Health Risk Behaviors Research Articles

Predictors of preventative behavior in the restaurant industry: learning from the COVID-19 pandemic

ABSTRACT This study used a structural model to analyze the health beliefs and prevention expectations of consumers in order to better understand their health risk behavior and their experience with restaurant precautionary measures. The findings indicated the perceived severity of COVID-19 during the pandemic led to a significant increase in the consumers’ preventative behaviors. Likewise, the customers’ perceived severity of the COVID-19 threat enhanced their concerns about the safety of restaurant service. Based on the moderating effect, we found that lower trust in restaurant precautionary measures weakened the otherwise positive relationship between the consumers’ perceived severity of the COVID-19 threat and their preventative behavior. Recommendations can help the restaurant prepare for future public health concerns.

Evaluation of the Friday Night Live Mentoring Program on Supporting Positive Youth Development Outcomes

Introduction: The use of alcohol, tobacco, and other drugs (ATOD) is a leading cause of preventable morbidity and mortality among adolescents. While traditional interventions have targeted specific health-risk behaviors (e.g., substance use, initiation of sexual intercourse, truancy, etc.), the evidence suggests that using a positive youth development (PYD) framework may have positive impacts across a number of domains. Friday Night Live Mentoring (FNLM) is a PYD-based, cross-age peer mentoring program that engages teams of older high school-aged youth to mentor teams of middle school-aged youth in a structured, ongoing, one-on-one relationship. While studies have demonstrated significant but small effect sizes of intergenerational youth mentoring programs in which an adult mentor is paired with the youth mentee, research on cross-age mentoring programs is limited. The purpose of the current study is to evaluate FNLM on its ability to improve participants’ knowledge, attitudes, skills, opportunities to develop caring relationships, school engagement, and academic performance. Methods: A retrospective, pre–post survey was administered online to FNLM participants across 13 California counties. Participants rated their knowledge and attitudes about ATOD, skills, relationships with peers and adults, and academic indicators. Open-ended questions gathered information about participants’ experiences in FNLM. Non-parametric related-samples Wilcoxon signed rank tests (an alternative to paired t-test) were used to compare pre–post differences. Participants were also asked two open-ended questions: “What are the best parts of FNLM?” and “What, if anything, would you change?”. The responses to each question were reviewed, coded, and analyzed according to key themes. Results: A total of 512 participants completed the survey (287 mentors and 225 protégés). There were small but statistically significant improvements across all items for both mentors and protégés. Qualitative analyses showed that most mentors and protégés especially enjoyed getting to know and spend time with one another. Several mentors added that it was rewarding to be a positive influence on or to make a positive difference in the protégé’s life. Many youth stated that the relationships formed, especially with their partner, and the activities were the best part of FNLM. The overwhelming majority would not change anything about the program. Those who provided recommendations for program improvement suggested more activities or more hands-on and engaging activities and more or longer meetings. Conclusion: FNLM actively engages youth and provides them with support and opportunities that promote knowledge, skill development, positive relationships, academic engagement, and success and raise awareness of the harms that the use of alcohol, tobacco, and other drugs (ATOD) can cause. While ATOD use was low prior to program participation, it was significantly lower after participating in the program.

Training physicians in motivational communication: An integrated knowledge transfer study protocol.

While behavior change counseling (BCC) targeting health risk behaviors has shown efficacy for improving patient health outcomes, barriers to knowledge translation have resulted in poor uptake among health care providers (HCPs). This article outlines the development of a new BCC training framework for HCPs, from inception to readiness for efficacy testing. It provides an example of integrated knowledge translation (iKT) used in alignment with the obesity-related behavioral intervention trials model. (a) A modified Delphi process identified essential BCC skills for HCPs; (b) a survey assessed HCP attitudes and training needs; (c) an online competency assessment tool was developed using iKT mixed methods; (d) a training program was developed and refined using a logic model; and (e) the program was optimized using iterative rounds of participant feedback. A future proof-of-concept trial (f) will determine the program's readiness for full efficacy testing. A Delphi panel (n = 46) identified 11 core BCC competencies for HCPs, defining "motivational communication." The HCP survey (n = 80) showed willingness to devote 4 hr to introductory training in BCC. The Motivational Communication Competency Assessment Test (MC-CAT: an online, interactive evaluation tool) and a motivational communication training program (MOTIVATOR: accredited for continuing education by the Royal College of Physicians and Surgeons of Canada) were collaboratively developed with knowledge users. The optimization process (n = 11) provided key feedback, with minor changes being made to the program. In developing a new BCC framework, obstacles to BCC implementation were addressed through an iterative iKT process. This should improve eventual intervention uptake. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

A four-factor model of executive function: Predicting physical and academic outcomes from cognitive assessments in adolescents

Impulsivity and cognitive function are essential for understanding behavioral regulation, particularly in relation to health-risk behaviors like substance use, physical activity, and academic performance. This study examined the factor structure underlying executive function in adolescents using the UPPS-P Impulsive Behavior Scale and NIH Toolbox Cognition Battery. We explored how parental monitoring moderates, and peer network health and perceived stress mediate, relationships between cognitive function and outcomes such as BMI, physical activity, and academic performance. Exploratory factor analysis (EFA) on 2228 observations identified a four-factor model (BIC = −97.92, RMSEA = 0.040, TLI = 0.936), validated by confirmatory factor analysis (CFA) (CFI = 0.961, RMSEA = 0.055). Structural equation modeling (SEM) on 5902 observations showed that parental monitoring moderated Factor 1 (adaptive impulsivity) in relation to physical activity and academic performance, while peer network health mediated Factor 2 (emotional impulsivity) effects on BMI and physical activity. This model underscores the influence of peer relationships, parental involvement, and stress on cognitive, health, and academic outcomes, suggesting that interventions enhancing peer support, reducing stress, and promoting healthy behaviors may improve adolescent well-being.

Bias-Motivated Physical or Verbal Violence Among Men Who Have Sex with Men: Findings from the Lisbon Cohort of MSM

Abstract Introduction Victimization based on sexual orientation or gender identity is a cause for concern. Bias-motivated violence affect not only the individuals targeted but also their communities and societies as a whole. Objective To estimate the proportion of bias-motivated victimization among cisgender men who have sex with men (MSM) and to compare sociodemographic and behavioral characteristics and HIV and syphilis test results between victims and non-victims. Methods We used data from the baseline visit of 2811 adult cisgender MSM from July 2017 to December 2020 in the Lisbon Cohort of MSM. Victimization was defined as self-reported lifetime or recent (in the previous 12 months) experience of physical or verbal violence motivated by sexual orientation or gender identity. Rapid HIV and syphilis tests determined serostatus. We conducted descriptive statistics to summarize the sociodemographic and behavioral characteristics and the prevalence of victimization and compared groups using the Student t-test or Mann–Whitney U test and chi-square test, as appropriate. Results Overall, 40.3% of participants reported lifetime bias-motivated physical or verbal violence, and 11.7% reported recent victimization. Recent victimization contexts more frequently reported were street/neighborhood (67.9%) and workplace/school (35.5%). Victimization was associated with younger age (mean age: 26.5 vs 30.2, p-value < 0.001), being born in Brazil or other American countries, or being 14 or younger at their anal intercourse with a man debut (19.5% vs. 11.0%, p-value < 0.001). Lifetime victimization was not significantly associated with reactive results for HIV (p-value = 0.135) or syphilis (p-value = 0.760). Conclusion The violence motivated by sexual orientation or gender identity was quite frequent in this community. The occurrence of violence based on sexual orientation or gender identity in the Lisbon Cohort of MSM was associated with adverse social conditions and health risk behaviors. Policy Implications Raising awareness about bias-motivated violence as a hate crime may deter potential aggressions. Primary violence prevention should tackle specificities of sexual and gender minorities.

Using a Bayesian analytic approach to identify county-level ecological factors associated with survival among individuals with early-onset colorectal cancer.

In the United States (US), incidence of early age of onset colorectal cancer (EOCRC, diagnosed <50 years of age) has been increasing. Using a Bayesian analytic approach, we evaluated the association between county-level ecological factors and survival among individuals with EOCRC and identified hotspot and coldspot counties with unexplained low and high survival, respectively. Principal component (PC) analysis was used to reduce dimensionality of 36 county-level social, behavioral, and preventive factors from the Centers for Disease Control and Prevention data. Survival information was derived from the Surveillance, Epidemiology, and End Results Program data from January 1, 2000 to December 31, 2019. The association between the identified PCs and survival was evaluated using multivariable spatial generalized linear mixed models. Counties with residual low and high survival (i.e., unexplained by the PCs) were classified as hotspots and coldspots, respectively. Four PCs were used to explain the spatial variability in 5-year survival among 75,215 individuals with EOCRC: PC1) poverty, chronic disease, health risk behaviors (β = -0.03, 95% credible interval (CrI): -0.04, -0.03); PC2) younger age, chronic disease-free, minority status (β = -0.01, 95% CrI: -0.02, 0.00); PC3) urban environment, preventive services (β = 0.02, 95% CrI: 0.00, 0.03); and PC4) older age (-0.04, 95% CrI: -0.06, -0.02). Among individuals with distant malignancies, the residual spatial variability remained high for two US counties: 1) Salt Lake County, UT residents experiencing 26.5% (95% CrI: 1.5%, 47.8%) lower odds of survival [hotspot], and 2) Riverside County, CA residents experiencing 37% (95% CrI: 7.97%, 78.8%) higher odds survival [coldspot] after adjustment for county-level factors. County-level ecological factors are strongly associated with survival among individuals with EOCRC. Yet there is some evidence of survival disparities among individuals with distant malignancies that remain unexplained by the included factors.

Interrogating the environmental and social correlates of health risk behaviours in West Africa

Abstract Background Despite the high incidences of health risk behaviors (HRBs) in sub-Saharan Africa, studies on the contextual determinants of HRBs across countries are generally lacking, concentrated on isolated countries and often focus solely on specific health behaviors. Thus, this study investigated the environmental and social correlates of HRBs in West Africa. Methods Data was from post-2015 Demographic and Health Surveys in three West African countries of Benin, Mali and Nigeria. A composite outcome variable of health risk behaviors (HRBs) was derived from variables of tobacco smoking, intimate partner violence, overweight/obesity and risky sexual behaviors. The contextual variables were normalized difference vegetation index, precipitation, maximum and minimum temperatures, region of residence and population Density. Data analysis involved descriptive statistics, chi square test, geographical mapping, and multilevel logistic regression. Results The engagement in HRBs varied from 42.65% in Nigeria to 42.88% in Benin and 51.06% in Mali as there are spatial variations in the engagement in HRBs within different regions of these countries. There also existed significant variations in HRBs regarding age, education, employment status, wealth index, household size, place of residence, and region of residence in the three countries. In the contextual models of environmental and social factors, population density significantly increased odds of HRBs in the three countries, maximum temperature significantly increased odds of HRBs in Benin and Mali, while precipitation significantly increased odds of HRBs in Nigeria and Mali. Other factors which significantly increased odds of HRBs across the three countries were increase in age, wealth index, households with 9+ persons, and regions of residence. Conclusions These findings suggest that among other things, changes in lifestyles regarding the different HRBs should be emphasized in specific contextual situations Key messages • There are variations in engagement in health risk behaviours across the countries. • Cliamte variables influence engagement in health risk behaviours.

Social influence on post-drinking risky sexual behaviours: evidence in France and South Korea

Abstract Background Post-drinking risky sexual behaviours are at the conjunction of the dual risks of sexually transmitted infections and further problematic substance use, necessitating contextual analysis for determinants that promote these behaviours. This study examines the influence of social groups on post-drinking risky sexual behaviours in different cultural samples. Methods A cross-sectional survey was conducted among young adults aged 18-30 in France and in South Korea in 2023-2024 (n = 998). A construct of post-drinking risky sexual behaviours includes 3 types: having sex without condoms, having sex with occasional partners, and having transactional sex. Perceived drinking norms were measured as a proportion. Multivariate logistic regression was conducted after controlling for sociodemographic factors. Results Young adults who reported that their social group had a higher proportion of drinkers were more likely to engage in a wider range of post-drinking risky sexual behaviours (aOR=1.02 [95%CI 1.01-1.03] in France; 1.01 [1.01-1.03] in Korea). Young adults in social groups who had experienced two types of risky sexual behaviours were more likely to engage in risky sexual behaviours after drinking (5.13 [2.21-14.1] in France; 10.65 [5.86-19.8] in Korea), compared to young adults in social groups with no experience. Young adults in social groups who had experienced all three types of risky sexual behaviours had a 10 times higher likelihood of engaging in post-drinking risky sexual behaviours in the French sample (10.12 [3.69-31.4]) and a 16 times higher likelihood in the Korean sample (16.0 [7.31-35.8]). Conclusions Alcohol-related risky sexual behaviours among young adults were found to be significantly associated with their social group’s drinking and risky sexual behaviours, across different cultural settings. More attention should be paid to direct/indirect influence of social groups on health risk behaviours. Key messages • The influence of social groups on alcohol-related risky sexual behaviours is significant regardless of cultural setting. • Peer and social norms-based health promotion is recommended to prevent IST and HIV/AIDS.

Food insecurity is associated with poor mental health and health risk behaviors in Czechia

Abstract Background Food insecurity (FI) is one of social determinants of health and a profound public health concern because it leads to malnutrition and hence poor health. COVID-19 impacted people disproportionately and exacerbated preexisting social and health inequalities. The aim of this study was to understand how socioeconomic and health conditions affected one’s FI in Czechia during the pandemic using a representative panel of Czech adults from a longitudinal survey, Life During the Pandemic collected in October 2022 as part of a Czech longitudinal survey. Methods A study sample of 1,499 respondents was included in our multiple logistic regression models. Depressive symptoms and anxiety symptoms were assessed using validated questionnaires PHQ-2 and DAG-2. Results Approximately one third of the study sample (32.4%) reported being food insecure. In the fully-adjusted model, adults with depressive symptoms (OR 2.37, CI 1.49, 5.02), problems with sleeping (OR 2.20, CI 1.64, 2.96), smoking habit (OR 2.27, CI 1.68, 3.07), lower fruit and vegetable consumption (OR 1.50, CI 1.04, 2.17) had greater odds of experiencing FI. The lowest income group was associated with 6.2 times greater odds of reporting FI as compared to the high-income group (CI 3.96, 9.67). Lower education attainment also had higher odds of experiencing FI (OR 2.15, CI 1.40, 3.31). Anxiety was not a significant predictor for FI. Conclusions Our study highlights that food insecurity is associated with depressive symptoms, poor quality of sleep and lower consumption of fruit and vegetables among adults. Food insecurity was also evident among lower income and lower education attainment. Funding source This study was supported by The Charles University Grant Agency (GA UK). Key messages • Our study suggests that adults with poor mental health and diet quality experience food insecurity. • Given the established link between a balanced diet and mental well-being, interventions should encompass not only food security but also the quality of dietary intake.

Loneliness and low fruit and vegetable consumption among adults in Japan

BackgroundLoneliness is the distressing feeling that arises when a person's network of social relations is perceived as being inadequate in some way. Research has linked loneliness to a number of detrimental health outcomes. There is also some evidence that lonely individuals are more likely to engage in poorer health behaviors. However, as yet, there has been comparatively little attention paid to the relation between loneliness and dietary behavior. In particular, there has been little focus on the association between loneliness and fruit and vegetable intake.ObjectiveThe aim of this cross-sectional study was to examine the association between loneliness and low fruit and vegetable consumption in the Japanese general population.MethodsData were analyzed from 3,410 Japanese adults collected in an online survey in early 2023. Information was obtained on past-week fruit and vegetable consumption with a single-item measure, while loneliness was assessed with the Three-Item Loneliness Scale. Information was also collected on sociodemographic characteristics, physical health status, health-risk behaviors and depressive symptoms. Logistic regression was used to assess associations.ResultsOne in twenty (5.3%) adults reported low fruit and vegetable consumption. In a fully adjusted analysis loneliness was associated with higher odds for low fruit and vegetable consumption (OR: 1.14, 95%CI: 1.04–1.26). In sex- and age-stratified analyses loneliness was significantly associated with low fruit and vegetable consumption in both women and middle-aged adults, although confidence intervals overlapped for this association across all of the sex and age groups in the fully adjusted analyses.ConclusionsLoneliness is associated with low fruit and vegetable consumption among adults in Japan. As loneliness and inadequate fruit and vegetable intake have both been linked to poorer health outcomes, the results of this study underscore the potential importance and public health benefits of reducing loneliness in Japan.

7.X.1. Providing BoD estimates on a regional level – necessity in assessing health inequalities

Abstract Burden of disease indicators, such as Disability-adjusted life years (DALY), Years lost due to disability (YLD) and Years lost due to death (YLL) have become standard indicators in public health reporting systems. Due to the combination of morbidity and mortality, the DALY provides valuable information on the burden due to specific diseases. These tools are employed by policymakers to devise intervention programs with the objective of enhancing the collective health of the population. Studies at the subnational level offer a greater added value to the public health information systems. Identifying variations in health outcomes and disease burden across different regions is a key factor when introducing targeted interventions and allocating resources. Health inequalities persist also in countries with good health systems and well-developed welfare state. There are notable contrasts in the political, economic and social environments across Europe. Moreover, the European countries are at different stages of the epidemiological transition, which encompasses a range of factors influencing health and modifiable risk behaviours. These differences are determined by socioeconomic inequalities at national and sub-national level, such as municipalities, counties and others. It is therefore imperative to provide BoD indicators at the most possible detailed regional-level and to link this information with further indicators such as deprivation indexes or Gini coefficients. Obtaining regional-level data for BoD analysis and health inequalities is not straightforward and can pose many challenges. Data availability is usually scarce and may involve significant resources in collecting it. Data quality and data completeness can also pose challenges in the reporting systems, which can result in under-reporting of certain diseases and overlooking health problems in the population. Also, countries with smaller populations are confronted with the challenge of a limited number of cases, which poses difficulties in obtaining regional estimates. The following workshop presents examples from European BoD studies, that have analysed health inequalities at regional level. The first presentation shows a country comparison study of the overall YLL and their association with socioeconomic and geographical inequalities. The second is from an Estonian study, representing a country with a small population that has developed its own methodology for assessing regional health issues. The third presentation from the German BoD study presents results on 96 spatial planning regions, which have been combined with the German index of socioeconomic deprivation. The final presentation brings example from Norway, where the association between YLL and education and income is examined at municipality level. Key messages • By comparing BoD estimates at the regional level, policymakers and public health officials can identify areas with higher disease burdens, indicating potential health inequalities. • Linking information on BoD indicators with data on regional and socioeconomic inequalities is essential when monitoring developments and tailoring strategies in public health outcomes.

Discussing health behavior change during pregnancy: co-creation of a training and conversation tool

Abstract Background Health risk behaviors during pregnancy are major risk factors for adverse health outcomes for mother and child, and they are more prevalent among vulnerable pregnant women. However, interventions often do not sufficiently meet the needs of disadvantaged groups. Changing behavior is more likely when people feel autonomous and when a behavior aligns with our identity (how we see ourselves). Despite the clear importance of identity in health behavior change, very few identity- based interventions exist for pregnant women, let alone for vulnerable pregnant women. Through co-creation, this study aims to develop an identity- and autonomy- based training program and conversation tool tailored to the needs and preferences of healthcare professionals and vulnerable pregnant women. Methods Four co-creation sessions were conducted with five professionals from medical and social domains, and five (expectant) parents in vulnerable situations. The Participatory Learning and Action research methodology was applied to ensure an equal and democratic process in designing the training and conversation tool. Results The training for professionals will focus on enhancing knowledge about the importance of identity and autonomy in behavior change, and on improving their self-efficacy through practicing the conversation tool. Example of the conversation tool, which can be integrated into daily practice, is a comic strip illustrating the conflict of being a smoker and a mother. Conclusions During intervention development, it is important to consider the needs and preferences of end-users, particularly for whom few appropriate interventions exist. Involving end-users yields valuable insights for feasible (e.g. one-consultation time frame) and accessible (e.g. easy-to-understand language) interventions. This study aligns with public health efforts toward early intervention and health promotion among vulnerable groups. Key messages • During intervention development, it is important to consider the needs and preferences of end-users. • This study aligns with public health efforts toward early intervention and health promotion among vulnerable groups.

The temporal trajectories of habit decay in daily life: An intensive longitudinal study on four health-risk behaviors.

Habits are cue-behavior associations learned through repetition that are assumed to be relatively stable. Thereby, unhealthy habits can pose a health risk due to facilitating relapse. In the absence of research on habit decay in daily life, we aimed to investigate how habit decreases over time when trying to degrade a habit and whether this differs by four health-risk behaviors (sedentary behavior, unhealthy snacking, alcohol consumption, and smoking). This 91-day intensive longitudinal study included four parallel non-randomized groups (one per behavior; N = 194). Habit strength was measured daily with the Self-Report Behavioral Automaticity Index (11,805 observations) and modelled over time with constant, linear, quadratic, cubic, asymptotic, and logistic models. Person-specific modelling revealed asymptotic and logistic models as the most common best-fitting models (54% of the sample). The time for habit decay to stabilize ranged from 1 to 65 days. Multilevel modelling indicated substantial between-person heterogeneity and suggested initial habit strength but not the decay process to vary by behavioral group. Findings suggest that habit decay when trying to degrade a habit typically follows a decelerating negative trend but that it is a highly idiosyncratic process. Recommendations include emphasizing the role of person-specific modelling and data visualization in habit research.

Examining the mediating effect of real and cyber self-control on cyberbullying and health risk behaviors among secondary vocational students in China: a cross-sectional study

BackgroundCyberbullying and health risk behaviors are pervasive issues for secondary vocational students that not only detrimentally impact their academic achievement but also pose a significant threat to overall health. The purpose of this study was to understand the current situation of cyberbullying and health risk behaviors among secondary vocational students in China and to explore the relationships among cyberbullying, self-control, self-control over internet usage, and health risk behaviors through a mediation model.MethodsThis was a cross-sectional study. From March to April 2023, a self-administered questionnaire was completed by a cluster sample of 1184 students from grades 1 to 3 at three secondary vocational schools in Jilin Province. The researchers utilized a sociodemographic questionnaire, the Cyberbullying and Cybervictimization Scale (CAV), the Adolescent Health Related Risky Behavior Inventory (AHRBI), the Self-Control Scale (SCS), and the Internet Usage Self-Control Scale (IUSCS-CS) to assess the prevalence and impact of cyberbullying and health risk behaviors. Descriptive statistics, spearman correlation analyses. Finally, the Process plug-in V2.16.3 was used to analyze a mediation model for the data.ResultsAmong secondary vocational students, 839 individuals (70.86%) experienced cyberbullying and 1036 individuals (87.50%) had one or more health risk behaviors. A chi-square test showed that the differences in cyberbullying incidence were statistically significant (P < 0.05) for being children, type of accommodation, residence, ethnicity, purpose of using the internet, and family composition. Statistically significant differences in health risk behaviors were observed based on gender, type of accommodation, residence, ethnicity, academic achievement, classmate relationships, purpose of using the internet, and family composition (P < 0.05). Health risk behaviors and cyberbullying were correlated (r = 0.60), health risk behaviors and self-control and internet usage self-control were negatively correlated (r = -0.42, -0.50). Mediation analysis indicated that self-control (0.02, 0.08) and internet usage self-control (0.08, 0.17) partially mediated the association between cyberbullying and health risk behaviors.ConclusionsSecondary vocational students exhibit a high prevalence of cyberbullying and health risk behaviors. The study confirmed that self-control and internet usage self-control has an important role in mediating cybeibullying and health risk behaviors. Adolescent health promoters should develop targeted strategies to enhance the self-control of secondary vocational school students to mitigate their engagement in health risk behaviors.

General hospital patients’ attitude towards systematic health risk behavior screening and intervention

BackgroundSystematic counseling on behavioral health risk factors (HRFs) may be suitable to promote health among general hospital patients. This study aimed to investigate the openness of patients towards systematic screening and intervention of HRFs, its relation to actual participation in a multi-behavioral intervention, and whether socio-economic characteristics, HRFs and health indicators are related to approval.MethodsAll 18- to 64-year-old patients hospitalized in five medical departments at the University Medicine Hospital Greifswald in Germany were asked between May and July 2022 to participate in a survey and in a subsequent pre-post intervention study. Among all eligible patients, 225 (78.9%) participated in the survey. Patients’ approval of systematic screening and intervention of HRFs was assessed using five statements with a total sum score of 0–20 (i.e., scores of 0–6, 7–13, 14–20 referring to low, medium and high approval). Associations with intervention participation, socio-economic, behavioral and health-related patient characteristics were analyzed using logistic and multivariable linear regression analyses.ResultsThe mean total approval of screening and intervention was 13.8 (SD = 4.8). Of the 125/ 73/ 16 patients with high/ medium/ low approval, 88.0%/ 78.1%/ 50.0% participated in the subsequent intervention, respectively. Approval was independent of socio-demographic and -economic characteristics and self-rated general health. Current tobacco smoking was the only HRF negatively (p = 0.02) and diabetes mellitus was the only disease positively (p = 0.01) associated with approval.ConclusionHigh approval of HRF screening, which was rather independent of socio-economic characteristics and worse self-rated general health, speaks in favor of proactively approaching and motivating all general hospital patients to participate in health behavior change intervention. Tobacco smokers might need higher efforts to motivate participation than non-smokers.Trial registrationClinicalTrials.gov Identifier NCT05365269 on May 9, 2022.

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.

Effect of stressors during COVID-19 lockdown on malnutrition and health-risk behaviors among Jordanian college students: A cross-sectional study.

A stressful condition such as the emergence of the coronavirus and its related lockdown measures might trigger alterations in college students' behaviors. This cross-sectional study aimed to identify the changes in college students' dietary and lifestyle behaviors during the lockdown and the effect of lockdown-related stressors on health-risk behaviors. A web-based survey was conducted among undergraduate college students in Jordan. Weight and height were reported by the students. The students' dietary and lifestyle behaviors and their changes during 1 month of the countrywide lockdown were assessed. The Perceived Stress Scale-4 was utilized to assess stress levels. Results indicated that 77.2% of the students reported weight changes. Notably, 45.9% increased their intake of unhealthy food, while and 38% opted for healthier food choices. Most students experienced alterations in physical activity (80.0%), screen time (86.2%), smoking, and sleep patterns (85.4%), with a higher tendency toward adopting health-risk behaviors. Perceptions of curfew-related stress were associated with distance learning-related stress (OR = 2.73, CI: 1.08-6.90, P = .034), and a greater change in physical activity (OR = 3.59, CI: 1.36-9.48, P = .010). Additionally, weight changes were associated with perception of other types of stressors (OR = 3.39, CI: 1.39-8.28, P = .007). Overall, there was a considerable increase in malnutrition and health-risk behaviors among students during the lockdown. Understanding students' responses to these stressful conditions and the role of stress in driving behavioral changes are crucial for developing interventions that enhance college students' adaptation to such changes and maintaining healthy dietary and lifestyle behaviors in the future.

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.

Report of Unfair Discipline at School and Associations with Health Risk Behaviors and Experiences - Youth Risk Behavior Survey, United States, 2023.

Relatively little is known about the association between school discipline and student health and well-being. Using CDC's 2023 Youth Risk Behavior Survey, CDC analyzed the prevalence of report of unfair discipline at school and associations with experiences at school, mental health, suicidal thoughts and behaviors, and health risk behaviors among high school students overall and stratified by race and ethnicity. Prevalence estimates, prevalence differences, and prevalence ratios adjusted for race (in overall models), grade, and sex were calculated. Overall, 19.3% of students reported receiving unfair discipline during the previous 12 months; Black or African American students had a higher prevalence (23.1%) compared with Hispanic or Latino students (18.4%) and White students (18.1%). Unfair discipline was reported among a majority of students who describe their sexual identity in some other way (besides gay, heterosexual, lesbian, bisexual, or questioning) for American Indian or Alaska Native (81.7%) and multiracial (57.1%) subgroups. Overall, report of unfair discipline was associated with every health risk behavior and experience examined, including being bullied at school or electronically, skipping school due to feeling unsafe, carrying a weapon at school, prescription opioid misuse, poor mental health, persistent feelings of sadness or hopelessness, seriously considered attempting suicide, and attempted suicide. This pattern of association was similar among most student groups in models stratified by race and ethnicity. This analysis is the first to demonstrate, among a nationally representative sample of high school students, that reports of unfair discipline are associated with various health risk behaviors and experiences. With these findings, public health and education practitioners can create interventions that equitably promote safe, supportive, and inclusive school environments for student health.

Experiences of Racism in School and Associations with Mental Health, Suicide Risk, and Substance Use Among High School Students - Youth Risk Behavior Survey, United States, 2023.

Racism is a fundamental determinant of health inequities among racial and ethnic groups and is understudied among adolescents. In 2023, the national Youth Risk Behavior Survey questionnaire included an item assessing experiences of racism in the school setting among students in grades 9-12 in the United States. This report estimates the prevalence of students who reported ever having experienced racism in school and compares prevalence by racial and ethnic groups. For each racial and ethnic group, prevalence differences and prevalence ratios were estimated comparing the prevalence of indicators of poor mental health, suicide risk, and substance use among students who reported that they have ever versus never experienced racism in school. In 2023, approximately one in three high school students (31.5%) said that they had ever experienced racism in school. Reported experiences of racism were most prevalent among Asian (56.9%), multiracial (48.8%), and Black or African American (Black) (45.9%) students and least prevalent among White students (17.3%). Black and Hispanic or Latino (Hispanic) students who reported experiencing racism had a higher prevalence of all health risk behaviors and experiences investigated, including indicators of poor mental health, suicide risk, and substance use compared with students of their racial and ethnic group who reported never experiencing racism. Many of these associations were also found among multiracial and White students. Student reports of racism were associated with indicators of mental health and suicide risk among American Indian or Alaska Native (AI/AN) and Asian students. Among students of color, including AI/AN, Asian, Black, Hispanic, and multiracial students, the prevalence of seriously considering and attempting suicide was more than two times higher among students who ever compared with never experienced racism. These findings demonstrate that racism in the school setting is experienced by high school students attending public and private schools and continues to disproportionately affect students of color. Students who reported experiencing racism had a higher prevalence of indicators of poor mental health, suicide risk, and substance use. Schools can incorporate policies and practices to prevent unfair treatment on the basis of race and ethnicity and offer resources to help students cope with these experiences.