Self-reported Health Risk Behaviors Research Articles

Association between adverse childhood experiences and self-reported health-risk behaviors among cancer survivors: A population-based study.

Existing evidence shows that people who report Adverse Childhood Experiences (ACEs) are more likely to exhibit health-risk behaviors. However, limited research on this topic pertains to oncology population. We aim to address this knowledge gap by estimating the prevalence of ACEs and investigating their association with self-reported health-risk behaviors among adult cancer survivors living in the U.S. We conducted a secondary analysis using cross-sectional data from the 2021 Behavioral Risk Factor Surveillance System ACE module. We included 4,126 adults, aged ≥18 years, with a history of cancer. The outcome variable was self-reported health-risk behaviors, which included cigarette smoking, e-cigarette use, and binge alcohol drinking. Self-reported ACEs history was the primary independent variable, comprised of 11 questions regarding child abuse and dysfunctional households. We conducted descriptive statistics and multivariable logistic regression to describe the relationship between the ACE history and health-risk behaviors. Overall, 84.2% of cancer survivors self-reported as White, 58.4% were women, and 76.6% were aged 65+ years. Nearly two-thirds of the sample (63.2%) self-reported at least one ACE (prior to age 18) and 21.7% engaged in ≥1 health-risk-behaviors, such as cigarette smoking, binge alcohol drinking, or e-cigarette use. Experiencing ≥3 ACEs was associated with 145% increased odds of reporting at least one health-risk behavior (OR = 2.45, 95% CI [1.78-3.38]) when compared to those without a history of ACEs. Besides, survivors who were younger, divorced, less educated, and had low income had higher odds of reporting at least one health-risk behavior. Overall, a history of ACEs is associated with health-risk behaviors. These all can negatively impact cancer survivors' overall well-being. Early screening for ACE during oncologic visits can be a protective measure for preventing health-risk behaviors among cancer survivors.

Risk-related brain activation is linked to longitudinal changes in adolescent health risk behaviors

Middle adolescence is the period of development during which youth begin to engage in health risk behaviors such as delinquent behavior and substance use. A promising mechanism for guiding adolescents away from risky choices is the extent to which adolescents are sensitive to the likelihood of receiving valued outcomes. Few studies have examined longitudinal change in adolescent risky decision making and its neural correlates. To this end, the present longitudinal three-wave study (Nw1 = 157, Mw1= 13.50 years; Nw2 = 148, Mw2= 14.52 years; Nw3 = 143, Mw3= 15.55 years) investigated the ontogeny of mid-adolescent behavioral and neural risk sensitivity, and their baseline relations to longitudinal self-reported health risk behaviors. Results showed that adolescents became more sensitive to risk both in behavior and the brain during middle adolescence. Across three years, we observed lower risk-taking and greater risk-related activation in the bilateral insular cortex. When examining how baseline levels of risk sensitivity were related to longitudinal changes in real-life health risk behaviors, we found that Wave 1 insular activity was related to increases in self-reported health risk behaviors over the three years. This research highlights the normative maturation of risk-related processes at the behavioral and neural levels during mid-adolescence.

Abstract P147: Characterizing Self-reported Religious Affiliation Among Patients With Vascular Disease And Associations With Health Risk Behaviors

Introduction: Religion is an important aspect of personal identity, which is linked to education and wealth. Religion is changing in prevalence, notoriously difficult to obtain from surveys, and seldom accounted for in clinical research. We characterized religious affiliation among patients with common diagnoses treated by vascular surgeons and explored associations with patient-level factors and health risk behaviors. Hypothesis: We hypothesize health risk behaviors will be more common among vascular patients that are unaffiliated with a particular religion. Methods: Patients treated from 2019-2021 at a single center with vascular disease (abdominal aortic aneurysm; carotid, renal, or mesenteric stenosis; or peripheral artery disease) were identified. Self-reported religious affiliation was obtained from the medical record. Patients self-reporting any religion (regardless of religion name or denomination) were categorized as religion-affiliated (RA); self-reporting as atheist, agnostic, or no religion were categorized as unaffiliated (UA). Health risk behaviors were evaluated as individual outcomes and in aggregate based on heavy drinking (per CDC recommendations), tobacco, or illegal drug use. Statistical comparisons used chi-square and Wilcoxon scores. Results: Among 3,568 patients identified, 3,247 (91%) had self-reported religion and form the basis of analysis. 2198 (67.7%) reported RA, and over 40 denominations were identified. RA was more common among women [70.3% (1041 of 1480) vs. 65.5% (1157 of 1767); P=0.003] and married patients [71.1% (1162 of 1635) vs. 65.5% (598 of 913): P=0.003]. RA by race was most common among African American patients [70.9% (158 of 223)] and least common among Asians [48.2% (26 of 54)] (P=0.002). Self-reported health risk behaviors were more common among UA patients [33.2% (348 of 1049) versus 27.2% (598 of 2198); P<0.001], who also had a higher median weekly alcohol consumption (1.2 [IQR 3.6] vs. 0.6 [IQR 2.4] ounces; P=0.024). Conclusions: Self-reported RA is associated with demographics and health risk behaviors among vascular patients. Interventions leveraging religious organizations and leaders may not reach nearly one third of patients who are UA. Future work will explore associations with socioeconomic factors and surgical outcomes.

Component Processes of Decision Making in a Community Sample of Precariously Housed Persons: Associations With Learning and Memory, and Health-Risk Behaviors.

The Iowa Gambling Task (IGT) is a widely used measure of decision making, but its value in signifying behaviors associated with adverse, “real-world” consequences has not been consistently demonstrated in persons who are precariously housed or homeless. Studies evaluating the ecological validity of the IGT have primarily relied on traditional IGT scores. However, computational modeling derives underlying component processes of the IGT, which capture specific facets of decision making that may be more closely related to engagement in behaviors associated with negative consequences. This study employed the Prospect Valence Learning (PVL) model to decompose IGT performance into component processes in 294 precariously housed community residents with substance use disorders. Results revealed a predominant focus on gains and a lack of sensitivity to losses in these vulnerable community residents. Hypothesized associations were not detected between component processes and self-reported health-risk behaviors. These findings provide insight into the processes underlying decision making in a vulnerable substance-using population and highlight the challenge of linking specific decision making processes to “real-world” behaviors.

Vital Signs: Prevalence of Multiple Forms of Violence and Increased Health Risk Behaviors and Conditions Among Youths - United States, 2019.

IntroductionExperiencing violence, especially multiple types of violence, can have a negative impact on youths’ development. These experiences increase the risk for future violence and other health problems associated with the leading causes of morbidity and mortality among adolescents and adults.MethodsData from the 2019 national Youth Risk Behavior Survey were used to determine the prevalence of high school students’ self-reported experiences with physical fighting, being threatened with a weapon, physical dating violence, sexual violence, and bullying. Logistic regression models adjusting for sex, grade, and race/ethnicity were used to test the strength of associations between experiencing multiple forms of violence and 16 self-reported health risk behaviors and conditions.ResultsApproximately one half of students (44.3%) experienced at least one type of violence; more than one in seven (15.6%) experienced two or more types during the preceding 12 months. Experiencing multiple types of violence was significantly more prevalent among females than among males and among students identifying as gay, lesbian, or bisexual or not sure of their sexual identity than among heterosexual students. Experiencing violence was significantly associated with higher prevalence of all examined health risks and conditions. Relative to youths with no violence experiences, adjusted health risk and condition prevalence estimates were up to seven times higher among those experiencing two types of violence and up to 21 times higher among those experiencing three or more types of violence.Conclusions and implications for public health practiceMany youths experience multiple types of violence, with potentially lifelong health impacts. Violence is preventable using proven approaches that address individual, family, and environmental risks. Prioritizing violence prevention is strategic to promoting adolescent and adult health.

Co-Occurring Health Risk Behaviors and Their Association with Self-Rated Health among Female College Students

ABSTRACT Background Existing research focuses on the co-occurrence of lifestyle-related health risk behaviors among college students. Although students’ self-reported health risk behaviors have been examined, students’ self-rated health and its association with these co-occurring health risk behaviors have been overlooked. Purpose: The goals of the current study were to identify levels of co-occurrence of health risk behaviors among female college students and to test the prediction that students with multiple co-occurring health risk behaviors would report poorer self-rated health. Methods: Data from an online survey that assessed the five selected health risk behaviors and self-rated health of undergraduate students at a liberal arts university in the northeast of the USA were analyzed. Results: High prevalence rates were found on all five risk behaviors and the majority of participants reported engaging in two or more co-occurring health behaviors. The inverse association between perceived health and level of co-occurrence of health risk behaviors was consistent with what was predicted. Discussion: Students’ perceived health should be considered in the examination of health risk behaviors among college students. Translation to Health Education Practice: These findings can inform efforts to provide Health Education and prevention programming on college campuses that incorporates multiple health behaviors. A AJHE Self-Study quiz is online for this article via the SHAPE America Online Institute (SAOI) http://portal.shapeamerica.org/trn-Webinars

Physical Disorders are Associated with Health Risk Behaviors in Chinese Adolescents: A Latent Class Analysis.

It is known that health risk behaviors (HRBs) can lead to a variety of physical and mental health problems among adolescents, but few studies have paid attention to the relationship between latent classes of HRBs and adolescent diseases. The purpose of this study was to use latent class analysis (LCA) to clarify the potential subgroups of HRBs (smoking, drinking, screen time, non-suicidal self-injuries, suicidal behaviors, and unintentional injuries) and examine the association between the subgroups of HRBs and physical disorders (diarrhea, fever, cough, and vomiting) with multiple logistic regression analysis, in Chinese adolescents. Self-reported HRBs and physical disorders were used to evaluate 22,628 middle school students in six cities of China, from November 2015 to January 2016, based on a multistage stratified cluster sampling approach. The prevalence of diarrhea, fever, cough, and vomiting was 23.5%, 15.9%, 50.6%, and 10.7%, respectively. We identified four latent classes of HRBs by LCA, including low-risk class, moderate-risk class 1 (smoking, drinking, and screen time), moderate-risk class 2 (non-suicidal self-injuries and suicidal behaviors, unintentional injuries), and high-risk class (smoking, drinking, screen time, non-suicidal self-injuries, suicidal behaviors, and unintentional injuries), which were 64.0%, 4.5%, 28.8% and 2.7% of participants, respectively. Compared to the low-risk class, all other classes showed higher risk for these physical disorders (P < 0.01 for each). In particular, the high-risk class had the highest risk (diarrhea (odds ratio (OR) = 2.628, 95% confidence interval (CI) 2.219 to 3.113), fever (OR = 3.103, 95% CI 2.591 to 3.717), cough (OR = 2.142, 95% CI 1.805 to 2.541), and vomiting (OR = 3.738, 95% CI 3.081 to 4.536). In conclusion, these results indicated that heterogeneity exists in HRBs, and subgroups of HRBs were correlated to the occurrence of common physical disorders in Chinese adolescents. Therefore, multiple HRBs rather than single factors should be considered for the prevention of common physical disorders in schools.

Adolescent Connectedness and Adult Health Outcomes.

Because little is known about long-term effects of adolescent protective factors across multiple health domains, we examined associations between adolescent connectedness and multiple health-related outcomes in adulthood. We used weighted data from Waves I and IV of the National Longitudinal Study of Adolescent to Adult Health (n = 14 800). Linear and logistic models were used to examine associations between family and school connectedness in adolescence and self-reported health risk behaviors and experiences in adulthood, including emotional distress, suicidal thoughts and attempts, physical violence victimization and perpetration, intimate partner physical and sexual violence victimization, multiple sex partners, condom use, sexually transmitted infection (STI) diagnosis, prescription drug misuse, and other illicit drug use. In multivariable analyses, school connectedness in adolescence had independent protective associations in adulthood, reducing emotional distress and odds of suicidal ideation, physical violence victimization and perpetration, multiple sex partners, STI diagnosis, prescription drug misuse, and other illicit drug use. Similarly, family connectedness had protective effects for emotional distress, all violence indicators, including intimate partner violence, multiple sex partners, STI diagnosis, and both substance use indicators. Compared to individuals with low scores for each type of connectedness, having high levels of both school and family connectedness was associated with 48% to 66% lower odds of health risk behaviors and experiences in adulthood, depending on the outcome. Family and school connectedness may have long-lasting protective effects across multiple health outcomes related to mental health, violence, sexual behavior, and substance use. Increasing both family and school connectedness during adolescence has the potential to promote overall health in adulthood.

Health risk behaviors, violence exposure, and current asthma among adolescents in the United States.

Asthma may worsen during adolescence, due to both health risk behaviors and psychosocial stressors commonly encountered during this life stage. Cross-sectional study of 24 612 high school students who participated in the 2009 and 2011 National Youth Risk Behavior Survey. Multivariable logistic regression was used to examine the relation between self-reported health risk behaviors or psychosocial stressors and current asthma. Mediation analysis was performed to assess whether depressive symptoms or suicidal behavior contribute to the link between psychosocial stressors and asthma. Current asthma was reported by 13.1% of the study participants. In a multivariable analysis, female sex, obesity, shorter sleep duration, frequent soda/pop consumption, and marijuana use were each significantly associated with 14-36% increased odds of asthma. Any violent behavior (adjusted odds ratio [OR] = 1.12, 95% confidence interval [CI] = 1.02-1.24), any victimization (OR = 1.43, 95%CI = 1.29-1.58), any suicidal behavior (OR = 1.41, 95%CI = 1.22-1.64) and having felt sad or hopeless in the past year (OR = 1.57, 95%CI = 1.40-1.75) were each associated with current asthma. In a mediation analyses, having felt sad/hopeless and suicidal behaviors accounted for 21% and 14%, respectively, of the victimization-asthma association. Potentially modifiable risk factors, including obesity, short sleep duration, frequent soda/pop consumption, and psychosocial stressors are associated with asthma in US adolescents. Promoting healthier lifestyles, as well as screening for violence exposure and treating depressive symptoms, could help reduce asthma burden in this population.

Health risk behaviors among high school and university adolescent students.

Tobacco, alcohol and drug abuse constitute a public health concern. Data regarding health risk behaviors among Greek youth are scarce. The aim of the present study was to investigate health risk behaviors of a large adolescent sample (730 adolescents, 294 males and 436 females), residing in different areas of Greece, trace perceived side effects and associate the findings with the adopted lifestyle. High school students and University newcomers, aged 14–21 years (17.8±4.5 years), self-reported health risk behaviors via an anonymous, closed-type, validated questionnaire. Simultaneous adoption of unhealthy habits, such as smoking and drug abuse, were not independent (χ2=38.668, P=0.01). Age was the most significant factor in the adoption of unhealthy behaviors; smoking (χ2=27.220, P=0.01), misuse of cannabis and recreational drugs (χ2=9.874, P=0.05) and combining alcohol and smoking with entertainment (χ2=8.708, P=0.05; χ2=317.309, P=0.05, respectively) were adopted more by the elder (18–20 years) than the younger (15–18 years) teenagers. Males were more prone to abuse of cannabis (χ2=8.844, P=0.01), whereas females combined drinking and smoking with loud music during entertainment (χ2=6.618, P=0.05). The majority (64%) reported driving after drinking alcohol and intense entertainment, especially in urban areas. Almost half of smokers (53.1%) and drug users (46.3%) first encountered smoking or drugs from friends. Educational institutions and entertainment venues were the main places of initiation of smoking (26%) or drug use (35.2%), respectively. Adolescents from touristic regions were more prone to smoking (33.9%, P=0.01) and drug abuse (53.7%, P=0.01). The lower the frequency of exercise, the higher the consumption of psychoactive substances (P=0.022). Youth engaging in unhealthy habits were also willing to use prohibited doping substances (56%, P=0.043). Health problems were the main reason to consider changing habits (72%). In conclusion, health risk behaviors were multifactorial and tended to cluster. Thus, preventive youth strategies should target negative peer influences, especially during late adolescence.

Sleep Disturbances, Psychosocial Difficulties, and Health Risk Behavior in 16,781 Dutch Adolescents

ObjectiveTo investigate the prevalence of adolescent sleep disturbances and their relation to psychosocial difficulties and health risk behaviors with the use of data from a province-wide health survey (n = 16,781). MethodsPsychosocial difficulties were measured with the Strength and Difficulties Questionnaire. Additional assessments included self-reported sleep disturbances, suicidality, and health risk behaviors including current use of tobacco, alcohol, and drugs, physical inactivity, and compulsive use of multimedia. We used multilevel analyses to investigate the relationhips, including differences, between boys and girls, as well as the mediating role of emotional problems. ResultsJust under 20% of adolescents reported sleep disturbances in the previous month. These sleep disturbances were associated with psychosocial problems (odds ratio [OR], 6.42; P < .001), suicidality (OR, 3.90–4.14; P < .001), and all health risk behaviors (OR, 1.62–2.66; P < .001), but not with physical inactivity. We found moderation by gender for the relations between sleep and suicide attempts (OR, 0.38; P < .002) and between sleep and cannabis use (OR, 0.52; P = .002), indicating attenuated relationships in girls compared with boys. Emotional problems partially mediated the relationships between sleep disturbances and multimedia use. ConclusionsThis study reiterates the high prevalence of sleep disturbances during adolescence. These sleep disturbances were strongly related to psychosocial problems and a wide range of health risk behaviors. Although the direction of causality cannot be inferred, this study emphasizes the need for awareness of impaired sleep in adolescents. Moreover, the gender differences in associated suicide attempts and cannabis use call for further research into tailored intervention strategies.

Abstract A88: Medicaid expansion and access to care among breast cancer survivors

Abstract Background: Breast cancer survival is improving due to early detection of the disease and advances in treatment. In the United States, there are more than 3 million breast cancer survivors and approximately 240 thousand women diagnosed with the disease every year. To receive effective treatment, breast cancer survivors need to follow a treatment plan prescribed by their physicians. However, access to healthcare services remains a barrier to completing needed treatment. Medicaid expansion under the Affordable Care Act improves access to care among vulnerable populations, but almost half of the states opted out of the expansion. Research Objective: We shed light on the potential effect of Medicaid expansion on access to care among breast cancer survivors by assessing inability to see a doctor due to cost before Medicaid expansion in non-expansion states versus expansion states. Study Design: We use a logistic model (accounting for the weighted sample) and control for demographics, insurance status, and general health. We calculate the odd ratios of inability of survivors of breast cancer to see a doctor in the past year due to cost. Population Studied: We use data from the Behavioral Risk Factor Surveillance (BRFSS) for the years 2009, 2010, and 2012, which are the only years containing data on cancer survivorship. The BRFSS is a nationally representative survey that collects information on self-reported preventive health practices and risk behaviors. The sample used for this study consists of women ages 40 to 64, in all 50 states and Washington D.C., and who were diagnosed with breast cancer (n = 3,223). Results: Preliminary results suggest that breast cancer survivors in non-expansion states had significantly higher odds of being unable to see a doctor due to cost (OR = 1.63, 95% CI =1.10, 2.42). Conclusions: Living in a state that expands Medicaid will be an advantage for low-income breast cancer survivors because it will improve their access to healthcare services. Existing disparities in access to care are likely to widen between survivors of breast cancer in non-expansion states and expansion states as a result of lack of affordable insurance coverage for low-income cancer survivors in non-expansion states. Citation Format: Wafa W. Tarazi. Medicaid expansion and access to care among breast cancer survivors. [abstract]. In: Proceedings of the Seventh AACR Conference on The Science of Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; Nov 9-12, 2014; San Antonio, TX. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2015;24(10 Suppl):Abstract nr A88.

Risky decision making in a laboratory driving task is associated with health risk behaviors during late adolescence but not adulthood

Adolescence is characterized by increasing incidence of health risk behaviors, including experimentation with drugs and alcohol. To fill the gap in our understanding of the associations between risky decision-making and health risk behaviors, we investigated associations between laboratory-based risky decision-making using the Stoplight task and self-reported health risk behaviors. Given that there has been no examination of potential age differences in the associations between risky decision-making and health risk behaviors, we also examined whether the association of risky decision-making with health risk behaviors is consistent across adolescence and adulthood using two-group structural equation modeling (SEM). The results indicated significant differences across the two age groups: adolescents (17–20 year olds) who took more risks on the Stoplight task reported greater frequency and earlier onset of substance use, whereas stoplight performance was not associated with substance use frequency or onset among adults (31–61 year olds). Our findings suggest that a laboratory-based measure of risky decision-making is significantly related to health risk behaviors among adolescents but not among adults.

Health-risk behaviors and quality of life among young men

To examine the associations between substance use and other health-risk behaviors and quality of life (QOL) among young men. The analytical sample consisted of 5,306 young Swiss men who participated in the Cohort Study on Substance Use Risk Factors. Associations between seven distinct self-reported health-risk behaviors (risky single-occasion drinking; volume drinking; cigarette smoking; cannabis use; use of any other illicit drugs; sexual intercourse without a condom; low physical activity) were assessed via chi-square analysis. Logistic regression analyses were conducted to study the associations between each particular health-risk behavior and either physical or mental QOL (assessed with the SF-12v2) while adjusting for socio-demographic variables and the presence of all other health-risk behaviors. Most health-risk behaviors co-occurred. However, low physical activity was not or negatively related to other health-risk behaviors. Almost all health-risk behaviors were associated with a greater likelihood of compromised QOL. However, sexual intercourse without a condom (not associated with both physical and mental QOL) and frequent risky single-occasion drinking (not related to mental QOL after adjusting for the presence of other health-risk behaviors; positively associated with physical QOL) differed from this pattern. Health-risk behaviors are mostly associated with compromised QOL. However, sexual intercourse without a condom and frequent risky single-occasion drinking differ from this pattern and are therefore possibly particularly difficult to change relative to other health-risk behaviors.

Self-reported health risk behaviors among adolescents in Luang Namtha province of Lao PDR: Prevalence and determinants

The purpose of this study was to assess self-reported prevalence of alcohol, tobacco, and drug use, and sexual risk behaviors, as well as to identify sources of sex education and individual, family, and peer factors that might influence adolescents’ health risk behaviors (HRB). In a community-based, cross-sectional study, 1360 adolescents aged 14–19 years were interviewed from June to September 2008 in Luang Namtha province. Multistage systematic random sampling was used to select participants. Logistic regression was used to identify the determinants of single HRB. Alcohol and tobacco use, and sexual risk behaviors were common. Just under half (42.5%) used alcohol, 9.6% smoked during the past 30 days, and 1.4% had used amphetamine during their lifetime, and 19.6% had ever had sex. Of those, 58.8% were currently sexually active, 40.1% reported having two or more sexual partners, and 34.5% had used a condom during last sexual intercourse. The mean age at sexual debut was 15.3 years for boys and 15.1 years for girls. Khamu ethnicity, not attending school, and peers’ drinking, smoking, and using drugs were significant determinants of current alcohol use, whereas being male, not attending school, Khamu ethnicity, and peers’ smoking and using drugs predicted current smoking. Being male, younger age, Akha ethnicity, having low level of education, peers’ smoking, being sexually active, and being pregnant or having made someone pregnant were significantly associated with ever having sex, whereas being male, Akha and Khamu ethnicities, peers’ smoking, drinking alcohol, and being sexually active were correlated with sexual risk behaviors. Individual and socio-demographic background factors as well as peer influence are determinants of risk behaviors. Thus, efforts should be made to keep adolescents in school, particularly until secondary school, and increase school connectedness.

Early adolescent health risk behaviors, conflict resolution strategies, and school climate

Drawing upon an ethnically and socio-economically diverse sample of 323 7th grade students from twelve urban schools within one school district, this mixed method study examined early adolescents' self-reported health risk behaviors as related to their conflict resolution strategies and their school's conflict resolution climate. Survey data suggested that early adolescents who reported using more cooperative and fewer aggressive conflict resolution strategies also reported to engage in fewer personal health risk behaviors. Reported engagement in fewer behavioral risks also was associated with attending schools with more supportive “conflict resolution climates.” Serial small group interviews in selected schools indicated that conflict resolution climate quality was associated with how well teachers were perceived to respond to students' conflicts and how they managed teacher–student conflicts. In addition, many students in less supportive climates exhibited cynical attitudes regarding the viability of the conflict resolution strategies promoted by schools and prevention programs.

Social desirability and self-reported health risk behaviors in web-based research: three longitudinal studies

BackgroundThese studies sought to investigate the relation between social desirability and self-reported health risk behaviors (e.g., alcohol use, drug use, smoking) in web-based research.MethodsThree longitudinal studies (Study 1: N = 5612, 51% women; Study 2: N = 619, 60%; Study 3: N = 846, 59%) among randomly selected members of two online panels (Dutch; German) using several social desirability measures (Marlowe-Crowne Scale; Balanced Inventory of Desirable Responding; The Social Desirability Scale-17) were conducted.ResultsSocial desirability was not associated with self-reported current behavior or behavior frequency. Socio-demographics (age; sex; education) did not moderate the effect of social desirability on self-reported measures regarding health risk behaviors.ConclusionsThe studies at hand provided no convincing evidence to throw doubt on the usefulness of the Internet as a medium to collect self-reports on health risk behaviors.

Depression symptoms and substance abuse in adolescents with asthma

Depression and risk behaviors occur often in adolescents in the United States, but their frequency in youth with asthma is not well documented. To establish rates of and associations between depression and substance use in youth with asthma. The Centers for Disease Control and Prevention conducted the 2005 Youth Risk Behavior Survey with 13,917 students in grades 9 to 12 from 159 high schools in 40 states, producing a nationally representative distribution of students by grade, sex, and race/ethnicity. The Youth Risk Behavior Survey documents self-reported suicide intent and health risk behaviors, including use of tobacco, marijuana, alcohol, and cocaine. In 720 adolescents reporting current asthma (5.2% of the total sample), depression symptoms, cigarette smoking, and cocaine use occurred more frequently than in youth without asthma. Substance use increased with depression; of youth with asthma reporting suicidal ideation, 40% had smoked cigarettes, 67% had smoked marijuana, 37% had engaged in binge drinking, and 12% had used cocaine in the past 30 days. Overall odds ratios for substance abuse in the group with asthma were not altered when controlling for age, sex, and race, although odds ratios for specific risk behaviors in those with asthma varied slightly within age, sex, and race groups. National rates of depression and associated risk behaviors in youth with asthma have not been previously reported, indicate a need to screen adolescents with asthma for depression, and suggest that risk behaviors in this population may signal heightened need for intervention.

DETERMINANTS OF PHYSICAL ACTIVITY AND DIETARY COUNSELING BY PHYSICIANS AT A LARGE LOW-INCOME CLINIC IN LOS ANGELES COUNTY.

Purpose Studies have shown that the burden of chronic disease due to poor diet and physical inactivity falls disproportionately on the underserved. Although brief physician counseling have demonstrated efficacy for reducing these modifiable risk behaviors, little is known about factors that influence the receipt of these services in the low-income clinic setting. This study addresses this scientific gap. Methods A 94-question, multiple-item Patient Health Assessment Survey was distributed to 475 adult patients at four clinic sites within the Venice Family Clinic (VFC) system. The survey was administered to selected participants from November 2005 to January 2006 in the waiting room of each clinic. The instrument collected information on patient demographics, self-reported health risk behaviors, and receipt of various lifestyle-counseling services. Statistical analyses were performed using the STATA 9.0 statistical software package. Results Adult patients who were more likely to receive physical activity counseling included individuals who ate a relatively healthier diet, earned an annual income of over $38,000, were overweight/obese, and whose native language was Spanish. Similarly, adult patients who were more likely to receive dietary counseling included individuals who ate a relatively healthier diet, were female, were physically active, and whose native language was Spanish. Adult patients who were less likely to receive physical activity and dietary counseling had substance use problems, such as excess alcohol use and drug abuse. Adult patients9 chronic disease status, defined specifically in this study as cardiovascular disease, hypertension, diabetes, and depression, did not influence the receipt of either physical activity or dietary counseling. Conclusion Clinic-based interventions targeting physical activity and dietary behaviors should tailor their designs to addressing clinical and socioeconomic factors that influence the receipt of counseling services in the low-income clinic setting.

The Association of Survey Setting and Mode with Self-Reported Health Risk Behaviors among High School Students

This study examined whether the prevalence of self- reported health risk behaviors among high school students varied by survey setting (school versus home) and mode of administration (paper and pencil versus computer). Students in grades 9 and 11 were assigned randomly to one of four conditions—school paper-and-pencil instrument (PAPI), school computer-assisted self-interview (CASI), home PAPI, and home CASI. During the spring of 2004, 4,506 stu- dents completed identically worded questionnaires based on the Youth Risk Behavior Survey questionnaire. Logistic regression analyses con- trolling for sex, grade, and race/ethnicity revealed that setting was associated significantly with the reporting of 30 of the 55 risk behav- iors examined, and mode was associated significantly with the report- ing of 7 of the 55 behaviors. For all behaviors with a significant setting main effect, the odds of reporting the behavior were greater among students who completed questionnaires at school than among students who completed questionnaires at home. For all behaviors