Search

An editorial is presented in which the authors discuss a strategy for improving physical activity disparities and promoting physical activity for young people by improving access to transportation.

Objectives. We investigated the development of and service utilization at Supporting Positive Opportunities with Teens (SPOT)--a community-based health and social service facility in St. Louis, Missouri, for youths that focuses on increasing HIV and sexually transmitted infection (STI) testing. Methods. We identified the US-based, co-located youth health and social service models that guided the establishment of the SPOT. We analyzed the first 5 years (2008-2013) of service delivery and utilization data. Results. During the study period, the SPOT provided services for 8233 youths in 37 480 visits. The 5 most utilized services included HIV and STI screening, food, transportation, contraception, and case management. A total of 9812 gonorrhea and chlamydia screenings revealed 1379 (14.1%) cases of chlamydia and 437 (4.5%) cases of gonorrhea, and 5703 HIV tests revealed 59 HIV infections (1.0%); 93.0% of patients found to have an STI were treated within a 5-day window. Conclusions. Co-locating health and social services in informal community settings attracts high-risk youths to utilize services and can prove instrumental in reducing STI burden in this population. [ABSTRACT FROM AUTHOR]

The "We Card" program is the most ubiquitous tobacco industry "youth smoking prevention" program in the United States, and its retailer materials have been copied in other countries. The program's effectiveness has been questioned, but no previous studies have examined its development, goals, and uses from the tobacco industry's perspective. On the basis of our analysis of tobacco industry documents released under the 1998 Master Settlement Agreement, we concluded that the We Card program was undertaken for 2 primary purposes: to improve the tobacco industry's image and to reduce regulation and the enforcement of existing laws. Policymakers should be cautious about accepting industry self-regulation at face value, both because it redounds to the industry's benefit and because it is ineffective. [ABSTRACT FROM AUTHOR]

Objectives. We tested the effect of aerobic exercise on autonomic regulation of the heart in healthy young adults. Methods. Healthy, sedentary young adults (n = 149; age = 30.4 ± 7.53 years) were randomized to receive 12 weeks of either aerobic conditioning or strength training. Primary outcomes were heart rate and RR interval variability (RRV) measured before and after training and after 4 weeks of sedentary deconditioning. RRV, a noninvasive index of cardiac autonomic regulation, reflects variability in the intervals between consecutive R waves of the electrocardiogram. Results. Aerobic conditioning but not strength training led to a significant increase in aerobic capacity (3.11 mL/kg/min), a decrease in heart rate (-3.49 beats per minute), and an increase in high-frequency RRV (0.25 natural log msec²), each of which returned to pretraining levels after deconditioning. Significant 3-way interactions, however, revealed autonomic effects only in men. Conclusions. In sedentary, healthy young adults, aerobic conditioning but not strength training enhances autonomic control of the heart, but post hoc analyses suggested that gender plays a significant role in this exercise-related cardioprotection. {Am J Public Health. 2009;99:921-928. doi:10.2105/AJPH.2007.133165) [ABSTRACT FROM AUTHOR]

Objectives. We sought to determine whether adolescents living in households in which smoking was banned were more likely to develop antismoking attitudes and less likely to progress to smoking compared with those living in households in which smoking was not banned. Methods. We completed a longitudinal 4-year, 3-wave study of a representative sample of 3834 Massachusetts youths aged 12 to 17 years at baseline; 2791 (72.8%) were reinterviewed after 2 years, and 2217 (57.8%) were reinterviewed after 4 years. We used a 3-level hierarchical linear model to analyze the effect of a household ban on antismoking attitudes and smoking behaviors. Results. The absence of a household smoking ban increased the odds that youths perceived a high prevalence of adult smoking, among both youths living with a smoker (odds ratio [OR] = 1.56; 95% confidence interval [Cl] = 1.15, 2.13) and those living with nonsmokers (OR = 1.75; 95% CI = 1.29, 2.37). Among youths who lived with nonsmokers, those with no home ban were more likely to transition from nonsmoking to early experimentation (OR = 1.89; 95% CI = 1.30, 2.74) than were those with a ban. Conclusions. Home smoking bans may promote antismoking attitudes among youths and reduce progression to smoking experimentation among youths who live with nonsmokers. [Am J Public Health. 2008;98:1886-1893. doi:10.2105/AJPH.2007, 129320) [ABSTRACT FROM AUTHOR]

Between 1999 and 2001, British American Tobacco, Philip Morris, and Japan Tobacco International executed Project Cerberus to develop a global voluntary regulatory regime as an alternative to the Framework Convention on Tobacco Control (FCTC). They aimed to develop a global voluntary regulatory code to be overseen by an independent audit body and to focus attention on youth smoking prevention. The International Tobacco Products Marketing Standards announced in September 2001, however, did not have the independent audit body. Although the companies did not stop the FCTC, they continue to promote the International Tobacco Products Marketing Standards youth smoking prevention as an alternative to the FCTC. Public health civil society groups should help policymakers and governments understand the importance of not working with the tobacco industry. (Am J Public Health. 2008;98:1630-1642. doi:10.2105/AJPH.2007.129478) [ABSTRACT FROM AUTHOR]

Objectives. Using a community-based participatory research approach, a tribe — university team conducted a formative assessment of local factors that influence youth wellness to guide the design of a culturally and locally relevant health promotion program. Methods. Open-ended interviews with key informants, a school self-assessment using the Centers for Disease Control's School Health Index, and a locally generated environmental inventory provided data that were triangulated to yield a composite of influential factors and perceived need within the community. Results. Family involvement and personal goal setting were identified as key to youth wellness. Supportive programs were described as having consistent adult leadership, structured activities, and a positive local and regional image. Availability of illicit drugs and alcohol, poor teacher attitude, and lack of adult involvement were significant negative factors that impact youth behavior. Conclusions. Local/native (emic) and university/nonnative (etic) perspectives and abilities can be combined to yield a culturally relevant formative assessment that is useful to public health planning. In this collaborative effort, standard means of data collection and analysis were modified in some cases to enhance and build upon the knowledge and skills of community researchers. (Am J Public Health. 2006;96:1623-1628. doi:10.2105/AJPH.2004.054254) [ABSTRACT FROM AUTHOR]

Objectives. This study assessed youth health in the Caribbean Community and Common Market countries and describes the prevalence of health-related factors. Methods. We used a self-administered classroom questionnaire; questions addressed general health, health care, nutrition, sexual history, drug use, mental health, violence, family characteristics, and relationships with others. Results. Most youths reported good health; however, 1 in 10 reported a limiting disability or significant health problems. Violence was a pervasive concern. Of those who reported history of sexual intercourse, many reported that their first intercourse was forced, and nearly half reported that they were aged 10 years or younger when they first had intercourse. Conclusions. Although most young people are healthy, problems indicate the importance of monitoring trends and designing effective youth health programs. (Am J Public Health. 2003;93:1851-1857) [ABSTRACT FROM AUTHOR]

Objectives. This study examines how the American Legacy Foundation's "truth" campaign and Philip Morris's "Think. Don't Smoke" campaign have influenced youths' attitudes, beliefs, and intentions toward tobacco. Methods. We analyzed 2 telephone surveys of 12- to 17-year-olds with multivariate logistic regressions: a baseline survey conducted before the launch of "truth" and a second survey 10 months into the "truth" campaign. Results. Exposure to "truth" countermarketing advertisements was consistently associated with an increase in anti-tobacco attitudes and beliefs, whereas exposure to Philip Morris advertisements generally was not. In addition, those exposed to Philip Morris advertisements were more likely to be open to the idea of smoking. Conclusions. Whereas exposure to the "truth" campaign positively changed youths' attitudes toward tobacco, the Philip Morris campaign had a counterproductive influence. (Am J Public Health. 2002;92:901-907) [ABSTRACT FROM AUTHOR]

Objectives. This study sought to determine the relationships between race/ethnicity, socioeconomic status (SES), and cardiovascular health behaviors among youths and whether neighborhood characteristics are associated with such behaviors independently of individual characteristics. Methods. Linear models determined the effects of individual and neighborhood characteristics (SES, social disorganization, racial/ethnic minority concentration, urbanization) on dietary habits, physical activity, and smoking among 8165 youths aged 12 to 21 years. Results. Low SES was associated with poorer dietary habits, less physical activity, and higher odds of smoking. After adjustment for SES, Black race was associated with poorer dietary habits and lower odds of smoking. Hispanic ethnicity was associated with healthier dietary habits, lower levels of physical activity, and lower odds of smoking than non-Hispanic ethnicity. Low neighborhood SES and high neighborhood social disorganization were independently associated with poorer dietary habits, while high neighborhood Hispanic concentration and urbanicity were associated with healthier dietary habits. Neighborhood characteristics were not associated with physical activity or smoking. Conclusions. Changes in neighborhood social structures and policies that reduce social inequalities may enhance cardiovascular health behaviors. (Am J Public Health. 2002;92:428-436) [ABSTRACT FROM AUTHOR]

This article examines the utility of a health and human lights framework for conceptualizing and responding to the causes and consequences of substance use among young people. It provides operational definitions of "youth" and "substances," a review of current international and national efforts to address substance use among youths, and an introduction to human rights and the intersection between health and human rights. A methodology for modeling vulnerability in relation to harmful substance use is introduced and contemporary international and national responses are discussed. When governments uphold their obligations to respect, protect, and fulfill human rights, vulnerability to harmful substance use and its consequences can be reduced. [ABSTRACT FROM AUTHOR]

Objectives. This report examines (1) the prevalence of psychological and minor physical violence victimization in a nationally representative sample of adolescents and (2) associations between sociodemographic factors and victimization. Methods. Analyses are based on 7500 adolescents who reported exclusively heterosexual romantic relationships in the National Longitudinal Study of Adolescent Health. Items from the Conflict Tactics Scale were used to measure victimization. Associations between victimization patterns and sociodemographic characteristics were assessed with polytomous logistic regression. Results. One third of adolescents reported some type of victimization, and 12% reported physical violence victimization. Although most sociodemographic characteristics were significantly associated with victimization, patterns varied by sex and type of victimization. Conclusions. Psychological and minor physical violence victimization is common in opposite-sex romantic relationships during adolescence. The sex-specific associations between sociodemographic characteristics and patterns of partner violence victimization underscore the importance of pursuing longitudinal, theory-driven investigations of the characteristics and developmental histories of both partners in a couple to advance understanding of this public health problem. (Am J Public Health. 2001;91:1679-1685) [ABSTRACT FROM AUTHOR]

Objectives. We developed a simulation model to predict the effects of policies aimed at reducing smoking initiation by youths younger than 18 years. Methods. The model projected the number of smokers, never smokers, and ex-smokers by age, sex, and racial/ethnic group and the effects of reductions in youth initiation. Results. The model predicted that even if tobacco policies eliminated youth initiation, the number of smokers would not be halved for more than 30 years. If initiation were halved and some of the initiation were delayed rather than eliminated, substantially smaller reductions would result. Conclusions. Policies that increase cessation rates are needed to reduce the number of current smokers and the more near-term health problems. (Am J Public Health. 2000;90:1311-1314) [ABSTRACT FROM AUTHOR]

The present study examined the relationships between exposure to a smoking awareness curriculum, attitudes toward and knowledge about smoking, sociodemographic anti smoking exposure characteristics, and change in smoking starts over three years. During this period, 4.5 per cent of the students decreased their involvement with cigarettes, 56.6 per cent reported no change, and 38.9 per cent reported an increase. Exposure to the curriculum did not bear a significant relationship to change in smoking; however, changes in peer smoking, knowledge, and parental smoking were significant predictors. (Am J Public Health 1981; 71: 1401-1404.) [ABSTRACT FROM AUTHOR]

Abstract: The Family Life Theatre, integrated into the Youth Health Services of a medical institution in a large urban community, has achieved rather unusual success. After seven years of experience marked by a constant quest for improvements, what was started in 1973 as a very modest health education program, through the medium of improvisational theatre, has now become a pilot project, duplicated by many groups and institutions throughout the country. The experiences of the Family Life Theatre, and its multiple ramifications leading to a comprehensive approach to the adolescent health problems, are presented and analyzed in a public health perspective. [ABSTRACT FROM AUTHOR]

Objectives. This study examined the prevalence of various violent behaviors among high school--age adolescents, the co-occurrence of teenage violence with other public health problems, and gender differences in violence. Methods. Longitudinal data for more than 4500 high school seniors and dropouts from California and Oregon were used to develop weighted estimates of the prevalence of violent behavior and its co-occurrence with other emotional and behavioral problems. Results. More than half the sample had engaged in violence during the last year, and one in four had committed predatory violence. Boys were more likely than girls to engage in most types of violence, but both were equally prone to violence within the family. Violent youth were more likely than their peers to have poor mental health, use drugs, drop out of school, and be delinquent. Violent boys were more likely than violent girls to commit nonviolent felonies and sell drugs, but less likely to have poor mental health or become a parent. Prevalence estimates for violence co-occurring with three or more other problems ranged from 4% to 21%. Conclusions. Teenage violence typically coexists with additional emotional and behavioral problems. Programs must consider the broader public health context in which violence occurs. [ABSTRACT FROM AUTHOR]

Objectives. Although interpersonal violence has increased among urban youth, its epidemiology remains unclear. To prevent such violence, identifying the susceptible population is important. Methods. Medical records for 998 patients aged 5 to 25 years at an urban hospital were reviewed to compare date for patients admitted for assault-related injuries, those admitted for unintentional injuries, and those for problems other than injuries. Results. Those initially admitted for treatment of assault were found to be at greater risk of subsequent treatment for assault than those admitted for nonijuries. Conclusions. Admission for injuries caused by violence may increase risk for future assaults; hospitalization may offer an opportunity to interrupt these patterns. [ABSTRACT FROM AUTHOR]

Objectives: This study assessed the self-reported mental health, physical health, and social functioning of young adult political exiles and relates their psychiatric symptoms to their trauma and survival strategies. Methods. A 1992/93 survey of Burmese who fled to Bangkok, Thailand, after participating in a 1988 uprising against Burma's government elicited information on employment, education, disability, trauma, survival strategies, and depressive and post-traumatic stress syndrome. Results. The 104 participants reported a mean of 30 trauma events, including interrogation (89%), imprisonment (78%), threats of deportation (70%), and torture (38%). Many reported poor health and lack of social supports, but few reported substantial social disability. The prevalence of elevated symptom scores was 38% for depressive symptoms and 23% for criterion symptoms of posttraumatic stress disorder. Symptoms of avoidance and of increased arousal were the most strongly related to cumulative trauma. Two survival strategies, camaraderic and a Buddhist concept of self-confidence (weria), were associated with somewhat reduced levels of both classes of symptoms. Conclusions. Burmese political exiles in Thailand are young adults adversely affected by severe trauma. Their psychosocial well-being may deteriorate further without legal protections to reduce the continuing stress and violence. [ABSTRACT FROM AUTHOR]

The article presents research which dealt with the impact of rap music on the health of African American female adolescents. Rap music videos are a media genre that is attracting considerable attention. Level of exposure to rap music videos, the predictor variable was determined by asking adolescents to estimate the number of hours they viewed rap music videos during an average day. Covariates examined included age, employment status, involvement in extracurricular activities, participation in religious events, family composition, and group assignment to either the HIV intervention or the comparison health situation.

Objectives. To inform a prevention strategy, this study determined the prevalence of and attitudes toward smoking among Chinese secondary school students. Methods. Self-completion questionnaires were administered to 13- to 18-year-olds attending school in Zhejiang Province, eastern China. Results. Of the 6674 respondents, 15.9% (25.7% of the boys, 5.4% of the girls) were ever smokers. Only 0.3% were regular smokers. Of the ever smokers, 41.9% had smoked before 10 years of age and 7.9% before 5 years of age. Parental smoking was the strongest predictor of smoking. Conclusions. The very low prevalence of regular smoking found in this age group suggests that prevention programs in school may be beneficial. Parents should be encouraged to adopt more responsible attitudes toward smoking in the home. (Am J Public Health. 2001;91:1653-1655) [ABSTRACT FROM AUTHOR]

Provides information on a study which estimated the prevalence of home pregnancy testing among adolescents. Methodology of the study; Results; Discussion of findings. [ABSTRACT FROM AUTHOR]

Skills intervention to prevent cigarette smoking was evaluated with 689 adolescents. At 24-month follow-up, youths who received health information and skills intervention had lower intentions to smoke and less cigarette use than youths who received health information alone and youths who received no intervention. Conclusions about the effects of skills intervention are strengthened by the common preparation and random assignment of intervention leaders and by process measurement data. (Am J Public Health 1985; 75:665-667.) [ABSTRACT FROM AUTHOR]

This section provides information on models for partnerships between public health and community organizations to increase health services to populations at risk for sexually transmitted diseases (STD). Persons at risk for STD face barriers in gaining access to health services, including limited understanding of the structure of the services, lack of insurance and distrust of providers. The Denver Gonorrhea Community Action Project (GCAP), administered by the Denver Department of Public Health, has formed a partnership with a community organization serving homeless youths that provides limited health services supervised by volunteer physicians. Other partners included a state-funded juvenile detention facility and a county jail, both with in-house nurse practitioners. Meanwhile, the Saint Louis GCAP, administered by the Division of Infectious Diseases of the Washington University School of Medicine, implemented regular screenings at 20 community organizations. In many cases, GCAP staff formed partnerships with local AIDS organizations and the Saint Louis Department of Health to offer ligase chain reaction screening and STD education in addition to HIV screening and educational efforts already ongoing in these sites. Finally, a third model is one in which staff at community organizations and establishments had no clinical skills but were interested in conducting screening and becoming a resource for STD prevention. In Denver, staff at an after-hours club, a place for youth to hang out in a safe environment, were interested in offering regular screenings.

The article reports on a local community project based on tobacco use among youth in Larimer County, Colorado. The Larimer County Tobacco Access and Youth Project makes a collaboration between public health officials, citizen activists, voluntary organizations, and a community coalition helped create new local laws to regulate the sale and use of tobacco products by minors in 3 cities in Larimer County. The project began after the Larimer County Department of Health and Environment discovered that the state law regulating the sale of tobacco to minors was ineffective. A strategy to address this problem was developed and used in the city of Loveland. The successful strategy was subsequently modified to meet the unique needs and characteristics of each of the other 2 cities, Fort Collins and Estes Park. The first step in the process was to identify the city's power structure and mode of operations for passing ordinances and to organize advocates. The second step was to establish a working relationship with the law enforcement establishment. The third step was documenting need for an ordinance to prevent tobacco sales to minors. The impact on the Loveland community has been positive. Compliance checks showed that tobacco sales to minors dropped to 14% shortly after the ordinance was passed and then to 5.8% after 1 year.

The article considers the grants provided by the Massachusetts Tobacco Control Program to local health departments to adopt and enforce regulations prohibiting the distribution of tobacco to minors. Communities which enforced these regulations followed several steps. First, they conducted compliance test, in which an underage youth enters a place of business to purchase tobacco while an adult supervisor waits outside. Second, the communities conduct surveillance of every tobacco vendors. And third, reinspecting violators. The key to all these enforcement is the participation of the youths themselves.

The article reflects on the various efforts toward prevention of smoking among adolescents. It discusses the papers published within the issue which focus on smoking among teenagers while emphasizing the positive result brought by smoking cessation programs and health risk assessment in improving the health of the youth.

The article discusses the provisions on health of school-age children by the American Public Health Association in the U.S. The organization asserted that the basic purpose of school health services is to boost the educational operations by improving the health conditions of children and youth. It also recognizes the need for physical, emotional, psychological and educational growth of individuals aged 3 to 21 years. Among the influential factors include comprehensive school health care providers, parents and community