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Stevely AK, Gray LA, Fairbrother H, Fenton L, Henney M, Holmes J. A latent class analysis of change and continuity in adolescent health and wellbeing in England during the decline in youth alcohol consumption: A repeat cross-sectional study. Prev Med Rep 2023; 36:102481. [PMID: 37881177 PMCID: PMC10594568 DOI: 10.1016/j.pmedr.2023.102481] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2023] [Revised: 10/13/2023] [Accepted: 10/14/2023] [Indexed: 10/27/2023] Open
Abstract
In England, the proportion of 13-15 year-olds who have ever drunk alcohol fell from 71% in 1999 to 35% in 2019. Despite substantial research literature studying this decline, we know little about connections with concurrent shifts in wider aspects of health and wellbeing. This paper aims to identify how indicators of health and wellbeing cluster within 15-year-olds in England, identify changes in clustering over time, and explore associations with sex and family affluence. We used latent class analysis of cross-sectional data from the Health Behaviours in School-aged Children study (n = 5,942; four waves 2001/02-2013/14). Classes were defined by indicators of substance use, sexual activity, diet, exercise, school-related measures, e-media use, parental relationships, and wellbeing. We identified three classes, which we labelled Overall unhealthy, Substance abstainers with behavioural risk indicators, and Overall healthy. The probability of being in the Overall unhealthy class fell (2001/02: 0.39; 2013/14: 0.18) while the probability of being in the Overall healthy class increased (0.21 to 0.41). The probability of weekly alcohol use fell in all classes (e.g. Overall unhealthy: 0.71 to 0.28). Females (female vs male OR: 1.74 95%CI: 1.30 - 2.34) and those with low family affluence (high vs low family affluence OR: 0.18 95%CI: 0.08 - 0.44) had significantly higher odds of being in the Overall unhealthy class. Overall, adolescents became more likely to have co-occurring indicators of good health and wellbeing, including reduced alcohol consumption, sexual activity and cigarette smoking. However, girls and those from poorer families remained more likely to have poor health and wellbeing.
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Affiliation(s)
- Abigail Kate Stevely
- Sheffield Alcohol Research Group, Sheffield Centre for Health and Related Research (SCHARR), School of Medicine and Population Health, University of Sheffield, UK
| | - Laura A Gray
- Health Economics and Decision Science, Sheffield Centre for Health and Related Research (SCHARR), School of Medicine and Population Health, University of Sheffield, UK
- Healthy Lifespan Institute, University of Sheffield, UK
| | | | - Laura Fenton
- Sheffield Alcohol Research Group, Sheffield Centre for Health and Related Research (SCHARR), School of Medicine and Population Health, University of Sheffield, UK
| | - Madeleine Henney
- Sheffield Alcohol Research Group, Sheffield Centre for Health and Related Research (SCHARR), School of Medicine and Population Health, University of Sheffield, UK
| | - John Holmes
- Sheffield Alcohol Research Group, Sheffield Centre for Health and Related Research (SCHARR), School of Medicine and Population Health, University of Sheffield, UK
- Healthy Lifespan Institute, University of Sheffield, UK
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2
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Fernandez A, Lozano A, Lee TK, Prado G. Screening for Adolescent Risk Behaviors: Preliminary Evidence for a Family Functioning Tool. Int J Behav Med 2023:10.1007/s12529-023-10209-7. [PMID: 37580481 DOI: 10.1007/s12529-023-10209-7] [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] [Accepted: 07/31/2023] [Indexed: 08/16/2023]
Abstract
BACKGROUND Family functioning is associated with adolescent drug use, alcohol use, cigarette use, and sexual risk behaviors. Assessing adolescents for family functioning, commonly associated with multiple risk behaviors, may help identify adolescents at risk for adverse health outcomes. This study examined whether a latent family functioning construct, encompassing multiple dimensions of family functioning, was associated with adolescents' substance use and sexual risk behaviors. METHOD This study used data harmonization with three intervention trials, including data from 1451 adolescents (M = 13.6, SD = 1.0), to perform a full-information item bifactor analysis on 46 family functioning items from five pre-existing family functioning measures. Regression analysis was used to examine the association between the identified subset of items and the following outcomes: cigarette use, alcohol use, drug use, and condom use. RESULTS Bifactor analysis identified a 26-item latent family functioning construct. Regression analysis indicated that a 26-item latent family functioning construct was associated negatively with lifetime and past 90-day cigarette use, alcohol use, and drug use. CONCLUSION In sum, the multi-dimensional latent family functioning construct may target specific barriers to risk screening in adolescent populations, including time constraint, hesitancy in discussing sensitive health topics, and use culturally appropriate and age-appropriate assessments.
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Affiliation(s)
- Alejandra Fernandez
- Department of Health Promotion and Behavioral Sciences, School of Public Health, The University of Texas Health Science Center at Houston, Dallas, TX, USA.
| | - Alyssa Lozano
- School of Nursing and Health Studies, University of Miami, Coral Gables, FL, USA
| | - Tae Kyoung Lee
- Department of Child Psychology and Education/Social Innovation Convergence Program, Sungkyunkwan University, Seoul, South Korea
| | - Guillermo Prado
- School of Nursing and Health Studies, University of Miami, Coral Gables, FL, USA
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3
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Silva TPRD, Matozinhos FP, Guedes GR, Gratão LHA, Silva ADC, Vilela LA, Oliveira TRPRD, Grillo CDFC, Mendes LL. The association between multiple cardiovascular risk factors and overweight in Brazilian adolescents: an analysis based on the grade of membership. CIENCIA & SAUDE COLETIVA 2023; 28:1937-1948. [PMID: 37436308 DOI: 10.1590/1413-81232023287.17402022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2022] [Accepted: 12/01/2022] [Indexed: 07/13/2023] Open
Abstract
The aim of the current research is to analyze the coexistence of modifiable risk behaviors for cardiovascular disease (CVD) in 12-to-17-year-old adolescents living in Brazil and their influence on overweight. National, cross-sectional, school-based epidemiological study focused on estimating the prevalence of cardiovascular risk factors and metabolic syndrome in 12 to 17 year old adolescents enrolled in public and private schools in Brazilian counties accounting for more than 100 thousand inhabitants. The grade of membership method was used to identify the coexistence of risk factors among adolescents. The analytical sample comprised 71,552 adolescents. According to the two herein generated profiles, adolescents classified under Profile 2 have shown behaviors such as smoking, alcohol consumption and diet rich in Ultra-processed food intake ≥ 80% of the percentage of total caloric value. In addition, adolescents presenting CVD risk profile have shown increased likelihood of being overweight. The study has found coexistence of risk factors for CVD in Brazilian adolescents, with emphasis on tobacco smoking and alcoholic beverage intake. In addition, it heads towards the analysis of the association between CVD risk factors and health outcomes, such as overweight.
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Affiliation(s)
| | - Fernanda Penido Matozinhos
- Departamento de Enfermagem Materno-Infantil e Saúde Pública, Escola de Enfermagem, Universidade Federal de Minas Gerais. Belo Horizonte MG Brasil
| | - Gilvan Ramalho Guedes
- Departamento de Demografia, Centro de Desenvolvimento e Planejamento Regional, Universidade Federal de Minas Gerais. Belo Horizonte MG Brasil
| | | | - Ariene do Carmo Silva
- Grupo de Estudos, Pesquisas e Práticas em Ambiente Alimentar e Saúde, Escola de Enfermagem, Universidade Federal de Minas Gerais. Belo Horizonte MG Brasil
| | - Luisa Arantes Vilela
- Departamento de Nutrição, Escola de Enfermagem, Universidade Federal de Minas Gerais. Av. Professor Alfredo Balena 190, 324, Santa Efigênia. 30130-100 Belo Horizonte MG Brasil.
| | | | | | - Larissa Loures Mendes
- Departamento de Nutrição, Escola de Enfermagem, Universidade Federal de Minas Gerais. Av. Professor Alfredo Balena 190, 324, Santa Efigênia. 30130-100 Belo Horizonte MG Brasil.
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Vakili M, Mirzadeh M, Mirzaei M, Modarresi M, Raei R, Karimi R, Aghakoochak A, Imani AA. Sex differences in high-risk health behaviors among school-going adolescents in Yazd, Iran; a cross-sectional study. Heliyon 2023; 9:e16404. [PMID: 37303572 PMCID: PMC10250580 DOI: 10.1016/j.heliyon.2023.e16404] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2022] [Revised: 05/14/2023] [Accepted: 05/15/2023] [Indexed: 06/13/2023] Open
Abstract
Objective Adolescents are exposed to a wide range of high-risk health behaviors. This study aimed to investigate the high-risk health behaviors of adolescents in an Iranian adolescent population and gender differences. Method This cross-sectional descriptive study recruited high school students in Yazd city in center of Iran. Schools were randomly selected. In each school, all selected classes were included. Sampling in each class was census. The study investigated self-reported high-risk health behaviors. Students completed the Global School-based Student Health Survey (GSHS), an anonymous, validated questionnaire. Results 2420 students participated in this study (52.5% male). The age range was 12-19 years. Daily consumption of ≥1 serving of fruit and vegetables per day was reported by 77.4% and 49.5% of respondents, respectively. Adequate physical activity was reported by only 18.4% of adolescents, and significantly less frequently by girls than boys (p < 0.001). 11.8% were current smokers (M/F ratio: 2.6), and 20.5% (M/F ratio: 1.5) were ever used hookah. The prevalence of ever alcohol and substance abuse was 15.5% and 8.8%, respectively. The prevalence of tobacco and substance use was significantly higher in participants' boys than in girls (p < 0.001). Males were over twice more likely to report frequent fighting in the past 12 months than girls. Overall, girls reported more parental supervision than boys (82.1% vs. 73.4%) and parental monitoring (90.6% vs. 86.8%), while boys reported higher levels of awareness over leisure activities than girls (65.8% vs. 58.4%). Conclusions High-risk health behaviors are more common in boys than girls. Health policymakers should use these results in prioritizing and designing health interventions to promote youth health. Further studies are recommended to identify the factors influencing the prevalence of these behaviors.
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Affiliation(s)
- Mahmood Vakili
- Health Monitoring Research Center, School of Medicine, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Mahboobahsadat Mirzadeh
- Department of Internal Medicine, School of Medicine, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Mohsen Mirzaei
- Accident Prevention and Crisis Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Mozhgan Modarresi
- Yazd Cardiovascular Research Center, School of Medicine, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Reihaneh Raei
- Health Monitoring Research Center, School of Medicine, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Reihaneh Karimi
- Health Monitoring Research Center, School of Medicine, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Arezoo Aghakoochak
- Health Monitoring Research Center, School of Medicine, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
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Kamran A, Aliakbari P, Nasimi Doost Azgomi R, Naeim M. Action status and willingness to change health-promoting behaviors during the COVID-19 pandemic among elementary school children: a study based on Prochaska's stages of behavior change theory (TTM). BMC Public Health 2023; 23:248. [PMID: 36747158 PMCID: PMC9900551 DOI: 10.1186/s12889-023-15178-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: 08/27/2022] [Revised: 01/12/2023] [Accepted: 01/31/2023] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND & AIM COVID-19 pandemic has significant effects on lifestyle and health-promoting behaviors and adolescence is a very critical period due to the importance of identity formation and individual behaviors. Therefore, the aim of this study was to determine the status of health- promoting behaviors in the sixth grade male students attending elementary schools in Ardabil city based on Prochaska 's stages of behavior change (TTM). MATERIALS & METHODS This analytical cross-sectional study was conducted on the 619 sixth grade male students attending elementary schools during 2021. The data were collected using two instruments (a researcher-made questionnaire and Health Promoting Lifestyle Profile-II (HPLP-II) questionnaire). The data were analyzed using SPSS version 22 and one-way analysis of variance. RESULTS The majority of students in physical activity and healthy eating behaviors were in the pre-contemplation stage, 29.6% (183 people) and 33.1% (205 people), respectively. All dimensions of health-promoting behaviors were observed to have a significant relationship with the stages of Prochaska's theory behavior change in students, their decision-making balance and self-efficacy scores (P < 0.001). CONCLUSION The health of students is under serious threat due to the poor state of health-promoting behaviors and the weak desire to change behavior. By planning in educating the students, significant changes can be made in changing their behavior and improving their health.
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Affiliation(s)
- Aziz Kamran
- grid.411426.40000 0004 0611 7226Social Determinants of Health Research Center, Ardabil University of Medical Sciences, Ardabil, Iran
| | - Parviz Aliakbari
- grid.411426.40000 0004 0611 7226Social Determinants of Health Research Center, Ardabil University of Medical Sciences, Ardabil, Iran
| | - Ramin Nasimi Doost Azgomi
- grid.411426.40000 0004 0611 7226Traditional Medicine and Hydrotherapy Research Center, Ardabil University of Medical Sciences, Ardabil, Iran
| | - Mahdi Naeim
- Social Determinants of Health Research Center, Ardabil University of Medical Sciences, Ardabil, Iran.
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Kankaanpää A, Tolvanen A, Heikkinen A, Kaprio J, Ollikainen M, Sillanpää E. The role of adolescent lifestyle habits in biological aging: A prospective twin study. eLife 2022; 11:80729. [PMID: 36345722 PMCID: PMC9642990 DOI: 10.7554/elife.80729] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2022] [Accepted: 10/01/2022] [Indexed: 11/09/2022] Open
Abstract
Background: Adolescence is a stage of fast growth and development. Exposures during puberty can have long-term effects on health in later life. This study aims to investigate the role of adolescent lifestyle in biological aging. Methods: The study participants originated from the longitudinal FinnTwin12 study (n = 5114). Adolescent lifestyle-related factors, including body mass index (BMI), leisure-time physical activity, smoking, and alcohol use, were based on self-reports and measured at ages 12, 14, and 17 years. For a subsample, blood-based DNA methylation (DNAm) was used to assess biological aging with six epigenetic aging measures in young adulthood (21–25 years, n = 824). A latent class analysis was conducted to identify patterns of lifestyle behaviors in adolescence, and differences between the subgroups in later biological aging were studied. Genetic and environmental influences on biological aging shared with lifestyle behavior patterns were estimated using quantitative genetic modeling. Results: We identified five subgroups of participants with different adolescent lifestyle behavior patterns. When DNAm GrimAge, DunedinPoAm, and DunedinPACE estimators were used, the class with the unhealthiest lifestyle and the class of participants with high BMI were biologically older than the classes with healthier lifestyle habits. The differences in lifestyle-related factors were maintained into young adulthood. Most of the variation in biological aging shared with adolescent lifestyle was explained by common genetic factors. Conclusions: These findings suggest that an unhealthy lifestyle during pubertal years is associated with accelerated biological aging in young adulthood. Genetic pleiotropy may largely explain the observed associations. Funding: This work was supported by the Academy of Finland (213506, 265240, 263278, 312073 to J.K., 297908 to M.O. and 341750, 346509 to E.S.), EC FP5 GenomEUtwin (J.K.), National Institutes of Health/National Heart, Lung, and Blood Institute (grant HL104125), EC MC ITN Project EPITRAIN (J.K. and M.O.), the University of Helsinki Research Funds (M.O.), Sigrid Juselius Foundation (J.K. and M.O.), Yrjö Jahnsson Foundation (6868), Juho Vainio Foundation (E.S.) and Päivikki and Sakari Sohlberg foundation (E.S.). For most animals, events that occur early in life can have a lasting impact on individuals’ health. In humans, adolescence is a particularly vulnerable time when rapid growth and development collide with growing independence and experimentation. An unhealthy lifestyle during this period of rapid cell growth can contribute to later health problems like heart disease, lung disease, and premature death. This is due partly to accelerated biological aging, where the body deteriorates faster than what would be expected for an individual’s chronological age. One way to track the effects of lifestyle on biological aging is by measuring epigenetic changes. Epigenetic changes consist on adding or removing chemical ‘tags’ on genes. These tags can switch the genes on or off without changing their sequences. Scientists can measure certain epigenetic changes by measuring the levels of methylated DNA – DNA with a chemical ‘tag’ known as a methyl group – in blood samples. Several algorithms – known as ‘epigenetic clocks’ – are available that estimate how fast an individual is aging biologically based on DNA methylation. Kankaanpää et al. show that unhealthy lifestyles during adolescence may lead to accelerated aging in early adulthood. For their analysis, Kankaanpää et al. used data on the levels of DNA methylation in blood samples from 824 twins between 21 and 25 years old. The twins were participants in the FinnTwin12 study and had completed a survey about their lifestyles at ages 12, 14, and 17. Kankaanpää et al. classified individuals into five groups depending on their lifestyles. The first three groups, which included most of the twins, contained individuals that led relatively healthy lives. The fourth group contained individuals with a higher body mass index based on their height and weight. Finally, the last group included individuals with unhealthy lifestyles who binge drank, smoked and did not exercise. After estimating the biological ages for all of the participants, Kankaanpää et al. found that both the individuals with higher body mass indices and those in the group with unhealthy lifestyles aged faster than those who reported healthier lifestyles. However, the results varied depending on which epigenetic clock Kankaanpää et al. used to measure biological aging: clocks that had been developed earlier showed fewer differences in aging between groups; while newer clocks consistently found that individuals in the higher body mass index and unhealthy groups were older. Kankaanpää et al. also showed that shared genetic factors explained both unhealthy lifestyles and accelerated biological aging. The experiments performed by Kankaanpää et al. provide new insights into the vital role of an individual’s genetics in unhealthy lifestyles and cellular aging. These insights might help scientists identify at risk individuals early in life and try to prevent accelerated aging.
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Affiliation(s)
- Anna Kankaanpää
- Gerontology Research Center (GEREC), Faculty of Sport and Health Sciences, University of Jyväskylä
| | - Asko Tolvanen
- Methodology Center for Human Sciences, University of Jyväskylä
| | - Aino Heikkinen
- Institute for Molecular Medicine Finland (FIMM), HiLife, University of Helsinki
| | - Jaakko Kaprio
- Institute for Molecular Medicine Finland (FIMM), HiLife, University of Helsinki
| | - Miina Ollikainen
- Institute for Molecular Medicine Finland (FIMM), HiLife, University of Helsinki
| | - Elina Sillanpää
- Gerontology Research Center (GEREC), Faculty of Sport and Health Sciences, University of Jyväskylä
- Institute for Molecular Medicine Finland (FIMM), HiLife, University of Helsinki
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Simmons JD, Smith JE, Erickson SJ, Warner TD. A factor analytic approach to understanding health risk behaviors and resilience among multi-racial/ethnic adolescents in New Mexico. ETHNICITY & HEALTH 2022; 27:1652-1670. [PMID: 33971771 DOI: 10.1080/13557858.2021.1925227] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/15/2020] [Accepted: 04/28/2021] [Indexed: 06/12/2023]
Abstract
OBJECTIVE This study examined the factor validity of health risk behaviors and resilience indicators and their covariation across a large racially/ethnically diverse adolescent population. DESIGN The study subsample (47% Hispanic, 31% White Non-Hispanic, 17% American Indian) was derived from the 2013 New Mexico Youth Risk Resilience Survey (YRRS; N-19,033). We conducted a confirmatory factor analysis on the 6 health risk domains identified by the CDC as contributing most to adolescent morbidity/mortality: (1) cigarette use, (2) alcohol and other illicit drug use, (3) marijuana use, (4) sexual activity, (5) nutrition habits, and (6) physical activity. RESULTS A 4-factor CFA model of adolescent health risk behaviors was replicated, and a hypothesized 6-factor structure based on behaviors that contribute most to adolescent morbidity/mortality was confirmed. The pattern of covarying risk behaviors differed by Hispanic, Native American, and Non-Hispanic White groups. We also confirmed a single external resilience-interference factor (decreased parental support, low school/community engagement, negative peer associations) that positively correlated with all six risk behaviors. CONCLUSION This study described the structure of adolescent health risk behaviors within a context of psychosocial resilience for American Indian and Hispanic adolescents in contrast to Non-Hispanic White adolescents. Our findings provided evidence for the construct validity of six health-risk behavior dimensions within a large racially/ethnically diverse adolescent sample, which reveal different patterns of loadings, degrees of model fit, and factor inter-correlations across the three racial/ethnic groups. Patterns of covarying risk behaviors differed in strength and direction by racial/ethnic group. Results suggest that interventions should target multiple behaviors and be tailored for different racial/ethnic groups. Targeting health risk and resilience indicators supports the use of multi-level health interventions at the individual, school, family, and community level by identifying individuals based on external resilience scores.
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Affiliation(s)
| | | | | | - Teddy D Warner
- Psychology Department, University of New Mexico
- Dept. of Family & Community Medicine, University of New Mexico, Albuquerque
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Regan C, Fehily C, Campbell E, Bowman J, Faulkner J, Oldmeadow C, Bartlem K. Clustering of chronic disease risks among people accessing community mental health services. Prev Med Rep 2022; 28:101870. [PMID: 35813396 PMCID: PMC9256721 DOI: 10.1016/j.pmedr.2022.101870] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2021] [Revised: 06/19/2022] [Accepted: 06/24/2022] [Indexed: 10/26/2022] Open
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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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Holmes J, Fairbrother H, Livingston M, Meier PS, Oldham M, Pennay A, Whitaker V. Youth drinking in decline: What are the implications for public health, public policy and public debate? THE INTERNATIONAL JOURNAL OF DRUG POLICY 2022; 102:103606. [PMID: 35131690 PMCID: PMC7612362 DOI: 10.1016/j.drugpo.2022.103606] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Revised: 01/21/2022] [Accepted: 01/26/2022] [Indexed: 11/03/2022]
Abstract
Youth drinking has declined across most high-income countries in the last 20 years. Although researchers and commentators have explored the nature and drivers of decline, they have paid less attention to its implications. This matters because of the potential impact on contemporary and future public health, as well as on alcohol policy-making. This commentary therefore considers how youth drinking trends may develop in future, what this would mean for public health, and what it might mean for alcohol policy and debate. We argue that the decline in youth drinking is well-established and unlikely to reverse, despite smaller declines and stabilising trends in recent years. Young people also appear to be carrying their lighter drinking into adulthood in at least some countries. This suggests we should expect large short- and long-term public health benefits. The latter may however be obscured in population-level data by increased harm arising from earlier, heavier drinking generations moving through the highest risk points in the life course. The likely impact of the decline in youth drinking on public and policy debate is less clear. We explore the possibilities using two model scenarios, the reinforcement and withdrawal models. In the reinforcement model, a 'virtuous' circle of falling alcohol consumption, increasing public support for alcohol control policies and apparent policy successes facilitates progressive strengthening of policy, akin to that seen in the tobacco experience. In the withdrawal model, policy-makers turn their attention to other problems, public health advocates struggle to justify proposed interventions and existing policies erode over time as industry actors reassert and strengthen their partnerships with government around alcohol policy. We argue that disconnects between the tobacco experience and the reinforcement model make the withdrawal model a more plausible scenario. We conclude by suggesting some tentative ways forward for public health actors working in this space.
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Affiliation(s)
- John Holmes
- School of Health and Related Research, University of Sheffield, 30 Regent Street, Sheffield, S1 4DA, UK.
| | - Hannah Fairbrother
- Health Sciences School, University of Sheffield, Barber House, 387 Glossop Road, Sheffield, S10 2HQ, UK
| | - Michael Livingston
- National Drug Research Institute and enAble Institute, Faculty of Health Sciences, Curtin University, Perth, WA 6008, Australia; Centre for Alcohol Policy Research, La Trobe University, Bundoora, Victoria, 3803, Australia
| | - Petra Sylvia Meier
- School of Health and Related Research, University of Sheffield, 30 Regent Street, Sheffield, S1 4DA, UK; MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, 99 Berkeley Square, Glasgow, G3 7HR, UK
| | - Melissa Oldham
- School of Health and Related Research, University of Sheffield, 30 Regent Street, Sheffield, S1 4DA, UK; Department of Behavioural Science and Health, University College London, 1-19 Torrington Place, London, WC1E 7HB, UK
| | - Amy Pennay
- Centre for Alcohol Policy Research, La Trobe University, Bundoora, Victoria, 3803, Australia
| | - Victoria Whitaker
- Health Sciences School, University of Sheffield, Barber House, 387 Glossop Road, Sheffield, S10 2HQ, UK
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11
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Reyes BD, Hargreaves DS, Creese H. Early-life maternal attachment and risky health behaviours in adolescence: findings from the United Kingdom Millennium Cohort Study. BMC Public Health 2021; 21:2039. [PMID: 34749702 PMCID: PMC8577004 DOI: 10.1186/s12889-021-12141-5] [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: 06/11/2021] [Accepted: 10/27/2021] [Indexed: 11/29/2022] Open
Abstract
Background Early uptake of multiple risky behaviours during adolescence, such as substance use, antisocial and sexual behaviours, can lead to poor health outcomes without timely interventions. This study investigated how early-life maternal attachment, or emotional bonds between mothers and infants, influenced later risky behaviours in adolescence alongside other potential explanatory pathways using the United Kingdom Millennium Cohort Study. Methods Total maternal attachment scores measured at 9 months using the Condon (1998) Maternal Postnatal Attachment Scale compared higher and lower attachment, where mothers in the lowest 10th percentile represented lower attachment. Multiple risky behaviours, defined as two or more risky behaviours (including smoking cigarettes, vaping, alcohol consumption, illegal drug use, antisocial behaviour, criminal engagement, unsafe sex, and gambling), were scored from 0 to 8 at age 17. Five multivariate logistic regression models examined associations between maternal attachment and multiple risky behaviours among Millennium Cohort Study members (n = 7796). Mediation analysis sequentially adjusted for blocks of explanatory mechanisms, including low attachment mechanisms (multiple births, infant prematurity, sex, breastfeeding, unplanned pregnancy and maternal age at birth), maternal depression, and social inequalities (single-parent status, socioeconomic circumstance by maternal education and household income) at 9 months and poor adolescent mental health at 14 years. Results Children of mothers with lower maternal attachment at 9 months had 23% increased odds of multiple risky behaviours at 17 years (OR: 1.23, 95% CI: 1.00–1.50) in the unadjusted baseline model. All five explanatory blocks attenuated baseline odds. Low attachment mechanisms attenuated 13%, social inequalities 17%, and poor mental health 17%. Maternal depression attenuated the highest proportion (26%) after fully adjusting for all factors (30%). Conclusions Lower maternal attachment in early life predicted increased adolescent multiple risky behaviours. Almost a third of the excess risk was attributable to child, maternal and socioeconomic factors, with over a quarter explained by maternal depression. Recognising the influence of early-life risk factors on adolescent health could innovate current policies and interventions addressing multiple risky behaviour uptake affecting health inequalities across the life course. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-021-12141-5.
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Affiliation(s)
- Beatrice D Reyes
- Department of Primary Care and Public Health, School of Public Health, Imperial College London, W6 8RP, London, UK.
| | - Dougal S Hargreaves
- Department of Primary Care and Public Health, School of Public Health, Imperial College London, W6 8RP, London, UK
| | - Hanna Creese
- Department of Primary Care and Public Health, School of Public Health, Imperial College London, W6 8RP, London, UK
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Champion KE, Chapman C, Gardner LA, Sunderland M, Newton NC, Smout S, Thornton LK, Hides L, McBride N, Allsop SJ, Mills K, Kay-Lambkin F, Teesson M, Slade T. Lifestyle risks for chronic disease among Australian adolescents: a cross-sectional survey. Med J Aust 2021; 216:156-157. [PMID: 34747039 DOI: 10.5694/mja2.51333] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2021] [Revised: 07/21/2021] [Accepted: 08/02/2021] [Indexed: 01/31/2023]
Affiliation(s)
- Katrina E Champion
- The Matilda Centre for Research in Mental Health and Substance Use, University of Sydney, Sydney, NSW
| | - Cath Chapman
- The Matilda Centre for Research in Mental Health and Substance Use, University of Sydney, Sydney, NSW
| | - Lauren A Gardner
- The Matilda Centre for Research in Mental Health and Substance Use, University of Sydney, Sydney, NSW
| | - Matthew Sunderland
- The Matilda Centre for Research in Mental Health and Substance Use, University of Sydney, Sydney, NSW
| | - Nicola C Newton
- The Matilda Centre for Research in Mental Health and Substance Use, University of Sydney, Sydney, NSW
| | - Scarlett Smout
- The Matilda Centre for Research in Mental Health and Substance Use, University of Sydney, Sydney, NSW
| | - Louise K Thornton
- The Matilda Centre for Research in Mental Health and Substance Use, University of Sydney, Sydney, NSW
| | - Leanne Hides
- Centre of Youth Substance Abuse, University of Queensland, Brisbane, QLD.,University of Queensland, Brisbane, QLD
| | - Nyanda McBride
- National Drug Research Institute, Curtin University, Perth, WA
| | - Steve J Allsop
- National Drug Research Institute, Curtin University, Perth, WA
| | - Katherine Mills
- The Matilda Centre for Research in Mental Health and Substance Use, University of Sydney, Sydney, NSW
| | - Frances Kay-Lambkin
- Priority Research Centre for Brain and Mental Health, University of Newcastle, Newcastle, NSW
| | - Maree Teesson
- The Matilda Centre for Research in Mental Health and Substance Use, University of Sydney, Sydney, NSW
| | - Tim Slade
- The Matilda Centre for Research in Mental Health and Substance Use, University of Sydney, Sydney, NSW
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Rodrigues da Silva TP, Matozinhos FP, Gratão LHA, Rocha LL, Vilela LA, de Oliveira TRPR, de Freitas Cunha C, Mendes LL. Coexistence of risk factors for cardiovascular diseases among Brazilian adolescents: Individual characteristics and school environment. PLoS One 2021; 16:e0254838. [PMID: 34280240 PMCID: PMC8289066 DOI: 10.1371/journal.pone.0254838] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2021] [Accepted: 07/02/2021] [Indexed: 11/18/2022] Open
Abstract
Cardiovascular diseases (CVD) share common and modifiable risk factors; among them, unhealthy eating, physical inactivity, alcohol intake and smoking habit. However, these factors are not observed in separate and, most often, they influence each other. Risk factors established during adolescence are highly likely to remain in adult life. The aims of the current study were to evaluate the prevalence and coexistence of risk factors for CVD, as well as to investigate individual characteristic of the adolescent and environmental factors associated with risk factors' coexistence profiles. This was a cross-sectional, national, school-based epidemiological study that estimated the prevalence of cardiovascular risk factors and metabolic syndrome in adolescents aged 12 to 17 years who attended public and private schools located in Brazilian counties with a population of more than 100 thousand. For this study, thematic blocks referring to alcohol consumption, eating habits, smoking, and physical activity were used. The grade of membership method was used to identify the coexistence of risk and protective factors for CVD among adolescents. The study analytical sample comprised 71,552 adolescents. Multilevel logistic regression was used to assess the association between factors influencing the coexistence profile of risk factors for CVD. Based on adolescent-level variables, has shown that meeting positive criterion for Common Mental Disorders and not consuming the meals provided by the school have significantly increased the likelihood of belonging to the CVD-risk profile. On the other hand, school-level variables, show that studying in private schools and living in economically favored Brazilian regions have increased adolescents' likelihood of belonging to the CVD-risk profile. These results can be used to substantiate the inclusion of food environment variables in public policies focused on preventing CVD development among Brazilian adolescents.
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Affiliation(s)
| | - Fernanda Penido Matozinhos
- Department of Maternal and Child Nursing and Public Health, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | | | - Luana Lara Rocha
- Department of Preventive and Social Medicine, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Luisa Arantes Vilela
- Nutrition Department, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | | | | | - Larissa Loures Mendes
- Nutrition Department, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
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