Urban Adolescent Population Research Articles

Asthma Prevalence among Athletes in an Urban Adolescent Population.

To identify individuals at risk of asthma by assessing the prevalence of asthma in an urban, athletic adolescent population using preparticipation physical evaluation (PPE) data. Using the Athlete Health Organization (AHO) PPE data from 2016 to 2019, asthma prevalence was collected by reported diagnosis in the history or physical. Chi-square tests and logistic regression were performed to characterize the relationship between asthma and social factors such as race, ethnicity, and income. Control variables such as age, body mass index, blood pressure, sex, and family history were also collected. Over 2016-2019, 1,400 athletes ranging from 9 to 19 years of age had completed PPEs (Table1). A large percentage of student-athletes were found to have asthma (23.4%), of whom a majority 86.3% resided in low-income zip-codes. Additionally, 65.5% of athletes with asthma identified as Black, with race being associated with asthma prevalence (p < 0.05). Demographic factors like income, age, and gender were not significantly associated with asthma prevalence. Self-identified Black individuals reported higher prevalence of asthma when compared to the general population. Identifying factors like race and income that place adolescent athletes at risk of asthma is a key step to understanding the complex relationship between asthma and social determinants of health. This work advances the conversation for establishing best practices for serving vulnerable populations, as seen in this urban population of children with asthma.

Perspectives on COVID-19 Vaccination and Vaccine Passports in a Diverse Urban Adolescent Population: A Youth Participatory Mixed Methods Study

PurposeDisparities in youth COVID-19 vaccine acceptance and uptake have been documented in several countries, yet few studies have explored the attitudes and perceptions underlying vaccine-related decision-making among adolescent populations with unique sociocultural, environmental, and/or structural contexts that may influence vaccine uptake. MethodsThis study used data from surveys and semistructured interviews collected between January and March 2022 as part of an ongoing community-based research project in two ethnoculturally diverse, lower income neighborhoods of Montreal, Canada. Youth researchers designed and conducted interviews with unvaccinated adolescents, and thematic analysis was employed to explore attitudes and perceptions underlying vaccine-related decisions and opinions about vaccine passports. Survey data were used to describe sociodemographic and psychological determinants of COVID-19 vaccination. ResultsAmong 315 survey participants aged 14–17 years, most (74%) were fully vaccinated against COVID-19. Prevalence ranged from 57% among Black adolescents to 91% among South and/or Southeast Asian adolescents (34% difference, 95% confidence interval: 20–49). Qualitative and quantitative findings highlighted several misconceptions about the safety, effectiveness, and necessity of COVID-19 vaccines and adolescents' desire for trusted sources of information to address their concerns. Vaccine passports likely increased uptake, yet adolescents were strongly resistant to the policy, and for some, it may have fueled distrust of government and scientific institutions. DiscussionStrategies that increase the trustworthiness of institutions and foster genuine partnership with underserved youth may improve vaccine confidence and help ensure an effective, proequity recovery from COVID-19.

A cross-sectional study to compare levels of physical activity among adolescents in rural and urban areas of Western Maharashtra

BackgroundChildhood and adolescent overweight and obesity has been associated with long term health deterioration. Lack of physical activity in this age group is an important contributing factor towards increase in overweight and obesity. Due to vast socio-cultural differences across India, it is important to assess the patterns of physical activity in different age groups and regions, to understand the differences among adolescents in different socio-geographic regions. However, the studies from India are inconsistent due to use of varied parameters and methodology and a need was felt of incorporating easy to use measures of quantifying physical activity. MethodsThe study was carried out on 416 adolescents (aged 10 to 17 years) from 2 schools each from urban and rural area of Western Maharashtra. The study populations were stratified by gender and age. The data on physical activity was collected using a pre-tested, researcher-administered questionnaire adapted from the Global Physical Activity Questionnaire (GPAQ) and the Physical Activity Questionnaire- Adolescent (PAQ-A). Results16.8 percent of rural adolescents did not meet the defined criteria for adequate physical activity as compared to 33.2 percent in the urban population. Urban adolescent population was found to have significantly higher anthropometric measures of adiposity. ConclusionHigher proportion of adolescents performing adequate physical activity is likely to be a key factor in keeping the BMI and TMI lower in rural as compared to urban adolescent population.

Factors Contributing to Mother-Daughter Talk about Sexual Health Education in an Iranian Urban Adolescent Population.

Background:Parent–adolescent dialog on sexual issues reduces high-risk sexual behavior in adolescents. However, many adolescents are deprived of such training. Several factors may affect the sexual dialog between parents and adolescents. This study aimed to investigate the factors associated with mother–adolescent daughter dialog on sexual health matters in Iran.Materials and Methods:This cross-sectional study was carried out on 363 female adolescents aged 14-18 years in Ahvaz-Iran, between June 2015 and January 2016. Data collection was conducted utilizing multi-stage cluster sampling in high schools using the Parent–adolescent sexual dialog questionnaire and the parent–adolescent general dialogue questionnaire. The validity of the questionnaires was confirmed using content and face validity and their reliability was confirmed through internal consistency. The data were analyzed using descriptive statistics, Pearson's correlation coefficient, independent one-sample and two-sample t-tests, one-way ANOVA, and Post-HOC (Duncan) test.Results:The mean score of mother–daughter sexual dialog had a significant relationship with mother's education (F = 4.03, p > 0.003), adolescent's major (F = 4.48, p < 0.004), mother–daughter general communication (p < 0.001), and emotional relationship with parents (F = 6.47, p < 0.002). The more is the mother–daughter general communication, the more will be their sexual communication (p < 0.001). There was no relationship between the score of mother–daughter sexual communication and the age of mother or adolescent, parents' job, parents' marital status, and having sisters (p = 0.86).Conclusions:Some demographic characteristics of parents and adolescents, and the parent–adolescent emotional relationship can affect the communication between them about sexual issues. So efforts to enhance this communication should consider these factors as mediator variables.

Implementing Routine HIV Screening in an Urban Adolescent Population at a General Pediatric Clinic

PurposeTo increase the rate of routine HIV screening during preventative visits for adolescent patients aged 15 to 21 in a pediatric and adolescent clinic in accordance with national recommendations, which are poorly implemented nationwide. MethodsThis was a quality improvement initiative. Four plan-do-study-act (PDSA) cycles were conducted from May 2016 to February 2020. Interventions included education of and reminders for the multidisciplinary team on guidelines and testing, creation of a standardized workflow, introduction of a rapid point-of-care HIV antibody test (POCT), and implementation of an opt-out, medical assistant/nursing-driven protocol for HIV rapid point-of-care testing. The primary outcome measure was the monthly percentage of adolescents screened for HIV during preventative visits. Data is presented in a p-control chart and means were adjusted for special cause variation according to the Institute for Healthcare Improvement guidelines. ResultsRates of routine HIV screening at preventative visits for youth ages 15 to 21 increased from the pre-intervention rate of 5.16% to a final rate of 41.5% over four PDSA cycles. Mean screening rates were adjusted after introducing the HIV POCT (+18.5%) and after implementing the medical assistant/nursing-driven protocol (+17.9%). ConclusionsWe successfully increased routine HIV screening rates at preventative visits for adolescents at an urban pediatric and adolescent clinic. This was in large part due to testing with a rapid HIV POCT and a clinic protocol allowing medical assistants and nurses to order the test under a physician’s name as part of the intake process. Ours can be a model for other clinics.

Rethinking Urban Female Adolescents' Safety Net: The Role of Family, Peers, and Sexual Partners in Social Support.

To examine how interpersonal factors are associated with family, peer, and partner social support among urban female adolescents in sexual relationships. Secondary data analysis of cross-sectional data. Two urban health clinics and community sites in Baltimore, Maryland. One hundred sixteen female adolescents (ages 16-19) with 131 heterosexual relationships from the Perceived Risk of Sexually Transmitted Diseases cohort. Interpersonal factors included parental monitoring, friend-partner connectedness, and feelings of intimacy for partner. Social support was measured using the Multidimensional Scale of Perceived Social Support with family, peer, and partner subdomains. Multivariable linear regression models using baseline data and accounting for clustering of partners. Adolescents perceived high levels of family, peer, and partner support, with the greatest coming from partners (range: 1-5; family mean: 4.0 [95% confidence interval, CI: 3.83-4.18]; peer mean: 4.2 [95% CI: 4.05-4.33]; partner mean: 4.5 [95% CI: 4.36-4.60]). Parental monitoring and friend-partner connectedness were significantly associated with greater family (b = 0.11, standard error [SE] = 0.03, P = 0.001; b = 0.15, SE = 0.06, P = .02) and peer support (b = 0.06, SE = 0.02, P = .01; b = 0.29, SE = 0.07, P < .001). Feelings of intimacy for partner was significantly associated with greater partner support (b = 0.08, SE = 0.03, P = .02). Feeling connected to one's social network and having a connected network is an important contribution to social support for urban female adolescents in sexual relationships. Future research targeting interpersonal factors is warranted, as it may result in increased social support and promote positive sexual health behaviors in an urban female adolescent population.

Sources and Biomarkers of Secondhand Tobacco Smoke Exposure in Urban Adolescents.

In an urban adolescent population, we evaluated sources of exposure to secondhand smoke exposure (SHS), examined differences in exposure by race/ethnicity, age and sex, and determined the relationship between exposure source(s) and the biomarkers cotinine and NNAL. Participants were recruited from a public hospital-based outpatient clinic in San Francisco, CA, USA. Of a sample of N=298 adolescents screened, 235 were biologically confirmed to be exposed to tobacco smoke. Of those, N=16 were active smokers and N=219 were exposed to SHS; 91 (39%) were heavily SHS exposed (median cotinine=0.76 ng/mL) and 128 (54%) had light SHS exposure (median cotinine=0.11 ng/mL). Within those SHS exposed, the most common source of exposure was in a public area. No significant racial/ethnic differences were found, although African American adolescents were more likely to live in a home that allowed smoking. Older adolescents were more likely to be exposed across several difference sources, and females more likely to be exposed in a car and in public areas. Past 7-day exposure in the home, in a car, and current blunt use were significantly related to biomarkers of exposure. Urban adolescents are exposed to SHS across a variety of sources. Although exposure in a public area is most common, exposure in the home and in cars significantly influences tobacco biomarker levels. Interventions to reduce exposure would have the greatest impact in this population if they focused on reducing exposure in the home and in cars. History of blunt use is a strong determinant of tobacco exposure.

Use of voice messaging via mobile phone to communicate female adolescents in Bangladeshi urban slum

Abstract Problem Utilization of available maternal health services is comparatively low among adolescent population in Dhaka urban slum areas and lack of adequate knowledge is one major contributor to low service utilization among slum dwelling adolescent mothers. Description of problem Dhaka urban slum dwelling female adolescents are difficult to reach adequately with health messages through traditional home visit by community health workers for counseling, because many of these adolescents in Dhaka urban slums have a job outside home. We designed and implemented an innovative health communication intervention “Health Boost” - an approach to provide reproductive, maternal and newborn health information for married female adolescents using the voice message system on mobile phone. Methods We delivered ‘Health Boost’ (HB) voice messages to enrolled married adolescent girls, twice a week, with re-listening option. Pregnant and non-pregnant participants received separate sets of messages. Enrollment was started after baseline survey (September 2016) and continued during October 2016 - April 2017. Pregnant participants received messages at least for 6 months before delivery. For evaluation, we followed pre-post observation study design and had the endline survey in November 2017. Results Comparing HB non-receivers at baseline (n = 321) and HB receivers at endline (n = 45), statistically significant improvement was revealed for knowledge on danger signs - (a) during pregnancy (55.5% vs. 93.3%; p &amp;lt; 0.001), (b) during child delivery (54.2% vs. 82.2%; p &amp;lt; 0.001), (c) for newborn (56.7% vs. 75.6%; p &amp;lt; 0.02). We also found significantly higher utilization of service among HB receivers: Utilization of antenatal care increased from 70.4% to 87.5% (p &amp;lt; 0.02); and use of postnatal care increased from 31.6% to 73.7% (p &amp;lt; 0.03). Lessons ‘Health Boost’ messages were instrumental and effective to increase knowledge and service utilization among married adolescent girls in Dhaka urban slum areas. Key messages Voice message is an innovative way to reach hard-to-reach population by using mobile phone technology. Voice messages were instrumental and effective to increase knowledge and service utilization among urban female adolescent population, for reproductive, maternal and newborn health.

HIV Screening in an Urban Adolescent Population

Background: The risk for HIV/AIDS is often unrecognized in adolescent populations. In 2015, 22% of new HIV diagnoses were in persons aged 13-24 years (37.2 per 100,000 population), of which, 8% were diagnosed with AIDS. Despite national and international recommendations for routine HIV screening starting during adolescence, screening rates remain low. In line with this trend, average HIV screening rates for adolescent patients in our urban General Pediatrics and Adolescent clinic were only 3% from 2015-16. Specific Aims: Our global aim is to increase clinicians’ rate …

HIV Screening in an Urban Adolescent Population

HIV Screening in an Urban Adolescent Population

Is Household Composition Associated With Repeat Fight Injuries in Adolescents Living in Urban Neighborhoods?

The association of household composition with violence-related injury risk has not been explored in the at-risk urban adolescent population. We hypothesize that, similar to the unintentional risk association, higher adult:child ratio, lower household size, and the presence of a grandparent are protective and thus associated with lower risk for repeat fight injury in this population. This is a cross-sectional study of 10- to 15-year-old adolescents who were evaluated in two urban, pediatric emergency departments (EDs; Baltimore, MD, Philadelphia, PA) for a peer fight-related injury between June 2014 and June 2016. Logistic regression was used to test for associations between each household composition measure of interest and youth self-report of a medically attended fight-related injury within the prior 12 months. Of 187 eligible youth, 62 (33%) reported at least one such repeat fight-related injury. With control for potential confounders, youth with past fight injuries did not differ in adult:child ratio (adjusted odds ratio [adj OR] = 1.3, 95% confidence interval [CI]: [0.9, 1.9] ) or household size (adj OR = 0.9, 95% CI: [0.8, 1.1]) but were more likely to have a grandparent residing in the household (adj OR = 3.3, 95% CI: [1.4, 7.9]). Our data demonstrate a positive association between presence of a grandparent in the household and risk for repeat fight injury in urban adolescents without a corresponding association with adult:child ratio or total household size. Further study should explore differences among the households of urban adolescents with and without grandparent presence to further understand this association and define the mechanisms that may contribute to these findings.

Identification of New Bacteria Scardovia wiggsiae in Caries Risk Indian Adolescent Population - Polymerase Chain Reaction Analysis

BACKGROUND: The independent association of S. mutans andScardovia wiggsiae and their association in ECC and as a risk indicator have been reported in the literature. Its prevalence in low and high caries risk of urban adolescent Indian population has not been reported so far. Hence the primary objective of the study is to identify the prevalence of new bacteria Scardovia wiggsiae in low and high caries risk urban adolescent population. METHODS: 50 adolescent subjects were screened based on ADA risk assessment criteria. Group 1(n=25) - Low caries risk (saliva, plaque) and Group 2 (n=25) - High caries risk (saliva, plaque and dentinal caries) were evaluated for the presence of Scardovia wiggsiae by PCR analysis. FINDINGS: Highest prevalent was found in dentinal caries followed by plaque and saliva samples of high caries risk subjects; whereas it was totally absent in both the samples of low risk caries subjects. INTERPRETATION: Scardovia wiggsiae could be one of the predominant microorganism for initiation and progression of caries and can be used as a risk indicator for dental caries assessment in a given population. Thus by identifying the actual predominant genera in the microbial communities, preventive strategies can be targeted specifically to decrease the level of prevalence, thereby lowering caries experience in a given population. FUNDING STATEMENT: The authors stated: Nil. DECLARATION OF INTERESTS: The authors have no financial interest in any of the companies or products mentioned in this article. ETHICS APPROVAL STATEMENT: Ethical clearance was obtained from Institutional Review Board (IRB) of S.R.M University (SRMDC/IRB/2014/MDS/No.307).

Validation of Asthma Control Assessment Among Urban Adolescents Using the Asthma Control and Communication Instrument

The National Institutes of Health guidelines recommend questionnaires to assess asthma control, but there are few self-reported asthma morbidity surveys validated among urban, African American, Hispanic, and/or poor adolescents. The Asthma Control and Communication Instrument (ACCI) is a 12-item self-reported questionnaire previously validated among a diverse adult population, but not among adolescents. To assess the ability of the ACCI to accurately describe asthma control in an urban adolescent population. Between November 13, 2014, and March 2, 2017, we collected information using the ACCI, the Asthma Control Test, the Pediatric Asthma Quality of Life Questionnaire, and lung function among adolescents enrolled in a school-based asthma intervention study. The ACCI measure of asthma control was validated by evaluating accuracy (on the basis of receiver operating characteristic curve), internal reliability, and concurrent and discriminative validity. We collected information on 280 adolescents (mean age, 13.4 years; 56% males; and 51% African American). ACCI control showed good internal reliability and strong concurrent and discriminative validity with the Asthma Control Test and the Pediatric Asthma Quality of Life Questionnaire. The accuracy of the ACCI in classifying adolescents with uncontrolled asthma was good (area under the curve, 0.83; 95% CI, 0.79-0.88). The ACCI, a clinical tool developed to assist communication about asthma control, has demonstrated strong construct validity as a self-reported questionnaire within an urban, African American, and Hispanic sample of adolescents. It has the potential to assist in the assessment of asthma control in urban, minority, and/or poor adolescents.

Over weight, obesity and metabolic syndrome in a semi urban adolescent population in Uyo, Nigeria

Background: Overweight and Obesity are becoming increasingly common in developing countries with the attendant health risks associated with these conditions including Metabolic syndrome. The aim of this study was to find out the prevalence of overweight, obesity and metabolic syndrome in a population of adolescents living in a semi urban area and the relationship between the weights of these children and the various components of the metabolic syndrome. Materials and Methods: One hundred and fifty-five adolescents aged 10-17 years were selected via a multistage random sampling technique. Sociodemographic data were obtained using a structured questionnaire and anthropometric indices were measured using standard tools. Overweight and obesity were defined based on the International Obesity Task Force criteria while metabolic syndrome was defined using the International Diabetes Foundation criteria. Blood samples were taken for Fasting blood sugar, serum Triglycerides and High-density lipoprotein cholesterol. Results: The prevalence of overweight, obesity and metabolic syndrome were 1.94%, 0%, and 1.94% respectively. Weight showed a significant positive correlation with the study participants’ waist circumference, systolic and diastolic blood pressures but not with serum triglyceride, high density lipoprotein cholesterol and fasting blood glucose levels. Abdominal obesity and hyperglycaemia werealso significantly associated with Metabolic syndrome. Conclusion:The prevalence of overweight, obesity and metabolic syndrome was very low in the population studied however, weight demonstrated a significant positive correlation with some components of the metabolic syndrome.

Awareness regarding H1N1 (swine flu) among urban and rural adolescent population

Awareness regarding H1N1 (swine flu) among urban and rural adolescent population

Facteurs associés au recours aux soins dentaires dans une population d’adolescents marocains

Untreated dental caries are a major public health concern because of the impact on quality of life and of the high cost of dental care. Our aim was to identify factors related to dental care use among a population of urban Moroccan adolescents. A cross-sectional study involving adolescents in an urban area was conducted. Adolescents were recruited in high schools selected by a cluster sampling method. The studied variables were recorded through a questionnaire and oral examinations. Collected data were socio-demographic parameters, medical insurance status and oral health status using DMFT (Decayed, Missing, Filled Teeth) and SiC (Significant Caries Index) indexes. Logistic regression analysis was applied to evaluate factors associated to dental care use. Four hundred and fifty adolescents were included in 2012 and 2013. Three hundred and eighty seven (86%) had one untreated dental caries at least. One hundred and seventy-one (38%) had at least one filled teeth. Logistic regression analysis showed that health insurance status, parental income, gender and DMFT index were statistically significant variables associated to dental care use. Renouncement to dental care is not only related to the lack of medical insurance. Other factors such as gender and income level seems to be as important.

High Prevalence of Obesity and High Blood Pressure in Urban Student-Athletes

To assess the prevalence of obesity and hypertension-level blood pressures in an urban, athletic adolescent population using preparticipation physical evaluation (PPE) data. The Athlete Health Organization provides free preparticipation physical evaluations to Philadelphia student-athletes via an annual mass-screening event. From 2009 to 2012, Athlete Health Organization personnel performed PPEs on more than 2700 middle school and high school athletes. The PPE included biometric information, a history, and a physical examination. Medical volunteers measured blood pressures using a manual blood pressure cuff with an aneroid manometer. The data from each PPE were collected and analyzed for prevalence of obesity, overweight, and hypertension-level blood pressure readings. A large percentage of student-athletes were found to be overweight (20%) or obese (24.0%). Many of these athletes also had stage 1 or 2 level blood pressure readings (14.8%), a finding which strongly correlated with elevated body mass index (P < .00001). The cardiovascular health of this urban adolescent athletic population is a major concern because their rates of obesity and elevated blood pressure place them at increased risk of cardiovascular complications later in life despite their participation in school athletics.

The assessment of orthorexia nervosa among 1899 Polish adolescents using the ORTO-15 questionnaire

Objective: Orthorexia nervosa (ON) is considered an eating disorder (ED), with an excessive fixation on the consumption of healthy food and an obsession with its biological purity. Since the adolescent period poses a risk for EDs, the aim of this study was to assess the prevalence of ON in a population of Polish urban adolescents and some possible contributory factors.Method: 1899 high school students, 992 girls and 907 boys aged 15–21 years were studied. Demographic and clinical data were collected using a validated questionnaire including information on preferred living choices, in the context of pro- and antihealth activities. The Polish version of the ORTO-15 questionnaire was used.Results: The mean value of the ORTO-15 was 39.2 ± 3.6 points, with no sex difference. The main factors connected with orthorexia, according to the ‘Orthorexia 33.35 and 40’ definitions were excess weight, sporting activities, out-of-school activities, smoking status, working parents and a high family income.Conclusions: This study, of a large number of adolescents, showed a prevalence of ON similar to that recorded in adult populations. Since factors predisposing to ON in adolescence differ from those for other eating disorders, it is not clear whether ON should be treated as a new form of ED.

Prevalence of orthorexia nervosa among polish adolescents – Assessment made by the ORTO-15 Questionnaire

ObjectiveOrthorexia nervosa (ON) is an excessive fixation on the consumption of healthy food and an obsession with its biological purity. The aim of this study was to assess the prevalence of ON in a population of Polish urban adolescents and some possible contributory factors.MethodValidation and adaptation of the ORTO-15 Questionnaire was made in the group of 399 participants (15–21 years old). The validation procedure incorporated three basic methods to be applied in the reliability analysis. The reliability analysis of the ORTO-15 Questionnaire based on repeatability of the responses presents a very good (kappa: 0.81–1.00 for 5 items) and a good repeatability (kappa: 0.61–0.80 for 10 items). The reliability analysis based on the value of the Cronbach's α reached a satisfactory level (0.7–0.9). The ORTO-15 questionnaire was considered a reliable tool to identify the risk of ON in population studies in the group of urban youth aged 15–21. Assessment was made among 1899 high school students, 992 girls, and 907 boys, aged 15–21 years.ResultsThe mean value of the ORTO-15 was 39.2 ± 3.6 points, with no sex difference. The main factors connected with orthorexia, according to the “Orthorexia 35” definition were excess weight, sporting activities, out-of-school activities, smoking status, working parents and a high family income.ConclusionsThis study, of a large number of adolescents, showed a prevalence of ON similar to that recorded in adult populations. This is a first assessment of orthorexia among adolescent population.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Exposure to Community Violence, Suicidality, and Psychological Distress Among African American and Latino Youths: Findings From the CDC Youth Violence Survey

The present investigation explored risk and protective factors for suicidal ideation and behavior in a sub-sample of African American and Latino adolescents (n = 2,626) who participated in the 2004 Centers for Disease Control Youth Violence Survey. Structural equation modeling was used to explore exposure to violence at the community level as a contextual factor that could potentially influence depressive symptomatology, substance abuse, parental support, social support, and suicidality among study participants. Findings indicated that exposure to violence at the community level was not directly related to suicidality among this population of urban adolescents. However, it was directly related with several other variables under study in the model, which in turn were directly related with suicidality. Tests of invariance revealed several across-group differences, particularly by race and gender, in how the identified risk and protective factors in the model related to suicidality. Implications for research and practice with urban, ethnic minority, adolescent populations are discussed.