Semester

Fall

Date of Graduation

2009

Document Type

Dissertation

Degree Type

PhD

College

School of Nursing

Department

Family/Community Health

Committee Chair

Mary Jane Smith

Abstract

Purpose. Successful management of recurrent headache among adolescents requires an understanding of the lifestyle behaviors (skipping meals, water intake, tobacco use, alcohol use, and physical activity) and illness related factors (depression, somatic complaints, insomnia and obesity) reported to be associated with this headache type. This study describes a multivariate model demonstrating how lifestyle behaviors and illness related factors work together to predict recurrent headache in an adolescent population.;Method. A descriptive, cross-sectional, secondary analysis using survey data from the National Longitudinal Study of Adolescent Health (Add Health) (1996) will be reported. Add Health is a large database providing a nationally representative sample of adolescents (ages 11--17, n=13,570). The database evaluated adolescent headache and is inclusive of all the predictors specific to this study. Add Health was obtained from the UNC Carolina Population Center after an IRB Security Plan was approved. Frequency analysis and forward logistic regression were performed using each of the lifestyle behaviors and illness related factors.;Results. Approximately 26% of the adolescents experienced recurrent headache. Recurrent headache was reported by 19% of males and 26% of females. A multivariate model was developed that demonstrated how lifestyle behaviors and illness related factors predict recurrent headache in adolescents. Main effects demonstrated that the odds of having recurrent headache were significantly associated with gender (OR .36, CI .32, .42), chest pain (OR 2, CI 1.8, 2.9), depression (OR 1.87, CI 1.6, 2.2), insomnia (OR 2.03, CI 1.6, 2.5), muscle and joint pain (OR 1.9, CI 1.6, 2.1), skipping breakfast 3 or more times a week (OR 1.2, CI 1.08, 1.33), and skipping lunch one or more times a week (OR 1.14, CI 1.02, 1.27). The main effect of race was significant for Hispanics (OR .59, CI .46, .75), African Americans (OR .62, CI .53, .72), and Asians (OR .42, CI .29, .61). Significant results were found when comparing "no sports activity" with "sports activity 5 or more times a week" (OR 1.17, CI 1.0042, 1.3714) as well as when comparing "sports activity 1 or more times a week" with "sports activity 5 or more times a week" (OR 1.28, CI 1.06, 1.56). The final model consisted of the following predictors: chest pain, muscle and joint pain, skip breakfast three or more times a week, skip lunch one or more times a week, and physical activity. The interactions of gender and age group, race and smoke regularly and depression and insomnia were also included in the final model.;Conclusion. Providing evidence to clinicians that lifestyle behaviors and illness related factors are associated with adolescent recurrent headache may improve overall headache assessment and may result in a more comprehensive plan of treatment. Future studies include development of interventions based upon the reported model and subsequent evaluation of the effectiveness of such interventions on adolescent recurrent headache.

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