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Haddad MR, Sarti FM. Determinants of Inequalities in the Exposure to and Adoption of Multiple Health Risk Behaviors among Brazilian Adolescents, 2009-2019. Eur J Investig Health Psychol Educ 2024; 14:2029-2046. [PMID: 39056650 PMCID: PMC11275622 DOI: 10.3390/ejihpe14070135] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2024] [Revised: 06/26/2024] [Accepted: 07/10/2024] [Indexed: 07/28/2024] Open
Abstract
The occurrence of multiple risk behaviors among adolescents imposes challenges in the context of public policies of health, particularly in low- and middle-income countries. Evidence on the conditions leading to the exposure to and adoption of multiple risk behaviors allows the identification of vulnerable groups of adolescents, and may support the proposition of targeted strategies directed to individuals at risk. Therefore, the aim of this study was to perform a quantitative analysis to identify recent trends in the exposure to and adoption of multiple health risk behaviors among Brazilian adolescents, highlighting individual-, household-, and school-level characteristics linked to inequalities among social groups. The analysis was based on cross-sectional data from the National Student Health Survey (PeNSE), conducted by the Brazilian Institute for Geography and Statistics in 2009, 2012, 2015, and 2019. The trends in the occurrence of multiple risk behaviors among adolescents were estimated according to social strata, allowing the calculation of concentration indexes and their disaggregation into major determinants of inequalities in the exposure and adoption of risk behaviors. The analyses were conducted using a complex survey design to allow representativeness at the population level. The results showed a rise in the incidence of multiple risk behaviors among youngsters in Brazil from 2009 to 2019. Factors influencing inequalities in the exposure to multiple risk behaviors were socioeconomic status and the characteristics of the household and school environments, whilst the adoption of multiple risk behaviors was also influenced by early exposure to multiple risk behaviors. Furthermore, trends in inequalities in the exposure to and adoption of multiple risk behaviors showed an intensification from 2009 to 2019, being initially concentrated among wealthier adolescents, followed by a transition to higher incidence in the lower socioeconomic strata in 2012 and 2015, respectively. The findings underscore the role of support systems for adolescents at risk within the familial and school contexts, whereas strategies of public policies of health based on the strengthening of community ties may require improvements to tackle socioeconomic inequalities in the occurrence of risk behaviors among youngsters.
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Affiliation(s)
- Mariana Rebello Haddad
- Biomedical Center, Department of Integrated Education in Health, Federal University of Espirito Santo, Vitória 29047-185, ES, Brazil
| | - Flavia Mori Sarti
- School of Arts, Sciences and Humanities, University of Sao Paulo, Sao Paulo 03828-000, SP, Brazil;
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2
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Demidenko MI, Huntley ED, Du L, Estor C, Si Y, Wagner C, Clarke P, Keating DP. Individual and Community level Developmental Adversities: Associations with Marijuana and Alcohol Use in Late-Adolescents and Young Adults. J Youth Adolesc 2024; 53:799-813. [PMID: 37848746 PMCID: PMC10923158 DOI: 10.1007/s10964-023-01881-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2023] [Accepted: 09/27/2023] [Indexed: 10/19/2023]
Abstract
Exposure to community and individual level stressors during adolescence has been reported to be associated with increased substance use. However, it remains unclear what the relative contribution of different community- and individual-level factors play when alcohol and marijuana use become more prevalent during late adolescence. The present study uses a large longitudinal sample of adolescents (Wave 1: N = 2017; 55% Female; 54.5% White, 22.3% Black, 8% Hispanic, 15% other) to evaluate the association and potential interactions between community- and individual-level factors and substance use from adolescence to young adulthood (Wave 1 to Wave 3 Age Mean [SD]: 16.7 [1.1], 18.3 [1.2], 19.3 [1.2]). Across three waves of data, multilevel modeling (MLM) is used to evaluate the association between community affluence and disadvantage, individual household socioeconomic status (SES, measured as parental level of education and self-reported public assistance) and self-reported childhood maltreatment with self-reported 12-month alcohol and 12-month marijuana use occasions. Sample-selection weights and attrition-adjusted weights are accounted for in the models to evaluate the robustness of the estimated effects. Across the MLMs, there is a significant positive association between community affluence and parental education with self-reported alcohol use but not self-reported marijuana use. In post hoc analyses, higher neighborhood affluence in older adolescents is associated with higher alcohol use and lower use in younger adolescents; the opposite association is found for neighborhood disadvantage. Consistent with past literature, there is a significant positive association between self-reported childhood maltreatment and self-reported 12-month alcohol and 12-month marijuana use. Results are largely consistent across weighted and unweighted analyses, however, in weighted analyses there is a significant negative association between community disadvantage and self-reported 12-month alcohol use. This study demonstrates a nuanced relationship between community- and individual-level factors and substance use during the transitional window of adolescence which should be considered when contextualizing and interpreting normative substance use during adolescence.
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Affiliation(s)
- Michael I Demidenko
- Department of Psychology, University of Michigan, Ann Arbor, MI, USA.
- Department of Psychology, Stanford University, Stanford, CA, USA.
| | - Edward D Huntley
- Institute for Social Research, University of Michigan, Ann Arbor, MI, USA
| | - Licheng Du
- Institute for Social Research, University of Michigan, Ann Arbor, MI, USA
| | - Caitlin Estor
- Institute for Social Research, University of Michigan, Ann Arbor, MI, USA
| | - Yajuan Si
- Institute for Social Research, University of Michigan, Ann Arbor, MI, USA
| | - Christine Wagner
- Institute for Social Research, University of Michigan, Ann Arbor, MI, USA
| | - Philippa Clarke
- Institute for Social Research, University of Michigan, Ann Arbor, MI, USA
- School of Public Health, University of Michigan, Ann Arbor, MI, USA
| | - Daniel P Keating
- Department of Psychology, University of Michigan, Ann Arbor, MI, USA
- Institute for Social Research, University of Michigan, Ann Arbor, MI, USA
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3
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Rogés J, González-Casals H, Bosque-Prous M, Folch C, Colom J, Casabona J, Drou-Roget G, Teixidó-Compañó E, Fernández E, Vives-Cases C, Espelt A. Monitoring health and health behaviors among adolescents in Central Catalonia: DESKcohort protocol. GACETA SANITARIA 2023; 37:102316. [PMID: 37413897 DOI: 10.1016/j.gaceta.2023.102316] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/13/2023] [Revised: 05/26/2023] [Accepted: 05/30/2023] [Indexed: 07/08/2023]
Abstract
The objective of the prospective cohort study (the DESKcohort project) is to describe and monitor health, health behaviors, and their related factors among 12 and 19-year-old adolescents schooled at centers of Compulsory Secondary Education or post-compulsory secondary education in Central Catalonia, considering social determinants of health. The DESKcohort survey is administered biannually between the months of October and June, and the project has been running for three years. We have interviewed 7319 and 9265 adolescents in the academic years 2019/20 and 2021/22, respectively. They responded a questionnaire created by a committee of experts, that included the following variables: sociodemographic factors, physical and mental health, food, physical activity, leisure and mobility, substance use, interpersonal relationships, sexuality, screen use and digital entertainment, and gambling. The results are presented to educational centers, county councils, municipalities, and health and third sector entities to plan, implement, and evaluate prevention and health promotion actions that address the identified needs.
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Affiliation(s)
- Judit Rogés
- Research Group in Epidemiology and Public Health in the Digital Health context (epi4Health), Departament d'Epidemiologia i Metodologia de les Ciències Socials i de la Salut, Facultat de Ciències de la Salut de Manresa, Universitat de Vic-Universitat Central de Catalunya (UVic-UCC), Manresa, Barcelona, Spain
| | - Helena González-Casals
- Research Group in Epidemiology and Public Health in the Digital Health context (epi4Health), Departament d'Epidemiologia i Metodologia de les Ciències Socials i de la Salut, Facultat de Ciències de la Salut de Manresa, Universitat de Vic-Universitat Central de Catalunya (UVic-UCC), Manresa, Barcelona, Spain
| | - Marina Bosque-Prous
- Research Group in Epidemiology and Public Health in the Digital Health context (epi4Health), Facultat de Ciències de la Salut, Universitat Oberta de Catalunya (UOC), Barcelona, Spain; Research Group in Epidemiology and Public Health in the Digital Health context (epi4Health), Departament de Psicobiologia i Metodologia en Ciències de la Salut, Universitat Autònoma de Barcelona, Bellaterra, Barcelona, Spain.
| | - Cinta Folch
- Centre d'Estudis Epidemiològics sobre les Infeccions de Transmissió Sexual i Sida de Catalunya, Agència de Salut Pública de Catalunya, Barcelona, Spain; CIBER de Epidemiología y Salud Pública (CIBERESP), Spain
| | - Joan Colom
- Subdirecció General d'Addiccions, VIH, Infeccions de Transmissió Sexual i Hepatitis Víriques, Agència de Salut Pública de Catalunya, Barcelona, Spain
| | - Jordi Casabona
- Centre d'Estudis Epidemiològics sobre les Infeccions de Transmissió Sexual i Sida de Catalunya, Agència de Salut Pública de Catalunya, Barcelona, Spain; CIBER de Epidemiología y Salud Pública (CIBERESP), Spain
| | - Gemma Drou-Roget
- Research Group in Epidemiology and Public Health in the Digital Health context (epi4Health), Departament d'Epidemiologia i Metodologia de les Ciències Socials i de la Salut, Facultat de Ciències de la Salut de Manresa, Universitat de Vic-Universitat Central de Catalunya (UVic-UCC), Manresa, Barcelona, Spain; Department of Community Nursing, Preventive Medicine and Public Health and History of Science, Universitat d'Alacant, San Vicente del Raspeig (Alacant), Spain
| | - Ester Teixidó-Compañó
- Research Group in Epidemiology and Public Health in the Digital Health context (epi4Health), Departament d'Epidemiologia i Metodologia de les Ciències Socials i de la Salut, Facultat de Ciències de la Salut de Manresa, Universitat de Vic-Universitat Central de Catalunya (UVic-UCC), Manresa, Barcelona, Spain
| | - Esteve Fernández
- Tobacco Control Unit, WHO Collaborating Center for Tobacco Control, Institut Català d'Oncologia, Barcelona, Spain; Tobacco Control Research Group, Epidemiology and Public Health Programme (EPIBELL), Institut d'Investigació Biomèdica de Bellvitge-IDIBELL, L'Hospitalet de Llobregat, Barcelona, Spain; School of Medicine and Health Sciences, Campus of Bellvitge, Universitat de Barcelona, L'Hospitalet de Llobregat, Barcelona, Spain; CIBER de Enfermedades Respiratorias (CIBERES), Spain
| | - Carmen Vives-Cases
- CIBER de Epidemiología y Salud Pública (CIBERESP), Spain; Department of Community Nursing, Preventive Medicine and Public Health and History of Science, Universitat d'Alacant, San Vicente del Raspeig (Alacant), Spain
| | - Albert Espelt
- Research Group in Epidemiology and Public Health in the Digital Health context (epi4Health), Departament d'Epidemiologia i Metodologia de les Ciències Socials i de la Salut, Facultat de Ciències de la Salut de Manresa, Universitat de Vic-Universitat Central de Catalunya (UVic-UCC), Manresa, Barcelona, Spain; Research Group in Epidemiology and Public Health in the Digital Health context (epi4Health), Departament de Psicobiologia i Metodologia en Ciències de la Salut, Universitat Autònoma de Barcelona, Bellaterra, Barcelona, Spain; CIBER de Epidemiología y Salud Pública (CIBERESP), Spain
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4
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Schelleman-Offermans K, Vieno A, Stevens GWJM, Kuntsche E. Family affluence as a protective or risk factor for adolescent drunkenness in different countries and the role drinking motives play. Soc Sci Med 2022; 311:115302. [PMID: 36113211 DOI: 10.1016/j.socscimed.2022.115302] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2022] [Revised: 08/09/2022] [Accepted: 08/15/2022] [Indexed: 11/28/2022]
Abstract
AIMS Previous research has shown mixed results (positive, negative or no effects) regarding socio-economic disparities in adolescent drunkenness. This study investigates whether family affluence is differently associated with frequency of adolescent drunkenness in traditional countries, at a later diffusion of innovation adopter stage according to the Theory of Diffusions of Innovations by Rogers (2003), compared with more progressive countries at a more advanced stage. Furthermore, we investigated as to whether differences in this association can be explained by differences in adolescent drinking motives. METHODS This study used data from the 2009/2010 survey of the Health Behaviour in School-aged Children (HBSC) study, including 25,566 alcohol-using adolescents aged 11-19 years old from 11 European countries. The Global Innovativeness Index was used to classify countries in progressive or more traditional countries. Multi-level regression analyses and structural equation modelling were conducted. FINDINGS In traditional countries, family affluence showed a positive association with adolescent frequency of drunkenness. A higher endorsement of social (drinking to celebrate an event) and enhancement motives (drinking to increase moods) by adolescents with a higher family affluence mediated this positive association between family affluence and frequency of drunkenness. In progressive countries, family affluence was negatively associated with frequency of drunkenness. In these countries, a higher endorsement of coping drinking motives by adolescents with a lower family affluence mediated this association. CONCLUSION A country's diffusion of innovation stage (i.e., traditional vs. progressive) seems to shape the direction of the association between family affluence and adolescent drunkenness including the psychological pathways that explain these socio-economic inequalities. This is most likely due to a quicker and smoother adoption of the new 'low drunkenness norms' ('it is not cool to drink to get drunk') in progressive countries and among adolescents with a higher family affluence.
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Affiliation(s)
- Karen Schelleman-Offermans
- Department of Work and Social Psychology, Maastricht University, PO Box 616, 6200, MD, Maastricht, the Netherlands.
| | - Alessio Vieno
- Department of Developmental and Social Psychology, University of Padova, Via Venezia 8, 35131, Padova, Italy.
| | - Gonneke W J M Stevens
- Department of Interdisciplinary Social Science, Faculty of Social and Behavioural Sciences, Utrecht University, Padualaan 14, 3584 CH, Utrecht, the Netherlands.
| | - Emmanuel Kuntsche
- Centre for Alcohol Policy Research (CAPR), La Trobe University, 360 Collins Street, Melbourne, Australia.
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5
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Romero-Rodríguez E, Amezcua-Prieto C, Morales-Suárez-Varela M, Pérez CA, Mateos-Campos R, Marcos-Delgado A, Ortíz-Moncada R, Martín SR, Rodríguez-Reinado C, Delgado-Rodríguez M, Abellán GB, Molero JA, Martín-Peláez S, Cancela-Carral JM, Valero Juan LF, Martínez-Ruiz V, Fernández-Villa T. Alcohol use and family-related factors among Spanish university students: the unHicos project. BMC Public Health 2022; 22:1573. [PMID: 35982433 PMCID: PMC9389699 DOI: 10.1186/s12889-022-13900-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2021] [Accepted: 07/18/2022] [Indexed: 11/12/2022] Open
Abstract
Background During adolescence and youth there are relevant changes in the consolidation, gain or loss of consumption habits and lifestyles and the family factors has a fundamental role to development these habits. The study of the consumption of toxins, such as alcohol intake, is crucial at this stage due to the repercussions that said consumption presents in adulthood. Therefore, the objective of our study was to evaluate the associations between alcohol consumption patterns and related family factors (family functioning, family history of alcohol consumption) in Spanish university students. Methods Observational, descriptive, cross-sectional, multicenter study, carried out in first-year university students from 11 Spanish universities. Through an online questionnaire, alcohol consumption (risky consumption and intensive consumption or binge drinking), family functioning and history of alcohol in the family were evaluated. Risky alcohol consumption and binge drinking were assessed using the AUDIT test, and family functioning was assessed using the family APGAR questionnaire. A descriptive analysis of the data was performed, as well as the Chi-Square test and Student's T-Test, and non-conditional logistic regression models were carried out to examine this association. Results The prevalence of risky alcohol consumption identified in the 10,167 respondents was 16.9% (95% CI = 16.2–17.6), and that of BD was 48.8% (95% CI = 47.9–48.8). There is a significant association between risky alcohol consumption and family functioning in students of both sexes, with greater consumption in the face of severe dysfunctional support (men OR = 1.72; p < 0.001 and women OR = 1.74; p < 0.001) and family history of consumption (p = 0.005). Regarding the binge drinking pattern, no statistically significant differences were observed. Conclusions Risky alcohol consumption in university students is associated with dysfunctional family support, unlike the binge drinking pattern, where there is no such association. The findings of this study show the importance of creating prevention programs focused on the family approach in university students, which include alcohol screening in the population with a family history of this substance, and greater social support from health services. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-022-13900-8.
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Affiliation(s)
- Esperanza Romero-Rodríguez
- Maimonides Biomedical Research Institute of Cordoba / Reina Sofia University Hospital / University of Córdoba, Córdoba, Spain
| | - Carmen Amezcua-Prieto
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBER Epidemiología Y Salud Pública-CIBERESP), Madrid, Spain.,Department of Preventive Medicine and Public Health, University of Granada, Granada, Spain.,Instituto de Investigación Biosanitaria (Ibs), Granada, Spain
| | - María Morales-Suárez-Varela
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBER Epidemiología Y Salud Pública-CIBERESP), Madrid, Spain.,Department of Preventive Medicine and Public Health, Food Sciences, Toxicology and Legal, Medicine, Area of Preventive Medicine and Public Health, University of Valencia, Valencia, Spain.,Biomedical Research Center Network on Epidemiology and Public Health (CIBERESP), Institute of Health Carlos III, Avenida Monforte de Lemos, 3-5, Pabellón 11, Planta 0, 28029, Madrid, Spain
| | - Carlos Ayán Pérez
- Department of Special Didactics, Galicia Sur Health Research Institute (IIS Galicia Sur), Sergas-UVIGO, HealthyFit Research Group, University of Vigo, Vigo, Spain
| | - Ramona Mateos-Campos
- Departament of Biomedical and Diagnostic Sciences. Area of Preventive Medicine and Public Health, University of Salamanca, Salamanca, Spain
| | - Alba Marcos-Delgado
- Faculty of Health Sciences, Department of Biomedical Sciences, Area of Preventive Medicine and Public Health, Universidad de León, Ponferrada Campus S/N, 24401, Ponferrada, Léon, Spain. .,Institute of Biomedicine (IBIOMED), The Research Group in Gene - Environment and Health Interactions, Universidad de León, León, Spain.
| | - Rocío Ortíz-Moncada
- Department of Community Nursing, Preventive Medicine and Public Health and History of Science, Food and Nutrition Research Group, Area of Preventive Medicine and Public Health, University of Alicante, Alicante, Spain
| | - Susana Redondo Martín
- Department of Preventive Medicine and Public Health, University of Valladolid, Valladolid, Spain
| | - Carmen Rodríguez-Reinado
- Centro de Investigación en Recursos Naturales, Salud Y Medio Ambiente, Universidad de Huelva, Huelva, Spain
| | - Miguel Delgado-Rodríguez
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBER Epidemiología Y Salud Pública-CIBERESP), Madrid, Spain.,Department of Health Sciences, Area of Preventive Medicine and Public Health, University of Jaen, Jaen, Spain
| | - Gemma Blázquez Abellán
- Department of Medical Sciences, Area of Preventive Medicine and Public Health. Faculty of Pharmacy, University of Castilla La Mancha, Albacete, Spain
| | - Jessica Alonso Molero
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBER Epidemiología Y Salud Pública-CIBERESP), Madrid, Spain.,Faculty of Health Sciences, Department of Biomedical Sciences, Area of Preventive Medicine and Public Health, Universidad de León, Ponferrada Campus S/N, 24401, Ponferrada, Léon, Spain
| | - Sandra Martín-Peláez
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBER Epidemiología Y Salud Pública-CIBERESP), Madrid, Spain.,Instituto de Investigación Biosanitaria (Ibs), Granada, Spain
| | - José M Cancela-Carral
- Department of Special Didactics, Galicia Sur Health Research Institute (IIS Galicia Sur), Sergas-UVIGO, HealthyFit Research Group, University of Vigo, Vigo, Spain
| | - Luis F Valero Juan
- Departament of Biomedical and Diagnostic Sciences. Area of Preventive Medicine and Public Health, University of Salamanca, Salamanca, Spain
| | - Virginia Martínez-Ruiz
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBER Epidemiología Y Salud Pública-CIBERESP), Madrid, Spain.,Department of Preventive Medicine and Public Health, University of Granada, Granada, Spain.,Instituto de Investigación Biosanitaria (Ibs), Granada, Spain
| | - Tania Fernández-Villa
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBER Epidemiología Y Salud Pública-CIBERESP), Madrid, Spain.,Faculty of Health Sciences, Department of Biomedical Sciences, Area of Preventive Medicine and Public Health, Universidad de León, Ponferrada Campus S/N, 24401, Ponferrada, Léon, Spain.,Institute of Biomedicine (IBIOMED), The Research Group in Gene - Environment and Health Interactions, Universidad de León, León, Spain
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6
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Schmengler H, Peeters M, Kunst AE, Oldehinkel AJ, Vollebergh WAM. Educational level and alcohol use in adolescence and early adulthood-The role of social causation and health-related selection-The TRAILS Study. PLoS One 2022; 17:e0261606. [PMID: 35045096 PMCID: PMC8769339 DOI: 10.1371/journal.pone.0261606] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2021] [Accepted: 12/06/2021] [Indexed: 11/27/2022] Open
Abstract
Both social causation and health-related selection may influence educational gradients in alcohol use in adolescence and young adulthood. The social causation theory implies that the social environment (e.g. at school) influences adolescents' drinking behaviour. Conversely, the health-related selection hypothesis posits that alcohol use (along other health-related characteristics) predicts lower educational attainment. From past studies it is unclear which of these mechanisms predominates, as drinking may be both a cause and consequence of low educational attainment. Furthermore, educational gradients in alcohol use may reflect the impact of 'third variables' already present in childhood, such as parental socioeconomic status (SES), effortful control, and IQ. We investigated social causation and health-related selection in the development of educational gradients in alcohol use from adolescence to young adulthood in a selective educational system. We used data from a Dutch population-based cohort (TRAILS Study; n = 2,229), including measurements of educational level and drinking at ages around 14, 16, 19, 22, and 26 years (waves 2 to 6). First, we evaluated the directionality in longitudinal associations between education and drinking with cross-lagged panel models, with and without adjusting for pre-existing individual differences using fixed effects. Second, we assessed the role of childhood characteristics around age 11 (wave 1), i.e. IQ, effortful control, and parental SES, both as confounders in these associations, and as predictors of educational level and drinking around age 14 (wave 2). In fixed effects models, lower education around age 14 predicted increases in drinking around 16. From age 19 onward, we found a tendency towards opposite associations, with higher education predicting increases in alcohol use. Alcohol use was not associated with subsequent changes in education. Childhood characteristics strongly predicted education around age 14 and, to a lesser extent, early drinking. We mainly found evidence for the social causation theory in early adolescence, when lower education predicted increases in subsequent alcohol use. We found no evidence in support of the health-related selection hypothesis with respect to alcohol use. By determining initial educational level, childhood characteristics also predict subsequent trajectories in alcohol use.
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Affiliation(s)
- Heiko Schmengler
- Department of Interdisciplinary Social Science, Utrecht Centre for Child and Adolescent Studies, Utrecht University, Utrecht, the Netherlands
| | - Margot Peeters
- Department of Interdisciplinary Social Science, Utrecht Centre for Child and Adolescent Studies, Utrecht University, Utrecht, the Netherlands
| | - Anton E. Kunst
- Department of Public and Occupational Health, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands
| | - Albertine J. Oldehinkel
- Department of Psychiatry, Interdisciplinary Center Psychopathology and Emotion Regulation, University Medical Center of Groningen, University of Groningen, Groningen, the Netherlands
| | - Wilma A. M. Vollebergh
- Department of Interdisciplinary Social Science, Utrecht Centre for Child and Adolescent Studies, Utrecht University, Utrecht, the Netherlands
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7
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Díaz-Geada A, Obradors-Rial N, Baena A, Teixidó-Compañó E, Colillas-Malet E, Mallah N, Moure-Rodríguez L, Caamaño-Isorna F, Barón-Garcia T. Contextual Determinants in Alcohol, Tobacco and Cannabis Consumption, Mood and Bullying during Adolescence. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:8480. [PMID: 34444240 PMCID: PMC8393869 DOI: 10.3390/ijerph18168480] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/23/2021] [Revised: 08/05/2021] [Accepted: 08/07/2021] [Indexed: 12/02/2022]
Abstract
The present study aimed to explore the differences in the consumption of alcohol, tobacco and cannabis, mood and bullying between adolescents. A cross-sectional study was carried out in five regions of Northern Spain (one in Galiza and four in central Catalonia) that share similar socioeconomic characteristics and encompass around 10,000 inhabitants each. Students living in Burela, Galiza (N = 71) were compared to those of Central Catalonia (N = 193). The independent variable was the municipality of residence. The dependent variables encompassed: weekly available pocket money, Family Affluence Scale, self-classified academic qualification, place of origin, alcohol consumption, tobacco and cannabis smoking, negative mood and bullying. The mean age and their 95% confidence intervals (95% CI) of participants were similar between the regions (Burela: 15.90 years (15.68-16.13) and Central Catalonia: 15.36 years (15.28-15.44)). More than half of the participants were females (Burela, Galiza (53.5%) and Catalonia (54.9%)). Prevalence ratios (PR) and their 95% CI were estimated using Poisson regression models. In comparison with adolescents from Burela (Galiza), those living in Central Catalonia had higher prevalence of diverse academic levels (adjusted PR = 3.92 (1.78-8.66)), tobacco consumption (adjusted PR = 2.41 (1.47-3.97)) and negative mood (adjusted PR = 5.97 (3.05-11.70)). Even when dealing with regions with similar socioeconomic characteristics and number of inhabitants, differences exist in terms of the socioeconomic level, tobacco consumption, mood and bullying, as reported by adolescents.
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Affiliation(s)
- Ainara Díaz-Geada
- Department of Public Health, University of Santiago de Compostela, 15782 Santiago de Compostela, Spain; (A.D.-G.); (N.M.); (L.M.-R.)
| | - Núria Obradors-Rial
- Faculty of Health Sciences of Manresa, University of Vic—Central University of Catalonia (UVic-UCC), 08242 Manresa, Spain; (N.O.-R.); (E.T.-C.); (E.C.-M.); (T.B.-G.)
| | - Antoni Baena
- Faculty of Health Sciences, Universitat Oberta de Catalunya (UOC), 08018 Barcelona, Spain;
- Tobacco Control Unit, Cancer Control and Prevention Programme, Institut Català d’Oncologia—ICO, Av. Granvia de L’Hospitalet 199-203, 08908 Barcelona, Spain
| | - Ester Teixidó-Compañó
- Faculty of Health Sciences of Manresa, University of Vic—Central University of Catalonia (UVic-UCC), 08242 Manresa, Spain; (N.O.-R.); (E.T.-C.); (E.C.-M.); (T.B.-G.)
| | - Ester Colillas-Malet
- Faculty of Health Sciences of Manresa, University of Vic—Central University of Catalonia (UVic-UCC), 08242 Manresa, Spain; (N.O.-R.); (E.T.-C.); (E.C.-M.); (T.B.-G.)
| | - Narmeen Mallah
- Department of Public Health, University of Santiago de Compostela, 15782 Santiago de Compostela, Spain; (A.D.-G.); (N.M.); (L.M.-R.)
- Biomedical Research Networking Center for Epidemiology and Public Health (CIBERESP), 28029 Madrid, Spain
- Health Research Institute of Santiago de Compostela (IDIS), 15706 Santiago de Compostela, Spain
| | - Lucía Moure-Rodríguez
- Department of Public Health, University of Santiago de Compostela, 15782 Santiago de Compostela, Spain; (A.D.-G.); (N.M.); (L.M.-R.)
| | - Francisco Caamaño-Isorna
- Department of Public Health, University of Santiago de Compostela, 15782 Santiago de Compostela, Spain; (A.D.-G.); (N.M.); (L.M.-R.)
- Biomedical Research Networking Center for Epidemiology and Public Health (CIBERESP), 28029 Madrid, Spain
| | - Tivy Barón-Garcia
- Faculty of Health Sciences of Manresa, University of Vic—Central University of Catalonia (UVic-UCC), 08242 Manresa, Spain; (N.O.-R.); (E.T.-C.); (E.C.-M.); (T.B.-G.)
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8
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Sjödin L, Livingston M, Karlsson P, Larm P, Raninen J. Associations between trust and drinking among adolescents. Drug Alcohol Rev 2021; 41:221-229. [PMID: 34151475 DOI: 10.1111/dar.13338] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2020] [Revised: 05/19/2021] [Accepted: 05/20/2021] [Indexed: 11/28/2022]
Abstract
INTRODUCTION Trust is closely linked with health, but previous research on its association with alcohol use has yielded mixed findings. The aim of this study is to examine: (i) how two different dimensions of trust (general/institutional) are associated with alcohol use among adolescents; (ii) how these dimensions interact with alcohol use; and (iii) whether the associations are moderated by sex, parenting, health, school satisfaction or economic disadvantage. METHODS A nationwide sample of 5549 adolescents (aged 15-16 years) in Sweden answered a questionnaire in school. General and institutional trust were measured with five items each. Logistic regressions were used to examine associations between drinking and the trust dimensions, and the cross-combinations of these. Moderation by sex, parenting, health, school satisfaction and economic disadvantage was tested. RESULTS General and institutional trust were both significantly associated with drinking. High scores on both dimensions simultaneously were associated with the lowest probability of drinking, and low scores on both with the highest. Low institutional trust had a stronger association than low general trust. The combination of high institutional/low general trust was more protective than low institutional/high general trust. The association between general trust and drinking was moderated by school satisfaction, and the relationship between institutional trust and drinking was moderated by parental support and control. DISCUSSION AND CONCLUSIONS High trust is associated with a lower probability of past-year drinking among 15-16-year-olds. Parents and schools can be useful in endeavours to prevent low-trusting individuals in this age group from drinking.
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Affiliation(s)
- Lars Sjödin
- Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Michael Livingston
- Centre for Alcohol Policy Research, School of Psychology and Public Health, La Trobe University, Melbourne, Australia.,National Drug Research Institute, Curtin University, Perth, Australia
| | - Patrik Karlsson
- Department of Social Work, Stockholm University, Stockholm, Sweden
| | - Peter Larm
- Department of Public Health Sciences, Stockholm University, Stockholm, Sweden
| | - Jonas Raninen
- Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.,Centre for Alcohol Policy Research, School of Psychology and Public Health, La Trobe University, Melbourne, Australia.,Swedish Council for Information on Alcohol and Other Drugs, Stockholm, Sweden.,School of Social Sciences, Unit of Social Work, Södertörn University, Huddinge, Sweden
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9
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Brunborg GS, von Soest T, Burdzovic Andreas J. Adolescent income and binge drinking initiation: prospective evidence from the MyLife study. Addiction 2021; 116:1389-1398. [PMID: 33009694 DOI: 10.1111/add.15279] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2020] [Revised: 05/20/2020] [Accepted: 09/25/2020] [Indexed: 12/27/2022]
Abstract
BACKGROUND AND AIMS No previous studies have examined the prospective association between disposable income and binge-drinking initiation among adolescents. We aimed to examine whether there is such an association and, if so, whether it is robust to confounders, uniform across individual characteristics and linear versus non-linear. DESIGN Prospective study of adolescents from 32 middle schools, stratified according to geographic location, urban and rural locations and standard of living. Adolescents were assessed in 2017 (T1) and 1 year later (T2). SETTING Norway. PARTICIPANTS A nation-wide sample of 1845 adolescents (mean age 13.5 years, 44% boys) with no binge-drinking experience at T1. MEASUREMENTS Data were collected on binge drinking at T1 and T2. Data on disposable income and on a range of demographic, individual and family factors were collected at T1. FINDINGS Overall, 7.2% initiated binge drinking between T1 and T2. Logistic regression showed that the crude linear effect of disposable income on binge drinking initiation was substantial, and only slightly attenuated in the fully adjusted model including all putative confounders [odds ratio (OR) = 1.19, 95% confidence interval (CI) = 1.08, 1.31, P < 0.001]. However, interaction analyses showed disposable income to be negatively related to binge drinking initiation for adolescents who had experienced light drinking at T1 (OR = 0.66, 95% CI = 0.49, 0.89, P = 0.006) or who had seen their mothers intoxicated [OR = 0.62, 95% CI = 0.39, 0.99, P = 0.043). CONCLUSION Norwegian adolescents with higher disposable income have a greater risk of subsequent binge drinking initiation than those with lower disposable income. Each additional 100 NOK (≈ €10) of weekly income increased the risk of binge drinking initiation in the following year by approximately 20%.
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Affiliation(s)
- Geir Scott Brunborg
- Department of Alcohol, Tobacco, and Drugs, Norwegian Institute of Public Health, Oslo, Norway
| | - Tilmann von Soest
- PROMENTA Research Center, Department of Psychology, University of Oslo, Oslo, Norway
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10
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Predicting adolescent alcohol and other drug problems using electronic health records data. J Subst Abuse Treat 2021; 132:108487. [PMID: 34098206 DOI: 10.1016/j.jsat.2021.108487] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2020] [Revised: 12/18/2020] [Accepted: 05/15/2021] [Indexed: 11/22/2022]
Abstract
IMPORTANCE Alcohol and other drug (AOD) use problems may cause significant burden on affected adolescents and their families, yet treatment providers often do not identify these problems early enough. OBJECTIVE To develop, and internally and externally validate a multivariable prediction model of adolescent AOD problems using child- and maternal-level predictors before age 12, and child-level predictors between ages 12 to 18, as recorded in the electronic health records (EHR). DESIGN A retrospective cohort study conducted time-to-event analyses using Cox proportional hazards models. SETTING AND PARTICIPANTS 41,172 children born between 1997 and 2000 at four health plans (Kaiser Permanente Hawaii, KPHI; Kaiser Permanente Northern California, KPNC; Geisinger Clinic, GC; and Henry Ford Health System, HFHS) who had continuous membership since birth and linkable maternal records in the health plan. OUTCOMES AOD use problems between ages 12 to 18, defined as either: 1) having a contact with the AOD treatment program or 2) receiving a non-tobacco AOD diagnosis in an inpatient or outpatient encounter. EXPOSURES Candidate predictor variables include demographics, socioeconomic status, and clinical diagnoses of the children and the mothers. RESULTS Overall, 1400 (3.4%) adolescents had an AOD disorder between ages 12 to 18; the median follow-up time post-age 12 was 5.3 years. The research team developed two final prediction models: a "baseline" model of 10 child-level and 7 maternal-level predictors before age 12, and a more comprehensive "time-varying" model, which incorporated child risk factors after age 12 as time-varying covariates in addition to the baseline model predictors. Model performance evaluation showed good discrimination performance of the models, with the concordance index improved for the time-varying model, especially for prediction of AOD events in late adolescence. CONCLUSIONS AND RELEVANCE This study identified a number of child and maternal characteristics and diagnoses routinely available in EHR data as predictive of risk for developing AOD problems in adolescence. Further, we found that risk of developing problems varies significantly by the timing and persistence of the risk factors. Findings may have potential clinical implications for prevention and identification of adolescent AOD problems, but more research is needed, especially across additional health systems.
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11
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Falese L, Federico B, Kunst AE, Perelman J, Richter M, Rimpelä A, Lorant V. The association between socioeconomic position and vigorous physical activity among adolescents: a cross-sectional study in six European cities. BMC Public Health 2021; 21:866. [PMID: 33952232 PMCID: PMC8097935 DOI: 10.1186/s12889-021-10791-z] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2021] [Accepted: 04/05/2021] [Indexed: 11/30/2022] Open
Abstract
Background The relationship between socioeconomic position (SEP) and adolescent physical activity is uncertain, as most evidence is limited to specific settings and a restricted number of SEP indicators. This study aimed to assess the magnitude of socioeconomic differences in adolescent vigorous physical activity (VPA) across various European countries using a wide range of SEP indicators, including family-based (education, family affluence, perceived social standing, parents’ employment, housing tenure) and adolescent-based (academic performance and pocket money) ones. Methods We used data from a survey among 10,510 students aged 14–17 from 50 schools in six European cities: Namur (BE), Tampere (FI), Hannover (DE), Latina (IT), Amersfoort (NL), Coimbra (PT). The questionnaire included socio-demographic characteristics and the amount of time spent in VPA. Results The mean time spent practicing VPA was 60.4 min per day, with lower values for Namur (BE) and Latina (IT), and higher values for Amersfoort (NL). In the multivariable analysis, both categories of SEP indicators (family-based and adolescent based indicators) were independently associated with VPA. For each SEP indicator, lower levels of VPA were recorded in lower socioeconomic groups. In the total sample, each additional category of low SEP was associated with a decrease in mean VPA of about 4 min per day. Conclusions This study showed that across European cities adolescent VPA is positively related to both family-based SEP and adolescents’ own SEP. When analysing socioeconomic differences in adolescent VPA, one should consider the use of multiple indicators of SEP. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-021-10791-z.
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Affiliation(s)
- L Falese
- Department of Human Sciences, Society and Health, University of Cassino and Southern Lazio, via S. Angelo (Folcara), 03043, Cassino, FR, Italy.
| | - B Federico
- Department of Human Sciences, Society and Health, University of Cassino and Southern Lazio, via S. Angelo (Folcara), 03043, Cassino, FR, Italy
| | - A E Kunst
- Department of Public Health, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - J Perelman
- NOVA National School of Public Health, Public Health Research Centre, Universidade NOVA de Lisboa, Lisbon, Portugal
| | - M Richter
- Institute of Medical Sociology, Medical Faculty, Martin Luther University Halle-Wittenberg, Halle (Saale), Germany
| | - A Rimpelä
- Faculty of Social Sciences, Unit of Health Sciences, Tampere University, Tampere, Finland.,Department of Adolescent Psychiatry, Tampere University Hospital, Nokia, Finland
| | - V Lorant
- Institute of Health and Society, Université Catholique de Louvain, Bruxelles, Belgium
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12
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Ali MM, Merdad L, Bellizzi S. Socioeconomic variations in risky sexual behavior among adolescents in 14 sub-Saharan Africa countries who report ever having had sex. Int J Equity Health 2021; 20:11. [PMID: 33407497 PMCID: PMC7789383 DOI: 10.1186/s12939-020-01352-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2020] [Accepted: 12/09/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Equity is a guiding principle of the Global Strategy for Women, Children and Adolescents' Health (2016-2030) aimed at improving adolescent health and responding more effectively to adolescents' needs. We investigated the socioeconomic differentials in having multiple sexual partners and condom use among unmarried adolescents who reported ever having had sex aged 15-19 years in 14 sub-Saharan countries. METHODS Using the most recent publicly available Demographic and Health Surveys conducted between 2011 and 2018, we calculated survey- and sex-specific proportions of two or more partners and condomless sex, both overall and by selected socioeconomic characteristics and we fitted logistic regression models to estimate the survey- and sex-specific adjusted odds ratios. The pooled adjusted odds ratios were estimated using multilevel logistic regression. RESULTS In most countries, higher percentages of male adolescents than female adolescents reported having more than one partner in the last 12 months. Conversely, a lower percentage of young male reported having condomless sex when compared to young female: from 19.8% in Gabon to 84.5% in Sierra Leone among male adolescents and from 32.6% in Gabon to 93.2% in Sierra Leone among female adolescents. In the multilevel analyses, condomless sex was associated with place of residence, wealth and schooling for both female and male adolescents, while among male adolescents multiple partnerships was significantly associated with place of residence. CONCLUSION Our findings on disparities in condomless sex associated with socioeconomic characteristics might reflect constraint choice and decision making. Results also suggest the need for educational programming and services and better access to barrier methods.
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Affiliation(s)
- Mohamed M Ali
- UNDP-UNFPA-UNICEF-WHO-World Bank Special Programme of Research, Development and Research Training in Human Reproduction (HRP), World Health Organization, 20 Avenue Appia, 1211, Geneva, Switzerland.
| | - Leena Merdad
- Faculty of Dentistry, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Saverio Bellizzi
- Partnership for Maternal, Newborn and Child Health, Geneva, Switzerland
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13
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Marconcin P, Matos MG, Ihle A, Ferrari G, Gouveia ÉR, López-Flores M, Peralta M, Marques A. Trends of Healthy Lifestyles Among Adolescents: An Analysis of More Than Half a Million Participants From 32 Countries Between 2006 and 2014. Front Pediatr 2021; 9:645074. [PMID: 34113585 PMCID: PMC8185050 DOI: 10.3389/fped.2021.645074] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2020] [Accepted: 04/07/2021] [Indexed: 11/13/2022] Open
Abstract
The purpose of this study was to provide data regarding the prevalence and trends of adolescents' healthy lifestyles from 32 countries between 2006 and 2014 by sex and age interval. The data used in the present study were derived from the Health Behavior in School-aged Children (HBSC) 2006, 2010, and 2014 international database. Healthy lifestyle was assessed using the combination of daily physical activity, daily fruit and vegetable consumption, <2 h daily on screen-based behaviors, abstinence from alcohol, and abstinence from tobacco products. Healthy lifestyle measures were based on self-report. The final sample comprised 519,371 adolescents (aged between 10 and 16 years old). The prevalence of healthy lifestyle behaviors increased between 2006 and 2014. The healthy lifestyle score worsened with advancing age for boys and girls. Comparing countries, for boys, the highest values were observed in adolescents from Ireland (5.2%, 95% CI: 3.9, 6.4), and for girls, the highest values were observed in adolescents from Iceland (4.2%, 95% CI: 3.6, 4.7). The present study showed a slight trend to an improved healthy lifestyle among adolescents, although much more has to be done. A joint effort from multiple areas of knowledge must be made to improve adolescent health policies, since lifestyles in adolescence play an important role for the development of vulnerability and health in later life.
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Affiliation(s)
| | - Margarida G Matos
- Faculty of Human Kinetics, University of Lisbon, Lisbon, Portugal.,Instituto de Saúde Ambiental, Universidade de Lisboa, Lisboa, Portugal
| | - Andreas Ihle
- Center for the Interdisciplinary Study of Gerontology and Vulnerability, University of Geneva, Geneva, Switzerland.,Swiss National Centre of Competence in Research LIVES-Overcoming Vulnerability: Life Course Perspectives, Geneva, Switzerland.,Department of Psychology, University of Geneva, Geneva, Switzerland
| | - Gerson Ferrari
- Escuela de Ciencias de la Actividad Física, el Deporte y la Salud, Universidad de Santiago de Chile (USACH), Santiago, Chile
| | - Élvio R Gouveia
- Departamento de Educaçao Física e Desporto, Universidade da Madeira, Funchal, Portugal.,Interactive Technologies Institute, Laboratory of Robotics and Engineering Systems, Funchal, Portugal
| | | | - Miguel Peralta
- Instituto de Saúde Ambiental, Universidade de Lisboa, Lisboa, Portugal.,Centro Interdisciplinar de Estudo da Performance Humana, Faculty of Human Kinetics, University of Lisbon, Lisbon, Portugal
| | - Adilson Marques
- Instituto de Saúde Ambiental, Universidade de Lisboa, Lisboa, Portugal.,Centro Interdisciplinar de Estudo da Performance Humana, Faculty of Human Kinetics, University of Lisbon, Lisbon, Portugal
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14
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Dias PC, Tavares E, Simões M, Cadime I. Motives for cannabis use in a sample of portuguese users. JOURNAL OF SUBSTANCE USE 2020. [DOI: 10.1080/14659891.2020.1760377] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Affiliation(s)
- Paulo César Dias
- Faculty of Philosophy and Social Sciences, Centre for Philosophical and Humanistic Studies, Universidade Católica Portuguesa, Portugal
| | - Eduardo Tavares
- Faculty of Philosophy and Social Sciences, Centre for Philosophical and Humanistic Studies, Universidade Católica Portuguesa, Portugal
| | - Marta Simões
- Faculty of Philosophy and Social Sciences, Centre for Philosophical and Humanistic Studies, Universidade Católica Portuguesa, Portugal
| | - Irene Cadime
- Research Centre on Child Studies, University of Minho, Braga, Portugal
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15
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Addictions in Spanish College Students in Confinement Times: Preventive and Social Perspective. SOCIAL SCIENCES-BASEL 2020. [DOI: 10.3390/socsci9110195] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Diverse studies have shown that a significant percentage of the Spanish university population suffers from different addictions. They are both a personal and public health problem if there is not a greater awareness of the risks involved and if the appropriate prevention measures are not taken, among them educational ones. In this context, a descriptive and explanatory cross-sectional study was conducted during the first half of June 2020, coinciding with the period of confinement that occurred in Spain during the first wave of the COVID-19 pandemic. Given that this is such an exceptional time, the main objective of this study was to obtain information especially on students’ substance consumption and possible addictions at this time. Knowing the specific situation of this problem in that specific situation may allow for comparative studies in the future. The sample was composed of 310 university students from 14 Spanish universities. The instrument used in the research was the ASSIST questionnaire, developed by the WHO for the detection of alcohol, tobacco, and substance consumption. As result, a moderate and high risk was observed mainly in the following substances: alcohol (36.2%), tobacco (33.2%), cannabis (22.9%), and sedatives (10.3%). Through the logistic regression of the set of drugs, it has been proven that, on the one hand, the addiction to cocaine and sedatives in the family environment and age, on the other hand, are the main predictive variables of drug consumption. The existence of polysubstance abuse was also determined. These data show the need for educational bodies and university institutions to promote awareness, sensitization, and health education programs to deal with this important problem, especially in extraordinary situations, such as the one referred to, which could increase this consumption.
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16
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Perelman J, Leão T, Kunst AE. Smoking and school absenteeism among 15- to 16-year-old adolescents: a cross-section analysis on 36 European countries. Eur J Public Health 2020; 29:778-784. [PMID: 31168621 PMCID: PMC6660109 DOI: 10.1093/eurpub/ckz110] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Background Schools have a crucial role to play in preventing youth smoking. However, the well-known long-term health consequences of youth smoking may be insufficient to convince education stakeholders to devote efforts to implement school-based programmes. However, if youth smoking were to have short-term consequences, this evidence could prompt education stakeholders’ action. In this article, we investigate the link between smoking and school absenteeism. Methods We used data from the 2011 wave of the European School Survey Project on Alcohol and Other Drugs, on adolescents aged 15–16. We applied logistic models to assess the risk of more than 3 missed school days, by cause, as function of smoking intensity, adjusting for age, sex, socioeconomic status, academic performance, parental involvement and other risk behaviours (alcohol and cannabis consumption). Consistency was assessed by replicating the analyses for each sex and age group and further adjusting for depression and self-esteem. Results Smoking more than five cigarettes per day was significantly linked to school absenteeism, with a 55% excess risk of missing more than 3 school days per month due to illness (OR = 1.55, 95% CI 1.46–1.64), and a more than two times excess risk due to skipping (OR = 2.29; 95% CI 2.16–2.43). These findings were consistent across age and sex groups. Conclusion We observed an association between smoking intensity and absenteeism among youth in Europe. This implies that, to the extent that this association is causal, school tobacco control policies may reduce the short-term consequences of smoking on adolescents’ education and health.
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Affiliation(s)
- Julian Perelman
- Centro de Investigação em Saúde Pública, Escola Nacional de Saúde Pública, Universidade NOVA de Lisboa, Lisbon, Portugal
| | - Teresa Leão
- Escola Nacional de Saúde Pública, Universidade NOVA de Lisboa, Lisbon, Portugal
| | - Anton E Kunst
- Department of Public Health, Amsterdam UMC, University of Amsterdam, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
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17
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Trias-Llimós S, Bosque-Prous M, Obradors-Rial N, Teixidó-Compañó E, Belza MJ, Janssen F, Espelt A. Alcohol and educational inequalities: Hazardous drinking prevalence and all-cause mortality by hazardous drinking group in people aged 50 and older in Europe. Subst Abus 2020; 43:152-160. [PMID: 32543303 DOI: 10.1080/08897077.2020.1773597] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
Background: We examined educational inequalities in hazardous drinking prevalence among individuals aged 50 or more in 14 European countries, and explored educational inequalities in mortality in hazardous drinkers in European regions. Methods: We analyzed data from waves 4, 5 and 6 of the Survey of Health Ageing and Retirement in Europe (SHARE). We estimated age-standardized hazardous drinking prevalence, and prevalence ratios (PR) of hazardous drinking by country and educational level using Poisson regression models with robust variance. We estimated the relative index of inequality (RII) for all-cause mortality among hazardous drinkers and non-hazardous drinkers using Cox proportional hazards regression models and for each region (North, South, East and West). Results: In men, educational inequalities in hazardous drinking were not observed (PRmedium = 1.09 [95%CI: 0.98-1.21] and PRhigh = 0.99 [95%CI: 0.88-1.10], ref. low), while in they were observed in women, having the highest hazardous drinking prevalence in the highest educational levels (PRmedium = 1.28 [95%CI: 1.15-1.42] and PRhigh = 1.53 [95%CI: 1.36-1.72]). Overall, the Relative Index of Inequality (RII) in all-cause mortality among hazardous drinkers was 1.12 [95%CI: 1.03-1.22] among men and 1.10 [95%CI: 0.97-1.25] among women. Educational inequalities among hazardous drinkers were observed in Eastern Europe for both men (RIIhazardous = 1.21 [95%CI: 1.01-1.45]) and women (RIIhazardous = 1.46 [95%CI: 1.13-1.87]). Educational inequalities in mortality among non-hazardous drinkers were observed in Southern, Western and Eastern Europe among men, and in Eastern Europe among women. Conclusions: Higher educational attainment is positively associated with hazardous drinking prevalence among women, but not among men in most of the analyzed European countries. Clear educational inequalities in mortality among hazardous drinkers were only observed in Eastern Europe. Further research on the associations between alcohol use and inequalities in all-cause mortality in different regions is needed.
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Affiliation(s)
- Sergi Trias-Llimós
- Department of Non-communicable Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Marina Bosque-Prous
- Faculty of Health Sciences, Universitat Oberta de Catalunya, Barcelona, Spain
| | - Nuria Obradors-Rial
- Facultat de Ciències de la Salut de Manresa, Universitat de Vic-Universitat Central de Catalunya (UVicUCC), Manresa, Spain
| | - Ester Teixidó-Compañó
- Facultat de Ciències de la Salut de Manresa, Universitat de Vic-Universitat Central de Catalunya (UVicUCC), Manresa, Spain
| | - Maria José Belza
- Escuela Nacional de Sanidad, Instituto de Salud Carlos III, Madrid, Spain.,Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Fanny Janssen
- Netherlands Interdisciplinary Demographic Institute - KNAW/University of Groningen, The Hague, The Netherlands.,Netherlands Interdisciplinary Demographic Institute, The Hague, The Netherlands
| | - Albert Espelt
- Facultat de Ciències de la Salut de Manresa, Universitat de Vic-Universitat Central de Catalunya (UVicUCC), Manresa, Spain.,Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain.,Departament de Psicobiologia i Metodologia en Ciències de la Salut, Universitat Autònoma de Barcelona (UAB), Bellaterra, Spain
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18
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Dos Santos CS, Picoito J, Loureiro I, Nunes C. Clustering of health-related behaviours and its relationship with individual and contextual factors in Portuguese adolescents: results from a cross-sectional study. BMC Pediatr 2020; 20:247. [PMID: 32450829 PMCID: PMC7249363 DOI: 10.1186/s12887-020-02057-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/04/2019] [Accepted: 03/30/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Health behaviours are shaped early in life and tend to occur in complex specific patterns. We aimed to characterise these patterns among Portuguese adolescents and their association with individual and contextual factors. METHODS This study was based in the Portuguese 2009/10 survey of Health Behaviour in School-Aged Children Study, comprising 4036 adolescents. Individuals were grouped using two-step cluster analysis based on 12 behaviours regarding diet, physical activity, screen use and substance use. The association between clusters and individual and contextual factors was analysed using multinomial regression. RESULTS The median age was 13,6, and 54% were female. Overweight and obesity were highly prevalent (25%). We identified four behavioural clusters: "Active screen users", "Substance users", "Healthy" and "Inactive low fruit and vegetable eaters". Sociodemographics varied across clusters. The "Substance users" and "Active screen users" clusters were associated with poor family communication, academic performance and school attachment and violent behaviours, and the "Inactive low fruit and vegetable eaters" were associated with lower socioeconomic status. CONCLUSION The understanding of these health-compromising patterns and their social determinants is of use to Public Health, allowing tailored health-promoting interventions. Further research is needed to understand how cluster membership evolves and its influence on nutritional status.
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Affiliation(s)
- Constança Soares Dos Santos
- Escola Nacional de Saúde Pública, Universidade NOVA de Lisboa, Avenida Padre Cruz, 1600-560, Lisbon, Portugal. .,Department of Pediatrics, Centro Hospitalar Cova da Beira, Quinta do Alvito, 6200-251, Covilhã, Portugal.
| | - João Picoito
- Escola Nacional de Saúde Pública, Universidade NOVA de Lisboa, Avenida Padre Cruz, 1600-560, Lisbon, Portugal.,Department of Child and Adolescent Psychiatry, Centro Hospitalar e Universitário de Coimbra, Rua Doutor Afonso Romão, 3000-609, Coimbra, Portugal
| | - Isabel Loureiro
- Escola Nacional de Saúde Pública, Universidade NOVA de Lisboa, Avenida Padre Cruz, 1600-560, Lisbon, Portugal.,Centro de Investigação em Saúde Publica, Escola Nacional de Saúde Pública, Universidade NOVA de Lisboa, Avenida Padre Cruz, 1600-560, Lisbon, Portugal
| | - Carla Nunes
- Escola Nacional de Saúde Pública, Universidade NOVA de Lisboa, Avenida Padre Cruz, 1600-560, Lisbon, Portugal.,Centro de Investigação em Saúde Publica, Escola Nacional de Saúde Pública, Universidade NOVA de Lisboa, Avenida Padre Cruz, 1600-560, Lisbon, Portugal
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19
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Vargas-Martínez AM, Trapero-Bertran M, Mora T, Lima-Serrano M. Social, economic and family factors associated with binge drinking in Spanish adolescents. BMC Public Health 2020; 20:519. [PMID: 32303203 PMCID: PMC7165377 DOI: 10.1186/s12889-020-08605-9] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2019] [Accepted: 03/27/2020] [Indexed: 11/10/2022] Open
Abstract
Background The main aim of this study was to determine the socioeconomic and family factors associated with binge drinking (BD) in Spanish adolescents who participated in a web-based computer intervention for the prevention of binge drinking known as Alerta Alcohol. Methods Longitudinal analyses were carried out in a sample of Andalusian adolescents aged 15 to 19 enrolled in public schools, which was part of a two-arm cluster randomized controlled trial with an intervention group (IG) who received the Alerta Alcohol programme and a control group (CG) who did not receive any active intervention. Panel count data and the following econometric procedures were used: negative binomial, a two-part model and a finite mixture model. The endogenous variable in all models was the number of BD occasions in the last 30 days. A total of 1247 subjects in the pre-intervention period, with an average age of 16.8 years, plus 612 adolescents in the follow-up period (4 months later), were included in the analysis. Results In relation to findings, being older (≥ 17 years old), having more pocket money and higher family alcohol consumption were associated with greater BD. By contrast, subjects who completed the questionnaire on Wednesday, Thursday or Friday, further from the previous weekend, indicated a lower number of BD occasions. Conclusions Our results suggest the need to include families, especially parents and siblings, in interventions aimed at preventing alcohol use among adolescents, given the association shown between BD and both family alcohol consumption and weekly pocket money or availability of money to adolescents. Given the findings with regard to age, future research aimed at intervening in early adolescence to prevent BD would be justified. Trial registration (ClinicalTrials.gov): NCT03288896. Registration date: September 20, 2017. “Retrospectively registered”.
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Affiliation(s)
| | - Marta Trapero-Bertran
- Faculty of Economics and Social Sciences, Universitat Internacional de Catalunya, Barcelona, Spain
| | - Toni Mora
- Research Institute for Evaluation and Public Policies (IRAPP), Universitat Internacional de Catalunya, Barcelona, Spain
| | - Marta Lima-Serrano
- Department of Nursing. Faculty of Nursing, Physiotherapy and Podiatry, Universidad de Sevilla, Seville, Spain
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El Ansari W, Salam A, Suominen S. Is Alcohol Consumption Associated with Poor Perceived Academic Performance? Survey of Undergraduates in Finland. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17041369. [PMID: 32093287 PMCID: PMC7068310 DOI: 10.3390/ijerph17041369] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/29/2020] [Revised: 02/12/2020] [Accepted: 02/17/2020] [Indexed: 12/12/2022]
Abstract
The relationship between academic performance and alcohol consumption among students remains inconsistent. We assessed this relationship, controlling for sociodemographic characteristics across seven faculties at the University of Turku (1177 undergraduates). An online questionnaire assessed: seven sociodemographic characteristics (age, gender, year/discipline of study, accommodation type, being in intimate relationship, parental education, and income sufficiency); two perceived academic performance (students’ subjective importance of achieving good grades and students’ appraisal of their academic performance compared to peers); and six alcohol consumption behaviors (length of time, amount consumed, frequency, heavy episodic drinking, problem drinking, and possible alcohol dependence). Simple logistic regression assessed relationships between sociodemographic and academic variables with alcohol consumption behaviors; multiple logistic regression assessed the same relationships after controlling for all other variables. Students reported long duration and large amount of drinking (46% and 50%), high frequency of drinking (41%), heavy episodic drinking (66%), problem drinking (29%), and possible alcohol dependence (9%). After controlling, gender was associated with all alcohol consumption behaviors, followed by religiosity (associated with four alcohol behaviors), living situation, marital status, age (each associated with two alcohol behaviors), and parental education and year of study (each associated with one alcohol behavior). Study discipline, income sufficiency, importance of achieving good grades, and academic performance compared to peers were not associated with any alcohol behaviors. Universities need to assess problem drinking and alcohol use disorders among students. Prevention strategies are required to reduce risk. Health promotion efforts could focus on beliefs and expectations about alcohol and target student groups at risk for more efficient and successful efforts.
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Affiliation(s)
- Walid El Ansari
- Department of Surgery, Hamad General Hospital, Doha 3050, Qatar
- College of Medicine, Qatar University, Doha 3050, Qatar
- School of Health and Education, University of Skovde, 541 28 Skövde, Sweden;
- Correspondence:
| | - Abdul Salam
- Neuroscience Institute, Hamad General Hospital, Doha 3050, Qatar;
| | - Sakari Suominen
- School of Health and Education, University of Skovde, 541 28 Skövde, Sweden;
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Thor S, Karlsson P, Landberg J. Social Inequalities in Harmful Drinking and Alcohol-Related Problems Among Swedish Adolescents. Alcohol Alcohol 2020; 54:532-539. [PMID: 31206150 PMCID: PMC7011164 DOI: 10.1093/alcalc/agz044] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2018] [Revised: 05/07/2019] [Accepted: 05/13/2019] [Indexed: 02/04/2023] Open
Abstract
Aims The study aims to examine how socio-economic status (SES) among youth is related to binge-drinking and alcohol-related problems using three SES indicators: (i) SES of origin (parental education level), (ii) SES of the school environment (average parental education level at student’s school) and (iii) SES of destination (academic orientation). Methods Cross-sectional data on upper secondary students (n= 4448) in Sweden. Multilevel logistic and negative binomial regression were used to estimate the relationship between each SES indicator and binge-drinking and alcohol-related problems, respectively. Results Only SES of destination was significantly associated with binge-drinking, with higher odds for students in vocational programmes (OR= 1.42, 95% CI= 1.13–1.80). For the second outcome, SES of destination (rr=1.25; 95%CI=1.08–1.45) and SES of the school environment (rr=1.19, 95% CI=1.02–1.39) indicated more alcohol-related problems in vocational programmes and in schools with lower-educated parents. After adjustment for drinking patterns, the relationship remained for SES of the school environment, but became non-significant for SES of destination. Conclusion Our results suggest that the SES gradient among youth is stronger for alcohol-related problems than for harmful drinking. By only focusing on SES differences in harmful alcohol use, researchers may underestimate the social inequalities in adverse alcohol-related outcomes among young people. Our findings also support the notion that the environment young people find themselves in matters for social inequalities in alcohol-related harm.
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Affiliation(s)
- Siri Thor
- Department of Clinical Neuroscience, Karolinska Institutet, Sweden.,The Swedish Council for Information on Alcohol and Other Drugs, Stockholm, Sweden
| | - Patrik Karlsson
- Department of Social Work, Stockholm University, Stockholm, Sweden
| | - Jonas Landberg
- Department of Clinical Neuroscience, Karolinska Institutet, Sweden.,The Swedish Council for Information on Alcohol and Other Drugs, Stockholm, Sweden.,Department of Public Health Sciences, Stockholm University, Stockholm, Sweden
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Obradors-Rial N, Ariza C, Continente X, Muntaner C. School and town factors associated with risky alcohol consumption among Catalan adolescents. Alcohol 2020; 82:71-79. [PMID: 31082505 DOI: 10.1016/j.alcohol.2019.04.005] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2017] [Revised: 03/24/2019] [Accepted: 04/25/2019] [Indexed: 11/17/2022]
Abstract
Risky alcohol consumption among adolescents has health and social consequences. Evidence identifying the school context that determines alcohol consumption among rural and urban adolescents is lacking. This study aimed to describe the contextual school and town factors determining risky alcohol consumption among rural and urban 10th-grade adolescents (15-17 years old) from Catalonia (northeastern Spain). The study had a cross-sectional design. Cluster sampling with the class as the sampling unit was used, and a total of 1268 10th-grade adolescents from Catalonia nested in 26 high schools participated in the study. A computerized and self-administrated questionnaire was used to collect individual variables. Contextual variables were collected from the Catalan police registers, geocoded sources, and governmental internet databases, and by aggregation of answers from the self-administrated questionnaire. The prevalence of risky alcohol consumption was calculated, and a multilevel Poisson regression analysis with robust variance was conducted with data from adolescents nested within high schools. The results show that risky alcohol consumption is higher among rural adolescents (59.3%) than among urban youth (51.1%) (p < 0.005). Positive expectancies, drunkenness of siblings and friends, and most of the variables indicating accessibility are associated with risky alcohol consumption at the individual level. At the contextual level, the sports center rate and the high school's percentage of risky student alcohol consumption are strongly associated with individual risky alcohol consumption. The town environment (rural or urban), the unemployment rate, and the number of pubs and nightclubs lost their significance after adjustment by the individual and mediating variables. In conclusion, individual factors, such as the influence of drinking patterns of siblings and friends, and more alcohol access opportunities, are associated with adolescents' risky alcohol consumption. The associated contextual factors are the sports center rate and the percentage of risky classmate alcohol consumers. Interventions targeting adolescents should focus at community and high school levels, trying to reduce adolescents' accessibility to alcohol.
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Affiliation(s)
- Núria Obradors-Rial
- Facultat de Ciències de la Salut de Manresa, Universitat de Vic - Universitat Central de Catalunya (UVic-UCC), Av. Universitària 4-6, 08242 Manresa, Barcelona, Spain.
| | - Carles Ariza
- Agència de Salut Pública de Barcelona, Pl. Lesseps, 1, PC: 08023, Barcelona, Spain; Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Av. Monforte de Lemos, 3-5. Pabellón 11. Planta 0, PC 28029, Madrid, Spain; Instituto de Investigación Biomédica Sant Pau (IIB Sant Pau), Sant Antoni Ma Claret 167, 08025 Barcelona, Spain
| | - Xavier Continente
- Agència de Salut Pública de Barcelona, Pl. Lesseps, 1, PC: 08023, Barcelona, Spain; Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Av. Monforte de Lemos, 3-5. Pabellón 11. Planta 0, PC 28029, Madrid, Spain; Instituto de Investigación Biomédica Sant Pau (IIB Sant Pau), Sant Antoni Ma Claret 167, 08025 Barcelona, Spain
| | - Carles Muntaner
- Bloomberg Faculty of Nursing and Dalla Lana School of Public Health, University of Toronto, Toronto, Canada; K-21 program Mind-Society Interaction, Korea University, Suite 606B, Jeongui Building, San 1, Jeongreung-3dong, Seongbuk-gu, Seoul, Seoul 136-853, Republic of Korea
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Lee H, Park S. [Patterns of Drinking Behaviors and Predictors of Class Membership among Adolescents in the Republic of Korea: A Latent Class Analysis]. J Korean Acad Nurs 2020; 49:701-712. [PMID: 31932565 DOI: 10.4040/jkan.2019.49.6.701] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2019] [Revised: 09/19/2019] [Accepted: 09/19/2019] [Indexed: 11/09/2022]
Abstract
PURPOSE Despite the high drinking rates and the complexity of drinking behaviors in adolescents, insufficient attention has been paid to their drinking patterns. Therefore, we aimed to identify patterns of adolescent drinking behaviors and factors predicting the distinct subgroups of adolescent drinking behaviors. METHODS We analyzed nationally representative secondary data obtained in 2017. Our final sample included 24,417 Korean adolescents who had consumed at least one glass of alcohol in their lifetime. To investigate patterns of drinking behaviors, we conducted a latent class analysis using nine alcohol-related characteristics, including alcohol consumption levels, solitary drinking, timing of drinking initiation, and negative consequences of drinking. Furthermore, we investigated differences in demographics, mental health status, and characteristics of substance use across the latent classes identified in our study. To do so, we used the PROC LCA with COVARIATES statement in the SAS software. RESULTS We identified three latent classes of drinking behaviors: current non-drinkers (CND), binge drinkers (BD), and problem drinkers (PD). Compared to the CND class, both BD and PD classes were strongly associated with higher academic year, lower academic performance, higher levels of stress, suicidal ideation, lifetime conventional or electronic cigarette use, and lifetime use of other drugs. CONCLUSION Health professionals should develop and implement intervention strategies targeting individual subgroups of drinking behaviors to obtain better outcomes. In particular, health professionals should consider different characteristics across subgroups of adolescent drinking behaviors when developing the interventions, such as poor mental health status and other substance use among binge and problem drinkers.
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Affiliation(s)
- Haein Lee
- College of Nursing · Research Institute of Nursing Science, Daegu Catholic University, Daegu, Korea
| | - Sunhee Park
- College of Nursing Science · East-West Nursing Research Institute, Kyung Hee University, Seoul, Korea.
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Moor I, Kuipers MAG, Lorant V, Pförtner TK, Kinnunen JM, Rathmann K, Perelman J, Alves J, Robert PO, Rimpelä A, Kunst AE, Richter M. Inequalities in adolescent self-rated health and smoking in Europe: comparing different indicators of socioeconomic status. J Epidemiol Community Health 2019; 73:963-970. [DOI: 10.1136/jech-2018-211794] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2018] [Revised: 05/02/2019] [Accepted: 06/27/2019] [Indexed: 11/03/2022]
Abstract
BackgroundAlthough there is evidence for socioeconomic inequalities in health and health behaviour in adolescents, different indicators of socioeconomic status (SES) have rarely been compared within one data sample. We examined associations of five SES indicators with self-rated health (SRH) and smoking (ie, a leading cause of health inequalities) in Europe.MethodsData of adolescents aged 14–17 years old were obtained from the 2013 SILNE survey (smoking inequalities: learning from natural experiments), carried out in 50 schools in 6 European cities (N=10 900). Capturing subjective perceptions of relative SES and objective measures of education and wealth, we measured adolescents’ own SES (academic performance, pocket money), parental SES (parental educational level) and family SES (Family Affluence Scale, subjective social status (SSS)). Logistic regression models with SRH and smoking as dependent variables included all SES indicators, age and gender.ResultsCorrelations between SES indicators were weak to moderate. Low academic performance (OR=1.96, 95% CI 1.53 to 2.51) and low SSS (OR=2.75, 95% CI 2.12 to 3.55) were the strongest indicators of poor SRH after adjusting for other SES-indicators. Results for SSS were consistent across countries, while associations with academic performance varied. Low academic performance (OR=5.71, 95% CI 4.63 to 7.06) and more pocket money (OR=0.21, 95% CI 0.18 to 0.26) were most strongly associated with smoking in all countries.ConclusionsSocioeconomic inequalities in adolescent health were largest according to SES indicators more closely related to the adolescent’s education as well as the adolescent’s perception of relative family SES, rather than objective indicators of parental education and material family affluence. For future studies on adolescent health inequalities, consideration of adolescent-related SES indicators was recommended.
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Møller SP, Pisinger VSC, Christensen AI, Tolstrup JS. Socioeconomic position and alcohol-related harm in Danish adolescents. J Epidemiol Community Health 2019; 73:839-845. [PMID: 31221897 DOI: 10.1136/jech-2018-211634] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2018] [Revised: 04/29/2019] [Accepted: 05/13/2019] [Indexed: 11/04/2022]
Abstract
BACKGROUND In adults, it has consistently been observed that with equal alcohol consumption levels, alcohol harms individuals with low socioeconomic position (SEP) more than individuals with high SEP. It is unknown if this so-called alcohol harm paradox is also present in adolescents. We aim to test the hypothesis that low SEP is associated with more alcohol-related harm as compared with higher SEP in Danish adolescents. METHODS We used survey data from the Danish National Youth Study 2014 including 70 566 students from 119 high schools. Alcohol-related harm was measured by self-report as having been in a fight, involved in an accident, had problems with parents or friends, had sex that was regretted afterwards and done drugs that was regretted afterwards, because of alcohol. Further, a combined measure was constructed defined as having experienced any harm more than once within the last year. SEP was measured as parents' educational level, family income, parents' employment status and experiencing financial strain in the family. Analyses were adjusted by age, sex, perceived ethnicity, class type and binge drinking. RESULTS Lower SEP was associated with higher odds of experiencing alcohol-related harm more than once as compared with highest SEP, and lower SEP was associated with higher odds of having been in a fight, problems with parents or friends, sex and regretting afterwards or drugs and regretting afterwards, as compared with highest SEP. These associations were statistically significant. Adjustment for the frequency of binge drinking did not change results. CONCLUSION The alcohol harm paradox exists in Danish adolescents, and this should be addressed in future prevention strategies to reduce the risk of alcohol-related harm among adolescents.
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Affiliation(s)
- Sanne Pagh Møller
- National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark
| | | | | | - Janne S Tolstrup
- National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark
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Liu GZ, Pan YG, Li BB, Hou XL, Zhang DJ. The protective effect of psychological suzhi on the relationship between school climate and alcohol use among Chinese adolescents. Psychol Res Behav Manag 2019; 12:307-315. [PMID: 31118847 PMCID: PMC6500878 DOI: 10.2147/prbm.s202127] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2019] [Accepted: 03/26/2019] [Indexed: 11/23/2022] Open
Abstract
Background: There issome research on school climate impact on adolescent alcohol use in the Western social context; however, there is no research on school climate impact on adolescent alcohol use in China. This study aimed to explore the effect of school climate on Chinese adolescents' alcohol use, and the moderating role of psychological suzhi between them. Methods: A total of 801 adolescents (45.8% boys, 14.96±1.66 years) completed self-reports on school climate, psychological suzhi, and alcohol use. Results: Moderation analyses revealed that both school climate and psychological suzhi significantly negatively predicted adolescents' alcohol use, and the interaction of school climate and psychological suzhi significantly positively predicted adolescents' alcohol use. Moreover, the effect of school climate on adolescents' alcohol use was stronger for low psychological suzhi adolescents than high psychological suzhi adolescents. Conclusions: We can build good school climate by formulating of national level legal and regulations and good social norms, and use mature interventions or cultivation strategies to improve adolescents' psychological suzhi in order to better play its role in protection.
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Affiliation(s)
- Guang-Zeng Liu
- Faculty of Psychology, Research Center of Mental Health Education, Southwest University, Chongqing 400715, People's Republic of China
| | - Yan-Gu Pan
- Research Institute of Social Development, Southwestern University of Finance and Economics, Chengdu 610052, People's Republic of China
| | - Bing-Bing Li
- Faculty of Psychology, Research Center of Mental Health Education, Southwest University, Chongqing 400715, People's Republic of China
| | - Xiang-Ling Hou
- School of Psychology and Cognitive Science, East China Normal University, Shanghai 200062, People's Republic of China
| | - Da-Jun Zhang
- Faculty of Psychology, Research Center of Mental Health Education, Southwest University, Chongqing 400715, People's Republic of China
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Picoito J, Santos C, Loureiro I, Aguiar P, Nunes C. Gender-specific substance use patterns and associations with individual, family, peer, and school factors in 15-year-old Portuguese adolescents: a latent class regression analysis. Child Adolesc Psychiatry Ment Health 2019; 13:21. [PMID: 31110558 PMCID: PMC6511212 DOI: 10.1186/s13034-019-0281-4] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2018] [Accepted: 04/30/2019] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Adolescence is a critical period of vulnerability to substance use. Recent research has shown that gender differences in adolescence substance use are complex and in constant flux. The present study aims to investigate gender differences in substance use and initiation patterns in male and female adolescents, and to assess individual, family, peer, and school associated factors of these patterns. METHODS We applied latent class regression analysis to a Portuguese representative population sample of 1551 15-year-old adolescents, drawn from the 2010 'Health Behavior in School-Aged Children' survey, to characterise different profiles of substance use and initiation for boys and girls, and to identify factors associated with latent class membership, stratifying the associations analysis by gender. RESULTS Three common classes were found for both genders, specifically, Non-Users (boys [B] 34.42%, girls [G] 26.79%), Alcohol Experimenters (B 38.79%, G 43.98%) and Alcohol and Tobacco Frequent Users (B 21.31%, G 10.36%), with two additional unique classes: Alcohol Experimenters and Tobacco Users in girls (18.87%), and Early Initiation and Poly-Substance Users in boys (5.48%). Poor school satisfaction, bullying, fighting and higher family affluence scale score formed a common core of associated factors of substance use, although we found gender differences in these associations. In girls, but not in boys, family factors were associated with more problematic substance use. Not living with both parents was associated with girl's Alcohol and Tobacco Frequent Users (gATFU) class (OR 3.78 CI 1.18-12.11) and Alcohol Experimenters and Tobacco Users (AETU) class (OR 3.22 CI 1.4-7.44). Poor communication with mother was also associated with gATFU class membership (OR 3.82 CI 1.26-11.53) and AETU class (OR 3.66 CI 1.99-6.75). Additionally, a higher psychological symptoms score was associated with gATFU class membership (OR 1.16 CI 1.02-1.31). CONCLUSION Although we found common patterns and associated factors between boys and girls, we report two unique patterns of substance use in boys and girls and specific associations between family, school and peers, and individual factors with these patterns. These findings underscore the need for substance use prevention and health promotion programmes that address potential differences in substance use patterns and associated factors.
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Affiliation(s)
- João Picoito
- Department of Child and Adolescent Psychiatry, Hospital Pediátrico, Centro Hospitalar e Universitário de Coimbra, Rua Doutor Afonso Romão, 3000-609 Coimbra, Portugal
- Escola Nacional de Saúde Pública, Universidade NOVA de Lisboa, Avenida Padre Cruz, 1600-560 Lisbon, Portugal
| | - Constança Santos
- Escola Nacional de Saúde Pública, Universidade NOVA de Lisboa, Avenida Padre Cruz, 1600-560 Lisbon, Portugal
- Department of Pediatrics, Centro Hospitalar Cova da Beira, Quinta do Alvito, 6200-251 Covilhã, Portugal
| | - Isabel Loureiro
- Escola Nacional de Saúde Pública, Universidade NOVA de Lisboa, Avenida Padre Cruz, 1600-560 Lisbon, Portugal
| | - Pedro Aguiar
- Escola Nacional de Saúde Pública, Universidade NOVA de Lisboa, Avenida Padre Cruz, 1600-560 Lisbon, Portugal
| | - Carla Nunes
- Escola Nacional de Saúde Pública, Universidade NOVA de Lisboa, Avenida Padre Cruz, 1600-560 Lisbon, Portugal
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Oliveira-Campos M, Oliveira MMD, Silva SUD, Santos MAS, Barufaldi LA, Oliveira PPVD, Andrade SCDA, Andreazzi MARD, Moura LD, Malta DC, Souza MDFMD. Risk and protection factors for chronic noncommunicable diseases in adolescents in Brazilian capitals. REVISTA BRASILEIRA DE EPIDEMIOLOGIA 2018; 21:e180002. [PMID: 30517453 DOI: 10.1590/1980-549720180002.supl.1] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2017] [Accepted: 12/19/2017] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE To analyze trend estimates on the prevalence of risk and protective behaviors for chronic noncommunicable diseases in adolescents, according to data from the National School Health Survey in 2009, 2012 and 2015. METHODS Data from the three cross-sectional studies in Brazilian capitals and the Federal District were used. In total, 173,310 adolescents enrolled in the ninth grade of elementary school were interviewed, with average age of 14 years. The prevalence of indicators of protective (consumption of beans and fruit; physical education classes at school; practice of physical activity for 60 minutes or more) and risk factors (consumption of candies and soft drinks; use of cigarettes and alcohol in the last 30 days; drug testing) were estimated through linear regression. RESULTS There was a significant increase (p < 0.05) in the prevalence of fruit consumption and in the reduction of bean, soft drinks and candies consumption, as well as the consumption of alcoholic beverages and cigarettes. However, an increase in the prevalence of illicit drug experimentation was observed. Discussion: Despite the tendency to reduce risk factors, prevalences are high when compared with other sociocultural realities. CONCLUSION The school is an important area of access to the adolescent public, and it is necessary to encourage school health promotion programs to reduce health risk behaviors, as well as to stimulate protective ones.
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Affiliation(s)
- Maryane Oliveira-Campos
- Departamento de Vigilância de Doenças e Agravos não Transmissíveis e Promoção da Saúde, Ministério da Saúde - Brasília (DF), Brasil
| | - Max Moura de Oliveira
- Departamento de Epidemiologia, Faculdade de Saúde Pública, Universidade de São Paulo - São Paulo (SP), Brasil
| | - Simoni Urbano da Silva
- Departamento de Vigilância de Doenças e Agravos não Transmissíveis e Promoção da Saúde, Ministério da Saúde - Brasília (DF), Brasil
| | - Maria Aline Siqueira Santos
- Departamento de Vigilância de Doenças e Agravos não Transmissíveis e Promoção da Saúde, Ministério da Saúde - Brasília (DF), Brasil
| | - Laura Augusta Barufaldi
- Departamento de Vigilância de Doenças e Agravos não Transmissíveis e Promoção da Saúde, Ministério da Saúde - Brasília (DF), Brasil
| | | | | | | | | | - Deborah Carvalho Malta
- Escola de Enfermagem, Universidade Federal de Minas Gerais - Belo Horizonte (MG), Brasil
| | - Maria de Fátima Marinho de Souza
- Departamento de Vigilância de Doenças e Agravos não Transmissíveis e Promoção da Saúde, Ministério da Saúde - Brasília (DF), Brasil
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Nowak M, Papiernik M, Mikulska A, Czarkowska-Paczek B. Smoking, alcohol consumption, and illicit substances use among adolescents in Poland. SUBSTANCE ABUSE TREATMENT PREVENTION AND POLICY 2018; 13:42. [PMID: 30497492 PMCID: PMC6267883 DOI: 10.1186/s13011-018-0179-9] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/20/2018] [Accepted: 11/09/2018] [Indexed: 12/28/2022]
Abstract
Background The use of alcohol, tobacco, and illicit substances typically first occurs in adolescence. The purpose of this study was to examine alcohol, cigarette, and illicit substance use among adolescents in Poland, including the age of initiation, frequency of use, methods of access, location of use, and parental knowledge and attitude. Methods An author-derived questionnaire was used to cross-sectionally survey 541 participants aged 13–17 years old. Due to the fact that some answers were lacking, the number of questionnaires analysed was 538 in case of smoking and illicit substances use, and 535 in case of alcohol drinking. Results The use of alcohol, cigarette, and illicit substance among the investigated group was 36.1, 37.6, and 10.8% respectively. The average age of initiation was 13–14 years old. Parents were aware of alcohol, cigarette, and illicit substance use 49.5, 35.8 and 22.4% of the time, respectively, and the rate of acceptance was 5.7 and 6.7% for alcohol and cigarettes. More than 28% of participants smoked in school, and 32.7% accessed illicit substances in the school’s neighborhood. Conclusions The rate of alcohol, cigarette, and illicit substance use in Poland is high and increasing, despite globally designed preventative actions. Parents’ awareness of children’s alcohol, cigarette, or illicit substance use is low, and schools hardly fulfil their educational and protective role. Preventative actions are necessary, and local challenges should be considered.
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Affiliation(s)
- Maria Nowak
- Department of Clinical Nursing, Medical University of Warsaw, E. Ciolka Street 27, 01-445, Warsaw, Poland
| | - Malgorzata Papiernik
- Department of Clinical Nursing, Medical University of Warsaw, E. Ciolka Street 27, 01-445, Warsaw, Poland
| | - Alicja Mikulska
- Department of Clinical Nursing, Medical University of Warsaw, E. Ciolka Street 27, 01-445, Warsaw, Poland
| | - Bozena Czarkowska-Paczek
- Department of Clinical Nursing, Medical University of Warsaw, E. Ciolka Street 27, 01-445, Warsaw, Poland.
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Moñino-García M, Adoamnei E, Gadea-Nicolás A, Arense-Gonzalo JJ, López-Espín JJ, Torres-Cantero AM. Family environmental factors associated with underage drinking. JOURNAL OF SUBSTANCE USE 2018. [DOI: 10.1080/14659891.2018.1523965] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
- Miriam Moñino-García
- Division of Preventive Medicine and Public Health, Department of Public Health Sciences, University of Murcia School of Medicine, Espinardo (Murcia), Spain
- Institute for Biomedical Research of Murcia, IMIB-Arrixaca, El Palmar (Murcia), Spain
| | - Evdochia Adoamnei
- Division of Preventive Medicine and Public Health, Department of Public Health Sciences, University of Murcia School of Medicine, Espinardo (Murcia), Spain
- Institute for Biomedical Research of Murcia, IMIB-Arrixaca, El Palmar (Murcia), Spain
| | - Alicia Gadea-Nicolás
- Division of Preventive Medicine and Public Health, Department of Public Health Sciences, University of Murcia School of Medicine, Espinardo (Murcia), Spain
| | - Julián J. Arense-Gonzalo
- Division of Preventive Medicine and Public Health, Department of Public Health Sciences, University of Murcia School of Medicine, Espinardo (Murcia), Spain
- Institute for Biomedical Research of Murcia, IMIB-Arrixaca, El Palmar (Murcia), Spain
| | - José J. López-Espín
- Institute for Biomedical Research of Murcia, IMIB-Arrixaca, El Palmar (Murcia), Spain
- Center of Operation Research, Miguel Hernández University of Elche, Elche, Spain
| | - Alberto M. Torres-Cantero
- Division of Preventive Medicine and Public Health, Department of Public Health Sciences, University of Murcia School of Medicine, Espinardo (Murcia), Spain
- Institute for Biomedical Research of Murcia, IMIB-Arrixaca, El Palmar (Murcia), Spain
- CIBER Epidemiology and Public Health (CIBERESP), Carlos III Health Institute, Madrid, Spain
- Department of Preventive Medicine, “Virgen de la Arrixaca” University Clinical Hospital, El Palmar (Murcia), Spain
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Too much or too little? A short-term longitudinal study of youth's own economic resources and risk behaviour. J Adolesc 2018; 66:21-30. [DOI: 10.1016/j.adolescence.2018.04.005] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2018] [Revised: 04/06/2018] [Accepted: 04/26/2018] [Indexed: 11/21/2022]
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