Structural relationships among adolescents' peer attachment, career-related self-efficacy, parents' attitudes and health risk behaviours.

AIM: This study aimed to determine whether the peer attachment of adolescents, mediated by career-related self-efficacy and having parents with positive attitudes, influences health risk behaviours. DESIGN: A cross-sectional questionnaire survey. METHODS: This study adopted the secondary data analysis method, using the 2010 Korean Children and Youth Panel Survey (KCYPS). The 7th-wave panel data of 1,932 first graders in high schools were analysed using structural equation modelling. RESULTS: The final model provided a good fit for the data. Having a close relationship with peers had a direct effect on adolescents' health risk behaviours. High peer attachment also had an indirect effect on health risk behaviours, mediated by career-related self-efficacy and having parents with positive attitudes. Though adolescents with broad and intimate peer relationships may be exposed to more temptations towards health risk behaviours and tend to make riskier decisions, these influences are reduced by being exposed to positive parenting attitudes and having clear, conscious career goals.

Factors Affecting Obesity in Urban and Rural Adolescents: Demographic, Socioeconomic Characteristics, Health Behavior and Health Education.

In this study, we aimed to analyze the demographic factors, socioeconomic factors, health behavior factors, and health education of urban and rural adolescents and their impact on obesity in rural and urban youths. We analyzed data from 60,040 students from 800 schools using the 14th Youth Health Behavior Web-based Survey data for 2018. The mean age of the participants was 15.01 ± 1.77; 30,463 (50.7%) males and 29,577 (49.3%) females. The data were analyzed using a chi-square test and multinominal logistic regression analysis. Rural adolescents had significantly lower parental income, parental education, and academic performance levels. Urban adolescents tended to have a higher rate of breakfast fasting, ate more fast-food, exercised less, had a higher rate of sleep dissatisfaction, and had significantly higher current alcohol intake. Rural adolescents reported more stress and obesity levels than their urban counterparts. Factors influencing the obesity of urban adolescents were grade level, father's education, mother's education, academic performance level, fast-food, exercise, current alcohol intake, and sleep satisfaction. Factors influencing the obesity of rural adolescents were parents' income level, academic performance level, exercise, and sleep satisfaction. To effectively prevent and manage adolescent obesity, which is an indicator of health equity among adolescents, an effort must be made to improve health education and the local environment in both urban and rural areas.

The Sexual Risk Behaviors of Middle School Students According to School Nurse Placement Levels in Korea.

PURPOSE: This study aimed to provide basic data for the future development of school-based sexuality education and school nurse placement policies by examining the sexuality education experience in middle schools according to levels of school nurse placement and identifying factors influencing on adolescent sexual risk behaviors. METHODS: This study examined data from the 2018 14th Korean Youth Risk Behavior Survey. The raw data from 30,229 middle school students enrolled in 400 schools were analyzed using descriptive statistics, Chi-square test, independent t test, and complex sample logistic regression analysis. RESULTS: It is found that, in Korea, school nurse placement rates varied by region from 37.9% to 114.8%, resulting in different levels of sexuality and alcohol prevention education (p < .001). Sexuality and alcohol prevention education lowered the likelihood of sexual risk behaviors by 0.54 and 0.87 times, respectively. The experience of drinking alcohol increased a student's likelihood of committing sexual risk behaviors by 4.40 and 3.57 times, respectively, whereas the experience of using a drug increased the risk by 9.42 and 5.00 times, respectively. Personal factors (e.g., gender and academic achievement) and socioenvironmental factors (e.g., school type and perceived economic status) were also found to influence on the sexual risk behaviors of adolescents, although, not to the same degree as sexuality education or health risk behaviors. CONCLUSION: To protect students' sex-related health equity, more elaborate support policies are needed to ensure adequate placement of school nurses able to provide professional sexuality and related health education.

Effects of an obesity management mentoring program for Korean children.

AIM: This research aimed to develop and test a mentored obesity management program guiding physical exercise, improving eating habits, and promoting self-esteem among elementary school learners. METHODS: A nonequivalent control group pretest-posttest design was used. Thirty learners were recruited through convenience sampling from two elementary schools, then evenly assigned to the experimental and control groups. Six nursing students were mentored, receiving 16h of mentorship training. A 10-week mentored obesity management program promoting physical exercise and proper nutrition was developed and provided. RESULTS: The two groups' pretest and posttest body mass index and self-esteem differences were statistically significant. Most participants were satisfied with the program, endorsing its provision in the regular school curriculum. CONCLUSIONS: A mentored obesity management program for elementary school learners would effectively manage weight and improve self-esteem. Programs purportedly curtailing childhood obesity should be expanded, and school policies regulated to enable implementation.

Association of school, family, and mental health characteristics with suicidal ideation among Korean adolescents.

In a cross-sectional research design, we investigated factors related to suicidal ideation in adolescents using data from the 2013 Online Survey of Youth Health Behavior in Korea. This self-report questionnaire was administered to 72,435 adolescents aged 13-18 years in middle and high school. School characteristics, family characteristics, and mental health variables were analyzed using descriptive statistics, χ(2) tests, and logistic regression. Both suicidal ideation and behavior were more common in girls. Suicidal ideation was most common in 11th grade for boys and 8th grade for girls. Across the sample, in logistic regression, suicidal ideation was predicted by low socioeconomic status, high stress, inadequate sleep, substance use, alcohol use, and smoking. Living apart from family predicted suicidal ideation in boys but not in girls. Gender- and school-grade-specific intervention programs may be useful for reducing suicidal ideation in students.

Perception and needs in health education curriculum among school nurses as health teachers in Korea.

The study investigated perceived effectiveness and perceived barriers to health education curriculum targeting school nurses as health teachers in Korea. A total of 741 health teachers participated. The questionnaire included perceived effectiveness and perceived barriers to health education curriculum, future roles of health teachers, and needs for in-service training programs. The most frequently selected perceived barrier was a lack of personnel to serve in the health clinic when the nurse was teaching, although 60.9-61.7% wanted to continue both duties of health education and school health services. Perceived effectiveness of health education was positively associated with duration of teaching career (p < .05). Elementary school health teachers had higher perceived effectiveness than those in middle and high schools, while those with bachelor's degrees had lower perceived effectiveness than those with master's degrees (p < .05). In-service training and efforts to decrease the perceived barriers would help to offer effective health education.

[A comparison of stress levels of elementary students by geographical regions].

PURPOSE: The purpose of this study was to compare stress levels of elementary students according to three regional levels: a large city, a medium-sized city, and a rural area. METHODS: This was a descriptive comparative survey using a convenience sample of 1,161 5th-and 6th-grade students. The stress level was measured by a stress scale that consisted of 65 items regarding personal characteristics, family, school, and peer factors. The data were analyzed by chi2-test, t-test, ANOVA and multiple regression using the SPSS 10.0 statistical program. RESULTS: Overall, the mean stress scores reported by the participants were near the middle of a 5-point scale and the level of family-related stress was highest, followed by peer, school, and individual-related stress. Sixth-graders and female students showed higher stress levels than 5th-graders and male students, respectively. The participants reporting unsatisfaction with their lives and those living in large cities tended to have significantly higher stress levels. CONCLUSION: Grade, gender, life satisfaction, and regional levels were all significant factors associated with high stress levels among elementary students. Development of stress management programs for this specific population, especially targeting students who are female and living in large cities, is needed.