School health promotion and fruit and vegetable consumption in secondary schools: a repeated cross-sectional multilevel study.

BACKGROUND: Worldwide, recommendations for fruit and vegetable consumption are not met, which can cause chronic diseases. Especially adolescence is an important phase for the development of health behaviours. Therefore, in the Netherlands, the Healthy School program was established to aid schools in promoting healthy lifestyles among their students. We examined to what extent the variation between secondary schools regarding students' fruit and vegetable consumption could be explained by differences between schools regarding Healthy School certification, general school characteristics, and the school population. Additionally, we examined whether Healthy School certification was related to the outcomes, and whether the association differed for subgroups. METHODS: We performed a repeated cross-sectional multilevel study. We used data from multiple school years from the national Youth Health Monitor on secondary schools (grades 2 and 4, age ranged from approximately 12 to 18 years) of seven Public Health Services, and added data with regard to Healthy School certification, general school characteristics and school population characteristics. We included two outcomes: the number of days a student consumed fruit and vegetables per week. In total, we analysed data on 168,127 students from 256 secondary schools in the Netherlands. RESULTS: Results indicated that 2.87% of the variation in fruit consumption and 5.57% of the variation in vegetable consumption could be attributed to differences at the school-level. Characteristics related to high parental educational attainment, household income, and educational track of the students explained most of the variance between schools. Additionally, we found a small favourable association between Healthy School certification and the number of days secondary school students consumed fruit and vegetables. CONCLUSIONS: School population characteristics explained more variation between schools than Healthy School certification and general school characteristics, especially indicators of parental socioeconomic status. Nevertheless, Healthy School certification seemed to be slightly related to fruit and vegetable consumption, and might contribute to healthier dietary intake. We found small differences for some subgroups, but future research should focus on the impact in different school contexts, since we were restricted in the characteristics that could be included in this study.

The relationship between physical activity and the health of primary and secondary school teachers: the chain mediating effects of body image and self-efficacy.

BACKGROUND: Active health is a new concept, model, and system to maintain the state of whole-person health. In the context of the increasingly serious health problems of primary and secondary school teachers, it is of great significance to explore the relationship between physical activity and primary and secondary school teachers' health based on the active health perspective. METHODS: The survey involving 741 primary and secondary school teachers across representative provinces in China utilized the International Physical Activity Scale, Body Imagery State Scale, and General Self-Efficacy Scale. Data analysis employed SPSS 25.0 and Amos 24.0 software. RESULTS: While no significant gender disparities were observed in body image and self-efficacy, age groups exhibited a bipartite and "V" shaped distribution. Female teachers demonstrated higher physical activity levels (2456.46) and superior physical fitness compared to males (2297.86). A positive correlation emerged between physical activity, body image, self-efficacy, and health status. Importantly, body image and self-efficacy partially mediated the relationship between physical activity and health status, accounting for 82.31% of the total effect. CONCLUSIONS: Primary and secondary school teachers have real problems such as teachers' physical activity is generally insufficient, teachers' body image status is generally poor, and teachers' self-efficacy is low; physical activity is an important factor in promoting primary and secondary school teachers' health status, and low, medium, and high levels of activity all have a promoting effect on the health of primary and secondary school teachers, and the more active primary and secondary school teachers are in terms of physical activity, the better their body image, self-efficacy, and health status are, and the more active primary and secondary school teachers are in terms of physical activity, the more positive the physical activity, self-efficacy, and health status are. The more physically active primary and secondary school teachers are, the better their physical intention, self-efficacy and health status are. SUGGESTIONS: improve the quality and effectiveness, promote the concept of active health among teachers; empower teachers, strengthen the institutional protection of teachers' health; reduce the burden and increase the quantity,and optimise the supply of health services for teachers.

The Mentors in Violence Prevention programme: impact on students' knowledge and attitudes related to violence, prejudice, and abuse, and willingness to intervene as a bystander in secondary schools in England.

BACKGROUND: Violence is a leading cause of death and disability for young people and has serious impacts on prospects across the lifecourse. The education sector is a crucial setting for preventing youth violence through incorporating programmes that address attitudes and behaviours. The Mentors in Violence Prevention (MVP) programme aims to change harmful attitudes and norms, and increase non-violent bystander intervention, through a peer mentoring approach. To date there is limited evidence on the effectiveness of the intervention in UK school settings. The aim of the current study was to evaluate the impact of the programme on students' attitudes and knowledge related to violence prevention. METHODS: The study employed a mixed methods design. Pre and post surveys measured changes in students' (aged 11-18) attitudes and knowledge related to violence prevention and bystander behaviour, gender stereotyping, acceptability of violence, and perceptions of others' willingness to intervene. Interviews/focus groups with programme delivers and students, and anonymised programme data were used to explore and supplement survey findings. RESULTS: Overall, perceptions of the programme content and delivery were positive. Several beneficial impacts of the programme were found for mentors (students delivering the programme), including significant positive changes on measures of knowledge and attitudes towards violence prevention and the bystander approach, acceptability of violence perpetration, and perceptions of other students' willingness to intervene (effect sizes were small-medium). However, the study found no significant change on any of the outcomes amongst mentees (younger students receiving the programme from mentors). Despite this, qualitative evidence suggested mentees enjoyed the content of the programme and the peer-led delivery, and this built relationships with older students. Qualitative evidence also identified additional benefits of the programme for mentors, including leadership and communication skills, and increased confidence and supportive relationships. CONCLUSIONS: Evidence from this study suggests MVP is effective as a targeted programme for mentors, but no significant evidence was found to demonstrate its effectiveness as a universal bystander and violence prevention programme for mentees. Whilst further research with more robust study design is needed, developing mentors as leaders in violence prevention is a valuable impact of the programme in its own right.

Nutritional improvement status of primary and secondary school students in the pilot nutrition improvement areas of Hainan, China from 2014 to 2021.

OBJECTIVE: By meticulously tracking the evolving growth, development, and nutritional status of primary and secondary school students in Qiongzhong County from 2014 to 2021 post-implementation of the "Nutrition Improvement Program for Rural Compulsory Education Students"(NIPRCES, This project provides a supplementary food allowance of at least ï¿¥4 per person per day for primary and secondary school students. The project area undergoes annual routine monitoring.), this study aims to offer a scientific basis for enhancing and promoting the project. Through thorough monitoring of students' nutritional status changes influenced by this program, we strive to establish a comprehensive and evidence-based framework for its future advancement. METHODS: From 2014 to 2021, this study employed a multi-stage sampling method utilizing cluster sampling to select six primary and six secondary schools in Qiongzhong County, Hainan Province. Data on the growth and development of respondents were collected. This cohort was a dynamic cohort with a total of 18,762 final data recovered. The prevalence of malnutrition was evaluated using the Cochran Armitage Trend Test (CATT) to assess year-to-year changes. Furthermore, height/weight and the prevalence of malnutrition between groups were compared using the t-test, χ2 test, and Bonferroni's corrected analysis. RESULTS: The average height of both boys and girls has increased. In 2021, boys and girls of all ages showed an average height increase of 2.31 cm and 1.98 cm, respectively, compared to 2014. Nevertheless, the growth and development levels, and rate of improvement of these students remain comparatively lower than their rural counterparts across China, who are of the same age. From 2014 to 2021, the prevalence of undernutrition (mainly wasting) showed a significant downward trend (P < 0.05) from 29.30% to 22.19%, and the prevalence of overnutrition showed an upward trend (both P < 0.05). The prevalence of undernutrition was higher among boys, students in grades 1-3 and those of Li nationality. Meanwhile, the prevalence of overnutrition was higher among boys, students in grades 1-3 and those of Han nationality. CONCLUSIONS: Over the 8-year period of NIPRCES, there has been progress in the growth and development of students, yet levels still lag behind the national average for rural students of the same age. While malnutrition prevalence have decreased, they remain high, with a concerning rise in overnutrition prevalence. Undernutrition and overweight/obesity are more prevalent among boys and younger students. Li students show higher prevalence of undernutrition, while overnutrition is a growing issue among Han students. Simultaneously, local education and health care departments must acknowledge the disparities in growth and nutritional status among primary and secondary school students residing in rural areas within the tropics and those in rural areas across the entire nation. Nutritional improvement measures should be tailored to local conditions.

Inability to start or complete upper secondary school strongly predicts unemployment and psychosocial and psychiatric adversities - A register-based follow-up study from southwestern Sweden.

AIM: To study academic, social and psychiatric outcomes among adults in the general population in southwestern Sweden. Groups of individuals born in 1998 and ineligible, eligible but not completed, and eligible and completed upper secondary school were followed in 2020. METHODS: Data were retrieved from Statistics Sweden, the Swedish National Agency for Education, the Longitudinal Integrated Database for Health Insurance and Labour Market Studies, the Swedish National Crime Register and the National Patient Register. The four adverse outcomes neither engaging in post-secondary studies nor having a regular salary, needing social benefits, having any criminal conviction, and having a psychiatric disorder at age ≥16 were examined. RESULTS: Of the final sample of 2706 individuals who had attended 9th grade of compulsory school in 2014, 273 (10%) were ineligible for upper secondary school. Of eligible individuals, 82 (3%) never started, 282 (10%) did not complete and 2065 (77%) completed upper secondary school. Compared with completers, the odds ratios for adverse outcomes were markedly increased for all other groups up to 22 years old. CONCLUSION: Inability to start or complete upper secondary school strongly predicted unemployment and psychosocial and psychiatric adversities. School authorities should consider offering vocational programmes post compulsory school without grade restrictions.

Curriculum-based sexual and reproductive health education: revealing its relevance for risky sexual behaviors among secondary school students in Mwanza, Tanzania.

BACKGROUND: Secondary school students are vulnerable to risky sexual behaviors (RSBs) which may lead to adverse health consequences, such as teenage pregnancies and sexually transmitted diseases (STDs), including HIV/AIDS. In Tanzania, the burden of teenage pregnancy was reported to be 27% in 2016. The integration of sexual and reproductive health (SRH) education into the school curriculum is one of the proven crucial interventions. However, there is limited information on the extent to which curriculum-based SRH education is relevant for fostering good practices for coping with RSBs. This study sought to describe students' and teachers' perceptions of the relevance of curriculum-based SRH education. METHODS: A qualitative study was conducted from May to June 2020 (involving 5 secondary schools in Ilemela district, Mwanza, Tanzania). In-depth interviews (30) were conducted among secondary school students and 10 interviews for teachers. The data were collected in Swahili and then transcribed and translated into English after which thematic content analysis was performed. RESULTS: The majority (56%) of secondary school students were revealed to have a limited understanding of curriculum-based SRH education, which was limited to a few aspects of health that involved married people and pregnant women. Teachers of different subjects had different perceptions about the relevance of curriculum-based SRH education. Civics teachers had the perception that it was relevant and enough, while Biology teachers thought that it was not enough. Students reported utilizing the information taught in class to manage and navigate RSBs. Moreover, they expressed a need for additional delivery strategies to be used for a comprehensive understanding of sexual and reproductive health. CONCLUSION: Despite the identified gaps in providing a comprehensive knowledge that builds on the appropriate attitudes and skills, the existing curriculum-based SRH education in secondary schools was utilized to help students in addressing and managing RSBs. However, there is a need for more comprehensive information and an improved delivery approach for SRH to equip students with the necessary skills when faced with RSBs.

Sexual and reproductive health (SRH) education integrated into school curricula has proven effective in addressing risky sexual behaviors (RSBs) among in-school adolescents. Adolescents attending secondary schools, are susceptible to RSBs such as early sexual activity, multiple partners, unprotected intercourse, and unsafe abortions, leading to adverse health outcomes such as teenage pregnancies and HIV/AIDS. Despite the integration of SRH education into secondary school syllabi, these behaviors are still evident among students. There is a lack of data on the impact and relevance of curriculum-based SRH education on RSBs. To explore the relevance and effectiveness of SRH education in addressing RSB patterns, in-depth interviews were conducted among secondary school students and civics and biology teachers focusing on their perceptions and practical outcomes of SRH education in reducing RSBs. After conducting a thematic content analysis three main themes were discovered: (1) Student's understanding of curriculum-based SRH education in coping with RSBs (2), Perceptions of curriculum-based SRH education in coping with RSBs and (3) Utilizing curriculum-based SRH education in coping with RSBs. Majority of secondary school students (56%) had a limited understanding of SRH narrowed to aspects concerning married individuals and pregnancy. Teachers provided varying opinions regarding the efficacy of curriculum-based SRH education, with Civics instructors believing there is relevance while Biology teachers considered it limited. Students acknowledged using the available knowledge to address RSBs but expressed a desire for supplementary strategies to achieve a more thorough understanding of SRH. Improving the SRH education provided in schools will help reduce the consequences of RSBs.

Long-Term Effectiveness of a Multi-Strategy Choice Architecture Intervention in Increasing Healthy Food Choices of High-School Students From Online Canteens (Click & Crunch High Schools): Cluster Randomized Controlled Trial.

BACKGROUND: School canteens are a recommended setting to influence adolescent nutrition due to their scope to improve student food choices. Online lunch ordering systems ("online canteens") are increasingly used and represent attractive infrastructure to implement choice architecture interventions that nudge users toward healthier food choices. A recent cluster randomized controlled trial demonstrated the short-term effectiveness (2-month follow-up) of a choice architecture intervention to increase the healthiness of foods purchased by high school students from online canteens. However, there is little evidence regarding the long-term effectiveness of choice architecture interventions targeting adolescent food purchases, particularly those delivered online. OBJECTIVE: This study aimed to determine the long-term effectiveness of a multi-strategy choice architecture intervention embedded within online canteen infrastructure in high schools at a 15-month follow-up. METHODS: A cluster randomized controlled trial was undertaken with 1331 students (from 9 high schools) in New South Wales, Australia. Schools were randomized to receive the automated choice architecture intervention (including menu labeling, positioning, feedback, and prompting strategies) or the control (standard online ordering). The foods purchased were classified according to the New South Wales Healthy Canteen strategy as either "everyday," "occasional," or "should not be sold." Primary outcomes were the average proportion of "everyday," "occasional," and "should not be sold" items purchased per student. Secondary outcomes were the mean energy, saturated fat, sugar, and sodium content of purchases. Outcomes were assessed using routine data collected by the online canteen. RESULTS: From baseline to 15-month follow-up, on average, students in the intervention group ordered significantly more "everyday" items (+11.5%, 95% CI 7.3% to 15.6%; P<.001), and significantly fewer "occasional" (-5.4%, 95% CI -9.4% to -1.5%; P=.007) and "should not be sold" items (-6%, 95% CI -9.1% to -2.9%; P<.001), relative to controls. There were no between-group differences over time in the mean energy, saturated fat, sugar, or sodium content of lunch orders. CONCLUSIONS: Given their longer-term effectiveness, choice architecture interventions delivered via online canteens may represent a promising option for policy makers to support healthy eating among high school students. TRIAL REGISTRATION: Australian Clinical Trials ACTRN12620001338954, https://anzctr.org.au/Trial/Registration/TrialReview.aspx?id=380546 ; Open Science Framework osf.io/h8zfr, https://osf.io/h8zfr/.

Running Habits and Injury Frequency Following COVID-19 Restrictions in Adolescent Long-Distance Runners.

PURPOSE: A decline in youth running was observed at the start of the COVID-19 pandemic. We investigated whether the resumption of organized running after social distancing restrictions changed running habits or injury frequency in adolescent runners. METHODS: Adolescents (age = 16.1 [2.1] y) who participated in long-distance running activities completed an online survey in the Spring and Fall of 2020. Participants self-reported average weekly running habits and whether they sustained an injury during the Fall 2020 season. Poisson regression models and 1-way analysis of variance compared running habits while Fisher exact test compared differences in frequencies of injuries during Fall 2020 among season statuses (full, delayed, and canceled). RESULTS: All runners, regardless of season status, increased weekly distance during Fall 2020. Only runners with a full Fall 2020 season ran more times per week and more high-intensity runs per week compared with their Spring 2020 running habits. There were no differences in running volume or running-related injury frequency among Fall 2020 season statuses. CONCLUSIONS: There were no significant differences in running-related injury (RRI) frequency among runners, regardless of season status, following the resumption of cross-country. Health care providers may need to prepare for runners to increase running volume and intensity following the resumption of organized team activities.

The effect of self-esteem development programme applied to secondary school students on self-esteem and peer bullying victimization: A randomized controlled trial.

BACKGROUND: Self-esteem and peer bullying, which affect the academic success and psychological development of secondary school students, are increasingly becoming a serious problem. AIM: This study was conducted to examine the effect of the Self-Esteem Development Programme applied to secondary school students on self-esteem and peer bullying victimization. METHODS: This randomized controlled trial was conducted with 66 students (intervention = 33, control = 33) studying in the 6th grade at a secondary school. Personal Information Form, Rosenberg Self-Esteem Scale and Peer Bullying Identification Scale Adolescent Form were used to collect the data. The intervention group received 8 sessions of Self-Esteem Development Programme in the form of one session per week of 45-60 min; the control group continued their routine education programme. RESULTS: In the study, after the Self-Esteem Development Programme, the mean self-esteem score of the intervention group increased and the mean peer bullying score decreased, and the difference between the groups was found to be statistically significant (p < 0.05). CONCLUSION: In conclusion, it can be stated that the Self-Esteem Programme is an effective psychiatric nursing intervention in increasing self-esteem and reducing peer bullying. IMPLICATIONS FOR PRACTICES: Students with low self-esteem are at risk of exposure to peer bullying. This study provides significant evidence for improving the self-esteem and reducing peer bullying among students who are at risk due to low self-esteem and peer bullying. The results of this study demonstrate that the Self-Esteem Development Programme can be utilized to enhance self-esteem and reduce exposure to peer bullying among students. CLINICALTRIALS ID: NCT04737374.

Anxiety and Teacher-Student Relationships in Secondary School: A Systematic Literature Review.

Anxiety disorders are the most prevalent mental disorders experienced by adolescents. As students spend a significant amount of time within a school environment, it is not surprising that factors in the school environment have been linked to student mental health. Positive teacher-student relationships (TSRs) in children have been found to improve student mental health outcomes, with supportive TSRs associated with reduced student anxiety, and in turn, student anxiety has also been associated with reduced poorer TSR quality. The findings in adolescents are less clear. This review aimed to systematically evaluate the impact of TSRs on anxiety in secondary school students, and vice-versa using PRISMA guidelines. Searches were conducted in five databases and studies screened against inclusion and exclusion criteria, and rated for study quality by two independent researchers. Twenty-six studies across 12 countries were included. Most studies reported higher quality TSRs (e.g., those that are perceived as more supportive, caring, and warm) was associated with decreased anxiety. Conversely, TSRs that were characterised by dependence, motivational support, conflict, or harassment, were associated with increased anxiety. Most studies used a cross-sectional design and as such conclusions regarding causality as well as the direction of the effects cannot be made. However, early evidence from a limited number of longitudinal studies indicated that positive TSRs reduced anxiety over time. Future research is warranted to investigate whether anxiety affects TSRs, as well as exploring specific strategies and approaches teachers can use to establish positive relationships with their students.

The relationship between internet addiction, sleep quality, and psycho-social problems among secondary school students in Erbil, 2023-2024.

OBJECTIVE: This study aimed to show the association between internet addiction (IA), sleep quality, and psycho-social problems among secondary school students DESIGN: A cross-sectional, descriptive, and correlational study design was used. SAMPLE: A total of 557 students from four secondary schools in Erbil were selected using multistage cluster sampling MEASUREMENTS: The questionnaires of this research contained socio-demographic data, Internet Addiction Test (IAT), Pittsburgh Sleep Quality Index (PSQI), and Pediatric Symptom Checklist-Y (PSC-Y) questionnaire. RESULTS: Findings indicated that students displayed a mild IA, averaging a score of 42.9 ± 19.18. Furthermore, the average sleep quality (PSQI) score was 8.95 ± 2.75, indicating moderate sleep disturbance, and the average score for psycho-social problems was 27.78 ± 13.29. Importantly, there was a strong and positive association between IA and psycho-social issues, as shown by a correlation coefficient of 0.31 (p < .001). Sleep quality was correlated with IA and psychosocial issues (p < .001, correlation values: .23 and .27, respectively) CONCLUSIONS: The study highlights the urgent need for health policymakers and nursing managers in Erbil to develop targeted interventions, such as awareness campaigns and digital well-being programs in school curricula, to mitigate the interlinked issues of IA, sleep quality, and psycho-social problems among students.

Prevalence and associated factors of non-medical use of prescription drugs among adolescents in secondary schools in Buea, Cameroon: a cross-sectional study.

BACKGROUND: The non-medical use of prescription drugs is a growing public health problem worldwide. Recent trends in Cameroon show that the use of psychoactive substances, among which are prescription drugs by adolescents is becoming a public health issue and is linked to juvenile delinquency and violence in schools. However, there is a paucity of data on the burden of this phenomenon among adolescent secondary school students in the country. The aim of this study was to determine the prevalence and factors associated with the use of non-prescription drugs in secondary schools in Buea, South West region of Cameroon. METHODS: We conducted a cross-sectional study from 1st February 2021 to 30th April 2021. Secondary school students were recruited using a multistage stratified cluster sampling. A modified and standardized version of the World Health Organization student drug-use survey model questionnaire was used. Ethical approval was obtained from the Institutional Review Board of the Faculty of Health Sciences, University of Buea (No. 2021/1273-02/UB/SG/IRB/FHS). The Statistical Package for Social Sciences, IBM SPSS Statistics for Windows, Version 25.0. was used for data analysis. Descriptive statistics were used to describe the sociodemographic characteristics of participants. Univariate and multivariate logistic regression models were used to explore associated factors of non-medical use of prescription drugs. RESULTS: A total of 570 participants were enrolled for the study, and 510 participants responded giving a response rate of 89.5%. The prevalence of non-medical use of prescription drugs was 15.3%, tramadol being the most used. Motivators for non-medical use of prescription drugs were "to work longer", "to be courageous", and "curiosity". Logistic regression results showed that alcohol consumption [OR 3.68; 95% CI: 2.24-6.06; p < 0.001], smoking [OR 6.00; 95% CI: 3.07-11.75; p < 0.001] and use of illicit drugs [OR 10.85; 95% CI: 5.48-21.48; p < 0.001] were independent factors associated with non-medical use of prescription drugs. CONCLUSION: Non-medical use of prescription drugs was prevalent among adolescent secondary school students in Buea, Cameroon. Tramadol is the main drug of prescription involved. Our results can guide policymakers on strategies to screen, prevent and control non-medical use of prescription drugs among secondary school students in Cameroon.

Menstruation hygiene management among secondary school students of Chitwan, Nepal:a cross-sectional study.

BACKGROUND: Despite significant progress in reproductive health, many societies still treat menstruation as disgraceful and shameful process and relate it with negative consequences. This belief and attitude may increase the incidence of reproductive tract infection, leading to significant negative impact on women's health. To manage menstruation hygienically and with dignity, it is essential that women and adolescent girls have sufficient knowledge on menstruation hygiene management. Thus, this study aims to identify the knowledge, associated factors related to menstrual hygiene management (MHM) and effectiveness of health education on MHM. METHODS: A school-based study was conducted between August 2021 to April 2022 among 400 secondary school girls. The sampling unit was selected by using systematic random sampling method. Health education was given in the interval between the pretest and posttest of knowledge assessment on MHM. Logistic regression analysis and Wilcoxon rank test were applied to identify predictors and to evaluate the effectiveness of health education. RESULTS: Overall, 57.7% of the girls had unsatisfactory level of knowledge. Around two third (61.4%) missed school days during the menstrual period. Almost 99.5% had experienced some form of cultural restrictions during the menstrual period. After imparting health education, the level of knowledge on menstruation hygiene had significantly improved (z = 17.129, p = < 0.001) to satisfactory compared to the baseline knowledge level (42.3% vs. 92.5%). During multivariate analysis, factors such as having studied in public schools (AoR = 1.7, p = 0.026), having no or one close female friend (AoR = 2.2, p = 0.011), caste other than Brahmin/Chhetri (AoR = 1.4, p = 0.05) and factors such as living in joint family (AoR = 1.6, p = 0.048) were significantly associated with unsatisfactory level of knowledge on MHM. CONCLUSIONS: A substantial number of respondents had unsatisfactory level of knowledge on MHM. Factors such as ethnicity status, types of family, number of close female friends, types of schools and mothers' education were associated with unsatisfactory level of knowledge. School absenteeism and cultural restriction were found to be common/frequent. Imparting of health education was found to be an effective measure to enhance knowledge on MHM.

Parental separation and school dropout in adolescence.

AIMS: To document the association between parental separation and school dropout in adolescence and to examine the factors that may potentially account for this association. METHODS: Data stem from the large youth@hordaland study that was linked to the Norwegian National Educational Database to obtain objective measures of educational outcomes and disposable income (N = 8323). Logistic regression analysis was used to investigate the association between parental separation and school dropout. A Fairlie post-regression decomposition was used to examine the influence of parental education, household income, health complaints, family cohesion, and peer problems in explaining the association between parental separation and school dropout. RESULTS: Parental separation was associated with a higher odds ratio (OR) of school dropout in crude and adjusted (adjusted odds ratio (AOR)) analyses (OR=2.16, 95% confidence interval (CI) =1.90-2.45; AOR = 1.72, 95% CI = 1.50-2.00). About 31% of the higher odds of school dropout among adolescents with separated parents was explained by the covariates. The decomposition analysis suggested that parental education (43%) and disposable income (20%) accounted for most of the explained differences in school dropout. CONCLUSIONS: Adolescents with separated parents are at higher risk for not completing secondary education. Parental education and disposable income accounted for most of the explained differences in school dropout between the groups. Still, the majority of the difference in school dropout remained unaccounted for, indicating that the link between parental separation and school dropout is complex and likely influenced by multiple factors.

School health promotion and the consumption of water and sugar-sweetened beverages in secondary schools: a cross-sectional multilevel study.

BACKGROUND: Overweight among adolescents remains a serious concern worldwide and can have major health consequences in later life, such as cardiovascular diseases and cancer. Still, 33% of secondary school adolescents in the Netherlands consume sugar-sweetened beverages daily and over 26% do not consume water every day. The Dutch Healthy School program was developed to support schools in stimulating healthier lifestyles by focusing on health education, school environments, identifying students' health problems, and school policy. We examined the variation between secondary schools regarding the daily consumption of water and sugar-sweetened beverages and whether this variation can be explained by differences between schools regarding Healthy School certification, general school characteristics, and the school population. METHODS: We performed a cross-sectional multilevel study. We used data from the national Youth Health Monitor of 2019 on secondary schools (grades 8 and 10, age range about 12 to 18 years) of seven Public Health Services and combined these with information regarding Healthy School certification and general school- and school population characteristics. Our outcomes were daily consumption of water and sugar-sweetened beverages. In total, data from 51,901 adolescents from 191 schools were analysed. We calculated the intraclass correlation to examine the variation between schools regarding our outcomes. Thereafter, we examined whether we could explain this variation by the included characteristics. RESULTS: The school-level explained 4.53% of the variation in the consumption of water and 2.33% of the variation in the consumption of sugar-sweetened beverages. This small variation in water and sugar-sweetened consumption could not be explained by Healthy School certification, yet some general school- and school population characteristics did: the proportion of the school population with at least one parent with high educational attainment, the educational track of the adolescents, urbanicity (only for water consumption) and school type (only for sugar-sweetened beverages consumption). CONCLUSIONS: The low percentages of explained variation indicate that school-level characteristics in general (including Healthy School certification) do not matter substantially for the daily consumption of water and sugar-sweetened beverages. Future research should examine whether school health promotion can contribute to healthier lifestyles, and if so, under which level of implementation and school conditions.

Human papillomavirus vaccine knowledge and conspiracy beliefs among secondary school students in Lebanon.

BACKGROUND: Human Papillomavirus (HPV) is widely prevalent across the globe. In Lebanon, the society is transitioning from traditional conservatism to a more open attitude. Although previous studies have examined the knowledge of adults in Lebanon with regard to HPV and its vaccine, there is a lack of research on secondary school students. Moreover, HPV is considered a worldwide public health matter that needs to be addressed. Therefore, the objective of our study is to assess factors associated with knowledge and conspiracy beliefs towards HPV vaccine among a sample of Lebanese adolescents. METHODS: Between December 2022 and February 2023, we conducted a cross-sectional study on Lebanese adolescents aged 15 to 18 years old. Parental approval was needed in order to participate. We used a questionnaire to collect data, which included the HPV-knowledge questionnaire (HPV-KQ) and the Vaccine Conspiracy Belief Scale (VCBS). RESULTS: Of the 406 participants who filled the survey, 64.8% were female, with a mean age of 16.62 ± 1.01. Results showed that 31.0% of students had high knowledge about HPV, while 27.6% had high conspiracy beliefs, and 48% of participants relied on the internet to access information on HPV. Students who had previously heard of HPV, received sexual education at school or outside, and had received at least one dose of the HPV vaccine demonstrated significantly higher knowledge of HPV. Additionally, students with high knowledge had a lower mean House Crowding Index, and those whose fathers had a university education had lower conspiracy beliefs. Females had a higher vaccination rate than males, while no significant difference was found between those who had engaged in sexual activity and those who had not. The multivariate analysis indicated that previous awareness of HPV and receiving sexual education outside school were significantly associated with higher knowledge. CONCLUSION: Our study brings to light the urgent need for action to increase HPV awareness and vaccination among Lebanese secondary school students. The prevalence of vaccine misconceptions and conspiracy beliefs and the limited knowledge of HPV underscore the importance of more comprehensive sexual education in schools and the dissemination of accurate information about HPV and its vaccine. Furthermore, given the low vaccination rate among males, efforts should be made to promote HPV vaccination among this population. Addressing these issues can improve public health and help prevent the spread of HPV and its related diseases.

Reproductive health service utilization and associated factors among secondary school students in Harari regional state, eastern Ethiopia, 2022: a multicenter study.

INTRODUCTION: Reproductive health encompasses all conditions relating to the reproductive system and goes beyond simply being free from disease or infirmity. Several socioeconomic and socio-cultural factors affect reproductive health service utilization. OBJECTIVES: To assess reproductive health service utilization and its associated factors among government secondary school students in Harari regional state, Eastern Ethiopia 2022. METHODS: A school-based cross-sectional study design was conducted among 1275 secondary school students in six randomly selected secondary schools in Harari Regional state, in eastern Ethiopia. The study participants were chosen using a simple random sampling method. Data was gathered using self-administered questionnaires, entered into Epi Data version 3.1, and exported to SPSS version 25 for cleaning and analysis. Descriptive statistics, bivariable, and multivariable logistic regression analyses were carried out to compute the frequency of each independent variable and the magnitude of the outcome variables, then to identify factors associated with the outcome variable, respectively. To declare a significant association, an adjusted odd ratio (AOR) with a 95% confidence interval and a p-value of 0.05 were used. RESULTS: Our finding indicated that 25.3% (95% CI:22.9, 27.7) of the secondary school students utilized reproductive health services. Being in grade 11-12 (AOR = 1.67, 95% CI: 1.18, 2.38), having a history of sexually transmitted infection (AOR = 6.11, 95% CI: 2.20, 16.99), presence of a health facility nearby (AOR = 1.49, 95% CI: 1.12, 1.99), discuss voluntary counseling and testing with family (AOR = 2.73, 95% CI: 1.90, 3.94), and discussing about contraceptive with friends (AOR = 1.22, 95% CI: 0.91, 1.65) were the elements that had a strong correlation with reproductive health service utilization. CONCLUSION: In this study, only one-fourth of secondary school students utilized RH service during the past year. The student's educational level, having a history of STI, the presence of a health facility nearby, and discussing RH service with family/friends were the factors significantly associated with reproductive service utilization among secondary school students.

Examining Secondary School Choice Processes as a Predictor of Adjustment After the School Transition.

The secondary school transition is an important moment in adolescents' lives. Taking a prospective approach, the present study examined whether educational identity regarding a secondary school choice and own and parental expectations during the last year of primary school predicted post-transition school and psychological adjustment in Dutch adolescents (N = 314, Mage = 11.58). Additionally, the study qualitatively examined the reasons adolescents gave for their school choice, and linked these reasons to exploration behavior and post-transition adjustment. Identity processes and expectations predicted adjustment. Adolescents mostly reported multiple reasons for their school choice, with educational, practical, and social aspects of secondary schools appearing most important. The number of reasons mentioned was associated with pre-transition exploration behavior.

The inter-relatedness and demographic predictors of physical activity, self-rated health, and mental well-being: A three-wave study in secondary school children.

INTRODUCTION: The World Health Organisation recommends that children and adolescents engage in at least 60 min of moderate-to-vigorous physical activity per day. Previous research has shown that physical activity is related to other constructs such as mental well-being and self-rated health. This study examined the inter-relatedness of these constructs in Northern Irish school children. METHODS: This study was a secondary analysis of data gathered as part of a longitudinal study. Participants were n = 1791 adolescents in their final years of secondary (high) school (age range 15-18; female = 64.6%). Data were gathered on three occasions over a 2-year period on self-rated health, physical activity, mental well-being, heavy episodic drinking, lifetime smoking, psychological and somatic symptoms, as well as a range of socio-demographic measures. RESULTS: Descriptive results showed extremely low levels of self-reported physical activity within the past week, with <6% of the sample attaining the WHO guidelines at each wave of data collection. There were significant gender differences on all variables assessed. Results further showed a small-sized relationship (statistically significant for girls only) between physical activity and mental well-being. There was also a small-sized relationship between physical activity and self-rated health. Notably, effect sizes for the relationship between self-rated health and both physical activity and mental well-being were higher. In terms of socio-demographic predictors of lower physical activity, being female, lifetime cigarette smoking, and higher somatic and psychological symptoms were all statistically significant factors. CONCLUSION: Self-rated health emerged as the most important predictor of physical activity among adolescents.

Student Athletes' Causal Attributions for Sport and School Achievement in Relation to Sport Dropout and Grade Point Average.

The present study longitudinally examined stability and change in the attributional profiles of Finnish student athletes (n = 391) in upper secondary sport schools. Moreover, it examined the extent to which these profiles, and changes in them, were associated with athletes' level of sport competition and school achievements and dropouts at the end of upper secondary sport school. Using latent profile analysis, five different and highly stable attributional profiles were identified for student athletes: (a) depressive (6.9%), (b) athletic self-serving (23.0%), (c) average (16.4%), (d) learned helplessness (30.9%), and (e) responsible (22.8%). The results further showed that over the 3-year study period, the responsible attributional style, wherein individuals take responsibility for successes and failures, predicted student athletes' subsequent high grade point average and low sport dropout rates even after controlling for the impacts of their earlier grade point average, gender, and type of sport.