Protective and risk factors in health-enhancing behavior among adolescents in China and the United States: does social context matter?

The association of motivation and perceived social norms with eating behaviors in emerging adults

OBJECTIVE

This study examines the associations of eating-related motivation, perceived norms, and their interaction with eating behaviors in emerging adults.

DESIGN

Data are from the NEXT Generation Health Study, a nationally representative sample of US emerging adults. Binominal logistic regression analyses estimated associations of eating behaviors with self-determined motivation, non-self-determined motivation, and perceived social norms. Multiplicative interaction terms between each motivation construct and perceived social norms were tested in the models.

RESULTS

Self-determined motivation was positively associated with intake frequency of whole grains, low-fat dairy, and fruit and vegetables. Soda intake frequency was inversely associated with greater non-self-determined motivation, but not self-determined motivation or perceived social norms. Perceived social norms were positively associated with the intake of whole grains, low-fat dairy, and fruit and vegetables. Perceived social norms did not moderate the association of motivation constructs with eating behaviors.

CONCLUSION

Self-determined motivation and perceived social norms may be considered in intervention targeting healthful eating behaviors in emerging adults.

Bullying victimization among Lebanese adolescents: The role of child abuse, Internet addiction, social phobia and depression and validation of the Illinois Bully Scale

Background

Both bullying victimization and perpetration were associated with depression, social phobia, physical and psychological child abuse and Internet addiction in Lebanon. The prevalence of bullying in Lebanon is alarming, with 50% of school-aged children and adolescents reporting being bullied at some point. The high rate of both bullying victimization can be reflective of the inefficacy of current prevention and intervention policies in targeting associated problematic individual and contextual factors. The objective of the present study was to analyze factors associated with bullying victimization and validate the Illinois Bully Scale among Lebanese adolescents.

Methods

This is cross-sectional study that took place between January and May 2019. We enrolled 1810 adolescents between 14 and 17 years of age. The Illinois Bully scale was used to measure bullying victimization. In order to ensure the adequacy of the sample with values greater than 0.8 - an indicator that component or factor analysis was useful for these variables - we used Kaiser-Meyer-Olkin (KMO) measurement. Statistical significance considered if the p-value < 0.05.

Results

The results showed that 841 (46.5%, CI: 44.1% – 48.7%) participants were classified as having been previously bullied. None of the bullying scale items was removed. Items on the bullying scale converged on a two-factor solution with Eigenvalues greater than 1, accounting for a total of 73.63% of the variance (Factor 1: bullying victimization; Factor 2: bullying perpetration; KMO = 0.899, Bartlett’s sphericity test p < 0.001; αCronbach = 0.955). Having a separate parents (ORa = 3.08), Mild (ORa-4.71) to moderate (ORa = 3.84) internet addiction test, higher social fear (ORa = 1.50), higher psychological abuse (ORa = 3.59), higher child neglect (ORa = 2.21) and physical (ORa = 4.55) abuse were significantly associated with higher odds of being bullied. However, higher social avoidance (ORa = 0.49), poor (ORa = 0.20), fair (ORa = 0.94) and very good (ORa = 0.04) physical activity as compared to sedentary were significantly associated with lower odds of being bullied.

Conclusions

Our findings attest that bullying victimization is likely to be associated with certain factors such as child abuse of all forms, Internet addiction, social fear and avoidance. In addition, the Illinois Bully Scale was validated in Lebanon. More attention should be paid to students vulnerable to bullying victimization, such as those with environmental or domestic problems, and adolescents with psychological disorders such as behavioral addictions.

Positive influence of peers' interpersonal character on children's interpersonal character: The moderating role of children's and peers' social status

INTRODUCTION

Peers are an important source of influence on children's social development. This study investigated the positive association between peers' and children's interpersonal character (i.e., humanity and justice) and the moderating role of children's and peers' social status including wealth (family SES), power (class leadership), and prestige (social preference and social visibility).

METHODS

The participants were 1555 fourth-to ninth-graders (M_age = 12.76; 46.9% boys) and their reciprocal playmates in China. Questionnaires and peer nomination methods were used to measure interpersonal character and social status. Children's reciprocal playmates were used as the source of peer influence.

RESULTS

The playmates' humanity and justice were positively associated with the children's humanity and justice regardless of the child's grade, gender, or sibling status. Children's level of social visibility moderated the associations between the playmates' and the children's humanity and justice, with children of low social visibility being more strongly influenced by their playmates. The moderating role of playmates' social status was displayed in two modes and appeared in the secondary school and singleton samples. First, playmates with a higher social preference were more closely related to secondary school children's justice; second, playmates with lower social visibility were more closely related to secondary school children's and singletons' justice.

CONCLUSIONS

The findings confirm the positive relationships between peers' and children's interpersonal character and reveal an important moderating role of prestige status, especially social visibility, among the relationships. This study extends the research on positive peer influence and contributes to knowledge of peer influence mechanisms.

The role of family factors and self-regulation: Problem behavior in Georgian adolescents

The aim of this study is to assess the psychosocial factors of adolescents’ problem behavior. Within this research, the relationships among family structure, parental modeling, parental monitoring, and adolescents’ self-regulation were assessed. Data were collected by self-report questionnaires. The sample consisted of 150 participants aged 14 to 17. Sixty adolescents were in conflict with the law, and the other 90 adolescents who did not have such a contact with the legal system. Results show that more adolescents in conflict with the law live in single-parent families than their peers who do not have a similar experience. At the same time, adolescents living with single parents have a higher mean score of problem behavior and a lower mean score of parental monitoring. Correlational and regression analyses revealed that parents’ problem behavior models and parental monitoring are statistically significant predictors of adolescents’ problem behavior. In the present study, self-regulation was revealed to be a significant correlate of adolescents’ problem behavior, and that family factors mediate the relationship between self-regulation and problem behavior. Results also confirm the importance of an approach for the prevention of deviant behavior focused primarily on family supporting measures.

Identifying Violent Behavior Using the Oxford Mental Illness and Violence Tool in a Psychiatric Ward of a German Prison Hospital

Background: Although there is evidence that individuals who suffer from severe mental disorders are at higher risk for aggressive behavior, only a minority eventually become violent. In 2017, Fazel et al. developed a risk calculator (Oxford Mental Illness and Violence tool, OxMIV) to identify the risk of violent crime in patients with mental disorders. For the first time, we tested the predictive validity of the OxMIV in the department of psychiatry at the prison hospital in Berlin, Germany, and presented findings from our internal validation. Materials and Methods: We designed a cohort study with 474 patients aged 16-65 years old who met the inclusion criteria of schizophrenia-spectrum or bipolar disorder and classified the patients into two groups: a violent group with 191 patients and a nonviolent group with 283 patients. Violence was defined as the aggressive behavior of a patient with the necessity of special observation. We obtained all the required information retrospectively through patient files, applied the OxMIV tool on each subject, and compared the results of both groups. Sensitivity, specificity, and positive/negative predictive values were determined. We used logistic regression including variable selection and internal validation to identify relevant predictors of aggressive behavior in our cohort. Results: The OxMIV score was significantly higher in the violent group [median 4.21%; Interquartile range (IQR) 8.51%] compared to the nonviolent group (median 1.77%; IQR 2.01%; p < 0.0001). For the risk of violent behavior, using the 5% cutoff for "increased risk," the sensitivity was 44%, and the specificity was 89%, with a positive predictive value of 72% and a negative predictive value of 70%. Applying logistic regression, four items were statistically significant in predicting violent behavior: previous violent crime (adjusted odds ratio 5.29 [95% CI 3.10-9.05], p < 0.0001), previous drug abuse (1.80 [1.08-3.02], p = 0.025), and previous alcohol abuse (1.89 [1.21-2.95], p = 0.005). The item recent antidepressant treatment (0.28 [0.17-0.47]. p < 0.0001) had a statistically significant risk reduction effect. Conclusions: In our opinion, the risk assessment tool OxMIV succeeded in predicting violent behavior in imprisoned psychiatric patients. As a result, it may be applicable for identification of patients with special needs in a prison environment and, thus, improving prison safety.

Prevalence and predictors of alcohol and drug use among secondary school students in Botswana: a cross-sectional study

BACKGROUND

Alcohol and illicit drug use has been recognized as a growing problem among adolescents in Botswana. Little is known about factors affecting alcohol and drug use among Botswana's secondary school students. To aid the design and implementation of effective public health interventions, we sought to determine the prevalence of alcohol and drug use in secondary school students in urban and peri-urban areas of Botswana, and to evaluate risk and protective factors for substance use.

METHODS

We performed a 72-item cross-sectional survey of students in 17 public secondary schools in Gaborone, Lobatse, Molepolole and Mochudi, Botswana. The World Health Organization's (WHO) Alcohol Use Disorder Identification Test (AUDIT) was used to define hazardous drinking behavior. Using Jessor's Problem Behavior Theory (PBT) as our conceptual framework, we culturally-adapted items from previously validated tools to measure risk and protective factors for alcohol and drug use. Between-group differences of risk and protective factors were compared using univariate binomial and multinomial-ordinal logit analysis. Relative risks of alcohol and drug use by demographic, high risks and low protections were calculated. Multivariate ordinal-multinomial cumulative logit analysis, multivariate nominal-multinomial logit analysis, and binominal logit analysis were used to build models illustrating the relationship between risk and protective factors and student alcohol and illicit drug use. Clustered data was adjusted for in all analyses using Generalized Estimating Equations (GEE) methods.

RESULTS

Of the 1936 students surveyed, 816 (42.1%) reported alcohol use, and 434 (22.4%) met criteria for hazardous alcohol use. Illicit drug use was reported by 324 students (16.7%), with motokwane (marijuana) being the most commonly used drug. Risk factors more strongly associated with alcohol and drug use were reported alcohol availability, individual and social vulnerability factors, and poor peer modeling. Individual and social controls protections appear to mitigate risk of student alcohol and drug use.

CONCLUSIONS

Alcohol and illicit drug use is prevalent among secondary school students in Botswana. Our data suggest that interventions that reduce the availability of alcohol and drugs and that build greater support networks for adolescents may be most helpful in decreasing alcohol and drug use among secondary school students in Botswana.

Transmission of risk from parents with chronic pain to offspring: an integrative conceptual model

Offspring of parents with chronic pain are at increased risk for pain and adverse mental and physical health outcomes (Higgins et al, 2015). Although the association between chronic pain in parents and offspring has been established, few studies have addressed why or how this relation occurs. Identifying mechanisms for the transmission of risk that leads to the development of chronic pain in offspring is important for developing preventive interventions targeted to decrease risk for chronic pain and related outcomes (eg, disability and internalizing symptoms). This review presents a conceptual model for the intergenerational transmission of chronic pain from parents to offspring with the goal of setting an agenda for future research and the development of preventive interventions. Our proposed model highlights 5 potential mechanisms for the relation between parental chronic pain and pediatric chronic pain and related adverse outcomes: (1) genetics, (2) alterations in early neurobiological development, (3) pain-specific social learning, (4), general parenting and family health, and (5) exposure to stressful environment. In addition, the model presents 3 potential moderators for the relation between parent and child chronic pain: (1) the presence of chronic pain in a second parent, (2) timing, course, and location of parental chronic pain, and (3) offspring's characteristics (ie, sex, developmental stage, race or ethnicity, and temperament). Such a framework highlights chronic pain as inherently familial and intergenerational, opening up avenues for new models of intervention and prevention that can be family centered and include at-risk children.

The role of social support in the association between gambling, poor health and health risk-taking

AIMS

Studies have shown that gambling is associated with poor health and health risk-taking behaviour. However, little is known about those factors that can influence the association between gambling, health risk-taking and health. Using a population-based School Health Promotion Study of eighth- and ninth-grade Finnish boys and girls (N = 62,956), we investigated the relationships between gambling frequency, health risk-taking and poor health as well as whether social support from parents, friends and school staff could mediate these associations.

METHODS

Path analysis was used to discover direct and indirect effects of health, health risk-taking and gambling.

RESULTS

Social support from parents and school staff decreased gambling among boys and girls, whereas among boys support from friends increased gambling. However, the role of social support as a mediator was very weak. Overall poor health and health risk-taking were associated with increased gambling. CONCLUSIONS GAMBLING SHOULD BE CONSIDERED AN IMPORTANT PUBLIC HEALTH ISSUE BECAUSE IT CLUSTERS WITH OTHER UNHEALTHY BEHAVIOUR PATTERNS INTERVENTIONS CONCERNING ADOLESCENT GAMBLING SHOULD ALSO TAKE OTHER SIMULTANEOUS RISK-TAKING INTO CONSIDERATION ALSO SOCIAL SUPPORT FROM PARENTS AND SCHOOL SHOULD BE NOTED WHEN TRYING TO DECREASE ADOLESCENTS' GAMBLING.

Lifestyle and Addictive Behaviors Among Chinese Adolescents in Hong Kong, Macau, Taipei, Wuhan, and Zhuhai-a First Cross-subculture Assessment

PURPOSE

This study aimed at assessing the differences in prevalence rates of common health behavior among adolescents in the five Chinese cities and the influential factors at the contextual and individual levels.

METHOD

We compared the standardized rates of three lifestyle behaviors (sedentary, dietary, and physical activity) and three addictive behaviors (cigarette smoking, alcohol consumption, and participation in gambling) among a sample of 13,950 adolescents. The sample was randomly selected from five cities, including Hong Kong, Macau, Taipei, Zhuhai, and Wuhan. Population size, GDP per capita, and literacy at the city level as well as parental monitoring and school performance at the student's level were assessed. Multi-level mixed effect models were used to examine the interaction of individual level factors with study sites.

RESULTS

The six health behaviors differed significantly across sites with the highest rates of alcohol consumption in Hong Kong (39.5 %), of cigarette smoking in Macau (9.8 %), and of gambling in Taipei (37.1 %) and Hong Kong (35.9 %). The city-level measures were associated with only a few behavioral measures. Relative to Hong Kong, parental monitoring had stronger association with the three addictive behaviors in the other sites.

CONCLUSION

Findings suggest that although the study sites share similar Chinese culture, students in the five cities differed from each other with regard to levels of health behaviors. Relative to the broad socioeconomic development, differences in parental monitoring played a significant role in explaining the observed difference.

Characteristics of adolescents who intervene to stop the risky and dangerous behavior of their friends

Adolescents value protecting friends from harm and report that they do intervene as bystanders in friends' risky and dangerous behavior. Moreover intervention can be effective in reducing such behaviors. The Protection-Risk Framework was used to explain bystander intervention. There were 962 students from 13 Australian high schools (mean age at time 1=13.44 years) surveyed in their 9th grade and again 1-year later when students were in 10th grade. We found that protective factors of self-efficacy, support, prosocial models, social control, and ease of opportunity related to greater intervening behavior after 12-months. Among those who reported that they had intervened in a 3-month period, a cumulative measure of protective factors was associated with their reports of intervening. Risk factors were non-significant predictors after accounting for earlier, time 1, bystander intervening behavior and demographic factors. The findings highlight potential mechanisms to promote adolescents' looking out for their friends and provide an assessment over time of bystander behavior. The theory-guided inquiry into such behavior provides a foundation on which to better develop our understanding of benefits to adolescent friendship in the injury field.

Diversion of ADHD Stimulants and Victimization Among Adolescents

OBJECTIVE

To examine whether a recent prescription for stimulant medication is associated with peer victimization among youth with attention deficit/hyperactivity disorder (ADHD).

METHODS

Data from 4,965 adolescents attending five public schools who completed an annual web survey over 4 years were used to examine recent stimulant medication prescription and self-reported frequent victimization.

RESULTS

Adolescents with ADHD and recent stimulant prescription reported more victimization than those without ADHD, but similar to adolescents with ADHD and no recent prescription. Adolescents with ADHD and past 12-month diversion of their prescribed stimulants were at greatest risk of 12-month frequent victimization compared with adolescents without ADHD and adolescents with ADHD but no recent prescription. Youth approached to divert reported more victimization than youth not approached. Youth who diverted reported more victimization than those who did not divert.

CONCLUSIONS

Close parent-prescriber collaboration is needed to ensure effective medical treatment for ADHD without greater risk for victimization and treatment failure.

Social support influences on eating awareness in children and adolescents: the mediating effect of self-regulatory strategies

The impact of the social environment on healthy eating awareness results from complex interactions among physical, economic, cultural, interpersonal and individual characteristics. This study investigated the impact of social support and social influence on healthy eating awareness, controlling for socio-economic status, gender and age. Additionally, the mediating effect of self-regulation strategies was examined. A total of 2764 children and adolescents aged 10-17 from four European countries completed self-report measures on healthy eating awareness, social influence and the use of self-regulation strategies. Healthy eating awareness and the use of self-regulation strategies were more likely to occur among younger participants. An interaction between gender and age was related to the use of some self-regulation strategies; compared to girls, boys decreased the use of self-regulation strategies more from pre-adolescence to adolescence. Peer social influence was associated with more unhealthy eating in older participants. Results suggest a need to promote self-regulatory competences among young people in order to assist them with regulating their eating behaviours, especially in the presence of peers. Both school-based interventions and family-based interventions, focusing on self-regulation cognitions and social (peer) influence, could help children and adolescents to use self-regulatory strategies which are essential to eat healthier.

Assessing Drug Consumption Behavior With the Heidelberger Drogenbogen (Heidelberg Drug Scales): Reliabilities, Validities, and Cut-Off Criteria

BACKGROUND

The Heidelberger Drogenbogen (HDB) is a German language assessment of substance-specific knowledge and consumption patterns of the illicit psychoactive substances cannabis, MDMA (ecstasy), amphetamines, cocaine, and hallucinogens. The behavior modules for each of these five drugs/drug groups allow for a diagnostic evaluation of the extent of harmful consumption behavior. Each of the five modules represents a single standardized test.

OBJECTIVES

This paper outlines several statistical parameters, Cronbach's alpha, retest reliabilities, as well as numerous validity and cut-off-criteria of the behavioral modules.

METHODS

Participants (N = 4,794) were recruited at schools, universities, in subcultural contexts, and in institutions of substance abuse treatment.

RESULTS

Internal consistencies range from = .68 to .79 while test-retest reliabilities between .87 and .94 were found. The behavior modules of the HDB can discriminate between populations with and without clinical levels of substance use. Furthermore, this measure has incremental validity and higher diagnostic accuracy over competing measures.

CONCLUSIONS

The behavior modules of the HDB are reliable and valid measures of substance use and misuse.

Parsing protection and risk for problem behavior versus pro-social behavior among US and Chinese adolescents

This study investigates the different roles played by protective factors and risk factors-and by particular protective and risk factors-when the concern is with accounting for adolescent problem behavior than when the concern is with accounting for adolescent pro-social behavior. The protective and risk factor literature on adolescent problem behavior reveals considerable conceptual and operational ambiguity; an aim of the present study was to advance understanding in this domain of inquiry by providing a systematic conceptualization of protection and risk and of their measurement. Within the systematic framework of Problem Behavior Theory, four protective and four risk factors are assessed in a cross-national study of both problem behavior and pro-social behavior involving large adolescent samples in China (N = 1,368) and the US (N = 1,087), in grades 9, 10, and 11; females 56 %, US; 50 %, China. The findings reveal quite different roles for protection and risk, and for particular protective and risk factors, when the outcome criterion is problem behavior than when it is pro-social behavior. The protective factor, Controls Protection, which engages rule and regulations and sanctions in the adolescent's ecology, emerges as most important in influencing problem behavior, but it plays a relatively minor role in relationship to pro-social behavior. By contrast, Models Protection, the presence of pro-social models in the adolescent's ecology, and Support Protection, the presence of interest and care in that same ecology, have no significant relationship to problem behavior variation, but they are both the major predictors of variation in pro-social behavior. The findings are robust across the samples from the two very diverse societies. These results suggest that greater attention be given to protection in problem behavior research and that a more nuanced perspective is needed about the roles that particular protective and risk factors play in reducing problem behavior and in promoting pro-social behavior.

The impact of a rural or urban context in eating awareness and self-regulation strategies in children and adolescents from eight European countries

Complex relationships exist between eating behaviour and personal and environmental factors. Rural and urban geographic contexts seem to play a role in eating behaviour, and therefore deserve a deeper study. A healthy eating behaviour and the conditions that promote it are a major issue in the promotion of adolescent health. The study aims to investigate the associations between the area of residence (urban vs. rural), self-regulation strategies (TESQ-E) and eating behaviours among children and adolescents. A total of 11,820 adolescents (50.6% girls) participated in the study, with a mean age of 13.30 years (SD= 2.13). Nine countries (The Netherlands, United Kingdom, Poland, Portugal, Denmark, Romania, Germany, Finland and Belgium) completed a questionnaire in the school context, asking about the use of self-regulation strategies, eating behaviour awareness/care and sociodemographic questions such as age, gender and residential area. Both areas of residence (urban vs. rural) are associated with eating awareness/care in Romania and Portugal, controlling for age, gender and self-regulation strategies. In some European countries at least, and most probably around the world, health promotion should focus on an ecological approach that includes the understanding of the effect of both environmental factors and personal skills on eating behaviour/awareness.

Parental migration, self-efficacy and cigarette smoking among rural adolescents in south China

Objectives

Millions of children and adolescents in rural China are left behind as their parents move away for work. Little is known about the impact of parental migration on their smoking and self-efficacy. This study explores the associations among parental migration, self-efficacy and smoking.

Methods

A cross-sectional study was conducted among middle school students in Liangying Township, Guangdong, China. Socio-demographic and parental migration characteristics, as well as adolescent past 30-day smoking and self-efficacy level were collected using a self-administered questionnaire. Univariate and multivariate analyses were performed to estimate the risk of parental migration features for smoking and self-efficacy. Hierarchical regression was fitted to examine the relationship among parental migration, self-efficacy and smoking.

Results

2609 students (93.4%) participated into the study, 44% of who were with parents who had ever been or were currently migrating. Smoking prevalence was 9.7% in boys and 0.9% in girls. Paternal migration was protective for adolescent smoking, whilst maternal migration increased the risk. Both paternal and maternal migration had adverse effects on self-efficacy, a strong influencing factor for smoking. No significant relationship was found between other migration features and smoking and self-efficacy. The smoking risk of maternal migration was partly mediated by self-efficacy. There were no differences between boys and girls.

Conclusions

Our findings suggest that adolescents whose mothers migrate from home to work elsewhere are at elevated risk for smoking. Improving self-efficacy may be an effective means to keep adolescents away from smoking, especially for those with maternal migration.

The conceptualization and communication of risk among rural appalachian adolescents

This study uses a meta-theoretical perspective for examining risk perceptions and behavior in the rural Appalachian cultural context, an area that remains largely unexplored. The authors conducted in-depth interviews with 113 rural adolescents to describe how youth conceptualize risk and how risk is communicated in the rural environment. Analyses revealed adolescents viewed behavior as risky when they had personal or vicarious experiences resulting in a loss of control or physical harm. Elements of the rural Appalachian culture including activities, familism, and community ties can prevent and promote adolescent risk taking in various forms. This study demonstrates the conceptualization of risk and messages about risk are culturally situated and communicatively devised and enacted. The implications of these findings for adolescent risk prevention programs are discussed.

"Making it": Understanding adolescent resilience in two informal settlements (slums) in Nairobi, Kenya

Many adolescents living in contexts characterized by adversity achieve positive outcomes. We adopt a protection-risk conceptual framework to examine resilience (academic achievement, civic participation, and avoidance of risk behaviors) among 1,722 never-married 12-19 year olds living in two Kenyan urban slums. We find stronger associations between explanatory factors and resilience among older (15-19 years) than younger (12-14 years) adolescents. Models for pro-social behavior and models for anti-social behavior emerge as key predictors of resilience. Further accumulation of evidence on risk and protective factors is needed to inform interventions to promote positive outcomes among youth situated in an ecology of adversity.

Life dissatisfaction and eating behaviors among older African Americans: the protective role of social support

OBJECTIVES

To examine (a) the influences of life dissatisfaction and dietary social support on eating behaviors (a high-fat diet and fruit/vegetable consumption) of older African Americans and (b) the moderating role of perceived dietary social support on the association between their life dissatisfaction and unhealthy eating behaviors.

DESIGN

Baseline data from a larger intervention study of mid-life and older African Americans. The study incorporated a quasi-experimental design with random selection of participants, stratifying for age and gender.

SETTING

Six churches in North Florida.

PARTICIPANTS

One hundred and seventy-eight (132 females and 46 males with a median age of 60) older African Americans.

MEASUREMENTS

A structured questionnaire elicited personal data as well as information on eating behaviors, life dissatisfaction, and perceived dietary social support.

RESULTS

Older African Americans with more cumulative life adversity, as reflected by high life dissatisfaction, had significantly poorer eating behaviors including the consumption of a high-fat diet and low intake of fruits and vegetables. Older African Americans' dietary choices were also associated with their perceived social support. More importantly, perceived social support acted as a buffer to mitigate the influence of life dissatisfaction on older African Americans' eating behaviors.

CONCLUSION

Life dissatisfaction places older African Americans at risk for unhealthy eating behaviors. However, high levels of dietary social support can protect older African Americans from the influence of life dissatisfaction on unhealthy eating behaviors. There are practical implications of this research for health interventions and programming.

Adolescent problem behavior in Nairobi's informal settlements: applying problem behavior theory in sub-Saharan Africa

Adolescent involvement in problem behaviors can compromise health, development, and successful transition to adulthood. The present study explores the appropriateness of a particular theoretical framework, Problem Behavior Theory, to account for variation in problem behavior among adolescents in informal settlements around a large, rapidly urbanizing city in sub-Saharan Africa. Data were collected from samples of never married adolescents of both sexes, aged 12-19, living in two Nairobi slum settlements (N = 1,722). Measures of the theoretical psychosocial protective and risk factor concepts provided a substantial, multi-variate, and explanatory account of adolescent problem behavior variation and demonstrated that protection can also moderate the impact of exposure to risk. Key protective and risk factors constitute targets for policies and programs to enhance the health and well-being of poor urban adolescents in sub-Saharan Africa.

Health compromising behaviors among Chinese adolescents: role of physical abuse, school experience, and social support

This study examined the influence of immediate social environment on health compromising behaviors (HCB) among 6564 high school students in China. Results showed that physical abuse by parents was a major risk factor that accounted for high rates of HCB. Perceived positive school experience and social support were protective factors associated with low rates of HCB. These two protective factors also buffered the adverse influence of abuse on the practice of individual HCB. In particular, parental abuse was associated with sexual experimentation, non-fatal self-harm, and suicide behaviors only at low levels of protective factors.

Effects of parental monitoring and exposure to community violence on antisocial behavior and anxiety/depression among adolescents

The aim of the research was to investigate the influence of gender, exposure to community violence, and parental monitoring upon antisocial behavior and anxiety/depression in adolescence. Involved in the study were 489 adolescents (290 males and 189 females) from 4 secondary schools in the city of Naples, Italy. The age of participants ranged from 16 to 19 (mean age = 17.53, standard deviation = 1.24). All were in the 3rd (11th grade) or 5th year (13th grade) of high school. Self-reported measures were used to assess antisocial behavior, symptoms of anxiety/depression, parental monitoring and exposure to community violence as a victim or as a witness. First of all we tested, through a hierarchical multiple regression, the independent contribution of gender, exposure to community violence and parental monitoring upon antisocial behavior and symptoms of anxiety/depression; then we tested the moderating role of gender and parental monitoring on the negative effects of exposure to violence. The results show that male gender, high level of exposure to community violence (both as a victim and a witness), and low level of parental monitoring predict a higher involvement in antisocial behavior. Female gender, being a victim and low level of parental monitoring predict symptoms of anxiety/depression. Furthermore, parental monitoring and gender play a moderating role, minimizing or amplifying the negative effects of exposure to community violence. The results of the research suggest that a similar pattern of risk and protective factors can give rise to multiple paths of adaptive or maladaptive development.

The association of religiosity, sexual education, and parental factors with risky sexual behaviors among adolescents and young adults

This study examined the association of religiosity, sexual education and family structure with risky sexual behaviors among adolescents and young adults. The nationally representative sample, from the 2002 National Survey of Family Growth, included 3,168 women and men ages 15-21 years. Those who viewed religion as very important, had frequent church attendance, and held religious sexual attitudes were 27-54% less likely to have had sex and had significantly fewer sex partners than peers. Participants whose formal and parental sexual education included abstinence and those from two-parent families were 15% less likely to have had sex and had fewer partners.

The effects of perinatal morbidity and environmental factors on health status of preterm children at age 12

Children born prematurely have later morbidity, yet little is known about their health in adolescence. This study examined multiple dimensions of health at age 12 and the predictors of biological, behavioral, social, and physical environmental factors. Analysis of variance and logistic regression models were tested. Perinatal morbidity predicted health at age 12. Preterm status increases the risk of later alterations in health. Bronchopulmonary dysplasia, necrotizing enterocolitis, intraventricular hemorrhage, small-for-gestational age, parental perception of child health, and parental psychological distress affect later health. Prematurity and perinatal morbidity continue to impact child health 12 years after birth.

A test of Jessor's problem behavior theory in a Eurasian and a Western European developmental context

PURPOSE

The current study tested the applicability of Jessor's problem behavior theory (PBT) in national probability samples from Georgia and Switzerland. Comparisons focused on (1) the applicability of the problem behavior syndrome (PBS) in both developmental contexts, and (2) on the applicability of employing a set of theory-driven risk and protective factors in the prediction of problem behaviors.

METHODS

School-based questionnaire data were collected from n = 18,239 adolescents in Georgia (n = 9499) and Switzerland (n = 8740) following the same protocol. Participants rated five measures of problem behaviors (alcohol and drug use, problems because of alcohol and drug use, and deviance), three risk factors (future uncertainty, depression, and stress), and three protective factors (family, peer, and school attachment). Final study samples included n = 9043 Georgian youth (mean age = 15.57; 58.8% females) and n = 8348 Swiss youth (mean age = 17.95; 48.5% females). Data analyses were completed using structural equation modeling, path analyses, and post hoc z-tests for comparisons of regression coefficients.

RESULTS

Findings indicated that the PBS replicated in both samples, and that theory-driven risk and protective factors accounted for 13% and 10% in Georgian and Swiss samples, respectively in the PBS, net the effects by demographic variables. Follow-up z-tests provided evidence of some differences in the magnitude, but not direction, in five of six individual paths by country.

CONCLUSION

PBT and the PBS find empirical support in these Eurasian and Western European samples; thus, Jessor's theory holds value and promise in understanding the etiology of adolescent problem behaviors outside of the United States.

Healthy lifestyle behaviour decreasing risks of being bullied, violence and injury

Background

Bullying and violence are problems of aggression in schools among adolescents. Basic daily healthy practices including nutritious diet, hygiene and physical activity are common approaches in comprehensive health promotion programs in school settings, however thier relationship to these aggressive behaviours is vague. We attempted to show the advantages of these healthy lifestyle behaviours in 9 developing countries by examining the association with being frequently bullied, violence and injury.

Methodology/Principal Findings

A cross-sectional cross-national survey of 9 countries using the WHO Global School Based Student Health Survey dataset was used. Measurements included experiences of “being frequently bullied” in the preceding 30 days and violence/injury in the past 12 months. Association of risk behaviours (smoking, alcohol, sexual behaviour) and healthy lifestyle (nutrition, hygiene practices, physical activity) to being bullied, and violence/injury were assessed using multivariate logistic regression. Hygiene behaviour showed lower risks of being frequently bullied [male: RR = 0.7 (97.5CI: 0.5, 0.9); female: RR = 0.6 (0.5, 0.8)], and lower risk of experiences of violence/injury [RR = 0.7 (0.5, 0.9) for males], after controlling for risk behaviours, age, education, poverty, and country.

Conclusion/Significance

Healthy lifestyle showed an association to decreased relative risk of being frequently bullied and violence/injury in developing countries. A comprehensive approach to risk and health promoting behaviours reducing bullying and violence is encouraged at school settings.

Risk compensation and vaccination: can getting vaccinated cause people to engage in risky behaviors?

BACKGROUND

Some believe that vaccinating young women against human papillomavirus (HPV) will increase their risky behavior. In more formal terms, vaccination lowers risk perception, and people compensate for their lower perceived risk by reducing other preventive behaviors.

PURPOSE

We test several predictions from the risk compensation hypothesis in the context of vaccination behavior.

METHODS

We obtained a random sample of adults (N=705), interviewing them by phone just as the Lyme disease vaccine first became available to the public and again 18 months later. Analyses controlled for age, sex, education, and race.

RESULTS

Vaccinated respondents were less likely to continue engaging in two of five protective behaviors after vaccination. The frequency of these protective behaviors did not dip below that among the unvaccinated respondents.

CONCLUSIONS

We found some evidence of regression (protective behaviors dropping, after vaccination, to levels reported by the unvaccinated cohort). However, we did not find disinhibition (exceeding the risk taking of the unvaccinated cohort), the greater threat to public health. Although we will not know for several years what effect HPV vaccination has on other behaviors, if any, data on other vaccinations can offer critically important information in the interim.