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Unfortunately, the influence of friendships is a neglected area of investigation in studies of youth physical activity. This study investigated the degree to which three friendship variables (ability to make friends, level of involvement with friends, perceived friends' involvement in exercise/physical activity) was associated with physical activity participation in a sample of 2,519 secondary level students from Chiang Mai Province, Thailand. In general, results showed that overall participation in physical activity was lowest among adolescents who said that making new friends was difficult, who were less involved with friends, and who reported that no or only some of their friends participated in exercise/physical activity. Conversely, adolescents who said that making new friends was easy, who were more involved with friends, and who reported that most of all of their friends were more likely to engage in physical activity themselves. Although physical activity participation among girls was lower than boys, the association between the three friendship variables and participation in physical activity was found for both boys and girls. The results of this study suggest that school health educators should give serious consideration to including friendship skill-development strategies in the mix of strategies currently used to improve participation in physical activity. (Contains 4 tables.)

Every year in the United States, health and social problems result from adolescents' use and abuse of alcohol. Alcohol use is associated with high-risk behaviors and is a leading cause of death among adolescents. Research indicates that alcohol advertising influences drinking intentions for children and adolescents. Using content analysis of 486 advertisements, the focus of this study was to analyze persuasive themes and responsibility messages in alcohol advertising from a popular youth-oriented magazine over a three-year period. Findings indicate that product quality, humor, sex appeal, romance/relationships, and hanging out/partying were the most frequently used persuasive themes. Nearly 75% of advertisements included a responsibility message, but less than 1% included statements warning against underage drinking or encouraging the use of a designated driver. Chi-square analysis indicated a relationship between persuasive themes and the presence of responsibility messages. Given the susceptibility of youth to the emotional appeals of advertising, health education implementing media literacy and advocacy strategies can inform adolescents of the persuasive techniques and mixed messages used in advertising, and help develop skills to decrease their susceptibility to them. (Contains 5 tables.)

This study describes the prevalence of suicide ideation in 109 Global School-based Health Surveys (GSHS) conducted from 2003-2010 representing 49 different countries and 266,694 school-attending students aged 13-15 years primarily living in developing areas of the World. Prevalence of suicide ideation varied widely among and between countries, regions, and by gender, with an overall mean prevalence of suicide ideation of 15.3%. When grouped by region, Africa had the highest percentage of participants reporting suicide ideation (19.8%). The wide variability in the prevalence of suicide ideation found in this study confirms that school psychologists and counselors must be prepared to deal with the unique needs and characteristics of the specific populations of youth they serve, as the needs are likely to vary substantially from locality to locality, and country to country.

The purpose of this study was to assess the perceptions of Thailand adolescents regarding the prevalence of smoking, the popularity of smoking among successful/elite elements of society, and disapproval of smoking by friends and parents. These perceptions were analyzed in conjunction with actual smoking and smoking susceptibility rates among the subjects to determine whether beliefs and behaviors were associated with each other. This study was conducted among a school-based sample of 2516 Chiang Mai, Thailand upper secondary and vocational students. Although perceived prevalence of smoking was not associated with smoking outcomes, perceived popularity of smoking among the successful and elite was associated with higher risk, and perceived disapproval by friends/parents was associated with lower risk. Youth smoking programs should consider assessing and taking these social normative factors into account when considering educational intervention strategies that aim to lower adolescent smoking rates. (Contains 5 tables.)

Background: Understanding the cognitive attributions of smoking has the potential to advance youth smoking prevention efforts; however, research on this subject is limited in Asian countries. We attempted to determine the degree to which cognitive attributions of smoking differ among adolescents in 2 Asian countries, Thailand and South Korea. Methods: We surveyed 10th- to 12th-grade students in Chiang Mai, Thailand (N = 2516) and Seoul, South Korea (N = 1166). Logistic regression determined association of attributions and current smoking and differences in attributions between Thai and South Korean students. Results: Items with the highest agreement among South Koreans were "helps me to deal with stress" and "helps relax" and among Thai were "feel like I am making my own decisions" and "keeps from being bored." Significant predictors of current smoking were different between samples. Only 1 cognitive attribution predicted current smoking in both samples ("helps me to deal with stress"). Conclusion: The pattern of relevant cognitive attributions of smoking for the 2 samples was distinct, suggesting that cross-cultural differences merit consideration when designing prevention and cessation programs. Health education should strive to dispel the use of smoking as a coping strategy for dealing with stressful situations and distressful feelings and teach adolescents alternative healthy strategies for dealing with stress. (Contains 5 tables.)

The purpose of this study was to determine cigarette brand preference trends and differences in Marlboro smokers in smoking-related attitudes and behaviors from smokers of other brands. This study analyzed data from 25,027 adolescents represented in the 2000, 2003, and 2007 Philippine Global Youth Tobacco Surveys. Results indicated that from 2000 to 2007 Marlboro clearly became the most preferred brand in both boys and girls. Further, Marlboro smokers were found to exhibit a stronger commitment to smoking, to smoke more frequently, and to hold more positive images of smoking compared to other brand smokers. Tobacco control efforts in the Philippines may benefit from educational and policy initiatives that lead to aggressive counter marketing efforts to address the industry's efforts to portray positive images of smoking. (Contains 4 tables.)

This study analyzed data from 118,743 adolescents completing 30 different Global Youth Tobacco Surveys conducted in 15 different Middle Eastern countries between 1999 and 2007 to determine the proportion of young smokers who usually smoked Marlboro, other cigarette brands, or no usual brand smoked in these countries. Marlboro was the most prevalent brand smoked in 7 of the 15 Middle Eastern countries examined, the second most common brand smoked in four Middle Eastern countries, and the third most common in eight of the countries. Marlboro smokers were found to exhibit stronger commitment to smoking, to smoke more frequently, to have more close friends who smoke, to score higher on beliefs that smoking is attractive, and to score lower on the belief that smoking is harmful in comparison to other brand smokers. Understanding youth smokers' brand preferences and choices is advantageous because it provides insight into what influences young people to start and continue to smoke, and subsequently may inform smoking prevention and control strategy development. This information can be incorporated into targeted mass media campaigns and other interventions to counter advertising and marketing messages. (Contains 5 tables.)

Objective: To assess smoking media literacy in a sample of Hungarian youth and to determine its association with current smoking and susceptibility to future smoking. Design: Quantitative cross-sectional survey. Setting: Four elementary and four high schools in Mako, Hungary. Method: A survey form was administered in regularly-scheduled classes to 546 eighth- and twelfth-grade students that included the smoking media literacy (SML) scale and items assessing cigarette use. Logistic regression was used to examine the relationship of smoking media literacy with current smoking, and also separately for susceptibility to smoking in the future, as dependent dichotomous variables. Results: Smoking media literacy was lower among the Hungarian adolescents than what has been previously reported in American adolescents. Multivariate logistic regression analysis results showed smoking media literacy to be associated with reduced risk of current smoking status at a similar level to that found in American adolescents. However, unlike previous research in American adolescents, smoking media literacy and susceptibility to future smoking was not associated. Reduced smoking may be most associated with the representation-reality domain of media literacy, which relates recognition of what is portrayed in the media with reality. Conclusion: Based on this study's findings, prevention and health promotion planners in Hungary should consider media literacy training as a possible addition to smoking prevention efforts in community- and school-based efforts. (Contains 5 tables.)

The purpose of the current study was to examine the relationship between adolescent substance use and psychosocial distress indicators among 30,851 adolescents aged 11 to 16 in four countries (Philippines, China, Chile, and Namibia). Global School-Based Student Health Survey data from these countries provided information about frequency and lifetime use of alcohol, tobacco, and other drugs as well as items about early adolescents' feelings of loneliness, worry, hopelessness, suicide, and number of close friends. Overall, there were significant relationships between adolescent substance-use behaviors and a measure of "global" psychosocial distress for both boys and girls in all four countries and for four of the five items of psychosocial distress (often lonely, often worry, sad/hopeless, and having a suicide plan). The association between substance use and psychosocial distress was also consistent in both genders and across the four countries. These results have important implications for professionals who work with adolescent populations. (Contains 7 tables.)

Objectives: To determine if there is an association between psychosocial distress, health-risk behaviors and 12-month suicidal ideation among sub-Saharan African adolescents. Methods: Subjects included a cross-national sample of adolescents (N25,568) representing 7 African countries who completed the Global School-based Student Health Survey (GSHS). Results: Students with 3-4 psychosocial distress indicators were 4-5 times more likely to report suicide ideation or having made a suicide plan, and those with 4-5 risky health behaviors were 2.5-3.5 times more likely. Conclusions: Interventions designed to identify African adolescents with cumulative psychosocial distress indicators and risky health behaviors have potential as effective suicide prevention strategies.

Background: Smoking media literacy (SML) has been found to be independently associated with reduced current smoking and reduced susceptibility to future smoking in a sample of American adolescents, but not in other populations of adolescents. Thus, the purpose of this study was to assess SML in Vietnamese adolescents and to determine the association with smoking behavior and susceptibility to future smoking. Methods: A cross-sectional survey of 2000 high school students completed the SML scale, which is based on an integrated theoretical framework of media literacy, and items assessing cigarette use. Ordinal logistic regression was used to determine the association of SML with smoking and susceptibility to future smoking. Ordinal logistic regression was also to determine whether smoking in the past 30 days was associated with the 8 domains/core concepts of media literacy which comprise the SML. Results: Smoking media literacy was lower among the Vietnamese adolescents than what has been previously reported in American adolescents. Ordinal logistic regression analysis results showed that in the total sample SML was associated with reduced smoking, but there was no association with susceptibility to future smoking. Further analysis showed that results differed according to school and grade level. There did not appear to be association of smoking with the specific domains/concepts that comprise the SML. Conclusions: The association of SML with reduced smoking suggests the need for further research involving SML, including the testing of media literacy training interventions, in Vietnamese adolescents and also other populations of adolescents. (Contains 5 tables.)

Background: This study examines the relationship between sexual behavior, alcohol use, and indicators of psychosocial distress (mental health) of adolescents in 6 sub-Saharan African countries using the Global School-based Student Health Survey (GSHS). Methods: The sample consisted of 22,949 adolescents from Botswana, Kenya, Namibia, Uganda, Zambia, and Zimbabwe who participated in 2003 or 2004 GSHS surveys. Statistical analysis was conducted to determine whether sexual behaviors increased with levels of psychosocial distress and alcohol use. Results: Sexual behaviors (having sex or having sex with 2 or more people) were associated with both psychosocial distress and alcohol use. Odds ratios showed that both boys and girls reporting psychosocial distress and alcohol use were at higher risk for having sex. Results also indicated that the likelihood of sexual behaviors increased when there was an increase in the number of psychosocial indicators and frequency of alcohol consumption. Conclusion: The results of this study are consistent with those conducted in the United States suggesting that sexual behavior, psychosocial distress, and substance use are interconnected. These findings highlight the need for school health education and health services in sub-Saharan Africa, specifically the efforts to reduce psychosocial distress and prevent substance use in efforts to prevent the spread of human immunodeficiency virus and other sexually transmitted infections. (Contains 5 tables.)

The purpose of this study was to examine the association of cigarette smoking and 2 indicators of psychosocial distress (hopelessness and loneliness) among adolescents from 2 distinctly different regions of the world: Central-Eastern Europe (Hungary, Ukraine, Slovakia, Czech Republic, Romania, Poland) and Southeast Asia (Thailand, Taiwan, and the Philippines). Among Southeast Asian boys and girls, smokers had elevated hopelessness in comparison to nonsmokers but among Central-Eastern European students, this relationship was true only for girls and there was no relationship for boys. Across the country samples, there was only association of smoking with loneliness among Southeast Asian girls and Central-Eastern European girls. While Southeast Asian girls who smoked scored higher on loneliness than nonsmokers, the opposite was true among Central-Eastern European girls, with smokers scoring "lower" on loneliness. (Contains 5 tables.)

The purpose of this study was to determine alcohol use (particularly heavy drinking) and social normative estimations of alcohol use according to student residence (fraternity, sorority, residence hall, or apartment complex). To achieve this purpose, a survey was conducted in all 34 sections of a general education core English class at a northwestern public university. Students living in fraternities, compared with males living in apartment complexes and residence halls, consumed more alcohol, engaged more frequently in heavy episodic drinking, and drank more when "partying." A similar pattern was true for females living in sororities relative to females students living in apartment complexes and residence halls. In most cases, social normative estimations were higher than reported use among those living in fraternities, sororities, residence halls, and apartment complexes. As hypothesized, social normative estimates of alcohol use were highest among students living in fraternities and sororities. Thus, it appears that social normative estimations of frequent and heavy drinking may contribute to alcohol use patterns, particularly among members of fraternities and sororities. These results confirm that students' choice of residence is a dominant influence when it comes to drinking behavior.

Studies investigating smoking behavior among adolescents living in post-communistic Central-European countries are sparse. This study focused on the relationship between cigarette smoking, certain friendship factors, and social norm perceptions among 1,886 Central-Eastern European adolescents from high schools in Hungary, Slovakia, Czech Republic, and Romania. Smoking behavior was related to having friends who smoke, ease or difficulty making new friends, time spent with friends after school and during evenings, and estimations of the prevalence of smoking by schoolmates. Because these youth appear to overestimate the prevalence of smoking by schoolmates, the use of a norms-correction strategy may have potential merit in smoking prevention efforts targeting these adolescents. Smoking prevention and reduction are critical issues for Central-Eastern European youth because they appear to smoke cigarettes at a high rate. (Contains 5 tables.)

The aim of this study was to assess the level of suicide attempts in three school-based samples of Southeast Asian adolescents (Taipei, Taiwan; the Philippines; Chiang Mai, Thailand) and determine whether adolescent suicide attempters score higher on measures of hopelessness and loneliness relative to nonattempters. It was hypothesized that hopelessness and loneliness would be related to suicide attempts, and that hopelessness would continue to be associated with suicide attempts when controlling for loneliness. The prevalence of suicide attempts across the three samples of Asian youth were not consistent with Taiwanese girls and boys as the most likely to have ever attempted suicide. As expected, results showed that suicide attempters (in past 12 months and ever) scored higher on hopelessness and loneliness than nonattempters across all three samples and for both genders. However, the statistical control of loneliness demonstrably weakened the association between suicide attempt behaviour and hopelessness across the samples and for both genders, and resulted in nonsignificant ANCOVA tests for some of the sample-gender groups. These results attest to the need for more research investigating connections between youth suicide attempts, hopelessness and loneliness in adolescent populations. Loneliness should be included as a potential determinant of youth suicidal behaviour in future research. (Contains 5 tables.)

This study compared consistency of age- and gender-specific self-reported height and weight and calculated body mass index among a sample of high school students in Taipei County, Taiwan to reference values for Taiwanese school-aged youth obtained through national studies. Taipei high school students provided self-reports of height and weight that were similar to national reference values. Use of self-reported height and weight in this sample appeared warranted and may reliably be used to calculate aggregate indices of body mass, overweight, and obesity. This study compared prevalence of overweight and obesity in the current sample with other adolescent populations using international criteria (International TaskForce on Obesity). Using these criteria, 17.6% of boys and 9.4% of girls met the definition of overweight and 3.7% of boys and 1.6% of girls met the definition of obesity. While use of self-reported height and weight appears justified in this sample, researchers should not assume self-report measures will always be accurate. Researchers considering use of self-reported height and weight should compare their results to normative reference values when possible to increase confidence in using self-report measures of height and weight.

The prevalence of marijuana use and perceptions of the prevalence of marijuana use was assessed in a sample of intercollegiate athletes and a separate sample of primarily first-year non-athlete students at a northwestern public university. Marijuana use prevalence in the non-athlete sample was higher than the prevalence found in nationwide surveys of drug use on college campuses. Current use of marijuana was greater in non-athletes than athletes, however, lifetime use was equivalent. The perceptions of prevalence of marijuana use among both athletes and non-athletes exceeded self-reported use in these groups. Students who used marijuana held higher perceptions of the prevalence of marijuana use among their campus peers and those believing that marijuana use was normative on campus were more likely to be current marijuana users themselves. The findings from this study have important implications for designing college drug prevention programs.

Assesses adolescents' estimations of the prevalence of alcohol and other drug use and examines the consistency between these estimations and reported use. Results reveal that students grossly overestimated the prevalence of substance use when compared to self-reports of use. Results imply the need for school personnel to provide students with accurate information regarding the actual prevalence of substance abuse. (GCP)

Examined relationship between shyness and physical activity among Philippine high schoolers. Found that Philippine students reported less physical activity than U.S. students on the Youth Risk Behavior Survey. Highly shy Filipino students participated in vigorous physical activity significantly less often than those with average or low shyness and were less likely to play on sports teams. (Author/KB)

Assessed college students' perceptions of campus norms for recent sexual activity, investigating whether personal behavior related to those perceptions. Student surveys indicated that students who estimated high levels of sexual activity among peers were more likely to have had sexual intercourse in the past month than were students who made lower estimates. Some differences by gender were evident. (SM)

Reports marijuana users gave significantly higher estimates of percentage of students who use marijuana. States that there is a greater risk of using marijuana among students who held the perception that it was used by more than half the students on campus. Prevention programs need to consider that marijuana users are at risk for engagement in other heath risk behaviors. (Author/JDM)

Investigated relationship between perceived physical attractiveness and frequency of substance use among 1,297 adolescents. Female adolescents who rated themselves as unattractive were more likely to use illicit psychoactive substances than those who rated themselves as average or attractive. Perceived attractiveness did not contribute to differences in substance use in males, except in case of smokeless tobacco. (Author/NB)

Discusses the need for many interdisciplinary approaches and interventions, including societal and economic reforms, in preventing interpersonal violence. After examining factors related to violent behavior, violence prevention in health promotion, and the health educator's role, the article presents examples of violence prevention efforts. (SM)

Administered Short Michigan Alcoholism Screening Test to subjects over age 18. Among late adolescents (aged 18 to 20), lonely females had highest mean scores, indicating higher degree of alcoholism risk than lonely males and nonlonely subjects. For males, loneliness appeared to increase alcoholism risk, not in late adolescence, but during early and middle adulthood. (Author/NB)

Addresses issue of whether underweight, normal-weight, and overweight adolescent females who maintain perception of being too fat differ with respect to loneliness, hopelessness, and shyness from each other and from those who do not think they are fat. Results indicate that underweight girls with perception of being too fat suffer significantly more psychosocial distress than do other girls. (SH)

Examined relationship of shyness and sociability to illicit substance use in 654 male high school students. Found that, in general, shy males were significantly more likely to use illicit substances than were not-shy peers. Shy, highly sociable males were significantly more likely to use hallucinogenic substances than were shy, less sociable males and not-shy males. (Author/NB)

A discussion is presented on the safety and potential side effects of radial keratotomy, a surgical procedure that results in a flattening of the cornea and a reduction of refractive myopia (nearsightedness). (JD)