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PURPOSE: To examine: (1) how adolescent physical activity (PA) and screen-based media use (SBM) relate to physical and social health indicators, and (2) crossnational differences in these relationships. METHODS: Essentially identical questions and methodologies were used in the Health Behavior in School-Aged Children cross-sectional surveys of nationally representative samples of American (N = 14,818) and Canadian (N = 7266) students in grades 6 to 10. Items included questions about frequency of PA, SBM, positive health indicators (health status, self-image, quality of life, and quality of family and peer relationships), and negative health indicators (health complaints, physical aggression, smoking, drinking, and marijuana use). RESULTS: In regression analyses controlling for age and gender, positive health indicators were uniformly positively related to PA while two negative health indicators were negatively related to PA. However, PA was positively related to physical aggression. The pattern for SBM was generally the opposite; SBM was negatively related to most positive health indices and positively related to several of the negative health indicators. The notable exception was that SBM was positively related to the quality of peer relationships. Although there were crossnational differences in the strength of some relationships, these patterns were essentially replicated in both countries. CONCLUSIONS: Surveys of nationally representative samples of youth in two countries provide evidence of positive physical and social concomitants of PA and negative concomitants of SBM. These findings suggest potential positive consequences of increasing PA and decreasing SBM in adolescents and provide further justification for such efforts. [ABSTRACT FROM AUTHOR]

OBJECTIVE: To examine the associations of sociodemographic characteristics with both the prevalence and the causes of delayed or forgone care in a nationally representative sample of children with special health care needs. METHODS: Data were abstracted from the 2001 National Survey of Children with Special Health Care Needs. The families of children with special health care needs (CSHCN) who reported delayed or forgone care were asked about the reasons. The 12 reasons in the questionnaire were grouped into 5 categories. Bivariate and multivariate logistic regression analyses were conducted in SUDAAN to examine the relationship between sociodemographic characteristics of CSHCN and the incidence of delayed or forgone care by its reasons. RESULTS: Nearly 10% of CSHCN had experienced delayed or forgone health care in the past 12 months in 2001. Logistic regression showed that delayed or forgone care was more likely to be reported by the families of CSHCN who were adolescents, who had more severe limitations, lived in the South or West, lacked medical insurance, and who lived in families under or near the federal poverty line. Hispanics were more likely to report 'lack of medical specialty' and 'had language, communication, or cultural problems with provider.' Both Hispanics and non-Hispanic others were twice as likely to report 'provider not accessible' as reasons for the delayed or forgone care compared with non-Hispanic whites or blacks. conclusion: CSHCN with certain socioeconomic status and sociodemographic characteristics, as well as those with severe limitations in activity, were more likely to be affected by circumstances that result in delayed or forgone care. [ABSTRACT FROM AUTHOR]

OBJECTIVE: To examine the association between the parent's language of interview and the access to care for children with special health care needs (CSHCN). METHODS: We used the 2001 National Survey of Children with Special Health Care Needs to compare socio-demographic characteristics and health care access variables among CSHCN with parents who interviewed in English and another language. Additional multivariate analyses explored the effect of language of interview on access to health care for the subgroup of Hispanic respondents. RESULTS: CSHCN with non-English-speaking parents were from less-educated and lower-income families and were more likely to lack insurance and have conditions that greatly affected their activities. These children were also more likely to have inadequate insurance (odds ratio [OR]=11.29), have an unmet need for family support services (OR=1.88), lack a personal doctor or nurse (OR=1.98), lack a usual source of care (OR=1.89), and lack family-centered care (OR=1.74). Non-English-speaking parents were more likely to report having employment consequences (OR=1.94) and spending over $500 out-of-pocket annually on the child's health care needs (OR=1.49). The likelihood of Hispanic children experiencing health care access barriers compared with non-Hispanic children was reduced when language was controlled for and several disparities between Hispanic children and other children became insignificant. CONCLUSIONS: CSHCN with non-English-speaking parents were more likely to be from disadvantaged families and to experience barriers to access than were CSHCN with English-speaking parents. Systems of care for CSHCN should consider the needs and challenges experienced by families whose primary language is not English. [ABSTRACT FROM AUTHOR]

PURPOSE: To examine the association of acculturation, as measured by language spoken at home, with the health, psychosocial, school, and parental risk factors of adolescents of various racial/ethnic groups. METHODS: Using the U.S. component of the 1997-98 World Health Organization Study of Health Behavior in School Children, bivariate and multiple logistic regression analyses were conducted of records for adolescents in four racial/ethnic groups to explore the relationship between the language spoken at home and outcome variables regarding health status and risks, psychosocial and school risk factors, and parental factors. Data were analyzed using Software for the Statistical Analysis of Correlated Data (SUDAAN). RESULTS: Adolescents of all racial and ethnic groups who primarily speak a language other than English at home are at elevated risk for psychosocial risk factors such as alienation from classmates and being bullied, and parental risk factors such as feeling that their parents are not able or willing to help them. Those who speak a combination of languages are also at risk for being bullied and for high parental expectations. Language spoken at home is generally not associated with health and safety measures for adolescents across racial/ethnic groups. CONCLUSIONS: Adolescents whose primary language at home is not English experience higher psychosocial, school, and parental risks than non-Hispanic white English-speakers. New immigrant youths of all races and ethnic groups would potentially benefit from preventive and risk-reduction services. [ABSTRACT FROM AUTHOR]

OBJECTIVE: To examine the prevalence of vitamin-mineral supplement use and its association with sociodemographic, health status, and health behavior characteristics in a nationally representative sample of US women. METHODS: We analyzed the cancer supplement file of the 2000 National Health Interview Survey, which included 11,888 non-Hispanic white, 2866 non-Hispanic black, 3035 Hispanic, and 599 non-Hispanic other women. Bivariate and multivariate analyses were conducted to examine the relationships between sociodemographic, health status, and health behavior characteristics and the use of selected vitamin-mineral supplements. RESULTS: Nearly 60% of US women took at least one supplement in 2000. Logistic regression showed that women who were non-Hispanic white, married, older, more educated, not poor, former smokers, alcohol users, and regular exercisers were significantly more likely to take the most commonly reported vitamin-mineral supplements. Women who were obese or overweight and women who had not had contact with a health professional in the past 12 months were less likely to use supplements. CONCLUSION: Our study suggests high levels of vitamin-mineral supplement use among US women. Supplement use was generally associated with a healthier lifestyle and more resources. Our data suggest the need for public health education on the benefits of age- and health-appropriate use of supplements. [ABSTRACT FROM AUTHOR]

PURPOSE: Low adult supervision during the after-school hours has been associated with numerous problem behaviors among youth. We examined the extent to which this relationship pertains to the evening hours and aggressive behaviors. METHODS: Cross-sectional self-report data were obtained from a nationally representative sample of 14,818 youth in grades 6-10 in the 2001-2002 Health Behaviors of School-aged Children Survey. The relationship between spending evenings out with friends and involvement in problem behaviors was examined using logistic regression analyses. RESULTS: One-fifth of U.S. youth surveyed reportedly spent five or more evenings out with friends each week. After adjusting for grade, race/ethnicity, parental education, parental involvement, and perception of neighborhood safety, boys and girls who reported spending five or more evenings out were 4.3 and 3.1 times, respectively, than boys and girls who spent less than two evenings out, more likely to be involved in four or more physical fights in the past year; 3.0 and 4.0 times, respectively, more likely to have bullied another at least once a week at school; 2.7 and 4.9 times, respectively, more likely to have carried a weapon 6 or more days in the past month; 3.8 and 4.8 times, respectively, more likely to consume alcohol at least once a month; and 3.3 and 7.2 times, respectively, more likely to have smoked every day. CONCLUSIONS: Although the majority of youth who spend most evenings out do not frequently participate in problem behaviors (69.7%), their consistently increased risk for substance use and aggressive behaviors warrants attention. Further examination of specific evening activities, extracurricular involvement, neighborhood context, adult supervision, and parental monitoring is required. [ABSTRACT FROM AUTHOR]