Self-rated health among adolescents from vulnerable areas and their sociodemographic, lifestyle and contextual factors: A multilevel analysis.

PURPOSE: Understanding self-rated health in young people can help orient global health actions, especially in regions of social vulnerability. The present study analysed individual and contextual factors associated with self-rated health in a sample of Brazilian adolescents. DESIGN AND METHODS: Cross-sectional data from 1272 adolescents (aged 11-17; 48.5% of girls) in low human development index (HDI) neighbourhoods were analysed (HDI from 0.170 to 0.491). The outcome variable was self-rated health. Independent variables relating to individual factors (biological sex, age and economic class) and lifestyle (physical activity, alcohol, tobacco consumption and nutritional state) were measured using standardised instruments. The socio-environmental variables were measured using neighbourhood registered data where the adolescents studied. Multilevel regression was used to estimate the regression coefficients and their 95% confidence intervals (CI). RESULTS: Good self-rated health prevalence was of 72.2%. Being male (B: -0.165; CI: -0.250 to -0.081), age (B: -0.040; CI: -0.073 to -0.007), weekly duration of moderate to vigorous physical activity (B: 0.074; CI: 0.048-0.099), body mass index (B: -0.025; CI: -0.036 to -0.015), number of family healthcare teams in the neighbourhood (B: 0.019; CI: 0.006-0.033) and dengue incidence (B: -0.001; CI: -0.002; -0.000) were factors associated with self-rated health among students from vulnerable areas. CONCLUSIONS/PRACTICAL IMPLICATIONS: Approximately three in every 10 adolescents in areas of social vulnerability presented poor self-rated health. This fact was associated with biological sex and age (individual factors), physical activity levels and BMI (lifestyle) and the number of family healthcare teams in the neighbourhood (contextual).

Factors related to depressive symptoms during the second year of COVID-19 pandemic in Brazil: A cross-sectional study with adolescents.

PURPOSE: This study aimed to identify factors associated with depressive symptoms in adolescents during the COVID-19 pandemic in Brazil. DESIGN AND METHODS: A cross-sectional study was conducted in 2021 with a sample of 1303 students (50.96% females; mean age = 16.32 ± 1.1y) enrolled in high schools integrated with professional education. Depressive symptoms, socioeconomic variables (sex, age, skin color/ethnicity, and head of the household education level), body mass index categories, and adherence to the recommendations on physical activity, recreational screen time, and sleep were evaluated using an online survey. Linear regressions were used to test associations. RESULTS: Female, older adolescents, those who self-identified as Black, and those whose head of household had an incomplete primary education were associated with depressive symptoms. Not doing any moderate to vigorous physical activity (0 min/week) and not meeting recommendations for recreational screen time (<2 h) and sleep (≥8 h) were associated with higher depressive symptoms (ß = 3.04, 95%CI: 1.16;4.92; ß = 4.54, 95%CI:1.99;7.10; ß = 2.95, 95%CI:1.58;4.31; respectively). CONCLUSION: Depressive symptomology during the COVID-19 pandemic is prominent in groups of adolescents who experience health inequities. PRACTICAL IMPLICATIONS: The results suggest that and at-risk groups may benefit from mental health care initiatives, and additional research is needed to evaluate the long-term impacts of depression during the pandemic and global health crises.

Health Promoting School Interventions in Latin America: A Systematic Review Protocol on the Dimensions of the RE-AIM Framework.

Understanding the dimensions of internal and external validities (e.g., using the RE-AIM model: Reach, Effectiveness/Efficacy, Adoption, Implementation, and Maintenance) of school interventions is important to guide research and practice in this context. The aim of this systematic review protocol is to synthesize evidence on the RE-AIM dimensions in interventions based on the Health Promoting School (HPS) approach from the World Health Organization (WHO) in Latin America. Studies of interventions based on HPS-WHO that were carried out in Latin America involving the population of 5 to 18-year-olds will be eligible. Searches in nine electronic databases, a study repository, the gray literature, and the retrieved articles' reference lists will be performed, without year or publication language limits. Study selection and data extraction will be conducted by independent researchers. Data on intervention implementation will be summarized in categories of HPS-WHO actions: (1) school curriculum, (2) changes in the social and/or physical environment of schools, and (3) actions with families and the community. A previously validated tool will be used to summarize the information on the dimensions of the RE-AIM model. The strengths and limitations of the included studies will be evaluated using the Critical Appraisal Skills Program (CASP) tool, and the confidence level of evidence will be assessed according to the GRADE CERQual tool.