Activity In Adolescents Research Articles

Association between licit drugs, physical activity and health-related quality of life in adolescents in northern Brazil

Adolescence is a period in which several transformations and identity formation occur, making adolescents vulnerable to risky situations. Therefore, this study aimed to verify the association between physical activity, health-related quality of life (HRQoL), and the use of licit drugs by high school adolescents in Tocantinopolis (Brazil). One hundred and sixty-two adolescents (aged 16.3; SD = 1.7 years old) answered a questionnaire with sociodemographic information, time of physical activity and of sedentary behaviors, and use of cigarettes and alcohol. The HRQoL was assessed through the KIDSCREEN-27. As a result, the practice of physical activity among adolescents was significantly associated only with the domains of physical well-being (β= 0.003; p < 0.001) and with the domain of the social support and peer group (β= 0.002; p < 0.012). In addition, the adolescents who reported not smoking and not consuming alcoholic beverages were four times more likely to have a better perception of quality of life in the domain of physical well-being (OR = 4.06; p < 0.001). In conclusion, physically active adolescents, who do not drink alcohol and do not smoke, had better HRQoL.

Subdermal Contraceptive Implant Insertion Trends and Retention in Adolescents.

There is growing advocacy for use of long-acting reversible contraception among sexually active adolescents. Our primary aims were to evaluate the etonogestrel subdermal contraceptive implant (SCI) insertion trends among adolescents, as well as SCI retention at 1, 2, and 3years, indications for removal, and to identify pregnancies that occurred during SCI use. DESIGN, SETTING, PARTICIPANTS, INTERVENTIONS, AND MAIN OUTCOME MEASURES: A retrospective cohort study was conducted of adolescents aged 13-19years with SCI insertions in 2008-2014 within a large integrated health care system. Demographic and clinical characteristics included age, race/ethnicity, body mass index, gravidity, parity, insertions, reinsertions, indications for removal, and pregnancy. Electronic medical record review was conducted on a randomized sample of 540 adolescents with insertions during 2008-2011 for the retention objective to validate electronically extracted variables. Analyses included descriptive statistics, survival analysis with Kaplan-Meier estimates for implant retention and Cochran-Armitage trend test for insertions according to year during 2008-2014. Most adolescent SCI users were non-Hispanic white (43%), or Hispanic (34.2%) and 16years or older (84.2%) at the time of insertion. Overall, 1-, 2-, and 3-year retention rates were 78.6%, 59.4%, and 26.2%, respectively, with retention at 44.3% at 2years 9months (indicative of removal of method for near expiration of 3-year device). The insertion rate trend showed statistically significant increases annually, from 0.14% in 2008 to 0.91% in 2014; P<.0001. No pregnancies were documented during implant use. The most common indication for SCI removal was device expiration. SCI insertions increased annually among adolescents, with more than a sixfold increase over the 6-year study period, and more than half of the SCIs were retained through 2years of use. The most common indication of SCI removal was completion of Food and Drug Administration-approved duration.

Prevalence and determinants of substance use among a sample of Iranian adolescents with ease of access to drugs: an application of Social Development Model

ABSTRACT The aim of this study was to investigate the prevalence rate and determinants of SU in adolescents based on the social development model (SDM). In 2018, applying a cross-sectional design, cluster multistage random sampling was employed to recruit 600 adolescents in Bam County, Iran, to participate in the study. A valid and reliable SDM-based instrument was used to collect data. The prevalence rate of using at least one substance was 42% (in girls 33.6% and in boys 50.3%). Adjusted for covariates, having close friends with SU was found as the factor with the highest risk. Higher scores in involvement in prosocial activities and interactions (OR: 0.47; 95% Confidence interval (CI): 0.33–0.66, p < 0.001), attachment and commitment to prosocial others (family and school) (OR: 0.73; 95% CI: 0.58–0.93, p < 0.05), and skills for interaction/involvement (OR: 0.51; 95%CI: 0.39–0.67, p < 0.001) reduced the odds of ever use of SU among adolescents. Also, higher levels of perceived rewards for antisocial interaction/involvement (OR: 2.22; 95% Confidence interval (CI): 1.53–3.22, p < 0.001) and belief in antisocial values (OR: 2.24; 95% CI: 1.67–2.94, p < 0.001) increased the odds of ever use SU among the respondents. In community-based interventions to prevent SU among adolescents, a great focus should be firstly on identifying the probability of SU in close friends. Moreover, the involvement of adolescents in prosocial activities and interactions, attachment and commitment to prosocial others (family and school), and skills for interaction/involvement should be core categories while designing community-based interventional studies.

Condom use self-efficacy centered on sexual experience, cannabis, and CBD use among college students

Objectives The goal of this study was to understand how condom use self-efficacy varies based on sexual experience, cannabis and CBD use. Methods A cross-sectional survey was implemented through Qualtrics. A total of 455 undergraduate students were surveyed at a large U.S. northeastern university. Results Findings suggested that sexual experience itself and sexual experience with cannabis and CBD are associated with a person’s condom use self-efficacy. Precisely, non-sexually active and cannabis or CBD nonusers perceived themselves as less efficacious in their future use of condoms compared with sexually active adolescents. Conclusions Implications for health interventions are discussed, such as the importance of giving attention to non-sexually active adolescents and strengthening their condom use self- efficacy. It is critical to promote healthy sexual behaviors among future sexually active college students and reinforce healthy sexual behaviors among sexually active adolescents

Optimizing Screening for Anorectal, Pharyngeal, and Urogenital Chlamydia trachomatis and Neisseria gonorrhoeae Infections in At-Risk Adolescents and Young Adults in New Orleans, Louisiana and Los Angeles, California, United States

Abstract Background Public health organizations have inconsistent recommendations for screening adolescents and young adults for Chlamydia trachomatis and Neisseria gonorrhoeae infections. Guidelines suggest different combinations of anorectal, pharyngeal, and urogenital testing based on age, sex, and sexual activity. Further evaluation of how identity and behaviors impact the anatomic distribution of C. trachomatis and N. gonorrhoeae infection is needed to optimize future screening practices. Methods We assessed the positivity of C. trachomatis and N. gonorrhoeae infections at different anatomic sites in a cohort of at-risk sexually active adolescents and young adults aged 12–24 years in New Orleans, Louisiana and Los Angeles, California. Participants were tested for C. trachomatis and N. gonorrhoeae at 3 sites (anorectum, pharynx, and urethral/cervix) every 4 months using self-collected swabs. We stratified anatomic distributions of infection into 4 gender and sexual behavior categories: (1) cisgender men who have sex with men and transgender women (MSMTW); (2) cisgender heterosexual males; (3) cisgender heterosexual females; and (4) gender minorities assigned female at birth. Results While three-site testing detected all infections, two-site (anorectum and urethra/cervix) testing identified 92%–100% of C. trachomatis or N. gonorrhoeae infections in participants assigned female at birth and cisgender heterosexual males. For MSMTW, two-site anorectal and pharyngeal testing vs single-site anorectal testing increased the proportion of individuals with either infection from 74% to 93%. Conclusions Sexual behavior and gender identity may influence detection of C. trachomatis and N. gonorrhoeae infections at specific anatomic testing sites. Testing guidelines should incorporate sexual behavior and gender identity. Clinical Trials Registration NCT03134833.

Kulturowe uwarunkowania i społeczne konsekwencje funkcjonowania szkół tauromachicznych w Hiszpanii

Corrida de toros is a centuries-old Spanish tradition. For many years we have observed a significant increase in the number of activities criticizing the organization of such shows. Therefore, bullfights can be described as a difficult tradition. The article touches upon the issue of tauromachical schools in the context of research on difficult traditions and cultural conditions of their practice. In addition, the social consequences of bullgfight and the activities of schools for those who want to become toreros were analysed. Tauromachical schools operate in almost all regions of Spain, although most of them are in Andalusia and Castile-La Mancha. The programme of teaching in these schools must be compatible with the programmes of public (or private) schools carrying out their educational duties. Children and adolescents can enroll in such school with their parents’ consent. The participation of children and adolescents in practical activities is very controversial: fighting young bulls or heifers, injuring them and killing them. Research conducted on children experiencing the view of the corrida de toros does not bring a clear assessment that it has a negative impact on their mental health. However, opponents of tauromachy in the discourse of corrida de toros are citing this type of argumentation.

Sexual and reproductive health in HIV-positive adolescents

Objectives: Adolescents grow to experience both emotional and sexual changes that occur at this stage in life. During this stage, these adolescents have increased experimentation, including sexuality, this also affects HIV-positive adolescents. The aim of this study was to evaluate the sexual and reproductive health of HIV-positive adolescents. Material and Methods: A semi-structured interviewer-administered questionnaire was used to obtain relevant information from adolescents who were enrolled into the study over a 6 months period. Information obtained included the bio-data, menstruation, sexual activity, HIV status of partner, use of contraceptives, abortion, and treatment of sexually transmitted infections (STIs). Data were analyzed using SPSS version 23. Results: One hundred and forty-seven HIV-positive adolescents were recruited into the study, males were 56 (38.1%), while females were 91 (61.9%). Fifty-nine (64.8%) of the females have started menstruating, out of which nine (6.1%) of them were sexually active. All those that were sexually active did not know the HIV status of their partners. Four (44.4%) of those who were sexually active use contraceptives, while three became pregnant out of wedlock and one had an abortion. Three (33.3%) of the sexually active adolescents had sexually transmitted infection. None of the 46 early adolescents was sexually active, but three out of the 71 middle adolescents and 6 out of the 30 late adolescents were sexually active. Conclusion: HIV-positive adolescents engage in sexual activities which are sometimes risky, just like other adolescents. The consequences of such acts include unplanned pregnancies and abortions in addition to sexually transmitted infections. Therefore, additional programs/interventions should be put in place to address these observations as well as prepare them as they transit to adulthood.

Cell phone use is associated with alcohol and tobacco consumption in insufficiently active adolescents.

The aim of this study was to estimate the prevalence of alcohol and tobacco experimentation by adolescents and to verify the association between cell phone use with alcohol and tobacco consumption in adolescents with different physical activity levels. This work is a cross-sectional study with a representative sample of 772 adolescents (52.6% girls; age: 16.63±0.70 years old). Self-reported questionnaires were assessed to verify the cell phone use, physical activity level, alcohol and tobacco consumption. Logistic regressions tested the associations obtaining odds ratios with 95% confidence intervals. Alcohol and tobacco consumption prevalence reached 43.4% and 7.8% of adolescents, respectively. Insufficiently active adolescents who reported using cell phones more than and 2 hours a day were more likely to use alcohol (OR: 1.58; 95% CI: 1.14 - 2.19) and tobacco (OR: 2.46; 95% CI: 1.23 - 4.96). We found a high prevalence of cell phone use and a worrying prevalence of alcohol and tobacco consumption by adolescents. The use of the cell phone for more than two hours a day seemed to be a risk factor for alcohol and tobacco consumption in insufficiently active adolescents.

Adolescence and endometriosis: symptoms, ultrasound signs and early diagnosis

To evaluate the ultrasonographic presence of different forms of endometriosis and the associated clinical symptoms in adolescent women. Retrospective observational study. University hospital. Two hundred and seventy women aged 12-20 years referred to the gynecologic ultrasound unit from January 2014 to June2019. Two-dimensional, three-dimensional, and power Doppler ultrasound (US) pelvic examination (transvaginal or transrectal in pre-sexually active adolescents) were performed in all included adolescents. Medical history was collected for each patient before the scan. All possible locations of endometriosis evaluated and recorded using a dedicated ultrasound mapping sheet and severity of painful symptoms evaluated through a visual analogue scale (VAS). Dysmenorrhea was detected in 147 (54.4%) of 270 patients and heavy menstrual bleeding in 76 (28.1%) of 270. At least one ultrasound feature of endometriosis was identified in 36 (13.3%) of 270 cases. Ovarian endometriomas were found in 22 (11%) patients, adenomyosis in 16 (5.2%), and deep infiltrating endometriosis (DIE) in 10 (3.7%). Ultrasound signs of endometriosis were found in 21% of adolescents who reported dysmenorrhea and 33% with dyspareunia. The presence of DIE at ultrasound was associated with bowel symptoms in 33% of patients and associated with dyspareunia in 25% of patients. The detection rate of pelvic endometriotic lesions at ultrasound was 13%. The rates of dysmenorrhea, dyspareunia and heavy menstrual bleeding in adolescents with endometriosis ultrasound signs were statistically significantly higher compared with those without. In patients with dysmenorrhea, the detection rate of pelvic endometriosis at ultrasound increased to 20%. Professionals involved with teens should be aware of the clinical presentation of endometriosis to reduce the delay between the onset of symptoms and the diagnosis, referring these young women to dedicated centers.

Longitudinal Association between Sport Participation and Depressive Symptoms after a Two-Year Follow-Up in Mid-Adolescence.

Sport participation has been advocated as a strategy to improve adolescents’ mental health. However, how these variables evolve during the adolescent years is uncertain. The objective of the present work was to examine the longitudinal associations of sports participation and depressive symptoms in adolescents. Participants were 525 Spanish adolescents (50.3% boys), aged between 12 and 15 years old (M = 13.45, SD = 0.69). They were enrolled in 18 secondary schools located in Andalusia (Spain) in the first two academic years of Compulsory Secondary Education. Data were collected in three waves, separated by one year, by administering self-report measures of depressive symptoms and sport participation. Repeated measures analyses of variance were conducted to examine the change in depressive symptoms and sport participation, and a latent growth curve model was tested to examine the change in depressive symptoms controlling initial sport participation and gender. At each wave, more frequent sport participation was related to lower depressive symptoms. Two years after the first assessment, adolescents became more depressed but not more active. Less active adolescents had more depressive symptoms in each assessment time. At all moments of assessment, girls were less active and reported more depressive symptoms. Moreover, girls had a higher increase in depressive symptoms than boys. Promotion of physical activity (PA) as a mental health strategy needs to consider gender differences as boys and girls have different patterns of presentation of depressive symptoms throughout adolescence.

A rare case of Buschke-Löwenstein tumor in HPVnegative patient.

Buschke–Löwenstein tumor is known to manifest not only in sexually active people and adolescents exposed to violence or drugs, but also in people who do not have any predisposing factors or bad habits. Several studies have shown that in the majority of children with anogenital warts, HPV can be transmitted asexually by hetero- inoculation or through infected objects. To our knowledge, there are currently few reports on BLT in HPV-negative patients in the literature. In our case, the patient presented early, with multiple slow growing warts, no history of alcohol intake, drug use or smoking and no HPV infection, which makes this case unique and important.

Associated factors and sex differences in condom non-use among adolescents: Brazilian National School Health Survey (PeNSE)

BackgroundCondom non-use among sexually active adolescents is a major cause of unintended pregnancy and sexually transmitted infections. In order to promote condom use, it is essential to understand factors associated with condom non-use.AimOur aim was to evaluate sex differences and associated factors of condom non-use based on the nationally representative Brazilian National School Health Survey.MethodsThe study participants were 100,962 adolescents 13–18 years old, 9th graders from both public and private schools throughout Brazil. The following factors were considered as explanatory group variables for the outcome of condom non-use among adolescents: school and health service, sexual behavior, substance use, and self-reported body and health perception. Poisson regression model was performed.ResultsOf the total students, 28% (n = 28,157) had had sexual intercourse at least once. (boys, 37.1%; girls, 19.5%). Of these, 69.2% had used condoms the last time they had intercourse (girls: 68%; boys: 69.9%). The variables associated with condom non-use for both sexes were not having accessed a health service or approached a health professional for health-related care; not having received pregnancy prevention counseling or guidance on AIDS or STI prevention at school; early sexual initiation; no additional contraception method; substance use; feeling alone; not being satisfied with their own body; feeling fat or thin; and poor self-reported health. The number of sexual partners was also associated with condom non-use; however, contrasting behavior was indicated between sexes. A higher number of sexual partners indicated less use of condoms among girls, while for boys, a higher number of sexual partners indicated higher condom use.ConclusionHigh condom non-use appears to be associated with lack of health care access and sexual health education, poor sexual practices, substance use, and poor self-perception, indicating areas for health promotion programs.

Adolescent physical activity-related injuries in school physical education and leisure-time sports.

ObjectiveThe aims of this study were to investigate the prevalence of sports injuries in school physical education (PE) and leisure-time sports among 1011 15- to 16-year-old adolescents in relation to physical activity, and to examine goal orientation.MethodsA survey was used with additional narrative descriptions.ResultsThere was a higher prevalence of injuries in leisure time (645/993 = 65%) than in PE (519/998 = 52%). Two groups with high PE injury rates were identified: a) highly active (258/998 = 26%) in both school PE and leisure-time sports and b) highly inactive (180/998 = 18%) in both contexts. There were no differences between girls and boys. Task-oriented adolescents were more prone to injury.ConclusionsThe high prevalence of injuries in PE appears to have two mechanisms: renewed inadequately recovered leisure-time injuries among highly active adolescents, and injuries among fragile inactive adolescents unfamiliar with exercise. PE educators of these two groups with different injury patterns have a considerable didactic challenge. Knowledge of inadequately recovered injuries and consideration of the high volume and intensity of early sport-specific training in children and adolescents are important parameters in the design of lesson plans for PE.

Contexts and persistence of age of consent for accessing family planning services in Lagos, Nigeria: A qualitative study.

Nigeria has one of the lowest adolescents family planning uptake in sub-Saharan Africa. Previous studies show that a high age of consent is a significant predictor. Little evidence exists about the contexts and persistence of the high age of consent for accessing family planning in Nigeria. Hence, this study used a qualitative methodology to explore the contexts, persistence and implications of high age of consent for accessing family planning in Lagos State. Forty-four in-depth interviews and 31 key-informant interviews were conducted in two Local Government Areas. NVIVO 12 plus was used to analyse data. The results suggest that contexts consisted of health and moral concerns, religious opposition and negative attitudes, which were underlying the persistence of high age of consent for accessing family planning. The contexts formed the basis for the exclusion of adolescents from family planning services. Consequently, sexually active adolescents adopted local herbs, a combination of different medicines, concoctions and local alcoholic drink (ogogoro) to prevent or abort pregnancies. Therefore, community-based NGOs should engage communities to promote perception change about adolescents accessing family planning and motivate the communities to begin to demand of their representatives in government a policy to lower age of consent for accessing family planning.

Study of socio-medical aspects of reproductive health of adolescents

The WHO strategy «Health for All in the 21st Century» recommends giving priority to the medical and social needs of the younger generation with the development and implementation of comprehensive measures in terms of identifying risk factors and focusing on disease prevention.The objective: to assess the awareness of adolescent girls on a healthy lifestyle and the risks of reproductive health disorders.Materials and methods. Anonymous survey of 1569 girls aged 14–20 was carried out.Results. The low level of use of methods with proven effectiveness for preventing unwanted pregnancies indicates significant gaps in educational work with young people and, accordingly, a lack of knowledge on healthy lifestyles and family planning. Analysis of the questionnaires showed that at the age of 15–16 years 23,1% of girls used methods with proven effectiveness, with increasing age their share increased to 30,2% at 17–18 years old and up to 50,9% at 19–20 years old. The survey data obtained by us indicate that the level of awareness of adolescents and young people about modern methods of preventing pregnancy in Ukraine is unsatisfactory, this creates a risk of teenage pregnancy and negative medical and social consequences associated with it. At the same time, literature data indicate that about 72% of 15–17-year-old sexually active adolescents and 84% of 18–19-year-old adolescents living in developed countries use contraception; every year the level of its use is growing, since a significant stratum of the population of these countries considers contraception as the most important integral part of a healthy lifestyle.Conclusion. The use of an integrated approach using a questionnaire survey of adolescent girls makes it possible to identify risk factors for reproductive health disorders, to investigate the mechanisms of formation of adolescents’ knowledge on healthy lifestyles, the dangers of early sexual relations, the use of STI and pregnancy prevention tools, and contributes to the development of educational and information programs.

Blunted cardiac output response to exercise in adolescents born preterm.

Premature birth is associated with lasting effects, including lower exercise capacity and pulmonary function, and is acknowledged as a risk factor for cardiovascular disease. The aim was to evaluate factors affecting exercise capacity in adolescents born preterm, including the cardiovascular and pulmonary responses to exercise, activity level and strength. 21 preterm-born and 20 term-born adolescents (age 12-14years) underwent strength and maximal exercise testing with thoracic bioimpedance monitoring. Baseline variables were compared between groups and ANCOVA was used to compare heart rate, cardiac output (Q) and stroke volume (SV) during exercise between groups while adjusting for body surface area. Preterm-borns had lower maximal aerobic capacity than term-borns (2.0 ± 0.5 vs. 2.5 ± 0.5 L/min, p = 0.01) and lower maximal power (124 ± 26 vs. 153 ± 33 watts, p < 0.01), despite similar physical activity scores. Pulmonary function and muscular strength did not differ significantly. Although baseline Q and SV did not differ between groups, preterm adolescents had significantly lower cardiac index (Qi) at 50, 75 and 100% of maximal time to exhaustion, driven by SV volume index (SVi, 50% max time: 53.0 ± 9.0 vs. 61.6 ± 11.4; 75%: 51.7 ± 8.4 vs. 64.3 ± 11.1; 100%: 51.2 ± 9.3 vs. 64.3 ± 11.5ml/m2, all p < 0.01), with similar heart rates. Otherwise healthy and physically active adolescents born very preterm exhibit lower exercise capacity than term-born adolescents. Despite similar baseline cardiovascular values, preterm-born adolescents demonstrate significantly reduced Qi and SVi during incremental and maximal exercise.

Engaging children and adolescents with acquired brain injury and their families in goal setting: The clinician perspective

ABSTRACT This paper explored clinicians’ experiences of the goal setting process with children and adolescents with acquired brain injuries (ABI) and their families in paediatric neurorehabilitation. Semi-structured interviews were conducted with 13 clinicians, all members of an interdisciplinary paediatric rehabilitation service, who work with children and adolescents with ABI and their families. Interview transcripts and additional data were analysed using constructivist grounded theory methods. Three main themes and sub-themes were developed: (1) Seeing the bigger picture: Goals change over time; Families set bigger picture goals; Need-to-dos: Goals that the child/adolescent needs to achieve; and Want-to-dos: Goals that the child/adolescent wants to achieve; (2) Collaborating as a team: Everyone needs to be on the same page; Hearing the child's/adolescent's voice; and Parents as advocates; and (3) Recognizing and navigating challenges: Child-/adolescent- and family-related challenges and Time as a service-related challenge. Participants perceived the clinician's role during goal setting as that of an active collaborator, enabling children and adolescents with ABI and their families to generate meaningful goals. These findings demonstrate insights into goal setting in paediatric ABI neurorehabilitation from clinicians’ perspectives, and highlight the importance of collaboration, flexibility and anticipation of challenges in facilitating children's, adolescents’ and families’ involvement in this process.

Baseline prevalence and type distribution of Human papillomavirus in sexually active non-vaccinated adolescent girls from Argentina

In 2011, Argentina launched a government-funded national Human papillomavirus (HPV) immunization program incorporating a bivalent HPV vaccine, with a 0–1–6-month schedule, for girls 11 years of age, born after January 2000. Monitoring the changes of HPV infection prevalence among young women has been proposed as an endpoint for early assessment of HPV vaccination programs. However, the data on HPV prevalence at young ages are very limited. The aim of this work was to determine the prevalence of HPV infection and type-specific distribution in sexually active 15–17-year-old non-vaccinated girls. Cervical samples from 1073 adolescents were collected for HPV detection and genotyping using the BSGP5+/GP6+PCR-reverse line blot (RLB) assay. Out of 957 specimens analyzed, 56.3% were positive for any HPV type; 42.2% harbored at least one high-risk HPV (HR-HPV) type and 30.8% low-risk HPV (LR-HPV) types. Multiple and single infections were identified in 36.3% and 20.0% of the samples respectively. The 6 most common HR-HPV types were HPV16 (11.1%), HPV52 (10.8%), HPV56 (8.3%), HPV51 (7.4%), HPV58 (7.3%) and HPV31 (7.1%). The prevalence of HR-HPV-16/18 was 15.2%. In conclusion, results confirm that HPV (particularly HR-types) are very common among sexually active adolescents, and prevalence rises quickly after their sexual debut. Our HPV type-specific prevalence baseline may be used to monitor post-vaccinal longitudinal changes in Argentina.

Trajectories of Physical Activity Among Adolescents in the Transition From Primary to Secondary School.

Research on physical activity (PA) behavior reveals an overall decrease worldwide from early childhood and throughout adulthood. The ability to illuminate which factors promote activity for whom and in which phase of life, therefore, becomes a key concept in extending our understanding of individuals' physical activity trajectories. Accordingly, this study investigates latent trajectories of objectively measured PA in adolescents (n = 306) over 3 years from ages 13 to 15. Further, it was tested whether eagerness for physical activity, perceived athletic competence, and parental support were associated with the different trajectories of PA. Latent class growth analysis revealed two PA trajectories (trajectory 1: “decrease from very high” and trajectory 2: “steeper decrease from high”). Trajectory 1 had a higher PA level at baseline and less PA decline than trajectory 2. Trajectory 1, “decrease from very high,” was associated with higher levels of eagerness for physical activity and perception of competence at all three time points. Furthermore, the effect size of differences between trajectory 1, “decrease from very high,” and trajectory 2, “steeper decrease from high,” increased from baseline (age 13, seventh grade) to posttest (age 15, ninth grade). This finding indicates a stronger experience of PA as enjoyable, personally relevant, and self-confirming behavior (i.e., “I regard myself as a person who exercises”) within the most active adolescents and even stronger as they get older. Consistent with previous research, the PA level declined from seventh to ninth grade. Being more eager for PA and perceiving oneself more as athletically competent is related to higher levels of PA. This highlights the importance of optimizing environmental factors that increase adolescents' experience of eagerness for physical activity and physical athletic competence.

Factors influencing sexual and reproductive health among adolescents in Lao PDR

ABSTRACT Background Adolescents are particularly vulnerable to poor sexual and reproductive health outcomes. In addition, Lao PDR has the highest teenage pregnancy rate in southeast Asia and a high maternal mortality ratio. Objective This study aimed to provide a comprehensive exploration of factors that influence SRH knowledge, attitudes, and practices of adolescents in Bokeo Province, Lao PDR. Method Data from the Adolescent Girl Situation Analysis cross-sectional study, collected in 2018 using a mixed-method approach with 837 adolescents aged 10–19, and key informant interviews, were analysed. Regression analyses were used to identify predictors of modern contraception knowledge, autonomy, gender-based violence, sexual activity, and contraception use. This was complemented with qualitative thematic content analysis. Results Adolescents living in two rural districts had lower sexual and reproductive health knowledge compared to urban district residents. Findings showed misconceptions about the birth control pill, a belief that sex education is important, but that the current teaching quality is problematic. There was a strong positive association between knowledge and autonomy. In the two rural districts, residents were more likely to lack autonomy. Marriage was described as an autonomous decision, yet 40.4% lacked autonomy regarding marriage. Among sexually active adolescents, 35.2% used contraception. Boys and girls were said to be equal, yet education access and gender roles favoured boys. Additionally, violence was more justified by husbands against their wives. Conclusion The study helps to understand the views and perceptions of adolescents and key informants on gender equality and gender-based violence. Three main areas require more effort and greater investment to improve adolescent sexual and reproductive health: knowledge and use of contraceptives, gender inequality, and autonomy. There is poor knowledge of contraceptive methods, indicating a need to further integrate comprehensive sexual education, introduced in primary school, and to increase investment in training and monitoring teachers.