PURPOSE: Female secondary school students are the primary recommended population for human papillomavirus (HPV) vaccines. However, vaccine hesitancy may affect uptake. In this study, we assessed the vaccine hesitancy levels among the guardians of female secondary school students in China. METHODS: We developed a questionnaire and conducted cross-sectional surveys among guardians of secondary school girls aged 12-19 years in mainland China based on the Increasing Vaccination Model and the Precaution Adoption Process Model. RESULTS: We collected 3,225 valid samples. Among the participating guardians, 53.9% were vaccine hesitant, although only 0.9% had refused HPV vaccines. Some individual characteristics of guardians (e.g. sex, education/income level) were associated with understanding HPV vaccines. Better knowledge of HPV vaccines and communication with reliable sources of information were associated with vaccine nonhesitancy. Practical barriers such as vaccine shortage and busy schedules prevented nonhesitant guardians from vaccinating their children. DISCUSSION: A substantial proportion of the guardians surveyed were HPV vaccine hesitant. Promoting HPV knowledge and communication with reliable sources (e.g. clinical doctors) could help fight against vaccine hesitancy.
PURPOSE: The coronavirus disease 2019 (COVID-19) pandemic has caused changes in the daily lives of Korean adolescents and affected their emotional well-being. This study compared lifestyle factors and the mental health status of adolescents before and during the COVID-19 pandemic. METHODS: We conducted a secondary analysis using data from a national cross-sectional cohort (Korean Youth Risk Behavior Web-based Survey, KYRBS) collected in 2019 before the COVID-19 outbreak and in 2020 during the pandemic. This study included 57,303 students from the 2019 KYRBS and 54,948 from the 2020 KYRBS. Lifestyle factors such as dietary habits, physical activity levels, time spent studying, duration of Internet use, and mental health status, including perceived stress, experience of depressive mood, and suicidal ideation and attempts, were included in the analyses. RESULTS: The perceived stress levels, self-reported depressive mood, and suicidal thoughts and attempts were lower in the students surveyed in 2020 during the COVID-19 pandemic than in the students surveyed in 2019 before the COVID-19 outbreak. The time spent studying and sleep duration decreased compared to before the pandemic, and sleep satisfaction increased during the COVID-19 pandemic. DISCUSSION: Our results showed an improvement in mental health status in Korean adolescents during the pandemic, but caution is needed when interpreting these results. Future research is needed to determine the effects of a long-lasting pandemic on mental health and lifestyle factors in adolescents.
PURPOSE: Children who are left behind when their parents migrate for work have a high prevalence of emotional and behavioral problems, which affect social function and increase family burden. To date, no national survey has been conducted on the emotional and behavioral problems of left-behind children (LBC) in China. This study aimed to investigate the emotional and behavioral outcomes of primary school LBC in the fourth grade in impoverished rural China and the possible influences of family environment and parenting practices. METHODS: A cross-sectional study was carried out in 27 rural counties in the central and western parts of China from November 2016 to January 2017. The method of quota sampling was adopted to achieve a representative sample using postweighting adjustment. The survey sample was distributed proportionately across each county. LBC were defined as children aged <16 years who had two parents leave home to work or one parent leave home while the other lost the capacity to rear their children. The term "non-left-behind children" (NLBC) refers to children who have at least one parent who has not migrated for work. The Strengths and Difficulty Questionnaire (SDQ) was applied to measure children's emotional and behavioral problems. RESULTS: After the weighted calculations were performed, there were 1,147 LBC and 3,953 NLBC. The proportion of abnormal SDQ total scores (>17) was significantly higher in the LBC group than in the NLBC group (15.6% vs. 11.6%; p < .01). Binary regression analysis showed that high levels of insomnia (odds ratio [OR] 1.54, 95% confidence interval [CI] 1.04-2.27), loneliness (OR 1.65, 95% CI 1.13-2.43), and self-harm (OR 1.92, 95% CI 1.17-3.16) may increase the risk of abnormal SDQ total scores in LBC. CONCLUSIONS: LBC showed a higher prevalence of abnormal SDQ total scores than NLBC. Insomnia, loneliness, and self-harm behavior were associated with abnormal SDQ total scores in LBC.
PURPOSE: There is increasing recognition that gender norms affect adolescent health and well-being. This study explores the consistency of adolescents' gender norm perceptions across different dimensions (roles, traits, relations) and describes how the patterns of these perceptions vary across four culturally different settings. METHODS: The study includes 8,977 adolescents aged 10-14 years from Kinshasa, Shanghai, Cuenca, and Indonesia. Three gender norm scales were examined: sexual double standard, gender stereotypical traits, and stereotypical roles. We investigated patterns of gender norms across dimensions (roles, traits, and relations) and compared results between sites. We also examined how adolescents' individual responses across the scales compared with average responses in their site, to assess the consistency of their gender views. RESULTS: Patterns of gender norms varied across sites, reflected in different levels of endorsement of each gender norms scale, from least equal in Kinshasa to most equal in Shanghai, while greater variation of perspectives across gender dimensions was noted in Cuenca and Indonesia. Moving from a societal to an individual perspective, most adolescents in each site (62%-67%) held both more progressive and less progressive views compared with their average peer depending on the gender dimension. CONCLUSIONS: Our study demonstrates the coexistence of multiple gender worldviews that are assessed and enacted as per adolescents' experiences and social context. Accounting for such complexities is essential for gender-transformative programs, as shifting gender attitudes in one area does not necessarily translate in more gender equitable views across other spheres of life.
Caroline Moreau, Mengmeng Li, Saifuddin Ahmed et al.
PURPOSE: This study examined the prevalence of posttraumatic stress disorder (PTSD) symptoms among adolescents in mainland China under COVID-19. The direct effects of the perceived threat of COVID-19 and positive youth development (PYD) qualities, as well as the moderating effect of PYD qualities on PTSD symptoms, were studied. METHODS: Five schools in Chengdu, Sichuan, China, participated in this study. Two waves of data were collected before school lockdown (Wave 1, between December 2019 and January 2020) and after school resumption (Wave 2, between June 2020 and July 2020), respectively. A total of 4,981 adolescents aged above 11 years (Mean age = 13.15, SD = 1.32 at Wave 1, 51.5% girls) completed questionnaires at both waves. Students responded to measures of PYD qualities at both waves and perceived threat and PTSD symptoms at Wave 2. RESULTS: A total of 517 adolescents (10.4%) could be regarded as having PTSD. Results indicated significant unique main effects of perceived threat (β = .13, p < .001) and Wave 1 PYD qualities (β = -.16, p < .001) on PTSD symptoms. Besides, results showed a significant moderating effect of PYD qualities in mitigating the negative impact of perceived threat on PTSD symptoms. CONCLUSIONS: This study revealed the protective effect of PYD attributes in reducing the negative influence of traumatic situations such as COVID-19 on adolescent mental health. Results underscore the importance of promoting PYD qualities in adolescents in mainland China via effective PYD programs.
PURPOSE: This article explores differences between the current health status of adolescents and the targets set in Healthy China 2030 (HC2030). METHODS: Global and domestic policies and strategies relating to adolescent health were reviewed. Data from the Global Burden of Disease Study (1990-2016) and the Chinese National Survey on Students' Constitution and Health (1985-2014) were used to analyze time trends and geographical distributions of health indicators for adolescents aged 10-19 years in China. RESULTS: The Chinese government has released many health policies over the past 3 decades. In this context, there has been a major decline in all-cause mortality and stunting. However, gaps between the current health status of adolescents and the targets set in HC2030 were numerous. The prevalence of obesity and poor vision increased rapidly, and few adolescents meet the physical activity and fitness targets set in HC2030. Urban/rural differences were marked for some indicators such as obesity, whereas for other indicators (e.g., stunting), there remained notable differences across provinces. CONCLUSIONS: Many long-standing health problems of adolescents have improved, but new problems related to noncommunicable disease risks have emerged and should be a prominent focus for policy action under HC2030.
Importance: There is limited information describing the full spectrum of coronavirus disease 2019 (COVID-19) and the duration of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) RNA detection in children. Objective: To analyze the full clinical course and the duration of SARS-CoV-2 RNA detectability in children confirmed with COVID-19 in the Republic of Korea, where rigorous public health interventions have been implemented. Design, Setting, and Participants: This case series of children with COVID-19 was conducted in 20 hospitals and 2 nonhospital isolation facilities across the country from February 18, 2020, to March 31, 2020. Children younger than 19 years who had COVID-19 were included. Exposures: Confirmed COVID-19, detected via SARS-CoV-2 RNA in a combined nasopharyngeal and oropharyngeal swab or sputum by real-time reverse transcription-polymerase chain reaction. Main Outcomes and Measures: Clinical manifestations during the observation period, including the time and duration of symptom occurrence. The duration of SARS-CoV-2 RNA detection was also analyzed. Results: A total of 91 children with COVID-19 were included (median [range] age, 11 [0-18] years; 53 boys [58%]). Twenty children (22%) were asymptomatic during the entire observation period. Among 71 symptomatic cases, 47 children (66%) had unrecognized symptoms before diagnosis, 18 (25%) developed symptoms after diagnosis, and only 6 (9%) were diagnosed at the time of symptom onset. Twenty-two children (24%) had lower respiratory tract infections. The mean (SD) duration of the presence of SARS-CoV-2 RNA in upper respiratory samples was 17.6 (6.7) days. Virus RNA was detected for a mean (SD) of 14.1 (7.7) days in asymptomatic individuals. There was no difference in the duration of virus RNA detection between children with upper respiratory tract infections and lower respiratory tract infections (mean [SD], 18.7 [5.8] days vs 19.9 [5.6] days; P = .54). Fourteen children (15%) were treated with lopinavir-ritonavir and/or hydroxychloroquine. All recovered, without any fatal cases. Conclusions and Relevance: In this case series study, inapparent infections in children may have been associated with silent COVID-19 transmission in the community. Heightened surveillance using laboratory screening will allow detection in children with unrecognized SARS-CoV-2 infection.
An Effective Intervention at the Global Level?In most countries, attempts to reduce severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) circulation and new coronavirus disease 2019 (COVID-19) development have been mainly based on restrictive measures, including the avoidance of social interactions, the prohibition of movements within the national territory, and the closureofallnonessentialactivities,includingschools.While the closure of factories and the avoidance of other social interaction together with proper hand washing remain the best measures to reduce the total burden of COVID-19, the usefulness of school closure can be debated.It is highly likely that the most important reason leadinggovernmentstocloseschoolswastheevidencethatthe early introduction of this restrictive measure had been effective in reducing influenza incidence rates and related clinical,social,andeconomicproblemsduringbothseasonal and pandemic influenza outbreaks. 1However, it is not at all certain that the same advantages can be expected in the case of the COVID-19 pandemic.It is even possible that schoolclosuremayhavenegativeeffectsandleadtogreater medical, economic, and social problems.Modeling studies seem to indicate that school closure can be significantly effective for infection control only when the outbreaks are due to viruses with low transmissibility and attack rates are higher in children than in adults.This applies to influenza viruses and influenza infection but does not seem valid for coronaviruses,includingSARS-CoV-2,whichhavedifferent transmission dynamics, or for COVID-19, which affects mainlyadultsandelderlyindividuals.Ithasbeencalculated that the expected number of cases directly generated by 1 case of SARS-CoV-2 infection (R 0 ) is high and not lower than 2.5. 2 Moreover, children younger than 10 years account for only 1% of COVID-19 cases, 3 and although a certain number of them can experience an asymptomatic infection, the total number of children with SARS-CoV-2 infection seems lower than expected.Although no official data are available, to our knowledge, on the effectiveness of school closure during the COVID-19 epidemic, the poor relevance of this restrictive measure seems confirmed by the evidence that in Taiwan, the spread of COVID-19 was minimized without widespread planned school closures. 4n the other hand, using UK population and school data together with data on SARS-CoV-2 transmission dynamics calculated in the early COVID-19 pandemic in China, it was predicted that school closure would be insufficient to mitigatethepandemic.Finally,thepooreffectofschoolclosure during coronavirus epidemics has already been evidenced in some studies carried out during the SARS epidemic.In China,itwasfoundthatschoolclosurefor2monthswasnot significantlyeffectivefordiseasepreventionmainlybecause of the very low incidence of symptomatic disease among school-aged children. 5Moreover, in Taiwan, it was evidenced that the risk of transmission of infection among
by Sams Arefin There is a particular pride in handing a neighbour something you grew yourself. Morzina Bibi knows this well. She grew up with it, in Rakhine Province, where her family cultivated crops, raised cattle, and never once had to buy vegetables because everyone around them did the same. Food was not a transaction. It moved between houses as a matter of course, carried in baskets, given without ceremony. That life ended in the last months of 2016. When the threat of violence made staying impossible, Morzina and her husband Juhar crossed the Naf River into Bangladesh with a small amount of money and almost no certainty about what came next. Their extended family stayed behind, unconvinced. The couple came alone, with their neighbours, into a country that was not theirs. “We were afraid,” she says simply. “All the people around us were afraid. We discussed what we would do if something happened. My husband decided we would go.” Today, Morzina is 25 years old and lives in Camp 8 East with Juhar and their three children, aged 13, 10, and 5. Juhar earns what he can as a daily labourer at a market outside the camp. For years that was the only income. Then, in 2025, a World Vision volunteer visited their household. The visit was not about a garden. It began with Morzina’s second child, who was identified for case management support. Over weeks of follow-up and referral, the child recovered. But the visit opened something else. The volunteer told Morzina about the Positive Parenting Group sessions being run out of the Peacock Centre, a programme under the GFFO-funded JF-FS-&CPiE project. Once a week, for three months. “I was struggling to feed my children properly,” Morzina says. “I was deeply worried. I decided to attend.” Her husband encouraged her to go regularly and she did. “I did not know much before about childcare, the impact of love and affection, or nutritious food. I learned everything from World Vision. Showing love to children is very important. It helps them grow confidently.” The sessions covered topics like child protection, nutrition, hygiene, maternal care, and child marriage. They also covered gardening. That was the part that stayed with Morzina most. She had space around her shelter. She had grown things before. What she did not have, she thought, was viable soil. “I was afraid vegetables would not grow well here because of soil infertility and lack of water,” she says. “But through the sessions, I learned that if you maintain the area properly and water the plants regularly, it is possible. You can consume nutritious food and also sell what remains.” JF_FS&CPiE project provided her with a gardening kit: seeds of Bitter Gourd, Bottle Gourd, Indian Spinach, Yard Long Bean, Sweet Gourd, and Sponge Gourd, along with organic compost, vermicompost, a watering can and grow bags. Her daughter received a moringa sapling from the centre. She planted. She watered. The garden grew. By selling moringa pods and leaves alone, Morzina earns between 400 and 600 Taka. The vegetables from the rest of the garden go first to her family’s table. Whatever remains, she sells or shares. When World Vision provided a second round of seeds, she expanded the plot. She is now working on a larger, more systematic garden. She plans to collect seeds from this season’s harvest and preserve them for the next year, then share what she has with her neighbours. The food rations do not include leafy greens. The garden fills that gap. Her children eat fresh vegetables now, grown ten steps from where they sleep. “My nearby neighbours, especially women, come to me to learn how I grow vegetables and what techniques I use.” Morzina is now a volunteer with Mukti Cox’s Bazar and holds membership in the Positive Parents Group. The woman who came to Bangladesh with little money and no certainty is the one her neighbours now come to, asking about soil and season and technique. In Rakhine, she says, everyone grew their own food, no one needed to buy it. Vegetables moved between houses without ceremony. It was simply what people did. In Camp 8 East something like that is beginning again. This story was produced under the GFFO-funded JF-FS-&CPiE project implemented by World Vision Bangladesh. The post What the Soil Gives Back appeared first on Joining Forces.
Hassem, an adolescent living in Camp 17, Banglasdesh, has called the camp home since 2017. Despite the many challenges of displacement, he remained determined to continue his education and attended the Learning Center regularly. Like many children in the camp, he spent his free time studying, playing with friends, and dreaming of a brighter future. The Learning Center became more than a place of education—it was a safe space where he developed friendships, confidence, and hope. However, life in the refugee camp is marked by poverty and uncertainty. Many families struggle to meet their basic needs, and child labor has become a common negative mechanism. Under financial pressure, some parents believe that sending their children to work is the only way to support the household, often at the cost of their education and wellbeing. These decisions expose children to exploitation, deprive them of their right to learn, and limit their opportunities for a better future. Hassems’ journey toward becoming a child protection advocate began when Hassems became a participant in the Life Skills Programme under the Joining Forces for Food Security and Child Protection in Emergencies (JF-FS & CPiE) project, implemented by Bangladesh Institute of Theatre Arts (BITA), funded by the German Federal Foreign Office (GFFO) and supported by Plan International Bangladesh (PIB). Through regular Life Skills sessions, Hassems learned about child rights, child protection, the harmful consequences of child labor, communication and negotiation skills, leadership, positive decision-making, and community responsibility. More importantly, the sessions helped him understand that every child has a role in protecting other children and creating positive change within their community. One day, Hassam noticed that one of his closest friends had suddenly stopped attending the Learning Center. The friend who used to study, play, and spend time with him had disappeared from their daily routine. Worried about his friend’s wellbeing, Hassems decided to visit his home to understand what had happened. When Hassems visited his friend’s family, he learned that the boy had been forced to leave the Learning Center after repeated pressure from his father, who believed that earning money was more important than education. The child had started working long hours at a local tea stall instead of attending classes. Drawing on the confidence and communication skills he had developed through the Life Skills sessions, Hassems did not remain silent. He met with his friend’s father several times, patiently explaining the harmful effects of child labor, the importance of education, and every child’s right to grow up in a safe and protective environment. Rather than criticizing or blaming him, Hassems spoke respectfully and encouraged him to think about his son’s future. Gradually, these conversations changed the father’s perspective. Realizing the long-term consequences of his decision, he agreed to withdraw his son from work and support his return to education. Today, Hassems’ friend has successfully returned to the Learning Center, where he has resumed his education and reconnected with his classmates. Reflecting on his experience, Hassems said, “The Life Skills sessions taught me that protecting children is everyone’s responsibility. I couldn’t ignore my friend’s situation. I’m happy that he is back in the Learning Center and can continue his dream.” The positive impact extended beyond one child. Hassems’ actions helped change a father’s perception of child labor and demonstrated that education offers a stronger path toward a better future. Sharing his reflection, the boy’s father said, “Stopping my son’s education and forcing him to work was my biggest mistake. After talking with Hassems, I realized how harmful child labor is. I am grateful that my son is studying again.” The child who returned to school also expressed his gratitude, saying, “The days I worked instead of studying were the hardest days of my life. Thanks to Hassems, I am back in the Learning Center and with my friends again.” Hassems’ story is a powerful example of how empowering adolescents with knowledge, leadership skills, and confidence can create lasting change within their communities. His courage to speak up protected a fellow child from labor, restored a child’s right to education, and inspired others to take responsibility for safeguarding children. It demonstrates that when adolescents are equipped with the right skills and support, they can become influential child protection advocates and catalysts for positive change, helping build safer and more protective communities for every child. The post From Learning to Leadership: Hassem’ Stand Against Child Labor appeared first on Joining Forces.
