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StudentsStudents’’ Health Health Survey 2006Survey 2006
Highlights Of Highlights Of Findings Among Findings Among
Secondary StudentsSecondary Students
Health Promotion Board, Singapore
www.hpb.gov.sg
Objectives of StudyObjectives of Study
• To assess the following health behaviours and health risk among Sec 1-4 students:
– Cigarette smoking
– Nutrition
– Physical activity
– Sexual practices
– Mental health
• To explore determinants of health risk behaviours
MethodologyMethodology
• Study cleared by HPB Ethics Committee
• Random selection of 3844 students from Sec 1-4 across 51 secondary schools selected by MOE
• 1907 students in Sec 3-4 answered questions with regard to sexual behaviour
MethodologyMethodology
• Letters were sent to parents
of selected students who
were given a choice to opt
their children out of the
study
• Self-administered
questionnaire conducted at
the schools
Outline of PresentationOutline of Presentation
• Profile of students
• Prevalence of health behaviours/risks
– Smoking
– Sexual practices
– Dietary practices
– Physical activity
– Mental health
• Comparisons
– Gender
– Academic level
– Relevant determinants (social influences, perception of health behaviours etc)
Distribution of participantsDistribution of participants-- By gender & ethnicityBy gender & ethnicity
52.7%47.3%
Male
Female1.8%
22.4%68.1%
7.7%
Chinese
Malay
Indian Others
SmokingSmokingSmoking
26%
11%
2%
19%
9%
2%
0%
5%
10%
15%
20%
25%
30%
Ever tried smoking Smoke at least one day
in the past 30 days
Smoke everyday in the
past 30 days
GYTS SHS
Cigarette Smoking rates Cigarette Smoking rates
((GYTS 2000 and SHS 2006)GYTS 2000 and SHS 2006)
GYTS: Global Youth Tobacco Survey (2000)
SHS: Student Health Survey (2006)
17%
6%
1%
22%
11%
2%
0%
5%
10%
15%
20%
25%
Ever tried smoking* Smoke at least one day in
the past 30 days*
Smoke everyday in the
past 30 days*
Female Male
Student Health Survey Student Health Survey (SHS)(SHS)
Cigarette Smoking Cigarette Smoking By genderBy gender
*p<0.001
26%
12%
3%
13%
5%
1%
0%
5%
10%
15%
20%
25%
30%
Ever tried smoking* Smoke at least one day in
the past 30 days*
Smoke everyday in the past
30 days*
Upper Secondary Lower Secondary
Cigarette SmokingCigarette SmokingBy academic levelBy academic level
Lower Secondary students: Secondary 1 to 2, Upper Secondary students: Secondary 3 to 4
*p<0.001
Cigarette SmokingCigarette SmokingAge of initiationAge of initiation
12 yearsCurrent Smokers
(Smoke at least one day in
the past 30 days)
Median age of initiation
Social Influence on Smoking StatusSocial Influence on Smoking Status
95%
59%
44%42%
34%
11%
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
Close friends are
smokers*
At least one parent is
a smoker*
Siblings are smokers*
Current smokers Non-current smokers
Current Smokers: Those who smoked at least 1 day in the past 30 days
*p<0.001
Perception of SmokingPerception of SmokingBy smoking statusBy smoking status
71%
19% 17%
53%
86%*
69%*
6%*
65%*
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
"I can stop
smoking anytime I
want to"
"Smoking is not
harmful to my
health"
"Smoking is a very
wrong behaviour
for someone my
age"
"Parents think that
smoking is a very
wrong behaviour"
Non-current smokers Current smokers
Current smokers: Those who smoked at least 1 day in the past 30 days
*p<0.001
Sexual BehaviourSexual Sexual BehaviourBehaviour
Sexual Sexual behaviourbehaviourAmong Sec 3Among Sec 3--4 students4 students
15 yearsMedian age of initiation
4%Prevalence of sexual intercourse
- No gender differences in sexual intercourse
11%
15% 15%
9%
13% 13%
24%
0%
5%
10%
15%
20%
25%
30%
0 1 2 3 4 5 More
than 5Number of times
Frequency of sexual intercourse in the past Frequency of sexual intercourse in the past
12 months12 months Among Sec 3 Among Sec 3 -- 4 students4 students
*p<0.001
Top 3 Top 3 rreasons for Engaging in Sexual Intercourseeasons for Engaging in Sexual IntercourseAmong Sec 3Among Sec 3--4 Students4 Students
62%
57%
49%
0%
10%
20%
30%
40%
50%
60%
70%
It just happened It felt good I was curious
Main reasons for Not Engaging in Sexual Main reasons for Not Engaging in Sexual BehaviourBehaviourAmong Sec 3Among Sec 3--4 Students4 Students
73%
69%
64%
63% 63%
58%
60%
62%
64%
66%
68%
70%
72%
74%
I want to avoid
sexually
transmitted
diseases (STDs)
or AIDs
I want to avoid
unwanted
pregnancies
I am too young for
sexual activities
I do not want to
upset my family
I do not want to
engage in any
sexual activity
before marriage
NutritionNutritionNutrition
Important Food GroupsImportant Food Groups
Comparison of Knowledge and intake of Fruit and Comparison of Knowledge and intake of Fruit and
VegetablesVegetablesSec 1Sec 1--4 Students (SHS) 4 Students (SHS) vsvs Adult SingaporeansAdult Singaporeans
70%
44%*
19%^24%
0%
10%
20%
30%
40%
50%
60%
70%
80%
Students Health Survey Comparison with adult Singaporeans
Aware of recommended intake of 2 servings of fruit and 2 servings of vegetables daily
Eat 2 servings of fruit and 2 servings of vegetables daily
*Evaluation of National Healthy Lifestyle Campaign 2004, 30-70 yrs old
^National Nutrition Survey 2004; 18-29 yrs
77%80%
77% 79%
68%71%
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
Male Female*
Aware that a person should consume at least 2 servings of fruit a day
Aware that a person should consume at least 2 servings of vegetables a day
Aware that a person should consume at least 2 servings of fruit and 2 servings ofvegetables a day
Awareness of the Healthy Pyramid Guidelines for Fruit Awareness of the Healthy Pyramid Guidelines for Fruit
and Vegetables Consumption and Vegetables Consumption By Gender (Student Health Survey)By Gender (Student Health Survey)
*p<0.001
SelfSelf--reported Consumption of Recommended Amounts reported Consumption of Recommended Amounts
of Fruit and Vegetables of Fruit and Vegetables By GenderBy Gender
41%39%
48%44%
26%23%
0%
10%
20%
30%
40%
50%
60%
Male Female*
Eat at least 2 servings of fruit a day
Eat at least 2 servings of vegetables a day
Eat at least 2 servings of fruit and 2 servings of vegetables a day
*p<0.001
Meet the 2 +2 Fruits and Meet the 2 +2 Fruits and VegsVegs
Guideline Guideline By academic levelBy academic level
27%
22%24%
0%
5%
10%
15%
20%
25%
30%
Lower secondary Upper secondary All
*p<0.001
Consumption of the Recommended Amounts of Fruit Consumption of the Recommended Amounts of Fruit
and Vegetables and Vegetables By Awareness of the Recommended Intake GuidelinesBy Awareness of the Recommended Intake Guidelines
11%
30%
0%
5%
10%
15%
20%
25%
30%
35%
Not aware of recommended servings Aware of recommended servings*
Eats at least 2 servings of fruit and 2 servings of vegetables a day
*p<0.001
Consumption of Sweetened DrinksConsumption of Sweetened DrinksMore than once a dayMore than once a day
31%
26%
29%
28%
23%
24%
25%
26%
27%
28%
29%
30%
31%
Male Female* All students Adults NNS (18-
29 yrs)
NNS National Nutrition Survey (2004)
*p<0.001
Consumption of Milk / Milk ProductsConsumption of Milk / Milk ProductsAt least once a dayAt least once a day
43%
39%
41%
37%
38%
39%
40%
41%
42%
43%
Male Female* All students
*p<0.001
Consumption of Deep Fried FoodConsumption of Deep Fried FoodMore than twice a weekMore than twice a week
57%
47%
52%52%
0%
10%
20%
30%
40%
50%
60%
Male Female* All students Adults NNS (18-
29yrs)
*p<0.001
NNS National Nutrition Survey 2004
Physical ActivityPhysical ActivityPhysical Activity
Physical Activity Level Physical Activity Level Vigorous Physical ActivityVigorous Physical Activity
• † Vigorous physical activity is defined as any activity
that take hard physical effort and make a person
breathe much harder than normal.
• Examples of vigorous physical activities listed in this
questionnaire include heavy lifting, aerobics,
running, fast bicycling, taekwondo, judo, football,
basketball, squash, skipping, moving and pushing
heavy furniture.
Physical Activity Level Physical Activity Level Moderate Physical ActivityModerate Physical Activity
• †† Moderate physical activity is defined as activities those that take moderate physical effort and make a person breathe somewhat harder than normal.
• Examples of moderate physical activities include carrying light loads, bicycling at a regular pace, doubles tennis, gymnastics, badminton, table tennis, skateboarding, inline skating at a leisure pace, and moving light furniture.
Question adapted from the US Youth Risk Behavioural Surveillance Survey
Physical Activity Level Physical Activity Level By genderBy gender
18%
6%
12%13%
7%
10%
26%
11%
19%
0%
5%
10%
15%
20%
25%
30%
Male Female* All students
Engage in †vigorous activity for at least 30 mins/day for 5 or more days per week
Engage in ††moderate activity for at least 30 mins/day for 5 or more days per week
Engage in †vigorous or ††moderate activity for 30 mins/ day for 5 or more days per week
*p<0.001
Physical Activity Level Physical Activity Level By academic levelBy academic level
13%
11%12%
10%11%
10%
20%
18%19%
0%
5%
10%
15%
20%
25%
Lower secondary Upper secondary* All students
Engage in †vigorous activity for 30 mins each, 5 or more days per week
Engage in ††moderate activity for 30 mins each, 5 or more days per week
Engage in †vigorous or ††moderate activity for 30 mins each, 5 or more days per week
*p<0.001
47%
41%37%
67%
56%
31%
51%
44%
36%
0%
10%
20%
30%
40%
50%
60%
70%
80%
I am usually pretty good at
sports
My close friends exercise
regularly
It is often too hot to exercise
in Singapore
Did not engage in moderate† or vigorous†† activity for 30 minutes each, 5 or more days per week
Engaged in moderate† or vigorous†† activity for 30 minutes each, 5 or more days per week*
All Students
Factors associated with Engaging in Factors associated with Engaging in
Physical ActivityPhysical Activity
*p<0.001
Comparison of proportion of students engaging in Comparison of proportion of students engaging in
Physical Activity Physical Activity Sec 1Sec 1--4 Students (SHS) 4 Students (SHS) vsvs Adult Singaporeans Adult Singaporeans
19.0%
34.0%
29.7%
8.0%
0.0%
5.0%
10.0%
15.0%
20.0%
25.0%
30.0%
35.0%
40.0%
Students Health Survey Comparison with adult Singaporeans ^
Physically active Physically inactive
^National Health Survey 2004;18-69 yrs
Mental HealthMental HealthMental Health
71%
56%
51%
42% 41%
0%
10%
20%
30%
40%
50%
60%
70%
80%
Listen to
music
Watch TV Play
computer
games
Surf
internet
Talk to
someone
about it
Coping Strategies with StressCoping Strategies with Stress
SummarySummary
• Importance of social influences and
misconceptions in smoking
behaviour
• Teaching lifeskills with regard to
sexual practices
• Translation of awareness of healthy
diet (eg 2+2 fruits and vegs etc) into
consumption behaviour
• Building skills in physical activity and
promoting a supportive environment
for physical activity
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