Associations between household dysfunction in childhood and school-to-work trajectories throughout young adulthood were examined along with the mediating role of adolescent mental health problems. Data from 1134 participants in the Dutch prospective cohort TRacking Adolescents' Individual Lives Survey (TRAILS) with 18-year follow-up were used. Factors of household dysfunction were assessed at age 11; (1) parental socio-economic status (SES), (2) parental mental health, and (3) parental divorce. Mental health was assessed at age 16. School-to-work trajectories from ages 20 to 28 were identified using sequence and hierarchical clustering analysis. Structural equation modelling was used to examine direct effects of household dysfunction on school-to-work trajectories, and the mediating role of mental health. Young adults with low parental SES backgrounds were more likely to follow trajectories of Neither in Education, Employment, nor Training or early work (adjusted odds ratio [aOR] 3.83, 95% confidence interval [CI] 2.24-6.54 and aOR 5.15, 95% CI 3.13-8.49, respectively) compared to a study to work trajectory. Young adults whose parents divorced in childhood were less likely to follow an early work trajectory, compared to a study to work trajectory (aOR 0.63, 95% CI 0.40-0.92). Parental mental health problems were not associated with school-to-work trajectories. Adolescent mental health did not mediate the associations between household dysfunction and school-to-work trajectories. Our study showed the importance of childhood parental SES, relative to other parental factors, for young adults' school-to-work trajectories. More research in larger samples is needed to unravel the underlying mechanisms to better inform policy and practice.

OBJECTIVE: This study investigated whether (i) young adults’ mental health problems change when starting career work, (ii) potential changes in mental health problems differ by psychosocial work quality, and (iii) mental health problems during adolescence moderate potential changes in mental health by psychosocial work quality. METHODS: We used data from the TRracking Adolescents’ Individual Lives Survey (TRAILS) cohort. Follow-up time was 2–4 years. Mental health was measured with the youth and adult self-report scales. Longitudinal fixed-effects regression analyses were applied to estimate within-person changes in mental health of young adults entering career work with good, moderate, or poor psychosocial work quality (N=850) and model adolescent mental health as effect modifier of this change (N=766). RESULTS: When psychosocial job quality of the first career job was ignored, mental health problems did not significantly change among young adults after having entered career work compared with not having career work. Taking psychosocial job quality into account, mental health problems increased among young adults starting career work in poor psychosocial quality compared with not having career work (adjusted mean score increase 0.12, 95% confidence interval 0.03−0.21). No significant changes in mental health problems were found for young adults entering work with moderate-to-good psychosocial work quality. We found no evidence for adolescent mental health problems as moderator. CONCLUSION: Psychosocial work quality potentially plays a role for young workers’ mental health. Improving poor psychosocial work quality of young adults might contribute to a mentally healthier start of one’s working life.

BACKGROUND:Little is known about whether and how the timing and duration of work-family experiences are associated with subsequent mental health outcomes in the current generation of young adults. Such information may inform the development of timely interventions to promote better mental health. In this study, we use two complementary approaches to examine the complex relationship between work, family and mental health in young Dutch adults born around 1990. First, we examine the association between work-family trajectories and mental health. Second, we examine which timing and duration features of work-family trajectories are related to subsequent mental health. METHODS:Sequences of monthly work-family states from ages 18 to 28 years were constructed in a sample of Dutch young adults participating in the TRAILS cohort study (N = 992). Mental health was operationalised as experiencing internalising or externalising problems at age 29. We created a typology of work-family trajectories by clustering individual sequences and used regression analysis to examine the association between work-family trajectories and mental health. Next, we used the Boruta feature selection algorithm to identify timing and duration features of work-family trajectories related to mental health at age 29 and conducted a regression analysis to examine the associations between the identified features and mental health. All regression analyses were controlled for mental health problems between ages 11 and 16. RESULTS:Women in the work-family trajectories long education and inactive were most likely to experience internalising problems at age 29. Women in the work-family trajectory inactive were also most likely to experience externalising problems. In line, the feature selection analysis showed that both being inactive and being in education in the first stage of young adulthood, being a parent and in work in the last stage of young adulthood and the total duration of inactivity were associated with internalising problems. Being inactive in the first and the last stages of young adulthood and being inactive and a parent in the third stage of young adulthood were associated with externalising problems. Men in the work-family trajectory inactive were most likely to experience both internalising and externalising problems. Additionally, men in the work-family trajectory continuous education and work were most likely to report externalising problems. The feature selection analysis showed that being in education in the last stage of young adulthood was associated with internalising problems. Similar to women, inactivity in the first stage of young adulthood was associated with internalising and externalising problems at age 29. CONCLUSION:Work-family trajectories in young adulthood are associated with mental health problems at age 29, even when controlling for early-life mental health problems. In particular, the timing and duration of inactivity and education were found to be associated with subsequent mental health problems. Combining sequence analysis and feature selection provides a more nuanced understanding of the dynamics between work-family experiences and mental health.

BACKGROUND:Young adults in Neither in Employment, Education nor Training (NEET) are at risk of adverse labour market outcomes. Earlier studies often measured NEET status at one time point or compared persistent NEETs with non-NEETs, neglecting other patterns of NEET status. Evidence on early life factors associated with NEET patterns is lacking. This study aims to (i) identify patterns of NEET status over time and (ii) examine whether factors in childhood and adolescence are associated with these patterns. METHODS:Data were used from 1499 participants of the TRacking Adolescents' Individual Lives Survey (TRAILS), a Dutch prospective cohort study with 15-year follow-up. NEET status was assessed at ages 19, 22 and 26. Socioeconomic status of parents (SES), intelligence and negative life events were measured at age 11, educational attainment at age 26 and mental health problems at ages 11, 13.5 and 16. Data were analyzed using multinomial logistic regression analysis. RESULTS:Four NEET patterns were identified: (i) non-NEETs (85.2%), (ii) early NEETs (4.5%), (iii) late NEETs (5.7%) and (iv) persistent NEETs (4.5%). Reporting internalizing problems at age 11 was a risk factor for early and late NEETs [odds ratio (OR) 2.77, 95% confidence interval (CI) 1.16-6.62; OR 5.00, 95% CI 2.22-11.3, respectively]. Low parental SES, lower intelligence scores and negative life events (≥3) were risk factors for persistent NEETs (OR 4.45, 95% CI 2.00-9.91; OR 0.96, 95% CI 0.94-0.98; OR 4.42, 95% CI 1.62-12.08, respectively). CONCLUSIONS:The results highlight the importance of timing and duration of NEET status and emphasize the need for tailored interventions to prevent specific NEET patterns.

Purpose Work-family life courses have been associated with mental health at various time points in life but little is known about how mental health develops during these work-family life courses. The aim of this study was to examine mental health trajectories from adolescence to young adulthood in women and men with different work-family life courses. Methods Data from 992 young adults participating in the 18-year follow-up TRacking Adolescents' Individual Lives Survey (TRAILS) were used. Work-family life courses from ages 18 to 28 years were previously constructed using sequence analysis. For each work-family life course, trajectories of internalising and externalising problems from ages 11 to 29 years were estimated using a multi-group random intercept growth model. Differences in mental health trajectories were examined across work-family life courses. Results For women, trajectories of internalising and externalising problems in young adulthood differed significantly between work-family life courses (p = 0.037 and p < 0.001, respectively). Women in the inactive work-family life course reported the highest scores of internalising and externalising problems during the entire young adulthood but the differences in mental health scores became most pronounced at age 29. Trajectories of internalising and externalising problems of men did not significantly differ between the work-family life courses. Conclusion Mental health trajectories differed between women depending on their work-family life course. In men, differences between work-family life courses were less pronounced. Future studies should examine which work-family events and transitions captured in work-family life courses are associated with subsequent mental health problems during longer follow-up.

T he International Alliance of Dermatology Patient Organizations (also known as GlobalSkin) and the European Society for Dermatological Research (ESDR) cohosted an online Roundtable "Addressing Under-Prioritized Skin Diseases: Policy Responses to High-Burden Conditions" on February 6, 2024. This initiative was prompted by the European Commission's 2023 discussion paper entitled "Scoping Study on Evidence to Address High-Burden Under-Researched Medical Conditions" in which skin and subcutaneous diseases were identified as one of the 12 therapeutic areas defined as high burden and under-researched. The event convened a diverse array of experts, policymakers, and stakeholders in the field of dermatology and public health. Speakers formulated a set of policy recommendations aimed to address the current challenges in dermatology, proposing actionable strategies to foster greater awareness, allocate resources effectively, and enact supportive public health policies.

Mental health challenges in adolescence may affect labour market transitions in young adulthood. Policies addressing early labour market disconnection largely focus on early school-leaving and educational attainment; however, the role of low educational attainment on the path from adolescent mental health to labour market disconnection is unclear. Using the TRacking Adolescents' Individual Lives Survey from the Netherlands (n = 1,197), we examined the extent to which achieving a basic educational qualification (by age 22) in the contemporary Dutch education system, mediates the effect of adolescent mental health (age 11–19) on early adult labour market disconnection, defined as ‘not in education, employment, or training’ (NEET, age 26). We estimated the total effect, the natural direct and indirect effects, and the controlled direct effects of internalizing and externalizing symptoms on NEET by gender. Among young men, clinical levels of adolescent externalizing symptoms were associated with a 0.093 higher probability of NEET compared with no symptoms (95% confidence interval, CI: 0.001, 0.440). The indirect effect through educational attainment accounted for 15.1% of the total effect. No evidence of mediation was observed for the relationship between externalizing symptoms and NEET in young women. No evidence of mediation was observed for the relationship between adolescent internalizing symptoms and NEET in either gender. The findings imply that adolescent externalizing symptoms disrupts the achievement of a basic educational qualification, leading to a higher probability of NEET in young men. This mechanism may play a smaller role in the risk of NEET associated with internalizing symptoms and in young women.

Background The consequences of a single point-in-time compared to cumulative exposure to psychosocial work conditions (PWCs) for young adults' mental health have received relatively little attention. This study investigates (i) the associations between single and cumulative exposure to adverse PWCs at ages 22 and 26 with mental health problems (MHPs) among young adults at age 29 and (ii) the effect of early life MHPs on MHPs at age 29. Methods Data were used from 362 participants in the TRacking Adolescents' Individual Lives Survey (TRAILS), a Dutch prospective cohort study with 18-year follow-up. PWCs were assessed at ages 22 and 26 with the Copenhagen Psychosocial Questionnaire. Internalizing (i.e. depressive and somatic complaints, anxiety) and externalizing MHPs (i.e. aggressive and rule-breaking behaviour) were measured by the Youth/Adult Self-Report at ages 11, 13, 16, 19, 22 and 29. Regression analyses were conducted to examine the associations between single and cumulative exposure to PWCs and MHPs. Results Single exposure to high work demands at ages 22 or 26 and high-strain jobs at age 22 were associated with internalizing problems at age 29; the association attenuated after adjustment for early life internalizing problems but remained significant. No associations were found between cumulative exposures and internalizing problems. No associations were found between single or cumulative exposures to PWCs and externalizing problems at age 29. Conclusions In view of the mental health burden in working populations our findings call for early implementation of programmes targeting both work demands and MHPs to keep young adults working.

Background: Work and family lives interact in complex ways across individuals' life courses. In the past decade, many studies constructed work-family trajectories, some also examined the relation with health. The aims of this systematic review were to summarise the evidence from studies constructing work-family trajectories, and to synthesise the evidence on the association between work-family trajectories and health. Methods: We searched MEDLINE, EMBASE, PsycINFO, SocINDEX and Web of Science databases. Key search terms related to work, family and trajectories. Studies that built combined work-family trajectories or examined the relationship between work and family trajectories were included. Risk of bias was assessed independently by two authors. The identified work-family trajectories were summarised and presented for men and women, age cohorts and contexts. The evidence on the association with health as antecedent or consequence was synthesised. Results: Forty-eight studies, based on 29 unique data sources, were included. Thirty-two studies (67%) were published in 2015 or later, and sequence analysis was the primary analytic technique used to construct the trajectories (n = 43, 90%). Trajectories of women were found to be more diverse and complex in comparison with men. Work-family trajectories differed by age cohorts and contexts. Twenty-three studies (48%) examined the association between work-family trajectories and health and most of these studies found significant associations. The results indicate that work-family trajectories characterised by an early transition to parenthood, single parenthood, and weak ties to employment are associated with worse health outcomes. Conclusions: Work-family trajectories differed greatly between men and women, but differences seemed to decrease in the youngest cohorts. Given the current changes in labour markets and family formation processes, it is important to investigate the work and family lives of younger cohorts. Work-family trajectories were associated with health at different life stages. Future research should examine longitudinal associations of work-family trajectories with health and focus on elucidating why and under which circumstances some trajectories are associated with better or worse health compared with other trajectories.

Abstract Background Young adults with a history of mental health problems (MHPs) report lower work functioning (WF) compared to their peers without a history of MHPs. The identification of modifiable, protective workplace factors, such as workplace social support, is needed to increase WF.We examined the moderating role of workplace social support from supervisors and co-workers in the prospective association between MHP trajectories from childhood to young adulthood and WF among young adults. Methods The most recent 2019/2020 data of N = 861 young workers, participating in the 18-year follow-up Dutch TRAILS (TRacking Adolescents’ Individual Lives Survey) cohort study, was used. MHP trajectories for internalising and externalising problems included measurements at ages 11, 13, 16, 19, 22 and 26. Supervisor and co-worker social support were measured at age 29. WF was assessed at age 29. Logistic regression analyses were conducted to examine the moderating role of workplace social support in the association between MHP trajectories and WF. Results Four trajectories were identified for both internalising and externalising problems. Young adults with high-stable MHP trajectories reported more often low WF (ORs 3.73 (95% CI 2.28-6.12) and 2.88 (1.78-4.65) for internalising and externalising problems respectively) than those with low-stable trajectories. Higher supervisor and co-worker social support were associated with a lower odds for low work functioning (adjusted ORs ranging from 0.67 (0.54-0.83) to 0.84 (0.71-1.00)). No moderating effect of workplace social support was found for the association between MHP trajectories and WF. Conclusions Both supervisor and co-worker support were shown to be important for all young workers, regardless their history of mental health problems. Occupational health professionals should create awareness among employers and employees that workplace social support is beneficial for young adults’ work functioning. Key messages • Both supervisor and co-worker social support are important for all young workers’ work functioning, regardless of their history of mental health problems. • Creating awareness of the impact of workplace social support on young adults’ work functioning among employers and employees should be a priority area for occupational health practice and policy.

During young adulthood, several transitions in work and family lives occur, but knowledge of the work-family trajectories of the current generation of young adults, i.e. people born in the 1990s, is lacking. Moreover, lit-tle is known about whether the mental health status before the start of the working life may shape work-family trajectories. We used 18-year follow-up data from the TRAILS cohort study of individuals born between 1989 and 1991 (n = 992; 63.2% women). Internalising and externalising problems were measured with the Youth Self -Report at ages 11, 13 and 16 years. Monthly employment, education and parenthood states were recorded be-tween 18 and 28 years. Applying sequence analysis, we identified six work-family trajectories in women and men. The first five trajectories were labelled: long education, continuous education and work, education and work to work, early work, and inactive. The main difference between trajectories of women and men was in the timing of parenthood, thus the remaining trajectory of women was labelled active with children, and the remaining tra-jectory of men active. Women who experienced externalising problems in adolescence were more likely to belong to the trajectory characterised by parenthood. Men who experienced internalising problems in adolescence were more likely to belong to the trajectory characterised by a long time spent in education. The TRAILS data allowed us to consider timing, duration and ordering of the work and family states in young adulthood, and to use multiple assessments of mental health in adolescence. Further research needs to examine the mechanisms through which early mental health affects later work and family outcomes.

IntroductionMental health problems cause a considerable burden of disease in adolescents, with potential negative consequences on employment later in life. Earlier, five trajectories of internalising and externalising problems (high-stable, moderate-high, decreasing, moderate-low, low-stable) among adolescents from 11 to 19 years were identified and a relationship with employment status at age 19 was found. However, at age 19, many participants were still in education.ObjectivesThis study aims to examine associations of trajectory membership with having paid work and type of employment contract in young adults at age 26.MethodsFifteen-year follow-up data of the longitudinal TRacking Adolescents’ Individual Lives Survey (TRAILS) cohort study (N=1711) were used. Logistic regression analyses were applied to examine associations of trajectory membership of internalising and externalising problems with having paid work and type of employment contract at age 26. The analyses were stepwise adjusted for sex, intelligence, parental education, family composition, physical health, negative life events and mental health comorbidity, all measured at age 11.ResultsFor internalising problems, the high-stable (adjusted OR: 2.19; 95% CI: 1.17–4.11) and moderate-high (adjusted OR: 1.75; 95% CI: 1.14–2.69) trajectories were strongly associated with not having paid work, compared to the low-stable trajectory. No associations were found between the trajectories of externalising problems and having paid work. For both internalising and externalising trajectories, no associations were found between trajectory membership and having a permanent or temporary employment contract.ConclusionThis study expands current knowledge about the impact of internalising problems on employment of young adults. To prevent the effects of mental health problems on work, a life course perspective is needed taking into account the development of mental health problems in childhood and adolescence. In the transition from school to work, integrating youth- and occupational healthcare may be key to prevent negative employment outcomes due to internalising problems.

Purpose Depressive symptoms are negatively associated with labour market outcomes but whether the timing and duration of depressive symptoms or educational attainment (EA) affect NEET (Neither in Employment, Education, nor Training) is unknown. Therefore, this study aims to examine the effects of timing and duration of depressive symptoms in adolescence and the moderating and mediating role of EA on NEET in young adulthood. Methods Data were used from 1512 participants in the Vestliv Study, a Danish prospective cohort study. Depressive symptoms were measured at age 14, 18 and 21. EA at age 21 and NEET at age 23 were derived from national registers. Logistic regression analyses and a 4-way decomposition approach were applied. Results Among boys, depressive symptoms at ages 14 and 21 increased the risk of NEET (OR 1.65, 95% CI 1.00–2.74 and OR 2.20, 95% CI 1.37–3.53). Among girls, this regarded depressive symptoms at ages 18 and 21 (OR 1.76, 95% CI 1.26–2.46 and OR 1.59, 95% CI 1.13–2.22). For the duration of depressive symptoms, among boys any depressive symptoms increased the risk of NEET. Among girls, only persistent depressive symptoms increased the risk of NEET. EA did not mediate or moderate the association between depressive symptoms and NEET. Conclusion The timing and duration of depressive symptoms in adolescence matter for the association with NEET in young adulthood, with a double burden for those with both depressive symptoms and low EA. The results emphasize the importance of support for those who experience depressive symptoms in the school-to-work transition.

Background Little is known about the timing and duration of mental health problems (MHPs) on young adults’ labour market participation (LMP). This life-course study aims to examine whether and how the timing and duration of MHPs between childhood and young adulthood are associated with LMP in young adulthood. Methods Logistic regression analyses were performed with data from the Tracking Adolescents’ Individual Lives Survey (TRAILS), a Dutch prospective cohort study with 15-year follow-up (N=874). Internalising and externalising problems were measured by the Youth/Adult Self-Report at ages 11, 13, 16, 19 and 22. Labour market participation (having a paid job yes/no) was assessed at age 26. Results Internalising problems at all ages and externalising problems at age 13, 19 and 22 were associated with an increased risk of not having a paid job (internalising problems ORs ranging from 2.24, 95% CI 1.02 to 4.90 at age 11 to OR 6.58, CI 3.14 to 13.80 at age 22; externalising problems ORs from 2.84, CI 1.11 to 7.27 at age 13 to OR 6.36, CI 2.30 to 17.56 at age 22). Especially a long duration of internalising problems increased the risk of not having a paid job in young adulthood. Conclusion The duration of MHPs during childhood and adolescence is strongly associated with not having paid work in young adulthood. This emphasises the necessity of applying a life-course perspective when investigating the effect of MHPs on LMP. Early monitoring, mental healthcare and the (early) provision of employment support may improve young adult’s participation in the labour market.

Objectives Mental health problems (MHPs) during childhood and adolescence are negatively associated with having a paid job in young adulthood. Yet, little is known about how young adults function at work, that is, do they experience difficulties in meeting their job demands given their health state. This longitudinal study aims to examine the impact of MHPs from childhood to young adulthood on young adults’ work functioning (WF). Methods Data were used from 1004 participants in the TRacking Adolescents’ Individual Lives Survey, a Dutch prospective cohort study with 18-year follow-up. MHP trajectories, including 11, 13.5, 16, 19, 22 and 26 age points, were identified using growth mixture models. WF was assessed at age 29 with the Work Role Functioning Questionnaire 2.0 (WRFQ). Regression analyses were conducted to examine the association between MHP trajectories and WF. Results Young adults with high-stable trajectories of internalising and externalising problems reported lower WF (mean WRFQ scores of 70.5 and 70.7, respectively) than those with low-stable trajectories (78.4 and 77.2), that is, they experience difficulties in meeting the work demands for more than one work day per full-time work week. Young adults with moderate-stable or decreasing MHP trajectories reported lower WF scores compared with those with low-stable trajectories. Conclusions Both persistent high and elevated levels of MHPs from childhood to young adulthood are associated with lower WF scores in young adulthood compared with low-level MHPs. Occupational healthcare professionals should support young workers with a history of MHPs to optimise their work functioning.

ObjectiveGeneration Y has to earn a living in a new world of work in changing labor markets. To date, little is known about the working lives of todays’ young adults and how early life factors impact their working lives. The aim of this study is to examine how educational and work factors cluster in young workers and to assess the impact of mental health problems from childhood to young adulthood on the work-life clusters.MethodsLongitudinal data of N=1235 participants of the Tracking Adolescents Individual Life Study (TRAILS), a prospective cohort study from age 11 to 26, was used. To examine the participants’ clusters regarding educational attainment, employment status, social benefits, type of contract, and working hours at age 26, latent class analysis was performed. Trajectories of mental health problems measured at ages 11, 13.5, 16, 19 and 26 were identified with latent class growth models. Multinomial logistic regression analyses were used to examine the associations between mental health and work-life clusters.ResultsFive clusters were identified: 1) high educated fulltime workers (30.6%), 2) medium educated part-time and fulltime workers (21.6%), 3) students and medium educated workers with small jobs (26.0%), 4) fulltime students (15.7%), and 5) social benefit recipients (6.0%). Participants with high-stable trajectories of internalizing and externalizing problems had an increased risk of receiving social benefits (OR 9.80, 95%CI 4.26–22.5 and OR 13.9, 95%CI 4.15–46.9, respectively).ConclusionAt age 26, five work-life clusters were identified, showing the diversity of the working lives of today’s young adults. The results of this study also show the long-term consequences of early mental health problems on the working lives of young adults. During the presentation, conceptual and analytical challenges will be discussed, for example: ‘When does employment begin’ and ‘How can we best capture the new world of work?’

Background Little is known about factors that may explain the association between depressive symptoms and poor labour market participation (LMP). The aim of this study is to examine the mediation and interaction effects of social support on the association between depressive symptoms and LMP. Methods Data were used from 985 participants (91% of the initial cohort) of the Northern Swedish Cohort, a longitudinal study of Swedish participants followed from adolescence throughout adulthood. Depressive symptoms were measured at age 16, social support at age 21 and LMP from age 30 to 43. Poor LMP was defined as being unemployed for a total of 6 months or more between the ages of 30 and 43. A four-way decomposition approach was applied to identify direct, mediation and interaction effects, together and separately. Results Both depressive symptoms during adolescence and social support at young adulthood were associated with poor LMP [odds ratio (OR) = 1.70, 95% confidence interval (CI) 1.17-2.47 and OR = 2.56, 95% CI 1.78-3.68 respectively]. The association between depressive symptoms and poor LMP was partially mediated by a lack of social support. No interaction effect of a lack of social support was found. Conclusion The results suggest that depressive symptoms influence not only later LMP but also the intermediary level of social support, and in turn influencing later LMP. Recommendations for public health are to detect and treat depressive symptoms at an early stage and to focus on the development of social skills, facilitating the increased availability of social support, thereby improving future LMP.

Background: Self-management is a key element in person-centered and integrated care. It involves several related concepts, such as self-management ability, behavior, and support. These concepts are poorly delineated. The aim of this study was to examine hypothesized associations between self-management ability, behavior, and support in older adults (taking their frailty and complexity of care needs into account) and to examine underlying aspects of these concepts, if these hypotheses lacksupport. Methods: Cross-sectional data from the Embrace study, a stratified randomized controlled trial, evaluating person-centered and integrated care in Dutch community-living older adults, were used. Participants (n=537) were aged 75 and older, assigned to health-related risk profiles based on self-reported frailty and complexity of care needs. Ability was assessed with the Self-Management Ability Scale, behavior with the Partner in Health Scale for Older Adults, and support with the Patient Assessment of Integrated Elderly Care. Results: Ability and behavior were positively associated for participants with the risk profiles “Robust” and “Complex care needs” (betas are 0.38 and 0.46). Coping (an aspect of behavior) turned out to be a key element for participants with risk profiles “Robust” and “Complex care needs” (betas ranging from 0.13 to 0.45). Support was associated with aspects of behavior, varying per risk profile. Conclusion: We found no associations for self-management on the conceptual level, but the aspect coping did appear to play a major role. Improving coping strategies of older adults may be a promising way of enhancing self-management ability, and of reducing the need for self-management support.