Health Risk Behaviors Research Articles

Applications of dialectical behavioural therapy in the perinatal period: A scoping review.

Psychological distress is the most common complication of pregnancy. High-risk concerns can include severe emotion dysregulation, suicidality and self-injury, and health risk behaviours, which bear substantial consequences for caregivers and families. Yet, effective, comprehensive interventions for high-risk caregivers have received limited attention. Dialectical behaviour therapy (DBT) is a frontline treatment for such concerns. Accordingly, we conducted a scoping review on the implementation of DBT in the perinatal period. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were followed. Seven studies were identified; study designs included case studies and single-arm pilot trials. Most studies used DBT-informed protocols with significant adaptations, few included multiple components of DBT (i.e. skills group, individual therapy, phone coaching and consultation team), and none met criteria for adherent delivery of all four modes of DBT treatment. Findings suggest DBT-informed interventions may be successfully implemented to treat a range of perinatal mental health symptoms, including borderline personality disorder, depression, anxiety, and post-traumatic stress, and to promote emotion regulation and positive parenting behaviours. While results provide preliminary support for perinatal DBT, this literature is scant and empirical rigour considerably lacking. Clinical implications and future directions are outlined to aid researchers and providers in addressing the ongoing perinatal mental health crisis and developing sorely needed interventions to address the needs of high-risk caregivers.

Potential Mediators of a School-Based Digital Intervention Targeting Six Lifestyle Risk Behaviours in a Cluster Randomised Controlled Trial of Australian Adolescents

Lifestyle risk behaviours—physical inactivity, poor diet, poor sleep, recreational screen time, and alcohol and tobacco use—collectively known as the “Big 6” emerge during adolescence and significantly contribute to chronic disease development into adulthood. To address this issue, the Health4Life program targeted the Big 6 risk behaviours simultaneously via a co-designed eHealth school-based multiple health behaviour change (MHBC) intervention. This study used multiple causal mediation analysis to investigate some potential mediators of Health4Life’s effects on the Big 6 primary outcomes from a cluster randomised controlled trial of Health4Life among Australian school children. Mediators of knowledge, behavioural intentions, self-efficacy, and self-control were assessed. The results revealed a complex pattern of mediation effects across different outcomes. Whilst there was a direct effect of the intervention on reducing moderate-to-vigorous physical activity risk, the impact on sleep duration appeared to occur indirectly through the hypothesised mediators. Conversely, for alcohol and tobacco use, both direct and indirect effects were observed in opposite directions cancelling out the total effect (competitive partial mediation). The intervention’s effects on alcohol and tobacco use highlighted complexities, suggesting the involvement of additional undetected mediators. However, little evidence supported mediation for screen time and sugar-sweetened beverage intake risk. These findings emphasise the need for tailored approaches when addressing different risk behaviours and designing effective interventions to target multiple health risk behaviours. The trial was pre-registered with the Australian and New Zealand Clinical Trials Registry: ACTRN12619000431123.

A Relationship-Based Resilience Program for Promotores: Protocol for a Randomized Controlled Waitlist Trial.

Community service providers (CSPs) play an integral role in the health care of low-income Hispanic or Latinx (HL) communities. CSPs have high-stress frontline jobs and share the high-risk demographics of their communities. Relational savoring (RS) has been associated with lower cardiovascular reactivity and psychosocial benefits, with particular promise among HL participants. In this study, we aim to identify RS's potential in promoting CSPs' cardiometabolic health and, in so doing, having broader impacts on the community they serve. This randomized controlled waitlist study aims to examine the effect of an RS intervention on (1) CSPs' cardiometabolic health (cardiometabolic risk factors and outcomes) and (2) CSPs' threats to leaving the workforce. We will recruit a sample of 80 CSPs from community health agencies serving low-income HL populations. Participating CSPs will be randomized into an experimental or a waitlist control. Participants will complete 1 or 2 baseline assessment batteries (before the intervention), depending on the assigned group, and then complete 2 more assessment batteries following the 4-week RS intervention (after the intervention and at a 3-mo follow-up). The RS intervention consists of guided reflections on positive moments of connection with others. Electrocardiogram data will be obtained from a wearable device (Polar Verity Sense or Movisens) to measure heart rate variability. The primary outcome is cardiometabolic health, consisting of cardiometabolic risk (obtained from heart rate variability) and cardiometabolic health behaviors. The secondary outcomes include CSPs' threats to leaving the workforce (assessed via psychological well-being), intervention acceptability, and CSPs' delivery of cardiometabolic health programming to the community (exploratory). Analyses of covariance will be used to examine the effects of RS on cardiometabolic health and on CSPs' threats to leaving the workforce, comparing outcomes at baseline, postintervention, and at follow-up across participants in the experimental versus waitlist group. The study has been approved by the University of California, Irvine, Institutional Review Board and is currently in the data collection phase. By May 2023, 37 HL CSPs have been recruited: 34 have completed the baseline assessment, 28 have completed the 4 intervention sessions, 27 have completed the posttreatment assessment, and 10 have completed all assessments (including the 3-mo follow-up). This study will provide valuable information on the potential of RS to support cardiometabolic health in HL CSPs and, indirectly, in the communities they serve. ClinicalTrials.gov NCT05560893; https://clinicaltrials.gov/study/NCT05560893. DERR1-10.2196/51427.

Intersectional Microaggressions and Cardiovascular Disease Risk Perception in Bisexual Black, Indigenous, and People of Color

Cardiovascular diseases (CVDs), or heart diseases, are the leading cause of morbidity and mortality nationwide. Separate bodies of research indicate that Lesbian, Gay, and Bisexual (LGB) individuals and Black, Indigenous, and People of Color (BIPOC) demonstrate high risk for CVD and report greater levels of intersectional microaggressions compared with their Heterosexual White and BIPOC counterparts. Within LGB communities, Bisexual individuals report more discrimination that is associated with more CVD risk factors compared with their Heterosexual and Lesbian and Gay (LG) counterparts. Research has not examined differences in the rates of CVD risk factors between Bisexual and LG BIPOC or the associations between intersectional microaggressions and heart disease risk perception in LGB BIPOC, a relevant construct correlated with health behavior and objective risk. Participants (N= 264) self-identified as LGB BIPOC and filled out measures on their CVD risk factors, CVD risk perception, and experiences of intersectional microaggressions or intersectional minority stress. Results showed that Bisexual and LG BIPOC reported similar odds for CVD risk factors. Intersectional minority stress and CVD risk perception were positively associated with Bisexual participants only. Findings underscore the importance of extending beyond traditional biomedical frameworks of CVD risk and recognizing the unique contribution of intersectional microaggressions for LGB BIPOC, with strong associations of intersectional minority stress for Bisexual BIPOC heart health.

Financial hardship among siblings of long-term survivors of childhood cancer: A Childhood Cancer Survivor Study report.

Siblings of children with cancer may experience adverse household economic consequences, but their financial outcomes in adulthood are unknown. A total of 880 siblings (aged 18-64years) of adult-aged childhood cancer survivors were surveyed to estimate the prevalence of financial hardship by three established domains (behavioral, material, and psychological). For individual financial hardship items matching the contemporaneous National Health Interview Survey or Behavioral Risk Factor Surveillance System, siblings were compared with the general population by calculating adjusted prevalence odds ratios (ORs) to sample-weighted responses. Multivariable logistic regression models examined associations between sibling characteristics and each hardship domain and between sibling hardship and survivors' cancer/treatment characteristics. Behavioral, material, and psychological hardship was reported by 24%, 35%, and 28%, respectively. Compared with national survey respondents, siblings were more likely to report worries about medical bills (OR, 1.14; 95% confidence interval [CI], 1.06-1.22), difficulty affording nutritious foods (OR, 1.79; 95% CI, 1.54-2.07), and forgoing needed medical care (OR, 1.38; 95% CI, 1.10-1.73), prescription medications (OR, 2.52; 95% CI, 1.99-3.20), and dental care (OR, 1.34; 95% CI, 1.15-1.57) because of cost. Sibling characteristics associated with reporting financial hardship in one or more domains included female sex, older age, chronic health conditions, lower income, not having health insurance, high out-of-pocket medical expenditures, and nonmedical/nonhome debt. No survivor cancer/treatment characteristics were associated with sibling financial hardship. Adult siblings of childhood cancer survivors were more likely to experience financial hardship compared with the general population. Childhood cancer may adversely affect entire households, with potentially lasting implications.

Metabolic syndrome risk among adolescents in the Deep South and the relationships with behavioral health, food insecurity, and physical activity.

A combination of physical and psychosocial risk factors put adolescents at risk for poor cardiometabolic health and chronic disease burden, often recognized as metabolic syndrome. The purposes of this study were to (1) identify the prevalence of metabolic syndrome risk among adolescents, utilizing the metabolic syndrome severity index, and (2) determine the relationship between metabolic syndrome risk and behavioral health, food insecurity, and physical inactivity among adolescents. A cross-sectional, descriptive, correlational design was deployed in an inner-city high school in the Deep South. An 8-month recruitment and enrollment period yielded a sample of 55 adolescents. A battery of measures included assessment of demographic data, anthropometric, cardiovascular, and psychosocial data. Utilizing these data elements, a progressive methodological approach was used to identify metabolic severity risk as a continuous variable for use in the adolescent population. All participants identified as African American/Black. Among them, 71% (N = 39) were female and an average age of 16 (SD = 1.3) years old, with 67.3% (N = 37) of the sample at risk for metabolic syndrome. There was not a statistically significant relationship between metabolic syndrome severity score and behavioral health risk, food insecurity, and physical inactivity in this sample. Future use of the continuous metabolic syndrome severity score may guide practice by utilizing longitudinal data to assess the trends of metabolic syndrome severity scores in relation to disease outcomes in adolescents. This may promote the identification of psychosocial and physical interrelationships with metabolic syndrome, thus improving overall health through the development of age-appropriate interventions.

Daily Optional Physical Education Does Not Counteract Increasing Inactivity by Age among Adolescents.

This paper describes the outcomes of an integrated health promotion programme implemented in a Hungarian high school offering health education in the curriculum, daily optional physical education, teacher training in applying a person-centered approach in teaching, and parental involvement in school activities. The evaluation used mixed methods of which results of the before-6-months-after quantitative survey among pupils is described. The health status and behaviour of students were assessed by applying the Hungarian version of the HBSC questionnaire. Significant improvement was found in the self-rated health of girls (6.6% increase in being of excellent health, p = 0.04), and the consumption of sweets and sugary soft drinks decreased significantly for both genders (boys: -10.2%, p = 0.01; girls: -6.06%, p = 0.04). However, the proportion of physically inactive girls significantly increased (girls: 11.2%, p = 0.01), and substance use did not change significantly. The intervention had significant positive impacts on subjective health and dietary habits and could counteract the secular trend of increasing tobacco, alcohol, and drug consumption by age among adolescents, but this unfortunately does not include physical inactivity. Offsetting the most widespread health risk behavior, physical inactivity, may require mandatory daily physical education in schools.

Impact of Integrated Training Program on Behavioural Outcome of Adolescents regarding Lifestyle Pattern from selected schools of Mysuru City

Background: Adolescents are independent and they build new relationships, create social skills and learn new habits and practices that they can carry with them for rest of their lives. Adolescent health and wellbeing are influenced by school environment and they must be provided special consideration and emphasis because of their health conditions and needs. A positive lifestyle can bring health and happiness, while a negative life-style can lead to illness and depression. A lifestyle has different components which includes: nutrition, physical activity, sleep pattern, healthy habits, hygienic practices, safety and health awareness, and these components contribute to an individual`s health. Health requires the promotion of healthy lifestyle. Health risk behaviours such as smoking, alcohol abuse, unhealthy dietary patterns, sedentary habits, and unsafe and aggressive behaviours have been found to have an important influence on morbidity and mortality. Health risk behaviours, which develop over time, can also contribute to an unhealthy lifestyle. Adolescent population and health of adolescents is a very special issue and is focus of attention globally for various reasons. An essential component in the prevention and management of diseases is the adoption of a healthy lifestyle that would include the promotion of non-smoking, eating a healthy balanced diet, and actively engaging in organized physical activities Methods: The main objective of the study was to determine the impact of integrated training program on behavioural outcome of adolescents regarding lifestyle pattern. The research design selected for this study was Pre-experimental - One group pre test post-test design. 500 adolescents were selected from selected schools of Mysuru through convenience sampling technique. Socio demographic Proforma was used to assess the selected socio demographic variables of adolescents. Structured knowledge questionnaire, self administered attitude scale and adolescent lifestyle practice scale was to assess the knowledge, attitude and practice of adolescents regarding lifestyle pattern. Results: The results of the study revealed that Knowledge, attitude and practice of adolescents were improved after implementation of Integrated Training Program. There was significant difference between pretest and post test knowledge, pre-test and post test attitude, pre-test and post test practice score after the Integrated training program Conclusion: The study concluded that integrated training program is effective in enhancing the knowledge, attitude and practice of adolescents regarding lifestyle pattern

Association between living arrangements and health risk behaviors among the Hakka older adults in Fujian, China

BackgroundBehavioral lifestyles are important social determinants of health. The impact of changes in living arrangements on behavioral lifestyles is currently under-explored. This study aims to examine the association between living arrangements and health risk behaviors among the Hakka older adults.MethodsData were extracted from China’s Health-Related Quality of Life Survey for Older Adults 2018. Living arrangements were divided into five categories: living alone, living with spouse only, living with child, mixed habitation, and others. Five health risk behaviors, including unhealthy dietary patterns, drinking, smoking, irregular sleep practices, and physical inactivity were measured. Logistic regression analysis was used to assess the association between living arrangements and specific health risk behaviors, and generalized linear models were established to test the association between living arrangements and the number of health risk behaviors.ResultsA total of 1,262 Hakka older adults were included in this study. Compared to those living alone, those living with spouse only were less likely to have unhealthy dietary patterns (OR = 0.45, P < 0.05) and drinking (OR = 0.50, P < 0.05), those living with the child were less likely to experience unhealthy dietary patterns (OR = 0.35, P < 0.001), drinking (OR = 0.32, P < 0.001), smoking (OR = 0.49, P < 0.05), and physical inactivity (OR = 0.13, P < 0.01). Moreover, those who were living with child (β = -0.78, P < 0.001) or mixed habitation (β = -0.33, P < 0.05) tended to engage in fewer health risk behaviors than those living alone.ConclusionsThis study suggests significant differences in health risk behaviors among the Hakka older adults with different living arrangements. Living with the child could reduce the occurrence of health risk behaviors in the Hakka older adults and thus maintain their health status.

Abstract A118: Prevalence and risk factors of breast cancer diagnoses among Native Hawaiian &amp; Pacific Islander women

Abstract Purpose: Breast cancer is the most common type of cancer for women nationally with evidence indicating clear racial and ethnic disparities in risk and occurrence. Yet our understanding of the distinct, population-level impacts among Native Hawaiian and Pacific Islander (NHPI) women is limited. NHPIs show elevated levels of multiple comorbidities and emerging evidence from local community studies suggests NHPIs suffer disproportionately from higher incidence, advanced stage of diagnoses, and lower survivability rates from breast cancer. The purpose of this study was to investigate the prevalence, sociodemographic characteristics, and risk factors associated with NHPI women diagnosed with breast cancer. Methods/Data: We utilized the 2014 Native Hawaiian and Pacific Islander National Health Interview Survey (NHPI NHIS), a nationally representative survey conducted by the CDC-NCHS to collect high-quality data on health conditions, health risk behaviors, and healthcare utilization among NHPI populations. Among 2,588 participants, 4% reported having ever been diagnosed with cancer, and among those breast cancer was the most common. Descriptive and regression analysis of socio-demographic characteristics, risk behaviors, and comorbidities to evaluate disparities in the incidence of breast cancer among NHPI women compared to other racial or ethnic populations. Findings/Conclusion: Population-based estimates of breast cancer prevalence among a diverse NHPI population show breast cancer inequities persist. Ongoing research is needed to better understand the underlying conditions and risks, prevention, and treatment of breast cancer in the population. Citation Format: Sarah A. McNally, Daniel J. Salas-Escabillas, Nicholas A. Sowizral, Sela V. Panapasa. Prevalence and risk factors of breast cancer diagnoses among Native Hawaiian &amp; Pacific Islander women [abstract]. In: Proceedings of the 16th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2023 Sep 29-Oct 2;Orlando, FL. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2023;32(12 Suppl):Abstract nr A118.

Finnish Retirement and Aging Study: a prospective cohort study

PurposeThe Finnish Retirement and Aging (FIREA) Study was set up to study changes in health behavioural and cardiometabolic risk factors across retirement transition, and to examine the long-term consequences of...

Dementia risk reduction in the general practice: a proof‐of‐concept study evaluating the use of a brain health promotion smartphone app

AbstractBackgroundDuring the last decades, evidence supporting the relevance of brain health promotion and dementia risk reduction has considerably expanded (1). Currently, this evidence is sufficient to take public health action (2, 3). However, implemented interventions are still scarce, especially at a large scale. In the Netherlands, evidence‐based cardiovascular risk management is already implemented in primary care. Since there is a large overlap between modifiable risk factors for dementia and those for cardiovascular disease, discussing dementia risk reduction next to cardiovascular health in the general practice seems a feasible, first step towards future large‐scale implementation of dementia risk reduction strategies.MethodA proof‐of‐concept study is currently being conducted in ten general practices in the Netherlands in which 180 participants between 40 and 60 years old, with room for improvement on at least one modifiable risk factor, will have a consultation with their general practitioner or practice nurse. During this consultation, they will learn about brain health promotion and how they could personally improve their risk profile. Practices have been randomly allocated (1:1) to either provide the consultation only, or to additionally provide the participants with a brain health promotion smartphone app (i.e. MijnBreincoach).ResultFeasibility will be evaluated using validated questionnaires assessing knowledge on dementia risk reduction, health behavior, motivation, usability, satisfaction, and user experience with the smartphone app. Surveys will be administered before the consultation at the general practice and three months thereafter. Further, ten participants and four healthcare professionals will be invited for a qualitative interview to get a more in‐depth view of the intervention’s feasibility.ConclusionDiscussing dementia risk reduction in the general practice may constitute a feasible and effective, scalable approach towards dementia risk reduction. Results of the study are expected by July 2023.

Рискогенное поведение россиян в сфере здоровья: динамика и факторы воздействия

The review analyzes health risk behaviors of Russians in the ‘pre-pandemic’ (2018–2019), ‘pandemic’ (2020–2021) and ‘post-pandemic’ (2022) periods. Risk behaviors of Russians have been studied in dynamics relying on the secondary analysis of the longitudinal database of the Russian Longitudinal Monitoring Survey of the National Research University Higher School of Economics; also, factors able to induce changes in them have been established. Evidence is provided to prove a multidirectional dynamics in risk behaviors among Russians during the COVID-19 pandemic: there was a decrease in medical and physical activities along with conditionally stable alcohol and tobacco consumption Men, people younger than 35, and those who did not have children were established to be less active in their interactions with official healthcare organizations and less concerned about their health. A size of a settlement where respondents resided had certain influence on their physical activity (more than 80 % of rural residents pointed out they did not do sports regularly). Addictive behaviors depended on sex, age, and having a partner: men and those respondents who were either married or cohabitated with a partner smoked and drank alcohol much more often. Certain socio-demographic groups tended to replace health protection practices with risky behaviors during the COVID-19 pandemic. Women, elderly people and single people tended to become less active as regards healthcare (and many of them remained non-active in the post-pandemic period). In addition to that, single respondents tended to become less physically active during eh pandemic. Addictive behaviors were more typical for men and employed people. Based on the obtained empirical data, the ‘pandemic’ period is described as a stage that does not facilitate occurrence and maintenance of greater adherence to health protection behavior among Russian citizens. Given low levels of trust in the public healthcare and high anxiety, lower medical activity of population has become an entrenched risk behavior pattern as regards health during the ‘post-pandemic’ period as well. It seems highly advisable to develop effective complex programs on health protection for different population groups including those aimed at making healthcare more available, conducting relevant preventing activities, and raising people’s awareness about value of health and ways to protect it.

Peer group leadership for dementia health risk reduction

AbstractBackgroundWith the worldwide number of persons with dementia predicted to triple by 2050 and a current lack of curative treatment [1], reduction of modifiable risks is increasingly important. In 2020 the Lancet Commission on Dementia, Prevention, and Care reported on twelve health risk management factors that could potentially reduce the risk of dementia [2]. Peer support groups have a history in supporting self‐management of health risk behaviour [3,4]. We wanted to learn if older adults have successfully provided peer leadership in group interventions for older adult health management.MethodUsing the Joanna Briggs Institute methodology for scoping reviews we searched three databases (Medline, Embase, and AgeLine) for articles describing older adult leadership for older adult health improvement in older adult health promotion or improvement groups. From the initial 16,000+ results, 19 studies met the criteria for full text screening and analysis.ResultOf the 19 studies, 12 used peer leaders and seven had a reciprocal support model. For those using peer leaders, training varied from none to 30 weeks. Older adult leadership or reciprocal support occurred in a range of settings. There were studies examining an older adult run seniors centre and a supportive community engagement program. Six studies focused on diabetes or hypertension, conditions linked with dementia risks. Interventions lasted from four weeks to 24 years. No quantifiable patterns of health management were observed. The only pattern that emerges is that positive physical and behaviour changes occurred more often when peer leaders or co‐facilitators were expected to motivate or encourage participant engagement or mutual support and where expectations included participant goal setting behaviour. Most of the studies of 12 weeks or less did not see lasting changes.ConclusionsWhen asked participants preferred and appreciated peer leadership; however, peer leadership itself was not sufficient for positive health changes. Research with a sharing and empowerment focus within groups often led to improved self‐efficacy and self‐management behaviours. Research with longer participant engagement may result in longer lasting health habits.

Digital health coaching to improve patient preparedness for elective lower limb arthroplasty: a quality improvement project

Major surgery carries high risks with comorbidities, frailty and health risk behaviours meaning patients are often unprepared for the physiological insult. Since 2018, the Prepwell programme at South Tees Hospitals...

Risky health-related behavior of Russians: dynamics and impact factors

The review analyzes health risk behaviors of Russians in the ‘pre-pandemic’ (2018–2019), ‘pandemic’ (2020–2021) and ‘post-pandemic’ (2022) periods. Risk behaviors of Russians have been studied in dynamics relying on the secondary analysis of the longitudinal database of the Russian Longitudinal Monitoring Survey of the National Research University Higher School of Economics; also, factors able to induce changes in them have been established. Evidence is provided to prove a multidirectional dynamics in risk behaviors among Russians during the COVID-19 pandemic: there was a decrease in medical and physical activities along with conditionally stable alcohol and tobacco consumption Men, people younger than 35, and those who did not have children were established to be less active in their interactions with official healthcare organizations and less concerned about their health. A size of a settlement where respondents resided had certain influence on their physical activity (more than 80 % of rural residents pointed out they did not do sports regularly). Addictive behaviors depended on sex, age, and having a partner: men and those respondents who were either married or cohabitated with a partner smoked and drank alcohol much more often. Certain socio-demographic groups tended to replace health protection practices with risky behaviors during the COVID-19 pandemic. Women, elderly people and single people tended to become less active as regards healthcare (and many of them remained non-active in the post-pandemic period). In addition to that, single respondents tended to become less physically active during eh pandemic. Addictive behaviors were more typical for men and employed people. Based on the obtained empirical data, the ‘pandemic’ period is described as a stage that does not facilitate occurrence and maintenance of greater adherence to health protection behavior among Russian citizens. Given low levels of trust in the public healthcare and high anxiety, lower medical activity of population has become an entrenched risk behavior pattern as regards health during the ‘post-pandemic’ period as well. It seems highly advisable to develop effective complex programs on health protection for different population groups including those aimed at making healthcare more available, conducting relevant preventing activities, and raising people’s awareness about value of health and ways to protect it.

The prevalence of health risk behavior engagement among grade 4 to 7 learners in primary schools: A phase one needs analysis.

Health risk behaviour, as it pertains to adolescent behaviour, poses a massive challenge for many fields of medicine, not only due to developmental and psychological concerns but also its inevitable contribution to the burden of disease through trauma and non-communicable diseases resulting from risky behavioural choices. The objective study is to explore the prevalence of health risk behavior engagement among grade 4-7 learners at four primary schools in the Western Cape, South Africa, as well as establish a need for a prevention program starting at primary school level. An observational, descriptive, quantitative design was used to conduct this study. Non-probability, heterogenous, purposive sampling was used to select the study population. A needs analysis assessment using a modified self-administered Child Health Risk Behaviour survey was conducted using 7-inch electronic tablets. Four primary schools agreed to participate yielding a total sample size of n=1147 learners in grades 4 to 7. Learners' age ranged from nine years old to fourteen years old with a mean age of 11.45 (SD 1.271). Riding a bicycle without a helmet, physical fight (86.1 and 64.1% among boys and girls respectively), ever smoked a cigarette (boys 36.3%; girls 28.3%) and consuming alcohol without permission (boys 28.7%; girls 23.8%) had the most engagement. Sexual curiosity questions had by far the most positive engagement and consistency of engagement among both boys and girls. This evidence reaffirms the need that early, bespoke and scientific intervention/prevention programs are needed to combat health risk behaviour and subsequently reduce the burden of disease.

Substance use typologies among young people experiencing homelessness in seven cities across the United States: A latent class analysis

BackgroundSubstance use and other health-risk risk factors, including mental health, trauma, and sexual-risk behaviors, often co-occur among youth experiencing homelessness (YEH). The present study aimed to identify subgroups of YEH based on polysubstance use and the linkages to sociodemographic and health-risk characteristics. MethodsFrom June 2016 to July 2017, 1,426 YEH (aged 18–26 years) were recruited from seven cities (Houston, Los Angeles, Denver, Phoenix, New York City, St. Louis, San Jose). Participants provided information via a self-administered electronic survey on substance use, mental health, trauma, sexual risk behaviors, and sociodemographic characteristics. The majority of YEH identified as Black (37.3%), cisgender (92.8%), and heterosexual (69.2%). On average, YEH were 20.9 years (SD = 2.1). This study employed latent class analysis (LCA) to identify subgroups of YEH according to their substance use. Multinomial logistic regression analyses were conducted to identify sociodemographic and health-risk characteristics associated with class-membership. ResultsFour latent classes of YEH substance use were identified: (1) high polysubstance use; (2) moderate stimulant and high marijuana, alcohol, and prescription drug use; (3) high marijuana, alcohol, and prescription drug use; (4) low/moderate marijuana and alcohol use. Multinomial logistic regression models indicated that geographic location, gender, race/ethnicity, mental health, trauma history, and sexual risk behaviors were significant correlates of substance use class membership among YEH. ConclusionsThese findings offer important implications for the prevention and treatment of substance use among YEH. Screening protocols should consider co-occurring risk factors such as traumatic experiences, sexual risk behaviors, and mental health history as indicators of polysubstance use.

Negative Sexual Experiences Among Gay, Bisexual, and Other Men Who Have Sex with Men Using GPS-Enabled Hook-Up Apps and Websites

ABSTRACT Gay, bisexual, and other men who have sex with men (GBMSM) often use GPS-enabled dating apps and websites to facilitate in-person sexual encounters. Many of these encounters are positive and enjoyable. However, there is limited research on GBMSM’s negative experiences with partners from hookup and dating apps/websites, especially those characterized by threats to GBMSM’s sexual, physical, and/or psychological safety. In this report, we investigated this matter. We analyzed data from interviews with GBMSM (N = 60) and identified four categories of negative sexual experiences, each of which were comprised by sub-categories: 1) sexual violence (physical sexual assault, verbal sexual coercion, intoxicated assault/coercion), 2) sexual health risk behaviors (condom use resistance and coercion, deception related to HIV/STI status), 3) non-negotiated behaviors (undiscussed/unexpected sex acts, rough sex, sexualized racism, undesired substance use by the partner), and 4) threats to physical safety beyond sexual violence (being blocked from leaving, stalked, robbed, drugged). These results can inform future research and interventions that aim to promote safety on dating apps/websites within the GBMSM community.

Validity of an online, self-administered Timeline Followback for alcohol use with adolescents

ObjectiveThe Timeline Followback (TLFB) is a widely used and well-validated interview-based tool for assessing patterns of recent health risk behavior. There is some evidence of the validity of the TLFB as a self-administered online tool for assessing alcohol use, but further research is needed to establish its validity in younger populations and populations outside the United States. Further, it is unknown how self-administered online TLFB formats compare to more timesaving and commonly used single-item alcohol questions. The primary aim of the current study was to validate a new online, self-administered TLFB for alcohol use against the TLFB interview in a sample of European (Danish) adolescents aged 16–18 years (N = 30).MethodsParticipants completed a TLFB telephone interview, a self-administered online version of the TLFB, and single-item alcohol questions. Assessments were administered using a within-subject, counter-balanced design. Estimates of number of drinking days, binge-drinking days, maximum drinks consumed on one occasion, total drinks, and drinks per drinking day were compared across metrics.ResultsAll correlations between the drinking outcomes assessed via the TLFB interview and the TLFB online were positive, and statistically significant (rss = 0.86–0.94, p &amp;lt; 0.01). Wilcoxon signed-rank tests showed no significant differences between the TLFB interview and the TLFB online on drinking days, binge drinking days, max drinks, and total drinks. Participants reported drinking significantly more drinks per drinking day on the TLFB online (M = 4.66) compared to on the TLFB interview (M = 4.12; p = 0.009).ConclusionOverall, the results support the validity of the online, self-administered TLFB in a sample of European (Danish) adolescents.