Multiple Health Risk Behaviors Research Articles

Parental School‐Involvement and Substance Use? A Novel Family‐Based Prevention Strategy for Latino Youth

ObjectiveTo examine the association of parental school involvement with reductions in adolescent substance initiation among Latino immigrant youth.BackgroundParental school involvement is an important determinant of children's academic achievement. Likewise, academic achievement is associated with multiple adolescent health risk behaviors. Little research has examined whether parental school involvement is associated with adolescent drug use, and no research has examined this link among Latino immigrant youth.MethodUsing a census of Latino students (N = 661; mean age = 13.1 years) in 12 urban middle schools, we used a multilevel model with zero‐inflated outcomes to test whether (a) parental school involvement is inversely associated with alcohol, tobacco, and other drug use; (b) school‐level parental involvement affects individual‐level drug use; and (c) child gender moderates these associations.ResultsParental school involvement was negatively associated with lifetime prevalence of all substances and with increases in the age of first alcohol use. School‐level parental involvement was negatively associated with lifetime prevalence of substance use and age of first use for girls and marginally significant with boys.ConclusionParental school involvement is a promising target for prevention efforts to reduce early‐onset substance use.ImplicationsParental school involvement may address multiple negative outcomes in youth even for youth whose parents are relatively uninvolved, and may increase program dosage.

The Longitudinal Association Between Exposure to Violence and Patterns of Health Risk Behaviors Among African American Youth.

We investigate whether exposure to violence (ETV) during adolescence and emerging adulthood predicts engagement in chronic disease-related health risk behaviors years later among African Americans. A longitudinal study following youth from mid-adolescence (mean age = 14.8 years) to young adulthood (mean age = 32.0 years). Flint, Michigan. Four hundred forty-two African American (96.2%) and mixed African American and White (3.8%) participants. Outcomes were diet, smoking, drinking, and physical inactivity. Covariates were ETV, sex, mother's educational attainment, and substance use by siblings, peers, and parents. Latent profile analysis was conducted to identify distinct patterns of adult health risk behaviors and assess the association of youth ETV and identified patterns. Four latent profiles were identified: high substance use (n = 46; 10.41%), high overall risk (n = 71; 16.06%), low overall risk (n = 140; 31.67%) and inactive (n = 185, 41.86%). Relative to the low overall risk profile, ETV was associated with being in the high overall risk profile (b = 0.37, p = 0.04), but not other profiles. Female gender and higher maternal education were associated with being in the inactive profile compared to the low overall risk profile. Peer alcohol and tobacco use were associated with being in the high substance use profile. ETV during adolescence and emerging adulthood increased the risk of engagement in multiple health risk behaviors later in life.

Childhood psychopathology mediates associations between childhood adversities and multiple health risk behaviours in adolescence: analysis using the ALSPAC birth cohort.

BackgroundChildhood adversity strongly predicts adolescent multiple health risk behaviours (MRBs) such as alcohol/tobacco use, self‐harm and physical inactivity, and both adversities and MRBs are associated with premature mortality and several chronic health conditions that are among the leading causes of death in adults. It is therefore important to understand the relationship between adversities and MRBs and what could mediate any association. The aim of this study was to explore whether childhood psychopathology mediates associations between adversities and MRBs.MethodsParticipants were young people in the Avon Longitudinal Study of Parents and Children (ALSPAC) (N = 5,799). Using structural equation modelling, we explored the associations between adversities before 9 years and MRBs at age 16 years. We also explored potential mediating pathways through dimensional psychopathology measured by the Strength and Difficulties Questionnaire subscales at age 12 years.ResultsThere were strong positive associations between adversities and MRBs (β .25, 95% CI 0.20, 0.31, p < .001) suggesting that each additional adversity is associated with a 0.25 increase in number of MRBs out of 13 total risk behaviours. We found robust evidence of mediating pathways from adversities through conduct problems (β .05, 95% CI 0.03, 0.06, p < .001), hyperactivity/inattention (β .02, 95% CI 0.01, 0.03, p < .001) and peer relationship problems (β −.02, 95% CI −0.03, −0.02, p < .001) to MRBs.ConclusionsIncreased conduct problems and hyperactivity/inattention appear to partially explain the relationship between adversities and MRBs. Peer relationship problems also appear to reduce the association between adversities and MRBs, and further research is needed to understand how to encourage peer connectivity without increasing risk of MRBs. These results suggest that interventions aimed at reducing MRBs among those exposed to childhood adversities could focus on prevention of behavioural problems.

Latent Class Analysis of Multiple Health Risk Behaviors among Australian University Students and Associations with Psychological Distress.

University students have high rates of health risk behaviors and psychological distress. This study explores patterns of health behaviors among a sample of Australian university students, and determines whether patterns of health behaviors are associated with psychological distress and demographic characteristics. Cross-sectional data from the University of Newcastle Student Healthy Lifestyle Survey 2019 were analyzed. Fruit and vegetable intake, sugar-sweetened beverage intake, physical activity, sitting time, smoking, alcohol intake, drug use, sleep and psychological distress were assessed. Latent class analysis (LCA) was used to identify patterns of health risk behaviors, and latent class regression to explore associations between psychological distress and demographic characteristics with health behavior classes. Analysis included 1965 students (mean age 25.8 ± 8.6 years, 70.7% female). Three patterns of health behaviors were identified: healthier (48.6%), moderate (40.2%) and unhealthy (11.2%) lifestyle classes. Students in the moderate and unhealthy lifestyle classes had higher odds of moderate (OR 1.43 and 2.37) and high/very high psychological distress risk (OR 2.71 and 11.69). Students in the unhealthy and moderate lifestyle classes had a higher odds of being male, younger, enrolled in transition to university and English language courses, Aboriginal or Torres Strait Islander descent and to report some financial difficulty. Study findings may be used to inform the design of mental health interventions for university students that target key health risk behaviors.

Mindfulness-based intervention to reduce multiple health risk behaviors in Chinese undergraduates:a randomized controlled trial

College students are most susceptible to highest-risk of health risk behaviors (HRBs) in China. Mindfulness-based interventions (MBIs) have shown significant benefit in specific HRB; however, evidence of its effectiveness in multiple HRBs in college students is limited. The current study aimed to address the effectiveness of the Mindfulness-Based Cognitive Therapy (MBCT) on trait mindfulness and multiple HRBs among general Chinese undergraduates, and the relationship between trait mindfulness and HRBs. A randomized controlled trial (RCT) was conducted in a Chinese university from April to June 2016. A total of 164 enrolled participants were randomized to no intervention (n = 82), or MBCT (n = 82). The outcomes were measured by the Adolescent Health Related Risky Behavior Inventory (AHRBI) and the Five Facet Mindfulness Questionnaire (FFMQ). Data were analyzed with intent-to-treat analysis and per-protocol analysis.The results yielded significant group by pre-post interaction terms for the trait mindfulness facets (P < 0.01) and the HRBs (P < 0.05), the MBCT group changed more than the control group. The five types of HRB measures had significant inverse correlation with the five facets of the trait mindfulness measures (r = −0.50 ~ −0.16, P < 0.05). The structural model of the intervention effect of MBCT on HRBs mediated by trait mindfulness was well-fitted (P < 0.01).The findings suggests that MBI has beneficial effects in both improving trait mindfulness and reducing multiple HRBs, and the improvement of trait mindfulness can effectively decreases the risks of HRBs.

Uptake of Proactively Offered Online and Telephone Support Services Targeting Multiple Health Risk Behaviors Among Vocational Education Students: Process Evaluation of a Cluster Randomized Controlled Trial.

BackgroundA high proportion of vocational education students smoke tobacco, have inadequate nutrition (ie, low fruit and vegetable intake), drink alcohol at risky levels, or are physically inactive. The extent to which vocational education students will sign up for proactively offered online and telephone support services for multiple health risk behaviors is unknown.ObjectiveThe aim of this study is to examine the uptake of proactively offered online and telephone support services for smoking, nutrition, alcohol consumption, and physical activity risk behaviors, individually and in combination, among vocational education students in the Technical and Further Education (TAFE) setting. The characteristics associated with the uptake of online or telephone services for smoking, nutrition, alcohol consumption, and physical activity risk behaviors were also examined.MethodsVocational education students enrolled in a TAFE class in New South Wales, Australia, which ran for 6 months or more, were recruited to participate in a cluster randomized controlled trial from May 2018 to May 2019. In the intervention arm, participants who did not meet the Australian health guidelines for each of the smoking, nutrition, alcohol consumption, and physical activity risk behaviors were provided electronic feedback and proactively offered online and telephone support services. Uptake of support was measured by whether participants signed up for the online and telephone services they were offered.ResultsVocational education students (N=551; mean age 25.7 years, SD 11.1; 310/551, 56.3% male) were recruited into the intervention arm. Uptake of the proactive offer of either online or telephone services was 14.5% (59/406) for fruit and vegetables, 12.7% (29/228) for physical activity, 6.8% (13/191) for smoking, and 5.5% (18/327) for alcohol use. Uptake of any online or telephone service for at least two health behaviors was 5.8% (22/377). Participants who were employed (odds ratio [OR] 0.10, 95% CI 0.01-0.72) and reported not being anxious (OR 0.11, 95% CI 0.02-0.71) had smaller odds of signing up for online or telephone services for smoking, whereas participants who reported not being depressed had greater odds (OR 10.25, 95% CI 1.30-80.67). Participants who intended to change their physical activity in the next 30 days had greater odds (OR 4.01, 95% CI 1.33-12.07) of signing up for online or telephone services for physical activity. Employed participants had smaller odds (OR 0.18, 95% CI 0.06-0.56) of signing up for support services for at least two behaviors.ConclusionsAlthough the uptake of proactively offered online and telephone support services is low, these rates appear to be higher than the self-initiated use of some of these services in the general population. Scaling up the proactive offer of online and telephone services may produce beneficial health outcomes.Trial RegistrationAustralian New Zealand Clinical Trials Registry: ACTRN12618000723280; https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=375001.

Sociodemographic Disadvantage, Living With a Smoker, and Health Risk Behaviors in Middle-Aged and Older Women

Sociodemographic disadvantage places individuals at risk for an unhealthy lifestyle (Kushi et al., 2012; Shanker et al., 2010), as well as for exposure to second-hand household smoke (Gan et al., 2015; Zhang et al., 2012). However, the role of living with a smoker in the association between sociodemographic status and health behavior is unstudied. This study investigated the role of living with a smoker in partially explaining the link between sociodemographic disadvantage and physical inactivity and poor dietary behaviors. The study used limited access data from the Women’s Health Initiative Observational Study obtained from NHLBI. Participants were 83,597 women ranging in age from 49 to 81; 6038 participants lived with a smoker. Cross-sectional logistic regression analyses examined paths in the models; bias-corrected bootstrapped confidence intervals tested indirect effects in probit analyses. Analyses controlled for age, ethnicity, marital status, and participants’ current smoking status. Results demonstrated a significant association (p < .001) between sociodemographic disadvantage (composite of low education and low income) and living with a smoker (OR = 1.74). The unstandardized indirect effects (CIs are in brackets) from sociodemographic disadvantage through living with a smoker to no exercise, no walking, high percent dietary fat, and low servings of fruits and vegetables through living with a smoker were statistically significant (.023 [.019, .028], .026 [.023, .033], .041 [.037, .047], and .032 [.027, .036], respectively). These findings illustrate the need to address multiple non-smoking health risk behaviors in household smoking interventions for disadvantaged families. This project was supported by the NIH/NCI (R03CA215947).

A latent class analysis of psychological symptoms and health risk behaviors among Chinese adolescents.

Multiple health risk behaviors (HRBs) tend to co-occur which increase risks of mental disorder. In this study, we identified the association between latent class of HRBs and psychological symptoms in Chinese adolescents. We assessed 22 628 Chinese adolescents from November 2015 to January 2016. The average age of the students were (15.36 ± 1.79), among which there were 10 990 male students and 11 638 female students. A latent class analysis was applied to identity HRBs patterns. The multivariable logistic regression models were utilized to examine the association between HRBs patterns and psychological symptoms. Four latent classes were identified, characterized as low-risk class, moderate-risk class 1 (smoking/ alcohol use (AU)/screen time (ST)), moderate-risk class 2 (unhealthy losing weight (ULW)/ problematic mobile phone use (PMPU)), and high-risk class (ULW/smoking/AU/ST/ PMPU), which were 71.2 %, 3.2 %, 22.3 %, and 3.3 % of involved participants, respectively. Compared to the low-risk class, moderate-risk class 1, moderate-risk class 2, and high-risk class showed that adjusted OR (95 %CI) value of 1.97 (1.68-2.32), 3.98 (3.72-4.26) and 6.38 (CI: 5.47-7.44) were significantly associated with psychological symptoms (P < 0.001 for each). Our findings indicated that identifying different latent class of HRBs would be helpful for the design of tailored interventions, and prevention of different patterns of HRBs should be considered in the implementation of effective intervention programs related to psychological symptoms.

Clustering of multiple health risk behaviours and association with socio-demographic characteristics and psychological distress among adolescents in Ghana: A latent class analysis.

This study examined the prevalence of multiple health risk behaviours, the clustering patterns of health risk behaviours, the association between socio-demographic characteristics, psychological distress and clusters and the relationship between number of health risk behaviours and psychological distress among adolescents in Ghana. Participants were senior high school (SHS) students aged 11–19 years who participated in the 2012 Global School-based Students Health Survey (n = 1763). Five health risk behaviours (smoking tobacco, inadequate fruit intake, inadequate vegetable intake, alcohol intake and physical inactivity) were measured. Participants were classified to be at risk if they indicated they smoked tobacco, did not eat fruit ≥ 2 times a day and vegetables ≥ 5 a day, drank alcohol during the past 30 days and did not engage in physical activity for ≥ 60 min per day during the past 7 days. Latent class analysis and latent regression were used to identify the clusters and factors associated with the clusters respectively. Multiple logistic regression was used to determine the relationship between number of health risk behaviours and psychological distress. The prevalence of multiple health risk behaviours (2 or more) was 94.8%. Two clusters emerged: Cluster 1 (“Poor nutrition, inactive, low substance use cluster”; 91%); Cluster 2 (“High Risk Cluster”; 9%). Using cluster 1 as a reference group, adolescents in the 11–15 years category had lower odds of belonging to cluster 2 (OR = 0.21 CI 0.05–0.91, ρ = 0.036) while those experiencing symptoms of depression had higher odds of belonging to cluster 2 (OR = 2.45 CI 1.45–4.14, ρ = 0.001). No significant relationship was found between number of health risk behaviour and psychological distress. Health risk behaviours cluster among adolescents with age and depression associated with the identified clusters. Early interventions that target these clusters are needed at the individual, school and community level to mitigate the burden of non-communicable diseases.

Single and Multiple Suicide Attempts: Prevalence and Correlates in School-Going Adolescents in Liberia in 2017.

BackgroundThis investigation aimed to estimate the prevalence and correlates of single and multiple suicide attempts among adolescents in Liberia.MethodsCross-sectional nationally representative data were analysed from 2744 adolescents (18 years of median age) who participated in the “2017 Liberia Global School-Based Student Health Survey (GSHS)”.ResultsResults indicate that 33.7% of students had made a suicide attempt in the past 12 months (16.5% single and 17.2% multiple suicide attempts). In adjusted multinomial logistic regression analysis, having no close friends, loneliness, having been frequently physically attacked, ever used amphetamine and fast food intake were associated with multiple suicide attempts in the past 12 months. In addition, having been frequently in a physical fight and current tobacco use were associated with single suicide attempt. In sex stratified analyses, in addition, among boys frequent bullying victimization and among girls, parental tobacco use and parents never or rarely check on home work were associated with multiple suicide attempts. Multiple psychosocial distressors, multiple social-environmental factors, and multiple health risk behaviours were associated with single and multiple suicide attempts.ConclusionOne in three students had made suicide attempt in the past 12 months (one in six students multiple suicide attempts) and several associated variables were detected which can aid in designing intervention strategies.

Transitions in risk-behavior profiles among first-year college students

Objective The current study utilized a longitudinal person-centered approach (latent transition analysis [LTA]) to assess transitions into and out of risk-behavior profiles during the transition into and throughout the first year of college. Participants: Participants included 579 first-year college students (Mage = 18.13, SD = .94) from a large mid-Atlantic university. Methods: Participants completed surveys at five points throughout their freshman year. Results: LTA suggested that most individuals either abstained from engaging in risk behaviors or transitioned toward profiles of less risk over time. A smaller portion of individuals either began and ended the year in the same risk profile or transitioned into profiles of greater risk. Conclusions: The findings highlight the importance of utilizing person-centered analyses to examine change in multiple health-risk behaviors.

Emotional and behavioral problems associated with health-risk behaviors in preschool children

Objective: To explore the relationship between multiple health-risk behaviors and emotional and behavioral problems in preschool children. Method: From October to November 2017, 27 987 children aged 3 to 6 years from 109 kindergartens of 11 cities from Hubei, Anhui and Jiangsu Provinces in the middle and lower reaches of the Yangtze River were selected by using the cluster sampling method. Finally, 27 200 valid questionnaires were collected. A questionnaire was used to investigate the demographic characteristics, video time and outdoor activities, eating behavior, sleep time, emotional and behavioral problems of parents and children. Multivariate logistic regression model was used to quantify the association between multiple health-risk behaviors and emotional and behavioral problems. Results: Emotional symptoms, conduct problems, hyperactivity, peer problems, total difficulties and prosocial behavior abnormalities were detected in 9.5% (2 587), 9.5% (2 590), 18.2% (4 958), 24.5% (6 670), 11.2% (3 058) and 10.2% (2 770), respectively. Three groups of low, medium and high scores of multiple health-risk behaviors were accounted for 30.6% (8 316), 60.9% (16 568) and 8.5% (2 316), respectively. Multivariate logistic regression model analysis showed that after controlling for the confounding factors, compared with those in the low score group, preschool children in the middle and high score groups had higher risks of emotional symptoms, conduct problems, hyperactivity, peer problems, total difficulties and prosocial behavior (all P values<0.05). Conclusion: Health-risk behaviors are associated with the emotional and behavioral problems of preschool children.

Living with a Smoker and Multiple Health-Risk Behaviors.

Behavioral medicine is showing growing theoretical and applied interest in multiple health-risk behaviors. Compared to engaging in a single health-risk behavior, multiple health-risk behaviors are linked to increased morbidity and mortality. A contextual determinant of multiple risk behaviors may be living with a smoker. This study investigated the role of living with a smoker in predicting multiple health-risk behaviors compared to a single health-risk behavior, as well as whether these multiple risk behaviors occur across both physical activity and dietary domains. Moreover, the study tested these effects across 3 years in longitudinal and prospective (controlling for health-risk behaviors at baseline) analyses. Participants were 82,644 women (age M = 63.5, standard deviation = 7.36, age range = 49-81) from the Women's Health Initiative Observational Study. Analyses used multinomial and binary logistic regression. Living with a smoker was more strongly associated with multiple health-risk behaviors than with a single health-risk behavior. These multiple risk behaviors occurred across both physical activity and dietary domains. The effects persisted across 3 years in longitudinal and prospective analyses. Living with a smoker, compared to not living with a smoker, increased the odds of multiple health-risk behaviors 82% cross-sectionally and, across 3 years, 94% longitudinally and 57% prospectively. These findings integrate research on multiple health-risk behaviors and on living with a smoker and underscore an unrecognized public health risk of tobacco smoking. These results are relevant to household-level interventions integrating smoking-prevention and obesity-prevention efforts.

Identifying clusters of health risk behaviors and their predictors in adult survivors of childhood cancer: A report from the French Childhood Cancer Survivor Study.

Health risk behaviors (HRB) of childhood cancer survivors (CCS) are generally studied separately, despite the evidence suggesting that HRB are not independent. To our knowledge, few studies have examined HRB profiles in the former pediatric cancer patients. In this study, we identified HRB profiles and examined predictors engaging in unhealthy behaviors in CCS. We used data from a French cohort of CCS that includes five-year survivors diagnosed between 1945 and 2000 and treated before reaching age 18, in five centers in France. A total of 2961 adult CCS answered a self-reported questionnaire pertaining to HRB. Latent class analysis was used to identify HRB profiles combining physical activity, smoking, cannabis use, and alcohol drinking. Multinomial logistic analyses examined predictors for engaging in unhealthy behaviors. Three HRB patterns emerged: "Low-risk" (n = 1846, 62.3%) included CCS who exhibited the highest frequency for usual physical activity and the lowest probabilities for current smoking or cannabis use, but most drank at least moderately; "Moderate-risk behaviors" (n = 291, 9.8%), and "High-risk behaviors" (n = 824, 27.8%) for CCS who exhibited the highest frequencies for current smoking, cannabis use, and heavy drinking. The multivariable regression revealed that male CCS, less educated or not married were significantly more likely to be in the high-risk behaviors group than the low-risk group. As CCS remain a vulnerable population, screening for HRB should be routinized in long-term follow-up care and interventions targeting multiple HRB simultaneously among survivors should be developed.

A longitudinal study of multiple lifestyle health risk behaviours among nursing students and non-nursing peers.

The aim of this paper is to compare the evolution of health risk behaviours between undergraduate nursing and social work students. Nursing includes the promotion of health and the shaping of healthy behaviours. An important determinant for providing lifestyle advice is the lifestyle of nurses themselves. Longitudinal comparative study. We compared lifestyle risk behaviours (binge drinking, cannabis/hashish/marijuana use, smoking, oral hygiene/toothbrushing, breakfast/fruit/vegetable consumption, physical activity and screen time/sedentary behaviours) using a self-administered standardized questionnaire in nursing (n = 121) and social work (n = 140) students at the beginning (2012) and the end of their studies (2015). Adjusted multivariable logistic/Poisson regression models were performed. There were no statistically significant differences between the departments in most risk factors in both assessments. However, in relation to their first year, both nursing and social work students displayed higher relative risk of engaging in more behavioural risk factors at the end of their studies (in delivery/junk food consumption, sunburns, hashish/marijuana use and multiple sexual partners). Social work students displayed better behaviours in physical activity and breakfast intake. Nursing students share the patterns of their nonnursing peers in behavioural risk factors compromising their future health and health-promoting role. We need strategies to safeguard the professional nursing practice.

Tobacco use and associated health risk behaviours among university students in 27 countries.

Evidence of the relationship between tobacco use and multiple health risk behaviours is limited. The study aimed to investigate the relationship between tobacco use and health risk behaviours in university students across different cultures. In a cross-sectional study the sample included 23,396 university students from 27 countries in Africa, Asia and the Americas. Indicate that 5.8 and 5.5% were daily and not daily tobacco users, respectively. In adjusted logistic regression analysis, less than daily and/or daily tobacco use was associated with nutrition and dietary risk behaviour (overweight or obesity, high sodium consumption, rarely or never having breakfast and not avoiding fat and cholesterol), addictive behaviour (binge drinking, drug use, and gambling), sleep risk behaviours (long sleep, poor sleep quality and restless sleep) and other health risk behaviour (having been in a physical fight, inadequate tooth brushing, and multiple sexual partners in the past year). Compared to non-tobacco users, less than daily and/or daily tobacco users had significantly higher overweight or obesity, dietary risk behaviour, addictive behaviour, sleep risk behaviours and other health risk behaviour. These associations may be taken into account in health promotion strategies targeting multiple health compromising behaviours.

Health risk behaviour is associated with psychological distress among school-going adolescents in five association of Southeast Asian Nations (ASEAN) countries.

This investigation aimed to study associations between multiple health risk behaviour and psychological distress among in-school adolescents in five association of Southeast Asian Nations (ASEAN) countries. Cross-sectional data from the 2015 "Global School-based Health Survey (GSHS)" included 33,184 students (mean age 14.3 years, standard deviation (SD)=1.6 years) that were representative of all students in middle school students in Indonesia, Laos, Philippines, Thailand and Timor-Leste. The mean prevalence of health risk behaviours was 3.1 (SD=1.2) (range 0-8), and the prevalence of single psychological distress was 14.6% and multiple psychological distress 8.6%. In adjusted multinomial logistic regression analysis, engaging in a greater number of health risk behaviours, being female, older age, food insecurity (experience of hunger) were positively and parental or guardian support and school attendance were negatively associated with both single and multiple psychological distress. This study confirms that the co-occurrence of multiple health risk behaviours is associated with psychological distress among adolescents, which should be considered when designing intervention programmes in this population.

Co-Occurring Health Risk Behaviors and Their Association with Self-Rated Health among Female College Students

ABSTRACT Background Existing research focuses on the co-occurrence of lifestyle-related health risk behaviors among college students. Although students’ self-reported health risk behaviors have been examined, students’ self-rated health and its association with these co-occurring health risk behaviors have been overlooked. Purpose: The goals of the current study were to identify levels of co-occurrence of health risk behaviors among female college students and to test the prediction that students with multiple co-occurring health risk behaviors would report poorer self-rated health. Methods: Data from an online survey that assessed the five selected health risk behaviors and self-rated health of undergraduate students at a liberal arts university in the northeast of the USA were analyzed. Results: High prevalence rates were found on all five risk behaviors and the majority of participants reported engaging in two or more co-occurring health behaviors. The inverse association between perceived health and level of co-occurrence of health risk behaviors was consistent with what was predicted. Discussion: Students’ perceived health should be considered in the examination of health risk behaviors among college students. Translation to Health Education Practice: These findings can inform efforts to provide Health Education and prevention programming on college campuses that incorporates multiple health behaviors. A AJHE Self-Study quiz is online for this article via the SHAPE America Online Institute (SAOI) http://portal.shapeamerica.org/trn-Webinars

Clustering of multiple health risk behaviors and its association with diabetes in a Southern Chinese adult population: a cross-sectional study.

BackgroundIdentifying the clustering patterns of health risk behaviors (HRBs) within individuals and their health impacts are essential to develop lifestyle promotion strategies. This study aimed to explore the clustering of a range of HRBs and the associations between such identified clusters and diabetes in Southern Chinese adults.MethodsData from 5,734 adults aged 35–75 years and underwent health examinations from November 2012 to December 2013 at a tertiary hospital in Guangzhou were analyzed. Behavioral characteristics, including smoking, alcohol use, physical activity, and sleep duration and quality, were measured by questionnaires. Latent class analysis was conducted by gender to identify HRBs clustering patterns, and logistic regression models were used to estimate the associations between behavioral patterns and diabetes.ResultsThree distinct behavioral clusters emerged in both genders. Male classes were defined as: (1) healthy lifestyle (Class 1, 62.9%); (2) cumulate harmful habits (Class 2, 27.1%); (3) poor sleep and risky habits (Class 3, 10.0%). Female classes were: (1) healthy lifestyle (Class 1, 83.0%); (2) inactive, daytime dysfunction (Class 2, 5.7%); (3) poor sleep habits (Class 3, 11.3%). Individuals of Class 2 and Class 3 showed a higher likelihood of diabetes across genders (multivariable-adjusted ORs [95% CIs], 2.03 [1.49–2.76] and 2.61 [1.78–3.81] among males, 2.64 [1.16–5.98] and 1.81 [1.07–3.06] among females) when compared with those of Class 1.ConclusionsOur data provided additional evidence of HRBs clustering among adults, and such clustering was associated with an increased risk of diabetes. These findings have implications for identifying vulnerable subgroups and developing diabetes prevention programs.

Health-Risk Behaviours and Injuries among Youth and Young Adults in Chiang Mai, Thailand: A Population-Based Survey.

This study aimed to identify the prevalence of health-risk behaviours (alcohol use, tobacco smoking and gambling) and the associations between health-risk behaviours and injuries among youth (15–24 years) and young adults (25–39 years). A multi-stage cluster sampling survey was conducted in Chiang Mai, Thailand. The associations between health-risk behaviours and injuries were analysed using logistic regression and adjusted for potential confounders. Sample weights were applied in all analyses. Six-hundred-and-thirty participants were included. Fifty-three percent of males and 12.3% of females drank in the past three months. Smoking in the past three months was higher among males (38.5%) than females (0.7%). About a quarter of men and a fifth of the women had gambled in the past year. A total of 6.4% of males and 4.8% of females sought medical attention in the past year due to injuries. Compared to those without any of the three health-risk behaviours, the odds ratio for injuries requiring medical attention was 3.81 (95% CI: 1.33 to 10.90, p = 0.013) for those with two health-risk behaviours and 13.8 (95% CI: 4.24 to 45.10, p < 0.001) for those with all three health-risk behaviours. Injury prevention policies may need to incorporate interventions designed to assess multiple health-risk behaviours.