Lila C. Fleming

Bullying among middle-school students in low and middle income countries

This analysis of data from the Global School-based Student Health Survey examined the prevalence of bully victimization in middle-school students in 19 low- and middle-income countries and also explored the relationship between bullying, mental health and health behaviors. In most countries, boys were more likely than girls to report being bullied and the prevalence of bullying was lower with increasing age. Students who reported being bullied in the past month were more likely than non-bullied students to report feelings of sadness and hopelessness, loneliness, insomnia and suicidal ideation. Bullied students also reported higher rates of tobacco use, alcohol use, drug use and sexual intercourse.

Bullying and Symptoms of Depression in Chilean Middle School Students

BACKGROUND The goal of this study was to assess the association between bullying and symptoms of depression among middle school students in Chile. METHODS Secondary data analysis of Chiles 2004 Global School-Based Health Survey. RESULTS A total of 8131 middle school students participated in the study. Forty-seven percent of students reported having been bullied in the past month and 30% reported having been sad and hopeless for 2 or more weeks in the past year. Students in the seventh and eighth grades were more likely to report having been bullied in the past month than students in ninth grade. Ninth grade students reported higher levels of loneliness, difficulty sleeping, and suicidal thoughts than students in the seventh and eighth grades. Boys were more likely than girls to report being bullied in the past month, but girls were more likely than boys to report symptoms of depression, such as prolonged feelings of sadness and hopelessness, loneliness, difficulty sleeping, and suicidal thoughts. Students who reported being bullied in the past month were more likely than nonbullied students to report symptoms of depression. A higher number of days of being bullied in the past month was associated with a statistically significant increase in reported rates of sadness and hopelessness (p < .001). CONCLUSIONS Bullying is common among middle school children in Chile, and bullying and symptoms of depression are strongly linked. This finding is consistent with studies of bullying and depression in adolescents from other parts of the world.

Parental involvement and bullying among middle-school students in North Africa.

Bullying, especially in developing countries, has not been much examined, especially the influence of parents on the risk of being bullied. The aim of this study was to determine whether active parenting is associated with reduced peer victimization among middle-school students in North Africa. A secondary analysis of data from more than 13,000 middle-school students who participated in the Global School-based Student Health Survey (GSHS) in Egypt, Libya, Morocco and Tunisia between 2006 and 2008, was conducted using multiple logistic regression models. About 60% of students in Egypt and one-third of students in Libya, Morocco and Tunisia reported having been bullied in the past month. In all 4 countries, boys reported more peer victimization than girls. In Egypt, Morocco and Tunisia, students who reported that their parents checked their homework, were understanding, and knew how the student spent free time had a reduced likelihood of peer victimization but this association was not significant in Libya. Interventions for reducing bullying should consider the positive impact of involved parents.

Parenting Practices and Tobacco Use in Middle School Students in Low- and Middle-Income Countries

BACKGROUND Parenting practices have been shown to have a strong influence on adolescent tobacco use in high-income countries. This study examined whether parenting practices also were associated with tobacco use by middle school students (approximately ages 13-15) in low- and middle-income countries. METHODS A secondary analysis was performed on data from 106,041 middle school students in 27 countries who participated in the Global School-Based Health Survey conducted between 2003 and 2007. RESULTS In nearly all countries, boys and older students were significantly more likely to use tobacco than girls and younger students. In most countries, students who reported a high level of parental understanding or a high level of parental awareness of their childrens activities were significantly less likely to use tobacco than other students. The children of parents who used tobacco were significantly more likely to use tobacco than children of non-users. After adjustment for age, sex, and parental tobacco use, the associations between parental understanding and awareness were statistically significant in 16 and 24 countries, respectively, of the 26 countries with parental tobacco use data. CONCLUSION This multivariate analysis shows that positive parenting practices are significantly associated with decreased tobacco use among adolescents in low- and middle-income countries, which matches previous findings from high-income countries. Educating parents on the importance of their parenting practices may be an effective component of school-based programs aimed at reducing adolescent tobacco use.

Inpatient healthcare provider bypassing by women and their children in urban Bo, Sierra Leone.

Introduction Bypassing refers to a persons decision to seek care at a healthcare facility that is not the nearest one of its type to the persons home. Methods This study examined inpatient care facility bypassing in urban Bo, Sierra Leone using data from 1,980 women with children 15 years of age and younger who were interviewed in 2010-2011. The locations of residential structures and hospitals were identified using a geographic information system (GIS), and the road distances from participating households to the nearest and preferred inpatient care facilities were measured. Results Nine inpatient care facilities serve Bo residents, but more than 70% of the participating women reported that the citys main public hospital (Bo Government Hospital), located in the city center, was their preferred inpatient care provider. Participants resided within a median distance of 0.9 km (Interquartile range (IQR): 0.6, 1.8) from their closest inpatient facility, but they would travel a median distance of 2.4 km (IQR: 1.0, 3.3) to reach their preferred providers. About 87% of the women would bypass their nearest inpatient care facility to access care at a preferred provider. Bypassing rates were similar for various demographic and socioeconomic groups, but higher for women living farther from the city center. Conclusion Although Bo has a diverse healthcare marketplace, access to affordable advanced care options is limited. Most women in Bo would choose to bypass facilities nearer to their homes to seek the low-cost and comprehensive care offered by Bo Government Hospital.