Integrative research review of risk behaviors among adolescents in rural, suburban, and urban areas

Purpose: The purpose of this integrative review was to describe the state o f the science regarding adolescent risk behaviors, with particular emphasis on comparisons among rural, urban, and suburban populations. Method: The review was done at two levels, moving from the major national s urvey studies which included data collected in the late 1980s up to 1993, t o more focused topical areas including studies with data collection and pub lication between 1990 and 1996 within each identified category of adolescen t health issues. A total of 137 published works across several disciplines were reviewed. Suggestions for clinical practice were drawn from the signif icant research findings. In addition, risk behaviors were compared to natio nal baseline data and objectives. Results: The level of research in this topic area was primarily descriptive . Currently, only a small portion of the national objectives for decreasing adolescent risk behaviors have been met. Successful intervention programs, although few in number, usually included not only topical education but al so adolescent interaction with peers and support systems to raise awareness and change behaviors. Conclusions: The risk behaviors for the adolescent population as a whole ha ve been well described. Education alone is not sufficient to change behavio rs. Objective outcomes must be identified and health care providers need to use research findings in their practice with adolescents. It is time to in tervene with developmentally and culturally appropriate strategies. There w as a large gap in the literature regarding risk behaviors and protective fa ctors for rural adolescents. The few studies that included subjects from ru ral settings indicated that the view that rural adolescents are engaged in fewer or less severe risk behaviors is misleading. (C) Society for Adolesce nt Medicine, 1999.