Associations between school difficulties and family type and the role of socioeconomic, behavior and health-related difficulties in early adolescents: a population-based study

Abstract

Objectives Nowadays many early adolescents are living in non-intact families (parents divorced/separated, reconstructed families or single parents) and have many school difficulties (learning difficulty, skipping school, school absence due to family problems, grade repetition, low school performance, and school dropout ideation). This study assessed the associations between school difficulties and family type which remain little addressed and the confounding role of socioeconomic adversities and behavior, social support and health-related difficulties (BSSHDs). Methods The study population included 1559 middle-school adolescents from north-eastern France (mean age 13.5 ± 1.3). They completed at the end of school-year a questionnaire gathering socioeconomic adversities, school difficulties and BSSHDs (being obese, substances use, sustained physical/verbal violence, sexual abuse, perpetrated violence, poor social support, depressive symptoms, and suicide attempt; cumulated number noted BSSHDCM). Data was analyzed using logistic regression models. Results The adolescents with parents divorced/separated, reconstructed families or single parents had a much higher risk for various school difficulties than those in intact families (sex-age-adjusted odds ratios 1.60–4.70, mostly with p < 0.001). These risks were robust and remained significant (often with p < 0.01/0.001) after adjustment for socioeconomic adversities and BSSHDCM. The contributions of socioeconomic adversities plus BSSHDCM to the risks were mostly elevated (>40%, reaching 65%) while those of socioeconomic adversities alone were mostly moderate (<30%, but reaching 52%). Conclusions Family type plays a strong role in school difficulties among early adolescents, mainly due to socioeconomic adversities and BSSHDCM. Our results may help primary care providers identify at-risk adolescents and their problems and establish timely prevention and care. Highlights Learning difficulty, school absence, grade repetition, low academic performance, and school dropout ideation are common in early adolescents. The adolescents with parents divorced/separated, reconstructed families or single parents have up to 4.7-time higher risk for these school difficulties than those in intact families. These risks are robust after adjustment for socioeconomic, behavior and health-related difficulties which explain up to 65% of the risks. School-difficulty prevention should consider family features and include early monitoring behavior and health-related difficulties in adolescents.