Current evidence is equivocal as to whether adolescent's perception of weight status is linked to both healthy and risky behaviors. This study examined the association between accurate and inaccurate perception of weight and self-reported health and risk behaviors among a diverse sample of obese, urban adolescents. Data were analyzed from 1,180 participants in the 2009 Philadelphia Youth Risk Behavior Survey. Health behaviors of obese students self-identifying as very or slightly overweight were compared to obese students who underestimated their weight status. Accurate self-identifiers of weight status were significantly more likely to report trying to lose weight, bullying victimization, and suicide attempts as compared to obese students underestimating their weight status. Findings suggest that it is important for school nurses to understand that perceived weight status confers distinct risk profiles and differing needs for health-related services related to the physical, mental, and social health of adolescents.

Background. Adolescent girls are less likely to meet physical activity recommendations than boys. This study examined the relative contribution of structured physical activity opportunities including physical education (PE) class and sports teams to overall activity levels for girls and boys. Methods. Data from 591 9th-12th grade students who completed the 2009 Philadelphia Youth Risk Behavior Survey were examined. Logistic regression was used to estimate the relationship between PE and sports teams and physical activity levels. Models were stratified by gender to estimate gender differences. Results. Girls were less likely to be active than boys: 27.9% of girls were sedentary as compared to 10.6% of boys. PE class was not related to activity levels among boys, while highly active girls were seven times more likely to participate in daily PE than were sedentary girls. Playing on one or more sports teams was associated with low-moderate and high activity in girls; among boys, sports team participation was only associated with high activity. Conclusions. The structured physical activity opportunities of PE and sports teams may contribute more to overall activity levels in girls than boys. A more rigorous assessment of this hypothesis is warranted to inform efforts to promote activity levels in girls.

BackgroundA growing proportion of adolescents have poor cardiovascular health behaviors, including low levels of physical activity and high levels of sedentary behavior, thus increasing the likelihood of poor heart health in later years. This study tested the hypothesis that low perceived neighborhood safety would be associated with low levels of physical activity and high levels of recreational sedentary behavior in high-school students.MethodsUsing cross-sectional, weighted data from the 2015 Pennsylvania (USA) State and Philadelphia city Youth Risk Behavior Survey, multivariable logistic regression modeling was used to examine the association between perceived neighborhood safety, and physical activity levels and recreational screen-based sedentary behavior time respectively, while controlling for potential confounders.ResultsAfter adjustment for other significant correlates of physical activity, students with low perceived neighborhood safety had a 21% reduced odds of being physically active on 5 or more days of the last week as compared to those who felt safe (p = 0.044). Perceived safety was not related to sedentary behavior; but sports team participation emerged as a strong correlate of low screen-based sedentary behavior (OR = 0.73, p = .002).ConclusionThese data add to a growing body of work demonstrating the importance of perceived safety with physical activity levels in youth. Sports team participation may be a viable target to reduce screen-based sedentary time.

His research program focuses on prevention and resiliency in urban youth, and school-based mental health services. Of primary interest is designing and evaluating culturally relevant and evidence-based psychosocial interventions in youth.

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