Risk Behavior Among Visitors at Swedish Youth Health Clinics and Organizational Readiness for Alcohol and Drug Prevention

Introduction: Risk behavior is common among youths. There is an association between risky sexual behavior (RSB) and the consumption of alcohol and/or other substances. Moreover, an early drinking onset and binge drinking increase the risk of injuries and unwanted events. Many youths have a risky alcohol consumption and are difficult to reach with preventive measures. In Sweden, youth health clinics may be an important arena for the prevention of risky substance use as part of the work to reduce RSB.

Aim: To investigate substance use patterns among youths visiting youth health clinics in Stockholm county as a basis for development of systematic alcohol and drug prevention focusing on sexual health, and also to investigate the organizational readiness for this.

Methods: A questionnaire including questions about alcohol and drug use and RSB was administrated to visitors at 11 youth health clinics in Stockholm county in the fall of 2016. Face-to face interviews were conducted with midwives and social workers (n=22) at 11 youth health clinics in Stockholm county during the same period. A semi-structured interview guide covering issues related to organizational readiness was used and the interviews were transcribed verbatim. Descriptive statistics and chi-square test were used, as well as qualitative content analysis.

Results: The questionnaire was answered by 328 visitors (89% girls). 61.7% had a risky alcohol consumption and 41.8% had used other substances than alcohol. Those with a risky alcohol consumption had a significantly higher level of RSB compared to those who did not have a risky alcohol consumption. Respondents who did not study had a higher level of RSB than those who studied. The interviewees were to a large extent aware of the connection between alcohol consumption and RSB and the subject was often brought up in the conversations with the youths. The interviewees expressed interest in developing their knowledge and activities regarding alcohol and drug prevention work, but made clear that shortage of time and resources could be an obstacle for this.

Conclusions: Youths visiting youth health clinics in Stockholm are a risk group in terms of consumption of alcohol and other drugs. Visitors with a risky alcohol consumption had a higher level of RSB than those who had a lower alcohol consumption, making the youth health clinics an important arena for alcohol prevention. There were several factors contributing to the organizational readiness to implement systematic alcohol and drug prevention at the clinics. Time and resource efficient interventions are recommended for a successful implementation. Web-based tools and programs may be suitable options.