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The Effect of the Economic Crisis on Adolescents' Perceived Health and Risk Behaviors: A Multilevel Analysis.

ABSTRACT: BACKGROUND:Previous studies have analyzed the impact of economic crises on adult's health and lifestyles, but evidence among children and adolescents is limited. The objective of this study was to analyze the impact of the economic crisis on self-perceived health and some risk behaviors in the Spanish adolescent population. METHODS:We used data from four waves (2002, 2006, 2010, 2014) of the Health Behavior in School-Aged Children (HBSC) survey in Spain. Separate multilevel logistic and linear regression models were applied for health complaints, self-rated health, life satisfaction, smoking, alcohol consumption, and breakfast skipping. Annual change in Spanish regional unemployment rates was used as a proxy of the economic crisis. An increasing set of control variables were included, consisting of individual, socioeconomic, and family and peer relationships indicators. Median odds ratios were estimated to quantify the cross-region and cross-school variation. RESULTS:Increases in unemployment rates were linked to a higher risk of poorer health and bad habits in the simplest models. The effect was no longer statistically significant when indicators of family and peer relationships were included, suggesting a protective effect against the impact of the economic crisis. Our findings also show that schools had a larger effect on health and lifestyles than regions. CONCLUSION:The child's social context-family, peers, school, and region-play an important role on the effects of the economic crisis on health and risk behaviors.

SUBMITTER: Zozaya N

PROVIDER: S-EPMC7013908 | biostudies-literature | 2020 Jan

REPOSITORIES: biostudies-literature

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The Effect of the Economic Crisis on Adolescents' Perceived Health and Risk Behaviors: A Multilevel Analysis.

Zozaya Néboa N Vallejo Laura L

International journal of environmental research and public health 20200119 2

<h4>Background</h4>Previous studies have analyzed the impact of economic crises on adult's health and lifestyles, but evidence among children and adolescents is limited. The objective of this study was to analyze the impact of the economic crisis on self-perceived health and some risk behaviors in the Spanish adolescent population.<h4>Methods</h4>We used data from four waves (2002, 2006, 2010, 2014) of the Health Behavior in School-Aged Children (HBSC) survey in Spain. Separate multilevel logist ...[more]

PMID: 31963837

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Project description:BackgroundAdolescence is a vulnerable period for many lifestyle risk behaviors. In this study, we aimed to 1) examine a clustering pattern of lifestyle risk behaviors; 2) investigate roles of the school health promotion programs on this pattern among adolescents in Vietnam.MethodsWe analyzed data of 7,541 adolescents aged 13-17 years from the 2019 nationally representative Global School-based Student Health Survey, conducted in 20 provinces and cities in Vietnam. We applied the latent class analysis to identify groups of clustering and used Bayesian 2-level logistic regressions to evaluate the correlation of school health promotion programs on these clusters. We reassessed the school effect size by incorporating different informative priors to the Bayesian models.FindingsThe most frequent lifestyle risk behavior among Vietnamese adolescents was physical inactivity, followed by unhealthy diet, and sedentary behavior. Most of students had a cluster of at least two risk factors and nearly a half with at least three risk factors. Latent class analysis detected 23% males and 18% females being at higher risk of lifestyle behaviors. Consistent through different priors, high quality of health promotion programs associated with lower the odds of lifestyle risk behaviors (highest quality schools vs. lowest quality schools; males: Odds ratio (OR) = 0·67, 95% Highest Density Interval (HDI): 0·46 - 0·93; females: OR = 0·69, 95% HDI: 0·47 - 0·98).InterpretationOur findings demonstrated the clustering of specific lifestyle risk behaviors among Vietnamese in-school adolescents. School-based interventions separated for males and females might reduce multiple health risk behaviors in adolescence.FundingThe 2019 Global School-based Student Health Survey was conducted with financial support from the World Health Organization. The authors received no funding for the data analysis, data interpretation, manuscript writing, authorship, and/or publication of this article.

Project description:BackgroundSuboptimal healthcare quality may be a barrier to achieving child health improvements, yet little is known about the relationship between provider compliance with evidence-based practices and client behavior change. We assess provider compliance in the context of infant and young child feeding (IYCF) counseling, its relationship with client IYCF behaviors in Bangladesh, and explore its potential determinants.MethodsWe use data from a 2017 evaluation of an IYCF program that includes a health worker survey (n = 74), caregiver survey (n = 232), and direct service observation checklists of counseling sessions (n = 232 observations of 74 health workers). We assess the relationship between provider compliance with recommended IYCF counseling topics and behaviors (standardized to a 100-point scale) and three reported IYCF behaviors among clients using multi-level models with random effects at the health worker and sub-district (sampling) levels. We also evaluate whether health worker self-efficacy, satisfaction, and technical knowledge are associated with provider compliance.ResultsHealth worker compliance was significantly associated with reported exclusive breastfeeding for children under 6 months of age (adjusted odds ratio per 1 percentage point increase in counseling compliance score = 1.06, 95% CI 1.01, 1.12) and marginally associated with minimum dietary diversity (adjusted odds ratio per 1 percentage point increase in counseling compliance score = 1.05, 95% CI 1.00, 1.11). Counseling compliance was significantly and positively associated with both health worker self-efficacy and technical knowledge.ConclusionsWe find evidence for an association between health worker compliance and client health behaviors; however, small effect sizes suggest that behavior change is multifactorial and affected by factors beyond care quality. Improvements to technical quality of care may contribute to desired health outcomes; but policies and programs seeking to change health behaviors through counseling may also wish to target upstream factors such as self-efficacy, alongside technical skill-building and knowledge, for maximum impact.

Project description:It is known that health risk behaviors (HRBs) can lead to a variety of physical and mental health problems among adolescents, but few studies have paid attention to the relationship between latent classes of HRBs and adolescent diseases. The purpose of this study was to use latent class analysis (LCA) to clarify the potential subgroups of HRBs (smoking, drinking, screen time, non-suicidal self-injuries, suicidal behaviors, and unintentional injuries) and examine the association between the subgroups of HRBs and physical disorders (diarrhea, fever, cough, and vomiting) with multiple logistic regression analysis, in Chinese adolescents. Self-reported HRBs and physical disorders were used to evaluate 22,628 middle school students in six cities of China, from November 2015 to January 2016, based on a multistage stratified cluster sampling approach. The prevalence of diarrhea, fever, cough, and vomiting was 23.5%, 15.9%, 50.6%, and 10.7%, respectively. We identified four latent classes of HRBs by LCA, including low-risk class, moderate-risk class 1 (smoking, drinking, and screen time), moderate-risk class 2 (non-suicidal self-injuries and suicidal behaviors, unintentional injuries), and high-risk class (smoking, drinking, screen time, non-suicidal self-injuries, suicidal behaviors, and unintentional injuries), which were 64.0%, 4.5%, 28.8% and 2.7% of participants, respectively. Compared to the low-risk class, all other classes showed higher risk for these physical disorders (P < 0.01 for each). In particular, the high-risk class had the highest risk (diarrhea (odds ratio (OR) = 2.628, 95% confidence interval (CI) 2.219 to 3.113), fever (OR = 3.103, 95% CI 2.591 to 3.717), cough (OR = 2.142, 95% CI 1.805 to 2.541), and vomiting (OR = 3.738, 95% CI 3.081 to 4.536). In conclusion, these results indicated that heterogeneity exists in HRBs, and subgroups of HRBs were correlated to the occurrence of common physical disorders in Chinese adolescents. Therefore, multiple HRBs rather than single factors should be considered for the prevention of common physical disorders in schools.

Project description:ObjectivesTo explore the relationship between cumulative ecological risk and individual risky behavior and multiple forms of aggregated behaviors among adolescents, and examine the gender differences.MethodsA large-scale, nationally representative, and students-based investigation was conducted in rural and urban areas of eight provinces in China from October to December 2021. A total of 22 868 adolescents with an average age of 14.64 years completely standardized questionnaire in which the sociodemographic characteristics, socio-ecological risk factors and risky behaviors were used to analyze.ResultsOf included students, 48.4% encountered the high level of social-ecological risk. The prevalence of breakfast intake not daily, alcohol use (AU), smoking, physical inactivity, prolonged screen time (ST) on weekdays and weekends, suicidal ideation, suicidal plan, suicidal attempt, and non-suicidal self-injury (NSSI) was 41.0%, 11.9%, 3.4%, 61.9%, 15.1%, 51.1%, 27.7%, 13.9%, 6.5% and 27.0% respectively. 22.2% of participants engaged in high-risk behaviors. All were significantly influences of increased cumulative ecological risk on individual behavior and low-risk clustering behaviors separately. The odds ratio of breakfast intake not daily, AU, smoking, physical inactivity, prolonged ST in weekday and weekend, suicidal ideation, suicidal plan, suicidal attempt, and NSSI for the adjusted model in low versus high level of cumulative ecological risk was respectively significant in both boy and girls, and the ratio of odds ratios (ROR) was separately 0.95 (p = 0.228), 0.67 (p < 0.001), 0.44 (p < 0.001), 0.60 (p < 0.001), 0.78 (p = 0.001), 0.83 (p = 0.001), 0.80 (p = 0.001), 0.83 (p = 0.022), 0.71 (p = 0.005), 0.75 (p = 0.001). Girls encountering a high level of cumulative ecological risk were more likely to engage in multiple forms of clustering risky behaviors than boys (RORs: 0.77, p = 0.001).ConclusionsResearch and effective inventions at the social-ecological environment, based on the view of cumulative risk, are needed to promote the healthy development of behaviors in adolescence, and pay more attention to decreasing the occurrence of risky behaviours in girls than boys.

Project description:Objectives This study aimed to elucidate the potential moderating effect of fair-, empowering-, and supportive-leadership behaviors on the relationship between job predictability, future employability, and subsequent clinically relevant mental distress. Method The study had a full panel, prospective design, utilizing online, self-administered questionnaire data collected at two time points, two years apart. Fair-, empowering-, and supportive-leadership behaviors, job predictability and future employability were measured by the General Nordic Questionnaire for Psychological and Social Factors at Work (QPSNordic). Mental health was measured using the 10-item Hopkins Symptom Checklist (HSCL-10), with cut-off set to >1.85 to identify clinically relevant cases. As data were nested within work units, a multilevel analytic approach was chosen. Results Individual-level direct effects: (i) higher levels of job predictability [odds ratio (OR) 0.83, 95% confidence interval (CI) 0.70-0.98], (ii) future employability (OR 0.83, 95% CI 0.74-0.93), (iii) fair- (OR 0.78, 95% CI 0.68-0.91), empowering- (OR 0.77, 95% CI 0.67-0.87), and supportive- (OR 0.71, 95% CI 0.61-0.81) leadership behavior, and (iv) the combination "quality of leadership" (OR 0.69, 95% CI 0.59-0.81) were significantly associated with a lower risk of reporting subsequent mental distress. Work-unit level direct effects: higher work-unit levels of fair- (OR 0.52, 95% CI 0.34-0.80) and empowering- (OR 0.61, 95% CI 0.40-0.94) leadership behaviors and quality of leadership (OR 0.54, 95% CI 0.34-0.87) were significantly associated with a lowered risk of subsequent mental distress. Cross-level interactions: No cross-level interaction effects were shown. Conclusions Leadership behaviors did not moderate the effects of job predictability and future employability on mental health. However, employees embedded within work-units characterized by fair, empowering and supportive leadership behaviors had a lower risk of subsequent mental distress.

Dataset Information

The Effect of the Economic Crisis on Adolescents' Perceived Health and Risk Behaviors: A Multilevel Analysis.

Publications

The Effect of the Economic Crisis on Adolescents' Perceived Health and Risk Behaviors: A Multilevel Analysis.

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