title: Integrative research review of risk behaviors among adolescents in rural, suburban, and urban areas.
abstract: OBJECTIVE
  The purpose of this integrative review was to describe the state of the science regarding adolescent risk behaviors, with particular emphasis on comparisons among rural, urban, and suburban populations.
  
  
  METHODS
  The review was done at two levels, moving from the major national survey studies which included data collected in the late 1980s up to 1993, to more focused topical areas including studies with data collection and publication between 1990 and 1996 within each identified category of adolescent health issues. A total of 137 published works across several disciplines were reviewed. Suggestions for clinical practice were drawn from the significant research findings. In addition, risk behaviors were compared to national baseline data and objectives.
  
  
  RESULTS
  The level of research in this topic area was primarily descriptive. Currently, only a small portion of the national objectives for decreasing adolescent risk behaviors have been met. Successful intervention programs, although few in number, usually included not only topical education but also adolescent interaction with peers and support systems to raise awareness and change behaviors.
  
  
  CONCLUSIONS
  The risk behaviors for the adolescent population as a whole have been well described. Education alone is not sufficient to change behaviors. Objective outcomes must be identified and health care providers need to use research findings in their practice with adolescents. It is time to intervene with developmentally and culturally appropriate strategies. There was a large gap in the literature regarding risk behaviors and protective factors for rural adolescents. The few studies that included subjects from rural settings indicated that the view that rural adolescents are engaged in fewer or less severe risk behaviors is misleading.
authors.affiliation: Decker School of Nursing, Binghamton University, State University of New York, 13902-6000, USA.
authors.forename: P S
authors.initials: PS
authors.lastname: Fahs
authors.forename: B E
authors.initials: BE
authors.lastname: Smith
authors.forename: A S
authors.initials: AS
authors.lastname: Atav
authors.forename: M X
authors.initials: MX
authors.lastname: Britten
authors.forename: M S
authors.initials: MS
authors.lastname: Collins
authors.forename: L C
authors.initials: LC
authors.lastname: Morgan
authors.forename: G A
authors.initials: GA
authors.lastname: Spencer
mesh_terms: D000293:Adolescent; D000294:Adolescent Behavior / Q000145:classification*; D004032:Diet; D005260:Female; D006291:Health Policy; D006801:Humans; D008297:Male; D012106:Research; D012309:Risk-Taking; D012424:Rural Population; D012725:Sexual Behavior / Q000706:statistics & numerical data; D019966:Substance-Related Disorders / Q000453:epidemiology; D013383:Suburban Population; D013406:Suicide, Attempted; D014481:United States / Q000453:epidemiology; D014505:Urban Population