Adolescent Risk Behaviors Research Articles

The influence of socioenvironmental risk factors on risk-taking behaviors among Bahamian adolescents: a structural equation modeling analysis

ABSTRACT Background Adolescents’ risk-taking behaviors can have profound impacts on their future health. Few studies have established a relationship between multiple social environmental factors and adolescent risk behaviors. We used structural equation modeling to examine the role of parental monitoring and environmental risks on adolescents’ behavioral intentions and risk behaviors. Methods Data were collected through the baseline survey of a national implementation project among 2205 Grade 6 students in 24 government schools in The Bahamas in 2019. Structural equation modeling examined relations among parental monitoring, environmental risk factors, behavioral intentions, and risk behaviors. Results Students had engaged in various delinquent, substance use, and sexual risks. In the structural equation model, parental monitoring demonstrated direct negative (protective) effects on behavioral intentions and risk behaviors, whereas environmental risk factors had a direct positive effect on adolescent behavioral intentions and risk behaviors. The model had an R2 value of 0.57 for adolescent risk behaviors. Conclusion Parental monitoring and environmental risk factors had strong influences on risk-taking behaviors of early adolescents. Future adolescent health behavior interventions should consider offering additional prevention resources to early adolescents who are exposed to multiple environmental risk factors.

Exploring the associations between adverse childhood experiences (ACEs) and adolescent cancer risk behaviours in the ALSPAC cohort

BackgroundSome modifiable risk factors for cancer originate during adolescence. While there is evidence indicating relationships between adverse childhood experiences and health risk behaviours generally, little is known about how childhood adversity influences the engagement of adolescents in cancer risk behaviours. This study aimed to determine the relationship between adverse childhood experiences and adolescent cancer risk behaviours.MethodsData were collected prospectively from birth to age 18 years on children born to mothers enrolled into the Avon Longitudinal Study of Parents and Children (ALSPAC) cohort study. Multivariable linear regression models assessed relationships of a composite exposure measure comprised of adverse childhood experiences (total number of childhood adversities experienced from early infancy until age 9 years) with multiple cancer risk behaviours. The latter was expressed as a single continuous score for tobacco smoking, alcohol consumption, obesity, unsafe sex, and physical inactivity, at ages 11, 14, 16 and 18 years. Analysis was carried out on the complete case and imputation samples of 1,368 and 7,358 participants respectively.ResultsAll adolescent cancer risk behaviours increased in prevalence as the adolescents grew older, except for obesity. Each additional adverse childhood experience was associated with a 0.25 unit increase in adolescent cancer risk behaviour (95% CI 0.16–0.34; p < 0.001). Individually, parental substance misuse (β 0.64, 95% CI 0.25–1.03, p < 0.001) and parental separation (β 0.56, 95% CI 0.27–0.86, p < 0.001) demonstrated the strongest evidence of association with engagement in adolescent cancer risk behaviour.ConclusionChildhood adversity was associated with a greater degree of engagement in adolescent cancer risk behaviours. This finding demonstrates the need for targeted primary and secondary prevention interventions that reduce engagement across multiple cancer risk behaviours for children and adolescents who have experienced adversity in childhood, such as parental substance misuse and separation, and reduce exposure to adversity.

Relationship between Health Belief Model constructs and smoking behavior among school-age adolescents in Indonesia: A cross-sectional study

Background: Programs aimed at altering health risk behavior in adolescents have frequently been a priority for the health department in Indonesia. However, these efforts have not yielded optimal results thus far. The Health Belief Model (HBM) is considered a dependable indicator for predicting health-risk behavior. Objective: This study sought to establish the relationship between the constructs of the Health Belief Model (HBM) – namely, perceived susceptibility to health-related issues due to smoking, perceived barriers to non-smoking, perceived benefits of non-smoking, perceived self-efficacy to non-smoking, and cues to action for non-smoking – and smoking behavior among adolescents of school age. Methods: The study employed a cross-sectional design, examining smoking behavior in 171 school-age adolescents in Indonesia. This was done using an online Indonesian Smoking Behavior Questionnaire and a validated Indonesia Health Belief Model Questionnaire that measures the five domains of HBM. The Chi-square test was utilized to explore associations among different variables. Results: Adolescents with an average age of 16.04 years (ranging from 12 to 17 years) reported a 5.8% incidence of smoking in the past 30 days. Significantly, there was a relationship between perceived susceptibility (p = 0.002), barriers to quitting smoking (p &lt;0.001), cues to action (p = 0.019), and smoking behavior in adolescents. Conclusion: The study provides valuable insights into how the Health Belief Model is linked to the involvement of adolescents in health risk behavior, particularly smoking. This information is crucial for the development of health education tailored to adolescents of school age.

Role of polygenic risk scores in the association between chronotype and health risk behaviors

BackgroundThis study explores the association between chronotypes and adolescent health risk behaviors (HRBs) by testing how genetic background moderates these associations and clarifies the influence of chronotypes and polygenic risk score (PRS) on adolescent HRBs.MethodsUsing VOS-viewer software to select the corresponding data, this study used knowledge domain mapping to identify and develop the research direction with respect to adolescent risk factor type. Next, DNA samples from 264 students were collected for low-depth whole-genome sequencing. The sequencing detected HRB risk loci, 49 single nucleotide polymorphisms based to significant SNP. Subsequently, PRSs were assessed and divided into low, moderate, and high genetic risk according to the tertiles and chronotypes and interaction models were constructed to evaluate the association of interaction effect and clustering of adolescent HRBs. The chronotypes and the association between CLOCK-PRS and HRBs were examined to explore the association between chronotypes and mental health and circadian CLOCK-PRS and HRBs.ResultsFour prominent areas were displayed by clustering information fields in network and density visualization modes in VOS-viewer. The total score of evening chronotypes correlated with high-level clustering of HRBs in adolescents, co-occurrence, and mental health, and the difference was statistically significant. After controlling covariates, the results remained consistent. Three-way interactions between chronotype, age, and mental health were observed, and the differences were statistically significant. CLOCK-PRS was constructed to identify genetic susceptibility to the clustering of HRBs. The interaction of evening chronotypes and high genetic risk CLOCK-PRS was positively correlated with high-level clustering of HRBs and HRB co-occurrence in adolescents, and the difference was statistically significant. The interaction between the sub-dimensions of evening chronotypes and the high genetic CLOCK-PRS risk correlated with the outcome of the clustering of HRBs and HRB co-occurrence.ConclusionsThe interaction of PRS and chronotype and the HRBs in adolescents appear to have an association, and the three-way interaction between the CLOCK-PRS, chronotype, and mental health plays important roles for HRBs in adolescents.

A moderated mediation model of the relationship between adolescent screentime, online privacy cognitions and exposure to online substance marketing

AbstractAdolescent exposure to substance‐related marketing is associated with subsequent substance initiation and progression. The extent to which adolescents are exposed to such content may be associated with adolescent cognitions about digital privacy and media‐specific parenting behaviours. The present study assesses whether the relationship between screentime and online marketing risk is mediated by adolescent digital privacy‐related cognitions and moderated by media‐specific parenting behaviours. Parents and their 10–14‐year‐old adolescents (n = 960) completed an online survey on media parenting techniques and adolescent media use and attitudes. Associations between screentime, Adolescent Cognitions about Online Privacy (ACOP; comprising privacy‐related attitudes, subjective norms and perceived behavioural control), TECH parenting (Talk, Educate, Co‐Use, House Rules) and adolescent online marketing exposure were explored via a moderated mediation model. A significant total effect between screentime and online marketing exposure was identified, including an indirect path via ACOP. TECH parenting significantly strengthened ACOP's mediation of the relationship between screentime and online marketing risk. This study indicates that adolescent privacy‐related cognitions may be an important mechanism for future studies related to adolescent online risk behaviour. Implications for child and family social work are discussed.

Social media use and health risk behaviours in young people: systematic review and meta-analysis

ObjectivesTo examine the association between social media use and health risk behaviours in adolescents (defined as those 10-19 years).DesignSystematic review and meta-analysis.Data sourcesEMBASE, Medline, APA PsycINFO, SocINDEX, CINAHL, SSRN, SocArXic,...

Associations of Parents-Adolescent Relationship with Adolescent Sexual Risk Behaviors: A Global Analysis Based on 156,649 School-Going Adolescents from 50 Countries

Our study, examining the Global School-Based Student Health Survey data from 50 countries across four WHO regions, found boys have higher sexual exposure (33.5 vs 17.7%) and risk behaviors – early sexual initiation (55.0 vs. 40.1%), multiple partners (45.2 vs. 26.2%), and condom nonuse (29.2 vs. 26.8%) – than girls. We found that adolescents with parents who understood their problems, monitored academic and leisure-time activities, and respected privacy were less likely to be engaged in sexual activities and risk behaviors. This study highlights the importance of parental involvement and advocates for gender-specific, family-focused interventions to mitigate adolescent sexual risks.

Longitudinal Relations Among Parental Substance Use Disorder and Adolescent Drinking Behavior: The Role of Temperament, Negative Urgency, and Maternal Parenting.

Research suggests that parental substance use disorder is associated with adolescent drinking indirectly through negative urgency, a form of impulsivity that is particularly associated with high-risk drinking. Moreover, childhood mechanisms of risk may play a role in this developmental chain such that childhood temperament and parenting may be mechanisms through which parental substance use disorder is associated with adolescent negative urgency and drinking behavior. Therefore, the current study tested whether parental substance use disorder was indirectly associated with adolescent drinking frequency through childhood temperament (i.e., "dysregulated irritability") and adolescent negative urgency, and whether relations differed by levels of maternal support and consistency of discipline. Data come from a multigenerational, longitudinal study of familial substance use disorder (N = 276, Mage in childhood = 6.28 (SD = 1.16), Mage in adolescence = 15.86 (SD = 1.56), 45.3% female). Findings indicated that parental substance use disorder indirectly predicted adolescent drinking through both childhood dysregulated irritability and adolescent negative urgency (mediated pathways). This indirect relation was stronger at higher vs. lower levels of maternal support but did not vary by maternal consistency of discipline. Parental substance use disorder also indirectly predicted adolescent drinking separately through childhood dysregulated irritability and negative urgency. Findings thus suggest that childhood dysregulated irritability may be an early marker of risk toward high-risk personality traits and behavior in adolescence that are associated with having a parental history of substance use disorder. Findings also suggest that increased maternal support may only be helpful in buffering risk for those with low levels of dysregulated irritability. Prevention efforts focused on childhood emotion regulation and emotion-based action may be useful in preventing adolescent risk behavior.

Family factors and offline/online risk behaviors among South Korean adolescents: A multidimensional approach using latent profile analysis

The family is a crucial ecological system that shapes adolescent risk behaviors in many ways. However, existing studies have mostly focused on how selective family variables are linked to adolescent’s engagement in risky behavior rather than considering a comprehensive set of family domains. Although new forms of risky behaviors via technical devices are prevalent among adolescents, the relationship between online risk behaviors and family factors has not been fully investigated. In response to these research gaps, the current study aimed to (1) investigate the latent profiles of family characteristics as represented by four domains (parent–adolescent relationship, socioeconomic and demographic characteristics, parental psychological well-being, and family smartphone use); and (2) examine features of latent family profiles most associated with adolescent offline and online risk behaviors. Data were drawn from the second wave of the Korean Children and Youth Panel Survey (KCYPS) (N = 2,197), which is nationally representative of South Korean middle school students. A total of eighteen family indicators were used in the latent profile analysis. Five heterogeneous subgroups of unique family experiences emerged: low perceived socioeconomic status (SES), poor family environment, high-quality and low-quantity parenting, high perceived SES, and positive parent–youth relationship. Results from logistic regression suggested that the poor family environment group had the highest risk of engaging in both types of risk behaviors. The findings lend support for adapting a comprehensive approach in addressing various dimensions of family needs and provide insight for future intervention programs and services.

Elterliche Sexualaufklärung und sexuelles Risikoverhalten bei Töchtern und Söhnen: Befunde aus der Repräsentativbefragung „Jugendsexualität“

ZusammenfassungHintergrundSexualaufklärung im Elternhaus soll laut Sozialisationstheorie zu mehr sexueller Handlungskompetenz bei Jugendlichen führen. Aktuelle Daten für Deutschland fehlen jedoch.Ziel der ArbeitVor diesem Hintergrund war es Ziel der vorliegenden Studie, erstmals das allgemeine Sprechen über Sexualität im Elternhaus (Forschungsfrage 1, F1) sowie speziell die Verhütungsberatung durch die Eltern (F2) mit dem sexuellen Risikoverhalten der Jugendlichen in Verbindung zu setzen.Material und MethodenDatengrundlage ist die 9. Welle der Repräsentativbefragung „Jugendsexualität“ der Bundeszentrale für gesundheitliche Aufklärung (BZgA). Analysiert wurden Daten aller sexuell aktiven 14- bis 17-jährigen Jugendlichen im Sample, von denen eigene Angaben zum Sexualverhalten sowie Angaben ihrer Eltern zum Aufklärungsverhalten vorliegen (N = 357). Zur Beantwortung der beiden Forschungsfragen wurden logistische Regressionsanalysen mit 4 zentralen Merkmalen des jugendlichen Sexualverhaltens gerechnet.ErgebnisseEs zeigte sich, dass das Sprechen über Sexualität im Elternhaus bei Mädchen und Jungen positiv korreliert mit 1. dem erreichten Konsensalter beim ersten Geschlechtsverkehr, 2. einem positiven Erleben des ersten Geschlechtsverkehrs, 3. einem zuverlässigen Verhütungsverhalten und 4. einer geringen Anzahl an Sexualpartner*innen (F1). Das gleiche Ergebnismuster ergab sich für die Verhütungsberatung durch die Eltern (F2).DiskussionDie positiven Zusammenhänge zwischen elterlicher Sexualaufklärung und risikoärmerem jugendlichen Sexualverhalten gilt es hinsichtlich der zugrunde liegenden Kausalmechanismen genauer zu untersuchen.

Longitudinal transmission of risk behaviors between mothers, fathers, and adolescents.

Despite the critical need to understand the processes and predictors behind adolescent substance use and risk behaviors, research has focused primarily on individual predictors rather than family dynamics, and mothers rather than fathers. Family systems theory would suggest that children are impacted both directly by parents' behavior (e.g., modeling risk behaviors) and indirectly by their parents' behaviors toward one another (e.g., coparenting) and their relationships with their parents (mother-child and father-child closeness). This article investigates links between parental substance use at child age 9 and children's substance use and delinquent behaviors at age 15, and relational mediators of these associations (coparenting, parent-child closeness). Data from 2,453 mothers, fathers, and children from the Fragile Families and Child Well-Being Study (Reichman et al., 2001) were analyzed. Fathers' drug and alcohol use at child age 9 were not directly associated with adolescent risk behaviors at age 15, but his drug use was associated with adolescent substance use indirectly via its influence on maternal coparenting and thereafter father-child closeness. Mothers' alcohol and drug use were both directly associated with later adolescent drug use and delinquency, and indirectly with delinquency via their associations with fathers' coparenting and thereafter mother-child closeness. Implications of the findings for intervention and prevention as well as future research are discussed. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Recreational Cannabis Legalization and Adolescent Sexual Risk Behaviors

Little is known about the implications of cannabis legalization on adolescent health behaviors. This study sought to examine the relationship between recreational cannabis legalization and adolescent sexual risk behaviors. Data on 371,487 respondents who have ever had sexual intercourse from 41 states in the 2005 to 2019 Youth Risk Behavior Survey was linked with data on state-level cannabis policies. Difference-in-differences logistic regression models were conducted. Recreational cannabis legalization was associated with a reduced likelihood of respondents having 2+ sexual partners (adjusted OR [aOR] 0.63, 95% CI [0.47, 0.84]), but had no association with condom use (aOR 0.94, 95% CI [0.80, 1.11]). Changing social norms around cannabis is a potential pathway linking cannabis legalization to a reduction in sexual risk behaviors.

The impact of adverse childhood experiences on mental and somatic health in childhood and adolescence

Multiple studies prove that children who were exposed to adverse childhood experiences within their families are increasingly at risk of various high-risk behaviours, bullying, mental and somatic disorders. In children/adolescents who undergo terrifying experiences on a repetitive, sometimes daily basis without being provided support and the basic safety they would need, all aspects of personality development will be seriously affected. Urgent action is needed in Hungary to identify these children and provide them with therapeutic support. The field of childhood adversities and their consequences has been undeservedly neglected by research, despite the fact that preventive and therapeutic interventions could be specifically designed based on this knowledge during childhood and adolescence. In our study, we present international data on the prevalence of adverse childhood experiences. We discuss in detail the association of adverse childhood experiences with biological and cognitive impairments attachment disorders, externalising and internalising disorders, somatic disorders and health risk behaviours in childhood and adolescence. Besides presenting empirical data on adverse experiences and consequences, the purpose of our publication is to raise awareness and sensitisation among professionals. Orv Hetil. 2023; 164(37): 1447-1455.

Effect of Technology and Digital Media Use on Adolescent Health and Development: Protocol for a Multimethod Longitudinal Study.

Technology and digital media (TDM) use is integral to modern adolescence; adolescents have been labeled as "digital natives," since they have had exposure to digital technology for their entire lives. Previous evidence has illustrated TDM's connections with adolescent risk behaviors such as increased alcohol use and social media exposure, as well as relationships with adolescent well-being such as improved socioemotional health and social media connections with peers. Although several recent review articles have described both the benefits and risks of technology use, most individual studies adopt a singular risk-centered approach. In addition, reviews suggest that little evidence exists on the potential mediating and moderating factors between TDM use and well-being and health outcomes, which limits our understanding of what influences the outcomes of interest. Therefore, there is an urgent need to fill these gaps. This protocol addresses the need to understand how TDM exposure and use affect multiple developmental domains and health outcomes. We address the fragmented nature of previous research, the common focus on single behaviors or conditions, and the typical narrow lens on risks. Our approach further aligns with reviews that called for studies identifying and investigating the factors that moderate the relationships between social media and health behaviors and outcomes. We will address our objective by longitudinally examining over a 2-year period a common set of adolescent participants (N=400, aged 13-15 years) across 3 studies that adopt a multimethodological approach. Study 1 will use TDM to understand the mechanisms behind adolescent health and risk behaviors. Study 2 will use functional magnetic resonance imaging to understand how positive and negative TDM experiences relate to mental and behavioral health in a subsample of 150 adolescents. Study 3 will use a mixed methods design to evaluate self- and other-generated TDM content as the predictors of socioemotional well-being in sexual and gender minority and non-sexual and gender minority adolescents. Recruitment is ongoing, and the initial results from the first wave of recruitment are expected in 2024. This integrated approach to longitudinal data collection from a shared adolescent participant pool will lead to novel analyses and findings, allowing for the examination of the health and well-being risks and benefits associated with TDM use and factors that moderate these relationships. The findings from this study will advance conceptual models and inform new interventions to improve adolescent health. DERR1-10.2196/50984.

Methodology of National Health and Morbidity Study (NHMS): Adolescent Health, Malaysia 2022

Introduction: In Malaysia, the adolescent health studies conducted in 2012 and 2017 revealed an increasing trend of adolescent health risk behaviours and protective factors. This current study aims to determine health risk behaviours and protective factors among adolescents in the country. Methods: The current nationwide cross-sectional study of Malaysian secondary school students used multistage stratified sampling to select 240 nationally representative schools. This study was conducted from June to July 2022 among the students in forms 1, 2, 3, 4, and 5 in all Malaysian states by 34 data collection teams. A validated self-administered questionnaire was used, similar to those used in the NHMS 2012 and NHMS 2017. The quality control was done twice, once at the field level and once at the central level. Sample weighting and analysis were conducted using SPSS statistical software version 28.0. Results: A total of 239 schools out of 240 schools took part in the study (response rate, 99.6%) and total of 33,523 students were involved in this study (response rate, 89.4%). In terms of ethnicity, the highest number of students who participated in the study were Malay (63.0%), followed by Chinese (18.1%) and Indian (6.0 %). While the distribution of sex and form among the students were almost the same. Conclusion: To obtain an accurate representation of the nation's adolescent population for this study, samples from public and private schools that are governed by the Ministries of Education and Rural and Regional Development were deemed to be the most reliable. Keywords: Adolescent - NHMS - Methodology - Malaysia

Pendidikan Kesehatan dengan Permainan Edukasi Monopoli Kesehatan Reproduksi (E-Mon Kespro) pada Remaja di Panti Asuhan Putri Muhammadiyah Tanjung Purwokerto

Adolescence, as individuals in the age group 10-19 years, is marked by physical, emotional, cognitive, and behavioural changes. Behaviours characteristic of adolescence, such as alcoholism, use of narcotics, smoking, and high-risk sexual behaviour, are associated with risk to sexual and reproductive health. Unwanted pregnancies and sexually transmitted diseases can lead to serious common reproductive health concerns for adolescents. Lack of information is a significant factor behind poor adolescent knowledge, attitudes, and risk behaviours. This activity aims to discover adolescents' knowledge of Monopoly game-based learning on reproductive health. Activity in 42 adolescents undergoing health education monopoly game-based learning on reproductive health in July 2022 at Panti Asuhan Putri Muhammadiyah Tanjung Purwokerto. The questionnaire consisted of characteristic data filled by adolescent students such as age, body mass index, early age of menarche, cycle menstruation, and knowledge of adolescents about sexual and reproductive health before intervention measured. The pre-test results found that 42.86% of knowledge on reproductive health was poor. Innovative health education can be used to improve the sexual health education of adolescents. The methods can potentially contribute socially, particularly in improving sexual health behaviour and adolescent knowledge of sexual and reproductive health problems.

Relationship Between Knowledge Level and Family Rules with Adolescent Risk Behavior

Health risk behavior emerges due to risk factors within adolescents, family factors, and external factors outside the family. Poor knowledge about risk behavior and parental control may cause adolescents to develop risky behaviors that affect their health. This study aimed to identify the relationship between family factors and knowledge of adolescent risk behavior. It is a cross-sectional study conducted on 271 adolescents aged 17–25 years in Central Java from April to November 2021, taken by random sampling. Data analysis was performed using the chi-square test with a meaning level of 95%. Results show no relationship between knowledge level and adolescent risk behavior (p=0.665), and there was a relationship between family rules and adolescent risk behavior (p=0.001). Family rules significantly prevent adolescent risk behavior; hence, parents must apply family rules to limit teenage behavior, especially in opposite-sex relationships, to avoid sexual risk behavior.

The longitudinal association between sexual violence victimization and sexual risk behavior in adolescence

Being a victim of sexual violence (SV) is generally believed to be associated with subsequent sexual risk behavior (SRB) during adolescence. While this assumption makes intuitive sense, it is based on methodologically limited research, including a reliance on cross-sectional data. To address this gap in research, we test whether experiencing SV victimization in early adolescence is associated with self-reported SRB approximately two years later. The sample comprised 4,618 youth (58% female; 52% Hispanic; 39% Black) attending 44 schools in the southern United States. Self-reported data were collected using an audio computer-assisted self-interview (ACASI). Baseline data were collected when students were in 7th or 8th grade and follow-up data were collected approximately 24 months later when students were in 9th or 10th grade. Indices of SRB included behaviors related to oral, vaginal, and anal sex (e.g., number of partners, number of times without a condom). Girls, but not boys, who reported SV victimization at baseline reported engaging more frequently in all oral and vaginal SRBs at 24 month follow-up compared to their non-victimized female counterparts. Additionally, girls reporting SV victimization reported more anal sex partners than non-victimized girls. Girls who are victims of SV engage in significantly more SRB by early high school placing them at greater risk to contract STIs and become pregnant. Victims of SV should be screened for SRB and provided access to the appropriate resources. Teen pregnancy and STI prevention planning should consider SV victimization in their strategy planning.

Risk-related brain activation is linked to longitudinal changes in adolescent health risk behaviors

Middle adolescence is the period of development during which youth begin to engage in health risk behaviors such as delinquent behavior and substance use. A promising mechanism for guiding adolescents away from risky choices is the extent to which adolescents are sensitive to the likelihood of receiving valued outcomes. Few studies have examined longitudinal change in adolescent risky decision making and its neural correlates. To this end, the present longitudinal three-wave study (Nw1 = 157, Mw1= 13.50 years; Nw2 = 148, Mw2= 14.52 years; Nw3 = 143, Mw3= 15.55 years) investigated the ontogeny of mid-adolescent behavioral and neural risk sensitivity, and their baseline relations to longitudinal self-reported health risk behaviors. Results showed that adolescents became more sensitive to risk both in behavior and the brain during middle adolescence. Across three years, we observed lower risk-taking and greater risk-related activation in the bilateral insular cortex. When examining how baseline levels of risk sensitivity were related to longitudinal changes in real-life health risk behaviors, we found that Wave 1 insular activity was related to increases in self-reported health risk behaviors over the three years. This research highlights the normative maturation of risk-related processes at the behavioral and neural levels during mid-adolescence.

Screening for Adolescent Risk Behaviors: Preliminary Evidence for a Family Functioning Tool.

Family functioning is associated with adolescent drug use, alcohol use, cigarette use, and sexual risk behaviors. Assessing adolescents for family functioning, commonly associated with multiple risk behaviors, may help identify adolescents at risk for adverse health outcomes. This study examined whether a latent family functioning construct, encompassing multiple dimensions of family functioning, was associated with adolescents' substance use and sexual risk behaviors. This study used data harmonization with three intervention trials, including data from 1451 adolescents (M = 13.6, SD = 1.0), to perform a full-information item bifactor analysis on 46 family functioning items from five pre-existing family functioning measures. Regression analysis was used to examine the association between the identified subset of items and the following outcomes: cigarette use, alcohol use, drug use, and condom use. Bifactor analysis identified a 26-item latent family functioning construct. Regression analysis indicated that a 26-item latent family functioning construct was associated negatively with lifetime and past 90-day cigarette use, alcohol use, and drug use. In sum, the multi-dimensional latent family functioning construct may target specific barriers to risk screening in adolescent populations, including time constraint, hesitancy in discussing sensitive health topics, and use culturally appropriate and age-appropriate assessments.