reduce the prevalence college students' premenstrual syndrome. We examined associations between premenstrual syndrome and physical activity and sedentary behavior in Chinese female college students. METHODS In this cross-sectional study, 315 female college students volunteered to participate at a university in Shanghai, China. We measured physical activity and sedentary behavior using the ActiGraph GT3X-BT and assessed premenstrual syndrome using the Premenstrual Symptoms Screening Tool. The data were statistically analyzed using SPSS 24.0 software, and the primary analysis methods included Kruskal-Wallis test and logistic regression analysis. RESULTS Among the 221 female college students who met the inclusion criteria, 148 (67.0%) had PMS while 73 (33.3%) did not. After controlling for confounding variables, moderate physical activity and moderate to vigorous intensity physical activity were significantly associated with premenstrual syndrome. There was no correlation between light-intensity physical activity, sedentary behavior, and premenstrual syndrome in the study. CONCLUSION Premenstrual syndrome is prevalent among Chinese female college students. Moderate physical activity and moderate-to-vigorous physical activity can be effective in reducing PMS symptoms.
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Affiliation(s)
- Yuqing Shi
- Department of Physical Education, Shanghai Jiao Tong University, Shanghai, 200240, China
| | - Mengyao Shi
- Department of Physical Education, The High school Affiliated to, Southern University of Science and Technology, Shengzhen, 518109, China
| | - Chang Liu
- Department of Physical Education, Shanghai Jiao Tong University, Shanghai, 200240, China
| | - Lu Sui
- Department of Physical Education, Shanghai Jiao Tong University, Shanghai, 200240, China
| | - Ying Zhao
- Department of Physical Education, Shanghai Jiao Tong University, Shanghai, 200240, China
| | - Xiang Fan
- Department of Physical Education, Shanghai Jiao Tong University, Shanghai, 200240, China.
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21
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Champion KE, Newton NC, Gardner LA, Chapman C, Thornton L, Slade T, Sunderland M, Hides L, McBride N, O'Dean S, Kay-Lambkin F, Allsop S, Lubans DR, Parmenter B, Mills K, Spring B, Osman B, Ellem R, Smout S, Whife J, Stewart C, McCann KM, Catakovic A, Hunter E, Teesson M. Health4Life eHealth intervention to modify multiple lifestyle risk behaviours among adolescent students in Australia: a cluster-randomised controlled trial. Lancet Digit Health 2023; 5:e276-e287. [PMID: 37032200 DOI: 10.1016/s2589-7500(23)00028-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2022] [Revised: 01/20/2023] [Accepted: 02/06/2023] [Indexed: 04/11/2023]
Abstract
BACKGROUND Lifestyle risk behaviours are prevalent among adolescents and commonly co-occur, but current intervention approaches tend to focus on single risk behaviours. This study aimed to evaluate the efficacy of the eHealth intervention Health4Life in modifying six key lifestyle risk behaviours (ie, alcohol use, tobacco smoking, recreational screen time, physical inactivity, poor diet, and poor sleep, known as the Big 6) among adolescents. METHODS We conducted a cluster-randomised controlled trial in secondary schools that had a minimum of 30 year 7 students, in three Australian states. A biostatistician randomly allocated schools (1:1) to Health4Life (a six-module, web-based programme and accompanying smartphone app) or an active control group (usual health education) with the Blockrand function in R, stratified by site and school gender composition. All students aged 11-13 years who were fluent in English and attended participating schools were eligible. Teachers, students, and researchers were not masked to allocation. Primary outcomes were alcohol use, tobacco use, recreational screen time, moderate to vigorous physical activity (MVPA), sugar-sweetened beverage intake, and sleep duration at 24 months, measured by self-report surveys, and analysed in all students who were eligible at baseline. Latent growth models estimated between-group change over time. This trial is registered with the Australian New Zealand Clinical Trials Registry (ACTRN12619000431123). FINDINGS Between April 1, 2019, and Sept 27, 2019, we recruited 85 schools (9280 students), of which 71 schools with 6640 eligible students (36 schools [3610 students] assigned to the intervention and 35 [3030 students] to the control) completed the baseline survey. 14 schools were excluded from the final analysis or withdrew, mostly due to a lack of time. We found no between-group differences for alcohol use (odds ratio 1·24, 95% CI 0·58-2·64), smoking (1·68, 0·76-3·72), screen time (0·79, 0·59-1·06), MVPA (0·82, 0·62-1·09), sugar-sweetened beverage intake (1·02, 0·82-1·26), or sleep (0·91, 0·72-1·14) at 24 months. No adverse events were reported during this trial. INTERPRETATION Health4Life was not effective in modifying risk behaviours. Our results provide new knowledge about eHealth multiple health behaviour change interventions. However, further research is needed to improve efficacy. FUNDING Paul Ramsay Foundation, the Australian National Health and Medical Research Council, the Australian Government Department of Health and Aged Care, and the US National Institutes of Health.
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Affiliation(s)
- Katrina E Champion
- The Matilda Centre for Research in Mental Health and Substance Use, University of Sydney, Sydney, NSW, Australia.
| | - Nicola C Newton
- The Matilda Centre for Research in Mental Health and Substance Use, University of Sydney, Sydney, NSW, Australia
| | - Lauren A Gardner
- The Matilda Centre for Research in Mental Health and Substance Use, University of Sydney, Sydney, NSW, Australia
| | - Cath Chapman
- The Matilda Centre for Research in Mental Health and Substance Use, University of Sydney, Sydney, NSW, Australia
| | - Louise Thornton
- The Matilda Centre for Research in Mental Health and Substance Use, University of Sydney, Sydney, NSW, Australia
| | - Tim Slade
- The Matilda Centre for Research in Mental Health and Substance Use, University of Sydney, Sydney, NSW, Australia
| | - Matthew Sunderland
- The Matilda Centre for Research in Mental Health and Substance Use, University of Sydney, Sydney, NSW, Australia
| | - Leanne Hides
- School of Psychology, The University of Queensland, Brisbane, QLD, Australia
| | - Nyanda McBride
- National Drug Research Institute, enAble Institute for Health Research, Curtin University, Perth, WA, Australia
| | - Siobhan O'Dean
- The Matilda Centre for Research in Mental Health and Substance Use, University of Sydney, Sydney, NSW, Australia
| | | | - Steve Allsop
- National Drug Research Institute, enAble Institute for Health Research, Curtin University, Perth, WA, Australia
| | - David R Lubans
- Centre for Active Living and Learning, University of Newcastle, Callaghan, NSW, Australia
| | - Belinda Parmenter
- School of Health Sciences, University of New South Wales, Sydney, NSW, Australia
| | - Katherine Mills
- The Matilda Centre for Research in Mental Health and Substance Use, University of Sydney, Sydney, NSW, Australia
| | - Bonnie Spring
- Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - Bridie Osman
- The Matilda Centre for Research in Mental Health and Substance Use, University of Sydney, Sydney, NSW, Australia
| | - Rhiannon Ellem
- School of Psychology, The University of Queensland, Brisbane, QLD, Australia
| | - Scarlett Smout
- The Matilda Centre for Research in Mental Health and Substance Use, University of Sydney, Sydney, NSW, Australia
| | - Jesse Whife
- National Drug Research Institute, enAble Institute for Health Research, Curtin University, Perth, WA, Australia
| | - Courtney Stewart
- National Drug Research Institute, enAble Institute for Health Research, Curtin University, Perth, WA, Australia
| | - Karrah M McCann
- The Matilda Centre for Research in Mental Health and Substance Use, University of Sydney, Sydney, NSW, Australia
| | - Amra Catakovic
- School of Psychology, The University of Queensland, Brisbane, QLD, Australia
| | - Emily Hunter
- The Matilda Centre for Research in Mental Health and Substance Use, University of Sydney, Sydney, NSW, Australia
| | - Maree Teesson
- The Matilda Centre for Research in Mental Health and Substance Use, University of Sydney, Sydney, NSW, Australia
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Li Y, Fan X, Wei L, Yang K, Jiao M. The impact of high-risk lifestyle factors on all-cause mortality in the US non-communicable disease population. BMC Public Health 2023; 23:422. [PMID: 36864408 PMCID: PMC9979572 DOI: 10.1186/s12889-023-15319-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2022] [Accepted: 02/24/2023] [Indexed: 03/04/2023] Open
Abstract
BACKGROUND Previous studies have suggested that lifestyle factors are associated with mortality in different population. However, little is known about the impact of lifestyle factors on all-cause mortality in non-communicable disease (NCD) population. METHODS This study included 10,111 NCD patients from the National Health Interview Survey. The potential high-risk lifestyle factors were defined as smoking, excessive drinking, abnormal body mass index, abnormal sleep duration, insufficient physical activity (PA), overlong sedentary behavior (SB), high dietary inflammatory index (DII) and low diet quality. Cox proportional hazard model was used to evaluate the impact of the lifestyle factors and the combination on all-cause mortality. The interaction effects and all combinations of lifestyle factors were also analyzed. RESULTS During 49,972 person-years of follow-up, 1040 deaths (10.3%) were identified. Among eight potential high-risk lifestyle factors, smoking (HR = 1.25, 95% CI 1.09-1.43), insufficient PA (HR = 1.86, 95% CI 1.61-2.14), overlong SB (HR = 1.33, 95% CI 1.17-1.51) and high DII (HR = 1.24, 95% CI 1.07-1.44) were risk factors for all-cause mortality in the multivariable Cox proportional regression. The risk of all-cause mortality was increased linearly as the high-risk lifestyle score increased (P for trend < 0.01). The interaction analysis showed that lifestyle had stronger impact on all-cause mortality among patients with higher education and income level. The combinations of lifestyle factors involving insufficient PA and overlong SB had stronger associations with all-cause mortality than those with same number of factors. CONCLUSION Smoking, PA, SB, DII and their combination had significant impact on all-cause mortality of NCD patients. The synergistic effects of these factors were observed, suggesting some combinations of high-risk lifestyle factor may be more harmful than others.
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Affiliation(s)
- Ying Li
- Department of Science and Education, the Third People's Hospital of Longgang District Shenzhen, Shenzhen, 518100, China
| | - Xue Fan
- Department of Science and Education, the Third People's Hospital of Longgang District Shenzhen, Shenzhen, 518100, China
| | - Lifeng Wei
- The Personnel Department, Harbin Medical University, Harbin, 150086, China
| | - Kai Yang
- Shenzhen Institute of Respiratory Diseases, Shenzhen People's Hospital (Second Clinical Medical College of Jinan University, First Affiliated Hospital of Southern University of Science and Technology), Shenzhen, 518001, China.
| | - Mingli Jiao
- Research Center of Health Policy and Hospital Management, School of Health Management, Harbin Medical University, Harbin, 150086, China.
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Honicky M, Cardoso SM, Lima LRAD, Souza JN, Vieira FGK, Back IDC, Moreno YMF. Changes in lifestyle behaviors during the COVID-19 pandemic in children and adolescents with congenital heart disease. REVISTA PAULISTA DE PEDIATRIA : ORGAO OFICIAL DA SOCIEDADE DE PEDIATRIA DE SAO PAULO 2023; 41:e2022023. [PMID: 36921174 PMCID: PMC10014030 DOI: 10.1590/1984-0462/2023/41/2022023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 02/01/2022] [Accepted: 06/26/2022] [Indexed: 03/18/2023]
Abstract
OBJECTIVE To describe the changes in lifestyle behaviors during the COVID-19 pandemic in children and adolescents with congenital heart disease and to investigate the association of congenital heart disease complexity with lifestyle behavior changes. METHODS Cross-sectional study with 127 children and adolescents with congenital heart disease, who underwent cardiac procedure (mean postoperative time: 10.11±3.13 years), conducted between December 2020 and January 2021. Lifestyle behaviors, such as dietary intake, physical activity, sedentary behavior, and sleep, were assessed through telephone interview based on validated questionnaires. Dietary patterns were identified using principal component analysis. Frequency of general and specific combinations of healthy and unhealthy lifestyle behavior changes was evaluated. Multinomial logistic regressions were used to test the association between congenital heart disease complexity and changes in lifestyle behavior. RESULTS The main lifestyle behaviors acquired during pandemic were: 83.5% decreased physical activity; 37.0% increased sedentary behavior; 26.0% slept more than usual; and 23.6% adopted a less-healthy dietary pattern. Almost half of the participants (41.8%) had at least one unhealthy change in lifestyle behavior. Complex congenital heart diseases were associated with increased sedentary behavior (OR 3.49, 95%CI 1.23-9.90). CONCLUSIONS Children and adolescents with congenital heart disease had unhealthy lifestyle behavior during the pandemic, mainly in the form of reduced physical activity and increased sedentary behavior.
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Affiliation(s)
- Michele Honicky
- Universidade Federal de Santa Catarina, Florianópolis, SC, Brazil
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Bhandari S, Frongillo EA, Suwal R, Schreinemachers P, Gupta AS, Blake CE, Tiwari NP, Cunningham K. Sustaining Agriculture and Nutrition Interventions: Continued Engagement of Village Model Farmers in Nepal. Food Nutr Bull 2022; 43:412-428. [PMID: 35726207 DOI: 10.1177/03795721221106588] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
BACKGROUND In homestead food production (HFP) programs, village model farmers (VMFs), after training, implement agriculture and nutrition activities to improve household knowledge and practices. Little evidence exists on what enables VMFs to remain actively engaged and for impacts to be sustained. OBJECTIVE To examine variables explaining active engagement of VMFs, at least 4 years post-training, in an HFP program in Nepal. METHODS We used cross-sectional data, collected from 2018 to 2019, among 4750 VMFs of Suaahara, a multisectoral nutrition program. We assessed whether respondents registered their HFP group with the local government, conducted regular group meetings, discussed vegetable growing and chicken rearing practices with group members, or engaged in saving and credit activities in their HFP group. Outcome variable was a count of these 4 activities in which the VMF engaged. Socioeconomic, demographic, and programmatic explanatory variables were identified a priori and by bivariate analysis and were adjusted in ordinal regression models accounting for clusters. RESULTS On average, VMFs engaged in 1.4 activities. Having attended primary or secondary school (adjusted odds ratios [AOR] = 1.39), being a female community health volunteer (AOR = 1.27), being from an advantaged caste/ethnic group (AOR = 1.34), receiving additional trainings (AOR = 1.56) and inputs (AOR = 1.31) were associated with more active engagement of VMFs. CONCLUSION Village model farmers receiving more training and inputs were more likely to remain actively engaged. Female community health workers, people from higher caste/ethnic groups, and those with primary or secondary education were more likely to remain active VMFs and could be targeted for this role in HFP programs leading to sustained impact.
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Affiliation(s)
- Shiva Bhandari
- Department of Health Promotion, Education, and Behavior, University of South Carolina, Columbia, SC, USA
| | - Edward A Frongillo
- Department of Health Promotion, Education, and Behavior, University of South Carolina, Columbia, SC, USA
| | | | | | | | - Christine E Blake
- Department of Health Promotion, Education, and Behavior, University of South Carolina, Columbia, SC, USA
| | | | - Kenda Cunningham
- London School of Hygiene and Tropical Medicine, London, United Kingdom
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Biswas T, Townsend N, Huda MM, Maravilla J, Begum T, Pervin S, Ghosh A, Mahumud RA, Islam S, Anwar N, Rifhat R, Munir K, Gupta RD, Renzaho AM, Khusun H, Wiradnyani LAA, Radel T, Baxter J, Rawal LB, McIntyre D, Mørkrid K, Mamun A. Prevalence of multiple non-communicable diseases risk factors among adolescents in 140 countries: A population-based study. EClinicalMedicine 2022; 52:101591. [PMID: 36016694 PMCID: PMC9396043 DOI: 10.1016/j.eclinm.2022.101591] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/07/2022] [Revised: 06/30/2022] [Accepted: 07/12/2022] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Modifiable non-communicable disease (NCD) risk factors are becoming increasingly common among adolescents, with clustering of these risk factors in individuals of particular concern. The aim of this study was to assess global status of clustering of common modifiable NCD risk factors among adolescents. METHODS We used latest available data from nationally representative survey for 140 countries, namely the Global School-based Student Health Survey, the Health Behaviour in School-Aged Children and the longitudinal study of Australian Children. Weighted mean estimates of prevalence with corresponding 95% confidence intervals of nine NCD risk factors - physical inactivity, sedentary behaviour, insufficient fruits and vegetable consumption, carbonated soft drink consumption, fast food consumption, tobacco use, alcohol consumption and overweight/obesity - were calculated by country, region and sex. FINDINGS Over 487,565 adolescents, aged 11-17 years, were included in this study. According to trend analysis, prevalence of four or more NCD risk factors increased gradually over time. Prevalence of four or more NCD risk factors was 14.8% in 2003-2007 and increased to 44% in 2013-2017, an approximately three-fold increase (44.0%). Similar trends were also observed for three and two risk factors. Large variation between countries in the prevalence of adolescents with four or more risk factors was found in all regions. The country level range was higher in the South-East Asia Region (minimum Sri Lanka = 8%, maximum Myanmar = 84%) than Western Pacific Region (minimum China = 3%, maximum Niue = 72%), European Region (minimum Sweden = 13.9%, maximum Ireland = 66.0%), African Region (minimum Senegal = 0.8%, maximum Uganda = 82.1%) and Eastern Mediterranean Region (minimum Libya = 0.2%, maximum Lebanon = 80.2%). Insufficient vegetable consumption, insufficient fruit consumption and physically inactivity were three of the four most prevalent risk factors in all regions. INTERPRETATION Our results suggest a high prevalence of four or more NCD risk factors in adolescents globally, although variation was found between countries. Results from our study indicate that efforts to reduce adolescent NCD risk factors and the associated health burden need to be improved. These findings can assist policy makers to target the rollout of country- specific interventions. FUNDING None.
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Affiliation(s)
- Tuhin Biswas
- Institute for Social Science Research, The University of Queensland, Queensland, Australia
- ARC Centre of Excellence for Children and Families over the Life Course, The University of Queensland, Queensland, Australia
- UQ Poche Centre, University of Queensland, Queensland, Australia
- Corresponding author at: UQ Poche Centre, University of Queensland, Queensland, Australia.
| | - Nick Townsend
- Department for Health, University of Bath, Bath BA2 7AY, UK
| | - M. Mamun Huda
- Institute for Social Science Research, The University of Queensland, Queensland, Australia
- ARC Centre of Excellence for Children and Families over the Life Course, The University of Queensland, Queensland, Australia
- UQ Poche Centre, University of Queensland, Queensland, Australia
| | - Joemer Maravilla
- Institute for Social Science Research, The University of Queensland, Queensland, Australia
- ARC Centre of Excellence for Children and Families over the Life Course, The University of Queensland, Queensland, Australia
- Institute of Nursing, Far Eastern University, Manila, Philippines
| | - Tahmina Begum
- Institute for Social Science Research, The University of Queensland, Queensland, Australia
- ARC Centre of Excellence for Children and Families over the Life Course, The University of Queensland, Queensland, Australia
- UQ Poche Centre, University of Queensland, Queensland, Australia
| | - Sonia Pervin
- Institute for Social Science Research, The University of Queensland, Queensland, Australia
- ARC Centre of Excellence for Children and Families over the Life Course, The University of Queensland, Queensland, Australia
| | - Arpita Ghosh
- The George Institute for Global Health, UNSW Sydney, New Delhi, India
| | - Rashidul Alam Mahumud
- NHMRC Clinical Trials Centre, Faculty of Medicine and Health, The University of Sydney, Australia
| | - Shariful Islam
- Institute for Physical Activity and Nutrition, Faculty of Health, Deakin University, Melbourne, Victoria, Australia
| | - Novera Anwar
- Institute of Health Economics, University of Dhaka, Dhaka, Bangladesh
| | - Rukaiya Rifhat
- Department of Soil, Water and Environment, University of Dhaka, Dhaka-1, Bangladesh
| | - Kerim Munir
- Developmental Medicine Center, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA
| | - Rajat Das Gupta
- Department of Epidemiology and Biostatistics, University of South Carolina, USA
| | - Andre M.N. Renzaho
- Translational Health Research Institute, Western Sydney University, Penrith, Australia
- Maternal, Child and Adolescent Health Program, Burnet Institute, Melbourne, Australia
| | - Helda Khusun
- SEAMEO Regional Center for Food and Nutrition (RECFON) - Pusat Kajian Gizi Regional Universitas Indonesia (PKGR UI), Jakarta, Indonesia
| | - Luh Ade Ari Wiradnyani
- SEAMEO Regional Center for Food and Nutrition (RECFON) - Pusat Kajian Gizi Regional Universitas Indonesia (PKGR UI), Jakarta, Indonesia
| | - Tim Radel
- Institute for Social Science Research, The University of Queensland, Queensland, Australia
- ARC Centre of Excellence for Children and Families over the Life Course, The University of Queensland, Queensland, Australia
| | - Janeen Baxter
- Institute for Social Science Research, The University of Queensland, Queensland, Australia
- ARC Centre of Excellence for Children and Families over the Life Course, The University of Queensland, Queensland, Australia
| | - Lal B. Rawal
- School of Health, Medical and Applied Sciences, College of Science and Sustainability, Central Queensland University, Sydney Campus, Australia
| | - David McIntyre
- School of Health, Medical and Applied Sciences, College of Science and Sustainability, Central Queensland University, Sydney Campus, Australia
| | - Kjersti Mørkrid
- Mater Clinical Unit, The University of Queensland Brisbane, Australia
- Global Health Cluster, Division for Health Services, Norwegian Institute of Public Health, Oslo, Norway
| | - Abdullah Mamun
- Institute for Social Science Research, The University of Queensland, Queensland, Australia
- ARC Centre of Excellence for Children and Families over the Life Course, The University of Queensland, Queensland, Australia
- UQ Poche Centre, University of Queensland, Queensland, Australia
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Seib C, Moriarty S, McDonald N, Anderson D, Parkinson J. Changes in health behaviours in adults at-risk of chronic disease: primary outcomes from the My health for life program. BMC Public Health 2022; 22:1648. [PMID: 36042442 PMCID: PMC9429361 DOI: 10.1186/s12889-022-14056-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2021] [Accepted: 08/08/2022] [Indexed: 11/10/2022] Open
Abstract
Background Chronic disease is the leading cause of premature death globally, and many of these deaths are preventable by modifying some key behavioural and metabolic risk factors. This study examines changes in health behaviours among men and women at risk of diabetes or cardiovascular disease (CVD) who participated in a 6-month lifestyle intervention called the My health for life program. Methods The My health for life program is a Queensland Government-funded multi-component program designed to reduce chronic disease risk factors amongst at-risk adults in Queensland, Australia. The intervention comprises six sessions over a 6-month period, delivered by a trained facilitator or telephone health coach. The analysis presented in this paper stems from 9,372 participants who participated in the program between July 2017 and December 2019. Primary outcomes included fruit and vegetable intake, consumption of sugar-sweetened drinks and take-away, alcohol consumption, tobacco smoking, and physical activity. Variables were summed to form a single Healthy Lifestyle Index (HLI) ranging from 0 to 13, with higher scores denoting healthier behaviours. Longitudinal associations between lifestyle indices, program characteristics and socio-demographic characteristics were assessed using Gaussian Generalized Estimating Equations (GEE) models with an identity link and robust standard errors. Results Improvements in HLI scores were noted between baseline (Md = 8.8; IQR = 7.0, 10.0) and 26-weeks (Md = 10.0; IQR = 9.0, 11.0) which corresponded with increases in fruit and vegetable consumption and decreases in takeaway frequency (p < .001 for all) but not risky alcohol intake. Modelling showed higher average HLI among those aged 45 or older (β = 1.00, 95% CI = 0.90, 1.10, p < .001) with vocational educational qualifications (certificate/diploma: β = 0.32, 95% CI = 0.14, 0.50, p < .001; bachelor/post-graduate degree β = 0.79, 95% CI = 0.61, 0.98, p < .001) while being male, Aboriginal or Torres Strait Islander background, or not currently working conferred lower average HLI scores (p < .001 for all). Conclusions While participants showed improvements in dietary indicators, changes in alcohol consumption and physical activity were less amenable to the program. Additional research is needed to help understand the multi-level barriers and facilitators of behaviour change in this context to further tailor the intervention for priority groups. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-022-14056-1.
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Affiliation(s)
- Charrlotte Seib
- School of Nursing and Midwifery, Griffith University, Queensland, Australia.,Menzies Health Institute of Queensland, Griffith University, Queensland, Australia
| | - Stephanie Moriarty
- Australian eHealth Research Centre, CSIRO, Queensland, Australia.,Institute of Urban Indigenous Health, Brisbane, Australia
| | - Nicole McDonald
- School of Nursing and Midwifery, Griffith University, Queensland, Australia.,Australian eHealth Research Centre, CSIRO, Queensland, Australia
| | - Debra Anderson
- Menzies Health Institute of Queensland, Griffith University, Queensland, Australia.,Faculty of Health, University of Technology Sydney, New South Wales, Australia
| | - Joy Parkinson
- Menzies Health Institute of Queensland, Griffith University, Queensland, Australia. .,Australian eHealth Research Centre, CSIRO, Queensland, Australia.
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Honicky M, Cardoso SM, Kunradi Vieira FG, Hinnig PDF, Back IDC, Moreno YMF. Ultra-processed food intake is associated with children and adolescents with congenital heart disease clustered by high cardiovascular risk factors. Br J Nutr 2022; 129:1-24. [PMID: 35856269 DOI: 10.1017/s0007114522002240] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
The excessive intake of ultra-processed foods (UPF) is associated with an increase in cardiovascular risk. However, the effect of UPF intake on cardiovascular health in children and adolescents with congenital heart disease (CHD) is unknown. The aim of the present study was to describe UPF intake and evaluate associations with isolated cardiovascular risk factors and children and adolescents with CHD clustered by cardiovascular risk factors. A cross-sectional study was conducted involving 232 children and adolescents with CHD. Dietary intake was assessed using three 24-hour recalls. UPFs were categorized using the NOVA classification. The cardiovascular risk factors evaluated were central adiposity, elevated high-sensitivity C-reactive protein (hs-CRP) and subclinical atherosclerosis. The clustering of cardiovascular risk factors (waist circumference, hs-CRP and carotid intima-media thickness) was performed, allocating the participants to two groups (high versus low cardiovascular risk). UPFs contributed 40.69% (SD 6.21) to total energy intake. The main UPF groups were ready-to-eat and take-away/fast foods (22.2% energy from UPFs). The multivariable logistic regression revealed that an absolute increase of 10% in UPF intake (OR=1.90; 95% CI: 1.01;3.58) was associated with central adiposity. An absolute increase of 10% in UPF intake (OR=3.77; 95% CI: 1.80;7.87) was also associated with children and adolescents with CHD clustered by high cardiovascular risk after adjusting for confounding factors. Our findings demonstrate that UPF intake should be considered a modifiable risk factor for obesity and its cardiovascular consequences in children and adolescents with CHD.
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Affiliation(s)
- Michele Honicky
- Postgraduate Program in Nutrition, Federal University of Santa Catarina, Health Sciences Center, University Campus, Trindade, Florianopolis, SC, Brazil
| | - Silvia Meyer Cardoso
- Polydoro Ernani São Tiago University Hospital, Federal University of Santa Catarina, Florianopolis, Santa Catarina, Brazil
| | - Francilene Gracieli Kunradi Vieira
- Postgraduate Program in Nutrition, Federal University of Santa Catarina, Health Sciences Center, University Campus, Trindade, Florianopolis, SC, Brazil
| | - Patricia de Fragas Hinnig
- Postgraduate Program in Nutrition, Federal University of Santa Catarina, Health Sciences Center, University Campus, Trindade, Florianopolis, SC, Brazil
| | - Isabela de Carlos Back
- Department of Pediatrics, Federal University of Santa Catarina, Health Sciences Center, University Campus, Trindade, Florianopolis, SC, Brazil
| | - Yara Maria Franco Moreno
- Postgraduate Program in Nutrition, Federal University of Santa Catarina, Health Sciences Center, University Campus, Trindade, Florianopolis, SC, Brazil
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Smedbråten K, Grotle M, Jahre H, Richardsen KR, Småstuen MC, Skillgate E, Øiestad BE. Lifestyle behaviour in adolescence and musculoskeletal pain 11 years later: The Trøndelag Health Study. Eur J Pain 2022; 26:1910-1922. [PMID: 35851511 PMCID: PMC9545098 DOI: 10.1002/ejp.2012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2022] [Revised: 06/29/2022] [Accepted: 07/09/2022] [Indexed: 11/19/2022]
Abstract
Background There is limited knowledge on the association between lifestyle behaviour in adolescence and musculoskeletal pain in young adulthood. This study aimed to investigate whether an accumulation of adverse lifestyle behaviours in adolescents with and without musculoskeletal pain at baseline, was associated with persistent musculoskeletal pain (pain duration ≥3 consecutive months the last year) 11 years later. Methods Longitudinal data from the Trøndelag Health Study in Norway including 1824 adolescents (13–19 years old) was analysed. The outcome was persistent musculoskeletal pain (≥3 months). The number of adverse lifestyle behaviours (low physical activity level, sleep problems, insufficient fruit/vegetables consumption, smoking, frequent alcohol intoxication [drunkenness] and/or illicit drug use) were summed up to comprise an ordinal variable and analysed with 0 or 1 adverse behaviours as the reference. Multiple logistic regression analyses, stratified by individuals with and without baseline musculoskeletal pain, were conducted. The results were expressed as odds ratios (ORs) with 95% confidence intervals (CIs). Results In adolescents with musculoskeletal pain at baseline, reporting ≥ four adverse lifestyle behaviours increased the odds of persistent musculoskeletal pain (OR 2.23, 95% CI 1.36, 3.66) 11 years later. Two and three adverse behaviours were not associated with future persistent musculoskeletal pain. In adolescents without musculoskeletal pain at baseline, an accumulation of adverse lifestyle behaviours was not associated with future persistent musculoskeletal pain. Conclusion An accumulation of adverse lifestyle behaviours in adolescents with musculoskeletal pain at baseline was associated with persistent musculoskeletal pain 11 years later, but not in adolescents without musculoskeletal pain at baseline. Significance An accumulation of four or more adverse lifestyle behaviours in adolescents with musculoskeletal pain was associated with persistent musculoskeletal pain in young adulthood. In future health care of adolescents with musculoskeletal pain, lifestyle behaviours should be assessed, with emphasis on accumulation of multiple adverse lifestyle behaviours. Focusing on an accumulation of multiple adverse lifestyle behaviours, rather than each individual behaviour, might provide a potential area for future research and interventions targeting musculoskeletal pain in youth.
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Affiliation(s)
- K. Smedbråten
- Department of Physiotherapy, Faculty of Health Sciences Oslo Metropolitan University Norway
| | - M. Grotle
- Department of Physiotherapy, Faculty of Health Sciences Oslo Metropolitan University Norway
- Research and Communication Unit for Musculoskeletal Health Oslo University Hospital Norway
| | - H. Jahre
- Department of Physiotherapy, Faculty of Health Sciences Oslo Metropolitan University Norway
| | - K. R. Richardsen
- Department of Physiotherapy, Faculty of Health Sciences Oslo Metropolitan University Norway
| | - M. C. Småstuen
- Department of Physiotherapy, Faculty of Health Sciences Oslo Metropolitan University Norway
| | - E. Skillgate
- Musculoskeletal & Sports Injury Epidemiology Center Sophiahemmet University Sweden
- Institute of Environmental Medicine Karolinska Institutet Sweden
| | - B. E. Øiestad
- Department of Physiotherapy, Faculty of Health Sciences Oslo Metropolitan University Norway
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First Report on the Co-Occurrence and Clustering Profiles of Cardiovascular Lifestyle Risk Factors among Adults in Burkina Faso. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19148225. [PMID: 35886077 PMCID: PMC9316222 DOI: 10.3390/ijerph19148225] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/07/2022] [Revised: 06/15/2022] [Accepted: 06/17/2022] [Indexed: 02/01/2023]
Abstract
The co-occurrence of cardiovascular risk factors is usually associated with a higher risk of cardiovascular disease (CVD) or cancer. This study aimed to determine the prevalence of the co-occurrence and its determinants and to identify the clustering profiles of lifestyle risk factors among the adult population in Burkina Faso. Among 4692 participants, 4377 adults from the first STEPS survey conducted in Burkina Faso were considered in this analysis. Four lifestyle risk factors (smoking, alcohol consumption, inadequate fruit and vegetable intake and low physical activity) were analysed. The clustering was evaluated using the observed/expected (O/E) ratio approach. To identify the determinants of co-occurrence, we performed a modified Poisson regression. The prevalence of the co-occurrence of two or more cardiovascular lifestyle risk factors was 46.4% (95% CI: 43.1–49.7). The main determinants of the co-occurrence were being male (adjusted prevalence ratio (aPR): 1.27 (95% CI: 1.16–1.38)), advanced age (55–64 years old: aPR: 1.45 (95% CI: 1.31–1.60)) and a high level of education (aPR: 1.29 (95% CI: 1.09–1.52)). The clustering profile for lifestyle risk factors was tobacco consumption combined with alcohol consumption (O/E: 2.77 (95% CI: 2.12–3.56)), and concurrent involvement in all four lifestyle risk factors (O/E = 1.51 (95% CI: 1.19–1.89)). This first population-based report on the co-occurrence of lifestyle risk factors calls for action to tailor health-promoting interventions to increase healthy lifestyle behaviors. The identified CVD-risk clustering should be considered as an important step in this strategy development in Burkina Faso.
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Araujo DAM, Carvalho RBND, Oliveira ASSD, Oliveira EAR, Machado ALG, Lima LHDO. Temporal trend of simultaneous risk factors for chronic non-communicable diseases: National School Health Survey 2009, 2012, 2015. REVISTA BRASILEIRA DE EPIDEMIOLOGIA 2022; 25:e220013. [PMID: 35674577 DOI: 10.1590/1980-549720220013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2021] [Accepted: 04/13/2022] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE To analyze the temporal trend of simultaneous occurrence of behavioral risk factors for chronic non-communicable diseases in Brazilian school adolescents. METHODS Ecological time-series study that analyzed data from the three editions of the National Survey of School Health with students in the 9th year of public and private schools. Cluster analysis was performed to identify the simultaneity of the following factors: irregular consumption of fresh or minimally processed foods, regular consumption of processed and ultra-processed foods, insufficient level of physical activity during leisure time, consumption of alcoholic beverages, use of cigarettes and illicit drugs. The cluster trend was tested using simple linear regression. RESULTS The sample was composed of 173,310 school adolescents. Sixty-four possible combinations were evaluated, resulting in the formation of six clusters. The grouping formed by all factors showed the highest ratios observed/expected prevalence in the last two years of the series. The highest ratios were observed for combinations in which alcohol and cigarettes were present. These substances integrated five of the six clusters. One of the groups (insufficient level of physical activity during leisure time + consumption of alcoholic beverages + use of cigarettes and illicit drugs) had an upward trend throughout the series. CONCLUSION The trend analysis showed four out of six clusters remaining stable throughout the series, which shows that the factors are persistently present among school adolescents.
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Eswaramoorthi V, Suhaimi MZ, Abdullah MR, Sanip Z, Abdul Majeed APP, Suhaimi MZ, Clark CCT, Musa RM. Association of Physical Activity with Anthropometrics Variables and Health-Related Risks in Healthy Male Smokers. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19126993. [PMID: 35742242 PMCID: PMC9223046 DOI: 10.3390/ijerph19126993] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/10/2022] [Revised: 05/27/2022] [Accepted: 06/03/2022] [Indexed: 02/04/2023]
Abstract
Anthropometric variables (AV) are shown to be essential in assessing health status and to serve as markers for evaluating health-related risks in different populations. Studying the impact of physical activity (PA) on AV and its relationship with smoking is a non-trivial task from a public health perspective. In this study, a total of 107 healthy male smokers (37 ± 9.42 years) were recruited from different states in Malaysia. Standard procedures of measurement of several anthropometric indexes were carried out, and the International Physical Activity Questionnaire (IPPQ) was used to ascertain the PA levels of the participants. A principal component analysis was employed to examine the AV associated with physical activity, k-means clustering was used to group the participants with respect to the PA levels, and discriminant analysis models were utilized to determine the differential variables between the groups. A logistic regression (LR) model was further employed to ascertain the efficacy of the discriminant models in classifying the two smoking groups. Six AV out of twelve were associated with smoking behaviour. Two groups were obtained from the k-means analysis, based on the IPPQ and termed partially physically active smokers (PPAS) or physically nonactive smokers (PNAS). The PNAS were found to be at high risk of contracting cardiovascular problems, as compared with the PPAS. The PPAS cluster was characterized by a desirable AV, as well as a lower level of nicotine compared with the PNAS cluster. The LR model revealed that certain AV are vital for maintaining good health, and a partially active lifestyle could be effective in mitigating the effect of tobacco on health in healthy male smokers.
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Affiliation(s)
- Vijayamurugan Eswaramoorthi
- Faculty of Health Science, School of Rehabilitation Science, Universiti Sultan Zainal Abidin, Gong Badak Campus, Kuala Terengganu 21300, Terengganu, Malaysia;
| | - Muhammad Zulhusni Suhaimi
- Department of Allied Health Sciences, Faculty of Science, Universiti Tunku Abdul Rahman (UTAR), Bandar Barat, Kampar 31900, Perak, Malaysia
- Correspondence: (M.Z.S.); (R.M.M.)
| | - Mohamad Razali Abdullah
- East Coast Environmental Research Institute, Universiti Sultan Zainal Abidin, Kuala Terengganu 21300, Terengganu, Malaysia;
| | - Zulkefli Sanip
- Central Research Laboratory, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian 16150, Kelantan, Malaysia;
| | - Anwar P. P. Abdul Majeed
- Innovative Manufacturing, Mechatronics and Sports Laboratory, Faculty of Manufacturing Engineering, Universiti Malaysia Pahang, Pekan 26600, Pahang, Malaysia;
- School of Robotics, XJTLU Entrepreneur College (Taicang), Xi’an Jiaotong-Liverpool University, Suzhou 215123, China
| | - Muhammad Zuhaili Suhaimi
- Centre for Fundamental and Continuing Education, Universiti Malaysia Terengganu, Kuala Terengganu 21030, Terengganu, Malaysia;
| | - Cain C. T. Clark
- Centre for Intelligent Healthcare, Coventry University, Coventry CV1 5FB, UK;
| | - Rabiu Muazu Musa
- Centre for Fundamental and Continuing Education, Universiti Malaysia Terengganu, Kuala Terengganu 21030, Terengganu, Malaysia;
- Correspondence: (M.Z.S.); (R.M.M.)
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Risk Behaviors, Family Support, and Emotional Health among Adolescents during the COVID-19 Pandemic in Israel. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19073850. [PMID: 35409535 PMCID: PMC8997377 DOI: 10.3390/ijerph19073850] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/26/2022] [Revised: 03/21/2022] [Accepted: 03/22/2022] [Indexed: 12/23/2022]
Abstract
We investigated the prevalence of risk behaviors among Israeli adolescents (tobacco smoking, alcohol consumption, drug use) during the COVID-19 pandemic. Associations between different risk behaviors were examined and so was whether specific characteristics could predict risk behaviors in adolescents. The study consisted of 1020 Israeli adolescents aged 15-18. Study subjects completed an online survey between the first and second lockdowns in Israel (April 2020 to September 2020). Participants reported the frequency at which they engaged in four different risky behaviors: general risky behavior, tobacco smoking, alcohol consumption (binge drinking), and cannabis use. The most prevalent risky behavior in the sample was binge drinking (33.8%). The four measured risky behaviors were significantly correlated. Among participants who had previously engaged in a risky behavior assessed, most did not change the behavior frequency during the pandemic. All independent variables (sociodemographic characteristics, family support, and emotional, health excluding friends' support, physical activity volume, and coronavirus restrictions) were significantly different between participants engaging vs. not engaging in risky behaviors. Our findings suggest that family support is one of the most influential factors in preventing risky behavior during the pandemic, and they emphasize the importance of family-based interventions with children and adolescents from elementary to high school.
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Multimorbidity and simultaneity of health risk factors, from adolescence to early adulthood: 1993 Pelotas Birth Cohort. Prev Med 2022; 155:106932. [PMID: 34954241 DOI: 10.1016/j.ypmed.2021.106932] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2021] [Revised: 12/14/2021] [Accepted: 12/19/2021] [Indexed: 11/21/2022]
Abstract
The co-occurrence of two or more diseases is called multimorbidity, and the occurrence of two or more risk factors is called simultaneity of risk factors. Multimorbidity and simultaneity of risk factors are not widely understood in adolescence and early adulthood. This paper aims to describe how multimorbidity and simultaneity of risk factors are distributed throughout adolescence and early adulthood, considering demographic and socioeconomic characteristics, among the 1993 Pelotas Birth Cohort members. This study was carried out using data from the 11, 15, 18, and 22y of the 1993 Pelotas Birth Cohort, Brazil (n = 5249). A self-reported questionnaire assessed allergies, asthma/bronchitis/wheezing, diabetes, vision problems, hypertension, common mental disorders, other mental disorders, physical inactivity, sedentary behaviour, insufficient sleep time, smoking, alcohol abuse behaviour, and illicit drugs. Glucose, cholesterol, blood pressure, weight, and height were objectively collected. The prevalence of multimorbidity was 26.3%, 31.3%, 37.9%, and 44.4% at 11, 15, 18, and 22y, respectively. Around 70% of all ages presented simultaneity of risk factors. Women presented a higher prevalence of simultaneity of risk factors, and the multimorbidity gradually increased from 11 to 22y. The presence of both multimorbidity and simultaneity of risk factors was 19.7% at 11 and 35.4% at 22y. Less than 2% have no morbidity and no risk factors at each age assessed. This study highlighted the early emergence and accelerated growth of diseases and risk factors in a young population, especially their co-occurrence.
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Participation in Physical Education Classes and Health-Related Behaviours among Adolescents from 67 Countries. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19020955. [PMID: 35055777 PMCID: PMC8775417 DOI: 10.3390/ijerph19020955] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/02/2021] [Revised: 01/04/2022] [Accepted: 01/11/2022] [Indexed: 02/01/2023]
Abstract
The present study sought to examine the associations between participation in physical education (PE) classes and a range of health-related behaviours among adolescents. Secondary analysis of self-reported data from the Global Student Health Survey, collected between 2010 and 2017 from 222,121 adolescents (N = 117,914 girls; 49.0%; aged 13–17 years) from 67 countries and five world regions, was carried out. Participation in PE classes (0, 1–2, ≥3 days/week) was the independent variable. Physical activity (PA); sedentary behaviour (SB); active travel to school; fruit, vegetables, and alcohol consumption; and smoking; as well as adopting ≥5 of these healthy behaviours; were the dependent variables. Complex samples logistic regressions were performed to explore the associations between participation in PE classes and health-related behaviours. The results revealed that 18.2% of adolescents did not take part in PE classes. A total of 56.7% and 25.1% of adolescents reported participating in PE classes on 1–2 and ≥3 days/week, respectively. Only 26.8% of adolescents adopted ≥5 healthy behaviours. Participation in PE classes was positively associated with PA, active travel, fruit consumption, and vegetable consumption (only for ≥3 days/week), but was negatively associated with meeting SB recommendations, and with not smoking (only for girls and ≥3 days/week). Overall, PE participation was positively associated with adopting ≥5 healthy behaviours, with favourable results found for those who attended more PE classes. The findings revealed a positive association between participation in PE classes and a range of health-related behaviours among adolescents. This suggests that, worldwide, quality PE should be delivered at least 3 days per week up to daily to promote healthy lifestyles among adolescents.
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Araujo DAM, Carvalho RBND, Oliveira ASSD, Oliveira EAR, Machado ALG, Lima LHDO. Tendência temporal dos fatores de risco simultâneos para doenças crônicas não transmissíveis: Pesquisa Nacional de Saúde do Escolar 2009, 2012, 2015. REVISTA BRASILEIRA DE EPIDEMIOLOGIA 2022. [DOI: 10.1590/1980-549720220013.2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
RESUMO: Objetivo: Analisar a tendência temporal da ocorrência simultânea de fatores de risco comportamentais para doenças crônicas não transmissíveis em adolescentes escolares brasileiros. Métodos: Estudo ecológico de série temporal, que analisou os dados das três edições da Pesquisa Nacional de Saúde do Escolar dos alunos do 9º ano de escolas públicas e privadas. Realizou-se a análise de cluster para a identificação da simultaneidade dos seguintes fatores: consumo irregular de alimentos in natura ou minimamente processados, consumo regular de alimentos processados e ultraprocessados, nível insuficiente de atividade física no lazer, consumo de bebidas alcoólicas, uso de cigarro e de drogas ilícitas. A tendência dos clusters foi testada utilizando-se regressão linear simples. Resultados: A amostra constituiu-se de 173.310 escolares. Sessenta e quatro possíveis combinações foram avaliadas, havendo a formação de seis clusters. O agrupamento formado por todos os fatores apresentou as maiores razões entre prevalências observadas e esperadas para os dois últimos anos da série. As maiores razões foram verificadas para as combinações em que estavam presentes o álcool e o cigarro. Além disso, essas substâncias integraram cinco dos seis clusters. Um dos agrupamentos (nível insuficiente de atividade física no lazer + consumo de bebidas alcóolicas + uso de cigarro e drogas ilícitas) apresentou tendência crescente durante toda a série. Conclusão: A análise de tendência constatou que quatro de seis clusters mantiveram-se estáveis durante toda a série, demonstrando que os fatores continuam presentes de forma persistente entre os adolescentes escolares.
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Barbosa BCR, Parajára MDC, de Paula W, Machado EL, Meireles AL. Age, skin color, self-rated health, and depression associated with co-occurrence of obesogenic behaviors in university students: a cross-sectional study. SAO PAULO MED J 2022; 141:e2022301. [PMID: 36541955 PMCID: PMC10065088 DOI: 10.1590/1516-3180.2022.0301.r1.10102022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/16/2022] [Accepted: 10/10/2022] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND The university context plays an important role in the health-disease process since students are potentially vulnerable to obesogenic behaviors that can influence long-term health. OBJECTIVE To estimate the prevalence of and factors associated with the co-occurrence of obesogenic behaviors among university students. DESIGN AND SETTING This was a cross-sectional study at a Brazilian public university. METHODS This study was conducted with all university students in the first and second semesters of 2019 at Universidade Federal de Ouro Preto, Minas Gerais, Brazil. Data were collected between April and September 2019, using a self-administered questionnaire. The outcome was the co-occurrence of obesogenic behaviors, measured as the sum of three risk behaviors: inadequate eating practices, leisure-time physical inactivity, and sedentary behavior. A Venn diagram was used to evaluate the simultaneous occurrence of risk behaviors. Pearson's chi-square test and multivariate logistic regression were used for statistical analyses. RESULTS A total of 351 students participated in the study. Inadequate eating practices constituted the most prevalent isolated risk behavior (80.6%), which was also the most prevalent when combined with sedentary behavior (23.6%). University students aged 20 years or younger, with non-white skin color, poor self-rated health, and symptoms of depression had increased chances of simultaneous occurrence of obesogenic behaviors. CONCLUSION These findings highlight the importance of developing and implementing actions to reduce combined obesogenic behaviors in the university environment. Institutions should focus on creating an environment that promotes health-protective behaviors such as physical activity and healthy eating.
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Affiliation(s)
- Bruna Carolina Rafael Barbosa
- MSc. Doctoral Student, Postgraduate Program in Health and
Nutrition, School of Nutrition, Universidade Federal de Ouro Preto (UFOP), Ouro
Preto (MG), Brazil
| | - Magda do Carmo Parajára
- MSc. Doctoral Student, Postgraduate Program in Health and
Nutrition, School of Nutrition, Universidade Federal de Ouro Preto (UFOP), Ouro
Preto (MG), Brazil
| | - Waléria de Paula
- MSc. Doctoral Student, Postgraduate Program on Pharmaceutical
Sciences, School of Pharmacy, Universidade Federal de Ouro Preto (UFOP), Ouro
Preto (MG), Brazil
| | - Elaine Leandro Machado
- PhD. Professor, Department of Preventive and Social Medicine,
Faculty of Medicine, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte
(MG), Brazil
| | - Adriana Lúcia Meireles
- PhD. Professor, Department of Clinical and Social Nutrition,
School of Nutrition, Universidade Federal de Ouro Preto (UFOP), Ouro Preto (MG),
Brazil
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Liu CH, Chang FC, Niu YZ, Liao LL, Chang YJ, Liao Y, Shih SF. Students' perceptions of school sugar-free, food and exercise environments enhance healthy eating and physical activity. Public Health Nutr 2021; 25:1-9. [PMID: 34933694 PMCID: PMC9991674 DOI: 10.1017/s1368980021004961] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Revised: 11/16/2021] [Accepted: 12/13/2021] [Indexed: 11/07/2022]
Abstract
OBJECTIVE The objective of this study was to examine the relationships between students' perceptions of their school policies and environments (i.e. sugar-sweetened beverages (SSB) free policy, plain water drinking, vegetables and fruit eating campaign, outdoor physical activity initiative, and the SH150 programme (exercise 150 min/week at school)) and their dietary behaviours and physical activity. DESIGN Cross-sectional study. SETTING Primary, middle and high schools in Taiwan. PARTICIPANTS A nationally representative sample of 2433 primary school (5th-6th grade) students, 3212 middle school students and 2829 high school students completed the online survey in 2018. RESULTS Multivariate analysis results showed that after controlling for school level, gender and age, the students' perceptions of school sugar-free policies were negatively associated with the consumption of SSB and positively associated with consumption of plain water. Schools' campaigns promoting the eating of vegetables and fruit were positively associated with students' consumption of vegetables. In addition, schools' initiatives promoting outdoor physical activity and the SH150 programme were positively associated with students' engagement in outdoor physical activities and daily moderate-to-vigorous physical activity. CONCLUSIONS Students' perceptions of healthy school policies and environments promote healthy eating and an increase in physical activity for students.
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Affiliation(s)
- Chieh-Hsing Liu
- Department of Health Promotion and Health Education, National Taiwan Normal University, 162, Ho-Ping E. Rd., Sec.1, Taipei10610, Taiwan
| | - Fong-Ching Chang
- Department of Health Promotion and Health Education, National Taiwan Normal University, 162, Ho-Ping E. Rd., Sec.1, Taipei10610, Taiwan
| | - Yu-Zhen Niu
- Office of Student Affairs, National Yang Ming Chiao Tung University, Hsinchu, Taiwan
| | - Li-Ling Liao
- Department of Health Management, I-Shou University, Kaohsiung City, Taiwan
| | - Yen-Jung Chang
- Department of Health Promotion and Health Education, National Taiwan Normal University, 162, Ho-Ping E. Rd., Sec.1, Taipei10610, Taiwan
| | - Yung Liao
- Department of Health Promotion and Health Education, National Taiwan Normal University, 162, Ho-Ping E. Rd., Sec.1, Taipei10610, Taiwan
| | - Shu-Fang Shih
- Department of Health Administration, Virginia Commonwealth University, Richmond, USA
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Lifestyle in Female Teachers: Educational Intervention Based on Self-Efficacy Theory in the South of Fars Province, Iran. BIOMED RESEARCH INTERNATIONAL 2021; 2021:6177034. [PMID: 34912893 PMCID: PMC8668293 DOI: 10.1155/2021/6177034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/24/2021] [Revised: 10/27/2021] [Accepted: 11/18/2021] [Indexed: 12/02/2022]
Abstract
Introduction Today, improving lifestyles and promoting health are basic needs for human society. The main goal in promoting health is to achieve healthy lifestyle behaviors, and self-efficacy is one of the factors influencing people's lifestyle. Therefore, the impact of educational intervention based on self-efficacy theory on improving lifestyles of the female teachers in Galledar was investigated. Method This study was a semiexperimental study with educational intervention with a control group that was performed on 120 teachers in Galledar. Data collection tools included demographic information questionnaires, health-promoting lifestyle questionnaires, and Sherry's self-efficacy questionnaire. Data were analyzed using SPSS 25 software. Result The mean age and standard deviation of teachers in the control and intervention groups were 33.40 ± 5.68 and 32.83 ± 6.46 years, respectively. Health-promoting lifestyle variables are significant correlation with self-efficacy and overall lifestyle index. Six dimensions which consisted of spiritual growth and self-actualization, health responsibility, interpersonal relationships, stress management, exercise and physical activity, and nutrition showed significant statistical differences before and after educational intervention (P = 0.001). Conclusion Due to the sensitive role of teachers as an effective human force in the development and evolution of society and their students' role modeling, the authorities should formulate policies, regulate educational interventions, and design strategies for promoting self-efficacy beliefs and promoting a healthy lifestyle for all teachers. We suggest that other methods and theories of behavior change be used in future studies to promote a healthy lifestyle.
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Pengpid S, Peltzer K. Prevalence and correlates of multiple behavioural risk factors of non-communicable diseases among university students from 24 countries. J Public Health (Oxf) 2021; 43:857-866. [PMID: 34918087 DOI: 10.1093/pubmed/fdaa138] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2020] [Revised: 06/10/2020] [Accepted: 07/22/2020] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Globally non-communicable diseases (NCDs) are on the increase. The goal of the study was to estimate the prevalence and correlates of multiple behavioural risk factors of NCDs among university students from 24 countries. METHODS In a cross-sectional study, the sample included 18 017 university students from countries in Africa, the Americas and Asia. RESULTS indicate that prevalence of single behavioural NCD risk indicators were 38.2% for physical inactivity, 80.5% for inadequate fruit and vegetables intake, 23.1% for having overweight/obesity, 10.5% for heavy alcohol use and 11.8% for current tobacco use. Students had on average 1.6 (SD = 0.9), and 15.9% had three or more behavioural NCD risk factors. In adjusted linear regression, male sex was positively and stronger beliefs in health benefits were negatively associated with multiple behavioural NCD risk factors. CONCLUSIONS A high prevalence and co-occurrence of behavioural risk factors of NCDs was discovered. Several behavioural NCD risk factors, such as male sex and low health behaviour benefits beliefs, were found that could be utilized in targeted interventions.
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Affiliation(s)
- Supa Pengpid
- ASEAN Institute for Health Development, Mahidol University, Salaya, Phutthamonthon, Nakhon Pathom 73170, Thailand.,Department of Research Administration and Development, University of Limpopo, Polokwane 0727, South Africa
| | - Karl Peltzer
- Department for Management of Science and Technology Development, Ton Duc Thang University, 19 Nguyen Huu Tho street, Tan Phong ward, District, 7 Ho Chi Minh City, Vietnam.,Faculty of Pharmacy, Ton Duc Thang University, 19 Nguyen Huu Tho street, Tan Phong ward, District, 7 Ho Chi Minh City, Vietnam
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Irvine DS, McGarity-Shipley E, Lee EY, Janssen I, Leatherdale ST. Longitudinal associations between e-cigarette use, cigarette smoking, physical activity and recreational screen time in Canadian adolescents. Nicotine Tob Res 2021; 24:978-985. [PMID: 34850182 DOI: 10.1093/ntr/ntab248] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2021] [Revised: 11/03/2021] [Accepted: 11/25/2021] [Indexed: 11/14/2022]
Abstract
INTRODUCTION This study examined longitudinal associations between e-cigarette use, cigarette smoking, physical activity, and recreational screen time (ST) in a cohort of Canadian adolescents (ages 14-17 years; grades 9-12). METHODS Data from 5,951 adolescents who participated in COMPASS Year 4 (2015-16; baseline) and Year 6 (2017-18; follow-up) were used. Exposures included e-cigarette use and cigarette smoking. Outcomes included cut-points for moderate- to vigorous- physical activity (MVPA; ≥ 60 min/d), muscular strengthening exercises (MSE; ≥ 3 time/wk), participation in sport (SP; intramural or competitive), and recreational screen time (ST; ≤ 430 min/day). Generalized linear mixed models were performed. RESULTS E-cigarette use (16.6% vs 39.2%), cigarette smoking (0.9% vs 4.7%) and dual use (0.8% vs 4.1%) increased from baseline to follow-up. SP (70.8% vs 61.3%) and the prevalence of meeting MVPA (49.8% vs 42.1%) and MSE cut-points (54.0% vs 45.3%) decreased from baseline to follow-up. Recreational ST remained similar from baseline to follow-up. New e-cigarette use at follow-up was associated with maintenance of SP and meeting MVPA and MSE cut-points, but also with increased ST. New cigarette smoking at follow-up was associated with maintaining high ST and low SP. Cigarette smoking at baseline and follow-up was associated with maintaining high ST, low MSE, and low SP. Cigarette smoking cessation at follow-up was associated with increasing MVPA and MSE, decreasing ST, and maintaining low SP. CONCLUSION Given the clustering and co-occurring unhealthy behavioral patterns, intervention strategies to promote healthy lifestyles should take a holistic approach, by targeting multiple behavioral changes simultaneously. IMPLICATIONS This investigation highlighted that, unhealthy behaviors, particularly e-cigarette use, cigarette smoking, and excessive use of screens, tend to co-occur among Canadian adolescents. Therefore, intervention strategies to promote healthy lifestyles should take a holistic approach, by targeting multiple behavioral changes simultaneously particularly in school and community settings. As an exception, new and stable e-cigarette use appears to co-occur with achieving sufficient levels of physical activity. Increasing awareness about the risk of e-cigarette use may target population groups that are physically and socially active (e.g., athletes, sport teams).
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Affiliation(s)
- Dylan S Irvine
- School of Kinesiology and Health Studies, Queen's University, Kingston, ON, Canada.,College of Osteopathic Medicine, Nova Southeastern University, Davie, FL, United States of America
| | | | - Eun-Young Lee
- School of Kinesiology and Health Studies, Queen's University, Kingston, ON, Canada.,Department of Gender Studies, Queen's University, Kingston, ON, Canada
| | - Ian Janssen
- School of Kinesiology and Health Studies, Queen's University, Kingston, ON, Canada.,Department of Public Health Sciences, Queen's University, Kingston, ON, Canada
| | - Scott T Leatherdale
- School of Public Health and Health Systems, University of Waterloo, Waterloo, ON, Canada
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Wood S, Harrison SE, Judd N, Bellis MA, Hughes K, Jones A. The impact of behavioural risk factors on communicable diseases: a systematic review of reviews. BMC Public Health 2021; 21:2110. [PMID: 34789209 PMCID: PMC8596356 DOI: 10.1186/s12889-021-12148-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2021] [Accepted: 10/22/2021] [Indexed: 12/24/2022] Open
Abstract
Background The coronavirus (COVID-19) pandemic has highlighted that individuals with behavioural risk factors commonly associated with non-communicable diseases (NCDs), such as smoking, harmful alcohol use, obesity, and physical inactivity, are more likely to experience severe symptoms from COVID-19. These risk factors have been shown to increase the risk of NCDs, but less is known about their broader influence on communicable diseases. Taking a wide focus on a range of common communicable diseases, this review aimed to synthesise research examining the impact of behavioural risk factors commonly associated with NCDs on risks of contracting, or having more severe outcomes from, communicable diseases. Methods Literature searches identified systematic reviews and meta-analyses that examined the association between behavioural risk factors (alcohol, smoking, illicit drug use, physical inactivity, obesity and poor diet) and the contraction/severity of common communicable diseases, including infection or associated pathogens. An a priori, prospectively registered protocol was followed (PROSPERO; registration number CRD42020223890). Results Fifty-three systematic reviews were included, of which 36 were also meta-analyses. Reviews focused on: tuberculosis, human immunodeficiency virus, hepatitis C virus, hepatitis B virus, invasive bacterial diseases, pneumonia, influenza, and COVID-19. Twenty-one reviews examined the association between behavioural risk factors and communicable disease contraction and 35 examined their association with communicable disease outcomes (three examined their association with both contraction and outcomes). Fifty out of 53 reviews (94%) concluded that at least one of the behavioural risk factors studied increased the risk of contracting or experiencing worse health outcomes from a communicable disease. Across all reviews, effect sizes, where calculated, ranged from 0.83 to 8.22. Conclusions Behavioural risk factors play a significant role in the risk of contracting and experiencing more severe outcomes from communicable diseases. Prevention of communicable diseases is likely to be most successful if it involves the prevention of behavioural risk factors commonly associated with NCDs. These findings are important for understanding risks associated with communicable disease, and timely, given the COVID-19 pandemic and the need for improvements in future pandemic preparedness. Addressing behavioural risk factors should be an important part of work to build resilience against any emerging and future epidemics and pandemics. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-021-12148-y.
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Affiliation(s)
- Sara Wood
- Policy and International Health, World Health Organization Collaborating Centre on Investment for Health and Well-being, Public Health Wales, Wrexham, UK
| | - Sophie E Harrison
- Public Health Collaborating Unit, School of Medical and Health Sciences, Bangor University, Wrexham, UK.,Institute for Applied Human Physiology, School of Human and Behavioural Sciences, Bangor University, Bangor, UK
| | - Natasha Judd
- Policy and International Health, World Health Organization Collaborating Centre on Investment for Health and Well-being, Public Health Wales, Wrexham, UK.,Public Health Collaborating Unit, School of Medical and Health Sciences, Bangor University, Wrexham, UK
| | - Mark A Bellis
- Policy and International Health, World Health Organization Collaborating Centre on Investment for Health and Well-being, Public Health Wales, Wrexham, UK. .,Public Health Collaborating Unit, School of Medical and Health Sciences, Bangor University, Wrexham, UK.
| | - Karen Hughes
- Policy and International Health, World Health Organization Collaborating Centre on Investment for Health and Well-being, Public Health Wales, Wrexham, UK.,Public Health Collaborating Unit, School of Medical and Health Sciences, Bangor University, Wrexham, UK
| | - Andrew Jones
- Health Protection and Screening Services, Public Health Wales, Cardiff, UK
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Peltzer K, Pengpid S. Health risk behaviours among adolescents in Argentina: trends between 2007, 2012 and 2018 national cross-sectional school surveys. BMC Pediatr 2021; 21:464. [PMID: 34670497 PMCID: PMC8529741 DOI: 10.1186/s12887-021-02929-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/11/2021] [Accepted: 09/22/2021] [Indexed: 11/13/2022] Open
Abstract
Background The aim of this study was to assess trends of various health risk behaviours among adolescents across three different surveys in Argentina. Methods Data from 115,697 adolescents (mean age:14.6 years, SD=1.2) that participated in three cross-sectional national school surveys in 2007, 2012 and 2018 were analysed. In all, 27 health risk behaviours were assessed through a self-administered questionnaire. Significance of a linear trend was tested by treating study year as categorical variable in logistic regression analyses, adjusted by age group and food insecurity for boys and girls separately Results Among both sexes, four health risk behaviours (current cigarette use, passive smoking, trouble from alcohol use, and physically attacked) significantly reduced from 2007 to 2018. Among boys five health risk behaviours (experience of hunger, parental tobacco use, current alcohol use, involvement in physical fighting, and multiple sexual partners), and among girls, inadequate physical activity significantly reduced over time. Among both sexes, the prevalence of four health risk behaviours (overweight/obesity, obesity, leisure-time sedentary behaviour and insufficient fruit intake) significantly increased among both sexes, and among girls ten health risk behaviours (not walking/biking to school, current other tobacco use, bullying victimisation, lifetime drunkenness, having no close friends, suicide plan, suicidal ideation, worry-induced sleep disturbance, loneliness, and ever sexual intercourse) significantly increased over time. Conclusion Nine health risk behaviours among boys and five health risk behaviours among girls decreased, and four health risk behaviours among boys and 14 health compromising behaviours among girls increased over a period of 11 years. School health programmes for adolescents should be strengthened in Argentina.
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Affiliation(s)
- Karl Peltzer
- Department of Psychology, College of Medical and Health Science, Asia University, Taichung, Taiwan.,Department of Research Administration and Development, University of Limpopo, Turfloop, South Africa
| | - Supa Pengpid
- Department of Research Administration and Development, University of Limpopo, Turfloop, South Africa. .,ASEAN Institute for Health Development, Mahidol University, Salaya, Phutthamonthon, Nakhon Pathom, Thailand.
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Long KQ, Ngoc-Anh HT, Phuong NH, Tuyet-Hanh TT, Park K, Takeuchi M, Lam NT, Nga PTQ, Phuong-Anh L, Van Tuan L, Bao TQ, Thinh OP, Van Huy N, Lan VTH, Van Minh H. Clustering Lifestyle Risk Behaviors among Vietnamese Adolescents and Roles of School: A Bayesian Multilevel Analysis of Global School-Based Student Health Survey 2019. LANCET REGIONAL HEALTH-WESTERN PACIFIC 2021; 15:100225. [PMID: 34528007 PMCID: PMC8342779 DOI: 10.1016/j.lanwpc.2021.100225] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/02/2021] [Revised: 06/10/2021] [Accepted: 07/07/2021] [Indexed: 11/17/2022]
Abstract
Background Adolescence is a vulnerable period for many lifestyle risk behaviors. In this study, we aimed to 1) examine a clustering pattern of lifestyle risk behaviors; 2) investigate roles of the school health promotion programs on this pattern among adolescents in Vietnam. Methods We analyzed data of 7,541 adolescents aged 13–17 years from the 2019 nationally representative Global School-based Student Health Survey, conducted in 20 provinces and cities in Vietnam. We applied the latent class analysis to identify groups of clustering and used Bayesian 2-level logistic regressions to evaluate the correlation of school health promotion programs on these clusters. We reassessed the school effect size by incorporating different informative priors to the Bayesian models. Findings The most frequent lifestyle risk behavior among Vietnamese adolescents was physical inactivity, followed by unhealthy diet, and sedentary behavior. Most of students had a cluster of at least two risk factors and nearly a half with at least three risk factors. Latent class analysis detected 23% males and 18% females being at higher risk of lifestyle behaviors. Consistent through different priors, high quality of health promotion programs associated with lower the odds of lifestyle risk behaviors (highest quality schools vs. lowest quality schools; males: Odds ratio (OR) = 0·67, 95% Highest Density Interval (HDI): 0·46 – 0·93; females: OR = 0·69, 95% HDI: 0·47 – 0·98). Interpretation Our findings demonstrated the clustering of specific lifestyle risk behaviors among Vietnamese in-school adolescents. School-based interventions separated for males and females might reduce multiple health risk behaviors in adolescence. Funding The 2019 Global School-based Student Health Survey was conducted with financial support from the World Health Organization. The authors received no funding for the data analysis, data interpretation, manuscript writing, authorship, and/or publication of this article.
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Affiliation(s)
| | | | - Nguyen Hong Phuong
- Poverty, Health and Nutrition Division, International Food Policy Research Institute, Washington, DC 20006
| | | | - Kidong Park
- World Health Organization, Country Office for Vietnam, Hanoi, 100000, Vietnam
| | - Momoe Takeuchi
- World Health Organization, Country Office for Vietnam, Hanoi, 100000, Vietnam
| | - Nguyen Tuan Lam
- World Health Organization, Country Office for Vietnam, Hanoi, 100000, Vietnam
| | - Pham Thi Quynh Nga
- World Health Organization, Country Office for Vietnam, Hanoi, 100000, Vietnam
| | - Le Phuong-Anh
- World Health Organization, Country Office for Vietnam, Hanoi, 100000, Vietnam
| | - Le Van Tuan
- Vietnam Ministry of Education and Training, Hanoi, 100000, Vietnam
| | - Tran Quoc Bao
- General Department of Preventive Medicine, Ministry of Health, Hanoi, 100000, Vietnam
| | - Ong Phuc Thinh
- Hanoi University of Public Health, Hanoi, 100000, Vietnam
| | - Nguyen Van Huy
- Health Innovation and Transformation Centre, Federation University, Victoria, 3353, Australia.,Graduate School of Public Health, St. Luke's International University, Tokyo, 104-0044, Japan
| | | | - Hoang Van Minh
- Hanoi University of Public Health, Hanoi, 100000, Vietnam
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Brazo-Sayavera J, Aubert S, Barnes JD, González SA, Tremblay MS. Gender differences in physical activity and sedentary behavior: Results from over 200,000 Latin-American children and adolescents. PLoS One 2021; 16:e0255353. [PMID: 34383803 PMCID: PMC8360534 DOI: 10.1371/journal.pone.0255353] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2020] [Accepted: 07/14/2021] [Indexed: 11/18/2022] Open
Abstract
More physical activity and less sedentary behavior is beneficial for children and adolescents. Worldwide, gender differences are >8% favorable for men and the Latin-American region presents an even higher level of insufficient physical activity among women, with a lack of information in young population. Thus, the aim of the current study was to describe the gender differences in physical activity and recreational sedentary behavior in children and adolescents from Latin-American countries. The targeted age range was 5 to 17 years and included 219,803 participants (106,698 boys and 113,105 girls) from 33 out of 47 Latin-American countries identified. Physical activity guidelines from the World Health Organization (≥60 minutes of moderate-to-vigorous physical activity seven days of the week) and <3 hours recreational sedentary behavior daily were the references. In general, boys showed a higher prevalence of meeting physical activity guidelines in comparison with girls. A higher proportion of girls met the <3 hours recreational sedentary behavior cut-point in only ten countries. Thirty percent of the identified countries had no available data. The majority had data from the Global School-based Student Health Survey with data principally on adolescents and only 11/33 countries reported data in the last 5-year period. In conclusion, gender differences in the compliance with physical activity guidelines and the <3 hours recreational sedentary behavior cut-point are evident among children and adolescents from Latin-American countries, with boys being more active than girls.
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Affiliation(s)
- Javier Brazo-Sayavera
- PDU EFISAL, Centro Universitario Regional Noreste, Universidad de la República, Rivera, Uruguay
- Healthy Active Living and Obesity Research Group, CHEO Research Institute, Ottawa, Ontario, Canada
- * E-mail:
| | - Salomé Aubert
- Healthy Active Living and Obesity Research Group, CHEO Research Institute, Ottawa, Ontario, Canada
| | - Joel D. Barnes
- Healthy Active Living and Obesity Research Group, CHEO Research Institute, Ottawa, Ontario, Canada
| | - Silvia A. González
- Healthy Active Living and Obesity Research Group, CHEO Research Institute, Ottawa, Ontario, Canada
| | - Mark S. Tremblay
- Healthy Active Living and Obesity Research Group, CHEO Research Institute, Ottawa, Ontario, Canada
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Khan A, Lee EY, Rosenbaum S, Khan SR, Tremblay MS. Dose-dependent and joint associations between screen time, physical activity, and mental wellbeing in adolescents: an international observational study. THE LANCET CHILD & ADOLESCENT HEALTH 2021; 5:729-738. [PMID: 34384543 DOI: 10.1016/s2352-4642(21)00200-5] [Citation(s) in RCA: 32] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/03/2021] [Revised: 06/30/2021] [Accepted: 07/01/2021] [Indexed: 01/30/2023]
Abstract
BACKGROUND Mental wellbeing in adolescents has declined considerably during past decades, making the identification of modifiable risk factors important. Prolonged screen time and insufficient physical activity appear to operate independently and synergistically to increase the risk of poor mental wellbeing in school-aged children. We aimed to examine the gender-stratified dose-dependent and joint associations of screen time and physical activity with mental wellbeing in adolescents. METHODS We used data from three rounds of Health Behaviour in School-aged Children cross-sectional surveys (2006, 2010, and 2014) from 42 European and North American countries. Survey participants, aged 11 years, 13 years, and 15 years, provided self-reported information by completing an anonymous questionnaire that included items on health indicators and related behaviours. We used the self-reported variables of life satisfaction and psychosomatic complaints as indicators of adolescents' mental wellbeing, combining these with the self-reported discretionary use of screens and engagement in physical activity. We used generalised additive models and multilevel regression modelling to examine the gender-stratified relationships between mental wellbeing and screen time and physical activity. FINDINGS Our sample included 577 475 adolescents (mean age 13·60 years, SD 1·64), with 296 542 (51·35%) girls and 280 933 (48·64%) boys. The mean reported life satisfaction score (on a scale of 0-10) was 7·70 (95% CI 7·69-7·71) in boys and 7·48 (7·46-7·50) in girls. Psychosomatic complaints were more common among girls (mean 9·26, 95% CI 9·23-9·28) than boys (6·89, 6·87-6·91). Generalised additive model analyses showed slightly non-linear associations of screen time and physical activity with life satisfaction and psychosomatic complaints for girls and boys. Detrimental associations between screen time and mental wellbeing started when screen time exceeded 1 h per day, whereas increases in physical activity levels were beneficially and monotonically associated with wellbeing. Multilevel modelling showed that screen time levels were negatively associated with life satisfaction and positively associated with psychosomatic complaints in a dose-dependent manner. Physical activity levels were positively associated with life satisfaction and negatively associated with psychosomatic complaints in a dose-dependent manner. Joint associations of screen time-physical activity with mental wellbeing showed that, compared with the least active participants with more than 8 h per day of screen time and no physical activity, most of the other screen time-physical activity groups had considerably higher life satisfaction and lower psychosomatic complaints. INTERPRETATION Higher levels of screen time and lower levels of physical activity were associated with lower life satisfaction and higher psychosomatic complaints among adolescents from high-income countries. Public health strategies to promote adolescents' mental wellbeing should aim to decrease screen time and increase physical activity simultaneously. FUNDING None.
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Affiliation(s)
- Asaduzzaman Khan
- School of Health and Rehabilitation Sciences, University of Queensland, Brisbane, QLD, Australia.
| | - Eun-Young Lee
- School of Kinesiology and Health Studies, Queen's University, Kingston, ON, Canada
| | - Simon Rosenbaum
- School of Psychiatry, University of New South Wales, Sydney, NSW, Australia
| | - Shanchita R Khan
- School of Public Health and Social Work, Queensland University of Technology, Kelvin Grove, QLD, Australia
| | - Mark S Tremblay
- CHEO Research Institute and Department of Pediatrics, University of Ottawa, Ottawa, ON, Canada
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Raina P, Ali MU, Joshi D, Gilsing A, Mayhew A, Ma J, Sherifali D, Thompson M, Griffith LE. The combined effect of behavioural risk factors on disability in aging adults from the Canadian Longitudinal Study on Aging (CLSA). Prev Med 2021; 149:106609. [PMID: 33984371 DOI: 10.1016/j.ypmed.2021.106609] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/23/2020] [Revised: 03/19/2021] [Accepted: 05/09/2021] [Indexed: 11/28/2022]
Abstract
The objective of this study was to explore how behavioural risk factors (smoking, physical activity, and nutrition) cluster together and assess how clusters of behavioural risk factors are associated with functional disability by age and sex at the individual and population level. We used currently available baseline cross-sectional data from the Canadian Longitudinal Study on Aging (CLSA). The CLSA is a national, population-based longitudinal study established to understand and examine health of an aging population. This study included 51,338 Canadian men and women aged 45 to 85 years residing in the community in 10 Canadian provinces. Behavioural risk factors included smoking, physical activity, and nutrition. The main outcome used in the study was functional disability, which was assessed using a questionnaire adapted from the Older Americans Resources and Services Multidimensional Assessment Questionnaire. In this analyses of unique combinations of the risk factors of smoking, physical activity, and nutritional risk, the magnitude of the association of the behavioural risk factors with functional disability was dependent on which risk factors were included and differed by age and sex strata. Of the risk factors, physical activity accounted for between 70% to 90% of the total population level risk in individuals with all three risk factors, suggesting it is a key driver of the population burden of disability. Together, these results show that considering unique clusters of risk factors, as well as age and sex, is essential for tailoring public health strategies to reduce the burden of disability among aging populations.
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Affiliation(s)
- Parminder Raina
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada; Labarge Centre for Mobility in Aging, McMaster University, Hamilton, Ontario, Canada; McMaster Institute for Research on Aging, McMaster University, Hamilton, Ontario, Canada.
| | - Muhammad Usman Ali
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada; Labarge Centre for Mobility in Aging, McMaster University, Hamilton, Ontario, Canada; McMaster Institute for Research on Aging, McMaster University, Hamilton, Ontario, Canada; School of Nursing, McMaster University, Hamilton, Ontario, Canada
| | - Divya Joshi
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada; Labarge Centre for Mobility in Aging, McMaster University, Hamilton, Ontario, Canada; McMaster Institute for Research on Aging, McMaster University, Hamilton, Ontario, Canada
| | - Anne Gilsing
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada; Labarge Centre for Mobility in Aging, McMaster University, Hamilton, Ontario, Canada; McMaster Institute for Research on Aging, McMaster University, Hamilton, Ontario, Canada
| | - Alexandra Mayhew
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada; Labarge Centre for Mobility in Aging, McMaster University, Hamilton, Ontario, Canada; McMaster Institute for Research on Aging, McMaster University, Hamilton, Ontario, Canada
| | - Jinhui Ma
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada; McMaster Institute for Research on Aging, McMaster University, Hamilton, Ontario, Canada
| | - Diana Sherifali
- McMaster Institute for Research on Aging, McMaster University, Hamilton, Ontario, Canada; School of Nursing, McMaster University, Hamilton, Ontario, Canada; Population Health Research Institute, McMaster University and Hamilton Health Sciences, Hamilton, Ontario, Canada
| | - Mary Thompson
- Department of Statistics & Actuarial Science, University of Waterloo, Waterloo, Ontario, Canada
| | - Lauren E Griffith
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada; Labarge Centre for Mobility in Aging, McMaster University, Hamilton, Ontario, Canada; McMaster Institute for Research on Aging, McMaster University, Hamilton, Ontario, Canada
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Clustering of Lifestyle Risk Factors among Algerian Adolescents: Comparison between Urban and Rural Areas: GSHS Data. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18137072. [PMID: 34281010 PMCID: PMC8297194 DOI: 10.3390/ijerph18137072] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/10/2021] [Revised: 06/24/2021] [Accepted: 07/01/2021] [Indexed: 11/30/2022]
Abstract
Objective: Compare the clustering of LBRs between urban and rural Algerian adolescents. Design: Data of this cross-sectional study was derived from the Global School-based Health Survey (GSHS). A self-administered, anonymous questionnaire was filled out by 4532 adolescents (11–16 years), which addressed LBRs of NCDs. Life style behavioral risk factors (LBRs) clustering was measured by the ratios of observed (O) and expected (E) prevalence of one or more simultaneously occurring LBRs for urban and rural areas separately. Multivariate logistic regression was performed to examine the association of LBRs as dependent variable with demographic variables (location, age, gender). Results: The most common LBR was physical inactivity (84.6%: 50.9% for urban and 49.1% for rural). Adolescents in urban areas had a higher prevalence of two (56.8% vs. 43.2%) and three and more (61.3% vs. 38.7%) LBRs than in rural areas. In urban areas, a significant positive association was found between (low fruit and vegetable consumption + physical inactivity) [2.06 (1.61–2.64)] and (high SB + smoking) [2.10 (1.54–2.76)], while (physical inactivity + high SB) [0.70 (0.54–0.91)] showed a significant negative association. In rural areas, (high SB + overweight/obesity) [1.49 (1.09–2.04)] had a significant positive association. While, (low fruit and vegetable consumption + high SB) [0.75 (0.60–0.94)], (physical inactivity + high SB) [0.65 (0.49–0.86)], and (physical inactivity + smoking) [0.70 (0.49–0.99)] had a negative association. Conclusions: Several socio-demographic factors have been identified to play a role in LBRs clustering among Algerian adolescents. Results of the study suggest the development of intervention aiming to tackle different LBRs rather than focusing on a single LBR.
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Yen ST, Tan AKG. Cigarette Consumption Patterns of Non-Smokers, Occasional Smokers, and Daily Smokers in Selected ASEAN Countries. Asian Pac J Cancer Prev 2021; 22:1997-2004. [PMID: 34319019 PMCID: PMC8607097 DOI: 10.31557/apjcp.2021.22.7.1997] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2020] [Indexed: 11/25/2022] Open
Abstract
Background: This study investigates the socio-demographic factors associated with smoking status in five Southeast Asian countries: Malaysia, Thailand, Indonesia, Vietnam, and Philippines. Methods: This cross-sectional study utilizes data of adults ≥15 years who completed the Global Adult Tobacco Surveys. Ordered probit analysis is used to account for the smoking statuses of non-smokers, occasional smokers, and daily smokers. Results: Malaysian and Vietnamese households with more family members face lower smoking likelihoods than otherwise. Urbanites in Philippines and rural residents in Thailand and Indonesia are more likely to smoke on occasional and daily basis than others. Males are consistently more likely to smoke occasionally or daily and less likely to be non-smokers than females across all countries. Younger middle-age (retiree) individuals aged 30-35 (≥60) years in Malaysia and Thailand exhibit higher (lower) likelihoods to smoke occasionally or daily than their younger cohorts aged 15-29 years. Individuals aged 30 years and above in Indonesia, Vietnam, and Philippines display higher daily smoking propensities than others. Higher education levels dampens smoking likelihoods and increases non-smoking propensities in all countries. Non-government or self-employed workers in all countries are more likely to smoke occasionally or daily than unemployed persons. Being married is associated with higher non-smoking likelihoods in Thailand although this association is not evident in Malaysia. Conclusion: These findings suggest that a portfolio of targeted interventions is necessary to meet the needs of specific subpopulations within the various countries.
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Affiliation(s)
- Steven T Yen
- International College, Jiangxi University of Finance and Economics, Nanchang City, Jiangxi Province, China
| | - Andrew K G Tan
- School of Social Sciences, Universiti Sains Malaysia, Minden, Penang, Malaysia
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Petro J, Arango-Paternina CM, Lema-Gómez L, Eusse-López C, Petro-Petro J, López-Sánchez M, Watts-Fernández W, Perea-Velásquez F. Fitness, fatness, body movement, and diet in adolescents: clustering and associations with elevated blood pressure. J Sports Med Phys Fitness 2021; 62:859-866. [PMID: 34132514 DOI: 10.23736/s0022-4707.21.12266-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND The study of clusters of risk factors for elevated blood pressure (EBP) among adolescents from low- middle-income countries has received little research attention. The objective of the study was to identify clusters of EBP precursors (i.e., overweight, physical fitness, risk diet, and body movement) and to analyze its associations with EBP. METHODS This a cross-sectional study conducted in a sample of 965 secondary schools' students aged between 12 and 17 years-old from Colombia. Measurements included blood pressure, sociodemographic information, and four EBP precursors: Overweight, body movement, risk diet, and physical fitness. Cluster analysis was applied with the two-step method to identify the patterns of EBP precursors, and logistic regression models were used to analyze the association between clusters and EBP. RESULTS Findings indicate that EBP was present in 28.9% of the students, approximately 20% of adolescents had desirable profile (normal weight, normal-high physical fitness, low-risk diet, and middle-high body movement), and 16% of them had the four EBP precursors. The cluster solution revealed five clusters, formed according to the accumulation of EBP precursors, this is, characterized by having zero, one (low body movement), two (low body movement and high-risk diet), three (low body movement, high risk diet, and low fitness), or four (low body movement, high risk diet, low fitness, and overweight) EBP precursors. The cluster with four EBP precursors had a higher risk of having EBP. CONCLUSIONS According to these findings, it is necessary to implement programs that simultaneously address multiple health-related behaviors to promote health in adolescents.
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Affiliation(s)
- Jorge Petro
- Research Group in Physical Activity, Sports and Health Sciences (GICAFS), Departamento de Cultura Física, Universidad de Córdoba, Montería, Colombia
| | | | - Lucía Lema-Gómez
- Research Group in Physical Activity, Sports and Health Sciences (GICAFS), Departamento de Cultura Física, Universidad de Córdoba, Montería, Colombia
| | - Cleiber Eusse-López
- Research Group in Physical Activity, Sports and Health Sciences (GICAFS), Departamento de Cultura Física, Universidad de Córdoba, Montería, Colombia
| | - Jose Petro-Petro
- Research Group in Physical Activity, Sports and Health Sciences (GICAFS), Departamento de Cultura Física, Universidad de Córdoba, Montería, Colombia
| | - Milton López-Sánchez
- Research Group in Physical Activity, Sports and Health Sciences (GICAFS), Departamento de Cultura Física, Universidad de Córdoba, Montería, Colombia
| | - Willinton Watts-Fernández
- Research Group in Physical Activity, Sports and Health Sciences (GICAFS), Departamento de Cultura Física, Universidad de Córdoba, Montería, Colombia
| | - Fabio Perea-Velásquez
- Research Group in Physical Activity, Sports and Health Sciences (GICAFS), Departamento de Cultura Física, Universidad de Córdoba, Montería, Colombia
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Pengpid S, Peltzer K. Multiple behavioural risk factors of non-communicable diseases among adolescents in four Caribbean countries: prevalence and correlates. Int J Adolesc Med Health 2021; 33:305-312. [PMID: 34142510 DOI: 10.1515/ijamh-2021-0021] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2021] [Accepted: 04/29/2021] [Indexed: 11/15/2022]
Abstract
OBJECTIVES The study assessed the prevalence and associated factors of behavioural risk factors of non-communicable diseases (NCDs) among adolescents in four Caribbean countries. CONTENT In all 9,143 adolescents (15 years = median age) participated in the cross-sectional "2016 Dominican Republic, 2016 Suriname, 2017 Jamaica, and 2017 Trinidad and Tobago Global School-Based Student Health Survey (GSHS)". Eight behavioural risk factors of NCDs were assessed by a self-administered questionnaire. SUMMARY Prevalence of each behavioural NCD risk factor was physical inactivity (84.2%), inadequate fruit and vegetable intake (82.2%), leisure-time sedentary behaviour (49.6%), daily ≥2 soft drinks intake (46.8%), ever drunk (28.6%), twice or more days a week fast food consumption (27.6%), having overweight/obesity (27.4%), and current tobacco use (13.8%). Students had on average 3.6 (SD=1.4), and 79.0% had 3-8 behavioural NCD risk factors. In multivariable linear regression, psychological distress and older age increased the odds, and attending school and parental support decreased the odds of multiple behavioural NCD risk factors. OUTLOOK A high prevalence and co-occurrence of behavioural risk factors of NCDs was discovered and several factors independently contributing to multiple behavioural NCD risk factors were identified.
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Affiliation(s)
- Supa Pengpid
- ASEAN Institute for Health Development, Mahidol University, Salaya, Nakhon Pathom, Thailand.,Department of Research Administration and Development, University of Limpopo, Polokwane, South Africa
| | - Karl Peltzer
- Department of Research Administration and Development, University of Limpopo, Polokwane, South Africa.,Department of Psychology, College of Medical and Health Science, Asia University, Taichung, Taiwan
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