Clustering of multiple health risk behaviours and association with socio-demographic characteristics and psychological distress among adolescents in Ghana: A latent class analysis

Abstract

This study examined the prevalence of multiple health risk behaviours, the clustering patterns of health risk behaviours, the association between socio-demographic characteristics, psychological distress and clusters and the relationship between number of health risk behaviours and psychological distress among adolescents in Ghana. Participants were senior high school (SHS) students aged 11–19 years who participated in the 2012 Global School-based Students Health Survey (n = 1763). Five health risk behaviours (smoking tobacco, inadequate fruit intake, inadequate vegetable intake, alcohol intake and physical inactivity) were measured. Participants were classified to be at risk if they indicated they smoked tobacco, did not eat fruit ≥ 2 times a day and vegetables ≥ 5 a day, drank alcohol during the past 30 days and did not engage in physical activity for ≥ 60 min per day during the past 7 days. Latent class analysis and latent regression were used to identify the clusters and factors associated with the clusters respectively. Multiple logistic regression was used to determine the relationship between number of health risk behaviours and psychological distress. The prevalence of multiple health risk behaviours (2 or more) was 94.8%. Two clusters emerged: Cluster 1 (“Poor nutrition, inactive, low substance use cluster ”; 91%); Cluster 2 (“High Risk Cluster”; 9%). Using cluster 1 as a reference group, adolescents in the 11–15 years category had lower odds of belonging to cluster 2 (OR = 0.21 CI 0.05–0.91, ρ = 0.036) while those experiencing symptoms of depression had higher odds of belonging to cluster 2 (OR = 2.45 CI 1.45–4.14, ρ = 0.001). No significant relationship was found between number of health risk behaviour and psychological distress. Health risk behaviours cluster among adolescents with age and depression associated with the identified clusters. Early interventions that target these clusters are needed at the individual, school and community level to mitigate the burden of non-communicable diseases.

A Latent Class Analysis of Health Lifestyles in Relation to Suicidality among Adolescents in Mauritius

“…These smoking and alcohol behaviors are known as predisposing factors for injury and violence [ 51 ]. This last profile also showed the concomitant use of tobacco and alcohol, substances frequently used together [ 7 , 19 ]. The adolescents in profile 3 were also more susceptible to anxiety and loneliness.…”

“…The sociodemographic characteristics were age (11–15 years or 15 years and over [ 7 , 38 ]), gender (male or female), level of education (grades 8/9, grade 10, and grades 11/12) and socioeconomic status. Since the WHO’s data do not directly provide socioeconomic status, it was measured in terms of hunger over the past 30 days, as in the case of other similar studies [ 8 , 39 ].…”

“…The proportion of multiple behaviors was calculated. Each indicator was coded as follows: 0 = “no risk” and 1 = “presence of a risk”; the sum of the eight factors was calculated to obtain a value associated with multiple risks [ 7 ], with this value ranging from 0 (no risk) to 8 (presence of all risks).…”

“…Moreover, many studies have shown that the transition from childhood to adolescence is characterized by the discovery and first use of alcohol and tobacco and other health risk factors. This period is also marked by other risky behaviors such as physical inactivity [ 6 , 7 ]. These factors may be associated with various future chronic diseases [ 8 ], a significant problem for our societies today.…”

Associations between mental health problems and risky oral and sexual behaviour in adolescents in a sub-urban community in Southwest Nigeria

“…Prior studies had indicated that adolescents in developed countries have reported high prevalence of multiple health risk behaviours among adolescents [ 44 , 45 ]. The study conducted in Ghana [ 46 ], a country in the same sub-region as Nigeria, indicates that a high prevalence of multiple health risk behaviours among adolescents was also observed in a low-middle income country. This study findings seem to suggest that there may be a clustering of high-risk behaviours associated with psychological distress in adolescents in Nigeria also.…”