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PubMed1998

Socio-economic differences in health risk behavior in adolescence: do they exist?

Socio-economic differences in risk behaviors in adolescence can be seen as a prelude to the re-emergence of socio economic health differences in adulthood. We studied whether or not socio-economic differences in health risk behaviors are present in male and female adolescents in The Netherlands. The relation between socio-economic status (SES) and health risk behaviors was examined, by testing both the main and interaction effects of SES and gender on separate health risk behaviors on one hand, and on the behaviors cumulatively on the other. The data were derived from 1984 adolescents in the four northern provinces of The Netherlands. SES was measured by means of the educational level and the occupational status of both parents. Four health risk behaviors were included in this study: smoking, alcohol consumption, soft drug use, and (no) physical exercise. We found that the relationships between SES and health risk behaviors are not as linear as is often found in adulthood. Our findings can be characterised overall by an absence of relationship between SES and health risk behaviors. The only exception applies to sport, which is linearly related to SES. Adolescents in the lower SES groups engage in sport less than adolescents in the higher SES groups. There was an irregular relationship between the father's occupational status and the adolescents' smoking and drinking. Adolescents in the highest, lowest and middle of the six SES groups have the highest rates of health risk behaviors. All observed relationships are similar for both male and female adolescents. A relationship between gender and the separate health risk behaviors was found only for alcohol consumption and drug use. For both male adolescents showed higher rates of risk behavior. Males also scored higher on the cumulative health risk behaviors than their female counterparts. The findings of this study do not support the hypothesis of latent differences in adolescence.

Adolescent↗
PubMed1993

Validity of cardiovascular disease risk factors assessed by telephone survey: the Behavioral Risk Factor Survey.

The Behavioral Risk Factor Surveillance System (BRFSS) collects telephone interview data on behaviors for the leading causes of premature death and disability. Its validity has never been adequately studied. The authors replicated BRFSS methodology to validate self-reported cardiovascular disease (CVD) risk factors. Nine-hundred and eleven subjects from three upstate New York counties were interviewed between 1/89 and 5/90. Interviewees were offered physical examinations and laboratory testing for CVD risk factors; 282 men and 344 women participated. The authors studied validity by comparing objectively measured to self-reported CVD risk factors. Sensitivities for self-reported hypertension, hypercholesterolemia, obesity, smoking, and diabetes were: 43, 44, 74, 82 and 75%, respectively. Only smoking sensitivity differed by gender: men, 77%; women, 86%. Specificity was > 85% for all risk factors, except hypercholesterolemia in men (75%). Prevalence was underreported for hypertension, hypercholesterolemia, obesity, and smoking by 43, 50, 25 and 17%, respectively. Results suggest telephone survey research includes physiologic measurements for blood pressure, cholesterol, height, weight, and smoking to validate self-reported CVD risk factors. When this is impossible, results such as these can be used, in similar samples, to correct risk factor prevalence rates from telephone surveys for misclassifications.

Adult↗
PubMed2004

Youth risk behavior surveillance--United States, 2003.

PROBLEM/CONDITION: Priority health-risk behaviors, which contribute to the leading causes of morbidity and mortality among youth and adults, often are established during youth, extend into adulthood, are interrelated, and are preventable. REPORTING PERIOD: This report covers data collected during February-December 2003. DESCRIPTION OF SYSTEM: The Youth Risk Behavior Surveillance System (YRBSS) monitors six categories of priority health-risk behaviors among youth and young adults--behaviors that contribute to unintentional injuries and violence; tobacco use; alcohol and other drug use; sexual behaviors that contribute to unintended pregnancy and sexually transmitted diseases (STDs), including human immunodeficiency virus (HIV) infection; unhealthy dietary behaviors; and physical inactivity--plus overweight. YRBSS includes a national school-based survey conducted by CDC as well as state and local school-based surveys conducted by education and health agencies. This report summarizes results from the national survey, 32 state surveys, and 18 local surveys conducted among students in grades 9-12 during February-December 2003. RESULTS AND INTERPRETATION: In the United States, 70.8% of all deaths among persons aged 10-24 years result from only four causes: motor-vehicle crashes, other unintentional injuries, homicide, and suicide. Results from the 2003 national Youth Risk Behavior Survey demonstrated that, during the 30 days preceding the survey, numerous high school students engage in behaviors that increase their likelihood of death from these four causes: 30.2% had ridden with a driver who had been drinking alcohol; 17.1% had carried a weapon; 44.9% had drunk alcohol; and 22.4% had used marijuana. In addition, during the 12 months preceding the survey, 33.0% of high school students had been in a physical fight, and 8.5% had attempted suicide. Substantial morbidity and social problems among young persons also result from unintended pregnancies and STDs, including HIV infection. In 2003, 46.7% of high school students had ever had sexual intercourse; 37% of sexually active students had not used a condom at last sexual intercourse; and 3.2% had ever injected an illegal drug. Among adults aged > or =25 years, 62.9% of all deaths results from two causes: cardiovascular diseases and cancer. Results from the 2003 national Youth Risk Behavior Survey demonstrate that the majority of risk behaviors associated with these two causes of death are initiated during adolescence. In 2003, a total of 21.9% of high school students had smoked cigarettes during the 30 days preceding the survey; 78% had not eaten > or =5 servings/day of fruits and vegetables during the 7 days preceding the survey; 33.4% had participated in an insufficient amount of physical activity; and 13.5% were overweight. ACTIONS TAKEN: YRBSS data are being used to measure progress toward achieving 15 national health objectives for 2010 and three of the 10 leading health indicators. In addition, education and health officials at national, state, and local levels are using these YRBSS data to improve policies and programs to reduce priority health-risk behaviors among youth.

Adolescent↗
PubMed2001

Association of alcohol use and other high-risk behaviors among trauma patients.

BACKGROUND: Risk behaviors and psychological problems may limit recovery after trauma, may be related to injury recidivism, and may limit the effectiveness of alcohol interventions in trauma patients. The aim of the current study was to evaluate the prevalence of behaviors associated with injury and their relationship with alcohol use in adult trauma patients. METHODS: A prospective cohort of 301 adult patients admitted to a single Level I trauma center were interviewed regarding risk behaviors and alcohol use. RESULTS: There was evidence of acute and/or chronic alcohol use in 48.2% of cases. Over three fourths of patients (77%) engaged in one or more high-risk driving practices, 40% engaged in one or more violence-related behaviors, and 19% reported suicidal ideation in the last year. These risk behaviors were more common in patients who evidenced acute and/or chronic alcohol use. CONCLUSION: Behaviors that place an individual at greater risk for traumatic injury are common among seriously injured adult patients admitted to an urban Level I trauma center and frequently coexist with alcohol use. Their importance to injury, injury recidivism, and recovery after trauma requires further investigation.

Adult↗
PubMed1999

Proximal impact of two first-grade preventive interventions on the early risk behaviors for later substance abuse, depression, and antisocial behavior.

We assessed the immediate effects of two universal, first-grade preventive interventions on the proximal targets of poor achievement, concentration problems, aggression, and shy behaviors, known early risk behaviors for later substance use/abuse, affective disorder, and conduct disorder. The classroom-centered (CC) intervention was designed to reduce these early risk behaviors by enhancing teachers' behavior management and instructional skills, whereas the family-school partnership (FSP) intervention was aimed at improving parent-teacher communication and parental teaching and child behavior management strategies. Over the course of first and second grades, the CC intervention yielded the greatest degree of impact on its proximal targets, whereas the FSP's impact was somewhat less. The effects were influenced by gender and by preintervention levels of risk. Analyses of implementation measures demonstrated that greater fidelity to the intervention protocols was associated with greater impact on behavior ratings and on achievement scores, thus providing some evidence of specificity in the effect of the interventions.

Baltimore↗
PubMed1996

Structure of health risk behavior among high school students.

The authors test the contention of R. Jessor's (1977) problem behavior theory that adolescent health risk behaviors comprise a single behavioral syndrome. Multidimensional scaling (MDS) and cluster analysis are used to analyze data from a statewide survey of high school students' (n = 5,537) health risk behaviors. A classical MDS analysis was calculated to test the dimensionality of the behaviors. All indicators supported a multidimensional model. An individual-differences MDS (INDSCAL) analysis revealed that a 4-dimensional solution best fit the data, with gender and racial-ethnic differences emerging in the relative salience of the dimensions. The INDSCAL dimensional coordinates for each health risk behavior were then submitted to a hierarchical cluster analysis technique. Five behavioral clusters were identified, 1 of which included many of the traditional "problem behaviors," such as smoking, unprotected sexual intercourse, and alcohol consumption. These findings support a multidimensional structure underlying adolescent health risk behavior. Implications for theory and prevention of health risk behaviors are discussed.

Adolescent↗
PubMed2005

Applying the interpersonal circumplex to children's behavior: parent-child interactions and risk behaviors.

This article examined the applicability of the interpersonal circumplex (IC) to the observable social behaviors of children during parent-child interactions. In Study 1, the observational ratings of behaviors of 117 children (mean age = 9.88 years) were examined. Randomization tests of hypothesized order relations found that these behaviors tended to occur in the circular pattern predicted by the IC. To illustrate the applicability of the IC to children's behavior, Study 2 (n = 94) used the circular structure of children's behavior to longitudinally examine children's participation in two risk behaviors, smoking cigarettes and consuming alcohol. Results indicated that children who behaved in an arrogant-calculating manner were at risk for smoking cigarettes and children who behaved in an assured-dominate manner were at risk for drinking alcohol 1 year later. Implications of these results are discussed in terms of their relevance for helping researchers better understand and categorize children's interpersonal behaviors.

Alcohol Drinking↗
PubMed2004

Suicide, high-risk behaviors, and coping style in homeless adolescent males' adjustment.

PURPOSE: To evaluate the association among suicide behaviors, high-risk behaviors, coping style, and psychological adjustment (i.e., depressive symptomatology, internalizing and externalizing behavior problems) in homeless and non-homeless adolescent males (aged 16 to 19 years). METHODS: Data were obtained from 100 homeless youth accessing an emergency shelter (Ottawa, ON). The comparison group was comprised of 70 youth accessing local community drop-in centers that lived with their parent(s)/guardian(s) and had never stayed in a shelter. Data were analyzed using Chi-square, Student's t-tests, and regression statistics. RESULTS: Relative to non-homeless youth, homeless youth were more likely to report drug, alcohol, and tobacco use, legal problems, academic difficulties, and mental health problems. Homeless youth presented with a higher prevalence of suicidal ideation, past suicide attempts, depressive symptomatology, and internalizing and externalizing behavior problems. Disengagement coping was a predictor of suicidal ideation, past attempts, depressive symptoms and both internalizing and externalizing behavior problems in homeless youth. CONCLUSIONS: Relative to non-homeless youth, findings indicate that homeless youth reported greater use of a disengaging coping style and are at greater risk for high-risk behaviors, past suicide attempts, and clinically elevated levels of depressive symptoms and behavior problems.

Adaptation, Psychological↗
PubMed1996

Reliability and changes in validity of self-reported cardiovascular disease risk factors using dual response: the behavioral risk factor survey.

The authors previously studied the validity of self-reported cardiovascular disease (CVD) risk factors assessed by telephone surveys, and found the validity low, especially for self-reported hypertension and hypercholesterolemia. One way to improve validity is to combine repeated measurements (dual response) into a single measure. The authors explored this and the reliability of self-reported CVD data collected by the Behavioral Risk Factor Survey in three New York counties from January 1989 to May 1990. Nine hundred and eleven subjects were interviewed by telephone to collect CVD risk factor and health behavior information. Interviewees were offered physical examination and laboratory testing to verify self-reported CVD risk factors; 628 participated. Subjects were also reinterviewed to assess the test-retest reliability of the survey, and to study how validity of self-reported CVD data changes by dual response. Reliability coefficients for CVD risk factors, preventive health practices, and knowledge of risk factor levels ranged from 0.42 to 0.99. Minimal improvement in sensitivity of self-reported risk factors was found using dual response, and it did not improve specificity. Also, for prevalence of risk factors, dual response minimally improved self-reported rates compared to objective estimates. Combining self-reported measurements causes minimal changes in the validity of these variables. Physiological assessment for hypertension and hypercholesterolemia, or correction for misclassification, is needed for valid individual measurement and for community prevalence estimates from telephone surveys. Self-reported cigarette smoking, obesity, and diabetes mellitus have better validity, but physiological assessment or correction for misclassification may supplement these self-reported risk factors.

Adult↗
PubMedDate not supplied

Using the Behavioral Risk Factor Surveillance System to monitor year 2000 objectives among American Indians.

The Behavioral Risk Factor Surveillance System, a data set based on telephone surveys that have been conducted by States in collaboration with the Centers for Disease Control, has been used to estimate the prevalence of behavioral risk factors for adults in the United States so health objectives can be set and progress towards accomplishing them measured. Data for adult American Indians in this regard have not been available generally. The use of these data to estimate behavioral risk prevalence for American Indians by geographic region was examined and the results compared with those for white Americans. In addition, data from the system were compared with other data sets, including the results of selected surveys in American Indian communities, to explore the validity of the system as a tool for evaluating the behavioral risks of Indians. Behavioral Risk Factor Surveillance System data for the period 1985 to 1988 were used. During this period, the 1,055 American Indian respondents constituted 0.63 percent of those responding under the system and 0.70 percent of the population of the participating States. Separate (sex-specific) behavioral risk prevalence estimates were derived for Indians and whites for four geographic regions--Southwest, Plains, West Coast, and Other States. The system's behavioral risk estimates for the Plains region were compared with available data from behavioral risk surveys done in three American Indian communities in Montana (Blackfeet, Fort Peck, and Great Falls) from 1987 to 1989. The behavioral risk factors compared include use of automobile seatbelts, current smoking, current use of smokeless tobacco, heavy drinking, drinking and driving, overweight, hypertension, and sedentary lifestyle. Although large regional differences in the prevalence of these risk factors were found, the magnitude and direction of the differences are frequently similar among American Indians and whites living in the same geographic regions. The findings from the Behavioral Risk Factor Surveillance System among American Indians are largely consistent within dependently collected data from more resource intensive household surveys, at least when surveys in Montana are compared with system data from the Plains. These data are generally consistent with other epidemiologic studies.When they are used in conjunction with community-specific surveys, the Behavioral Risk Factor Surveillance System data may be useful for monitoring the progress of American Indians towards the Year 2000 national health objectives. The value of the surveillance system for monitoring trends in behavioral risk factors among Indians would be enhanced if States attempted to over sample regions (such as Indian reservations) with a high proportion of Indian residents. It appears that aggressive health promotion and disease prevention efforts will be needed if these objectives are to be achieved.

Adolescent↗
PubMed2000

Youth risk behavior surveillance--United States, 1999.

PROBLEM/CONDITION: Priority health-risk behaviors, which contribute to the leading causes of mortality and morbidity among youth and adults, often are established during youth, extend into adulthood, are interrelated, and are preventable. REPORTING PERIOD: February-May 1999. DESCRIPTION OF THE SYSTEM: The Youth Risk Behavior Surveillance System (YRBSS) monitors six categories of priority health-risk behaviors among youth and young adults --behaviors that contribute to unintentional and intentional injuries; tobacco use; alcohol and other drug use; sexual behaviors that contribute to unintended pregnancy and sexually transmitted diseases (STDs) (including human immunodeficiency virus [HIV] infection); unhealthy dietary behaviors; and physical inactivity. The YRBSS includes a national school-based survey conducted by CDC as well as state, territorial, and local school-based surveys conducted by education and health agencies. This report summarizes results from the national survey, 33 state surveys, and 16 local surveys conducted among high school students during February-May 1999. RESULTS AND INTERPRETATION: In the United States, approximately three fourths of all deaths among persons aged 10-24 years result from only four causes: motor-vehicle crashes, other unintentional injuries, homicide, and suicide. Results from the 1999 national Youth Risk Behavior Survey demonstrate that numerous high school students engage in behaviors that increase their likelihood of death from these four causes--16.4% had rarely or never worn a seat belt; during the 30 days preceding the survey, 33.1% had ridden with a driver who had been drinking alcohol; 17.3% had carried a weapon during the 30 days preceding the survey; 50.0% had drunk alcohol during the 30 days preceding the survey; 26.7% had used marijuana during the 30 days preceding the survey; and 7.8% had attempted suicide during the 12 months preceding the survey. Substantial morbidity and social problems among young persons also result from unintended pregnancies and STDs, including HIV infection. In 1999, nationwide, 49.9% of high school students had ever had sexual intercourse; 42.0% of sexually active students had not used a condom at last sexual intercourse; and 1.8% had ever injected an illegal drug. Two thirds of all deaths among persons aged > or = 25 years result from only two causes--cardiovascular disease and cancer. The majority of risk behaviors associated with these two causes of death are initiated during adolescence. In 1999, 34.8% of high school students had smoked cigarettes during the 30 days preceding the survey; 76.1% had not eaten > or = 5 servings/day of fruits and vegetables during the 7 days preceding the survey; 16.0% were at risk for becoming overweight; and 70.9% did not attend physical education class daily. ACTIONS TAKEN: These YRBSS data are already being used by health and education officials at national, state, and local levelsto analyze and improve policies and programs to reduce priority health-risk behaviors among youth. The YRBSS data also are being used to measure progress toward achieving 16 national health objectives for 2010 and 3 of the 10 leading health indicators.

Adolescent↗
PubMed1989

Knowledge about AIDS and reported risk behaviors among black college students.

This study surveyed 975 undergraduates attending a large East Coast university during the spring semester of the 1987/88 academic year. A convenience sample of predominantly black students (94%) participated. Overall, knowledge of basic AIDS-related facts was satisfactory. Raw scores on the 25-item knowledge scale ranged from 7 to 25, with a mean of 20.5 (82%) and a mode of 22 (88%). Selected questions on how HIV is not transmitted, however, posed some problems for respondents. Less than 30% of respondents knew that the AIDs virus was not transmitted by insects; less than 80% knew that AIDS was not transmitted on toilet seats, through blood donations, kissing, and coughing. The survey also asked students whether they had ever engaged in certain behaviors that put them at risk of HIV infection. Approximately 17% of respondents had experienced anal intercourse, 6.5% reported use of heroin, 32.6% reported having had multiple sex partners, and 16% had been treated for a sexually transmitted disease. Students who reported engaging in high-risk behaviors had statistically significant lower mean knowledge scores than those who reported not engaging in those same high-risk behaviors. Results of the study support the need to increase efforts to deliver AIDS information specifically targeted to individuals who may be engaged in high-risk behaviors. Special health education programs must be designed to focus attention on risk behaviors (ie, unprotected anal intercourse) instead of risk groups (ie, homosexual and bisexual males).

Acquired Immunodeficiency Syndrome↗
PubMed2004

Methodology of the youth risk behavior surveillance system.

CDC developed the Youth Risk Behavior Surveillance System (YRBSS) to monitor six categories of priority health-risk behaviors among youth--behaviors that contribute to unintentional injuries and violence; tobacco use; alcohol and other drug use; sexual behaviors that contribute to unintended pregnancy and sexually transmitted diseases, including human immunodeficiency virus (HIV) infection; unhealthy dietary behaviors; and physical inactivity--plus overweight. These risk behaviors contribute markedly to the leading causes of death, disability, and social problems among youth and adults in the United States. YRBSS includes a national school-based survey conducted by CDC as well as state, territorial, and local school-based surveys conducted by education and health agencies. In these surveys, conducted biennially since 1991, representative samples of students in grades 9--12 are drawn. In 2003, a total of 15,214 students completed the national survey, and 32 states and 20 school districts also obtained data representative of their jurisdiction. Although multiple publications have described certain methodologic features of YRBSS, no report has included a comprehensive description of the system and its methodology. This report describes the background and rationale for YRBSS and includes a detailed description of the methodologic features of the system, including its questionnaire; operational procedures; sampling, weighting, and response rates; data-collection protocols; data-processing procedures; reports and publications; and data quality. YRBSS is evolving to meet the needs of CDC and other users of the data.

Adolescent↗
PubMed2005

A population-based estimate of the prevalence of behavioral risk factors among adult cancer survivors and noncancer controls.

BACKGROUND: Behavioral risk factors have significant biomedical and psychosocial effects for cancer survivors. Representative data on the prevalence of a wide range of behavioral risk factors among cancer survivors are lacking. METHODS: We used data from the 2000 National Health Interview Survey to examine the prevalence of smoking, physical inactivity, dietary risk factors, being overweight, risky alcohol use, and sun protection behaviors among a sample of 32,346 adults, 1646 of whom were cancer survivors. RESULTS: With the exception of smoking, there were few differences in age-stratified behavioral risk factor prevalences between cancer survivors and noncancer controls. Among the cancer survivors, there were few differences in behavioral risk factor prevalence rates for survivors of different cancers. Exceptions included a high rate of current smoking for cervical and uterine cancer survivors. The prevalences of physical inactivity, dietary risk factors, and being overweight were relatively high across cancer types, whereas the prevalence of risky drinking was particularly low. CONCLUSIONS: This study provides benchmark estimates of the prevalence of multiple cancer-related behavioral risk factors among U.S. cancer survivors. The results reveal considerable opportunities for behavioral risk factor interventions among cancer survivors. We discuss implications of the results and outline directions for future research.

Adolescent↗
PubMed2004

Risk behaviors and health-related quality of life among adults with asthma: the role of mental health status.

BACKGROUND: Previous research indicates that asthma is strongly associated with depressive disorders. Depression among persons with asthma is associated with poor adherence to medication regimens, more severe asthma, and poorer disease outcomes. The objective of our study was to examine the association of frequent mental distress (FMD) [ie, > or = 14 days in the past 30 days in which respondents reported that their mental health was not good] with modifiable risk behaviors (ie, smoking, physical inactivity, and obesity) and health-related quality of life among adults with asthma. METHODS: The Behavioral Risk Factor Surveillance System is an ongoing, state-based survey that is conducted by random-digit dialing of noninstitutionalized US adults aged > or = 18 years. In 2001, all 50 states administered the asthma and risk behavior questionnaires (15,080 questionnaires). A total of 12 states administered the health-related quality-of-life questionnaire (3,226 questionnaires). We estimated prevalences, 95% confidence intervals, odds ratios, and adjusted odds ratios (AORs) using a statistical software program to account for the complex survey design. RESULTS: The prevalence of FMD among adults with asthma was 18.8%. After adjusting for sociodemographic characteristics, the overall associations between smoking and FMD (AOR, 1.9), and between physical inactivity and FMD (AOR, 1.7) were statistically significant. In addition, among those with asthma, persons with FMD were significantly more likely than those without FMD to report fair/poor general health, frequent physical distress, frequent activity limitations, frequent anxiety, and frequent sleeplessness. CONCLUSIONS: FMD is highly prevalent among persons with asthma, suggesting an apparent synergistic effect of these two conditions. The assessment of the mental health status of persons with asthma by health-care providers appears to be warranted and may prevent the emergence of risk behaviors yielding deleterious effects on the management of this disease.

Adolescent↗
PubMed2005

Changes in women's sexual risk behaviors after therapeutic community treatment.

This study examines sexual risk behaviors among 197 women mandated to substance abuse treatment in therapeutic communities. The women's risk behaviors after treatment are compared with their behaviors prior to treatment, and risk behaviors among those who completed treatment are compared with those who did not. The women had a high prevalence of sexual risk behaviors (i.e., multiple partners, unprotected sex, sex trade, not asking partners to use condoms, sex with injection drug users [IDUs]) and relationship violence and conflict before treatment and a significant decrease in unprotected sex, sex trade, sex with multiple partners, and relationship violence or conflict after treatment. Those who completed treatment were significantly less likely to participate in sex trade or have sex with IDUs and were more likely to have a new sexual partner and only one sexual partner after treatment as compared with those who did not complete treatment. The present study shows that therapeutic community treatment is associated with the reduction of sexual risk behaviors among female substance abusers mandated to treatment.

Adult↗
PubMed2004

Attempted suicide and associated health risk behaviors among Native American high school students.

Suicide represents the second-leading cause of death among American Indian/Alaska Native (AI/AN) youth aged 15-24 years. Data from the 2001 Bureau of Indian Affairs (BIA) Youth Risk Behavior Survey were used to examine the association between attempted suicide among high school students and unintentional injury and violence behaviors, sexual risk behaviors, tobacco use, and alcohol and other drug use. The study included students in BIA-funded high schools with 10 or more students enrolled in grades 9-12. Overall, 16% of BIA high school students attempted suicide one or more times in the 12 months preceding the survey. Females and males who attempted suicide were more likely than females and males who did not attempt suicide to engage in every risk behavior analyzed: unintentional injury and violence behaviors, sexual risk behaviors, tobacco use, and alcohol and other drug use. These data enable educators, school health professionals, and others who work with this population to better identify American Indian youth at risk for attempting suicide by recognizing the number and variety of health risk behaviors associated with attempted suicide.

Adolescent↗
PubMed2004

Rural Mexican-American adolescent sexual risk behavior.

CONTEXT: There is a need for community-based, culturally sensitive, cognitive-behavioral interventions to reduce sexual risk behavior among minority adolescents. Studies of adolescent risk and protective behaviors have focused on identifying modifiable psychosocial variables that predict differential outcomes for subsequent intervention efforts. Research has been scarce in studies of rural minority adolescent women. PURPOSE: To examine the protective and risk behaviors of these rural Mexican-American adolescent women and their relationship to physical or sexual abuse. METHODS: Mexican-American adolescent women aged 14-19 years were recruited through a rural health clinic and administered a self-report assessment for protective and risk behavior and sexual, physical, and psychological abuse. FINDINGS: Rural minority adolescent women endured high levels of psychological distress and many risk behaviors yet experienced few protective behaviors. Barriers to health care included access and confidentiality. Physically or sexually abused adolescents endured relatively greater risk and fewer protective behaviors than nonabused. CONCLUSIONS: Rural Mexican-American adolescent women may benefit from confidential identification and assessment of abuse history and risk and protective behaviors so that appropriate psychological treatment can accompany accessible medical treatment. The prevalence of risk behaviors and abuse among these women presents a need for development of behavioral interventions for risk reduction and promotion of health protective behaviors.

Adolescent↗