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PURPOSE: To evaluate the test-retest reliability of self-reported sexuality-related data in a sample of African American adolescents residing in four U.S. cities. METHODS: Using audio computer-assisted self-interviewing (ACASI), 156 African American teens (mean age = 15.5 years) provided data on lifetime and recent sexual behavior, HIV/sexually transmitted disease (STD) testing, and theoretical antecedents of sexual risk behavior on two occasions separated by 2 weeks. RESULTS: Most self-reports of lifetime sexual behavior and STD/HIV testing were stable across the two assessment points. Test-retest agreement was substantial for dichotomous indices of lifetime sexual behaviors and STD testing (kappas ranging from .61-.87), and for 3-month recall of vaginal sex (kappa = .72) and number of sexual partners (intraclass correlation coefficient [ICC] = .68). Lower reliability estimates emerged for count data of unprotected vaginal sex occasions (ICC = .44). Test-retest reliability estimates for antecedents of sexual risk behavior were highest for a validated measure of HIV-related knowledge (r = .73), but somewhat lower for peer norms (r = .58) and condom use self-efficacy (r = .50). CONCLUSIONS: Although variability in the stability of self-report data was observed, findings confirm that most sexual behavior, STD and HIV testing history, and psychosocial measures can be assessed reliably among adolescents. Research should continue to identify strategies to enhance the reliability of self-report sexual behavior data from youth at risk for HIV and other sexually transmitted infections. [ABSTRACT FROM AUTHOR]

Objective and Participants: The authors investigated the effect of physical activity (PA), fruit and vegetable intake, and alcohol use on 6-month weight change in 193 college freshmen (78.8% white, 88.2% women, 94.5% on a meal plan). Methods: The authors administered a Web-based survey in fall 2002 (baseline) and spring 2003 (follow-up). Results: There was an overall average weight gain of 2.5 lbs (p < .05), although only 57% reported weight gain (M = 7.1 lbs). Fruit and vegetable intake decreased (p = .034), alcohol use increased (p > .05), and PA was unchanged. Weight gain for students with body mass indexes (BMI) >/=25 kg/m2 was nearly twice that of students with BMIs < 25 (p < .05). Students with low-frequency baseline PA were twice as likely to be overweight. Follow-up data showed that students reporting >/= 4 sessions per week (ie, high frequency) of low-intensity PA were twice as likely to have healthy BMIs as students engaging in low- and moderate-frequency PA. Conclusions: PA interventions should target freshmen with BMIs >/= 25. [ABSTRACT FROM AUTHOR]

OBJECTIVES: To examine the association between depressed mood and clusters of health risk behaviors. METHODS: A nationally representative sample of adolescents (N=15,214) was utilized to construct 10 pseudocontinuous health risk behaviors. Cluster analysis was performed to group adolescents, and subsequent multivariable logistic models were created. RESULTS: Compared to non-risk takers, belonging to risk clusters significantly increased the odds of reporting depressed mood. African Americans in high-risk clusters appeared to be more vulnerable to depressed mood, when compared to remaining racial groups. CONCLUSIONS: Results suggest that adolescents engaging in multiple health-risk behaviors do so in the context of depressed mood. [ABSTRACT FROM AUTHOR]

OBJECTIVES: To examine correlates of self-regulation (personal regulation of goal-directed behavior or performance) for physical activity (PA) in older adults. METHODS: A convenience sample (N=296) of older adults was surveyed (M age=70.4 years). RESULTS: Hierarchical regression analyses revealed current PA engagement and sets of sociodemographic, health-related, and theoretical variables as independent correlates of self-regulation (model R2 = 37%, P < 0.0001). In the final model, female gender, older age, social support, self-efficacy, and greater PA were positive, independent correlates. CONCLUSIONS: Self-regulatory strategies are vital to PA promotion across the life span. Therefore, it is important to understand factors associated with self-regulation and use this information for intervention design and implementation. [ABSTRACT FROM AUTHOR]

OBJECTIVES: To examine the relationship between an aggregate risk score (smoking, drinking, and number of sex partners) and measures of youth assets in a sample of 3439 youth aged 14-18 years. METHODS: Linear regression models for African American and white males and females predicted an aggregate risk score. RESULTS: After adjustments, the youth asset most predictive of risk was self/peer values regarding risk behaviors. Perceived school support was also predictive. CONCLUSIONS: Taking an ecological approach to the measurement of adolescent health behaviors contributes to our understanding of these risk behaviors. [ABSTRACT FROM AUTHOR]

The contribution of the construct of perceived quality of life (PQOL) to adolescent health assessment and promotion is discussed. Theory, measurement, and correlates of PQOL in adolescence are reviewed, with a focus on the incremental validity of PQOL data in relationship to more traditional pathology-based health indices. Similar to Diener's proposal, which pertained exclusively to adults, we call for the inclusion of PQOL data in national databases that monitor adolescent health outcomes. [ABSTRACT FROM AUTHOR]

OBJECTIVES: To assess the prevalence of dieting and investigate clusters of risk behaviors among adolescents. METHODS: Data were secured from a random sample of adolescents (4,636) and analyzed using bivariate methods and logistic regression. RESULTS: From the survey sample, 19.2% adolescents were classified as extreme, 43.2% as moderate dieters, 37.2% as nondieters. Extreme dieters were more likely to use alcohol, cigarettes, and/or marijuana and to attempt suicide and less likely to practice vigorous exercise. Moderate dieters were less likely to use cigarettes, marijuana and more likely to engage in vigorous exercise, with differences across gender-race categories. CONCLUSIONS: Results have relevance for developing multicomponent programs for adolescents. [ABSTRACT FROM AUTHOR]

OBJECTIVE: To demonstrate the differences of 2 approaches to data analysis. METHODS: Using the South Carolina YRBS data, study focused on contingency tables and ANOVA. Additive chi squares are utilized to illustrate information loss when collapsing a contingency table. Odds ratios are derived from contingency tables or logistic regression. Means are utilized in ANOVA. Five measures of life satisfaction were summed to create a pseudo-continuous response variable that was subsequently trichotomized. All predictors are dichotomized risk variables. RESULTS: Chi squares from subtables added exactly to that of the original table measuring lost information. ANOVA conveyed the same clinical message. CONCLUSION: Clinically relevant conclusions might be the same even when drawn from any of several different analyses of the same risk-behavior data. [ABSTRACT FROM AUTHOR]

OBJECTIVE: To explore risk factors and behaviors associated with aggressive and violent behaviors among adolescents. METHODS: A comprehensive review of research literature from various disciplines associated with improving the health and well-being of adolescents. RESULTS: Risk factors and behaviors associated with adolescent aggression and violence are discussed via 6 major factor categories: individual, family, school/academic, peer-related, community and neighborhood, and situational. CONCLUSION: Adolescent aggression and violence develops and manifests within a complex constellation of factors. Prevention intervention efforts should be theory based, multicomponent, and multisystem; they should begin in middle school and continue into high school with a comprehensive evaluation design. [ABSTRACT FROM AUTHOR]

OBJECTIVE: To explore relationships between life satisfaction and violent behaviors among 5,032 adolescents. METHODS: Adjusted polychotomous logistic regression analyses and multivariate models were used via SUDAAN with the 1997 CDC YRBS. RESULTS: Carrying a weapon; carrying a gun; carrying a weapon at school; physical fighting; physical fighting at school; physical fighting that required physician treatment; drinking and driving; riding with a drinking driver; having property stolen/damaged at school; feeling unsafe while at, going to or returning from school; and being injured/threatened with a weapon were associated (p=.05) with reduced life satisfaction. CONCLUSION: Measures of life satisfaction as a component of comprehensive assessments of adolescent violence/aggression in field-work, research, and program-evaluation efforts should be considered. [ABSTRACT FROM AUTHOR]

Objective: To examine physical activity differences between public (PUBHS) and private (PVTHS) high school students (n=6,627). Methods: The 1995 SC Youth Risk Behavior Survey was utilized. Chi-square analyses compared PVTHS and PUBHS students. Results: PVTHS school students reported greater involvement in regular exercise programs (p<.001) and participation on school-based sport teams (p<.001). However, PUBHS school students reported greater participation in physical education (p<.001). PUBHS males participated in more community-based sport programs than did PVTHS males (p<.001); however, PVTHS females participated in more community-based sports than PUBHS males did (p<.001). Conclusion: Significantly different physical activity behaviors exist between PVTHS and PUBHS students in South Carolina. [ABSTRACT FROM AUTHOR]

To examine differences in weight control and nutritional behaviors among public (PUBHS) and private (PVTHS) high school students (n=6,627). Methods: The 1995 YRBS was utilized. Chi-square analyses compared PVTHS and PUBHS. Results: PVTHS females were more likely to diet and exercise than PUBHS females (p less than .01). PUBHS males were more likely to attempt to gain weight than were PVTHS males (p less than .001). PVTHS students were more likely to consume fruit, juice, green salad, and cooked vegetables than were PUBHS students (p less than .001). Moreover, PUBHS students were more likely to consume meat and fried foods than were PVTHS students (p less than .01). Conclusion: PVTHS students may make healthier choices regarding eating compared to those made by PUBHS students. [ABSTRACT FROM AUTHOR]

This study examined differences in selected health risk behaviors among 5,517 students attending public high schools (PUBHS) and 1,089 students attending private high schools (PVTHS) in South Carolina. The 1995 CDC Youth Risk Behavior Survey was used to collect self-report information on adolescent risk behaviors. Chi-square analyses were performed for comparing public and private students on selected risk behaviors. Both PUBHS and PVTHS students reported substantial involvement in most of the risk-taking behaviors examined. PUBHS students, in general, were more likely to report higher prevalence rates than PVTHS students for most of the selected health risk behaviors. However, PVTHS students reported even higher prevalence rates than PUBHS students for alcohol use, driving after drinking, and binge drinking; smoking cigarettes (past 30 days); chewing tobacco (males only); marijuana use during the past 30 days (females only); and use of alcohol or other drugs before last act of sexual intercourse. Results suggest attendance at a private high school is not a panacea for protection against adolescent risk behaviors, and that all high school students could benefit from a coordinated school health program. [ABSTRACT FROM AUTHOR]

This study analyzed the association between physical activity level and cigarette, smokeless tobacco, and marijuana use among a selected group of public high school students from South Carolina (N = 4,800). The 1993 CDC Youth Risk Behavior Survey was used to collect self-report information on physical activity, substance use, and other risk-taking behaviors. Multiple logistic regression analysis for weighted data (SUDAAN) was used for data analysis. Adjusted analysis showed significant associations (p < .05) among White males for use of cigarettes, smokeless tobacco, and marijuana, where higher levels of physical activity were inversely associated to use of these substances. Results from the study substantiate the importance of physical activity for adolescents, and demonstrate the need for future research to clarify the causal relationship between physical activity and substance use behaviors. [ABSTRACT FROM AUTHOR]

Objective: To study smoking experimentation among 374 rural fifth grade students. Methods: A self-report questionnaire was utilized. Results: 26% of males and 16% of females had tried cigarette smoking. In regard to race, 25.2% of whites had tried cigarette smoking compared to 19.6% for blacks. For males, correlates of smoking included greater age, best friend who smokes and having tried alcohol. For females, race (whites>blacks), greater age, father (adult male) who smokes and having tried alcohol were significant correlates of smoking experimentation. Conclusion: Primary prevention efforts for rural preadolescents should begin prior to fifth grade. [ABSTRACT FROM AUTHOR]

The impact of a required college health and physical education course on selected health knowledge, attitudes, and behaviors of alumni was evaluated. The design was a cross-sectional study (mail out/mail back survey) using a stratified random sample of 2,000 college alumni. The overall response rate was 50%. Results were analyzed by college of graduation (college with a required health/physical education course versus no required course). Alumni who took the course were more likely to know their blood pressure, blood cholesterol, and recommended dietary fat intake than the comparison group were. They also reported that the course positively influenced their attitudes toward exercise, eating, and smoking They were more likely to engage in aerobic exercise and less likely to smoke; and they had lower intakes of dietary fat, cholesterol, and sodium. The results suggested that a required college course enhanced selected health-related knowledge, attitudes, and behaviors of alumni. [ABSTRACT FROM AUTHOR]

Objective: To assess the relationship between physical activity and athletic participation levels and body-size perceptions, diet, and weight-control practices among high school students. Methods: Youth Risk Behavior Survey developed by the CDC was randomly administered statewide with 7,846 students responding. Results: Diet quality improved as physical activity and athletic participation increased. Members of all activity categories were significantly more likely than sedentary nonathletes to be trying to lose weight. Conclusion: Young athletes should be encouraged to have realistic body perceptions and weight goals and to engage in healthy weight-loss behaviors if necessary. [ABSTRACT FROM AUTHOR]

This study examined the relationship between adolescent smoking under stress, psychological distress, and social support. Sophomore and junior high school students, N=1,168, completed Derogatis' Brief Symptom Inventory, Spielberger's Anger Expression Scale, and revised version of Coppel's Index of Social Support. White students were more likely to engage in stress-related smoking than were black students (OR=5.74, 95% C.I. [4.00, 8.24]), as were adolescents with higher psychological distress and lower social-support scores. Adolescent smoking prevention and cessation programs should consider incorporating behavioral strategies aimed at coping with psychological distress and strengthening social support as students may smoke in response to stress. [ABSTRACT FROM AUTHOR]

A stratified, random sample of 344 White and Black adolescent females participated in a survey of ideal body size beliefs, which included responses to a questionnaire and a series of nine female and male body size drawings. Using SES and race as independent variables and BMI (kg/m2) as a covariate, Black females preferred a significantly heavier ideal female body size than Whites. They also perceived their parents and both male and female friends would select as ideal a significantly heavier female body size than White subjects. Black subjects' body size preferences were significantly more influenced by family members than were White subjects, who were significantly more influenced by their peer group. These findings suggest a greater social approval of increasing weight and body size for Black adolescent females, a desire for a smaller size by White adolescent females, and cultural differences in the influencing factors that help to communicate these body size preferences. [ABSTRACT FROM AUTHOR]

Purpose: Addressing adolescent sexual risk behaviors in the STI/HIV prevention literature is well documented; however, intervention impacts on life satisfaction are relatively unexplored. This study is a secondary analysis of data (N = 1,658) from a randomized, multisite, multilevel safer sex media campaign (Project iMPPACS) analyzing life satisfaction across baseline and follow-up data collected from 2006 to 2008 among participants (mean age 15.08 years) who reported never having had vaginal sex at baseline (n = 787)., Methods: Participants were separated into groups based on whether they reported having vaginal sex (yes/no) at baseline. Then taking into account the nested study design and controlling for confounders, a mixed model repeated measures analysis of variance assessed whether differences in mean total life satisfaction (LS) were associated across time in the media and nonmedia study conditions separately by gender., Results: A significant interaction between time and media condition was detected (p = .039) where mean total LS increased +.065 units from baseline (M = 5.364) to last contact in media cities and decreased -.084 units from baseline (M = 5.557) to last contact in nonmedia cities when controlling for the effect of initiating vaginal sex. No significant differences in LS at baseline were observed between media and nonmedia intervention cities. Results by gender suggest most positive change in LS was observed for females with mixed findings for males., Conclusions: Although Project iMPPACS was not designed with the intent on improving participants' life satisfaction, results advance the LS literature by demonstrating a temporal sequence for sexual risk taking and LS over time., (Copyright © 2019 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.)

This study identified associations between perceived neighborhood stress and adolescents' perceptions of life satisfaction. African American adolescents aged 13-18 ( n =1,658) from four matched, mid-sized cities in the northeastern and southeastern USA, completed a self-report questionnaire using an audio computer-assisted self-interview (ACASI). Analyses examined relationships between perceived neighborhood stress and perceived life satisfaction, while controlling for socioeconomic status (SES). Life satisfaction was found to be related to neighborhood stress for both males and females, with variability in neighborhood stress characteristics and in the magnitude of associations by gender. Further research should identify the particular characteristics of youth and specific aspects of adolescent life satisfaction associated with perceived neighborhood stress to develop community-based and culturally-sensitive quality of life improvement/health promotion programs., Competing Interests: Conflict of Interest: The authors of this manuscript declare that they have no conflict of interest.

Addressing adolescent sexual risk behaviors in the STI/HIV prevention literature is well documented; however, impacts from interventions on life satisfaction are relatively unexplored. This study examined data (n = 1658) from a randomized, multi-site, multi-level STI/HIV prevention intervention trial (Project iMPAACS) to determine whether increased protective and reduced sexual risk-taking behaviors associated with STI/HIV would also improve self-reported life satisfaction. Taking into account the nested study design and controlling for confounders, a mixed model ANOVA was performed where Total mean life satisfaction scores were analyzed at baseline and 3, 6, 12, and 18 months post-recruitment. Significance levels of 0.05 were used to determine significance and η 2 was used to assess effect size. We hypothesized that as intervention participants engaged in the intentional activity associated with increasing protective behaviors and reducing sexual risk-taking behaviors associated with STI/HIV, life satisfaction reports would also improve over the course of the intervention. A significant main effect for sex was detected ( F = 5.19, p = .02, η 2 = .03), along with three interactions: between experimental condition and media intervention ( F = 7.96, p = .005, η 2 = .04); experimental condition, sex, and media intervention ( F = 6.51, p = .01, η 2 = .04); and experimental condition, sex, assessment point, and media intervention ( F = 3.23, p = .01, η 2 = .02). With the exception of the control condition, female life satisfaction reports improved from baseline assessments to 18-months post-recruitment, whereas male reports decreased. Project iMPPACS was not designed with the intent on improving participants' life satisfaction. However, study results suggest incorporating strategies to address subjective well-being into future adolescent STI/HIV risk-reduction interventions is beneficial for females and additional research is necessary for males., Competing Interests: Conflict of interest This work was partially supported through the iMPPACS network supported by the National Institutes of Mental Health (Grant Number 1-UO1-MH66802; Pim Brouwers, NIMH Project Officer) at the following sites and local contributors: Columbia, SC (MH66803; Robert F. Valois [PI], Naomi Farber, Andre Walker); Macon, GA (MH66807; Ralph J. DiClemente [PI], Gina Wingood, Laura Salazar, Rachel Joseph, Delia Lang); Philadelphia, PA (MH66809; Daniel Romer [PI], Sharon Sznitman, Bonita Stanton, Michael Hennessy, Susan Lee, Eian More, Ivan Juzang, Thierry Fortune); Providence, RI (MH66785; Larry K. Brown [PI], Christie Rizzo, Nanetta Payne); and Syracuse, NY (MH66794; Peter A. Vanable [PI], Michael P. Carey, Rebecca Bostwick).

Objective: Understanding individual level factors associated with sexual risk behaviors among African-American adolescents remains an important public health priority. The current secondary data analysis examined the longitudinal association between a baseline assessment of depressive symptoms and sexual risk behaviors reported 6 months later; the purpose was to determine whether the association of depressive symptoms to risky sex varies as a function of gender. A secondary aim was to examine self-efficacy for sex refusal and condom use assessed at a 3-month follow-up as mediators of the depressive symptoms-sexual risk relationship., Methods: The sample consisted of 782 sexually active African-American adolescents ( M age = 15.3 years, SD = 1.08; 54% female) recruited to participate in a sexual health intervention trial. Data analyses focused on vaginal sex, and outcomes included: (a) sexual activity with 2 or more partners in the previous 3 months; (b) the relative frequency of condom use in the previous 3 months; (c) noncondom use at last occasion of sex; and (d) positive sexually transmitted infection (STI) screening., Results: Depressive symptoms predicted sex with 2 more partners for female participants, but no other risk markers for the sample as a whole. However, there was a significant indirect effect of depressive symptoms on condomless sex via decreased condom use self-efficacy for both male and female adolescents., Conclusions: These findings have important implications for HIV/STI prevention, in which behavioral interventions may benefit from modules that include a focus on the influence of mood on self-efficacy for safer sex practices. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Purpose: To better understand sexual health disparities among African-American sexual minority adolescents., Methods: African-American adolescents (N = 1120; mean age = 15.24 years) were recruited from 4 cities (Columbia, SC; Macon, GA; Providence, RI; Syracuse, NY) to a larger trial. The current analyses used data from the 18-month follow-up when adolescents reported on their sexual partnerships, condom use knowledge, self-efficacy and outcome expectancies for condom use, sexual risk behavior, and STI testing history., Results: Compared with heterosexual adolescents, sexual minority adolescents reported more concerns about potential relationship harms resulting from safer sex negotiation. Sexual minority adolescents were also more likely to engage in riskier sexual behaviors, with females reporting more sexual partners and drug use prior to sex, and males reporting inconsistent condom use and higher rates of HIV., Conclusions: African-American sexual minority adolescents evidence disparities in sexual risk behavior and STI history that appear to result from interpersonal and relationship concerns. These concerns need to be targeted in sexual health interventions for sexual minority adolescents., (Copyright © 2018 National Medical Association. Published by Elsevier Inc. All rights reserved.)

Purpose: To investigate the relationship between selected disordered eating behaviors and self-reported sexual minority status (gay/lesbian, bisexual, and unsure) among a representative sample of high school adolescents., Methods: The 2013 Centers for Disease Control and Prevention (CDC)-sponsored Connecticut Youth Risk Behavior Survey was utilized (N = 2242). Unadjusted and adjusted logistic regression analyses, separated by gender, examined sexual minority adolescents (gay/lesbian, bisexual, and unsure) and selected eating behaviors. Analyses adjusted for race, age, cigarette use, binge drinking, organized school activity participation, body mass index (BMI), and depression., Results: Gay males were significantly more likely to report exercising or eating less to lose weight in the unadjusted models (p < 0.05) and fasting, vomiting, and taking diet pills in both adjusted (p < 0.05) and unadjusted models (p < 0.01) when compared to the referent heterosexual males. Bisexual females were significantly more likely to report fasting, vomiting, and taking diet pills in the unadjusted model (p < 0.05) when compared to the referent heterosexual females and significantly less likely to report exercising or eating less to lose weight in the adjusted models (p < 0.05)., Conclusions: Although additional studies are needed owing to small sample sizes, preliminary findings support previous research suggesting that high school-aged sexual minority youth subgroups are a priority target population for increased efforts to prevent disordered eating.

Background: Health promotion/education strive to promote healthful conditions that improve quality of life 1 based on the perceptions of those whose lives are affected. 2-4 Though health promotion/education might have instrumental value in reducing risks for premature morbidity and mortality, their ultimate value lies in contributions to quality of life. 1 Life satisfaction (LS) has been defined as an individual's assessment of their quality of life based upon personal criteria 5,6 and linked to adolescent health risk behaviors 7,8 and developmental assets. 9 ., Purpose: We investigated the psychometrics of the Brief Multidimensional Students' Life Satisfaction Scale [BMSLSS] with an adolescent sample of African Americans (N=1,658) from four mid-sized cities in the United States (US). Reliability and validity of the BMSLSS has not been determined for samples of exclusively African American adolescents., Methods: Data analysis included calculating mean ratings, standard deviations and effect sizes (Cohen's d ) and inspecting the scale's internal structure, reliability, and relationships to other variables., Results: Evidence of internal structure, internal consistency reliability, and hypothesized relationships to other variables for participants were determined., Translation to Health Education Practice: The BMSLSS is a useful indicator of LS for research and health education assessment purposes among African American adolescents where brevity of psychometric measures is imperative.

Objective: African-American adolescents experience higher rates of sexually transmitted infections (STIs) compared to same-age Caucasian peers. Substance use, sensation seeking, and depression have all been linked to risky sexual practices. Theory suggests that problem-solving skills may help to buffer against these risk factors., Method: To test this hypothesis, we used data from African-American adolescents ( N = 1018; M age = 16.7, SD = 1.1; 58% female) who participated in a prevention trial., Results: Nearly half of the sample (47%) reported lifetime marijuana use, while 13% reported drug use prior to most recent sexual encounter. Sexual sensation seeking was directly associated with drug use prior to sex ( β = 1.13, b = 0.13 ,
SE = 0.02, p < .001) and lower problem-solving skills ( β = -0.08, b = -0.06 ,
SE = 0.02, p = .01). Problem-solving skills were associated with drug use prior to sex ( β = 0.92, b = -0.08 , SE = 0.03, p = .004), such that those with greater problem-solving skills were less likely to report drug use prior to most recent sex. Lastly, problem solving skills mediated the association between sexual sensation seeking and drug use prior to sex, though the effect was small ( β = 0.01, 95% CI: .001, .01)., Conclusions: Problem-solving skills can have a protective influence on risky behavior for adolescents. Future research might examine the utility of strengthening problem-solving skills in order to reduce STI/HIV risk among African American adolescents.

Background: In this cross-sectional study we explored relationships between aggressive and violent behaviors and emotional self-efficacy (ESE) in a statewide sample of public high school adolescents in South Carolina (N = 3836)., Methods: The US Centers for Disease Control and Prevention Youth Risk Behavior Survey items on aggressive and violent behavior items and an adolescent ESE scale were used. Logistic regression analyses and multivariate models constructed separately, revealed significant race by sex findings., Results: Results suggest that carrying a weapon to school (past 30 days) and being threatened or injured with a gun, knife, or club at school (past 12 months) were significantly associated (p < .05) with reduced ESE for specific race/sex groups., Conclusions: Results have implications for school- and community-based mental health services and social and emotional learning and aggression/violence prevention programs for adolescents. Measures of ESE as a component of comprehensive assessments of adolescent mental health, social and emotional learning and aggressive/violent behaviors in fieldwork, research, and program-evaluation efforts should be considered., (© 2017, American School Health Association.)

Researchers examined the association between perceptions of harm from substance use and social self-efficacy (SSE) in a sample of early adolescents in public middle schools ( n = 4,122). One-way analysis of covariance and post hoc tests were used to assess the relationships between perceptions of harm from tobacco, alcohol, marijuana, and cocaine use and SSE while controlling for the effects of grade, sex, race, and socioeconomic status. Effect sizes were calculated from the post hoc comparisons to estimate practical importance. Results suggest that lower perceptions of harm from each examined substance were significantly associated with lower SSE ( p < .0001). Effect sizes were of medium practical importance. Enhancing SSE in early adolescents may be an effective component of interventions designed to reduce perceptions of harm associated and subsequent substance use.

Although emotional disorders and disordered eating behaviors are known to be related, the relationship between emotional self-efficacy (ESE) and disordered eating is unknown. This study examined the relationship between ESE and disordered eating in a statewide sample of public high school adolescents (n=2566). The Centers for Disease Control Youth Risk Behavior Survey and an adolescent ESE scale were utilized. Logistic regression adjusted for key covariates explored the relationship between low ESE and disordered eating among selected race and gender groups. Self-perceived weight as underweight or overweight; and dieting, vomiting or taking laxatives, taking diet pills, and fasting to lose weight were each associated (p<.05) with lower levels of ESE for certain race/gender groups. Findings provide increased justification for tailoring disordered eating interventions and treatments to accommodate the highest risk groups. Measures of ESE should be considered for adolescent mental health assessments in fieldwork, research, and evaluation efforts., (Copyright © 2015 Elsevier Ltd. All rights reserved.)

Background: The new Whole School, Whole Community, Whole Child (WSCC) model, designed to depict links between health and learning, is founded on concepts of coordinated school health (CSH) and a whole child approach to education., Methods: The existing literature, including scientific articles and key publications from national agencies and organizations, was reviewed and synthesized to describe (1) the historical context for CSH and a whole child approach, and (2) lessons learned from the implementation and evaluation of these approaches., Results: The literature revealed that interventions conducted in the context of CSH can improve health-related and academic outcomes, as well as policies, programs, or partnerships. Several structural elements and processes have proved useful for implementing CSH and a whole child approach in schools, including use of school health coordinators, school-level and district-level councils or teams; systematic assessment and planning; strong leadership and administrative support, particularly from school principals; integration of health-related goals into school improvement plans; and strong community collaborations., Conclusions: Lessons learned from years of experience with CSH and the whole child approaches have applicability for developing a better understanding of the WSCC model as well as maximizing and documenting its potential for impacting both health and education outcomes., (© 2015 The Authors. Journal of School Health published by Wiley Periodicals, Inc. on behalf of American School Health Association.)

Research on the relationship between adolescent health risk behaviors, sexual risk behaviors in particular, and perceived life satisfaction is emerging. Some researchers suggest that life satisfaction has been a neglected component of adolescent health research. African American adolescents aged 13-18 (n = 1,658) from four matched, mid-sized cities in the northeastern and southeastern USA, completed a self-report questionnaire via Audio Computer Assisted Self-Interview. Analyses were conducted to examine relationships between perceived difficulty in performing HIV/AIDS preventive behavior and perceived life satisfaction, while controlling for socioeconomic status. Results suggest that perceived life satisfaction is related to perceived difficulty in performing HIV/AIDS preventive behaviors, for both males and females, with variability in the magnitude of associations by gender. Further research is necessary to identify the particular characteristics of youth and specific aspects of adolescent life satisfaction associated with perceived difficulty in performing HIV/AIDS preventive behavior to develop gender-appropriate and culturally-sensitive quality of life/health promotion programs.

Although region and neighborhood condition's effect on HIV/sexually transmitted infection (STI) risk has been studied separately, there is little research examining their interplay. African American adolescents (n = 1,602) from four matched cities in the Northeastern and Southeastern US completed Audio Computer Assisted Self-Interviews and submitted biospecimen samples to detect Sexually Transmitted Infections (chlamydia, gonorrhea, and trichomonas). Logistic and negative binomial regressions determined HIV/STI risk differences by region, neighborhood stress, and stress-region dyads. Northeastern participants demonstrated lower HIV/STI risk while participants from higher stress neighborhoods exhibited greater risk. Relationships between neighborhood condition and ever having anal sex (p < 0.01), anal condom use (p < 0.05), and number of anal partners (p < 0.05) were significant in the Northeast only. Participants in unstressed Northeastern neighborhoods were less likely to have vaginal sex than those in comparable Southeastern neighborhoods (p < 0.05). Participants in unfavorable Northeastern neighborhoods had fewer anal partners than participants in comparable Southeastern neighborhoods (p < 0.01). In concert, neighborhood and region differentially affect HIV/STI risk.

HIV-related stigma undermines HIV prevention, testing, and treatment. Multipronged risk-reduction strategies may reduce stigma among African American adolescents. To test the effectiveness of a risk-reduction strategy in addressing stigma, 1613 African American adolescents from four mid-sized cities participated in a randomized control trial. Participants received a sexual-risk reduction [Focus on Youth (FOY)] or general health curriculum [Promoting Health Among Teens (PHAT)]. Two cities received a culturally-tailored media intervention. Participants completed baseline, 3-, 6-, and 12-month surveys to measure HIV-related stigma and knowledge. Analysis of covariance tested for stigma and knowledge differences by media city status and curriculum/media city status (PHAT media vs. PHAT non-media, FOY media vs. FOY non-media; FOY media vs. PHAT media; FOY non-media vs. PHAT non-media) at each measurement. Hierarchical linear modeling (HLM) determined stigma and knowledge differences over time. Media participants demonstrated greater HIV-related knowledge (p<0.10) at 6 months and lower stigma at 3 months (p<0.10). FOY media participants had lower 3-month (p<0.05) and 12-month (p<0.10) stigma scores than non-media FOY participants. FOY media and non-media participants had greater knowledge than PHAT for all intervals after baseline. FOY media had lower stigma than PHAT media after baseline for all intervals after baseline. HLM indicated greater knowledge slopes for the media group (p<0.05). FOY media participants had greater knowledge slopes (p<0.05) relative to non-media FOY participants and media PHAT participants (p<0.01). A combination of a HIV risk-reduction curriculum and culturally-tailored media demonstrated some effectiveness in reducing stigma. Future use of media in HIV-prevention should include and evaluate effects on stigma.

HIV-related stigma inhibits optimal HIV prevention and treatment among African-Americans. Regional differences in HIV/AIDS prevalence may be related to stigma among young African-Americans. Baseline data (N = 1,606) from an HIV prevention intervention were used to investigate regional differences in HIV-related stigma and knowledge among African-American adolescents in four midsized cities in the Northeastern and Southeastern US. Analyses indicated greater HIV-related stigma among adolescents from the Southeast relative to adolescents from the Northeast (F = 22.23; p < 0.0001). Linear regression indicated a negative relationship between HIV stigma and HIV knowledge (b = -0.65; p < 0.0001). Addressing HIV/AIDS in high prevalence locales should include efforts to reduce HIV-related stigma.

This study examined relationships between emotional self-efficacy (ESE) and alcohol and tobacco use in a statewide sample of public high school adolescents (n = 2,566). The Center for Disease Control Youth Risk Behavior Survey and an adolescent ESE scale were utilized. Logistic regression analyses indicated the presence of any significant race by gender associations between lower ESE and alcohol and tobacco use. Results suggest that alcohol and cigarette use was significantly associated (p ≤ .05) with lower levels of ESE for certain race/gender groups. Results have implications for school- and community-based mental health services and substance use prevention/education programs for adolescents. Measures of ESE as a component of comprehensive assessments of adolescent mental health in fieldwork, research, and substance abuse prevention/education program evaluation efforts should be considered., (© The Author(s) 2015 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.)

Background: Preliminary data were collected to evaluate the psychometric properties of an emotional self-efficacy (ESE) measure in a sample of 3836 public high school adolescents who completed the Centers for Disease Control and Prevention (CDC) Youth Risk Behavior Survey in South Carolina., Methods: Principal axis factor analysis was followed by a 4-way between-groups analysis of variance (ANOVA) testing for differences in total score means on selected demographic estimates and their interactions. Relationships between total score and selected risk behaviors were examined through a series of 1-way ANOVA procedures and subsequent Tukey Honest Significant Difference (HSD) tests., Results: Factor analysis results suggested that a 1-factor model best explained factor structure of the scale items (factor loadings .64 to .71, eigenvalue = 3.24, h(2)  = .46). Girls reported a significantly higher mean total ESE rating than boys; White students reported a significantly higher mean total ESE rating than Black students. Statistically significant lower mean total ESE ratings were also noted for those who reported physical fighting, lifetime alcohol use, and sexual intercourse., Conclusion: This 7-item scale is a reliable measure and could aid school health researchers and mental health practitioners in psychosocial screening and as an outcome of social and emotional learning as a brief measure of adolescent ESE., (© 2013, American School Health Association.)

Background: African Americans are disproportionately affected by cardiovascular disease and cancer. Health promotion interventions hold promise for reducing health disparities., Purpose: Promoting Health Among Teens (PHAT) is a brief, culturally tailored health education intervention to decrease cardiovascular disease and cancer risk for African Americans. This study evaluated the effects of PHAT for African American adolescents ages 14 to 17 in four eastern cities in the USA., Methods: A randomized controlled design (N = 1,654) was used to determine differences in health knowledge, diet, physical activity, and substance use behaviors between PHAT participants and a sexual health promotion control group. Data were collected at baseline, three, six, and twelve months post intervention. Growth curve modeling was used to detect differences in health knowledge, dietary behaviors, physical activity, and substance use between PHAT and control group participants., Results: PHAT participants had significantly greater knowledge gains but modest behavior changes compared to control group participants., Discussion: PHAT is a promising intervention to increase knowledge and address selected health behaviors in African American youth., Translation to Health Education Practice: Future attempts to execute PHAT should continue its emphasis on knowledge building while increasing intervention dosage and modifying length of time for intervention sessions.

Objectives: We estimated the long-term (36-month) effects of Project iMPPACS, a multisite randomized controlled trial of mass media and small-group intervention for African American adolescents., Methods: We collected 6 waves of longitudinal data on program participants aged 14 to 17 years (n = 1139) in Providence, Rhode Island; Syracuse, New York; Columbia, South Carolina; and Macon, Georgia, 36 months (December 2009-December 2010) after the intervention began (August 2006-January 2008). Seemingly unrelated regressions at each wave estimated the effects of 3 types of mass media messages (the thematic mediators: selection, pleasure, and negotiation) on condom use intention and self-reported unprotected vaginal sex events., Results: All 3 mediators of behavior change that were introduced during the media intervention were sustained at the follow-up assessments at least 18 months after the intervention ended, with intention having the largest correlation. Unprotected vaginal sex increased with each wave of the study, although cities receiving media exposure had smaller increases., Conclusions: Project iMPPACS demonstrates that mass media influence delivered over an extended period, when adolescents were beginning to learn patterns of behavior associated with sex, persisted after the media program ended.

This study examined correlates of the discordance between sexual behavior self-reports and Incident Sexually Transmitted Infections. African American adolescent females (N = 964) from four U.S. cities were recruited for an HIV/STI prevention trial. Self-reported sexual behaviors, demographics, and hypothesized psychosocial antecedents of sexual risk behavior were collected at baseline, 6-, 12-, and 18-month follow-up assessments. Urine specimens were collected and tested for three prevalent STIs (chlamydia, gonorrhea, trichomonas) at each assessment. Seventeen percent of participants with a laboratory-confirmed STI reported either lifetime abstinence or recent abstinence from vaginal sex (discordant self-report). Lower STI knowledge, belief that fewer peers were engaging in sex, and belief that more peers will wait until marriage to have sex were associated with discordant reports. Discordance between self-reported abstinence and incident STIs was marked among African American female adolescents. Lack of STI knowledge and sexual behavior peer norms may result in underreporting of sexual behaviors.

HIV-related stigma has been shown to impede HIV-antibody testing and safer sexual practices in adults. Less is known about its effects on prevention programs among at-risk youth. This study examined the longitudinal relationships between HIV-stigma and HIV-knowledge following completion of a validated group-based intervention. Data were provided by 1,654 African-American adolescents who participated in a large multi-city prevention trial (Project iMPACCS). Participants were randomly assigned to an empirically-validated skill-based intervention or a general health promotion control group. Both stigma and knowledge were assessed at baseline and post-intervention. Results suggested that adolescents participating in the intervention showed improvements in knowledge and decreases in stigma when compared to controls. Improvements in stigma appeared to be partly driven by improvements in knowledge. Higher baseline stigma was shown to reduce gains in knowledge in both the treatment and control groups. Results suggest that HIV-stigma can interfere with how youth identify with and internalize messages from group-based prevention trials.

Minority adolescents are affected disproportionately by HIV and STIs, and the Internet is a popular venue to meet sex partners. Little is known about the risks of this behavior for minority adolescents. The majority of studies that have examined sexual risk behavior online or STI/HIV prevention programs online have been among adult MSM. In this study, data from 1,045 African American youth found that 6% met sex partners online and in chat rooms. Odds ratios, adjusting for gender, found this behavior was associated with alcohol (AOR = 2.33, 95% CI [1.1, 4.7]) and drug use (AOR = 3.45, 95% CI [1.9, 6.1]), unprotected vaginal (AOR = 4.71, 95% CI [1.9, 8.4]) and anal sex (AOR = 4.77, 95% CI [1.3,17.1]) in the last 90 days, more lifetime vaginal (AOR = 3.65, 95% CI [2.0, 6.8]) and anal sex (AOR = 2.74, 95% CI [1.5, 4.8]), greater sexual sensation seeking (AOR = 2.92, 95% CI [1.5, 5.7]) and greater depression (AOR = 2.06, 95% CI [1.2, 3.6]. A final multiple logistic regression analyses found that male gender (AOR = 3.13, 95% CI [1.7, 5.8]), drug use at last sex (AOR = 2.41, 95% CI [1.3, 4.5]), lifetime history of vaginal (AOR = 2.90, 95% CI [1.5, 5.5]) and anal sex (AOR = 2.09, 95% CI [1.2, 3.6]), and cocaine use (AOR = 8.53, 95% CI [2.7, 27.3]) were independently associated with having sex with a partner met online. Meeting sex partners online is associated with a variety of risks among African American youth; however, the Internet may be an opportunity for intervention.

Objective: To evaluate the self-rated health (SRH) status among college students who reported receiving the majority of their health-related information from health educators., Participants: Students (n = 49,921) who completed the 2006 National College Health Association survey., Methods: Bivariate associations between SRH and the believability of health information received were analyzed. Multiple logistic regression tested the relationship after covariate adjustment., Results: Although a modest correlation (r = .06, p < .0001) existed between the variables, SRH declined as the believability of health information received from health educators ratings became increasingly unfavorable (χ(2) = 110.96, p < .0001). After covariate adjustment, the relationship persisted with increased odds of reporting fair/poor health for those who reported the health information received from health educators as "neutral" (odds ratio [OR] = 1.31) or "unbelievable" (OR = 2.25) when compared to those who reported the health information received as "believable" (p < .0001)., Conclusions: The field of health education, and health educators, may positively influence college student SRH.

Preliminary data were collected to evaluate the performance of a social self-efficacy measure among 4,061 public high school adolescents. Principal-axis factor analysis was followed by a 4-way between-groups analysis of variance (ANOVA) to test for differences in the Total score means on selected demographic estimates and their interactions. Relations between the Total score and selected risk behaviors were examined through a series of one-way ANOVAs and the Tukey HSD test. Factor analysis results suggested a one-factor model best explained the factor structure of the scale items (factor loading range = .64 - .77, eigenvalue = 4.05, h(2) = .51). Females reported a significantly higher mean Total social self-efficacy rating than males, while White students reported a significantly higher mean Total social self-efficacy rating than Black and Asian students. Statistically significant lower mean Total social self-efficacy ratings were also noted for those who reported physical fighting, avoiding school, and being bullied.

We examined the long-term effects of two interventions designed to reduce sexual risk behavior among African American adolescents. African American adolescents (N = 1383, ages 14-17) were recruited from community-based organizations over a period of 16 months in two northeastern and two southeastern mid-sized U.S. cities with high rates of sexually transmitted infection (STI). Participants were screened for three STIs (gonorrhea, chlamydia, and trichomoniasis) and completed an audio computer-assisted attitude, intention, and behavior self-interview. Youth who tested positive for an STI (8.3%) received treatment and risk reduction counseling. In addition, television and radio HIV-prevention messages were delivered during the recruitment period and 18 months of follow-up in one randomly selected city in each region. Analyses determined effects of the media program for those receiving a positive versus negative STI test result on number of sexual partners and occurrence of unprotected sex. Adolescents who tested STI-positive reduced their number of vaginal sex partners and the probability of unprotected sex over the first 6 months. However, in the absence of the mass media program, adolescents returned to their previously high levels of sexual risk behavior after 6 months. Adolescents who tested STI-positive and received the mass media program showed more stable reductions in unprotected sex. Community-based STI treatment and counseling can achieve significant, but short-lived reductions in sexual risk behavior among STI-positive youth. A culturally sensitive mass media program has the potential to achieve more stable reductions in sexual risk behavior and can help to optimize the effects of community-based STI screening.

Purpose: To test the long-term effects of a mass media intervention that used culturally and developmentally appropriate messages to enhance human immunodeficiency virus (HIV)-preventive beliefs and behavior of high-risk African American adolescents., Methods: Television and radio messages were delivered for more than 3 years in two cities (Syracuse, NY; and Macon, GA) that were randomly selected within each of the two regionally matched city pairs, with the other cities (Providence, RI; and Columbia, SC) serving as controls. African American adolescents, aged 14-17 years (N = 1,710), recruited in the four cities over a 16-month period, completed audio computer-assisted self-interviews at recruitment and again at 3, 6, 12, and 18-months postrecruitment to assess the long-term effects of the media program. To identify the unique effects of the media intervention, youth who completed at least one follow-up and who did not test positive for any of the three sexually transmitted infections at recruitment or at 6-and 12-month follow-up were retained for analysis (N = 1,346)., Results: The media intervention reached virtually all the adolescents in the trial and produced a range of effects including improved normative condom-use negotiation expectancies and increased sex refusal self-efficacy. Most importantly, older adolescents (aged 16-17 years) exposed to the media program showed a less risky age trajectory of unprotected sex than those in the nonmedia cities., Conclusion: Culturally tailored mass media messages that are delivered consistently over time have the potential to reach a large audience of high-risk adolescents, to support changes in HIV-preventive beliefs, and to reduce HIV-associated risk behaviors among older youth., (Copyright © 2011 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.)

Situated within a positive psychology perspective, this study explored linkages between adolescent students' positive subjective well-being and their levels of engagement in schooling. Specifically, using structural equation modeling techniques, we evaluated the nature and directionality of longitudinal relationships between life satisfaction and student engagement variables. It was hypothesized that adolescents' life satisfaction and student engagement variables would show bidirectional relationships. To test this hypothesis, 779 students (53% female, 62% Caucasian) in a Southeastern US middle school completed a measure of global life satisfaction and measures of cognitive, emotional, and behavioral engagement at two time points, 5 months apart. A statistically significant bidirectional relationship between life satisfaction and cognitive engagement was found; however, non-significant relationships were found between life satisfaction and emotional and behavioral student engagement. The findings provide important evidence of the role of early adolescents' life satisfaction in their engagement in schooling during the important transition grades between elementary and high school. The findings also help extend the positive psychology perspective to the relatively neglected context of education.