Adolescents In Rural Areas Research Articles

Factors Affecting The Choices of Healthy Diet among Adolescents in Rural Areas

Many adolescents tend to pick unhealthy diets with high amount of sugar, salt and fat, while the number of adolescents who consume vegetables and fruit is relatively low. As adolescents begin to pick their own diets by themselves, there are certain reasons behind each of their preferences in foods. This study was aimed to analyze the factors affecting the choices of healthy diet among adolescents in rural areas. This was quantitative research with analytical and observational research method with a cross sectional design. The data sampling method used in this study was a multistage random sampling method. This research was conducted to 160 respondents with a population of 1,143 from 10 different high schools. The sample size was calculated using the OpenEpi software. The data on factors or reasons behind the choice of healthy diet was taken using the Food Choice Questionnaire (FCQ), while the data on the choices of healthy foods was taken using a structured questionnaire, both of which had been tested for validity and reliability. The collected data were analyzed using the Spearman Rank test. The main reasons that can influence adolescents to pick healthy diets in rural area were for healthiness concerns, the natural contents of the foods, and body weight control (BW) (p=<0.005). It is recommended for adolescents to optimize their knowledge and skills in food selection, especially healthy food.

Urban-Rural Differences in Children's and Adolescent's Physical Activity and Screen-Time Trends Across 15 Years.

Urban and rural areas have been experiencing major demographic and structural changes, characterized by an aging population in rural areas and a growth of cities in number and size. However, it is poorly researched how children's physical activity and screen time developed in urban and rural areas. To address this deficit, we investigated physical activity and screen-time trends in Germany's pediatric population across four urbanicity levels (rural, small town, medium-sized town, city). We obtained weighted data at three cross-sectional timepoints between 2003 and 2017, representative for Germany's child and adolescent population. Physical activity and screen time were self-reported. We analyzed trends using a structural equation modeling framework for the overall sample and calculated interactions between the trends and age and gender, respectively. In total, 12,161 children and adolescents between 4 and 17 years participated in the study. Children and adolescents in rural areas experienced a downward trend in total physical activity. Outdoor play and leisure-time physical activity decreased across all areas, with the strongest decline in rural areas. Computer and gaming time increased across all areas except for cities, with the sharpest increase in rural areas. The decline in outdoor play and the incline in computer and gaming time were driven by adolescents. Females showed stronger increases in computer and gaming time than males. Our findings suggest that in a representative sample of children and adolescents in Germany, detrimental trends in children's physical activity and screen time occur at a higher rate in rural areas compared with urban environments. This provides critical information for health policy: While all children and adolescents should be targeted for physical activity promotion, a special focus should be on tailoring interventions for rural areas to prevent and mitigate inequalities in physical activity across urban and rural areas.

Prevalence of Anemia Among Children and Adolescents in Rural Area of Khulais in Saudi Arabia.

IntroductionThe decreased absolute circulating red blood cell count or the inability of red blood cells to meet physiological needs is called anemia. Anemia can affect mental health, learning capacity, and the ability to concentrate. The present study aimed to assess the prevalence of anemia among children and adolescents living in the rural areas of Khulais, Saudi Arabia.MethodsThis cross-sectional study including 417 individuals was conducted at Khulais Hospital in the rural areas in Saudi Arabia to estimate the prevalence of anemia among children and adolescents. The inclusion criterion for the study was that participants must be Saudi citizens. Data for this study were collected in March 2021. The age of the children ranged from 7 to 11 years, whereas that of adolescent males and females was between 12 and 18 years.ResultsIn total, the study included 147 male adolescents, 123 female adolescents, and 147 children participants. The overall prevalence of anemia among adolescents was high (39.1%). The prevalence of anemia was 44.9% (66/147), 46.3% (57/123), and 27.2% (40/147) in male adolescents (age 12-18 years), female adolescents (age 12-18 years), and children (age 7-11 years), respectively. Statistical analysis revealed an association between the prevalence of anemia and the increasing age of participants from rural areas.ConclusionThe present study results indicate that the prevalence of anemia in the rural areas of Saudi Arabia is high. The high prevalence can be explained by several factors, such as parents’ low socioeconomic status and living in rural areas, which limits the availability as well as different types of nutritious food and thereby negatively affects the nutritional status of such children and adolescents.

Noise Exposure and Use of Hearing Protection Among Adolescents in Rural Areas.

Noise-induced hearing loss (NIHL) has been found in rural children, potentially due to occupational and recreational noise exposure without consistent use of hearing protection devices (HPDs). However, questions remain regarding the specifics of rural adolescents' noise exposure and use of hearing protection around different types of noise. As such, the purpose of the current study was to provide preliminary results on rural adolescents' noise exposure and use of hearing protection for gunfire, heavy machinery, power tools, all-terrain vehicles (ATVs), and music. A questionnaire was administered to 197 students (seventh to 12th grade) from rural schools in West Texas. Questions were related to noise exposure and use of HPDs for specific categories of noise. Testing was performed at the schools, with an investigator recording each student's responses. Approximately 18%-44% of adolescents reported exposure 12 or more times a year to gunfire, heavy machinery, power tools, and ATVs. Only 1%-18% of the adolescents reported never being exposed to such noise sources. Almost half of rural adolescents never used hearing protection around gunfire, and 77%-91% reported never wearing hearing protection when exposed to heavy machinery, power tools, and ATVs. The current study revealed that rural adolescents are exposed to noise sources that could damage their hearing. However, the majority of rural adolescents do not consistently wear hearing protection. Additional research is now needed to extend these findings by assessing rural adolescents' duration of exposure to different noise sources, in addition to investigating prevention of NIHL in this population. Supplemental Material https://doi.org/10.23641/asha.17139335.

Does Living with Grandparents Affect Children's and Adolescents' Health? Evidence from China.

The level of nutritional health of children and adolescents is an important indicator of social development, and grandparents, as common co-caregivers, may have a considerable impact on the health level of their grandchildren. In this paper, we investigated the effects of grandparents’ coresidence on children’s and adolescents’ nutritional health levels using the CHNS (China Health and Nutrition Survey) database using the PSM (Propensity Score Matching) method’ and identified heterogeneity in the effects of grandparents’ coresidence by PSM grouping in terms of urban and rural areas, age, and the mothers’ education level. It was found that grandparents’ coresidence is beneficial for children’s and adolescents’ health to a certain extent. Overfeeding and spoil that many people worried when grandparents involved in childcare did not happen in our samples. Moreover, grandparents’ coresidence had a more significant effect on the health level of children and adolescents in rural areas at a younger age and with a lower level of maternal education. Government and families should put more effort into equipping caregivers with knowledge on how to raise their grandchildren better.

Dietary intake in indigenous adolescents in rural Buryatia, Russia

Background. The diet of adolescents is an important factor in their future health. The diet is formed under the influence of biological, personal, family, socio-economic, environmental, and cultural factors.The aim: to study the diet of adolescents in rural areas of Buryatia and compare the dietary intake of the Russian and Buryat ethnic groups.Materials and methods.The study included 92 rural adolescents 11–17 years old (44 boys, 48 girls); 49 of them were Buryats, 43 – Russians. Dietary intake was assessed by the food record method. The intake of energy, macronutrients (proteins, fats and carbohydrates) and micronutrients (major groups of vitamins and trace elements) of the diet was determined. The values obtained were compared with references to daily energy and nutrient intake, and between groups of adolescents of different ethnicity.Results.The diets of rural adolescents were not balanced. Only 7.6 % of adolescents include fish in their diet. Milk and dairy products are consumed by 38 % of the respondents. Daily energy intake was significantly lower the recommended guidelines. The diet is characterized by a deficiency of vitamins of groups A, C, and D, group B (with the exception of cobalamin), niacin, biotin, essential trace elements (calcium, phosphorus, iodine), high sodium intake. A significant deficiency of dietary fiber has been noted. The Buryats showed a shift in the ratio of proteins, fats and carbohydrates in the diet towards carbohydrates (1 : 1.2 : 5.3).Conclusion.The results indicate significant disturbances in the composition of the diet in rural adolescents in Buryatia, more pronounced in the Asian subgroup. This can be a rationale for the development of targeted nutrition monitoring programs aimed at preserving the health of the youth.

Effects of an Internet-Based and Teacher-Facilitated Sexuality Education Package: A Cluster-Randomized Trial.

Background: This study aimed to evaluate the effects of an internet-based and teacher-facilitated sexuality education package on the sexual knowledge and attitudes of Chinese adolescents. Methods: Six middle schools where no sexuality education had been performed with a total of 501 adolescent students (245 males and 256 females) were included in the trial. In total, 14 classes were randomly assigned to the intervention (internet-based sexuality education package) or the control group (classes were conducted as per normal). Students’ sexual knowledge and attitudes were assessed at the baseline, at the end of the intervention, and 12 months after the intervention. Generalized linear models were employed to assess the effects of the intervention. Results: Positive effects of the intervention were observed on sexual knowledge (β = 4.65, 95% CI: 4.12—5.17) and attitudes (β = 1.25, 95% CI: 1.00—1.50) at the end of the intervention. After 12 months, the effects sustained but the magnitude declined for sexual knowledge (β = 2.39, 95% CI: 1.85—2.93) and attitudes (β = 0.49, 95% CI: 0.23—0.75). There were no significant differences between male and female students. Conclusions: Although further modifications are required, the sexuality education package can increase the accessibility of comprehensive sexuality education to adolescents in rural areas in China.

Female adolescents and the use of contraceptives in rural areas

Contraception is an effort used to prevent pregnancy in women of childbearing age. Presently, contraception is not only used for adult women or those who have had a partner, but also for female adolescents. This study aimed to understand the practice of using contraceptives among female adolescents in rural areas. The theory used as an analytical tool was the theory of social construction by Peter L Berger and Thomas Luckmann. This study used a qualitative method. The research subjects in this study were women who used contraceptives as an adolescent. This study showed that the use of contraceptives or family planning by female adolescents in the Kabuh District is a common practice. Female adolescents interpreted family planning practices as prevention of pregnancy. The most commonly used contraceptives are the contraceptive injection and the birth control pill. Adolescents obtained preference for contraceptives from their parents and family. Meanwhile, family planning services were only provided through a midwife using the One-Stop Service method. Cultural values and customs that are deeply rooted in the Manduro community make the practice of pre-marital family planning perpetuated, even though it contradicts information in general and religion. This study concluded that the practice of pre-marital family planning is believed to be the best solution for female adolescents who are engaged but still want to seek new experiences.

Prolonged parent-child separation and pain in adolescence: The role of HPA-axis genetic variations

BackgroundIncreasing evidence has demonstrated that childhood adversity was a predictor of pain and hypothalamic-pituitary-adrenal (HPA) axis genetic variation is associated with pain risk. This study aims to explore possible effects of prolonged childhood separation from parents and HPA polygenic risk score (PRS) on pain among adolescents in rural China. MethodWe used data from 219 adolescents in rural area of Fuyang city, Anhui province, China. Parent-child separation was collected through interview and pain intensity was reported using the 11-point Numerical Rating Scale. SNP genotyping was performed using an improved multiplex ligation detection reaction (iMLDR) technique. The PRS was computed based on 3 single nucleotide polymorphisms (SNPs) in 2 genes (FKBP5 and NR3C1) related to HPA-axis stress reactivity. ResultsPain among adolescents separated from both parents scored higher compared to those without parent-child separation, however, this association was only observed in adolescents with moderate to high tertiles of PRS groups (parent-child separation in moderate group vs. no parent-child separation in moderate group: 3.07 vs. 1.57, P < 0.001; parent-child separation in highest group vs. no parent-child separation in highest group: 3.02 vs. 1.26, P < 0.001; parent-child separation in lowest group vs. no parent-child separation in lowest group: 2.34 vs. 1.25, P = 0.225). After controlled for demographic characteristics, psychopathological symptoms, adverse childhood experiences, parental warmth, prolonged childhood parent-child separation increased pain scores by 1.52 points (95% CI:0.72, 2.33) and 1.72 points (95% CI:1.13, 2.31) in moderate and high PRS groups, respectively. ConclusionOur findings suggest that adolescents separated from both parents while carrying more risk alleles related to HPA-axis stress reactivity are at heightened risk of pain.

Substance use and subjective health in Chinese Left-behind adolescents in rural areas: The moderating role of cognitive reappraisal

Background/ObjectiveThis study investigated the relationship between substance use (i.e., smoking, drinking, and using illicit drugs), subjective health, and cognitive reappraisal in Chinese left-behind adolescents in rural areas. MethodsA total of 1,375 Chinese adolescents aged 15–19 years with left-behind experience in rural areas participated in this study. Substance use, substance use risk profile, subjective health complaints, and cognitive reappraisal were assessed. ResultsSubstance use was negatively correlated with subjective health, and cognitive reappraisal was positively correlated with both substance use and subjective health. The regression analysis showed that substance use (negative) and cognitive reappraisal (positive) significantly predicted subjective health. The interaction between drinking frequency and cognitive reappraisal was also a significant predictor of subjective health. Furthermore, the simple slope analysis showed that for the group with low cognitive reappraisal, drinking frequency was negatively associated with subjective health, whereas there was no significant effect of drinking frequency on subjective health in the group with high cognitive reappraisal. These results indicated that cognitive reappraisal was a significant moderator in the relationship between drinking frequency and subjective health. ConclusionsOur results suggest that while substance use has an adverse effect on subjective health, cognitive reappraisal can reduce this adverse effect.

Evaluating Intersectionality of Policies and Populations

* Abbreviations: e-cigarette — : electronic cigarette T21 — : tobacco 21 Although policies and populations do not occur in isolation, researchers often investigate them as if they do. When variables are one-dimensional (ex, race-ethnicity, rural-urban), statistical models produce outputs that do not represent the real world. Uncovering and addressing health disparities necessitates an approach that captures the complexity of population health.1 Intersectionality embraces the overlap of identities, social positions, and social policies.2 We used this approach when evaluating tobacco control policies related to prenatal smoking and found a significant interaction between women’s race and ethnicity, education, and cigarette taxes. Low-educated white and Black women had the highest prevalence of smoking during pregnancy and were the most responsive to taxes, which in turn, improved birth outcomes.3 Examining the effects by women’s race and ethnicity or, separately, education would not have produced the same conclusions. An underresearched disparity in tobacco control is geographic differences within state boundaries. Adolescents in rural areas have higher levels of tobacco use4–6 and are covered by less comprehensive tobacco control policies.5–7 In this issue of Pediatrics , Dai et al8 examine rural-urban differences in the effect … Address correspondence to Summer Sherburne Hawkins, PhD, MS, McGuinn Hall, School of Social Work, Boston College, 140 Commonwealth Ave, Chestnut Hill, MA 02467. E-mail: summer.hawkins{at}bc.edu

Does physical activity and body weight status determine musculoskeletal health among adolescents in Malaysia?

This study was conducted to examine the association between physical activity (PA) and body weight status among adolescents in rural and urban areas. This cross-sectional study involved 257 adolescents aged 13-19 years, randomly selected from secondary schools around Kelantan, Malaysia. Body weight and height were measured and body mass index (BMI) was calculated. The students completed the International Physical Activity Questionnaire - Short Form, to assess their physical activity. Ethical clearance was obtained from respected bodies. Adolescents in the urban area had significantly higher BMI (p-value<0.001) and lower physical activity (p-value<0.001) than adolescents in the rural area. A significant association also found between BMI and PA in both urban and rural areas. In conclusion, more physically active adolescents had lower BMI than who are less physically active. Being physically active could lower the body weight and BMI, hence improve musculoskeletal health, and could reduce co-morbidity.

Social Media Addiction and the Association with Self-Esteem among Adolescents in Rural Areas of Indonesia

The use of social media has increased significantly in recent years, particularly among adolescents and this has triggered an upsurge in research into the connection between social media and self-esteem. However, there has been little attention paid to the association between social media and self-esteem in adolescents in rural areas, an oversight this study will address – focusing on adolescents in rural areas of Indonesia. This descriptive correlational study was conducted in 2018 at two senior high school in rural area of Bandung, West Java. Disproportion stratified random sampling was used to select the sample. Social Media Addiction Scale-Student Form Questionnaires (SMAS-SF) and Rosenberg’s Self-Esteem Scale were used to collect the data. Pearson Product Moment correlation was performed to test the relationship between social media addiction and self-esteem. A total of 340 students joined our study, of which 59.7% were female. About 57.6% of the respondents felt discomfort when they had to reduce time spent using social media and 77.6% were addicted to using social media. 57.1% of the respondents have low self-esteem. There was a moderate positive relationship between addiction to social media and self-esteem among adolescents in rural area (r=0.418, p&lt;0.05). This study suggest that social media addiction was correlated with self-esteem, for future studies could be considering gender difference to have better insight. Healthcare professional needs to design an intervention utilize social media to promote self-esteem among adolescents.&#x0D; &#x0D; Keywords: social media, self-esteem, adolescents

Hemoglobin level in relation with physical fitness among female adolescents in rural area

Hemoglobin level in relation with physical fitness among female adolescents in rural area

Gender differences in the association between social support and caregiver alcohol use in posttraumatic stress disorder of east Taiwan adolescents.

Objectives:This study investigates traumatic experiences in a sample of high-risk Taiwanese adolescents in rural areas of Taiwan; correlation with psychosocial factors is assessed with focus on social support and caregiver alcohol use.Materials and Methods:This was a cross-sectional study using stratified cluster sampling. Structured questionnaires were used to collect demographic characteristics, social support (Taiwan Relationship Inventory for Children and Adolescents), and posttraumatic stress disorder (PTSD) symptoms (Chinese version of UCLA-PTSD Reaction Index) from a sample of 751 adolescents (54.6% females) with 61.2% response rate in high schools in Hualien County, Taiwan.Results:Girls with trauma experiences manifested significantly higher PTSD scores, concurrent with higher number of traumatic events (TE), while the likelihood of reporting trauma and subsequent PTSD symptoms was similar in both genders. Increased risk of reported trauma and PTSD in adolescent Taiwanese is strongly associated with caregiver alcohol use and lack of social support, particularly in girls.Conclusion:We found that girls reported higher numbers of TE which was concurrent with significantly higher PTSD scores. Early detection of alcohol use disorders among caregivers as well as assessment of quality of family interaction would benefit at risk adolescents through specifically tailored interventions to address these factors.

Prevalence of Severe Depression among Adolescents in Rural Area of Odisha, India.

Background:In adolescents, major depression is projected to rank the second most cause of human illness by the year 2022. Unfortunately, half of the depressed adolescents go undiagnosed in primary care settings.Objectives:The objective is to estimate the prevalence of severe depression among rural adolescents and also to identify few epidemiological determinants causing severe depression.Settings and Design:This cross-sectional study included 341 adolescents from a selected village of Balasore, Odisha.Materials and Methods:A semi-structured questionnaire, and “Beck's Depression Inventory II” questionnaire for screening depression.Results:Only 24 (7%) of adolescents were found to be having severe depression. The subcategories of depression showed mild mood disturbance in 8.8%, borderline depression in 15.2%, and moderate depression in 12% individuals. Almost 267 (78.2%) were between 15 and 19 years of age. The mean age (standard deviation) of the participants was 16 ± 1.9 years. Majority of the participants belonged to joint family and lower middle-class status as per the Modified Kuppuswamy Scale.Conclusion:Female gender was found to be significantly associated with depression (P = 0.006). Other contributory factors for depression were sleep duration (<6 h), parental fighting, and socioeconomic status.

Exploration of aggressive behavior among adolescent in Indonesia

Aggressive behaviour is one of the problems which have a negative impact on adolescents, especially on their development process. This study aims to determine the extent to which students' aggressive behaviour is predictable by gender and domicile origin. The participants of this study were a total of 2681 Indonesian teenagers aged 14-20 years, that anonymously and voluntarily filled out this instrument. The instrument used was the AF Aggressive Behaviour Instrument Scale (AFABIS), which has been tested for validity and reliability with a significance of 0.08. Furthermore, data testing was carried out using network psychometrics and Rasch analysis. The results from the network psychometrics analysis showed that there was a good structure of participants in terms of gender and domicile origin (city, suburban, rural) and a significant difference in aggressive behaviour as seen from the sparsity that was raised. The results showed that male adolescents tend to show more aggressive behaviour compared to females. Furthermore, it showed that the tendency of displaying aggressive behaviour by adolescents in rural areas is more tenuous compared to those in suburbs of cities and cities. These results may be used as initial data by counselors for psychological intervention on aggressive behaviour featured by adolescents.

Level and Associated Factors of Knowledge regarding Menstrual Hygiene among School-Going Adolescent Girls in Dang District, Nepal.

Background Adolescent girls in developing countries do not have proper information, and proper information is covered up by sociocultural boundaries resulting in various morbidities. This study aimed to determine level of knowledge and its associated factors regarding menstrual hygiene amongst adolescent school girls in Dang district, Nepal. Methods Institution-based cross-sectional study was conducted between April and October 2019 among 406 adolescent girls studying in grades 8–10 between ages of 10–19 years in Dang district, Nepal. From a total of 10 local units, 5 were selected randomly. Out of the selected 5 units, 10 schools consisting of 5 government and 5 private schools were selected through disproportionate stratified random sampling. A further 406 students were then selected randomly from the 10 selected schools. Bivariate analysis was used primarily to assess the association between dependent and independent variables. Variables which were associated with bivariate analysis were entered into a multivariable logistic regression model to identify associated factors of menstrual hygiene practice. Results The mean age and family size were 15.13 ± 1.19 and 5.58 ± 1.81, respectively. A total of 87.7% of adolescents had good knowledge regarding menstrual hygiene. Adolescents living in rural area (AOR = 0.27, CI: 0.12–0.61, p ≤ 0.001), private schools (AOR = 6.10, CI: 1.58–23.46, p ≤ 0.001), mothers who can read and write (AOR = 0.22, CI: 0.07–0.64, p ≤ 0.001), fathers who have up-to-grade-10 education (AOR = 5.15, CI: 1.84–14.39, p ≤ 0.001), and living only with mothers (AOR = 0.29, CI: 0.12–0.69, p ≤ 0.018) were significantly associated with level of knowledge of menstrual hygiene. Conclusions Though the majority of respondents had a good level of knowledge regarding menstrual hygiene, there was a knowledge gap in specific areas. The level of knowledge was significantly poor among adolescents in rural areas and those living only with mothers. Thus, this study concerns the need for policy makers to focus on specific education regarding menstrual hygiene in rural areas including both parents.

Sociodemographic profile of psychoactive substance use among selected secondary school students in rural Nigeria.

Use of Psychoactive substances by young people poses an important public health threat despite mass campaigns and education. There have been documentations of rise in prevalence and use of psychoactive substances by Nigerian adolescents in urban areas of Nigeria. Few reports exist on in-school adolescents in rural areas, and differences in their sociodemographic profile such as public/private school attendance, day/boarding status and socioeconomic status of students. The study determined the rate and sociodemographic profile of psychoactive substance use among secondary school students in selected rural communities in Anambra state, Nigeria. This was a cross-sectional study in which multistage sampling was used to select 494 students from selected secondary schools in Anambra state. Data on age, gender, socioeconomic status, student status, school category, alcohol, tobacco and intravenous drug use were obtained using pretested semi-structured questionnaires. Analysis of data was done using IBM SPSS statistics software version 20.0, frequency, percentages and means were calculated, with cross-tabulation done for variables (Chi-square and Fishers exact test where applicable). Level of significance for tests of association set at 5%. A total of 494 participants were studied of which 48.8% (n=241) were males. The mean age was 14.5±1.8 years. The prevalence of lifetime use of psychoactive substance was 22.5%. Prevalence for individual substances were 21.9% (n=108), 1.8% (n=9) and 0.8% (n=4) respectively for alcohol, tobacco and illicit intravenous drugs. Neither gender {6 males (2.5%), 3 females (1.2%), p=0.890}, age {10-13 years (1.3%), 14-16 years (2.1%), >16 years (1.7%), p=0.329}, student status {day (2.6%), boarding (1.2%), p=0.320}, social class {upper (0.9%), middle (0.6%), lower (3.1%), p=0.208 } nor school category {private (1.5%), public (2.1%), p=0.742} of students was significantly associated with smoking and respectively. More males (73/241=30.3%, p<0.001) took alcohol than females (35/253=13.8%) and this was statistically significant. Participants from the lower socioeconomic class (30.3%, p<0.001) had a significantly higher rate of alcohol consumption than those from the upper (11.8%) and middle classes (16.7%) respectively. Higher rate was noted among those who attended public schools (30.8%, p<0.001) compared to those who attended private schools (13.8%). Day students (30.2%, p<0.001) indulged more inalcohol than boarding students (14.3%). There was noassociation between either the class (junior=22.5%,senior=21.3%,p=0.759) or age of participants (10-13years=20.7%, 14-16 years=20.1%, >16 years=33.3%, p=0.071) and alcohol consumption. No association was found between age (0.7%, 1.1%, p=1.000), gender (male=1.2%, female=0.4%, p=0.362), social class (lower=1.3%, upper=0.9%, p=0.443), student status (day=0.9%, boarding=0.8%, p=1.000), school category (junior=0.8%, senior=0.8%, p=1.000) and intravenous drug use. The rate of about 22% alcohol use by secondary school students in rural south eastern Nigeria, which is strongly associated with male gender, low socioeconomic status, day student status and public school attendance is high.

Environmental factors and physical activity among youth in rural Japan: a 1-year prospective study

Abstract Background Although moderate-to-vigorous physical activity (MVPA) has multiple health benefits, current global activity levels among children are quite low. Environmental influences on MVPA levels among children and adolescents in rural areas are unclear. The present study examined if environmental factors were associated with MVPA in children and adolescents in rural Japan. Methods Two school-based serial surveys were conducted in 2017 and 2018 for 1,461 children and adolescents (10-14 years old) in Unnan City, Japan. If meeting the WHO recommended MVPA levels: at least 60 minutes/day was assessed via the Japanese translation of the WHO Health Behaviour in School-aged Children survey questionnaire. Environmental factors, namely habitable land area, population size, and population density were calculated for each individuals' residential town, and categorized into three levels (small, medium, and large). Logistic regression was used to determine odds ratios (OR) and 95% confidence intervals (CI) of engaging in the recommended level of MVPA after 1 year by each environmental factor, adjusting for sex, school grades, body mass index, screen time, preference for PA, and MVPA level at baseline. Results Only 22.4% of children and adolescents were engaging in the recommended MVPA levels in 2018. Engaging in the recommended level of MVPA after 1 year was significantly associated with medium (OR = 1.63; 95%CI, 1.08-2.46) and large (OR = 1.69; 95%CI, 1.15-2.47) compared to small habitable areas, and with medium (OR = 1.01; 95%CI, 0.61-1.67) and large (OR = 1.75; 95%CI, 1.09-2.81) compared to small population size. Population density was not associated with MVPA. Conclusions This prospective study found that habitable area and population size were positively associated with MVPA at 1-year follow-up in rural Japan. In rural areas, habitable land areas and population size itself may be a better predictor for MVPA among children than population density. Key messages Habitable area and population size was positively associated with physical activity among children and adolescents in rural Japan. Population density as an environmental factor was not associated with physical activity.