Cette thèse a pour objectif de contribuer à la compréhension de rôle des valeurs, des attitudes et des stratégies de coping dans le comportement lié à la santé et les symptômes de l'anxiété et de la dépression des adolescents russes et français atteints d'asthme. L'analyse de médiation a étudié les associations entre les valeurs (la valeur de santé, la valeur de la vie excitante) et le comportement (le comportement préventif et le comportement à risque) à travers les facteurs médiateurs : les attitudes affectives (explicites et implicites), cognitives (explicites) chez les adolescents atteints d'asthme et en bonne santé (N = 200). L'analyse de médiation a aussi étudié les associations entre les valeurs et les symptômes de l'anxiété et de la dépression à travers les stratégies de coping. L'étude qualitative, basée sur une méthodologie de recherche anthropologique, a exploré la phénoménologie de l'asthme et de la santé chez les adolescents russes et français (N = 20). Les valeurs sont associées avec le comportement lié à la santé à travers les attitudes affectives et cognitives. En valorisant la santé ou la vie excitante, les adolescents utilisent des stratégies de coping spécifique à l'asthme qui influent sur les symptômes de l'anxiété et de la dépression. En incluant les valeurs dans les programmes éducatifs il est possible de favoriser le comportement préventif et améliorer la qualité de vie chez les adolescents atteints d'asthme. / This thesis aims to help better understand the role of values, attitudes and coping strategies in health behaviors alongside with anxiety/depression symptoms among Russian and French adolescents with asthma. Mediation analysis was employed to study the associations between values (health value, value of exciting life) and health behaviors (preventive and risk behaviors) through affective (explicit and implicit) and cognitive (explicit) attitudes among adolescents suffering from asthma and healthy adolescents (N = 200). Mediation analysis has also been used to reveal the associations between values and anxiety/depression symptoms through coping strategies. Qualitative study based on anthropological research methodology were applied to study the phenomenology of asthma and health among Russian and French adolescents (N = 20). The study confirmed that values are associated with health behaviors through affective and cognitive attitudes. In valuing health or exciting life, adolescents use coping strategies specific to asthma which influence the symptoms of anxiety and depression. Inclusion of the above values in educational programs makes it possible to promote healthy behaviors and ameliorate the quality of life among adolescents with asthma.

An inverse relationship exists between self-reported religiousness and substance use. However, we question whether religious culture impacts the veracity of self-reported substance use. The primary aim of this study of low-income pregnant women in South Central Appalachia was to determine the accuracy of self-reported substance use in pregnant women as well as to determine whether there were differences in use rates and/or differences in the degree to which women would accurately report substance use depending on their religiousness. Self-reported use and toxicology screening results taken from a larger prospective, longitudinal, smoking cessation study were compared for five substances (cannabinoids [marijuana or other cannabinoids], benz/barb/sed [including benzodiazepines, barbiturates, or any sedative], opioids [including heroin, methadone or other medication-assisted treatment medications, or other opiates], crack/cocaine [crack or cocaine], and meth/amph [including methamphetamine or any other amphetamine]). Women who attend church frequently reported lower rates of substance use than infrequent or nonattenders, as did women who rated themselves as high in intrinsic religiosity (IR), although the difference between high and low groups is less extreme for IR as opposed to attendance. Women who attended church frequently were far less likely to report use or to have use confirmed than any of the other groups including those high in IR. Rates of positive toxicology screens did not differ statistically across religiousness groupings, but the pattern of proportionally fewer positive toxicology results was seen in frequent attenders but not in women self-reporting as high IR. Women’s tendency to underreport substance use was unrelated to religiousness variables, indicating underreporting is not necessarily driving this difference in reported substance use.

Adolescence is a time of great exploration and change. During this time, youth are transitioning both biologically and sexually into adults. Adolescents are also testing the boundaries of self-reliance and making choices about their personal relationships. Not surprisingly, aggressive urges are often driven by peers in pursuit of some form of identity (Masten 2004). Peers can have both positive and negative effects on the wellbeing on youth. Peer groups can provide emotional, physical, and social support to youth during a time of immense change (Parker and Asher 1987; Gest, Graham-Berman, and Hartup 2001). Peers can also model delinquent and risk-taking behaviors that have lasting health, social, and economic consequences throughout the life course. In an effort to understand the role of friendships in adolescent health, social scientists have increasingly focused on adolescent network structures within schools and the role various positions and peer group formations influence behaviors such as alcohol and cigarette use, violent and serious delinquency, and sexual risk-taking. While informative, peer networks studies have yet to adequately address how peer network structures based on immigrant generation and types of marginalized social positions influence health risk behavior engagement among adolescents. In three studies, I address the dearth of research in these areas, using data from the National Longitudinal Study of Adolescent to Adult Health (Add Health). The first study investigates the influence of generational peers on alcohol misuse among immigrant youth. Testing hypotheses derived from sociological theories of generations regarding race/ethnicity, gender, and immigrant generation, findings from this study demonstrate generational ties are inversely related to alcohol misuse for immigrants and these effects depend partly on race/ethnicity and gender. The second study investigates the effects of specific network forms of social isolation on heavy episodic drinking and cigarette use among adolescents. The central finding from this study is that different network-based forms of social isolation had varying effects on alcohol and cigarette use when compared to sociable youth. The final study examines the relationship between types of social isolation and violent delinquency when compared to sociable youth. Deriving hypotheses from general strain theory, I test whether the isolation-violence relationship varies across isolation types when compared to sociable youth. I also test whether other negative experiences and circumstances (strains) tied to adolescence moderate the relationship between isolation types and violent delinquency. Finally, studies indicate a consistent gender gap in criminality. Therefore, I test whether the isolation-violence relationship differs by gender. Findings demonstrate that socially disinterested youth show a greater capacity for violent behavior, but other types of marginalized youth showed no difference in violence when compared to sociable youth. Results also suggest that some types of strain moderate the isolation-violence relationship and that these patterns are gendered.

Introduction: The Insufficient Physical Activity Level (IPAL) resulting from Leisure Time, School Physical Education classes and Displacement mode is a harmful factor for adolescents' health and may be associated with economic, social, demographic and behavioral indicators. Objective: To analyze the prevalence and association of the Insufficient Level of Physical Activity in the domains of Leisure, School and Displacement in relation to demographic, socioeconomic factors and risk behaviors in students in the state of Sergipe, Brazil, 2011-2016. Methods: The study was carried out in two epidemiological surveys with a cross-sectional design, carried out in 2011 and 2016, with a representative sample of students from the Sergipe State Teaching Network, composed of 8143 adolescents (2011 = 3992, 2016 = 4151), aged between 14 and 19 years. The instrument used was the Global School-based Student Health Survey (GSHS). The development originated two studies, each with three dependent variables related to IPAL domains, the first being associated with sociodemographic characteristics, and the second with health risk behaviors. The data were analyzed in the form of descriptive statistics, the application of the Chi-square test for inferential analysis and the Gross and Adjusted Logistic Binary Logistic Regression for association among the variables. Results: There was a high prevalence of IPALs among adolescents. In study 1, IPAL in Lazer was associated with female students and the 3rd year of high school in both surveys, and with day shift and white skin color only in the year 2016. With IPAL Escolar, were associated with female, night shift and urban residents in both years of research; with white skin color in 2011 and those with the highest socioeconomic level in 2016. The IPAL of Displacement was significant for the night shift, residents of the rural area, with mothers of higher educational level and who had a family income above 2 minimum wages in the year 2011; in 2016 the same odds were maintained except for the family income. In study 2, IPAL in Lazer was associated with exposure to sedentary behavior in both surveys, not smoking tobacco in 2011, and with non-users of drugs and consuming low portions of fruit in the year 2016. The IPAL School was associated with low fruit consumption and IPAL in Displacement with non-use of tobacco. Conclusion: It was evidenced a high prevalence of IPAL among the surveys and the Physical Activity domains are associated differently with sociodemographic and behavioral aspects, depending on the characteristics, the IPAL of Displacement being the only domain influenced by economic aspects. / Introdução: O Nível Insuficiente de Atividade Física (NIAF) resultante do tempo de Lazer, das aulas de Educação Física Escolar e do modo de Deslocamento constitui fator prejudicial à saúde dos adolescentes e pode estar associado a indicadores econômicos, sociais, demográficos e comportamentais. Objetivo: Analisar a prevalência e a associação do Nível Insuficiente de Atividade Física nos domínios do Lazer, da Escola e do Deslocamento em relação à fatores demográficos, socioeconômicos e de comportamentos de risco em escolares do estado de Sergipe, Brasil, 2011 e 2016. Método: O estudo trata-se de dois levantamentos epidemiológicos com delineamento transversal, realizados em 2011 e 2016, com amostra representativa de escolares da Rede Estadual de Ensino de Sergipe, composta por 8143 adolescentes (2011=3992; 2016=4151), com idade entre 14 e 19 anos. O instrumento utilizado foi o Global School-based Student Health Survey (GSHS). O desenvolvimento originou dois manuscritos, cada qual com três variáveis dependentes relativas aos domínios de NIAF, sendo o primeiro associado com características socioeconômicas, e o segundo com comportamentos de risco à saúde. Os dados foram analisados na forma de estatística descritiva, aplicação do teste do Qui-quadrado para análise inferencial e a Regressão Logística Binária Bruta e Ajustada para associação entre as variáveis. Resultados: Houve elevada prevalência dos NIAFs entre os adolescentes. No estudo 1, o NIAF no Lazer foi associado com os estudantes do sexo feminino e do 3º Ano do Ensino Médio nos dois inquéritos, e com o turno diurno e a cor da pele branca apenas no ano de 2016. Com o NIAF Escolar verificou-se associação com o sexo feminino, do turno noturno e residentes da zona urbana em ambos os anos de pesquisa; com a cor de pele branca em 2011 e os de maior nível socioeconômico em 2016. O NIAF de Deslocamento foi significativo para o turno noturno, residentes da zona rural, com mães de nível superior de escolaridade e que possuíam renda familiar acima de 2 salários mínimos no ano de 2011; em 2016 manteve-se as mesmas chances com exceção da renda da família. No estudo 2, o NIAF no Lazer apresentou associação com a exposição ao comportamento sedentário nos dois inquéritos, com o fato de não fumar tabaco em 2011, e com os não usuários de drogas e que consumiam baixas porções de frutas no ano de 2016. O NIAF Escolar foi associado com o baixo consumo de frutas e o NIAF no Deslocamento com o não uso do tabaco. Conclusão: Foi evidenciado elevadas prevalências de NIAF entre os inquéritos e os domínios de Atividade Física se associam diferentemente com aspectos sociodemográficos e comportamentais, a depender das características, sendo o NIAF de Deslocamento o único domínio influenciado por aspectos econômicos. / São Cristóvão, SE

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Adolescence involves an increase in risky decisions, such as reckless driving and illicit substance use, but prosocial characteristics and peer affiliation have yet to be investigated as protective factors. The present study assessed altruistic tendencies, prosocial peer affiliation (PPA), and empathic concern as predictors and moderators of risk-taking, including both self-reported health risks and riskiness in a behavioral task. Young adults from ages 20 to 25 (M = 22.55, SD = 1.38) completed a battery of behavioral tasks (including the Balloon Analogue Risk Task and the Dictator Game) and questionnaires on Amazon MTurk, measuring risk-taking (drunk driving, texting while driving, binge drinking, illicit substance use, and tobacco use), altruistic tendencies, PPA, empathic concern, reward sensitivity, and self-regulation. Results indicated that drunk driving and texting while driving were negatively associated with all three prosocial characteristics, and binge drinking was related to PPA and empathic concern. Moderating effects included interactions between altruistic tendencies and reward sensitivity on drunk driving, altruistic tendencies and self-regulation on drunk driving, PPA and reward sensitivity on binge drinking, and empathic concern and self-regulation on binge drinking. Mediating effects, however, were not found. Overall, prosocial characteristics seemed to buffer against reward sensitivity and strengthen self-regulation in several models. The discussion centers on how prosocial individuals might be less prone to risk-taking, and how affiliating with positive peers can offset the effects of heightened reward sensitivity during this crucial developmental period.

Childhood sexual abuse (CSA) is one of the least studied HIV-related risk factors in Haiti although research in the United States and Europe has clearly established the link between childhood trauma and HIV risk behaviors. Understanding the role and impact of CSA on HIV-positive Haitian women is likely to strengthen future HIV prevention and treatment efforts aimed at this vulnerable group. The current study was a cross-sectional examination of baseline data collected during a randomized trial of a cognitive-behavioral stress management (CBSM) intervention in Haiti. The purpose of this study was to analyze the association between CSA and sexual risk behaviors, alcohol use, and social support in a group of Haitian women, ages 17-55 (n=229), who are HIV-positive alcohol users living in Haiti. The outcomes investigated were the respondents’ level of exposure to CSA and their current HIV-related risk factors. The Theory of Gender and Power provided the theoretical framework for variable selection and associative exploration. Statistical tests included descriptive analyses, chi-square tests, analysis of variance (ANOVA), and correlations. Results showed that women who were exposed to some level of sexual abuse during childhood had less favorable attitudes towards condom use than women who reported no exposure to sexual abuse during childhood [F(2, 217) = 5.10, p = .007]. There were no differences between exposure groups for the remaining sexual risk behaviors: multiple partners, knowledge of HIV, and sexual self-efficacy. Women who were exposed to CSA also reported higher levels of alcohol use than reported by the women in the non-exposure group. Finally, there were no differences between exposure groups for social support. Group differences in attitudes towards condom use and levels of alcohol use among HIV-positive Haitian women demonstrate that HIV-positive individuals have different past and present experiences that affect their current beliefs and behaviors. Examining women at the beginning of their diagnosis for childhood trauma and providing targeted interventions for coping with that trauma presents a valuable research opportunity. The findings of the current study suggest that more research is required to understand the association between CSA and HIV-related risk factors in this subset of the HIV-positive population.

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