Whitaker Victoria, Oldham Melissa, Boyd Jennifer, Fairbrother Hannah, Curtis Penny, Meier Petra, Holmes John
Health Sciences School, University of Sheffield, Sheffield, UK.
School of Health and Related Research, University of Sheffield, Sheffield, UK.
BMC Public Health. 2021 Jan 14;21(1):137. doi: 10.1186/s12889-020-10140-6.
We aimed to systematically review and synthesise evidence on the clustering of a broad range of health-related behaviours amongst 11-16 year olds.
A literature search was conducted in September 2019. Studies were included if they used cluster analysis, latent class analysis, prevalence odds ratios, principal component analysis or factor analysis, and considered at least three health-related behaviours of interest among 11-16 year olds in high-income countries. Health-related behaviours of interest were substance use (alcohol, cigarettes and other drug use) and other behavioural risk indicators (diet, physical activity, gambling and sexual activity).
The review identified 41 studies, which reported 198 clusters of health-related behaviours of interest. The behaviours of interest reported within clusters were used to define eight behavioural archetypes. Some included studies only explored substance use, while others considered substance use and/or other health-related behaviours. Consequently, three archetypes were comprised by clusters reporting substance use behaviours alone. The archetypes were: (1) Poly-Substance Users, (2) Single Substance Users, (3) Substance Abstainers, (4) Substance Users with No/Low Behavioural Risk Indicators, (5) Substance Abstainers with Behavioural Risk Indicators, (6) Complex Configurations, (7) Overall Unhealthy and (8) Overall Healthy.
Studies of youth health behavioural clustering typically find both a 'healthy' cluster and an 'unhealthy' cluster. Unhealthy clusters are often characterised by poly-substance use. Our approach to synthesising cluster analyses may offer a means of navigating the heterogeneity of method, measures and behaviours of interest in this literature.
我们旨在系统回顾和综合关于11至16岁青少年中广泛的健康相关行为聚集情况的证据。
于2019年9月进行文献检索。纳入的研究需使用聚类分析、潜在类别分析、患病率比值比、主成分分析或因子分析，并考虑高收入国家11至16岁青少年中至少三种感兴趣的健康相关行为。感兴趣的健康相关行为包括物质使用（酒精、香烟和其他药物使用）以及其他行为风险指标（饮食、体育活动、赌博和性行为）。
该综述确定了41项研究，这些研究报告了198个感兴趣的健康相关行为聚类。聚类中报告的感兴趣行为被用于定义八种行为原型。一些纳入研究仅探讨了物质使用，而其他研究则考虑了物质使用和/或其他健康相关行为。因此，有三种原型由仅报告物质使用行为的聚类组成。这些原型分别是：（1）多种物质使用者，（2）单一物质使用者，（3）物质戒断者，（4）无/低行为风险指标的物质使用者，（5）有行为风险指标的物质戒断者，（6）复杂组合，（7）整体不健康，（8）整体健康。
青少年健康行为聚类研究通常会发现一个“健康”聚类和一个“不健康”聚类。不健康聚类通常以多种物质使用为特征。我们综合聚类分析的方法可能提供一种手段，用于梳理该文献中方法、测量和感兴趣行为的异质性。
