Departamento de Medicina Preventiva, Faculdade de Medicina FMUSP, Universidade de Sao Paulo, Sao Paulo, SP, BR. Address: Av. Dr. Arnaldo, 455 - 2o. andar - sala 2214, São Paulo, Postal Code: 01246-903, Brazil.
Institute of Criminology, University of Cambridge and Professor of Developmental Criminology, Jacobs Center for Productive Youth Development, University of Zurich, Zurich, Switzerland.
BMC Public Health. 2021 Sep 19;21(1):1706. doi: 10.1186/s12889-021-11718-4.
Self-control (SC) has been consistently found associated with diverse health risk behaviors (HRBs), but little research refers to low- and middle-income countries. Furthermore, there is evidence that some HRBs tend to aggregate, however studies with the specific purpose of addressing the relation between SC and multiple health risk behaviors (MHRBs) are rare. The objective of this study is to analyze these associations and provide evidence to help filling these gaps.
A sample of 2106 9th grade students from the city of São Paulo responded a self-administered questionnaire in 2017. We tested the association of SC measured as an ordinal variable with four levels (higher, high, medium and low) with six HRBs (binge drinking, marijuana use, smoking, high consumption of ultra-processed food, sedentary behavior and bullying perpetration), in both separated and aggregated forms (MHRBs), controlling for potential confounders. Binary logistic regression was used to test the association between exposure (SC) and single outcomes. In order to analyze the association of SC with MHRBs, multinomial logistic regression was employed.
SC was associated with five of six HRBs investigated and with MHRBs. The effect size of the association of SC and MHRBs increased in a steep pattern with accumulation of more HRBs.
Low self-control is associated with most HRBs investigated and the magnitude of the association increases when more than two or three HRBs are accumulated. There seems to be a group of adolescents in a position of pronounced vulnerability for MHRBs. This should be considered when designing public policy and prevention programs. In contexts of limited or scarce resources and public funds, interventions focusing the most vulnerable groups, instead of universal interventions, should be considered.
自我控制（SC）一直与各种健康风险行为（HRB）相关，然而，很少有研究涉及中低收入国家。此外，有证据表明，一些 HRB 往往会聚集在一起，但是，专门研究 SC 与多种健康风险行为（MHRB）之间关系的研究很少。本研究的目的是分析这些关联，并提供证据来帮助填补这些空白。
2017 年，来自圣保罗市的 2106 名 9 年级学生对一份自我管理问卷进行了回答。我们测试了 SC 与六个 HRB（狂饮、大麻使用、吸烟、超加工食品高消费、久坐行为和欺凌行为）之间的关联，SC 作为一个有序变量，分为四个水平（高、较高、中、低），控制了潜在的混杂因素。我们使用二元逻辑回归来检验暴露（SC）与单一结果之间的关联。为了分析 SC 与 MHRB 的关联，我们采用了多项逻辑回归。
SC 与六个调查 HRB 中的五个以及 MHRB 相关。SC 与 MHRB 的关联效应大小随着 HRB 数量的增加而呈陡峭模式增加。
低自我控制与大多数调查的 HRB 相关，当积累超过两个或三个 HRB 时，关联的幅度会增加。似乎有一群青少年处于 MHRB 的明显脆弱地位。在设计公共政策和预防计划时应考虑到这一点。在资源有限或稀缺的情况下，应考虑针对最脆弱群体的干预措施，而不是普遍性干预措施。
