The global school-based student health survey as a tool to guide adolescent health interventions in rural Guatemala

Abstract

Background Adolescents from rural areas in low-middle income countries face increasing physical and mental health challenges that are not well characterized or addressed due to resource limitations. We used the Global School-based Student Health Survey (GSHS) to describe adolescent health behaviors, and to inform prioritization of health promotion efforts in a resource-limited, rural, agricultural region in Guatemala. Methods In July 2015, a group of volunteers administered the GSHS to students from seven schools in four communities in the southwest Trifinio region of Guatemala. Prevalence and predictors of nutritional, mental, and sexual health behaviors were calculated from survey responses, and summarized in region- and school-level reports. Facilitated discussion of survey results with local leadership in January 2016 led to the identification of priorities for school-based health interventions. Results Five hundred fifty-four out of 620 (87%) students aged 12–18 years completed the survey. Prevalence of unhealthy dietary behaviors and body size was high: 61% reported high current soft drink intake, 18% were overweight, and 31% were moderate-severely stunted. In multivariable regression models, being food insecure was marginally associated with being underweight/stunted (OR = 1.95, 95%CI = 0.95–4.0). Boys were more likely than girls to report being sexually active (25% versus 6.4%, p < 0.001). Local school leadership identified food insecurity and sexual education as priority areas for intervention, and made plans for providing breakfast in schools, sexual education curriculum development and teacher training, and continued adolescent health reporting and evaluation. Conclusions The GSHS is a rapid, cost-efficient, useful tool for surveillance of adolescent health behaviors in vulnerable, resource-limited populations. Results of a locally-administered GSHS informed school-based interventions to decrease food insecurity, early sexual initiation, and teen pregnancy in a rural Guatemalan region.

<p>Prevalence and correlates of past 12-month suicide attempt among in-school adolescents in Guatemala</p>

“…A significant increase in suicide rates among adolescents (15–19 years) was found in Guatemala for both genders, among boys from 3.07 in 1990–1999 to 4.74 2000–2009, and among girls from 1.63 in 1990–1999 to 3.12 in 2000–2009 5. In a school survey among students (12–18 years) in southwest Trifinio region of Guatemala, 11.6% reported suicidal ideation 6. In the 2009 Guatemala “Global School-based Health Survey (GSHS)”, the prevalence of suicide attempt was 13.4% (10.4% among boys and 16.7% among girls) 7.…”

Food Insecurity and Anthropometry in Adolescents: A Literature Review

“…All of them used a cross-sectional design. Six studies mentioned that the sampling methods used were as follows: Two studies used the cluster sampling method [17], [18], two studies used the multi-stage sampling method [19], [20], one study used a simple random sampling method [21], and one study used a combination of cluster sampling and simple random sampling (two-stage sampling) [22]. Three studies were multi-country studies conducted in developing countries or lower-middle-income countries (LMIC) [17], [18], [23] and five studies were conducted in Africa [19], [22], [24], [25], [26].…”

“…Three studies were multi-country studies conducted in developing countries or lower-middle-income countries (LMIC) [17], [18], [23] and five studies were conducted in Africa [19], [22], [24], [25], [26]. One study was conducted in Guatemala, Central America [21], one study in Canada [27], one study in the United States [28], and one study in Indonesia [20].…”

“…One study assessed the nutritional status of adolescents based on BMI, one study assessed the nutritional status based on weight-for-age [27], and one study assessed the nutritional status based on WHtR [24]. Nine studies measured BMI-for-age [17], [18], [19], [20], [21], [22], [23], [24], [28] and six studies assessed the nutritional status based on the height-forage indicator [19], [20], [21], [23], [24], [25], [26].…”

“…Two studies used the question, "During the past 30 days, how often did you go hungry because there was not enough food in your home?" to determine the food-secure or food-insecure adolescents [18], [21], while two other studies used the Household Food Insecurity Access Scale (HFIAS) [19], [20]. One study used adolescents' confession whether they slept on a hungry stomach or not as an indicator of household food security levels [17].…”