A Person-Centred Analysis of the Time Use, Daily Activities, and Health-Related Quality of Life of Irish School-Going Late Adolescents

Eithne Hunt

Background
In the last 50 years, the health of the world’s 1.2 billion adolescents has improved to a lesser extent than that of younger children (Sawyer et al., 2012). In fact, worsening mental health outcomes have been noted in Ireland (Cannon, Coughlan, Clarke, Harley, & Kelleher, 2013; UNICEF Ireland, 2011) and internationally (Becker & Kleinman, 2013; Gore et al., 2011; Koh, Blakey, & Roper, 2014; Patel, Flischer, Hetrick, & McGorry, 2007). Moreover, the daily lived experience of young people internationally confronts them with “more complex worlds, with more contractions and challenges” than before (Larson & Tran, 2014, p. 1013). Against this backdrop, recent policies call for increased attention to non-communicable causes of disease burden and lifestyle risk factors in adolescence (Gore et al., 2011), not least because important determinants of health and well-being are imbedded in young people’s daily behavior, as reflected in their time-use (Olds, Ferrar, Gomersall, Maher, & Walters, 2012; Zuzanek, 2005). Indeed, how one lives out one’s daily life is closely connected with health and quality of life (Erlandsson, 2013a; Harvey, 1993; Hocking, 2013). It is argued that “much of today’s ill-health is developed and caused by people’s doing; their lifestyle” (Hocking et al., 2014, p. 41). Given this, the promotion of healthy lifestyles amongst adolescents is now particularly important (Hagell, Coleman & Brooks, 2013; The Lancet 2012) to prevent the accelerating burden of non-communicable diseases in adulthood (Viner, 2013). To that end, research is needed on how “the quantities and qualities of experiences in different activities act in combination” (Larson, 2001, p. 163) to affect adolescent development, health, well-being and quality of life.

Aim
This cross-sectional study sought to establish whether distinct profiles of adolescent 24-hour time use exist and to examine the relationship of any identified profiles to self-reported HRQoL.

Method
Two 24-hour time diaries and the KIDSCREEN-52 (Ravens-Sieberer et al., 2005) were completed by a random sample of 731 adolescents (response rate 52%) from 28 schools (response rate 76%) across Cork city and county, Ireland. We used a model-based, person-centred approach, latent profile analysis, to examine adolescent 24-hour time use and relate the identified profiles to HRQoL as a distal outcome.

Results
Three male profiles emerged, namely productive, high leisure and all-rounder. Two female profiles, higher study/lower leisure and moderate study/higher leisure, were identified. The quantitative and qualitative differences in male and female profiles support the gendered nature of adolescent time use. No identifiable unifying trends emerged in the analysis of probable responses in the HRQoL domains across profiles, reinforcing the complex nature of HRQoL for this group of young people. Females in the moderate study/higher leisure group were twice as likely to have above average global HRQoL.
Conclusion: Distinct time use profiles can be identified among adolescents but their relationship with HRQoL is complex. As eminent adolescent developmental psychologist Reed Larson (2001) wrote, the “evaluation of [adolescents’] time allocation is a useful entry point for examining links between experience and development, but only one small piece of a much more complex inquiry” (p. 163). Moreover, it has been said that youth development is “not readily reducible to variables” (Larson & Tran, 2014, p. 1014). Increasingly, scholars are calling for a mix of variable-centred, person-centred and qualitative research (Agans et al., 2014; Hamilton, 2014; Masten, 2014) to create a more complete picture of the many systems that comprise the complex “disorderly world” (Larson, 2011, p. 317) of today’s adolescents. Equally, rich mixed-method research is required to illuminate our understanding of the time use and HRQoL of adolescents in the 21st century.

Contact: e.hunt@ucc.ie

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