An examination of the co-occurrence of modifiable risk factors associated with chronic disease among youth in the COMPASS study.

PURPOSE: To examine the prevalence of major modifiable risk factors for cancer, examine risk factor co-occurrence, and examine how demographic and social factors are associated with risk factor co-occurrence among youth in the COMPASS study.

METHODS: Data from 23,280 grade 9-12 students in Year 1 (2012-2013) of the COMPASS study were used to examine the prevalence of seven different modifiable risk factors and the co-occurrence of these risk factors by gender and by grade. The between-school variance in the number of risk factors was calculated, and a model was developed to examine how demographic and social factors were associated with the number of co-occurring risk factors.

RESULTS: Among youth in this sample, 5.5% were current smokers, 22.9% were current binge drinkers, 16.5% were current marijuana users, 20.0% were overweight/obese, 53.1% were physically inactive, 96.7% were highly sedentary, and 95.1% had inadequate fruit and vegetable consumption. The mean number of co-occurring risk factors among students was 3.2 (± 1.1) and only 0.2% (n = 42) reported having none of the risk factors and 0.4% (n = 67) reported having all seven risk factors. Significant between-school random variation in the number of co-occurring risk factors was not identified. The number of risk factors was associated with most of the correlates examined although the effect sizes were generally small.

CONCLUSION: This research identifies that risk factor co-occurrence is common, most of student characteristics examined are only modestly associated with the likelihood of co-occurrence and that the school environment is not associated with variability in the number of co-occurring risk factors.