Physical activity, health, BMI and body complaints in high school students

AIM: Children and adolescents in the industrial world are becoming less physically active and are adopting a sedentary lifestyle in front of computers and TV. The aim of the present investigation was to determine self-related health, physical activity, prevalence of overweight and body complaints in high school students in Norway, and to compare students in academic programs with those in vocational programs. METHODS: Seven hundred and two high school students aged 16-19 years were included in the study. A questionnaire was completed in three high schools and included questions about weight and height, health, physical activity, type of physical activity/sport, intensity, possible injuries or complaints during the last three months. RESULTS: Twenty three percent of the students suffers from overweight/obesity are at risk of being overweight. Males reported better health than females (P<0.02). Sixty-six percent of the study group reported body complaints during the last three months, a higher number of females than males (P=0.001). Students in vocational programs reported poorer self-related health than those in academic programs and the males reported better self-related health generally than females. Furthermore, there were a higher level of prevalence of overweight students in vocational programs than academic programs (P=0.039). CONCLUSION: It is important to make it easy for school children and adolescents to do physical activity at school and during leisure time in order to prevent overweight and obesity as well as chronic diseases later in life.     

Associations between health screening questions and sexual risk behaviors in adolescent female clinic patients: identifying a brief question format to yield critical information

This study examines the ability of brief screening questions to identify adolescent girls at high risk for sexually transmitted infections and teen pregnancy. Participants included 103 sexually active 13-year-old to 17-year-old girls recruited from adolescent clinics who (1) were identified as at risk for negative sexual health outcomes through responses to an 8-item Health Screening Survey, and (2) returned to clinic within 2 weeks to complete a self-report survey about sexual risk behaviors and contraceptive use. Analyses examined relationships between girls' total screening scores, individual screening survey items, and 5 self-reported sexual risk behaviors. Higher screening scores correlated with lower levels of refusing unprotected sex and less consistent condom use (P < .05 and P < .01, respectively). High-risk responses to 2 screening items were associated with all 5 sexual risk behaviors. Findings suggest useful questions in routine clinical screening of sexually active adolescent girls to identify those at high levels of sexual risk.     

The association between health risk behaviors and sexual orientation among a school-based sample of adolescents

OBJECTIVE: This study is one of the first to examine the association between sexual orientation and health risk behaviors among a representative, school-based sample of adolescents. DESIGN: This study was conducted on an anonymous, representative sample of 4159 9th- to 12th-grade students in public high schools from Massachusetts' expanded Centers for Disease Control and Prevention 1995 Youth Risk Behavior Survey. Sexual orientation was determined by the following question: "Which of the following best describes you?" A total of 104 students self-identified as gay, lesbian, or bisexual (GLB), representing 2.5% of the overall population. Of GLB youth, 66.7% were male and 70% were white (not Hispanic). Health risk and problem behaviors were analyzed comparing GLB youth and their peers. Those variables found to be significantly associated with GLB youth were then analyzed by multiple logistic regression models. RESULTS: GLB youth were more likely than their peers to have been victimized and threatened and to have been engaged in a variety of risk behaviors including suicidal ideation and attempts, multiple substance use, and sexual risk behaviors. Four separate logistic regression models were constructed. Model I, Onset of Behaviors Before Age 13, showed use of cocaine before age 13 years as strongly associated with GLB orientation (odds ratio [OR]: 6.10; 95% confidence interval [CI] = 2.45-15.20). Early initiation of sexual intercourse (2.15; 10.6-4.38), marijuana use (1.98; 1.04-4.09), and alcohol use (1.82; 1.03-3.23) also was associated with GLB orientation. Model II, Lifetime Frequencies of Behaviors, showed that frequency of crack cocaine use (1.38; 1.06-1.79), inhalant use (1.30; 1.05-1.61), and number of sexual partners (1.27; 1.06-1.43) was associated with GLB orientation. Model III, Frequency of Recent Behaviors, showed smokeless tobacco use in the past 30 days (1.38; 1. 20-1.59) and number of sexual partners in the previous 3 months (1. 47; 1.31-1.65) were associated with GLB orientation. Model IV, Frequency of Behaviors at School, showed having one's property stolen or deliberately damaged (1.23; 1.08-1.40) and using marijuana (1.29; 1.05-1.59) and smokeless tobacco (1.53; 1.30-1.81) were associated with GLB orientation. Overall, GLB respondents engaged disproportionately in multiple risk behaviors, reporting an increased mean number of risk behaviors (mean = 6.81 +/- 4.49) compared with the overall student population (mean = 3.45 +/- 3.15). CONCLUSION: GLB youth who self-identify during high school report disproportionate risk for a variety of health risk and problem behaviors, including suicide, victimization, sexual risk behaviors, and multiple substance use. In addition, these youth are more likely to report engaging in multiple risk behaviors and initiating risk behaviors at an earlier age than are their peers. These findings suggest that educational efforts, prevention programs, and health services must be designed to address the unique needs of GLB youth.     

Self-related health, physical activity and musculoskeletal complaints in Swedish high school students

AIM: There is a positive correlation between physical activity and health. The aim of this study was to describe self-related health, sports, level of physical activity and possible musculoskeletal complaints among Swedish high school students and to analyze whether there were any differences in these aspects between gender and students from different high school programs. METHODS: A questionnaire was distributed and a total of 1,090 high school students answered it (468 males, 622 females), aged 16-26 years. RESULTS: Students from theoretical programs reported better self-related health than students from practical programs. Females from practical programs reported poorer self-related health than other students. Physically active students reported better self-related health than less physically active students. Fifty-seven percent reported to be physically active in sport. Students from practical programs were less physically active than those from theoretical programs. Females from the practical programs were the least active ones. Fifty percent of the students reported complaints; the percentage was higher among females. There was no difference between students from theoretical and practical programs in terms of reporting complaints. Back and knee complaints were the most common ones. CONCLUSION: According to these results it would be advisable for adolescents to be stimulated to participate in physical activity in order to increase the possibility of a healthy life.     

Prevalence,severity and impact of chronic pain among a representative cross-sectional study of New Zealand high school students

Aim

To report the prevalence of self-reported chronic pain and severity among young people in New Zealand and explore the relationships between pain and mental health, substance use, socialisation and school engagement.

Methods

Prevalence of self-reported chronic pain frequency and severity are reported from an anonymous, representative cross-sectional self-administered health and well-being questionnaire by students aged 12–18 years in New Zealand. Multivariable models exploring chronic pain and mental health, substance use, socialisation and school engagement are reported controlling for age, sex, ethnicity, socio-economic status, disability and history of sexual abuse.

Results

Overall, 22.8% (95% confidence interval (CI) 21.2–24.5) of young people reported chronic pain for 6 months or more, with 3.2% (95% CI 3.1–4.5) reporting severe pain weekly or more often. Females and rural adolescents were more likely to report chronic and severe pain. Asian youth reported less pain than other ethnic groups. Increased severity of pain was associated more with poorer daily functioning and socialising than with frequency of pain. Severe pain occurring weekly or more often was more common among students who had a disability (2.3% 95% CI 1.8–2.7 vs. 9.8%, 95% CI 7.2–12.5) or a history of sexual abuse (2.4% 95% 1.9–2.9 vs. 8.5%, 95% CI 6.3–10.5). Those reporting chronic pain had higher proportions of self-reported significant depressive symptoms, lower well-being, lower school engagement and lower access to health care, particularly for those reporting higher levels of intensity and frequency of pain.

Conclusions

Chronic pain is common in adolescent populations, and has a significant association with decreased daily functioning, socialising, school engagement and mental well-being. Adolescents with chronic pain report significant unmet health-care needs.     

Health concerns of high school students and teachers' beliefs about student health concerns

Information about health concerns of adolescents can assist in assessment and treatment of their particular medical problems. Because teachers are important figures in the lives of young people, their beliefs about student health concerns are often solicited. A survey to assess adolescent health concerns and teachers' beliefs about student health concerns was conducted in two urban high schools on a sample of 831 students and 146 teachers. An assessment of 22 health concerns among the students revealed that a moderate level of concern existed on virtually every issue (the mean percentage "very concerned" was 55%), with black students and girls reporting more concern about many topics. In contrast, teachers significantly underestimated the level of concern of the students by an average of 13%, consistently having inaccurate beliefs about the types and level of student concerns. Students are concerned about health issues and are in need of health education and counseling in these areas. Teachers are not always aware of the level and types of student health concerns and may not be good sources of information about adolescent health.     

Identifying combinations of risk and protective factors predicting physical activity change in high school students

Research sought to identify combinations of risk and protective factors predicting change in physical activity (PA) over one year in high school students. Adolescents (N = 344; M = 15.7 years) participated in a longitudinal study with assessment of demographics, substance use/smoking exposure, height and weight, psychological factors, and PA in 10th and 11th grade. PA participation in 11th grade was greatest for adolescents who engaged in PA and had high sports competence (78%), and least for adolescents who did not engage in or enjoy PA (13%) in 10th grade. Identifying adolescent subgroups at risk for decreasing PA can inform the development of tailored interventions.     

Associations of body mass index and perceived weight with suicide ideation and suicide attempts among US high school students

BACKGROUND: Previous research with adolescents has shown associations of body weight and perceptions of body size with suicide ideation and suicide attempts, but it is unclear whether these associations are direct or whether a mediating effect exists. OBJECTIVES: To determine if body mass index and perceived weight are associated significantly with suicide ideation and suicide attempts, controlling for weight control practices, and if perceived weight mediates the associations of body mass index with suicide ideation and suicide attempts. DESIGN, SETTING, AND PARTICIPANTS: Data were analyzed from the 2001 Youth Risk Behavior Survey, a school-based survey administered to a nationally representative sample of students in grades 9 through 12 (N = 13 601). MAIN OUTCOME MEASURE: Self-reported past-year suicide ideation and suicide attempts, compared by perceived weight and body mass index category, calculated from self-reported height and weight. RESULTS: Body mass index category was associated significantly with suicide ideation (among all students) and suicide attempts (among white and Hispanic students) without perceived weight in the model but not with perceived weight added to the model. In contrast with those who perceive themselves as about the right weight, students who perceived themselves as very underweight (odds ratio [OR], 2.29 [95% confidence interval (CI), 1.46-3.59]), slightly underweight (OR, 1.36 [95% CI, 1.03-1.79]), slightly overweight (OR, 1.33 [95% CI, 1.12-1.58]), and very overweight (OR, 2.50 [95% CI, 1.73-3.60]) had greater adjusted odds of suicide ideation. Among white students, perceiving oneself as very underweight (OR, 3.04 [95% CI, 1.40-6.58]) or very overweight (OR, 2.74 [95% CI, 1.21-6.23]) was associated with greater odds of suicide attempts. Perceiving oneself as very underweight was associated with greater odds for suicide attempts among black (OR, 2.86 [95% CI, 1.10-7.45]) and Hispanic (OR, 3.40 [95% CI, 1.54-7.51]) students. CONCLUSIONS: How adolescents perceive their body weight may be more important than their actual weight in terms of increased likelihood of suicidal behavior. Regardless of body mass index, extreme perceptions of weight appear to be significant risk factors for suicidal behavior; important racial/ethnic differences exist.     

Bullying behaviours and psychosocial health: results from a cross-sectional survey among high school students in Istanbul, Turkey

The aim of this study was to investigate bullying behaviours and their associations with health and health risk behaviours. This study involved completion of the Health Behaviour in School-Aged Children (HBSC) and Youth Self Report (YSR) questionnaires by 3,519 students. Of the students, 59.4% (n=2,091) were neither bullies/nor victims, 22% (n=774) victims, 9.4% (n=331) bully/victims and 9.2% (n=323) bullies. Generally, students involved in bullying behaviours were more likely to have higher YSR scale scores than students who were not involved in bullying behaviours. Bully/victims had higher scores on the YSR subscales than others. Students involved in bullying behaviours were more likely not to use seat belts, to watch TV >or= 4 h/day, to be involved in a physical fight, to skip class and to spend time with friends than students who were not involved in bullying behaviours. Bully/victims and bullies were more likely to smoke cigarettes, to drink alcohol, to be drunk, to play computer games and to be sexually active than others. Bully/victims were more likely to have less educated mothers and to have difficulty in talking to both parents than others. Victims were more likely to have a lower socioeconomic status, to have difficulty in talking to opposite gender friends and to have difficulty in making new friends than others. Bullying behaviour is common and associated with other risk behaviours and psychological health problems in Istanbul high school students. Health professionals should be aware of the influence of bullying on health and particularly on bully/victims' health. There is a strong need for bullying prevention programmes in schools in Turkey.     

Determinants of condom use among junior high school students in a minority, inner-city school district.

Condoms reduce the risk of human immunodeficiency virus (HIV) transmission; however, their use among adolescents has been inconsistent. Little is known about factors which motivate consistent condom use, particularly among younger adolescents. In a study designed to identify such factors, 1899 inner-city junior high school students were surveyed. In June 1988, students completed an anonymous self-report questionnaire assessing HIV-related knowledge, attitudes, and behaviors. Among sexually active students (N = 403), logistic regression analysis evaluated the influence of demographic, psychosocial, and behavioral factors on frequency of condom use. Respondents who believe condoms are effective in preventing HIV transmission were 2.2 times more likely to report using condoms consistently during sexual intercourse; those with low perceived costs associated with condom use were 1.9 times more likely to be consistent users. Number of lifetime sexual partners was inversely related to frequency of condom use. Respondents with a history of three or more sex partners were half as likely to use condoms consistently. Factors not associated with consistent condom use include age, age at sexual debut, ethnicity, HIV knowledge, perceived efficacy to avoid HIV infection, and alcohol and drug use. School- and community-based HIV prevention programs will have to go beyond the didactic transfer of factual information and include more interactive teaching strategies to improve adolescents' attitudes toward condoms are self-efficacy to increase condom use and to counter negative peer influences and adolescents' perceptions of invulnerability. Physicians are an underutilized source of HIV prevention information. They have an important role in counseling adolescents about effective HIV-prevention methods and dispelling misperceptions which hinder consistent condom use.     

Psychosocial and behavioral factors associated with risk of sexually transmitted diseases, including human immunodeficiency virus infection, among urban high school students

The main purpose of this study was to evaluate the role of multiple psychosocial and knowledge-related antecedent factors that may predict sexual and alcohol and drug use behaviors that are associated with the transmission of sexually transmitted diseases (STDs), including human immunodeficiency virus infection. Five hundred forty-four ninth-grade urban high school students were surveyed regarding knowledge, attitudes, and behaviors related to STDs and acquired immunodeficiency syndrome (AIDS). Results of multiple regression analyses indicate that higher levels of STD and AIDS knowledge were associated with lower levels of STD and AIDS anxiety (R2 delta = 0.09; p less than 0.001), fewer negative attitudes toward people with AIDS (R2 delta = 0.09; p less than 0.001), stronger perceptions of self-efficacy (R2 delta = 0.03; p less than 0.01), and stronger peer affiliation (R2 delta = 0.02; p less than 0.05). Negative attitudes toward people with AIDS were inversely related to knowledge (R2 delta = 0.08; p less than 0.001), social support (R2 delta = 0.02; p less than 0.01), and perceived self-efficacy (R2 delta = 0.01; p less than 0.05). Predictors of alcohol and drug use included perceived peer norms (R2 delta = 0.08; p less than 0.001) and strong peer affiliation (R2 delta = 0.05; p less than 0.001). The best predictor of sexual risk behavior was alcohol and drug use (R2 delta = 0.07; p less than 0.001). Lower levels of knowledge (R2 delta = 0.14; p less than 0.01) and perceived peer norms (R2 delta = 0.05; p less than 0.05) predicted nonuse of condoms. Our results indicate that several factors relate to adolescent risk for STDs: the connection between peer influence and adolescent risk behaviors, the link between alcohol and drug use and sexual risk behavior, and the role of knowledge in determining nonuse of condoms.