Adolescent Prevention Programs Research Articles

Development of the "KARUNI" (young adolescents community) model to prevent stunting: a phenomenological study on adolescents in Gunungkidul regency, Yogyakarta, Indonesia.

Stunting is a major health problem in developing countries due to chronic malnutrition that impacts physical growth, cognitive ability, and long-term productivity. The focus of stunting prevention is generally aimed at pregnant women and toddlers, while adolescents, especially adolescent girls, are often neglected. In fact, theywill be thefuture mothers who determine the qualityof the next generation. Malnutrition and anemia in adolescents increase the risk of giving birth to stunted children. Innovative nutritional intervention programs, such as nutrition education and iron supplements, are needed to break the cycle of stunting, involving adolescents as important targets in prevention. Karuni is a program specifically designed for teenagers aged 12-15 years with the main focus being on empowering teenagers through nutrition education, reproductive health and clean and healthy living behavior as well as involving parents to optimize the program. This study used a phenomenological approach toexplore the understanding of adolescent girls aged 12-15years about the stunting prevention program in Gunungkidul Regency, Indonesia. Data were collected through in-depth interviews and FGDs with adolescents, officials running the Adolescent Health Care (PKPR) program, and related agencies. Data validity was guaranteed by triangulation of sources and NVivo was used for analysis. The identified five themes related to the adolescent intervention program for stunting prevention: program implementation, achievements, barriers, needs, and KARUNI model design. Program monitoring is important, butfaces barriers such as the lack of prioritization and motivation. Cross-sectoral collaboration, innovation, and appropriate media are needed in the implementation of theKARUNI model to increase the effectiveness of the stunting prevention program for adolescents. The importance of the role of adolescents in efforts to reduce the prevalence of stunting, especially through collaboration between health centers (Puskesmas) and schools in implementing the PKPR program, providing iron tablets, and health screening.

Protective Factors Against e-Cigarette Use Among First Nations People Aged 16-24 in the Next Generation Youth Wellbeing Study.

Adolescent e-cigarette use is increasing and is associated with subsequent smoking. This study examines potential protective factors associated with not vaping among First Nations adolescents in Australia to inform community programs. The 'Next Generation: Youth Wellbeing Study' is a cohort study of First Nations adolescents aged 10-24 years from urban, rural and remote communities in Central Australia, Western Australia and New South Wales. Analysis of self-reported vaping from 16 to 24-year-olds, collected 2018-2020, using multi-level mixed-effects Poisson regression to estimate age-site-adjusted prevalence ratios (PRs) for never-vaping in relation to various factors. Among 419 participants, 65% were female, 75% had never vaped, 49% had never smoked and 82% lived in smoke-free homes. Never vaping was more common among those who had: never-smoked (PR = 1.78, 95%CI: 1.56-2.04); never used cannabis (1.89, 1.60-2.24); non-smoking friends (1.38, 1.26-1.51); good mental health (1.15, 1.01-1.30), never diagnosed with depression (1.21, 1.01-1.46) or anxiety (1.31, 1.08-1.57); and no experiences of racism (1.21, 1.08-1.36), no negative criminal justice system experiences (1.25, 1.11-1.41), or vicarious racism through negative media (1.24, 1.10-1.39). Most First Nations adolescents have never vaped, with potential protective factors being better mental health, no other substance use and fewer experiences of racism and justice system interactions. Comprehensive community adolescent prevention programs are needed to prevent vaping and protect future health, including preventing nicotine addiction and future smoking. SO WHAT?: Policies and programs must address e-cigarettes directly as well as structural factors, promoting broader adolescent wellbeing, centring culture and family in a strengths-based approach.

Factors associated with habitual drug use among adolescents: A secondary data analysis.

Drug use during adolescence can have lasting health consequences, and understanding the factors that contribute to drug use is essential for effective prevention. This study aimed to identify the factors influencing habitual drug use among South Korean adolescents. It employed Bronfenbrenner's ecological model to examine personal, familial, school-related, and social factors. The study analyzed data from the 19th Korea Youth Risk Behavior Survey for 41,928 students from 1st grade of middle school to 3rd grade of high school. Data analysis involved cross-tabulation and logistic regression for complex samples. The prevalence of habitual drug use was 1.4%. Significant personal factors included smoking (adjusted odds ratio [aOR] = 2.61), alcohol consumption (aOR = 1.55), sexual intercourse (aOR = 1.45), smartphone overdependence (aOR = 2.04), suicidal ideation (aOR = 2.66), depressed mood (aOR = 1.87), and loneliness (aOR = 1.88). Significant family factors included non-cohabitation with family (aOR = 1.86) and both parents being foreign-born (aOR = 3.36). Experience of violence (aOR = 2.95) was also a significant factor. This study highlights the need for an integrated approach to prevent adolescent drug use by addressing adolescents' personal behaviors, family dynamics, and school environments. Prevention programs should account for the influence of multiple systems on habitual drug use. School and community nurses should adopt a comprehensive, multi-dimensional strategy that involves families, schools, and communities to prevent adolescent drug use. Additionally, there is a need to develop family-centered and culturally sensitive drug prevention programs for adolescents.

La vaccinazione anti-papillomavirus: mai più senza!

Human papillomavirus is the most common sexually transmitted infection in the world. Most HPV infections resolve spontaneously within 2 years from infection; however, persistent infection may result in a wide array of diseases, ranging from genital warts to cancer. Most cases of cervical, anal and oropharyngeal cancers are due to HPV infection, with cervical cancer being one of the leading causes of cancer death in women worldwide. The development of HPV vaccine has shown a drastic decrease in HPV-related diseases. The vaccine, if administered before the start of sexual activity, prevents cervical cancer and shows effectiveness in over 90% of cases. Vaccination uptake remains low worldwide because of a limited knowledge of HPV. The use of a single-dose vaccine may facilitate the completion of prevention programmes for many children and adolescents as its efficacy and duration of protection is comparable to the two-dose schedule. Regular community sensitization and awareness campaigns by relevant authorities and implementers may help to increase the HPV vaccine uptake and decrease cancer and HPV-related morbidity and mortality worldwide.

Risk Perception and Knowledge Following a Social Game-Based Tobacco Prevention Program for Adolescents: Pilot Randomized Comparative Trial.

Adolescence is a critical developmental stage that is particularly vulnerable to the initiation of tobacco use. Despite the well-documented health risks associated with tobacco use, it remains prevalent among adolescents. Games for health are a promising strategy for tobacco prevention, using experiential and social learning theories to enhance engagement and improve behavior change. This pilot study aims to (1) compare the social game-based program Storm-Heroes to a nonsocial program regarding adolescents' personal and social experiences and (2) examine how these experiences predict higher tobacco knowledge and perceived risks of vaping and conventional tobacco use. In a cluster-randomized comparative design, 4 after-school sites (N=79 adolescents) were recruited in person and randomized in a single-blinded format to 1 of 2 interventions: the social game Storm-Heroes (44/79, 56%) or the nonsocial program A Smoking Prevention Interactive Experience (ASPIRE; 35/79, 44%). A study team member supervised both interventions. Data were collected at baseline, immediate follow-up, and a 1.5-month follow-up (45/74, 61% retained). Repeated measures mixed effects models were conducted. A total of 45 participants continued until the 1.5-month follow-up. Participants in the Strom-Heroes group were more likely to increase their perceived risk of vaping (B=0.40; P<.001), perceived risk of conventional tobacco use (B=0.35; P=.046), and tobacco knowledge (B=1.63; P<.001) than those in the control condition. The usability level of the program was related to a higher perceived risk of vaping (B=0.16; P=.003) and conventional tobacco use (B=0.16; P=.02) by follow-up. Attention to the program was also related to higher perceived risk of vaping (B=0.12; P=.002) and conventional tobacco use (B=0.14; P<.001). Distraction was not related to either perceived risk of vaping (P=.15) or perceived risk of conventional tobacco use (P=.71). In contrast, both more attention (B=0.60; P<.001) and less distraction (B=-0.37; P<.001) were related to higher tobacco knowledge. The increased perceived risk of vaping and conventional tobacco among Storm-Heroes participants aligns with the program's goals of improving participants' awareness of the risks associated with tobacco use and their tobacco knowledge. However, distraction weakened the effect of the program on tobacco knowledge, indicating that emphasis needs to be placed on minimizing distraction for better outcomes. With the results of this study, researchers can work to advance the current version of Storm-Heroes and amplify engagement in the program to improve its potential for preventing adolescents' initiation of tobacco use. ClinicalTrials.gov NCT02703597; https://clinicaltrials.gov/study/NCT02703597.

Neuroplasticity and Cocaine Exposure During Adolescence

The adolescent brain is particularly vulnerable to the effects of cocaine exposure due to ongoing neurodevelopment especially in areas that are crucial for cognitive and emotional regulation. This review explores the multifaceted impact of cocaine on neuroplasticity during adolescence, thereby highlighting both the immediate and long-term consequences of drug exposure. Key findings from recent studies indicate that cocaine use during adolescence leads to significant alterations in synaptic plasticity, dendritic spine morphology, and neurotransmitter systems, which may persist into adulthood and contribute to addictive behaviors. Additionally, the interaction between genetic predispositions, environmental stressors, and drug exposure is emphasized. The review also analyzed the risks of early-life stress and social isolation on cocaine-induced neuroplasticity, which can render anxiety-related behaviors and lead to neurological changes. Future studies should incorporate longitudinal design to understand the long-term trajectory of neuroplasticity induced by cocaine. This paper can provide some suggestions to the development of prevention and intervention programs for adolescents at risk.

Associations Between Acculturation, Discrimination, and Adolescent Relationship Abuse: A Matched Parent-Adolescent Study of Latine Families.

Adolescent relationship abuse (ARA) is prevalent among adolescents, including those who identify as Latine. However, there is limited research that has considered the cultural and structural mechanisms that may impact ARA experiences among Latine youth. Further, although parents play a crucial role in ARA prevention, few studies have investigated how adolescent-parent differences in acculturation and discrimination are associated with ARA. The objective of this exploratory study of Latine families was to examine how acculturation, discrimination, and adolescent-parent acculturation/discrimination differences relate to ARA victimization and perpetration. Parent-adolescent dyads recruited from clinic and community-based settings in Pittsburgh and Kansas City completed matched surveys. Parent-adolescent acculturation and discrimination differences were calculated using multilevel linear models. Multivariable logistic regression was used to examine associations among ARA victimization and perpetration and adolescent-reported acculturation, adolescent-reported discrimination, and adolescent-parent acculturation and discrimination differences. One hundred eighty-two adolescents and their parent/caregiver (n = 364) completed a matched survey in English or Spanish from March 2020 to March 2021. Forty-three percent of adolescents reported that they had started dating; of these 35% and 24% reported ARA victimization and perpetration, respectively. Higher levels of adolescent-reported acculturation conflict were associated with lower ARA victimization (adjusted odds ratio [aOR]: 0.24; 95% confidence interval, CI [0.08, 0.75]); conversely, higher adolescent-reported discrimination was associated with ARA victimization (aOR: 2.50 [1.30, 4.60]) and perpetration (aOR: 2.10 [1.10, 3.90]). Wider adolescent-parent acculturation differences in Spanish language (aOR: 3.40 [1.04, 11.30]) and interpersonal discrimination (aOR: 2.40 [1.10, 5.20]) were associated with increased ARA victimization. Results underscore the importance of discrimination in understanding ARA experiences among Latine youth. Future work should consider developing culturally and linguistically affirming ARA prevention programs for Latine adolescents and parents.

Health Risk Behaviors of Adolescents in Europe: A Latent Profile Analysis of Health Behavior in School-Aged Children Survey Data From 43 Countries

Current literature on prevention and intervention programs for European adolescents who engage in health risk behaviors is limited. Few studies have utilized latent profile analysis methods and internationally comparative data on adolescents and their health risk behaviors, highlighting the need for more comprehensive research using internationally comparative data. The current study aimed to examine the health risk behavior profiles and identify subgroups of adolescents with similar patterns of health risk behaviors using a representative sample of European countries. Findings will inform better targeted prevention strategies for this population. The study used a quantitative approach and implemented secondary data analysis using the Health Behavior in School-Aged Children survey 2017/2018 from 43 European countries to understand the prevalence of health risk behaviors among European adolescents and yield latent profiles regarding their health risk behaviors by sex. Five latent profiles of health risk behaviors were identified for boys and six for girls. For both boys and girls, low-risk (83.4% and 85.7%), poor lifestyle, smoking (6.2% and 5.1%), balanced lifestyle, aggressive acts (5.4% and 3.7%), poor lifestyle, high substance use (2% and 1%), moderate lifestyle, and moderate substance use (3% and 0.9%) were common profiles. A moderate lifestyle and low substance use profile (3.6%) was only specific to girls. The current study provides important insights regarding European adolescents' health risk behaviors. The findings suggest the need for better targeted prevention programming.

Analysis of Impact and Sustainability in Chronic Diseases Prevention Program in XXX Highschool Balikpapan (Systematic Review)

A healthy lifestyle requires discipline. It's not easy, particularly adolescent who feel free and are looking for their existence. Its implementaiton needs to be applied to adolescent due to many cases of chronic diseases developing among them, following their lifestyle. Sedentary/lazy to move, smoking, alcohol, lack of rest and not being able to manage mental health. Generally, adolesecent at the educational level of Junior and Senior High School. The objective of this study is to analyze aspects of the impact and sustainability of chronic disease prevention programs for adolescents. This study is a systematic review using the PRISMA (Preferred Reporting Items for Systematic Reviews &amp; Meta Analyses) method combined with open-source search engine. The database used for searching data and information is PubMed. The keywords used during the search process are "Prevention of Chronic Disease" AND "Chronic Disease" OR "Non-communicable Disease" OR "Infectious Disease" AND “Impact of Chronic Diseases” AND “Teenagers” OR “Adolescents” AND “School”. The most variable aspects of disease prevention are more information related to chronic diseases, knowledge, attitudes and stakeholder support. The CERDIK program provides knowledge, education and information among adolescents. These factors must be taken into consideration to improve lifestyle, maintain health so that you are not vulnerable to health problems during the teenage period

Suicide progression and influencing factors in Chinese adolescents: A latent transition analysis

Suicide progression and influencing factors in Chinese adolescents: A latent transition analysis

The Role of Parenting Behaviors and Their Influence on Adolescent Drunk and Drugged Driving: 2016-2019, USA.

Drugged driving, the act of driving a vehicle under the influence of illicit drugs, by adolescents is a serious public health concern. Many factors contribute to this risk behavior, but much less is known regarding the role of parenting behaviors in this phenomenon. The purpose of this study was to examine specific parenting behaviors and their influence among a nationally representative sample of adolescents. Pooled data from the 2016-2019 National Survey on Drug Use and Health (NSDUH) among 17,520 adolescents ages 16-17 years old were analyzed. Differences were found in specific parenting behaviors and adolescent drugged/drunk driving, with parents not checking homework and not telling their children they are proud of them being the most influential. Findings from the present study may inform drugged driving prevention programs for parents and adolescents and enhance road safety interventions.

Feasibility of Fit24, a Digital Diabetes Prevention Program for Hispanic Adolescents: Qualitative Evaluation Study.

Digital health interventions are promising for reaching and engaging high-risk youth in disease prevention opportunities; however, few digital prevention interventions have been developed for Hispanic youth, limiting our knowledge of these strategies among this population. This study qualitatively assessed the feasibility and acceptability of Fit24, a 12-week goal-setting intervention that uses a Fitbit watch (Fitbit Inc) and theoretically grounded SMS text messages to promote physical activity and sleep among Hispanic adolescents (aged between 14 and 16 years) with obesity. After completing the intervention, a subsample of youth (N=15) participated in an in-depth interview. We categorized the themes into dimensions based on participant perspectives using the Practical, Robust Implementation, and Sustainability Model (PRISM) framework. Participants shared positive perceptions of wearing the Fitbit and receiving SMS text messages. Youth were highly engaged in monitoring their behaviors and perceived increased activity and sleep. Almost all youth organically received social support from a peer or family member and suggested the use of a group chat or team challenge for integrating peers into future interventions. However, most youth also expressed the need to take personal responsibility for the change in their behavior. Barriers that impacted the feasibility of the study included the skin-irritating material on the Fitbit watch band and environmental barriers (eg, lack of resources and school schedules), that limited participation in activity suggestions. Additionally, sync issues with the Fitbit limited the transmission of data, leading to inaccurate feedback. Fit24 is a promising approach for engaging Hispanic youth in a diabetes prevention program. Strategies are needed to address technical issues with the Fitbit and environmental issues such as message timing. While integrating peer social support may be desired by some, peer support strategies should be mindful of youth's desire to foster personal motivation for behavior change. Findings from this study will inform future diabetes prevention trials of Fit24 and other digital health interventions for high-risk pediatric populations.

The role of monitoring skills in mediating the association between parent's hazardous alcohol consumption and adolescents' drinking.

This study aimed to investigate whether parental monitoring skills mediate the effect of hazardous parental alcohol consumption on adolescents' lifetime alcohol use. This three wave longitudinal study was conducted with 884 families (n = 1,768 participants) to evaluate the effectiveness of a family-based drug prevention program for adolescents and parents across 12 Brazilian cities. We used structural equation mediation modeling to analyze the effect of hazardous parental alcohol consumption at baseline on adolescents' lifetime alcohol use at 12-month follow-up, mediated by parental monitoring skills latent dimension at 6-month follow-up. We found a significant indirect effect of parents' hazardous alcohol use on adolescents' alcohol use through parental monitoring (OR:1.18, 95%CI:1.02;1.36). Our finding underscores the importance of comprehensive preventive family alcohol approaches targeting adolescent alcohol use, which should consider both parental drinking behavior and monitoring practices.

Accelerating implementation of adolescent digital health prevention programs: analysis of insights from Australian stakeholders.

Chronic disease risk factors are increasing amongst adolescents, globally. Digital health prevention programs, which provide education and information to reduce chronic disease risk factors need to be equitable and accessible for all. For their success, multiple highly engaged stakeholders should be involved in development and implementation. This study aimed to evaluate stakeholders' support for, and perspectives on potential public health impact of digital health prevention programs for adolescents and potential pathways for future implementation. Qualitative semi-structured online interviews with stakeholders. Stakeholder mapping identified key individuals, groups and organizations across Australia that may influence the implementation of digital health prevention programs for adolescents. Recorded and transcribed interviews were analyzed within the Reach, Effectiveness, Adoption, Implementation and Maintenance (RE-AIM) Framework, using deductive content analysis. Nineteen interviews were conducted in 2023 with stakeholders from government, health, non-government organizations, youth services, education, community settings and others. Four overarching themes were identified: (i) existing digital health initiatives are not fit for purpose; (ii) the co-creation of digital health prevention programs is critical for successful implementation; (iii) digital health prevention programs must address equity and the unique challenges raised by technology and; (iv) system level factors must be addressed. Stakeholders broadly supported digital health prevention programs, yet raised unique insights to ensure that future programs create public health impact by improving chronic disease risk factors among adolescents. These insights can be applied in future development of digital health prevention programs for adolescents to strengthen widespread implementation.

How to decrease teenage pregnancy: rural perspectives in Ecuador.

This study aimed to understand the sociocultural context of teenage pregnancy in an Ecuadorian city with a large indigenous population, to gauge the acceptability of a multifaceted pregnancy prevention program for adolescents, and to elicit perspectives on the optimal program design from adolescents and adult key informants. We ascertained qualitative data via an online, electronic survey administered from August to September 2020. Open- and closed-ended questions elicited perspectives relating to burden of adolescent pregnancies, acceptability of pregnancy prevention programs, and optimal design of future programs. Twenty-four adolescents (13-19 years of age) and 15 adult key informants working in the healthcare, business, and education sectors in Cotacachi completed the survey. Survey responses were analyzed using a structural and in vivo coding, and an inductive approach to consensus-building around key themes. Most adolescent survey respondents (75%) believed that teen pregnancy is "fairly common" in Cotacachi, and 41.7% believed differences in teen pregnancy rates are not associated with ethnicity. In comparison, 66.7% of adult survey respondents said teen pregnancy disproportionately occurs among indigenous teenagers. Additionally, 45.8% of adolescent and 80% of adult survey respondents believed that a comprehensive sexual education program would help reduce teenage pregnancy rates by imparting reliable sexual health knowledge. Adult respondents noted that the past programs were unsuccessful in preventing teenage pregnancy because of these programs' inability to fully engage teenagers' attention, very short time duration, or inappropriate consideration of cultural context. In Cotacachi, Ecuador, a sexual health education program is both desired and feasible according to adult and teenager key informants. A successful program must adapt to the cultural context and engage youth participation and attention.

Engaging caregivers to prevent substance use by at-risk adolescents in pediatric primary care.

Improving adolescent substance use prevention and treatment is an urgent public health priority in the United States. Current intervention models do not address how adolescents with a history of caregiver substance use are at particular risk for problematic substance use. We, therefore, reviewed the evidence on adolescent substance use prevention programs integrating caregiver-focused components and propose opportunities to incorporate adaptations of existing programs into pediatric primary care to improve outcomes for at-risk adolescents exposed to caregiver substance use. There are multiple evidence-based universal prevention programs that target adolescent substance use and incorporate caregivers; however, these programs do not address the specific concerns of caregivers with substance use. Caregiver-focused programs efficaciously address family and child risk factors for adolescent substance use but are not accessible to many families and have not been longitudinally studied to assess impact on adolescent substance use. Adaptation of existing prevention programs to pediatric primary care settings may open opportunities to improve engagement of families with caregiver substance use in targeted prevention strategies. Family Screening, Brief Intervention, and Referral to Treatment (F-SBIRT) is one model that can be incorporated into pediatric primary care to contextualize evidence-based practices to address substance use in a family-focused approach. To develop F-SBIRT, further research is needed to validate caregiver-focused screening tools, determine brief intervention (BI) best practices, and adapt existing evidence-based and caregiver-focused adolescent prevention programs for use with caregivers with substance use in pediatric primary care settings.

Factors associated with informal and formal help-seeking among Asian adolescents with nonsuicidal self-injury.

Although nonsuicidal self-injury (NSSI) is prevalent among adolescents and is associated with an increased risk of adverse outcomes, many adolescents with NSSI do not seek help. However, there is a lack of research on the factors that may increase the likelihood of help-seeking, especially within Asia. To address this gap, the present study examined whether certain factors were associated with informal and formal help-seeking - specifically gender, severity of NSSI, functions of NSSI and authoritative parenting. 121 adolescents (Mage = 16.2years, 71.1% female) were recruited from specialist outpatient clinics and inpatient psychiatric wards from a public hospital in Singapore. One caregiver per adolescent was also recruited. Data from self-report questionnaires were analysed using logistics regression analyses. The results suggest that the severity of NSSI increases the likelihood of informal help-seeking, while adolescents who have parents with more authoritative parenting style are less likely to seek informal help. Gender and functions of NSSI were not found to be associated with help-seeking. The findings from this study can guide professionals in their efforts to encourage help-seeking within Asian populations, as well as inform prevention and treatment programs for Asian adolescents with NSSI.

Comparing Ruminative and Distracting Responses and Emotion Regulation Difficulties in Early Community Adolescents With and Without Self-Harm.

This study aimed to compare the demographic characteristics, responses to negative emotions, and difficulties in emotion regulation between self-harming adolescents and control individuals aged 12-14 years from the community. Data were collected from adolescents in Chungcheong Province, South Korea, between September 2021 and November 2022. Demographic characteristics and responses to the Depressed Mood Questionnaire and Difficulties in Emotion Regulation Scale-16 (DERS-16) were compared between the self-harm and control groups. The self-harm group exhibited a higher prevalence of child abuse (odds ratio [OR]=4.787, 95% confidence interval [CI]=1.591-14.409, p=0.005) and school bullying victimization (OR=4.495, 95% CI=2.353-8.588, p<0.001) than those in the control group. The selfharm group displayed higher levels of rumination (t=7.88, p<0.001) and reduced distraction responses (reverse score t=2.25, p=0.025) than those of the control group. Additionally, the self-harm group scored higher on all subscales and the total DERS-16 score (t=7.61, p<0.001). Interventions for self-harming adolescents should address child abuse and bullying victimization. Prevention programs for self-harming adolescents should focus on reducing rumination responses, increasing distractive responses, and addressing difficulties in emotion regulation using dialectical behavior therapy-skill training.

Self-injury and suicidal ideation among Chinese adolescents involved in different subtypes of aggression: The role of gender

Although aggression associated self-injury and suicidal ideation, but the specific impact of different subtypes of aggression is unclear. Therefore, the current study aims to quantify the associations between five subtypes of aggression, self-injury, and suicidal ideation in Chinese adolescents. A total of 18,532 students were recruited in grades 7 to 12 using a stratified cluster sampling across five representative provinces in China. The Functional Assessment of Self-Mutilation (CH-FASM) and Buss and Warren's Aggression Questionnaire (BWAQ) assess self-injury and aggression, respectively. During the last year, the proportion of self-injury, suicidal ideation, and self-injury plus suicidal ideation (SSI) were 13.4%, 10.0%, 12.4%, respectively. Multivariate logistic regression indicated that hostility was associated with self-injury-only (OR=1.033, 95% CI=1.021-1.044), suicidal ideation-only (OR=1.075, 95% CI=1.061-1.088), and SSI (OR=1.100, 95% CI=1.087-1.114) (all P<0.001) across five subtypes of aggression. In gender stratification, physical aggression was risk factor for self-injury-only, suicidal ideation-only, and SSI (OR=1.028, 95% CI=1.018-1.037, P<0.001) in females. While anger was association with self-injury-only and suicidal ideation-only in males (P<0.05). This study was a cross-sectional design and self-reported questionnaire. Hostility is a strong predictor of self-injury and suicidal ideation across five subtypes of aggression. There are gender differences in relationships. Prevention programs for adolescents' self-injury and suicidal ideation should consider different subtypes of aggression and gender differences.

The residential, area-specific prevalence and associated factors of suicidal ideation among South Korean adolescents

This study investigated the residential, area-specific prevalence and associated factors of suicidal ideation among adolescents in South Korea, based on nationally representative data. A secondary analysis was performed using the database of the 17th Korean Youth Health Behavior Survey, which contained data from 54,848 adolescents. Female adolescents (more influential in counties), low economic status (more influential in metropolitan cities), perceived stress (more influential in metropolitan cities), depression (more influential in counties), loneliness (more influential in counties), and anxiety (more influential in counties) were influencing factors in all areas, and the factors associated with suicidal ideation differed by residential area. The factors related to suicidal ideation were similar by residential area, but the degree of relevance differed from area to area; in particular, the prevalence of variables related to mental health (depression, loneliness, and anxiety) was high in counties. Alcohol drinking was significant only in small- and medium-sized cities in terms of suicidal ideation. Suicide prevention programs for adolescents should be implemented given the higher incidence of suicidal ideation among female adolescents, the greater influence of mental health-related variables in counties, and the influence of smoking in cities. There were differences in the prevalence and risk factors of suicidal ideation by residential areas.