ABSTRACT 

The study determined the socio demographic differences in multiple risk taking behaviour patterns among secondary school adolescents in Enugu urban. Six (6) objectives and five (5) hypotheses were set to guide the study. Relevant literatures were reviewed to enhance the theoretical background of the study. Descriptive survey design was adopted for the study. A sample size of 422 respondents, who met the inclusion criteria, was used for the study. A convenience sampling technique was used to reach the respondents. Data were collected using a researcher developed questionnaire with a reliability of 0.76.Simple descriptive analysis of data obtained was done to show frequency, percentages and mean scores. Chi square was used to test the hypotheses on the socio-demographic differences in multiple risk behaviour patterns. Result revealed that majority of adolescents do not engage in risk behaviour and very few engaged in multiple risk behaviour: those that engaged in two risks behaviours were either drinking and smoking or drinking and sexual activity, or smoking and sexual activity. Those that engage in three risk behaviours were engaged in smoking, drinking and sexual activity. Most of the adolescents that engaged in multiple risks behaviour started less than a year as at the time of study. Averagely the adolescent started the multiple risk taking behaviours at age of 15; major reason for engagement in multiple risks bahaviour by adolescents was to have fun; there was a significant association between adolescents’ socio-demographic characteristics and their engagement in multiple risks taking behaviours: males engaged in multiple risk behaviours than females; catholic adolescents engaged more in multiple risks taking behaviours than other Christian denominations; adolescents whose parents had tertiary education engaged more in multiple risk behaviour than other adolescents; adolescents from high socio-economic background engaged more in multiple risks taking behaviour than those from low socioeconomic background; early adolescents engaged more in multiple risks taking behaviour than the late adolescents.It is therefore recommended that the school nurse through health education program should teach students some problem solving skills, structured time use and interpersonal connections that will help adolescents to be gainfully employed. 

         

CHAPTER ONE

INTRODUCTION

Background of the Study

All teenagers take risk as a normal part of growing up. Risk is a tool an adolescent uses to define and develop his or her own identity and to make the transition to adulthood exciting (Wu, Burns, Stanton, Li, and Harris& Galbraith 2009). Adolescence is a period of stress and storm, a period when the society sends mixed signals to its youngsters, resulting in confusion, frustrations, despair and risk taking behaviour (Bhan, Mahajan &Sondhi, 2009).Risk behaviours by definition are behaviours that threaten the well-being of teens and limit their potential for achieving responsible adulthood (Wu, Burns, Stanton, Li, Harris& Galbraith 2009). Such behaviours also are commonly referred to as problem behaviours.

Being neither a child nor an adult, adolescent has sought for help and conforming identifications with their peers. Characteristically, he has always had the need to establish his identity, develop independence and if a male, prove his masculinity. A sense of invincibility, combined with bravado may increase the appeal of behaviour that is frowned upon by older adults (Waldron, Turner &Ozechowski 2010). If the stress becomes too great he could run away, out of home or can escape into anonymity of the group. In these circumstances, the adolescent’s behaviour is rather determined by their own moral and behavioural code. The parents only guide rather than directly control the adolescent’s actions. There is tendency therefore towards exploratory and experimental behaviours especially if the activities involve a sense of risk.

Adolescent risk taking behaviour could be healthy or unhealthy (Stueve& O’ Dannell, 2010). Healthy risk taking behaviouris a valuable experience and tends to have a positive impact on an adolescent’s development. These include participation in sports, development of artistic and creative abilities, volunteer activities, travelling, running for school offices, making new friends, constructive contribution to the family and others(Stueve& O’ Dannell, 2010). Inherent in all these activities is the possibility of failure. These should be recognized and supported. Negative or unhealthy risk taking behaviour on the other hand can be dangerous for the adolescent and they include drinking, smoking, drug abuse, sexual activities, reckless driving and disordered eating, self-mutilation, running away from home, stealing, gang activity(Stueve& O’ Dannell, 2010).

While most adolescents will experiment with at least one potentiallyhazardous behaviour, a good number of others will engage in several (Terzian, Andrew & Moore, 2011). This is because engaging in one risk sets stage for engaging in other risk behaviours. Adolescents who engage in cigarette smoking are more likely to use other substances (Mcmahon&Luthar 2006). Terzian (2007) noted that 59% of heavy alcohol users smoke cigarettes. These tendencies to multiple risk behaviours have been reported to be on the increase (Mason, Hitch, Kosterman, McCarty, and Herrenkohl& Hawkins 2010). This increase together with the association between different types of risk behaviour has been referred to as risk behaviour epidemics, risk syndrome or multiple risk activities (Lillehoj, Trudeau, Spoth&Madon 2006).

Multiple risk behaviour is of special concern to individuals who engage themselves in it as it poses a range of potential, immediate and long term health problems. Generally, risk behaviours can be associated sometimes with serious long term, and in some cases life threatening problems (Terzian,Andrew& Moore, 2011) but this is more so when individuals engage in multiple risk behaviours as they are more likely to develop immediate as well as long term health problems and the likelihood of poor outcome is elevated. For example, heavy drinking in adolescence is associated with negative health outcome in adulthood such as alcoholism, obesity, high blood pressure and cardiac diseases (D’Amico, Ellicson, Collins, Martino& Klein 2009). Adolescent marijuana use has also been linked to higher rates of cognitive difficulties, isolation, stealing, cutting class and aggressive behaviour. Illicit drug use in general has been found to heighten the likelihood to engage in risky sexual behaviour, delinquency, crime and drug abuse as well as to increase in the risk of injury and death resulting from motorvehicle crashes (Child Health Databank (N.D) 2011). Aggression and delinquency have been found to predict lower levels of educational attainment, and higher levels of mental health, substance abuse and economic problems (Colman, Murray, Abbot, Maugham et. at.,2009). While risky sexual behaviour places youth in danger of acquiring sexually transmitted infections, having an unwanted pregnancy and becoming a teen parent.

However, not all young people are equally likely to indulge in activities that might jeopardize their health and safety. The circumstances of some teenagers and young adults seem to deter them from taking risks while the situation of others acts to facilitate involvement in potentially hazardous practices. Roberts, Freeman, &Samdal, (2009) thus discussed a number of situations that may predispose an adolescent to risk taking. Among them are changing relationships with parents that result in alienation of the adolescent from their families, a lack of connection between youths and supportive institutions, inadequate educational opportunities, participation of youths in deviant behaviours so much that their transition into adulthood is prevented and lack of civic engagement experience such that the youth withdraws from the main stream of society.

Multiple risk taking is thus said to be associated with several factors. The conceptual framework developed by Harrelmann and Richter (2006) suggests that in the assessment of adolescent risk behaviour, demographic, socio-psychological and environmental risk factors should also be considered. Concurrent predictors of health risk behaviours include not only the personality but also the biological factor, the family situation and peer influence(Lillehoj, C,J.,Trudeau,L.,Spoth,R.,&Madon R.,(2006). Socio-demographic status of adolescents has especially been noted as influencing the possibility and the degree to which adolescents take risks. Age, sex, and religious differences have been reported as concurrent health risk factors. Some differences, for example, have been seen in the age of onset of sexual behaviour among races (Aunola&Nurmi, 2008). Other factors such as socio-economic status, family composition and academic standing also influence adolescent multiple risk-taking behaviour. Moreover, the youths connection with others, whether they are family members, friends, teachers or other non-related adults have equally been reported to influence their participation in multiple risk behaviours (Aunola&Nurmi, 2008).

Since research has shown that adolescents do not only engage in risk behaviours, but also in multiple risk behaviours and that several risk factors are associated with these behaviours, it becomes necessary to look into the pattern of multiple risk behaviours and its association with socio demographic characteristics of the adolescents. This will help in employing a comprehensive ecological approach to prevention, and intervention, and enacting a social support initiative at all levels.

 

Statement of the Problem

Increases in adolescent risk behaviour have been reported in international trade analysis (Terzian&Mbwana, 2009). According to US Department of Health and Human Services (2005), adolescents’ drug abuse remains alarmingly high. It also states that youths aged 16 to 17 have the second highest rate (16.4%) of current illicit drug use in the U.S. The highest rate is found among young people of 18 to 20 (Office of Applied Studies, 2007). An estimate of 1.1 million adolescents meets the diagnostic criteria for dependency on alcohol (U.S Department of Health and Human Services, 2005).

In Nigeria, research revealed a substance use prevalence rate of 71.7%. 81.5% of the adolescents substance users were males as against the 18.4% who were females (Okwaraji, 2006). Makunjuola, Daramola&Obember (2007) in a study to find out the pattern of substance abuse among students in Nigeria also revealed a high rate of mild stimulant (alcohol) and sedative (tobacco) use among the students. In Nigeria, a substantial percentage of the National budgetary health allocation is utilized for treatment and rehabilitation of people with substance abuse problems (Adelekan& West, 2006).

These high risk activities in adolescents (delinquency, substance abuse, sexual activity) and other forms of risky behaviours remain a pervasive and costly problem worldwide despite exclusive efforts to prevent and reduce the activities through intervention programes (Hawkins, Carbalamo& Miller, 2008). Consistently engaging in even one type of risky behaviour can undermine progress towards positive educational goal and can increase the likelihood of social, behavioural, physical and mental health problems which will develop later in life. This is especially one of the major challenges facing stake holders in the health sector because it puts millions of adolescents and others at increased risk behaviour related disorders such as low self-esteem, stress, anxiety, depression, violence, bullying, personality disorder, heart disease, haemophilia and coagulation disorders(Hawkins et al, 2008). Some of these consequences are observable in our environment as evidenced in many cases of mentally challenged adolescents in neuro-psychiatric hospitals consequent to drug abuse. Deaths and severe injuries resultant from reckless driving by adolescents under the influence of alcohol, or drugs.Juvenile pregnancies, armed robbery, kidnapping, gang raping, school dropout and cultism etc (Hawkins, J.D., Oesterle, S., Brown, E.C., Arthur, M.W., Abbott, R.D., & Catalano, R.F. (2008). These are also constantly being reported by the mass media.

In fact, risk behaviour that is tried out during adolescent is not necessarily abandoned in adulthood. This indicates accumulated consequences. There are even more threatening consequences when adolescents engage in more than one harmful behaviour and the tendency for risky behaviour to co-occur has been documented (Terzian et al, 2011). Unfortunately however, preventive efforts traditionally have taken a targeted approach, seeking to prevent a single risky behaviour. A more powerful and cost effective approach will be to employ strategies designed to address concurrent risk behaviour (multiple risk behaviour) and associated factors with these multiple risk behaviours.

Addressing the concurrent risk behaviour and their associated factors will aid in tailoring behaviour change interventions to individual needs and circumstances. It is essential that primary prevention strategy should recognize and target vulnerable groups who are more prone to multiple risk behaviours. Yet studies that will provide information not only on multiple risk behaviour patterns but also on the associated factors for these interventions have been grossly neglected especially in this environment. There is, therefore a gap within this field of study in Nigeria which this study seeks to bridge as the findings will help in taking the management of these risk behaviours to those in need of help.Hence the need to establish the socio-demographic differences in multiple risk behavior patterns among secondary school adolescents in Enugu urban.

 

Purpose of the Study

The purpose of this study is to determine the socio-demographic differences in multiple risk behaviour patterns among secondary school adolescents in Enugu Urban.

 

Objectives of the Study

Specifically, the study seeks to:

1. Assess the pattern of multiple risks taking behaviours among secondary school adolescents in Enugu urban.
2. Identify the gender differences in the multiple risks taking behaviour pattern among secondary school adolescents in Enugu urban.
3. Determine the association between religion and adolescents’ multiple risk taking behaviour pattern.
4. Assess the association between adolescents’ engagement in multiple risk taking behaviour and the educational level of parents. Determine any difference between adolescents from high and low socio-economic background in their multiple risks taking behaviour pattern.
5. Assess the difference between the early and late adolescents in their multiplerisks taking behaviour pattern.

 

Research Questions

1. What is the pattern of multiple risks taking behaviour of secondary school adolescents in Enugu urban?
2. What differences are there between male and female adolescents in secondary schools in their multiple risks taking behaviourpattern?
3. What is the association between religion and adolescents’ multiple risk behaviour pattern?
4. What is the association between parents’ level of education and adolescents’ multiple risk taking behaviour pattern?
5. What difference is there between adolescents from high and low socio-economic backgrounds in their multiple risk taking patterns?
6. What difference is there between early and late adolescents in their multiple risk taking behaviourpatterns?

 

Hypotheses

1. There is no significant difference between male and female adolescents in their multiple risks taking behaviour pattern.
2. There is no significant association between religion and adolescents’ multiple risk taking behaviour pattern.
3. There is no significant association between the pattern of adolescents’ multiple risk taking behaviour and their parents’ level of education.
4. There is no significant difference between adolescent from high and low socioeconomic background in their multiple risk taking behaviour pattern.
5. There is no significant difference between early and late adolescents in their multiple risks taking behaviour pattern.

 

 

Significance of the Study

 The findings from the study will provide clues and information to the adolesents involved in risk behaviours to make them rethink about their actions, the side effects and the health implications-some of them are school drop outs,somewho manage to graduate could not keep jobs,some roam about the streets whilesome end up in psychiatric homes as a result of these risk behaviours. As high risk behaviours in adolescents are found to co-occur and share common origins, it will suggest that improving outcomes for youth may require a more integrated approach to prevention that targets multiple contexts of adolescents’ lives (family, peer, school and community) and multiple forms of riskbehaviours. This study therefore is significant for all stakeholders like school nurse, teachers, policy makers and parents.

The school nurse through the school health education program may be sensitized through the information obtained to teach students some problem solving skills, structured time use and interpersonal connections that will help adolescents to be gainfully engaged.  The school teacher could moreover organize interactive sessions for vulnerable groups. These sessions could also include parents whereby discussions could be held on one on one basis or as a group.  Also policy makers can make policies that will relieve socio-economic factors, for example; health insurance scheme and welfare packages for the poor ones if the study is found to be associated with those from low socio-economic background. It could also enact social support groups that might facilitate the rehabilitation of the mostly affected group identified by the study.

The government could also through the information obtained, ensure that polices that prohibit the sale of alcohol, cigarette and drugs to minors in the society are adequately implemented. If all thesechallenges and measures could be addressed and taken, then, involvement in multiple risk behaviours will be greatly reduced and the consequences involved in risk taken will also reduce. The findings may also be of benefits for people interested in carrying out research in this area.

 

          

Scope of the Study

The study was delimited to adolescent males and females between the ages of 14 and 19years from secondary schools in Enugu urban.The study is also delimited to the socio-demographic characteristics such as gender, socio-economic background,age,religion and educational levels of parents and to such multiple risk behaviours as substance abuse (drug, alcoholand smoking) and sexual activity.

 

Operational Definition of Terms

Adolescent – young people (males and females) between the ages of 10 and 19 years, classified in early and late adolescents.

Secondary School Adolescents– These are boys and girls between ages 10 and 19years who are currently in senior secondary school one (1) to senior secondary school three (3) in Enugu urban.

Early Adolescents-are males and females between ages 10 and 14 years.

Late Adolescents- are males and females between the ages of 15 and 19 years.

Adolescents’ risk behaviours-arebehaviours or actions that pose or are sources of threat to the health or life of adolescents such as substance abuse (drug and alcohol) and sexual activities.

Substance abuse –here refers to the use of substances in a manner outside socio-cultural conventions (according to physician’s orders or socio-cultural norms). For example,regular and excessive use/consumption of alcohol, cigarette, marijuana. Involvement in substance abuse include initiation of abused substances, types of substances abused, pattern of abuse and reasons for being involved in substance abuse. Sexual activity –here refers to frequency(how often),how many partners, if homosexual or heterosexual, use of protective measures, if there had been pregnancies and abortions. Multiple Risk Behaviour -refers to combinations of two, three, or four actions that pose or are sources of threat to the health or life of adolescents.

Pattern of multiple Risk-Behaviours-This refers to the prevalence of co-occurrence of multiple risk behavious,the initiation of abused substances,types of abused substances, frequency of use, combination of risk behaviours and if  some risk behaviours tend to fall into specific patterns;if this multiple risk behaviour is increased with age,gender,socioeconomic status etc.

Socio-demographic status -to be used in this study include age, gender, religion, socioeconomic status, and level of education of parents.

Socio-economic status – refers to a measure of an individual’s or family’s economic and social position based on education, income and occupation with reference to wealth index which is a composite measure of a household cumulative living standard. It is calculated using easy-to-collect data on a house hold’s ownership of collected assets, such as televisions, car, bicycles, and handsetetcetera.