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PubMed1998

Health risk behaviors of rural sixth graders.

The purposes of this study were to examine the frequency and risk factors (correlates) of single and concurrent health risk behaviors (HRBs) including obesity, physical inactivity, smoking, and alcohol use in a sample of 352 rural, predominately African-American sixth graders. This study was guided by Jessor's (1992) adolescent risk behavior conceptual framework. Data were collected using physical measures and a self-report questionnaire. Thirty-two percent of the sample had no HRB, 44% had one HRB, and 24% had two or more HRBs. Obesity and physical inactivity were more prevalent in this sample than in the general population. Gender differences in risk factors were evident. Our findings suggest the testing of interventions that focus on the social needs of girls and that influence behavioral modeling for boys to reduce single and concurrent health risk behaviors.

Adolescent↗
PubMed1996

Covariations of unhealthy weight loss behaviors and other high-risk behaviors among adolescents.

OBJECTIVES: To determine if unhealthy weight loss methods are associated with other health-compromising behaviors among adolescents and to examine covariation patterns across gender and age groups. STUDY DESIGN AND PARTICIPANTS: The study sample was drawn from a larger population of 123 132 adolescents in the 6th, 9th, and 12th grades in Minnesota who completed a statewide school-based survey. The index group included all adolescents who used unhealthy weight loss methods (n=4514), and the comparison group comprised a random sample of 4514 adolescents who did not use these methods and who were matched for gender, ethnicity, and grade. MAIN OUTCOME MEASURES: Unhealthy weight loss methods included vomiting and use of laxatives, diuretics, and diet pills. Other health-compromising behaviors that were assessed included suicide attempts; delinquency; tobacco, alcohol, and marijuana use; unprotected sexual intercourse; and multiple sexual partners. RESULTS: Adolescents who used unhealthy weight loss methods were more likely to engage in other health-compromising behaviors. Odds ratios ranged from 1.9 to 14.8, and odds ratios were all highly significant among boys and girls in early, middle, and late adolescence. Among the girls, a monotonic decrease in the strength of all associations was found with increased age. CONCLUSIONS: Adolescents who engage in unhealthy weight loss methods are more likely to engage in a range of other health-compromising behaviors. Different perceptions of unhealthy weight loss behaviors (eg, normative vs problematic) may in part explain the differences in the strengths of associations between different grade and gender groups. Our results suggest that screening and counseling of adolescents who engage in unhealthy weight loss methods should be comprehensive and intervention programs aimed at the secondary prevention of disordered eating need to address other problematic behaviors.

Adolescent↗
PubMed2003

Prevalence and correlates of asthma in the Puerto Rican population: Behavioral Risk Factor Surveillance System, 2000.

The 2000 Behavioral Risk Factor Surveillance System (BRFSS) showed that Puerto Rico had the highest self-reported prevalence of asthma. Our objective was to estimate the self-reported prevalence of asthma among different population subgroups and determine its correlates in Puerto Rican adults as reported by the BRFSS. The BRFSS data gathered during 2000 were analyzed. To determine factors associated with self-reported prevalence of asthma, a simple unconditional logistic regression model was employed; then, to estimate adjusted weighted prevalence odds ratios, a multiple unconditional logistic regression model was used. The self-reported weighted prevalence of ever having asthma among Puerto Rican adults was 15.9% (14.8%-16.9%). Asthma prevalence was significantly higher in the following population subgroups: females (18.8%), educational attainment > 12 years (18.4%), having health coverage (16.3%), and obesity (21.0%). Asthma prevalence did not differ among age groups, region of residence, annual income, smoking at least 100 cigarettes in entire life, and physical activity. Almost half (45.6%) of asthmatics reported having children affected with the condition. The prevalence of asthma in any children of the interviewed was 33.2%, 51.3% were receiving treatment, and 30.6% and 24.3% reported having one to three visits to emergency departments and hospital admissions, respectively, resulting from asthma last year. Based on the logistic regression model, the following factors were significantly associated with asthma: sex, high educational attainment, health coverage and obesity. Consistent with previous studies in Puerto Ricans living in the mainland, a higher than expected prevalence of asthma was observed. The possibility of a genetic-environment interaction deserves further investigation.

Adolescent↗
PubMed2004

Religious activity and risk behavior among African American adolescents: concurrent and developmental effects.

This study examines how religious activity is associated with risk behaviors, concurrently and developmentally among urban African American adolescents. Seven hundred and five African American youths were interviewed annually during high school. Retention rates for the study exceeded 90%. Frequency of religious activity, sexual intercourse, and alcohol, cigarette, and marijuana use were assessed at each wave. Growth curve analyses found negative concurrent associations between religious activity and each of the four risk behaviors. The developmental effects of religious activity varied by gender. Higher levels of religious activity in 9th grade predicted smaller increases in marijuana use among males and cigarette use among females. In addition, larger decreases in religious activity during high school were associated with greater increases in alcohol use among males and sexual intercourse among females. During high school, religious activity limits the development of certain types of risk behavior among African American youth, even after controlling for reciprocal effects.

Adolescent↗
PubMed2004

[Epidemiologic study of the psychological health and risk behaviors of medical students].

INTRODUCTION AND AIMS: In the present study the authors conducted a cross sectional study of fourth-year (eighth-semester) students at Semmelweis University, to assess their stress-related complaints, and also some of the more common forms of risk behavior, including smoking, regular alcohol consumption, past or current drug use and the regular use of pharmaceuticals. METHODS: A total of 410 students were evaluated; 263 medical students, 96 pharmaceutical students and 78 dentistry students. An adapted version of Anderson's questionnaire was used for the evaluation of the total burden of stress based on emotional, physical and work-related complaints. Respondents who mentioned more than three signs of increased stress involving any of the above three categories (emotional, physical and work-related) were designated "high risk" subjects. RESULTS: The overall prevalence of "high risk" subjects was 30.5% (29.7% in medical, 38.5% in pharmaceutical and 23.1% in dentistry students) with no significant gender differences. 55.2% of "high risk" subjects had over three complaints in only one category, 32.6% in two categories, and 12.2% in all three categories. 43.6% of the subjects experienced work-related complaints, 33.3% of them had emotional and 23.1% had physical complaints. The overall prevalence of various forms of risk behavior was found to be 19.3% for smoking (25.2% in males and 15% in females), 30.2% for regular alcohol intake (47.1 in males and 18.3% in females), 25.4% for the regular use of some kind of medication (14.7% in males and 33.0% in females) and 24.9% for those who admitted to previous drug-use (37.6% in males and 16.3% in females). CONCLUSION: All forms of risk behavior were more common in the "high risk" group, but only smoking and the regular use of medication were increased significantly. There were no differences in risk behavior prevalence with regards to a particular category of complaints.

Adult↗
PubMed2001

Early initiation of sex, drug-related risk behaviors, and sensation-seeking among urban, low-income African-American adolescents.

The purpose of this study was to examine the relationship of early initiation of sex, drug-use, drug-trafficking, and sensation-seeking among urban, African-American adolescents. A longitudinal follow-up of 383 youth ages 9 to 15 years at baseline over four years with serial risk-assessments was used. Sexual experience and several drug-related risk behaviors increased significantly during the four-year study interval. Sensation-seeking scores were higher after the baseline assessment among youth reporting tobacco, alcohol, and marijuana use and were higher, both at baseline and through several follow-up assessments, among youth reporting drug-selling and sexual activity. At baseline, the correlations among drug-related risk behaviors were all strong, except those between initiation of sex and drug-related risk behaviors. However, over time, early initiators of sex were significantly more likely to report involvement in substance use and drug-delivery/sales than were late initiators. Youth reporting repeated involvement in drug-related activities were more likely to report intensive sexual involvement than they were to report experimental sex or no sex. Sensation-seeking scores were lower among youth reporting no involvement in risk behaviors. However, scores did not differ between youth exhibiting experimental behavior compared to youth demonstrating repeated risk involvement. These results support the need for alternative experiences for youth exhibiting high levels of sensation-seeking and the need for early drug/sexual risk prevention programs.

Adolescent↗
PubMed2007

Predictors of discordant reports of sexual and HIV/sexually transmitted infection risk behaviors among heterosexual couples.

OBJECTIVES: Assessments undertaken as part of couple-based HIV/sexually transmitted infection (STI) prevention intervention studies offer opportunities to expand our understanding of couple reporting of sexual and HIV/STI risk behavior. Increases in heterosexual transmission of HIV worldwide support more attention on the quality and use of couple-level sexual risk assessment. STUDY DESIGN: This study examined interpartner concordance of self-reported sexual behaviors and HIV/STI risk behaviors among 217 women and their main male sexual partners at high risk for HIV/STI transmission and further explored specific individual and relationship characteristics by partner gender associated with discordant reporting of sexual and HIV/STI risk behaviors. RESULTS: Consistent with prior studies, findings suggest fair to substantial agreement between partners on reports of most sexual and HIV/STI risk behavior, but only poor to fair agreement on reports of concurrent sexual behaviors and drug or alcohol use. Factors significantly associated with discordant reporting of sexual behaviors included length of couple relationship, level of relationship satisfaction, female partner's marital status, and male partner's HIV status, ethnicity, and age. CONCLUSIONS: Individual- and relationship-level factors predicting discordant partner reports of sexual and sexual risk behaviors highlight an opportunity to improve couple assessment by anticipating such discrepancies and developing effective mechanisms of quality assurance to avoid, address, or better explain such discordance in couple data sets.

Adult↗
PubMed2003

Public health surveillance for disease prevention: lessons from the behavioral risk factor surveillance system.

The burden of chronic diseases is increasing worldwide. Surveillance of behavioral risk factors is a crucial element for prevention and control of chronic diseases. Adequate surveillance data will provide the basis for developing and implementing appropriate preventive programs at the local and country level. A standardized surveillance system worldwide will allow data comparability, and will decrease the cost of the surveillance system. By using lessons from the Behavioral Risk Factor Surveillance System, a large, ongoing, state-based surveillance system in the United States, countries may save limited resources, and expedite the initiation of their own surveillance systems. To prevent cardiovascular diseases worldwide, it is time to develop and implement appropriate surveillance systems at a country level, in order to track risk factors. This strategy will provide the basis for developing intervention programs designed to reduce, or prevent a further increase in, the burden of chronic diseases.

Behavioral Risk Factor Surveillance System↗
PubMed2002

Association of adolescents' history of sexually transmitted disease (STD) and their current high-risk behavior and STD status: a case for intensifying clinic-based prevention efforts.

BACKGROUND: Adolescents are at high risk of sexually transmitted disease (STD)/HIV infection, and one vulnerable subgroup is African American females. The association between adolescents' previous experience of STD and recent sexual risk behaviors has been ill-defined. GOAL: The goal was to examine the associations between adolescents' self-reported history of STD diagnosis and current sexual risk behaviors, prevention knowledge and attitudes, and STD infection status. STUDY DESIGN: This was a cross-sectional survey. Recruitment sites were in low-income neighborhoods of Birmingham, Alabama, characterized by high rates of unemployment, substance abuse, violence, and STDs. Participants were sexually active adolescent females (N = 522) 14 to 18 years of age. Information on STD history and current sexual behaviors (within the 30 days before assessment) was collected in face-to-face interviews. Less sensitive topics, such as STD prevention knowledge, attitudes about condom use, and perceived barriers to condom use, were addressed via self-administered survey. DNA amplification of vaginal swab specimens provided by the adolescents was performed to determine current STD status. Outcomes associated with past STD diagnosis were determined by means of logistic regression to calculate adjusted odds ratios (AORs) in the presence of observed covariates. RESULTS: Twenty-six percent of adolescents reported ever having an STD diagnosed. Although past STD diagnosis was associated with increased STD prevention knowledge, it was not associated with increased motivation to use condoms. Compared with adolescents who had never had an STD, adolescents with a history of diagnosed STD were more likely to report not using a condom at most recent intercourse (AOR = 2.54; 95% CI = 1.64-3.93; = 0.0001), recent unprotected vaginal intercourse (AOR = 1.79; 95% CI = 1.15-2.79; = 0.010), inconsistent condom use (AOR = 2.27; 95% CI = 1.46-3.51; < .0001), sexual intercourse while drinking alcohol (AOR = 2.09; 95% CI = 1.33-3.28; = 0.001), and unprotected intercourse with multiple partners (AOR = 3.29; 95% CI = 1.09-9.89; = 0.034). Past STD diagnosis was associated with increased risk for current biologically confirmed gonorrhea and trichomoniasis (AOR = 2.48; 95% CI = 1.09-5.23; = 0.030; and AOR = 2.05; 95% CI = 1.18-3.59; = 0.011, respectively). Past STD diagnosis was not significantly associated with increased risk of current biologically confirmed chlamydia (AOR = 0.78; 95% CI = 0.45-1.37; = 0.38). CONCLUSION: Among this sample of female adolescents, past STD diagnosis was an indicator of current high-risk sexual activity and increased risk for two common STDs: gonorrhea and trichomoniasis. Although adolescents may gain factual knowledge from the experience of having an STD diagnosed, they are not applying that knowledge to their current sexual behaviors. Thus, these adolescents remain at risk for subsequent STD infection. Therefore, the findings suggest that there is a need to intensify clinic-based prevention efforts directed toward adolescents with a history of STDs, as a strategy for reducing STD-associated risk behaviors and, consequently, the likelihood of new STD infections.

Adolescent↗
PubMed1998

Developing and conducting a health risk behavior survey among school-aged students.

PURPOSE: To conduct a survey in the school setting which inquires about health risk behaviors among students in grades 7-12. METHOD: The survey was designed by the National Centers for Disease Control and Prevention (CDC), in conjunction with many federal and state agencies, to monitor behaviors in the following six areas: unintentional and intentional injuries, tobacco use, alcohol and drug use, sexual behaviors, dietary behaviors, and physical activity. Surveys are administered at the national and state levels and can be optionally administered by local school districts. The standard survey instrument allows for comparisons of national, state, and, where appropriate, local data. Computer software allows for the selection of a random sample and when a sufficient response rate is achieved, survey results can be generalized to the entire sampling frame. Standard software packages can be used for analysis of the data. RESULTS: The Youth Risk Behavior Survey developed by the CDC provides a useful and practical tool to monitor health risk behaviors in adolescent populations. This type of instrument may prove useful to public health professionals in other countries.

Adolescent↗
PubMed1999

Health concerns and risk behaviors of rural adolescents.

Although much has been written about the health status of adolescents, little is known about adolescents' perception of their own health. The purpose of this article is to describe the health concerns of rural adolescents. Two national studies, the Youth Risk Behavior Survey and the National Longitudinal Study of Adolescent Health (Add Health Project), are used as comparisons. Data from the rural survey represent 624 community adolescents attending 4 rural Pennsylvania schools. The students were in the 9th, 10th, and 11th grades. The Adolescent Health Inventory was used to report concerns related to general health, psychosocial issues, and risk behaviors. Overall, rural adolescents in the study reported an average of 6.5 (SD = 3.2) health concerns with frequencies of occurrence being always or often and reported an average involvement in 1 (SD = 1.3) risk behavior. Psychosocial issues were reported by 28%, and 23% worried about their general health. Frequently reported risk behaviors included alcohol use, drug use, and a lack of exercise. There was minimal concern expressed regarding venereal disease or AIDS, whereas 12% expressed concern about the possibility of pregnancy. These results suggest the likelihood that adolescents perceive health from a holistic perspective and that health promotion programs should consider involving adolescents in planning, both (a) to ensure congruence of the plan of care with adolescents' concerns and (b) to clarify the interpretation and meaning of their concerns. We present implications for the community health nurse.

Adolescent↗
PubMed1997

Conduct disorder and HIV risk behaviors among runaway and homeless adolescents.

This study was designed to assess the prevalence of conduct disorder (CD) among runaway and homeless adolescents and to investigate associations between CD and HIV risk behaviors. The Diagnostic Interview Schedule for Children and a standardized HIV risk assessment questionnaire were administered to 219 runaway and homeless adolescents recruited from a drop-in center serving high-risk youth. One-half of the males and 60% of the females were diagnosed with CD. In multivariate analyses, CD was the strongest predictor of lifetime use of heroin and/or cocaine and exchanging sex for money, drugs, food or shelter, as well as the number of drugs used and the number of sex partners in the 3 months preceding the interview. The high rate of CD in this population, and the association between CD and both drug and sex-related HIV risk behaviors, indicate a need for interventions that consider the influence of this psychiatric diagnosis on high-risk behaviors.

Adolescent↗
PubMed2003

The relationship between health risk behaviors and fear in one urban seventh grade class.

A descriptive, correlational study was undertaken with 54 urban, 7th graders (age, 11-13 y) from one class. By using the Youth Risk Behaviors Surveillance System Questionnaire (YRBSS), information was collected about health risk behaviors as well as unintentional and intentional injury. Findings indicate that these adolescent students have significant fears related to their environment; they are fearful of being hurt. These students also reported increased incidence of health risk behaviors including alcohol use, carrying weapons, and staying up late at night. The findings suggest a need to understand how adolescents channel fear of harm to self into other unhealthy behaviors. Nurses are often in an ideal position to assess the health and behaviors of adolescents and to offer education, health promotion, and support to this at-risk population.

Adolescent↗
PubMed1999

Prevalence of sexual and drug-related HIV risk behaviors in the U.S. adult population: results of the 1996 National Household Survey on Drug Abuse.

CONTEXT: Data on the prevalence of HIV risk behavior that are representative of the general population are needed to help evaluate the effectiveness of prevention programs. OBJECTIVE: To use data from a large national interview survey to make estimates of the prevalence of sexual and drug-related HIV risk behaviors in the adult population of the United States. DESIGN: Nationally representative cross-sectional survey with in-person interviews collecting information on drug use and sexual behavior. SETTING AND PARTICIPANTS: 12,381 U.S. adults aged between 18 and 59 who were respondents to the 1996 National Household Survey on Drug Abuse, as part of sample of the noninstitutionalized population. Interviews took place in respondents homes using face-to-face interviewer-administered and self-administered questionnaires. RESULTS: In total, 2.8% of respondents were classified as having increased risk for HIV through sexual behavior; this represents 3.9 million persons. 1.7% reported some degree of risk through drug-related behaviors, representing 1.2 million persons. 3.5% of adults (5 million persons) were found to have some degree of HIV risk from sexual or drug-related behavior. Persons who were at risk through drug behavior were much more likely than others to be at risk through sexual behavior. Condom use was not related to HIV risk, although having a recent HIV test was found to be. Among those who reported some behaviors that placed them at increased risk for HIV infection, only 22% used a condom the last time they had sex with a regular partner. CONCLUSIONS: The high rate of sexual risk behavior on the part of drug users suggests increasing condom use for this group should be a priority goal for programs, especially condom use with main partners. Survey work needs to be continued and improved to make it possible to assess the impact of successful local prevention efforts on national rates of HIV risk behavior.

Adolescent↗
PubMed2002

An assessment of the effect of data collection setting on the prevalence of health risk behaviors among adolescents.

PURPOSE: To examine the effect of data collection setting on the prevalence of priority health risk behaviors among adolescents. METHODS: Analyses were conducted using data from two national probability surveys of adolescents, the 1993 national school-based Youth Risk Behavior Survey (YRBS) and the 1992 household-based National Health Interview Survey (NHIS/YRBS). Forty-two items were worded identically on both surveys. RESULTS: Thirty-nine of the 42 identically worded items (93%) showed that the YRBS produced estimates indicating higher risk than the NHIS. Twenty-four of these comparisons yielded statistically significant differences. The prevalence estimates affected most were those for behaviors that are either illegal or socially stigmatized. CONCLUSIONS: School-based surveys produce higher prevalence estimates for adolescent health risk behaviors than do household-based surveys. Each has advantages and disadvantages, and both can play a role in assessing these behaviors.

Adolescent↗
PubMed2005

Demographic, HIV risk behavior, and health status characteristics of "crack" cocaine injectors compared to other injection drug users in three New England cities.

OBJECTIVES: To compare demographic, HIV risk behaviors, and health status characteristics of injection drug users (IDUs) who have injected "crack" cocaine with IDUs who have not. METHODS: Nine hundred and eighty-nine IDUs were recruited in New Haven, CT, Hartford, CT and Springfield, MA from January 2000 to May 2002. Participants were administered a modified version of the National Institute on Drug Abuse Risk Behavior Assessment Questionnaire. RESULTS: Nine percent (n = 89) of participants reported "ever" injecting crack cocaine and 4.2% (n = 42) reported injecting crack in the past 30 days. Lifetime and current crack injectors did not differ significantly on any demographic characteristics. Lifetime and current crack injectors did not differ on gender, age or marital status from IDUs who have never injected crack. Significant differences were found on race, education, employment and residence, with crack injectors more likely to be white, employed, better educated and living in New Haven than IDUs who have never injected crack. After adjusting for current (past 30 day) speedball and powder cocaine injection, crack injectors reported higher rates of risky drug use behaviors and female crack injectors reported higher rates of risky sexual behaviors. Crack injectors reported higher rates of abscesses, mental illness and Hepatitis C infection, but not Hepatitis B or HIV infection. CONCLUSIONS: The emergence of crack cocaine injection requires urgent attention, as this new drug use behavior is associated with elevated rates of high risk behaviors.

Adult↗
PubMed2004

Effects of 2 prevention programs on high-risk behaviors among African American youth: a randomized trial.

OBJECTIVE: To test the efficacy of 2 programs designed to reduce high-risk behaviors among inner-city African American youth. DESIGN: Cluster randomized trial. SETTING: Twelve metropolitan Chicago, Ill, schools and the communities they serve, 1994 through 1998. PARTICIPANTS: Students in grades 5 through 8 and their parents and teachers. INTERVENTIONS: The social development curriculum (SDC) consisted of 16 to 21 lessons per year focusing on social competence skills necessary to manage situations in which high-risk behaviors occur. The school/community intervention (SCI) consisted of SDC and school-wide climate and parent and community components. The control group received an attention-placebo health enhancement curriculum (HEC) of equal intensity to the SDC focusing on nutrition, physical activity, and general health care. MAIN OUTCOME MEASURES: Student self-reports of violence, provocative behavior, school delinquency, substance use, and sexual behaviors (intercourse and condom use). RESULTS: For boys, the SDC and SCI significantly reduced the rate of increase in violent behavior (by 35% and 47% compared with HEC, respectively), provoking behavior (41% and 59%), school delinquency (31% and 66%), drug use (32% and 34%), and recent sexual intercourse (44% and 65%), and improved the rate of increase in condom use (95% and 165%). The SCI was significantly more effective than the SDC for a combined behavioral measure (79% improvement vs 51%). There were no significant effects for girls. CONCLUSIONS: Theoretically derived social-emotional programs that are culturally sensitive, developmentally appropriate, and offered in multiple grades can reduce multiple risk behaviors for inner-city African American boys in grades 5 through 8. The lack of effects for girls deserves further research.

Adolescent↗
PubMed1996

[Health locus of control and health related risk behavior--an analysis of locus of control patterns].

In this study we related health locus of control beliefs to risk-behavior (little physical exercise, overweight and smoking) in a sample of n = 956 persons, First, we used a correlative method and later we analysed health locus of control patterns. The sample is divided in eight different health locus of control beliefs patterns by the three dimensions (internal, social external and fatalistic external). The hypothesis that some subgroups have a different risk-behavior can't supported. Only the subgroup with high internal and high social external health locus of control showed in tendency lower risk-behavior. Finally we discuss different possibilities for the interpretation of the results.

Adult↗