title: Associations between school difficulties and health-related problems and risky behaviours in early adolescence: A cross-sectional study in middle-school adolescents in France.
abstract: Health-related problems and risky behaviours (substance use) are frequent in adolescents, may alter their physical and mental capabilities, and may thus generate school absenteeism, low academic performance, and school dropout ideation. This study assessed their associations and the contribution of socioeconomic factors among 1559 middle-school adolescents (mean age 13.5+1.3) from north-eastern France. They completed a questionnaire including socioeconomic characteristics, health-related problems (poor physical health, psychological health, social relationships, and living environment) assessed with the World Health Organization's quality of life measure (score<25th percentile), risky behaviours, school absences during the present school year, last-trimester academic performance, and school dropout ideation. Data were analysed using logistic regression models. School absenteeism was frequent (12.6% of subjects for 8-14 days, and 6.0% for ≥15 days); 8.2% of subjects had low academic performance (average school-mark <10/20) and 3.9% school dropout ideation. All school difficulties were strongly associated with all health-related problems (gender-age-school-level-adjusted odds ratios gasOR between 1.5 and 4.2), and with risky behaviours (gasOR between 1.4 and 14). Socioeconomic factors differently contributed to these associations (contribution reaching 77%). Policy makers, schools, physicians and parents should be more aware of the problems and help adolescents to reduce health-related problems and risky behaviours and to increase resilience.
authors.affiliation: Université de Lorraine, Département de Médecine Générale, Faculté de médecine, Service de Pédo-psychiatrie, Hôpital d'Enfants de Nancy-Brabois, Vandoeuvre-lès-Nancy, France. Electronic address: c.kenora@yahoo.fr.
authors.forename: Kénora
authors.initials: K
authors.lastname: Chau
authors.affiliation: Université de Lorraine, Faculté de médecine, Service de Pédo-psychiatrie, Hôpital d'Enfants de Nancy-Brabois, Vandoeuvre-lès-Nancy, France.
authors.forename: Bernard
authors.initials: B
authors.lastname: Kabuth
authors.affiliation: Inspection Académique, Centres médicaux, Académie Nancy-Metz, Nancy, France.
authors.forename: Odile
authors.initials: O
authors.lastname: Causin-Brice
authors.affiliation: Collège-Lycée la Malgrange, Jarville-la-Malgrange, France.
authors.forename: Yves
authors.initials: Y
authors.lastname: Delacour
authors.affiliation: Collège Albert Camus, Académie Nancy-Metz, Jarville-la-Malgrange, France.
authors.forename: Catherine
authors.initials: C
authors.lastname: Richoux-Picard
authors.affiliation: Collège Montaigu, Académie Nancy-Metz, Heillecourt, France.
authors.forename: Monique
authors.initials: M
authors.lastname: Verdin
authors.affiliation: Inspection Académique, Service de Promotion de la Santé en Faveur des Elèves, Académie Nancy-Metz, Nancy, France.
authors.forename: Isabelle
authors.initials: I
authors.lastname: Armand
authors.affiliation: INSERM, U1178, University Paris-Sud, University Paris Descartes, Paris F-75014, France.
authors.forename: Nearkasen
authors.initials: N
authors.lastname: Chau
mesh_terms: D000041:Absenteeism; D000293:Adolescent; D000294:Adolescent Behavior / Q000502:physiology / Q000523:psychology*; D003430:Cross-Sectional Studies; D004521:Educational Measurement / Q000379:methods; D005260:Female; D005602:France / Q000453:epidemiology; D006801:Humans; D008297:Male; D008603:Mental Health / Q000191:economics / Q000639:trends*; D011788:Quality of Life / Q000523:psychology; D012309:Risk-Taking; D012574:Schools / Q000191:economics / Q000639:trends*; D057566:Self Report; D012959:Socioeconomic Factors; D013334:Students / Q000523:psychology*; D019966:Substance-Related Disorders / Q000191:economics / Q000453:epidemiology / Q000523:psychology; D011795:Surveys and Questionnaires; D055815:Young Adult
keywords: Adolescents; Health-related problems; Predictors; Risky behaviours; School absenteeism; School difficulties; Socioeconomic factors