Behavioural risk factors clusters and their associations with self-reported burdens among university students in Finland

OBJECTIVES: No research among Finnish universities grouped students into clusters, based on their lifestyle behavioural risk factors (BRFs), and appraised relationships of the clusters with self-reported burdens, adjusting for confounders. The aim of the study was to undertake this task. METHODS: Students (N = 1,169) at Turku University completed online questionnaire comprising socio-demographic variables (age, sex, income, social support), 18 burdens, and 4 BRFs (smoking, alcohol, drug use, food habits). Factor analysis reduced burdens into factors; cluster analysis of BRFs categorized students into clusters. Regression models appraised associations between socio-demographics and clusters with burdens. RESULTS: Mean age was 23 ± 5 years, with 70.4% females, 23.4% smokers, 28.8% problematic drinkers, 21.1% illicit drug/s users, and mean dietary guideline adherence 4.84 ± 1.57 (maximum score of 8 points). Factor analysis of burdens generated four factors: 'Studies' - 3 items; 'Future' - 3 items; 'Relationships' - 7 items; and 'Needs' - 5 items. Cluster analysis produced four BRFs clusters with significantly different BRFs and socio-demographics. Cluster 1 exhibited less risk-taking behaviours, cluster 4 comprised more risk-taking, and the other two clusters fell in between. Regression showed that females were more likely to report all four burdens; higher social support was associated with less burdens generally; older age was associated with less 'Studies' + 'Future' + 'Relationships' burdens; and sufficient income was associated with less 'Studies' + 'Future' burdens. Compared to cluster 1, cluster 3 and 4 membership was more likely to feel 'Needs' burdens; cluster 2 and 3 was more likely to report 'Relationships' burdens (p-range: < 0.05 to < 0.001 for all). CONCLUSION: Controlling for socio-demographics, cluster membership was more influenced by students' perceptions of 'Relationships' + 'Needs', rather than academic difficulties of 'Studies' or unsecure 'Future'. Risk taking was more likely with relationship difficulties, isolation, and day-to-day problems (housing, financial situation, health) rather than academic load or concerns for future prospects. Preventive and intervention efforts tackling students' lifestyle behaviours need to consider programmes aimed at better relationship building/maintenance to prevent isolation, while mitigating 'on-the-ground' everyday challenges that students face.