Can We Reverse this Trend? Exploring Health and Risk Behaviours of Grade 12 Cohorts of Ontario Students from 2013–2019
Abstract
:1. Introduction
2. Materials and Methods
2.1. Sample Selection
2.2. Measures
2.2.1. Movement Behaviours
2.2.2. Dietary Behaviours
2.2.3. Substance Use
2.3. Analysis
3. Results
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
- Leatherdale, S.T.; Rynard, V. A Cross-Sectional Examination of Modifiable Risk Factors for Chronic Disease among a Nationally Representative Sample of Youth: Are Canadian Students Graduating High School with a Failing Grade for Health? BMC Public Health 2013, 13, 569. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Williams, G.C.; Battista, K.; Leatherdale, S.T. An Examination of How Age of Onset for Alcohol, Cannabis, and Tobacco Are Associated with Physical Activity, Screen Time and BMI as Students Are Preparing to Graduate from High School. Prev. Med. Rep. 2019, 15, 100956. [Google Scholar] [CrossRef] [PubMed]
- Tremblay, M.S.; Carson, V.; Chaput, J.-P.; Gorber, S.C.; Dinh, T.; Duggan, M.; Faulkner, G.; Gray, C.E.; Gruber, R.; Janson, K.; et al. Canadian 24-Hour Movement Guidelines for Children and Youth: An Integration of Physical Activity, Sedentary Behaviour, and Sleep. Appl. Physiol. Nutr. Metab. 2016, 41, S311–S327. [Google Scholar] [CrossRef]
- Katamay, S.W.; Esslinger, K.A.; Vigneault, M.; Johnston, J.L.; Junkins, B.A.; Robbins, L.G.; Sirois, I.V.; Jones-McLean, E.M.; Kennedy, A.F.; Bush, M.A.A.; et al. Eating Well with Canada’s Food Guide (2007): Development of the food intake pattern. Nutr. Rev. 2007, 65, 155–166. [Google Scholar] [CrossRef]
- Butt, P.; Beirness, D.; Gliksman, L.; Paradis, C.; Stockwell, T. Alcohol and Health in Canada: A Summary of Evidence and Guidelines for Low-Risk Drinking; Canadian Centre on Sustance Abuse: Ottawa, ON, Canada, 2011; p. 66. [Google Scholar]
- Fischer, B.; Russell, C.; Sabioni, P.; van den Brink, W.; Le Foll, B.; Hall, W.; Rehm, J.; Room, R. Lower-Risk Cannabis Use Guidelines: A Comprehensive Update of Evidence and Recommendations. Am. J. Public Health 2017, 107, e1–e12. [Google Scholar] [CrossRef]
- World Health Organization. WHO Guidelines on Physical Activity and Sedentary Behaviour: At a Glance; World Health Organization: Geneva, Switzerland, 2020; p. 24. [Google Scholar]
- Durkee, T.; Carli, V.; Floderus, B.; Wasserman, C.; Sarchiapone, M.; Apter, A.; Balazs, J.A.; Bobes, J.; Brunner, R.; Corcoran, P.; et al. Pathological Internet Use and Risk-Behaviors among European Adolescents. Int. J. Environ. Res. Public Health 2016, 13, 294. [Google Scholar] [CrossRef] [Green Version]
- Coleman, C.; Wileyto, E.P.; Lenhart, C.M.; Patterson, F. Multiple Health Risk Behaviors in Adolescents: An Examination of Youth Risk Behavior Survey Data. Am. J. Health Educ. 2014, 45, 271–277. [Google Scholar] [CrossRef]
- Leatherdale, S.T. An Examination of the Co-Occurrence of Modifiable Risk Factors Associated with Chronic Disease among Youth in the COMPASS Study. Cancer Causes Control 2015, 26, 519–528. [Google Scholar] [CrossRef]
- Plotnikoff, R.C.; Karunamuni, N.; Spence, J.C.; Storey, K.; Forbes, L.; Raine, K.; Wild, T.C.; McCargar, L. Chronic Disease–Related Lifestyle Risk Factors in a Sample of Canadian Adolescents. J. Adolesc. Health 2009, 44, 606–609. [Google Scholar] [CrossRef] [PubMed]
- Pronk, N.P.; Anderson, L.H.; Crain, A.L.; Martinson, B.C.; O’Connor, P.J.; Sherwood, N.E.; Whitebird, R.R. Meeting Recommendations for Multiple Healthy Lifestyle Factors: Prevalence, Clustering, and Predictors among Adolescent, Adult, and Senior Health Plan Members. Am. J. Prev. Med. 2004, 27, 25–33. [Google Scholar] [CrossRef] [PubMed]
- Kirst, M.; Mecredy, G.; Borland, T.; Chaiton, M. Predictors of Substance Use among Young Adults Transitioning Away from High School: A Narrative Review. Subst. Use Misuse 2014, 49, 1795–1807. [Google Scholar] [CrossRef]
- Helgeson, V.S.; Reynolds, K.A.; Becker, D.; Escobar, O.; Siminerio, L. Relations of Behavioral Autonomy to Health Outcomes Among Emerging Adults With and Without Type 1 Diabetes. J. Pediatr. Psychol. 2014, 39, 1126–1137. [Google Scholar] [CrossRef] [Green Version]
- Hale, D.R.; Viner, R.M. Policy Responses to Multiple Risk Behaviours in Adolescents. J. Public Health 2012, 34, i11–i19. [Google Scholar] [CrossRef] [Green Version]
- Leatherdale, S.T.; Brown, K.S.; Carson, V.; Childs, R.A.; Dubin, J.A.; Elliott, S.J.; Faulkner, G.; Hammond, D.; Manske, S.; Sabiston, C.M.; et al. The COMPASS Study: A Longitudinal Hierarchical Research Platform for Evaluating Natural Experiments Related to Changes in School-Level Programs, Policies and Built Environment Resources. BMC Public Health 2014, 14, 331. [Google Scholar] [CrossRef] [Green Version]
- Thompson-Haile, A.; Leatherdale, S.T. School Board and School Recruitment Procedures; COMPASS Technical Report; University of Waterloo: Waterloo, ON, Canada, 2013; pp. 1–4. [Google Scholar]
- Courser, M.W.; Shamblen, S.R.; Lavrakas, P.J.; Collins, D.; Ditterline, P. The Impact of Active Consent Procedures on Nonresponse and Nonresponse Error in Youth Survey Data: Evidence from a New Experiment. Eval. Rev. 2009, 33, 370–395. [Google Scholar] [CrossRef]
- Pokorny, S.B.; Jason, L.A.; Schoeny, M.E.; Townsend, S.M.; Curie, C.J. Do Participation Rates Change When Active Consent Procedures Replace Passive Consent. Eval. Rev. 2001, 25, 567–580. [Google Scholar] [CrossRef]
- Leatherdale, S.T.; Laxer, R.E. Reliability and Validity of the Weight Status and Dietary Intake Measures in the COMPASS Questionnaire: Are the Self-Reported Measures of Body Mass Index (BMI) and Canada’s Food Guide Servings Robust? Int. J. Behav. Nutr. Phys. Act. 2013, 10, 42. [Google Scholar] [CrossRef] [Green Version]
- Wong, S.L.; Shields, M.; Leatherdale, S.; Malaison, E.; Hammond, D. Assessment of Validity of Self-Reported Smoking Status. Health Rep. 2012, 23, 47–53. [Google Scholar] [PubMed]
- SAS Institute Inc. The SAS System for Windows; SAS Institute Inc.: Cary, NC, USA, 2012. [Google Scholar]
- Anderson, E.; Durstine, J.L. Physical Activity, Exercise, and Chronic Diseases: A Brief Review. Sports Med. Health Sci. 2019, 1, 3–10. [Google Scholar] [CrossRef]
- Dempsey, P.C.; Matthews, C.E.; Dashti, S.G.; Doherty, A.R.; Bergouignan, A.; Van Roekel, E.H.; Dunstan, D.W.; Wareham, N.J.; Yates, T.E.; Wijndaele, K.; et al. Sedentary Behavior and Chronic Disease: Mechanisms and Future Directions. J. Phys. Act. Health 2020, 17, 52–61. [Google Scholar] [CrossRef]
- Neuhouser, M.L. The Importance of Healthy Dietary Patterns in Chronic Disease Prevention. Nutr. Res. 2019, 70, 3–6. [Google Scholar] [CrossRef]
- Wallace, T.C.; Bailey, R.L.; Blumberg, J.B.; Burton-Freeman, B.; Chen, C.-Y.O.; Crowe-White, K.M.; Drewnowski, A.; Hooshmand, S.; Johnson, E.; Lewis, R.; et al. Fruits, Vegetables, and Health: A Comprehensive Narrative, Umbrella Review of the Science and Recommendations for Enhanced Public Policy to Improve Intake. Crit. Rev. Food Sci. Nutr. 2020, 60, 2174–2211. [Google Scholar] [CrossRef] [Green Version]
- Buchan, M.C.; Carson, V.; Faulkner, G.; Qian, W.; Leatherdale, S.T. Factors Associated with Students Meeting Components of Canada’s New 24-Hour Movement Guidelines over Time in the COMPASS Study. Int. J. Environ. Res. Public Health 2020, 17, 5326. [Google Scholar] [CrossRef]
- Farooq, A.; Martin, A.; Janssen, X.; Wilson, M.G.; Gibson, A.-M.; Hughes, A.; Reilly, J.J. Longitudinal Changes in Moderate-to-Vigorous-Intensity Physical Activity in Children and Adolescents: A Systematic Review and Meta-Analysis. Obes. Rev. 2020, 21, e12953. [Google Scholar] [CrossRef] [Green Version]
- Dollman, J.; Ridley, K.; Olds, T.; Lowe, E. Trends in the Duration of School-Day Sleep among 10- to 15-Year-Old South Australians between 1985 and 2004. Acta Paediatr. 2007, 96, 1011–1014. [Google Scholar] [CrossRef]
- Hayley, A.C.; Skogen, J.C.; Øverland, S.; Wold, B.; Williams, L.J.; Kennedy, G.A.; Sivertsen, B. Trajectories and Stability of Self-Reported Short Sleep Duration from Adolescence to Adulthood. J. Sleep Res. 2015, 24, 621–628. [Google Scholar] [CrossRef] [Green Version]
- Patte, K.A.; Qian, W.; Leatherdale, S.T. Sleep Duration Trends and Trajectories among Youth in the COMPASS Study. Sleep Health 2017, 3, 309–316. [Google Scholar] [CrossRef]
- Matricciani, L.; Olds, T.; Petkov, J. In Search of Lost Sleep: Secular Trends in the Sleep Time of School-Aged Children and Adolescents. Sleep Med. Rev. 2012, 16, 203–211. [Google Scholar] [CrossRef]
- Calamaro, C.J.; Mason, T.B.A.; Ratcliffe, S.J. Adolescents Living the 24/7 Lifestyle: Effects of Caffeine and Technology on Sleep Duration and Daytime Functioning. Pediatrics 2009, 123, e1005–e1010. [Google Scholar] [CrossRef] [Green Version]
- Owens, J.; Group, A.S.W.; Adolescence, C.O. Insufficient Sleep in Adolescents and Young Adults: An Update on Causes and Consequences. Pediatrics 2014, 134, e921–e932. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Patte, K.A.; Qian, W.; Leatherdale, S.T. Modifiable Predictors of Insufficient Sleep Durations: A Longitudinal Analysis of Youth in the COMPASS Study. Prev. Med. 2018, 106, 164–170. [Google Scholar] [CrossRef]
- Godos, J.; Grosso, G.; Castellano, S.; Galvano, F.; Caraci, F.; Ferri, R. Association between Diet and Sleep Quality: A Systematic Review. Sleep Med. Rev. 2021, 57, 101430. [Google Scholar] [CrossRef]
- Chaput, J.-P.; Gray, C.E.; Poitras, V.J.; Carson, V.; Gruber, R.; Olds, T.; Weiss, S.K.; Gorber, S.C.; Kho, M.E.; Sampson, M.; et al. Systematic Review of the Relationships between Sleep Duration and Health Indicators in School-Aged Children and Youth. Appl. Physiol. Nutr. Metab. 2016, 41, S266–S282. [Google Scholar] [CrossRef]
- Faulkner, G.; Weatherson, K.; Patte, K.; Qian, W.; Leatherdale, S.T. Are One-Year Changes in Adherence to the 24-Hour Movement Guidelines Associated with Flourishing among Canadian Youth? Prev. Med. 2020, 139, 106179. [Google Scholar] [CrossRef] [PubMed]
- Patte, K.A.; Faulkner, G.; Qian, W.; Duncan, M.; Leatherdale, S.T. Are One-Year Changes in Adherence to the 24-Hour Movement Guidelines Associated with Depressive Symptoms among Youth? BMC Public Health 2020, 20, 793. [Google Scholar] [CrossRef] [PubMed]
- Weatherson, K.; Gierc, M.; Patte, K.; Qian, W.; Leatherdale, S.; Faulkner, G. Complete Mental Health Status and Associations with Physical Activity, Screen Time, and Sleep in Youth. Ment. Health Phys. Act. 2020, 19, 100354. [Google Scholar] [CrossRef]
- Vandendriessche, A.; Ghekiere, A.; Van Cauwenberg, J.; De Clercq, B.; Dhondt, K.; DeSmet, A.; Tynjälä, J.; Verloigne, M.; Deforche, B. Does Sleep Mediate the Association between School Pressure, Physical Activity, Screen Time, and Psychological Symptoms in Early Adolescents? A 12-Country Study. Int. J. Environ. Res. Public Health 2019, 16, 1072. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Semenza, D.C.; Jackson, D.B.; Testa, A.; Meldrum, R.C. Adolescent Sleep Problems and Susceptibility to Peer Influence. Youth Soc. 2020, 1–22. [Google Scholar] [CrossRef]
- Romano, I.; Williams, G.; Butler, A.; Aleyan, S.; Patte, K.A.; Leatherdale, S.T. Psychological and Behavioural Correlates of Cannabis Use among Canadian Secondary School Students: Findings from the COMPASS Study. Can. J. Addict. 2019, 10, 10–21. [Google Scholar] [CrossRef]
- Gariépy, G.; Janssen, I.; Sentenac, M.; Elgar, F.J. School Start Time and Sleep in Canadian Adolescents. J. Sleep Res. 2017, 26, 195–201. [Google Scholar] [CrossRef]
- Patte, K.A.; Qian, W.; Cole, A.G.; Faulkner, G.; Chaput, J.-P.; Carson, V.; Leatherdale, S.T. School Start Time Changes in the COMPASS Study: Associations with Youth Sleep Duration, Physical Activity, and Screen Time. Sleep Med. 2019, 56, 16–22. [Google Scholar] [CrossRef] [Green Version]
- Whitaker, R.C.; Dearth-Wesley, T.; Herman, A.N.; Oakes, J.M.; Owens, J.A. A Quasi-Experimental Study of the Impact of School Start Time Changes on Adolescents’ Mood, Self-Regulation, Safety, and Health. Sleep Health 2019, 5, 466–469. [Google Scholar] [CrossRef]
- Godin, K.M.; Patte, K.A.; Leatherdale, S.T. Examining Predictors of Breakfast Skipping and Breakfast Program Use among Secondary School Students in the COMPASS Study. J. Sch. Health 2018, 88, 150–158. [Google Scholar] [CrossRef]
- Medin, A.C.; Myhre, J.B.; Diep, L.M.; Andersen, L.F. Diet Quality on Days without Breakfast or Lunch—Identifying Targets to Improve Adolescents’ Diet. Appetite 2019, 135, 123–130. [Google Scholar] [CrossRef]
- De Souza, M.R.; Neves, M.E.A.; Souza, A.D.M.; Muraro, A.P.; Pereira, R.A.; Ferreira, M.G.; Rodrigues, P.R.M. Skipping Breakfast Is Associated with the Presence of Cardiometabolic Risk Factors in Adolescents: Study of Cardiovascular Risks in Adolescents—ERICA. Br. J. Nutr. 2020, 1–9. [Google Scholar] [CrossRef]
- Cole, A.G.; Aleyan, S.; Battista, K.; Leatherdale, S.T. Trends in Youth E-Cigarette and Cigarette Use between 2013 and 2019: Insights from Repeat Cross-Sectional Data from the COMPASS Study. Can. J. Public Health 2020, 112, 60–69. [Google Scholar] [CrossRef] [PubMed]
- Dutra, L.M.; Glantz, S.A. E-Cigarettes and National Adolescent Cigarette Use: 2004–2014. Pediatrics 2017, 139, e20162450. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Levy, D.T.; Warner, K.E.; Cummings, K.M.; Hammond, D.; Kuo, C.; Fong, G.T.; Thrasher, J.F.; Goniewicz, M.L.; Borland, R. Examining the Relationship of Vaping to Smoking Initiation among US Youth and Young Adults: A Reality Check. Tob. Control. 2019, 28, 629–635. [Google Scholar] [CrossRef] [Green Version]
- Hammond, D.; Rynard, V.L.; Reid, J.L. Changes in Prevalence of Vaping among Youths in the United States, Canada, and England from 2017 to 2019. JAMA Pediatr. 2020, 174, 797. [Google Scholar] [CrossRef] [PubMed]
- Hammond, D.; Reid, J.L.; Burkhalter, R.; Rynard, V.L. E-Cigarette Marketing Regulations and Youth Vaping: Cross-Sectional Surveys, 2017–2019. Pediatrics 2020, 146, e20194020. [Google Scholar] [CrossRef] [PubMed]
- Grant, C.N.; Bélanger, R.E. Cannabis and Canada’s Children and Youth. Paediatr. Child Health 2017, 22, 98–102. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Delaney-Black, V.; Chiodo, L.M.; Hannigan, J.H.; Greenwald, M.K.; Janisse, J.; Patterson, G.; Huestis, M.A.; Ager, J.; Sokol, R.J. Just Say “I Don’t”: Lack of Concordance between Teen Report and Biological Measures of Drug Use. Pediatrics 2010, 126, 887–893. [Google Scholar] [CrossRef] [PubMed] [Green Version]
Gender | Data Collection Wave | ||||||
---|---|---|---|---|---|---|---|
Wave 1 2013/14 n (%) | Wave 2 2014/15 n (%) | Wave 3 2015/16 n (%) | Wave 4 2016/17 n (%) | Wave 5 2017/18 n (%) | Wave 6 2018/19 n (%) | % Change (Relative) from Wave 1 to 6 | |
Movement behaviours | |||||||
Inadequate physical activity | |||||||
Female | 2744 (62.2) | 2420 (60.9) | 2285 (61.2) | 1991 (59.5) | 2020 (65.9) | 1922 (64.7) | +4.0% |
Male | 2179 (47.4) | 1876 (47.1) | 1755 (44.7) | 1578 (46.2) | 1632 (50.8) | 1490 (48.4) | +2.0% |
Inadequate sleep duration | |||||||
Female | 2777 (62.2) | 2668 (66.2) | 2521 (66.6) | 2373 (69.5) | 2240 (72.5) | 2204 (73.4) | +18.1% |
Male | 2790 (59.5) | 2533 (61.9) | 2574 (63.5) | 2325 (66.2) | 2240 (68.8) | 2176 (69.8) | +17.4% |
Excessive screen-based sedentary time | |||||||
Female | 3800 (85.1) | 3495 (86.7) | 3322 (87.8) | 3000 (87.9) | 2741 (88.7) | 2685 (89.4) | +5.1% |
Male | 4354 (92.8) | 3759 (91.8) | 3713 (91.7) | 3216 (91.5) | 3062 (94.0) | 2924 (93.8) | +1.1% |
Dietary behaviours | |||||||
Inadequate fruit and vegetable consumption | |||||||
Female | 4134 (94.0) | 3779 (95.1) | 3532 (94.7) | 3195 (95.2) | 2923 (95.8) | 2850 (96.3) | +2.4% |
Male | 4348 (95.6) | 3732 (94.7) | 3710 (95.3) | 3228 (95.2) | 3046 (96.7) | 2882 (95.7) | +0.1% |
Do not eat breakfast every school day | |||||||
Female | 2570 (58.2) | 2366 (59.1) | 2295 (61.3) | 2187 (64.7) | 2052 (67.0) | 2040 (68.8) | +18.1% |
Male | 2578 (56.1) | 2224 (55.4) | 2227 (56.5) | 2066 (59.9) | 1937 (60.8) | 1891 (61.8) | +10.3% |
Substance use behaviours | |||||||
Past 30 day tobacco use | |||||||
Female | 797 (17.8) | 724 (17.9) | 677 (17.9) | 593 (17.5) | 493 (16.0) | 415 (13.9) | −22.1% |
Male | 1475 (31.3) | 1240 (30.2) | 1210 (29.7) | 940 (27.0) | 838 (25.9) | 655 (21.1) | −32.5% |
Past 30 day vape use | |||||||
Female | 219 (4.9) | 322 (8.0) | 302 (8.0) | 266 (7.8) | 488 (15.7) | 827 (27.4) | +461.2% |
Male | 517 (11.0) | 616 (15.0) | 694 (17.0) | 541 (15.3) | 918 (27.9) | 1090 (34.6) | +216.4% |
Monthly binge drinking | |||||||
Female | 1467 (32.9) | 1230 (30.5) | 1092 (28.9) | 1023 (29.9) | 804 (25.9) | 773 (25.7) | −21.7% |
Male | 1954 (41.6) | 1599 (39.1) | 1563 (38.6) | 1224 (34.7) | 1080 (33.0) | (952) 30.4 | −26.9% |
Monthly cannabis use | |||||||
Female | 813 (18.4) | 735 (18.5) | 667 (17.9) | 664 (19.6) | 660 (21.5) | 661 (22.2) | +20.5% |
Male | 1299 (28.4) | 1161 (29.1) | 1165 (29.6) | 977 (28.6) | 919 (28.7) | 946 (31.0) | +8.0% |
Risk Behaviour Category and Gender | Data Collection Wave | ANOVA | |||||
---|---|---|---|---|---|---|---|
Wave 1 2013/14 Mean (stdev) | Wave 2 2014/15 Mean (stdev) | Wave 3 2015/16 Mean (stdev) | Wave 4 2016/17 Mean (stdev) | Wave 5 2017/18 Mean (stdev) | Wave 6 2018/19 Mean (stdev) | ||
Overall | 4.4 (1.6) | 4.5 (1.6) | 4.5 (1.6) | 4.5 (1.6) | 4.7 (1.6) | 4.8 (1.6) | F = 51.8, p < 0.001 |
Female | 4.3 (1.5) | 4.4 (1.5) | 4.4 (1.5) | 4.5 (1.5) | 4.6 (1.6) | 4.8 (1.5) | F = 44.2, p < 0.001 |
Male | 4.6 (1.6) | 4.6 (1.7) | 4.6 (1.7) | 4.5 (1.7) | 4.8 (1.7) | 4.8 (1.7) | F = 15.2, p < 0.001 |
Movement behaviours (maximum 3) | 2.0 (0.8) | 2.1 (0.8) | 2.1 (0.8) | 2.1 (0.8) | 2.2 (0.7) | 2.2 (0.7) | F = 57.5, p < 0.001 |
Female | 2.1 (0.8) | 2.1 (0.8) | 2.1 (0.8) | 2.2 (0.8) | 2.3 (0.7) | 2.3 (0.7) | F = 34.5, p < 0.001 |
Male | 2.0 (0.8) | 2.0 (0.8) | 2.0 (0.8) | 2.0 (0.8) | 2.1 (0.8) | 2.1 (0.7) | F = 25.5, p < 0.001 |
Dietary behaviours (maximum 2) | 1.5 (0.6) | 1.5 (0.6) | 1.5 (0.6) | 1.6 (0.6) | 1.6 (0.5) | 1.6 (0.5) | F = 31.9, p < 0.001 |
Female | 1.5 (0.6) | 1.5 (0.6) | 1.5 (0.6) | 1.6 (0.6) | 1.6 (0.5) | 1.6 (0.5) | F = 26.9, p < 0.001 |
Male | 1.5 (0.6) | 1.5 (0.6) | 1.5 (0.6) | 1.5 (0.6) | 1.5 (0.6) | 1.5 (0.6) | F = 9.2, p < 0.001 |
Substance use behaviours (maximum 4) | 0.9 (1.2) | 0.9 (1.2) | 0.9 (1.2) | 0.9 (1.2) | 1.0 (1.3) | 1.0 (1.3) | F = 8.8, p < 0.001 |
Female | 0.7 (1.0) | 0.7 (1.1) | 0.7 (1.1) | 0.7 (1.1) | 0.8 (1.1) | 0.9 (1.2) | F = 10.3, p < 0.001 |
Male | 1.1 (1.3) | 1.1 (1.3) | 1.1 (1.3) | 1.0 (1.3) | 1.1 (1.4) | 1.2 (1.4) | F = 3.5, p < 0.01 |
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Cole, A.G.; Laxer, R.E.; Patte, K.A.; Leatherdale, S.T. Can We Reverse this Trend? Exploring Health and Risk Behaviours of Grade 12 Cohorts of Ontario Students from 2013–2019. Int. J. Environ. Res. Public Health 2021, 18, 3109. https://doi.org/10.3390/ijerph18063109
Cole AG, Laxer RE, Patte KA, Leatherdale ST. Can We Reverse this Trend? Exploring Health and Risk Behaviours of Grade 12 Cohorts of Ontario Students from 2013–2019. International Journal of Environmental Research and Public Health. 2021; 18(6):3109. https://doi.org/10.3390/ijerph18063109
Chicago/Turabian StyleCole, Adam G., Rachel E. Laxer, Karen A. Patte, and Scott T. Leatherdale. 2021. "Can We Reverse this Trend? Exploring Health and Risk Behaviours of Grade 12 Cohorts of Ontario Students from 2013–2019" International Journal of Environmental Research and Public Health 18, no. 6: 3109. https://doi.org/10.3390/ijerph18063109