Clustering of multiple health risk factors among a sample of adolescents in Liberia: a latent class analysis

Abstract

Aim: Non-communicable diseases (NCDs) are associated with modifiable health risk factors. There is a lack of evidence regarding clusters of health-related behaviours among school-going adolescents from sub-Saharan Africa. This study was conducted to identify clustering patterns of health risk factors (i.e. smoking tobacco, inadequate fruit intake, inadequate vegetable intake, physical inactivity, sedentary behaviour, anxiety and depression) and association with sociodemographic factors among school going adolescents in Liberia. Subject and methods The 2017 Liberian Global School-based Student Health Survey on 2774 adolescents aged 11 years and above (52.5% females) sampled with a two-stage cluster sample design was used. Latent class analysis was used to generate the clusters and latent class regression assessed the associations between sociodemographic factors and the clusters. Results: We identified three clusters labelled as (1) ‘low substance use, moderately active cluster’ (34.8%); (2) ‘inadequate fruit and vegetable cluster’ (48.9%) and (3) ‘risk taking cluster’ (16.3%)’. Compared to cluster 1, adolescent boys [AOR = 1.71, 1.29– 2.27, p < 0.001], and those in grade 10–12 [AOR = 1.51, 1.13–2.02, p < 0.001] were more likely to belong to cluster 2. Participants aged 15 years and above [AOR = 0.60, 0.39–0.91, p = 0.018] were less likely to belong to cluster 2. Compared to cluster 1, adolescents aged 15 years and above [AOR = 3.58, 1.33–9.62, p = 0.011] and those with low socio-economic status [AOR = 1.83, 1.22–2.73, p = 0.003] were more likely to belong to cluster 3. Conclusion: These results underscore the need for interventions that address adolescent multiple health risk factors, especially considering socio-demographic differences.