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ObjectiveMethodsResultsConclusionsThe study examined the association of various socioeconomic, demographic, health risk behavior, and social capital factors with the cognitive health status of older adults in India.Data from the Longitudinal Ageing Study in India (LASI, 2017–18), wave-1 was used. Binary logistic regression was applied to explore the significant predictor variables of poor cognitive health status. Further, decomposition analysis was employed to explore the gender differences in cognitive health status.The results revealed that female older adults had a higher odds of poor cognitive health status than male older adults (aOR: 2.37; 99% CI: 1.97–2.85). Increasing years of age, not being in a marital union, lower levels of social capital, and the presence of health risk behavior increased the odds of poor cognitive health. Education had a protective effect against the decline in cognitive health. The decomposition analysis results indicated that the gender difference in educational attainment contributed largely to the gender inequality in poor cognitive health status.The results suggest that gender equality in educational attainment could reduce the gender difference in cognitive health among male and female older adults to a large extent. [ABSTRACT FROM AUTHOR]

Introduction: Asthma is a chronic inflammatory disease of the lower airways that affects more than 260 million people worldwide and has been related to more than 460,000 deaths a year. It is estimated that in 60% of asthma cases, the symptoms are not adequately controlled. The objective of this study was to determine the association between some comorbidities, habits, and health risk behaviors with uncontrolled asthma in a sample of young people with asthma. Methods: Through a cross-sectional study, data from 1,078 young people aged 17 to 19 years were analyzed. Information was collected through physical examination, direct questioning, and the application of a self-administered questionnaire. Results: In the group of young people with asthma, the prevalence of uncontrolled asthma was 20.6%, of which 53.8% were women, 76.9% suffered from rhinitis, 46.2% were overweight and 23.1% were obese. In the group of young with uncontrolled asthma, gingivitis was detected in 53.8% and alcohol consumption in 84.6%. Logistic regression analysis showed a significant association between allergic rhinitis, gingivitis, carbohydrate intake, alcohol consumption, overweight, and obesity with uncontrolled asthma. Conclusions: Parents and members of the health team need to identify on time the risk factors associated with uncontrolled asthma in young people with asthma to limit its development and the negative effects it generates. The results of this study should be used to strengthen programs that promote the comprehensive health of adolescents. [ABSTRACT FROM AUTHOR]

Existing studies have verified the effect of information access on health behaviors, while less is known about the different impacts of distinct information access in a pandemic context. This study identified four information types (including disease knowledge, dynamic news, government measures, and social news) and then investigated how different information access affected preventive behaviors via perceived risk and media credibility during the COVID-19 outbreak in China. A nationally representative sampling survey on Chinese netizens was conducted (N = 8 0 2). It found that access to dynamic news, disease knowledge, and government measures positively predicted perceived severity, while only social news positively predicted perceived susceptibility. Access to disease knowledge, government measures, and social news were positively correlated with media credibility. The mediating roles of perceived risk and media credibility were proved. Besides, the statement of "cues-to-action" was also proved, which indicated that information access impacted behavioral changes more directly rather than through the mediators during COVID-19 pandemic. These findings contribute to a better understanding of how information access impacts public health behaviors in a pandemic context. [ABSTRACT FROM AUTHOR]

Unhealthy diet-related behaviors and poor diet quality during childhood and adolescence are the main factors contributing to noncommunicable diseases such as obesity, dyslipidemia, diabetes, hypertension, and cardiometabolic syndrome. Unhealthy diet-related behaviors can become lifelong habits associated with mental health problems, including depression, anxiety, attention deficit hyperactivity disorder, and substance abuse issues such as smoking, drinking, and other chemical compounds. Children and adolescents are in the developmental stages of brain structure, function, and neurotransmission systems, which can make them more susceptible to substance abuse (tobacco, alcohol, and drugs). Thus, mental health problems and substance use in children and adolescents may originate from unhealthy diet-related behaviors and poor diet quality. Here we reviewed the impact of diet-related behaviors and diet quality on children's and adolescents' physical and mental health and substance use by scrutinizing the 2021 Korean Youth Risk Behavior Survey (54,848 participants) and other relevant studies. [ABSTRACT FROM AUTHOR]

Purpose: Physical inactivity and sedentary behaviors are key contributors to the rising rates of childhood obesity. Though many adolescents are aware of the benefits of exercise, youth in America are not sufficiently active. This study examined changes in physical activity (PA), physical education (PE), and sedentary behaviors among Black adolescents. Methods: Pooled data from Black high school students (n = 2,233) who completed the Youth Risk Behavior Survey (YRBS) from 2009–2019 in Broward County, Florida, were analyzed. Logistic and linear regression models examined trends in selected physical activity indicators. Results: There were no significant changes in recommended physical activity levels (p =.829), daily physical activity (p =.44), PE class attendance (p =.054), or the average number of days of PA engagement (p =.304) for this time period. However, there was a significant decline in daily PE class attendance, the average number of days of PE attendance, and excessive television watching (p <.001). There were also increases in excessive video gaming and computer usage (p =.002). Conclusion: Adolescents' physical activity behaviors have not declined substantially over the past decade. However, sedentary behaviors, such as computer use and video gaming, have markedly increased. Results presented here should assist in broadening the understanding of Black adolescents' views on weight and physical activity and developing local programs and interventions to promote regular physical activity aimed at this population. [ABSTRACT FROM AUTHOR]

Disasters are increasing in frequency and intensity due to climate change. Youth are the largest and most vulnerable group exposed to disasters. More evidence is needed regarding how youth mental health and health behaviors vary based on disaster exposure, how mental health influences health behaviors, and how diverse groups of youth may be differentially affected. Using data from the Youth Risk Behavior Survey and Federal Emergency Management Agency, we examined the impact of Hurricane Sandy (2012) on mental health (sadness, suicidality) and health behaviors (substance use, physical activity, screen time, sexual behaviors) of 240,365 youth. Difference-in-differences regression analyses evaluated pre-disaster (2005–2011) and post-disaster (2013–2019) changes. There were 83,442 (34.7 %) adolescents (51.2 % female, 18.1 % non-Hispanic White) located in 6 districts exposed to Hurricane Sandy and 156,923 (65.3 %) adolescents located in 13 non-exposed districts. Exposure was associated with differences in substance use, physical (in)activity, and risky sexual behaviors, but not mental health outcomes. Mental health did not moderate the association between disaster exposure and health behaviors. Hispanic adolescents and those identifying as Other races/ethnicities were most vulnerable to post-disaster negative health outcomes. Study limitations include questionnaire design, cross-sectional data, sampling, and possible response biases. Findings provide critical information about youth mental health and health behaviors following disasters, as well as how youth may differ in their responses. Findings provide guidance for early identification and resource allocation for youth at higher risk for post-disaster health issues. • We evaluated Hurricane Sandy's impact on adolescent health using difference-in-difference logistic regression models. • No association found between Hurricane Sandy exposure and mental health outcomes (depression, suicidality). • Exposure was linked to changes in substance use, physical (in)activity, and risky sexual behaviors. • Mental health did not moderate the link between disaster exposure and adolescent health. • Youth in areas exposed to the hurricane demonstrated smaller decreases in smoking and larger increases in cannabis use. • Adolescents identifying as Hispanic and Other races were at the highest risk for adverse health outcomes. [ABSTRACT FROM AUTHOR]

Background Objective Methods Results Conclusions While headache disorders are linked to low physical activity levels, the impact of depression on this relationship is unclear.To assess how single and comorbid diagnoses of migraine and tension‐type headache (TTH) interact with depression and leisure‐time physical activity (LTPA) levels in The Brazilian Longitudinal Study of Adult Health (ELSA‐Brasil).In this cross‐sectional analysis based on the ELSA‐Brasil baseline data, the relationship of migraine, TTH (both assessed with the International Classification of Headache Disorders, Second Edition), and depression (assessed with the Clinical Interview Schedule–Revised) with LTPA levels (International Physical Activity Questionnaire) was investigated by employing linear regression models. Models were adjusted for sociodemographic, lifestyle, and clinical covariates, and interaction terms were created to examine additive effects of comorbid conditions.Among 14,088 participants, 54.4% (7668/14,088) were female, prevalence rates were: TTH = 39.6% (5573/14,088), migraine = 27.0% (3806/14,088), depression = 0.7% (94/14,088), depression + TTH = 1.1% (148/14,088), and depression + migraine = 2.5% (356/14,088). The mean (standard deviation) LTPA levels across the groups were: no headache + no depression = 148.7 (183.0) min/week, TTH = 133.5 (170.1) min/week, migraine = 110.3 (154.8) min/week, depression = 76.5 (146.3) min/week, depression + TTH = 84.5 (127.7) min/week, and depression + migraine = 64.3 (123.2) min/week. Negative associations were found for depression (β = −55.1, 95% confidence interval [CI] −93.6 to −17.0; p = 0.005), migraine (β = −24.7, 95% CI −33.2 to −15.4; p < 0.001), and TTH (β = −15.5, 95% CI −23.1 to −7.6; p < 0.001) with LTPA. No interaction effect was observed for depression + TTH (β = 36.0, 95% CI −12.6 to 84.6; p = 0.147) and depression + migraine (β = 31.7, 95% CI −11.3 to 74.7; p = 0.149), indicating no additive effect of comorbid conditions on LTPA levels. After adjusting for headache attack frequency, only depression + migraine remained negatively associated with LTPA (β = −38.7, 95% CI −71.6 to −5.8; p = 0.021).Headache disorders and depression were independently and inversely associated with LTPA, with the strongest effects seen in depression alone or comorbid with migraine. [ABSTRACT FROM AUTHOR]

Purpose: College students' academic achievement has crucial implications for their future success. Students' health may be a key determinant of academic performance, but more research is needed to understand this relationship. Design/Setting/Subjects: Secondary analysis of the American College Health Association-National College Health Assessment III pre-COVID-19 Spring 2020 dataset. N = 39 146 undergraduates at 75 higher education institutions (14% mean response rate, comparable with other large-scale national college health surveys). Measures: Self-reported grade point average (GPA) and 33 health behaviors in the categories of dietary behavior, physical activity, sedentary behavior, substance use, sexual risk behavior, violence-related behavior, mental health, and sleep behavior. Analysis: Weighted cross-tabulations examining the association between GPA and health behaviors; multinomial logistic regressions assessing if behaviors predicted GPA, controlling for year, sex/gender, and race/ethnicity. Individual GPA categories were also compared to a D/F referent group. Results: There were gradient trends across GPA categories for A through D/F (18 behaviors) or A through C (12 behaviors) (P <.001). Each health behavior predicted GPA differences (P <.001), except heroin use (P =.052). The A GPA group was significantly different from the D/F GPA group for 27 behaviors (P <.001). In general, protective behaviors corresponded with higher GPAs and most risk behaviors were associated with lower GPAs. Conclusions: There is a link between numerous health behaviors and academic performance. Stakeholders invested in college students' health and academics should engage in mutually beneficial strategies to safeguard students' current and future well-being and success. [ABSTRACT FROM AUTHOR]

Adolescence is a time when important changes occur in behavioral development, and previous studies have confirmed the relationship between excessive Internet use and decreased oral health behavior. Our purpose is to identify the indirect effects and behavioral factors of smartphone screen time on the caries symptom experience of adolescents. Using data from the 16–17th Korea youth risk behavior web based survey (2020–2021), we investigated the smartphone screen time of 109,796 students in middle school 1st to high school 3rd. Adolescents who used smartphones more than 6 h per week were 28% more likely to experience caries symptoms than those who used smartphones less than 2 h (odds ratio = 1.28; 95% confidence interval, 1.22–1.35). Those who consumed cariogenic drinks more than once a day were 25% more likely to experience caries symptoms, and those who brushed their teeth less than once a day were 26% more likely to experience caries symptoms (odds ratio = 1.25, 1.26; 95% confidence interval, 1.07–1.46, 1.06–1.51). Excessive smartphone screen time is associated with addictive eating habits and reduced physical activity that increase cariogenic dietary behaviors, and decrease oral health behaviors. It suggests that excessive smartphone use indirectly related to the experience of caries symptoms. [ABSTRACT FROM AUTHOR]

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Background: In the United States (US), incidence of early age of onset colorectal cancer (EOCRC, diagnosed <50 years of age) has been increasing. Using a Bayesian analytic approach, we evaluated the association between county-level ecological factors and survival among individuals with EOCRC and identified hotspot and coldspot counties with unexplained low and high survival, respectively. Methods: Principal component (PC) analysis was used to reduce dimensionality of 36 county-level social, behavioral, and preventive factors from the Centers for Disease Control and Prevention data. Survival information was derived from the Surveillance, Epidemiology, and End Results Program data from January 1, 2000 to December 31, 2019. The association between the identified PCs and survival was evaluated using multivariable spatial generalized linear mixed models. Counties with residual low and high survival (i.e., unexplained by the PCs) were classified as hotspots and coldspots, respectively. Results: Four PCs were used to explain the spatial variability in 5-year survival among 75,215 individuals with EOCRC: PC1) poverty, chronic disease, health risk behaviors (β = -0.03, 95% credible interval (CrI): -0.04, -0.03); PC2) younger age, chronic disease-free, minority status (β = -0.01, 95% CrI: -0.02, 0.00); PC3) urban environment, preventive services (β = 0.02, 95% CrI: 0.00, 0.03); and PC4) older age (-0.04, 95% CrI: -0.06, -0.02). Among individuals with distant malignancies, the residual spatial variability remained high for two US counties: 1) Salt Lake County, UT residents experiencing 26.5% (95% CrI: 1.5%, 47.8%) lower odds of survival [hotspot], and 2) Riverside County, CA residents experiencing 37% (95% CrI: 7.97%, 78.8%) higher odds survival [coldspot] after adjustment for county-level factors. Conclusions: County-level ecological factors are strongly associated with survival among individuals with EOCRC. Yet there is some evidence of survival disparities among individuals with distant malignancies that remain unexplained by the included factors. [ABSTRACT FROM AUTHOR]

Background: Cyberbullying and health risk behaviors are pervasive issues for secondary vocational students that not only detrimentally impact their academic achievement but also pose a significant threat to overall health. The purpose of this study was to understand the current situation of cyberbullying and health risk behaviors among secondary vocational students in China and to explore the relationships among cyberbullying, self-control, self-control over internet usage, and health risk behaviors through a mediation model. Methods: This was a cross-sectional study. From March to April 2023, a self-administered questionnaire was completed by a cluster sample of 1184 students from grades 1 to 3 at three secondary vocational schools in Jilin Province. The researchers utilized a sociodemographic questionnaire, the Cyberbullying and Cybervictimization Scale (CAV), the Adolescent Health Related Risky Behavior Inventory (AHRBI), the Self-Control Scale (SCS), and the Internet Usage Self-Control Scale (IUSCS-CS) to assess the prevalence and impact of cyberbullying and health risk behaviors. Descriptive statistics, spearman correlation analyses. Finally, the Process plug-in V2.16.3 was used to analyze a mediation model for the data. Results: Among secondary vocational students, 839 individuals (70.86%) experienced cyberbullying and 1036 individuals (87.50%) had one or more health risk behaviors. A chi-square test showed that the differences in cyberbullying incidence were statistically significant (P < 0.05) for being children, type of accommodation, residence, ethnicity, purpose of using the internet, and family composition. Statistically significant differences in health risk behaviors were observed based on gender, type of accommodation, residence, ethnicity, academic achievement, classmate relationships, purpose of using the internet, and family composition (P < 0.05). Health risk behaviors and cyberbullying were correlated (r = 0.60), health risk behaviors and self-control and internet usage self-control were negatively correlated (r = -0.42, -0.50). Mediation analysis indicated that self-control (0.02, 0.08) and internet usage self-control (0.08, 0.17) partially mediated the association between cyberbullying and health risk behaviors. Conclusions: Secondary vocational students exhibit a high prevalence of cyberbullying and health risk behaviors. The study confirmed that self-control and internet usage self-control has an important role in mediating cybeibullying and health risk behaviors. Adolescent health promoters should develop targeted strategies to enhance the self-control of secondary vocational school students to mitigate their engagement in health risk behaviors. [ABSTRACT FROM AUTHOR]

Background: Systematic counseling on behavioral health risk factors (HRFs) may be suitable to promote health among general hospital patients. This study aimed to investigate the openness of patients towards systematic screening and intervention of HRFs, its relation to actual participation in a multi-behavioral intervention, and whether socio-economic characteristics, HRFs and health indicators are related to approval. Methods: All 18- to 64-year-old patients hospitalized in five medical departments at the University Medicine Hospital Greifswald in Germany were asked between May and July 2022 to participate in a survey and in a subsequent pre-post intervention study. Among all eligible patients, 225 (78.9%) participated in the survey. Patients' approval of systematic screening and intervention of HRFs was assessed using five statements with a total sum score of 0–20 (i.e., scores of 0–6, 7–13, 14–20 referring to low, medium and high approval). Associations with intervention participation, socio-economic, behavioral and health-related patient characteristics were analyzed using logistic and multivariable linear regression analyses. Results: The mean total approval of screening and intervention was 13.8 (SD = 4.8). Of the 125/ 73/ 16 patients with high/ medium/ low approval, 88.0%/ 78.1%/ 50.0% participated in the subsequent intervention, respectively. Approval was independent of socio-demographic and -economic characteristics and self-rated general health. Current tobacco smoking was the only HRF negatively (p = 0.02) and diabetes mellitus was the only disease positively (p = 0.01) associated with approval. Conclusion: High approval of HRF screening, which was rather independent of socio-economic characteristics and worse self-rated general health, speaks in favor of proactively approaching and motivating all general hospital patients to participate in health behavior change intervention. Tobacco smokers might need higher efforts to motivate participation than non-smokers. Trial registration: ClinicalTrials.gov Identifier NCT05365269 on May 9, 2022. [ABSTRACT FROM AUTHOR]

This study departs from the acknowledged absence of validated measures to assess social and emotional competencies in incarcerated individuals. This is a critical gap given that most available programs aimed at fostering prosocial behavior and reducing antisocial behaviors are theoretically based on enhancing these competencies. This study assessed the psychometric properties of the Social and Emotional Competencies Questionnaire (SEC-Q) in a sample of 219 Portuguese incarcerated males (M age = 37.21 years, SD = 10.61), and to explore the impact of the SEC-Q dimensions on health risk behaviors in this population. The study used confirmatory factor analysis (CFA) to examine the factor structure of the SEC-Q. The four-factor model fitted well to the data (SB χ2 = 267.75; df = 120; Robust CFI = 0.99; Robust RMSEA = 0.06), and, as expected, it includes four dimensions: self-awareness, self-management and motivation, social awareness and prosocial behavior, and decision-making. The four dimensions showed appropriate internal consistency (Cronbach's alpha = 74–81; McDonald's omega = 75–82). Additionally, social and emotional competencies were related to higher self-control (rs=0.45, p <.01) and lower health risk behaviors (rs = − 0.25, p <.01), supporting convergent and divergent validity. Findings from the negative binomial regression suggest that higher social awareness and prosocial behavior is related to less health risk behaviors among incarcerated males. This study is a pivotal step to promote an affordable and valid measure to assess social and emotional competencies among Portuguese justice-involved males. SEC-Q can be an important complementary measure for evaluating the effectiveness of interventions aimed at preventing criminal recidivism. [ABSTRACT FROM AUTHOR]

Background: Studies investigating the association between cannabis use and physical activity have had mixed results. This study provided a population-based assessment while determining how the relationship is affected by variables such as cannabis legalization status and chronic medical conditions. Methods: Behavior Risk Factor Surveillance System (BRFSS) data were used to evaluate the association between cannabis use and physical activity among adults ages 18 years and older in several states and territories of the U.S. during 2016–2022. Adjusted odds ratios (ORs) measuring the relationship between physical activity in the past 30 days (yes vs. no) and cannabis use in the past 30 days (yes vs. no) based on legalization and health status were estimated using logistic regression. Results: Physical activity increased from 73.16% in 2016 to 75.72% in 2022 (3.5% increase) and current cannabis use increased from 7.48% in 2016 to 14.71% in 2022 (96.7% increase). Current cannabis use was 6.5% higher in areas of legalized recreational cannabis (vs. not legal) and 0.7% higher in areas of legalized medical cannabis (vs. not legal). For the combined years, the OR measuring the association between cannabis use and physical activity was 1.24 (95% CI 1.10–1.41), after adjusting for age, sex, race/ethnicity, marital status, employment status, education, smoking status, weight classification, legal status, and chronic medical condition. The adjusted OR was 1.47 (95% CI 1.34–1.62) in areas with legalized recreational and medical cannabis (vs. illegal) and 1.05 (95% CI 0.98–1.12) in areas with legalized medical cannabis only (vs. illegal). Having a medical condition was significantly associated with lower prevalence of physical activity in the adjusted models (overall adjusted OR = 0.79, 95% CI 0.73–0.85). However, this significantly lower odds ratio was insignificant for current cannabis users. Conclusions: Public policy and personal health behaviors may improve with the findings that legal medical cannabis promotes greater physical activity in those experiencing chronic medical conditions and legal recreational cannabis promotes (even more so) greater physical activity in those not experiencing chronic medical conditions. [ABSTRACT FROM AUTHOR]

Background/Objectives: Despite the importance of resistance exercise in older adults, factors associated with participation remain unclear, especially regarding sex differences. This study investigated sociodemographic, behavioral, and comorbidity factors associated with insufficient resistance exercise participation among community-dwelling older adults in Korea, with analyses stratified by sex. Methods: Nationally representative cross-sectional data from 8671 participants aged ≥65 years (3758 men and 4913 women; mean age 72.8) were analyzed using the 6th-8th Korea National Health and Nutrition Examination Surveys (2014–2019). Complex-sample multivariable logistic regression identified factors associated with insufficient resistance exercise overall and by sex. Results: Women had a higher prevalence of insufficient resistance exercise than men (91.27% vs. 71.04%, p < 0.001). Older age groups, particularly those aged ≥80 years (OR: 2.39; 95% CI: 1.86–3.07), and those with lower education (OR: 1.56; 95% CI: 1.33–1.82), rural residence (OR: 1.89; 95% CI: 1.49–2.38), low household income, (OR: 1.45; 95% CI: 1.13–1.88), insufficient aerobic exercise (OR: 1.68; 95% CI: 1.46–1.94), current smoking (OR: 1.70; 95% CI: 1.26–2.29), and diabetes (OR: 1.28; 95% CI: 1.09–1.51) were independently associated with a higher likelihood of insufficient resistance exercise. The association of household income, current smoking, hypertension, and diabetes with resistance exercise adherence showed differences in sex-stratified analyses. Conclusions: Multiple sociodemographic, behavioral, and comorbid factors are linked to resistance exercise adherence among older Koreans. Tailored, sex-specific interventions are needed to promote resistance exercise in this population, informing public health strategies and further research on effective approaches for diverse older adults. [ABSTRACT FROM AUTHOR]

Background: Artificial light at night (ALAN) is a common phenomenon and contributes to the severe light pollution suffered by more than 80% of the world's population. This study aimed to evaluate the relationship between outdoor ALAN exposure and cardiovascular health (CVH) in patients with diabetes and the influence of various modifiable factors. Methods: A survey method based on the China Diabetes and Risk Factor Monitoring System was adopted. Study data were extracted for 1765 individuals with diabetes in Anhui Province. Outdoor ALAN exposure (nW/cm2/sr) within 1000 m of each participant's residential address was obtained from satellite imagery data, with a resolution of ~1000 m. Health risk behaviors (HRBs) were measured via a standardized questionnaire. A linear regression model was employed to estimate the relationship between outdoor ALAN, HRBs, and CVH. Results: Participants' mean age was 59.10 ± 10.0 years. An association was observed between ALAN and CVH in patients with diabetes (β = 0.205) and exercise (β = −1.557), moderated by HRBs, or metabolic metrics. There was an association between ALAN, ALAN, vegetable intake, and CVH. Conclusions: Exploring the relationship between ALAN exposure and cardiovascular and metabolic health provides policy data for improving light pollution strategies and reducing the risk of cardiovascular and metabolic disease in patients with diabetes. [ABSTRACT FROM AUTHOR]

Background and Aims: Healthcare students are expected to lead healthy lives yet they may engage in health risk behaviors (HRBs) like physical inactivity, poor diet, and substance use. These behaviors can have negative consequences for both the individual's health and well‐being, as well as their ability to perform their future roles as healthcare providers. This study aimed to assess the prevalence of HRBs and associated factors among medical and nursing students at Lumbini Medical College, Nepal. Methods: A cross‐sectional study was conducted among 412 undergraduate healthcare students using a self‐administered questionnaire. HRBs across various domains were assessed. Validated scales screened for anxiety and depression. Regression analyses determined associations between mental health and HRBs. Results: Low physical activity was prevalent, with only 10.7% exercising ≥5 times/week. Inadequate fruit/vegetable intake (1–2 servings/day) was reported by 79.9% students. Short sleep duration (5–6 h) on weeknights (51.2%) was common. More than three quarter (76.5%) of students met the screening cutoff score for HRBs. The study highlighted that students with addiction, depression and anxiety are more likely to exhibit HRBs (p < 0.01). Conclusion: Multiple HRBs were highly prevalent among the students. A considerable proportion demonstrated a clustering of risky lifestyle factors, which were linked to poor mental health. Interventions should address academic burden, promote positive health behaviors, and target mental well‐being in this vulnerable group. [ABSTRACT FROM AUTHOR]

Understanding tourist profiles and behaviors during health pandemics is key to better preparedness for unforeseen future outbreaks, particularly for tourism and hospitality businesses. This study develops and applies a novel data analytics methodology to gain insights into the health risk reduction behavior of restaurant diners/patrons during their dining out experiences in a pandemic. The methodology builds on data relating to four constructs (question categories) and measurements (questions and attributes), with the constructs being worry, health risk prevention behavior, health risk reduction behavior, and demographic characteristics. As a unique contribution, the methodology generates a behavioral typology by identifying risk profiles, which are expressed as one- and two-level decision rules. For example, the results highlighted the significance of restaurants' adherence to cautionary measures and diners' perception of seclusion. These and other factors enable a multifaceted analysis, typology, and understanding of diners' risk profiles, offering valuable guidance for developing managerial strategies and skill development programs to promote safer dining experiences during pandemics. Besides yielding novel types of insights through rules, another practical contribution of the research is the development of a public web-based analytics dashboard for interactive insight discovery and decision support. [ABSTRACT FROM AUTHOR]

Despite the negative health impact of multiple risk-taking behaviors (RTBs), there is a lack of understanding of adolescents who are more prone to multiple RTBs. This study aimed to identify sociodemographic, mental, and physical health variables associated with increased susceptibility to multiple RTBs in each sex. Cross-sectional data from the 2020 and 2021 Korea Youth Risk Behavior Web-based Survey was used. A total of 106,979 Korean adolescents (55,460 men and 51,519 women) were assessed on five RTBs (alcohol use, smoking, sexual intercourse, illicit substance use, no seat belt wearing). In comparison to no RTB group, odds ratios of the relevant covariate factors were calculated in one RTB or multiple RTBs groups. Male and female adolescents engaging in multiple RTBs were 6.4% and 3.8%, respectively. Increasing age, low subjective socioeconomic status, and living in rural areas were associated with multiple RTBs regardless of sex. All mental health variables except anxiety were associated with multiple RTBs in both sexes. Physical inactivity and obesity were associated with decreased odds of multiple RTBs in both sexes. This study identifies diverse factors associated with multiple RTBs of Korean adolescents and demonstrates existing sex differences. Age and mental health status are the most critical factors that distinguish multiple risk-taking groups from those involved in one or no RTB. • Adolescents' risk-taking behaviors include alcohol use, smoking, sexual intercourse, drug use, and not wearing seatbelts. • Identifying teens vulnerable to multiple risk-taking behaviors is important for promoting overall health of adolescents. • Poor mental health status and late teens are significant risk factors for multiple risk-taking behaviors. • Subtle sex differences in anxiety and living arrangements are significant only for female adolescents' risk-taking. [ABSTRACT FROM AUTHOR]

Background: Empowering adolescents to manage and reduce unhealthy behaviors and promote adaptive behaviors is a promising approach to promoting healthy behaviors. This review was an attempt to evaluate adolescent empowerment programs aimed at preventing and managing risky behaviors. Materials and Methods: This narrative review was conducted in 2023. The texts were reviewed in two sections: (1) a review of articles and books in databases and (2) a review of international websites. The keywords used to search for studies and programs included substance-related disorders, risky behaviors, empowerment, program, adolescent, suicide, and risky sexual behaviors. These keywords were individually searched in international databases such as "PubMed, Scopus, and Web of Science." In the second section, a search was conducted on the websites of international organizations such as the World Health Organization (WHO). The inclusion criteria included having the full text of the original articles, articles in English, articles related to the development and evaluation of the effectiveness of empowerment programs, and the age range of adolescents. The texts that only had abstracts and were in non-English languages were excluded. Results: The programs designed to empower adolescents were in three areas: (1) community-based and peer-based programs, (2) family-based programs, and (3) comprehensive programs. Most programs focused on peer group participation and skill interventions. Conclusions: A powerful and effective empowering program for adolescents to prevent and control risky behaviors should be designed in the form of comprehensive programs in social, educational, economic, and health dimensions, and with the active engagement and participation of adolescents. [ABSTRACT FROM AUTHOR]

Background: Work-related musculoskeletal disorders (WRMDs) are frequently observed among market vendors, and engaging in health risk behaviors can exacerbate these issues, leading to various health problems. Common health risk behaviors among market vendors include alcohol consumption and insufficient physical activity. However, there is currently a lack of research examining the prevalence of WRMDs and health risk behaviors among market vendors in Bangkok. Furthermore, the emerging trend of drug misuse within this group remains poorly understood. This study aims to explore the prevalence of muscle pain and flexibility issues and assess health risk behaviors, including alcohol consumption, inadequate exercise, and drug misuse, among market vendors. Methods: A mixed-method study was undertaken among 213 market vendors in Bangkok. Data collection utilized direct observation techniques, questionnaires, and muscle flexibility tests. Qualitative data were elucidated and showcased through textual descriptions and quotations. Quantitative data were analyzed using descriptive statistics to present numerical and percentage values. Results: Qualitative findings revealed that market vendors often engage in static muscular work and maintain awkward postures due to their job characteristics and workstation setups. Quantitatively, the right arm was the most common pain region (34.7%), followed by the left leg (31.0%), right leg (30.0%), and left arm (28.6%). Additionally, 64.3% of participants showed poor muscle flexibility. The study also found that 35% of market vendors resorted to alcohol and 11.7% to drug misuse to cope with fatigue and prevent adverse symptoms. Moreover, 68.5% of participants reported no regular exercise due to lack of time. Conclusion: The study highlights the prevalence of musculoskeletal issues among market vendors, largely attributed to static muscular work and awkward postures dictated by their job roles and workstation arrangements. The right arm emerged as the most commonly affected area, followed by the left leg, right leg, and left arm, with significant rates of reported pain. The research also points to a notable lack of muscle flexibility in a majority of vendors and a concerning tendency towards alcohol and drug misuse as coping mechanisms for fatigue and symptom management. Furthermore, a significant portion of the vendors do not participate in regular exercise, primarily due to time constraints. These findings can be used to implement health prevention programs within the market vendor group. [ABSTRACT FROM AUTHOR]

Background: Clustering lifestyle risk behaviors is important for predicting cardiovascular disease risk. However, it is unclear which behavior mediates other ones to influence cardiovascular disease risk. We aimed to assess the causal inference of each lifestyle risk behavior for the atherosclerotic cardiovascular disease (ASCVD) risk of the general population. Methods: We performed a Bayesian network mediation analysis using data from the Korea National Health and Nutrition Examination Survey from 2014 to 2019. The main exposure was a combination of lifestyle risk behaviors including unhealthy weight, heavy alcohol consumption, inadequate sleep, physical inactivity, excessive sodium intake, and current smoking among subjects 40 to 79 years of age. The high risk of ASCVD (≥7.5% for the 10-year risk) was assessed using logistic regression, Bayesian networks, and structural equational models to examine the causal relationships between these six lifestyle risk behaviors. Results: Among all participants, the most prevalent lifestyle risk behavior for those at high risk for ASCVD was excessive sodium intake (95.6%), followed by inadequate sleep (49.9%) and physical inactivity (43.8%). Older age (65–79 years) and male sex were directly associated with a high risk for ASCVD. Physical inactivity, current smoking, excessive sodium intake, and unhealthy weight indirectly mediated the effects of older age (8.2% of the older age) and male sex (39.9% of males) to high ASCVD risk. Physical inactivity, current smoking, excessive sodium intake, and unhealthy weight particularly mediated the high ASCVD risk sequentially. Heavy alcohol consumption and inadequate sleep were not directly associated with high ASCVD risk and did not indirectly mediate the effects of older age and males on the high ASCVD risk. Conclusion: Lifestyle risk behaviors mediated the atherosclerotic cardiovascular disease risk in a different manner. Especially, physical inactivity preceded current smoking, excessive sodium intake, and unhealthy weight in relation to high ASCVD risk, and this causal relationship was different according to age and sex. Therefore, tailored strategies according to specific target populations may be needed to effectively reduce the high ASCVD risk. [ABSTRACT FROM AUTHOR]

This study examined how clustered health risk behaviors (HRBs) affect mind wandering (MW) and whether sleep quality and emotional symptoms play a serial mediating role. 1041 college students were recruited through convenience sampling. The measurement scale included a Health Risk Behaviors Questionnaire, the Brief Pittsburgh Sleep Quality Index, the Patient Health Questionnaire-4, and the Mind-Wandering Questionnaire. We identified four clusters of HRBs including low-risk behaviors (Class 1), takeaway intake-nutritional imbalance (Class 2), substance use-irregular diet (Class 3), and sedentary (Class 4). There was the highest level of MW in Class 3, followed by Class 1, Class 2, and Class 4. Compared to Class 1, sleep quality and emotional symptoms positively mediated the relationship between Class 2, Class 3, Class 4 and MW. Additionally, the number of HRBs still affected MW via serial mediators of sleep quality and emotional symptoms. Clustered HRBs were significantly associated with MW among young adults via the mediating mechanism of sleep quality and emotional symptoms. This study expands the theoretical knowledge of the relationship between lifestyle, sleep, emotion, and cognition. Our research provides some suggestions for the sake of personality health in young adults. [ABSTRACT FROM AUTHOR]

Background: Unhealthy weight control behaviors (UWCBs) involve weight control strategies to reduce or maintain weight, such as fasting, taking diet pills, and vomiting or taking laxatives. UWCBs in teenagers can escalate into severe health issues such as eating disorders. Understanding the trends of UWCBs and their association with risk behaviors in teenagers is crucial, as early intervention and prevention strategies are pivotal. Methods: This study utilized eight waves of the youth risk behavior surveillance system (YRBSS) data from 1999 to 2013. Our primary outcome was UWCBs engagement. We used multinomial logistic models to analyze the association between UWCBs and risk behaviors among adolescents including driving after alcohol consumption, suicide attempts, smoking, alcohol use, and sexual intercourse. Results: Among 109,023 participants, UWCBs prevalence was 16.64%. Body Mass Index (BMI) was significantly associated with UWCBs risk. In addition, we found the intention of weight management confounded the relationship between BMI and UWCBs. The unadjusted logistic regression indicated a monotone-increasing association between BMI and the risk of UWCBs. In contrast, the adjusted logistic regression indicated a U-shaped curve with the lowest (BMI < 17 kg/m2) and highest (BMI > 30 kg/m2) BMI groups having significantly higher odds of engaging in UWCBs compared to the reference BMI group (18.5 ≤ BMI ≤ 24.9 kg/m2). Conclusions: The intention of weight management confounded the relationship between Body Mass Index (BMI) and the risk of UWCBs. These findings suggest that healthcare interventions for weight management behaviors should be tailored to adolescents with BMI ≥ 25 and BMI < 18.5. Plain English Summary: This study looked at unhealthy weight control behaviors (UWCBs) in American teenagers, such as fasting, taking diet pills, or vomiting to control weight. These behaviors can lead to serious health problems, including eating disorders. The research analyzed data from over 100,000 teenagers between 1999 and 2013 to understand the connection between UWCBs and other risky behaviors like drinking alcohol, smoking, and attempting suicide. While previous research suggested that teens with higher body weight were more likely to engage in UWCBs, our findings showed a shift in this relationship after considering the teens' intentions to manage weight. Specifically, teens with very low body weight (BMI < 17) and a strong desire to lose weight had an increased risk of UWCBs. This highlights the need for healthcare providers to focus on the mental health and weight management goals of these teens to prevent harmful behaviors. Additionally, reconsidering the removal of UWCB-related questions from national surveys like YRBSS is important to continue monitoring these behaviors. [ABSTRACT FROM AUTHOR]

Adolescents' chronic experience of peer victimization may exacerbate a wide range of health risk behaviors and have negative outcomes for families, schools, and societies. The aim of this study was to explore peer victimization, fear of missing out, and family connectedness as potential predictive mechanisms for adolescent health risk behaviors. A moderated mediation analysis of cross-sectional data served as the basis for an examination of peer victimization levels as a predictive mechanism for adolescent health risk behaviors (N = 602, Mage = 12.86, SD = 0.71). The path analysis showed that peer victimization significantly and positively predicted fear of missing out and health risk behaviors with fear of missing out partially mediating the relationship between peer victimization and health risk behaviors. Moreover, family connectedness moderated the predictive effects of peer victimization on health risk behaviors. These findings suggest that fear of missing out may be essential to understanding how peer victimization impairs adolescents' health risk behaviors; furthermore, strengthening the sense of connectedness between adolescents and family members may be beneficial in mitigating the impact of peer victimization on health risk behaviors. [ABSTRACT FROM AUTHOR]

Background: Sexual behavior in adolescents is related to sexually transmissible diseases and not planned pregnancies. Sexual intercourse prevalence is unknown among student adolescents from Santa Marta, Colombia. Objective: To determine the prevalence and related factors with sexual relationships in adolescent students between 13 to 17 year-old of three private high schools at Santa Marta. Method: A transversal study was done with the application of a self-administrated survey that inquired into sexual behavior and health risk behaviors. In order to establish associations and controlling for other variables a logistic regression model was carried out. Results: 767 students participated with an average age was 14.5 (SD 1.2), 50.1% male, and a mean scholastic was 9.6 years (SD 1.1). Lifetime prevalence of sexual relationship was 25.0% (95%CI 21.9-28.1). Reporting having sexual relationship was associated with being a girl (OR 0.68, 95%CI 0.04-0.11), being younger (OR 0.45, 95%CI 0.33-0.62), not lifetime cigarette smoking (OR 0.24, 95%CI 0.12-0.48) nor alcohol consumption (OR 0.51, 95%CI 0.33-0.79). Conclusions: A quarter of the adolescents students, aged from 13 to 17 years, reports sexual intercourse, this is related to risky behaviors for health such as cigarette and alcohol consumption. [ABSTRACT FROM AUTHOR]

AbstractObjectiveDesignSettingInterventionSubjectsMain outcome measuresResultsConclusionClinicalTrials.gov\nKEY POINTSTo examine cardiovascular risk factors in 40-year-old participants in the health screening program targeted health dialogues (THDs).Cross-sectional study.99 Swedish healthcare centers.Metabolic risk factors and health behaviors were assessed. THDs were provided.1831 (62.3%) THD participants that consented to take part in the research project.(1) Prevalence of metabolic risk factors (blood pressure, LDL cholesterol, fasting plasma glucose, BMI, waist-hip ratio) and unhealthy behaviors (tobacco, alcohol, diet, physical activity) by sex, education, and place of birth. (2) Associations between different health behaviors and between the number of unhealthy behaviors and prevalence of metabolic risk factors. (3) THD participation by sociodemographics compared to age-matched controls.Men had a higher prevalence of all metabolic risk factors, excessive alcohol use and tobacco use than women. Lower educated individuals had a higher prevalence of metabolic risk factors (except for LDL cholesterol) and tobacco use than highly educated. Participants born outside Sweden had a higher prevalence of obesity, high waist-hip ratio, and tobacco use. Participants with 3–4 unhealthy behaviors had significantly higher prevalence of each of the metabolic risk factors except BMI. Women, highly educated and Swedish-born participants were slightly over-represented in the THDs.Considering the associations between unhealthy behaviors and metabolic risk factors, the THD method, covering lifestyle as well as objective health measures, may be an appropriate method for early identification of individuals at risk for future non-communicable diseases in the whole population with a specific focus on certain groups.NCT04912739The study presents health determinants in 40-year-old targeted health dialogue (THD) participants in a Swedish metropolitan, multi-ethnic region.Only half of the men had normal blood pressure and less than 40% had a BMI < 25 kg/m2.Having 3–4 unhealthy behaviors was associated with significantly higher prevalence of all metabolic risk factors (except BMI) compared to zero unhealthy behaviors.The predominance of female, highly educated and Swedish-born participants in THDs calls for a targeted outreach to certain population groups. [ABSTRACT FROM AUTHOR]

Introduction: The aim of the study was to assess the prevalence and associated factors of hand hygiene (HH) and oral hygiene (OH) behavior in adolescents in Central America. Methods: In total, 15807 school-aged adolescents (mean age=14.4 years, SD=1.4) were analyzed using secondary data from the cross-sectional Global School-based Student Health Survey (GSHS) conducted in six Central American countries (El Salvador, Belize, Costa Rica, Guatemala, Honduras, and Panama) between 2009 and 2018. HH and OH were assessed by questionnaire. Adjusted logistic regression was used to determine the associations with suboptimal ('not always') HH (SHH) and suboptimal (<2 times/day) OH (SOH). Results: The proportion of SHH before meals was 44.5% (the highest in Panama 69.0%), SHH after toilet use was 21.5% (the highest in Panama 33.3%), SHH with soap was 51.0% (the highest in Honduras 83.1%), and SOH (<2 times tooth brushing/day) was 11.3% (the highest in Panama 13.0%). Male sex (AOR=1.10; 95% CI: 1.03–1.35, SHH after toilet use), health risk behavior, including history of alcohol intoxication (AOR=1.54; 95% CI: 1.32–1.81 for SHH before meals, AOR=1.49; 95% CI: 1.23–1.99 for SHH after toilet use, and AOR=1.35; 95% CI: 1.17–1.57 for SHH with soap), inadequate fruit intake (AOR=1.53; 95% CI: 1.33–1.76 for SHH before meals and AOR=1.57; 95% CI: 1.34–1.84 for SHH after toilet use), inadequate vegetable intake (AOR=1.24; 95% CI: 1.05–1.47 for SHH before meals), and sedentary behavior (AOR=1.45; 95% CI: 1.28–1.64 for SHH before meals and AOR=1.23; 95% CI: 1.11–1.37 for SHH with soap), and poor mental health, including having no close friends (AOR=1.53; 95% CI: 1.20–1.96 for SHH before meals, and AOR=1.51; 95% CI: 1.22–1.99 for SHH after toilet use), and suicidal ideation (AOR= 1.22; 95% CI: 1.01–1.47 for SHH after toilet use, and AOR=1.27; 95% CI: 1.11–1.45 for SHH with soap) were associated with SHH. Male sex (AOR=1.80; 95% CI: 1.55–2.10), having no close friends (AOR=1.98; 95% CI: 1.50– 2.60), and suicidal ideation (AOR=1.32; 95% CI: 1.05–1.68) increased the odds and soft drink intake (AOR=0.75; 95% CI: 0.64–0.88) decreased the odds of SOH. Conclusions: This study presents SHH and SOH behavior practices. Several factors, including sociodemographics, health risk behaviors, and poor mental health, were identified that were associated with SHH and SOH behaviors, which can help in designing school OH and HH health promotion. [ABSTRACT FROM AUTHOR]

Meta-analyses have concluded that positive emotions do not reduce appetitive risk behaviors (risky behaviors that fulfill appetitive or craving states, such as smoking and excessive alcohol use). We propose that this conclusion is premature. Drawing on the Appraisal Tendency Framework and related theories of emotion and decision-making, we hypothesized that gratitude (a positive emotion) can decrease cigarette smoking, a leading cause of premature death globally. A series of multimethod studies provided evidence supporting our hypothesis (collective N = 34,222). Using nationally representative US samples and an international sample drawn from 87 countries, Studies 1 and 2 revealed that gratitude was inversely associated with likelihood of smoking, even after accounting for numerous covariates. Other positive emotions (e.g., compassion) lacked such consistent associations, as expected. Study 3, and its replication, provided further support for emotion specificity: Experimental induction of gratitude, unlike compassion or sadness, reduced cigarette craving compared to a neutral state. Study 4, and its replication, showed that inducing gratitude causally increased smoking cessation behavior, as evidenced by enrollment in a web-based cessation intervention. Self-reported gratitude mediated the effects in both experimental studies. Finally, Study 5 found that current antismoking messaging campaigns by the US Centers for Disease Control and Prevention primarily evoked sadness and compassion, but seldom gratitude. Together, our studies advance understanding of positive emotion effects on appetitive risk behaviors; they also offer practical implications for the design of public health campaigns. [ABSTRACT FROM AUTHOR]

In a context where pessimistic survival perceptions have been widespread as a result of the HIV/AIDS epidemic (Fig. 1A), we study vaccine uptake and other health behaviors during the recent COVID-19 pandemic. Leveraging a longitudinal cohort study in rural Malawi that has been followed for up to 25 y, we document that a 2017 mortality risk information intervention designed to reduce pessimistic mortality perceptions (Fig. 1B) resulted in improved health behavior, including COVID-19 vaccine uptake (Fig. 1C). We also report indirect effects for siblings and household members. This was likely the result of a reinforcing process where the intervention triggered engagement with the healthcare system and stronger beliefs in the efficacy of modern biomedical treatments, which led to the adoption of health risk reduction behavior, including vaccine uptake. Our findings suggest that health information interventions focused on survival perceptions can be useful in promoting health behavior and participation in the formal healthcare system, even during health crises--such as the COVID-19 pandemic--that are unanticipated at the time of the intervention. We also note the importance of the intervention design, where establishing rapport, tailoring the content to the local context, and spending time with respondents to convey the information contributed to the salience of the message. [ABSTRACT FROM AUTHOR]

Purpose: The Youth Risk Behavior Survey (YRBS) monitors behaviors, experiences, and conditions affecting the health of high school students nationwide. This study examined the test-retest reliability of the 2021 national YRBS questionnaire. Design: Respondents completed a Time 1 and Time 2 paper-and-pencil questionnaire approximately 2 weeks apart during February to May 2022. Data were linked in such a way as to preserve anonymity. Setting: Convenience sample of high schools. Subjects: High school students (N = 588). Measures: Health risk behaviors and experiences assessed on the 2021 national YRBS questionnaire. Analysis: Time 1 and Time 2 responses were compared for each questionnaire item using the McNemar's test. Then, Cohen's kappa coefficients tested the agreement between Time 1 and Time 2 responses overall, and by sex, grade, and Black, White, and Hispanic race and ethnicity. Results: Among the 74 items analyzed, 96% had at least moderate reliability, and 73% had substantial or almost perfect reliability. The mean Cohen's kappa was.68. McNemar's test findings showed Time 1 and Time 2 data significantly differed (P <.01) for 9 items (12%). Conclusion: Reliable health behavior measures are important in the development of youth-focused public health programs and policies. Findings suggest the national YRBS questionnaire is a reliable instrument. Such findings lend support to relying on adolescent self-reported data when monitoring health behaviors using the YRBS. [ABSTRACT FROM AUTHOR]

The population with depression had a considerable excess mortality risk. This increased mortality may be attributed to the biological consequences of depression or the substantial prevalence of health risk behaviors (HRBs). This study aimed to quantify the combined effects of four major HRBs - smoking, excessive alcohol use, physical inactivity, and an unhealthy diet - on excess mortality among depressed individuals. This study included 35,738 adults from the National Health and Nutrition Examination Survey 2005–06 to 2017–18, with mortality follow-up data censored through 2019. The standardized prevalence of HRBs was calculated for populations with and without depression. Poisson regression models were used to calculate the mortality rate ratio (MRR). Based on model adjusting for socio-demographic factors, the attenuation of MRR was determined after further adjustment for HRBs. A total of 3147 participants were identified as having depression. All HRBs showed a significantly higher prevalence among the population with depression. After adjusting for socio-demographic factors, depression was associated with 1.7 and 1.8 times higher all-cause and cardiovascular disease mortality rate, respectively. Further adjustment for all current HRBs resulted in a 21.9 % reduction in all-cause mortality rate and a 15.4 % decrease in cardiovascular disease mortality rate. HRBs were reported at a single time point, and we are unable to demonstrate a causal effect. At least 1/5 of excess mortality for population with depression was attributable to HRBs. Efforts should be made to address HRBs among population with depression. • Depression is related to excess mortality due to depression itself and health risk behaviors. • Depression was related to 1.7 and 1.8 times higher all-cause and CVD mortality. • Adjusting for HRBs led to a 21.9 % and 15.4 % drop in all-cause and CVD mortality. [ABSTRACT FROM AUTHOR]

Little is known about the implications of cannabis legalization on adolescent health behaviors. This study sought to examine the relationship between recreational cannabis legalization and adolescent sexual risk behaviors. Data on 371,487 respondents who have ever had sexual intercourse from 41 states in the 2005 to 2019 Youth Risk Behavior Survey was linked with data on state-level cannabis policies. Difference-in-differences logistic regression models were conducted. Recreational cannabis legalization was associated with a reduced likelihood of respondents having 2+ sexual partners (adjusted OR [aOR] 0.63, 95% CI [0.47, 0.84]), but had no association with condom use (aOR 0.94, 95% CI [0.80, 1.11]). Changing social norms around cannabis is a potential pathway linking cannabis legalization to a reduction in sexual risk behaviors. [ABSTRACT FROM AUTHOR]

The occurrence of multiple risk behaviors among adolescents imposes challenges in the context of public policies of health, particularly in low- and middle-income countries. Evidence on the conditions leading to the exposure to and adoption of multiple risk behaviors allows the identification of vulnerable groups of adolescents, and may support the proposition of targeted strategies directed to individuals at risk. Therefore, the aim of this study was to perform a quantitative analysis to identify recent trends in the exposure to and adoption of multiple health risk behaviors among Brazilian adolescents, highlighting individual-, household-, and school-level characteristics linked to inequalities among social groups. The analysis was based on cross-sectional data from the National Student Health Survey (PeNSE), conducted by the Brazilian Institute for Geography and Statistics in 2009, 2012, 2015, and 2019. The trends in the occurrence of multiple risk behaviors among adolescents were estimated according to social strata, allowing the calculation of concentration indexes and their disaggregation into major determinants of inequalities in the exposure and adoption of risk behaviors. The analyses were conducted using a complex survey design to allow representativeness at the population level. The results showed a rise in the incidence of multiple risk behaviors among youngsters in Brazil from 2009 to 2019. Factors influencing inequalities in the exposure to multiple risk behaviors were socioeconomic status and the characteristics of the household and school environments, whilst the adoption of multiple risk behaviors was also influenced by early exposure to multiple risk behaviors. Furthermore, trends in inequalities in the exposure to and adoption of multiple risk behaviors showed an intensification from 2009 to 2019, being initially concentrated among wealthier adolescents, followed by a transition to higher incidence in the lower socioeconomic strata in 2012 and 2015, respectively. The findings underscore the role of support systems for adolescents at risk within the familial and school contexts, whereas strategies of public policies of health based on the strengthening of community ties may require improvements to tackle socioeconomic inequalities in the occurrence of risk behaviors among youngsters. [ABSTRACT FROM AUTHOR]

College student athletes are at risk for mental health difficulties. Athletic identity – the degree of strength and exclusivity to which a person identifies with the athletic role – is associated with health risk behaviors and mental health concerns broadly among student athletes. Given a variety of barriers to college athletes disclosing mental health difficulties, measuring athletic identity may be an indirect way to screen athletes for being at-risk for mental health concerns. The current study examined the factor structure of an increasingly popular measure of athletic identity (the AIMS-Plus) across two samples of self-identified athletes (Nstudy1 = 201; 60.2% male; 61.19% White; 21.39% Hispanic; NStudy2 = 175; 45.29% male; 70.86% White; 20.57% Hispanic) to offer a peer-reviewed validation of the measure. Results suggest that the factor structure of the AIMS-Plus was not supported; however, both a modified version of the AIMS-Plus (the AIMS-Plus-R) and the 7-item AIMS may be acceptable. Continued work refining measures of athletic identity is needed. [ABSTRACT FROM AUTHOR]

We examined associations between adolescent self-reported hunger, health risk behaviors, and adverse experiences during the 2018–2019 school year. Youth Risk Behavior Survey data were pooled from 10 states. Prevalence ratios were calculated, and we assessed effect measure modification by sex. The prevalence of self-reported hunger was 13%. Self-reported hunger was associated with a higher prevalence of every health risk behavior/adverse experience analyzed, even after adjusting for sex, grade, and race/ethnicity. Sex did not modify associations. Findings underscore needs for longitudinal research with more robust measures of adolescent food insecurity to clarify the temporality of relationships. [ABSTRACT FROM AUTHOR]

Background: Avoidant/restrictive food intake disorder (ARFID), an eating disorder not associated with weight and shape concerns, results in nutrient or energy deficiencies related with further health consequences and a pronounced need for specialized treatment. These interventions need to be tailored to individual health behavior. However, research about health behavior and treatment utilization in ARFID is scarce, particularly in adults, as ARFID is more common in children despite occurring across the lifespan. One important aspect of health behavior is the individual's health regulatory focus (i.e., health prevention and health promotion). Additionally, symptoms of eating disorders have generally been associated with various health risk behaviors, such as smoking, drinking, or unhealthy physical (in)activity. Therefore, the present study aimed to investigate health behavior and psychological treatment utilization in adults with symptoms of ARFID. Methods: A representative adult population sample (N = 2415) completed several self-report questionnaires assessing symptoms of eating disorders and health behavior. Differences between groups (symptoms of ARFID vs. no symptoms of ARFID) were tested with analysis of variance, Mann-Whitney-U-tests, and binary logistic regression. Results: Individuals with symptoms of ARFID (n = 20) did not differ in their health regulatory focus, smoking status, physical activity or psychological treatment utilization from individuals without symptoms of ARFID (n = 2395). However, they reported higher alcohol misuse than individuals without symptoms of ARFID. Conclusion: The findings suggest a relevance of further exploration of the relationship between alcohol misuse and ARFID, given the preliminary nature of these results. This exploration could inform treatment strategies for addressing potential comorbid substance misuse. Furthermore, the low psychological treatment utilization in adults with symptoms of ARFID suggest a need for more specialized psychological treatment services, public education about ARFID being an indication for psychological treatment, and further research about treatment barriers. Plain English Summary: Avoidant/restrictive food intake disorder (ARFID), an eating disorder not associated with body image or weight concerns, results in nutrient or energy deficiencies related with further health consequences. It is most common in children, but can occur across the lifespan, although there is little research in adults. Therefore, the study investigated if adults with symptoms of ARFID differ from adults without symptoms of ARFID in health behaviors. A total of 2415 adults from a German national population sample completed questionnaires assessing symptoms of ARFID, health regulatory focus (health promotion focus with the aim of improving one's health and health prevention focus aiming to avoid any deterioration in health), alcohol misuse, smoking behavior, physical activity and psychological treatment utilization. Adults with symptoms of ARFID did not differ from those without symptoms of ARFID in treatment utilization or any of the assessed health behaviors except reporting higher alcohol misuse. We, therefore, suggest to further explore potential alcohol misuse in individuals with ARFID. Furthermore, more research about treatment barriers in ARFID and more specialized psychological treatment services as well as public education about ARFID being an indication for psychological treatment, are needed to address the low psychological treatment utilization. [ABSTRACT FROM AUTHOR]

Background: Healthy behaviors are paramount in preventing long‐term adverse health outcomes in childhood, adolescent, and young adult (CAYA) cancer survivors. We systematically reviewed and synthesized existing literature on barriers, facilitators, and other factors associated with health behaviors in this population. Methods: MEDLINE and PsycInfo were searched for qualitative and quantitative studies including survivors aged 16–50 years at study, a cancer diagnosis ≤25 years and ≥2 years post diagnosis. Health behaviors included physical activity, smoking, diet, alcohol consumption, sun exposure, and a combination of these behaviors (defined as health behaviors in general). Results: Barriers, facilitators, and other factors reported in ≥2 two studies were considered relevant. Out of 4529 studies, 27 were included (n = 31,905 participants). Physical activity was the most frequently examined behavior (n = 12 studies), followed by smoking (n = 7), diet (n = 7), alcohol (n = 4), sun exposure (n = 4), and health behavior in general (n = 4). Relevant barriers to physical activity were fatigue, lack of motivation, time constraints, and current smoking. Relevant facilitators were perceived health benefits and motivation. Influence of the social environment and poor mental health were associated with more smoking, while increased energy was associated with less smoking. No relevant barriers and facilitators were identified for diet, alcohol consumption, and sun exposure. Barriers to healthy behavior in general were unmet information needs and time constraints whereas lifestyle advice, information, and discussions with a healthcare professional facilitated healthy behavior in general. Concerning other factors, women were more likely to be physically inactive, but less likely to drink alcohol and more likely to comply with sun protection recommendations than men. Higher education was associated with more physical activity, and lower education with more smoking. Conclusion: This knowledge can be used as a starting point to develop health behavior interventions, inform lifestyle coaches, and increase awareness among healthcare providers regarding which survivors are most at risk of unhealthy behaviors. [ABSTRACT FROM AUTHOR]

Tobacco and alcohol have been identified as health risk behaviors associated with significant unfavorable health consequences, ranking within the list of the top ten causes of mortality and disability-adjusted life years (DALY). The combustion of tobacco leads to the formation of acrylamide (ACR), which is well known for its neurotoxic effects. Similarly, alcohol consumption has also been widely recognized for its neurotoxic effects. Both substances can affect neurons and neuroglia cells through various pathways. This study sought to examine the impacts of co-administration of ACR and intermittent-access ethanol (IAE) consumption over a period of one month. The experimental group received 20 mg/kg of ACR, administered orally, along with IAE of 20% ethanol sessions lasting 24 h, three times per week. The cognitive outcomes were assessed utilizing the elevated plus maze (EPM), which was employed as a means of assessing the capability to learn and remember, the novel object recognition (NOR) test, which was employed to assess recognition memory, and the Y-maze, which was used to explore a new environment and navigate. Additionally, ELISA assays were performed to examine underlying mechanisms, including markers associated with inflammation (NF-κB, PGE2, and TNF-α), apoptosis (Bcl2, Bax, and Caspase-3), and oxidative stress (MDA, catalase, and GSH). These markers were assessed in the brain homogenate as part of the investigation. Furthermore, a histopathological study was conducted. The findings indicated that NF-κB levels increased significantly in the combination of ACR and IAE groups (ACR + IAE) compared to either the ACR-alone or IAE-alone groups. However, parallel changes were observed in TNF-α, PGE2, Bax, Bcl-2, Caspase-3, GSH, and CAT levels when comparing the ACR + IAE group to the ACR-alone group. Comparable alterations were noted between the ACR + IAE treatment and IAE-alone groups in TNF-α, Bcl-2, MDA, GSH, and CAT levels. Moreover, the histopathological analysis revealed significant changes between the ACR + IAE and the ACR- or IAE-alone groups. Regarding memory parameters assessed using tests including EPM, NOR, and Y-maze, considerable changes were observed across all treatment groups as opposed to the control. Surprisingly, there were no notable differences in the NOR and Y-maze tasks between the alone and combination treatment. Further study is necessary to explore the long-term alteration of co-administering ACR and IAE on behavior, memory, and neurotoxicity-related mechanisms, in order to elucidate their combined effects more clearly. [ABSTRACT FROM AUTHOR]

This study examined how health behavior patterns are associated with anxiety and suicidal behaviors among Korean adolescents. Data were collected from a national cross-sectional sample of adolescents (n = 54,948, 51.5 % boys) in the 2020 Korea Youth Risk Behavior Web-based Survey. Latent class analysis was conducted based on 12 health behaviors (e.g., eating habits, physical activity, and substance use) using the R-based Jamovi 2.3.21 program. Four classes of health behaviors were identified: Class 1 (boys: 45.4 %, girls: 34.4 %) engaged in healthy behaviors; Class 2 (boys: 31.7 %; girls: 22.3 %) had unhealthy eating habits; Class 3 (boys: 18.0 %; girls: 39.9 %) had the lowest physical activity; and Class 4 (boys: 5.0 %, girls: 3.4 %) engaged in substance use, including smoking, drinking, and problematic smartphone use. Overall, girls had a higher odds ratio (OR) for anxiety and suicidal behaviors than boys did. Among girls, Class 4 had a higher OR for anxiety (OR = 2.78, 95 % confidence interval [CI] = 2.40–3.21), suicidal ideation (OR = 3.99, 95 % CI = 3.46–4.62), suicide plan (OR = 3.32, 95 % CI = 2.66–4.16), and suicide attempts (OR = 5.62, 95 % CI = 4.43–7.12) than Class 1. This study has a few limitations including the participants' response bias, the use of a self-report survey, and the lack of diagnosis by clinicians. Adolescents engaging in substance abuse (Class 4) were more prone to anxiety symptoms and suicidal behaviors (ideation, plan, and attempts) than those engaged in healthy behaviors (Class 1). We suggest that more attention is needed to develop suicide prevention strategies that consider adolescent substance use patterns such as current smoking, drinking, and problematic smartphone use. • Four classes of health behaviors among Korean adolescents were identified according to LCA. • Compared to Class 1 (engagement in healthy behaviors), both boys and girls in Class 4 (substance use) were 1.77 and 2.78 times more likely to have anxiety symptoms. • Class 4 had a higher OR for suicidal ideation, suicide plan, and suicide attempts than Class 1. [ABSTRACT FROM AUTHOR]

Background: An association between increased risk of dental caries with increased levels of clinically severe obesity has been reported. Data linking body mass index (BMI) and dietary behaviors, including at‐risk dietary factors and oral hygiene habits, are lacking in a cohort with clinically severe obesity. This study aimed to explore the dietary and oral hygiene behaviors in individuals with clinically severe obesity attending a hospital‐based obesity service. Methods: Adult patients attending a hospital‐based obesity service in Greater Western Sydney with clinically severe obesity were invited to participate in a self‐administered survey, which collected data on their nutritional and oral hygiene behaviors. Demographic data (age, gender) and BMI were extracted from the participants' medical records. The primary outcome was the relationship between BMI and frequency of toothbrushing. Results: Of the 82 individuals who consented to participate, 81 (98.8%) completed the study questionnaire. The median BMI of the cohort was 49.1 kg/m2 (interquartile range [IQR]: 43.2–57.3 kg/m2) and median age 51 (IQR: 39–63) years. BMI was not significantly correlated with individual oral health behaviors (p >.05). Many participants reported dietary risk behaviors, which have the potential to influence their oral health. Conclusions: While oral health behaviors were not associated with increasing BMI, patients with clinically severe obesity in this study reported unique dietary behaviors and mixed oral hygiene habits that may complicate nutritional and dental management. Awareness of these behaviors among clinicians including dental professionals is required in this cohort. [ABSTRACT FROM AUTHOR]

Unhealthy behaviors such as poor diet and tobacco use contribute to disease burden and escalating healthcare costs. This paper evaluates potential savings from people adopting reduced risk behaviors in Mexico. Using the Preventable Risk Integrated Model, we compare actual consumption in 2016 (baseline) to optimal intake following WHO guidelines (counterfactual) for salt, fiber, fruit/vegetables, and fat to estimate reductions in coronary, cerebrovascular, cancer, diabetes and hypertensive diseases. We also model 50% of smokers switching to e-cigarettes/heated tobacco with 65–97% lower disease risk. Results indicate over 650,000 preventable cases annually, mostly from diet changes (fruits/vegetables, fat, salt). Healthcare cost savings reach $3.4 billion USD; $2.8 billion from nutrition and $0.3 billion from smoking substitution. Fruit/vegetable intake and reduced fat confer over $1 billion savings each. Salt and fiber also contribute significantly. Adding smoking transitions provides further savings. Shifting Mexicans towards healthier diets and alternative nicotine products could substantially lower disease burden and healthcare costs. These findings underscore the economic imperative of promoting reduced-risk behaviors through public health policies. [ABSTRACT FROM AUTHOR]

Depression, anxiety and other psychosocial factors are hypothesized to be involved in cancer development. We examined whether psychosocial factors interact with or modify the effects of health behaviors, such as smoking and alcohol use, in relation to cancer incidence. Two‐stage individual participant data meta‐analyses were performed based on 22 cohorts of the PSYchosocial factors and CAncer (PSY‐CA) study. We examined nine psychosocial factors (depression diagnosis, depression symptoms, anxiety diagnosis, anxiety symptoms, perceived social support, loss events, general distress, neuroticism, relationship status), seven health behaviors/behavior‐related factors (smoking, alcohol use, physical activity, body mass index, sedentary behavior, sleep quality, sleep duration) and seven cancer outcomes (overall cancer, smoking‐related, alcohol‐related, breast, lung, prostate, colorectal). Effects of the psychosocial factor, health behavior and their product term on cancer incidence were estimated using Cox regression. We pooled cohort‐specific estimates using multivariate random‐effects meta‐analyses. Additive and multiplicative interaction/effect modification was examined. This study involved 437,827 participants, 36,961 incident cancer diagnoses, and 4,749,481 person years of follow‐up. Out of 744 combinations of psychosocial factors, health behaviors, and cancer outcomes, we found no evidence of interaction. Effect modification was found for some combinations, but there were no clear patterns for any particular factors or outcomes involved. In this first large study to systematically examine potential interaction and effect modification, we found no evidence for psychosocial factors to interact with or modify health behaviors in relation to cancer incidence. The behavioral risk profile for cancer incidence is similar in people with and without psychosocial stress. [ABSTRACT FROM AUTHOR]

Background: Earth's climate changes are progressing at an alarming rate. One of the most severe effects of climate change is extreme heat. This study aimed to assess knowledge and adaptation behavior to heat-related illness (HRI) among solid waste disposal workers in the 10th of Ramadan City, Egypt, and to study the predictors for their knowledge and adaptation behavior. Methods: An exploratory cross-sectional study was conducted on 220 solid waste disposal workers. A structured interview questionnaire was used to assess the studied workers' sociodemographic and occupational characteristics, heat exposure risk, and their knowledge, and adaptation behavior. Results: The results showed that 40% and 30% of participants had adequate levels of total knowledge and adaptation behavior, respectively. There was a statistically significant relationship between workers' knowledge and both age and education. There was a statistically significant relationship between workers' adaptation behavior and age, duration of employment, working hours, and education. A binary logistic regression for significant predictors of knowledge and adaptation behavior showed that age and education were the most significant predictors. Conclusion: Solid waste disposal workers were at high risk of HRI due to their low levels of knowledge and adaptation behavior regarding HRI. Educational health programs that guide workers to follow healthy behaviors and prevent HRI are recommended. [ABSTRACT FROM AUTHOR]

This study examines adolescent game usage and corresponding health-related risk behaviors during a period of limited social interaction and activity due to the COVID-19 pandemic. Participants included 225 middle- and 225 high-school students in Seoul who completed a survey online from October 1 to 30, 2021. The study measured participants' game usage level and the health-related risk behavior index. Findings showed that participants who engaged in excessive gaming showed higher levels of health-related risk behaviors. A multivariate analysis of variance was conducted to compare the health-related risk behaviors of students in the general, potential, and high-risk groups on excessive gaming. Results indicated that female students in the high-risk group showed higher stress levels and fatigue (f = 5.549, p <.01, Cohen's d = 0.016) than the males of the same group. However, male students showed higher physical inactivity levels (f = 3.195, p >.05, Cohen's d = 0.009) than females. The post hoc test indicated clear sex distinctions among the general, potential, and high-risk groups on excessive gaming (p <.001). Among the high-risk game usage group, female students displayed a higher level of risk behaviors than males. Adolescent gaming addiction should be considered an emotional and behavioral disorder for which parental guidance and support are needed, and counseling experts and professionals must come together to provide a cure and reform program. [ABSTRACT FROM AUTHOR]

Bullying, traditional or cyber, among adolescents, is a public health concern. In this study, we explored frequencies and correlates of different forms of bullying among Connecticut high-school students. Youth Risk Behavior Survey data from 2019 from Connecticut adolescents (N = 1814) were used. χ2 tests and survey-weighted logistic regressions examined relationships between bullying subgroups (in-school traditional bullying (ISTB) only, cyberbullying only, and both) and mental concerns, risk behaviors, academic performance, physical health, and receipt of social support, with the logistic regressions adjusted for demographics. The past-12-month frequency of having experienced only cyberbullying was 5.6%, only ISTB was 9.1%, and both forms was 8.7%. Between-group differences were observed by bullying status in terms of sex and race/ethnicity. In adjusted models, bullying status was associated with suicide attempts, suicidal ideation, self-harm, depression/dysphoria, mental health, use of alcohol, marijuana, injection drugs, tobacco, and e-vapor, gambling, driving under influence of alcohol, high-risk sexual behavior, physical fights, weapon-carrying, injuries/threats at school, feeling unsafe at school, dating violence, obesity, poor general health, insecure housing, less perceived family support, and poor academic performance. People experiencing both types of bullying were typically more likely to report adverse measures. High-school students commonly report bullying. The findings that both forms (traditional and cyber) were more robustly linked to negative experiences highlight the need for examining further relationships between types and patterns of bullying and mental health and functioning. Better understanding may help improve preventive anti-bullying interventions. • Bullying (cyber, in school traditional, and both) was associated with poor health. • Rates of in-school traditional bullying-only were highest, followed by both forms. • Experiencing both forms of bullying was associated with more severe correlates. • The patterns of correlates differed among those with both or either form of bullying. [ABSTRACT FROM AUTHOR]

The goal of this project was to substantiate a more positive conceptualization of adolescent risk behavior and to compare adolescent viewpoints of risk behavior to the items on the Prosocial and Health Adolescent Risk Behavior Scale (PHARBS). A total of 57 high school students participated in the research. Researchers recruited students from an Advanced Placement (AP) Psychology course at a large Midwestern high school. The high school serves approximately 1,750 students in grades 9 through 12. The university Institutional Review Board approved the study procedures. Families provided informed consent, and students assented to participating in one of eight focus group discussions. The focus groups were audio taped, transcribed, and coded. Researchers analyzed the coded data using word count analysis. Students discussed prosocial risk behaviors in addition to health risk behaviors, providing support for the PHARBS and suggesting that adolescents view taking some risks as positive. A more positive conceptualization of risk behavior may better align with how adolescents view risk behavior. Researchers and clinicians might approach adolescent risk behavior measurement and research on the importance of understanding risk behaviors as a normal and potentially positive aspect of adolescent development. [ABSTRACT FROM AUTHOR]

The purpose of the study was to determine how Adverse Childhood Experiences (ACE) relate to adulthood flourishing, symptoms of depression, anxiety, somatization, self-reported health, sexual risk behaviors, and alcohol consumption. A quantitative cross-sectional methodology was used. A total of 452 adults completed the survey. The most prevalent ACE include physical abuse (44.69%), separation/divorce of parents (41.81%), living with someone with alcohol problems (39.38%), and being sworn, insulted, or humiliated by adults at home (35.62%). Almost one out of every four respondents (24.34%) reported being touched by an adult, 17.92% reported that an adult tried to manipulate the respondent into touching them, and 8.19% were forced to have sexual intercourse. Results indicate that women reported a higher number of ACE than men. The number of ACE is inversely related to flourishing and self-reported health; while being positively associated with participant's scores in depression, anxiety, somatization, sexual risk behaviors, and alcohol use. The regression model, including the eleven ACE and respondents' sex and age, achieved medium effect sizes for somatization, depression, and anxiety symptoms and small effect sizes for flourishing, self-reported health, sexual risk behaviors, and alcohol consumption. Specific ACE have a particularly significant negative impact on mental health outcomes: forced intercourse, witnessing familial violence, verbal humiliation, and living with individuals struggling with mental health issues and drug consumption or who were incarcerated. In conclusion, the study highlights the alarming prevalence of ACE among the Honduran population and their significant negative impact on mental health outcomes during adulthood. [ABSTRACT FROM AUTHOR]

Clinicians and scholars routinely use behavioral decision tasks to assess real-world decision making capabilities. However, many common behavioral decision making tasks lack data on the extent to which they predict real-world risky behaviors. Across two pre-registered studies, and two timepoints, we assessed decision making abilities using common behavioral tasks and predicted participants' real-world risky decision making from task performance. In Study 1, 918 Mechanical Turk (MTurk) workers completed three decision making tasks in addition to assessments of real-world risk behavior: preventive health behaviors, COVID-19 vaccination status, and virtual social distancing task performance. In Study 2, 221 college student participants completed the Study 1 tasks plus additional assessments of decision making and real world risk and protective behaviors. Across both studies, the selected behavioral decision tasks rarely predicted real world behavior and, when they did, the relationship was weak at best. These data suggest that these behavioral decision making tasks may not be good predictors of real world risky behavior at present, with some evidence that the specificity of the behavior being assessed matters (i.e. the closer the task was to the specific behavior being predicted), calling for additional ecological validity research, with a greater variety of tasks in the future. [ABSTRACT FROM AUTHOR]