title: Clustering of adolescent health concerns: a latent class analysis of school students in New Zealand.
abstract: OBJECTIVE
  The aims of this study are to identify clinically meaningful groups of adolescents based on their engagement in high levels of risk behaviours or severe emotional health concerns and to describe the demographic characteristics of these groups in two populations of school students in New Zealand.
  
  
  METHODS
  A nationally representative sample of secondary school students was surveyed in 2007; alternative education (AE) students in Auckland and Northland were surveyed in 2009. A total of 9107 secondary school students and 335 AE students completed a youth health questionnaire using Internet tablets. Latent class analysis (LCA) was used to identify groups of students on the basis of distinct profiles of their risk behaviours and mental health concerns.
  
  
  RESULTS
  The majority (80%) of students in secondary schools are 'healthy' and report few health concerns, 16% are considered 'risky' or 'distressed', and 4% report 'multiple' risk behaviour profiles or emotional health concerns. In AE, only 21% of students were considered 'healthy' with most featuring in the 'risky' or 'multiple' groups. Females were more likely to be 'distressed', whereas males were more likely to feature in the 'risky' or 'multiple' groups.
  
  
  CONCLUSIONS
  Clinically-concerning health risk behaviours and emotional health concerns 'cluster' in up to 20% of students in secondary schools and up to 79% of students in AE. Gender, ethnic and socio-economic disparities are also observed. This highlights the importance of comprehensive psychosocial assessment and appropriate service provision, particularly for at-risk groups.
authors.affiliation: Department of Paediatrics: Child and Youth Health, University of Auckland, Auckland, New Zealand.
authors.forename: Hannah
authors.initials: H
authors.lastname: Noel
authors.affiliation: Department of Paediatrics: Child and Youth Health, University of Auckland, Auckland, New Zealand.
authors.forename: Simon
authors.initials: S
authors.lastname: Denny
authors.affiliation: Department of Paediatrics: Child and Youth Health, University of Auckland, Auckland, New Zealand.
authors.forename: Bridget
authors.initials: B
authors.lastname: Farrant
authors.affiliation: Department of Social and Community Health, University of Auckland, Auckland, New Zealand.
authors.forename: Fiona
authors.initials: F
authors.lastname: Rossen
authors.affiliation: School of Population Health, University of Auckland, Auckland, New Zealand.
authors.forename: Tasileta
authors.initials: T
authors.lastname: Teevale
authors.affiliation: School of Nursing, University of Auckland, Auckland, New Zealand.
authors.forename: Terryann
authors.initials: T
authors.lastname: Clark
authors.affiliation: Department of Paediatrics: Child and Youth Health, University of Auckland, Auckland, New Zealand.
authors.forename: Terry
authors.initials: T
authors.lastname: Fleming
authors.affiliation: School of Learning, Development and Professional Practice, University of Auckland, Auckland, New Zealand.
authors.forename: Pat
authors.initials: P
authors.lastname: Bullen
authors.affiliation: School of Pharmacy, University of Auckland, Auckland, New Zealand.
authors.forename: Janie
authors.initials: J
authors.lastname: Sheridan
authors.affiliation: School of Population Health, University of Auckland, Auckland, New Zealand.
authors.forename: Sarah
authors.initials: S
authors.lastname: Fortune
mesh_terms: D000293:Adolescent; D000294:Adolescent Behavior; D016497:Adolescent Health Services; D001294:Attitude to Health; D016000:Cluster Analysis; D016001:Confidence Intervals; D005260:Female; D006306:Health Surveys; D006801:Humans; D008297:Male; D008603:Mental Health; D009520:New Zealand; D012309:Risk-Taking; D013334:Students / Q000523:psychology*
keywords: adolescent behaviour; adolescent health service; cluster analysis; mental health; risk-taking; school