Individual and social determinants of multiple chronic disease behavioral risk factors among youth

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Abstract

Background

Behavioral risk factors are known to co-occur among youth, and to increase risks of chronic diseases morbidity and mortality later in life. However, little is known about determinants of multiple chronic disease behavioral risk factors, particularly among youth. Previous studies have been cross-sectional and carried out without a sound theoretical framework.

Methods

Using longitudinal data (n = 1135) from Cycle 4 (2000-2001), Cycle 5 (2002-2003) and Cycle 6 (2004-2005) of the National Longitudinal Survey of Children and Youth, a nationally representative sample of Canadian children who are followed biennially, the present study examines the influence of a set of conceptually-related individual/social distal variables (variables situated at an intermediate distance from behaviors), and individual/social ultimate variables (variables situated at an utmost distance from behaviors) on the rate of occurrence of multiple behavioral risk factors (physical inactivity, sedentary behavior, tobacco smoking, alcohol drinking, and high body mass index) in a sample of children aged 10-11 years at baseline. Multiple behavioral risk factors were assessed using a multiple risk factor score. All statistical analyses were performed using SAS, version 9.1, and SUDAAN, version 9.01.

Results

Multivariate longitudinal Poisson models showed that social distal variables including parental/peer smoking and peer drinking (Log-likelihood ratio (LLR) = 187.86, degrees of freedom (DF) = 8, p < .001), as well as individual distal variables including low self-esteem (LLR = 76.94, DF = 4, p < .001) increased the rate of occurrence of multiple behavioral risk factors. Individual ultimate variables including age, sex, and anxiety (LLR = 9.34, DF = 3, p < .05), as well as social ultimate variables including family socioeconomic status, and family structure (LLR = 10.93, DF = 5, p = .05) contributed minimally to the rate of co-occurrence of behavioral risk factors.

Conclusions

The results suggest targeting individual/social distal variables in prevention programs of multiple chronic disease behavioral risk factors among youth.

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Most cited references 46

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Longitudinal data analysis for discrete and continuous outcomes.

K Liang, S Zeger (1986)

Longitudinal data sets are comprised of repeated observations of an outcome and a set of covariates for each of many subjects. One objective of statistical analysis is to describe the marginal expectation of the outcome variable as a function of the covariates while accounting for the correlation among the repeated observations for a given subject. This paper proposes a unifying approach to such analysis for a variety of discrete and continuous outcomes. A class of generalized estimating equations (GEEs) for the regression parameters is proposed. The equations are extensions of those used in quasi-likelihood (Wedderburn, 1974, Biometrika 61, 439-447) methods. The GEEs have solutions which are consistent and asymptotically Gaussian even when the time dependence is misspecified as we often expect. A consistent variance estimate is presented. We illustrate the use of the GEE approach with longitudinal data from a study of the effect of mothers' stress on children's morbidity.

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Age at first alcohol use: a risk factor for the development of alcohol disorders.

D DeWit, E M Adlaf, D R Offord … (2000)

This study aimed to describe the natural course of DSM-III-R alcohol disorders as a function of age at first alcohol use and to investigate the influence of early use as a risk factor for progression to the development of alcohol disorders, exclusive of the effect of confounding influences. Data were obtained from a community sample (N=5,856) of lifetime drinkers participating in the 1990-1991 Mental Health Supplement of the Ontario Health Survey. Survival analyses revealed a rapid progression to alcohol-related harm among those who reported having their first drink at ages 11-14. After 10 years, 13.5% of the subjects who began to drink at ages 11 and 12 met the criteria for a diagnosis of alcohol abuse, and 15.9% had a diagnosis of dependence. Rates for subjects who began to drink at ages 13 and 14 were 13.7% and 9.0%, respectively. In contrast, rates for those who started drinking at ages 19 and older were 2.0% and 1.0%. Unexpectedly, a delay in progression to harm was observed for the youngest drinkers (ages 10 and under). Hazard regression analyses revealed a nonlinear effect of age at first alcohol use, marked by an elevated risk of developing disorders among subjects first using alcohol at ages 11-14. First use of alcohol at ages 11-14 greatly heightens the risk of progression to the development of alcohol disorders and therefore is a reasonable target for intervention strategies that seek to delay first use as a means of averting problems later in life.

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A maximal multistage 20-m shuttle run test to predict VO2 max.

L Leger, Christopher Lambert (1981)

In order to validate a maximal multistage 20-m shuttle run test for the prediction of VO2 max, 91 adults (32 females and 59 males, aged 27.3 +/- 9.2 and 24.8 +/- 5.5 year respectively and with mean VO2 max (+/- SD) of 39.3 +/- 8.3 and 51.6 +/- 7.8 ml . kg-1 . min-1 respectively) performed the test and had VO2 max estimated by the retroextrapolation method (extrapolation to time zero of recovery of the exponential least squares regression of the first four 20-s recovery VO2 values). Starting at 8 km . h-1 and increasing by 0.5 km . h-1 every 2 min, the 20-m shuttle run test enabled prediction of the VO2 max (y, ml . kg-1 . min-1) from the maximal speed (x, km . h-1) by means of the following regression equation: y = 5.857x - 19.458; r = 0.84 and SEE = 5.4. Later, the multistage protocol was slightly modified to its final version, in which the test started at stage 7 Met and continued with a 1 Met (3.5 ml O2 . kg-1 . min-1) increment every 2 min. Twenty-five of the 91 subjects performed the 20-m shuttle test twice, once on a hard, low-friction surface (vinyl-asbestos tiles) and another time on a rubber floor, as well as a walking maximal multistage test on an inclined treadmill. There was no difference between the means of these tests or between the slopes of the VO2max - maximal speed regressions for the two types of surfaces. The 20-m shuttle run test and another maximal multistage field test involving continuous track running gave comparable results (r = 0.92, SEE = 2.6 ml O2 . kg-1 . min-1, n = 70). Finally, test and retest of the 20-m shuttle run test also yielded comparable results (r = 0.975, SEE = 2.0 ml O2 . kg-1 . min-1, n = 50). It is concluded that the 20-m shuttle run test is valid and reliable test for the prediction of the VO2 max of male and female adults, individually or in groups, on most gymnasium surfaces.

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Author and article information

Journal

Journal ID (nlm-ta): BMC Public Health

Journal ID (iso-abbrev): BMC Public Health

Title: BMC Public Health

Publisher: BioMed Central

ISSN (Electronic): 1471-2458

Publication date Collection: 2012

Publication date (Electronic): 22 March 2012

Volume: 12

Page: 224

Affiliations

[1 ]Department of Biostatistics and Epidemiology, College of Public Health, East Tennessee State University, Johnson City, Tennessee, USA

[2 ]Department of Epidemiology, Biostatistics and Occupational Health, Faculty of Medicine, McGill University, Montreal, Quebec, Canada

[3 ]Research Institute of the McGill University Health Centre, Montreal, Quebec, Canada

Article

Publisher ID: 1471-2458-12-224

DOI: 10.1186/1471-2458-12-224

PMC ID: 3331803

PubMed ID: 22439966

SO-VID: e9c24752-3eb3-4f78-a01a-9ef347865420

License:

This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Individual and social determinants of multiple chronic disease behavioral risk factors among youth

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Abstract

Background

Methods

Results

Conclusions

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Global Health Next Generation Network

Most cited references 46

Longitudinal data analysis for discrete and continuous outcomes.

Age at first alcohol use: a risk factor for the development of alcohol disorders.

A maximal multistage 20-m shuttle run test to predict VO2 max.

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