{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,9]],"date-time":"2025-12-09T15:43:11Z","timestamp":1765294991847,"version":"build-2065373602"},"reference-count":47,"publisher":"MDPI AG","issue":"12","license":[{"start":{"date-parts":[[2018,12,19]],"date-time":"2018-12-19T00:00:00Z","timestamp":1545177600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJERPH"],"abstract":"<jats:p>Biological and psychosocial factors are recognized contributors to the worldwide burden of asthma. However, the relationship between psychosocial factors and asthma symptoms among students in low- and middle-income countries remains underexplored. We aimed to identify socioeconomic, environmental, psychosocial, family-related and lifestyle factors associated with the self-reporting of asthma symptoms in Brazilian adolescents. This is a cross-sectional study using data from the 2012 PeNSE survey (n = 109,104). We analyzed the following variables: socioeconomic conditions, demographic characteristics, lifestyle, family context and dynamics, psychosocial indicators, smoking, and exposure to violence. Our outcome variable was the self-report of asthma symptoms in the past 12 months. The prevalence of wheezing was 22.7% (21.5\u201323.9). After adjusting for sex, age and the variables from higher hierarchical levels, exposure to violence (feeling unsafe at school, being frequently bullied, being exposed to fights with firearms) and physical aggression by an adult in the family were the environmental factors that showed the strongest associations with self-reporting of asthma symptoms. For psychosocial indicators of mental health and social integration, feelings of loneliness and sleeping problems were the strongest factors, and among individual behavioral factors, the largest associations were found for tobacco consumption. Our findings were consistent with previous studies, showing an association between self-reported asthma symptoms and socio-economic status, family context and dynamics, psychosocial indicators of mental health, exposure to violence and social integration, as well as a sedentary lifestyle and tobacco use.<\/jats:p>","DOI":"10.3390\/ijerph15122904","type":"journal-article","created":{"date-parts":[[2018,12,19]],"date-time":"2018-12-19T12:12:44Z","timestamp":1545221564000},"page":"2904","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Social, Environmental and Behavioral Determinants of Asthma Symptoms in Brazilian Middle School Students\u2014A National School Health Survey (Pense 2012)"],"prefix":"10.3390","volume":"15","author":[{"given":"Rita C.","family":"Ribeiro-Silva","sequence":"first","affiliation":[{"name":"School of Nutrition, Federal University of Bahia, Salvador 40.110-150, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Deborah C.","family":"Malta","sequence":"additional","affiliation":[{"name":"School of Nursery, Federal University of Minas Gerais, Belo Horizonte 30.130-100, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Laura C.","family":"Rodrigues","sequence":"additional","affiliation":[{"name":"Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, London WC1E 7HT, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9162-0456","authenticated-orcid":false,"given":"Dandara O.","family":"Ramos","sequence":"additional","affiliation":[{"name":"Center for Data and Knowledge Integration for Health (CIDACS), Institute Gon\u00e7alo Moniz (IGM), Oswaldo Cruz Foundation (FIOCRUZ), Salvador 41.745-715, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rosemeire L.","family":"Fiaccone","sequence":"additional","affiliation":[{"name":"Institute of Mathematics and Statistics, Federal University of Bahia, Salvador 40.170-110, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Daiane B.","family":"Machado","sequence":"additional","affiliation":[{"name":"Center for Data and Knowledge Integration for Health (CIDACS), Institute Gon\u00e7alo Moniz (IGM), Oswaldo Cruz Foundation (FIOCRUZ), Salvador 41.745-715, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maur\u00edcio L.","family":"Barreto","sequence":"additional","affiliation":[{"name":"Center for Data and Knowledge Integration for Health (CIDACS), Institute Gon\u00e7alo Moniz (IGM), Oswaldo Cruz Foundation (FIOCRUZ), Salvador 41.745-715, Brazil"},{"name":"Institute of Collective Health (ISC), Federal University of Bahia, Salvador 40110-040, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2018,12,19]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"S95","DOI":"10.1016\/j.jaci.2009.10.047","article-title":"Asthma: Clinical expression and molecular mechanisms","volume":"125","author":"Lemanske","year":"2010","journal-title":"J. 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