Alcohol Drinking Among Kosovar Adolescents: An Examination of Gender-Specific Sociodemographic, Sport, and Familial Factors Associated With Harmful Drinking

Association of sports practice aspects with health risk behaviors in adolescents: a systematic review and meta-analysis

OBJECTIVE

To conduct a systematic review and meta-analysis to verify the association of aspects of sports practice with health risk behaviors in adolescents.

DATA SOURCE

A systematic search was conducted of electronic manuscripts from the United States National Library of Medicine (PubMed)/ Medical Literature Analysis and Retrieval System Online (MEDLINE), Web of Science, Science Direct, and Scientific Electronic Library Online (SciELO) published from January 2015 to December 2022. Studies examining the association between sport and health risk behaviors in adolescents aged 11 to 19 years were included. This study was registered in the International Prospective Register of Systematic Reviews (PROSPERO) under number CRD42023392053.

DATA SYNTHESIS

In total, 22 studies fulfilled the inclusion criteria. The association of sports practice with sedentary behavior showed odds ratio (OR) values ranging from 0,61 to 0,92, tobacco use from 0,35 to 0,73, illicit drugs from 0,40 to 0,91, and reduced inadequate sleep on weekdays of 0.57 (95% confidence interval - 95%CI 0.52-0.63) and weekends 0.79 (95%CI 0.69-0.89). In the meta-analysis, sports practice was significantly associated with alcohol consumption for boys (OR 1,36; CI95% 1,09-1,70), and was inversely associated with tobacco use for boys and girls (OR 0,59; CI95% 0,56-0,61).

CONCLUSIONS

Adolescents who practice sports tend to have lower occurrences of sedentary behavior, tobacco and illicit drug use, and adequate amounts of sleep; and, in the meta-analysis, boys present higher values for alcohol consumption and boys and girls present lower values for tobacco use.

Analyzing the Relationship between Participation in Sports and Harmful Alcohol Drinking in Early Adolescence: Two-Year Prospective Analysis

Alcohol drinking is an important health-related problem and one of the major risk factors for a wide array of non-communicable diseases, while there is a lack of studies investigating environment-specific associations between sports participation and alcohol drinking in adolescence. This study prospectively investigated the relationship between sports factors (i.e., participation in sports and competitive achievement), with the prevalence of harmful alcohol drinking (HD), and HD initiation in 14-to-16 years old adolescents from Bosnia and Herzegovina (n = 641, 337 females, 43% living in rural community). Participants were tested over 4-time points divided by approximately 6 months, from the beginning of high school to the end of the second grade. Variables included gender, factors related to sport participation, a community of residence (urban or rural), and outcome: alcohol consumption was assessed by the AUDIT questionnaire. Results evidenced that the prevalence of HD increased over the study period from 6 to 19%, with no significant differences between urban and rural youth. Logistic regression for HD as criterion evidenced adolescents who participated in sports and then quit as being at particular risk for drinking alcohol at the study baseline. Sports factors were not correlated with HD initiation in the period between 14 and 16 years of age. It seems that the problem of alcohol drinking should be preventively targeted in all youth, irrespective of living environment. Although sports participation was not evidenced as being a factor of influence on HD initiation, results highlight the necessity of developing targeted preventive campaigns against alcohol drinking for adolescents who quit sports.

Risk and protective factors associated with health risk behaviours among school learners in Western Cape, South Africa

BACKGROUND

Health risk behaviour is rife among school learners in the Western Cape province. This paper assesses risk and protective factors related to health risk behaviours among high school learners.

METHOD

Longitudinal data were sourced from 2950, 2675 and 2230 at Time 0, Time 1 and Time 2 among grade 8 learners aged 13-18 years between 2012 and 2013. Health risk behaviours were assessed on alcohol consumption, smoking cannabis in the past six months, and ever having sexual intercourse. The sociodemographic variables examined were age, sex, residence, socioeconomic status (SES), family structure and population group. Contextual variables studied were the feeling of learners about the intervention program, participation in religious activities, paid casual work and school sports. Descriptive statistics, bivariate associations and binary logistic analyses predicting health risk behaviours were carried out using generalized linear mixed models after restructuring the data collected at different time points.

RESULT

Health risk behaviours increased consistently for alcohol consumption (25.7-42.7%), smoking cannabis (10.4-22.1%) and (22.3-36.0%) engaging in sexual intercourse. Increasing age emerged as a risk factor for all the health risk behaviours: alcohol consumption [OR:1.3 (1.2-1.4), p < 0.001]; smoking cannabis [OR:1.3 (1.2-1.4), p < 0.001] and had sex [OR:1.5 (1.4-1.7), p < 0.001]. Participation in paid casual work also predicted health risk behaviour: alcohol use [OR:1.5 (1.2-1.8), p < 0.001]; smoking cannabis [OR:1.3 (1.0-1.7), p < 0.05] and sex [OR:1.4 (1.1-1.7), p < 0.01]. High SES and feelings about the EPEP programme enhanced alcohol consumption and smoking cannabis. Smoking cannabis was augmented by residing in an urban area. Participation in school sports was associated with increased alcohol consumption and engaging in sexual intercourse. Participation in religious activities was protected against alcohol consumption [OR:0.7 (0.53-0.83), p < 0.001]; and sex [OR: 0.5 (0.4-0.7), p < 0.001]. Being a female and belonging to a coloured population group diminished engaging in sexual intercourse, and the family structure of both parents attenuated involvement in smoking cannabis.

CONCLUSION

The findings of the study on risks and protective factors on health risk behaviours mirror those of school-based programmes in developing countries. Learners who participated in paid work and school sports are at risk of adverse health outcomes. Furthermore, participation in religious practices and family structure roles in attenuating health risk behaviours should be integrated and considered in the school-based intervention programme.

Exploring the Association between Alcohol Drinking and Physical Activity in Adolescence; Two-Year Prospective Study in Younger Adolescents from Bosnia and Herzegovina

Insufficient physical activity and alcohol consumption (AC) are important health-threatening behaviors in adolescence, but there are controversial findings regarding the association that may exist between AC and physical activity levels (PALs) at this age. This study aimed to prospectively examine the relationship that may exist between AC and PAL in younger adolescence, considering the potential confounding effect of sports participation. The participants (n = 669, 337 females) were adolescents from Bosnia and Herzegovina who were tested on two occasions, at baseline (14 years of age) and again at follow-up (16 years of age). The variables included AC (as indicated by the AUDIT questionnaire), sports participation, age, gender (predictors), and PAL (obtained by the PAQ-A questionnaire) criterion. The results indicated that PAL at baseline was higher in those adolescents (boys) with a higher AUDIT score, but this association was partially confounded by sports participation. Multinomial regression indicated a higher risk of a decline in PAL over the study course in adolescents with a higher AUDIT score at baseline (OR = 1.32, 95%CI: 1.11-1.54 for being in the high-risk group for a decline in PAL). The most probable explanation is likely found in the high drop-out from sports in the studied period and earlier initiation of AC in adolescents involved in sports. Public health and sports authorities should urgently act preventively and develop educational programs against alcohol drinking in youth athletes.

Familial and Parental Predictors of Physical Activity in Late Adolescence: Prospective Analysis over a Two-Year Period

Children’s health behaviors are highly influenced by their parents and family. This study aimed to prospectively evaluate the parental/familial factors associated with physical activity levels (PALs) among older adolescents. The participants were 766 adolescents, who were prospectively observed at baseline (when they were 16 years of age), at first follow-up measurement (FU1; 17 years of age), and second follow-up measurement (FU2; 18 years of age). Sociodemographic factors (age, gender, socioeconomic status, and sport participation) and parental/familial variables were evaluated at baseline. PALs (evidenced by the Physical-Activity Questionnaire-for-Adolescents) were prospectively evidenced at baseline, FU1, and FU2. Factorial analysis of variance for repeated measurements showed a significant decrease in PALs during the study course (F = 83.05, p < 0.001). Sport participation and male gender were significant predictors of PALs at baseline, FU1, and FU2. Logistic regression, controlled for sport participation and male gender, evidenced paternal education as a significant predictor of baseline PALs. Parental conflict was a significant predictor of PALs in all three testing waves. The significant influence of paternal education on the children’s PALs existed from younger adolescence until the age of 17 years. The association between parental conflict and PALs developed in older adolescence. These results should be used in the development of specific and targeted interventions aimed at the improvement of PALs and a reduction of sedentarism in youth.

Evidencing Protective and Risk Factors for Harmful Alcohol Drinking in Adolescence: A Prospective Analysis of Sport-Participation and Scholastic-Achievement in Older Adolescents from Croatia

Background: The prevalence of alcohol drinking (AD) in Croatian adolescents is alarming, but there is an evident lack of prospective analyses of the protective/risk factors of AD. This study aimed to prospectively investigate the relationships between scholastic and sport factors and harmful alcohol drinking (HD) in older adolescents. Methods: The participants (n = 644, 53.7% females) were 16 years of age at study baseline and were tested at baseline and again 20 months later (follow-up). The predictors included four variables of scholastic achievement and four factors evidencing involvement in sport. Criterion was AD observed on the Alcohol Use Disorders Identification Test (AUDIT), and results were later categorized into harmful drinking (HD) and non-harmful drinking (NHD). The HD at baseline, HD at follow-up and HD initiation during the study course were observed as criteria in logistic regression analyses, which were additionally controlled for confounders (age, gender, socioeconomic status, and conflict with parents). Results: With 22% and 29% adolescents who reported HD at baseline and follow-up, respectively, the prevalence of HD remains among the highest in Europe. Scholastic failure was systematically related to HD at baseline and follow-up, but scholastic variables did not predict HD initiation during the course of the study. The higher odds for HD at baseline were evidenced for current and former team sport athletes. Those who quit individual sport were more likely to engage in HD at follow-up. Longer involvement in sport (OR: 2.10, 95% CI: 1.18–3.72), higher sport result (OR: 3.15, 95% CI: 1.19–8.34), and quitting individual sport (OR: 13.13, 95% CI: 2.67–64.62) were predictive of HD initiation. Conclusions: The results indicated specific associations between sport factors with HD initiation, which is understandable knowing the high stress placed on young athletes in this period of life, mainly because of the forthcoming selection between junior (amateur) and senior (professional) level. The results did not allow interpretation of the cause-effect relationship between scholastic failure and HD in the studied period.

Binge drinking: Health impact, prevalence, correlates and interventions

OBJECTIVE

Binge drinking (also called heavy episodic drinking, risky single-occasion drinking etc.) is a major public health problem. This paper provides an overview of recently published evidence concerning the definition and measurement, prevalence rates, health impact, demographic and psychosocial correlates of, and interventions for, binge drinking.

DESIGN

Narrative review.

RESULTS

Mostly occurring among young people at weekends, binge drinking increases the risk of both acute (e.g. injuries) and long-term negative consequences (e.g. alcohol disorders). Binge drinkers tend to be extrovert, impulsive and sensation-seeking. Stress, anxiety, traumatic events and depression are also related to binge drinking. Both alcohol-related behaviour of parents and general parenting (e.g. parenting styles, monitoring) are also important. Other major risk factors for binge drinking are frequently spending time with friends who drink, and the drinking norms observed in the wider social environment (e.g. school, community, culture). Emergency departments, birthday parties, fraternities and the workplace serve as settings for interventions; these are increasingly delivered via digital and mobile technology. There is evidence of small-sized effects across approaches (brief interventions, personalised normative feedback, protective behavioural strategies etc.) and populations.

CONCLUSION

A more consistent terminology, investigating multi-level influences and identifying the most effective intervention components are challenges for future research.

An Examination of the Ethnicity-Specific Prevalence of and Factors Associated with Substance Use and Misuse: Cross-Sectional Analysis of Croatian and Bosniak Adolescents in Bosnia and Herzegovina

Substance use and misuse (SUM) in adolescence is a significant public health problem and the extent to which adolescents exhibit SUM behaviors differs across ethnicity. This study aimed to explore the ethnicity-specific and gender-specific associations among sports factors, familial factors, and personal satisfaction with physical appearance (i.e., covariates) and SUM in a sample of adolescents from Federation of Bosnia and Herzegovina. In this cross-sectional study the participants were 1742 adolescents (17–18 years of age) from Bosnia and Herzegovina who were in their last year of high school education (high school seniors). The sample comprised 772 Croatian (558 females) and 970 Bosniak (485 females) adolescents. Variables were collected using a previously developed and validated questionnaire that included questions on SUM (alcohol drinking, cigarette smoking, and consumption of other drugs), sport factors, parental education, socioeconomic status, and satisfaction with physical appearance and body weight. The consumption of cigarettes remains high (37% of adolescents smoke cigarettes), with a higher prevalence among Croatians. Harmful drinking is also alarming (evidenced in 28.4% of adolescents). The consumption of illicit drugs remains low with 5.7% of adolescents who consume drugs, with a higher prevalence among Bosniaks. A higher likelihood of engaging in SUM is found among children who quit sports (for smoking and drinking), boys who perceive themselves to be good looking (for smoking), and girls who are not satisfied with their body weight (for smoking). Higher maternal education is systematically found to be associated with greater SUM in Bosniak girls. Information on the associations presented herein could be discretely disseminated as a part of regular school administrative functions. The results warrant future prospective studies that more precisely identify the causality among certain variables.

Prevalence and Factors Associated with Substance Use and Misuse among Kosovar Adolescents; Cross Sectional Study of Scholastic, Familial-, and Sports-Related Factors of Influence

Adolescence is considered to be the most important period for the prevention of substance use and misuse (SUM). The aim of this study was to investigate the problem of SUM and to establish potentially important factors associated with SUM in Kosovar adolescents. Multi-stage simple random sampling was used to select participants. At the end of their high school education, 980 adolescents (623 females) ages 17 to 19 years old were enrolled in the study. The prevalence of smoking, alcohol consumption (measured by Alcohol Use Disorder Identification Test–AUDIT), and illegal drug use (dependent variables), as well as socio-demographic, scholastic, familial, and sports-related factors (independent variables), were assessed. Boys smoke cigarettes more often than girls with daily-smoking prevalence of 16% among boys and 9% among girls (OR = 1.85, 95% = CI 1.25–2.75). The prevalence of harmful drinking (i.e., AUDIT scores of >10) is found to be alarming (41% and 37% for boys and girls, respectively; OR = 1.13, 95% CI = 0.87–1.48), while 17% of boys and 9% of girls used illegal drugs (OR = 2.01, 95% CI = 1.35–2.95). The behavioral grade (observed as: excellent–average-poor) is the factor that was most significantly correlated with SUM both in boys and girls, with lower behavioral grades among those adolescents who consume substances. In girls, lower maternal education levels were associated with a decreased likelihood of SUM, whereas sports achievement was negatively associated with risky drinking. In boys, sports achievement decreased the likelihood of daily smoking. Information on the factors associated with SUM should be disseminated among sports and school authorities.