High-risk Health Behaviors Research Articles

Establishing Health Status Indicators by Surveying Youth Risk Behaviors of High School Students in the Dominican Republic

The purpose of this survey was to determine the health-risk behaviors among high school students in the Dominican Republic. Samples were taken from communities with an industrial base and an increasing population (n = 1175). The communities under study had dissimilar population sizes (i.e., 5,000, 30,000, 50,000) and were located in various geographical locations. Frequency data are compared by gender and population differences for high-risk health behavior indicators associated with urban migration. We found significant differences in tobacco, alcohol, and crack use among the different population sites, with higher rates reported by the more populous communities. Boys reported more fighting and sexual activity. Girls reported higher rates of suicide ideation and attempts. These results can be used to 1) help focus on those behaviors rooted during the school years that most influence health, 2) monitor those behaviors by establishing baseline data, and 3) supply data that are comparable with recognized categories of high-risk behaviors.

Physical activity and the initiation of high-risk health behaviors in adolescents

The association of physical activity to the initiation of health risk behaviors was examined in a 3-yr prospective study of a population-based cohort of 1245 adolescents aged 12-16 yr. Four hundred thirty-seven students (35% of the cohort) were identified at baseline via self-report survey as never having smoked cigarettes, consumed alcohol, used marijuana, or carried a weapon. Three measures of physical activity were obtained at baseline: leisure-time physical activity (LTPA), level of aerobic fitness (AF), and participation in competitive athletics. Significant associations, with notable gender differences, were observed between physical activity and the initiation of cigarette smoking and alcohol use. The cumulative proportion of male students initiating alcohol use was 48%, 42%, and 24% for high, moderate, and low LTPA, respectively (P < 0.01). Males who participated in competitive athletics were significantly more likely than nonathletes to initiate alcohol use (44% vs 17%, P < 0.01). The cumulative proportion of female students initiating cigarette use was 10%, 23%, and 22% for high, moderate, and low LTPA, respectively (P < 0.05) and 7%, 28%, and 16% for high, moderate, and low AF, respectively (P < 0.05). No association was found between physical activity and weapon carrying. These results indicate that in this cohort of adolescents, the most active or most fit females were less likely to initiate cigarette smoking. In contrast, the most active males or males who participated in competitive athletics appeared more at-risk for initiating alcohol consumption than their less active counterparts.

Using the Youth Risk Behavior Survey to Estimate Prevalence of Sexual Abuse Among Oregon High School Students

To estimate the extent of childhood sexual abuse, questions were added to the 1993 Oregon Youth Risk Behavior Survey of students in grades 9-12. Twenty-five high schools throughout Oregon participated in the survey. Among the 2,332 students who answered sexual abuse questions, 20.9% had ever been sexually abused; females (33.1%) were much more likely to have ever been abused than were males (8.1%). Females (10.3%) also were more likely than males (3.4%) to have been sexually abused within the past year. High school students sexually abused in the past year engaged in many high risk health behaviors such as weapon carrying, substance abuse, seriously considering suicide in the past year, and sexual activity when compared with students who had never been sexually abused. Further educational efforts with teachers, health care providers, parents, and child care providers, as well as development and use of school curricula, are needed to reduce sexual abuse.

Nutrition and health education for limited income, high-risk groups: Implications for nutrition educators

Nutrition educators have made much progress in educating families about food and its relationship to health, but many families who hear these health messages are not able to make the necessary changes to incorporate them into their lifestyles. For families with limited incomes or social patterns that predispose them to high-risk health behaviors, the struggle to cope with life's everyday problems takes precedence over health promotion and disease prevention. These families are often at high risk for health problems arising from the abuse of alcohol and tobacco, a lack of exercise, and a poor diet. Youths raised in such families are at particular risk for engaging in a number of negative health behaviors that are linked to chronic disease in adulthood. As the health care gap between the poor and the wealthy continues to widen, nutrition educators are faced with the challenge of meeting the needs of such high-risk families. Risk factors are individual or environmental hazards that increase one's vulnerability to negative developmental outcomes. 1 They do not guarantee negative outcomes but, rather; increase the odds that problem behaviors will occur. Poverty is one of many risk factors that place families at risk for engaging in poor health and nutrition behaviors2; it is associated with an increased risk for developing cardiovascular disease, obesity, and diabetes.36 The Report of the Task Force on Minority Health released in 1985 and 1986 emphasized the need for special attention to be paid to chronic health problems among minorities, whose average annual income is lower than that of white Americans. 7 In an article about blacks in the Mississippi Delta, Clancy recognized poverty as the most overwhelming cause of poor health among minorities.s Further, researchers in a Harlem study found that one third of the deaths that occurred among poor, black Americans would not have occurred if poor, black Americans had the same health status as white Americans with comparable incomes.

Computer-assisted detection and intervention in adolescent high-risk health behaviors

Because adolescents avoid bringing sensitive issues, such as substance abuse, suicide, and sexual activity, to pediatricians, and may fail to realize that they need health education or services, a computer program was designed to facilitate reporting of high-risk psychosocial and health behaviors and to provide specific health advice and referral for timely professional intervention. Computer printouts done anonymously by a random sample of 265 adolescents after a physical examination were compared with those of a matched group of 294 who were predirected to share the printout with the clinician at their examinations. The former elicited more positive responses to sensitive health problems, but both computer groups responded significantly more often about most high-risk issues than a matched written questionnaire group of 251. Almost all adolescents said that they reported true information to the computer and read all the information it printed. Experience with 3327 teenagers demonstrated that 89% preferred the computer over a questionnaire or personal interview, but nearly all were willing to share the printout with the pediatrician, which should facilitate clinical evaluation. The nonjudgmental computer can identify problem areas and deliver automated medical advice and referral. Automated health assessment and education may become a useful adjunct for addressing adolescent health issues.

Physicians' assessment of deficiencies and desire for training in adolescent care.

Over the past decade, there has been growing awareness among medical educators and care providers of the deficits in the training of primary care physicians to meet the health care needs of adolescents. The study reported here is the first national survey of primary care physicians' perceptions of their competency in dealing with adolescents' health concerns. In the survey, 351 internists, family practitioners, and pediatricians rated their competency in 19 areas of adolescent health care. Approximately three-quarters or more of the internists indicated deficits in all 19 areas. In areas related to gynecologic concerns, more pediatricians reported deficits than family physicians; but more family physicians than pediatricians reported deficiencies in managing acute conditions of youth (growth and developmental problems, endocrinopathies, school-based problems, and chronic illnesses). All physicians indicated deficiencies in dealing with high-risk health behaviors: eating disorders, drug and alcohol abuse, homosexuality, and delinquency. Finally, more than 45 percent of the physicians overall reported deficiencies in areas related to social and/or emotional concerns, including suicide, depression, and family conflicts. Despite these acknowledged deficits, most of the primary care physicians did not indicate adolescents to be the least desirable age group with which to work. However, few of the physicians expressed a desire to improve their skills. Overall, in none of the 19 areas did more than 30 percent of the physicians who had reported deficiencies in an area express interest in improving their competency.