Socio-ecological determinants of alcohol, tobacco, and drug use behavior of adolescents in Kilifi County at the Kenyan coast.
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ABSTRACT:
SUBMITTER: Ssewanyana D
PROVIDER: S-EPMC7116417 | biostudies-literature | 2020 Oct
REPOSITORIES: biostudies-literature
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Socio-ecological determinants of alcohol, tobacco, and drug use behavior of adolescents in Kilifi County at the Kenyan coast.
Ssewanyana Derrick D Mwangala Patrick N PN Marsh Vicki V Jao Irene I van Baar Anneloes A Newton Charles R CR Abubakar Amina A
Journal of health psychology 20180626 12
Alcohol, tobacco, and other drug use form a risk factor for health and social problems during adolescence. From a socio-ecological model, perceptions of 85 young people and 10 stakeholders on the types of alcohol, tobacco, and other drugs used and the predisposing and protective factors were explored; among adolescents at the Kenyan Coast in the Kilifi County. We found that the consumption of home-brewed alcohol, tobacco and marijuana smoking, and khat chewing was common and requires multi-compo ...[more]
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Project description:BackgroundSevere childhood illnesses present a major public health challenge for Africa, which is aggravated by a suboptimal response to the child's health problems with reference to the health-seeking behaviour of the parents or guardians. We examined the health-seeking behaviour of parents at the Kenyan coast because understanding impediments to optimal health-seeking behaviour could greatly contribute to reducing the impact of severe illness on children's growth and development.Methods and resultsHealth-seeking behaviour, and the factors influencing this behaviour, were examined in two traditional communities. We held in-depth interviews with 53 mothers, fathers and caregivers from two rural clinics at the Kenyan Coast. Biomedical medicine (from health facilities and purchased over the counter) was found to be the most popular first point of treatment. However, traditional healing still plays a salient role in the health care within these two communities. Traditional healers were consulted for various reasons: a) attribution of causation of ill-health to supernatural sources, b) chronic illness (inability of modern medicine to cure the problem) and c) as prevention against possible ill-health. In developing an explanatory model of decision-making, we observed that this was a complex process involving consultation at various levels, with elders, but also between both parents, depending on the perceived nature and chronicity of the illness. However, it was reported that fathers were the ultimate decision makers in relation to decisions concerning where the child would be taken for treatment.ConclusionsHealth systems need to see traditional healing as a complementary system in order to ensure adequate access to health care. Importantly, fathers also need to be addressed in intervention and education programs.
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Project description:AimsTo quantify tobacco and alcohol content, including branding, in popular contemporary YouTube music videos; and measure adolescent exposure to such content.DesignTen-second interval content analysis of alcohol, tobacco or electronic cigarette imagery in all UK Top 40 YouTube music videos during a 12-week period in 2013/14; on-line national survey of adolescent viewing of the 32 most popular high-content videos.SettingGreat Britain.ParticipantsA total of 2068 adolescents aged 11-18 years who completed an on-line survey.MeasurementsOccurrence of alcohol, tobacco and electronic cigarette use, implied use, paraphernalia or branding in music videos and proportions and estimated numbers of adolescents who had watched sampled videos.FindingsAlcohol imagery appeared in 45% [95% confidence interval (CI)?=?33-51%] of all videos, tobacco in 22% (95% CI?=?13-27%) and electronic cigarettes in 2% (95% CI?=?0-4%). Alcohol branding appeared in 7% (95% CI?=?2-11%) of videos, tobacco branding in 4% (95% CI?=?0-7%) and electronic cigarettes in 1% (95% CI?=?0-3%). The most frequently observed alcohol, tobacco and electronic cigarette brands were, respectively, Absolut Tune, Marlboro and E-Lites. At least one of the 32 most popular music videos containing alcohol or tobacco content had been seen by 81% (95% CI?=?79%, 83%) of adolescents surveyed, and of these 87% (95% CI?=?85%, 89%) had re-watched at least one video. The average number of videos seen was 7.1 (95% CI?=?6.8, 7.4). Girls were more likely to watch and also re-watch the videos than boys, P?<?0.001.ConclusionsPopular YouTube music videos watched by a large number of British adolescents, particularly girls, include significant tobacco and alcohol content, including branding.
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Project description:BackgroundTobacco, alcohol, and marijuana are the top three substances used by adolescents. The adverse health effects of these three substances are well documented in epidemiological literature, yet little is known about the substance use and associated factors among adolescents in Bangladesh. This study examines the risk factors for tobacco and other substances use among school-going adolescents in Bangladesh.MethodsWe analyzed data from the 2014 Bangladesh Global School-based Student Health Survey (GSHS) of adolescents aged 13-17 years. We used two outcome measures: tobacco use (TU) and other substance use (SU; alcohol and/or marijuana). We examined a set of reported psychosocial and socio-environmental adverse events as risk factors. Logistic regression analyses were used to identify associations.ResultsThe prevalence of TU and other SU among school-going adolescents was 9.6% and 2.3%, respectively. The likelihood of TU and other SU was higher among adolescents who reported being bullied (TU: adjusted odd ratio [AOR]: 1.93; 95% confidence interval [CI]: 1.24-3.00; and other SU: AOR: 3.43; 95% CI: 1.46-7.99) and having sexual history (TU: AOR: 19.38; 95% CI: 12.43-30.21; and other SU: AOR: 5.34; 95% CI: 2.17-13.29). Moreover, anxiety-related sleep loss was associated with adolescents' TU (AOR: 2.41; 95% CI: 1.02-5.82) whereas the likelihood of other SU (AOR: 3.27; 95% CI: 1.14-9.44) was higher among lonely adolescents. Experience of adverse socio-environmental factors, such as parental substance use (TU: AOR: 7.81; 95% CI: 5.08-12.01), poor monitoring (TU: AOR: 1.96; 95% CI: 1.16-3.31) and poor understanding (TU: AOR: 2.22; 95% CI: 1.36-3.65), and lack of peer support (TU: AOR: 3.13; 95% CI: 1.84-5.31; and other SU: AOR: 2.45; 95% CI: 1.02-5.91), and truancy (other SU: AOR: 4.29; 95% CI: 1.81-10.12) were also positively associated with TU and/or other SU. Additionally, higher odds of tobacco use were observed among adolescents who reported 1 (AOR: 4.36 times; 95% CI: 1.34-14.24), 2 (AOR: 8.69 95% CI: 1.67-28.23), and ≥3 (AOR: 17.46; 95% CI: 6.20-49.23) adverse psychosocial experiences than who did not report any psychosocial events.ConclusionsTobacco and other substance use among school-going adolescents are prevalent in Bangladesh. Several psychosocial and socio-environmental events are associated with TU and other SU, which should be incorporated into adolescent substance use and health promotion programs.
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Project description:Madagascar has experienced significant environmental change since 1960, particularly through forest clearing for agricultural expansion. Climatic patterns are undergoing change in Madagascar as well, with increasing temperatures, droughts, and cyclonic activity. The impact of these environmental and climatic changes will pose threats to food availability, income generation, and local ecosystems, with significant potential effects on the spatial and temporal distribution of disease burden. This study seeks to describe the health status of a large sample of geographically and socially diverse Malagasy communities through multiple clinical measurements, detailed social surveys, and paired data on regional variation in local ecologies. With an increased understanding of the current patterns of variation in human health and nutrition, future studies will be better able to identify associations with climate and anticipate and mitigate the burdens expected from larger, longer-term changes. Our mixed-method approach included an observational cross-sectional study. Research subjects were men, women, and children from 1,125 households evenly distributed across 24 communities in four ecologically and socio-demographically distinct regions of Madagascar. For these 1,125 households, all persons of both sexes and all ages therein (for a total of 6,292 individuals) were recruited into the research study and a total of 5,882 individuals were enrolled. Through repeated social survey recalls and focus group meetings, we obtained social and demographic data, including broad categories of seasonal movements, and characterized the fluctuation of income generation, food production and dietary consumption. Through collection of clinical and biological samples for both point-of-care diagnoses and laboratory analyses, we obtained detailed occurrence (and importantly co-occurrence) data on micronutrient nutritional, infectious disease, and non-communicable disease status. Our research highlights the highly variable social, cultural, and environmental contexts of health conditions in Madagascar, and the tremendous inter-regional, inter-community, and intra-community variation in nutritional and disease status. More than 30% of the surveyed population was afflicted by anemia and 14% of the population had a current malaria infection. This type of rich metadata associated with a suite of biological samples and nutritional and disease outcome data should allow disentangling some of the underlying drivers of ill health across the changing landscapes of Madagascar.
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Project description:BackgroundMothers and other primary caregivers play a crucial role in looking after perinatally HIV infected, and HIV exposed uninfected adolescents in sub-Saharan Africa. Day- to-day caregiving in the context of limited instrumental support and added biomedical risk (HIV seropositivity) may expose these caregivers to adverse states of health. Unfortunately, very few studies have examined their health-related quality of life (HRQoL). Our study documents the HRQoL profile, and associated factors in primary caregivers of perinatally HIV infected, perinatally HIV exposed but uninfected and HIV unexposed/uninfected adolescents aged 12-17 years at the Kenyan Coast.MethodsThis was a cross-sectional analysis of 485 primary caregivers: 195 of perinatally HIV infected adolescents, 128 of perinatally HIV exposed but uninfected adolescents and 162 of HIV unexposed/uninfected adolescents. All caregivers completed a self-report measure of HRQoL (having 8 subscales), depressive symptoms, and parenting stress. They also provided their sociodemographic information and that of the care recipients. We used one-way analysis of variance to assess statistical differences among the groups. Linear regression analyses were used to identify correlates of HRQoL.ResultsOverall, caregivers of HIV unexposed/uninfected adolescents reported significantly higher mean HRQoL scores than the other caregivers in the overall HRQoL domain and majority of the subscales. There were no statistical differences in the overall HRQoL scores and most subscales between caregivers of HIV exposed adolescents. Linear regression analyses across the sample indicated that depressive symptoms, increasing age of caregiver, and caring for an adolescent perinatally exposed to HIV were significantly associated with reduced HRQoL at both the overall and sub-scale level. Having a professional job relative to subsistence farming was the only factor associated with improved overall HRQoL. At subscale level, higher socioeconomic status correlated positively with HRQoL while being a grandparent, level of education, parenting stress were negatively associated with HRQoL.ConclusionsCaregivers in this sample, especially those who are ageing, at risk of mental ill-health, and taking care of adolescents perinatally exposed to HIV, appear to be vulnerable to poor quality of life. Inclusive and multi-component interventions tailored to the caregivers' psychosocial and mental needs will potentially enhance their quality of life.
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Project description:This study examines whether child maltreatment experience predicts adolescent tobacco and alcohol use.The subjects were participants in the Mater-University Study of Pregnancy (MUSP), a birth cohort of 7223, of whom 5158 (71.4%) were available for analysis at the 14-year follow-up. Child protection history was obtained from the state's child protection agency and confidentially linked. Exposure to reported child maltreatment was the primary predictor variable. The outcome variables were self-reported smoking and alcohol use. Associations were adjusted for potential confounders.Reported child maltreatment was associated with early adolescent smoking [odds ratio (OR) 1.76, 95% confidence interval (CI)?=?1.32-2.34] after adjustment for socio-demographic variables and coexisting alcohol use. Both neglect/emotional abuse (OR 2.03, 95% CI?=?1.20-3.42) and neglect/emotional abuse that included physical abuse (OR 1.85, 95% CI?=?1.19-2.88) were associated with smoking after full adjustment, including for coexisting alcohol use. After full adjustment, including coexisting smoking, only child neglect/emotional abuse predicted early adolescent alcohol use (OR 1.78, 95% CI?=?1.06-2.97), but not the other types of maltreatment.Reported child maltreatment predicts early adolescent smoking after adjusting for alcohol use, but does not predict alcohol use after adjustment for smoking. Both smoking and alcohol use are predicted by reported child neglect. Early adolescent smoking is also predicted by multi-type maltreatment that includes physical abuse.
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