Harmful Health Behaviors Research Articles

Depressive Symptoms and Serum Lipid Fractions in Middle-Aged Men: Physiologic and Health Behavior Links

To investigate alternative hypothetical models that could clarify the relationship between depressive symptoms and serum cholesterol fractions, i.e., high-density lipoprotein (HDL) and low-density lipoprotein (LDL). It was hypothesized that the impact of the depressive symptoms on cholesterol fractions is mediated through health behavior and body mass index, and at the same time there would be a direct link from depression to cholesterol. The study sample consisted of 893 middle-age men who participated in a trial aimed at preventing the metabolic syndrome, Type 2 diabetes and cardiovascular diseases. Serum cholesterol was measured by the enzymatic method. Participants completed self-report questionnaires assessing health behavior and depressive symptoms. Depressive symptoms consistently correlated statistically significantly with adverse lifestyle factors and, as hypothesized, positively with HDL. Path analyses supported the parallel existence of two main pathways: from depression through adverse health behavior to unfavorable cholesterol fraction balance, and a direct physiological link indicative of beneficial effect of depression on cholesterol levels. It is concluded that, among a sample of men, depressive symptoms are linked to cholesterol fractions through two different pathways. An adverse relationship of depression with serum lipids HDL-LDL balance is partly mediated through harmful health behaviors. At the same time, the results indicate a direct, physiological link between depressive symptoms and cholesterol that has a beneficial influence on the HDL-LDL balance.

Predictors of health‐harming and health‐protective behaviors in adolescents with cancer

Given adolescent cancer survivors' increased susceptibility to late effects, it is imperative that we understand factors that influence their engagement in healthy and unhealthy behaviors. The purpose of this exploratory study was to identify significant predictors of health-harming and health-protective behaviors in adolescent cancer patients. Forty-two adolescents (ages 12-19 years) currently on-treatment for cancer and their parents were recruited from outpatient pediatric cancer clinics. Adolescents completed a battery of questionnaires that assessed their health-behaviors, quality of life, and psychological distress, while parents completed a demographic questionnaire. Regression analyses indicated that specific demographic, illness, and psychosocial variables significantly predicted health-harming and health-protective behaviors. Older adolescent age and unmarried parent status emerged as the best predictors of adolescent health-harming behaviors, whereas married parent status, increased adolescent time since diagnosis, increased adolescent-rated quality of life, and increased distress emerged as the best predictors of health-protective behaviors. Demographic, illness, and psychosocial variables may help inform the development of interventions designed to promote the initiation and/or maintenance of good health practices among adolescents on-treatment for cancer. Interventions are needed that target health behaviors while adolescents are approaching treatment completion, in order to help facilitate the practice of good health practices in survivorship.

The Effects of Peer Influence on Disordered Eating Behavior

Peer influence has been found to be correlated with a host of harmful health behaviors. However, little research has been conducted investigating the relationship between peer influence and disordered eating. The present study surveyed 6th-, 7th-, and 8th-grade girls and boys using the Eating Disorder Inventory (EDI) and Inventory of Peer Influence (I-PIEC). This study found a significant positive correlation between peer influence and disordered eating. Multiple regression analyses revealed that peer influence was equally present in both males and females. There were no significant differences between males and females and EDI or I-PIEC scores. The likeability construct of peer influence was the most significant predictor of disordered eating in this study. School nurses are in a unique position to educate both male and female students about the dangers of disordered eating behaviors as well as identify students who may be at risk for these behaviors.

Exposure to domestic violence associated with adult smoking in India: a population based study

Objective:To investigate the relation between domestic violence and tobacco use among adults in India.Design:Multilevel cross sectional analyses of a nationally representative population based sample from the 1998–9 Indian national family...

Cross-sectional Study of Female Students Reporting Anabolic Steroid Use

To determine the characteristics of female US high school students reporting anabolic steroid use. Cross-sectional assessment using the 2003 Centers for Disease Control and Prevention national school-based Youth Risk Behavior Survey database. Nationally representative sample of US high schools. Female students in grades 9 through 12 (n = 7544). Participants' self-reported anabolic steroid use was compared with other health-related behaviors and with sports participation. Prior or ongoing anabolic steroid use was reported by 5.3% of female high school students. Those adolescent girls had a marked increase in other health-compromising behaviors, including past 30-day use of alcohol (odds ratio [OR], 8.83; 95% confidence interval [CI], 5.49-14.20]), cigarettes (OR, 5.14; 95% CI, 3.14-8.42), marijuana (OR, 7.91; 95% CI, 5.20-12.04), cocaine (OR, 10.78; 95% CI, 6.18-18.81), and diet pills (OR, 4.86; 95% CI, 2.98-7.93). They were more likely to carry a weapon (OR, 7.54; 95% CI, 4.83-11.76), have had sexual intercourse before age 13 years (OR, 2.90; 95% CI, 1.58-5.33), and have had feelings of sadness or hopelessness almost every day for at least 2 consecutive weeks (OR, 4.13; 95% CI, 2.57-7.22). They were less likely to play school-sponsored team sports (OR, 0.52; 95% CI 0.34-0.80). Steroid users participating in sports shared the same problem behaviors as steroid users not participating in team athletics. Self-reported anabolic steroid use is not confined to adolescent girls in competitive athletics and is an indicator of adolescent girls with a marked increase in a cluster of other health-harming behaviors.

Health behaviors and masculinity in Kenyan and U.S. male college students.

Approaching men’s health behaviors from a gender socialization framework, we hypothesized that (a) men’s health behaviors would significantly relate to their conformity to traditional masculine norms, (b) these behaviors would significantly differ as a function of their nationality, and (c) masculinity and nationality would significantly interact to predict men’s health behaviors. Five hundred forty-six male college students (384 Kenyan men, 162 U.S. men) completed the Health Behavior Inventory and the Conformity to Masculine Norms Inventory. ANCOVA results indicated that 30 of 52 health behaviors were associated with traditional masculinity, nationality, or their interaction. The discussion focuses on masculinity’s relationship to harmful health behaviors. In addition, limitations and potential interventions to improve men’s health behaviors are discussed.

Birth outcomes among urban African-American women: A multilevel analysis of the role of racial residential segregation

Residential segregation is a common aspect of the urban experiences of African-Americans in the United States (US), yet few studies have considered how segregation might influence perinatal health. Here, we develop a conceptual model of relationships between segregation and birth outcomes and test the implications of the model in a sample of 434,376 singleton births to African-American women living in 225 US Metropolitan Statistical Areas (MSAs). Data from the National Center for Health Statistics 2002 birth files were linked to data from the 2000 US Census and two distinct measures of segregation: an index of isolation (the probability that an African-American resident will encounter another African-American resident in any random neighborhood encounter) and an index of clustering (the extent to which African-Americans live in contiguous neighborhoods). Using multilevel regression models, controlling for individual- and MSA-level socioeconomic status and other covariates, we found higher isolation was associated with lower birthweight, higher rates of prematurity and higher rates of fetal growth restriction. In contrast, higher clustering was associated with more optimal outcomes. We propose that isolation reflects factors associated with segregation that are deleterious to health including poor neighborhood quality, persistent discrimination and the intra-group diffusion of harmful health behaviors. Associations with clustering may reflect factors associated with segregation that are health-promoting such as African-American political power empowerment, social support and cohesion. Declines in isolation could represent positive steps toward improving birth outcomes among African-American infants while aspects of racial contiguity appear to be mitigating or indeed beneficial. Segregation is a complex multidimensional construct with both deleterious and protective influences on birth outcomes, depending on the dimensions under consideration. Further research to understand racial/ethnic and economic health disparities could benefit from a focus on the contributory role of neighborhood attributes associated with the dimensions segregation and other social geographies.

Definition and Outcome of a Curriculum to Prevent Disordered Eating and Body‐Shaping Drug Use

Almost one half of male and female students participate in high school-sponsored athletics, and high school also is a time when classroom health promotion curricula are less effective. The Athletes Training and Learning to Avoid Steroids is a sport team-centered drug-use prevention program for male high school athletes, which has been shown to reduce alcohol and illicit drug use. Just as anabolic steroid use is associated with male athletes, female sport participants may be at a greater risk for disordered eating and body-shaping drug use. Extending sport team-centered programs to young women athletes required defining and ranking factors related to developing those harmful behaviors. Survey results from a cross-sectional cohort of female middle and high school student athletes were used to identify and prioritize potential curriculum components, including mood and self-esteem, norms of behavior, perceptions of healthy body weight, effects of media depictions of women, and societal pressures to be thin. The derived sport team-centered program was prospectively assessed among a second group of female student athletes from 18 high schools, randomized to receive the intervention or the usual care control condition. The Athletes Targeting Healthy Exercise and Nutrition Alternatives (ATHENA) intervention is a scripted, coach-facilitated, peer-led 8-session program, which was incorporated into a team's usual training activities. The ATHENA program significantly altered the targeted risk factors and reduced ongoing and new use of diet pills and body-shaping substances (amphetamines, anabolic steroids, and sport supplements). These findings illustrate the utility of a structured process to define curriculum content, and the program's positive results also confirm the sport team's potential as a vehicle to effectively deter health-harming behaviors.

Supporting adolescents through behaviour change

This article, the fifth of eight in the health promotion series, aims to inform practitioners about potentially harmful health and lifestyle-related behaviours in adolescents, and to provide some strategies for supporting young people to make changes.

Preventing Substance Use and Disordered Eating

To implement and to assess the efficacy of a school-based, sport team-centered program to prevent young female high school athletes' disordered eating and body-shaping drug use. Prospective controlled trial in 18 high schools, with balanced random assignment by school to the intervention and usual-care control conditions. We enrolled 928 students from 40 participating sport teams. Mean age was 15.4 years, 92.2% were white, and follow-up retention was 72%. The ATHENA (Athletes Targeting Healthy Exercise and Nutrition Alternative) curriculum's 8 weekly 45-minute sessions were incorporated into a team's usual practice activities. Content was gender-specific, peer-led, and explicitly scripted. Topics included healthy sport nutrition, effective exercise training, drug use and other unhealthy behaviors' effects on sport performance, media images of females, and depression prevention. We assessed participants by confidential questionnaire prior to and following their sport season. We determined program effects using an analysis of covariance-based approach within the Generalized Estimating Equation framework. Experimental athletes reported significantly less ongoing and new use of diet pills and less new use of athletic-enhancing substances (amphetamines, anabolic steroids, and sport supplements) (P<.05 for each). Other health-harming actions also were reduced (less riding with an alcohol-consuming driver [P = .05], more seat belt use [P<.05], and less new sexual activity [P<.05]). The ATHENA athletes had coincident positive changes in strength-training self-efficacy (P<.005) and healthy eating behaviors (P<.001). Reductions occurred in intentions toward future use of diet pills (P<.05), vomiting to lose weight (P<.05), and use of tobacco (P<.05) and muscle-building supplements (P<.005). The program's curriculum components were altered appropriately (controlling mood [P<.005], refusal skills [P = .05], belief in the media [P<.005], and perceptions of closest friends' body-shaping drug use [P<.001]). Sport teams are effective natural vehicles for gender-specific, peer-led curricula to promote healthy lifestyles and to deter disordered eating, athletic-enhancing substance use, and other health-harming behaviors.

Betel nut chewing and related factors in adolescent students in Taiwan

Objective. To investigate the prevalence of betel nut chewing and related factors among adolescent students in general, manufacturing, commercial, agricultural and medical technology schools in Taiwan. To make suggestions regarding how health authorities can reduce the number of students taking up the habit. Materials and methods. A cross-sectional survey was designed, and 10,288 students answered the questionnaire. Results. Significantly more male than female students were betel nut chewers. The less urbanized areas were also associated with a higher prevalence of the habit. The prevalence of the habit grew with increasing age. By analysing betel nut chewing behaviour, it was found that most students started chewing betel nuts because of curiosity, and most obtained betel nuts from their friends and classmates. Betel nut chewing behaviour is definitely related to peer pressure. Most betel nut chewers did not realize that withdrawal could lead to physiological reactions, and they were ignorant of any risk to health even though they were compulsive betel nut chewers. The health-harming behaviours of both smoking and drinking were found in many betel nut chewers, particularly smoking. Conclusion. This study confirmed the need for a health education programme dealing with the health risks of betel nut chewing for students at risk. The health authorities could also develop a programme for betel nut chewing among Taiwan's adolescent students, emphasizing the dangers of this habit.

Sexual Violence among Female Street Adolescents in Addis Ababa, April 2000

Background: Violence against women is an important public health problem not only because of the physical injury that may result but also because of potentially harmful health behaviors that may be triggered in response to violence. The health consequence on women due to gender-based violence is a serious problem worldwide, which has devoid of women from participating in socio-economic development. The severity of the problem and scarcity of studies in this area prompted the undertaking of this study. Objectives: The aim of this study was to determine the magnitude and consequences of rape, (included attempted rape), to describe life skills of escaping the attempt, to assess the attitudes of male street adolescents towards rape and factors associated with sexual violence among female street adolescents. Methods: A cross-sectional survey was conducted among 654 female street adolescents. Additionally, four focus group discussions (FGD) among male street adolescents were undertaken to assess attitudes of male street adolescents towards rape in Addis Ababa from April-July 2000. The data were analyzed using EPI6 and SPSS (Statistical Package for Social Sciences). Results: The quantitative study revealed that the prevalence of rape among female street adolescents in the last 3 months was 15.6%, attempted rape 20.4% and unwelcome kiss 16.4%. The most popular way of escaping the attempt was yelling. Rape was significantly associated with living alone (OR=8.5, 95% CI=2.0,36.5). Unwanted pregnancy, abortion, STDs, and psychological, problems were reported as consequences of rape. This study has showed that girls in the street are at a high risk of rape, therefore serious attention must be paid in order to control this problem. [Ethiop.J.Health Dev. 2002;16(2):119-128]

Volition and alcohol-risk reduction: the role of action orientation in the reduction of alcohol-related harm among college student drinkers.

The present study examined the role of action orientation in health behavior change. Eighty-six binge drinking college students completed measures of alcohol use, alcohol-related consequences (e.g., driving drunk), motivation to change drinking, and action orientation. Alcohol use and consequences were reassessed 1 month later. Results showed that, although there was no significant change in alcohol quantity per occasion, students reported a significant decline in alcohol-related problems over time. Hierarchical regression analyses were conducted to examine whether action orientation was associated with changes in alcohol involvement. Controlling for alcohol problems and motivation to change at Time 1, those with higher dispositional action orientation showed fewer alcohol-related consequences at Time 2. These results suggest that those who are low in action orientation may have more difficulty enacting intentions to modify harmful health behaviors. The findings underscore the importance of volitional skills in interventions to promote change in health behavior.

Number of sexual partners and health lifestyle of adolescents. Use of the AMA Guidelines for Adolescent Preventive Services to address a basic research question.

To expand understanding of the behavioral epidemiology of an important sexually transmitted disease risk factor within a clinical framework of the AMA Guidelines for Adolescent Preventive Services (GAPS): Recommendations and Rationale. Cross-sectional analysis of the fourth year of a longitudinal study of adolescent health behavior. High schools in a single major urban school district. Nine hundred and forty-six white, African American, and Hispanic sexually active adolescents. Number of sexual partners in previous year and other health-risk and health-protective behaviors. Measures are operationalized according to guidelines for adolescent preventive services recommendations. Adolescents with 3 or more sexual partners annually were more involved with potentially health-harming behaviors such as illicit substance use and less involved with potentially health-protective behaviors such as seat belt use. These relationships were independent of sex, ethnic group, or socioeconomic status. The number of sexual partners may be considered part of a larger pattern of adolescent health-risk and health-protective behaviors. The guidelines may provide a useful framework for clinical assessment of these patterns as part of a routine health care visit of adolescent patients.

Management of a Potentially Harmful Health Behavior by Clinical Trial

A parent had been giving mega-doses of vitamin E to an 8-year-old child with 21-D trisomy for five years in the firmly rooted belief that this therapy was responsible for the child's freedom from constant symptoms of systemic and respiratory infection. The design of an unbiased double-blind clinical trial permitted the parent to reach, on her own, the face-saving conclusion that continuation of this therapy was no longer necessary. Applications of this approach and the underlying nonjudgmental attitude to other potentially harmful health behaviors and practices are discussed.