Young People's Health: Challenges for Education and Intervention by Today's CAROLINIAN

Young Peopleâ&#x20AC;&#x2122;s Health: Challenges for Education and Intervention

Fiscalina Amadora-Nolasco Elmira Judy T. Aguilar Zona Hildegarde S. Amper

UNIVERSITY OF SAN CARLOS PRESS

Young People’s Health: Challenges for Education and Intervention

Edited by Fiscalina Amadora−Nolasco Elmira Judy T. Aguilar Zona Hildegarde S. Amper

UNIVERSITY OF SAN CARLOS PRESS Cebu City, Philippines 2012

Young people’s health: Challenges for education and intervention Edited by: Fiscalina Amadora−Nolasco Elmira Judy T. Aguilar Zona Hildegarde S. Amper Copyright © 2012 University of San Carlos Press All rights reserved. No part of this publication may be reproduced or used in any form or by any means whether graphic, electronic, or mechanical, including photocopying, recording, taping or through other digitized information storage and retrieval systems without the written permission of the publisher. Co-Published by: University of San Carlos Press Arthur Dingman Bldg., Main Campus P. del Rosario Street, Cebu City, 6000 Philippines Telefax: +63 32 2531000 loc. 175 www.usc.edu.ph and University of San Carlos - College of Arts and Sciences Philip van Engelen Bldg., Talamban Campus Nasipit, Talamban, Cebu City, 6000 Philippines Telefax: 63 32 345-1518 The National Library of the Philippines CIP Data Recommended entry: Young people’s health : challenges for education and intervention / edited by Fiscalina Amadora−Nolasco, Elmira Judy T. Aguilar, Zona Hildegarde S. Amper. -- Cebu City : University of San Carlos Press, c2012. p. ; cm. ISBN 978-971-539-035-4 1. Youth--Health and hygiene. 2. Youth--Health and hygiene-Research--Philippines--Cebu. 3. Youth--Social conditions. 4. Health behavior in adolescence--Philippines--Cebu. I. Nolasco, Fiscalina Amadora- II. Aguilar, Elmira Judy T. III. Amper, Zona Hildegarde S. RA777

613.0433

Illustrations: Ivy Marie Apa Copy editor: Rene’ E. Alburo

2012

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Preface This monograph is about understanding the dynamics of young people’s life and the broad range of issues occurring in the home, school, and workplace to allow for identification of potential areas for policy formulation and school-based intervention and research. It may not be an exhaustive study on health–related experiences but is a step towards appreciating what young people think and developing a comprehensive school-based intervention to address the multidimensional risks they face. Findings from this study suggest a need for collective action given the crucial role of the family, school, peers, media, and religion in values formation. The study is relevant, meaningful and timely not only because there is a paucity of literature on young people’s health in the Province of Cebu (or, Region VII) but also because it addresses the need for multidisciplinarity and the urgency to contribute to efforts toward developing a supportive environment for young people. The choice of USC students for this study is particularly interesting given the heterogeneity of its student population and the wide range of socio-economic and geographic representation. The USC Young People’s Health project obtained counterpart funding from the Commission on Population, Region VII (POPCOM7) and the Philippine Council for Health Research & Development (PCHRD) through the Central Visayas Consortium for Health Research & Development (CVCHRD). The research was first conceptualized by the College of Arts and Sciences - Social Science Research Center and the Department of Anthropology, Sociology and History. We sincerely appreciate the involvement of our collaborating partners from the Departments of Political Science, Philosophy and Religious Studies, Economics, Psychology, and the Office of Population Studies Foundation. The monograph consists of 11 chapters: Chapter 1 provides an overview of the research design, some background information on young people and health, and the policy implications of the study. Chapter 2 presents the profile of the survey population. It discusses both positive and socially-risky activities engaged in by young people, and how they develop and strengthen interpersonal relationship with peers. iii

Chapter 3 describes the school and work environments and experiences of young people. Perceived relationship with teachers and peers, perceived performance in school (or, at work), and plans for future education and employment are also explored. Chapter 4 explores how young people look after themselves. It discusses whether diet, exercise and sleeping patterns are associated with certain socio-demographic characteristics. Chapter 5 provides a glimpse into the home environment and family relationships of young people. Chapter 6 highlights young people’s involvement in spiritual activities such as Bible reading, praying, going to mass and joining religious organizations. Chapter 7 explores the smoking, drinking and drug use behaviors of young people and explains these behaviors in light of sociological theories. Chapter 8 endeavors to identify young people’s sexuality-related and sexual experiences, including abortion and contraceptive use. Their knowledge of sexually transmitted infections such as HIV and AIDS is also presented. Chapter 9 employs a psychological perspective and multivariate analysis to determine situations that could make young people vulnerable to selfharm attempts. Chapter 10 revisits the sexual and non-sexual risk-taking behaviors of young people and puts together discussions made for these behaviors. Emphasis is also given to the discussion of young people’s coping mechanisms and social support networks. Chapter 11 focuses on young people’s utilization of services at the USC, their level of satisfaction and their recommendations to improve healthcare services.

Acknowledgment Funding Agencies

Commission on Population, Region VII Tomas M. Osias - Executive Director Atty Bruce N. Ragas - Regional Director Philippine Council for Health Research & Development, through the Central Visayas Consortium on Health Research & Development, Department of Science and Technology, Region VII

USC Administrators

Danilo B. Largo, Ph.D., Director, Office of Research Ramon S. del Fierro, Ph.D., Dean, College of Arts and Sciences

Interviewers

Marie Therese Abuan Heddie Aiza Baclayo Punky Bacon Yanessa Shannen Tormis Maria Diana Mejia Mariejo Sevilla Chelonae Damayo Marlouize Villanueva Pedro Gumera Candice Ca単ete Kimberly Gacayan Hannah Obispo Kris Cane

Field and Office Support Staff Brenette L. Abrenica Chalemae O. Mi単oza Jessa Mae B. Lozano

University of San Carlos Research Contribution No. 20111015

About the editors Fiscalina Amadora-Nolasco is Professor of Anthropology and Graduate Program Coordinator in the Department of Anthropology, Sociology and History, and currently Coordinator of the Social Science Research Center. She served as Project Leader of the Young People’s Health Project. Her research interests include women and health, HIV and AIDS, environment and water, and adolescent sexuality and health. Elmira Judy T. Aguilar is Professor of Anthropology in the Department of Anthropology, Sociology and History. She obtained her Masters in Health Social Science degree at the De La Salle University, and her Ph.D. degree in Anthropology at the USC. Over the past 15 years, Dr. Aguilar’s research interests have revolved around gender, sexuality and adolescent sexuality and reproductive health. Zona Hildegarde S. Amper is Assistant Professor in the Department of Anthropology, Sociology and History. She earned her Master’s degree in Public Administration at the Cebu Normal University, and her M. A. in Anthropology degree at the USC. Her research specialization includes anthropology of development, indigenous knowledge and heritage conservation.

About the contributors Lauren V. Ligaton is an AB Sociology and Master of Sociology graduate at the USC. Since 2010, he teaches basic sociology courses at the Department of Anthropology, Sociology and History and has been involved in several of the research undertakings of the Social Science Research Center since 1993, including adolescent sexuality and health projects. Rey Uzhmar C. Padit is a full-time faculty of the Department of Economics, School of Business and Economics. He teaches introductory courses in economics. His areas of interest include political and institutional economics, and economics education. Sonny S. Agustin works as a junior research associate for the University of San Carlos Office of Population Studies Foundation Inc. (USC-OPSF) and a part-time lecturer at the USC Department of Anthropology, Sociology and History. He has a Master’s degree in Demography from the

University of the Philippines-Diliman, and presently specializes in conducting health and nutrition-related researches for the USC-OPSF. Leny G. Ocasiones is currently Assistant Professor in the Department of Anthropology, Sociology and History. She obtained her M. A. and Ph.D. in Anthropology at the USC. Her research specialization includes women in prostitution, women and armed conflict, reproductive health, and environmental health. Br. Romualdo E. Abulad, SVD is currently Chair of the Department of Philosophy and Religious Studies, and Editor to the USC Graduate Journal. His area of expertise is on Christology. He obtained his Ph.D. in Philosophy at the University of Sto. Tomas and M.A. in Theology at the Divine Word Seminary in Tagaytay. Dr. Abulad is also a former Fellow of the Alexander von Humboldt-Stiftung, Germany. Fr. Aleksander Gaut, SVD is currently Chair of the Department of Anthropology, Sociology and History. He finished his M.A. in Theology at the Divine Word School of Theology, and M.A. in Sociology and Ph.D. in Community Development at the University of the Philippines-Los Baños. Dr. Gaut’s areas of interest include poverty, social exclusion, child trafficking and women’s rights. Ruby D. Ilustrisimo is a faculty of the Department of Psychology, University of San Carlos. She graduated from the University of the Philippines-Visayas Cebu College with a BA in Psychology, and an MSc in Educational Studies from the University of Glasgow.

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Table of Contents Page iii v vi

Preface Acknowledgment About the editors and contributors

Chapter 1.

Young people: What else do we need to know?

Young people’s activities and social relationships

Education and employment: The Carolinian experience

Managing student bodies: Eating, exercise and sleeping patterns among Carolinians

The family: Facing challenges amid a changing environment

Spirituality of the Carolinian student today

Smoking, alcohol intake and drug use among young people at USC

Fiscalina Amadora-Nolasco Lauren V. Ligaton

Rey Uzhmar C. Padit 4.

Sonny S. Agustin

Leny G. Ocasiones

Romualdo E. Abulad, SVD

Aleksander Gaut, SVD 8.

Young people’s sexual vulnerabilities: The uncomfortable truth

Elmira Judy T. Aguilar

Deliberate self- harm and negative affect: Experiences of young people at USC

108

Revisiting young people’s health challenges: Examining social support networks

118

Health and services: Exploring gaps, building a supportive environment for young people

139

Ruby D. Ilustrisimo

10.

Zona Hildegarde S. Amper 11.

Fiscalina Amadora-Nolasco

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Young people: What else do we need to know? Fiscalina Amadora-Nolasco

Department of Anthropology, Sociology and History This monograph, entitled “Young people’s health: Challenges for education and intervention,” pays attention to young people’s health challenges and brings together findings and recommendations from the Young People’s Health Project conducted by the Department of Anthropology, Sociology and History in partnership with the Social Science Research Center (SSRC), College of Arts and Sciences, University of San Carlos. The undertaking, which was carried out from March to October 2011, obtained counterpart funding from the Commission on Population, Region VII (POPCOM7) and the Philippine Council for Health Research & Development through the Central Visayas Consortium for Health Research & Development, Department of Science and Technology, Region VII (DOST7).

Why do we need to understand the life circumstances, the healthcompromising behaviors of young people? Why do we need to re-examine the dynamics of young people’s social life? Why do parents, teachers and university-based service support units need to take proactive roles in promoting health and the well-being of young people? These are among the questions the current undertaking seeks to address. “Young People’s Health: Challenges for Education and Intervention” is USC’s contribution to POPCOM7 and PCHRD-CVCHRD in the formulation of young people-responsive policies and programs in the Region as well as to government efforts in achieving the Millennium Development Goals by 2015. An added value of this undertaking is the cognizance of responsible parenthood in various dimensions. It examines young people’s home and school environments, and sexual and non-sexual health issues. It is presumed that these factors influence young people’s decisions and choices which, in effect impinge on their physical, social, spiritual and psychological well-being. A young person’s awareness, experiences and life choices, for instance, will help shape future life events as he/she continues to encounter certain crossroads in life such as the decision to become a parent.

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Young peopleâ&#x20AC;&#x2122;s health: Challenges for education and intervention

The goal here is to provide a summary of challenges faced by young people. Valuable lessons can be used as guides for developing a framework and crafting recommendations for education, university-based interventions, and future research. It is imperative that steps are taken to better protect them from health risks. While there is a large body of national and global data concerning young people and health, the Province of Cebu has a paucity of these. Much has been written about their sexual vulnerabilities but few studies have focused on non-sexual risk behaviors such as smoking, drinking, drug use, suicide and violence, and how these may be interlinked. Further, little is known about the home and school environments and the spiritual life of young people. A domain in this study which has not been thoroughly explored by others is spirituality. USC, being a Catholic University, promotes spiritual growth among its studentry and acknowledges the religious practices of those who are not Roman Catholics. A chapter in this monograph will present how spirituality is manifested in young peopleâ&#x20AC;&#x2122;s involvement in spiritual activities such as Bible reading, church attendance and other faith-related practices. Young people have a subculture of their own. They have a set of beliefs, attitudes, practices, life expectations and decisions which are different from adults. Their views and behaviors are therefore understandable only within their social and cultural context. It is thus crucial that they be given the chance to express their views on matters concerning their wellbeing. Early intervention and gender-specific health education are of great importance considering that risk-taking behaviors are central to the onset of health issues they come across. Involvement in a risk-taking behavior among this group is, to some extent, a way to escape from unhappy situations either in the home, school or community. Given their multiple-problem behaviors, the numerous challenges they face in contemporary society especially at a crucial stage of their development, young people need an enabling and a listening environment that allows them to make sound decisions and life choices. The academe is therefore duty-bound to complement government and civil society initiatives in achieving a healthy society for everyone. This monograph can be used as part of USCâ&#x20AC;&#x2122;s support learning materials to effectively reach out to young people. Service support units of other universities in Cebu can also use the results to appreciate the subculture of young people as a step towards understanding why they behave the

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way they do and how the broad range of issues that confront them are interrelated. Such appreciation can lead to rethinking strategies and assessing the type and quality of services they offer. Objectives The Young People’s Health Project aims to assess USC young people’s psychosocial, behavioral and lifestyle background, and determine the factors associated with their health (i.e. physical, sexual, mental, social, psychological and spiritual). In this study, “young people” refers to any male and female student who is enrolled at the USC (Academic Year 2010-2011) in seven of its Colleges, namely: Commerce, Pharmacy, Architecture and Fine Arts, Arts and Sciences, Education, Engineering and Nursing. [It was only in AY 2011-2012 when college compositions were changed (e.g. School of Business and Economics, School of Health Care Professions, and School of Law and Governance). In this monograph, the previous setup is used.] Emphasis is placed on situating and determining young people’s experiences in the following domains: (i) home environment; (ii) education, employment, eating and exercise; (iii) activities and peer relationships; (iv) drugs, smoking and alcohol; (v) sexuality; (vi) suicide and depression; and (vii) spirituality. The domains are adapted from the HEADSSS Assessment Tool of Goldenring and Cohen (1988) for reasons of relevance and applicability proceeding on the assumption that major health problems encountered by young people are psychosocial. Questions crafted under each domain are limited but nonetheless embedded in the matrix of the local context. Specifically, the objectives include: 1. To obtain an insight into young people’s family life, actual situations obtaining in the home and inter-familial relationships; 2. To determine young people’s sense of belonging at school, relationships with teachers and peers and how these impact on academic performance as well as lifestyles in the campus; 3. To determine young people’s sense of belonging at work (for those who are working), relationships with workmates and changes in work performance;

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4. To describe how young people look after themselves including their eating and sleeping patterns; 5. To understand the dynamics surrounding young people’s social and interpersonal relationships; 6. To identify the factors or conditions that push or constrain young people to or from substance use, cigarette, and alcohol intake; 7. To determine young people’s knowledge, experience, sexual orientation, sexual practices, and risk-taking behaviors; 8. To identify situations or conditions that could make young people vulnerable to mental health problems as well as coping strategies and potential support mechanisms; 9. To determine young people’s attitudes toward religion vis-a-vis their actual religious practices and assess what gives them a sense of meaning; 10. To determine the factors associated with young people’s health and well-being; and 11. To gauge young people’s impressions regarding the health services offered by service support units at USC and other health-care providers outside of USC. In this study, a complex interplay of factors were assessed to determine how these might be associated with young people’s behaviors and interaction with family, peers, school and community. The assumption is that they experience various forms of health-compromising issues and pressures from other people which, if left unaddressed, could have serious implications on development, health policies, and programs. The challenge therefore is to give young people the opportunity to talk about what they think and how their health and well-being are promoted or undermined by their experiences and problems. Whether these are caused by situations obtaining in the home, at school, workplace (for those who are working), in the community, or by a lack of proper guidance, information and services is something which the succeeding sections will assess.

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The monograph will provide a model for similar studies that other colleges and universities in Cebu might want to pursue to capture significant similarities and differences in young people’s opinions, knowledge, attitudes, actual conditions and practices. It is envisioned that a study of this sort will lay the groundwork in building a more accommodating, supportive and non-discriminatory environment for young people to allow them to make healthier choices and act responsively on their decisions. The academe plays a significant role in national development but it is also aware that recommendations crafted must be evidence-based and supported by actual conditions and felt needs of the target population. Why the Young People at USC? The heterogeneity of USC’s student population is considered a suitable reason for choosing the institution for the pilot study. USC has a wide variety of students ranging from families of the middle and high income to low-income brackets. There are also many students at USC who are not from Cebu. While others come from various parts of the Visayas region, a considerable number of them are from Mindanao. Given this situation, it is believed that USC’s range of studentry will afford a wide selection of samples that will provide the study team with a balanced picture of the sub-culture of young people. USC is composed of four campuses: the Main Campus, Talamban Campus, North Campus, and the South Campus (see http://www. usc.edu.ph). In this study, however, no students were interviewed from the North Campus because it offers programs only for the pre-elementary, elementary and secondary levels. Figure 1 illustrates the locations of the three USC campuses where study participants were identified and interviewed. Literature Review Studies have shown that most problems faced by today’s youth are not necessarily of their own making. Many of them are “not being adequately reared by adults, not being adequately instructed in school, and not being adequately supported by society” (Santrock, 2001, p.491) or the community in which they live. School-based interventions have been proven to be as equally important as community-based efforts. Both initiatives entail the cooperation of parents, peers, service providers and support networks. The problem, however, is that most intervention responses for young people are designed by adults—perhaps the reason

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why such programs do not usually produce substantial impact on the target population. Young people know about what they want. What they need are a trusting relationship and a society that gives them the opportunity to learn from their experiences. Initiatives that involve young people in planning, implementation and evaluation have proven to create significant results. A case in point is the review on drug prevention conducted by Dryfoos in 1990 which reveals that peer-led programs, where older students are the leaders and role models for younger students, are often more effective than programs which are teacher-led or counselor-led. This is an indication that the youth can indeed take care of themselves, under proper guidance by adults. As Hawkins (1995) puts it, “young people must be treated as individuals who best know about what they want.” A study conducted by Aguilar and Nolasco (2009) also points to adolescents who say that their active involvement in HIV and AIDS-related activities in the community has brought about some positive change in their behaviors. These activities include, among others, small-group discussions, radio broadcasting, unveiling of billboards and posters, and other HIV and AIDS consciousness-raising initiatives. One of the pressing issues raised in the State of the Philippine Population Report entitled “Pinoy Youth: Making Choices, Building Voices” (Commission on Population, 2003) is that adults do not know how to communicate openly about sexuality with young people. Implied in this material is that there is need for parents and/or guardians to understand the life experiences of today’s youth and assess the consequences of decisions they make for them. The family, for instance, is the core for educating young people about sexuality but several studies have pointed out that this is rarely done within its confines as the topic is considered taboo (Alvarez, 1995). In 2002, Aguilar et al. raised various issues and recommendations in their study of young people in Cebu. As borne-out by the data, unwanted pregnancies, abortions, sexually-transmitted infections and diseases, and drug addiction are among the most pressing issues that confront many young people in Cebu, both in the university and in the upland and lowland communities. Whenever such problems occur, young people turn to their peers for help.

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The study also indicates that young people express a clear reluctance to discuss their problems with parents, and they see the school as the best venue for getting correct information. They believe that schools should provide the opportunity for interaction between teacher and students that is otherwise not possible with TV, radio, and the mass media in general. In this context, university administrators, service support units, local government officials, parents, and non-government organizations recognize the existence of health-compromising behaviours of young people, and they see the solutions as coming from the family, school and community. Barangay officials also see the need for policy advocacy and implementation of programs that directly accrue to the best interests of young people. One must also realize that young people are also engaged in non-sexual behaviors (e.g., smoking, drinking, drug use, suicide, violence) that put them at risk to problems leading to premature death, disability or chronic illnesses (Commission on Population, 2003). Both sexual and non-sexual risk behaviors have been proven to be interconnected and mutually reinforcing. The YAFS3 (UPPI/DRDF, 2002) also provides quantitative and qualitative data on many aspects of young peopleâ&#x20AC;&#x2122;s life which may be useful to initiatives that promote the welfare of the youth. More domainspecific literature reviews are presented in the succeeding sections. Methodology The study is descriptive in nature and employed three informationgathering methods (i.e. survey, key-informant interviews, and focus group discussions) to allow for cross-checking of data sources and provide depth towards discovering the range of important factors needed to fulfill the objectives of the study. While the survey was used to elicit quantifiable information related to the study domains, the KIIs and FGDs were employed to supplement data generated from the survey. Using the simple random sampling technique, a total survey sample of 699 (Table 1) was drawn from seven sampling frames--list of enrolled students in seven colleges, excluding the College of Law (currently the School of Law and Governance). Sixteen student-researchers were recruited and trained to form part of the team who administered the survey. One-on-one interviews were carried out at USC unless a participant requested that it be done outside the premises of the university. The students were interviewed individually after obtaining their consent to participate, and at a place where there is a neutral atmosphere (e.g. gym, quadrangle, â&#x20AC;&#x153;covered court,â&#x20AC;? canteen, library). Care was taken to ensure that interviews were done in an environment of

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respect and confidentiality. Replacements were sought for outright refusals, for students who had already graduated at the time of the interview, and those who were not enrolled during the Summer term. Table 1 Study sample by college (N=699). College

Percentage

Commerce

105

15.0

Pharmacy Architecture and Fine Arts Arts and Sciences

89 100 104

12.7 14.3 14.9

Education

13.7

Engineering

104

14.9

Nursing

101

14.4

699

100

Total

For the KII aspect of the study, three categories of participants were interviewed: (i) service providers; (ii) young people who admitted, in the survey and through referrals, to having experienced a “serious” health challenge (e.g. suicide, abortion, drugs, violence); and (iii) off-campus service providers, for a total of 16 informants. Owing to the sensitivity of the topics, KIIs were conducted only by trained faculty-researchers who have had extensive experience in qualitative research. Three guides that conformed to the general format that covers the study domains were developed for this method. To complement the two other methods, four FGD sessions were conducted, with five to 10 participants per session. While the first two sessions (i.e. 1 male group and 1 female group) were carried out to obtain an overview of the general perceptions and norms of young people on matters that relate to the study domains, the other two sessions (i.e. 1 male group and 1 female group) were done for those who have experienced serious health concerns. For representation purposes and to ensure that various perspectives are generated, utmost effort was exerted to ensure that the composition of participants is diverse. Each session was carried out by a trained facilitator (male for male sessions; female for female sessions), a documenter who took notes and recorded the entire conversation, and an observer. The proceedings hewed closely to two separate topic guides designed for the FGD. Names, if any, used in this monograph are pseudonyms to protect the participants’ privacy. For both KII and FGD, notes, observations and conversations were entered into a computer using a word processing A POPCOM-7 and PCHRD-CVCHRD-supported Project

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program. Prior to data analysis, word-for-word transcription of conversations in the local language and coding of significant findings related to identified themes were done. Quantitative data were analyzed using the SPSS software and are presented in the succeeding sections using simple frequency distributions. Cross-tabulations, whenever appropriate, of any two aspects were done to determine associations. In some instances, multivariate analysis of data was attempted. On the other hand, qualitative data were categorized according to type of participant and subsequently analyzed according to identified constants and themes. In compliance with ethical standards in social science research, participation in the study was voluntary and no names, specific addresses of students and other identifying information were collected or recorded. The nature, purpose and objectives of the study were presented, informed consent was obtained, and how their participation in the study can contribute to improving services for young people at USC was explained. In all three strategies that were employed, the willingness of students to participate in the study was given primary consideration. Limitations of the Study The results of this study are confined to the descriptions of USC young peopleâ&#x20AC;&#x2122;s psychosocial, behavioral and lifestyle background; the factors associated with their health and well-being; the challenges they face; and their impressions of the health services at the USC and service providers outside of USC. Students enrolled in the College of Law were excluded from the survey given the difficulty in accessing participants and because many of them no longer belong to the young people category (15-24 years old). The questions asked were limited for reasons of focus and feasibility and were not designed to capture all aspects of young peopleâ&#x20AC;&#x2122;s life. The outcome of the survey component is limited only to the primary data gathered from a sample of 699 USC students coming from seven colleges and do not necessarily represent other young people in Cebu (or, Region VII). On the other hand, results of KIIs with service providers at USC should not be taken as an evaluation of the services they offer to students, and their views about young people should not be construed as the position that USC administration takes insofar as young peopleâ&#x20AC;&#x2122;s issues are concerned. Owing to the limited sample, the KII and FGD analyses are inconclusive and the body of information does not lend itself to hard generalizations. Instead, insights that may be useful for determining A POPCOM-7 and PCHRD-CVCHRD-supported Project

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approaches for education, further research and intervention are presented. References Aguilar, E. J., Nolasco, F., & Bersales, J. E. (2002). Breaking the mold: Promoting young people’s reproductive health. An unpublished research report for the David and Lucile Packard Foundation. Department of Sociology and Anthropology, University of San Carlos. Aguilar, E. J., & Nolasco, F. (2009). An evaluation of the adolescent sexual and reproductive health initiatives of Kartada Samar: Focus on HIV and AIDS prevention. Metamorphosis. Pasay City, Philippines: Population Services Pilipinas, Incorporated. Alvarez, R. (1995). Getting teens talk about sexuality. Planned Parenthood Challenges, 1, 21-23. Commission on Population. (2003). Pinoy youth: Making choices, building voices. State of the Philippine Population Report, 2nd Issue. Craig, A., Hainge, M., Taylor, C., & Porter, T. (1995). Talking about it: Young people, sexual behavior and HIV, pp. 22-54. Dryfoos, J. G. (1990). Adolescents at risks: Prevalence and prevention. New York: Oxford University Press. Goldenring, J., & Cohen, E. (1988). Getting into adolescents’ heads. Contemporary Paediatrics, July: 75-90. Hawkins, C. (1995). Making youth involvement a reality. Planned Parenthood Challenges, 1, 11-14. Santrock, J. W. (2001). Adolescence. 8th Edition. New York: The McGrawHill Companies, Inc. UPPI/DRDF. (2002). 2002 Young adult fertility & sexuality study (YAFS3). Quezon City, Philippines: UP Population Institute and the Demographic Research and Development Foundation, Inc.

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Figure 1

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Young people’s activities and social relationships Lauren V. Ligaton

Department of Anthropology, Sociology and History This chapter presents the activities engaged in by young people at USC, and describes how they build interpersonal relationships with peers. Both quantitative (survey) and qualitative (key informant interviews and focus group discussions) methods were employed. Specifically, the study aims to better understand the dynamics surrounding young people’s social and interpersonal relationships, and determine the conditions that could make them vulnerable to health problems. Perceptions about themselves were also asked to determine their level of self-concept. Results generated can be used to improve university-based programs for students to ensure that their health and well-being are maintained. Most discussions of socialization stress the role of peers in the life of adolescents. Although research indicates that the family continues to be a powerful agent of socialization, peers are considered of equal importance in adolescence. Establishing good relationship with peers is essential to young people, and what their peers think matters significantly, sometimes more than what their parents think. Parents and children often run into conflicts, and as a consequence, young people are drawn to friends who can reinforce their own values and self image. One of the factors in the selection of friends is similarity; that is, one is drawn to those who reaffirm one’s behavior, attitude and belief. Another factor is proximity, thus, those who are always together are more likely to develop friendship (or, an intimate relationship). The type of activities that young people are engaged in shape the type of interaction and relationship that occurs in groups. This is perhaps the basis for the saying “Tell me who your friends are and I will tell you who you are.” The school helps shape the minds of young people. It provides them with basic knowledge of society and culture as well as the skills and positive attitude needed to face the demands of the contemporary world. As an agent of socialization, the school is a venue for young people to experience life away from home, develop new relationships, and learn the rules of society (Henslin, 2001). In trying to build a relationship at school, young people conform to the “rules” of the group. The need to be socially

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accepted is crucial to them, the reason why they participate in activities even as some of these could be detrimental to their health and wellbeing. Young people spend a large amount of the time with their peers. They get together frequently, are emotionally involved in the group, and they value one another. An example is the behavior of smoking, alcohol intake and drug use. Evidence points to peer-influence or peer pressure as the primary reason why some young people are engaged in these behaviors. In a study conducted by the Commission on Population (2002), almost half of the youth smoke cigarettes, with a larger proportion of males than females who do so. On the other hand, 70% of them take alcoholic drinks. The 2002 YAFS data showed an increase in the proportion of young people who use drugs (UPPI/DRDF, 2002). These are only a few of the activities that young people nowadays are engaged in. Evidently, the behavioral pattern of young people changes as society becomes complex and technology becomes more advanced. The Internet, for example, has made many people spend a great deal of amount surfing, chatting and “facebooking.” Online games have also become a popular activity for many individuals (Grohol, 2005). The Internet has both positive and negative consequences. While it encourages pro-social behavior, such activity has also made people unconsciously create a network of weak social ties (Macionis, 2006). Internet addiction, as others would call it, is a worldwide concern (Grohol, 2005). Experts say that it takes time to change people’s attitude and behavior especially if they have been accustomed to the practice. To some extent, use of the Internet has become more of a dysfunction. The study conducted by Gordoncillo et al. (2010) among public high school students in the Philippines reveals that more than half of the students use both computer and Internet. Three quarters of the students use the Internet at Internet cafés, followed by the school. While there are more boys who use the facility at Internet cafés, there are more girls who use it at school or at home. Girls are also more likely to send and receive email messages than boys. Results and Discussion While the findings revealed in these previous studies point out seemingly universal tendencies among the youth, this current study seeks to delve into the attitudes and practices of a specific target group - the students of USC - and thus be able to compare earlier findings with current data. Profile of Survey Participants A total of 699 young people at USC were included in the survey sample (Table 1), with more females (57.9%) than males (42.1%). Expectedly, the

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Ligaton: Young peopleâ&#x20AC;&#x2122;s activities and social relationships

majority of both sexes are single (99.1%) and within the ages of 18 to 20 (59.4%). The mean and median ages of the sample population are the same, at 19 years old. Table 1 Study sample by gender, marital status, and age group (N=699). N

Gender Male Female Marital Status

294 405

42.1 57.9

Single

693

99.1

Married

0.3

Living-in

0.4

Separated

0.1

15-17

171

24.5

18-20

415

59.4

21-24

113

16.1

Age Group (Mean & Median: 19 years old)

A little over half of the sample come from Cebu City while the others are from other places in Metro Cebu, Cebu Province, Visayas Region, and even from Luzon and Mindanao. Two of the survey participants are foreigners (Table 2). Table 2 Study sample by place of origin (N=699). Place of Origin Cebu City

357

51.1

Mandaue City

7.6

Lapu-Lapu City

6.3

Talisay City

2.1

Danao City

0.7

Other Places/Cities in Cebu Province

10.3

Other Places/ Cities in the Visayas Region

9.9

Luzon

2.4

Mindanao

9.3

Other Countries

0.3

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Young people’s health: Challenges for education and intervention

As presented in Chapter 1 (see Nolasco), the survey sample of 699 was drawn from seven sampling frames. One can see in Table 3 that the number of respondents from the colleges of Commerce, Arts and Sciences and Engineering is greater than those from the other colleges. This is primarily because these three colleges had the greater number of student-enrollees at the time of the study. Table 3 Study sample by college (in per cent). College

All

Male

Female

Commerce Pharmacy Architecture and Fine Arts

15.0 12.7 14.3

8.2 6.5 18.7

20.0 17.3 11.1

Arts and Sciences

14.9

13.9

15.6 15.8

Education

13.7

10.9

Engineering

14.9

26.5

6.4

Nursing

14.4

15.3

13.8

N of cases

699

294

405

With regard to year level, there is an almost equal proportion of students who are in the First and Second year levels (Table 4). The same pattern holds true for students in the Third and Fourth year. Fifth-year students account for a mere 3.1% of the sample. On average, these students have been studying at USC for three years. Table 4 Study sample by year level and number of years at USC (in per cent). Year Level

All

Male

Female

First

27.0

25.9

27.9

Second

27.3

23.5

30.1

Third

21.6

23.5

20.2

Fourth

20.9

22.1

20.0

Fifth

3.1

5.1

1.7

N of cases

699

294

405

Mean & Median Number of Years at USC: 3 years

Activities of young people at USC The students were asked about the most usual thing they do during their free time. Table 5 shows that more than a third of them use the “Internet” when they are free from academic or domestic responsibilities, with more

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Ligaton: Young people’s activities and social relationships

males than females who said so. Only one answer was required for this question to determine what they usually do. Although more than a fifth of them say that they only “stay at home” (23.7%), there could be an inference here that Internet use is still pursued at home if this facility is available. Other male and female students watch television or a movie (23.5%) during their free time. With the advent of Information Technology, it is not surprising to note that a significant amount of activities engaged in by young people revolve around Internet use. The same activities (i.e., “facebooking,” surfing, chatting, involvement in online games) were also mentioned by students in key informant interviews and focus group discussions. The word “Internet addiction” was, in fact, cited by the respondents. They said that it has somehow affected academic performance because of absences and/or failure to submit a class requirement. Table 5 Study sample by activities during free time by sex (in per cent). Activities During Free Time

All

Male

Female

Internet, computer Stay home Watch TV, movie, DVD

33.9 23.7 23.5

43.2 18.7 20.4

27.2 27.4 25.7

Shopping/go to the mall

5.7

2.4

8.1

Hang-out with friends

5.4

Study

2.4

2.0

2.7

Exercise, sport

2.4

4.1

1.2

Texting/SMS

1.7

Attend mass, read Bible

0.6

1.0

0.2

Charity work

0.3

0.2

Compose poem, song, rap, play guitar

0.3

0.2

N of cases

699

294

405

When asked with whom they usually spend their “free time” (from school work) with, close to 50% of the students disclosed that they spend it with their “friends” (Table 6). The figure registered for “family” accounts for only 21.9% of the sample. Interestingly, 19% of the students prefer to be “alone” during their free time while others spend it with “other relatives” (3.0%) or with a “boyfriend, girlfriend, or casual partner” (6.9%). In Table 7, one can see that many male and female students in the survey sample have more than six friends or barkada. A POPCOM-7 and PCHRD-CVCHRD-supported Project

Young people’s health: Challenges for education and intervention

Table 6 Study sample by spending free time with whom by sex (in per cent). Spend free time usually with whom

All

Male

Female

Friends

49.2

51.7

47.4

Family

21.9

19.7

23.5

Alone

19.0

17.7

20.0

Boyfriend/Girlfriend/Casual partner

6.9

7.1

6.7

Other relatives

3.0

3.7

2.5

N of cases

699

294

405

Note: one answer only. Table 7 Study sample by number of friends or barkada by sex (in per cent). All

Male

Female

None

0.6

0.7

0.5

1 friend

1.9

2.4

1.5

2-3 friends

12.7

9.5

15.1

4-5 friends

15.6

12.6

17.8

6 and more

69.2

74.8

65.2

N of cases

699

294

405

Next, they were asked whether they have been engaged in socially-risky activities with their friends − whether for a single time only, for curiosity reasons, or on a regular basis (Table 8). Of the socially-risky activities they engaged in, “drinking alcohol” obtained the highest frequency of mentions (77.1%), followed by “smoking cigarettes” (34.2%), and “gambling” (18.7%). Other risky activities, albeit with the least number of mentions, include: cybersex (1.4%), group sex (1.4%), and sex with a sex worker (1.0%). Recognizing the need to know which of the two sexes is more likely to engage in socially-risky activities, Table 8 also shows the distribution by sex. The most common activity engaged in by males is alcohol intake (82%), followed by smoking (43.5%). Among the females, alcohol intake (73.6%) is also a common activity. There are also more males than females who engage in gambling. The proportion of students who admitted to experiencing cybersex, group sex, and sex with sex workers may be low but is worth noting considering the danger or the risks (e.g. sexually transmitted infections) that these pose to health and well-being.

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Table 8 Study sample by socially-risky activities by sex (in per cent). All Smoking*** Drug use**

Sex

34.2 5.4

Male

Female

43.5 8.2

27.4 3.5

Alcohol intake**

77.1

82.0

73.6

Gambling***

18.7

28.6

11.6

Cybersex

1.4

3.4

Group Sex

1.4

3.1

0.2

Sex w sex worker

1.0

2.4

No. of cases

699

294

405

**Chi-sq p<.01, ***Chi-sq. p<.001

Results generated from the FGD and KIIs also affirm the same pattern; that students spend most of their free time with friends. They drink, smoke, engage in sports and other activities with them. Gambling, particularly betting in online games, was also cited by this group of participants. Those who cited “gambling” (131 students or 18.7%) in the survey were also asked about the frequency of their involvement in such activity/activities. The overwhelming majority of them (92.4%) said “sometimes.” and a mere 7.6% of them said “always.” The nature and type of gambling activities, however, have not been explored. The KII and FGD participants narrated that involvement in online gambling has affected their performance in class due to a lack of sleep. To a certain degree, school allowances have been compromised. Students in the lower years appear less-likely to be involved in gambling compared to students in the higher years. This relationship between “gambling” and “level of education” is evident in Table 9 which shows a gradual increase in gambling activities as one progresses to higher year levels. Table 9 Gambling by level of education. Gambling**

All

1 year

Level of Education rd year 3 year

Yes No

18.7 81.3

15.3 84.7

15.7 84.3

18.5 81.5

26.2 73.8

No. of cases

699

189

191

151

168

**Chi-sq. p<.01

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Young people’s health: Challenges for education and intervention

The fear of not being accepted by the group is usually the reason cited by FGD and KII participants why they need to be involved in their peers’ activities. A key informant revealed that he does not want to be considered an “outsider” because it does not make him feel good about himself. He elaborated that being with peers makes him happy and gives him the opportunity to meet new friends. The others said that drinking alcohol with peers is a way of socializing, establishing good relationships, and gaining the trust of friends. Positive perception about oneself Students in the sample appear to have a positive self-concept which they use to establish relationships with peers. This is evident in Table 10 which registers more mentions for “I am friendly and accommodating” (47.6%). Similarly, the mention for “I listen to and I understand my friends’ problems” (25.8%) is an indication of the importance they place on friendship and social or group support. Of equal importance is the mention for “I am a happy person to be with” (19.6%). Combining the figures registered for these three categories, one can say that the survey sample is generally happy and they find contentment in providing support to their friends by being open and accommodating. A limitation of the study, however, is that the question focuses only on positive characteristics. It is presumed that if the question were “What do you hate most about yourself?,” the answers could be different. Now we look at students’ positive self-concept by sex. A greater proportion of males than females mentioned “friendly and accommodating” while a greater proportion of females than males cited “I listen to my friends’ problems.” The first category implies that males are expected to be friendly and accommodating while the females are expected to possess a caring and supportive attitude. No relationship, however, has been found between “self concept” and “sex” but the data are worth presenting to underline the responses from both sexes. Table 10 Study sample by self-concept by sex (in per cent). All

Male

Female

I am friendly and accommodating I listen to and I understand my friends problems I am a happy person to be with

47.6 25.8 19.6

% 50.3 21.4 20.1

% 45.7 28.9 19.3

I do not back-bite my friends

2.6

2.4

2.7

Others

4.4

5.8

3.5

N of cases

699

294

405

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Another positive finding obtained from this study is that the majority of the sample is engaged in sports, hobbies or club activities (Table 11). The data show that students also engage in positive behaviors. This observation from the survey is validated by responses obtained from FGD and KII participants who mentioned basketball, tennis, biking, swimming, martial arts and other forms of exercise. Table 11 Study sample by involvement in sports/hobbies/clubs by sex (in per cent). All

Male

Female

Yes

57.7

64.6

52.6

42.3

35.4

47.4

N of cases

699

294

405

Are you involved In sports, hobbies, or clubs?

Conclusion and Recommendations The study has shown that establishing good interpersonal relationship with peers is important to young people. They strongly feel the need for social acceptance and feel good when they are with their peers. Peers provide them with moral, psychological and emotional support, and their involvement in their peers’ activities is a way of strengthening interpersonal relationships, even if some of these activities are detrimental to their health. Owing to their involvement in various activities, students have developed personality traits molded through social interaction and created bonding relationships for social identity. The survey sample was able to cite the role of peers, school and family as the fundamental agents of socialization. The study also showed that a rather high percentage of survey participants indulge in risky behavior or activities which have made them vulnerable to health-related problems. It is likely, however, that those who indulge in such behaviors may have their own coping mechanisms to address the risks that arise. Such mechanisms could be explored in further studies. What appears to be evident in this study is that risky behaviors arise from the desire for peer-bonding. Such are seen as avenues for social acceptance (see also Amper, Chapter 10). They feel that they have a moral obligation to maintain the trust and confidence of their peers. The feeling of being considered part of the “in” group gives them a sense of purpose. Being with friends also gives them A POPCOM-7 and PCHRD-CVCHRD-supported Project

Young people’s health: Challenges for education and intervention

the opportunity to express their problems, be these family, school, or personal problems. The study has also shown that young people at USC have a positive self-concept. Their tendency to engage in “clean” activities such as sports is indicative of this. On the basis of the results, the following recommendations are put forward: 1. Establish a young people-friendly Recreational Center in all campuses at the USC, equipped with amenities appealing to students. 2. Conduct a more focused study on the extent to which young people’s involvement in a student organization (or, fraternity) impact on their health and well-being. 3. Intensify campaigns related to promoting students’ involvement in campus activities initiated by service support units. 4. Enhance awareness programs on risk-taking behaviors (alcohol intake, smoking, drug use, and long hours of internet use) and its effects on students’ well-being. References Commission on Population. (2003). Pinoy youth: Making choices, building voices. State of the Philippine Population Report, 2nd Issue. Gordoncillo, P., Gultiano, S., Kind, E., & Orbeta, A. (2010 ). Internet use among Filipino public high school students. University of the Philippines-Los Baños, University of San Carlos-Office of Population Studies Foundation, The World Bank, and Philippine Institute for Development Studies. Grohol, J. M. (2005). Internet addiction guide. Retrieved from http://psychcentral.com/netaddiction. Henslin, J. M. (2011). Sociology: A down-to-earth approach, 5th ed. Boston: Allyn and Bacon. Maciones, J. (2006). Society: understanding the basics, 8th ed. New Jersey: Pearson Prentice Hall. UPPI/DRDF. (2002). 2002 Young adult fertility & sexuality study (YAFS3). Quezon City, Philippines: UP Population Institute and the Demographic Research and Development Foundation, Inc.

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Education and employment: The Carolinian experience Rey Uzhmar C. Padit

Department of Economics, School of Business and Economics Education encompasses all learning experiences from both formal and informal settings. As a social institution, it transmits culture, regulates behavior, and prepares individuals for future undertakings. In standard economic theory, education is considered as an investment decision an individual faces; a trade-off between present consumption in return for an expected higher income stream in the future through better employment opportunities. It is an investment in human capital – information, knowledge, and skills acquired by individuals – for an expected better well-being in the future (Becker, 1962). This aptly explains the life-cycle behavior of an individual, from birth to compulsory schooling, to higher education or special training to the labor market, retirement, and finally death (Ben-Porath, 1967). Compulsory schooling is a permanent phase in the life-cycle behavior of an individual (Tisdell & Hartley, 2008). This phase spans between the ages of 6 to 161, which covers both primary and secondary basic education. After elementary and high school, one may decide to pursue tertiary education, be employed, or study and work at the same time. Taking into account the Philippine context, there is a strong household preference for children to finish college than high school when given the opportunity. Thus, an average of 4 more years is added to schooling which lasts up to the age of 21 or even longer for those who proceed to graduate studies. Basically, schooling is a major activity that affects the lives of young people, aged 10–24. For some young people in this age range, employment is likewise a major activity that has some effect on their lives. The importance of education was underlined by the United Nations in its declaration of the UN Decade of Education for Sustainable Development (2005-2014) in 2002. UNESCO’s Education for All (EFA) states that governments tend to believe that education plays an important part in 1

For the Philippines, approximate starting age for basic education is 6 and ends at 16 for secondary level.

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Padit: Education and employment: The Carolinian experience

attaining well-being. As such, education should be able to create not just economic, but also personal, mental, social, physical, and environmental well-being (UNESCO, 2004). This is being emphasized by the humancentered approach to education wherein the focus of learning is to attain human qualities and virtues within appropriate socio-cultural contexts, rather than merely acquiring knowledge and skills (Gill & Thomson, 2009). A school environment that ensures such kind of holistic learning necessarily incorporates content and methodology with other aspects of learning. Education outcomes and academic performance are greatly affected by classroom environment, teachers’ approach and attitude, students’ motivation and inspiration, and other socio-economic factors (Maligalig et al., 2010). In this study, we focus on the experiences on education and employment by Carolinians (see Nolasco, Chapter 1) in relation to their health and well-being as students. We examine factors which are generated by the school and work environments affecting their holistic development. These environments provide signals that are critical in the development of healthy young people (Dalisay, 1996). This view is supported by the POPCOM report (2003, p. 16) which states that: “The proximal socializing agent to convey norms and prohibitions is the school. Positive school experience can compensate for the antisocial influence of the family and community.”

For the school setting, students’ relationships with teachers, other students, and peers shall be examined. Perceptions on their academic performance and plans related to their education shall likewise be presented. For the work setting, working students’ relationship with supervisors and workmates shall be examined. Perceptions on work performance and employment plans shall also be presented. Results Education and the school environment The following are the survey results with 699 student-respondents from different colleges of the University focusing on their responses on education and the school setting. General student profile. Table 1 presents general demographic and education information of the 699 respondents distributed per college. These include descriptors such as year level, number of years in school, age, sex, and marital status. Surveyed students come from seven colleges namely the Colleges of Commerce (COM) – 15%, Pharmacy (PHARM) – 12.7%, Architecture and Fine Arts (CAFA) – 14.3%, Arts and

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Young people’s health: Challenges for education and intervention

Sciences (CAS) – 14.9%, Education (EDUC) – 13.7%, Engineering (ENG) – 14.9%, and Nursing (NUR) – 14.4%. The table shows that most respondents per college are juniors (1st to 2nd year) except for NUR with 68.3% seniors (3rd to 5th year) as compared to 31.7% juniors. It is a general trend in college that there are more junior students than senior students due to attrition. However, the College of Nursing at USC is an exception because the demand for nurses abroad has declined, and thus enrollment for the junior years has likewise declined. The average number of years of school residency in the survey sample is 2.67 years. Table 1 General demographic and education information by college (in per cent). COM PHARM N of cases 105 89 % 15.0 12.7 Year Level st nd 61.0 71.9 Junior (1 -2 ) rd th Senior (3 -5 ) 39.0 28.1 No. of years: Mean = 2.67 Age Group: Mean = 18.82 15-19 76.2 76.4 20-24 23.8 23.6 Sex Male 22.9 21.3 Female 77.1 78.7 Marital Status Single 100.0 100.0 Married Living-in Separated -

CAFA 100 14.3

CAS 104 14.9

EDUC 96 13.7

ENG 104 14.9

NUR 101 14.4

61.0 39.0

50.0 50.0

53.1 46.9

53.8 46.2

31.7 68.3

58.0 42.0

72.1 27.9

61.5 38.5

62.5 37.5

61.4 38.6

55.0 45.0

39.4 60.6

33.3 66.7

75.0 25.0

44.6 55.4

99.0 1.0 -

99.0 1.0

99.0 1.0 -

98.0 2.0 -

The average age of the respondents is 18.82 years. The mean age is reflective of the average age of tertiary education students in the Philippines considering that basic education only covers 10 years unlike in other countries where they have 12 years. Based on studies, college students in the Philippines are younger than their counterparts from other countries. This is one basis of government to undertake a restructuring of Philippine education following a 12-year basic education curriculum plus a mandatory kindergarten. Majority of the respondents are females with a proportion of 57.9% and males with 42.1%. There are variations per college with CAFA having more males (55%) than females (45%) and ENG with 75% males vs. 25% females. In general this is reflective of gender stereotypes in terms of

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Padit: Education and employment: The Carolinian experience

courses (and professions) with more males than females and vice versa. Architecture and Engineering are considered as traditionally masculine professions; while Commerce, Education, Nursing, Pharmacy are generally considered feminine. The Arts and Sciences are relatively diverse in terms of gender stereotypes. Lastly, 99.1% of the students are single, 0.3% married, 0.4% living-in, and 0.1% separated. This is expected since as discussed earlier, compulsory schooling is a permanent phase of the life-cycle normally preceding marriage or work. General school environment. Given that young people are expected to be in school at this phase of their life cycle, the school environment is considered important in the health and well-being of young people. What makes school likeable to young people? Table 2 shows the aggregate results of student responses as regards what they like (or not like) about school. This addresses the first objective of this chapter which is to look into factors in the school environment that affects young people’s holistic development. Table 2 Survey responses on what students like (or, do not like) about school. %

What do (don’t)* you like about school? The course I am taking is (not) interesting and challenging The teachers are (not) qualified/competent My classmates are (not) friendly/accommodating The school is (not) equipped with many facilities for learning Health services are (not) available at any time Activities/events are (not) enjoyable I have (not) met many friends

65.1 21.7 54.8 25.6 7.4 27.0 53.5

(6.9) (40.2) (7.7) (12.2) (14.2) (11.2) (2.7)

*Numbers in parentheses represent the responses from the negated questions. Multiple response.

This question allowed for multiple responses and thus frequencies may exceed the total of 699 student-respondents. Table 2 presents the number of mentioned responses for every item on the list. The numbers enclosed in parentheses are the responses on what students do not like about school. The Table does not present the “others” specified by the students due to overwhelming heterogeneity of responses, e.g. receiving school allowance from parents, learning new things, and gaining more knowledge, to mention a few. From Table 2, there are three top responses as to what students like about school, all of which had more than 50% of the total responses. Sixty-five percent of the student-respondents said that what they like about school is that their “course is interesting and challenging,” 54.8% A POPCOM-7 and PCHRD-CVCHRD-supported Project

Young people’s health: Challenges for education and intervention

said “classmates are friendly and accommodating,” and 53.5% said “they have met new friends.” Foremost, their respective courses are the primary motivations of young people to go to school and earn a degree. This is, in fact, the manifest function of the school in society. Aside from the academic side of schooling however, the social environment is likewise considered important among young people as can be gleaned from their responses above. This is said to be the latent function of schooling in society. Surprisingly, when asked with the negated question, the results showed that the top response as to what students do not like about school was because “some of their teachers are incompetent,” with 40.2% of the respondents saying so. This study however has not explored what students meant by “incompetent” and the kind of competencies they prefer. Although these are only perceptions which can be subjective and may not be the general sentiment of the USC studentry, it is best that a more in-depth study on this matter be done to clarify and address competency-related concerns. Students are the most reliable evaluators of teaching competence since they are the learners with whom teachers constantly interact and who are supposed to learn from the lessons facilitated by the teacher in class. Necessarily how the teacher handles students would affect not only their academic performance but their attitude towards schooling in general as well. It is worthwhile to note here some responses from FGDs conducted with students. FGD participants cited “terror teachers” as the reason why they do not like some of their subjects. They defined the term “terror” as those having one or more of these characteristics: (1) imposing difficult requirements, (2) not listening to students, (3) inconsiderate, (4) insulting students, and (5) giving failing marks even to students who really try their best. As clarified by an FGD participant, “there are teachers who are very brilliant but do not know how to teach.” Availability of health services in school did not get a high proportion of responses. Only 7.4% responded that this was what they liked about the school. This may be because these are not a priority concern for young people in going to school. Health services are only considered support services for the students and school personnel. On the other hand, a larger proportion (14.2%) said that this was one of the things they do not like about school. The social environment at school. Another area on education examined is the inter-relationship between students and teachers as well as among students themselves. Respondents were asked if they usually get along

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Padit: Education and employment: The Carolinian experience

well with teachers and other students, and whether they usually performed well in different subjects. Table 3 Getting along well with teachers and other students at school and performing well in different subjects. Do you usually perform well in different subjects?

Do you usually get along well with teachers at school?

Do you usually get along well with other students at school?

Yes

502

83.0

Total

103

17.0

605

86.6

71.3

28.7

13.4

569

81.4

130

18.6

699

100

Yes

546

81.7

122

18.3

668

95.6

No Total

23 569

74.2 81.4

8 130

25.8 18.6

31 699

4.4 100

Yes

In Table 3, 86.6% of the student-respondents said they usually get along well with their teachers; while only 13.4% said they don’t. Probes of “no” answers were difficult to aggregate due to the heterogeneity of responses, including that “they are shy,” that “some teachers are not easy to get along with,” and that “some teachers are strict and intimidating,” to cite a few. As regards getting along well with other students, 95.6% or 668 students replied that they do; while only 4.4% said they do not. From the data, it can be inferred that young people get along better with their peers than with their teachers, who obviously do not belong to the same age group as they. The majority of the student-respondents, however, appear to get along well with their teachers in general. Health studies show that harmonious interpersonal relationship can enhance performance, health and well-being. Positive relationships are said to buffer the effects of stress on the immune system. Thus, interpersonal relationships in the school environment can affect academic performance of students as well as their physical and mental health and well-being. The table also shows student-respondents’ perception of their performance in different subjects. A large proportion of the respondents (81.4%) answered in the affirmative; while only 18.6% replied in the negative.

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Furthermore, the table shows that 83% of the student-respondents who got along well with their teachers also performed well in different subjects. However, there were also those (17%) who, despite getting along well with their teachers, did not perform well in class. On the other hand, 71.3% of the respondents who did not get along well with their teachers still performed well in different subjects, while 28.7% of them did not. When asked if they perform well in different subjects, a “yes” response (if probed) could be linked to students’ intelligence (multiple) level, time management, and course interest. While a “no” answer may be linked to intellectual incapacity, weak focus, and multiple interests. This aspect could be subjected to further study. Future plans for education. Table 4 presents students’ future plans for education. Close to 70% of the survey sample want to finish school and get a job, 25.2% would like to proceed to graduate studies, 3.9% just want to finish schooling, while 1% would like to engage in entrepreneurial activity after schooling, and 0.1% will prepare for their licensure examinations. Table 4 Goals for future education (N=699). Finish schooling only Finish schooling, get a job Further studies (graduate studies) Prepare for board exam Finish schooling, then entrepreneurship

% 3.9 69.8 25.2 0.1 1.0

This is the only question that may have captured factors affecting education investment decision by individuals. The data is reflective of common notions and practices in the Philippines wherein educational attainment is used as a gauge for hiring qualifications. Earning a college degree is also generally perceived as a way of increasing one’s social capital and thus increasing one’s chances at landing a good-paying job. Employment and the work environment The second set of survey results presents data related to employment of 55 student-respondents who are currently working or earning. These results will address this chapter’s second objective of looking into factors in the work environment that affect young people’s holistic development. Young people’s work relationships, perceptions on work performance, and future plans on employment shall be presented.

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Padit: Education and employment: The Carolinian experience

General student-employee profile. As presented in Table 5, only 55 student-respondents or 7.9% of the sample are currently working or earning as of the time of survey. Of these 55 students, 23.5% are regular employees and 76.4% work on a part-time basis. Since at this stage of the life-cycle young people are not yet expected to work, it follows that only a small percentage of students would be employed. Those who are working would generally be on a part-time basis as they are also going to school. Table 5 Profile of working students (N=55). % Work Status Regular Part-time Sex Male Female Year Level Group st nd Junior (1 -2 ) rd th Senior (3 -5 ) Age Group 15-17 18-24 Marital Status Single Married Living-in Separated

23.6 76.4 49.1 50.9 40.0 60.0 9.0 91.0 96.4 1.8 1.8

In terms of sex, the difference is marginal with 49.1% male and 50.9% female students working. As expected, 60% of those who are working are senior students while only 40% are junior students. Looking at age and employment, only 9% of those working belongs to the 15-17 age bracket and while 91% are 18-24 years of age. This is expected since those in the junior years (15-17 years old) are still generally dependent on their parents for financial support. Life-cycle behavior would tell us that the average age of respondents is still part of the phase where schooling is compulsory assuming other things are equal, otherwise students may decide to work with different motivations. A surprising result when considering the civil status of the respondents is that married students are not currently working or earning, while 96.4% of working students are single, 1.8% are living-in or separated. Generally,

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following the life-cycle behavior, married individuals are more likely to be at work in order to provide for the needs of the family. However, since they are also studying, they might also have preferred to concentrate on their studies rather than work at the same time. Table 6 Type of work (N=55).

Apprentice/On-the-job Training Working Scholar Call Center Agent Business (own or family) Computer-related Service Crew Fashion, Music and Arts-related Sanggunian Kabataan, Chair Others

% 18.2 20.0 14.6 9.1 10.9 5.5 10.9 1.8 9.1

Table 6 presents the types of work engaged in by the 55 studentrespondents. These are very diverse: 20% are working scholars either in the university or elsewhere; 18.2% work as part of their on-the-job training or apprenticeship; 14.6% are call center agents; 10.9% work in computer data processing; 10.9% are either into fashion, music, and other arts-related jobs such as fashion designer, band member, photographer, and the like; 9.1% are either engaged in small business endeavors or are helping out in the family business; and 5.5% work as service crew in food chains. However, one limitation in this study is that students studying and working at the same time were not asked regarding their motivation in deciding to work. Being employed would mean competition in the use of time intended for studying which might have implications on academic performance. Results from these questions related to employment are very important in order to derive an intuitive understanding of studentsâ&#x20AC;&#x2122; school performance since they have to allocate time for competing interests. The sacrifice of one priority over the other would be a possibility although synergy could be achieved between studying and working if students can employ efficient time management and possess a certain degree of maturity.

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Padit: Education and employment: The Carolinian experience

General work environment. Table 7 presents responses regarding what they like (or do not like) about their work, based on seven indicators. The top answer was that their work is interesting and challenging registering an appreciable 54.5%. This is expected since the primary motivation of most workers is the job itself. Responses pertaining to the social environment include (1) I have met many new friends (38.2%); (2) workmates are friendly and accommodating (29.1%); and (3) activities and events are enjoyable (21.8%). Table 7 Survey responses on what students like (or, do not like) about work (N=55). What do (donâ&#x20AC;&#x2122;t)* you like about work? My work is (not) interesting and challenging My supervisors are (not) qualified/competent My workmates are (not) friendly/accommodating The office is (not) equipped with many facilities for learning Health services are (not) available at any time Activities/events are (not) enjoyable I have (not) met many friends

% 54.5 16.4 29.1 20.0 1.8 21.8 38.2

(3.6) (5.5) (7.3) (5.5) (3.6) (7.3)

*Numbers in parentheses represent the responses from the negated questions. Multiple response.

Other work-related aspects obtained lower percentages than the social factors â&#x2C6;&#x2019; (1) the office is equipped with many facilities for work (20%); and (2) my supervisors are qualified and competent (16.4%). When asked what they donâ&#x20AC;&#x2122;t like about their work, all categories posted below 10% of the responses. The availability of health services at any time as one of the reasons they like their job only had a 1.8% positive response. Interestingly, more (3.6%) said this is one of the things they do not like about their work. Just as in the school setting, this likewise shows that health services in the work setting are not given much importance, even among employees, as these are only considered as support services. The social environment at work. The general wellness of every employed individual is affected by interrelationships with supervisors and co-workers in the working environment. From Table 8, 83.6% of the respondents said they get along well with their supervisors and 90.9% said they get along well with their workmates. This generally depicts a positive atmosphere in their workplaces, although 16.4% said they did not get along well with their supervisors; and 9.1% said they did not get along well with their workmates. In terms of performing well in different tasks or assignments, 92.7% answered in the affirmative, while only 7.3% answered in the negative.

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Table 8 Getting along well with supervisors and workmates and performing well in different tasks/assignments Do you usually perform well in different tasks/assignments? Do you usually get along well with supervisors at work? Do you usually get along well with your workmates?

Yes Yes No Total Yes No Total

Total

93.5

6.5

83.6

88.9

11.1

16.4

92.7

7.3

100

92.0

8.0

90.9

100.0

9.1

92.7

7.3

100

Table 8 presents respondents’ perceptions as to getting along with supervisors and workmates and work performance. Of those who said they got along well with their work supervisors, 93.5% said they also performed well in different tasks; while only 6.5% said they did not perform well. Of those who said they did not get along well with work supervisors, 88.9% said they still performed well in different tasks, while only 11.1% said they did not perform well. On the other hand, 92% of those who said they got along well with their workmates said they also performed well in different tasks, while 8% said they did not perform well. 100% of those who said they did not get along well with workmates said they still performed well. In general, student-employees studying at USC perceive the social environment in their respective workplaces as well as their performance of tasks in a positive light. Psychological studies have pointed out that work environments affect job performance and general well-being of employees. A positive perception of one’s job likewise affects academic performance since the employees in this case are also students at the same time. However, this study lacks the basis to correlate these factors. This may be a subject for further study. Future plans for employment. On employment plans (See Table 9), 45.4% of the respondents said they will continue with their current work and wait for better opportunities, and 18.2% said they will finish their contract and get another job. Another 18.2% said they will pursue

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Padit: Education and employment: The Carolinian experience

graduate studies, while 16.4% would like to finish their current contract and stop working. Table 9 Goals for future employment (N=55). What are your goals for future employment? Finish current contract and stop working Finish contract and get another job Further studies (graduate studies) after graduation Continue with current work assignment & wait for better opportunities Give time for people to be employed

% 16.4 18.2 18.2 45.4 1.8

The aspect on plans for employment would capture the human capital approach. It would have been different if decision factors of students to work while studying had been explored. Some students are working simply to address their schooling needs. Although employment of students while still at a stage of compulsory schooling is not the general trend in the Philippines, it is on a positive note that the general work environment of the few students who are employed is okay as perceived by them in terms of the likability of the work environment as well as their interrelationships with supervisors and workmates. However, this study has not incorporated other questions related to workersâ&#x20AC;&#x2122; welfare such as wage rate and employment benefits. In standard labor economics theory, wage rate and employment benefits are directly related to the decision to work, not to work, and to continue working. Such are only related to employment decisions but may affect the well-being of the workers as well. In this case, impressions on employment provided categories on environmental factors but excluded wage rates and employment benefits. Conclusion and Recommendations To understand what constitute total well-being is crucial in the holistic development of an individual. We can argue that the whole range of experiences over the life-cycle can mold what and who an individual may become in the future. Experiences from the varying environments and interaction with other individuals in the family, school, work, and other groups contribute to impressions of their well-being. An inevitable stage in the life-cycle of an individual is compulsory schooling, as well as employment which young people undergo at this stage. Most of what happens to peopleâ&#x20AC;&#x2122;s lives is directly related to their actions and experiences in these various environments.

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This paper focused on the education and employment experiences of young people. General profiles of students as well as student-employees, the social environments in school and at work, perceptions on school and work performance, and future education and employment plans were presented. Results showed that general student profiles are reflective of education norms in the Philippines in terms of sex and age. In the area of school environment, academic motives generally drive students to pursue college education, but the social environment is also considered important. Among Carolinians, the teacher factor is perceived as an important consideration for liking or not liking school. This is an academic factor, at the same time a social one, which should seriously be studied. A more indepth research could be pursued on this aspect since teachers form part of the inputs in students’ intellectual and social development. As regards inter-relationships with teachers, generally Carolinians get along well with their teachers and with their classmates. Good interrelationships, especially peer relationships, enhance one’s social well-being and provide the necessary support mechanisms for young people who usually turn to their peers in times of difficulties (see also Amper, Chapter 10). This interesting contrast tells us the distinction between interpersonal and academic relationships. Academically, teachers are expected to be qualified and competent in their respective fields of specialization in order to effectively transmit knowledge and skills to their students. On the other hand, teachers likewise establish social relationships with their students while in the process of constant interaction. Good interpersonal relationships with students may or may not directly have a bearing on the academic performance of students. But both academic and social relationships with and among students are important in maintaining a good school environment. The school environment generally affects students’ academic performance. As to plans for education, the majority exhibit a desire to finish schooling and get a job. This follows the life-cycle behavior of an individual to primarily seek employment after compulsory schooling. This life-cycle behavior is also reflected in the fact that only 7.9% of the survey sample are currently working, with most of them doing part-time jobs, since generally young people are not expected to work while they are still in school. The respondents who are currently working show a positive perception of their work environment in terms of the job itself, interrelationships with supervisors and workmates, as well as their job performance. However, A POPCOM-7 and PCHRD-CVCHRD-supported Project

Padit: Education and employment: The Carolinian experience

the link between job performance and academic performance needs to be studied further to determine whether one affects the other in terms of time management, efficiency and other relevant aspects. As to future employment plans, majority of the student-workers appear to have no plans of terminating current employment, but rather plan to continue working either in the same job or in another one. Once again, going back to the human capital perspective and life-cycle behavior, compulsory schooling is a cycle phase lived by Carolinians, although a few of them pursue active employment. What occurs at this stage and the manner they treat this stage, either as an investment for employment or just purely for consumption, certainly affects their current and future health and well-being. Ensuring a balanced environment conducive to developing skills, talents and health will be of great concern for them. There is a need for sectors responsible for education to learn about the young people’s universe if they are to provide an environment conducive to this stage of development. Thus, this chapter provides information on Carolinians’ school and work environments derived from their own impressions and perceptions. This knowledge output is crucial in understanding our young people and is a necessary input to how school authorities should respond to them thereby enhancing a healthy school environment, both academically and socially. On the education and well-being of the Carolinians, the study recommends the following areas to be further explored: 1. 2. 3. 4.

decision factors affecting students’ choice of program/course teacher qualifications and competence student-teacher relations peer relations

On the issue of employment and well-being of Carolinians, the study suggests that the following areas be looked into: 1. factors affecting employment decision by students 2. impact of employment on academic performance 3. wage rate and employment benefits of student-employees Compulsory schooling is an important stage in the students’ life-cycle which, if successful, would enhance the holistic development of the individual. The school environment should positively contribute not only to the academic and intellectual development of students but to their social, mental, physical and emotional development as well. For those A POPCOM-7 and PCHRD-CVCHRD-supported Project

Young peopleâ&#x20AC;&#x2122;s health: Challenges for education and intervention

who are working at this stage of compulsory schooling, the work environment should likewise positively contribute to their holistic development as individuals. A balance between school and work should also be ensured so as not to put unnecessary stress on the studentemployee that affects their health and well-being. References Becker, G. S. (1962). Investment in human capital: A theoretical analysis. The Journal of Political Economy, Part 2: Investment in Human Beings, 70 (5), 9-49. Retrieved from http://vanpelt.sonoma.edu. Ben-Porath, Y. (1967). The production of human capital and the life cycle of earnings. The Journal of Political Economy, Part 1, 75 (4), 352-365. Retrieved from http://www.uib.es/depart/deaweb/personal/ profesores/personalpages/amedeospadaro/workingpapers/bibliosecp ub/benporath1967.pdf. Calder, D., & Aoyama, E. (Eds.). (2009). Secondary education regional information base: Country profile-Philippines. Bangkok: UNESCO Bangkok. Retrieved from http://unesdoc.unesco.org. Commission on Population. (2003). Pinoy youth: Making choices, building voices. State of the Philippine Population Report, 2nd Issue. Dalisay, G. (1996). Promoting the well-being of the Filipino youth. Country Paper prepared for Youth Across Asia Workshop, Kathmandu, Nepal. Gill & Thomson. (2009). Human-centred education â&#x20AC;&#x201C; A summary. Brighton: Centre for Research in Human Development, GuerrandHermes Foundation. Maligalig, D. S., Caoli-Rodriguez, R. B., Martinez, A. J., & Cuevas, S. (2010). Education outcomes in the Philippines. ADB Working Paper Series No. 199. Retrieved from http://www.adb.org. Tisdell, C., & Hartley, K. (2008). Microeconomic policy: A new perspective. Northampton, MA: Edward Elgar Publishing. UNESCO. (2004). Education for all: The quality imperative. EFA Global Monitoring Report 2005. Paris: UNESCO.

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Managing student bodies: Eating, exercise and sleeping patterns among Carolinians Sonny S. Agustin

Office of Population Studies Foundation, Inc. Department of Anthropology, Sociology and History This chapter will describe the dietary, physical exercise, and sleep characteristics of the USC sample (N=699), and explore whether key demographic characteristics are related to the patterns observed for these variables. This chapter aims to accomplish the fourth objective of this monograph, namely â&#x20AC;&#x153;to describe how young people look after themselves including their eating and sleeping patternsâ&#x20AC;? (see Nolasco, Chapter 1). This will show us how the Carolinian students maintain and manage their own bodies through a quantitative examination of their eating, exercise, and sleeping behaviors. The eating, exercise and sleeping patterns of college students are still lacking serious study in our country. On the other hand, it is evident that it is important to study the diet and lifestyle of Filipino college students as they constitute a potent and valued sector in society. Traditionally, the tertiary level educational system in the Philippines is the provider of personnel for key positions in the labor force. Engineers, doctors, lawyers, teachers and other professionals would have to pass through the tertiary educational system to earn their credentials. In the usual course of events, they need to undergo years of training, which may be expected to demand substantial effort on their physical as well as their intellectual abilities. Young people, therefore, should not only be intellectually but also physically fit in order to meet the demands of their course of study. Eating, exercising and sleeping are activities that are very important in this regard. In a society moving towards a regime of low death and fertility rates (the demographic transition), prevalence of lifestyle-related diseases (the epidemiological transition), and growing malnutrition due to improper nourishment (the nutrition transition), the proper nourishment and management of the body is commonly seen as having primary significance. Data from the 7th National Nutrition Survey (FNRI, 2008) show that in the 11-19 years old age group, 17% are underweight

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Agustin: Managing student bodies: Eating, exercise & sleeping patterns….

and 4.6% are overweight. Males are more likely to be underweight while no gender differential exists in terms of being overweight. Researchers also note a “double burden” of under- and over - nutrition in the country (Pedro et al., 2007) What the young people eat, the activities they do to maintain physical fitness, and the amount of rest they have affect not only their present role in the society, but also the future of old age in the Philippines. The University of San Carlos, as one of the premier higher educational institutions in the Visayas, is expected to have a student population that is technologically proficient, consumers of a wide range of media, highly literate, and urban in their outlook. An important subgroup, however, is composed of those who come from rural areas to pursue higher education in the city. The change from a rural to an urban environment may also bring about a corresponding change in lifestyle. The trend towards urbanization in all levels of society is usually associated with the adoption of a more Western lifestyle. Nutritionally, this is reflected in a risky diet that is characterized by high cholesterol and saturated fat, processed foods, and refined carbohydrates (Pedro et al., 2007). This type of diet, which is related to degenerative, lifestyleand nutrition-related, non-communicable diseases (e.g. obesity, kidney failure, hypertension), may also be more likely to occur among busy students who might prefer instant foods or those that could be bought and prepared quickly (e.g. instant coffee and instant noodles). The pursuit of higher education, with its emphasis on long periods of academic study may create a tendency to adopt a sedentary lifestyle. This, coupled with substance intake risks like smoking and drinking which, although of lower proportion compared to those who are out of school, are still substantial among the youth who are in school (see Cruz & Berja, 2004). The tendency to consume instant and processed foods may also pose physical health and morbidity risks faced by young Filipino college students of today. Fortunately, higher education is also expected to increase one’s general understanding of bodily processes and factors that are conducive to physical health. Their greater knowledge may include the ability to read and assess nutritional facts in the labels of food items. Most higher educational institutions also offer physical education classes. And, as college students are active consumers of the mass media and users of modern communication technologies, they are also more likely not only to adopt the Western lifestyle, but also to be in touch with a cultural genre that is also growing in the West.

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The pursuit of health-enhancing physical regimens like sports, yoga, and bodybuilding may be given further impetus among college students as these regimens not only promote physical fitness but also “sexiness,” well-valued in a setting like the school where one is more likely to meet the opposite sex. Choosing healthy lifestyles empower them to take control of and manage their bodies. Such positive trends contribute not only to current health conditions but also to successful aging in the future. Lastly, there is a growing awareness of the importance of sleep in the attainment of physical and general health. The trend in developing countries follows those of the West in terms of shortened periods of sleep per day. Preliminary observations done in a cohort of young adults in Metro Cebu indicate that, consistent with findings in other countries, the average amount of sleep each night among young Filipino adults also gets shorter across time (Agustin et al., 2011). This trend is likely to intensify with the rise of the business process outsourcing (BPO) industry in Metro Cebu and in other urban centers of the country. This will become crucial to students who also work in BPOs, as globalization forces higher educational institutions to be competitive, creating greater pressure for students to excel. The BPO working students will be more likely to be females (TESDA, 2007), given the greater likelihood of females to be accepted in call centers and the greater educational attainment of Filipino females in general. In a study of call center agents in Cebu, a substantial fifth of the purposively-chosen sample (n=118) either studied or was studying at the University of San Carlos (Amadora-Nolasco, 2010). With this context in mind, the need for sleep time and its association with health should not be overlooked. Sleep duration, for instance, has been found in numerous studies to be associated with mortality and health outcomes among various populations and age groups (e.g. Ayas et al., 2003; Ferrie et al., 2007; Hublin et al., 2007; Lan et al., 2007; Van Cauter et al., 2007). Lack of sleep, with unhealthy diet and lack of physical activity, together constitute substantial health risks for students. With all these in mind, it is interesting to know whether the USC sample can be considered a “healthy” sample in terms of their eating, physical exercise, and sleeping behaviors. If risky behavioral patterns are observed, what are the extent and nature of these risks? Background and structural factors may also be associated with these unhealthy behavioral patterns and the understanding of these background factors may help minimize and manage the risks. Results As can be seen in Table 1, about a third of the USC sample (36%) usually do not eat breakfast. This practice is especially observed among females (40.5%) and among those who are not living with their parents (50.9%). A POPCOM-7 and PCHRD-CVCHRD-supported Project

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Among the colleges (Table 2), the largest proportions that usually skip breakfast are observed among the students of Pharmacy (44.9%), Nursing (40.6%), and Architecture and Fine Arts or CAFA (44.0%). Meals for the majority of students are generally light, especially among the females (58.0%). Majority of the students also reported that they sometimes find themselves overeating (75.4%) or they sometimes find themselves undereating (51.9%). Thus, while light meals characterize the general diet of the students, it is also true that overeating seems to be a prevalent concern, as reported by about 8 out of 10 of the women and 7 out of 10 of the men. Concern about undereating, on the other hand, is reported by about 6 out 10 students from the colleges of Pharmacy (60.7%) and CAFA (63.0%). About one in five students said they currently have dietary restrictions to control weight. Table 1 Eating patterns by selected background characteristics (in per cent). All

Sex Male

Usually eat breakfast yes no

63.4 36.6

68.7 31.3

Female *

Age group

Living w/ parents? Yes No

15-19

20-24

59.5 40.5

64.7 35.3

60.8 39.2

66.2 33.8

58.0 42.0

52.9 47.1

50.0 50.0

53.5 46.5

43.9 56.1

79.8 20.2

75.8 24.2

74.6 25.4

75.7 24.3

73.7 26.3

49.1 50.9

***

Diet light meal heavy meal

51.9 48.1

43.5 56.5

Sometimes overeating yes no

75.4 24.6

69.4 30.6

51.9 48.1

51.4 48.6

52.3 47.7

53.1 46.9

49.6 50.4

52.1 47.9

50.9 49.1

19.0 81.0 699

17.0 83.0 294

20.5 79.5 405

17.6 82.4 467

22.0 78.0 232

18.3 81.7 114

22.8 77.2 585

Sometimes under-eating yes no Dietary restrictions to control weight yes no N of cases

*Chi-sq. p<.05, **Chi-sq p<.01, ***Chi-sq. p<.001

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Young peopleâ&#x20AC;&#x2122;s health: Challenges for education and intervention

Table 2 Eating patterns by college (in per cent). College COM

PHARM

CAFA

CAS

EDUC

ENG

NUR

74.3 25.7

55.1 44.9

56.0 44.0

63.5 36.5

60.4 39.6

73.1 26.9

59.4 40.6

58.1 41.9

41.6 58.4

47.0 53.0

58.7 41.3

54.2 45.8

52.9 47.1

49.5 50.5

82.9 17.1

75.3 24.7

79.0 21.0

74.0 26.0

77.1 22.9

63.5 36.5

76.2 23.8

Usually eat breakfast yes no Diet light heavy Sometimes find yourself over-eating yes no Sometimes find yourself under-eating yes no Dietary restrictions to control weight yes no

40.0 60.0

60.7 39.3

63.0 37.0

55.8 44.2

54.2 45.8

47.1 52.9

44.6 55.4

17.1 82.9

20.2 79.8

23.0 77.0

24.0 76.0

19.8 80.2

13.5 86.5

15.8 84.2

N of cases

105

100

104

101

*Chi-sq. p<.05, **Chi-sq p<.01

The overwhelming majority of the students (90.6%) engage in some form of physical exercise (Table 3). The most common forms of physical exercise are walking (36.7%) and jogging (26.2%). Other types of physical exercises include sports, dancing, doing sit-ups, and gym/weight-lifting. Females are more likely to walk, jog, and dance while males are more likely than females to engage in sports, sit-ups, and gym/weight-lifting. There may be important differences among the colleges in terms of preferred forms of physical exercise (Table 4). Nursing and Pharmacy students have the highest proportions engaged in walking while the College of Arts and Sciences (CAS) students have the highest percentage that engage in jogging. Engineering students are the ones most likely to do sit-ups and gym/weight-lifting, while CAFA students are most likely to engage in sports.

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Agustin: Managing student bodies: Eating, exercise & sleeping patternsâ&#x20AC;Ś.

Table 3 Physical exercise patterns by selected background characteristics (in %). All

Do you exercise? yes no N of cases Usual exercise jogging walking sit-ups dancing sports gym/weight lifting others N of cases

Sex

Age group

Living with parents? Yes No

Male

Female

15-19

20-24

90.6 9.4 699

92.2 7.8 294

89.4 10.6 405

89.7 10.3 467

92.2 7.8 232

90.9 9.1 114

88.6 11.4 585

26.2 36.7 7.3 8.7 9.5 4.7 6.9

24.4 28.8 10.7 4.8 16.2 8.1 7.0

27.6 42.5 4.7 11.6 4.4 2.2 7.0

26.0 39.0 6.9 8.8 9.0 3.6 6.7

26.8 31.9 8.0 8.5 10.3 7.0 7.5

25.6 36.8 7.3 8.1 9.8 5.1 7.3

29.7 35.6 6.9 11.9 7.9 3.0 5.0

633

271

362

420

213

101

532

ENG

NUR

***

***Chi-sq. p<.001

Table 4 Physical exercise patterns by college (in per cent). College COM

PHARM

CAFA

Do you exercise? yes no N of cases

*** 84.8 15.2 105

CAS

EDUC

98.9 1.1 89

100.0 0.0 100

95.2 4.8 104

85.4 14.6 96

84.6 15.4 104

86.1 13.9 101

Usual exercise jogging walking sit-ups dancing sports gym/weight lifting others N of cases

*** 27.0 32.6 12.4 10.1 6.7 4.5 6.7 89

19.3 45.5 1.1 8.0 10.2 5.7 10.2 88

29.0 30.0 3.0 6.0 18.0 6.0 8.0 100

36.4 27.3 4.0 12.1 7.1 6.1 7.0 99

25.6 39.0 4.9 17.1 8.5 1.2 3.7 82

24.1 29.9 14.9 4.6 10.3 8.0 8.2 87

20.5 54.5 11.4 3.4 4.5 1.1 4.6 88

***Chi-sq. p<.001

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Young peopleâ&#x20AC;&#x2122;s health: Challenges for education and intervention

The majority of the students (66.8%) usually sleep less than 8 hours a day and 6.4% sleep only 4 hours or less a day (Table 5). There are no statistically significant differences among the various groups of students in terms of sleep duration (Tables 5 and 6) although looking at the proportions, sleeping less than 5 hours a day has greater proportions among the males, those who are older (aged 20-24), those not living with their parents, and students of the College of Arts and Sciences. Most of the students (66.1%) also reported that they sometimes experience difficulty sleeping at night. About 12.3% even reported that they always experience sleeping difficulty. Chronic sleeping difficulty is especially observed among males (12.9%), the older students (14.7%), and among the students of CAFA (21.0%), Pharmacy (20.2%), Commerce (14.3%), and Arts and Sciences (13.5%). Table 5 Sleeping patterns by selected background characteristics (in per cent).

All Usual hours of sleep at night 4 hrs or less 5-7 hrs. 8 hrs. 9-10 hrs. 10 hrs. or more

6.4 60.4 24.2 7.3 1.7

Sex

Age group

Living with parents? Yes No

Male

Female

15-19

20-24

7.1 57.8 26.2 6.5 2.4

5.9 62.2 22.7 7.9 1.2

5.4 61.2 23.1 8.4 1.9

8.6 58.6 26.3 5.2 1.3

6.3 58.8 25.0 8.0 1.9

7.0 68.4 20.2 3.5 0.9

Experienced difficulty in sleeping at night always sometimes never

12.3 66.1 21.6

12.9 60.2 26.9

11.9 70.4 17.8

11.1 69.4 19.5

14.7 59.5 25.9

12.0 66.2 21.9

14.0 65.8 20.2

N of cases

105

100

104

101

**Chi-sq p<.01, *Chi-sq. p<.05

A POPCOM-7 and PCHRD-CVCHRD-supported Project

Agustin: Managing student bodies: Eating, exercise & sleeping patternsâ&#x20AC;Ś.

Table 6 Sleeping patterns by college (in per cent). College How many hours do you usually sleep at night? 4 hrs. or less 5-7 hrs. 8 hrs. 9-10 hrs. 10 hrs. or more How often do you experience difficulty in sleeping at night? always sometimes never N of cases

COM

PHARM

CAFA

CAS

EDUC

3.8 56.2 32.4 6.7 1.0

ENG

NUR

4.5 58.4 21.3 13.5 2.2

6.0 51.0 28.0 13.0 2.0

13.5 58.7 20.2 6.7 1.0

4.2 69.8 19.8 5.2 1.0

6.7 65.4 22.1 3.8 1.9

5.9 63.4 24.8 3.0 3.0

14.3 63.8 21.9

20.2 59.6 20.2

21.0 47.0 32.0

13.5 70.2 16.3

7.3 80.2 12.5

3.8 67.3 28.8

6.9 74.3 18.8

105

100

104

101

***

***Chi-sq. p<.001

Discussion This study is an important first step in providing factual data and understanding on the current eating, physical exercise, and sleeping patterns of college students in Metro Cebu, or even of college students in the Philippines. Furthermore, the sampling design of the study allowed for differentiating the practices of students according to the college that they belong. The results reveal patterns that would indicate how the current students treat their bodies through their eating, exercising and sleeping behaviors. The first thing noticed is the large proportion of students going to school without taking breakfast (36.6%). This is especially true among females, and those not living with their parents. It may be that the lack of parental support in breakfast preparation and the lack of parental advice and motivation are associated with problems of time management (e.g. not waking up on time) and the greater tendency to think that breakfast is something that could be skipped. The colleges of Pharmacy, CAFA and Nursing are identified as among those with the greatest percentages of students skipping breakfast. It is not clear whether the location and accessibility of these colleges has something to do with these patterns, but clearly this needs further investigation.

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Young people’s health: Challenges for education and intervention

There is not much dietary data gathered to describe the quality of the USC student diet. According to the reports, however, light meals are as preferred or even more preferred than heavy meals. There may be an expected gender difference in this, as females are more likely to prefer more light meals while males are more likely to prefer heavier ones. Females are also more likely than males to notice themselves overeating (79.8% vs. 69.4%), which may reflect a greater concern among female college students over “excessive” amounts of food intake. How much the desire to be thin as promoted by the mass media, the current ideas about “sexiness,” and the proximity of the members of the opposite sex in coeducational college campuses are associated with this behavior is not clear but may also be interesting subjects of future research. The study did not have weight measures but about one in five student said that they have dietary restrictions to control weight. This may be a proxy indicator for the extent of weight problems in the USC student population and should alert the university health service providers to this concern. The majority of the students, however, have reported engaging in some form of physical exercise, which indicates their level of awareness of this aspect of physical health management. It is possible that the Physical Education classes offered by the university, the campus-promoted opportunities to engage in various forms of sports, and the physical landscape of the university may have contributed to this. The majority of students have less than 8 hours of sleep, which is understandable given the demands of school. About 6.4%, however, said that they usually get only 4 hours or less of sleep per day, which is somewhat disturbing given the potential health risks of this kind of behavioral pattern. As previously mentioned, less sleep, especially the chronic lack of sleep, has been associated with adverse health and mortality outcomes (Ayas et al., 2003; Ferrie et al., 2007; Hublin et al., 2007; Lan et al., 2007; Van Cauter et al., 2007). Sleeping difficulties may be a symptom of a negative state of mental health and questions related to these are often included in some common depression scales like the CES-D (the Center for Epidemologic Studies Depression Scale), the Zung Self-Rating Depression Scale (SDS), the Montgomery-Asberg Depression Scale (MADRS), the Goldberg Depression Test, and the Hamilton Rating Scale for Depression. Among the sample respondents, 12.3% said that they always experience difficulty in sleeping at night. Males, the older students, and students from certain colleges (e.g. Pharmacy, CAFA) are observed to have a higher reported percentage of this problem. Although such a single question is not enough to establish the presence of depression or other psychological problems, A POPCOM-7 and PCHRD-CVCHRD-supported Project

Agustin: Managing student bodies: Eating, exercise & sleeping patternsâ&#x20AC;Ś.

there may be background or structural characteristics connected with this that warrant further study. Recommendations It is recommended that the university system be more sensitive to these patterns and be more responsive to the nutritional and physical health needs of the students. The eating of breakfast should be promoted among the students, and breakfast food should be made available in the canteens, especially for those students who go to school early in fear of being late for class. Similarly, nutritious food should be made available in the canteens and information on proper nutrition should be disseminated. It is also a good idea to make the classrooms more physically available to the students, either by faster and more efficient transportation within the campus or by setting up more in-campus dormitories. Weight management programs should be made available to the students, especially by the campus health providers. This may also be integrated in the physical education courses offered by the university. Proper time management should also be promoted, as this may lessen the need for some students to stay very late at night and get minimal sleep. Although not analyzed in this study, students who work in business process outsourcing (BPO) occupations may probably need some assistance by the university, probably in terms of developing time management skills or health care in the prevention and medication of night-shift related illnesses. Lastly, as the body is intimately linked with the mind, the psychological well-being of the students in the university needs to be monitored, understood, and ensured. Researches on the current state of psychological well-being of Carolinians need to be conducted and updated on a regular basis. Social and university structures that threaten the physical and psychological well-being of USC students need to be identified and the necessary steps for correction should be undertaken. It is hoped that through research and the willingness of the university leaders to provide the best home for student learning, higher educational institutions like USC will also be environments conducive to physical and mental health. References Agustin, S. S., Carba, D. C., Perez, L. L., Borja, J. B., Kuzawa, C. W., & Adair, L. S. (2011). Correlates of sleep patterns among Cebuano young adults. Unpublished paper presented at the 2011 Annual Scientific Conference of the Philippine Population Association, Cagayan De Oro City. February 2011.

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Young peopleâ&#x20AC;&#x2122;s health: Challenges for education and intervention

Ayas, N. T., White, D. P., Manson, J. E., Stampfer, M. J., Speizer, F. E., Malhotra, A. & Hu, F. B. (2003). A prospective study of sleep duration and coronary heart disease in women. Archives of Internal Medicine 163, 205-209. Amadora-Nolasco, F. (2010). Academe and BPO linkage: Matching workforce competencies. In The BPO in Cebu: Challenges and Opportunities. Cebu City: University of San Carlos Press. Cruz, G. T. & Berja, C. L. (2004). Non-sexual risk behaviors. In Raymundo, C. M. & Cruz, G. T. (Eds.). Youth Sex and Risk Behaviors in the Philippines. Diliman, Quezon City: Demographic Research and Development Foundation, Inc. and the University of the Philippines Population Institute. Ferrie, J. E., Shipley, M. J., Cappuccio, F. P., Brunner, E., Miller, M. A., Kumari, M., & Marmot, M. G. (2007). A prospective study of change in sleep duration: associations with mortality in the Whitehall II cohort. Sleep 30, 1659-1666. Food and Nutrition Research Institute. (2008). Anthropometric survey component: pre-school children, adolescent, adults, pregnant and lactating mothers. 7th National Nutrition Survey. Retrieved from http://www.fnri.dost.gov.ph/images/stories/7thNNS/anthrop/anthrop _preschool_adoles.pdf. June 9, 2011, a.m. Hublin, C., Partinen, M., Koskenvuo, M., & Kaprio, J. (2007). Sleep and mortality: A population-based 22-year follow-up study. Sleep 30, 1245-1253. Lan, T. Y., Lan, T. H., Wen, C. P., Lin, Y. H., & Chuang, Y. L. (2007). Nighttime sleep, Chinese afternoon nap, and mortality in the elderly. Sleep 30, 1105-1110. Pedro, M. R. A., Barba, V. C., & Benavides-de Leon, R. (2007). Nutrition transition in the Philippines. Philippine Population Review 6 (1), 1-19. Technical Education & Skills Development Authority Region VII. (2007). A survey of the graduates of the PGMA-TWSP 100-hour finishing course for call center agents (2005-2007) in Region VII. Philippine-Australia Human Resources Development Facility (PAHRDF). Van Cauter, E., Holmback, U., Knutson, K., Leproult, R., Miller, A., Nedeltcheva, A., Pannain, S., Penev, P., Tasali, E., and Spiegel, K. (2007). Impact of sleep and sleep loss on neuroendocrine and metabolic function. Hormone Research 67, Suppl.1, 2-9. A POPCOM-7 and PCHRD-CVCHRD-supported Project

The family: Facing challenges amid a changing environment Leny G. Ocasiones

Department of Anthropology, Sociology and History The impact of home environment on the youth cannot be downplayed. Recent news reports on the suicide of a 12-year old girl and a 13-year old boy (SunStar Daily, 2011) after their mothers scolded them for their poor performance in school, highlight this claim. This section discusses young peopleâ&#x20AC;&#x2122;s actual conditions in the home, including relationships. Knowledge of the situation of young people at home can be a useful guide not only for USCâ&#x20AC;&#x2122;s support units but also for other colleges and universities in designing intervention programs. Results generated from the survey, key informant interviews and focus group discussions will be presented in the discussion. The family is defined as a social institution that unites people in cooperative groups to oversee the bearing and raising of children (Macionis, 2006). As the primary agent of socialization, it carries the ultimate responsibility for the well-being of children. Numerous studies suggest that nothing is more likely to produce a happy, well-adjusted child than a loving family (Gibbs, 2001). The discipline of sociology offers a range of insights about the family. The structural-functional approach sees family as the backbone of society as it performs the vital tasks of helping children become well-integrated and contributing members of society. According to this approach, the family regulates sexual activity to maintain kinship organization and property rights, the passing on of parentsâ&#x20AC;&#x2122; social identity for the maintenance of social organization, and offers physical protection, emotional support and financial assistance. The symbolic-interactionist approach, on the other hand, sees family living as an opportunity for intimacy. As family members share many activities over time, they build emotional bonds although the fact that parents act as authority figures often limits closeness with younger children. Only as young people reach adulthood do kinship ties open up to include sharing confidences as well as turning to one another for help with daily tasks and responsibilities.

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Ocasiones: The family: Facing challenges amid a changing environment

The social-conflict approach sees the family as a tool that perpetuates social inequality. F. Engels in the classic book Origin of the Family, Private Property and the State (1884) traced the origin of the family to menâ&#x20AC;&#x2122;s need to identify heirs so that they could easily hand down property to their sons. Thus, families concentrate wealth and reproduce the class structure in each new generation. Likewise, family perpetuates patriarchy as men must control the sexuality of women in order to be able to know their heirs. Families therefore transform women into sexual and economic property of men. Further, the social-conflict approach argues that the family supports racial and ethnic hierarchies as people marry only those who are like themselves (Macionis, 2006). The Filipino family The Filipino family is basically nuclear but functionally extended as most families consist of parents and their children but with recognition and respect for ties between the nuclear family and a whole network of relatives from both sides (Ong, 2011). It is thus common to see grandparents, uncles and aunts playing a part in the raising and nurturing of children. In a recent study by the Commission on Population (2003), more than eight out of 10 youths are raised by both natural father and mother in the Philippines. Living with both parents is considered protective against risks according to the Young Adults Fertility Survey 3 (UPPI/DRDF, 2002). However, four out of nine or 44% have experienced living away from home and increasingly doing so. The same study shows that more females than males live away from home (David, 2001). Based on the structural-functional perspective, the Filipino family is still considered the backbone of society as it functions to maintain kinship ties as well as provide protection, emotional and financial support to its members. However, changes in Philippine society brought about by rapid technological development and modernization have also brought about changes in the Filipino family (Medina, 1995). It is being transformed in form and function in response to changes in society (David, 2001). The once clannish and close-knit Filipino family is now faced with increasing marriage fragility and loosening of family ties as members go abroad to seek greener pastures. The overseas Filipino worker phenomenon has given rise to families where one or both parents are absent and children are raised by relatives. Family experiences and situations are becoming more diverse based on varying economic, social, and personal circumstances. Using the symbolic-interactionist approach, these varied family experiences have affected intimacy among family members which, in effect, has affected individual behaviors especially that of the children. A POPCOM-7 and PCHRD-CVCHRD-supported Project

Young people’s health: Challenges for education and intervention

Varied economic circumstances of Filipino families have contributed to social inequality, as posed by the conflict approach. The typical lowerclass Filipino family, for example, is economically-disadvantaged, with parents having jobs which could not provide for all the needs of the family and with limited access to and awareness of social services (Ong, 2001). On the other hand, upper and middle class families are confronted with a different type of challenge − no longer on survival but on family relationships. Because of work both of the mother and father, children are usually left in the care of domestic helpers or teachers at school (David, 2001). Observed changes in family structural arrangements include the emergence of solo-parent families as well as live-in arrangements. There is also the increasing fragility of marriage particularly in urban areas which, in some instances, have led to dissolution (Medina, 1995). Such circumstances in the family affect young people’s experiences, perceptions and behaviors. Linking the various approaches, the Filipino family continues to be considered the basic unit of society performing both social and economic functions. However, family relationships and intimacy have been affected by changes in family circumstances. Gender inequality is still prevalent within the Filipino family even with the entry of more women to the labor force. Families from the different social classes have different experiences and concerns. Family and adolescent sexual health One emerging issue affecting families is adolescent sexuality. Parents have an important role in providing sex education to their adolescent children. Although policy-makers, program managers, and parents themselves often agree that parents are the preferred providers of sex education, in many societies few parents talk to their children about sex. In the Philippines, it is generally agreed that adolescent sexuality attitudes are initially formed at home and so parental models and teachings are important (UNFPA, 1999). Parents are seen as the appropriate source of information about sex but they are not always open and children hesitate to ask them (Maglasang, 2007; Conaco et al., 2003). This finding is consistent with the study conducted by Mende (2008) and Aguilar et al. (2002) where parents reveal that they find it awkward and difficult to discuss sex and reproductive health matters with their children and would gladly relegate the task to their children’s teachers. Not educated themselves on sex and reproductive health issues, adults often hold mistaken views about the youth’s sexual and reproductive behavior and its consequences as they base more upon assumptions or stereotypes rather than understanding (Kiragu, 2011).

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Ocasiones: The family: Facing challenges amid a changing environment

Family and violence Another issue affecting families is domestic violence, a situation in which one family member causes physical or emotional harm to another family member. At the center of this violence is the abuser's need to gain power and control over the victim through: physical (e.g. slapping, hitting, kicking, punching or burning), emotional (e.g. threats, harassment and insults), and/or sexual abuse (e.g. incest or rape). Through such actions, the abuser tears down the victim's sense of power and security (Cleveland Clinic, 2011). In the Philippines, the number of Violence Against Women (VAW) cases reported to the police in 2008 rose by 37.4 percent. The increase caused the trend to go upward after a six-year downward trend from 2001 to 2006. Physical injuries and/or wife battering remain the most prevalent cases across the twelve-year period, from 1997â&#x20AC;&#x201C;2009, accounting for nearly half (45.5%) of all reported VAW cases nationwide (Philippine Commission on Women Factsheet, 2010). According to the U.S. Department of Justice (2005), a male commits three-quarters of the cases of family violence and more than three women a day are killed by a spouse or significant other. Children who witness this kind of violence in their families suffer traumatic, long-lasting effects. These effects can do mental and emotional harm, and even cause problems with their behaviors and ability to interact well with others (Jernigan, 2011). Thus, the family as the basic institution in society and primary agent of socialization, is faced with various changes and challenges posed by larger societal transformations. Children have varied family experiences which also bring about varied responses to situations of their respective families, and which have implications on their health and well-being. Support mechanisms within the family help promote young peopleâ&#x20AC;&#x2122;s psychological as well as physical well-being. Results The results of the survey (N=699), focus group discussions and key informant interviews give us a glimpse of the actual home environment and family relationships among selected students in USC. Data in Table 1 show that the majority of the survey sample (84%) still live with their parents, with more males (85%) than females (83%) who do so. Among students who live alone (n=114), the proportion of females (44%), as shown in Table 2, is slightly greater than the males (41%). This finding supports the earlier study conducted by the Commission on Population (2003) and reveals a growing independence among young women who are often stereotyped as vulnerable and need protection.

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Young people’s health: Challenges for education and intervention

Other students live only with their siblings (22%), and there are also those who live with relatives (24%). Interestingly, there were students, particularly males (6.8%), who admitted to living together with a partner. Table 1 Study sample by sex and currently living with parents. Currently living with parents

Yes no N

All %

Male %

83.7 16.3 699

85.0 15.0 294

Sex

Female % 82.7 17.3 405

Table 2 Study sample by sex and whom do you live with. Whom do you live with? (for students not living with parents) none (living alone) with siblings only with extended family friends organization live-in partner N

All %

Male %

43.0 21.9 23.7 7.9 0.9 2.6 114

40.9 20.5 27.3 2.3 2.3 6.8 44

Sex

Female % 44.3 22.9 21.4 11.4 .0 .0 70

Table 3 reveals that 41% of students interviewed come from a family that gets along “very well.” Those who say that family relationship is “okay, problems are manageable” account for 55% of the sample. Such perceived good relationship is further reinforced in the way they described their home environment in Table 4 where an overwhelming majority described it as “happy” (62%). A little over a third of the students described their home as “moderately happy,” and a mere two percent of them said that it is “sad and lonely.” This finding shows that despite many of the challenges that our students’ families face, many are able to surpass these and even manage to maintain a positive atmosphere and able to provide physical, emotional and financial needs of family members.

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Ocasiones: The family: Facing challenges amid a changing environment

Table 3 Family relationship by sex. How each member in the family get along

very well okay (problems manageable) relationship not good N

All

Sex

Male %

Female %

40.6 55.2 4.1 699

44.2 51.7 4.1 294

38.0 57.8 4.2 405

Table 4 Home environment by sex (in percent). How would you describe your family and home environment? happy (problems are manageable) moderately happy sad, lonely (full of problems) no response N

All 61.8 34.3 2.4 1.4 699

Sex Male 66.3 30.6 2.0 1.0 294

Female 58.5 37.0 2.7 1.7 405

While majority of students may have answered that they have a â&#x20AC;&#x153;happyâ&#x20AC;? family, Table 5 reveals that the majority of them (59.4%) are faced with a family problem. This inconsistency of answers may be due to Filipino resilience in the face of adversity. Family members as well as relatives tend to bond more and assist each other in times of difficulty and need. Table 5 Problems faced by the family by sex (in percent). Has your family experienced or is your family currently experiencing a serious problem? Yes no N

All 59.4 40.6 699

Male 55.8 44.2 294

Female 62.0 38.0 405

Table 6 presents the kind of problems besetting the family. Here, study participants were allowed to give multiple responses. The majority answered financial woes as the main challenge due to debts, out of job, no income, and gambling. Parents who are always fighting came in second and illnesses of family members came in third. Domestic violence took the lowest rank.

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Young people’s health: Challenges for education and intervention

Table 6 Type of problems by sex (in percent). What kind of problem is/was this? marital (parents always fighting, infidelity) financial (debts, out of job, no income, gambling) health/Illness/disease (any member) domestic violence in the home multiple response

All

Male

Female

32.3 58.8 28.7 3.9

26.2 62.8 26.8 5.5

36.6 56.2 29.9 2.8

These data from Table 6 are reinforced by the results from the key informant interviews and focus group discussions. The first two problems mentioned, i.e. financial and marital woes, were two of the reasons why one key informant attempted to commit suicide. Tired of hearing his parents fight over money and his father’s infidelity to his mother, he sought to end his life by slashing his wrist using a blade. Other familyrelated problems mentioned by both FGD and KII participants are the perceived neglect by parents of their children (e.g. “they are always not around,” “they have no time for children,” “unreasonable comparisons made among siblings”) and favoritism. Another male key informant who got hooked on drugs and impregnated his girlfriend said: “Wala man pirmi si papa, sige mag larga-larga. Wala man sad na sya nagpuyo sa amoa kay second family ra man mi niya. Naa man siyay first family, adto man sya mopauli didto, naa man siyay asawa ug mga anak. Bisita ra man sya usahay namo” (My father is not always around as he travels a lot. He’s not also living with us as we are only his second family. He has his first family and he goes home there to his wife and children).

A female informant mentioned that she got undue pressure from her parents after they repeatedly told her that her sister and brother always excelled in school. This was one of the reasons why she once attempted to commit suicide. She said: “Akong sister ug brother kay mga achievers man kunohay so I get the pressure. My mother would say, ang imong ate daghan kaayog medal pag-graduate.” (My sister and brother are achievers so I get the pressure. My mother would say that your sister has so many medals).

Another male participant revealed that his parents’ employment of favoritism among siblings resulted in his soured relationship with his family: “Kung naa koy pangayoon kay dugay mahatag, unlike sa akong ate or mga manghod. Usahay mag-away mi sa akong mga manghod” (If I ask for something, it takes a long time before they are able to give unlike with my older and younger sisters. Sometimes I get into a quarrel with my younger siblings.

A POPCOM-7 and PCHRD-CVCHRD-supported Project

Ocasiones: The family: Facing challenges amid a changing environment

Table 7 presents the perceptions of survey participants on the effect of a problem on school performance. While the majority said “no” (51.8%), the ones who said “yes” came in a close second at 45.5%. Table 7 Perceived effect of problem on school performance by sex (in percent). Can you say that such problem (s) has/have affected your performance in school? Yes no don’t know N

All

Male

Female

45.5 51.8 2.7 415

43.6 54.6 1.8 163

46.8 50.0 3.2 252

Table 8 implies where young people go in times of family problems. The large majority answered that they go to their friends/peers (44.5%). About 26.9% answered that they go to their parents, next to their siblings at 10.4%, and then to extended family members at 7.9%. A small percentage mentioned teachers, neighbors, priests and guidance counsellors respectively. In the male and female FGDs, approximately half of the participants also mentioned peers as their first choice to turn to when family life gets tough. Here, it is understandable that if the problem is about the family, young people prefer talking to somebody from outside the family circle such as their peers who might have experienced the same situation as they had (see also Amper, Chapter 10). Table 8 Social support by sex (in percent). To whom do you usually go to if you needed help with a family problem? no one parents siblings aunts/uncle/grand-parents/other extended family neighbor friends/peers teachers/professors guidance counselor priest/religious group N

All

Male

Female

7.7 26.9 10.4 7.9 0.9 44.5 1.0 0.1 0.6 699

8.5 29.9 9.2 8.5 1.4 40.5 0.7 1.0 294

7.2 24.7 11.4 7.4 0.5 47.4 1.2 0.3 0.2 405

Table 9 shows that majority of the study participants have not resorted to running away from home in times of family crisis. About 11.4%, though, answered “yes.” This finding means that young people of today still consider the family as important and consider it as the most stable social support they can rely on. A POPCOM-7 and PCHRD-CVCHRD-supported Project

Young people’s health: Challenges for education and intervention

A female key informant had this to say about her family: “Karon noon mas nakasabot ko nila. They did not want me to feel discouraged. Gi-encourage ko nila to do better than my sister. They just want me to be challenged.” (Now I already understand them. They do not want me to feel discouraged. They are just encouraging me to do better than my sister). Table 9 Running away from home by sex (in percent). Have you ever tried running away from home? Yes no N

All

Male

Female

11.4 88.6 699

10.9 89.1 294

11.9 88.1 405

Table 10 Abuses experienced in the family by sex (in percent). At any time in the past, have you experienced the following: physical abuse verbal abuse financial abuse sexual abuse (multiple response)

All

Male

Female

22.7 40.9 8.6 2.1

25.5 39.8 9.9 2.0

20.7 41.7 7.7 2.2

Table 10 presents the type of abuses experienced by students of USC within their families. The majority experienced verbal abuse (40.9%), followed by physical abuse (22.7%) and fewer still experienced financial as well as sexual abuse. This finding suggests that while families can be a “haven in a heartless world” as structural functional theorists argue, abuse and violence in some households are clearly present. This gives credence to the social-conflict assertion that the family could be a tool in perpetuating social inequality − in this case, the parents asserting their dominance by controlling their children through various types of violence and abuse. The result of the survey is complemented by the results in the FGDs. While majority of the participants claimed their family relationships to be okay, a significant number has revealed patterns of abuse and neglect. In the female FGD, one participant was in deep tears when recounting how her mother constantly calls her bogo (stupid) and tiguwang og nawong (looks old). “Uwaw kaayo ko kay there was a time when a friend came and my mom said nga tan-awa, pareha ra siya og age nimo pero tiguwang na kaayo ka og nawong. Mas proud sad ang akong mama sa akong manghud compared sa

A POPCOM-7 and PCHRD-CVCHRD-supported Project

Ocasiones: The family: Facing challenges amid a changing environment 61 Ocasiones: The family: Facing challenges amid a changing environment 61 ako. This happens too often nga sometimes makatubag na lang ko niya.” (Iako. felt so ashamed therenga wassometimes a time when a friend came andkomom said, This happenswhen too often makatubag na lang niya.” look you are of the same age and yet you look so much older. She is also (I felt so ashamed when there was a time when a friend came and mom said, prouder myofyounger siblings. This that sometimes I felt I look youofare the same age and yethappens you looksosooften much older. She is also had to talk back). prouder of my younger siblings. This happens so often that sometimes I felt I --FGD female participant had to talk back).

This atmosphere of criticism has prompted her to--FGD seek female love and participant appreciation outside the homehas resulting to aher same-sex The This atmosphere of criticism prompted to seekrelationship. love and same-sex relationship however did not work out as her lesbian lover appreciation outside the home resulting to a same-sex relationship. The physically emotionally abused on lesbian to the lover same-sex and relationship however didher. not Still, workshe outheld as her relationship for six years even though her girlfriend repeatedly physically and emotionally abused her. Still, she held on to the cheated on her. Another key informant incidences of physical and relationship for female six years even thoughrevealed her girlfriend repeatedly cheated financial abuse from a drunkard father.revealed She said:incidences of physical and on her. Another female key informant financial abuse from a drunkard father. She said: “Akong papa palainom, akong mama namatay sa cancer ug diabetes at 42 years old. Sakit kaayo kay siya mama man akong suod,saang akong “Akong papa palainom, akong namatay cancer ugmasumbungan diabetes at 42 sa akong mga problema. Karon i-keep na lang nako sa akong self, wa ko years old. Sakit kaayo kay siya man akong suod, ang akong masumbungan kahibaw kun sakto ba akong mga decision sa kinabuhi.” (My father a ko sa akong mga problema. Karon i-keep na lang nako sa akong self,iswa drunkard and my mother died due to cancer and diabetes at 42 years kahibaw kun sakto ba akong mga decision sa kinabuhi.” (My father is old. a It was very painful only one I could share my years problems drunkard and mybecause mother she diedwas due the to cancer and diabetes at 42 old. It with. I just keep thingsshe to myself. no longer I have made was Now very painful because was theI only one I know could whether share my problems the right decisions in life). with. Now I just keep things to myself. I no longer know whether I have made the right decisions in life).

Conclusion and Recommendations Conclusion and Recommendations This study undeniably shows that the family is still the primary means of social support among young ofstill students in the means sampleof This study undeniably showspeople. that theMajority family is the primary still livesupport with their parents, siblings or Majority relativesof and they describe their social among young people. students in the sample family relationships in a positive light well”). some their still live with their parents, siblings or(“very relatives andDespite they describe problems, the majority not light to run(“very awaywell”). from home even when family relationships in chose a positive Despite some faced with challenges. Students’ coping mechanism and resiliency are problems, the majority chose not to run away from home even when evident. The majority claim that family problems have not affected faced with challenges. Students’ coping mechanism and resiliency their are performance school.claim The that economic afflicting evident. The in majority familycrisis problems havethe notPhilippine affected their economy however has taken toll on some families. This has performance in school. The its economic crisis Filipino afflicting the Philippine resulted marital conflict, illness ofon family members, violence This and abuse economyinhowever has taken its toll some Filipino families. has in variousinforms in the very place love,members, warmth and acceptance resulted marital conflict, illnesswhere of family violence and abuse ought to have prevailed. Thisplace in turn results towarmth young people’s feelings of in various forms in the very where love, and acceptance insecurity, desire to commit suicide, and engaging in live-in relationships, ought to have prevailed. This in turn results to young people’s feelings of same-sex and other practices. insecurity,relationships desire to commit suicide, and engaging in live-in relationships, same-sex relationships and other practices. While the majority of survey participants perceive that problems in the home affect of their school performance, a significant number While do thenot majority survey participants perceive that problems in of the FGD participants andtheir key school informants reveal thata these do have an effect home do not affect performance, significant number of not on their school performance also on these their social skills and FGDonly participants and key informants but reveal that do have an effect general A cause for concernbut is that of them to and their not onlywell-being. on their school performance also most on their socialrun skills friends when faced with family problems. While nurturing friendship is general well-being. A cause for concern is that most of them run to their friends when faced with family problems. While nurturing friendship is A POPCOM-7 and PCHRD-CVCHRD-supported Project A POPCOM-7 and PCHRD-CVCHRD-supported Project

Young peopleâ&#x20AC;&#x2122;s health: Challenges for education and intervention

important, young people are likely to become more vulnerable to negative influences and practices since their friends to whom they run for comfort may also have problems or even vices of their own. Or, they may be equally inexperienced in dealing with problematic situations in the home. Given the realities in the home and family life of USC students who have been part of this study, it is strongly recommended that student services in the university, particularly the Guidance Office and Office of Student Affairs (OSA) be equipped to provide counseling services and assist students in a non-judgmental manner. Since students are also likely to turn to their friends for support, the peer education approach must be strengthened. This can be done by designing a research-based capacitybuilding program to address the felt needs of USC students. Likewise, teachers, being considered as the second parents, should be tolerant, ready and equipped with counseling skills. This is so that students will not feel that they can only count on their peers or friends whenever they have problems as this study reveals. They need to have other places and persons to turn to who are capable of providing them professional, expert care and guidance. It is also strongly recommended that a mechanism be put in place in the university that would open avenues for the active involvement of parents in the education and university life of their sons and daughters as well as in addressing their emotional needs. Departments/colleges can send letters to parents, hold regular assemblies and other equally important activities to constantly update parents on the progress of their children in school. References Aguilar, E. J., Nolasco, F., & Bersales, J. E. (2002). Breaking the mold: Promoting young peopleâ&#x20AC;&#x2122;s reproductive health. An unpublished research report for the David and Lucile Packard Foundation. Department of Sociology and Anthropology, University of San Carlos. Cleveland Clinic. (2011). Family violence. Retrieved on July 5, 2011 at http://my.clevelandclinic.org. Conaco, C., Jimenez, C. & Billedo, C. J. (2003). Filipino adolescents in changing times. Quezon City: University of the Philippines Center for Womenâ&#x20AC;&#x2122;s Studies. Commission on Population. (2003). Pinoy youth: Making choices, building voices. State of the Philippine Population Report, 2nd Issue. David, R. S. (2001). The Filipino family in the throes of development. In Reflections on Sociology and Philippine Society. Quezon City: UP Press.

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Ocasiones: The family: Facing challenges amid a changing environment

Gibbs, N. (2001). What kids (really) need. Time, April 30, 48-49. Jernigan, K. (2011). The impact of family violence on youth. Retrieved on May 20, 2011 at http://www.livestrong.com. Kiragu, K. (2011). Do adults and youth have differing views?: A case study in Kenya. Retrieved on April 5, 2011 at http://info.k4health.org. Macionis, J. J. (2006). About family and religion. In Society Understanding the Basics (8th ed.). Jurong, Singapore: Pearson Education South Asia. Maglasang, A. G. (2007). Attitude of parents towards the teaching of sexuality education in selected secondary schools of Cebu City. Paper presented at the UPV in-house research presentation. Medina, B. (1995). Issues relating to Filipino marriage and family. PSSC Social Science Information Vol 23, Nos. 1-2, pp. 36-41. Mende, R. V. (2008). The parent, the teacher, the adolescent and sex education. Master’s Thesis. UP Visayas Cebu College. Ong, M. (2011). The role of the family in Philippine society and in the protection of children’s rights. Retrieved on July 1, 2011 at http://www.google.com.ph. Philippine Commission on Women Factsheet. (2010). Retrieved on July 25, 2011 at http://pcw.gov.ph. Sun Star Daily. (2011). Boy’s suicide to teach parents. Retrieved on June 10, 2011 at www.sunstar.com.ph/cebu. Sun Star Daily. (2011). Girl, 12, kills self after mom told her she's 'dumb'. Retrieved on June 10, 2011 at www.sunstar.com.ph. United Nations Population Fund. (2011). Sexuality and adolescent development. Retrieved on April 11, 2011 at http://www.popcom.gov.ph/sppr/sppr02/pdf/sppr02- whole.pdf. UPPI/DRDF. (2002). 2002 Young adult fertility & sexuality study (YAFS3). Quezon City, Philippines: UP Population Institute and the Demographic Research and Development Foundation, Inc. US Department of Justice. (2005). Bureau of Justice Statistics: Family Violence Statistics: Including Statistics on Strangers and Acquaintances. A POPCOM-7 and PCHRD-CVCHRD-supported Project

Spirituality of the Carolinian student today Br. Romualdo E. Abulad, SVD

Department of Philosophy and Religious Studies What is spirituality? This is a word which even scholars and theologians have struggled to define. Happily, however, the word itself contains a key to its meaning which we might as well take as a cue to how we would like to use it in this study. This key is “spirit.” The spirit of the law, for instance, is not necessarily the same as the letter of the law. Without getting ourselves into much controversy, which is not the intent of this chapter, one might say that spirit is to be distinguished from matter, the soul from the body. The latter is external, while the former is internal. Indeed, true spirituality is an intimate, perhaps even a hidden aspect of the human condition, and yet it has sure manifestations in a person’s external behavior, personal as well as social. There is thus a whole range of spirituality (or spiritualities), from the crudest to the subtlest types, justifying the observation of Philip Sheldrake (1992: 32) that “every generation has to redefine what precisely spirituality is meant to encompass.” Is there a relationship between spirituality and health? Various studies in the medical field have pointed out the interconnectedness between body, mind and spirit. J. Levin (2001), in his book God, faith and health: Exploring the spirituality-healing connection, presents compelling evidence from various religious traditions on the connection between health and a wide array of spiritual beliefs, faith and practices including prayer, meditation and worship services. Levin posits that improving one’s spiritual health may not solve a problem nor cure an illness but it helps one feel better, prevents health problems and helps one cope with illness, stress or death, thereby contributing to a person’s healing and sense of well-being. This study would like to show the USC students’ spirituality level based, however, on external criteria which do not necessarily reflect the true interior life of the students, nor how this spirituality is manifested in the everyday movements of their life.

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Young people’s health: Challenges for education and intervention

Using the survey results of the Young People’s Health Project, this chapter will describe the level of spirituality of the USC sample (N=699) on the basis of the following criteria: (1) whether they go to church; (2) whether they read the Bible; (3) whether they pray; and (4) whether they join religious organizations. We will try to interpret the data (i.e. going to church, reading the Bible, praying, and joining religious organizations) for what they are worth, recognizing that this is the first time that such a study on the spirituality of our students has ever been undertaken. For that reason alone this effort must be taken seriously and indeed followed up earnestly by other studies. Qualitative data on spirituality are presented in Chapter 10 of this monograph (see Amper) especially among young people with serious health concerns. Results and Discussion Going to Church Table 1 shows that 97% of the sample go to church, either “always” (54.4%) or “sometimes” (42.6%). This is an impressively good proportion, with only 3% of students saying they “never” go to church or attend mass. It is, of course, not known whether “always” means “everyday” or “every Sunday only.” The worst scenario would be that “always” means “every Sunday,” which could easily be taken for “sometimes.” Even in this context, however, it remains that 97% of our students go to Church “sometimes,” at least on Sunday. Although this does not measure the authenticity and interior passion of their faith, much less their understanding of it, this at least implies that our students are safely secure in their religion and are not avowed atheists. There is a larger proportion of females (57.8%) than males (49.7%) who always go to church, and a larger proportion of males (4.8%) than females (1.7%) who claim they never to go to church. “Church” refers, of course, to any church, although the majority of the USC students are Catholics. The data show that there is a relationship between “sex” and “going to mass/church” (at the p<.05 level). Hence, one can therefore say that females are more likely to go to church than males.

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Abulad: Spirituality of the Carolinian student today

Table 1 Study sample by sex and going to mass/church. How often do you attend mass?* always sometimes never N *Chi-sq. p<.05

All

Male

Female

54.4 42.6 3.0

49.7 45.6 4.8

57.8 40.5 1.7

699

294

405

Of equal interest is Table 2 which shows that the highest proportion of church-goers (“sometimes” and “always”) in the sample is registered by students enrolled in the College of Pharmacy (100%), closely followed by the College of Commerce (99%). On the other hand, the lowest proportion of church-goers is registered by students from the College of Engineering (93.2%) where majority of the population are males and are scienceinclined. The College of Arts and Sciences follows next (94.2%), the college which is composed of students who are studying natural and social sciences. What the data want to tell us is that the study sample generally goes to church. Again, a significant relationship between “college” and “going to church” is established in the study (at the p<.01 level). Students who are in the science and technology-related courses are less likely to go to church when compared to the other groups. Table 2 Study sample by college and going to mass. How often do you attend mass?** always sometimes never N **Chi-sq. p<.01

All

COM

PHA

AFA

ENG

NUR

54.4 42.6 3.0

61.0 38.1 1.0

69.7 30.3 0

57.0 40.0 3.0

50.0 44.2 5.8

44.8 53.1 2.1

44.2 49.0 6.7

55.4 42.6 2.0

699

105

100

104

101

Reading the Bible Based on Table 3, roughly two-thirds of the sample population read the Bible (63.4%), with a larger proportion of females (69.1%) than males (55.4%) who do so. Whether the association (at the p<.001 level) is accurate is hard to say given the fact that more females than males were drawn in the sample. A POPCOM-7 and PCHRD-CVCHRD-supported Project

Young people’s health: Challenges for education and intervention

Table 3 Study sample by sex and reading the Bible. Do you read Bible?*** Yes No N ***Chi-sq. p<.001

All

Male

Female

63.4 36.6

55.4 44.6

69.1 30.9

699

294

405

Table 4 heavily favors “sometimes” (87.1%) as the rate of frequency of Bible reading. Still, a larger proportion of females (12.1%) say they always read the bible as compared to the proportion of males (9.8%) who say they do. It is, however, not clear if this reading of the Bible is done privately as a matter of personal initiative or in class as a requirement of a Religious Education teacher. This likewise shows no indication as to the quality of the understanding that results from such a reading. Much less do these statistical figures show what effect this has on their personal and social life and relationships, or how much the message of the Scripture has been translated into ethical and apostolic action. At its face value, however, the statistics shows that majority of our students are at least familiar with the Bible. Table 4 Study sample by sex and frequency of Bible reading. How often do you read Bible? (%) Always Sometimes Never

All

Male

Female

11.3 87.1 1.6

9.8 87.7 2.5

12.1 86.8 1.1

443

163

280

Somewhat interesting is the tendency of students to read the Bible less and less, the longer they stay in the University, as reflected in Table 5. The test for association, however, does not indicate that a relationship exists between these two variables. Table 5 Study sample by year level and reading the Bible. Do you read the Bible?

All

Yes No

63.4 36.6

1 Year 69.3 30.7

699

189

2 Year 61.3 38.7

3 Year 61.6 38.4

4 &5 Years 60.7 39.3

191

151

168

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Abulad: Spirituality of the Carolinian student today

Nursing (77.2%), followed by Commerce (72.4%) and the College of Arts and Sciences (68.3%), registered the highest proportion of students who read the Bible. The data show that “college” and “Bible reading” are two related variables. The significance of chi square for this relationship is at the p<.01 level (Table 6). From the data, one can therefore say that the study sample generally read the Bible. It may be well to note here that “reading the Bible” can be interpreted in different ways, and females and males or students from each college might have varying interpretations. This is perhaps one area of concern which can be explored in future research. Table 6 Study sample who read the Bible by college. Do you read the Bible?** (%) Yes No N **Chi-sq. p<.01

All

COM

PHA

AFA

ENG

NUR

63.4 36.6

72.4 27.6

58.4 41.6

54.0 46.0

68.3 31.7

56.2 43.8

55.8 44.2

77.2 22.8

699

105

100

104

101

Praying Going by Tables 7, 9 and 10, one may conclude that almost all (98.8%) of our students pray at least once daily or when the need arises. Only 1.3% of them say they do not pray at all. “Praying” here includes not only the prayer formulas (the usual Our Father, Hail Mary, Glory Be, as well as the prayers before and after meal, etc.), novenas and rosaries, and other external devotions, but also personal prayers. Still, one can see in Table 7 that a larger proportion of females (94.1%) pray once to thrice a day as compared to the proportion of male (85.7%) who say they do. On the other hand, a larger proportion of males (12.2%) say they pray only when the need arises as compared to the proportion registered for females (5.2%). As in other indicators of spirituality presented earlier (going to church and reading the bible), the females are more prayerful than the male students. These prayerful students cut across all the colleges (see Table 8). All of the survey sample from the Colleges of Commerce, Education, Pharmacy and Nursing say they pray at least once a day or when the need arises. A larger proportion of respondents from the Colleges of Nursing (41.6%) and Pharmacy (43.8%) say they pray thrice a day. These students belong to the health care sciences, currently under the School of Health Care Professions.

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Young peopleâ&#x20AC;&#x2122;s health: Challenges for education and intervention

Table 7 Study sample by sex and praying. How often do you pray in a day? *** (%) once a day twice a day thrice a day I do not pray at all I pray only when the need arises N ***Chi-sq. p<.001

All

Male

Female

32.2 27.3 31.0 1.3 8.2

36.4 22.4 26.9 2.0 12.2

29.1 30.9 34.1 0.7 5.2

699

294

405

A few students from the Colleges of Architecture and Fine Arts (4.8%), Arts & Sciences (3.8%) and Engineering (1%) do not pray at all. Furthermore, a larger proportion of students from the College of Engineering (17.3%) pray only when the need arises when compared to those coming from other colleges. Table 8 Study sample by college and praying. How often do you pray in a day?*** (%) once a day twice a day thrice a day I do not pray at all I pray only when the need arises N ***Chi-sq. p<.001

All

COM

PHA

AFA

ENG

NUR

32.2 27.3 31.0 1.3 8.2

31.4 37.1 23.8 .0 7.6

31.5 20.2 43.8 .0 4.5

34.0 28.0 29.0 4.0 5.0

33.7 25.0 30.8 3.8 6.7

33.3 30.2 29.2 .0 7.3

41.3 19.2 21.2 1.0 17.3

19.8 30.7 41.6 .0 7.9

699

105

100

104

101

Prayer is likewise resorted to in times when students are faced with problems. From Tables 9 and 10, only 5% say they never pray even when faced with a problem; while 95% say they do. As to gender, a larger proportion of female students (97.2%) pray when they have a problem; as compared to the proportion of male students (91.9%) who say they do. It may be well worth to note here that from the focus group discussions, the male and female participants said they pray in the face of problems including financial, family, love life, and academics. Young people with serious health challenges likewise shared that prayer became their last resort when they had no one else to turn to during the times they had to

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Abulad: Spirituality of the Carolinian student today

face a lot of trials and problematic situations (see also Amper, Chapter 10). Table 9 Study sample by sex and praying when faced with a problem. When you are faced with a problem, do you resort to praying?*** (%)

All

Male

Female

always sometimes never

60.2 34.8 5.0

48.0 43.9 8.2

69.1 28.1 2.7

699

294

405

***Chi-sq. p<.001

Across all colleges, the study sample pray when faced with a problem. From Table 10, CAFA (10%) had the largest proportion of those who said they never pray when faced with a problem; followed by Engineering (6.7%); and Arts & Sciences (5.8%). On the other hand, the largest proportion of respondents who say they pray when they have problems are from the College of Commerce (98.1%) followed by Nursing (97%) and Pharmacy (96.7%). Table 10 Study sample by college and praying when faced with a problem. When you are faced with a problem, do you resort to praying? (%)

All

COM

PHA

AFA

ENG

NUR

always sometimes never

60.2 34.8 5.0

69.5 28.6 1.9

60.7 36.0 3.4

64.4 29.8 5.8

58.3 37.5 4.2

55.8 37.5 6.7

65.3 31.7 3.0

699

105

47.0 43.0 10.0 100

104

101

However, there is no way the interior life is measured by these statistics. The most that can be said is that almost all our students pray, even if (at worst) mechanically, which indicates sufficiently enough that they at least believe in God, even if (at worst) merely as a matter of habit or conditioning. There is just no way these figures will be able to reflect the quality of prayer of our students.

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Young peopleâ&#x20AC;&#x2122;s health: Challenges for education and intervention

Joining religious organizations If membership in a religious organization were to be used as the basis by which to gauge the spirituality of our students, Tables 11 and 12 would show how little spirituality our students have. Only 24.3% have joined a religious organization, against 75.7% who have not. Still, a larger proportion of females (27.9%) as compared to the proportion of males (19.4%) say they are members of a religious organization. These religious organizations that they are members of may be on-campus or off-campus as it is not specified in the survey instrument. Table 11 Study sample by sex and membership in a religious organization. Are you currently a member of a religious organization?

All

Male

Female

Yes No

24.3 75.7

19.4 80.6

27.9 72.1

699

294

405

Interestingly from Table 12, the College of Education (82.3%) had the largest proportion of respondents who say they are not members of any religious organization, followed by Engineering (78.8%). Table 12 Study sample by college and membership in a religious organization. Are you currently a member of a religious organization?

All

COM

PHA

AFA

ENG

NUR

Yes No

24.3 75.7

29.5 70.5

27.0 73.0

28.0 72.0

26.0 74.0

17.7 82.3

21.2 78.8

20.8 79.2

699

105

100

104

101

The finding that few students have registered positively when asked if they belong to any official religious group is surprising. At USC alone, there are existing religious organizations apart from Campus Ministry such as Youth for Christ, Catholic Charismatic Carolinian, Carolinian Youth Ministry, and The Movement. The non-membership of many students is perhaps an indication of their lack of interest or lack of information on this aspect. Every academic department with a majorsâ&#x20AC;&#x2122; program has a mandate to put up a co-curricular student organization, to include those which serve the spiritual needs of USC students. Besides Campus Ministry, there is also CES (Community Extension Services), an A POPCOM-7 and PCHRD-CVCHRD-supported Project

Abulad: Spirituality of the Carolinian student today

office that handles the school apostolates, although it is more of an office than an organization. The low statistics registered in Tables 11 and 12, however, do not in any way affect the figures in Tables 1-10. Conclusion Based on the survey results, the Carolinian students who are included in the sample go to church (97%), read the Bible (63.4%) and pray at least once a day (98.7%). If these are made the bases of spirituality, then we can say that our students are a spiritual lot, even if many of them do not belong to any religious organization. We have, therefore, the externals of spirituality, but such externals are just about the minimum required of an authentic spirituality which have to do, too, with the interior life. Going to church “always” could very well be a matter of Sunday habit, reading the bible “sometimes” could just be a requirement in a REED class, and prayer can be merely the recitation of formulas. What the impressive figures indicate is that we have just a few unbelieving atheists among our students, and that is a very heartening thing indeed. The seed of spirituality is therefore in the midst of us. The challenge is to nourish and make the seed grow into a passion that is truly of the spirit, private and creative as well as free, expressing itself outwardly in terms of a stalwart, practical morality and an apostolic zeal for dialogue and mission. Recommendations This first academic attempt to do research on the spirituality of the Carolinian students can hardly be described as adequate and thus should be followed by more studies. Considering that the life of the spirit cannot be fully measured by external indicators, research in this area calls for much creativity and subtle strategy. For example, why do students go to church at all? There is a whole range of motivations from fear of hell and mere habit to authentic call and profound charity. Exactly when do students go to church “always” and “sometimes”? Is it to attend the Sunday mass, or make a visit to the Sacrament, or as a private spiritual exercise to commune with the Lord? Exactly what is meant by reading the Bible “sometimes”? If this is done only in a Religious Education class at the instruction of a teacher, how much value may we attach to it? Moreover, does reading necessarily imply understanding? How solid is our students’ grasp of the meaning and scope of the Bible? How well is this understanding, if at all, integrated into one’s life?

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Young people’s health: Challenges for education and intervention

Again, there is a whole range of prayers, from the mere recitation of formulas to a truly meditative and mystical experience. If the psalmist enjoins us to pray ceaselessly, there should then be a sense in which counting the times we pray daily may no longer be too profound. Why do our students pray anyway? And what sort of an experience is prayer? Can the effect of the Carolinian students’ life of prayer be felt in the community? These are some of the questions which future research can explore. It is also recommended that a study on how far our students understand the SVD spirituality. Do they at least know the names of our SVD saints and founders? Are they aware of the missionary nature of our university? Why is the SVD spirituality characterized by “prophetic dialogue”? Lastly, there is a need to establish the link between spirituality, health and a sense of well being among the Carolinian students. Spirituality should address multiple parts of one’s life, not just the participation in organized rituals or religious life.

References Levin, J. (2001). God, faith and health: Exploring the spirituality-healing connection. New York: John Wiley and Sons. Sheldrake, P. (1992). Spirituality and history: Questions of interpretation and method. New York: Crossroad.

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Smoking, alcohol intake and drug use among young people at USC Aleksander Gaut, SVD

Department of Anthropology, Sociology and History This chapter will describe the smoking, alcohol intake and drug use patterns of the USC survey sample (N=699), and explore whether these behaviours are associated with family problems. The study seeks to identify the factors or conditions that push or constrain young people to or from smoking, alcohol intake and drug use. It is envisioned that results generated will be able to capture and unveil the complex and multi-layered dimensions of young people’s social life, and will be used to craft intervention approaches to address young people’s health concerns. Smoking, alcohol intake and drug use are risk-taking behaviours commonly observed among young people across time, space and generation. People attach different meanings to these practices according to their existential environments. Culture plays a critical role in shaping the meaning of these behaviours. In more traditional societies, these practices are widely accepted and considered part of socio-cultural processes. The culturally-shaped patterns of meaning and assumptions evolve as society changes. As society becomes more complex and modern, new world views emerge, the grip of control over behavioural pattern, and the traditionally maintained meanings are shaken, if not discarded altogether (Durkheim, 1984). Culture change promotes heterogeneous behavioural patterns, and as a consequence, the controlling mechanisms of society become lenient. The loose observance of commonly-accepted norms partially explains why young people, even at an early age, engage in smoking, drinking alcoholic beverages and drug use. From a medical perspective, drug use envelops human existence from birth to death − from a hospital’s delivery room to the intensive care unit. Smoking and drinking, on the other hand, are universally considered ordinary and accepted by different cultures, and even becoming part of cultural initiation and the socialization process. People who are into drugs, smoking and drinking alcohol do so for a vast number of reasons − medical, pleasure, relief and other culturally-influenced reasons -76-

Gaut: Smoking, alcohol intake and drug use among young people at USC

including initiation/rites of passage and rituals. Just as drug use goes far back in history, so does drug abuse. History tells us that drug use for medical purposes could be traced back to ancient Chinese practices as early as 2737 B.C. (Ray, 1978) where drugs were used as pain relievers. Marijuana was used as pain reliever in Afghani and Pakistani villages. The famous ancient Greek physician, Hippocrates even recommended drugs and wine to relieve depression and anxiety (Blum, 1969, cited in Henzlin, 2000). Sigmund Freud also experimented on the therapeutic uses of cocaine (Santrock, 2001). Reports on drug addiction, drug use, smoking and drinking alcohol among young people are skyrocketing (Henzlin, 2000; Santrock, 2001; Flemming & Towey, 2004; Mayer & Kelly, 2006). The situation has led to serious health, economic and socio-cultural problems in society (e.g., accidents, violence, crimes, respiratory diseases, and other health concerns). Other consequences are expected to stem from these practices (Fleming & Towey, 2004; IYDS, 2004; Wechsler et al., 2002; Hingson et al., 2002). Studies have also shown that the mean age of young people who are engaged in smoking, drinking and drug use reflects the prevalence of these practices among the very young. The universal availability of substances (illegal drugs are circulated or distributed through the underground economy or black market), and the frequent and enticing advertisements in both print and electronic mass media have contributed to their penetration in various spheres of social life, encompassing various target groups across age brackets (Unger & Chen, 1999; Flemming & Toway, 2004). The conditions are exacerbated by other factors such as the collapse of collective conscience (Durkheim, 1984), the absence of parental control (Cohen et al., 1994), permissive environment and peer influence (Fleming & Towey, 2004). Todayâ&#x20AC;&#x2122;s young people are thrown into an open market of various commodities where the only arbiter (control mechanism) is oneâ&#x20AC;&#x2122;s personal judgment and conscience. All of these result in unprecedented statistical figures of young peopleâ&#x20AC;&#x2122;s involvement in smoking, alcohol intake and drug use. In the United States, Gassman et al. (2009) found that marijuana use among students in Grades 10 and 11 is prevalent and the number is increasing. The trend indicates serious threats on the health and wellbeing of high school and college students (Lewis & Gouker, 2007; Johnston et al., 2009).

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Philippine situation In the Philippines, young adults engage in smoking, drinking and drug use usually between the ages of 12 and 21. In 1999, the smoking prevalence among males was at 40.3% higher when compared to females (4.1%). Alcohol intake (37%) among this group was also found to be a common practice (Domingo & Marquez, cited in Raymundo et al., 1999). Similarly, a study conducted by the University of the Philippines Population Institute in 1996 showed that the initial use of nicotine, alcohol and drugs in the Philippines is usually engaged in between the ages of 16 and 17. Forty percent of the males surveyed were found to be smokers, and 37% of the sample take alcoholic drinks (Banaag & de Jesus, n.d). A survey on school-based students revealed that one in five students experience drinking an alcoholic beverage at age 13, or even younger. The boys (24.8%) were more likely than girls (14.3%) to start drinking alcohol at this age (Miguel-Baquilod, 2004). Various studies point to an unprecedented prevalence of Filipino youths who use illegal drugs, including high school students (Banaag & de Jesus, n.d.; Raymundo, 1999; Domingo & Marquez, 1999; Miguel-Baquilod, 2004). The commonly-used drugs among Filipino youths include “shabu” (the local name for methamphetamine), marijuana, and inhalants. The magnitude of young people who use substances such as nicotine and alcohol continues to rise. Condrad et al. (1992) raised other dimensions on this issue. First, they noted that young people whose parents are smokers are more likely to smoke. Second, they argued that smoking, drinking alcohol and drug use among young people are caused by the ready availability of cigarettes, alcoholic beverages, and even drugs at home. Despite some sporadic reports which claim a declining tendency in young peoples’ involvement in these behaviours, other studies point to a high and critical prevalence of these practices. Implied in these studies is that the phenomenon of smoking, drinking and drug use is a multifaceted issue (private, social, economic, cultural, political, moral, and even environmental). Endeavors to control or reduce the prevalence of these practices require the restructuring of the abovecited dimensions. The unanticipated by-products of smoking, drinking alcohol and drug use have triggered massive concern among the various sectors of society − the reason why continuing studies are conducted to develop recommendations to the challenges posed by these behaviours.

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Gaut: Smoking, alcohol intake and drug use among young people at USC

Results The present study was conducted at the University of San Carlos in Cebu City, Philippines. A total of 699 students, spread over USCâ&#x20AC;&#x2122;s seven colleges, were included in the sample. Focus group discussions and key informant interviews were likewise conducted. This chapter, however, presents only the results of the survey. Qualitative data on the same domains (smoking, drinking and drug use) are discussed in Chapter 10 (see Amper). Smoking The data in Table 1 show that slightly over 70% of young people in the sample do not smoke cigarettes. This study has established that males (33.3%) are more likely to indulge in smoking than females (24.9%). Smokers from both sexes reported that they have friends who also smoke. A possible explanation for this behaviour is that students have the tendency to socialize with peers who possess the same behaviour. The relatively low incidence of smoking among this group could be attributed to factors such as (i) family upbringing and control, (ii) USCâ&#x20AC;&#x2122;s no smoking policy, or (iii) the respondentsâ&#x20AC;&#x2122; understanding of the negative effects of smoking. Table 1 Smoking by sex and friends who smoke (in percent). Do your friends smoke cigarettes? ***

All

Male

Female

29.6 23.5 46.9 699

37.8 13.9 48.3 294

23.7 30.4 45.9 405

Yes 28.5 No 71.5 N 699 **Chi-sq p<.01, ***Chi-sq. p<.001

33.3 66.7 294

24.9 75.1 405

Yes No Some of them, not all N Do you smoke? **

Worth noting is the minimal 8.4% difference in the proportion of males and females in the sample who smoke, an indication that smoking is becoming a common practice among young people be they male or female.

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Alcohol intake Another behaviour which has been found to be prevalent in the study sample is alcohol intake. Table 2 shows that more males (90.8%) than females (82.2%) are engaged in this behaviour, and that the figures registered by both sexes are significantly high. When asked whether they have friends who drink beer or any alcoholic beverage, a considerable number of them said “yes” (70.5%). If responses for “some of them” (23.7%) are considered, the figure would be higher. In Table 3, a significant proportion of students from all colleges have tried drinking an alcoholic beverage. Alcohol intake is also becoming an acceptable practice among young people regardless of the course they are taking. The great majority of them, particularly the males, also have friends who drink alcohol. Students from the College of Engineering and Architecture and Fine Arts are, however, more likely to drink than students from other colleges. Table 2 Alcohol intake by sex and friends who drink (in percent). Do your friends drink beer or any other alcoholic beverage? *** Yes No Some of them, not all N Have you ever tried drinking beer or any alcoholic beverage? *** Yes No N ***Chi-sq. p<.001

All

Male

Female

% 70.5 5.7 23.7 699

% 77.2 3.4 19.4 294

% 65.7 7.4 26.9 405

85.8 14.2 699

90.8 9.2 294

82.2 17.8 405

Table 3 Alcohol intake by college (in percent). Alcohol Intake ** Yes No N **Chi-sq p<.01

All

COM

PHA

CAFA

EDUC

ENG

NUR

85.8 14.2 699

77.1 22.9 105

79.8 20.2 89

91.0 9.0 100

83.7 16.3 104

88.5 11.5 96

91.3 8.7 104

89.1 10.9 101

As can be gleaned from Table 4, the proportion of students who have been taking alcoholic beverages is significantly high regardless of age

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Gaut: Smoking, alcohol intake and drug use among young people at USC

group, although the behaviour is more pronounced among those within the 21-24 age group, followed by those in the 18-20 age bracket. Incidence of alcohol intake among the study sample increases as they become older. Table 4 Alcohol intake by age group (in percent). Alcohol Intake *** Yes no N ***Chi-sq. p<.001

All 85.8 14.2 699

15-17 76.0 24.0 171

18-20 86.7 13.3 415

21-24 97.3 2.7 113

Regardless of sex, close to 80% of the sample drink beer or other alcoholic beverage occasionally, that is, during special events or parties (Table 5). Among the “regular” drinkers, more males (13.5%) than females (7.5%) do so. There are more females (15.3%) than males (9.4%), however, who said they have tried drinking alcohol a few times only out of curiosity. Table 5 Frequency of drinking by sex (in percent). How often do you drink alcoholic beverage? ** Regularly (everyday or every weekend) Occasionally (special events, parties) Tried a few times only due to curiosity N **Chi-sq p<.01

All

Male

Female

10.2 77.2 12.7 600

13.5 77.2 9.4 26.7

7.5 77.2 15.3 333

Looking at students’ drinking pattern across year levels, Table 6 shows that a larger proportion of fifth year students (33.3%) drink on a more regular basis, be it everyday or every weekend. Occasional drinkers are more evident among the other year levels. Table 6 Frequency of drinking by year level (in percent). How often do you drink alcoholic beverage? * Regularly (everyday/every weekend) Occasionally (special events, parties) Tried a few times only due to curiosity N *Chi-sq p<.05

All

10.2 77.2 12.7 600

7.2 77.6 15.1 152

9.2 80.9 9.9 152

7.9 79.3 12.9 140

13.3 73.3 13.3 135

33.3 57.1 9.5 21

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Evident in Table 7 is that the proportion of students who drink regularly is higher among those in the 21-24 age group. For occasional drinkers, the figure registered for all age groups is high. Table 7 Frequency of drinking by age group (in percent). How often do you drink alcoholic beverage? Regularly (everyday or every weekend) Occasionally (special events, parties) Tried a few times only due to curiosity N

All

15-17

18-20

21-24

10.2 77.2 12.7 600

6.2 79.2 14.6 130

10.3 76.7 13.1 360

14.5 76.4 9.1 110

Drug use Majority of the study sample (94.3%) have not tried using drugs for recreational purposes, and more than half of them (59.2%) have no friends who are engaged in drug use. Table 8 shows that only 10.7% of the students have friends who have used drugs, although this figure could be higher when responses given to “some of them” (15.3%) actually means that their friends are into drugs. The low exposure of respondents to friends who are using drugs may explain why only 5.7% of them are engaged in drug use. A larger proportion of the male sample (9.5%), as compared to females (3.0%), have tried using drugs. The study has established that there is a significant association between drug use and having friends who use drugs (p<.000). The lower the degree of exposure to drug users, the lesser is the likelihood of using drugs, and so does the opposite. Table 8 Drug use by sex and friends using drugs (in percent). Have friends who are using drugs *** Yes No Some of them Don’t know N Ever tried using drugs for recreational purposes? *** Yes No N ***Chi-sq. p<.000

All

Male

Female

10.7 59.2 15.3 14.7 699

16.0 50.7 17.0 16.3 294

6.9 65.4 14.1 13.6 405

5.7 94.3 699

9.5 90.5 295

3.0 97.0 405

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Gaut: Smoking, alcohol intake and drug use among young people at USC

Types of drugs used. Table 9 displays the different drugs which have been tried by user-respondents. Marijuana (85%) is the most common drug used while shabu (30%) ranks second. Other drugs used include cocaine (10%), ecstacy (7.5%) and rugby (2.5%). Despite the relatively low figures registered for cocaine and ecstacy, the fact remains that these are dangerous drugs. Further, these are expensive drugs which only highincome groups can afford. In this study, drug use is more evident among the males. Of the 28 males and 12 females who have tried using drugs, 89.3% and 75%, respectively, tried marijuana. A third of the females and 29% of the males tried â&#x20AC;&#x153;shabu.â&#x20AC;? The data also show that only males have used other types of drugs. Table 9 Types of drugs ever tried by sex (in percent). What drugs have you tried?

All N=40 85.0 30.0 2.5 7.5 2.5 10.0

Marijuana/Cannabis Shabu Cough Syrup Ecstacy Rugby Cocaine

Multiple Response

Male (n=28) 89.3 28.6 3.6 10.7 3.6 14.3

Female (n=12) 75.0 33.3 .0 .0 .0 .0

Note: % within Sex.

Looking at the data for types of drugs ever tried by college, one can see in Table 10 that all of the students who admitted to having used drugs in the past from the Colleges of Pharmacy and Engineering used marijuana. The figures registered by other colleges, however, is also significantly high for this type. In reference to shabu, students from the College of Nursing registered the highest proportion, at 50%, followed by the College of Commerce (42.9%), Education (40%), College of Arts and Sciences (28.6%), and Architecture and Fine Arts (10%). Table 10 Types of drugs ever tried by college (in percent). Drugs ever tried? Marijuana/Cannabis Shabu Cough Syrup Ecstacy Rugby Cocaine

Multiple Response

All

COM

PHA

AFA

CAS

EDU

ENG

NUR

85.0 30.0 2.5 7.5 2.5 10.0

85.7 42.9 14.3 14.3

100 -

90 10.0 10.0 10.0

85.7 28.6 14.3 14.3

80.0 40.0 20.0

100 50.0 -

75.0 50.0 12.5 -

Note: % of Total.

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Age at first drug use. Half of the respondents (N=40) who admitted to having used drugs had their first taste of the substance when they were between the ages of 16 and 18 (Table 11), with a larger proportion of females (83.3%) than males (35.7%) who said so. The age bracket points to a group of junior college students (1st year to 2nd year). The mean and median ages at first use of drugs is the same, at 17 years old. Those who first tried using drugs at an earlier age (13-15 years old) account for 25% of the sample, and this is more evident among the males (32.1%) than females (8.3%). The data imply that these students were still in high school at the time they first experienced using drugs. Table 11 Age at first drug use by sex (in percent). Age at first use of drugs

All

13-15 years old 25.0 16-18 years old 50.0 19-21 years old 25.0 N 40 Mean & Median Ages: 17 years old

Male

Female

32.1 35.7 32.1 28

8.3 83.3 8.3 12

In reference to age at first use of drugs by year level, it is alarming to note that half of the 1st year respondents who admitted to have engaged in drug use were initiated into drugs while at the ages of 13 to 15. This age range translates to when they were still in high school. This figure is higher compared to that registered by 3rd (40%) and 4th (27.3%) year respondents. All 5th year respondents admitted to using drugs while at the ages of 16 to 18. This observation holds true as well for 2nd year (61.5%), 3rd year (40%), and 4th year respondents (36.4%) (Table 12). Table 12 Age first use of drugs by year level (in percent). Age at first use of drugs 13-15 years old 16-18 years old 19-21 years old N

All

25.0 50.0 25.0 40

50.0 50.0 -4

7.7 61.5 30.8 13

40.0 40.0 20.0 10

27.3 36.4 36.4 11

-100.0 -2

Moreover, Table 13 shows that almost all of the respondents said that they first tried using drugs in the presence of their peers or friends (92.5%). Only 7.5% of both sexes reported that they used drugs for the first time while alone by themselves.

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Gaut: Smoking, alcohol intake and drug use among young people at USC

Table 13 First use of drugs alone or with friends by sex (in percent). During the 1st drug experience, did you do it alone or with some friends? alone with friends N

All

Male

Female

7.5 92.5 40

10.7 89.3 28

100.0 12

Family problems, drug use and alcohol intake Although a separate chapter is devoted to discussing about the home and family environment of young people at USC (see Ocasiones, Chapter 4), this chapter attempts to determine whether there is an association between family problems and drug use, and family problems vis-Ă -vis alcohol intake. Evident in Table 14 is that 59.4% of the respondents (or, 415 young people at USC) are experiencing a serious family problem. Of this number, 7.5% of them have tried using drugs. On the other hand 40.6% of the respondents (or, 284 young people at USC) reported that their family is not currently experiencing a serious family problem, and of this number, 3.2% of them have tried using drugs. The data imply that students with family problems are more likely to resort to drug use. The association between problems and drug use may not be strong (at the p<.05 level) but is nonetheless worth mentioning. On the whole, however, the study has shown that only a minority of the sample population at USC have used drugs. Table 14 Family problem and drug use. Have you ever tried using drugs for recreational purposes? * Yes no N % to the Total *Chi-sq p<.05

Is your family currently experiencing a serious problem? Yes No All n % n % N % 31 7.5 3.2 9 5.7 40 384 92.5 96.8 275 94.3 659 415

100 (59.4)

284

100 (40.6)

699

100 (100)

In reference to family problems and alcohol intake, the data in Table 15 show that whether or not young people are experiencing a serious problem, the majority of them drink alcohol. No association has been found between the two variables. A POPCOM-7 and PCHRD-CVCHRD-supported Project

Young peopleâ&#x20AC;&#x2122;s health: Challenges for education and intervention

Table 15 Family problem and alcohol intake. Have you tried drinking beer or any alcoholic beverages? Yes no N % to the Total

Is your family currently experiencing a serious problem? Yes No All n % n % N % 354 85.3 246 86.6 600 85.8 61 14.7 38 13.4 99 14.2 415

100 (59.4)

284

100 (40.6)

699

100 (100)

Discussion This section attempts to put the study in the context of basic sociological perspectives. Structural-Functionalism. The old dictum (â&#x20AC;&#x153;no drug is good or bad in or of itselfâ&#x20AC;?) remains valid and true (Szazs, 1975). This dictum is loaded with functional statements, shaped by complex figuration of the context where and how drug is being used. Smoking, alcohol intake, and drug use signify functions. These functions are multifaceted when the rationale for its use is considered. Medicalization of drug use (Macionis, 2008; Henzlin, 2000) changes the landscape of its meaning and the functions it imposes to the individual and society. The same is true with smoking and drinking alcoholic beverages because these behaviors have functions, e.g. socialization, establishing bonding and belongingness, and for some, a coping mechanism. Students who admitted to smoking, drinking and using drugs also have friends who do so. This study has shown that the three behaviours have a close affinity with peer influence. Results generated from other studies also point to the role that peer influence plays in the formation of the youth. The six percent of students in the sample who have tried using drugs reported that they did it in the presence of, or with their friends. Like any other subgroups in society, young people have their own ritual and habits of acceptance and belongingness. Drinking alcoholic beverages, smoking cigarettes and drug use have become means and rituals for acceptance by peers and thus facilitate a sense of belonging (see also Ligaton, Chapter 2). The danger, however, is when the ritual develops into a habit.

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Gaut: Smoking, alcohol intake and drug use among young people at USC 87 Gaut: Smoking, alcohol intake and drug use among young people at USC 87 Another functional element that has emerged from the study is that Another element that has in emerged from the study is that drinkingfunctional and drug use are engaged by young people as a coping drinking and Although drug use this are engaged in has by young people as to a coping mechanism. dimension not been found be highly mechanism. dimension has not been found to be highly significant, itAlthough is worth this mentioning. The positive aspect, however, is that, significant, it is worth mentioning. The positive aspect, however, that, notwithstanding the problems encountered in the family, many ofisthe notwithstanding the problems encountered in the family, many of the students do not resort to drug use. The data also show an association students not resort a toserious drug use. Theproblem data alsoand show anuse, association between do experiencing family drug but not between a serious familyintake. problem and drug use, but not between experiencing family problems and alcohol between family problems and alcohol intake. Given the situation, the continuing relevance of institutions such as the family,the education, and government formationsuch of the Given situation,religion the continuing relevanceinofthe institutions asyouth the is crucial. The structural perceives school andyouth family, education, religionfunctionalism and government in thefamily, formation of the religion fundamental forperceives socialization values, norms is crucial.asThe structural institutions functionalism family, school and and patternsas offundamental behaviour. Government, on the other hand, is thenorms institution religion institutions for socialization values, and that deals the latency dimension theother societal interconnectedness patterns ofwith behaviour. Government, onofthe hand, is the institution . It crafts laws, implements monitors its (Turner, that deals1999) with 1the latency dimension of theand societal interconnectedness implementation (latency). The implements unprecedented of young people crafts laws, andprevalence monitors its (Turner, 1999)1. It engaged in drug(latency). use, drinking and smoking serve as wake call to implementation The unprecedented prevalence ofup young people agencies in and institutions. In other theserve realities of the are engaged drug use, drinking and words smoking as wake upyouth call to actually reflections of whatInthe family, schools, religion government agencies and institutions. other words the realities of and the youth are have become todayof (Durkheim, 1984; Rittenhouse & Miller, actually reflections what the family, schools, religion and government 1984)).Traditional have1984; stressed the importance of sociohave become todaytheories (Durkheim, Rittenhouse & Miller, cultural, psychological, social structure, learning, social control and 1984)).Traditional theories have stressedsocial the importance of sociosocialization factors, individually or in combination, in understanding the cultural, psychological, social structure, social learning, social control and behavior of young people who are in these in risk-taking behaviors socialization factors, individually orinvolved in combination, understanding the (Dembo, of et young al., 1992; Harris & Chan, 1999).in these risk-taking behaviors behavior people who are involved (Dembo, et al., 1992; Harris & Chan, 1999). Conflict Perspective. The conflict theory demands a radical restructuring of the economic chainThe thatconflict thrives theory the business. Smoking, intake demands a radicalalcohol restructuring Conflict Perspective. and drug use arechain closely related tothe four powerfulSmoking, and closely of the economic that thrives business. alcohol intake interconnected economic processes, i.e.powerful production, and drug use are closely related to four anddistribution, closely advertisement, economic and consumption. Preventive measures on the production, interconnected processes, i.e. production, distribution, distribution, advertising and consumption ofmeasures substances advertisement, and consumption. Preventive on(cigarette, the production, alcoholic beverage, drugs) will result in collision of interests, which distribution, advertising and consumption of substances (cigarette, means that conflict drugs) is mostwill likely to arise. alcoholic beverage, result in collision of interests, which means that conflict is most likely to arise. Conflicting issues which have emerged in the study include the following: First, the law delineates parameter who include can legally illegally Conflicting issues which the havelegal emerged in theofstudy the or following: use the substances. However, there is nocan legal control as to First, theprohibited law delineates the legal parameter of who legally or illegally where substances are to be sold and howisthey are to be advertised. use thethese prohibited substances. However, there no legal control as to The entire chain to the growing magnitude of where theseeconomic substances arecontributes to be sold and how they are to be advertised. young people who are engaged in risk-taking practices. Such increasing The entire economic chain contributes to the growing magnitude of young people who are engaged in risk-taking practices. Such increasing 1 1

Turner, J. 1999. A POPCOM-7 and PCHRD-CVCHRD-supported Project Turner, J. 1999. A POPCOM-7 and PCHRD-CVCHRD-supported Project

Young people’s health: Challenges for education and intervention

prevalence could also be due to the universal availability of materials which are actually legally protected, except for the illegal drugs which have become the commodity of the underground economy or black market. This phenomenon is aggravated by the delicate character and the growing efficiency of the black market or underground economy. The circulation of illegal substances undermines the entire communal efforts to slow down the count, if not, eliminate young people’s involvement in risk behaviours. In a micro context, conflict also takes place in the family. The data show that family problems can lead to drug use. The data also show that with or without family problems, young people are most likely to drink alcohol with peers. Young people with family problems who resort to drug use are a critical and urgent concern. The strong association between peer presence and drinking, smoking and drug use among the respondents confirm previous studies which argued that young people are more likely to indulge in these practices with their friends (Conrad et al. 1992; Dembo et al. 1992). Other reasons cited: the availability of cigarettes at home, parents being models of smoking and drinking behaviour, and, consequently, parents’ lack of credibility as advocates for abstention from smoking and drinking. Symbolic Interactionism. Earlier mentioned here is that “no drug is good or bad in and of itself” (Szasz, 1975). “Good” or “bad” is a label which people attach to certain things, practice, or phenomena. It is a social definition dictated by a complex meaning system of a particular context, group or subgroup of people. Adolescents may view drinking and smoking as privileges of adults and may want to engage in them to feel grown-up and to present themselves as adults to others. Young people may drink and smoke to keep the company of their friends who are engaged in these behaviours, especially if sharing of drinks and cigarettes are common and considered “cool” in group activities (Choe & Raymundo, 2001). The difficulty of curbing young people from engaging in these practices is derived from the heterogeneity of meaning that an individual, a group (subgroup) or society may attach to the substances. The complexity of people’s world views, the socially constructed meaning and reality, the weakened sense of what is communal, result in extensive tolerance and laxity of punitive intervention to smokers, drinkers and drug users. The issue is aggravated by the absence of strong public policy on the one hand, and the universal availability of the substances, on the other.

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Gaut: Smoking, alcohol intake and drug use among young people at USC

Conclusion and Recommendations The study points to some basic facts on the degree of USC students’ involvement in smoking, alcohol intake and drug use. The great majority of the sample population has not tried using drugs. This is attributed to the low exposure of students to friends who use drugs. The study has also shown that there is an association between smoking and alcohol intake and having friends who smoke and drink alcohol, and between experiencing a family problem and having tried using drugs. Majority of the respondents, whether male or female, drink beer or any other alcoholic beverage. The degree of occurrence, however, among students who smoke is relatively low. Despite the positive findings generated from this study, early exposure of young people to smoking and alcohol intake, and even to drug use, poses a significant risk and challenge. Institutions which are concerned with the welfare and formation of young people (the family as domestic school, the school as formal socialization institution, religion as social and moral institution) serve as fundamental channels of socialization of knowledge, norms, values and behavioral patterns. The risk and challenge also goes to government whose concern encompasses the social and private dimensions of youth life. Based on the findings, the following recommendations are given: 1. To conduct a longitudinal study on the prevalence of smoking, alcohol intake and drug use among the young people at USC to monitor the increase, or decrease, in the number of students who are engaged in these risk behaviors over time; 2. Recognizing that the phenomenon of smoking, alcohol intake and drug use is a complex and multifaceted problem, curbing its outgrowth must involve various institutions such as the family, schools, church, local government units, non-governmental organizations, and the business sector; 3. For USC in particular. Despite the low prevalence of USC students who are engaged in smoking and drug use, a considerable number of them drink alcohol and have been doing so at an early age. This calls for the establishment of preventive and curative facilities. USC’s “no smoking policy” must also be complemented with intervention facilities and programs (e.g. guidance-counseling, rehabilitation sessions and psychological treatment) particularly for students who are engaged in vices due to family problems; and

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Young people’s health: Challenges for education and intervention

4. For government. Re-evaluate the implementation of the “anti-drug policy,” and re-structure legal provisions related to smoking, alcohol intake and drug use to aggressively promote and implement government policies. Of equal importance is that government must be able to control the distribution and the mode of advertising the substances, and bring to justice the violators and distributors. References Banaag, C. & de Jesus, R. (n d). Drug abuse prevention among the youth: The Philippine mental health association experience. Retrieved from www.mentorfoundation.org. Choe, M. & Raymundo, C. (2001). Initiation of smoking, drinking and drug-use among Filipino youths. Population Series. East-West Center Asian Young Adult Reproductive Risk Project. Cohen, D., Richardson, J. & Labbree, L. (2004). Parenting behaviors and the onset of smoking and alcohol use: A longitudinal study. Conrad, K., Flay, B., & Hill, D. (1992). Why children start smoking cigarettes: Predictors of onset. British Journal of Addiction 87 (12), 1711-1724. Corraro, M., Guidon, G., Sharma, N. & Shokoohi, D. (eds.). (2000). Tobacco control country profiles. Atlanta: American Cancer Society. Dembo, R., Williams, L., Wothke, W., Schmeidler, J. & Brown, H. (1992). The role of family factors, physical abuse, and sexual victimization experiences in high-risk youths' alcohol and other drug Use and delinquency: A longitudinal model. Violence and Victims, Volume: 7, Issue 3, pp: 245+. Durkheim, E. (1984). The division of labor in society. New York: Free Press. “Introduction” by Louis Coser. Translated by W. D. Halls. Domingo, L. & Marquez, M. P. (1999). Smoking, drinking, and drug use. Young Adult Fertility and Sexuality Study. Fleming, M. & Towey, K. (eds). (2004). Educational forum on adolescent health: Youth drinking patterns and alcohol advertising. Chicago: American Medical Association. Gassman, R., Jun, M., Samuel, S., Agley, J., Swanson, J., Lee, E., Agley, B., Eber, J., Joshi, S., Kaptan, N., Kim, N., Oi, S., Olsen, B., Pardue, N., Pardue, S., Singhal, P., Smith, R., Stephen, S. & Stewart, C. (2009). A POPCOM-7 and PCHRD-CVCHRD-supported Project

Gaut: Smoking, alcohol intake and drug use among young people at USC

Alcohol, tobacco, and other drug use by Indiana children and adolescents: The Indiana prevention resource center survey â&#x20AC;&#x201C; 2009 (IDAP Monograph No. 09-01). Bloomington, IN: Indiana Prevention Resource Center. Harris, J. & Chan, S. (1999). The continuum-addiction: Cigarette smoking in relation to price among Americans aged 15-29. Health Economics 8 (1), 81-86. Henzlin, M. J. (2000). Social problems (5th Ed). Prentice Hall, New Jersey Hingson, R., Heeren, T., Zakocs, R., Kopstein, A. &, A. & Wechsler, H. (2002). Magnitude of alcohol-related mortality and morbidity among U.S. college students ages 18-24. Journal of Studies on Alcohol 63, 136-144. Johnston, L., Oâ&#x20AC;&#x2122;malley, P., Bachman, J. & Schulenberg, J. (2010). Monitoring the future national results on adolescent drug use: Overview of key findings, 2009 (NIH Publication No. 10-7583). Bethesda, MD: National Institute on Drug Abuse. Lemert, E. (2002). Human deviance, social problems, and social control. New Jersey: Prentice-Hall, Inc. Miguel-Baquilod, M. (2004). Global school-based students health survey (GSHS) in the Philippines. A country report. Manila. Myers Mark, G. & Kelly, J. (2006). Cigarette smoking among adolescents with alcohol and other drug use problems. Alcohol Research and Health, Vol. 29, No. 3. University of California. Macionis, J. (2008). Sociology (12th ed). New Jersey: Prentice Hall. Ray, O. (1978). Drugs, society, and human behavior (2nd Ed). St. Louis, Mo. Mosby. Raymundo, C., Xenos, P. & Domingo, L. (1999). Adolescent sexuality in the Philippines. Quezon City: UP Office of the Vice Chancellor for Research and Development. Rittenhouse, J. & Miller, J. (1984). Social learning and teenage drug use: An analysis of Lustily dyads. Health Psychology 3 (4), 329-345. Santrock, J. (2001). Adolescence (8th Ed). Boston: McGraw Hill.

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Szazs, T. (1975). Ceremonial Chemistry: The ritual persecution of drugs, addicts, and pushers. New York: Garden City. Todd, F., Lewis, _, GOUKER, J. (2007). Ideological maturity and drinking behaviors among college students. Journal of Alcohol & Drug Education, Volume 51, Issue 1. pp.17+. American Alcohol & Drug Information Foundation. The Institute for Youth Development. (2004). Youth Facts. Washington, D.C. Turner, J. (1998). The structure of sociological theory (6th ed). Belmont, CA: Wadsworth Publishing Company. Unger, J. & Chen, X. (1999). The role of social networks and media receptivity in predicting age of smoking initiation: A proportional hazards model of risk and protective factors. Addictive Behaviors 24 (3), 371-381. Wechsler, H., Lee, J., Kuo, M., Seibring, M., Nelson, T. & Lee, H. (2002). Trends in college binge drinking during a period of increased prevention efforts. Findings from Four Harvard School of Public Health College Alcohol Surveys: 1993-2001. Journal of American College Health, 50, 203-217.

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Young peopleâ&#x20AC;&#x2122;s sexual vulnerabilities: The uncomfortable truth Elmira Judy T. Aguilar

Department of Anthropology, Sociology and History This chapter presents the results of 699 interviews with young people at USC on matters that pertain to sex, abortion, contraception and STI/HIV and AIDS. Results generated from key informant interviews and focus group discussions are also included in the discussion, whenever appropriate. It is hoped that the data would be useful in designing responsive educational campaigns and services for young people on campus. The sexual and reproductive health of young people has been a main concern not only of government but of other sectors of society as well. Such concern was validated in a series of major studies done among young people. In these studies, sexual knowledge, attitudes and behaviors are no longer as conservative as adults perceived them to be. This has called the attention of many agencies to implement programs that address pressing issues involving the sexuality of young adults. In 2000, NSO reported that the youth comprised 20% of the population in the Philippines. This figure is almost the same as the reported youth population in Region VII, at 19%. The mean age was established at 19 years old with 86% of them unmarried, and more than half were urban residents. On virginity. A number of sexuality issues were covered in the YAFSâ&#x20AC;&#x2122; studies (1982, 1994, 2002), one of which is the issue on virginity. Although the majority of the youth continues to value virginity, a change in perception has been observed between 1994 and 2002. In 1994, as many as 80% of females put a premium on virginity, but the 2002 data showed a significant decline in this perception (cited in Commission on Population, 2003, p. 24). Females generally believe that virginity is an important male consideration in choosing a wife (Gastardo-Conaco et al., 2003), a view shared mostly by youth residing in rural areas (Zablan, 2000).

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Related to the issue of virginity, YAFS III showed an increasing percentage of young adults who engage in pre-marital sex, from 18% in 1994 to 23% in 2002 â&#x2C6;&#x2019; an indication that PMS is fast becoming an acceptable practice among the youth. In actual numbers, 4.9M young adults aged between 15 to 27 years old had engaged in PMS. In Region VII, 23% were already having sex with 17 years as the mean age of first encounter. Majority of these youths had their first sexual experience with a boyfriend or girlfriend, with almost half of them wanting it to happen. Some of these youths reported they were forced to have sex the first time they experienced it. Almost three out of ten were not planned or were consumated against their will with more females than males saying so (UPPI/DRDF, 2002). On same-sex relationships. Not all sexual acts happen only with the opposite sex. It is common knowledge that the youth of today are open to the topic of homosexuality. In fact, homosexuals and bisexuals are now acceptable as friends (Zablan, 2000). Same-sex encounters are also surfacing with five percent of males admitting to having the first sexual encounter with the same sex while less than one percent of females admitted to having had lesbian sexual relationships. Worth noting is that 12% of those who were 13 years old and below had a homosexual encounter as a first sexual experience (UPPI/DRDF, 2002). A study by Cruz and Diaz in 2001 showed that 70% of those surveyed felt that having sex with a person of the same sex was not acceptable. Despite this, 43.2% agreed to the statement that attraction to the same sex was acceptable, while 59.9% believed that homosexuals could be good company and 53.4% thought it was alright to have them as close friends. On contraception. Despite the growing number of young people who engage in premarital sex, only 25% of them used contraceptives during the first consensual sexual encounter (UPPI/DRDF, 2002). The majority of the youth, including 67% of these who are Roman Catholics, think that their religion favors contraception (Raymundo, 2003). In a study done by Aguilar et al. (2002) in Cebu, all students across genders agree that family planning is necessary and that using contraceptives is tantamount to being responsible parents. Family planning is seen as needed to prevent and space out pregnancies, and perceived as a way to control population growth. Despite such perception, the use of contraception is not being adhered to. The primary reasons given for not using contraceptives were the lack of knowledge about contraception, followed by objections from the partner (UPPI/DRDF, 2002). In an earlier study, the youth declared they desired spontaneity in the sexual acts and thus they were not motivated to use A POPCOM-7 and PCHRD-CVCHRD-supported Project

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any protection (YAFS, 1994). Among those who used contraceptive methods, withdrawal was the preferred option (40%). The condom was used by 20% of young adults while 13% of them used the pill (Zablan et al., 2003). On abortion. The YAFS III data disclosed that 95% of the study participants were against abortion. This is reflected in the results obtained in Region VII which showed that only 3.7% approved of such practice as a way out of an unwanted pregnancy. Zablan’s (2000) study also affirmed the YAFS3 results that the youth would still not approve of abortion even if the life of the mother is in danger, if the pregnancy is a result of rape or incest, or if the child is likely to suffer physical deformities. In Region VII, only four percent of the males and three percent of the females approved of abortion as a way out of unwanted pregnancy. In a 2003 study conducted by the Health Action Information Network, data indicated that adolescents considered abortion as an acceptable option (58%) if a pregnancy endangered the mother’s life. This view was corroborated by the Aguilar et al. study in Cebu (2002) among female students who expressed openness to the advisability of abortion if the woman is confronted by difficult situations such as being ill-prepared to raise a child or the inability to face familial responsibilities due to the absence of a father. A similar study was done in Baguio, and the data showed that 78% of the student-respondents considered abortion as wrong regardless of the circumstances surrounding any situation (Cruz & Diaz, 2001). What is clear, however, is that despite these mixed reactions to abortion, roughly 400,000 abortions are performed each year. An estimated 36% of women treated for abortion complications in selected hospitals came from those aged 15 to 24 years (Raymundo et al., 2001). On sexually transmitted infections and HIV and AIDS. Non-use of any other form of protection can also lead to acquiring an STI. The YAFS III data (2002) showed that males have a slightly higher knowledge level of STI (70%) as compared to females (63%). The situation is the same in Region VII where 77% of males have knowledge of STI, and females, 72%. However, both males and females (19%) in the Region VII believe that AIDS is curable. This is lower though when compared to the national data which registers 28%. Compared to the 1994 data, only 12% of the youth think that AIDS is curable. With regard to the transmission of HIV and AIDS, the Ramon Aboitiz Foundation, Inc. (1995) data showed that the youth believe “that one should not share needles and syringes or urinate in areas used by A POPCOM-7 and PCHRD-CVCHRD-supported Project

Aguilar: Young people’s sexual vulnerabilities: The uncomfortable truth

infected persons.” Further, they think that “one should not go near a person who has AIDS nor share his food.” In another study, Aguilar et al. (2002) cited that students think that “a person can get STI and HIV by using contaminated needles,” “by kissing a person infected with HIV,” and “having open wounds on any part of the body.” The prevailing myths on HIV transmission should be seriously looked into and examined if indeed positive changes have already occurred on the improvement of knowledge. AIDS education is now incorporated in the curriculum as mandated in R.A 8504, otherwise known as The Philippine AIDS Prevention and Control Act of 1998. Results On sex and sexual encounters More than half of the 699 survey participants averred to have not been involved in a relationship (Table 1). Among those who responded in the affirmative, the proportion of males (49%) is higher than that of the females (40%). In this study, “sex” is found to be associated with “involvement in a relationship” (at the p<.01 level). In Table 2, one can see that all figures registered for “involvement in a relationship” by “year level” are high for all year levels. The proportion of 5th (73%) and 4th (53%) year students is, however, higher compared to the three other groups. This indicates that students in higher years are more likely to be involved in a relationship (at the p<.001 level). Table 1 Involvement in a relationship by sex. Male Yes No N **Chi-sq. p<.01

N 144 150 294

Female

% 49.0 51.0

N 162 243 405

All

% 40.0 60.0

N 306 393 699

% 43.8 56.2

Table 2 Involvement in a relationship by year level (in percent). 1

Yes no N ***Chi-sq. p<.001

33.9 66.1 189

43.5 56.5 191

43.7 56.3 151

52.7 47.3 146

72.7 27.3 22

All 306 393 699

43.8 56.2 100.0

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Involvement in a relationship can have positive and negative consequences for young people. Results from the qualitative data support this idea. A fourth year male student who was using drugs mentioned that he stopped using illegal drugs for fear that he might lose his girlfriend if she finds out about it: “Nabag-o ra akong lifestyle pagka-ila namo. Mao man guy ingon nako sa akong kaugalingon nga og magkarelasyon na ko og balik, di na ko mosuyop kay makadaot na sad sa relasyon. Mao to, pagkauyab na namo, sukad ato, undang na jud ko.” (My lifestyle changed after I met her. I said to myself that if I will be in a relationship again, I will no longer take illegal drugs because it will destroy the relationship. Thus, when I had a relationship with her, I decided to stop for fear of losing her).

Contrary to the positive experience mentioned above, a female student narrated how her boyfriend had caused her to suffer from emotional abuse: “Five years na mi sa ako uyab pero dili ko kabulag niya kay in love man ko niya sa una. Ingon ang akong mga amiga nga obsessed siya nako unya iya kong blackmailon. Then ingnon niya kuno akong parents nga naay scandal pero dili tinuod. Magbuwag na unta mi pero namabdos man ko.” (Five years into the relationship, I still could not let go because I was in love. My friends said that he was obsessed with me. He even blackmailed me. He said that he would tell my parents that we have committed scandalous acts even if it is not true. We were supposed to part ways but I got pregnant).

Table 3 shows that majority of students are in a heterosexual relationship. Only six percent of both sexes have experienced same-sex relationship. A few of them (4%) also admitted to having experienced both types. Table 3 Type of relationship tried by sex.

N Heterosexual Homosexual Both N

Male

127 15 2 144

88.2 10.4 1.4

Female N % 148 5 9 162

91.4 3.1 5.6

N 275 20 11 306

All

% 89.9 6.5 3.6

A heterosexual or homosexual relationship may turn out to have an adverse effect on a person. A female FGD participant narrated about an

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abusive relationship she experienced with another female when she was 16 years old: “Nakaexperience ko og physical abuse kay uyab nako nga tomboy kulatahon ko. If mouli ko, iya kong kulatahon. There was a time sa mall gikulata ko niya.” (I experienced physical abuse from my lesbian girlfriend. If I wanted to go home, she would beat me. There was a time when we were in the mall where she beat me up).

In reference to sexual experience, more males (75%) than females (38%) responded in the affirmative (Table 4), and the proportion of those who said so is higher among higher-year students, particularly those in the 4th (67%) and 5th (75%) year levels (Table 5). The relationship between “sexual experience” and “year level” is established in this study (p<.001). The majority of students who are in a relationship have experienced sex, and higher year students are more likely to have done so. Table 4 Sexual experience with a guy/girl or both by sex. Male

Female %

Yes No N

108 36 144

75.5 2

All %

62 100 162

38.3 61.7

% 170 136 306

55.6 44.4

Table 5 Sexual experience with a guy/girl or both by year level (in percent). 1

yes 33.8 no 66.2 N 65 ***Chi-sq. p<.001

59.0 41.0 83

53.8 46.2 65

67.5 32.5 77

75.0 25.0 16

All N

170 136 306

55.6 44.4

In reference to age at first sexual experience, one can see in Table 6 that the proportion of males (52%) who have tried having sex within ages 1517 is greater compared to females. On the other hand, most of the females (53%) have had sex when they were between ages 18-20 years old. The mean and median age for both sexes is the same, at 17.

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Table 6 Age at first sexual experience. Male

Female %

7 56 40 5 108

12-14 years old 15-17 years old 18-20 years old 21-23 years old N

6.5 51.9 37 4.6

All

% 1 26 33 2 62

1.6 41.9 53.2 3.2

% 8 82 73 7 170

4.7 48.2 42.9 4.1

Mean: 17 for both sexes Median: 17 for both sexes

On sexuality issues Contraception and pregnancy. Of the 170 students who admitted to having had sex, more males than females use contraceptive devices to prevent a pregnancy (Table 7), with condom as the most frequently cited method (Table 8). It is presumed that the males, in this study, take pregnancy prevention as a matter of concern considering that condom, a male contraceptive, is preferred over pills, a method which is likely to be used by sexually active females. Table 7 Use of contraception to prevent pregnancy by sex. Male

Female %

Yes No N

60 48 108

55.6 44.4

All %

30 32 62

48.4 51.6

% 90 80 170

52.9 47.1

Table 8 Type of contraceptive used in the past by sex. Male

Female %

Condom Pill Cortal N

59 0 1 60

98.3 0 1.7

All %

25 5 0 30

83.3 16.7 0

% 84 5 1 90

93.3 5.6 1.1

Pregnancy and abortion. Of the 62 females who have had sex (Table 9), 47% of them reported that they have friends who got pregnant and had an abortion as well as friends who got pregnant but did not resort to abortion (39%). Despite having friends who had opted for abortion when

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they got pregnant, only 3% of this group took the same course of action (Table 10). Eight out of 10 of them did not get pregnant despite their being sexually active. Table 9 Know of friends who got pregnant and had an abortion. Female Yes (pregnant and abortion) No (none of the two) Pregnant -- but no abortion N

29 9 24 62

46.8 14.5 38.7 100

Table 10 Experienced being pregnant and had an abortion. Female Yes (pregnant and abortion) No (none of the two) Pregnant -- but no abortion N

2 51 9 62

3.2 82.3 14.5 100

Still on the topic of abortion, a female key informant narrated her experience when she decided to have an abortion: “Niinum ko og tablet. Although naa koy kaila na nakagamit na sad atu na medicine, nagduha-duha sad ko og buhat. But murag mas bug-at akong feeling sa kahadlok ug sa kanang fear nga mapakaulawan ko kaysa fear naku sa akong health ug sa akong self.” (I took a medicine. Although I knew somebody who used it, I was ambivalent about it. But I was more fearful of the shame rather than of my health.)

A male third year student who is a single parent, shared that when his former girlfriend got pregnant, they had plans to seek abortion but did not push through with the plan because they were not able to save enough money for it. A question which was asked of both males and females (N=699) is whether they have friends at school who underwent abortion. The data presented in Table 11 show that more females, than males, responded in the affirmative. This is an indication that females feel more comfortable discussing about their situation with another female than with a male friend. One can see in Table 12 that majority of both sexes know of at least one person who resorted to abortion.

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Table 11 Know of friends at school who have had an abortion by sex. All Yes No N

Male % 17.3 82.7

121 578 699

% 14.6 85.4

43 251 294

Female % 78 19.3 327 80.7 405

Table 12 Number of female friends who have had an abortion by sex. All 1 2 3 4 5 7 9 N

69 34 9 5 2 1 1 121

Male

% 57.0 28.1 7.4 4.1 1.7 0.8 0.8

21 12 5 3 1 .0 1 43

% 48.8 27.9 11.6 7.0 2.3 .0 2.3

Female % 48 61.5 22 28.2 4 5.1 2 2.6 1 1.3 1 1.3 .0 .0 78

Non-consensual sex. Females who have had sex were also asked if they had experienced non-consensual sex (Table 13). A few (4.8%) affirmed that they experienced non-consensual sex. Despite this, the study reveals that young people may be subjected to forced sex which is an important concern. Table 13 Experienced non-consensual sex. Female Yes No N

3 59 62

4.8 95.2 100

Sexually transmitted infections and HIV and AIDS. Another important issue faced by young people are sexually transmitted infections (STIs) and HIV and AIDS (Table 14). Almost all have heard of this issue but only a little over a fifth claimed to have a very high knowledge on modes of transmission (Table 15). More males affirmed to have very high knowledge.

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Table 14 Heard of sexually transmitted infections and HIV and AIDS by sex. Male

Female %

Yes No N

285 9 294

96.9 3.1

All %

397 8 405

98.0 2.0

682 17 699

97.6 2.4

Table 15 Level of knowledge of how HIV and AIDS can be transmitted by sex. All very knowledgeable moderately knowledgeable slightly knowledgeable N

144 338 200 682

Male % 21.1 49.6 29.3

65 141 79 285

% 22.8 49.5 27.7

Female 79 197 121 397

% 19.9 49.6 30.5

Having presented the level of knowledge on STI/HIV and AIDS, a female fourth-year student shared that in most of her sexual encounters with men whom she is not committed to, she expected them to use condoms because she did not want to experience what happened to her cousin who had a sexually transmitted infection. She said “you have no way of knowing whether you are the only partner.” The FGD and KII results affirm the survey data presented in the two previous tables. Both sexes have heard of sexually transmitted infections and HIV and AIDS with more males having a very high knowledge on its transmission. Thus, they are expected to translate this into positive behavior. Implications The data obtained support the assumption that young people experience various health challenges. Almost half of the sample is involved in relationships which, at times, place a few of them in a difficult situation. Among those in a relationship, students in higher levels account for the most number. Having adjusted to university life, they find friends and acquaintances, one of which would become a suitable partner. The study found that many of the students who are in a relationship are engaged in sex, with more males belonging to ages 15 to 17 and females in ages 18-20 years. The mean age at first sex is 17 years old, a figure similar to Region VII, as reported in the YAFS III in 2002. One can therefore say that sex among young people usually occurs at this age.

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Young people’s health: Challenges for education and intervention

The YAFS III data revealed that despite young people’s open disapproval of premarital sex, a considerable number of them engage in it. It also presented that over the years, virginity which was favored by 80 percent in 1994, was favored by only 70 percent in 2002. Among the youth who have been engaging in sex, males were more likely to use contraceptive devices than females. The study also revealed that both sexes prefer to use condom to avoid pregnancy. The findings seem to run counter to the study done by Zablan et al. (2003) which stressed that young people preferred withdrawal over the condom. Even if there is now an increase in condom use aside from the pill, still, there are those who do not use any contraceptive method. This has resulted in unwanted pregnancies among two study participants, both of which ended in abortion. Although the study reveals that relationships are mostly heterosexual, it bared that homosexual relationships are tolerated. In fact, more males admitted to being in a same-sex relationship than females. This is not surprising because in the YAFS3 study, homosexual encounters were admitted more by males. Aside from issues on contraceptive use, abortion and homosexual relationships, another issue that should be seriously looked into is STI/HIV and AIDS education and prevention. Even if the majority of study participants have heard of STI/HIV and AIDS, only a few consider themselves to have adequate knowledge of these, despite the introduction of HIV and AIDS education in the curriculum as mandated in R.A. 8504. This is consistent with the study done by Aguilar et al. in 2002 which pointed out that students still had a number of misconceptions about the transmission of HIV and AIDS. Recommendations Given the circumstances that young people in the University of San Carlos face with regard to sexuality issues, the following recommendations are made: •

Craft a module that includes sexuality issues affecting young people, and use this in social science subjects. It is imperative that discussions are age-appropriate, culturally-sensitive and anchored on the rights-based approach. The classroom is a venue for students to discuss concerns affecting them, an environment that provides confidentiality and privacy, and where information is current and timely;

•

Develop a module on family planning and responsible parenthood, employing the informed-choice approach which requires that all modern contraceptive methods available are presented and A POPCOM-7 and PCHRD-CVCHRD-supported Project

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discussed. It is not enough to tackle only the methods and their accompanying advantages, disadvantages and effectiveness. Special attention must be given to the social, cultural and political dimensions of family planning and responsible parenthood; •

Develop a module on the prevention of STI and HIV and AIDS, and evaluate the implementation of R.A. 8504, otherwise known as The Philippine AIDS Prevention and Control Act of 1998 in the school curriculum. There is a need to determine if teachers are trained, capable, and comfortable in handling the challenges faced by young people. Class, gender, and the rights-based perspectives need to be included. Topics on prevention and transmission must be able to bring in the social and cultural views of the disease; and

•

Offer on-campus integrated services. This means that clinics, guidance centers and campus ministry offices will need to formulate an overall plan that will address the felt needs of young people in relation to issues pertaining to sex and sexuality. The staff should provide an enabling environment for students to avail of their services. References

Aguilar, E. J., Nolasco, F., & Bersales, J. E. (2002). Breaking the mold: Promoting young people’s reproductive health. An unpublished research report for the David and Lucile Packard Foundation. Department of Sociology and Anthropology, University of San Carlos. Commission on Population. (2003). Pinoy youth making choices, building voices. Commission on Population. State of the Philippine Population Report, 2nd Issue. Cruz, G. & Diaz, M. (2001). Baseline survey on the knowledge, attitudes, and practices of adolescents and adults on reproductive health. University of the Philippines-Baguio. Gastardo-Conaco, M. C., Jimenez, M. C., & Billedo, C. J. (2003). Filipino adolescents in changing times. Quezon City: University Center for Women Studies Foundation and Philippine Center for Population and Development. Health Action Information Network. (2003). HIV/AIDS Country Profile Philippines 2002. HAIN, Philippine National AIDS Council and United Nations Joint Programme on HIV/AIDS in the Philippines.

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National Statistics Office. (2000). 2000 Census of Population and Housing. Ramon Aboitiz Foundation, Inc. (1995). Qualitative data relevant to AIDS prevention gathered from sex workers, injecting drug users, and at-risk youth in Cebu. RAFI and AIDS Surveillance and Education Program. Raymundo, C. (2003b). Sex and Filipino adolescents: Facts, issues and concerns. Paper presented in the celebration of the World Population Day with the theme Sex Files: All about the young and the curious at Far Eastern University. Raymundo, C., Zablan, C., Cabigon, J. & Cruz, G. (2001). Unsafe abortion in the Philippines: A threat to public health. Quezon City: Demographic Research and Development Foundation, Inc. University of the Philippines Population Institute, UP Office of the ViceChancellor for Research and Development. UPPI/DRDF. (2002). 2002 Young adult fertility & sexuality study (YAFS 3). Quezon City, Philippines: UP Population Institute and the Demographic Research and Development Foundation, Inc. World Health Organization Western Pacific Region. (2005). Sexual and reproductive health of adolescents and youths in the Philippines: A review of literatures and projects 1995-2003. Manila, Philippines. Young Adult Fertility & Sexuality Study II. (1994). University of the Philippines Population Institute. Zablan, Z. (2000). The 2000 IEC impact survey in Apayao, Kalinga and Ifugao Provinces. Demographic Research and Development Foundation, Inc. Zablan, Z. & Cabigon, J. (2001). The participatory planning process: Research utilization and plan formulation for adolescent reproductive health in Southern Leyte. University of the Philippines Population Institute and Demographic Research and Development Foundation, Inc. Zablan, Z., Marquez, M. & Laguna, E. (2003). Facing the risks: The reproductive health of Filipino adolescents. Paper presented at the Fifth National Social Science Congress held on 15-17 May 2003 at the Philippine Social Science Center, Diliman, Quezon City.

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Deliberate self-harm and negative affect: Experiences of young people at USC Ruby D. Ilustrisimo

Department of Psychology To a layperson, deliberate self-harm is often misconstrued as a product of suicidal ideation. However, in a psychological perspective, it is known that most individuals who commit self-injury have no intention of ending their lives. This phenomenon is actually more common in societies compared to suicide. In an attempt to understand these two seemingly similar but different concepts, there is a need to delineate between the two. If they are indeed two disparate ideas, how are they different from each other? The answer lies in the intent behind self-destructive acts. Suicidal ideators are known to have ruminated about finishing their lives but have not yet executed a potentially life-threatening act. This intent is known to be an indicator of suicidal acts (Beck et al., 1979; Bonner & Rich, 1987; Shaffer et al., 1988 as cited in Lai & McBride-Chang, 2001). A good example of this is an ideatorâ&#x20AC;&#x2122;s attempt to jump off a building high enough to extinguish oneâ&#x20AC;&#x2122;s life. Self-harmers on the other hand are those who purposefully destroy or alter bodily parts without intentionally committing a suicidal act but whose actions have resulted in severe injuries (Gratz, 2003). Various types of self-mutilation have been documented ranging from head butting, fist hitting, to body amputation (Kahan & Pattison, 1984). Although, the intent of ending oneâ&#x20AC;&#x2122;s life is absent, this type of behavior is an identified predictor for future suicide tendencies. (Hawton et al., 2003; Owens et al., 2002). Studies (i.e. Chapman, Gratz, & Brown, 2006; Kleindienst et al., 2008) indicate that self-harm is utilized as an emotion regulation strategy as well as a form of self-punishment. Studies made by Klonsky (2007) & Gratz (2003) have indicated that strong negative affect (in other words, sadness, loneliness, anger, selfhatred) is felt before self-harm. Self-injury is then done in order to

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diminish the negative affect which actually brings momentary respite from those emotions. This reprieve from negative affect will then lead the individual to actively form visual images of performing self-harm which will prompt another incident of this type. Thus, self-harm functions in three pathways as identified by Mikolajczak, Petrides & Hurry, 2009, p.182: â&#x20AC;&#x153;The avoidance of unwanted emotions (i.e. distract oneself from intolerable feelings), their materialization (i.e. make the emotional pain tangible) and/or their alteration (self-harm may cause the releasing of endorphins that, in turn, produce analgesia and a sense of well-being)â&#x20AC;? Thus, self-harm is used as a way to avoid feeling intolerable strong negative emotions and used as a band-aid to pain. Despite its identified role in alleviating emotional distress, it still remains a maladaptive form of emotional regulation which leads researchers (e.g. Mikolajczak, Petrides & Hurry, 2009) to make an attempt at deciphering the factors that can possibly increase the risk of deliberate self-harm. Their findings have shown that lower levels of emotional intelligence (EI) would propel an individual towards self-injury. This is further exacerbated by ineffectual emotional coping strategies such as rumination, self-blame and helplessness (Mikolajczak, Petrides & Hurry, 2009). This phenomenon is reported to be prevalent amongst adolescents whose physiologies are undergoing the surge of bodily hormones which can only intensify the outpouring of emotions. Consistent predictors of incidents of self-harm also include the following: problems in relationships amongst family and friends; school difficulties; as well as depression (Rodham et al., 2004). These known factors have also been identified to be involved in suicidal ideation as well (Lai & McBride-Chang, 2001). There is definitely a thin line between suicidal ideation and deliberate self-harm which is only separated by intent. Since this study is highly descriptive in nature and the tools used in this research do not confidently assure that suicide was indeed the phenomenon being measured, the researcher assumes that the phenomenon being studied is actually deliberate self-harm which is more common of the two constructs. Using the survey results, this chapter will identify situations or conditions that could make young people (N=699) vulnerable to mental health problems as well as coping strategies and

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potential support mechanism. Qualitative data related to this phenomenon is also discussed in Chapter 10 (see Amper). Results Down below are descriptive results generated after undergoing data analysis. “Self-harm attempts” pertains to the survey question: “Have you ever attempted to commit suicide?” Although, the phrasing of this question is quite specific, all answers pertaining to the method of how it was done points to self-harm rather than suicide. Table 1 Frequency of attempts in inflicting self-harm. Variable

Attempts to inflict self-harm

% of individuals indicating nonexistence of attempts 87.7%

% of individuals indicating the existence of attempts

12.3%

699

Self-reports indicate that majority (87.7%) of the sample respondents have not committed acts of deliberate self-harm and only 12.3% of the sample size have indicated they have. Qualitative data also indicate that some of the respondents have attempted to cut their wrists, drunk household chemicals, overdosed on medication, and attempted to jump off buildings. At first glance of the data, the incidents seem like suicidal attempts. However, the researcher remains skeptical if the intent is really to end their lives but rather serves as a signaling mechanism (Farberow & Shneidman, 1961; Henderson, Byrne, & Duncan-Jones, 1981) to their social partners as well as a way to regulate negative affect (Mikolajczak et al., 2009). Data from the key informant interviews reveal that students who attempted to commit self-destruction did not have the intention to end their lives but rather to inflict physical pain to ease the emotional pain. Table 2 shows recoded data for three questions: “How does each member of your family get along?” (interpreted as perceived dynamics of family relationships); “How would you describe your family?” (recoded as perceived familial happiness); and “How often do you feel sad, angry or hurt?” (interpreted as perceived negative affect). A POPCOM-7 and PCHRD-CVCHRD-supported Project

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Table 2 Mean and SD of perceived dynamics of family relationships, perceived familial happiness and the frequency of negative affect experienced by the respondent. Factor

Mean

Std. Deviation

a. Perceived dynamics of family relationships

2.36

0.56

699

b. Perceived familial happiness

2.77

11.37

699

c. Frequency of Negative affect

2.03

0.25

699

The sample yielded scores on perceived dynamics on family relationship at M=2.36 and SD of 0.56. This signifies that on average, most respondents perceive the relationships within their families as doing alright. Data analysis also indicates that the variability of the data is not quite spread out. Therefore, the data are perceived to be homogenous. This is also the case of the “Frequency of Negative Affect”, which yielded a M=2.03. This indicates that on average, respondents experience negative affect (i.e. depression, sadness, anger & hurt) occasionally. From this variable alone, one can already deduce that respondents are typically not prone to self-harm nor suicidal ideation. Analysis also yielded a M=2.77 and SD=11.37 for the variable “perceived familial happiness.” This indicates that, on average, most respondents perceive their familial environment to be moderately happy. However, the value of the standard deviation indicates that outliers exist in the data and therefore, there are respondents whose families fall in either of the two sides of the continuum, of either being really happy or quite sad. This indicates as a possible reason for why a minority of the sample size have inflicted selfharm. This points out that those respondents must have had sad family lives, which is an identified predictor of self-harm (Rodham et al., 2004). Inferential analysis was also conducted and the generated results are found below.

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Table 3 Correlational matrix of nine variables: Perceived dynamics of family relationship (PDFR), perceived familial happiness (PFH), physical abuse (PA), verbal abuse (VA), sexual abuse (SA), social support (SS), drug use (DU), drinking habits (DRH) and frequency of negative affect (FNA) that might possibly serve as correlates to self-harm attempts (SHA). Factor

PDFR

PFH

DRH

SHA

FNA

PDFR PFH PA VA SA SS DU DRH SHA FNA

-.126**

-.055

-.074*

.080*

.170**

.004

.001

-.088*

-.064

-.013

-.058

-.018

.003

.002

.053

-.014

.176** .075*

.347**

.061

-.180**

.057

.024

.140**

.037

-.130**

.071

-.046

.131**

.080*

.021

.006

.032

.125**

.023

-.006

.117**

-.029

-.047

.100**

.039

-.028

.040

.014

1 1

.114** 1

** p<.01 (2-tailed) * p<.05 (2-tailed)

The correlational matrix illustrated above contains a lot of relationships amongst variables. However, focus will be provided on the self-harm attempts and the other nine variables. Results indicate that there are negative correlations amongst self-harm attempts with perceived family happiness (r=-0.014) & social support (r=-0.029). Both correlations are negligible and not statistically significant. Self-harm attempts yielded moderately positive correlations but not statistically significant results with drug use and drinking habit at r (699) =0.039 & r (699) =0.040 respectively. Although, these results are modest, one can only apply the findings to the sample. Therefore, this data cannot be used to make a generalization to the whole university student population. However, significant relationships were established amongst self-harm attempts and a number of variables. Findings have shown that there is a negative correlation between self-harm attempts and perceived good dynamics of family relationships with an r (699) =.-0.088, p<.05 and an r2 = 0.007744. This indicates that if a family is perceived to have a difficult interrelationship by the respondent, there is a possibility that self-harm attempts will take place. This finding is actually in line with the study conducted by Rodham et al. (2004). Although, it is statistically significant

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at p<.05 level, the coefficient of determination (r2) is too negligible and therefore, many factors can account for the variance in the relationship. There were also positive yet low correlations among self-harm attempts with physical abuse (r=0.140, p<.01), verbal abuse (r=0.131, p<.01) and sexual abuse (r=0.125, p<.01). Despite its low values, these are important correlations since the presence of abuse indicates that there is indeed an existing relationship between abuse and self-injury. These findings tacitly confirm the findings of Farberow & Shneidman, 1961; Henderson, Byrne, & Duncan-Jones, 1981, where they iterated that self-harm is a form of signaling mechanism to their social partners so that help can be provided to them. Further statistical analysis was conducted and regression analysis yielded an r=0.245 with an adjusted r2=0.048. It indicates that 4.8% of the nine variables (i.e. perceived dynamics of family relationships, perceived familial happiness, physical abuse, verbal abuse, sexual abuse, social support, drug use, drinking habits and frequency of negative affect) can predict the existence of attempts to do self-injury. However, since there is no statistical significance, this result can only be applied to the sample at hand. The tables below show the regression analysis results in detail using the Enter Method and the Stepwise Method. Judging from the standardized Beta (B) weights in the table, one can already deduce that the values are negligible. Furthermore, the number of standard deviations that the outcome will change as a result of one-standard deviation change in one of the predictor variables is actually miniscule at best. Table 4 Coefficients for regression analysis (enter method).

Model

Constant PDFR PFH PA VA SA SS DU DRH FNA

B 0.423 -0.050 -0.001 0.073 0.053 0.269 0.005 0.039 0.037 0.132

SE b 0.172 0.022 0.001 0.031 0.027 0.084 0.032 0.053 0.035 0.050

Beta -0.086 -0.037 0.093 0.079 0.119 0.006 0.028 0.039 0.100

In an effort to isolate the variables that can serve as significant predictors of self-harm in the sample, the Stepwise Method was utilized. A POPCOM-7 and PCHRD-CVCHRD-supported Project

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Table 5. Regression analysis results (stepwise method). Model

a. b. c. d. e.

1 0.019 b 2 0.033 c 3 0.043 d 4 0.051 e 0.056 5 Predictors: (Constant), PA Predictors: (Constant), PA, SA Predictors: (Constant), PA, SA, FNA Predictors: (Constant), PA, SA, FNA, PDFR Predictors: (Constant), PA, SA, FNA, PDFR, VA

ďż˝R

0.018 0.030 0.039 0.045 0.050

Data analysis revealed that if physical abuse is the only variable used to predict the existence of self-harm attempts, it will account for 1.8% of its variance. If sexual abuse is added into the model, both variables will account for 3.0%. If frequency of negative affect is added to the predictor variables, all three will be able to account for 3.9% of the variance. The inclusion of perceived dynamics of family relationship will pull the variance to 4.5% and verbal abuse will further increase it to 5%. These findings merely confirm the studies made by Klonsky (2007), Gratz (2003) and Rodham et al. (2004) that identified problems in relationship within the family and peer circles as well as depression as consistent predictors of self-harm. This finding is not surprising since in the developmental perspective, family and peer circles are the salient milieus that adolescents operate in (Bolger et al., 1989) and therefore, sources where they derive emotional support. If these circles prove to be dysfunctional, negative emotional regulation happens which will eventually lead to self-harm and suicidal ideation that can ultimately end in tragedy. Conclusion and Recommendations Despite the descriptive nature of the data gathered, consistency of predictors (i.e. problems in relationships amongst family and friends, depression and negative affect) to self-harm still surfaced in the study. This research endeavor has not only reaffirmed the existence of these predictors but it also serves as a wake-up call for psychologists and policy makers alike.

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In order to minimize the occurrence of self-harm and suicidal ideation, there is need to support and advocate family therapy & counseling as well as teaching the young on how to veer away from negative emotional regulation but rather practice positive affect. Studies on positive psychology are on the rise and it would be perspicacious and wise of us to actively utilize this surge of abundant scientific resource. The best way to start it off is to implement an in-depth study on selfharm and depression by utilizing scales that have proven its reliability and validity in the scientific. As soon as diagnosis and assessments are done, appropriate support can be identified and provided for these students who are at risk of deliberate self-harm and perhaps, suicidal ideation. References Beck, A., Kovacs, M., & Weissman, A. (1979). Assessment of suicidal ideation: The scale for suicidal ideators. Journal of Consulting and Clinical Psychology, 47, 343-352. Bolger, N., Downey, G., Walker, E., & Steininger, P. (1989). The onset of suicidal ideation in childhood and adolescence. Journal of Youth and Adolescence, 18 (2), 175-190. Bonner, R., & Rich, A. (1987). Towards a predicate model of suicidal ideation and behavior: Some preliminary data in college students. Suicide and Life-Threatening Behavior, 17, 50-63. Chapman, A. L., Gratz, K. L., & Brown, M. Z. (2006). Solving the puzzle of deliberate self-harm: The experiential avoidance model. Behaviour Research and Therapy, 44, 371–394. Farberow, N. L., & Shneidman, E. S. (1961). The cry for help. New York: Blakiston Division, McGraw-Hill. Gratz, K. L. (2003). Risk factors for and functions of deliberate self-harm: An empirical and conceptual review. Clinical Psychology: Science and Practice, 10, 192-205. Hawton, K., Zahl, D., & Weatherall, R. (2003). Suicide following deliberate self-harm: Long-term follow-up of patients who presented to a general hospital. The British Journal of Psychiatry, 182, 537–542. Henderson, S., Byrne, D. G., & Duncan-Jones, P. (1981). Neurosis and the social environment. New York: Academic Press. A POPCOM-7 and PCHRD-CVCHRD-supported Project

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Kahan, J., & Pattison, E. M. (1984). Proposal for a distinctive diagnosis: The deliberate self-harm syndrome (DSH). Suicide and LifeThreatening Behaviors, 14, 17–35. Kleindienst, N., Bohus, M., Ludascher, P., Limberger, M. F., Kuenkele, K., Ebner-Priemer, U. W., et al. (2008). Motives for non-suicidal self-injury among women with borderline personality disorder. Journal of Nervous and Mental Diseases, 196, 230–236. Klonsky, E. D. (2007). The functions of deliberate self-injury: A review of the evidence. Clinical Psychology Review, 27 (2), 226-239. Lai, K. & McBride-Chang, C. (2001). Suicidal ideation, parenting style, & family climate among Hong Kong adolescents. International Journal of Psychology, 36 (2), pp. 81-87. Mikolajczaki, M., PEtrides, K.V. & Hurry, J. (2009). Adolescents choosing self-harm as an emotion regulation strategy: The protective role of trait emotional intelligence. British Journal of Clinical Psychology, 48, 181–193. Owens, D., Horrocks, J., & House, A. (2002). Fatal and non-fatal repetition of self-harm systematic review. The British Journal of Psychiatry, 181, 193–199. Rodham, K., Hawton, K., & Evans, E. (2004). Reasons for deliberate self-harm: Comparison of self-poisoners and self-cutters in a community sample of adolescents. American Academy of Child American Academy of Child and Adolescent Psychiatry, 43, 80-87. Shaffer, D., Garland, A., Gough, M., Fisher, R., & Trautman, P. (1988). Preventing teenage suicide: A critical review. Journal of American Academy of Child and Adolescent Psychiatry, 27, 675-687.

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Revisiting young people’s health challenges: Examining social support networks Zona Hildegarde Saniel-Amper

Department of Anthropology, Sociology and History This chapter brings together the health challenges earlier presented by other writers in this monograph. Special emphasis is, however, given to the analysis of qualitative results as a way of substantiating the survey data (N=699) and to show a bigger picture of sexual and non-sexual risktaking behaviors of young people at USC. Of equal importance is the discussion on social support networks. Recognizing young people’s tendency to engage in risk-taking behaviors, the study sees the need to determine how they cope with the challenges they face and from whom or where they obtain support when confronted with a problem that might have an effect on their health and well-being. Another aspect discussed in this chapter is fraternity-related violence, a domain which was not explored in the survey but was mentioned in the qualitative study. Young people within the ages of 10 to 24 are more than a mere age group. It is a stage wherein they undergo a transitional and critical phase in their life. Such stage is characterized by rapid physical, mental, emotional, social and spiritual development. Young people’s experiences vary across individuals and groups, countries and cultures (WHO, 2003). In the contemporary world, they find themselves confronted with many new situations and challenges which present not only opportunities but also risks to their health and well-being (WHO, 1997). Risk-taking behaviors among the youth generally include a series of behaviors that expose them to the probability of death or of being injured, or harm to their health. Risk-taking among adolescents often occurs discreetly and results in jeopardizing one’s potential as it impinges on one’s ability to integrate socially. Such behaviors are likewise considered an ambivalent way of adolescents to appeal to those who are closest to them. These also constitute a means of finding meaning in life through active resistance to standard norms. Risk-taking behaviors range from refraining from doing what are expected, ranging from minor offenses such as not paying transport -118-

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fares, lying to parents, and cheating in exams, to the more serious ones that negatively affect their health and put their lives in danger (Breton, 2004). Ideally, the outcomes of this stage of life when the adolescent undergoes many types of development include: the feeling of self-worth that comes when one is able to contribute to other people and to society; the sense of belonging to groups and communities outside the family; the feeling of being loved by peers and involvement in intimate relationships; the feeling of accomplishment; the assumption of responsibility, autonomy and independence in daily activities and decision-making; and developing values and standing by one’s principles. To effectively achieve these outcomes in life, adolescents should seek to maintain a healthy lifestyle, gain basic knowledge and skills, and pursue career options. Aside from these, they ought to form and sustain friendships and relationships, understand one’s culture, develop and maintain a sense of well-being, and distinguish between right and wrong. However, the ideal seldom happens without support and guidance from the social groups to which the adolescent belongs. The outcome of adolescent development largely depends on the quality of his/her relationships with the family, school, peer groups, and to a certain extent, religion and other institutions (WHO, 2003). Research suggests that in many parts of the world, the normative tasks of adolescence are becoming more difficult given the context of reduced social control by families, increased individualism, and declining importance of traditional cultural norms (Frydenberg, 1997). Statistics show that adolescence brings with it the highest risks of morbidity and mortality from various causes, including accidents and injuries, early pregnancy and infection of sexually-transmitted diseases. Furthermore, many lifestyle diseases caused by smoking, risky sexual behavior, alcohol and drug dependence are also said to have their roots in adolescence (WHO, 2003). Global Facts Around the world, adolescence is considered the period of vulnerabilities to risk-associated behaviors that can have lifelong consequences for health and well-being. In 2010, the World Health Organization reported that about 16M girls aged between 15 and 19 give birth every year accounting for roughly 11% of all births worldwide. More than 150M adolescents use tobacco − a number which has been found to be increasing globally. Moreover, at least 20% of young people experience some form of mental illness such as depression, mood disturbances, suicidal behaviors and

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eating disorders. Among those within the ages of 15 to 19, suicide is reported as the second leading cause of death, followed by the instigation of violence in the community and in the family. On the aspect of HIV and AIDS, young people aged 15 to 24 account for an estimated 45% of new HIV infections worldwide. In developing countries, children entering adolescence are often undernourished. Such a condition makes them more vulnerable to disease and early death. On the other hand, there is also an increasing trend of being overweight and obese among them, both in low and high income countries. Drinking alcohol is also an increasing trend among young people in many countries. The phenomenon is a growing concern because this has been found to be the primary cause of injuries and accidents brought about by loss of self-control and involvement in other risky behaviors. Nearly two thirds of premature deaths and one third of the total disease burden in adults are associated with conditions that are traceable to their behaviors in youth, such as tobacco use, drinking of alcohol, lack of physical activity, unprotected sex and exposure to violence. A study of 53 countries from all regions of the world identifies three major health risks for adolescents, namely: early sexual initiation; substance abuse; and depression. Early sexual initiation is associated with unprotected intercourse, which could lead to unplanned pregnancies, sexually transmitted infections, and abortion. Substance abuse refers to indulgence in tobacco and alcohol as well as drugs, which lead to illness and even death. This is also correlated with unsafe sex, accidents, and violence. Depression affects the capacity to function, and is likewise associated with alcohol and drug abuse which may lead to loss of productivity and even suicide. Studies have shown that the family, school, community, friends/peers, and beliefs of adolescents definitely affect behavior. Adolescents whose environment harbors positive relationships in the home, in the community, the school, and where peers have positive social attitudes and behaviors, are less likely to initiate early sexual activity, less likely to use substances, and less likely to experience depression. Based on these results, WHO (2002) concluded that there is indeed a link between the social environment and the health outcomes of adolescents. The Philippine experience In the Philippines, the Young Adults Fertility Survey (YAFS) reveals that 23% of Filipino youth engage in pre-marital sex. This accounts for 30% of all births from young mothers. This situation also apparently explains why 36% of women who have been treated for abortion complications belong to those aged between 15 to 24. A POPCOM-7 and PCHRD-CVCHRD-supported Project

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Further, the YAFS data show a tendency towards other high-risk nonsexual behaviors among the Filipino youth such as smoking, drinking, drug use and suicide. The YAFS data also show that 47% of the youth indulge in smoking, 70% drink, 12% have had at least one suicide attempt, and 11% use illegal drugs (Commission on Population, 2003). The current study focuses on the health challenges experienced by students of the University of San Carlos, a school located in Cebu City, Philippines. It seeks to determine whether the global and national facts presented earlier are also reflected in the experiences of young people here. Risk-taking behaviors presented in previous chapters shall be reiterated and substantiated with more qualitative data from focus group discussions and in-depth interviews. Further, this chapter presents the social support networks of young people that help them cope with the challenges inherent in such experiences. Results Non-sexual health challenges This section presents the non-sexual risk-taking behaviors experienced by study participants. These behaviors include overeating, under-eating, lack of sleep, smoking, drinking liquor, drug use and suicide attempts. The data presented below show the proportion of students who have been interviewed for the survey on risk-taking behaviors by college (Table 1), and by sex (Table 2). Table 1 Non-sexual risk-taking behaviors by college.

Overeating Under-eating Sleeping below 8 hrs Smoking Drinking liquor Drug use Suicide attempts

CoC

CoEd

Proportion per College CoE CAS CAFA CoN

CoP

Total

82.9 40.0 60.0 26.7 77.1 6.7 19.0

77.1 54.2 74.0 27.1 88.5 5.2 22.9

63.5 47.1 72.1 18.3 91.3 2.9 3.8

75.3 60.7 62.9 39.0 79.8 1.1 5.6

75.4 51.9 66.8 28.5 85.8 5.7 12.3

74.0 55.8 72.2 24.0 83.7 6.7 13.5

79.0 63.0 57.0 39.0 91.0 10.0 13.0

76.2 44.6 69.3 34.7 89.1 6.9 7.9

Note: The figures represent only the “yes” responses for each behavior.

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Table 2 Non-sexual risk-taking behaviors by sex. Male

Female

Total

Overeating 69.4 79.8 75.4 Undereating 51.4 52.3 51.9 Sleeping below 8 hours 64.9 68.1 66.8 Smoking 33.3 24.9 28.5 Drinking liquor 90.8 82.2 85.8 Drug use 9.5 3.0 5.7 Suicide attempts 7.1 16.0 12.3 N of cases 294 405 699 Note: The figures represent only the “yes” responses for each behavior.

Overeating and under-eating. Majority of the survey participants from the various colleges have experienced over-eating (Table 1), and such practice is more pronounced among females (79.8%) than males (69.4%) (Table 2). It is presumed that accessibility of fast food chains and other food outlets may have contributed to this practice. In the focus group discussions, the students narrated that the usual food they eat are junk foods that are readily available in supermarkets, canteens and sidewalk vendors. They emphasized that stressful situations trigger overeating among them. In a key informant interview, one student revealed, “katong naproblema kog maayu, sige ra kog kaon, nanambok gud kog maayu ato” (when I had a problem, I resorted to eating a lot, and so I gained weight). On the other hand, stressful situations have also caused students of both sexes to under-eat. This was reported in 51.9% of the survey sample, particularly students from the College of Architecture and Fine Arts (63.0%). An FGD participant from CAFA shared that sometimes they skip a meal because they need to submit a class requirement on time. The need to maintain a slim body was also mentioned by FGD participants as a reason why they sometimes skip a meal. Over-eating and under-eating have been experienced by young people given different circumstances and contexts. Thus, even as one overeats sometimes, one also undereats at other times. Eating has a direct effect on one’s health as it determines the intake of nourishment for the body. Overeating or under-eating have negative effects that could lead to health challenges (See also Agustin, Chapter 4). Whether overeating or undereating is a habitual practice among young people or a mere reaction to a specific situation is something which this study has not thoroughly looked into.

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Lack of sleep. Another risk-taking behavior experienced by young people in the sample is lack of sleep. The survey data show that majority of the students usually sleep less than eight hours a day. Seven out of 10 students from the Colleges of Education, Arts and Sciences, and Engineering admitted to this. FGD participants narrated that staying up late at night is usual among young people because this is the time when they are relatively free from school work. They said that they usually go out with friends to hang out (laag) and drink (inom). As shared by one key informant, her friends could stay up drinking until the wee hours of the night and even till dawn. Another informant related that he was not allowed by his parents to go out at night, but he finds a way to do so anyway. “Strikto kaayu…wala jud koy night life sa una kay di sila mosugot molaag kog gabii. Pagsulod na nako sa frat nga molaag na ko, di man gihapon ko nila tugtan ato. Mao na ang akong buhaton aron makalaag ko, di na lang ko mo-uli para di sila kapugong nga molaag ko. Silbi gikan school, magtambay ra ko hangtod gabii, dayon laag na dayon, unya kadlawon na ko mouli sa amoa.” [My parents are very strict. They would not allow me to go out at night. At first I asked their permission to go out at night, especially when I already joined a fraternity. But still they would not allow me. So instead of asking permission, I would stay in school until evening and go out with my friends, and go home only at dawn.]

Aside from drinking sessions, FGD participants revealed that most young people stay up at night “facebooking” (using Facebook, a social networking site over the internet). Personnel from the Office of Student Affairs (OSA) likewise shared that there are students who come to them to seek advice on sleeping problems. “Lack of sleep sila, mureklamo og dizziness, ug kanang digestive problems. Mao na ilang kanunay reklamo why mu-instruct ko nila in formal talks or when they come here, mangutana ko nila. So usually kanang lack of sleep gyud sila pero macompensate nila by waking up late sad tungod anang computer. Unya kanang insomnia − mga insomniac na sila. Ngano man? kay naanad man og sleeping late. Therefore they cannot sleep early anymore. Mao na ang akong nahibaw-an. Mao na ila esturya, magmorning the night man.” [They lack sleep and complain about dizziness and digestive problems as a result. I instruct them during formal talks when they come to the office. Some compensate for their lack of sleep by waking up late. It’s because of computers. Some become insomniac because they are so used to sleeping late. Thus they cannot sleep early anymore. That’s what I know from what they tell me. They treat the night as though it were morning.]

Other FGD participants mentioned that the need to finish a class requirement takes up much of their time at night. This appears to be the reason why they sleep under eight hours a day. Like food, good sleep is necessary for the body because it reinvigorates the body’s systems and functions. A well-rested body is necessary to maintain good health while

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lack of sleep has been proven to have many negative consequences for the individual. A more comprehensive discussion on eating and sleeping patterns is presented in Chapter 4 (see Agustin). Cigarette smoking. Smoking among young people is also a common practice. Twenty-eight percent of the survey sample smoke cigarettes, with a larger proportion of males (33.3%) than females (24.9%) who do so. Gender stereotypes related to smoking may explain this difference. The survey data also show that more than a third of the students from the Colleges of Nursing (34.7%), Pharmacy (39%), and CAFA (39%) have experienced smoking. From the FGDs, both male and female participants cited that smoking was usually done first out of curiosity. The males, however, are more likely to continue the habit as compared to females. Such behavior is presumed to be partly because of gender stereotypes, such as the “macho” image of smokers depicted in mass media. Key informants shared that smoking is usually done while drinking liquor to counter the taste of alcohol. “Kung kan-on pa nang inom, sud-an ang sigarilyo” (if liquor were rice, then cigarette smoke is the viand), said one female key informant who has been smoking since she was in high school. Another key informant shared that it is also a way of being accepted by one’s peers, “Manigarilyo ko way back high school pa ko. Manigarilyo, mu-inom kay aron “cool” tan-awon. Sa high school man gud, kung dili ka, ma-left out man ka sa group. Sa among school, kay murag gi-group group man na gud – naay mga varsity, naay mga manigarilyohay ug manginumay… naa sa’y mga nerd…unya ang considered nga naa sa top sa social structure kay ang mga manigarilyohay ug manginumay. Nagsugod jud akong exposure ato pag-2nd year high school nako, pag-apil nako og club. Adto nga club kay considered ka nga chups kaayu ka kung di ka manigarilyo. [I smoked cigarettes way back when I was in high school. I smoked and I drank liquor to be considered “cool.” In high school, you are left out by the group if you do not do these things. In our school, it’s like we are being grouped – there are those who are in the varsity, the nerds, and those who drink and smoke. You are considered on top of the social structure if you nd drink and smoke. So, I was exposed to drinking and smoking when I was in 2 year high school when I joined a club. In this club you are considered out of place if you do not smoke.]

Unlike food and sleep that are necessary for the body, intake of foreign substances is not. Cigarette smoking introduces toxins inside one’s body which may be accumulated over time and cause negative effects such as diseases of the respiratory system and even cancer. Survey data on this health challenge, including alcohol intake and drug use, is discussed extensively in Chapter 7 (see Gaut).

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Alcohol intake. Drinking liquor (85.8%) is a common practice among the male (90.8%) and female (82.2%) students in the sample. Among the colleges, the College of Engineering registered the largest proportion (91.3%) of students who drink alcoholic beverages, closely followed by CAFA (91%) and the College of Nursing (89.1%). FGD participants said that drinking alcoholic beverages is primarily for “bonding” purposes with friends. As one key informant shared, “Lingaw man gud. Murag ang feeling of company, mga storya, ki-at. Feel nako nga if dili ko mukuyog, ma-miss out nako ang istorya. Kay pananglitan inig abot nako, unya gainom sila the previous day unya mag-istorya sila unsay nahitabo, morag makahuna-huna ko nga kalingaw nila uy. Mao na sunod mukuyog na jud ko para apil ug istorya ug lingaw.” [It is fun. You have a feeling of company, there are different stories, just having fun. I feel left out if I am not able to participate in the drinking session, I miss out on the stories. When I go to school and learn that they had gone drinking the previous day and I miss out on the topics they talked about, I always feel that I missed out on the fun. So, the next time they go drinking I really go with them so that I won’t miss out on the stories and the fun.]

Male FGD participants shared that they often drink with friends during weekends and after class hours. The females, on the other hand, shared that they do not drink alcohol on a regular basis. Common places for drinking include boarding houses and eateries in the vicinity of the school campuses. A key informant shared that there are times when they hold drinking sessions everyday, from late in the afternoon till the wee hours of dawn. What usually takes place during a drinking session is talking about just anything, including problems. Another key informant revealed that inhibitions are erased during drinking sessions such that one can talk freely. He added that these sessions become outlets for airing out problems related to family matters, love, academics, and others. Drinking alcoholic beverages usually has immediate effects on the body systems and functions. According to FGD participants as well as key informants, immediate effects include having a headache as well as upset stomach that leads to vomiting. A hangover the day after likewise affects normal body functions. These often lead to further jeopardy such as physical injuries from accidents or acts of violence. As one key informant shared, “natingala na lang ko nga naa na koy mga bun-og sa akong bukton, samad sa akong nawong, ug sakit kaayu ang akong lawas pagmata nako. Wa jud ko kahinumdum naunsa ko kay hubog man kaayu ko ato.” (I was surprised to discover when I woke up that I had some wounds and bruises on my arms and face and my body ached. I really could not remember what happened because I was very drunk that time.) A POPCOM-7 and PCHRD-CVCHRD-supported Project

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Drug use. Although less rampant, drug use is also one risk-taking behavior indulged in by some young people at USC. The survey showed that they (5.7%) used drugs at one time or another. While some do not pursue the habit, a few become drug dependent. Again, like smoking and drinking which account for larger proportions of males than females, males also register a larger proportion (9.5%) of those who have tried using drugs. Females account for only 3%. CAFA has the largest proportion (10%) in the sample which admitted to the use of drugs (see also Gaut, Chapter 7). It was learned from the FGDs that participants resort to drug use as a way to forget problems. First-time usage of drugs was usually done out of curiosity and often due to influence from friends. According to them, it is really up to the person whether or not they will pursue such practice. However, they said that most young people in school tend to stay away from drugs due to some negative experiences of drug addicts they learned about. One key informant related that he was first initiated into drugs out of curiosity and peer pressure. This led to occasional use of drugs during parties and drinking sessions, which eventually led to regular use. He shared that most of his acquaintances who were into drugs were “rich kids” who had the money to buy the expensive shabu which costs at least P200, good for one person’s use only. According to him, a number of “outlets” where they could buy this stuff are easily accessible from both the Downtown and Talamban campuses. “Depende asa duol nga safety. Kanang bangag asa ka nasuhito. Diri sa TC, ang duol kay sa Dita, Pit-os, Cabantan, Lahug, Apas. Didto sa main, duol ang Bato sa Carbon, Pasil sa Lawis, Sawsaw, Dulho, Lorega. Depende ra na sa kaila. Di man na sila mobaligya og dili kaila kay basig ahente pa lang na. Referral sad gihapon ilang basehan. Dili basta-basta mobaligya. Una ka makasulod naa juy modala nimo didto. Kay di man mobaligya ang mga parok kung walay kaila nila nga gadala nimo. [It depends on the nearest safe location you know where to buy. Here at TC, you could go to Dita, Pit-os, Cabantan, Lahug, Apas. If you are at the main campus, the closer locations are Bato in Carbon, Pasil in Lawis, Sawsaw, Dulho, Lorega. This also depends on where your contacts are located. They do not sell shabu to just anybody for fear that you might be a government agent. They base it on referrals. Before you can buy from them, someone they know must bring you there first so you can be properly introduced.]

He said he usually joined sessions arising from invitations because he did not have the money to buy shabu for himself. But according to him, “di man jud ko addict kay di man ko mo-crave, mogamit lang ko, so user ra ko, dili ko addict” (I am not an addict because I do not crave for drugs. I only use drugs, thus, I’m a drug user but not an addict). Drug use, like smoking and alcohol intake, introduces toxins to the body which disrupts its normal functions. This leads to immediate health consequences, not

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just physiological but mental as well. As shared by one key informant on the effects of shabu use, “Kanang energetic kaayu ka…pero depende ra man na sa tripping. Naay magtripping og istorya, naa sa’y magtanga, naa sa’y magtuon. Ang “amats” kay molast na og mga 12 hours, depende sa gidaghanon. Naa sa’y mulast og 24 hours ang tama. Inig human ana kay mo-tugpa jud dapat. Kay og walay tugpa, lain man sad imong feeling ana.” [You feel energetic but it usually depends on the person – there are those who become talkative, there are others who just do nothing while others just study. The effect lasts for 12 to 24 hours depending on the amount of shabu taken. After this lapse of time, the “high” usually tapers off. If this does not happen, then this would cause a bad feeling.]

Another key informant who has already stopped using drugs after years of drug addiction talked about his experience when he drastically stopped using drugs for one month, “Grabe kaayu to akong experience ato, morag naa koy withdrawal symptoms ba. Akong buhat ato kay kaon-tulog ra jud. Murag pirmi man kong gutomon, laina lagi sa akong lawas ato, uromon gud ko sa kabusog. Ingon nila mao kuno na kung mu-undang kay naanad na ang lawas ba nga mosuyop, then gi-undang drastically.” [I experienced withdrawal symptoms. What I did was I just ate because I felt so hungry all the time. I really did not feel well. I even had nightmares due to overeating. My acquaintances said that this really happens when one drastically stops using drugs since one’s body has already gotten used to the substance].

These direct admissions underline the negative health consequences of drug use whether one is still into drug use or even when they already stop using drugs. Aside from this, further consequences are reportedly experienced, as shared by FGD participants and some key informants. They mentioned incidences involving relatives or friends who became mentally ill as a consequence of drug dependence. This knowledge has deterred them from using drugs themselves for fear that they might experience the same adverse consequence. Suicide Attempts. Interestingly, 12.3% of the survey sample admitted to have attempted committing suicide at one time or another through various ways such as laslas (slashing the wrist), medicine overdose, banging one’s head on wall, and other self-inflicted injuries. The College of Education accounted for the highest incidences (22.9%), followed by the College of Commerce (19%). This is alarming since those from the College of Education are trained to become future teachers for basic education and are, therefore, expected to be level-headed and mentally stable. A larger proportion of females (16%), as compared to males (7%), attempted to commit suicide (see also Ilustrisimo, Chapter 9). This

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confirms findings from cross-cultural research on suicide that females are more prone to attempt suicide than males. However, deaths arising from suicide are more likely to occur among males than females. In this study, however, the reasons for trying to commit suicide were not captured in the survey. This aspect was, however, explored in key informant interviews as well as in the FGDs. FGD participants averred that suicide attempts are usually done by young people due to the perceived gravity of problems which they are not able to resolve. According to them, those who attempt to commit suicide do not really have the intention of dying, but merely to inflict pain on oneself. As one key informant said, “…actually dili man hikog nga para mamatay ko, mura ganig physical pain to ease the emotional pain, ah…murag ingon ana ba… murag ang sakit ba dili na sa sulod, naa ra sa gawas…” [attempting to commit suicide is not really done so that I will die, but rather to inflict physical pain to ease the emotional pain, it’s like the pain is already outside, no longer inside of you.]

Taking one’s life or attempting to do so is a risk-taking behaviour that has serious health consequences which could lead to death. These have immediate negative effects such as physical pain, injuries, loss of blood, as well as mental anguish. As one key informant shared, “Giingnan jud ko nga kung buhaton pa ko to balik kay di na daw ko mabuhi kunu kay gisumpay raman nang ugat. Gamay ra baya na ang ugat diri. Gisumpay ra ba, di najud daw ko mabuhi. Unya nadali lang to siya kay kana ganing magpalaba ko, mao na nanuktok man to ang landlady.” [I was told that if I did it again, I would no longer survive because the vein was just reconnected. The vein is quite thin and I would not survive another suicide attempt. At that time, I was saved because my landlady at the boarding house knocked on my door to get my laundry.]

The proportion of the sample attempting to commit suicide is an indicator that there is indeed a growing number of young people in need of youth-friendly services in the university where they can openly talk about various problems they experience, as a deterrent to committing suicide. A comprehensive discussion based on the survey data on this health challenge is presented in Chapter 9 (see Ilustrisimo). Fraternity-related violence Although not included in the survey, this risk-taking behaviour is discussed in this section based on the qualitative data obtained from the FGDs and key informant interviews. From the FGDs, participants said that joining fraternities is a way of being accepted by peers. One key informant said that it was really the fad at USC-TC to join fraternities.

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According to him, Ang-ang kay ang mentality gud sa una, kay kanang di ka tagdon diri kung di ka apil og frat. Labi na diri sa TC, itapok ka sa mga nerd og di ka apil og frat. Bisag ang mga naning-naning gani mosulod na man og frat. Ana jud na sa una. [The mentality then was that you are nobody if you do not join a fraternity, especially at the Talamban Campus. You will be labeled as a nerd if you do not join. Thus, even the nerdy ones would even join fraternities. That was then.]

Joining fraternities entails undergoing initiation rites, which include providing services as well as being inflicted with physical pain by fraternity members. Initiation jud na.Naay paddle nga three stages, then “candleing” kanang patuloan og candila imong likod ba, unya belting dayun kanang ang gamiton pagtangtang sa tulo sa kandila sa imong likod kay bakus. Ang katapusan kay massacre – kanang kulatahon kag maayu ba sa tanan membro sa frat nga imong gi-apilan. Ang diri sa college kay walay candleing ug belting. Ang gipuli ani kay service. Kanang sugo-sugoon ka ba sa mga master. [There is an initiation. There is paddling in three stages, then “candleing” wherein hot candle wax is dripped onto your back, then “belting” wherein a belt is used to remove the candle wax on your back. The last stage is called massacre wherein one is manhandled by all the fraternity members. However here in college, “candleing” and “belting” have been replaced by service to one’s master.]

According to personnel from the Office of Student Affairs, fraternityrelated violence had been one big problem at USC in the past. This has, however, been solved through the banning of fraternities in the university. There were incidents then when various fraternities would engage in rumbles whereby members of one group would inflict harm to members of a rival group. This has, in fact, once resulted in homicide which caused the imprisonment of perpetrators. The incident has led the school administration to disallow fraternities inside the university. But even with the ban on fraternities, they continue to exist covertly in the campus. A key informant narrates his experience with fraternity rumbles, “Mag-abot ang duha ka grupo unya rambol dayun. Magsinumbagay. Kung sa community, mas delikado kay naay dunggab ug pusilanay. Last man standing man na. Kung gikan kinsa nga frat ang awahing natumba, mao to nga frat ang daog. Kung kinsay mapildi, mobaws na man sad na sunod.” [Two rival groups confront each other and then a rumble ensues. They box each other. It is more dangerous in the community because it involves stabbing and shooting. It’s a “last man standing” thing. The fraternity to which the last one standing belongs is the winner. The loser then plans to retaliate at another time.]

Effects of fraternity violence on young people’s health, while mainly physical, may have psychological consequences. As shared by one key informant about his experience,

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Young people’s health: Challenges for education and intervention “Kaapil ko mga ever since, mga three times na tingale ko kaapil og frat war… Bun-og, black eye, sakit sa lawas. Kaluoy sa Ginoo, wala pa jud tawn ko madunggabi, wa sad ko mapusili.” [I got involved in fraternity wars three times. I got bruises, a black eye and intense body pain. Thank God I have not been stabbed or shot.]

Exposure to violence is said to have psychological effects on young people, as shown in a number of studies. However, in this study, we cannot directly correlate the experience of fraternity violence to mental health due to lack of data on this aspect. This could be a subject for future studies. Sexual health challenges This section presents the sexual risk-taking behaviors experienced by study participants. Such behaviors include pre-marital sex, contraceptive use, pregnancy and abortion. Like the previous category, the behaviours are tackled separately to highlight the need for specific attention on adolescent sexual health. Table 3 presents the proportion of the survey sample per college who experienced various sexual risk-taking behaviors and Table 4 shows the proportions of the survey sample by sex in relation to the same. This health challenge is discussed thoroughly in Chapter 8 (see Aguilar). Table 3 Sexual risk-taking behaviors by college. Risk-taking Behaviors

CoC

CoEd

Proportion per College CoE CAS CAFA CoN

CoP

Total

Pre-marital Sex Contraceptive Use No Contraceptive Pregnancy (female) Abortion (female)

53.3 62.5 37.5 9.1 9.1

78.0 43.8 56.2 33.3 -

85.7 50.0 50.0 -

16.4 40.0 60.0 33.4 16.7

55.6 52.9 47.1 17.7 3.2

77.8 57.1 42.9 -

47.8 46.9 53.1 14.3 -

71.4 70.0 30.0 14.3 -

Note: The figures represent only the “yes” responses for each behavior. Table 4 Sexual risk-taking behaviors by sex. Risk-taking Behaviors

Male

Sex Female

Total

Pre-marital Sex Contraceptive Use No Contraceptive Use

75.5 55.6 44.4

38.0 48.4 51.6

55.6 52.9 47.1

Note: The figures represent only the “yes” responses for each behavior.

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Pre-marital sex. Of the various sexual risk-taking behaviours among the youth, the most common is engaging in pre-marital sex, with 55.6% admitting to have already experienced having sex. More males (75.5%) than females (38.0%) among the respondents have engaged in pre-marital sex. This again reflects the gender stereotypes prevalent in Philippine society where men are considered “macho” if they have already engaged in sex. On the other hand, these gender stereotypes label women who have experienced sex outside of marriage as “immoral.” In terms of college affiliation, a larger proportion of respondents who have had sexual encounters come from the College of Engineering (85.7%). While this is a significant proportion, this may not be conclusive considering that 75% of the participants in the CoE survey were males. FGD participants disclosed that the usual reasons for engaging in sex were curiosity and peer influence. As one key informant said, “wala jud koy alamag anang sex sa una, pero nakahibaw na ko ana nadugay kanang inig storya kon mag-inom mi kuyog akong friends or akong cousins.” According to FGD participants, and among males especially, sex is considered a normal part in the life of an adolescent − whether with an intimate partner or not. Among females, however, virginity is still considered important, but consensual sex between intimate partners is also becoming an accepted norm. Indeed, a counsellor from OSA confided that nowadays sex is already considered quite normal for boyfriend-girlfriend relationships among young people even as early as high school. Coital debut among the survey participants who have experienced having sex is at age 17. Other than the moral aspects of sex before marriage and at an early age, serious consequences to one’s health are likely to occur as such may result in pregnancy and contracting of sexually transmitted infections (see also Aguilar, Chapter 8). Contraceptive use. Of those in the survey sample who have engaged in pre-marital sex, 52.9% said they used contraceptives while 47.1% said they did not. Either way, these pose health challenges. The use of contraceptives, especially without a medical check-up prior to its use, might have certain effects on the body’s functions and systems. On the other hand, non-use of contraceptives may lead to unwanted pregnancy and possibly abortion. There is also the risk of contracting sexually-transmitted infections. Based on the survey data, there is an equal risk for both possibilities as roughly half of those engaged in sex either used or did not use contraceptives. FGD participants and key informants said contraceptive use is being practiced by sexually active

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young people, although others do not. Information regarding contraceptives usually come from friends and mass media, specifically from the internet. One key informant said that she learned about using pills and condoms from her friends. A male informant shared that his drinking buddies were his source of information on contraceptives. It is likely that information obtained from informal sources may be insufficient or inaccurate. These could lead to serious health challenges arising from pregnancy and abortion, diseases of the reproductive system, and other health-related problems. Pregnancy. The lack of knowledge and information of reproductive health and the consequences of engaging in sex at a young age have led to a number of pregnancies. From the survey, 17.7% of the females who engaged in sex have experienced being pregnant, the largest proportion (33.3%) of whom were from the Colleges of Education and Pharmacy. Pregnancy is generally considered an obstacle in the pursuit of one’s studies. Suspecting and knowing that one is pregnant usually leads to anxiety. The same feeling was shared by one key informant who got pregnant at age 19. Another key informant shared that she really did not know what to do when, after buying and using four pregnancy test kits, it was confirmed that she was pregnant. Such a situation often leads to desperation and anxiety. Due to fear of the consequences, some young people resort to abortion. As shared by a male key informant who got his girlfriend pregnant, “Mao to, hugno kalibutan uy. Nag-abot ang langit ug yuta…Wa ko kabalo unsa akong buhaton. Unang nakabantay ang pamilya sa babaye. Nakulatahan ko sa iyang maguwang ato uy. Ipakuha jud unta na namo, nagtigom na gud ko para pakuha. Unya kay ma-timing man sad nga sige kog naay gastuhanan, mao to wa jud mi katigum og sakto, gipadayon na lang namo. Giingnan sila mama nga mao na namabdos…suko akong mama. Wa gud mi magtagad ni mama ato. Ibutang nalang niya akong bawon didto, kuhaon lang sad nako, di mi mag-istorya.” [It was like the world collapsed, heaven seemed to fall to earth. I really did not know what to do. It was the girl’s family who first discovered the situation. I was mauled by her elder brother. That’s why we thought of aborting the baby, I saved some money. However, I was not able to save enough and we decided to go on with the pregnancy. They told my parents that my girlfriend was pregnant and my mother got so mad. She did not talk to me anymore, she would just place my allowance on the table for me to get. She never talked to me anymore.]

Abortion. Based on the survey, abortion attempts have been experienced by 3.2% of the survey respondents who have had sexual experience. From the FGDs, participants said that this usually happens when young people feel they are not yet ready to face parenthood. Family support is also considered crucial in decision-making. Key informants said that they considered abortion for fear of the possible consequences. Other

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methods of abortion are also learned from peers. A key informant said she took an oral medicine for fever and pain with a soda drink, as advised by a friend. While another informant said they were told by some friends to use a medication for gastric ulcers. Abortion, and even attempts at abortion, pose threats to the reproductive health of an individual. Possible side effects include hemorrhage and fetal deformities (if not aborted, but attempted). Although this practice has been experienced by only a small proportion of the female sample, it is nonetheless a serious concern worth noting. Personnel from OSA cited isolated cases of abortion in the campus as evidenced by discovery of a fetus in one of the toilets. But according to OSA, these are isolated cases and should there be similar occurrences, they would immediately investigate and take appropriate actions, such as expelling the student. Personnel from the guidance center, on the other hand, shared that they have ways of counselling those contemplating on having an abortion. However, they seldom encounter students with such concerns. Support networks and coping mechanisms Young people, when faced with challenges resulting from risk-taking behaviors, usually consult their friends. Outside of these readily-available sources, they also seek information from the internet and close relatives. The data also suggest that parents are also consulted although this is resorted to only when they have no one else to turn to. The FGD participants, however, averred that “parents are the best persons who could provide support in times of difficult situations.” On the other hand, young people who do not have close ties with their family prefer to consult their friends, saying that “they can undertand the situation better” (mas makasabot man gud sila nimo). A key informant said that she finds it weird to talk to her parents about sex-related matters: “Mag-istorya man mi anang mga regular things ba, sa skuylahan…pero ingon ana…weird lang nga mostorya ko sa akong mama ug papa og mga ingon ana. Di ko ka-imagine…mas makastorya ko sa akong mga amiga…” [We talk about regular things about school, but it just feels weird to talk to my parents about these things. I can’t imagine telling them, I prefer to talk to my friends…]

Another key informant explained why it is difficult to discuss risk-taking behaviors with parents: “Akong mga barkada, sa frat ug sa silingan kay sa ilaha ra man ko komportable mo-storya. Kung adto ko sa akong mama ug papa, dili man tabang ang madawat, kasab-an nuon. Ang barkada, kay dungan baya mig tubo, suod na jud

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Young people’s health: Challenges for education and intervention mi, wala nay secreto. Lahi man nang amigo ug acquaintance…kani akong barkada, amigo jud ni sila. Mutambag man sad ni sila pero dili ta kasab-an. Maminaw sad sila.” [My friends from the fraternity and our neighborhood are the ones with whom I can comfortably talk to. If I tell my parents about my problems, I won’t get any help from them, instead I will get a scolding. My close friends know me well since we’ve grown up together and we no longer keep secrets from each other. Friends are different from mere acquaintances. Friends give you advice but they won’t scold you. They also listen to what you have to say.]

Interestingly, the data show that aside from consulting friends, many of the young people in the sample seek spiritual guidance through praying (see also Abulad, Chapter 6). FGD participants mentioned that they also pray and attend mass especially when they have problems. One key informant shared that she visited the prayer room of the Blessed Sacrament several times when she got pregnant and found it difficult to handle the situation: Nakabisita kog Blessed Sacrament ana kadaghan uy. Blessed Sacrament ba, kanang naa bitaw sa kilid kanang sa Sto. Rosario dapit sa kumpisalan naa man nay murag prayer room ba. Nakaadto kog kadaghan ana didto… maglingkod, mangadye, mangayog guidance unsay buhaton sunod, especially katong nadawat na nako nga mabdos na ko. Nangayo ko og strength ba nga makasulti ko sa akong mamag papa…Ang akong gikahadlokan unsaon nako pagpadako sa akong anak og tarong, apil sad na nako sa akong pangadye. Nga unta healthy ra akong anak, nga mudako syang tarong, og unsa man gani, makakita kog trabaho for me… [I visited the Blessed sacrament at the prayer room at Sto. Rosario church near the confessionals. I went there several times…I just sat there praying, asking for guidance on what to do next, especially when I had accepted I was pregnant. I asked for strength to be able to tell my parents…I was afraid of how I would be able to raise my child well was included in my prayers, that my baby would be healthy, and grow well, and that I would find a job…]

Another key informant narrated his spiritual experience when faced with the same problem, “Pagka-problema nakog maayu katong pagkamabdos sa akong uyab, morag naabot ko sa punto nga wala na jud koy laing maduolan, mao to nangadye na lang ko. Suwayan nato beh kay wala na may laing mosabot, kapangadye jud kog ahat. Sangpit ra lagi og madiskuhido. Ingon ko, “tabangi ko Lord beh nga makalingkawas ko sa akong problema”. Mao ra to. Murag gitubag man sad tingale akong pag-ampo kay morag nasulbar ra man sad…nakatrabaho ko, nakasabot nag hinay-hinay silang mama. Mao to nakaingon ko nga bisag unsa pa diay ta, pwede ra jud ta mangayog tabang sa Lord. [When I was confronted with a problem of my girlfriend’s pregnancy, I felt so lost that I had no one to turn to. So, that’s why I prayed. I just tried praying. I called on the Lord only when I had a really big problem. I said, “Lord, please help me surpass this problem”. That was it. It seemed that my prayer was answered since everything just fell into place…I was able to find a job, my parents gradually understood and accepted the situation. That’s why I can say that we can always ask help from the Lord.]

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The study has shown that talking to peers and praying are part of the coping mechanisms young people, and these have enabled to The study has shownofthat talking to peers and praying are partthem of the face many challengesofand surpass trials. school authorities coping mechanisms young people, andIronically, these have enabled them toand face many challenges and surpass Ironically, school authorities offices (related to student services,trials. such as guidance, clinic, student and offices (related student services, as guidance, clinic, affairs, etc.) areto seldom resorted to such by young people for helpstudent in times affairs,they etc.) are seldom resortedrelated to by young people forchallenges. help in times when experience problems to these health Personnel the Office of Student Affairs admitted students when they from experience problems related to these healththat challenges. seldom come tothe them withofthese types of health challenges, except for Personnel from Office Student Affairs admitted that students problems related to lack of these sleep.types According to one key informant, seldom come to them with of health challenges, exceptshe for feels that school would According not understand are going problems related personnel to lack of sleep. to onewhat key they informant, she feels thatShe school personnel wouldfear notamong understand whattothey arethese going through. said, there is often students go to through. said, there often fear among students to gokey to these offices forShe they might beisjudged for their actions. Another informant offices for might be judged for their actions. Another key informant shared thisthey sentiment, shared this sentiment,

“Di man ta tabangan ani, i-criticize ra man nuon ta. Pareha katong high school pa ko, mangayo tag tabang sa guidance, kasab-an nuon ta, gi-ahak uy. Bad “Di man ta tabangan ani, i-criticize ra man nuon ta.man Pareha katong high school pa tripamangayo uy. Mas labaw ang criticism kaysa kasab-an help. Maglagot man ta, ko anang ko, tag tabang sa guidance, man nuon gi-ahakmo-judge uy. Bad dayon walabaw pa gani kaila kaysa nimo ba.” will not help us, instead they tripa uy.nga Mas angsila criticism help.[They Maglagot man ko anang mo-judge would criticize was still high school, seek fromthey the dayon nga wa us. pa Just ganilike silawhen kaila Inimo ba.”in[They will not we help us,help instead guidance personnel. Instead we get a scolding. I don’t likewe it. seek Criticism prevails would criticize us. Just like when I was still in high school, help from the over help.personnel. I don’t likeInstead peoplewe who immediately knowing the guidance getjudge a scolding. I don’t even like it.before Criticism prevails person andIthe circumstances the action.] over help. don’t like people behind who judge immediately even before knowing the person and the circumstances behind the action.]

This view was shared by a participant who had a friend who went to the guidance to seek about a personal She was This view office was shared byhelp a participant who hadproblem. a friend who went to the reportedlyoffice told that theyhelp would onlya entertain pertaining to guidance to seek about personal problems problem. She was reportedly told and that not theyproblems would only entertain problems school matters about lovelife (see alsopertaining Nolasco, to school matters and not problems about (see also Chapter 11). Another key informant saw lovelife this situation in aNolasco, more Chapter 11).way: Another key informant saw this situation in a more enlightened enlightened way:

“Kinahanglan sad jud naa silay ma-estoryahan ba. As much as, daghan bayag issues ang mga adolescents…daghan jud kaayug theas, factdaghan nga mabag“Kinahanglan sad jud naa silay ma-estoryahan ba. issues As much bayag ohan saang college nga relatively free ba. na kinahanglan sad tingale ang issues mga life adolescents…daghan jud Mao kaayug issues the fact nga mabagschool ing-ana nga free services ba, murag support group ba, informal ohan samuprovide college lifeognga relatively ba. Mao na kinahanglan sad tingale ang gud morag Alcoholics, Inc. ba,nga murag ingonba, ana… Naasupport juy place ngaba, kaadtoan school muprovide og ing-ana services murag group informal nga sila Alcoholics, i-judge, dili Inc. sila ba, i-turn away,ingon dili sila i-look ogjuy lainplace nga eye. Siguro gud dili morag murag ana… Naa nga kaadtoan naka-sala pero dili yousila don’t have to slap in i-look their faces ba.nga Mao ganing niduol nga dili silasila, i-judge, i-turn away, dili itsila og lain eye. Siguro sila kay aron magpatabang unsay buhaton sunod, nga na man jud naka-sala sila, pero you don’t haveilang to slap it in their faces ba.nahitabo Mao ganing niduol ni. Ana ba.” [They need someone to talkbuhaton to. Adolescents face a lot ofna issues sila kay aron magpatabang unsay ilang sunod, nga nahitabo man jud especially because college life is relatively So the school provide ni. Ana ba.” [They need someone to talk to.free. Adolescents faceneeds a lot oftoissues support services or college support life groups like Alcoholics, shouldtobeprovide a place especially because is relatively free. So Inc…There the school needs where people with serious health challengesInc…There can go to where supportyoung services or support groups like Alcoholics, shouldthey be awon’t place be judged, they won’twith be turned they won’t bego regarded with a critical where young people seriousaway, healthand challenges can to where they won’t eye. It’s true thatwon’t they be might haveaway, doneand wrong, yoube don’t have to slap it in be judged, they turned theybut won’t regarded with a critical their faces. precisely why they seeking on what to to doslap nextit given eye. It’s trueThat that is they might have doneare wrong, but help you don’t have in that have already engaged specific risk-taking theirthey faces. That is precisely whyinthey are seeking helpbehaviors.] on what to do next given that they have already engaged in specific risk-taking behaviors.]

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Young people’s health: Challenges for education and intervention Conclusion and Recommendations

The quantitative and qualitative data presented in this chapter clearly show that young people at USC are no different from other young people worldwide; they act their age and they experience both sexual and nonsexual risk-taking behaviors. The WHO and YAFS’ data are also confirmed as reflected in the behaviors of young people in this Catholic university, although at varying degrees. They face the risks of overeating, undereating, lack of sleep, smoking, drug use, alcohol intake, suicide, pre-marital sex, contraception (and non-contraception), pregnancy and abortion. Coping mechanisms primarily involve talking to peers and praying. Given the situation, one can say that university support services are necessary to enable young people to cope with the consequences of sexual and non-sexual risk-taking behaviors they face. It is imperative that data generated from this study must be seriously considered by service support units at USC, including the Office of Student Affairs, Guidance Center, Clinic and Campus Ministry. Of equal importance is that academic departments maintain a student-friendly atmosphere to encourage young people to talk about the health challenges they face with teachers, advisers or peer facilitators. To effectively equip these units with the necessary skills, knowledge, and attitudes to handle such concerns, training of personnel is of utmost importance. Services available from these units should be more student-friendly rather than judgmental, coercive and discriminatory. A change of outlook as regard risk-taking behaviors needs to be developed. This poses a real challenge to service providers within the university particularly because they admit to having lack of training and exposure in handling cases such as sexual abuse, suicide attempts, pregnancy, abortion and drug use. Such re-orientation and/or re-training needs administrative support considering that a revamp of specific student services units may need to be done in order to be more responsive to students’ needs, issues and concerns. As implied by Breton (2004), risk-taking behaviors among young people are new forms of ‘rites of passage’ from adolescence to adulthood. Involvement in risk-taking behaviors is a reality that the communities to which they belong (e.g., home, school, work, etc.) should tackle with an open mind, as the behaviors are more transitory than permanent. Outcomes of risk-taking behaviors largely depend on the quality of young people’s relationships with the family, school, peer groups, and to a certain extent, religion and other institutions (WHO, 2003).

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References Breton, D. L. (2004). The anthropology of adolescent risk-taking behaviours. Body & Society, Vol. 10 (1): 1-15. Commission on Population. (November 2003). Pinoy youth: making choices, building voices. State of the Philippine Population Report 2nd Issue. Frydenberg, E. (1997). Adolescent coping: Theoretical and research perspectives. London: Routledge. World Health Organization. (1997). Adolescent health and development programme. Family and Reproductive Health. World Health Organization. (2002). Broadening the horizon: Balancing protection and risk for adolescents. Retrieved June 27, 2011 from http://www.who.int/child-adolescent-health. World Health Organization. (2003). Value adolescents invest in the future. Educational Package Facilitators’ Manual World Health Organization. (2010). 10 facts on adolescent health. Retrieved June 27, 2011 from http://www.who.int/features/factfiles/ adolescent_health/facts/en/index.html.

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Health and services: Exploring gaps, building a supportive environment for young people Fiscalina Amadora-Nolasco

Department of Anthropology, Sociology and History This study aims to gauge young peopleâ&#x20AC;&#x2122;s impressions regarding the services offered by support units at USC and other providers outside of USC. The data, albeit limited, can be used as preliminary bases in crafting evidence-based initiatives which could lead to promoting young peopleâ&#x20AC;&#x2122;s health and reducing their vulnerability to health risks. Earlier in this monograph, the assumption that young people are faced with challenges related to health is supported by quantitative and qualitative data, and these problems appear to vary with gender and life circumstances. The challenge now is to examine the type of services availed of by students, their impressions and their recommendations on what improvements may be undertaken to improve access and utilization. The data analyzed here were collected through personal interviews with 699 young people within the ages of 15 to 24. Subsequent sections focus on examining male and female studentsâ&#x20AC;&#x2122; responses to a set of openended questions, using key informant interviews (henceforth, KII) and focus group discussions (henceforth, FGD). The two approaches were employed to complement the survey, to elicit the most detailed points of view of students and provide depth towards understanding their healthrelated issues, albeit inconclusive. The survey results hold true for the sample population but the qualitative data should not be taken to mean as the general impression of the sample, or of the Carolinians. To provide a balance and to determine similarities and differences in opinion, impressions from service providers are also presented in the discussion. The UN Convention on the Rights of the Child ensures the right of young people to health, healthy development and protection from harm. Further, the 1994 International Conference on Population and Development reaffirmed the right of adolescents to counseling, information, education, communication and services (cited in WHO, 2004). Given these rights, the schools are therefore duty-bound to -139-

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guarantee that a supportive mechanism is put in place to address the special needs of the young. The success of any program designed for adolescents, be it school-based or community-based, hinges on the delivery of quality services and carefully thought-out programs and activities. Information dissemination alone is futile unless the growing need for appropriate services is addressed. Studies show that most health providers have difficulty understanding situations from the perspective of the young. As a consequence, the latter become hesitant to seek professional advice and end up resorting to selfmedication or obtaining information from friends. Although peer support is recognized as crucial, there are specific aspects which they may not be able to handle appropriately. Support units must therefore come across suitable ways to increase young people’s receptiveness to health education and information, counseling, treatment, referrals and other equally important services as a step towards achieving the right of young people to healthy development. According to Craig et al. (1995), health providers can start by being trustworthy rather than instilling fear among the youth. Such statement implies that personnel must try to make efforts to break the distrust of the young. On the aspect of reproductive health, for example, FOCUS on Young Adults (Shah et al., 1999) presents a field guide on how to effectively reach-out to adolescents. It discusses interesting approaches that deal with young adult’s pressing concerns, including their need for direct and gender-specific services. The topics include, but are not limited to, sexuality, gender roles and power relations, sexual exploitation and coercion, alcohol and drug use, friendship influences and other social pressures. School administrators recognize the struggles and difficulties faced by young people particularly those who are engaged in sexual (e.g. premarital sex, early pregnancy, abortion) or non-sexual risk behaviors (e.g. suicide, drugs, alcoholism, violence, gambling). A study conducted by Aguilar et al. in 2002 supports this claim. Administrators know that they have the responsibility to deal with the issues in the most appropriate manner, without having to compromise the Catholic sense of morality and ethical responsibility of the school. The problem, however, is that concerns only come to the fore when these are reported to the service support unit that is mandated to handle specific issues. On matters concerning sexuality, it is noted in the Aguilar et al. study that university administrators expressed reservations on whether or not service support personnel are adequately equipped to handle sexuality issues. In this context, the position of the Roman Catholic Church and issues of morality and ethical responsibility were emphasized. They articulated that “being a Catholic institution, the university is guided by A POPCOM-7 and PCHRD-supported Project

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the position of the Catholic faith.” Such opinion has led Aguilar et al. to say that it may be the reason why “issues are dealt with peripherally or only when related cases are reported to a facility.” Discussions about young people are not confined to school or community settings. In a study of the business process outsourcing workers in Cebu, Nolasco (2010) found that there are young people between the ages of 19 to 24 who have pursued a career in this sector, even as some of them are still in school. In the same study, Aguilar (2010) points to health issues faced by young workers in the BPO. She recommended that efforts must be made to provide quality services to young employees who are faced with concerns and who may have reservations in availing of health services. Inclusion of quality health services in the workplace is seen as imperative to improving workers’ satisfaction of the work environment. Results: Quantitative Data Presented in Table 1 is a list of service support units that students who participated in the survey usually visit or consult when confronted with a problem. Only one answer was required of students for this item to determine which of the service units in the university is most frequently visited and whether off-campus facilities are also resorted to. No definition of “health problem” was given when the question was asked because the study would also want to determine what constitutes the domain of health concerns among young people at USC. The “school clinic” turned out to be the most common facility visited, with about 37% of the sample accounting for this choice. There is hardly a difference in the proportion of males (36.7%) and females (37.5%) who frequent this facility. Interestingly, a third of them also admitted to not having visited any of the support facilities in the university or off-campus providers. This observation is more pronounced among females. Students who usually seek professional help from off-campus providers (public and private clinics and hospitals) account for 16%, with more females than males who said so. The result shows that “sex” and “visit to a facility” are related (at the p<.05 level). Hence, one can say that females are more likely to visit a facility and seek professional health care than males. Of the three big facilities (i.e. clinic, guidance office, office of student affairs) at USC, the OSA (17 or 2%) appears to be the least utilized for health-related purposes. The proportion of students who frequent the school clinic is higher among those within the ages of 18 to 20 (41%), followed by those in the 21-24 age bracket (34%). These are the ages when students are in the 3rd, 4th and 5th year levels. The lowest proportion (30%) is registered by younger students (15-17 years old). Table 2 also shows a preponderance A POPCOM-7 and PCHRD-supported Project

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of students within the ages of 15-17 (41%) who have not visited any of the facilities, whether in or off-campus. The relationship between “age group” and “visit to a facility” is established in this study. That is, older students (18-20 and 21-24 years old) are more likely to visit a facility than the younger ones. The association (at the p<.05 level) may not be strong but is worth noting, and will still prove useful to program planners. Table 1 Study sample by sex and service support unit visited (in per cent). Support Facility *

All

Sex Male

Female

school clinic guidance office office of student affairs off-campus (public-private) others (at USC) none

37.2 10.3 2.4 16.5 1.0 32.6

36.7 13.9 2.7 14.3 1.7 30.6

37.5 7.7 2.2 18.0 0.5 34.1

N of cases

699

294

405

*Chi-sq. p<.05 Table 2 Study sample by age group and service support unit visited (in per cent). Support Facility *

All

15-17

18-20

21-24

school clinic guidance office office of student affairs others (at USC) off-campus (public-private) none

37.2 10.3 2.4 16.5 1.0 32.6

30.4 10.5 1.8 0.6 15.8 40.9

40.7 10.4 2.4 0.5 16.1 29.9

34.5 9.7 3.5 3.5 18.6 30.1

N of cases

699

171

415

113

*Chi-sq. p<.05

Clinic. Now that we have an idea of students’ health-seeking behavior, we move on to analyze the type of services availed of from the four facility categories (Table 3). Multiple responses were obtained for this aspect of the study. Students who usually visit the clinic go there primarily for “consultation and information” (153 mentions: 59%).

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A considerable number of mentions were also made for curative services such as “treatment of ailment/ illness or injuries” (106 mentions: 41%). It is, however, possible that services related to treatment, consultation and information were availed of at the same time. Only in four incidences was the clinic mentioned for referral services, although the nature of referral was not dealt with in the survey. Responses generated for “others” were combined as these were not found to be relevant. When asked about their level of satisfaction for the services received from the clinic, those who answered “always” account for a third of the sample. While 58% of them said they are “sometimes” satisfied, a mere nine percent responded in the negative. On the whole, one can say that students who frequent the clinic are generally satisfied (91%) with the facility’s services. The bar graph for this is reproduced here as Figure 1.

Figure 1 Level of Satisfaction: USC Clinic

Table 3 Services availed of from the USC Clinic Clinic (N=260)

Consultation/information

58.8

Treatment

40.8

Counseling

6.5

Filing a complaint

1.5

Seek referral

1.5

Others

6.5 Multiple Response

140 120 100 80 60 40 20 0 Clinic

Alw ays

Sometimes

Never

33.2

57.9

8.9

Guidance. We now turn to students who usually go to the guidance office. Expectedly, they go to the facility primarily to obtain “counseling services” (42 mentions: 58%), followed by 22 mentions (31%) for “consultation” (Table 4), although it is likely that survey participants’ understanding of the two services are the same. There are two mentions for “treatment” but the data could not say on what particular aspect. Similarly, students gave an appreciable satisfaction rating for the services received from the guidance office, with 39% registered for “always” and 58% for “sometimes,” at a combined figure of 97% (Figure 2).

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Table 4 Services availed of from Guidance Office

Guidance (N=72)

Figure 2 Level of Satisfaction: Guidance

Consultation/information

30.6

Treatment

2.8

Counseling

58.3

Filing a complaint

1.4

Seek referral

140 120 100 80 60 40 20 0

Others

15.3 Multiple Response

Guidance

Alw ays

Sometimes

Never

38.9

58.3

2.8

OSA. Students who visit the OSA account for only 2.4% of the study population. Many mentions were made for school-related policies that do not necessarily fall within the category of consultation or treatment. Although there were mentions for “counseling,” the data could not say whether these are for health-related concerns or for violation of a school policy (Table 5). The satisfaction rating given by students to the OSA is also noticeable in Figure 3, at a combined figure of 76% for “always” and “sometimes.” Considering however that there are only 17 students who availed of the OSA services, the satisfaction rating registered for this facility may not be accurate. Worth noting is that the OSA, when compared to the two other facilities (i.e. clinic and guidance), registered more mentions for “never” satisfied. The non-satisfaction rating given by students for this facility is presumed to be associated with school policyrelated services which may not be directly related to health but may have caused students to experience anxiety or depression. Figure 3 Level of Satisfaction: OSA

Table 5 Services availed of from the SAO OSA (N=17)

Consultation/information

17.6

Treatment

Counseling

29.4

Filing a complaint

11.8

Seek referral

5.9

Others (school policy) Multiple Response

35.3

140 120 100 80 60 40 20 0 OSA

Alw ays

Sometimes

Never

11.8

64.7

23.5

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Off-Campus Providers. Next, we examine the type of services availed of by students from off-campus providers. “Off-campus” here refers to public and private clinics and/or hospitals. In Table 6, mentions for “consultation and information” (79%), followed by “treatment” (38%) are readily apparent. Combining the figures registered for the two abovementioned services (although these could have been availed of at the same time), it appears that students are more likely to seek professional advice from off-campus facilities when faced with a health problem. The reasons for doing so have not been dealt with in the survey. It is perhaps one area of concern which can be explored in future research. The general impression given for off-campus providers is positive (Figure 4). This is, in fact, the category which registered the highest proportion of students who are “always” satisfied with the services, compared to the level of satisfaction given to the clinic, guidance office and OSA. Table 6 Services availed of from off-campus providers Off-Campus (N=115)

Consultation/information

79.1

Treatment

38.3

Counseling

2.6

Filing a complaint

2.6

Seek referral

1.7

Others

1.7 Multiple Response

Figure 4 Level of Satisfaction: Off-Campus 140 120 100 80 60 40 20 0 Off-Campus

Alw ays

Sometimes

Never

34.8

5.2

Reasons for being and not being satisfied. Looking now at the reasons for the appreciably high level of satisfaction (Table 7), “friendly staff,” by far, was mentioned by close to 40% of the students who visited a facility, followed by competent providers (30%). The obverse side of the picture is presented in Table 8. Apparently, the 36 students do not have much to say about their non-satisfaction of the services obtained. Among the most prominently mentioned are: “unfriendly staff,” “incompetent providers” and “prolonged waiting time.”

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Table 7 Reasons cited for “always” and “sometimes” satisfied (in percent). Reasons

Always & Sometimes

Friendly Staff

39.1

Competent Providers

29.7

Timely Delivery of Service

9.7

Privacy Provided

9.4

Referral System

6.7

Others

5.5

N of cases

435

Table 8 Reasons cited for “never” satisfied (in per cent). Reasons

Never Satisfied

Unfriendly Staff

22.2

Incompetent Providers

16.7

Prolonged Waiting Time

13.9

Privacy Not Provided

2.8

No Referral System

2.8

Was passed around

5.5

Needed service is not available

11.1

Others

25.0

N of cases

Discussion: Quantitative Data Data generated from the survey, albeit limited in scope, point to students’ recognition, particularly the females, of the role that each facility (clinic, guidance, office of student affairs, off-campus providers) performs. While the school clinic appears to be the most commonlyvisited facility for consultation and treatment services, the guidance office is the most-likely to be consulted for counselling services. On the other hand, services sought from the OSA are apparently for matters that relate to school policy. The figures registered for OSA imply that the office is not known to students to offer services that directly relate to health and they see it as a facility that deals primarily with matters concerning the implementation of school regulations, e.g. student behavior or misdemeanor in and out of the classroom, school uniform, hair cut,

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student activities and membership in student organizations. Whether they consider these issues as affecting their health and well-being is something which the qualitative aspect of this study will explore. There is also a sense of openness from these students to go to an offcampus health facility, an indication that they want to better understand their situation and they are open to expert advice or high levels of expertise when faced with conditions that may be difficult for them to comprehend. Whether or not they resort to on-campus or off-campus providers is not the issue. What is most important is that young people seek assistance, be it for personal, family related or other concerns that directly affect their health. What is alarming is the fact that there is an appreciably high proportion of students who do not go or have not been to any of the facilities at all. This is more pronounced among students within the 15 to 17 age bracket. The data can be used by support units to rethink their strategies and enhance students’ awareness of the wide range of services available in each facility. Although knowledge does not necessarily translate into positive health-seeking behaviors, launching a more intensive campaign in this direction is an important step particularly for First and Second Year students. Their aversion to consult any of the facilities (on or offcampus) may be an indication that they are faced with some discomfort in a facility when faced with a problem that affects their well-being, or they may not consider the challenges they face as problems that need professional help. It would seem that services sought from the USC school clinic, guidance office, student affairs’ office and off-campus providers were received optimistically by survey participants. By and large, most of them are satisfied with the services received. Foremost among the reasons cited for the level of satisfaction is that they find the staff in the facility “friendly.” They also believe that providers are “competent,” an indication that students put a high premium on these qualities (pleasant attitude of provider and professional service) above all other considerations. These are notable qualities which indicate what students’ expect in a facility and perhaps, a deciding factor in the choice of facility. Also, an almost equal proportion of students consider “timely delivery of service” and provision of “privacy” as reasons for being satisfied with the facility they visited. Again, this would suggest that young people opt for quality and a facility that could offer them privacy and provisions for anonymity than a facility that is concerned less on these. On the question related to why they are not satisfied, the reasons advanced by a few students appear to be consistent with the reasons and qualities given to support the perceived high level of satisfaction. They A POPCOM-7 and PCHRD-supported Project

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are not satisfied because the personnel in the facility are reportedly “unfriendly,” “not competent” and “waiting time is prolonged,” all of which boil down to their preference for quality service. Results: Qualitative Data In general, the young people use their own and their peers’ experiences with a facility as a gauge to determine what they expect from a provider, be it from the school clinic, guidance office, or the office of student affairs. Experiences with off-campus providers were not thoroughly elaborated. Thus, these are not included in the analysis. In both KII and FGD, the students were replete with stories about the challenges they face, how these were addressed or not addressed by the health facility they visited or why a facility was not consulted when faced with a difficult situation. Judging from the results, the students (male and female) were in agreement that young people must seek assistance for health-related issues that confront them. It would seem, however, that males, when compared to females, had less to say about health and services, and they rarely utilize the services of practitioners. Although a few good impressions were cited about each facility, the major impression obtained with regard to seeking advice is negative. Several criticisms regarding attitude, professionalism and competence of some providers as well as the quality of care given them were put forward. The students generally expressed reservations on availing of the services, and they expressed doubts regarding the capacity of personnel to understand and handle their situation. Apparently, they do not consider any of the facilities as the right venue when it comes to personal or private matters, saying that confidentiality of information might not be afforded them. The fear of being rejected, misunderstood, and reported to the school authorities, was cited as the primary reasons why they keep the problem to themselves, why they seek advice from friends, or why they resort to self-medication unless professional help from an offcampus provider is deemed necessary. Clinic. Students, particularly the females, go to the clinic more frequently than to other facilities but only when the need arises or when they experience minor ailments such as: headache, migraine, toothache, stomach ache, fever, or a minor injury. Both sexes point to a significant level of dissatisfaction of services received from the facility. Positive responses given by a few include: “clinic personnel are helpful and hospitable” and “the clinic attends to students’ needs.” Impressions obtained from students point to their marked recognition of the role the school clinic plays in health maintenance but only insofar as A POPCOM-7 and PCHRD-supported Project

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common health complaints, symptoms and curative services are concerned. They suggest that the clinic must go beyond curative and counselling services, and needed equipment must be in place. Some negative impressions include: (i) irregular presence of a doctor; (ii) priority given to First Year students; (iii) inability to maintain good relations; (iv) inability to attend to students’ needs; (v) lack of trust in working students assigned at the clinic to help them; (vi) undesirable attitude; (vii) no prompt service (pabalik-balikon ka); (viii) lack of equipment; and the reported (ix) practice of “having students replace the medicine for asthma.” Suggestions put forward by students on how best the services at the clinic can be improved to address young people’s concerns were: (i) establishment of a youth-friendly clinic (with accommodating and supportive personnel) that ensures privacy and confidentiality of information (e.g. drug use, sexual abuse, self-harm, abortion); (ii) conduct of a needs assessment survey to determine young people’s needs and identify which of these could be or could not be addressed by the facility; (iii) conduct of a regular health check-up for students; (iv) purchase of necessary clinic equipment and other facilities that will attract students to go to the facility; (v) hire more clinic personnel; (vi) longer clinic hours; (vii) a room where students suffering from a minor ailments can temporarily stay and rest; and (viii) putting-up of a clinic in all the buildings at the Talamban campus. Guidance. Surprisingly, there were students from both sexes who are not aware that there is a guidance office that caters to the needs of college students (naa diay ana dire?), and that it can be consulted for health concerns. The impression may not hold true for many of them but is worth noting because it points to an information gap. Like the clinic, both positive and negative impressions were obtained for this facility, particularly coming from the female group. On the positive side, the students expressed satisfaction with the services received, saying that the “staff are okay, helpful and accommodating,” “concerns have been addressed,” “needed advice was provided,” “staff know how to maintain good student relations,” “counsellor can relate with their situation,” and “seminars and events initiated for students are important and enjoyable.” On the negative side, some students questioned the sincerity of some guidance counsellors to help students with personal problems. A case in point is when a student consulted a counsellor regarding her frustrations about a former boyfriend. She said “they do not give advice pertaining to concerns which are not educationrelated.” It does seem also that some students possess some doubts about the capacity of the office to help them (magduha-duha sa ilaha, walay salig nila). A POPCOM-7 and PCHRD-supported Project

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Another female student who admitted to attempting to commit suicide due to a family problem, school-related concern and problem with a boyfriend narrated that she did not go to the guidance office (or, clinic) for counselling for fear that she might be referred from one facility to the other and the incident might be made known to the many who will only pass judgment on her action. She was also doubtful whether the guidance counselor would be able to understand the severity of her problem. OSA. The assumption that students do not see the OSA as a facility that offers services directly related to health is supported by the results of the KII and FGD. Almost all of the concerns cited have something to do with the “no uniform/I.D./belt no entry policy” and the perceived undesirable attitude of personnel at the facility. Stories about how male students, and some female students, are reportedly “harassed” by a security guard for not complying with certain policies from OSA were also narrated. When asked about how these are affecting their health or well-being, there seems to be a consensus among students in this regard. They say that their inability to attend classes because they were not allowed to enter the school premise (e.g. fire victim) redounds to their not being able to take a scheduled examination or their inability to participate in graded class activities, thereby affecting their grades. Various criticisms regarding the perceived “inconsiderate” and “unfriendly” attitudes of some personnel at the OSA were cited by students but will no longer be included here as experiences narrated are related to school-policy violations. One can say, however, that these contribute to a negative school environment. Students say they sometimes experience anxiety, anger and depression which affect their mental and emotional well-being. As a result, it deters them from seeking help from OSA whenever they have problems. Generally, the FGD and KII participants see the OSA as a facility that “punishes” students engaging in risk-taking behaviors. Opinions of Service Providers: Clinic, Guidance and OSA. The clinic’s major “client” load is the provision of curative services for common ailments and/or symptoms. Because equipment in the facility are reportedly limited, only “first-aid” services are readily available. The facility, however, has also handled and referred cases of students suspected to manifest some forms of behavioral and personality “disorders” to the guidance office. On the other hand, the heaviest “client” load of the guidance office is the provision of counseling services which include, among others, the following aspects: self-awareness, relationship enhancement, parental relationship, teacher and peer relationship, emotions management, A POPCOM-7 and PCHRD-supported Project

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anxiety and depression, career path and job preparation. Needs assessment surveys, information campaigns, informal conversations with students, seminars and special events related to the abovementioned are conducted on a regular basis as a way of reaching-out and addressing the needs of students at USC. The OSA’s major “client” load revolves around problems related to misbehaviour and non-compliance with university policies. This facility also claims to have provided guidance and counselling services to students experiencing problems related to: selfharm behaviour, pre-marital sex, sexual abuse, teenage pregnancy, abortion, contraceptives use, drugs and alcohol, and extra-marital relationships. In extreme cases, or when a student is found to commit a serious violation of a school policy (including morality issues), the OSA convenes the Formal Inquiring Committee to evaluate the case and recommend sanctions to the Board of Discipline. Such committee is composed of the following: Director, student discipline officer, supreme student council representative, Dean/Department Chair, a faculty representative and the chief of security services. If we are to judge by the impressions of providers, we can say that they possess knowledge of young people’s health and the services needed to help them meet the challenges. They have handled and/or referred several cases in the past but only for those who come to them for advice and counseling. Among others, the cases they have encountered include: parental problems, domestic violence, depression, anxiety, self-harm behavior, drug use, smoking, excessive drinking, premarital sex, sexual abuse, early pregnancy, abortion, use of contraceptives, sexually transmitted infections (e.g. gonorrhea among males, recurrent urinary tract infection among females), date rape, physical abuse, incest, extramarital affairs, and sexual harassment (reportedly committed by male teachers). Providers’ claim they have intensive trainings in counseling because the service is not confined only to personnel of the guidance office. Judging from their responses, it appears that all three facilities at USC are visited by students when they experience a health concern. Apparently, service support units at USC have some kind of a referral system. A personal matter (e.g. self-harm behavior) for instance, which could not be handled adequately by the clinic or OSA, is referred to the guidance office. Should the “client” display symptoms of trauma, she/he is referred to a psychiatrist (or, psychologist) in a private institution that could best handle the condition. Or, a student misbehaving and causing harm and disrespect for others is referred to the OSA. In severe cases, the providers would seek audience with the parents of the affected student. Providers also claim that confidentiality of information is assured to students who come to them for help. A POPCOM-7 and PCHRD-supported Project

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Based on the interviews, issues that do not seem to be a strong point among the service providers are: self-harm, incest, abortion, STI/HIV and AIDS and extra-marital relationships. These are “emotionally-charged” concerns which they are not comfortable with given their lack of training to handle these issues. For many of the concerns, Information, Education and Communication (IEC) materials are, however, available at the various facilities. The problems are perceived by providers as affecting students’ mental, physical and spiritual health, which in effect, result in low selfesteem, poor relationship with teachers and peers, poor academic performance and poor spirituality. The contributing factors cited by providers are “broken families” and “peer influence.” It is said that students experiencing these problems are more likely to be engaged in other undesirable and health-compromising behaviors. A holistic program that captures all aspects of young people’s life, including spirituality, is suggested. They believe that young people’s problems are caused by several factors which include the family, school and the community. In this context, providers see the need to involve the family in initiatives that aim at promoting the health and well-being of young people. Discussion: Qualitative Data The apparent variation that could be seen among the two sexes is that females, more than males, have a better record of reporting illnesses and other health challenges. The responses of males indicate a lack of awareness of health and services. They had less experiences to share, they do not seek information and services more often than females and they utilize on-campus services to a lesser degree. Although the qualitative data could not be certain if sex or gender accounts for the difference in health practices, this study apparently supports Waldron’s (1983) and Deans’ (1988) contention that females are more likely to avail of health services than do males. The seeming lack of awareness of students on the wide range of services available to them in each facility is evident. This observation is readily apparent among males. Responses given by young people, however, seem to contradict the data gathered from service support personnel at USC who averred that students, particularly First Year students, are given a thorough orientation and are introduced to the full range of services offered by the university. Providers confine their opinions and assessments primarily to cases which have been reported to their respective offices. This is understandable because each facility has basically limited staff and there is no way they could attend to the life circumstances of every student unless reports are made to their facility. Providers see most of the

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problems as coming from the home, saying that “students in problematic situations usually come from broken families.” They recognize the role of parents in health maintenance and they claim that an unhappy home is contributing to the difficulty in carrying out activities aimed at improving students’ well-being. There seems to be no significant variation in students’ opinions and they appear to have a consensus regarding the level of satisfaction they received from a facility. It would seem that students could not cite a reason why they should feel satisfied with the services, and such general dissatisfaction is seen in most aspects of the service offices. Responses range from the reported regular absence of a provider to the perceived inability to maintain good relations with students, lack of concern for students, inability to understand and handle students’ problems, lack of trust on the provider to maintain confidentiality of information, undesirable attitude, inadequate and/or unavailable service, lack of equipment, and inadequate health facilities. Apart from these reasons, the decision not to seek help from a facility on matters that concern their sexual or non-sexual risk-taking behaviours is overwhelmingly rooted in the fear of being rejected, misunderstood and reported to school administrators and parents. They are embarrassed to share their problems with a provider, saying that she/he might not be the right person to talk to. Instead, they consult their friends or resort to selfmedication. By and large, students are in agreement that services are inadequate because their “real” needs could not be addressed. The young people expect to be taken care of in a manner they feel comfortable, secure and well-attended to by friendly, competent and supportive personnel. They seek assurance that whatever complaints they have will be addressed in an atmosphere of respect, privacy and confidentiality. They expect that quality of care be afforded them considering the corresponding fee for the services. Conclusion The apparent incongruence between some aspects of the survey and qualitative data is presumed to be caused by “social desirability bias,” which, in this study, refers to the tendency of survey participants to answer in a socially-desirable manner or in a way that will be viewed positively by the researcher. On the other hand, there is also the tendency of KII and FGD participants to share detailed experiences that reflect the actual condition they have encountered in a facility, or share a previous experience of a friend. While it is not within the province of the writer to say which of the participants’ impressions are correct (service provider or students), the diversity of opinions may lead one to suspect that there is a flaw in information dissemination and delivery of service. A POPCOM-7 and PCHRD-supported Project

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The health-compromising issues faced by young people are very complex. Their needs are specific, special and distinct from adults, and must therefore be understood in the context of young people’s general health needs. Questions are raised on who should and should not be consulted, and what specific health facility and service can best address their problem at hand. With the apparent efforts exerted by service support units at USC to fulfill their mandate and responsibility to students, it is likely that young people’s concerns are factored in and given importance in a facility’s program of activities. There is, however, a long way to go for these providers when it comes to handling delicate and emotionally-charged issues (e.g. self-harm behaviours, abortion, nonconsensual sex, sexually transmitted infections and extra-marital relationships). The general perception among providers is that their office is mandated to oversee and handle student concerns appropriately. Several activities have been carried out to show their commitment to the issues of the young. While a general appreciation for the services is put forward by survey participants, the qualitative results show a different picture. The reported undesirable attitude of some providers toward the challenges faced by young people indicates a seeming lack of understanding and concern for the latter’s needs and can be presumed as putting young people at greater risk, if suitable ways are not put in place to address this complaint. Adoption of positive behaviours among the young is contingent on their trust and confidence in the provider’s capacity to assist them in difficult situations. If such could not be guaranteed, it is likely that young people will resort to unhealthy practices. There is some evidence to show in this study that young people want to be more responsible, but the lack of information on health and services, the lack of trust on providers and the perceived lack of support for their needs often have led them to veer away from adopting positive healthseeking behaviours. The general conclusion is that young people are aware of their problems, they recognize the need to maintain good health and they want to avail of information on health and services. Studies may have shown that knowledge is not associated with behaviour, but putting in place a comprehensive, respectful and youth-friendly facility, where privacy and confidentiality are assured, can be a significant step towards building a healthy environment in the campus.

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Recommendations University 1. Implement a provider-education program in health that gives special attention to sexual and non-sexual risk-taking behaviors of young people to adequately train providers to handle young people’s health challenges. 2. Develop more appealing, gender-specific, youth-friendly and evidence-based health communication materials and other innovative approaches that will heighten young people’s sensitivity to availing of the services at each service facility. 3. Develop a more effective referral system in the campus that ensures an accommodating and non-discriminatory environment where respect and confidentiality are assured. Existing partnership with public and private health institutions must be institutionalized and strengthened to achieve a synergy in helping young people. 4. Conduct a more focused study on gender issues and involvement in health-care practices among young people to substantiate and address gaps of the current study. Government 1. Health policy initiatives must give special attention to intensifying young people’s access to health information and utilization of health services. 2. Develop gender-specific and problem-specific frameworks to ensure a comprehensive understanding of young people’s general health agenda. References Aguilar, E. J. T., F. A. Nolasco & J. E. Bersales. (2002). Breaking the mold: Promoting young people’s reproductive health. An unpublished research report for the David and Lucile Packard Foundation. Department of Sociology and Anthropology, University of San Carlos. Aguilar, J. E. (2010). Identifying and addressing gender and reproductive health issues in the Business Process Outsourcing companies. In The BPO in Cebu: Challenges and Opportunities. Cebu City: University of San Carlos Press. A POPCOM-7 and PCHRD-supported Project

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Amadora-Nolasco, F. (2010). Academe and BPO linkage: Matching workforce competencies. In The BPO in Cebu: Challenges and Opportunities. Cebu City: University of San Carlos Press. Deans, W. (1998). Wellman clinics. Nursing26: 975. Shah, M., Zambezi, R. & Simasiku, M. (1999). Listening to young voices: Facilitating participatory appraisals on reproductive health with adolescent. FOCUS on Young Adults. Zambia: CARE International. Waldron, I. (1988). Gender and health-related behavior. In Davis S. Gochman (ed.). Health Behavior: Emerging Research Perspectives. New York: Plenum Press. WHO. (2004). Protecting young people from HIV and AIDS: The role of health services. 20 Avenue Appia, CH-1211 Geneva 27, Switzerland: World Health Organization.

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