DETERMINANTS OF HEALTH RISK BEHAVIORS AMONG ALBANIAN ADOLESCENTS AND YOUNG ADULTS: IMPLICATIONS FOR TEACHERS' AND PARENTS' EDUCATION PROGRAMS

Definition of the problem: Albania is facing rapidly increasing rates of health risk behaviors including smoking, substance use, and unprotected sex especially among adolescents and young adults. In this context, health education especially during adolescence is becoming a priority; hence several educational campaigns have been organized to inform on the negative outcomes of health risk behaviors. Nonetheless, several studies have demonstrated that preventive efforts directly targeting adolescents and based on 'the fear' emotional response are not very effective. Studies investigating predictive variables of health behaviors rather suggest that several personal and social factors are involved. Adolescents might start health risk behaviors as coping strategies in a context where their identity is not fully formed, the orientation towards risk is strong, and the social context is not supportive (e.g., authoritarian parenting style, peer pressure). Consequently these behaviors are stabilized in young adulthood, as a stable repertoire. This paper presents results from 4 research studies in Albania, investigating personal and social factors involved in health risk behaviors. Methodology and Results: Study 1 was conducted among 140 adolescents using two self-report scales the Adolescent Questionnaire and the Adolescent Invulnerability Scale. Results suggested that perceptions of invulnerability (a developmental feature of adolescence) are actually predictive of smoking, drinking, substance use, and engagement in sexual intercourse. Study 2 was conducted among 459 adolescents using the Adolescent Alcohol and Drug Involvement Scale (AADIS) and Identity Orientation Questionnaire. Results suggested that adolescents with a stronger orientation towards personal identity (well established personal values, standards of behavior) were less likely to use substances as compared to their colleagues who were oriented towards other forms of identity (e.g., collective, social, religious identity etc.) Study 3 was conducted among 334 adolescents using AADIS and the Parental Authority Questionnaire. Results showed that authoritative parental style predicted the index of substance use involvement; also, gender and authoritative parenting style predicted individuals at risk for substance abuse. Finally study 4 was conducted among 565 young adults and found that personal variables such as risk orientation, self-efficacy and social variables such as quality of social relationships, modeling and social norms were predictive of health risk behaviors and health promoting behaviors too (e.g., physical activity, healthy diet etc.). Conclusions: These findings have implications for preventive/educational programs for health risk behaviors. These results suggest that effective programs should focus on 'inoculating' adolescents and young adults, so that they do not use health risk behaviors as coping strategies in the first place. Considering the extensive influence of parents and teachers on adolescents, they represent the two most important target groups for educational programs. These programs might focus on healthy parenting styles, stress management techniques, processes of reorientation of risk behavior tendencies towards more acceptable behavior, increasing self-efficacy etc.