Exploring the Reasons for Preferring Digital Games Over Physical Activity Games in Adolescents: A Qualitative Study

PURPOSE

In the current world, adolescents are less likely to turn to physical activity games and often prefer to spend more time in the technological and digital world and have fun with digital games. This study aimed to explore reasons for preferring digital games to physical activity games in adolescents.

METHODS

Twenty-one adolescents participated in this qualitative study. The participants' age ranged from 11 to 19 who participated in semistructured interviews. The recorded interviews underwent thematic analysis to identify overall themes.

RESULTS

Five overall themes were identified from the interviews regarding reasons for preferring digital games over physical activity games. Identified themes included game characteristics, game space, game outcomes, peer pressure, and accessibility.

DISCUSSION

The findings of this research contribute to design adolescent-centered interventions that sustain/increase adolescents' interest in physical activity games and protect them from excessive/harmful use of digital games.

Peer Pressure and Risk-Taking Behaviors Among Adolescent Girls in a Region Impacted by HIV/AIDS in Southwestern Uganda

PURPOSE

This paper uses data from a 3-arm Cluster Randomized Control Trial, Suubi4Her (N = 1260; 14-17-year-old school-going girls) to (1) assess the relationship between peer pressure and adolescent risk-taking behaviors; and (2) test the mediating effect of peer pressure on an intervention on adolescent risk-taking behaviors.

METHODS

Students in the southwestern region of Uganda were assigned to three study arms: control (n = 16 schools, n = 408 students) receiving usual care comprising of sexual and reproductive health curriculum; and two active treatment arms: Treatment 1 (n = 16 schools, n = 471 students) received everything the control arm received plus a savings led intervention. Treatment 2 (n = 15 schools, n = 381 students) received everything the control and treatment arms received plus a family strengthening intervention. We used multilevel models to assess the relationship between peer pressure and risk-taking behaviors. We ran structural equation models for mediation analysis.

RESULTS

Using baseline data, we found that direct peer pressure was significantly associated with substance use risk behaviors, (β = 0.044, 95% CI = 0.008, 0.079). We also found a statistically significant effect of the intervention on acquiring STIs through the mediating effect of sexual risk-taking significant (β = -0.025, 95% CI: -0.049, -0.001, p = .045) and total indirect (β = -0.042, 95% CI: -0.081, -0.002, p = .037) effects. Also, there was a significant mediation effect of the intervention on substance use through peer pressure (β = -0.030, 95% CI: -0.057, -0.002, p = .033).

DISCUSSION

Overall, the study points to the role of peer pressure on adolescent girls' risk-taking behaviors; and a need to address peer pressure at an early stage.

Under pressure: The paradox of autonomy and social norms in drug education

Much contemporary youth drug education operates from the assumption that young people's decisions to use alcohol and other drugs often stem from a misunderstanding that youth consumption is so common as to constitute a 'social norm'. Known as the 'social norms' approach, the stated aim of this form of drug education is to empower young people to avoid consumption by constituting it as uncommon and, therefore, abnormal. Taking the relationship between autonomy and norms as my primary concern, I examine key assumptions of the social norms approach through an analysis of a dataset of 23 'evidence-based' drug education texts currently recommended for use in Australian secondary schools. Drawing on Rasmussen's (2011) analysis of autonomy as a 'paradox' in which young people are compelled to demonstrate their autonomy by submitting to external authority, I argue that drug education constitutes young people's (lack of) autonomy as the key cause of and solution to youth drug use through three strategies: (1) decision-making exercises that position consumption as the result of an inability to make the rational choice; (2) activities that equate drug consumption with succumbing to peer pressure and failing to demonstrate autonomy; and (3) deployment of population level data on youth drug use that constitutes it as atypical. Together these strategies suggest that while drug education often purports to empower young people to make empowered decisions, it operates as a broader social intervention that seeks to produce compliant rather than autonomous subjects.

Dialogic communication on local government social media during the first wave of COVID-19: Evidence from the health commissions of prefecture-level cities in China

Although some scholars have explored the level and determinants of Dialogic Communication on Government Social Media (DCGSM), none have conducted their studies in the context of public crisis. The current study contributes to the understanding on DCGSM by 16,822 posts crawled from the official Sina Weibo accounts of 104 Chinese health commissions in prefecture-level cities during the first wave of the COVID-19 pandemic. Results show that Chinese local government agencies have great variations in their DCGSM during the pandemic and the overall performance is poor. Furthermore, Chinese local governments prefer to conserve visitors and generate return visits, rather than dialogic loops development and the usefulness of information enhancement. The findings suggest that both public pressure and peer pressure contribute to the DCGSM of Chinese local governments during the public health crisis. In addition, the effect of public pressure is stronger than that of the peer pressure, indicating that local government agencies have experienced more demand-pull DCGSM.

Peer pressure and web-based peer learning: an exploratory case study

This study explores whether and how peer pressure influenced students' participation in web-based peer learning (WPL). Fifteen students enrolled in a university reading course were followed over the course of one semester, and interviews with them along with the researcher's observational notes on their learning activities were qualitatively analyzed. Peer pressure slowly and steadily occurred during the students' WPL, with the students feeling differently about it at different levels. All of the students became somewhat used to it later in the semester. The peer pressure was mainly influenced by technological factors (e.g., the openness of the web platform) and non-technological factors (e.g., the academic gaps between students), along with other accompanying reasons (e.g., self-motivation for looking academically decent). The study concludes that students' experiences of peer pressure in relation to WPL involved a gradual process, had multiple causes, and ultimately positively impacted the students, although in the process, peer pressure exerted either negative or positive power on the students.

Peer pressure and risky driving: Development of a new scale

INTRODUCTION

Peer pressure is a main factor influencing risky driving behavior in young people. Most empirical studies have focused either on direct or indirect peer pressure, and comprehensive measures assessing both are currently lacking. The present study aimed at developing and validating a scale to examine the influence of different types of peer pressure on risky driving in young drivers: the Peer Pressure on Risky Driving Scale (PPRDS).

METHOD

Scale construction and assessment of its psychometric properties involved four phases: item development, assessment of content validity by expert reviewers, pre-testing of the scale and evaluation of psychometric properties of the final version in a sample of 773 young drivers aged 18-29.

RESULTS

Confirmatory factor analysis supported a three-factor structure that reflected the multifaceted definition of peer pressure on risky driving in the immediate driving context: risk-encouraging direct peer pressure; risk-discouraging direct peer pressure, and indirect pressure. The three factor scales showed good internal consistency and construct reliability, and correlated as expected with self-reported risky driving. Younger drivers (18-24) reported more direct and indirect peer pressure to engage in risky driving. Males indicated more direct peer pressure towards risky driving. Finally, interaction effects between age and sex were observed. Young male drivers reported the greatest direct peer pressure and adult female drivers the lowest direct peer pressure.

CONCLUSIONS

The 23-item PPRDS scale has good psychometric properties and provides a useful tool for assessing different forms of peer pressure on risky driving.

PRACTICAL APPLICATIONS

The PPRDS can be used for evaluating the impact of peer-based education and road safety programs. The scale also provides valuable information for the design of evidence-based intervention.

[School-based alcohol prevention with virtual reality]

Riskanter Alkoholkonsum ist bei Jugendlichen in Deutschland nach wie vor von hoher Public-Health-Relevanz, weshalb vorbeugend die Kompetenzen von Jugendlichen im Umgang mit Alkohol und Gruppendruck gefördert werden sollten. Interaktive und geschlechtssensible schulische Primärpräventionsangebote besitzen ein großes Potenzial, die Erreichbarkeit der Zielgruppe und die Effektivität von Interventionen zu fördern. Dabei können virtuelle Simulationen als digitales Medium genutzt werden.

Virtual Reality (VR) ermöglicht die Erfahrung von risikobehafteten Situationen in sicherer Umgebung. International gibt es zwei Alkoholpräventionsprojekte für Jugendliche, die VR einsetzen. Die gemeinsame Entwicklung mit der Adressat*innengruppe war dabei ein bedeutendes Kernelement und es wurden bereits umfassende Untersuchungen zur Benutzungsfreundlichkeit sowie zur subjektiven Wirksamkeit durchgeführt. Gängige Effektivitätsevaluationen wie randomisierte kontrollierte Studien kommen bei interaktiven Formaten allerdings an ihre Grenzen, weshalb auch alternative und ergänzende Evaluationsansätze zukünftig eine Rolle spielen sollten. Zusätzlich muss untersucht werden, inwiefern VR-Simulationen auf Rezipient*innen zugeschnitten werden können. Hierbei ist die gendersensible Gestaltung gleichzeitig als Potenzial und als Herausforderung zu sehen.

Auch in Deutschland sollte die Möglichkeit des Einsatzes von VR in der Alkoholprävention bei Jugendlichen vertiefend untersucht werden.

Perceived friendship and binge drinking in young adults: A study of the Human Connectome Project data

BACKGROUND

Peer influences figure prominently in young adult binge drinking. Women have trended to show a level of alcohol use on par with men during the last decades. It would be of interest to investigate the neural processes of social cognition that may underlie binge drinking and the potential sex differences.

METHODS

Here, we examined the data of the Human Connectome Project where we identified a total of 175 binge drinkers (125 men) and 285 non-binge drinkers (97 men) performing a social cognition task during brain imaging. We analyzed the imaging data with published routines and evaluated the results at a corrected threshold.

RESULTS

Both male and female binge relative to non-binge drinkers showed higher perceived friendship. Binge relative to non-binge drinkers demonstrated diminished activations in the anterior medial orbitofrontal cortex (amOFC) during perception of social vs. random interaction, with a more prominent effect size in women. Further, whole-brain regression identified activity of the right posterior insula (rPI) in negative correlation with perceived friendship score in non-binge drinking women. Post-hoc analyses showed significant correlation of rPI activity with perceived friendship, amOFC activity, and a summary measure of alcohol use severity identified by principal component analysis, across all subjects. Mediation and path analysis demonstrated a significant model: amOFC activity → rPI activity → perceived friendship → severity of alcohol use.

CONCLUSIONS

These findings support peer influences on binge drinking and suggest neural correlates that may relate altered social cognitive processing to alcohol misuse in young adults.

Detachment, peer pressure, and age of first substance use as gateways to later substance use

BACKGROUND

Prior research using psychosocial developmental models have identified emotional detachment from family and susceptibility to peer pressure as predictors of adolescent substance use. Despite mixed support for the gateway hypothesis, less is known about how these psychosocial developmental factors facilitate adolescent substance use. The purpose of this study was to examine how age of first substance use, emotional detachment from parents, and susceptibility to peer pressure influence the progression from alcohol, marijuana, and tobacco use to other illicit substance use (e.g., cocaine, hallucinogens).

METHOD

Data (N = 5792) were collected from high school students across seven semesters. Latent growth curve modeling was used to examine how age of first use of alcohol, marijuana, and tobacco predicted initial levels and changes in emotional detachment, peer pressure, and other illicit substance use.

RESULTS

Earlier age of first use of alcohol, marijuana, and tobacco predicted detachment, peer pressure, and a greater likelihood of initial use of other illicit substances. More initial emotional detachment was associated with increases in other illicit substance use. Earlier ages of first use of alcohol, marijuana, and tobacco had indirect effects on initial use of other illicit substances through initial emotional detachment.

CONCLUSION

Emotional detachment from parents and peer pressure impact the likelihood of other illicit substance use across the high school years. Prevention programs may benefit by focusing on delaying the onset of first use of substance use and by preventing emotional detachment from parents and peer pressure.

Peer pressure and alcohol consumption in adults living in the UK: a systematic qualitative review

Background

Peer pressure to drink alcohol may influence excessive alcohol consumption, which can have adverse impacts on health and wellbeing. While peer pressure to drink alcohol is extensively studied among youth, less examination exists among adults. This systematic review examined qualitative research studies which explored the role and concept of peer pressure within the context of alcohol consumption in adults living in the UK.

Methods

Qualitative studies which explored peer pressure within the context of alcohol consumption or alcohol related behaviours and views in adults (age range approximately 18–52 years) living in the UK were included. Systematic searches conducted in Medline, PsycINFO and Web of Science identified 1462 references, of which 13 studies met inclusion criteria. Thematic analysis was conducted.

Results

Five overarching themes were identified. Four of these themes directly address aspects of peer pressure, including: experiences of peer pressure; consequences of peer pressure; strategies to deal with peer pressure; and conditions perceived to affect peer pressure. The fifth overarching theme explains the wider social context influencing peer pressure. Pressure to drink alcohol affects individuals across the life span and can be experienced as overt and aggressive, or subtle and friendly. Those consuming little or no alcohol are more likely to feel overt forms of peer pressure. Some developed strategies to cope with pressure from drinkers. Peer pressure can result in feelings of social isolation, or giving in by consuming alcohol against ones wishes.

Conclusion

Peer pressure to drink alcohol is a complex and multifaceted phenomenon experienced across adulthood requiring better understanding to support initiatives to decrease the impact of pressure-inducing environments and develop strategies to deal with perceived pressure conditions.

Trial Registration

The protocol for this review is registered with PROSPERO (CRD42019122201). Registered 11 February 2019

African American adolescent substance use: The roles of racial discrimination and peer pressure

Peer pressure to use drugs and alcohol is one of the strongest predictors of adolescent substance use. In addition to this normative adolescent stressor, African American adolescents often also face race-related stress in the form of racial discrimination, which has been linked to maladaptive coping responses such as substance use. The interaction of these stressors may help explain substance using behaviors for African American adolescents. The present study explored the relationship between eighth-grade school-based racial discrimination experiences, peer pressure to use drugs and alcohol, and gender to predict 11th-grade marijuana and alcohol use (N = 610; 49% female). Logistic regression analyses indicated teacher- and peer-perpetrated racial discrimination experiences were related to higher alcohol use. Eighth-grade peer pressure to use drugs moderated the relations between teacher- and peer-perpetrated racial discrimination and 11th-grade marijuana use. Overall, results indicate that school-based racial discrimination increases risk for adolescent substance use, and peer pressure moderates this relation for multiple types of racial discrimination. No moderation by gender was found. The importance of considering race-related stress in conjunction with more general adolescent stress to understand African American adolescent substance use is discussed.

Associations Between Peer Pressure and Adolescents' Binge Behaviors: The Role of Basic Needs and Coping

Framed from a framework based on the integration of self-determination theory (Ryan & Deci, 2000 ) and Endler and Parker's (1990) conception of coping strategies, the authors analyzed the relationships between peer pressure and binge behaviors (binge eating and binge drinking) in adolescence. Moreover, the authors explored the mediating role of satisfaction/frustration of basic psychological needs and coping strategies in these associations. Participants were 570 high school students (M = 15.75 years, SD = 1.14 years) living in Italy. The study design was cross-sectional and adolescents were administered self-report questionnaires. Path analysis showed significant and positive direct associations of peer pressure with both binge eating and binge drinking. Moreover, findings show that there is an indirect path in which peer pressure is positively associated with need frustration that is related to the use of emotion-oriented coping strategies that, on their turn, are associated with binge eating. Differently, binge drinking seems to be only directly related to peer pressure. The authors put light to the complex nature of the relationships between peer pressure and binge behaviors in adolescence, taking into account the separate contribution of need satisfaction and need frustration, as well as of coping strategies. Finally, practical implications of the study are discussed.

Cognitive and affective empathy in binge drinking adolescents: Does empathy moderate the effect of self-efficacy in resisting peer pressure to drink?

Binge drinking during adolescence is influenced by peer pressure and group norms as risk factors. Conversely, drinking refusal self-efficacy is a protective factor. Thus, adolescents with impaired social skills could be more vulnerable to binge drinking. However, there is still little research on impaired social abilities, such as low empathy, in adolescent binge drinkers. This study aimed to investigate the moderating roles of empathic concerns and perspective-taking in the relationship between self-efficacy in resisting peer pressure to drink (SRPPD) and binge drinking. Participants were 188 Italian adolescents (M_age = 16.93, SD_age = 0.76; age-range: 15-19). Self-report instruments were administered. Binge drinking was evaluated with an open response item according to the clinical definition of symptoms; SRPPD was assessed with an item from the Perceived Self-Efficacy scale; empathic concerns and perspective-taking were measured with the Interpersonal Reactivity Index scale. A moderation regression analysis was run. Results showed that binge drinking is positively predicted by age, and negatively predicted by SRPPD and empathic concerns. Only perspective-taking proved to be a moderator in the relationship between SRPPD and binge drinking. In the presence of low perspective-taking, adolescents with low SRPPD reported more binge drinking than adolescents with high SRPPD. Conversely, for adolescents with high levels of perspective-taking, low SRPPD did not predict binge drinking. Our results shed light on patterns of cognitive and affective empathy in binge drinking adolescents, providing relevant implications for research and prevention for at-risk teenagers.

The effect of active and passive peer encouragement on adolescent risk-taking

INTRODUCTION

In this experiment, we investigated the effect of active (pressure) and passive (imitation) peer encouragement on adolescent risk-taking and assessed gender differences.

METHOD

The participants performed the Balloon Analogue Risk Task (BART) with the same-sex e-confederate. The experiment consisted of a 2 (passive encouragement: no/yes updates about the number of pumps of the e-confederate) by 2 (active encouragement: no/yes messages received from the e-confederate) by 2 (gender: girls/boys) by 3 (time: baseline/first message or update/second message or update) mixed design. The participants comprised 138 Dutch secondary-school students aged 11-19 years old of whom 46% boys. They were assigned to one of the four conditions: 1. neutral (e-confederate present), 2. passive (two updates received), 3. active (two messages received), or 4. combined (two updates and two messages received).

RESULTS

Only a significant main effect of passive peer encouragement and a significant interaction effect of passive peer encouragement*time were shown. The participants exposed to passive peer encouragement took significantly more risk compared to other participants. Moreover, adolescent risk-taking significantly increased after the first and second update compared to baseline (no update).

CONCLUSION

The findings suggest that adolescents are more likely to engage in risk-taking because of passive rather than active peer encouragement. Thus, communication through text-based messages in which young people provide information solely about their own risk-taking may be an important aim of prevention and intervention programs.

Experiences of pressure to conform in postgraduate medical education

BACKGROUND

Perception of pressure to conform prevents learners from actively participating in educational encounters. We expected that residents would report experiencing different amounts of pressure to conform in a variety of educational settings.

METHODS

A total of 166 residents completed questionnaires about the frequency of conformity pressure they experience across 14 teaching and clinical settings. We examined many individual characteristics such as their age, sex, international student status, level of education, and tolerance of ambiguity; and situational characteristics such as residency program, type of learning session, status of group members, and type of rotation to determine when conformity pressure is most likely to occur.

RESULTS

The majority of participants (89.8%) reported pressure to conform at least sometimes in at least one educational or clinical setting. Residents reported higher rates of conformity during informal, rather than formal, teaching sessions, p < .001. Also, pressure was greater when residents interacted with higher status group members, but not with the same or lower level status members, p < .001. Effect sizes were in the moderate range.

CONCLUSIONS

The findings suggest that most residents do report feeling pressure to conform in their residency settings. This result is consistent with observations of medical students, nursing students, and clerks conforming in response to inaccurate information within experimental studies. Perception of pressure is associated with the setting rather than the trainee personal characteristics.

A cross-sectional study of depression with comorbid substance use dependency in pregnant adolescents from an informal settlement of Nairobi: drawing implications for treatment and prevention work

INTRODUCTION

Adolescent pregnancy is a highly prevalent and significant public health problem in Kenya, and mental health needs of pregnant adolescent girls have been overlooked. Nearly, 50% of the world's population comprises children and adolescents and 85% live in lower and middle-income countries.

OBJECTIVE

Pregnant adolescents were interviewed to ascertain certain social determinants of mental health such as social support, partner or parent support, and demographic profile and assessed for depression using EPDS and for severity of depression using BDI, and their alcohol abuse assessed using AUDIT.

METHODS

A cross-sectional descriptive study using a purposive sample of 212 pregnant adolescents visiting Kangemi Health Centre in Nairobi was conducted.

RESULTS

We found that 60.4% had depressive symptoms scores of 8 and above on EPDS, 51.9% were found to have severe depression score on BDI. About 26.9% were currently consuming alcohol. The more severely depressed participants were demonstrating greater alcohol use. Of the 110 pregnant adolescents who were severely depressed, 39 were currently consuming alcohol. We identified several alcohol use disorder factors associated with depression such as living with an alcoholic, ever and current use of alcohol, alcohol-related harm being experienced, being pressured to take alcohol. On our final multivariate logistic regression, we found that being a student (AOR 5.12, 95% CI 1.19-22.0, P = 0.028); low family income (between 5000 and 10,000 shillings) (AOR 0.22, 95% CI 0.09-0.56, P = 0.02); unplanned pregnancy (AOR 3.41, 95% CI 1.19-9.80, P = 0.023); both negative and ambivalent attitudes of the unborn baby's father, respectively (AOR 8.72 95% CI 2.88-26.37 P < 0.001; AOR 4.26 95% CI 1.35-13.45, P = 0.013); early age at sexual debut (AOR 0.70, 95% CI 0.55-0.89, P = 0.003); and ever used any psychoactive substances (AOR 3.21, 95% CI 1.31-7.88, P = 0.011).

CONCLUSION AND RECOMMENDATIONS

Alcohol abuse during pregnancy presents a significant public health burden and the associated health risks for the adolescent mother and her baby are enormous. We need to bolster screening for the comorbid disorders such as depression and substance use disorders, particularly alcohol in order to address mental health and psychosocial functioning of adolescents. The underlying adversities and sociocultural challenges need to be better understood and mechanisms that lead to comorbidities require further research. Depression interventions for Kenyan adolescents would need to embed screening, treatment and management of substance abuse.

Prevalence and determinants of risky sexual practice in Ethiopia: Systematic review and Meta-analysis

BACKGROUND

Risky sexual practice is a major public health problem in Ethiopia. There are various studies on the prevalence and determinants of risky sexual practice in different regions of the country but there is no study which shows the national estimate of risky sexual practices in Ethiopia. Therefore, this review was conducted to estimate the national pooled prevalence of risky sexual practice and its risk factors in Ethiopia.

METHODS

The Preferred Reporting Items for Systematic Reviews and Meta-Analyses guideline was followed to review published and unpublished studies in Ethiopia. The databases used were; PubMed, Google Scholar, CINAHL and African Journals Online. Search terms were; risky sexual behavior, risky sexual practice, unprotected sex, multiple sexual partner, early sexual initiation, and/or Ethiopia. Joanna Briggs Institute Meta-Analysis of Statistics Assessment and Review Instrument was used for critical appraisal. The meta-analysis was conducted using Review Manager software. Descriptive information of studies was presented in narrative form and quantitative results were presented in forest plots. The Cochran Q test and I ² test statistics were used to test heterogeneity across studies. The pooled estimate prevalence and the odd ratios with 95% confidence intervals were computed by a random effect model.

RESULTS

A total of 31 studies with 43,695 participants were included in the meta-analysis. The pooled prevalence of risky sexual practice was 42.80% (95% CI: 35.64%, 49.96%). Being male (OR: 1.69; 95% CI: 1.21, 2.37), substance use (OR: 3.42; 95% CI: 1.41, 8.31), peer pressure (OR: 3.41; 95% CI: 1.69, 6.87) and watching pornography (OR: 3.6; 95% CI: 2.21, 5.86) were factors associated with an increase in risky sexual practices.

CONCLUSIONS

The prevalence of risky sexual practices is high in Ethiopia. Being male, substance use, peer pressure and viewing pornographic materials were found to be associated with risky sexual practices. Therefore, life skills training is recommended to reduce peer pressure among individuals. Interventions should be designed to reduce substance use and viewing pornography.

Risky substance use and peer pressure in Swiss young men: Test of moderation effects

BACKGROUND

Peer pressure (PP) toward misconduct is a well-known risk factor for substance use. However, the way it interacts with social factors and the associations of the aspects of PP other than PP toward misconduct have been understudied. This study examined the associations of three aspects of PP with risky substance use and tested whether the associations of PP toward misconduct were moderated by social factors.

METHOD

A representative sample of 5,680 young Swiss males completed a questionnaire assessing risky alcohol, cigarette, and cannabis use, PP toward misconduct, toward peer involvement, and toward peer conformity, as well as social support (SS) and neighbourhood cohesion. Multinomial logistic regression models were used.

RESULTS

PP toward misconduct was positively associated with all substance use outcomes. The PP toward misconduct-risky alcohol use association was stronger in individuals reporting high than in those reporting low levels of PP toward peer involvement, SS, and neighbourhood cohesion. The PP toward misconduct-risky cannabis use association was stronger in individuals reporting high than in those reporting low levels of SS and neighbourhood cohesion. The PP toward misconduct-smoking association was stronger in individuals reporting high than in those reporting low levels of PP toward peer involvement.

CONCLUSIONS

The risk for substance use associated with PP toward misconduct varies as a function of social factors. Being well connected with others (high level of PP toward peer involvement and SS), and living in a cohesive neighbourhood may amplify the risk for risky substance use associated with PP toward misconduct.

Analysis of factors associated with injury severity in crashes involving young New Zealand drivers

Young people are a risk to themselves and other road users, as motor vehicle crashes are the leading cause of their death. A thorough understanding of the most important factors associated with injury severity in crashes involving young drivers is important for designing well-targeted restrictive measures within youth-oriented road safety programs. The current study estimates discrete choice models of injury severity of crashes involving young drivers conditional on these crashes having occurred. The analysis examined a comprehensive set of single-vehicle and two-vehicle crashes involving at least one 15-24 year-old driver in New Zealand between 2002 and 2011 that resulted in minor, serious or fatal injuries. A mixed logit model accounting for heterogeneity and heteroscedasticity in the propensity to injury severity outcomes and for correlation between serious and fatal injuries proved a better fit than a binary and a generalized ordered logit. Results show that the young drivers' behavior, the presence of passengers and the involvement of vulnerable road users were the most relevant factors associated with higher injury severity in both single-vehicle and two-vehicle crashes. Seatbelt non-use, inexperience and alcohol use were the deadliest behavioral factors in single-vehicle crashes, while fatigue, reckless driving and seatbelt non-use were the deadliest factors in two-vehicle crashes. The presence of passengers in the young drivers' vehicle, and in particular a combination of males and females, dramatically increased the probability of serious and fatal injuries. The involvement of vulnerable road users, in particular on rural highways and open roads, considerably amplified the probability of higher crash injury severity.

Peer influence on speeding behaviour among male drivers aged 18 and 28

Despite extensive research, preventive efforts and general improvements in road safety levels, the accident risk of young male drivers remains increased. Based on a standardized survey of a random sample of 2018 male drivers at the age of 18 and 28, this study looked into attitudes and behaviours related to traffic violations of male drivers. More specifically, the role of peer influence on speeding was examined in both age groups. In regression analyses it could be shown that the descriptive subjective norm, i.e., the perception of friends' speeding, was the most important predictor of speeding in both age groups. Other significant factors were: negative attitude towards speed limits, injunctive subjective norm, and the perceived risk of having an accident when speeding. In the older age group it was more common to drive faster than allowed and their speeding was largely in line with the perceived level of their friends' speeding. In the younger age group a higher discrepancy between own and friends' speeding was found indicating that young male drivers are socialized into increased speeding behaviour based on peer pressure. By contrast for the 28-year-olds peer pressure mainly seems to maintain or justify individual speeding behaviour. It is suggested that preventive measures should take these different influences of peer pressure into account by using a peer-based approach for the 18-year-olds and a more individual approach for the 28-year-olds.

Peer pressure and alcohol use in young men: a mediation analysis of drinking motives

BACKGROUND

Peer pressure (PP) has been shown to play a major role in the development and continuation of alcohol use and misuse. To date, almost all the studies investigating the association of PP with alcohol use only considered the PP for misconduct but largely ignored other aspects of PP, such as pressure for peer involvement and peer conformity. Moreover, it is not clear whether the association of PP with alcohol use is direct or mediated by other factors. The aim of the present study was to investigate the association of different aspects of peer pressure (PP) with drinking volume (DV) and risky single-occasion drinking (RSOD), and to explore whether these associations were mediated by drinking motives (DM).

METHODS

A representative sample of 5521 young Swiss men, aged around 20 years old, completed a questionnaire assessing their usual weekly DV, the frequency of RSOD, DM (i.e. enhancement, social, coping, and conformity motives), and 3 aspects of PP (i.e. misconduct, peer involvement, and peer conformity). Associations between PP and alcohol outcomes (DV and RSOD) as well as the mediation of DM were tested using structural equation models.

RESULTS

Peer pressure to misconduct was associated with more alcohol use, whereas peer involvement and peer conformity were associated with less alcohol use. Associations of drinking outcomes with PP to misconduct and peer involvement were partially mediated by enhancement and coping motives, while the association with peer conformity was partially mediated by enhancement and conformity motives.

CONCLUSIONS

Results suggest that PP to misconduct constitutes a risk factor, while peer conformity and peer involvement reflect protective factors with regard to alcohol use. Moreover, results from the mediation analyses suggest that part of the association of PP with alcohol use came indirectly through DM: PP was associated with DM, which in turn were associated with alcohol use.

Longitudinal study of adolescents' attempts to promote and deter friends' smoking behavior

PURPOSE

Little research has examined the extent to which adolescents directly attempt to influence friends' smoking. This study examines adolescents' reported actions to promote or deter friends' smoking, and whether actions vary by adolescents' smoking experience.

METHODS

Data were collected between 2001 and 2004 at four time points across the 9th and 10th grades from an ethnically diverse school-based sample (N = 395; 53% female).

RESULTS

Deterrence of smoking was reported by a greater percentage of adolescents than was promotion of smoking, both among those who had ever smoked and never smoked. By the end of the study, over 45% of ever smokers and less than 5% of never smokers had promoted smoking among friends. In contrast, over 70% of ever smokers and roughly 40% of never smokers had deterred smoking. Among adolescents who had ever smoked, positive consequences of smoking by fall of 10th grade predicted attempts to promote smoking by the end of 10th grade (OR = 4.37, p < .05). To a lesser extent, negative consequences of smoking predicted attempts to deter smoking (OR = 2.60, p < .08). These effects were independent of the opposite type of smoking consequences, level of personal smoking experience, having close friends who smoked, prior attempts to influence friends' behavior, and smoker's gender.

CONCLUSIONS

Models of peer influence should account for both positive and negative influence of adolescents on friends' health behavior. Adolescents who have engaged in risk-taking and experienced negative consequences may be a resource in designing and delivering interventions; future research should evaluate their ability to change friends' behavior.

Tobacco Quit Rates among Youth in an Urban Health Centre of Mumbai: A Cross Sectional Study

BACKGROUND

Tobacco use is a major cause of preventable death and disease in India.A nationally representative case-control study of smoking in India(2008) revealed that only 2% of smokers had spontaneously quit. Thisstudy was undertaken to assess tobacco quit rates among the youth in anurban health center and to determine barriers in quitting tobacco use.

METHODS

This cross sectional study was conducted among the youth attendingMalwani Urban Health Centre. Hundred-thirty-three subjects wereselected by a universal sampling method. Data was collected using asemi structured questionnaire.

FINDINGS

The majority of the youth were in the 18 to 21-year-old age group (43%),Male (82.4%), Muslim (65.4%) and unmarried (57.1%). The tobacco quitrate among these cases was 8.3%. Quitting tobacco use was significantlyassociated with the person's religion, marital status and living with the family.

CONCLUSION

Fear of cancer was the most common reason for quitting tobacco. Themajor reason for initiation of tobacco consumption was peer pressureand betel quid was the most common form. Not experiencing anyharmful effects of tobacco was the most common reason for notquitting tobacco.