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Full-Text Articles in Public Health

Trends In Substance Use And Mental Health Among Adolescents In Georgia, 2002-2022, Saumya S. Palipudi, Bangaru Talli Palipudi, Murty Komanduri May 2024

Trends In Substance Use And Mental Health Among Adolescents In Georgia, 2002-2022, Saumya S. Palipudi, Bangaru Talli Palipudi, Murty Komanduri

Georgia Public Health Association Annual Meeting and Conference

Background: While substance use and absence of mental health disorders among youth in the United States (US) have declined over the past two decades, post COVID-19 pandemic, these conditions have increased significantly with notable disparities, and witnessed a crisis in public health. In 2022, 24.7% or 6.1 million adolescents aged 12 to 17 in the US had either Major Depressive Episodes (MDE) or Substance Use Disorder (SUD) and 3.7 percent had both in the prior year2. Increased stress, lack of peer connections, parental abuse, and poor mental health conditions were attributed to this increase in substance use3-7 …


Social Supports For Adolescent And Young Adult Polycystic Ovary Syndrome Patients: A Scoping Review, Caitlin E. Mungall Oct 2023

Social Supports For Adolescent And Young Adult Polycystic Ovary Syndrome Patients: A Scoping Review, Caitlin E. Mungall

Western Libraries Undergraduate Research Awards (WLURAs)

Polycystic ovary syndrome (PCOS) is a chronic disorder with negative health consequences for millions of women. The paucity of research regarding interventions targeting the psychosocial symptoms of PCOS for adolescents and young adults (AYAs), susceptible to low self-esteem and depression, warranted this review. This paper provides an overview of research on the social supports currently available for AYAs and identifies areas where further research is required to elucidate their support needs. A scoping review methodology identified 15 studies that met inclusion criteria. Findings revealed that this is an emerging field of research and most included studies originated in North America. …


Association Of Physical Activity And Screen Time Usage Of Adolescents In Rural Areas Of Mysore., Aakash Pavan Kumar, Nayanabai Shabadi, Bikram Sinha Roy, Anchu R. Nath, Arun Gopi Mar 2023

Association Of Physical Activity And Screen Time Usage Of Adolescents In Rural Areas Of Mysore., Aakash Pavan Kumar, Nayanabai Shabadi, Bikram Sinha Roy, Anchu R. Nath, Arun Gopi

Digital Journal of Clinical Medicine

Introduction:

In these changing times there have been increased usage of screen device due to more accessibility to both device and the internet and a greater number of children are having reduced physical activity. The purpose of the current study was to determine if screen usage among adolescents (11-17yrs) who live in supportive environments is associated with decreased levels of moderate to vigorous physical activity.

Methods & materials:

A school-based cross-sectional study was conducted in two rural schools of Mysore, Karnataka in February 2023, in 176 students between the age group of 11 – 17yrs. Physical activity and screen …


Emergency Care For Youth Who Experience Suicidality And Identify As Lesbian Gay Bisexual Transgender Queer/Questioning (Lgbtq+): An Interpretive Phenomenology, Theresa Schultz Aug 2022

Emergency Care For Youth Who Experience Suicidality And Identify As Lesbian Gay Bisexual Transgender Queer/Questioning (Lgbtq+): An Interpretive Phenomenology, Theresa Schultz

Electronic Theses and Dissertations

Purpose: Suicide is a leading cause of death in children; youth who identify as LGBTQ+ are at an exponentially higher risk of suicide. The purpose of this study was to explore the lived experiences of young adults who identify as LGBTQ+ and sought emergency care for suicidality when they were adolescents.

Methods: Heideggerian hermeneutics phenomenology is the research method used in this study. Youth, ages 18-25 years, who identify as LGBTQ+ and sought emergency treatment for suicidality when they were adolescents (13-17 years) were recruited to participate;fifteen youth enrolled. Individuals ranged in age from 20 to 25 years. Participants described …


Ask Your Doctor About: Prescribing Activism For Eco-Anxiety In Adolescents, Lexi Nutkiewicz Aug 2022

Ask Your Doctor About: Prescribing Activism For Eco-Anxiety In Adolescents, Lexi Nutkiewicz

Master's Projects and Capstones

Climate change is an ongoing public health crisis. Efforts to protect future generations' physical and mental health are more urgent than ever. Youth, in particular, are experiencing eco-anxiety, a specific form of anxiety relating to stress or distress caused by environmental changes and one’s knowledge of them due to the climate crisis. This scoping review provides a better understanding of the value of youth climate change activism as a strategy to mitigate eco-anxiety. This review evaluates the current definitions of eco-anxiety, the risk factors for eco-anxiety among adolescents, and considers the benefits and drawbacks of youth activism. To identify relevant …


Practicing Trauma-Informed Care In Nursing For A Better Outcome In Hospitalized Adolescents With Adverse Childhood Experiences And Trauma, Allysa Mia Fabricante May 2022

Practicing Trauma-Informed Care In Nursing For A Better Outcome In Hospitalized Adolescents With Adverse Childhood Experiences And Trauma, Allysa Mia Fabricante

Nursing | Senior Theses

As nurses we want to give our patients the best care. That is why trauma-informed care (TIC) is important to include into nursing practice. TIC is a fairly new idea that addresses a patient's whole past and present life. Incorporating it into nursing practice can benefit patients who have adverse childhood experiences and trauma. Adverse Childhood Experiences (ACEs) are traumatic events that occur to a person starting from birth to 17 years old. In a hospital setting an adolescent patient can be triggered if ACEs and trauma is not properly addressed. The long-term effects of ACEs can affect adolescents into …


The Impact Of Outcomes On Depression Literacy In School-Age Children Who Received Depression Education, Loretta Q. Smith Aprn, Pnp-Bc, Bobby Bellflower Dnsc, Nnp-Bc, Faanp Apr 2022

The Impact Of Outcomes On Depression Literacy In School-Age Children Who Received Depression Education, Loretta Q. Smith Aprn, Pnp-Bc, Bobby Bellflower Dnsc, Nnp-Bc, Faanp

Doctor of Nursing Practice Projects

Purpose/Background Recognizing mental illness is crucial in adolescence. It is the second leading cause of suicide and death in children 10-19 years of age. Early identification and recognition of signs and symptoms could prevent progressive mental health illness in early childhood and adulthood. We are seeking to answer the PICO question: In adolescents between 10 and 19 years of age who are enrolled in school (P), how does receiving education on depression awareness (I) compared to not receiving education on depression awareness (C) affect depression scores (O)?

Methods This review was conducted on articles about adolescent children. These articles were …


Social Media Use And Mental Health: An Educational Intervention To Reduce Depression And Anxiety In Adolescents, Natalie Catlett Jan 2022

Social Media Use And Mental Health: An Educational Intervention To Reduce Depression And Anxiety In Adolescents, Natalie Catlett

DNP Projects

Background: Most adolescents spend a great deal of their time using various social media platforms. However, excessive and maladaptive social media use is correlated with worsening symptoms of depression and anxiety among adolescents.

Objective: This project aimed to determine whether an educational intervention could help decrease overall time spent using social media and improve mood and mental health outcomes among adolescents with depression or anxiety disorders.

Methods: This was a quasi-experiment with a pretest and posttest design. An educational intervention about the relationship between social media use and symptoms of depression and anxiety among adolescents and strategies to minimize risk …


The Ecology Of Mental Health And The Impact Of Barriers On Mental Health Service Utilization, Alisha Aggarwal Dec 2021

The Ecology Of Mental Health And The Impact Of Barriers On Mental Health Service Utilization, Alisha Aggarwal

Theses & Dissertations

Mental health has emerged as a major public health concern in recent times with several disparities and barriers related to adequate health service utilization. Different age groups experience diverse symptoms and face distinct barriers in accessing and utilizing healthcare. Policies like Mental Health Parity and Addiction Equity Act and the Patient Protection and Affordable Care Act were launched to improve insurance coverage and delivery of mental health services. However, a large gap of unmet needs exists for adequate mental health service utilization in the country. This dissertation aims to describe the financial and non-financial barriers to mental health service utilization …


Longitudinal Association Between Parental-To-Child-Maltreatment And Self-Reported Generalized Anxiety Disorder Symptoms In Pakistani Adolescents, Maryam Pyar Ali Lakhdir, Ghazal Peerwani, Salman Muhammad Soomar, Apsara Ali, Salima Farooq, Naureen Akber Ali, Asif Khaliq, Muhammad Masood Kadir, Syed Iqbal Azam Jul 2021

Longitudinal Association Between Parental-To-Child-Maltreatment And Self-Reported Generalized Anxiety Disorder Symptoms In Pakistani Adolescents, Maryam Pyar Ali Lakhdir, Ghazal Peerwani, Salman Muhammad Soomar, Apsara Ali, Salima Farooq, Naureen Akber Ali, Asif Khaliq, Muhammad Masood Kadir, Syed Iqbal Azam

Community Health Sciences

Background: Parent-to-child maltreatment is considered one of the risk factors for Generalized Anxiety Disorder (GAD) symptoms, but this hypothesis has not been adequately tested in Pakistani settings.
Aim: This study aimed to examine the association between parent-to-child maltreatment and the risk of developing GAD symptoms among adolescents.
Methods: The association of none to rare, occasionally, and frequently parent-to-child maltreatment with the incidence of GAD symptoms was investigated in a sample of 800 adolescents aged 11-17 years who were followed for two years. Parent-to-child maltreatment was assessed using ICAST-C (International child abuse screening tool). GAD Symptoms were determined by SCARED (Screen …


Intimate Partner Violence Education For High School Students, Morgan Foster Jul 2021

Intimate Partner Violence Education For High School Students, Morgan Foster

Dissertations

Problem Adolescents are at risk for experiencing intimate partner violence (IPV). As early as seventh grade, over half of adolescents have reported being in a romantic relationship. Adolescent screening for and education of IPV is minimal, and only the Healthy Relationships Quiz developed by the U.S. Department of Health and Human Services [HHS] screens young adolescents across all aspects of IPV, including psychological and sexual violence. The purpose of this project was to develop an IPV education plan for high school students in a health course.

Methods An educational lesson plan for IPV was created for high school teachers.

Results …


Mental Health Of Children And Adolescents Amidst Covid-19 And Past Pandemics: A Rapid Systematic Review, Salima Meherali, Neelam Punjani, Samantha Louie-Poon, Komal Abdul Rahim, Jai K. Das, Rehana A. Salam, Zohra S. Lassi Mar 2021

Mental Health Of Children And Adolescents Amidst Covid-19 And Past Pandemics: A Rapid Systematic Review, Salima Meherali, Neelam Punjani, Samantha Louie-Poon, Komal Abdul Rahim, Jai K. Das, Rehana A. Salam, Zohra S. Lassi

School of Nursing & Midwifery

Background: The COVID‑19 pandemic and associated public health measures have disrupted the lives of people around the world. It is already evident that the direct and indirect psychological and social effects of the COVID‑19 pandemic are insidious and affect the mental health of young children and adolescents now and will in the future. The aim and objectives of this knowledge-synthesis study were to identify the impact of the pandemic on children's and adolescent's mental health and to evaluate the effectiveness of different interventions employed during previous and the current pandemic to promote children's and adolescents' mental health.
Methodology: We conducted …


Mental Health Screening For Low Income Adolescents: An Evidence-Based Project, Allison Bryden May 2020

Mental Health Screening For Low Income Adolescents: An Evidence-Based Project, Allison Bryden

Doctor of Nursing Practice Final Manuscripts

Abstract

TITLE: Mental Health Screening For Low-Income Adolescents

BACKGROUND: Nearly 80% of adolescents in the United States will suffer from a mental illness and not receive evaluation or services. Children from low socio-economic backgrounds have an increased risk of mental health disorders which permeate into adulthood, leading to additional negative sequel and lower quality of life. Among adolescent mental health conditions, depression and anxiety are the most common. Literature has suggested provider intuition alone has low sensitivity and specificity for detecting mental illness and that screening tools are indicated.

PURPOSE: The aim of this project is to implement standardized routine …


Unplugging: An Evidence-Based Project To Reduce Screen Time And Improve Healthy Media Use In The Adolescent Population, Erica Persichetti May 2020

Unplugging: An Evidence-Based Project To Reduce Screen Time And Improve Healthy Media Use In The Adolescent Population, Erica Persichetti

Doctor of Nursing Practice Final Manuscripts

Abstract

Background:Excessive media use is an emerging health concern amongst the pediatric population. The American Academy of Pediatrics (AAP) recommends less than 2 hours per day of recreational screen time, yet the national average is between 7 to 9 hours per day for adolescents. A media-saturated lifestyle has consequences on a child’s mental, physical, and emotional health. Despite guidelines stating media use should be assessed at annual well-visits, only 16% of providers are following this recommendation. This gap in care leaves many families with a limited understanding of the impact of media on their child's health and represents a …


Addressing Adolescent And Young Adult Mental Health During The Covid-19 Pandemic, Megan Boyer Jan 2020

Addressing Adolescent And Young Adult Mental Health During The Covid-19 Pandemic, Megan Boyer

Family Medicine Clerkship Student Projects

This quality improvement project at South Burlington Family Medicine aimed to investigate the mental health of individuals ages 13-25 in our practice during the COVID-19 pandemic. Eligible patients received a PHQ-9 questionnaire with two additional questions related to COVID-19. Recommendations for future interventions to serve this population were made based on these preliminary findings, with the goal of doing a full PDSA cycle in the near future.


Search For The Cause Of Vaping Associated Lung Injury In Adolescents, Alexandra E. Krueger Jan 2020

Search For The Cause Of Vaping Associated Lung Injury In Adolescents, Alexandra E. Krueger

All Graduate Theses, Dissertations, and Other Capstone Projects

In August 2019 an unexplained, exponential rise in severe respiratory illnesses in previously healthy young adults, swept across America catching the attention of medical providers. Hospital admissions for lung injury increased 10-fold over two months’ time leaving practitioners scrambling for answers. All affected patients were found to have used e-cigarettes prior to symptoms and endorsed using nicotine and marijuana vape pens. The medical community quickly began to search for the cause of these vaping associated lung injuries. Understanding the mechanism of injury is important in order to assist in educating the public about the risks associated with e-cigarettes. The aim …


Patterns Of Problem Behaviours Among A Representative Sample Of Youth In Ontario, Chantal Williams Aug 2019

Patterns Of Problem Behaviours Among A Representative Sample Of Youth In Ontario, Chantal Williams

Electronic Thesis and Dissertation Repository

Behavioural addictions among adolescents are becoming a growing public health concern. It is well established that problem behaviours, particularly substance use behaviours, tend to cluster together. Some research indicates that gambling is associated with substance use, aligning with Problem Behaviour Theory, which suggests that problem behaviours stem from an underlying disposition toward deviance. This study sought to assess whether a) behavioural addictions, including gambling, video gaming and technology use, cluster together and with substance use and b) profiles of problem behaviours are associated with age, race, socioeconomic status, grade achievement, school connectedness, and antisocial behaviour in the total sample and …


Addressing Alcohol And Marijuana Use Disparities Among Latino Adolescents, Jessica Weissman Mar 2018

Addressing Alcohol And Marijuana Use Disparities Among Latino Adolescents, Jessica Weissman

FIU Electronic Theses and Dissertations

In the early 1990s, a series of seminal research studies were published on substance use disorders among Latino adolescent males in Miami-Dade County, Florida. Expanding upon these studies, the aims of the present dissertation project were to (1) Determine whether the following adolescents’ and parents’ characteristics/cultural values are associated with current (past 30 days) or lifetime (ever) alcohol or marijuana use among Latino adolescents: sex, age, country of birth, GPA, family’s socio-economic status, living with both parents, mother’s highest level of education, father’s highest level of education, Familism Support, Familism Obligations, Familism Referents, Respect, Religion, …


Predictors Of Readmission To Youth Counseling Services Among Adolescents In Saskatoon Canada, Felicia Lawal Jan 2018

Predictors Of Readmission To Youth Counseling Services Among Adolescents In Saskatoon Canada, Felicia Lawal

Walden Dissertations and Doctoral Studies

Anxiety, depression, and substance use disorders are some of the frequently occurring mental illnesses among Canadian children and adolescents that can result in debilitating short and long terms outcomes. The rise in readmission rates for recipients of mental illness in Saskatchewan, coupled with the high incidences of suicide-related deaths, necessitates a patient outcome evaluation for predictors of readmission to youth counseling services among adolescents. The purpose of this secondary data analysis study was to explore the associations between anxiety, depression, substance use disorder, individual counseling, family counseling, group counseling, and the outcome of readmission within 1 year following discharge from …


Association Of Dietary Intake With Suicidal Ideation Or Suicide Attempts In Adolescents, Zenobia J. Bryant Jan 2018

Association Of Dietary Intake With Suicidal Ideation Or Suicide Attempts In Adolescents, Zenobia J. Bryant

Walden Dissertations and Doctoral Studies

Suicide is among the leading cause of adolescent deaths worldwide and thus a significant public health concern. Risk factors for suicidal behavior include drinking alcohol, smoking, and engaging in risky sexual behaviors. One area of concern is dietary patterns and their association with depressive symptoms and suicidal ideation. Bandura's social cognitive theory emphasizes the assumption that one can perform specific actions to bring about desired outcomes. The primary research questions for this quantitative, retrospective, cross-sectional study concerned whether there is a statistically significant interaction between fruit and vegetable intake and suicidal ideation or suicide attempts. Data from 71,776 adolescents in …


Smoking Prevention Program For Adolescents: A Hands-On Approach, Sean Closs Jan 2018

Smoking Prevention Program For Adolescents: A Hands-On Approach, Sean Closs

Family Medicine Clerkship Student Projects

This project is an initial pilot idea for hands-on experiences to reinforce smoking prevention in adolescents. The proposed idea is to have students specifically those identified 'at-risk', being given opportunities to interact with pathology specimens on-site at the hospital, introduce spirometry, and real-world panel discussions. The resources of the hospital provide a unique opportunity for promotion of this public health goal.


Clinical Topic Review 2013 - Behavioral Health Screening Among Masshealth Children And Adolescents, Judith A. Savageau, Georgianna Willis, Kathy Muhr, David M. Keller, Gideon Aweh, Elizabeth O'Connell Feb 2017

Clinical Topic Review 2013 - Behavioral Health Screening Among Masshealth Children And Adolescents, Judith A. Savageau, Georgianna Willis, Kathy Muhr, David M. Keller, Gideon Aweh, Elizabeth O'Connell

Judith A. Savageau

Results from the 2013 evaluation suggest that the Children’s Behavioral Health Initiative had a large impact on formal behavioral health screening and treatment utilization among children and adolescents enrolled in MassHealth.


Clinical Topic Review: Behavioral Health Screening For Children With Well Visits, Judith A. Savageau, Linda M. Cabral, Jack Gettens, Elizabeth O'Connell, Lana Miller, Susan Maguire Feb 2017

Clinical Topic Review: Behavioral Health Screening For Children With Well Visits, Judith A. Savageau, Linda M. Cabral, Jack Gettens, Elizabeth O'Connell, Lana Miller, Susan Maguire

Judith A. Savageau

The first Clinical Topic Review was conducted in order to better understand how behavioral health screenings were occurring for children and adolescents during well visits prior to the implementation of a requirement that primary care providers perform behavioral health screening using a standardized behavioral health screening tool during every well child visit.


Mental Health Workout: Lifting Stigma, Jeremy Bambery Dec 2016

Mental Health Workout: Lifting Stigma, Jeremy Bambery

Master's Projects and Capstones

Mental illness affects one out of every five Americans between the ages 13-18, and it is estimated that two-thirds of these individuals will not seek treatment due to the stigma associated with having a mental illness or mental health issue (National Alliance on Mental Illness). Access to information and the ability to talk openly without fear will aid in creating a stigma free future. The goal of this project is to supply high school students in the San Francisco Bay Area with information regarding the stigma associated with mental health and mental illness via videos that will be used as …


Depression Symptoms , Acculturation, Needing Care, And Receiving Care: A Study Of Adolescents Living In California, Shahrzad Bazargan-Hejazi, Mohsen Bazargan, Magda Shaheen, Senait Teklehaimnot, Alireza Ahmadi, Joan Cooper, Stacey Teruya Oct 2016

Depression Symptoms , Acculturation, Needing Care, And Receiving Care: A Study Of Adolescents Living In California, Shahrzad Bazargan-Hejazi, Mohsen Bazargan, Magda Shaheen, Senait Teklehaimnot, Alireza Ahmadi, Joan Cooper, Stacey Teruya

Journal of Health Disparities Research and Practice

Background: The objectives of this study are 1) to depict the prevalence of moderate depressive symptoms (MDS) in adolescents living in California, 2) to examine the role of acculturation in reported MDS, and 3) to identify any relationship between acculturation, “needing emotional help,” and “receiving psychological or emotional counseling,” as reported by adolescents with MDS. Methods: We analyzed data from a cross-sectional population-based telephone survey for adolescents who completed the California Health Interview Survey (CHIS) in 2007, 2009, and 2011-2012. The primary predictor variable was level of acculturation. Outcome variables were 1) the presence of MDS, 2) whether participants needed …


The Impact Of Foster Care On Depression: An Examination Of Placement Type And Mental Health Service Utilization Among Children And Adolescents, Kisha Cummings Feb 2016

The Impact Of Foster Care On Depression: An Examination Of Placement Type And Mental Health Service Utilization Among Children And Adolescents, Kisha Cummings

Dissertations, Theses, and Capstone Projects

Background: Children and adolescents in foster care with a history of complex trauma such as neglect, emotional, physical, and sexual abuse have a greater odds of being clinically diagnosed with depression in adulthood compared to children and adolescents without such a history. The current study examines the prevalence of depression in a national sample of children and adolescents aged 7 to 17 years. This study asks whether a) foster care is associated with a greater prevalence of depression among children and adolescents in foster care compared to children and adolescents not in foster care; b) there is an association between …


Exploring The Association Between Maternal Mental Health And Housing Conditions During Early Childhood And Anxiety And Depression At Age 15, Diane Marie Butrym Jan 2016

Exploring The Association Between Maternal Mental Health And Housing Conditions During Early Childhood And Anxiety And Depression At Age 15, Diane Marie Butrym

Legacy Theses & Dissertations (2009 - 2024)

Abstract


Improving Mental Health Literacy: A Single-Subject Design Experiment Examining The Effects Of Text Messaging On Adolescent Mental Health Literacy, Emma Coffman Aug 2015

Improving Mental Health Literacy: A Single-Subject Design Experiment Examining The Effects Of Text Messaging On Adolescent Mental Health Literacy, Emma Coffman

Theses and Dissertations

The purpose of the study is to determine the feasibility of delivering a text-based mental health literacy intervention for adolescent children who have family members with mental illness. The effectiveness of the text message intervention was measured using a single subject, multiple baseline study design. Each participant received three text messages per week for a total of 6 weeks, containing information regarding mental illness, managing crisis, resources, stigma, and assertiveness. The subjects were evaluated using qualitative and quantitative measures at multiple periods throughout the study. Assessments utilized include: Schizophrenia Vignette quiz developed by Jorm et. al. (1997), Perceived Stress Scale-14(PSS-14) …


Sexuality Education Websites For Adolescents: A Framework-Based Content Analysis, Sara Silverio Marques, Jessica S. Lin, Summer Starling, Aubrey G. Daquiz, Eva Goldfarb, Kimberly Garcia, Norman A. Constantine Jul 2015

Sexuality Education Websites For Adolescents: A Framework-Based Content Analysis, Sara Silverio Marques, Jessica S. Lin, Summer Starling, Aubrey G. Daquiz, Eva Goldfarb, Kimberly Garcia, Norman A. Constantine

Department of Public Health Scholarship and Creative Works

The web has unique potential for adolescents seeking comprehensive sexual health information. As such, it is important to understand the nature, scope, and readability of the content and messaging provided by sexuality educational websites. We conducted a content analysis of 14 sexuality education websites for adolescents, based on the 7 essential components (sexual and reproductive health and HIV, relationships, sexual rights and sexual citizenship, pleasure, violence, diversity, and gender) of the International Planned Parenthood Framework for Comprehensive Sexuality Education. A majority of content across all sites focused on sexual and reproductive health and HIV, particularly pregnancy and STI prevention, and …


Rural Adolescents’ Help Seeking Intentions For Emotional Problems: The Influence Of Perceived Benefits And Stoicism., Coralie Wilson Dec 2010

Rural Adolescents’ Help Seeking Intentions For Emotional Problems: The Influence Of Perceived Benefits And Stoicism., Coralie Wilson

Coralie J Wilson

This paper is the second from a larger multi-cite study developed and led by the third author which explores factors that influence adolescents' help-seeking intentions. Specifically, this paper investigates the extent to which perceived benefits of help seeking, stoicism, gender and symptoms of psychological distress are associated with intentions to seek professional help for emotional problems. A cross sectional self-report questionnaire was administered to adolescents recruited from seven high schools in rural towns in the Riverina region of New South Wales. A total of 778 adolescents were recruited. The sample included 373 male and 404 female participants between 13 and …