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This paper uses a dynamic latent factor model to investigate the determinants of not in education, employment or training (NEET) status among adolescents in the United Kingdom. We bring together within one framework various determinants of NEET status, such as educational achievements, non‐cognitive skills, family socio‐economic factors, aspirations, mental health and local labour market conditions. We model the educational progress over multiple periods through the life of the young person, up to the completion of compulsory schooling. By taking into account this progression, we can determine the direct and indirect impacts of different determinants of NEET status, and the stage in the life of the young person at which each determinant is important. Our findings suggest that cognitive ability (as measured by educational achievements) remains the key predictor of NEET status. Further, while a range of individual and family factors determines NEET status, the impact of most of these factors is largely indirect, through ability formation and not necessarily direct. To gauge the relative contributions of various determinants, we conduct simulations to predict the probability of the young person being NEET under different scenarios and assumptions. The exercise indicates that the effects of aspirations of the young person, their school engagement, and the local youth unemployment rate on the likelihood of the young person being NEET are as large as boosting their cognitive skills. [ABSTRACT FROM AUTHOR]

This paper examines the development of the impact of family background on young people's political engagement during adolescence and early adulthood in order to test a number of hypotheses derived from the impressionable years and family socialization perspectives. The study analyses data of the British Household Panel Study and Understanding Society to assess these hypotheses. Political interest and voting intentions are used as outcomes of political engagement. The study finds parental education to have no effect on initial levels of these outcomes at age 11 but to be positively related to the change in these outcomes between ages 11 and 15. This indicates that the effect of parental education becomes stronger over time and that social disparities in political engagement are widening significantly during early adolescence. In contrast, parental political engagement is positively related to initial levels of voting intentions at age 11 but not related to the change in voting intentions between ages 11 and 15, which supports the hypothesis drawn from the family socialization perspective. Neither parental education nor parental political engagement are related to post-16 changes in political engagement. These results point to early adolescence as a crucial period for the manifestation of social inequalities in political engagement. They provisionally suggest that the influence of parental education runs through educational conditions in lower secondary and that these conditions could play an important role in amplifying the said inequalities. [ABSTRACT FROM AUTHOR]

Background: There is evidence that mental health problems are increasing and substance use behaviours are decreasing. This paper aimed to investigate recent trends in mental ill health and health-related behaviours in two cohorts of UK adolescents in 2005 and 2015.Methods: Prevalences in mental health (depressive symptoms, self-harm, anti-social behaviours, parent-reported difficulties) and health-related behaviours (substance use, weight, weight perception, sleep, sexual intercourse) were examined at age 14 in two UK birth cohorts; Avon Longitudinal Study of Parents and Children (ALSPAC, N = 5627, born 1991-92) and Millennium Cohort Study (MCS, N = 11 318, born 2000-02). Prevalences and trend estimates are presented unadjusted and using propensity score matching and entropy balancing to account for differences between samples.Results: Depressive symptoms (9% to 14.8%) and self-harm (11.8% to 14.4%) were higher in 2015 compared with 2005. Parent-reported emotional difficulties, conduct problems, hyperactivity and peer problems were higher in 2015 compared with 2005 (5.7-8.9% to 9.7-17.7%). Conversely, substance use (tried smoking, 9.2% to 2.9%; tried alcohol, 52.1% to 43.5%, cannabis, 4.6% to 3.9%), sexual activity (2% to 0.9%) and anti-social behaviours (6.2-40.1% to 1.6-27.7%) were less common or no different. Adolescents in 2015 were spending less time sleeping (<8 h 5.7% to 11.5%), had higher body mass index (BMI) (obese, 3.8% to 7.3%) and a greater proportion perceived themselves as overweight (26.5% to 32.9%). The findings should be interpreted bearing in mind limitations in ability to adequately harmonize certain variables and account for differences in attrition rates and generalizability of the two cohorts.Conclusions: Given health-related behaviours are often cited as risk factors for poor mental health, our findings suggest relationships between these factors might be more complex and dynamic in nature than currently understood. Substantial increases in mental health difficulties, BMI and poor sleep-related behaviours highlight an increasing public health challenge. [ABSTRACT FROM AUTHOR]

This paper presents findings from a Department of Health-funded study into the emotional well-being of young people seeking asylum on their own in the UK. It discusses how young people accounted for only partly disclosing information about the circumstances surrounding their quest for asylum and subsequent aspects of their lives since arriving in the UK. Foucault's panoptic mechanism and its focus on the effects of power as dispersed through scrutiny are applied as a theoretical framework to contextualise these experiences. The paper shows that young people's decisions about how much of their current or past lives they share with others are more complex than indicated by earlier research. The paper argues that, for many young people, the predominant impetus for selective disclosure was a desire to retain a degree of agency as they navigated their way through immigration, asylum, social care, health and education systems and simultaneously sought to establish themselves in the social world. These findings have implications for how social care (and other) professionals engage and work with young people seeking asylum alone. [ABSTRACT FROM PUBLISHER]

Background To estimate the effect of social media use in 14 year olds on risk of and inequalities in alcohol use and binge drinking at 17 years. Methods Using the UK-representative Millennium Cohort Study, the relationship between time spent on social media (assessed using questionnaires [ n  = 8987] and time-use-diaries [ n  = 2520]) with frequency of alcohol use in the past month and binge drinking was estimated using adjusted odds ratios (AORs) or adjusted relative risk ratios (ARRRs). Associations within low and high parental education groups were compared to examine effect modification. Analyses accounted for pre-specified confounders, baseline outcome measures (to address reverse causality), sample design, attrition and item-missingness (through multiple imputation). Results Questionnaire-reported time spent on social media was associated with increased risk of alcohol use and binge drinking in a dose–response manner. Compared to 1-< 30 min/day social media users, 30 min-<1 h/day users were more likely to report alcohol use ≥6 times/month (ARRR 1.62 [95% confidence interval 1.20 to 2.20]) and binge drinking (AOR 1.51 [1.22 to 1.87]), as were 1–<2 h/day users (ARRR 2.61 [1.90 to 3.58]; AOR 2.06 [1.69 to 2.52]) and ≥2 h/day users (ARRR 4.80 [3.65 to 6.32]; AOR 3.07 [2.54 to 3.70]). Social media measured by time-use-diary was associated with higher risks, although not always demonstrating a dose–response relationship. The effect of social media use (vs no-use) on binge drinking was larger in the higher (vs lower) parental education groups. Analyses repeated in complete case samples, and with adjustment for baseline outcome measures revealed consistent findings. Conclusions Findings suggest social media use may increase risk of alcohol use and binge drinking. Regulatory action protecting adolescents from harmful alcohol-related social media content is necessary. [ABSTRACT FROM AUTHOR]

READY is a self-report prospective longitudinal study of deaf and hard of hearing (DHH) young people aged 16 to 19 years on entry. Its overarching aim is to explore the risk and protective factors for successful transition to adulthood. This article introduces the cohort of 163 DHH young people, background characteristics and study design. Focusing on self-determination and subjective well-being only, those who completed the assessments in written English (n =  133) score significantly lower than general population comparators. Sociodemographic variables explain very little of the variance in well-being scores; higher levels of self-determination are a predictor of higher levels of well-being, outweighing the influence of any background characteristics. Although women and those who are LGBTQ+ have statistically significantly lower well-being scores, these aspects of their identity are not predictive risk factors. These results add to the case for self-determination interventions to support better well-being amongst DHH young people. [ABSTRACT FROM AUTHOR]

The interpersonal harms that young people experience beyond their families have been documented internationally as have the challenges of protecting those effected using existing child welfare systems. Concern about this in the UK has led to development of 'contextual' child protection systems—capable of targeting the peer group, school and community contexts where extra-familial harm (EFH) occurs. This study examined whether reviews of serious incidents (serious case reviews (SCRs)) provide an evidence-base for understanding the contextual dynamics of EFH and/or developing contextual responses. SCRs (n  = 49) from 2010–2020, where adolescents were harmed in extra-familial contexts, were analysed over two stages. Stage 1 involved thematic coding under four research questions. Using a framework analysis, Stage 1 themes were grouped around according to: contexts associated with EFH; the nature of social work responses and case review recommendations. Findings suggest that SCRs provide a limited account of the contextual dynamics of EFH. Whilst reviews illustrate that social work responses rarely address the contextual dynamics of EFH, many reviewers have neglected to focus on this shortfall when recommending service improvements. For case reviews to inform contextual child protection systems, information provided to review authors and the design of review requires adaptation. [ABSTRACT FROM AUTHOR]

The article presents a guideline from the British Society for Rheumatology for the management of patients with idiopathic inflammatory myopathy (IIM) in the United Kingdom (UK). The guideline used the Appraisal of Guidelines for Research and Evaluation II (AGREEII) methodology. The guideline includes treatment for diseases like skeletal muscle inflammation (myositis).

Background The potential for sexual health services to influence the sexual health and behaviour of school-aged young people is only likely to be realised if these services are accessed. This review and synthesis seeks to explore children and adolescents' views and experiences of school-based and school-linked sexual health services to identify barriers to and facilitators of service use. Methods The study design is a systematic review of studies focusing on the views of children and adolescents (11–18 years) about relevant services. Sixteen databases were searched, titles and abstracts were screened against the inclusion criteria, data extraction and quality assessment of included studies were performed and thematic synthesis was undertaken. Results Nineteen relevant studies were identified, but only studies from the USA and the UK satisfied the inclusion criteria. The principal themes to emerge from the analysis were awareness and need, confidentiality and disclosure, perceptions of staff, service location, physical environment, costs and types of services on offer. These findings were consistent across country and type of service. Conclusions In the view of young people, school-linked sexual health services need to guarantee and promote the ideas of privacy, confidentiality and approachability if they are to be accessed and have an impact on behaviour. [ABSTRACT FROM PUBLISHER]

This article examines the 1987 British AIDS education leaflet Love Carefully: Use a condom , drawing on methodologies from both the history of emotion and literary analysis. The informative leaflet, produced collaboratively by the sexual health charities Brook and the Family Planning Association, was intended to prevent the spread of HIV among heterosexual adolescents, a group increasingly viewed as 'at risk' by adult producers of health education globally. Steeped in British teenage popular culture, it deployed an introduction from well-known teenage agony aunt Melanie McFadyean, a cartoon strip, and statements from celebrities. The cartoon offered a representation of the difficulties experienced by heterosexual teenagers negotiating the prospect of penetrative sex with a new partner, offering a successful example of condom negotiation, while sympathetically examining why some found condom use and AIDS difficult subjects to broach. The article argues the leaflet deployed emotions and authenticity to persuade teenagers to practise safer sex. [ABSTRACT FROM AUTHOR]

The mental health effects of the coronavirus pandemic are likely to be significant and sustained, especially for those who experience adversity or preexisting mental health difficulties. This article examines the experiences of older adolescents during the United Kingdom government's "lockdown" period (April 2020 to June 2020) on mental health, social support, sleep, and routines using both quantitative and qualitative methods. Participants were enrolled in DISCOVER, a school-based stress management program, in London (N  =   107; 72 percent Black, Asian, or minority ethnicity). The Coping with COVID-19 questionnaire was developed and administered online. Changes in mental health, sleep, and routines were reported during the lockdown period as well as increased worry about family members' physical and mental health. Positive experiences of the lockdown period included improvements in quality of relationships and increased time to spend on hobbies. Participants reported the use of cognitive–behavioral therapy techniques for coping. Results have implications for supporting older adolescents during the pandemic, including on their return to school. [ABSTRACT FROM AUTHOR]

Background The coronavirus disease 2019 (COVID-19) pandemic may have a greater impact on people with disabilities than non-disabled people. Our aim was to compare the short-term impact of the 2020 COVID-19 pandemic and first lockdown on the employment and financial security of working age adults with and without disabilities in the UK. Methods Secondary analysis of data collected in Wave 9 and the special April, May and June COVID-19 monthly surveys of 'Understanding Society', the UK's main annual household panel study. Results During the first 3 months of the introduction of the COVID-19 lockdown in the UK, respondents with disability were more likely than their peers to be working reduced hours and experience higher levels of financial stress. These differences were attenuated, but not eliminated, when estimates were adjusted to take account of pre-lockdown financial status. Conclusions Working age adults with disability were particularly disadvantaged by the financial impact of the COVID-19 lockdown in the UK. The UN Secretary-General António Guterres has stated the need for a disability-inclusive COVID-19 government response. The results of our analysis suggest that these pleas have either not been heeded, or if measures have been implemented, they have so far been ineffectual in the UK. [ABSTRACT FROM AUTHOR]

Background Juvenile osteochondritis dissecans (JOCD) is a condition of bone and cartilage lesions. Contributory factors may include ischaemia, trauma, genetic or biomechanical factors such as abnormal joint loading. Children and young people (CYP) with juvenile idiopathic arthritis (JIA) have low physical activity levels, present with joint abnormalities and are exposed to immunosuppression including steroids which may cause reduced bone density. Here we describe JOCD in CYP with JIA in our service. Methods Retrospective reviews of case notes were conducted for current CYP with JIA in our service with known JOCD, detailing: JIA diagnosis Age & BMI at diagnosis Symptom duration pre-diagnosis Management (including steroids) JOCD diagnosis Age & BMI at diagnosis Imaging Management Results Table 1 summarises the results. Twelve (n = 10 female) CYP in our cohort of 270 had JOCD with 20 lesions diagnosed on magnetic resonance imaging (MRI). Polyarticular (n = 4) and extended oligoarticular (n = 5) were the commonest JIA sub-types with all CYP receiving systemic therapy and 75% (n = 9) requiring more than one biologic. Mean symptom duration before JIA diagnosis was 6 months (range: 1-24 months) with a mean age of 6.5 years (range: 1.5-13 years). Mean time to JOCD diagnosis was 5.5 years (range: 1.5-10.25 years) with a mean age of 12 years (range: 8-17 years) and 7 CYP having a high BMI (>85th percentile for age). The mean number of previous steroid injections per JOCD joint was 4 (range: 0-17) compared with 3 (range: 0-8) in the non-JOCD joint. Talar dome lesions (n = 9) were commonest, followed by femoral condyle (n = 4 medial, n = 3 lateral). Initial management was conservative, with half (n = 10) requiring surgery. P09 Table 1     P09 Table 1     Conclusion This review identifies that 4% (n = 12/270) of our CYP with JIA have known JOCD, compared with 0.03% (n = 29/100,000) of the general population. Risk factors appear to be polyarticular disease, exposure to ≥ 4 steroid injections per joint, biologic-resistant disease and high BMI with low physical activity. Where CYP with JIA report symptoms which do not fit an inflammatory pattern there should be a low threshold to consider JOCD, with prospective research needed to better understand the relationship between JOCD and JIA. Conflicts of Interest The authors declare no conflicts of interest. [ABSTRACT FROM AUTHOR]

Publications from the Avon Longitudinal Study of Parents and Children covering diet, growth, and obesity development during childhood are reviewed. Diet was assessed by food frequency questionnaires and food records. Growth data were collected by routine measurements, and in standardized clinics, body fatness was assessed by bioelectrical impedance and DXA (dual-energy X-ray absorptiometry) scans. Diets changed dramatically during the preschool period with an increase in the intake of free (added) sugars (12.3% rising to 16.4% of energy) that remained similar until adolescence. This was due to increased intake of energy-dense, nutrient-poor foods. Two periods of rapid growth were identified; infancy and mid-childhood (ages 7-11 y) and both were associated with obesity development. Diets with high energy density were associated with increasing fat mass from mid-childhood until adolescence. Genetic and dietary factors showed independent associations with increasing adiposity. At all ages studied, there were dietary inequalities related to maternal educational attainment that may influence inequalities found in obesity development. The Avon Longitudinal Study of Parents and Children has provided valuable insights into how disparities in diet and growth may affect the development of ill health in adulthood. [ABSTRACT FROM AUTHOR]

Publications from the Avon Longitudinal Study of Parents and Children that used empirically derived dietary patterns were reviewed. The relationships of dietary patterns with socioeconomic background and childhood development were examined. Diet was assessed using food frequency questionnaires and food records. Three statistical methods were used: principal components analysis, cluster analysis, and reduced rank regression. Throughout childhood, children and parents have similar dietary patterns. The "health-conscious" and "traditional" patterns were associated with high intakes of fruits and/or vegetables and better nutrient profiles than the "processed" patterns. There was evidence of tracking in childhood diet, with the "health-conscious" patterns tracking most strongly, followed by the "processed" pattern. An "energy-dense, low-fiber, high-fat" dietary pattern was extracted using reduced rank regression; high scores on this pattern were associated with increasing adiposity. Maternal education was a strong determinant of pattern score or cluster membership; low educational attainment was associated with higher scores on processed, energy-dense patterns in both parents and children. The Avon Longitudinal Study of Parents and Children has provided unique insights into the value of empirically derived dietary patterns and has demonstrated that they are a useful tool in nutritional epidemiology. [ABSTRACT FROM AUTHOR]

There are almost 90,000 young people in care in the UK. M any over the age of eleven years entercare due to anti-social behaviour, acute stress and family dysfunction. The short-term and long-term costs at an individual, family and societal level of going into care are high. There are a number of preventative interventions available for this vulnerable group in common use but not all have a strong evidence base. Multisystemictherapy (MST) is a community intervention which targets the systems around the young person including the family, school, peer and community. Some barriers of the intervention are that it does not target every young person at risk of care, nor is it available in every local authority and there is a low annual capacity. Some of the strengths of MST include the robust evidence base, the cost savings and the strong emphasis on implementation fidelity. It is argued that all young people at risk of care or entering custody need to have access to evidence-based treatments which aim to enable them to remain safely at home. The implications for commissioners and social care practitioners in changing current practice are discussed. [ABSTRACT FROM AUTHOR]

Aims: In 2011, online marketing became the largest marketing channel in the UK, overtaking television for the first time. This study aimed to describe the exposure of children and young adults to alcohol marketing on social media websites in the UK. Methods: We used commercially available data on the three most used social media websites among young people in the UK, from December 2010 to May 2011. We analysed by age (6–14 years; 15–24 years) and gender the reach (proportion of internet users who used the site in each month) and impressions (number of individual pages viewed on the site in each month) for Facebook, YouTube and Twitter. We further analysed case studies of five alcohol brands to assess the marketer-generated brand content available on Facebook, YouTube and Twitter in February and March 2012. Results: Facebook was the social media site with the highest reach, with an average monthly reach of 89% of males and 91% of females aged 15–24. YouTube had a similar average monthly reach while Twitter had a considerably lower usage in the age groups studied. All five of the alcohol brands studied maintained a Facebook page, Twitter page and YouTube channel, with varying levels of user engagement. Facebook pages could not be accessed by an under-18 user, but in most cases YouTube content and Twitter content could be accessed by those of all ages. Conclusion: The rise in online marketing of alcohol and the high use of social media websites by young people suggests that this is an area requiring further monitoring and regulation. [ABSTRACT FROM AUTHOR]

Background Childhood obesity is linked to a range of health and social problems. Solutions include the delivery of appropriate weight management interventions for those aged 16 and under. The ‘Balance It! Getting the Balance Right’ programme appears to be effective for those who complete the intervention, but the non-completion rate remains high. A qualitative evaluation was undertaken to explore the views of key stakeholders in the programme and identify possible reasons for non-completion. Methods Semi-structured interviews were conducted with a purposive sample of 16 NHS and local authority staff, and with 20 children (aged 4–16 years) and their families. A mosaic methodology was used, involving visual and verbal techniques employed to enable children of all ages to take an active role in expressing their opinions. Results Key themes included the challenges of approaching overweight children; positive outcomes for some families; and issues relating to communication and coordination. Participants spoke positively about the multi-disciplinary approach of ‘Balance It!’, but felt it could better meet the needs of its target population. Conclusions Structured interventions help to ensure consistency and coherence in terms of approaches to childhood overweight and obesity. Whole family approaches may be most effective in enhancing the user experience. [ABSTRACT FROM PUBLISHER]

Because few prospective studies have examined the independent influence of mothers and fathers on smoking experimentation, we tested the association between a set of parent-specific, familial and peer interactions with smoking experimentation in early adolescence. Data come from two cohorts in the British Youth Panel Survey (N = 1736; mean age at baseline, 11.26; SD = 0.65), a study of children resident with members of the British Household Panel Survey. Baseline data showed 8.2% of participants had smoked which increased to 40.3% after a 3-year follow-up. Multivariate logistic regression models showed risk factors for the onset of experimentation included frequent time spent with peers (P < 0.001), maternal smoking (P = 0.001), female gender and older participant age (P < 0.001). Parent–child quarrels, mother–child conversations, family meal frequency and household income were not significantly associated with experimentation. Frequent father–child conversations, about things which mattered to children, were the only type of parent–child contact associated with a reduced risk of experimentation (P < 0.001), and a significant interaction suggested that maternal smoking increased the likelihood of girls but not boys experimentation (P = 0.01). This study suggests that familial risk and protective factors operate independently and that more attention should be paid to the role of fathers in smoking prevention. [ABSTRACT FROM PUBLISHER]

Introduction: Tobacco use is common and remains one of the leading causes of preventable death in developed countries. Smoking commonly begins in adolescence, and hence, it is important to understand how smoking behavior develops during this period.Methods: In a U.K.-based birth cohort, we analyzed repeated measures of smoking frequency in a sample of 7,322 young adolescents. Latent class analysis was used to summarize the data, and the resulting classes of behavior were related to a range of smoking risk factors. Results from a complete case analysis were compared with estimation using full-information maximum likelihood (FIML) and estimation using multiple imputation (MI).Results: Fifty-three percent of the sample reported having smoked a whole cigarette by age 16 years. The longitudinal data were summarized by 4 distinct patterns of smoking initiation: nonsmokers (79.7%), experimenters (10.3%), late-onset regular smokers (5.5%), and early-onset regular smokers (4.5%). Social disadvantage, other substance use, conduct problems, and female sex were strongly related to being a regular smoker; however, no risk factors studied showed any strong or consistent association with experimentation. In the complete case sample, smoking prevalence was lower, and in addition, the association between different smoking patterns and covariates was often inconsistent with those obtained through FIML/MI.Conclusions: Most young people have experimented with tobacco smoking by age 16 years, and regular smoking is established in a substantial minority characterized by social disadvantage, other substance, use and conduct disorder. Prevention strategies should focus on this subgroup as most children who experiment with tobacco do not progress to regular smoking. [ABSTRACT FROM AUTHOR]

Background Biologic therapies have revolutionised the management of patients with rheumatological conditions; with considerable cost to the NHS. The switch of originators to biosimilar products was challenging. We aim to share our experience of adalimumab biosimilar switch and believe this is reflective of the challenges experienced in some other centres. The development of biosimilar aims to challenge the excesses of pharma profits by encouraging competition in the market place. Previous switches to intravenous biosimilar products had been uneventful. We were informed that the trust was implementing switch of biologics to biosimilar and later told biosimilar A was the biosimilar version allocated to us. This was a decision beyond the Trust, with NHS England deciding on the allocation. For our Trust, biosimilar A was allocated for patients weighing 30kg requiring a 40mg dose and biosimilar B allocated for patients weighing less than 30kg requiring a 20mg dose (NB: no 20mg preparation available for biosimilar A). Patients commenced on biosimilar B 20mg preparation can remain on biosimilar B and move on to its 40mg preparation once they weigh 30kg. Biosimilar A, the cheaper of the two preparations, contains preservative, citrate. Both biosimilars are double the volume of the originator biologic. Case a biologic-naïve 16 year-old patient was the first to be treated with the chosen biosimilar A, and, upon self-administrating; the patient clearly expressed a high level of pain. Following the experience with the patient the team felt that this was not an appropriate option. Methods With the feedback from the patient, rheumatology team highlighted the issues and focussed on high quality patient centred care not just focussing on the short term cost saving option but understanding that the patient engagement and compliance is cost saving in the long run. The team enquired with other specialities and regional paediatric rheumatology centres regarding their biosimilar switch. Results Liaising with the High cost pharmacy team, we successfully obtained authorisation to prescribe biosimilar B. We promptly switched the patient to biosimilar B and prescribe this now for all suitable to switch and new patients. So far there have been no negative comments or issues from the switch to the citrate free product. Conclusion It is vital that we provide an evidence based cost saving medication to treat children with long term conditions. However when new medications are being introduced, there needs to be greater consideration for the paediatric population which currently seems lacking. Collaborative working with the high cost pharmacy team, regular communications with other specialities, adult colleagues and involving the national nurse specialists group greatly benefitted us in managing this situation. More studies are required to identify patient factors involved in these scenarios. Conflicts of Interest The authors declare no conflicts of interest. [ABSTRACT FROM AUTHOR]

Background Adolescent risk behaviours such as smoking, alcohol use and antisocial behaviour are associated with increased risk of morbidity and mortality. Patterns of risk behaviour may vary between genders during adolescence. Methods Analysis of data from a longitudinal birth cohort to assess the prevalence and distribution of multiple risk behaviours by gender at age 15–16 years with a focus on alcohol use at age 10, 13 and 15 years. Results By age 15 years, over half of boys and girls had consumed alcohol and one-fifth had engaged in binge drinking with no clear difference by gender. At age 15–16 years, the most prevalent risk behaviours were physical inactivity (74%), antisocial and criminal behaviour (42%) and hazardous drinking (34%). Boys and girls engaged in a similar number of behaviours but antisocial and criminal behaviours, cannabis use and vehicle-related risk behaviours were more prevalent among boys, whilst tobacco smoking, self-harm and physical inactivity were more prevalent among girls. Conclusion Multiple risk behaviour is prevalent in both genders during adolescence but the pattern of individual risk behaviour varies between boys and girls. Effective interventions at the individual, family, school, community or population level are needed to address gender-specific patterns of risk behaviour during adolescence. [ABSTRACT FROM AUTHOR]

Background Engagement in risk behaviours may pose a significant threat to health if involvement spans multiple behaviours. The asset model suggests that contextual aspects of young people's lives, such as factors related to family, school and community, serve as a protective function against health risk behaviours. Methods A risk-taking index was created from the English health behaviour in school-aged children study on 15 years olds, substance use and sexual activity. Using a multinomial regression, potential asset variables relating to school, family, peers, community and family affluence were tested for their association with levels of risk behaviours. Results Sense of neighbourhood belonging, strong school belonging and parental involvement in decision-making about leisure time were related to lower engagement in health risk behaviours. A weaker sense of family belonging was associated with increased risk behaviours if connectedness with teachers was also low. Factors related to school and community played a greater role in adolescent participation in health-related risk behaviours than family-related factors, including family affluence. Conclusions Feelings of safety and belonging in the out-of-home settings of adolescents were positively associated with reduced risk behaviours, and indicate the importance of the wider community alongside parents and school as protective assets for health. [ABSTRACT FROM AUTHOR]