Is vulnerability associated with substance use? A study among youth in Switzerland.

Adolescence is a period of exploration and experimentation that includes risk behaviors such as substance use. Adolescents living in a situation of vulnerability could be more prone to using substances. In this cross-sectional study, we aimed to evaluate the association between the level of vulnerability and substance use considering explanatory factors. Data were obtained from the first wave of the GenerationFRee project (http://www.generationfree.ch), a longitudinal study based on data collected yearly between 2014 and 2019 on youth aged 15-24 years in high schools and professional schools. The sample included 5179 participants. We designated four risk behaviors: current tobacco smoking, alcohol misuse, cannabis use, and other illegal drug use. We defined vulnerability based on three criteria: the relationship with parents, school performance, and the family socioeconomic status (SES). According to this definition, participants were divided into three groups: no vulnerability, moderate vulnerability, and high vulnerability. Each substance was compared by vulnerability level and controlled with explanatory factors such as age, gender, perceived health, emotional well-being, academic track, nationality, living with parents, residence, family structure, money earned, and perceived personal financial situation. The results show that all substances except alcohol misuse are associated with vulnerability at the bivariate level. All the explanatory factors were also significant with the exception of academic track and amount of money earned per month. In the multinomial regression, for the moderate- and high-vulnerability groups, cannabis use was the only behavior that remained significant. In conclusion, this study shows the association between level of vulnerability and substance use, especially cannabis use. The results also demonstrate the complexity around vulnerability and how the interaction with social aspects influences vulnerability. Youths presenting familial, educational, or financial problems need to be especially screened for substance use by healthcare providers

Adolescent behavioural risk screening in primary care: physician's point of view.

Despite regular consultation between adolescents/young adults (AYA) and their physicians, they are not regularly screened for psychosocial risk behaviours. This study examines physicians' self-reported psychosocial risk behaviour screening in AYA. It aims to highlight which elements hinder or improve screening abilities. The design was a cross-sectional quantitative survey. Data were obtained through a self-reported questionnaire sent out to primary care physicians (PCP) in Switzerland in 2018. The target population consisted of 1,824 PCP (29% response rate). Participants were asked whether they screened youths from 3 age groups [10-14 y/o, 15-20 y/o, and 21-25y/o] for the HEEADSSS items during child well visits and routine checkups. Barriers to screening included primary consultation motive prioritization, insufficient time, patient compliance, reimbursement, lack of skills related to adolescent health, lack of referral options. Data were analysed first through a bivariate analysis using Chi-square tests then through a multinomial logistic regression. The majority of physicians partook in preventive screening for 3-5 psychosocial risk elements. They reported the primary consultation motive as well as a lack of available time as having a high impact on their screening habits. Physician's experience and having discussed confidentiality were related to an increase in the number of topics addressed. Confidentiality remained a significant variable throughout all analyses. Barriers such as lack of consultation time and prioritization issues were found by physicians to be critical but did not hinder screening habits. The main element impacting screening habits was assuring confidentiality and the second is self-efficacy

Is Being Overweight or Obese Really a Problem?

Purpose: To assess whether there are individual, familial, academic or social differences between youths being overweight, obese or normal weight. Methods: Data were drawn from the GenerationFRee study, a cross-sectional survey including 5179 youths aged 15-24. Using Cole’s cut-off points of body mass index (BMI), individuals were divided into normal weight (NW; N=4291), overweight (OW; N=646), and obese (OB, N=242). Groups were compared on age, gender, emotional wellbeing, self-reported health status, family structure, relationship with father and with mother, life satisfaction, socioeconomic status, pubertal timing, popularity among peers, easiness to make friends, at risk for eating disorders, parents nationality, own nationality, and academic track. All variables at the bivariate level were included in multinomial logistic regression using NW as the reference category. Results are given as Relative Risk Ratios (RRR) with 95% confidence interval

More Important Than You Thought: Some Chronically Ill Adolescents Rely a Lot on Their Health Professional

Purpose: To assess who do chronically ill adolescents rely on in their entourage. Methods: Data were drawn from the GenerationFRee study, a cross-sectional survey including 5149 youths aged 15-24 divided into 3 groups: healthy controls (HC; N=4529), chronically ill without limitations (CI; N=517) and chronically ill with limitations (CIWL; N=103). Groups were compared on perceived health status, socio-demographic variables and whether they could rely a lot on their father, their mother, their girl/boyfriend, their best friend or their health professional in case of difficulty. All variables significant at the bivariate level were included in a multinomial logistic regression using HC as the reference category. Results are given as Relative Risk Ratios (RRR) with 95% CI

Does Doing the Right Thing Pay? Comparing Youths Who Abstain from Risk Behaviors to Their Risk-taking Peers

Purpose: To assess whether young people not engaging in risk behaviors do better than their risk-taking peers. Methods: Data were drawn from the GenerationFRee study, a cross-sectional in-school survey including 5179 youths aged 15-24. Six risk behaviors were studied: smoking, alcohol misuse, cannabis use, use of other illegal drugs, violent behavior and antisocial behavior. A score obtained after adding the behaviors permitted to divide the subjects into Abstainers (score=0; N=1920) and Risk-takers (score>0; N=3259). Groups were compared on personal, familial, academic characteristics. All variables significant at the bivariate level were included in a logistic regression using Risk-takers as the reference category. Results are given as adjusted Odds Ratios (aOR) with 95% confidence interval

Gambling and Risk Behaviors: Characteristics of Young Problematic Gamblers in Switzerland

Purpose : To assess the characteristics and associated risk factors of young problematic gamblers. Methods: Data were drawn from the GenerationFRee study, a Swiss cross-sectional in-school survey including 5179 youths aged 15-24 (mean age 18.3). Among these participants, 1371 (26.5%) reported having gambled in the last 12 months and were included in the study. Gamblers were divided into two groups according to the South Oaks Gambling Screen (SOGS) scale adapted for adolescents: non-problematic gamblers (SOGS<2; N=1116) and at risk/problematic gamblers (SOGS>=2; N=255). Participants reported demographic, family and academic data, risk behaviors (current smoking, alcohol misuse, cannabis use, use of other illegal drugs, violent and antisocial acts, and Internet addiction) and sensation seeking. All variables significant at the bivariate level were included in a logistic regression analysis to assess the variables associated with at risk/problematic gambling using non-problematic gamblers as the reference category. Data are presented as adjusted odds ratios (aOR) with 95% confidence interval

Who Are Those Youths Who Consider Themselves as Unpopular?

Purpose: To examine the characteristics of adolescents and young adults (AYA) who perceive themselves as unpopular with peers from the same-sex, opposite-sex, or both. Methods: We used the baseline wave (2014-15; N¼5179) of the Generation FRee longitudinal study, gathering a cantonal representative sample of in-school 15-24 year-olds. The web-based in school administered questionnaire included the 2 items “Among same-sex/opposite-sex peers, I am very popular” (yes/no). Respondents were divided into 4 groups: Those who perceived themselves as popular with same-sex and opposite-sex peers (POP; N¼3’164, 61.09%); as unpopular with same-sex and opposite-sex peers (UNPOP; N¼1’228, 23.71%); as unpopular with same-sex peers only (UNPOPSame; N¼284, 5.48%), and as unpopular with opposite-sex peers only (UNPOPOther; N¼503, 9.72%). At the bivariate level, groups were compared on sociodemographic data, making same-sex and opposite-sex friends easily, emotional well-being, school performance and track, and substance use (current smoking, past 30-days e-cigarette, cannabis, and alcohol misuse, and other illegal drug use ever). All significant variables (p<.05) were included in a multinomial logistic regression using POP as the reference category. Data are presented as Relative Risk Ratios (RRR) with 95% confidence intervals

Living With a Chronic Condition and Risk Behaviors

Purpose: To assess whether living with a chronic condition (CC) is associated with risk behaviors among youths. Methods: Data were drawn from the baseline wave (2014-15; N¼5179) of the GenerationFRee survey, a longitudinal study among post-mandatory youths aged 15-24 years in Fribourg, Switzerland. Students were divided into three groups depending on whether they reported having a CC or not: healthy controls (no CC: N¼4529; 46.2% females), CC without limitation (CCWL: N¼536; 52.6% females) and CC limiting daily activities (CCLDA: N¼114; 58.9% females). At the bivariate level groups were compared on sociodemographic data and six risk behaviors (current smoking; current (at least once in the past 30 days) alcohol misuse, cannabis use and use of other illegal drugs; violent behavior and antisocial behavior at least once in the past 12 months). In a second step, a multinomial logistic regression was conducted including all variables significant at the .05 level. Results are given as Relative Risk Ratios (RRR) with 95% confidence intervals

Losing your virginity safely? A Swiss national survey.

Good practice and knowledge in terms of contraception at first sexual intercourse may lead adolescents to a safer sexual life. To date, research studies have mostly focused on women when investigating contraception use or on condom use only when addressing both genders. The present study adds to the current knowledge by offering a more in-depth view of contraception use at first intercourse among youths. This is achieved through a large selection of variables, the fact that we address both males and females and that we have considered a wide range of contraceptive means. To determine the rate of contraception use at first intercourse by youth in Switzerland and its association with social and personal characteristics. Data were obtained from a self-administrated national survey on sexual behaviour among young adults (mean age 26 years). Participants (n = 4036) were divided into three groups based on the means of contraception used at first intercourse: condom, with or without contraceptive (86.4%), contraceptive only (8.3%) and non-use (5.3%). Only 5.3% did not use any contraception. Compared with the condom group, individuals in the non-use group were more likely to report a lower family socioeconomic status, to be foreign born, to have foreign-born parents, to have a non-intact family and to live in a Catholic canton. They were also more likely to have had their first intercourse in the context of a casual relationship, to have been intoxicated at the time and more likely to regret it. Participants in the contraceptive group reported a higher family socioeconomic status, had intact families, did not live in Catholic cantons, were older and in a steady relationship at first intercourse. Contraception is generally used at first intercourse in Switzerland. Improvements can still be made concerning contraception use in the most vulnerable social strata such as low income families or foreign status