Resilience and patterns of health risk behaviors in California adolescents

University of California, Los Angeles (UCLA) School of Public Health, Department of Health Services, Division of Cancer Prevention and Control Research, USA.
Preventive Medicine (Impact Factor: 3.09). 03/2009; 48(3):291-7. DOI: 10.1016/j.ypmed.2008.12.013
Source: PubMed


Assess whether adolescent health risk behaviors cluster, and whether resiliency factors are associated with observed clusters.
The cross-sectional population-weighted 2003 California Health Interview Survey was used (N=4010). Four gender-specific clusters were based on smoking, alcohol use, low fruit/vegetables consumption, and physical inactivity. Resiliency factors included parental supervision, parental support, role model presence and adolescent mental health. Conditional regression was used to measure the association of individual health risk behaviors and clusters with resiliency factors.
Health risk behaviors clustered as follows: "Salutary Adherents" (no reported health risk behaviors), "Active Snackers" (physically active, low fruit/vegetable consumers), "Sedentary Snackers" (physically inactive, low fruit/vegetable consumers), and "Risk Takers" (smokers, alcohol users, many also physically inactive and low fruit/vegetable consumers). Greater parental supervision was associated with lower odds of being in unhealthful clusters. Among males, having greater parental support reduced odds of being an "Active Snacker" or "Sedentary Snacker." Among females, role model presence reduced odds of being in unhealthful clusters, while depressiveness increased the odds.
Health promoting interventions should address multiple health risk behaviors in an integrated fashion. Gender-specific, ethnically-targeted, family-centered strategies that address parenting, particularly parental supervision would be useful. Addressing depressiveness may be especially important for female adolescents.

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    • "These two clusters are quite distinct conceptually, with the first reflecting non-adherence to preventive behaviours , while the second, to undertaking risk behaviours. Previous studies reported associations between low fruit and vegetables consumption and low physical activity in adolescence[9,38394041, and between tooth brushing and eating habits[42]. However, those studies only reported associations between two behaviours at a time, and did not look at clustering patterns of multiple health-related behaviours. "

    Full-text · Dataset · Jan 2016
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    • "5 behaviors, (Frech 2012; Feunekes et al., 1998; Cameron et al., 2011; Sanchez et al., 2007) parental monitoring, (Mistry et al., 2009) support from parents, (Frech, 2012), peer influences (Hair, et al., 2009; Frech, 2012) and low socioeconomic status (SES) (Alamian and Paradis, 2009a; Alamian and Paradis, 2009b; Lawlor et al., 2005; Mistry et al., 2009). Trajectories of health risk behaviors in youth have been linked to health risk behaviors and health in adulthood (Hamil-Luker and Angela, 2007; Mahalik et al., 2013; Frech, 2012; Angela and Hamil-Luker, 2005). "
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    ABSTRACT: Background Most studies on multiple health risk behaviors among adolescents have cross-sectionally studied a limited number of health behaviors or determinants. PurposeTo examine the prevalence, longitudinal patterns and predictors of individual and multiple health risk behaviors among adolescents. Methods Eight health risk behaviors (no regular consumption of fruit, vegetables or breakfast, overweight or obesity, physical inactivity, smoking, alcohol use and cannabis use) were assessed in a prospective population study (second and third wave). Participants were assessed in three waves between ages 10 and 17 (2001-2008; n = 2230). Multiple linear regression was used to assess the influence of gender, self-control, parental health risk behaviors, parental monitoring and socioeconomic factors on the number of health risk behaviors adjusted for preceding multiple health risk behaviors (analysis: 2013-2014). ResultsRates of >. 5 health risk behaviors were high: 3.6% at age 13.5 and 10.2% at age 16. Smoking at age 13.5 was frequently associated with health risk behaviors at age 16. No regular consumption of fruit, vegetables and breakfast, overweight or obesity, physical inactivity and smoking predicted the co-occurrence of health risk behaviors at follow-up. Significant predictors of the development of multiple health risk behaviors were adolescents' levels of self-control, socioeconomic status and maternal smoking. Conclusions Multiple health risk behaviors are common among adolescents. Individual and social factors predict changes in multiple health risk behaviors, showing that prevention targeting multiple risk behaviors is needed. Special attention should be paid to adolescents with low self-control and families with low socioeconomic status or a mother who smokes.
    Full-text · Article · Dec 2015 · Preventive Medicine
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    • "Of the studies that identified clusters of health risk behaviours, only a few examined the relationship with mental health. These studies mainly focused on adolescents (Hallfors et al., 2004: Mistry et al., 2009; Dodd et al., 2010). Those studies which were performed among adults generally address (symptoms of) depression in relation to clusters of the " big-four " modifiable health behaviours (smoking, heavy drinking, physical inactivity and unhealthy diet) (Verger et al., 2009; Conry et al., 2011). "
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    ABSTRACT: Background: Health risk behaviours tend to co-occur and are found to be related to mental health symptoms. This is the first study to identify health behaviour clusters in relation to mental disorders. Methods: Data were used from the second wave of the Netherlands Mental Health Survey and Incidence Study (NEMESIS-2), a nationally representative sample of adults (n=5303). Latent class analysis was performed to identify clusters based on four health risk behaviours (smoking, heavy drinking, physical inactivity, and unhealthy diet). Concurrently, we examined the relationship between the identified clusters and a range of DSM-IV diagnoses, assessed with the Composite International Diagnostic Interview 3.0. Results: Four distinct health behaviour clusters were identified: most healthy (mainly non-smokers, moderate drinkers, active, healthy diet; class 1: 79.3%); smokers, moderate drinkers, inactive, unhealthy diet (class 2: 13.2%); smokers, heavy episodic drinkers, active, unhealthy diet (class 3: 3.8%); Smokers, frequent heavy drinkers, active, low fruit (class 4: 3.6%). Despite their different lifestyles, individuals in all three unhealthy clusters had double the risk of depression. Unhealthy behaviour clusters were strongly associated with drug dependence (classes 2 and 3), alcohol abuse and dependence (classes 3 and 4), and social phobia (class 4). Limitations: Due to the cross-sectional design, no conclusions about the causality of the relationship between HRB clusters and mental disorders can be drawn from the current study. Conclusions: Health behaviour clusters are strongly associated with mental disorders. This co-existence of behaviours and disorders emphasises the importance of an integrative approach in the prevention of mental illnesses.
    Full-text · Article · Sep 2014 · Journal of Affective Disorders
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