Evolution of risk behaviors over 2 years among a cohort of urban African American adolescents
B. Stanton, X. Fang, X. Li, S. Feigelman, J. Galbraith and I. Ricardo
Department of Pediatrics, University of Maryland School of Medicine, Baltimore, USA.
OBJECTIVE: To examine the evolution of risk behaviors over 2 years among a
community-based cohort of low-income African American preadolescents and
young adolescents enrolled in a randomized trial of an acquired
immunodeficiency syndrome risk reduction intervention. DESIGN:
Longitudinal, community-based cohort. SETTING: Nine recreation centers
serving 3 public housing developments. SUBJECTS: Three hundred eighty-three
African American youths aged 9 through 15 years at baseline. INTERVENTIONS:
Frequency distributions, chi 2 analyses, and regression analyses regarding
10 risk behaviors were conducted. To assess whether a specific risk
behavior or its protective (nonrisk) behavioral analogue, composing a
risk-nonrisk behavioral complex (eg, was sexually active and was sexually
abstinent or used drugs and refrained from drugs), was stable over time,
kappa values were determined for the 10 risk-nonrisk behavioral complexes.
MAIN OUTCOME MEASURES: Instrument assessing risk/ behaviors administered at
baseline and every 6 months aurally and visually via talking computer.
RESULTS: The prevalence of sexual intercourse, cigarette smoking, alcohol
consumption, and drug use increased notably over time. Drug use increased
from a 6-month cumulative prevalence of 7% at baseline to 27% at the
24-month follow-up (P < .001). Cumulatively over the 2-year study
interval, 81% of youths had engaged in fighting, 58% had engaged in sexual
intercourse, and from 33% to 40% had engaged in truancy, knife or bat
carrying or both, alcohol consumption, drug use, and cigarette smoking. All
of the risk-nonrisk behavioral complexes except weapon carrying were stable
during the semiannual assessment intervals. Fighting (kappa = 0.22, P <
.01), sexual intercourse (kappa = 0.33, P < .001), alcohol consumption
(kappa = 0.21, P < .001), and unprotected sexual intercourse (kappa =
0.34, P < .05) were stable for 2 years. Six risk-nonrisk behavioral
complexes were stable for the 2-year interval among youths aged 13 through
15 years at baseline, while only 2 risk-nonrisk behavioral complexes were
stable among younger youths. The intervention seemed to affect the
stability of 4 risk behaviors: truancy, drug use, unprotected sexual
intercourse, and, possibly, fighting. For unprotected sexual intercourse,
this intervention effect seemed to be due to stabilization of
nonparticipation in risky behavior. Intervention youths were less likely to
adopt a risk behavior (ie, engage in it for > or = 2 risk assessment
periods) than control youths, but they were not less likely to experiment
with a risk behavior. CONCLUSIONS: There is evidence that although the
prevalence of risk behaviors does change with age, most risk-nonrisk
behavioral complexes seem to be relatively stable over time and stability
may increase with time. Risk reduction interventions seem to decrease risk
adoption, stabilize nonrisk behaviors, and possibly destabilize risk
behavior.
