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Eisner-Fellay T, Suris JC, Barrense-Dias Y. Adolescent behavioural risk screening in primary care: physician's point of view. Fam Pract 2024; 41:123-130. [PMID: 37972300 PMCID: PMC11017776 DOI: 10.1093/fampra/cmad106] [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] [Indexed: 11/19/2023] Open
Abstract
BACKGROUND Despite regular consultation between adolescents/young adults (AYA) and their physicians, they are not regularly screened for psychosocial risk behaviours. This study examines physicians' self-reported psychosocial risk behaviour screening in AYA. It aims to highlight which elements hinder or improve screening abilities. METHODOLOGY The design was a cross-sectional quantitative survey. Data were obtained through a self-reported questionnaire sent out to primary care physicians (PCP) in Switzerland in 2018. The target population consisted of 1,824 PCP (29% response rate). Participants were asked whether they screened youths from 3 age groups [10-14 y/o, 15-20 y/o, and 21-25y/o] for the HEEADSSS items during child well visits and routine checkups. Barriers to screening included primary consultation motive prioritization, insufficient time, patient compliance, reimbursement, lack of skills related to adolescent health, lack of referral options. Data were analysed first through a bivariate analysis using Chi-square tests then through a multinomial logistic regression. RESULTS The majority of physicians partook in preventive screening for 3-5 psychosocial risk elements. They reported the primary consultation motive as well as a lack of available time as having a high impact on their screening habits. Physician's experience and having discussed confidentiality were related to an increase in the number of topics addressed. Confidentiality remained a significant variable throughout all analyses. CONCLUSION Barriers such as lack of consultation time and prioritization issues were found by physicians to be critical but did not hinder screening habits. The main element impacting screening habits was assuring confidentiality and the second is self-efficacy.
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Affiliation(s)
- Taslina Eisner-Fellay
- Research Group on Adolescent Health, Department of Epidemiology and Health Services, Center for Primary Care and Public Health (Unisanté), University of Lausanne, Lausanne, Switzerland
| | - Joan-Carles Suris
- Research Group on Adolescent Health, Department of Epidemiology and Health Services, Center for Primary Care and Public Health (Unisanté), University of Lausanne, Lausanne, Switzerland
| | - Yara Barrense-Dias
- Research Group on Adolescent Health, Department of Epidemiology and Health Services, Center for Primary Care and Public Health (Unisanté), University of Lausanne, Lausanne, Switzerland
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Tinner L, Kelly C, Caldwell D, Campbell R. Community mobilisation approaches to preventing adolescent multiple risk behaviour: a realist review. Syst Rev 2024; 13:75. [PMID: 38409098 PMCID: PMC10895861 DOI: 10.1186/s13643-024-02450-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/23/2023] [Accepted: 01/03/2024] [Indexed: 02/28/2024] Open
Abstract
BACKGROUND Adolescent multiple risk behaviour (MRB) is a global health issue. Most interventions have focused on the proximal causes of adolescent MRB such as peer or family influence, with systematic reviews reporting mixed evidence of effectiveness. There is increasing recognition that community mobilisation approaches could be beneficial for adolescent health. There are gaps in the current literature, theory and implementation that would benefit from a realist approach. We use a theory-driven evidence synthesis to assess how and why community mobilisation interventions work/do not work to prevent adolescent MRB and in what contexts. METHODS This realist review used a six-stage iterative process, guided by the RAMESES framework. We systematically searched PubMed, MEDLINE, PsycINFO, Web of Science, CINAHL and Sociological Abstracts, from their inception to 2021. Studies were screened for relevance to the programme theory, assessed for rigour and included based on a priori criteria. Two independent reviewers selected, screened and extracted data from included studies. A realist logic of analysis was used to develop context-mechanism-outcome configurations that contributed to our programme theory. FINDINGS We reviewed 35 documents describing 22 separate community mobilisation intervention studies. Most studies (n = 17) had a quality assessment score of three or four (out of four). We analysed the studies in relation to three middle range theories. To uphold our theory that these interventions work by creating a social environment where adolescents are less likely to engage in MRB, interventions should: (1) embed a framework of guiding principles throughout the community, (2) establish community readiness with population data and (3) ensure a diverse coalition with the support of intervention champions. Mechanisms such as empowerment through coalition ownership over the delivery of the intervention, cohesion across the community and motivation to work collaboratively to improve adolescent health are triggered to achieve social environment shifts. However, certain contexts (e.g. limited funding) restrict intervention success as these mechanisms are not fired. CONCLUSIONS For community mobilisation interventions to reduce adolescent MRB, the coalitions within them must seek to alter the social environment in which these behaviours occur. Mechanisms including empowerment, cohesion and motivation lead to this shift, but only under certain contexts. SYSTEMATIC REVIEW REGISTRATION PROSPERO CRD42020205342.
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Affiliation(s)
- Laura Tinner
- Population Health Sciences, Bristol Medical School, Canynge Hall, University of Bristol, Bristol, BS8 2PL, UK.
| | - Claire Kelly
- Population Health Sciences, Bristol Medical School, Canynge Hall, University of Bristol, Bristol, BS8 2PL, UK
| | - Deborah Caldwell
- Population Health Sciences, Bristol Medical School, Canynge Hall, University of Bristol, Bristol, BS8 2PL, UK
| | - Rona Campbell
- Population Health Sciences, Bristol Medical School, Canynge Hall, University of Bristol, Bristol, BS8 2PL, UK
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Okediji P, Troy D, Heron J, Kipping RR, Martin RM, Wright C. Exploring the associations between adverse childhood experiences (ACEs) and adolescent cancer risk behaviours in the ALSPAC cohort. BMC Public Health 2024; 24:95. [PMID: 38183020 PMCID: PMC10768201 DOI: 10.1186/s12889-023-17516-4] [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: 08/09/2023] [Accepted: 12/18/2023] [Indexed: 01/07/2024] Open
Abstract
BACKGROUND Some modifiable risk factors for cancer originate during adolescence. While there is evidence indicating relationships between adverse childhood experiences and health risk behaviours generally, little is known about how childhood adversity influences the engagement of adolescents in cancer risk behaviours. This study aimed to determine the relationship between adverse childhood experiences and adolescent cancer risk behaviours. METHODS Data were collected prospectively from birth to age 18 years on children born to mothers enrolled into the Avon Longitudinal Study of Parents and Children (ALSPAC) cohort study. Multivariable linear regression models assessed relationships of a composite exposure measure comprised of adverse childhood experiences (total number of childhood adversities experienced from early infancy until age 9 years) with multiple cancer risk behaviours. The latter was expressed as a single continuous score for tobacco smoking, alcohol consumption, obesity, unsafe sex, and physical inactivity, at ages 11, 14, 16 and 18 years. Analysis was carried out on the complete case and imputation samples of 1,368 and 7,358 participants respectively. RESULTS All adolescent cancer risk behaviours increased in prevalence as the adolescents grew older, except for obesity. Each additional adverse childhood experience was associated with a 0.25 unit increase in adolescent cancer risk behaviour (95% CI 0.16-0.34; p < 0.001). Individually, parental substance misuse (β 0.64, 95% CI 0.25-1.03, p < 0.001) and parental separation (β 0.56, 95% CI 0.27-0.86, p < 0.001) demonstrated the strongest evidence of association with engagement in adolescent cancer risk behaviour. CONCLUSION Childhood adversity was associated with a greater degree of engagement in adolescent cancer risk behaviours. This finding demonstrates the need for targeted primary and secondary prevention interventions that reduce engagement across multiple cancer risk behaviours for children and adolescents who have experienced adversity in childhood, such as parental substance misuse and separation, and reduce exposure to adversity.
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Affiliation(s)
- Paul Okediji
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - David Troy
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Jon Heron
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK.
- MRC Integrative Epidemiology Unit (IEU), Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK.
| | - Ruth R Kipping
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Richard M Martin
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
- MRC Integrative Epidemiology Unit (IEU), Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
- NIHR Bristol Biomedical Research Centre, University Hospitals Bristol and Weston NHS Foundation Trust and the University of Bristol, Bristol, UK
| | - Caroline Wright
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
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Carvalho CB, Arroz AM, Martins R, Costa R, Cordeiro F, Cabral JM. "Help Me Control My Impulses!": Adolescent Impulsivity and Its Negative Individual, Family, Peer, and Community Explanatory Factors. J Youth Adolesc 2023; 52:2545-2558. [PMID: 37620682 PMCID: PMC10522498 DOI: 10.1007/s10964-023-01837-z] [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: 05/02/2023] [Accepted: 07/27/2023] [Indexed: 08/26/2023]
Abstract
The literature shows that impulsivity, prevalent in adolescence, is negatively linked with a variety of psychosocial factors (e.g., positive interpersonal relationships, emotion regulation); however, there is limited research examining the relative contribution of multiple factors for this trait nor exploring how these factors influence the associations between impulsivity and risk-related outcomes. Drawing on multiple components of the unified theory of development (i.e., psychological variables, peers subsystem, community subsystem, family processes subsystem), this cross-sectional study aims to identify explanatory psychosocial variables (i.e., early memories of warmth and safeness, rational decision-making style, resilience, emotion regulation, coping, parental attachment, social group attachment, satisfaction with school and family-related variables) that are negatively related with impulsivity, in younger (13-15) and older (16-19 years) adolescents, and explore their moderating role in the associations between this trait and some risk-related outcomes (i.e., verbal aggression, anger, self-harm, other high-risk behaviors). A representative sample of 6894 adolescents (52.9% female) living in the Azores (Portugal), with ages ranging from 13 to 19 (M = 15.4), was used. Two stepwise multiple regressions, one for each age group, revealed that only emotion regulation, parental attachment, and social group attachment had a negative effect on impulsivity in both age groups; additionally, satisfaction with teachers also had this effect in younger adolescents. The first three variables weakened the positive associations between impulsivity and the risk-related outcomes. These results suggest that the psychological system and all subsystems of the social context measured play a relevant role in explaining adolescent impulsivity and that it may be reduced by promoting emotion regulation, positive parenting practices, healthier relationships with peers, and healthier relationships with teachers.
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Affiliation(s)
- Célia Barreto Carvalho
- Faculty of Social and Human Sciences, University of the Azores, Ponta Delgada, Portugal.
- Cognitive and Behavioural Centre for Research and Intervention, Faculty of Psychology and Education Sciences, University of Coimbra, Coimbra, Portugal.
| | - Ana Moura Arroz
- Faculty of Social and Human Sciences, University of the Azores, Ponta Delgada, Portugal
- Centre for Ecology, Evolution and Environmental Changes, Azorean Biodiversity Group (cE3c/ABG); CHANGE - Global Change and Sustainability Institute, University of the Azores, Ponta Delgada, Portugal
| | - Raquel Martins
- Gaspar Frutuoso Foundation, University of the Azores, Ponta Delgada, Portugal
| | - Rodrigo Costa
- Gaspar Frutuoso Foundation, University of the Azores, Ponta Delgada, Portugal
| | - Filipa Cordeiro
- Gaspar Frutuoso Foundation, University of the Azores, Ponta Delgada, Portugal
| | - Joana Moura Cabral
- Faculty of Social and Human Sciences, University of the Azores, Ponta Delgada, Portugal
- Cognitive and Behavioural Centre for Research and Intervention, Faculty of Psychology and Education Sciences, University of Coimbra, Coimbra, Portugal
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Lejone TI, Mahomed O. Magnitude and Determinants of Virological Failure Among Patients >15 Years on Anti-Retroviral Therapy in Rural Lesotho Between 2015 and 2019 - A Retrospective Cohort Study. HIV AIDS (Auckl) 2023; 15:611-620. [PMID: 37849794 PMCID: PMC10577259 DOI: 10.2147/hiv.s424277] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2023] [Accepted: 09/10/2023] [Indexed: 10/19/2023] Open
Abstract
Background Lesotho has the second-highest HIV prevalence globally at an estimated 23%, with approximately 87% of the population between 15 and 59 years of age reported to be receiving antiretroviral treatment. There is an urgent need to increase access to effective ART due to increasing rates of first- and second-line treatment failure. Sustaining successful treatment and limiting the development of virological failure is essential, hence the need for early detection of increased viral load indicating drug resistance or rapid progression of viral replication. Aim The aim of the study was to determine the proportion of patients with HIV with virological failure and to identify factors associated with virological failure in two districts of Lesotho. Methods A retrospective cohort study was conducted in two districts (Butha-Buthe and Mokhotlong) in Lesotho. Data for all patients (age ≥15 years) in the viral load (VL) monitoring database with at least two consecutive viral load results between December 2015 and December 2019 from 22 health facilities were extracted. Descriptive data were presented using tables and figures. Bivariate and multivariate analyses were performed. A p-value < 0.05 was considered a statistically significant association. Results Only 4% (n = 913) of the study participants had virological failure. Longer time on treatment >65 months (AOR: 1.85 CI: 1.59-2.15) and being on second-line ART regimen (AOR: 75.23 95% CI: 75.00-99.15) were significantly (p < 0.001) associated with virological failure. Conclusion Virological failure among the study participants is lower compared to other settings. The study identified duration on treatment, treatment regimen as high risk for virological failure. Targeted interventions should be developed for these high-risk group individuals, with continuous monitoring of virological response and appropriate drug switching to clients to achieve improved outcomes.
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Affiliation(s)
- Thabo Ishmael Lejone
- SolidarMed, Lesotho, South Africa
- Discipline of Public Health Medicine, University of KwaZulu Natal, Durban, South Africa
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Lu YS, Wu YR, Cheng YR, Chang CH, Jan CF. Ten years' trend analysis for Taiwanese youth high school students' health behaviors. J Formos Med Assoc 2023; 122:1077-1086. [PMID: 37095019 DOI: 10.1016/j.jfma.2023.04.010] [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: 08/19/2022] [Revised: 03/27/2023] [Accepted: 04/11/2023] [Indexed: 04/26/2023] Open
Abstract
PURPOSE To delineate the 10 years' trend regarding Taiwanese adolescents' health perspectives and compare the differences of six adolescent health aspects between Taiwan and the U.S. METHODS The anonymous structured questionnaire was done every other year with representative sampling methods as Youth Risk Behavior Surveillance System in the United States. Twenty-one questions from six health aspects were extracted for further analysis. Multivariate regression analysis was performed to delineate the relationship among protective factors and risk-taking behaviors, respectively. RESULTS Overall, 22,419 adolescents were recruited. There were decreasing trend in terms of risk-taking behaviors, such as early contact to pornography (< age 16) (70.6%-60.9%), early cigarette use (< age 13) (20.7%-14.0%), and seriously considering suicide (36.0%-17.8%). There was an increasing trend in behaviors harmful to health: current alcohol drinkers (18.9%-23.4%), and staying up late every day (15.2%-18.5%). Multivariate regression analysis after adjusting gender and grade; it disclosed an increasing trend in protective assets, such as having multiple intimate friends (75.8%-79.3%), satisfaction to body weight and body shape (31.5%-36.1% and 34.5%-40.7%), as well as always wearing a helmet while riding a bike (1.8%-3.0%). CONCLUSION We should continuously monitor the health status trend of the adolescents to provide them with a healthier environment and well-being.
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Affiliation(s)
- Yu-Sheng Lu
- Department of Family Medicine, National Taiwan University Hospital, Taipei, Taiwan
| | - Yu-Rui Wu
- Department of Family Medicine, Taitung Christian Hospital, Taitung, Taiwan
| | - Yih-Ru Cheng
- Clinical Psychology Center, National Taiwan University Hospital, Taipei, Taiwan
| | - Chin-Hao Chang
- Department of Medical Research, National Taiwan University Hospital, Taipei, Taiwan
| | - Chyi-Feng Jan
- Department of Family Medicine, National Taiwan University Hospital, Taipei, Taiwan; College of Medicine, National Taiwan University, Taipei, Taiwan.
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Kundu LR, Al Masud A, Islam Z, Hossain J. Clustering of health risk behaviors among school-going adolescents in Mymensingh district, Bangladesh. BMC Public Health 2023; 23:1850. [PMID: 37740226 PMCID: PMC10517506 DOI: 10.1186/s12889-023-16766-6] [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: 07/06/2023] [Accepted: 09/15/2023] [Indexed: 09/24/2023] Open
Abstract
BACKGROUND Adolescents frequently engage in risky behaviors that negatively influence their health and pose a serious public health concern. This study aimed to examine the clustering pattern of health risk behaviors among school-going adolescents in Bangladesh. METHODS A cross-sectional study was conducted from 15 April to 27 June 2022 among 412 school-going adolescents in Mymensingh district of Bangladesh through a convenience sampling technique. Data were collected via face-to-face interviews using a modified Global School-Based Student Health Survey (GSHS) 2021 questionnaire. Cluster membership was identified using the k-means clustering algorithm. The chi-square test was adopted to explore the association between sociodemographic variables and each cluster membership. The ordinal logistic regression model was employed to examine the predictors associated with cluster membership. RESULTS Most of the respondents were female (55.3%) and belonged to the 16-19 years (74.5%) age group. Three behavioral clusters were identified, including Cluster 1: Low-risk taker (50.2%), Cluster 2: Moderate risk taker (39.6%), and Cluster 3: High-risk taker (10.2%). Influential factors of high-risk behavior among adolescents were significantly associated with their age (p = 0.03), father's education who were illiterate (p = 0.02), monthly family income >30000 BDT (p = 0.04), parent's those were understanding their child's problems in most of the time (p = 0.001). CONCLUSIONS The study found that high-risk behaviors are significantly higher among late adolescents, those whose fathers are illiterate, whose monthly income is higher, those whose parents or guardians never realize their child's complications and worries, and those whose parents or guardians never recognize what they did in their leisure time. These findings will help to develop intervention programs, policies, strategies, and curricula in school by the experts following the necessity to adopt the adolescent toward healthy behavior and help to reduce the prevalence of health risk behavior.
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Affiliation(s)
- Lakshmi Rani Kundu
- Department of Public Health and Informatics, Jahangirnagar University, Savar, Dhaka, 1342, Bangladesh.
| | - Abdullah Al Masud
- Department of Public Health and Informatics, Jahangirnagar University, Savar, Dhaka, 1342, Bangladesh
| | - Zohurul Islam
- Department of Public Health, Hamdard University Bangladesh, Gazaria, Munshiganj, 1510, Bangladesh
| | - Jamil Hossain
- Department of Public Health and Informatics, Jahangirnagar University, Savar, Dhaka, 1342, Bangladesh
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Sadza A, Daalmans S, Rozendaal E, Buijzen M. Risk on Demand? A Quantitative Content Analysis of the Portrayal of Risky Health Behaviors in Popular on Demand Content. HEALTH COMMUNICATION 2023:1-10. [PMID: 37691182 DOI: 10.1080/10410236.2023.2255762] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/12/2023]
Abstract
Video on Demand (VOD) has become the most popular way for adolescent viewers to consume entertainment media, often without parental supervision. Given the potential for modeling, this study aims to investigate the prevalence and nature with which risky health behaviors are portrayed in popular VOD programs. A quantitative content analysis of trending programs (N = 529) from popular VOD-platforms investigated the prevalence, co-occurrence, tone, social context, and consequences with which alcohol use, tobacco use, drug use, unsafe sexual behavior, reckless behavior, and self-harm behaviors are portrayed in popular VOD programs. In addition, we analyzed the demographic characteristics of the characters who portrayed the risk behaviors Risk behaviors were portrayed frequently, with substance use behaviors (i.e. alcohol, smoking, drugs) being most prevalent and most likely to co-occur. Reckless behavior, self-harm behaviors, and explicitly unsafe sexual behaviors were much less common. Findings show that risk behavior was often portrayed in a normalized manner, with alcohol and smoking, in particular, being portrayed as neutral behaviors that rarely have consequences. Most risk-taking characters were (young) adult white males, mirroring the general overrepresentation of this demographic in popular media. Risk behavior was rarely problematized in popular on demand content. Potential consequences for adolescent viewers are discussed.
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Affiliation(s)
- Anne Sadza
- Behavioural Science Institute, Radboud University
| | | | - Esther Rozendaal
- Erasmus School of Social and Behavioural Sciences, Erasmus University Rotterdam
| | - Moniek Buijzen
- Behavioural Science Institute, Radboud University
- Erasmus School of Social and Behavioural Sciences, Erasmus University Rotterdam
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Chen G, Rahman S, Lutfy K. E-cigarettes may serve as a gateway to conventional cigarettes and other addictive drugs. ADVANCES IN DRUG AND ALCOHOL RESEARCH 2023; 3:11345. [PMID: 38389821 PMCID: PMC10880776 DOI: 10.3389/adar.2023.11345] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/08/2023] [Accepted: 06/14/2023] [Indexed: 02/24/2024]
Abstract
Electronic cigarettes (e-cigarettes) are devices that allow the user to inhale nicotine in a vapor, and are primarily marketed as a means of quitting smoking and a less harmful replacement for traditional cigarette smoking. However, further research is needed to determine if vaping nicotine via e-cigarettes can be effective. Conversely, nicotine has been considered a gateway drug to alcohol and other addictive drugs and e-cigarettes containing nicotine may have the same effects. Previous reports have shown that e-cigarette use may open the gate for the use of other drugs including conventional cigarettes, cannabis, opioids, etc. The increasing prevalence of e-cigarettes, particularly among youth and adolescents in the last decade have led to an increase in the dual use of e-cigarettes with alcohol, cannabis, and other illicit drug use like heroin and 3-4-methylenedioxymethamphetamine (MDMA). The advent of e-cigarettes as a device to self-administer addictive agents such as cocaine and synthetic cathinones may bring about additional adverse health effects associated with their concurrent use. This review aims to briefly describe e-cigarettes and their different generations, and their co-use with other addictive drugs as well as the use of the device as a tool to self-administer addictive drugs, such as cocaine, etc.
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Affiliation(s)
- Grace Chen
- College of Osteopathic Medicine, Western University of Health Sciences, Pomona, CA, United States
| | - Shafiqur Rahman
- Department of Pharmaceutical Sciences, College of Pharmacy, South Dakota State University, Brookings, SD, United States
| | - Kabirullah Lutfy
- College of Pharmacy, Western University of Health Sciences, Pomona, CA, United States
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Levkovich I, Labes M. "I wanted to hide but also to be found": the high school experiences of young adults who grew up in the same home as a sibling with depression. BMC Psychol 2023; 11:190. [PMID: 37386645 DOI: 10.1186/s40359-023-01234-y] [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: 02/08/2023] [Accepted: 06/21/2023] [Indexed: 07/01/2023] Open
Abstract
BACKGROUND Depression is a mental health condition that can have far-reaching consequences for the entire family, not just for the affected individual. Siblings are particularly vulnerable in that the unremitting stress and guilt at home can affect multiple aspects of their lives, including relationships, added responsibilities, and health. This pressure may affect siblings' own emotional well-being and academic success. Most studies in this field have examined the impact of depression on the affected adolescents or their parents, whereas few have examined the impact on siblings. Sibling studies have been limited by lack of sample homogeneity, especially in the context of coping in high school. This study sought to examine the retrospective experiences of young adults who lived in the same house as a sibling with depression while they were in high school. METHODS This qualitative study examined 21 young adults (aged 18-29) who grew up with a sibling with depression. In-depth, semi-structured interviews were conducted from May to September 2022. The interviews were recorded and transcribed and underwent thematic analysis. RESULTS Three main themes emerged from the interviews: (1) "School as a place of refuge": The perspective of participants who grew up with a sibling with depression regarding their high school experience. (2) "I wanted the adults at school to see me": Relations between research participants and the school educational staff. (3) "I was afraid people would relate to me as the sibling of a crazy person": Participants' relationships with their peers. CONCLUSIONS This study sheds light on the experiences of adolescents who grew up with a sibling with depression. The findings point to feelings of being invisible, self-nullification, avoiding sharing with others, and transparency. The participants were afraid that if their peers found out about their sibling they would also be stigmatized and alienated. The study shows that adolescents living with a sibling with depression need support at school.
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Affiliation(s)
- Inbar Levkovich
- Faculty of Graduate Studies, Oranim Academic College of Education, Kiryat Tiv'on, 36006, Israel.
| | - Michal Labes
- Faculty of Graduate Studies, Oranim Academic College of Education, Kiryat Tiv'on, 36006, Israel
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Srivastava S, Mohanty P, Muhammad T, Kumar M. Socio-economic inequalities in non-use of modern contraceptives among young and non-young married women in India. BMC Public Health 2023; 23:797. [PMID: 37127678 PMCID: PMC10150497 DOI: 10.1186/s12889-023-15669-w] [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: 05/18/2022] [Accepted: 04/13/2023] [Indexed: 05/03/2023] Open
Abstract
BACKGROUND It is documented that married women do not utilize contraceptive methods, because of the fear of adverse effects, no or seldom sexual interaction; perception that they should not use contraception during breastfeeding, postpartum amenorrhea, or dissatisfaction with a specific method of contraception. The current study aimed to examine the socio-economic inequalities associated with the non-use of modern contraceptive methods among young (15-24 years) and non-young (25-49 years) married women and the contributing factors in those inequalities. METHODS The present study utilized the cross-sectional data from the fourth round of the National Family Health Survey (NFHS-4) with a sample of 499,627 women who were currently married. The modern methods of family planning include sterilization, injectables, intrauterine devices (IUDs/PPIUDs), contraceptive pills, implants, the standard days method, condoms, diaphragm, foam/jelly, the lactational amenorrhea method, and emergency contraception. Multivariable logistic regression analysis was used to estimate the odds of non-use of modern contraceptive methods according to different age groups after controlling for various confounding factors. Additionally, concentration curve and Wagstaff decomposition method were used in the study. RESULTS The prevalence of non-use of modern contraceptive use was higher among women from young category (79.0%) than non-young category (45.8%). The difference in prevalence was significant (33.2%; p < 0.001). Women from non-young age group had 39% significantly lower odds of non-use of modern contraceptive use than women from young age group (15-24 years) [AOR: 0.23; CI: 0.23, 0.23]. The value of concentration quintile was -0.022 for young and -0.058 for non-young age groups which also confirms that the non-use of modern contraceptives was more concentrated among women from poor socio-economic group and the inequality is higher among non-young women compared to young women. About 87.8 and 55.5% of the socio-economic inequality was explained by wealth quintile for modern contraceptive use in young and non-young women. A higher percent contribution of educational status (56.8%) in socio-economic inequality in non-use of modern contraceptive use was observed in non-young women compared to only -6.4% in young women. Further, the exposure to mass media was a major contributor to socio-economic inequality in young (35.8%) and non-young (43.2%) women. CONCLUSION Adverse socioeconomic and cultural factors like low levels of education, no exposure to mass media, lack of or limited knowledge about family planning, poor household wealth status, religion, and ethnicity remain impediments to the use of modern contraceptives. Thus, the current findings provide evidence to promote and enhance the use of modern contraceptives by reducing socioeconomic inequality.
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Affiliation(s)
- Shobhit Srivastava
- International Institute for Population Sciences, Mumbai, Maharashtra, 400088, India
| | - Parimala Mohanty
- Institute of Medical Sciences & Sum Hospital, Siksha "O" Anusandhan Deemed to Be University, Bhubaneswar, Odisha, India
| | - T Muhammad
- International Institute for Population Sciences, Mumbai, Maharashtra, 400088, India.
| | - Manish Kumar
- International Institute for Population Sciences, Mumbai, Maharashtra, 400088, India
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Widnall E, Albers PN, Hatch L, Hopkins G, Kidger J, Vocht FD, Kaner E, Sluijs EMV, Fairbrother H, Jago R, Campbell R. Using systems thinking to understand how the South West - School Health Research Network can improve adolescent health and well-being: A qualitative process evaluation. Health Place 2023; 82:103034. [PMID: 37120949 PMCID: PMC7614868 DOI: 10.1016/j.healthplace.2023.103034] [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: 01/12/2023] [Revised: 04/24/2023] [Accepted: 04/24/2023] [Indexed: 05/02/2023]
Abstract
Schools offer a valuable setting to promote good health and mental well-being amongst young people. Schools are complex systems and therefore systems interventions are needed to improve pupil health and well-being. This paper presents a qualitative process evaluation of the South West- School Health Research Network, a systems level intervention. The evaluation is based on interviews with school staff, local authorities and wider stakeholders. Given the complexity of England's educational system there is a need to intervene and monitor health at multiple levels and to ensure close partnership working to effectively improve adolescent health through schools.
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Affiliation(s)
- Emily Widnall
- Population Health Sciences, University of Bristol, UK.
| | | | - Lorna Hatch
- Population Health Sciences, University of Bristol, UK
| | | | - Judi Kidger
- Population Health Sciences, University of Bristol, UK
| | | | - Eileen Kaner
- Faculty of Medical Sciences, Newcastle University, UK
| | | | | | - Russell Jago
- Population Health Sciences, University of Bristol, UK; Centre for Exercise Nutrition & Health Sciences, School for Policy Studies, University of Bristol, UK
| | - Rona Campbell
- Population Health Sciences, University of Bristol, UK
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O'Donnell MB, Scott SR, Ellisor BM, Cao VT, Zhou C, Bradford MC, Pihoker C, DeSalvo DJ, Malik FS, Hilliard ME, Rosenberg AR, Yi-Frazier JP. Protocol for the Promoting Resilience in Stress Management (PRISM) intervention: A multi-site randomized controlled trial for adolescents with type 1 diabetes. Contemp Clin Trials 2023; 124:107017. [PMID: 36410689 PMCID: PMC9839528 DOI: 10.1016/j.cct.2022.107017] [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: 09/15/2022] [Revised: 11/14/2022] [Accepted: 11/16/2022] [Indexed: 11/23/2022]
Abstract
BACKGROUND Adolescents with type 1 diabetes (T1D) are at high risk for elevated diabetes distress, which greatly impacts diabetes management, glycemic outcomes and overall quality of life. Developing protective skills and "resilience resources" to navigate adversity and manage diabetes distress has high potential to help adolescents with T1D achieve optimal behavioral, psychological, and health outcomes. The "Promoting Resilience in Stress Management" (PRISM) program is a manualized, brief, skills-based intervention delivered over 6 months via two 45-60 min one-on-one sessions and a family meeting with a PRISM coach, and supplemented by booster calls and a digital app. This trial (PRISM versus usual care)is designed to:: (1) assess PRISM's impact on glycemic outcomes and diabetes distress among adolescents with T1D, and (2) explor PRISM's impact on resilience, self-reported adherence, and quality of life. METHODS We describe the protocol for a multi-site randomized controlled trial designed for adolescents ages 13-18 with elevated diabetes distress. The primary trial outcomes are glycemic outcomes and diabetes distress 6 months post-randomization. Secondary outcomes include resilience, self-reported adherence, and QOL 6 months post-randomization. Our hypothesis is that youth in the PRISM group will demonstrate better glycemic outcomes and improved diabetes distress, adherence, resilience, and QOL compared to usual care. CONCLUSIONS This study will provide methodologically rigorous data and evidence regarding a novel intervention to promote resilience among adolescents with T1D and elevated diabetes distress. This research has the potential to offer a practical, skills-based curriculum designed to improve outcomes for this high-risk group. TRIAL REGISTRATION Prospectively registered at Clinicaltrials.gov (NCT03847194).
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Affiliation(s)
- Maeve B O'Donnell
- Palliative Care and Resilience Lab, Seattle Children's Research Institute, Center for Clinical & Translational Research, Seattle, WA, United States of America; University of Washington School of Medicine, Department of Pediatrics, Division of Diabetes/Endocrinology, Seattle, WA, United States of America; Cambia Palliative Care Center of Excellence, University of Washington School of Medicine, Seattle, WA, United States of America
| | - Samantha R Scott
- Palliative Care and Resilience Lab, Seattle Children's Research Institute, Center for Clinical & Translational Research, Seattle, WA, United States of America; Department of Psychology, University of Denver, Denver, CO, United States of America
| | - Britney M Ellisor
- Palliative Care and Resilience Lab, Seattle Children's Research Institute, Center for Clinical & Translational Research, Seattle, WA, United States of America
| | - Viena T Cao
- Texas Children's Hospital and Baylor College of Medicine, Department of Pediatrics, Houston, TX, United States of America
| | - Chuan Zhou
- Center for Child Health, Behavior, and Development, Seattle Children's Research Institute, Seattle, WA, United States of America; University of Washington, School of Medicine, Department of Pediatrics, Division of General Pediatrics, Seattle, WA, United States of America
| | - Miranda C Bradford
- Core for Biostatistics, Epidemiology and Analytics for Research (BEAR) Core, Seattle Children's Research Institute, Seattle, WA, United States of America
| | - Catherine Pihoker
- University of Washington School of Medicine, Department of Pediatrics, Division of Diabetes/Endocrinology, Seattle, WA, United States of America
| | - Daniel J DeSalvo
- Texas Children's Hospital and Baylor College of Medicine, Department of Pediatrics, Houston, TX, United States of America
| | - Faisal S Malik
- University of Washington School of Medicine, Department of Pediatrics, Division of Diabetes/Endocrinology, Seattle, WA, United States of America; Center for Child Health, Behavior, and Development, Seattle Children's Research Institute, Seattle, WA, United States of America
| | - Marisa E Hilliard
- Texas Children's Hospital and Baylor College of Medicine, Department of Pediatrics, Houston, TX, United States of America
| | - Abby R Rosenberg
- Palliative Care and Resilience Lab, Seattle Children's Research Institute, Center for Clinical & Translational Research, Seattle, WA, United States of America; Cambia Palliative Care Center of Excellence, University of Washington School of Medicine, Seattle, WA, United States of America
| | - Joyce P Yi-Frazier
- Palliative Care and Resilience Lab, Seattle Children's Research Institute, Center for Clinical & Translational Research, Seattle, WA, United States of America.
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Sharp CA, Widnall E, Albers PN, Willis K, Capner C, Kidger J, de Vocht F, Kaner E, van Sluijs EMF, Fairbrother H, Jago R, Campbell R. Creation of a Pilot School Health Research Network in an English Education Infrastructure to Improve Adolescent Health and Well-Being: A Study Protocol. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph192013711. [PMID: 36294290 PMCID: PMC9603152 DOI: 10.3390/ijerph192013711] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/05/2022] [Revised: 10/01/2022] [Accepted: 10/20/2022] [Indexed: 05/09/2023]
Abstract
Schools play a significant role in promoting health and well-being and the reciprocal links between health and educational attainment are well-evidenced. Despite recognition of the beneficial impact of school-based health improvement programmes, significant barriers to improving health and well-being within schools remain. This study pilots a School Health Research Network in the South West of England (SW-SHRN), a systems-based health intervention bringing together schools, academic health researchers and public health and/or education teams in local authorities to share knowledge and expertise to improve the health and well-being of young people. A maximum of 20 secondary schools will be recruited to the pilot SW-SHRN. All students in Years 8 (age 12-13) and 10 (age 14-15) will be invited to complete a health and well-being questionnaire, generating a cohort of approximately 5000 adolescents. School environment questionnaires will also be completed with each school to build a regional picture of existing school health policies and programmes. Each school will be provided with a report summarising data for their students benchmarked against data for all schools in the network. Quantitative analysis will model associations between health risk behaviours and mental health outcomes and a qualitative process evaluation will explore the feasibility and sustainability of the network. This study will create adolescent health data to help provide schools and local authorities with timely and robust information on the health and well-being of their students and help them to identify areas in which public health interventions may be required. SW-SHRN will also help public health professionals focus their resources in the areas most at need.
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Affiliation(s)
- Catherine A. Sharp
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol BS8 2PS, UK
| | - Emily Widnall
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol BS8 2PS, UK
- Correspondence:
| | - Patricia N. Albers
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol BS8 2PS, UK
| | - Kate Willis
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol BS8 2PS, UK
| | - Colin Capner
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol BS8 2PS, UK
| | - Judi Kidger
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol BS8 2PS, UK
| | - Frank de Vocht
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol BS8 2PS, UK
| | - Eileen Kaner
- Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne NE1 7RU, UK
| | | | | | - Russell Jago
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol BS8 2PS, UK
- Centre for Exercise Nutrition & Health Sciences, School for Policy Studies, University of Bristol, Bristol BS8 1TZ, UK
| | - Rona Campbell
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol BS8 2PS, UK
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Williams G, Kinchin I. The application of discrete choice experiments eliciting young peoples' preferences for healthcare: a systematic literature review. THE EUROPEAN JOURNAL OF HEALTH ECONOMICS : HEPAC : HEALTH ECONOMICS IN PREVENTION AND CARE 2022:10.1007/s10198-022-01528-9. [PMID: 36169764 DOI: 10.1007/s10198-022-01528-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/23/2021] [Accepted: 09/06/2022] [Indexed: 06/16/2023]
Abstract
OBJECTIVES Understanding young people's preferences for healthcare is critical for reducing the negative effect of undesirable choices. This review aims to synthesise the evidence obtained from discrete choice experiments (DCEs) eliciting young people's preferences for healthcare interventions and service deliveries, specifically, to (1) examine the methodology, including a selection of attributes and levels, experimental design, estimation procedure and validity; (2) evaluate similarities, differences and rigour of designs to the general population DCEs; and, (3) compare the DCEs' application to the seven health priority areas defined by the World Health Organisation (WHO). METHODS A systematic review searching Medline, EconLIT, PsychINFO, Scopus, and Web of Science was performed up until May 2021. INCLUSION CRITERIA a DCE, eliciting young peoples' preferences (10-24 years of age), on a healthcare-related topic defined by WHO, peer-reviewed, full-text available in English. A bespoke checklist was used to assess the methodological quality of the included studies. RESULTS Eighteen DCE studies were included in the review, exploring interventions and service in sexual and reproductive health (n = 9; 50%), smoking cessation (n = 4; 22%), mental health (n = 1), nutrition (n = 1), unintentional injuries (n = 1), vaccination against severe but rare diseases (n = 1); and diabetes (n = 1). Compared to the general population, DCEs eliciting young people's preferences had a high proportion of monetary measures and a smaller number of choices per respondent with the overwhelming number of surveys using fractional factorial design. The majority of studies were of moderate quality (50-75% of the criteria met). CONCLUSIONS While identified DCEs touched on most health priority areas, the scope was limited. The conduct and reporting of DCEs with young people could be improved by including the state-of-the-art design, estimation procedures and analysis.
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Affiliation(s)
- Galina Williams
- School of Business, Accounting and Law, CQUniversity, Brisbane, Australia.
| | - Irina Kinchin
- Centre for Health Policy and Management, School of Medicine, Trinity College Dublin, The University of Dublin, Dublin, Ireland
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Kleszczewska D, Mazur J, Porwit K, Kowalewska A. Who Is Able to Resist What Is Forbidden?—The Relationship between Health Literacy and Risk Behaviours in Secondary School Students in the Broader Social and Educational Context. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19159381. [PMID: 35954737 PMCID: PMC9368140 DOI: 10.3390/ijerph19159381] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/22/2022] [Revised: 07/23/2022] [Accepted: 07/28/2022] [Indexed: 02/04/2023]
Abstract
In the last Health Behaviour in School-Aged Children (HBSC) survey conducted in Poland in 2018, a group of 17-year-old adolescents (n = 1663; mean age 17.63 ± 0.36 years) was included outside the international protocol. This allowed an assessment to be made of their level of health literacy (HL) using the 10-point HBSC research tool. The aim of the study was to investigate the relationship between HL and risk behaviours (RB). A standardised index of RB in the last 30 days was considered as an outcome measure. This index was significantly higher in the group with low HL (0.318 ± 1.269) in comparison with the group with high HL (−0.083 ± 0.962). In a multivariate linear regression model, the strongest predictors of RB were gender, academic performance and level of regional deprivation, but the association with HL remained significant. This significant association persisted in general schools and in girls but disappeared in vocational schools and in boys. It was also shown that in rural areas, good academic performance has a less significant impact on RB if the HL level is low. The analyses led to the conclusion that when examining the relationship between HL and RB in older adolescents, it is advisable to take into account gender, the educational track and neighbourhood characteristics.
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Affiliation(s)
- Dorota Kleszczewska
- Institute of Mother and Child Foundation, 01-211 Warsaw, Poland
- Correspondence:
| | - Joanna Mazur
- Department of Humanization in Medicine and Sexology, Collegium Medicum, University of Zielona Gora, 65-729 Zielona Gora, Poland;
| | - Katarzyna Porwit
- Centre of Migration Research, University of Warsaw, 02-093 Warsaw, Poland;
| | - Anna Kowalewska
- Department of Biomedical Aspects of Development and Sexology, Faculty of Education, Warsaw University, 00-561 Warsaw, Poland;
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Belardinelli P, Torbica A, Fattore G. Longitudinal associations between different measures of socioeconomic status and health behavior among adolescents. Data from a wealthy Italian region. Prev Med 2022; 160:107092. [PMID: 35594925 DOI: 10.1016/j.ypmed.2022.107092] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/24/2021] [Revised: 04/29/2022] [Accepted: 05/13/2022] [Indexed: 11/26/2022]
Abstract
We investigate the association between socio-economic status and unhealthy behaviors among adolescents. By using different measures of socio-economic status, we capture both subjective aspects, as operationalized by perceived family affluence, and objective aspects, such as parents' educational levels and family affluence scale. We use data from a sample of 11,623 adolescents who participated in the Health Behavior in School-aged Children (HBSC) study in 2007, 2010, and 2014 in the Lombardy region of Italy. Results show that all of our measures of socio-economic status are correlated with unhealthy behaviors among adolescents. In particular, perceiving a family affluence below average is significantly correlated with a higher probability of reporting all of the unhealthy behaviors included in our analysis. Having at least one parent with university education significantly decreases the odds of being obese or overweight, having an unbalance diet, being physically inactive, and reporting sedentary behaviors. However, adolescents with at least one university educated parent are more likely to make use of cannabis. When controlling for all of our SES measures simultaneously, we find that family affluence scale is no longer significant in determining adolescents' behaviors. Our findings suggest that, when focusing on health inequalities among adolescents, self-perceptions and non-material dimensions of SES have more explanatory power than its material dimensions.
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Affiliation(s)
- Paolo Belardinelli
- London School of Economics, Department of Government, Houghton Street, London WC2A 2AE, United Kingdom.
| | - Aleksandra Torbica
- Bocconi University, Department of Social and Political Sciences, Centre for Research on Health and Social Care Management-CERGAS, Via Roentgen 1, Milan 20136, Italy.
| | - Giovanni Fattore
- Bocconi University, Department of Social and Political Sciences, Centre for Research on Health and Social Care Management-CERGAS, Via Roentgen 1, Milan 20136, Italy.
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Becker ABC, Lüken LM, Kelker L, Holtmann M, Daseking M, Legenbauer T. Cognitive Profiles of Adolescent Inpatients with Substance Use Disorder. CHILDREN 2022; 9:children9050756. [PMID: 35626933 PMCID: PMC9139439 DOI: 10.3390/children9050756] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/14/2022] [Revised: 05/19/2022] [Accepted: 05/19/2022] [Indexed: 11/16/2022]
Abstract
The prevalence of substance abuse is high during adolescence, and several studies have linked the use of alcohol and cannabis in adolescence to different cognitive impairments. To investigate whether specific cognitive deficits can be observed in adolescents with substance use disorder (SUD), we compared the cognitive profiles of inpatient adolescents diagnosed with SUD to a control group matched for sex, age and educational status. The inpatient adolescents received diagnoses of cannabis use disorder, alcohol use disorder or both. We compared the WISC-V profiles of 22 inpatients (45.5% female, Mage: 14.5; SD: 0.8) and the WAIS-IV profiles of 27 inpatients (44.4% female, Mage: 17.1; SD: 0.9) to 49 matched control participants with no diagnosed SUD. At the time of testing, participants were hospitalized for treatment of their SUD and were abstinent for a period of at least 6 weeks. To gain greater power, we jointly analyzed the Verbal Comprehension Index, Working Memory Index, Processing Speed Index and Full Scale IQ as assessed by WISC-V and WAIS-IV. The clinical group performed significantly worse than the control group on all the above indices. When only the group of inpatients was observed, in a model with the factors sex, educational status, presence of a comorbid diagnosis of depression and the number of comorbid diagnoses, only the factor educational status was significantly associated with the Full Scale IQ, whereas the factors sex and a comorbid diagnosis of depression in this group were associated with the Processing Speed Index. The results show that adolescents diagnosed with SUD (cannabis and/or alcohol) display broad cognitive impairments after 6 weeks of abstinence. Future research is required to further explore the role of comorbid diagnoses.
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Affiliation(s)
- Angelika Beate Christiane Becker
- Department of Educational Psychology, Helmut-Schmidt-University/University of the Federal Armed Forces, 22043 Hamburg, Germany; (L.K.); (M.D.)
- Correspondence:
| | - Luisa Marie Lüken
- LWL University Hospital for Child and Adolescent Psychiatry, Psychotherapy and Psychosomatics, Ruhr University Bochum, 59071 Hamm, Germany; (L.M.L.); (M.H.); (T.L.)
- Department of Psychology, University of Münster, 48149 Münster, Germany
| | - Lea Kelker
- Department of Educational Psychology, Helmut-Schmidt-University/University of the Federal Armed Forces, 22043 Hamburg, Germany; (L.K.); (M.D.)
| | - Martin Holtmann
- LWL University Hospital for Child and Adolescent Psychiatry, Psychotherapy and Psychosomatics, Ruhr University Bochum, 59071 Hamm, Germany; (L.M.L.); (M.H.); (T.L.)
| | - Monika Daseking
- Department of Educational Psychology, Helmut-Schmidt-University/University of the Federal Armed Forces, 22043 Hamburg, Germany; (L.K.); (M.D.)
| | - Tanja Legenbauer
- LWL University Hospital for Child and Adolescent Psychiatry, Psychotherapy and Psychosomatics, Ruhr University Bochum, 59071 Hamm, Germany; (L.M.L.); (M.H.); (T.L.)
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19
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Dickerson AS, Deng Z, Ransome Y, Factor-Litvak P, Karlsson O. Associations of prenatal exposure to mixtures of organochlorine pesticides and smoking and drinking behaviors in adolescence. ENVIRONMENTAL RESEARCH 2022; 206:112431. [PMID: 34848208 PMCID: PMC11108254 DOI: 10.1016/j.envres.2021.112431] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/30/2021] [Revised: 11/02/2021] [Accepted: 11/22/2021] [Indexed: 06/13/2023]
Abstract
It is important to identify the factors that influence the prevalence of disinhibitory behaviors, as tobacco and alcohol use in adolescence is a strong predictor of continued use and substance abuse into adulthood. Organochlorine pesticides (OCPs) are persistent organic pollutants that pose a potential risk to the developing fetus and offspring long-term health. We examined associations between prenatal exposure OCPs and their metabolites (i.e., p,p'-DDT, p,p'-DDE, o,p'-DDT, oxychlordane, and hexachlorobenzene (HCB)), both as a mixture and single compounds, and alcohol consumption and smoking at adolescence in a sample (n = 554) from the Child Health and Development Studies prospective birth cohort. Bayesian Kernel Machine Regression demonstrated a trend of higher risk of alcohol use and smoking with higher quartile mixture levels. Single-component analysis showed increased odds of smoking and drinking with increases in lipid-adjusted p,p'-DDE serum levels (aOR = 2.06, 95% CI 0.99-4.31, p = 0.05, per natural log unit increase). We found significant effect modification in these associations by sex with higher p,p'-DDT serum levels (aOR = 0.26, 95% CI 0.09-0.076, p = 0.01, per natural log unit increase) was associated with lower odds of smoking and drinking in female adolescents, while higher p,p'-DDE serum levels (aOR = 2.98, 95% CI 1.04-8.51, p = 0.04, per natural log unit increase) was associated with higher odds of the outcomes. Results of the mutually adjusted model were not significant for male adolescents. Further research to understand reasons for these sex-differences are warranted.
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Affiliation(s)
- Aisha S Dickerson
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA, 615 N Wolfe Street, E7638, Baltimore, MD 21205, USA
| | - Zhengyi Deng
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA, 615 N Wolfe Street, E7638, Baltimore, MD 21205, USA
| | - Yusuf Ransome
- Department of Social and Behavioral Sciences, Yale School of Public Health, 60 College Street, LEPH 4th Floor, New Haven, CT 06510, USA
| | - Pam Factor-Litvak
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY 10032, USA
| | - Oskar Karlsson
- Science for Life Laboratory, Department of Environmental Sciences and Analytical Chemistry, Stockholm University, Stockholm, 114 18, Sweden.
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Rahman M, Hossain F, Islam R, Jung J, Mahmud SR, Hashizume M. Equity in antenatal care visits among adolescent mothers: An analysis of 54 country levels trend and projection of coverage from 2000 to 2030. J Glob Health 2022; 12:04016. [PMID: 35356654 PMCID: PMC8932365 DOI: 10.7189/jogh.12.04016] [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] [Indexed: 11/21/2022] Open
Abstract
Background Ensuring utilization of antenatal care (ANC) services by adolescent mothers (ages 10-19) is an enormous challenge in low-and middle-income countries (LMICs). This study provides the first comprehensive analysis of ANC visits among adolescent and adult mothers. Methods Using all available Demographic and Health Survey and Multiple Indicator Cluster Surveys between 2000 and 2019 in 54 LMICs, we estimated proportion of ANC visits among women. Bayesian hierarchical regression models were used to estimate trend, projection, and determinants of single and four ANC visits (ANC1 and ANC4) independently. Equity analysis were performed to assess the magnitude of wealth-based and urban-rural inequalities in access to ANC visits. Results Compared to women aged 36-49 years, coverage of ANC1 and ANC4 are expected to increase significantly for adolescent mothers and women aged 20-35 years. This increase was observed at the national level, as well as both urban and rural areas in most countries between 2000 and 2030. By 2030, the coverage of ANC1 is predicted to reach 80% or more in all countries except Angola, Central African Republic and Togo, whereas only 16 countries are predicted to reach 80% or more for ANC4. According to wealth quintile, the lowest inequalities with highest coverage of 80% or more ANC4 will be observed in Armenia, Cambodia, Dominican Republic, Ghana, Maldives, Indonesia, and Sao Tome and Principe in 2030. Determinant analysis found increased odds of receiving ANC visits during pregnancy for adolescent mothers with higher educational levels, frequency of listening/watching mass media, and various household socio-economic status factors. Conclusions This study calls for advanced, innovative and cost-effective approaches to increase ANC coverage among adolescent mothers, particularly in rural areas and/or in low socioeconomic groups.
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Affiliation(s)
- Mizanur Rahman
- Hitotsubashi Institute for Advanced Study, University of Hitotsubashi, Tokyo, Japan
- Department of Global Health Policy, School of International Health, The University of Tokyo, Tokyo, Japan
| | - Fahima Hossain
- Global Public Health Research Foundation, Dhaka, Bangladesh
| | - Rashedul Islam
- Department of Global Health Policy, School of International Health, The University of Tokyo, Tokyo, Japan
| | - Jenny Jung
- Global Public Health Research Foundation, Dhaka, Bangladesh
- Maternal, Child and Adolescent Health Program, Burnet Institute, Melbourne, Australia
| | | | - Masahiro Hashizume
- Department of Global Health Policy, School of International Health, The University of Tokyo, Tokyo, Japan
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21
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Rahman MM, Taniguchi H, Nsashiyi RS, Islam R, Mahmud SR, Rahman S, Jung J, Khan S. Trend and projection of skilled birth attendants and institutional delivery coverage for adolescents in 54 low- and middle-income countries, 2000-2030. BMC Med 2022; 20:46. [PMID: 35115000 PMCID: PMC8813474 DOI: 10.1186/s12916-022-02255-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2021] [Accepted: 01/12/2022] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND Limitations to accessing delivery care services increase the risks of adverse outcomes during pregnancy and delivery for all pregnant women, particularly among adolescents in LMICs. In order to inform adolescent-specific delivery care initiatives and coverage, we conducted a comprehensive analysis of trends, projections and inequalities in coverage of delivery care services among adolescents at national, urban-rural and socio-economic levels in LMICs. METHODS Using 224 nationally representative cross-sectional survey data between 2000 and 2019, we estimated the coverage of institutional delivery (INSD) and skilled birth attendants (SBA). Bayesian hierarchical regression models were used to estimate trends, projections and determinants of INSD and SBA. RESULTS Coverage of delivery care services among adolescents increased substantially at the national level, as well as in both urban and rural areas in most countries between 2000 and 2018. Of the 54 LMICs, 24 countries reached 80% coverage of both INSD and SBA in 2018, and predictions for 40 countries are set to exceed 80% by 2030. The trends in coverage of INSD and SBA of adult mothers mostly align with those for adolescent mothers. Our findings show that urban-rural and wealth-based inequalities to delivery care remain persistent by 2030. In 2018, urban settings across 54 countries had higher rates of coverage exceeding 80% compared to rural for both INSD (45 urban, 16 rural) and SBA (50 urban, 19 rural). Several factors such as household head age ≥ 46 years, household head being female, access to mass media, lower parity, higher education, higher ANC visits and higher socio-economic status could increase the coverage of INSD and SBA among adolescents and adult women. CONCLUSIONS More than three-quarters of the LMICs are predicted to achieve 80% coverage of INSD and SBA among adolescent mothers in 2030, although with sustained inequalities.
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Affiliation(s)
- Md Mizanur Rahman
- Hitotsubashi Institute for Advanced Study, University of Hitotsubashi, 2-1 Naka, Kunitachi Tokyo, 186-8601, Japan.
| | - Hiroko Taniguchi
- Department of Global Health Policy, School of International Health, The University of Tokyo, Tokyo, Japan
| | - Raïssa Shiyghan Nsashiyi
- Department of Global Health Policy, School of International Health, The University of Tokyo, Tokyo, Japan.,Institute for Nature, Health, and Agricultural Research (INHAR), Yaoundé, Cameroon
| | - Rashedul Islam
- Department of Global Health Policy, School of International Health, The University of Tokyo, Tokyo, Japan
| | | | - Shafiur Rahman
- Hamamatsu University School of Medicine, Hamamatsu, Shizuoka, Japan
| | - Jenny Jung
- Global Public Health Research Foundation, Dhaka, Bangladesh
| | - Shahjahan Khan
- School of Sciences, Centre for Health Research, University of Southern Queensland, Toowoomba, Australia
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The Importance of Family and School Protective Factors in Preventing the Risk Behaviors of Youth. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19031630. [PMID: 35162651 PMCID: PMC8834957 DOI: 10.3390/ijerph19031630] [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: 12/31/2021] [Revised: 01/27/2022] [Accepted: 01/29/2022] [Indexed: 11/16/2022]
Abstract
The aim of this study was to examine cross-sectional associations of protective factors within a family and school context with adolescent risk behaviors. The study was conducted among adolescents (n = 9682) from five cities in Croatia. Mean age of participants was 16.2 years (SD = 1.2), and 52.5% were female. Multigroup structural equation modeling was used to examine relations between school attachment, school commitment, family communication, and family satisfaction with gambling, substance use, violence, and sexual risk behavior. Data analyses were conducted in two sets, the first using the full sample, and the second using a subsample (excluding Zagreb) for which there was data on sexual risk behavior. In the first model, school attachment was negatively associated with gambling and violence, while school commitment was negatively associated with students' gambling, substance use, and violence. Gambling was also associated with family satisfaction in this model. Results from the subsample model were similar with regards to school and family factors associated with gambling, substance use, and violence, with a few exceptions. In this model, family protective factors were found not to be significantly related with any risk behavior. These study results emphasize the importance of strengthening school protective factors, school attachment, and school commitment in preventing risk behaviors in adolescents.
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Wiedmann M, Atzendorf J, Basedow LA, Roessner V, Golub Y, Kuitunen-Paul S. [Substance Use, Resulting Disorders, and Collateral Mental Disorders Among Adolescents in a Special Outpatient Institutions for Addictions]. ZEITSCHRIFT FUR KINDER-UND JUGENDPSYCHIATRIE UND PSYCHOTHERAPIE 2022; 50:105-119. [PMID: 35005989 DOI: 10.1024/1422-4917/a000846] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Substance Use, Resulting Disorders, and Collateral Mental Disorders Among Adolescents in a Special Outpatient Institutions for Addictions Abstract. Objective: Only few clinics offer the outpatient treatment of substance use disorders (SUDs) among adolescents. Therefore, only limited data describe substance use patterns, SUDs, and co-occurring psychiatric disorders characteristic of adolescents who present in such outpatient clinics specialized in the treatment of SUDs. Method: Via interview we collected data from n = 201 patients between 12 and 19 years concerning their substance use, SUDs, and current co-occurring psychiatric disorders. We created descriptive presentation of data regarding use patterns, SUDs, and co-occurring disorders divided by sex and current age. Results: Tobacco (88 %) and cannabis (86 %) were the most frequently used substances. 67 % of all patients presented with more than one SUD, cannabis use disorder being the most prevalent one (84 %). 72 % presented with at least one co-occurring disorder, with conduct disorders (40 %), attention deficit (hyperactivity) disorders (21 %), and depressive disorders (18 %) being the most frequent ones. Conclusions: Adolescent SUD patients often present with co-occurring psychiatric disorders. Institutions for adolescent SUD treatment should also focus on treating co-occurring conduct disorders, depression, and attention deficit disorders.
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Affiliation(s)
- Melina Wiedmann
- Klinik und Poliklinik für Kinder- und Jugendpsychiatrie und -psychotherapie, Medizinische Fakultät, Technische Universität Dresden, Dresden
| | - Josefine Atzendorf
- Munich Center for the Economics of Aging (MEA), Max-Plank-Institut für Sozialrecht und Sozialpolitik, München
| | - Lukas Andreas Basedow
- Klinik und Poliklinik für Kinder- und Jugendpsychiatrie und -psychotherapie, Medizinische Fakultät, Technische Universität Dresden, Dresden
| | - Veit Roessner
- Klinik und Poliklinik für Kinder- und Jugendpsychiatrie und -psychotherapie, Medizinische Fakultät, Technische Universität Dresden, Dresden
| | - Yulia Golub
- Klinik und Poliklinik für Kinder- und Jugendpsychiatrie und -psychotherapie, Medizinische Fakultät, Technische Universität Dresden, Dresden
| | - Sören Kuitunen-Paul
- Klinik und Poliklinik für Kinder- und Jugendpsychiatrie und -psychotherapie, Medizinische Fakultät, Technische Universität Dresden, Dresden
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Taking Care of Friends: The Implementation Evaluation of a Peer-Focused School Program Using First Aid to Reduce Adolescent Risk-Taking and Injury. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182413030. [PMID: 34948640 PMCID: PMC8702208 DOI: 10.3390/ijerph182413030] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/09/2021] [Revised: 12/06/2021] [Accepted: 12/08/2021] [Indexed: 01/10/2023]
Abstract
Injury is a leading cause of adolescent deaths, with risk-taking associated with a sizeable proportion of injuries and many of those risks undertaken in the presence of peers or with peers’ knowledge. Novel ways to promote safety are required and using the peer-relationship may be an important mechanism for prevention. This study reports on the implementation evaluation of the Skills for Preventing Injury in Youth (SPIY) program. SPIY is a high-school program designed to reduce injury by encouraging peers to look out for one another and prevent risk-taking, complemented by developing peer helping and first aid skills as well as school connectedness. 152 students and 12 teachers who delivered SPIY participated in separate 30 min focus groups and reported on students’ understanding of peer protective behaviour and the program implementation (adherence, dose, quality of program delivery, and participant responsiveness). Students reported on many approaches to protecting friends and both students and teachers reported they found the program interesting, interactive, and able to be delivered. Peer protection messages were relevant and acceptable to teachers and students in a risk-taking harm reduction program to reduce adolescent injury.
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Calatrava M, Beltramo C, Osorio A, Rodríguez-González M, De Irala J, Lopez-del Burgo C. Religiosity and Sexual Initiation Among Hispanic Adolescents: The Role of Sexual Attitudes. Front Psychol 2021; 12:715032. [PMID: 34858256 PMCID: PMC8631753 DOI: 10.3389/fpsyg.2021.715032] [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: 05/26/2021] [Accepted: 10/15/2021] [Indexed: 11/13/2022] Open
Abstract
Introduction: Religiosity and sexuality present numerous interconnections. Little is known regarding the specific causal pathways between each religiosity dimension and sexual behavior. The objectives of this study were (1) to explore the relationship between religiosity (measured through attendance at religious services, salience, and prayer) and sexual initiation in adolescents and (2) to establish the role of sexual permissiveness as mediator of the impact produced by religiosity in sexual initiation. Methods: This study analyzes data from an ongoing school-based international study examining what young people feel and think about relationships, love, and sexuality. An anonymous, self-administered online questionnaire was developed in Spanish. A total of 4,366 students, aged 14-18, completed the questionnaire. A final sample of 2,919 questionnaires was analyzed. Two unconditional logistic regression models were fit with religiosity variables and possible confounders as independent variables (with and without permissiveness, respectively). The dependent variable was sexual initiation. A final path analysis was performed to further understand the results. Results: Our study highlights that, in predominantly Catholic and Spanish-speaking countries, the fact of attending church and praying may greatly contribute to postponing sexual relations during adolescence, even independently of their attitudes on sexual permissiveness. Conversely, the effect of salience on sexual initiation seems to be fostered only through the mediation of sexual permissiveness. Our findings point to an indirect effect of the three religiosity dimensions (and in particular, religious salience) through permissive attitudes. Conclusion: Religiosity could be a relevant factor to explain sexual initiation during adolescence.
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Affiliation(s)
- Maria Calatrava
- Institute for Culture and Society, University of Navarra, Pamplona, Spain
- Navarra Institute for Health Research (IdiSNA), Pamplona, Spain
- School of Education and Psychology, University of Navarra, Pamplona, Spain
| | - Carlos Beltramo
- Institute for Culture and Society, University of Navarra, Pamplona, Spain
- Navarra Institute for Health Research (IdiSNA), Pamplona, Spain
- School of Education and Psychology, University of Navarra, Pamplona, Spain
| | - Alfonso Osorio
- Institute for Culture and Society, University of Navarra, Pamplona, Spain
- Navarra Institute for Health Research (IdiSNA), Pamplona, Spain
- School of Education and Psychology, University of Navarra, Pamplona, Spain
| | - Martiño Rodríguez-González
- Institute for Culture and Society, University of Navarra, Pamplona, Spain
- Navarra Institute for Health Research (IdiSNA), Pamplona, Spain
- School of Education and Psychology, University of Navarra, Pamplona, Spain
| | - Jokin De Irala
- Institute for Culture and Society, University of Navarra, Pamplona, Spain
- Navarra Institute for Health Research (IdiSNA), Pamplona, Spain
- Department of Preventive Medicine and Public Health, School of Medicine, University of Navarra, Pamplona, Spain
| | - Cristina Lopez-del Burgo
- Institute for Culture and Society, University of Navarra, Pamplona, Spain
- Navarra Institute for Health Research (IdiSNA), Pamplona, Spain
- Department of Preventive Medicine and Public Health, School of Medicine, University of Navarra, Pamplona, Spain
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Taliaferro LA, Mishtal J, Chulani VL, Middleton TC, Acevedo M, Eisenberg ME. Perspectives on inadequate preparation and training priorities for physicians working with sexual minority youth. INTERNATIONAL JOURNAL OF MEDICAL EDUCATION 2021; 12:186-194. [PMID: 34709201 PMCID: PMC8994643 DOI: 10.5116/ijme.615c.25d3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/02/2021] [Accepted: 10/05/2021] [Indexed: 06/13/2023]
Abstract
OBJECTIVES To understand pediatric and family medicine residents' and practitioners' perceived ability to work with lesbian, gay, bisexual, and queer (LGBQ) youth, assessment of their prior educational experiences, and recommendations for medical training to better prepare physicians to provide quality care to this population. METHODS We conducted semi-structured individual interviews with 24 pediatric/family medicine residents (n=20) and practicing physicians (n=4) in the U.S. Recorded interviews were professionally transcribed. Data were analyzed using Grounded Theory and qualitative content analysis approaches. RESULTS Most physicians did not feel adequately prepared to provide quality care to LGBQ youth, and many who felt knowledgeable obtained their knowledge from on-the-job experiences of caring for LGBQ patients. Findings regarding physicians' recommendations for implementing a formal training program revealed three themes: (I) medical school training (implemented earlier in medical school within a structured program as part of the normal curriculum), (II) training content (LGBQ-specific health needs, self-awareness of implicit biases, interviewing techniques, and resources), and (III) training strategies (panels of LGBQ patients, role-playing/standardized patients, and online modules). CONCLUSIONS Understanding physicians' assessment of abilities and recommendations for training improvements based on their experiences is important for advancing the quality of healthcare for LGBQ youth. Guidance came mostly from residents who recently completed medical school. Thus, their perspectives are especially useful to improve medical education and, ultimately, the care provided to LGBQ youth. Findings suggest a multi-pronged approach that offers several training modalities encompassing individual, intrapersonal, and institutional/systemic/community levels can improve medical school curricula on caring for LGBQ youth.
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Affiliation(s)
- Lindsay A. Taliaferro
- Department of Population Health Sciences, University of Central Florida, Orlando, Florida, USA
| | - Joanna Mishtal
- Department of Anthropology, University of Central Florida, Orlando, Florida, USA
| | - Veenod L. Chulani
- Section of Adolescent Medicine, Phoenix Children's Hospital, Phoenix, Arizona, USA
| | - Tiernan C. Middleton
- Department of Pediatrics, University of Maryland Medical Center, Baltimore, Maryland, USA
| | - Meagan Acevedo
- rnold Palmer Hospital for Children, Orlando Health Regional Medical Center, Orlando, Florida, USA
| | - Marla E. Eisenberg
- Division of General Pediatrics and Adolescent Health, University of Minnesota, Minneapolis, Minnesota, USA
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Aboagye RG, Seidu AA, Adu C, Cadri A, Mireku DO, Ahinkorah BO. Interpersonal violence among in-school adolescents in sub-Saharan Africa: Assessing the prevalence and predictors from the Global School-based health survey. SSM Popul Health 2021; 16:100929. [PMID: 34660877 PMCID: PMC8502764 DOI: 10.1016/j.ssmph.2021.100929] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2021] [Revised: 09/03/2021] [Accepted: 09/22/2021] [Indexed: 11/15/2022] Open
Abstract
Interpersonal violence in adolescents has over the years grown into a serious public health problem that merits a robust intervention. This study, therefore, assessed the prevalence and predictors of interpersonal violence among in-school adolescents in sub-Saharan Africa (SSA). The study involved a cross-sectional analysis of data from the Global School-based Health Survey conducted between 2012 and 2017 from eight sub-Saharan African countries. A total of 14,967 in-school adolescents aged 10-19 years were included in the pooled analysis. A multivariable binomial logistic regression was used to determine the predictors of interpersonal violence using the adjusted odds ratio (aOR) with their respective 95% confidence intervals (CIs). The overall prevalence of interpersonal violence among in-school adolescents in SSA was 53.7%. The odds of interpersonal violence were higher among adolescents who were bullied (aOR = 2.52, 95% CI = 2.23-2.85), had an injury (aOR = 2.42, 95% CI = 2.15-2.72), had suicidal attempts (aOR = 1.40, 95% CI = 1.16-1.70), were truant (aOR = 1.51, 95% CI = 1.33-1.72), used alcohol (aOR = 1.49, 95% CI = 1.06-2.11), and used tobacco (aOR = 1.46, 95% CI = 1.23-1.74). In-school adolescents with peer support, parents or guardians bonding, those whose parents or guardians respected their privacy, and those aged 15 years or older were less likely to experience interpersonal violence. These factors provide education directors and school heads/teachers with relevant information to guide the design of specific interventions such as parent-teacher meetings and programs, peer educator network system, face-to-face counseling sessions, Rational Emotive Behavioural Education (REBE) and substance use cessation therapy to prevent interpersonal violence, particularly physical fights and attacks in school settings. Also, students should be sensitized on the negative effects of interpersonal violence and those who have been exposed to it should be counselled. School rules should be strengthened and appropriate punishment given to students who engage in violence baheviours in schools in order to deter others from engaging in them.
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Affiliation(s)
- Richard Gyan Aboagye
- Department of Family and Community Health, School of Public Health, University of Health and Allied Sciences, Ho, Ghana
| | - Abdul-Aziz Seidu
- Department of Population and Health, University of Cape Coast, Cape Coast, Ghana.,College of Public Health, Medical and Veterinary Services, James Cook University, Australia.,Department of Estate Management, Takoradi Technical University, P.O. Box, 257, Takoradi, Ghana
| | - Collins Adu
- Department of Health Promotion, Education and Disability Studies, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Abdul Cadri
- Department of Family Medicine, Faculty of Medicine, McGill University, Montreal, Quebec, Canada
| | - Dickson Okoree Mireku
- Directorate of Academic Planning and Quality Assurance, University of Cape Coast, Ghana
| | - Bright Opoku Ahinkorah
- School of Public Health, Faculty of Health, University of Technology Sydney, Sydney, Australia
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Guo Z, Li W, Yang Y, Kou Y. Honesty-Humility and unethical behavior in adolescents: The mediating role of moral disengagement and the moderating role of system justification. J Adolesc 2021; 90:11-22. [PMID: 34087510 DOI: 10.1016/j.adolescence.2021.05.009] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2020] [Revised: 05/18/2021] [Accepted: 05/21/2021] [Indexed: 11/20/2022]
Abstract
INTRODUCTION Honesty-Humility represents the tendency to be fair, genuine, and cooperative in social interactions. Although previous evidence has demonstrated that Honesty-Humility is related to decreased unethical behavior, little is known about the mediating and moderating mechanisms underlying this relationship, especially among adolescents. Based on social cognitive theory and system justification theory, the present study aims to examine the mediating role of moral disengagement and the moderating role of system justification in the relationship between Honesty-Humility and unethical behavior among Chinese adolescents. METHODS A large sample of Chinese adolescents (N = 2,576, 47% boys; Mage = 17.00 years, SD = 1.07) was recruited from four senior high schools. The participants completed questionnaires regarding Honesty-Humility, moral disengagement, system justification, and unethical behavior. RESULTS The findings suggested that Honesty-Humility was negatively associated with adolescents' unethical behavior, and moral disengagement partially mediated this negative association. Furthermore, system justification moderated the mediation model. Specifically, the negative relationships between Honesty-Humility and moral disengagement/unethical behavior were stronger among adolescents who perceive the society as fair. CONCLUSION These findings advance the understanding of when and how Honesty-Humility prevents adolescents from unethical behavior. The theoretical and practical implications of the current study as well as future research directions are discussed.
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Affiliation(s)
- Zhen Guo
- Beijing Key Laboratory of Applied Experimental Psychology, National Demonstration Center for Experimental Psychology Education (Beijing Normal University), Institute of Developmental Psychology, Beijing Normal University, Beijing, 100875, China
| | - Wenqi Li
- Beijing Key Laboratory of Applied Experimental Psychology, National Demonstration Center for Experimental Psychology Education (Beijing Normal University), Institute of Developmental Psychology, Beijing Normal University, Beijing, 100875, China
| | - Ying Yang
- Shanghai Key Laboratory of Mental Health and Psychological Crisis Intervention, School of Psychology and Cognitive Science, East China Normal University, Shanghai, 200062, China
| | - Yu Kou
- Beijing Key Laboratory of Applied Experimental Psychology, National Demonstration Center for Experimental Psychology Education (Beijing Normal University), Institute of Developmental Psychology, Beijing Normal University, Beijing, 100875, China.
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Laura T, Deborah C, Rona C. Community mobilisation approaches to preventing and reducing adolescent multiple risk behaviour: a realist review protocol. Syst Rev 2021; 10:147. [PMID: 33980307 PMCID: PMC8117311 DOI: 10.1186/s13643-021-01696-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/06/2020] [Accepted: 03/30/2021] [Indexed: 01/07/2023] Open
Abstract
BACKGROUND Adolescent multiple risk behaviour (MRB) continues to be a global health issue. Most interventions have focused on the proximal causes of adolescent MRB such as peer or family influence, rather than targeting the wider environmental or structural context. There is increasing recognition that community mobilisation approaches could be beneficial for adolescent health. Despite this, there are gaps in the current literature, theory and implementation that would benefit from a realist approach due to the suitability of this methodology to analysing complex interventions. The objective of this study is to understand 'how, why, for whom and in what circumstances and time periods' do community mobilisation interventions work to prevent and/or reduce adolescent multiple risk behaviour. METHODS This is a protocol for a realist review. The review will use a six-stage iterative process, guided by the RAMESES framework. We will systematically search PubMed, MEDLINE, PsycINFO, Web of Science, CINAHL and Sociological Abstracts, from their inception to 2021. Studies will be screened for relevance to the programme theory and included based on a priori eligibility criteria including (1) reporting a community mobilisation intervention (2) targeting two health risk behaviors (3) for adolescent populations. Two independent reviewers will select, screen and extract data related to the program theory from all relevant sources. A realist logic of analysis will be used to identify all context-mechanism-outcome configurations that contribute to our programme theory. The findings will be synthesised to produce a refined programme theory model. DISCUSSION The goal of this realist review is to identify and refine a programme theory for community mobilisation approaches to the prevention and/or reduction of adolescent multiple risk behaviour. Our aim is that the findings surrounding the programme theory refinement can be used to develop and implement adolescent multiple risk behaviour interventions and maintain collaboration between local policy makers, researchers and community members. SYSTEMATIC REVIEW REGISTRATION This realist review is registered on the PROSPERO database (registration number: CRD42020205342).
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Affiliation(s)
- Tinner Laura
- Population Health Sciences, Bristol Medical School, Canynge Hall, University of Bristol, Bristol, BS8 2PL UK
| | - Caldwell Deborah
- Population Health Sciences, Bristol Medical School, Canynge Hall, University of Bristol, Bristol, BS8 2PL UK
| | - Campbell Rona
- Population Health Sciences, Bristol Medical School, Canynge Hall, University of Bristol, Bristol, BS8 2PL UK
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Bozzini AB, Bauer A, Maruyama J, Simões R, Matijasevich A. Factors associated with risk behaviors in adolescence: a systematic review. ACTA ACUST UNITED AC 2021; 43:210-221. [PMID: 32756805 PMCID: PMC8023154 DOI: 10.1590/1516-4446-2019-0835] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2019] [Accepted: 04/15/2020] [Indexed: 01/10/2023]
Abstract
OBJECTIVE Understanding the distal (≤ 6 years of age) and proximal (between 6 years of age and early adolescence) factors in adolescent risk behavior is important for preventing and reducing morbidity and mortality in this population. This study sought to investigate the factors associated with the following adolescent risk behaviors: i) aggressiveness and violence, ii) tobacco, alcohol, and illicit substance use, iii) depressive behavior and self-harm (including suicidal ideation and attempts), iv) sexual risk behavior, and v) multiple risk behavior. METHODS A systematic review was conducted to identify longitudinal studies that examined factors associated with adolescent risk behaviors. The PubMed, PsycINFO, and LILACS databases were searched. RESULTS Of the 249 included studies, 23% reported distal risk factors, while the remaining reported proximal risk factors. Risk factors were related to sociodemographic characteristics (neighborhood, school, and peers), family patterns, and the presence of other adolescent risk behaviors. CONCLUSION Distal and proximal factors in adolescent risk behavior that are not exclusively socioeconomic, familial, environmental, or social should be explored more thoroughly.
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Affiliation(s)
- Ana Beatriz Bozzini
- Departamento de Medicina Preventiva, Faculdade de Medicina, Universidade de São Paulo (USP), São Paulo, SP, Brazil
| | - Andreas Bauer
- Department of Psychology, University of Bath, Bath, Somerset, UK
| | - Jessica Maruyama
- Departamento de Medicina Preventiva, Faculdade de Medicina, Universidade de São Paulo (USP), São Paulo, SP, Brazil
| | - Ricardo Simões
- Departamento de Ginecologia, Faculdade de Medicina, USP, São Paulo, SP, Brazil
| | - Alicia Matijasevich
- Departamento de Medicina Preventiva, Faculdade de Medicina, Universidade de São Paulo (USP), São Paulo, SP, Brazil.,Departamento de Epidemiologia, Universidade Federal de Pelotas (UFPel), Pelotas, RS, Brazil
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Yaya S, Zegeye B, Ahinkorah BO, Seidu AA, Ameyaw EK, Adjei NK, Shibre G. Predictors of skilled birth attendance among married women in Cameroon: further analysis of 2018 Cameroon Demographic and Health Survey. Reprod Health 2021; 18:70. [PMID: 33766075 PMCID: PMC7993505 DOI: 10.1186/s12978-021-01124-9] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2021] [Accepted: 03/17/2021] [Indexed: 01/03/2023] Open
Abstract
BACKGROUND In Cameroon, maternal deaths remain high. The high maternal deaths in the country have been attributed to the low utilization of maternal healthcare services, including skilled birth attendance. This study examined the predictors of skilled birth services utilization among married women in Cameroon. METHODS Data from the 2018 Cameroon Demographic and Health Survey was analyzed on 7881 married women of reproductive age (15-49 years). Both bivariate and multivariable logistic regression analyses were carried out to determine the predictors of skilled childbirth services. The results were presented with crude odds ratio (cOR) and adjusted odds ratio (aOR) and 95% confidence interval (CI). RESULTS The coverage of skilled birth attendance among married women of reproductive age in Cameroon was 66.2%. After adjusting for potential confounders, media exposure (aOR = 1.46, 95% CI: 1.11-1.91), higher decision making (aOR = 1.88, 95% CI: 1.36-2.59), maternal education (aOR = 2.38, 95% CI; 1.65-3.42), place of residence (aOR = 0.50, 95% CI; 0.33-0.74), religion (aOR = 0.55, 95% CI; 0.35-0.87), economic status (aOR = 5.16, 95% CI; 2.58-10.30), wife beating attitude (aOR = 1.32, 95% CI; 1.05-1.65), parity (aOR = 0.62, 95% CI; 0.41-0.93) and skilled antenatal care (aOR = 14.46, 95% CI; 10.01-20.89) were found to be significant predictors of skilled birth attendance. CONCLUSIONS This study demonstrates that social, economic, regional, and cultural factors can act as barriers to skilled childbirth services utilization in Cameroon. Interventions that target women empowerment, antenatal care awareness and strengthening are needed, especially among the rural poor, to reduce barriers to care seeking. Maternal healthcare services utilization interventions and policies in Cameroon need to focus on specific equity gaps that relate to socio-economic status, maternal education, and the economic empowerment of women. Such policies and interventions should also aim at reducing geographical barriers to access to maternal healthcare services, including skilled birth attendance. Due to the presence of inequities in the use of skilled birth attendance services, programs aimed at social protection and empowerment of economically disadvantaged women are necessary for the achievement of the post-2015 targets and the Sustainable Development Goals. Globally, Cameroon is one of the countries with high maternal deaths. Low utilization of maternal healthcare services, including skilled birth attendance have been found to account for the high maternal deaths in the country. This study sought to examine the factors associated with skilled childbirth services utilization among married women in Cameroon. Using data from the 2018 Cameroon Demographic and Health Survey, we found that the coverage of skilled birth attendance among married women of reproductive age in Cameroon is high. Factors such as higher decision-making power, higher maternal education, place of residence, religion, higher economic status, wife beating attitude, parity and skilled antenatal care were found to be the significant predictors of skilled birth attendance. This study has shown that socio-economic, regional and cultural factors account for the utilization of skilled childbirth services utilization in Cameroon. Interventions aimed at enhancing the utilization of skilled childbirth services in Cameroon should target women empowerment, antenatal care awareness creation and sensitization, especially among the rural poor, to reduce barriers to care seeking. Maternal healthcare services utilization interventions and policies in Cameroon need to focus on specific equity gaps that relate to socio-economic status, maternal education, and the economic empowerment of women.
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Affiliation(s)
- Sanni Yaya
- School of International Development and Global Studies, University of Ottawa, Ottawa, Canada
- The George Institute for Global Health, Imperial College London, London, UK
| | - Betregiorgis Zegeye
- HaSET Maternal and Child Health Research Program, Shewarobit Field Office, Shewarobit, Ethiopia
| | - Bright Opoku Ahinkorah
- School of Public Health, Faculty of Health, University of Technology Sydney, Sydney, NSW Australia
| | - Abdul-Aziz Seidu
- Department of Population and Health, University of Cape Coast, Cape Coast, Ghana
- College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville, QLD Australia
| | - Edward Kwabena Ameyaw
- School of Public Health, Faculty of Health, University of Technology Sydney, Sydney, NSW Australia
| | - Nicholas Kofi Adjei
- Leibniz Institute for Prevention Research and Epidemiology, BIPS, Heiligenhafen, Germany
| | - Gebretsadik Shibre
- Department of Reproductive, Family and Population Health, School of Public Health, Addis Ababa University, Addis Ababa, Ethiopia
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Santos O, Stefanovska-Petkovska M, Virgolino A, Miranda AC, Costa J, Fernandes E, Cardoso S, Vaz Carneiro A. Functional Health Literacy: Psychometric Properties of the Newest Vital Sign for Portuguese Adolescents (NVS-PTeen). Nutrients 2021; 13:nu13030790. [PMID: 33673682 PMCID: PMC7997379 DOI: 10.3390/nu13030790] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2021] [Revised: 02/21/2021] [Accepted: 02/23/2021] [Indexed: 01/10/2023] Open
Abstract
Self-management of health requires skills to obtain, process, understand, and use health-related information. Assessment of adolescents’ functional health literacy requires valid, reliable, and low-burden tools. The main objective of this study was to adapt and study the psychometric properties of the Newest Vital Sign for the Portuguese adolescents’ population (NVS-PTeen). Classic psychometric indicators of reliability and validity were combined with item response theory (IRT) analyses in a cross-sectional survey, complemented with a 3-month test-retest assessment. The NVS-PTeen was self-administered to students enrolled in grades 8 to 12 (12 to 17 years old) in a school setting. Overall, 386 students (191 girls) from 16 classes of the same school participated in the study (mean age = 14.5; SD = 1.5). Internal reliability of the NVS-PTeen was α = 0.60. The NVS-PTeen total score was positively and significantly correlated with Portuguese (r = 0.28) and mathematics scores (r = 0.31), school years (r = 0.31), and age (r = 0.19). Similar to the original scale (for the U.S.), the NVS-PTeen is composed of two dimensions, reading-related literacy and numeracy. Temporal reliability is adequate, though with a learning effect. IRT analyses revealed differences in difficulty and discriminative capacity among items, all with adequate outfit and infit values. Results showed that the NVS-PTeen is valid and reliable, sensible to inter-individual educational differences, and adequate for regular screening of functional health literacy in adolescents.
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Affiliation(s)
- Osvaldo Santos
- Instituto de Saúde Ambiental, Faculdade de Medicina, Universidade de Lisboa, 1649-028 Lisboa, Portugal; (M.S.-P.); (A.V.); (A.C.M.); (J.C.); (A.V.C.)
- Unbreakable Idea Research, Lda., 2550-426 Painho, Portugal
- Faculdade de Medicina, Universidade de Lisboa, 1649-028 Lisboa, Portugal;
- Correspondence: ; Tel.: +351-936-103-168
| | - Miodraga Stefanovska-Petkovska
- Instituto de Saúde Ambiental, Faculdade de Medicina, Universidade de Lisboa, 1649-028 Lisboa, Portugal; (M.S.-P.); (A.V.); (A.C.M.); (J.C.); (A.V.C.)
| | - Ana Virgolino
- Instituto de Saúde Ambiental, Faculdade de Medicina, Universidade de Lisboa, 1649-028 Lisboa, Portugal; (M.S.-P.); (A.V.); (A.C.M.); (J.C.); (A.V.C.)
- Faculdade de Medicina, Universidade de Lisboa, 1649-028 Lisboa, Portugal;
| | - Ana Cristina Miranda
- Instituto de Saúde Ambiental, Faculdade de Medicina, Universidade de Lisboa, 1649-028 Lisboa, Portugal; (M.S.-P.); (A.V.); (A.C.M.); (J.C.); (A.V.C.)
| | - Joana Costa
- Instituto de Saúde Ambiental, Faculdade de Medicina, Universidade de Lisboa, 1649-028 Lisboa, Portugal; (M.S.-P.); (A.V.); (A.C.M.); (J.C.); (A.V.C.)
| | | | - Susana Cardoso
- MARE, Escola Superior de Turismo e Tecnologia do Mar, Instituto Politécnico de Leiria, 2520-614 Peniche, Portugal;
- CiTechCare, Instituto Politécnico de Leiria, 2410-541 Leiria, Portugal
| | - António Vaz Carneiro
- Instituto de Saúde Ambiental, Faculdade de Medicina, Universidade de Lisboa, 1649-028 Lisboa, Portugal; (M.S.-P.); (A.V.); (A.C.M.); (J.C.); (A.V.C.)
- Faculdade de Medicina, Universidade de Lisboa, 1649-028 Lisboa, Portugal;
- Institute for Evidence Based Healthcare, 1649-028 Lisboa, Portugal
- Cochrane Portugal, 1649-028 Lisboa, Portugal
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Mitic M, Woodcock KA, Amering M, Krammer I, Stiehl KAM, Zehetmayer S, Schrank B. Toward an Integrated Model of Supportive Peer Relationships in Early Adolescence: A Systematic Review and Exploratory Meta-Analysis. Front Psychol 2021; 12:589403. [PMID: 33716860 PMCID: PMC7947339 DOI: 10.3389/fpsyg.2021.589403] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2020] [Accepted: 01/06/2021] [Indexed: 12/30/2022] Open
Abstract
Supportive peer relationships (SPR) are crucial for mental and physical health. Early adolescence is an especially important period in which peer influence and school environment strongly shape psychological development and maturation of core social-emotional regulatory functions. Yet, there is no integrated evidence based model of SPR in this age group to inform future research and practice. The current meta-analysis synthetizes evidence from 364 studies into an integrated model of potential determinants of SPR in early adolescence. The model encompasses links with 93 variables referring to individual (identity, skills/strengths, affect/well-being, and behavior/health) and environmental (peer group, school, family, community, and internet/technology) potential influences on SPR based on cross-sectional correlational data. Findings suggest the central importance of identity and social-emotional skills in SPR. School environment stands out as a compelling setting for future prevention programs. Finally, we underscore an alarming gap of research on the influence of the virtual and online environment on youth's social realm given its unquestionable importance as a globally expanding social interaction setting. Hence, we propose an integrated model that can serve as organizational framework, which may ultimately lead to the adoption of a more structured and integrated approach to understanding peer relationship processes in youth and contribute to overcoming marked fragmentation in the field.
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Affiliation(s)
- Marija Mitic
- D.O.T. Research Group for Mental Health of Children and Adolescents, Ludwig Boltzmann Society at Karl Landsteiner University of Health Sciences, Krems on the Danube, Austria
| | - Kate A. Woodcock
- Centre for Applied Psychology, School of Psychology, University of Birmingham, Birmingham, United Kingdom
| | - Michaela Amering
- Clinical Division of Social Psychiatry, Department of Psychiatry and Psychotherapy, Medical University of Vienna, Vienna, Austria
| | - Ina Krammer
- D.O.T. Research Group for Mental Health of Children and Adolescents, Ludwig Boltzmann Society at Karl Landsteiner University of Health Sciences, Krems on the Danube, Austria
| | - Katharina A. M. Stiehl
- D.O.T. Research Group for Mental Health of Children and Adolescents, Ludwig Boltzmann Society at Karl Landsteiner University of Health Sciences, Krems on the Danube, Austria
| | - Sonja Zehetmayer
- Centre for Medical Statistics, Informatics and Intelligent Systems, Medical University of Vienna, Vienna, Austria
| | - Beate Schrank
- D.O.T. Research Group for Mental Health of Children and Adolescents, Ludwig Boltzmann Society at Karl Landsteiner University of Health Sciences, Krems on the Danube, Austria
- Department of Psychiatry and Psychotherapy, University Hospital Tulln, Karl Landsteiner University of Health Sciences, Tulln, Austria
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Zegeye B, Ahinkorah BO, Idriss-Wheeler D, Olorunsaiye CZ, Adjei NK, Yaya S. Modern contraceptive utilization and its associated factors among married women in Senegal: a multilevel analysis. BMC Public Health 2021; 21:231. [PMID: 33509144 PMCID: PMC7845035 DOI: 10.1186/s12889-021-10252-7] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2020] [Accepted: 01/17/2021] [Indexed: 11/10/2022] Open
Abstract
Background Utilization of modern contraceptives is still low in low-and middle-income countries, although fertility and population growth rates are high. In Senegal, modern contraceptive utilization is low, with few studies focusing on its associated factors. This study examined modern contraceptive use and its associated factors among married women in Senegal. Methods Data from the 2017 Continuous Demographic and Health Survey (C-DHS) on 11,394 married women was analysed. We examined the associations between the demographic and socioeconomic characteristics of women and their partners and modern contraceptive use using multilevel logistic regression models. Adjusted odds ratios with 95% confidence intervals (CI) were estimated. Results The utilization of modern contraceptives among married women was 26.3%. Individual level factors associated with modern contraceptive use were women’s age (45–49 years-aOR = 0.44, 0.30–0.63), women’s educational level (higher-aOR = 1.88, 1.28–2.76) husband’s educational level (higher-aOR = 1.43, 1.10–1.85)), number of living children (5 or more children-aOR = 33.14, 19.20–57.22), ideal number of children (2 children-aOR = 1.95, 1.13–3.35), desire to have more children (wants no more-aOR = 2.46, 2.06–2.94), ethnicity (Diola-aOR = 0.70, 0.50–0.99), media exposure (yes-aOR = 1.44, 1.16–1.79)), wealth index (richer-aOR = 1.31, 1.03–1.67) and decision making power of women (decision making two-aOR = 1.20, 1.02–1.41). Whereas, region (Matam-aOR = 0.35, 0.23–0.53), place of residence (rural-aOR = 0.76, 0.63–0.93), community literacy level (high-aOR = 1.31, 1.01–1.71) and community knowledge level of modern contraceptives (high-aOR = 1.37, 1.13–1.67) were found as significant community level factors. Conclusions The findings indicate that both individual and community level factors are significantly associated with modern contraceptive use among married women in Senegal. Interventions should focus on enhancing literacy levels of women, their husbands and communities. Furthermore, strengthening awareness and attitude towards family planning should be given priority, especially in rural areas and regions with low resources.
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Affiliation(s)
- Betregiorgis Zegeye
- HaSET Maternal and Child Health Research Program, Shewarobit Field Office, Shewarobit, Ethiopia
| | - Bright Opoku Ahinkorah
- School of Public Health, Faculty of Health, University of Technology Sydney, Ultimo, Australia
| | - Dina Idriss-Wheeler
- Interdisciplinary School of Health Sciences, University of Ottawa, Ottawa, Ontario, Canada
| | | | - Nicholas Kofi Adjei
- Leibniz Institute for Prevention Research and Epidemiology, BIPS, Bremen, Germany
| | - Sanni Yaya
- School of International Development and Global Studies, University of Ottawa, 120 University Private, Ottawa, ON, K1N 6N5, Canada. .,The George Institute for Global Health, Imperial College London, London, UK.
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Reported Changes in Adolescent Psychosocial Functioning during the COVID-19 Outbreak. ADOLESCENTS 2021. [DOI: 10.3390/adolescents1010002] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
What effect the outbreak of the COVID-19 pandemic has had on adolescents’ psychosocial functioning is currently unknown. Using the data of 1767 (50.2% female and 49.8 male) adolescents in Sweden, we discuss adolescents’ thoughts and behaviors around the COVID-19 outbreak, as well as reported changes in substance use, everyday life, relations, victimization, and mental health during the outbreak. Results showed that (a) the majority of adolescents have been complying with regulations from the government; (b) although most adolescents did not report changes in their psychosocial functioning, a critical number reported more substance use, conflict with parents, less time spent with peers, and poorer control over their everyday life; and (c) the majority of adolescents have experienced less victimization, yet poorer mental health, during the COVID-19 outbreak. Adolescent girls and adolescents in distance schooling were likely to report negative changes in their psychosocial functioning during the COVID-19 outbreak. Based on these findings, we suggest that society should pay close attention to changes in adolescents’ psychosocial functioning during times of crisis.
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Adetoro D, Khamofu H, Badru T, Markson J, Adedokun O, Sandah-Abubakar N, Dafa I, Chen M, Chiegil R, Torpey K. Correlates of uptake of HIV testing among children and young adolescents in Akwa-Ibom state, Nigeria: a secondary data analysis of the Akwa-Ibom aids indicator survey, 2017. BMC Pediatr 2021; 21:33. [PMID: 33435898 PMCID: PMC7802279 DOI: 10.1186/s12887-021-02495-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/14/2020] [Accepted: 01/06/2021] [Indexed: 01/27/2023] Open
Abstract
Background In order to end the AIDS epidemic by 2030, there is a need to significantly reduce the rate of new infection among children and young adolescents. Identifying the correlates of testing behaviour is necessary to improve HIV testing campaigns by refining messages that target individuals in this age group. The objective of this study was to determine the correlates of HIV testing among children and young adolescents in Akwa-Ibom, Nigeria. Methods The outcome was a secondary data analysis of the 2017 Akwa-Ibom AIDS Indicator Survey. Data of 4037 children and young adolescents aged 0–14 years was assessed in this study. Analysis was done using STATA version 16. Chi-squared test and logistic regression models were used to measure association and its strength between uptake of HIV testing and some independent variables (child/caregiver’s age, sex, educational status, child’s location, caregiver’s knowledge of HIV and caregiver ever tested for HIV) at 5% significance level. Results Result showed that only 14.2% of the children and young adolescents have been tested for HIV. Previous history of blood transfusion (AOR = 5.33, 95%C.I = 2.60–10.92, P = < 0.001), caregiver’s level of education (AOR = 2.67, 95%C.I = 1.30–5.51, P = 0.008) and caregiver ever tested for HIV (AOR = 8.31, 95%C.I = 5.67–12.19, P = < 0.001) were significantly associated with uptake of HIV testing. Conclusion This study concludes that a large proportion of children and young adolescents in Akwa-Ibom state have never been tested for HIV. There is a need for HIV testing interventions to be targeted towards this age groups and their parents/guardian. Addressing the knowledge gap amongst caregivers especially in rural areas is crucial towards improving the effectiveness of HIV testing interventions. Supplementary Information The online version contains supplementary material available at 10.1186/s12887-021-02495-5.
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Affiliation(s)
| | | | | | | | | | | | - Ibrahim Dafa
- Achieving Health Nigeria Initiative, Abuja, Nigeria
| | | | | | - Kwasi Torpey
- University of Ghana School of Public Health, Accra, Ghana.
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Zegeye B, Ahinkorah BO, Idriss-Wheelr D, Oladimeji O, Olorunsaiye CZ, Yaya S. Predictors of institutional delivery service utilization among women of reproductive age in Senegal: a population-based study. Arch Public Health 2021; 79:5. [PMID: 33431061 PMCID: PMC7798284 DOI: 10.1186/s13690-020-00520-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2020] [Accepted: 12/15/2020] [Indexed: 01/31/2023] Open
Abstract
BACKGROUND In Senegal, sub-Saharan Africa, many women continue to die from pregnancy and childbirth complications. Even though health facility delivery is a key intervention to reducing maternal death, utilization is low. There is a dearth of evidence on determinants of health facility delivery in Senegal. Therefore, this study investigated the predictors of health facility-based delivery utilization in Senegal. METHODS Data from the 2017 Senegal Continuous Survey were extracted for this study, and approximately 11,487 ever-married women aged 15-49 years participated. Chi-square test was used to select significant variables and multivariable logistic regression analysis was performed to identify statistically significant predictors at a 95% confidence interval with a 0.05 p-value using Stata version 14 software. RESULTS Facility-based delivery utilization was 77.7% and the main predictors were maternal educational status (primary school Adjusted Odds Ratio [aOR] = 1.44, 95% CI; 1.14-1.83; secondary school aOR = 1.62, 95% CI; 1.17-2.25), husband's educational status (primary school aOR = 1.65, 95% CI; 1.24-2.20, secondary school aOR = 2.17, 95% CI; 1.52-3.10), maternal occupation (agricultural-self-employed aOR = 0.77, 95% CI; 0.62-0.96), ethnicity (Poular aOR = 0.74, 95% CI; 0.56-0.97), place of residence (rural aOR = 0.57, 95% CI; 0.43, 0.74), media exposure (yes aOR = 1.26, 95% CI; 1.02-1.57), economic status (richest aOR = 5.27, 95% CI; 2.85-9.73), parity (seven and above aOR =0.46, 95% CI; 0.34-0.62), wife beating attitude (refuse aOR =1.23, 95% CI; 1.05-1.44) and skilled antenatal care (ANC) (yes aOR = 4.34, 95% CI; 3.10-6.08). CONCLUSION Uptake of health facility delivery services was seen among women who were educated, exposed to media, wealthy, against wife-beating, attended ANC by skilled attendants and had educated husbands. On the other hand, women from ethnic groups like Poular, those working in agricultural activities, living in rural setting, and those who had more delivery history were less likely to deliver at a health facility. Therefore, there is the need to empower women by encouraging them to use skilled ANC services in order for them to gain the requisite knowledge they need to enhance their utilization of health facility delivery, whiles at the same time, removing socio-economic barriers to access to health facility delivery that occur from low education, poverty and rural dwelling.
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Affiliation(s)
- Betregiorgis Zegeye
- HaSET Maternal and Child Health Research Program, Shewarobit Field Office, Shewarobit, Ethiopia
| | - Bright Opoku Ahinkorah
- The Australian Centre for Public and Population Health Research (ACPPHR), Faculty of Health, University of Technology Sydney, Sydney, Australia
| | - Dina Idriss-Wheelr
- Interdisciplinary School of Health Sciences, University of Ottawa, Ottawa, Ontario Canada
| | - Olanrewaju Oladimeji
- Department of Public Health, Walter Sisulu University, Mthatha, Eastern Cape South Africa
- Faculty of Health Sciences, Durban University of Technology, Durban, South Africa
- Department of Family Medicine and Public Health, Faculty of Medicine, University of Botswana, Gaborone, Botswana
| | | | - Sanni Yaya
- Faculty of Social Sciences, School of International Development and Global Studies, University of Ottawa, 120 University Private, Ottawa, ON K1N 6N5 Canada
- The George Institute for Global Health, Imperial College London, London, UK
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Bozzini AB, Maruyama JM, Munhoz TN, Barros AJD, Barros FC, Santos IS, Matijasevich A. Trajectories of maternal depressive symptoms and offspring's risk behavior in early adolescence: data from the 2004 Pelotas birth cohort study. BMC Psychiatry 2021; 21:18. [PMID: 33413253 PMCID: PMC7792177 DOI: 10.1186/s12888-020-03026-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/22/2020] [Accepted: 12/22/2020] [Indexed: 01/07/2023] Open
Abstract
BACKGROUND This longitudinal study explored the relationship between trajectories of maternal depressive symptoms and offspring's risk behavior in adolescence contributing to an extremely scarce literature about the impacts of maternal depression trajectories on offspring risk behaviors. METHODS We included 3437 11-year-old adolescents from the 2004 Pelotas Birth Cohort Study. Trajectories of maternal depressive symptoms were constructed using Edinburgh Postnatal Depression Scale (EDPS) from age 3 months to 11 years. We identified five trajectories of maternal depressive symptoms: "low" "moderate low", "increasing", "decreasing", and "chronic high". The following adolescent outcomes were identified via self-report questionnaire and analyzed as binary outcome -yes/no: involvement in fights and alcohol use at age 11. We used logistic regression models to examine the effects of trajectories of maternal depressive symptoms on offspring's risk behavior adjusting for potential confounding variable. RESULTS Alcohol use and/or abuse as well as involvement in fights during adolescence, were not significantly associated with any specific trajectory of maternal depressive symptoms neither in the crude nor in the adjusted analyses. CONCLUSION Alcohol use and involvement in fights at age 11 were not associated with any specific trajectory of maternal depression.
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Affiliation(s)
- Ana Beatriz Bozzini
- Departamento de Medicina Preventiva, Faculdade de Medicina FMUSP, Universidade de São Paulo, São Paulo, Brazil.
| | - Jessica Mayumi Maruyama
- grid.11899.380000 0004 1937 0722Departamento de Medicina Preventiva, Faculdade de Medicina FMUSP, Universidade de São Paulo, São Paulo, Brazil
| | - Tiago N. Munhoz
- grid.411221.50000 0001 2134 6519Postgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil ,grid.411221.50000 0001 2134 6519Faculty of Psychology, Federal University of Pelotas, Pelotas, Brazil
| | - Aluísio J. D. Barros
- grid.411221.50000 0001 2134 6519Postgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil
| | - Fernando C. Barros
- grid.411965.e0000 0001 2296 8774Post-graduate Program in Health and Behavior, Catholic University of Pelotas, Pelotas, Brazil
| | - Iná S. Santos
- grid.412519.a0000 0001 2166 9094Postgraduate Program in Pediatrics and Child Health, School of Medicine, Pontifical Catholic University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Alicia Matijasevich
- grid.11899.380000 0004 1937 0722Departamento de Medicina Preventiva, Faculdade de Medicina FMUSP, Universidade de São Paulo, São Paulo, Brazil ,grid.411221.50000 0001 2134 6519Postgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil
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Ferm MS, Frazee LA, Kennard BD, King JD, Emslie GJ, Stewart SM. Fearlessness about death predicts adolescent suicide attempt: A preliminary analysis. Suicide Life Threat Behav 2020; 50:1288-1295. [PMID: 33103267 DOI: 10.1111/sltb.12715] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2019] [Revised: 06/26/2020] [Accepted: 06/29/2020] [Indexed: 01/05/2023]
Abstract
OBJECTIVE Several theories of suicide suggest that people will only attempt suicide if they have both the desire to die and the capability for suicide. Fearlessness about death is a key component of capability for suicide. There is little information in the literature about the prospective relationship between fearlessness about death and suicide attempt in adolescents. METHOD We obtained baseline fearlessness about death from adolescents (N = 122; ages 12-18; 80% girls; 82% Caucasian) who received intensive outpatient treatment for active suicidal ideation and/or a recent attempt. We tested if fearlessness about death at treatment entry predicted an attempt (n = 14) between entry and six-month follow-up after discharge from the program. RESULTS Fearlessness about death significantly predicted the presence of an attempt between treatment entry and six-month follow-up after controlling for common covariates (Quade F = 2.15, p < .02). CONCLUSIONS In a preliminary analysis of a group of suicidal adolescents, fearlessness about death was a significant independent predictor of attempt between treatment entry and six months post-discharge, even when controlling for other commonly cited risk factors.
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Affiliation(s)
- Mikael S Ferm
- Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Laura A Frazee
- Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Betsy D Kennard
- Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, Texas, USA.,Department of Psychiatry, Children's Health Children's Medical Center, Dallas, Texas, USA
| | - Jessica D King
- Department of Psychiatry, Children's Health Children's Medical Center, Dallas, Texas, USA
| | - Graham J Emslie
- Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, Texas, USA.,Department of Psychiatry, Children's Health Children's Medical Center, Dallas, Texas, USA
| | - Sunita M Stewart
- Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, Texas, USA.,Department of Psychiatry, Children's Health Children's Medical Center, Dallas, Texas, USA
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Ssewanyana D, Abubakar A, Newton CRJC, Otiende M, Mochamah G, Nyundo C, Walumbe D, Nyutu G, Amadi D, Doyle AM, Ross DA, Nyaguara A, Williams TN, Bauni E. Clustering of health risk behaviors among adolescents in Kilifi, Kenya, a rural Sub-Saharan African setting. PLoS One 2020; 15:e0242186. [PMID: 33180831 PMCID: PMC7660520 DOI: 10.1371/journal.pone.0242186] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2018] [Accepted: 10/29/2020] [Indexed: 02/02/2023] Open
Abstract
BACKGROUND Adolescents tend to experience heightened vulnerability to risky and reckless behavior. Adolescents living in rural settings may often experience poverty and a host of risk factors which can increase their vulnerability to various forms of health risk behavior (HRB). Understanding HRB clustering and its underlying factors among adolescents is important for intervention planning and health promotion. This study examines the co-occurrence of injury and violence, substance use, hygiene, physical activity, and diet-related risk behaviors among adolescents in a rural setting on the Kenyan coast. Specifically, the study objectives were to identify clusters of HRB; based on five categories of health risk behavior, and to identify the factors associated with HRB clustering. METHODS A cross-sectional survey was conducted of a random sample of 1060 adolescents aged 13-19 years living within the area covered by the Kilifi Health and Demographic Surveillance System. Participants completed a questionnaire on health behaviors which was administered via an Audio Computer-Assisted Self-Interview. Latent class analysis on 13 behavioral factors (injury and violence, hygiene, alcohol tobacco and drug use, physical activity, and dietary related behavior) was used to identify clustering and stepwise ordinal logistic regression with nonparametric bootstrapping identified the factors associated with clustering. The variables of age, sex, education level, school attendance, mental health, form of residence and level of parental monitoring were included in the initial stepwise regression model. RESULTS We identified 3 behavioral clusters (Cluster 1: Low-risk takers (22.9%); Cluster 2: Moderate risk-takers (67.8%); Cluster 3: High risk-takers (9.3%)). Relative to the cluster 1, membership of higher risk clusters (i.e. moderate or high risk-takers) was strongly associated with older age (p<0.001), being male (p<0.001), depressive symptoms (p = 0.005), school non-attendance (p = 0.001) and a low level of parental monitoring (p<0.001). CONCLUSION There is clustering of health risk behaviors that underlies communicable and non-communicable diseases among adolescents in rural coastal Kenya. This suggests the urgent need for targeted multi-component health behavior interventions that simultaneously address all aspects of adolescent health and well-being, including the mental health needs of adolescents.
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Affiliation(s)
- Derrick Ssewanyana
- Centre for Geographic Medicine Research Coast, Kenya Medical Research Institute (KEMRI), Kilifi, Kenya
- Utrecht Centre for Child and Adolescent Studies, Utrecht University, Utrecht, The Netherlands
| | - Amina Abubakar
- Centre for Geographic Medicine Research Coast, Kenya Medical Research Institute (KEMRI), Kilifi, Kenya
- Utrecht Centre for Child and Adolescent Studies, Utrecht University, Utrecht, The Netherlands
- Institute for Human Development, Aga Khan University, Nairobi, Kenya
| | - Charles R. J. C. Newton
- Centre for Geographic Medicine Research Coast, Kenya Medical Research Institute (KEMRI), Kilifi, Kenya
- Department of Psychiatry, Warneford Hospital, University of Oxford, Oxford, United Kingdom
| | - Mark Otiende
- Centre for Geographic Medicine Research Coast, Kenya Medical Research Institute (KEMRI), Kilifi, Kenya
- INDEPTH (International Network for field sites with continuous Demographic Evaluation of Populations and Their Health in developing countries), East Legon, Accra, Ghana
| | - George Mochamah
- Centre for Geographic Medicine Research Coast, Kenya Medical Research Institute (KEMRI), Kilifi, Kenya
- INDEPTH (International Network for field sites with continuous Demographic Evaluation of Populations and Their Health in developing countries), East Legon, Accra, Ghana
| | - Christopher Nyundo
- Centre for Geographic Medicine Research Coast, Kenya Medical Research Institute (KEMRI), Kilifi, Kenya
- INDEPTH (International Network for field sites with continuous Demographic Evaluation of Populations and Their Health in developing countries), East Legon, Accra, Ghana
| | - David Walumbe
- Centre for Geographic Medicine Research Coast, Kenya Medical Research Institute (KEMRI), Kilifi, Kenya
- INDEPTH (International Network for field sites with continuous Demographic Evaluation of Populations and Their Health in developing countries), East Legon, Accra, Ghana
| | - Gideon Nyutu
- Centre for Geographic Medicine Research Coast, Kenya Medical Research Institute (KEMRI), Kilifi, Kenya
- INDEPTH (International Network for field sites with continuous Demographic Evaluation of Populations and Their Health in developing countries), East Legon, Accra, Ghana
| | - David Amadi
- Centre for Geographic Medicine Research Coast, Kenya Medical Research Institute (KEMRI), Kilifi, Kenya
- INDEPTH (International Network for field sites with continuous Demographic Evaluation of Populations and Their Health in developing countries), East Legon, Accra, Ghana
| | - Aoife M. Doyle
- London School of Hygiene & Tropical Medicine, Bloomsbury, London, United Kingdom
| | - David A. Ross
- London School of Hygiene & Tropical Medicine, Bloomsbury, London, United Kingdom
| | - Amek Nyaguara
- Centre for Geographic Medicine Research Coast, Kenya Medical Research Institute (KEMRI), Kilifi, Kenya
- INDEPTH (International Network for field sites with continuous Demographic Evaluation of Populations and Their Health in developing countries), East Legon, Accra, Ghana
| | - Thomas N. Williams
- Centre for Geographic Medicine Research Coast, Kenya Medical Research Institute (KEMRI), Kilifi, Kenya
- INDEPTH (International Network for field sites with continuous Demographic Evaluation of Populations and Their Health in developing countries), East Legon, Accra, Ghana
- Department of Medicine, Imperial College, South Kensington Campus, London, United Kingdom
| | - Evasius Bauni
- Centre for Geographic Medicine Research Coast, Kenya Medical Research Institute (KEMRI), Kilifi, Kenya
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Yaya S, Zegeye B, Ahinkorah BO, Ameyaw EK, Seidu AA, Shibre G. Time trends, geographical, socio-economic, and gender disparities in neonatal mortality in Burundi: evidence from the demographic and health surveys, 2010-2016. Arch Public Health 2020; 78:115. [PMID: 33292519 PMCID: PMC7663869 DOI: 10.1186/s13690-020-00501-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2020] [Accepted: 11/05/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Programmatic and research agendas surrounding neonatal mortality are important to help countries attain the child health related 2030 Sustainable Development Goal (SDG). In Burundi, the Neonatal Mortality Rate (NMR) is 25 per 1000 live births. However, high quality evidence on the over time evolution of inequality in NMR is lacking. This study aims to address the knowledge gap by systematically and comprehensively investigating inequalities in NMR in Burundi with the intent to help the country attain SDG 3.2 which aims to reduce neonatal mortality to at least as low as 12 per 1000 live births by 2030. METHODS The Burundi Demographic and Health Survey (BDHS) data for the periods of 2010 and 2016 were used for the analyses. The analyses were carried out using the WHO's HEAT version 3.1 software. Five equity stratifiers: economic status, education, residence, sex and subnational region were used as benchmark for measuring NMR inequality with time over 6 years. To understand inequalities from a broader perspective, absolute and relative inequality measures, namely Difference, Population Attributable Risk (PAR), Ratio, and Population Attributable Fraction (PAF) were calculated. Statistical significance was measured by computing corresponding 95% Confidence Intervals (CIs). RESULTS NMR in Burundi in 2010 and 2016 were 36.7 and 25.0 deaths per 1000 live births, respectively. We recorded large wealth-driven (PAR = -3.99, 95% CI; - 5.11, - 2.87, PAF = -15.95, 95% CI; - 20.42, - 11.48), education related (PAF = -6.64, 95% CI; - 13.27, - 0.02), sex based (PAR = -1.74, 95% CI; - 2.27, - 1.21, PAF = -6.97, 95% CI; - 9.09, - 4.86), urban-rural (D = 15.44, 95% CI; 7.59, 23.29, PAF = -38.78, 95% CI; - 45.24, - 32.32) and regional (PAR = -12.60, 95% CI; - 14.30, - 10.90, R = 3.05, 95% CI; 1.30, 4.80) disparity in NMR in both survey years, except that urban-rural disparity was not detected in 2016. We found both absolute and relative inequalities and significant reduction in these inequalities over time - except at the regional level, where the disparity remained constant during the study period. CONCLUSION Large survival advantage remains to neonates of women who are rich, educated, residents of urban areas and some regions. Females had higher chance of surviving their 28th birthday than male neonates. More extensive work is required to battle the NMR gap between different subgroups in the country.
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Affiliation(s)
- Sanni Yaya
- School of International Development and Global Studies, University of Ottawa, Ottawa, Canada
- The George Institute for Global Health, Imperial College London, London, UK
| | - Betregiorgis Zegeye
- Shewarobit Field Office, HaSET Maternal and Child Health Research Program, Addis Ababa, Ethiopia
| | - Bright Opoku Ahinkorah
- School of Public Health, Faculty of Health, University of Technology Sydney, Ultimo, NSW Australia
| | - Edward Kwabena Ameyaw
- School of Public Health, Faculty of Health, University of Technology Sydney, Ultimo, NSW Australia
| | - Abdul-Aziz Seidu
- Department of Population and Health, College of Humanities and Legal Studies, University of Cape Coast, Cape Coast, Ghana
| | - Gebretsadik Shibre
- Department of Reproductive, Family and Population Health, School of Public Health, Addis Ababa University, Addis Ababa, Ethiopia
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Pengpid S, Peltzer K. Prevalence and correlates of interpersonal violence among in-school adolescents in Tanzania. JOURNAL OF PSYCHOLOGY IN AFRICA 2020. [DOI: 10.1080/14330237.2020.1796026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Affiliation(s)
- Supa Pengpid
- ASEAN Institute for Health Development, Mahidol University, Salaya, Phutthamonthon, Nakhon Pathom, Thailand
- Department of Research Administration and Development, University of Limpopo, Polokwane, South Africa
| | - Karl Peltzer
- Department for Management of Science and Technology Development, Ton Duc Thang University, Ho Chi Minh City, Vietnam
- Faculty of Pharmacy, Ton Duc Thang University, Ho Chi Minh City, Vietnam
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Alderson H, Kaner E, Brown R, Howel D, McColl E, Smart D, Copello A, Fouweather T, McGovern R, Brown H, McArdle P, Lingam R. Behaviour change interventions to reduce risky substance use and improve mental health in children in care: the SOLID three-arm feasibility RCT. PUBLIC HEALTH RESEARCH 2020. [DOI: 10.3310/phr08130] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Background
Looked-after children and care leavers (henceforth children in care) are young people placed under the care of local authorities, often because of a history of family abuse and/or neglect. These young people have significantly increased risk of substance use and mental health problems compared with peers.
Aim
The Supporting Looked After Children and Care Leavers In Decreasing Drugs, and alcohol (SOLID) trial aimed to investigate the feasibility of a definitive randomised controlled trial comparing two behaviour change interventions to reduce risky substance use (illicit drugs and alcohol) in and improve the mental health of children in care aged 12–20 years.
Methods
The study consisted of two phases: (1) a formative phase that adapted the motivational enhancement therapy and social behaviour and network therapy interventions for use with children in care and (2) a three-arm pilot randomised controlled trial (comparing motivational enhancement therapy, social behaviour and network therapy and usual care), and a linked process and economic (return on investment) evaluation. Trial feasibility was compared with prespecified STOP/GO criteria.
Setting
Six local authority areas in the north-east of England.
Participants
Children in care (aged 12–20 years) who screened positive for drug and/or alcohol use within the last 12 months were eligible for the trial. The formative and process evaluations included children in care, carers, social workers, and drug and alcohol workers.
Outcome measures
The primary outcomes were recruitment and retention rates at 12 months’ follow-up. Baseline and 12-month follow-up questionnaires measured self-reported drug and alcohol use, mental health and health-related quality of life. The process evaluation considered acceptability and engagement with the interventions and trial procedures.
Results
Formative findings (n = 65) highlighted the need for interventions to increase the emphasis on therapeutic relationships, use creative methods of engagement and support the identification of treatment goals wider than substance misuse. Within the randomised controlled trial, of 860 participants screened, 211 (24.5%) met the inclusion criteria. One hundred and twelve (53%) of the 211 eligible children were recruited and randomised. Just 15 of the 76 (20%) participants allocated to intervention attended any of the motivational enhancement therapy of social behaviour and network therapy sessions, and 60 (54%) participants completed the 12-month follow-up. The screening and recruitment of children in care required significantly more time and resource investment by researchers and children’s services than planned. The process evaluation (n = 116) demonstrated that, despite participants engaging in risky substance use, they did not often acknowledge this nor felt that they needed help. Children in care had complex, chaotic lives and children’s services departments were less research mature and extremely stretched; this, coupled with the multiple steps in the intervention pathway and study protocol, resulted in low adherence to the intervention and the trial.
Conclusions
The SOLID trial demonstrated successful engagement with children in care to adapt the motivational enhancement therapy and social behaviour and network therapy interventions. However, the pilot randomised controlled trial found that a definitive trial is not feasible. The current screen, refer and treat pathway for children in care did not work. There is an urgent need to radically rethink how we deliver therapeutic services for children in care. A pragmatic evaluation design, coupled with additional research resource for children’s services, is needed to evaluate these novel models of care at scale.
Trial registration
This study is registered as PROSPERO CRD42018098974 and Current Controlled Trials ISRCTN80786829.
Funding
This project was funded by the National Institute for Health Research (NIHR) Public Health Research programme and will be published in full in Public Health Research; Vol. 8, No. 13. See the NIHR Journals Library website for further project information.
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Affiliation(s)
- Hayley Alderson
- Institute of Health and Society, Newcastle University, Newcastle upon Tyne, UK
| | - Eileen Kaner
- Institute of Health and Society, Newcastle University, Newcastle upon Tyne, UK
| | - Rebecca Brown
- Institute of Health and Society, Newcastle University, Newcastle upon Tyne, UK
| | - Denise Howel
- Institute of Health and Society, Newcastle University, Newcastle upon Tyne, UK
| | - Elaine McColl
- Institute of Health and Society, Newcastle University, Newcastle upon Tyne, UK
| | - Deborah Smart
- Institute of Health and Society, Newcastle University, Newcastle upon Tyne, UK
| | - Alex Copello
- School of Psychology, University of Birmingham, Birmingham, UK
| | - Tony Fouweather
- Institute of Health and Society, Newcastle University, Newcastle upon Tyne, UK
| | - Ruth McGovern
- Institute of Health and Society, Newcastle University, Newcastle upon Tyne, UK
| | - Heather Brown
- Institute of Health and Society, Newcastle University, Newcastle upon Tyne, UK
| | - Paul McArdle
- Child and Adolescent Mental Health Services, Tyne and Wear NHS Foundation Trust, St Nicholas Hospital, Newcastle upon Tyne, UK
| | - Raghu Lingam
- Institute of Health and Society, Newcastle University, Newcastle upon Tyne, UK
- Faculty of Medicine, University of New South Wales, Randwick, NSW, Australia
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Rothrock AN, Andris H, Swetland SB, Chavez V, Isaak S, Pagane M, Romney J, Rothrock SG. Association of E-cigarettes with adolescent alcohol use and binge drinking-drunkenness: A systematic review and meta-analysis. THE AMERICAN JOURNAL OF DRUG AND ALCOHOL ABUSE 2020; 46:684-698. [PMID: 32795246 DOI: 10.1080/00952990.2020.1771723] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Background: E-cigarette (ECIG) use has increased substantially in the past decade. Co-use of alcohol and ECIGS may have serious consequences in adolescents. Objectives: To evaluate the association of e-cigarettes (ECIGs) with alcohol use in adolescents. Methods: Searched databases included PubMed, EMBASE, CINAHL, PsycINFO, Web of Science, and gray literature. Studies were included if they contained a non-E-cigarette group (NON-ECIG), an ECIG group, detailed rates of alcohol use, binge drinking, or drunkenness and included adolescents. Two independent reviewers extracted data using MOOSE guidelines. Evidence quality across studies was assessed using Cochrane GRADE methodology. Summary effects of ECIG vs. NON-ECIG use on any alcohol use and a composite of binge drinking/drunkenness were calculated using a random-effects model. Results: 28 of 3768 initially identified studies were included: 25 cross-sectional, 3 cohort studies, N = 458,357 total subjects (49.6% females). Pooling of data showed that ECIG users had a higher risk for any alcohol use compared to NON-ECIG users (Odds Ratio/OR 6.62, 95% confidence interval/CI 5.67-7.72) and a higher rate of binge drinking/drunkenness compared to NON-ECIG users (OR 6.73, 95% CI 4.5 - 10.07). The subset of high school ECIG users had higher rates of alcohol use (OR 8.17, 95% CI 5.95-11.2) and binge drinking/drunkenness (OR 7.98, 95% CI 5.98-10.63) compared to NON-ECIG users. Conclusion: ECIG users had a higher risk of alcohol use and binge drinking/drunkenness compared to NON-ECIG users. Our findings indicate that interventions to reduce ECIG use should be coupled with measures to reduce alcohol use in adolescents.Abbreviations: ECIG: e-cigarettes; NON-ECIG: non e-cigarettes.
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Affiliation(s)
| | - Halle Andris
- Lawton Chiles High School , Tallahassee, FL, USA
| | | | | | - Shira Isaak
- Winter Park High School , Winter Park, FL, USA
| | | | - Jake Romney
- Lake Mary Preparatory High School , Lake Mary, FL, USA
| | - Steven G Rothrock
- Department of Emergency Medicine, Dr. P Phillips Hospital, Orlando Health , Orlando, FL, USA
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Poorolajal J, Mohammadi Y, Soltanian AR, Ahmadpoor J. The top six risky behaviors among Iranian university students: a national survey. J Public Health (Oxf) 2020; 41:788-797. [PMID: 30452701 DOI: 10.1093/pubmed/fdy204] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2018] [Revised: 09/17/2018] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Multiple risk-taking behaviors are associated with increased risk of poor educational attainment, morbidity and premature mortality. This study involved a large representative sample of Iranian university students addressing multiple risk behaviors and associated factors. METHODS This cross-sectional study included 4261 participants, involving 13 medical universities throughout the country in 2017. The following six risky behaviors were addressed: (a) smoking cigarettes during the past month, (b) using some kinds of illicit drugs during the past month, (c) drinking alcohol during the past month, (d) engaging unprotected sex during the past year, (e) having suicidal ideation during the past month or attempting suicide in the past year, (f) and Internet addiction. The 20-item internet addiction test and the 28-item general health questionnaire were used. RESULTS Almost 37.3% of the participants engaged in at least one out of six risky behaviors. The prevalence of Internet addiction was 24.5%, cigarette smoking 13.5%, alcohol use 7.8%, illicit drug abuse 4.9%, unprotected sex 7.8%, suicidal ideation 7.4%, attempting suicide 1.7% and general health problems 38.9%. CONCLUSION A majority of the Iranian university students studied engaged in at least one risky behavior. Engaging in one risky behavior increases the risk of engaging in other risk-taking behaviors.
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Affiliation(s)
- Jalal Poorolajal
- Department of Epidemiology, School of Public Health, Hamadan University of Medical Sciences, Hamadan, Iran.,Research Center for Health Sciences, School of Public Health, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Younes Mohammadi
- Department of Epidemiology, School of Public Health, Hamadan University of Medical Sciences, Hamadan, Iran.,Social Determinants of Health Research Center, School of Public Health, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Ali Reza Soltanian
- Modeling of Noncommunicable Diseases Research Center, School of Public Health, Hamadan University of Medical Sciences, Hamadan, Iran.,Department of Biostatistics, School of Public Health, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Jamal Ahmadpoor
- Department of Epidemiology, School of Public Health, Hamadan University of Medical Sciences, Hamadan, Iran
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46
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Malik FS, Senturia KD, Lind CD, Chalmers KD, Yi-Frazier JP, Shah SK, Pihoker C, Wright DR. Adolescent and parent perspectives on the acceptability of financial incentives to promote self-care in adolescents with type 1 diabetes. Pediatr Diabetes 2020; 21:533-551. [PMID: 31863541 PMCID: PMC7663046 DOI: 10.1111/pedi.12970] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2019] [Revised: 10/02/2019] [Accepted: 11/25/2019] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND An understanding of acceptability among potential intervention participants is critical to the design of successful real-world financial incentive (FI) programs. The purpose of this qualitative study was to explore adolescent and parent perspectives on the acceptability of using FI to promote engagement in diabetes self-care in adolescents with type 1 diabetes (T1D). METHODS Focus groups with 46 adolescents with T1D (12-17 years old) and 39 parents of adolescents with T1D were conducted in the Seattle metropolitan area. Semistructured questions addressed participants' current use of incentives to promote change in diabetes self-care and receptivity to a theoretical incentive program administered by a third-party. Qualitative data were analyzed and emergent themes identified. RESULTS Three thematic categories informed participant views about the acceptability of FI programs: (a) the extent to which using FIs in the context of diabetes management fit comfortably into a family's value system, (b) the perceived effectiveness for FIs to promote improved diabetes self-care, and (c) the urgent need for improved self-care due to the threat of diabetes-related health complications. These factors together led most parents and adolescents to be open to FI program participation. CONCLUSIONS The results from this qualitative study suggest that well-designed FI programs to support diabetes management are acceptable to families with adolescents with T1D. Additionally, the use of FIs may have the potential to support adolescents with T1D in developing strong self-care habits and ease the often-turbulent transition to independent self-care.
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Affiliation(s)
- Faisal S. Malik
- Department of Pediatrics, University of Washington, 1959 NE Pacific St, Seattle, WA, USA,Seattle Children’s Research Institute, 2001 8th Ave #400, Seattle, WA, USA
| | | | - Cara D. Lind
- Seattle Children’s Research Institute, 2001 8th Ave #400, Seattle, WA, USA
| | | | | | - Seema K. Shah
- Northwestern University, 680 N Lake Shore Drive, Chicago, IL, USA
| | - Catherine Pihoker
- Department of Pediatrics, University of Washington, 1959 NE Pacific St, Seattle, WA, USA,Seattle Children’s Research Institute, 2001 8th Ave #400, Seattle, WA, USA
| | - Davene R. Wright
- Department of Pediatrics, University of Washington, 1959 NE Pacific St, Seattle, WA, USA,Seattle Children’s Research Institute, 2001 8th Ave #400, Seattle, WA, USA
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47
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Ahmadpoor J, Mohammadi Y, Soltanian AR, Poorolajal J. Psychiatric disorders and associated risky behaviors among Iranian university students: results from the Iranian PDABs survey. J Public Health (Oxf) 2020. [DOI: 10.1007/s10389-020-01229-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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48
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Zozaya N, Vallejo L. The Effect of the Economic Crisis on Adolescents' Perceived Health and Risk Behaviors: A Multilevel Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17020643. [PMID: 31963837 PMCID: PMC7013908 DOI: 10.3390/ijerph17020643] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/29/2019] [Revised: 01/13/2020] [Accepted: 01/16/2020] [Indexed: 11/22/2022]
Abstract
Background: Previous studies have analyzed the impact of economic crises on adult’s health and lifestyles, but evidence among children and adolescents is limited. The objective of this study was to analyze the impact of the economic crisis on self-perceived health and some risk behaviors in the Spanish adolescent population. Methods: We used data from four waves (2002, 2006, 2010, 2014) of the Health Behavior in School-Aged Children (HBSC) survey in Spain. Separate multilevel logistic and linear regression models were applied for health complaints, self-rated health, life satisfaction, smoking, alcohol consumption, and breakfast skipping. Annual change in Spanish regional unemployment rates was used as a proxy of the economic crisis. An increasing set of control variables were included, consisting of individual, socioeconomic, and family and peer relationships indicators. Median odds ratios were estimated to quantify the cross-region and cross-school variation. Results: Increases in unemployment rates were linked to a higher risk of poorer health and bad habits in the simplest models. The effect was no longer statistically significant when indicators of family and peer relationships were included, suggesting a protective effect against the impact of the economic crisis. Our findings also show that schools had a larger effect on health and lifestyles than regions. Conclusion: The child’s social context—family, peers, school, and region—play an important role on the effects of the economic crisis on health and risk behaviors.
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Affiliation(s)
- Néboa Zozaya
- Department of Quantitative Methods in Economics and Management, Universidad de Las Palmas de Gran Canaria, Calle Saulo Torón, 4 Las Palmas de Gran Canaria, 35017 Las Palmas, Spain
- Weber Economía y Salud, Calle Moreto 17, 28014 Madrid, Spain
- Correspondence:
| | - Laura Vallejo
- Department of Quantitative Methods in Economics and Management, Universidad de Las Palmas de Gran Canaria, Calle Saulo Torón, 4 Las Palmas de Gran Canaria, 35017 Las Palmas, Spain
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Basedow LA, Kuitunen-Paul S, Roessner V, Golub Y. Traumatic Events and Substance Use Disorders in Adolescents. Front Psychiatry 2020; 11:559. [PMID: 32625122 PMCID: PMC7314975 DOI: 10.3389/fpsyt.2020.00559] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/30/2019] [Accepted: 06/01/2020] [Indexed: 12/04/2022] Open
Abstract
OBJECTIVES Adolescents with substance use disorders (SUD) frequently report traumatic events (TEs) and symptoms of post-traumatic stress disorder (PTSD). This study aimed to assess whether lifetime prevalence rates of TEs and PTSD are related to SUD severity in adolescent psychiatric patients. METHODS We analyzed N = 114 self-reports of treatment-seeking German adolescents aged 12 to 18 years, who visited a specialized SUD outpatient unit. Standardized questionnaires were applied to assess SUD severity, the number of TEs and DSM-IV PTSD criteria. RESULTS Patients fulfilling PTSD criteria (28% of the total sample) had a higher Drug Use Disorders Identification Test (DUDIT) score compared to non-PTSD patients with TEs (p <.001), and compared to adolescents without TEs or PTSD (p = .003). Additionally, SUD severity was positively associated with the number of TEs and the number of intrusion, hyperarousal, and avoidance symptoms (all r = .33 to.48, all p <.01). DISCUSSION Adolescent patients with SUD reported 3-times higher rates of TEs, and a 5-time higher prevalence of PTSD following TEs, than the general adolescent population. Adolescent SUD patients with PTSD reported more severe substance use problems than patients without PTSD-regardless of previous TEs. Longitudinal studies are needed in order to investigate the temporal relationship between TEs, PTSD and SUD.
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Affiliation(s)
- Lukas A Basedow
- Department of Child and Adolescent Psychiatry, Faculty of Medicine, TU Dresden, Dresden, Germany
| | - Sören Kuitunen-Paul
- Department of Child and Adolescent Psychiatry, Faculty of Medicine, TU Dresden, Dresden, Germany
| | - Veit Roessner
- Department of Child and Adolescent Psychiatry, Faculty of Medicine, TU Dresden, Dresden, Germany
| | - Yulia Golub
- Department of Child and Adolescent Psychiatry, Faculty of Medicine, TU Dresden, Dresden, Germany
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50
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Snowdon N, Allan J, Shakeshaft A, Rickwood D, Stockings E, Boland VC, Courtney RJ. Outpatient psychosocial substance use treatments for young people: An overview of reviews. Drug Alcohol Depend 2019; 205:107582. [PMID: 31778903 DOI: 10.1016/j.drugalcdep.2019.107582] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/02/2019] [Revised: 08/12/2019] [Accepted: 08/16/2019] [Indexed: 01/08/2023]
Abstract
BACKGROUND Systematic reviews and meta-analyses (reviews) conflict regarding the efficacy and feasibility of substance disorder treatments for young people (YP). This overview of reviews, synthesizes, and methodologically assesses reviews examining substance disorder interventions for YP in outpatient settings. METHODS Reviews published between 1990 and March 2018 were searched using EBM Reviews, PsycINFO, Embase, Ovid Medline, and Campbell Collaboration. Reviews investigating efficacy and/or feasibility of YP substance disorder treatments in outpatient settings were included. FORTY-THREE REVIEWS MET ALL INCLUSION CRITERIA To appraise methodological biases, 40 reviews were assessed using A Measurement Tool to Assess Systematic Reviews 2 (AMSTAR2) and 3 were narratively assessed. One reviewer (NS) extracted study data and evaluated all 43 reviews. For inter-rater reliability, 13 (30%) reviews were extracted and appraised in duplicate by a second reviewer (JA, RC or ES). Agreement on AMSTAR2 ratings reached 100%. Agreement was moderate; κ = .52 (p < .05), 95% CI (.20, .84). RESULTS All high quality methodological reviews (n = 6) focused on intervention efficacy and none on treatment feasibility. One (n = 1) high quality review reported evidence for an intervention. Multidimensional Family Therapy (MDFT) has possible efficacy in reducing YP substance use when compared to treatment as usual, Cognitive Behavior Therapy, Adolescent Community Reinforcement Approach and Multifamily Educational Therapy. CONCLUSIONS Methodological and reporting quality of reviews require improvement. High quality reviews focused on intervention efficacy but treatments commonly lacked evidence. One high quality review found MDFT demonstrated promising outcomes. Reviews examining feasibility of interventions were of low methodological quality.
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Affiliation(s)
- Nicole Snowdon
- Lives Lived Well Research Team, Lives Lived Well, P.O. Box 9374, Orange, NSW, 2800, Australia; National Drug and Alcohol Research Centre, 22 - 32 King Street, The University of New South Wales, Randwick, Sydney, NSW, 2031, Australia.
| | - Julaine Allan
- Lives Lived Well Research Team, Lives Lived Well, P.O. Box 9374, Orange, NSW, 2800, Australia
| | - Anthony Shakeshaft
- National Drug and Alcohol Research Centre, 22 - 32 King Street, The University of New South Wales, Randwick, Sydney, NSW, 2031, Australia; Faculty of Health, Allawoona St, University of Canberra, Bruce, Canberra, ACT, 2617, Australia
| | - Debra Rickwood
- Research and Evaluation, headspace, The National Youth Mental Health Foundation, South Tower, Level 2, 485 La Trobe St, Melbourne VIC 3000, Australia; Faculty of Health, Allawoona St, University of Canberra, Bruce, Canberra, ACT, 2617, Australia
| | - Emily Stockings
- National Drug and Alcohol Research Centre, 22 - 32 King Street, The University of New South Wales, Randwick, Sydney, NSW, 2031, Australia
| | - Veronica C Boland
- National Drug and Alcohol Research Centre, 22 - 32 King Street, The University of New South Wales, Randwick, Sydney, NSW, 2031, Australia
| | - Ryan J Courtney
- National Drug and Alcohol Research Centre, 22 - 32 King Street, The University of New South Wales, Randwick, Sydney, NSW, 2031, Australia
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