Health-compromising Behavior Research Articles

A systematic review on the effect of identity-related interventions on physical activity and smoking

Abstract Background Identity (self-perceptions of ‘who I am’) is important for health behavior change. Hence, identity-related interventions, aiming to influence how people view themselves, show promise for health promotion. This systematic review describes the effect of identity-related interventions on physical activity (PA), a health-promoting behavior, and smoking, a health-compromising behavior, and PA- and smoking-related identities in adults. Methods A comprehensive search, updated in May 2023, identified 5801 publications across eleven databases. After screening, 19 quantitative and mixed-methods publications were selected, describing 20 different studies. Relevant data were systematically extracted and a quality assessment was conducted using the Mixed Methods Appraisal Tool. Results Identity-related interventions were more common for enhancing PA (n = 13) than for smoking cessation (n = 6). Only one study targeted PA- and smoking-related identities to change both behaviors simultaneously. Various identity-related interventions were used, e.g. possible (future) selves manipulations and avatar games. The target population was rarely involved in intervention development. The results are mixed; some studies showed (significant) positive effects of identity-related interventions on identities or behavior, and no significant negative effects were shown. Similar results were found for PA and smoking. The one study targeting both behaviors showed positive results. Conclusions Identity-related interventions hold promise in promoting PA and smoking cessation. Future research could investigate identity-related interventions targeting multiple health behaviors, e.g., PA-promotion and smoking cessation, leveraging the synergy between those identities and behaviors. Collaboratively developing these interventions with the target population (i.e., patient and public involvement) could optimize them for different populations, improving public health and reducing health disparities. Key messages • Identity-related interventions could improve public health. • Collaboratively developing identity-related interventions with the target population could optimize them for different populations.

Characteristics and risk factors of Health-Related Risky behaviors in adolescents with Depression

BackgoundTo explore the characteristics and risk factors for health-related risky behaviours (HRRBs) in adolescents with depression.MethodsA total of 136 adolescents aged 12–18 years who met the diagnostic criteria for depression, and 272 healthy controls. All the subjects were assessed with the Adolescent Health-Related Risky Behavior Inventory (AHRBI), and the AHRBI scores of the two groups were compared with the Mann–Whitney U test. The depression group was assessed with the Self-Rating Anxiety Scale (SAS), Self-Rating Depression Scale (SDS), Childhood Trauma Questionnaire (CTQ), Cognitive Emotion Regulation Questionnaire (CERQ), Egna Minnen av Barndoms Uppfostran (EMBU), and Family Adaptability and Cohesion Scale (FACES II-CV). Spearman correlation analysis and multiple linear regression were used to explore the risk factors for HRRBs in adolescents with depression.ResultsThe AHRBI total score and five-factor scores of self-injury and suicide (SS), aggression and violence (AV), rule-breaking (RB), smoking and drinking (SD), and health-compromising behavior (HCB) in the depression group were higher than those in the control group. The severity of anxiety, catastrophizing, cognitive emotional regulation strategy (self-blame and blaming of others), the frequency of depression, physical neglect, and sexual abuse all increased the risk of HRRBs in adolescents with depression, and paternal emotional warmth and understanding had protective effects.ConclusionFirst, depressed adolescents exhibited significantly more HRRBs than healthy adolescents. Second, there are many risk factors for HRRBs in adolescents with depression, and the risk factors for different types of HRRBs are also different.

PREVALENCE OF HEALTH COMPROMISING BEHAVIORS AMONG TERTIARY EDUCATION STUDENTS IN THE ENUGU STATE OF NIGERIA

Health compromising behaviors are detrimental behaviors that have been implicated in increased mortality and morbidity in every society. Although peculiar to all ages, gender, economic and social status. There is a growing indication that risky health behavior is more prevalent in adolescents. Notably, there is no known recent data on health-compromising behavior among adolescents in Enugu state. Thus, the current study examined the prevalence of risky behaviors among tertiary education students in Enugu state. Four hundred and eighty-nine undergraduates pooled from tertiary institutions participated in the study. The participants completed a self-report measure assessing their health-compromising behavior. The result showed physical inactivity 53.7% represented the highest rate of risky behavior identified among the students, followed by alcoholic use with an overall rate of 51.9%. Also, smoking 48.6% and self-medication 43.7% assumed an elevated rate of health risk behavior among the cohort, while unsafe sexual behavior rated 21.4%, and fighting 17% were rated the least prevalent health risky behavior among the students.

Consequences and predisposing factors of self-discharge against medical advice in plastic and hand surgery

PurposeTherapeutic success of surgical interventions is significantly affected by patients’ adherence. Patient autonomy can lead to unreasonable behavior. We analyzed the consequences and predisposing factors of patient self-discharge in a plastic and hand surgery cohort.Study design and settingData was collected retrospectively in a case–control study with n = 73 patients who had self-discharged in a 10-year time period and n = 130 controls (discharge by the surgeon). Data was collected through the hospital information systems and a particular questionnaire. Statistical analyses were performed via chi-squared test and logistic regression analyses.ResultsPatients who self-discharged against medical advice had a significantly higher complication rate (p = 0.045) and a higher number of revision operations (p < 0.001). They were more often dissatisfied with the primary inpatient treatment (p < 0.05). Secondly, they lived more often in shared households (p = 0.002; OR 5.387 (1.734–16.732)) or had to take care of their children at home (p = 0.006; OR 1.481 (1.280–1.741)). There was a significantly lower pain score (NAS) on time of self-discharge (p = 0.002) as well as 24 h after self-discharge (p < 0.001) in self-discharged patients.ConclusionSelf-discharge was associated with predisposing factors and poorer outcomes. Patient autonomy can lead to health-compromising behavior and patients should be counseled accordingly.

Health-related risky behaviors in Chinese adolescents with autism: a cross-sectional study

BackgroundHealth-related risky behaviors (HRB) generally refer to behaviors that have a negative influence on health and quality of life. HRB in adolescents with autism have not been well understood so far. We aim to explore health-related risky behaviors and their risk factors with autistic adolescents.MethodsIn this study, 150 adolescents with autism and 150 neurotypical adolescents were enrolled. Participants in both groups completed the Adolescent Health-Related Risky Behavior Inventory (AHRBI). Autism Spectrum Screening Questionnaire (ASSQ), Wechsler Intelligence Scale, Theory of Mind (ToM) Test, Zung Self-rating Anxiety Scale (SAS), Zung Self-rating Depression Scale (SDS), and Self-Esteem Scale (SES) were also assessed in the autism group to explore risk factors.ResultsThe results showed that the total score of AHRBI and scores of "aggression and violence (AV)", "suicide or self-injury (SS)", "health-compromising behavior (HCB)", and "unprotected sex (US)" subscales in the autism group were significantly higher than those in the control group (Z value = − 4.58 ~ − 2.26, all P < 0.05). Anxiety, depression, low self-esteem, low IQ score, low ToM test score, increasing age, and communication disorder were found as risk factors for health-related risky behaviors in autistic adolescents.ConclusionsAdolescents with autism have more health-related risky behaviors than neurotypical adolescents. We should pay attention to the emotional state, self-esteem, cognitive function, and verbal communication levels of autistic adolescent with health-related risky behaviors.

EFFECT OF MORTALITY SALIENCE ON HEALTH COMPROMISING BEHAVIOR

Over the decades, researchers have leaned on the TMT to explain numerous phenomena, including consumer choice, exercise motivation, risky driving behavior, and other behavioral domains. The present study aimed to investigate the effect of mortality salience on RSB as a health-compromising behavior. Sixty-two participants took part in the study. A quasi-experimental design was adopted. The result showed that MS increased resentment to RSB in the experimental condition (M = 44.82, SD= 9.28) compare to the control condition (M = 21.27, SD = 5.19). An independent t-test was used to test the studys hypothesis, and the result established a statistically significant differential effect of MS on RSB resentment between the conditions. We conclude that MS is effective in mitigating the incidence of RSB.

Minimizing Health-Compromising Behaviors via School-Based Programs: An Optimization Approach.

School health programs are united by their desire to promote health and health-related outcomes among youth. They are also united by the fact that their expected effects are contingent on successful program implementation, which is often impeded by a multitude of real-world barriers. Techniques used in management science may help optimize school-based programs by accounting for implementation barriers. In this exploratory study, we present a detailed example of the first known application of linear programming (LP), which is an optimization technique, to Positive Action (PA). PA is a social emotional and character development program that includes a six-unit, teacher-delivered, classroom curriculum. We specify how we used LP to calculate the optimal levels of program implementation needed to minimize substance use, subject to known levels of implementation barriers (e.g., disruptive behavior, teacher education, teacher attitudes towards character development, school resources, and school safety). We found that LP is a technique that can be applied to data from a school health program. Specifically, we were able to develop a model that calculated the number of lessons that should be taught to minimize a specific health-compromising behavior, given expected levels of predetermined implementation barriers. Our findings from this exploratory study support the utility of applying LP during the program planning and implementation processes of school health programs.

孤儿健康妥协行为与情绪、认知情绪调节的关系研究

孤儿健康妥协行为与情绪、认知情绪调节的关系研究

An Inside Look at Homeless Youths' Social Networks: Perceptions of Substance Use Norms

ABSTRACTSubstance use among homeless young people is a pervasive problem, and there have been many efforts to understand more about the dynamics of this health-compromising behavior. The current study examined perceived substance use norms within homeless youths' social networks utilizing in-depth interviews. The sample included 19 homeless individuals ages 16 to 21. Four elements of substance use within networks emerged: substance use choices, drug use safety issues, encouragement and/or discouragement, and appropriate situations in which substance use is condoned. These findings provide unique insight into the norms associated with drug and alcohol use within homeless youths' social networks.

Gender Imbalance and Parental Health-Compromising Behavior in Rural China

China and some other countries have experienced unbalanced sex ratios in the marriage market, which triggers intense competition and pressure to get married. This paper utilizes two household longitudinal datasets from rural China – a secondary national survey and a primary regional survey – to examine parental substance use in response to skewed sex ratios. Sex ratios are calculated using a 1‰ sample of the 2000 China Population Census. Strikingly, paternal smoking and alcohol use are more intense for families with son living in communities with higher sex ratios. In contrast, those with daughter do not demonstrate this pattern. Both direct and indirect evidence suggests that coping with the marriage market pressure is a more plausible pathway linking the observed skewed sex ratios and intense substance use, while we do not find evidence supporting income effect and status seeking motives. Considering the highly competitive marriage market in the coming decade and prevalent substance use that generates lasting health impacts and large negative externalities to society, policies that correct the skewed sex ratios could lead to substantial welfare gains.

Experimenting with cigarettes and physical activity among Mexican origin youth: a cross sectional analysis of the interdependent associations among sensation seeking, acculturation, and gender

BackgroundSensation seeking tendencies tend to manifest during adolescence and are associated with both health-compromising behaviors and health-enhancing behaviors. The purpose of this study is to evaluate the relationship between sensation seeking and physical activity, a health-enhancing behavior, and between sensation seeking and experimenting with cigarettes, a health compromising-behavior, among a cohort of Mexican origin adolescents residing in the United States with different levels of acculturation.MethodsIn 2009, 1,154 Mexican origin youth (50.5% girls, mean age 14.3 years (SD = 1.04)) provided data on smoking behavior, physical activity, linguistic acculturation, and sensation seeking. We conducted Pearson’s χ2 tests to examine the associations between categorical demographic characteristics (i.e. gender, age, country of birth and parental educational attainment) and both cigarette experimentation and physical activity and Student’s t-tests to examine mean differences on the continuous variables (i.e. sensation seeking subscale) by the behaviors. We examined mean differences in the demographic characteristics, acculturation, and both behaviors for each of the sensation seeking subscales using analysis of variance (ANOVA). To examine relationships between the sensation seeking subscales, gender, and both behaviors, at different levels of acculturation we completed unconditional logistic regression analyses stratified by level of acculturation.ResultsOverall, 23.3% had experimented with cigarettes and 29.0% reported being physically active for at least 60 minutes/day on at least 5 days/week. Experimenting with cigarettes and being physically active were more prevalent among boys than girls. Among girls, higher levels of sensation seeking tendencies were associated with higher levels of acculturation and experimentation with cigarettes, but not with physical activity. Among boys, higher levels of sensation seeking tendencies were associated with higher levels of acculturation, experimenting with cigarettes and being physically active.ConclusionsOur results suggest that interventions designed to prevent smoking among Mexican origin youth may need to address social aspects associated with acculturation, paying close attention to gendered manifestations of sensation seeking.

Denormalization of Tobacco Use and the Role of the Pediatric Health-Care Provider

Denormalization is an array of actions implemented to induce and reinforce the public perception of a health-compromising behavior as socially unacceptable. Active and second-hand tobacco use has substantial adverse effects on children's health. Tobacco has been marketed by associating its use with glamor, success, athleticism, and independence. Strategies for denormalization of tobacco use are designed to influence social norms to promote reduction of smoking behavior in our society. The social ecological model provides the theoretical framework on which these activities are based. Changing social norms about tobacco control requires a multilevel perspective that considers additive and interrelated effects on several levels—from the patient to the community. Models for changing social norms about tobacco have focused on reducing tobacco marketing, counter-marketing, restricting smoking in public places, reducing tobacco availability, and supporting tobacco dependence treatment services. As advocates for children's health, pediatricians can and should promote denormalization of tobacco use in their physician–patient communications, personal examples set, and in public policy advocacy activities. Pediatric health-care providers can promote denormalization of tobacco use through the following strategies: serve as a role model for a tobacco-free lifestyle, routinely address tobacco issues with pediatric patients, and provide treatment and/or referrals for tobacco prevention and cessation resources. Beyond the clinic, pediatric professionals can support tobacco-free ordinances in their communities and participating in state and national tobacco control campaigns. Wherever possible, training of medical students, residents, fellows, and other pediatric professionals in tobacco counseling and advocacy would contribute to further resources for denormalization of tobacco.

Changes in Childhood Risk Taking and Safety Behavior After a Peer Group Media Intervention

Risk taking is a significant health-compromising behavior among children that often is portrayed unrealistically in the media as consequence-free. Physical risk taking can lead to injury, and injury is a leading cause of hospitalization and death during childhood. The aim of this study was to examine the effectiveness of a 4-week program for school-age children in reducing risk-taking behaviors and increasing safety behaviors. A two-group, experimental, repeated-measures design was used to compare 122 White and Latino children randomly assigned to an intervention group or a wait-list group at baseline and at 1, 3, and 6 months after intervention. Children received a behaviorally based intervention delivered in four 2-hour segments conducted over consecutive weeks. The thematic concept of each week (choices, media, personal risk taking, and peer group risk taking) moved from the general to the specific, focusing on knowledge and awareness, the acquisition of new skills and behaviors, and the supportive practice and application of skills. Participants increased their safety behaviors (p = .006), but risk-taking behaviors remained unchanged. Families in the intervention group increased their consistent use of media rules (p = .022), but decreases in media alternatives suggest difficulty in taking up other habits and activities. Coping effectiveness was predictive of safety behaviors (p = .005) at 6 months, and coping effectiveness plus television watching was predictive of risk taking (p = .03). Findings from this study suggest that interventions that influence children's media experiences help enhance safety behaviors and that strategies to aid parents in finding media alternatives are relevant to explore.

Clustering of health-compromising behavior and delinquency in adolescents and adults in the Dutch population

Objective This study investigates the clustering of a broad range of health-compromising and delinquent behaviors. We examine whether these behaviors belong to a single but broad cluster, ‘risk-taking behavior’, and whether the nature and degree of clustering in adolescents differs from that in adults. Method A representative sample ( N = 4395) of the Dutch population aged 12 to 40 (overall response rate 67%), was asked about various health-compromising behaviors, such as alcohol consumption, smoking, illegal drug use, unsafe sexual behavior, physical inactivity, poor nutrition (such as skipping breakfast and not eating fruit and vegetables), poor sleep behavior, unlawful traffic behavior, and delinquent and aggressive behavior. Data were collected from fall 2005 to spring 2006 using internet questionnaires and face-to-face computer-assisted interviews. Results No single broad cluster was found. Instead, there were several separate but interrelated clusters. The contents of these clusters differed between age groups. For young adolescents (12–15) two clusters were identified: Alcohol and Delinquency. For older adolescents (16–18) and adults (19–40) three clusters were identified: Alcohol, Delinquency and Health. Conclusion The findings of this study support a more integrated approach to promoting healthier lifestyles, and suggest that the behavior targets of integrated prevention programs should be different for adolescents and adults.

Energy Drinks, Race, and Problem Behaviors Among College Students

Purpose This study examined relationships between energy drink consumption and problem behaviors among adolescents and emerging adults. It was hypothesized that frequent consumption of energy drinks would be positively associated with substance abuse and other risky behaviors, and that these relationships would be moderated by race. Methods Cross-sectional, self-report survey data were collected from 602 Western New York undergraduate students in the spring of 2006. Differences in problem behaviors by frequency of energy drink consumption were assessed with multivariate linear and logistic regressions, controlling for gender, race, age, parental education, and college grade point average. Follow-up regressions were conducted to test for a moderating effect of race. Results Frequency of energy drink consumption was positively associated with marijuana use, sexual risk-taking, fighting, seatbelt omission, and taking risks on a dare for the sample as a whole, and associated with smoking, drinking, alcohol problems, and illicit prescription drug use for white students but not for black students. Conclusions These findings suggest that energy drink consumption is closely associated with a problem behavior syndrome, particularly among whites. Frequent consumption of energy drinks may serve as a useful screening indicator to identify students at risk for substance use and/or other health-compromising behavior.

Impulsivity and the role of smoking-related outcome expectancies among dependent college-aged cigarette smokers

The relationship between trait-impulsivity and smoking expectancies on smoking progression in undergraduate college students was examined over a 48-hour period of smoking abstinence. Participants were forty-nine college-aged dependent cigarette smokers who completed measures designed to assess impulsivity, nicotine dependence, and smoking expectancies. Using a series of multilevel models, impulsivity by time analyses indicated significant differences in positive reinforcement expectancies, [ F (2, 94) = 3.19, p < .05], but not in negative reinforcement expectancies, [ F (2, 94) = 0.49, p = .61]. Simple slopes analyses indicated that heightened trait-impulsivity predicted greater increases in positive reinforcement outcome expectancies at 48 h of abstinence. Level of impulsivity, however, was not related to changes in negative reinforcement expectancies. Results indicate that during an abstinence period, college students higher in trait-impulsivity may be more prone to relapse due to stronger beliefs about the positive effects from smoking a cigarette. These findings highlight the importance of understanding the interaction of personality and cognitive factors when working with young adult smokers wishing to quit this health-compromising behavior.

Psychosocial predictors of sexual initiation and high-risk sexual behaviors in early adolescence

BackgroundThis longitudinal study examined psychosocial factors associated with risky sexual behavior in early adolescence.MethodsData were collected through a self-report survey, the Social and Health Assessment (SAHA), which was administered in three waves between 2001 and 2003 to a cohort of incoming sixth grade students in the public school system (149 classes at 17 middle and high schools, N = 1,175) of a small northeastern city in the United States.We first examined whether internalizing and externalizing problems in sixth grade, and the rate of change in these factors during middle school, were predictive of sexual initiation two years later, when most of the sample was in eighth grade. We then assessed whether internalizing and externalizing problems in sixth grade, and the rate of change in these factors during middle school, were predictive of engaging in high risk sexual behavior over the subsequent two years.ResultsExternalizing factors are more predictive of sexual risk in early adolescence than are internalizing factors. Specifically, substance use and violent delinquency over the course of middle school were associated with higher, while anxiety with lower, sexual initiation rates during middle school. Additionally, increased substance use over the course of middle school was associated with greater likelihood of engaging in high risk sexual behavior.ConclusionBy identifying particular psychosocial risk factors among young adolescents, the findings of this study have implications for designing multi-dimensional programs aimed at preventing health-compromising sexual behavior among young teens.

Health, health-compromising behavior, risk-taking behavior and sexuality in female and male high school students in vocational compared with theoretical programs in Sweden

The aim of the present study was to determine whether adolescents attending vocational high school programs in Sweden show unhealthy or risky behaviors to a higher extent than those attending theoretical programs, and whether there were gender differences. All eligible adolescents 16-18 years old, after exclusion of first- and second-generation immigrants, attending high school (1,332 pupils) in a medium-sized town in Sweden completed a validated in-depth questionnaire (Q90) with 165 questions in the classroom. In comparisons, adjustments were made for socio-demographic variables. A significant difference was found for the variable having at least one parent with university education (odds ratio (OR 0.28) for those attending vocational programs). In girls: have bullied (OR 2.01), eat breakfast all school days (OR 0.31), have shoplifted (OR 3.46), smoking (OR 5.69), and have had more than five sexual partners (OR 4.74) all differed significantly. Some variables with significant differences in boys were; eat fruit or vegetables every day (OR 0.55), feeling depressed (OR 0.62), sports activity at least once a week (OR 0.56), vandalizing (OR 2.11), regular alcohol use (OR 1.44), and contraceptive use at latest sexual intercourse (OR 0.47). The findings suggest that preventive interventional strategies, aimed at improving health maintenance among adolescents should take into consideration the differences between students in vocational and theoretical programs, including the cluster and accumulation of health-risk behaviors.

Emergency contraception among Finnish adolescents: awareness, use and the effect of non-prescription status

BackgroundAdolescents need to be aware that there is a method of preventing pregnancy even after an unprotected intercourse. Limited information is available on the awareness of young adolescents and the effects of selling emergency contraception (EC) over-the-counter, and the findings are controversial. The aims of this study were to investigate awareness and use of EC among Finnish girls aged 12–18 years in 1999–2003, and to assess the effect of the 2002 non-prescription status on the use.MethodsA self-administered questionnaire was sent to a population-based sample of 12–18-year-olds girls in 1999, 2001, and 2003. Response rate was 83% in 1999 (N = 4,369), 79% in 2001 (N = 4,024) and 77% in 2003 (N = 3,728), altogether N = 12,121. Logistic regression model was used to examine the association of unawareness and use of EC with socio-economic background and health behaviour.ResultsIn 2001, nearly all 14–18-year-olds and a majority of 12-year-olds were aware of EC. Among 12–14-year-olds, a slight increase in awareness between 1999 and 2003 was observed but this was not related to non-prescription status. Health-compromising behavior (alcohol use, smoking), dating and having good school achievement were related to higher awareness of EC.Nine percent of 14–18-year-olds had used EC once and 1% three times or more. No statistically significant change in EC use was found after non-prescription status. EC use increased with increasing alcohol consumption, particularly at age 14. Smoking, dating, and poor school achievement were related to increased use as well as not living in nuclear family. A lower use was observed if living in rural area or father's education was high. Mother's education was not related to use.ConclusionAdolescent girls were well aware of the existence of emergency contraception even before the non-prescription status. Over-the-counter selling did not increase the use.

Income, income inequality, and health: Evidence from China

This paper tests using survey data from China whether individual health is associated with income and community-level income inequality. Although poor health and high inequality are key features of many developing countries, most of the earlier literature has drawn on data from developed countries in studying the association between the two. We find that self-reported health status increases with per capita income, but at a decreasing rate. Controlling for per capita income, we find an inverted-U association between self-reported health status and income inequality, which suggests that high inequality in a community poses threats to health. We also find that high inequality increases the probability of health-compromising behavior such as smoking and alcohol consumption. Most of our findings are robust to different measures of health status and income inequality. Journal of Comparative Economics 34 (4) (2006) 668–693.