Risk and protective factors for noncommunicable chronic diseases in adolescents by race/skin color: National Adolescent School-Based Health Survey

Vaccination coverage according to race or skin color in children born in 2017-2018 in Natal, Rio Grande do Norte, Brazil: a population survey

OBJECTIVE

To analyze vaccination coverage up to 24 months of age according to race/ skin color in the 2017-2018 live birth cohort in Natal, Rio Grande do Norte, Brazil.

METHODS

Population-based survey conducted in 2020 and 2021. Vaccination coverage up to 24 months of age was estimated according to administered, valid and timely doses. Crude association of race/skin color was estimated by calculating the crude Prevalence Ratio and respective 95% Confidence Intervals, using Poisson regression.

RESULTS

Of the 688 children in the selected cohort, there was greater coverage among Black children for administered doses (White 30.5%; Black 47.8%; 95%CI) and valid doses (White 25.8%; Black 40.1%; 95%CI), although without statistical significance, and lower coverage for timely doses, in the full schedule excluding yellow fever (PR = 0.21; 95%CI 0.04;0.90).

CONCLUSION

There was lower timely coverage among Black children compared to White children.

MAIN RESULTS

It was found that racial inequalities and social disparities were reflected in vaccination coverage of Black children in the state of Rio Grande do Norte, showing lower prevalence of timely and full vaccination schedules among those children.

IMPLICATIONS FOR SERVICES

The results demonstrate the need to strengthen equitable public policies and the implementation of practices that seek to improve vaccination coverage, thus reducing racial inequalities in child immunization.

PERSPECTIVES

Health service managers will be able to plan actions and strategies in childhood immunization services, in order to increase vaccination coverage and reduce vaccination hesitancy among Black people and people from lower socioeconomic strata.

Changes in tobacco use and associated factors among Brazilian adolescents: National Student Health Survey

This cross-sectional study used data from Brazil's National Student Health Survey (PeNSE), from 2015 and 2019, to compare consumption of tobacco products among adolescent students in Brazil and identify associated factors. The study variables were current cigarette smoking, use of other tobacco products and use of any tobacco product. Pearson's Chi-square test was used to ascertain associations between the variables; bivariate and multivariate analyses were performed using logistic regression. Cigarette smoking remained stable between 2015 (6.6%) and 2019 (6.8%), but use of any tobacco product increased (from 10.6% in 2015 to 14.8% in 2019), involving particularly hookahs (7.8%) and e-cigarettes (2.8%). Cigarette smoking was greater among adolescents aged 16 and 17, whose skin colour was black or brown, who missed classes without permission, who reported having no friends, displayed other risk factors, such as drinking alcoholic beverages, or who were passive smokers. The prevalence of smoking has increased over the years and is associated with sociodemographic aspects and other health risk behaviour, highlighting the need for lifelong health promotion actions.

Impactos do Bullying na Autoestima e Autoimagem

A aparência física é um dos principais aspectos relacionados à vivência de bullying, violência que pode afetar a autoestima dos envolvidos. Com o objetivo de investigar a ocorrência de bullying motivado por aparência física no período da adolescência e seus impactos no bem-estar de estudantes por meio dos níveis de autoimagem e autoestima, 107 estudantes universitários responderam retrospectivamente a um questionário. Do total, 66,4% apontaram ter sofrido vitimização, destacando-se violências do tipo verbal, relacional e sexual. Peso, formato corporal e cabelo foram os aspectos da aparência física relacionados à ocorrência de violência mais relatados, e 35,1% das mulheres apontaram o gênero. Os participantes obtiveram uma média alta para autoimagem e baixa para autoestima, e aqueles que sofreram bullying apresentaram escores estatisticamente inferiores aos daqueles que não sofreram. São necessários trabalhos de prevenção ao bullying sensíveis às questões de gênero.

Temporal trend of simultaneous risk factors for chronic non-communicable diseases: National School Health Survey 2009, 2012, 2015

OBJECTIVE

To analyze the temporal trend of simultaneous occurrence of behavioral risk factors for chronic non-communicable diseases in Brazilian school adolescents.

METHODS

Ecological time-series study that analyzed data from the three editions of the National Survey of School Health with students in the 9th year of public and private schools. Cluster analysis was performed to identify the simultaneity of the following factors: irregular consumption of fresh or minimally processed foods, regular consumption of processed and ultra-processed foods, insufficient level of physical activity during leisure time, consumption of alcoholic beverages, use of cigarettes and illicit drugs. The cluster trend was tested using simple linear regression.

RESULTS

The sample was composed of 173,310 school adolescents. Sixty-four possible combinations were evaluated, resulting in the formation of six clusters. The grouping formed by all factors showed the highest ratios observed/expected prevalence in the last two years of the series. The highest ratios were observed for combinations in which alcohol and cigarettes were present. These substances integrated five of the six clusters. One of the groups (insufficient level of physical activity during leisure time + consumption of alcoholic beverages + use of cigarettes and illicit drugs) had an upward trend throughout the series.

CONCLUSION

The trend analysis showed four out of six clusters remaining stable throughout the series, which shows that the factors are persistently present among school adolescents.

Contextual Factors and Motor Skills in Indigenous Amazon Forest and Urban Indigenous Children

This study investigated the contextual factors, motor performance, and body mass index across indigenous land children, indigenous urban children, and non-indigenous urban children. A number of 153 children, both sexes (71 girls, 46.4%), from 8 to 10 years were assessed. The Test of Motor Gross Development-3 was utilized. Indigenous land children showed higher motor performance ( η 2 ρ = 0.37 and η 2 ρ = 0.19 locomotor and object control, respectively) than indigenous urban children (p < 0.03) and non-indigenous urban children (p < 0.01); Indigenous urban children showed higher motor performance than non-indigenous urban children (p < 0.01). Body mass index was similar across groups ( η 2 ρ = 0,02; p = 0.15). Motor performance of indigenous land children was explained by the contextual factors that lead to a more active lifestyle, unsupervised free time, and play outside. In urban areas, behavior was similar, and although indigenous urban children kept some play tradition, it was not strong enough to be a protective factor for the motor performance.

Tendência temporal dos fatores de risco simultâneos para doenças crônicas não transmissíveis: Pesquisa Nacional de Saúde do Escolar 2009, 2012, 2015

RESUMO: Objetivo: Analisar a tendência temporal da ocorrência simultânea de fatores de risco comportamentais para doenças crônicas não transmissíveis em adolescentes escolares brasileiros. Métodos: Estudo ecológico de série temporal, que analisou os dados das três edições da Pesquisa Nacional de Saúde do Escolar dos alunos do 9º ano de escolas públicas e privadas. Realizou-se a análise de cluster para a identificação da simultaneidade dos seguintes fatores: consumo irregular de alimentos in natura ou minimamente processados, consumo regular de alimentos processados e ultraprocessados, nível insuficiente de atividade física no lazer, consumo de bebidas alcoólicas, uso de cigarro e de drogas ilícitas. A tendência dos clusters foi testada utilizando-se regressão linear simples. Resultados: A amostra constituiu-se de 173.310 escolares. Sessenta e quatro possíveis combinações foram avaliadas, havendo a formação de seis clusters. O agrupamento formado por todos os fatores apresentou as maiores razões entre prevalências observadas e esperadas para os dois últimos anos da série. As maiores razões foram verificadas para as combinações em que estavam presentes o álcool e o cigarro. Além disso, essas substâncias integraram cinco dos seis clusters. Um dos agrupamentos (nível insuficiente de atividade física no lazer + consumo de bebidas alcóolicas + uso de cigarro e drogas ilícitas) apresentou tendência crescente durante toda a série. Conclusão: A análise de tendência constatou que quatro de seis clusters mantiveram-se estáveis durante toda a série, demonstrando que os fatores continuam presentes de forma persistente entre os adolescentes escolares.

Factors associated with non-frequent breakfast consumption in adolescents (EVA-JF Study)

ABSTRACT Objective To estimate the association of infrequent breakfast consumption with socioeconomic, behavioral, and individual factors in a sample of Brazilian adolescents from public schools. Methods Cross-sectional study with adolescents aged from 14 to 19 from public schools in Juiz de Fora, state of Minas Gerais. The frequency of consumption of breakfast, snacks, soft drinks, industrialized drinks, the usual food consumption, body mass index, body fat percentage, and waist circumference were evaluated. Other socioeconomic, behavioral, and individual data were obtained through questionnaires. Logistic regression analysis and hierarchical selection of variables were used to verify the associated factors. Results The sample consisted of 805 adolescents; 53.4% reported infrequent breakfast consumption. Through hierarchical logistic regression analysis, it was evidenced that the house occupancy status (OR: 0.618; 95%CI: 0.4410.865; p=0.005) was the distal factor associated with infrequent breakfast consumption; the intermediate factors were the consumption of industrialized beverages (OR: 0.658; 95%CI: 0.486-0.890; p=0.007) and percentage of energy from processed foods (OR: 0.935; 95%CI: 0.907-0.964; p<0.001); and the proximal factors were the male gender (OR: 0.696; 95%CI: 0.520-0.932; p=0.0015) and being nonwhite (OR: 1.529; 95%CI: 1.131-2.069; p=0.006). Conclusion Male adolescents who lived in owned houses, with occasional consumption of industrialized beverages and a higher percentage of energy derived from processed foods, had lower chances of infrequent breakfast consumption, while non-white adolescents had higher chances.

Do you think that you eat more than you should? Perception of adolescents from a Brazilian municipality

OBJECTIVES

To estimate the prevalence of the perception of eating more than one should and the associated factors in adolescents, and to analyze differences in dietary indicators according to the perception of overeating.

METHODS

This is a cross-sectional population-based study with a sample of 912 adolescents, participants of a food consumption survey conducted in 2015-2016, in Campinas, SP, Brazil.

RESULTS

The prevalence of the perception of eating more than one should was 35.0%, and higher in those who declared themselves non-white, those who had excess weight, those who had high waist circumference, those who would like to change their weight, those who did something to lose weight, and those who evaluated themselves as fat. The prevalence rates were also higher in those who perceived the quality of their diet as poor, who had higher frequencies of consumption of sweets, soft drinks, cold meats, and lower frequencies of consumption of fruits, raw vegetables, and breakfast up to three times a week. Among those who considered themselves as overeating, higher intakes of energy, carbohydrate, protein, fat, added sugar, and sodium were observed, and prevalence rates of 38.5% for overweight and 66.2% for obesity were identified.

CONCLUSION

The perception of eating more than one should was associated with unhealthy eating practices, the self-assessment of a poor quality diet, dissatisfaction with weight, and inadequate nutritional status. There is a need for further studies to investigate the application of the question "Do you think that you eat more than you should?" as a health behavior indicator.

Risk and protective factors related to domestic violence against Brazilian adolescents

OBJECTIVE

To describe the factors associated with domestic violence against Brazilian adolescents.

METHODOLOGY

Descriptive analysis of the variables and calculation of the prevalence of intrafamily violence reported by the students was performed, followed by multinomial regression with calculation of the adjusted odds ratio to analyze the association between the variables and the outcome investigated.

RESULTS

Black skin color (ORa = 1.9; 95%CI 1.4 - 2.7) and brown (ORa = 1.4; 95%CI 1.0 - 1.9), insomnia (ORa = 1.8; 95%CI 1.4 - 2.4), bullying (ORa = 2.5; 95%CI 1.7 - 3.7) and alcohol consumption (ORa = 1.5; 95%CI 1.1 - 1.9) increased the chances of adolescents suffering an episode of intrafamily violence. Bullying (ORa = 3.9; 95%CI 2.8 - 5.3) and alcohol consumption (ORa = 2.2; 95%CI 1.7 - 2.7) contributed up to 4 times more not to suffer more than one episode of domestic violence. Habits such as eating with family (ORa = 0.7; 95%CI 0.5 - 1.0) and having parents who understand their problems (ORa = 0.6; 95%CI 0.5 - 0,7) proved to be protective factors for intrafamily violence.

CONCLUSION

Intrafamily violence against adolescents is related to family interactions, psychoactive substance use and violence in the school environment. Thus, it reveals the importance of the participation of parents and guardians in the prevention of violence and risk behaviors in the lives of Brazilian adolescents.

Risk Behaviors in Teens with Chronic Kidney Disease: A Study from the Midwest Pediatric Nephrology Consortium

Introduction

There is a paucity of information about risk behaviors in adolescents with chronic kidney disease (CKD). We designed this study to assess the prevalence of risk behaviors among teens with CKD in the United States and to investigate any associations between risk behavior and patient or disease characteristics.

Methods

After informed consent, adolescents with CKD completed an anonymous, confidential, electronic web-based questionnaire to measure risk behaviors within five domains: sex, teen driving, alcohol and tobacco consumption, illicit drug use, and depression-related risk behavior. The reference group was composed of age-, gender-, and race-matched US high school students.

Results

When compared with controls, teens with CKD showed significantly lower prevalence of risk behaviors, except for similar use of alcohol or illicit substances during sex (22.5% vs. 20.8%, p=0.71), feeling depressed for ≥2 weeks (24.3% vs. 29.1%, p=0.07), and suicide attempt resulting in injury needing medical attention (36.4% vs. 32.5%, p=0.78). Furthermore, the CKD group had low risk perception of cigarettes (28%), alcohol (34%), marijuana (50%), and illicit prescription drug (28%). Use of two or more substances was significantly associated with depression and suicidal attempts (p < 0.05) among teens with CKD.

Conclusions

Teens with CKD showed significantly lower prevalence of risk behaviors than controls. Certain patient characteristics were associated with increased risk behaviors among the CKD group. These data are somewhat reassuring, but children with CKD still need routine assessment of and counselling about risk behaviors.

[Mortality from suicide in indigenous children in Brazil]

This study aimed to describe the characteristics, distribution, and mortality rates from suicide in indigenous children in Brazil compared to non-indigenous children. This descriptive study covered the years from 2010 to 2014, using national databases. The study collected deaths in individuals 10 to 14 years of age whose underlying cause was "inentional self-inflicted injury". Hanging was the most frequently used means in both indigenous and non-indigenous children, although it was more frequent in the former. Among indigenous children, suicides in hospitals or other healthcare establishments were less common than in non-indigenous. Approximately three-fourths of suicides in indigenous children occurred in just 17 municipalities. The mortality rate from suicide among indigenous children was 11.0/100,000 (8.4-14.3), or 18.5 times higher (10.9-31.6) than in non-indigenous, which was 0.6/100,000 (0.5-0.6), with no differences between boys and girls. This study showed for the first time on a national scale the specific characteristics of suicide in indigenous children, with high rates, and also identified priority areas for interventions.

ADOLESCENTES ESCOLARES: ASSOCIAÇÃO ENTRE VIVÊNCIA DE BULLYING E CONSUMO DE ÁLCOOL/DROGAS

RESUMO Objetivo: estimar a prevalência de alto risco para a vivência de bullying por adolescentes escolares e sua associação com o uso de álcool/drogas. Método: estudo transversal realizado em uma escola pública de Salvador, Bahia, Brasil. A coleta dos dados ocorreu por meio de um formulário padronizado, com 239 adolescentes, entre outubro/2014 e janeiro/2015. Os dados foram processados no Programa Stata versão12. Resultados: o estudo revelou elevada prevalência de alto risco para agressão direta (45,61%), relacional (43,5%) e vitimização (55,23%). Foi identificada associação estatisticamente significante entre o alto risco para agressão direta e o consumo de bebidas alcoólicas, bem como entre o bullying relacional e o consumo de maconha. Conclusão: destaca-se a inter-relação entre a violência escolar e o consumo de álcool e outras drogas, o que demanda o desenvolvimento de ações educativas, no âmbito escolar, para prevenção e enfretamento desses agravos.