title: Family structure and risk behaviors: the role of the family meal in assessing likelihood of adolescent risk behaviors.
abstract: BACKGROUND
  Previous literature has asserted that family meals are a key protective factor for certain adolescent risk behaviors. It is suggested that the frequency of eating with the family is associated with better psychological well-being and a lower risk of substance use and delinquency. However, it is unclear whether there is evidence of causal links between family meals and adolescent health-risk behaviors.
  
  
  OBJECTIVE
  The purpose of this article is to review the empirical literature on family meals and adolescent health behaviors and outcomes in the US.
  
  
  METHODS
  A SEARCH WAS CONDUCTED IN FOUR ACADEMIC DATABASES: Social Sciences Full Text, Sociological Abstracts, PsycINFO®, and PubMed/MEDLINE.
  
  
  METHODS
  We included studies that quantitatively estimated the relationship between family meals and health-risk behaviors.
  
  
  METHODS
  Data were extracted on study sample, study design, family meal measurement, outcomes, empirical methods, findings, and major issues.
  
  
  RESULTS
  Fourteen studies met the inclusion criteria for the review that measured the relationship between frequent family meals and various risk-behavior outcomes. The outcomes considered by most studies were alcohol use (n=10), tobacco use (n=9), and marijuana use (n=6). Other outcomes included sexual activity (n=2); depression, suicidal ideation, and suicide attempts (n=4); violence and delinquency (n=4); school-related issues (n=2); and well-being (n=5). The associations between family meals and the outcomes of interest were most likely to be statistically significant in unadjusted models or models controlling for basic family characteristics. Associations were less likely to be statistically significant when other measures of family connectedness were included. Relatively few analyses used sophisticated empirical techniques available to control for confounders in secondary data.
  
  
  CONCLUSIONS
  More research is required to establish whether or not the relationship between family dinners and risky adolescent behaviors is an artifact of underlying confounders. We recommend that researchers make more frequent use of sophisticated methods to reduce the problem of confounders in secondary data, and that the scope of adolescent problem behaviors also be further widened.
authors.affiliation: Department of Health Care Organization and Policy, School of Public Health, University of Alabama at Birmingham, Birmingham, AL, USA.
authors.forename: Samantha
authors.initials: S
authors.lastname: Goldfarb
authors.affiliation: Department of Health Care Organization and Policy, School of Public Health, University of Alabama at Birmingham, Birmingham, AL, USA.
authors.forename: Will L
authors.initials: WL
authors.lastname: Tarver
authors.affiliation: Department of Health Care Organization and Policy, School of Public Health, University of Alabama at Birmingham, Birmingham, AL, USA.
authors.forename: Bisakha
authors.initials: B
authors.lastname: Sen
keywords: adolescents; confounders; family meals; review; risk behaviors; study design