School Disconnectedness: Identifying Adolescents at Risk in Ontario, Canada

Background:  There is strong theoretical and empirical support for school connectedness as an important element of healthy youth development. The primary objective of this study was to replicate previous research identifying factors differentiating youth who do not feel connected to their schools in a sample of adolescents in Ontario, Canada. A secondary objective was to extend this work by assessing whether physical activity was an additional health behavior that differentiated youth who feel connected to their schools from those who do not.
Methods:  Data for this study were based on questionnaires from 2243 grade 7 to grade 12 students derived from the 2001 cycle of the Ontario Student Drug Use Survey. Logistic regression analysis was used to examine associations between physical activity, other health risk factors, and school disconnectedness.
Results:  The odds of feeling disconnected from their schools were substantially greater for female students who perceived their health or academic performance to be poor, engaged in no vigorous physical activity, reported 3 or more physician visits during the past year, and had low extracurricular involvement. None of the sociodemographic factors or substance use measures was significantly associated with school disconnectedness for any students.
Conclusions:  Our results highlight sex differences in how school disconnectedness is related to health-compromising behaviors such as physical inactivity. Further research is required to examine how boys and girls perceive, interpret, and internalize the school climate. Increasing school connectedness should be a consideration for academic administrators and health-promotion advocates.     

Extending the School Grounds?—Bullying Experiences in Cyberspace

Background:  Bullying is a national public health problem affecting millions of students. With the rapid increase in electronic or online communication, bullying is no longer limited to schools. The goal of the current investigation was to examine the overlap among targets of, and the similarities between, online and in-school bullying among Internet-using adolescents. Additionally, a number of common assumptions regarding online or cyberbullying were tested.
Methods:  An anonymous Web-based survey was conducted with one thousand four hundred fifty-four 12- to 17-year-old youth.
Results:  Within the past year, 72% of respondents reported at least 1 online incident of bullying, 85% of whom also experienced bullying in school. The most frequent forms of online and in-school bullying involved name-calling or insults, and the online incidents most typically took place through instant messaging. When controlling for Internet use, repeated school-based bullying experiences increased the likelihood of repeated cyberbullying more than the use of any particular electronic communication tool. About two thirds of cyberbullying victims reported knowing their perpetrators, and half of them knew the bully from school. Both in-school and online bullying experiences were independently associated with increased social anxiety. Ninety percent of the sample reported they do not tell an adult about cyberbullying, and only a minority of participants had used digital tools to prevent online incidents.
Conclusions:  The findings have implications for (1) school policies about cyberbullying, (2) parent education about the risks associated with online communication, and (3) youth advice regarding strategies to prevent and deal with cyberbullying incidents.     

广州市中学生性行为现况研究

目的了解广州市中学生性行为的现状,为制定青少年性健康教育政策和采取干预措施提供科学依据。方法采用分层整群抽样方法分别抽取广州市8所中学约6 420名学生进行无记名问卷调查。结果有3.4%的学生曾经发生过性行为。男生的危险性行为的发生高于女生,初中生的危险性行为的发生高于高中生。性行为与吸烟、饮酒、自杀、吸毒等健康危险行为的发生均有关联性（P〈0.001）。结论应重视青少年过早性行为的发生,并及早干预,减少其他危险行为的发生以促进青少年身心健康。     

Patterns of Vaginal, Oral, and Anal Sexual Intercourse in an Urban Seventh-Grade Population

Background:  This study examines the prevalence of vaginal, oral, and anal intercourse among a population of urban, public middle school students, the characteristics of early sexual initiators, and the sequence of sexual initiation. Such data are limited for early adolescents.
Methods:  A total of 1279 seventh-grade students (57.3% female, 43.6% black, and 41.8% Hispanic), mean age 12.5 years (SD = 0.63) from 10 middle schools in a large southeastern US public school district completed a cross-sectional survey using audio computer-assisted self-interviews. Main outcomes included lifetime and past 3-months' experience of vaginal, oral, and anal sex; condom use; age of initiation; and number of lifetime partners.
Results:  Overall, 12.0% of students had engaged in vaginal sex, 7.9% in oral sex, and 6.5% in anal sex. Among students who had initiated intercourse, approximately two thirds were currently sexually active and one quarter reported ≥4 lifetime partners. Six percent had engaged in 1 type of intercourse, 4% in 2 types of intercourse, and 4% in all 3 types of intercourse; vaginal sex was typically initiated at an earlier or at the same age as other types of intercourse. Only 2% had engaged in oral sex without engaging in vaginal sex. Although black students were significantly more likely to have initiated sex compared to other racial/ethnic groups, Hispanic students who had initiated each type of intercourse were more likely to be currently sexually active and to have engaged in recent unprotected sex.
Conclusions:  A small percentage of early adolescents are engaging in multiple sexual behaviors. These findings have implications for early adolescent school-based sexual health education.     

A Comparison of Weight-Related Behaviors Among High School Students Who Are Homeless and Non-Homeless

BACKGROUND: Previous research has shown that youth who are homeless engage in high-risk behaviors. However, there has been little information published on nutritional and physical activity behaviors in this population, and studies comparing homeless youth in school with their non-homeless peers are scarce. This study compares weight-related risk behaviors of public high school students in Massachusetts based on homeless status.
METHODS: We obtained data from 3264 9th through 12th grade students who participated in the 2005 Massachusetts Youth Risk Behavior Survey. Multivariable logistic regression, controlling for gender, grade, race/ethnicity, and sexual orientation, was performed to assess the relationship between homeless status as defined by the McKinney-Vento Homeless Assistance Act and weight-related indicators. Analyses were weighted and adjusted for the multistage complex sampling design.
RESULTS: Of this sample, 4.2% reported being homeless (n = 152). Higher prevalence of homelessness was found among males, racial/ethnic minorities, sexual minorities, and students who were not in a traditional grade level. The distribution of body mass index was similar among students who were homeless and non-homeless (underweight 4.0 and 3.0%, and overweight 27.1 and 27.1%, respectively). Homeless students were more likely than non-homeless students to report disordered weight-control behaviors including fasting (aOR 2.5, 95% CI 1.4–4.5) and diet pill use (aOR 3.3, 95% CI 1.6–6.9).
CONCLUSIONS: More than 4% of public high school students in Massachusetts meet the federal definition of homelessness. These students are at high risk for disordered weight-control behaviors. Policy decisions at the school, state, and federal levels should make a concerted effort to target these students with social services and nutritional interventions.     

Violent Behaviors in Early Adolescent Minority Youth: Results from a “Middle School Youth Risk Behavior Survey”

Objectives: To describe the prevalence and characteristics of violence and violence-related behaviors among six populations of U.S. minority adolescents in grades 6–8. Methods: Six thousand four hundred non-White adolescents were recruited from six sites that were part of a collaborative project. Surveys were administered either during the school day or at community facilities. All students at each site were asked 10 questions about recent violence-related behaviors (including use of threats, fighting, weapon carrying, and weapon use). Prevalence of each violence-related behavior was reported within and across sites, and stratified by race/ethnicity, gender, age, and other characteristics expected to influence the behaviors. Results: Sixty-six percent (66%) of the middle school students sampled reported being involved in some type of recent fighting and/or weapon-related behaviors. Sixty-one percent (61%) indicated some form of fighting behavior in the past 3 months (threatening to beat someone up, physical fighting, and/or being hurt in a fight). Thirty percent (30%) of participating youth reported one or more weapon-related behaviors (threatening to use a weapon, carrying a weapon, using a weapon, and/or being cut, stabbed or shot at). Reported gun carrying among males varied depending upon site, but was as high as 20%. Grade in school was positively associated with reported violent behaviors. Adolescents who reported living full-time with a parent or parent figure, and those who reported religious observance or beliefs, were less likely to report violence involvement. All violence-related behaviors were more common among male than female adolescents. Conclusions: Violence prevention efforts should begin in elementary school and continue throughout adolescence. Programs should be prepared to provide services or referrals to victims of violence, implement programs tailored toward females as well as males, and build partnerships with churches and other community organizations in which youth are involved.     

中国5省市中学生危险行为现状（二）—易导致意外伤害的危险行为

目的：了解中国中学生与意外伤害相关的危险行为的现状。方法：1999年5月至6月,选取中国北京、天津、沈阳和云南5省市40所中学的初一和高一学生16580名,采用中学生危险行为问卷调查。结果：有56．9％的学生乘车不系安全带,5．9％的学生近期乘坐过酒后驾驶开的车,初中学生发生打架行为并且因此而受伤的比例明显高于高中学生,男生发生易导致意外伤害的危险行为的比例要明显高于女生,性别、年级之间差异有显性（P＜0．01）。结论：中学生中存在着许多容易导致意外伤害的危险行为,应针对青少年的年龄、性别特点,尽早进行预防意外伤害的健康教育,以提高儿童青少年对意外伤害的预防和自我保健意识。     

青少年睡眠时间静态活动与超重肥胖的关系

目的 探讨中小学生睡眠时间、静态活动与超重肥胖的关系,为制定预防和干预青少年肥胖策略提供依据.方法 采用自行编制的“学生营养状况及饮食行为调查表”,对多阶段分层整群抽取的湖北省3 182名城乡中小学生进行睡眠时间、静态活动调查,并在现场测量身高、体重等指标,分析睡眠时间与静态活动对超重肥胖的影响.结果 中小学生超重肥胖检出率为11.7％,其中男生为14.8％,女生为8.5％,男生超重肥胖检出率显著高于女生(x2=30.49,P＜0.05);小学生超重检出率显著高于中学生(x2=72.40,P＜o.05).调查前的过去7d里,小学生睡眠不足1 003例,占98.9％;中学生睡眠不足1 659例,占76.5％,差异有统计学意义(x2=253.40,P＜0.05).小学生各项静态活动平均每天≥2 h的分别为看电视(13.6％)、上网(33.7％),中学生分别为看电视(13.5％)、上网(23.5％),中、小学生之间差异均有统计学意义(P值均＜0.05).睡眠不足、看电视和上网时间均≥2 h的学生超重肥胖率分别为12.3％,13.0％和15.8％.Logistic回归分析显示,上网时间长(≥2 h)的学生发生超重肥胖的危险性是上网时间短(＜2 h)学生的1.393倍(P＜0.05).结论 长时间上网为中小学生超重肥胖的独立危险因素.     

Effects of a parent-child communications intervention on young adolescents' risk for early onset of sexual intercourse

CONTEXT: The quality of parent-child communications about sex and sexuality appears to be a strong determinant of adolescents' sexual behavior. Evaluations of interventions aimed at improving such communications can help identify strategies for preventing early onset of sexual behavior. METHODS: A school-based abstinence-only curriculum was implemented among 351 middle school students, who were randomly assigned to receive either the classroom instruction alone or the classroom instruction enhanced by five homework assignments designed to be completed by the students and their parents. An experimental design involving pretest and posttest surveys was used to assess the relative efficacy of the curriculum delivered with and without the parent-child homework assignments. RESULTS: In analyses of covariance controlling for baseline scores, immediately after the intervention, adolescents who received the enhanced curriculum reported greater self-efficacy for refusing high-risk behaviors than did those who received the classroom instruction only (mean scores, 16.8 vs. 15.8). They also reported less intention to have sex before finishing high school (0.4 vs. 0.5), and more frequent parent-child communications about prevention (1.6 vs. 1.0) and sexual consequences (1.6 vs. 1.1). In all significant comparisons, the direction of the findings favored adolescents who received the enhanced curriculum. Dose-response relationships supported the findings. CONCLUSIONS: Parent-child homework assignments designed to reinforce and support school-based prevention curricula can have an immediate impact on several key determinants of sexual behavior among middle school adolescents.     

上海市某区青少年健康危险行为调查分析

目的 分析上海市某区青少年健康危险行为发生情况,为进一步于预提供依据.方法 采用单纯随机抽样方法,选取该区内初中、高中和职校各2所学校初一～高三年级共1 355名学生,其中初中592人,高中396人,职校367人,统一发放青少年健康相关行为调查问卷,采用Epi-data 3.0软件输入,使用SPSS 12.0软件进行统计分析.结果 调查发现,健康危险行为指标在初中、高中和职校生之间存在较大差异.职校生饮食行为、健康相关行为、伤害相关行为、吸烟相关行为以及游戏机和网络成瘾情况等指标均与初中、高中生有明显差异.其中职校生违规行为的比例明显高于初中生和高中生;在游戏机和网络成瘾情况调查中,职校生每天上网和玩游戏机超过4小时的比例明显高于初中、高中生;在上网活动内容中,职校生上网收发邮件、查阅学习资料的比例低于初中、高中生,而上网玩游戏、聊天的比例高于初中、高中生,经检验有统计学意义.结论 初中生、高中生及职校生由于存在年龄、学习层次不同的双重差异而在各项指标中存在明显差异.为了尽可能有效地实施干预工作,各项相关干预工作开展的愈早愈好.     

河南省中学生网络成瘾现况及其影响因素分析

了解河南省中学生网络成瘾行为的流行现况及其影响因素,为采取有效的预防和控制措施提供科学依据.方法 统一使用中国疾病预防控制中心制定的《中国青少年健康相关行为调查问卷》,分初中版、高中版,采用分层随机抽样的方法,选取河南省初中和高中学生共30 260名进行问卷调查.结果 河南省中学生电子游戏成瘾行为报告率为12.9%,且男生(16.8%)高于女生(8.9%)(x2=416.0,P<0.05);每天上网时间≥4 h的学生有3 691名(占12.2%),且男生(15.1%)高于女生(9.3%) (x2=240.0,P<0.05).网络成瘾率为7.6%,男生(10.7%)高于女生(4.6%)(x2=410.9,P<0.05);娱乐性赌博行为报告率为14.6%,参与者(19.6%)高于未参与者(5.6%)(x2=1 048.9,P<0.01).Logistic回归分析R2=0.085,预测百分比为92.2%,结果显示,学习成绩、孤独、学习压力感、焦虑和抑郁是网络成瘾行为的主要影响因素.结论 河南省中学生网络成瘾行为处于国内平均水平,应从缓解学生学习压力,关注学生心理状况角度出发,减少或避免网络成瘾行为的发生.     

Heightened vulnerability and increased risk-taking among adolescent chat room users: results from a statewide school survey.

PURPOSE: To profile adolescent Internet chat room users in terms of demographic characteristics, psychological and environmental factors, and behavioral risk factors. METHODS: The study sample was drawn from respondents to an anonymous statewide survey of 50,168 9th-grade public school students and included 40,376 students who reported Internet access at home and 19,511 who accessed chat rooms. Data were collected by the Minnesota Student Survey (MSS), a survey that has been administered triennially by the state's education department to public school students in grades 6, 9, and 12 since 1989. The MSS includes more than 117 questions (300 variables) addressing attitudinal, behavioral, and environmental issues. Data analysis consisted of comparing the odds of a particular characteristic or behavior for chat room users with that of nonusers. Analyses were run separately for boys and girls. The homogeneity of odd ratios was tested with the Breslow-Day statistic using SPSS for Windows. RESULTS: For boys and girls, use of Internet chat rooms was associated with psychological distress, a difficult living environment, and a higher likelihood of risky behaviors. Although most chat room users did not report serious problems, this group included a disproportionate number of troubled individuals. CONCLUSIONS: Because chat room use serves as an indicator of heightened vulnerability and risk-taking, parents and others need to be aware of potential dangers posed by online contact between strangers and youth.     

广州市青少年精神成瘾行为分析

目的 了解广州市青少年电子游戏、网络成瘾及赌博等精神成瘾行为现况,为制定干预措施提供科学依据.方法 采用“中国青少年健康相关行为调查问卷”对广州市66所学校11939名学生进行问卷调查.结果 青少年每天玩电子游戏≥4 h的比例为13.61％,男生(18.63％)远高于女生(9.30％),农村(14.56％)略高于城市(13.11％),职中生比例最高(25.65％),差异均有统计学意义(P值均＜0.05).青少年网络成瘾率为8.25％,男生(10.88％)明显高于女生(5.99％),职中生最高(10.25％),差异均有统计学意义(P值均＜0.01).青少年参加类似赌博的娱乐性活动的发生率为25.87％,男生(33.58％)高于女生(19.24％),城市(23.09％)低于农村(31.13％),职中生的发生率最高(38.63％),普通中学(24.26％)高于重点中学(20.84％),差异均有统计学意义.青少年上网的目的主要是:在线音乐、影视等的收听和收看(52.00％)、即时通讯(QQ,MSN等)(48.93％)、查阅资料(42.65％).结论 广州市青少年长时间玩电子游戏、上网及赌博等精神成瘾行为发生率较高,应通过学校、家庭及社会途径开展针对性干预.     

江苏启东市青少年伤害危险行为现况分析

目的了解青少年伤害相关的危险行为现状,为制定干预措施提供依据。方法采用二阶段抽样方法,抽取16所学校(初中、高中和中等职业学校)的86个班级共4090名在校学生,采用"江苏省青少年健康相关行为问卷"进行调查。结果学生步行乱穿马路、骑自行车违规、非安全场所游泳等非故意伤害危险行为的报告率分别为49.96%,39.99%,11.58%,故意伤害危险行为的发生以学习压力重、离家出走意念、自杀意念的发生率最高,高中生高于初中生(P<0.01),过去1a伤害的发生率为31.67%。结论青少年存在多种易导致伤害的危险行为。教育与卫生部门应针对青少年的性别、年龄特点开展相关的健康教育,以提高自我保健意识,预防伤害的发生。     

儿童青少年静态行为与主观幸福感的相关性

了解儿童青少年静态行为和主观幸福感现状及其关系,为促进儿童青少年身心健康提供参考.方法 采用方便抽样方法,选取上海市城区1 所公办小学和1 所公办初中628 名四至八年级学生,进行长时间看电视、互联网过度使用、游戏过度使用等静态行为、生活满意度量表、个人幸福指数—中小学生版、正负性情感量表儿童版等的测评.结果 学生长时间看电视、课外做作业、上网、电子游戏的比例依次为2.7%,6.0%,3.6%,5.1%.互联网过度使用率为14.3%,游戏过度使用率为8.2%.长时间上网、长时间电子游戏、互联网过度使用、游戏过度使用均与生活满意度、个人幸福指数、正性情感呈负相关,与负性情感呈正相关(P 值均<0.05).线性回归分析结果显示,网络游戏频度对主观幸福感大多指标有显著的预测效应.结论 需重视静态行为,加强网络游戏过度使用的干预,促进儿童青少年的健康.     

上海市2004—2019年青少年健康危险行为特征和变化趋势

  目的  分析上海市青少年健康危险行为变化趋势,为中学生健康危险行为综合干预工作提供参考依据。  方法  参考中国疾病预防控制中心的中国青少年健康相关行为调查问卷,根据实际监测需要编制问卷,分初中版、高中版,采用多阶段分层随机整群抽样方法,2004—2019年选取6次上海全市范围调查中问卷填写完整的59 209名中学生为研究对象。  结果  2004—2019年,调查前7 d内,9.2%~50.6%的中学生平均每天喝汽水饮料≥1次,54.2%~76.1%的中学生报告吃甜点≥2次; 48.3%~60.7%的中学生每天运动60 min以上的天数≤3 d,16.1%~35.2%的中学生报告课外学习时间过长且报告率逐年上升,年均百分比变化率(APC)为5.15%(t=9.28,P < 0.01),长时间上网报告率为6.0%~13.6%,在高中生中呈上升趋势(APC=5.35%,t=3.14,P < 0.05);中学生步行违规行为报告率为从2004年69.1%下降至2019年27.6%(APC=-6.28%,t=-8.18,P < 0.01),但骑车违规行为近年来有所上升; 故意伤害行为如打架、欺负行为等均在逐年下降; 初次吸烟年龄≤13岁的报告率逐年下降,但尝试饮酒行为报告率在初中生中有所上升,APC为1.61%(t=3.48,P < 0.05);1.6%~3.4%的中学生具有网络成瘾行为倾向,网络成瘾倾向报告率在高中生和女生中呈上升趋势,APC分别为6.59%和10.29%(t值分别为6.37,8.62,P值均 < 0.01)。  结论  2004—2019年间,上海市中学生非故意伤害行为、故意伤害行为、物质成瘾行为得到改善,然而不良饮食和缺乏体力活动行为报告率仍然较高,后续需重点关注不良饮食和缺乏体力活动行为并采取综合性干预手段加以控制。     

Sexual violence and its prevalence among adolescents,Brazil

OBJECTIVE: To assess the prevalence o sexual violence among adolescents of public schools. METHODS: Fifty-two public elementary schools of Porto Alegre, Brazil, were selected through random sampling stratified by school size. An 8th grade class was selected in each school through simple random sampling and all adolescents attending the classes who agreed to participate were included in the study. The Screening Survey of Children's Exposure to Community Violence was used to identify adolescents who were victims, witnesses or knew someone who had been a victim of sexual violence. RESULTS: There were 1,193 adolescents included in the study, representing 10.3% of all students enrolled on 8th grade classes in the city's public schools. Twenty-seven adolescents (2.3%) reported being victims of sexual violence, 54 (4.5%) reported witnessing some episode of sexual violence and 332 (27.9%) reported knowing someone who was a victim of sexual violence. CONCLUSIONS: Exposure to sexual violence in any of the three forms of contact was a common event among the studied adolescents. Studies focusing sexual violence as a broad social phenomenon with multiples associated factors are necessary to support preventive and treatment strategies at the community level.     

上海市青少年危险行为现状研究(二)--易导致意外伤害的危险行为

目的　了解上海市青少年与意外伤害相关的危险行为现状 ,为制定干预措施提供依据。　方法　于 2 0 0 2年 4～ 6月 ,在上海市 10 5所学校 (初中、高中和中等职业学校 )对 92 46名一年级学生 ,采用上海市青少年危险行为问卷进行调查。　结果　学生中步行乱穿马路、骑车违反交通规则、乘车不系安全带等危险行为发生率最高 ,分别为 40 .7%、48.4%、42 .0 % ,其次分别为打架行为 ( 2 7.3% )和到非泳区游泳 ( 9.8% ) ;学生中发生各种危险行为的比例有明显差异 ,男生显著高于女生 (P <0 .0 1) ;中等职业学校显著高于高中学生 (P <0 .0 1) ,骑车违反交通规则、打架等行为初中学生显著高于中等职业学校和高中学生 (P <0 .0 1) ;步行乱穿马路、乘车不系安全带等危险行为中心城区显著高于非中心城区 (P <0 .0 1) ,骑车违反交通规则、到非泳区游泳、受凶器威胁或伤害等危险行为非中心城区显著高于中心城区 (P <0 .0 1)。　结论　青少年中存在许多易导致意外伤害的危险行为 ,应针对青少年的性别、年龄特点和地区差异开展相关的健康教育 ,以提高其对意外伤害的预防和自我保健意识。     

Online behavior of youth who engage in self-harm provides clues for preventive intervention

OBJECTIVE: To explore the Internet use and interpersonal interactions of youth reporting deliberate self-harm as defined by any non-fatal act, regardless of intention. METHOD: The Second Youth Internet Safety Survey is a nationally representative telephone survey of 1500 Internet users (ages 10-17) in the United States, conducted March to June 2005. RESULTS: Youth reporting deliberate self-harm in the past 6 months (3%) were significantly more likely than other youth to have a sexual screen name or to talk with people known only online about sex (35% versus 5%) and to use chat rooms (57% versus 29%). All youth were equally likely to talk online with people known in person, yet youth engaging in deliberate self-harm were significantly more likely also to have a close relationship with someone met online (38% versus 10%). Three quarters (76%) of youth reporting self-harm used instant messaging. CONCLUSION: Findings suggest that youth who engage in self-harm may be more likely to engage in online behaviors that have the potential to place them in risky situations. Programs aimed at preventing deliberate self-harm should consider adding chat room and instant messaging to their telephone hotline capabilities.