Adolescent Health Behaviors Research Articles

Effects of a school-based lifestyle intervention on ideal cardiovascular health in Chinese children and adolescents: a national, multicentre, cluster-randomised controlled trial

BackgroundThe prevalence of ideal cardiovascular health among Chinese children and adolescents is alarmingly low. We aimed to examine whether a school-based lifestyle intervention against obesity would improve ideal cardiovascular health. MethodsIn this cluster-randomised controlled trial, we included and randomly assigned schools from the seven regions of China to intervention or control (1:1), stratified by province and school grade (grades 1–11; ages 7–17 years). Randomisation was done by an independent statistician. The 9-month intervention consisted of school promotion for diet, exercise, and self-monitor of obesity-related behaviours and the control group was no promotion. The primary outcome, assessed at both baseline and 9 months, was ideal cardiovascular health (six or more ideal cardiovascular health behaviours [non-smoking, BMI, physical activity, and diet] and factors [total cholesterol, blood pressure, and fasting plasma glucose]). We did intention-to-treat analysis and multilevel modelling. This study was approved by the ethics committee of Peking University, Beijing, China (ClinicalTrials.gov, NCT02343588). Findings30 629 students in the intervention group and 26 581 students in the control group from 94 schools with any follow-up cardiovascular health measures were analysed. At follow-up, 22·0% (1139/5186) of the intervention group and 17·5% (601/3437) in the control group met ideal cardiovascular health. Overall, the intervention was associated with ideal cardiovascular health behaviours (three or more; odds ratio 1·15; 95% CI 1·02–1·29), but not other ideal cardiovascular health metrics after adjusting for covariates. The intervention had higher effects on ideal cardiovascular health behaviours in primary school students aged 7–12 years (1·19; 1·05–1·34) than secondary school students aged 13–17 years (p<0·0001), with no apparent sex difference (p=0·58). The intervention protected senior students aged 16–17 years from smoking (1·23; 1·10–1·37) and improved ideal physical activity in primary school students (1·14; 1·00–1·30) but was associated with lower odds of ideal total cholesterol in primary school boys (0·73; 0·57–0·94). InterpretationThis school-based intervention, focused on diet and exercise, was effective in improving ideal cardiovascular health behaviours in Chinese children and adolescents. Early intervention might benefit cardiovascular health over the life course. FundingThe Special Research Grant for Non-profit Public Service of the Ministry of Health of China (201202010) and Guangdong Provincial Natural Science Foundation (2021A1515010439).

Oral health problems and treatment seeking behaviour of school going children and adolescents in Palampur area of Kangra district in Himachal Pradesh, India

Background: Poor oral health is still a major burden for populations throughout the world, particularly in developing countries. However, it could not receive proper attention in our country. Present study was conducted mainly to investigate oral health behavior of school going children and adolescents. Methods: Cross-sectional study was conducted during March 2022 to July 2022 among 268 students aged 6 to 19 years using stratified multistage random sampling technique in Palampur, Himachal Pradesh, India. Results: Among all 268 respondents including 118 (44%) females and 150 (56%) males, 116 (43.2%) respondents were aware of oral health problems. There were 251 (93.6%) respondents not aware of good oral hygiene practices and 224 (83.6%) suffered oral problems during last one year. Only 168 (62.7%) out of 268 respondents consulted dentists. Whereas, 231 (86.2%) were scared of consulting during covid-19 lockdown. Among those who consulted, 87 (51.7%) didn’t face any problem during dental checkup and satisfaction with consultation was reported by 146 (86.9%) respondents. High cost of treatment (41.7%) fear of absence from schools (40.0%) followed by misconception that treatment was not necessary (31.0%) came out to be the most common reasons on non-consultation. Conclusions: Present study reported high prevalence of oral health problems and lack of awareness regarding good oral hygiene practices among respondents. Oral health education should be imparted among children and adolescents for adopting good hygiene practices and timely seeking dental health care.

COVID-19 시기 청소년의 신체활동 수준에 영향을 미치는 요인 연구

This study was conducted with the aim of finding ways to promote physical activity for the healthy development of adolescents. As a result of checking the change in physical activity level using the three-year data of the Adolescent Health Behavior Survey, it was confirmed that the level of physical activity decreased in 2020 compared to 2019 and recovered again in 2021. The analysis centered on 2020 data, which represents the lowest level of physical activity. About 18.7% of the total were in the physically active group, which was more male and younger than the overall group. Comparing the mean values of happiness, stress, subjective health status, disease level, breakfast frequency, and smartphone dependence in the physically active high and middle low groups, the physically active high group showed more positive characteristics across all variables, and the differences were statistically significant. Logistic regression analysis of each variable under control for demographic characteristics showed that all characteristics except disease level had a significant impact. In a model in which all variables were added at the same time, it was confirmed that subjective health status variables had the greatest influence, the second was smartphone dependence, and the third was breakfast frequency. Based on these findings, we discussed ways to improve the level of physical activity among adolescents.

The Association of School Learning Environment With Adolescent Health Behaviors.

In 2020, schools shifted to remote learning in response to mitigating COVID-19. Since then, students have fluctuated between in-person and remote learning environments. Changes to instructional models raise questions about the impact on health. This study leveraged a statewide surveillance system (Healthy Kids Colorado Survey) to examine the relationship between learning environment and adolescent health. The survey was administered in Fall 2020 to 26 high schools, resulting in 4564 respondents. Overall, results suggested positive and negative associations between the 3 learning environments. Notably, as compared to in-person students, hybrid and remote students reported more stress (OR=1.82, p < .001; OR=1.41, p=.001), less school connectedness (OR=0.71 and 0.61, p < .001); remote students reported more parental abuse (OR=1.33, p=.010) and less alcohol consumption (OR=0.61, p < .001). This study may be used to better understand risk and protective factors experienced by youth at school and home with the goal of improving prevention strategies.

Changes in Physical Activity and Depression among Korean Adolescents Due to COVID-19: Using Data from the 17th (2021) Korea Youth Risk Behavior Survey

This study aimed to identify changes in the health behavior and mental health of adolescents due to coronavirus disease 2019 (COVID-19) and the characteristics related to changes in physical activity and depression among health behavior changes. Data were extracted from the 17th Korea Youth Risk Behavior Web-based Survey of 54,835 adolescents. We classified the adolescents into three groups according to changes in physical activity and depression: no change, increased, or decreased. Independent variables included changes in health behavior due to COVID-19, demographic characteristics, health-related behavior, and mental health. Data were analyzed using the χ2-test and multiple logistic regressions using the SPSS Statistics 27 program. Changes in physical activity and depression showing negative changes due to the pandemic were related to factors such as having breakfast, current smoking, current drinking, stress, loneliness, despair, suicidal ideation, suicide plans, and suicide attempts. The related factors differed between the increased and decreased groups. The results of this study confirm that it is necessary to develop programs to promote the health of youth by considering the factors that affect physical activity and depression, which in turn influences the status of their health.

Study of adolescent health behavior towards non-communicable disease risk factors in Special Region of Yogyakarta

Backgrounds: Non-Communicable Diseases (NCDs) are still one of the causes of high incidence and death rates in people of various age groups, especially adolescents with poor lifestyles and health behaviors due to a lack of awareness to prevent NCDs from an early age. This study aimed to analyze adolescents health behavior of adolescents aged 15-24 years toward risk factors for non-communicable diseases based on the RISKESDAS results of the Special Region of Yogyakarta. Methods: This research is a quantitative descriptive study using secondary data to analyze the health behavior of adolescents aged 15-24 towards risk factors for non-communicable disease behavior based on data collected from RISKESDAS data for the Special Region of Yogyakarta in 2007, 2013, and 2018. Data analysis was carried out descriptively for each risk factor and presented as a percentage chart. Results: The research shows that the risk factors for smoking every day and occasionally have decreased from 2007 to 2018. There has been an increase in the awareness of consuming fruits and vegetables. Meanwhile, there was an increase in alcohol consumption in 2018 and a decrease in doing sufficient physical activity for one week in adolescents aged 15-24 years in the Special Region of Yogyakarta. Conclusion: It can be concluded that risk factors for health behavior related to non-communicable diseases in adolescents are still caused by a lack of physical activity and the large number of adolescents who consume alcohol.

Intermittent Fasting Linked to Eating Disorder Behaviors

Back to table of contents Previous article Next article Clinical & ResearchFull AccessIntermittent Fasting Linked to Eating Disorder BehaviorsTerri D'ArrigoTerri D'ArrigoSearch for more papers by this authorPublished Online:26 Jan 2023https://doi.org/10.1176/appi.pn.2023.02.2.3AbstractA study points to the potential pitfalls of a dieting practice often touted as beneficial, or at least harmless.Intermittent fasting—the practice of limiting eating to certain hours of the day—may be associated with eating disorder behaviors in adolescents and young adults, a study in Eating Behaviors has found.Medical professionals should screen for intermittent fasting, says Kyle Ganson, Ph.D., M.S.W.University of Toronto“Public attention on intermittent fasting is only going to keep growing, so we need to continue to research the dietary practice holistically, not just how it may be beneficial, but also how it may be problematic,” lead author Kyle Ganson Ph.D., M.S.W., told Psychiatric News. He is an assistant professor at the Factor-Inwentash Faculty of Social Work at the University of Toronto. “We also need to continue to bring greater knowledge to [health professionals] on intermittent fasting to ensure proper guidance and oversight for patients.”Ganson and colleagues analyzed data from 2,762 people between the ages of 16 and 30 years who participated in the Canadian Study of Adolescent Health Behaviors. The participants answered questions about whether they engaged in intermittent fasting over the past 12 months or past 30 days, and if so, how often. The researchers used the Eating Disorder Examination Questionnaire (EDE-Q) 6.0 Global Score to assess the participants for eating disorder behaviors such as overeating, binge eating, vomiting, laxative use, compulsive exercise, and fasting.Overall, 47.7% of women, 38.4% of men, and 52% of transgender/gender nonconforming participants engaged in intermittent fasting in the past 12 months and 24.6% of women, 17.8% of men, and 24.1% of transgender/nonconforming participants engaged in intermittent fasting in the past 30 days. “Engagement in intermittent fasting is much more common than many might believe among a vulnerable age group—adolescents and young adults—where the codification of health behaviors largely occurs,” Ganson said. “It is important that medical professionals screen for intermittent fasting and are cautious about recommending intermittent fasting, particularly to young people.”Intermittent fasting in the past 12 months was associated with the following:All eating disorder behaviors (overeating, binge eating, vomiting, laxative use, compulsive exercise, and fasting) and higher EDE-Q global scores in women.Compulsive exercise, fasting, and higher EDE-Q scores in men.Fasting and higher EDE-Q scores in transgender/gender nonconforming people.The study is a reminder that eating disorders and their related behaviors cut across all genders, says Jason Nagata, M.D., M.Sc.Susan MerrellIntermittent fasting in the past 30 days was associated with the following:All eating disorder behaviors and higher EDE-Q global scores in women.Compulsive exercise, fasting, vomiting, and higher EDE-Q scores in men.Higher EDE-Q scores in transgender/gender nonconforming people.According to coauthor Jason Nagata, M.D., M.Sc., an assistant professor of pediatrics in the Division of Adolescent and Young Adult Medicine at the University of California, San Francisco, the results speak to the heterogeneity of eating disorders and their related behaviors.“Eating disorders can affect people of all genders, races, ethnicities, sexual orientations, ages, and sizes. You cannot tell that someone has an eating disorder based on appearance alone,” Nagata said. Ganson noted the visibility of intermittent fasting in both popular culture and research.“We often see ads for intermittent fasting apps on social media, influencers promoting it, and some research promoting it as a mechanism for weight loss, disease prevention, and increasing longevity,” Ganson said. “It is important to begin to change the popular conversation around intermittent fasting [and acknowledge] that it is not a benign dietary practice and can instead be connected to problematic behaviors.” ■“Intermittent Fasting: Describing Engagement and Associations With Eating Disorder Behaviors and Psychopathology Among Canadian Adolescents and Young Adults” ISSUES NewArchived

Effects of Welfare Reform on Positive Health and Social Behaviors of Adolescents.

This paper explores a missing link in the literature on welfare reform in the U.S.-the effects on positive health and social behaviors of adolescents, who represent the next generation of potential welfare recipients. Previous research on welfare reform and adolescents has focused almost exclusively on negative behaviors and found that welfare reform led to decreases in high school dropout and teenage fertility among girls, but increases in delinquent behaviors and substance use, particularly among boys. Using nationally representative data on American high school students in 1991-2006 and a quasi-experimental research design, we estimated the effects of welfare reform implementation on eating breakfast, regular fruit/vegetable consumption, regular exercise, adequate sleep, time spent on homework, completion of assignments, participation in community activities or volunteering, participation in school athletics, participation in other school activities, and religious service attendance. We found no robust evidence that welfare reform affected any of these adolescent behaviors. In concert with the past research on welfare reform in the U.S. and adolescents, the findings do not support the implicit assumption underlying welfare reform that strong maternal work incentives would increase responsible behavior in the next generation and suggest that welfare reform had overall adverse effects on boys, who have been falling behind girls in terms of high school completion for decades.

Adolescent Feelings on COVID-19 Distance Learning Support: Associations With Mental Health, Social-Emotional Health, Substance Use, and Delinquency

PurposeSchool social support is associated with improved adolescent wellbeing. However, positive school relationships were potentially disrupted when schools transitioned to distance learning in 2020 to mitigate the spread of COVID-19. This study investigated associations among perceived distance learning school support, mental health, social-emotional wellbeing, substance use, and delinquency among low-income, public high school students. MethodsWe analyzed longitudinal survey data, collected between June 2020 and June 2021, from 372 students attending five large urban public high schools. Mixed-effects regression models examined associations among changes in distance learning support and changes in mental health, social-emotional wellbeing, substance use, and delinquency, controlling for time, social-demographics, and baseline health. ResultsIn this predominantly Latinx (83%) sample, within-person increases in perceived distance learning support were associated with improved mental health, increased grit, increased self-efficacy, and decreased stress. Between-person differences in distance learning support indicated that students reporting greater support had improved mental and social-emotional outcomes. Although there were no within-person associations among distance learning support and hopelessness or delinquency, students with greater distance learning support (between-person) had lower levels of hopelessness and lower odds of engaging in any delinquent behavior. There were no associations between distance learning support and 30-day substance use. DiscussionSchool social support, even without students physically on campus, may be critical to adolescent health behaviors and social-emotional outcomes.

Muscle dysmorphia symptomatology among a national sample of Canadian adolescents and young adults

The aim of this study was to describe muscle dysmorphia (MD) symptomatology among a large, diverse, and national sample of adolescents and young adults in Canada. Data from the Canadian Study of Adolescent Health Behaviors (N = 2256) were analyzed. MD symptomatology was assessed using the Muscle Dysmorphic Disorder Inventory (MDDI). Men (mean [M] = 33.9, standard deviation [SD] = 8.6) reported significantly greater overall MD symptomatology compared to women (M = 30.1, SD = 7.3) and transgender/gender non-conforming (TGNC; M = 31.5, SD = 7.6) participants. Similarly, the prevalence of clinical MD risk was also highest among men (25.7 %). In regression analyses, participants who identified as South Asian (B 1.97, 95 % confidence interval [CI] 0.41, 3.52) or Middle Eastern (B 2.92, 95 % CI 0.50,5.35), compared to White participants, or identified as gay or lesbian (B 2.65, 95 % CI 1.19, 4.10), compared to heterosexual participants, had greater MD symptomatology. Findings are the first to describe the MD symptomatology among Canadian adolescents and young adults. Health care and public health professionals should be aware of the overall high occurrence of MD symptomatology in this sample, and future research is needed to continue to describe MD among Canadian young people.

Global Research Trends in School Bullying: A Bibliometric Analysis

School bullying is recognised as a global issue that raises academic and practitioner concerns because of its adverse consequences on students' physical, mental, and subjective well-being. This study aims to comprehensively examine the area of research on school bullying by performing a bibliometric analysis of 634 publications between 1996 and August 2022 from the Scopus database. Apart from that, this study highlights the prolific and most influential countries, authors, sources and journal articles in the area, and the research topics on which researchers have been working. The findings showed that the USA, the UK, and China are the most productive countries in school bullying. Note that Smith, P.K. from UK and Espelage, D.L. from the US are the most active and among the most influential authors. The Journal of School Violence and the International Journal of Bullying Prevention are the most active journals, and the Journal of Adolescent Health and Aggressive Behavior are the most cited journals. Meanwhile, the journal article by Wang, Iannotti, and Nansel (2009) is the most cited article, being published in the most cited journals. Several areas that are currently well explored, such as victimisation, prevention, and cyberbullying, have been discovered. The analysis also presented some recently investigated keywords, such as mental health, peer aggression, bullying perpetration, and self-control, which can be explored further. This paper's findings trace the trend and contribute to the scholarly literature on collective school bullying knowledge.&#x0D; &#x0D; Received: 18 September 2022 / Accepted: 26 December 2022 / Published: 5 January 2023

Public Health Implications of Social Media on Adolescent Health Behaviors: Upstream Approaches to Prevention Strategies

This commentary provides a comprehensive overview of the influence of social media on the health and well-being of adolescents, focusing on emotional/mental health, self-esteem, alcohol and drug use, peer pressure, and both negative and positive influences. It highlights concerns about the potential negative impact of social media, including increased levels of anxiety, depression, and loneliness, as well as the impact on self- esteem through seeking validation and unrealistic comparisons. Furthermore, it discusses how social media exposes adolescents to content promoting alcohol and drug use and amplifies peer pressure, leading to potential substance abuse and negative decision-making. Despite these drawbacks, the abstract acknowledges the positive aspects of social media, such as providing social support, educational resources, and mental health awareness. It emphasizes that social media can be leveraged in the high school classroom to promote healthy behaviors. Strategies for responsible social media use, critical thinking skills, digital literacy, cyberbullying prevention, and content creation are suggested as ways to navigate the online world safely and foster positive online interactions. By understanding both the negative and positive impacts of social media, collectively we can guide adolescents in using social media in a way that promotes resilience, well-being, and healthy habits. Employing strategies that harness the positive aspects of social media, educators, parents, and society can play a pivotal role in helping adolescents navigate the digital landscape, promoting healthy behaviors, and fostering resilience in the face of online challenges.

Changes in Lifestyle and Body Weight in Children and Adolescents during the COVID-19 Pandemic: A Representative Survey of Parents in Germany

Introduction: The public restrictions taken during the COVID-19 pandemic have substantially affected lifestyle and health behavior of children and adolescents. In Germany, little is known how these changes influenced daily life in families with children and adolescents. Methods: A cross-sectional survey was performed in April/May 2022 across Germany, similar to a survey performed in 2020. Parents (N = 1,004, 20–65 years) with at least one child aged 3–17 years filled in an online questionnaire released by the Forsa Institute for Social Research and Statistical Analysis. Fifteen questions related to eating habits, dietary patterns, physical activity, media consumption, fitness, mental health, and body weight were included, and standard socioeconomic parameters were assessed. Results: Parents’ answers indicated that there was a parental self-reported weight gain in every sixth child since the beginning of the COVID-19 pandemic. This was most obvious in children from families with lower household income and preexisting overweight. Parents also reported that lifestyle patterns had worsened: 70% reported an increase of media consumption during leisure time, 44% a decrease in daily physical activity, and 16% the worsening of dietary habits (e.g., 27% stated to eat more cake and sweets). Children aged 10–12 years were most severely affected. Conclusion: Negative health effects related to the COVID-19 pandemic are predominantly observed in children 10–12 years of age and in children from families with low household income, suggesting a worsening social disparity. Political action is urgently needed to tackle the adverse consequences of the COVID-19 pandemic on childhood lifestyle and health.

Prevalence and correlates of dry scooping: Results from the Canadian Study of Adolescent Health Behaviors

Dry scooping is a novel dietary practice characterized by consuming pre-workout powders without mixing with a liquid as directed. Despite purported benefits of this practice, such as increased energy due to the high concentration of caffeine, there are potential harms of engagement. To date, no known empirical research has investigated dry scooping in epidemiological research. Therefore, the aim of this study was to characterize the prevalence and correlates of dry scooping among a sample of Canadian adolescents and young adults. Data from the Canadian Study of Adolescent Health Behaviors (N = 2731) were analyzed. Prevalence of any dry scooping in the past 12 months among the overall sample, and by gender, was estimated. Modified Poisson regression analysis was used to determine the adjusted associations between sociodemographic and descriptive characteristics and dry scooping. Overall, 16.9 % of the sample reported dry scooping in the past 12 months, which was significantly more common among men (21.8 %) compared to women (14.2 %) and transgender/gender non-confirming participants (8.0 %). Participants who reported weight training, greater time spent on social media, and clinically significant symptoms of muscle dysmorphia were more likely to report dry scooping, while sexual minorities, relative to heterosexual participants, and those with higher education were less likely to report dry scooping. This study is the first known epidemiological study of dry scooping, underscoring the common nature of this contemporary dietary behavior. Findings emphasize the need for future research and prevention and intervention efforts to protect the health and well-being of young people.

Association between smartphone overdependency and mental health in Korean adolescents during the COVID pandemic; Age-and gender-matched study.

This study aimed to examine the relationship between smartphone dependency (SD) and mental health (MH) in adolescents in order to develop and implement plans pertaining to SD control. Raw data from the 16th Online Adolescent Health Behavior Survey in 2020 were analyzed. A total of 482 respondents were selected as study subjects based on their experience of smartphone overdependence (SO), specifically, 241 participants whose score for SO was 37 or higher (Group 2) and age- and gender-matched 241 participants whose score was lower than 10 (Group 1). Frequency analysis, cross-tab analysis (χ2 test), and multinomial logistic regression were performed Analysis shows that the MH affecting the increase in SO is the subjective perception of happiness, subjective perception of stress, sadness and despair, and experience of Loneliness. But, the variable affecting the reduction is the subjective evaluation of sleep quality. The likelihood of SO increased as adolescents felt unhappier [Exp (β) = 2.408] and more stressed [Exp (β) = 4.453] and more often felt lonely [Exp (β) = 8.149], but the likelihood decreased as they had neither sufficient nor insufficient sleep duration [Exp (β) = 0.344]. The findings suggest that it is necessary to develop aggressive measures for the prevention and management of MH in adolescents showing SO because mental health is closely linked to SD. In developing the measures, realistic approaches to widely pervasive SO among adolescents should be explored by taking into account MH factors, that is, predictors of SO, and the characteristics of youths, such that they can self-control smartphone use and form desirable life habits.

Use of Legal Appearance- and Performance-Enhancing Drugs and Substances: Findings from the Canadian Study of Adolescent Health Behaviors

Background Use of appearance- and performance-enhancing drugs and substances (APEDS) is common among adolescent and young adults. Many APEDS are legally sold “over-the-counter,” however research has documented contamination of legal APEDS and many adverse effects of use. Despite this, little research has been conducted on legal APEDS use in Canada, particularly regarding the prevalence and sociodemographic predictors of use, which was the aim of this study. Methods Data from the Canadian Study of Adolescent Health Behaviors (N = 2,731) were analyzed. Prevalence and frequency of use of 10 common APEDS in the past 12 months were estimated overall and across genders. Multiple modified Poisson regression analyses were conducted to determine the sociodemographic predictors of APEDS use. Results Overall, use of caffeine was most common among the sample (71.3%), along with protein bars (63.4%), and whey protein powders or protein shakes (63.1%). Boys and men reported greater prevalence of use of eight of the 10 APEDS, with the exception of diuretics or water pills and probiotics, compared to girls and women and transgender/gender non-confirming participants. Over three quarters (82.5%) of boys and men reported use of whey protein powders or protein shakes and 50.3% reported use of creatine monohydrate. Use of APEDS varied based on several key sociodemographic identifiers. Conclusions This study is the first to document legal APEDS use among a sample of Canadian adolescents and young adults, providing important implications for health care and policymaking professionals. Further research is needed to gain greater insight into APEDS use among Canadian young people.

Adolescent learning and health behavior during the COVID-19 pandemic

Background: COVID-19 pandemic, in its first year, forced restrictions on social, economic, work, education, and religious activities. All activities were diverted and conducted online to avoid exposure to the coronavirus. These online activities had an impact on students, particularly learning behavior and behavior related to health aspects. Objective: This research aimed to analyze adolescent learning and health behavior. Methods: A descriptive method with a cross-sectional study design was used. The research was conducted from November to December 2021 among students of the Faculty of Public Health, Halu Oleo University, Kendari City, South East Sulawesi Province, Indonesia. Data were collected using online questionnaires with Google Forms and were processed using epi info. Results: The impact of the COVID-19 pandemic on adolescents from the aspect of learning behavior was, during the online learning process, many adolescents experienced constraints, such as the lack of optimal internet networks in their areas in rural areas, the limited quota due to the pandemic also had an impact on the economy of students’ parents, power outages and unfavorable weather condition. In addition, changes in adolescent learning behavior became more skilled in using various applications. In terms of health behavior, there was a change in perspective and behavior, which is more sensitive to health, including dietary habits, exercise pattern, and readiness to face the new normal. Conclusion: The students got difficulty learning technically due to online learning, but there were also many positive impacts, namely increasing skills related to the use of technology, social communication, and health behavior.

Anxiety and Aggressive Behavior in Adolescents: A Correlational Study

Background: Aggressive behavior has become a severe behavioral problem in adolescents recently. Some cases have even been deemed an emergency for mental health behavior in adolescents. Many factors are suspected to be associated with aggressive behavior, one of which is anxiety. Anxiety and aggressive behavior remain widely studied in children, but the number of studies is limited to middle and late adolescents. In addition, there is no clear description of the psychosocial aspects between anxiety and aggressive behavior in adolescents based on the psychosocial development tasks. Objective: The study aims to identify the association between adolescents’ anxiety and aggressive behavior.Methods: The research used an analytical correlation design with a cross-sectional approach. The research was conducted in senior high schools in Surakarta in July 2021. Subjects were taken using convenience sampling, in which 626 students filled out the online questionnaire, while 32 students did not complete some items resulting in a total sample of 594 respondents. Then, the research instruments employed DASS 21 for anxiety and Buss Perry Questionnaire for aggressive behavior. The statistical analysis then utilized the Pearson product-moment test.Results: The research revealed that most respondents were female (67,8%). The respondents had a bullying victim history (44.8%), a violence victim history (13.3%), and parental divorce history (10.3%). The statistical test also uncovered a significant correlation between anxiety and aggressive behavior (p-value 0.0001, r: 0.649, OR:7.86, CI 95%).Conclusion: The finding demonstrates the association between adolescents’ anxiety and aggressive behavior. Consequently, the community mental health nurses should organize a partnership mental health program with the senior high schools to manage adolescent anxiety and aggressive behavior

The relationship between health literacy and correlates of adolescents' obesogenic and substance use behaviors

PurposeRisk perception (RP) and self-efficacy are targeted in adolescent health behavior interventions, however these variables have not been explored in relation to health literacy (HL). HL may affect how adolescents assess, prioritize, and integrate information when forming RP and self-efficacy and, ultimately, their health behaviors. This study assessed the relationship between functional, interactive, and critical HL and adolescents' behavior-specific RP and self-efficacy and health behaviors. Design and methodsCross-sectional data were collected from 380 adolescents attending high school via an online survey. Survey measures included demographics, functional, interactive, and critical HL, and substance use and obesogenic behavior-related beliefs, attitudes, and behaviors. Pearson correlations and regressions were estimated. ResultsThe relationship between HL and RP, self-efficacy, and behaviors varied by behavior and HL type. Critical HL was related to obesogenic-specific RP and behaviors, while interactive and critical HL were related to self-efficacy. Interactive and critical HL were related to substance use-specific RP and self-efficacy while functional and interactive HL were related to substance use behaviors. HL moderated several RP/behavior and self-efficacy/behavior relationships. ConclusionsThe significant relationships between HL and RP and self-efficacy highlight how HL may be an underlying factor or help shape adolescents' perceptions and beliefs adolescents have about behaviors and themselves, which ultimately influence their behaviors. Practical implicationsAdolescent interventions should be assessed to determine what underlying HL skills are needed for behavior change and assess and address HL directly as adolescents with low HL may be at a disadvantage for intervention uptake and outcomes.

Health behaviors and psychological burden of adolescents after parental cancer diagnosis

This study aims to investigate health behaviors and psychological burdens in adolescent children of cancer parents. We compared health behaviors and mental health outcomes between 266 adolescent children with a parent diagnosed with cancer and 3163 control adolescents aged 12–19 years using data from the Korean National Health and Nutrition Examination Survey (KNHANES) from 2010 to 2018. Alcohol use of adolescents increased between 2 and 5 years after parental cancer diagnosis (adjusted odds ratio [aOR], 1.72; 95% confidence interval [CI], 1.01–2.94) but decreased after 5 years. Parental cancer was associated with increased vaccination uptake in adolescents within 1 year of diagnosis (aOR, 3.19; 95% CI, 1.55–6.54), but after 2 years, there was no difference from rates in their peers. Maternal cancer was associated with increased depression among adolescents (aOR, 1.73; 95% CI, 1.10 − 2.73). Although the risks of suicidal thoughts/plans/attempts increased within 1 year after parental cancer diagnosis (aOR, 2.96; 95% CI, 1.00 − 8.83), it reduced 2 years after diagnosis, leading to no significant difference from the frequency in peers. Within five years after the parent was diagnosed with cancer, support for their adolescent children's health behaviors and mental health is necessary in the community.