title: The triply troubled teenager--chronic conditions associated with fewer protective factors and clustered risk behaviours.
abstract: OBJECTIVE
  This study aimed to measure protective factors and risk behaviour among adolescents with chronic conditions (CCs) and to evaluate the impact of protective factors on risk-taking.
  
  
  METHODS
  A population-based study of 7262 students aged 15 and 17 years old was performed in Sörmland, Sweden 2008 (response rate 82%). The questionnaire explored background factors, CCs, risk behaviours and protective factors. CCs were reported by 8%, while 58% had no health problems.
  
  
  RESULTS
  Girls with CCs encompassed less individual protective factors, while boys with CCs tended to over-report all individual risk behaviours compared with healthy peers. Both boys and girls with CCs were more likely to report few protective factors and co-occurrence of risk behaviours. The adjOR for clustered health risk behaviours was 1.6 (1.0-2.5) in youths with CCs and ≥4 protective factors and 6.3 (3.6-10.9) in youths with CCs and 0-3 protective factors, as compared to healthy peers with ≥4 protective factors.
  
  
  CONCLUSIONS
  Adolescents with CCs reported fewer protective factors and more risk behaviours than their healthy peers. The vulnerability of adolescents with CCs and few protective factors is important to acknowledge. Professionals should provide stronger protection for these adolescents, to prevent risky behaviour.
authors.affiliation: Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden; Centre for Clinical Research Sörmland, Uppsala University, Uppsala, Sweden; Department of Paediatrics, Mälarsjukhuset Hospital, Eskilstuna, Sweden.
authors.forename: Charlotte
authors.initials: C
authors.lastname: Nylander
authors.forename: Carina
authors.initials: C
authors.lastname: Seidel
authors.forename: Ylva
authors.initials: Y
authors.lastname: Tindberg
mesh_terms: D000293:Adolescent; D000294:Adolescent Behavior; D000704:Analysis of Variance; D002908:Chronic Disease / Q000523:psychology*; D005260:Female; D015438:Health Behavior; D006801:Humans; D008297:Male; D012309:Risk-Taking; D011795:Surveys and Questionnaires; D013548:Sweden; D013694:Temperament
keywords: Adolescent development; Adolescent medicine; Chronic disease; Health behaviour; Risk-taking