title: Clustering of modifiable biobehavioral risk factors for chronic disease in US adults: a latent class analysis.
abstract: OBJECTIVE
  Examining the co-occurrence patterns of modifiable biobehavioral risk factors for deadly chronic diseases (e.g. cancer, cardiovascular disease, diabetes) can elucidate the etiology of risk factors and guide disease-prevention programming. The aims of this study were to (1) identify latent classes based on the clustering of five key biobehavioral risk factors among US adults who reported at least one risk factor and (2) explore the demographic correlates of the identified latent classes.
  
  
  METHODS
  Participants were respondents of the National Epidemiologic Survey of Alcohol and Related Conditions (2004-2005) with at least one of the following disease risk factors in the past year (N = 22,789), which were also the latent class indicators: (1) alcohol abuse/dependence, (2) drug abuse/dependence, (3) nicotine dependence, (4) obesity, and (5) physical inactivity. Housing sample units were selected to match the US National Census in location and demographic characteristics, with young adults oversampled. Participants were administered surveys by trained interviewers.
  
  
  RESULTS
  Five latent classes were yielded: 'obese, active non-substance abusers' (23%); 'nicotine-dependent, active, and non-obese' (19%); 'active, non-obese alcohol abusers' (6%); 'inactive, non-substance abusers' (50%); and 'active, polysubstance abusers' (3.7%). Four classes were characterized by a 100% likelihood of having one risk factor coupled with a low or moderate likelihood of having the other four risk factors. The five classes exhibited unique demographic profiles.
  
  
  CONCLUSIONS
  Risk factors may cluster together in a non-monotonic fashion, with the majority of the at-risk population of US adults expected to have a high likelihood of endorsing only one of these five risk factors.
authors.affiliation: Departments of Preventive Medicine and Psychology, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA adam.leventhal@usc.edu.
authors.forename: Adam M
authors.initials: AM
authors.lastname: Leventhal
authors.affiliation: Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA.
authors.forename: Jimi
authors.initials: J
authors.lastname: Huh
authors.affiliation: Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA.
authors.forename: Genevieve F
authors.initials: GF
authors.lastname: Dunton
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D002908:Chronic Disease / Q000453:epidemiology* / Q000208:ethnology / Q000517:prevention & control; D005260:Female; D015438:Health Behavior; D006801:Humans; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000453:epidemiology; D012307:Risk Factors; D057185:Sedentary Behavior / Q000208:ethnology; D012737:Sex Factors; D012959:Socioeconomic Factors; D019966:Substance-Related Disorders / Q000453:epidemiology* / Q000208:ethnology; D014481:United States / Q000453:epidemiology; D055815:Young Adult
keywords: latent class analysis; multiple risk factors; obesity; physical activity; substance-use disorders
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