[Alcohol consumption and physical violence among adolescents: which is the predictor?]

Examining Associations Between Race, Gender, Alcohol Use, School Performance, and Patterns of Bullying in the School Context: A Latent Class Analysis

Although many studies addressed bullying occurrence and its associations, they often use individual variables constructed from few items that probably are inadequate to evaluate bullying severity and type. We aimed to identify involvement patterns in bullying victimization and perpetration, and its association with alcohol use, school performance, and sociodemographic variables. Baseline assessment of a randomized controlled trial were used and a latent class analysis was conducted to identify bullying patterns among 1,742 fifth-grade and 2,316 seventh-grade students from 30 public schools in São Paulo, Brazil. Data were collected using an anonymous self-reported, audio-guided questionnaire completed by the participants on smartphones. Multinomial logistic regressions were performed to verify how covariant variables affected bullying latent classes. Both grades presented the same four latent classes: low bullying, moderate bullying victimization, high bullying victimization, and high bullying victimization and perpetration. Alcohol use was associated with all bullying classes in both grades, with odds ratio up to 5.36 (95% CI 3.05; 10.38) among fifth graders from the high bullying victimization and perpetration class. Poor school performance was also strongly associated with this class (aOR = 10.12, 95%CI = 4.19; 24.41). Black/brown 5th graders were 3.35 times more likely to fit into the high bullying victimization class (95% CI 1.34; 8.37). Lack of evidence for association of sociodemographic variables and bullying latent class among seventh-grade students was found. Bullying and alcohol use are highly harmful behaviors that must be prevented. However, prevention programs should consider how racial and gender issues are influencing the way students experience violence.

Fatores relacionados ao padrão de consumo de bebida alcoólica em mulheres rurais

Objetivo: investigar fatores relacionados ao padrão de consumo de bebida alcoólica em mulheres rurais. Método: estudo quantitativo de amostragem não probabilística por conveniência realizado com 259 mulheres de comunidade rural da Bahia na atenção primária à saúde. Utilizou-se formulário estruturado e o Alcohol Use Disorders Identification Test. Os dados foram analisados empregando estatísticas descritivas para estimar a contribuição independente de cada variável na probabilidade dos desfechos relacionados ao consumo de bebida alcoólica. Aplicou-se a análise de regressão logística pelo software R 4.0.2 for Windows, com variáveis em ordem decrescente de significância estatística. Resultados: amostra composta por mulheres de 30 a 49 anos, predominantemente pretas, com religião, com companheiro, ensino médio completo, atividade remunerada, renda familiar menor que um salário mínimo, residentes em casa própria ou cedida. Ter religião diminui em 0,15% a chance de consumir bebida alcoólica. Morar em habitação com até 3 residentes, “não ficar ferida porque bebeu” e ter religião aumentam, respectivamente, em 89,1, 21,7 e 8,43% as chances de se manter na zona de baixo risco. Não possuir religião aumenta em 97,4% as chances de beber moderadamente. Ficar ferida porque bebeu aumenta em 98,9% as chances de fazer consumo nocivo de bebida alcoólica. Não ter religião e ficar ferida porque bebeu aumentam em 99,7% as chances de fazer uso de bebida alcoólica com provável dependência. Conclusão: a religião evidenciou-se como fator de proteção para o maior consumo de bebida alcoólica. Por outro lado, ficar ferida ou ferir alguém porque bebeu, se caracterizou como fator de risco.

Alcoholic beverage purchase by Brazilian adolescents: individual and contextual factors associated in a multilevel analysis

OBJECTIVE

To analyze the individual and contextual factors associated with the purchase of alcoholic beverages by adolescents in Brazil.

METHODOLOGY

A cross-sectional study with data from the National Adolescent Health Survey (2015). The study sample consisted of 21,125 adolescents who reported having consumed alcohol in the 30 days before the survey. Bivariate and multivariate analysis was performed by calculating the Prevalence Ratios in a multilevel Poisson Regression (95%CI) to verify the effect of individual variables, school context, and Brazilian federation units on the outcome.

RESULTS

17.54% (95%CI 17.03-18.06) bought the alcoholic beverage for their consumption. The outcome was associated with male gender (PR 1.69; 95%CI 1.56-1.83), the age group from 15 to 17 years old (PR 1.52 95%CI 1.41-1.65), who ingested alcohol more than six times in 30 days (PR 1.47; 95%CI 1.37-1.61), who work (PR 1.26 95%CI 1.16-1.37), who are children of women with low education, who study in public schools (RP 1.16 95%CI 1.04-1.30), who missed classes (RP 1.14 95%CI 1.05-1.23) and who do not have a follow-up responsible in their free time (PR 1.13 95%CI 1.04-1.21) and who live in states with higher illiteracy rates of people aged 25 years old and over (PR=1.19; 95%CI 1, 02-1.39).

CONCLUSION

The adolescents' access to alcohol purchase was associated with individual factors, the school context, and the federation unit. These findings indicate the importance of strengthening health promotion aimed at vulnerable youth people.

Physical violence and associated factors in participants of the National Student Health Survey (NSHS)

The objective of this article was to analyze the association between physical violence in students with socioeconomic factors, family context, mental health, individual risky behaviors, and unsafe environment. Study with data from the National School Health Survey (NSHS) in 2015, with 9th graders. The outcome variable was the report of involvement in a physical struggle and the associated exposure variables used were related to socioeconomic and demographic conditions, family supervision and support, mental health, risky behaviors, and unsafe environment. Multivariate logistic regression with a hierarchical approach was used in the analyzes. The prevalence of involvement in a fight was higher in boys (30.2%; CI 29.3-31.0) than in girls (16.7%; CI 16.0-17.4). In both genders, there was a greater chance of involvement with physical violence when using drugs, missing classes, sedentary lifestyle, insomnia, loneliness and insecurity at school or in the community and, especially, when victimized by family aggression, OR 2.59 (CI 2.31-2.90) in boys and girls OR 2.42 (CI 2.17-2.71). There was a reduction in the chance of involvement in physical violence in boys because they were working and, in girls, when they study in a private school, having their problems and concerns welcomed by their parents or their participation in school activities.

Consumo de álcool e drogas ilícitas e envolvimento de adolescentes em violência física em Pernambuco, Brasil

O objetivo foi estimar a prevalência e analisar a associação do consumo de álcool e drogas ilícitas com indicadores de violência física em adolescentes. Estudo transversal repetido com estudantes do Ensino Médio em escolas da rede pública em Pernambuco, Brasil (2006, n = 4.207; 2011, n = 6.264). Os dados foram obtidos por questionário. Os indicadores de violência física foram: vitimização por violência física; envolvimento em brigas. As variáveis independentes foram: consumo de álcool e uso de drogas ilícitas. A regressão logística binária foi utilizada para verificar a associação entre o consumo de álcool e drogas e ter sofrido violência física. A prevalência do consumo de álcool por adolescentes que sofreram violência física reduziu em cinco anos, porém, nenhuma alteração foi constatada no uso de drogas ilícitas. As variáveis comportamentais estiveram associadas aos diferentes indicadores de violência, apresentando em geral uma tendência de aumento. Em 2006, adolescentes que usavam drogas ilícitas apresentaram uma chance 2,12 maior de sofrer violência física, e em 2011 este valor foi de 2,41 (IC95%: 1,80; 3,22). A chance de adolescentes que consumiam bebida alcoólica ter envolvimento em brigas aumentou de 1,96 (IC95%: 1,64; 2,34) em 2006, para 2,11 (IC95%: 1,78; 2,51) em 2011. O consumo de álcool pelos adolescentes que sofreram violência física diminuiu em cinco anos, entretanto, o risco de os adolescentes que consumiram bebida alcoólica ou usaram drogas ilícitas sofrerem violência física aumentou ao longo de cinco anos.

Prevalence and factors associated with binge drinking among Brazilian young adults, 18 to 24 years old

OBJECTIVE

To evaluate the prevalence and factors associated with binge drinking (BD) among young Brazilians.

METHODS

This cross-sectional study used data from the 2013 National Health Survey. The sample consisted of 7,823 young people aged between 18 and 24 years. The outcome was BD: four or more doses on one occasion for women and five doses or more for men. Sociodemographic, health and behavioral explanatory variables were considered. Binary Logistic Regression was used, with estimation of odds ratio (OR) and 95% confidence intervals (95%CI).

RESULTS

The prevalence of BD among young Brazilians was 17%, with regional differences. The associated factors with a higher chance of BD were: 21 and 24 years old (OR = 1.35; 95%CI 1.08 - 1.70); employed (OR = 1.27; 95%CI 1.01 - 1.61); report tiredness (OR = 1.53; 95%CI 1.19 - 1.97) and currently smoking (OR = 4.10; 95%CI 2.95 - 5.70). Women (OR = 0.43; 95%CI 0.34 - 0.54) and participating in religious activities (OR = 0.67; 95%CI 0.53 - 0.84) were associated with a lower chance of BD.

CONCLUSIONS

A national study evaluating the profile of young Brazilians who present episodes of binge drinking is important to favor the implementation of public prevention policies aimed at this specific population.

Violence against adolescents: analysis of health sector notifications, Brazil, 2011-2017

INTRODUCTION

Violence experienced in adolescence results in serious damage and suffering to society. This study aims to characterize the profile of violence victims and likely perpetrators of violence against adolescents, as well as to describe the percentage of notifying municipalities according to the federation unit.

METHODS

Cross-sectional study conducted with data on notification of violence against adolescents from the Information System for Notifiable Diseases, from 2011 to 2017. The chi-square test was used to assess the statistical significance of the differences between the proportions in the comparison between genders. Proportion ratios for the most frequent types of violence were estimated according to selected variables.

RESULTS

The notifications came from 75.4% of all the Brazilian municipalities. Physical violence predominated among males, aged 15-19 years. Psychological violence was predominant among females, between 10 and 14 years old, when perpetrated repeatedly at home by family aggressors. Sexual violence prevailed among females, aged 10 to 14 years old, in the indigenous, black and yellow races/colors, when perpetrated repeatedly at home. Negligence was more common among males, between 10 and 14 years old, when perpetrated repeatedly by family aggressors.

CONCLUSIONS

Sexual violence occurred predominantly against females and generated significant negative impacts on mental, physical, sexual and reproductive health. Community violence, perpetrated with sharp objects and firearms, were prominent among males and are important risk factors for male over-mortality. Because the problems are complex, addressing them requires intersectoral actions.