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UNICEF Innocenti's complete catalogue of international peer reviewed journals

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Contextualising the link between adolescents’ use of digital technology and their mental health: a multi‐country study of time spent online and life satisfaction

AUTHOR(S)
Daniel Kardefelt Winther, Gwyther Rees, Sonia Livingstone

Published: 2020

Evidence on whether the amount of time children spend online affects their mental health is mixed. There may be both benefits and risks. Yet, almost all published research on this topic is from high‐income countries. This paper presents new findings across four countries of varying wealth.

We analyse data gathered through the Global Kids Online project from nationally representative samples of Internet‐using children aged 9 to 17 years in Bulgaria (n  = 1,000), Chile (n  = 1,000), Ghana (n  = 2,060) and the Philippines (n  = 1,873). Data was gathered on Internet usage on week and weekend days. Measures of absolute (comparable across countries) and relative (compared to other children within countries) time use were constructed. Mental health was measured by Cantril’s ladder (life satisfaction). The analysis also considers the relative explanatory power on variations in mental health of children’s relationships with family and friends. Analysis controlled for age, gender and family socioeconomic status.

In Bulgaria and Chile, higher‐frequency Internet use is weakly associated with lower life satisfaction. In Ghana and the Philippines, no such pattern was observed. There was no evidence that the relationship between frequency of Internet use and life satisfaction differed by gender. In all four countries, the quality of children’s close relationships showed a much stronger relationship with their life satisfaction than did time spent on the Internet.

Time spent on the Internet does not appear to be strongly linked to children’s life satisfaction, and results from one country should not be assumed to transfer to another. Improving the quality of children’s close relationships offers a more fruitful area for intervention than restricting their time online. Future research could consider a wider range of countries and links between the nature, rather than quantity, of Internet usage and mental health.

Uptake of HIV testing among adolescents and associated adolescent-friendly services

AUTHOR(S)
Jennifer Waidler, Rachel Kidman, Tia Palermo

Published: 2020

HIV testing remains low among adolescents. Making public health services more adolescent-friendly is one strategy used to encourage testing. However, it remains unclear whether government-led initiatives have a meaningfully impact. The current study is observational and utilizes two sources of data (health-facility and adolescent-level) from one round of data collection of an on-going, longitudinal impact evaluation of a pilot cash plus program targeting adolescents. This study linked data from adolescent surveys (n = 2191) to data collected from nearby government-run health facilities (n = 91) in two rural regions of Tanzania. We used log binomial regression models to estimate the association between specific adolescent-friendly health service (AFHS) characteristics and adolescents’ uptake of 1) HIV testing and 2) visiting a health care facility in the past year for sexual and reproductive health (SRH) services.

Most adolescents (67%) lived in a village with a health facility, and all offered HIV services. We find, however, that AFHS have not been fully implemented. For example, less than 40% of facilities reported that they had guidelines for adolescent care. Only 12% of facilities had a system in place for referral and follow-up with adolescent clients, yet this was an important predictor of both past-year HIV testing (RR = 1.28, p < 0.1) and SRH visits (RR = 1.44, p < 0.05). Less than half (44%) offered services for survivors of gender-based violence (GBV), a significant predictor of past-year HIV testing (RR = 1.20, p < 0.05) and SRH visits (RR = 1.41, p < 0.01) among sexuallyactive adolescents.

We find that national guidelines on AFHS have not been fully translated into practice at the local level. We highlight particular gaps in adolescent referral systems and GBV services. Scaling up these two essential services could encourage greater HIV testing among a high-risk population, in addition to providing much needed support for survivors of violence.

International trends in ‘bottom-end’inequality in adolescent physical activity and nutrition: HBSC study 2002–2014

AUTHOR(S)
Yekaterina Chzhen, Irene Moor, William Pickett, Emilia Toczydlowska, Gonneke W J M Stevens

Published: 2018
In spite of many positive trends that have emerged in the health of young people, adolescents from more affluent groups continue to experience more favourable health outcomes. There are no groups that are more vulnerable than those who report very poor (‘bottom-end’) indicators of health behaviour. The present study investigated the role of socio-economic factors as potential determinants of bottom-end health behaviours pertaining to physical activity and diet.
Multidimensional Poverty Among Adolescents in 38 Countries: Evidence from the Health Behaviour in School-aged Children (HBSC) 2013/14 Study

AUTHOR(S)
Yekaterina Chzhen, Zlata Bruckauf, Emilia Toczydlowska, Frank Elgar, Conception Moreno-Maldonado, Gonneke W.J.M. Stevens, Dagmar Sigmudova, Geneviève Gariépy

Published: 2017
This study applied UNICEF’s Multiple Overlapping Deprivation Analysis (MODA) framework to adolescents (aged 11, 13 and 15) in 37 European countries and Canada using data from the 2013/14 Health Behaviour in School-aged Children survey. It is one of the first applications of MODA based entirely on data collected from adolescents themselves rather than from household reference persons on their behalf. Unlike most other multidimensional child poverty studies, the present analysis focuses on non-material, relational aspects of child poverty. Substantial cross-country variation was found in the prevalence of adolescent deprivations in nutrition, perceived health, school environment, protection from peer violence, family environment and information access. These single dimensions of poverty did not closely relate to national wealth and income inequality. However, when we looked at deprivation in three or more dimensions (i.e., multidimensional poverty), we found association with income inequality. In most countries, girls were at a higher risk of multidimensional poverty than boys. In addition, adolescents who lived with both parents in the household or reported higher family wealth were consistently less poor than other adolescents, in both single and multiple dimensions. The results of this study show the interconnectedness of social (family, school support) and psychological (health and violence) dimensions of poverty for adolescents in higher income countries. Children poor in the domains of family and school environment are also likely to be poor in terms of perceived health and protection from peer violence.
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