Project description:ObjectiveTo compare adolescents' reports of sexual and contraceptive behaviors between the National Survey of Family Growth (NSFG) and the Youth Risk Behavior Survey (YRBS).MethodsFor each survey, we estimated the year- and sex-specific prevalence of sexual and contraceptive behaviors among a comparably defined sample of US respondents ages 15-19 currently attending high school. We used logistic regression to test for changes in prevalence from 2007-2019 and conducted sensitivity analyses to investigate between-survey differences.ResultsWe found differences in both prevalence and trends between the YRBS and NSFG when limited to a comparably defined sample. Compared to the NSFG, adolescents in the YRBS were more likely to report being sexually experienced, less likely to report use of prescription methods for both sexes, and less likely to report condoms among males. Only the YRBS estimated significant declines in sexual experience for both sexes, and significant increases in prescription methods and declines in condom use among males. Differences between surveys in the prevalence of specific contraceptive methods reflected greater combined use of methods in the NSFG. We identified differences in question-wording and other aspects that may influence these differential patterns.ConclusionsThe NSFG and YRBS produced inconsistent prevalence estimates and trends for sexual and contraceptive behaviors among in-school adolescents. Further efforts to improve these national surveillance systems are critical to inform policy and research efforts that support adolescent sexual and reproductive health and wellbeing.
Project description:Survey calibration methods modify minimally sample weights to satisfy domain-level benchmark constraints (BC), e.g. census totals. This allows exploitation of auxiliary information to improve the representativeness of sample data (addressing coverage limitations, non-response) and the quality of sample-based estimates of population parameters. Calibration methods may fail with samples presenting small/zero counts for some benchmark groups or when range restrictions (RR), such as positivity, are imposed to avoid unrealistic or extreme weights. User-defined modifications of BC/RR performed after encountering non-convergence allow little control on the solution, and penalisation approaches modelling infeasibility may not guarantee convergence. Paradoxically, this has led to underuse in calibration of highly disaggregated information, when available. We present an always-convergent flexible two-step global optimisation (GO) survey calibration approach. The feasibility of the calibration problem is assessed, and automatically controlled minimum errors in BC or changes in RR are allowed to guarantee convergence in advance, while preserving the good properties of calibration estimators. Modelling alternatives under different scenarios using various error/change and distance measures are formulated and discussed. The GO approach is validated by calibrating the weights of the 2012 Health Survey for England to a fine age-gender-region cross-tabulation (378 counts) from the 2011 Census in England and Wales.
Project description:PurposeTo compare estimates of moderate-vigorous physical activity (MVPA) duration derived from accelerometers calibrated only to walking and running activities to estimates from calibrations based on a broader range of lifestyle and ambulatory activities.MethodsIn a study of 932 older (50-74 yr) adults we compared MVPA estimates from accelerometer counts based on three ambulatory calibration methods (Freedson 1952 counts per minute; Sasaki 2690 counts per minute; activPAL 3+ METs) to estimates based on calibrations from lifestyle and ambulatory activities combined (Matthews 760 counts per minute; Crouter 3+ METs; Sojourn3x 3+ METs). We also examined data from up to 6 previous-day recalls describing the MVPA in this population.ResultsThe MVPA duration values derived from ambulatory calibration methods were significantly lower than methods designed to capture a broader range of both lifestyle and ambulatory activities (P < 0.05). The MVPA (h·d) estimates in all participants were: Freedson (median, 0.35; interquartile range, 0.17-0.58); Sasaki (median, 0.91; interquartile range, 0.59-1.32); and activPAL (median, 0.97; interquartile range, 0.71-1.26) compared with Matthews (median, 1.82; interquartile range, 1.37-2.34); Crouter (2.28 [1.72-2.82]); and Sojourn3x (median, 1.85; interquartile range, 1.42-2.34). Recall-based estimates in all participants were comparable (median, 1.61; interquartile range, 0.89-2.57) and indicated participation in a broad range of lifestyle and ambulatory MVPA.ConclusionsAccelerometer calibration studies that employ only ambulatory activities may produce MVPA duration estimates that are substantially lower than methods calibrated to a broader range of activities. These findings highlight the potential to reduce potentially large differences among device-based measures of MVPA due to variation in calibration study design by including a variety of lifestyle and ambulatory activities.
Project description:Indigenous youth mental health is an urgent public health issue, which cannot be addressed with a one-size-fits-all approach. The success of health policies in Indigenous communities is dependent on bottom-up, culturally appropriate, and strengths-based prevention strategies. In order to maximize the effectiveness of these strategies, they need to be embedded in replicable and contextually relevant mechanisms such as school curricula across multiple communities. Moreover, to engage youth in the twenty-first century, especially in rural and remote areas, it is imperative to leverage ubiquitous mobile tools that empower Indigenous youth and facilitate novel Two-Eyed Seeing solutions. Smart Indigenous Youth is a 5-year community trial, which aims to improve Indigenous youth mental health by embedding a culturally appropriate digital health initiative into school curricula in rural and remote Indigenous communities in Canada. This policy analysis explores the benefits of such upstream initiatives. More importantly, this article describes evidence-based strategies to overcome barriers to implementation through the integration of citizen science and community-based participatory research action.
Project description:BackgroundSexually transmitted infection (STI) rates continue to rise in the U.S., with disproportionately high rates among those aged 15-24 years. Effective programs and policies are necessary to address this growing public health problem. The purpose of this study is to assess the perspectives of a national sample of youth on access to STI care and behaviors regarding STIs.MethodsMyVoice, a national text message survey of youth, was used to pose four open-ended questions on STI screening and treatment to 1115 youth aged 14-24 in August 2018. A mixed-methods strategy was employed for the study. Qualitative data was analyzed using a modified grounded theory approach. Summary statistics were calculated for demographic data and prevalence of themes.ResultsOf the 800 participants who responded to at least one question (72% response rate), mean age was 19 years (SD = 3.1), 55% identified as female, 61% identified as non-Hispanic white, and 33% qualified for free/reduced lunch. A majority felt it would be easy to get screened (69%) or treated (68%) for an STI. Nearly all respondents (95%) stated they would share an STI diagnosis with their sexual partners.ConclusionsDespite high rates of STIs among youth, most respondents reported that STI screening and treatment is accessible, and they would share an STI diagnosis with their partner.
Project description:BackgroundHealthy childhood development is fostered through sufficient physical activity (PA; including time outdoors), limiting sedentary behaviours (SB), and adequate sleep; collectively known as movement behaviours. Though the COVID-19 virus outbreak has changed the daily lives of children and youth, it is unknown to what extent related restrictions may compromise the ability to play and meet movement behaviour recommendations. This secondary data analysis examined the immediate impacts of COVID-19 restrictions on movement and play behaviours in children and youth.MethodsA national sample of Canadian parents (n = 1472) of children (5-11 years) or youth (12-17 years) (54% girls) completed an online survey that assessed immediate changes in child movement and play behaviours during the COVID-19 outbreak. Behaviours included PA and play, SB, and sleep. Family demographics and parental factors that may influence movement behaviours were assessed. Correlations between behaviours and demographic and parental factors were determined. For open-ended questions, word frequency distributions were reported.ResultsOnly 4.8% (2.8% girls, 6.5% boys) of children and 0.6% (0.8% girls, 0.5% boys) of youth were meeting combined movement behaviour guidelines during COVID-19 restrictions. Children and youth had lower PA levels, less outside time, higher SB (including leisure screen time), and more sleep during the outbreak. Parental encouragement and support, parental engagement in PA, and family dog ownership were positively associated with healthy movement behaviours. Although families spent less time in PA and more time in SB, several parents reported adopting new hobbies or accessing new resources.ConclusionsThis study provides evidence of immediate collateral consequences of the COVID-19 outbreak, demonstrating an adverse impact on the movement and play behaviours of Canadian children and youth. These findings can guide efforts to preserve and promote child health during the COVID-19 outbreak and crisis recovery period, and to inform strategies to mitigate potential harm during future pandemics.
Project description:PurposeThe purpose of this study was to calibrate and cross-validate the Youth Activity Profile (YAP), a self-report tool designed to capture physical activity (PA) and sedentary behaviors (SB) in youth.MethodsEight schools in the Midwest part of the U.S. were involved and a total of 291 participants from grades 4-12 agreed to wear an accelerometer (SWA Armband) and complete the YAP in two separate weeks (5-7 days apart). Individual YAP items capture PA behavior during specific segments of the week and these items were combined with temporally matched estimates of moderate-to-vigorous PA (MVPA) and sedentary time from the SWA to enable calibration. Quantile regression procedures yielded YAP prediction algorithms that estimated MVPA at School, MVPA at Out-of-School, MVPA on Weekend, as well as time spent in SB. The YAP estimates of time spent in MVPA and SB were cross-validated using Pearson product correlations and limits of agreement, as indicative of individual error and, equivalence testing techniques as indicative of group-level error.ResultFollowing calibration, the correlations between YAP and SWA estimates of MVPA were low to moderate (rrange = .19 to .58) and individual-level YAP estimates of MVPA ranged from -134.9% to +110.0% of SWA MVPA values. Differences between aggregated YAP and SWA MVPA ranged from -3.4 to 21.7 minutes of MVPA at the group-level and predicted YAP MVPA estimates were within 15%, 20%, and 30%, of values from the SWA for the School, Out-of-School, and Weekend time periods, respectively. Estimates of time spent in SB were highly correlated with each other (r = .75). The individual estimates of SB ranged from -54.0% to +44.0% of SWA sedentary time, and the aggregated group-level estimates differed by 49.7 minutes (within 10% of the SWA aggregated estimates).ConclusionsThis study provides preliminary evidence that the calibration procedures enabled the YAP to provide estimates of MVPA and SB that approximated values from an objective monitor. The YAP provides a simple, low-cost and educationally sound method to accurately estimate children's MVPA and SB at the group level.
Project description:BACKGROUND:In the ever-growing and technologically advancing world, an increasing amount of social interaction takes place through the Web. With this change, loneliness is becoming an unprecedented societal issue, making youth more susceptible to various physical and mental health problems. This societal change also influences the dynamics of addiction. OBJECTIVE:Employing the cognitive discrepancy loneliness model, this study aimed to provide a social psychological perspective on youth addictions. METHODS:A comprehensive survey was used to collect data from American (N=1212; mean 20.05, SD 3.19; 608/1212, 50.17% women), South Korean (N=1192; mean 20.61, SD 3.24; 601/1192, 50.42% women), and Finnish (N=1200; mean 21.29, SD 2.85; 600/1200, 50.00% women) youths aged 15 to 25 years. Perceived loneliness was assessed with the 3-item Loneliness Scale. A total of 3 addictive behaviors were measured, including excessive alcohol use, compulsive internet use, and problem gambling. A total of 2 separate models using linear regression analyses were estimated for each country to examine the association between perceived loneliness and addiction. RESULTS:Loneliness was significantly related to only compulsive internet use among the youth in all 3 countries (P<.001 in the United States, South Korea, and Finland). In the South Korean sample, the association remained significant with excessive alcohol use (P<.001) and problem gambling (P<.001), even after controlling for potentially confounding psychological variables. CONCLUSIONS:The findings reveal existing differences between youths who spend excessive amounts of time online and those who engage in other types of addictive behaviors. Experiencing loneliness is consistently linked to compulsive internet use across countries, although different underlying factors may explain other forms of addiction. These findings provide a deeper understanding in the mechanisms of youth addiction and can help improve prevention and intervention work, especially in terms of compulsive internet use.