Clustering of health-related behaviours within children aged 11–16: a systematic review

Abstract

Objective We aimed to systematically review and synthesise evidence on the clustering of a broad range of health-related behaviours amongst 11–16 year olds. Method A literature search was conducted in September 2019. Studies were included if they used cluster analysis, latent class analysis, prevalence odds ratios, principal component analysis or factor analysis, and considered at least three health-related behaviours of interest among 11–16 year olds in high-income countries. Health-related behaviours of interest were substance use (alcohol, cigarettes and other drug use) and other behavioural risk indicators (diet, physical activity, gambling and sexual activity). Results The review identified 41 studies, which reported 198 clusters of health-related behaviours of interest. The behaviours of interest reported within clusters were used to define eight behavioural archetypes. Some included studies only explored substance use, while others considered substance use and/or other health-related behaviours. Consequently, three archetypes were comprised by clusters reporting substance use behaviours alone. The archetypes were: (1) Poly-Substance Users, (2) Single Substance Users, (3) Substance Abstainers, (4) Substance Users with No/Low Behavioural Risk Indicators, (5) Substance Abstainers with Behavioural Risk Indicators, (6) Complex Configurations, (7) Overall Unhealthy and (8) Overall Healthy. Conclusion Studies of youth health behavioural clustering typically find both a ‘healthy’ cluster and an ‘unhealthy’ cluster. Unhealthy clusters are often characterised by poly-substance use. Our approach to synthesising cluster analyses may offer a means of navigating the heterogeneity of method, measures and behaviours of interest in this literature.

Lifestyle risks for chronic disease among Australian adolescents: a cross‐sectional survey

“…Physical inactivity, poor diet, alcohol use, smoking, poor sleep, and excessive recreational screen time are lifestyle risk factors that emerge during adolescence, continue into adulthood, and often occur together 1 . They are linked with obesity 2 and mental health problems in the short term, 3 and with increased risk of chronic disease in adulthood 4 …”

Coexistence of risk factors for cardiovascular diseases among Brazilian adolescents: Individual characteristics and school environment

“…Based on cutoff value of 20%, the likely incidence of l-th response to j-th variable in k-th profile among pure types of that profile must be at least 20% higher than the observed marginal likelihood [28,29]. Risk factors coexisted in the current study when there were at least two risk factors for CVD in the generated profile [20].…”

“…Thus, it is essential assessing CVD risk factors at this developmental stage, by taking into consideration their coexistence, rather than approaching them in separate. Grouped patterns of health-related risk behaviors often appear in adolescence [17][18][19][20] and the coexistence of these risk factors, mainly for CVD, can increase the number of unfavorable outcomes [21]. Thus, it is necessary conducting analyses focusing on the correlation between these factors to enable performing more effective interventions based on multiple components.…”

Early-life maternal attachment and risky health behaviours in adolescence: findings from the United Kingdom Millennium Cohort Study

“…The majority of individual risky behaviours were significantly associated with each other, supporting recommendations from Hale and Viner (2016) and a systematic review by Meader et al (2016) to target MRBs concurrently [ 6 , 8 ]. Whitaker et al (2021) found that substance use such as alcohol consumption, smoking and illegal drugs clustered in unhealthy adolescents, while risky sexual activity and gambling typically occurred in isolation [ 42 ]. By contrast, this study finds reduced odds in alcohol consumption with vaping and gambling, suggesting that adolescents who drink may not engage in other risky behaviours.…”