Adolescents, Volume 2, Issue 2 (June 2022) – 14 articles

The objective of the present research was to evaluate if and to what extent the encounter between different cultures in a context of globalization may have influenced the adherence to the Mediterranean diet (MD) in adolescents. The study comprised a structured questionnaire packet that inquired about anthropometric data, demographic information and both dietary and lifestyle habits. The KIDMED questionnaire was used to evaluate the adherence to the MD. A total of 103 respondents, aged 10–24 years (39.8% born in Italy or first-generation immigrants from Mediterranean countries) were included in the study. The results showed the highest percentage of adolescents having a medium adherence to the MD (44.7%), without differences according to geographical area of origin. Furthermore, the study proved that a higher adherence to the MD was significantly associated with daily breakfast (p = 0.008) and the consumption of fruit and vegetables (p = 0.002 and p = 0.000, respectively). Volunteers representing some of the different cultures and geographical proveniences currently present in Italy were perfectly integrated regarding diet and lifestyle, aspects considered in this study. Our investigation suggests the existence of incorrect dietary habits. It is certainly necessary to implement public health policies targeting adolescents to promote healthier lifestyle choices; the nutritional patterns of the MD should be among these choices. Full article

This study aimed to identify the level of stress in teenagers from multicultural families in Korea and examine the factors influencing this stress. This cross-sectional study utilized the 15th (2019) Korea Youth Risk Bsehavior Web-based Survey. Of the 57,303 survey participants, 749 reported that their father, mother, or both parents were born outside of Korea. These 749 multicultural individuals were selected as study participants. We examined general characteristics (sex, grade, parental education level, academic performance level, foreign nationality, residence type, economic status, exposure to violence, and frequency of physical activity), health risk behaviors (sexual activity, drug use, and drinking), and mental health factors (sleep, depression, and presence of suicidal thoughts) to determine whether these factors may contribute to multicultural adolescent stress. Multicultural adolescents who reported insufficient sleep, depression, or suicidal thoughts were more likely to experience stress than those who did not report these factors. Moreover, participants with insufficient sleep were 3.73 times more likely to feel stress than those with good sleep. Among general characteristics, health risk behaviors, and mental health factors, mental health factors were observed to significantly predict an increase in multicultural adolescents’ stress levels. Considering the increase in the number of multicultural adolescents in Korea, it is important to address the difficulties they experience to provide appropriate interventional programs. Such programs should include techniques to help with the management of stress. Full article

We investigated whether bedtime schedules and bedtimes in childhood were associated with obesity risk and adiposity in adolescence. We analysed the data of 12,645 singleton children classified as not obese at 7 years from the Millennium Cohort Study in the United Kingdom. Bedtimes and the regularity of bedtimes of 7-year-olds were reported by parents. Bio-electric impedance body fat percentage (BFP) measurements and obesity at 11 and 14 years were the considered outcomes. The International Obesity Task Force age- and sex-specific thresholds were used to define obesity. Obesity risk at 11 and 14 years was higher among children with never-regular bedtimes at 7 years compared with those with always-regular bedtimes (risk ratio, RR, 2.8 (95% CI, 1.8–1.4) and 2.3 (95% CI, 1.5–3.6), respectively). An increasing irregularity in childhood bedtime was associated with an increasing risk of obesity at both 11 and 14 years in a dose–response manner (p trend < 0.001; and p trend = 0.002, respectively). BFP at 11 years increased by 1.1% (95% CI, 0.8–1.5) for boys and 1.0% (95% CI, 0.6–1.4) for girls for every hour delay in childhood bedtime. Irregular bedtime schedules and later bedtimes in childhood were associated with an increased risk of obesity in early- and mid-adolescence in a dose–response manner. There was marginal, but significant, increases in BFP during adolescence for children with later bedtimes. Full article

An increasing number of parents and scholars have begun expecting schools and the government to share the responsibility of reducing the potential negative effects of SNS use among adolescents. This study examines how the public understands the risks that adolescents face, as well as the causes and solutions, and how news media influence not only the public’s risk perceptions but also their policy preference for public interventions. Drawing on framing and attribution theories, this study used two datasets. First, the content analysis data explore Taiwanese news media’s coverage of youths’ online behaviors and how the media has framed the question “Who is responsible for adolescents’ risky and opportunity behaviors?” Second, the public opinion survey data addresses the influence of news consumption on the public perception of the risks facing adolescent Facebook users, the public’s attribution of related responsibilities to various stakeholders, and the public’s evaluation of parental mediation and government regulations. Full article

Introduction: Cognitive dysfunction is a hallmark feature of many psychiatric disorders. We aimed to study the prevalence and predictors of cognitive dysfunction (CD) among U.S. high school students and its association with time spent on digital devices. Methods: We performed a cross-sectional survey study using YRBSS 2019 data of U.S. high school students in grades 9–12. Cognitive dysfunction was defined by difficulties with remembering, concentrating, and making decisions due to emotional, physical, or mental problems. Digital screen time was described by daily time spent on TV, computers, tablets, and phone. We performed univariate and multivariable survey logistic regression analysis to identify the prevalence of cognitive dysfunction and its association with time spent on digital devices. Results: Out of 10,317 total participants, 3914 (37.9%) reported CD. The prevalence of CD was higher in females compared to males (46.0% vs. 29.9%). Compared to participants with no CD, participants with CD reported substance abuse, such as alcohol (35.8% vs. 26.6%), marijuana (28.3% vs. 17.6%), cigarette (8.1% vs. 4.7%), and illicit drugs (18.9% vs. 9.0%) and they reported a higher prevalence (p < 0.0001 for all substances). Participants who felt sad and hopeless (62.8 vs. 22.1%) reported a high prevalence of CD, whereas participants with adequate sleep reported low prevalence (15.7% vs. 25.6%). In a regression, daily video game/internet use for non-work-related activities for 4 h (aOR:1.27; p = 0.03) and ≥5 h (aOR:1.70; p < 0.0001) demonstrated higher odds of CD, compared to participants with no daily use. Female sex, substance use, and depressed mood were additional predictors of CD. Conclusion: The prevalence of CD is high in U.S. high-school students. Female sex, substance abuse, depressed mood, and excessive VG/PC use is associated with high odds of cognitive dysfunction. Further research is needed to explore the complex relationship between screen time and cognitive dysfunction. Full article

The vast majority (90%) of the world’s young people aged 10–24 years live in low and middle-income countries (LMICs). Pakistan has one of the world’s largest populations under 30 years. Adolescents’ access to basic sexual and reproductive health (SRH) services, such as family planning and sexuality education, remains low, especially in rural areas such as the Gilgit-Baltistan (GB) province of Northern Pakistan. This study addressed these gaps by exploring the SRH priorities and health information needs of adolescents living in GB. A cross-sectional survey was conducted with adolescents and healthcare providers. A total of 216 adolescents and 22 healthcare providers completed the survey forms. The findings pointed out that adolescents in GB have unmet SRH needs and are more interested in learning about SRH, human immunodeficiency virus (HIV) and sexually transmitted infections (STIs), and sexual abuse. The majority of the participants highlighted that their age, fear of being judged/stigmatized, and society’s attitude toward sex hinder them from opting for SRH services. The majority of healthcare providers reported that they are not well-equipped to tackle SRH-related issues and require training to better serve the adolescent SRH needs. The findings from this study have highlighted that there is a need to formulate robust interventions and strategies to raise knowledge and awareness about SRH needs among adolescents. Full article

The aim of the current study was to investigate the relationship between school bullying and inter-peer group status among Japanese middle-school students. A total of 2294, 7th–9th grade Japanese middle-school students participated in this study. Using a self-report questionnaire, we measured their inter- and intra-peer group status, bullying behavior, victimization, coping strategy, and current victimization status. The results showed that, compared to those in the higher-status groups, students in lower-status peer groups tended to be bullied and experienced prolonged victimization. These findings suggest that a lower peer-group status predisposes students to victimization. Full article

Cyberbullying victimization (CV), a widespread experience in adolescence, is associated with increased depression and suicidality. However, few studies have taken a gender approach when investigating the association between CV and suicidality, despite research that indicates disparate experiences by gender for both CV and mental health. We conducted a secondary data analysis of the 2019 Youth Risk Behavior Survey (N = 10,309; 50.1% girls), a cross-sectional survey drawn from a representative sample of US high school students. We found that CV remained significantly associated with suicidality after controlling for emotional and behavioral risk factors, for both boys and girls. CV increased the odds of suicidality directly and indirectly by increasing risk for depression, for both boys and girls. Boys contending with both CV and sexual violence were particularly vulnerable to suicidality, and binge drinking was positively associated with CV for girls but negatively associated with CV for boys. Findings confirmed that CV is a pervasive issue among U.S. adolescents. A gendered approach is necessary in order to understand and address the effects of CV. Full article

Scoliosis is an abnormal curvature of the spine, which generally develops during childhood or adolescence. It affects 2–4 percent of the global population and is more prevalent among girls. Scoliosis is classified by its etiology: idiopathic, congenital, or neuromuscular. Among these, the former is the most common. Treatment options for scoliosis vary depending on the severity of the curve. Most scoliosis diagnoses tend to be mild and only require monitoring. However, curves between 20 and 40 degrees require bracing, while 40 degrees and above require surgery. There are various bracings available, such as Boston, Charleston, and Milwaukee. In severe cases of scoliosis, either fusion or fusionless surgery may be required. This review aims to discuss etiologies and different treatment interventions for scoliosis. Full article

Adolescence is a period between childhood and adulthood with eating habits often against the nutritional needs of adolescents. The present study used a socio-ecological approach to investigate personal and environmental factors influencing the eating habits of 15- to 19-years old Beninese urban schoolgirls. Eleven focus groups (n = 77) and seven individual interviews were conducted with adolescent girls attending school in Cotonou, Benin. Focus groups were as homogeneous as possible regarding age group and school character. Transcripts were analyzed using an inductive-deductive thematic method using the socio-ecological model. Taste preference for sweet foods, insufficient dietary knowledge and low personal income were factors explaining unhealthy food choices, while higher self-efficacy and healthy outcome expectations mainly characterized their healthy eating habits at the intrapersonal level. Family influence was beneficial for healthy eating while friends’ pressure led to an unhealthy diet at the interpersonal level. At the organizational level, adolescents reported unhealthy school food environments and urban areas increased their unhealthy eating habits. It appears that one factor alone is not enough to influence adolescent girls’ eating habits. Therefore, this study presents the need of elaborating interventions in a school context to improve eating habits in adolescents focusing on different factors in Beninese adolescent schoolgirls. Full article

Background. This study examined the effects of post-traumatic stress symptoms and child–primary caregiver relationships on the ethnic identity of Yi ethnic minority adolescents (n = 550; aged 13–18) in rural China over one school year. The moderating effect of caregivers’ relationships over time and ethnic identity, and post-traumatic stress and ethnic identity, were investigated. Methods. Participants completed two waves of the survey. Longitudinal multilevel modeling was used. Results. (1) Ethnic identity exploration increased over time, while ethnic identity commitment remained stable. (2) Post-traumatic stress symptoms led to high levels of ethnic identity exploration and commitment. (3) Participants with distinct caregivers’ relationship patterns, i.e., secured, optimal, deprived, and disengaged, differed in their ethnic identity exploration scores, but not in ethnic identity commitment. (4) While the secured group scored highest in their ethnic identity development over time, youths who felt disengaged with their caregivers showed the fastest rate of positive change in their ethnic identity exploration. (5) Having a secured caregivers’ relationship weakened the effect of post-traumatic stress on ethnic identity exploration. Conclusion. Practical implications for the meaning of ethnic identity exploration, the promoting effect of caregivers’ relationships, and the negative impact of post-traumatic stress among ethnic minority youths were discussed. Future research directions were also proposed. Full article

Background: During puberty and emerging sexuality, adolescents experience important physical, mental, and social transformations. In the process of dealing with these changes, adolescents can become potentially vulnerable to mental health problems. Aim: The aim is to identify and synthesize published research evidence on sexuality-related mental health stressors among adolescent girls and boys, identify gaps (if any) in the current knowledge, and contribute to the knowledge about the experiences of emerging sexuality and health among adolescents, to further inform research, practice, and policy initiatives in sexual health. Design: A scoping literature review of peer-reviewed articles published between 1990 and 2021. MEDLINE, CINAHL, EMBASE, PsycINFO, Global health, ERIC, and Sociological Abstracts databases were searched for research studies that reported experiences of sexuality-related mental health issues and symptomatology of adolescents. We targeted studies conducted with adolescent populations between ages 10–19 years living in LMICs. Results: Data from 12 published research papers, including 8 qualitative studies, 3 quantitative studies, and 1 mixed method study, were systematically analyzed. Four major themes and four sub-themes were identified regarding the sexual and mental health of adolescents: (1) Relationship of sexuality and mental health; (2) Social and cultural influences; (3) Challenges in seeking sexuality information and services among adolescents; and (4) Educational needs among adolescents related to sexuality. Conclusions: Lack of social support, unmet needs for accessible adolescent-friendly sexual health services, counseling, and age-appropriate information may be associated with several mental health stressors and symptoms, such as sadness, depressive and anxiety symptomatology, regret, fear, embarrassment, low self-esteem, guilt, shame, and anger. Therefore, tackling sexuality-related stressors could play an important role in addressing the overall well-being of young people. Future studies need to generate a deeper understanding of the concept of sexual health and its relation to mental health in diverse contexts. Implications for Practice: Health care professionals need to be aware of sexuality-related experiences of adolescent girls and boys by offering effective youth-friendly sexual and reproductive health education to support overall mental health and improve the experiences of emerging sexuality in adolescents. Full article

Young people (YP), defined as individuals aged between 10 and 24 years, are a vulnerable population. Leveraging digital platforms to reach YP is essential in identifying protective and risk behaviors among this population. The objectives of this study were to (1) examine the user-inclusive development process of a theory-based digital platform to reach YP, (2) describe aspects of the digital application prototype, and (3) provide preliminary findings from the utilization of the app. We present the five-step design process for building the app. The app, known as the REACH-AYA survey, consisted of 98 closed-ended questions with built-in skip-logic algorithms and took approximately 7 min to complete. The survey questions centered on behavioral, lifestyle, and psychosocial factors, which were adopted from different validated instruments, thereby addressing 10 different domains. During the pilot phase, participants utilized the app, critiqued its features, and provided iterative feedback. We used respondent-driven sampling to recruit participants in Nairobi, Kenya, the leading county in high-speed data connectivity. Once recruited, each participant completed the survey and later sent it to their peers until the desired sample size was achieved. The REACH-AYA app prototype was guided and developed by the design thinking approach with an initial pilot sample of 33 YP for pre-testing. The end-user pre-testing assessed for functionality, time, and adaptability. The app was then launched initially through social media, reaching 1101 YP, with approximately eighty percent (n = 887) having completed the survey by the close of the study. The majority of the participants were male (59%), and approximately (69%) of the participants were aged between 15 and 24 years. This is one of the few studies that demonstrate user-centric methodologies of app development and real-life application in identifying protective and risk factors for the wellbeing of YP. Methodologies and lessons learned from this research may benefit other disciplines using digital technology to reach YP or other difficult-to-reach populations. Full article

We assessed whether the coronavirus disease 2019 (COVID-19) pandemic-related disruptions impacted the physical fitness of adolescent athletes. We reviewed the age-, sex-, and sports category-matched data of 78 adolescent athletes (divided into two groups: 2019 group = 37; 2020 group = 41) from the clinical database and investigated their height, weight, body composition, flexibility muscle strength, and jump height. We also provided questionnaires to the teams’ coaches to collect data on the duration of practice suspension due to the COVID-19 pandemic; the practice hours per week in August 2019, immediately after the suspension ended, and in August 2020; and the guidelines for the players after resuming their practice. For data analyses, we considered p ≤ 0.05 as statistically significant. The strength of knee flexion and extension was significantly lower in the 2020 group than in the 2019 group; there was no difference in the other physical fitness parameters. The practice duration in August 2019 and August 2020 was the same. COVID-19-related interruptions did not alter the athletes’ jump height, upper-limb strength, and flexibility but reduced lower-limb muscle strength. We recommend that basic strength training protocols be followed to prevent sports-related injuries after such unexpected practice interruptions. Full article