Health risk behavior among chronically ill adolescents: a systematic review of assessment tools

Abstract

BackgroundAdolescents living with chronic illnesses engage in health risk behaviors (HRB) which pose challenges for optimizing care and management of their ill health. Frequent monitoring of HRB is recommended, however little is known about which are the most useful tools to detect HRB among chronically ill adolescents.AimsThis systematic review was conducted to address important knowledge gaps on the assessment of HRB among chronically ill adolescents. Its specific aims were to: identify HRB assessment tools, the geographical location of the studies, their means of administration, the psychometric properties of the tools and the commonest forms of HRB assessed among adolescents living with chronic illnesses globally.MethodsWe searched in four bibliographic databases of PubMed, Embase, PsycINFO and Applied Social Sciences Index and Abstracts for empirical studies published until April 2017 on HRB among chronically ill adolescents aged 10–17 years.ResultsThis review indicates a major dearth of research on HRB among chronically ill adolescents especially in low income settings. The Youth Risk Behavior Surveillance System and Health Behavior in School-aged Children were the commonest HRB assessment tools. Only 21% of the eligible studies reported psychometric properties of the HRB tools or items. Internal consistency was good and varied from 0.73 to 0.98 whereas test–retest reliability varied from unacceptable (0.58) to good (0.85). Numerous methods of tool administration were also identified. Alcohol, tobacco and other drug use and physical inactivity are the commonest forms of HRB assessed.ConclusionEvidence on the suitability of the majority of the HRB assessment tools has so far been documented in high income settings where most of them have been developed. The utility of such tools in low resource settings is often hampered by the cultural and contextual variations across regions. The psychometric qualities were good but only reported in a minority of studies from high income settings. This result points to the need for more resources and capacity building for tool adaptation and validation, so as to enhance research on HRB among chronically ill adolescents in low resource settings.

A contextually relevant approach to assessing health risk behavior in a rural sub-Saharan Africa setting: the Kilifi health risk behavior questionnaire

“…A systematic review of published literature on HRB tools commonly utilized among adolescents was conducted to identify the etic aspects of tool assembly such as the commonly utilized HRB tools or sources of items on HRB assessment of adolescents, their psychometric properties, and the common means of HRB tool administration [ 10 ]. We also conducted 11 focus group discussions (FGDs) with 78 adolescents (10–19 years); and consultations with 7 young adults (20–30 years) and 10 local stakeholders who work extensively on adolescent issues for example clinicians, teachers, and employees of community based organizations based in Kilifi County.…”

“…A list of items identified in the systematic review and generated from consultations during the qualitative data collection (see prior section) was prepared. The items were mainly borrowed (with some modification to suit context) from the Youth Risk Behavior Surveillance System (YRBSS) [ 26 ] which had been identified as the most commonly utilized HRB assessment tool from the systematic review [ 10 ].…”

“…Understanding HRB of adolescents especially from low resource settings such as sub-Saharan Africa (SSA) is partly hindered by the lack of culturally appropriate measures of HRB, considering that majority of the available HRB tools have been developed and utilized in high income settings [ 10 ]. In Kenya, which is also the setting for this current study, there is a growing body of research on adolescents’ HRB [ 11 – 17 ].…”

Positive health behaviours Polish and Ukrainian medical students in the context of chronic diseases

“…W Polsce wśród nastolatków w wieku 17 lat choroby przewlekłe i długotrwałe problemy zdrowotne występowały u 22,4% osób, a 14,1% przyjmowało z tego powodu leki (17), w przeciętnej populacji odsetek ten wynosił w grupie wieku 15-19 lat -23,5%; 20-29 lat -28,0% (18). Wyniki badań wskazują, że wśród nastolatków z chorobami przewlekłymi występuje wiele niedostatków zachowań prozdrowotnych oraz wiele zachowań ryzykownych (19,20), co może niekorzystnie wpływać na ich leczenie, samopoczucie i funkcjonowanie w codziennym życiu. Dane te były inspiracją do sprawdzenia, czy u młodych ludzi z chorobami przewlekłymi, którzy posiadają dużą wiedzę z nauk przyrodniczych i rozpoczęli studia na kierunkach medycznych występuje również wiele nieprawidłowości w zakresie prozdrowotnego stylu życia.…”

“…In Poland, among teenagers aged 17 years chronic diseases and longlasting health conditions occur in 22.4% persons and 14.1% take medication as a result (17), while in the average population this percentage is 23.5% in the 15-19 age group and 28.0% in the age group 20-29 years (18). Study results indicate that numerous deficiencies in positive health behaviours and numerous risky behaviours occur among teenagers with chronic diseases (19,20), which may have a negative effect on their treatment, wellbeing and everyday functioning. These data served as an inspiration to investigate whether among young people with chronic diseases who have a lot of knowledge about science and began their medical studies there are as many deficiencies in terms of a health promoting lifestyle.…”