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1.
PLoS One ; 17(2): e0261773, 2022.
Article in English | MEDLINE | ID: covidwho-1793545

ABSTRACT

PURPOSE: The COVID-19 pandemic and associated risk-mitigation strategies have altered the social contexts in which adolescents in low- and middle-income countries live. Little is known, however, about the impacts of the pandemic on displaced populations, and how those impacts differ by gender and life stage. We investigate the extent to which the pandemic has compounded pre-existing social inequalities among adolescents in Jordan, and the role support structures play in promoting resilience. METHODS: Our analysis leverages longitudinal quantitative survey data and in-depth qualitative interviews, collected before and after the onset of COVID-19, with over 3,000 Syrian refugees, stateless Palestinians and vulnerable Jordanians, living in camps, host communities and informal tented settlements. We utilize mixed-methods analysis combining multivariate regression with deductive qualitative tools to evaluate pandemic impacts and associated policy responses on adolescent wellbeing and mental health, at three and nine months after the pandemic onset. We also explore the role of support systems at individual, household, community, and policy levels. FINDINGS: We find the pandemic has resulted in severe economic and service disruptions with far-reaching and heterogenous effects on adolescent wellbeing. Nine months into the pandemic, 19.3% of adolescents in the sample presented with symptoms of moderate-to severe depression, with small signs of improvement (3.2 percentage points [pp], p<0.001). Two thirds of adolescents reported household stress had increased during the pandemic, especially for Syrian adolescents in host communities (10.7pp higher than any other group, p<0.001). Social connectedness was particularly low for girls, who were 13.4 percentage points (p<0.001) more likely than boys to have had no interaction with friends in the past 7 days. Adolescent programming shows signs of being protective, particularly for girls, who were 8.8 percentage points (p<0.01) more likely to have a trusted friend than their peers who were not participating in programming. CONCLUSIONS: Pre-existing social inequalities among refugee adolescents affected by forced displacement have been compounded during the COVID-19 pandemic, with related disruptions to services and social networks. To achieve Sustainable Development Goal targets to support healthy and empowered development in adolescence and early adulthood requires interventions that target the urgent needs of the most vulnerable adolescents while addressing population-level root causes and determinants of psychosocial wellbeing and resilience for all adolescent girls and boys.


Subject(s)
Adolescent Health/trends , COVID-19/psychology , Refugees/psychology , Adolescent , Child , Female , Humans , Jordan/epidemiology , Male , Mental Health , Pandemics , Psychology , SARS-CoV-2/pathogenicity , Social Environment , Socioeconomic Factors , Young Adult
2.
Front Public Health ; 9: 724779, 2021.
Article in English | MEDLINE | ID: covidwho-1775841

ABSTRACT

Background: The use of chatbots may increase engagement with digital behavior change interventions in youth by providing human-like interaction. Following a Person-Based Approach (PBA), integrating user preferences in digital tool development is crucial for engagement, whereas information on youth preferences for health chatbots is currently limited. Objective: The aim of this study was to gain an in-depth understanding of adolescents' expectations and preferences for health chatbots and describe the systematic development of a health promotion chatbot. Methods: Three studies in three different stages of PBA were conducted: (1) a qualitative focus group study (n = 36), (2) log data analysis during pretesting (n = 6), and (3) a mixed-method pilot testing (n = 73). Results: Confidentiality, connection to youth culture, and preferences when referring to other sources were important aspects for youth in chatbots. Youth also wanted a chatbot to provide small talk and broader support (e.g., technical support with the tool) rather than specifically in relation to health behaviors. Despite the meticulous approach of PBA, user engagement with the developed chatbot was modest. Conclusion: This study highlights that conducting formative research at different stages is an added value and that adolescents have different chatbot preferences than adults. Further improvement to build an engaging chatbot for youth may stem from using living databases.


Subject(s)
Adolescent Health , Health Promotion , Adolescent , Adult , Focus Groups , Humans , Qualitative Research
3.
Front Public Health ; 10: 766101, 2022.
Article in English | MEDLINE | ID: covidwho-1775975

ABSTRACT

In this study, the blood test index, demographic data, and health promotion behavior of adolescents were analyzed to provide a reference for early prevention and treatment of physical decline and abnormal biochemical indexes of adolescents. Using a cross-sectional study design, 1,436 valid samples were obtained by stratified random sampling, and the data were processed by SPSS21.0 statistical analysis software. The results showed that the overall health-promoting lifestyle of adolescents was good, and the interpersonal support behavior was the best, and the health responsibility and sports participation behavior were the worst; the interpersonal support and sports participation behavior of adolescents with normal weight were significantly better than those with overweight or light weight, while the overall health-promoting behavior of adolescents with high fasting blood glucose (FBG) before meals was poor, those with high glutamate pyruvate transaminase (GPT) had poor nutritional behavior and health responsibility behavior, while those with high uric acid (UA) had poor interpersonal support and stress coping behavior. The overweight rate and abnormal detection rate of UA and triglyceride (TG) in boys were significantly higher than those in girls, and the higher BMI of teenagers, the higher abnormal detection rate of GPT, UA, and TG, the better nutritional behavior, health responsibility behavior, and sports participation behavior, the lower abnormal detection rate of GPT, UA, and TG; the higher education level of parents, the better teenagers' sports participation and health responsibility behavior, the lower the incidence of overweight, the more time they spend playing online games and drinking sugary drinks on weekdays (or holidays), the higher the incidence of overweight.


Subject(s)
Adolescent Health , Body Mass Index , Health Behavior , Adolescent , Cross-Sectional Studies , Exercise , Female , Humans , Male
5.
Afr Health Sci ; 21(4): 1518-1526, 2021 Dec.
Article in English | MEDLINE | ID: covidwho-1726490

ABSTRACT

Background: The implementation of COVID-19 lockdown measures across the globe could affect adolescents' health. Objective: This review was conducted to assess the impact of the COVID-19 lockdown on the health of the adolescents. Methodology: We conducted this study using the scope reviews methodological framework. We searched for articles on the effects of COVID-19 lockdown among adolescents on four databases; MedLine, PubMed, Directory of Open Access Journals and Google Scholar. Screening of articles was done for relevance to the study objective. Results: The positive effects of the COVID-19 lockdown on adolescents included increased physical activity for adolescents 17 years and below, increased resource mobilization for healthy lifestyle, and psychosocial support programs for schools. The negative effects of the lockdown period were decreased physical activity with resulting disruptive sleep patterns; increased screen time, behavioral addictive disorder from excessive use of the internet, increased levels of domestic abuse, and worsening of existing mental health disorders. Overall, the COVID-19 lockdown period has had considerable adverse effects on adolescents' health. Conclusion: To curb the negative effects of the COVID-19 lockdown, we recommend parental supervision of adolescents' screen time. Adolescent health should be prioritized by policymakers to ensure that future lockdown does not adversely affect them.


Subject(s)
Adolescent Health , COVID-19 , Adolescent , COVID-19/epidemiology , COVID-19/prevention & control , Communicable Disease Control , Exercise , Humans , SARS-CoV-2
6.
J Glob Health ; 11: 04071, 2021.
Article in English | MEDLINE | ID: covidwho-1716064

ABSTRACT

Background: This research prioritization aimed to identify major research gaps in maternal, newborn, child and adolescent health (MNCAH) to help mitigate the direct and indirect effects of the COVID-19 pandemic. Methods: We adapted the Child Health and Nutrition Research Initiative methodology. We defined scope, domains, themes and scoring criteria. We approached diverse global experts via email to submit their research ideas in MNCAH and MNCAH-related cross-cutting/health systems area. We curated the research ideas as research questions (RQs) and sent them to the consenting experts for scoring via the online link. For each RQ, the research priority score (RPS) was calculated as an average of individual criterion scores and ranked based on RPS in each area. Results: We identified top-ranked 10 RQs in each maternal, newborn, and child and adolescent health and 5 in the cross-cutting/health systems area. In maternal health, indirect effects on care, measures to improve care, health risks and outcomes, and preventing and managing SARS-CoV-2 infection/COVID-19 disease were priority RQs. In newborn health, clinical characterization and managing SARS-CoV-2 infection/COVID-19 disease, mode of transmission and interventions to prevent transmission were the focus. For child and adolescent health, top-ranked RQs were indirect effects on care, clinical status and outcomes, interventions to protect against SARS-CoV-2 infection/COVID-19 disease, and educational institute-related RQs. The cross-cutting RQs were the effects of the pandemic on availability, access, care-seeking and utilization of MNCAH services and potential solutions. Conclusions: We call on partners, including governments, non-governmental organizations, research institutes, and donors, to address this urgent research agenda.


Subject(s)
COVID-19 , Adolescent , Adolescent Health , Child , Child Health , Female , Global Health , Humans , Infant, Newborn , Pandemics , Research , SARS-CoV-2
8.
BMJ Open ; 12(1): e053919, 2022 01 17.
Article in English | MEDLINE | ID: covidwho-1627475

ABSTRACT

OBJECTIVE: The aim of this study was to identify knowledge translation (KT) strategies aimed at improving sexual, reproductive, maternal, newborn, child and adolescent health (SRMNCAH) and well-being. DESIGN: Rapid scoping review. SEARCH STRATEGY: A comprehensive and peer-reviewed search strategy was developed and applied to four electronic databases: MEDLINE ALL, Embase, CINAHL and Web of Science. Additional searches of grey literature were conducted to identify KT strategies aimed at supporting SRMNCAH. KT strategies and policies published in English from January 2000 to May 2020 onwards were eligible for inclusion. RESULTS: Only 4% of included 90 studies were conducted in low-income countries with the majority (52%) conducted in high-income countries. Studies primarily focused on maternal newborn or child health and well-being. Education (81%), including staff workshops and education modules, was the most commonly identified intervention component from the KT interventions. Low-income and middle-income countries were more likely to include civil society organisations, government and policymakers as stakeholders compared with high-income countries. Reported barriers to KT strategies included limited resources and time constraints, while enablers included stakeholder involvement throughout the KT process. CONCLUSION: We identified a number of gaps among KT strategies for SRMNCAH policy and action, including limited focus on adolescent, sexual and reproductive health and rights and SRMNCAH financing strategies. There is a need to support stakeholder engagement in KT interventions across the continuum of SRMNCAH services. Researchers and policymakers should consider enhancing efforts to work with multisectoral stakeholders to implement future KT strategies and policies to address SRMNCAH priorities. REGISTRATION: The rapid scoping review protocol was registered on Open Science Framework on 16 June 2020 (https://osf.io/xpf2k).


Subject(s)
Adolescent Health , Adolescent , Child , Humans , Infant, Newborn , Policy , Reproduction , Reproductive Health
10.
JAMA Netw Open ; 5(1): e2142100, 2022 01 04.
Article in English | MEDLINE | ID: covidwho-1603397

ABSTRACT

Importance: Although negative associations of COVID-19 pandemic high school closures with adolescents' health have been demonstrated repeatedly, some research has reported a beneficial association of these closures with adolescents' sleep. The present study was, to our knowledge, the first to combine both perspectives. Objective: To investigate associations between adolescents' sleep and health-related characteristics during COVID-19 pandemic school closures in Switzerland. Design, Setting, and Participants: This survey study used cross-sectional online surveys circulated among the students of 21 public high schools in Zurich, Switzerland. The control sample completed the survey under regular, prepandemic conditions (May to July 2017) and the lockdown sample during school closures (May to June 2020). Survey respondents were included in the study if they provided their sex, age, and school. Exposures: High school closures during the first COVID-19 pandemic wave in Switzerland (March 13 to June 6, 2020). Main Outcomes and Measures: Sleep-wake patterns, health-related quality of life (HRQoL, assessed by the KIDSCREEN-10 questionnaire), substance use (caffeine, alcohol, and nicotine), and depressive symptoms (lockdown sample only; assessed using the withdrawn/depressed scale from the Youth Self Report). Multilevel regression models were used to assess sample differences and associations of health-related characteristics with sleep duration and depressive symptoms. Results: The total sample consisted of 8972 students, including 5308 (59.2%) in the control sample (3454 [65.1%] female) and 3664 (40.8%) in the lockdown sample (2429 [66.3%] female); the median age in both samples was 16 years (IQR, 15-17 years). During school closures, the sleep period on scheduled days was 75 minutes longer (semipartial R2 statistic [R2ß*], 0.238; 95% CI, 0.222-0.254; P < .001) and the students had better HRQoL (R2ß*, 0.007; 95% CI, 0.004-0.012; P < .001) and less consumption of caffeine (R2ß*, 0.010; 95% CI, 0.006-0.015; P < .001) and alcohol (R2ß*, 0.014; 95% CI, 0.008-0.022; P < .001). Longer sleep duration was associated with better HRQoL (R2ß*, 0.027; 95% CI, 0.020-0.034; P < .001) and less caffeine consumption (R2ß*, 0.013; 95% CI, 0.009-0.019; P < .001). In the lockdown sample, an inverse association was found between depressive symptoms and HRQoL (R2ß*, 0.285; 95% CI, 0.260-.0311; P < .001) and a positive association was found with caffeine consumption (R2ß*, 0.003; 95% CI, 0.000-0.008; P = .01). Conclusions and Relevance: In this survey study, 2 opposing associations between school closures and adolescents' health were identified: a negative association with psychological distress and a beneficial association with increased sleep duration. These findings should be considered when evaluating and implementing school closures. Furthermore, the findings provide support for delaying school start times for adolescents.


Subject(s)
Adolescent Health , COVID-19 , Communicable Disease Control , Pandemics , Psychological Distress , Schools , Sleep , Adolescent , COVID-19/prevention & control , COVID-19/psychology , Caffeine/administration & dosage , Cross-Sectional Studies , Depression , Female , Humans , Life Style , Male , Quality of Life , SARS-CoV-2 , Self Report , Students , Surveys and Questionnaires , Switzerland
12.
Int J Environ Res Public Health ; 18(23)2021 11 25.
Article in English | MEDLINE | ID: covidwho-1551592

ABSTRACT

The COVID-19 pandemic enforced countries to close schools and rapidly transfer to distance teaching without preparation. Little is known about how different distance teaching practices influenced students' wellbeing. We studied this during the period of school closures in Finland. Wellbeing was measured by health complaints and perceived loneliness, and distance learning was measured in terms of structure and dialogue of teaching, functioning of internet and digital equipment, difficulty of given tasks, and support for studies. All lower secondary schools were invited, and 29,898 students from 340 schools (grades 7-9) participated. A digital survey was distributed through schools just when these were reopened in May 2020. The main results were that the distance learning practices were related to adolescent health complaints and loneliness, so that less structure and dialogue in teaching, more problems with digital devices and internet, more difficult tasks and less support for studies were associated with higher health complaints and loneliness. From the point of view of students' wellbeing, it matters how the distance learning is organised, how digital communication works, and if enough support for studies is available. These results of our research on distance learning practices during the present pandemic may guide schools in future crises and pandemic situations when distance learning is needed.


Subject(s)
COVID-19 , Education, Distance , Adolescent , Adolescent Health , Finland , Humans , Loneliness , Pandemics , SARS-CoV-2 , Schools , Students
14.
J Health Psychol ; 27(6): 1354-1364, 2022 May.
Article in English | MEDLINE | ID: covidwho-1511662

ABSTRACT

We examined the prospective associations of COVID-19 fears and behavior, and daily physical activity and dysregulated eating. Adolescents (N = 31) aged 11-17 completed selected subscales of the Fear of Illness and Virus Evaluation and completed a 7-day health behavior diary. Greater fear of contamination was associated with lower daily physical activity. In contrast, greater COVID-19 precautionary behavior was associated with greater daily physical activity. COVID-19 fears and precautionary behaviors have differential associations with health promoting behavior engagement. Future studies should explore the mechanisms underlying these links to guide adaptation of health behavior interventions for this unique cohort.


Subject(s)
COVID-19 , Adolescent , Adolescent Health , Fear , Health Behavior , Humans , Pandemics
15.
JAMA Pediatr ; 175(11): 1108-1110, 2021 11 01.
Article in English | MEDLINE | ID: covidwho-1503634
17.
J R Soc Med ; 114(11): 513-524, 2021 11.
Article in English | MEDLINE | ID: covidwho-1488342

ABSTRACT

OBJECTIVE: To offer a quantitative risk-benefit analysis of two doses of SARS-CoV-2 vaccination among adolescents in England. SETTING: England. DESIGN: Following the risk-benefit analysis methodology carried out by the US Centers for Disease Control, we calculated historical rates of hospital admission, Intensive Care Unit admission and death for ascertained SARS-CoV-2 cases in children aged 12-17 in England. We then used these rates alongside a range of estimates for incidence of long COVID, vaccine efficacy and vaccine-induced myocarditis, to estimate hospital and Intensive Care Unit admissions, deaths and cases of long COVID over a period of 16 weeks under assumptions of high and low case incidence. PARTICIPANTS: All 12-17 year olds with a record of confirmed SARS-CoV-2 infection in England between 1 July 2020 and 31 March 2021 using national linked electronic health records, accessed through the British Heart Foundation Data Science Centre. MAIN OUTCOME MEASURES: Hospitalisations, Intensive Care Unit admissions, deaths and cases of long COVID averted by vaccinating all 12-17 year olds in England over a 16-week period under different estimates of future case incidence. RESULTS: At high future case incidence of 1000/100,000 population/week over 16 weeks, vaccination could avert 4430 hospital admissions and 36 deaths over 16 weeks. At the low incidence of 50/100,000/week, vaccination could avert 70 hospital admissions and two deaths over 16 weeks. The benefit of vaccination in terms of hospitalisations in adolescents outweighs risks unless case rates are sustainably very low (below 30/100,000 teenagers/week). Benefit of vaccination exists at any case rate for the outcomes of death and long COVID, since neither have been associated with vaccination to date. CONCLUSIONS: Given the current (as at 15 September 2021) high case rates (680/100,000 population/week in 10-19 year olds) in England, our findings support vaccination of adolescents against SARS-CoV2.


Subject(s)
COVID-19 Vaccines , COVID-19/prevention & control , Hospitalization , Intensive Care Units , Public Health , Severity of Illness Index , Vaccination , Adolescent , Adolescent Health , Age Factors , COVID-19/complications , COVID-19/mortality , COVID-19/therapy , COVID-19 Vaccines/adverse effects , Child , Child Health , England , Female , Humans , Incidence , Male , Myocarditis/etiology , Risk , SARS-CoV-2 , Treatment Outcome , Vaccination/adverse effects
20.
BMJ Open ; 10(7): e035335, 2020 07 01.
Article in English | MEDLINE | ID: covidwho-1455702

ABSTRACT

INTRODUCTION: Previous studies have attempted to review the vast body of evidence on adolescent sexual and reproductive health (ASRH), but none has focused on a complete mapping and synthesis of the body of inquiry and evidence on ASRH in sub-Saharan Africa (SSA). Such a comprehensive scoping is needed, however, to offer direction to policy, programming and future research. We aim to undertake a scoping review of studies on ASRH in SSA to capture the landscape of extant research and findings and identify gaps for future research. METHODS AND ANALYSIS: This protocol is designed using the framework for scoping reviews developed by the Joanna Briggs Institute. We will include English and French language peer-reviewed publications and grey literature on ASRH (aged 10-19) in SSA published between January 2010 and June 2019. A three-step search strategy involving an initial search of three databases to refine the keywords, a full search of all databases and screening of references of previous review studies for relevant articles missing from our full search will be employed. We will search AJOL, JSTOR, HINARI, Scopus, Science Direct, Google Scholar and the websites for the WHO, UNICEF, UNFPA, UNESCO and Guttmacher Institute. Two reviewers will screen the titles, abstracts and full texts of publications for eligibility and inclusion-using Covidence (an online software). We will then extract relevant information from studies that meet the inclusion criteria using a tailored extraction frame and template. Extracted data will be analysed using descriptive statistics and thematic analysis. Results will be presented using tables and charts and summaries of key themes arising from available research findings. ETHICS AND DISSEMINATION: Ethical approval is not required for a scoping review as it synthesises publicly available publications. Dissemination will be through publication in a peer-review journal and presentation at relevant conferences and convening of policymakers and civil society organisations working on ASRH in SSA.


Subject(s)
Adolescent Health , Reproductive Health , Sexual Behavior , Adolescent , Africa South of the Sahara , Child , Female , Humans , Male , Pregnancy , Pregnancy in Adolescence , Sexually Transmitted Diseases
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