Abstract
ObjectiveTo analyze the prevalence and factors associated with the co‐occurrence of health risk behaviors in adolescents. MethodsA cross‐sectional study was performed with a sample of high school students from state public schools in Pernambuco, Brazil (n=4,207, 14‐19 years old). Data were obtained using a questionnaire. The co‐occurrence of health risk behaviors was established based on the sum of five behavioral risk factors (low physical activity, sedentary behavior, low consumption of fruits/vegetables, alcohol consumption and tobacco use). The independent variables were gender, age group, time of day attending school, school size, maternal education, occupational status, skin color, geographic region and place of residence. Data were analyzed by ordinal logistic regression with proportional odds model. ResultsApproximately 10% of adolescents were not exposed to health risk behaviors, while 58.5% reported being exposed to at least two health risk behaviors simultaneously. There was a higher likelihood of co‐occurrence of health risk behaviors among adolescents in the older age group, with intermediate maternal education (9‐11 years of schooling), and who reported living in the driest (semi‐arid) region of the state of Pernambuco. Adolescents who reported having a job and living in rural areas had a lower likelihood of co‐occurrence of risk behaviors. ConclusionsThe findings suggest a high prevalence of co‐occurrence of health risk behaviors in this group of adolescents, with a higher chance in five subgroups (older age, intermediate maternal education, the ones that reported not working, those living in urban areas and in the driest region of the state).
Highlights
The results of this study show that the prevalence of simultaneous exposure to health risk behaviors among adolescents from the state of Pernambuco was high, as observed in similar studies.8,10---12
Another important result was the identification of five significant factors associated to the higher co-occurrence of these behaviors, namely: age range, maternal education, geographic region, working status, and place of residence
The results of this survey indicated that 58.5% of adolescents were simultaneously exposed to two or more risk behaviors, as observed in a study carried out in the city of João Pessoa, state of Paraiba.[15]
Summary
Exposure to health risk behaviors has become one of the most widely investigated subjects in studies with young populations.[1,2] The interest in investigations focusing on this subject can be explained, at least in part, by the fact that such behaviors can be established and incorporated into the lifestyle at an early age,[3,4] and due to their connection with biological risk factors[5] and the presence of established metabolic or cardiovascular disease (CVD).[6]The prevalence of co-occurrence of health risk behaviors in adolescents has been described in several studies.7---17 it was observed that the studies developed in Brazil, except for the survey performed by Farias Júnior et al.,[15] relied on very specific samples: laboratory school students[17] and day-shift students from public schools in a city from southern Brazil.[16]. The prevalence of co-occurrence of health risk behaviors in adolescents has been described in several studies.7---17. It was observed that the studies developed in Brazil, except for the survey performed by Farias Júnior et al.,[15] relied on very specific samples: laboratory school students[17] and day-shift students from public schools in a city from southern Brazil.[16] the results of these studies cannot be extrapolated to other regions of the country due to socioeconomic and cultural contrasts, which are known to differentiate the exposure to health risk behaviors, as reported by Nahas et al.[18]. Epidemiological surveys on the co-occurrence of health risk behaviors in adolescents and their associated factors can help to identify risk groups and to monitor the health levels of this population, which can support the development of public policies to promote health, using earlier intervention strategies to prevent these habits. The aim of this study was to analyze the prevalence and factors associated with co-occurrence of health risk behaviors in adolescents
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