Clustering of adolescents' health behaviors before and during the COVID-19 pandemic: examining transitions and the role of demographics and parental health behaviors.

backgroundThe COVID-19 pandemic and its measures have profoundly affected adolescents' lives, including their health behaviors. As a host of research indicates that adolescent health behaviors cluster together and that adolescents can respond differently to the pandemic, we examined adolescents' changes in clusters of health behaviors and its correlates during different phases of the pandemic.

methodsA total of 710 Dutch adolescents (53% female; at pre-pandemic: M

resultsThe Latent Transition Analysis (LTA) identified three classes before the pandemic: one class characterized by health-risk substance use and food intake, one class characterized by health-protective versions of these behaviors, and a medium health-risk class. During the pandemic phases, two classes were identified: most adolescents in the health-risk or health-protective class transitioned to a class with similar health-risk and health-protective behaviors. The third, medium health-risk, class was split into a health-protective and a health-risk class during the pandemic, with most adolescents transitioning to the health-risk class. Age, educational type, sex, and parental food intake behavior were related to latent class membership at some, but not all, time points. Some parental health behaviors, but not adolescent demographic factors, were related to the transition from the medium health-risk to the health-risk class.

conclusionsAdolescents at-risk for unhealthy behaviors may remain so during the pandemic. Adolescent demographics and parental (food intake) behaviors are relevant to consider as forms of screening adolescents who may be more at risk to show health-risk behaviors. Larger studies are needed to corroborate these findings.