Associations among adolescent risk behaviours and self-esteem in six domains.

Background: This study investigated associations among adolescents’ self‐esteem in 6 domains (peers, school, family, sports/athletics, body image and global self‐worth) and risk behaviours related to substance use, bullying, suicidality and sexuality. Method: A multistage stratified sampling strategy was used to select a representative sample of 939 English‐, Afrikaans‐ and Xhosa‐speaking students in Grades 8 and 11 at public high schools in Cape Town, South Africa. Participants completed the multidimensional Self‐Esteem Questionnaire (SEQ; ) and a self‐report questionnaire containing items about demographic characteristics and participation in a range of risk behaviours. It included questions about their use of tobacco, alcohol, cannabis, solvents and other substances, bullying, suicidal ideation and attempts, and risky sexual behaviour. Data was analysed using a series of logistic regression models, with the estimation of model parameters being done through generalised estimation equations. Results: Scores on each self‐esteem scale were significantly associated with at least one risk behaviour in male and female adolescents after controlling for the sampling strategy, grade and race. However, specific self‐esteem domains were differentially related to particular risk behaviours. After taking the correlations between the self‐esteem scales into account, low self‐esteem in the family and school contexts and high self‐esteem in the peer domain were significantly independently associated with multiple risk behaviours in adolescents of both sexes. Low body‐image self‐esteem and global self‐worth were also uniquely associated with risk behaviours in girls, but not in boys. Conclusions: Overall, the findings suggest that interventions that aim to protect adolescents from engaging in risk behaviours by increasing their self‐esteem are likely to be most effective and cost‐efficient if they are aimed at the family and school domains.

Addressing Common Risk and Protective Factors Can Prevent a Wide Range of Adolescent Risk Behaviors

Adolescents and risks: Why not change our paradigm?

140. Prevalence And Early Life Factors Associated With Risk Behaviors In Adolescence: A Population-Based Cohort Study

Downwards trends in adolescent risk-taking behaviours in New Zealand: Exploring driving forces for change.

ObjectivesThe authors aimed to examine whether changes in health risk behaviour rates alter the relationships between behaviours during adolescence, by comparing clustering of risk behaviours at different time points.DesignComparison of...

BackgroundHealth risk behaviours often co-occur in adolescence. This may be partially explained by a set of common risk and protective factors. The current study examines the association between risk behaviours throughout adolescence and identifies common risk factors for multiple risk behaviour in late adolescence.MethodsWe use data from the Longitudinal Study of Young People in England. We examined the association between risk behaviours at age 14 (n = 15,588), age 16 (n = 12,416) and age 19 (n = 9,548). The associations between age 19 risk behaviour and earlier risk behaviours and risk and protective factors were assessed longitudinally. Health risk behaviours included smoking, alcohol use, illicit drug use, delinquency and unsafe sexual behaviour.ResultsAll risk behaviours were found to be associated with other risk behaviours with associations weakening through adolescence. A number of sociodemographic, interpersonal, school and family factors at age 14 predicted risk behaviour and multiple risk behaviour at 19, though predictors for heavy alcohol use often differed from other health risk behaviours. Past risk behaviour was a strong predictor of age 19 risk behaviour though many involved in only one form of risk behaviour in mid-adolescence do not progress to multiple risk behaviour.ConclusionsOur findings reaffirm the links between health risk behaviours, but these diminish throughout adolescence with multiple risk behaviour usually initiated in mid-adolescence. Multiple risk behaviour is initiated in early or mid adolescence with a number of common risk factors explaining the co-occurrence of risk behaviours.

Adolescence has long been considered a period of increased risk behaviour. This supposition has been supported by a wealth of empirical evidence and recently, health risk behaviours have been identified as a key mechanism for the general deterioration of adolescent health relative to other age groups. Research regarding adolescent risk behaviour suggests that there are often strong links between individual risk behaviours. The mechanisms for these associations have been attributed to common risk and protective factors, as well as gateway effects stemming from increased accessibility to additional risk behaviours. This has important implications for policy interventions designed to reduce risk behaviours in adolescence. Not only does a multiple risk behaviour approach increase the effectiveness of individual risk behaviour policy, but it is also conducive to a more cohesive, coherent and efficient approach to adolescent risk in general. Several examples of cohesive policy responses to multiple risk behaviours have emerged, but generally, policy remains segregated into individual risk domains. With increasing evidence for the effectiveness of integrated approaches, multiple risk behaviours require consideration to design and implement effective and efficient policy responses.

Little is known about how physical activity (PA), sedentary behavior, and various adolescent health risk behaviors are associated. The objective of this study was to examine relationships between PA and sedentary behavior patterns and an array of risk behaviors, including leading causes of adolescent morbidity/mortality. Nationally representative self-reported data were collected (National Longitudinal Study of Adolescent Health; wave I: 1994-1995; II: 1996; N = 11957). Previously developed and validated cluster analyses identified 7 homogeneous groups of adolescents sharing PA and sedentary behaviors. Poisson regression predicted the relative risk of health risk behaviors, other weekly activities, and self-esteem across the 7 PA/sedentary behavior clusters controlling for demographics and socioeconomic status. Main outcome measures were adolescent risk behaviors (eg, truancy, cigarette smoking, sexual intercourse, delinquency), other weekly activities (eg, work, academic performance, sleep), self-esteem. Relative to high television (TV) and video viewers, adolescents in clusters characterized by skating and video gaming, high overall sports and sports participation with parents, using neighborhood recreation center, strict parental control of TV, reporting few activities overall, and being active in school were less likely to participate in a range of risky behaviors, ranging from an adjusted risk ratio (ARR) of 0.42 (outcome: illegal drug use, cluster: strict parental control of TV) to 0.88 (outcome: violence, cluster: sports with parents). Active teens were less likely to have low self-esteem (eg, adolescents engaging in sports with parents, ARR: 0.73) and more likely to have higher grades (eg, active in school, ARR: 1.20). Participation in a range of PA-related behaviors, particularly those characterized by high parental sports/exercise involvement, was associated with favorable adolescent risk profiles. Adolescents with high TV/video viewership were less likely to have positive risk behavior outcomes. Enhancing opportunities for PA and sport may have a beneficial effect on leading adolescent risk behaviors.

In this study the fitness of a path model for the relationship among biological risk disposition, sociocultural risk factors, self-control, parent-adolescent communication, and risk behavior in adolescents was examined. The participants were 387 adolescents. The data were analyzed with the PASW 18.0 and AMOS 18.0 programs. Sociocultural risk factors, self-control, and parent-adolescent communication showed a direct effect on risk behavior for adolescents, while biological risk disposition and sociocultural risk factor showed an indirect effect on risk behavior for adolescents. The modified path model of adolescents' risk behavior was showed a good fit with the model (χ2/df=2.37, GFI=.95, AGFI=.92, RMSEA=.06 [.05<RMSEA<.07], NNFI=.95, CFI=.97). These results suggest that adolescents' risk behavior can be decreased by reducing biological risk disposition and sociocultural risk factor, and increasing parent-adolescent communication and self-control. Thus there is a need to design intervention programs that emphasizes reducing biological risk disposition and sociocultural risk factor and increasing parent-adolescent communication and self-control in order to decrease adolescents' risk behavior.

To identify and assess the effectiveness of experimental studies of interventions that report on multiple risk behaviour outcomes in young people. A systematic review was performed to identify experimental studies of interventions to reduce risk behaviour in adolescents or young adults and that reported on both any substance (alcohol, tobacco and illicit drug) use and sexual risk behaviour outcomes. Two authors reviewed studies independently identified through a comprehensive search strategy and assessed the quality of included studies. The report was prepared in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. From 1129 papers, 18 experimental studies met our inclusion criteria, 13 of which were assigned a strong or moderate quality rating. The substantial heterogeneity between studies precluded the pooling of results to give summary estimates. Intervention effects were mixed, with most programmes having a significant effect on some outcomes, but not others. The most promising interventions addressed multiple domains (individual and peer, family, school and community) of risk and protective factors for risk behaviour. Programmes that addressed just one domain were generally less effective in preventing multiple risk behaviour. There is some, albeit limited, evidence that programmes to reduce multiple risk behaviours in school children can be effective, the most promising programmes being those that address multiple domains of influence on risk behaviour. Intervening in the mid-childhood school years may have an impact on later risk behaviour, but further research is needed to determine the effectiveness of this approach.

The clustering of risk behaviours in adolescence and health consequences in middle age

Clusters of parental and peer variables associated with adolescent risk behaviors are explored using the mixture model. Questionnaires were completed by 917 high school freshmen in the Daegu Kyungpook area and included measures of risk behaviors, parental attachment, autonomy, parental monitoring, and peers' risk behaviors and desirable behaviors. As a result of the mixture model, five clusters were produced. Two of the subgroups were consistent with the literature of showing linear relationships among adolescent risk behaviors and above variables; a group of higher parental attachment and autonomy as well as parental monitoring, lower friends' risk behaviors, and lower adolescent risk behaviors, and a group of lower parental attachment and autonomy as well as parental monitoring, higher friends' risk behaviors, and higher adolescent risk behaviors. Two other subgroups were similar in parental attachment and autonomy, but differed in parental monitoring, friends' risk behaviors, and adolescent risk behaviors. The last subgroup was characterized by scoring the lowest parental attachment and autonomy, parental monitoring, friends' risk behaviors, and lower adolescent risk behaviors compared to other subgroups. The utility of the mixture model in research on adolescent risk behaviors is discussed in the conclusion.

This study examined differences in selected health risk behaviors among 5,517 students attending public high schools (PUBHS) and 1,089 students attending private high schools (PVTHS) in South Carolina. The 1995 CDC Youth Risk Behavior Survey was used to collect self-report information on adolescent risk behaviors. Chi-square analyses were performed for comparing public and private students on selected risk behaviors. Both PUBHS and PVTHS students reported substantial involvement in most of the risk-taking behaviors examined. PUBHS students, in general, were more likely to report higher prevalence rates than PVTHS students for most of the selected health risk behaviors. However, PVTHS students reported even higher prevalence rates than PUBHS students for alcohol use, driving after drinking, and binge drinking; smoking cigarettes (past 30 days); chewing tobacco (males only); marijuana use during the past 30 days (females only); and use of alcohol or other drugs before last act of sexual intercourse. Results suggest attendance at a private high school is not a panacea for protection against adolescent risk behaviors, and that all high school students could benefit from a coordinated school health program.

The purpose of this study was to examine the associations of sleep duration and socioecological protective factors with patterns of adolescent risk behaviors in Fairfax County, VA-one of the largest public school districts in the United States. A total of 21,360 and 20,330 students in 10th and 12th grades who completed the Youth Risk Behavior Survey were included in this cross-sectional analysis. Sleep duration was measured by self-report of the average number of hours of sleep on a school night. Ten socioecological protective factors included peer-individual, family, school, and community domains. Latent class analysis was used to classify 7 risk behaviors (alcohol use, cigarette use, illicit drug use, inappropriate prescription drug use, risky sexual behavior, deviant behavior, and academic failure) into 4 class memberships (low, some, moderate, and high). Multinomial regression models were adjusted for age, sex, and race. Adolescents who reported sleeping the recommended 8 to 9 hours were significantly less likely to belong to the class memberships of greater risk behaviors compared with those who reported short and long sleep duration after controlling for age, sex, race, and survey year. There was a significant inverse relationship between the number of socioecological protective factors and risk behaviors for both 10th and 12th graders. Potential risks of age, sex, and race on risk behaviors were observed. No significant interaction between sleep duration and protective factors was found in either grade. This study highlights the significant associations between sleep duration and risk behaviors in adolescents with diverse socioecological protective factors. Prioritization of prevention-focused resources should consider sleep duration in addition to the socioecological protective factors commonly cited in the literature when addressing adolescent risk behaviors.