Development of body modification and excessive exercise scales for adolescents

The present study was designed to develop a Body Modification Scale (BMS) to measure body change among adolescents and to modify an Excessive Exercise Scale (EES) into a shorter form for adolescents. Two hundred and twenty-one girls and 192 boys from Grades 7 to 10 completed the BMS and the EES. Factor analysis revealed three identical factors for the BMS for girls and boys: weight loss, weight gain, and muscle mass. Two identical factors for girls and boys were also revealed for the EES. Both factor structures were further validated on a separate sample of 286 adolescents (140 girls, 146 boys). The BMS and EES demon-strated excellent reliability (alpha > .86) and high test-retest reliability (alpha > .82) over 1 month. Good concurrent validity was also found for the weight loss factor of the BMS. These findings demonstrate the utility of these two scales for use with adolescents.

The management of adolescents at risk of suicide by Australian general practitioners: issues in practice and confidence

This study involved an anonymous survey of 41Victorian GPs regarding their diagnostic and treatment practices with adolescent patients with depression and/or suicide ideation. The results indicated that the majority of respondents correctly diagnosed the level of depression and the risk of suicide in a case scenario. Although they commonly asked some of the questions related to an assessment of suicide risk, they rarely conducted a comprehensive risk assessment and the level of referral to telephone and internet crisis services was poor. Most GPs indicated a lack of confidence in their ability to detect and manage depression and suicide in this population and strongly emphasized a need for more training.

Evidence-based strategies to promote physical activity among children, adolescents and young adults: review and update

This paper updates evidence reviewed in the first edition of Getting Australia Active on effective physical activity (PA) intervention strategies among children, adolescents and young adults. Intervention studies published between 1999 and September 2003 were identified using electronic databases and hand searching. A total of 28 discrete studies were identified (31 papers). Six of nine studies reported significant effects on child or youth PA in school settings. Those that incorporated whole-of-school approaches including curriculum, policy and environmental strategies appeared to be more effective than those that incorporated curriculum-only approaches. Five of 10 studies with children and two of five studies with adolescents reported increased PA or decreased sedentary behaviour in other settings. Interventions that included contact with families generally appeared to be most effective. One study with adolescents provided some evidence of the potential effectiveness of interventions based in primary care. Two of four papers reported modest short-term results among young adults, including increased PA stage of change or a higher likelihood of being adequately physically active, but none showed any evidence of sustained increases in PA. There is an urgent need for additional studies examining interventions aimed at young adults. Across the three life stages, future studies should include objective PA measures, longer-term follow-up, larger sample sizes, a specific focus on PA (rather than weight) and culturally-specific strategies that build evidence in Australian populations. Future studies should target high risk groups and a broad range of settings and strategies focusing on reducing sedentary behaviours as well as increasing PA.

Body image importance and body dissatisfaction among Indigenous Australian adolescents

Despite their elevated risk of health problems and a propensity to be more overweight or underweight relative to the other members of the Australian population, there has been no previous investigation of body image concerns among Indigenous Australians. In this study we investigated the level of body image importance and body image dissatisfaction among 19 rural Indigenous adolescents (7 males, 12 females) and 28 urban Indigenous adolescents (15 males and 13 females). Our hypotheses that there would be gender differences in body image importance and body image satisfaction were not generally supported. However, males placed more importance on muscle size and strength than females, and rural participants placed more importance on weight than urban participants. Comparison to existing data obtained from Caucasian adolescents suggested that Indigenous youth may be less concerned and dissatisfied with body weight and shape. These results are discussed in relation to findings from studies of non-Indigenous adolescents, and Indigenous health issues. The limitations of the current study and the need for further studies are also discussed.

How do perceptions of local neighborhood relate to adolescents` walking and cycling?

Purpose. To examine how perceptions of the local neighborhood relate to adolescents' walking and cycling. Design. Exploratory cross-sectional study. Setting. Birth cohort from the Nepean Hospital, Sydney, Australia. Subjects. Three hundred forty-seven adolescents (79.1 % response rate; 49.6% boys; mean age - 13.0 ± 0.2 years) and their parents. Measures. Self-report and parental-report questionnaires. Results. Multiple linear regressions, adjusted for level of maternal education, revealed that boys who reported having many peers to hang out with locally, cycled for recreation (β = 0.242, p = .006) or for transport (β = 0.141, p = . 046) more often, and walked for transport for longer (β = 0.129, p = .024) on weekdays. For girls this variable was related to cycling for recreation on weekends (β = 0.164, p = .006) and walking to school (β = 0.118, p = .002). Adolescents who waved/talked to neighbors walked for transport more often (boys, β = 0.149, p = .037; girls, β = 0.119, p = .012). Girls who perceived local roads to be safe spent more time walking for transport on weekdays (β = 0.183, p = .007) and for exercise on weekends (β = 0.184, p = . 034). Parents' perception of heavy traffic was negatively associated with boys' walking for transport (β = -0.138, p = .037) and many aspects of girls' walking and cycling. Conclusion. Social interaction and road safety may be important predictors of adolescents' walking and cycling in their neighborhood. Limitations are the use of self-report and cross-sectional data. Longitudinal studies may clarify these relations.

Stalking, and social and romantic functioning among adolescents and adults with autism spectrum disorder

We examine the nature and predictors of social and romantic functioning in adolescents and adults with ASD. Parental reports were obtained for 25 ASD adolescents and adults (13–36 years), and 38 typical adolescents and adults (13–30 years). The ASD group relied less upon peers and friends for social (OR = 52.16, p < .01) and romantic learning (OR = 38.25, p < .01). Individuals with ASD were more likely to engage in inappropriate courting behaviours (χ² df = 19 = 3168.74, p < .001) and were more likely to focus their attention upon celebrities, strangers, colleagues, and ex-partners (χ2 df = 5 = 2335.40, p < .001), and to pursue their target longer than controls (t = −2.23, df = 18.79, p < .05). These results show that the diagnosis of ASD is pertinent when individuals are prosecuted under stalking legislation in various jurisdictions.

Beyond the workshop : doing multiliteracies with adolescents

Engaging students’ lifeworlds and the concerns of their communities in globalised, semiotic and information societies is imperative with the complexity of multimodal communication (Lemke 2006) in the ‘new media age’ (Kress 2003). As youth continue to demonstrate their multiliteracies proficiency with new literacies emerging from Internet Communication Technologies (ICTs), education - particularly curriculum and instruction - remains largely focused around monomodal, print-only literacy practices, often ignoring their multiple voices. In New Times (Hall 1996), there has been much rhetoric about the role of education in equipping students for the future. Multiliteracies pedagogy allows individual teachers to reconceptualise pedagogy and curriculum thereby addressing adolescents’ complex and demanding literacy needs (New London Group 1996). This paper presents new and emerging virtual contexts and environments for adolescent literacy instruction highlighting one teacher’s curricular interruptions where Multiliteracies pedagogies replaced the progressive monomodal reading and writing workshop. In conclusion, new perspectives on research related to the education of teachers in the education in post-typographic societies of the 21st century.

Who thinks I need a perfect body? Perceptions and internal dialogue among adolescents about their bodies

The main aim of this study was to provide a detailed examination of the nature of the messages that adolescent boys and girls receive about their bodies. Forty adolescent boys and 40 adolescent girls participated in an in-depth interview to gain an understanding of the range of potential ‘sources’ of body-related messages. Messages were organized around the source of these messages (self, mother, father, brother, sister, female friends, male friends, media). There were consistent gender differences in the way that adolescents received and interpreted messages about their bodies. Overall girls received more positive and more negative messages than boys did. Boys reported having received virtually no negative messages from most people. The content of internal dialogue among adolescents revealed that messages about the body could be interpreted, distorted, and deflected. The implications of these findings for preventing body image-related problems and disordered eating among adolescents are discussed.

Sun exposure and sun protection behaviours among Australian adolescents: trends over time

Background
This study compared the sun exposure and sun protection behaviours of adolescent students between 1993 and 1999.

Methods
Schools from all Australian states and the two territories participated in each of the 1993, 1996, and 1999 surveys and a sample of students from years 7 to 12 were surveyed. In each of the states and territories a random sample of schools was selected within each education sector (government, Catholic, independent). The questionnaire was a self-completed booklet with questions about sunburn history during the previous summer, tan preferences, skin-type, and usual reported behaviour. Data from a total of 78,032 students were available for analysis.

Results
From 1993 to 1999 there was a significant increase in the number of students reporting sunburn during the previous summer (χ2 = 225.77, df = 2, P < 0.01). However, the percentage of students who preferred no tan at all increased over the same period (χ2 = 184.47, df = 2, P < 0.01). The percentage of students who usually or always wore clothing that covered most of their body decreased between 1993 and 1999 (χ2 = 20.46, df = 2, P < 0.01); the percentage of students usually or always wearing maximum protection sunscreen decreased over time (χ2 = 27.71, df = 2, P < 0.01). Staying in the shade increased from 1993 (26%) to 1996 (32%) but decreased slightly in 1999 (30%). Across all survey years, only 11% of students routinely followed all three protective behaviours of wearing a hat, sunscreen, and clothes that cover the body.

Conclusions
Sun protection practices among adolescents are still below optimal levels. Future educational programs require innovative approaches that aims to change attitudes toward tanning as being healthy and attractive and modify adolescent behaviours in relation to sun exposure.

The health and well-being of adolescents: a school-based population study of the self-report child health questionnaire

Purpose: To evaluate a new generic measure of adolescent health status, the self-report version of the Child Health Questionnaire (CHQ), and provide population-based data. Furthermore, we aimed to examine the impact of common adolescent illness and health concerns on their health and well-being.

Methods: A stratified, two-stage, random cluster sampling design was used to obtain a cross-sectional sample of subjects through schools. A written questionnaire included the 80-item 12-scale self-report CHQ and items measuring health concerns, illnesses/health conditions, and sociodemographics.

Results: A total of 2361 adolescents participated (response rate of 70%). Reliability was high: Tests of internal consistency and discriminant validity reported 90% of item-scale correlations >.4; all scales had Cronbach alpha coefficients >.7. Adolescents with illnesses/conditions or health concerns reported lower scores and larger differences for content-related scales, supporting content and construct validity. Statistically significant age and gender trends were observed for Mental Health, Self-Esteem, General Health, and Family Cohesion scales. Health status worsened as health concerns increased (X2 linear trend, p = .00) with deterioration in health of 5–20% on all scales for emotional health concerns (40% of sample).

Conclusions: The self-report CHQ is a reliable and seemingly valid measure of health and well-being for adolescent health research, although additional measures may be required where scales have high ceiling values. The significantly lower scores reported by adolescents with illness and/or health concerns lend support to the use of standardized health measures and longitudinal research to further examine the impact of adolescent comorbidities and their causal determinants.

Re-envisioning literacy instruction with adolescents: multiliteracies, multimodality and new technologies

Engaging students' lifeworlds and the concerns of their communities in globalised, semiotic and information societies is imperative in New Times. As youth continue to exhibit their proficiency with new literacies emerging from Internet communication technologies (leTs), education-particularly curriculum and instruction-remains largely focused around monomodal, print-only literacy practices, often ignoring students' hybrid multiple voices. This paper reports on two curricular interruptions to the progressive reading and writing workshop that acknowledged adolescents' engagement with digital technologies and their new multimodalliteracy practices in a year eight public classroom within a small urban academy of technology.

Self-perceived quality of life of children and adolescents with physical disabilities in Hong Kong

Although illnesses and diseases are thought to adversely affect quality of life (QoL), whether children who have physical disabilities (PD) from a young age adapt to the effect of developmental disabilities has rarely been investigated. This study attempted to assess the subjective wellbeing, and examine the correlation between objective and subjective QoL, of children with PD. Using a self-reported non-disease-specific questionnaire, the QoL of 72 young persons (13.5 ± 2.0 years) with PD was contrasted with those who do not have disabilities (n = 510; age-matched). MANOVA analyses revealed that the PD group had lower objective QoL score (63.0 ± 7.4 vs. 66.8 ± 5.7, p < 0.001) but the two groups were not significantly different in subjective QoL score (70.9 ± 11.4 vs. 69.6 ± 13.6, p = 0.466). No correlation was found between objective and subjective QoL in the PD group (r ranged from 0.06 to 0.19), while weak to medium correlations (r ranged from 0.03 to 0.41) were observed for the controls. The apparent detachment of subjective feeling and objective circumstances in the PD group may reflect adjustment to developmental disabilities.

A new approach to assessing the health benefit from obesity interventions in children and adolescents: the assessing cost-effectiveness in obesity project

OBJECTIVE: To report on a new modelling approach developed for the assessing cost-effectiveness in obesity (ACE-Obesity) project and the likely population health benefit and strength of evidence for 13 potential obesity prevention interventions in children and adolescents in Australia. METHODS: We used the best available evidence, including evidence from non-traditional epidemiological study designs, to determine the health benefits as body mass index (BMI) units saved and disability-adjusted life years (DALYs) saved. We developed new methods to model the impact of behaviours on BMI post-intervention where this was not measured and the impacts on DALYs over the child's lifetime (on the assumption that changes in BMI were maintained into adulthood). A working group of stakeholders provided input into decisions on the selection of interventions, the assumptions for modelling and the strength of the evidence. RESULTS: The likely health benefit varied considerably, as did the strength of the evidence from which that health benefit was calculated. The greatest health benefit is likely to be achieved by the 'Reduction of TV advertising of high fat and/or high sugar foods and drinks to children', 'Laparoscopic adjustable gastric banding' and the 'multi-faceted school-based programme with an active physical education component' interventions. CONCLUSIONS: The use of consistent methods and common health outcome measures enables valid comparison of the potential impact of interventions, but comparisons must take into account the strength of the evidence used. Other considerations, including cost-effectiveness and acceptability to stakeholders, will be presented in future ACE-Obesity papers. Information gaps identified include the need for new and more effective initiatives for the prevention of overweight and obesity and for better evaluations of public health interventions.