Clustering of Six Key Risk Behaviors for Chronic Disease among Adolescent Females

Abstract

Chronic diseases are the leading cause of disability and mortality globally. In Australia, females are at heightened risk. This research explored the prevalence, patterns, and correlates of six key risk behaviors (physical inactivity, poor diet, recreational screen time, inadequate sleep, alcohol use, and smoking) among adolescent females and whether knowledge of health guidelines was associated with adherence. Adolescent females completed an anonymous online questionnaire (N = 687; Mage = 13.82). Logistic regression assessed the association between knowledge and adherence. A Latent Class Analysis (LCA) and three-step procedure identified risk behavior clusters and their correlates. Despite positive health self-ratings (77% good/very good), most participants reported insufficient moderate-to-vigorous physical activity (MVPA; 89%), vegetable intake (89%), and excessive screen time (63%). Knowledge of guidelines was associated with adherence for MVPA, vegetable intake, sleep, and alcohol abstinence. Three classes emerged: “moderate risk” (76%), “relatively active, healthy eaters” (19%), and “excessive screen users” (5%). These risk-behavior clusters were associated with perceived value of academic achievement and physical wellbeing. Adolescent females commonly perceive they are in good health, despite engaging in unhealthy behaviors. Public health interventions should utilize effective behavior change strategies, adopt a multiple health behavior change approach (MHBC), and be tailored to specific risk profiles and values among females.

Clustering of South Korean Adolescents’ Health-Related Behaviors by Gender: Using a Latent Class Analysis

“…In the present study, those behaviors were not important for clustering among girls. This finding was consistent with the Australian study identifying that alcohol consumption and smoking were not found to be essential factors for clustering among female adolescents [ 28 ]. Alcohol consumption and tobacco use are well-known as influential factors for various health problems, including cardiovascular diseases, cancers, liver disease, and lung disease [ 35 , 36 , 37 ].…”

“…The finding that about half of each gender group were classified as adolescents who had healthy behaviors is consistent with the findings from the study of adolescents in Australia [ 23 , 28 ]. However, in the United States, the highest proportion of male adolescents were classified as having unhealthy behaviors, while the mixed group had the highest proportion of female adolescents, based on data from Add Health in 1994 (Wave I) and 2008 (Wave IV) [ 24 ].…”

“…In Xiao et al’s study, about 7% of U.S. adolescents were classified into the low health-promoting behaviors group, using data from the 2017 Youth Risk Behavior Survey [ 22 ]. In the study of female Australian adolescents, the smallest class was approximately 5%, characterized by excessive screen time, low physical activity, and low vegetable intake [ 28 ]. Regardless of countries, adolescents with unhealthy behaviors consisted of the smallest proportion, although the behaviors that characterize the cluster differ.…”

“…However, healthy groups from other countries were more likely to engage in physical activity regardless of gender. In the studies from the United States and Australia, adolescents were asked to answer whether they engaged in moderate to vigorous activities or whether they participated in physical activities [ 23 , 24 , 28 ]. However, in the present study, only vigorous physical activity was assessed.…”

Multiple Health Risk Factors in Vocational Education Students: A Systematic Review

“…Modifiable behavioural health risk factors such as smoking tobacco, inadequate fruit consumption, inadequate vegetable intake, risky alcohol consumption, physical inactivity and obesity have consistently been found to be associated with increased risk of NCDs and mortality from such diseases [ 2 , 3 , 4 , 5 ]. Often, these health risk factors can co-occur or cluster with psychological distress such as depression and anxiety [ 6 , 7 , 8 , 9 ]. Co-occurrence of health risk factors refers to concurrent engagement in two or more health risk factors and clustering refers to the association between co-occurring health risk factors [ 10 ].…”