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Objectives: To examine the association between depressed mood and clusters of health risk behaviors. Methods: A nationally representative sample of adolescents (N=15,214) was utilized to construct 10 pseudocontinuous health risk behaviors. Cluster analysis was performed to group adolescents, and subsequent multivariable logistic models were created. Results: Compared to non-risk takers, belonging to risk clusters significantly increased the odds of reporting depressed mood. African Americans in high-risk clusters appeared to be more vulnerable to depressed mood, when compared to remaining racial groups. Conclusions: Results suggest that adolescents engaging in multiple health-risk behaviors do so in the context of depressed mood.

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Abstract available in the Annals of Behavioral Medicine.

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Research has identified a number of putative risk factors that places adolescents at incrementally higher risk for involvement in alcohol and other drug (AOD) use and sexual risk behaviors (SRBs). Such factors include personality characteristics such as sensation-seeking, cognitive factors such as positive expectancies and inhibition conflict as well as peer norm processes. The current study was guided by a conceptual perspective that support the notion that an integrative framework that includes multi-level factors has significant explanatory value for understanding processes associated with the co-occurrence of AOD use and sexual risk behavior outcomes. This study evaluated simultaneously the mediating role of AOD-sex related expectancies and inhibition conflict on antecedents of AOD use and SRBs including sexual sensation-seeking and peer norms for condom use. The sample was drawn from the Enhancing My Personal Options While Evaluating Risk (EMPOWER: Jonathan Tubman, PI), data set (N = 396; aged 12-18 years). Measures used in the study included Sexual Sensation-Seeking Scale, Inhibition Conflict for Condom Use, Risky Sex Scale. All relevant measures had well-documented psychometric properties. A global assessment of alcohol, drug use and sexual risk behaviors was used. Results demonstrated that AOD-sex related expectancies mediated the influence of sexual sensation-seeking on the co-occurrence of alcohol and other drug use and sexual risk behaviors. The evaluation of the integrative model also revealed that sexual sensation-seeking was positively associated with peer norms for condom use. Also, peer norms predicted inhibition conflict among this sample of multi-problem youth. This dissertation research identified mechanisms of risk and protection associated with the co-occurrence of AOD use and SRBs among a multi-problem sample of adolescents receiving treatment for alcohol or drug use and related problems. This study is informative for adolescent-serving programs that address those individual and contextual characteristics that enhance treatment efficacy and effectiveness among adolescents receiving substance use and related problems services.

Background: Men who have sex with men (MSM) are heterogeneous with respect to sexual behavior. We examined differences in sexual risk behaviors and HIV protective behaviors between men who have sex with men and women (MSMW) and men who have sex with men only (MSMO). Among MSMW, we also examined associations between partner gender and disclosure of same-sex attraction to sexual risk behaviors. Methods: Data for this analysis were from MSM who participated in National HIV Behavioral Surveillance (NHBS) in 2011 and 2014. Prevalence differences comparing MSMW and MSMO were calculated for demographics and behaviors. Adjusted prevalence ratios comparing MSMW to MSMO were calculated for the outcomes condomless sex, exchange sex, testing for HIV, and disclosure of same-sex behavior. Results: MSMW were less likely than MSMO to have condomless sex with male partners (aPR 0.77; 95%CI 0.73-0.80), to have been diagnosed with another STD (aPR 0.83; 95%CI 0.73-0.95), and to disclose their same-sex behavior to healthcare providers (aPR 0.72; 95%CI 0.69-0.76). However, MSMW were more likely than MSMO to engage in exchange sex (aPR 2.43; 95%CI 2.17-2.72) and to have ever injected drugs (aPR 2.00; 95%CI 1.76-2.28) Conclusions: MSMW have distinctive sexual risk behaviors and could benefit from tailored interventions to reduce the prevalence of HIV in this population.

Orientador: Sandra Regina Gimeniz Paschoal / Banca: Silvia Regina Ricco Lucato Sigolo / Banca: Maria de Lourdes Morales Horiguela / Banca: Maria Regina Cavalcante / Banca: Maria Aparecida Miranda de Paula Machado / Resumo: Este trabalho identifica a emissão de comportamentos de risco para acidentes infantis durante interações de crianças em playgrounds escolares e as características de risco dos brinquedos recreativos, bem como analisa as opiniões dos profissionais da educação infantil em relação a tais interações e aos possíveis acidentes que possam delas decorrer, em especial dos professores, mediante intervenção com cenas das interações. São participantes 52 escolares do Pré-I e Pré-II, 33 profissionais e 31 docentes de duas escolas municipais de educação infantil de uma cidade do interior do Estado de São Paulo. Utiliza filmagem, roteiros de investigação (questionários) pré-testados e cenas selecionadas das filmagens para intervenção breve com professores. Como resultados, identifica, por meio das filmagens, a emissão de diversos comportamentos de risco nos playgrounds, como o "uso inadequado dos brinquedos", "imitação" (de brincadeiras perigosas), "competição por um brinquedo" e "desafio/competição entre si", bem como diversas características de risco nos brinquedos, como permanência de brinquedo no sol acumulando energia solar e ausência de barreiras físicas ao redor dos equipamentos. As opiniões dos profissionais, obtidas por meio dos questionários, apontam: quedas e choques com brinquedos e/ou com outras crianças como os acidentes mais freqüentes, motivados pela falta de atenção/cuidado da criança; o trepa-trepa como brinquedo de maior risco, bem como as situações interativas entre crianças e brinquedos, sobretudo no balanço, e das crianças entre si, durante o correr; as orientações às crianças sobre o uso correto dos brinquedos como medidas preventivas já adotadas e que poderiam ser realizadas e as conversas informais/regras como os trabalhos sobre prevenção de acidentes já realizados com as crianças...(Resumo completo, clicar acesso eletrônico abaixo) / Abstract: This work identifies the emission of risk behaviors for children injury during children interaction in school playgrounds and the risk characteristics of toy, as such analyses the preschoolar professionals'opinions (specially teachers'one) in relation to those interactions and to the possible accidents that can occur intervention, by intervention with interaction scenes. 52 preschoolar students, 33 professionals and 31 teachers of two city infant schools of a city of São Paulo state. It uses movie takes, pré-tested questionnaires, and selected taken scenes, for brief intervention with teachers.As results, it identifies, by movie takes, the emission of risk behaviors at playgrounds, like "inapropriated use of toys", "imitation (of dangerous behaviors)", "competition for a toy", and challenges (self-competition), such as several risk characteristics of toys, like toys standying at sun getting Sun energy and lack of physical barriers around the toys. The professionals' opinions, got by questionnaires, shows: falls and schocks with toys and/or other children are the most frequent accidents, cause lack of attention by children; the trepa-trepa as the most dangerous toy, as well interactive situations between children and toys, mainly at slalow, and among children, during running; the orientation to children about the correct use of toys, as already taken measure, and that could be done, and chats and rules as already adopted works of injury prevention. At intervention, teachers saw risk behavior for injury prevention scenes and justify as variables to the occurance of these behaviors to the lack of perception of risk/danger, and that children want to explore the possibilities that toys get. They point as consequences injuries and traumas and point as injury prevention and promotion of safety the teachers' attitudes, such as orientation and diary chats ...(Complete abstract, click electronic access below) / Doutor