Global School-based Student Health Survey Research Articles

Association between meal frequency with anthropometric measures and blood pressure in Iranian children and adolescents

This study aimed to assess the association of meal frequency with anthropometric measures and blood pressure in Iranian children and adolescents. In this national survey, 14,880 students with 6-18 years of age were selected by stratified multistage sampling method from urban and rural regions of 30 provinces of Iran. Meal frequency was assessed by a questionnaire prepared based on global school-based student health survey. Physical measurements included height, weight, waist circumference, systolic blood pressure (SBP), and diastolic blood pressure (DBP). The participation rate was 90.6% including 49.24% girls and 75.5% urban residents. Skipping breakfast and dinner were more frequent in girls than in boys (71.6% vs. 64.1%, 91.2% vs. 86.9%, respectively, P<0.05). Overweight, obesity, and abdominal obesity were more prevalent in those who had two meals, one meal, or very low intake (P<0.001) than those had three meals. There were no significant differences in SBP, DBP, and blood pressure across to different meal frequency groups (P>0.05). Students who had very low intake and one meal per week had a higher risk of abdominal obesity compared with those who had three meals (OR 1.7, 95% CI: 1.3-2.3, and OR 1.6, 95% CI: 1.4-2.0, respectively). An inverse significant association between higher meal frequency and anthropometric indices was observed. Therefore, encouraging children and adolescents for regular meal intake should be considered as a health priority in the pediatric population.

Examining mediators of associations of food insecurity and being bullied with suicide among in-school adolescents in Eswatini: a cross-sectional study

We examined the potential mediating roles of anxiety and loneliness on the association of concurrent food insecurity (FI) and being bullied (BB) with suicidal behavior (SB) in Eswatini, a lower-middle-income country. We used data from the Global School-based Student Health Survey (GSHS; N = 3264), which employed a two-stage cluster sampling: first, 25 schools were selected based on the proportionate probability of enrollment; second, classes were randomly selected. A self-reported 84-item GSHS questionnaire was used to collect data for students aged 13–17 years. FI was measured by requesting students to recall how often they went hungry because of a lack of food at home in the 30 days before the study. Multiple logistic regressions and binary mediation function was applied to examine mediating factors of SB. The prevalence of SB, FI, and BB among adolescents was 27.5%, 7.7%, and 30.2%, respectively. Moreover, the relationship between FI and BB with SB was partly (approximately 24%) mediated by anxiety and loneliness. Our results highlight the mediating roles of anxiety and loneliness in suicidal adolescents who experience FI and BB. In conclusion, interventions for alleviating SB in high-risk adolescents experiencing FI and BB should also be aimed at ameliorating anxiety and loneliness.

Prevalence and Determinants of Depressive Symptoms among Young Adolescents in Malaysia: A Cross-Sectional Study.

Depression is the most common mental health problem affecting adolescents globally, wherein its increasing prevalence together with the negative health impacts escalates the need for further research in this area. This work determined the prevalence and factors associated with depressive symptoms among young adolescents in Malaysia. A total of 1350 adolescent aged 13 to 14 years in school across nine secondary schools in Selangor state, Malaysia participated in a cross-sectional study. Independent variables were examined using the using the Global School-Based Student Health Survey included age, gender, ethnicity, alcohol intake, smoking and illicit drug use, loneliness, bullying, parental marital status, income and supervision; and the Health Literacy and Stigma questionnaire examined mental health literacy levels. Depressive symptoms were the dependent variable which was examined using the Center for Epidemiology Study Depression (CESD) instrument. Prevalence of depressive symptoms among all participants was 19 % (95% CI [16.9, 21.2]), with a higher prevalence of depressive symptoms being reported among females 26.3% (95% CI [23.0, 29.8]) compared to males 11.7% (95% CI [9.4, 14.4]). Determinants namely females (AOR = 3.83; 95% CI [2.66, 5.52]), smoking (AOR = 6.16; 95% CI [3.15, 12.05]), been bullied (AOR = 3.70; 95% CI [2.51, 5.47]), felt lonely (AOR = 10.46; 95% CI [7.09, 15.42]) and having no parental supervision (AOR = 1.79; 95% CI [1.26, 2.53]) significantly increased the odds of depressive symptoms among all adolescents in the multivariate model. In addition, feeling lonely, being bullied and smoking were identified as common significant determinants of depressive symptoms across both genders. Feeling lonely (65% to 71%) and being bullied (10% to 19%) were ranked as the most important determinants of depressive symptoms among young adolescents. Tackling these factors would be instrumental in helping decision makers formulate depression prevention strategies and activities for adolescents.

Social indicators with serious injury and school bullying victimization in vulnerable adolescents aged 12–15 years: Data from the Global School-Based Student Survey

ObjectiveThe prevalence rates of injury and bullying victimization in adolescents are continuing to rise; however, little is known about the influence of social determinants, especially for vulnerable adolescents. We aimed to estimate the prevalence of serious injury and bullying victimization in vulnerable adolescents with mental health issues or poor social support and examine the associations between social indicators and these two outcomes. MethodWe used the most recent datasets from the Global School-based Student Health Survey, and vulnerable adolescents aged 12–15 years from 54 countries were included. The pooled overall and regional estimates were obtained by random-effects models. Multivariable logistic regression was performed to estimate the adjusted association between five common social indicators and the two outcomes. Dose-response association was estimated by using a restricted cubic spline. ResultsThe prevalence rates of serious injury and bullying victimization were high in vulnerable adolescents, with apparent variation between regions and countries. The pooled prevalence of serious injury ranged from 45.10 % to 50.11 %, whereas the pooled prevalence of bullying victimization ranged from 35.54 % to 45.21 %. Social indicators of national wealth, health status, income and gender inequality were significantly associated with the prevalence of serious injury and bullying victimization in vulnerable adolescents. ConclusionsSerious injury and school bullying victimization are prevalent in vulnerable adolescents aged 12–15 years. Social indicators were prominent associated factors of serious injury and bullying victimization in vulnerable adolescents. The results emphasize the importance of social environment when developing intervention measures to address injury and bullying among disadvantaged teenagers.

Active school commuting in adolescents from 28 countries across Africa, the Americas, and Asia: a temporal trends study

BackgroundEvidence examining trends in active school commuting among adolescents are mainly single-country studies, and principally focused on high-income countries. Thus, the present study aims to examine temporal trends in adolescents’ active school commuting and to examine if there are differences in such trends by sex. We used nationally representative samples of 28 countries, which were predominantly low- and middle-income countries (LMICs), covering 5 different WHO regions.MethodsData from the Global School-based Student Health Survey 2004–2017 were analyzed in 177,616 adolescents [mean (SD) age: 13.7 (1.0) years; 50.7% girls]. Active school commuting was self-reported (frequency of walking or riding a bike to and from school in the past 7 days). The prevalence and 95%CI of active school commuting (i.e., ≥ 3 days/week) was calculated for the overall sample and by sex for each survey. Crude linear trends in active school commuting were assessed by linear regression models. Interaction analyses were conducted to examine differing trends among boys and girls.ResultsTrends in active school commuting were heterogeneous across countries, with results showing stable patterns for the majority (16/28), decreasing trends for some (7/28) and increasing trends over time for a few (5/28). The majority of countries showed no differences in active school commuting trends between girls and boys.ConclusionsThe quantification of changes in adolescents’ active school commuting over time, together with a deeper understanding of local determinants for such behaviors will provide valuable evidence to inform the development of tailored and context-specific actions.

Global School-Based Student Health Survey 2016-Bahrain: Mental health

Background: The Global school-based student health survey (GSHS) was developed to help countries measure and assess students' health behaviors and protective factors. This report discusses results from the first GSHS carried out in Bahrain during 2015-2016 by the Ministry of Education in collaboration with World Health Organization (WHO) and Centers for Disease Control and Prevention (CDC). Methods: The GSHS includes students aged 13-17 years and employed a two-stage sample design involving a school and class level. 64 public and private schools were sampled out of 162 schools, and 320 classes of students in grades 7-11 were selected. Students completed a questionnaire addressing mental health, protective factors, sexual behaviors, violence, and unintentional injury. Results: 7,143 (89%) of the 8,068 sampled students completed the questionnaire. Of the students who responded, 3,685 (51.1%) were males, and 5,843 (84.5%) were between the ages of 13 to 17 years old. 27.2% of students were physically attacked, 41.4% were in a physical fight, and 28.6% were bullied one or more times during the past 12 months. 38.1% of the students never or rarely wore a seatbelt when in a car, and 30.7% never or rarely wore a helmet when riding a bicycle. 16.2% of students felt lonely most of the time or always, and 15.2% seriously considered attempting suicide during the past 12 months. Conclusion: The study reported rates of violence, physical fights, bullying, and unsafe practices among school-Age children. Raising awareness regarding mental health and emotional well-being, assessment and support among school children is vital. Keywords: Bahrain, Mental health, School, School health, WHO

Study of Selected Noncommunicable Disease Risk Factors Among Adolescents in A Rural Area of Karnataka

Background and Aim Non-communicable diseases NCD in recent times have attained a magnitude of epidemic proportions with an increasing number of adolescents being reported as obese. Noncommunicable diseases can cause mortality due to excessive smoking absence of physical activity habituation to alcohol and diet which is unhealthy. The earlier knowledge of the occurrence of these diseases among well-to-do urban groups is now changed with the increasing evidence of the occurrence of these non-communicable diseases in people living in rural areas. Hence this study aims at determining the prevalence of certain selected non-communicable risk factors which are lifestyle related such as undernutrition and overnutrition unhealthy eating habits consumption of alcohol and tobacco use and inadequate physical activity among adolescents in the rural area of Karnataka.Methods This community-based cross-sectional study collected information from 516 adolescents aged 10-19 years in the school or house-to-house survey. Anthropometric measurements were done. Validated questionnaires i.e. nutrition questionnaire for adolescents Source Bright Future nutrition and a Global school-based student health survey were used to collect the data. Results Among the 516 adolescents 339 66 were in schooling and 175 33.6 were attending college. Physical inactivity among 139 27 was observed which is alarming in rural areas. About 139 29.1 adolescents were underweight which is also a risk factor for some non-communicable diseases. The proportion of underweight adolescents consuming alcohol and not consuming adequate vegetablesfruits is significant.Conclusion The risk factors identified will help policymakers develop health promotion policies and programs directed toward adolescents to address the growing tide of non-communicable diseases.nbsp

Prevalence and correlates of physical fighting among adolescents in Paraguay: Findings from the 2017 national school-based health survey.

Interpersonal violence among adolescents is a serious public health issue across the globe and has been one of the leading causes of death among Paraguayan adolescents. This study aims to investigate the prevalence of physical fighting among adolescents in Paraguay in order to identify problematic fighting behaviour. We also aim to examine the correlates of physical fighting and the extent to which previously identified factors correlate with physical fighting. We used the Paraguay 2017 Global School-based Student Health Survey (GSHS). This survey collects health-related information on school-attending adolescents aged 13-17 years. We defined physical fighting as having participated in at least two physical fights in the previous 12 months. We chose 16 independent variables: 12 individual-level variables and four social-level variables. Multivariable logistic regression models were developed to identify factors associated with physical fighting. One of the limitations of this study is that it only captured the responses of the students who attended school on the day of the survey. A total of 3,149 students completed the survey questionnaire, with the response rates for the school, student, and total response being 100%, 87%, and 87%, respectively. In 2017, 8% of the survey participants (11.4% of the males, and 4.7% of the females) had been involved in two or more physical fights during the past 12 months. In the multivariable model, having been physically attacked, male gender, physical activity, alcohol use, early sexual debut, and suicide planning were significantly associated with involvement in physical fighting. Having helpful peers and supportive parents was not statistically significant in the model adjusted for all variables. Although Paraguay shows relatively lower prevalence of physical fighting than other countries, the high association between physical fighting and having been physically attacked is noteworthy. Considering the serious interpersonal violence among Paraguayan adolescents, preventive attributes should be considered, and further assessment of other types of interpersonal violence should be made.

Sexual risk behaviour among school-going adolescents in Sierra Leone and Liberia: a secondary analysis of the 2017 Global school-based student health surveys

BackgroundSierra Leone and Liberia have experienced civil wars and, recently, Ebola outbreaks that led to profound economic hardship, psychopathologies and family disruptions. These factors are associated with sexual risk behaviours among youths. However, there is very little information on sexual risk behaviour among Sierra Leonean and Liberian school-going adolescents. The present study assessed the prevalence and determinants of sexual risk behaviours among school-going adolescents (10–19 years) in Sierra Leone and Liberia. MethodWe used publicly available nationally representative cross-sectional datasets of the 2017 Sierra Leone and Liberia Global school health survey. The sample consisted of 2798 and 2744 school-going adolescents from Sierra Leone and Liberia, respectively. Complex sample descriptive and regression analysis was used to analyse our data.ResultsThe majority of adolescents in the two countries were involved in multiple sexual risk behaviour (80.2%), with a higher prevalence observed in Sierra Leone (85.2%) than in Liberia (75.3%). Liberian adolescents showed lesser odds of indulging in multiple sexual risk behaviours than their Sierra Leonean counterparts (AOR = 0.572; 95%CI: 0.345–0.946). Male, compared to females, were more likely to engage in multiple sexual risk behaviour (AOR = 2.310;95%CI:1.543–3.458), with a similar pattern observed in both countries. Alcohol use was associated with multiple sexual risk behaviour (AOR = 3.064; 95%CI: 2.137–4.392). Also, in Sierra Leone and Liberia, adolescents with one and two or more forms of psychological distress were more likely to have ever had sex than those who did not show any form of psychological distress. Missing class/school was associated with multiple sexual risk behaviour (AOR = 1.655; 95%CI:1.133–2.418). Peer support was only found to be a protective factor against no condom use among Liberian adolescents (AOR = 0.608; 95%CI: 0.435–0.850). Less parental support was only associated with ever had sex among adolescents in Sierra Leone (AOR = 2.027; 95%CI: 1.322–3.107) but not in Liberia (AOR = 1.034; 95%CI: 0.650–1.644).ConclusionOur study found a high sexual risk behaviour among school-going adolescents in Sierra Leone and Liberia. Our finding highlights the need to strengthen sexual and reproductive health education in schools and communities that incorporate mental health promotion activities tailored to this group.

The use of condoms and other birth control methods among sexually active school-going adolescents in nine sub-Saharan African countries

BackgroundAdolescents in sub-Saharan Africa still face sexual and reproductive health challenges. Contraceptives have been used to address these challenges. Despite efforts at national and global levels, contraceptive uptake among young people in Africa remains a challenge due to personal, societal, and health systems-based barriers. We estimated the prevalence and correlates of condom use and other birth control methods among sexually active school-going adolescents in nine sub-Saharan African (SSA) countries.MethodsWe conducted a secondary analysis of the Global School-based Student Health Surveys (GSHS) datasets pooled from nine SSA countries. We included a sample of 27,504 school-going adolescents 11 years and younger and 18 years and older. We employed meta-analysis using a random-effects model to estimate the total prevalence of the use of condoms, other birth control methods other than a condom and any birth control method at last sexual intercourse. We conducted complex sample descriptive and logistic regression analyses to determine the characteristics and determinants of not using condoms and other birth control methods among sexually active school-going adolescents in nine sub-Saharan African countries, respectively.ResultsMore than half [n = 4430, 53.8% (43.9–63.8)], two-fifth [n = 3242, 39.5% (33.2–45.9) and two-thirds of adolescents [n = 4838, 65.6% (57.5–73.7)] of sexually active in school adolescents across the nine sub-Saharan African countries used condom, other birth control methods and any form birth control method during their last sexual intercourse, respectively. The non-use of condoms at last sex was associated with being younger (less than 16 years) [AOR = 1.48;95%CI: 1.12–1.94], early sexual debut [AOR = 1.81(1.47–2.22)], having two or more sexual partners [AOR = 1.30(1.06–1.58)] and no/minimal parental support [AOR = 1.54(1.17–2.03)]. The non-use of other birth control methods at last sex was associated with being male [AOR = 1.37 (1.09–1.73)], early sexual debut [AOR = 1.83(1.48–2.27) and having no parental support [AOR = 1.64(1.34–2.00)].ConclusionContraceptive need among sexually active school adolescents in the nine sub-Saharan African countries is high. Such a need calls for the development of country-specific and or the review of existing school-based sexual health education and youth-friendly sexual and reproductive health interventions that target risky adolescents and promote adolescent-parent effective communication, connectedness and support.

Suicidal behaviours (ideation, plan and attempt) among school-going adolescents: A study of prevalence, predisposing, and protective factors in Saint Vincent and the Grenadines.

Suicide occurs throughout life and is among the leading causes of death among adolescents globally. Aside from the growing literature on this serious mental health issue, little is known about the prevalence of suicide and the variables that predispose and protect adolescents against it in Saint Vincent and the Grenadines. We analysed the Global School-based Student Health Survey data collection among school-going adolescents in Saint Vincent and the Grenadines to explore the prevalence, risk and protective variables associated with suicidal behaviours. We observed prevalence rates of 26%, 26%, and 19% for suicide ideation, plan, and attempt, respectively. Furthermore, sex (being male) and having parents or guardians who understand the problems and worries of adolescents served as protective factors against all three suicide behaviours. However, we observed truancy, cigarette smoking, bullying victims (on/off school property), being cyberbullied, loneliness, and worry as risk factors for suicide ideation among adolescents. Risk for suicide plan was predicted by truancy, cigarette smoking, physical fight, bullying victims (on/off school property), being cyberbullied, loneliness, and worry. After controlling for other factors, truancy, amphetamine or methamphetamine use, cigarette smoking, physical fight, bullying victims (on/off school property), serious injury, close friends, loneliness, and worrying about life issues predicted suicide attempt risk among adolescents in Saint Vincent and the Grenadines. Early identification and suicide prevention interventions focusing on identified protective and risk factors may help minimise the prevalence of suicide behaviours among school-going adolescents in Saint Vincent and the Grenadines.

Anxiety and school absenteeism without permission among adolescents in 69 low- and middle-income countries.

Anxiety disorders are common among adolescents. In high-income countries, anxiety is a known contributor to truancy and school refusal, but this association has been understudied in low- and middle-income countries (LMICs). We used complex samples analysis to examine the association between self-reported worry-induced insomnia (an indicator of anxiety) and unauthorized school absenteeism among 268,142 adolescents from 69 LMICs that participated in the Global School-based Student Health Survey (GSHS). The median proportion of students who reported experiencing symptoms of anxiety most or all of the time during the previous year was 11.4% (range: 3.6%-28.2%); in 44 of the 69 countries, girls had a significantly higher prevalence of anxiety than boys. The percentage of students reporting school absence without permission during the past month was 30.2% (range: 14.7%-56.0%); in 40 countries, boys were significantly more likely than girls to report that they had missed school without permission. In 53 countries, adolescents who reported frequent anxiety were significantly more likely to miss school than adolescents reporting infrequent anxiety; in most of those countries, the association was significant for both girls and boys. School-based interventions that help children and adolescents learn how to manage stress and refer students with symptoms of psychiatric disorders to healthcare services that can provide formal diagnosis and clinical treatment may be useful for improving both mental health and school attendance, thus contributing to achievement of Sustainable Development Goals related to both health (SDG 3.4) and education (SDG 4.1).

Factors associated with single and multiple suicide attempts in adolescent school children in Morocco: A national cross-sectional survey

The study aimed to assess factors associated with multiple suicide attempts (MSA) in adolescents with a history of suicide attempts in Morocco. National cross-sectional data from the Global School-Based Student Health Survey (GSHS) in Morocco in 2016 were analysed. Students who reported to have a history of past 12-month suicide attempts were included in the final sample (n = 931). In multiple logistic regression, students with MSA were compared with students with a single suicide attempt (SSA). Results indicated that among the subsample of school adolescents (median age = 15 years), 55.8% had attempted suicide once, and 44.2% multiple times in the past 12 months. Compared to students who attempted suicide once, students with MSA more often had anxiety-induced sleep disturbance and were more frequently bullied. Compared to participants without psychosocial distress, students with three or more psychosocial distress factors had higher odds of MSA. Further, compared to students without health risk behaviours, students with three or more health risk behaviours had a higher odd of MSA. Psychosocial distress (anxiety-induced sleep disturbance and frequently being bullied) and multiple health risk behaviours increased the odds of MSA, suggesting the potential relevance of these variables in identifying multiple suicide attempters among adolescents in Morocco.

Data Resource Profile: The Global School-based Student Health Survey-behavioural risk and protective factors among adolescents.

Data Resource Profile: The Global School-based Student Health Survey-behavioural risk and protective factors among adolescents.

Gender differences in social environmental factors of psychological distress among Indonesian adolescents: Findings from the 2015 Global School-based Student Health Survey.

This study aimed to investigate gender differences in social environmental factors of psychological distress among Indonesian adolescents. This was a cross-sectional study using the data from the 2015 Indonesia Global School-based Student Health Survey. Binary logistic regression was used to assess the influences of main independent variables - social environmental factors (i.e., peer support, having close friends, bullying victimisation, physical fight, physical attack, parental supervision, connectedness, bonding), demographic characteristics, and health-related behaviours on the measures of psychological distress (loneliness, anxiety-induced sleep disturbance, and a combination of both measures as psychological distress). The prevalence of psychological distress measured as loneliness, anxiety-induced sleep disturbance, and combined psychological distress was 6.12%, 4.52%, and 8.04%, respectively. Findings from multivariate analyses indicated that bullying victimisation, physical attack, experience of hunger (a proxy of socioeconomic status), and sedentary behaviour were associated with all measures of psychological distress. Meanwhile, age, gender, drug use, parental connectedness and bonding, and having no close friends were correlates of one or two measures of psychological distress. Based on gender-stratified analyses, experience of hunger, sedentary behaviour, bullying victimisation, and having no close friends were consistently associated with measures of psychological distress among both girls and boys. In addition, the influence of some social environmental factors, such as parental connectedness, peer support, and physical attack, were more salient among girls. The findings suggest that social environmental factors, demographic characteristics, and health-related behaviours were associated with psychological distress, and the associations appeared to differ by gender. Interventions that include improving positive social environmental factors (e.g., reducing interpersonal violence, encouraging positive relationships with parents and peers) and promoting healthy behaviours (e.g., less sedentary behaviour, preventing substance use) might help reduce the risk of psychological distress among Indonesian adolescents.

Epidemiology of suicidal behaviors among junior and senior high school adolescents: Exploring the interactions between bullying victimization, substance use, and physical inactivity

Suicide is a pandemic among global youths and adolescents. Still, there is insufficient evidence to show whether the interactions between bullying victimization, physical inactivity, substance use, and mental health illness aggravate suicidal behaviors among high school students. Based on the Global School-Based Student Health Survey, we analyzed the individual and interaction impacts of bullying victimization, physical inactivity, substance use, and suicidal behaviors among 3,632 adolescents. The 12-month prevalence of suicidal thoughts and plans among senior high school students was over fifty percent. Junior high school students had higher rates of suicide attempts and bullying victimization than senior high school students. Multivariate results indicate that bullying victimization, substance use, and physical inactivity were significantly associated with suicidal thoughts, plans, and attempts among high school students. The interaction of physical inactivity and alcohol was significantly associated with suicidal thoughts in junior high school. In contrast, the interaction of bullying and alcohol was associated with suicidal plans among senior high school adolescents. We hope the findings from this study will generate interventions toward reducing the suicide epidemic in Ghana.

Estimated prevalence and gender disparity of physical activity among 64,127 in-school adolescents (aged 12-17 years): A multi-country analysis of Global School-based Health Surveys from 23 African countries.

The Africa sub-region currently lacks quantitative normative data to illustrate the extent of burden and gender inequities of physical activity level in order to inform policy and education, towards meeting the WHO's 2030 physical activity milestone. The study aimed to provide insights on the current prevalence of sufficient physical activity and gender disparity, using a nationally representative data from the Global School-based student Health Survey (GSHS) from 23 African countries. The study used the multi-country GSHS data from 23 African countries (2003-2017). Sufficient physical activity was measured through self-administered questionnaire. The prevalence of sufficient physical activity among in-school adolescents in each country was estimated by proportion with corresponding 95% confidence intervals. Meta-analysis with random effect was employed to pool the prevalence of physical activity level in the 23 African countries. Additionally, sub-group, sensitivity, and meta-regression analyses were performed. The study included 23 African countries representing 64,127 in-school adolescents aged 12-17 years. Overall, only 20% [95% CI: 18%-22%] of adolescents in Africa engaged in sufficient physical activity. With respect to sex, only 25% [95% CI: 22%-28%] of males and 16% [95% CI: 14%-18%] of females met the WHO recommendation of sufficient physical activity. Sufficient physical activity ranged from 11.6% [9.2%-14.5%] in Sudan to 38.3% [CI:30.2%-47.1%] in Benin. Sufficient physical activity in boys ranged from 7.5% [95% CI: 6.2%-9.0%] in Zambia to 29.2% [95% CI: 22.5%-36.8%] in Benin, and ranged from 2.5% [95% CI: 1.6%-4.0%] in Senegal to 12.2% [95% CI:10.6%-14.1%] in Tanzania for girls. Only 20% of in-school adolescents met the WHO's recommended physical activity level. Generally, adolescent girls in Africa are less active than adolescent boys. Addressing the rising burden of insufficient physical activity in adolescents and narrowing the gender gap could ultimately increase the overall physical activity engagement and achieve the WHO's global physical activity target by 2030.

Prevalences of Parental and Peer Support and Their Independent Associations With Mental Distress and Unhealthy Behaviours in 53 Countries.

Objective: Parental and peer support are both associated with mental distress and unhealthy behaviour indices in adolescents. Methods: We used the Global School-Based Student Health Survey data (n = 192,633) from 53 countries and calculated the weighted prevalence of individual and combined parental and peer support. Multiple logistic regression analysis was used to estimate the adjusted associations between combined parental and peer support with mental distress and unhealthy behaviours. Results: The prevalence figures for having all four categories of parental support and two peer-support were 9.7% and 38.4%, respectively. Compared with no parental support, adolescents with all four parental support negatively associated with all five mental distress and eight unhealthy behaviours factors, and the ORs ranged from 0.19 to 0.75. Additionally, adolescents with two peer support were negative association with all mental distress and four health risk behaviours, and positively associated with a sedentary lifestyle. Conclusion: Parental and peer support were lacking in some countries, while greater parental and peer support were negative associated with mental distress and most unhealthy behaviours in adolescents, and the relationships were independent.

Tobacco and electronic cigarette smoking among in-school adolescents in Vietnam between 2013 and 2019: prevalence and associated factors

ABSTRACT Background Smoking among adolescents in schools is a major global public health concern. There is limited evidence regarding prevalence and associated factors in Vietnam. Objective To compare the prevalence of smoking and associated factors among in-school adolescents aged 13–17 years in Vietnam between 2013 and 2019. Methods Data were collected from two rounds of the national representative Vietnam Global School-based Student Health Survey (GSHS) conducted in 2013 (n = 3,331) and 2019 (n = 7,690). Logistic regression was used to identify the factors associated with tobacco and electronic cigarette smoking among in-school adolescents. Results There was a significant reduction in the prevalence of current smoking (water pipes and cigarettes) from 5.4% (95% CI: 4.0–7.2) in 2013 to 2.8% (95% CI: 2.2–3.6) in 2019. In 2019, 2.6% of the in-school adolescents reported having used electronic cigarette products 30 days prior to the survey. Factors associated with a significantly higher likelihood of current smoking status included gender, loneliness, suicidal ideation, sexual activity, truancy, and alcohol consumption. Similar patterns were observed for e-cigarettes. Conclusion Smoking among in-school adolescents in Vietnam decreased between 2013 and 2019. Follow-up studies are needed to further investigate causal factors so that future policies and communication programmes can be more effectively targeted to reduce smoking in adolescents.

Validation of global school-based student health survey in Bahrain

Validation of global school-based student health survey in Bahrain