Internalization of rules and risk-behavior among early adolescents and relevance for public health

Abstract

Abstract Introduction Self-determination theory (SDT) is a macro theory of human behavior and provides a substantial theoretical background for understanding and changing qualitative aspects of behavioral regulation such as the level of internalization in the context of health-related behaviors of individuals and communities. The aim of this study is to use this theory to focus on the internalization of parental rules in early adolescents in Slovakia and examine it in relation to their risk behavior. Methods A sample of 581 early adolescents (mean age = 12.5 SD = 0.5; 49% girls) from Slovakia participated in a larger project focusing on health-related behaviors (APVV-0253-11, APVV-15-0662). They completed measures based on SDT addressing the level of internalization or parental rules and the risk behaviors of alcohol use and smoking. These risk behaviors were measured on a dichotomous level (used/ not used). Binary logistic regressions were used to explore the relationship between the level of the internalization of rules with respect to alcohol use and smoking controlling for the relevant variables. Results The results of the analyses showed that after controlling for age and gender, internalized parental rules were negatively associated with alcohol use (95%CI=0.918-0.981). Conversely, the extrinsic regulation of parental rules indicated a higher likelihood of using alcohol (95%CI=1.039-1.151). However, this was not observed in smoking which was found to not be associated with rule internalization. Conclusions The findings stress the importance and relevance of the internalization process when studying behavioral regulation in the context of health. This was demonstrated in the internalizing of parental rules among early adolescents. However, the findings also suggest that a different approach might be needed with different contexts and different health related behaviors. Key messages Acknowledging the importance of the qualitative aspects of self/behavioral regulation such as the level of internalization may improve public health interventions. A different approach might be needed when internalization is considered in different contexts and different health related behaviors.