Unintentional injuries and socio-psychological correlates among school-going adolescents in four ASEAN countries

Figures & data

Table 1 Sample characteristics, Global School-based Health Survey, Indonesia, Laos, Philippines and Thailand, 2015

Variables	N (%)	Study year	Overall response rate (%)	Age M (SD)	Boys (%)	Girls (%)	Net enrolment rate, lower secondary, 2015 (%)^Citation11	Country income classification^Citation12
Country
Indonesia	11,142 (37.8)	2015	94.0	14.0 (1.6)	48.9	51.1	77.8	Lower middle income
Laos	3,683 (12.5)	2015	70.0	15.8 (1.2)	53.3	46.7	57.1	Lower middle income
Philippines	8,761 (29.7)	2015	79.0	14.6 (1.5)	49.5	50.5	62.4	Lower middle income
Thailand	5,894 (20.0)	2015	89.0	14.6 (1.7)	47.1	52.9	75.1	Upper middle income
All	29,480			14.5 (1.6)	48.9	51.1

Notes: Lower middle income=Gross National Income (GNI)/Capita (current US$): 996–3,895; upper middle income=GNI/Capita (current US$): 3,896–12,055.

Table 2 Past 12-month prevalence of injury events, cause and type of injury by sex in four ASEAN countries, 2015

Variables	Total % (95% CI)	Boys % (95% CI)	Girls % (95% CI)
Injury (in the past 12 months)
Injured once	21.4 (20.3, 22.6)	25.2 (23.9, 26.6)	17.8 (16.6, 19.2)
Injured multiple times	15.4 (14.5, 16.4)	19.3 (18.0, 20.7)	11.7 (16.6, 19.2)
Injuried once or more times	36.9 (35.1, 38.7)	44.5 (42.4, 46.6)	30.0 (27.7, 31.5)
Cause (of most serious injury)
“I was in a motor vehicle accident or hit by a motor vehicle”	5.8 (5.2, 6.4)	7.1 (6.4, 7.9)	4.4 (3.7, 5.2)
“I fell”	10.2 (9.4, 11.0)	12.2 (11.1, 13.5)	8.3 (7.6, 9.1)
“Something fell on me or hit me”	2.5 (2.2, 2.8)	2.9 (2.5, 3.3)	2.2 (1.9, 2.5)
“I was attacked or abused or was fighting with someone”	2.0 (1.7, 2.2)	2.7 (2.3, 3.1)	1.3 (1.0, 1.5)
“I was in a fire or too near a flame or something hot”	0.5 (0.4, 0.6)	0.6 (0.4, 0.9)	0.4 (0.3, 0.5)
“I inhaled or swallowed something bad for me”	0.6 (0.5, 0.8)	0.7 (0.5, 0.9)	0.6 (0.5, 0.8)
“Something else caused my injury”	4.9 (4.4, 5.4)	5.9 (5.1, 6.8)	4.0 (3.5, 4.5)
Type of injury (of most serious injury)
“I had a broken bone or a dislocated joint”	8.1 (7.3, 9.0)	11.2 (10.2, 12.4)	5.1 (4.4, 6.0)
“I had a cut, puncture, or stab wound”	3.4 (2.9, 4.0)	4.3 (3.7, 5.0)	2.5 (2.1, 3.1)
“I had a concussion or other head or neck injury, was knocked out, or could not breath”	2.0 (1.8, 2.2)	2.1 (1.8, 2.5)	1.9 (1.7, 2.2)
“I had a gunshot wound”	0.3 (0.26, 0.44)	0.5 (0.4, 0.7)	0.2 (0.1, 0.3)
“I had a bad burn”	1.1 (0.9, 1.3)	1.2 (1.0, 1.6)	1.0 (0.8, 1.2)
“I was poisoned or took too much of a drug”	0.2 (0.1, 0.3)	0.2 (0.1, 0.3)	0.2 (0.1, 0.3)
“Something else happened to me”	10.5 (9.9, 11.1)	12.1 (11.4, 12.9)	8.9 (8.2, 9.7)

Notes: The annual prevalence of injury ranged from 16.8% in Laos to 49.3% in the Philippines. Among the four study countries, fall-related injuries were the highest in Indonesia (12.3%) and Thailand (9.6%); motor vehicle-related injuries in Thailand (8.8%) and the Philippines (5.5%); broken bone or dislocated joint was the highest in the Philippines (9.3%) and Indonesia (8.7%); cut, puncture, or stab wound in Thailand (6.5%) and the Philippines (4.2%) (see Table 3).

Table 3 Past 12-month prevalence of injury events, cause and type of injury by country, 2015

Variables	Indonesia % (95% CI)	Laos % (95% CI)	Philippines % (95% CI)	Thailand % (95% CI)
Injury (in the past 12 months)
Injured once	18.6 (17.2, 20.0)	13.1 (11.6, 14.7)	26.9 (25.1, 28.8)	21.3 (19.4, 23.3)
Injured multiple times	11.0 (10.0, 12.1)	3.7 (2.9, 4.7)	22.4 (20.4, 24.5)	18.3 (15.9, 21.1)
Injuried once or more times	29.6 (27.5, 31.8)	16.8 (14.9, 18.8)	49.3 (46.4, 52.2)	39.6 (35.9, 43.5)
Cause (of most serious injury)
“I was in a motor vehicle accident or hit by a motor vehicle”	5.2 (4.6, 5.8)	3.0 (2.3, 3.8)	5.5 (3.9, 7.7)	8.8 (7.5, 10.3)
“I fell”	12.3 (11.1, 13.4)	1.2 (0.9, 1.7)	7.3 (6.2, 8.7)	9.6 (8.3, 11.2)
“Something fell on me or hit me”	1.6 (1.3, 2.0)	0.5 (0.3, 0.8)	4.2 (3.6, 4.8)	2.5 (1.9, 3.4)
“I was attacked or abused or was fighting with someone”	1.2(0.9, 1.5)	0.5 (0.3, 1.0)	3.3 (2.8, 3.9)	2.1 (1.5, 2.9)
“I was in a fire or too near a flame or something hot”	0.3 (0.2. 0.4)	0.03 (0.0, 0.2)	0.7 (0.5, 0.1)	0.7 (0.4, 0.1)
“I inhaled or swallowed something bad for me”	0.6 (0.4, 0.8)	0.1 (0.05, 0.3)	0.6 (0.5, 0.9)	0.7 (0.5, 0.1)
“Something else caused my injury”	0.3 (0.27, 0.35)	3.9 (3.0, 5.1)	6.7 (5.7, 7.9)	8.3 (7.2, 9.5)
Type of injury (of most serious injury)
“I had a broken bone or a dislocated joint”	8.7 (7.9, 9.6)	1.6 (1.1, 2.2)	9.3 (7.4, 12.2)	3.6 (2.9, 4.6)
“I had a cut, puncture, or stab wound”	2.2 (1.8, 2.8)	1.2 (0.8, 1.7)	4.2 (3.0, 5.7)	6.5 (5.6, 7.6)
“I had a concussion or other head or neck injury, was knocked out, or could not breath”	0.9 (0.8, 1.2)	0.7 (0.4, 0.1)	3.8 (3.2, 4.4)	2.5 (1.9, 3.4)
“I had a gunshot wound”	0.3 (0.2, 0.5)	0.08 (0.02, 0.3)	0.2 (0.1, 0.4)	0.8 (0.5, 0.1)
“I had a bad burn”	0.6 (0.4, 0.8)	0.05 (0.0, 0.3)	1.9 (1.6, 2.3)	1.4 (0.9, 2.0)
“I was poisoned or took too much of a drug”	0.1 (0.08, 0.2)	0.08 (0.02, 0.3)	0.2 (0.1, 0.3)	0.5 (0.2, 1.0)
“Something else happened to me”	9.4 (8.8, 10.2)	4.5 (3.6, 5.6)	11.3 (10.3, 12.4)	13.2 (11.6, 15.0)

Table 4 Multinomial logistic regression analysis for associations with one and multiple injuries in the past 12 months, with no injury as reference category

Variables	All injuries		All injuries
	One	Multiple	One	Multiple
	Unadjusted RRR (95% CI)	Unadjusted RRR ratio (95% CI)	Adjusted RRR ratio^a (95% CI)	Adjusted RRR ratio^a (95% CI)
Country
Indonesia	1 (Reference)	1 (Reference)	1 (Reference)	1 (Reference)
Laos	0.60 (0.51, 0.70)***	0.28 (0.21, 0.38)***	0.58 (0.49, 0.68)***	0.25 (0.18, 0.33)***
Philippines	2.02 (1.74, 2.34)***	2.82 (2.34, 3.40)***	1.57 (1.36, 1.82)***	1.78 (1.48, 2.14)***
Thailand	1.34 (1.14, 1.57)***	1.94 (1.53, 2.46)***	1.24 (1.05, 1.45)**	1.46 (1.21, 1.76)***
Age in years
13 or younger (35.8%)	1 (Reference)	1 (Reference)	1 (Reference)	1 (Reference)
14 (23.4%)	1.18 (1.05, 1.34)**	1.14 (0.98, 1.32)	1.09 (0.95, 1.24)	0.98 (0.86, 1.12)
15 (17.8%)	1.20 (0.98, 1.47)	1.24 (1.05, 1.46)*	0.93, 0.79, 1.09)	0.91 (0.77, 1.07)
16 or older (23.0%)	1.00 (0.85, 1.19)	1.11 (0.90, 1.35)	0.87 (0.69, 1.02)	0.80 (0.69, 2.02)
Gender
Female (51.1%)	1 (Reference)	1 (Reference)	1 (Reference)	1 (Reference)
Male (48.9%)	1.76 (1.57, 1.95)***	2.11 (1.87, 2.40)***	1.64 (1.49, 1.81)***	1.81 (1.64, 2.02)***
Hunger
Never (40.4%)	1 (Reference)	1 (Reference)	1 (Reference)	1 (Reference)
Rarely (20.0%)	1.41 (1.20, 1.66)***	1.62 (1.39, 1.88)***	1.29 (1.12, 1.47)***	1.40 (1.21, 1.61)***
Sometimes/always (39.6%)	1.57 (1.40, 1.76)***	1.84 (1.59, 2.14)***	1.63 (1.45, 1.83)***	1.72 (1.49, 1.99)***
Current tobacco use (13.9%)	2.04 (1.64, 2.54)***	3.34 (2.67, 4.19)***	1.45 (1.23, 1.72)***	1.58 (1.33, 1.88)***
Current alcohol use (12.5%)	2.37 (2.01, 2.79)***	3.77 (3.20, 4.44)***	1.27 (1.08, 1.49)**	1.44 (1.25,1.65)***
Ever cannabis use (4.0%)	4.57 (3.18, 6.56)***	9.00 (6.58, 12.3)***	0.93 (0.68, 1.28)	1.37 (1.01, 1.87)*
Ever amphetamine use (3.0%)	7.33 (4.73, 11.35)***	12.88 (8.49, 19.52)***	2.46 (1.42, 4.27)***	2.07 (1.18, 3.62)**
Soft drink consumption (≥2/day) (15.1%)	1.60 (1.43, 1.80)***	2.21 (1.93, 2.53)***	1.29 (1.15, 1.46)***	1.59 (1.40, 1.81)***
Physical education (three or more days/week) (22.8%)	1.46 (1.27, 1.66)***	1.85 (1.59, 2.14)***	1.10 (0.99, 1.22)	1.36 (1.21, 1.53)***
Truancy in the past month (25.2%)	1.79 (1.56, 2.05)***	2.62 (2.26, 3.04)***	1.58 (1.39,1.78)***	1.92 (1.71, 2.15)***
Psychological distress
0 (76.8%)	1 (Reference)	1 (Reference)	1 (Reference)	1 (Reference)
1 (14.6%)	1.58 (1.40, 1.79)***	2.35 (2.01, 2.72)***	1.29 (1.16, 1.44)***	1.62 (1.40, 1.87)***
2 or more (8.6%)	2.75 (2.34, 3.22)***	4.83 (4.06, 5.75)***	2.04 (1.74, 2.40)***	3.04 (2.51, 3.68)***
Peer support (mostly or always) (36.8%)	0.79 (0.71 (0.87)***	0.65 (0.58, 0.74)***	0.97 (0.89, 1.05)	0.93 (0.83, 1.03)
Parental or guardian support
Low: 0-1 (51.5 %)	1 (Reference)	1 (Reference)	1 (Reference)	1 (Reference)
Medium: 2 (27.0%)	0.76 (0.67, 0.86)***	0.63 (0.55, 0.71)***	0.97 (0.88, 1.06)	0.93 (0.85, 1.03)
High: 3-4 (21.5%)	0.60 (0.54, 0.67)***	0.61 (0.52, 0.71)***	0.81 (0.74, 0.89)***	0.90 (0.79, 1.02)

Note: ^aAll variables in the table were included in the adjusted model; ***P<0.000, **P<0.01, *P<0.05.

Abbreviation: RRR, relative risk ratio.

Table S1 Description of variables and response options analyzed in this paper

Variables	Question	Response options (coding scheme)
Age	“How old are you?”	“11 years old or younger to 18 years old or older”
Sex	“What is your sex?”	“Male, Female”
Hunger	“During the past 30 days, how often did you go hungry because there was not enough food in your home?”	“1= never to 5= always (coded 1–3=0 and 4–5=1 mostly or always)”
Injury	“During the past 12 months, how many times were you seriously injured?” “(An injury is serious when it makes you miss at least one full day of usual activities (such as school, sports, or a job) or requires treatment by a doctor or nurse.)”	“1=0 times to 8=12 or more times (coded 1=0 times and 2–8=1 at least once)”
Past month or current tobacco use	“During the past 30 days, on how many days did you smoke cigarettes/use any tobacco products other than cigarettes, such as such as country examples … ?”	“1=0 days to 7= All 30 days (coded 1=0 days and 2–7=1 at least one day)”
Current alcohol use	“During the past 30 days, on how many days did you have at least one drink containing alcohol?”	“1=0 days to 7= All 30 days (coded 1=0 days and 2–7=1 at least one day)”
Cannabis use	“During your life, how many times have you used marijuana (also called country examples)?”	“1=0 times to 5=20 or more times (coded 1=0 times and 2–5=1 one or more times)”
Amphetamine use	“During your life, how many times have you used amphetamines or methamphetamines (also called … .country specific names)?”	“1=0 times to 5=20 or more times (coded 1=0 times and 2–5=1 one or more times)”
Soft drinks	“During the past 30 days, how many times per day did you usually drink carbonated soft drinks, such as country examples … ? (Do not include diet soft drinks.)?”	“1=not in the past days to 7=5 or more times per day (coded 1–3=0 zero to 1 time and 4–7=1 2 or more a day)”
Physical education	“During this school year, on how many days did you go to physical education (PE) class each week?”	“1=0 days to 6=5 or more days (coded 1–3=0 zero to two days/week and 4–6=1 three or more days a week)”
School truancy	“During the past 30 days, on how many days did you miss classes or school without permission?”	“1=0 days to 5=10 or more days (coded 1=0 days and 2–5=1 at least one day)”
No close friends	“How many close friends do you have?”	“1=0 to 4=3 or more (coded 1+=0, 0=1 none)”
Loneliness	“During the past 12 months, how often have you felt lonely?”	“1= never to 5= always (coded 1–3=0 and 4–5=1 mostly or always)”
Anxiety	“During the past 12 months, how often have you been so worried about something that you could not sleep at night?”	“1= never to 5= always (coded 1–3=0 and 4–5=1 mostly or always)”
Suicide ideation	“During the past 12 months, did you ever seriously consider attempting suicide?”	“Yes, No”
Suicide attempt	“During the past 12 months, how many times did you actually attempt suicide?”	“1=0 times to 5=6 or more times (coded 1=0 and 2–5=1 at least once)”
Peer support	“During the past 30 days, how often were most of the students in your school kind and helpful?”	“1=never to 5=always (coded 1–3=0 and 4–5=1 mostly or always)”
Parental supervision	“During the past 30 days, how often did your parents or guardians check to see if your homework was done?”	“1=never to 5=always (coded 1–3=0 and 4–5=1 mostly or always)”
Parental connectedness	“During the past 30 days, how often did your parents or guardians understand your problems and worries?”	“1=never to 5=always (coded 1–3=0 and 4–5=1 mostly or always)”
Parental bonding	“During the past 30 days, how often did your parents or guardians really know what you were doing with your free time?”	“1=never to 5=always (coded 1–3=0 and 4–5=1 mostly or always)”
Parental respect for privacy	“During the past 30 days, how often did your parents or guardians go through your things without your approval?”	“1=never to 5=always (coded 1–3=0 and 4–5=1 mostly or always)”

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