Executive Summary Background and objectives Scotland is widely recognised as the ‘sick man of Europe’, and the challenge of addressing health inequalities in children is as great as in adults. A recent UNICEF report places the UK as a whole at the bottom of a table of child wellbeing in rich countries. Given the impact that experiences in the formative years have on life trajectories and health and wellbeing in later years, there is an urgent need to improve the health and wellbeing of young people in Scotland. As a response to this challenge, the Adolescent and Young Adulthood Working Group of the Scottish Collaboration for Public Health Research and Policy (SCPHRP) identified the use of interventions to address multiple, or generic, risk behaviour in young people as a priority area to focus on. The aim of the environmental scan was to explore, through scoping the literature, potential benefits and risks of adopting a generic approach to equitably reducing or preventing risk behaviour in adolescents and young people. The specific objectives were to: (i) identify and summarise the current Scottish government policies relevant to young people; (ii) review and summarise existing surveys and cohort studies relevant to adolescent and young adult risk behaviours; (iii) describe the overlap between risk behaviours in adolescents and young adults; (iv) identify public health interventions applied during adolescence and young adulthood which reported on multiple risk behaviour outcomes or took a generic approach to risk (focusing on cigarette smoking, alcohol, illicit drug use and sexual risk behaviours); and (v) identify potential interventions for development by the Adolescent and Young Adulthood Working Group.
Methods In our review and summary of governmental policy, we searched relevant websites to identify international and Scottish Government policy relating to the health and wellbeing of young people. We identified data sources for risk behaviour indicators in Scotland through the existing knowledge of these sources within our team. To further investigate the clustering of risk behaviours in young Scottish people, we commissioned secondary data analyses of the West of Scotland Twenty–07 and 16+ studies by colleagues at the Medical Research Council (MRC) Social and Public Health Sciences Unit at the University of Glasgow. Our literature review consisted of three components. First, we performed a systematic review of reviews of primary studies of interventions to prevent or reduce multiple, or generic, risk behaviour in young people. We used a literature search strategy designed to identify reviews (published since 1999) of intervention studies that reported on alcohol, tobacco or illicit drug use, or sexual risk behaviour outcomes. From these reviews, we aimed to identify reviews of studies that had collected and reported on multiple (i.e. more than one) risk behaviour outcomes. Since we did not identify any reviews of studies that had collected multiple risk outcomes, we then performed a second primary systematic literature review of randomised controlled trials (RCTs) of interventions to reduce multiple risk behaviour in young people. Our search strategy was designed to identify RCTs in which both any of alcohol, tobacco or illicit drug use and sexual risk behaviour outcomes were collected. Finally, we used the reviews identified in the first review described above to identify reviews of primary studies of interventions addressing single risk behaviours, in order to identify common features of effective intervention approaches across multiple risk behaviours. In each of these reviews we excluded reviews of studies (or primary studies) that were: secondary prevention studies; clinical interventions; or that included highly selected, minority groups (such as young people from drug-using families, abused young people, for example).
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