Abstract
BackgroundLifestyle risk behaviours such as smoking, alcohol consumption, physical inactivity, sedentary behaviour and low fruit/vegetable intake have been identified as the major causes of chronic diseases. Such behaviours are usually instigated in adolescence and tend to persist into adulthood. Studies on the clustering of lifestyle risk behaviours among adolescents are scarce, particularly in developing countries. Therefore, the present paper aimed to determine the clustering of lifestyle risk behaviours and its determinants among school-going adolescents in Malaysia.MethodsData were extracted from a cross-sectional study, the Malaysian Adolescent Health Risk Behaviour (MyAHRB) study, which was conducted from May to September 2013 across 11 states in Peninsular Malaysia. A two-stage proportionate-to-size sampling method was employed to select a total of 3578 school-going adolescents aged 16–17 years from 20 selected schools in urban and rural settlements, respectively. The MyAHRB study adopted a set of self-administered questionnaires adapted from the Global School-based Student’s Health Survey (GSHS) and the Youth Risk Behaviour Surveillance.ResultsThe results from the analysis of 2991 school-going adolescents aged 16–17 years showed that 16 (in boys) and 15 (in girls) out of 32 combinations of lifestyle risk behaviours clustered. Girls (aOR 2.82, 95% CI: 2.32–3.43) were significantly more likely to have clustered risk behaviours than boys; however, no significant associated factors were observed among girls. In contrast, boys of Malay descent (aOR 0.64, 95% CI: 0.46–0.89) or boys who had at least three friends (aOR 0.65, 95% CI: 0.43–0.99) were less likely to engage in multiple risk behaviours.ConclusionThe present study demonstrated the clustering of multiple risk behaviours that occurred in both genders; these results suggest that multiple behaviour intervention programmes, instead of programmes based on siloed approaches, should be advocated and targeted to the high-risk sub-populations identified in the present study.
Highlights
Lifestyle risk behaviours such as smoking, alcohol consumption, physical inactivity, sedentary behaviour and low fruit/vegetable intake have been identified as the major causes of chronic diseases
Previous studies have demonstrated that adolescents tend to engage in a spectrum of lifestyle risk behaviours, such as smoking, drinking alcohol, being physically inactive, engaging in sedentary behaviour and having low fruit/vegetable intake [2, 3]; these unhealthy behaviours are more likely to continue into adulthood [4]
84.9% (n = 2538) of them provided a complete response to all five lifestyle risk behaviours of concern, whilst those with incomplete responses were excluded from the present study (n = 453)
Summary
Lifestyle risk behaviours such as smoking, alcohol consumption, physical inactivity, sedentary behaviour and low fruit/vegetable intake have been identified as the major causes of chronic diseases Such behaviours are usually instigated in adolescence and tend to persist into adulthood. There have been extensive international and local studies on the magnitude and determinants of individual lifestyle risk behaviours among adolescents, such as smoking [6, 7], alcohol consumption [8, 9], physical inactivity [10, 11], sedentary behaviour [12, 13] and low fruit/vegetable intake [14, 15]. This clustering of risk behaviours is distinct from the co-occurrence of multiple risk behaviours, as the former occurs due to an underlying association between the co-occurring risk behaviours, while the latter merely describes the concurrent but independent engagement in multiple risk behaviours [22]
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