RISK-TAKING BEHAVIOUR AND SCHOOL INJURY IN CANADIAN ADOLESCENTS
Kwong, Jonathan Lok-Ming
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Background: Adolescent school injuries are common and often result in serious consequences. Problem risk behaviours are known causes of injury and interventions have targeted these independent behaviours with modest success in the past. Although there is some research investigating relationships between risk behaviours, none have empirically evaluated measures of multiple risk behaviour using a theoretical framework of adolescent risk-taking. There is a need for research to utilize population health theory to investigate associations between measures of multiple risk behaviour and school injury. Objectives: The objectives of this thesis are to: 1) investigate the relationships between risk behaviours among a sample of Canadian adolescents using a framework of adolescent risk-taking, and 2) to evaluate adolescent risk behaviours and school climate as independent, and perhaps interactive, determinants of school injury under the Population Health Framework. Methods: Both objectives utilized an interim dataset from the 2014 Health Behaviour in School-aged Children (HBSC) Study. Objective 1. Factor-analytically derived (and validated) scales of multiple risk behaviours were used to describe relationships between these behaviours. Objective 2. Students reported their experiences with different types of school injury. Relationships between multiple risk behaviour and school injuries were assessed. The influence of school climate on that relationship was also evaluated. Results: Objective 1. Adolescent risk behaviours appear to cluster into three distinct categories: 1) Overt Risk-Taking, 2) Active Healthy Lifestyle Detriment, and 3) Passive Healthy Lifestyle Detriment. Objective 2. Young, overt-risk takers were identified as a specific high-risk group for general school injuries, as well as several sub-types of school injury. School climate influences relationships between risk behaviour and school injury in complex and context-specific ways. The inconsistency of its effects suggests that it is not an effect modifier. Conclusions: Objective 1. Currently, surveillance, intervention programs, and research target isolated domains of risk behaviour. This thesis shows that risk behaviours cluster in predictable ways and should be studied and addressed in their related groups. Objective 2. Associations between multiple risk behaviour and school injury appear to be strongest among younger students. Effects of school climate on these relationships cannot be easily generalized across different grades or injury types.