Range Of Risk Behaviors Research Articles

Associations between socio‐economic status (including school‐ and pupil‐level interactions) and student perceptions of school environment and health in English secondary schools

This article examines interactions between school‐level and pupil‐level measures of socio‐economic status for pupil reports of the school environment and a range of risk behaviours and health outcomes. The baseline survey for the INCLUSIVE trial provided data on pupil affluence and pupil reports of the school environment, smoking, drinking, anti‐social behaviour at school, quality of life and psychological wellbeing for over 6,000 pupils (aged 11–12 years) in 40 schools within a 1‐hour train journey from central London. The level of socio‐economic disadvantage of the school was measured using the percentage of pupils eligible for free school meals. Multilevel regression models examined the association between pupil affluence, the socio‐economic composition of the school and the interaction between these with the school environment, risk behaviours and health outcomes. Our findings provide some evidence for interactions, suggesting that less affluent pupils reported lower psychological wellbeing and quality of life in schools with more socio‐economically advantaged intakes. There appears to be a complex relationship for anti‐social behaviour. Where pupil affluence and school socio‐economic composition were discordant, pupils reported a higher number of anti‐social behaviours. This article provides further evidence that less affluent pupils are more likely to engage in a variety of risk behaviours and experience worse health outcomes when they attend schools with more socio‐economically advantaged intakes, supporting some of the mechanisms described in the theory of human functioning and school organisation.

Prevalence of Drug Injection, Sexual Activity, Tattooing, and Piercing Among Prison Inmates.

Prisoners engage in a range of risk behaviors that can lead to the transmission of viral infections, such as HIV, hepatitis B and hepatitis C. In this review, we summarize the epidemiologic literature from 2007 to 2017 on 4 key risk behaviors for human immunodeficiency virus and hepatitis C virus among prisoners globally: drug injection, sexual activity, tattooing, and piercing. Of 9,303 peer-reviewed and 4,150 gray literature publications, 140 and 14, respectively, met inclusion criteria covering 53 countries (28%). Regions with high levels of injection drug use were Asia Pacific (20.2%), Eastern Europe and Central Asia (17.3%), and Latin America and the Caribbean (11.3%), although the confidence interval for Latin America was high. Low levels of injection drug use in prison were found in African regions. The highest levels of sexual activity in prison were in Europe and North America (12.1%) and West and Central Africa (13.6%); low levels were reported from the Middle East and North African regions (1.5%). High levels of tattooing were reported from Europe and North America (14.7%), Asia Pacific (21.4%), and Latin America (45.4%). Prisons are burdened with a high prevalence of infectious diseases and risk behaviors for transmission of these diseases, and, commonly, a striking lack of evidence-based infection control measures, even when such measures are available in the surrounding community. Given that most prisoners return to these communities, failure to implement effective responses has repercussions not only prisoner health but also for public health.

Suicidal women may risk their lives but not their social relationships

ObjectiveRisk‐taking is an important but understudied suicidal factor, particularly concerning women. This study examined a broad range of risk behaviours and perceptions that might aid the early detection of suicidality by clinicians and gatekeepers.MethodA purposive anonymous online survey, preferable for collecting data on stigmatised issues, produced a sample of 273 Australian/New Zealand women (aged 18–67 years) covering a broad spectrum of suicidal factors and risk‐taking behaviours. Participants completed items on risk‐taking perceptions and behavioural willingness, and the Suicidal Affect‐Behavior‐Cognition Scale. Demographic factors were controlled for in partial correlations and hierarchical regression modelling, which tested the validity of risk‐taking variables as predictors of suicidality.ResultsSuicidality was positively associated with willingness to engage in infidelity, not wearing seatbelts or motorcycle helmets, and negatively associated with interpersonal risk‐taking (unwillingness to endanger social relationships). Hierarchical regression modelling revealed these risk‐taking perceptions and behaviours explained 34% of the variance in women's suicidality, after accounting for age and ethnicity.ConclusionsThis study demonstrated that some types of commonplace risk‐taking, or avoidance, may serve as important indicators or warning signs for suicidal crises in women. Clinicians should consider possible underlying psychological distress when encountering these symptoms and behaviours.

The Impact of Family-Centered Prevention on Self-Regulation and Subsequent Long-Term Risk in Emerging Adults.

Emerging adulthood is characterized by not only opportunity and transition but also a substantial increase in risk behaviors (Fosco et al. Journal of Family Psychology, 26(4), 565-575, 2012; Johnston et al. 2016). Building on prior research, we tested a mediational model hypothesizing that Family Check-Up (FCU) intervention effects on young adult risk would be mediated by increases in self-regulation, and that these changes would continue to affect risk behavior as high school youths transitioned to young adulthood. We also predicted that the intent-to-treat intervention would be associated with lower levels of risk in young adulthood and that this effect would be accounted for by intervention-induced improvements in self-regulation during early adolescence, which in turn would prevent young adult risk. Participants were 593 adolescents and their families recruited from three public middle schools and randomized either to the FCU or to a control group. Item response theory was applied to construct a measure of high-risk behavior at this age, including risk behaviors such as substance abuse, high-risk sexual behavior, and vocational risk. Results suggested that changes in children's self-regulation that occurred early during the middle school years, and that were associated with the FCU, led to reductions in risk behaviors during young adulthood. This study builds on our prior research that has suggested that effects of the FCU during middle school lead to changes in a range of risk behaviors during the transition to high school (Fosco et al. Journal of School Psychology, 51(4), 455-468, 2013; Stormshak et al. School Mental Health, 2(2), 82-9, 2010).

Youth–Adult Connectedness:: A Key Protective Factor for Adolescent Health

Over the past 30 years, prevention science in the adolescent health field has moved from interventions focused on preventing single problem behaviors to efforts employing a dual approach, addressing risk factors that predict problems while simultaneously nurturing protective factors and promoting positive development. Through an examination of previous research and empirical case examples with vulnerable youth, this article considers the hypothesis that adolescents' sense of connectedness to caring adults acts as a protective factor against a range of risk behaviors. Multivariate analyses with existing data examined indicators of youth-adult connectedness among two groups at high risk for poor health outcomes: (1) mentor-youth relationship quality in an urban, ethnically diverse sample of students in a school-based mentoring program (2014 survey, N=239); and (2) parent-youth connectedness in a statewide sample of high school students who reported homelessness in the past year (2013 survey, N=3,627). For youth in the mentoring program, a high-quality youth-mentor relationship was significantly associated with positive social, academic, and health-related behaviors. Among students who experienced homelessness, all measures of parent connectedness were significantly associated with lower sexual risk levels. Collectively, findings from these analyses and previously published studies by this research group provide evidence that strong, positive relationships with parents and other caring adults protect adolescents from a range of poor health-related outcomes and promote positive development. Youth-adult connectedness appears to be foundational for adolescent health and well-being. Program, practice, and policy decisions should consider what strengthens or hinders caring, connected youth-adult relationships.

‘But I've got something that makes me different’: Young men's negotiation of masculinities

ABSTRACTMuch current research about young people is located in studies on risk behaviour and consequently tends to pathologise their actions and behaviour. Particularly poor, young, African men are often regarded as the drivers of a range of risk behaviours from sexual risk to crime and violence. By drawing on an ethnographic study conducted in an informal settlement of Gauteng, South Africa, this article challenges common perceptions of young men as risk-takers. It demonstrates the various ways in which masculinity is practised in everyday life as young men attempt to carve out a masculine identity. Their agency, aspirations, and insights with regard to risk-taking, as well as how they attempt to avoid being stigmatised by the common perceptions of young, poor, African men are highlighted. The article thus challenges literature that assumes a hegemonic masculinity and contributes to the largely Western dominated youth transitions literature by giving voice to poor, young men in a developing country context. It points to the need for continued research, which seeks to place young people at the centre of research about them, and to provide insight into their everyday experiences.

On the association between sexual attraction and adolescent risk behavior involvement: Examining mediation and moderation.

On the basis of a large-scale survey of high-school youth, the authors compared adolescents reporting exclusively heterosexual, mostly heterosexual, bisexual, and predominately same-sex attraction based on high-risk involvement across a range of risk behaviors. Bisexual and same-sex attracted groups were characterized by heightened high-risk involvement relative to the other two groups. Mediation analysis was used to determine whether these group disparities were explained by a set of normative predictive factors spanning multiple life domains. Differences among a combined exclusively/mostly heterosexual attraction group and both the bisexual and same-sex attraction groups were attenuated (66% and 50%, respectively) after incorporating the hypothesized intervening predictive factors, providing evidence of partial mediation. Primary mediators included intrapersonal (attitudes toward risk-taking; academic orientation), interpersonal (peer victimization; parental relationships; unstructured activities), and environmental (substance availability) factors. Mediation results were consistent across participant age and sex. Implications, limitations, and directions for future research are discussed.

A Brief Screening Measure of Adolescent Risk Behavior

This study examined the factor structure and reliability of a brief but comprehensive measure, the adolescent risk inventory (ARI), designed to assess adolescent risk behaviors and attitudes. Measures assessing demographics and risk behaviors were administered to 134 youth (ages 12-19) in psychiatric treatment. A confirmatory factor analysis of the four attitude scales (HIV Anxiety, HIV Prevention Self-Efficacy, General Distress, and General Risk) revealed excellent goodness of fit statistics. Exploratory factor analysis of the behavior items revealed three behavior factors (Sex Risk, Abuse/Self-Harm, and Acting Out). The preliminary analysis suggested that all subscales had reasonable internal consistency reliability and appeared to be independent measures, rather than part of a single unitary construct. Differences emerged based on gender, sexual activity status, and trauma history. Exploratory regression analyses revealed that, even when controlling for demographic factors and sex risk attitudes (e.g., HIV Prevention Self-Efficacy), Abuse/self-harm behaviors were highly significantly predictive of sex risk. These analyses suggest that the ARI can be useful in quickly identifying the broad range of risk behaviors found among adolescents with psychiatric disorders.

Associations among adolescent risk behaviours and self‐esteem in six domains

Background: This study investigated associations among adolescents’ self‐esteem in 6 domains (peers, school, family, sports/athletics, body image and global self‐worth) and risk behaviours related to substance use, bullying, suicidality and sexuality.Method: A multistage stratified sampling strategy was used to select a representative sample of 939 English‐, Afrikaans‐ and Xhosa‐speaking students in Grades 8 and 11 at public high schools in Cape Town, South Africa. Participants completed the multidimensional Self‐Esteem Questionnaire (SEQ; DuBois, Felner, Brand, Phillips, & Lease, 1996) and a self‐report questionnaire containing items about demographic characteristics and participation in a range of risk behaviours. It included questions about their use of tobacco, alcohol, cannabis, solvents and other substances, bullying, suicidal ideation and attempts, and risky sexual behaviour. Data was analysed using a series of logistic regression models, with the estimation of model parameters being done through generalised estimation equations.Results: Scores on each self‐esteem scale were significantly associated with at least one risk behaviour in male and female adolescents after controlling for the sampling strategy, grade and race. However, specific self‐esteem domains were differentially related to particular risk behaviours. After taking the correlations between the self‐esteem scales into account, low self‐esteem in the family and school contexts and high self‐esteem in the peer domain were significantly independently associated with multiple risk behaviours in adolescents of both sexes. Low body‐image self‐esteem and global self‐worth were also uniquely associated with risk behaviours in girls, but not in boys.Conclusions: Overall, the findings suggest that interventions that aim to protect adolescents from engaging in risk behaviours by increasing their self‐esteem are likely to be most effective and cost‐efficient if they are aimed at the family and school domains.

Associations among adolescent risk behaviours and self-esteem in six domains.

This study investigated associations among adolescents' self-esteem in 6 domains (peers, school, family, sports/athletics, body image and global self-worth) and risk behaviours related to substance use, bullying, suicidality and sexuality. A multistage stratified sampling strategy was used to select a representative sample of 939 English-, Afrikaans- and Xhosa-speaking students in Grades 8 and 11 at public high schools in Cape Town, South Africa. Participants completed the multidimensional Self-Esteem Questionnaire (SEQ; DuBois, Felner, Brand, Phillips, & Lease, 1996) and a self-report questionnaire containing items about demographic characteristics and participation in a range of risk behaviours. It included questions about their use of tobacco, alcohol, cannabis, solvents and other substances, bullying, suicidal ideation and attempts, and risky sexual behaviour. Data was analysed using a series of logistic regression models, with the estimation of model parameters being done through generalised estimation equations. Scores on each self-esteem scale were significantly associated with at least one risk behaviour in male and female adolescents after controlling for the sampling strategy, grade and race. However, specific self-esteem domains were differentially related to particular risk behaviours. After taking the correlations between the self-esteem scales into account, low self-esteem in the family and school contexts and high self-esteem in the peer domain were significantly independently associated with multiple risk behaviours in adolescents of both sexes. Low body-image self-esteem and global self-worth were also uniquely associated with risk behaviours in girls, but not in boys. Overall, the findings suggest that interventions that aim to protect adolescents from engaging in risk behaviours by increasing their self-esteem are likely to be most effective and cost-efficient if they are aimed at the family and school domains.

Substance abuse, suicidality, and self-esteem in South African adolescents.

Associations among six different domains of self-esteem (peers, school, family, sports/athletics, body image, and global self-worth) and risk behaviors related to substance use and suicidality were investigated in a sample of South African adolescents. Students enrolled in Grades 8 and 11 at independent secondary schools in Cape Town (N = 116) completed the Self-Esteem Questionnaire (SEQ) and a questionnaire that asked about their participation in a range of risk behaviors. Logistic regression analyses indicated that particular domains of self-esteem were differentially associated with indicators of alcohol, cigarette and drug use and suicidal ideation or behaviors in adolescents. Family self-esteem showed the strongest overall pattern of associations with the risk behaviors. Overall, the findings of this study suggest that interventions which aim to protect adolescents from engaging in risk behaviors by increasing their self-esteem are likely to be most effective and cost-efficient if they are aimed at the family and school domains.

Impact of an empowerment-based parent education program on the reduction of youth suicide risk factors.

To evaluate the impact of parent education groups on youth suicide risk factors. The potential for informal transmission of intervention impacts within school communities was assessed. Parent education groups were offered to volunteers from 14 high schools that were closely matched to 14 comparison schools. The professionally led groups aimed to empower parents to assist one another to improve communication skills and relationships with adolescents. Australian 8th-grade students (aged 14 years) responded to classroom surveys repeated at baseline and after 3 months. Logistic regression was used to test for intervention impacts on adolescent substance use, deliquency, self-harm behavior, and depression. There were no differences between the intervention (n = 305) and comparison (n = 272) samples at baseline on the measures of depression, health behavior, or family relationships. Students in the intervention schools demonstrated increased maternal care (adjusted odds ratio [AOR] 1.9), reductions in conflict with parents (AOR.5), reduced substance use (AOR.5 to.6), and less delinquency (AOR.2). Parent education group participants were more likely to be sole parents and their children reported higher rates of substance use at baseline. Intervention impacts revealed a dose-response with the largest impacts associated with directly participating parents, but significant impacts were also evident for others in the intervention schools. Where best friend dyads were identified, the best friend's positive family relationships reduced subsequent substance use among respondents. This and other social contagion processes were posited to explain the transfer of positive impacts beyond the minority of directly participating families. A whole-school parent education intervention demonstrated promising impacts on a range of risk behaviors and protective factors relevant to youth self-harm and suicide.

Adolescent contraceptive non-use and covariation among risk behaviors.

To investigate whether adolescent contraceptive non-use is associated with other risk behaviors. A multistage sampling procedure produced a sample of 913 sexually active high school students. They completed a self-administered questionnaire that required mainly "yes" or "no" answers to questions involving participation in a range of risk behaviors. A series of multivariate logistic regression models investigated the relationships between contraceptive non-use and selected hypothesised correlates, controlling for key demographic variables. Contraceptive non-use was not significantly associated with use of cigarettes, alcohol, or inhalants; perpetration or being a victim of violence; exposure to risk of physical injury; and suicidality. For males only, there was a significant inverse association between contraceptive non-use and use of cannabis in the previous month. This was not the case for lifetime cannabis use for either gender. There was a significant inverse relationship between contraceptive non-use and knowing the most recent partner for more than 7 days, but no association for the number of partners nor duration since the last intercourse. For females only, there was a significant inverse association between contraceptive non-use and both age and age of first intercourse. This study does not support the hypothesis that contraceptive non-use is a component of the "risk behavior syndrome." Decisions to participate in intercourse and to use contraception have different psychosocial foundations. Prevention efforts should prioritize relationships with new partners and younger girls who commence intercourse early.

Prevalence of unprotected sex and HIV‐antibody testing among gay, lesbian, and bisexual youth

Prevalence of unprotected sex and HIV‐antibody testing were examined in a sample of Southern gay, lesbian, and bisexual youth (n = 117). In addition, a new measure was tested in terms of its ability to distinguish youth who obtain HIV‐antibody testing from those who do not. Data were collected at a conference for these youth, as well as at a Gay and Lesbian Community Center in a Southeastern metropolitan area. Youth reported engaging in a wide range of risk behaviors, yet less than one half had been tested for HIV. Factor analysis was conducted for the new measure, which assessed beliefs about HIV testing in youth, and each factor was significantly different for youth who had been tested compared to those who had not. Gay, lesbian, and bisexual youth were at high risk for HIV infection and were often untested for HIV antibodies.