Sociocultural Factors Underlying the Occurrence and Development of High-Risk Behaviors in Adolescent Girls with Substance Use Disorder: A Qualitative Study.

Substance use disorder, as a high-risk behavior in adolescence, can underlie other high-risk behaviors, such as suicide, sexual risk behaviors, and violence. The initial step in implementing an effective program is to identify the underlying factors and assess the relevant context. Therefore, the current research aimed to gain deep insight into the sociocultural factors that contribute to high-risk behaviors in adolescent girls with substance use disorders. The present study was conducted with a qualitative approach and with conventional content analysis methodology. The participants consisted of 26 teenage girls with substance use disorders, specialists, and officials relevant to vulnerable groups (i.e., policy makers and managers in a variety of health/social sectors), as well as families of teenage girls. Data were collected via semistructured qualitative interviews and then coded after rewriting via MAX QDA software. The identified factors were assigned to four main categories, namely, gender stereotypes, unsafe context, gaps in fulfilling social health needs, and immature policies. The main challenges in the formation of risky behaviors in vulnerable adolescent girls were related to disturbances in the living environment, especially problems in cultural and social contexts, which itself was perceived as a product of shortcomings in the implementation of policies and intersectoral collaboration gaps. Therefore, it is imperative to make serious management decisions in the macro area in the framework of codified policies along with effective monitoring and evaluation during executive processes by social welfare organizations and health ministries.