Adolescent lifestyle and behaviour: a survey from a developing country

The FRESHAIR4Life study: Global implementation research on non-communicable disease prevention targeting adolescents' exposure to tobacco and air pollution in disadvantaged populations

The FRESHAIR4Life study aims to reduce the non-communicable disease (NCD) burden by implementing preventive interventions targeting adolescents' exposure to tobacco use and air pollution (AP) worldwide. This paper presents the FRESHAIR4Life methodology and initial rapid review results. The rapid review, using various databases and PubMed, aimed to guide decision-making on risk factor focus, target areas, and populations. It showed variable NCD mortality rates related to tobacco use and AP across the participating countries, with tobacco as the main risk factor in the Kyrgyz Republic, Greece, and Romania, and AP prevailing in Pakistan and Uganda. Adolescent exposure levels, sources, and correlates varied. The study will continue with an in-depth situational analysis to guide the selection, adaptation, and integration of evidence-based interventions into the FRESHAIR4Life prevention package. This package will be implemented, evaluated, assessed for cost-effectiveness, and iteratively refined. The research places a strong emphasis on co-creation, capacity building, and comprehensive communication and dissemination.

Peer influence and its impact on behavior among South Indian adolescents: A descriptive cross-sectional study

BACKGROUND

Peer influence, the development of attitudes, and behavioral changes are some of the phenomenal changes that happen in adolescence.

MATERIALS AND METHODS

A descriptive cross-sectional study was undertaken to find out the association between peer influence and behavior among 355 adolescents within the age group of 16 to 18 years, randomly chosen from Pre-university schools of Udupi district, Karnataka using the Peer Influence Scale (PIS) and Strengths and Difficulties Questionnaire (SDQ).

RESULT

The results indicate that their peers highly influenced 43.9% of the participants. Meanwhile, 23.1% and 7.9% of adolescents who participated in the survey showed borderline and abnormal behavior, respectively. The association between peer influence and behaviour was assessed using the Chi-square test; the results (χ2=14.545, P = 0.001) revealed that peers highly influence adolescent behavior and change adolescent conduct significantly.

CONCLUSION

Adolescents should be aware of the accepted and non-accepted behaviors in society and be wise in choosing the right peers who later influence their behavior. Parents need to check the conduct of their children and guide them in developing their identity.

Disparity between Subjective Health Perception and Lifestyle Practices among Korean Adolescents: A National Representative Sample

Background

The relationship between subjective health perception (SHP) and lifestyle practices brings into question the future health status of an individual. Recognition of the disparity between one's health consciousness to the real practices encourages change and promotes development of better health programs. The adolescent stage is the best time to identify this disparity wherein lifestyle practices are still being developed. In Korea, adolescents experienced significant shifts in lifestyle due to the fast economic growth and the breakthrough of the digital era. Thus, determining the disparity between SHP and lifestyle practices among Korean adolescents poses a great deal of interest and importance.

Methods

Utilizing the 2019 Korea Youth Risk Behavior Web-based Survey (KYRBS), self-reported data with a national representative sample-57,303 respondents-of Korean adolescents in the 7-12^th grades, was used from a multistage sampling, stratification, and clustering was obtained. SHP and lifestyle practices were collected and analyzed.

Results

The findings revealed that most respondents with poor diet, exercise, and sleep behaviors perceived themselves to be normal, healthy, or extremely healthy, which resulted in a negative correlation between SHP and lifestyle behaviors-except in the case of substance use.

Conclusion

There is a significant disparity between Korean adolescents' SHP and lifestyle practices. This highlights the need for lifestyle interventions and re-education among Korean adolescents. Their current lifestyle practices may extend into adulthood, thereby increasing the risks of cardiovascular and other lifestyle-induced diseases.

Characteristics of Sleep Patterns in Adolescents: Comparisons between Saudi Arabia and the UK

There are concerns regarding sleep deprivation among adolescents, especially with mounting evidence for the importance of sleep during puberty, and its effects on health and families. The present study aimed to characterise sleep in typical development (TD) adolescents in Saudi Arabia, and compare their sleep profiles to TD adolescents in the UK, to evaluate sleep patterns in adolescents in Saudi Arabia, and to examine the relationship between sleep patterns and the use of social media in both groups. Findings from the current study reported a shorter sleep duration for the Saudi Arabia group than in previous studies and the UK group, which may be attributed to the lack of sleep hygiene practised in Saudi Arabia. Multiple analysis of variance results found significant differences in daytime sleepiness (p < 0.001) and a preference for morningness/eveningness (p < 0.001) between Saudia Arabia and UK adolescents. Statistically significant negative correlations (p > 0.05) between the duration of social media usage and sleep duration were found in both the Saudi Arabia and UK adolescents, where a lower number of sleep hours was observed with a higher duration of social media use. This study fills a gap in the research of sleep in Saudi Arabia in adolescents, and offers important insights on the comparison in sleep habits between Saudi Arabia and UK adolescents.

An Exploratory Analysis of the Effect of Demographic Features on Sleeping Patterns and Academic Stress in Adolescents in China

Adolescents typically engage in unhealthy lifestyle habits including short sleep and high academic stress. These in turn may have serious impacts on their development. The present study examines the effect of demographic characteristics on sleep patterns and academic stress in adolescents. A sample of 244 (119 females) junior high school adolescents aged between 11 and 16 were recruited from China. The Student Life Stress Questionnaire and the School Sleep Habits Survey were used to assess participants' sleep habits and academic stress. Multipair and corrected pairwise Kruskal-Wallis tests were conducted to assess the effect of school grade, gender, academic performance level, living situation, single child status, and parental education on adolescents' sleeping patterns and academic stress. Significant changes in facets of sleeping patterns emerged when examining groups of students in terms of school grade, living situation, and single-child status. Furthermore, caffeine consumption was found to be significantly higher in males, in students with poorer academic performances, and in single-child adolescents. Ultimately, academic stress was modulated by adolescents' school grade, academic performances, living situation, and single-child status. Developmental trajectories in sleep patterns together with differential exposure to stressors and adopted coping mechanisms are discussed in the manuscript.

Social connectedness and health risk behaviours among in-school adolescents in urban and rural areas of Oyo State, Nigeria

Adolescents are considered vulnerable due to their ability to venture into Health Risk Behaviours (HRBs) that may have a long-term detrimental effect on their total wellbeing. The major focus of previous adolescents' studies in Nigeria has been on parent-adolescent communication and the relationship it has with their academic performance and sexual behaviour; none has explored the association of social connectedness and HRBs among in-school adolescents. Thus, the aim of this study is to assess and compare social connectedness and HRBs among in-school adolescents in urban and rural areas of Oyo State. A school-based comparative cross-sectional design was employed wherein 2071 in-school adolescents were selected via a multistage cluster sampling in Ibarapa Central and Ibadan North Local Government Areas (LGAs) of Oyo State. The independent variables were socio-demographic characteristics, family characteristics and social connectedness while the dependent variable was HRBs. The data was analysed using descriptive statistics, chi square, t-test, ANOVA and logistic regression with level of statistical significance set at 5%. Overall, slightly over one-half of the respondents (51.9%) were from the urban LGA and 54.2% were females. The mean age of respondents was 13.7 ± 2.1 years and 46.7% were early adolescents aged 10-13 years. The prevalence of HRBs among in-school adolescents was high (91.8%) and the mean score of social connectedness among in-school adolescents was high, with a slightly higher mean in rural area (131.71 ± 16.43) compared to (131.04 ± 14.47) in urban area. However, this was not statistically significant (p = 0.322). The mean scores of the domains of religious connectedness (p = 0.176), school connectedness (p < 0.001), peer connectedness (p < 0.001) and social-media connectedness (p = 0.003) were higher in the rural areas. However, the mean score of family connectedness among respondents was higher in the urban area (p < 0.001). The odds of having engaged in HRBs were significantly 1.57 times more likely among respondents who were males than those who were females {AOR = 1.57, 95% CI: 1.12-2.19}. The odds of having engaged in HRBs was significantly 1.44 times more likely among respondents who live in an urban area than among those who live in a rural area {AOR = 1.44, 95% CI: 1.03-2.01}. For a unit increase in the total score of social-media connectedness of the students, the odds of having engaged in HRBs was reduced by 0.95 {AOR = 0.95, 95% CI: 0.92-0.99}. There were significantly lower mean scores for social connectedness among respondents who had engaged in HRBs compared to their counterpart who had not engaged in HRBs. Therefore, various efforts targeted at improving social connectedness with its domains could be recommended to prevent in-school adolescents from engaging in HRBs.

Development and validation of a questionnaire measuring knowledge, attitudes, and practices (KAP) to healthy eating and activity patterns in school children (HEAPS)

BACKGROUND

Development of culturally appropriate and psychometrically sound instruments that measure knowledge and health behaviors of children will help to inform appropriate interventions.

AIM

To develop and test the validity and reliability of a questionnaire measuring knowledge, attitudes, and practices to healthy eating and activity patterns in school children in India.

METHODS

Review of literature, focus-group discussions, and theoretical constructs of the Health Belief Model guided the development of an item pool. Face and content validity were assessed by children and a panel of experts and the item content validity, item difficulty, and discrimination indices were calculated. Construct validity was determined using the principal axis method of exploratory factor analysis among a cross-sectional sample of children (n=252). Internal consistency (Cronbach α values >0.7) and test-retest reliability (intraclass correlation coefficient values >0.75) were estimated.

RESULTS

Item content validity index for clarity and relevance were satisfactory (>0.80) and internal consistency for knowledge (Kuder-Richardson 20 = 0.832), attitude (Cronbach's α = 0.912), and practice items (Cronbach's α = 0.769) were good. Four factors (children's eating habits, family dietary practices, and consumption of healthy and unhealthy foods) and two factors (moderate to vigorous activities and sedentary activities) explained 67.7% and 48.2% of the total variance in practice items. Intraclass correlation coefficient estimates ranged from good to excellent (0.72-0.99).

CONCLUSIONS

The results of the validity and reliability of the 84-item knowledge, attitudes, and practices to healthy eating and activity patterns in schoolchildren questionnaire were promising. The detailed description of the methodology employed may prove useful to researchers conducting similar studies in children.

Associations between socioprovincial factors and self-reported mental disorders among students from grade 4 to 8 in rural China

Background

The focus on child mental health in developing countries was increasing. However, little was known in China. This study aimed to explore the associations between socioprovincial factors and self-reported mental disorders in rural China.

Methods

Data were from a publicly available survey with 54,498 students from Grade 4 to 8 in rural China. Chi-square test was used for descriptive analysis. Self-reported mental disorders included overall mental disorder, study anxiety, personal anxiety, loneliness, guilt, sensitivity, symptomatic psychosis, phobia, and impulsivity. Multiple logistic regressions and errors-in-variables regression models were employed to explore the associations between socioprovincial factors and mental disorders. Poisson regressions and errors-in-variables regression models were adopted to reveal the associations between socioprovincial factors and number of self-reported mental disorders.

Results

Descriptive statistics showed that mental health was poor in rural adolescents in China. Logistic regression showed that the odds of overall mental disorder and study anxiety were 189% (AOR = 2.89, 95%CI: 2.76, 3.02) and 92% (OR = 1.92, 95%CI: 1.84, 2.00) in Gansu more than those in Anhui, while the odds of personal anxiety, guilt, sensitivity, symptomatic psychosis, and phobia were 92% (AOR = 0.08, 95%CI: 0.08, 0.09), 71% (AOR = 0.29, 95%CI: 0.27, 0.30), 88% (AOR = 0.12, 95%CI: 0.11, 0.13), 69% (AOR = 0.31, 95%CI: 0.29, 0.32), and 78% (AOR = 0.22, 95%CI: 0.21, 0.23) in Gansu less than those in Anhui. Moreover, Gansu (Poisson regression: IRR =1.45, 95%CI: 1.42–1.47; errors-in-variables regression: Coefficient = 0.26, 95%CI: 0.16, 0.36), Ningxia (Poisson regression: IRR =1.63, 95%CI: 1.60–1.67; errors-in-variables regression: Coefficient = 0.43, 95%CI: 0.32, 0.53), Qinghai (Poisson regression: IRR =1.65, 95%CI: 1.60–1.69; errors-in-variables regression: Coefficient = 0.44, 95%CI: 0.34, 0.55), and Shaanxi (Poisson regression: IRR =1.28, 95%CI: 1.25–1.30; errors-in-variables regression: Coefficient = 0.11, 95%CI: 0.00, 0.21) were significantly associated with the number of self-reported mental disorders.

Conclusion

Class and provincial disparities in self-reported mental disorders were reported among the students from Grade 4 to 8 in rural China. Mental health care supported by governments and schools could be an effective way to reduce the disparities in mental disorders among the adolescents.

Secondary attachment and mental health in Pakistani and Scottish adolescents: A moderated mediation model

OBJECTIVES

Research into adolescent mental health has tended to focus on primary attachment relationships. However, the effect of secondary attachment relationships and the role of culture remain under-explored. This study examined the associations between primary attachment, secondary attachment, and coping strategies (task-focused, emotion-focused, and avoidant coping) with psychological well-being and psychological distress in adolescents across two cultural settings.

DESIGN

A cross-sectional study.

METHOD

An identical test battery was used across two geographic sites in Pakistan (N = 510; 12-18 years; 51.5% male; mean age = 14.50) and Scotland (N = 610; 12-18 years; 53.6% male; mean age = 13.97). Associations were tested separately in each sample using moderated mediation modelling for the outcome variables: psychological well-being and psychological distress.

RESULTS

For psychological well-being, all three coping strategies were significant partial mediators and secondary attachment was a significant moderator in both samples. Secondary attachment moderated the association between emotion-focused coping and psychological well-being in the Pakistani sample only. For psychological distress, task-focused coping was a significant full mediator in the Pakistani sample only. In contrast, for the Scottish sample, task-focused coping and emotion-focused coping were significant partial mediators. Secondary attachment's direct effect on psychological distress was significant in both samples. Secondary attachment also moderated the association between emotion-focused coping and psychological distress in the Pakistani sample only.

CONCLUSIONS

The cross-cultural evidence suggests that alongside primary attachment, it is important to target secondary attachment through coping strategies, in order to enhance psychological well-being and lessen psychological distress in adolescents.

PRACTITIONER POINTS

Secondary attachment plays a different role from primary attachment in adolescents. Therefore, it is important to target both primary attachment and secondary attachment security to enhance psychological well-being and lessen psychological distress. Cross-cultural differences in coping suggest that differential strategies to target different coping dimensions may enhance adolescent well-being across cultures. These cross-cultural differences highlight the ethical importance of cultural sensitivity among clinicians working with adolescents globally.

Cross-sectional research on sleep hygiene and health complaints among Pakistani college students

With recent technological advancement, a major shift in the lifestyle of individuals has been observed. This change is more evident in youth in terms of sleep pattern changes and socialization. It is therefore important to assess the quality of life in this productive group of society. The protocol consisted of the Urdu version of the demographic questionnaires, the Pittsburgh Sleep Quality Index (PSQI), the Cohen-Hoberman Inventory of Physical symptoms (CHIPS) and the World Health Organization Quality of Life (WHOQOL-BREF). A total of 150 young adults (boys = 62, girls = 88) were included through convenience sampling. A significant positive association was found between poor sleep quality and health complaints (r = 0.53**). However, a significant negative association was found between poor sleep and quality of life in terms of physical health, psychological health, social relationships and the environment (r = -0.57**, -0.35**, -0.39**, -0.33**), respectively, which indicates the importance of sleep in determining quality of life. Furthermore, the majority of the participants (57%) reported good sleep quality and low health complaints [M = 15.08, standard deviation (SD) = 13.29] whereas 43% of participants reported poor sleep quality, more health complaints (M = 32.94, SD = 22.59) and poor quality of life. It shows that most of the participants are healthy and able to manage their daily routine, work commitment and provide services for country's development.

Piloting a Culturally Adapted Arabic Structured Small-Group Education Program for Adolescents with Type 1 Diabetes

BACKGROUND

Kuwait has a high prevalence and incidence of type 1 diabetes (T1D). At present there is a need for structured educational programs (SEP) specifically tailored for Arabian youth with T1D. This SEP was locally and culturally adapted from the Kids In Control of Food (KICk-OFF) course delivered at the Dasman Diabetes Institute, Kuwait.

AIMS

To explore the psychological and social impact of a pilot SEP for Arabian youth with T1D and their mothers through exploring their respective perspectives.

METHODS

All 20 participants were interviewed using semistructured interviews individually, with a duration of approximately 30-45 min. The interviews were recorded and then transcribed verbatim. Data were analyzed using an inductive thematic approach.

RESULTS

The adolescents gained more self-confidence in managing their diabetes and their mothers were more confident in allowing their children take the lead in their diabetes self-management. Participants were empowered with adequate knowledge about the underlying pathophysiology of glucose metabolism and the nutritional and pharmacological management which made them feel in control and helped them to better cope with diabetes. It reduced diabetes-related family stress and gave them more social freedom, supporting behavioral change for a better lifestyle.

CONCLUSIONS

Attending the adapted SEP had a positive impact on adolescents with T1D and their mothers through enhancement of their knowledge and confidence, thus giving them a sense of disease control. This pilot study has proven effective in terms of enhancement of confidence in diabetes management and psychosocial factors. Therefore, there is a need for a wider implementation.

Diet, Physical Activity, and Screen Time among School Students in Manipur

Context:

Adolescence is a critical time in the development of lifelong healthy eating and exercise habits. The high prevalence of adolescents exposed to excessive screen time is a matter of concern because of its association with several health problems, such as overweight and obesity, alterations in blood glucose and cholesterol, poor school performance, decreased social interaction, and lower levels of physical activity.

Aims:

The aim of this study is to identify the lifestyle behaviors of young adolescents focusing on physical activity, diet, and screen time.

Settings and Design:

A cross-sectional study was conducted among 929 students of Class VII and VIII in schools in Imphal West and Kangpokpi districts of Manipur.

Subjects and Methods:

Data collection was done by questionnaire method.

Statistical Analysis Used:

The data were analyzed using IBM SPSS for Windows, Version 21.0. Armonk, NY, USA.

Results:

Seven in 10 of the students had inadequate physical activity at school and inadequate physical activity outside school. About 56.9% of the students have a smartphone, whereas one-third of them have Facebook and WhatsApp accounts. Only 5.8% were eating a healthy diet. Females and day scholars were less physically active. Males those staying in a nuclear family, less family income, and more number of siblings were found to have unhealthy dietary habits.

Conclusions:

Less than half of the students were physically active and only six out of 100 the students were eating a healthy diet.

Effectiveness of holistic group health promotion program on educational stress, anxiety, and depression among adolescent girls - A pilot study

BACKGROUND

Academic stress is one of the major stresses among adolescents and it has been associated with poor mental health.

AIM

Evaluate effectiveness of holistic intervention on educational stress among adolescent girls.

MATERIALS AND METHODS

Randomized controlled design was adopted and study was conducted at selected colleges of Dharwad city, India. 60 adolescent girls were randomly assigned to either experimental or control group. All subjects were initially assessed for educational stress, depression and anxiety. The experimental group subjects received 8 sessions of holistic intervention. No intervention was given to control group subjects. Post intervention assessments were done at the end of 1st, 2nd and 3rd months.

RESULTS

Experimental group subjects showed statistically significant decrease in educational stress, depression and anxiety over 3 months follow-up compared to control group subjects.

CONCLUSION

This study provided evidence of integrating a holistic intervention in reducing stress.

Sex and Trait Anxiety Differences in Psychological Stress are Modified by Environment

Evidence-based research has revealed how physiological and emotional responses to acute stress are adaptive. However, under conditions of unpredictable or protracted stress, health and drug vulnerability can be compromised. In this study, we examined anxiety-like behavioral responses of 4th generation adolescent male and female Long Evans rats selectively bred for high (HAn) and low (LAn) anxiety-like behavior when housed in an isolated environment (IE) versus a social environment (SE). After 35 days in IE or SE, animals were tested in the elevated plus maze (EPM), injected with amphetamine (AMPH: 0.5 mg/kg, IP) in the locomotor activity (LMA) chamber, measured for basal and post air puff-stressor core body temperature and blood pressure. Following select rearing, SE reduced the anxiogenic response in HAn rats with females displaying the lowest anxiety-like behavior in the EPM. During habituation in the LMA, IE rats remained active, while post-AMPH injection HAn females were hyperactive, followed closely by LAn females. Our findings from the post-stressor physiological measurements indicate that temperature differences due to environment are observed only in the SE females. We also observed group differences for diastolic (DBP) and systolic (SBP) blood pressure. HAn IE males experienced higher DBP and SBP but LAn IE females only experienced higher SBP. Not only do our findings corroborate earlier work on HAn/LAn lines but the findings obtained from this research offer new insights about the role of environment and the role of sex in (1) modulation of anxiety-like behavior, (2) AMPH sensitivity, and (3) basal and stress-induced physiological changes.

Systems and WBANs for Controlling Obesity

According to World Health Organization (WHO) estimations, one out of five adults worldwide will be obese by 2025. Worldwide obesity has doubled since 1980. In fact, more than 1.9 billion adults (39%) of 18 years and older were overweight and over 600 million (13%) of these were obese in 2014. 42 million children under the age of five were overweight or obese in 2014. Obesity is a top public health problem due to its associated morbidity and mortality. This paper reviews the main techniques to measure the level of obesity and body fat percentage, and explains the complications that can carry to the individual's quality of life, longevity and the significant cost of healthcare systems. Researchers and developers are adapting the existing technology, as intelligent phones or some wearable gadgets to be used for controlling obesity. They include the promoting of healthy eating culture and adopting the physical activity lifestyle. The paper also shows a comprehensive study of the most used mobile applications and Wireless Body Area Networks focused on controlling the obesity and overweight. Finally, this paper proposes an intelligent architecture that takes into account both, physiological and cognitive aspects to reduce the degree of obesity and overweight.

Cannabis use among middle and high school students in Ontario: a school-based cross-sectional study

BACKGROUND

Cannabis use can have serious detrimental effects in children and adolescents. It is therefore important to continually assess the use of cannabis among young people in order to inform prevention efforts. We assessed the prevalence of cannabis use among middle and high school students in Ontario and examined its association with demographic and behavioural factors.

METHODS

Data were obtained from the 2015 Ontario Student Drug Use and Health Survey, a province-wide school-based survey of students in grades 7 through 12. Analyses included a representative sample of 9920 middle and high school students. Bivariate cross-tabulations and logistic regression analyses were used to investigate the factors associated with cannabis use.

RESULTS

Overall, 21.5% and 13.9% of students reported using cannabis in the previous year and previous month, respectively. The conditional probability that an adolescent who reported cannabis use in the previous year would report daily use was 12.5%. There was a significant dose-response gradient with age, with older students being more likely to use cannabis than younger students. In multivariable analyses, being in grades 10 through 12 (odds ratios [ORs] ranged from 3.71 to 3.85), being black (OR 2.67 [95% confidence interval (CI) 1.76-4.05]), using tobacco cigarettes (OR 10.10 [95% CI 8.68-13.92]) and being an occasional (OR 5.35 [95% CI 4.01-7.13]) or regular (OR 14.6 [95% CI 10.8-19.89]) alcohol user were associated with greater odds of cannabis use. Being an immigrant was associated with lower odds of cannabis use (OR 0.55 [95% CI 0.39-0.78]).

INTERPRETATION

The findings suggest that cannabis use is prevalent among middle and high school students in Ontario and is strongly associated with tobacco cigarette smoking and alcohol consumption. Future research should document trends in cannabis use over time, including its risks, especially when the legalization of recreational cannabis comes into effect.

Financial wellness awareness: A step closer to achieve Millennium Development Goals for Pakistan

Objective:

To explore financial wellness (FW) awareness amongst public and private sector medical college students of Karachi.

Methods:

A cross sectional questionnaire based survey was conducted on medical students from 3 public and 5 private sector medical colleges of Karachi from February 2011 to December 2011. All ethnic groups having age range of 18-23 years were included. A questionnaire tailored from wellness wheel evaluated the responses of FW on a four point Likert’s scale ranging from 0-3(never, sometimes, mostly, and always). Factor analysis explored common FW factors among both public and private sector medical college (MC) students.

Results:

Private MC Students were better in terms of making short and long terms financial goals compared to students in public sector. The students of public MC were more focused to make and restricting to given budgets (p=0.05). The FW element of keeping savings in bank account was responded more by private MC candidates (P < 0.0001) but was spent thrift as well (P < 0.0001). Factor analysis revealed two factors; ‘Financial Security Wellness’ which was better in Private MC Students (p=0.001) and ‘Care towards Expenses Wellness” in which results were not significant.

Conclusion:

Both groups of medical college students lacked FW awareness element in terms of caring towards financial expenses. The awareness of importance of financial security was practiced better by private MC students in terms of making short and long term financial goals and keeping savings in bank accounts. They were however deficient in the knowledge of making and restricting themselves to budgets.

Assessment of health-promoting behavior and lifestyle of adolescents of a north Indian city

BACKGROUND

Several health-compromising behaviors (e.g., smoking, alcohol) as well as health-enhancing behaviors (e.g., physical exercise, nutrition) are adopted in adolescence and they often persist into adulthood. Thus, there is a definite need to investigate the health behavior of adolescents rather than focus on adults since it will be far more difficult for adults to change their unhealthy habits adopted in their youth. Therefore, the present study was conducted to ascertain health-promoting behavior and lifestyle of university graduates of Chandigarh.

METHODS

The present cross-sectional pilot study was conducted in Chandigarh during 2009 among university graduates of Chandigarh aged 17-20 years. A semi-structured, pretested questionnaire comprising of 28 items was used to get information from students regarding their involvement in diet, physical exercise, spirituality and philanthropy. Height, weight, waist and hip circumference of the respondents were measured using standardized equipments and procedures.

RESULTS

Mean score of health-promoting lifestyle profile of university graduates was found to be 67.5 ± 12.1 (maximum attainable score = 106). Fourteen students were found to be overweight. Frequent intake of fast food and less consumption of fruits and vegetables was reported by the students. Majority of students exercised as part of their daily routine.

CONCLUSIONS

The result of the study showed that North Indian students had reasonably good orientations toward health behaviors, with a mean score of 67.5. The topics related to diet, physical exercise, spiritual growth and philanthropy promotion should be incorporated within the curriculum of students for their all round personality development.

In Iranian female and male adolescents, romantic love is related to hypomania and low depressive symptoms, but also to higher state anxiety

BACKGROUND

Experiencing romantic love is important in individual development. Little is known about romantic love among adolescents in non-Western countries. The aim of the present study was to explore romantic love among Iranian male and female adolescents.

METHOD

A total of 201 adolescents (mean age: 17.73 years) took part in the study; of these, 81 indicated they were experiencing romantic love at the time of survey, and 120 indicated they were not in love. Participants answered questionnaires related to affective states (hypomania, depressive symptoms, state and trait anxiety) and exercise, and completed a sleep log for seven consecutive nights.

RESULTS

Compared to controls, participants in love displayed favourable hypomania scores, fewer depressive symptoms and increased concentration during the day. However, participants in love also had higher state anxiety scores. Moreover, hypomanic-like stages increased with duration of relationship in female, but not in male participants.

CONCLUSIONS

The pattern of results suggests a favourable association between being currently in love and emotional and cognitive processes. Sleep, however, seemed unrelated to this specific state.

Subjective reports of children's sleep duration: does the question matter? A literature review

Questionnaires are widely used to determine children's sleep duration. While authors have been encouraged to move on from the question: 'how many hours of sleep do you usually get?', the validity of different reports remains unclear, and there do not appear to be any evidence-based recommendations for how to best enquire about children's sleep. Our study aims to determine the validity of subjective reports of children's sleep duration and if elements of phrasing influence the accuracy of reports. A systematic literature review was conducted to identify studies that report the subjective sleep duration of children ages five to 18years, inclusive. A thematic analysis was used to identify 'elements' of phrasing that may influence the accuracy of reports, and a descriptive analysis was conducted to determine the validity of subjective reports. Our review identified five elements of phrasing that may affect the accuracy of reports. These include, specifying sleep parameters that define sleep duration, the recall period, the day type, the method of data collection, and the respondent. The validity of subjective reports varied across studies and in accordance with identified elements of phrasing. Future studies that assess subjective reports of children's sleep should define sleep duration, the recall period, the days constituting schooldays and nonschooldays, the method of data collection, and the respondent of the questionnaire.

Unhealthy Lifestyle, Poor Mental Health, and Its Correlation Among Adolescents

Objectives. The objective was to study the relationship between mental health and lifestyles of adolescents using samples representative of Japanese adolescents nationwide. Method. The survey was conducted between December 2004 and January 2005 among students enrolled in randomly selected junior and senior high schools. Self-administered questionnaires addressed lifestyles, sleeping habits, and mental health status. Of 103 650 questionnaires collected, 85 158 were analyzed. Results. Population characteristics associated with poor mental health were being female, being a senior high school student, skipping breakfast, not participating in extracurricular activities, not consulting parents about personal matters, parental smoking, students’ smoking or alcohol use, poor subjective sleep assessment, and short or long sleeping duration. Conclusion. Smoking and anxiety disorders are associated with an elevation in acculturative stress in adolescents. Prepossessing adolescents are in subclinical depression. Results suggest that lifestyles approaches in preventions that target students can be effective in reaching high-risk populations.

Measuring health-related quality of life of HIV-positive adolescents in resource-constrained settings

BACKGROUND AND OBJECTIVES

Access to antiretroviral treatment among adolescents living with HIV (ALH) is increasing. Health-related quality of life (HRQOL) is relevant for monitoring the impact of the disease on both well-being and treatment outcomes. However, adequate screening tools to assess HRQOL in low-resource settings are scarce. This study aims to fill this research gap, by 1) assessing the psychometric properties and reliability of an Eastern African English version of a European HRQOL scale for adolescents (KIDSCREEN) and 2) determining which version of the KIDSCREEN (52-, 27- and 10-item version) is most suitable for low-resource settings.

METHODS

The KIDSCREEN was translated into Eastern African English, Luganda (Uganda) and Dholuo (Kenya) according to standard procedures. The reconciled version was administered in 2011 to ALH aged 13-17 in Kenya (n = 283) and Uganda (n = 299). All three KIDSCREEN versions were fitted to the data with confirmatory factor analysis (CFA). After comparison, the most suitable version was adapted based on the CFA outcomes utilizing the results of previous formative research. In order to develop a general HRQOL factor, a second-order measurement model was fitted to the data.

RESULTS

The CFA results showed that without adjustments, the KIDSCREEN cannot be used for measuring the HRQOL of HIV-positive adolescents. After comparison, the most suitable version for low-resource settings--the 27-item version--was adapted further. The introduction of a negative wording factor was required for the Dholuo model. The Dholuo (CFI: 0.93; RMSEA: 0.039) and the Luganda model (CFI: 0.90; RMSEA: 0.052) showed a good fit. All cronbach's alphas of the factors were 0.70 or above. The alpha value of the Dholuo and Lugandan HRQOL second-order factor was respectively 0.84 and 0.87.

CONCLUSIONS

The study showed that the adapted KIDSCREEN-27 is an adequate tool for measuring HRQOL in low-resource settings with high HIV prevalence.

Psychosocial predictors of smoking among secondary school students in Al-Hassa, Saudi Arabia

The objective of this study was to determine the prevalence and determinants of the current smoking status among secondary school students in Al-Hassa, Saudi Arabia. A total of 1,652 secondary school adolescents were selected by multistage proportionate sampling method. Data collection was carried out through self-administered anonymous questionnaire including: Arabic version of the Global Youth Tobacco Survey, modified Fagerstrom Test for Nicotine Dependence and Patient Health Questionnaire to asses for anxiety and depressive disorders. This study revealed that the prevalence of current smokers was 21.7. Seventy-one percent of current cigarette smokers were minimally nicotine dependent. Major depressive and anxiety disorders were significantly higher among current smokers. Hierarchical regression analysis shows that, male, older age, smoking of close relatives and friends, anxiety disorders and socializing motives were statistically significant determinants of current smoking status among the included adolescents. Family members should be made aware of the detrimental influence their smoking behavior has on their youth. Counseling and preventive psychiatric services should be an integral part of the clinical facilities caring for secondary school students.