Abstract
Non-prescription steroid use can negatively impact adolescent physical and mental health and wellbeing. Determining correlates of this risk behavior is needed to help mitigate its prevalence. Two potential correlates are physical activity and school safety. The purpose of this study was to examine the associations of physical activity, school safety, and non-prescription steroid use within a sample of adolescents from the 2015–2019 US National Youth Risk Behavior Survey (YRBS). A multi-stage cluster sampling procedure yielded a representative sample of US adolescents from the 2015–2019 YRBS (n = 44,066; 49.6% female). Two latent variables indicating physical activity and unsafe schools were the independent variables. The dependent variable was a self-report of non-prescription steroid use. A weighted structural equation model examined the associations between physical activity and unsafe schools with non-prescription steroid use, controlling for age, sex, BMI %tile, race/ethnicity, and sexual minority status. The latent physical activity variable did not associate with non-prescription steroid use (β = 0.007, 95%CI: −0.01–0.02, p = 0.436); however, the unsafe schools latent variable did associate with non-prescription steroid use (β = 0.64, 95%CI: 0.59–0.69, p < 0.001). An unsafe school environment may be a determinant of non-prescription steroid use in adolescents. Physical activity behaviors did not associate with steroid use.
Highlights
Non-prescription steroid use is an adolescent risk behavior that may have both personal and environmental influences [1,2]
Males reported more times carrying a weapon at school (d = 0.16, p < 0.001) and being in more fights at school (d = 0.17, p < 0.001) compared to females
The results indicated that perceived school safety associated with non-prescription steroid use while physical activity did not associate with non-prescription steroid use
Summary
Non-prescription steroid use is an adolescent risk behavior that may have both personal and environmental influences [1,2]. Anabolic-androgenic steroids are steroidal compounds that are chemically related to the sex hormone testosterone [1,2]. They are used in the clinical setting to stimulate muscle growth, increase appetite, stimulate male puberty, and treat chronic wasting conditions. Adolescents may be more prone to risk taking behaviors compared to children and adults because of the surge of sex hormones during puberty onset that associates with sensation seeking and impulsivity [4]. Engaging in risk-taking behaviors activates the reward centers of the brain and it has been suggested that individual-level differences in reward drive may be a susceptibility factor to risk behaviors and make some adolescents more sensitive to the environment [5]
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