Co-occurring Health-Related Behavior Pairs in College Students: Insights for Prioritized and Targeted Interventions

Wells, Katelyn; Makela, Carole J.; Kennedy, Christopher

doi:10.1080/19325037.2014.916637

Cited by 5 publications

(3 citation statements)

References 14 publications

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“…An understanding of the combinations of risk behaviors that young people commonly engage in has important implications for the development and tailoring of universal multiple health behavior interventions. Previous research suggests that intervening synergistically via multiple health behavior interventions offers a potentially efficient ( 74 ) and cost-effective means ( 24 ) of educating young people about key risk factors for chronic disease, however, further research is needed.…”

Section: Discussionmentioning

confidence: 99%

Clustering of Multiple Risk Behaviors Among a Sample of 18-Year-Old Australians and Associations With Mental Health Outcomes: A Latent Class Analysis

Champion

Mather

Spring

et al. 2018

Front. Public Health

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IntroductionRisk behaviors commonly co-occur, typically emerge in adolescence, and become entrenched by adulthood. This study investigated the clustering of established (physical inactivity, diet, smoking, and alcohol use) and emerging (sedentary behavior and sleep) chronic disease risk factors among young Australian adults, and examined how clusters relate to mental health.MethodsThe sample was derived from the long-term follow-up of a cohort of Australians. Participants were initially recruited at school as part of a cluster randomized controlled trial. A total of 853 participants (Mage = 18.88 years, SD = 0.42) completed an online self-report survey as part of the 5-year follow-up for the RCT. The survey assessed six behaviors (binge drinking and smoking in the past 6 months, moderate-to-vigorous physical activity/week, sitting time/day, fruit and vegetable intake/day, and sleep duration/night). Each behavior was represented by a dichotomous variable reflecting adherence to national guidelines. Exploratory analyses were conducted. Clusters were identified using latent class analysis.ResultsThree classes emerged: “moderate risk” (moderately likely to binge drink and not eat enough fruit, high probability of insufficient vegetable intake; Class 1, 52%); “inactive, non-smokers” (high probabilities of not meeting guidelines for physical activity, sitting time and fruit/vegetable consumption, very low probability of smoking; Class 2, 24%), and “smokers and binge drinkers” (high rates of smoking and binge drinking, poor fruit/vegetable intake; Class 3, 24%). There were significant differences between the classes in terms of psychological distress (p = 0.003), depression (p < 0.001), and anxiety (p = 0.003). Specifically, Class 3 (“smokers and binge drinkers”) showed higher levels of distress, depression, and anxiety than Class 1 (“moderate risk”), while Class 2 (“inactive, non-smokers”) had greater depression than the “moderate risk” group.DiscussionResults indicate that risk behaviors are prevalent and clustered in 18-year old Australians. Mental health symptoms were significantly greater among the two classes that were characterized by high probabilities of engaging in multiple risk behaviors (Classes 2 and 3). An examination of the clustering of lifestyle risk behaviors is important to guide the development of preventive interventions. Our findings reinforce the importance of delivering multiple health interventions to reduce disease risk and improve mental well-being.

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Section: Discussionmentioning

confidence: 99%

Clustering of Multiple Risk Behaviors Among a Sample of 18-Year-Old Australians and Associations With Mental Health Outcomes: A Latent Class Analysis

Champion

Mather

Spring

et al. 2018

Front. Public Health

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“…Previous reviews of multiple health behaviour change interventions have largely focused on adults, with less evidence among adolescents. The adolescent-focused reviews that do exist [15][16][17][18] suggest that although universal multiple health behaviour change interventions might be efficient 16 and cost-effective, 19 more evidence is required to determine their effectiveness. A 2018 Cochrane review 18 found school-based interventions targeting change in multiple health behaviours to be effective in preventing substance use and increasing physical activity; however, this review did not include sleep in its inclusion criteria and did not focus on eHealth interventions.…”

Section: Introductionmentioning

confidence: 99%

Effectiveness of school-based eHealth interventions to prevent multiple lifestyle risk behaviours among adolescents: a systematic review and meta-analysis

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Parmenter

McGowan

et al. 2019

The Lancet Digital Health

126

136

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Background Lifestyle risk behaviours typically emerge during adolescence, track into adulthood, and commonly co-occur. Interventions targeting multiple risk behaviours in adolescents have the potential to efficiently improve health outcomes, yet further evidence is required to determine their effect. We reviewed the effectiveness of eHealth school-based interventions targeting multiple lifestyle risk behaviours. Methods In this systematic review and meta-analysis, we searched Ovid MEDLINE, Embase, PsycINFO, and the Cochrane Library databases between Jan 1, 2000, and March 14, 2019, with no language restrictions, for publications on school-based eHealth multiple health behaviour interventions in humans. We also screened the grey literature for unpublished data. Eligible studies were randomised controlled trials of eHealth (internet, computers, tablets, mobile technology, or tele-health) interventions targeting two or more of six behaviours of interest: alcohol use, smoking, diet, physical activity, sedentary behaviour, and sleep. Primary outcomes of interest were the prevention or reduction of unhealthy behaviours, or improvement in healthy behaviours of the six behaviours. Outcomes were summarised in a narrative synthesis and combined using random-effects meta-analysis. This systematic review is registered with PROSPERO, identifier CRD42017072163. Findings Of 10 571 identified records, 22 publications assessing 16 interventions were included, comprising 18 873 students, of whom on average 56•2% were female, with a mean age of 13•41 years (SD 1•52). eHealth schoolbased multiple health behaviour change interventions significantly increased fruit and vegetable intake (standard mean difference 0•11, 95% CI 0•03 to 0•19; p=0•007) and both accelerometer-measured (0•33, 0•05 to 0•61; p=0•02) and self-reported (0•14, 0•05 to 0•23; p=0•003) physical activity, and reduced screen time (-0•09,-0•17 to-0•01; p=0•03) immediately after the intervention; however, these effects were not sustained at follow-up when data were available. No effect was seen for alcohol or smoking, fat or sugar-sweetened beverage or snack consumption. No studies examined sleep or used mobile health interventions. The risk of bias in masking of final outcome assessors and selective outcome reporting was high or unclear across studies and overall we deemd the quality of evidence to be low to very low. Interpretation eHealth school-based interventions addressing multiple lifestyle risk behaviours can be effective in improving physical activity, screen time, and fruit and vegetable intake. However, effects were small and only evident immediately after the intervention. Further high quality, adolescent-informed research is needed to develop eHealth interventions that can modify multiple behaviours and sustain long-term effects.

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“…Together, these reviews suggest that whilst there is a possibility that universal multiple risk behaviour interventions for young people are more efficient [ 23 ] and cost-effective [ 44 ], there is not yet strong evidence regarding whether they are effective and further research is needed. Furthermore, whilst previous reviews have examined eHealth interventions targeting various combinations of lifestyle risk behaviours among adult [ 35 , 45 ] and youth [ 33 , 34 ] populations, to our knowledge, there has been no systematic review of school-based eHealth interventions encompassing all six health risk behaviours in an adolescent population.…”

Section: Introductionmentioning

confidence: 99%

A systematic review of school-based eHealth interventions targeting alcohol use, smoking, physical inactivity, diet, sedentary behaviour and sleep among adolescents: a review protocol

et al. 2017

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BackgroundSix key behavioural risk factors (risky alcohol use, smoking, poor diet, physical inactivity, sedentary behaviour and unhealthy sleep patterns) have been identified as strong determinants of chronic disease, such as cardiovascular disease, diabetes and cancers. School-based interventions targeting these multiple health risk behaviours among adolescents have the potential to halt the trajectory towards later disease, whilst online and mobile technology interventions offer advantages in terms of student engagement, reach and scalability. Despite this, the efficacy of eHealth school-based interventions targeting these six health risk behaviours among adolescents has not been evaluated. The proposed systematic review aims to address this by determining the nature and efficacy of existing eHealth school-based interventions targeting multiple health risk behaviours among adolescents.MethodsA systematic search of the MEDLINE, Embase, PsycINFO and Cochrane Library databases will be conducted to identify eligible published papers. Eligible studies will be randomised controlled trials, including cluster randomised controlled trials, of interventions targeting two or more of the following lifestyle risk behaviours: alcohol use, smoking, poor diet, physical inactivity, sedentary behaviour and sleep. Eligible studies will be those evaluating interventions delivered in a secondary school setting among participants 11–18 years of age, via an eHealth platform (Internet, computers of mobile technology). Two reviewers will independently screen studies for eligibility, extract data and assess the risk of bias. Study outcomes will be summarised in a narrative synthesis, and meta-analyses will be conducted where it is appropriate to combine studies.DiscussionIt is anticipated that the results from this review will serve to inform the development of future eHealth multiple health behaviour interventions for adolescents by identifying common characteristics of effective programs and highlighting knowledge gaps in the evidence base.Systematic review registrationPROSPERO CRD42017072163 Electronic supplementary materialThe online version of this article (10.1186/s13643-017-0645-x) contains supplementary material, which is available to authorized users.

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Co-occurring Health-Related Behavior Pairs in College Students: Insights for Prioritized and Targeted Interventions

Cited by 5 publications

References 14 publications

Clustering of Multiple Risk Behaviors Among a Sample of 18-Year-Old Australians and Associations With Mental Health Outcomes: A Latent Class Analysis

Clustering of Multiple Risk Behaviors Among a Sample of 18-Year-Old Australians and Associations With Mental Health Outcomes: A Latent Class Analysis

Effectiveness of school-based eHealth interventions to prevent multiple lifestyle risk behaviours among adolescents: a systematic review and meta-analysis

A systematic review of school-based eHealth interventions targeting alcohol use, smoking, physical inactivity, diet, sedentary behaviour and sleep among adolescents: a review protocol

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