Uncovering Hidden Risk Profile Phenotypes of Substance Use Among Canadian Adolescents via Cluster Analysis of COMPASS Data

Abstract This study utilized a longitudinal health survey to identify sub-phenotypes of behavioral risk profiles related to youth substance use. We analyzed 8824 Canadian secondary school students who completed COMPASS questionnaires in 2016/17 and were followed up until 2018/19. The fuzzy clustering algorithm was used to identify four sub-phenotypes of risk profiles, including low-risk, medium-low-risk, medium-high-risk, and high-risk subgroups. The study found that the mean scores of health risk behaviors within each subgroup increased across the three waves, indicating a rising risk of health behaviors over time. The results confirm heterogeneity in the prevalence and characteristics across the subgroups. These findings can help school program managers and policymakers develop targeted interventions to reduce substance use among at-risk individuals and improve youth health behaviors. By identifying at-risk groups, stakeholders can develop effective preventive measures against addictive behaviors in school settings. The study results offer evidence to support the development of risk reduction interventions for youth substance use and ultimately improve youth health behaviors.