ABSTRACT
OBJECTIVE: Behavioral risk assessment is critical to developing intervention strategies to promote adolescent health, but also presents logistical, ethical, and scientific challenges. This paper reports on feasibility of a school-based study of health-risk behaviors in ethnic Fijian adolescent girls. METHODS: We assessed feasibility of school-based participation and implementation of assessment in the local vernacular language by examining observational data and by calculating response rates and as well as language selection and item completion rates. RESULTS: All invited study area schools participated (n=12). Response rates were >70% for study participation among eligible study participants in the overall sample as well as the peri-urban and rural sub-samples. The majority of respondents (71.9%) selected the local Fijian vernacular language version rather than the English version (28.1%). Although 43.6% of respondents completed a questionnaire in a language not spoken as the primary language at home, only ten respondents (1.9%) were assessed as having difficulty with the language of the self-report questionnaire. Item completion rates for the primary outcomes were >90% for both study phases and in both language versions. Study participant response rate for further assessment of concerning symptoms was also very high and teachers were successfully recruited for participation in training and accepting referrals to support these students at each participating school. CONCLUSION: School-based behavioral risk data collection in the vernacular language was feasible. Evaluation and referral of individual study participants with concerning symptoms to educators for further assistance and support also appeared feasible. We suggest that close collaboration among Fiji-based and specialty consultants to address scientific, linguistic, logistical, and ethical challenges were contributing factors to study feasibility.
ABSTRACT
INTRODUCTION: The HEALTHY Fiji Study examines the impact of social transition on health risk behaviors among school-going ethnic Fijian adolescent girls. The primary aim of the present study was to assess prevalence and socio-demographic correlates of three risk behaviors, alcohol use, cigarette smoking, and unsafe sexual behavior in the study population. METHODS: We used an adapted version of the Global School-based Health Survey (GSHS) to assess health risk behaviors in a school-based sample of ethnic Fijian girls (n=523) in June and July 2007. We calculated prevalence of risk behaviors and then examined their relation to socio-demographic variables in logistic regression models. RESULTS: Prevalence estimates for any current alcohol use and cigarette smoking (20.1% and 17.6%) and lifetime history of sexual intercourse (20.8%) indicate that substantial percentage of this study sample has engaged in one of these health risk behaviors. Alcohol use was associated with two other risk behaviors, recurrent cigarette smoking and lifetime history of sexual intercourse. Although prevalence of alcohol use was lower than in several other Pacific populations, it was higher than previously reported among Fijian girls. CONCLUSIONS: The prevalence of alcohol use, cigarette smoking, and unsafe sexual behaviors in this study population warrants concern. Comparison with estimates from previous health behavior surveys in Fiji suggest that mode of assessment may impact prevalence estimates for health risk behaviors.
