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 |