Using the Youth Risk Behavior Survey to compare risk behaviors of Texas High School and college students

This study used the Youth Risk Behavior Survey (YRBS) to assess selected health behaviors of Texas high school and college students. The YRBS was administered during 1993 in paper and pencil form to 6,015 high school students representing 329 classrooms from 78 school districts. A total of 1,408 college students representing 23 college and universities were surveyed by telephone in 1993 using a modified version of YRBS. Texas college students reported a higher percentage who had experienced sexual intercourse (82% versus 55.4%), but Texas high school students reported a younger age of first sexual intercourse. High school students also initiated alcohol consumption at a younger age, although college students were more likely to binge drink (33.5% versus 31%). Regular cigarette use also was higher among college students (25.4% versus 19.3%), but was initiated at a younger age by high school students. Study results indicate that health education programs must begin much earlier than during the high school years. Due to early initiation of negative health behaviors, emphasis must be placed on abstinence and risk-reduction techniques for both populations.     

Caring for pregnant teens and their mothers, too

STUDY OBJECTIVE: To describe the sexual behavior and contraception use among a sample of high school and vocational school adolescents in Barcelona, Spain. DESIGN: Cross-sectional study. METHODS: A random sample of 3139 students, aged 14 to 19 years, living in the city of Barcelona, were surveyed by means of an anonymous, self-administered questionnaire. SPSS/PC+ was used for statistical analysis. Significance criterion was set at 0.01. MAIN RESULTS: 13% of the students had previously participated in sexual intercourse; percentages between the sexes was equal. Frequency increased with age. Boys had their first experience at a significantly earlier age, but girls participated in sexual intercourse more often. The majority of adolescents used condoms as their primary contraceptive method; seven (3.3%) of the sexually active girls had been pregnant, and two (1%) boys had caused their partners to become pregnant. CONCLUSIONS: The rate of sexual activity among adolescents in Barcelona is low compared with those in both European and American studies. However, a higher rate of condom use is observed.     

The Healthy for Life project: sexual risk behavior outcomes

Sexual risk behavior outcome data from the Healthy for Life (HFL) project is presented. Using a social influences model, the intervention was designed to positively affect the health behaviors of middle school students in five related areas: alcohol use, tobacco use, marijuana use, nutrition, and sexuality. The in-school program was supplemented by parent, community and peer components. The research used self-report data on an initial sample of 2,483 middle school students followed from Grade 6 to Grade 10. Twenty-one schools were assigned to three conditions--age appropriate (program taught in Grades 6, 7, and 8), intensive (program taught in Grade 7) and control--using blocked randomization. Attrition was 20% (by Year 4) and 33% (by Year 5). By ninth grade the lifetime intercourse rate among both groups of HFL subjects was significantly higher than for controls (controlling for baseline substance use risk and involvement with the opposite sex), but reported past month intercourse rates and condom use did not differ. At the tenth grade follow-up, the age appropriate subjects reported higher adjusted rates of lifetime and past month intercourse than did the controls. Intensive subjects perceived significantly lower normative rates of intercourse than controls at ninth grade follow-up, but age appropriate subjects perceived significantly higher norms at tenth grade. Our expectation that this approach would be effective in reducing adolescent sexual risk behavior has not been supported. The influence of social and community norms and contextual factors has a far greater influence on the behavior of students (even 6 years later) than this school-based social influences program targeting only one grade cohort.     

Use of drinking protective behavioral strategies in association to sex-related alcohol negative consequences: The mediating role of alcohol consumption.

Alcohol use has been implicated as a risk factor for sexual negative consequences, such as unprotected sexual intercourse. The present research was conducted to examine the relationship between drinking protective behavioral strategies and consensual sex-related alcohol negative consequences, and whether this relationship varied by gender. Additionally, typical number of drinks during sexual behavior was evaluated as a potential mediator of this association. Heavy drinking, sexually active college students (N = 297, 50.2% women) completed self-report measures of drinking protective behavioral strategies, alcohol consumption, and sex-related alcohol negative consequences. Findings indicated that women who used drinking protective behavioral strategies more frequently were less likely to experience sex-related alcohol negative consequences whereas this relationship was not significant for men. For women, this relationship was mediated by the typical number of drinks consumed during sexual behavior. The current research demonstrates that use of drinking protective behavioral strategies is related to a reduction in women's sex-related risks when drinking. Findings are discussed in terms of alcohol myopia theory. Implications for interventions aimed to reduce higher risk sexual behavior among college students are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Sexual behavior among U.S. high school students, 1990-1995

CONTEXT: High rates of unintended pregnancy and sexually transmitted diseases (STDs), including HIV infection, among adolescents are major public health concerns that have created interest in trends in teenage sexual activity. METHODS: Nationally representative data from Youth Risk Behavior Surveys conducted in 1990, 1991, 1993 and 1995 are used to examine levels of sexual experience, age at first intercourse, current sexual activity and condom use at last intercourse among students in grades 9-12. RESULTS: The proportion of students who reported being sexually experienced remained at 53-54% from 1990 through 1995, while the percentage of sexually active students who used condoms at last intercourse rose from 46% to 54% between 1991 and 1995. Black students were more likely than white students to report being sexually experienced, being currently sexually active and having had four or more lifetime sexual partners; black students also reported a significantly younger age at first intercourse. Gender differences in sexual behavior were found more frequently among black students than among white or Hispanic students. CONCLUSIONS: Although levels of sexual experience for high school students in the United States have not risen during the 1990s, a very high percentage of students continue to be at risk for unintended pregnancy and STDs, including HIV infection.     

Non-medical drug use amongst non-student youth in India

In a survey of non-medical drug use by 266 non-students in the age range 10-24 years, tobacco, alcohol and cannabis were found to be the drugs more commonly used. Use was greater in males, older age groups, those with lower educational levels and those from urban areas. In comparison to students, among non-students use was practically limited to tobacco, alcohol and cannabis, the use was more regular and the age at onset lower. In a pilot trial of two additional strategies to identify drug users among non-student youth, namely cross-validation by fellow employees and verbal group administration of the questionnaire, the number of current users identified was very similar to that found by individual verbal administration, suggesting that these cheaper methods may be useful in some circumstances.     

Youth Risk Behavior Surveillance--United States, 1997. State and Local YRBSS Coordinators

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, and are interrelated. 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 the Centers for Disease Control and Prevention 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, 3 territorial surveys, and 17 local surveys conducted among high school students from February through May 1997. In the United States, 73% of all deaths among youth and young adults 10-24 years of age result from only four causes: motor vehicle crashes, other unintentional injuries, homicide, and suicide. Results from the national 1997 YRBSS demonstrate that many high school students engage in behaviors that increase their likelihood of death from these four causes--19.3% had rarely or never worn a seat belt; during the 30 days preceding the survey, 36.6% had ridden with a driver who had been drinking alcohol; 18.3% had carried a weapon during the 30 days preceding the survey; 50.8% had drunk alcohol during the 30 days preceding the survey; 26.2% had used marijuana during the 30 days preceding the survey; and 7.7% had attempted suicide during the 12 months preceding the survey. Substantial morbidity among school-age youth, young adults, and their children also result from unintended pregnancies and STDs, including HIV infection. YRBSS results indicate that in 1997, 48.4% of high school students had ever had sexual intercourse; 43.2% of sexually active students had not used a condom at last sexual intercourse; and 2.1% had ever injected an illegal drug. Of all deaths and substantial morbidity among adults greater than or equal to 25 years of age, 67% result from two causes--cardiovascular disease and cancer. Most of the risk behaviors associated with these causes of death are initiated during adolescence. In 1997, 36.4% of high school students had smoked cigarettes during the 30 days preceding the survey; 70.7% had not eaten five or more servings of fruits and vegetables during the day preceding the survey; and 72.6% had not attended physical education class daily. These YRBSS data are already being used by health and education officials to improve national, state, and local policies and programs to reduce risks associated with the leading causes of morbidity and mortality. YRBSS data also are being used to measure progress toward achieving 21 national health objectives and one of the eight National Education Goals.     

Inhibition conflict and alcohol expectancy as moderators of alcohol's relationship to condom use.

Inhibition conflict theory predicts that alcohol will decrease condom use only among individuals who are highly conflicted about using a condom, whereas expectancy theory predicts such an effect only among individuals who hold strong beliefs about alcohol's effects on sexual risk taking. In Study 1, the first of these two theories was tested using a newly developed measure of conflict. Data from 308 college students who reported on the first time they had sexual intercourse with their most recent partner (FMRP) supported the utility of this measure and showed that quantity of alcohol consumed was negatively associated with condom use only among high-conflict individuals. In Study 2, 17–25-year-old respondents reported on their first sexual intercourse, FMRP, and last intercourse (ns = 465, 1136, and 984, respectively). In a simultaneous test of both inhibition conflict theory and expectancy theory, amount of alcohol consumed was found to be negatively associated with condom use at first intercourse among individuals high in both conflict and expectancy, at FMRP among high-expectancy individuals, and at last intercourse among high-conflict individuals. These results lend partial support to both theories of alcohol's effects and suggest that an integration of these two perspectives will ultimately be required if researchers are to model adequately alcohol's effects on human social behavior. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Patterns and correlates of initial and subsequent drug use among adolescents.

Studied survey data collected in 1978–1981 examining prior and current drug use in 8th, 10th, and 12th graders in Maryland public schools. A 6-variable model (legal drugs, cannabis, pills, psychedelics, cocaine, and heroin) was used to examine the sequential and cumulative nature of drug use in a sample of 2,036 students drawn from a total sample of 34,479 males and females. Guttman scaling, using current use data for both the original and a cross-validational sample, found a stable, sequential, and cumulative hierarchy of drug use in all grades. Regression analysis of psychosocial variables found that age at first use; frequency of use of marihuana, alcohol, and cigarettes; and amount of available spending money emerged as significant predictors of use, but with little difference in predictors between the 6 drug categories. For individuals who go on to hard drug use, the data indicate that initiation into the sequence begins with a legal substance such as alcohol or tobacco and proceeds through use of marihuana. The relationship between prevalence, as well as intensity of drug use, and several psychosocial variables (e.g., academic goals, grades, spending money) emphasizes the need for further causal modeling. (21 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Risk behaviors, self-efficacy, and AIDS prevention among adolescents

This study was conducted to investigate risk behaviors and AIDS-preventive variables in high school adolescents. One hundred fifty-two students in Grades 10 through 12 were administered an AIDS-related behavior questionnaire and the Attitudes Toward AIDS Scale-High School Version (ATAS-HS; Goh, 1992). The results indicated that use of alcohol was far more common than other risk behaviors among the respondents. Rates of sexual intercourse and intravenous drug use were significantly lower than those reported in other research. Self-efficacy was significantly related to AIDS-preventive behavioral intentions, perceived knowledge, and measured knowledge about AIDS. Because the AIDS-preventive variables functioned differently in their relationships to sexual practices, the correlations suggest a pattern of co-occurrence between specific behavior intentions and actual AIDS-preventive behaviors (i.e., sexual experience, use of condoms). In addition, significant gender and grade differences were found on selected risk behaviors and AIDS-preventive variables.     

Tobacco consumption among the student population. Related factors

OBJECTIVE: To know smoking prevalence among schoolchildren and factors related with this habit. METHODS: A cross-sectional study. 548 school-children in their 6th and 8th years of primary studies at schools from an area of Córdoba (Spain) were interviewed. INTERVENTIONS: Autoadministered questionnaire. RESULTS: Tobacco was tried in 22% (CI 95%: 18.7-25.8) school-children. The average age for starting with this habit was 11.6 (SD)(CI 95%: 11.4-11.8). 12.1% smoked regularly and 1.3% smokers every day. The tobacco consumption in children was related with age (OR = 2.96; CI 95%: 1.12-7.82), cough medicines consumption (OR = 3.15; CI 95%: 1.32-7.48), to have a smokers sister (OR = 2.53; CI 95%: 1.06-6.00) and best friend (OR = 4.42; CI 95%: 1.85-10.60) and drinking beer (OR = 3.68; CI 95%: 1.15-11.7). CONCLUSIONS: The prevalence of smoking in our school-children is very close to that reported by others. Among the factors accounted with the tobacco consumption in schoolchildren, highlight the presence of this habit in the eldest sister and the best friend.     

Increased drug use among old-for-grade adolescents

OBJECTIVE: To determine whether students older than most other students at their grade level ("old for grade") are more likely to report engaging in alcohol, tobacco, and drug-related behaviors. DESIGN: Cross-sectional analyses of the Centers for Disease Control and Prevention Youth Risk Behavior Survey. SETTING: Monroe County, New York. PARTICIPANTS: A total of 1396 high school students from selected classrooms; 68 classrooms randomly selected within schools with the number of students per school proportionally selected from the 28 schools in the county. MAIN OUTCOME MEASURE: Rates of drug-related behaviors by age-for-grade status. RESULTS: Thirty-six percent of adolescents surveyed were old for grade. Adjusting for multiple potential confounders, old-for-grade high school students were more likely to report being regular smokers, chewing tobacco, drinking alcoholic beverages, driving in a car with someone who had been drinking, using alcohol or other drugs before last sexual intercourse, using cocaine in the past month, ever using crack, and using injected or other illicit drugs. CONCLUSIONS: Old-for-grade status is a potentially important marker for drug-related behaviors in adolescents. The antecedents of adolescent risk-taking behavior may begin before the teen years, and prevention of school failure or interventions targeted toward old-for-grade children could affect their propensity to experiment with or use drugs during adolescence.     

Relationship between drug use and other problem behaviors in urban adolescents.

Tested the generality of R. Jessor and S. L. Jessor's (1977) problem behavior theory, which states that a variety of problem behaviors constitute a behavioral syndrome in normal adolescents. Relationships among 5 adolescent problem behaviors (cigarette use, alcohol use, marijuana use, delinquency, and sexual intercourse) were examined in 7th-grade boys (n?=?556) and girls (n?=?715), and 9th-grade boys (n?=?481) and girls (n?=?485) in an urban school system in which the majority of students were African American and from low-income families. Measures of problem behavior frequency were positively correlated with each other and negatively correlated with several measures of conventional behavior. Confirmatory factor analyses replicated findings of previous studies that a single common factor underlies adolescent problem behaviors. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Sexual behaviour of adolescents before and after the advent of AIDS

OBJECTIVES: To asses changes in sexual behaviour and use of contraceptive methods in Danish adolescents from the period before the advent of AIDS up to the present. DESIGN: Comparative study comparing data obtained from two identical cross sectional surveys SETTING: Grenaa Gymnasium, Denmark. SUBJECTS: 626 high school students in 1982 and 499 high school students in 1996. METHODS: An anonymous standardised self administered questionnaire handed out to high school students at Grenaa Gymnasium in spring 1982. In spring 1996 an identical questionnaire was handed out to every high school student at the same gymnasium. MAIN OUTCOME MEASURES: Age at first sexual intercourse, contraceptive use, and reasons for choice of contraceptive strategy. RESULTS: Today more males had experienced the first sexual intercourse before their 16th birthday (p = 0.047) compared with 1982, the reverse held for females (p = 0.003). From 1982 to 1996 condom use increased in males with no regular partner (p = 0.009). In females with no regular partner, there was during the same period an increase in considering the condom a personal contraceptive method (p = 0.017). In 1982 and 1996 protection from sexually transmitted diseases was given as reason for the choice of contraceptive strategy by 21% and 72% of males with no regular partner (p < 0.001), and by 7% and 32% of males with a regular partner (p < 0.001). The corresponding figures for females in 1982 and 1996 were 10% and 71% (p < 0.001) for those with no regular partner and 4% and 21% (p < 0.001) for those with a regular partner. CONCLUSION: Condom use has increased among adolescents with no regular partner brought up under the widespread awareness of AIDS, and the reason for this is to be protected from sexually transmitted diseases. A future decline in the incidence of various sexually transmitted diseases may be expected, and information on safe sexual practices should be continued.     

The future of Medicare. Their plans, your practice, Medicare reform, and how it will affect the practice of dermatology

OBJECTIVE: To investigate the relationship between adolescent risk behaviours, taking into account their influence upon one another. DESIGN: Cross-sectional survey utilising a self-completed questionnaire; stepwise logistic regression analyses were carried out, stratified for gender. SETTING: High schools in the Cape Peninsula, South Africa SUBJECTS: 7,340 students from 16 schools in the three major education departments. OUTCOME MEASURES: The outcome variables for each regression model were: cigarette smoking, cannabis smoking, alcohol bingeing, sexual intercourse, knife-carrying at school, walking home at night from beyond the neighbourhood, attempting suicide, and failure to use a seat belt. For each model, 26 risk behaviours served as independent variables. RESULTS: For each model, between 3 and 9 variables qualified for inclusion for each gender. There was a substantial association between many forms of substance abuse. In the previous 12 months, suicidal thoughts or statements of suicidal intent were predictors of a suicide attempt. Several variables involving injury were predictors of exposure to danger in getting home at night, and this was a predictor of substance abuse. Cannabis smoking, alcohol bingeing and exposure to danger in getting home at night were predictors of and were predicted by having had sexual intercourse. CONCLUSION: There are significant relationships between many adolescent risk behaviours, even when the influence of other risk behaviours is taken into account. The probability of adverse sequelae of risk behaviours, such as exposure to danger in getting home at night and sexual intercourse, is increased by the presence of selected other risk behaviours.     

Acupuncture in the treatment of asthma: a critical review

OBJECTIVES: This study was undertaken in the mid-1990s (1994) to describe the use of tobacco, alcohol, and non-institutionalized drugs among pre-adolescent and adolescent Spanish students. METHODS: Information was collected within the framework of a periodic transversal study of life styles among European students, with particular emphasis on health-related habits. In the current study we present the results of the last survey carried out in Spain within the context of this study (1994), which involved a representative sample of Spanish students 11, 13, 15, 17 and 18 years-old (n = 6,711). An anonymous questionnaire was completed by the students in class. The survey sampling uses proportionate stratification and multistage sampling. RESULTS: In 1994, 49% of the Spanish students in this age group had tried tobacco. Twenty-four percent were sporadic or regular smokers. There was a large proportion of female smokers than male smokers (27% vs 20%). The overall proportion of smokers increased from 3% at 11 years to 47% at 18 years. One third (33%) of the 18-year-old students smoked daily. Eighty-four percent of the students of this age indicated that they had tried one or more types of alcoholic beverage. Twenty-one percent consumed alcohol regularly (at least once a week). Regular alcohol use was somewhat more common among males (24%) than among females (19%). Forty-six percent of the 18-year-old students consumed alcoholic beverages regularly and 66% had been intoxicated one or more times. Almost one fifth (18%) of the 13-to-18 year-old students indicated that they had tried some type of non-institutionalized drug, although the current rate of consumption was 8%. Cannabis was the drug most frequently tried (18%) and the drug most often consumed at present (8%), followed by cocaine and heroin. More males than females had tried non-institutionalized drugs. DISCUSSION: Analysis of the data revealed that adolescent tobacco use is increasingly frequent among females. Alcohol use continues to be widespread among Spanish pre-adolescents and adolescents. Alcohol use begins in childhood and becomes consolidated in adolescence. The results suggest, in relation to gender differences in the use of tobacco, alcohol, and non-institutionalized drugs, that there is a strong tendency toward the homogenization of these habits between genders. It is necessary to emphasize the preventive measures of drug dependence among Spanish pre-adolescents and adolescents.     

Correlates and predictors of HIV risk among inner-city African American female teenagers.

Objective Design: For human immunodeficiency virus (HIV)-related prevention initiatives to be most effective, they should be broad-based and incorporate multiple domains of influence. This study tested how several ecodevelopmental domains influenced HIV-risk related attitudes and behaviors in a community sample of African American female teens (N = 242). Main Outcome Measures: Outcome measures were number of partners, frequency of intercourse, number of pregnancies, abstinence/condom use, HIV/AIDS-related attitudes and behaviors, and HIV testing. Results: Structural Equation Modeling revealed many direct paths from ecodvelopmental domains to risky sexual behaviors. The findings include having more partners was associated with parental alcohol-related problems, more drug use, and a younger age at first intercourse. More frequent intercourse was associated with less cultural pride and more drug use. More pregnancies were related to a younger age at first intercourse and parental alcohol problems. HIV testing was associated with having experienced sexual abuse, an older age at first intercourse, and stronger self-efficacy. Conclusions: Prevention programs that focus on risk reduction could expand their focus beyond sexual behavior to include a broad-range of psychosocial domains that are associated with HIV-risk. The effectiveness of prevention programs should be monitored carefully for appropriateness in different ethnic groups. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Differential response to lithium and carbamazepine in the prophylaxis of bipolar disorder

The relation between selected indicator foods, alcohol and coffee intake, and the risk of pancreatic cancer was evaluated in a case-control study conducted between 1983 and 1992 in northern Italy on 362 patients with histologically confirmed, incident cancers of the pancreas, and 1,552 controls in hospital for acute, non-neoplastic diseases. Odds ratios (ORs) for subsequent tertiles of intake were computed after allowance for sociodemographic factors and tobacco smoking. Pancreatic cancer risk was directly associated with consumption of meat (OR for the highest frequency tertile = 1.43), liver (OR = 1.43) and ham and sausages (OR = 1.64), and inversely with consumption of fresh fruit (OR = 0.59), fish (OR = 0.65) and olive oil (OR = 0.58). No appreciable association was found with coffee (OR = 1.21) and alcohol consumption (OR = 1.20). A summary score was derived by summing the six related food items; compared to the lowest level, the OR was 2.7 for the highest quintile, and the population attributable risk was 36% (95% confidence interval, 15-57%), indicating the scope of diet for the prevention of this common neoplasm in the Italian population.     

Sex-related alcohol expectancies predict sexual risk behavior among severely and persistently mentally ill adults.

Three hundred three adults (57% male, average age 42 years) with severe and persistent mental illness receiving treatment at community mental health clinics completed a survey, which included B. C. Leigh's (1990) sex-related alcohol expectancy scale and measures of alcohol use and sexual risk behavior. Hierarchical logistic regression analyses, controlling for drinking behavior, revealed that participants with stronger expectancies that drinking would lead to enhanced sexual experience were more likely to have drank prior to intercourse and that, among participants who drank prior to intercourse, those with stronger expectancies that alcohol would lead to riskier sexual behavior were more likely to have engaged in sexual risk behavior. Implications for preventing HIV infection among people with severe mental illness are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Relation of light and exercise to seasonal depressive symptoms: preliminary development of a scale

In the first large-scale survey on the use of alcohol and tobacco and the inhalation of paint thinner by Japanese high school students, a higher percentage of respondents reported past or regular use of these substances than in a 1978 survey. The survey was conducted in 44 high schools. The 14,438 respondents (ages 15-18 years) represented 9 of Japan's 47 geographically distinct urban and rural prefectures. Most (76%) reported that they had consumed alcohol at some time, and 50% reported drinking on a regular basis. Alcohol consumption, drinking partners, and motivation for drinking were compared by student gender, geographic region, and years of education. Fewer students reported smoking cigarettes: 32% had smoked at some time, and 14% smoked regularly. Inhalation of paint thinner was rare: 3% had purposely inhaled it, and 1% had abused it. A significant percentage of the alcohol drinkers also used tobacco and/or thinner, a tendency that was the same despite differences in gender, grade in high school, and urban or rural geographic region. A tendency toward polysubstance use was evident among these high school students.