To Örebro University

Background/purpose: This study examined the prevalence of multiple health risk behaviours, the clustering patterns of health risk behaviours, and the association between socio-demographic characteristics, psychological distress and clusters among adolescents in Ghana.

Methods: Participants were senior high school (SHS) students aged 11-19 years who participated in the 2012 Global School-based Students Health Survey (n = 1763). Five health risk behaviours (smoking tobacco, inadequate fruit intake, inadequate vegetable intake, alcohol intake and physical inactivity) were measured. Latent class analysis and latent regression were used to identify the clusters and factors associated with the clusters respectively.

Results: The prevalence of multiple health risk behaviours (2 or more) was 94.8%. Two clusters emerged: cluster1 ("Poor nutrition, inactive, low substance use cluster";91%); cluster 2 ("High Risk Cluster"; 9%). Using cluster 1 as a reference group, adolescents in the 11-15 years category had lower odds of belonging to cluster 2 (OR = 0.21, CI 0.05-0.91,ρ= 0.036) while those experiencing symptoms of depression had higher odds of belonging to cluster 2 (OR = 2.45, CI 1.45-4.14,ρ=0.001.

Conclusions and implications: Health risk behaviours cluster among adolescents with age and depression associated with the identified clusters. Early interventions that target these clusters are needed at the individual, school and community level to mitigate the burden of non-communicable diseases.