Global School-based Student Health Survey Research Articles

Intakes from healthy and unhealthy food groups and obesity among 5- to 9-year-old South African children

The global pandemic of paediatric overweight and obesity, along with undernutrition among children in low-income countries pose challenges for future health. Unhealthy dietary intake among children is of great concern(1). The aim of this study was to determine the association between intakes from healthy and unhealthy food groups and adiposity among 5- to 9-year-old South African children (n = 920). Conventional dietary intake assessment methods are burdensome; therefore, a short unquantified food frequency questionnaire was developed based on the WHO Global school-based student health survey, which focused on healthy and unhealthy food groups. The new questionnaire includes four healthy food groups (fruits, vegetables, milk, meats) and six unhealthy food groups (hot sugar-sweetened beverages (SSBs), cold SSBs, cookies, candies, salty snacks, fast foods) with five different responses of frequency of intake per week. The food groups reflect foods generally eaten by South African school children. The questionnaire was completed by the parents. Weight and height were measured and WHO BMI z-score (BAZ) was calculated(2). Descriptive statistics were reported using median and interquartile range. Frequency of intakes from food groups were compared across tertiles of BAZ using the Kruskal-Wallis test. The correlation between frequency of intakes from different food groups, and between the food groups and BAZ was calculated. The children reported similar daily intakes from the milk (35.3%), cold SSBs (33%) and hot SSBs groups (27%). Fruit (14%) and vegetables (9.6%) were consumed daily by a small percentage of children, while animal source protein foods (meat, fish, poultry, eggs) were consumed daily by 39% of children. The most frequent daily consumed snacks were salty snacks, e.g. crisps (13.2%), candy (11.1%) and cookies (5.3%), while fast foods were consumed once per week by the largest proportion of children (60.7%). Based on the WHO BMI z-scores, 15.2% of children were overweight, 4.4% were obese and 3.8% were underweight. Children in the highest two tertile groups of BAZ had a higher median weekly frequency of SSB intake (5, IQR 1,7), compared to those in the lowest BAZ tertile (3, IQR 1,7). No other differences were found between frequency of food group intake across BAZ tertiles. There was a weak positive correlation between BAZ and the frequency of SSB intake (r = 0.08, = 0.015), as well as between frequency of milk intake and frequency of SSB intake (r = 0.13, P<0.001), but a weak negative correlation between the frequency of vegetable intake and frequency of SSB intake (r = −0.08, P = 0.01). In conclusion, low fruit and vegetable intakes, combined with regular SSB intakes are evident in this group of children. The frequency of SSB intake was positively associated with adiposity, and SSB intake apparently replaced vegetable intake, but not milk intake among the children.

Alcohol use among in-school adolescents in Sierra Leone

ObjectiveTo examine the prevalence of alcohol use and its associated factors among in-school adolescents in Sierra Leone.DesignData for the study was sourced from the 2017 Sierra Leone Global School-Based Student...

Use of tobacco and other illicit drugs among adolescent boys and young men in Kampala, Uganda: A result of low parental attention?

Although the use of illicit drugs is common among young people, limited data exists on the use of illicit drugs among adolescent boys and young men (ABYM). We assessed the use of tobacco, marijuana and khat among ABYM to inform the design of harm-reduction interventions. This secondary analysis uses data from a formative study conducted among 2,500 ABYM across the five divisions of Kampala between July and August 2020. Survey questions were adopted from the Global Youth Tobacco Survey and Global School-based Student Health Survey. We computed proportions of ABYM that had ever used any form of tobacco or marijuana or khat in the past year and the proportion that had used any of these products in the past 30 days (i.e. 'current users'). In a sub-group analysis, we assessed if any patterns existed between ABYM's use of illicit drugs and selected parental attention attributes. Of 2,500 ABYM, 47.3% (n = 1,182) were aged 15-19 years. Overall, 16.4% (n = 410) reported past-year use of tobacco products while 11.6% (n = 289) and 10.5% (n = 263) reported past-year use of marijuana and khat, respectively. Current use of any illicit drugs was higher among past-year khat (46%, n = 133) and marijuana users (36.9%, n = 97) than past-year tobacco users (4%, n = 17). Current use of any illicit drugs was higher among out-of-school than in-school ABYM and increased with increasing age and education levels. However, parental attention was lower among out-of-school than in-school ABYM and decreased with increasing age and education levels. Use of illicit drugs is common among ABYM and increased with age and education levels but parental attention among current illicit drug users decreased with increasing age and education levels. These findings suggest that interventions intended to improve parental attention among illicit drug users may help to reduce the prevalence of illicit drug use among ABYM.

Loneliness and its associations with demographic, lifestyle, social and parental factors among adolescents in Timor-Leste

ABSTRACT Adolescent loneliness is prevalent and has serious adverse impacts on mental and physical health outcomes. This study aimed at examining factors associated with loneliness among school-going adolescents. The country of interest is a low-income country, Timor-Leste, where empirical studies are lacking. Data from the Global School-Based Student Health Survey Timor-Leste 2015 (n = 3455) were used for secondary analyses. An ordered probit model was utilized to assess demographic, lifestyle, social, and parental factors correlated with different levels of loneliness (no loneliness, moderate loneliness, and severe loneliness). Approximately 46.3% of adolescents felt moderately lonely and about 13.5% felt severely lonely. Older adolescents were more likely to experience severe and moderate loneliness than younger adolescents. Going hungry and being bullied were associated with an increased likelihood of being severely and moderately lonely. Adolescents had a higher probability of experiencing moderate and severe loneliness if they had sleep difficulties and were physically active. Having understanding parents was positively associated with the likelihood of severe loneliness. In conclusion, a large proportion of adolescents in Timor-Leste have feelings of loneliness, which have been found to be associated with demographic, lifestyle, social, and parental factors. Policymakers should recognize the correlated factors of loneliness in order to formulate a more effective intervention strategy.

Traditional, cyberbullying, and suicidal behaviors in Argentinian adolescents: the protective role of school, parental, and peer connectedness.

Bullying, both in person and online, is a significant risk factor for a range of negative outcomes including suicidal behaviors among adolescents and it is crucial to explore the protective effects of parental, school, and peer connectedness on suicidal behaviors among victims. This study is a secondary analysis of the Argentina Global School-based Student Health Survey (GSHS 2018). Logistic regression analysis, adjusting for age and sex, determines the likelihood of suicidal thoughts and attempts among bullying victims. To explore the modifying effect of school, parental, and peer connectedness on the association between bullying and suicide behaviors, the interaction term was included. Sampling design and weights were applied in all analyses in STATA 17. The study included 56,783 students in grades 8-12, with over half being female. Adolescents aged 14-15 exhibited the highest prevalence of bullying, cyberbullying, suicidal thoughts, and attempts, with females displaying a higher prevalence in all measured categories. The study found that adolescents whoreported being bullied or cyberbullied demonstrated a significantly higherlikelihood of experiencing suicidal thoughts and attempting suicide. Furthermore, protective factors such as school, parental, and peer connectedness were found to play a critical role in mitigating the adverse impacts of bullying and cyberbullying on suicidal thoughts and attempts. The findings underscore the critical prevalence of both bullying and cyberbullying among school-going Argentinian adolescents and their profound association with suicidal behaviors. The study emphasizes the importance of supportive family environments and peer and school connectedness in mitigating the negative effects of bullying and cyberbullying on mental health and suicide risk among adolescents.

Social poverty indicators with school bullying victimization: evidence from the global school-based student health survey (GSHS)

BackgroundSchool bullying is prevalent in children and adolescents. Bullying victims are seen higher risk of negative psychological outcomes. Previously published studies suggested that social indicators may pose significant influence on bullying victimization. However, the association between social poverty and bullying victimization has not been exclusively discussed.MethodsIn this cross-sectional study, we analyzed the association between 6 commonly used social poverty indicators (Poverty Headcount Ratio, PHR; Poverty Gap, PG; Squared Poverty Gap, SPG; monthly household per capita income, PCI; Watts’ Poverty Index, WPI; the Gini Index, Gini) and the prevalence of school bullying at country level by using the Global school-based Student Health Survey (GSHS) database.ResultsAltogether 16 countries were included into the final analysis, with school bullying victimization prevalence ranged from 12.9 to 47.5%. Bubble plots revealed statistically significant associations between the three indicators measuring absolute poverty level (PHR, PCI, WPI) and bullying victimization. Subsequently performed principal component regression indicated that, for all types of bullying victimization, the increase of absolute poverty level was related to elevated prevalence rates, and the association was particularly strong for verbal bullying victimization.ConclusionsOur study results may suggest that absolute social poverty is an important parameter for constructing and implementing school bullying victimization intervention strategies and measures.

The Mediating Effect of Loneliness on the Relationship between Bullying Victimization and Suicidal Behavior among Adolescents in Ghana

Research from Western countries, Asia, and some parts of Africa has documented that bullying victimization has ramifications for adolescents, including suicidal tendencies. Some studies have also reported that loneliness among teenagers is strongly linked to suicidal behavior. However, little is known about whether loneliness mediates bullying victimization and suicidal behavior. The present study aims to apply the general strain theory to explore the relationship between being bullied and suicidal behavior among juveniles in Ghana. The study also examines the effect of bullying victimization on loneliness. Additionally, the research evaluates the impact of loneliness on suicidal behavior. Lastly, the study explores the mediation role of loneliness on the association between peer victimization and suicidal behavior among juveniles in Ghana. Data from the 2012 Global School-based Student Health Survey (GSHS) and a sample size of 2626 were used in this research. The results revealed that bullying victimization positively predicted loneliness, and bullying victimization and loneliness significantly predicted suicidal behavior. Finally, loneliness partially mediated the association between bullying experience and suicidal behavior. This study not only provides new evidence to support the general strain theory (GST) but also discusses the theoretical and political implications of the findings.

Toothbrushing frequency among children and adolescents in 72 countries: Findings from the Global School-based Student Health Survey.

Toothbrushing twice daily is essential for maintaining oral hygiene, which is a cornerstone of overall health. This is particularly important during childhood and adolescence, when lifelong habits are established. Nevertheless, many children and adolescents worldwide face challenges in maintaining good oral health due to limited access to resources and education. This study used nationally representative samples from the Global School-based Student Health Survey (GSHS) (2010-2019) to determine the frequency of toothbrushing among school-going students (N = 266,113) in 72 countries. The country-specific sample size ranged from 130 in Tokelau to 25,408 in Malaysia. The outcome variable was the frequency of brushing or cleaning teeth once daily within the past 30 days prior to the survey. Bivariate analysis was conducted following a descriptive study to determine the frequency of toothbrushing or cleaning across different age groups (≤12, 13, 14, 15, ≥16 years), sexes, World Health Organization (WHO) regions, and gross domestic product (GDP) per capita quintiles. The overall proportion of males to females in the sample was 50.9:49.1. In 45 countries or territories (62.5%), the proportion of participants who reported brushing their teeth at least once a day was above 90%. Participants from 10 countries or territories (13.9%) reported never or rarely brushing their teeth. In 69 countries or territories (95.8%), male students were more likely than female students to never or rarely brush their teeth. The highest rate of individuals who never or rarely brush their teeth (32.1%) was reported in the Eastern Mediterranean Region. In comparison, the Region of the Americas had the highest frequency of brushing twice or more daily (82.9%). Educational interventions focused on dental health implemented in schools and aimed at early adolescents have the potential to promote the formation of healthy habits, which may lead to improved well-being over both short and long terms.

Temporal trends of carbonated soft-drink consumption among adolescents aged 12-15 years from eighteen countries in Africa, Asia and the Americas.

Carbonated soft-drink consumption is detrimental to multiple facets of adolescent health. However, little is known about temporal trends in carbonated soft-drink consumption among adolescents, particularly in non-Western countries. Therefore, we aimed to examine this trend in representative samples of school-going adolescents from eighteen countries in Africa, Asia and the Americas. Cross-sectional data from the Global School-based Student Health Survey 2009-2017 were analysed. Carbonated soft-drink consumption referred to drinking carbonated soft-drinks at least once per day in the past 30 d. The prevalence of carbonated soft-drink consumption was calculated for each survey, and crude linear trends were assessed by linear regression models. Data on 74055 students aged 12-15 years were analysed (mean age 13·9 (sd 1·0) years; 49·2 % boys). The overall mean prevalence of carbonated soft-drink consumption was 42·1 %. Of the eighteen countries included in the study, significant decreasing, increasing and stable trends of carbonated soft-drink consumption were observed in seven, two and nine countries, respectively. The most drastic decrease was observed in Kuwait between 2011 (74·4 %) and 2015 (51·7 %). Even in countries with significant decreasing trends, the decrease was rather modest, while some countries with stable trends had very high prevalence across time (e.g. Suriname 80·5 % in 2009 and 79·4 % in 2016). The prevalence of carbonated soft-drink consumption was high in all countries included in the present analysis, despite decreasing trends being observed in some. Public health initiatives to reduce the consumption of carbonated soft-drink consumption among adolescents are urgently required.

Intentional injury in Vietnam: Prevalence and contributing circumstances of suicidal ideation among ethnic boarding school graduates

The objective of this study was to investigate the prevalence of suicidal ideation and associated circumstances among students in ethnic boarding schools. The research employed a self-administered structured questionnaire adapted from the Vietnamese version of the World Health Organization (WHO) Global School-based Student Health Survey (GSHS) to assess the responses of 164 boarding school students. The results revealed that 12.2% of the students reported experiencing suicidal ideation within the last 12 months, with no discernible gender differences. Utilizing chi-square and logistic regression analyses, the study identified significant associations between suicidal ideation and factors such as a lack of parental understanding, insufficient peer support, and mental health challenges among students. The findings underscore the potential mitigating role of school social workers in addressing these risk factors and enhancing students' adjustment to the boarding school environment. The paper recommends the development of suicide prevention programs tailored to the specific needs of ethnic boarding school students. The research methodology involved the use of questionnaires in sociological surveys and employed SPSS tools for analysis. Furthermore, the study employs analytical, synthetic, historical, logical, statistical, and comparative methods to present its findings.

Marijuana use and its correlates among school-going Jamaican adolescents: a finding from a national survey.

The recent data indicate almost a fifth of Jamaican adolescents used marijuana in the past 30 days. To ensure the optimal allocation of resources, a country-specific understanding of factors associated with marijuana use among adolescents is essential. Therefore, this study aimed to address this gap among adolescents aged 13-17 years in Jamaica. We analyzed data from the recent Jamaica Global School-Based Student Health Survey conducted in 2017. The sample consists of school-going Jamaican adolescents of 7th-12th grades. The prevalence of recent marijuana use was assessed and compared across different demographics, substance use, and risk behaviors using bivariate and multivariable logistic regression analyses. Older adolescents and men had a higher likelihood of recent marijuana use. Psychosocial risks, such as loneliness, frequent worry, suicidal ideation, physical attacks, and school absenteeism, were associated with higher marijuana usage. Parental smoking increased the odds, whereas strong parental support and awareness decreased it. Other substance uses, especially amphetamine and tobacco products, had strong associations with marijuana use. Early initiation of substances was associated with a higher risk of marijuana use. Sexually active adolescents, especially those initiated before the age of 14 years, had higher rates of marijuana use. The intricate link between harmful and supportive psychosomatic and risk behaviors with recent marijuana use highlights the importance of holistic interventions and policies focusing on emotional health, parental guidance, substance education, and sexual activity implications.

Global Physical Activity, Active Commuting to School, and Sedentary Behavior Among Latin American Adolescents: Global School-Based Student Health Survey and the National School Health Survey.

This study aimed to compare the overall prevalence, stratified by sex and age group of global physical activity (GPA), active commuting to school (ACS), and sedentary behavior (SB) among adolescents from ten Latin American countries, and to assess the correlation of Development Index with the indicators. This research is grounded on data from the Global School-Based Student Health Survey (2009-2015) and the 2015 Brazilian National School Health Survey. The prevalence and 95% confidence intervals for GPA (≥5d/wk), ACS (≥1d/wk), and SB (>2h/d) were calculated using the chi-square test to compare the sexes (male; female) and age group (≤13y; 14y; 15y; ≥16y). We also performed Pearson correlation analysis with the Human Development Index. The prevalence of indicators ranged from 16.1% to 28.2% for GPA, from 56.7% to 71.2% for ACS, and from 20.7% to 62.6% for SB. Boys generally had a higher prevalence of GPA and ACS, and girls had a higher prevalence of SB. The prevalence of the indicators by age group varied between countries, with significant differences observed in some, depending on each indicator. A positive correlation was observed between Human Development Index, GPA, and SB. Health promotion policies must include guidelines that encourage and promote a more active and less sedentary lifestyle among young people in Latin America, considering specific groups, the local socioeconomic context, and differences between countries.

Prevalence and correlates of unintentional nonfatal injuries among school-going adolescents in Central America.

The aim of this study is to report on the frequency of serious physical injuries (SPI) among adolescents in Central America during the previous decade, 2009-2018. In total, 15,807 school adolescents (14.4 years mean age; SD=1.4) from six Central American countries participated in cross-sectional Global School-based Student Health Surveys in 2009-2018 (ranging from 1,779 students in Honduras in 2012 to 4,374 students in Guatemala in 2015). The prevalence of SPI was 33.8 % (22.9 % once, 7.4 % 2 or 3 times and 3.6 % 4 or more times), ranging from 31.8 % in Guatemala to 45.0 % in Belize and 45.6 % in Panama. The most frequent causes of SPI included fall (11.4 %, ranging from 6.9 % in Costa Rica to 15.6 % in Panama), and the type of SPI was fracture/dislocation (5.7 %, ranging from 4.3 % in Costa Rica to 6.7 % in Panama). In adjusted Poisson regression, male sex,food insecurity, a history of alcohol intoxication, soft drink consumption, fast food intake, truancy, multiple sexual partners, psychological distress, physical fight, physically attacked, bullied, and suicide attempt were significantly associated with a higher number of injury event counts. Overall, about one in three adolescents in Central America had sustained unintentional injuries in the past 12months and several contributing factors were identified which if addressed could aid injury prevention among adolescents.

Food Insecurity, Adolescent Suicidal Thoughts and Behaviors, and Country-Level Context: A Multi-Country Cross-Sectional Analysis

PurposePreventing adolescent suicide is a global priority. Inequalities in adolescent suicide and attempt rates are reported across countries, including a greater risk in adolescents experiencing food insecurity. Little is known about the extent to which country-level contextual factors moderate the magnitude of socio–economic inequalities in suicidal thoughts and behavior. We aimed to examine the cross-country variability and national moderators of the association between food insecurity and suicidal thoughts and behavior in school-attending adolescents. MethodsWe analysed data on 309,340 school-attending adolescents from 83 countries that participated in the Global School-based Student Health Survey between 2003 and 2018. We used Poisson regression to identify whether suicidal thoughts and behavior were more prevalent in adolescents experiencing food insecurity compared to food-secure adolescents. Meta-regression and mixed-effects regression were used to determine whether country-level indicators moderated the magnitude of inequality. ResultsSuicidal ideation, suicide planning, and suicide attempts were more prevalent in food-insecure adolescents compared to food-secure adolescents in 72%, 78%, and 90% of countries respectively; however, the magnitude of these associations varied between countries. We observed wider inequalities in countries with greater levels of national wealth and universal health coverage and lower prevalence of adolescent food insecurity. Economic inequality had no moderating role. DiscussionFood insecurity could contribute to the development of adolescent suicidal thoughts and behavior, and this association is likely to be moderated by country-level context. Food insecurity may be a modifiable target to help prevent adolescent suicide, especially in countries where food insecurity is less common.

Global Trends in the Prevalence of Alcohol Consumption Among School-Going Adolescents Aged 12–15 Years

PurposeAdolescent alcohol consumption is detrimental to multiple facets of health. However, there is a scarcity of data available on time trends in adolescents' alcohol consumption particularly from non-Western countries and low- and middle-income countries. Thus, we examined the temporal trend of alcohol use in a large representative sample of school-going adolescents aged 12–15 years from 22 countries in Africa, Asia, and the Americas. MethodsData from the Global School-based Student Health Survey were analyzed. Alcohol consumption referred to consuming alcohol on at least one day in the past 30 days. Crude linear trends of past 30-day alcohol consumption by country were assessed by linear regression models. ResultsData on 135,426 adolescents aged 12–15 years were analyzed [mean (standard deviation) age 13.8 (1.0) years; 52.0% females]. The overall mean prevalence of past 30-day alcohol consumption was 14.1%. Of the 22 countries included in the study, increasing, decreasing, and stable trends were observed in 3, 8, and 11 countries, respectively. Specifically, significant increases were observed in Benin between 2009 (16.1%) and 2016 (38.6%), Myanmar between 2007 (0.9%) and 2016 (3.6%), and Vanuatu between 2011 (7.6%) and 2016 (12.2%). The most drastic decrease was observed in Samoa between 2011 (34.5%) and 2017 (9.8%), but the rate of decrease was modest in most countries. DiscussionAmong school-going adolescents, decreasing trends in alcohol consumption were more common than increasing trends, but the rate of decrease was limited in most countries, suggesting that more global action is required to curb adolescent alcohol consumption.

Prevalence and factors associated with serious injuries and aggressive behaviours among in-school adolescents in Panama.

Injuries during adolescence cause lifelong harm and death. Our study used a nationally representative sample to examine the prevalence and risk factors associated with serious injuries among in-school adolescents in Panama. We analysed Panama's 2018 Global School-Based Student Health Survey data using SPSS. Percentages were used to summarise the results of the prevalence of serious injuries. Binomial logistic regression analysis was performed to examine the risk factors of serious injuries. The results were presented as an adjusted odds ratio (AOR) at a 95% confidence interval (CI). The prevalence of serious injury among in-school adolescents in Panama is 45%. Furthermore, the study found that males (AOR= 1.495, CI=1.272--1.756), truancy (AOR=1.493, CI=1.249--1.785), overweight (AOR= 1.246, 95% CI=11.057--1.469), drinking alcohol (AOR= 1.397, CI=1.151--1.695), experiencing physical attack (AOR= 2.100, CI=11.646--2.681), engaging in a physical fight (AOR=1.586, CI=1.289--1.952) and bullied outside school (AOR=1.276, CI=1.005--1.621) significantly predict serious injuries among adolescents in Panama. Multidisciplinary approaches targeting the correlates observed will help reduce the high prevalence of serious injuries among in-school adolescents in Panama.

Association of dietary behaviour and depression among adolescents in Malaysia: a cross-sectional study

BackgroundDepression is on the rise and has become a significant concern for public health. Limited research has explored the connection between dietary patterns and depression. This investigation aimed to examine how dietary behaviours relate to depression among adolescents attending school in Malaysia.MethodsThe study utilized data from the National School-Based Health Survey 2022, a nationwide survey involving school-going adolescents aged 13–17, with a total of 33,523 participants from 239 schools. To assess depression, the study employed the Patient Health Questionnaire (PHQ-9), considering a score of 10 or higher as indicative of depression. Dietary behaviours were assessed using a validated self-administered questionnaire adapted from the World Health Organization's Global School-based Student Health Survey. Descriptive analysis and complex sample logistic regression were carried out using SPSS version 26.0.ResultsThe study revealed a 26.9% overall prevalence of depression, with higher risks among female adolescents (AOR 2.71, 95% CI 2.51, 2.92) and those in higher grades. Malays (AOR 1.71, 95% CI 1.41, 2.07), Other Bumiputeras (AOR 1.69, 95% CI 1.32, 2.17), and Others (AOR 1.63, 95% CI 1.16, 2.30) had elevated odds of depression compared to Indians. Healthy dietary habits, like consuming less than two servings of fruits daily, correlated with depression (AOR 1.44 95% CI 1.35, 1.54). Additionally, unhealthy dietary behaviours such as fast food consumption (AOR 1.73 [95% CI 1.55, 1.93]) and carbonated soft drink intake (AOR 1.59 [95% CI 1.48, 1.70]) were positively associated with depression.ConclusionsOne out of every four Malaysian adolescents was identified to experience depression. Depression was linked to several factors, such as being female, belonging to higher grade levels, identifying as Malays, Other Bumiputeras, or belonging to other ethnicities, and participating in the consumption of fast food, carbonated soft drinks, and fruits. To address these observations, it is crucial to formulate effective public health programmes that prioritize adolescent mental health and encourage the adoption of healthy eating habits.

Associations of Parents-Adolescent Relationship with Adolescent Sexual Risk Behaviors: A Global Analysis Based on 156,649 School-Going Adolescents from 50 Countries

Our study, examining the Global School-Based Student Health Survey data from 50 countries across four WHO regions, found boys have higher sexual exposure (33.5 vs 17.7%) and risk behaviors – early sexual initiation (55.0 vs. 40.1%), multiple partners (45.2 vs. 26.2%), and condom nonuse (29.2 vs. 26.8%) – than girls. We found that adolescents with parents who understood their problems, monitored academic and leisure-time activities, and respected privacy were less likely to be engaged in sexual activities and risk behaviors. This study highlights the importance of parental involvement and advocates for gender-specific, family-focused interventions to mitigate adolescent sexual risks.

The prevalence of suicidal behaviour and its associated risk factors among school-going adolescents resident in the United Arab Emirates

Suicidal behaviour which includes suicidal ideation, having a plan to commit suicide and suicide attempts remains a global public health issue as it substantially impacts adolescent health and wellbeing. Suicidal behaviour, however, remains understudied in Middle Eastern contexts. This study analysed data from the 2016 Global School-based Student Health Survey collected in the United Arab Emirates (UAE). A sample of 5826 adolescents aged between 11 and 18 years were sampled. Potential risk factors associated with an elevated risk for engagement in suicidal behaviour were examined. These factors were stratified into categories for analysis (demographics, psychosocial, risky health, and socio-environmental). The age-adjusted prevalence of suicidal behaviour amongst the school-going adolescent population in the UAE was 54%. Analyses indicated that elevated risk was significantly associated with anxiety difficulties, the experience of loneliness, and amongst those who smoked tobacco. None of the socio-environmental factors emerged as significant. A dose-dependent relationship was evident in that the degree of risk that was evident appeared to compound as the number of adverse risk factors increased. The data suggest that suicidal behaviour may be highly prevalent in this location. Findings highlight the immense need to develop preventative interventions, some of which may be school-delivered and targeted at parents. Our findings provide initial indications as to which risk factors could be targeted for remediation in developing these interventions.

Global time trends of perceived loneliness among adolescents from 28 countries in Africa, Asia, and the Americas

BackgroundPerceived loneliness in adolescence is associated with a plethora of adverse outcomes. However, data on its temporal trends are scarce. Therefore, we aimed to examine the temporal trend of perceived loneliness among school-going adolescents aged 12–15 years from 28 countries in Africa, Asia, and the Americas, where temporal trends of loneliness are largely unknown. MethodsCross-sectional data from the Global School-based Student Health Survey 2003–2017 were analyzed. Perceived loneliness referred to feeling lonely most of the time or always in the past 12 months. Crude linear trends of perceived loneliness by country were assessed by linear regression models. ResultsData on 180,087 adolescents aged 12–15 years were analyzed [Mean (SD) age 13.7 (1.0) years; 51.4 % females]. The overall prevalence of perceived loneliness was 10.7 %. Among the 28 countries included in the study, significant increasing and decreasing trends were observed in six counties each, with stable trends found in 16 countries. The most drastic increase and decrease were observed in Egypt between 2006 (7.9 %) and 2011 (14.3 %), and in Samoa between 2011 (23.3 %) and 2017 (8.0 %), respectively. Stable trends with high prevalence across time were also common. ConclusionOur data suggest that perceived loneliness among adolescents is a global phenomenon, which has seen little improvement if any in recent years. It would be prudent to implement nationwide policies to combat loneliness globally.