Secondary School Adolescents Research Articles (Page 1)

Perception of Rubella Disease and Willingness to Vaccinate Against Rubella Vaccine among Secondary School Adolescents in Enugu, South East Nigeria

Overweight is highly prevalent in lower- and middle-income countries (LMICs), including Nepal. Due to the rapid physical and mental growth among adolescents, they are nutritionally vulnerable and sensitive to environmental factors and dietary habits. This study aimed to determine the prevalence of overweight and its associated factors among adolescents of higher secondary schools in Kathmandu Metropolitan City (KMC) of Nepal. A cross-sectional study was conducted among 282 adolescents in higher secondary schools. A stratified random sampling technique was used to select the participants for data collection. The frequencies, percentages, mean, and standard deviation were used to describe the characteristics of the participants. Binary logistic regression was performed to determine the association between individual characteristics and the prevalence of overweight. All the tests were performed at a 95% Confidence Interval (CI), and variables with p-values below 0.05 were considered statistically significant. The mean (±SD) age of the participants was 16.8 ± 0.1 years. The majority of the participants (66.3%) were from private schools. Around 13.4% of the participants were overweight. Characteristics such as type of school (AOR: 2.6, CI: 1.9–8.2), father’s education (AOR: 2.1, CI: 1.7–6.5), access to physical activity at school (AOR: 1.2, CI: 1.1–4.6), and pocket money for lunch at school (AOR: 0.3, CI: 0.2–0.5) were found to be significantly associated with overweight among adolescents in this study. This study found that a notable proportion of adolescents were overweight and were influenced by socio-economic and demographical characteristics such as education, income level, school type, and level of physical activity. School-based interventions and programs should be carried out to promote healthy eating and physical activity among adolescents. A holistic approach, including parental education on nutrition, controlling pocket money to reduce unhealthy purchases, and adding physical activities to school programs, should be tailored to the school setting to reduce the risk of being overweight.

IntroductionFamily-based weight stigma has been linked to adverse psychological outcomes in adolescents. Research on weight stigma in the Mediterranean area is scarce. This study aims to longitudinally explore the association between family-based weight stigma and adolescents’ psychological well-being, considering recent vs cumulative exposure.MethodsData from the two-year longitudinal WbSad study were drawn from baseline assessments (T1) of a representative sample of 1,016 secondary school adolescents in a large Spanish city. At follow-up (T2), 551 adolescents participated. The mean age at T2 was 15.8 years, with 48.5% girls. Multivariate linear regression models, adjusting for relevant covariates and baseline values, examined the impact of exposure (Never, Only at T1, at T1 and T2, or Only at T2) to family-based weight stigma and to parental comments about weight and dieting on psychological outcomes, measured with the Depression Anxiety Stress Scale-21 (DASS-21) and the Rosenberg Self-Esteem Scale.ResultsFamily-based weight stigma was reported more frequently among girls and was associated with higher psychological distress. Girls exposed to family stigma (at T1 and T2, and Only at T2) reported higher psychological distress, with significant associations across all DASS-21 outcomes for those exposed at T2 only. Maternal comments were linked to greater distress and lower self-esteem in girls and higher stress and total distress in boys at T2 only. Paternal comments at T2 were significantly associated with higher depression and total DASS-21 scores in girls, and higher scores in all DASS-21 outcomes in boys. No significant associations were found between parental encouragement to diet and any psychological outcomes in either gender.DiscussionThis study provides novel insights into how the timing (recency vs. persistent exposure) and source (maternal vs. paternal) of family-based stigma shape adolescent outcomes in a non-Anglo-Saxon sample. Recent family-based weight stigma negatively impacts adolescent psychological well-being, with girls being particularly vulnerable. The absence of an effect from cumulative exposure warrants further exploration. Preventive strategies should educate parents to avoid stigmatizing comments and promote messages that prioritize well-being over weight, particularly before the onset of mid-to-late adolescence. Finally, research is needed to better understand the temporal dynamics of parental weight-related comments and their impact on adolescents.

BackgroundAdolescence is a critical transitional phase characterized by rapid developmental changes, which makes this age group more vulnerable to mental health challenges and disorders. Despite the South African governments’ effort to implement the Integrated School Health Policy (ISHP), the prevalence of depression, anxiety, and suicidal behavior continues to rise among adolescents in rural based secondary schools. Therefore, this protocol aims to develop an intervention program to promote mental health awareness among adolescents in rural based secondary schools of Mopani district, Limpopo province, South Africa.MethodsThe study will be conducted in three phases. Phase 1 will involve a quantitative approach (phase 1A), using a cross-sectional descriptive research design. Cluster sampling method will be used to select schools, followed by systematic sampling to select adolescents between 12 and 18. Simple random sampling will be used to select teachers. Structured questionnaires will be used to collect data that will be analyzed using Statistical Package for Social Sciences software version 24 for data analysis. Qualitative approach (phase 1B) using explanatory research design will follow, which will be dependent on quantitative data. Both purposive and Snowball sampling methods will be utilized to sample adolescents and teachers. Semi-structured interviews will be used to collect data that will be analyzed thematically. Phase 1c will involve the synthesis and integration of the study through strength, weakness, opportunities, threats analysis; where findings from both phases will be consolidated and synthesized into a cohesive whole. Phase 2 will involve the development of a program using a logic model. The program will be presented in a table format, outlining specific objectives, activities, and outcomes. Phase 3 will focus on the validation of the developed program using the Delphi technique. The study has been approved by the University of Limpopo Research Ethics Committee: TREC/189/2025: PG.DiscussionThis research addresses the Sustainable Development Goals (SDGs) 3 and 4, ensuring healthy lives and promoting inclusive education. The study’s findings will contribute to the development of a tailored program to promote mental health awareness among adolescents in rural-based secondary schools. The study’s results will also provide valuable insights for policymakers, educators, and mental health professionals.ConclusionThe conclusion and recommendations will be based on the findings of the study.

Background/Objectives: Engaging in regular physical activity (PA) and reducing sedentary behaviors benefits youth health, especially for those with disabilities. However, two-thirds of European children remain insufficiently active. In schools, Active Breaks, brief 5–15 min PA sessions led by teachers during or between lessons, offer a feasible strategy to increase movement. This study investigated teachers’ perceptions of ABs by comparing implementers and non-implementers, examining facilitators and barriers to implementation, and exploring their potential to support the inclusion of students with disabilities. Methods: An observational cross-sectional study was conducted among primary and secondary school teachers in the Emilia-Romagna region (Italy), all of whom had completed a 6 h training course on the implementation of ABs. Data were collected using an ad hoc questionnaire consisting of four sections: sociodemographic data, an adapted Attitudes Toward Physical Activity scale, ABs’ practicality/sustainability, and inclusiveness. Results: Overall, 65% of teachers reported implementing ABs, with higher adoption in primary (69.5%) than secondary schools (58.6%). Implementers reported more positive perceptions and attitudes across individual, classroom, and school-support domains (p < 0.05). In addition, primary teachers consistently scored higher than their secondary counterparts, particularly in terms of class characteristics and benefit perceptions (p < 0.001). Most teachers, especially in primary schools (84.2%), reported no difficulties, although one-third of secondary teachers reported challenges. Exploratory factor analysis on barrier items identified two dimensions (practical/logistical feasibility; institutional/procedural difficulties), but internal consistency was low. Teachers mainly reported using motor activities, with sessions lasting 5–10 min, typically scheduled mid-morning. Inclusion analysis revealed that 60% of teachers had students with disabilities in their classes. While most students participated without adjustments, 25% required occasional or consistent modifications. Conclusions: ABs are a practical and inclusive strategy to reduce SBs in schools. However, not all teachers are currently able to implement them, due to varying contextual constraints, levels of support, and perceived barriers. Primary school settings appear more conducive to their integration, whereas secondary schools may require more tailored support. Fostering teacher confidence, peer collaboration, and inclusive planning can enhance both the implementation and long-term sustainability of educational initiatives.

The study investigated how home factors and digital socialization influence self-efficacy and social adjustment among secondary school adolescents. The research was motivated by the growing concern about adolescents’ adaptive functioning in an increasingly digital society and the limited understanding of how family environments interact with online experiences to shape developmental outcomes. A descriptive survey research design was adopted, involving 558 adolescents selected through a multi-stage sampling process. Validated instruments were used to assess home environment, digital socialization, self-efficacy, and social adjustment. Data were analyzed using descriptive and inferential statistics. Findings revealed that both home factors and digital socialization significantly contributed to adolescents’ self-efficacy and social adjustment. The results emphasized the importance of supportive home environments and responsible digital engagement in promoting adolescents’ confidence and social competence. The study provides insights for educators, parents, and policymakers on fostering healthy digital behaviors and enhancing family support systems to strengthen adolescents’ psychosocial development. Keywords: Adolescents; digital socialization; home environment; self-efficacy; social adjustment.

Adolescents in secondary schools begin to face various challenges and social demands that can trigger negative emotions such as guilt, shame, and social withdrawal. This condition requires the ability to manage thoughts and emotions in a healthy way. One effective psychological strategy is positive self-talk, a form of positive thinking that can enhance psychological well-being. Low levels of positive self-talk may negatively affect adolescents’ mental health. This study aimed to determine the level of positive self-talk among high school students in Kupang City. The research employed a quantitative descriptive method with a cross-sectional survey design. A total of 342 high school students were selected as participants using simple random sampling. Data were collected using a psychological scale instrument, specifically the Self-Talk Scale, and analyzed using IBM SPSS software through descriptive statistical analysis. The results showed that, in general, the positive self-talk level of high school students was in the moderate category. This indicates that students’ positive self-talk still requires special attention from guidance and counseling (BK) teachers or school counselors to strengthen students’ positive internal narratives. Enhancing students’ positive self-talk can help maintain their mental well-being, particularly when facing academic and social challenges. The findings of this study have important implications for school counseling practice. The results can serve as a reference for BK teachers in developing strategies and interventions to improve students’ positive self-talk and can also serve as a foundation for future researchers to design relevant interventions addressing positive self-talk issues among adolescents.

Background: Harmful use of substances by adolescents is adjudged a global epidemic by the World Health Organization, affecting both the individual and society. This study assessed the prevalence, patterns and predictors of substance abuse among in-school adolescents in Yenagoa Bayelsa State Nigeria Methods: This descriptive cross-sectional study was conducted in year 2022 among 310 secondary school adolescents, selected through a multistage sampling technique. Data were collected using a semi-structured, self-administered questionnaire adapted from the Global School-based Student Health Survey (GSHS) Core Questionnaire, specifically the 2021 version of the Drug Use Module. Data were analysed using SPSS version 25; level of significance was p ≤ 0.05 at 95% Confidence Interval. Chi-square and Fisher's exact tests were used to determine the association between categorical variables. Predictors were determined by binary logistic regression. Result: The mean age of the participants was 15.07 ± 1.573 years. Lifetime substance abuse prevalence was 32.3%, with a 12-month rate of 20.6%, including 13 (4.3%) daily users. The most abused substances were Alcohol 87(90.6%), Marijuana 20(20.5%) and Shisha 18(18.8%) and mean age of initiation was 12.42±2.971 years. Relaxation 23(24.0%) and curiosity 18(18.8%) were the most common reasons provided. Predictors include older adolescents, mother’s educational level, from a polygamous setting, negative influences from family members, easy access to drugs and money, and history of sexual abuse (p&lt;0.05). Conclusion: Substance abuse among in-school adolescents is widespread, with initiation at younger ages. The most abused substances are alcohol, cannabis, and shisha. Prevention should target younger adolescents before they start using these substances.

BackgroundAdolescent sexual intercourse in schools is a common phenomenon.AimThis study analysed the prevalence and contributing factors of sexual intercourse among adolescents attending school in Guinea.SettingThis study was conducted in Guinea (Conakry).MethodsThis was an analysis of the secondary data from a survey of adolescents in secondary schools in Guinea. A sex-stratified logistic regression analysis was performed. Adjusted odds ratios (AORs) and its 95% confidence intervals (CIs) were reported. The significance level was set at 0.05.ResultsThe overall prevalence of sexual intercourse among adolescents of school-age in Guinea was 35.2%. The sexual intercourse prevalence rate was 42.4% (95% CI: 40.4–44.4) among boys and 32.7% (95% CI: 31.6–33.9) among girls. High school (girls AOR: 1.64; 95% CI: 1.43–1.88 and boys AOR: 1.35; 95% CI: 1.07–1.69), Christian and other (boys AOR: 1.58; 95% CI: 1.22–2.06 and girls AOR: 1.49; 95% CI: 1.27–1.73), having a partner (boys AOR: 7.03; 95% CI: 5.61–6.80 and girls AOR: 6.29; 95% CI: 5.44–7.28), knowledge of family planning (boys AOR: 2.25; 95% CI: 1.83–2.75 and girls AOR: 1.67; 95% CI: 1.47–1.89) and age (boys AOR: 1.50; 95% CI: 1.38–1.63 and girls AOR: 1.74; 95% CI: 1.65–1.84) were the most important contributing factors of sexual intercourse.ConclusionFuture programmes targeting adolescents should include public health interventions that address these factors related to sexual intercourse to reduce early sexuality in schools.ContributionsThis study will help policymakers make decisions about reducing sexual intercourse among school-attending adolescents.

Background Physical fitness (PF) has been established as one of the most powerful markers of future health among youth. School-based physical education (PE) programs play a critical role in promoting lifelong health and physical activity among youth and have been identified as ideal settings for large-scale PF assessments. Schools are increasingly adopting fitness test battery (FTB) software platforms as a technological solution for efficiently monitoring and assessing students' PF. However, no comprehensive review currently summarises the available FTB software platforms used in schools. This scoping review will identify and examine existing FTB software platforms for monitoring adolescent PF in secondary schools, focusing on the fitness components measured, test items used, and platform functionality. Methods A scoping review will be conducted in accordance with the six-stage methodological framework developed by Levac et al. (2010). The review will adhere to the PRISMA-ScR (Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews) guidelines. Sources will include databases (PubMed, Scopus, SPORTDiscus, and APA PsycInfo via EBSCO) and grey literature to capture relevant unpublished evidence. To support data synthesis, additional information will be sought through internet searches of identified FTB platform websites, and system administrators will be contacted for clarification or additional details as necessary. Results The selection process will be presented using a PRISMA flow diagram. The review will map the key features and functionality of FTB software platforms currently used in secondary schools. Conclusion This review will be the first to comprehensively map existing FTB software platforms used in secondary schools. The findings will inform PE teachers, researchers, and policymakers about the functionality, capabilities and limitations of existing platforms. This evidence will guide future research and the development of software platforms for adolescent fitness monitoring in schools.

Self-esteem plays a crucial role in adolescent development, influencing psychological wellbeing, academic performance, and social interactions. However, there is limited research examining self-esteem differences between urban and rural adolescents in Nigeria. This study investigates the self-esteem levels of secondary school students in urban and rural settings in Oyo State, Nigeria, and identifies key predictors of low self-esteem. A cross-sectional comparative study was conducted among 1638 secondary school adolescents (1181 urban; 457 rural). Participants were recruited from randomly selected schools in Ibadan (urban) and Igbo-Ora (rural). Self-esteem was assessed using the Rosenberg Self-Esteem Scale, which was analyzed as both a continuous and categorical variable. Hierarchical linear modelling and logistic regression were used to account for clustering effects and identify factors associated with low self-esteem. Urban adolescents had significantly higher self-esteem scores than their rural counterparts (mean 14.2 v 12.1, p<0.001). The prevalence of low self-esteem was higher among rural adolescents (11.2% males, 8.2% females) compared to urban adolescents (7.8% males, 4.7% females). In the urban setting, attending a public school (odds ratio (OR)=2.24, 95% confidence interval (CI): 1.52-3.31) and identifying as Muslim (OR=2.10, 95%CI: 1.41-3.12) were significant predictors of low self-esteem. No single predictor was statistically significant for rural adolescents, suggesting self-esteem variability may be influenced by multiple interacting factors. This study highlights significant disparities in self-esteem levels between urban and rural adolescents, emphasizing the role of educational and sociocultural factors. Findings underscore the need for targeted interventions to enhance self-esteem, particularly among rural adolescents and public school students. Gender-sensitive strategies and improved access to psychological support services should be integrated into adolescent development programs.

The objective of this mixed-methods study was to improve the emotional competences of Tanzanian secondary school adolescents by examining and identifying successful social-emotional learning practices. Questionnaires and focus group talks were completed by 244 teenagers, ages 13 to 17. Students and teachers reported through surveys and interviews, respectively, the benefits of social emotional skills and social emotion regulation techniques. Perception of emotions was found to have a positive effect on students' interest in learning (β=.144, t(4, 239)= 2.141, p=.033). A student's participation, communication, cooperation, assertion, responsibility, empathy, and self-control were statistically shown to enhance social and emotional competences (the model summary's impact size was 54%). This research investigates how students manage their learning and develops their emotional competences by looking at their social-emotional skills. This study offers methods for fostering emotional competences as well as the impact of social emotional abilities on students' ability to cope with learning. The Ministry of Education, Science, and Technology should therefore provide curricula and a framework for the efficient control of teenage students' social and emotional behaviour.

Objective: The results of the fourth objective of the research on the care of transgender adolescents in secondary school are presented. This objective seeks to identify the main strengths and challenges of the Counseling professional in caring for transgender students. Methodology: The research was based on the naturalistic paradigm, using a qualitative approach and the phenomenological method. Semi-structured interviews were conducted with nine participants to collect the information (two counselors, two trans and cisgender students, one parent of the trans student, and two teachers). The analysis was conducted through triangulation between the interviews, theory, and guiding criteria, utilizing categorization and open coding to group the units of meaning into two analytical categories: strengths and challenges in the counseling intervention. Results: Respect, empathy, assertiveness, and confidentiality were identified as strengths. Regarding challenges, a lack of training on sexual diversity and tools for serving trans students was noted. Conclusions: The purpose emphasizes the need to enhance professional development and training on topics related to sexual diversity and inclusive sexuality education models. It also highlights the importance of inter-institutional coordination to strengthen care for transgender people in secondary school. A human rights-based approach and ongoing professional development are recommended to ensure safe educational environments for transgender people in their identity development.

Aim: Nowadays, the rate at which adolescent students victimize others is alarming. This study investigated the relationship between power imbalance and psychosocial maladjustment among adolescents in secondary schools in Cameroon. Methods: A mixed-methods approach was employed, utilizing purposive and stratified sampling, to recruit 577 students, 12 school counselors, and 12 discipline masters/mistresses from selected secondary schools in four regions of Cameroon. Data were collected via student questionnaires, focus group discussions, and key informant interviews. Quantitative data were analyzed using cross-tabulations and correlation tests, while qualitative responses were thematically examined. The instruments used for data collection included a closed-ended questionnaire for students, a focus group discussion with students, and interviews with counsellors and discipline masters/mistresses. Their age was nine to eighteen, from four school types, and four Regions of Cameroon. Results: Findings showed that power imbalance significantly predicts psychosocial maladjustment (P &lt; 0.001). The positive sign of the correlation (R = 0.581**) implied that adolescents are more likely to suffer psychosocial maladjustments when there is a persistent display of power imbalance in the school environment. Conclusion: The study concludes that addressing power imbalance is critical to reducing psychosocial distress among adolescents. Recommendation: It is recommended that schools implement structured peer-support systems and provide regular psychosocial training for staff and students.

Consumption of psychoactive substances remains one of the hot-button debate of the 21st century. Many puzzles regarding consumption of psychoactive substances have been captioned in the correlates of the phenomenon. The purpose of the study was to establish the relationship between socio-demographic characteristics and psychoactive drug use. The data was collected using a Self-administered, semistructured questionnaire. The data collected was processed and analysed using the Statistical Package for Social Scientists (SPSS V. 27). Logistic Regression was the main data analysis technique. The study was conducted among 08 randomly andpurposively selected schools in Buhweju District. The study population was secondary school students. 350 students were recruited for the study. The response was by filling out the questionnaire. It was established that students affiliated with the Anglican religion exhibited higher odds of psychoactive drug use, as compared to their counterparts in the Roman Catholic Religion, (OR = 1.6; 95% CI = 1.00, 2.4, p = 0.049). The results were significant. No observation of peers consuming psychoactive substances also demonstrated elevated odds of engaging in psychoactive drug use (OR = 1.9; 95% CI = 1.19, 2.9, p = 0.006), indicating unique and varying risk factors among students. Students affiliated with the Anglican dominion had higher odds of consumption of the psychoactive substances, as compared to other dominions. Observation of peers who consumed the substances was on a significant risk for consumption of suchsubstances.

Eating disorders (EDs) are complex medical conditions that primarily affect adolescents. In Italy, EDs are becoming a serious health concern, but the lack of up-to-date epidemiological data makes it difficult to assess their real impact across the country. Early identification of risk factors is crucial for timely intervention. A multicenter cross-sectional survey was conducted among 1,740 students aged 14-16 years in Sicily. Data on socio-demographic factors, EDs behaviors, social media usage, body appreciation, and bullying were collected through an electronic questionnaire. Regression models were used to test the role of gender and interaction effects with key risk factors. Based on Eating Disorder Examination-Questionnaire (EDE-Q) scores, 72.8% of participants were classified as "not at risk", 17.9% as "at risk" and 9.3% as "at higher risk" of developing EDs using gender-related cut-offs. Girls were overrepresented in the at-risk and higher-risk groups (p < 0.01). Analysis revealed that lower Body Appreciation Scale (BAS) scores, higher BMI, and body comparison on social media predicted higher EDE-Q scores (p < 0.01). Gender interacted with several risk factors, including body appreciation (ß = 0.30. p < 0.01), alcohol use (ß = - 0.14, p < 0.01), and the perceived impact of the COVID-19 pandemic (ß = - 0.06, p < 0.05), with females showing stronger associations. This study highlights the increasing concern about EDs among Italian adolescents and emphasizes the need for targeted screening and early intervention. Understanding the interplay between gender, body image, and social behaviors is key to preventing EDs mitigating their long-term consequences.

Fast food consumption is a growing public health concern and creates a burden of malnutrition and non-communicable diseases, especially among adolescents in low- and middle-income countries. Adolescents are particularly vulnerable due to increasing autonomy and exposure to unhealthy fast food environments. Adolescents are particularly vulnerable due to increasing autonomy and exposure to unhealthy food environments. To assess the prevalence of fast food consumption and associated factors among secondary school adolescents in Jigjiga town, Somali region, Eastern Ethiopia. An institution-based cross-sectional study was conducted. A total of 419 participants were selected using a systematic random sampling technique from six randomly selected secondary schools (2 public and 4 private schools). Data were collected using a structured questionnaire. Data entry was done using Epi-Data 3.1 and then was analyzed with SPSS version 23.0. Descriptive statistics were calculated, and logistic regression analyses were done to identify factors associated with fast food consumption. Variables with p-values <0.25 in bivariate analysis were included in the multivariable model. Adjusted odds ratios (AORs) with 95% CIs were reported, and finally statistical significance was declared at p-value < 0.05. Model fit was calculated using Hosmer and Lemeshow's test, and multicollinearity was checked using the Variance Inflation Factor (VIF). The prevalence of fast food consumption among adolescents was 49.2% (95% CI: 44.2, 54.1). Significant factors associated with consumption of fast food are being younger age (AOR = 2.02; 95% CI: 1.30, 3.16), being male (AOR = 1.94; 95% CI: 1.25, 3.01), living with individuals other than parents (AOR = 2.58; 95% CI: 1.51, 4.39), availability of fast food at home (AOR = 2.03 95% CI: 1.31, 3.14), having pocket money ≥ 500 ETB (AOR = 1.97; 95% CI: 1.12, 3.46), and being food insecure (AOR = 2.08; 95% CI: 1.32, 3.28). Fast food consumption among adolescents in the study area is high, with higher consumption. Younger age, male gender, living with individuals other than parents, availability of fast food at home, higher pocket money, and household food insecurity were significantly associated with fast food consumption. Community-based and school interventions are needed to promote healthy food-consuming habits and reduce the health risks associated with frequent fast food intake in the study area.

Substance use in adolescents poses a complex societal challenge, undermining nation-building and socioeconomic growth. Religiosity encompasses a person's religious beliefs, habits, and involvement in spiritual activities. Family functioning refers to a family unit's overall health and operation, including communication, emotional bonding, support, roles, and behavioral control. Both aspects are pivotal in determining substance use in adolescents. This study assesses the association between religiosity and family functioning and determines factors concerning substance use among adolescents in secondary schools in high-risk areas. A cross-sectional study was conducted with 312 adolescents from selected secondary schools in substance use hotspot areas in Northern Malaysia. The tools used were Alcohol, Smoking, and Substance Involvement Screening Tool-Lite (ASSIST-Lite), Family Adaptation and Cohesion Scale version IV (FACES-IV), and Hatta Islamic Religiosity Scale (HIRS). The prevalence of substance use among adolescents was 9.6% (n = 30). Most users used a single substance (76.7%; n = 23), and only 23.3% (n = 7) used multiple substances. The mean age was 14.13 years (SD:0.67), the majority being Malays (99.0%; n = 309) with an Islamic background. Adolescent substance use was significantly associated with gender (16.3% in males and 6.3% in females, P = 0.004) and having a recent family history of substance use (16.8%, P = 0.003). No significant association between substance use and religiosity scores were elicited (W(1)=2.610, P = 0.106 and W(1)=0.092, P = 0.761 for knowledge and practices, respectively). However, substance use was found to be associated with family functioning subscales, which were chaotic family scores (W(1)=4.588, P = 0.032), and family satisfaction score (W(1)=4.831, P = 0.028). Regression analysis revealed that being male (Adj.OR=3.08, P = 0.006) and having a recent family history of substance use (Adj.OR=3.17, P = 0.004) significantly predicted substance use. This study highlights the role of chaotic family dynamics and family satisfaction and its influence onto adolescent substance use. Despite the insignificant finding between religiosity and substance use, further exploration in this area is may prove beneficial to enhance care for individuals.

Introduction Globally, many adolescents suffer from mental health problems and related stigma. Assessing mental health stigma among youth is crucial to addressing this problem. The aim of this study was to examine the psychometric properties of a modified version of the Attitudes About Mental Illness and its Treatment (AAMIT) instrument and to describe attitudes according to the instrument, among Swedish adolescents. Methods A total of 2,079 adolescents in lower and upper secondary high schools on Gotland, Sweden, responded to the instrument. Exploratory and confirmatory factor analyses and assessment of internal consistency were conducted. The adolescents’ views on the instrument were analysed through qualitative content analysis of open-ended comments. Results Exploratory factor analysis suggested a three-factor model, with seven items in total. The internal consistency of the subscales was found to be acceptable, with alpha values at 0.72–0.80. Mean scores on the subscales indicated a low prevalence of negative attitudes overall. However, 34.7% of the participants agreed with the stereotype that people with mental health problems are unpredictable, and 25.5% agreed that it is difficult to talk to people with such conditions. Negative attitudes were more prevalent among boys and adolescents with a foreign background. Many participants, nonetheless, found it difficult to evaluate the item statements, and a substantial proportion selected the ‘don’t know’ response option. Conclusion Findings indicate a need for inclusive mental health education throughout the general population, youth involvement in attitude assessment design, and further validation of the AAMIT instrument before its application in future research.

INTRODUCTIONThe emergence of novel tobacco products has led to an increase in the consumption of diverse tobacco items among adolescents. The smoking habits of adolescents adversely affect their physical and emotional health. This study aimed to ascertain the prevalence of polytobacco use among Malaysian teenagers and to identify the mental health issues associated with dual or polytobacco use.METHODSThis is a secondary dataset analysis of cross-sectional data from 27479 secondary school adolescents who participated in the 2017 Malaysian Adolescent School Health survey. The primary outcome of our study pertained to self-reported mental health characteristics (stress and depressive symptoms). The research used multivariable logistic regression analysis to assess the associations between the use of tobacco products and mental wellness.RESULTSOf the respondents, 79.9% were non-tobacco users, 9.2% were single tobacco users, 4.7% were dual tobacco users, and 7.3% were polytobacco users. Individuals engaged in polytobacco use exhibited elevated levels of stress (16.7%; p<0.001) and depression (33.7%; p<0.001) relative to those utilizing fewer tobacco products. Polytobacco product users exhibited a 1.64-fold (95% CI: 1.30–2.06) increased likelihood of reporting stress symptoms and a 1.75-fold (95% CI: 1.46–2.09) increased likelihood of reporting depression symptoms in comparison to non-tobacco users.CONCLUSIONSAdolescents who engage in dual or polytobacco use frequently experience internalized mental health issues, including symptoms of stress and despair. It is essential to perform early assessments of high-risk individuals, provide them with information regarding the importance of cessation, and implement proactive interventions for these groups' psychological challenges.