Original article
Quality of life and health-risk behaviors among adolescents

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Abstract

Purpose: To assess the association between health-risk behaviors and self-perceived quality of life among adolescents

Methods: A sample of 2801 students (957 seventh and eighth graders and 1844 ninth through twelfth graders) completed the Teen Assessment Survey (TAP) and the surveillance module of the Youth Quality of Life Instrument (YQOL-S). TAP responses were used to determine health-risks related to tobacco use, alcohol use, illicit drug use, and high risk sexual behavior. Separate multivariate analyses of variance showed mean differences in contextual and perceptual items of the YQOL-S for each health-risk behavior. Differences among engagers (adolescents who often engage), experimenters (occasionally engage), and abstainers (never engage) in the health-risk behavior were evaluated by gender and junior/senior high school groups.

Results: In general, adolescent abstainers reported higher quality of life (QoL) than engagers and experimenters on YQOL-S items. Adolescents who engaged in multiple risk behaviors scored even lower than those who engaged in only one health-risk behavior. Experimenters tended to rate their QoL more similar to that of abstainers than to that of engagers.

Conclusions: The framework of QoL proved useful in the evaluation of adolescents’ engagement in health-risk behaviors. Additionally, assessing the areas of QoL that differ between the groups may provide information for planning interventions aimed at risk reduction among engagers and experimenters.

Section snippets

Sample

Data were collected from March through May, 1998, as a part of the Teen Assessment Project (TAP). They have been collected biannually since 1994. TAP [31] was developed to help communities identify, prevent, and begin to solve youth problems. It involves administering a questionnaire to local teens about their concerns, behaviors, and perceptions [32]. The community involved in the present study was a rural county in Oregon along with two schools in northern California. The TAP survey was

Demographics

Forty-eight percent of respondents were female; 71% white (not Hispanic); 10% Hispanic; and 19% other ethnic groups (not Hispanic) including 5% Native American (see Table 2). The ethnicity of the sample differs somewhat from the 1999 county census for this age group, which indicated that 94% of the population were white, 8.2% were Hispanic (any race), 4.2% were native Americans, and .9% were black. In the census data, white includes Hispanic, which in part may account for the difference

Discussion

The integrated framework of QoL was used to evaluate aspects of developmental theories of health-risk behavior among adolescents. Specifically, the QoL concept was used to look at differences among adolescent abstainers, experimenters and engagers in health-risk behaviors. Developmental theories of risk-taking behavior suggest that experimentation with health-risk behaviors is typical of adolescence [14]. Behaviors that are considered risky at age 12 years such as tobacco or alcohol use, may be

Acknowledgements

This research was supported by a cooperative agreement with the Centers for Disease Control and Prevention (#U48/CCU009654), and a grant awarded to the Klamath Tribes by the Substance Abuse and Mental Health Services Administration (#1 HD4 SP0770D).

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    1

    Address requests for Youth Quality of Life Instrument to: Donald L. Patrick, University of Washington, Department of Health Services, Box 358852, Seattle, Washington 98195-7660. Email: [email protected].

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