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Table 4 A summary of data extracted from the eligible studies included in this review

From: Health risk behavior among chronically ill adolescents: a systematic review of assessment tools

Author Country Age/mean age (years) illness Form of HRB HRB tool or source of HRB items Adaptation and psychometric properties
Holmberg and Hjern [71] Sweden 10 ADHD Behavior resulting into violence Items adapted from HBSC NR
Husarova et al. [72] Slovakia 13–15 Asthma, learning disability or presence of a long term illness Sedentary lifestyle Health Behaviour in School-aged Children NR
Park et al. [21] USA 15–17 Asthma Tobacco smoking, poor dietary habits 2009 YRBSS questionnaire Convergent validity: the item on soda-intake from the questionnaire correlated with soda intake from 24 h dietary recalls (r = 0.44)
Kim et al. [73] Korea 13–18 Asthma Tobacco use, physical inactivity, sedentary life-style 2007 Korea Youth Risk Behavior Web-Based Survey (KYRBWS) NR
Rhee et al. [13] USA 16 Asthma Tobacco use, illicit substance/drug use, alcohol drinking Periodic Assessment of Drug Use (PADU) NR
Jones et al. [8] USA 14–18 Asthma Physical inactivity, sedentary lifestyle 2003 YRBSS NR
Jones et al. [14] USA 14–18 Asthma Tobacco smoking, drug/substance use 2003 YRBSS NR
Tercyak [74] USA 16.1 Asthma Tobacco smoking behavior Adapted from the YRBSS NR
Swahn and Bossarte [16] USA 14–18 Asthma Behavior resulting into violence 2003 YRBSS NR
Lee and Shin [75] Korea 12–17 Atopic dermatitis depression Self-harm, poor sleep behavior, behavior resulting to violence, alcohol drinking, tobacco smoking, physical inactivity Korean Youth Risk Behavior Survey 2013 (KYRBS) NR
Oh et al. [76] Korea 14.8 Atopic disease (asthma, allergic rhinitis, atopic dermatitis) Poor sleep behavior Korean Youth Risk Behavior Survey 2013 (KYRBS) NR
Lunt et al. [60] Australia 14.6 Cardiac disease Physical inactivity Items adapted from New South Wales Schools Fitness and physical activity survey NR
Barbiero et al. [19] Brazil 2–18 Congenital heart disease Tobacco smoking, physical inactivity International Physical Activity Questionnaire (IPAQ) NR
Uzark et al. [42] USA 16.1 Congenital heart disease Sexual risk behavior, tobacco smoking, alcohol drinking, physical inactivity Source of items not clear NR
Nixon et al. [18] USA 7–17 Cystic fibrosis Physical inactivity Kriska’s Modifiable Activity questionnaire Convergent validity: physical activity measured by HRB tool correlated significantly with measurements by a Caltrac motion sensor (r = 0.4, p = 0.04)
Test–retest reliability: a 3 months period test–retest reliability was ICC = 0.77, 0.70, 0.58 for 3 levels of physical activity
Adrian et al. [77] USA 15–19 Depression Tobacco smoking, drug/substance use, alcohol drinking, poor dietary, physical inactivity, poor sleep behavior Washington State Healthy Youth Survey NR
Lampard et al. [78] USA 14.4 Depression Poor dietary habits, tobacco smoking EAT 2010 Survey Tool EAT 2010 Survey Tool was first pilot tested with 129 students
Test–retest reliability of the item used to capture any of these behaviors was ICC = 0.85
Frazer et al. [54] USA 16.1 Depression Anti-social acts (delinquent behavior), drug/substance use, alcohol use Delinquency scale Internal consistency (Cronbach’s alpha = 0. 84)
Allison et al. [79] Canada 12–17 Depression Physical inactivity Items extracted from the YRBSS NR
Tortolero et al. [37] USA 11.2 Depression Behavior resulting into violence Source of items is not clear NR
Dube et al. [80] USA 12–17 Depression Tobacco smoking National Health and Nutrition Examination Survey NR
Richardson et al. [81] USA 13–17 Depression Drug/substance use, alcohol drinking CRAFT substance Abuse Screening Test NR
Katon et al. [15] USA 13–17 Depression Tobacco smoking, drug/substance use, alcohol drinking, poor dietary habits, physical inactivity, sedentary lifestyle CRAFT substance Abuse Screening Test NR
Simpson et al. [12] Canada 14–18 Depression Sexual risk behavior, tobacco smoking, drug/substance use, alcohol drinking, poor dietary habits, physical inactivity, unintentional injuries, behavior resulting into violence 2001/2 HBSC Construct validity: a one-factor solution with loadings 0.63–0.80 indicated the following items: lifetime cannabis use; unprotected sexual intercourse; lifetime use of other illicit drugs; lifetime drunkenness; and present smoking status.
Internal consistency: an excellent Cronbach’s alpha = 0.81 was obtained for the entire HRB tool
Tercyak et al. [82] USA 14.1 Depression Tobacco smoking, physical inactivity, sun protective behavior Items derived from Youth Risk Behavior Survey (YRBSS) NR
Elder et al. [55] USA 15.5 Depression Tobacco use, alcohol drinking, poor dietary habits, physical inactivity, sedentary lifestyle Items adapted from: 1997 YRBSS, 24 h food intake record (FIR), 7 day physical activity recall Inter-observer reliability for FIR was r = 0.72 for 12 key nutrients
Test–retest reliability of the items on TV watching in terms of total hours per week was 0.80 at pilot testing
Pronk et al. [83] USA 13–17 Depression Tobacco smoking, alcohol drinking, poor dietary habits, physical inactivity, Items adapted from: Behavior Risk Factor Surveillance System and from Recommended Food Score NR
Brooks et al. [47] USA 14–18 Depression Sexual risk behavior, tobacco smoking, alcohol drinking, substance/drug use, poor dietary, physical inactivity, behavior resulting into violence Massachusetts Adolescent Health Survey The tool was reviewed by academic experts, adolescent health practitioners and survey researchers for content validity and cultural appropriateness
HRB items were pilot-tested among 4 adolescent focus groups and were pre-tested for clarity, length and completeness of closed ended questions
Schmitz et al. [38] USA 11–15 Depression Physical inactivity, sedentary lifestyle Source of items not clear The test–retest reliability for the item on physical activity was 0.65
The test–retest reliability for sedentary lifestyle was 0.81 and a Cronbach’s alpha of 0.73
Shrier et al. [39] USA 17.1 Depression Sexual risk behavior, drug/substance use, alcohol drinking Source of items not clear NR
Moradi-Lakeh et al. [84] Saudi Arabia 15–19 (majority) Diabetes mellitus, congestive heart failure, renal failure, cancer Physical inactivity, sedentary lifestyle, poor dietary habits, tobacco smoking, unintentional injuries Saudi Health Information Survey (SHIS) NR
Ohmann et al. [85] Austria 9–19 Diabetes Anti-social acts Child Behavior Checklist, Youth Self Report NR
Scaramuzza et al. [6] Italy 14 Diabetes Sexual risk behavior, self-harm, tobacco smoking, alcohol drinking, substance/drug use Items adapted from YRBSS NR
Kyngas [36] Finland 13–17 Diabetes Tobacco smoking, alcohol drinking, physical inactivity A newly developed questionnaire NR
Soutor et al. [86] USA 9–17 Diabetes Poor dietary habits, physical inactivity 24 h recall interviews NR
Gold and Gladstein [35] Not stated 15 Diabetes Tobacco smoking, substance/drug use, alcohol drinking Modified Michigan Alcohol Screening Test NR
Timko et al. [87] USA 10–11 Juvenile rheumatic disease Tobacco smoking, drug/substance use, alcohol drinking, Health and daily living form NR
MacDonell et al. [88] USA 15.8 HIV Substance use The car, relax, alone, forget, friends, trouble (CRAFT) NR
Elkington et al. [89] USA 9–16 HIV Sexual risk behavior, tobacco smoking, alcohol drinking, substance/drug use Adolescent Sexual Behavior Assessment (ASBA), Diagnostic Interview Schedule for Children-IV NR
Lagrange et al. [23] USA 17.2 HIV Poor dietary habits, physical inactivity, poor sleep behavior Six questions with unclear sources NR
Asnani et al. [48] Jamaica 17 Sickle cell disease Sexual risk behavior, tobacco smoking, drug/substance use, alcohol drinking Jamaican Youth Risk and Resilience Behavior Survey Validity of instrument was assured through pretesting it among a youth group and a panel of adolescent health experts
AlBuhairan et al. [49] Saudi Arabia 15 Mental illness, asthma, hematological disorders, skin disorders, genito-urinal disorders Tobacco smoking, drug/substance use, alcohol drinking, poor dietary habits, physical inactivity, sedentary lifestyle, unintentional injuries, behavior resulting into violence Items adapted from YRBSS and Global School-based Student Health Survey Items underwent cultural adaptation and culturally inappropriate items were excluded (e.g. on sexual behavior and sexually transmitted infections)
Kline-Simon et al. [46] USA 15 Mental illness conditions (depression, bipolar spectrum disorders, personality disorders, dementia, schizophrenia, other psychoses)
Asthma, sinusitis, arthritis, rhinitis, diabetes mellitus, inflammatory bowel disease, migraine
Substance use Source of items not clear NR
Kunz et al. [43] USA 16.1 Cystic fibrosis, inflammatory bowel disease, arthritis, hematologic condition, cardiac condition Tobacco smoking, alcohol drinking Source of items not clear NR
Conner et al. [90] USA 15.9 HIV, Depression Tobacco smoking, alcohol drinking, substance/drug use Items adapted from Reaching for Excellence in Adolescent Care and Health (REACH) NR
Olsson et al. [91] Sweden 15–16 Rheumatism, autism, epilepsy, diabetes, ADHD, eczema, mental problem, asthma, visual/speech impairment, dyslexia Poor dietary habits, physical inactivity, behavior resulting into violence 2008 Ung I Värmland questionnaire NR
Singh et al. [92] USA 10–17 Asthma, autism, depression, ADHD, learning disability, hearing problems Tobacco smoking, physical inactivity, sedentary lifestyle, poor sleep behavior National Survey of Children’s Health questionnaire NR
Woods et al. [51] USA 11–16 Asthma, persistent bowel problems, diabetes, sickle cell anaemia, and others Behavior resulting into violence Youth Self Report (YSR), Child Behavior Checklist (CBCL), Modified Self Report of Delinquency (MSRD) Test–retest reliability of YSR was r = 0.8 and internal consistence, Cronbach’s alpha = 0.96
Internal consistency of MSRD was Cronbach’s alpha = 0.98
The internal consistency of CBCL was Cronbach’s alpha = 0.91 and 0.80 for externalizing and internalizing sub-scales respectively
Wilens et al. [9] USA 6–17 ADHD, depression Tobacco smoking, alcohol drinking, drug/substance use Structured Clinical Interview for the DSM-IV Inter-rater reliability of the diagnosis procedures was assessed by comparing findings by assessment staff and those by certified child and adult psychologists who used the audio taped assessment interviews. Kappa coefficient for substance use disorder = 1.0
Bush et al. [41] USA 11–17 Asthma, depression Tobacco smoking Source not clear NR
Silburn et al. [93] Australia 12–17 Asthma, visual and hearing impairment, learning difficulties, speech problems Sexual risk behavior, tobacco smoking, drug/substance use, alcohol drinking, physical inactivity, self-harm Western Australia Aboriginal Child Health Survey NR
Suris and Parera [11] Spain 16.1 Diabetes, asthma, epilepsy, scoliosis, cancer, arthritis Sexual risk behavior, tobacco smoking, drug/substance use, alcohol drinking Catalonia Adolescent Health Survey 2001 NR
Blum et al. [40] USA 16.2 Physical disability, learning disability, emotional disability Sexual risk behavior, tobacco smoking, alcohol drinking, self-harm, behavior resulting into violence Source of items not clear NR
Britto et al. [59] USA 15.6 Cystic fibrosis, sickle cell disease Sexual risk behavior, tobacco smoking, drug/substance use, alcohol drinking, unintentional injuries, behavior resulting into violence, self-harm Modified version of YBS NR
Choquet et al. [10] France 16.2 Cancer, hemophilia, arthritis, nephropathy, diabetes, mental disease, metabolic disease, eczema, psoriasis, asthma, cardio-pathy Sexual risk behavior Items derived from HBSC and Choquet-Ledoux study NR
Frey et al. [53] USA 14.2 Diabetes, asthma Sexual risk behavior, tobacco smoking, alcohol drinking, substance/drug use Risky Behavior and Risk Scale Internal consistency ranged from 0.85 to 0.95 for the three subscales of the HRB tool
Frey [52] USA 9–16 Diabetes, asthma Poor dietary habits, physical inactivity, poor sleep behavior Denyes self care practice instrument Internal consistency ranged from 0.73 to 0.79
Suris et al. [7] USA 14–15 Scoliosis, arthritis, muscular dystrophy, diabetes, seizures, asthma Sexual risk behavior Minnesota Adolescent Health Survey 1986–7 NR
Nylanderet al. [61] Sweden 15–18 Presence of at least one chronic disease Sexual risk behavior, tobacco smoking, drug/substance use, alcohol drinking, physical inactivity, behavior resulting into violence, self-harm 2011 Life and Health in Youth questionnaire NR
Warren et al. [44] USA 16.6 Presence of comorbid chronic conditions Poor dietary habits, behavior resulting into violence, poor hygiene practices Items borrowed from previous population level surveys Clarity and understandability of items assessed by expert panel review and cognitive interviews of adolescents
Ardic and Esin [94] Turkey 16.0 Presence of any pre-existing or current chronic illness Poor dietary habits, physical inactivity Adolescent Lifestyle Profile Scale NR
Nylanderet al. [95] Sweden 15–18 Physical impairment or presence of a chronic disease (yes/no) Sexual risk behavior, tobacco smoking, drug/substance use, alcohol drinking, behavior resulting into violence, self-harm, anti-social acts 2008 Life and Health in Youth questionnaire NR
Santos et al. [96] Portugal 15 Presence of a chronic disease (yes/no) Alcohol use, behavior resulting into violence, self-harm 2010 Health Behavior in School-aged Children (HBSC) NR
Sentenac et al. [50] Multi-site (Europe and North America) 11–16 Presence of a chronic disease (yes/no) Behavior resulting into violence 2005/6 HBSC Language equivalence was ensured by translation and back translation
Rintala et al. [97] Canada and Finland 13–15 Physical disability or presence of a chronic disease (yes/no) Physical inactivity Items adapted from 2001/2 HBSC
Moderate-to-vigorous intensity physical activity screening measure
NR
Wilcox et al. [45] USA 10.4 Physical disability or presence of a chronic disease (yes/no) Self-harm, anti-social acts, sexual risk behavior, alcohol/substance use behavior Source of items not clear NR
Alriksson-Schmidt et al. [17] USA 15–18 Presence of a chronic disease (yes/no) Tobacco smoking, drug/substance use, alcohol drinking, behavior resulting into violence 2005 YRBSS NR
Han et al. [98] Korea 12–19 Presence of a chronic disease (yes/no) Tobacco smoking, alcohol drinking, self-harm 2006 Korea Youth Behavioral Risk Factor Surveillance NR
Jones and Lollar [20] USA 14–18 Presence of a chronic disease (yes/no) Sexual risk behavior, tobacco smoking, drug/substance use, alcohol drinking, poor dietary habits, behavior resulting into violence, self-harm 2005 YRBSS NR
Suris et al. [29] Switzerland 17.9 Presence of a chronic disease (yes/no) Sexual risk behavior, tobacco smoking, drug/substance use, alcohol drinking, poor dietary habits, behavior resulting into violence, anti-social behavior SMASH questionnaire NR
Erickson et al. [67] USA 14.9 Depression, presence of a chronic disease (yes/no) Tobacco smoking, drug/substance use, alcohol drinking, self-harm Items adapted from the Minnesota Student Survey The internal consistency of the items on substance use behavior was Cronbach’s alpha = 0.79
Heflinger and Saunders [99] USA 4–17 Depression, presence of a chronic disease (yes/no) Anti-social acts Child Behavior Checklist, Columbia Impairment Scale NR
Haarasilta et al. [100] Finland 15–19 Presence of at least one chronic illness, depression Tobacco smoking, alcohol drinking, physical inactivity 1996 Finnish Health Care Survey questionnaire NR
Mattila et al. [101] Finland 12–18 Presence of a chronic disease (yes/no) Tobacco smoking, drug/substance use, alcohol drinking, poor dietary habits, physical inactivity, behavior resulting into violence, poor hygiene/sanitation 1999 Adolescent Health and Life-style Survey questionnaire NR
Huurre et al. [102] Finland 16 Presence of at least one chronic illness, depression Tobacco smoking, alcohol drinking, physical inactivity, Alcohol Use Disorder Identification Test (AUDIT) NR
Miauton et al. [103] Switzerland 15–17 and 18–20 Presence of a chronic disease (yes/no) Sexual risk behavior, tobacco smoking, drug/substance use, alcohol drinking, unintentional injuries, behavior resulting into violence Swiss Multi-centre Adolescent Survey on Health (SMASH) NR
Tremblay et al. [104] Canada 12–17 Presence of at least one chronic illness, depression Tobacco smoking, alcohol drinking, physical activity, poor dietary habits Canadian Community Health Survey NR
Huurre and Aro [105] Finland 16 Presence of at least one chronic illness, depression Tobacco smoking, alcohol drinking, physical activity AUDIT NR
Williams and Shams [106] England 14–15 Presence of at least one chronic disease Tobacco smoking, drug/substance use, alcohol drinking, physical inactivity Health and Lifestyle Survey, London NR