Multiple Risk Behaviours

Current research


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The Avon Longitudinal Study of Parents and Children (ALSPAC) - which is also known as Children of the 90s - is a long-term health research project.  More than 14,000 mothers enrolled during pregnancy in 1991 and 1992, and the health and development of their children has been followed in great detail ever since.  The ALSPAC families have provided a vast amount of genetic and environmental information over the years. This resource is assisting scientists all over the world with research into a wide range of health problems. 

The Avon Longitudinal Study of Parents and Children (ALSPAC) and adolescent substance use trajectories: consolidation of a UK research resource

The aim of this study, led by Professor Matthew Hickman, was to use ALSPAC to develop an improved understanding of the causal pathways to different substance use in adolescence, and hence influence public health interventions.

Members of the longitudinal birth cohort Avon Longitudinal Study of Parents and Children were invited to attend a personal interview.

  • 5837 13-year-old children were asked about previous consumption of alcohol and tobacco.
  • Information on parental socioeconomic position was collected from questionnaires from the mother. This included both social class and education of the expectant mother and her partner, and average household disposable income in early preschool childhood.
  • The impact of missing data was assessed by multiple imputation.

Cochrane Review: Individual-, Family- and School-level Interventions for Preventing Multiple Risk Behaviours in Individuals Aged 8 to 25 years

Engagement in one risk behaviour during adolescence increases the likelihood of engagement in other risk behaviours and multiple risk behaviours may cluster together. As such, shared biological and environmental factors may influence the development of multiple risk behaviours, and preventive interventions may therefore have an impact on more than one outcome. Nevertheless, the majority of studies have focused on single behaviours and relatively little is known about the effectiveness of interventions that target multiple behaviours during adolescence. 

A Cochrane systematic review was undertaken, led by Dr Georgie MacArthur, to examine the effectiveness of individual, school and family interventions that aim to prevent two or more behaviours, including tobacco use, alcohol consumption, use of illicit drugs, antisocial behaviour and offending, self-harm, gambling, vehicle-related risk behaviours, sexual risk behaviour, activity levels and unhealthy diet. The review considered the effectiveness of universal interventions and those targeted to high-risk groups implemented from the antenatal period up to age 18 years. Examples of such interventions may be those that attempt to improve parenting skills, those addressing communication between teachers or parents and children; and interventions that aim to strengthen adolescents’ life skills, decision-making and/or resilience.

By reviewing the evidence relating to effectiveness and cost-effectiveness of interventions to prevent multiple risk behaviours and harms, the review will be useful to policy makers and commissioners in assisting with decisions around investment or dis-investment. In particular, it will provide evidence around appropriate stages to intervene during adolescence to prevent such behaviours.

Read the paper here.


Completed research

Sociological Theories of Multiple Risk Behaviour in Young People

This study, led by Pandora Pound, aimed to identify sociological theories of risk behaviour and multiple risk behaviour in young people, with a view to producing a synthesis of these theories. A clearer theoretical understanding is needed to provide insight into why multiple risk behaviours cluster in adolescence and to help inform the design of interventions and the analysis of data. A longer term goal was to develop a methodology for systematically searching for and synthesising theoretical literature.

Suicide Prevention: NIHR Programme Grant

The aim of this programme of research was to carry out a series of linked studies whose purpose was to improve the management of self-harm, reduce the incidence of suicide and provide reliable data to evaluate the impact of the National Suicide Prevention Strategy for England (2012).

The research was a collaboration between the Universities of Bristol (lead Professor David Gunnell), Oxford (lead Professor Keith Hawton) and Manchester (lead Professor Nav Kapur), the Avon and Wiltshire Mental Health Partnership NHS Trust, Manchester Mental Health & Social Care Trust, now taken over by the Greater Manchester Mental Health NHS Foundation Trust, and Oxford Health NHS Foundation Trust. Over 15 collaborating researchers, service users and voluntary sector representatives were part of the research group.

The project ran from April 2012 to March 2018.

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