BackgroundThe Co-occurrence of Health Risk Behaviors (ACEs) among adolescents has become a significant public health issue that urgently needs to be addressed. This study aims to investigate the prevalence of Co-occurrence of Health Risk Behaviors among adolescents and to explore the mediating role of self-efficacy (SE) and self-control (SC) in the relationship between adverse childhood experiences and Co-occurrence of Health Risk Behaviors (CHRBs). MethodsA total of 7901 adolescents in China were surveyed using the following instruments: the Adolescent Health Risk Behaviors Survey Questionnaire, the Patient Health Questionnaire-9 (PHQ-9), the Mobile Phone Addiction Index (MPAI), the Adverse Childhood Experiences Questionnaire (ACEQ), the General Self-Efficacy Scale (GSES), and the Self-Control Scale (SCS). Data were analyzed using SPSS 25.0 software.Results(1) Adverse childhood experiences significantly and positively predicted Co-occurrence of Health Risk Behaviors among adolescents (p < 0.05). (2) Adverse childhood experiences indirectly influenced Co-occurrence of Health Risk Behaviors through the partial mediating effects of self-efficacy and self-control (p < 0.05). (3) Adverse childhood experiences also indirectly influenced Co-occurrence of Health Risk Behaviors through the chained mediating effects of self-efficacy and self-control (p < 0.05).ConclusionsThis study further elucidates the relationship between adverse childhood experiences and Co-occurrence of Health Risk Behaviors among adolescents, as well as the chained mediating role of self-efficacy and self-control. These findings confirm the mechanism by which adverse childhood experiences influence Co-occurrence of Health Risk Behaviors. The results suggest that creating a favorable living environment for children and adolescents should become a societal consensus. Additionally, when intervening with adolescents who exhibit problematic behaviors, it is important to focus on enhancing their self-efficacy and self-control to mitigate the long-term impact of adverse childhood experiences.

Cumulative social-ecological risk factors and health-risk behaviors among Chinese adolescents: A latent class analysis.

Objective: This study used a large U.S. population-based dataset to examine associations between childhood attention problems and adolescent substance use, sexual risk behavior, and delinquency. Methods: This prospective cohort study used data from the Future of Families and Child Wellbeing Study (n = 2,716). Bivariate statistics, multivariable logistic regression, and negative binomial models assessed associations between attention problems at age 9 years and subsequent use of cigarettes, alcohol, and marijuana, engagement in sex without a condom, and delinquency at age 15 years. Results: Nearly one-fifth (18.3%) of adolescents had elevated scores (more than 1 standard deviation above the sample mean) for attention problems at age 9 years. Adolescents with elevated attention problem scores in childhood were more likely than adolescents who did not have elevated scores to have ever smoked an entire cigarette (9% vs. 4%) and ever tried marijuana (24% vs. 20%). Elevated attention problem scores were associated with higher odds of ever having smoked an entire cigarette (adjusted odds ratio [AOR] = 2.06, 95% CI [1.39, 3.05], p < .01) and higher delinquent behavior scores (incidence rate ratio [IRR] = 1.30, 95% CI [1.11, 1.53], p < .01). In adjusted models, there were no significant associations between elevated attention problem scores and ever having tried marijuana, consumed alcohol, or engaged in unprotected sex. Conclusions: This study found that elevated attention problem scores in childhood were associated with higher risk of cigarette smoking and delinquent behaviors in adolescence. Results provide support for screening for attention problems among elementary school-age children and early intervention strategies to prevent health risk behaviors in adolescence.

Objective: This study aimed to explore the association between adolescents' health risk behaviours (excessive use of alcohol, (e)cigarette smoking, cannabis use) and familial factors. A special objective of this study was to compare findings between Bulgarian and Lithuanian adolescents aged 15 years. Material and Methods: National samples from the WHO Health Behaviour in School-aged Children (HBSC) survey in 2021/2022 were analysed. The focus was on adolescents aged 15 (n = 64,349), including those from Bulgaria (n = 793) and Lithuania (n = 1137). The set of outcome variables included drunkenness, smoked cigarettes, e-cigarettes, and used cannabis (all variables were measured during the last 30 days); their indicators were child's talking separately to their father and separately to their mother, as well as the four-item family support scale. All variables were dichotomised and their associations were analysed using Structural Equation Modelling with a WLSMV estimator. Results: In the total sample, the prevalence of drunkenness was 14.9%, cigarette smoking at 12.6%, e-cigarette smoking at 18.4%, and cannabis use at 5.9%; while in Bulgaria, in contrast to Lithuania, these behaviours were much more prevalent, at 27.0%, 29.9%, 29.8%, and 11.1%, respectively. The use of substances was significantly associated with selected familial factors, which were more pronounced among girls than boys in most subsamples. Low family support showed the strongest association with increased substance use (in the total sample, regression weight B varied from 0.231 to 0.382). Adolescents' difficulty in talking to mother was more pronounced (B = 0.123 to 0.204) than difficulty in talking to their father (B = 0.058 to 0.140). Comparison of data samples from Bulgaria and Lithuania showed stronger relationships in Bulgarian adolescents compared to other countries, which are more pronounced among boys. In addition, among Bulgarian adolescents, easy communication with their father had an inverse association (increasing prevalence) with cannabis use. Conclusions: Adolescent health risk behaviours, such as use of substances, are associated with familial factors, including parent-teen communication and family support. Generally, these associations are more pronounced among girls than boys, and more evident among Bulgarian adolescents than their Lithuanian counterparts. Identifying environmental factors in families helps to plan interventions to prevent development of multiple health risk behaviours in adolescents.

Adolescents are a group vulnerable to reproductive health issues. One contributing factor is a lack of literacy and limited access to sexual and reproductive health services. Educational interventions supported by digital technology, such as mobile applications, websites, and social media, aim to provide information related to sexual and reproductive health. These interventions are expected to reduce risky behaviors, including preventing sexually transmitted infections, unwanted pregnancies, and making appropriate reproductive health decisions. However, the effectiveness of digital-supported educational interventions remains variable. Objective: examined the effectiveness of health education using digital support from various journal articles. Method: systematic review approach was used to analyze and evaluate several research results through literature searches with Proquest, Wiley, Science Direct and Spinger Link databases with experimental and RCT research types. Results: The results of a review of thirteen articles can be concluded that interventions with digital support can significantly ( &lt;0.05) increase adolescents' knowledge about reproductive health, improve attitudes towards preventing adolescent health risk behaviors, improve behavior in maintaining reproductive health disease prevention, increase self-efficacy and reduce the incidence of physical violence and sexual violence. Recommendations: It is recommended that interventions involve both adolescents and their parents, as parental roles are crucial in providing support to adolescents.

BackgroundAdolescent health-risk behaviors are prevalent and tend to co-occur. This study aimed to identify patterns of health-risk behaviors among Chinese adolescents during the COVID-19 pandemic and explore the effects of individual and social factors on health-risk patterns.MethodsThis cross-sectional study investigated 1607 adolescents from four high schools in 2021 through stratified cluster random sampling. Latent class analysis was conducted to identify patterns of health-risk behaviors and logistic regression was used to examine the risk and protective factors of latent class membership.ResultsFour latent classes were identified: “Low risk” (81.6%), “Problematic Internet use” (7.8%), “Alcohol use” (8.5%), and “High risk” (2.1%). Relative to the “Low risk”, adolescents with higher levels of sensation seeking, deviant peer affiliation, and childhood abuse were more likely to be assigned to the “Problematic Internet use” class, while those with high degrees of parental monitoring and school connectedness were less likely to be in the “Problematic Internet use” class. Those with higher levels of sensation seeking and deviant peer affiliation, lower scores of parental monitoring and school connectedness were more likely to be assigned to the “Alcohol use” class, compared to the “Low risk”. Students in the “High risk” class were more likely to report higher levels of sensation seeking, deviant peer affiliation, and childhood abuse, but lower degrees of parental monitoring and school connectedness than the “Low risk” class.ConclusionsThis study identified patterns of multiple risk behaviors among Chinese high school students during the COVID-19 pandemic and found that multi-level individual and social factors affected latent classes of adolescent health-risk behaviors. These findings provide clues for designing effective interventions to reduce health-risk behaviors among adolescents.

Drinking is the most problematic health behavior among adolescents. Adolescent drinking behavior is likely to continue into adulthood and can lead to various social problems, development of multiple diseases, and even death. Grit is defined as the ability to persist in the face of a struggle. While grit can be a protective factor against risky health behaviors, there is a lack of information on how grit is related to adolescent drinking behavior. Based on the integrative model of adolescent health risk behavior, this study aimed to examine how intrapersonal, interpersonal, and cultural/environmental factors were related to adolescent drinking behaviors. Especially, this study aimed to examine the relationship between grit and adolescent drinking behavior by adding grit as a psychosocial maturity factor. A cross-sectional study using a nationally representative sample of Korean adolescents. A secondary data analysis of the 5th wave of the Korean children and youth panel survey (N = 2252) was conducted. The study sample comprised 11th-grade high school students. Descriptive statistics and logistic regression analyses were performed RESULTS: Model 1 included intrapersonal, interpersonal, and cultural/environmental factors associated with adolescent drinking behavior. Model 2 added grit to the factors in model 1 to examine how grit is related to adolescent drinking behavior. After controlling for intrapersonal, interpersonal, and cultural/environmental factors, a higher level of grit was associated with lower odds of drinking behavior among adolescents (OR = 0.413, 95% CI = 0.257-0.662, p < 0.001) CONCLUSION: A higher level of grit was associated with lower odds of drinking behavior among adolescents after adjusting for intrapersonal, interpersonal, and cultural/environmental factors CLINICAL RELEVANCE: As grit can help deter risky health behaviors, guardians, teachers, and school nurses should focus on fostering grit among adolescents through education, mentorship, and intervention programs.

Introduction: Health-risk behaviors among adolescents are increasing at an alarming rate, as observed by families, educational institutions, and medical professionals. These risk behaviors are diverse and extensive. There is a need to identify the indulgence of adolescents in various risk behaviors and have a composite assessment of the same for any planned intervention initiative to enhance adolescent well-being. The authors, endorsing this need, have attempted to develop a comprehensive scale to assess the overall health-risk behavior of adolescents. Material and Methods: The adolescent health-risk behavior scale was standardized on a sample of 1388 adolescents aged 14-19 years from India. Results: The initial scale of 49 items was run through an exploratory factor analysis, resulting in a 30-item scale with nine factors. A confirmatory factor analysis resulted in a final scale of 20 items with seven factors. Conclusion: The scale showed satisfactory reliability and validity measures, resulting in a comprehensive assessment tool to assess adolescent risk behaviors. The scale can be used not just for research but also as a simple and comprehendible diagnostic tool to assess adolescent risk behaviors.

Most studies on the impact of maternal incarceration on adolescent health risk behaviors have focused on singular, separated behaviors, even though these behaviors often cluster and co-occur. This study used the FFCWS dataset to examine the association between maternal incarceration and the aggregation of health risk behaviors among adolescents. Latent class analysis suggested the four-class model had the optimal model fit. Multinomial logistic regression revealed that the odds of adolescents with maternal incarceration histories being classified into the "high dietary risk behavior," "high insomnia risk behavior," and "high health risk behavior" groups, compared to the "low health risk behavior" group, were 4.02 times, 3.12 times, and 7.80 times those of adolescents without such experience, respectively. Findings contributed to our knowledge of maternal incarceration's collateral consequences and suggested it be considered in bundled interventions targeting adolescents. Future research that disentangles these relationships' underlying explanatory factors and sociodemographic moderators is needed.

The Relationship between Adverse Childhood Experiences and Health Risk Behaviors of Adolescents: The Mediating Role of Executive Function Deficits

Adverse childhood experiences (ACEs) are preventable, potentially traumatic events occurring before age 18 years. Data on ACEs among adolescents in the United States have primarily been collected through parent report and have not included important violence-related ACEs, including physical, sexual, and emotional abuse. This report presents the first national prevalence of self-reported ACEs among U.S. high school students aged <18 years, estimates associations between ACEs and 16 health conditions and risk behaviors, and calculates population-attributable fractions of ACEs with these conditions and behaviors using cross-sectional, nationally representative 2023 Youth Risk Behavior Survey data. Exposures were lifetime prevalence of individual (emotional, physical, and sexual abuse; physical neglect; witnessed intimate partner violence; household substance use; household poor mental health; and incarcerated or detained parent or guardian) ACEs and cumulative ACEs count (zero, one, two or three, or four or more). Health conditions and risk behaviors included violence risk factors, substance use, sexual behaviors, weight and weight perceptions, mental health, and suicidal thoughts and behaviors. Bivariate analyses assessed associations between individual and cumulative ACEs and demographics. Adjusted prevalence ratios assessed associations between cumulative ACEs and health conditions and risk behaviors, accounting for demographics. Population-attributable fractions were calculated to determine the potential reduction in health conditions and risk behaviors associated with preventing ACEs. ACEs were common, with approximately three in four students (76.1%) experiencing one or more ACEs and approximately one in five students (18.5%) experiencing four or more ACEs. The most common ACEs were emotional abuse (61.5%), physical abuse (31.8%), and household poor mental health (28.4%). Students who identified as female; American Indian or Alaska Native; multiracial; or gay or lesbian, bisexual, questioning, or who describe their sexual identity in some other way experienced the highest number of ACEs. Population-attributable fractions associated with experiencing ACEs were highest for suicide attempts (89.4%), seriously considering attempting suicide (85.4%), and prescription opioid misuse (84.3%). ACEs are prevalent among students and contribute substantially to numerous health conditions and risk behaviors in adolescence. Policymakers and public health professionals can use these findings to understand the potential public health impact of ACEs prevention to reduce adolescent suicidal behaviors, substance use, sexual risk behaviors, and other negative health conditions and risk behaviors and to understand current effects of ACEs among U.S. high school students.

Abstract Introduction: Risky behavior among adolescents is a major public health problem in India and it affects health both at that time and in later years. Poor mental health is strongly related to other health and development concerns in young people notably lower educational achievements, substance abuse, and violence. The aim of this study is to assess the health risk behaviors of male school-going tribal adolescents from Jharkhand, India. Methodology: The present study is a cross-sectional descriptive study design. Schools were selected from rural areas of Ranchi district, Jharkhand. Sociodemographic data sheet and the Global School-based Student Health Survey were administered. Results: A total of 780 male students participated in the study. In the present study, 3.46% of the respondents have felt lonely always during the past 12 months, and 1.15% of the students have seriously considered attempting suicide. In this survey, the prevalence of current alcohol use among students (i.e., drinking at least one drink containing alcohol on one or more of the past 30 days) was 14.35%. In the school survey, it was found that during the past 30 days, 1.41% of the students have used marijuana (cannabis) 20 or more times. During the past 30 days, 18.46% of the students reported that they smoked cigarettes all 30 days. Conclusion: The finding of the study shows that mental health scenarios and high-risk behaviors are prevalent among adolescents from the tribal community; considering their social, religious, cultural, and economic backgrounds, adequate psychosocial intervention plans can be made for early identification and adequate intervention. This information might help policymakers, health professionals, and researchers to incorporate prevention and treatment strategies to reduce risk behaviors and prevent psychiatric disorders among these adolescents.

Health Risk Behaviors of Adolescents in Europe: A Latent Profile Analysis of Health Behavior in School-Aged Children Survey Data From 43 Countries

IntroductionAdolescent health risk behaviors are linked to poor physical and mental health outcomes. While past research shows that maternal psychological distress predicts those behaviors, we know less about the role of paternal psychological distress and the role of sensitive periods.MethodsUsing 11,128 data from families (50.5% female children) from the UK's Millennium Cohort Study, we examined the role of timing of exposure to paternal and maternal psychological distress in engagement in health risk behaviors (smoking, alcohol use, binge drinking, and sexual activity) at age 14. Paternal and maternal psychological distress, measured with the Kessler‐6 scale, were assessed at child ages 3, 7, and 11. We performed path analysis, adjusting for key covariates, modeling maternal distress parallel to paternal, and allowing for autoregressive paths.ResultsPaternal distress experienced at age 11 predicted a higher likelihood of smoking at age 14. Maternal distress at age 7 also predicted a higher likelihood of smoking, alcohol use, and binge drinking, but only for boys. Moreover, maternal distress at age 3 was associated with a lower risk for alcohol use. Effects were not replicated in the sensitivity analysis we performed, including only families with resident biological fathers across the study period. Instead, maternal and paternal distress at age 11 raised girls' risk for binge drinking and sexual activity, respectively.ConclusionsParental distress in early childhood does not predict adolescent health risk behaviors. In late childhood, however, both paternal and maternal distress seem to influence the likelihood of engagement in such behaviors.

There are no trend studies on various health risk behaviours among adolescents in Uruguay. Therefore, this study looked at trends in a number of health-risky behaviours among adolescents in Uruguay from three separate surveys. Data from 9272 adolescents (age range: 11-16 years), who took part in three cross-sectional national in-school surveys in Uruguay in 2006, 2012 and 2019 were analysed. A self-administered survey was used to evaluate 24 health risk behaviours. By using logistic regression analyses to treat the study year as a categorical variable and adjusting food insecurity and age, linear trends were examined. We found a significant increase in the prevalence of being overweight, having obesity, inadequate fruit intake, sedentary behaviour in leisure-time, physical inactivity, bullying victimisation, loneliness, suicidal ideation, and sexual activity. We found a significant decrease in current cigarette use, physical fighting and current alcohol use. Among males, a significant increase of non-condom use, and a decrease in current other tobacco use (other than cigarettes), being physically attacked and the number of sexual partners. Among females, we found an increase in food insecurity, trouble from alcohol use, multiple sexual partners, and sleep problems. Overall, from 2006 to 2019, there was a decrease in seven health risk behaviours among boys and/or girls. Among boys, there was an increase in 10 health risk behaviours and among girls, 15 health risk behaviours increased, highlighting adolescent girls' greater vulnerability, thereby perpetuating further gendered health inequalities. In Uruguay, school health programmes for adolescents are recommended.

Objectives: Research suggests that adolescents exposed to maternal incarceration have higher odds of being classified into more severe health risk behavior patterns than those without such experiences. However, the potentially heterogeneous effect of maternal imprisonment on adolescents with distinct individual characteristics remains under-investigated. This study aimed to advance the knowledge base by examining its impact based on adolescent gender and race. Methods: Specifically, this research used a nationwide dataset to examine the moderating effect of adolescent gender and racial background on the association between maternal incarceration and adolescent health risk behavior patterns. Results: The interaction terms were not statistically significant in predicting health risk behavior patterns, except for some trends toward significance worth noting. Specifically, black adolescents with maternal incarceration experiences trended toward lower odds, and Hispanic and multiracial or other adolescents trended toward higher odds of being classified into Class 3 than Class 2, compared to their white counterparts. Additionally, multiracial or other adolescents with maternal incarceration experiences trended toward higher odds of being classified into Class 4 than Class 2, compared to their white peers. Conclusions: Maternal incarceration may have a distinct impact on the health risk behavior patterns of adolescents with different racial backgrounds.

RESUMO A pandemia de covid-19 reduziu o acesso aos alimentos e aumentou a insegurança alimentar. Objetivouse analisar a prevalência de Insegurança Alimentar e Nutricional (IAN) em adolescentes brasileiros durante a pandemia de covid-19 segundo características sociodemográficas e examinar a associação entre IAN e comportamentos de risco e proteção em adolescentes brasileiros durante esse período. Estudo transversal com dados da ‘ConVid Adolescentes – Pesquisa de Comportamentos’, realizada entre junho e outubro de 2020, utilizando-se um questionário autoaplicado por meio de celular ou computador. A população foi adolescentes de 12 a 17 anos, totalizando 9.470. Utilizou-se a Razão de Prevalência (RP) e Intervalo de Confiança de 95% (IC95%), por meio da regressão de Poisson com variância robusta. A prevalência de IAN (26,1%) foi mais elevada entre os adolescentes da raça/cor preta e parda e que estudam em escola pública. Os adolescentes que relataram IAN tiveram menor consumo de hortaliças e frutas, menor prática de atividade física e maior uso de cigarros e álcool. A IAN foi mais prevalente em adolescentes com piores condições socioeconômicas, e, adolescentes com IAN apresentaram maior frequência de comportamentos de risco para a saúde evidenciando a importância de políticas públicas intersetoriais para a redução de desigualdades.

Since there is no certainty about when the coronavirus disease 2019 (COVID-19) lockdown will be affected by health risk behaviors, so we investigate the effect of COVID-19-related health risk behavior changes using school-based self-reported data from a nationally representative South Korean adolescent population. We analyzed web-based self-reported data from the Korea Youth Risk Behavior Web-based Survey in 111,878 participants (57,069 in COVID-19 prepandemic); 54,809 in during the COVID-19 pandemic. This study included 12 to 18-year-olds. Self-report questionnaires were used to assess socioeconomic status, health risk behaviors, and psychological factors. Health risk behaviors such as alcohol consumption, substance use, and sexual experience significantly decreased in COVID-19 pandemic than in COVID-19 prepandemic. Psychosomatic changes such as stress levels, violence experience, depression, suicidal ideation, suicidal plans, and suicide attempts were significantly lower in COVID-19 pandemic compared to COVID-19 prepandemic (P < .001). After adjusting for multiple confounding variables, less alcohol consumption (odds ratio [OR] = 0.98; 95% confidence interval [CI] = 0.88-0.93), less exercise (OR = 0.92; 95% CI = 0.89-0.94), less sexual experience (OR = 0.82; 95% CI = 0.77-0.86), less violence experience (OR = 0.61; 95% CI = 0.55-0.67), less stress (OR = 0.86; 95% CI = 0.84-0.88), less depression (OR = 0.85; 95% CI = 0.83-0.88), less suicidal ideation (OR = 0.93; 95% CI = 0.89-0.97), plans (OR = 0.82; 95% CI = 0.76-0.88), attempts (OR = 0.78; 95% CI = 0.71-0.85) were significantly associated with the COVID-19 pandemic compared to COVID-19 prepandemic. The COVID-19 pandemic was associated with changes in health risk behaviors among Korean adolescents, resulting in alcohol drinking, sexual experience, drug use, violence experience, and suicidal behaviors (idea, plan, and attempts) being decreased during the lockdown period.

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.

Retracted: Application of Artificial Intelligence in the Intervention of Sports on Adolescent Health Risk Behavior