AJPH May 2015 highlights

Date: May 14 2015

AJPH research: School start times, pregnancy and sexual minority youth, bottled water bans

In this month’s release, find new embargoed research about school start times and teen sleep duration; risk of pregnancy for sexual minority youths; and possible beverage consumption and waste impacts of a campus bottled water ban.

EMBARGOED until May 14, 2015, 4 p.m. (EDT)

Contact: For copies of articles or full table of contents of an issue, contact Kimberly Short, 202-777-2511.

American Journal of Public Health highlights:
1. Later school start times may lead to increased sleep duration for teens
2. Risk of pregnancy greater for sexual minority youths
3. Campus bottled water ban resulted in increased shipment of less healthy beverages 

Later school start times may lead to increased sleep duration for teens
New research from the American Journal of Public Health finds that later school start time is associated with greater sleep duration which may help to alleviate current cases of insufficient sleep in US youths.

Researchers analyzed data on sleep patterns from the National Comorbidity Survey – Adolescent Supplement, a nationally representative sample of students ages 13-17. Information about students’ mental and physical health, family and individual characteristics, sleep patterns, school characteristics and demographics was collected from more than 7,000 students via direct in-person interviews. Questionnaires were also completed by parents and school representatives.

The study found that students at schools with later start times were more likely to exceed the national recommendations for adolescent sleep duration. Specifically, the associations between school start time and lower sleep duration were strongest for start times before 8 a.m. Further, the school start times were found to be more strongly associated with sleep duration for boys in major metropolitan cities. Students with later school start times went to bed later than those with earlier start times, yet on average, obtained more sleep. This research provides empirical support for the recent recommendation of later school start times by the American Academy of Pediatrics.

However, the researchers caution, “the association between start time and sleep may not be the same for all students or in all contexts. The decision to delay a school’s start time involves numerous considerations, including transportation, athletics, community programs, student employment and afterschool programs that are not addressed here.” 

“There continues to be an urgent need for more in depth information on school start times and sleep to inform changes that could have major public health impact on U.S. adolescents,” the authors explain.

[“School start time and adolescent sleep patterns: Results from the US national comorbidity survey –adolescent supplement.” Contact: Kathleen R. Merikangas, PhD, National Institute of Mental Health, Bethesda, Maryland].

Risk of pregnancy greater for sexual minority youth
Sexual minority youth who have engaged in vaginal intercourse may have a greater risk of pregnancy compared to heterosexual youth, according to new research from the American Journal of Public Health.

Researchers used data collected from the Centers for Disease Control and Prevention’s Youth Risk Behavior Surveillance System. This included 2005, 2007 and 2009 data from more than 9,000 New York City students between grades 9 through 12. Participants were asked about whether they’d ever been pregnant or gotten someone else pregnant along with questions regarding their sexual orientation and details about their sexual histories and activity.

Results from the study indicated that sexual minority high school students who had engaged in vaginal intercourse were at a greater risk of pregnancy than their heterosexual peers. Specifically among females, 20.1 percent of those who had both male and female sexual partners and 22.6 percent of lesbian or bisexual students reported ever being pregnant. This was compared to 13.7 percent of females who only had male sexual partners and 13.3 percent of heterosexual females who reported ever being pregnant. In addition, among male students, 37.7 percent of students with male and female partners and 28.6 percent of gay or bisexual males reported getting someone pregnant. Conversely, 10 percent of heterosexual male students and 9.9 percent of male students with only female partners had gotten someone pregnant.

“Results from this investigation suggest that current pregnancy-prevention efforts focused exclusively on heterosexual adolescents are too narrow and that these campaigns should seek ways to become more inclusive of diverse populations of sexual minority youths,” the authors conclude.

[“Sexual orientation and risk of pregnancy among New York City high-school students.” Contact: Lisa Lindley, Department of Global and Community Health, George Mason University, Fairfax, Virginia]. 

Campus bottled water ban resulted in increased shipment of less healthy beverages 
According to a new study from the American Journal of Public Health, the removal of bottled water from a college campus resulted in increased shipments of less healthy bottled beverages and did not decrease campus waste from plastic bottles.

The study analyzed policy changes to the beverage offerings at the University of Vermont in which campus locations selling bottled beverages were first required to maintain a 30 percent healthy beverage ratio effective August 2012. This was followed by the required removal of bottled water, while still maintaining the healthy beverage ratio, which went into effect January 2013. Researchers collected shipment data for all bottled beverages sold to the university the semester prior to policy changes, during the semester in which the 30 percent health beverage policy was enacted and finally, during the semester when bottled water was removed from the offerings. The shipment data were reviewed alongside nutrition scores determined for each beverage using the Nutrition Environment Measures Survey-Vending calculator.

Findings revealed that, though the number of bottles per capita shipped to the university did not change after the 30 percent healthy beverage requirement was enacted, there was a significant increase in bottles shipped following the water ban, from 21.8 bottles per person to 26.3 bottles per person. This suggests that the bottled water ban did not result in decreased waste from bottles. In addition, following the bottled water ban, shipments of healthier beverage options decreased and less healthy beverage options increased, suggesting greater consumption of higher calorie drinks following the water bottle ban.

“Further research is needed on the long-term impact of removing bottled water on the health status of consumers to better understand whether consumers adjust their behavior over time to make healthier beverage choices. Remembering to carry a reusable bottle, like any other behavior change, takes time,” the authors explain. 

[“The unintended consequences of changes in beverage options and the removal of bottled water on a university campus.” Contact: Rachel Johnson, PhD, MPH, RD, FAHA, Department of Nutrition and Food Sciences, University of Vermont, Burlington, Vermont. Elizabeth Berman can also be contacted for inquiries regarding this study]. 

Find a full list of research papers to be published online on May 14, 2015, at 4 p.m. EDT below:

  • Work Safety Climate, Safety Behaviors, and Occupational Injuries of Youth Farmworkers in North Carolina 
  • Measuring Knowledge Gains Following a Child Sexual Abuse Prevention Program among Urban Students in a Cluster Randomized Evaluation 
  • School start time and adolescent sleep patterns: Results from the U.S. National Comorbidity Survey - Adolescent Supplement 
  • Multiple Service System Involvement and Later Offending Behavior: Implications for Prevention and Early Intervention 
  • Incarcerated Youths' Perspectives on Protective and Risk Factors for Juvenile Offending—A Qualitative Analysis  (not under embargo)
  • Behavioral health care needs, detention-based care and criminal recidivism at community reentry from juvenile detention: A multi-site survival curve analysis 
  • Sexual Orientation and Risk of Teen Pregnancy among New York City High School Students 
  • Regularly Drinking Alcohol Prior to Sexual Activity in a Nationally Representative Sample: Prevalence, Sociodemographics, and Associations with Psychiatric and Substance Use Disorders 
  • Supporting Positive Opportunities with Teens- The SPOT for High Risk Youth 
  • Initiation of HPV Vaccination among Predominantly Minority Female and Male Adolescents at Inner-City Community Health Centers 
  • Ethical challenges in school-based immunisation programs for adolescents: a qualitative study (not under embargo)
  • The unintended consequences of changes in beverage options and the removal of bottled water on a university campus
  • Racial/Ethnic disparities in the self-reported number of drinks in 2 hours before driving becomes impaired  (not under embargo)\
  • Randomized Trial of Two Dissemination Strategies for a Skin Cancer Prevention Program in Aquatic Settings (not under embargo)
  • Determinants of First Time Cancer Examinations in a Rural Community: A Mechanism for Behavior Change 
  • Post-Arrival Tuberculosis Screening at a Local Health Department of High-Risk Immigrants (not under embargo)
  • Sedentary Behavior is a Distinct Risk Factor from Low Level of Moderate Activity for Incident Physical Frailty 
  • Store Impulse Marketing Strategies and Body Mass Index (not under embargo)
  • The Supplemental Nutrition Assistance Program (SNAP), Food Insecurity, Dietary Quality and Obesity among US Adults 
  • The Interaction between an Individual's Acculturation and Community Factors on Physical Inactivity and Obesity: a Multilevel Analysis
  • Transit use, physical activity, and body mass index changes: Objective measures associated with Complete Street light rail construction 
  • Translating a Fall Prevention Intervention into Practice: A Randomized Community Trial (not under embargo)
  • Health Outcomes of Obtaining Housing Among Older Homeless Adults
  • The Impact of Weather on Mobility and Participation in Older Americans 
  • Suicide risk in nursing homes and assisted living facilities: 2003 – 2011

The articles above will be published online May 14, 2015, at 4 p.m. (EDT) by the American Journal of Public Health under “First Look.” “First Look” articles have undergone peer review, copyediting and approval by authors but have not yet been printed to paper or posted online by issue. The American Journal of Public Health is published by the American Public Health Association, www.apha.org, and is available at www.ajph.org.

Complimentary online access to the Journal is available to credentialed members of the media. Address inquiries to Kimberly Short at APHA, 202-777-2511, or email her. A single print issue of the Journal is available for $35 from the Journal’s Subscriptions department. If you are not a member of the press, a member of APHA or a subscriber, online single issue access is $30 and online single article access is $22 at www.ajph.org or for direct customer service, call 202-777-2516, or email.

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The American Journal of Public Health is the monthly journal of the American Public Health Association. APHA champions the health of all people and all communities by strengthening the profession of public health, sharing the latest research and information, promoting best practices and advocating for public health issues and policies grounded in research. More information is available at www.apha.org.