Development of a youth survey to measure risk behaviors, attitudes and assets: examining multiple influences

The use of risk homeostasis theory to reduce smartphone use during low-speed driving

Driving while distracted by smartphones is an unsafe behavior and constitutes a serious worldwide road safety issue. In line with the risk homeostasis theory, during high-speed driving, drivers perceive smartphone usage as an unwarranted risk and in most cases refrain from doing so. During low-speed driving, however, drivers often use their smartphones, as they do not perceive this as inherently unsafe, even though it is. The goal of this study was to examine an intervention, based on the risk homeostasis theory, aimed at decreasing the use of smartphones while driving at low speeds. Thirty-seven young drivers participated in the research group that aimed to alter drivers' risk perceptions, decision making, and behavior. The study also included a control group of 33 young drivers. All of the participants' smartphone usage was monitored using a dedicated application that measured both the number of times drivers touched their smartphone screens while driving and the driving speed each time the screen was touched. The results indicate that drivers in the research group decreased their smartphone usage while driving, unlike the control group drivers who did not alter their behavior. In conclusion, a risk homeostasis-based intervention can decrease dangerous and unsafe driving behavior, even when such behavior is not perceived as significantly dangerous. Furthermore, additional types of risky and unsafe driving behaviors may be decreased using this type of intervention.

A contextually adapted model of school engagement in Kazakhstan

This study introduces a culturally adapted 17-item scale of school engagement. It offers an important contribution to the international literature by seeking to measure the school engagement of young people in a society undergoing transition from a collectivist to individualist mind-set alongside an education system focused on improving performance in international benchmarks such as those from the Organisation for Economic Co-operation and Development (OECD Programme for International Student Assessment, PISA) and the International Association for the Evaluation of Educational Achievement (IEA Trends In International Mathematics And Science Study, TIMSS). To date, little has been written on how intra-individual and inter-individual factors contribute to young people’s engagement in education as societal and systemic educational reform occurs. The school engagement scale is validated by testing the empirical fit of a second-order multidimensional factor model of school engagement taken from the Western literature to large-scale data in Kazakhstan. Culturally relevant features are added such as the strong influence of ‘important others’. The model tested was formed from 1) an individual’s cognitions and behaviours associated with school and 2) the social influences of parents, peers, and teachers. 1767 secondary education students in Kazakhstan participated in the study. Confirmatory analyses supported the hypothesized additional contributory factors to school engagement. Use of the overall model indicated differences in means across gender, grade, school-type, and geographic location to show: (1) higher cognitive engagement for young women; (2) rural students with higher levels of behavioural engagement; and (3) substantial differences in social support by grade and rurality.

Prospective Associations Among Youth Assets and Alcohol, Tobacco, and Other Drug Use in a Hispanic Youth Population

This study’s purpose was to determine whether specific youth assets (conceptualized as influencing health behavior at the individual, family, or community level) were prospectively associated with reduced alcohol, tobacco, and other drug use (ATD) in a sample of Hispanic youth. A longitudinal community-based study was conducted with five waves of data collected annually over 4 years. Participants were Hispanic youth (14.1 years old; 53% female) and their parents ( N = 306 youth/parent pairs). Generalized linear mixed models were used to determine the prospective influence of 17 youth assets on ATD over five waves of data. Results indicated that Hispanic youth with three of seven individual-level assets (e.g., educational aspirations), any of four family-level assets (e.g., family communication), or with one of six community-level assets (e.g., positive peer role models) were significantly less likely to engage in ATD. The results suggest that assets protect Hispanic youth from ATD and that family-level assets may be particularly important.

Examining the role of youth empowerment in preventing adolescence obesity in low-income communities

INTRODUCTION

Youth empowerment programs have increasingly gained attention in public health as emphasis shifts on children and adolescents as decision makers in their health and well-being. Adolescence obesity is among the public health concerns that require more active engagement at individual and community level while empowering adolescents to take charge of their own health. This study examines the influence of youth empowerment on nutritional and physical activity factors associated with adolescence obesity.

METHODS

Data were gathered through a self-administered survey among adolescents (N = 410) ages 11-15 years in three U.S. States - Kansas, Ohio and South Dakota.

RESULTS

Findings show that youth empowerment significantly influences adolescents' self-efficacy, perceptions for healthy food choice, healthy eating, attitudes towards physical activity and the overall motivation for health. Gender differences exist in adolescents' self-efficacy for physical activity whereas ethnicity played a role in perceived youth empowerment and perceived barriers to healthy eating. Age was also a significant contributor in efficacy for healthy food choice and perception of healthy food availability.

CONCLUSIONS

This study suggests more focus on youth empowerment in interventions that seek to reduce obesity and improve adolescents' overall health by creating environments where they can play a more active decision-making role. With empowerment, adolescents are more likely to be motivated to adopt healthier dietary habits and engage more in physical activity. Further research would establish the impact of youth empowerment on obesity reduction and other public health problems that impact children across ages.

The Efficacy of an American Indian Culturally-Based Risk Prevention Program for Upper Elementary School Youth Residing on the Northern Plains Reservations

Culturally-based risk behavior prevention programs for American Indian elementary school children are sparse. Thus a group of American Indian educators collaborated in the creation of a program that helps children make healthy decisions based on their cultural and traditional value system. In this paper the effectiveness of Lakota Circles of Hope (LCH), an elementary school culturally-based prevention program was studied and evaluated. Three cohorts of fourth and fifth graders participated in a mixed methods quasi-experimental evaluative research design that included focus groups and surveys prior to and following the intervention. Five research questions regarding the program's impact on students' self-esteem and self-efficacy, Lakota identity, communication, conflict resolution and risk behaviors were addressed in this study. Participants were compared to non-participants in three American Indian reservation school sites. Educators completed a survey to record their observations and feedback regarding the implementation of the program within their respective school sites. The study provides preliminary evidence that, when delivered with fidelity, LCH contributes to statistically significant changes in risk behaviors, Lakota identity, respect for others, and adult and parent communication. A two-way multivariate analysis of variance with post hoc analysis of data collected from the LCH participants (N = 1392) were used to substantiate a significant increase in respect for others and a decrease in risk behaviors which included alcohol, tobacco, and substance use at the 0.10 alpha level. Significant positive improvements in parent and adult communication and an increased Lakota identity at the 0.01 alpha level were obtained. There were no significant differences in self-esteem and conflict resolution from pre to post intervention and in comparison with non LCH participating students.

Psychological empowerment of NGO women in Iran: Designing a tool

Background

As the core of health promotion, proper assessment of empowerment is a base for planning for a process that increases people’s control on their decisions, lifestyle, and effective activities for their health.

Objective

To design and develop a special tool to assess the empowerment of NGO women in Iran.

Methods

This successive exploratory study of combinational type was conducted in 2015 in two steps. In the first step, using comments of participants and the help of authentic texts related to this field, dimensions of psychological empowerment were developed. In the second step, psychometric properties of the scale or tool were determined using formal content, and structural validity and reliability were determined using internal consistency and stability via SPSS version 21.

Results

In the first step, the initial tool including 58 items was developed in the form of eight domains. In the second step, based on exploratory factor analysis (EFA), the number of items was reduced to 37. Considering the eigenvalues of higher than one, items were classified into eight factors. KMO index was 0.896 in this study. Reliability of the tool was 0.81 using Cronbach’s alpha. This tool is able to predict 66.1% of total changes in psychological empowerment.

Conclusion

A questionnaire with relevant reliability and validity, including eight domains of participation, motivation, cognitive thinking, critical thinking, self-efficacy, intention, perceived control and social support was developed to measure psychological empowerment of NGO women in Iran.

The representation of risk in routine medical experience: what actions for contemporary health policy?

Background

The comprehension of appropriate information about illnesses and treatments, can have beneficial effects on patients’ satisfaction and on important health outcomes. However, it is questionable whether people are able to understand risk properly.

Aim

To describe patients’ representation of risk in common medical experiences by linking such a representation to the concept of trust. A further goal was to test whether the representation of risk in the medical domain is associated to the level of expertise. The third goal was to verify whether socio-demographic differences influence the representation of risk.

Methods

Eighty voluntary participants from 6 health-centers in northern Italy were enrolled to conduct a semi-structured interview which included demographic questions, term-associations about risk representation, closed and open questions about attitudes and perception of risk in the medical context, as well as about medical expertise and trust.

Results

The results showed that people do not have in mind a scientific definition of risk in medicine. Risk is seen as a synonym for surgery and disease and it is often confused with fear. However, general knowledge of medical matters helps people to have a better health management through risk identification and risk information, adoption of careful behaviors and tendency to have a critical view about safety and medical news. Finally, trust proved to be an important variable in risk representation and risk and trust were correlated positively.

Conclusions

People must receive appropriate information about the risks and benefits of treatment, in a form that they can understand and apply to their own circumstances. Moreover, contemporary health policy should empower patients to adopt an active self-care attitude. Methodologies to enhance people’s decision-making outcomes based on better risk communication should be improved in order to enable low literacy population as well elderly people to better understand their treatment and associated risk.

Beyond prevention: promoting healthy youth development in primary care

Training primary care providers to incorporate a youth development approach during clinical encounters with young people represents an opportunity to integrate public health into primary care practice. We recommend that primary care providers shift their approach with adolescents from focusing on risks and problems to building strengths and assets. Focusing on strengths rather than problems can improve health by fostering resilience and enhancing protective factors among adolescents. A strength-based approach involves intentionally assessing and reinforcing adolescents' competencies, passions, and talents, as well as collaborating with others to strengthen protective networks of support for young people. Training programs should incorporate interactive strategies that allow clinicians to practice skills and provide tools clinicians can implement in their practice settings.

Perceptions of social support, empowerment and youth risk behaviors

This study examined the association of perceived social support and community empowerment among urban middle-school students living in Matamoros, Mexico and the risk behaviors of fighting, alcohol and tobacco use, and sexual activity. Middle school students (n = 1,181) from 32 public and private Mexican schools were surveyed. Weighted multiple logistic regression analyses were conducted. Among girls, lack of parent/teacher interactions regarding school increased odds for fighting, alcohol and tobacco use. Among boys, lack of empowerment increased odds of alcohol and tobacco use and lack of parent/teacher interactions regarding school increased odds for sexual activity. Community empowerment and perceived social support are uniquely associated with risk behaviors for girls and boys. Additionally, perceived social support from individuals most immediate to the youth are associated with protection against risk for some behaviors, while perceived social support from individuals more removed from youth have mixed association with risk behaviors.

Evaluation of changes in individual community-related empowerment in community health promotion interventions in Estonia

This study assessed changes in community members' ratings of the dimensions of individual community related empowerment (ICRE) before and two years after the implementation of an empowerment expansion framework in three community health promotion initiatives within the Estonian context. We employed a self-administered questionnaire, the adapted mobilisation scale-individual. As the first step, we investigated the multidimensional nature of the ICRE construct and explored the validity and reliability (internal consistency) of the ICRE scale. Two datasets were used. The first dataset comprised a cross-sectional random sample of 1,000 inhabitants of Rapla County selected in 2003 from the National Population Register, which was used to confirm the composition of the dimensions of the scale and to examine the reliability of the dimensions. The second dataset comprised two waves of data: 120 participants from three health promotion programs in 2003 (pre-test) and 115 participants in 2005 (post-test), and the dataset was used to compare participants' pre-test and post-test ratings of their levels of empowerment. The content validity ratio, determined using Lawshe's formula, was high (0.98). Five dimensions of ICRE, self-efficacy, intention, participation, motivation and critical awareness, emerged from the factor analysis. The internal consistency (α) of the total empowerment scale was 0.86 (subscales self-efficacy α=0.88, intention α=0.83, participation α=0.81 and motivation α=0.69; critical awareness comprised only one item). The levels of ICRE dimensions measured after the application of the empowerment expansion framework were significantly more favourable for the dimensions self-efficacy, participation, intention and motivation to participate. We conclude that for Rapla community workgroups and networks, their ICRE was rendered more favourable after the implementation of the empowerment expansion framework.

Sustaining a positive body image in adolescence: an assets-based analysis

The increasing impetus to provide an effective response to childhood obesity has generated a corresponding concern that weight management interventions may lead to emotional problems among young people, notably in relation to the development of a negative body image. However, currently the processes and factors that contribute to the acquisition of body image among young people is poorly understood. Drawing on salutogenic theory, this paper employs an assets-based approach that focuses on health promoting and protective factors to identify how young people may create or sustain positive body images. Secondary data analysis was undertaken from the WHO Health Behaviour in School Aged Children Study. During the spring term of 2002, information was collected from 6425 English adolescents aged 11-15 using a self-administered questionnaire. The data were analysed using stepwise multinomial logistic regression to determine which factors were associated with positive body image; a total of 2898 students were included in the final analysis. Adolescents who self-identified as having a positive body image were more likely to report ease of talking with a father figure, feeling intelligent, perceiving that their family were well off and a belief that their teachers were interested in them as people. Body Mass Index, age, gender and living within a household containing a father were also significant predictors of body image. The discussion provides an exploration of how the construction of young people's emotional health is in part linked with the attainment of a secure and positive body image. The implications for health promotion and educational programmes are then examined. By considering the assets, which support or sustain a positive body image during adolescence, obesity prevention programmes could be better tailored to meet the needs of young people. In the future, a salutogenic curriculum might provide an alternative to unsustainable levels of deficit led, targeted programmes.

Testing the feasibility of developmental asset measures on college students to guide health promotion efforts

The purpose of this investigation was to assess the reliability and validity of eight developmental asset measures among a stratified, random sample (N = 540) of college students to guide health promotion efforts. The sample was randomly split to produce exploratory and confirmatory samples for factor analysis using principal axis factoring and varimax rotation and structural equation modeling techniques. Items were retained on factors if they had high loadings greater than .40 and were not complex. Concurrent validity was examined among substance use (including alcohol and tobacco) and sexual risk-taking variables. Exploratory and confirmatory samples did not differ on demographics. Parallel analysis confirmed the eight theorized constructs. Exploratory factor loadings were greater than .40. Concurrently, validity analyses were in the predicted direction. Cronbach alphas were .70 or greater with the exception of the Future Aspirations asset. Preliminary analyses support the reliability and validity of measuring developmental assets among emerging adults. Implications and potential uses are discussed.

An exploration of the relationship between youth assets and engagement in risky sexual behaviors

PURPOSE

To examine the relationship between specific youth assets and adolescents' engagement in risky sexual behaviors, as measured by an Aggregate Sexual Risk score, and to specifically explore which youth assets and demographic variables were predictive of youth engagement in risky sexual intercourse.

METHODS

A total of 2108 sexually active high school students attending public high schools in a southern state completed a self-report questionnaire that measured youth assets. Based upon responses to items measuring risk behaviors, an Aggregate Sexual Risk score was calculated for each student. Unconditional logistic regression and multivariate logistic regression analyses were conducted to examine the relationships between the assets and the Aggregate Risk Score. Four separate analyses (white females, white males, black females, and black males) were conducted.

RESULTS

In general, the patterns in all four groups indicated that students who had an Aggregate Risk Score of > or = 3 (high risk) possessed less of the measured youth assets. The assets that were most significantly associated with engagement in risky sexual behaviors included self peer values regarding risky behaviors, quantity of other adult support, and youths' empathetic relationships. Thus, students who reported not having these assets were significantly more likely to engage in the risky sexual behaviors.

CONCLUSIONS

Results underscore the relationship of specific youth assets to sexual risk behaviors. Health researcher and practitioners who work to prevent teen pregnancy and sexually transmitted infections among teenagers need to understand and acknowledge these factors within this population so that the assets can be built or strengthened.