Vincent Busch

Clustering of health-related behaviors, health outcomes and demographics in Dutch adolescents: A cross-sectional study

BackgroundRecent studies show several health-related behaviors to cluster in adolescents. This has important implications for public health. Interrelated behaviors have been shown to be most effectively targeted by multimodal interventions addressing wider-ranging improvements in lifestyle instead of via separate interventions targeting individual behaviors. However, few previous studies have taken into account a broad, multi-disciplinary range of health-related behaviors and connected these behavioral patterns to health-related outcomes. This paper presents an analysis of the clustering of a broad range of health-related behaviors with relevant demographic factors and several health-related outcomes in adolescents.MethodsSelf-report questionnaire data were collected from a sample of 2,690 Dutch high school adolescents. Behavioral patterns were deducted via Principal Components Analysis. Subsequently a Two-Step Cluster Analysis was used to identify groups of adolescents with similar behavioral patterns and health-related outcomes.ResultsFour distinct behavioral patterns describe the analyzed individual behaviors: 1- risk-prone behavior, 2- bully behavior, 3- problematic screen time use, and 4- sedentary behavior. Subsequent cluster analysis identified four clusters of adolescents. Multi-problem behavior was associated with problematic physical and psychosocial health outcomes, as opposed to those exerting relatively few unhealthy behaviors. These associations were relatively independent of demographics such as ethnicity, gender and socio-economic status.ConclusionsThe results show that health-related behaviors tend to cluster, indicating that specific behavioral patterns underlie individual health behaviors. In addition, specific patterns of health-related behaviors were associated with specific health outcomes and demographic factors. In general, unhealthy behavior on account of multiple health-related behaviors was associated with both poor psychosocial and physical health. These findings have significant meaning for future public health programs, which should be more tailored with use of such knowledge on behavioral clustering via e.g. Transfer Learning.

The Effects of Adolescent Health-Related Behavior on Academic Performance A Systematic Review of the Longitudinal Evidence

Schools are increasingly involved in efforts to promote health and healthy behavior among their adolescent students, but are healthier students better learners? This synthesis of the empirical, longitudinal literature investigated the effects of the most predominant health-related behaviors—namely, alcohol and marijuana use, smoking, nutrition, physical activity, sexual intercourse, bullying, and screen time use (television, Internet, video games)—on the academic performance of adolescents. Thirty studies dating back to 1992 were retrieved from the medical, psychological, educational, and social science literature. Healthy nutrition and team sports participation were found to have a positive effect on academic performance, whereas the effects of alcohol use, smoking, early sexual intercourse, bullying, and certain screen time behaviors were overall negative. Generally, all relations of health-related behaviors and academic performance were dependent on contextual factors and were often mediated by psychosocial problems, social structures, and demographics. Findings were interpreted with use of sociological theories.

Screen Time Associated with Health Behaviors and Outcomes in Adolescents

OBJECTIVES To study the associations of screen time (Internet / video games / television) with health-related behaviors and outcomes in adolescents. METHODS Regression analyses were performed to assess the associations of screen time with several health-related behaviors and outcomes in 2425 Dutch adolescents. RESULTS Screen time was associated with bullying, being bullied, less physical activity, skipping school, alcohol use and unhealthy eating habits. Compulsive and excessive screen times were associated respectively with several psychosocial problems and being overweight. CONCLUSIONS Screen time was of significant importance to adolescent health. Behavioral interrelatedness caused significant confounding in the studied relations when behaviors were analyzed separately compared to a multi-behavioral approach, which speaks for more multi-behavioral analyses in future studies.

Results of a Multibehavioral Health-Promoting School Pilot Intervention in a Dutch Secondary School

PURPOSE Recent studies increasingly show adolescent health-related behaviors to be interrelated, interacting synergistically and sharing several common determinants. Therefore, research increasingly focuses on studying interventions that target a range of health behaviors simultaneously. This report describes the results of a pilot study of a secondary school-based, health-promoting intervention that simultaneously targets a range of adolescent health behaviors via a whole-school approach. METHODS We collected self-reported behavioral data via an annual online questionnaire to 336 students. We collected data before the intervention implementation and after the interventions first completed, 3-year curriculum cycle on the fourth-grade students (15- to 16-year-olds). We analyzed differences between pre- and postintervention groups. RESULTS Significant behavioral changes were reported for extreme alcohol use, smoking, sedentary time, and bullying behaviors. Certain behaviors were significantly different only in girls: namely, weekly alcohol use, ever having used cannabis, compulsive Internet or computer use score, compulsive gaming score, and recent bully victimization. Differences in several sedentary time behaviors (television watching and Internet or computer use) were significant only in boys. No changes were reported regarding body mass index; physical activity; or the time spent on, or the compulsiveness of, video game playing. In addition, the postintervention group showed significantly fewer psychosocial problems. CONCLUSIONS The intervention successfully changed student health behaviors on many accounts. It remains largely unclear as to what causes the different effects for boys and girls. Further studies regarding multiple health behavior targeting interventions for adolescents are required.

Bidirectional longitudinal associations of perpetration and victimization of peer bullying with psychosocial problems in adolescents: A cross-lagged panel study

Research on school bullying often focuses on the directional path of bullying and/or victimization leading to psychosocial problems, while such one-dimensional views have been shown to be too simplistic. Furthermore, recent research has shown that patterns of bullying at school differ for boys and girls, which makes gender a particularly relevant factor in exploring the causes and consequences of bullying. Therefore, the present study explored the bidirectional, longitudinal associations of bullying and bullying victimization on several psychosocial problems via a longitudinal cross-lagged panel study in 1243 adolescents in the Netherlands, while taking into account potential gender differences. Data were collected in September 2011 and 2012. Results showed that both bullied boys as well as girls reported more conduct problems at follow-up. Both boy and girl bullies reported less pro-social behavior and more peer problems at follow-up, but boys also reported more conduct problems at follow-up, while girls did not. Furthermore, in girls, emotional problems were associated with more victimization at follow-up, while inattention-hyperactivity problems and less pro-social behavior were related to increased chances of being a perpetrator of bully at follow-up. Conversely, in boys, baseline inattention-hyperactivity problems were not associated with being a bully later on, but rather with increased chances of being a bullying victim at later times. These results can help to tailor future anti-bullying interventions at schools.

A Controlled Health Promoting School Study in the Netherlands Effects After 1 and 2 Years of Intervention

Purpose. Many unhealthy behavioral habits often originate in adolescence. In the literature, the school-based whole school approach is stated be the most promising way to promote healthy behavior. Herein, interventions are evidence based and integrated into the curriculum, while embedded in complementary healthy school policies and environment. This study evaluates the effects of such an intervention on Dutch high schools. Methods. Two Dutch high schools and two controls were followed to evaluate the intervention’s effects on health behaviors, body mass index, and psychosocial problems after 1 year (N = 969) and 2 years (N = 605). Outcomes were measured via self-report surveys and analyzed with mixed methods regression analyses. To complement information on intervention effects, structured interviews were held with a representative sample of teachers per intervention school to map their respective whole school approach implementation success. Results. After 2 years, one intervention school showed significant improvements: Body mass index and excessive screen time use were reduced. In the other intervention school, priority targets did not improve. These findings reflected their respective success in intervention implementation, for example, differences in intervention integration and tailoring. Conclusions. This study shows that it is feasible for schools to implement a comprehensive Health Promoting School intervention themselves and that, when successful, effects in terms of improving behaviors and health outcomes are promising. The process evaluation helped understand these findings in context.

Unhealthy Behaviors in Adolescents: Multibehavioral Associations with Psychosocial Problems

BackgroundSeveral unhealthy behaviors are associated with psychosocial health in adolescents. Previous studies have shown that different adolescent health behaviors cluster, and, in order to understand these associations, it is important to investigate the relations between individual behaviors and psychosocial problems.PurposeThis study addressed the research question “Are adolescent health behaviors associated with psychosocial problems, and to what extent do certain health behaviors confound the relations between other health behaviors and psychosocial problems in adolescents?”MethodsSelf-reported questionnaire data on a broad range of health behaviors and demographics were collected from 2,690 high school students in the Netherlands in September 2012.ResultsAfter adjustment for demographic characteristics, nearly all unhealthy behaviors were found to be significantly associated with psychosocial problems. However, after correction for confounding by other behaviors, psychosocial problems were associated with fewer behaviors, namely compulsive internet use and videogame playing, smoking, cannabis use, and being bullied. These associations differed in boys and girls.ConclusionsIn multibehavioral analyses adjusted for behavioral clustering, which can cause considerable interbehavioral confounding, several behaviors were associated with psychosocial problems in adolescents. This approach to behavior analysis provides a better insight into behaviors and psychosocial health, and the specific associations identified can be utilized when designing effective prevention programs, such as health-promoting school interventions.