Fetal, childhood, and adolescence interventions leading to adult disease prevention

Assessing the health information source perceptions of tweens using card-sorting exercises

As young people are increasingly turning to the Internet to meet their information needs, it is imperative to investigate their perceptions regarding various potential sources of health information. A series of card-sorting exercises were administered to new participants in an after-school programme (HackHealth) to find out which sources of health information these greater Washington DC metro area middle school students would turn to, which they would not and their reasons behind these judgements. The findings revealed that participants were very aware of the importance of trustworthiness when looking for health information and they valued both professional expertise based on formal education and expertise born of personal experience with a particular health condition. However, they also valued convenience, ease and speed, and sometimes sacrificed information quality. Some important implications of these findings for healthcare and information professionals are identified and suggestions for future research in this area are offered.

Bit by bit: using design-based research to improve the health literacy of adolescents

BACKGROUND

Although a low health literacy level has been found to be among the most powerful predictors of poor health outcomes, there is very little research focused on assessing and improving the health literacy skills of adolescents, particularly those from socioeconomically disadvantaged backgrounds. The vast majority of existing research focuses solely on reading comprehension, despite the fact that health literacy is actually a multifaceted concept, which entails many different types of skills.

OBJECTIVE

The aim of this paper is to first mine existing literature to identify the many different skills that have been posited to constitute health literacy, and then, using this collection of skills as an overarching structure, to highlight the challenges that disadvantaged youth participating in our HackHealth after-school program encounter as they identify and articulate their health-related information needs, search for health-related information online, assess the relevance and credibility of this information, and manage and make use of it.

METHODS

We utilized the design-based research method to design, implement, and revise our HackHealth program. To collect data regarding HackHealth participants' health literacy skills and associated challenges, we used a variety of methods, including participant observation, surveys, interviews, focus groups, and logging of Web browser activities. We also collected data through specialized instructional activities and data collection forms that we developed for this purpose. Quantitative and qualitative techniques were used to analyze this data, as well as all of the artifacts that each student produced, including their final projects.

RESULTS

We identified the various challenges that the 30 HackHealth participants faced in completing various health-related information activities during the course of the program. Based on these findings, we describe important implications for working with youth from socioeconomically disadvantaged backgrounds, how to assess and improve their health literacy skills, and offer specific recommendations for health literacy instruction aimed at this population.

CONCLUSIONS

With an increased societal focus on health and a shift from viewing patients as passive recipients of medical care to viewing them as active arbiters of their own health, today's youth need to possess an array of health literacy skills to ensure that they can live long and healthy lives. Working with adolescents to help them develop and practice these skills will also help to break the cycle between poor health literacy and poor health outcomes, thereby reducing health disparities and improving the long-term outlook for the health of our nation.

Experiencing sexuality in youth living in Greece: contraceptive practices, risk taking, and psychosocial status

STUDY OBJECTIVE

To assess initiation of sexual activity and contraception methods used among Greek adolescents. To determine the association of adolescents' emotional and behavioral status with their sexual activity.

DESIGN

A descriptive cross-sectional survey was conducted.

SETTING, PARTICIPANTS

The population (N = 1074, age 14-16) consisted of a random sample, stratified according to locality and population density, of 20 public junior high and high schools located in the urban district of Athens, Greece.

INTERVENTIONS

Anonymous self-reported questionnaires were used to assess sexual activity choices and contraception methods. The Youth Self-Report questionnaire was used to evaluate the psychosocial competencies and difficulties of Greek adolescents.

MEASURES

Analyses included frequencies with chi-square tests and multivariate logistic regression analysis.

MAIN OUTCOME

Factors that may influence sexual engagement of Greek adolescents were assessed.

RESULTS

Of the adolescents who completed the questionnaire 21.8% reported having experienced sexual intercourse. The male/female ratio was 3/1 (P < .001) and the mean age of sexual debut was 14.5 ± 0.9 years. Condoms were the most preferred contraceptive method (79.9%), followed by withdrawal (38.9%). Emergency contraception was used by 9.6% of participants. Adolescents with separated, divorced or with a deceased parent, and non-Greek nationality have higher possibility of being sexually active. Adolescents who reported sexual intercourse had significantly higher score of thought problems (β = 1.07, SE = 0.35, P = .002), attention difficulties (β = 0.67, SE = 0.29, P = .022), delinquent behavior problems (β = 2.37, SE = 0.34, P < .001), aggressive behavior (β = 1.97, SE = 0.48, P < .001), and externalizing problems (β = 4.18, SE = 0.78, P < .001).

CONCLUSIONS

Engagement in sexual activities was significantly associated with psychosocial difficulties among adolescents living in Greece.

Chinese new immigrant mothers' perception about adult-onset non-communicable diseases prevention during childhood

Many non-communicable diseases (NCDs) are largely preventable via behaviour change and healthy lifestyle, which may be best established during childhood. This study sought insights into Chinese new immigrant mothers' perceptions about adult-onset NCDs prevention during childhood. Twenty-three semi-structured interviews were carried out with new immigrant mothers from mainland China who had at least one child aged 14 years or younger living in Hong Kong. Interviews were audio taped, transcribed and analysed using a Grounded Theory approach. The present study identified three major themes: perceived causes of adult NCDs, beliefs about NCDs prevention and everyday health information practices. Unhealthy lifestyle, contaminated food and environment pollution were perceived as the primary causes of adult NCDs. Less than half of the participants recognized that parents had responsibility for helping children establish healthy behaviours from an early age to prevent diseases in later life. Most participants expressed helplessness about chronic diseases prevention due to lack of knowledge of prevention, being perceived as beyond individual control. Many participants experienced barriers to seeking health information, the most common sources of health information being interpersonal conversation and television. Participants' everyday information practice was passive and generally lacked awareness regarding early prevention of adult-onset NCDs. Updated understanding of this issue has notable implications for future health promotion interventions.

Adolescents dealing with sexuality issues: a cross-sectional study in Greece

STUDY OBJECTIVE

To evaluate the prevalence of sexual activity and contraception methods used by Greek adolescents. To assess the effect of various factors in the decision making on sexual activity.

DESIGN

A cross-sectional study design was applied. SETTING-PARTICIPANTS: The population (N = 1538) consisted of a random sample, stratified according to locality and population density, of 20 public junior high and high schools located in the urban district of Athens, Greece.

INTERVENTIONS

Anonymous self-completed questionnaires were used to assess sexual practices, contraception methods, and factors affecting sexual activity choices.

MEASURES

Spearman association calculations and chi-square were used, while regression analysis models were also applied.

MAIN OUTCOME

We examined the sexual practices among Greek adolescents, and indicated the psychosocial factors that may influence adolescents' sexual behavior.

RESULTS

16% of the adolescents have had sexual intercourse, while the boy/girl ratio was 3/1 (P < 0.05). Mean age of sexual debut was 14 +/- 1.5 years. An additional 20% have had any other sexual experience at a mean age 13.5 +/- 1.5 years. Although sexually active adolescents generally use condoms (90.6%), only 32% use them properly (at every and throughout sexual contact). At least half of them do not have adequate protection (no method used or unreliable methods applied), while 8.2% of the girls have used emergency contraception. Adolescents with unstable home environment (divorce, recent death, not living with mother) or sexually experienced peers, as well as those that seek sexual education from siblings or friends have higher possibilities of being sexually active.

CONCLUSION

Greek adolescents can be sexually active at a young age and they need sexual education on safe sex practices.

A comparison of weight-related behaviors among high school students who are homeless and non-homeless

BACKGROUND

Previous research has shown that youth who are homeless engage in high-risk behaviors. However, there has been little information published on nutritional and physical activity behaviors in this population, and studies comparing homeless youth in school with their non-homeless peers are scarce. This study compares weight-related risk behaviors of public high school students in Massachusetts based on homeless status.

METHODS

We obtained data from 3264 9th through 12th grade students who participated in the 2005 Massachusetts Youth Risk Behavior Survey. Multivariable logistic regression, controlling for gender, grade, race/ethnicity, and sexual orientation, was performed to assess the relationship between homeless status as defined by the McKinney-Vento Homeless Assistance Act and weight-related indicators. Analyses were weighted and adjusted for the multistage complex sampling design.

RESULTS

Of this sample, 4.2% reported being homeless (n = 152). Higher prevalence of homelessness was found among males, racial/ethnic minorities, sexual minorities, and students who were not in a traditional grade level. The distribution of body mass index was similar among students who were homeless and non-homeless (underweight 4.0 and 3.0%, and overweight 27.1 and 27.1%, respectively). Homeless students were more likely than non-homeless students to report disordered weight-control behaviors including fasting (aOR 2.5, 95% CI 1.4-4.5) and diet pill use (aOR 3.3, 95% CI 1.6-6.9).

CONCLUSIONS

More than 4% of public high school students in Massachusetts meet the federal definition of homelessness. These students are at high risk for disordered weight-control behaviors. Policy decisions at the school, state, and federal levels should make a concerted effort to target these students with social services and nutritional interventions.