Protecting Youth: Countering Risk Behaviour with Universal Protective Factors

Manirul I. Khan, Mahidol University
Khurshid K. Talukder, Institute of Child and Mother Health
Sabina Faiz Rashid, BRAC
AMR Mushtaque Chowdhury, BRAC
Shamim H. Talukder, Institute of Child and Mother Health

Abstract: Protecting youth: countering risk behaviour with universal protective factors describes the first research done on protective factors for adolescent risk behaviour in Bangladesh. The qualitative and quantitative results of this research indicates that both youth and adults members of this society are convinced of the importance of the cultural context in which youth is brought up.This context is supportive of resilience to risk behaviour when there are meaningful relationships with the parents (connection), when there are boundaries set by the parents in relation to behaviour (regulation) and when religion is important in the lives of youth. Whilst all youth live in the same cultural environment, only a small section are involved in smoking, drinking, drug abuse, premarital sex or violence. What prevents most adolescents from undertaking such risk behaviours? Certain universal protective factors such as connection to parents, regulation, religion (ideology) and psychological autonomy can protect youth for risk factors. Introduction: This study has identified four domains of youth protective factors viz. connection, regulation, psychological autonomy and religion (ideology). The work was carried out by the Institute of Child and Mother Health in 2001 in collaborations with Bangladesh Rural Advance Committee (BRAC) and funded by the Department of Child and Adolescent Health and Development (CAH) section of WHO. The objective of this study is to identify the risk behaviors of youth and to find out the relationship between individual, community and family characteristics of youth in Narayonganj City in Bangladesh. This research included investigation of the prevalence of youth risk behaviour of smoking, suicide, violence, alcohol, drug abuse, gang fight and pre and extra-marital sexual activity along with the relationship between such behaviour in a number of social settings such as family, peer and community. Recently this concept has been changing so that protective factors (factors which protect youth from risk taking behaviour) e.g. "having parents who disapprove of premarital sex". Protective factors are "the whole, complex social and environmental factors" which hinders adolescents from getting involved in problem behaviour through direct personal or social controls through strong family ties, religion, parental sanctions, institutions. The research ( Rutter M, 1993, Luthar S and Ziglar E, 1991), related to protective factors or resilience has identified factors, which moderate, insulate and thereby mitigate the impact of risk factors. Other properties of protective factors are that they provide models and support for positive behaviours of good quality family interactions, they provide personal or social controls against risk behaviours, constitute activities incompatible with risk behaviour and they often indicate a commitment to conventional institutions of adult society such as bonding with school, family and the community. Both bivariate and multivariate analysis have been used to find out the relationship between individual, community and family characteristics of youth in relation to each of the health risk behaviors like smoking, drinking alcohol, drug and premarital sexual exposure. Methodology: The study population 1,084 comprised male and female youth aged between 15 and 24 years in Narayagonj city. This study was designed to assess the risk taking behaviour of youth in Narayanganj city through a cross-sectional survey. A systemic random sampling method was used in selection of youth sample and it was stratified according to number of boys and girls of sample size. Univariate, bivariate analyses in the form of cross tabulation, multiple regression and correlation were done for the analysis. The qualitative phase included 21 key-informant interviews (with school teachers, principal of a college, religious leaders, factory owners, individuals, union parishad members and youth), 17 focus group discussions of the following groups: (school going youth, college going youth, married youth, out of school and college youth, garment factory workers and parents of youth) and 19 in-depth interviews (10 of youth and 9 of parents of youth). Results: From the qualitative works, it appears that connection to family is an important factor for both male and female adolescents. Love, closeness, communication, speaking openly and freely with their parents, trusts and respect were important factors that discouraged them from indulging in risk behaviour. Parents were judged to be primarily responsible for their children's conduct - for their upbringing and guidance. Emphasis was placed on the role of parents to guide and monitor their children. A parent remarked that the power of good family relationships could overcome adverse material and social circumstances. In addition, positive attitudes towards regulation were qualified by statements about the dangerous effects of too harsh a regimen of regulation. Extended community and family members, peers and teachers were seen to be a strong influence both positively and negatively. Religion was also identified as an important means of staying on track, although there was much criticism of a false show of religion and using religion for worldly gains. Overall religion was seen as a positive influence on adolescents risk behaviour if it was followed from the heart. Hypocrisy in religion was identified as a barrier to adolescents subscribing to religion way. The qualitative results of this research clearly indicates that both youth and adults members of this society are convinced of the importance of the cultural context in which youth is brought up. This context is supportive of resilience to risk behaviour when there are meaningful relationships with the parents (connection), when there are boundaries set by the parents in relation to behaviour (regulation) and when religion is important in the lives of youth. From the quantitative analysis it showed that just over half the 1084 adolescents surveyed by questionnaire were male and the remainder were female. The quantitative data (from 15 to 24 years) showed that about 16% of adolescent's admitted to using tobacco, either in the form of cigarettes or locally produced "biris". The harmful nature of smoking was by far the biggest (69%) reason given for not smoking. Prevalence of marijuana smoking was about 2.2% and this was almost exclusively a male activity with 3.9% of males and only 0.4% of female involved. Drinking alcohol was reported by 5.6% of adolescent and hard drugs such as pholcodeine cough mixture, heroine and cocaine were used by 1.2% of the male population. Forty-three per cent of all adolescents had held hands with a person of the opposite sex before marriage- 55% in boys and 30% among girls. Thirteen per cent of adolescent had kissed a person of the opposite sex before marriage-21% males and 5% in females. A total of 3.4% adolescent has been engaged in premarital sexual intercourse, the prevalence being 5% in males and about 2% in females. Regression analysis were carried out using each of the risk behaviours such as tobacco use, premarital sexual activity, gang fight etc. as a dependent variable in each analysis and various adolescent characteristics such as individuals, family and community as independent variables. The analysis showed that peer and community connection was a risk factor for alcohol use and marijuana use, destructive activities and hitting peoples also. Peer regulation was protective against threatening and attacking people, destroying other people's property and attempting suicide. School connection was protective against tobacco use and depression. For individual characteristics empathy was a risk factor for depression and private religiosity is protects against drug abuse and attacking people. Parent regulation is protective against tobacco use, alcohol use, drug abuse, threatening people and premarital sexual activity. Family stress was a risk factor for threatening people, attacking people, fighting, premarital sexual activity and attempted suicide. The findings of the regression analysis indicate that connection to parents, regulation by parents and religiosity are protective factors for youth risk behaviour. These findings are consistent with the international data (WHO, 2001) that has been demonstrated similar concepts in the past decade or more. Whilst all youth live in the same cultural environment, only a small section are involved in smoking, drinking, drug abuse, premarital sex or violence. What prevents most youth from undertaking such risk behaviours? Certain universal protective factors such as connection to parents, regulation, religion or ideology and psychological autonomy can protect risk factors. The qualitative and quantitative results of this research indicates that both youth and adults members of this society are convinced of the importance of the cultural context in which youth is brought up. Conclusion: The findings in this study also indicated that smoking and drinking alcohol was quite common among the youth in the study. It also pointed out that premarital sexual exposure was not unusual among the youth and all of the risk behaviors were dominated by male youth. Premarital sexual activity was related to both smoking and alcohol drinking behavior of youth in the study. The study findings and analysis lead to the policy makers and planners to take necessary action regarding youth risk factors especially smoking, drugs, alcohol, premarital sex, suicide and violence. The work also elucidates both qualitatively and quantitatively the factor that protects youth from such risk behaviour in urban settings. The report recommends that intervention research done in this important field to develop social intervention programs for reducing risk behaviours. Besides, in the national level youth, home, religious, health and family welfare ministry to take necessary action regarding the youth risks taking behavior and protecting factors for the youth. Therefore this study pointed out that in order to prevent health risk behavior of youth, enforcement of law on availability and accessibility of tobacco and alcoholic beverages by children and youth are to be strengthened. Life skill training programs on health risk behaviors especially issues regarding reproduction and sexuality should be gender specific and focused to not only in school youth but also to be designed to reach out-of-school youth. Refernces: Rutter M.Resilience: some conceptual considerations.J Adolescent Health 1993; 14:626-31 Luthar S, Ziglar E. Vulnerability and comptence: a review of research on resilience in childhood. Am J Orthopsychiattr 1991; 6:6-22 World Health Organization. Broadening the horizon: balancing protection and risk for adolescents. Department of Child and Adolescent Health and Development, Family and Community Health, WHO, Geneva, 2001.WHO/FCH/CAH/01.20.