Youth Soccer Parents' Attitudes and Perceptions About Concussions

PurposeParents are important figures in properly managing youth sport concussions. Although media attention has predominantly centered on concussions in contact/collision sports, evidence suggests that the concussion rate in soccer is comparable to those found in contact/collision sports. Given the high rate of concussions in youth soccer, this study aimed to examine parents of youth soccer athletes' attitudes and perceptions about concussions and associated factors.MethodsA cross-sectional study was conducted by surveying parents of youth soccer athletes from the five largest organized youth soccer programs across the U.S. The researchers developed a questionnaire after an extensive literature review and by modifying previously used instruments.ResultsOverall, 419 parents completed the survey. The vast majority (85%) agreed that a concussion is a serious injury, but only 27.9% believed that their child could suffer a concussion during the next season. Parents were most concerned about permanent brain damage when their child suffers a concussion. The vast majority (4.37 ± .89) perceived concussion reporting as an important injury prevention strategy. Greater appreciation and perceived risk about concussions was found particularly among parents who received concussion education and those who had witnessed or heard about a concussive incidence(s).ConclusionsFindings suggest that youth soccer parents have high appreciation and perceived risk about concussions. However, the need for more targeted education was noted, as improvements to better manage and reduce concussions can be made. Future research should continue examining youth sport parents' belief and understanding about concussions as well as factors affecting them.     

Adult Connection in Assault Injury Prevention among Male Youth in Low-Resource Urban Environments

Strengths-based strategies to reduce youth violence in low-resource urban communities are urgently needed. Supportive adolescent-adult relationships may confer protection, but studies have been limited by self-reported composite outcomes. We conducted a population-based case-control study among 10- to 24-year-old males in low-resource neighborhoods to examine associations between supportive adult connection and severe assault injury. Cases were victims of gunshot assault injury (n?=?143) and non-gun assault injury (n?=?206) from two level I trauma centers. Age- and race-matched controls (n?=?283) were recruited using random digit dial from the same catchment. Adolescent-adult connections were defined by: (1) brief survey questions and (2) detailed family genograms. Analysis used conditional logistic regression. There were no significant associations between positive adult connection, as defined by brief survey questions, and either gunshot or non-gun assault injury among adolescents with high prior violence involvement (GSW OR?=?2.46, 95% CI 0.81–7.49; non-gun OR?=?1.59, 95% CI 0.54–4.67) or low prior violence involvement (GSW OR?=?0.92, 95% CI 0.34–2.44; non-gun OR?=?1.96, 95% CI 0.73–5.28). In contrast, among adolescents with high levels of prior violence involvement, reporting at least one supportive adult family member in the family genogram was associated with higher odds of gunshot assault injury (OR?=?4.01, 95% CI 1.36–11.80) and non-gun assault injury (OR?=?4.22, 95% CI 1.48–12.04). We were thus unable to demonstrate that positive adult connections protected adolescent males from severe assault injury in this highly under-resourced environment. However, at the time of injury, assault-injured adolescents, particularly those with high prior violence involvement, reported high levels of family support. The post-injury period may provide opportunities to intervene to enhance and leverage family connections to explore how to better safeguard adolescents.     

Prevalence of electronic nicotine delivery systems (ENDS) use among youth globally: a systematic review and meta‐analysis of country level data

Objective: To describe the prevalence and change in prevalence of electronic nicotine delivery systems (ENDS) use in youth by country and combustible smoking status. Methods: Databases and the grey literature were systematically searched to December 2015. Studies describing the prevalence of ENDS use in the general population aged ≤20 years in a defined geographical region were included. Where multiple estimates were available within countries, prevalence estimates of ENDS use were pooled for each country separately. Results: Data from 27 publications (36 surveys) from 13 countries were included. The prevalence of ENDS ever use in 2013–2015 among youth were highest in Poland (62.1%; 95%CI: 59.9–64.2%), and lowest in Italy (5.9%; 95%CI: 3.3–9.2%). Among non‐smoking youth, the prevalence of ENDS ever use in 2013–2015 varied, ranging from 4.2% (95%CI: 3.8–4.6%) in the US to 14.0% in New Zealand (95%CI: 12.7–15.4%). The prevalence of ENDS ever use among current tobacco smoking youth was the highest in Canada (71.9%, 95%CI: 70.9–72.8%) and lowest in Italy (29.9%, 95%CI: 18.5–42.5%). Between 2008 and 2015, ENDS ever use among youth increased in Poland, Korea, New Zealand and the US; decreased in Italy and Canada; and remained stable in the UK. Conclusions: There is considerable heterogeneity in ENDS use among youth globally across countries and also between current smokers and non‐smokers. Implications for public health: Population‐level survey data on ENDS use is needed to inform public health policy and messaging globally.     

Incidence and Cost of Nonfatal Farm Youth Injury,United States, 2001–2006

ABSTRACT

The objective of this study was to estimate the annual incidence and cost of nonfatal farm youth injury in the United States for the period 2001–2006. The authors used 2001–2006 Childhood Agricultural Injury Survey data to estimate the annual incidence of farm youth nonfatal injury. To estimate the costs for injuries suffered by youth working/living on the farm, the number of injuries was multiplied by published unit costs by body part, nature of injury, and age group. The annual number of nonfatal injuries to youth (ages 0–19) on farms in 2001–2006 was 26,570. The annual cost of nonfatal farm youth injuries was $1 billion (in 2005 dollars), with 26% of costs related to working on the farm and 47% on beef cattle farms. Around 9.3% of the cost was medical costs, 37.2% work and household productivity loss, and 53.5% quality of life loss.     

Safety and Injury Characteristics of Youth Farmworkers in North Carolina: A Pilot Study

Agriculture is a unique US industry in how youth are involved. Youth employed in agriculture experience high rates of injury, and youth migrant and seasonal farmworkers may be extremely vulnerable. The primary aim for this analysis is to describe the personal characteristics, work characteristics, occupational safety behaviors, and occupational injuries of North Carolina youth farmworkers. This pilot study uses data from interviewer-administered questionnaires with 87 youth farmworkers. Participants included males (62.1%) and females (37.9%), with 26.4% aged 10–13 years, 39.1% 14–15 years, and 34.5% 16–17 years. The majority (78.2%) were born in the United States. Most worked in tobacco (46.0%), sweet potatoes (28.7%), and berries (28.7%). They were paid by the hour (54.0%) and piece rate (55.2%); 21.8% reported a problem getting paid the amount earned. Three quarters wore a hat, and 63.2% wore gloves while working. Five (5.7%) had received pesticide use training in the past year. Over half reported a musculoskeletal injury (54.0%), a traumatic injury (60.9%), or a dermatological injury (72.4%) in the last year. Six of the injuries led to medical treatment, and 10 resulted in missed school or work. Farmworker youth in North Carolina are at times not treated fairly when they work, occupational safety behaviors are limited (increasing exposure to pesticides and other environmental hazards), and they commonly experience injuries. Research on the occupational exposures and health experienced by youth farmworkers is needed to inform policy. Changes in policy are warranted to improve the safety of youth farmworkers.     

Contraception use among female youth with disabilities: Secondary analysis of a Canadian cross-sectional survey

BackgroundNon-use of contraception among sexually active youth is an important contributor to unintended pregnancy, but contraception use among disabled youth is poorly understood.ObjectiveTo compare contraception use in female youth with and without disabilities.MethodsWe used data from the 2013–2014 Canadian Community Health Survey on sexually active 15 to 24-year-old females with (n = 831) and without (n = 2,700) a self-reported functional or activity limitation, who reported that it was important to them to avoid getting pregnant. We used log binomial regression to derive adjusted prevalence ratios (aPR) for use of any vs. no contraception, and for oral contraception, injectable contraception, condoms, other contraception methods, and dual methods separately, comparing youth with and without disabilities. Adjusted analyses controlled for age, school enrollment, household income, marital status, race/ethnicity, immigrant status, and health region.ResultsThere were no differences in the use of any contraception (85.4% vs. 84.2%; aPR 1.03, 95% CI 0.998–1.06), oral contraception (aPR 0.98, 95% CI 0.92–1.05), condoms (aPR 1.00, 95% CI 0.92–1.09), or dual methods (aPR 1.02, 95% CI 0.91–1.15), comparing youth with and without disabilities. Those with disabilities were more likely to use injectable contraception (aPR 2.31, 95% CI 1.59–3.38) and other contraception methods (aPR 1.54, 95% CI 1.25–1.90).ConclusionYouth at risk of unintended pregnancy had similar overall use of contraception, regardless of disability status. Future studies should examine the reasons for higher uptake of injectable contraception in youth with disabilities, with possible implications for health care provider education on access to youth-controlled methods for this group.     

Youth Violence and Connectedness in Adolescence: What Are the Implications for Later Sexually Transmitted Infections?

PurposeTo examine associations between (1) youth violence victimization and perpetration and later sexually transmitted infections (STI) and (2) parent–family and school connectedness and later STI, and to explore the moderating role of connectedness on the associations between youth violence victimization and perpetration and later STI.MethodsWe used data from Waves I and IV of the National Longitudinal Study of Adolescent Health, which provided a baseline weighted sample of 14,800 respondents. We used logistic regression to examine associations between youth violence and connectedness with self-reported ever STI diagnosis, including gonorrhea, chlamydia, syphilis, genital herpes, genital warts or human papillomavirus, or human immunodeficiency virus. If participants reported having an STI at Wave I they were excluded from the analysis.ResultsControlling for biological sex, race/ethnicity, age, parent's highest education level, and parent's marital status, both youth violence victimization and perpetration were associated with an increased risk of later STI (adjusted odds ratio [AOR], 1.27, 95% confidence interval [CI], 1.07–1.52; and AOR, 1.21, 95% CI, 1.04–1.41, respectively). Parent–family and school connectedness in adolescence were associated with a decreased risk for later STI (AOR, .96, 95% CI, .95–.98; and AOR, .97, 95% CI, .95–.99, respectively); however, connectedness did not moderate the associations between nonsexual violence involvement and later STI.ConclusionsThese results indicate that youth violence victimization and perpetration may be risk factors for STI later in life. Conversely, parent–family and school connectedness in adolescence appear to protect against subsequent STI. The findings suggest that provider efforts to address youth violence and connectedness in adolescence can promote positive sexual health outcomes in adulthood.     

Weight Misperception and Unhealthy Weight Control Behaviors Among Sexual Minorities in the General Adolescent Population

PurposeGay, lesbian, and bisexual youth may experience significant body dissatisfaction. We examined sexual orientation differences in self-perceived weight status and the prevalence of potentially dangerous weight control behaviors in a representative sample of adolescents.MethodsData were obtained from 12,984 youth between 2003 and 2009 over four cycles of the Massachusetts Youth Risk Behavior Survey, a statewide survey of ninth- through 12th-grade students. Self-perceived weight status and past-month unhealthy weight control behaviors (fasting >24 hours, using diet pills, and vomiting or using laxatives) were compared among gay/lesbian, bisexual, or self-identified heterosexual youth with same-sex partners, unsure youth, and exclusively heterosexual youth using logistic regression, adjusting for age and race/ethnicity.ResultsCompared with exclusively heterosexual males, heterosexual males with prior same-sex partners and bisexual males were more likely to self-perceive as overweight despite being of healthy weight or underweight (respectively, adjusted odds ratio [AOR], 2.61; 95% confidence interval [CI], 1.68–4.05; and AOR, 2.56; 95% CI, 1.64–4.00). Compared with exclusively heterosexual females, lesbians and bisexual females were more likely to self-perceive as being of healthy weight or underweight despite being overweight or obese (respectively, AOR, 3.17; 95% CI, 1.15–8.71; and AOR, 2.00; 95% CI, 1.20–3.33). Unhealthy weight control behaviors were significantly more prevalent among sexual minority males (32.5%; AOR, 4.38; 95% CI, 3.38–5.67) and females (34.7%; AOR, 2.27; 95% CI, 1.85–2.78) when considered together relative to exclusively heterosexual males (9.7%) and females (18.8%).ConclusionsOne third of sexual minority youth engage in hazardous weight control behaviors. Future research should investigate underlying mechanisms and determine whether clinicians should routinely screen for these behaviors.     

Protective Assets for Non-use of Alcohol,Tobacco and Other Drugs among Urban American Indian Youth in Oklahoma

Objective This study explored associations between nine youth assets and tobacco, alcohol and other drug non-use among participating American Indian adolescents. Methods Data from 134 American Indians, ages 13–19 years, participating in an inner-city youth asset study, were analyzed. Individual logistic regression analyses were conducted, controlling for demographic variables, with nine youth assets as the independent variables and alcohol, tobacco and other drug non-use as the dependent variables. Results Among American Indian youth, nearly 79% reported not using alcohol in the past 30 days. The prevalence of tobacco non-use was somewhat lower than that of alcohol, with 71% reporting not using tobacco in the past 30 days. For other drug non-use, 87% reported not using other drugs in the past 30 days. The non-parental adult role models asset was significantly associated with non-use of alcohol (OR = 4.4, 95% CI 1.5–13.3), tobacco (OR = 7.5, 95% CI 2.2–25.6), and other drugs (OR = 5.0, 95% CI 1.5–16.8). The use of time (religion) asset was also significantly associated with alcohol non-use (OR = 2.8, 95% CI 1.1–7.2). The family communication asset was associated only with other drug non-use (OR = 3.1, 95% CI 1.02–9.4). For tobacco non-use, an interaction was observed between family structure and the good health practices (exercise/nutrition) asset. Among youth in single-parent households, the odds of tobacco non-use were 4.4 times greater among those who possessed the good health practices (exercise/nutrition) asset. Conclusions Despite the relatively small sample size of American Indian youth, these results suggest an important role for specific youth assets in the prevention of substance abuse among American Indian youth.     

Street-based STD testing and treatment of homeless youth are feasible,acceptable and effective

PurposeCurrent Centers for Disease Control (CDC) guidelines recommend that sexually transmitted disease (STD) screening measures for high-risk populations such as homeless youth prioritize testing in out-of-clinic settings and incorporate new approaches to STD eradication, such as field-delivered testing and treatment and patient-delivered partner therapy (PDPT). Our non-medically trained research staff offered field-based STI testing, field-delivered therapy, and PDPT to homeless youth in the context of a longitudinal study.MethodsA total of 218 ethnically diverse (34% female) 15–24-year-old homeless youth recruited from street sites in San Francisco completed an audio computer-administered self-interview survey and provided a first-void urine sample for testing for chlamydia (CT) and gonorrhea (GC). Youth testing positive were offered field-delivered therapy and PDPT. A random subset of 157 youth was followed prospectively, of whom 110 (70%) were interviewed and 87 (55%) retested at six months.ResultsAt baseline, 99% of youth in the study consented to STI testing, of whom 6.9% and .9% tested positive for CT and GC, respectively. Ninety-four percent of positive youth were treated, 50% within one week. The incidence rate for CT was 6.3 per 100 person-years (95% confidence interval [CI]: 1.3–18.4) and for GC was 4.2 per 100 person-years (95% CI: .5–15.2). None of the youth treated by study staff and tested six months later (n = 6) had CT or GC on follow-up testing (95% CI: 0–131.3).ConclusionsField-delivered testing and field-delivered therapy are feasible, acceptable and effective interventions for the diagnosis and treatment of STDs in homeless youth. These measures along with PDPT may decrease rates of subsequent reinfection.     

Vocational Rehabilitation of Transition-Age Youth with Disabilities: A Propensity-Score Matched Study

Objective To investigate the employment outcomes of vocational rehabilitation (VR) services for youth with disabilities in a targeted, enhanced, and contract-based secondary transition program as compared to the traditional VR transition services. Methods A population-based study was conducted on 4422 youth with physical, intellectual, learning, mental and hearing disabilities aged 14–21 at application and whose case was closed after receiving VR transition services in a Midwestern state. Selected youth were classified into either targeted secondary transition program (START) or non-START treatment group. The employment outcomes of the groups were compared using propensity-score matching procedures. Results 2211 youth with disabilities in each treatment group were successfully matched based on demographic characteristics, types of disabilities, existence of severe functional limitations, and year of referral. The overall rehabilitation rate was 57 % [95 % confidence interval (CI) 56–59 %], where the START group rate was 61 % (95 % CI 59–63 %) and the non-START group 53 % (95 % CI 51–55 %). The propensity-score matched odds ratio (OR) was 1.40 (95 % CI 1.24–1.58; p < 0.001). Subgroup analyses showed that the odds of rehabilitation in youth with disabilities were consistently higher when they were in START as compared to non-START (OR ranged from 1.27 to 1.92 with p < 0.05 except for the Hispanic subgroup). Conclusion The results suggest that VR services in a targeted, enhanced, and contract-based secondary transition program are more effective in transitioning youth with disabilities to employment than the regular VR transition services.     

Changing Farm Injury Trends by Sex for Youth Living on US Farms, 1998-2006

Purpose: To estimate the number and rate of on-farm injuries to youth living on farms in the United States by sex from 1998 to 2006 and compare the trends in youth injury by sex. Methods: Data from 4 childhood agricultural injury surveys for the years 1998, 2001, 2004, and 2006 were analyzed using a Poisson regression model utilizing generalized estimating equations. Rate ratios with corresponding 95% confidence intervals were calculated from the model, which compared the estimated rates of injury in 2001, 2004, and 2006 to the estimated rate of injury in the baseline year, 1998. Results: There was an overall decline in the estimated number and rate of injuries to youth living on farms from 1998 to 2006, with a linear decline of the rate ratios for all youth on farms that was found to be significant. By sex, the trend in injury rate ratios for male youth significantly declined, while the trend for female youth for the same time period initially increased then returned to the baseline. Nonhomogeneity in trends by age group, work versus nonwork injury, and source of injury was also identified. Conclusion: Additional surveillance is needed to determine if injury trends to youth living on farms will continue to differ by sex. More detailed data on exposure to hazards for these youth by sex are needed to determine what factors are associated with these disparate injury trends and to design and implement effective interventions to further reduce injuries to youth living on farms.     

Acute work injuries among electric utility linemen

This analysis presents differences in acute work injury rates among electric utility linemen who perform different work tasks. Incidence-density rate ratios were the primary measure of association and are based on the work injury and person-time data for each job title. Logistic regression was used to model race, age, job experience, total inservice, prior injury, and time from prior injury. Transmission linemen had the lower acute injury rate with 18.9 per 100 person-work-years (95% CI 16–20), distribution linemen had 27.8 per 100 person-work-years (95% CI 27–28), and apprentice linemen had 43.3 per 100 person-work-years (95% CI 41–45). Injuries to the trunk and sprains and strains are the predominant injury categories. Having a prior lost time injury increases the risk for subsequent lost time injury for transmission linemen (OR = 1.6, 95% CI = 1.0–2.7) and for distribution linemen (OR = 1.5, 95% CI = 1.3–1.6). Am. J. Ind. Med. 31:223–232, 1997. © 1997 Wiley-Liss, Inc.     

Convenience Store Access and E-cigarette Advertising Exposure Is Associated With Future E-cigarette Initiation Among Tobacco-Naïve Youth in the PATH Study (2013–2016)

PurposeThe association between e-cigarette marketing exposure and youth e-cigarette initiation is not well understood. This study examines whether convenience store access, exposure to retail e-cigarette marketing, and having a favorite e-cigarette ad before e-cigarette use is associated with susceptibility to use and future e-cigarette initiation in a national longitudinal study of youth.MethodsA nationally representative longitudinal cohort of youth in the Population Assessment of Tobacco and Health study (12–17 years) was followed up over three waves of annual data collection (2013–2016). Tobacco-naïve (wave 1) and e-cigarette-naïve (wave 2) youth (n = 6,470) were included. Marketing exposure at wave 2 was examined in association with e-cigarette susceptibility (wave 2) and e-cigarette initiation (wave 3) using adjusted logistic regression models. Analysis occurred in 2019.ResultsYouth visiting convenience stores at least weekly (vs. never) had 1.51 times the odds of e-cigarette susceptibility (95% confidence interval [CI]: 1.25, 1.81) and 1.79 times the odds of e-cigarette initiation (95% CI: 1.29, 2.48). Noticing a retail e-cigarette ad (vs. not noticing) was associated with e-cigarette susceptibility (adjusted odds ratio [AOR] 1.36, 95% CI: 1.18, 1.57), but not initiation. Youth reporting a favorite branded e-cigarette ad had greater odds of both susceptibility (AOR 1.31, 95% CI, 1.10, 1.56) and e-cigarette initiation (AOR 1.60, 95% CI: 1.18, 2.17) compared to youth without a favorite ad.ConclusionsTobacco-naïve youth with frequent convenience store access and exposure to e-cigarette marketing were at greater risk of e-cigarette susceptibility and progression to e-cigarette initiation over a 2-year period. Policies to restrict retailer locations and e-cigarette marketing could enhance youth e-cigarette use prevention efforts.     

Asthma among Household Youth on Racial Minority Operated Farms—United States, 2008

Objectives: Youth on farms are at risk for injuries and illnesses, including asthma, which continues to disproportionately affect minority groups.

Methods: For this study, the 2008 Minority Farm Operator Childhood Agricultural Injury Survey (M-CAIS) data were used to estimate the prevalence of asthma among youth aged 0–19 years living on racial minority-operated farms. Youth were considered to have a lifetime diagnosis of asthma based on an affirmative response to the question “Has he/she ever been diagnosed as having asthma by a health professional?”

Results: In 2008, of the estimated 37,400 youth (0–19 years) who lived on racial minority operated farms, 11% had asthma. Asthma prevalence was highest among males (13%) and youth 10–19 years of age (12%). Asthma prevalence among youth varied by race, ranging from 13% among household youth living on Black/African American operated farms to 7% among youth living on Asian/Native Hawaiian/Pacific Islander operated farms. In 2008, nearly half (46%) of household youth (0–19 years) worked on the farm. The odds of having asthma were higher among working youth compared with non-working youth (POR, 1.5; 95% CI: 1.3–1.8).

Conclusion: Disparities in asthma among youth living or working on racial minority-operated farms were observed. These findings may assist agricultural safety and health researchers, practitioners, and educators in identifying and designing targeted interventions to reduce asthma burden among youth on racial minority-operated farms.     

Association of cardiovascular risk factors between Hispanic/Latino parents and youth: the Hispanic Community Health Study/Study of Latino Youth

PurposeHispanic/Latinos have a high burden of cardiovascular disease (CVD) risk factors which may begin at young ages. We tested the association of CVD risk factors between Hispanic/Latino parents and their children.MethodsWe conducted a cross-sectional study in the Hispanic Community Health Study/Study of Latinos Youth study. Girls (n = 674) and boys (n = 667) aged 8 to 16 years (mean age 12.1 years) and their parents (n = 942) had their CVD risk factors measured.ResultsCVD risk factors in parents were significantly positively associated with those same risk factors among youth. After adjustment for demographic characteristics, diet and physical activity, obese parents were significantly more likely to have youth who were overweight (odds ratios [ORs], 2.39; 95% confidence interval [CI], 1.20–4.76) or obese (OR, 6.16; 95% CI, 3.23–11.77) versus normal weight. Dyslipidemia among parents was associated with 1.98 higher odds of dyslipidemia among youth (95% CI, 1.37–2.87). Neither hypertension nor diabetes was associated with higher odds of high blood pressure or hyperglycemia (prediabetes or diabetes) in youth. Findings were consistent by sex and in younger (age <12 years) versus older (≥12 years) youth.ConclusionsHispanic/Latino youth share patterns of obesity and CVD risk factors with their parents, which portends high risk for adult CVD.     

Identifying characteristics and outcomes in youth with obesity and developmental disabilities

BackgroundYouth with developmental disability are at increased risk of obesity; literature focusing on the two is rare.ObjectiveTo identify characteristics and outcomes of youth presenting for obesity care having a disability as compared to without.MethodsA medical record review of youth aged 2–18 years initiating obesity care 2013–2015 at a tertiary care obesity management program. Youth were grouped by disability status to identify differences in presenting characteristics and factors associated with a reduction in body mass index (BMI) percent of the 95th BMI percentile (BMIp95) over 12 months. Logistic regression (LR) models examined associations with BMIp95 drop (<5-points versus ≥5-points) for each disability group.ResultsOf 887 subjects, 253 (28.5%) had a disability. At presentation, youth with disability were more often (p < 0.01) male (58.5% versus 47.9%), had birth weight <2500 g (14.1% versus 8.4%), had a father who was not obese (61.6% versus 47.4%), and were on weight influencing medications. Overall, 182 subjects (20.5%) completed 12-month follow-up. At follow-up, the with disability group (n = 63) had mean ?2.3 (SD 10.7) BMIp95 change (p = 0.679); youth having a motor disability less often had ≥5-point BMIp95 drop (odds ratio 0.15, 95% confidence interval 0.04–0.59). At follow-up, the no disability group (n = 119) had mean ?2.9 (SD 8.5) BMIp95 change; youth identified as having initial severe obesity status and not having a parent with diabetes more often had ≥5-point BMIp95 drop.ConclusionYouth with developmental disabilities were as successful in obesity care as those without disabilities. Predictors of success differed between the groups.     

On Campus HIV Self-Testing Distribution at Tertiary Level Colleges in Zimbabwe Increases Access to HIV Testing for Youth

PurposeHIV self-testing allows youth to access testing outside of healthcare facilities. We investigated the feasibility of peer distribution of HIV self-testing (HIVST) kits to youth aged 16–24 years and examined the factors associated with testing off-site rather than at distribution points.MethodsFrom July 2019 to March 2020, HIVST kits were distributed on 12 tertiary education campuses throughout Zimbabwe. Participants chose to test at the HIVST distribution point or off-site. Factors associated with choosing to test off-site and factors associated with reporting a self-test result for those who tested off-site were investigated using logistic regression.ResultsIn total, 5,351 participants received an HIVST kit, over 129 days, of whom 3,319 (62%) tested off-site. The median age of recipients was 21 years (interquartile range 20–23); 64% were female. Overall, 2,933 (55%) returned results, 23 (1%) of which were reactive. Being female (adjusted odds ratio [aOR] 1.16, 95% confidence interval [CI] 1.03–1.31), living on campus (aOR 1.24, 95% CI 1.09–1.40), used a condom at last sex (aOR 1.44, 95% CI 1.26–1.65), and previous knowledge of HIVST (aOR 1.22, 95% CI 1.09–1.37) were associated with off-site testing. Attending a vocational college and teachers training college compared to a university was associated with choosing to return results for those who tested off-site (OR 2.40, 95% CI 1.65–3.48, p < .001).DiscussionHIVST distribution is an effective method of reaching a large number of youth over a short period of time. Efforts to increase awareness and roll out of HIVST on campuses should be coupled with support for linkage to HIV prevention and treatment services.     

Kava drinking associated with suicidal behaviour among young Kanaks using kava in New Caledonia

Objective : To examine associations between recreational use of kava and indicators of suicidal behaviour among youth in New Caledonia. Methods : This cross‐sectional community‐based survey was administered to 1,400 young people aged 16–25 years. A multivariate analysis tested for associations between lifetime kava use and lifetime suicidal ideation and attempts. Because ethnicity affected the correlation between kava use and suicidal behaviour, data were analysed separately for Kanak youth and youth of other ethnic communities. Results : Overall, 42% of respondents reported any lifetime kava use, 34% reported past suicidal ideation and 12% any suicide attempts. Among Kanak youth, kava use increased the likelihood of reporting both suicidal ideation (aOR = 2.40, 95% CI: 1.58–3.66) and suicide attempts (aOR = 1.98, 95% CI: 1.11–3.52). No such association was found in the non‐Kanak group. Conclusions : The discrepancy between the effects of kava drinking on suicidal behaviour between Kanak youth and youth of other ethnic groups may be related to differences in patterns and quantity of kava use. In view of the paucity of data on the effects of kava on mental health in young people, further investigation is required. Implications : The results call for an increased awareness of the potential adverse health effects of kava consumption in New Caledonia where it has spread in recent times and among communities where previously it was never used.     

Youth United Through Health Education: Community-Level, Peer-Led Outreach to Increase Awareness and Improve Noninvasive Sexually Transmitted Infection Screening in Urban African American Youth

PurposeTo evaluate the effectiveness of the Youth United Through Health Education (YUTHE) program, a community-level, peer-led outreach program to increase awareness and improve noninvasive sexually transmitted infection (STI) screening in youth residing in the targeted community.MethodsSexually experienced youth, aged 12–22 years, anonymously participated in the YUTHE program (a 15-minute encounter, including a risk assessment with feedback and prevention messages). A street- and venue-based intercept approach using a nonequivalent control group design was implemented to evaluate the YUTHE program.ResultsYUTHE community respondents were more likely to know that STIs could be asymptomatic (odds ratios [OR] 1.36, 95% confidence interval [CI] 1.08–1.72), know about urine-based STI screening tests (OR 1.34, 95% CI 1.04–1.72), perceive themselves to be at risk for STIs (OR 1.71, 95% CI 1.11–2.62), and worried about acquiring an STI (OR 1.50, 95% CI 1.04–2.18). No other community differences were identified. However, respondents who reported a single contact (OR = 2.12, 95% CI = 1.11–4.03) or multiple contacts (OR 2.78, 95% CI 1.81–4.26) with the YUTHE program were more likely to have been tested for STIs in the previous six months.ConclusionsWe did not accomplish our overall goal of increasing STI screening in our outreach community relative to the comparison community; our findings suggest that a peer-led, street- and venue-based community outreach approach is a feasible means for reaching large numbers of adolescents for STI prevention.