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Background: Yuva Spandana (YS) is a unique community-based youth mental health promotion program implemented across Karnataka., Objective: We assessed factors affecting PD among the population served by YS between January 1, 2017, and December 31, 2021., Materials and Methods: A retrospective cross-sectional analysis was done utilizing the visit forms of 10,340 YS's care recipients. A conceptual framework was developed, and all hypothesized variables within this framework were considered exposures. All exposure variables significant at P < 0.10 in univariate analysis were included in multivariable analysis. Multivariable logistic regression analysis was performed by including each of the significant potential exposure variables from univariate analysis using a forward-stepping process., Results: Care recipients with health and lifestyle issues were at almost two times increased risk for PD (adjusted odds ratio [AOR] =1.74 and 95% confidence interval [CI] - 1.52-2.00), and those with self-development issues were almost 2.5 times more likely to have PD (AOR = 2.44 and 95% CI - 2.12-2.79). Those who reported emotional statuses of feeling worried, lost, incapable, lonely, and distrusting were at 21.4, 3.5, 26.3, 37.9, and 4.7 times higher odds of having PD, respectively., Conclusions: Isolating the risk factors associated with PD will help tailor the mental health promotion provided by YS to at-risk groups., (Copyright © 2023 Copyright: © 2023 Indian Journal of Public Health.)

A unique youth mental health promotion program called Yuva Spandana is implemented and functional across all districts within Karnataka. Trained guidance providers named Yuva Parivarthakas (YPs) and Yuva Samalochakas (YS) provide support to youth having issues at Yuva Spandana Kendras (YSKs). We highlight the process of development of the program "Yuva Spandana" into a sustainable community-based youth mental health promotion model addressing youth issues across Karnataka and describe the profile of beneficiaries attending YSKs in Karnataka between 2017 and 2019. Yuva Spandana has evolved over time and got established in local-self-governments and communities., Competing Interests: None

Objective: To assess the population-level impact of "Avahan," the India AIDS Initiative of the Bill & Melinda Gates Foundation, between 2003 and 2008 in Karnataka state, India., Design: Secondary data analysis using all consistent data collection sites from antenatal clinic (ANC) sentinel surveillance data from 2003 to 2008 in Karnataka., Methods: A multilevel logistic regression model considering individual- and district-level variables was developed to compare time trends in HIV prevalence among young ANC women (younger than 25 years of age) between Avahan (18) and non-Avahan (9) districts. District-level random effects were considered for the intercept and time. The impact was assessed using interaction terms between district type (Avahan vs. non-Avahan) and time. The number of cases averted was estimated, comparing predicted ANC HIV prevalence in the presence versus the absence of Avahan. Data from the National Family Health Survey Round 3 (2006) were used to extrapolate these numbers to the general population., Results: HIV prevalence among young ANC women declined from 1.46% (2003) to 0.83% (2008). The HIV prevalence trend was significantly different between Avahan and non-Avahan districts (P = 0.046). Overall, 87,035 cases of HIV infection were estimated to have been averted in the Karnataka general population because of Avahan during the 2003-2008 period (range under varying assumptions: 55,160-150,784)., Conclusions: Our results suggest that Avahan has had a significant impact on the HIV epidemic in the general population of Karnataka. These results suggest that targeted interventions similar to Avahan should be implemented and scaled up in all concentrated and mixed HIV epidemics.

Background: Sensitization plays a pivotal role in raising awareness about critical youth issues and encouraging them to access support services, contributing to the success of programs like Yuva Spandana, a youth-centric mental health promotion initiative in Karnataka, India. For youth to access support within YSKs, the quality and effectiveness of sensitization programs (SPs) are crucial. A standard quality assessment through indicators for SPs is required to provide recommendations for improvement. To enlist quality indicators and assess the quality of SP conducted under Yuva Spandana (YS) program across Karnataka. Material and Methods: We performed secondary data analysis (utilizing data available within the computerized management information system over 5 years; 2017-2022) and direct/in-person observation of SPs (by the researcher and the core team of YS between June and July 2022 using a specifically developed checklist). Quality indicators were developed using a process of consensus building. Each attribute within the checklist was scored, and a composite mean score and mean percentage scores for quality were calculated. Results: Overall, 33257 SP reports and 31 in-person SPs were assessed. A total of 36 quality indicators (10 quality indicators based on SP reports and 26 based on in-person observation) were developed. The average quality score of report-based SPs was 10.93 (±2.59; range 1-20) and in-person assessment was 63.06 (±6.61; range 50-73). Conclusion: The study emphasizes the importance of addressing all youth issues, including sensitive topics like gender, sex, and sexuality, to ensure a holistic approach to youth mental health. Challenges faced during program execution and the distribution of Information, Education, and Communication (IEC) materials also contribute to program quality. This research offers valuable insights for improving the conduct of SPs, enhancing youth access to services, and guiding future community-based health promotion initiatives. [ABSTRACT FROM AUTHOR]

Introduction: Indian National Mental Health Survey reports an alarming prevalence of 20.9% for tobacco dependence in India. Dependence on smoked tobacco can be prevented by thorough knowledge of the risk factors associated with it. Objectives: To estimate the prevalence and identify the factors associated with smoked tobacco dependence among participants attending the life skills training and counselling services programme (LSTCSP) across Karnataka from 2017 to 2022. Materials and Methods: Pretraining data of 3104 participants from training programmes between 2017 and 2022 were utilised. Univariate and multivariable logistic regression analysis was performed based on a conceptual framework with various hypothesised exposure variables and smoked tobacco dependence as outcome. Results: The overall prevalence of smoked tobacco dependence among LSTCSP participants who used smoked tobacco products was 59.4%. Ever use of smokeless tobacco products (Adjusted odds ratio (AOR) =2.05, 95% CI: 1.11–3.78) and screening positive for symptoms of generalised anxiety (AOR = 2.53, 95% CI: 1.32–4.84) significantly increased the odds of smoked tobacco dependence, whereas making decisions collectively in the family (AOR = 0.35, 95% CI: 0.18–0.66) and individuals with increased score for neurotic personality traits (AOR = 0.64, 95% CI: 0.44–0.93) were the factors associated with reduced odds of smoked tobacco dependence. Conclusion: The identified risk factors associated with smoked tobacco dependence are important to develop tobacco control programmes as well as in preventing its onset. With the risk factors for smoked tobacco dependence identified, the results of this study have implications for health promotion and prevention programmes as well as cessation programmes related to smoked tobacco dependence, within India and similar countries. [ABSTRACT FROM AUTHOR]

Background: Suicidality among youth is one of the most challenging public health issues. A thorough understanding of the risk factors that contribute to youth suicidality is necessary. The main aim of the study is to estimate the proportion of suicidality and understand factors associated with suicidality amongst clients attending youth mental health promotion clinics in Karnataka, India. Methods: A retrospective cross-sectional case record analysis was performed utilising data from real-time digitised management information system specifically developed for the programme. All case records of clients aged 15 to 35 years who received mental health promotion (MHP) services between January 2017 and December 2020 across 30 districts of Karnataka were included in this analysis. Multivariate logistic regression analysis was performed with suicidality among clients as outcome. Socio-demographic characteristics, issues reported, feelings/emotions that indicate underlying mental health issue/crisis, being aware of suicidality among friends and family and personal habits (smoking/chewing tobacco and drinking alcohol) were considered potential exposure variables. Findings: Overall proportion of suicidality among youth presenting to youth mental health promotion clinics in Karnataka was 3.5% (357/10,340). Among factors associated with suicidality, the strongest association was found among those clients who reported attempted suicide among friends (AOR 8.94; 95% CI 5.95–13.45), family members (AOR 5.50; 95% CI 3.66–8.29), being anxious (AOR 4.90; 95% CI 3.43–6.99), inability to trust anyone (AOR 4.07; 95% CI 2.75–6.03), had issues of Gender, Sex and Sexuality (AOR 3.16; 95% CI 1.93–5.17) and relationship issues (AOR 2.77; 95% CI 2.05–3.73). Conclusion: The results alert all institutions, organisations and departments that cater to services and development of youth, to be sensitive towards risk factors of suicidality. The study advocates youth mental health promotion clinics to be equipped with measures/interventions to identify and manage such risk factors. This study has implications for Youth mental health promotion in India and other similar South-East Asian countries. [ABSTRACT FROM AUTHOR]

Promoting positive identity and seeking early support for gender, sex and sexuality (GSS) issues among youth is vital. Understanding and addressing factors associated withGSS among them is critical. We assessed four-year case records (January 2017-December 2020) of all first visit youth mental health promotion clinic (YMHPC) clients (15-35 years) for factors associated with GSS issues in Karnataka. Overall, prevalence of GSS issues was 1.8% (189/10,340). Increased risk of GSS issues was observed among clients reporting suicidality (AOR = 4.27, 95% CI = 2.70-6.74) and relationship issues (AOR = 3.63, 95% CI = 2.36-5.57), followed by issues of safety (AOR = 2.56, 95% CI = 1.72-3.81), personality (AOR = 2.48, 95% CI = 1.60-3.85), health and lifestyle (AOR = 2.27, 95% CI = 1.77-4.19), smokers (AOR = 2.30, 95% CI = 1.24-4.27), and those who felt depressed (AOR = 2.10, 95% CI = 1.43-3.09) and worthless (AOR = 2.08, 95% CI = 1.28-3.39). Clients aged 21-25 years (AOR = 1.80,95% CI = 1.27-2.54), male (AOR = 1.72, 95% CI = 1.20-2.46) and who had been married (AOR = 2.32, 95% CI = 1.51-3.57) had a higher risk of GSS issues than those aged 15-20 years and other counterparts, respectively. Clients who drank alcohol (AOR = 0.49, 95% CI = 0.30-0.81) had reduced risk of GSS issues. The findings re-iterate the importance of early recognition of factors (essential precursors) of GSS issues among youth. The study highlights the importance of promoting awareness and improving primordial prevention of possible GSS issues in later life. This study has important implications on youth mental health promotion programs, especially in countries like India. [ABSTRACT FROM AUTHOR]

Background: A key component of prevention programmes aimed at reducing the risk of HIV and sexually transmitted infections (STI) among high-risk groups such as female sex workers (FSW) is the provision of quality STI services. The attitudes and practices of care providers are critical factors in the provision of services and in achieving better participation of high-risk individuals in accessing services. Objectives: To assess the attitudes and practices of STI care providers towards FSW, and the perceptions of FSW towards STI services, following training. Methodology: After an intensive physician capacity building programme, 393 exit interviews of FSW were conducted following clinical encounters, and discussions were held with 131 STI care providers (physicians) across several districts in Karnataka. Focus group discussions were held among FSW to understand the perceptions of non-users of services. Results: 60% of women reported that the clinics were accessible. 76% of the women who visited clinics for STI consultations were offered a speculum examination. 85% received a condom demonstration, but only 52% were advised for partner treatment. 69% of women were referred for HIV testing. 79% of physicians felt that sex workers were responsible for spreading HIV in the community, and 47% believed that sex work should be banned to control HIV. Conclusions: Following physician training, quality of care appears to be generally acceptable, but it is important to improve further the attitudes of providers towards sex work, and improve practices such as speculum examination and partner referral that can enhance quality of care. [ABSTRACT FROM AUTHOR]