Psychosocial school factors and risk behavior in first-grade secondary school students in Serbia

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Background: Adolescent age is a critical period in one's life when different risk behaviors may occur. Among other factors, school environment may be associated with these behaviors. Methods and Objectives: We aimed to examine the association of psychosocial school factors with risk behavior of the first-grade secondary school students in Serbia. We performed a secondary analysis of data from the 2018 Health Behavior in School-aged Children Study conducted in Serbia. A standardized questionnaire was used as a study instrument. We analyzed the following psychosocial school factors: school satisfaction, schoolwork pressure, teacher support, classmate support and being bullied at school. We included the following types of risk behavior in the analysis: smoking, alcohol consumption, risky sexual behavior, and gambling. Univariable and multivariable binary logistic regression was used to assess the independent predictors of each risk behavior among psychosocial school factors. Results: This study included 1605 students (50.3% females), of whom 78.5% attended secondary vocational school and 21.5% grammar school. Students mostly reported low school satisfaction (56.2%), low schoolwork pressure (56.6%), low teacher support (58.5%), high classmate support (67.2%) and not being bullied at school (86.2%). Alcohol consumption was the most prevalent (53.9%) and smoking the least prevalent (20%) risk behavior among students. All tested psychosocial school factors were associated with smoking except for classmate support. Low school satisfaction, low teacher support and being bullied at school independently predicted alcohol consumption. Low school satisfaction and high schoolwork pressure were significantly associated with risky sexual behavior. Low school satisfaction, low teacher support and high classmate support were significantly associated with gambling. Conclusions: Multiple psychosocial school factors were associated with different types of risk behavior in Serbian first-grade secondary school students. This calls for targeted actions aimed at improving psychosocial school environment among the first-grade secondary school students in Serbia.