National Survey Of Adolescents Research Articles

Prevalence of periodontal disease in young Moroccans: A national survey.

There are few large surveys of periodontal disease in young age cohorts, and national surveys in Africa do not exist. This study assessed the prevalence and severity of periodontal disease in a national survey of adolescents and young adults in Morocco. A multistage probability sampling design was used to draw a sample of 14,667 students 12-25 years old attending 87 schools. The sample was representative of approximately three million Moroccan students in this age group. A total of 27.9%, 11.9%, and 7.7% of the subjects had ≥1 tooth with ≥4, ≥5, and ≥6mm probing depth, and the population estimates were ≈ 822,436, 349,961, and 226,297 affected subjects, respectively. For attachment loss, the prevalences were: 11.6%, 9.5%, and 6.9% (or ≈ 341,761, 281,043, and 203,977 affected subjects) for ≥4, ≥5, and ≥6mm, respectively. The rates of probing depth and attachment loss increased significantly with the increase in age (p<0.01, p<0.001). Sex and urban status did not show significant effects on the prevalence of periodontal disease (p>0.05). Similarly, the relationship between the occupation status and periodontal status was modest and not statistically significant (p>0.05). Children and young adults attending public schools in Morocco have a high prevalence and severity of periodontal disease compared with other populations of similar age. The rate of periodontal disease reported here may be used as baseline population estimates in the surveillance of disease status in this population.

Descriptive norms about condom use predict odds of using a condom during last sexual experience in a large, national survey of adolescents from Australia.

Reducing sexually transmitted infections among adolescents is an important public health goal in Australia and worldwide. This study estimated the association between condom use during last heterosexual sexual experience with two descriptive norms among a large, national sample of secondary school students from Australia. A large, national online survey of 14- to 18-year-olds in Australia was conducted in 2018; a sub-analysis of sexually active participants (n =2989) used multivariable logistic regression to estimate the relationships between condom use during last sexual experience and condom use norms. The analysis controlled for the effects of age, sex, sexual orientation, religious affiliation, remoteness and knowledge of sexually transmitted diseases. Overall, 1673 (56.0% [95% confidence interval: 54.2%, 57.8%]) sexually active respondents reported using condoms during their last sexual experience. Perceiving that all same-age peers used condoms conferred higher odds of using condoms during their last heterosexual sexual experience (adjusted odds ratio: 3.06 [95% CI: 1.6, 6.0]). Perceptions about whether the suggestion to initiate condom use came from boys, girls, or both boys and girls was not associated with condom use. Differences in condom use related to socio-demographic characteristics are reported. As part of a holistic approach to sexuality education, health educators and service providers may emphasise that young people frequently choose to use condoms.

Sources of Bias When Combining Routine Data Linkage and A National Survey of Secondary School-Aged Children: A Record Linkage Study

IntroductionLittle is known of the potential impacts of introducing data linkage processes on response rates and biases in school-based surveys.&#x0D; Objectives and ApproachThis paper assessed: i) the impact on parental consent rates for student participation in a school survey; ii) sample representativeness; and iii) the quality of identifiable data provided to facilitate linkage. An option for data linkage was piloted in a sub-sample of schools participating in the Student Health and Wellbeing survey, a national survey of adolescents in Wales, UK. Schools agreeing to participate were randomized 2:1 to receive the data linkage question. Survey responses from consenting students were anonymised and linked to routine datasets (e.g. general practice, inpatient, and outpatient records). Parental withdrawal rates were calculated for linkage and non-linkage samples. Multilevel logistic regression models compared characteristics between: i) consenters and non-consenters; ii) successfully and unsuccessfully linked students; and iii) linked cohort and peers within the general population, with additional comparisons of mental health diagnoses and health service contacts.&#x0D; ResultsThe sub-sample comprised 64 eligible schools (out of 193), with data linkage piloted in 39. Parental consent was comparable across linkage and non-linkageschools. 48.7% (n=9,232) of students consented to data linkage. Consenting students were more likely to be younger, more affluent, have higher positive mental wellbeing, and report fewer risk-related behaviours compared to non-consenters. Overall, 69.8% of consenting students were successfully linked, with higher rates of success among younger students. The linked cohort had lower rates of mental health diagnoses (5.8% vs. 8.8%) and specialist contacts (5.2% vs. 7.7%) than general population peers.&#x0D; ConclusionIntroducing data linkage within a national survey of adolescents had no impact on study completion rates. Students consenting to data linkage, and those successfully linked, differed from non-consenting students on numerous key characteristics, raising questions concerning the representativeness of linked cohorts.

Sources of potential bias when combining routine data linkage and a national survey of secondary school-aged children: a record linkage study

BackgroundLinking survey data to administrative records requires informed participant consent. When linkage includes child data, this includes parental and child consent. Little is known of the potential impacts of introducing consent to data linkage on response rates and biases in school-based surveys. This paper assessed: i) the impact on overall parental consent rates and sample representativeness when consent for linkage was introduced and ii) the quality of identifiable data provided to facilitate linkage.MethodsIncluding an option for data linkage was piloted in a sub-sample of schools participating in the Student Health and Wellbeing survey, a national survey of adolescents in Wales, UK. Schools agreeing to participate were randomized 2:1 to receive versus not receive the data linkage question. Survey responses from consenting students were anonymised and linked to routine datasets (e.g. general practice, inpatient, and outpatient records). Parental withdrawal rates were calculated for linkage and non-linkage samples. Multilevel logistic regression models were used to compare characteristics between: i) consenters and non-consenters; ii) successfully and unsuccessfully linked students; and iii) the linked cohort and peers within the general population, with additional comparisons of mental health diagnoses and health service contacts.ResultsThe sub-sample comprised 64 eligible schools (out of 193), with data linkage piloted in 39. Parental consent was comparable across linkage and non-linkage schools. 48.7% (n = 9232) of students consented to data linkage. Modelling showed these students were more likely to be younger, more affluent, have higher positive mental wellbeing, and report fewer risk-related behaviours compared to non-consenters. Overall, 69.8% of consenting students were successfully linked, with higher rates of success among younger students. The linked cohort had lower rates of mental health diagnoses (5.8% vs. 8.8%) and specialist contacts (5.2% vs. 7.7%) than general population peers.ConclusionsIntroducing data linkage within a national survey of adolescents had no impact on study completion rates. However, students consenting to data linkage, and those successfully linked, differed from non-consenting students on several key characteristics, raising questions concerning the representativeness of linked cohorts. Further research is needed to better understand decision-making processes around providing consent to data linkage in adolescent populations.

The Impact of the London Bombings on the Well‐Being of Adolescent Muslims*

AbstractWe exploit the timing of the London bombings of July 2005, coinciding with a large‐scale national survey of adolescents, to identify the impact of extremist Islamic terror attacks on the well‐being of adolescent Muslims. Our analysis reveals interesting gender differences. We find evidence of a decline in the happiness of Muslim teenage girls after the bombings, which is also accompanied by a rise in expectations of facing discrimination in the labour market. These findings are robust to several falsification tests. However, we fail to uncover compelling evidence of any impact of the bombings on Muslim teenage boys.

Mechanisms of Social Media Effects on Attitudes Toward E-Cigarette Use: Motivations, Mediators, and Moderators in a National Survey of Adolescents.

BackgroundExposure to risk behavior on social media is associated with risk behavior tendencies among adolescents, but research on the mechanisms underlying the effects of social media exposure is sparse.ObjectiveThis study aimed to investigate the motivations of social media use and the mediating and moderating mechanisms of their effects on attitude toward electronic cigarette (e-cigarette) use among adolescents.MethodsUsing data from a national sample survey of adolescents (age=14-17 years, N=594), we developed and validated a social media use motivation scale. We examined the roles of motivations in the effect of social media use on risk exposure and risk attitude.ResultsMotivations for social media use included agency, self-expression, realism, social learning, social comparison, and filter. These motivations were associated differentially with the frequency of use of Facebook, Instagram, Snapchat, and YouTube. Frequency of social media use was positively associated with exposure to e-cigarette messages across the four platforms (Ps<.001). Exposure to e-cigarette messages on Instagram (P=.005) and Snapchat (P=.03) was positively associated with attitude toward e-cigarette use. Perceived social media realism moderated the effects of e-cigarette message exposure such that when realism was high, the exposure effect was amplified, but when realism was low, the effect was mitigated (P<.001). A three-way interaction effect (P=.02) among exposure, social learning motivation, and social norm on attitude toward e-cigarette use was found. When perceived social norm was high, the moderating effect of social learning motivation on e-cigarette use attitude was amplified, but when social norm was low, the social learning motivation effect was attenuated.ConclusionsBecause perceived social media realism moderates the effect of exposure to e-cigarette messages on attitude toward e-cigarette use, future intervention efforts should address the realism perceptions. The three-way interaction among exposure, social learning motivation, and social norm indicates the importance of addressing both the online and offline social environments of adolescents. The social media use motivation scale, reflecting perceived affordances, is broadly applicable. Understanding social media use motivations is important, as they indirectly influence attitude toward e-cigarette use via frequency of social media use and/or frequency of exposure to e-cigarette messages on social media.

New Directions to Improve Preventive Care Discussions for Adolescents and Young Adults.

The passage of the Affordable Care Act reduced financial barriers to preventive care,1 and the development of adolescent vaccines prompts patients to visit their primary care providers more frequently.2 This provides a rich opportunity to improve the delivery of adolescent preventive services. In this month’s Pediatrics , Santelli et al3 report findings from a national survey of adolescents and young adults about discussing potentially sensitive topics with medical providers during primary care visits. Notably, private time with providers, explanation of confidentiality, and risk-factor screening were associated with discussing more topics during these visits. Collectively, these findings provide important direction for efforts to improve the delivery of adolescent preventive care. Advances in primary care management of chronic conditions, preventive care for young children, and quality improvement science over the past 2 decades inform how best to implement these elements of primary care. Changing office systems to promote consistent screening, private time with providers, and confidentiality policies can be done through changing office culture, assigning new roles to office staff, working in teams, and measuring performance. … Address correspondence to Jeanne Van Cleave, MD, Department of Pediatrics, University of Colorado, 13199 E. Montview Blvd, Suite 300, Aurora, CO 80045. E-mail: jeannemarie.vancleave{at}childrenscolorado.org

Assessing the relationship between smoking and abdominal obesity in a National Survey of Adolescents in Brazil

Abdominal obesity is even a stronger risk factor than overall obesity for noncommunicable chronic diseases. We examined the association between smoking and abdominal obesity among adolescents. Analyses were based on 38,813 subjects aged 15–17 years from the Study of Cardiovascular Risks in Adolescents (ERICA), a Brazilian school-based national survey. Abdominal obesity was defined considering waist circumference (WC) percentiles. Statistical analyses, stratified by sex, considered the sample complex design. Poisson regression with robust variance was used to estimate smoker-to-nonsmoker abdominal obesity prevalence ratio (PR), adjusting by sociodemographic and lifestyle variables. Higher prevalence of abdominal obesity was observed among adolescents who consumed >1 cigarettes/day, comparing to nonsmokers: considering WC >80th percentile, adjusted-PR for boys was 1.27 [95%CI:1.05,1.52] and, for girls, 1.09 [95%CI:1.00,1.19]; using the 90th percentile, adjusted-PR were 2.24 [95%CI:1.70,2.94] and 1.27 [95%CI:1.12,1.46], respectively for male and female adolescents. Our findings suggest a positive association between cigarette consumption and the prevalence of abdominal obesity, for both boys and girls. Although other studies had found this association in adults, our study contributes to this discussion by assessing it in adolescents using a nationwide representative sample of medium and large municipalities.

Examining the Gendered Effect of Experienced and Vicarious Victimization: A General Strain Theory Perspective

Although general strain theory has broadened our theoretical perspectives, there remains a need to learn about the relationship between victimization and violence. In addition, studies applying general strain theory have yielded mixed findings about gender issues. Using data from the National Survey of Adolescents (NSA), the current study examined the effects of violent victimization on violent offending by gender. More specifically, the study assessed the relationship between two types of victimization (experienced and vicarious) and three types of violent offending (gang fights, robbery, and assault) and investigated whether gender plays a role in the association. Findings of negative binomial regression analyses offered overall support for experienced and vicarious victimization as predictors of violence. However, gendered effects of experienced and vicarious victimization on violence were not supported by results. Interaction effects between gender and victimization were only significant in baseline models (without control factors), however, became insignificant in full models. The implications of these results and limitations were discussed.

Religiosity and adolescent marijuana use

ABSTRACTAmong adolescents, religiosity has been associated with lower rates of marijuana use, though few studies have examined its impact on the perceived risk of use. There is strong support that perceived risk of using marijuana is negatively correlated with the frequency of use. We examined the relationship among religiosity, perceived risk, and marijuana use from a national survey of adolescents that contained questions about lifetime, weekly, and past month substance use, social support, religious involvement and attitudes, and perceived riskiness of use. We tested a structural equation model of relationships among latent variables of religiosity and perceived risk, and an observed variable of total days of marijuana use in the past 12 months. Results indicated the model was a good fit to the data and described a mediating relationship of perceived risk of use between religiosity and marijuana use. Implications for leveraging religiosity in prevention of substance use are discussed.

Boys are not exempt: Sexual exploitation of adolescents in sub-Saharan Africa

Research on youth sexual exploitation in Africa has largely neglected the experiences of exploited boys. To date, much of the research in sub-Saharan Africa continues to consider boys mainly as exploiters but not as exploited. Using the only publicly available population-based surveys from the National Survey of Adolescents, conducted in four sub-Saharan African countries — Burkina Faso, Ghana, Malawi, and Uganda—we assessed factors associated with transactional sexual behaviour among never-married adolescent boys and girls. We also examined whether boys’ reported sexual exploitation was linked to similar risky sexual behaviours as has been noted among girls in sub-Saharan Africa. Results from our analyses indicated that even though adolescent girls have a somewhat higher likelihood of reporting sexual abuse and exploitation, the odds of trading sex were significantly elevated for previously traumatized boys (that is those with a history of sexual and physical abuse) but not for their female counterparts. Just like adolescent girls, transactional sexual behaviour was associated with the risk of having concurrent multiple sexual partners for boys. These findings support the reality of boys’ sexual exploitation within the African context, and further highlight the importance of including males in general and boys in particular in population-based studies on sexual health, risk, and protective factors in the sub-Saharan African region. Understanding the factors linked to sexual exploitation for both boys and girls will help in developing policies and programs that could improve the overall sexual and reproductive health outcomes among adolescents and youth in sub-Saharan Africa.

Victim Reports of Bystander Reactions to In-Person and Online Peer Harassment: A National Survey of Adolescents.

Bullying prevention is increasingly targeting education to bystanders, but more information is needed on the complexities of bystander actions across a wide variety of incidents, including both online and in-person peer harassment. The current study analyzes victim report data from a nationally representative survey of youth ages 10-20 (n = 791; 51% female). Bystander presence was common across all harassment incident types (80% of incidents). In contrast to previous research, our study found that supportive bystander behaviors occurred at relatively high rates. Unfortunately, antagonistic bystander behaviors, although less common, were predictive of higher negative impact for the victim. A large percentage of victims (76%) also disclosed the harassment to confidants, who play an important role as secondary bystanders. While friends were the most common confidant, incidents were also disclosed to adults at high rates (60%) and with mostly positive results. The findings suggest that prevention programs could increase their impact by targeting education to both direct witnesses and confidants, and considering a wider variety of peer victimization incident types.

“Sexting” and Its Relation to Sexual Activity and Sexual Risk Behavior in a National Survey of Adolescents

PurposeTo examine the relation between “sexting” (sending and sharing sexual photos online, via text messaging, and in person) with sexual risk behaviors and psychosocial challenge in adolescence. MethodsData were collected online between 2010 and 2011 with 3,715 randomly selected 13- to 18-year-old youth across the United States. ResultsSeven percent of youth reported sending or showing someone sexual pictures of themselves, in which they were nude or nearly nude, online, via text messaging, or in person, during the past year. Although females and older youth were more likely to share sexual photos than males and younger youth, the profile of psychosocial challenge and sexual behavior was similar for all youth. After adjusting for demographic characteristics, sharing sexual photos was associated with all types of sexual behaviors assessed (e.g., oral sex, vaginal sex) as well as some of the risky sexual behaviors examined—particularly having concurrent sexual partners and having more past-year sexual partners. Adolescents who shared sexual photos also were more likely to use substances and less likely to have high self-esteem than their demographically similar peers. ConclusionsAlthough the media has portrayed sexting as a problem caused by new technology, health professionals may be more effective by approaching it as an aspect of adolescent sexual development and exploration and, in some cases, risk-taking and psychosocial challenge.

Household living arrangements and transition to sexual debut among young people in Ghana

There is abundant research on the links between family and household structure and young people's sexual risk-taking behaviours, but this scholarship although emerging in sub-Saharan Africa is largely limited to the West. Using data from the 2004 National Adolescent Survey conducted among 12–19 year olds in Ghana, and applying discrete time hazard models, this study examined the effects of household living arrangements on the timing of first sexual intercourse among adolescents in Ghana. The study also explored the extent to which parental monitoring and supervision mediates the effects of household living arrangements on age at first sex. Results indicate that young people who live alone, with grandparents or other households had a higher risk of first sex compared with those who lived with both biological parents. Much of this advantage, however, could be attributed to parental monitoring and household wealth. There were significant gender differences among Akan and non-Akans regarding the timing of sexual debut among young people in Ghana.

Community factors shaping early age at first sex among adolescents in Burkina Faso, Ghana, Malawi, and Uganda.

Using data from the National Survey of Adolescents (2004), we examine the community-level factors associated with early age at first sex among adolescents 14-19 years old in four African countries. Regression models are fitted separately by sex for each country for an outcome measuring early age at first sex, with a focus on community-level factors as potential influences of age on sexual debut. The community-level factors associated with adolescents' sexual debut vary widely by both country and gender. Community influences that emerge as risk or protective factors of early sexual debut include community levels of adolescent marriage, wealth, religious group affiliation, sex education, parental monitoring, reproductive health knowledge, media exposure, membership in adolescent social group, and use of alcohol. Results indicate the importance of context-specific understanding of adolescents' sexual behaviour and suggest how elements of place should be harnessed in the development of effective HIV and sexual health interventions.

Association between Family Environment and Sexual Behaviour of Adolescents in Burkina Faso

Studies conducted in Africa have demonstrated the existence of a significant association between family environment and the sexual behaviour of adolescents. Generally, empirical studies of this topic are based on parental control, and family or conjugal instability and socialization approaches. The objective of this study is to assess the association between family environment and the sexual behaviour of adolescents aged 12 to 19 years. The 2004 National Survey of Adolescents (NSA) in Burkina Faso provides data for studying operationalization. Analyses were bivariate and multivariate. The former were conducted using cross tabulations while the latter used three logistic regression models. Results indicate a significant but low association among family environment variables. Absence of both parents, or a number of individuals under 20 years old higher than the number of adults in a household is not systematically associated with risky sexual behaviour. Parental control was shown to be more discriminating of sexual behaviour of adolescents from Burkina Faso, compared with communication with family members regarding sexuality. Despite current ongoing economic crises and sociocultural mutations in Burkinabe societies, household members and family still play major roles in adolescents’ education. Results reinforce sexual and reproductive health programs where parents and household members are central to strategies.

Support, coercion, and delinquency: testing aspects of an emerging theory

This research tests aspects of differential social support and coercion theory of crime as proposed by Colvin, Cullen and Vander Ven (2002). The theory argues social interactions, either coercive or supportive, figure into development of self-control, delinquent behavior, and mental health. Coercive interactions involve force, direct and indirect intimidation and violence that compel compliance out of fear or anxiety. Coercive interactions can be employed consistently or erratically and individuals that are disciplined in an erratic manner will tend to develop strong anger directed toward others, low self-control, and weak alienated social bonds. These individuals are likely to become chronic offenders. Individuals that receive consistent coercion develop strong self-directed anger, high-externalized self-control, and weak social bonds. These individuals will have minimal legal difficulties, but are likely to have persistent mental health problems Social supports can also be erratic or consistent in nature. According to the theory, erratic social supports will generally result in low-self control, moderate anger, and intermediate social bonds. These individuals may engage in criminal behavior depending on the access to illegitimate social supports offered by criminals. Individuals that receive consistent support will have low anger, high-internalized self-control, and strong social bonds. These individuals are likely to display few criminal behaviors and possess high levels of pro-social behaviors (Colvin, Cullen and Vander Ven, 2002). Data are drawn from the 1995 National Survey of Adolescents (NSA), to examine the connection between support and coercion on delinquent behavior. Results indicate support for the theory among NSA participants as evidenced by Logistic Regression Analysis and we discus broader implications of the theory for criminal justice responses to juvenile offending.

Childhood Adversities and First Onset of Psychiatric Disorders in a National Sample of US Adolescents

Although childhood adversities (CAs) are known to be highly co-occurring, most research examines their associations with psychiatric disorders one at a time. However, recent evidence from adult studies suggests that the associations of multiple CAs with psychiatric disorders are nonadditive, arguing for the importance of multivariate analysis of multiple CAs. To our knowledge, no attempt has been made to perform a similar kind of analysis among children or adolescents. To examine the multivariate associations of 12 CAs with first onset of psychiatric disorders in a national sample of US adolescents. A US national survey of adolescents (age range, 13-17 years) assessing DSM-IV anxiety, mood, behavior, and substance use disorders and CAs. The CAs include parental loss (death, divorce, and other separations), maltreatment (neglect and physical, sexual, and emotional abuse), and parental maladjustment (violence, criminality, substance abuse, and psychopathology), as well as economic adversity. Dual-frame household-school samples. In total, 6483 adolescent-parent pairs. Lifetime DSM-IV disorders assessed using the World Health Organization Composite International Diagnostic Interview. Overall, exposure to at least 1 CA was reported by 58.3% of adolescents, among whom 59.7% reported multiple CAs. The CAs reflecting maladaptive family functioning were more strongly associated than other CAs with the onset of psychiatric disorders. The best-fitting model included terms for the type and number of CAs and distinguished between maladaptive family functioning and other CAs. The CAs predicted behavior disorders most strongly and fear disorders least strongly. The joint associations of multiple CAs were subadditive. The population-attributable risk proportions across DSM-IV disorder classes ranged from 15.7% for fear disorders to 40.7% for behavior disorders. The CAs were associated with 28.2% of all onsets of psychiatric disorders. Childhood adversities are common, highly co-occurring, and strongly associated with the onset of psychiatric disorders among US adolescents. The subadditive multivariate associations of CAs with the onset of psychiatric disorders have implications for targeting interventions to reduce exposure to CAs and to mitigate the harmful effects of CAs to improve population mental health.

Examining posttraumatic stress symptoms in a national sample of homicide survivors: Prevalence and comparison to other violence victims

The present study examined posttraumatic stress disorder (PTSD) symptoms among friends and family members of homicide victims (homicide survivors). Out of a national sample of 1,753 young adults who completed follow-up interviews after participating in the National Survey of Adolescents, 268 homicide survivors and 653 victims of other interpersonal violence were selected for the study. Participants completed structured telephone interviews that covered the loss of a family member or close friend to homicide, violence exposure, and PTSD symptomatology. Findings indicated that 39% of homicide survivors met criteria for all 3 symptom clusters and 30% of homicide survivors met criteria for 2 PTSD clusters (functional impairment was not assessed). Multivariate logistic regression analyses demonstrated that homicide survivors were more likely than victims of other violence to meet criteria for all 3 PTSD symptom clusters (OR = 1.91, p < .05) and 2 symptom clusters (OR = 1.77, p < .05) when demographic characteristics and number of violent events were included in the model. These findings highlight the high prevalence of subthreshold PTSD symptoms among homicide survivors. Results suggest that homicide survivors are at elevated risk for PTSD symptoms in comparison to victims of other interpersonal violence.

Predictors of physical assault victimization: Findings from the National Survey of Adolescents

Exposure to interpersonal victimization during childhood and adolescence is prevalent and has been found to be associated with negative physical and mental health outcomes. The present study examined the relations between childhood violence exposure and mental health on subsequent exposure to new physical assault in young adults using longitudinal nationally representative, prospective data from the initial (Wave I) and follow-up interviews (Wave II) of the National Survey of Adolescents (NSA). Among the 1,753 participants who completed both assessment time points, 15.8% reported a new physical assault experience at Wave II. Results indicated that racial/ethnic status, gender, history of child physical abuse, witnessed violence drug use, and family drug problems reported at Wave I were all significant predictors of new physical assault. Implications are discussed.