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As part of efforts to modernize the Youth Risk Behavior Surveillance System, the national Youth Risk Behavior Survey (YRBS) is moving from paper-and-pencil instrument (PAPI) administration to electronic administration using tablets. This study aimed to examine differences in demographic characteristics and the reporting of health behaviors and experiences between the PAPI- and tablet-administered 2021 national YRBS questionnaire. High school students (grades 9–12) in classrooms from 57 schools participating in the 2021 national YRBS were assigned randomly to complete the survey using PAPI (n = 4,684 students) or using tablets (n = 3,645 students). Eighty-nine behavior and experience items were examined to compare the missingness in reporting and the prevalence estimation (i.e., proportions) by administration mode. Demographic characteristics (sex, race/ethnicity, grade, and sexual identity) did not differ by mode (PAPI vs. tablet). For the majority (93.2%, 83 out of 89) of YRBS behavior and experience items, mode was not significantly associated with the reported proportions, adjusting for sex, race/ethnicity, grade, and sexual identity. However, 30 out of 89 (33.7%) items showed significant variation in missingness by mode; 10 items had higher missingness with PAPI administration while 20 had higher missingness with tablet administration. Survey administration mode was not significantly associated with behavior and experience reporting among high school students. More research is needed to understand differential patterns of missingness by mode. Aligning with Centers for Disease Control and Prevention's Public Health Data Modernization Initiative, findings from this study provide evidence to support electronic survey administration for the national YRBS, particularly using tablet data collection. [ABSTRACT FROM AUTHOR]

Background: The treatment gap for people with common mental disorders is large, estimated to be 75–95% in India; the reasons are multi-factorial. It was found that 89% of the primary health centers are not providing mental health care services. Technology like the electronic-mental Health Global Action Program-Intervention Guide (e-mhGAP-IG) is necessary to fill this gap, which in turn helps to attain one of the aims of National Mental Health Program-1982. Hence, the study is planned to understand the feasibility and adaptability of WHO’s e-mhGAP-IG by the primary health workers in the delivery of mental health care for child and adolescent mental/behavioral disorders (CMH) and substance use disorders (SUB). Methods: It is an open-label randomized control trial planned to conduct at primary healthcare centers, Chittoor district. Primary health care staff working at PHCs/Sub-centers having one year experience, and being able to handle smart phones will be included in the study. Data will be collected using a self-structured case report form (CRF) and analyzed by applying per protocol analysis using JAMOVI software. The cost of intervention and the impact on disease outcomes will be taken concurrently to estimate the cost-effectiveness of the intervention. Trial registration: CTRI/2023/04/051899 dated 24/04/2023 under the clinical trials registry-India Protocol version: 1.0 dated 24/04/2023

Pre-exposure prophylaxis (PrEP) is a biomedical prevention intervention that has demonstrated high efficacy in reducing human immunodeficiency virus (HIV) transmission. While an increasing number of jurisdictions have endorsed the use of emtricitabine/tenofovir disoproxil fumarate (FTC/TDF) for PrEP, access to PrEP varies widely. Adolescents and young adults (AYAs), especially those at high risk of HIV acquisition, such as young gay, bisexual, and other men having sex with men (YGBMSM) and individuals living in countries where HIV is endemic, face multiple barriers that limit their access to PrEP. This position paper provides context and recommendations for the promotion and use of PrEP among AYAs., (Copyright © 2018. Published by Elsevier Inc.)

Abstinence from sexual intercourse can be a healthy choice for adolescents, particularly if an adolescent is not ready to engage in sex. However, government programs exclusively promoting abstinence-only-until-marriage (AOUM) are problematic from scientific and ethical viewpoints. Most young people initiate sexual intercourse as adolescents or young adults, and given a rising age at first marriage around the globe, increasingly fewer adolescents wait until marriage to initiate sex. While theoretically fully protective, abstinence intentions often fail, as abstinence is not maintained. AOUM programs are not effective in delaying initiation of sexual intercourse or changing other behaviors. Conversely, many comprehensive sexuality education programs successfully delay initiation of sexual intercourse and reduce sexual risk behaviors. AOUM programs inherently provide incomplete information and are often neglectful to sexually active adolescents; lesbian, gay, bisexual, transgender, and questioning adolescents; pregnant and parenting adolescents; and survivors of sexual assault. Promotion of AOUM policies by the U.S. government has undermined sexuality education in the United States and in U.S. foreign aid programs to prevent HIV infection. In many U.S. communities, AOUM programs have replaced more comprehensive approaches to sexuality education., (Copyright © 2017 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.)

Youth incarceration is an international public health concern among developed and developing countries. Worldwide, youth are held in incarceration, detention, and other secure settings that are inappropriate for their age and developmental stages, jeopardizing their prosocial development, and reintegration into society. Youth incarceration lacks evidence and cost-effectiveness. The well-being of youth is a key indicator of the welfare of families, communities, and society at large; therefore, the Society for Adolescent Health and Medicine (SAHM) supports a paradigm shift in the role of the justice system as it relates to treatment of youth. SAHM recommends justice systems focus greater attention and resources on identifying and reducing the antecedents of high-risk and criminal behaviors, recognizing the rights and freedom of young persons, and prioritizing the well-being of youth over punitive measures that may harm and disrupt healthy adolescent development. SAHM supports the following positions: (1) incarceration is a last option for selected offenders who have committed the most serious violent crimes and are unable to remain safely in the community; (2) youth justice policies, programs, and practices affecting youth be evidence based and trauma informed; (3) youth justice policies, programs, and practices must incorporate research and ongoing program evaluation; (4) youth justice policies shall protect the privacy and dignity of children younger than 18 years; and (5) health care professionals and media will promote positive portrayals of youth in healthy relationships within their communities and reduce representations and images of youth that are negative, violent, deviant, and threatening., (Copyright © 2016 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.)

Schools are ideal settings to promote adolescent physical activity (PA), yet school-based interventions have shown limited long-term impact. This position paper presents key issues surrounding school-based PA interventions. Collaborative conceptual thinking drawing on multi-author expertise and available evidence advanced our understanding and opinion. Key arguments: 1) the adoption of a systems approach, which maximizes partnership action and leverages policy, is crucial for understanding the complexities of implementing whole-school programs; 2) a reorientation to an assets perspective optimizes existing strengths and resources allowing greater emphasis on the full range of physical, cognitive, emotional and social benefits that PA provides, and 3) a move beyond traditional positivist research designs to advance our knowledge of what works better, for whom and in what context is needed for greater progress We provide suggestions, specifically advocating for systems approaches, as a realistic way to improve how we support PA in schools in the future. [ABSTRACT FROM AUTHOR]

Background: This qualitative descriptive study gauged the perceptions of adolescent focus group participants and outdoor adventure education teachers on their preferred program components to improve adolescent wellbeing during a secondary school outdoor adventure education program., Methods: Five student focus groups (N = 29) and four key informant interviews were conducted. Manual clustering of transcripts and template thematic analysis involving the development of a priori codes from interview questions resulted in an initial deductive code frame, followed by an inductive coding process., Findings: Six themes were developed, namely perceptions of the outdoors, motivators for participation, barriers to participation, staff traits, and ideal program components. The main findings were that self-efficacy, resilience, and individual empowerment opportunities were highly valued. Students also valued autonomy and independence, which presented a challenge for teachers managing the risks of their programs. Social connections and relationships were also held in high regard., Contribution: Whilst adrenalin-fuelled adventurous activities such as white water canoeing or rock climbing were popular with students and staff, the most valued aspects of outdoor adventure education were the opportunities to develop relationships, build social connections, self-efficacy, resilience, and a sense of individual empowerment. Greater access to this style of education for adolescent students from lower socio-economic areas would be beneficial due to the extant "opportunity gap" for this population., (© 2023 The Authors. Journal of Adolescence published by Wiley Periodicals LLC on behalf of Foundation for Professionals in Services to Adolescents.)

Objectives: Adolescents make up an estimated 22 % of the 11.8 million population of Papua New Guinea (PNG), yet, as in many low and middle income countries, there are limited specific services for adolescents, who in traditional health service design fall between paediatric and adult patients. With more survivors of chronic illnesses, including tuberculosis and HIV, congenital and acquired heart disease, epilepsy and cerebral palsy, diabetes, cancer and other chronic conditions, there are gaps in the care of such young people, and in their eventual transition to adult services. Moreover, traditional health service design rarely addresses many adolescent health concerns - mental health, self-esteem, substance use, and adolescent-friendly sexual and reproductive health. This study, amongst a cohort cared for in a provincial hospital in Milne Bay Province, Papua New Guinea, aimed to explore the perceptions of adolescents on the health care they receive, and their views on their health priorities., Methods: A qualitative study was carried out from April to August 2022, amongst adolescents (persons aged 10-19 years) attending or admitted to Alotau Provincial Hospital. Data were collected via semi-structured wide-ranging interviews, and contextual data obtained from their medical charts. Thematic data analysis was done., Results: Fifty-four adolescents were interviewed. Adolescents were generally content with the care they received, although many raised concerns regarding feeling out of place in a ward with older adults or infants, and staff attitudes towards them including not directly communicating. Forty four adolescents preferred an adolescent-friendly setting, as opposed to the adult or children's wards, stating that it would allow for positive peer-interaction, improve their experience in the hospital, and improve the quality of health care received. Many adolescents with chronic illnesses had concerns regarding loneliness and isolation, and uncertainty of their future. Pregnant adolescents highlighted the lack of education on sexual and reproductive health, and experiences of gender-based violence., Conclusions: This study shows that adolescents can perceive the need for adolescent-friendly health services and advocate for improvement in the quality of health care they receive, and the breadth of adolescent health care concerns., (© 2024 Walter de Gruyter GmbH, Berlin/Boston.)

Purpose: Research demonstrates that play is promotive of health and development in children across multiple domains. Outdoor play may be especially beneficial as environmental elements are conducive to recreation and relaxation. Maternal perception of neighbourhood collective efficacy (NCE), or sense of cohesion among residents, may be a form of social capital especially effective in promoting outdoor play, and thus healthy development. Yet little research has examined the long-term benefits of play beyond childhood., Methods: We utilized longitudinal data from the Fragile Families and Child Wellbeing Study (N = 4441) to evaluate outdoor play during middle childhood as a mediator between perceived NCE in early childhood and adolescent health determinants. Maternal self-reported perceived NCE at age 5, children's outdoor play was assessed at age 9 and adolescents' self-reported height, weight, physical activity and depressive and anxiety symptoms at age 15., Results: Total play served as mediator between NCE and later adolescent health determinants. Perceived NCE in early childhood (age 5) significantly predicted more total play in middle childhood (age 9), which in turn predicted more physical activity and lower anxiety symptoms in adolescence (age 15)., Conclusions: Consistent with a developmental cascades approach, maternal perceptions of NCE shaped children's engagement in outdoor play that may serve as a foundation for later emerging health behaviours., (© 2023 John Wiley & Sons Ltd.)

Introduction: Despite a growing body of research on associations between adolescent digital use and well-being, few studies have investigated these associations a) longitudinally and b) across socioeconomic status. The present study uses high-quality longitudinal data to examine how digital engagement shapes socioemotional and educational outcomes from early to late adolescence across socioeconomic status (SES)., Methods: Participants are 7685 individuals (49.0% female) from the 1998 birth cohort of the longitudinal Growing Up In Ireland (GUI) survey. The survey was administered to Irish parents and children between 2007 and 2016 (at ages 9, 13, and 17/18). Fixed-effects regression modeling was used to establish associations between digital engagement and socioemotional and educational outcomes. Further Fixed-Effects models were analyzed separately by SES, to assess how associations between digital use and adolescent outcomes differ by socioeconomic groups., Results: Results show that digital screen time increases markedly from early to late adolescence, but to a higher extent among low-SES versus high-SES groups. Heavy levels of digital screen time (i.e., 3+ hours daily) are associated with declines in well-being, particularly for external and prosocial functioning, while engagement in learning-oriented digital activities and gaming is associated with better adolescent outcomes. Yet, low-SES adolescents are globally more harmed than high-SES adolescents by their digital engagement, and high-SES adolescents benefit more from moderate levels of digital use and from engaging in learning-oriented digital activities., Conclusions: This study suggests that digital engagement is associated with socioeconomic inequalities in adolescents' socioemotional well-being and, to a lesser extent, educational outcomes., (© 2023 The Authors. Journal of Adolescence published by Wiley Periodicals LLC on behalf of Foundation for Professionals in Services to Adolescents.)

Abstract: Familial hypercholesterolemia (FH) affects on average 1 in 500 individuals in European countries, and it is estimated that FH in Poland may affect more than 80,000 people. However, in Poland, only about 20% of the population is estimated to have been diagnosed with FH, of which only a small number receive adequate treatment. FH results in more rapid development of atherosclerosis and is associated with a high risk of cardiovascular events. Atherosclerosis develops beginning in childhood in patients with FH and reaches advanced stages before clinical manifestations develop. Inadequate diagnostics and treatment of FH in Polish children suggests a need for raising the level of awareness and understanding of the condition in both society and among health professionals. These recommendations present the current epidemiological status, guidelines for diagnosing FH in Polish children and adolescents, and effective treatment options. [Copyright &y& Elsevier]

Background: Health risks associated with the high consumption of sugar-sweetened beverages (SSBs) include overweight or obesity and their complications such as diabetes, as well as oral and dental decay, among others. Aim: The aim of the present statement is to inform health care professionals, parents, care-givers, teachers and school head teachers, stakeholders and governing bodies about the risks associated with drinking SSBs in infants, children and adolescents. Methods: We searched PubMed and the Cochrane databases for English language studies published from 2010 through October 1, 2018, for randomized clinical trials, meta-analyses, systematic reviews and observational studies (search terms are reported in eAppendix in the Supplement). We also manually searched the references of selected articles, reviews, meta-analyses and practice guidelines. Recommendations: Consumption of SSB by children and adolescents should be limited, and the consumption of water and other non-sweetened beverages should be promoted. Educational institutions such as nurseries, pre-schools and schools should offer unlimited access to drinking water, whereas the sale of SSBs should be banned. [ABSTRACT FROM AUTHOR]

Preferences for child and adolescent health states used to generate health state utility values can be elicited from adults, young adults, adolescents, or combinations of these. This commentary paper provides a critical overview of issues and implications arising from valuing child and adolescent health states using a novel approach of a mixed sample of adolescents and adults. The commentary is informed by critical analysis of normative, ethical, practical and theoretical arguments in the health state valuation literature. Discussion focusses upon adolescent empowerment, understanding and psychosocial maturity; ethical concerns; elicitation tasks; perspective; and selection of sample proportions across adolescents and adults. It is argued that valuation of child and adolescent health states by both adolescents and adults could involve all participants completing the same preference elicitation task using the same perspective (e.g. time trade-off imagining they are living in the health state), and all preferences being modelled to generate a combined value set that reflects both adolescent and adult preferences. It is concluded that the valuation of child and adolescent health states by a mixed adolescent and adult sample appears feasible and has the advantage that it includes some of the population who can potentially experience the health states, thus enabling adolescents to express their views around matters that may affect them, and the population that are taxpayers and voters. However, both the relative proportion of adults and adolescents to include in a valuation sample and the elicitation technique require careful consideration., (© 2022. The Author(s), under exclusive licence to Springer Nature Switzerland AG.)

Background: The recent commentary article in this journal by Chandra-Mouli et al. speaks of a never-before opportunity to strengthen investment and action on adolescent contraception. We endorse the positive 'can-do' tone of the article, but noticed that at least four issues, which in our view are crucial, merit a comment. Main body: First of all, the article suggests that there is some sort of shared interest, based on a presumed global consensus around the use of contraceptives by adolescents - which is not the case: sexual rights are controversial. Secondly, for real progress in adolescent contraception to occur, we believe it is critical to thoroughly investigate and mention the factors, including political ones, that would need to be overcome. Thirdly, new avenues need to be explored that allow for accurate and positive teaching of adolescents about contraception in socio-cultural and political environments that are ambivalent about the issue. Fourthly, barriers at the global level that we already know of should not be silenced. There is sufficient evidence to call upon donors and international agencies to choose position and stop obstructing women's - including young women's - access to a broad range of contraceptives. The 'She Decides' movement is a heartening example. Conclusion: It is crucial to acknowledge the political dimension of sexual rights. It requires solutions not only at national levels, but also at the global level. [ABSTRACT FROM AUTHOR]

Cervical cancer is the leading cause of cancer-related morbidity and mortality in many sub-Saharan African (SSA) countries, including Tanzania. Most cervical cancer cases worldwide are attributable to infection of the cervix with Human Papillomavirus (HPV), a vaccine-preventable sexually transmitted infection (STI). Over the past 10 years, we have conducted a programme of HPV research in pre-adolescents and adolescents in Mwanza, the second-largest city in Tanzania, which is situated in a malaria-endemic region. In this narrative review article, we summarise the contribution of our work, alongside work of others, to improve the understanding of HPV epidemiology in SSA and development of setting-appropriate, evidence-based intervention strategies. We present evidence for very high prevalence and incidence of HPV infection among female SSA adolescents around the time of sexual debut, describe risk factors for HPV acquisition, and discuss associations between HPV, HIV and other STIs, which are also highly prevalent within this population. We summarise findings from early clinical trials of HPV vaccines in SSA, the first of which was an immunogenicity and safety trial conducted in Mwanza, Tanzania, and Dakar, Senegal. Within the trial, we evaluated for the first time the potential impact of malaria and helminth infection on vaccine-induced antibody responses in Tanzanian girls. We describe research evaluating optimal HPV vaccine delivery strategies within this setting, perceived requirements for and barriers to vaccine implementation among key informants from LMIC, vaccine acceptability among girls and parents, and opportunities for co-delivery of interventions alongside HPV vaccination to an adolescent population. Finally, we discuss country-level barriers to vaccine uptake in LMIC, and ongoing studies in Tanzania and other SSA countries of reduced-dose HPV vaccination schedules that may alleviate cost and logistical barriers to vaccine implementation., (© 2021 John Wiley & Sons Ltd.)

This study examined the role of temperament type and gender of adolescents and teachers in adolescents' well-being in school. The sample consisted of 677 Finnish students and 56 classroom teachers. Parents rated adolescent temperament and teachers rated their own temperament in autumn of Grade 6. Self-reports of school well-being among adolescents were obtained in autumn and the fall of Grade 6. The results showed that being a girl and having resilient temperament type predicted higher school well-being. In turn, boys with undercontrolled temperament, who were otherwise at risk for decreased school well-being, particularly benefited from having a female teacher with resilient temperament. Overall, the results suggest that both adolescent temperament type and gender play important roles in adolescents' well-being in school., (© 2021 The Authors. Scandinavian Journal of Psychology published by Scandinavian Psychological Associations and John Wiley & Sons Ltd.)

In this study we evaluated indicators of the feasibility, reliability, and validity of the Child Health Questionnaire-Child Form (CHQ-CF). We compared the results in a subgroup of adolescents who completed the standard paper version of the CHQ-CF with the results in another subgroup of adolescents who completed an internet version, i.e., an online, web-based CHQ-CF questionnaire. Under supervision at school, 1,071 adolescents were randomized to complete the CHQ-CF and items on chronic conditions by a paper questionnaire or by an internet administered questionnaire. The participation rate was 87%; age range 13–17 years. The internet administration resulted in fewer missing answers. All but one multi-item scale showed internal consistency reliability (Cronbach’s α > 0.70). All scales clearly discriminated between adolescents with no, a few, or many self-reported chronic conditions. The paper administration resulted in statistically significant, higher scores on 4 of 10 CHQ-CF scales compared with the internet administration ( P < 0.05), but Cohen’s effect sizes d were ≤ 0.21. Mode of administration interacted significantly with age ( P < 0.05) on four CHQ-CF scales, but Cohen’s effect sizes for these differences were also ≤ 0.21. This study supports the feasibility, internal consistency reliability of the scales, and construct validity of the CHQ-CF administered by either a paper questionnaire or online questionnaire. Given Cohen’s suggested guidelines for the interpretation of effect sizes, i.e., 0.20–0.50 indicates a small effect, differences in CHQ-CF scale scores between paper and internet administration can be considered as negligible or small. [ABSTRACT FROM AUTHOR]

The purpose of this study was to examine the influence of mode of administration (internet-based, web survey format versus pencil-and-paper format) on responses to the Dimensions of Tobacco Dependence Scale (DTDS). Responses from 1,484 adolescents that reported using tobacco (mean age 16 years) were examined; 354 (23.9%) participants completed a web-based version and 1,130 (76.1%) completed a paper-based version of the survey. Both surveys were completed in supervised classroom environments. Use of the web-based format was associated with significantly shorter completion times and a small but statistically significant increase in the number of missing responses. Tests of measurement invariance indicated that using a web-based mode of administration did not influence the psychometric functioning of the DTDS. There were no significant differences between the web- and paper-based groups' ratings of the survey's length, their question comprehension, and their response accuracy. Overall, the results of the study support the equivalence of scores obtained from web- and paper-based versions of the DTDS in secondary school settings. [ABSTRACT FROM AUTHOR]

The authors examine the comparability of paper and voice formats of the Massachusetts Youth Screening Instrument-Second Version (MAYSI-2) as well as each format’s concordance with the Voice Diagnostic Interview Schedule for Children (DISC) among adjudicated youth. Comparability is assessed among 248 youths admitted to a South Carolina Assessment Center. Mean scores and alpha coefficients are calculated, and area under the curve and positive and negative predictive values are used to compare concordance to the DISC. Paper and voice formats are significantly correlated, have similar alpha coefficients, and have comparable concordance with the DISC, suggesting that the MAYSI-2 paper and voice formats are comparable instruments. The voice format may be preferable to the paper format for screening justice youth for mental health problems because it may reduce incomplete data and increase reporting of stigmatized behaviors and because of its ability to automatically generate scored reports and aggregate data. [ABSTRACT FROM AUTHOR]

This study assessed the comparability and reliability of paper-based and computer-based administration of psychosocial construct measures related to adolescents engaging in physical activity and sedentary behaviors. Adolescents (n = 76; 55 % girls, 49% Hispanic, 18 % non-Hispanic-white; M age = 13 years) completed measures of behavior change strategies, self-efficacy, decisional balance, family and peer influences, enjoyment, activity choices, and environmental influences. Overall, the adolescents provided equivalent responses on paper and computer formats. Reliability estimates were generally good for the multiple-item constructs, but single-item measures tended to demonstrate low reliability. Average scale internal consistency was significantly higher for measures administered with the computer format compared to the paper format, but test-rest reliability estimates were not significantly different between formats. [ABSTRACT FROM AUTHOR]

Since various dance teaching systems have attracted much attention with the development of Artificial Intelligence (AI) technology, this paper improves the recognition performance of Latin dance teaching systems by optimizing the action recognition model. Firstly, the object detection and action recognition technology under the current AI technology is analyzed, and the Two-stage object detection algorithm and One-stage object detection algorithm are evaluated. Secondly, the technologies and functions contained in the adolescent health Latin dance teaching system are described, including image acquisition, feature extraction, object detection, and action recognition. Finally, the action recognition algorithm is optimized based on object detection, and the rationality and feasibility of the proposed algorithm are verified by experiments. The experimental results show that the optimization algorithm can search the optimal feature subset after five iterations on Undefine Classes of 101 (UCF101) dataset, but it needs seven iterations on Human Motion Database 51 (HMDB51) dataset. Meanwhile, when using support vector machine classifier, the optimization algorithm can achieve the highest accuracy of motion recognition. Regressive Function, Multinomial Naive Bayes and Gaussian Naive Bayes Algorithms have lower prediction delay, as low as 0.01s. Therefore, this paper has certain reference significance for the design and implementation of adolescent health Latin dance teaching system. [ABSTRACT FROM AUTHOR]

The article presents abstracts of articles that were presented at the American Psychosocial Oncology Society (APOS) 11th Annual Conference including "Breast Cancer Disparities in Northern Florida," by Sarah Rausch Osian and colleagues, "Adolescent and Young Adult Sexual Health in Oncology: Current Practices and Quality Improvement," by Dava Szalda and colleagues, and "Teaching Healthcare Providers How to Provide Spiritual Care: A Pilot Study," by Angelika Zollfrank and colleagues.

Background: In order to more effectively promote fruit and vegetable intake among children and adolescents, insight into determinants of intake is necessary. We conducted a review of the literature for potential determinants of fruit and vegetable intake in children and adolescents. Methods: Papers were identified from Medline and PsycINFO by using all combinations of the search terms: "fruit(s) or vegetable(s)" and "children or adolescents". Quantitative research examining determinants of fruit and/or vegetable intake among children and adolescents aged 6-18 years were included. The selection and review process was conducted according to a four-step protocol resulting in information on country, population, design, methodology, theoretical basis, instrument used for measuring intake, statistical analysis, included independent variables, and effect sizes. Results: Ninety-eight papers were included. A large number of potential determinants have been studied among children and adolescents. However, for many presumed determinants convincing evidence is lacking, mostly because of paucity of studies. The determinants best supported by evidence are: age, gender, socio-economic position, preferences, parental intake, and home availability/accessibility. Girls and younger children tend to have a higher or more frequent intake than boys and older children. Socio-economic position, preferences, parental intake, and home availability/accessibility are all consistently positively associated with intake. Conclusion: The determinants most consistently supported by evidence are gender, age, socio-economic position, preferences, parental intake and home availability/accessibility. There is a need for internationally comparative, longitudinal, theory-based and multi-level studies taking both personal and environmental factors into account. [ABSTRACT FROM AUTHOR]