Question

Many teenagers participate in risk behaviors that threaten their current and future health. Substance use, violence, and unprotected sexual intercourse are responsible for much of the mortality and morbidity experienced in adolescence and early adulthood.1 While older adults are vulnerable to illnesses such as heart disease, cancer, and diabetes, adolescents are threatened by homicide, suicide, car accidents, and AIDS — ailments that are behavioral and, therefore, preventable.2 There is growing recognition that teens who engage in risk behaviors often participate in multiple types of behaviors, referred to as clustering or co-occurrence.3 Evidence suggests that adolescent risk behaviors share common underlying causes as well as having unique influences; individual, biological, family, school, and neighborhood factors all influence the types of risks teens take.4 In addition to monitoring adolescent participation in specific behaviors, it is important to focus on the co-occurrence of risk-taking among teens. In this chapter, we present a portrait of multiple risk-taking among teens. Using recent data from the National Longitudinal Study of Adolescent Health (Add Health) and the 1995 National Survey of Adolescent Males (NSAM) [see box 1], we describe the degree to which teens engage in multiple health risk behaviors and contrast it with the extent to which teens participate in positive behaviors such as spending time with parents and being involved in extra-curricular activities. Describing participation in these behaviors is an important part of understanding teens= exposure to health risks and monitoring efforts to reduce those risks Table 1 identifies the 10 health risk behaviors examined in this study: regular tobacco use, regular alcohol use, regular binge drinking, recent marijuana use, recent use of illicit drugs other than marijuana, physical fighting, carrying a weapon at school, suicidal thoughts, non-fatal suicide attempt,7 and unprotected sexual intercourse. Although these 10 behaviors are not an exhaustive list of adolescent health risk, they reflect key areas of risk-taking. Conclusions from this study do not necessarily extend to other types of health risk behaviors. Other studies have explored additional types of risk taking such as dangerous driving, eating disorders, and criminal activity.8 The definitions employed here are designed to be comparable to measures of similar behaviors in other surveys and to reflect a wide range of behaviors that concern researchers and policymakers. The measurement of these behaviors addresses regular or established patterns of risk-taking, not just exploratory behavior, by incorporating indicators of recency and frequency. For example, Aregular tobacco use@ refers to the daily use of cigarettes or chewing tobacco during the last 30 days — not infrequent experimentation with smoking products.9 While there is no clear rule for establishing the minimum recency or frequency for classifying a behavior as regular or patterned10, an effort was made to establish similar frequencies of participation across behaviors to the extent possible with the available. Conclusion This analysis examines the participation in 10 health risk behaviors by students in grades 7 through 12. Nearly half of students do not engage in any of the 10 risk behaviors. One out of four students engage in multiple risk behaviors. Multiple risk-taking increases with age, so that one out of three students in grades 11 and 12 engage in two or more health risk behaviors. Although multiple risk-taking involves the minority of students, its importance to overall risk-taking among adolescents is great. Multiple-risk students are responsible for most risk-taking. For each specific risk behavior, the majority of students involved in it also engage in other risk behaviors as well. Risk-taking among adolescents does not preclude participation in positive behaviors. Most teens, even those engaging in multiple risk behaviors, also engage in positive behaviors. Positive behaviors connect students to a range of adults — parents, ministers, priests or rabbis, coaches, or club advisors — and social institutions. Such connections provide potential points of contact for providing health education to teens.18 Moreover, the emotional quality of these connections may influence teens= well-being and protect them from risk-taking and its negative consequences.

1. What sampling technique was used to draw the sample? How representative of the population is the sample? To whom can the results of this research study be generalized?

2. If you were a school social worker in a middle or high school, and were interested in conducting a similar research study, what type of sampling would you choose? Justify your choice. Would you be better off to conduct a census rather than a sample?

3. Could you use a nonprobability sample to answer the same research question? What would be the benefits and limitations of a nonprobability sampling approach?

4. Discuss the concepts of homogeneity and diversity with regard to the research study's sample and youth health risk and protective behaviors?

Answer 1

Answer:

This research is based in part on data from the Add Health project, a program designed by J. Richard Udry (PI) and Peter Bearman, and funded by grant P01-HD31921 from the National Institute of Child Health and Human Development to the Carolina Population Center, University of North Carolina at Chapel Hill, with cooperative funding participation by the National Cancer Institute; the National Institute of Alcohol Abuse and Alcoholism; the National Institute on Deafness and Other Communication Disorders; the National Institute on Drug Abuse; the National Institute of General Medical Sciences; the National Institute of Mental Health; the National Institute of Nursing Research; the Office of AIDS Research, NIH; the Office of Behavior and Social Science Research, NIH; the Office of the Director, NIH; the Office of Research on Women's Health, NIH; the Office of Population Affairs, DHHS; the National Center for Health Statistics, Centers for Disease Control and Prevention, DHHS; the Office of Minority Health, DHHS; the Office of the Assistant Secretary for Planning and Evaluation, DHHS; and the National Science Foundation. Persons interested in obtaining data files from The National Longitudinal Study of Adolescent Health should contact Jo Jones, Carolina Population Center, 123 West Franklin Street, Chapel Hill, NC, 27516-3997 (email: jo Jones ®unc.edu). The National Survey of Adolescent Males was funded with the support of the National Institute of Child Health and Human Development, with additional support from the Office of Population Affairs, the National Institute of Mental Health and the Centers for Disease Control and Prevention.