Youth Risk Behavior Web-based Survey Research Articles

Association between stress types and adolescent suicides: findings from the Korea Youth Risk Behavior Survey

ObjectiveThis study aims to explore the association between types of stress and suicidal behaviors—ideation and attempts—among Korean adolescents in two distinct years: 2015 and 2020.MethodsData were acquired from the Korea Youth Risk Behavior Web-based Survey conducted in 2015 and 2020. Participants’ desire for suicide was evaluated by asking questions about suicidal ideation and attempts, during the past year. Types of stress were divided into five categories: none, home, school, academic achievement, and appearance. Multiple logistic regression was used to investigate the association between variables of interest and dependent variables.ResultsAmong the 77,363 adolescents included in this study, 8.8% male and 13.2% female participants had seriously thought about committing suicide, and the rate of male and female participants who tried committing suicide was 1.6% and 2.5%, respectively. While every type of stress was highly associated with suicidal ideation, family and home types of stress had the highest odds ratio (OR), that was statistically significant for both sexes (Male: OR 3.81, 95% Confidence Interval [CI] 2.81 to 5.15; Female: OR 3.64, 95% CI 2.42 to 5.50). Moreover, the OR increased in order of: appearance; academic achievement; school and friends; and family and home, compared to the group that perceived no stress. Suicidal attempts were statistically significant and higher in likelihood, only amongst the female group that experienced stress from family and home (OR 2.48, 95% CI 1.08 to 5.67). In comparison to year 2015, suicidal ideation and attempts decreased in year 2020, but participants experiencing stress from family and home had a higher tendency of attempting suicide, though not statistically significant, regardless of their sex (Male: OR 1.03, 95% CI 0.74 to 1.44; Female: OR 1.06, 95% CI 0.81 to 1.4).ConclusionAdolescents who experience stress from family and home, or school and friends, are more likely to think about suicide, or carry it out, as compared to those having different causes of stress.

Food-related online media (mukbang and cookbang) exposure and dietary risk behaviors in Korean adolescents

BackgroundStudies have shown that prolonged smartphone use is associated with dietary risk behaviors among adolescents. However, little is known about whether the exposure to food-related online media contents, such as mukbang (eating broadcast) and cookbang (cooking broadcast), is associated with unhealthy dietary behaviors, independent of overall duration of smartphone use. ObjectiveThis study investigated the associations between the frequency of mukbang/cookbang watching and dietary risk behaviors among Korean adolescents, using nationally representative survey data. MethodsIn this cross-sectional study, we examined the data from 50,044 middle and high school students in the Korea Youth Risk Behavior Web-based Survey 2022. Participants reported their frequency of mukbang/cookbang watching, average duration of smartphone use, frequency of breakfast eating, frequency of nighttime eating, and intakes of fast foods, sugar sweetened beverages (SSBs), and high-caffeine drinks. We performed multivariable logistic regression to estimate odds ratios (OR) and 95% confidence intervals (CI) for the associations between mukbang/cookbang watching and dietary risk behaviors, accounting for complex survey sampling and adjusting for potential confounders. ResultsFrequent mukbang/cookbang watching (≥5 times/wk vs. never) was positively associated with dietary risk behaviors, including frequent breakfast skipping (OR [95% CI]=1.20 [1.13, 1.28]), frequent nighttime eating (1.43 [1.33, 1.54]) and frequent intakes of fast foods (1.69 [1.58, 1.80]), SSBs (1.47 [1.30, 1.66]), and high-caffeine drinks (1.41 [1.33, 1.50]), adjusting for duration of smartphone use. All mukbang/cookbang viewers, including those who perceived that mukbang/cookbang videos had “no influence” on their dietary behavior, had higher prevalence of dietary risk behaviors compared with non-viewers (perceived “no influence” vs. non-viewers: OR [95% CI]=1.18 [1.10, 1.26] breakfast skipping; 1.15 [1.06, 1.24] nighttime eating; 1.40 [1.30, 1.50] fast foods; 1.22 [1.07, 1.38] SSBs; 1.28 [1.20, 1.37] high-caffeine drinks). ConclusionsOur findings suggest that frequent mukbang/cookbang watching may be associated with unhealthy dietary behaviors among Korean adolescents.

Association of Soda Drinks and Fast Food with Allergic Diseases in Korean Adolescents: A Nationwide Representative Study

Introduction: A high consumption of carbonated soft drinks (i.e., soda drinks) and fast food is potentially associated with the observed global rise in adolescent allergic diseases. Thus, our study aimed to examine the potential associations between the consumption of soda drinks and fast food and allergic conditions, identifying specific relationships across subgroups and each allergic condition (asthma, allergic rhinitis, and atopic dermatitis). Methods: This study uses large-scale data from the Korea Youth Risk Behavior Web-Based Survey (total n = 865,614). Soda drinks and fast food were defined by a self-reported questionnaire and allergic conditions by physician-diagnosed within 1 year. Multivariable logistic regression was used to analyze the weighted odds ratios (ORs), along with 95% confidence intervals (CIs), for allergic diseases associated with the intake of soda drinks and fast food. Results: Among 865,614 adolescents in grades 7–12 (male, 51.40%), patients with asthma, allergic rhinitis, and atopic dermatitis were 18,568 (2.15%), 153,536 (17.74%), and 59,014 (6.82%), respectively. Current asthma was associated with soda drinks (OR, 1.07; 95% CI, 1.03–1.12) and fast food consumption (1.25; 1.17–1.33). Interestingly, stronger associations were observed for female high schoolers, compared to male high schoolers and middle schoolers, in relation to the consumption of soda drinks (1.31; 1.19–1.44) and fast food (1.46; 1.26–1.69) with asthma. Current allergic rhinitis and atopic dermatitis had no significant association with fast food consumption and soda drinks. Conclusion: This first large-scale study suggests that fast food and soda drinks consumption are potentially associated with current asthma, with stronger associations observed in females than males, underscoring the need for sex-specific allergy prevention programs.

Food-related online media (mukbang and cookbang) exposure and dietary risk behaviors in Korean adolescents

BackgroundStudies have shown that prolonged smartphone use is associated with dietary risk behaviors among adolescents. However, little is known about whether the exposure to food-related online media contents, such as mukbang (eating broadcast) and cookbang (cooking broadcast), is associated with unhealthy dietary behaviors, independent of overall duration of smartphone use. ObjectiveThis study investigated the associations between the frequency of mukbang/cookbang watching and dietary risk behaviors among Korean adolescents, using nationally representative survey data. MethodsIn this cross-sectional study, we examined the data from 50,044 middle and high school students in the Korea Youth Risk Behavior Web-based Survey 2022. Participants reported their frequency of mukbang/cookbang watching, average duration of smartphone use, frequency of breakfast eating, frequency of nighttime eating, and intakes of fast foods, sugar sweetened beverages (SSBs), and high-caffeine drinks. We performed multivariable logistic regression to estimate odds ratios (OR) and 95% confidence intervals (CI) for the associations between mukbang/cookbang watching and dietary risk behaviors, accounting for complex survey sampling and adjusting for potential confounders. ResultsFrequent mukbang/cookbang watching (≥5 times/wk vs. never) was positively associated with dietary risk behaviors, including frequent breakfast skipping (OR [95% CI]=1.20 [1.13, 1.28]), frequent nighttime eating (1.43 [1.33, 1.54]) and frequent intakes of fast foods (1.69 [1.58, 1.80]), SSBs (1.47 [1.30, 1.66]), and high-caffeine drinks (1.41 [1.33, 1.50]), adjusting for duration of smartphone use. All mukbang/cookbang viewers, including those who perceived that mukbang/cookbang videos had “no influence” on their dietary behavior, had higher prevalence of dietary risk behaviors compared with non-viewers (perceived “no influence” vs. non-viewers: OR [95% CI]=1.18 [1.10, 1.26] breakfast skipping; 1.15 [1.06, 1.24] nighttime eating; 1.40 [1.30, 1.50] fast foods; 1.22 [1.07, 1.38] SSBs; 1.28 [1.20, 1.37] high-caffeine drinks). ConclusionsOur findings suggest that frequent mukbang/cookbang watching may be associated with unhealthy dietary behaviors among Korean adolescents.

National trends in sexual intercourse and usage of contraception among Korean adolescents.

The exact influence of the COVID-19 pandemic on sexual intercourse and usage of contraception remains largely uncharted territory. To bridge this gap in knowledge, we conducted a comprehensive, cross-sectional examination of long-term trends in the prevalence of sexual intercourse and usage of contraception among South Korean adolescents from 2006 to 2022. In our research, we drew upon data encompassing 1,138,799 South Korean adolescents aged 12 to 18years, derived from the Korean Youth Risk Behavior Web-based Survey (KYRBS) over a period spanning from 2006 to 2022. We focused on the prevalence of sexual intercourse, contraception utilization, and the underlying associated factors among this demographic. The KYRBS data was collected using a complex sampling strategy to determine the national prevalence estimates and shifts in prevalence before (2006-2019) and during (2020-2022) the COVID-19 pandemic era. During the pre-pandemic period, a decrease in adolescent sexual intercourse was observed (6.34% in 2006, 5.53% in 2012, and 5.87% in 2019). However, in the post-pandemic period (2020-2022), there was a surge in sexual intercourse (4.55% in 2020 and 6.20% in 2022). This evident alteration in sexual intercourse trajectory between pre- and post-pandemic periods was statistically significant [βdiff, 0.950; 95% confidence interval (CI), 0.756-1.144]. Regarding contraceptive use among South Korean adolescents, there was an increase in the pre-COVID-19 pandemic phase across all demographic segments (14.61% in 2006, 22.30% in 2012, and 47.69% in 2022) but a notable decline when compared with the pre- and post-pandemic periods (βdiff, -0.319; 95% CI, -0.454 to -0.184). Additionally, during the study period, a decrease in sexual intercourse was observed in the pre-pandemic period (β, -0.129; 95% CI, -0.148 to -0.110), followed by an increase in the post-pandemic period (β, 0.821; 95% CI, 0.627 to 1.014). This shift is highlighted by an effect size of 0.96 [weighted odds ratio (wOR); 95% CI, 0.92 to 1.00], indicating a substantial change in adolescent sexual behaviors across study periods. The increase in sexual intercourse and decrease in usage of contraception observed in our study between the pre- and post-COVID-19 periods suggests a potential threat to sexual health among South Korean adolescents. This trend emphasizes the ongoing necessity of raising awareness about adolescent sexual behavior in South Korea.

National prevalence of atopic dermatitis in Korean adolescents from 2009 to 2022

Previous studies have examined the prevalence of allergic diseases in adolescents 1–2 years after the emergence of the COVID-19 pandemic. However, more data is needed to understand the long-term impact of COVID-19 on allergic diseases. Thus, we aimed to examine the trend of the atopic dermatitis prevalence in Korean adolescents before and during the COVID-19 pandemic across 14 years. Additionally, we analyze the risk factors of atopic dermatitis (AD) based on the results. The Korean Disease Control and Prevention Agency conducted the Korea Youth Risk Behavior Web-based Survey from 2009 to 2022, from which the data for this study were obtained. Prevalence trends were compared across subgroups, and the β difference (βdiff) was calculated. We computed odds ratios to examine changes in the disease prevalence before and during the pandemic. This study included a total of 917,461 participants from 2009 to 2022. The prevalence of atopic dermatitis increased from 6.79% (95% CI 6.66–6.91) in 2009–2011 to 6.89% (95% CI 6.72–7.05) in 2018–2019, then decreased slightly to 5.82% (95% CI 5.60–6.04) in 2022. Across the 14 years, middle school student status, low parent’s highest education level, low household income, non-alcohol consumption, non-smoker smoking status, no suicidal thoughts, and no suicide attempts were associated with increased risk of atopic dermatitis, while female sex, rural residence, high BMI, low school performance, low household income, and no feelings of sadness and despair was associated with a small increase. This study examined the prevalence of atopic dermatitis across an 18-year, and found that the prevalence increased in the pre-pandemic then decreased during the start of the pandemic and remained constant throughout the pandemic. This trend could be explained mainly by the large scale social and political changes that occurred during the COVID-19 pandemic.

Association of Body Image Distortion with Smartphone Dependency and Usage Time in Adolescents: A Cross-Sectional Korean Youth Study.

Adolescent dependency on smartphones is the highest among all age groups. Adolescents can be influenced to evaluate their body image by popular ideals about beautiful bodies via smartphone content, which can cause body image distortion. This study aimed to examine the association between body image distortion and smartphone dependency and the duration of smartphone usage among Korean adolescents. This study used data from the 16th Korean Youth Risk Behavior Web-Based Survey (2020), and included 42,981 participants, who were grouped according to self-reported duration of smartphone usage and smartphone dependency, as measured by a questionnaire. Body image distortion is defined as an exaggerated subjective body image compared to the actual body image. Multivariable-adjusted logistic regression was used to determine the odds ratios (ORs) with 95% confidence intervals (CIs) of body image distortion on smartphone dependency and usage time after adjusting for various factors related to body image distortion. Among the 42,981 participants, both moderate and high levels of smartphone dependency were associated with body image distortion in boys (moderate: adjusted OR [aOR], 1.11; 95% CI, 1.01-1.22; high: aOR, 1.18; 95% CI, 1.05-1.32) and girls (moderate: aOR, 1.14; 95% CI, 1.05-1.23; high: aOR, 1.30; 95% CI, 1.18-1.42) compared to the low-level dependency group. However, no significant association was found between smartphone usage duration and body image distortion. Our study demonstrated that moderate to high levels of smartphone dependency are associated with body image distortion in adolescents. Therefore, it is necessary to establish strategies for checking and managing adolescents' smartphone dependence.

Machine Learning-Based Prediction of Suicidal Thinking in Adolescents by Derivation and Validation in 3 Independent Worldwide Cohorts: Algorithm Development and Validation Study.

Suicide is the second-leading cause of death among adolescents and is associated with clusters of suicides. Despite numerous studies on this preventable cause of death, the focus has primarily been on single nations and traditional statistical methods. This study aims to develop a predictive model for adolescent suicidal thinking using multinational data sets and machine learning (ML). We used data from the Korea Youth Risk Behavior Web-based Survey with 566,875 adolescents aged between 13 and 18 years and conducted external validation using the Youth Risk Behavior Survey with 103,874 adolescents and Norway's University National General Survey with 19,574 adolescents. Several tree-based ML models were developed, and feature importance and Shapley additive explanations values were analyzed to identify risk factors for adolescent suicidal thinking. When trained on the Korea Youth Risk Behavior Web-based Survey data from South Korea with a 95% CI, the XGBoost model reported an area under the receiver operating characteristic (AUROC) curve of 90.06% (95% CI 89.97-90.16), displaying superior performance compared to other models. For external validation using the Youth Risk Behavior Survey data from the United States and the University National General Survey from Norway, the XGBoost model achieved AUROCs of 83.09% and 81.27%, respectively. Across all data sets, XGBoost consistently outperformed the other models with the highest AUROC score, and was selected as the optimal model. In terms of predictors of suicidal thinking, feelings of sadness and despair were the most influential, accounting for 57.4% of the impact, followed by stress status at 19.8%. This was followed by age (5.7%), household income (4%), academic achievement (3.4%), sex (2.1%), and others, which contributed less than 2% each. This study used ML by integrating diverse data sets from 3 countries to address adolescent suicide. The findings highlight the important role of emotional health indicators in predicting suicidal thinking among adolescents. Specifically, sadness and despair were identified as the most significant predictors, followed by stressful conditions and age. These findings emphasize the critical need for early diagnosis and prevention of mental health issues during adolescence.

Association between mukbang and cookbang viewing and body image perception and BMI in adolescents

BackgroundAdolescence is a critical period for establishing healthy eating habits and weight management, essential for preventing obesity and promoting overall health. This study investigates the impact of mukbang and cookbang—popular online broadcasts in Korea that feature excessive consumption of food—on the dietary habits and body image perception of Korean adolescents. With digital media, especially platforms like YouTube, becoming an integral part of daily life, these broadcasts have the potential to significantly influence adolescent health behaviors.MethodsEmploying data from the 18th Korea Youth Risk Behavior Web-based Survey (2022), this descriptive survey research explores the relationship between watching mukbang and cookbang and various health-related factors among adolescents. The survey’s comprehensive dataset provided a unique opportunity to examine this association in a population that is increasingly exposed to digital media content. The analysis focused on the frequency of watching mukbang and cookbang, their impact on eating habits, body mass index (BMI), body shape perception, and body image distortion among adolescents.ResultsThe results revealed a significant engagement with mukbang and cookbang among adolescents, with notable gender differences in viewing habits and effects. Increased frequency of viewing was associated with negative impacts on eating habits and body image perception. Furthermore, psychological factors such as stress levels and sleep quality emerged as significant predictors of the frequency of watching these broadcasts.ConclusionsThis study highlights the need for further investigation into the causal relationships between mukbang and cookbang viewership and adolescent health outcomes. The findings suggest the importance of developing targeted interventions to mitigate the negative influences of such content on adolescents’ eating habits and body perceptions. Given the widespread popularity of these broadcasts, it is crucial to address their potential health implications through public health strategies, educational content, and policy development aimed at promoting healthier lifestyles among adolescents.

Identification of important features in overweight and obesity among Korean adolescents using machine learning

Overweight and obesity in adolescents have been reported as one of the most serious threats worldwide including South Korea. This study aims to investigate the complex factors contributing to overweight and obesity in Korean adolescents using various machine learning methods. The research includes a dataset of 43,268 records from the 16th Korean Youth Risk Behavior Web-based Survey and explores 71 different factors, such as sociodemographic characteristics, dietary habits, health, behavior problems, family, and peer and school-related factors. Our analysis encompassed an array of algorithms, including Logistic Regression, Ridge, LASSO, Elasticnet, Decision tree, Bagging, Random forest, AdaBoost, and XGBoost. A total of nine machine learning models exhibited accuracy levels within the range of 0.7662 to 0.8403. Based on the domains and sub-domains of factors, it was determined that domains including sociodemographic characteristics, dietary habits, physical health, psychological health, behavioral problems, family factor, and peer and school factors were deemed important. Additionally, it is suggested that attention be given to newly-emerged features indicated by machine learning techniques, including oral health, smartphone addiction, smoking, sexual behavior, school violence, and nationality of parents. The current study's findings emphasize the critical need for collective and customized prevention programs considering multi-facet features to prevent overweight and obesity among Korean adolescents.

Association between smartphone overdependence and mental health in South Korean adolescents: a secondary data analysis.

The rising prevalence of smartphone overdependence among adolescents and its detrimental impact on mental health have become a growing concern. This study aimed to investigate the association between smartphone overdependence and the mental health of Korean adolescents. Participants were drawn from the 16th Korea Youth Risk Behavior Web-based Survey conducted in 2020. The dependent variable as smartphone overdependence, while the main exposure of interest was mental health, encompassing generalized anxiety disorder (GAD), perceived stress, sources of perceived stress, perceived loneliness, and perceived depressive symptoms. The study employed the Rao-Scott chi-square test and multiple logistic regression using IBM SPSS version 26.0. The participants comprised 54,948 adolescents aged 13 to 18 years. Among them, 25.1% (n=13,775) were categorized as smartphone overdependence group. Specifically, 20.3% of adolescents who reported GAD ≥10 and 22.5% of those who reported experiencing high levels of perceived loneliness were identified as smartphone overdependent. The GAD increased a risk of smartphone overdependence by 2.61 times (95% confidence interval [95% CI]: 2.46-2.77). Perceived loneliness was associated with 1.98-fold (95% CI: 1.87-2.09) increased risk of smartphone overdependence. Additionally, conflict with peers was found to increase the risk of smartphone overdependence by 4.63-fold (95% CI: 3.89-5.52), followed by conflict with parents (odds ratio [OR]: 4.52, 95% CI: 3.84-5.31), and family environment (OR: 4.52, 95% CI: 3.75-5.46). The findings underscore a significant association between smartphone overdependence and mental health in Korean adolescents. Healthcare services to improve their emotional coping and interpersonal skills are necessary.

Combined effects of sugar-sweetened beverage consumption, screen-based sedentary behavior, and sleep duration on South Korean adolescent obesity: a cross-sectional study.

This study examined the combined effects of sugar-sweetened beverage (SSB) consumption, screen-based sedentary behaviors, and sleep duration on adolescent obesity. It followed a cross-sectional study design and conducted secondary analysis on data from 20,497 high school students who participated in the 17th (2021) Korea Youth Risk Behavior Web-based Survey. This study underwent logistic regression analysis in complex sampling analysis. The combinations of low and medium consumption of SSBs, excessive screen-based sedentary behaviors, and short sleep durations were associated with a 1.18 and 1.12 fold increased likelihood of obesity (95% confidence interval [CI]=1.03-1.35) and (95% CI=1.02-1.22), respectively. The combination of high SSB consumption, appropriate screen-based sedentary behaviors, and short sleep duration (adjusted odds ratio [aOR]=1.15, 95% CI=1.01-1.31) and high SSB consumption, excessive screen-based sedentary behaviors, and short sleep duration (aOR=1.40, 95% CI=1.16-1.69) were associated with obesity. Integrated and tailored programs considering combination patterns of SSB consumption, screen-based sedentary behaviors, and short sleep duration need to be developed for preventing adolescent obesity.

Association between watching eating broadcast “Mukbang and Cookbang” and body mass index status in South Korean adolescents stratified by gender

BackgroundIt has been suggested that Mukbang and Cookbang, a type of eating broadcast originating from Korea and gaining popularity, may contribute to obesity. However, despite suggestions that Mukbang might contribute to obesity, studies investigating the impact of watching Mukbang on obesity is lacking. The goal of this study is to analyze the relationship between watching Mukbang and Cookbang and body mass index (BMI) status in Korean adolescents. All analyses were stratified by gender.MethodsThis study utilized data from the 2022 Korea Youth Risk Behavior Web-based Surveys. The anonymous online survey was conducted with 56,213 students, and 51,850 students (92.2%) who participated in the survey were analyzed. Participants reported the frequency of watching Mukbang and Cookbang per week over the previous 12 months. BMI was categorized into four subgroups based on percentiles: underweight (< 5th percentile), normal (5th − 85th percentiles), overweight (85th − 95th percentiles), and obese (> 95th percentile). This study used multinomial logistic regression for analysis.ResultsThe likelihood of being obese was significantly higher in Mukbang-watching boys compared to those who never watched Mukbang and Cookbang (adjusted odds ratio [aOR]: 1.22, 95% confidence interval [CI]: 1.12–1.32). A dose-dependent association was found between the frequency of Mukbang and Cookbang watching and the likelihood of obesity among boys (p-for-trend < 0.0001). Subgroups that currently smoke, currently drink alcohol, frequently consume fast food, or drink sweetened beverages showed significantly higher odds of being obese in the “Ever” group than those in the “Never” group.ConclusionThis study found a relationship between watching Mukbang and Cookbang and obesity in boys. Appropriate interventions should be considered for boys watching Mukbang and Cookbang.

Racial/ethnic disparities in sleep health among adolescents in South Korea: The role of substance use behaviours.

To examine the relationship between racial/ethnic disparities and substance use behaviours (alcohol and tobacco use) and their impact on the sleep health of South Korean adolescents. Secondary analysis of cross-sectional study data from the 2021 Korea Youth Risk Behaviour Web-based Survey dataset. Given that Korean society has historically linked its racial/ethnic identity to a shared bloodline, we categorized 2644 adolescents from the Korea Youth Risk Behaviour Web-based Survey based on their racial/ethnic status, determined by their parents' birthplaces. Using multiple linear regression, we investigated whether the impact of racial/ethnic disparities on sleep health (sleep duration, debt, and timing) varies depending on substance use behaviours (alcohol and tobacco use) after controlling for age, sex, household economic status, depressed mood, suicidal ideation, perceived excessive stress, and anxiety level. Despite no statistical differences in sleep health and the prevalence of substance use between racial/ethnic groups, racial/ethnic minority adolescents experienced greater sleep debt than racial/ethnic majority adolescents when consuming alcohol. Moreover, racial/ethnic minority adolescents were more likely to report psychosocial distress and had lower parental education level. Racial/ethnic minority adolescents were more vulnerable to the detrimental effects of alcohol use on sleep health compared to racial/ethnic majority adolescents. This heightened vulnerability may be attributed to the more pronounced psychosocial challenges and the lower socioeconomic status of parents in the racial/ethnic minority group. Racial/ethnic disparities are concerning in South Korea, particularly since the negative effects of substance use on sleep health are intensified among racial/ethnic minority adolescents. Nurses and other healthcare providers should recognize the importance of addressing the social disadvantages linked to racial/ethnic disparities. Beyond just advocating for the cessation of substance use, it is crucial to address these underlying issues to reduce sleep disparities among South Korean adolescents. No patient or public contribution.

Social and Behavioral Factors Related to Contraception in Korean Adolescents with Sexual Experience: Based on the 2018 and 2021 Korea Youth Risk Behavior Web-Based Survey

Social and Behavioral Factors Related to Contraception in Korean Adolescents with Sexual Experience: Based on the 2018 and 2021 Korea Youth Risk Behavior Web-Based Survey

The Mediating Effect of Depression on the Relationship between Loneliness and Substance Use in Korean Adolescents.

Substance use among adolescents is a major emerging health problem worldwide. Although loneliness and depression are major risk factors for substance use, few studies have examined the relationship between loneliness, depression, and substance use in adolescents. This study aimed to determine the mediating effect of depression on the relationship between loneliness and substance use among Korean adolescents, based on the data from 53,310 adolescents from the 17th Korea Youth Risk Behavior Web-based Survey in 2021. Using a complex sample analysis module, hierarchical logistic regression analysis was employed to confirm the mediating effect of depression on the relationship between loneliness and substance use. The results showed that loneliness and depression have a significant effect on substance use (smoking, drinking alcohol, and drug use). Depression was found to have a partial mediating effect on the relationship between loneliness and substance use. Overall, the results suggested that loneliness and depression in adolescents increase substance use, and loneliness can affect substance use through depression. Therefore, proactive strategies to prevent and reduce loneliness and depression in adolescents can be effective in preventing substance use.

Latent class analysis of health behaviors, anxiety, and suicidal behaviors among Korean adolescents

BackgroundThis study examined how health behavior patterns are associated with anxiety and suicidal behaviors among Korean adolescents. MethodsData were collected from a national cross-sectional sample of adolescents (n = 54,948, 51.5 % boys) in the 2020 Korea Youth Risk Behavior Web-based Survey. Latent class analysis was conducted based on 12 health behaviors (e.g., eating habits, physical activity, and substance use) using the R-based Jamovi 2.3.21 program. ResultsFour classes of health behaviors were identified: Class 1 (boys: 45.4 %, girls: 34.4 %) engaged in healthy behaviors; Class 2 (boys: 31.7 %; girls: 22.3 %) had unhealthy eating habits; Class 3 (boys: 18.0 %; girls: 39.9 %) had the lowest physical activity; and Class 4 (boys: 5.0 %, girls: 3.4 %) engaged in substance use, including smoking, drinking, and problematic smartphone use. Overall, girls had a higher odds ratio (OR) for anxiety and suicidal behaviors than boys did. Among girls, Class 4 had a higher OR for anxiety (OR = 2.78, 95 % confidence interval [CI] = 2.40–3.21), suicidal ideation (OR = 3.99, 95 % CI = 3.46–4.62), suicide plan (OR = 3.32, 95 % CI = 2.66–4.16), and suicide attempts (OR = 5.62, 95 % CI = 4.43–7.12) than Class 1. LimitationsThis study has a few limitations including the participants' response bias, the use of a self-report survey, and the lack of diagnosis by clinicians. ConclusionAdolescents engaging in substance abuse (Class 4) were more prone to anxiety symptoms and suicidal behaviors (ideation, plan, and attempts) than those engaged in healthy behaviors (Class 1). We suggest that more attention is needed to develop suicide prevention strategies that consider adolescent substance use patterns such as current smoking, drinking, and problematic smartphone use.

The Association between High-Caffeine Drink Consumption and Anxiety in Korean Adolescents.

As excessive caffeine intake may be associated with anxiety disorders, one of the most prevalent mental illnesses among adolescents globally, this study investigated the association between high caffeine consumption and anxiety in a nationally representative sample of South Korean adolescents. 46,873 participants from the Korea Youth Risk Behavior Web-based Survey (KYRBS) 2022 were included. The Generalized Anxiety Disorder-7 (GAD-7) questionnaire was used to evaluate anxiety symptoms. Survey questions determined the number of times each participant consumed high-caffeine drinks per week. The chi-square test was used to investigate and compare the general characteristics of the study population, and a modified Poisson regression was used to analyze the relationship. Both male and female participants reporting excessive high-caffeine drink consumption exhibited higher anxiety levels (adjusted prevalence ratio [aPR]: 1.19, 95% confidence interval [CI]: 1.08-1.31 in males; aPR: 1.14, CI: 1.05-1.23 in females). This association remained statistically significant in subgroup analyses, particularly among high school students and those with a shorter sleep duration. The relationship between high-caffeine drink consumption and anxiety strengthened with increasing anxiety levels. Additionally, there was a dose-dependent relationship between the prevalence of anxiety and high-caffeine drinks. High caffeine consumption increases anxiety in South Korean adolescents. This association proved consistent regardless of sex or other socioeconomic factors.

Associations between Physical Activity, Mental Health, and Suicidal Behavior in Korean Adolescents: Based on Data from 18th Korea Youth Risk Behavior Web-Based Survey (2022).

This study aims to identify the current status and relationship between physical activity (PA), mental health, and suicidal behavior among Korean adolescents and recommend appropriate PA types and levels to lower the risk of mental health problems and suicidal behavior among adolescents. This study used the frequency of participation, three mental health factors, and four suicidal behavior factors, according to the seven types of PA, Vigorous PA (VPA), Strength training, Walks, PA on the move, and Physical education questions that 51,636 Korean adolescents responded to in the data of the 18th Korean Youth Health Behavior Survey in 2022. The results showed that physical activity levels and the mental health of female adolescents were the lowest, and the experience rate of suicidal behavior was the highest. Physical activity level and mental health were negative in the upper grades, and the experience rate of suicidal behavior was higher in the lower grades. Thus, the study proposes the following: To lower the overall risk of mental health and suicidal behavior experienced by adolescents, it is effective to encourage them to participate in physical activities which have higher exercise intensities than the Low-level Physical Activity (LPA) type of Walks and PA on the move.

Machine Learning-Based Prediction of Suicidality in Adolescents With Allergic Rhinitis: Derivation and Validation in 2 Independent Nationwide Cohorts.

Given the additional risk of suicide-related behaviors in adolescents with allergic rhinitis (AR), it is important to use the growing field of machine learning (ML) to evaluate this risk. This study aims to evaluate the validity and usefulness of an ML model for predicting suicide risk in patients with AR. We used data from 2 independent survey studies, Korea Youth Risk Behavior Web-based Survey (KYRBS; n=299,468) for the original data set and Korea National Health and Nutrition Examination Survey (KNHANES; n=833) for the external validation data set, to predict suicide risks of AR in adolescents aged 13 to 18 years, with 3.45% (10,341/299,468) and 1.4% (12/833) of the patients attempting suicide in the KYRBS and KNHANES studies, respectively. The outcome of interest was the suicide attempt risks. We selected various ML-based models with hyperparameter tuning in the discovery and performed an area under the receiver operating characteristic curve (AUROC) analysis in the train, test, and external validation data. The study data set included 299,468 (KYRBS; original data set) and 833 (KNHANES; external validation data set) patients with AR recruited between 2005 and 2022. The best-performing ML model was the random forest model with a mean AUROC of 84.12% (95% CI 83.98%-84.27%) in the original data set. Applying this result to the external validation data set revealed the best performance among the models, with an AUROC of 89.87% (sensitivity 83.33%, specificity 82.58%, accuracy 82.59%, and balanced accuracy 82.96%). While looking at feature importance, the 5 most important features in predicting suicide attempts in adolescent patients with AR are depression, stress status, academic achievement, age, and alcohol consumption. This study emphasizes the potential of ML models in predicting suicide risks in patients with AR, encouraging further application of these models in other conditions to enhance adolescent health and decrease suicide rates.