Korea Youth Risk Behavior Survey Research Articles

Unhealthy Weight Control Behaviors according to the Status of Combustible Cigarette and Noncombustible Nicotine or Tobacco Product Use among Korean Adolescents with Experience Attempting to Reduce or Maintain Their Body Weight: The 15th Korea Youth Risk Behavior Survey, 2019.

Noncombustible nicotine or tobacco product (NNTP) use, and cigarette smoking are associated with a high likelihood of unhealthy weight control behaviors (UWCBs) among adolescents. However, no study has addressed the differences in UWCBs among non-users, single users of combustible cigarettes (CCs) or NNTPs and dual users. This study compared the frequencies of weight control behaviors according to the status of CC and NNTP use among Korean adolescents. This was a cross-sectional study of 25,094 adolescents who had attempted to reduce or maintain their body weight during the past 30 days, using data from the 15th Korea Youth Risk Behavior Survey, 2019. Data on the status of CC and NNTP use, weight status, and weight control behaviors were obtained using self-report questionnaires. Subjects were categorized into four groups: non-users, cigarette-only users, NNTP-only users, and dual users. Among boys and girls, current smokers and NNTP users were 8.9%±0.3% and 5.5%±0.3%, and 4.2%±0.2% and 1.7%±0.1%, respectively. Among boys, NNTP-only users were more likely to engage in extreme weight control behaviors than non-users. Among girls, users of either CCs or NNTPs were more likely to engage in extreme weight control behaviors and less extreme weight control behaviors than non-users. This study shows that users of either CCs or NNTPs are more likely to engage in UWCBs, and NNTP-only users are the most likely to do so.

Association between allergic diseases, generalized anxiety disorder, and depressive symptoms in South Korean adolescents: a secondary data analysis of the 2022 Korea Youth Risk Behavior Survey.

This study investigated the relationship between allergic diseases, general anxiety disorder, and depressive symptoms among Korean adolescents. A secondary analysis was conducted on the findings of the 18th Korea Youth Risk Behavior Survey (2022). The study included 51,850 adolescents and analyzed the relationships among allergic diseases, general anxiety disorder, and depressive symptoms using complex samples logistic regression analysis. Among the Korean adolescents, 12.7% experienced general anxiety disorder, while 28.7% experienced depressive symptoms. The prevalence of allergic diseases was 5.7% for asthma, 36.3% for allergic rhinitis, and 22.2% for atopic dermatitis. General anxiety disorder was associated with asthma and allergic rhinitis but not atopic dermatitis. Depressive symptoms were associated asthma, allergic rhinitis, and atopic dermatitis. Examining the correlation among allergic diseases, general anxiety disorder, and depressive symptoms in adolescents underscores the need for implementing suitable strategies. Moreover, when addressing general anxiety disorder and depressive symptoms in adolescents, it becomes crucial to consider the presence of allergic diseases.

Factors influencing smartphone overdependence among adolescents

Adolescents are particularly vulnerable to smartphone overdependence. Therefore, we identified the factors influencing smartphone overdependence and risk subgroups among adolescents. The current study is a secondary analysis of nationally representative data from the 2020 Korea Youth Risk Behavior Survey. The survey targeted middle- and high-school students in South Korea aged 12–18 using stratified, clustered, multistage probability sampling, and 53,457 students from 793 schools participated in this study. Complex sample data were analyzed considering the strata, clusters, and weights. Multiple logistic regression analysis revealed age, gender, household economic status, anxiety, loneliness, depressive symptoms, and experience of violent treatment as significant predictors of smartphone overdependence. Adolescents with severe anxiety were at a 3.326 times higher risk of smartphone overdependence than adolescents with minimal anxiety. Decision tree analysis showed that anxiety, gender, loneliness, and depressive symptoms were important in differentiating risk subgroups, with anxiety being the most significant factor. Group 13, comprising girls with severe anxiety, had the highest risk at 52.9%. Thus, early detection and prevention of issues such as anxiety, loneliness, and depressive symptoms, as well as treatment for violence, can prevent smartphone overdependence among adolescents. Additionally, more thorough interventions for anxiety are warranted to prevent smartphone overdependence.

Trends in substance use among sexual minority adolescents in South Korea.

Substance use, that is of cigarettes, alcohol and chemical inhalants, is a major contributor to health-compromising behaviors and the related consequences among adolescents around the world. The purpose of this paper is to examine trends in this phenomenon in South Korea among sexually active adolescents who reported sexual minority behaviors as compared to their heterosexual (HS) peers. This study used data from the annual web-based survey called Korea Youth Risk Behavior Survey in 5-year intervals: 2006, 2011, and 2016. From 2017, the questions regarding the gender of sex partners were excluded from the survey, thus no data is available for sexual minorities after 2016. Selected data (Unweighted n = 10,029) was used to assess whether substance use increased, decreased, or remained unchanged among adolescents who reported same-sex (SS) behaviors and bisexual (BS) behaviors compared to their peers reporting HS behaviors. Demographic variables included age and assigned gender. Substances referred to are cigarettes, alcohol, and chemical inhalants. Logistic regression models were sex-stratified according to assigned gender. Trend analyses were carried out to examine disparities in substance use among sexually active adolescents across the three survey years. Across the three survey years, cigarette use, alcohol use, and problematic drinking declined among all sexually active youths, but there were some differences among the subgroups. In 2016, SS girls were more likely to use cigarettes than HS girls. The prevalence of alcohol use and problematic drinking among BS girls was relatively higher than among girls who exhibited either HS or SS behaviors. Inhalant use was very high among both boys and girls with SS and BS behaviors. The findings of the study reveal disparities in substance use between sexual minority and heterosexual adolescents in South Korea. This creates an alarm for collecting data separately for sexually diverse youth in future Korean national surveys with a goal of reducing substance use among all adolescents.

Mediating Effect of Loneliness on Anxiety and Smartphone Overdependence among Korean Adolescents: Based on the 16th Korea Youth Risk Behavior Survey

Background: This study aimed to determine the mediating role of loneliness in the relationship between anxiety and smartphone overdependence among Korean adolescents.Methods: This national cross-sectional secondary study used data from the 16th (2020) Korea Youth Risk Behavior Survey. The sample comprised 54,948 adolescents in middle and high schools. The mediating effects were analyzed using the procedure of Baron and Kenny and the Sobel test. Results: Anxiety impacted both loneliness and smartphone overdependence (P<0.001). Additionally, loneliness was identified as a factor influencing smartphone overdependence (P<0.001). Loneliness demonstrated a statistically significant mediating effect in the relationship between anxiety and smartphone overdependence (P<0.001).Conclusions: It was concluded that smartphone overdependence increases with the heightened maladaptive emotions of adolescents, such as anxiety and loneliness. These findings confirmed the mediating role of loneliness in the relationship between anxiety and smartphone overdependence.

Does Watching Mukbang and Cookbang Broadcasts Affect Subjective Body Image, Perceived Stress, and Physical Activity Levels among Korean Adolescents?

Background: We investigated whether physical activity, subjective body image, and perceived stress were linked to watching Mukbang and Cookbang broadcasts among Korean adolescents. Adolescents mainly watch Mukbang and Cookbang shows through media platforms such as YouTube and Instagram.
 Methods: We examined data on 51,743 Korean adolescents who participated in the Korea Youth Risk Behavior Survey in 2022. Data were evaluated using frequency, chi-square, and multivariate logistic regression analyses. Specifically, the relationship between watching Mukbang and Cookbang broadcasts and physical activity participation, subjective body image, and perceived stress was evaluated through a multivariate logistic regression analysis after adjusting for covariates such as sex, age, school type, and residential area.
 Results: The results showed that among Korean adolescents, watching Mukbang and Cookbang broadcasts was significantly related to the negative effects of feeling fatter and more stressed and the positive effect of greater participation in physical activities (possibly to combat feeling fat) (P<0.05). In other words, this study confirms that watching Mukbang and Cookbang broadcasts has the simultaneous effect of increased physical activity participation in conjunction with negative subjective body images. Moreover, it increased perceived stress in adolescents.
 Conclusion: Adolescents must be better educated about Mukbang and Cookbang broadcasts and their negative impact on subjective body image and perceived stress (as well as their positive impact on physical activity). Such education can help prevent these shows from creating negative teenage habits that can continue into adulthood. These results can be used as basic data for health education and policies that warn about the potential negative effects of such programs.

Korean Adolescents before and after COVID-19: Changes in Physical Activity, Mental Health, and Hygiene Management.

Adolescence is when health behaviors, namely, physical activity (PA), mental health, and hygiene management, are established. As the young represent our future societal welfare, their health requires attention, particularly in the face of a pandemic. We explored changes in Korean adolescent PA, mental health, and hygiene management before and after the COVID-19 pandemic to identify recommendations for improving adolescent health. We collected 2019-2021 data from the Korea Youth Risk Behavior Surveys from the Korea Disease Control and Prevention Agency for 166,590 middle and high school students (2019: 57,069; 2020: 54,809; 2021: 54,712). We analyzed seven variables (regular PA, high-intensity PA, and strength exercise participation, stress recognition, sleep-time satisfaction, brushing practice, and handwashing practice) to examine changes in adolescent behavior during these years. The findings indicated statistically significant differences in all seven variables over the three years (P<0.05). Specifically, regular PA was higher in 2019 and 2021 than in 2020; high-intensity PAs were highest in 2019, followed by 2021 and 2020; strength exercises were the highest in 2020, followed by 2021 and 2019; stress recognition was higher in 2019 and 2021 than in 2020; sleep-time satisfaction was the highest in 2020, followed by 2021 and 2019; brushing practice was the highest in 2019, followed by 2020 and 2021; and handwashing practice was the highest in 2020, followed by 2021 and 2019. The results recommend the need to encourage structured moderate-to-vigorous adolescent PA and systematic health education to improve Korean adolescent health behavior after COVID-19.

Association Between Atopic Dermatitis and Suicidal Behaviors in North Korean Adolescent Defectors From 2011 to 2019.

To evaluate the association between atopic dermatitis (AD) and suicidal behaviors in adolescent defectors among residents who escaped from North Korean (adolescent defectors, n=423) and adolescents with South Korean parents (Korean adolescents, n=540,265). The study used data from the Korea Youth Risk Behavior Survey conducted from 2011 to 2019. Differences in general characteristics, health behaviors, suicidal ideation, suicide plans, suicide attempts, and AD between adolescent defectors and Korean adolescents were examined. Multiple logistic regression analysis was used to determine the association between AD and suicidal behaviors. The adolescent defectors group had lower AD (16.3% vs. 24.2%), poorer subjective health (10% vs. 6%), smoked more (47% vs. 18%), drank more (60% vs. 43%), lived with family less frequently (56% vs. 96%), and were more than twice as likely to have depression (42% vs. 27%), suicidal ideation (30% vs. 14%), a suicide plan (23% vs. 5%), or have made a prior suicide attempt (19% vs. 3%) compared with the Korean adolescent group (p<0.001). The adjusted odds ratio for the adolescent defectors group compared to the Korean adolescent group was 1.66 for suicidal ideation, 3.59 for suicide plans, and 4.34 for suicide attempts (p<0.001). AD was found to be associated with suicide plans and attempts in adolescent defectors and associated with suicidal ideation in Korean adolescents. AD was significantly associated with suicide plans and suicidal attempts among adolescent defectors and suicidal ideation in Korean adolescents, based on a random sample of middle- and high-school students.

The Associations between the Number of School Sports Teams That a Student Regularly Participates in and Factors Such as Perceived Stress, Loneliness, and Sleep Satisfaction among Korean Adolescents Who Have Attempted Suicide.

Adolescents who have attempted suicide are more likely to experience a recurrence of suicidal behavior, thus necessitating systematic follow-ups and management. We aimed to investigate the association between the number of school sports teams that a student regularly participates in and psychological factors such as perceived stress, loneliness, and sleep satisfaction among 1393 Korean adolescents who have attempted suicide by using data from the 2022 Korea Youth Risk Behavior Survey. Frequency analyses were performed to evaluate participant characteristics. Chi-square analyses were used to examine the differences in participant characteristics according to the number of teams. Multivariate logistic regression analysis was used to examine the associations between the number of teams and perceived stress, loneliness, and sleep satisfaction. Our results indicated that participating in a greater number of sports teams at school was more strongly associated with reduced perceived stress, reduced loneliness, and increased sleep satisfaction. Specifically, the odds ratio (OR) for feeling very much stressed was 0.613 (range: 0.387-0.969; p = 0.036) among the participants who belonged to one team. Among those who belonged to two teams, the OR for feeling very much stressed was 0.482 (range: 0.281-0.286; p = 0.008). Among those who belonged to two teams, the OR for feeling a lot of stress was 0.514 (range: 0.304-0.870; p = 0.013), and that for not feeling much stress was 2.663 (range: 1.103-6.426; p = 0.029). The OR for not feeling much stress was 4.697 for those who belonged to three teams (range: 1.531-14.408; p = 0.007) and 6.671 for those who belonged to four or more teams (range: 1.858-23.953; p = 0.004). The OR for feeling no stress at all was 11.629 (range: 2.229-60.661; p = 0.004) for those who belonged to three teams and 93.531 (range: 19.260-454.207; p < 0.001) for those who belonged to four or more teams. In terms of loneliness, the OR for rarely feeling lonely was 2.651 (range: 1.148-6.123; p = 0.022) among those who belonged to one team. The OR for feeling lonely all the time was 0.370 (range: 0.155-0.884; p = 0.025) among those who belonged to two teams. In terms of sleep satisfaction, the OR for having very sufficient sleep was 4.371 (range: 1.627-11.742; p = 0.003) for those who belonged to four or more teams. These results suggest that school sports are an advantageous tool for suicide prevention, given their low costs, absence of side effects, and ease of participation.

A comparative study on eating habits and mental health of Korean middle school students according to their bedtime across regions: using data from the 2020-2022 Korea Youth Risk Behavior Survey.

The objective of this study was to compare dietary habits and mental health among middle school students in urban and rural areas based on bedtime, and to provide evidence supporting appropriate bedtime for Korean middle school students in relation to their healthy dietary habits and mental well-being. The study population consisted of 25,681 second-year middle school students who participated in the Korea Youth Risk Behavior Survey in 2020-2022. Participants were asked about their bedtime and wake-up time during the past 7 days and were classified into five categories. The study compared the general characteristics, academic factors, dietary habits, and mental health of urban and rural students based on their bedtime. Bedtime was found to be later in the following order: urban female students, rural female students, urban male students, and rural male students. As bedtime got later, the rates of smoking and alcohol consumption increased. Students who went to bed before 11 p.m. had lower academic performance, while rural male students who went to bed after 2 a.m. had lower academic performance. Later bedtime was associated with increased smartphone usage, skipping breakfast, consuming fast food, and drinking carbonated beverages. Later bedtime was also associated with higher perceived stress levels, particularly among students who went to bed after 2 a.m., higher rates of suicidal ideation, experiencing sadness and despair, as well as the prevalence of clinically significant anxiety disorders. These results suggest that middle school students who go to bed too late have higher rates of smoking and alcohol drinking, as well as unhealthy eating habits, stress, suicidal ideation, sadness, and anxiety. Therefore, it is necessary to provide educational and social institutional support to promote adequate sleep for the health of adolescents.

Effects of watching Mukbang and Cookbang videos on adolescents’ dietary habits and mental health: cross-sectional study using the 18th Korea Youth Risk Behavior Survey

Effects of watching Mukbang and Cookbang videos on adolescents’ dietary habits and mental health: cross-sectional study using the 18th Korea Youth Risk Behavior Survey

Relationship of the number of days of participation in school physical education classes in a week with body mass index, number of hospital treatments for school violence, and mental health status among Korean male adolescents

School sports activities may help address obesity, school violence and mental health issues, which can be considered the biggest issues related to adolescents. However, previous research has not examined the relationship between participation in school physical education classes and obesity, school violence and mental health among adolescents by focusing on the number of days adolescents participate in school physical education classes. Therefore, this study investigated the association of the number of days of participation in physical education classes in a week with body mass index, number of hospital treatments for school violence, and mental health status among Korean male adolescents. Data of 25,749 male Korean adolescents were collected from the 2022 Korea Youth Risk Behavior Survey. Data collected were analyzed using frequency analyses, chi-square analyses and multivariate logistic regression analyses. The results showed that the more Korean male adolescents participate in physical education classes in a week, the more likely they are to become healthy, overweight and obese. The more they participate in physical education classes in a week, the less often they are treated in hospitals for school violence. The more they participate in school physical education classes in a week, the less likely they are to experience suicidal ideation but more likely to feel lonely. Overall, increasing the number of physical education classes can help solve adolescents’ health problems, but they must participate actively and voluntarily in the classes. Efforts must be made to increase their active and voluntary participation.

Lifestyle Changes Caused by COVID-19 Pandemic Increase Oral Disease Symptoms.

The COVID-19 pandemic has led to severe restrictions on society worldwide, and social restrictions can lead to poor physical and oral health. This study investigated the association between oral disease symptoms and changes in lifestyle due to COVID-19. A multivariate logistic regression analysis was used to analyze data from the 2021 Korea Youth Risk Behavior Survey (N = 54 848). It showed that most households' economic conditions as "did not change at all" (adjusted odds ratio [aOR] = 1.00), "no change" (aOR = 1.10), "slightly worsened" (aOR = 1.21), and "very worsened" (aOR = 1.24). Information in a with "did not change at all" (aOR = 1.00), "no change" (aOR = 1.13), "slightly worsened" (aOR = 1.15), and "very worsened" (aOR = 1.18) economic conditions experienced heightened gingival pain and bleeding. In conclusion, the COVID-19 pandemic has caused a change in lifestyle and worsened socioeconomic status. In addition, as lifestyle changed and socioeconomic status declined, symptoms of deteriorating dental health emerged.

Association between Energy Drink Consumption and Sleep in High School Students Based on the 15th Korea Youth Risk Behavior Survey

Association between Energy Drink Consumption and Sleep in High School Students Based on the 15th Korea Youth Risk Behavior Survey

청소년의 범불안장애 수준에 따른 식생활 행태 및 관련 요인 분석: 제16차-제18차 (2020년-2022년) 청소년건강행태조사를 이용하여

The purpose of this study is to investigate the association between dietary behavior and related factors according to the generalized anxiety disorder (GAD) in adolescents. The results of analyzing demographic characteristics according to the GAD showed that gender, age, BMI, type of school, residence type, father's nationality, smoking and drinking experience, perceived health status, perception of body shape, economic status, academic achievement, physical activity, sedentary time and smartphone usage time were related to the GAD (p&lt;0.01). The results of analyzing dietary behavior according to the GAD showed that the frequency of water intake, sweetened beverage intake, fast food intake, fruit intake and breakfast intake were related to the GAD (p&lt;0.001). The results of analyzing depression and suicidality according to the GAD showed that depression, suicidal ideation, planning, and attempts were all related to the GAD (p&lt;0.001). Even after adjusting for factors corresponding to demographic characteristics, it was confirmed that the level of GAD had a significant effect on depression and suicidality. This study is significant in that it provided basic data on adolescent mental health problems by analyzing dietary behavior and related factors according to the level of GAD.

Changes in the Perceptions of Oral Symptoms Due to COVID-19 in Korean Adolescents.

This study investigated the oral symptoms and subjective health perceptions of Korean adolescents due to COVID-19. Data from the 17th Korea Youth Risk Behavior Survey (KYRBS; 2021) were analyzed, and 54,848 Korean middle and high school students were included in the study. Frequency, cross-tabulation, and logistic regression analyses were performed using IBM SPSS (v. 22.0; IBM Corp., Armonk, NY, USA). Statistical significance was set at p < 0.05. The survey results on subjective health perception showed that 64.8% considered themselves "healthy", 26.1% rated themselves "moderate" in health, and 9.26% rated themselves "unhealthy." When asked about brushing their teeth after lunch at school, students answered "no" more frequently than "yes". Participants provided significantly different responses to questions related to receiving "sealant treatment", "having broken teeth", "experiencing tooth pain when eating", "having throbbing tooth pain", and "having pain and bleeding in gums". Regarding the relationship between oral symptoms and subjective health perceptions due to COVID-19, students perceived themselves as healthy when they had no throbbing tooth pain, risk of pain, bleeding in the gums, or symptoms of toothache when eating. Results reveal a relationship between oral symptoms and subjective health perceptions due to COVID-19. Thus, appropriate oral health management for adolescents is needed in response to the COVID-related changes.

Health behaviors and mental health among adolescents: A comparison based on BMI using the 2021 Korea Youth Risk Behavior Survey.

Obesity and underweight can have adverse effects on adolescents. However, previous obesity management program conducted in Korea for adolescents with obesity showed low effectiveness, and there are few studies on underweight Korean adolescents. This study aims to analyze differences in the health behaviors and mental health of adolescents based on their body mass index (BMI). Data from the 2021 Korea Youth Risk Behavior Survey were examined. The health behaviors and mental health of 53,445 adolescents were analyzed according to BMI using SAS version 9.4 with the Rao-Scott χ2 test and logistic regression analysis. Regarding the difference in health behaviors according to BMI, a higher proportion of participants who are drinking alcohol and are exposed to secondhand smoke were in the underweight group than in the obesity group. The rate of obesity among those engaged in physical activity was higher than that among those involved in non-physical activity. In addition, the obesity group used smartphones more than the underweight group, while the quality of sleep was better among the underweight group than the obesity group. While the health behaviors and mental health of adolescents according to BMI are similar to those of previous studies, there are also distinct aspects. Consequently, further exploration of health behaviors and mental health based on BMI is crucial for developing and implementing targeted nursing intervention programs for adolescents with different weights.

Relationship between Family Type and Health Behaviors in Korean Adolescent: Based on the 17th Youth Health Behavior Survey

Objectives: This study was performed to identify the relationship between family type and health behaviors in Korean adolescents.Methods: The study included 41,551 students who participated in the 17th Korea Youth Risk Behavior Survey. Chi-square tests and multiple logistic regression analyses were used to compare health behaviors such as smoking, drinking, sexual experience, excessive smartphone use and physical activities by family type which were classified as general and broken families.Results: In this study, 85.7% of adolescents’ families were general families and 14.3% were broken families. According to multiple logistic regression analysis, the odds ratios (95% confidence intervals) for health behaviors among adolescents from broken families compared to adolescents from general families were 1.38 (1.21-1.58) for lifetime smoking, 1.53 (1.27-1.83) for current smoking, 1.46 (1.33-1.61) for lifetime drinking, 1.46 (1.29-1.66) for current drinking, sexual experience 1.65 (1.38-1.98), and excessive smartphone use on weekdays and weekends 1.39 (1.26-1.54) and 1.44 (1.30-1.58), respectively.Conclusions: Adolescents from broken families often have undesirable health behaviors, and are more likely to be exposed to high-risk groups than adolescents from general families. Depending on the type of family, the main caregiver’s active intervention through guidance and encouragement for the healthy behaviors is required, and it is necessary to prepare the direct psychological and behavioral support through the development of supporting programs in the community and continuous counseling program, which may play an alternative role of main caregiver.

Factors Influencing Adolescent Generalized Anxiety Disorder: A Zero-Inflated Negative Binomial Regression Model.

The current study used secondary data from the 17th Korea Youth Risk Behavior Survey conducted in 2021 to identify risk factors influencing the frequency with which adolescents in Korea experience generalized anxiety. Participants were 54,848 adolescents. Risk factors for generalized anxiety were analyzed using a zero-inflated negative binomial regression model. Of participants, 23.7% reported no generalized anxiety experiences. Risk factors identified in the count model were being female and having low household economic status as well as perceived stress, sadness, subjective sleep insufficiency, and loneliness. In the logit model, being female, in middle school, having middle and low household economic status, not living with family, having perceived stress, sadness, suicidal ideation, subjective sleep insufficiency, loneliness, and body image distortion were significant predictors of future anxiety among participants without anxiety. These results may be useful for planning nursing interventions to improve and prevent future health problems in adolescents. [Journal of Psychosocial Nursing and Mental Health Services, xx(x), xx-xx.].

Changes in Adolescent Health Behavior and the Exacerbation of Economic Hardship During the COVID-19 Pandemic: A Cross-sectional Study From the Korea Youth Risk Behavior Survey.

This study investigated the association between exacerbated economic hardship during the coronavirus disease 2019 (COVID-19) pandemic and changes in the health behaviors of Korean adolescents. We analyzed data from the 2021 Korea Youth Risk Behavior Survey and included 44 908 students (22 823 boys and 22 085 girls) as study subjects. The dependent variables included changes in health behaviors (breakfast habits, physical activity, and alcohol use) that occurred during the COVID-19 pandemic. The aggravation of economic hardship by COVID-19 and the subjective economic status of the family were used as exposure variables. Multiple logistic regression analysis was utilized to calculate the prevalence odds ratios (PORs). Severe exacerbation of a family's economic hardship due to COVID-19 was negatively associated with the health behaviors of adolescents, including increased breakfast skipping (POR, 1.85; 95% confidence interval [CI], 1.55 to 2.21 for boys and POR, 1.56; 95% CI, 1.27 to 1.92 for girls) and decreased physical activity (POR, 1.37; 95% CI, 1.19 to 1.57 for boys and POR, 1.38; 95% CI, 1.19 to 1.60 for girls). These negative changes in health behaviors were further amplified when combined with a low subjective family economic status. The experience of worsening household hardship can lead to negative changes in health behavior among adolescents. It is crucial to implement measures that address the economic challenges that arise from stressful events such as COVID-19 and to strive to improve the lifestyles of adolescents under such circumstances.