Adolescents, Volume 3, Issue 3 (September 2023) – 16 articles

(1) Background: Texting is a prevalent communication method between late adolescents and their families that has implications for their relationships and well-being. This study used mixed-method analysis to understand what late adolescents, specifically college students, text their families about (i.e., themes), and how they feel about their family texting experiences (i.e., sentiments). (2) Methods: Our analyses used text transcripts of semi-structured individual interviews from 19 college students (aged 18–22 years, 13 female, 10 students of color), with 357 sentences/passages coded in total. (3) Results: Inductive content analysis revealed four themes: emotional support, relationship maintenance, conflict, and difficult conversations. Quantitative sentiment analysis revealed the highest level of positive sentiment attached to emotional support, and the highest level of negative sentiment attached to difficult conversations. The interviews that covered more conflict-based themes tended to have higher positive and negative sentiments. Differences between participants texting with their mothers and fathers were also revealed. (4) Conclusions: This research advances the understanding, in terms of both content and emotions, of the texting interactions with family members among late adolescents, along with providing methodological contributions, by highlighting the utility of the mixed-method analysis of interview data. Full article

In Canada, the demands of female immigrant adolescents in terms of sexual health are largely unmet and have grown significantly in recent years. According to studies, racialized immigrant adolescents are less likely than non-immigrant adolescents to be knowledgeable about sexual and reproductive health and to use resources for sex education and related services. This difference seems to be related to socio-cultural and religious practices in Pakistani immigrant adolescents. This paper intends to explain the viewpoints of female adolescents of first- or second-generation Pakistani descent who reside in Canada with regard to their development of sexuality and psychological well-being. Moreover, this paper also describes how female adolescents perceive the necessity to support their sexuality as they go through the adolescent stage. Individual interviews and timelines were created using qualitative interpretative descriptive design. We included 21 female adolescents of first- or second-generation Pakistani ethnicity using a purposive sample. Data analysis was performed using a thematic analysis. The findings indicate that immigrant adolescent girls received conflicting messages about sexuality from their parents which impacted their psychological well-being. Additionally, survey participants noted that prejudice, exclusion from sex education classes, and a lack of sexual health information contributed to social isolation, health care avoidance, and poor mental health outcomes like melancholy and anxiety among adolescent girls. The absence of sexuality-related communication with parents and the scarcity of medical professionals who can relate to and address the needs and realities of immigrants may have an impact on the participants’ experiences. Female immigrant girls also spoke up on the need for open, honest, and stigma-free conversations as well as for the need to end the taboo around the subject of sexuality. This study used principles from both intersectionality and postmodern feminist theories to increase our understanding of the interplay between the experiences of developing sexuality and overall well-being in female immigrant adolescents of Pakistani descent. It is crucial to involve, listen to, and incorporate female adolescents’ voices when planning and implementing interventions to support healthy sexuality among immigrant adolescents. Full article

Adolescents with close relatives having severe health conditions or who have died (RSHC) are vulnerable, and this has long-term influences on their lives and health. This study investigated how adolescents with RSHC experiences reported having poor mental health and protective factors and the combined influence of these compared to their peers who had not had these experiences. A cross-sectional school-based survey among students aged 15–18 years (N = 3410) in Sörmland, Sweden, was used to analyse the association between poor mental health and experiences from having one or several RSHC experiences with physical illness, mental illness, or substance abuse/gambling disorder, as well as having relatives who have died. Logistic regression models were performed, adjusting for background factors, and protective factors against poor mental health related to school, home relations, safety in everyday life, and lifestyle were assessed. Adolescents with one RSHC experience had an OR of 1.45 (95% CI: 1.23–1.72) for poor mental health, and those with several RSHC experiences had an OR of 2.35 (95% CI: 1.94–2.84) compared to those with no RSHC experiences. The greatest OR for poor mental health was seen among adolescents with the combination of several RSHC experiences and few protective factors against poor mental health (18.83; 95% CI: 11.86–29.91). Adolescents with RSHC experiences have increased odds of poor mental health compared to adolescents without these experiences, especially those with several RSHC experiences and few protective factors. When meeting adolescents with RSHC experiences, supporting their key protective factors may play an important role in improving mental health. Full article

Adolescent eating disorders and disordered eating behaviours appear to be a growing public health concern. The aetiology of these conditions is complex, as many different factors contribute to their development. Among them, family factors such as parenting styles and comments regarding weight coming from family members are considered critical and are extensively researched. However, the impact of parental dieting has received less attention. A literature review was conducted in order to examine the relationship between parental engagement in weight-reduction dieting and their adolescent offspring’s disordered eating behaviours. The review was conducted in three databases (PubMed, Scopus and Google Scholar) regarding the period between January 2000 and May 2023. The initial search retrieved 339 abstracts, and 113 full reports were evaluated for eligibility. Six studies fulfilled the inclusion criteria and were included in the final literature review. A number of studies indicated that adolescents whose parents were engaged in dieting in order to lose weight are more likely to showcase disordered eating behaviours. However, research regarding this relationship is very scarce. More studies on the link between parental eating and dieting habits and the risk of disordered eating in adolescents are required. Moreover, parents should be informed regarding the possible risks when they choose to follow weight-loss diets and the importance of adopting healthy eating and weight-control habits for the whole family. Full article

This qualitative case study explored the experiences of one Canadian adolescent with symptom-persistent Lyme disease. Lyme disease is the most prevalent vector-borne illness in North America, and infection rates are rising across Canada. Peak incidence occurs in children aged 5–9 years, making it a significant childhood infectious disease. This involves collaboration with an adolescent with symptom-persistent Lyme disease in Canada to address a gap in the literature. This empirical research was guided by the central research question: “What is the experience of an adolescent with symptom-persistent Lyme disease in Canada?” The purpose of this study was to understand the unique experiences of symptom-persistent Lyme disease in Canada by emphasizing one adolescent’s unique voice. The findings of this case study demonstrate the challenges this adolescent faced in receiving appropriate diagnosis and treatment for Lyme disease, pointing to a need for increased awareness among health professionals regarding the impact and prevalence of tick-borne illnesses for young people, their caregivers, and their healthcare providers. Additional findings suggest that collaborative healthcare may be beneficial for patients with symptom-persistent Lyme disease, and health researchers should continue to engage young people to ensure accurate representation of their experiences. Full article

The social and emotional health of adolescents is increasingly a concern worldwide. To date, there remains a lack of research on how school climate influences adolescents’ learning experiences and their social and emotional health. To address this gap in the literature, this critical review addresses the role that the school climate plays in an adolescent’s school life and emotional well-being. This article takes a critical approach and outlines the key issues in research on the secondary school climate in the digital and real-life sense and the implications for adolescent’s well-being. We first outline the definitional and methodological issues regarding research on school climate in adolescence. We then outline why mental health is a key issue for adolescents across the globe and conclude with a list of implications for theory, research, and practice. Thus, this article builds on past, current, and ongoing research on adolescents’ emotional well-being and school climate across the globe. The article provides new directions and recommendations for future research on inclusive educational philosophies and positive psychology and suggestions for practice aimed to best support adolescents’ learning experience and mental well-being. Full article

Global interest in child, early, and forced marriage and unions (CEFMU) is reflected in a large and growing body of research and interventions. Those interventions have focused on raising the minimum age of marriage, establishing laws and penalties for those who ignore these minimums, investing more heavily in girls’ education, addressing structural inequalities, and bringing about gender and social norm change. Missing has been any discussion of the right to leave marriage. As we learn more about the forces that drive child marriages and unions and what works to prevent them, rare is any mention of how these marriages sometimes end and what happens when they do. Human rights standards focus on the ability to choose “if, when, and whom to marry”. We posit that without the ability to decide if and when to leave marriage, marriage cannot be considered a choice. This paper explores why the right to leave marriage matters so deeply, describes the obstacles to girls’ access to divorce and to protections after divorce or separation, and links these to the factors that drive child, early, and forced marriages and unions. Full article

Direct experiences of sexual harassment have been found to be associated with substance use and poor mental health among girls. Indirect experiences, such as witnessing the sexual harassment of others, may be indicative of a climate supportive of sexual harassment against girls and elicit similar adverse outcomes. The current study sought to assess reports of witnessing sexual harassment and associations with substance use and mental heath outcomes among adolescent girls. The data were from questionnaires among girls (n = 152) ages 15–19 recruited from a health clinic serving a low-resource community in San Diego County. Using crude and adjusted regression models, we assessed witnessing the sexual harassment of girls (past year) as well as the frequency of witnessing such acts in relation to substance use, anxiety, depression, and suicidal ideation. The adjusted models included demographics and direct experiences of sexual harassment (past 6 months) as covariates. The participants had an average age of 17, and 76% were Latina. The majority (70%) reported witnessing sexual harassment (past year); 65% reported directly experiencing sexual harassment (past 6 months). Among those reporting witnessing, most witnessed sexual harassment at school (69%), at a party (45%), in their neighborhood (34%), or on public transport (33%). In adjusted logistic regression models, witnessing sexual harassment was significantly associated with past 30-day alcohol use, ever using drugs, feeling depressed (past 30 days), feeling anxious (past 30 days), and past-year suicidal ideation (ORs range 2.9–18.2). The findings suggest that, in addition to direct experiences of sexual harassment, indirect experiences of witnessing the sexual harassment of others may also be associated with negative outcomes regarding girls’ health and well-being. Full article

Background: Considering its deleterious effects on health, as well as the importance of information to support actions, strategies, and public policies, the present study was developed, aiming at identifying and classifying the main variables associated with ultra-processed foods consumption in Brazilian adolescents. Data sources: Targeting observational studies involving samples of Brazilian adolescents (11 to 19 years old), which evaluated possible associations between the consumption of ultra-processed foods and individual, interpersonal, environmental, and public policy variables, in October 2022, a systematic review was conducted, consulting electronic databases (Lilacs, Pubmed, Scielo, Scopus, and Web of Science), Google Scholar, and the reference lists of included articles. Data synthesis: The descriptive synthesis consisted of 11 papers, representing nine original studies. The main variables identified were: sedentary behavior (specially screen time), studying at a private school, having a higher body mass index, and being female. Conclusions: Based on this evidence, it is important to direct actions, strategies, and public policies aimed at confronting the consumption of ultra-processed foods for these groups. Full article

Understanding the determinants that influence obesity among children and adolescents is critical to the prevention of obesity and obesity-related diseases later in life. The findings presented here broaden the understanding of obesity-related challenges by adding analyses that compare nutritional indicators among boys and girls between the ages of 11 and 16 years, by exploring the more recent literature to examine if past trends have continued or not, and by synthesizing the recent findings concerning the causes and determinants of such trends in obesity. Both data from 2005 and the more recent literature review have shown that the consumption of high calorie foods and snacks, greater screen time, body image, and depressive factors play a significant role regarding obesity during adolescence in Thailand. There continues to be a trend of increasing obesity among adolescents in Thailand, and this may be more of a concern in boys. Interviews with health professionals and parents from the 2005 study suggested that girls were more aware of their physical appearance, and there was more societal acceptance to be obese as a boy in Thailand compared to girls. These findings can inform nutritional education practices and policies. Full article

Cases of teenage pregnancy remain high in Eastern Province of Zambia—contributing to health, economic, and social problems. This study sought to determine the effect of exposure to boarding schooling on pregnancy among school-going teenagers, taking into account individual and school characteristics. This was a retrospective case-control study involving 261 cases and 522 controls obtained from nine boarding and nine day secondary schools, between 2019 and 2021. STATA 16.1 MP was used for all statistical analyses at a 5% level of significance. Unadjusted and adjusted effects were obtained using logistic regression analysis—taking into account 18 school clusters. Cases had a mean age of 17.4 years (±1.14 years), controls were 16.1 years (±1.71 years) old on average, and 315 (40%) of the participants were exposed to boarding schooling. The unadjusted odds of pregnancy in the exposed and unexposed (day scholars) girls were 0.25 and 0.73, respectively (cOR = 0.34, CI: 0.24–0.48, p < 0.0001). Adjusting for other characteristics, teenage girls in boarding schools had 60% lower odds of pregnancy (aOR = 0.40, CI = 0.16–1.00, p = 0.049). In light of this evidence, enrollment of teenage girls in boarding schools is encouraged to help mitigate teen pregnancy in the province. Additionally, a multicenter prospective study is recommended. Full article

(1) Background: In adolescence, the onset of physical signs of sexual maturity and early sexual contact have become increasingly common. However, most adolescents are not adequately prepared for this event, which can lead to significant negative consequences for young people. This study aimed to evaluate knowledge about sexuality during adolescence. (2) Methods: A quantitative, descriptive, and correlational design was used, with 289 students from a school in the northern region of Portugal. From an online questionnaire, sociodemographic information and the Sexuality Knowledge Questionnaire were used to collect data. (3) Results: Most adolescents (54.0%) were female and aged between 15 and 17 years, with an average knowledge score of 17.04. The worst results were found in the dimensions of first sexual intercourse and sexual concerns, with men scoring lower, and the dimension of sexually transmitted infections and HIV/AIDS, where women performed better. The best scores were in the sexuality and sexual pleasure dimension, with women performing better, and the counseling and care in sexual and reproductive health dimension, where men performed better. (4) Conclusions: The approach to sexuality education must be constant throughout the life cycle, and it is essential to provide appropriate information to adolescents about issues related to sexuality. Full article

Most of the research examining student motivation, particularly achievement goals, has relied on experimental or survey methods that narrow the number and type of goals students can report. A few researchers have asked students open-ended questions, either using surveys or interviews, about what they want to accomplish and their reasons for studying or trying to achieve. These studies have generally found a larger number of goals across a broader set of categories (e.g., social-comparison, internal standard, social, work-avoidance, utilitarian) than is typically examined in research on achievement goals. In this study, we asked a sample of 152 undergraduate students at one university in California (USA) to describe how they defined success in two different classes: One they liked and one they disliked. Our objectives were to examine how students described their definitions for success, whether those definitions differed for liked and disliked classes, and to learn about students’ perceptions regarding the sources of their definitions of success. The results indicated that students’ definitions of success were more varied in classes they liked than in those they disliked. In addition, their definitions focused more on developing competence and positive relationships with the teacher in classes they liked, but they focused on getting a good grade, completing the class, and avoiding work in classes they disliked. The results also indicated that students perceived different sources of the same definitions of success for liked and disliked classes, with a greater emphasis on bad teaching and difficult course material in the disliked class. The implications for conceptualizing the methodology for studying achievement goals are discussed. Full article

Background: Risky sexual behaviors remain common among adolescents regardless of those with comprehensive knowledge of safer sex practices. Self-efficacy has been shown to have a positive relationship with safer sex practices. Thus, investigating self-efficacy, and enhancing it to agency is important. The current study explores the predictors of self-efficacy for avoiding risky sexual behaviors and what limits agency among sexually active adolescents (15–19 years) in Northern Uganda. Methods: The study consisted of a sub-sample of 396 sexually active adolescents (145 in school, 251 out of school) interviewed as part of a household survey for the program on Advancing Sexual Reproductive Health and Rights in Northern Uganda. Poisson and Poisson regression models with survey weights were implemented in Stata. Results: A total of 94% of male and 64% of female adolescents reported self-efficacy to avoid unsafe sex, including using condoms and avoiding multiple sexual partnerships or transactional sex. At multivariable analysis, a higher proportion of adolescents who listened to a radio or television program about sexual and reproductive health within the past 12 months had self-efficacy as compared to others (PR = 1.13, p-value = 0.002). Similarly, higher proportions of adolescents who knew all the sexual and reproductive health (SRH) rights (PR = 1.33, p-value = 0.007) and who had comprehensive knowledge about pregnancy, prevention of sexual transmission infections, and sources of SRH services (PR = 1.24, p-value = 0.013) had self-efficacy as compared to others. However, among those who reported self-efficacy, 42% of the girls and 53% of the boys could not uphold their self-efficacy in actual sexual encounters in the past 12 months. Partner’s refusal or girls’ fear to ask their sexual partner to use a condom were commonly cited reasons. Alcohol consumption was associated with failure to act on one’s self-efficacy (RR = 0.74, p-value = 0.048). Conclusions: Programs should target self-efficacy beliefs and attempt to enhance them into agency by increasing positive and decreasing negative expectations associated with risky sexual behavior. Full article

Mobile software applications (apps) have transformed how individuals oversee and maintain their own health. One way that girls can monitor their menstrual cycles is through the increasingly widespread use of mobile menstrual tracking apps. This study aimed to examine menstrual symptom tracking for adolescents in English and Chinese apps, exploring menstrual literacy, cross-cultural differences, and framing, or presentation, of symptoms. The mixed-methods content analysis involved 15 popular free menstrual tracking apps in English (n = 8) and Chinese (n = 7), sampled from December 2022 to January 2023. A quantitative analysis of qualitative data was conducted through manual coding of content and automatically analyzing sentiment, or emotional tone, using a computational approach. We found that (1) menstrual literacy on symptom management or treatment was generally insufficient, (2) there were more available emotional than physical symptoms in English than Chinese apps, and (3) symptoms were framed more negatively than positively somewhat more in Chinese than English apps. Our findings emphasize the urgency to provide better evidence-informed communication about symptoms, either presented more positively or neutrally, in menstrual tracking apps for adolescent users. Since adolescence is a critical developmental stage that requires ample support, we recommend that digital menstrual trackers be crucially improved and future research should investigate how they can uniquely shape attitudes and experiences, and subsequent sexual and reproductive health empowerment and bodily autonomy. Full article

Adolescent pregnancies adversely impact mental and reproductive health as well as educational and socio-economic outcomes. In Kakamega County, Kenya, 20% of adolescents begin childbearing by age 19. To inform interventions to reduce adolescent pregnancy, Jhpiego used the Barrier Analysis methodology, which is based on the Doer/Non-Doer study model, in which participants are categorized according to whether they are “Doers” or “Non-Doers” of the study behavior. This study examines the determinants of the behavior, “young unmarried women currently use modern contraceptive methods”. Participants included young women aged 15–19 who were sexually active, unmarried, and were using (“Doers”) or not using (“Non-Doers”) modern contraception. The findings reveal that the majority of Doers (88%) and Non-Doers (80%) understand the pregnancy risk associated with non-use, and there is no statistically significant difference between Doers’ and Non-Doers’ understanding of contraceptive benefits. Knowledge of side effects and misconceptions, such as the belief that contraception causes infertility, does not deter Doers from using contraception. Seventy percent of Doers note that contraception is accessible/available, while 39% of Non-Doers state the opposite. Doers are almost three times more likely than Non-Doers to say that most people approve of their contraceptive use, while Non-Doers are twice as likely as Doers to say that most people would not approve. Doers are four times more likely to indicate approval from their mothers and boyfriends. Non-Doers are five times more likely than Doers to have specific professional goals for the future. These findings illustrate the importance of moving away from fear-based messaging and instead highlighting social acceptability and contraception’s role in achieving future goals. Full article