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Determinants of Risk-Taking Behaviour in Young People: Implications for Innovative Interventions

A special issue of International Journal of Environmental Research and Public Health (ISSN 1660-4601). This special issue belongs to the section "Adolescents".

Deadline for manuscript submissions: closed (31 December 2020) | Viewed by 42737

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Guest Editor
Institute of Health and Nursing Science, Charité—Universitätsmedizin Berlin, 13353 Berlin, Germany
Interests: adolescent risk-taking behaviour; health promotion; student health; health-promoting university; school-based programmes, alcohol and other drugs; prevention; co-creation; social norms theory; game-based learning; virtual reality
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Special Issue Information

Dear Colleagues,

Adolescence is an important period in life where knowledge, skills and practices are shaped that have impact on life prospects and chances. In this developmental phase, the complex interplay of biological, psychological and social changes results in new opportunities, but also in increased vulnerabilities. The focus here is on young people between 10 and 25, because nowadays adolescence tends to start earlier and last longer. In this period, adolescents form their own lifestyle, habits, social relationships and identity. They are also more prone to risk-taking behaviour than during childhood and adulthood and such behaviour often persists for the rest of their life. A multidisciplinary perspective is warranted to understand the complex determinants of adolescent risk-taking behaviour that takes neurobiological, psychological, sociological and economical aspects into account.
Adolescence is also a window of opportunity for intervention. A multidisciplinary perspective is also needed to design innovative programmes that promote positive developments in adolescence. Effective programmes focus on aspects of the environments in which young people grow up, such as legal frameworks, school policies, parental, social and peer influences as well as emotional and social support. Moreover, programmes that support adolescents in managing their emotions and increasing their self-efficacy, self-control and social skills have been shown to have promising effects on several risk-taking behaviours and to promote academic achievement.
This Special Issue will synthesize what is known about the complex determinants of adolescent risk-taking behaviour, with an emphasis on multidisciplinary perspectives taking individual and environmental factors into account. It also aims to collect lessons learned from innovative interventions, with a focus on interventions designed in co-creation with adolescents and those that use both quantitative and qualitative or realist evaluation designs.

Prof. Dr. Christiane Stock
Guest Editor

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Keywords

  • adolescents
  • risk-taking behaviour
  • prevention
  • co-creation
  • intervention
  • alcohol and other drugs

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Published Papers (11 papers)

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Research

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16 pages, 365 KiB  
Article
Health Promoting Schools in Germany. Mapping the Implementation of Holistic Strategies to Tackle NCDs and Promote Health
by Kevin Dadaczynski and Thomas Hering
Int. J. Environ. Res. Public Health 2021, 18(5), 2623; https://doi.org/10.3390/ijerph18052623 - 5 Mar 2021
Cited by 13 | Viewed by 3743
Abstract
Noncommunicable diseases (NCDs) and their underlying risk factors are seen as major public health problems that threaten health and welfare systems worldwide. The holistic and resource oriented Health Promoting School (HPS) approach can serve as an appropriate framework for the prevention and control [...] Read more.
Noncommunicable diseases (NCDs) and their underlying risk factors are seen as major public health problems that threaten health and welfare systems worldwide. The holistic and resource oriented Health Promoting School (HPS) approach can serve as an appropriate framework for the prevention and control of NCDs. The paper aimed to map the implementation of HPS activities in German schools and to examine associations with potential influencing factors. A series of cross-sectional online studies including five federal states and 5006 school principals (40.2% males, 50.8% females) from primary and secondary public schools was conducted from 2013 to 2018. Principal component analysis (PCA) resulted in two factors of HPS implementation (F1: concrete HPS action, F2: capacity building for HPS). Comparing both factors, a lower implementation level could be identified for HPS capacity building with lowest mean values found for regular teacher training and intersectoral collaboration. Multiple binary regression analyses revealed significant associations between low HPS implementation and male gender (OR: 1.36 to 1.42), younger age (OR: 1.47 to 1.90), secondary school (OR: 1.78 to 3.13) and federal state (Lower Saxony = OR: 1.27 to 1.45; Schleswig-Holstein = OR: 1.95 to 2.46). Moreover, low access to resources, decision-latitude and perceived educational benefits were independently associated with both factors of HPS implementation. Based on the results of this study, there is a need to support schools in their capacity building for health (e.g., regular teacher training, cooperation with local health services). Moreover, considering the core mission of schools, more evidence of the educational impact of health promotion and its translation into the language of education is needed for secondary schools in particular. Full article
13 pages, 533 KiB  
Article
What Predicts Adherence to Governmental COVID-19 Measures among Danish Students?
by Gabriele Berg-Beckhoff, Julie Dalgaard Guldager, Pernille Tanggaard Andersen, Christiane Stock and Signe Smith Jervelund
Int. J. Environ. Res. Public Health 2021, 18(4), 1822; https://doi.org/10.3390/ijerph18041822 - 13 Feb 2021
Cited by 25 | Viewed by 4453
Abstract
Knowledge on compliance with governmental recommendations in combating the spread of COVID-19 in different groups is important to target efforts. This study investigated the adherence to the governmental implemented COVID-19 measures and its predictors in Danish university students, a not-at-risk group for COVID-19 [...] Read more.
Knowledge on compliance with governmental recommendations in combating the spread of COVID-19 in different groups is important to target efforts. This study investigated the adherence to the governmental implemented COVID-19 measures and its predictors in Danish university students, a not-at-risk group for COVID-19 mortality and normally characterized by many social contacts. As part of the COVID-19 International Student Wellbeing Study, a survey on socio-demographic situation, study information, living arrangements, lifestyle behaviors, stress, questions about COVID-19 infection and knowledge and concern about COVID-19 infection was sent via email to relevant university students in Denmark in May, 2020 (n = 2.945). Stepwise multiple linear regression analysis was employed. Our results showed that around 60% of the students were not concerned about COVID-19, while 68% reported that they followed governmental measures. The main facilitators for following the recommendations were older age, concern about COVID-19 and depression, while barriers were living in a student hall, being physical active or reporting mental stress. Only 9% of the variation in adhering to governmental recommendations could be explained by the analyzed predictors. Results may inform health communication. Emotionally appealing information rather than knowledge-based information may be more effective in motivating students to follow COVID-19 measures. Full article
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16 pages, 365 KiB  
Article
“Tell Me How Much Your Friends Consume”—Personal, Behavioral, Social, and Attitudinal Factors Associated with Alcohol and Cannabis Use among European School Students
by Stefanie M. Helmer, Gregor Burkhart, João Matias, Christoph Buck, Feline Engling Cardoso and Julian Vicente
Int. J. Environ. Res. Public Health 2021, 18(4), 1684; https://doi.org/10.3390/ijerph18041684 - 10 Feb 2021
Cited by 8 | Viewed by 3044
Abstract
Background: Substance use in European adolescents remains a serious health concern. Assessing what affects adolescents’ substance use is crucial for implementing effective prevention. This study aims to examine alcohol and cannabis use-related behavioral, social, and attitudinal variables that might directly be considered to [...] Read more.
Background: Substance use in European adolescents remains a serious health concern. Assessing what affects adolescents’ substance use is crucial for implementing effective prevention. This study aims to examine alcohol and cannabis use-related behavioral, social, and attitudinal variables that might directly be considered to guide prevention responses for adolescents. Methods: Cross-sectional data of 78,554 15–16-year-old school students from the 2011 European School Survey Project on Alcohol and Other Drugs (ESPAD) from 26 European countries were analyzed. Self-reported drunkenness in the last 30 days and cannabis use in the last 12 months served as dependent variables. To investigate which factors are associated with risky substance use, multivariable logistic regressions were used. Results: 17.7% of respondents reported drunkenness in the last 30 days, and 14.9% used cannabis in the last 12 months. The most important predictor for risky substance use was the perception that most/all of their friends engaged in substance use behavior, followed by lack of parental support, low personal adherence to rules, and low school performance. Conclusion: Interventions addressing the perceived descriptive norms either directly or by changing environmental cues, opportunities, and regulations, as well as effective parenting and academic support may prevent and reduce risky substance use behavior among adolescents. Full article
16 pages, 374 KiB  
Article
Engagement in Health Risk Behaviours before and during the COVID-19 Pandemic in German University Students: Results of a Cross-Sectional Study
by Heide Busse, Christoph Buck, Christiane Stock, Hajo Zeeb, Claudia R. Pischke, Paula Mayara Matos Fialho, Claus Wendt and Stefanie Maria Helmer
Int. J. Environ. Res. Public Health 2021, 18(4), 1410; https://doi.org/10.3390/ijerph18041410 - 3 Feb 2021
Cited by 68 | Viewed by 7193
Abstract
Tobacco and cannabis use, alcohol consumption and inactivity are health risk behaviors (HRB) of crucial importance for health and wellbeing. The impact of the COVID-19 pandemic on university students’ engagement in HRB has yet received limited attention. We investigated whether HRB changed during [...] Read more.
Tobacco and cannabis use, alcohol consumption and inactivity are health risk behaviors (HRB) of crucial importance for health and wellbeing. The impact of the COVID-19 pandemic on university students’ engagement in HRB has yet received limited attention. We investigated whether HRB changed during the COVID-19 pandemic, assessed factors associated with change and profiles of HRB changes in university students. A web-based survey was conducted in May 2020, including 5021 students of four German universities (69% female, the mean age of 24.4 years (SD = 5.1)). Sixty-one percent of students reported consuming alcohol, 45.8% binge drinking, 44% inactivity, 19.4% smoking and 10.8% cannabis use. While smoking and cannabis use remained unchanged during the COVID-19 pandemic, 24.4% reported a decrease in binge drinking while 5.4% reported an increase. Changes to physical activity were most frequently reported, with 30.6% reporting an increase and 19.3% reporting a decrease in vigorous physical activity. Being female, younger age, being bored, not having a trusted person and depressive symptoms were factors associated with a change in HRB. Five substance use behavior profiles were identified, which also remained fairly unchanged. Efforts to promote student health and wellbeing continue to be required, also in times of the COVID-19 pandemic. Full article
19 pages, 990 KiB  
Article
Importance of Mediation against Addictive, Affective-Emotional, and Sexual Behavior in Adolescents. Educational System versus Associations
by Antonio Manuel Barbero-Radío, María Ángeles García-Carpintero Muñoz and José Rafael González-López
Int. J. Environ. Res. Public Health 2021, 18(3), 1249; https://doi.org/10.3390/ijerph18031249 - 30 Jan 2021
Cited by 1 | Viewed by 2691
Abstract
This article analyzes health mediation among equals as an educational strategy against risk behaviors in young people from both the educational and associative systems in Seville (Spain), based on qualitative research, with the aim of assessing and comparing its impact in those areas. [...] Read more.
This article analyzes health mediation among equals as an educational strategy against risk behaviors in young people from both the educational and associative systems in Seville (Spain), based on qualitative research, with the aim of assessing and comparing its impact in those areas. To this end, interviews with 49 professionals and 427 adolescents were conducted in discussion groups. Results acknowledge mediation as individual or group intervention accepted by young people as advice and information on health issues and conflict resolution, but also as a method for data collection in order to obtain a community health diagnosis. The educational system implements this strategy, but in associations it seems to work better, particularly in the psycho-emotional and sexual spheres. Unfortunately, intervention programs are usually discontinuous due to lack of resources and territorial variability. And this is why mediators’ support is highly valued by the target users, with preference for a male figure in the case of boys, and larger predisposition towards a female mediator in girls, except in cases where this agent has a special social relevance. Full article
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20 pages, 769 KiB  
Article
Individual, Familial, and Socio-Environmental Risk Factors of Gang Membership in a Community Sample of Adolescents in Southern Italy
by Dario Bacchini, Mirella Dragone, Concetta Esposito and Gaetana Affuso
Int. J. Environ. Res. Public Health 2020, 17(23), 8791; https://doi.org/10.3390/ijerph17238791 - 26 Nov 2020
Cited by 2 | Viewed by 4174
Abstract
Despite the growing social alarm generated by the recurrent news concerning violent episodes involving youth gangs, systematic research in Italy in this field, especially within a psychological framework, is still limited. Following a social-ecological approach, the present study aimed at investigating the role [...] Read more.
Despite the growing social alarm generated by the recurrent news concerning violent episodes involving youth gangs, systematic research in Italy in this field, especially within a psychological framework, is still limited. Following a social-ecological approach, the present study aimed at investigating the role of self-serving cognitive distortions (CDs), parental rejection, and community violence witnessing in youth gang membership (YGM). Furthermore, we examined the mediating and/or moderating role of YGM in the association between risk factors and involvement in antisocial behaviors (ASBs). A community sample of 817 adolescents attending middle and high schools in a high-risk urban area in Southern Italy (46.9% males; 53% middle school students; Mage = 14.67; SD = 1.65) were involved in the study. One hundred and fifty-seven participants (19.2%) were found to be gang members. Employing counterfactual-based mediation analysis, we found that CDs and community violence witnessing were directly associated with YGM and ASBs. The association between CDs and ASBs was mediated by YGM. Parental rejection was directly related to ASBs but not to YGM. A significant interaction effect between parental rejection and YGM was found, revealing that high levels of parental rejection, along with being a gang member, amplified the involvement in ASBs. These findings pointed out that distorted moral cognitions and the experience of violence witnessing within the community may represent a fertile ground for gang involvement. Both individual and contextual factors should be considered in order to implement interventions aimed to prevent adolescents’ risk of joining a gang. Full article
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13 pages, 367 KiB  
Article
A Social Ecological Approach to Hazardous Alcohol Use among Flemish Higher Education Students
by Robert Tholen, Edwin Wouters, Koen Ponnet, Sara De Bruyn and Guido Van Hal
Int. J. Environ. Res. Public Health 2020, 17(21), 8288; https://doi.org/10.3390/ijerph17218288 - 9 Nov 2020
Cited by 3 | Viewed by 3407
Abstract
Hazardous use of alcohol is a global public health concern. Statistics suggest that this is particularly common in Europe, and among higher education students. Although it has been established that various factors—ranging from the individual to the overarching societal level—are associated with misuse [...] Read more.
Hazardous use of alcohol is a global public health concern. Statistics suggest that this is particularly common in Europe, and among higher education students. Although it has been established that various factors—ranging from the individual to the overarching societal level—are associated with misuse of alcohol, few studies take multiple levels of influence into account simultaneously. The current study, therefore, used a social ecological framework to explore associations between variables from multiple levels of influence and the hazardous use of alcohol. Data were obtained from a representative sample of higher education students from Flanders, Belgium (n = 21,854), and explored using hierarchical multiple regression analyses. The results demonstrated that the individual, interpersonal, organizational, community, and policy levels, were all associated with risky alcohol consumption. When devising interventions, policymakers should, therefore, take into consideration that variables from multiple levels of influence are at play. Students’ capacities to change or maintain their alcohol consumption behaviors may be undermined if social settings, overarching environments, social norms, and policies are not conducive to their motivations and social expectations. Full article
14 pages, 916 KiB  
Article
User Experiences with a Virtual Alcohol Prevention Simulation for Danish Adolescents
by Julie Dalgaard Guldager, Satayesh Lavasani Kjær, Patricia Lyk, Timo Dietrich, Sharyn Rundle-Thiele, Gunver Majgaard and Christiane Stock
Int. J. Environ. Res. Public Health 2020, 17(19), 6945; https://doi.org/10.3390/ijerph17196945 - 23 Sep 2020
Cited by 13 | Viewed by 3170
Abstract
This pilot study explores 31 Danish adolescent user experiences for the newly developed virtual party simulation app—Virtual Reality (VR) FestLab. The main objective of this study was to investigate usability for VR FestLab, which aims to improve alcohol resistance skills for Danish adolescents. [...] Read more.
This pilot study explores 31 Danish adolescent user experiences for the newly developed virtual party simulation app—Virtual Reality (VR) FestLab. The main objective of this study was to investigate usability for VR FestLab, which aims to improve alcohol resistance skills for Danish adolescents. A secondary objective was to understand gameplay experiences. The study is a mixed method study that draws on questionnaire data (n = 31) and focus group interviews (n = 10) of boarding school students participating in the pilot study. Descriptive statistics were used to examine quantitative data, and qualitative data were analyzed thematically. Quantitative findings indicated that gameplay experiences of the VR simulation were positive, and all User Experience Questionnaire (UEQ) items were answered positively. The focus group interviews showed that adolescents found the simulation to be realistic. Feedback indicated that the group pressure experienced in the simulation was regarded to be less than in real life. Adolescents had varying approaches to playing the VR simulation, they thought the quality of the simulation was good, and only a few users experienced technical difficulties. These initial study findings indicate that VR FestLab is a promising tool for the prevention of alcohol use among adolescents. Full article
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14 pages, 350 KiB  
Article
Aggressive Behaviors among 15–16-Year-Old Romanian High School Students: Results from Two Consecutive Surveys Related to Alcohol and Other Drug Use at the European Level
by Adina Bucur, Sorin Ursoniu, Constantin Caraion-Buzdea, Virgil Ciobanu, Silvia Florescu and Cristian Vladescu
Int. J. Environ. Res. Public Health 2020, 17(10), 3670; https://doi.org/10.3390/ijerph17103670 - 22 May 2020
Cited by 8 | Viewed by 3355
Abstract
The aim of this paper is to examine aggressive behaviors among Romanian high school students between 15 and 16 years old, to compare data in two national representative samples and to identify factors associated with physical fighting. This study investigates the association of [...] Read more.
The aim of this paper is to examine aggressive behaviors among Romanian high school students between 15 and 16 years old, to compare data in two national representative samples and to identify factors associated with physical fighting. This study investigates the association of selected factors (social, school performance and substance use) with physical fighting. A total of 2289 Romanian students were included in the 2007 database and 2770 in the 2011 database. This study revealed that 35.87% of the teenagers have taken part in a physical fight during the previous 12 months, as compared with the European average of 31.5%. Romania has the highest prevalence of violent behavior by participating in a group bruising of an individual in both surveys, 2007 and 2011. A logistic regression analysis performed for the 2011 study revealed the following factors associated with physical fighting: binge drinking during the previous 30 days, male gender, serious problems with friends, parent(s) who do not know where and with whom the adolescents spend their evenings, poor parental caring, low school grades, and high truancy. A decrease in almost all aggressive behaviors was noticed in 2011, compared to 2007. These findings may be useful to support and guide policy makers regarding improvement and implementation of strategies to further prevent aggressive behaviors in teenagers. Full article
13 pages, 331 KiB  
Article
Youth Experiences with Social Norms Feedback: Qualitative Findings from The Drug Prevention Trial the GOOD Life
by Christiane Stock, Satayesh Lavasani Kjær, Birthe Marie Rasmussen and Lotte Vallentin-Holbech
Int. J. Environ. Res. Public Health 2020, 17(9), 3200; https://doi.org/10.3390/ijerph17093200 - 4 May 2020
Cited by 4 | Viewed by 2550
Abstract
Background: Normative feedback is an intervention strategy commonly used in drug prevention programmes. This study collected process evaluation data about how programme recipients engage with social norms (SN) feedback in The GOOD Life intervention and how they experience it. Methods: Eight focus [...] Read more.
Background: Normative feedback is an intervention strategy commonly used in drug prevention programmes. This study collected process evaluation data about how programme recipients engage with social norms (SN) feedback in The GOOD Life intervention and how they experience it. Methods: Eight focus group interviews were conducted with a total of 44 adolescents (pupils aged 14–16 years) who have participated in the social-norms-based intervention The GOOD Life. The interviews focused on three topics: (1) interest in and impact of the intervention; (2) perception of the intervention elements; and (3) suggestions for improvement of The GOOD Life. They were transcribed and analysed with content analysis. Results: The analysis revealed that The GOOD Life motivated pupils to re-evaluate their own drug use behaviour and overall met their interest regarding receiving engaging and non-moral forms of drug prevention programmes. While pupils perceived the normative feedback session in the classroom and the posters with SN messages as positive, stimulating and surprising, the web-based application with SN feedback was rarely used and less positively evaluated. Anonymity and confidentiality were regarded as essential to provide honest answers in the poll. The pupils suggested even more variety in ways to engage them and to use more gaming elements. Conclusions: SN feedback was well perceived by adolescents. The intervention met their interest and needs and was able to achieve the intended impact of challenging norm perceptions. Anonymity and confidentiality are key in order to build trust and engage adolescents in the intervention. Full article

Review

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14 pages, 949 KiB  
Review
The Effects of Exercise on BDNF Levels in Adolescents: A Systematic Review with Meta-Analysis
by Kesley Pablo Morais de Azevedo, Victor Hugo de Oliveira, Gidyenne Christine Bandeira Silva de Medeiros, Ádala Nayana de Sousa Mata, Daniel Ángel García, Daniel Guillén Martínez, José Carlos Leitão, Maria Irany Knackfuss and Grasiela Piuvezam
Int. J. Environ. Res. Public Health 2020, 17(17), 6056; https://doi.org/10.3390/ijerph17176056 - 20 Aug 2020
Cited by 17 | Viewed by 3845
Abstract
The aim of this study was to analyze the evidence available in the literature about the effects of exercise on brain-derived neurotrophic factor levels in adolescents. The literature searches were conducted in PubMed, Embase, Scopus, ScienceDirect, Web of Science, SportDiscus, the Cochrane Central [...] Read more.
The aim of this study was to analyze the evidence available in the literature about the effects of exercise on brain-derived neurotrophic factor levels in adolescents. The literature searches were conducted in PubMed, Embase, Scopus, ScienceDirect, Web of Science, SportDiscus, the Cochrane Central Register of Controlled Trials (CENTRAL) and CINAHL. Randomized controlled trials and non-randomized controlled trials performed with adolescents (10–19 years) who underwent different exercise programs and who evaluated BDNF levels before and after the intervention were included. We included six studies, four RCTs and two non-RCTs in the systematic review with a total of 407 adolescents. In two randomized trials and one non-RCT, the intervention groups showed significant improvements in BDNF levels compared with the control group. The results presented in the meta-analysis indicate that despite the positive effect in favor of the intervention, there were no significant differences (standardized mean difference 0.28 ng/mL, 95% confidence interval −0.28 to 0.85; p = 0.32, I² = 0%). The results presented in our review indicate that aerobic exercise programs practiced in moderate- or high-intensity are promising strategies to increase BDNF levels in adolescents. However, further studies are required to support this finding. Full article
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