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Health Behavior Clustering and Mental Health Outcomes in Children, Adolescents, and Young Adults

A special issue of International Journal of Environmental Research and Public Health (ISSN 1660-4601). This special issue belongs to the section "Adolescents".

Deadline for manuscript submissions: closed (31 January 2023) | Viewed by 62648

Special Issue Editors

Special Issue Information

Dear Colleagues,

During this uncertain time in world history, maintaining adequate mental health is important. Children, adolescents, and young adults are susceptible to anxiety, depression, loneliness, and low self-esteem that may affect their physical health and overall well-being. These burdens may transfer into the academic classroom and negatively affect academic performance. Health behaviors such as adequate physical activity, a healthy diet, and sufficient sleep quantity and quality have been shown to mitigate deteriorating mental health and improve well-being. Conversely, risk behaviors such as alcohol consumption, substance abuse, and smoking may exacerbate poor mental health. The clustering or combining of these health and risk behaviors may have additive effects on mental health outcomes. This Special Issue of the International Journal of Environmental Research and Public Health, “Health Behavior Clustering and Mental Health Outcomes in Children, Adolescents, and Young Adults”, offers an opportunity to publish high-quality research relating health and risk behavior clustering with mental health outcomes in young individuals. We are particularly interested in novel multi-behavioral interventions that target these outcomes within underserved populations. We also welcome observational studies examining longitudinal, moderated, and mediated relationships. Manuscripts will be rigorously peer-reviewed by experts in the field. Thank you for your consideration.

Dr. Ryan D. Burns
Dr. Wonwoo Byun
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. International Journal of Environmental Research and Public Health is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2500 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • alcohol
  • cognition
  • diet
  • mental health
  • physical activity
  • sedentary behavior
  • sleep
  • smoking
  • social support
  • well-being

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Published Papers (20 papers)

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11 pages, 320 KiB  
Article
The Link between Sleep Insufficiency and Self-Injury among In-School Adolescents: Findings from a Cross-Sectional Survey of Multi-Type Schools in Huangpu District of Shanghai, China
by Shan Zhang and Chunyan Yu
Int. J. Environ. Res. Public Health 2022, 19(23), 15595; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph192315595 - 24 Nov 2022
Cited by 1 | Viewed by 980
Abstract
Both insufficient sleep and self-injury are rising public health issues among middle school students. Understanding their relationship may guide the intervention and policy making to help youths gain a healthy life. Thus, we analysed the data collected from the Shanghai Students Health Risk [...] Read more.
Both insufficient sleep and self-injury are rising public health issues among middle school students. Understanding their relationship may guide the intervention and policy making to help youths gain a healthy life. Thus, we analysed the data collected from the Shanghai Students Health Risk Behavior Surveillance (2015) in the Huangpu District. Self-injury was self-reported and categorized into ever or never. Sleep duration was classified as sufficient and insufficient according to the Health China 2030 Plan and the National Sleep Foundation’s updated sleep duration recommendations. Crude OR and adjusted OR of sleep duration and covariates were estimated for self-injury using the logistic regression models with standard error clustered on school types. Results showed that 8.42% of the participants had conducted self-injury, with girls more than boys and ordinary school students more than key school students. After full adjustment, sleep insufficiency increased the odds of conducting self-injury by approximately two folds (AOR = 2.08, 95%CI = 1.40–3.07). The odds of self-injury were higher among students studying at ordinary schools (AOR = 3.58, 95%CI = 1.25–10.27) or vocational schools (AOR = 2.00, 95%CI = 1.77–2.26), with comparison to those at key schools. Interventions seeking to solve insufficient sleep need to be multifaceted, with consideration of changing the school environment and multiple social contexts, which create stressful burdens for adolescents’ development. Full article
15 pages, 873 KiB  
Article
Health Education Module Based on Information–Motivation–Behavioural Skills (IMB) for Reducing Depression, Anxiety, and Stress among Adolescents in Boarding Schools: A Clustered Randomised Controlled Trial
by Rahmat Dapari, Mohd Safrin Mohamad Bashaabidin, Mohd Rohaizat Hassan, Nazri Che Dom, Syed Sharizman Syed Abdul Rahim and Wan Rozita Wan Mahiyuddin
Int. J. Environ. Res. Public Health 2022, 19(22), 15362; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph192215362 - 21 Nov 2022
Cited by 3 | Viewed by 1840
Abstract
Depression, anxiety, and stress (DAS) among adolescents have become a public health concern. The aim of this study was to develop, implement, and measure an IMB-based health education intervention module for reducing DAS among adolescents in boarding schools in the state of Negeri [...] Read more.
Depression, anxiety, and stress (DAS) among adolescents have become a public health concern. The aim of this study was to develop, implement, and measure an IMB-based health education intervention module for reducing DAS among adolescents in boarding schools in the state of Negeri Sembilan, Malaysia. A single-blinded cluster randomised control trial (RCT) was conducted among students with abnormal DASS-21 scores. They were divided into an intervention group (three schools, 62 participants) and a control group (three schools, 57 participants). Participants in the intervention group received IMB-based health education, while participants in the control group underwent the standard care session. To determine the effectiveness of the intervention, the Generalised Linear Mixed Model (GLMM) analysis was conducted. A total of 119 students participated in this study, and no loss to follow-up was reported. Both intervention and control groups showed significantly reduced DAS scores (p < 0.005). However, the reduction of these scores was greater in the intervention group. The GLMM analysis revealed that the intervention was effective in reducing depression (ß = −2.400, t = −3.102, SE = 0.7735, p = 0.002, 95% CI = −3.921, −0.878), anxiety (ß = −2.129, t = −2.824, SE = 0.7541, p = 0.005, 95% CI = −3.612, −0.646), and stress (ß = −1.335, t = −2.457, SE = 0.536, p = 0.015, 95% CI = −2.045, −0.266) among adolescents. The IMB-based health education module was effective in reducing DAS among adolescents in boarding schools. Full article
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16 pages, 646 KiB  
Article
Urban–Rural Comparison of the Association between Unsupportive Relationships, Perceived Stress, Authentic Self-Presentation, and Loneliness among Young Adults in Taiwan
by Yuting Sun and Chaoyun Liang
Int. J. Environ. Res. Public Health 2022, 19(14), 8808; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph19148808 - 20 Jul 2022
Cited by 4 | Viewed by 1622
Abstract
This study examined and compared how unsupportive relationships, perceived stress, and authentic self-presentation influence loneliness and what differences exist between these relationships across urban and rural young adults in Taiwan. In total, 356 young adults (188 urban and 168 rural) were investigated, and [...] Read more.
This study examined and compared how unsupportive relationships, perceived stress, and authentic self-presentation influence loneliness and what differences exist between these relationships across urban and rural young adults in Taiwan. In total, 356 young adults (188 urban and 168 rural) were investigated, and partial least squares structural equation modelling was used in this study. The results indicated that authentic self-presentation directly and negatively affects loneliness in the urban group, but only indirectly affects loneliness in the rural group through unsupportive relationships and perceived stress. Unsupportive relationships and perceived stress in both the urban and rural groups positively affect their loneliness. In addition, multiple group analysis revealed that significant differences only existed between the effects of authentic self-presentation on unsupportive relationships between urban and rural young adults. Full article
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14 pages, 382 KiB  
Article
Predictors of COVID-19 Stress and COVID-19 Vaccination Acceptance among Adolescents in Ghana
by Emma Sethina Adjaottor, Frimpong-Manso Addo, Florence Aninniwaa Ahorsu, Hsin-Pao Chen and Daniel Kwasi Ahorsu
Int. J. Environ. Res. Public Health 2022, 19(13), 7871; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph19137871 - 27 Jun 2022
Cited by 9 | Viewed by 2740
Abstract
Coronavirus disease 2019 (COVID-19) continues to ravage world economies, and with its recent mutations, countries worldwide are finding ways of ramping up their vaccination programmes. This cross-sectional design study, therefore, examined the predictors of COVID-19 stress and COVID-19 vaccination acceptance among adolescents in [...] Read more.
Coronavirus disease 2019 (COVID-19) continues to ravage world economies, and with its recent mutations, countries worldwide are finding ways of ramping up their vaccination programmes. This cross-sectional design study, therefore, examined the predictors of COVID-19 stress and COVID-19 vaccination acceptance among adolescents in Ghana. A total of 817 participants were conveniently selected to respond to measures on fear of COVID-19, perceived stigma from COVID-19, self-stigma from COVID-19, believing COVID-19 information, COVID-19 infection prevention behaviours, COVID-19 stress, and COVID-19 vaccination acceptance. It was found that females believed COVID-19 information and accepted COVID-19 vaccination more than males did. Moreover, there were significant relationships between the majority of the COVID-19-related variables. Furthermore, fear of COVID-19, self-stigma from COVID-19, and COVID-19 infection prevention behaviours were found to be significant predictors of COVID-19 stress. Additionally, believing COVID-19 information, danger and contamination fears (a subscale of COVID-19 stress), and traumatic stress (a subscale of COVID-19 stress) were significant predictors of COVID-19 vaccination acceptance. These findings imply that different factors influence different COVID-19 variable. Therefore, careful considerations and research should be employed by health authorities and policymakers in preparing COVID-19 information to target different age groups and for different COVID-19 purposes. Full article
13 pages, 830 KiB  
Article
The Determinants of Mental Health Literacy among Young Adolescents in Malaysia
by Sarbhan Singh, Rafdzah Ahmad Zaki, Nik Daliana Nik Farid and Kushilpal Kaur
Int. J. Environ. Res. Public Health 2022, 19(6), 3242; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph19063242 - 09 Mar 2022
Cited by 13 | Viewed by 5217
Abstract
Mental health literacy (MHL) is an established multifaceted concept that comprises mental health knowledge, help-seeking, and stigma. Adequate MHL (i.e., the ability to correctly recognize mental health disorders alongside having the intention to seek help) is able improve mental health outcomes among individuals. [...] Read more.
Mental health literacy (MHL) is an established multifaceted concept that comprises mental health knowledge, help-seeking, and stigma. Adequate MHL (i.e., the ability to correctly recognize mental health disorders alongside having the intention to seek help) is able improve mental health outcomes among individuals. This study aims to examine the determinants of MHL among young Malaysian adolescents. A cross-sectional study was conducted among 1400 adolescents between 13 and 14 years old from nine national secondary schools in Selangor state, Malaysia. Sociodemographic determinants assessed included gender, age, ethnicity, smoking status, alcohol consumption, history of being bullied, feeling lonely, parental marital status, and parental income which were assessed using the Global School Based Student Health Survey. MHL was assessed using the Mental Health Literacy and Stigma questionnaire. Several factors were significantly associated with adequate levels of MHL following multivariate analysis, such as being female (AOR = 1.68; 95% CI 1.12, 2.52), older adolescents (AOR = 1.56; 95% CI 1.07, 2.30), not smoking (AOR = 1.99; 95% CI 1.20, 4.26), not consuming alcohol (AOR = 1.23; 95% CI 1.18, 2.41), and not feeling lonely (AOR = 1.25; 95% CI 1.06, 1.85). Addressing these determinants could be key in assisting the development of policies and programs to prevent mental health disorders among adolescents, which are currently on the rise. Full article
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17 pages, 741 KiB  
Article
Effects of Bullying Forms on Adolescent Mental Health and Protective Factors: A Global Cross-Regional Research Based on 65 Countries
by Xiaoou Man, Jiatong Liu and Zengxin Xue
Int. J. Environ. Res. Public Health 2022, 19(4), 2374; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph19042374 - 18 Feb 2022
Cited by 14 | Viewed by 9239
Abstract
Adolescent bullying is a public health issue of great global concern. Given the serious negative effect of bullying on adolescent mental health, it is critical to seek protective factors to protect adolescent mental health. From a global cross-regional perspective, the study aims to [...] Read more.
Adolescent bullying is a public health issue of great global concern. Given the serious negative effect of bullying on adolescent mental health, it is critical to seek protective factors to protect adolescent mental health. From a global cross-regional perspective, the study aims to explore the relationship between forms of bullying and adolescent mental health and the role of parental support as a protective factor. Data were drawn from adolescents aged 12–17 years in 65 countries from the Global School-based Student Health Survey between 2003 and 2015. After controlling the state-fixed effects, individual adolescent behavior, and family factors, the ordinary least squares model was used to analyze the influence of bullying frequency and forms of bullying on adolescent mental health. The results found that the prevalence of bullying in the sample of 167,286 adolescents was 32.03%, with the highest prevalence of bullying in the sample countries in Africa. Verbal bullying had the highest prevalence and the most significant negative effect on adolescent mental health. The study also discussed the differences in bullying among adolescents by gender, age, and region. “Parental supervision”, “parental connectedness” and “parental bonding” played a positive and protective role in the mental health of adolescents who experienced bullying. Full article
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9 pages, 790 KiB  
Article
Adolescents’ Physical Activity and Depressive Symptoms: A Psychosocial Mechanism
by Liang Shen, Xiangli Gu, Tao Zhang and Joonyoung Lee
Int. J. Environ. Res. Public Health 2022, 19(3), 1276; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph19031276 - 24 Jan 2022
Cited by 4 | Viewed by 3246
Abstract
Guided by the Theory of Planned Behavior (TPB; Ajzen, 1991), this study aimed to test a hypothesized path model of TPB variables (i.e., attitude toward behavior, subjective norm, perceived behavioral control, and intention) with physical activity (PA) and depressive symptoms. A total of [...] Read more.
Guided by the Theory of Planned Behavior (TPB; Ajzen, 1991), this study aimed to test a hypothesized path model of TPB variables (i.e., attitude toward behavior, subjective norm, perceived behavioral control, and intention) with physical activity (PA) and depressive symptoms. A total of 792 Chinese adolescents (Mage = 16.9; SD = 0.82; 54.5% females) completed previously validated questionnaires assessing their TPB variables, PA, and depressive symptoms. Correlation analysis revealed TPB variables were positively associated with PA (p < 0.01), and negatively correlated to depressive symptoms (p < 0.01). The path analyses indicated that the hypothesized model produces a goodness of fit (χ2/df = 16.14/5, CFI = 0.99, RMSEA = 0.06). The findings support the theoretical tenets of TPB and provide empirical evidence of the psychosocial mechanism of PA and depressive symptoms in Chinese adolescents. It suggests that building PA intervention strategies while considering the TPB framework may promote adolescents’ physical and mental health. Full article
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9 pages, 1124 KiB  
Article
Vitamin D Status and Its Association with Multiple Intelligence among Arab Adolescents
by Ahmed S. Mohammed Metwally, Sobhy M. Yakout, Malak N. K. Khattak, Ghadah Alkhaldi and Nasser M. Al-Daghri
Int. J. Environ. Res. Public Health 2021, 18(24), 13036; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph182413036 - 10 Dec 2021
Cited by 3 | Viewed by 1890
Abstract
Studies investigating the association of vitamin D on intelligence is limited. The present study therefore aims to determine the association of vitamin D status with the different domains of intelligence among Saudi Arabian adolescents. This study used relational survey method among 1864 Saudi [...] Read more.
Studies investigating the association of vitamin D on intelligence is limited. The present study therefore aims to determine the association of vitamin D status with the different domains of intelligence among Saudi Arabian adolescents. This study used relational survey method among 1864 Saudi adolescent, including 549 boys and 1315 girls (mean age 14.7 ± 1.7 years) recruited using a multistage, stratified cluster randomization of 47 public and private schools in Riyadh in Saudi Arabia. A general questionnaire was used to collect demographic information. Intelligence was assessed using multiple intelligence inventory. Anthropometrics were measured and fasting blood samples collected for assessment of glucose and lipid profile. Vitamin D deficiency (25(OH)D <50 nmol/L) was observed in 84.2% of boys and 93.5% of girls. Girls had higher levels of verbal, kinesthetic, musical, naturalist and existential intelligence than boys, while boys have higher logical intelligence than girls (p-values < 0.05). Mixed regression analysis controlled for age, BMI and sex revealed that kinesthetic intelligence was significantly associated with 25(OH)D in boys (β 5.6 (2.8–8.5; p < 0.001)) and inversely associated with musical intelligence (β −1.2 (−2.3–0.1; p = 0.03)) and positively with naturalist (β 2.3 (0.5–4.2; p = 0.01)) in girls. Vitamin D status is associated with several domains of intelligence in adolescents and is sex-specific. Development a specific domain of intelligence may indirectly affect vitamin D status among adolescents, but needs to be proven prospectively. Full article
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11 pages, 886 KiB  
Article
Eight-Year Retrospective Study of Young Adults in a Diabetes Transition Clinic
by Aarooran Sritharan, Uchechukwu L. Osuagwu, Manjula Ratnaweera and David Simmons
Int. J. Environ. Res. Public Health 2021, 18(23), 12667; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph182312667 - 01 Dec 2021
Cited by 4 | Viewed by 2213
Abstract
The transition of people from paediatric to adult diabetes services is associated with worsening glycaemia and increased diabetes-related hospitalisation. This study compared the clinical characteristics of those with and without mental health conditions among attenders at a diabetes young adult clinic diabetes before [...] Read more.
The transition of people from paediatric to adult diabetes services is associated with worsening glycaemia and increased diabetes-related hospitalisation. This study compared the clinical characteristics of those with and without mental health conditions among attenders at a diabetes young adult clinic diabetes before and after changes in service delivery. Retrospective audit of 200 people with diabetes attending a Sydney public hospital over eight years corresponding to the period before (2012–2016) and after (2017–2018) restructuring of a clinic for young adults aged 16–25 years. Characteristics of those with and without mental health conditions (depression, anxiety, diabetes related distress, eating disorders), were compared. Among clinic attenders (type 1 diabetes n = 184, 83.2%), 40.5% (n = 89) had a mental health condition particularly, depression (n = 57, 64%), which was higher among Indigenous than non-Indigenous people (5.6% vs. 0.8%, p = 0.031) but similar between diabetes type. Over eight years, those with, compared with those without a mental health condition had higher haemoglobin A1c (HbA1c) at the last visit (9.4% (79 mmol/mol) vs. 8.7% (71 mmol/mol), p = 0.027), the proportion with diabetic ketoacidosis (DKA 60.7% vs. 42.7%, p = 0.009), smoking (38.4 vs. 13.6%, p = 0.009), retinopathy (9.0 vs. 2.3%, p = 0.025), multiple DKAs (28.4 vs. 16.0%, p = 0.031) were significantly higher. Having a mental health condition was associated with 2.02 (95% confidence intervals 1.1–3.7) fold increased risk of HbA1c ≥9.0% (75 mmol/mol). Changes to the clinic were not associated with improvements in mental health condition (39.0% vs. 32.4%, p = 0.096). In conclusion, we found that mental health conditions, particularly depression, are common in this population and are associated with diabetes complications. Diabetes type and clinic changes did not affect the reported mental health conditions. Additional strategies including having an in-house psychologist are required to reduce complication risks among those with mental health conditions. Full article
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13 pages, 631 KiB  
Article
The Influence of Discrepancies between Parents’ Educational Aspirations and Children’s Educational Expectations on Depressive Symptoms of Left-Behind Children in Rural China: The Mediating Role of Self-Efficacy
by Xiaoou Man, Jiatong Liu and Yutong Bai
Int. J. Environ. Res. Public Health 2021, 18(21), 11713; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph182111713 - 08 Nov 2021
Cited by 8 | Viewed by 2685
Abstract
Although long-term separation has made discrepancies between parents’ educational aspirations and children’s own educational expectations among families with left-behind children (LBC), limited researches on the influence of these discrepancies on children’s mental health are carried out at present. Based on China Family Panel [...] Read more.
Although long-term separation has made discrepancies between parents’ educational aspirations and children’s own educational expectations among families with left-behind children (LBC), limited researches on the influence of these discrepancies on children’s mental health are carried out at present. Based on China Family Panel Studies (CFPS) conducted in 2018, we selected 875 LBC aged 9~15 as the sample, explored the influence of the direction and degree of these discrepancies on LBC’s depressive symptoms by hierarchical regression, and examined the mediating role of children’s academic self-efficacy and mediation effect pathway with Baron and Kenny method and Bootstrap mediation analysis methods. Results showed that LBC’s mental health was worse when parents’ educational aspirations were higher than their children’s educational expectations, compared to that without discrepancies. The degree of such discrepancies was negatively associated with LBC’s mental health. In the relationship between the direction of discrepancies and LBC’s depressive symptoms, academic self-efficacy played a mediating role partially. In addition, the study indicated that mothers played a significant role in the development of LBC’s mental health. These findings also provided critical evidence for the intervention practice of LBC’s mental health. Full article
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13 pages, 368 KiB  
Article
Gender Differences in Lifestyle and Mental Health among Senior High School Students in South Korea
by Hyunlye Kim, Kwang-Hi Park and Suin Park
Int. J. Environ. Res. Public Health 2021, 18(20), 10746; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph182010746 - 13 Oct 2021
Cited by 4 | Viewed by 4258
Abstract
Gender differences in health outcomes have long been a concern worldwide. We investigated the gender differences in the lifestyle and mental health status of senior students in general high schools who were preparing for college entrance exams. This secondary analysis was based on [...] Read more.
Gender differences in health outcomes have long been a concern worldwide. We investigated the gender differences in the lifestyle and mental health status of senior students in general high schools who were preparing for college entrance exams. This secondary analysis was based on data from the 14th Korea Youth Risk Behavior Web-Based Survey (2018). The data of 8476 students in the third year (12th grade) of general high school, among a total of 60,040 middle and high school students nationwide, were analyzed. Mean and standard error (SE) and weighted percentage data were obtained, and the Rao–Scott χ2 test was performed. Boys reported more risky behaviors related to drinking and smoking, while girls had more negative perceptions of their bodies and overall health. In addition, girls showed unhealthier lifestyle-related behaviors (breakfast, physical activity, weight control) and greater vulnerability to poor mental health, including lower sleep satisfaction, stress, depression, and suicidal thoughts. Our results suggest that education and health institutions should consider the needs of each gender separately. A gender-specific approach to maintaining healthy lifestyles and good health status among senior high school students is highly recommended. Full article
12 pages, 674 KiB  
Article
Physical Exercise and Psychological Distress: The Mediating Roles of Problematic Mobile Phone Use and Learning Burnout among Adolescents
by Yansong Li, Qilong Sun, Mingzhe Sun, Peishuai Sun, Qihui Sun and Xue Xia
Int. J. Environ. Res. Public Health 2021, 18(17), 9261; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph18179261 - 02 Sep 2021
Cited by 22 | Viewed by 2828
Abstract
Psychological distress among adolescents adversely affects their development and negatively impacts them later in life. The aim of the present study was to determine whether an association exists between physical exercise and psychological distress and to explore the roles of problematic mobile phone [...] Read more.
Psychological distress among adolescents adversely affects their development and negatively impacts them later in life. The aim of the present study was to determine whether an association exists between physical exercise and psychological distress and to explore the roles of problematic mobile phone use and learning burnout with respect to this association. A total of 2077 Chinese adolescents were evaluated by using the Physical Exercise Questionnaire, the Self-rating Questionnaire for Adolescent Problematic Mobile Phone Use, the Learning Burnout Questionnaire, and the Depression Anxiety Stress Scale-21. A serial multiple mediation model was constructed using the SPSS PROCESS macro. The results showed that physical exercise was negatively associated with psychological distress in this Chinese adolescent population. Serial multiple mediation analysis revealed that problematic mobile phone use and learning burnout both independently and serially mediated the association between physical exercise and psychological distress. These findings provide evidence suggesting that increased attention should be given to problematic mobile phone use and learning burnout when establishing and implementing specific strategies that leverage greater participation in physical exercise to decrease psychological distress in adolescents. Full article
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17 pages, 527 KiB  
Article
Motivation Research on the Content Creation Behaviour of Young Adults in Anxiety Disorder Online Communities
by Jingfang Liu and Yafei Liu
Int. J. Environ. Res. Public Health 2021, 18(17), 9187; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph18179187 - 31 Aug 2021
Cited by 2 | Viewed by 2135
Abstract
With the advancements in science and technology and the improvement of medical care, mental health problems are receiving increasing attention. Increasing numbers of children, adolescents, and young adults are susceptible to anxiety. This paper assesses young adults based on self-determination theory and the [...] Read more.
With the advancements in science and technology and the improvement of medical care, mental health problems are receiving increasing attention. Increasing numbers of children, adolescents, and young adults are susceptible to anxiety. This paper assesses young adults based on self-determination theory and the theory of planned behaviour to determine the intrinsic and extrinsic motivations and mediating variables behind young adults’ content creation behaviour within anxiety disorder online communities (ADOCs). In addition, the paper introduces empathy as a moderating variable, builds a model of the content creation behavioural motivation of young adults, studies the motivation behind young adults’ content creation behaviour in ADOCs, and determines the moderating effect of empathy on young adults’ content creation behaviour. The research data were obtained using a questionnaire survey, and the SmartPLS structural equation model was used for empirical analysis. The study found that expressing one’s anxiety was the most obvious motivation, the content creation intention of young adults significantly positively affected their content creation behaviour, perceived enjoyment motivation had a significant negative influence on young adults’ intention to create content, reward motivation had no significant influence on the content creation intention of young adults, other motivations had significant positive influences on young adults’ content creation intention, and empathy only had a significant negative moderating effect on the relationship between self-efficacy and young adults’ content creation intention. This study not only enriches and expands research on motivation theory but also has practical significance for the improvement and active development of ADOCs. Full article
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12 pages, 356 KiB  
Article
Using Latent Class Analysis to Identify Health Lifestyle Profiles and Their Association with Suicidality among Adolescents in Benin
by Fanny Hoogstoel, Lucresse Corine Fassinou, Sékou Samadoulougou, Céline Mahieu, Yves Coppieters and Fati Kirakoya-Samadoulougou
Int. J. Environ. Res. Public Health 2021, 18(16), 8602; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph18168602 - 15 Aug 2021
Cited by 3 | Viewed by 2202
Abstract
Youth suicidality is considerably prevalent in low- and middle-income countries, including Benin. Factors such as psychosocial distress, socio-environmental factors, and health risk behaviors are associated with suicidality. However, little is known about how these factors co-occur in these countries. An analysis of these [...] Read more.
Youth suicidality is considerably prevalent in low- and middle-income countries, including Benin. Factors such as psychosocial distress, socio-environmental factors, and health risk behaviors are associated with suicidality. However, little is known about how these factors co-occur in these countries. An analysis of these factors taken together would help to identify the profiles most at risk and better target prevention policies. Our study aimed to identify profiles related to these factors and their association with suicidality among adolescents in Benin. Data from the 2016 Global School-Based Student Health Survey were used, and factors related to lifestyle (tobacco and alcohol consumption and physical activity), physical violence, parental support, and psychological distress were studied. Latent class analysis was used to identify the profiles, and a modified Poisson regression with generalized estimating equations, adjusted for sociodemographic characteristics, was performed to assess the association between these profiles and suicidality. The survey results show that globally, 13.8% of the adolescents (n = 2536) aged 11 to 18 had thought about suicide, 15.6% had planned suicide, and 15.6% had attempted suicide. Four profiles were identified: a low-risk group, one with psychological distress problems, a group with violence problems, and one with alcohol, tobacco, and violence problems. The risk of suicidality, in terms of ideation, planning, or attempting, was higher for adolescents in Profiles 2, 3, and 4 than those in Profile 1 (p < 0.05). Adolescents in Profile 2 were particularly affected by this increased risk (prevalence ratio (PR) for ideation = 1.13, 95% CI = 1.03–1.23; PR for planning = 1.12, 95% CI = 1.04–1.22; PR for attempting = 1.09, 95% CI = 1.01–1.17). This study highlights the typical profiles that may be linked with suicidality among adolescents in Benin. A holistic consideration of these factors could help in planning better preventive measures to reduce suicidality among adolescents in Benin. Full article
15 pages, 539 KiB  
Article
A Latent Class Analysis of Health Lifestyles in Relation to Suicidality among Adolescents in Mauritius
by Fanny Hoogstoel, Sékou Samadoulougou, Vincent Lorant and Fati Kirakoya-Samadoulougou
Int. J. Environ. Res. Public Health 2021, 18(13), 6934; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph18136934 - 28 Jun 2021
Cited by 7 | Viewed by 2641
Abstract
Suicidality, which includes suicidal thoughts, planning, and suicide attempts, results mainly from a combination of psychological, sociological, and environmental factors. Despite a high prevalence of suicidality among adolescents in Africa, only a few studies have considered these factors simultaneously. The objective of the [...] Read more.
Suicidality, which includes suicidal thoughts, planning, and suicide attempts, results mainly from a combination of psychological, sociological, and environmental factors. Despite a high prevalence of suicidality among adolescents in Africa, only a few studies have considered these factors simultaneously. The objective of the study was to identify the prevalence of suicidality, to draw up profiles of concomitant risks, and to examine the associations between these profiles and suicidality in Mauritius. This study used data from the 2017 Mauritian Global School-based Student Health Survey including 3012 adolescents with a mean age of 14.9 ± 1.4 years. Factors related to lifestyle such as consumptions of alcohol and tobacco, physical activity, violence, parental support, anxiety, and loneliness were considered. A latent class analysis was performed to identify the profiles. Finally, a modified Poisson regression analysis with generalized estimating equations, adjusted with sociodemographic characteristics, was used to assess the association between these profiles and suicidality. Overall, more than one in ten adolescents had at least one of the suicidality behaviors. Three profiles were identified: 1 = “low risk group” (63.9%); 2 = “problems with violence” (15.2%); 3 = “problems with violence, alcohol, tobacco and psychological distress” (20.9%). Profiles 2 and 3 were mainly made up of males. Adolescents under 15 represented the majority of individuals in profile 2. Finally, the risk of suicidality was higher in adolescents belonging to profiles 2 and 3 compared to profile 1 for the three suicidality behaviors (profile 3: Prevalence ratio (PR) for suicidal thoughts = 1.26, 95% CI = 1.19–1.34; PR for planning = 1.23, 95% CI = 1.17–1.30; PR for attempt = 1.23, 95% CI = 1.17–1.29). This study highlights the high prevalence of suicidality and a list of concomitant risks, emphasizing this suicidality in Mauritian adolescents. Therefore, these results recommend focusing preventive efforts toward a simultaneous consideration of these factors. Full article
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11 pages, 588 KiB  
Article
The Sequential Mediating Effects of Dietary Behavior and Perceived Stress on the Relationship between Subjective Socioeconomic Status and Multicultural Adolescent Health
by Youlim Kim, Hyeonkyeong Lee, Mikyung Lee, Hyeyeon Lee, Sookyung Kim and Kennedy Diema Konlan
Int. J. Environ. Res. Public Health 2021, 18(7), 3604; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph18073604 - 31 Mar 2021
Cited by 3 | Viewed by 2337
Abstract
Studies have examined the impact of social determinants of health on the health behaviors and health statuses of ethnic minority adolescents. This study examines the subjective health of this population by examining the direct effects of multicultural adolescents’ subjective socioeconomic status (SES) and [...] Read more.
Studies have examined the impact of social determinants of health on the health behaviors and health statuses of ethnic minority adolescents. This study examines the subjective health of this population by examining the direct effects of multicultural adolescents’ subjective socioeconomic status (SES) and the sequential mediating effects of their dietary behaviors and perceived stress. We utilized secondary data of 500 middle school students from multicultural families who participated in the 15th Korean Youth Health Behavior Survey, 2019. Information about SES, perceived stress, subjective health status, and dietary behavior (measured by the breakfast intake frequency during the prior week) were utilized. For the relationship between the SES and the subjective health status, we confirmed the sequential mediating effects of breakfast frequency and perceived stress using SPSS 25.0 and PROCESS macro with bootstrapping. The results showed that SES had a direct effect on subjective health status and indirectly influenced subjective health status through the sequential mediating effect of breakfast frequency and perceived stress. However, SES had no direct effects on perceived stress. These findings emphasize that broadening the community-health lens to consider the upstream factor of SES when preparing health promotion interventions is essential to achieving health equity for vulnerable populations. Full article
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19 pages, 1098 KiB  
Article
Effects of a Home Literacy Environment Program on Psychlinguistic Variables in Children from 6 to 8 Years of Age
by Marta Romero-González, Rocío Lavigne-Cerván, Marta Sánchez-Muñoz de León, Sara Gamboa-Ternero, Rocío Juárez-Ruiz de Mier and Juan Francisco Romero-Pérez
Int. J. Environ. Res. Public Health 2021, 18(6), 3085; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph18063085 - 17 Mar 2021
Cited by 2 | Viewed by 2577
Abstract
(1) Background: the objective of this study was to improve certain psycholinguistic and cognitive skills that are fundamental to the development of the reading process, such as phonological awareness, reading decoding, vocabulary and oral narrative comprehension, through the introduction of an Home Literacy [...] Read more.
(1) Background: the objective of this study was to improve certain psycholinguistic and cognitive skills that are fundamental to the development of the reading process, such as phonological awareness, reading decoding, vocabulary and oral narrative comprehension, through the introduction of an Home Literacy Environment Active (HLE(A)) program that involved 54 participants enrolled in the first and second grades of elementary school (from 6 to 8 years old) in the city of Malaga area. (2) Methods: The central task of the intervention program was for the child to read aloud to an adult in the family for between 10 and 15 min, four days per week. In addition, the school students were evaluated on four occasions, at the beginning and end of each academic year, using the Batería de Evaluación de los Procesos Lectores Revisada, Test para la Detección de la Dislexia en niños and Escala Weschsler de Inteligencia instruments. (3) Results: the results demonstrated the efficacy of the HLE(A) program in the improvement of psycholinguistic and cognitive variables measured and, consequently, to an improvement in reading learning and cognitive development. Ultimately, the scientific literature on the subject and the data from the study led us to suggest that it would not only be beneficial for HLE(A) programs to be instituted in early childhood education stage (up to 6 years of age), but that they should be continued after age 6, in elementary education. Full article
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13 pages, 501 KiB  
Article
Movement Behaviors and Perceived Loneliness and Sadness within Alaskan Adolescents
by Ryan D. Burns, Yang Bai, Christopher D. Pfledderer, Timothy A. Brusseau and Wonwoo Byun
Int. J. Environ. Res. Public Health 2020, 17(18), 6866; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph17186866 - 20 Sep 2020
Cited by 7 | Viewed by 2674
Abstract
Physical activity, screen use, and sleep are behaviors that integrate across the whole day. However, the accumulative influence of meeting recommendations for these 24-h movement behaviors on the mental health of Alaskan adolescents has not been examined. The purpose of this study was [...] Read more.
Physical activity, screen use, and sleep are behaviors that integrate across the whole day. However, the accumulative influence of meeting recommendations for these 24-h movement behaviors on the mental health of Alaskan adolescents has not been examined. The purpose of this study was to examine the associations between movement behaviors, loneliness, and sadness within Alaskan adolescents. Data were obtained from the 2019 Alaska Youth Risk Behavior Survey (YRBS). The number of adolescents participating in the 2019 Alaska YRBS was 1897. Associations between meeting recommendations for movement behaviors with loneliness and sadness were examined using weighted logistic regression models, adjusted for age, sex, race/ethnicity, and body mass index (BMI). Approximately 5.0% of the sample met recommendations for all three movement behaviors. Meeting 2 or 3 movement behavior recommendations was associated with lower odds of loneliness (odds ratio (OR) range = 0.23 to 0.44, p < 0.01). Additionally, meeting 1 to 3 movement behavior recommendations was associated with lower odds of sadness (OR range = 0.29 to 0.52, p < 0.05). Joint association analyses determined that these relationships were primarily driven by meeting the sleep recommendation for loneliness and meeting the screen use recommendation for sadness. The results support use of multiple movement-based behavior programming to attenuate feelings of loneliness and sadness within Alaskan adolescents. Full article
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Review

Jump to: Research

12 pages, 1023 KiB  
Review
The Effects of Playground Interventions on Accelerometer-Assessed Physical Activity in Pediatric Populations: A Meta-Analysis
by Christopher D. Pfledderer, Sunku Kwon, Ildiko Strehli, Wonwoo Byun and Ryan D. Burns
Int. J. Environ. Res. Public Health 2022, 19(6), 3445; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph19063445 - 15 Mar 2022
Cited by 3 | Viewed by 2425
Abstract
Playgrounds are designed to be a safe, enjoyable, and effective means to promote physical activity in children and adolescents. The purpose of this study was to conduct a meta-analysis to determine the effectiveness of playground interventions for improving accelerometer-assessed ambulatory moderate-to-vigorous physical activity [...] Read more.
Playgrounds are designed to be a safe, enjoyable, and effective means to promote physical activity in children and adolescents. The purpose of this study was to conduct a meta-analysis to determine the effectiveness of playground interventions for improving accelerometer-assessed ambulatory moderate-to-vigorous physical activity (MVPA) and to identify common aspects of playground interventions that may be beneficial to promote behavior change. An internet database search was performed. The final analyzed sample of studies was obtained from several criteria, including being a playground-based intervention targeting children or adolescents, having a control or comparison group, having an accelerometer-assessed MVPA outcome target variable, and reporting of the mean difference scores’ variability. A random-effects model meta-analysis was employed to obtain pooled effect sizes. Ten studies (n = 10) were analyzed from the internet search. The weighted pooled effect (Hedges’ g) across all studies was Hedges’ g = 0.13, 95% CI: 0.02–0.24, p = 0.023. There was moderate study heterogeneity (I2 = 55.3%) but no evidence for publication bias (p = 0.230). These results suggest that school-based playground interventions have a small effect on increasing accelerometer-assessed MVPA within the pediatric population. The playground should still be an environmental target during school or community-based interventions aimed at providing opportunities to promote MVPA. Full article
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28 pages, 1209 KiB  
Review
The Acceptability, Feasibility, and Effectiveness of Wearable Activity Trackers for Increasing Physical Activity in Children and Adolescents: A Systematic Review
by Amy V. Creaser, Stacy A. Clemes, Silvia Costa, Jennifer Hall, Nicola D. Ridgers, Sally E. Barber and Daniel D. Bingham
Int. J. Environ. Res. Public Health 2021, 18(12), 6211; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph18126211 - 08 Jun 2021
Cited by 30 | Viewed by 5077
Abstract
Wearable activity trackers (wearables) embed numerous behaviour change techniques (BCTs) that have previously been shown to increase adult physical activity (PA). With few children and adolescents achieving PA guidelines, it is crucial to explore ways to increase their PA. This systematic review examined [...] Read more.
Wearable activity trackers (wearables) embed numerous behaviour change techniques (BCTs) that have previously been shown to increase adult physical activity (PA). With few children and adolescents achieving PA guidelines, it is crucial to explore ways to increase their PA. This systematic review examined the acceptability, feasibility, and effectiveness of wearables and their potential mechanisms of action for increasing PA in 5 to 19-year-olds. A systematic search of six databases was conducted, including data from the start date of each database to December 2019 (PROSPERO registration: CRD42020164506). Thirty-three studies were included. Most studies (70%) included only adolescents (10 to 19 years). There was some—but largely mixed—evidence that wearables increase steps and moderate-to-vigorous-intensity PA and reduce sedentary behaviour. There were no apparent differences in effectiveness based on the number of BCTs used and between studies using a wearable alone or as part of a multi-component intervention. Qualitative findings suggested wearables increased motivation to be physically active via self-monitoring, goal setting, feedback, and competition. However, children and adolescents reported technical difficulties and a novelty effect when using wearables, which may impact wearables’ long-term use. More rigorous and long-term studies investigating the acceptability, feasibility, and effectiveness of wearables in 5 to 19-year-olds are warranted. Full article
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