Introdução A obesidade entre adolescentes é um problema que afeta a saúde pública como um todo. Pode ser caracterizada como um distúrbio do estado nutricional normal que gera um aumento de tecido adiposo, reflexo do excesso de gordura resultante do balanço energético positivo. É uma doença multifatorial de origem desconhecida com diagnóstico complexo. As ações de saúde direcionadas para os jovens com essa patologia, devem levar em consideração importantes aspectos dessa fase da vida do indivíduo. A transição da infância para a vida adulta acarreta mudanças biológicas, cognitivas, emocionais e sociais para os adolescentes. Objetivo - Compreender um dos problemas relacionados ao corpo na contemporaneidade na visão de adolescentes em estão em tratamento; o significado de emagrecer e possuir um corpo magro para as mesmas. Métodos - Pesquisa exploratória de corte qualitativo que busca as representações sociais das adolescentes que fazem parte do Programa de Atividades ao Paciente Obeso (PAPO); um programa multidisciplinar que visa a mudança de comportamento para melhora na qualidade de vida e conseqüente perda de peso. A análise foi feita com base na metodologia do Discurso do Sujeito Coletivo. Podendo assim resgatar as representações sociais presentes nas falas das adolescentes acerca do tema. Resultados - As adolescentes quase na sua totalidade apontam que alimentação errada/ maus hábitos em casa e emoções negativas levam a compulsão por comida, sendo fatores determinantes para o acúmulo de peso. A expectativa em relação ao programa nos mostra que a perda de peso para as jovens é o mais importante, sendo presente absolutamente em todas as falas. A maior parte das respostas sobre o imaginário do emagreciemnto, traz a idéia de aceitação e sociabilidade e que não vai mais sofrer preconceito, e alguns conceitos mais subjetivos como auto-estima e felicidade. Conclusão - A adolescência é uma fase de transição entre a infância e a vida adulta, durante a qual muitos hábitos serão sedimentados. Portanto, esse período de profundas mudanças é crucial para modificar práticas inadequadas ou reforçar comportamentos saudáveis. As medidas sugeridas são na efetivação das ações de saúde que devem tomar como objeto as necessidades de saúde, seus determinantes e condicionantes. A importância da abordagem dos pais e volatilidade das modificações sociais e a sua influência na vida dos adolescentes / Introduction - Obesity among adolescents is a problem that affects public health as a whole. Can be characterized as a disturbance of normal nutritional status that generates an increase in adipose tissue, reflecting the excess fat from the resulting positive energy balance. It is a multifactorial disease of unknown origin with complex diagnosis. Health activities directed at young people with this disease, should take into account important aspects of this phase of life of the individual. The transition from childhood to adulthood involves biological changes, cognitive, emotional and social consequences for adolescents. Objective - To understand the problems related to a body in the contemporary vision of adolescents, the significance of losing weight and having a lean body for them. Methods - An exploratory research of qualitative nature that seeks the social representation of teenagers who are part of the Programa de Atividades ao Paciente Obeso (PAPO); a multidisciplinary program that aims to change behavior to improve quality of life and loss of weight. The analysis was based on the methodology of the Discurso do Sujeito Coletivo. Thus being able to rescue the social representations present in the speech of teenagers on the subject. Results - The teenagers almost entirely bad habits at home and negative emotions lead to compulsive overeating, and factors for the accumulation of weight. The expectation for the program shows that weight loss for girls is the most important being absolutely present in every answer. Most responses on the imagery of loss weight, brings the idea of acceptance and sociability and it will no longer suffer prejudice, and some more subjective concepts such as selfesteem and happiness. Conclusion - Adolescence is a transitional stage between childhood and adulthood, during which many habits will be verified. Therefore, this period of profound change is crucial to changing inappropriate practices or reinforce healthy behaviors. The suggested measures are effective in health actions they should take as its object the health needs, their determinants. The importance of gathering parents and volatility of social changes and their influence on teenagers\' lives

This qualitative study explores the experiences of female adolescents in relation to physical activity. The study investigates the experience of being adolescent and the meaning of a female adolescent’s experience of physical activity. A qualitative description with a phenomenological hue was the methodology used. Their perceptions of their lived experiences in relation to physical activity were revealed through stories. The participants were six adolescent females. The study data was gathered through open-ended questions and in-depth conversations, to seek meaning of the adolescent’s experience of physical activity. The interviews were transcribed and stories extracted from the data. Results from the findings of the study indicate that physical activity needs to be enjoyable for the female adolescent for her to be motivated to participate. What specifically constitutes enjoyment for the adolescent differs for each individual. The data also suggested that other persons of influence or the female adolescent’s environment may also have an impact on their participation. Peers, parents, their gender, body issues, competition, running, and certain restrictions were revealed as making a difference. For the female adolescent participating in physical activity, it would be advantageous to find an approach that allows a girl to experience physical activity in the way that works for her. Some participants, already good at sports, are likely to be very competitive, want to train hard, and will build friendships among their like-minded peers. These female adolescents are not so problematic. They already love physical activity and participate in it. The challenge is to target those female adolescents who do not participate on a regular basis, and to design successful interventions which promote and encourage them into physical activity. This change may prevent a further decline in the levels of physical activity for the adolescent who is at a stage when physical activity may be so advantageous.

Several studies have documented a deficiency in the delivery of preventive services to adolescents during physician visits in the United States. In many instances, a correlation has been noted between insufficient training and provision of adolescent medicine services in the practicing physician population. The American Medical Association, American Academy of Pediatrics, American Academy of Family Physicians, American College of Obstetrics and Gynecology and Society for Adolescent Medicine recommend adolescent providers deliver comprehensive health services to teenagers. This study sought to assess and compare Pediatric, Family Medicine and Obstetric-Gynecology resident perceptions of their responsibility, training, experience and comfort with providing comprehensive health care services adolescents. We asked residents to identify the following: (1) adolescent health services they considered part of their scope of practice in their respective field; (2) the level of training they had received with regard to select adolescent health services; (3) the experience they had performing select clinical activities with adolescents; and (4) their comfort with aspects of adolescent care. We further asked two questions to test resident knowledge of an adolescents right to consent to contraception or an abortion without parental notification in the state of their residency. A total of 87 residents (31 Obstetric-Gynecology, 29 Family Medicine and 27 Pediatric) were surveyed. Most residents from all three fields felt the full range of adolescent preventive and clinical services represented in the survey fell under the scope of their practice. Most residents also reported high levels of comfort with examined aspects of adolescent care. In regard to some activities, the positive scope and comfort responses were matched by high reported levels of training and experience, including defining confidentiality; counseling about eating, exercise and obesity; counseling about substance abuse; and discussing STDs, sexual partners and contraception. However, for multiple key adolescent services, considerable discrepancies existed between reported levels of training and experience and the positive responses concerning scope and comfort. In particular the results of study suggested all residents need considerably more training and experience with mental health issues, referring teenagers for substance abuse treatment, and addressing physical and sexual abuse. Overall, there were also significant differences between fields. Family Medicine residents reported the greatest potential for providing comprehensive health care. However, they suffered from the overall deficiencies in training and experience noted above. Obstetric-Gynecology residents reported deficiencies in the provision of several preventive counseling and general health services. Pediatric residents reported multiple deficiencies in the provision of sexual health services. Our results indicate, at this time and in the near future, it is unlikely that adolescents will be able to obtain the full range of recommended preventive and clinical services in a single physician visit unless residencies programs actively incorporate increased training in the full range of adolescent preventive and clinical health services.

Obesity, as defined as BMI at or above the 95th percentile on the Centers for Disease Control and Prevention’s growth charts, has increased almost 3-fold among children in the United States since 1980. Overweight in adolescence has been associated with increased fat retention and high blood pressure in adulthood, among other symptoms of metabolic syndrome. However, normative patterns of weight change in childhood have not been developed. Groups of children may follow different trajectory patterns of BMI change over time. If common trajectory patterns could be identified, and their risk factors and outcomes understood, more nuanced intervention with families and children at risk for obesity could be developed. This study used a national dataset of 1,364 children whose weight and length was measured 12 times from birth through 15 ½ years. Testing both latent class growth analysis and growth mixture modeling identified four distinct subgroups, or classes, of BMI growth trajectory from 24 months – 8th grade. These classes were compared on numerous demographic, biological, and psychosocial risk factors identified in previous research as related to obesity. Classes were differentiated primarily on the child’s BMI at 15 months, the mother’s BMI at 15 months, birth weight for age, and percent increase in birth weight. Being male, Black, and lower SES were also related to membership in the higher-BMI trajectory classes. Of the psychosocial factors, maternal sensitivity, maternal depression, and attachment classification were also related to BMI class. Membership in these trajectories strongly predicted weight-related and blood-pressure outcomes at 15 ½ years over and above individual risk factors, demonstrating that patterns of change themselves are highly influential. The best-fitting models of weight-related outcomes at 15 ½ years included change trajectory in combination with biological, psychosocial, and SES risk factors from 0-24 months, with R² ranging from .31 = .50. Characteristics predicting adolescent overweight can be identified in the first years of life and should trigger the development and implementation of early intervention protocols in obstetrics and pediatrics. / text

Access to health care is an important resource for sexually experienced adolescent females in the prevention of unintended pregnancy and sexually transmitted infections, including HIV. However, a paucity of research exists regarding the extent to which social disparities in access to health care exist among this vulnerable population of adolescents, including the potential contribution of the neighborhood context. Therefore, the primary aims of this dissertation were to examine (1) the extent to which racial and socioeconomic disparities in access to health care exist among sexually experienced adolescent females, (2) the extent to which access to health care among sexually experienced adolescent females varies across neighborhoods, and (3) the extent to which the neighborhood racial and socioeconomic context contribute to racial and socioeconomic disparities in access to health care among sexually experienced adolescent females. A multilevel design was employed for this dissertation utilizing secondary data from Wave I of the National Longitudinal Study of Adolescent Health (Add Health). Analyses included hierarchical generalized linear modeling to examine the receipt of a routine physical, the receipt of contraceptive services, and reported unmet health needs among the dissertation sample of 1,526 sexually experienced Non-Hispanic Black and Non-Hispanic White adolescent females between 15 years to 19 years of age who were dispersed across 546 neighborhoods. After adjusting for a variety of factors that may influence access to health care, the findings revealed no racial disparities and few socioeconomic disparities in access to health care among this sample of adolescents. No significant relationship was noted between the neighborhood racial and socioeconomic context and access to health care or social disparities in access to health care among this sample of adolescents. However, the findings revealed that access to health care among this sample of sexually experienced adolescent females varied across neighborhoods, above and beyond the individual composition of the neighborhood. Further studies are indicated to explore the underlying factors that contribute to socioeconomic disparities in access to health care among sexually experienced adolescent females, and the potential neighborhood characteristics that may contribute to differential access to health care across neighborhoods among this vulnerable population of adolescents.

Youth violence is a major public health problem for US adolescents. Sports participation has been shown to decrease the likelihood of certain forms of youth violence, such as suicide. Using a national representative sample, the study seeks to determine the association of dating and sexual abuse victimization with sports participation. Analyses of data from the 2005 Youth Risk Behavior Survey (YRBS) suggest that sports participation is significantly associated with an increased likelihood of male dating abuse victimization. There was no significant association between sexual abuse victimization and sports participation for girls nor boys. These findings underscore the importance of evaluating contextual aspects of sports education and team dynamics that may have violence prevention potential. Primary recommendations include further research on the feasibility of disseminating youth violence prevention messaging via school and community sports, training for coaches, and rigorous evaluation of adolescent sports programs.

This project examined the extent to which Nova Scotian adolescents’ counselling needs are being met with respect to physical, sexual, substance use, and psychosocial health by their family physicians. This was accomplished by assessing how well Nova Scotian physicians provide preventative advice consistent with the Guidelines for Adolescent Preventative Services (GAPS). Analyses were performed using pooled data from surveys carried out in 2003 and 2006. Descriptive analyses, Poisson and logistic regression were used to examine associations of sociodemographic characteristics, need, and the presence of school based health centres (SBHCs) with the provision of advice. Advice was not well provided and appeared to be need-driven. Females were significantly more likely to be provided advice and respondent access to a SBHC increased the likelihood of advice being provided. These results have implications for policy and practice, specifically, ways to refine preventative healthcare services for the province’s adolescents to ensure optimal care.

This qualitative study explores the experiences of female adolescents in relation to physical activity. The study investigates the experience of being adolescent and the meaning of a female adolescent’s experience of physical activity. A qualitative description with a phenomenological hue was the methodology used. Their perceptions of their lived experiences in relation to physical activity were revealed through stories. The participants were six adolescent females. The study data was gathered through open-ended questions and in-depth conversations, to seek meaning of the adolescent’s experience of physical activity. The interviews were transcribed and stories extracted from the data. Results from the findings of the study indicate that physical activity needs to be enjoyable for the female adolescent for her to be motivated to participate. What specifically constitutes enjoyment for the adolescent differs for each individual. The data also suggested that other persons of influence or the female adolescent’s environment may also have an impact on their participation. Peers, parents, their gender, body issues, competition, running, and certain restrictions were revealed as making a difference. For the female adolescent participating in physical activity, it would be advantageous to find an approach that allows a girl to experience physical activity in the way that works for her. Some participants, already good at sports, are likely to be very competitive, want to train hard, and will build friendships among their like-minded peers. These female adolescents are not so problematic. They already love physical activity and participate in it. The challenge is to target those female adolescents who do not participate on a regular basis, and to design successful interventions which promote and encourage them into physical activity. This change may prevent a further decline in the levels of physical activity for the adolescent who is at a stage when physical activity may be so advantageous.

Thesis (M.S.)--University of Michigan, 1981.

Homens e mulheres têm iniciado sua vida sexual, em grande parte, na adolescência e de formas um tanto diferenciadas. As práticas sexuais, nessa fase, têm sido descritas como dinâmicas e em constantes transformações, sendo que seus perfis podem acarretar impacto importante na vida reprodutiva dos adolescentes. Com o intuito de analisar o início da vida sexual de adolescentes, foram realizadas entrevistas domiciliárias com 383 homens e mulheres, não unidos, de 15 a 19 anos de idade, matriculados em uma unidade básica de saúde da família da zona leste do município de São Paulo, correspondendo a uma amostra representativa dos indivíduos deste grupo etário. A análise de regressão logística múltipla identificou como variáveis associadas ao início da vida sexual de adolescentes do sexo masculino a idade, a situação de estudo, a idade materna no primeiro filho, a concordância materna de que adolescentes tenham vida sexual, o fato de que o pai gostaria que seu filho iniciasse a vida sexual independentemente do casamento, o namoro anterior e o namoro atual. Por sua vez, as variáveis associadas ao início da vida sexual entre adolescentes do sexo feminino foram a idade, o tipo de domicílio, o namoro anterior, o namoro atual e a presença de irmão(ã) que tenha vivenciado uma gestação previamente à união. Entre os 164 adolescentes com experiência sexual, foi observada uma convergência na idade em que homens e mulheres tiveram a primeira relação sexual (mediana de 15 anos). No entanto, mesmo que a primeira relação sexual tenha ocorrido em idades similares e igualmente sem planejamento prévio, aspectos importantes do comportamento sexual diferiram entre os adolescentes e deveriam ser lembrados na assistência e promoção de sua saúde reprodutiva e sexual. Assim, as mulheres relataram ter iniciado a vida sexual, principalmente, porque estavam apaixonadas pelo parceiro, que foi, com maior freqüência, seu namorado. Por outro lado, os homens iniciaram sua vida sexual em relacionamentos ocasionais e justificaram como motivação a atração física. A prática contraceptiva foi deixada de lado por 41,5% dos homens e 31,7% das mulheres. Desta forma, os resultados indicaram que os diferenciais de gênero estiveram presentes em todo o processo de iniciação sexual e, ainda, os fatores individuais, tais como o namoro e a idade, e os fatores familiares, tais como os valores e atitudes dos pais e mães acerca da sexualidade, foram marcantes na iniciação sexual dos adolescentes. / Women and men initiate their sexual life in different ways mainly during adolescence. Sexual practices in youth have been described as dynamic and in constant transformation, though its profile should be considered as having an impact in reproductive health. This study aimed to analyse associated factors to the onset of sexual life and to describe the first sexual relationship. Therefore, 383 fifteen to nineteen year-old single males and females enrolled in a family health unit from the east area of the city of São Paulo were interviewed at home. From multiple logistic regression analysis, data showed that associated variables to the onset of sexual life in males were age, schooling insertion, maternal age at first delivery, maternal acceptance that adolescents engage in sexual practices, paternal opinion that son should have the first intercourse independently from a marriage, previous and current dating. On the other hand, associated variables among females were age, house affording, previous and current dating and the presence of a single sibling who had already faced a pregnancy. Among the 164 adolescents who had sexual experience, a convergence in the age males and females initiated their sexual life (median at 15) was observed. Even though the first intercourse occurred at the same age and without planning, important aspects of the sexual behaviour differed between males and females and ought to be taken into consideration in their reproductive and sexual health promotion. Girls said they had the first intercourse because they were in love and it thus occurred majority with a boyfriend. Boys had their first intercourse mainly in occasional relationships and because of physical attraction. Contraceptive practice was observed in 58,5% of the boys and 68,3% of the girls. The results indicated that gender differences were present at the whole sexual initiation process and that individual factors, such as dating and age, and familial factors, such as parents attitudes towards sexuality, were determinants for the sexual initiation of these adolescents.