中国北方两城市青少年健康危险行为多发特点分析

目的了解城市青少年健康危险行为的多发特点。方法典型抽取北京、济南两城市7230名大中学生进行无记名式问卷调查,比较不同年级、家庭结构和学习成绩学生10种主要健康危险行为多发情况。结果33.3%学生无任何健康危险行为,男生、大学生、单亲/重组家庭和成绩差的学生中健康危险行为多发现象比较突出。随年级增高,步行违规、斗殴、自杀等伤害相关行为逐渐被吸烟、饮酒等物质成瘾性行为取代。与具有一种健康危险行为学生相比,具有四种及以上健康危险行为的学生中吸烟、不健康减肥、网络成瘾发生率大幅增加,可作为青少年学生标志性的健康危险行为。结论青少年健康危险行为多发现象与年龄、家庭结构和学习成绩有关,应针对行为多发特点,在青少年中开展综合性行为干预。     

Binge eating and substance use among male and female adolescents.

OBJECTIVE: This study examines the relationship between binge eating and substance use behaviors and attitudes in adolescents and explores gender differences and mental health correlates. METHOD: The data are derived from the 1997 Ontario Student Drug Use Survey of public and Catholic school students. A weighted sample of 1,031 girls and 888 boys was categorized as nonbingers, past bingers, and noncompensating or compensating binge eaters. RESULTS: Binge eaters, particularly those who compensated, were more likely to use all types of substances, particularly cannabis and drugs other than tobacco and alcohol. Binge eating was associated with more problematic and heavier substance use and with lowered self-esteem and more depression. Female bingers were more likely to report compensatory behaviors than male students but gender differences in the relationship between binge eating and substance use were few. DISCUSSION: Adolescent binge eaters who engage in compensatory behaviors may be an appropriate target group for preventive programs in high schools.     

Characteristics and Behaviors of Non-overweight College Students Who are Trying to Lose Weight

The purpose of the current study was to examine characteristics and behaviors of college students who perceive themselves as underweight or about the right weight, yet report trying to lose weight, as compared to their counterparts. Participants included 944 students (M = 20.4 years, 61.1 % White; 64.7 % female) at a southwestern university. A composite of perceived weight and weight-related behavior was created. Participants who reported they were under- or about the right weight and trying to lose weight were included in this composite group. Cross-sectional logistic regression analyses were run to assess characteristics and behaviors of the composite group. Individuals in this group were significantly more likely to be women, in a fraternity/sorority, have a lower body mass index, engage in regular vigorous physical activity, exercise and/or diet to lose weight, and engage in unhealthy weight-control behaviors. These individuals were not more likely than their counterparts to consume 5 or more servings of fruits/vegetables daily, to engage in moderate physical activity, or to report smoking cigarettes in the past month. Further research is needed to understand why individuals who perceive themselves as under- or about the right weight engage in certain weight-loss behaviors. Interventions to target weight-related perceptions and behaviors among college-age individuals may need to address unhealthy weight-control measures.     

Purging and alcohol-related effects in college women

OBJECTIVE: Previous research indicates that college students who purge are more likely to consume alcohol in an unhealthy manner. The current study replicates and extends a previous study but employs a much larger, national sample. This study addresses 2 questions: (a) Are 18-24-year-old college women who purge more likely to engage in high-risk alcohol behavior? (b) Are 18-24-year-old alcohol-drinking college women who purge more likely to report greater negative consequences of alcohol use. METHOD: 47,202 U.S. students completed the National College Health Assessment during Spring 2004. Alcohol consumption and negative alcohol-related consequences were compared in purging and nonpurging groups. RESULTS: Respondents who purged reported heavier alcohol use and more negative consequences. CONCLUSION: The current study expands previous research regarding the association between purging behaviors and consequences of alcohol use. Further research is necessary to elucidate the most effective prevention and treatment programs.     

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.     

Prevalence of health risk behaviors among Asian American/Pacific Islander high school students.

PERPOSE: To compare the prevalence of selected risk behaviors among Asian American/Pacific Islander (AAPI) students and white, black, and Hispanic high school students in the United States. METHODS: The national Youth Risk Behavior Survey conducted in 1991, 1993, 1995, and 1997 by the Centers for Disease Control and Prevention produced nationally representative samples of students in grades 9 through 12 in all 50 states and the District of Columbia. To generate a sufficient sample of AAPI students, data from these four surveys were combined into one dataset yielding a total sample size of 55, 734 students. RESULTS: In the month preceding the survey, AAPI students were significantly less likely than black, Hispanic, or white students to have drunk alcohol or used marijuana. AAPI students also were significantly less likely than white, black, or Hispanic students to have had sexual intercourse; however, once sexually active, AAPI students were as likely as other racial or ethnic groups to have used alcohol or drugs at last intercourse or to have used a condom at last intercourse. AAPI students were significantly less likely than white, black, or Hispanic students to have carried a weapon or fought but were as likely as any of the other groups to have attempted suicide. CONCLUSIONS: A substantial percentage of AAPI students engage in risk behaviors that can affect their current and future health. Prevention programs should address the risks faced by AAPI students using culturally sensitive strategies and materials. More studies are needed to understand the comparative prevalence of various risk behaviors among AAPI subgroups.     

Recency of immigration, substance use, and sexual behavior among Massachusetts adolescents

OBJECTIVES: This study examined the relationships between recency of immigration, substance use, and sexual behavior. METHODS: Surveys were conducted with 2635 Massachusetts 8th and 10th graders that allowed comparisons of health behaviors and risk and protective factors among students living in the United States "always," more than 6 years, or 6 years or less. RESULTS: Compared with lifetime residents, immigrant youths (particularly those living in the United States 6 years or less) reported lower lifetime and recent alcohol and marijuana use (P < .001); sexual intercourse rates were similar across groups. However, recent immigrants were most likely to report peer pressures to engage in, and less parental support to avoid, risk behaviors (P < .001). CONCLUSIONS: A window of opportunity exists to provide primary prevention programs in schools to immigrant youths that may reduce adolescent health risk behaviors.     

Intervene: Modeling Pro-Social Bystander Behavior in College Students through Online Video

ABSTRACT

This study evaluates the impact of a theory- and empirical evidence- based 20-minute video, Intervene, on college students’ intentions to intervene on behalf of others in multiple problematic situations: an alcohol emergency, emotional distress, hazing, intimate partner violence, racial bias, sexual assault, and sexual harassment. A randomized controlled trial of undergraduate and graduate students (N = 1,243) was conducted to determine the effectiveness of the video as an intervention for increasing students’ self-reported likelihood to engage in pro-social bystander behavior across these various situations. Results showed that participants who viewed the video online reported higher likelihood at 4 weeks post-viewing to intervene in situations involving hazing, intimate partner violence, racial bias, and sexual harassment than did their control group counterparts. Intervene is the first video-based bystander education intervention shown to be effective, even 4 weeks after viewing, at increasing college students’ self-reported likelihood to intervene in multiple problematic social situations. Providing access to this free online video represents a cost-effective prevention and communication strategy that can be employed by other colleges and universities.     

Physical dating violence among high school students--United States, 2003

Dating violence is defined as physical, sexual, or psychological violence within a dating relationship. In a study of dating violence victimization among students in grades 7-12 during 1994-1995, the 18-month prevalence of victimization from physical and psychological dating violence was estimated at 12% and 20%, respectively. In addition to the risk for injury and death, victims of dating violence are more likely to engage in risky sexual behavior, unhealthy dieting behaviors, substance use, and suicidal ideation/attempts. Dating violence victimization can be a precursor for intimate partner violence (IPV) victimization in adulthood, most notably among women. Among adult women in the United States, an estimated 5.3 million IPV incidents occur each year, resulting in approximately 2 million injuries and 1,300 deaths. By using data from the 2003 Youth Risk Behavior Survey (YRBS), CDC analyzed the prevalence of physical dating violence (PDV) victimization among high school students and its association with five risk behaviors. The results indicated that 8.9% of students (8.9% of males and 8.8% of females) reported PDV victimization during the 12 months preceding the survey and that students reporting PDV victimization were more likely to engage in four of the five risk behaviors (i.e., sexual intercourse, attempted suicide, episodic heavy drinking, and physical fighting). Primary prevention programs are needed to educate high school students about healthy dating relationship behaviors, and secondary prevention programs should address risk behaviors associated with dating violence victimization.     

Health risk behaviors of adolescent participants in organized sports

Purpose: To assess differences in health-related behaviors between athletes and nonathletes.

Methods: In Grades 9-12 in seven high schools during the 1991-1992 academic year, 7179 (82%) students were asked to complete a survey with six categories of health-related behaviors associated with adolescent morbidity and mortality. Of the 6849 students who completed the survey, 4036 (56%) were classified as athletes. Analyses of differences were controlled for age, race, and gender.

Results: Athletes and nonathletes differed in specific health-risk behaviors. Nonathletes were more likely than athletes ever to have smoked cigarettes (15% vs. 10%) or used marijuana (24% vs. 23%), and fewer ate breakfast daily (34% vs. 45%), never added salt to food (18% vs. 22%), consumed calcium (56% vs. 64%), or consumed fruit or vegetables (40% vs. 47%) daily. More nonathletes reported frequent feelings of hopelessness (15% vs. 10%) and rarely or never using seatbelts (24% vs. 20%), but more athletes reported exceeding the speed limit by 10 mph (39% vs. 35%) and riding bicycles (40% vs. 28%) and/or motorcycles (13% vs. 8%) without helmets. These differences were statistically significant.

Conclusions: Because of their behaviors, adolescent athletes put themselves at significant risk for accidental injuries. However, athletes appear less likely to smoke cigarettes or marijuana, more likely to engage in healthy dietary behaviors, and less likely to feel bored or hopeless.     

Correlates of gambling among eighth-grade boys and girls

BACKGROUND: This study examined the correlates of gambling behavior among eighth‐grade students. METHODS: Children (n = 15,865) enrolled in publicly funded schools in Oregon completed the 2008 Oregon Healthy Teens survey. Multivariate logistic regression analyses assessed the combined and independent associations between risk and protective factors with active gambling among male and female youth separately. RESULTS: Approximately 17% of eighth‐grade girls and 33% of eighth‐grade boys had gambled during the past 3 months. Most health risk behaviors were positively associated with gambling. However, gambling was also positively associated with frequent physical activity participation and, among boys, eating 5 daily servings of fruits and vegetables. Logistic regression analyses identified significant differences among risk and protective factors between active gamblers and non‐gamblers. Regardless of gender, relative to active gamblers, non‐gamblers were more likely to hold strong personal health beliefs, be uninvolved in antisocial behavior, exhibit good safety behaviors, and not have experienced a mouth injury while playing sports during the past year. Female gamblers were more likely to be active tobacco users, to speak a language other than English at home, and engage in more than 2 hours a day of screen time than non‐gamblers. Male gamblers were more likely to be physically active, Hispanic, use alcohol, and perceive lower levels of social control in their neighborhoods than non‐gamblers. CONCLUSIONS: Gambling may be a topic that is appropriate for inclusion in school programs targeting health risk reduction among eighth‐grade students.     

A Comparison of Weight-Related Behaviors Among High School Students Who Are Homeless and Non-Homeless

BACKGROUND: Previous research has shown that youth who are homeless engage in high-risk behaviors. However, there has been little information published on nutritional and physical activity behaviors in this population, and studies comparing homeless youth in school with their non-homeless peers are scarce. This study compares weight-related risk behaviors of public high school students in Massachusetts based on homeless status.
METHODS: We obtained data from 3264 9th through 12th grade students who participated in the 2005 Massachusetts Youth Risk Behavior Survey. Multivariable logistic regression, controlling for gender, grade, race/ethnicity, and sexual orientation, was performed to assess the relationship between homeless status as defined by the McKinney-Vento Homeless Assistance Act and weight-related indicators. Analyses were weighted and adjusted for the multistage complex sampling design.
RESULTS: Of this sample, 4.2% reported being homeless (n = 152). Higher prevalence of homelessness was found among males, racial/ethnic minorities, sexual minorities, and students who were not in a traditional grade level. The distribution of body mass index was similar among students who were homeless and non-homeless (underweight 4.0 and 3.0%, and overweight 27.1 and 27.1%, respectively). Homeless students were more likely than non-homeless students to report disordered weight-control behaviors including fasting (aOR 2.5, 95% CI 1.4–4.5) and diet pill use (aOR 3.3, 95% CI 1.6–6.9).
CONCLUSIONS: More than 4% of public high school students in Massachusetts meet the federal definition of homelessness. These students are at high risk for disordered weight-control behaviors. Policy decisions at the school, state, and federal levels should make a concerted effort to target these students with social services and nutritional interventions.     

Hazing of suburban middle school and high school athletes.

Little is known about the prevalence of hazing behaviors among adolescent athletes. Our survey of 1105 6th-12th grade athletes found that 17.4% had been subjected to practices that qualify as hazing. Many of these teenagers do not comprehend the abusive and potentially dangerous nature of hazing.     

Midwestern rural adolescents' oral sex experience

BACKGROUND: This study examined the prevalence of oral sexual activity in rural Midwestern adolescents. We also examined the correlates of a series of risk behaviors with oral sexual activity. METHODS: A questionnaire based on the Youth Risk Behavior Surveillance System was distributed to 2121 rural middle and high school students in grades 6–12 across 5 rural counties in a Midwestern state. The schools within districts were stratified by grade level and a stratified random sample of schools was used (n = 49). RESULTS: A total of 2000 (94%) students completed the survey. The rural adolescents were: male (51%), White (85%), with an average age of 14.7 years (SD = 1.9). Overall, one‐fourth (26%) of the students had engaged in sexual intercourse (8% of middle school and 39% of high school students). Slightly more than one‐fourth of the students (29%) had engaged in oral sex (9% of middle school and 44% of high school students). Logistic regression was used to calculate adjusted odds ratios and found 3 risk behaviors were statistically significantly associated with oral sexual behavior: ever having had sexual intercourse (16.6 times more likely to engage in oral sex), having drunk alcohol in the past 30 days (2.2 times more likely), and having smoked 1 or more cigarettes in the past 30 days (2.0 times more likely). CONCLUSIONS: Oral sexual activity is an established component of many rural adolescents' sexual experiences. These findings have important implications for sex education programs targeted to rural adolescent youths.     

《卫生化学》课程研究型教学方法与成效研究

摘要:目的 探讨研究型教学对本科学生《卫生化学》课程学习行为和成效的影响。方法 以医学高等教育预防医学专业《卫生化学》专业基础课程为例,采用准实验设计,分别进行传统讲授式教学和研究型教学,对2种教学实践的学习成效及行为进行比较。结果 研究型教学下有更好的学业成绩（t = 3.071,P ＜0.05）;有更多学习时间投入（t = 2.254,P ＜0.05）,更多合作学习时间（t = 5.845,P ＜0.05）;传统教学学生更多看教师PPT进行学习（t = 2.740,P ＜0.05）,研究型教学下学生更多使用老师推荐的课外网络学习资源（t = 2.960,P ＜0.05）;基础知识课后学习方式与传统教学的差异是更多与同学探讨（t = 5.510,P ＜0.05）或寻求帮助（t = 2.550,P ＜0.05）。结论 研究型教学对自主探究能力的培养与知识学习并不冲突,学生可以通过自主学习实现更佳的学习成效。研究型教学能够激发学生更多学习投入,自主进行扩展性知识探究,以及更多的合作学习。     

Associations Between Adolescent Risk Behaviors and Injury: The Modifying Role of Disability

BACKGROUND:  Adolescents with disabilities are at risk for poor health outcomes including injury. The objective of this study was to examine if disability status modifies the association between risk behavior and injury among adolescents.
METHODS:  The cross-sectional Health Behavior in School-Aged Children Survey was administered to a representative sample of 7235 Canadian students (grades 6-10) in 2002. Students who reported at least 1 functional difficulty due to a health condition were classified as having a disability. Engagement in up to 6 individual risk behaviors and a summative multiple risk behavior score were considered the primary exposures. Primary outcomes included medically attended injury experienced during a 12-month period.
RESULTS:  Sixteen percent of students reported a disability. Almost all risk behaviors and all injury outcomes were more common among students with disabilities than in those without disabilities (eg, older age group's smoking: 17.5% vs 8.9%, p = <.01; medically attended injury: 67.4% vs 51.4%, p = <.01). Clear risk gradients were observed between engagement in multiple risk behavior and all injury outcomes. The association between multiple risk behavior and injury was accentuated by disability status among older students, particularly for students with disabilities who engaged in frequent multiple risk behavior (adjusted risk ratio 1.8, 95% CI: 1.6-1.9).
CONCLUSIONS:  Canadian students with disabilities who engage in risk behaviors experience higher risks for medically attended injury than their nondisabled peers who engage in those same risk behaviors. Injury prevention programs that focus on risk-taking behavior should integrate the needs of this high-risk group of adolescents in order to prevent additional disability.     

Association between use of complementary/alternative medicine and health-related behaviors among health fair participants.

BACKGROUND: The relationship between complementary and alternative medicine (CAM) and standard preventive care is not well defined. METHODS: We surveyed 1,593 health fair participants on their use of CAM and determined odds ratios for standard preventive care and healthy behaviors among users of provider-based CAM (e.g., chiropractic) and users of herbs or supplements. RESULTS: Users of provider-based CAM were no less likely than nonusers to receive standard preventive care, with the exception of lower likelihood of influenza vaccination among elderly CAM users (OR 0.2). Herbs or supplements were used by a majority of respondents (61%), and users were more likely to report engaging in healthy behaviors such as eating a low-fat diet (OR 1.5) and taking a daily multivitamin (OR 2.0). CONCLUSIONS: Those who use alternative therapies, including herbs or supplements, appear no less likely overall than nonusers to receive standard preventive care. In addition, users of herbs or supplements are more likely to engage in healthy behaviors and appear to be a more health-conscious group. Overall, our findings support the notion that unconventional therapies are more complementary than alternative to standard preventive care.     

The contextual effect of school satisfaction on health-risk behaviors in Japanese high school students

BACKGROUND: The importance of school contextual effects on health and well-being among young people is currently recognized. This study examines the contextual effects of school satisfaction as well as the effects of individual-level school satisfaction on health-risk behaviors in Japanese high school students. METHODS: Self-administered questionnaires were distributed to 3248 students in grades 10 through 12 at 29 public high schools throughout Okinawa, Japan. Using multilevel logistic regression models, the effects of individual- and contextual-level school satisfactions on health-risk behaviors were analyzed. The contextual-level school satisfaction was defined as satisfaction at the school level and was measured using aggregated individual scores. Behaviors studied included current smoking, current drinking, and sexual activity. RESULTS: Approximately 15%, 6%, and 5% of the total individual differences in smoking, drinking, and sexual behaviors, respectively, occurred at the school level. Students with lower school satisfaction were more likely to engage in health-risk behaviors compared with those with higher school satisfaction. After adjustment for individual-level school satisfaction and other covariates, the odds of smoking and drinking increased with decreasing contextual-level school satisfaction. However, the association of contextual school satisfaction with sexual activity did not reach statistical significance. CONCLUSIONS: This study showed that individual- and contextual-level school satisfactions affected smoking and drinking behaviors in Japanese high school students. However, no significant association between contextual-level school satisfaction and sexual activity was observed.     

Increasing MDMA use among college students: results of a national survey.

PURPOSE: To examine the prevalence and changing patterns of ecstasy use among college students, and to determine characteristics, associated behaviors, and interests of ecstasy users. METHODS: The study analyzes data regarding ecstasy use and related behaviors from the 1997 and 1999 Harvard School of Public Health College Alcohol Study. This is a survey of a nationally representative sample of over 14,000 college students at 119 U.S. four-year colleges. Changes in self-reported annual ecstasy use were examined, and lifestyle and high-risk behaviors associated with Ecstasy use were identified. Data were analyzed using 2 x 2 Chi-square tests and multiple logistic regression fitted by the generalized estimating equations (GEE). RESULTS: The prevalence of past year ecstasy use rose from 2.8% to 4.7% between 1997 and 1999, an increase of 69%. This increase was observed across nearly all subgroups of student and college type. A smaller sample of ten colleges revealed that the increase continued in 2000. Ecstasy users were more likely to use marijuana, engage in binge drinking, smoke cigarettes, have multiple sexual partners, consider arts and parties as important, religion as less important, spend more times socializing with friends, and spend less times studying. Unlike other illicit drug users, ecstasy users were not academic underachievers and their satisfaction with education was not different from that of non-ecstasy users. CONCLUSION: Ecstasy use is a high-risk behavior among college students which has increased rapidly in the past decade.     

A Gender Discrepancy Analysis of Heterosexual Sexual Behaviors in Two University Samples

The current study aimed to (1) offer a large-scale enumeration of college students’ lifetime sexual behaviors and sexual behaviors at last event, and (2) apply a gender discrepancy lens to college students’ sexual behaviors in order to examine potential gender differences in heterosexual college students’ experiences. Nine-hundred and seventy college students between the ages of 18 and 27 from two large universities in the United States participated in the current study. Participants filled out a paper–pencil questionnaire during the last 30 min of class. Measures of lifetime sexual behaviors and engagement in behaviors at last sexual event were replicated from the National Survey of Sexual Health Behavior. Most college students engaged in some form of sexual behavior (manual, oral, vaginal-penile, anal). Men more frequently reported engaging in receptive sexual behaviors (e.g., receiving oral sex) where as women were more likely to engage in performative sexual behaviors (e.g., performing oral sex). At most recent sexual event, men were more likely than women to report being the sexual initiator. Findings highlight gender differences in sexual behavior and provide a foundation for social norms interventions. Holistic sexual health promotion for young adults includes acknowledging and discouraging sites of disparity in equity and pleasure. Therefore, college-level sexual health educators should pay attention to the potential pleasure gap between men and women in heterosexual encounters, and to see pleasure as an important part of sexual health that should be included in social norms campaigns.