Home Efficacy of behavioral interventions to increase engagement in sexual health services among LatinX youth in the United States: A meta-analysis for post-pandemic implications
Article
Licensed
Unlicensed Requires Authentication

Efficacy of behavioral interventions to increase engagement in sexual health services among LatinX youth in the United States: A meta-analysis for post-pandemic implications

  • Aviana O. Rosen ORCID logo EMAIL logo , Lauren Bergam , Ashley L. Holmes , Emma Krebs , Melanie Moreno , Geycel S. Muñiz and Tania B. Huedo-Medina
Published/Copyright: February 20, 2024
International Journal of Adolescent Medicine and Health
From the journal International Journal of Adolescent Medicine and Health Volume 36 Issue 1

Abstract

Introduction

LatinX youth in the U.S. are disproportionately affected by HIV and STIs, commonly attributed to a lack of diagnostic testing and regular physician consultations to address sexual health. These disparities have been exacerbated by the COVID-19 pandemic. This meta-analysis seeks to assess the efficacy of behavioral interventions among LatinX youth in the U.S. that aim to increase engagement in sexual health services (i.e., STI/HIV testing, physician consultations).

Content

Following PRISMA guidelines, seven electronic databases were searched. We systematically extracted data with a coding form, and effect sizes were obtained from each study on HIV/STI testing outcomes and physician consultation. Moderator analyses were run for demographic and intervention characteristics.

Summary and Outlook

Of nine included studies, the interventions created a small-to-moderate effect on increased engagement of sexual health services (d +=0.204, 95 % CI=0.079, 0.329). Moderator analyses showed that interventions including the following characteristics were most efficacious at facilitating care services: community-based or online setting, access to diagnostic testing, social media/remote components, parental involvement, and longer session duration. This meta-analysis provides informative results regarding behavioral interventions that have proven efficacious in facilitating engagement in sexual health services among LatinX youth. Most prominently, interventions that are remote or through social media, community-based, and incorporated parents had large positive effects. These findings prove useful for the ongoing COVID-19 pandemic situation and provide guidance for targeting LatinX youth to engage them in sexual health services as primary and secondary STI and HIV prevention.

Keywords: Latino youth; HIV prevention; STI prevention; meta-analysis; sexual healthcare
Corresponding author: Aviana O. Rosen, Department of Allied Health Sciences, University of Connecticut, Storrs, CT, USA, E-mail:

Funding source: National Institute of Mental Health

Award Identifier / Grant number: T32MH074387

Acknowledgments

The research team gratefully acknowledges Jill Livingston, the former University of Connecticut Health Sciences Librarian, for her guidance and assistance with the literature search. We also extend a grateful thank you to Dr. Flavio F. Marsiglia and Dr. Stephanie Ayers for their efforts and kindness in providing us additional data from their published research in a format usable for our effect size calculator, allowing us to include their valuable data in our synthesis. Finally, we express gratitude to Dr. Tricia M. Leahey for her contributions to the editing of this work.

  1. Research ethics: Not applicable.

  2. Informed consent: Not applicable.

  3. Author contributions: All authors have accepted responsibility for the entire content of this manuscript and approved its submission.

  4. Competing interests: Authors state no conflict of interest.

  5. Research funding: This project was supported by the National Institute of Mental Health (T32MH074387) Social Processes of HIV/AIDS Training Grant. The funding organization played no role in the study design; in the collection, analysis, and interpretation of the data; in the writing of the report; or in the decision to submit the report for publication.

  6. Data availability: The raw data can be obtained on request from the corresponding author.

References

1. Satterwhite, CL, Torrone, E, Meites, E, Dunne, EF, Mahajan, R, Ocfemia, MC, et al.. Sexually transmitted infections among US women and men: prevalence and incidence estimates, 2008. Sex Transm Dis 2013;40:187–93, https://doi.org/10.1097/olq.0b013e318286bb53.Search in Google Scholar PubMed

2. National Academies of Sciences EaM, Health and Medicine D, Board on Population Health and Public Health P, Committee on Prevention and Control of Sexually Transmitted Infections in the United S. In: Crowley, JS, Geller, AB, Vermund, SH, editors. Sexually Transmitted Infections: Adopting a Sexual Health Paradigm. Washington (DC): National Academies Press (US). Copyright 2021 by the National Academy of Sciences; 2021. All rights reserved.Search in Google Scholar

3. Keller, LH. Reducing STI cases: young people deserve better sexual health information and services Guttmacher Institute; 2020. Available at: https://www.guttmacher.org/gpr/2020/04/reducing-sti-cases-young-people-deserve-better-sexual-health-information-and-services.Search in Google Scholar

4. Hoover, KW, Tao, G, Berman, S, Kent, CK. Utilization of health services in physician offices and outpatient clinics by adolescents and young women in the United States: implications for improving access to reproductive health services. J Adolesc Health 2010;46:324–30. https://doi.org/10.1016/j.jadohealth.2009.09.002.Search in Google Scholar PubMed

5. Shannon, CL, Klausner, JD. The growing epidemic of sexually transmitted infections in adolescents: a neglected population. Curr Opin Pediatr 2018;30:137–43. https://doi.org/10.1097/mop.0000000000000578.Search in Google Scholar PubMed PubMed Central

6. Centers for Disease Control and Prevention. STDs in racial and ethnic minorities; 2018. Available at: https://www.cdc.gov/std/stats18/minorities.htm.Search in Google Scholar

7. Cordova, D, Bauermeister, JA, Fessler, K, Delva, J, Nelson, A, Nurenberg, R, et al.. A community-engaged approach to developing an mHealth HIV/STI and drug abuse preventive intervention for primary care: a qualitative study. JMIR Mhealth Uhealth 2015;3:e106. https://doi.org/10.2196/mhealth.4620.Search in Google Scholar PubMed PubMed Central

8. Chacko, MR, Wiemann, CM, Kozinetz, CA, von Sternberg, K, Velasquez, MM, Smith, PB, et al.. Efficacy of a motivational behavioral intervention to promote chlamydia and gonorrhea screening in young women: a randomized controlled trial. J Adolesc Health 2010;46:152–61. https://doi.org/10.1016/j.jadohealth.2009.06.012.Search in Google Scholar PubMed PubMed Central

9. Loosier, PS, Hsieh, H, Cramer, R, Tao, G. Young adults’ access to insurance through parents: relationship to receipt of reproductive health services and Chlamydia testing, 2007-2014. J Adolesc Health 2018;63:575–81. https://doi.org/10.1016/j.jadohealth.2018.04.015.Search in Google Scholar PubMed

10. Fuzzell, L, Shields, CG, Alexander, SC, Fortenberry, JD. Physicians talking about sex, sexuality, and protection with adolescents. J Adolesc Health 2017;61:6–23. https://doi.org/10.1016/j.jadohealth.2017.01.017.Search in Google Scholar PubMed

11. Guttmacher Institute. Minors’ access to STI services 2019. Available at: https://www.guttmacher.org/state-policy/explore/minors-access-sti-services.Search in Google Scholar

12. Leichliter, JS, Copen, C, Dittus, PJ. Confidentiality issues and use of sexually transmitted disease services among sexually experienced persons aged 15–25 years – United States, 2013–2015. MMWR Morb Mortal Wkly Rep 2017;66:237–41. https://doi.org/10.15585/mmwr.mm6609a1.Search in Google Scholar PubMed PubMed Central

13. National Academies of Sciences EaM, Health and Medicine D, Division of Behavioral and Social Sciences and E, Board on Children YaF, Committee on the Neurobiological and Socio-behavioral Science of Adolescent Development and Its A. In: Backes, EP, Bonnie, RJ, editors. The Promise of Adolescence: Realizing Opportunity for All Youth. Washington (DC): National Academies Press (US). Copyright 2019 by the National Academy of Sciences; 2019. All rights reserved.Search in Google Scholar

14. Cuffe, KM, Newton-Levinson, A, Gift, TL, McFarlane, M, Leichliter, JS. Sexually transmitted infection testing among adolescents and young adults in the United States. J Adolesc Health 2016;58:512–9. https://doi.org/10.1016/j.jadohealth.2016.01.002.Search in Google Scholar PubMed

15. Centers for Disease Control and Prevention. Vital Signs: HIV infection, testing, and risk behaviors among youths – United States; 2012. Available at: https://www.cdc.gov/mmwr/pdf/wk/mm6147.pdf.Search in Google Scholar

16. Center for Disease Control and Prevention. Sexually transmitted disease surveillance; 2014. Available at: https://www.cdc.gov/std/stats14/surv-2014-print.pdf.Search in Google Scholar

17. Centers for Disease Control and Prevention. Sexually transmitted disease surveillance; 2017. Available at: https://www.cdc.gov/std/stats17/2017-STD-Surveillance-Report_CDC-clearance-9.10.18.pdf.Search in Google Scholar

18. Centers for Disease Control and Prevention. Gonorrhea basic fact sheet; 2022. Available at: https://www.cdc.gov/std/gonorrhea/stdfact-gonorrhea.htm.Search in Google Scholar

19. Centers for Disease Control and Prevention. Syphilis basic fact sheet; 2022. Available at: https://www.cdc.gov/std/syphilis/stdfact-syphilis.htm.Search in Google Scholar

20. Lindberg, LD, Bell, DL, Kantor, LM. The sexual and reproductive health of adolescents and young adults during the COVID-19 pandemic. Perspect Sex Reprod Health 2020;52:75–9. https://doi.org/10.1363/psrh.12151.Search in Google Scholar PubMed PubMed Central

21. Montalti, M, Salussolia, A, Masini, A, Manieri, E, Rallo, F, Marini, S, et al.. Sexual and reproductive health and education of adolescents during COVID-19 pandemic, results from “Come Te La Passi?”-survey in Bologna, Italy. Int J Environ Res Public Health 2022;19. https://doi.org/10.3390/ijerph19095147.Search in Google Scholar PubMed PubMed Central

22. Shockley, KM, Gabriel, AS, Robertson, D, Rosen, CC, Chawla, N, Ganster, ML, et al.. The fatiguing effects of camera use in virtual meetings: a within-person field experiment. J Appl Psychol 2021;106:1137–55. https://doi.org/10.1037/apl0000948.Search in Google Scholar PubMed

23. Stavridou, A, Samiakou, C, Kourti, A, Tsiorou, S, Panagouli, E, Thirios, A, et al.. Sexual activity in adolescents and young adults through COVID-19 pandemic. Children 2021;8. https://doi.org/10.3390/children8070577.Search in Google Scholar PubMed PubMed Central

24. Wiederhold, BK. Connecting through technology during the Coronavirus disease 2019 pandemic: avoiding “zoom fatigue”. Cyberpsychol, Behav Soc Netw 2020;23:437–8. https://doi.org/10.1089/cyber.2020.29188.bkw.Search in Google Scholar PubMed

25. Williams, N. Working through COVID-19: ‘Zoom’ gloom and ‘Zoom’ fatigue. Occup Med 2021;71:164. https://doi.org/10.1093/occmed/kqab041.Search in Google Scholar

26. Bailenson, JN. Nonverbal overload: a theoretical argument for the causes of Zoom fatigue. Technology, Mind, and Behavior 2021;2. https://doi.org/10.1037/tmb0000030.Search in Google Scholar

27. Bekaert, S, Azzopardi, L. Safeguarding teenagers in a sexual health service during the COVID-19 pandemic. Sex Transm Infect 2022;98:219–21. https://doi.org/10.1136/sextrans-2021-055055.Search in Google Scholar PubMed

28. Frederikson, B, Gomez, I, Salganicoff, A. A look at online platforms for contraceptive and STI services during the COVID-19 pandemic KFF; 2020. Available at: https://www.kff.org/womens-health-policy/issue-brief/a-look-at-online-platforms-for-contraceptive-and-sti-services-during-the-covid-19-pandemic/.Search in Google Scholar

29. Homere, A, Reddy, S, Haller, L, Richey, J, Gefter, L. How do underserved adolescents want to learn about health? An exploration of health concerns, preferences, and resources utilized. J Natl Med Assoc 2022;114:518–24. https://doi.org/10.1016/j.jnma.2022.06.004.Search in Google Scholar PubMed PubMed Central

30. Moher, D, Liberati, A, Tetzlaff, J, Altman, DG, Group, P. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. J Clin Epidemiol 2009;62:1006–12. https://doi.org/10.1016/j.jclinepi.2009.06.005.Search in Google Scholar PubMed

31. IBM Corp. IBM SPSS statistics for Windows. 25.0. Armonk, NY: IBM Corp.; 2017.Search in Google Scholar

32. Higgins, JPT, Thomas, J, Chandler, J, Cumpston, M, Li, T, Page, MJ, Welch, VA. Cochrane handbook for systematic reviews of interventions, 2nd ed. Chichester (UK): John Wiley & Sons; 2019.10.1002/9781119536604Search in Google Scholar

33. Begg, CB, Mazumdar, M. Operating characteristics of a rank correlation test for publication bias. Biometrics 1994;50:1088–101. https://doi.org/10.2307/2533446.Search in Google Scholar

34. Egger, M, Davey Smith, G, Schneider, M, Minder, C. Bias in meta-analysis detected by a simple, graphical test. BMJ 1997;315:629–34. https://doi.org/10.1136/bmj.315.7109.629.Search in Google Scholar PubMed PubMed Central

35. Becker, BJ. Synthesizing standardized mean-change measures. Br J Math Stat Psychol 1998;41:257–78. https://doi.org/10.1111/j.2044-8317.1988.tb00901.x.Search in Google Scholar

36. Huedo-Medina, TB, Johnson, BT. Estimating the standardized mean difference effect size and its variance from different data sources 2011. p. A spreadsheet.Search in Google Scholar

37. Hedges, LV. Distribution theory for glass’s estimator of effect size and related estimators. J Educ Behav Stat 1981;6:107–28. https://doi.org/10.3102/10769986006002107.Search in Google Scholar

38. Johnson, BT, Huedo-Medina, TB. Meta-analytic statistical inferences for continuous measure outcomes as a function of effect size metric and other assumptions. Storrs, CT: University of Connecticut, Hartford Hospital Evidence-Based practice center under contract no 290200710067; 2013. Methods Research Report No. 13-EHC075-EF.Search in Google Scholar

39. Schmidt, FL, Oh, IS, Hayes, TL. Fixed-vs. random-effects models in meta-analysis: model properties and an empirical comparison of differences in results. Br J Math Stat Psychol 2009;62:97–128. https://doi.org/10.1348/000711007x255327.Search in Google Scholar PubMed

40. Knapp, G, Hartung, J. Improved tests for a random effects meta-regression with a single covariate. Stat Med 2003;22:2693–710. https://doi.org/10.1002/sim.1482.Search in Google Scholar PubMed

41. van Houwelingen, HC, Arends, LR, Stijnen, T. Advanced methods in meta-analysis: multivariate approach and meta-regression. Stat Med 2002;21:589–624. https://doi.org/10.1002/sim.1040.Search in Google Scholar PubMed

42. Marsiglia, FF, Jacobs, BL, Nieri, T, Smith, SJ, Salamone, D, Booth, J. Effects of an undergraduate HIV/AIDS course on students’ HIV risk. J HIV AIDS Soc Serv 2013;12:172–89. https://doi.org/10.1080/15381501.2013.790750.Search in Google Scholar PubMed PubMed Central

43. Higgins, JP, Thompson, SG, Deeks, JJ, Altman, DG. Measuring inconsistency in meta-analyses. BMJ 2003;327:557–60. https://doi.org/10.1136/bmj.327.7414.557.Search in Google Scholar PubMed PubMed Central

44. Huedo-Medina, TB, Sánchez-Meca, J, Marín-Martínez, F, Botella, J. Assessing heterogeneity in meta-analysis: Q statistic or I2 index? Psychol Methods 2006;11:193–206. https://doi.org/10.1037/1082-989x.11.2.193.Search in Google Scholar PubMed

45. Viechtbauer, W. Conducting meta-analyses in R with the metafor package. J Stat Software 2010;36. https://doi.org/10.18637/jss.v036.i03.Search in Google Scholar

46. Johnson, BT, Huedo-Medina, TB. Depicting estimates using the intercept in meta-regression models: the moving constant technique. Res Synth Methods 2011;2:204–20. https://doi.org/10.1002/jrsm.49.Search in Google Scholar PubMed PubMed Central

47. Eastman-Mueller, HP, Habel, MA, Oswalt, SB, Liddon, N. Get yourself tested (GYT) campaign: investigating campaign awareness and behaviors among high school and college students. Health Educ Behav 2019;46:63–71. https://doi.org/10.1177/1090198118788617.Search in Google Scholar PubMed PubMed Central

48. Lustria, ML, Cortese, J, Gerend, MA, Schmitt, K, Kung, YM, McLaughlin, C. A model of tailoring effects: a randomized controlled trial examining the mechanisms of tailoring in a web-based STD screening intervention. Health Psychol 2016;35:1214–24. https://doi.org/10.1037/hea0000399.Search in Google Scholar PubMed

49. Sacca, L, Markham, C, Hernandez, B, Shegog, R, Peskin, M, Craig Rushing, S, et al.. The impact of COVID-19 on the delivery of educational programs in native American Communities: qualitative study. JMIR Form Res 2022;6:e32325. https://doi.org/10.2196/32325.Search in Google Scholar PubMed PubMed Central

50. Sznitman, S, Vanable, PA, Carey, MP, Hennessy, M, Brown, LK, Valois, RF, et al.. Using culturally sensitive media messages to reduce HIV-associated sexual behavior in high-risk African American adolescents: results from a randomized trial. J Adolesc Health 2011;49:244–51. https://doi.org/10.1016/j.jadohealth.2010.12.007.Search in Google Scholar PubMed PubMed Central

51. Zimmerman, RS, Palmgreen, PM, Noar, SM, Lustria, ML, Lu, HY, Lee Horosewski, M. Effects of a televised two-city safer sex mass media campaign targeting high-sensation-seeking and impulsive-decision-making young adults. Health Educ Behav 2007;34:810–26. https://doi.org/10.1177/1090198107299700.Search in Google Scholar PubMed PubMed Central

52. Ahrens, K, Kent, CK, Montoya, JA, Rotblatt, H, McCright, J, Kerndt, P, et al.. Healthy Penis: San Francisco’s social marketing campaign to increase syphilis testing among gay and bisexual men. PLoS Med 2006;3:e474. https://doi.org/10.1371/journal.pmed.0030474.Search in Google Scholar PubMed PubMed Central

53. VanDevanter, NL, Messeri, P, Middlestadt, SE, Bleakley, A, Merzel, CR, Hogben, M, et al.. A community-based intervention designed to increase preventive health care seeking among adolescents: the Gonorrhea Community action project. Am J Public Health 2005;95:331–7. https://doi.org/10.2105/ajph.2003.028357.Search in Google Scholar PubMed PubMed Central

54. Galloway, CT, Duffy, JL, Dixon, RP, Fuller, TR. Exploring African-American and Latino teens’ perceptions of contraception and access to reproductive health care services. J Adolesc Health 2017;60:S57–62. https://doi.org/10.1016/j.jadohealth.2016.12.006.Search in Google Scholar PubMed PubMed Central

55. Cardoza, VJ, Documét, PI, Fryer, CS, Gold, MA, Butler, J3rd. Sexual health behavior interventions for U.S. Latino adolescents: a systematic review of the literature. J Pediatr Adolesc Gynecol 2012;25:136–49. https://doi.org/10.1016/j.jpag.2011.09.011.Search in Google Scholar PubMed PubMed Central

56. Coyle, K, Basen-Engquist, K, Kirby, D, Parcel, G, Banspach, S, Collins, J, et al.. Safer choices: reducing teen pregnancy, HIV, and STDs. Public Health Rep 2001;116:82–93. https://doi.org/10.1093/phr/116.s1.82.Search in Google Scholar PubMed PubMed Central

57. Coyle, K, Basen-Engquist, K, Kirby, D, Parcel, G, Banspach, S, Harrist, R, et al.. Short-term impact of safer choices: a multicomponent, school-based HIV, other STD, and pregnancy prevention program. J Sch Health 1999;69:181–8. https://doi.org/10.1111/j.1746-1561.1999.tb06383.x.Search in Google Scholar PubMed

58. Dittus, PJ. Promoting adolescent health through triadic interventions. J Adolesc Health 2016;59:133–4. https://doi.org/10.1016/j.jadohealth.2016.06.001.Search in Google Scholar PubMed PubMed Central

59. Ford, CA, Davenport, AF, Meier, A, McRee, AL. Partnerships between parents and health care professionals to improve adolescent health. J Adolesc Health 2011;49:53–7. https://doi.org/10.1016/j.jadohealth.2010.10.004.Search in Google Scholar PubMed

60. Guilamo-Ramos, V, Thimm-Kaiser, M, Benzekri, A, Rodriguez, C, Fuller, TR, Warner, L, et al.. Father-son communication about consistent and correct condom use. Pediatrics 2019;143. https://doi.org/10.1542/peds.2018-1609.Search in Google Scholar PubMed

61. ACOG (American College of Obstetricians and Gynecologists) Committee. Confidentiality in adolescent health care: ACOG Committee Opinion, number 803. Obstet Gynecol 2020;135:e171-7.10.1097/AOG.0000000000003770Search in Google Scholar PubMed

62. Centers for Disease Control and Prevention. Health care providers and teen pregnancy prevention; 2018. Available at: https://www.cdc.gov/teenpregnancy/health-care-providers/index.htm.Search in Google Scholar

63. Burke, PJ, Coles, MS, Di Meglio, G, Gibson, EJ, Handschin, SM, Lau, M, et al.. Sexual and reproductive health care: a position paper of the Society for Adolescent Health and Medicine. J Adolesc Health 2014;54:491–6. https://doi.org/10.1016/j.jadohealth.2014.01.010.Search in Google Scholar PubMed

64. Lemieux, AF, Fisher, JD, Pratto, F. A music-based HIV prevention intervention for urban adolescents. Health Psychol 2008;27:349–57. https://doi.org/10.1037/0278-6133.27.3.349.Search in Google Scholar PubMed

65. Rohrbach, LA, Berglas, NF, Jerman, P, Angulo-Olaiz, F, Chou, CP, Constantine, NA. A rights-based sexuality education curriculum for adolescents: 1-year outcomes from a cluster-randomized trial. J Adolesc Health 2015;57:399–406. https://doi.org/10.1016/j.jadohealth.2015.07.004.Search in Google Scholar PubMed

Supplementary Material

This article contains supplementary material (https://doi.org/10.1515/ijamh-2022-0113).

Received: 2022-12-09
Accepted: 2024-01-30
Published Online: 2024-02-20

© 2024 Walter de Gruyter GmbH, Berlin/Boston

Articles in the same Issue

  1. Frontmatter
  2. Reviews
  3. Efficacy of behavioral interventions to increase engagement in sexual health services among LatinX youth in the United States: A meta-analysis for post-pandemic implications
  4. Electronic nicotine delivery system: a narrative review on growing threat to tobacco control and health of the young Indian population
  5. Original Articles
  6. Mindful awareness and resilience skills for adolescents (MARS-A): a mixed-methods study of a mindfulness-based intervention for a heterogeneous adolescent clinical population
  7. Adolescent health care and perceptions in a provincial hospital in Papua New Guinea
  8. Adolescents on an inpatient unit and their healthcare providers: what’s working and what’s not
  9. Adolescent and young adult long-acting reversible contraception post-insertion visit attendance before and after COVID-19
  10. Knowledge and beliefs of Greek parents towards HPV infection and vaccination – are they willing to vaccinate their sons?
  11. Prevalence and correlates of unintentional nonfatal injuries among school-going adolescents in Central America
  12. Prevention starts here: effectiveness of substance abuse prevention module among adolescent students in Bengaluru – a quasi experimental study
  13. Association of tobacco experimentation with anxiety and depression: findings from a representative sample of Tunisian adolescents
  14. Knowledge of smoking and influencing factors among school-going adolescents in Timor-Leste
  15. Tobacco use and oral health related quality of life among Indian adolescents
https://doi.org/10.1515/ijamh-2022-0113
Keywords for this article
Latino youth; HIV prevention; STI prevention; meta-analysis; sexual healthcare

Articles in the same Issue

  1. Frontmatter
  2. Reviews
  3. Efficacy of behavioral interventions to increase engagement in sexual health services among LatinX youth in the United States: A meta-analysis for post-pandemic implications
  4. Electronic nicotine delivery system: a narrative review on growing threat to tobacco control and health of the young Indian population
  5. Original Articles
  6. Mindful awareness and resilience skills for adolescents (MARS-A): a mixed-methods study of a mindfulness-based intervention for a heterogeneous adolescent clinical population
  7. Adolescent health care and perceptions in a provincial hospital in Papua New Guinea
  8. Adolescents on an inpatient unit and their healthcare providers: what’s working and what’s not
  9. Adolescent and young adult long-acting reversible contraception post-insertion visit attendance before and after COVID-19
  10. Knowledge and beliefs of Greek parents towards HPV infection and vaccination – are they willing to vaccinate their sons?
  11. Prevalence and correlates of unintentional nonfatal injuries among school-going adolescents in Central America
  12. Prevention starts here: effectiveness of substance abuse prevention module among adolescent students in Bengaluru – a quasi experimental study
  13. Association of tobacco experimentation with anxiety and depression: findings from a representative sample of Tunisian adolescents
  14. Knowledge of smoking and influencing factors among school-going adolescents in Timor-Leste
  15. Tobacco use and oral health related quality of life among Indian adolescents
Sign up now to receive a 20% welcome discount
Institutional Access
How does access work?
Have an idea on how to improve our website?
Please write us.
© 2025 De Gruyter Brill
Downloaded on 10.9.2025 from https://www.degruyterbrill.com/document/doi/10.1515/ijamh-2022-0113/html
Scroll to top button