|Year : 2019 | Volume
| Issue : 4 | Page : 151-157
Factors affecting adolescents' risk-taking in single-child families
Tahereh Ataei1, Reza Zeighami2, Nezal Azh3, Maryam Mafi4
1 Student Research Committee, School of Nursing and Midwifery, Qazvin University of Medical Sciences, Qazvin, Iran
2 Department of Nursing, School of Nursing and Midwifery, Qazvin University of Medical Sciences, Qazvin, Iran
3 Department of Midwifery, School of Nursing and Midwifery, Qazvin University of Medical Sciences, Qazvin, Iran
4 Department of Biostatistics, School of Nursing and Midwifery, Qazvin University of Medical Sciences, Qazvin, Iran
|Date of Submission||31-May-2019|
|Date of Decision||11-Jun-2019|
|Date of Acceptance||26-Sep-2019|
|Date of Web Publication||18-Oct-2019|
Dr. Nezal Azh
Department of Counseling in Midwifery, School of Nursing and Midwifery, Qazvin University of Medical Sciences, Bahonar Blv., Qazvin
Source of Support: None, Conflict of Interest: None
Introduction: Given the current concerns about population decline and the prevalence of single-child families, as well as risky behaviors which are increasing in the community, there is a need to provide backgrounds for more information regarding the characteristics of single child and factors affecting the risk-taking of adolescents in these families to modify the risk factors of these in adolescents. Methods: This is a descriptive, analytical study. The sample was single-child adolescents and their parents conducted in the census method. The data collection tools were demographics questionnaires, Iranian adolescents risk-taking, and Baumrind parenting style inventory completed by the participants in health centers of Qazvin, Iran, in 2017–2018. The SPSS software version 24 as well as step-wise multiple linear regression model were used to analyze the data. Results: One hundred and seventeen adolescents aged 12–19 years participated in this study. About 79% of mothers and 69.3% of fathers had high education. Most of the mothers were homemakers (62.9%) and fathers were employees (76.9%). The regression model demonstrated that emotional and social supports reduce risk-taking. If a decision-maker or supervisor for a teenager is someone other than parents, moreover, when the number of meals served by parents is less than twice a day and lack of leisure-time increase the risky behaviors (adjusted R2 = 0.66, P = 0.003). Conclusion: Although many factors affect the risk-taking of adolescents in single-child families, parents can reduce their adolescents' risk-taking by increasing their social and emotional supports, planning for spending more time, and allowing them to participate in family decision-making process.
Keywords: Adolescence, risk-taking, single child
|How to cite this article:|
Ataei T, Zeighami R, Azh N, Mafi M. Factors affecting adolescents' risk-taking in single-child families. Soc Health Behav 2019;2:151-7
| Introduction|| |
Risk-taking is referred to behaviors which increase the likelihood of physical, psychological, and social harmful activities. It includes not only risky behaviors but also being at risks by environment, relatives, incorrect and threatening beliefs, and tendencies. These behaviors are divided into two groups: behaviors that endanger the health and well-being of individuals, such as drug abusing, alcohol, smoking, and having unprotected sexual behaviors. The second group is behaviors threatening the health and well-being of others, such as rubbery, aggression, violence, and running away from the school and home. According to the Center for Disease Control and Prevention, physical inactivity and unhealthy dietary behaviors are considered as health-threatening behaviors.
Worldwide studies have shown that most risky behaviors begin before the age of 18. According to the World Health Organization declaration in 2015, one-sixth of the world's population and based on the 2016 census in Iran, 13.9% of Iranian population are adolescents between 10 and 19 years. Hence, deficiency in long-term physical and mental health can have a negative effect on public health.
According to the latest results of the Youth Risk Behavior Surveillance System of Center for Disease Control and Prevention, many high school students are involved in risky behaviors. In Iran, studies also indicate the prevalence of risky behaviors among adolescents aged 14–18 years., The causes of tendency toward risky behaviors among adolescents are divided into four, namely cognitive, emotional, social-environmental, and family factors. The role of the family in reducing adolescents' risk-taking is significant. Various factors in the family reduce the likelihood of risky behaviors in adolescents such as intimate relationship of family members with each other, managing and supervising the children by parents, and parents' proper interaction with each other., Parenting style,, family composition, and size could determine the interaction between the family members; therefore, parent–children interaction manner could possibly differ in single-child and nonsingle-child families., Recently, population growth and childbearing have reduced the tendency toward childbearing in Iran because of the process of globalization and lifestyle transformation. According to the 2017 Census in Iran, growth rate is equal to 1.4 and the household size is 3.3.
Single-child families spend much more time with their children, and in the absence of sibling, they play crucial roles of caretaker, instructor, peers group, brother, or sister. Several studies justify excessive parental attention in single-child families, and they suggest that this excessive attention paid to single child sometimes results in internalization, loneliness, child's dependency, emotional problems, and probably risky behaviors. In multichild families, adolescents spend most of their times with their siblings  who are regarded as both sources of support, empathy and security, and in case of similar age and gender, conflict, and competition. Although most studies emphasize the positive role of having multichild family and intellectual-emotional independence, cooperation, dignity, and collaboration with peers,,, increased risky behaviors in these families are also reported which suggests that high-risk behaviors increase along with increasing family size.,
Given that the current concerns about population decline and the prevalence of single-child families as a result of various reasons, as well as risky behaviors that are increasing in the community, there is a need to provide more information regarding characteristics of single children and multichildren and factors affecting the risk-taking of adolescents in these families to provide educational and counseling planning to modify the risk factors of these in adolescents.
| Methods|| |
Study design and participants
This was a cross-sectional study. The research population consisted of adolescents, along with one of their parents who had written household records in health centers. Adolescents aged 12–18 years willingness to study, along with father or mother were the inclusion criteria of adolescents. Residence in Qazvin and willingness were the inclusion criteria for parents. Adolescents' exclusion criteria were psychological problems, addiction, and social problems. Illiteracy, single or divorced parents, and addiction were parents' exclusion criteria.
Due to the low prevalence of single-child families, sampling was done by the census. For this purpose, household records were reviewed in 15 health centers in Qazvin, the call numbers of single-child families were listed, and then we called and informed them about this study. Of the 195 families, 117 adolescents with one parent (60%) participated in this study.
Demographic questionnaires, Iranian Adolescents Risk-taking Scale (IARS), and Baumrind parenting style inventory were used to collect the data. Demographic characteristics included age, gender, educational level, parental education, economic status, and reason for being single child. These questions were prepared in accordance with respective studies, and validity and reliability of which were assessed by some of the faculty members of the faculty of nursing and midwifery.
IARS has 38 questions, and the aim of which was to assess the risk-taking amount of adolescents in seven dimensions (tendency to abuse drug, tendency to drink alcohol, tendency to smoke cigarette, tendency toward violence, tendency toward sexual relationship and behavior, tendency to have relationship with the opposite sex, and tendency to drive dangerously). Its scoring method is based on the five-point Likert Scale. The minimum and maximum possible scores were 38 and 190, respectively. Scores 38–76: The amount of risk-taking of the adolescent is low. The score between 76 and 114: the amount of risk-taking of the adolescent is average. Scores higher than 114 show high amount of adolescent risk-taking. Validity and reliability of this tool have been done in the research by Zadeh Mohammadi et al. in 2011.
Baumrind parenting style inventory has been developed to examine the patterns of infiltration and parenting practices. The questionnaire has thirty questions, ten of which are related to absolute permissiveness, ten questions in an authoritarian way, and ten other questions related to parenting's authoritativeness on childbearing. This questionnaire is graded in terms of a 5-point scale from 0 to 4, and with scores totaling 3 distinct scores on absolute, authoritative, and authoritativeness for each subject, the lowest of which is zero and the highest for each style is 40. Any style that gets more scores is the dominant child-rearing style of the family. Validity and reliability of the questionnaire in Iran were approved by Minaei and Nikzad 2017.
Data collection method
All the adolescents filled out the IARS and parenting style questionnaires were completed by one of the parents. Parents were asked to complete the questionnaire together.
Data were analyzed via the SPSS software (version 24, IBM, Armonk New York, USA). The Pearson's correlation test (or Spearman, its nonparametric equivalent) was used to compare the quantitative data, and the Chi-square and ANOVA were utilized to analyze the qualitative data. To determine the predictive factors such as age and gender (independent variables) on tendency toward risky behaviors (depended variable), a step-wise multiple linear regression model was utilized. Prior to using the regression model, its assumptions, namely normalization and homogeneity of the data, were investigated using histogram drawing and large size of samples, the independence of the groups, and linearity of the model (residual: 0 and tolerance: 0.5–0.88).
Ethical considerations included the following: ethical code from Qazvin University's Ethics Committee (No. IRQUMS.REC.1396.404), written informed consent of the participants in the study, respecting personality and self-esteem of the participants, letting the participants answer the questions freely, and explaining the research goals for the participants.
| Results|| |
Of the 195 families, 117 adolescents with one parent (60%) participated in this study including 70 male and 47 female students participated in the study with their parents. Their demographic information is presented in [Table 1]. Risk-taking average among adolescents which were in the low-risk group was 61.29 [Table 2]. Good economic situation, warm and intimate families, parental supervision, parents as decision-makers for adolescents, adolescent participation in decision-making process, satisfaction with time spent with parents, spending three meals with parents, and having a plan for leisure time contribute to reducing the tendency toward risky behaviors in adolescents. These relationships were statistically significant in t-test, ANOVA, and Pearson correlation [Table 3].
|Table 1: Demographic information of participants participating in the study of parenting styles and risk-taking amount in adolescence|
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|Table 3: The relationship between demographic information and risk-taking average in risky behaviors predictor study|
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To determine the factors affecting the tendency toward risky behaviors, demographic factors were divided into two broad modifiable and nonmodifiable categories (the length of marriage, the age of parents, the occupation of parents, and economic situation). To determine the modifiable predictable risk-taking factors for adolescents such as emotional, financial, and social supports, having more meals together and so forth, a stepwise multiple linear regression model was used. The results showed that when emotional and social supports increase by 0.31 and 0.15, respectively, the tendency toward risky behaviors will decrease. Having plans compared with the lack of planning for adolescents' leisure time by their parents will decrease risky behaviors by 0.21. In addition, if the decision-maker for the adolescent or their supervisors are someone else than their parent, risk-taking is increased by 0.18, and if the meal is eaten with parents less than twice a day, compared to three times, the risk-taking is increased by 0.18 [Table 4].
|Table 4: Modifiable predictor regression table of adolescents' risk-taking in only-child families|
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| Discussion|| |
This study was conducted to determine the predictive factors of tendency toward risky behaviors in adolescents of single-child families. The results show that, although the average risk-taking in this type of families is in the low-risk group, about one-fifth (21.35%) of adolescents tend to risky behaviors, including dangerous driving and drug abuse, respectively, that are consistent with Sohrabivafa et al.'s study in Dezful. By considering demographic factors mentioned in the other studies, we found two modifiable and nonmodifiable types of demographic factors. In this study, nonmodifiable demographic factors such as parental education, occupation, parents' age, adolescent gender, economic status, along with modifiable factors, including authoritative and authoritarian parenting styles, were directly associated with tendency toward risky behaviors. However, some nonmodifiable factors such as adolescent age, educational level, and duration of marriage were significantly related to the high-risk behaviors tendency.
To explain the low-risk behaviors in these families, exploring other studies demonstrated that demographic factors such as excellent economic status,,,,, parental education, especially father's education,,,, parents' occupation, particularly father's occupation,, female gender,,,,,, and adolescent age ,,, were positively or negatively effective. Furthermore, reference has indicated that the economic and social situations and the high education of the family are associated with the reduction of high-risk behaviors., In this study, most parents also had high level of economic status and education. In this study unemployed fathers were few (2.6), most of father (44.4%) were self-employed who had own businessas as a shpkeepe or real state. Therefore, a reduction in the risky behavior was expected as above. However, there is no relationship between being single child and the gender as Sylvester pointed  while it is in contrast with Esmaielzadeh et al., Shokri et al., and Rashid  results which observed in the Iranian population. They showed that female gender is protected against high-risk behavior; however, their studies were in multichild families versus our study performed in single-child families which is could be the result of parents' attention to their single child. Therefore, being single child reduces the gender effects in comparison with multichild families in the Iranian population. It is also worth mentioning that the pattern of risky behaviors in some diseases, such as AIDS, has changed from being masculine to feminine. Cases such as smoking and AIDS have increased ten times over a short period, in such way that about 85% of AIDS patients were men and 15% were women in 2016, these numbers have increased to 33% for women and 67 for men on January 2017. Therefore, the impact of gender on risky behaviors is likely to be diminished.
In this study, there was a meaningful relationship between the age of adolescents, educational level, and risk-taking behavior. By increasing the age and educational level of adolescents, the amount of risk-taking was increased. This finding is consistent with the study by Calafat et al. and  Mohammadkhani. Hence, in their studies, the prevalence of some high-risk behaviors increased with age and educational levels,, but it was opposed to Rashid  and Rahmani et al. results. It should be noted that in the study of Rahmani, the mean age was 17 years and the age group studied was 15–18 years old, who were mostly in their late adolescence, but in the current study, the average age of adolescents was 15 years, and most of them were in their early and middle adolescence. Although adults and adolescences experience risky behaviors, it is more prevalence in the adolescents. Several studies have confirmed the prevalence of risky behaviors in the early and middle adolescence., As the age increases, the teenagers and adolescents will gradually revise their behaviors; therefore, age as an agent can be effective on risky behaviors.
The duration of parents' marriage, according to our results, has a meaningful relationship with risk-taking in children, which may be interpreted as a generational gap and a cause for the occurrence of these behaviors, which is addressed in the study by Alizadegani et al. On the other hand, the increase in the duration of marriage is associated with an increase in the age of children, which discussed above. Another point to be made is that with the increase in the duration of marriage and the increase in the age of adolescents, the media literacy gap generated between parents and adolescents, which is a factor in the emergence of risky behaviors in the absence of effective parental supervision.
There was a meaningful relationship between the point of tendency toward risky behaviors and the types of relationships among family members from adolescent's point of view in the study. The average of tendency toward risky behaviors in families with nonintimate relationships is more than the other two types, and several other studies confirm this issue, as well.,,
The study also showed that there is a significant relationship between planning for leisure time, spending more time with children and having meals with parents with the amount of risky behaviors, in such a way that a decrease in number of meals with parents increases risky behaviors. The correlation between family meals with family members and high-risk behaviors is consistent with the results of the study by Fulkerson et al., Goldfarb et al., and  DeVore and Ginsburg. Given that meals are an opportunity to share the values and concerns by family members, it helps to strengthen parent–adolescent relationships to discuss and resolve family issues. It is valuable to be considered the fact that Goldfarb's review study also shows multiple meals with parents have been confirmed in numerous studies to reduce high-risk behaviors, although it emphasizes on the family member's communication not the meal.
In numerous studies, it has been shown that adolescent loneliness at home addition to environmental pressure, such as the impact of peer groups, tends to raise risky behaviors., DeVore and Ginsburg stated that when the adolescent spends their time with family, it is considered as a protective factor against risky behaviors, and the increased presence of parents at home is accompanied by a reduction in these behaviors, which is consistent with the results of the current study. In the current study, most mothers were homemakers and spent more with their child. Brooks also emphasized on the family's warm environment as a factor in reducing the risky behaviors. Peers' pressure leads adolescents to make risky decisions. For instance, a study in Nigeria has shown that 32% of teenagers who started smoking at the age of 12 were influenced by their friends and had a smoker parents.
Emotional, financial, and social supports which were shown to be reduced the risk-taking rate of adolescents were also considered in other studies.,,,, Partovi states that social support along with family conditions among girls and social acceptance among both genders will decrease risky behaviors. Zadeh Mohammadi and Ahmad Abadi emphasize that social supports by school and family would be influential on the reduction of adolescent's risk-taking. Even in a study, it has been showed that parental support would be supporter for adolescents' friends indirectly which would diminish the incidence of risky behaviors.
To determine the effect and predictive power of the 14 modifiable factors that influenced the risk level in single-child families, a multiple linear regression model was used stepwise. The variables of social and emotional support reduced risk-taking of adolescents; having two meals or less with parents, having decision-makers and other supervisors, and having no plans for leisure time would increase the adolescents' risk-taking. This model represents a predictive power of 66% for high-risk behaviors.
In the study of Sohrabivafa et al., parent occupation and education were effective factors in risky behaviors incidence. In the study of Eric, intention, perceived norms, environmental pressure, and loneliness at home build a model for predicting risky sexual behaviors. Ahmadi regards social skills and economic and family status influential on risky behaviors occurrence. In a systematic review, Goldfarb refers to meals and the close relationship between parents and their children. In the study of DeVore and Ginsburg, factors such as parental control, parent–child-friendly dialog, supervision, and high-quality parent–child relationship were the key determinants of the prevention for risky behaviors in adolescents. The above-mentioned studies are partly confirming our model, but it should be noted that the explanation of this model in reducing risky behaviors could be due to the golden opportunities created by having single child. Therefore, parents should be aware that spending time with their child and family communicating, including participating their child in decision-making process, agreeing on their child training, and having a program for leisure times can increase parental supervision and minimize the negative impact of peers. This could be generalized for both single-child and multichild families, although this seems to be very difficult due to the economic and social problems as well as employment of both types of parents.
Because of this cross-sectional study is self-reporting in nature, it may not accurately predict the determinants of high-risk behaviors among adolescents. The completion of IARS was considered to be another limitation in which parents refused to complete it because they believed the questionnaire may lead their children to the risky behaviors.
| Conclusion|| |
This study illustrated the determinants of high-risk behaviors among adolescents in single-child families. The results showed that about one-fifth of adolescents in these families had high- and moderate-risk behaviors and the most important predictor of this risk rely on communication between parents and their child. It will be possible to pass this critical period safely if the teenagers' relationships with their parents are more intense and intimate. The lack of scheduling for leisure time and the lack of emotional and social support will make the transfer duration difficult.
The present study has been conducted as a part of master's degree thesis in the field of consultation in midwifery entitled “Determining the Prevalence of Risky Behaviors and Parenting Styles in Adolescent single-child Families” approved by the Ethics Committee of Qazvin University of Medical Sciences. Therefore, the respectable University Research and Postgraduate Studies Deputy of Faculty of Nursing and Midwifery as well as all the adolescents and their parents who have cooperated with the researchers are hereby kindly appreciated.
Financial support and sponsorship
The project was financially supported by the students' research committee and Vice-Chancellor for the Research of Qazvin University of Medical Sciences.
Conflicts of interest
There are no conflicts of interest.
| References|| |
Zadeh Mohammadi A, Ahmad Abadi Z. The co-occurrence of risky behaviors among high school adolescents in Tehran. Fam Res 2008;4:87-100.
Adibnia F, Ahmadi A, Mousavi AM. A review of the reasons for risky behaviors in adolescents. Soc Heal Addict 2016;3:11-36.
Sylvester OA. Influence of self-esteem, parenting style and parental monitoring on sexual risk behaviour of adolescents in Ibadan. Gend Behav 2014;12:6341-53.
Esmaielzadeh H, Asadi M, Miri N, Keramatkar M. Prevalence of High Risk Behaviors Among High School Students of Qazvin in 2012. Iran J Epidemiol 2014;10:75-82.
Kann L, McManus T, Harris WA, Shanklin SL, Flint KH, Hawkins J, et al.
Youth risk behavior surveillance – United States, 2015. MMWR Surveill Summ 2016;65:1-74.
Rashid K. Epidemiology of high-risk behaviors among Tehran adolescent girls and boys. Soc Welfare (India) 2015;15:31-55.
Shokri N, Yusefi M, Safaye Rad I, Akbari T, Musavi S, Nazari H. Correlation between risky behaviors in the pre-university adolescent students in Hamadan with Parents' child raising method. J Heal Promot Manag 2015;5:73-82.
Fulkerson JA, Story M, Mellin A, Leffert N, Neumark-Sztainer D, French SA, et al.
Family dinner meal frequency and adolescent development: Relationships with developmental assets and high-risk behaviors. J Adolesc Health 2006;39:337-45.
Alaie Kharayem R, Kadivar P, Mohamad Khani S, Sarami GR, Alaie Kharayem MH. Analyzing the causation model of effective factors on consuming the narcotics by the juveniles of Karaj. Police-e-Zan 2010;4:52-76.
Zadeh Mohammadi A, Ahmad Abadi Z. Risk taking behaviors among adolescents: The strategies to prediction crimes commitment. J Fam Res 2009;5:467-85.
Li S, Chen R, Cao Y, Li J, Zuo D, Yan H, et al.
Sexual knowledge, attitudes and practices of female undergraduate students in Wuhan, China: The only-child versus students with siblings. PLoS One 2013;8:e73797.
Yang J, Hou X, Wei D, Wang K, Li Y, Qiu J, et al.
Only-child and non-only-child exhibit differences in creativity and agreeableness: Evidence from behavioral and anatomical structural studies. Brain Imaging Behav 2017;11:493-502.
Enayat H, Parnian L. The study Of cultural globalization and tendency to fertility. Soc Women J Woman Soc 2013;4:109-37.
Sadeghi M, Roshannia S. The Role of family crowd on children's mental dimensions: Life expectancy, resiliency and differentiation. J Cult Educ Women Fam 2017;11:99-121.
Whiteman SD, Christiansen A. Processes of sibling influence in adolescence: Individual and family correlates. Fam Relat 2008;57:24-34.
Broek T, Dykstra PA. The impact of siblings on the geographic distance between adult children and their ageing parents. Does parental need matter? Population, Space and Place in Wiley Online Library 2017;23:1-13.
Goel M, Aggarwal P. A comparative study of self confidence of single child and child with sibling. Int J Multidisciplinary Research Academy 2012;2:89-98.
Hockenberry MJ, Wilson D. Wong's Nursing Care of Infants and Cgildren. 11th
ed. USA. Elsevier Mosby; 2019. p. 27-8.
Marcdante KJ, Kliegman RM. Nelson Essential of Pediatrics [Internet]. 7th
ed. USA. Elsevier Saunders; 2015. p. 76-8.
Zadeh Mohammadi A, Ahmadabadi Z, Heidari M. Construction and assessment of psychometric features of Iranian adolescents risk-taking scale. Iran J Psychiatry Clin Psychol 2011;17:218-25.
Minaei A, Nikzad S. The factor structure and validity of the persian version of the baumrind parenting style inventory. J Fam Res 2017;13:91-108.
Sohrabivafa M, Tosang MA, Molaei Zadeh SZ, Goodarzi E, Asadi ZS, Alikhani A, et al.
Prevalence of risky behaviors and related factors among students of Dezful. Iran J Psychiatry 2017;12:188-93.
Barati M. Allahverdipour H. Hidarnia A. Niknami SH. Predicting tobacco smoking among male adolescents in Hamadan city, west of Iran in 2014; an application of the prototype willingness model. J Res Health Sci 2015;15:113-118.
Rahmani M, Qasemi V, Hashemeian Far A. The relationship between loneliness and high-risk behaviors among adolescents of Bojnourd. J Heal Dev 2016;5:313-23.
Marashi T, Ramezankhani A, Dadipoor S, Safari-Moradabadi A. Health problem multiple behaviors in Iranian adolescents: A cross-sectional study. Int J Adolesc Youth 2018,24:224-33.
Ahmadi H, Moeini M. An investigation of the relationship between social skills and high risk behaviors among the youth: The case of Shiraz city. Secur Soc Order Strateg Stud J 2015;41:1-24.
Joulaei H. Baghri lankarani K. Afsar Kazerooni P. Marzban M. Number of HIV infected in Iran: True or just an iceberg. Indian J Sex Transm Dis AIDS 2017;38:157-62.
Mardani M. Risk of Prevalences Of Hiv; 2019. Available from: http//.www.aids.ir
. [Last accessed on 2019 Feb 18].
Firoozi M. Alexithymia and perceived loneliness: An alarm for girls' tendency to High-risk behaviors. J Women's Stud Soc Psychol 2017;15:189-212.
Calafat A, García F, Juan M, Becoña E, Fernández-Hermida JR. Which parenting style is more protective against adolescent substance use? Evidence within the European context. Drug Alcohol Depend 2014;138:185-92.
Mohammadkhani S. Prevalence of cigarette smoking, alcohol drinking and illegal drugs use among Iranian adolescents. J Kerman Univ Med Sci 2012;19:32-48.
Buhi ER, Goodson P. Predictors of adolescent sexual behavior and intention: A theory-guided systematic review. J Adolesc Health 2007;40:4-21.
Brooks FM, Magnusson J, Spencer N, Morgan A. Adolescent multiple risk behaviour: An asset approach to the role of family, school and community. J Public Health (Oxf) 2012;34 Suppl 1:i48-56.
DeVore ER, Ginsburg KR. The protective effects of good parenting on adolescents. Curr Opin Pediatr 2005;17:460-5.
Alizadegani F, Akhavan T, Khadami M. Investigating the causes of tendency to risky behaviors in male high school students in Tehran. Entezam Ejtemaei 2017;9:103-28.
Khorraminejad M. Educating Media Literacy and Coping With The Phenomenon Of Generation Gap (with Emphasis On Digital Breaks Between Generations). In: The first National Pathological Conference and Damage of the Intergenerational gap (background, challenges and solutions). Bamm Pazhouhesh Parvaz Jonoub Cultural & Artistic Institution. 2017.:52–8. Available from: https://www.civilica.com/Paper-APSN01-APSN01_025.html
. [Last accessed on 2019 Feb 19].
Atashnafas E, Ghorbani R, Tabatabaee MS, Abdoos H, Abbas Poor S, Mahmoudian A. Prevalent high risk behaviors and important family factors from the point of view of adolescents: a qualitative research. Fam Res 2014;10:217-33.
Goldfarb SS, Tarver WL, Locher JL, Preskitt J, Sen B. A systematic review of the association between family meals and adolescent risk outcomes. J Adolesc 2015;44:134-49.
Okagua J, Opara P, Alex-Hart BA. Prevalence and determinants of cigarette smoking among adolescents in secondary schools in Port Harcourt, southern nigeria. Int J Adolesc Med Health 2016;28:19-24.
Helsen M, Vollebergh W, Meeus W. Social support from parents and friends and emotional problems in adolescence. J Youth Adolesc 2000;29:319-35.
[Table 1], [Table 2], [Table 3], [Table 4]