Prevalence and correlates of physical fighting among adolescents in Paraguay: Findings from the 2017 national school-based health survey

BACKGROUND: Interpersonal violence among adolescents is a serious public health issue across the globe and has been one of the leading causes of death among Paraguayan adolescents. This study aims to investigate the prevalence of physical fighting among adolescents in Paraguay in order to identify problematic fighting behaviour. We also aim to examine the correlates of physical fighting and the extent to which previously identified factors correlate with physical fighting. METHODS: We used the Paraguay 2017 Global School-based Student Health Survey (GSHS). This survey collects health-related information on school-attending adolescents aged 13–17 years. We defined physical fighting as having participated in at least two physical fights in the previous 12 months. We chose 16 independent variables: 12 individual-level variables and four social-level variables. Multivariable logistic regression models were developed to identify factors associated with physical fighting. One of the limitations of this study is that it only captured the responses of the students who attended school on the day of the survey. FINDINGS: A total of 3,149 students completed the survey questionnaire, with the response rates for the school, student, and total response being 100%, 87%, and 87%, respectively. In 2017, 8% of the survey participants (11.4% of the males, and 4.7% of the females) had been involved in two or more physical fights during the past 12 months. In the multivariable model, having been physically attacked, male gender, physical activity, alcohol use, early sexual debut, and suicide planning were significantly associated with involvement in physical fighting. Having helpful peers and supportive parents was not statistically significant in the model adjusted for all variables. CONCLUSIONS: Although Paraguay shows relatively lower prevalence of physical fighting than other countries, the high association between physical fighting and having been physically attacked is noteworthy. Considering the serious interpersonal violence among Paraguayan adolescents, preventive attributes should be considered, and further assessment of other types of interpersonal violence should be made.