Adolescents' health in times of COVID-19: a scoping review

Digital health literacy, behavior and knowledge of adolescents for hand hygiene during the COVID-19 pandemic

OBJECTIVE

to investigate factors associated with digital health literacy, hand hygiene knowledge and behavior among Brazilian adolescents during the COVID-19 pandemic.

METHOD

cross-sectional study with 473 adolescents aged 15 to 19. Data were collected virtually between June and August 2021 through a questionnaire on sociodemographic characteristics, digital health literacy, knowledge and behavior regarding hand hygiene. Variables were adjusted using multiple linear regression models with normal response.

RESULTS

the average digital health literacy score was 29.89 ±5.30; for hand hygiene knowledge and behavior was 13.1 ±1.5 and 11.1±2.7, respectively. Higher knowledge and behavior scores for hand hygiene were associated with having completed high school, compared to those attending college, among those who attend health courses, seek information about the pandemic and in scientific articles. Higher digital health literacy scores in adolescents who did not wear masks when playing sports (p= 0.017). There was an association between digital health literacy and knowledge (p = 0.000) and behavior (p = 0.000) regarding hand hygiene.

CONCLUSION

there is an association between higher digital health literacy scores and hand hygiene knowledge and behavior.

Navigating the Challenges and Resilience in the Aftermath of the COVID-19 Pandemic in Adolescents with Chronic Diseases: A Scoping Review

BACKGROUND/OBJECTIVES

The COVID-19 pandemic has profoundly affected the lives of adolescents worldwide, especially those living with chronic diseases. This study aims to explore the impact of the COVID-19 pandemic on the daily lives of adolescents with chronic diseases.

METHODS

This is a scoping review that follows the guidelines proposed by JBI. Eligibility criteria include articles focusing on adolescents aged 10 to 19 during the COVID-19 pandemic, regardless of chronic diseases. Searches were performed in PUBMED, LILACS, CINAHL, SCOPUS, grey literature, and manual searches in March 2024.

RESULTS

This review is composed of 35 articles. The analysis revealed two main categories: (1) Adolescents facing social isolation, school closure, and new family interactions, striving to reinvent themselves, and (2) Chasing the best decision: following up the chronic disease while fighting the COVID-19 pandemic. These categories encompass subcategories highlighting changes in social and family interactions and lifestyle habits. The findings suggest a multifaceted interaction of factors influencing adolescents' well-being, including improved family bonding, heightened disease management, and increased stress and strains on resources.

CONCLUSIONS

This review emphasizes the importance of long-term follow-up and social inclusion efforts for adolescents with chronic diseases and their families, addressing their unique needs during public health crises.

Vulnerability in adolescents' daily life during the COVID-19 pandemic

OBJECTIVE

To know the vulnerability in adolescents' daily life during the COVID-19 pandemic.

METHOD

Qualitative research carried out with 25 adolescents from a public school in a municipality in southern Brazil in the second half of 2021 through individual semi-structured interviews. Data were submitted to thematic content analysis and interpreted with the vulnerability theoretical framework.

RESULTS

These adolescents' daily lives during the COVID-19 pandemic presented difficulties in keeping family members working, changing habits and routines, accessing classes, the internet and increasing intra-family violence.

CONCLUSION

Vulnerability in adolescents' daily life during the pandemic can be identified as the absence of interaction in the school context and access to learning resources, reflecting on individual and social vulnerability. Unemployment and possible access to other sources of income have an impact on programmatic vulnerability. Reflection on practices in the context of health and school is suggested, based on the vulnerability identified in adolescents' daily lives during the COVID-19 pandemic.

Alruwaili K, Alanezi YSA, Abdulhadi Alruwaili A. Assessment of health promotion behavior and associated factors among the northern Saudi adolescent population: a cross-sectional study

Background and Aim

Health promotions among the adolescent population have a significant role in achieving the 2030 sustainable development goals of the World Health Organization. The COVID-19 pandemic has led to several devastating impacts on the health, economic, social, and healthcare systems, and adolescents' health promotions are no exception. We assessed health promotion behaviors and associated factors among the adolescent population of northern Saudi Arabia (KSA).

Methods

We used the Arabic version of the adolescent health promotion scale (AHPS-40) among the 400-adolescent population. The AHPS-40 assessed six domains of adolescent health behavior: nutrition, social support, health responsibility, life appreciation, exercise, and stress management. We applied the Chi-square test to identify the associated factors of adolescent health promotion activities and the logistic regression test to find the predictors for overall health promotion categories.

Results

Of the studied participants, the mean ± SD of the total AHPS-40 was 103.31 ± 18.78. The nutrition domain of the AHPS-40 was significantly associated with the age group (p = 0.002), and the social support domain was significantly related to fathers' (p = 0.022) and mothers' education (p = 0.006). The exercise domain of AHPS-40 was significantly associated with age group (p = 0.018) and school level (p = 0.026). Gender was significantly associated with most of the six domains. Furthermore, more than half (52.7%) of them had a low health promotion behavior, which was significantly associated with gender (adjusted odds ratio = 1.59, 95% CI of AOR = 1.04 -2.45, p = 0.032).

Conclusion

Our study results suggest improving health promotion behaviors by instituting awareness-raising and health promotion intervention programs for adolescent groups. Furthermore, we recommend a focused, exploratory, mixed-method survey among the adolescents of other regions of KSA to identify the region-specific adolescent's health promotion behaviors.

Children and adolescents' mental health in pandemics and confinement: A scoping review of vulnerability factors and repercussions

Children and adolescents are a population at particular risk of experiencing adverse mental health repercussions related to pandemics. To understand vulnerability factors and repercussions of pandemics and related sanitary measures on children and adolescents' mental health, we performed a scoping review to examine and synthesize literature. In total, 66 articles were included. Results present: (1) factors that increase vulnerability to adverse mental health repercussions (e.g., having a pre-existing mental health condition, social isolation, low socio-economic status, parental distress, and overexposure to media content) and (2) specific mental health repercussions (e.g., anxiety, fear, depression, and externalizing behaviors). Addressing concerns underlined in this review could contribute to preventing further negative mental health repercussions of pandemics for children and adolescents and better prepare governments and professionals to address these highly challenging situations. Recommendations for practice include enhancing healthcare professionals' awareness about possible detrimental repercussions pandemics and sanitary measures have on children and adolescents' mental health, assessing changes for those with pre-existing mental health conditions, allocating funding for telehealth research, and providing greater support to healthcare providers.

Autopercepção Negativa de Saúde em Adolescentes durante a Pandemia de Covid-19 e Fatores Associados

O objetivo deste estudo foi analisar a prevalência da autopercepção negativa de saúde de adolescentes durante a pandemia de covid-19 e fatores associados. Trata-se de um estudo descritivo de corte transversal, realizado com 287 adolescentes. Foram avaliadas questões referentes à autopercepção de saúde, ao perfil sociodemográfico e aos fatores comportamentais. As razões de prevalência (RP) e os intervalos com 95% de confiança (IC95%) foram estimados por meio de modelos múltiplos de regressão de Poisson. A prevalência de autopercepção negativa de saúde foi observada em 31,0% dos adolescentes. Observou-se que a imagem corporal (RP = 1,14; IC95%:1,05-1,23), a prática de atividade física (RP = 1,12; IC95%:1,03-1,21), a qualidade do sono (RP = 1,17; IC95%:1,08-1,28) e o consumo de frutas (RP = 1,18; IC95%:1,07-1,30) mostraram-se associados à autopercepção negativa de saúde dos adolescentes. Conclui-se que, durante a pandemia de covid-19, foi observada alta prevalência de autopercepção negativa da saúde. Ademais, a insatisfação com a imagem corporal, a prática de atividade física insuficiente, a qualidade do sono ruim e o consumo de frutas afetaram a autopercepção de saúde dos adolescentes.

Educação Sexual: Dificuldades dos Pais de Jovens com Síndrome de Down

Resumo Com este estudo buscou-se conhecer as dificuldades e barreiras de pais na educação sexual de jovens com Síndrome de Down, a partir de uma pesquisa descritiva e de natureza qualitativa, utilizando-se o conceito das representações sociais como referencial teórico-metodológico. O estudo foi conduzido em uma Organização Não Governamental (ONG), localizada em Recife (PE), após aprovação do Comitê de Ética e Pesquisa, sob parecer consubstanciado 3.558.587. A amostra do estudo envolveu 11 pais de jovens com Síndrome de Down com idades entre 15 e 24 anos. A coleta de dados foi realizada por meio de entrevistas semiestruturadas. A abordagem escolhida para a interpretação desses dados foi a análise de conteúdo proposta por Bardin. Pode-se elencar como principais dificuldades enfrentadas pelos pais ao conversarem com seus filhos sobre sexualidade: a infantilização do jovem com Síndrome de Down, julgando-o incapaz de experienciar tais fenômenos e compreender a orientação que pudesse ser repassada; o medo em ultrapassar etapas e, de repente, “estimular” o filho a viver sua sexualidade de maneira “precoce”; e o fato de os pais também terem recebido pouca ou nenhuma orientação sexual por parte de suas famílias. Diante das narrativas dos pais, é possível perceber que ainda são muitos os mitos, tabus e preconceitos que permeiam a sexualidade dos jovens com Síndrome de Down, demonstrando que os responsáveis estão despreparados para dar as devidas orientações.

Toxic stress on a pediatric population during the COVID-19 pandemic

OBJECTIVE

The aim of this study was to analyze the impact of social isolation as a result of the coronavirus-19 disease (COVID-19) pandemic in children and adolescents aged 0-17 years in Southern Brazil.

METHODS

This is a cross-sectional study in which 542 questionnaires answered by parents or legal guardians of children and adolescents aged 0-17 years residing in the Brazilian South region, through Google Forms®. Questionnaires answered incompletely or from children outside the stipulated age group and from other regions of the country were excluded from the research. The collected data were organized into descriptive and association tables containing absolute and relative frequencies, medians, averages, standard deviations, quartile deviations, average, and proportion estimates in the form of 95% confidence intervals and the result of the chi-square test of independence. Data analysis was fulfilled with the application aid of Microsoft Excel 2016 and Epi Info version 7.2.1.0 of 01/27/2017. Statistically significant associations were considered when p<0.05.

RESULTS

There was an increase in the perception of nervousness (62.7%), anxiety (67.7%), and sadness (51.3%) in children and adolescents during the pandemic period. This study evidenced a high prevalence of screens overuse (50.9%) and sedentary lifestyle (39.1%) in this age group during the period. Furthermore, the occurrence of regressive behaviors occurred more frequently in the age group of 3-6 years (57.1%) and between 7 and 10 years (44.6%).

CONCLUSIONS

It is inferred from this study that one of the implications resulting from the pandemic period is the increase of toxic stress in the pediatric population.

Sense of Coherence and Self-Rated Aggression of Adolescents during the First Wave of the COVID-19 Pandemic, with a Focus on the Effects of Animal Assisted Activities

The COVID-19 pandemic has caused extreme deviations from everyday life. The aim of this study was to investigate how these deviations affected adolescents' sense of coherence and their level of aggression, and whether this was influenced by their relationship with animals, especially horses. In two random samples of students from vocational schools in Hungary, taken in June 2018 and June 2020 (n1 = 525, n2 = 412), separate groups were drawn from those who had regularly engaged in equine-assisted activities (ES) and those who had not (OS) before the pandemic. Data were collected using an anonymous, paper-based questionnaire, and during the pandemic an online version of the Sense of Coherence (SOC13) and Bryant-Smith (B12) scales. During the pandemic, boys' sense of coherence weakened and their aggressiveness increased. Multiple linear regression analyses showed that, regardless of gender and age group, increased time spent using the internet (p < 0.001), a lack of classmates (p = 0.017), reduced time spent outdoors (p = 0.026) and reduced physical activity (p < 0.038) during the pandemic significantly increased the tendency for aggressive behavior, whereas being with a horse or pet was beneficial (p < 0.001). The changes imposed by the curfew were rated as bad by 90% of the pupils, however, those with a strong sense of coherence felt less negatively about them. Schools should place a great emphasis on strengthening the students' sense of coherence.

Feasibility of a secondary school-based mental health intervention: Reprezents' On The Level

AIMS

There is a need for innovative school-based mental health interventions to promote good mental health, healthy coping strategies, and engagement with support services. Consequently, Reprezent, a youth development organization, with mental health professionals and young people co-developed an online mental health intervention show, On The Level (OTL). This study assessed the acceptability and feasibility of delivering OTL to young people (aged 11-18 years) in 36 secondary schools across London and Essex, UK.

METHODS

OTL was delivered online as part of the school curriculum, in classrooms at timepoint 1 (T1, 50 min). Follow-up data was collected at timepoint 2 (T2) 4-6 weeks later, during a 20-min OTL review show. For interactive OTL elements and data collection participants logged into an online survey. Measures of acceptability and engagement, mental health and well-being outcomes and intervention evaluation were taken at T1 and T2. We also assessed the feasibility of implementing the OTL intervention in secondary schools.

RESULTS

10,315 participants received the intervention (T1) and 3369 attended the follow-up session (T2), this high attrition, and potential selection bias, was due to only 30% of schools being able to take part in T2. Rates of acceptability were high among young people and school staff. At T1, 88% found OTL engaging, and 84% felt more confident they had the tools to help them better manage stress and anxiety. At T2, 66% viewed mental health in a more positive way, and 71% had better understanding of how to maintain good mental health. Rates of engagement with mental health tools and services were good, and significant reduction in levels of stress were found 4-6 weeks after the OTL show (T2). The low mental health and well-being indices reported by the school children at baseline strongly support the need and use for a mental health intervention such as OTL in secondary schools.

CONCLUSION

These findings indicated good feasibility and acceptability of OTL intervention and support the delivery of the OTL mental health intervention at UK-based secondary schools to educate young people about mental health and well-being and give them the necessary tools to support their mental health.

Population-Level Trends in Emergency Department Encounters for Sexual Assault Preceding and During the COVID-19 Pandemic Across Ontario, Canada

IMPORTANCE

Lockdown measures and the stress of the COVID-19 pandemic are factors associated with increased risk of violence, yet there is limited information on trends in emergency department (ED) encounters for sexual assault.

OBJECTIVE

To compare changes in ED encounters for sexual assault during the COVID-19 pandemic vs prepandemic estimates.

DESIGN, SETTING, AND PARTICIPANTS

This retrospective, population-based cohort study used linked health administrative data from 197 EDs across Ontario, Canada, representing more than 15 million residents. Participants included all patients who presented to an ED in Ontario from January 11, 2019, to September 10, 2021. Male and female individuals of all ages were included. Data analysis was performed from March to October 2022.

EXPOSURES

Sexual assault, defined through 27 International Statistical Classification of Diseases and Related Health Problems, Tenth Revision, procedure and diagnoses codes.

MAIN OUTCOMES AND MEASURES

Ten bimonthly time periods were used to compare differences in the frequency and rates of ED encounters for sexual assault between 2020 to 2021 (during the pandemic) compared with baseline prepandemic rates in 2019. Rate differences (RDs) and age adjusted rate ratios (aRRs) and Wald 95% CIs were calculated using Poisson regression.

RESULTS

From January 11, 2019, to September 10, 2021, there were 14 476 656 ED encounters, including 10 523 for sexual assault (9304 [88.4%] among female individuals). The median (IQR) age was 23 (17-33) years for female individuals and 15 (4-29) years for male individuals. Two months before the pandemic, ED encounters increased for sexual assault among female individuals (8.4 vs 6.9 cases per 100 000; RD, 1.51 [95% CI, 1.06 to 1.96]; aRR, 1.22 [95% CI, 1.09 to 1.38]) and male individuals (1.2 vs 1.0 cases per 100 000; RD, 0.19 [95% CI, 0.05 to 0.36]; aRR, 1.19 [95% CI, 0.87 to 1.64]). During the first 2 months of the pandemic, the rates decreased for female individuals (4.2 vs 8.3 cases per 100 000; RD, -4.07 [95% CI, -4.48 to -3.67]; aRR, 0.51 [95% CI, 0.44 to 0.58]) and male individuals (0.5 vs 1.2 cases per 100 000; RD, -0.72 [95% CI, -0.86 to -0.57]; aRR, 0.39 [95% CI, 0.26 to 0.58]). For the remainder of the study period, the rates of sexual assault oscillated, returning to prepandemic levels during the summer months and between COVID-19 waves.

CONCLUSIONS AND RELEVANCE

These findings suggest that lockdown protocols should evaluate the impact of limited care for sexual assault. Survivors should still present to EDs, especially when clinical care or legal interventions are needed.

Care friendliness in adolescent sexual and reproductive health services in Mexico and a characterisation of their clients

BACKGROUND

Sexual and reproductive health (SRH) is a very important issue in public health programs in low -and middle-income countries (LMICs). Health services that meet specific and differentiated needs of adolescents are increasingly relevant in LMICs. To provide quality services, it is necessary to know the profile of its users and the perspective that adolescents have about SRH services aimed at them.

METHODS

We conducted a cross-sectional analysis of primary data from a survey of 489 adolescents recruited in 11 primary-care facilities in the state of Morelos, Mexico. We followed the guidelines outlined in the World Health Organization Quality Assessment Guidebook: A guide to assessing health services for adolescent clients. Data on friendliness of services were obtained through 70 questions divided into 18 characteristics which, in turn, were grouped into five domains: equity, accessibility, acceptability, appropriateness, and effectiveness. The "friendliness" (a proxy for quality of care) of services was measured according to an additive index of friendliness (FI) ranging from 0 (no friendliness) to 1 (maximum friendliness). We also described the socio-demographic, SRH, and service utilization profiles of clients.

RESULTS

The health services analysed were characterised as having low levels of accessibility (FI = 0.62) and effectiveness (FI = 0.77), moderate acceptability (FI = 0.84), and high levels of appropriateness (FI = 0.93) and equity (FI = 0.92). Of the total number of adolescents surveyed, 51% stated that they had initiated a sexual life, 37% did not use any method of protection during their first sexual intercourse and 64% of the adolescents had already experienced a pregnancy.

CONCLUSIONS

It is essential to improve the accessibility and effectiveness dimensions of adolescent-friendly services in Mexico. This requires the implementation of strategies specifically designed to promote well-informed, planned and healthy sexual behaviours that avert risk and vulnerability. Strategies need to consider the profile of the adolescent client population.

Screen time and adolescents' mental health before and after the COVID-19 lockdown in Switzerland: A natural experiment

Background

During the COVID-19 lockdown in 2020, adolescents' mental health was largely undermined. A general increment in screen time was reported. However, the long-term effects of the latter on adolescents' mental health are still little explored.

Methods

In the present natural experiment, we investigated these effects using longitudinal data collected before and after the first lockdown in Switzerland. Data come from 674 Swiss adolescents (56.7% females, Mage = 14.45, SDage = 0.50) during Spring 2019 (T1) and Autumn 2020 (T2) as part of the longitudinal MEDIATICINO study. Self-reported mental health measures included somatic symptoms, inattention, anxiety, irritability, anger, sleep problems, obsessive-compulsive symptoms, loneliness, and depression. Measures for screen-media activities included time spent on the Internet, smartphones, social media, video gaming, instant messaging, and television viewing. They were all assessed at T1 and T2.

Results

Paired-sample t-tests with Bonferroni's correction showed that most mental health problems increased over time with an overall medium effect size (Hedge's g = 0.337). In particular, medium effect sizes were found for anxiety, depression, and inattention; small-to-medium effect sizes were reported for loneliness, sleep problems, and obsessive-compulsive symptoms; and a small effect size was found for somatic symptoms. Screen-media activities increased, with the exception of television viewing and video gaming. The results of the hierarchical regression analyses showed that, controlling for covariates, increased time spent on social media - calculated as the difference between T2 and T1 - was the only screen-media activity significantly associated with worse mental health at T2 (β = 0.112, p = 0.016). More time spent in structured media activities like television viewing diminished levels of inattention (β = -0.091, p = 0.021) and anxiety (β = -0.093, p = 0.014). Among covariates, being female, experiencing two or more life events, having mental health problems at T1, and using screens for homeschooling negatively influenced mental health at T2.

Conclusion

These results align with literature indicating a small but negative effect of social media time on mental health. Underlying mechanisms are manifold, including increased exposure to COVID-19 news, heightened fear of missing out, social comparison, and time-displaced for activities such as physical activity and green time. However, in line with the structured days hypothesis, getting involved in media-structured activities like television viewing might protect against mental health symptoms.

Adolescent health in the Covid-19 pandemic: a construction through Nola Pender's model

OBJECTIVE

To construct perspectives of adolescent health in the face of the Covid-19 pandemic, through emancipatory dialogues guided by Nola Pender's Model.

METHOD

This is a participatory research based on the methodology of Psychodramatic Pedagogy of María Alicia Romaña. The action was carried out with 17 school-aged adolescents from a city in the Center-West Region of Brazil. The theoretical-analytical framework used was Nola Pender's Health Promotion Model, and the data collected were discussed based on Paulo Freire's dialogical framework.

RESULTS

The workshop allowed the sharing of individual characteristics and experiences of adolescents regarding the reality experienced in the pandemic, highlighting mental health as a main theme for health promotion.

FINAL CONSIDERATIONS

It was construct, along with the adolescents, important knowledge about health in the pandemic, supporting the thematic reflection and the elaboration of timely health promotion interventions.

Health and health inequalities impact assessment for non-clinical measures to control COVID-19 in the Basque Country and Navarre (Spain)

This article describes the results of a health and health inequalities impact assessment of the COVID-19 pandemic control measures in the regions of the Basque Country and Navarre in Spain. A literature review was conducted on Pubmed and Web of Science (WoS) databases, in addition to individual semi-structured interviews and focus groups with experts, key informants and different profiles of citizens. A wide variety of social determinants of health have been affected by the measures, which included individual health-related behaviors, service disruption in formal care, educational settings, and health care provision. These changes have particularly affected certain population groups including children and adolescents, older people, those with health conditions and disabilities together with caregivers, women, as well as people with low levels of education, income, and resources. In future scenarios it will be necessary to pay attention to the potential impacts of policy responses on health inequalities to avoid an increase in existing health gaps.

Social Determinants of Health and Distance Learning in Italy in the Era of the SARS-CoV-2 Pandemic

Objectives: To investigate the experiences by distance learning (DL) method during the first wave of the SARS-CoV-2 pandemic in Italy, and to search for correlations with purported experiences and respective levels of social determinants of health (SDH). Study design and methods: Cross-sectional online survey, investigating various SDH and parents’ attitude towards DL, proposed 6 months after the beginning of the pandemic to a sample population of parents with school-aged children throughout Italy. Results: A total of 3791 questionnaires were analyzed. Non-Italian parents complained more frequently of difficulties in providing support to their children in DL due to poor digital skills (p = 0.01), lack of good-quality digital equipment (p = 0.01), problems with the Italian language (p < 0.001), and a lower level of education (p < 0.001). When parents lived apart, greater difficulties in concentration in children using DL (p = 0.05) and a lower parental capacity to support DL (p = 0.002) were reported. Adequate digital structures appeared related to living in owned compared to rented property, higher levels of parental education, and better familial financial situations. Conclusions: Students from families with financial difficulties and low levels of parental education, or even those living in houses for rent or having separated parents, may be disadvantaged in an educational context since the introduction of DL.

Associação entre letramento em saúde, ameaça pela COVID-19 e intenção vacinal de adolescentes brasileiros

Resumo Objetivo: investigar a influência do letramento em saúde na avaliação da ameaça à saúde pela COVID-19 e sobre a intenção de não se vacinar de adolescentes brasileiros. Método: estudo transversal com 526 adolescentes brasileiros de 14 a 19 anos. Aspectos socioeconômicos, perfil saúde-doença, letramento em saúde, ameaça à saúde pela COVID-19 e intenção de não se vacinar foram analisados por associação bivariada e regressão linear múltipla com resposta Poisson. Resultados: maior pontuação de letramento em saúde (p=0,010), doença cardíaca (p=0,006), menor renda (p=0,000) e morar na região norte (p=0,007) foram fatores que contribuíram para o sentimento de maior ameaça pela COVID-19. O letramento em saúde não influenciou a intenção de não se vacinar (p=0,091), cuja prevalência foi menor entre os adolescentes do Sudeste quando comparados aos do Norte (p=0,010), entre os que cursavam o ensino superior (p=0,049) e entre aqueles com maior renda (p=0,000). Conclusão: letramento em saúde influenciou a percepção da ameaça da doença, mas não a intenção de não se vacinar. Avaliação da ameaça à saúde pela COVID-19 e a prevalência da intenção de não se vacinar foram influenciadas pela região de residência, renda e escolaridade, o que reforça a importância dos determinantes sociais da saúde nesse contexto.

Relación entre alfabetización en salud, amenaza por COVID-19 e intención de vacunación entre los adolescentes brasileños

Resumen Objetivo: investigar la influencia de la alfabetización en salud sobre la evaluación de la amenaza por COVID-19 y sobre la intención de los adolescentes brasileños de no vacunarse. Método: estudio transversal con 526 adolescentes brasileños entre 14 y 19 años. Se analizaron aspectos socioeconómicos, perfil epidemiológico, alfabetización en salud, amenaza a la salud por COVID-19 y la intención de no vacunarse mediante una relación bivariada y regresión lineal múltiple de respuesta de Poisson. Resultados: una elevada puntuación de alfabetización en salud (p=0,010), enfermedades cardiovasculares (p=0,006), menor nivel de renta (p=0,000) y vivir en la región norte (p=0,007) fueron factores que ayudaron a la sensación de mayor amenaza por COVID-19. La alfabetización en salud no influyó en la intención de no vacunarse (p=0,091), cuya prevalencia fue más baja entre los adolescentes del Sudeste en comparación con los del Norte (p=0,010), entre los que cursaban estudios superiores (p=0,049) y mayor nivel de renta (p=0,000). Conclusión: la alfabetización en salud influyó sobre la percepción de la amenaza de la enfermedad pero no en la intención de no vacunarse. La evaluación de la amenaza a la salud por COVID-19 y la prevalencia de la intención de no vacunarse fueron condicionadas por la región de residencia, nivel de renta y educación, acentuando la importancia de los determinantes sociales de la salud en este contexto.

Letramento em saúde de adolescentes na pandemia de COVID-19: revisão integrativa

RESUMO Objetivo: analisar a produção científica sobre o letramento em saúde (LS) de adolescentes durante a pandemia de COVID-19. Método: revisão integrativa, nas bases de dados MEDLINE, LILACS, CINAHL e Web of Science, entre março de 2020 e agosto de 2021. Foram incluídos artigos originais nos idiomas inglês, espanhol e português. Resultados: dos 65 estudos encontrados na busca, oito foram incluídos para análise, não havendo nenhuma publicação no Brasil, com cinco publicações no ano de 2021, predominância na língua inglesa (n=7) e todos classificados com nível de evidência VI. Dos instrumentos utilizados, eHealth literacy foi a ferramenta mais aplicada (n=2). Televisão, família e internet foram apontadas como as principais fontes de informações de saúde durante a pandemia. Considerações finais: a literatura sinalizou que o LS pode interferir na tomada de decisão dos adolescentes e que um baixo LS pode levar a decisões e ações de exposição física e mental dos adolescentes.

Changes in Youth Mental Health, Psychological Wellbeing, and Substance Use During the COVID-19 Pandemic: A Rapid Review

Since the onset of the COVID-19 pandemic, researchers around the world have made efforts to assess its impact on youth mental health; however, the breadth of this topic has impeded a clear assessment of pandemic outcomes. This study aimed to address this gap by reviewing changes in youth (age ≤ 25) mental health, psychological wellbeing, substance use, and the use or delivery of relevant services during the pandemic. PubMed and Embase were searched in May 2021 to conduct a rapid review of the literature. The results encompass 156 primary publications and are reported using a narrative synthesis. Studies of mental health (n = 122) and psychological wellbeing (n = 28) generally indicated poor outcomes in many settings. Publications regarding substance use (n = 41) noted overall declines or unchanged patterns. Studies of service delivery (n = 12) indicated a generally positive reception for helplines and telehealth, although some youth experienced difficulties accessing services. The findings indicate negative impacts of the pandemic on youth mental health, with mixed results for substance use. Services must support marginalized youth who lack access to telehealth.

SUPPLEMENTARY INFORMATION

The online version contains supplementary material available at 10.1007/s40894-022-00185-6.

Saúde do adolescente na pandemia de Covid-19: uma construção através do modelo de Nola Pender

RESUMO Objetivo: Construir perspectivas de saúde dos adolescentes em face à pandemia de Covid-19, a partir dos diálogos emancipatórios, orientados pelo modelo de Nola Pender. Método: Trata-se de uma pesquisa participativa, metodologicamente estruturada com a Pedagogia Psicodramática de María Alicia Romaña, realizada com 17 adolescentes escolares de um município na região Centro-Oeste do Brasil. Utilizou-se como referencial teórico-analítico o Modelo de Promoção da Saúde de Nola Pender, sendo os dados discutidos com base no referencial dialógico de Paulo Freire. Resultados: A oficina propiciou o compartilhamento de características e experiências individuais dos adolescentes sobre a realidade vivenciada na pandemia, evidenciando a saúde mental como tema protagônico para a promoção da saúde. Considerações finais: Foi possível elaborar com os adolescentes um conhecimento sobre a saúde na pandemia, fundamentando a reflexão temática e a construção de intervenções oportunas de promoção da saúde.

Health literacy of adolescents in the COVID-19 pandemic: an integrative review

ABSTRACT Objective: to analyze the scientific production on health literacy (HL) of adolescents during the COVID-19 pandemic. Method: an integrative review, in the MEDLINE, LILACS, CINAHL and Web of Science databases, between March 2020 and August 2021. Original articles in English, Spanish and Portuguese were included. Results: of the 65 studies found in the search, eight were included for analysis, with no publication in Brazil, with five publications in 2021, predominantly in English (n=7) and all classified with level of evidence VI. Of the instruments used, eHealth literacy was the most applied instrument (n=2). Television, family and the internet were identified as the main sources of health information during the pandemic. Final considerations: the literature has indicated that HL can interfere with adolescents’ decision making and that a low HL can lead to decisions and physical and mental exposure actions of adolescents.

Consulta de enfermagem de adolescentes: um recorte importante do cuidado prestado por enfermeiros em um Estado brasileiro

Resumo Objetivo: o cuidado de adolescentes com ou sem doença crônica deve ser completo, padronizado e focado nas demandas individuais e no processo de transição para a assistência ao adulto e adesão ao tratamento. Este estudo teve como objetivo caracterizar a assistência prestada por enfermeiros do estado de São Paulo que atuam com adolescentes. Método: trata-se de um estudo transversal e descritivo sobre a assistência prestada a adolescentes por enfermeiros de São Paulo, a partir das respostas a um questionário autoaplicável, disponível no instrumento REDCap entre agosto de 2018 e outubro de 2019. Resultados: os participantes responderam a 1632 questionários. Apenas 38% dos enfermeiros trabalham com adolescentes, e 11,2% deles de forma exclusiva. Os profissionais foram divididos de acordo com a mediana de tempo de experiência profissional nos Grupos A e B (≤ 5 anos e > 5 anos). A dependência de drogas (p=0,01) e o trabalho com uma equipe multidisciplinar (p=0,04) foram significativamente mais relatados no Grupo B. O acompanhamento rotineiro (p=0,02) e o questionamento sobre violência sexual ou física (p=0,03) foram significativamente mais realizados pelos profissionais do Grupo A. Conclusão: este estudo identificou a necessidade de um protocolo de assistência que possa ser replicado em larga escala e que inclua o tratamento e as particularidades dos adolescentes para melhorar a adesão e a transição para o cuidado do adulto.

Emotional consequences of the COVID-19 pandemic in adolescents: challenges to public health

Abstract Objective: To describe adolescents’ everyday activities and emotional consequences related to the COVID-19 pandemic. Method: Qualitative study grounded in Alfred Schütz’s social phenomenology, involving 22 students at two public schools in a municipality in the state of São Paulo, Brazil. Interviews were conducted, had their audio recorded, and were analyzed according to a thematic categorization. Results: Five categories emerged from the accounts: i) adolescents’ reaction before the COVID-19 pandemic; ii) emotional consequences; iii) concern about the family; iv) adolescents’ adaptation; and v) fragmentation of social support networks. Feelings such as uncertainty, fear, anguish, anxiety, and lack of motivation, depressive symptoms, and extreme suicidal ideation were reported. Conclusion: Paying attention to adolescents’ psychosocial needs is essential, especially in face of the possibility of post-traumatic stress as a result of the COVID-19 pandemic. Health professionals’ technical competence combined with sensibility, strengthening of social support networks, and engagement of different community sectors are fundamental for promoting adolescent mental health in the current transition and resignification period following the COVID-19 pandemic.

La consulta de enfermería para adolescentes: una parte importante de los cuidados prestados por los profesionales de enfermería en un estado brasileño

Resumen Objetivo: el cuidado de los adolescentes con o sin enfermedad crónica debe ser completo, estandarizado y centrado en las demandas individuales y en el proceso de transición a la atención para adultos y la adherencia al tratamiento. Este estudio tuvo como objetivo caracterizar los cuidados prestados por el personal de enfermería del estado de São Paulo que trabaja con adolescentes. Método: se trata de un estudio transversal y descriptivo sobre los cuidados prestados a los adolescentes por el personal de enfermería de São Paulo, a partir de las respuestas a un cuestionario autoadministrado, disponible en la herramienta REDCap entre agosto de 2018 y octubre de 2019. Resultados: los participantes respondieron a 1.632 cuestionarios. Solo el 38% del personal de enfermería trabaja con adolescentes, el 11,2% de forma exclusiva. Los profesionales se dividieron según la duración media de la experiencia profesional en los grupos A y B (≤5 años y >5 años). La drogadicción (p=0,01) y el trabajo con un equipo multidisciplinar (p=0,04) fueron significativamente más reportados en el grupo B. El seguimiento rutinario (p=0,02) y las preguntas sobre violencia sexual o física (p=0,03) fueron significativamente más realizadas por los profesionales del grupo A. Conclusión: este estudio identificó la necesidad de un protocolo de atención que pueda ser replicado a gran escala y que incluya el tratamiento y las particularidades de los adolescentes para mejorar la adherencia y la transición a la atención de adultos.

Association of health literacy, COVID-19 threat, and vaccination intention among Brazilian adolescents

Objective:

investigate the influence of health literacy on the assessment of COVID-19 threat to health and the intention not to be vaccinated among Brazilian adolescents.

Method:

cross-sectional study with 526 Brazilian adolescents aged 14 to 19 years. Socioeconomic aspects, health-disease profile, health literacy, health threat by COVID-19 and intention not to be vaccinated were analyzed by bivariate association and multiple linear regression with Poisson response.

Results:

higher health literacy score (p=0.010), cardiovascular disease (p=0.006), lower income (p=0.000), and living in the North region (p=0.007) were factors that contributed to feeling more threatened by COVID-19. Health literacy did not influence the intention not to be vaccinated (p=0.091), whose prevalence was lower among adolescents in the Southeast region when compared to those in the North region (p=0.010), among those who attended higher education (p=0,049) and those with higher income (p=0.000).

Conclusion:

health literacy influenced the perception of COVID-19 threat, but not the intention not to be vaccinated. Assessment of COVID-19 threat to health and prevalence of the intention not to be vaccinated were influenced by the region of residence, income, and education, which reinforces the importance of social determinants of health in this context.

Adolescent nursing consultation: an important excerpt from care provided by nurses in a Brazilian state

Abstract Objective: the care of adolescents with or without a chronic disease must complete, standardized and focused on individual demands and the transition process to adult care and adherence to treatment. This study aimed to characterize the care provided by nurses from the state of São Paulo who work with adolescents. Method: this is a cross-sectional and descriptive study on the care provided to adolescents by nurses in São Paulo, based on the answers to a self-administered questionnaire, available in the REDCap tool between August 2018 and October 2019. Results: participants answered 1632 questionnaires. Only 38% of nurses work with adolescents, 11.2% exclusively. Professionals were divided according to the median length of professional experience in groups A and B (≤5 years and >5 years). Drug addiction (p=0.01) and working with a multidisciplinary team (p=0.04) were significantly more reported in group B. Routine follow-up (p=0.02) and questioning about sexual or physical violence (p=0.03) were significantly more performed by professionals from group A. Conclusion: this study identified the need for a care protocol that can be replicated on a large scale and that includes the treatment and the particularities of adolescents to improve adherence and the transition into adult care.

Depression, anxiety and stress symptoms in Brazilian university students during the COVID-19 pandemic: Predictors and association with life satisfaction, psychological well-being and coping strategies

Background

The COVID-19 pandemic raises concerns about the mental health of the world population. Protection measures to prevention the disease impacted education and undergraduate students were exposed to additional stressors.

Objectives

Analyze depression, anxiety and stress symptoms in undergraduates, their respective predictors and the association with satisfaction with life, psychological well-being and coping strategies.

Methods

An online cross-sectional study was conducted from September 14 to October 19, 2020, involving undergraduate students enrolled in 33 courses from 5 public university campuses in the state of Parana, Brazil, using: questionnaire with sociodemographic, academic, health and pandemic effects variables; Depression, Anxiety and Stress Scale-21 (DASS-21); Satisfaction with Life Scale (SWLS); Psychological Well-Being (PWB); BriefCOPE. The convenience sample was composed of 1,224 participants, with 18 years old or older, that completed all research instruments. Spearman correlation and logistic analysis (univariate and multivariate) were applied to the collected data.

Results

Most of the undergraduates presented symptoms of depression (60.5%), anxiety (52.5%) and stress (57.5%). Depression, anxiety and stress presented significant correlations in common: negative with satisfaction with life, all dimensions of psychological well-being, and 3 adaptive copings (active coping, planning, positive reframing); positive with 5 maladaptive copings (behavioral disengagement, denial, self-blame, self-distraction, substance use). In addition, there were 7 common predictors for symptoms of depression, anxiety and stress: female; age 18–24 years old; having a chronic disease; lower scores in 2 dimensions of psychological well-being (positive relations with others, self-acceptance); higher scores in 2 maladaptive copings (self-blame, substance use).

Conclusions

The data indicate a high prevalence of symptoms of depression, anxiety and stress, and suggest that higher scores of satisfaction with life, psychological well-being dimensions and adaptive copings may present protective effects in undergraduates during a pandemic crisis.

"My Life during the Lockdown": Emotional Experiences of European Adolescents during the COVID-19 Crisis

This study investigates, using an online self-report questionnaire, adolescents' emotional reactions during the lockdown in a sample of 2105 secondary school students (aged 14-19) in Italy, Romania, and Croatia. We used a self-reported online questionnaire (answers on a 5-point scale or binary), composed of 73 questions investigating the opinions, feelings, and emotions of teenagers, along with sociodemographic information and measures of the exposure to lockdown. The survey was conducted online through a web platform in Italy (between 27 April and 15 June 2020), Romania, and Croatia (3 June and 2 July 2020). Students aged >14 years, living in a small flat, and not spending time outside were more likely to report anger, sadness, boredom/emptiness, and anxiety. Boys were significantly less likely than girls to report all measured emotional reactions. Those who lost someone from COVID-19 were more than twice as likely to experience anger compared to those who did not. Our findings may help identifying adolescents more likely to report negative emotional reactions during the COVID-19 pandemic and inform public health strategies for improving mental health among adolescents during/after the COVID-19 crisis.

Young people in oncological treatment during COVID-19: indicators of the social representation of the coronavírus

Abstract Objectives: to understand indicators of the social representation of the coronavirus in adolescents undergoing cancer treatment during the COVID -19pandemic. Methods: the theory of social representations was used as theoretical and methodological support in its procedural approach in an exploratory study of a qualitative nature. The free word association technique was used in the application of virtual forms using guidelines of the snowball method. The terms ‘Coronavirus’, ‘Going to the hospital’ and ‘Cancer treatment’ were applied. After that moment, the participants were asked for a hierarchy and justification of the evoked words. Data analysis was based on content analysis and frequency distribution of the content produced. Results: articulations were made on the impacts that the pandemic situation had on the treatment experience of that population. It was identified a character endowed with fear and tension about the elaboration of the reality of these subjects in the current period in face of the inevitability of a hospital scenario that facilitates contamination and facing the immunological vulnerability characteristic of their treatments. Conclusions: the participants constructed different contents of psychological suffering aimed at expressions of fear and insecurity experienced during the pandemic period in the face of assistance in the hospital setting. This study is understood as a contribution to more effective actions in order to adapt the care plan of this population, aiming at future professional interventions.