title: Patterns of multiple health risk-behaviours in university students and their association with mental health: application of latent class analysis.
abstract: BACKGROUND
  University and college campuses may be the last setting where it is possible to comprehensively address the health of a large proportion of the young adult population. It is important that health promoters understand the collective challenges students are facing, and to better understand the broader lifestyle behavioural patterning evident during this life stage. The purpose of this study was to examine the clustering of modifiable health-risk behaviours and to explore the relationship between these identified clusters and mental health outcomes among a large Canadian university sample.
  
  
  METHODS
  Undergraduate students (n = 837; mean age = 21 years) from the University of Toronto completed the National College Health Assessment survey. The survey consists of approximately 300 items, including assessments of student health status, mental health and health-risk behaviours. Latent class analysis was used to identify patterning based on eight salient health-risk behaviours (marijuana use, other illicit drug use, risky sex, smoking, binge drinking, poor diet, physical inactivity, and insufficient sleep).
  
  
  RESULTS
  A three-class model based on student behavioural patterns emerged: "typical," "high-risk" and "moderately healthy." Results also found high-risk students reporting significantly higher levels of stress than typical students (χ2(1671) = 7.26, p < .01).
  
  
  CONCLUSIONS
  Students with the highest likelihood of engaging in multiple health-risk behaviours reported poorer mental health, particularly as it relates to stress. Although these findings should be interpreted with caution due to the 28% response rate, they do suggest that interventions targeting specific student groups with similar patterning of multiple health-risk behaviours may be needed.
authors.affiliation: Department of Family Medicine, McMaster University, Hamilton, Ontario, Canada.|Michael G. DeGroote School of Medicine, Niagara Regional Campus, McMaster University, St. Catharines, Ontario, Canada.
authors.forename: M Y
authors.initials: MY
authors.lastname: Kwan
authors.affiliation: Faculty of Kinesiology and Physical Education, University of Toronto, Toronto, Ontario, Canada.
authors.forename: K P
authors.initials: KP
authors.lastname: Arbour-Nicitopoulos
authors.affiliation: Department of Psychiatry and Behavioural Neurosciences and Offord Centre for Child Studies, McMaster University, Hamilton, Ontario, Canada.
authors.forename: E
authors.initials: E
authors.lastname: Duku
authors.affiliation: Faculty of Kinesiology and Physical Education, University of Toronto, Toronto, Ontario, Canada.|School of Kinesiology, University of British Columbia, Vancouver, British Columbia, Canada.
authors.forename: G
authors.initials: G
authors.lastname: Faulkner
mesh_terms: D000328:Adult; D002170:Canada / Q000453:epidemiology; D005260:Female; D006126:Group Processes; D006293:Health Promotion; D054624:Health Status Disparities; D006306:Health Surveys; D006801:Humans; D008297:Male; D008603:Mental Health / Q000706:statistics & numerical data*; D012309:Risk-Taking; D057185:Sedentary Behavior; D013223:Statistics as Topic; D013315:Stress, Psychological / Q000453:epidemiology / Q000517:prevention & control / Q000523:psychology; D013334:Students / Q000523:psychology / Q000706:statistics & numerical data; D019966:Substance-Related Disorders / Q000453:epidemiology / Q000523:psychology; D014495:Universities; D047568:Unsafe Sex / Q000523:psychology / Q000706:statistics & numerical data
keywords: health-risk behaviours; latent class analysis; mental health; university students