Youth Risk Behavior Web-based Survey Research Articles

Changing Trends in School Absenteeism and Identification of Associated Factors in Adolescents with Atopic Dermatitis.

Atopic dermatitis (AD) has a negative influence on school attendance. We aimed to identify factors associated with school absenteeism in adolescents with AD. We used data from the 3rd to 11th annual Korean Youth Risk Behavior Web-based Survey completed from 2007 to 2015. Survey data were obtained from a stratified, multistage, clustered sample. Participants responded to the question "have you ever been diagnosed with AD?" Factors associated with AD-related school absenteeism (ADSA), which is defined as at least one school absence due to AD, were evaluated. Among the 141,899 subjects, the prevalence of AD increased (17.3% to 24.2%), while that of ADSA decreased (7.3% to 2.6%) from 2007 to 2015. Compared to adolescents without ADSA, those with ADSA were more likely to be male, middle school students, and have negative mental health states, including suicidality. In the multivariate logistic regression model, the association of sleep dissatisfaction and depression with ADSA was high (adjusted odds ratio, 6.12; 95% confidence intervals, 4.61-7.95; and 5.44; 5.23-5.67, respectively). The prevalence of ADSA has decreased despite an increase in the prevalence of AD in Korean adolescents; however, it is important for pediatricians to screen for factors associated with ADSA to improve school attendance in adolescents with AD.

Association between smartphone usage and health outcomes of adolescents: A propensity analysis using the Korea youth risk behavior survey.

We aimed to investigate the association between smartphone use and adverse behavioral health outcomes using nationwide Korea Youth Risk Behavior Web-based Survey data for 2017 and 2020. The 2020 data (N = 54,809) were used to analyze the relationships between daily smartphone usage time (non-user, 0-2 h [hour], 2-4 h, 4-6 h, 6-8 h, and > 8 h), and adverse health outcomes (stress, sleep, depression, suicide, substance use, and smartphone overdependence). A 1:1 propensity score matching (PSM) was used to control for confounding variables. A total of 40,998 adolescents with < 4 h/day and > 4 h/day of usage were included. Adolescents' mean smartphone usage time in 2020 increased compared to that in 2017 (weighted % of > 2 h/day; 64.3% vs. 85.7%). The curvilinear relationships between smartphone usage time and adverse health outcomes were prominent after > 4 h/day. Adolescents using smartphones 2-4 h/day showed no increased adverse health outcomes compared to non-users, except for smartphone overdependence. Using a smartphone > 4 h/day was significantly associated with stress perception (1.16; 1.11-1.22), suicidal ideation (1.22; 1.13-1.31), and substance use (alcohol, 1.66; 1.57-1.75) after PSM. Our study demonstrated the curvilinear relationship between smartphone usage time and adverse health outcomes in adolescents. Our findings can help establish smartphone usage guidelines for adolescents.

A Comparison of Changes in Health Behavior, Obesity, and Mental Health of Korean Adolescents Before and During the COVID-19 Pandemic: Online Cross-Sectional Study.

The health behavior and mental health problems of adolescents have shown a variety of changes due to the coronavirus disease-2019 (COVID-19) pandemic. This study compared health behavior, obesity, and mental health among Korean adolescents before and during the early COVID-19 pandemic. Population-based and cross-sectional data from the 2019 and 2020 Korea Youth Risk Behavior Web-Based Surveys were used. Data of 57,048 and 54,948 adolescents from the 2019 and 2020 surveys, respectively, were compared. Multiple logistic regression analysis was conducted to compare health behavior, obesity, and mental health before and during the COVID-19 pandemic. The adjusted odds ratio (aOR) of overweight, obesity, and body image perceived subjectively as fat, were higher in the 2020 sample compared to the 2019 sample. The aOR of the frequency (more than 3 times a week) of fast-food consumption was higher in 2020 than in 2019. However, the aOR of physical activity, alcohol use, and smoking experience were lower in 2020 than in 2019. In addition, during COVID-19, adolescents were less likely to have perceived severe stress, depressive moods, and suicidal ideation. Current evidence suggests the co-occurrence of positive and negative changes in health behavior, obesity, and mental health among Korean adolescents during the early COVID-19 pandemic. The results contribute insights for monitoring adolescents' health behavior and promoting their mental health during school shutdowns.

Poor sleep is associated with energy drinks consumption among Korean adolescents.

A growing number of Korean adolescents consume energy drinks, which may increase the risk of obesity, anxiety and insomnia. We examined whether poor sleep was associated with energy drink consumption among study participants. We used a cross-sectional design. The Korea Youth Risk Behavior Web-Based Survey data from 2019. To determine the association between sleep and energy drink consumption, we compared the independent variables for 50,455 adolescents in Korea (aged 14-19 years) using multivariate logistic regression and sensitivity analyses. In Korea, 69·5 % adolescents consumed energy drinks, 17·1 % slept for less than 5 h, 22·4 % slept for 5-6 h, 23·8 % slept for 6-7 h, 19·9 % slept for 7-8 h and 16·7 % slept for 8 h or more. Regarding sleep satisfaction, 21·0 % reported sufficient, 32·6 % reported just enough and 46·5 % reported insufficient. Regarding sleep duration, it was found that less than 5 h (OR, 2·36; 95 % CI (2·14, 2·60)) and lower sleep satisfaction (OR, 1·12; 95 % CI (1·03, 1·21)) were highly associated with energy drink consumption, with statistical significance at P < 0·05. Adolescents with lower sleep duration (adjusted OR (aOR), 6·37; 95 % CI (4·72, 8·61)) and a lack of sleep satisfaction (aOR, 1·44; 95 % CI (1·16, 1·78)) reported drinking a high amount of energy drinks, that is, at least once a day. In addition to efforts to decrease the amount of energy drinks consumed, sleep hygiene education needs to be strengthened.

Factors Related to Suicidal Ideation in Adolescents According to Types of Stress.

We aimed to identify the factors associated with suicidal ideation by classifying adolescents into three groups: no stress, interpersonal stress, as well as academic and career stress. Using the data from the 16th Korea Youth Risk Behavior Web-Based Survey (2020), 15,343 adolescents were included in the study, and their socio-demographic characteristics as well as physical and psychological factors were assessed. A complex sample logistic regression was performed to identify factors associated with suicide. The following factors were significantly associated with suicide: fatigue recovery by sleep, body mass index, physical activity, and depression in the no stress group; current school, academic grade, drinking, depression, loneliness, and anxiety in the interpersonal stress group; and gender, current school, academic grade, father's educational level, drinking, fatigue recovery by sleep, depression, loneliness, subjective health, smartphone overdependence, as well as anxiety in the academic and career stress group (P < 0.05). To prevent suicide among adolescents, it is necessary to consider these factors when developing educational policies.

Suicide risk among racial minority students in a monoethnic country: A study from South Korea: Suicide risk among racial minority students

BackgroundSuicide is one of the leading causes of death among adolescents. Students from intercultural families (ICFs) are hypothesized to be vulnerable to suicide. This study aimed to identify the current status of depression and suicide in students from ICFs and the risk of suicide according to family type. MethodsData from the Korea Youth Risk Behavior Web-based Survey (KYRBS) were used for this study. We selected 586,829 participants from 2011 to 2020. We analyzed the statistical differences between groups using the chi-square and Bonferroni tests. Last, multiple logistic regressions were performed. ResultsRegarding experiencing extreme sadness/desperation and suicidal ideation, the group with both parents born outside Korea had the highest rate (37.1 % and 24.7 %, respectively), followed by the father-only, non-ICF, and mother-only groups. The both-parents group had the highest risk for suicidal plan and attempts, and for suicidal attempts after hospital visits (17.2 %, 14.9 %, and 59.5 %, respectively), followed by the father-only, mother-only, and non-ICF groups. In particular, the both-parents group had 1.74, 3.40, 4.56, and 6.44 times higher odds for suicidal ideation, suicidal plan, and suicidal attempt, and hospital visit after suicidal attempt than the non-ICF group, respectively. ConclusionsICF students were more vulnerable to suicide than the non-ICF group, particularly the both-parents and father-only groups. Thus, adolescents from ICFs are a high-risk group for suicide and should be a top priority for intervention.

Water intake and oral disease symptoms in adolescents: a cross-sectional study conducted in Korea in 2021

Objectives: Water constitutes a majority of the human body and is essential for health. In addition, water intake can prevent dental caries by improving salivary lubrication and self-cleaning. This study aimed to determine the relationship between the amount of daily water intake and the symptoms of oral disease in Korean adolescents. Methods: We used data from the Korea Youth Risk Behavior Web-based Survey (KYRBS), conducted in Korea in 2021, and identified the relationship between daily water intake and oral disease symptoms in Korean adolescents. KYRBS is a nationwide cross-sectional survey conducted by the Korea Disease Control and Prevention Agency (KDCA), and a total of 54,848 participants were included in this study. Results: After adjusting for confounding factors, logistic regression analysis showed that tooth pain was more often experienced by those who drank less than two cups of water per day (odds ratio [OR]: 1.14; 95% confidence interval [CI]: 1.01–1.30) than those who drank five or more cups of water per day. Conclusions: A low daily water intake is associated with tooth pain, a symptom of dental caries. The results of our study suggest that increasing water intake may reduce dental caries. Therefore, adequate water intake may help prevent dental caries.

Mental health of South Korean adolescents in the COVID-19 Era: Web-based survey focused on suicide-related factors

BackgroundThe coronavirus disease 2019 (COVID-19) pandemic has negatively impacted many aspects of life. Measures for preventing the spread of COVID-19 (e.g., school lockdowns, remote and hybrid classes, group and outdoor activity restrictions, and social distancing in the classroom and meal time) could have led to adolescents to experience anxiety and depressive symptoms. Such mental health impacts could increase the risk of suicidal ideation in this population. Moreover, according to a report by the Organization for Economic Co-operation and Development, although the total number of suicide deaths in South Korea decreased in 2021, the suicide rate of those aged 10–29 years increased. One factor affecting the result is adolescent mental health by COVID-19. This study examines the mental health status of South Korean adolescents amid the prolonged COVID-19 pandemic, and identifies and analyzes predictors of suicidal ideation, suicide planning, and suicide attempts.MethodsThe study used data from 54,948 adolescents who participated in the 2020 Korea Youth Risk Behavior Web-based Survey. Based on their responses to suicide-related questions, the sample was divided into a healthy group, suicide-ideation group, suicide-planning group, and suicide-attempt group. The descriptive statistics of these groups were then analyzed. An analysis of covariance, post-hoc tests, and multiple logistic regression analysis were performed on the four groups.ResultsOverall, 6.9% of the participants reported suicidal ideation, 2.2% reported planning suicide, and 1.9% reported attempting suicide in the previous 12 months.ConclusionsDuring the prolonged COVID-19 pandemic, there is a strong need for various individualized programs that identify and intervene to support adolescents at risk of suicide by accurately assessing their mental health risk factors, such as stress, sadness and despair, loneliness, and generalized anxiety disorder. Accordingly, it is necessary to develop and distribute a mental health and well-being curriculum, strengthen suicide prevention programs and support services, expand mental health diagnostic tests, and school-based mental health programs.

Association between allergic rhinitis and despair, suicidal ideation, and suicide attempts in Korean adolescents: a nationally representative study of one million adolescents.

There is a lack of studies establishing the association between allergic rhinitis (AR) and despair, suicidal thinking, and suicide attempts in adolescents and children at a population level. This study aimed to investigate whether there are associations between allergic rhinitis and despair, suicidal thinking, and suicide attempts. The study utilized data from middle through high school adolescents from 2005-2021 who enrolled in the Korea Youth Risk Behavior Web-based Survey (KYRBS; 1,067,169). We assessed despair, suicidal thinking, and suicide attempts in the context of both non-atopic and atopic AR. Multivariable analysis was used to determine the association of variables. The prevalence of allergic rhinitis was 28.0%. 1,067,169 enrolled participants were included in the final analysis. There were 299,468 individuals with allergic rhinitis and 767,701 without. In the context of AR, adolescents were more likely to have despair [adjusted odds ratio (aOR), 1.16; 95% CI, 1.15-1.17], suicidal thoughts (aOR, 1.12; 95% CI, 1.11-1.13 for model 2), and suicide attempts (aOR, 1.13; 95% CI, 1.10-1.15 for model 2). Individuals with atopic AR were more likely in almost all measures to have despair, suicidal thinking, and suicide attempts than individuals with non-atopic AR. Females with AR were more likely to have suicide attempts and middle school students were more likely to have despair, suicidal thoughts, and suicide attempts. The results of this study warrant future studies investigating why AR is so closely associated with despair, suicidal ideation, and suicide attempts, with the goal of establishing suicide prevention strategies as well as improving overall mental health for adolescents.

4.11 Multiple Risk-Taking Behaviors in Korean Adolescents and Associated Factors: 2020 and 2021 Korea Youth Risk Behavior Web-Based Survey

4.11 Multiple Risk-Taking Behaviors in Korean Adolescents and Associated Factors: 2020 and 2021 Korea Youth Risk Behavior Web-Based Survey

Problematic Smartphone Use and Its Relationship With Anxiety and Suicidal Ideation Among South Korean Adolescents.

This study aimed to investigate the prevalence of problematic smartphone use (PSU) among adolescents and its association with anxiety and suicidal ideation. The 16th cross-sectional, population-based Korea Youth Risk Behavior Web-Based Survey was administered in 2020 and included 54,948 adolescents. We used the Korean version of the smartphone overdependence scale and the 7-item Generalized Anxiety Disorder scale to assess PSU and anxiety. Suicidal ideation was assessed through responses to the self-report question. Multiple logistic regression analyses with complex sampling were conducted to identify the association of PSU with anxiety and suicidal ideation. In total, 25.1% of the adolescents reported PSU, 33.2% had anxiety symptoms, and 10.9% had seriously considered suicide during the past 12 months. Girls with PSU had a higher risk of anxiety (adjusted odds ratio [aOR], 2.81; 95% confidence interval [CI], 2.65 to 2.97) and suicidal ideation (aOR, 1.77; 95% CI, 1.64 to 1.91) than non-PSU girls. Boys with PSU reported more anxiety (aOR, 2.89; 95% CI, 2.72 to 3.07) and suicidal ideation (aOR, 1.82; 95% CI, 1.66 to 1.99) than the non-PSU group. In addition, girls with the lowest household income reported more suicidal ideation than girls with the highest household income (aOR, 3.40; 95% CI, 2.69 to 4.28). This study demonstrated the prevalence of PSU among South Korean adolescents in 2020. The prioritization of the detection of PSU and the identification of psychological factors may help improve the diagnosis and management of mental health problems and potentially yield significant psychosocial benefits.

Association between anti-smoking campaign types and smoking cessation attempts

ObjectiveThis study explored the association between anti-smoking campaign types and smoking cessation attempts. MethodsThis study included 4,594 individuals (3,292 male and 1,302 female) from the Korea Youth Risk Behavior Web-based Survey (KYRBWS) in 2018 and 2020. The methods of anti-smoking promotion were divided into online, offline, online and offline, and none. Attempts to quit smoking were classified as yes or no. Multiple logistic regression was performed to examine the association between antismoking campaign type and smoking cessation attempts. ResultsThose who saw anti-smoking advertisements both online and offline were found to have tried to quit smoking more than those who did not. (Online & offline: male, odds ratio [OR] 1.36; 95% confidence interval [95% CI], 1.08–1.71; female, OR, 1.75; 95% CI 1.21–2.54) In a subgroup analysis of the independent variables into which smoking cessation advertisements were subdivided, males were found to have the highest OR for smoking cessation attempts when they encountered advertisements in newspapers. (Newspaper: male, OR, 2.25; 95% CI, 1.00–5.02) Females had the highest OR for smoking cessation attempts when accessed via the Internet. (Internet: female, OR, 1.93; 95% CI, 1.07–3.50). ConclusionThis study showed that there is a correlation between smoking cessation advertisements and adolescents' smoking cessation attempts. The possibility of smoking cessation attempts is high when encountering smoking cessation advertisements both online and offline. Although offline smoking cessation advertisements have a great effect on adolescents’ smoking cessation attempts, it can be confirmed that the frequency of exposure for offline advertisements is less than that for online advertisements.

Impact of emotional state and suicidal intentions on suicide attempts among Korean adolescents with household financial difficulties following the outbreak of COVID-19: A cross-sectional study.

The recent prolonged coronavirus disease-2019 pandemic has brought an economic crisis to various households, leading to negative mental health such as depression, anxiety, traumatic distress, and suicide risk among adolescents. Adolescents with household financial difficulties due to the coronavirus disease-2019 pandemic show high suicidal tendencies and attempts such as suicidal ideation and plans, their suicidal ideation and plans increase the risk of suicide attempts in South Korea. The purpose of this study was to determine the effects of emotional state and suicidal tendencies on suicide attempts among adolescents with household financial difficulties in early pandemic. This was a secondary data analysis study using statistical data from the 16th (2020) Korea Youth Risk Behavior Web-based Survey. Among 54,948 who participated in the survey, 16,839 (30.6%) adolescents who had household financial difficulties were included in final analysis. Descriptive statistics, chi-squared test, and logistic regression analysis were conducted to analyze data. The strengthening the reporting of observational studies in epidemiology checklist was used for reporting this study. 16,839 adolescents (mean age 15.68 ± 1.76 years; 8709, 51.7% male) who experienced household financial difficulties in the prior year revealed 3 percent (508) had attempted suicide. Suicide attempts differed according to several characteristics and were significantly associated with sex, residence type, drinking experience, depressive mood, perceived happiness, suicidal ideation, and suicide planning. The findings indicate high-risk adolescents with household financial difficulties need a multi-dimensional safety network, suicide screening, and emotional interventions during the pandemic.

Association between Problematic Smartphone Use and Physical Activity among Adolescents: A Path Analysis Based on the 2020 Korea Youth Risk Behavior Web-Based Survey.

Physical activity is known to prevent several diseases and positively affect mental health. Previous studies have shown that smartphone addiction negatively affects the physical activity of children and adolescents. This study aimed to investigate the relationship between problematic smartphone use and physical activity among adolescents and the related factors using path analysis. Using data from the 16th Youth Risk Behavior Web-based Survey from 2020, scores on the Smartphone Addiction Scale-Short Version for Adolescents, physical activity, sex, socioeconomic status (SES), academic performance, depression, smoking, drinking, and sitting time were assessed. Complex sampling and path analyses were performed. Of the total 54,948 students, 25.5% were smartphone risk users, including potential and high-risk users. The direct path coefficients of each factor indicated that female sex (-0.14 for male), low SES (-0.062), high academic performance (0.056), low sitting time for studying purposes (-0.033), high sitting time for non-studying purposes (0.071), and depressive mood (0.130) were related to problematic smartphone use (all P<0.001). Each factor affected problematic smartphone use, and subsequently had a negative effect on the amount of physical activity, with a direct path coefficient of -0.115 (P<0.001). In this study, we confirmed that problematic smartphone use among adolescents was negatively associated with performing an adequate amount of physical activity and that various factors, such as sex, SES, academic performance, and sitting time, directly and indirectly affected this relationship.

한국 청소년의 인터넷 사용 수준이 건강상태(BMI)에 미치는 영향

Objectives The purposes of this study were to investigate the socio-demographics, health and dietary factors, and health status (BMI) of Korean adolescents according to their internet usage level, using data from the 2019 Korea Youth Risk Behavior Web-Based Survey. Additionally, the study aimed to examine the relationship between internet usage level and the risk of obesity.&#x0D; Methods For this purpose, the raw data from the 2019 KYRBS was analyzed, and a total of 57,302 individuals were selected as the study subjects. To analyze the differences in socio-demographics, health and dietary factors, and health status (BMI) according to the level of internet usage, Rao-Scott χ2 test was used, and logistic regression analysis was used to calculate the odds ratios (OR) and 95% confidence intervals (95% CI) for the risk of obesity according to internet usage level.&#x0D; Results This study found that adolescents who overused the internet were more likely to be female, middle school students, and have lower parental education and economic status. They also showed unhealthy dietary and lifestyle behaviors, including high alcohol consumption, low physical activity, irregular breakfast, inadequate fruit and vegetable intake, inadequate milk and water intake, excessive consumption of sugary drinks and fast food, and rely on convenience food instead of regular meals. They had a higher risk of obesity compared to non-internet users.&#x0D; Conclusions This study was able to explain the association between internet usage level and obesity, and found that the group that overused the internet had a higher risk of obesity compared to the group that non-internet users.

Health-Related Behavior and Psychosocial Characteristics of Adolescent Female Smokers in Korea, Compared with Adolescent Male Smokers.

This study aimed to investigate the relationship between health-related behavior and psychosocial characteristics among adolescent female smokers in South Korea using data from the 17th Korea Youth Risk Behavior Web-based Survey (KYRBWS) conducted in 2021. The analysis participants comprised 2407 adolescent smokers who were currently smoking, out of a sample of 54,835 participants. The characteristics of adolescent female smokers were examined by comparing them with those of adolescent male smokers. The results showed that male and female adolescent smokers accounted for 69.2% and 30.8% of the sample, respectively. Multiple logistic regression analysis identified school type, subjective socioeconomic status, physical activity, breakfast consumption, alcohol consumption, sexual experience, stress, generalized anxiety, and suicidal ideation as significant factors associated with adolescent female smokers. These findings provide important foundational data for the development of smoking-cessation programs and policies tailored specifically to adolescent female smokers.

Association between COVID-19 lockdown and sleep behaviors in Korean adolescents.

To find the effect of coronavirus disease 2019 (COVID-19)-related sleep behavior changes using school-based self-reported data from a nationally representative Korean adolescent population. We analyzed web-based self-reported data from the Korean Youth Risk Behavior Web-based Survey in 98,126 participants (51,651 in 2019 [before the COVID-19 pandemic]; 46,475 in 2020 [during COVID-19 pandemic] 12 through 18 years old were included in this study. Self-report questionnaires were used to assess socioeconomic status, health behaviors, psychological factors, and sleep patterns. During the COVID-19 pandemic, Korean adolescents had a later weekend bedtime (≥1:00 am: 68.2% vs 71.5%, P < .001) and late weekend wake time (≤7:00 am: 13.3% vs 10.7%, P < .001) compared to before COVID-19 pandemic. Average sleep duration (434.7 ± 102.6 vs 428.2 ± 100.4 minutes; P < .001) was significantly lower during the COVID-19 pandemic and weekend catch-up sleep >2 hours (42.1% vs 43.7%; P < .001), late chronotype (17.1% vs 22.9%, P < .001) were significantly higher during COVID-19 pandemic. After adjusting for multiple confounding variables, short sleep duration (≦5 hours, odds ratio [OR] 1.14; 95% confidence interval [CI] 1.10-1.19), 6 hours, OR 1.07; 95% CI 1.03-1.12), long weekend catch-up sleep (OR, 1.08; 95% CI, 1.06-1.11) and late chronotype (OR, 1.43; 95% CI, 1.38-1.47) were significantly associated with COVID-19 pandemic. The COVID-19 pandemic was associated with changes in sleep behavior among Korean adolescents, resulting in later bed and wake-up times, increased weekend catch-up sleep, and a shift of chronotype toward eveningness.

National Trends in Sadness, Suicidality, and COVID-19 Pandemic–Related Risk Factors Among South Korean Adolescents From 2005 to 2021

Despite the COVID-19 pandemic's effect on daily life, limited research exists on the prevalence and risk factors of suicidality and sadness among South Korean adolescents. To examine whether the observed sadness and suicidality in the early to middle periods of the COVID-19 pandemic differed from the expected level and to investigate changes in risk factors for sadness and suicidality. This nationwide serial cross-sectional survey study used data on 1 109 776 Korean adolescents aged 13 to 18 years from the Korea Youth Risk Behavior Web-based Survey from 2005 to 2021. The COVID-19 pandemic. The pattern of changes in the percentage or proportion of sadness or suicidality, as well as the risk factors for sadness or suicidality. The transitional effect of the COVID-19 pandemic was assessed using weighted odds ratios (wORs) or weighted beta coefficients with 95% CIs. Between 2005 and 2021, 1 109 776 adolescents (mean [SD] age, 15.0 [1.7] years; 51.5% male adolescents; and 51.7% in grades 7-9 and 48.3% in grades 10-12) were included in the Korea Youth Risk Behavior Web-based Survey. The slope of the long-term trends in sadness and suicidality decreased in the prepandemic period (sadness: from 37.8% [95% CI, 37.4%-38.2%] in 2005-2007 to 26.1% [95% CI, 25.9%-26.4%] in 2016-2019; suicidality: from 23.0% [95% CI, 22.7%-23.3%] in 2005-2007 to 12.3% [95% CI, 12.1%-12.5%] in 2016-2019), whereas the slope increased during the COVID-19 pandemic (sadness: from 25.0% [95% CI, 24.5%-25.6%] in 2020 to 26.6% [95% CI, 26.1%-27.1%] in 2021; trend difference in β, 0.249 [95% CI, 0.236-0.262]; suicidality: from 10.7% [95% CI, 10.3%-11.1%] in 2020 to 12.5% [95% CI, 12.1%-12.9%] in 2021; trend difference in β, 0.328 [95% CI, 0.312-0.344]). The trends presented a similar tendency in the subgroups according to sex, school grade, residential area, smoking status, and current alcohol use. Compared with the prepandemic period, the risk factors associated with sadness during the pandemic were younger age (wOR, 0.907; 95% CI, 0.881-0.933), female sex (wOR, 1.031; 95% CI, 1.001-1.062), urban residence (wOR, 1.120; 95% CI, 1.087-1.153), current smoking status (wOR, 1.134; 95% CI, 1.059-1.216), and current alcohol use (wOR, 1.051; 95% CI, 1.002-1.102). Female sex (wOR, 1.064; 95% CI, 1.021-1.109), urban residence (wOR, 1.117; 95% CI, 1.074-1.162), and low economic status (wOR, 1.286; 95% CI, 1.180-1.403) were the risk factors significantly associated with suicidality after the COVID-19 pandemic began. In this nationwide serial cross-sectional survey study of South Korean adolescents, the slope of the prevalence of sadness and suicidality increased during the COVID-19 pandemic after a decrease prior to the pandemic. The findings suggest that public health measures are needed to recognize vulnerable groups with risk factors and to prevent an increase in sadness and suicidality among adolescents during the COVID-19 pandemic.

A Study on the Factors Influencing Smoking in Multicultural Youths in Korea.

Based on the ecological integration model, this study examined the factors affecting smoking in adolescents from multicultural families by dividing them into two levels: microsystem and social network factors. The data were from the Korea Youth Risk Behavior Web-Based Survey (KYRBS) from 2016 to 2020. It included 4577 respondents whose fathers, mothers, or both, were not born in Korea. The factors affecting smoking among multicultural teenagers were determined by a composite-sample multiple logistic regression analysis. Male smoking rates among multicultural adolescents were 2.49 times higher than female rates in the microsystem. When the father was "Korean" rather than a "Foreigner", smoking was 0.55 times lower in family factors in terms of social network. In social factors of social networks, multicultural adolescents' smoking was 12.02 times greater when they were drinking than when they were not, and 3.62 times higher when the answer to the question of whether they had experienced violence was "yes" than "no." Based on the ecological model in this study, social factors such as drinking, and violence were highly related to smoking. Since multicultural adolescents were closely influenced by the surrounding environment, such as family, school, and social relationship, it was necessary to let parents and schoolteachers be involved in the intervention of smoking of multicultural adolescents so that they can help multicultural adolescents adjust better to school and perform better academically while decreasing risky behaviors for their health, such as drinking and, ultimately, smoking.

Difference in Sugar-Sweetened Beverage Consumption before and during the COVID-19 Pandemic among Korean Adolescents

BackgroundPrevious studies have identified various factors associated with sugar-sweetened beverage (SSB) consumption among children and adolescents. Recent studies attempted to analyze changes in SSB consumption of adolescents during the COVID-19 pandemic and showed conflicting results. ObjectivesThis study aimed to estimate the difference in SSB consumption before (2018–2019) and during (2020–2021) the COVID-19 pandemic among Korean adolescents. MethodsThe study population consisted of students (n = 227,139) aged 12–18 y from the Korean Youth Risk Behavior Web-based Survey (KYRBWS). Data collection was done between 2018 and 2021. The primary outcome was the difference in the SSB consumption status (none/<7 times/wk, ≥7 times/wk) before and during the COVID-19 pandemic. Multinomial logistic regression was used to examine the association. Additional analysises were also conducted by gender, school grades, household income, grade point average, region, household members, fast-food intake, and fruit intake. ResultsThe COVID-19 pandemic was associated with a decrease in adolescents’ SSB intake. [(<7 times/wk) 2019: 59.4, 2020: 58.8, (≥7 times/wk) 2019: 35.3, 2020: 33.4]. ConclusionsThe study found a difference in SSB consumption among Korean adolescents between before and during the COVID-19 pandemic. These findings are noteworthy considering the importance of continuous care in managing SSB intake.