Advances in the Study of Psychological Stress and Eating Behavior in Children and Adolescents

With the rapid development and change in society,children and adolescents are facing more and more psychological pressure,which comes not only from academic performance and interpersonal relationships but also from family environment,social expectations and other aspects.Psychological stress not only affects the mental health of children and adolescents but is also closely related to their eating behavior.Therefore,exploring the relationship between psychological stress and eating behaviors is of great significance in promoting the physical and mental health development of children and adolescents.Based on this,the study reviewed the research progress on the relationship between psychological stress and eating behavior of children and adolescents in recent years.The relationships between psychological stress and general eating behaviors,abnormal eating behaviors and eating disorders were successively reviewed,and the related physiological mechanisms were explored with a view to providing a scientific basis for mental health education and eating behavior intervention for children and adolescents.

Relationship between Levels of Testosterone and Cortisol in Saliva and Aggressive Behaviors of Adolescents

Objective To explore the endocfinal factors which influence the aggressive behavior of adolescents. Methods The levels of cortisol （CORT）, testosterone （T）, prolactin （PRL）, and growth hormone （GH） in saliva from 20 aggressive students and 20 non-aggressive control students were measured by radioimmunoassay （RIA）. The students were matched for their gender, age, grade, stage of pubertal development, and economic status of their families. Results The salivary T levels were 22.20±14.50 pg/mL and 19.54±12.52 pg/mL in aggressive male and female students, 13.20±6.85 pg/mL and 5.24±3.03 pg/mL in non-aggressive male and female students （P〈0.05）. The male aggressive students had a lower level of CORT in saliva than non-aggressive male students （P〈0.05）. There were no significant differences in the salivary levels of PRL or GH between the aggressive and non-aggressive groups. Correlation analysis revealed a negative relationship in male students between the salivary CORT levels and the aggression factor scores of the child behavior checklist （CBCL）. In addition, the data also showed a positive relationship between the salivary T levels and the aggression factor scores of CBCL in female students. Multiple linear regression analysis showed that the salivary CORT level was an independent predictive factor for aggressive behaviors in adolescent boys. The higher the CORT level, the less aggressive the boys were. Conclusion CORT and T levels may play a certain role in adolescent aggressive behaviors.

Relationship between Family Characteristics and Aggressive Behaviors of Children and Adolescents

In order to identify family factors obviously relevant to aggression, and offer a theoretical foundation for the prevention of aggression, 4010 students from primary and secondary schools in 5 different areas in Hubei province were surveyed. The Child Behavior Checklist ＂ parents＂ form＂ （Chinese version） and the four scales of Family Environment Scale were used. A multiple logistic regression was used to identify risk factors of children＇s and adolescents＂ aggressive behavior. The results showed that maternal education, paternal occupation, family type, parental child-rearing attitude and patterns, students＂ interpersonal relationship were significantly associated with the childreffs and adolescents＂ aggression. The risk factors of aggression were parental child-rearing patterns, peer relationship, teacher-student relationship, and family conflicts.

Determinants of Sexual Activity among HIV-Infected Adolescents in Cameroon

Introduction: Adolescence is a period of transition to adulthood, including for HIV-infected adolescents (HIA), when sexual problems emerge. Few studies have been carried out on the sexuality of HIA. This study aimed to assess the sexual behavior of HIV-infected adolescents in Cameroon. Methodology: A cross-sectional study was conducted in three hospitals in the cities of Yaoundé and Douala, from November 2019 to June 2020. All HIA aged 13 to 19 years followed in the study who knew their HIV status were included in the study after obtaining their assent and their parent’s consent. Socio-demographic and clinical characteristics were collected, as well as sexual practices and the determinants of their sexual activity. A multivariate analysis was performed to explore the relationship between the different variables studied and the sexual activity of these adolescents. Results: Of 204 HIA enrolled in the study, 64 (31.7%) were sexually active, the mean age at first sexual intercourse was 15.6 ± 2.8 years and the sex ratio was 0.94. Of the adolescents in the study, 75.7% of girls and 61.2% of boys had regular sexual activity, while 21.3% of girls and 35.4% of boys had multiple sexual relationships in the six months preceding the study. Nearly 16 (25.0%) of the sexually active HIA had more than 2 sexual encounters per month, 6 (9.3%) of these encounters had been paid for and 9 (27.2%) of the girls had already had at least one pregnancy. More than 7 out of 10 HIA (79.6%) had used a condom the last time they had sex. Age less than 18 years [OR = 11.1 (95% CI: 3.1 - 39.4), p = 0.001], lack of remuneration [OR = 9.8 (95% CI: 2.0 - 47.4), p = 0.001] and self-care were significantly associated with sexual activity in HIA, while school attendance was a protective factor. Self-funded HIAs were 21 times more likely to be sexually active [OR = 21.6 (95% CI: 2.3 - 179), p = 0.004]. Conclusion: More than a third of HIV-infected adolescents were sexually active and risky sexual practices were not negligible.

Cecal microbiota transplantation:unique influence of cecal microbiota from divergently selected inbred donor lines on cecal microbial profile,serotonergic activity,and aggressive behavior of recipient chickens

Background Accumulating evidence from human trials and rodent studies has indicated that modulation of gut microbiota affects host physiological homeostasis and behavioral characteristics.Similarly,alterations in gut micro-biota could be a feasible strategy for reducing aggressive behavior and improving health in chickens.The study was conducted to determine the effects of early-life cecal microbiota transplantation(CMT)on cecal microbial composi-tion,brain serotonergic activity,and aggressive behavior of recipient chickens.Methods Chicken lines 63 and 72 with nonaggressive and aggressive behavior,respectively,were used as donors and a commercial strain Dekalb XL was used as recipients for CMT.Eighty-four 1-d-old male chicks were randomly assigned to 1 of 3 treatments with 7 cages per treatment and 4 chickens per cage(n=7):saline(control,CTRL),cecal solution of line 6_(3)(6_(3)-CMT),and cecal solution of line 7_(2)(7_(2)-CMT).Transplantation was conducted via oral gavage once daily from d 1 to 10,and then boosted once weekly from week 3 to 5.At weeks 5 and 16,home-cage behavior was recorded,and chickens with similar body weights were assigned to paired aggression tests between the treat-ments.Samples of blood,brain,and cecal content were collected from the post-tested chickens to detect CMT-induced biological and microbiota changes.Results 63-CMT chickens displayed less aggressive behavior with a higher hypothalamic serotonergic activity at week 5.Correspondingly,two amplicon sequence variants(ASVs)belonging to Lachnospiraceae and one Ruminococ-caceae UCG-005 ASV were positively correlated with the levels of brain tryptophan and serotonin,respectively.7_(2)-CMT chickens had lower levels of brain norepinephrine and dopamine at week 5 with higher levels of plasma serotonin and tryptophan at week 16.ASVs belonging to Mollicutes RF39 and GCA-900066225 in 7_(2)-CMT chickens were nega-tively correlated with the brain 5-hydroxyindoleacetic acid(5-HIAA)at week 5,and one Bacteroides ASV was negatively correlated with plasma serotonin at week 16.Conclusion Results indicate that CMT at an early age could regulate aggressive behavior via modulating the cecal microbial composition,together with central serotonergic and catecholaminergic systems in recipient chickens.The selected CMT could be a novel strategy for reducing aggressive behavior through regulating signaling along the microbiota-gut-brain axis.

Impact of media violence on aggressive attitude for adolescents

The goal of this study was mainly to examine the impact of media violence on aggressive attitude among Chinese adolescents by using a modified STROOP task. 74 adolescents participated in this study, 37 were assigned to violent movie group and 37 were assigned to non-violent movie group. The results showed significant Movie Type and Trait Aggressiveness interaction, and adolescents with high aggressiveness (HA) had a significantly higher aggressive attitude than adolescents with mild aggressiveness (MA) and low aggressiveness (LA) after watching violent movies. Furthermore, the relation between significant Movie Type and Gender interaction was also found, and boys showed a significantly higher aggressive attitude than girls after watching violent movies. This implied that violent movies could effectively affect aggressive attitude for adolescents in China.

Impact of social isolation and resident intruder stress on aggressive behavior in the male rat

Stress studies frequently utilize physical stressors to establish animal models of stress. In the majority of cases, these models are not consistent with human circumstances. The present study simulated a social isolation plus resident intruder stress model in the rat. The rats were subjected to daily social isolation and resident intruder stress for 2 weeks. Behaviors were then tested. Rats subjected to social stress exhibited different aggressive behavior styles; some rats had greater scores on composite aggression behaviors, as well as locomotor and exploratory activity, but lower scores on latency than others. The high-aggressive group exhibited predominantly anger-out, while the low-aggressive group exhibited anger-in. Results suggest that social isolation plus resident intruder may serve as an appropriate model for anger-in and anger-out emotion modeling in the rat.

The impact of height-adjustable desks and classroom prompts on classroom sitting time,social,and motivational factors among adolescents

Purpose:This quasi-experimental study examined the impact of height-adjustable desks in combination with prompts to break up prolonged sitting time during class time and identified social and motivational factors associated with breaking up sitting time among adolescents.Teachers’perceptions of strategies were also examined.Methods:Over 17 weeks,1 classroom in a government secondary school in Melbourne,Australia,was equipped with 27 height-adjustable desks and prompts(posters and desk stickers)to break up classroom sitting time.Teachers received professional development in the use of the desks and prompts.One group of adolescents(n=55)had 2-5 lessons/week using the height-adjustable desks in an intervention classroom,and a comparison group matched by year level and subject(n=50)was taught in traditional“seated”classrooms.Adolescents wore an activPAL monitor at baseline(T0),4 weeks(T1),and 17 weeks(T2)and completed a survey at T0 and T2.Six teachers participated in interviews at T2.Effect sizes were calculated(d).Results:Linear mixed models found that,compared to the traditional“seated”classrooms,the adolescents in the intervention classroom had significantly lower sitting time(T1:-9.7 min/lesson,d=-0.96;T2:-6.7 min/lesson,d=-0.70)and time spent in sitting bouts>15 min(T2:-11.2 min/lesson,d=-0.62),and had significantly higher standing time(T1:7.3 min/lesson,d=0.84;T2:5.8 min/lesson,d=0.91),number of breaks from sitting(T1:1.3 breaks/lesson,d=0.49;T2:1.8 breaks/lesson,d=0.67),and stepping time(T1:2.5 min/lesson,d=0.66).Intervention classroom adolescents reported greater habit strength(d=0.58),self-efficacy for breaking up sitting time(d=0.75),and indicated that having a teacher/classmate remind them to stand as helpful(d=0.50).Conclusion:This intervention shows promise for targeting sitting behaviors in the classroom and indicates that incorporating social and motivational strategies may further enhance outcomes.

Health production and risk of obesity among Chilean adolescents: Understanding health related behaviors in youth

Background: Adolescent obesity is associated with high cardiovascular and metabolic risk. Western diet and reduced physical activity are strong environmental determinants. The “Health Production” model posits that individuals born with a certain amount of health stock, which depreciates over life, but can be augmented by individual behaviors, including exercise and dieting. Objective: To study the association between health production and obesity in a random sample of 1692 Chilean adolescents (14.8 ± 0.7 years old), and to study the effect of gender and socioeconomic characteristics on health production. Method: We used an indicator that considered the quality of food intake and physical activity, establishing three categories: good (GHP), intermediate (IHP) and poor health producers (PHP). Multivariate analysis was used to study the odds of obesity and good health production. Results: There was 31% of GHP, 32% of IHP and 38% of PHP. Obesity (Adj. OR: 1.59;95%CI: 1.04 - 2.42) and abdominal obesity (Adj. OR: 2.24;95%CI: 1.35 - 3.40) were significantly higher in the PHP group, compared to the GHP and IHP group. Health production was significantly associated with socioeconomic factors and gender. Female sex and coming from a less wealthy household significantly reduced the odds of good health production. Conclusions: Poor health production in adolescence, as defined by food intake and physical activity, depreciates individuals’ “health stock”, increasing the risk of obesity. In our sample, health production was strongly associated with socio-economic factors and gender.

Socio-Demographic Factors Associated with Obesity among Adolescents in Secondary School in Onitsha, South East Nigeria

Background: The prevalence of obesity among adolescent has been on the increase worldwide. This is probably a result of increase in the sedentary life style and the increasing shift to western diet. Obesity in children and adolescents has adverse consequences. These include increase in the rate of Diabetes Mellitus, hypertension, dyslipidemia, cardiovascular diseases, etc with resultant increase in premature deaths. Objectives: To determine the socio-demographic and behavioral factors associated with overweight and obesity in apparently healthy secondary school adolescents. Methods: This was a cross-sectional study of secondary school adolescents aged 10 - 19 years randomly selected from two public schools and three private schools. The weight and heights of study subjects were measured using standard equipment. Body mass index (BMI) was appropriately calculated and the WHO growth reference standard for age and gender, specific percentile for BMI was used to define overweight 85th to 97th and obese (97th percentile and above). Results: Data were initially collected from 1250 participants, but 52 were excluded due to improperly completed questionnaires. Thus, a total of 1198 students were ultimately included in the study, giving a response rate of 95.8%. These included 621 females (51.8%) and 577 males (48.2%) aged 10 - 19 years giving a F:M ratio of 1:0.9. The mean age of the students was 15.07 ± 1.96 years overall, 15.13 ± 2.08 years for males and 15.03 ± 1.83 years for females. There was no statistically significant difference between male and female in the distribution of age groups (p = 0.12). The mean BMI was 21.51 ± 3.57 kg/m2 for females and 20.22 ± 3.16 kg/m2 for males. The BMI was significantly higher in females in all age groups (p < 0.001) except those aged 10 - p = 0.13). The prevalence rates of overweight and obesity were higher in females than males (17.7% vs 10.7%, 5.6% vs 4.5% respectively;p ≤ 12 yrs;p = 0.04). The frequent consumption of sugar based beverages (p p p = 0.03) were significantly associated with both overweight and obesity (p p p < 0.001) were also significantly associated with obesity. Conclusion: Sociodemographic factors such as gender, socioeconomic status and behavioral patterns were major contributors to obesity. Behavioral interventions including regulating the intake of sugar based beverages and reducing the time spent on sedentary activities could be useful strategies in reducing the high prevalence of overweight and obesity among adolescents.

Health-related risky behaviors and their risk factors in adolescents with high-functioning autism

BACKGROUND Health-related risky behaviors generally refer to behaviors that have a negative impact on health and quality of life.Health-related risky behaviors in adolescents with high-functioning autism(HFA)have not been well understood so far.Adolescents with HFA may have more health-related risky behaviors than neurotypical adolescents.AIM To investigate health-related risky behaviors and their risk factors with HFA.METHODS This is an observational study.Our study enrolled 110 adolescents aged 12-19-years-old meeting Diagnostic and Statistical Manual of Mental Disorders 4th edition criteria for HFA.They were recruited from Peking University Sixth Hospital.There were also 110 age,sex and nationality matched controls enrolled who came from a public school in Beijing,China.Both groups completed the Adolescents Health-related Risky Behavior Inventory.Nonparametric tests were carried out for comparison of the Adolescents Health-related Risky Behavior Inventory scores between the two groups.Expression recognition,the Inventory of Subjective Life Quality for Child and Adolescent,Chinese Wechsler Intelligence Scale for Children,Wechsler Intelligence Scale for Adult-Chinese Revised,Theory of Mind test and Autism Spectrum Screening Questionnaire were assessed in the autism group to explore factors associated with health-related risky behaviors.Multivariate regression analysis was conducted to explore the risk factors of health-related risky behaviors in the HFA group.RESULTS The results showed that the total score of the Adolescents Health-related Risky Behavior Inventory and scores of“aggression and violence,”“suicide and selfinjury,”“health compromising behavior”and“unprotected sex”subscales in the HFA group were significantly higher than those in the control group(Z range-4.197 to-2.213,P<0.05).Among the associated factors,poor emotional experience(B=-0.268,P<0.001),depression(B=-0.321,P<0.001),low score of intelligence(B=-0.032,P=0.042),low score of Theory of Mind test(B=-1.321,P=0.003)and poor adaptation to school life(B=-0.152,P=0.006)were risk factors.These risky behaviors may promote the occurrence of health-related risky behaviors in adolescents with HFA.CONCLUSION This study showed that adolescents with HFA were more likely to be involved in health-related risky behaviors.Different health-related risky behaviors have different reasons.

Parenting Skills Determinant in Preventing Adolescents’ Sexual Health Risk Behavior

Parenting skill is one of the crucial needs that parents must have in caring adolescents’ sexual health risk behavior. Present study aims to determine predictors of parenting skills in preventing adolescents’ sexual health risk behavior. A cross sectional study was conducted among adolescents’ parents who attended government health clinics in a semi-urban district, West Malaysia. Data were collected by systematic random sampling using validated questionnaire from eight government health clinics based on routine daily out-patient services. There were 386 respondents participated with 98.9% of response rate. Parental skill is categorized as appropriate or inappropriate based on Trans-Theoretical Model (TTM) staging. Eighteen independent variables were used: parental socioeconomic status, adolescent characteristic, parenting style, parent-adolescent communication, parental stress, perception on adolescent sexual risk, comfortable in discussing sexual issues, knowledge in sexual reproductive health (SRH) and knowledge in HIV/AIDS. Assessment of parenting skills using the TTM stage showed 139 respondents (36%) had inappropriate parenting skills, in which they were in pre contemplation, contemplation or preparedness stages, while 247 respondents (64%) showed appropriate parenting skills when they were in action and maintenance stages of TTM. Older parent, late adolescent, low parental education level, extended family living arrangement, comfortable in discussing sexual issues, good parent-adolescent communication and higher knowledge in HIV/AIDS were found significant in bivariate analysis. Multivariate logistic regression analysis identified older parent (AOR = 1.927, 95% CI = 1.889 - 1.966, p < 0.001), lower parental education (AOR = 2.394, 95% CI = 1.348 - 4.254, p = 0.003), comfortable in discussing sexual issues (AOR = 3.810, 95% CI = 1.622 - 8.948, p = 0.002), good parent-adolescent communication (AOR = 4.741, 95% CI = 2.478 - 9.071, p ≤ 0.001) and having higher knowledge on HIV/AIDS (AOR = 2.804, 95% CI = 1.528 - 5.147, p = 0.001) as significant predictors for appropriate parenting skills in preventing adolescent sexual health risk behavior. In conclusion, more than one third of parents were still not ready in preventing adolescent sexual risk behavior. Targeting the young parents and those having difficulty in communicating sexual issues with theirs adolescents should be emphasized in early intervention program for parents. Self-assessment using TTM stage questionnaire will help parents to identify their parenting skills in preventing adolescent sexual health risk behavior.

Peer educator training program for enhancing knowledge on issues in the growth and development of adolescents and risk behavior problems in Indonesian context

Objective： This article aimed to evaluate the effects of an educational intervention programme on improving peer educator （PE） knowledge in issues around growth and development and its risk behavior problems of adolescents in Indonesia. Methods： The study was conducted in 31 of PEs to evaluate their knowledge in adolescents. The PEs received health education and were assessed by individual work during the structured three-week programme. Data were collected before and after the training programme as pre- and post-tests. Results： The PE demonstrated significant improvements in their knowledge after attending the three-week structured training programme. The post-test scores had significant effects on the dimensions of PE knowledge scores. The PE become knowledgeable to maintain and monitor adolescents health issues around growth and development and its risk behavior problems of adolescents. Conclusions： The PE become knowledgeable to respond to the adolescent problems and readiness to become PE during puberty.

Remain Aggressive Behavior in Children with Temporal Lobe Epilepsy after Surgery

Behavioral problems have a high rate in patients with temporal lobe epilepsy but there have been few detailed reports about pediatric patients. We report two children with temporal lobe epilepsy who manifest behavior abnormality remaining after surgery. One child developed complex partial seizures at 10 years and 3 months of age caused by a left temporal ganglioglioma and manifested behavioral problems of lability, aggression, impulsivity and disinhibition. Seizures were relieved after temporal lobe resection at 10 years and 8 months of age but behavioral symptoms had been remained. The second child developed epilepsy at 3 years of age. He manifested similar behavioral problems at 7 years old. Seizures were relieved after temporal lobe resection at 13 years old but behavioral symptoms had been remained. Their courses suggested that aggressive behavior might be associated with not only temporal lesion but also other lesions such as frontal lobe or neural circuitry between both lobes. It is important to inform families of patients that behavioral disorders may not improve after epileptic surgery.

Clustering of Multiple Risk Behaviors among Ethnically Diverse Adolescents Living in Hawaii

The current study examined the prevalence and clustering of 5 health-risk behaviors among adolescents in Hawaii, including physical inactivity, low fruit and vegetable consumption, junk food consumption, excessive television time, and inadequate sleep. High school students were recruited from 5 classrooms in Oahu Hawaii. Data were collected in the spring semester of 2011. Proportions were used to describe the prevalence of single and multiple health risk behaviors. Significant health behavior clusters were revealed using an observed-to-expected (O/E) ratio method. Participating adolescents (n = 114) were 11th and 12th grade students with a mean age of 16.28 (SD = 0.62). Participants were predominantly female (75%) and Filipino-American (68%). Seventy-seven percent of adolescents were physically inactive, 90% watched excessive TV, 66% consumed inadequate fruits and vegetables, 94% reported inadequate levels of sleep, and 80% consumed excessive junk food. Overall, 94% reported at least 3 risk factors, 73% reported at least 4 risk factors, and 37% reported all 5 risk factors. No significant clusters were found. Conclusion: Health-risk behaviors cluster and occur more often than expected among adolescents living in Hawaii. Non-significant clustering may be due to insufficient variability within the sample data;future examinations of this highly understudied population are necessary.

Prevention and Control of Adolescents' Deviant Behavior in Rural Community

Firstly,an analysis is made from the point of view of sociology on traditional modeling logic of prevention and control of adolescents' deviant behavior in rural community,and maintenance and reproduction of this model.The traditional prevention and control model of adolescents' deviant behavior in rural community is diversity-orderly pattern prevention and control system.This system is based on natural economy,especially on agricultural economy."Supervision by public opinion and moral imitation" is the basic operation logic of this system.It contains a compensation mechanism of "bringing up children for the purpose of being looked after in old age" and "favor returning".Then,deconstruction of traditional prevention and control model for adolescents' deviant behavior in rural community is analyzed.Along with advance in rural modern democratic management and legal construction and growing of rural market economy,function of traditional diversity-orderly pattern of prevention and control of adolescents' deviate behavior in rural community is weak and weak in prevention and control of modern rural adolescents' deviant behavior.Finally,modeling ideas of new(coordinative) prevention and control of rural adolescents' deviant behavior are put forward from four aspects,namely,democracy and legal system,community,family and various rural adolescent admittance organizations.

Cognitive behavioral therapy group intervention for HIV transmission risk behavior in perinatally infected adolescents

Purpose: This study analyzed treatment effects of cognitive behavioral therapy (CBT) group counseling intervention on HIV transmission risk behavior, depression, anxiety, and alcohol use in HIV perinatally infected adolescents attending an HIV clinical care center in Uganda, Africa. Method: A total of 186 adolescents were randomly assigned to an experimental or control arm and assigned into groups of 11 - 16 adolescents. The experimental groups received an 80-minute CBT based weekly intervention for 8 consecutive weeks, while the control groups received only standard group care. Data from self report assessments were analyzed at pre- and post-test using repeated measures of analysis of variance. The participants, analyzed by variable, included 115 for sexual behavior, 106 for depression, 88 for anxiety, and 115 for alcohol use. Results: The results from the study show a large significant difference (p = 0.006) between the experimental and control groups on the anxiety variable. There were no significant differences between the experimental and control groups on the variables of sexual behavior (p = 0.876), depression (p = 0.700), and alcohol use (p = 0.815). There was an indication of reduced levels of HIV sexual transmission risk behavior, depression, and alcohol use levels in the participants in both the experimental and control groups. Conclusions: Risky sexual behavior places HIV perinatally infected adolescents at risk of re-infection, sexually transmitted diseases, and transmitting HIV to their sexual partners. CBT group counseling intervention equipped the participating adolescents with appropriate life skills to deal with psychological distress and anxiety often seen in their lives and may be useful in routine medical care to reduce transmission risks and improve wellness and call for its incorporation into HIV preventive programs and counselor education.

Cognitive and Behavioral Effects of Participatory Sex Education on the Dual Prevention of STI/HIV/AIDS and Unwanted Pregnancies among Adolescents in Kinshasa High Schools, DR Congo

Context: With the view to reorient both STI/HIV/AIDS prevention and adolescents pregnancies, this research study aims at evaluating cognitive and behavioral acquisitions, as well as the process of interactive sex education participatory approach among adolescents in Kinshasa high schools. Methods: Based on a “pre and post” virtually experimental design, two crosswise surveys were conducted in Kinshasa, for six months in 2011-2012 on 484 high school students (pre-survey) and on 441 high school students (post-survey), whose age range from 14 - 19 years including both sexes. Two participatory educational talks (PET) “A” and “B”, covered weekly in two different schools, were compared to a control group school. The PET “A” consisted of interactive interpersonal communication sessions given by an external expert as a substitute for the life education course in one school. The PET “B” carried out in another school, included more educational talk sessions, led by the external expert and supplemented by a close follow-up of teenagers divided into small groups of 10 participants. The subjects’ assessment was based on their knowledge, attitudes and practices relating to STI/HIV/AIDS dual prevention as well as to unwanted pregnancies. Results: The subjects involved in the PET “B” displayed a better/higher performance based on their knowledge, attitudes and practices related to STI/HIV/AIDS dual prevention and unwanted pregnancies. Broadly speaking, knowledge has been improved 6 times with the PET “B” (OR = 6, 10, IC 95%) (3.24 - 11.9), and 3 times with the PET “A” (OR = 3, 45, IC 95%) (1.79 - 6.81), compared to control school. Similarly, findings on subjects’ attitudes show an improvement rated 12 times with the PET”B” (OR = 11, 99, IC 95%) (5.67 - 27.38) and 5 times for the PET “A” (OR = 5.51, IC 95%) (2.54 - 12.87). As far as the subjects’ practices are concerned, an improvement of 6 more times of protected sexual intercourses with the PET “B” compared with the control school group (OR = 6, 52, IC 95%) (3.60 - 12.0). The process assessment records a spontaneous involvement of schools enhanced by the positive contribution of Life Education and Biology teachers;add a massive participation of adolescents who requested permanent PET program. Conclusion: The results of this study suggest that school sexual education programs can be improved to increase the quality of apprenticeship. The use of interactive methods and the consideration of the adolescents’ specific needs that take into account the gender approach may bring about beneficial advantages on both educational outcomes and reproductive health of adolescents.

Incorporating HPS Model into Lebanese Public Schools: Comparison of Adolescents’ Smoking, Alcohol and Drug Use Behavior in HPS versus Other Public and Private Schools in Lebanon

In 2010, the World Health Organization supported the Lebanese Ministry of Education and Higher Education to establish a network of 10 Health Promoting Schools (HPS). This study was undertaken to address the extent to which the HPS model was able to produce changes in the risk behaviors of adolescents (Smoking, Drinking, and Drug Use) and prepare them to respond to evolving health challenges. A cross-sectional survey was carried out during 2011-2012 and compared Grade 6 - 9 students in HPS, and 10 other public and private schools. The Youth Risk Behavior Survey [1], and Carbon Monoxide measurements in adolescent breaths were used for data collection. Findings revealed that the current School Health Program failed to address issues of concern to adolescents with no significant differences in risk behaviors: smoking, alcohol and drug use. The HPS network needs reassessment to upgrade the outcomes of health education curricula. Expected learning outcomes and healthy practices must be designed to match students’ age, grade level, and developmental milestones.

Peer Pressure Is the Prime Driver of Risky Sexual Behaviors among School Adolescents in Addis Ababa, Ethiopia

Background: Understanding ecological factors that influence risky sexual behavior of adolescents is vital in designing and implementing sexual risk reduction interventions in specific contexts. Interventions undertaken without understanding the critical factors may not produce the desired results. Objective: The objective of this study was to identify the factors associated with adolescent risky sexual behavior among school adolescents in Addis Ababa, Ethiopia. Methods: This cross-sectional study was done among randomly selected school adolescents in Addis Ababa, Ethiopia. Data were collected by an anonymous self administered questionnaire. Risky sexual behavior was assessed by asking question about sexual activity, consistent condom use and faithfulness to a single partner. Logistic regression analysis was done to identify factors related to sexual behavior using the ecological framework. Result: Overall 377(10.6%) of the 723 sexually active students were involved in risky sexual practices. Risky sexual behavior was significantly and very strongly associated with perception of peers' involvement in sexual intercourse [AOR = 11.68 (95% CI: 8.76 - 15.58)]. Conclusion: This study demonstrated that peer pressure is the most important factor associated with risky sexual behavior among school adolescents in Addis Ababa. Interventions aimed at reducing sexual behavior among school adolescents should target adolescents as a group rather than individually.