Co-occurrence patterns of multiple health risk behaviors and transition dynamics across adolescence: a five-wave...

Multiple health risk behaviors (MHRBs) co-occur during adolescence and evolve across developmental stages, yet longitudinal person-centered analyses remain limited in Asian contexts. This study aimed to identify latent classes of co-occurring MHRBs across five annual waves and examine transition dynamics and predictors of favorable transitions among Korean adolescents.

The data from 5051 adolescents (25,255 person-waves) in the Korea Youth Health Panel Survey (KYHPS, 2019-2023) were analyzed for alcohol use, physical inactivity, poor diet, and short sleep duration. Latent class analysis (LCA) identified behavioral profiles at each wave, and latent transition analysis (LTA) modeled class membership transitions.

Three classes consistently emerged: Low-Risk (13.9-83.2%), Moderate-Risk (6.3-82.6%), and High-Risk (3.5-14.0%). Prevalence of ≥ 2 risk behaviors rose from 15.7% to 54.9%, and that of short sleep duration surged from 20.3% to 78.6%. For high-risk person-waves, 78.0% transitioned favorably across consecutive waves.

Korean adolescents show dynamic, heterogeneous MHRB patterns and an alarming increases in sleep deprivation. High transition fluidity suggests critical intervention windows for person-centered, syndemic-informed prevention.