Physical violence and associated factors in participants of the National Student Health Survey (NSHS)

Romeiro, Juliana Souza; Corrêa, Márcia Mara; Pazó, Rosalva; Leite, Franciele Marabotti Costa; Cade, Nágela Valadão

doi:10.1590/1413-81232021262.04552020

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ARTICLE • Ciênc. Saúde Colet. 26 (02) • Feb 2021 • https://doi.org/10.1590/1413-81232021262.04552020 copy

Physical violence and associated factors in participants of the National Student Health Survey (NSHS)

Authorship SCIMAGO INSTITUTIONS RANKINGS

Abstract

The objective of this article was to analyze the association between physical violence in students with socioeconomic factors, family context, mental health, individual risky behaviors, and unsafe environment. Study with data from the National School Health Survey (NSHS) in 2015, with 9th graders. The outcome variable was the report of involvement in a physical struggle and the associated exposure variables used were related to socioeconomic and demographic conditions, family supervision and support, mental health, risky behaviors, and unsafe environment. Multivariate logistic regression with a hierarchical approach was used in the analyzes. The prevalence of involvement in a fight was higher in boys (30.2%; CI 29.3-31.0) than in girls (16.7%; CI 16.0-17.4). In both genders, there was a greater chance of involvement with physical violence when using drugs, missing classes, sedentary lifestyle, insomnia, loneliness and insecurity at school or in the community and, especially, when victimized by family aggression, OR 2.59 (CI 2.31-2.90) in boys and girls OR 2.42 (CI 2.17-2.71). There was a reduction in the chance of involvement in physical violence in boys because they were working and, in girls, when they study in a private school, having their problems and concerns welcomed by their parents or their participation in school activities.

Key words:
Violence; Adolescent; Adolescent behavior; School health

Variables	All % (CI)	Boys % (CI)	Girls % (CI)
No	76.7 (76.1 - 77.3)	69.8 (68.9 - 70.6)	83.3 (82.5 -83.9)
Once	11.9 (11.4 - 12.2)	14.3 (13.7 - 14.9)	9.5 (9.0 - 10.01)
2 times	5.7 (5.4 - 6.0)	7.6 (7.1 - 8.0)	4.0 (3.6 - 4.3)
3 times	2.1 (1.9 - 2.2)	2.9 (2.7 - 3.2)	1.2 (1.0 - 1.5)
≥ 4 times	3.6 (3.3 - 3.8)	5.3 (4.9 - 5.7)	1.8 (1.6 - 2.1)

Variables	Boys		p-value*	Girls		p-value*
	Physical Violence			Physical Violence
	Yes (%)	No (%)		Yes (%)	No (%)
Age group (years old)			0.129			<0.001
11-13	28.6	71.4		13.7	86.3
14-16	30.5	69.5		17.4	82.6
≥17	31.4	68.6		20.8	79.2
Skin color			0.264			<0.001
White	29.3	70.7		15.0	85.0
Black	30.7	69.1		18.2	81.8
Brown	30.5	69.5		17.4	82.6
Others	31.9	68.1		18.6	81.4
People living in the house			<0.001			0.065
Living alone	73.6	26.4		23.1	76.9
2 people	32.8	67.2		19.1	80.9
3 people	28.8	71.2		15.6	84.4
≥4 people	30.3	60.7		16.8	83.2
Housekeeper			<0.001			0.896
Yes	39.2	60.8		16.9	83.1
No	29.2	70.8		16.7	83.3
Bathroom/shower			<0.001			0.033
None	25.3	74.7		13.6	86.4
1	28.0	72.0		82.8	82.8
≥2	34.5	65.5		83.7	83.7
Mother’s education level			0.002			<0.000
Illiterate	28.4	71.6		17.6	82.4
Inc. Elementary	29.1	70.9		17.8	82.2
Comp. Elementary	32.7	67.3		17.1	82.9
High school	31.5	68.5		16.9	83.1
Higher education	33.7	66.3		13.1	86.9
Working Adolescent			<0.001			<0.001
Yes	41.8	58.2		23.0	77.0
No	27.7	72.3		16.1	83.9
Paid work			<0.001			<0.001
Never worked	27.7	72.3		16.1	83.9
Yes	41.8	58.2		23.4	77.6
No	40.8	59.2		28.8	77.1
Related to School			0.617			0.160
Shift
Morning/Afternoon/Night	30.2	69.8		16.7	83.3
Full-time	32.3	67.7		19.7	80.3
Type			<0.001			<0.001
Public	29.3	70.7		17.5	82.5
Private	35.5	64.5		12.1	87.9

Variables	Boys		p- value*	Girls		p- value*
	Physical Violence			Physical Violence
	Yes (%)	No (%)		Yes (%)	No (%)
Risk behaviors
Alcohol intake in the last 30 days			<0.001			<0.001
Never	19.5	80.5		7.2	92.8
Yes, but not drinking in 30 days	31.3	68.7		18.3	81.7
Drank at least 1 time in 30 days	50.1	49.9		31.6	68.4
Drug use in the last 30 days			<0.001			<0.001
Never	27.5	72.4		14.3	85.7
Consumes but has not used within 30 days	50.9	49.1		37.7	62.3
Used at least once in 30 days	61.7	38.3		50.8	49.2
Smoking in the last 30 days			<0.001			<0.001
Never	26.0	74.0		12.5	87.5
Yes, but not smoking in the last 30 days	43.7	56.3		31.8	68.2
Smoked at least 1 time in 30 days	56.7	42.3		49.0	51.0
Physical activity in the last 7 days			<0.001			<0.001
Sedentary	28.4	71.6		16.1	83.9
Active	34.8	65.2		21.1	78.9
Missed classes in the last 30 days without parental or guardian permission			<0.001			<0.001
None	26.9	73.1		13.8	86.2
≥1 day	40.1	59.9		27.3	72.7
Mental health
Insomnia			<0.001			<0.001
No	26.7	73.3		11.8	88.2
Yes	39.8	60.2		22.8	77.2
Feeling of Loneliness			<0.001			<0.001
No	26.8	73.2		12.3	87.7
Yes	37.6	62.4		20.3	79.7
Number of close friends			0.954			0.004
No friends	30.1	69.9		21.5	78.5
≥1 friend	30.2	69.8		16.5	83.5
Family Supervision and Support
Living with the mother			<0.000			<0.000
Yes	29.7	70.3		16.3	83.7
No	35.2	64.8		20.8	79.2
Living with the father			<0.000			<0.000
Yes	28.4	71.6		15.1	84.9
No	33.9	66.1		19.4	80.6
Have meals with parents or guardians			<0.000			<0.000
Yes	29.2	70.8		14.9	85.1
No	36.0	64.0		23.1	76.9
Problems and concerns welcomed by parents or guardians			<0.000			<0.000
Yes	28.2	71.8		13.7	86.3
No	35.2	64.8		22.0	78.0
Parents or guardians knew what they were doing in their free time			<0.000			<0.000
Yes	28.3	71.7		14.8	85.2
No	37.2	62.8		25.8	74.2
Safe Environment
Family assault in the last 30 days			<0.001			<0.001
None	25.8	74.2		13.0	87.0
≥Once	57.5	42.5		37.7	62.3
Insecurity at school in the last 30 days			<0.001			<0.001
None	27.5	72.5		15.2	84.8
≥Once	53.9	46.1		32.5	67.5
Insecurity on the way home/school in the last 30 days			<0.001			<0.001
None	27.7	72.3		15.0	85.0
≥1 day	49.5	50.5		30.3	69.7
Parents or guardians checked lessons or homework			<0.000			<0.000
Yes	28.0	72.0		13.8	86.2
No	33.5	66.5		19.9	80.1

Variables	Boys
	Gross Analysis	p- value*	Adjusted Analysis	p- value*
	Odds Ratio (CI95%)	p- value*	Odds Ratio (CI95%)	p- value*
Bathroom/shower		<0.001		<0.001
None	1.00		1.00
1	1.14 (0.94 - 1.38)		1.23 (1.02 - 1.50)
≥2	1.55 (1.28 - 1.87)		1.56 (1.29 - 1.90)
Working adolescent		<0.001		<0.001
Yes	1.00		1.00
No	0.53 (0.48 - 0.58)		0.76 (0.69 - 0.85)
Related to School - Type		<0.001		<0.001
Public	1.00		1.00
Private	1.32 (1.18 - 1.48)		1.52 (1.35 - 1.72)
Living with the father		<0.001		0.004
Yes	1.00		1.00
No	1.29 (1.20 - 1.39)		1.12 (1.04 - 1.23)
Insomnia		<0.001		<0.001
Yes	1.80 (1.65 - 1.97)		1.27 (1.15 - 1.35)
No	1.00		1.00
Feeling of Loneliness		<0.001		<0.001
Yes	1.64 (1.52 - 1.76)		1.24 (1.04 - 1.38)
No	1.00		1.00
Alcohol intake in the last 30 days		<0.001		<0.001
Never	1.00		1.00
Yes, but not drinking in 30 days	1.87 (1.71 - 2.06)		1.57 (1.43 - 1.72)
Drank at least 1 time in 30 days	1.79 (1.32 - 2.44)		2.49 (2.23 - 2.78)
Drug use in the last 30 days		<0.001		<0.001
Never	1.00		1.00
Consumes but has not used within 30 days	2.72(2.29 - 3.23)		1.39 (1.14 - 1.70)
Used at least once in 30 days	4.24 (3.60 - 4.98)		1.55 (1.26 - 1.90)
Smoking in the last 30 days		<0.001		<0.001
Never	1.00		1.00
Yes, but not smoking in the last 30 days	2.21 (1.99 - 2.45)		1.32 (1.17 - 1.49)
Smoked at least 1 time in 30 days	3.88 (3.35 - 4.48)		1.43 (1.16 - 1.72)
Physical activity		<0.001		<0.001
Active	1.00		1.00
Sedentary	1.34 (1.24 - 1.46)		1.35 (1.24 - 1.48)
Missed classes in the last 30 days without parental or guardian permission		<0.001		<0.001
None	1.00		1.00
≥1 day	1.81 (1.65 - 1.98)		1.31 (1.18 - 1.46)
Family aggression in last 30 days		<0.001		<0.001
None	1.00		1.00
≥Once	3.89 (3.52 - 4.29)		2.59 (2.31 - 2.90)
Insecurity on the way home/school in the last 30 days		<0.001		0.003
None	1.00		1.00
≥1 day	3.08 (2.72 - 3.48)		1.24 (1.07 - 1.43)
Insecurity at school in the last 30 days		<0.000		<0.000
None	1.00		1.00
≥1 day	2.56 (2.31 - 2.83)		1.68 (1.41 - 2.00)

Variables	Meninas
	Gross Analysis	p- value*	Adjusted Analysis	p- value*
	Odds Ratio IC95%	p- value*	Odds Ratio IC95%	p- value*
Type of school		<0.001		<0.001
Public	1.00		1.00
Private	0.64 (0.57 - 0.73)		0.78 (0.69 - 0.89)
Problems and concerns welcomed by parents or guardians		<0.001		0.015
Yes	0.56 (0.50 - 1.61)		0.89 (0.71 - 0.93)
No	1.00		1.00
Parents or guardians knew what they were doing at free time		<0.001		0.006
Yes	0.49 (0.44 - 0.56)		0.81 (0.71 - 0.93)
No	1.00		1.00
Insomnia		<0.001		<0.001
Yes	2.21 (2.02 - 2.42)		1.42 (1.27 - 1.59)
No	1.00		1.00
Feeling of Loneliness		<0.001		0.015
Yes	1.81 (1.64 - 2.00)		1.13 (1.01 - 1.26)
No	1.00		1.00
Alcohol intake in the last 30 days		<0.001		<0.001
Never	1.00		1.00
Yes, but not drinking in 30 days	2.87 (2.55 - 3.22)		2.08 (1.83 - 2.35)
Drank at least 1 time in 30 days	5.92 (5.27 - 6.66)		2.82 (2.44 - 3.26)
Drug use in the last 30 days		<0.001		<0.001
Never	1.00		1.00
Consumes but has not used within 30 days	3.61 (3.04 - 4.29)		1.38 (1.12 - 1.70)
Used at least once in 30 days	6.16 (5.00 - 7.60)		1.70 (1.32 - 2.19)
Smoking in the last 30 days		<0.001		<0.001
Never	1.00		1.00
Yes, but not smoking in the last 30 days	3.27 (2.90 - 3.69)		1.62 (1.40 - 1.87)
Smoked at least 1 time in 30 days	6.74 (5.73 - 7.93)		2.15 (1.75 - 2.65)
Physical activity		<0.001		<0.001
Active	1.00		1.00
Sedentary	1.39 (1.25 - 1.55)		1.33 (1.17 - 1.50)
Missed classes in the last 30 days without parental or guardian permission		<0.001		<0.001
None	1.00		1.00
≥1 day	2.33 (2.09 - 2.60)		1.31 (1.16 - 1.49)
Family aggression in last 30 days		<0.001		<0.001
None	1.00		1.00
≥Once	4.04 (3.65 - 4.47)		2.42 (2.17 - 2.71)
Insecurity on the way home/school in the last 30 days		<0.001		<0.001
None	1.00		1.00
≥1 day	2.46 (2.17 - 2.80)		1.48 (1.27 - 1.72)
Insecurity at school in the last 30 days		<0.000		0.005
None	1.00		1.00
≥1 day	2.69 (2.36 - 3.06)		1.29 (1.09 - 1.54)

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[1] Collaborations

JS Romeiro participated in the idealization of the article, worked on data interpretation and writing of the article. MM Corrêa worked on the analysis and interpretation of the data, carried out a critical review and approved the final version of the manuscript. R Pazó and FMC Leite collaborated in the critical review and approved the final version. NV Cade participated in the idealization of the article, contributed in the analysis and interpretation of data, in the critical review and approved the final version.