Associations of Physical Activity, School Safety, and Non-Prescription Steroid Use in Adolescents: A Structural Equation Modeling Approach

Abstract

Non-prescription steroid use can negatively impact adolescent physical and mental health and wellbeing. Determining correlates of this risk behavior is needed to help mitigate its prevalence. Two potential correlates are physical activity and school safety. The purpose of this study was to examine the associations of physical activity, school safety, and non-prescription steroid use within a sample of adolescents from the 2015–2019 US National Youth Risk Behavior Survey (YRBS). A multi-stage cluster sampling procedure yielded a representative sample of US adolescents from the 2015–2019 YRBS (n = 44,066; 49.6% female). Two latent variables indicating physical activity and unsafe schools were the independent variables. The dependent variable was a self-report of non-prescription steroid use. A weighted structural equation model examined the associations between physical activity and unsafe schools with non-prescription steroid use, controlling for age, sex, BMI percentile, race/ethnicity, and sexual minority status. The latent physical activity variable did not associate with non-prescription steroid use (β = 0.007, 95%CI: −0.01–0.02, p = 0.436); however, the unsafe schools latent variable did associate with non-prescription steroid use (β = 0.64, 95%CI: 0.59–0.69, p < 0.001). An unsafe school environment may be a determinant of non-prescription steroid use in adolescents. Physical activity behaviors did not associate with steroid use.

Association of physical activity, school safety and opioid use in adolescents: A structural equation analysis

“…Some studies conducted between 2013 and 2017 linked adult family members and exposure to opioid prescriptions at home as a contributing source to access and misuse of adolescent opioids (Burghardt et al, 2013;McKnight et al, 2017). A study produced in 2019 stated that school administrators and friends of school are the most common sources of adolescents who obtain non prescribed opioids ( Students' perceptions of school safety and violence problems have been associated with unhealthy risk behaviors (Brusseau & Burns, 2021). Although the relationship between school safety and opioid use among adolescents needs future exploration due to the lack of evidence-based research, there is concrete evidence that shows that school environments (physical and social) have an adverse effect on drug sharing and use among adolescents.…”

“…Research shows that a positive school environment yields high educational attainment and low levels of unhealthy risk behaviors in adolescents (Wong et al, 2014). Furthermore, unsafe school environments and students' perception of school violence issues have been associated with unhealthy risk behaviors (Brusseau & Burns, 2021). While student perceptions of school violence have been documented, student perceptions of the connection between school safety, violence, and opioid use are still relatively unknown.…”