Adolescent Risk Behaviors Research Articles

A Study on Factors Affecting Oral Disease Symptoms in Adolescents

Objectives: The purpose of this study was to investigate the factors affecting oral diseases symptoms in Korean adolescents. Methods: Chi-square test and logistic regression analysis were performed using complex sampling to determine the effect of oral symptom experience using the 16th Korean adolescent risk behavior web-based survey. Results: Oral symptom experience was affected by sex (female), educational stage (middle school), drinking and smoking habit, low brushing frequency, stress, suicidal thoughts, depression, and loneliness. Conclusions: To ensure proper oral care among Korean adolescents, regular oral health education is imperative.

Sexual Risk Behaviors of Adolescents with Type 1 Diabetes in Comparison with Their Peers.

Background: Adolescents with type 1 diabetes mellitus (T1D) may differ from peers regarding sexual risk behaviors. Objectives: To explore sexual risk behaviors of adolescents with T1D in comparison with peers. Materials and methods: The subjects were 174 adolescents, 58 adolescents with T1D (mean ± SD age 16.3 ± 2.0 yrs, disease duration 6.7 ± 3.5 yrs and HbA1c:8.0 ± 1.3%) and 116 without (matched 1:2). Anonymous, self-reported questionnaires were used to evaluate sexual education and behaviors. Results: Fewer adolescents with T1D than those without had a sexual experience (74.1% vs. 87.4%, p = 0.033), with similar age of sexual debut. Among adolescents with T1D, ≥2 risky behaviors were observed less frequently than adolescents without T1D (8.62% vs. 23.27%, p = NS respectively) and in fewer girls than boys in both adolescents with T1D (0% vs. 18.5%, p = NS) and adolescents without T1D (11% vs. 44%, p = 0.022). Adolescents with T1D with ≥2 risky behaviors were older (p = 0.031), younger at first sexual intercourse (p = 0.031), with higher maternal education (p = 0.039). Early sexual debut was associated with higher maternal education (p = 0.014) and HbA1c (p = 0.049). Most adolescents without T1D with ≥2 risky behaviors were boys and older than peers. Conclusions: Adolescents with T1D and females were more cautious than adolescents without T1D regarding sex. The associations of increased risky behaviors with male gender, older age, younger age at sexual debut and higher maternal education in adolescents with T1D merit further investigation.

Associations between State-Level High School HIV Education Policies and Adolescent HIV Risk Behaviors.

School-based human immunodeficiency virus (HIV) education can reach most adolescents, but inconsistencies exist in state-level content policies. The purpose of this study was to evaluate the associations between state-level high school HIV education policies and adolescent HIV risk behaviors. This was a cross-sectional analysis of the 2019 Youth Risk Behavior Survey linked to the Guttmacher Institute Sex and HIV Education report. Logistic regression models examined the associations of state-level HIV education mandates and content policies with 3 HIV risk behaviors: (1) 4 or more lifetime sexual partners; (2) substance use before last sex; (3) condomless last sex. Across 33 states, 128,986 high school students were included. Multivariable adjusted models demonstrated no associations between mandated HIV education and risk behaviors. Covering abstinence along with other safe sex options was associated with lower odds, whereas stressing abstinence was associated with higher odds of at least 4 lifetime sexual partners and condomless last sex. Discriminatory sexual orientation content was associated with increased condomless last sex; associations for all HIV risk behaviors were stronger among sexual minority youth. Increased HIV risk behaviors associated with state policies stressing abstinence or requiring discriminatory sexual orientation content support the need for comprehensive and inclusive HIV education.

Lise Öğrencilerinin Riskli Davranışlarının Belirlenmesi

Objectives: The aim of this descriptive and cross-sectional study is to identify the risk behaviors of adolescents attending high schools in Şanlıurfa. Methods: The population of this study was 44217 students in high schools in Şanlıurfa. The minimum sample size of the study according to the known population sampling formula was calculated as approximately 1000 participants. Within the scope of the stratified sampling method, the number of students going to high schools in each district was determined. A high school was chosen from each district using the simple random sampling method. The data of the study were obtained by using a “Socio-Demographic Characteristics Questionnaire” and the “Risky Behaviors Scale”. Descriptive statistics, Mann Whitney U test, and Kruskal Wallis H test were used to analyze the data. Results: The finding that the students had a high mean score of 144±22.2 on the Risky Behaviors Scale revealed that the students in the study engaged in a variety of risky behaviors. The sub-behavior in the scale with the largest mean value was alcohol consumption with the mean score of 32.7±5.0. The students at higher grades tended to show fewer risky behaviors (p<0.05). Those who had more educated fathers showed fewer anti-social behaviors (p<0.05). In this study, female students, those under the age of 15, prep-school students, and 9th graders had a higher median score for the sub-behavior of smoking. (p<0.05). Male students had a higher risk of suicide than female students. (p<0.05). The median score for smoking was higher for those who did not work outside the school (p<0.05). The level of tendencies towards risky behaviors were higher for the students who enjoyed school and attended classes in comparison to those who did not like school and skipped classes (p<0.05). Conclusion: As a result, risky behaviors were found to be common among the students, and these behaviors were found to be affected by the students’ socio-demographic characteristics. In this regard, establishing nurse-led school health initiatives is advocated.

Modeling changes in adolescent health risk behaviors approaching and just after the time of emancipation from foster care

BackgroundEmancipated foster youth frequently engage in behaviors that contribute to poor health. Whether health risk behaviors increase following emancipation or are established while in foster care remains unclear. ObjectiveThis secondary data analysis examined substance use and attitudes toward sexual risk behaviors to understand continuity in risk behaviors among foster youth before emancipation and following emancipation. Participants and settingYouth ages 16–20 (N = 151) who had been in foster care for at least 12 months and were expected to emancipate were recruited. The urban county where the study was conducted allowed youth to remain in foster care until 21 years of age. MethodsParticipants completed surveys assessing substance use and attitudes toward sexual risk behaviors at baseline, 6 and 12 months. Multilevel models estimated trajectories of health behaviors and attitudes, with emancipation timing as the primary predictor. Individual and child welfare characteristics were included as covariates. ResultsSubstance use did not change with emancipation (Bs = 0.01, p = 0.81) and positive attitudes about risky sexual behavior significantly decreased as youth approached emancipation (Bs = 1.67, p < 0.01). Placement instability and adversity were not associated with either outcome (ps > 0.08). Females reported more positive attitudes about higher-risk sexual behavior than males (B = 3.09, p < 0.01) and less substance use (B = −1.15, p = 0.03). ConclusionsSubstance use and attitudes about sexual risk behaviors are established before emancipation; interventions prior to emancipation are necessary to improve health outcomes.

Confirmation of a Reconceptualized Definition and Measure of Adolescent Risk Behavior: Adolescent Viewpoints

The goal of this project was to substantiate a more positive conceptualization of adolescent risk behavior and to compare adolescent viewpoints of risk behavior to the items on the Prosocial and Health Adolescent Risk Behavior Scale (PHARBS). A total of 57 high school students participated in the research. Researchers recruited students from an Advanced Placement (AP) Psychology course at a large Midwestern high school. The high school serves approximately 1,750 students in grades 9 through 12. The university Institutional Review Board approved the study procedures. Families provided informed consent, and students assented to participating in one of eight focus group discussions. The focus groups were audio taped, transcribed, and coded. Researchers analyzed the coded data using word count analysis. Students discussed prosocial risk behaviors in addition to health risk behaviors, providing support for the PHARBS and suggesting that adolescents view taking some risks as positive. A more positive conceptualization of risk behavior may better align with how adolescents view risk behavior. Researchers and clinicians might approach adolescent risk behavior measurement and research on the importance of understanding risk behaviors as a normal and potentially positive aspect of adolescent development.

Is there a Relationship between the Characteristics and Attitudes of Adolescents with Premarital Sex?

Background: Premarital sex is one of the high-risk behaviors of adolescents today. The characteristics of adolescents can also be a triggering factor for premarital sex. The purpose of this study was to analyze the relationship between characteristics and attitudes of adolescents towards premarital sex in East Java Province.Methods: This is a quantitative research with a cross sectional research design. The data used were taken from Program Performance and Accountability Survey (2018) on adolescents aged 15-24 years in East Java Province. The sample of this study was 2796 adolescents after normal weight adolescents were carried out. The dependent variable in this study is the attitude of adolescents, while the independent variables are place of residence, age, gender, education, and economic status. Data collection using smartphones and instruments that refer to the IDHS and PMA. The data were analyzed descriptively and tested using chi-square with a significance level of 0.05.Result and Conclusion: The results showed that the characteristics associated with the attitude of female adolescent was the place of residence with a significance value of 0.026. Age was related to the attitude of male adolescent with a significance value of 0.014. Education was related to the attitude of female adolescent (p-vaue = 0.000) and attitudes of male adolescent (p-value = 0.016). Economic status was related to the attitude of female adolescent (p-value = 0.000) and attitudes of male adolescents (p-value = 0.035). Characteristics had a relationship with adolescent attitudes in conducting pre-primary sex behavior. Therefore, it is necessary to have appropriate efforts to prevent adolescent risk behavior in accordance with the characteristics and needs of today’s youth

Parent-focused prevention of adolescent health risk behavior: Study protocol for a multisite cluster-randomized trial implemented in pediatric primary care

Evidence-based parenting interventions play a crucial role in the sustained reduction of adolescent behavioral health concerns. Guiding Good Choices (GGC) is a 5-session universal anticipatory guidance curriculum for parents of early adolescents that has been shown to reduce substance use, depression symptoms, and delinquent behavior. Although prior research has demonstrated the effectiveness of evidence-based parenting interventions at achieving sustained reductions in adolescent behavioral health concerns, public health impact has been limited by low rates of uptake in community and agency settings. Pediatric primary care is an ideal setting for implementing and scaling parent-focused prevention programs as these settings have a broad reach, and prevention programs implemented within them have the potential to achieve population-level impact. The current investigation, Guiding Good Choices for Health (GGC4H), tests the feasibility and effectiveness of implementing GGC in 3 geographically and socioeconomically diverse large integrated healthcare systems. This pragmatic, cluster randomized clinical trial will compare GGC parenting intervention to usual pediatric primary care practice, and will include approximately 3750 adolescents; n = 1875 GGC intervention and n = 1875 usual care. The study team hypothesizes that adolescents whose parents are randomized into the GGC intervention arm will show reductions in substance use initiation, the study's primary outcomes, and other secondary (e.g., depression symptoms, substance use prevalence) and exploratory outcomes (e.g., health services utilization, anxiety symptoms). The investigative team anticipates that the implementation of GGC within pediatric primary care clinics will successfully fill an unmet need for effective preventive parenting interventions.Trial registration: Clinicaltrials.govNCT04040153

ONLINE TRAINING ON OBESITY PREVENTION DURING THE COVID-19 PANDEMIC FOR STUDENTS OF SMP MUHAMMADIYAH 4 AND 36 DKI JAKARTA PROVINCE

ABSTRACT&#x0D; Obesity in children is one of the public health problems at the world level that is worrying because the trend of increasing prevalence continues to increase. Obese children are more likely to be obese in adulthood. The method used in this community service is divided into two methods, the first is training on the identification of obesity risk behavior in adolescents, the second is training on prevention of obesity risk behavior in adolescents. This intervention aims to evaluate whether online training for the prevention of COVID-19 can increase the average knowledge score of respondents and whether this method is well accepted. The results of the intervention showed an increase in the mean value of participants' knowledge. In the pre-test the average was 6,69, while the average in the post-test rose to 7,93. This online training on COVID-19 prevention was also well received by the participants and also the Principal. To prevent the increased risk of obesity in junior high school students, schools need to collaborate with other institutions in order to carry out online training.&#x0D; Keywords : COVID-19 prevention, adolescence, junio high school Muhammadiyah

Factors Predicting Sexual Risk Behaviors of Adolescents in North-Eastern Thailand.

The number of young people who have had sex at an early age increases in proportion, it concerns unsafe sexual behaviors, teenage pregnancy, HIV aids and sexually transmitted infections (STIs). This study examines the health behaviors and factors predicting sexual risk behaviors pertaining to teenage pregnancy among adolescents in Thailand. Adolescents consulted the reproductive health center about problems with the same gender. The factors of adolescent reproductive behaviors were significantly associated with age, education level, and the perception of peer norms. Receiving social support from media information also significantly correlated with those behaviors. The results recommend that to prevent premature pregnancy, adolescents should protect themselves. Parents should take the issue of social media use by their teenagers very seriously.

Experiences and Perceived Benefits of a Youth Skateboarding Program in South Africa: From the Physical to Emotional and Beyond

This study aimed to assess the mental health needs and risk behaviors of adolescents attending an afterschool life-skills skateboarding program, to evaluate the perceived benefits of the program, and to identify potential modifications required to meet the identified needs. Program participants were from three gang- and poverty-affected urban communities in Cape Town, South Africa. Seventy-six adolescents aged between 10 and 19 years old (83% male) completed a self-report survey, and 24 adolescents and 19 key influencers participated in in-depth interviews and focus groups. Descriptive analyses were conducted on survey data and a framework approach was used to analyze qualitative data. 72% of the adolescents reported symptoms of moderate to severe anxiety and/or depressive symptoms, 66% had experienced food insecurity, 45% had been physically abused at home, 47% had been bullied, and 59% had used alcohol. Benefits of the program included experiencing a sense of belonging to a skateboarding subculture, protection from gang recruitment and community violence, physical and emotional benefits of exercise, mentors as positive role models, and learning life skills. Recommendations to improve the program were to include information on depression, anxiety, suicidal thoughts and grief, and to include stress management and emotion regulation skills.

Impact of Reduced School Exposure on Adolescent Health Behaviors and Food Security: Evidence From 4-Day School Weeks.

ABSTRACTBACKGROUNDFour‐day school week (FDSW) use has increased substantially among US districts in recent years, but limited data exist on health impacts of this school schedule. This study examined associations of reduced school exposure via FDSWs with adolescent health and risk behaviors, obesity, and food security.METHODSSelf‐report data from 8th‐ and 11th‐grade students from the Oregon Healthy Teens survey across 5 survey years (odd years 2007‐2015, total N = 91,860‐104,108 respondents depending on the survey question) were linked to a FDSW indicator. Regression analyses controlling for student and school characteristics compared outcomes between students in 4‐ and 5‐day schools overall (without school fixed effects) and outcomes associated with switching to a FDSW (with school fixed effects).RESULTSWhen controlling for multiple student‐ and school‐level factors, we observed adolescents in FDSW schools report they consume sugar sweetened beverages more frequently and water less frequently, have access to fewer days of physical education, are more likely to be food insecure, and are more likely to report the use of any drugs and specifically marijuana than 5‐day school week students.CONCLUSIONSLimiting exposure to the school environment via FDSWs may impact adolescent health behaviors, including diet, physical activity, and drug use.

Physical Activity, Screen-Based Sedentary Behavior and Physical Fitness in Chinese Adolescents: A Cross-Sectional Study.

Purpose: The aim of this study is to explore the relationship between screen-based sedentary behavior, physical activity and physical fitness among Chinese adolescents.Methods: This study randomly selected adolescents from 10 administrative districts in Shandong, China. The data gathering tools for demographic and other characteristics (gender, age, body mass index and socioeconomic status), PA (PAQ-A) and screen-based sedentary behavior (YRBSS) and physical fitness (NSPFH 2014) were utilized in this study. Statistical analysis was performed by T-test, chi-square test and multiple linear regression.Results: 10,002 adolescents (14.39 years ± 1.79) participated in the study. The results demonstrated that BMI and high TV viewing time had a significant negative correlation with physical fitness, but there was no association between the amount of time spent playing computer/video games and physical fitness among adolescents. High SES and physical activity in leisure time five or more times per week were significantly associated with most dimensions of physical fitness.Conclusions: the results suggest that we not only need to focus on adolescent risk behavior associated with low socioeconomic status and obesity, but also enforce physical activity and reduce sedentary television-watching behavior, which will be crucial pathways and strategies to improve the physical fitness of Chinese adolescents.

Duration-Weighted Exposure to Neighborhood Disadvantage and Racial-Ethnic Differences in Adolescent Sexual Behavior.

Racial-ethnic disparities in adolescent sexual risk behavior are associated with health disparities during adulthood and are therefore important to understand. Some scholars argue that neighborhood disadvantage induces disparities, yet prior research is mixed. We extend neighborhood-effects research by addressing long-term exposure to neighborhood disadvantage and estimation bias resulting from inclusion of time-varying covariates. Drawing from the Fragile Families and Child Well-Being Study, we compare a point-in-time proximal measure of neighborhood disadvantage with a duration-weighted measure using marginal structural models with inverse probability of treatment weights. Findings indicate that multiracial, non-Hispanic black, and Hispanic youth exhibit significantly higher sexual risk and duration-weighted exposure to neighborhood disadvantage than non-Hispanic white adolescents. Duration-weighted exposure is a better predictor of sexual initiation and number of partners by age 15 than a point-in-time proximal measure of neighborhood disadvantage and accounts for a substantial portion of the race-ethnic differences in sexual risk.

Towards a hybrid criminological and psychological model of risk behavior: The developmental neuro-ecological risk-taking model (DNERM)

Adolescents have long been characterized as the stereotypical risk-takers, due to their apparent heightened risk behavior (e.g., delinquency, substance use). Hence, the raising of minimum ages for substance use are common legal actions that presume that limiting the exposure to substances (i.e., “risk exposure”) will decrease such heightened adolescent risk behavior. This ecological concept of risk exposure (access to risk conducive situations) is acknowledged in criminological models—to some extent. However, risk exposure is virtually absent from contemporary psychological models, which focus on neuropsychological development, particularly socio-affective and cognitive control development. Moreover, when theories in these disciplines do consider risk exposure, the ubiquitous developmental (i.e., age-dependent) component of this concept is overlooked. For example, in the real-word, adolescents encounter far more risk conducive situations (both offline and online) than children, which could at least partially account for heightened adolescent risk behaviors compared to children. A meta-analysis (Defoe et al. 2015) on laboratory studies provided suggestive evidence for this assertion. Namely, this meta-analysis showed that in laboratory settings—where risk exposure is equal for all participants regardless of age—children and adolescents are generally equally susceptible to engage in risks. Hence, in the above-mentioned meta-analysis, a hybrid Developmental Neuro-Ecological Risk-taking Model (DNERM) was put forward. DNERM emphasizes an interaction between adolescents’ neuropsychological development and their changing physical- and social- ecology, which is further embedded in a cultural context. The current paper further develops DNERM’s aims, which include bridging contemporary psychology models with criminology models to comprehensively describe the development of risk behavior during the youth period (ages 11–24).

Impacts of the respecting the circle of life teen pregnancy prevention program on risk and protective factors for early substance use among native American youth

BackgroundEarly substance use disproportionately impacts Native American (Native) youth and increases their risk for future abuse and dependence. The literature urges for interventions to move beyond focusing on single risk behaviors (e.g. substance use) and instead have capacity to improve health risk behaviors co-occuring during adolescence, particularly among Native populations for whom few evidence-based interventions (EBI) exist. We evaluated the effectiveness of the Respecting the Circle of Life program (RCL) on risk and protective factors for early substance use. RCL is a culturally tailored EBI shown to improve sexual health outcomes among Native youth. MethodsWe conducted secondary analyses of data collected through a community-based randomized controlled trial of RCL evaluated among Native youth (ages 11–19) residing on a rural reservation between 2015–2020 (N = 534, 47.4 % male). We used linear regression, controlling for baseline age and sex, to test between study group differences in outcomes at 3-, 9-, and 12-month post-intervention. Models were stratified by sex and age (11−12, 13−14, and 15+ years of age) to examine differences within these subgroups. ResultsYouth receiving RCL reported lower intention to use substances through 12-months follow-up (p = 0.006). Statistically significant improvements were also observed across peer, parent, and sexual partner risk and protective factors to delay substance use initiation, with notable differences among boys and participants ages 13−14. ConclusionsRCL is a primary prevention, skills-based program effective in preventing risks for substance use. This evaluation underscores the value in developing programs that influence concurrent adolescent risk behaviors, especially for Native communities who endure multiple health disparities.

Epidemiology of suicidal behaviours amongst school-going adolescents in post-conflict Sierra Leone

BackgroundChildren and young people living in post-conflict contexts are at an increased risk of suicidal behaviours (ideations and attempts). Not much is known about the extent of suicidal behaviours amongst adolescents in most notable post-conflict countries in sub-Saharan Africa, including Sierra Leone. MethodsWe performed a secondary analysis of data from the 2017 Sierra Leone World Health Organisation Global School-based Student Health Survey conducted amongst students in secondary schools nationwide. We estimated the 12-month prevalence and performed bivariable and multivariable analyses to assess the correlates of suicidal behaviours. ResultsOf the 2,798 analytic sample, 14.6% (males = 15.1%, females = 14.0%) reported suicidal ideation, and the 12-month prevalence estimate of suicide attempt was 19.6% (male = 20.9%, females =17.8%). The factors associated with suicidal behaviours were multi-layered. While no statistically significant gender association with suicide ideation or attempt was observed at the personal level, being aged 18 or older, loneliness, and health risk behaviours (cannabis use, and leisure time sedentary behaviour) were associated with increased odds of suicidal behaviours. Within the family context, parental monitoring was associated with increased odds of suicidal ideation, but parental supervision was associated with reduced odds of suicide ideation. LimitationsThe cross-sectional nature of the data did not support causal inferences. ConclusionsTaken together, professional mental healthcare would be helpful in treating adolescent emotional problems (e.g., depression and loneliness) related to suicidal behaviours; but prevention and intervention programmes targeted at addressing adolescent health risk behaviours, and familial and interpersonal problems may yield more favourable outcomes.

Is adolescent multiple risk behaviour associated with reduced socioeconomic status in young adulthood and do those with low socioeconomic backgrounds experience greater negative impact? Findings from two UK birth cohort studies

BackgroundAdolescent multiple risk behaviour (MRB) is associated with negative outcomes such as police arrests, unemployment and premature mortality and morbidity. What is unknown is whether MRB is associated with socioeconomic status (SES) in adulthood. We test whether adolescent MRB is associated with socioeconomic status (SES) in young adulthood and whether it is moderated by early life SES variables.MethodsProspective cohort studies; British Cohort Study 1970 (BCS70) and Avon Longitudinal Study of Parents and Children (ALSPAC), born in 1991–1992, were used and two comparable MRB variables were derived. Logistic regression was used to determine the association between MRB and young adult SES. The moderating effect of three early life SES variables was assessed using logistic regression models with and without interaction parameters. Evidence to support the presence of moderation was determined by likelihood ratio tests ≤p = 0.05. Multiple imputation was used to account for missing data.ResultsAdolescents had a median of two risk behaviours in BCS70 and three in ALSPAC. Adolescent MRB was negatively associated with young adult SES (university degree attainment) in BCS70 (OR 0.81, 95% CI: 0.76, 0.86) and ALSPAC (OR 0.85, 95% CI: 0.82, 0.88). There was a dose response relationship, with each additional risk behaviour resulting in reduced odds of university degree attainment. MRB was associated occupational status at age 34 in BCS70 (OR 0.86 95% CI: 0.82, 0.90). In BCS70, there was evidence that maternal education (p = 0.03), parental occupational status (p = 0.009) and household income (p = 0.03) moderated the effect of adolescent MRB on young adult SES in that the negative effect of MRB is stronger for those with low socioeconomic backgrounds. No evidence of moderation was found in the ALSPAC cohort.ConclusionsAdolescence appears to be a critical time in the life course to address risk behaviours, due to the likelihood that behaviours established here may have effects in adulthood. Intervening on adolescent MRB could improve later SES outcomes and thus affect health outcomes later in life. Evidence for a moderation effect in the BCS70 but not ALSPAC suggests that more detailed measures should be investigated to capture the nuance of contemporary young adult SES.

Contraceptive literacy among school-going adolescents in Botswana.

AimTo examine adolescent contraceptive literacy and condom knowledge in Botswana.BackgroundIn Botswana, adolescent HIV infection rates remain high and unintended pregnancies are the predominant reason girls drop out of school. Despite a national mandate for comprehensive sexuality education and youth‐friendly health services, access to accurate sexual and reproductive health information for adolescents remains limited.MethodsTwo hundred forty adolescents attending secondary schools in Maun, Botswana, completed cross‐sectional surveys in 2020. Bivariate and logistic regression examined factors associated with contraceptive literacy and self‐reported condom knowledge.FindingsAlthough 90% of students were aware of one or more forms of contraception, only 67% could name a method for which they knew a source and only half of sexually active respondents had used birth control during their last sexual experience. Respondents reported that teachers and family members were the most important sources of information; only 8.2% of respondents identified health professionals in that role. Adolescents who consulted nurses had eight times greater odds of reporting correct condom‐use knowledge than those who consulted teachers.Implications for Nursing PolicyThe positive association between adolescents’ condom‐use knowledge and nurses as information resources supports a call to expand nurses’ role in health education in secondary schools and clinics in Botswana. Education and training programs for health professionals that build communication skills for working with adolescents should be promoted as an essential step in youth‐friendly service provision.ConclusionContraceptive literacy among adolescents in Botswana is low and may contribute to risk behaviors that drive rates of HIV and pregnancies in this population. Interventions to reduce adolescent HIV risk behaviors and unintended pregnancy may prove more effective if they involve nurses as communicators and educators.

The Effect of E-Module TRIAD Kesehatan Reproduksi Remaja (KRR) on HIV Self-Efficacy in Preventing HIV Vulnerable Behaviour

HIV infection is one of the three threats to reproductive health in adolescents (TRIAD Kesehatan Reproduksi Remaja). In order to reduce this risk to adolescents, a strategy is needed to prevent this problem by providing education through electronic modules or e-modules. Education with e-modules is expected to increase adolescent self-efficacy in preventing HIV risk behaviour. This study purpose was to determine the effect of education through e-module on changes in self-efficacy to prevent HIV risk behaviour in adolescents. This quantitative study used a single group pretest-posttest research design. The sample in this study were VIII grade junior high school students at one of the private schools in Bandung Regency which consisted of several classes by providing education using e-modules. There were 40 students involved in this research. The intervention given to students was education about the dangers of HIV and risk behaviours using E-Module of TRIAD Kesehatan Reproduksi Remaja. Meanwhile, the instrument used in the study was the self-efficacy assessment instrument for the prevention of HIV-risk behaviour. The results of the study found that there was a change in the scores of self-efficacy in the prevention of HIV risk behaviour in students, before and after education through e-modules. Therefore, it can be concluded that e-module is effective in increasing adolescent self-efficacy. The results of this study become recommendations for academics and practitioners who are involved in the health sector for adolescents to implement an intervention to prevent risky behaviours that threaten adolescents, especially in relation to HIV/AIDS problems.