Demographic and Psychosocial Correlates of Mobile Phone Ownership and Usage among Youth Living in the Slums of Kampala, Uganda

Introduction: The use of mobile phones and other technology for improving health through research and practice is growing quickly, in particular in areas with difficult-to-reach population or where the research infrastructure is less developed. In Sub-Saharan Africa, there appears to be a dramatic increase in mobile phone ownership and new initiatives that capitalize on this technology to support health promotion campaigns to change behavior and to increase health literacy. However, the extent to which difficult-to-reach youth in the slums of Kampala may own and use mobile phones has not been reported despite the burden of injuries, substance use, and HIV that they face. The purpose of this study is to determine the prevalence of mobile phone ownership and use in this high-risk population and to identify psychosocial characteristics that may differentiate those owning and using a phone from those who do not. Methods: We conducted secondary analyses of the Kampala Youth Survey (N¼457). Data collection took place in 2011, and the survey was designed to quantify high-risk behaviors in a convenience sample of urban youth living on the streets or in the slums, 14–24 years of age, who were participating in a Uganda Youth Development Link drop-in center for disadvantaged street youth. We computed chisquare analyses to determine any significant differences in psychosocial characteristics based on phone ownership and use. Results: Overall, 46.9% of youth reported owning a mobile phone and ownership did not vary by sex but was more common among youth older than 18 years of age. Mobile phone ownership was also more common among those who reported taking care of themselves at night, who reported current drug use and who reported trading sex for money, food or other things.Conclusion: Given that nearly half of the youth own and use phones daily, new research is needed to determine next steps for mobile health (mhealth), including the feasibility of using mobile phones for data collection and interventions with this hard-to-reach population. Moreover, this technology may also be suitable for injury-specific research given that there were few differences with respect to injuryrelated variables in mobile phone ownership and usage. [West J Emerg Med. 2014;15(5):600–603.

Using Policy to Strengthen the Reach and Impact of Injury Prevention Efforts

West J Emerg Med. 2011;12(3):268-270

The Emory Center for Injury Control: Vision and Priorities for Reducing Violence and Injuries through Interdisciplinary Collaborations

Injury is the leading cause of death in the United States for persons between the ages of 1 and 44 1. We see evidence of the scope and burden of injuries in the emergency department (ED), where annually an estimated 41.4 million patients are seen with injury-related visits, accounting for over one-third of ED presentations 2. While many disciplines are involved in injuryrelated research, prevention, and practice, emergency physicians are on the frontlines of this epidemic, and they treat patients with preventable injuries as well as those with the sequelae of violence. Emergency physicians are also in a unique position to prevent future injuries and to reduce the consequences of existing injuries especially through screening and brief interventions, and the use of a teachable moment for the benefit and future safety of their patients 2. It is because emergency medicine is so integrated and important for injury prevention and research 3 that we wante

Nonreciprocal and Reciprocal Dating Violence and Injury Occurrence among Urban Youth

Objective: Dating violence is a significant health problem among youth that leads to adverse health outcomes, including injuries. Reciprocal violence (perpetrated by both partners) is associated with increased injury in adults, but very little is known about the prevalence and context for reciprocal violence, as well as injury rates, among youth. We sought to determine the prevalence and scope of reciprocal dating violence and injury occurrence among urban youth in a high-risk community. Methods: Analyses were based on data from the Youth Violence Survey, conducted in 2004, and administered to over 80 % of public school students in grades 7, 9, 11, and 12 (N=4,131) in a highrisk, urban school district. The current analyses were restricted to those who reported dating in the past year and who also reported any dating violence (n=1,158). Dating violence was categorized as reciprocal (the participant reported both violence perpetration and victimization) and non-reciprocal (the participant report either violence perpetration or victimization, but not both). Results: Dating violence reciprocity varied by sex. Girls who reported any dating violence were more likely to report reciprocal dating violence (50.4%) than were boys (38.9%). However, reciprocity did not vary by race/ethnicity or grade level. Reciprocal dating violence was more common among participants who reported more frequent violence experiences. Reciprocal violence was als

In Reply

A reply to a letter to the editor regarding their article: Swahn MH, Alemdar M, Whitaker DJ. 2009. Nonreciprocal and Reciprocal Dating Violence and Injury Occurrence Among Urban Youth. The Western Journal of Emergency Medicine. 11(3):264-268

Alcohol Exposures, Alcohol Marketing, and Their Associations with Problem Drinking and Drunkenness among Youth Living in the Slums of Kampala, Uganda

This study determined the associations between alcohol use exposures, marketing, education, and problem drinking and drunkenness among youth living in the slums of Kampala. This cross-sectional study of youth was conducted in 2011 to quantify and describe high-risk behavior and exposures in a convenience sample (N=457) of urban youth living in the slums, 14–24 years of age, who were participating in a drop-in center for disadvantaged street youth. Logistic regression analyses were computed to determine associations between alcohol use exposures, marketing exposures, alcohol education, and problem drinking and drunkenness while controlling for possible confounders. Among participants, 30.2% reported problem drinking and 32.8% reported drunkenness. In multivariate analyses, obtaining free drinks was associated with problem drinking (AOR: 2.47; 95% CI =  1.23–4.96) and drunkenness (AOR: 2.40; 95% CI = 1.22–4.70) after controlling for potential confounders. Alcohol education measures were not significantly associated with either problem drinking or drunkenness in multivariate analyses. There are important associations between alcohol marketing and drinking among these youth. Moreover, the findings underscore the need for additional research related to the impact of alcohol marketing among vulnerable youth and also the need for policy regulations that restrict alcohol marketing that involve providing free alcohol directly to youth

Co-Occurring Physical Fighting and Suicide Attempts among U.S. High School Students: Examining Patterns of Early Alcohol Use Initiation and Current Binge Drinking

Introduction: A growing body of empirical research documents a significant co-occurrence of suicide attempts and interpersonal violence among youth. However, the potential role of early alcohol use initiation and current heavy alcohol use as correlates of this comorbidity has not been examined in a nationally representative sample of high school students. Methods: We based our analyses on cross-sectional data from the 2009 Youth Risk Behavior Survey, which includes a nationally representative sample (n=16,410) of high school students in grades 9 through 12 in the United States. Multinomial logistic regression analyses were conducted to test the associations between measures of alcohol use (early alcohol use initiation and heavy drinking) and comorbid suicidal and violent behavior while controlling for potential confounders. Results: Among high school students, 3.6% reported comorbid physical fighting and suicide attempt in the past year. Early alcohol use (prior to age 13) and heavy drinking (5 or more drinks in a row) were strongly associated with comorbid reports of physical fighting and suicide attempts (Adj. odds ratio [OR]=3.12; 95% confidence interval [CI]:2.49-3.89) and (Adj. OR=3.45; 95%CI:2.63-4.52). Conclusion: These findings underscore the importance of both early alcohol use initiation and heavy drinking as statistically significant correlates of comorbid fighting and suicide attempts among youth. While future research is needed to determine the temporal ordering between problem drinking and violent or suicidal behaviors, existing prevention programs may benefit from including components aimed at reducing and delaying alcohol use. [West J Emerg Med. 2013;14(4):341–346.

Alcohol Marketing, Drunkenness, and Problem Drinking among Zambian Youth: Findings from the 2004 Global School-Based Student Health Survey

This study examines the associations between alcohol marketing strategies, alcohol education including knowledge about dangers of alcohol and refusal of alcohol, and drinking prevalence, problem drinking, and drunkenness. Analyses are based on the Global School-Based Student Health Survey (GSHS) conducted in Zambia (2004) of students primarily 11 to 16 years of age (N = 2257). Four statistical models were computed to test the associations between alcohol marketing and education and alcohol use, while controlling for possible confounding factors. Alcohol marketing, specifically through providing free alcohol through a company representative, was associated with drunkenness (AOR = 1.49; 95% CI: 1.09–2.02) and problem drinking (AOR = 1.41; 95% CI: 1.06–1.87) among youth after controlling for demographic characteristics, risky behaviors, and alcohol education. However, alcohol education was not associated with drunkenness or problem drinking. These findings underscore the importance of restricting alcohol marketing practices as an important policy strategy for reducing alcohol use and its dire consequences among vulnerable youth