Behaviors In Korean Adolescents Research Articles

Multiple risk-taking behaviors in Korean adolescents and associated factors: 2020 and 2021 Korea youth risk behavior web-based survey

ObjectiveDespite the negative health impact of multiple risk-taking behaviors (RTBs), there is a lack of understanding of adolescents who are more prone to multiple RTBs. This study aimed to identify sociodemographic, mental, and physical health variables associated with increased susceptibility to multiple RTBs in each sex. MethodsCross-sectional data from the 2020 and 2021 Korea Youth Risk Behavior Web-based Survey was used. A total of 106,979 Korean adolescents (55,460 men and 51,519 women) were assessed on five RTBs (alcohol use, smoking, sexual intercourse, illicit substance use, no seat belt wearing). In comparison to no RTB group, odds ratios of the relevant covariate factors were calculated in one RTB or multiple RTBs groups. ResultsMale and female adolescents engaging in multiple RTBs were 6.4% and 3.8%, respectively. Increasing age, low subjective socioeconomic status, and living in rural areas were associated with multiple RTBs regardless of sex. All mental health variables except anxiety were associated with multiple RTBs in both sexes. Physical inactivity and obesity were associated with decreased odds of multiple RTBs in both sexes. ConclusionThis study identifies diverse factors associated with multiple RTBs of Korean adolescents and demonstrates existing sex differences. Age and mental health status are the most critical factors that distinguish multiple risk-taking groups from those involved in one or no RTB.

Food-Related Online Media (Mukbang and Cookbang) Exposure and Dietary Risk Behaviors in Korean Adolescents

BackgroundStudies have shown that prolonged smartphone use is associated with dietary risk behaviors among adolescents. However, little is known about whether the exposure to food-related online media contents, such as mukbang (eating broadcast) and cookbang (cooking broadcast), is associated with unhealthy dietary behaviors, independent of overall duration of smartphone use. ObjectivesThis study investigated the associations between the frequency of mukbang/cookbang watching and dietary risk behaviors among Korean adolescents, using nationally representative survey data. MethodsIn this cross-sectional study, we examined the data from 50,044 middle and high school students in the Korea Youth Risk Behavior Web-based Survey 2022. Participants reported their frequency of mukbang/cookbang watching, mean duration of smartphone use, frequency of breakfast eating, frequency of nighttime eating, and intakes of fast foods, sugar-sweetened beverages (SSBs), and high-caffeine drinks. We performed multivariable logistic regression to estimate odds ratios (ORs) and 95% confidence intervals (CIs) for the associations between mukbang/cookbang watching and dietary risk behaviors, accounting for complex survey sampling and adjusting for potential confounders. ResultsFrequent mukbang/cookbang watching (≥5 times/wk compared with never) was positively associated with dietary risk behaviors, including frequent breakfast skipping (OR: 1.20; 95% CI: 1.13, 1.28), frequent nighttime eating (OR: 1.43; 95% CI: 1.33, 1.54), and frequent intakes of fast foods (OR: 1.69; 95% CI: 1.58, 1.80), SSBs (OR: 1.47; 95% CI: 1.30, 1.66), and high-caffeine drinks (OR: 1.41; 95% CI: 1.33, 1.50), adjusting for duration of smartphone use. All mukbang/cookbang viewers, including those who perceived that mukbang/cookbang videos had “no influence” on their dietary behavior, had higher prevalence of dietary risk behaviors than nonviewers (perceived “no influence” compared with nonviewers—OR: 1.18; 95% CI: 1.10, 1.26, breakfast skipping; OR: 1.15; 95% CI: 1.06, 1.24, nighttime eating; OR: 1.40; 95% CI: 1.30, 1.50, fast foods; OR: 1.22; 95% CI: 1.07, 1.38, SSBs; OR: 1.28; 95% CI: 1.20, 1.37, high-caffeine drinks). ConclusionsOur findings suggest that frequent mukbang/cookbang watching may be associated with unhealthy dietary behaviors among Korean adolescents.

Associations between Physical Activity, Mental Health, and Suicidal Behavior in Korean Adolescents: Based on Data from 18th Korea Youth Risk Behavior Web-Based Survey (2022).

This study aims to identify the current status and relationship between physical activity (PA), mental health, and suicidal behavior among Korean adolescents and recommend appropriate PA types and levels to lower the risk of mental health problems and suicidal behavior among adolescents. This study used the frequency of participation, three mental health factors, and four suicidal behavior factors, according to the seven types of PA, Vigorous PA (VPA), Strength training, Walks, PA on the move, and Physical education questions that 51,636 Korean adolescents responded to in the data of the 18th Korean Youth Health Behavior Survey in 2022. The results showed that physical activity levels and the mental health of female adolescents were the lowest, and the experience rate of suicidal behavior was the highest. Physical activity level and mental health were negative in the upper grades, and the experience rate of suicidal behavior was higher in the lower grades. Thus, the study proposes the following: To lower the overall risk of mental health and suicidal behavior experienced by adolescents, it is effective to encourage them to participate in physical activities which have higher exercise intensities than the Low-level Physical Activity (LPA) type of Walks and PA on the move.

Mukbang and Cookbang watching and dietary behavior in Korean adolescents.

Given that adolescents watch Mukbang (eating broadcast) more frequently than other age groups, interest in the potential health effects of watching Mukbang and Cookbang (cooking broadcast) is growing. This study aimed to determine the status of watching Mukbang and Cookbang among Korean adolescents and its relationship with their dietary behaviors. We used data from the 18th Korea Youth Risk Behavior Survey, conducted in 2022 (n = 51,850). The study included the frequency of watching Mukbang and Cookbang and the self-rated impact of watching them. Dietary behaviors included consumption of the following items: fruits (≥ once a day), vegetables (≥ 3 times a day), fast foods (≥ 3 times a week), late-night snacks (≥ 3 times a week), caffeinated drinks (≥ 3 times a week), and sweet-flavored drinks (≥ 3 times a week). Furthermore, obesity, weight loss attempts during the past 30 days, body image distortion, and inappropriate methods to control weight were also included. Among adolescents, 70.6% watched Mukbang and Cookbang, and 13.2% watched them more than 5 times a week. Approximately 27.6% of the adolescents responded that they were influenced by watching Mukbang and Cookbang. Adolescents who frequently watched Mukbang and Cookbang consumed less vegetable and fruit; however, the likelihood of consuming fast food, late-night snacks, sugary drinks, and caffeinated drinks increased. In addition, they were more likely to attempt inappropriate weight-loss methods and become obese. Adolescents who responded that their eating habits were influenced by watching Mukbang and Cookbang were more likely to have unhealthy eating behavior compared to the group who responded that their habits were not influenced by these shows. Watching Mukbang and Cookbang is common among Korean adolescents and is associated with unhealthy dietary behaviors. Prospective studies, including broadcasting content, should evaluate the impact of Mukbang and Cookbang on health.

4.11 Multiple Risk-Taking Behaviors in Korean Adolescents and Associated Factors: 2020 and 2021 Korea Youth Risk Behavior Web-Based Survey

4.11 Multiple Risk-Taking Behaviors in Korean Adolescents and Associated Factors: 2020 and 2021 Korea Youth Risk Behavior Web-Based Survey

Trends in the effects of socioeconomic position on physical activity levels and sedentary behavior among Korean adolescents.

We examined trends in physical activity and sedentary behavior in Korean adolescents, and their association with socioeconomic position (SEP). We used data from the Korea Youth Risk Behavior Survey, a nationwide study involving students aged 12-19 conducted between 2009 and 2021. SEP was assessed based on economic status, parental education attainment, and urbanization. Physical activity was categorized into vigorous physical activity, moderate physical activity, and muscle training, and sedentary time was also measured. We conducted the log-binomial regression to calculate prevalence ratios (PRs) and prevalence differences. Our analysis included a total of 593,896 students. We observed an increasing trend in physical activity, but a worsening trend in sedentary behavior. A positive association was found between an adolescent's physical activity and SEP indicators, except for urbanization. Adolescents with higher economic status engaged in more vigorous physical activity (high: PR, 1.26; 95% confidence interval [CI], 1.25 to 1.28; middle: PR, 1.03; 95% CI, 1.02 to 1.04). Similar associations were observed for father's education (tertiary or above: PR, 1.11; 95% CI, 1.09 to 1.13; upper secondary: PR, 1.05; 95% CI, 1.03 to 1.07) and mother's education (tertiary or above: PR, 1.17; 95% CI, 1.15 to 1.20; upper secondary: PR, 1.06; 95% CI, 1.04 to 1.08). Adolescents with higher economic status also showed a higher compliance rate with the guideline restricting sedentary time to 2 hours per day (high: PR, 1.28; 95% CI, 1.25 to 1.30; middle: PR, 1.03; 95% CI, 1.01 to 1.05). Adolescents with higher SEP exhibited more physical activity and less sedentary time than those with lower SEP.

Longitudinal relationship between depression and antisocial behaviors in Korean adolescents.

It is well known that depression and delinquency in adolescents are highly correlated, but longitudinal studies on the causal relationship between them are not active in East Asia compared to in Western culture. In addition, even the results of research on causal models and sex differences are inconsistent. This study examines the longitudinal reciprocal effects between depression and delinquent behavior in Korean adolescents based on sex differences. We conducted multiple-group analysis by using an autoregressive cross-lagged model (ACLM). Longitudinal data from 2,075 individuals (2011-2013) were used for analysis. The longitudinal data are from the Korean Children and Youth Panel Survey (KCYPS), and data were used beginning with students at 14 years old (in the second grade of middle school) and tracked them until they were 16 (in the first grade of high school). Boys' delinquent behaviors at 15 years (the third grade of middle school) affected their depression at 16 years (the first grade of high school). In contrast, girls' depression at 15 years (the third grade of middle school) influenced their delinquent behaviors at 16 years (the first grade of high school). The findings support the failure model (FM) among adolescent boys and the acting-out model (ACM) among girls. The results imply that strategies to effectively prevent and treat delinquency and depression in adolescents must consider sex effects.

Association between COVID-19 lockdown and sleep behaviors in Korean adolescents.

To find the effect of coronavirus disease 2019 (COVID-19)-related sleep behavior changes using school-based self-reported data from a nationally representative Korean adolescent population. We analyzed web-based self-reported data from the Korean Youth Risk Behavior Web-based Survey in 98,126 participants (51,651 in 2019 [before the COVID-19 pandemic]; 46,475 in 2020 [during COVID-19 pandemic] 12 through 18 years old were included in this study. Self-report questionnaires were used to assess socioeconomic status, health behaviors, psychological factors, and sleep patterns. During the COVID-19 pandemic, Korean adolescents had a later weekend bedtime (≥1:00 am: 68.2% vs 71.5%, P < .001) and late weekend wake time (≤7:00 am: 13.3% vs 10.7%, P < .001) compared to before COVID-19 pandemic. Average sleep duration (434.7 ± 102.6 vs 428.2 ± 100.4 minutes; P < .001) was significantly lower during the COVID-19 pandemic and weekend catch-up sleep >2 hours (42.1% vs 43.7%; P < .001), late chronotype (17.1% vs 22.9%, P < .001) were significantly higher during COVID-19 pandemic. After adjusting for multiple confounding variables, short sleep duration (≦5 hours, odds ratio [OR] 1.14; 95% confidence interval [CI] 1.10-1.19), 6 hours, OR 1.07; 95% CI 1.03-1.12), long weekend catch-up sleep (OR, 1.08; 95% CI, 1.06-1.11) and late chronotype (OR, 1.43; 95% CI, 1.38-1.47) were significantly associated with COVID-19 pandemic. The COVID-19 pandemic was associated with changes in sleep behavior among Korean adolescents, resulting in later bed and wake-up times, increased weekend catch-up sleep, and a shift of chronotype toward eveningness.

Association of Smartphone Use With Body Image Distortion and Weight Loss Behaviors in Korean Adolescents

Despite high use of smartphones among adolescents, little is known about the association of smartphone use with body image and related behaviors. To examine the associations of duration of smartphone use and types of content most frequently accessed via smartphone with body image distortion and weight loss behaviors in adolescents. This cross-sectional study used data from the population-based Korea Youth Risk Behavior Web-Based Survey 2017. Participants comprised a nationally representative sample of 53 133 Korean adolescents aged 12 to 18 years. Data were collected from June 1 to July 18, 2017. The analysis was performed from February 7, 2020, to March 30, 2022. Self-reported duration of smartphone use (min/d) and types of content (educational or informational searches; chatting, messaging, or email; social networking services or forums; games; videos, movies, or music; webtoons or web novels; and shopping or other activities) most frequently accessed during smartphone use. Body image distortion (overperception of body weight), weight loss attempt, use of inappropriate weight loss strategies (skipping meals, eating only 1 food at a time, vomiting, or using laxatives), and healthy weight loss behaviors (muscle-strengthening and aerobic physical activity). Multivariable logistic regression analysis was performed to estimate odds ratios (ORs) and 95% CIs, accounting for survey sampling and adjusting for potential confounders. Among 53 133 participants, the mean (SD) age was 15.0 (1.8) years; 50.7% of participants were female, and 49.3% were male. After adjusting for types of content accessed, prolonged smartphone use (≥301 min/d) was positively associated with body image distortion (boys: OR, 1.17; 95% CI, 1.07-1.28; girls: OR, 1.20; 95% CI, 1.10-1.30) and inappropriate weight loss strategies (boys: OR, 1.54; 95% CI, 1.25-1.90; girls: OR, 2.45; 95% CI, 2.14-2.79) in both sexes compared with minimal smartphone use (1-120 min/d). After adjusting for duration of smartphone use, the use of smartphones mainly for videos, movies, or music (OR, 1.15; 95% CI, 1.02-1.29), webtoons or web novels (OR, 1.28; 95% CI, 1.10-1.48), and games (OR, 1.17; 95% CI, 1.03-1.32) was positively associated with body image distortion in boys compared with the use of smartphones mainly for educational or informational content. Among boys, the use of smartphones mainly for chatting, messaging, or email was positively associated with muscle-strengthening activity (OR, 1.31; 95% CI, 1.18-1.44) and aerobic physical activity (OR, 1.41; 95% CI, 1.29-1.55), as was the use of smartphones mainly for social networking services or forums (muscle-strengthening activity: OR, 1.27; 95% CI, 1.13-1.42; aerobic physical activity: OR, 1.28; 95% CI, 1.15-1.43). Among girls, the use of smartphones mainly for chatting, messaging, or email was positively associated with weight loss attempts (OR, 1.34; 95% CI, 1.19-1.51) and the use of inappropriate weight loss strategies (OR, 1.57; 95% CI, 1.25-1.99), as was the use of smartphones mainly for social networking services or forums (weight loss attempts: OR, 1.20; 95% CI, 1.07-1.36; use of inappropriate weight loss strategies: OR, 1.37; 95% CI, 1.08-1.73). In this cross-sectional study, both the duration of smartphone use and the types of content most frequently accessed via smartphone were associated with body image distortion and weight loss behaviors in adolescents. These findings suggest a need for the identification of strategies to help adolescents develop healthy smartphone use behaviors.

Leisure-time and study-time Internet use and dietary risk factors in Korean adolescents

Prolonged screen time is associated with an increased risk of obesity in adolescents. However, little is known about whether Internet use is also associated with dietary risk factors including consumption of obesogenic foods. In this study, we examined the associations of leisure-time and study-time Internet use with dietary risk factors in Korean adolescents using nationally representative survey data. We conducted a cross-sectional analysis among 54,416 middle and high school students in the Korea Youth Risk Behavior Web-based Survey 2015. Participants were asked to report the average duration of leisure-time and study-time Internet use, days of skipping breakfast, and frequency of fruit, vegetable, instant noodle, fast-food, chip/cracker, and sugar-sweetened beverage (SSB) intakes. We performed multivariable logistic regression to estimate ORs and 95% CIs for the relations between duration of Internet use and dietary risk factors, accounting for complex survey sampling and adjusting for potential confounders. Prolonged leisure-time Internet use (≥241 compared with 1-60min/d) was associated with higher prevalence of frequent skipping breakfast (OR: 1.39; 95% CI: 1.29, 1.49), low intakes of fruits (OR: 1.27; 95% CI: 1.18, 1.36) and vegetables (OR: 1.43; 95% CI: 1.33, 1.55), and high intakes of instant noodles (OR: 1.87; 95% CI: 1.74, 2.02), fast-food (OR: 1.63; 95% CI: 1.49, 1.78), chips/crackers (OR: 1.37; 95% CI: 1.24, 1.52), and SSBs (OR: 1.63; 95% CI: 1.52, 1.75). Prolonged study-time Internet use (≥121 compared with 1-60min/d) was inversely associated with prevalence of low fruit (OR: 0.94; 95% CI: 0.88, 1.00) and vegetable (OR: 0.91; 95% CI: 0.85, 0.98) intakes but was positively associated with high intakes of instant noodles (OR: 1.10; 95% CI: 1.03, 1.19) and chips/crackers (OR: 1.13; 95% CI: 1.04, 1.23). The overall associations remained consistent in analyses stratified by sex, grade, region, parental co-residence, perceived household income, perceived stress level, physical activity, and obesity status. Our data suggest that prolonged Internet use, particularly during leisure time, is associated with less healthful dietary behaviors in Korean adolescents.

Influence of Experiencing Bullying Victimization on Suicidal Ideation and Behaviors in Korean Adolescents.

This study was conducted to identify the association between experiencing bullying victimization and suicidal ideation and behaviors, so as to identify the influencing factors on suicidal ideation, suicide plans, and suicide attempts among Korean adolescents. This study analyzed data from the Korean Psychosocial Anxiety Survey. The survey used nationally representative samples of Korean adolescents aged 14 to 18 years old. The experience of bullying victimization negatively influenced suicidal ideation and suicide plans, but not suicide attempts. This influence was reduced, but still remained after controlling depression, anxiety, relationships with family, relationships with teachers and friends, and social support. Influencing factors differed with suicidal ideation, plans, and attempts. Anxiety was the only factor associated with all stages of suicidality. When developing future interventions, health providers need to consider the differences in the factors associated with each stage of suicidality in adolescents.

A Meta Analysis of Impulsivity Related to Self-destructive Behavior in Korean Adolescents

A Meta Analysis of Impulsivity Related to Self-destructive Behavior in Korean Adolescents

Association between food-related media program watching and dietary behaviors in Korean adolescents

Association between food-related media program watching and dietary behaviors in Korean adolescents

Association between Substance Use and Risky Sexual Behavior among Korean Adolescents

Objectives : This study aimed to investigate the association between substance use and risky sexual behavior in Korean adolescents. Methods ： A cross-sectional survey using a self-administered questionnaire was conducted in 12-18 year-old adolescents in Korea in 2018. The data of 60,040 adolescents who participated in the survey were analyzed. Logistic regression was performed to investigate the association between substance use (alcohol use, tobacco use, and the use of other drugs) and risky sexual behavior (having sexual intercourse during adolescence, and having unprotected sexual intercourse), for males and females, separately. Results ： The percentage of adolescents who had sexual intercourse was 5.3%. Among those who had sexual intercourse, 53.9% had unprotected sexual intercourse. Logistic regression analyses showed that all types of substance use were associated with having an early sexual debut and having unprotected sexual intercourse. Conclusion : The study showed that substance use, including alcohol use, tobacco use, and the use of other drugs, was associated with risky sexual behavior among Korean adolescents. Sexual health education and interventions are necessary for adolescents with a history of substance use.

Energy Drink Consumption and Dietary-, Lifestyle-, and Mental Health-Related Behaviors in Korean Adolescents: Based on the 10th–13th Korea Youth Risk Behavior Web-Based Survey

Energy Drink Consumption and Dietary-, Lifestyle-, and Mental Health-Related Behaviors in Korean Adolescents: Based on the 10th–13th Korea Youth Risk Behavior Web-Based Survey

Internet use and oral health behaviors in Korean adolescents

Internet use and oral health behaviors in Korean adolescents

Longitudinal reciprocal effects between peer relationship difficulties and aggressive behaviors in Korean adolescents

Peer relationship difficulties are strongly correlated with aggressive behaviors among adolescents in cross-sectional studies. However, effects of aggressive behaviors on peer relationship difficulties are known to be inconsistent. Longitudinal reciprocal effects between these two variables are currently unclear. Using data from the Korean Children and Youth Panel Survey from 2011 to 2013, this study investigated longitudinal reciprocal effects between these two variables in Korean adolescents. Participants were 2,280 second-grade middle school students (eighth graders in the USA) at Time 1. Results from autoregressive cross-lagged model showed that peer relationship difficulties and aggressive behaviors were stable over a three-year period while longitudinal effects between these two variables were mutually and positively significant. However, the impact of peer relationship difficulties on aggressive behaviors was greater than that of the opposite (i.e., the impact of aggressive behaviors on peer relationship difficulties). Findings of this study suggest that schools should focus on preventive education and counseling for adolescents' peer relationship problems and aggressive behaviors. Furthermore, in-service trainings for teachers and counselors focusing on enhancing their understandings of these reciprocal relationships may help students improve peer relationship while reducing aggressive behaviors.

Gender Differences in Sexual Behaviors in Korean Adolescents

PurposeThe purposes of this study were to identify whether there are gender differences in sexual behaviors among Korean adolescents and to explore the factors that influence safe sex practices across both sexes. MethodsA secondary analysis was conducted using nationally representative data obtained from the 2014 Youth Risk Behavior Web-based Survey. Sample consisted of 3,210 adolescents who had experience of sexual intercourse. The dependent variable in this study was practicing safe sex. The independent variables included a range of individual, family, and school factors. ResultsFemale adolescents were less likely to practice safe sex (i.e., always using a condom). Individual (smoking, no drinking before sexual intercourse), family (living with parents, higher allowance per week) and school factors (non-coeducational school students, had received school-based sex education) were significant predictors of practicing safe sex in males. In contrast, family (lower economic status) and school factors (middle school students) predicted practicing safe sex among female adolescents. ConclusionWe demonstrated that gender plays an important role in the sexual behavior of adolescents. The findings of this study indicate a need to design and implement gender-specific interventions.

Is insufficient sleep duration associated with suicidal behavior in Korean adolescents?

The second leading cause of death among Korean adolescents was suicide in 2014. We assessed the relationship between sleep duration and suicidal behavior (ideation, planning and attempt) using data from the Korea Youth Risk Behavior Web-based Survey (KYRBS). KYRBS is an anonymous online survey in self-reporting format that investigates the health status of middle and high school students. Weekly sleep duration was divided into six groups (more than 8, 7–8, 6–7, 5–6, 4–5 h, less than 4 h). We compared the more-than-8-h group with others for sleep duration-associated suicidal behavior. Results showed that even though the confidence interval for the odds ratio for some sleep duration groups was not significant, there was a statistically significant inverse positive trend of suicidal behavior (ideation, planning and attempt) with the sleep duration groups (P value for trend ≤0.001). In conclusion, this study found that short average weekday sleep duration among Korean adolescents was associated with suicidal behavior independent of various confounding factors, which includes depressed mood.

Secular trends in weight status and weight-related behaviors in Korean adolescents from 2006 to 2013.

The purpose of this study was to examine the secular trends in weight status and weight-related behaviors in adolescents in Korea from 2006 to 2013. Using a repeated cross-sectional design, we analyzed raw data from the 2006 and 2013 Korea Youth Risk Behavior Web-based Survey, which included 69,500 adolescents in 2006 and 70,354 adolescents in 2013. Subjects were 12- to 18-year-old boys and girls from the first grade of middle school through the third grade of high school. The data was collected by using an anonymous self-administered online survey. From 2006 to 2013, the prevalence of obesity increased by 0.7 (percent point; %p) (p < 0.001) in boys and 1.0%p (p < 0.001) in girls. At the same time, the prevalence of obesity increased by 1.0%p (p < 0.001) in middle-school students and decreased by 0.7%p (p < 0.001) in high-school students. Healthy, unhealthy, and extreme weight-control behaviors decreased in all adolescents (all p < 0.001). Obesity and unhealthy weight control behaviors in Korean adolescents remain major public concerns, and programs to encourage healthy weight control behaviors are required.