Perception of environmental obstacles to commuting physical activity in Brazilian elderly

ObjectiveTo evaluate the association between perceived environmental attributes and commuting physical activity (PA) in a population-based sample of elderly persons.MethodsCross-sectional study was performed in 2009/2010, including 1652 elderly individuals aged 60 years or greater living in Florianopolis-SC, Brazil. Physical activity was measured using the long version of the International Physical Activity Questionnaire. Perceived environmental variables were assessed using a modified version of the Neighborhood Environment Walkability Scale. Multinomial logistic regression was used and a 5% significance level was taken into account.Results36.8% and 35.2% of the subjects were inactive or did not reach 150 min/week on transport-related physical activity, respectively. Physical and social environmental characteristics, such as the absence of parks and athletic courts (OR_Inactive:1.75; 95% CI:1.22–2.51); presence of garbage (OR_Low-active:1.55; 1.04–2.30); street lighting (OR_Low-active:2.51; 95% CI:1.36–4.64; OR_Low-active:2.43; 95% CI:1.43–4.15); not walking with the dog (OR_Inactive: 3.08; 95% CI:1.42–6.69) and don't have a dog (OR_Inactive:2.45; 95% CI:1.06–5.66) were associated with lower levels of commuting PA.ConclusionsResults showed that poor physical and social environmental characteristics were related to lower commuting. Building public facilities and promoting physical activity in groups are likely to impact in active commuting among the elderly in Brazil.     

Physical activity growth curves relate to adiposity in adolescents

PurposeFindings from prospective studies on associations between physical activity and adiposity among youth are inconsistent. Our aim was to describe physical activity trajectories during secondary school and examine the association with change in adiposity in youth.MethodsPhysical activity was measured in 20 survey cycles from 1999 to 2005; anthropometrics were measured in survey cycles 1, 12, and 19. Individual growth curves modeling moderate-to-vigorous physical activity (MVPA) and vigorous physical activity (VPA) were estimated. Estimates of initial level and rate of decline in MVPA and VPA bouts per week were included as potential predictors of body fat% and body mass index using age- and sex-specific linear regression.ResultsComplete data were available for 840 and 760 adolescents aged 12–13 years at baseline, followed from survey cycles 1–12 and 12–19, respectively. Among girls, yearly declines of one MVPA and one VPA bout per week during earlier adolescence were associated with increases of 0.19 (95% confidence interval [CI], 0.02–0.36) and 0.47 (95% CI, 0.015–0.92) units of body fat%, respectively. In boys, a yearly decline of one MVPA bout per week was associated with an increase of 0.38 (95% CI, 0.05–0.70) units of body fat% during later adolescence.ConclusionsObesity prevention programs should include strategies to prevent declines in physical activity.     

Trends and risk factors associated with the perpetration of physical intimate partner violence by women in Haiti, 2000-2012

ABSTRACT

Trends in the proportion of women reporting ever having perpetrated physical intimate partner violence (IPV) and factors associated with such IPV in Haiti between 2000 and 2012 were analyzed. We used datasets from Haitian couples in the 2000, 2005, and 2012 Demographic and Health Surveys. Physical IPV was assessed by the Conflict Tactics Scale. Trends were tested with the Cochrane–Armitage test. Women’s and spouses’ factors associated with physical IPV perpetration by women were estimated using binomial multivariable regressions. In 2000, 2005 and 2012, 3.5%, 3.4% and 3.2% women, respectively, reported perpetrating physical IPV (p for trend = 0.732). Factors associated with physical IPV by women included exposure to any IPV [Adjusted prevalence ratio (APR): 9.37; 95% Confidence Interval (CI): 5.05–17.38], living with a male partner who had a genital ulcer in the year preceding the survey [APR: 2.92; 95% CI: 1.11–7.65], living with a male partner who drank alcohol [APR: 2.58; 95% CI: 1.42–4.69], and having witnessed her father beating her mother during childhood [APR: 2.08; 95% CI: 1.14–3.81]. Exposure to IPV and history of genital ulcer in husbands/partners were the important factors associated with perpetration of physical IPV by women in Haiti over a 10-year period.     

Low Physical Activity Is a Predictor of Thinness and Low Self-rated Health: Gender Differences in a Swedish Cohort

PurposeTo examine the relationship between leisure time physical activity in 15-year-old students, and weight status and self-rated health 3 years later.MethodsData were used from two follow-up waves, one in 2002 (grade 9, age 15 years) and one in 2005 (grade 12, age 18 years) of a cohort of approximately 2,500 adolescents. Adolescents reported height and weight, health behaviors, and self-rated health by a questionnaire at both occasions. Age and gender-specific body mass index cut-off points for thinness, overweight, and obesity were used to assess weight status. Logistic regression analyses were performed with weight status and self-rated health as the outcomes and level of leisure time physical activity as the independent variable. Adjustments were made for parental years of education, student's current smoking habits, and baseline body mass index.ResultsAs compared with students who were active for more than 4 hours per week during leisure time, being active 2–4 hours (odds ratio [OR]: 4.15, confidence interval [CI]: 1.62–10.60) and <2 hours (OR: 3.92, CI: 1.30–11.78) predicted thinness in boys. In girls, the risk was smaller and became significant at <2 hours per week (OR: 2.57, CI: 1.38–4.77). Overweight or obesity was not significantly predicted by physical activity. A significant risk of low self-rated health was found at follow-up in boys active for <4 hours per week compared with those active for >4 hours per week.ConclusionPhysical activity is important to maintain a healthy body weight and for future self-rated health in boys.     

Physical activity behaviours of adults in the Greater Green Triangle region of rural Australia

Objective: To assess physical activity (PA) behaviours of adults in rural Australia. Design and setting: Three cross‐sectional surveys in the Greater Green Triangle area covering the south‐east of South Australia (Limestone Coast), and south‐west (Corangamite Shire) and north‐west (Wimmera) of Victoria during 2004–2006. Participants: A total of 1546 persons, aged 25– 74 years, randomly selected from the electoral roll. Main outcome measures: Overall PA, leisure‐time PA, occupational PA, active commuting and moderate‐to‐vigorous PA. Results: Approximately 80% of participants, more women than men, engaged in 30 minutes or more of daily PA. Only 30% (95% CI 26.3, 33.0) of men and 21% (95% CI 18.3, 23.9) of women did moderate‐to‐vigorous PA for at least 20–30 minutes four or more times a week. In leisure time, most participants were moderately active; almost one‐fifth were inactive and another fifth highly active. Two‐thirds of men engaged in high‐level occupational PA, compared with one‐sixth of women. Only 30% of participants actively commuted to work. There was a tendency for a positive association between income level and leisure‐time PA. Conclusions: One‐fifth of adults in rural Australia were inactive. While there was a high prevalence of participants who engaged in daily PA, few did so at moderate‐to‐vigorous intensity to achieve health benefits. As occupational PA is difficult to change, improvements in levels of PA are more likely during leisure‐time and for some people by engaging in commuting PA.     

Are school-based measures of walkability and greenness associated with modes of commuting to school? Findings from a student survey in Ontario,Canada

ObjectivesIn Canada, students are increasingly reliant on motorized vehicles to commute to school, and few meet the recommended overall physical activity guidelines. Infrastructure and built environments around schools may promote active commuting to and from school, thereby increasing physical activity. To date, few Canadian studies have examined this research question.MethodsThis study is a cross-sectional analysis of 11,006 students, aged 11–20, who participated in the 2016/2017 Ontario Student Drug Use and Health Survey. The remote sensing-derived Normalized Difference Vegetation Index (NDVI), at a buffer of 500 m from the schools’ locations, was used to characterize greenness, while the 2016 Canadian Active Living Environments (Can-ALE) measure was used for walkability. Students were asked about their mode of regular commuting to school, and to provide information on several socio-demographic variables. Multivariable logistic regression models were used to quantify associations between active commuting and greenness and the Can-ALE. The resulting odds ratios, and their 95% confidence intervals, were adjusted for a series of risk factors that were collected from the survey.ResultsOverall, 21% of students reported active commuting (biking or walking) to school, and this prevalence decreased with increasing age. Students whose schools had higher Can-ALE scores were more likely to be active commuters. Specifically, the adjusted odds ratio (OR) of being an active commuter for schools in the highest quartile of the Can-ALE was 2.11 (95% CI = 1.64, 2.72) when compared with those in the lowest. For children, aged 11–14 years, who attended schools in high dwelling density areas, a higher odds of active commuting was observed among those in the upper quartile of greenness relative to the lowest (OR = 1.41; 95% CI = 0.92, 2.15). In contrast, for lower dwelling density areas, greenness was inversely associated with active commuting across all ages.ConclusionOur findings suggest that students attending schools with higher Can-ALE scores are more likely to actively commute to school, and that positive impacts of greenness on active commuting are evident only in younger children in more densely populated areas. Future studies should collect more detailed data on residential measures of the built environment, safety, distance between home and school, and mixed modes of commuting behaviours.Electronic supplementary materialThe online version contains supplementary material available at 10.17269/s41997-020-00440-0.     

Evaluation of a Computer-Tailored Physical Activity Intervention in Adolescents in Six European Countries: The Activ-O-Meter in the HELENA Intervention Study

PurposeThe present study investigates the effect of the Activ-O-Meter, an internet-based computer-tailored physical activity intervention in adolescents in six European centers involved in the HELENA study.MethodsAdolescents (12–17 years old) from Vienna, Ghent, Heraklion, Dortmund, Athens, and Stockholm were randomized into intervention and control schools. Participants in the intervention condition received the computer-tailored advice at baseline and after 1 month. Participants in the control condition received a generic standard advice. Effects were evaluated after 1 (n = 675) and 3 months (n = 494) using multi-level modeling. Physical activity levels were measured using the International Physical Activity Questionnaire for adolescents (IPAQ-A).ResultsAfter 1 month, the intervention group reported higher levels of moderate (β = ?32.8, 95% CI (confidence interval): ?64.2 to ?1.4) and vigorous (β = ?28.0, 95% CI: ?50.7 to ?5.3) physical activity in leisure time, as well as higher levels of cycling for transport (β = ?19.1, 95% CI: ?34.4 to ?7.6) compared to the control group. After 3 months, when the intervention group had received the tailored feedback twice, intervention effects were even stronger. Favorable changes in physical activity levels of all intensities and in different contexts were found in the tailored group compared to the control group. Among adolescents not reaching the physical activity recommendations at baseline similar effects as in the total sample were found.ConclusionsThe data indicated that the computer-tailored physical activity intervention had positive effects on physical activity levels among the adolescents. However, the implementation of the computer-tailored intervention in the schools was not feasible in all countries.     

Social–Ecological Correlates of Active Commuting to School Among High School Students

PURPOSE: It has been suggested that health benefits from physical activity may be accrued through active commuting to school. Considering that active commuting is modifiable via policy and that there is limited research examining active commuting among high school students, this is a domain that warrants further investigation. The purpose of this study is to explore the relationships between demographic, behavioral, social/psychological, and environmental correlates of active commuting to school among a sample of high school students. METHODS: Students (N = 21,345) from 76 Ontario high schools (grades 9-12) completed the School Health Action, Planning and Evaluation System Physical Activity Module between 2005-2006. Demographic (gender, grade, body mass index), behavioral (smoking status, physical activity, sedentary time), social/psychological (perceived athletic ability, weight status, parental encouragement), and environmental (school location, type, weather) predictors of active commuting (daily or mixed mode) were assessed. RESULTS: Only 42.5% of high school students reported actively commuting to school. Students were less likely to actively commute to school if they were girls, in grade 12, smoked daily, were low-moderate in physical activity, or attended a rural school. CONCLUSIONS: Patterns of active commuting to school are influenced by multiple factors, some of which are modifiable through intervention. This has important implications for future school-based programming designed to enhance health and physical activity of adolescents through using active modes of transportation to school.     

Use of a children questionnaire of health-related quality of life (KIDSCREEN) as a measure of needs for health care services

PurposeTo check if the expected association is observed between children and adolescents’ self-perceived health-related quality of life (HRQL) and the use of health care services.MethodsThe data come from the pilot test of a European measure of HRQL for children and adolescents (KIDSCREEN). Children answered the KIDSCREEN 52-item pilot version. Visits to a health professional in the past four weeks and hospitalisation in the past 12 months were collected from parents. A logistic regression model was adjusted to analyse the relationship between the use of health services and HRQL.ResultsA total of 2526 children and their parents were included in the analysis. Factors associated to visits in the past four weeks were poor physical well-being (odds ratio [OR] 1.83; 95% confidence interval [CI] 1.42–2.35), and poor school environment (OR 1.32; 95% CI 1.02–1.71). Low scores on moods and emotions was the associated factor to hospitalization in the past 12 months (OR 2.13; 95% CI 1.29–3.81).ConclusionsChildren and adolescents are a feasible source for their self-assessment of HRQL. They should be taken into account in health care needs studies.     

Moderating effect of gross family income on the association between demographic indicators and active commuting to work in Brazilian adults

ObjectiveTo investigate the moderating effect of gross family income on the association between demographic indicators and active commuting to work in Brazilian adults.MethodsSecondary analysis of the survey “Lifestyle and leisure habits of industry workers” (n = 46,981), conducted in 24 Brazilian states (2006–2008). Self-reported information was collected with a previously tested questionnaire. Crude and adjusted logistic regression models were applied to analyze the association between sociodemographic variables (sex, age, marital status, number of children, education, country area and company size) and active commuting to work in different strata of gross family income. To test the moderating effect, an interaction analysis was applied.ResultsThe proportion of active commuters among low-, medium- and high-income workers was 40.7% (95%CI:40.0%;41.5%), 27.0% (95%CI:26.3;27.6%) and 11.1%, (95%CI:10.5%;11.7%), respectively. The moderating effect of gross family income was confirmed. Men were more likely (OR:1.22 95%CI:1.12;1.32) to commute actively than women among low-income individuals. Active commuting was less likely among older workers in low—(OR_30-39:0.90 95%CI: 0.83;0.98; OR_≥ 40: 0.76 95%CI: 0.68;0.85) and medium-income strata (OR_30-39:0.87 95%CI:0.80;0.95; OR_≥ 40:0.84 95%CI:0.76;0.93) and among married individuals in high-income strata (OR:0.72 95%IC:0.61;0.84). Adults with lower education (OR_high:10.80 95%CI:8.47;13.77), working in the south (OR_high:1.93 95%CI:1.53;2.44) and in small companies (OR_low:2.50 95%CI:2.28;2.74) were more likely to commute actively; however, the magnitude of these associations differed at each income strata.ConclusionThere was an inverse association between gross family income and active commuting. Gross family income acts as a moderator of the association between demographic indicators and active commuting.     

Longitudinal associations of active commuting with body mass index

ObjectiveTo investigate the longitudinal associations between active commuting (walking and cycling to work) and body mass index (BMI).MethodWe used self-reported data on height, weight and active commuting from the Commuting and Health in Cambridge study (2009 to 2012; n = 809). We used linear regression to test the associations between: a) maintenance of active commuting over one year and BMI at the end of that year; and b) change in weekly time spent in active commuting and change in BMI over one year.ResultsAfter adjusting for sociodemographic variables, other physical activity, physical wellbeing and maintenance of walking, those who maintained cycle commuting reported a lower BMI on average at one year follow-up (1.14 kg/m², 95% CI: 0.30 to 1.98, n = 579) than those who never cycled to work. No significant association remained after adjustment for baseline BMI. No significant associations were observed for maintenance of walking. An increase in walking was associated with a reduction in BMI (0.32 kg/m², 95% CI: 0.03 to 0.62, n = 651, after adjustment for co-variates and baseline BMI) only when restricting the analysis to those who did not move. No other significant associations between changes in weekly time spent walking or cycling on the commute and changes in BMI were observed.ConclusionsThis work provides further evidence of the contribution of active commuting, particularly cycling, to preventing weight gain or facilitating weight loss. The findings may be valuable for employees choosing how to commute and engaging employers in the promotion of active travel.     

Uncorrected distance visual impairment among adolescents in the United States

PurposeTo describe uncorrected distance visual impairment (VI).MethodsWe conducted an analysis of the 3,555 adolescents aged 12 through 21 years who participated in the 2005–2008 National Health and Nutrition Examination Survey. Distance VI was defined as 20/40 or worse in the better-seeing eye. Data were weighted to represent the civilian noninstitutionalized population.ResultsOverall, 12.3% (95% confidence interval [CI]: 10.7%–14.1%) had distance VI, which was correctable to 20/30 or better in both eyes in 86.1% (95% CI: 83.6%–89.5%). The prevalence was higher among those who reported not having corrective lenses available (44.3%) compared with those who reported that they did not need them (8.5%) or who had them available (5.2%; p < .001). After adjusting for potential confounders, those who were 12 or 13 years of age had 2.27 (95% CI: 1.32–3.90) greater odds of distance VI than older adolescents, and the odds of distance VI were greater among non-Hispanic blacks (1.66 [95% CI: 1.11–2.48]), Hispanics (1.96 [95% CI: 1.35–2.84]), or other race/ethnicities (2.06 [95% CI: 1.19–3.57]) than among non-Hispanic whites.ConclusionsMore than 1 in 10 adolescents had uncorrected distance VI. To address this, interventions should address case detection, access to eye care, and adherence with corrective lenses.     

Painfully Obvious: A Longitudinal Examination of Medical Use and Misuse of Opioid Medication Among Adolescent Sports Participants

PurposeThe objective of this longitudinal study was to assess the prevalence of medical use, medical misuse, and non-medical use of opioid medication among adolescents who participate in organized sports.MethodsData for this study were taken from the Secondary Student Life Survey. A total of 1,540 adolescents participated in three waves of data collection occurring between the 2009–2010 and 2011–2012 school years, with 82% of the baseline sample completing all three waves.ResultsUsing generalized estimating equation models to analyze the longitudinal data, it was found that male adolescents who participated in organized sports during each wave of the Secondary Student Life Survey had higher odds of being prescribed an opioid medication (i.e., medical use) during the past year (adjusted odds ratio [AOR], 1.86; 95% confidence interval [CI], 1.23–2.82), higher odds of past-year medical misuse of opioid medication as a result of taking too much (AOR, 10.5; 95% CI, 2.42–45.5), and higher odds of past-year medical misuse of opioid medication to get high (AOR, 4.01; 95% CI, 1.13–14.2) compared with males who did not participate in organized sports during the study period. Among females, no association was found between participation in organized sports and medical use, medical misuse, and non-medical use of opioid medication.ConclusionsThe results of this study indicate that adolescent males who participate in sports may have greater access to opioid medication, which puts them at greater risk to misuse these controlled substances.     

School-Based Health Center Access,Reproductive Health Care,and Contraceptive Use Among Sexually Experienced High School Students

PurposeThe current analyses compared receipt of reproductive health care, contraceptive use, and screening for sexually transmitted diseases (STD) among adolescents who are sexually experienced, with or without access to a school clinic.MethodsA total of 12 urban California high schools, selected from areas with high teen pregnancy and STD rates, half with school-based health centers (SBHCs), participated in an intervention study designed to improve sexual health among adolescents. Of the participating students, 44% indicated that they had ever had intercourse and were included in these analyses.ResultsAccess to an SBHC did not influence receipt of reproductive health care for either males or females and did not influence contraceptive use, either hormonal or condoms, for males. For females, however, those with access to an SBHC had increased odds of having received pregnancy or disease prevention care (adjusted odds ratio [AOR] = 1.45, 95% confidence interval [CI] = 1.16–1.80), having used hormonal contraceptives at last sex (AOR = 1.68, 95% CI = 1.24–2.28), and were more likely to have ever been screened for an STD (AOR = 1.85, 95% CI = 1.43–2.40). Also among female students, those with access to an SBHC were more likely to have used emergency contraception at last sex (AOR = 2.1, 95% CI = 1.08–4.22).ConclusionAlthough access to an on-site clinic does not seem to lead to increases in all types of reproductive care in the population as a whole, sexually active females are more likely to have received more specific care and to have used hormonal contraceptives if their school has an SBHC.     

Active commuting and perceptions of the route environment: A longitudinal analysis

ObjectiveTo assess associations between changes in perceptions of the environment en route to work and changes in active commuting.Methods655 commuters in Cambridge, UK reported perceptions of their commuting route and past-week commuting trips in postal questionnaires in 2009 and 2010. Associations between changes in route perceptions and changes in time spent walking and cycling, proportion of car trips, and switching to or from the car on the commute were modelled using multivariable regression.ResultsChanges in only a few perceptions were associated with changes in travel behaviour. Commuters who reported that it became less pleasant to walk recorded a 6% (95% CI: 1, 11) net increase in car trips and a 12 min/week (95% CI: − 1, − 24) net decrease in walking. Increases in the perceived danger of cycling or of crossing the road were also associated with increases in car trips. Increases in the perceived convenience of public transport (OR: 3.31, 95% CI: 1.27, 8.63) or safety of cycling (OR: 3.70, 95% CI: 1.44, 9.50) were associated with taking up alternatives to the car.ConclusionsInterventions to improve the safety of routes and convenience of public transport may help promote active commuting and should be evaluated.     

Association between Sexual Behaviors,Bullying Victimization and Suicidal Ideation in a National Sample of High School Students: Implications of a Sexual Double Standard

PurposeThe sexual double standard is the notion that women are more harshly judged for their sexual behaviors than men. The purpose of this study was to investigate if the sexual double standard could explain gender differences in bullying victimization among adolescents and the extent to which that relationship correlated with depression and suicidal ideation.MethodsAnalyses were conducted using a sample of high school students (n = 13,065) from the 2011 Youth Risk Behavior Survey, a cross-sectional and national school-based survey conducted by the Centers for Disease Control and Prevention. Data were assessed using multiple logistic regression, gender-stratified analyses, and interaction terms.FindingsStudents who engaged in sexual intercourse (sexually active) had higher odds of being bullied. When this association was stratified by gender, odds of being bullying increased for girls (odds ratio [OR], 1.83; 95% CI, 1.58–2.13) and decreased for boys (OR, 0.94; 95% CI, 0.77–1.16). Sexually active students who were bullied also displayed more than five times (OR, 5.65; 95% CI, 4.71–6.78) the adjusted odds of depression and three times (adjusted OR, 3.38; 95% CI, 2.65–4.32) the adjusted odds of suicidal ideation compared with students who reported neither of those behavioral characteristics. When stratified by gender, girls had slightly higher odds of depression and suicidal ideation but overall, the odds remained strong for both genders.ConclusionsResults provide some evidence that a sexual double standard exists and may play a prominent role in bullying victimization among girls. Therefore, addressing the sexual double may be important to consider when tailoring school bullying intervention programs.     

The association between disability and unintentional injuries among adolescents in a general education setting: Evidence from a Swedish population-based school survey

BackgroundUnintentional injuries are the leading cause of death among adolescents. Adolescents with disabilities may be particularly vulnerable with an increased risk of unintentional injuries.ObjectiveTo study the association between a set of disabilities and unintentional injury risks among adolescents, accounting for comorbidity, subjective disability severity and sex.MethodCross-sectional data from a Swedish national school survey including 4,741 students (15 and 17-year olds) conducted in 2016 was analyzed using log-binomial generalized linear models.ResultsWe found a 33% increased risk of injury the last 12 months and a 53% increased risk of injury leading to hospitalization for adolescents with any disability compared to their peers with no disability. The differences in injury risk were greater for girls than boys. There was a dose-response relationship between disability severity and injury risk. In analyses adjusted for sociodemographic factors and comorbidity, attention-deficit/hyperactivity disorder (ADHD) and epilepsy were associated with an increased risk of injury the last 12 months, risk ratios [RR] were 1.41 (95% Confidence Interval [CI] 1.08–2.97) and 1.79 (95% CI 1.10–1.81) respectively. Autism spectrum disorder was associated with a decreased injury risk the last 12 months (RR = 0.43, CI 0.2–0.92). ADHD, mobility impairment and visual impairment were associated with hospitalization due to injury during lifetime.ConclusionsThere was an increased risk of unintentional injuries for adolescents with disabilities compared to their non-disabled peers, specifically for individuals with ADHD, epilepsy, visual impairment and mobility impairment. Injury prevention strategies may include adapting the physical environment and medical treatment.     

Relationships between hours of sleep and health-risk behaviors in US adolescent students

ObjectiveTo examine associations between insufficient sleep (< 8 h on average school nights) and health-risk behaviors.Methods2007 national Youth Risk Behavior Survey data of U.S. high school students (n = 12,154) were analyzed. Associations were examined on weighted data using multivariate logistic regression.ResultsInsufficient sleep on an average school night was reported by 68.9% of students. Insufficient sleep was associated with higher odds of current use of cigarettes (age-adjusted odds ratio [AOR], 1.67; 95% confidence interval [CI], 1.45–1.93), marijuana (AOR, 1.52; 95% CI, 1.31–1.76), and alcohol (AOR, 1.64; 95% CI, 1.46–1.84); current sexual activity (AOR, 1.41; 95% CI, 1.25–1.59); seriously considered attempting suicide (AOR, 1.86; 95% CI, 1.60–2.16); feeling sad or hopeless (AOR, 1.62; 95% CI, 1.43–1.84); physical fighting (AOR, 1.40; 95% CI, 1.24–1.60), not being physically active at least 60 min ≥ 5 days in the past 7 days (AOR, 1.16; 95% CI, 1.04–1.29), using the computer ≥ 3 h/day (AOR, 1.58; 95% CI, 1.38–1.80), and drinking soda/pop > 1 time/day (AOR, 1.14; 95% CI, 1.03–1.28).ConclusionTwo-thirds of adolescent students reported insufficient sleep, which was associated with many health-risk behaviors. Greater awareness of the impact of sleep insufficiency is vital.