title: Cultural, social and intrapersonal factors associated with clusters of co-occurring health-related behaviours among adolescents.
abstract: BACKGROUND
  Adverse health-related behaviours (HRBs) have been shown to co-occur in adolescents. Evidence lacks on factors associated with these co-occurring HRBs. The Theory of Triadic Influence (TTI) offers a route to categorize these determinants according to type (social, cultural and intrapersonal) and distance in the causal pathway (ultimate or distal). Our aims were to identify cultural, social and intrapersonal factors associated with co-occurring HRBs and to assess the relative importance of ultimate and distal factors for each cluster of co-occurring HRBs.
  
  
  METHODS
  Respondents concerned a random sample of 898 adolescents aged 12-18 years, stratified by age, sex and educational level of head of household. Data were collected via face-to-face computer-assisted interviewing and internet questionnaires. Analyses were performed for young (12-15 years) and late (16-18 years) adolescents regarding two and three clusters of HRB, respectively.
  
  
  RESULTS
  For each cluster of HRBs (e.g. smoking, delinquency), associated factors were found. These accounted for 27 to 57% of the total variance per cluster. Factors came in particular from the intrapersonal stream of the TTI at the ultimate level and the social stream at the distal level. Associations were strongest for parenting practices, risk behaviours of friends and parents and self-control.
  
  
  CONCLUSIONS
  Results of this study confirm that it is possible to identify a selection of cultural, social and intrapersonal factors associated with co-occurring HRBs among adolescents.
authors.affiliation: 1 TNO (Netherlands Organization for Applied Scientific Research), Behavioural and Societal Sciences, Leiden, The Netherlands mariska.kleinvelderman@tno.nl.
authors.forename: Mariska
authors.initials: M
authors.lastname: Klein Velderman
authors.affiliation: 1 TNO (Netherlands Organization for Applied Scientific Research), Behavioural and Societal Sciences, Leiden, The Netherlands.
authors.forename: Elise
authors.initials: E
authors.lastname: Dusseldorp
authors.affiliation: 2 Department of Clinical Child and Family Studies, and the EMGO Institute for Health and Care Research and LEARN! Research institute for learning and education, VU University of Amsterdam, Amsterdam, The Netherlands.
authors.forename: Maroesjka
authors.initials: M
authors.lastname: van Nieuwenhuijzen
authors.affiliation: 3 School of Management and Governance, University of Twente, The Netherlands.
authors.forename: Marianne
authors.initials: M
authors.lastname: Junger
authors.affiliation: 1 TNO (Netherlands Organization for Applied Scientific Research), Behavioural and Societal Sciences, Leiden, The Netherlands.
authors.forename: Theo G W M
authors.initials: TG
authors.lastname: Paulussen
authors.affiliation: 1 TNO (Netherlands Organization for Applied Scientific Research), Behavioural and Societal Sciences, Leiden, The Netherlands 4 Department of Health Sciences, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
authors.forename: Sijmen A
authors.initials: SA
authors.lastname: Reijneveld
mesh_terms: D000293:Adolescent; D000294:Adolescent Behavior / Q000523:psychology*; D002648:Child; D016000:Cluster Analysis; D003430:Cross-Sectional Studies; D003469:Culture; D005260:Female; D033062:Friends / Q000523:psychology; D015438:Health Behavior; D006801:Humans; D007398:Interpersonal Relations; D007604:Juvenile Delinquency / Q000523:psychology / Q000706:statistics & numerical data; D008297:Male; D009426:Netherlands / Q000453:epidemiology; D016487:Parenting / Q000523:psychology; D010290:Parents / Q000523:psychology; D012309:Risk-Taking; D012649:Self Concept; D012907:Smoking / Q000453:epidemiology / Q000523:psychology; D012919:Social Behavior; D011795:Surveys and Questionnaires