Background Characteristics of the Adolescents in Samoa.
We found the prevalence of serious injuries among in-school adolescents in Samoa to be 46.8% (see Figure 1). More (21.6%) male in-school adolescents in Samoa significantly experienced serious injuries. Moreso, an additional percentage of in-school adolescents who missed classes or school without permission (19.7%), mostly or always went hungry (6.7%), ever used amphetamine (5.0%), smoke marijuana (5.4%), currently consume alcohol (8.0%), ever got drunk after consuming alcohol (7.1%) and smokes cigarettes (7.6%) experienced serious injuries. Similarly, more in school adolescents who were physically attacked (13.3%), engaged in a physical fight (27.3%), bullied (21,.1%), mostly felt lonely (6.0%), worried about things they could not study (6.5%), had suicidal ideation (13.8%), planned to commit suicide (12.5%), attempted suicide (12.9%) and those who attend PE classes on five or more days significantly experienced serious injuries (see Table 2).
Distribution and Chi-Square analysis of Serious Injuries across Demographic, Psychological, Personal Attribute Factors, Drugs and Substance Use Factors, and Psychosocial Factors.
The Chi Square test demonstrates that, sex (χ2=53.65, p<0.000), missing class/school without permission (χ2=26.28, p < 0.000), mostly or always experiencing hunger (χ2=8.36, p<0.004), amphetamine use (χ2=24.30, p<0.000), marijuana use (χ2=27.80, p<0.000), current consumption of alcohol (χ2=24.34, p < 0.000), ever got drunk after consuming alcohol (χ2=26.12, p<0.000), Smoked cigarettes (χ2=33.52, p < 0.000), physically attacked (χ2=98.90, p<0.000), physical fight (χ2=142.44, p<0.000), bullied (χ2=70.48, p<0.000), loneliness (χ2=15.39, p<0.000), worry (χ2=19.41, p<0.000), suicidal ideation (χ2=22.40, p<0.000), suicide plan (χ2= 7.74, p<0.006), suicide attempt (χ2=29.62, p<0.000) and attending PE classes on five or more days (χ2=5.83, p<0.016) (See table 2).
Table 2: Bivariate analysis of injuries among adolescents of school-going age in Samoa (n=1779)
Variables
|
|
Serious injuries
|
Chi-square (χ2)
|
φc
|
|
|
Injuries (%)
|
No injuries (%)
|
|
|
Demographic
|
|
|
|
|
|
Age (years)
|
13-15
|
44(25%)
|
515(28.9%)
|
0.19
|
-0.010
|
≥16
|
388(21.8%)
|
431(24.2%)
|
|
Sex
|
Male
|
384(21.6%)
|
277(15.6%)
|
53.65***
|
|
Female
|
449(25.2%)
|
669((37.6%)
|
|
Grade
|
Grade 8-10
|
459(25.8%)
|
504(28.3%)
|
0.594
|
0.441
|
Grade 11-13
|
374(21.0%)
|
442(24.8%)
|
|
Personal
|
|
|
|
|
|
Truancy
|
Yes
|
350(19.7%)
|
287(16.1%)
|
26.28***
|
0.122
|
No
|
483(27.2%)
|
659(37.0%)
|
|
|
Hunger
|
Yes
|
120(6.7%)
|
94(5.3%)
|
8.36**
|
0.069
|
|
No
|
713(40.1%)
|
852(47.9%)
|
|
|
Drugs and substance use
|
|
|
|
|
Amphetamine use
|
Yes
|
89(5.0%)
|
43(2.4%)
|
24.30***
|
|
No
|
744(41.8%)
|
903(50.8%)
|
|
|
Marijuana use
|
Yes
|
96(5.4%)
|
45(2.5%)
|
27.80***
|
0.125
|
No
|
737(41.4%)
|
901(50.6%)
|
|
|
Current consumption of Alcohol
|
Yes
|
142(8.0%)
|
87(4.9%)
|
24.34***
|
|
No
|
691(38.8%)
|
859(48.3%)
|
|
|
Ever got drunk after consuming alcohol
|
Yes
|
126(7.1%)
|
71(4.0%)
|
26.12***
|
0.121
|
No
|
707(39.7%)
|
875(49.2%)
|
|
|
Smoke cigarettes
|
Yes
|
136(7.6%)
|
71(4.0%)
|
33.52***
|
0.137
|
No
|
697(39.2%)
|
875(49.2%)
|
|
|
Psychosocial
|
|
|
|
|
|
Physically attacked
|
Yes
|
237(13.3%)
|
95(5.3%)
|
98.90***
|
0.236
|
No
|
596(33.5%)
|
851(47.8%)
|
|
|
Physical fight
|
Yes
|
485(27.3%)
|
285(16.0%)
|
142.44***
|
0.283
|
No
|
348(19.6%)
|
661(37.2%)
|
|
|
Bullied
|
Yes
|
376(21,.1%)
|
247(13.9%)
|
70.48***
|
0.199
|
No
|
457(25.7%)
|
699(39.3%)
|
|
|
Loneliness
|
Yes
|
106(6.0%)
|
68(3.8%)
|
15.39***
|
0.093
|
|
No
|
727(40.9%)
|
878(49.4%)
|
|
|
Worry
|
Yes
|
116(6.5%)
|
71(4.0%)
|
19.41***
|
0.104
|
|
No
|
717(40.3%)
|
875(49.2%)
|
|
|
Suicidal ideation
|
Yes
|
246(13.8%)
|
188(10.6%)
|
22.40***
|
0.112
|
No
|
587(33.0%)
|
758(42.6%)
|
|
|
Suicide plan
|
Yes
|
223(12.5%)
|
200(11.2%)
|
7.74**
|
0.066
|
No
|
610(34.3%)
|
746(41.9%)
|
|
|
Suicide attempt
|
Yes
|
230(12.9%)
|
160(9.0%)
|
29.62***
|
0.129
|
No
|
603(33.9%)
|
786(44.2%)
|
|
|
Attending PE classes on ≥5 days
|
Yes
|
160 (9.0%)
|
141(7.9%)
|
5.83*
|
0.057
|
|
No
|
673(37.8%)
|
805(45.3%)
|
|
|
Note. ∗p < 0.05, ∗∗p < 0.01, ∗∗∗p < 0.001.
The binomial logistic regression analysis results on the factors associated with serious injuries among adolescents in Samoa show that being a male (AOR=1.601, 95%CI=1.292-1.985), experiencing physical attack (AOR=2.210, 95% CI=1.662-2.940), engaging in a physical fight (AOR=2.270, 95%CI=1.839-2.803) and bullied (AOR=1.594, 95% CI=1.277-1.990) (Table 3).
Table 3. Relationship between the significant variables and serious injuries among adolescents in Samoa.
|
B
|
Wald test (z-ratio)
|
Adjusted Odds Ratio
|
95% confidence interval for odds ratio
|
Lower
|
Upper
|
Demographic
|
|
|
|
|
|
Sex (male)
|
0.471***
|
18.446
|
1.601
|
1.292
|
1.985
|
Personal
|
|
|
|
|
|
Truancy
|
.194
|
3.036
|
1.214
|
.976
|
1.509
|
Hunger
|
0.292
|
3.259
|
1.339
|
.975
|
1.837
|
Substance use and abuse
|
|
|
|
|
Marijuana smoking
|
.081
|
.111
|
1.084
|
.674
|
1.745
|
Current smoking of cigarettes
|
.241
|
1.649
|
1.273
|
.881
|
1.840
|
Amphetamine use
|
.120
|
.242
|
1.127
|
.700
|
1.816
|
Alcohol
|
.071
|
.133
|
1.073
|
.734
|
1.568
|
Ever got drunk after consuming alcohol
|
.208
|
1.039
|
1.232
|
.825
|
1.839
|
Psychosocial
|
|
|
|
|
|
Physically attacked
|
.793***
|
29.687
|
2.210
|
1.662
|
2.940
|
Physical fight
|
.820***
|
58.140
|
2.270
|
1.839
|
2.803
|
Bullied
|
.466***
|
16.934
|
1.594
|
1.277
|
1.990
|
Loneliness
|
.236
|
1.622
|
1.267
|
.880
|
1.822
|
Worry
|
.296
|
2.664
|
1.344
|
.942
|
1.917
|
Suicidal ideation
|
.230
|
1.883
|
1.259
|
.906
|
1.748
|
Suicidal plan
|
-.258
|
2.339
|
.773
|
.556
|
1.075
|
Suicidal attempt
|
.222
|
1.842
|
1.249
|
.906
|
1.723
|
Attending physical education classes on ≥5 days
|
.186
|
1.785
|
1.205
|
.917
|
1.584
|
Close friends
|
-.218
|
1.379
|
.804
|
.558
|
1.157
|
(Constant)
|
-7.411
|
81.306
|
.001
|
|
|
Note. ∗p < 0.05, ∗∗p < 0.01, ∗∗∗p < 0.001; Hosmer and Lemeshow test (goodness of fit), χ2 (8) =12822.576, p= 0.000