Health promoting Behaviors Among Adolescents: A Cross-sectional Study

A Comparative Study on the Prevalence of Lifestyle Risk Factors Among Users and Non-users of Any Health-Based Mobile App Among University Students in Chennai

Introduction Adolescents and young adults are often neglected in terms of healthcare, despite forming a significant demographic and economic force. This study aims to compare the prevalence of lifestyle risk factors among users and non-users of health-based mobile apps among university students in Chennai. Methods This cross-sectional study was conducted from January 2019 to June 2019, with a sample size of 680 undergraduate college students. A standardized WHO STEPwise approach to noncommunicable disease (NCD) risk factor surveillance (WHO STEPS) questionnaire was used to collect data on sociodemographic features, behavioral risk factors, and mobile app usage, along with physical measurements like height, weight, waist circumference, and blood pressure. Results About 238 (35%) study participants were regularly using health-based mobile apps, and 442 (65%) were not using any health-based mobile apps, of which 540 (79.41%) were between 22 and 24 years old, with the majority being female (362, 53.2%). The prevalence of various risk factors was higher among non-users of mobile health apps, except for physical activity, which was similar in both groups. On adjusted multivariable analysis, age category, place of current stay, and unhealthy diet were found to be significant. Conclusion This study helps assess the efficacy of health-based mobile apps in promoting healthy lifestyles among university students. Health-based mobile apps for delivering effective healthcare services are to be promoted among college students for a healthy lifestyle and well-being.

Key factors affecting health promoting behaviors among adolescents: a scoping review

BACKGROUND

Health-promoting behaviors have been noticed recently as one of the most critical factors in raising life expectancy, which can be formed during adolescence. Thus, the current scoping review aimed to identify the key factors affecting health-promoting behaviors among adolescents.

METHODS

In this scoping review, we searched multiple English online databases, including PubMed, Web of Science, Science Direct, ProQuest, and Scopus, for articles published between 1977 and 2020. All eligible studies describing health-promoting behaviors in adolescents were included. We followed the JBI guideline for conducting a scoping review and increasing the study's rigor. Extracted data were synthesized through inductive approaches.

RESULTS

A total of 3199 articles were identified during the first phase. After the screening process, 20 articles were found eligible for final inclusion. Educational factors (individualized education and school health promotion programs), Economic factors (income, economic incentives and national health insurance), Social factors (support system, responsibility and peers), Spiritual, Psychological and Personal factors (gender, family structure, patterns of living, and medical problems) were found effective in health-promoting behaviors among adolescents.

CONCLUSIONS

Health-promoting behaviors among adolescents require careful consideration. The current review identified some fundamental factors affecting health-promoting behaviors in adolescents. Based on the findings, it is recommended that policymakers and healthcare providers develop several interventions based on identified factors to increase adolescent's health-promoting behaviors among adolescents.

Alruwaili K, Alanezi YSA, Abdulhadi Alruwaili A. Assessment of health promotion behavior and associated factors among the northern Saudi adolescent population: a cross-sectional study

Background and Aim

Health promotions among the adolescent population have a significant role in achieving the 2030 sustainable development goals of the World Health Organization. The COVID-19 pandemic has led to several devastating impacts on the health, economic, social, and healthcare systems, and adolescents' health promotions are no exception. We assessed health promotion behaviors and associated factors among the adolescent population of northern Saudi Arabia (KSA).

Methods

We used the Arabic version of the adolescent health promotion scale (AHPS-40) among the 400-adolescent population. The AHPS-40 assessed six domains of adolescent health behavior: nutrition, social support, health responsibility, life appreciation, exercise, and stress management. We applied the Chi-square test to identify the associated factors of adolescent health promotion activities and the logistic regression test to find the predictors for overall health promotion categories.

Results

Of the studied participants, the mean ± SD of the total AHPS-40 was 103.31 ± 18.78. The nutrition domain of the AHPS-40 was significantly associated with the age group (p = 0.002), and the social support domain was significantly related to fathers' (p = 0.022) and mothers' education (p = 0.006). The exercise domain of AHPS-40 was significantly associated with age group (p = 0.018) and school level (p = 0.026). Gender was significantly associated with most of the six domains. Furthermore, more than half (52.7%) of them had a low health promotion behavior, which was significantly associated with gender (adjusted odds ratio = 1.59, 95% CI of AOR = 1.04 -2.45, p = 0.032).

Conclusion

Our study results suggest improving health promotion behaviors by instituting awareness-raising and health promotion intervention programs for adolescent groups. Furthermore, we recommend a focused, exploratory, mixed-method survey among the adolescents of other regions of KSA to identify the region-specific adolescent's health promotion behaviors.

Health-promoting domains and lifestyle of a sample of Brazilian adolescents

BACKGROUND

Reports indicate that the health habits of adults are strongly linked to the behaviors incorporated in adolescence. Therefore, it is essential to monitor the lifestyle of adolescents to promote their present and future health. This study aimed to identify differences in health-promoting domains according to demographic data and lifestyle behaviors, including physical activity, sedentary behavior, sleep duration, and food intake, in a sample of Brazilian adolescents.

MATERIALS AND METHODS

Cross-sectional school-based study, with the participation of 306 adolescents aged 14 to 18 years. A questionnaire was applied with structured questions to collect demographic data and lifestyle behaviors. To examine the health-promoting domains the Adolescent Health Promotion Scale (AHPS) was used. Data were analyzed using multivariate analysis.

RESULTS

Scores attributed to each of the health-promoting domains showed substantial variations according to sex, age, year of study, parents' schooling, and family economic class. After adjustment for covariables, the adolescent who presented significantly higher scores equivalent to the overall index of health promotion reported being more physically active (F = 4.848; P = 0.009), sleeping 6-8 hours/night (F = 2.328; P = 0.046), consuming fruit/vegetable more frequently (F = 3.168; P = 0.024), while sedentary behavior and intake of sweetened products/soft drinks have not shown any significant effect.

CONCLUSION

The findings confirmed the consistent positive influence of health-promoting domains assessed by AHPS on healthy lifestyle behaviors, suggesting in the intervention programs aimed at adopting healthy lifestyle approaches it is important enough to contemplate actions aimed at all the areas of health promotion with characteristics aimed at nutrition behavior, social support, health responsibility, life appreciation, exercise behavior, and stress management.

Childhood trauma and college student health: a review of the literature

The experience of childhood trauma is known to predict health-relevant outcomes across the lifespan. Previous reviews summarize existing knowledge of the implications of childhood trauma for health in young adults and adults more generally. The current theoretical review aims to integrate the existing literature on the relationship between childhood trauma and health-relevant outcomes specifically in college students, consolidating findings across specific health domains. Further, the following theoretical review highlights the need for more research in this area and discusses how college campuses may use the knowledge in this area of work to develop targeted interventions aimed at improving the health of college students who experienced trauma in childhood.

Lifestyle, psychological well-being, and body mass index of indigenous women

Lifestyle, psychological well-being, and body mass index of indigenous women. Introduction. Obesity is more common in women and has also been found to be present in indigenous populations. During university studies, obesity-related lifestyles are in the process of consolidation, and although this is known, research is limited to addressing physical activity and diet, ignoring other lifestyle components, such as life appreciation. Additionally, there is a need to corroborate whether psychological well-being contributes to excess weight in indigenous women. Objective. To determine whether there is an association between lifestyle, psychological well-being, and body mass index (BMI) in indigenous women. Materials and methods. A cross-sectional study was conducted among 110 female Zapotec university students in Juchitán, Oaxaca, Mexico. The Psychological Well-Being Scale, the Healthy Lifestyle Scale for University Students, and a questionnaire about personal data were used. Body weight and height were measured to calculate BMI. Results. There was a negative correlation between BMI, self-acceptance (r = -0.33; p < 0.01), and life appreciation (r = -0.22; p < 0.05). Positive correlations were found between lifestyle and psychological well-being dimensions, with the strongest correlations being observed between life appreciation and purpose in life (r = 0.55) and self-acceptance (r = 0.48). The multivariable models determined that life appreciation and self-acceptance are associated with BMI. Conclusion. Life appreciation and self-acceptance are predictors of BMI and are even more strongly associated than exercise and nutrition behaviors.

A comparative study on the health-promoting behaviors of patients with and without hypertensive heart disease in Iran

BACKGROUND

Health-promoting behaviors can affect the psychological and physical consequences of hypertension. For the prevention and control of hypertension, lifestyle modification has been recommended. This study aimed to investigate the health-promoting behaviors of patients with hypertensive heart disease in Iran and compare them with those of healthy people.

MATERIALS AND METHODS

This was a descriptive comparative study with cross-sectional design. Participants were 141 patients with hypertensive heart disease (mean age = 39 ± 10.2 years) referred to the cardiac clinic of Madani Hospital in Khorramabad, Iran, and 141 healthy people selected from those referred to the hospital. The Persian version of the revised Health-Promoting Lifestyle Profile-II (HPLP-II) was used to evaluate the health-promoting behaviors of participants. After collecting data, they were analyzed in SPSS v. 22 software using descriptive statistics and statistical tests including independent t-test and one-way ANOVA.

RESULTS

The overall HPLP-II score was 142.34 ± 30.48 in patients and 150.52 ± 37.07 in controls. The highest and lowest HPLP-II dimension scores in both groups were related to health responsibility and stress management dimensions. There was a significant difference between groups only in dimensions of nutrition (P = 0.017) and physical activity (P = 0.016), and in the overall score (P = 0.044), whose scores were lower in patients compared to controls. The difference in HPLP-II score of patients with different demographic characteristics (marital status, place of residence, gender, age, educational level, and occupation) was not statistically significant.

CONCLUSION

Patients with heart disease caused by high blood pressure in Iran have poorer diet and physical activity compared to healthy people. Educational interventions with a focus on the importance of dietary regime and exercise are recommended for them.

Exploring the factors related to adolescent health literacy, health-promoting lifestyle profile, and health status

BACKGROUND

Health literacy has been concerned a key factor for determining the use of health information and promoting health. The study aimed to explore adolescent health literacy, health-promoting lifestyle profile, and health status and related factors.

METHODS

A cross-sectional study design was used; 918 first year junior college students were recruited in Taiwan. The measurements were the Chinese Health Literacy Survey Questionnaire (HLS-C-Q), the Chinese Health-Promoting Lifestyle Profile (HPLP-S), and the Health Status Questionnaire.

RESULTS

The mean score for health literacy was 36.15 (±6.21), with 30.17% of the participants having insufficient or problematic health literacy. Further, 19.9% of participants were obese and 11.2% experienced emotional instability. Health literacy and health-promoting lifestyle profile showed significant positive and negative correlations with perceived health status and depression, respectively (p < 0.05). An exercise frequency of ≥3 times/week was a predictor of health literacy, health-promoting lifestyle profile, and emotional stability.

CONCLUSIONS

Adolescent health literacy, health-promoting lifestyle profile, and health status require careful consideration. In adolescents, developing regular exercise may increase health literacy, thereby developing healthy lifestyle profiles and ameliorating obesity and depression-related issues.

Development and validation of the Health Promoting Behaviour for Bloating (HPB-Bloat) scale

Background

Health management strategies may help patients with abdominal bloating (AB), but there are currently no tools that measure behaviour and awareness. This study aimed to validate and verify the dimensionality of the newly-developed Health Promoting Behaviour for Bloating (HPB-Bloat) scale.

Methods

Based on previous literature, expert input, and in-depth interviews, we generated new items for the HPB-Bloat. Its content validity was assessed by experts and pre-tested across 30 individuals with AB. Construct validity and dimensionality were first determined using exploratory factor analysis (EFA) and Promax rotation analysis, and then using confirmatory factor analysis (CFA).

Results

During the development stage, 35 items were generated for the HPB-Bloat, and were maintained following content validity assessment and pre-testing. One hundred and fifty-two participants (mean age of 31.27 years, 68.3% female) and 323 participants (mean age of 27.69 years, 59.4% male) completed the scale for EFA and CFA, respectively. Using EFA, we identified 20 items that we divided into five factors: diet (five items), health awareness (four items), physical activity (three items), stress management (four items), and treatment (four items). The total variance explained by the EFA model was 56.7%. The Cronbach alpha values of the five factors ranged between 0.52 and 0.81. In the CFA model, one problematic latent variable (treatment) was identified and three items were removed. In the final measurement model, four factors and 17 items fit the data well based on several fit indices (root mean square error of approximation (RMSEA) = 0.044 and standardized root mean squared residual (SRMR) = 0.052). The composite reliability of all factors in the final measurement model was above 0.60, indicating acceptable construct reliability.

Conclusion

The newly developed HPB-Bloat scale is valid and reliable when assessing the awareness of health-promoting behaviours across patients with AB. Further validation is needed across different languages and populations.

Health-Risk Behaviors and Dietary Patterns Among Jordanian College Students: A Pilot Study

Background/Aims: Health promotion and the incorporation of health-protective behaviors in people's lifestyles have a great role in enhancing individuals' overall health and well-being. College students are at increased risk of developing unhealthy dietary and lifestyle behaviors. A cross-sectional pilot study was conducted to assess the health-risk behaviors among undergraduate college students at Jordan University of Science and Technology. Methods: The final sample included 136 students, with a mean age of 21.1 ± 2.37 years, mostly females (69%). A self-reported questionnaire was used for data collection about dietary and lifestyle behaviors among college students. The questionnaire consisted of four parts: sociodemographic characteristics, body weight classifications, lifestyle behaviors, and dietary patterns and intake, and eating behaviors. Results: Most of the students did not meet the daily recommendations for fruit (76%) and vegetable (82%) intake. Males were significantly consuming fast food more frequently (p = 0.019), and smoked cigarettes (p < 0.001) or hookah (p = 0.015) more frequently than did females. Further, the majority met the recommendations for physical activity (81%), but exceeded recommendations for sedentary behavior. Females were more likely to have normal weight or be underweight (OR = 4.865), to have a fear of weight gain (OR = 3.387), and to have the recommended sleeping hours (OR = 7.685) than were males. Conclusion: The results indicate the health-risk behaviors and the gender-related differences among college students.

A population-based study of health-promoting behaviors and their predictors in Iranian males, 2019

BACKGROUND

Health-promoting lifestyle (HPL) is any measure taken to maintain a person's health. The most important and influential factor in maintaining and enhancing health are health-promoting behaviors (HPB). This study aimed to determine HPB and their predictors among Iranian men.

METHODS

In this cross-sectional study, 783 Iranian men, living in Tehran, were selected, using multistage cluster sampling. The employed questionnaires, namely the sociodemographic questionnaire, Health-Promoting Lifestyle Profile II (HPLP-II), and the second part of the Personal Resource Questionnaire (PRQ 85-Part 2), were completed through interviews. The relationship between the dependent variables (HPLP-II and its subdomains) and independent variables (sociodemographic characteristics and social support) was investigated using the adjusted General Linear Model (GLM).

RESULTS

The mean ± standard deviation of the total HPLP-II score was 2.72 ± 0.44 in the range of 1-4. Among the six dimensions of the HPB, the participants achieved the highest score (3.00 ± 0.52) and lowest score (1.96 ± 0.56) in spiritual growth and physical activity, respectively. The Pearson test showed that the perceived social support was significantly correlated with HPLP-II (r = 0.23; p < 0.001) and all of its subdomains (r = 0.09-0.24; p < 0.001). Based on the adjusted general linear model, social support, age, job, and income adequacy were the predictors of HPL in men and could explain 30.9% of the variance of the HPL score.

CONCLUSIONS

The research findings confirmed the importance of social support and modifying variables (social and personal) in the incidence of HPB in men.

Health-promoting lifestyle and its association with the academic achievements of medical students in Saudi Arabia

Objective:

This study aimed to assess health-promoting lifestyles among university medical students and to investigate whether such lifestyles are associated with students’ academic achievement.

Methods:

A cross-sectional descriptive investigative study was performed on 576 medical college students of King Saud University (KSU) in March 2019. Data were collected using the Health-Promoting Lifestyle Profile II (HPLP II) scale, which includes six dimensions (health responsibility, spiritual growth, physical activity, interpersonal relationships, nutrition, and stress management). The data were analyzed using descriptive and inferential statistics at a significance level of P < 0.05.

Results:

A mean score of 3.39 for total health-promoting behaviors was reported. The highest mean score was reported for spiritual growth (3.75) and the lowest was reported for health responsibility (3.23). The mean body mass index (BMI) of the students was 24.9 ± 6.4 kg/m². An analysis of variance identified an association between a student’s GPA and the spiritual growth dimension (P = 0.014). Based on the Pearson matrix correlation coefficient, there was a statistically significant and positive relationship between the HPLP II dimensions (P < 0.05).

Conclusion:

Since the HPLP scores were good, there is a need to enhance and promote healthy behaviors in students. The BMI data indicated that one-third of male students were overweight or obese; thus, health program planning, particularly involving physical activity and nutrition, is recommended.

Health Literacy and Health Promotion Behaviors of Adolescents in Turkey

PURPOSE

This study was conducted to determine the health literacy and health promotion behaviors of adolescents.

DESIGN AND METHODS

This study used cross sectional and correlational design. The population of the study consisted of 6th, 7th, and 8th grade students from three different secondary schools selected from high, middle, and low income levels. The sample consisted of 2498 students.

RESULTS

The mean score of the health literacy scale of the students was 30.26. The mean score of the adolescent health promotion scale was 143.75. The mean scores of health literacy and adolescent health promotion scores of the students in high income level, sixth grade, and have parents with a baccalaureate or graduate degree were significantly higher (p < 0.005). A moderate positive correlation was found between the school age health literacy scale and the adolescent health promotion scale (p < 0.001).

CONCLUSIONS

Adolescents' health literacy, and their health promotion behaviors were at moderate level. By integrating a basic health knowledge and healthy lifestyle behaviors course into the student curriculum, health literacy of the students could be increased.

PRACTICE IMPLICATIONS

The determination of health literacy and health promotion behaviors in adolescents by nurses in the schools will be a guide for the promotion of enhanced adolescent health.

Behavioural Patterns of Physical Activity and Nutritional Habits among Urban and Rural Students

Background:

Adolescence is considered as one of the most vulnerable periods. The deficiencies and poor nutritional habits and lack of physical activity will have irreparable consequences in adulthood. This study was aimed to determine the behavioural patterns of nutritional and physical activity among the urban and rural students in Urmia, Iran.

Methods:

The present study was designed and implemented using a sectional and descriptive-analytic approach. Using a stratified random sampling method, 194 males and 191 female high school students were chosen to participate. Health-Promoting Lifestyle Profile II (HPLPII) was used for data collection. The overall average score of physical activity in students was 55.57 ± 4.88, and in the aspect of nutritional behaviour it was equal to 64.04 ± 3.67.

Results:

No significant difference was observed between physical activity, nutritional behaviours and socio-demographic variables (gender, type of school, place of residence, parental education). Based on multivariate regression analysis, there was a significant relationship between physical activity and the field of education. Furthermore, a significant relationship was found between children’s nutritional behaviour and mothers’ education.

Conclusion:

Considering importance of mothers’ role in upbringing adolescents and forming their healthy behavioural patterns and the significant relationship of mothers’ education and healthy behaviours, training and increasing health literacy level of this class of population can be an imperative step in promoting the mental and physical health of adolescents.

Relationships between depression, health‑related behaviors, and internet addiction in female junior college students

Introduction

Depressive emotions can lead to subsequent unhealthy behaviors such as Internet addiction, especially in female adolescents; therefore, studies that examine the relationships among depression, health‑related behaviors, and Internet addiction in female adolescents are warranted.

Purpose

To examine (1) the relationship between depression and health-related behaviors and (2) the relationship between depression and Internet addiction.

Method

A cross-sectional study design was adopted using a structured questionnaire to measure depression, health-related behaviors, and Internet addiction in female adolescents. The data were collected from students of a junior college in southern Taiwan using convenience sampling to select the participants. The questionnaire was divided into four sections: demographics, the Center for Epidemiologic Studies Depression Scale (CES-D), the Health Promoting Lifestyle Profile (HPLP), and the Internet Addiction Test (IAT).

Results

The final sample comprised 503 female junior college students, with the participants mainly aged between 15 to 22 years (mean age = 17.30 years, SD = 1.34). Regarding the HPLP scores, the overall score, nutrition subscale score, and self-actualization subscale score were significantly and negatively associated with the CES-D depression score (p < 0.05–0.01). In other words, depression level was lower in students who exhibited more healthy behaviors, put more emphasis on dietary health, and had higher levels of self-admiration and confidence toward life. Regarding the IAT scores, the overall score and six domain scores were all positively associated (p < 0.01) to the CES-D depression score. In other words, the higher an individual’s Internet addiction score was, the higher her depression level was.

Conclusions

The results confirmed the relationship between depression, health-related behaviors, and Internet addiction. The cultivation of health-related behaviors may help in lowering depressive symptoms. Teenagers with depression have higher risks of developing Internet addiction, and such addiction is likely to affect their daily functioning.

Non-communicable Disease Risk Reduction Teaching in India: A Curricular Landscape

Non-communicable diseases (NCDs) have today become a growing epidemic, surpassing infectious diseases and adversely impacting national health systems, policies, and socio-economic developments. Management of NCD and its risk factors such as tobacco use, poor diet, physical inactivity, and obesity has garnered paramount importance under the Sustainable Development Goals (SDGs). However, the educational settings for healthcare professionals to prepare them for delivery of preventive interventions w.r.t. to NCD risk factors require a stronger foundation. In the present work, a landscaping exercise of the teaching of NCD risk factors in the extant Bachelor of Medicine and Bachelor of Surgery (MBBS) curricula of healthcare professionals from select medical colleges in India has been undertaken. Our assessment indicates that in the present MBBS curriculum, effort is largely directed upon teaching only specific aspects of NCDs, such as hypertension, diabetes, mental illness, blindness, and cancer with greater inclination toward clinical aspects. With regard to NCD risk factors, there is inadequate focus on the healthcare promotion aspects. The overall syllabus also does not address long-term health implications of tobacco smoking, lack of proper diet or physical activity, excessive alcohol consumption etc. It also does not reflect any practical trainings or sessions related to health promotion or behavior change activities. As a way forward, we suggest that NCD risk reduction aspects be incorporated extensively into existing health professional education through the development of a curricular framework and an intervention plan contextualized to India. Findings from this study are expected to help provide critical inputs for the design and development of a curricular plan with thrust on tobacco cessation, physical activity, healthy diet, and restricted alcohol consumption, leading to creation of a health competent workforce engaged in NCD prevention and health promotion.

Structural model of factors relating to the health promotion behavior of reproductive health among Indonesian adolescents

Objectives

We aim to explore the factors related to the health promotion behavior of reproductive health (RH) among Indonesian adolescents via structural equation modeling.

Methods

A cross-sectional quantitative study was used to measure 108 adolescents aged 12–16 years. We employed a self-administered questionnaire developed from the health promotion model (HPM) and the empowerment model (EM) on the basis of self-efficacy to determine the factors related to health promotion in maintaining RH behavior. Structural equation modeling (SEM) was used to examine relationships among the variables. The Analysis of Moment Structures (AMOS) approach was used to evaluate if the proposed model is suitable for the data based on goodness-of-fit indices.

Results

The model is appropriate for the data. Three interrelationships emerge among independent variables (P > 0.05), namely, personal and cognitive behaviors (r = −0.01), cognitive and health promotion behaviors (r = 0.09), and affective and health promotion behaviors (r = −0.17). The strongest relationship is between empowerment and health promotion behavior (r = 0.72). Affection (interpersonal and situational influences), immediate competing demands and preferences, and empowerment (participation and control) are directly related to RH behavior maintenance. Meanwhile, willingness of adolescents, prior related behavior, personal factor, and commitment to a plan of action are indirectly related to RH behavior maintenance. The model explains 43.9% of the variance in maintaining RH behavior.

Conclusions

The HPM and EM models help determine the factors related to RH behavior maintenance among adolescents. Intervention to promote RH among Indonesian adolescents should begin from the level of child–parent–health care professional encounter for empowering the RH of adolescents.