Purpose: Substance use and weapon carrying among adolescents is a growing concern. The objective of this study is to investigate the association between adolescent substance use and weapon carrying using the 2013 Youth Risk Behavior Survey (YRBS). Methods: Analyses were conducted using the 2013 YRBS, a nationally representative dataset sampling public and private high school students throughout the United States (US). Data from a total of 148,282 US adolescents were used in the present study. Results: Two outcomes were assessed: weapon carrying within the past 30 days and weapon carrying on school property within the past 30 days. Among adolescents who carried a weapon, 77.3% were male, 62.7% were white, 28.5%% were in 9th grade, 33.8% used a tobacco product and 57.4% drank alcohol within the past 30 days, while 22.8% used a Schedule 1 drug and 14.0% used a Schedule 2 drug during their lifetime. Among adolescents who carried a weapon on school property, 74.4% were male, 55.1% were white, 26.5% were in 11th grade, 40.1% used a tobacco product and 61.9% drank alcohol within the past 30 days, while 32.1% used a Schedule 1 drug and 26.9% used a Schedule 2 drug during their lifetime. For the multivariable model predicting adolescent weapon carrying, tobacco use (adjusted odds ratio (AOR) = 2.31, 95% CI: 2.06, 2.59), alcohol use (AOR = 2.04, 95% CI: 1.81, 2.29), and Schedule 2 drug use (AOR = 2.27, 95% CI: 1.83, 2.80) were significantly associated with increased risk of carrying a weapon, adjusting for all covariates in the model simultaneously. For the multivariable model predicting adolescent weapon carrying on school property, tobacco use (AOR = 2.33, 95% CI: 1.89, 2.86), alcohol use (AOR = 2.53, 95% CI: 2.02, 3.18), and Schedule 2 drug use (AOR = 2.58, 95% CI: 1.94, 3.43) were significantly associated with increased risk of carrying a weapon on school property, adjusting for all covariates in the model. Raw counts and weighted frequencies are reported. Conclusions: Statistically significant associations between adolescent substance use and weapon carrying were found, suggesting that adolescent substance use is associated with increased weapon carrying behavior, both off and on school property. Future weapon carrying prevention efforts should target not only adolescents who are high risk for weapon carrying, but also those who are at risk for misusing substances.

The major purposes of this study were to determine the relationships among resilience, risk-taking behavior and personal characteristics of Thai adolescents living in Bangkok and to examine the differences in risk-taking behavior by school grades or gender. To accomplish these, a cross-sectional correlational research design was conducted. Resilience was measured by using the State-Trait Resilience Inventory developed by Hiew, Mori, Shirnizu and Torninaga.Risk-taking behavior was measured by the Risk-taking Behavior Questionnaire for Thai Adolescents which is a modified version of the 2003 Youth Risk Behavior Survey (YRBS) originally developed by the U.S. Centers for Disease Control and Prevention. In order to make it more applicable to the Thai setting, the author modified the 2003 YRBS. The modified instrument was then translated and back translated; equivalence testing was performed; a pilot study was conducted; and test-retest reliability was measured. Overall, these procedures indicated that the modified version of YRBS had evidence of equivalence (semantic, content, and conceptual), feasibility and acceptability as well as good reliability for use among Thai adolescents to measure risk behavior. Risk-taking behavior in this study includes six categories of behavior: (1) behavior that contributes to unintentional injuries and violence; (2) tobacco use; (3) alcohol and other drug use; (4) sexual behavior contributing to unintended pregnancy and sexually transmitted diseases, including HIV infection; (5) unhealthy dietary behavior; and (6) inadequate physical activity.In all, 1409 students, grades 7 to 12 from six secondary schools in Bangkok, Thailand, participated in the study. Their mean age was 14.9 ± 1.8 years, and 54% were female. Data sets were analyzed using the SPSS for Windows, version 14.0 statistical software program. Resilience scores ranged from 72 to 161 with a mean of 125.55 and standard deviation of 11.44. There were significant positive and negative relationships between resilience and various risk-taking behavior (p Overall findings from this study provided more understanding of risk-taking behavior and its relationship with resilience among Thai adolescents. The recommendations for implementation and further studies were discussed.

This study described self-injury within a general adolescent population. This study involved secondary analysis of data gathered using the middle school Youth Risk Behavior Survey (YRBS) from 1,748 sixth- and eighth-grade students in eight middle schools in a large, southeastern county in Florida. A substantial percentage of students surveyed (28.4%) had tried self-injury. The prevalence of having ever tried self-injury did not vary by race or ethnicity, grade, school attended, or age but did differ by gender. When controlling for all other variables in the multivariate model including suicide, having ever tried self-injury was associated with peer self-injury, inhalant use, belief in possibilities, abnormal eating behaviors, and suicide scale scores. Youth who knew a friend who had self-injured, had used inhalants, had higher levels of abnormal eating behaviors, and higher levels of suicidal tendencies were at increased risk for having tried self-injury. Youth who had high belief in their possibilities were at decreased risk for having tried self-injury. During the past month, most youth had never harmed themselves on purpose. Approximately 15% had harmed themselves one time. Smaller proportions of youth had harmed themselves more frequently, including two or three different times (5%), four or five different times (2%), and six or more different times (3%). The frequency of self-injury did not vary by gender, race or ethnicity, grade, or school attended. Almost half of students surveyed (46.8%) knew a friend who had harmed themselves on purpose. Peer self-injury demonstrated multivariate relationships with gender, having ever been cyberbullied, having ever tried self-injury, grade level, and substance use. Being female, having been cyberbullied, having tried self-injury, being in eighth grade, and higher levels of substance use placed youth at increased risk of knowing a peer who had self-injured. Chi-squared Automatic Interaction Detection (CHAID) was used to identify segments of youth at greatest and least risk of self-injury, frequent self-injury, and knowing a friend who had harmed themselves on purpose (i.e., peer self-injury).

Background: The rate of adolescent overweight and obesity has more than quadrupled over the past few decades, and has become a major public health problem [1]. In 2011, 55% of 12-19 year olds in the United States (U.S.) were overweight or obese [2]. Adolescence is a pivotal time in which many health risk behaviors such as tobacco, alcohol, and drug use are initiated. Such health risk behaviors have been significantly associated with overweight and obesity among adolescents. Objective: The purpose of this study is to evaluate the relationship between obesity and the health risk behaviors most commonly associated with premature morbidity and mortality among adolescents with a novel micro area estimate approach that uses weighted hierarchical logistic regression to nest individuals in classes, classes in schools, and schools in districts. Methods: This study is a secondary analysis of a state-wide representative sample of middle school students that participated in the 2010 Tennessee Middle School Youth Risk Behavior Survey (YRBS). Data was collected from 119 (85.6%) of Tennessee’s local education agencies (LEAs), 456 (95.2%) schools, and 64,790 of 78,441 (82.6%) students. The outcome variable was adolescent obesity (≥ 95th BMI percentile). Explanatory variables were divided into four levels [1] district level: use seatbelt/helmet, asked to show ID for tobacco purchase; [2] school level: ever tried smoking, received HIV education in school; [3] class level: average number of days smoked, having ever exercised to lose weight; [4] individual level: having ever been in fight, early onset of substance use, physical activity, and thought about, planed, or attempted suicide. Weighted hierarchical logistic regression analysis was performed to assess the association between risk factors or protective factors and obesity using effect size (ES) and odds ratio (OR) estimates. Results: The study sample included 64,790 middle school students in the state of Tennessee with a mean age of 12.8 years, of which (49.42%) were females and (50.58%) were males. Nearly one-fourth of the students had a BMI at or above the 95th percentile (22.30%). Weighted hierarchical logistic regression analysis shows that seatbelt and helmet use [ES: -2.161 OR: 0.020, 95% CI: (0.006, 0.070)], and weight misperception [ES: 1.256 OR: 9.720, 95% CI: (9.216, 10.251)], having ever exercised to lose weight [ES: -0.340 OR: 0.540, 95% CI: (0.446, 0.654)], having ever tried smoking [ES: 0.705 OR: 3.581, 95% CI: (2.637, 4.863)] and gender (male vs female) [ES: 0.327 OR: 1.810, 95% CI: (1.740, 1.880)] were strongly associated with adolescent obesity. Results from this study also showed that Black, Hispanic or Latino adolescents were more likely to be obese than Whites, Indian, and Asian adolescent [ES: 0.129 OR: 1.260, 95% CI: (1.200, 1.330)], students with grades of mostly C, D and F were more likely to be obese than those with grades of mostly A and B [ES: 0.189 OR: 1.409, 95% CI: (1.303, 1.523)], and that students having an eating disorder [ES: 0.251 OR: 1.576, 95% CI: (1.508, 1.648)] and/or engagement in sports teams [ES: -0.197 OR: 0.700, 95% CI: (0.674, 0.728)] had small or medium ES association with adolescent obesity. Conclusion:This study uses small area estimates in weighted hierarchical logistic regression models to describe the prevalence and distribution of health risk behaviors associated with adolescent obesity among middle school student subpopulations in Tennessee. The value of small area estimates has been demonstrated previously in a variety of other contexts, and again here offers important insights for intervention design and resource allocation at different micro-levels within small and large areas (i.e., district, school, and class). This work adds to the growing body of research that supports community-driven school-based lifestyle interventions targeting early-onset chronic disease and, more specifically, enhances the geographic resolution with which adolescent obesity can be addressed in middle school populations across Tennessee.

Indiana University-Purdue University Indianapolis (IUPUI) / Rates of vaping among high school students have increased significantly over the past decade. Prior research has found significant associations between youth vaping and substance use. However, little is known about how vaping is associated with various patterns of polysubstance use and asthma in youth. We aimed to identify how youth are best categorized into classes based on co-occurring vaping and polysubstance use behaviors, how these classes are associated with youth background and demographic characteristics, and if these classes significantly predict asthma outcomes. Our sample consisted of nationally representative data from the 2017 and 2019 waves of the Youth Risk Behavior Survey (N = 28,442). We utilized Latent Class Analysis, multinomial logistic regression analyses, and binary logistic regression analyses to examine relationships between youth vaping, polysubstance use, and asthma. Three latent classes of substance use were identified: Polysubstance Users, Lifetime Alcohol and Vape Users, and Abstainers. Age, gender, grade and race were all significantly associated with odds of membership in the Polysubstance Users class, compared to the Abstainers class. Sexual identity was not associated with class membership. Membership in the Polysubstance Users class was significantly associated with higher odds of asthma, as compared to membership in the other two classes. These findings indicate that recent vaping is associated with high probabilities of recent polysubstance use. They also suggest that youth with high probabilities of vaping and polysubstance use are at significantly high risk for asthma compared to other classes vi of youth users and non-users. We recommend that future youth intervention strategies be tailored differently toward different classes of substance use and vaping. Future research should examine how the classes of vaping and substance use that we identify emerge in youth and what social factors (e.g., peer behavior, parental connectedness, etc.) influence their development.

No description available.

Physical fights among middle school students is a problem in our school systems, with 24.7% of students having been in a physical fight one or more times in 2013. The purpose of this study was to estimate the extent to which physical fights among middle school students in Tennessee was associated with demographic factors (age, sex and race) and to identify individual level factors that influence the likelihood of middle school students engaging in a physical fight.The 2013 Tennessee Youth Risk Behavior Survey (YBRS) data was used for this study, which is an annual cross-sectional school data collected by the National Center for Health Statistics of the Center for Disease Control and Prevention. A total of 5589 Tennessee Middle school students were included in the analysis. The outcome variable was physical fighting. Explanatory variables included demographic variables, life styles and health behavior risk factors. Odds ratios (ORs) and corresponding 95% confidence intervals (CIs) were reported.The analyses indicate that male students were more likely to be involved in a physical fight than the female students (OR 2.89, 95% CI 2.49-3.36) and white students were less likely to be involved in a physical fight than the non-White students (OR 0.50, 95% CI 0.43-0.58). For every one year increase in age, the relative odds of being involved in a physical fight increased by 9.4% (OR 1.09, 95% CI 1.02-1.18). Similarly, students who ever tried to commit suicide (OR 1.89, 95% CI 1.39-2.53), drink alcohol (OR 2.48, 95% CI 2.02-3.05) and smoke cigarettes (OR 1.95, 95% CI 1.56-2.44) were more likely to be involved in a physical fight than those who did not. Students who carried a weapon were more likely to be involved in a physical fight than those students who did not (OR 2.72, 95% CI 2.31-3.20). While Students who watched television for 3 or more hours per day were more likely to engage in physical fights (OR 1.20, 95%CI 1.04-1.39) than students who did not, students with school grades A and B (OR 0.58, 95% CI 0.49-0.68), feeling safe and secure at school (OR 0.73, 95% CI 0.62-0.87), sleeping eight or more hours per day (OR 0.80, 95% CI 0.69-0.92) were less likely to be involved in a fight in school than other students.Age, gender, race, smoking, alcohol, use of marijuana, sleeping time, school performance, school safety environment, suicide attempt and TV time were potential risk factors associated with physical fights among middle school students. Strategies to reduce physical fights among students in Tennessean middle schools are needed.

Introduction. Suicide-related fatalities are the third leading cause of death among adolescents, resulting in approximately 4,600 deaths annually. According to findings from the 2005 National College Health Assessment, engagement in weekly physical activity (PA) reduced the risk of suicidal behaviors. Data from the 2010 middle school Youth Risk Behavior Survey (YRBS) administered by Tennessee Coordinated School Health this study investigates the cross-sectional relationships of PA with suicidal behaviors, while simultaneously considering explanatory variables such as personal characteristics, sedentary behaviors, drug use, extreme weight control behaviors (EWCB), body mass index (BMI) and weight misperception. Methods. This is a secondary analysis of data from the 2010 Tennessee Middle School YRBS conducted among 65,182 middle school students of which 60,715 students were included in the final analysis. Items assessed were PA, sports team engagement, PE class, sedentary behaviors, suicidal behaviors, drug use, EWCB, BMI, weight misperception and selected personal characteristics. A bivariate analysis was used to create simple descriptive statistics, including means, standard deviations and proportions. Overall, approximately 21.15% (N= 13,704) reported suicidal behaviors, specifically, 18.30% reported ever having thoughts of suicide, 11.13% had ever made a suicide plan and 7.02% had one or more suicide attempts in their lifetime. A logistic regression analysis was conducted to compare the odds of experiencing suicidal behaviors in adolescents who engaged in PA, sports teams, and PE class, with students who did not perform these activities. We used odds ratios (OR) to assess effect size (ES), rather than p-values to assess statistical significance due to the study’s large sample size. As general rules of thumb, there is a small effect size when ES=0.20 or OR = 1.44, 0.694, medium effect size when ES=0.50 or OR = 2.47, 0.405 and large effect size when ES=0.80 or OR = 4.25, 0.235. Results. Based on ES, age, race/ethnicity, gender, grade in school, sports team engagement, PE class attendance, sedentary behaviors, drug use and EWCB were associated with suicidal behaviors. Associations were strongest for drug/substance use and EWCB and suicidal behaviors, both with large ESs. Although weakened when controlling for other independent variables, the ES of race/ethnicity (other vs white non-Hispanic), gender, sports team engagement, drug/substance use and EWCB on suicidal behaviors were >0.20. The ES of age, PE class attendance, and sedentary behaviors were <0.20. Conclusion. Findings suggest that sports team engagement is associated with reduced risk for suicidal behaviors; whereas, no effects were found for PA or PE class attendance. Asking adolescents questions about sports team engagement may help screen for risk of suicidal behaviors.

Introduction: Childhood obesity has more than quadrupled in the last 30 years, with the prevalence in adolescents aged 12-17 years increasing from 5% in 1980 to 21% in 2012. The purpose of this study was to estimate the extent to which childhood obesity in Tennessee is associated with between-context differences (districts, schools and classes) and to identify factors at the district, school, class, and individual level that influence the individual weight status among 64,790 Tennessee children and adolescents. Methods: Crosssectional data from the Youth Risk Behavior Survey (YRBS) conducted in Tennessee (2010) were used to conduct multilevel analyses that account for the nesting of students in classes, classes in schools and schools in districts. The outcome variable was childhood obesity (>95th percentile). Explanatory variables included district-level factors (the proportion of children wearing seat belts or helmets in district and the proportion of being asked to show proof of age), school-level factors (current tobacco use in school, and HIV/AIDS education in school), class-level factors (the average of smoking days in past 30 days and the proportion of ever having exercised to lose weight in class) and individual-level factors (state geographical regions, age, gender, grade, ever ridden in a car driven by someone who had been drinking alcohol, ever carried a weapon, made a plan to kill yourself, ever used or early onset use of tobacco, alcohol, marijuana, exercised to control weight, school day television time, days of physical education (PE) classes. Odds ratios (ORs) and corresponding 95% confidence intervals (CIs) were reported. Results: Multilevel analyses indicate that 0.90%, 0.08%, and 0.45% of the variation in obesity is associated with class, school and district differences, respectively. Male middle schoolers were at greater risk for obesity [OR: 1.82, C.I. (1.75, 1.89)] compared to females. For every one year increase in age, the relative odds of obesity increased by 11% (OR 0.89, 95% CI 0.88-0.91). Students with worse grades were more likely to have obesity [OR: 1.33, C.I. (1.13, 1.56)]. Students who watched TV 3 hours or more per day were more likely to be obese [OR: 1.31, C.I. (1.23, 1.40)] compared to those who did less than 3 hours per day. Similarly students who ever tried cigarettes were more likely to be obese [OR: 2.15, C.I. (1.62, 2.85)] compared to those students who did not. Students who reported wearing seat belts [OR: 0.05, C.I. (0.02, 0.16)] were less likely to be obese. Conclusions: This study highlights a number of modifiable factors on multiple levels associated with child and adolescent obesity in the state of Tennessee. The results emphasize the importance of targeting programs beyond individual adolescent factors to the child’s classes, schools, and school districts, to reduce the prevalence of obesity among Tennessee adolescents.

No description available.