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1.
Acad Pediatr ; 20(2): 143-144, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-31622783
2.
Subst Use Misuse ; 53(10): 1624-1632, 2018 08 24.
Artigo em Inglês | MEDLINE | ID: mdl-29364764

RESUMO

INTRODUCTION: Early adolescence is a critical risk period for initiation of substance use. Internal assets (IAs), which are individual qualities guiding positive choices, and adverse childhood experiences (ACEs) are important protective and risk factors, respectively, against substance use. The purpose of this study is to investigate whether IAs modify associations between ACEs and early initiation of alcohol and marijuana use. METHOD: Data were from 9th and 11th graders who completed the 2013 Minnesota Student Survey (n = 79,339). Students reported on experiences of abuse, household dysfunction, and substance use. Multivariable logistic regressions examined associations between different types of ACEs and substance use. Interactions between IAs and ACEs were added to models to test effect modification. For significant interactions, main effects models were re-estimated at different percentiles of IAs. RESULT: IAs moderated associations of both abuse and household dysfunction with early initiation of marijuana (p <.003) and alcohol (p =.007) for females but not for males. For females with low IAs, odds of early initiation of marijuana were approximately twice as high as students without any ACEs. A similar pattern was detected for females' initiation of alcohol use. No effect modification was detected for IAs and experiencing only abuse or household dysfunction on initiation. CONCLUSION: Special attention should be paid to improving IAs among girls who have already experienced ACEs. Future research should examine protective factors that buffer the effects of ACEs for boys.


Assuntos
Comportamento do Adolescente/psicologia , Experiências Adversas da Infância , Consumo de Bebidas Alcoólicas/psicologia , Autoimagem , Adolescente , Consumo de Bebidas Alcoólicas/epidemiologia , Feminino , Humanos , Controle Interno-Externo , Modelos Logísticos , Masculino , Abuso de Maconha/epidemiologia , Minnesota/epidemiologia , Fatores de Risco , Distribuição por Sexo , Inquéritos e Questionários
3.
Soc Sci Med ; 146: 266-75, 2015 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-26603310

RESUMO

Violence in all forms poses a concern because of associations with multiple adverse effects including injuries and mental health problems. There is however limited data on violence in general and youth violence in particular in Ghana. To explore the nature and scope of youth violence in Ghana, we used the nationwide Global School-based Health Survey, conducted among senior high school students in Ghana, to explore risk and protective factors at the individual, family, and environmental levels associated with sexual and physical violence victimization. A fifth of these students reported being forced to have sex in their lifetime while two out of five had been a victim of a physical attack in the year preceding the survey. In final multivariate analysis, for sexual violence victimization, history of sexual activity with or without condom use at last sex, feeling sad or hopeless, and being a victim of bullying and electronic bullying were identified as risk factors, while having friends who were not sexually active was protective. Independent risk factors for physical violence victimization were attempting suicide in the last year, alcohol use in the past month, and bullying other students in the past month. Parent respect for privacy just reached significance as a protective factor for physical violence victimization in the final model. Recognition of the magnitude of violence victimization among Ghanaian students and associated factors must be used to guide development and implementation of appropriate concrete measures to prevent and address the problem.


Assuntos
Abuso Físico/estatística & dados numéricos , Delitos Sexuais/estatística & dados numéricos , Adolescente , Comportamento do Adolescente , Consumo de Bebidas Alcoólicas/efeitos adversos , Estudos Transversais , Feminino , Gana , Inquéritos Epidemiológicos , Humanos , Estudos Interdisciplinares , Masculino , Abuso Físico/prevenção & controle , Fatores de Proteção , Fatores de Risco , Delitos Sexuais/prevenção & controle , Delitos Sexuais/psicologia , Inquéritos e Questionários , Adulto Jovem
4.
Pediatr Clin North Am ; 62(5): 1137-58, 2015 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-26318944

RESUMO

Violence involvement remains a leading cause of morbidity and mortality for youth and young adults in the United States. The impact of adverse childhood experiences on violence involvement can be translated to the cellular level, including alterations in brain structure and function responsible for stress reactivity and coping. This knowledge is counterbalanced by a growing understanding of what works in the realm of youth violence prevention. Incorporating a resilience framework, with its focus on building developmental assets and resources at individual, family, and community levels, offers a renewed approach to fostering healthy behaviors and coping strategies.


Assuntos
Comportamentos Relacionados com a Saúde , Promoção da Saúde/métodos , Violência/prevenção & controle , Adolescente , Adulto , Criança , Pessoal de Saúde , Humanos , Programas de Rastreamento , Resiliência Psicológica , Fatores de Risco , Estados Unidos , Violência/psicologia , Adulto Jovem
5.
Prim Care ; 41(3): 671-89, 2014 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-25124212

RESUMO

Violence involvement is a leading cause of morbidity and mortality among adolescents. This review provides a summary of the burden of adolescent violence and violence-related behavior, risk, and protective factors for violence outcomes. The importance of screening for violence involvement in the primary care setting and examples of online resources to support providers in advocating, assessing, and intervening on behalf of youth are also reviewed. The article draws attention to bullying and dating/relationship violence, not as new forms of violence-related behavior, but as behaviors with health outcomes that have recently received increased attention.


Assuntos
Medicina do Adolescente , Violência , Adolescente , Bullying/psicologia , Feminino , Humanos , Masculino , Resiliência Psicológica , Fatores de Risco , Delitos Sexuais/prevenção & controle , Violência/prevenção & controle
7.
J Adolesc Health ; 53(1 Suppl): S4-12, 2013 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-23790200

RESUMO

PURPOSE: To identify risk and protective factors associated with thinking about or attempting suicide among youth involved in verbal and social bullying. METHODS: We analyzed data on 130,908 students in the sixth, ninth, and twelfth grades responding to the 2010 Minnesota Student Survey. Among students involved in frequent bullying (once a week or more during the past 30 days), we compared those who did and did not report suicidal ideation or a suicide attempt during the past year. Separate analyses were conducted for perpetrators only, victims only, and bully-victims. RESULTS: Overall, 6.1% of students reported frequent perpetration only, 9.6% frequent victimization only, and 3.1% both. Suicidal thinking or a suicide attempt was reported by 22% of perpetrators only, 29% of victims only, and 38% of bully-victims. In logistic regression models controlling for demographic and other risk and protective factors, a history of self-injury and emotional distress were risk factors that cross-cut the three bullying involvement groups. Physical abuse, sexual abuse, a mental health problem, and running away from home were additional risk factors for perpetrators only and victims only. Parent connectedness was a cross-cutting protective factor, whereas stronger perceived caring by friends and by nonparental adults were additional protective factors for some groups. CONCLUSIONS: A range of risk and protective factors were associated with suicidal ideation and a suicide attempt among youth involved in verbal and social bullying. Findings may assist in identifying youth at increased risk for suicidal thinking and behavior and in promoting key protective factors.


Assuntos
Bullying/psicologia , Ideação Suicida , Adolescente , Estudos Transversais , Feminino , Humanos , Masculino , Minnesota/epidemiologia , Fatores de Risco , Comportamento Social , Tentativa de Suicídio/prevenção & controle , Tentativa de Suicídio/psicologia , Tentativa de Suicídio/estatística & dados numéricos
9.
Acad Med ; 86(3): 342-7, 2011 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-21248597

RESUMO

Many young people who present to primary care providers (PCPs) have high levels of emotional distress and/or suicidal ideation. Therefore, PCPs are in an ideal position to recognize and respond to early symptoms and distress signals that accompany suicide warning signs, yet they underrecognize mood disorders and suicidality among youth. Medical school and residency programs typically provide inadequate training on pediatric mental health and adolescent suicide prevention. Thus, PCPs lack complete knowledge of risk factors and feel unprepared to handle mental health problems among youth. In this article, the authors provide an overview of the epidemiology of adolescent suicide and describe risk factors, protective factors, and warning signs. They propose that physician education represents a promising strategy to prevent adolescent suicide, and they establish the need for improved educational opportunities that would provide PCPs with the necessary skills and supports to identify and respond to psychosocial concerns that may increase suicide risk among youth. They recommend strategies, methods, and content areas for addressing educational gaps, as well as organizational approaches to support enhanced physician education. They also suggest areas for future research.


Assuntos
Educação Médica/organização & administração , Pediatria/educação , Papel do Médico , Médicos de Atenção Primária/educação , Suicídio/prevenção & controle , Adolescente , Criança , Feminino , Humanos , Masculino , Fatores de Risco , Adulto Jovem
11.
Pediatrics ; 125(3): e452-8, 2010 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-20142281

RESUMO

OBJECTIVE: The goal of this study was to examine weight misperception among overweight adolescents in recent years and compare the demographic characteristics and weight-related behaviors of overweight adolescents who accurately and inaccurately perceive their weight status. METHODS: We used data from the nationally representative Youth Risk Behavior Surveillance System, collected every 2 years from 1999 through 2007. On the basis of self-reported height and weight, BMI percentile for age and sex was calculated. Overweight and obese respondents (BMI > or = 85th percentile) were classified into 2 groups: (1) misperceivers (weight perception "about right" or "underweight") or (2) accurate perceivers (weight perception "overweight"). We examined the proportion of misperceivers at each time point. Using the 2007 data, we compared demographic characteristics and weight-related behaviors of accurate perceivers and misperceivers with bivariate and multivariate analyses. RESULTS: Among overweight adolescents, the overall proportion of misperceivers ranged between 29% and 33% from 1999 through 2007. In 2007, 23% of overweight girls and 40% of overweight boys were misperceivers (P < .001). Both male and female accurate perceivers were significantly more likely than misperceivers to report trying to maintain or lose weight, exercising for weight control, and eating less for weight control. Adjusting for age, race/ethnicity, and BMI percentile, no significant differences in unhealthy weight-related behaviors were found between accurate perceivers and misperceivers in boys or girls. Male accurate perceivers were significantly less likely to report achieving recommended levels of fruit and vegetable intake and physical activity. CONCLUSIONS: Nearly 3 in 10 overweight adolescents do not consider themselves overweight. Those with an accurate weight perception reported some healthy weight-related behaviors but not higher levels of unhealthy weight-related behaviors. With the substantial prevalence of weight misperception, clinicians should consider their patients' perceived weight status when pursuing patient-centered counseling of overweight adolescents.


Assuntos
Imagem Corporal , Peso Corporal , Sobrepeso/psicologia , Autoimagem , Adolescente , Feminino , Humanos , Masculino
12.
Pediatrics ; 124(1): e81-8, 2009 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-19564273

RESUMO

OBJECTIVE: The relationship between adolescents' perceived risk for dying and their involvement in risk behaviors is unknown. We sought to determine the proportion of US youth who anticipate a high likelihood of early mortality and relationships with health status and risk behaviors over time. METHODS: We analyzed data from times 1 (1995), 2 (1996), and 3 (2001-2002) of the National Longitudinal Study of Adolescent Health, a nationally representative sample of youth in grades 7 through 12. The relationship between perceived risk for premature mortality and health behaviors/outcomes was assessed by using bivariate and multivariate analyses. RESULTS: At time 1, 14.7% of the 20594 respondents reported at least a 50/50 chance that they would not live to age 35. In adjusted models, illicit drug use, suicide attempt, fight-related injury, police arrest, unsafe sexual activity, and a diagnosis of HIV/AIDS predicted early death perception at time 2, time 3, or both (adjusted odds ratios: 1.26-5.12). Conversely, perceived early mortality at time 1 predicted each of these behaviors and outcomes, except illicit drug use, at time 2 or time 3, most strongly a diagnosis of HIV/AIDS (adjusted odds ratios: 7.13 [95% confidence interval: 2.50-20.36]). CONCLUSIONS: Adolescent involvement in risk behaviors predicted a belief in premature mortality 1 and 7 years later. Reciprocally, adolescents' perceived risk for early death predicted serious health outcomes, notably a diagnosis of HIV/AIDS in young adulthood. Given its frequency and influence on behavior and health, adolescents' perceived risk for early death should be incorporated into psychosocial assessments and interviews.


Assuntos
Nível de Saúde , Mortalidade , Assunção de Riscos , Adolescente , Comportamento do Adolescente , Sistema de Vigilância de Fator de Risco Comportamental , Feminino , Humanos , Masculino , Análise Multivariada , Estados Unidos/epidemiologia
13.
Pediatrics ; 123(3): 966-71, 2009 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-19255027

RESUMO

BACKGROUND: Primary care physicians can enhance the health and quality of life of children with autism by providing high-quality and comprehensive primary care. OBJECTIVE: To explore physicians' perspectives on primary care for children with autism. METHODS: National mail and e-mail surveys were sent to a random sample of 2325 general pediatricians and 775 family physicians from April 2007 to October 2007. RESULTS: The response rate was 19%. Physicians reported significantly lower overall self-perceived competency, a greater need for primary care improvement, and a greater desire for education for children with autism compared with both children with other neurodevelopmental conditions and those with chronic/complex medical conditions. The following barriers to providing primary care were endorsed as greater for children with autism: lack of care coordination, reimbursement and physician education, family skeptical of traditional medicine and vaccines, and patients using complementary alternative medicine. Adjusting for key demographic variables, predictors of both higher perceived autism competency and encouraging an empirically supported therapy, applied behavior analysis, included having a greater number of autism patient visits, having a friend or relative with autism, and previous training about autism. CONCLUSIONS: Primary care physicians report a lack of self-perceived competency, a desire for education, and a need for improvement in primary care for children with autism. Physician education is needed to improve primary care for children with autism. Practice parameters and models of care should address physician-reported barriers to care.


Assuntos
Transtorno Autístico/epidemiologia , Competência Clínica/estatística & dados numéricos , Deficiências do Desenvolvimento/epidemiologia , Acesso aos Serviços de Saúde/estatística & dados numéricos , Pediatria/estatística & dados numéricos , Atenção Primária à Saúde/estatística & dados numéricos , Adulto , Transtorno Autístico/terapia , Criança , Terapias Complementares/estatística & dados numéricos , Comportamento Cooperativo , Estudos Transversais , Deficiências do Desenvolvimento/terapia , Feminino , Necessidades e Demandas de Serviços de Saúde/estatística & dados numéricos , Inquéritos Epidemiológicos , Humanos , Masculino , Pessoa de Meia-Idade , Equipe de Assistência ao Paciente/estatística & dados numéricos , Estados Unidos
14.
Pediatrics ; 117(2): 441-7, 2006 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-16452364

RESUMO

OBJECTIVE: We sought to examine the relationship between perceived and stated parental expectations regarding adolescents' use of violence, parental use of physical punishment as discipline, and young adolescents' violence-related attitudes and involvement. METHODS: Surveys were completed by 134 youth and their parents attending 8 pediatric practices. All youth were 10 to 15 years of age and had scored positive on a psychosocial screening test. RESULTS: Multivariate analyses revealed that perceived parental disapproval of the use of violence was associated with a more prosocial attitude toward interpersonal peer violence and a decreased likelihood of physical fighting by the youth. Parental report of whether they would advise their child to use violence in a conflict situation (stated parental expectations) was not associated with the adolescents' attitudes toward interpersonal peer violence, intentions to fight, physical fighting, bullying, or violence victimization. Parental use of corporal punishment as a disciplining method was inversely associated with a prosocial attitude toward interpersonal peer violence among the youth and positively correlated with youths' intentions to fight and fighting, bullying, and violence victimization. CONCLUSIONS: Perceived parental disapproval of the use of violence may be an important protective factor against youth involvement in violence, and parental use of physical punishment is associated with both violence perpetration and victimization among youth. Parents should be encouraged to clearly communicate to their children how to resolve conflicts without resorting to violence and to model these skills themselves by avoiding the use of physical punishment.


Assuntos
Comportamento do Adolescente , Atitude , Pais/psicologia , Punição/psicologia , Violência , Adolescente , Criança , Feminino , Humanos , Masculino , Relações Pais-Filho , Psicologia do Adolescente , Violência/psicologia
16.
Pediatrics ; 114(4): e392-9, 2004 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-15466063

RESUMO

OBJECTIVE: Although many major health care organizations have made recommendations regarding physicians' roles in preventing youth violence, the efficacy of violence prevention strategies in primary care settings remains to be empirically tested. METHODS: We conducted a randomized, controlled trial to evaluate the effects of an office-based intervention on children's violent behaviors and violence-related injuries. Children 7 to 15 years of age who presented at 8 pediatric practices and scored positive on a brief psychosocial screening test (n = 224) were randomly assigned to an intervention group (clinicians saw the screening test results during the visit and a telephone-based parenting education program was made available to clinicians as a referral resource for parents) or a control group (clinicians did not see the screening test results). RESULTS: Compared with control subjects, at 9 months after study enrollment, children in the intervention group exhibited decreases in aggressive behavior (adjusted mean difference: -1.71; 95% confidence interval [CI]: -2.89 to -0.53), delinquent behavior (adjusted mean difference: -0.71; 95% CI: -1.28 to -0.13), and attention problems (adjusted mean difference: -1.02; 95% CI, -1.77 to -0.26) on the Child Behavior Checklist. Children in the intervention group had lower rates of parent-reported bullying (adjusted odds ratio: 4.43; 95% CI: 1.87-10.52), physical fighting (adjusted odds ratio: 1.79; 95% CI: 1.11-2.87), and fight-related injuries requiring medical care (adjusted odds ratio: 4.70; 95% CI: 1.33-16.59) and of child-reported victimization by bullying (adjusted odds ratio: 3.23; 95% CI: 1.96-5.31). CONCLUSIONS: A primary care-based intervention that includes psychosocial screening and the availability of a parenting education resource can decrease violent behavior and injury among youths.


Assuntos
Transtornos do Comportamento Infantil/terapia , Poder Familiar , Violência/prevenção & controle , Adolescente , Sintomas Afetivos/terapia , Agressão , Criança , Feminino , Humanos , Masculino , Serviços de Saúde Mental/estatística & dados numéricos , Relações Pais-Filho , Pais/psicologia , Atenção Primária à Saúde , Testes Psicológicos , Ferimentos e Lesões/prevenção & controle
17.
Pediatrics ; 113(3 Pt 1): 530-6, 2004 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-14993545

RESUMO

OBJECTIVE: Nonfatal fight-related injuries among youths result in lost capacity and high costs of medical care and rehabilitation and constitute a major public health problem. This study identifies factors that predict the occurrence of a fight-related injury that requires medical attention among boys and girls. METHODS: We analyzed data from 14 787 adolescents who completing 2 interviews, approximately 1 year apart, in the National Longitudinal Study of Adolescent Health, a nationally representative, school-based sample of youths. We identified time 1 factors at the community, family, and individual levels that predicted any self-reported fight-related injury that required medical treatment at time 2. RESULTS: Factors that predict future injury among both boys and girls in multivariate models were violence-related factors: witnessing or being a victim of violence (odds ratio [OR]: 3.69; 95% confidence interval [CI]: 1.81-7.49 for boys; OR: 5.13; 95% CI: 1.25-21.09 for girls), history of a violence-related injury (OR: 2.30; 95% CI: 1.60-3.29 for boys; OR: 3.18; 95% CI: 1.87-5.41 for girls), and physical fighting (OR: 2.02; 95% CI: 1.44-2.84 for boys; OR: 5.15; 95% CI: 3.18-8.34 for girls). Among boys, illicit drug use was also an independent predictor of future injury (OR: 1.72; 95% CI: 1.24-2.37), whereas excellent perceived general health (OR: 0.48; 95% CI: 0.25-0.93) and a high grade point average (OR: 0.52; 95% CI: 0.29-0.95) were significant protective factors against fight-related injury. Girls who reported a high level of depressive symptoms were much more likely to report fight-related injury than nondepressed girls (OR: 8.98; 95% CI: 2.43-33.25). CONCLUSIONS: Factors related to violence, substance use, school achievement, and physical and mental health predicted a future fight-related injury that required medical treatment. The results could assist health and social service providers, educators, and others in identifying youths who are at high risk for fight-related injury and may benefit from appropriate intervention.


Assuntos
Violência/estatística & dados numéricos , Ferimentos e Lesões/epidemiologia , Adolescente , Feminino , Humanos , Masculino , Fatores de Risco , Fatores Socioeconômicos , Estados Unidos/epidemiologia , Ferimentos e Lesões/etiologia
18.
Pediatrics ; 112(1 Pt 1): 129-33, 2003 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-12837878

RESUMO

OBJECTIVE: To identify factors associated with positive scores on a brief psychosocial screening tool with subscales for internalizing, externalizing, and attention problems. METHODS: Parents of 2028 children between the ages of 7 and 15 years seen in a sample of 8 primary care practices in the Minneapolis-St Paul metropolitan area completed a brief questionnaire that included the 17-item Pediatric Symptom Checklist (PSC), demographic information, and the reason for the child's visit to the clinic. RESULTS: Overall, 22% of the youth had at least 1 positive PSC-17 subscale or a positive PSC-17 total score. Twelve percent scored positive on the internalizing subscale, 10% on the externalizing subscale, 7% on the attention subscale, and 11% had a positive PSC-17 total score. Although boys were more likely than girls to score positive on the attention and aggression subscales, boys and girls were equally likely to have a positive score on the depression subscale. Children not living with both biological parents and those with a household member receiving public assistance were significantly more likely to show psychosocial dysfunction. Controlling for demographic characteristics, patients presenting for an illness-related or injury visit were more likely to score positive on the screen than those presenting for a routine well-child visit (odds ratio: 1.46; 95% confidence interval: 1.07-1.98). CONCLUSIONS: Clinicians will miss opportunities to identify emotional and behavioral disorders among children and adolescents who may be at a higher risk if they limit psychosocial screening to health supervision visits. Further research is needed to identify effective strategies for using primary care for recognizing, diagnosing, and treating mental health disorders in children and adolescents.


Assuntos
Programas de Rastreamento , Transtornos Mentais/epidemiologia , Visita a Consultório Médico , Atenção Primária à Saúde , Testes Psicológicos , Doença Aguda , Adolescente , Agressão , Atenção , Criança , Transtornos do Comportamento Infantil/diagnóstico , Transtornos do Comportamento Infantil/epidemiologia , Serviços de Saúde da Criança , Depressão , Feminino , Humanos , Masculino , Anamnese , Transtornos Mentais/diagnóstico , Minnesota/epidemiologia , Aceitação pelo Paciente de Cuidados de Saúde , Psicologia , Fatores Socioeconômicos , Inquéritos e Questionários
19.
J Community Health ; 28(2): 79-97, 2003 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-12705311

RESUMO

Cigarette smoking remains a substantial threat to the current and future health of America's youth. The purpose of this study was to identify the risk and protective factors for cigarette smoking among US adolescents. Data from the National Longitudinal Study of Adolescent Health was used, comparing the responses of all non-smokers at Time 1 for their ability to predict the likelihood of smoking at Time 2, one year later. Data was stratified into four gender by grade group cohorts. Cross-cutting risk factors for smoking among all four cohorts were: using alcohol, marijuana, and other illicit drugs; violence involvement; having had sex; having friends who smoke and learning problems. Having a higher grade point average and family connectedness were protective across all cohorts. Other gender and grade group specific risk and protective factors were identified. The estimated probability of initiating smoking decreased by 19.2% to 54.1% both in situations of high and low risk as the number of protective factors present increased. Of the factors that predict or protect against smoking some are influential across all gender and grade group cohorts studied, while others are specific to gender and developmental stage. Prevention efforts that target both the reduction of risk factors and enhancement of protective factors at the individual, family, peer group and community are likely to reduce the likelihood of smoking initiation.


Assuntos
Comportamento do Adolescente/psicologia , Comportamentos Relacionados com a Saúde , Assunção de Riscos , Fumar/psicologia , Logro , Adolescente , Comportamento do Adolescente/etnologia , Estudos de Coortes , Análise Fatorial , Família/etnologia , Feminino , Comportamentos Relacionados com a Saúde/etnologia , Humanos , Estudos Longitudinais , Masculino , Grupo Associado , Probabilidade , Medição de Risco , Fatores de Risco , Autoimagem , Fatores Sexuais , Fumar/etnologia , Prevenção do Hábito de Fumar , Estados Unidos/epidemiologia
20.
Ambul Pediatr ; 2(6): 475-84, 2002.
Artigo em Inglês | MEDLINE | ID: mdl-12437395

RESUMO

OBJECTIVE: To identify risk and protective factors for violence perpetration among youth with a history of grade retention. DESIGN: Longitudinal analysis of in-home interviews of 13,781 adolescents in grades 7 through 12 conducted in 1995 and 1996. METHODS AND MEASURES: Serious interpersonal violence perpetration at time 2 by time 1 independent variables including measures of community and school context, family context, and individual characteristics. RESULTS: The 20% of girls and 28% of boys who had repeated 1 or more grades were more likely than those who had not to be in the top quintile of violence perpetration at time 2 (P <.001). For both girls and boys with a history of grade repetition, predictive risk factors with an odds ratio of 3 or greater (P <.001) included time 1 violence perpetration, violence victimization, weapon carrying, school problems, and alcohol and marijuana use. Although a high grade point average was a significant protective factor against violence perpetration for both girls (odds ratio, 0.36; P <.05) and boys (odds ratio, 0.23; P <.001), performance on a validated measure of verbal knowledge was not associated with violence perpetration over the study period. School connectedness, parent-family connectedness, and emotional well-being were also significant universal protectors against violence perpetration. CONCLUSIONS: Youth who are held back in school are at heightened risk for violence perpetration. Violence-related behaviors and substance use considerably increase the likelihood of this outcome. The findings suggest that schools can participate in violence prevention by providing youth with a positive community and academic experience.


Assuntos
Educação , Estudantes/psicologia , Baixo Rendimento Escolar , Violência/prevenção & controle , Adolescente , Família/psicologia , Feminino , Humanos , Modelos Logísticos , Estudos Longitudinais , Masculino , Análise Multivariada , Fatores de Risco , Estados Unidos
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