The determinants of health behaviours among adolescents

Background: Adolescent smoking rate is increasing in South Korea. An adolescent period is influenced by surrounding environment. Adolescents spend most of their days in the school. Therefore, school environment is important to them. While previous studies have found individual, a family and peers factors among adolescents in smoking, school environment factors have been neglected.
Objectives: The aim of this study is to examine school environment influence as factors in smoking behavior of adolescents.
Contents and Methods: Data are used from The 3st Korea Youth Risk Behavior Web-based Survey (KYRBWS) conduced by the Korea Center for Disease Control and Prevention (KCDC) in 2007 and the “school factors” data. Multi-level logistic regression analysis is used to identify school environmental factors.
Contribution: The results of the analysis show school environmental factors among adolescents. This study finds school environmental factors and those factors are utilized for school smoking policies considering school factors and school smoking prevalence. The study suggests that Individual level and school level be linked. So, Adolescent smoking prevalence rate can be effectively reduced by changing school environment.

Considering the criticallity of perceptively gauging combined effect of risky sexual behavior and substance abuse, this study employs ‘concept of critical events’. Critical event is formulated based on combination of alcohol use, partner type and un/protected sex focusing at context and sequence of events. Data used is collected through randomized cluster sample of 1239 young men from slums of Mumbai. Over three-fourths respondents engaged in critical events, four-fifths of which were unprotected. Girlfriend(s) are more risky partner as perceived partner faithfulness translates into unprotected sex (66%), which further falls six times after alcohol intoxication. Men reporting sex with commercial partner were 8 and 3 times more likely to mix alcohol-sex and unprotected sex. Peer pressure is influential in sexual experimentation and condom use even with girlfriend. Findings highlight alcohol-sex interface with girlfriend being receiver of elevated risk. Study underlines inevitability of innovative methodology to expose convoluted sexuality issues.

CARE-Bangladesh has conducted a study to explore the knowledge of the adolescent boys and girls on reproductive and sexual health using Participatory Research Appraisal and Focus Group Discussion. Data suggests that adolescent boys and girls are aware of physical and mental development that might take place during this period. Adolescent girls were concerned more about menarche and its management. Attaining menarche is still being treated as threshold point to adulthood in the society. This is the period when restriction on girl’s mobility is imposed.

While most of the adolescent boys admit that harassment of girls in the street is undesirable, they all seem subject to a “sense of thrill” obtained from passing comment to girls. Girls face gender discrimination from the parents, family and society from birth. This attitude of the community towards female children has lead to the development of a “hypothesis” to identify the female fetus at pregnancy which in turn has often evoked the need of clandestine unsafe abortion endangering the life of the women. Study suggests that adolescents have reasonable knowledge on reproductive and sexual health. There is also a sign of change in attitude of adolescents in the field of girl’s education and marriage.

Currently debated issue in the last elections in Korea was offering free meals at schools. Since adolescent spend most of their days in school, it is considered that school meal play an important role in maintaining health. The adolescent prevalence of obesity has been increasing from 4.3% in 1979 to 13.1% in 2008. In 1981 the government passed the school meals act, this allowed local authorities to provide every child at school with a meal. While parental social economic status and nutritional factors have been widely studied by a number of previous studies on adolescent health; little attention has been paid to school meal factors. This study examines health inequalities on adolescent by expanding school meals in Korea. We will employ the KNHNES (1998, 2009) to compute the prevalence of obesity. Parental academic background and family affluence score will be considered as indicators of social economic status on adolescent. Regression analysis is used to identify parental SES factors
It may result that over the last decade, health condition on adolescents is improved and health inequalities between socioeconomic groups reduced than before starting school meals. This finding will be a useful resource for school nutrition policies in Korea and will cut down health problems on adolescent.

India is standing at a crucial juncture relating to substance abuse. The use of alcohol and tobacco is very prevalent among larger masses, including the adolescents. The country is passing through a crucial phase of epidemiological shift. It is estimated that India would have fastest rate of deaths attributable to substance abuse due to the high addiction rate during youth periods of life. Accordingly, the paper aims to assess the present condition of substance abuse among adolescent boys in India by identifying the key factors responsible for their engulfing into Substance abuse. The NFHS-3 data is used by applying appropriate statistical and GIS techniques. Findings reveal that the prevalence of substance abuse is highest among those adolescent boys who are illiterate, have low mass media exposure, living away from home, economically poor and living in the North-Eastern states of India. The use of alcohol is highest among adolescent boys belongs to Christian and Sikh religion whereas tobacco use is highest among Muslims. Adolescents must be educated and make aware of harmful effects of substance abuse through special programmes, especially through peer based approach. Role of mass-media should be strengthened to highlight the health warnings and adverse health implications.

The proportion of adolescent deaths (9%) due to pregnancy or during child birth to total maternal mortality is very high in India. Although some studies on local scale are available, no study as yet has explored the factors affecting maternal health care utilization in adolescent mothers at national level. Using the data from third wave of District Level Household Survey (2007 -08), this paper examines the factors associated with the utilization of maternal healthcare services among adolescent women (aged 13 -19 years) in urban India. Bi-variate analyses including chi -square test was used to determine the difference in proportion, and multilevel binary logistic regression models were applied to understand the net effect of predictor variables on selected outcomes. About 23% of all adolescent mothers in India availed full ANC; 70% had a safe delivery and 64% had postnatal care in 2007 -08.After controlling for a number of factors, we find that the women, who are rich, older, highly educated, exposed to mass media , were more likely to utilize prenatal and natal care. These groups may be small portion of population but contribute significantly to maternal and child mortality, therefore, it is imperative to focus on such vulnerable groups in the policy.

On the basis of the unique setting in Seoul, Korea where middle school graduates are randomly assigned into high schools within school districts and also where the assignment of high school students into homeroom classes is likely to be random, we address whether peers matter for adolescents’ risky behaviors (drinking and smoking). These procedures of student assignment provide an exceptional opportunity to estimate the effects of peer groups, which are not contaminated by an adolescent’s selection of peer groups. Using the sample of Seoul high school students from a nationally representative survey of Korean high school students in 10th – 12th grades conducted every year since 2005 to 2011, we model an adolescent’s initiation of drinking or smoking in time t conditional on no initiation though through t-1, by the average percentage of her (his) current classmates who undertook the risky behavior p years earlier (i.e., a lagged group variable), after taking into account a variety of individual-level variables. Our school-fixed effect models, furthermore, control for unobserved school environments that may simultaneously affect the adolescent and her (his) classmates. Our study significantly improves estimates of the effects of peer groups on adolescents’ risky behaviors.

The aim of this study was to (i) develop a material affluence scale (MAS) for measuring adolescent SES in health inequality research in developing countries, (ii) compare the association of the MAS with the parental SES measures (parental occupation and education), and (iii) evaluate the association of parental SES and MAS with key health and health behaviour indicators. We used school-based cross-sectional survey conducted in thirty districts within three administrative regions in southern Ghana (a West African country) among adolescents ages 12-18-year old (N=1,195) as an example. Principal Component Analysis (PCA) was used as the main statistical technique. MAS categorised adolescents into material affluence groups (MAS scores for the poorest, poor, average, affluent and most affluent were-1.679, -0.355, 0.354, 0.725 and 1.022 from the first principal component quintile respectively), it has adequate internal coherence (α =0.622) and moderately correlates with parental SES (r=0.39, p<0.001). MAS and parental SES showed similar pattern of strength and direction of association with selected health and health behaviour indicators. MAS presents a viable alternative method for measuring adolescent’s SES in health inequality research in developing countries and could be useful as well in western countries.

Using cross sectional data from Nepal Adolescents and Youths Survey 2011, this study attempts to explore the determinants associated with practice during menstruation among Nepalese female adolescents and youths. The survey of this study uses two stages stratified sampling techniques. Altogether 14853 adolescents youths (7109 boys and 7644 girls) aged 10-24 from 300 cluster comprising 9000 households were selected for the interview.
Although bi-variate analysis reveals a positive association between selected background characteristics (education, mass media exposure and parental education) and avoidance of touching during menstruation, multivariate analysis confirms that education, mass media exposure, parental education have positive impact to avoid superstitions regarding menstrual practices in Nepal. As expected, female youths having better education, exposed to mass media and whose parents are educated are less likely to avoid touching during menstruation.
This study is conclusive that education of female, particularly for the remote, rural and interior parts of the country should be focused. In addition, information, education and communication can be one of the best strategies to air the positive messages towards living healthy life.

In India, low female age at marriage, early childbearing initiation, high infant and maternal mortality are the major barriers in attaining the MDGs. Thus, family life education (FLE) that includes basic understanding of human reproduction, sex education, contraceptive knowledge and women's rights is a necessary condition to meet the goals. This paper attempts to examine the level, source of receiving FLE among unmarried women aged 15-24 and factors affecting its access and quality in India. The information available on FLE from 1,66,260 unmarried women (15-24) in the nationwide district level household survey (2007-08) have been analysed. At all India level 73% of unmarried women are aware of FLE and 49% ever received FLE. The minimum 10 years of formal education increases the odds of receiving FLE by six folds in India. Above half of the respondents reported that they felt embarrassed in the sessions of FLE irrespective to the sources. Implementation of govt. prog. significantly increases the likelihood of having FLE. Those who received FLE are rated significantly high on the index of contraceptive and SRH knowledge. 28% of unmarried women expressed their desire to receive FLE only from their family members. Thus, this study also recommends to involving these stakeholders in the culturally suited community FLE programmes.