Depressive symptoms and clustering of risk behaviours among adolescents and young adults attending vocational education: a cross-sectional study.

BACKGROUND: Depressive symptoms and risk behaviours often do not occur in isolation among adolescents and young adults. In order to improve intervention programmes, more research is needed to elucidate the clustering of risk behaviours, the association with depressive symptoms, and demographic variables. Therefore, this study examined the clustering of risk behaviours, the association with depressive symptoms, and demographic variables among adolescents and young adults in vocational education. Furthermore, the prevalence of depressive symptoms and risk behaviours was examined. METHODS: This study included 584 students (mean age 18.3 years) attending vocational education in the Netherlands. Depressive symptoms and risk behaviours (binge drinking, cannabis use, smoking, delinquency and incurring debts) were assessed with self-report questionnaires. Truancy was monitored via the school registration system. Principal Components Analysis (PCA) was conducted to assess the factor structure of the risk behaviours (i.e. clustering). Linear regression analyses with a bootstrapping method were performed to assess the associations. RESULTS: Binge drinking was reported by 50.5% and cannabis use by 14.2% of the students (both in the past 4 weeks), whereas 37.7% reported currently being a smoker. More than 10% reported having been questioned at a police station in the past year. Furthermore, 82.2% had been truanting in the first two months of education, 21.0% reported having debts and 29.2% reported clinically-relevant depressive symptoms. The PCA indicated two clusters. The 'substance use' cluster consisted of the risk behaviours: binge drinking, cannabis use and smoking. The 'problem behaviours' cluster consisted of the risk behaviours: delinquency, truancy and incurring debts. Both clusters were associated with depressive symptoms. Various demographic variables were associated with both clusters. CONCLUSIONS: Risk behaviours formed two clusters, both of which were associated with depressive symptoms. These findings underscore the importance of screening adolescents and young adults at lower educational levels for multiple risk behaviours and depressive symptoms and of focusing on multiple risk behaviours in interventions simultaneously.

Your health, an intervention at senior vocational schools to promote adolescents' health and health behaviors.

UNLABELLED: This study evaluates the appreciation, application and effects of an intervention (Your Health), in which adolescents received a consultation with the school nurse. A cluster randomized controlled trial with an intervention and control group (care-as-usual) was conducted among first-grade senior vocational students. Adolescents (n = 418) completed a questionnaire at baseline and 6-month follow-up assessing health and health behaviors. School absenteeism was monitored via the school registration system. After the consultation, adolescents and nurses evaluated the consultation by questionnaire. Adolescents appreciated being invited for the consultation and gave the consultation a positive mean rating of 8.78 on a 10-point scale. Adolescents rated the other nine items on the appreciation of the consultation also high. In 36.8% of the adolescents, nurses suspected problems. Most often these adolescents were given tailored advice (59.3%) or they were referred to another professional (40.7%). No statistically significant effects of the intervention were found on the health and health behaviors of adolescents. This study supports the use of Your Health as a promising intervention to reach senior vocational students. Future research is needed to evaluate long-term effects and the effects and appreciation of the subsequent help that is offered. TRIAL REGISTRATION: www.trialregister.nl, NTR3545.

Psychometric properties of self-sufficiency assessment tools in adolescents in vocational education.

BACKGROUND: Self-sufficiency is the realisation of an acceptable level of functioning either by the person him/herself or through the adequate organisation of help from informal or formal care providers. Assessment of self-sufficiency for determining an individual's functional strengths and areas for improvement is increasingly being applied among adolescents in vocational education, a group considered vulnerable with high school dropout rates and often characterised by an accumulation of problems. This study examined the psychometric properties of two instruments, i.e. a self-report questionnaire assessing self-sufficiency and the Self-Sufficiency Matrix for professionals (SSM-D) conducted among adolescents in vocational education. METHODS: The self-report questionnaire used to assess self-sufficiency was completed by 581 adolescents. Professionals completed the SSM-D for 224 of the 581 adolescents. Furthermore, constructs related to the domains of self-sufficiency were assessed with self-report questionnaires and information about school absenteeism was monitored via the school registration system. RESULTS: For both self-report and professional-report ratings, the internal consistency was satisfactory (Cronbach'α > 0.70) and various minor to strong correlations were found between the domains of self-sufficiency and related constructs. For most of the domains, there was little or no agreement between professionals and adolescents. CONCLUSIONS: Both the self-report questionnaire assessing self-sufficiency and the SSM-D applied in this study seem to possess adequate psychometric properties. The results indicated that adolescents and professionals provide different views of adolescents' self-sufficiency, which merits further study. In the meantime, we recommend assessment of adolescents' self-sufficiency by using both the self-report questionnaire and the SSM-D to get a comprehensive measure of adolescents' self-sufficiency. TRIAL REGISTRATION: Netherlands Trial Register: NTR3545 ; 30 July 2012.