OBJECTIVE:Behavioral risk assessment is critical to developing intervention strategies to promote adolescent health, but also presents logistical, ethical, and scientific challenges. This paper reports on feasibility of a school-based study of health-risk behaviors in ethnic Fijian adolescent girls.METHODS:We assessed feasibility of school-based participation and implementation of assessment in the local vernacular language by examining observational data and by calculating response rates and as well as language selection and item completion rates.RESULTS:All invited study area schools participated (n=12). Response rates were >70% for study participation among eligible study participants in the overall sample as well as the peri-urban and rural sub-samples. The majority of respondents (71.9%) selected the local Fijian vernacular language version rather than the English version (28.1%). Although 43.6% of respondents completed a questionnaire in a language not spoken as the primary language at home, only ten respondents (1.9%) were assessed as having difficulty with the language of the self-report questionnaire. Item completion rates for the primary outcomes were >90% for both study phases and in both language versions. Study participant response rate for further assessment of concerning symptoms was also very high and teachers were successfully recruited for participation in training and accepting referrals to support these students at each participating school.CONCLUSION:School-based behavioral risk data collection in the vernacular language was feasible. Evaluation and referral of individual study participants with concerning symptoms to educators for further assistance and support also appeared feasible. We suggest that close collaboration among Fiji-based and specialty consultants to address scientific, linguistic, logistical, and ethical challenges were contributing factors to study feasibility.
INTRODUCTION:The HEALTHY Fiji Study examines the impact of social transition on health risk behaviors among school-going ethnic Fijian adolescent girls. The primary aim of the present study was to assess prevalence and socio-demographic correlates of three risk behaviors, alcohol use, cigarette smoking, and unsafe sexual behavior in the study population. METHODS:We used an adapted version of the Global School-based Health Survey (GSHS) to assess health risk behaviors in a school-based sample of ethnic Fijian girls (n=523) in June and July 2007. We calculated prevalence of risk behaviors and then examined their relation to socio-demographic variables in logistic regression models. RESULTS:Prevalence estimates for any current alcohol use and cigarette smoking (20.1% and 17.6%) and lifetime history of sexual intercourse (20.8%) indicate that substantial percentage of this study sample has engaged in one of these health risk behaviors. Alcohol use was associated with two other risk behaviors, recurrent cigarette smoking and lifetime history of sexual intercourse. Although prevalence of alcohol use was lower than in several other Pacific populations, it was higher than previously reported among Fijian girls. CONCLUSIONS:The prevalence of alcohol use, cigarette smoking, and unsafe sexual behaviors in this study population warrants concern. Comparison with estimates from previous health behavior surveys in Fiji suggest that mode of assessment may impact prevalence estimates for health risk behaviors.
The Central Division Health Office in Suva (Fiji) has been keeping records of the method of infant feeding used by mothers attending Maternal and Child Health Clinics since 1977. An analysis of these and other records was conducted in order to determine the extent of artificial feeding in Suva and trends in infant feeding over the past 3-1/2 years. A declining trend in the extent of breast feeding over the 1977-1980 period was found. The declining trend was most marked in "other" infants, i.e., Chinese, other Pacific islanders, European, and part Europeans. During the first 6 months of 1980, there were some indication of a leveling off of the number of artificially fed infants. If the results for all these are combined, then the percentage of wholly breast fed infants falls from 44.6 in 1977 to 30.9% for the first 6 months of 1980. Data collected at Labasa Maternal-Child Health clinic during January 1980 revealed that the majority of both Indians and Fijian infants were wholly breast fed up to 6 months of age. In order to investigate the effect of artificial feeding on the nutritional status of infants, an analysis of the records at the pediatric ward of the Colonial War Memorial Hospital in Suva were conducted. In 1979, 100 children were admitted suffering from clinical malnutrition. 20 (80%) of the children had been bottlefed only, 2 were both breastfed and bottlefed, and only 3 were wholly breastfed. It is recommended that the Ministry of Health renew its efforts to encourage the universal adoption of breast feeding.
