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. 2019 Feb 22;19(1):226.
doi: 10.1186/s12889-019-6539-1.

The global school-based student health survey as a tool to guide adolescent health interventions in rural Guatemala

Randi K Johnson  1   2 , Molly Lamb  1   2 , Hillary Anderson  2 , Michelle Pieters-Arroyo  3 , Bradley T Anderson  4 , Guillermo A Bolaños  5 , Edwin J Asturias  6   7   8   9
Affiliations

The global school-based student health survey as a tool to guide adolescent health interventions in rural Guatemala

Randi K Johnson et al. BMC Public Health. .

Abstract

Background: Adolescents from rural areas in low-middle income countries face increasing physical and mental health challenges that are not well characterized or addressed due to resource limitations. We used the Global School-based Student Health Survey (GSHS) to describe adolescent health behaviors, and to inform prioritization of health promotion efforts in a resource-limited, rural, agricultural region in Guatemala.

Methods: In July 2015, a group of volunteers administered the GSHS to students from seven schools in four communities in the southwest Trifinio region of Guatemala. Prevalence and predictors of nutritional, mental, and sexual health behaviors were calculated from survey responses, and summarized in region- and school-level reports. Facilitated discussion of survey results with local leadership in January 2016 led to the identification of priorities for school-based health interventions.

Results: Five hundred fifty-four out of 620 (87%) students aged 12-18 years completed the survey. Prevalence of unhealthy dietary behaviors and body size was high: 61% reported high current soft drink intake, 18% were overweight, and 31% were moderate-severely stunted. In multivariable regression models, being food insecure was marginally associated with being underweight/stunted (OR = 1.95, 95%CI = 0.95-4.0). Boys were more likely than girls to report being sexually active (25% versus 6.4%, p < 0.001). Local school leadership identified food insecurity and sexual education as priority areas for intervention, and made plans for providing breakfast in schools, sexual education curriculum development and teacher training, and continued adolescent health reporting and evaluation.

Conclusions: The GSHS is a rapid, cost-efficient, useful tool for surveillance of adolescent health behaviors in vulnerable, resource-limited populations. Results of a locally-administered GSHS informed school-based interventions to decrease food insecurity, early sexual initiation, and teen pregnancy in a rural Guatemalan region.

Keywords: Community-based participatory research; Food insecurity; Guatemala; Malnutrition; Obesity; School health survey; Sexual initiation; Suicide.

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Conflict of interest statement

Ethics approval and consent to participate

The project was determined to be non-human subject research by the Colorado Multiple Institutional Review Board (COMIRB No. 15–0755) and reviewed and agreed upon by the southwest Trifinio Community Advisory Board for Research. Parental consent was obtained via letters sent home from school, and student assent obtained on the day of survey administration via the opportunity to elect not to participate. Consenting processes were approved by COMIRB and the Trifinio Community Advisory Board for Research.

Consent for publication

Not applicable.

Competing interests

The authors declare that they have no competing interests.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Figures

Fig. 1
Fig. 1
Proportion of adolescents surveyed by age and gender from schools at the rural southwest Trifinio in Guatemala 2015
See this image and copyright information in PMC

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