Concurrent multiple health risk behaviors among adolescents in Luangnamtha province,Lao PDR

Background

Switzerland has a low mortality rate from cardiovascular diseases, but little is known regarding prevalence and management of cardiovascular risk factors (CV RFs: hypertension, hypercholesterolemia and diabetes) in the general population. In this study, we assessed 10-year trends in self-reported prevalence and management of cardiovascular risk factors in Switzerland.

Methods

data from three national health interview surveys conducted between 1997 and 2007 in representative samples of the Swiss adult population (49,261 subjects overall). Self-reported CV RFs prevalence, treatment and control levels were computed. The sample was weighted to match the sex - and age distribution, geographical location and nationality of the entire adult population of Switzerland.

Results

self-reported prevalence of hypertension, hypercholesterolemia and diabetes increased from 22.1%, 11.9% and 3.3% in 1997 to 24.1%, 17.4% and 4.8% in 2007, respectively. Prevalence of self-reported treatment among subjects with CV RFs also increased from 52.1%, 18.5% and 50.0% in 1997 to 60.4%, 38.8% and 53.3% in 2007 for hypertension, hypercholesterolemia and diabetes, respectively. Self-reported control levels increased from 56.4%, 52.9% and 50.0% in 1997 to 80.6%, 75.1% and 53.3% in 2007 for hypertension, hypercholesterolemia and diabetes, respectively. Finally, screening during the last 12 months increased from 84.5%, 86.5% and 87.4% in 1997 to 94.0%, 94.6% and 94.1% in 2007 for hypertension, hypercholesterolemia and diabetes, respectively.

Conclusion

in Switzerland, the prevalences of self-reported hypertension, hypercholesterolemia and diabetes have increased between 1997 and 2007. Management and screening have improved, but further improvements can still be achieved as over one third of subjects with reported CV RFs are not treated.     

Self-reported health risk behaviors among adolescents in Luang Namtha province of Lao PDR: Prevalence and determinants

The purpose of this study was to assess self-reported prevalence of alcohol, tobacco, and drug use, and sexual risk behaviors, as well as to identify sources of sex education and individual, family, and peer factors that might influence adolescents’ health risk behaviors (HRB). In a community-based, cross-sectional study, 1360 adolescents aged 14–19 years were interviewed from June to September 2008 in Luang Namtha province. Multistage systematic random sampling was used to select participants. Logistic regression was used to identify the determinants of single HRB. Alcohol and tobacco use, and sexual risk behaviors were common. Just under half (42.5%) used alcohol, 9.6% smoked during the past 30 days, and 1.4% had used amphetamine during their lifetime, and 19.6% had ever had sex. Of those, 58.8% were currently sexually active, 40.1% reported having two or more sexual partners, and 34.5% had used a condom during last sexual intercourse. The mean age at sexual debut was 15.3 years for boys and 15.1 years for girls. Khamu ethnicity, not attending school, and peers’ drinking, smoking, and using drugs were significant determinants of current alcohol use, whereas being male, not attending school, Khamu ethnicity, and peers’ smoking and using drugs predicted current smoking. Being male, younger age, Akha ethnicity, having low level of education, peers’ smoking, being sexually active, and being pregnant or having made someone pregnant were significantly associated with ever having sex, whereas being male, Akha and Khamu ethnicities, peers’ smoking, drinking alcohol, and being sexually active were correlated with sexual risk behaviors. Individual and socio-demographic background factors as well as peer influence are determinants of risk behaviors. Thus, efforts should be made to keep adolescents in school, particularly until secondary school, and increase school connectedness.     

云浮市大中学生健康危险行为调查

了解云浮市青少年健康危险行为流行特征,为制定青少年健康危险行为综合性干预措施提供科学依据.方法 采用多阶段分层整群随机抽样方法,抽取云浮市2 666名大中学生进行健康危险行为问卷调查.结果 初中生骑自行车违规、动手打架、自我伤害的发生率分别为45.79%,16.85%,10.65%,均高于初中以上学生.高职学生不能每天吃早餐、运动时间不足、非安全游泳、现在吸烟、现在喝酒、游戏成瘾、赌博行为的发生率分别为47.87%,57.38%,12.79%,15.41%,42.79%,23.11%,25.57%,均高于其他学段学生.10.39%的学生无任何健康危险行为,具有4种及以上危险行为的高职学生比例(35.74%)高于其他学段的学生.与具有1种健康危险行为的人群相比,同时具有4种及以上危险行为的男生动手打架发生风险最高(OR=65.01),女生网络成瘾发生风险最高(OR=77.54).结论 云浮市青少年健康危险行为多发现象表现突出,应开展针对性的健康促进活动,加强健康指导.     

Longitudinal patterns and predictors of multiple health risk behaviors among adolescents: The TRAILS study

BackgroundMost studies on multiple health risk behaviors among adolescents have cross-sectionally studied a limited number of health behaviors or determinants.PurposeTo examine the prevalence, longitudinal patterns and predictors of individual and multiple health risk behaviors among adolescents.MethodsEight health risk behaviors (no regular consumption of fruit, vegetables or breakfast, overweight or obesity, physical inactivity, smoking, alcohol use and cannabis use) were assessed in a prospective population study (second and third wave). Participants were assessed in three waves between ages 10 and 17 (2001–2008; n = 2230). Multiple linear regression was used to assess the influence of gender, self-control, parental health risk behaviors, parental monitoring and socioeconomic factors on the number of health risk behaviors adjusted for preceding multiple health risk behaviors (analysis: 2013–2014).ResultsRates of > 5 health risk behaviors were high: 3.6% at age 13.5 and 10.2% at age 16. Smoking at age 13.5 was frequently associated with health risk behaviors at age 16. No regular consumption of fruit, vegetables and breakfast, overweight or obesity, physical inactivity and smoking predicted the co-occurrence of health risk behaviors at follow-up. Significant predictors of the development of multiple health risk behaviors were adolescents' levels of self-control, socioeconomic status and maternal smoking.ConclusionsMultiple health risk behaviors are common among adolescents. Individual and social factors predict changes in multiple health risk behaviors, showing that prevention targeting multiple risk behaviors is needed. Special attention should be paid to adolescents with low self-control and families with low socioeconomic status or a mother who smokes.     

Variations in associations of health risk behaviors among ethnic minority early adolescents

PurposeTo investigate patterns of vulnerability and protection factors associated with risk behaviors and the co-occurrence of risk behaviors in minority ethnicity early adolescents.MethodsAnalysis of data from the Research with East London Adolescents Community Health Survey (RELACHS), a school-based study of a representative sample of 2789 adolescents age 11–14 in 2001 (sample 73% non-Caucasian, 21% born outside the United Kingdom). Questionnaire data were obtained on sociodemographic variables, ethnicity, smoking, drinking, drug use, psychological well-being, physical health, and social support from family and peers. Models of associations for each behavior and co-occurrence of risk behaviors (defined as engaging in ≥ 2 behaviors) were developed by hierarchical stepwise logistic regression.ResultsTwo hundred ninety-two (10.9%) reported 1 risk behavior, 84 (3.1%) reported 2, and 25 (0.9%) reported 3 behaviors. In multivariate models, psychological morbidity was associated with higher risk of all behaviors and co-occurrence, while higher family support was associated with lower risk in all models. Non-Caucasian ethnicity was associated with lower risk of regular smoking and co-occurrence but not drinking or drugs. Birth outside the United Kingdom was associated with lower risk for individual behaviors but not co-occurrence. Religion and religious observance were associated with lower risk of smoking and drinking but not drug use or co-occurrence. Peer connectedness was associated with drug use, but with increased risk. Socioeconomic status was associated only with smoking.ConclusionsPatterns of associations of personal, family, and environmental factors appear to differ between smoking, drinking, lifetime drug use, and the co-occurrence of these behaviors. Hypotheses regarding common factors related to health risk behaviors may be misleading in ethnic minorities and immigrants. Co-occurrence may represent a distinct behavioral domain of risk that is partly culturally determined.     

青少年发展性资产与危害健康行为的关联

通过了解重庆市青少年发展性资产与危害健康行为间的关系,为青少年健康促进提供参考.方法 采用分层随机抽样方法选择重庆市12所中学,在每所学校随机选取初一至高三各1个班的学生进行问卷调查,共获得72个班级3513名研究对象,运用SPSS 17.0统计软件对数据进行处理.结果 重庆市中学生发展性资产总分为(37.34±9.81)分,外在资产为(18.44±7.21)分,内在资产为(18.99±6.33)分,皆为中等水平;中学生发展性资产最受家庭结构的影响,其次为母亲、父亲教育水平的影响,与性别、学段及家庭经济状况无关;中学生发展性资产、外在资产、内在资产及8项资产均与各项危害健康行为呈负相关(r=-0.64~-0.14,P值均<0.05);外在资产与内在资产对整体危害健康行为及各维度均有影响(OR=-0.39~-0.19,P值均<0.05),其中内在资产的影响广度与深度高于外在资产;中学生背景因素中,家庭结构对危害健康行为的影响力最大(OR=-0.16),其次为母亲教育水平,父亲教育水平次之,与中学生性别、学段及家庭经济状况无关.结论 应强化青少年外在资产、内在资产及学习投入资产,以促进其健康成长.     

上海市金山区青少年健康危险行为现况调查分析

目的了解青少年健康危险行为的现况,为制定促进青少年健康成长的相关政策、策略提供理论依据。方法采用《中国青少年健康危险行为调查研究方案》确定的调查表对金山区4所学校359名学生进行问卷调查。统计学处理采用SPSS 17.0统计软件,率的比较采用χ2检验,P0.05为差异有统计学意义。结果在过去1个月内有步行乱穿马路行为和骑车违反交通规则行为的学生分别占61.57%和31.20%;在过去1年中有打架行为的学生占28.13%,初中生比例较高;66.57%的学生在1年中感觉到过孤独,高中生比例最高;在过去1年中有13.37%的学生有过自杀意图,有6.41%的学生有过自杀计划,有1.39%的学生尝试过自杀;在过去1年中有20.33%的学生有过出走意念,有4.74%的学生尝试过出走;有吸烟史、喝酒史的学生分别占26.46%和42.90%。结论青少年健康危险行为现状问题突出,不容忽视。中学生心理健康教育工作亟待加强,健康危险行为干预急需进行。     

江西省两地区高中生健康危险行为调查

了解江西省南昌市和婺源县高中生各类健康危险行为的流行现状,为有针对性地预防青少年危险行为的发生提供参考依据.方法 采取多阶段分层随机整群抽样的方法,抽取南昌市5所中学高一、高二年级10个班级的高中生;采用整群抽样的方法,抽取婺源县1所中学全体高一、高二学生作为研究对象,分别描述2个地区的高中生健康危险行为流行现状,并进行比较.结果 在造成高中生伤害的行为中,过去12个月中骑自行车的时候从不或很少戴头盔(婺源县56.6%,南昌58.6%)、乘坐别人开的车的时候从不或很少系安全带(婺源县48.7%,南昌39.7%)、边发信息边骑车(婺源县13.5%,南昌9.4%)和打架(婺源县10.2%,南昌10.0%)的报告率较高.婺源县高中生有35.2%曾经吸烟,51.5%曾经饮酒,4.0%发生过性行为,32.7%认为自己微胖或超重,49.1%准备减肥,南昌市高中生大部分健康危险行为报告率高于婺源县.不同性别、不同类型学校学生多数健康危险行为报告率差异有统计学意义(P值均<0.05).结论 南昌市高中生多数健康危险行为报告率高于婺源县.应采取有针对性的措施引导学生树立健康的行为习惯,以有效减少健康危险行为的发生.     

Revolving drug funds at front-line health facilities in Vientiane, Lao PDR

Pharmaceutical cost recovery programmes, which have been mainly implemented in Africa, are gradually spreading to Southeast Asian countries that formerly belonged to the socialist bloc. This report describes the economic and operational realities of revolving drug funds (RDFs) at district hospitals and health centres in the capital of the Lao PDR by reviewing research conducted by the implementing department. People in the municipality spent an average of US$11 on drugs in 1996. The RDFs comprised only 3% of the total yearly drug sales in the municipality, whereas private pharmacies accounted for 75%. The RDFs were forced to operate in conjunction with the remaining government drug endowment and the thriving private pharmacies. This scheme has provided a stable supply of essential drugs. The assurance of drug availability at the front-line health facilities has resulted in increased utilization of the facilities despite the introduction of a drug fee. The cost recovery rate was 107% at health centres and 108% at district hospitals in two monitored districts during the 10 months from November 1997. Decentralized financial management was essential for cost recovery, allowing timely adjustment of selling prices as purchase prices rapidly inflated after the Asian economic crisis. The health staff observed that the people perceived drugs as everyday commodities that they should buy and take based on self-diagnosis and personal preference. Adaptation of the public health authorities to market-oriented thinking along with the establishment of pharmaceutical cost recovery occurred with few problems. However, both financial and operational management capacity at the municipal level pose a major challenge to policy clarification and scheme setting, especially in procurement, control of prescribing practices and the integration of drug dispensing with other components of quality clinical care.     

辽宁省中学生健康危险行为调查

目的了解辽宁省中学生健康危险行为发生情况,为制定相关伤害的控制措施提供依据。方法采用《中国青少年健康相关行为调查问卷》,对省内18所初中3 960名中学生进行问卷调查。结果中学生各类健康危险行为发生率较高的依次为长时间上网（62.0%）、饮酒（50.7%）、运动不足（49.8%）、偏食（40.3%）、郁闷（26.8%）、打架（26.5%）和出走意念（25.9%）等。中学生意外伤害发生率为30.35%,与伤害相关的健康危险行为主要有打架、骑车违章等不良行为和经常感到郁闷、出走意念等不良心理因素。结论中学生健康危险行为发生率高且与意外伤害密切相关。     

Vaccination status,knowledge and awareness towards hepatitis B among students of health professions in Vientiane,Lao PDR

Health care workers (HCW) are a population at high risk of hepatitis B virus (HBV) infection, especially in endemic countries such as Lao PDR. Effective vaccines are available since over 10 years, but many HCWs are not aware of the risk of infection and are still not immunized against hepatitis B. This study aimed to assess immunization coverage against hepatitis B among the students of the University of Health Sciences (UHS) of Lao PDR in 2013 and to look for the causes of non-vaccination. A cross-sectional survey was conducted by self-administered questionnaire on a representative stratified sample of each academic year in each faculty. In total, 961 questionnaires were collected, Basic Sciences: 143, Medicine: 167, Pharmacy: 148, Dentistry: 139, Nursing Sciences: 159, Medical Technology: 99, and Postgraduate Studies: 106. Respondents were predominantly female (59.1%), mean age 25.1 ± 7.0 years, single (76.3%), from the provinces (68.0%), of the Lao Loum ethnic group (84.4%). Among them, 21% were fully vaccinated against hepatitis B and 9.5% partially. Immunization coverage rates were significantly higher among women (p = 0.01), students aged over 25 years, married or belonging to the post-graduate faculty (p < 0.001). The most common reason (38.6%) given for non-vaccination was not knowing where to get vaccinated. Knowledge about hepatitis B, scored from 0 to 5, was poor (0–1) for 86.5% of the students, but 77.5% were aware of the hepatitis B vaccine. The knowledge scores were significantly higher for students aged over 25 years, married or post-graduated (p < 0.001). Vaccination coverage against hepatitis B is dramatically low among students of health professions in Laos, largely because of their lack of knowledge and awareness. Upon admission to the University, all future HCWs should receive information about the occupational risks of blood-borne viruses transmission and be encouraged to get vaccinated against hepatitis B.     

常州市2013年青少年健康危险行为监测结果

了解常州市青少年健康危险行为流行特征,为卫生与教育部门制定相关干预措施提供依据.方法 采用“中国青少年健康危险行为调查问卷”,对多阶段分层整群抽取的17所常州市大、中学校3 645名学生进行问卷调查.结果 男生喝碳酸饮料、锻炼、玩电子游戏、吸烟、饮酒比例高于女生,女生认为体重过重、不健康减肥行为比例高于男生(P值均<0.05).高中生偏食率高(44.3%).职中、大学生玩电子游戏、现在吸烟、现在饮酒报告率较高,职中男生分别为24.7%,35.7%,45.1%,职中女生分别为14.9%,16.4%,33.7%;大学男生分别为10.5%,27.9%,61.3%,大学女生分别为6.9%,0.6%,26.2%,性别间差异均有统计学意义(P值均<0.05).结论 常州市青少年各类健康危险行为存在性别和年龄差异.在制定预防青少年危险行为措施时,要充分考虑年龄、性别和心理特点,重点干预高危人群.     

Influence of prior sexual risk experience on response to intervention targeting multiple risk behaviors among adolescents

PurposeTo identify correlates of sexual risk variations among African-American adolescents, and to examine the influence of prior sexual experience on response to a HIV risk-reduction intervention.MethodsEight hundred seventeen African-American youth aged 13 to 16 years living in and around urban public housing in Baltimore were recruited to participate in a HIV risk-reduction intervention targeting multiple risk behaviors. An instrument designed to measure three levels of sexual risk (“abstinent,” “protected sex” [having sex with a condom], and “unprotected sex” [having sex without a condom]) was administered at baseline, 6 months and 12 months postintervention. Multiple regression analyses were conducted to identify predictors of the degree of sexual risk using longitudinal data. Repeated measure analyses were conducted to assess behavioral changes over time among the three groups.ResultsData confirmed the co-variation of sexual risk behavior and other problem behaviors among adolescents, cross-sectionally and longitudinally. After exposure to an 8-session risk-reduction intervention, youth engaging in the highest degree of sexual risk demonstrated the greatest reduction in both sexual risk and other risks. These improvements were seen at both 6 months and 12 months postintervention. Youth who were abstinent at baseline maintained the lowest levels in risk involvement throughout the study period when compared with sexually active youth. However, abstinent youth risk involvement significantly increased at 6 months and 12 months after baseline. Youth engaging in protected sex at baseline demonstrated a significant increase in non-condom use and a significant decrease in multiple risk involvement over time.ConclusionsResults support HIV risk-reduction intervention efforts that target multiple risk behaviors. Response of adolescents to the intervention is directly related to the sexual risk behavior at baseline. These data may suggest that the response to risk behavior intervention depends in part on the risk behavior profile of the population to which it is being applied.     

柳州市大中学生健康危险行为变化分析

目的了解柳州市区大中学生健康危险行为变化情况,为制定干预措施提供依据。方法采用分层整群抽样方法,分别于2005年和2009年抽取柳州市区4 007名和3 720名大中学生进行问卷调查。结果 2009年比2005年发生率上升的健康危险行为包括骑车违规由31.45%上升至46.31%、在非安全区游泳由21.75%上升至30.83%、因焦虑而失眠由9.56%上升至13.31%、重度饮酒由11.88%上升至13.19%等(χ2值分别为143.65,37.99,26.54,17.84,P值均<0.01)。学生2009年现在吸烟率为13.57%,与2005年13.83%相比,差异无统计学意义。男、女生变化趋势基本一致。结论学生多数健康危险行为发生率上升,少数行为发生率下降或无变化。需进一步制定全面防治规划和相应的策略措施。     

Religious participation and risky health behaviors among adolescents

Previous studies have shown that adolescent religious participation is negatively associated with risky health behaviors such as cigarette smoking, alcohol consumption, and illicit drug use. One explanation for these findings is that religion directly reduces risky behaviors because churches provide youths with moral guidance or with strong social networks that reinforce social norms. An alternative explanation is that both religious participation and risky health behaviors are driven by some common unobserved individual trait. We use data from the National Longitudinal Study of Adolescent Health and implement an instrumental variables approach to identify the effect of religious participation on smoking, binge drinking, and marijuana use. Following Gruber (2005), we use a county-level measure of religious market density as an instrument. We find that religious market density has a strong positive association with adolescent religious participation, but not with secular measures of social capital. Upon accounting for unobserved heterogeneity, we find that religious participation continues to have a significant negative effect on illicit drug use. On the contrary, the estimated effects of attendance in instrumental variables models of binge drinking and smoking are statistically imprecise.     

Psychosocial correlates of health compromising behaviors among adolescents

The objective of the present study was to examine psychosocial correlates of diverse health-compromising behaviors among adolescents of different ages. The study population included 123,132 adolescents in sixth, ninth and 12th grades. Psychosocial correlates of substance abuse, delinquency, suicide risk, sexual activity and unhealthy weight loss behaviors were examined. Risk-taking disposition was significantly associated with nearly every behavior across age and gender groups. Other consistent correlates included sexual abuse and family connectedness. Correlates of health-compromising behaviors tended to be consistent across age groups. However, stronger associations were noted between sexual abuse and substance use for younger adolescents, and risk-taking disposition and school achievement were stronger correlates for older youth. The results suggest the presence of both common and unique etiological factors for different health-compromising behaviors among youth. The results emphasize the importance of focusing on positive 'risk-taking' experiences for youth in prevention programs; being sensitive to possible sexual abuse experiences among both female and male adolescents in health-care consultations; integrating strategies for improved family connectedness into health promotion efforts; and making school relevant for all adolescents.