Adolescent Risk Behaviors Research Articles

Multi-scale asynchronous correlation and 2D convolutional autoencoder for adolescent health risk prediction with limited fMRI data.

Adolescence is a fundamental period of transformation, encompassing extensive physical, psychological, and behavioral changes. Effective health risk assessment during this stage is crucial for timely intervention, yet traditional methodologies often fail to accurately predict mental and behavioral health risks due to the intricacy of neural dynamics and the scarcity of quality-annotated fMRI datasets. This study introduces an innovative deep learning-based framework for health risk assessment in adolescents by employing a combination of a two-dimensional convolutional autoencoder (2DCNN-AE) with multi-sequence learning and multi-scale asynchronous correlation information extraction techniques. This approach facilitates the intricate analysis of spatial and temporal features within fMRI data, aiming to enhance the accuracy of the risk assessment process. Upon examination using the Adolescent Risk Behavior (AHRB) dataset, which includes fMRI scans from 174 individuals aged 17-22, the proposed methodology exhibited a significant improvement over conventional models. It attained a precision of 83.116%, a recall of 84.784%, and an F1-score of 83.942%, surpassing standard benchmarks in most pertinent evaluative measures. The results underscore the superior performance of the deep learning-based approach in understanding and predicting health-related risks in adolescents. It underscores the value of this methodology in advancing the precision of health risk assessments, offering an enhanced tool for early detection and potential intervention strategies in this sensitive developmental stage.

Adverse Childhood Experiences and Health Conditions and Risk Behaviors Among High School Students - Youth Risk Behavior Survey, United States, 2023.

Adverse childhood experiences (ACEs) are preventable, potentially traumatic events occurring before age 18 years. Data on ACEs among adolescents in the United States have primarily been collected through parent report and have not included important violence-related ACEs, including physical, sexual, and emotional abuse. This report presents the first national prevalence of self-reported ACEs among U.S. high school students aged <18 years, estimates associations between ACEs and 16 health conditions and risk behaviors, and calculates population-attributable fractions of ACEs with these conditions and behaviors using cross-sectional, nationally representative 2023 Youth Risk Behavior Survey data. Exposures were lifetime prevalence of individual (emotional, physical, and sexual abuse; physical neglect; witnessed intimate partner violence; household substance use; household poor mental health; and incarcerated or detained parent or guardian) ACEs and cumulative ACEs count (zero, one, two or three, or four or more). Health conditions and risk behaviors included violence risk factors, substance use, sexual behaviors, weight and weight perceptions, mental health, and suicidal thoughts and behaviors. Bivariate analyses assessed associations between individual and cumulative ACEs and demographics. Adjusted prevalence ratios assessed associations between cumulative ACEs and health conditions and risk behaviors, accounting for demographics. Population-attributable fractions were calculated to determine the potential reduction in health conditions and risk behaviors associated with preventing ACEs. ACEs were common, with approximately three in four students (76.1%) experiencing one or more ACEs and approximately one in five students (18.5%) experiencing four or more ACEs. The most common ACEs were emotional abuse (61.5%), physical abuse (31.8%), and household poor mental health (28.4%). Students who identified as female; American Indian or Alaska Native; multiracial; or gay or lesbian, bisexual, questioning, or who describe their sexual identity in some other way experienced the highest number of ACEs. Population-attributable fractions associated with experiencing ACEs were highest for suicide attempts (89.4%), seriously considering attempting suicide (85.4%), and prescription opioid misuse (84.3%). ACEs are prevalent among students and contribute substantially to numerous health conditions and risk behaviors in adolescence. Policymakers and public health professionals can use these findings to understand the potential public health impact of ACEs prevention to reduce adolescent suicidal behaviors, substance use, sexual risk behaviors, and other negative health conditions and risk behaviors and to understand current effects of ACEs among U.S. high school students.

Adolescent risk behaviours are associated with educational attainment in early adulthood: results from the Raine Study cohort

BackgroundHigher educational attainment is important for economic wellbeing and associated with better health and longevity. Previous research focused on intelligence, socioeconomic status and mental health or individual risk behaviours as predictors of educational attainment, but the role of multiple domains of adolescent risk behaviours is less clear. This study examined the association between multiple domains of risk behaviour in adolescence and educational attainment by 22 years-of-age.MethodsYoung people (Generation 2, Gen2) and their parents (Generation 1, Gen1) participating in the Raine Study completed questionnaires at years 1, 5, 8, 10 (Gen1 only), 14, 17 (both) and 22 (Gen2 only). The Raine Study is an ongoing longitudinal study initiated in Perth, Western Australia, between 1989 and 1991. The 1,102 Gen2 participants who responded to questions about highest educational attainment were included in this study. The association between Gen2 self-reported risk behaviours (including age at commencement of drinking alcohol, smoking, sexual intercourse and drug use) and educational attainment (defined as self-reported years of completed high school: ≤10, 11, 12 or tertiary education (> 12)) at year 22, after adjusting for mother’s age and combined parental education level, participant sex, and family income, educational performance and adolescent mental health, was explored using ordinal regression models and presented as odds ratios (OR) with 95% confidence intervals (CI).ResultsOrdinal models suggested that never smoking or starting older than 18 compared with smoking before age 15 (OR 2.02, 95%CI: 1.28–2.14); first drinking alcohol between 15 and 17 years compared with younger than 15 (OR 1.52, 95%CI: 1.08–2.14); and, first sexual intercourse aged ≥ 18 years compared with under 15 (OR 1.67, 95%CI: 1.08–2.57) were associated with higher levels of educational attainment at 22-year follow-up. Additionally, lower (“better”) behavioural scores increased the odds of higher levels of attainment.ConclusionsAbsence of health risk behaviours at a younger age or later commencement was associated with higher educational attainment. Evidence-based interventions that address the societal influences underpinning risk behaviours in adolescents may support longer school retention.

Online Sexual Risk Behaviors in Adolescents: Roles of Family Relationships, Impulsivity, and Attention-Deficit/Hyperactivity Disorder.

This study examined the associations of passive and active online sexual risk behaviors with perceived family relationships, impulsivity, and attention-deficit/hyperactivity disorder (ADHD). A total of 176 adolescents with ADHD and 173 adolescents without ADHD participated in this study. The participants' parents rated their parenting style on the Parental Bonding Instrument. The adolescents self-reported their lifelong experiences of passive and active online sexual risk behaviors, perceived family relationship quality on the family domain of the Taiwanese Quality of Life Questionnaire for Adolescents, and three domains of impulsivity on the Barratt Impulsiveness Scale version 11. Multivariable logistic regression was used to examine the associations of online sexual risk behaviors with perceived family relationships, impulsivity, and ADHD. Overall, 114 participants (32.7%) reported passive forms of online sexual risk behaviors, and 49 (14.0%) reported active online sexual risk behaviors. Lack of foresight and self-control was significantly associated with passive online sexual risk behaviors (p = 0.003). Good family relationship was significantly associated with a decreased risk of active online sexual risk behaviors (p = 0.011), whereas seeking novelty and making decisions hastily was significantly associated with an increased risk of active online sexual risk behaviors (p = 0.048). ADHD diagnosis and inability to plan were not significantly associated with online sexual risk behaviors (p > 0.05). A high proportion of Taiwanese adolescents reported exhibiting online sexual risk behaviors. The factors related to the manifestation of these behaviors should be considered when designing relevant intervention programs.

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

PurposeCurrent 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. MethodsThe 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. ResultsFive 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. DiscussionThe current study provides important insights regarding European adolescents' health risk behaviors. The findings suggest the need for better targeted prevention programming.

Effectiveness of digital interventions to reduce school-age adolescent sexual risks: A systematic review.

The increase in risky sexual behaviors among adolescent students has sparked alarm and has become an area of research interest. As adolescents prioritize confidentiality and accessibility, digital interventions are becoming increasingly relevant in sex education. We therefore posed the following research question: Are digital application interventions effective to prevent risky sexual behaviors in school adolescents? A systematic peer review was conducted between January and December 2023 in five databases (PubMed, Web of Science, Scopus, EMBASE, and PsycINFO) without restricting for language or year of publication. We included randomized control trials or quasi-experimental studies that measured the effectiveness of interventions targeting young people aged 10-19 years or their parents and developed in a school setting. Interventions aimed at young people with intellectual disabilities, learning difficulties, or any disease requiring a specific intervention were excluded. The search ultimately yielded 27 studies covering a total of 18 digital interventions that demonstrated positive effects, not maintained over time, on knowledge, attitudes, and behaviors, although the latter to a lesser extent. We have found very interesting digital interventions with effects, among others, on knowledge, attitudes, and contraceptive use in adolescents. In general, digital interventions have positive effects on knowledge and attitudes, but it is more difficult to modify behaviors with strictly digital interventions or combined with complementary face-to-face sessions or group class activities. We thus believe that digital interventions are adequate to reduce adolescent sexual risk behaviors, and our systematic review facilitates the implementation of these interventions by sharing existing digital interventions that have had positive effects, as well as the main characteristics a digital intervention should possess to reduce sexually risky behaviors in adolescents. Digital interventions with adolescents improve sexual behaviors and can be a valuable resource in education on this topic due to their accessibility and confidentiality, two key points for young people.

Prevalence and determinants of risky behaviors: a comprehensive review of substance use and sexual risk behaviors among adolescents in the United States

Adolescents are often the most vulnerable to risky behaviors due to their quest for independence, experimentation, and identity development, resulting in deep-rooted patterns that affect health across the life course. This review examines the prevalence and determinants of substance use and sexual risk behaviors among adolescents in the United States. A systematic search of peer-reviewed literature published between 1980-2023 was conducted using multiple databases. Studies focusing on U.S. adolescents aged 12-19 and reporting on prevalence or associated factors of substance use (alcohol, tobacco, marijuana, or any illicit drugs) or sexual risk behaviors (early sexual initiation, multiple partners, or inconsistent condom use) were included. The review synthesized data from 40 studies meeting inclusion criteria. Results indicate concerning rates of substance use and sexual risk-taking, with variations by demographic factors. Alcohol and marijuana use were most prevalent, reported by 30-40% of adolescents. Nearly half of high school students reported having sexual intercourse, with 40% not using condoms consistently. Prevalence was generally higher among older adolescents, sexual minorities, and some racial minority groups. Key determinants of risk behaviors were reviewed based on socioecological models including individual, interpersonal, community and societal factors. The review highlights the multilevel nature of influences on adolescent risk behaviors. Findings underscore the need for tailored interventions addressing multiple determinants. Particular attention to vulnerable groups such as African American Adolescents and social determinants of health inequities is warranted. More research on risk and protective factors and effective interventions is needed. This synthesis can inform the development of evidence-based policies and programs to reduce substance use and sexual risk behaviors among U.S. adolescents.

Paternal and maternal psychological distress and adolescent health risk behaviors: The role of sensitive periods.

Adolescent health risk behaviors are linked to poor physical and mental health outcomes. While past research shows that maternal psychological distress predicts those behaviors, we know less about the role of paternal psychological distress and the role of sensitive periods. Using 11,128 data from families (50.5% female children) from the UK's Millennium Cohort Study, we examined the role of timing of exposure to paternal and maternal psychological distress in engagement in health risk behaviors (smoking, alcohol use, binge drinking, and sexual activity) at age 14. Paternal and maternal psychological distress, measured with the Kessler-6 scale, were assessed at child ages 3, 7, and 11. We performed path analysis, adjusting for key covariates, modeling maternal distress parallel to paternal, and allowing for autoregressive paths. Paternal distress experienced at age 11 predicted a higher likelihood of smoking at age 14. Maternal distress at age 7 also predicted a higher likelihood of smoking, alcohol use, and binge drinking, but only for boys. Moreover, maternal distress at age 3 was associated with a lower risk for alcohol use. Effects were not replicated in the sensitivity analysis we performed, including only families with resident biological fathers across the study period. Instead, maternal and paternal distress at age 11 raised girls' risk for binge drinking and sexual activity, respectively. Parental distress in early childhood does not predict adolescent health risk behaviors. In late childhood, however, both paternal and maternal distress seem to influence the likelihood of engagement in such behaviors.

Maternal Incarceration and Adolescent Health Risk Behavior Patterns: Exploring Gender and Racial Differences

Objectives: Research suggests that adolescents exposed to maternal incarceration have higher odds of being classified into more severe health risk behavior patterns than those without such experiences. However, the potentially heterogeneous effect of maternal imprisonment on adolescents with distinct individual characteristics remains under-investigated. This study aimed to advance the knowledge base by examining its impact based on adolescent gender and race. Methods: Specifically, this research used a nationwide dataset to examine the moderating effect of adolescent gender and racial background on the association between maternal incarceration and adolescent health risk behavior patterns. Results: The interaction terms were not statistically significant in predicting health risk behavior patterns, except for some trends toward significance worth noting. Specifically, black adolescents with maternal incarceration experiences trended toward lower odds, and Hispanic and multiracial or other adolescents trended toward higher odds of being classified into Class 3 than Class 2, compared to their white counterparts. Additionally, multiracial or other adolescents with maternal incarceration experiences trended toward higher odds of being classified into Class 4 than Class 2, compared to their white peers. Conclusions: Maternal incarceration may have a distinct impact on the health risk behavior patterns of adolescents with different racial backgrounds.

Food and nutritional insecurity and health risk behaviors in adolescents during the COVID-19 pandemic

RESUMO A pandemia de covid-19 reduziu o acesso aos alimentos e aumentou a insegurança alimentar. Objetivouse analisar a prevalência de Insegurança Alimentar e Nutricional (IAN) em adolescentes brasileiros durante a pandemia de covid-19 segundo características sociodemográficas e examinar a associação entre IAN e comportamentos de risco e proteção em adolescentes brasileiros durante esse período. Estudo transversal com dados da ‘ConVid Adolescentes – Pesquisa de Comportamentos’, realizada entre junho e outubro de 2020, utilizando-se um questionário autoaplicado por meio de celular ou computador. A população foi adolescentes de 12 a 17 anos, totalizando 9.470. Utilizou-se a Razão de Prevalência (RP) e Intervalo de Confiança de 95% (IC95%), por meio da regressão de Poisson com variância robusta. A prevalência de IAN (26,1%) foi mais elevada entre os adolescentes da raça/cor preta e parda e que estudam em escola pública. Os adolescentes que relataram IAN tiveram menor consumo de hortaliças e frutas, menor prática de atividade física e maior uso de cigarros e álcool. A IAN foi mais prevalente em adolescentes com piores condições socioeconômicas, e, adolescentes com IAN apresentaram maior frequência de comportamentos de risco para a saúde evidenciando a importância de políticas públicas intersetoriais para a redução de desigualdades.

Association of the COVID-19 lockdown with health risk behaviors in South Korean adolescents.

Since there is no certainty about when the coronavirus disease 2019 (COVID-19) lockdown will be affected by health risk behaviors, so we investigate the effect of COVID-19-related health risk behavior changes using school-based self-reported data from a nationally representative South Korean adolescent population. We analyzed web-based self-reported data from the Korea Youth Risk Behavior Web-based Survey in 111,878 participants (57,069 in COVID-19 prepandemic); 54,809 in during the COVID-19 pandemic. This study included 12 to 18-year-olds. Self-report questionnaires were used to assess socioeconomic status, health risk behaviors, and psychological factors. Health risk behaviors such as alcohol consumption, substance use, and sexual experience significantly decreased in COVID-19 pandemic than in COVID-19 prepandemic. Psychosomatic changes such as stress levels, violence experience, depression, suicidal ideation, suicidal plans, and suicide attempts were significantly lower in COVID-19 pandemic compared to COVID-19 prepandemic (P < .001). After adjusting for multiple confounding variables, less alcohol consumption (odds ratio [OR] = 0.98; 95% confidence interval [CI] = 0.88-0.93), less exercise (OR = 0.92; 95% CI = 0.89-0.94), less sexual experience (OR = 0.82; 95% CI = 0.77-0.86), less violence experience (OR = 0.61; 95% CI = 0.55-0.67), less stress (OR = 0.86; 95% CI = 0.84-0.88), less depression (OR = 0.85; 95% CI = 0.83-0.88), less suicidal ideation (OR = 0.93; 95% CI = 0.89-0.97), plans (OR = 0.82; 95% CI = 0.76-0.88), attempts (OR = 0.78; 95% CI = 0.71-0.85) were significantly associated with the COVID-19 pandemic compared to COVID-19 prepandemic. The COVID-19 pandemic was associated with changes in health risk behaviors among Korean adolescents, resulting in alcohol drinking, sexual experience, drug use, violence experience, and suicidal behaviors (idea, plan, and attempts) being decreased during the lockdown period.

Developing a parental empowerment model to prevent health risk behaviors among adolescents in East Java, Indonesia

Introduction: Parental empowerment in monitoring adolescents plays a crucial role in preventing health-risk behaviors. This research aimed to develop a model of parental empowerment against the prevention of health risk behavior (PE-HRB) in adolescents based on the theory of health promotion model. Methods: The research design used was an explanative survey method. The research population was parents who have adolescent children in East Java and able to access online questionnaires. Consecutive sampling obtained a large sample of 704 respondents from July - September 2020. Questionnaires were distributed online using the online Zoho platform and distributed to parents. The data analysis used a smart PLS (Partial Least Squares) statistical test with significance level T&gt;1.96. Results: Personal factors positively and significantly influenced cognition and affect (T=2.82;p=0.005). Cognition and affection variables influence on parental empowerment (T=5.19; p=&lt;.001). Cognition and affection have no effect on preventive behavior (T=1.49; p=.135). Parental empowerment is an important point in shaping preventive behavior. Conclusions: Empowerment is a factor that significantly affects the formation of parental behavior without going through commitment variables. Parental involvement in adolescents’ academic and personal lives is an important aspect to prevent health-risk behavior in adolescents. Cognition and affection variables cannot directly form preventive behavior but must go through parental empowerment pathways to form preventive behavior. Parental empowerment has no effect on commitment, but commitment affects prevention behavior. Empowering parents is a topic that can be used as material in health education in primary health services.

Self-Esteem and Risk Behaviours in Adolescents: A Systematic Review.

Adolescence is recognised as a notoriously vulnerable period in the human life cycle. Influenced by a complex interplay of biological, psychological and social factors, adolescents show a marked propensity to engage in risk behaviours. A systematic review was conducted of studies published in the Web of Science, PsycInfo and MEDLINE databases over the last decade, with the aim of collecting studies on the relationship between self-esteem and risk behaviour in individuals aged 12-18 years. The aim was to confirm the role of high self-esteem as a consistent protective factor against risk behaviour. The results show that self-esteem is negatively related to risk behaviour. Our results also reflect the need for further research on how sociodemographic factors, among others, affect the relationship between self-esteem and risk behaviours. This review highlights the relevance of implementing specific educational interventions to strengthen self-esteem in adolescents, with the aim of preventing various risk behaviours that may emerge during adolescence and persist throughout life if not addressed early.

A cluster analysis of the family dynamics in a family prevention programme for adolescents from vulnerable families

ABSTRACT In social work with families, evidence-based programmes increase the chances of effective applications. Additionally, family prevention programmes are an excellent opportunity to bond with families and work effectively with them. The Family Competence Programme-AFECT 12–16 pursues the prevention of new risk behaviours in adolescents in the field of addictions and affective-sexual relationships, given the social changes that have occurred in adolescence in recent years. After the application of the programme with new contents and the incorporation of the motivational interview, an evaluation is carried out. This evaluation confirms three types of participating families. It is relevant to verify the effectiveness of the programme and that the different results of the families are not associated with family vulnerability or with the structure of the families. In conclusion, it should be noted that a preventive intervention of a selective type, aimed at families at risk, is effective after its content update, with the incorporation of new content related to addictive behaviours and affective-sexual relationships.

Genetic associations of risk behaviours and educational achievement

Risk behaviours are common in adolescent and persist into adulthood, people who engage in more risk behaviours are more likely to have lower educational attainment. We applied genetic causal inference methods to explore the causal relationship between adolescent risk behaviours and educational achievement. Risk behaviours were phenotypically associated with educational achievement at age 16 after adjusting for confounders (−0.11, 95%CI: −0.11, −0.09). Genomic-based restricted maximum likelihood (GREML) results indicated that both traits were heritable and have a shared genetic architecture (Risk h2\\documentclass[12pt]{minimal} \\usepackage{amsmath} \\usepackage{wasysym} \\usepackage{amsfonts} \\usepackage{amssymb} \\usepackage{amsbsy} \\usepackage{mathrsfs} \\usepackage{upgreek} \\setlength{\\oddsidemargin}{-69pt} \\begin{document}$${{{{{{\\boldsymbol{h}}}}}}}^{{{{{{\\boldsymbol{2}}}}}}}$$\\end{document} = 0.18, 95% CI: −0.11,0.47; education h2\\documentclass[12pt]{minimal} \\usepackage{amsmath} \\usepackage{wasysym} \\usepackage{amsfonts} \\usepackage{amssymb} \\usepackage{amsbsy} \\usepackage{mathrsfs} \\usepackage{upgreek} \\setlength{\\oddsidemargin}{-69pt} \\begin{document}$${{{{{{\\boldsymbol{h}}}}}}}^{{{{{{\\boldsymbol{2}}}}}}}$$\\end{document} = 0.60, 95%CI: 0.50,0.70). Consistent with the phenotypic results, genetic variation associated with risk behaviour was negatively associated with education (rg\\documentclass[12pt]{minimal} \\usepackage{amsmath} \\usepackage{wasysym} \\usepackage{amsfonts} \\usepackage{amssymb} \\usepackage{amsbsy} \\usepackage{mathrsfs} \\usepackage{upgreek} \\setlength{\\oddsidemargin}{-69pt} \\begin{document}$${{{{{{\\boldsymbol{r}}}}}}}_{{{{{{\\boldsymbol{g}}}}}}}$$\\end{document} = −0.51, 95%CI: −1.04,0.02). Lastly, the bidirectional MR results indicate that educational achievement or a closely related trait is likely to affect risk behaviours PGI (β=−1.04, 95% CI: −1.41, −0.67), but we found little evidence that the genetic variation associated with risk behaviours affected educational achievement (β=0.00, 95% CI: −0.24,0.24). The results suggest engagement in risk behaviour may be partly driven by educational achievement or a closely related trait.

Community mobilisation approaches to preventing adolescent multiple risk behaviour: a realist review

BackgroundAdolescent multiple risk behaviour (MRB) is a global health issue. Most interventions have focused on the proximal causes of adolescent MRB such as peer or family influence, with systematic reviews reporting mixed evidence of effectiveness. There is increasing recognition that community mobilisation approaches could be beneficial for adolescent health. There are gaps in the current literature, theory and implementation that would benefit from a realist approach. We use a theory-driven evidence synthesis to assess how and why community mobilisation interventions work/do not work to prevent adolescent MRB and in what contexts.MethodsThis realist review used a six-stage iterative process, guided by the RAMESES framework. We systematically searched PubMed, MEDLINE, PsycINFO, Web of Science, CINAHL and Sociological s, from their inception to 2021. Studies were screened for relevance to the programme theory, assessed for rigour and included based on a priori criteria. Two independent reviewers selected, screened and extracted data from included studies. A realist logic of analysis was used to develop context-mechanism-outcome configurations that contributed to our programme theory.FindingsWe reviewed 35 documents describing 22 separate community mobilisation intervention studies. Most studies (n = 17) had a quality assessment score of three or four (out of four). We analysed the studies in relation to three middle range theories. To uphold our theory that these interventions work by creating a social environment where adolescents are less likely to engage in MRB, interventions should: (1) embed a framework of guiding principles throughout the community, (2) establish community readiness with population data and (3) ensure a diverse coalition with the support of intervention champions. Mechanisms such as empowerment through coalition ownership over the delivery of the intervention, cohesion across the community and motivation to work collaboratively to improve adolescent health are triggered to achieve social environment shifts. However, certain contexts (e.g. limited funding) restrict intervention success as these mechanisms are not fired.ConclusionsFor community mobilisation interventions to reduce adolescent MRB, the coalitions within them must seek to alter the social environment in which these behaviours occur. Mechanisms including empowerment, cohesion and motivation lead to this shift, but only under certain contexts.Systematic review registrationPROSPERO CRD42020205342

Edukasi Kesehatan Reproduksi (Personal Hygiene, Pubertas, Perubahan Fisik) Di Boarding School Man 2 Surakarta

Reproductive health is very important for everyone to understand, especially young women. According to WHO, adolescents are defined as residents in the age range 10-19 years, according to the Republic of Indonesia Minister of Health Regulation Number 25 of 2014, adolescents are residents in the age range 10-18 years and according to the Population and Family Planning Agency (BKKBN) the age range for adolescents is 10-18 years. 24 years old and not married. Adolescence is a period of transition from childhood to adulthood which is marked by physical, emotional and psychological changes. During this period, there was rapid growth and development, both physical and mental. This adolescent phase is also the time for the maturation of human reproductive organs, so it is often called the transition period. In this age range, teenagers are generally pursuing their formal education at junior high school, high school and college. Currently, access to information for Indonesian teenagers regarding reproductive health is still very limited because many people still think that sexuality is a taboo subject to discuss. Limited access to information regarding reproductive health results in a lack of knowledge, characteristics and risk behavior in adolescents which has an impact on the reproductive health status of adolescents. This situation requires the availability of caring health services for adolescents that can meet the health needs of adolescents, especially services for reproductive health that are friendly to adolescents To provide reproductive health education (personal hygiene, puberty, physical changes to female students at the MAN 2 Surakarta Boarding School. This community service is carried out based on the current phenomenon, especially what happened to the female students of Boarding School MAN 2 Surakarta, namely that there is still a lack of information obtained about reproductive health. This community service will be implemented on August 26 2023, starting with preparing a proposal, preparing educational media in the form of PPTs, leaflets, preparing the audience and place. This reproductive health education was attended by 50 female students. This reproductive health education was carried out in the hall of the MAN 2 Surakarta Boarding School. The results of community service show that there is an increase in female students' knowledge about reproductive health, especially regarding personal hygiene, puberty and physical changes.

Prevention of risky sexual behavior in primary healthcare: a best practice implementation project.

Sexually transmitted infections are a public health problem affecting 45% of adolescents and young adults worldwide. The evidence suggests that primary care settings are uniquely positioned to provide an opportunity for these preventive interventions. The aim of this project is to improve nurses' interventions for preventing risky sexual behaviors in adolescents attending nursing consultations in a primary healthcare unit. An audit and feedback were conducted by the JBI Model and Implementation Framework. Five audit criteria representing best practice recommendations for preventing risky sexual behaviors in adolescents were used. Barriers to compliance with the best practices were identified, and strategies were adopted to overcome them. A follow-up audit was conducted using the same approach as the baseline audit. Compliance rates improved in four criteria from baseline audit to follow-up audit. Through auditing and feedback, evidence-based interventions were implemented to prevent sexual risk behavior in adolescents in primary care settings. Further best practice implementation projects should be conducted to improve adolescent health outcomes.

An Electronic Teen Questionnaire, the eTeenQ, for Risk Behavior Screening During Adolescent Well Visits in an Integrated Health System: Development and Pilot Implementation.

Screening for risk behaviors is a routine and essential component of adolescent preventive health visits. Early identification of risks can inform targeted counseling and care. If stored in discrete fields in the electronic health record (EHR), adolescent screening data can also be used to understand risk behaviors across a clinic or health system or to support quality improvement projects. Goals of this pilot study were to adapt and implement an existing paper adolescent risk behavior screening tool for use as an electronic data capture tool (the eTeenQ), to evaluate acceptance of the eTeenQ, and to describe the prevalence of the selected risk behaviors reported through the eTeenQ. The multidisciplinary project team applied an iterative process to develop the 29-item eTeenQ. Two unique data entry forms were created with attention to (1) user interface and user experience, (2) the need to maintain patient privacy, and (3) the potential to transmit and store data for future use in clinical care and research. Three primary care clinics within a large health system piloted the eTeenQ from August 17, 2020, to August 27, 2021. During preventive health visits for adolescents aged 12 to 18 years, the eTeenQ was completed on tablets and responses were converted to a provider display for teens and providers to review together. Responses to the eTeenQ were stored in a REDCap (Research Electronic Data Capture; Vanderbilt University) database, and for patients who agreed, responses were transferred to an EHR flowsheet. Responses to selected eTeenQ questions are reported for those consenting to research. At the conclusion of the pilot, the study team conducted semistructured interviews with providers and staff regarding their experience using the eTeenQ. Among 2816 adolescents with well visits, 2098 (74.5%) completed the eTeenQ. Of these, 1811 (86.3%) agreed to store responses in the EHR. Of 1632 adolescents (77.8% of those completing the eTeenQ) who consented for research and remained eligible, 1472 (90.2%) reported having an adult they can really talk to and 1510 (92.5%) reported feeling safe in their community, yet 401 (24.6%) reported someone they lived with had a gun and 172 (10.5%) reported having had a stressful or scary event that still bothered them. In addition, 157 (9.6%) adolescents reported they were or wondered if they were gay, lesbian, bisexual, pansexual, asexual, or other, and 43 (2.6%) reported they were or wondered if they were transgender or gender diverse. Of 11 staff and 7 providers completing interviews, all felt that the eTeenQ improved confidentiality and willingness among adolescents to answer sensitive questions. All 7 providers preferred the eTeenQ over the paper screening tool. Electronic capture of adolescent risk behaviors is feasible in a busy clinic setting and well accepted among staff and clinicians. Most adolescents agreed for their responses to risk behavior screening to be stored in the EHR.

Is there an association between gender stereotypes and sexual risk attitudes and behaviors? A population-based study among Peruvian adolescents.

Adolescents, particularly those aged 14 to 15y, often begin exploring their sexuality, during which time they are more vulnerable to traditional influences and ideologies imposed by society. This study aimed to identify the association between more traditional attitudes toward women and sexual risk attitudes and behaviors in Peruvian adolescents. Cross-sectional study with data from the fifth round of the Young Lives study with 1860 adolescents aged 14 and 15y. Population characteristics were described by relative frequencies and using chi-squared test with p-value. The 12 items of the Attitudes toward Women Scale for Adolescents instrument were analyzed by relative frequencies and mean with standard deviation. For further analysis, the values of the global scores of all participants were divided into two categories, using the median as the cutoff point, where the group with higher scores indicated that these adolescents had more traditional attitudes (or more gender stereotypes). More traditional attitudes were associated with sexual risk attitudes and behaviors, with crude prevalence ratio (PR) and then adjusted prevalence ratio (aPR) with 95% CI. The Universidad Privada de Tacna's ethics committee approved the research protocol. Adolescents with more traditional attitudes were more likely to have sexual risk attitudes compared to those with less traditional attitudes. In addition, adolescents with more traditional attitudes were 2.6 times more likely to have at least one sexual intercourse while drunk as compared to the reference group (95% CI: 1.43-4.74; p=0.002). The expression of more traditional attitudes toward women was associated with sexual risk attitudes. However, there was no association with most of the sexual risk behaviors studied, except for the higher probability of having at least one sexual intercourse while drunk.