Special Issue "Risk Behaviors and Substance Abuse among Adolescents"

A special issue of International Journal of Environmental Research and Public Health (ISSN 1660-4601). This special issue belongs to the section "Health Behavior, Chronic Disease and Health Promotion".

Deadline for manuscript submissions: 31 August 2021.

Special Issue Editors

Prof. Dr. Marta Lima-Serrano
E-Mail Website
Guest Editor
Department of Nursing, University of Sevilla, Sevilla, 41009, Spain
Interests: adolescence and health; positive development; health promotion; prevention; risk behaviors and substance use; program development and evaluation
Prof. Dr. Isotta Mac Fadden
E-Mail Website
Assistant Guest Editor
Department of Sociology, Pablo de Olavide University, Seville, 410013, Spain; Department of Nursing, University of Sevilla, Sevilla, 41009, Spain; Global Center for Applied Health Research, Arizona State University, Phoenix, 85004, AZ, USA
Interests: cohesion and social development; prevention; culturally adapted program for adolescents; socio-educational policies; sustainable human development of proactive citizenship
Assoc. Prof. Dr. Elena Gervilla
E-Mail Website
Assistant Guest Editor
Department of Psychology, University of the Balearic Islands, Palma, 07122, Spain
Interests: prevention; risk behaviors; substance use; evidence-based intervention; data science; data mining
Dr. Alexandra Morales
E-Mail Website
Assistant Guest Editor
AITANA Research Group, Department of Health Psychology, Miguel Hernández University, Elche, 03202, Spain
Interests: sexual health; substance use; risk behaviors; cultural adaptation and implementation of evidence-based interventions; prevention; adolescence and health

Special Issue Information

Dear Colleagues,

Adolescence is a crucial stage in life—a period of transition from childhood to adulthood in which adolescents have to face a multitude of stimuli. Depending on their capacity to face these stimuli, adolescents can engage in positive development or, conversely, adopt risk behavior and get involved with substance use, putting at risk their growth and health. In fact, in this period of life, the risk of adopting risk behaviors and substance use shows exponential growth, which has been recognized as a major public health issue, being related to main causes of morbidity and mortality worldwide.

For this reason, the study of adolescent health is one of the main issues for recognized international organizations, such as the World Health Organization, which reported in 2017 the “Global Accelerated Action for the Health of Adolescents (AA-HA!): Guidance to support country implementation”, and specifically related to substance use, the National Institute on Drug Abuse in the United States of America or the European Monitoring Centre for Drugs and Drug Addiction in Europe, which have specific programs for prevention of substance use in adolescents, including the registration of model practices or evidence-based prevention.

The well-being of adolescents is related to the different social and ecological environments and contexts to which adolescents belong, such as family, neighbors, friends, classmates, school climate, and other social environments. It should be highlighted that, from an eco-evolutionary perspective, culture frames the norms and values that operate at all levels of young adolescents’ lives: individual beliefs and behaviors, family customs and communication patterns, and how that individual perceives and interacts with larger structures, such as the school system. In intervention and prevention, according to these approaches, it is essential to keep in mind the context and relationships that develop in environments at different levels and between different actors. That is why a preventive intervention is necessary that factors in the individual’s assertive responses and resilience and his or her ability to face the diverse experiences of life positively and constructively, allowing for individual learning and growth, as well as the training of communities in empowerment processes. For these reasons, it is essential, especially in the most delicate phase of the process of identity construction—adolescence—to provide individuals with the tools to cope with the numerous new stimuli and risk situations that the adolescent population in the complex society of modernity have to face.

In this Special Issue, we invite multidisciplinary researchers interested in adolescence health, risk behavior, and substance use to submit their work based on different methodologies, including qualitative studies or quantitative studies, study protocols and results of randomized trials, and systematic or scoping reviews. The objective of these contributions should be to study the social and environmental determinants or other risk factors related to the adoption of risk behavior and substance abuse in adolescents in order to improve our understanding of youth culture as well as increase the evidence regarding the achievements and challenges in the implementation and evaluation of preventive intervention in this research area, including cultural adaptation, which is essential for the effectiveness of programs for substance use prevention.

Prof. Dr. Marta Lima-Serrano
Prof. Dr. Isotta Mac Fadden
Prof. Dr. Elena Gervilla
Dr. Alexandra Morales
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All papers will be peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. International Journal of Environmental Research and Public Health is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2300 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • Adolescence
  • Risk behavior
  • Non-substance and substance addictions
  • Sexual health
  • Social and environmental determinants
  • Risk factors
  • Evidence-based prevention
  • Health promotion
  • Program evaluation
  • Positive development
  • Health assets

Published Papers (10 papers)

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Research

Article
“Who Are at Higher Sexual Risk?” Latent Class Analysis of Behavioral Intentions among Spanish Adolescents
Int. J. Environ. Res. Public Health 2021, 18(4), 1855; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph18041855 - 14 Feb 2021
Viewed by 705
Abstract
Consistent condom use tends to be limited in youth, which makes this group especially vulnerable for sexually transmitted infections (STIs) and unplanned pregnancies. It is known that sexual risk may vary as a function of behavioral intentions (e.g., condom use intention or having [...] Read more.
Consistent condom use tends to be limited in youth, which makes this group especially vulnerable for sexually transmitted infections (STIs) and unplanned pregnancies. It is known that sexual risk may vary as a function of behavioral intentions (e.g., condom use intention or having sex under the influence of alcohol), but no studies have yet characterized the sexual risk profiles considering behavioral intentions. This study utilizes latent class analysis (LCA) to explore the subtyping of behavioral intentions related to sexual risk in a community-based sample of adolescents aged 14 to 16 years from Spain. Multinomial logistic regression was used to assess the association between class membership and participants’ sociodemographic variables (sex, age, educational level, socioeconomic status, and family situation), and behavioral variables (sexual experience and percentage of condom use). Among the 1557 participants, four latent classes of risk were identified: “Condom + drugs”, “abstinent”, “condom + no drugs”, and “no condom + drugs”. Differences in adolescents’ sex, age, educational level, sexual experience, and condom use across latent classes were found. Findings highlight opportunities for psychologists, educators, and health-care providers to promote condom use in adolescents with differing sexual risk profiles. Increased understanding of behavioral intentions among adolescents may help to reduce sexual risk behaviors in this group. Full article
(This article belongs to the Special Issue Risk Behaviors and Substance Abuse among Adolescents)
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Article
Does Flourishing Reduce Engagement in Unhealthy and Risky Lifestyle Behaviours in Emerging Adults?
Int. J. Environ. Res. Public Health 2020, 17(24), 9472; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph17249472 - 17 Dec 2020
Cited by 1 | Viewed by 701
Abstract
Emerging adulthood is a transitional life stage with increased probability of risky and unhealthy lifestyle behaviours that are known to have strong links with premature mortality and morbidity. Wellbeing, as a positive subjective experience, is identified as a factor that encourages self-care and [...] Read more.
Emerging adulthood is a transitional life stage with increased probability of risky and unhealthy lifestyle behaviours that are known to have strong links with premature mortality and morbidity. Wellbeing, as a positive subjective experience, is identified as a factor that encourages self-care and may steer individuals away from risky lifestyle behaviours. Investigating wellbeing–behaviour links in the emerging adult population may increase understanding of the factors that lead to, and ways to prevent, engagement in risky behaviours. This study examines the association between flourishing, that is, the experience of both high hedonic and eudaimonic wellbeing, and a broad range of risky and unhealthy lifestyle behaviours among emerging adults in Australia. A cross-sectional survey of 1155 emerging adults aged 18–25 years measured wellbeing, socio-demographics, and six groups of lifestyle behaviours surrounding substance use, physical activity, diet, sex, sun protection, and driving. Bivariate and multivariate statistics were used to analyse the data. The findings revealed that flourishing was negatively associated with more dangerous types of risk behaviours, such as driving under the influence of drugs, and positively associated with self-care behaviours, such as healthier dietary behaviour and sun protection. If enabling emerging adults to flourish can contribute to reduced engagement in risky/unhealthy lifestyle behaviours, then promoting it is an important goal for health promotion efforts not only because flourishing is desirable in its own right, but also to bring about sustainable change in behaviour. Further research is needed to inform the designs of such interventions. Full article
(This article belongs to the Special Issue Risk Behaviors and Substance Abuse among Adolescents)
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Article
Applicability of the Theory of Planned Behavior for Predicting Alcohol Use in Spanish Early Adolescents
Int. J. Environ. Res. Public Health 2020, 17(22), 8539; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph17228539 - 18 Nov 2020
Cited by 1 | Viewed by 744
Abstract
According to the theory of planned behavior (TPB), intentions to perform a specific behavior are the result of attitudes, norms, and perceived control, and in turn, intentions and perceived control are the main predictors of the behavior. This study aimed to test the [...] Read more.
According to the theory of planned behavior (TPB), intentions to perform a specific behavior are the result of attitudes, norms, and perceived control, and in turn, intentions and perceived control are the main predictors of the behavior. This study aimed to test the applicability of TPB in predicting alcohol use in normative pre-adolescents. The sample was composed of 755 Spanish adolescents aged 11 to 15 (M = 12.24; SD = 0.56), 47.1% females, from 12 state secondary schools in Spain. The results of path analysis indicate that positive attitudes towards alcohol, favorable norms towards alcohol, and offer vulnerability (perceived control) are significantly positively related to intentions to use alcohol as well as negatively related to actual behavioral control (i.e., actual strategies to avoid alcohol use). In turn, intentions to use and actual control predict higher alcohol frequency and heavy drinking. Significant indirect effects of these antecedents were found on alcohol outcomes through the mediation of intentions and actual control. The findings suggest that the validity and applicability of the TPB in normative pre-adolescents depend on the severity of alcohol use and point to a need to consider negative social influence in decision making processes in early adolescence. Full article
(This article belongs to the Special Issue Risk Behaviors and Substance Abuse among Adolescents)
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Article
Barriers and Facilitators in the Strengthening Families Program (SFP 10–14) Implementation Process in Northeast Brazil: A Retrospective Qualitative Study
Int. J. Environ. Res. Public Health 2020, 17(19), 6979; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph17196979 - 24 Sep 2020
Cited by 1 | Viewed by 633
Abstract
This study analyzed contextual barriers and facilitators in the implementation of Strengthening Families Program (SFP 10–14), Brazilian version, a family-based preventive program focused on the prevention of risk behaviors for adolescent health. SFP 10–14 was implemented between 2016 and 2017 for socioeconomically vulnerable [...] Read more.
This study analyzed contextual barriers and facilitators in the implementation of Strengthening Families Program (SFP 10–14), Brazilian version, a family-based preventive program focused on the prevention of risk behaviors for adolescent health. SFP 10–14 was implemented between 2016 and 2017 for socioeconomically vulnerable families in four Northeast Brazilian states as a tool of the National Drug Policy. A retrospective qualitative study was carried out in which 26 implementation agents participated. Data from 16 individual interviews and two group interviews were analyzed through content analysis. The most recurrent barriers were the group facilitators’ working conditions, weak municipal administration, precarious infrastructure, inadequate group facilitator training methodologies, low adherence of managers and professionals, and funding scarcity. The conditions highlighted as favorable to the implementation were proper intersectoral coordination, engagement of involved actors, awareness of public agency administrators, municipal management efficacy, and efficient family recruitment strategies. Favorable political contexts, engagement of implementation agents, and intersectoral implementation strategies were identified as central to the success of the implementation of SFP 10–14, especially in the adoption of the intervention, community mobilization, and intervention delivery stages. Further studies should combine contexts, mechanisms, and results for a broad understanding of the effectiveness of this intervention in the public sector. Full article
(This article belongs to the Special Issue Risk Behaviors and Substance Abuse among Adolescents)
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Article
Effectiveness of a Community-Based Intervention to Increase Supermarket Vendors’ Compliance with Age Restrictions for Alcohol Sales in Spain: A Pilot Study
Int. J. Environ. Res. Public Health 2020, 17(16), 5991; https://doi.org/10.3390/ijerph17165991 - 18 Aug 2020
Cited by 2 | Viewed by 1124
Abstract
In Spain the legal age to buy alcohol is 18 years. However, official surveys show that minors perceive alcohol availability to be easy. This paper describes the impacts of a community-based intervention to increase vendors’ compliance with age limits regarding alcohol sales in [...] Read more.
In Spain the legal age to buy alcohol is 18 years. However, official surveys show that minors perceive alcohol availability to be easy. This paper describes the impacts of a community-based intervention to increase vendors’ compliance with age limits regarding alcohol sales in supermarkets. The aim of this study was to explore the association between implementation of a multicomponent intervention to reduce adolescents’ alcohol use and sale of alcohol to minors in the city of Palma (Spain). Twenty trained adolescents (14–17 years old) conducted 138 alcohol test purchases in nine supermarket chains in August 2018 (baseline; n = 73) prior to the intervention, and again in January 2020 (follow-up; n = 65). Analysis was conducted according to three levels of intervention implemented across the supermarkets: (i) personnel from the supermarkets’ Human Resources or Corporate Social Responsibility teams received alcohol service training as trainers (i.e., community mobilization); (ii) managers and vendors training by the capacitated trainers; and (iii) no training of managers or vendors (i.e., control group). In the supermarkets that completed the Training of Trainers and the vendors’ training program, average sales decreased significantly from 76.9% in 2018 to 45.5% in 2020, asking for the age of the shopper significantly increased from 3.8% to 45.4%, and asking for proof of age significantly increased from 15.4% to 72.7%. Additionally, a statistically significant increase was observed in the visibility of prohibition to sell alcohol to minors’ signs, from 61.5% to 100%. No statistically significant differences were found for the Training of Trainers intervention alone nor in the control group. In conclusion, community mobilization combined with staff training is associated with significant increases in supermarket vendors’ compliance with alcohol legislation in Spain. Full article
(This article belongs to the Special Issue Risk Behaviors and Substance Abuse among Adolescents)
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Article
Consumption of Substances in Nightlife Settings: A Qualitative Approach in Young Andalusians (Spain)
Int. J. Environ. Res. Public Health 2020, 17(16), 5646; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph17165646 - 05 Aug 2020
Viewed by 753
Abstract
Adolescence and youth are stages of exploration and experimentation, when the consumption of psychoactive substances for recreational or experimental purposes often begins. The general objective of this study was to explore youth consumption habits in nightlife settings and associated factors in Andalusia (Spain). [...] Read more.
Adolescence and youth are stages of exploration and experimentation, when the consumption of psychoactive substances for recreational or experimental purposes often begins. The general objective of this study was to explore youth consumption habits in nightlife settings and associated factors in Andalusia (Spain). To this end, we took into account young people’s perceptions about patterns of drug polyconsumption in nightlife settings and the perceptions and actions of health and teaching professionals towards this issue. We carried out a qualitative methodology with 24 in-depth interviews and 3 discussion groups with Andalusian girls and boys aged between 16 and 22 (n = 45) and 13 in-depth interviews with social agents (health and teaching professionals). We performed narrative discourse analysis and triangulation of identified categories and measured the units of analysis. The results show information relating to gender, age of initiation, most commonly consumed substances, motivation and effects, peer group pressure and how they obtained the substances, and the perceptions held and main activities carried out in the educational institutions and health centers. Full article
(This article belongs to the Special Issue Risk Behaviors and Substance Abuse among Adolescents)
Article
Exploring Associations between Susceptibility to the Use of Electronic Nicotine Delivery Systems and E-Cigarette Use among School-Going Adolescents in Rural Appalachia
Int. J. Environ. Res. Public Health 2020, 17(14), 5133; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph17145133 - 16 Jul 2020
Viewed by 968
Abstract
Electronic nicotine delivery systems (ENDS) use, including e-cigarettes, has surpassed the use of conventional tobacco products. Emerging research suggests that susceptibility to e-cigarette use is associated with actual use among adolescents. However, few studies exist involving adolescents in high-risk, rural, socioeconomically distressed environments. [...] Read more.
Electronic nicotine delivery systems (ENDS) use, including e-cigarettes, has surpassed the use of conventional tobacco products. Emerging research suggests that susceptibility to e-cigarette use is associated with actual use among adolescents. However, few studies exist involving adolescents in high-risk, rural, socioeconomically distressed environments. This study examines susceptibility to and subsequent usage in school-going adolescents in a rural distressed county in Appalachian Tennessee using data from an online survey (N = 399). Relying on bivariate analyses and logistic regression, this study finds that while 30.6% of adolescents are ever e-cigarette users, 15.5% are current users. Approximately one in three adolescents are susceptible to e-cigarettes use, and susceptibility is associated with lower odds of being a current e-cigarette user (OR = 0.03; CI: 0.01–0.12; p < 0.00). The age of tobacco use initiation was significantly associated with decreased current use of e-cigarettes (OR = 0.89; CI: 0.83–0.0.97; p < 0.01). Overall, the results of this exploratory study suggest the need for larger studies to identify unique and generalizable factors that predispose adolescents in this high-risk rural, socioeconomically disadvantaged region to ENDS use. Nevertheless, this study offers insight into e-cigarette usage among U.S adolescents in rural, socioeconomically disadvantaged environments and provides a foundation for a closer examination of this vulnerable population. Full article
(This article belongs to the Special Issue Risk Behaviors and Substance Abuse among Adolescents)
Article
Community Intervention Self-Efficacy Scale for Parent Leaders (CONNECTED): Parents’ Empowerment to Prevent Adolescent Alcohol Use
Int. J. Environ. Res. Public Health 2020, 17(13), 4812; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph17134812 - 04 Jul 2020
Viewed by 1126
Abstract
Empowering parents by actively engaging them in environmental prevention strategies is a promising approach that only a few programs use. Evidence suggests that when families and the wider community are engaged, alcohol prevention is more efficient. However, due to the novelty of this [...] Read more.
Empowering parents by actively engaging them in environmental prevention strategies is a promising approach that only a few programs use. Evidence suggests that when families and the wider community are engaged, alcohol prevention is more efficient. However, due to the novelty of this approach, no specific assessment tools for measuring this type of engagement are available. The objective of this study is to design a parental empowerment measurement tool to evaluate parents’ self-efficacy when engaging in environmental and community actions and to analyze its psychometric properties. A total of 132 parents active in in-school parent associations from Spain (n = 77; 58.4%) and Portugal (n = 55; 41.7%) completed a pencil and paper battery of four questionnaires, including the developed scale COmmuNity iNtervention SElf-Efficacy SCale for ParenT LEaDers (CONNECTED). The scale showed a good reliability and good test-retest stability in a three-month period. The convergent validity with other well-established instruments that assess similar constructs was significant. A preliminary confirmatory factor analysis (CFA) showed an acceptable fit. Environmental prevention supported by families is a promising preventive strategy because the participation and involvement of families is an effective way to address some risks in adolescence; however, new assessment tools are needed in this field. The developed scale could be a first step to identify the areas of need in a community and to monitor the progress and evaluate the outcomes of the preventive interventions implemented. Full article
(This article belongs to the Special Issue Risk Behaviors and Substance Abuse among Adolescents)
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Article
Psychometric Properties of the Colombian Version of the HIV Attitudes Scale for Adolescents
Int. J. Environ. Res. Public Health 2020, 17(13), 4686; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph17134686 - 29 Jun 2020
Viewed by 823
Abstract
The HIV Attitudes Scale (HIV-AS) evaluates attitudes towards different aspects of HIV. In view of the lack of scales measuring this construct in Colombia, this study sought to validate the HIV-AS test for adolescents from Colombia. A total of 867 Colombian students, aged [...] Read more.
The HIV Attitudes Scale (HIV-AS) evaluates attitudes towards different aspects of HIV. In view of the lack of scales measuring this construct in Colombia, this study sought to validate the HIV-AS test for adolescents from Colombia. A total of 867 Colombian students, aged between 14 and 19 years (M = 15.97 years; SD = 1.37) were evaluated. Participants responded to the HIV-AS test and a set of scales used to assess external validity. Content validity analyses reflected good adequacy indices for the items. Exploratory factor analyses revealed a four-factor structure and reliability indices were satisfactory. The structural equation model showed good levels of fit. Most of the items presented a discrimination index above 0.30 and contributed to the reliability of the scale, except for item 9, which was eliminated. Concurrent validity showed significant correlations among the HIV-AS and other similar constructs. A reliable measurement of attitudes toward HIV allows for an improved assessment of the risk associated with exposure to sexually transmitted infections in adolescent populations. Full article
(This article belongs to the Special Issue Risk Behaviors and Substance Abuse among Adolescents)
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Article
Why are Spanish Adolescents Binge Drinkers? Focus Group with Adolescents and Parents
Int. J. Environ. Res. Public Health 2020, 17(10), 3551; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph17103551 - 19 May 2020
Cited by 3 | Viewed by 1046
Abstract
Binge drinking in adolescents is a worldwide public healthcare problem. The aim of this study was to explore the perceptions about determinants of binge drinking in Spanish adolescents from the perspective of adolescents and parents. A qualitative study using fourteen semi-structured focus groups [...] Read more.
Binge drinking in adolescents is a worldwide public healthcare problem. The aim of this study was to explore the perceptions about determinants of binge drinking in Spanish adolescents from the perspective of adolescents and parents. A qualitative study using fourteen semi-structured focus groups of adolescents was conducted during the 2014/2015 school year (n = 94), and four with parents (n = 19), based on the I-Change Model for health behaviour acquisition. Students had a low level of knowledge and risk perception and limited self-efficacy. Girls reported more parental control, and when they get drunk, society perceives them worse. Adolescents suggested focus preventive actions to improve self-efficacy and self-esteem. Parents were permissive about alcohol drinking but rejected binge drinking. They offered alcohol to their children, mainly during celebrations. A permissive family environment, lack of control by parents, adolescents’ low-risk perception, low self-esteem and self-efficacy, as well as the increase of binge drinking in girls as part of the reduction of the gender gap, emerge as risk factors for binge drinking. Future health programmes aimed at reducing binge drinking should focus on enhancing motivational factors, self-esteem, and self-efficacy in adolescents; supervision and parental control; as well as pre-motivational factors by increasing knowledge and risk awareness, considering gender differences. Full article
(This article belongs to the Special Issue Risk Behaviors and Substance Abuse among Adolescents)
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