Global School-based Student Health Research Articles

Sexual risk behaviour among in-school adolescents in Central America

ABSTRACT The purpose of the study was to assess sexual risk behaviours among young people in Central America. Secondary data were analysed from 15,807 school adolescents (mean age = 14.4 years) who were part of the most recent cross-sectional Global School Based Student Health Survey (GSHS) in six Central American countries. Results show that almost a quarter (24.3%) of participants had sexual initiation, with 19.7% in Guatemala and 40.9% in Panama. Among those students who had sexual initiation, 51.7% had it early (≤14 years), 27.7% had non-condom use, 45.1% had non-birth control use and 41.5% had multiple sexual partners. Older age (≥15 years), male sex, psychological distress, suicide attempt, bullying victimization, school truancy, in physical fight, history of alcohol intoxication, trouble from alcohol use, no physical education, physical injury, soft drink intake and low parental support were associated with sexual risk behaviours. One in four adolescents in the Central America had sexual risk behaviours, calling for interventions.

Association of Adverse Childhood Experiences with Non-Suicidal Self-Injury and Suicidality: Baseline Survey of the Chinese Adolescent Health Growth Cohort

Many studies have identified that adverse childhood experiences (ACEs) are associated with non-suicidal self-injury (NSSI) and suicidality. However, most studies have been restricted to a few types of ACEs. This study aims to investigate the association of 13 common types of ACEs with NSSI, suicidal ideation (SI), and suicide attempts (SA), as well as the mediation of depressive and anxiety symptoms therein. A total of 1771 (994 male, 777 female) students aged 11–16 (12.9 ± 0.6) years who participated in the baseline survey of the Chinese Adolescent Health Growth Cohort study were included in the analysis. ACEs, including childhood maltreatment, other common forms of ACEs, and smoking, were measured via the Chinese version of the Child Trauma Questionnaire (CTQ) and a series of valid questionnaires that were derived from previous studies. NSSI was measured using the Chinese version of the Functional Assessment of Self-mutilation. SI and SA were measured using questions derived from the Global School Based Student Health Survey. Depressive symptoms were measured via the Chinese version of the Center for Epidemiologic Studies Depression Scale, and anxiety symptoms were measured via the General Anxiety Disorder-7. Of the included participants, 92.0% reported one or more category of ACEs. Smoking, parent–child separation, emotional abuse, physical abuse, and being bullied were positively associated with NSSI; smoking, parent–child separation, emotional abuse, physical abuse, emotional neglect, and being bullied were positively associated with SI; smoking, emotional abuse, and being bullied were positively associated with SA. The associations of ACEs with NSSI, SI, and SA were each partially or completely mediated through depressive and anxiety symptoms. Children and adolescents who had experiences of smoking, physical abuse, and being bullied during childhood are consistently and independently associated with NSSI and suicidality, and these associations may be largely mediated through depressive and anxiety symptoms. In conclusion, not all the types of ACEs are independently associated with NSSI, and suicidality and other associations may mediate through depressive and anxiety symptoms. Target interventions for adolescents’ NSSI and suicidality should focus on those who have a history of ACEs and depressive and anxiety symptoms.

Individual And Environmental Factors Associated With Physical Activity Practices Among Adolescents Of Devchuli Municipality

Background: Regular physical activity helps children and adolescents to remain healthy and fit, improve muscular and cardiorespiratory fitness, have psycho-social benefits The Global School Based Student Health Survey of Nepal 2015 shows that only 15.1% of adolescents of age 13-17 years were physically active daily. The risk factor of chronic diseases are traced back up to childhood hence promoting physical activity should start from childhood. Identification of these factors that affects level of physical activity among adolescents of Nepal and its better understanding will aid in promoting physically active lifestyle and designing effective interventions.

Lifestyle Risk Behaviours and Nutritional Status Associated with Mental Health Problems among Myanmar Adolescents: Secondary Analysis of a Nationwide 2016 School Survey.

Engaging in unhealthy lifestyles may be considered a risk factor for mental health problems, but there is limited evidence. This study aimed to identify the relationship between unhealthy lifestyles and mental health problems among Myanmar school-going adolescents. Global School Based Student Health Survey (GSHS) data from 2838 school-going adolescents from Myanmar were analysed. Bivariable and multivariable logistic regression analyses were applied. After adjusting for confounding variables, adolescents who were seated for more than three hours per day had higher odds of loneliness, anxiety-induced sleep disturbance, suicide ideation, and suicide attempts compared to others. Moreover, students who ate fruit less than one time per day were more likely to experience anxiety-induced sleep disturbance and suicidal ideation. Being a current drinker was significantly associated with suicidal ideation and attempt. Obese students were more likely to feel lonely compared to normal weight students. Our study indicates there is a strong association between unhealthy lifestyle behaviours and mental health problems among school adolescents in Myanmar.

Parent and school modelling factors associated with physical activity practices among adolescents of Devchuli municipality

Background: Regular physical activity helps children and adolescents to remain healthy and fit, improve muscular and cardiorespiratory fitness, have psycho-social benefits. The Global School Based Student Health Survey of Nepal 2015 shows that only 15.1% of adolescents of age 13-17 years were physically active daily. Identification of these factors that affects level of physical activity among adolescents of Nepal and its better understanding will aid in promoting physically active lifestyle and designing effective interventions. Methods: The cross sectional study was conducted to determine the factors associated with physical activity among adolescents of 15 to 19 years in Devchuli Municipality. Physical activity level of adolescents were measured along with parental and school/teacher modelling variables. Results: The study shows that most of the participants (68.8%) had moderate level of physical activity while 28.8% of participants were doing high level of physical activity. Only 7% of females were doing high level of physical activities compared to 53% males doing the high level of physical activities. The result showed that male participants were more likely to do high level of physical activity (AOR=16, 95% CI=7.3-33.7) than female participants. Similarly, the participants from other than Hindu religion (which consists Buddhist and Christian) were more likely to do high level of physical activity (AOR=6.5, 95% CI=1.8-23.5) than the participants from Hindu religion. Conclusions: The study showed that male participants and the participants from other than Hindu religion (which consists Buddhist and Christian) were more likely to do high level of physical than their counterparts.

Adolescent Loneliness in 70 Countries Across Africa, America, and Asia: A Comparison of Prevalence and Correlates

PurposeEmerging studies address adolescent loneliness a public health problem due to its negative associations with adverse health. However, evidence concerning adolescent loneliness and its correlation in nonwestern, low- and middle-income countries is scarce. This study examined the prevalence of loneliness and its correlates (i.e., sex, bullying victimization, and peer support) across 70 countries from five WHO regions. MethodsData were collected from the Global School–based Student Health Survey of children aged 13–17 (2003–2018) years. Loneliness was defined as feeling lonely most of the time or always in the past 12 months based on self-reports. The prevalence of loneliness was estimated, and multivariable logistic regression ascertained prevalence ratios of correlates by country. Meta-analysis was used to examine regional and overall pooled estimates. ResultsAmong the 248,017 students included in the study, the overall prevalence of loneliness was 11.7% (95% confidence interval (CI): 10.6–12.7), with significant variations across countries. Girls (vs. boys prevalence ratio (PR = 1.4 95% CI: 1.3–1.4), students who experienced bullying victimization (PR = 2.2, 95% CI: 2.1–2.3), and students who reported a lack of close friends (PR = 1.8, 95% CI: 1.7–1.9) were at increased risk of experiencing loneliness. There was significant heterogeneity between countries for sex and lack of close friends but not for bullying victimization. DiscussionAdolescent loneliness is prevalent globally, especially in Africa and the Eastern Mediterranean. The considerable heterogeneity in its prevalence and correlates suggest that tailoring to the country context may benefit policy initiatives. Bullying may be a common intervention target in all countries.

Mental Health and Parental Factors among Adolescents during the COVID Pandemic in Malaysia

Purpose: The study aims to determine the prevalence of mental health problems among early adolescents and their associations with parental relationships. Methods: A cross-sectional study was conducted on 535 adolescents aged 13 to 14 on the east coast of Peninsular Malaysia using online surveys from February 2021 to April 202. Mental health status was assessed using the Depression, Anxiety and Stress Scale- 21 (DASS-21), and parental or guardian supervision, connectedness, bonding, respect for privacy, physical activity, and risk behaviours were asked using the Malaysian Global School-based Student's Health Survey. Multiple logistic regression analysis was done to examine the associations of the variables. Results: The prevalence of depression, anxiety and stress were 28.2%, 38.1% and 18.5%, respectively. Adolescent with low parental/guardian connectedness and bonding were associated with depression (AOR = 3.82, 95% CI =1.80 – 8.08), anxiety (AOR 2.17,95% CI = 1.34 – 3.50) and stress (AOR 2.29, 95% CI = 1.13 – 4.65). Low parental supervision (AOR = 2.37, 95% CI = 1.19 – 4.54), low academic performance (AOR = 3.57, 95% CI = 1.10 – 11.62), stress (AOR = 8.56, 95% CI = 4.38 – 16.70) and anxiety AOR = 7.83, 95% CI = 4.48 – 13.70) were predictors for depression. Adolescent who had divorced or separated parents/guardians (AOR = 3.57, 95%CI = 1.10 – 11.62) and married parents/guardian but living apart due to working (AOR = 3.57, 95% CI = 1.10 – 11.62) were higher risk for stress. Conclusions: Depression and anxiety were prevalent among adolescents in Malaysia. Poor relationship with parents or guardians was a significant factor for mental health problems among adolescents during the COVID pandemic.

Coexistence of obesity and hunger in young adolescents: Evidence from the Global School-based Student Health Survey.

Hunger and obesity among young adolescents are serious public health issues; however, the relationship between these issues in this demographic has yet to be examined. To determine whether both obesity and hunger coexist in young adolescents from a global perspective. We analysed data of 142 565 adolescents (age, 12-15 years) from 60 countries from the Global School-based Student Health Survey. Total prevalence of moderate and severe hunger was 22.32% and 7.8%, respectively-with the highest in Africa (29.14% and 12.14%, respectively) and the lowest in the Americas (16.83% and 5.31%, respectively). The prevalence of obesity among adolescents with severe hunger was 1.26 (95% confidence interval [CI]: 1.15-1.38) times the prevalence among those without hunger; however, this association varied across countries or regions. Moreover, the prevalence of obesity was 17% (95% CI: 1.04-1.29) higher in adolescent girls with moderate hunger in high-income countries, 91% (95% CI: 1.23-2.58) higher in adolescents with severe hunger in low-income countries and 54% (95% CI: 1.34-1.76) higher in lower middle-income countries compared to those without hunger. Both obesity and hunger coexist in adolescent populations worldwide. Our findings emphasize the need for double-duty actions to simultaneously address burdens of hunger and obesity among adolescents.

The Determinants of Mental Health Literacy among Young Adolescents in Malaysia.

Mental health literacy (MHL) is an established multifaceted concept that comprises mental health knowledge, help-seeking, and stigma. Adequate MHL (i.e., the ability to correctly recognize mental health disorders alongside having the intention to seek help) is able improve mental health outcomes among individuals. This study aims to examine the determinants of MHL among young Malaysian adolescents. A cross-sectional study was conducted among 1400 adolescents between 13 and 14 years old from nine national secondary schools in Selangor state, Malaysia. Sociodemographic determinants assessed included gender, age, ethnicity, smoking status, alcohol consumption, history of being bullied, feeling lonely, parental marital status, and parental income which were assessed using the Global School Based Student Health Survey. MHL was assessed using the Mental Health Literacy and Stigma questionnaire. Several factors were significantly associated with adequate levels of MHL following multivariate analysis, such as being female (AOR = 1.68; 95% CI 1.12, 2.52), older adolescents (AOR = 1.56; 95% CI 1.07, 2.30), not smoking (AOR = 1.99; 95% CI 1.20, 4.26), not consuming alcohol (AOR = 1.23; 95% CI 1.18, 2.41), and not feeling lonely (AOR = 1.25; 95% CI 1.06, 1.85). Addressing these determinants could be key in assisting the development of policies and programs to prevent mental health disorders among adolescents, which are currently on the rise.

Suicidal ideation and attempt among school going adolescents in Bhutan \u2013 a secondary analysis of a global school-based student health survey in Bhutan 2016

BackgroundSuicide is one of the leading causes of death and Disability Adjusted Life Years (DALYs) worldwide. The economic, emotional and human cost of suicidal behaviour to individuals, families, communities and society makes it a serious public health issue. We aim to determine the prevalence and factors associated with self-reported suicidal behaviour (suicidal ideation and attempt) among school going adolescents (13–17 years).MethodsThis is a secondary analysis of a nationally representative data for Bhutan namely Global School Based Student Health Survey in 2016 which reports on various dimensions of adolescent health including suicidal behaviour. The survey employed a multistage sampling method to recruit participants aged 13–17 years (n = 5809) from 50 schools (25 each in rural and urban area). The survey used an anonymous self-administered pre-tested 84-item questionnaire. Weighted analysis was done. Adjusted prevalence ratios (aPRs) and adjusted Odds Ratios (aORs) have been presented with 95% confidence intervals (95% CI).ResultsA total of 667 (11.6%) adolescents reported considering a suicide attempt whereas 656 (11.3%) reported attempting suicide in the past 12 months. Among those reporting suicidal ideation, 388 (58.6%) reported attempting a suicide and 274 (41.4%) had ideation alone, whereas, 247 (38.9%) reported attempting a suicide without previous ideation. Female sex, food insecurity, physical attack, sexual violence, bullying, feeling of loneliness, low parental engagement, reported worry about lack of sleep, urge to use drugs/alcohol, smokeless tobacco use, drug abuse and parental smoking were the factors associated with suicidal attempt. All these factors except smokeless tobacco use and parental smoking were associated with suicidal ideation. Having helpful/close friends was found to be protective against suicide ideation.ConclusionSuicidal behaviour among school going adolescents in Bhutan is high and alarming, especially among girls. Bullying, sexual violence, feeling of loneliness and drug abuse were some of the key risk factors identified. It is important to identify these risk factors early and effectively tackle them in order to prevent suicides. It requires a multi-faceted intervention with the support of the children, community, teachers and parents.

Bullying Victimization, School Environment, and Suicide Ideation and Plan: Focusing on Youth in Low- and Middle-Income Countries

PurposeThis study examines the relationship between bullying victimization, measured at individual and school levels, and suicide intent and plan among youth living in less developed parts of the world. MethodsMultilevel modeling is used to estimate the degree to which school-level bullying has an independent effect on the two suicide measures and how it moderates the impact of individual-level victimization on contemplating and planning suicide. Data are drawn from the Global School-Based Student Health (2000–2012) survey that consists of probability samples of adolescents in low- and middle-income countries. ResultsBy fitting three-level mixed effects models, we find that adjusting for personal experience of victimization, greater school-level prevalence of bullying has a positive independent relationship with suicide plan, but not ideation. Significant cross-level interaction effects are shown, that is, the bullying–suicide linkage at the individual level is moderated by the school environment. For suicide ideation only, it is weaker in schools where more students are bullied. The association is also less pronounced in the context characterized by higher proportion of physical violence among students and peer hostility on campus. ConclusionsThe bulk of prior research narrowly defines the relationship between bullying and suicide at the individual (e.g., student) level. This study shows that school context (e.g., proportion of bullied peers) must be incorporated into the analysis in better understanding the conditions under which youth think about and/or plan on inflicting lethal self-harm.

Association of Tobacco Use and Exposure to Secondhand Smoke With Suicide Attempts Among Adolescents: Findings From 33 Countries.

There is evidence to suggest that tobacco use is associated with suicide attempts. However, it is unclear whether such an association can be extended to include secondhand smoke exposure. Using nationally representative data of school-attending adolescents from 33 countries, we examined the association of tobacco use and exposure to secondhand smoke with suicide attempts. We used data from the Global School-based Student Health Survey, a cross-sectional survey conducted among adolescents 12-15 years of age. We used logistic regression to estimate the country-specific associations. We then conducted random effect meta-analyses to obtain overall and country-income level pooled estimates. Lastly, we used logistic regression analyses to investigate a dose-response association of cigarette smoking and exposure to secondhand smoke with suicide attempts. A positive association between tobacco use and suicide attempts among adolescents was present regardless of country-income level (low income: odds ratio 4.98, 95% CI: 3.11-7.96; lower middle income: 3.47, 2.91-4.15; upper middle income: 3.09, 2.75-3.47; and high income: 3.18, 2.63-3.84) and gender (boys: 3.28, 2.86-3.76; girls: 3.86, 3.30-4.51). Exposure to secondhand smoke was associated with suicide attempts, albeit weakly, among girls only (1.26, 1.14-1.39; boys: 1.00, 0.87-1.15). There was some evidence that a dose-response association of cigarette smoking and exposure to secondhand smoke with suicide attempts may only exist among girls. Adolescents who use tobacco, and adolescent girls exposed to secondhand smoke were found to be more likely to attempt suicide; however, future longitudinal studies are warranted to assess causality. Our findings indicate that routine screening of adolescents for tobacco use should be implemented globally, especially when assessing suicidal behaviors and risk. Future longitudinal and intervention studies are warranted to assess causality and whether prevention efforts such as tobacco control interventions and programmes targeting tobacco use and exposure to secondhand smoke among adolescents could ultimately lead to a reduction in the occurrence of suicide attempts.

Prevalence, clustering and sociodemographic distributions of non-communicable disease risk factors in Nepalese adolescents: secondary analysis of a nationwide school survey

ObjectivesTo assess the prevalence, clustering and sociodemographic distribution of non-communicable disease (NCD) risk factors in adolescents in Nepal.DesignData originated from Global School Based Student Health Survey, Nepal conducted in 2015–2016.SettingThe...

The double burden of malnutrition among adolescents: analysis of data from the Global School-Based Student Health and Health Behavior in School-Aged Children surveys in 57 low- and middle-income countries

Adults and young children in countries experiencing the nutrition transition are known to be affected simultaneously by undernutrition and overnutrition. Adolescence is a critical period for growth and development. Yet, it is unknown to what extent this double burden of malnutrition affects adolescents in low- and middle-income countries (LMICs) and the macrolevel contextual factors associated with the double burden of malnutrition. The aim was to quantify the magnitude of the double burden of malnutrition among adolescents and to examine the potential sources of heterogeneity in prevalence estimates across LMICs. We used individual-participant data from the Global School-Based Student Health and Health Behavior in School-Aged Children surveys conducted in 57 LMICs between 2003 and 2013, comprising 129,276 adolescents aged 12-15 y. Pooled estimates of stunting, thinness, or both; overweight or obesity; and concurrent stunting and overweight or obesity were calculated overall, by regions, and stratified by sex, with random-effects meta-analysis. Guided by UNICEF's conceptual framework for child malnutrition, we used ecological linear regression models to examine the association between macrolevel contextual factors (internal conflict, lack of democracy, gross domestic product, food insecurity, urbanization, and survey year) and stunting, thinness, and overweight and obesity prevalence, respectively. The prevalence of stunting was 10.2% (95% CI: 8.3%, 12.2%) and of thinness was 5.5% (95% CI: 4.3%, 6.9%). The prevalence of overweight or obesity was 21.4% (95% CI: 18.6%, 24.2%). Between 38.4% and 58.7% of the variance in adolescent malnutrition was explained by macrolevel contextual factors. The prevalence of concurrent stunting and overweight or obesity was 2.0% (95% CI: 1.7%, 2.5%). The double burden of malnutrition among adolescents in LMICs is common. Context-sensitive implementation and scale-up of interventions and policies for the double burden of malnutrition are needed to achieve the Sustainable Development Goal to end malnutrition in all of its forms by 2030. This trial was registered at clinicaltrials.gov as NCT03346473.

Prevalence of Hypertension and its Risk Factors Among School Going Adolescents of Patna, India.

Hypertension (HT) has its origin in childhood and adolescent period but it goes undetected due to absence of sign and symptoms, unless specifically looked for during this period. It has been seen that one with raised blood pressure level in this period will also have raised Blood Pressure (BP) level in their adulthood and elderly period. The present study was conducted to estimate the prevalence of HT and its risk factor among apparently healthy school going adolescents of Patna district. A cross-sectional study among 2913 school going adolescents of eighth to 10th standard was conducted from April 2014 to August 2015 by adopting a two stage cluster sampling technique. The questions pertaining to risk behavior in relation to cardiovascular diseases from WHO's Global School based Student Health Survey were used for this study. The mean systolic and diastolic blood pressure of study population was 107.4 mm of Hg (95% C.I. 106.93-107.77) and 67.4 mm of Hg (95% C.I. 67.26-67.54), respectively. Prevalence of pre-HT and HT was 10.9% and 4.6% in school going adolescents while prevalence of overweight/obesity was 1.5%. Both systolic and diastolic blood pressures had positive and significant correlation with age, height and body mass index. The proportion of children who had ever taken tobacco was 5.3%, cigarette smoking 4.3%, alcohol consumption 2.1%, and excess salt intake 22.3%. Only 49.1% children were doing physical activity at least one hour a day in past seven days for maintenance of good health. The present study recommends that regular screening of blood pressure level must be initiated in adolescents so that remedial measure can be initiated as early as possible.

Prevalence and correlates of perceived teeth health status and oral health behavior among school-going adolescents in Cambodia.

ABSTRACTThe purpose of the study was to investigate perceived teeth health status and oral health behavior, as well as their correlates, among adolescents in Cambodia. The analysis included 3806 Cambodian school children (mean age 15.7 years, SD=1.8 years) who took part in the “Global School-based Student Health Survey” (GSHS) in 2013. Overall, 7.8% of the students reported poor perceived teeth status, 18.0% had missed school in the past year because of a toothache, 26.7% engaged in combined oral health behavior (brushing teeth twice daily or more often = 79.8%, using fluoride toothpaste = 59.9%, and drinking soft drinks less than once a day = 53.6%), and 59.9% had never visited a dentist for a routine examination or other dental work. In the multivariate logistic regression analysis, older age, being female, missing school because of a toothache, having a toothache in the past 12 months, poor oral health behavior and sedentary leisure time were associated with poor perceived teeth status. Older age, good perceived teeth status, having had a dental check-up, washing hands before eating and after toilet use, and not eating fast food were associated with a positive oral health behavior (brushing teeth twice daily or more often, using fluoride toothpaste, and drinking soft drinks less than once a day). Significant proportions of poor perceived teeth status and poor oral health behavior were found among school children in Cambodia. Various risk factors (sociodemographic, dental variables, general health risk behaviors) for perceived poor teeth status, oral health behavior and never having had a dental check-up were identified, which can be utilized for intervention programs.

LBPS 03-26 ARE THE ADOLESCENTS AT THE RISK OF CARDIO-VASCULAR DISEASES?

Objective: To assess the prevalence of hypertension and pre-hypertension among apparently healthy school going adolescents of Patna district, Bihar, India. Design and Method: A cross-sectional study among 2913 school going adolescents of 8–10th standard was conducted in Patna district of Bihar from April 2014 to August 2015 by adopting a two stage cluster sampling technique. Blood pressure, height and weight were measured by using standard procedure. The questions pertaining to risk behaviour in relation to cardiovascular diseases were taken from WHO's Global School based Student Health Survey (GSHS). Mean, 95% confidence interval (C.I.), chi-square test, ANOVA and correlation coefficient were used for statistical analysis. Results: The mean systolic and diastolic blood pressure of study population was 107.4 (95% C.I. 106.93–107.77) and 67.4 (95% C.I. 67.26–67.54) respectively. Prevalence of pre-hypertension and hypertension was 10.9% and 4.6% in school going adolescents while prevalence of overweight/Obesity was 1.5%. Both systolic and diastolic blood pressures had positive and significant correlation with age, height and body mass index. The proportion of children who had ever taken tobacco was 5.3%, cigarette smoking 4.3%, alcohol consumption 2.1%, and excess salt intake 22.3%. Only 49.1% children were doing physical activity at least one hour a day in past seven days for maintenance of good health. Nearly 35.6% children had never taken fruits in last 7 days while 20.2% children had taken cold drink one or more time in past seven days. The proportion of children who had taken junk foods every day in past 7 days was 3.2%. Conclusions: The present study recommends that adolescents must be screened regularly for blood pressure so that remedial measure can be initiated as early as possible.

Suicidal ideation among school-attending adolescents in Dar es Salaam, Tanzania

Background: Suicidal ideation is an understudied risk factor for suicidal intent. The present study investigates the patterns and risk factors for suicidal ideation among a sample of school-attending adolescents in Dar es Salaam, Tanzania. Methods: This study examined secondary data collected in 2006 through the Global School-Based Student Health Survey. The data were collected via two-stage cluster sampling representative of all secondary schools in Dar es Salaam. We compared adolescents who reported suicidal ideation (SI) and those who reported a plan to carry out a suicide attempt (SP), with those reporting neither ideation nor an attempt (controls) within the 12 months preceding the survey. Our analyses targeted demographic, behavioral, social, mental health and family factors. Results : A total of 2,176 students aged 11-16 years participated. Within the recall period, 7% (n=149) of participants had thought about suicide with 6.3% (n=136) having created a plan to carry out an attempt. Fifty percent of those reporting SP were female. We found that significant associations existed across all categories of psychological health, substance use and among those who reported being bullied. In the multivariate analysis adolescents reporting suicidal intent were more than twice as likely to report having been lonely (RRR=2.33; CI=1.36-4.01); more likely to suffer from depressive symptoms (RRR=2.26; CI=1.56-3.27) and have previously used an illicit substance (RRR=1.97; CI=1.12-3.48). We found an inverse association with age and suicidal planning (RRR=0.74; CI=0.62-0.90) as well as poverty and SP (RRR=0.53; CI=0.29-0.98) and an increased likelihood for adolescents reporting SP to be lonely (RRR=2.76; CI=1.55-4.90) and depressed (RRR=3.98; CI=2.71-5.86). Tobacco use (RRR=2.15; CI=1.22-3.78) and illicit substance use (RRR=1.99; CI=1.10-3.60) were associated with SP as was having parents who were knowledgeable of what adolescents did during their free time (RRR=2.15; CI=1.07-4.31). Respondents who reported having no friends were also more likely to report SP (RRR=3.68; CI=2.22-6.08). Conclusion: Our results suggest that, as in high-income settings, psychological factors, risky health behaviors such as substance use, and social and familial support impact suicidal ideation. This knowledge should be used to help inform further research as well as prevention and intervention strategies.

Consumo de alcohol y conductas de riesgo asociadas en escolares colombianos

ObjectivesTo describe alcohol use and associated risk behavior among school children in five Colombian cities as the means to provide an information base for program development and application of diverse intervention strategies in this age group. MethodsThe Global School Based Student Health Survey was carried out in public and private secondary schools in five Colombian cities. A two-stage cluster sampling was performed. Survey was filled out by students on their own in the class room, without teacher present. Statistic analysis took place by Centers for Disease Control and Prevention (CDC). Results are representative for students between the ages of 13 and 15. ResultsIn the five cities, 54.8% of students reported alcohol use during the previous 30 days; 40% reported at least one episode of excessive alcohol use in their lifetime; and 19.2% revealed effects of alcohol use. Initiation was at age 11.2 years. ConclusionsEvidence revealed high alcohol use among students which demonstrates the need for intervention in this age group in order to lower associated risks.

Parental involvement and mental well-being of Indian adolescents

This study examined the association between parental involvement and mental well being among the 6721 school going adolescents aged 13 to 15 years who participated in Indias nationally representative Global School based Student Health Survey (GSHS) in 2007. Parental involvement (homework checking, parental understanding of their childrens problems, and parental knowledge of their childrens freetime activities) was reported by students to decrease with age, while poor mental health (loneliness, insomnia due to anxiety, and sadness and hopelessness) increased with age. Age adjusted Logistic regression models showed that high levels of reported parental involvement were significantly associated with a decreased likelihood of poor mental health.