Rural Adolescents Research Articles

Does Vitamin D3 Supplementation Improve Depression Scores among Rural Adolescents? A Randomized Controlled Trial.

Contemporary evidence has been established demonstrating that stunted vitamin D levels are associated with depression, poor mood, and other mental disorders. Individuals with normal vitamin D levels have a much lower probability of developing depression. Improving vitamin D levels by supplementation has shown betterment in depressive patients among different age groups. The objective of this study was to assess the effect of vitamin D supplementation on depression scores among rural adolescents. This study was a cluster randomized controlled trial carried out for a period of 3 years among adolescents from rural Kolar. The sample size was calculated based on previous research and was determined to be 150 for each group. The intervention arm received 2250 IU of vitamin D, and the control arm received a lower dose of 250 IU of vitamin D for 9 weeks. To assess sociodemographic status, a pretested, semi-structured questionnaire was used, and, to assess depression, the Beck Depression Inventory (BDI-II) was used. A baseline assessment was carried out for vitamin D status and depression status, followed by a post-intervention assessment. From the start of the trial, the participants were contacted every week by the pediatric team to investigate any side effects. Out of 235 school students in the vitamin D supplementation arm, 129 (54.9%) belonged to the 15 years age group, 124 (52.8%) were boys, and 187 (79.6%) belonged to a nuclear family. Out of 216 school students in the calcium supplementation arm, 143 (66.2%) belonged to the 15 years age group, 116 (53.7%) were girls, and 136 (63%) belonged to a nuclear family. By comparing Beck depression scores before and after the intervention, it was found that the vitamin D intervention arm showed a statistically significant reduction in Beck depression scores. The present study showed that vitamin D supplementation reduced depression scores, showing some evidence that nutritional interventions for mental health issues such as depression are an excellent option. Vitamin D supplementation in schools can have numerous beneficiary effects on health while mutually benefiting mental health.

EXPLORING DIGITAL LITERACY USAGE FOR SELF-DIRECTED LEARNING: RURAL ADOLESCENTS’ PERSPECTIVES

This study aims to address this gap by examining rural adolescents' perspectives on the use of digital literacy in self-directed learning and its potential to transform rural education. The research employed a qualitative approach and involved in-depth interviews with thirty rural adolescents. The findings indicate that rural adolescents perceive themselves to have good digital literacy skills and actively use digital media for learning. They recognise the benefits of digital literacy in accessing information, collaborating with others, and overcoming learning barriers. The study underscores the significance of digital literacy in empowering rural adolescents to take charge of their education and navigate the digital landscape. These findings have implications for educators and policymakers in promoting digital literacy in rural areas to ensure equitable access to high-quality education. Future research should further investigate the intersection of digital literacy and self-directed learning among adolescents to enhance educational outcomes in an increasingly digital world.

Rural Appalachian Adolescent Alcohol Misuse and the Triple Threat for Marginalization

Rural Appalachian adolescents are disproportionately affected by alcohol misuse, depression, and mortality rates. Disparities in Appalachia influence national health indicators and the social determinants of health, which may lead to marginalization and vulnerability to poorer health outcomes. Geographic and social isolation often results in missed opportunities for preventative and mental health care. There are an estimated 35% fewer mental health providers in rural areas to deal with these issues. This article examines the influence of marginalization on rural Appalachian adolescents. A case example was used to describe rural Appalachian adolescent alcohol misuse within the context of the Triple Threat for Marginalization, utilizing conversation within a natural setting. Marginalization contributes to alcohol misuse and adverse health outcomes. Nurses must advocate for marginalized rural adolescent patients to decrease alcohol misuse, depression, and mortality rates in this vulnerable population.

Accelerometer-Measured Physical Activity, Fitness and Indicators of Cardiometabolic Risk among Rural Adolescents: A Cross-Sectional Study at 15-Year Follow-up of the MINIMat Cohort.

Little is known about the relationship of physical activity (PA) and fitness with cardiometabolic risk among rural adolescents in low- and middle-income countries. Thus, we examined the associations of PA and fitness with selected cardiometabolic indicators along with potential gender-based differences in a birth cohort of rural adolescents from southeast Bangladesh. We utilized data from the 15-year follow-up of Maternal and Infant Nutrition Interventions in Matlab (MINIMat) cohort (n = 2253). Wrist-worn ActiGraph wGT3x-BT accelerometers were used to estimate sedentary time (ST) and PA. Fitness was assessed using: handgrip strength, standing long jump, and Chester Step Test. Anthropometric parameters, systolic blood pressure (SBP), and fasting lipid, insulin and glucose levels were measured. We calculated insulin resistance using the Homeostasis Model Assessment equation (HOMA-IR). Linear regression and isotemporal substitution models were fitted. The adolescents spent 64min/day (inter-quartile range: 50-81) in moderate-to-vigorous physical activity (MVPA). A 10-minute-per-day higher vigorous PA (VPA) was associated with: 4.9% (95% confidence interval (CI): 2.9-6.8%) lower waist circumference (WC), 3.2 mmHg (95% CI: 1.5-4.8) lower SBP, 10.4% (95% CI: 2.9-17.3%) lower TG, and 24.4% (95% CI: 11.3-34.9%) lower HOMA-IR. MVPA showed similar associations of notably smaller magnitude. Except for WC, the associations were more pronounced among the boys. Substituting ST with VPA of equal duration was associated with lower WC, SBP, triglyceride and HOMA-IR. Grip strength was favorably associated with all indicators, displaying considerably large effect sizes. Our findings indicated beneficial roles of PA- particularly VPA- and muscular fitness in shaping cardiometabolic profile in mid-adolescence. VPA and grip strength may represent potential targets for preventive strategies tailored to adolescents in resource-limited settings.

Depression, anxiety, and stress among urban and rural adolescents in Shivamogga, Karnataka.

Currently there are 1.3 billion adolescents worldwide, which makes up 16% of the world population. Over 20% of adolescents around the world are thought to have behavioural or mental health issues. Addressing mental health issues is very important for the promotion of positive health in adolescents. This study aimed to estimate the prevalence of depression, anxiety and stress among adolescents in urban and rural areas of Shivamogga. A cross-sectional study was conducted among 350 adolescents aged 16 to 19 years each from urban and rural areas of Shivamogga. Depression, anxiety and stress were found to be 23.1%, 29.4% and 26.6% in urban areas and 19.1%, 24% and 21.1% in rural areas respectively. Depression was more common among females in both urban and rural settings, with a significant difference observed in rural areas. Anxiety and stress were also more prevalent among females, with anxiety significantly higher in urban females. Urban adolescents exhibited higher levels of depression, anxiety, and stress compared to their rural counterparts. About a quarter of the adolescent population suffers from depression anxiety and stress. Adopting and implementing better education and health policies are necessary to enhance adolescent mental health.

Secular trend and projection of overweight and obesity among Chinese children and adolescents aged 7-18 years from 1985 to 2019: Rural areas are becoming the focus of investment.

The urban-rural disparities in overweight and obesity among children and adolescents are narrowing, and there is a need for long-term and updated data to explain this inequality, understand the underlying mechanisms, and identify priority groups for interventions. We analyzed data from seven rounds of the Chinese National Survey on Students Constitution and Health (CNSSCH) conducted from 1985 to 2019, focusing on school-age children and adolescents aged 7-18 years. Joinpoint regression was used to identify inflection points (indicating a change in the trend) in the prevalence of overweight and obesity during the study period, stratified by urban/rural areas and sex. Annual percent change (APC), average annual percent change (AAPC), and 95% confidence interval (CI) were used to describe changes in the prevalence of overweight and obesity. Polynomial regression models were used to predict the prevalence of overweight and obesity among children and adolescents in 2025 and 2030, considering urban/rural areas, sex, and age groups. The prevalence of overweight and obesity in urban boys and girls showed an inflection point of 2000, with AAPC values of 10.09% (95% CI: 7.33-12.92%, t =7.414, P <0.001) and 8.67% (95% CI: 6.10-11.30%, t =6.809, P <0.001), respectively. The APC for urban boys decreased from 18.31% (95% CI: 4.72-33.67%, t =5.926, P =0.027) to 4.01% (95% CI: 1.33-6.75%, t =6.486, P =0.023), while the APC for urban girls decreased from 13.88% (95% CI: 1.82-27.38%, t =4.994, P =0.038) to 4.72% (95% CI: 1.43-8.12%, t =6.215, P =0.025). However, no inflection points were observed in the best-fit models for rural boys and girls during the period 1985-2019. The prevalence of overweight and obesity for both urban and rural boys is expected to converge at 35.76% by approximately 2027. A similar pattern is observed for urban and rural girls, with a prevalence of overweight and obesity reaching 20.86% in 2025. The prevalence of overweight and obesity among Chinese children and adolescents has been steadily increasing from 1985 to 2019. A complete reversal in urban-rural prevalence is expected by 2027, with a higher prevalence of overweight and obesity in rural areas. Urgent action is needed to address health inequities and increase investments, particularly policies targeting rural children and adolescents.

Food insecurity is related to eating disorder psychopathology beyond psychological distress in rural Chinese adolescents.

This study aimed to examine the relationship between food insecurity (FI) and eating disorder psychopathology in a large sample of rural Chinese adolescents. Analyses included 1654 adolescents (55.4% girls; Mage = 16.54 years, SD = 1.45) from a rural high school in southwestern China. FI, eating disorder psychopathology, and psychological distress (i.e., symptoms of depression, anxiety, and stress) were assessed. Data were analyzed by sex. Pearson correlation analysis was performed to investigate the zero-order association between FI and eating disorder psychopathology. Hierarchical linear regressions were used to explore whether FI could explain meaningful variance in eating disorder psychopathology beyond psychological distress and demographic covariates (e.g., socioeconomic status). FI was significantly associated with higher eating disorder psychopathology for boys (r = 0.44, p < 0.001) and girls (r = 0.43, p < 0.001), with medium-to-large effect sizes. FI accounted for significant unique variance in eating disorder psychopathology beyond psychological distress and demographic covariates for boys (ΔR2 = 0.14, p < 0.001) and girls (ΔR2 = 0.10, p < 0.001). Using a large sample of rural Chinese adolescents, this study extends the connection between FI and eating disorder pathology in adolescents beyond the Western context. Future investigations on the mechanisms underlying FI and eating disorder psychopathology are warranted for developing prevention strategies for eating disorders among rural Chinese adolescents. This is the first investigation that examined the link between FI and eating disorder psychopathology among rural Chinese adolescents. Our findings highlight the importance of incorporating FI as a potential risk factor to screen for the prevention and intervention of eating disorders among rural Chinese adolescents.

Childhood maltreatment and alcohol and tobacco use trajectories in rural Chinese adolescents

BackgroundThere is a high prevalence of childhood maltreatment among Chinese children and adolescents, but little is known about its impact on alcohol and tobacco use trajectories and how positive school and neighborhood environments moderate the associations. The objective of this study was to assess the association between multiple forms of childhood maltreatment and longitudinal alcohol and tobacco use trajectories, and to assess the possibility that perceived connections to school and neighborhood moderate these associations.MethodsThis longitudinal cohort study included 2594 adolescents (9 to 13 years) from a low-income rural area in China. Childhood exposure to abuse and neglect was assessed using the Childhood Trauma Questionnaire. Participants reported past-month alcohol and tobacco use at three time points over 1 year.ResultsGrowth curve models revealed that childhood sexual abuse was associated with a higher risk of past-month drinking (OR = 1.53, 95% CI 1.19–2.03, p < 0.001) and smoking (OR = 1.82, 95% CI 1.30–2.55, p < 0.001). Neglect was associated with a higher risk of past-month drinking (OR = 1.52, 95% CI 1.06–1.90, p < 0.05) and smoking (OR = 2.02, 95% CI 1.34–3.02, p < 0.001). None of the maltreatment forms predicted a faster increase in either drinking or smoking. These associations were found independent of personal, family, and contextual characteristics. School and neighborhood connection moderated the association between physical abuse and past-month drinking, such that physical abuse was associated with a greater risk of drinking only for youth who perceived low school or neighborhood connections.ConclusionsFindings demonstrate the importance of early experiences of childhood maltreatment for adolescent alcohol and tobacco use. Enhancing school and neighborhood connectedness for physically abused youth may help protect them from alcohol use.

ARE ADOLESCENTS CONSUMING MORE SALT THAN RECOMMENDED?

Objective: To study and compare the amount and pattern of sodium (Na) consumption in urban and rural school-going adolescents in Western India and identify high risk groups for conducting awareness programs. Design and method: 1850 subjects (urban- 935; rural- 915; Males-1012, Females -838) aged 14 - 17 years were recruited with prior permission from 5 schools in and around Mumbai. Data pertaining to demography, anthropometry and eating habits was collected. A self-administered semi-quantitative Food Frequency Questionnaire was used to record consumption pattern of 22 high salt containing food items, divided into 5 categories (bakery, fried, packed, preserved and fast foods). Each participant‘s sodium consumption from these food items was calculated. Additional sodium consumption from regular meals was excluded. Data was analyzed using standard growth charts and MS Excel. Results: Only 13% of subjects added table salt. 67% and 81% brought homemade food for snacks and lunch respectively. Median Sodium consumption of the study population was 573 mg/day (∼ 1.5 g salt) (Q1-Q3:254 - 851 mg/day). There was no statistically significant difference (p&gt; 0.05) in the Median Na consumption of girls (454 mg/day) and boys (489 mg/day). Daily Median Na consumption was not significantly different (p &lt; 0.05) in urban students (624 mg/day) as compared to rural (592 mg/day). Bakery and fried foods together comprised 51% of sodium consumption among the rural population, whereas all five food categories had almost equal representation in the urban population. 54% subjects’ BMI (34% urban, 20% rural) was above the normal range. Higher BMI values correlated significantly with higher daily Na consumption (p =0.001, Mann-Whitney test). Conclusions: The salt intake over and above the usual dietary salt consumption was high (∼ 2 g per day for urban and ∼1.8 g/day for rural adolescents). Nearly half the study population was found to be either overweight or obese. This double whammy has a singular potential for producing future hypertensives. Thus, targeted awareness and counselling programs for salt reduction in adolescents is the urgent need of the hour.

A cross-sectional study of sleep quality in urban and rural adolescents with reference to their digital exposure

Abstract Background: With the widespread use of digital devices and increased screen time among adolescents, concerns have arisen regarding its potential impact on sleep quality. This study aims to investigate the correlation between excessive screen time and Pittsburgh Sleep Quality Index (PSQI) global scores in adolescents. Materials and Methods: A cross-sectional study was conducted among 167 adolescents aged 10–19 years residing in rural and urban areas. Participants completed self-report questionnaires evaluating their screen time habits and sleep quality using the PSQI. Excessive screen time was defined as more than 2 h per day of exposure to digital screens, and an abnormal PSQI global score was defined as more than 5. Statistical analyses, including unpaired t test, Spearman’s correlation, and chi-square test, were employed to examine the association between excessive screen time and PSQI global scores. Results: The results revealed a significant positive correlation between excessive screen time and abnormal PSQI scores in adolescents (r = 0.623, P &lt; 0.001). Adolescents reporting excessive screen time were significantly more prone to abnormal PSQI scores compared to those with lower screen time (P &lt; 0.0001, t = 9.63, degree of freedom = 165). Conclusion: This study highlights a correlation between excessive screen time and abnormal sleep quality in adolescents, as assessed by the PSQI. These findings underscore the importance of promoting healthy screen time habits among adolescents to mitigate potential adverse effects on their sleep quality and overall health. Further research is needed to explore the mechanisms underlying this relationship and to develop effective interventions to address this issue.

Self-reported and accelerometry measures of sleep components in adolescents living in Pacific Island countries and territories: Exploring the role of sociocultural background.

The objective of this study is to assess the concordance and its association with sociocultural background of a four-question survey with accelerometry in a multiethnic adolescent population, regarding sleep components. Based on questions from the Pittsburgh Sleep Quality Index and adapted to a school context, the questionnaire focussed on estimating sleep onset time, wake-up time and sleep duration on both weekdays and weekends. This subjective survey was compared with accelerometry data while also considering the influence of sociocultural factors (sex, place of living, ethnic community and socio-economic status). Adolescents aged 10.5-16 years (n = 182) in New Caledonia completed the survey and wore an accelerometer for seven consecutive days. Accelerometry was used to determine sleep onset and wake-up time using validated algorithms. Based on response comparison, Bland-Altman plots provided agreement between subjective answers and objective measures. We categorized participants' answers to the survey into underestimated, aligned and overestimated categories based on time discrepancies with accelerometry data. Multinomial regressions highlighted the sociocultural factors associated with discrepancies. Concordance between the accelerometer and self-reported assessments was low particularly during weekends (18%, 26% and 19% aligned for onset sleep time, wake-up time and sleep duration respectively) compared with weekdays (36%, 53% and 31% aligned, respectively). This means that the overall concordance was less than 30%. When considering the sociocultural factors, only place of living was associated with discrepancies in onset sleep time and wake-up time primarily on weekdays. Rural adolescents were more likely to overestimate both onset sleep time (B = -1.97, p < 0.001) and wake-up time (B = -1.69, p = 0.003). The study found low concordance between self-assessment and accelerometry outputs for sleep components. This was particularly low for weekend days and for participants living in rural areas. While the adapted four-item questionnaire was useful and easy to complete, caution should be taken when making conclusions about sleep habits based solely on this measurement.

Adolescents in urban and rural communities in Rivers state, Nigeria: Factors influencing access and utilization of reproductive health services

Introduction: Reproductive health services (RHS) are used and accessed differently in rural and urban areas, though to what extent is unknown. In Rivers State, Nigeria, we identified and examined the characteristics impacting adolescents' access to and use of RHS in rural and urban areas. Methods: A cross-sectional comparative study design was employed, five hundred and seven adolescents—255 from urban and 252 from rural communities—were surveyed. Access and utilization were measured and using adjusted odd ratios in multivariate logistic regression models, predictors of access and utilization were identified. Results: The corresponding median ages and interquartile ranges were 16.0 (14–19) and 14.0 (12–16) years, respectively. RHS utilization was low, with 57 (22.6 percent) in rural areas and 65 (25.5 percent) in urban areas. There was also a lack of access to services; only 8 (3.17 percent) rural and 81 (31.76 percent) urban residents had economic access to RHS. Access and utilization were predicted by age, level of education, awareness of RHS, sexual experience in both communities, beliefs that condoms can prevent STIs/ HIV, and exposure to mass and socio-media influenced access and utilization of RHS. Specifically, age group (15-19 years) of respondents was found to be a significant predictor of utilization of RHS for both urban (cOR=4.32, 95% CI; 0.82-22.69, p=0.001) and rural (aOR=7.65, 95% CI; 1.99-29.40, p=0.003) adolescents. Conclusion: Adolescents in urban areas have more access (3 in 10) and utilization of RHS compared with their rural (3 in 100) counterparts. There is a need to promote information and education on RHS among adolescents, especially in rural areas.

Clustering of non-communicable disease risk factors among adolescents in urban and rural Rajasthan

Background: Non communicable diseases (NCDs) are primarily driven by the modifiable risk factors that often emerge during the childhood/adolescence and contribute towards majority of premature deaths during adulthood. This study aimed to assess the prevalence of multiple NCD risk factors and the associated factors among adolescents in urban and rural areas of Rajasthan. Methods: It was a community-based cross-sectional study conducted among 430 school going adolescents. A self-administered questionnaire adapted from STEPS survey format of the WHO and indian adolescent health questionnaire was used; anthropometric measurements were taken using standard procedure. Presence of two or more risk factors in one individual was considered as clustering of NCD risk factors. Results: Prevalence of two risk factors (Dyads) was 48.8% (urban) and 33% (rural), three or more risk factors were found in about 12.1% urban and 7.9% rural adolescents. For “Dyads”, males had OR 3.58 (95% CI 1.9- 6.4) and OR 4.1 (95% CI 2.6-7.9) in urban and rural areas, respectively. The risk of clustering was higher with increasing age [Dyad: OR 1.26 (CI 1.1-5.73) in urban, OR 2.2 (CI 1.56-3.7) in rural; ≥ 3 risk factors: OR 2.3 (CI 1.98-4.11) in urban, OR 1.52 (CI 1.21-4.9)]. Conclusions: Clustering of the risk factors was prevalent among urban as well as rural adolescents emphasizing the importance of developing primary prevention strategies which can be effective across all demographic and socioeconomic backgrounds.

Alcohol Use Amongst Rural Adolescents and Young Adults: A Brief Review of the Literature.

The sociodevelopmental periods of adolescence and young adulthood are rife with alcohol use. However, much of the literature demonstrating this comes from 'traditional' settings and college campuses (i.e., large suburban/urban campuses, or those containing their own infrastructure). Alcohol culture in rural areas has largely been understudied, which may be problematic given the unique stressors they face (e.g., economic hardship, lack of social activities, healthcare inequality). There has also been difficulty both within and across fields classifying rural versus urban geographical locations; no distinct system used broadly, making ittrea difficult to generalize and accurately collect data. The geographic categorizations are often viewed as homogenous identifiers; however, diversity occurs both within and outside of these classification systems. It appears that rurality may be a risk factor for increased drinking both earlier and later in life, but the research has failed to extend to the formative college years. This short review has two main focuses: attempting to disentangle the definition of rurality and reviewing the literature regarding alcohol use in rural areas, with a specific focus on adolescents and young adults. Identifying the mechanisms responsible for substance use in rural areas is a crucial component of prevention and treatment programs.

Longitudinal Trajectories of Social Mobility Beliefs among Chinese Adolescents: The Protective Roles of Parental Academic Involvement and Adolescent Future Orientation.

Social mobility beliefs play a significant role in shaping adolescents' adaptive developmental outcomes, including well-being and academic functioning. Nevertheless, existing research may not cast light on the distinct trajectories and potential protective factors of social mobility beliefs. The present study aims to identify heterogeneity in trajectory patterns of social mobility beliefs among Chinese adolescents (Mage = 12.45, SDage = 2.60; 55.1% boys; 40.0% rural adolescents) in a four-wave (i.e., fall 2017, fall 2018, spring 2019, and fall 2019) longitudinal design, and examines the protective roles of parental academic involvement and adolescent future orientation. Three distinct trajectories of social mobility beliefs were identified: high-increasing (35.1%; a positive trajectory with the best developmental outcomes, including the lowest problem behaviors and depression symptoms, and the highest life satisfaction and academic competence), moderate-stable (49.8%), and low-decreasing (15.1%; a negative trajectory with the worst developmental outcomes, including the highest problem behaviors and depression symptoms, and the lowest life satisfaction and academic competence). Apart from the main effects of parental academic involvement and future orientation, a significant interaction effect of these two protective factors and adolescent group was detected, and only rural adolescents who reported both high levels of parental academic involvement and future orientation have a greater chance of being placed in the high-increasing trajectory than the low-decreasing trajectory. These findings highlight the significance of clarifying individual differences in the dynamic process of social mobility beliefs during adolescence, and elucidate rural-urban disparities in the influences of protective factors on social mobility beliefs trajectories, and inform individualized intervention strategies.

Reflections of well-being: navigating body image, chronic energy deficiency, and nutritional intake among urban and rural adolescents.

Adolescent growth and development is a period of very specific nutritional problems. As a result of poor growth and development, 36.3% of adolescents in Indonesia are at risk of developing CED. The purpose of this study was to determine the description of body image, the incidence of Chronic Energy Deficiency (CED), and nutritional intake in adolescents in urban and rural areas. This study used a descriptive quantitative design with a cross-sectional study conducted in Bandung and Sumedang on 387 adolescents aged 13-15 years. The instruments used in this study were body image questionnaire Figure Rating Scale (FRS) method, 2 × 24-h food recall, and anthropometry for Measuring mid upper arm circumference (MUAC). Results of this study showed that more than half of adolescents in urban (54.0%) and rural areas (61.7%) were at risk of CED, had negative body image perceptions in urban (69.1%) and rural areas (62.3%), and underconsumption of macronutrients in both urban and rural adolescents. Most adolescents in urban and rural areas still consume less energy, carbohydrates, and protein. Perceived body image and nutrient intake contribute to the incidence of CED in adolescents.

Characteristics and Correlates of Meaning in Life Profiles among Chinese Rural Adolescents

The meaning in life (MIL) in adolescence is crucial in the developmental process of life. Anchored in the Integrated Model of Meaning Making and the Dual-Systems Model of Meaning, the present study aimed to explore the MIL profiles among Chinese rural adolescents and their characteristics, as well as the role of depression, well-being, character strengths, and academic encouragement in differentiating the MIL profiles. A sample of 579 adolescents from rural China (Mean age = 15.33, SD = 1.69, aged from 12 to 19, female = 56.47%) participated in the survey. Latent profile analysis examined six dimensions of MIL: search for meaning, presence of meaning, need for meaning, meaning confusion, meaning anxiety, and meaning avoidance. Four profiles with different meaning characteristics were revealed: Meaning Oriented profile (18.48%), Bewildered profile (17.62%), Perfunctory profile (51.47%), and Indifferent profile (12.44%). The Meaning Oriented profile had the highest well-being scores and the lowest depression scores compared to the other three profiles. Adolescents with higher character strengths or academic encouragement were less likely to be in the other three profiles than in the Meaning-Oriented profile. The current findings suggest the need for targeted intervention strategies for adolescents with different MIL profiles.

IJCM_337A: Prevalence Of Social Anxiety Disorder Among Adolescents In Ernakulam District, Kerala

Background: Social anxiety disorder (SAD), a prevalent form of anxiety disorder is a chronic, disabling and treatable one with common onset in adolescence. Individuals experiencing SAD exhibit symptoms of anxiety or fear in circumstances where they could face scrutiny, evaluation, or judgment from others. Objective: The primary objective of the study was to determine the prevalence of SAD among adolescents in Ernakulam district, Kerala. The secondary objectives were to compare the prevalence of SAD among urban and rural adolescents and to determine the factors associated with SAD among adolescents in Ernakulam district, Kerala. Methodology: School based cross-sectional study was done among 474 students from schools of Ernakulam district, Kerala. Students were enrolled using multi-stage sampling method. A semi structured questionnaire consisting of sociodemographic details and Social Phobia Inventory (SPIN) was administered to the participants by face-to-face interview after attaining the necessary assent and consent. Results: The overall prevalence of SAD among the study participants was 19.6% with the prevalence of SAD among the urban and rural students being 17.6% and 22.9% respectively. Having to give speeches was the most common phobia in majority (40.9%) of participants. Female sex [aOR=2.02(1.26-3.21); p=0.003] was found to be a determinant of SAD in the study population. Age, type of family, number of family members, place of residency were not statistically associated with SAD in this study Conclusion: The current study showed that 1/5th of the study population had social anxiety disorder. With appropriate intervention through health education and psychotherapy, its progression can be effectively impeded.

IJCM_350A: Tobacco Abuse Among Adolescents in Shivamogga

Background: Tobacco and alcohol are very commonly used by the youth in urban and rural areas. NFHS-3 data shows that, among adolescents, 29% and 4% is the prevalence of tobacco use among males and females respectively. These numbers represent the overall usage of tobacco in some form, either cigarette, beedis or gutka. Studies have also shown a direct relationship between depression and prevalence of higher daily smoking rates. Objective: To estimate the prevalence of tobacco abuse among adolescents Methodology: A cross-sectional study was conducted among 700 adolescent boys and girls aged 16-19 years in rural and urban field areas of SIMS Shivamogga from August 2020 to September 2020. A pre-tested semi structured questionnaire which included questions on demographic details and tobacco consumption was used to collect data. Data was entered into Microsoft Excel spread sheet. SPSS (Version 21) was used to perform statistical analysis. Results were expressed in terms of frequency and percentages. Results: The prevalence of smoking among urban and rural adolescents was 9.1% and 11.1% respectively. Pan masala was the most common form of smokeless tobacco used. Conclusion: The prevalence of tobacco use among adolescents in Shivamogga aligns consistently with findings observed in comparable studies conducted across various regions of India.

Haddon’s matrix for spectrum of road-related major injuries in rural adolescents: a case series analysis

Unintentional injuries in children pose public health threat that often leads to serious consequences in the child and the family, especially in case of major injuries. Prevention strategies need to be worked out for all injuries, particularly for major injuries which cause considerable disability and mortality. We present three road-related major injury events which had occurred during the entire period of a larger study, which have been analyzed using the Haddon’s matrix through an epidemiological tetrad model involving host, vector, physical environment and socio-economic environment. Intervention strategies for prevention of similar injuries in future have been outlined at various time points for each case, as well as general measures, in various levels of care. Of the three major road-related injury cases (12 years, female; 17 years, female; and 17 years, male), two were automobile accidents in 17 years old adolescents and one was a case of injury of a 12-year-old girl due to fall on road. Risk factors were present in all three cases related to host, vector, physical environment and socio-economic environment. Strategies for prevention have been outlined at various time points i.e. pre-event, event, post-event at various levels for each case, as well as intervention strategies that can be implemented in general by the individual, family, community including panchayat, and both State and National governments. All major road-related injuries and their complications that occurred in subjects of the present study could have been prevented by taking responsibility at various levels.