Trends in Inequalities in the Use of Condom by Urban Teenagers in Spain.

Social and economic inequalities in condom use by adolescents have been reported previously. Also, condom use has declined during the last decade. The aim of the study was to describe trends in the use of condoms in our setting, and how these trends may differ between socioeconomic groups in boys, and separately in girls, aged 17-19 years attending school in Barcelona between 2004 and 2012. We analyzed data from three annual surveys on risk factors in secondary students, which included a representative sample of the city's population; individuals who had previously had sexual intercourse (n = 1570) were included in the study. We calculated adjusted prevalence ratios (aPR) and their confidence intervals (95% CI) using robust Poisson regression models. The prevalence of condom use among boys was 87.0% in 2004 and 76.2% in 2012, and 76.7 and 64.7% among girls, respectively. This decrease was greater in adolescents with a low socioeconomic level, both in boys (aPR = 0.80) and girls (aPR = 0.84). The observed increase of socioeconomic inequalities in condom use in adolescents highlights a possible deterioration in good sexual practices and policies during the studied period.

Factors associated with media use among adolescents: a multilevel approach.

BACKGROUND: During the last few years, several studies have reported a high screen time use among adolescents that can be related to negative health effects. The aims of this study were to describe screen time use among secondary school students and to identify individual- and school-level factors associated with media use. METHODS: A cross-sectional study based on a self-reported questionnaire was performed among a representative sample of 2675 secondary school students (13-19 years old). Adolescents reported the amount of time spent viewing television, playing videogames and using the computer as well as other health-related behaviours and attitudes. Multilevel analysis was carried out and prevalence ratios were calculated to determine the association between media use and related factors. RESULTS: Around 50% of the students reported watching television for ≥2 h/day during weekdays. Boys reported playing videogames for ≥2 h/weekday much more often than girls (14.6 and 1.5%, respectively). 68.2% of boys and 61.7% of girls reported using the computer for ≥2 h/weekday. In the multilevel analysis, the main factors associated with screen-related sedentary behaviours were attending schools from a low socio-economic status neighbourhood, eating unhealthy food and not reading books frequently. CONCLUSION: The prevalence of adolescents reporting an excessive use of media devices is high, especially among students attending schools from deprived areas. Interventions to reduce screen time among adolescents may be necessary to reduce the risk of some metabolic and cardiovascular diseases such as being overweight and obesity in late adolescence or early adulthood.

Long-term effect of the influenza A/H1N1 pandemic: attitudes and preventive behaviours one year after the pandemic.

This study aimed to describe changes in attitudes and behaviours regarding influenza A infection 1 year after the end of the pandemic. A cross-sectional study was performed based on two population-based telephone surveys including 1027 (February, 2010) and 1000 (February, 2011) participants in Spain. The percentages of the respondents who reported that they had adopted preventive measures to avoid Influenza infection declined 1 year after the pandemic. Influenza-related consultations decreased, whereas confidence in vaccination increased. Despite the decrease observed in adopting preventive measures, some behaviours were still being adopted long time after the pandemic in general population.

[The problematic use of the mobile phone: cross-sectional analysis of the individual profile and associated factors.] / El uso problemático del teléfono móvil: análisis transversal del perfil individual y factores asociados.

OBJECTIVE: The problematic use of mobile phones is a phenomenon that can be associated with a specific individual profile and it has been seen that there are associated factors, although most of them have been studied in a limited way and in small samples. The aim of this study was to describe the association between the problematic use of the mobile phone and social traits, health, and health-related behaviors among high school students. METHODS: This is a cross-sectional study performed in a representative sample of students aged 13-18 years in the Lifestyle Risk Factors in Secondary School Students (FRESC) survey conducted in 2016 in Barcelona (n=3,778). Problematic mobile phone use was obtained from the Mobile Related Experiences Questionnaire (CERM). Multivariate logistic regression models were built to assess the relationship between this variable and social, health and behavioural variables. RESULTS: A total of 52% of girls and 44% of boys reported frequent or occasional problems with their mobile phone usage. The factors associated with the dependent variable were poor relationships with the family, mobile phone usage before sleeping or during dinner, inadequate hours of sleep, sedentariness, substance consumption and poor mental health. CONCLUSIONS: The problematic use of the mobile is frequent among students and there are several associated social, health and behavioral factors. There are substantial differences by sex and age, with the strongest associations in younger girls.

OBJETIVO: El uso problemático del teléfono móvil es un fenómeno que puede estar asociado a un perfil individual concreto y se ha visto que hay factores asociados, aunque, mayoritariamente, se han estudiado de forma limitada y en muestras pequeñas. El objetivo de este estudio fue describir la asociación entre el uso problemático del teléfono móvil y los rasgos sociales, la salud y las conductas relacionadas con la salud entre estudiantes de Secundaria. METODOS: Se realizó un estudio transversal realizado en una muestra representativa de estudiantes de trece a dieciocho años procedentes de la encuesta Factores de riesgo en el estilo de vida en estudiantes de secundaria (FRESC), realizada en 2016 en Barcelona (n=3.778). El uso problemático del móvil se obtuvo del Cuestionario de experiencias relacionadas con el móvil (CERM). Se construyeron modelos de regresión logística multivariante para evaluar la relación entre esta variable y las variables sociales, de salud y de comportamiento. RESULTADOS: Un total de 52% de chicas y 44% de chicos reportaron problemas frecuentes u ocasionales con el uso de su teléfono móvil. Los factores asociados al uso problemático del teléfono móvil fueron: malas relaciones con la familia; uso del móvil antes de dormir o visionado de pantallas durante la cena; horas de sueño inadecuadas; sedentarismo; consumo de sustancias; y mala salud mental. CONCLUSIONES: El uso problemático del teléfono móvil es frecuente entre los estudiantes y hay varios factores sociales, de salud y comportamientos asociados. Existen diferencias sustanciales por sexo y edad, siendo las asociaciones más fuertes en las chicas más jóvenes.

[Changes in smoking prevalence among adolescents in Spain]. / Cambios en la prevalencia del tabaquismo en los adolescentes en España.

OBJECTIVE: To analyse information on adolescent use of tobacco in Spain from different school surveys. DESIGN: Data on daily smoking prevalence by sex at the end of compulsory education is extracted and figures are compared, analysing trends. SETTING: The five representative studies on adolescents in Spain are reviewed: The National Survey on Drug Use in Secondary School Children (Encuesta estatal sobre uso de drogas en estudiantes de secundaria (ESTUDES); Survey of Health Behaviour in School-aged Children (HBSC-ECERS); Surveillance System of Risk Factors Associated With Non-Transmittable diseases in the Young Population (Sistema de Vigilancia de Factores de Riesgo Asociados a Enfermedades No Transmisibles dirigido a población Juvenil)(SIVFRENT-J); Study of Risk Factors in Secondary School Children (Estudio de factores de riesgo en estudiantes de secundaria) (FRESC); Surveillance Study of Health Behaviour in Adolescents (Estudio de Monitorización de las Conductas de Salud de los Adolescentes) (EMCSAT). RESULTS: The prevalence of daily smokers varies among studies, in boys from 8.5 to 13.3% and in girls from 12.7 to 16.4%. Although some series show variations, the trend from 1993 to 2008 is downwards. With data from recent years, weighted annual declines in smoking prevalence in adolescence can be estimated to be 6.47% for boys and 6.96% for girls. CONCLUSIONS: There is a decreasing pattern in adolescent daily smoking prevalence in Spain from the different existing studies, which provide consistent data, although surveillance must be kept due to fluctuations. This is in agreement with tobacco sales statistics and health surveys in the adult population. However, the pace of change should be more rapid and constant.

Adoption of preventive measures during and after the 2009 influenza A (H1N1) virus pandemic peak in Spain.

OBJECTIVE: This study describes the preventive measures adopted by the Spanish population towards 2009 influenza A (H1N1) virus and their associated factors. METHOD: An anonymous computer-assisted telephone interview survey was conducted in Spain in December 2009 and February 2010. Respondents were asked about their perceptions of influenza A (H1N1) virus and the preventive measures adopted. Factors associated with the adoption of preventive measures were assessed by logistic regression analyses. RESULTS: Out of 4892 households approached, 1627 valid responses were obtained (response rate of 33.3%). The most commonly adopted preventive measures were respiratory hygiene and hand washing. Factors independently associated with the adoption of the preventive measures recommended by the Spanish Ministry of Health were female gender, higher educational level, size of municipality of residence >50,000 inhabitants, high perceived susceptibility to infection, high perceived effectiveness of the measures and high perceived usefulness of the information provided by the government. The presence of school-aged children in household was associated with purchasing masks and hand sanitizer. CONCLUSION: In addition to demographic factors, modifiable factors such as personal beliefs and expectations play a role in the adoption of preventive measures.

[Potential selection bias in telephone surveys: landline and mobile phones]. / Potencial sesgo de selección en las encuestas telefónicas: teléfonos fijos y móviles.

The increasing use of mobile phones in the last decade has decreased landline telephone coverage in Spanish households. This study aimed to analyze sociodemographic characteristics and health indicators by type of telephone service (mobile phone vs. landline or landline and mobile phone). Two telephone surveys were conducted in Spanish samples (February 2010 and February 2011). Multivariate logistic regression analyses were performed to analyze differences in the main sociodemographic characteristics and health indicators according to the type of telephone service available in Spanish households. We obtained 2027 valid responses (1627 landline telephones and 400 mobile phones). Persons contacted through a mobile phone were more likely to be a foreigner, to belong to the manual social class, to have a lower educational level, and to be a smoker than those contacted through a landline telephone. The profile of the population that has only a mobile phone differs from that with a landline telephone. Therefore, telephone surveys that exclude mobile phones could show a selection bias.

[Tobacco use by adolescents in Barcelona (Spain) and trends in the last 20 years]. / Consumo de tabaco de los adolescentes en Barcelona y tendencias a lo largo de 20 años.

OBJECTIVES: Smoking is a preventable cause of early death and the habit starts in adolescence. The aim of this study was to describe tobacco consumption in secondary school students in 2008 and trends in the last 20 years in Barcelona. MATERIAL AND METHODS: We analyzed the trend in tobacco consumption by comparing data from 8 surveys carried out between 1987 and 2008 in the 8th (2nd year of Compulsory Secondary Education), 10th (4th year of Compulsory Secondary Education) and 12th (2nd year of Compulsory Secondary Education) years of secondary school. The FRESC questionnaire was used. Data on regular and daily consumption and associated factors in 2008 were gathered and compared with those corresponding to the previous studies. Percentages of annual change were calculated with Joinpoint regression and data were stratified by sex and year of education. RESULTS: In 2008, 6.1% of boys and 4.5% of girls in the 8th year, 15.8% and 20.4% of those in the 10th year, respectively, and 26.1% and 33.1% of those in the 12th year, respectively, were regular smokers. A strong association was noted between regular smoking and cannabis consumption in three school years, as well as with having friends who were smokers and poor school performance. At 15-16 years old, the average annual decrease from 1996 to 2008 was 6.8% in girls and 6.1% in boys. CONCLUSIONS: Adolescent smoking has been decreasing in the last few years in Barcelona. There is a strong association between tobacco use and cannabis consumption.

[The study of social inequalities in child and adolescent health in Spain]. / El estudio de las desigualdades sociales en la salud infantil y adolescente en España.

OBJECTIVE: To identify and describe studies on social inequalities in child and adolescent health conducted in Spain with special emphasis on social determinants. METHODS: In July 2012, we conducted a systematic review in the PubMed, MEDES, SCOPUS and COCHRANE databases. We included studies on social inequalities in child and adolescent health in Spain published between 2000 and 2012. A total of 2147 abstracts were reviewed by two researchers and 80 manuscripts were fully reviewed by three researchers. Risk of bias was assessed. Seventy-two articles were finally included. RESULTS: A total of 83% of the studies were cross-sectional and the most frequently studied age group consisted of 13-15-year-olds. More than 20 individual or group determinants were identified. The most frequently analyzed determinants were the most advantaged educational level and occupation of the mother or the father. In 38% of the studies analyzing education and occupation, there was no definition of the determinant. Social inequalities were detected in dental health with all determinants and in all age groups (9% of studies with a high risk of bias). Social inequalities were also detected in obesity, physical activity and mental health with some determinants. Specific data were missing for younger children. No social inequalities were found in the use of health services, excluding dental care. Few studies analyzed immigration and 42% of them had a high risk of bias. CONCLUSION: Wide diversity was found in the measurement of social determinants, with a lack of studies in preschoolers and of studies with longitudinal designs. The results of this study confirm social inequalities in some aspects of health.

Bullying among schoolchildren: differences between victims and aggressors.

OBJECTIVE: To identify the factors associated with bullying behaviors among adolescents by analyzing victims, aggressors and victims/aggressors separately. METHODS: A cross-sectional study was performed in a representative sample of 3,089 secondary school students (13-18 years old) in Barcelona (Spain). To define bullying behaviors, we used three questions about different types of mistreatment (jeering, attacking, marginalizing). RESULTS: Compared with secondary school students not involved in bullying, victims, aggressors and victims/aggressors were more likely to be boys and to report negative mood states. Victims were younger, were more overweight or obese and were lighter cannabis users, while aggressors were also younger but reported more antisocial behaviors and more cannabis and alcohol use. Victims/aggressors reported more antisocial behaviors and were overweight. CONCLUSIONS: Being involved in bullying, independently of the role adopted, was associated with health-related problems, which can lead to psychological disorders in adulthood.

Driving under the influence of alcohol or drugs among adolescents: the role of urban and rural environments.

This study aimed to describe driving under the influence of alcohol or drugs (DUIAD) and riding in a vehicle with a driver under the influence of alcohol or drugs (RDUIAD) and their associated factors among rural and urban adolescents in Spain. We performed a cross-sectional study including 2067 students from Barcelona and a rural area 60 km north of this city. The prevalences of ever DUIAD and RDUIAD were 17% and 41% among 17-18 year-old adolescents. DUIAD was more common in boys. Living in the rural area was independently associated with these behaviours. Exposure to these behaviours is common among Spanish adolescents, especially in rural areas.

[Attitudes and preventive behaviours adopted during the (H1N1) 2009 influenza virus epidemic in Spain]. / Actitudes y comportamientos preventivos durante la pandemia de gripe (H1N1) 2009 en España.

BACKGROUND: In the spring of 2009 the emergence of new influenza virus (H1N1) 2009 caused widespread alarm. The objective of this study is to describe the knowledge and risk perceptions towards the disease and its vaccine and the preventive measures adopted by the population. METHODS: A telephone survey was conducted in two rounds with quotas for age, sex, Autonomous Regions and size of municipality. Respondents were asked regarding perceptions, preventive measures, vaccination related to 2009 influenza (H1N1) 2009 and sociodemographic data. Proportional quota sampling based on age, sex, province and size of municipality was used. We performed a descriptive analysis of the main study variables and applied the chi-square test to study the statistical analysis for categorical data. RESULTS: Overall we obtained 1,627 valid responses. 823 (51,6%) were women, 502 (30.9%) were between 18 and 34 years old and 580 (35.6%) were between 35 and 55 years old. 729 (49,1%) were unskilled, manual workers, and 857 (52,7%) were living in cities larger than 50,000 inhabitants. Only 15,7 % declared to feel at risk to get influenza, and this proportion was much lower (3,9%) in the second wave, after the epidemic peak. Overall, more than 80% (n=1353) felt that unnecessary social alarm had been generated (n=1353). 1.253 (77%) of the participants adopted at least one preventive measure. Respiratory hygiene (n=951 58,5%) and hand washing (n= 624 38,4%). were the most common preventive measures adopted. CONCLUSIONS: The main adopted measures were those recommended by the government.

[Factors related to bullying in adolescents in Barcelona (Spain)]. / Factores relacionados con el acoso escolar (bullying) en los adolescentes de Barcelona.

OBJECTIVES: Violence and bullying in the school setting are a serious social and health problem that have created great alarm in the last few years. We aimed to describe bullying and factors related to this phenomenon in students in the city of Barcelona. METHODS: We performed a cross-sectional study of a representative sample of 2,727 students from 66 secondary schools in Barcelona. Bullying was defined as having been laughed at, hit or marginalized four or more times, or as having been the target of all three of these behaviors at least once, in the last 12 months. To analyze the associations among bullying and related factors including sociodemographic variables, attitudes and behaviors, we used bivariate and multivariate logistic regression. RESULTS: The prevalence of bullying was 18.2%, 10.9% and 4.3% in boys and 14.4%, 8.5% and 4.5% in girls in the 8th, 10th and 12th grades, respectively. Factors associated with an increased likelihood of being bullied were negative mood states and violent behavior, while being older, alcohol consumption, cannabis use and going to bars and discos were negatively associated with being bullied. CONCLUSIONS: This study confirms that bullying is a serious problem in our context and identifies certain factors, such as negative mood states and other risk behaviors. These factors should be further analyzed in longitudinal studies in order to design and implement appropriate prevention programs.