Risk-Taking Behaviors in Iranian Children and Adolescents: A Latent Class Analysis Approach: Caspian IV Study

Abstract

Background: Risk taking behaviors have several negative consequences. This study aimed to identify the subgroups of students based on risk-taking behaviors and to assess the role of demographic characteristics, depression, anxiety, socioeconomic status (SES), physical inactivity and screen time on membership of specific subgroup. Study design: Cross-sectional study. Method: This nationwide survey was conducted in 2011-2012 among 14880 students, aged 6-18 yr, selected by multistage, cluster-sampling method from 30 provinces of Iran. The students completed two sets of anonymous and validated questionnaires, obtained from the World Health Organization-Global School Health Survey questionnaires. Latent class analysis was performed to achieve the study objectives. Result: Overall, 13486 children and adolescents participated were enrolled (response rate 90.6). They consisted of 50.8 boys, with a mean age of 12.47 +/- 3.36 year. The prevalence of physical fight, bullying, victimization, active smoking, passive hookah and passive cigarette smoking was 39.7, 17.4, 27.2, 5.9, 21.1 and 33.8, respectively. Five latent classes were identified: (a) low risk (46.7), (b) passive smoker (25.2), (c violence and aggression taker with passive smoking (13.5), (d) violence and aggression taker without passive smoking (10.8) and (e) high risk (3.8). Higher age (OR=1.41), being male (OR=5.21), depression (OR=4.58), anxiety (OR=3.38) and screen time (OR=3.11) were associated with high-risk class. Conclusion: The prevalence of some risk-taking behaviors among Iranian students is high. Our findings emphasize the importance of planning and evaluating preventive interventions by considering different high-risk behaviors simultaneously.