@article{ref1,
title="Initial engagement and persistence of health risk behaviors through adolescence: longitudinal findings from urban South Africa",
journal="BMC pediatrics",
year="2021",
author="Stein, Aryeh D. and Richter, Linda M. and Waford, Rachel N. and Martorell, Reynaldo and Kramer, Michael R. and Addo, O. Yaw and Kowalski, Alysse J. and Norris, Shane A.",
volume="21",
number="1",
pages="e31-e31",
abstract="BACKGROUND: Little is known about longitudinal patterns of adolescent health risk behavior initial engagement and persistence in low- and middle-income countries. <br><br>METHODS: Birth to Twenty Plus is a longitudinal birth cohort in Soweto-Johannesburg,  South Africa. We used reports from Black African participants on cigarette smoking,  alcohol, cannabis, illicit drug, and sexual activity initial engagement and  adolescent pregnancy collected over 7 study visits between ages 11 and 18 y. We fit  Kaplan-Meier curves to estimate behavior engagement or adolescent pregnancy,  examined current behavior at age 18 y by age of first engagement, and performed a  clustering analysis to identify patterns of initial engagement and their  sociodemographic predictors. <br><br>RESULTS: By age 13 y, cumulative incidence of smoking  and alcohol engagement were each > 21%, while the cumulative incidence of other  behaviors and adolescent pregnancy were < 5%. By age 18 y (15 y for cannabis),  smoking, alcohol, and sexual activity engagement estimates were each > 65%, cannabis  and illicit drug engagement were each > 16%; adolescent pregnancy was 31%. Rates of  engagement were higher among males. Current risk behavior activity at age 18 y was  generally unrelated to age of initial engagement. We identified three clusters  reflecting low, moderate, and high-risk patterns of initial risk behavior  engagement. One-third of males and 17% of females were assigned to the high-risk  cluster. Sociodemographic factors were not associated with cluster membership. <br><br>CONCLUSIONS: Among urban dwelling Black South Africans, risk behavior engagement  across adolescence was common and clustered into distinct patterns of initial  engagement which were unrelated to the sociodemographic factors assessed. Patterns  of initial risk behavior engagement may inform the timing of primary and secondary  public health interventions and support integrated prevention efforts that consider  multiple behaviors simultaneously.<p /> <p>Language: en</p>",
language="en",
issn="1471-2431",
doi="10.1186/s12887-020-02486-y",
url="http://dx.doi.org/10.1186/s12887-020-02486-y"
}