The objective of this study was to explore gender differences in the prevalence of silent and clinical apparent cardiovascular risk factors among adolescents in Aseer Region, southwestern Saudi Arabia.
Materials and methods
A cross-sectional study on a stratified sample of 1869 adolescents was carried out. They were interviewed and examined for weight and height, systolic and diastolic blood pressure using standardized techniques.
The study revealed high prevalence of some potential behavioral and biological cardiovascular diseases (CVD) risk factors among adolescent males and females in the study area. Behavioral risk factors included inadequate low consumption of fruits and vegetables, physical inactivity, and smoking. Physical inactivity was significantly more prevalent among females than males (42.9% and 25.7%, respectively). Smoking was significantly more among females than males (11.8% and 1.3%, respectively). Biological risk factors found were family history of CVD, obesity and high blood pressure. Obesity was significantly prevalent among females (29.4%) compared to males (20.6%). Males had significantly more high blood pressure than females. In logistic regression analysis, being male (aOR = 2.992, 95% CI = 1.933–4.742) and obesity (aOR = 2.995, 95% CI = 2.342–3.991) were found to be significant risk factors in developing high blood pressure among adolescents in the region.
Presence of cardiovascular risk factors among adolescents is a public health problem in the region. There is a need for a national program in the country to prevent and control cardiovascular risk factors among adolescents.
Cardiovascular risk factors; Adolescents; Saudi Arabia
The primary aim of the study was to calculate the prevalence of some of the health risk associated behavior like insufficient amount of exercise, cigarette smoking, alcohol intake, illicit drug use, driving below age of 18, and illegal sexual practices among the Saudi adolescents in Riyadh city. The second was to study the association between cigarette smoking and the above behaviors.
Material and Methods:
It was a cross-sectional survey with 1473 Saudi adolescents, 852 males (57.8%) and 621 females (42.2%) aged 11 to 21 years attending the selected 10 Primary Health Care Centers (PHCCs) were invited to complete a 23-item questionnaire. Part of the questionnaire was used to measure the frequency of some adolescent behavior. These questionnaires were collected within a period of one month from 15 May to 15 June 1998. The PHCCs were selected randomly in Riyadh city.
The prevalence of cigarette smoking was 12.7%, males smoking more than females (19.0% vs. 4.0%); male smokers exercised significantly less than nonsmokers (p<0.025). Only 4.5% of the sample reported alcohol use, 6.4% reported illicit drug use, and 8.0% reported illegal sexual practice. There is a statistically significant association between smoking and other risk behavior. It was found that 41.1% of males below the age of 18 drive a car, and 45.1% of the study sample that drive had a car accident.
The prevalence of illicit drug use, alcohol intake, and illegal sex in Riyadh city is much less than in the west. Cigarette smoking is an antecedent to more negative behavior. Antismoking programs including the prevention of the sale and use of cigarettes in public places are needed to decrease its prevalence. The application of firm traffic laws is also essential.
Saudi adolescents; primary health care centers; behaviours
Sexually transmitted infections constitute the main health risk among adolescents. In developing countries the diagnosis and treatment of cervical infections is based on the syndromic approach. In this study we estimated the prevalence of Chlamydia trachomatis and Neisseria gonorrhoeae among female adolescents from a Health Sector of the city of Goiânia, Brazil, and validated cervicitis diagnosis using World Health Organization/Ministry of Health risk score and gynecological examination.
A cross-sectional community-based sample of 914 15- to 19-year-old female teenagers was randomly selected and referred to the local Family Health Program. Of these, 472 (51.6%) were sexually active and gynecological examinations were carried out for 427. Endocervical samples were collected to perform the polymerase chain reaction for C. trachomatis and N. gonorrhoeae. Performance of risk score, the presence of mucopurulent discharge, friability, ectopia and pain during cervical maneuver were compared with the presence of C. trachomatis or N. gonorrhoeae or both.
The prevalence of C. trachomatis and N. gonorrhoeae was 14.5% and 2.1%, respectively. The risk score had a specificity of 31.9% (95% confidence interval, 21.2 to 44.2) and a positive predictive value of 20.8% (95% confidence interval, 13.5 to 29.7). Friability was the component of the gynecological examination that presented the best performance with a sensitivity of 43.5%, specificity of 81.0%, and 30.6% of positive predictive value.
The prevalence of infection by C. trachomatis and N. gonorrhoeae was high among these sexually active adolescents. The syndromic approach is clearly inadequate for screening and treating these infections in this population. Therefore, the implantation of other strategies to control these infections among adolescents is urgently required.
When toxoplasmosis is acquired during pregnancy, it can be transmitted to the fetus causing severe lesions in the first two gestational trimesters. This study analyzed the main factors associated with the preventive behavior for toxoplasmosis among pregnant adolescents in the city of Fortaleza in northeast Brazil.
It is a cross-sectional study conducted from March 2009 to November 2010, with a sample of 320 pregnant adolescents, ages ranging from 12 to 19 years old, receiving prenatal care in the Public Health Care System. Bivariate and multivariate logistic regression model analyses were used to identify the association between preventive behavior for toxoplasmosis, and the independent variables and 95% confidence interval.
We observed that 16.3% of the pregnant adolescents showed preventive behavior for toxoplasmosis. The factors positively associated to the preventive behavior for toxoplasmosis were: age group between 12 and 14 years old (OR = 2.75; 95%CI 1.23-6.12) and more than two prenatal consultations (OR = 2.19; 95%CI 1.17-4.09).
Noteworthy is the importance of a serologic follow-up for pregnant adolescents with clearer and more precise information about risk factors and the importance of adopting preventive behaviors. Thus, it is necessary to establish educational measures for handling food and raising kittens during prenatal care.
Adolescent smoking problem has still remained as a public health concern, but factors that attributing to the initiation of adolescent smoking are not well known in Iran.
The aim of this study is to estimate the prevalence of smoking, and its associations among high school male adolescents in Iran, in the context of the theory of planned behavior (TPB).
Patients and Methods
This was a cross-sectional study involving male adolescent students (high school) in the city of Zarandieh, Iran. A multiple-stage sampling protocol was used. The participants completed an anonymous, voluntary, and self-report questionnaire. Prevalence was estimated, and demographic variables, psychological factors, and the theory of planned behavior components were used to indicate factors contributing to adolescents’ cigarette smoking.
In all, 365 students were entered the study. The mean age of respondents was 16.49 ± 1.11 years. The prevalence of current smoking was 15.1%. The result obtained from logistic regression analysis revealed that all theory of planned behavior (TPB) components [knowledge (OR = 0.75; 95% CI: (0.59-0.97), attitude (OR = 0.75; 95% CI: (0.65-0.86), self-efficacy (OR = 0.82; 95% CI: (0.71-0.95), subjective norms (OR = 0.84; 95% CI: (0.72-0.98)] were significant predating factors for adolescents smoking habits. In addition, having parents who smoke (OR = 4.75; 95% CI: (1.38-12.35), smoking friends (OR = 3.76; 95% CI: (1.20-11.76), and smoking siblings (OR = 4.21; 95% CI: (1.17-11.16) were significant contributing factors to adolescents’ cigarette smoking behavior.
The results showed that the prevalence of cigarette smoking in adolescents was high, and the theory of planned behavior (TPB) components were significant predictors of cigarette smoking. It seems that interventions targeting adolescents’ smoking habits might benefit using the TPB model.
Assess whether adolescent health risk behaviors cluster, and whether resiliency factors are associated with observed clusters.
The cross-sectional population-weighted 2003 California Health Interview Survey was used (N=4010). Four gender-specific clusters were based on smoking, alcohol use, low fruit/vegetables consumption, and physical inactivity. Resiliency factors included parental supervision, parental support, role model presence and adolescent mental health. Conditional regression was used to measure the association of individual health risk behaviors and clusters with resiliency factors.
Health risk behaviors clustered as follows: “Salutary Adherents” (no reported health risk behaviors), “Active Snackers” (physically active, low fruit/vegetable consumers), “Sedentary Snackers” (physically inactive, low fruit/vegetable consumers), and “Risk Takers” (smokers, alcohol users, many also physically inactive and low fruit/vegetable consumers). Greater parental supervision was associated with lower odds of being in unhealthful clusters. Among males, having greater parental support reduced odds of being an “Active Snacker” or “Sedentary Snacker.” Among females, role model presence reduced odds of being in unhealthful clusters, while depressiveness increased the odds.
Health promoting interventions should address multiple health risk behaviors in an integrated fashion. Gender-specific, ethnically-targeted, family-centered strategies that address parenting, particularly parental supervision would be useful. Addressing depressiveness may be especially important for female adolescents.
tobacco; alcohol; nutrition; physical activity; resilience; lifestyle; clusters
Adolescence is a time in which individuals are particularly likely to engage in health-risk behaviors, with marijuana being the most prevalent illicit drug used. Perceptions of others’ use (i.e., norms) have previously been found to be related to increased marijuana use. Additionally, low refusal self-efficacy has been associated with increased marijuana consumption. This cross-sectional study examined the effects of normative perceptions and self-efficacy on negative marijuana outcomes for a heavy using adolescent population. A structural equation model was tested and supported such that significant indirect paths were present from descriptive norms to marijuana outcomes through self-efficacy. Implications for prevention and intervention with heavy using adolescent marijuana users are discussed.
marijuana; adolescent substance abuse; social norms; social learning theory
The study presents a geographical analysis of dental trauma in a population of 12 and 15 year-old school-children, in the city of Curitiba, Brazil (n = 1581), using a database obtained in the period 2005-2006. The main focus is to analyze dental trauma using a geographic information system as a tool for integrating social, environmental and epidemiological data.
Geostatistical analysis of the database and thematic maps were generated showing the distribution of dental trauma cases according to Curitiba's Health Districts and other variables of interest. Dental trauma spatial variation was assessed using a generalized additive model in order to identify and control the individual risk-factors and thus determine whether spatial variation is constant or not throughout the Health Districts and the place of residence of individuals. In addition, an analysis was made of the coverage of dental trauma cases taking the spatial distribution of Curitiba's primary healthcare centres.
The overall prevalence of dental trauma was 37.1%, with 53.1% in males and 46.7% in females. The spatial analysis confirms the hypothesis that there is significant variation in the occurrence of dental trauma, considering the place of residence in the population studied (Monte Carlo test, p = 0,006). Furthermore, 28.7% of cases had no coverage by the primary healthcare centres.
The effect of the place of residence was highly significant in relation to the response variable. The delimitation of areas, as a basis for case density, enables the qualification of geographical territories where actions can be planned based on priority criteria. Promotion, control and rehabilitation actions, applied in regions of higher prevalence of dental trauma, can be more effective and efficient, thus providing healthcare refinement.
The potential synergistic effects of multiple dietary and physical activity behaviours on the risk of chronic conditions and health outcomes is a key issue for public health. This study examined the prevalence and clustering patterns of multiple health behaviours among a sample of adolescents in the UK.
Cross-sectional survey of 176 adolescents aged 12–16 years (49% boys). Adolescents wore accelerometers for seven days and completed a questionnaire assessing fruit, vegetable, and breakfast consumption. The prevalence of adolescents meeting the physical activity (≥ 60 minutes moderate-to-vigorous physical activity/day), fruit and vegetable (≥ 5 portions of FV per day) and breakfast recommendations (eating breakfast on ≥ 5 days per week), and clustering patterns of these health behaviours are described.
Boys were more active than girls (p < 0.001) and younger adolescents were more active than older adolescents (p < 0.01). Boys ate breakfast on more days per week than girls (p < 0.01) and older adolescents ate more fruit and vegetables than younger adolescents (p < 0.01). Almost 54% of adolescents had multiple risk behaviours and only 6% achieved all three of the recommendations. Girls had significantly more risk factors than boys (p < 0.01). For adolescents with two risk behaviours, the most prevalent cluster was formed by not meeting the physical activity and fruit and vegetable recommendations.
Many adolescents fail to meet multiple diet and physical activity recommendations, highlighting that physical activity and dietary behaviours do not occur in isolation. Future research should investigate how best to achieve multiple health behaviour change in adolescent boys and girls.
Increased body weight has been associated with an unhealthy diet, low consumption of fruits and vegetables. Our objective was to investigate whether adolescents had low intake of fruits and vegetables, and whether gender, age and education could affect the feeding patterns.
A population-based sample of adolescents, aged 12–19 years, were randomly selected in southern Brazil and included in this cross-sectional study. The total daily consumption of fruits, vegetables, rice and beans were investigated in standardized household interviews, using a food frequency questionnaire and questions, being categorized as five or more servings per day as the five-a-day diet. ANOVA, ANCOVA, and modified Poisson regression were used in the analysis.
Adolescents (n = 568) were included, 49.5% boys, 14.3% had overweight and 8.8% obesity. Approximately 23% of participants consumed five daily servings of fruits and vegetables. It was observed that 36.7% of boys and 31.0% of girls consumed less than one serving of fruit per day, and 58.4% and 44.6%, respectively, consumed less than one serving of vegetables. The consumption of vegetables, fruits, and rice and beans were not independently associated with gender. Overweight was associated with higher intake of five-a-day, independently of confounding factors.
Adolescents from southern Brazil have lower frequency of consumption of five servings a day of fruits and vegetables combined.
Adolescents; Fruits; Vegetables; Five-a-day; Dietary pattern; Diet
Marijuana use in adolescents is associated with many adverse outcomes, including neurobiological and health consequences. Despite this, little is known about gender differences in the correlates of adolescent marijuana use. This study attempted to fill this gap by examining gender differences in the correlates of lifetime and past 30-day marijuana use. Data from a cross-sectional statewide survey of adolescent risk behavior participation in Connecticut were analyzed using chi-square and hierarchical logistic regression methodologies to examine the demographic, psychosocial and risk behavior correlates of adolescent marijuana use. Gender-by-trait interactions were tested with hierarchical logistic regression. Of the 4523 participants (51.8% female, 75.8% Caucasian), 40.4% endorsed lifetime marijuana use and 24.5% endorsed past 30-day marijuana use. Risk behavior participation, particularly other substance use, had the most robust associations with lifetime and past 30-day adolescent marijuana use; participation in extracurricular activities appeared protective. Gender interactions were observed for African-American, Asian or other race and participation in extracurricular activities; in these three cases, males had a greater likelihood of use. They were also observed for having a job (lifetime use only), with females having elevated odds, and past 30-day cigarette smoking (past 30-day use only), with males having elevated odds. Finally, there was preliminary evidence of a faster transition from initiation of marijuana use to regular use in females, as compared to males. These results indicate important gender differences in the correlates of marijuana use in adolescents, and these findings may facilitate the development of gender-informed prevention and early intervention programs for adolescent marijuana use.
Cannabis; Adolescent; Gender Differences; Risk Behaviors
The aim of this study was to assess the prevalence of alcohol consumption, tobacco use and risky sexual behaviour among adolescents, and to evaluate the socioeconomic factors potentially influencing these behaviours.
This cross-sectional study was conducted from January to April 2011 among 376 adolescents (15–19 years old) studying in different schools and colleges in Udupi, India. The Youth Risk Behavior Survey questionnaire and guidelines were followed for data collection. Participants’ alcohol consumption, smoking habits and sexual behaviour patterns were explored. Univariate analysis followed by multivariate logistic regression was done.
The prevalence of alcohol consumption, tobacco use and sexual activity was found to occur in 5.7%, 7.2% and 5.5% of participants, respectively. The mean age of the participants’ first sexual activity, consumption of alcohol and tobacco use was reported to be approximately 16.8 years. Multivariate analysis showed that males were more likely to have used alcohol and tobacco. Other factors, such as religion and tobacco use among family members, were found to be influential.
The potential coexistence of multiple risk behaviours in a student demands an integrated approach. Emphasis should be placed on health education in schools and an increased awareness among parents in order to prevent adolescents’ behaviours from becoming a risk to their health.
Adolescents; Risk Behaviors; Tobacco; Alcoholic Beverages; Sexual Behavior; India
Multiple health risk behaviors (HRBs) among adolescents pose a threat to their health, including HIV/AIDS. Health risk behaviors such as alcohol use, smoking, substance use, and sexual risk behaviors among youth have been shown to co-occur with each others. The objectives of this study was to estimate the prevalence of single and concurrent health risk behaviors and to explore how health risk behavior is associated with socio-demographic factors and peers' behaviors.
A cross sectional design was used to examine health risk behaviors of adolescents between the age 14 and 19 years living in the Luangnamtha province, Lao PDR. The study was conducted between June and August, 2008. An ordinal logistic regression model that simultaneously explored demographic factors and the influence of the behavior of peers on three categories of multiple HRBs (no risk, one risk, and two or more health risk behaviors) was performed.
A total of 1360 respondents, 669 (49.1%) boys with mean age 16.7 ± 1.6 and 699 (50.9%) girls aged 16.1 ± 1.5 were recruited into the study. The majority reported two or fewer risk behaviors. However, multiple risk behaviors increased with age for both sexes. About 46.8% (n = 637) reported no risk, 39.3 percent (n = 535) reported one risk, 8.1 percent (n = 110) reported two risks, and 5.8 percent reported more than two health risk behaviors.
The protective factors among boys were school attendance (OR = .53, CI = .33-.86), being Hmong and Yao ethnicity (OR = .48, CI-.26-.90), while being above the age of 15 (OR = 2.20, 95% CI = 1.33-3.60), Akha ethnicity (OR = 2.20, 95% CI = 1.04-4.61), peer's smoking (OR = 3.11, 95% CI = 2.1-4.6), and peer's drinking alcohol (OR = 1.88, 95% CI = 1.1-3.21) were significantly associated with the presence of multiple risk behaviors among boys.
Having some education (OR = 0.17, 95% CI = 0.06-0.45), and being of Hmong and Yao ethnicity (OR = 0.38, 95% CI = 0.18-0.80) were factors that protected girls from multiple risk behaviors; while peer's drinking alcohol (OR = 2.55, 95% CI = 1.59-4.09) and peer's being sexually active (OR = 2.82, 95% CI = 1.65-4.8) were significantly associated with the presence of multiple risk behaviors among girls.
There are sex, age and ethnic differences in the concurrent health risk behaviors. The influencing factors are adolescent's education and peer influence. Interventions should focus to encourage adolescents to complete the compulsory primary education as well as help them to establish friendships and follow peers with good behavior. Risk reduction messages need to take account of diverse multiple HRBs within the specific socio-cultural and gender specific context and target vulnerable adolescents such as ethnic minorities and less educated adolescents.
In southern and eastern Mediterranean countries, changes in lifestyle and the increasing prevalence of excess weight in childhood are risk factors for high blood pressure (BP) during adolescence and adulthood. The aim of this study was to evaluate the BP status of Tunisian adolescents and to identify associated factors.
A cross-sectional study in 2005, based on a national, stratified, random cluster sample of 1294 boys and 1576 girls aged 15-19 surveyed in home visits. The socio-economic and behavioral characteristics of the adolescents were recorded. Overweight/obesity were assessed by Body Mass Index (BMI) from measured height and weight (WHO, 2007), abdominal obesity by waist circumference (WC). BP was measured twice during the same visit. Elevated BP was systolic (SBP) or diastolic blood pressure (DBP) ≥ 90th of the international reference or ≥ 120/80 mm Hg for 15-17 y., and SBP/DBP ≥ 120/80 mm Hg for 18-19 y.; hypertension was SBP/DBP ≥ 95th for 15-17 y. and ≥ 140/90 mm Hg for 18-19 y. Adjusted associations were assessed by logistic regression.
The prevalence of elevated BP was 35.1%[32.9-37.4]: higher among boys (46.1% vs. 33.3%; P < 0.0001); 4.7%[3.8-5.9] of adolescents had hypertension. Associations adjusted for all covariates showed independent relationships with BMI and WC: - obesity vs. no excess weight increased elevated BP (boys OR = 2.1[1.0-4.2], girls OR = 2.3[1.3-3.9]) and hypertension (boys OR = 3.5[1.4-8.9], girls OR = 5.4[2.2-13.4]), - abdominal obesity (WC) was also associated with elevated BP in both genders (for boys: 2nd vs. 1st tertile OR = 1.7[1.3-2.3], 3rd vs.1st tertile OR = 2.8[1.9-4.2]; for girls: 2nd vs. 1st tertile OR = 1.6[1.2-2.1], 3rd vs.1st tertile OR = 2.1[1.5-3.0]) but only among boys for hypertension. Associations with other covariates were weaker: for boys, hypertension increased somewhat with sedentary lifestyle, while elevated BP was slightly more prevalent among urban girls and those not attending school.
Within the limits of BP measurement on one visit only, these results suggest that Tunisian adolescents of both genders are likely not spared from early elevated BP. Though further assessment is likely needed, the strong association with overweight/obesity observed suggests that interventions aimed at changing lifestyles to reduce this main risk factor may also be appropriate for the prevention of elevated BP.
Adolescent; Blood pressure; Tunisia; Prevalence; Risk factors
Testis cancer has one of the highest 5-year survival rates of all cancer sites. The survival period is marked by increased risk for secondary cancer and cardiovascular events due to treatment related toxicities. The purposes of this cross-sectional study were to determine the prevalence of health behaviors and depressive symptoms and to assess the relationship between depression and health behaviors.
162 testis cancer survivors 2 to 10 years post-diagnosis completed a one-time phone interview. The interview included a battery of questions from the BRFSS assessing health behaviors (smoking, physical activity, cholesterol screening, colorectal cancer screening, alcohol consumption, and fruit and vegetable intake) as well as the CES-D assessing depressive symptoms.
The interviews revealed low prevalences of health behaviors among testis cancer survivors. The percentage of testis cancer survivors who scored above the cutoff on the CES-D, 17.5%, was higher than large-scale population-based estimates in males aged 19–44, 11%. Smoking was significantly related to depression. Depressive symptoms (CES-D score) differed significantly depending on smoking status (current smokers, M=15.2; former smokers, M=6.2, p<.001; and never smokers, M=8.7, p<.001).
Given the increased risk of cancer and treatment-related morbidities of these survivors, the findings of this study suggest that health care professionals should encourage testis cancer survivors to engage in health behaviors and check for depressive symptoms.
Smoking; cholesterol screening; colorectal cancer screening; alcohol; diet; physical activity; depression; cancer survivor; testicular cancer
Toothache is a dental public health problem and one of the predictors of dental attendance and it is strongly associated with the life quality of individuals. In spite of this, there are few population-based epidemiological studies on this theme. Objective: To estimate the prevalence of toothache and associated factors in adults of Lages, Southern Brazil.
A cross-sectional population-based study was carried out in a sample of 2,022 adults aged 20 to 59 years living in the urban area of a medium sized city in Southern Brazil. A questionnaire including socioeconomic, demographic, smoking, alcohol, and use of dental service variables was applied at adults household. Toothache occurred six months previous of the interview was considered the outcome. Poisson regression analyses were performed following a theoretical hierarchical framework. All analysis was adjusted by the sample design effect.
The response rate was 98.6%. The prevalence of toothache was 18.0% (95% CI 16.0; 20.1). The following variables were associated with toothache after adjustment: female (PR = 1.3 95% CI 1.3; 2.0), black skin colour vs. whites (PR = 1.5 95% CI 1.1, 1.9), low per capita income (PR = 1.7 95% CI 1.2, 2.3), smokers (PR = 1.5 95% CI 1.2, 1.9) and those who reported alcohol problems (PR = 1.4 95% CI 1.1; 1.9). To be 40 years of age (PR = 0.5 95% CI 0.4, 0.7) and use dental service in the last year (RR = 0.5 95% CI 0.4, 0.6) were protective factors for toothache.
The prevalence of toothache in adults of Lages can be considered a major problem of dental public health.
Introduction. Adolescent interpersonal violence is a global public health problem, yet gaps remain in the epidemiologic literature on adolescent violence in low- and middle-income countries (LMIC). Prevalence rates and risk and protective factors reported in high-income countries may be different from those reported in LMICs. Culturally-relevant epidemiologic data is important in efforts aimed at addressing adolescent interpersonal violence in these countries.
Methods. A cross-sectional study of Egyptian adolescent involvement in violent behavior was conducted. Data collected from a 2006 school-based survey initiative were used; participants were adolescents aged 11–17 (N = 5, 249). Some participants were excluded from the dataset due to incomplete data (N = 111) resulting in a final sample of 5,138. Bivariate and logistic regression analyses were run to determine demographic and social variables associated with participation in physical fighting.
Results. Thirty-one percent of adolescents reported being involved in a physical fight. Previously reported risk factors for violent behavior among adolescents such as depressive symptoms (OR = 1.29; CI = 1.11–1.50) and bullying victimization (OR = 2.44; CI = 2.12–2.83) were positively associated with violent behavior in the present study, while the more novel factor of sedentary behavior was also observed as having a positive association with violent behavior (OR = 1.43; CI = 1.21–1.69). Known protective factors such as helpful peers (OR = 0.75; CI = 0.62–0.90) and understanding parents (OR = 0.67; CI = 0.56–0.81) were found to have negative associations with violent behavior in the present study, in addition to the counterintuitive protective effect of having fewer friends (OR = 0.75; CI = 0.60–0.92).
Conclusions. Prevalence rates of adolescent interpersonal violence in Egypt are similar to rates in other LMICs. The high reported rates of depressive symptomatology and bully victimization along with their positive association with physical fighting suggest that interventions aimed at treating and preventing these problems may help mitigate the likelihood of adolescents engaging in violent behavior; involvement in appropriate physical activity in a safe environment may be beneficial as well. More research is needed to understand the observed protective factor of having fewer friends.
Violence; Adolescent behavior; Adolescents; School health
To determine prevalence and correlates of handgun access among adolescents seeking care in an urban Emergency Department (ED) in order to inform future injury prevention strategies.
In this observational cross-sectional study performed in the ED of a large urban hospital, 14- to 18-year-old adolescents completed a computerized survey of risk behaviors. Adolescents seeking ED care (for injury or medical complaint) were approached seven days a week over a 22-month period. Validated measures included measures of demographics, sexual activity, substance use, injury, violent behavior, and handgun access. A logistic regression model predicting handgun access was performed.
A total of 3050 adolescents completed the survey (44% male, 58.9% African American), with 417 (12%) refusing to participate. One-third of the sample (n=1003) reported access to a handgun, and of those 54% were males (n=542). Logistic regression results indicated that older age (AOR: 1.58; 95% CI: 1.30–1.94), African American race (AOR: 1.34; 95% CI: 1.11–1.61), male gender (AOR: 1.99; 95% CI: 1.66–2.37), and being employed (AOR: 1.35; 95% CI: 1.11–1.65), as well as seeking ED care for a medical complaint as compared to intentional injury (AOR: 1.69; 95% CI 1.62–2.50) predicted handgun access. Binge drinking (AOR: 1.75; 95% CI: 1.37–2.27),marijuana use (AOR: 1.93; 95% CI: 1.58–2.36), sexual activity (AOR: 1.64; 95% CI: 1.32–2.02), prior injury by a gun (AOR: 1.80; 95% CI: 1.32–2.46), serious physical violence (AOR: 1.37; 95% CI: 1.13–1.66) and group fighting (AOR: 2.07; 95% CI: 1.68–2.56) also predicted access.
High rates of handgun access were evident among adolescents presenting in an inner city ED, including those seeking care for non injury related reasons. Adolescents with access to handguns were more likely to report risk behaviors and past injury, providing clinicians with an opportunity for injury prevention initiatives.
Injury Prevention and Control; Adolescents; Youth Violence; Emergency Department; Handgun Access
The prevalence of metabolic syndrome (MetS) has increased in developing countries in recent decades. This syndrome, a clustering of metabolic abnormalities, has been correlated to various socioeconomic and behavioral variables. We investigated the prevalence and prevalence ratios (PR) of MetS and related factors in an adult population of the Federal District (FD) of Brazil, which is located in the central region of the country.
A cross-sectional, population-based study conducted in 2007, with 2130 adults (aged 18 years or older) in the FD of Brazil. Metabolic syndrome was defined according to the recently harmonized criteria. The prevalence of MetS and PR were estimated for each sex according to the diagnostic components and the overall contribution of the selected correlates.
The overall prevalence of MetS was 32.0% (95%CI: 28.9–35.2), with no gender difference. The single component with the greatest contribution to the diagnosis of MetS was hypertension in men (PR 5.10, 95%CI: 3.17–8.22) and high waist circumference in women (PR 5.02, 95%CI: 3.77–6.69). The prevalence of MetS increased significantly and progressively with age and excess weight. In women, higher education was protective against MetS (PR 0.66, 95%CI: 0.49–0.89) compared to 8 or less years of education. There was no association between the prevalence of MetS and behavioral variables studied.
This study provides comprehensive and alarming data about the prevalence of MetS among the adult population of Brazil’s FD. The results suggest that reducing education inequalities may be an important public policy goal to improve health outcomes, especially among women.
Metabolic syndrome; Prevalence; Developing country; Education; Brazil
Understanding the correlates of dietary intake is necessary in order to effectively promote healthy dietary behavior among children and adolescents. A literature review was conducted on the correlates of the following categories of dietary intake in children and adolescents: Fruit, Juice and Vegetable Consumption, Fat in Diet, Total Energy Intake, Sugar Snacking, Sweetened Beverage Consumption, Dietary Fiber, Other Healthy Dietary Consumption, and Other Less Healthy Dietary Consumption in children and adolescents.
Cross-sectional and prospective studies were identified from PubMed, PsycINFO and PsycArticles by using a combination of search terms. Quantitative research examining determinants of dietary intake among children and adolescents aged 3–18 years were included. The selection and review process yielded information on country, study design, population, instrument used for measuring intake, and quality of research study.
Seventy-seven articles were included. Many potential correlates have been studied among children and adolescents. However, for many hypothesized correlates substantial evidence is lacking due to a dearth of research. The correlates best supported by the literature are: perceived modeling, dietary intentions, norms, liking and preferences. Perceived modeling and dietary intentions have the most consistent and positive associations with eating behavior. Norms, liking, and preferences were also consistently and positively related to eating behavior in children and adolescents. Availability, knowledge, outcome expectations, self-efficacy and social support did not show consistent relationships across dietary outcomes.
This review examined the correlates of various dietary intake; Fruit, Juice and Vegetable Consumption, Fat in Diet, Total Energy Intake, Sugar Snacking, Sweetened Beverage Consumption, Dietary Fiber, Other Healthy Dietary Consumption, and Other Less Healthy Dietary Consumption in cross-sectional and prospective studies for children and adolescents. The correlates most consistently supported by evidence were perceived modeling, dietary intentions, norms, liking and preferences. More prospective studies on the psychosocial determinants of eating behavior using broader theoretical perspectives should be examined in future research.
Self-medication, often without adult guidance, has been reported to be a
common practice during adolescence. Similar to other preventable health-risk
behaviors initiated in early adolescence, it has become a cause for concern
This study examines the prevalence of self-medication with both prescribed
and non-prescribed (OTC) medications, related health complaints, sources of
drugs, and sources of drug recommendation, and gender differences related to
self-medication among expatriate high school students in the United Arab
A cross-sectional survey was conducted among 324 expatriate students through
a validated, self-administered questionnaire and data was analyzed using
SPSS 19 version. Means and proportions were calculated and Pearson
Chi-square test of significance was used to analyze association among
Majority of the participating students, almost equally distributed by gender,
was aged 16 to 17 years. The period prevalence rate of self-medication with
prescribed and OTC medications were 89.2%, which did not vary with age,
gender, ethnicity or parents’ educational level. The most common sources of
drug and drug recommendation were community pharmacies and parents
respectively. Headache and fever were the common self-medicated conditions
and consequently, analgesics and antipyretics were most commonly used both
in the previous two weeks and the previous year prior to the survey. A high
prevalence of self-medication with antibiotics (53%) and sedative/hypnotics
(27%) was also observed. A female excess emerged for certain health
complaints and use of medicines except for the use of anti-allergic and
This is the first study to explore self-medication practices among high
school students in UAE and provides baseline data critical in creating
awareness about the risks and benefits of self-medication. Health care
providers, educators and parents should be actively involved in health
education strategies for inculcating responsible self-medication practices
in the adolescent population of UAE.
Self Medication; Adolescent; Prevalence; Patient Medication Knowledge; Patient Education as Topic; United Arab Emirates
This study examined the prevalence and correlates of exchanging sex for drugs or money among a nationally representative sample of 13 294 adolescents in the United States.
Data are from the National Longitudinal Study of Adolescent Health, waves I and II. The lifetime prevalence of exchanging sex was estimated and a cross sectional analysis of sociodemographic and behavioural correlates was conducted. Unadjusted odds ratios were obtained.
3.5% of adolescents had ever exchanged sex for drugs or money. Two thirds of these youths were boys. The odds of having exchanged sex were higher for youths who had used drugs, had run away from home, were depressed, and had engaged in various sexual risk behaviours. 15% of boys and 20% of girls who had exchanged sex reported they had ever been told they have HIV or another sexually transmitted infection (STI).
Adolescents with a history of exchanging sex have engaged in other high risk behaviours and may experience poor health outcomes, including depression and HIV/STIs. These findings should help inform strategies to prevent this high risk sexual behaviour and its potential consequences.
sexual behaviour; adolescents; HIV; sexually transmitted infections; substance abuse
Chronic low back pain (CLBP) is a highly disabling morbidity with high social, economic and individual effects. Demographic, occupational and behavioral changes that took place in Brazil over the last decade are related with an increasing burden of chronic conditions. Despite these changes, comparison studies on CLBP prevalence and associated factors, over time are scarce in the literature in general, and unknown in Brazil. The present study compared the CLBP prevalence in a medium sized city in Brazil between the years 2002 and 2010 and examined factors associated with prevalence in 2010.
Two cross-sectional studies with similar methodology were conducted in a medium-sized city in southern Brazil, in 2002 and 2010. 3182 individuals were interviewed in the first study and 2732 in the second one, all adults aged twenty years or more. Those who reported pain for seven weeks or more in the last three months in the lumbar region where considered cases of CLBP.
The CLBP prevalence increased from 4.2% to 9.6% in 8 years. In most of the studied subgroups the CLBP prevalence has at least doubled and the increase was even larger among younger individuals with more years of education and higher economic status.
Increase in CLBP prevalence is worrisome because it is a condition responsible for substantial social impact, besides being an important source of demand for health services.
The underlying mechanisms of overweight and obesity in adolescents are still not fully understood. The aim of this study was to investigate modifiable and non-modifiable correlates of weight status among 1103 Norwegian 11-year-old adolescents in the HEalth in Adolescents (HEIA) study, including demographic factors such as gender and parental education, and behavioral factors such as intake of sugar-sweetened beverages, snacks and breakfast consumption, watching TV and playing computer games, physical activity and sedentary time.
Weight and height were measured objectively, body mass index (BMI) was calculated and International Obesity Task Force cut-offs were used to define weight status. Physical activity and sedentary time were measured by accelerometers. Other behavioral correlates and pubertal status were self-reported by questionnaires. Parental education was reported by the parents on the consent form for their child. Associations were investigated using logistic regressions.
There were gender differences in behavioral correlates of weight status but not for weight status itself. Adolescents with parents in the highest education category had a 46% reduced odds of being overweight compared to adolescents with parents in the lowest education category. Adolescents with parents with medium education had 42% lower odds of being overweight than adolescents with parents with the lowest education category. Level of parental education, breakfast consumption and moderate to vigorous physical activity were positively associated with being normal weight, and time watching TV was positively associated with being overweight for the total sample. Gender differences were detected; boys had a doubled risk of being overweight for every additional hour of watching TV per week, while for girls there was no association.
The present study showed a social gradient in weight status in 11-year-olds. Both breakfast consumption and moderate to vigorous physical activity were inversely associated with weight status. No associations were found between intake of sugar-sweetened beverages and snacks, playing computer games and weight status. Watching TV was positively associated with weight status for boys but not for girls. Interventions are needed to gain more insight into the correlates of change in weight status.
Overweight; Physical activity; Sedentary time; Parental education; Diet; Children; Adolescents
This study describes the food intake of adolescents participating in the 1993 birth cohort from Pelotas, Southern Brazil, according to socioeconomic position. We carried out a cross-sectional analysis of data collected in the 2004-2005 follow-up visit. Food intake in the previous year was evaluated using the Block questionnaire. Socioeconomic status was evaluated based on an assets index, divided into quintiles. Foods with the highest frequency of daily intake were white bread (83%), butter or margarine (74.6%), beans (66.4%) and milk (48.5%). Intake of butter or margarine, bread, and beans was more frequent among poorer adolescents, and the inverse was true for milk. Intake of fruits and vegetables was low in all socioeconomic strata, but particularly low among the poor. In early adolescence, all socioeconomic groups showed high consumption of foods rich in fat and low consumption of foods rich in fiber.
Eating; Food Habits; Socioeconomic Factors; Adolescent; Cohort Studies