Abstract
Objective: With advances in knowledge about health promotion, public health professionals are in search for the determinants of personal health behaviors. The purpose of this study was to assess the prevalence of health behaviors and its associated factors in a sample of Indian university students.
Materials and methods: Using a cross-sectional survey, we assessed health behavior among a sample of randomly selected university students. The sample included 800 university students from non-health (mainly engineering and sciences) undergraduate courses of Gitam University, Visakhapatnam in India. The students were 541 (67.6%) males and 259 (32.4%) females in the age range of 17–20 years (Median age=18.2 years, SD=1.0).
Results: On average, students engaged in 15.8 out of 25 health behavior practices. There was a high rate of overweight and obesity (26.8% and 10.7%, respectively), low rate of brushing teeth at least twice a day (28.6%), annual dental check-up (25.8%), habitual seatbelt use (23%), and poor dietary patterns (79% ate less than the recommended fruit and vegetable consumption of five servings a day, and 68.5% did not avoid eating fat and cholesterol). In multivariate analysis among men, personal constraints (Odds Ratio=OR 1.75, Confidence Interval=CI 1.09–2.82), health benefits (OR=2.01, CI=1.27–3.17), and not suffering from depression (OR=0.60, CI=0.22–0.94) were associated with the health behavior index. Among women, those who were living away from their parents or guardians (OR=1.94, CI=1.06–3.55), economically better off (OR=2.16, CI=1.00–4.63), and had higher social support (OR=3.65, CI=1.75–7.63), were associated with the health behavior index.
Discussion: Students had a high proportion of health behavior practices. Several high health risk practices were identified, including overweight, poor dental practices, poor dietary and sleeping habits. It is hoped that the gender-specific predictors identified, including sociodemographics as well as social and mental health variables, can also be utilized in designing health promotion programs.
Partial funding for this study was provided by the South African Department of Higher Education.
Conflict of interest statement
Authors’ conflict of interest disclosure: The authors declare no conflict of interest.
References
1. World Health Organization (WHO). Preventing chronic diseases: a vital statement. Geneva, Switzerland: Department of Chronic Diseases and Health Promotion, World Health Organization; 2005.Search in Google Scholar
2. Kinra S, Bowen LJ, Lyngdoh T, Prabhakaran D, Reddy KS, et al. Sociodemographic patterning of non-communicable disease risk factors in rural India: a cross sectional study. Br Med J 2010;341:c4974.10.1136/bmj.c4974Search in Google Scholar
3. Mokdad AH, Marks JS, Stroup DF, Gerberding JL. Actual causes of death in the United States, 2000. J Am Med Assoc 2004;291:1238–45.10.1001/jama.291.10.1238Search in Google Scholar
4. Yusuf S, Hawken S, Ounpuu S, Dans T, Avezum A, et al. Effect of potentially modifiable risk factors associated with myocardial infarction in 52 countries (the INTERHEART study): case-control study. Lancet 2004;364:937–52.10.1016/S0140-6736(04)17018-9Search in Google Scholar
5. Lawlor DA, O’Callaghan MJ, Mamun AA, Williams GM, Bor W, et al. Socioeconomic position, cognitive function, and clustering of cardiovascular risk factors in adolescence: findings from the Mater University Study of Pregnancy and its outcomes. Psychosom Med 2005;67:862–68.10.1097/01.psy.0000188576.54698.36Search in Google Scholar
6. Meng L, Maskarinec G, Lee J, Kolonel LN. Lifestyle factors and chronic diseases: application of a composite risk index. Prev Med 1999;29:296–304.10.1006/pmed.1999.0538Search in Google Scholar
7. Alamian A, Paradis G. Individual and social determinants of multiple chronic disease behavioral risk factors among youth. BMC Public health 2012;12:224.10.1186/1471-2458-12-224Search in Google Scholar
8. Steptoe A, Wardle J. The European health and behaviour survey: the development of an international study in health psychology. Psychol Health 1996;11:49–73.10.1080/08870449608401976Search in Google Scholar
9. Patton GC, Coffey C, Cappa C, Currie D, Riley L, et al. Health of the world’s adolescents: a synthesis of internationally comparable data. Lancet 2012;379:1665–75.10.1016/S0140-6736(12)60203-7Search in Google Scholar
10. Alwan A, Maclean DR, Riley LM, d’Espaignet ET, Mathers CD, et al. Monitoring and surveillance of chronic non-communicable diseases: progress and capacity in high-burden countries. Lancet 2010;376:1861–68.10.1016/S0140-6736(10)61853-3Search in Google Scholar
11. Gore F, Bloem P, Patton GC, Ferguson J, Joseph V, et al. Global burden of disease in young people aged 10–24 years: a systematic analysis. Lancet 2011;377:2093–102.10.1016/S0140-6736(11)60512-6Search in Google Scholar
12. Rustagi N, Taneja DK, Mishra P, Ingle GK. Cardiovascular risk behavior among students of a medical college in Delhi. Indian J Community Med 2011;36:51–3.10.4103/0970-0218.80794Search in Google Scholar PubMed PubMed Central
13. Bleske BE, Erickson SR, Fahoum S, Devarakonda KR, Welage LS, et al. Cardiovascular risk among university students from developed and developing nations. Open Cardiovasc Med J 2011;5:117–22.10.2174/1874192401105010117Search in Google Scholar PubMed PubMed Central
14. Bhojani UM, Chander SJ, Devadasan N. Tobacco use and related factors among pre-university students in a college in Bangalore, India. Natl Med J India 2009;22:294–7.Search in Google Scholar
15. Singh I, Anup N, Manjunath BC. Prevalence of tobacco habits among health care students in Jaipur. Science 2010;12:116–9.Search in Google Scholar
16. Chatterjee T, Haldar D, Mallik S, Sarkar GN, Das S, et al. A study on habits of tobacco use among medical and non-medical students of Kolkata. Lung India 2011;28:5–10.10.4103/0970-2113.76293Search in Google Scholar PubMed PubMed Central
17. Nichter M, Nichter M, Van Sickle D. Popular perceptions of tobacco products and patterns of use among male college students in India. Soc Sci Med 2004;59:415–31.10.1016/j.socscimed.2003.10.032Search in Google Scholar PubMed
18. Ramakrishnan N. A study on perceptions and practices about physical activity among undergraduate medical students. Indian J Surg 2011;2:278.Search in Google Scholar
19. Seo DC, Torabi MR, Jiang N, Fernandez-Rojas X, Park BH. Correlates of college students’ physical activity: cross-cultural differences. Asia Pac J Public Health 2009;21:421–32.10.1177/1010539509344112Search in Google Scholar PubMed
20. Reddy DC, Singh SP, Tiwari IC, Shukla KP, Srivastava MK. An epidemiological study of cannabis abuse among college students of Varanasi. Indian J Public Health 1993;37:10–5.Search in Google Scholar
21. von Bothmer MI, Fridlund B. Gender differences in health habits and in motivation for a healthy lifestyle among Swedish university students. Nurs Health Sci 2005;7:107–18.10.1111/j.1442-2018.2005.00227.xSearch in Google Scholar PubMed
22. Htay SS, Oo M, Yoshida Y, Harun-Or-Rashid M, Sakamoto J. Risk behaviours and associated factors among medical students and community youths in Myanmar. Nagoya J Med Sci 2010;72:71–81.Search in Google Scholar
23. Nanakorn S, Osaka R, Chusilp K, Tsuda A, Maskasame S, et al. Gender differences in health-related practices among university students in northeast Thailand. Asia Pac J Public Health 1999;11:10–5.10.1177/101053959901100103Search in Google Scholar PubMed
24. Refaat A. Practice and awareness of health risk behaviour among Egyptian university students. East Mediterr Health J 2004;10:72–81.10.26719/2004.10.1-2.72Search in Google Scholar
25. Suraj S, Singh A. Study of sense of coherence health promoting behavior in north Indian students. Indian J Med Res 2011;134:645–52.10.4103/0971-5916.90989Search in Google Scholar PubMed PubMed Central
26. Steptoe A, Wardle J, Vinck J, Tuomisto M, Holte A, et al. Personality and attitudinal correlates of healthy and unhealthy lifestyles in young adults. Psychol Health 1994;9:331–43.10.1080/08870449408407492Search in Google Scholar PubMed
27. Ulla Díez SM, Pérez-Fortis A. Socio-demographic predictors of health behaviors in Mexican college students. Health Promot Int 2010;25:85–93.10.1093/heapro/dap047Search in Google Scholar PubMed
28. Oksuz E, Malhan S. Socioeconomic factors and health risk behaviors among university students in Turkey: questionnaire study. Croat Med J 2005;46:66–73.Search in Google Scholar
29. Suchday S, Chhabra R, Wylie-Rosett J, Almeida M. Subjective and objective measures of socioeconomic status: predictors of cardiovascular risk in college students in Mumbai, India. Ethn Dis 2008;18(2 Suppl 2):S2-235-7.Search in Google Scholar
30. El Ansari W, Stock C. Is the health and wellbeing of university students associated with their academic performance? Cross sectional findings from the United Kingdom. Int J Environ Res Public Health 2010;7:509–27.10.3390/ijerph7020509Search in Google Scholar PubMed PubMed Central
31. Sigfúsdóttir ID, Kristjánsson AL, Allegrante JP. Health behaviour and academic achievement in Icelandic school children. Health Educ Res 2007;22:70–80.10.1093/her/cyl044Search in Google Scholar PubMed
32. Zini A, Sgan-Cohen HD, Marcenes W. Religiosity, spirituality, social support, health behavior and dental caries among 35- to 44-year-old Jerusalem adults: a proposed conceptual model. Caries Res 2012;46:368–75.10.1159/000338404Search in Google Scholar PubMed
33. Binkowska-Bury M, Januszewicz P. Sense of coherence and health-related behaviour among university students – a questionnaire survey. Cent Eur J Public Health 2010;18:145–50.10.21101/cejph.a3591Search in Google Scholar PubMed
34. Posadzki P, Stockl A, Musonda P, Tsouroufli M. A mixed-method approach to sense of coherence, health behaviors, self-efficacy and optimism: towards the operationalization of positive health attitudes. Scand J Psychol 2010;51:246–52.10.1111/j.1467-9450.2009.00764.xSearch in Google Scholar PubMed
35. Pitel L, Madarasova Geckova A, Kolarcik P, Halama P, Reijneveld SA, et al. Gender differences in the relationship between religiosity and health-related behaviour among adolescents. J Epidemiol Community Health 2012;66:1122–8.10.1136/jech-2011-200914Search in Google Scholar PubMed
36. Steptoe A, Wardle J. Cognitive predictors of health behaviour in contrasting regions of Europe. Br J Clin Psychol 1992;31: 485–502.10.1111/j.2044-8260.1992.tb01021.xSearch in Google Scholar PubMed
37. Helmer SM, Krämer A, Mikolajczyk RT. Health-related locus of control and health behaviour among university students in North Rhine Westphalia, Germany. BMC Res Notes 2012;5:703.10.1186/1756-0500-5-703Search in Google Scholar PubMed PubMed Central
38. Halpin HA, Morales-Suárez-Varela MM, Martin-Moreno JM. Chronic disease prevention and the New Public Health. Public Health Reviews 2010;32:120–54.10.1007/BF03391595Search in Google Scholar
39. Cody R, Lee C. Behaviours, beliefs, and intentions in skin cancer prevention. J Beh Med 1990;13:373–89.10.1007/BF00844885Search in Google Scholar PubMed
40. Sutton S. The contribution of behavioural science to primary care research: development and evaluation of behaviour change interventions. Prim Health Care Res Dev 2011;12:284–92.10.1017/S1463423611000168Search in Google Scholar PubMed
41. Allgöwer A, Wardle J, Steptoe A. Depressive symptoms, social support, and personal health behaviors in young men and women. Health Psychol 2001;20:223–7.10.1037/0278-6133.20.3.223Search in Google Scholar
42. Peltzer K. Prevalence and correlates of substance use among school children in six African countries. Int J Psychol 2009;44:378–86.10.1080/00207590802511742Search in Google Scholar PubMed
43. Conry MC, Morgan K, Curry P, McGee H, Harrington J, et al. The clustering of health behaviours in Ireland and their relationship with mental health, self-rated health and quality of life. BMC Public Health 2011;11:692.10.1186/1471-2458-11-692Search in Google Scholar PubMed PubMed Central
44. World Health Organization (WHO). Guidelines for controlling and monitoring the tobacco epidemic. Geneva, Switzerland: WHO, 1998.Search in Google Scholar
45. Craig CL, Marshall AL, Sjöström M, Bauman AE, Booth ML, et al. International physical activity questionnaire: 12-Country reliability and validity. Med Sci Sports Exerc 2003;35: 1381–95.10.1249/01.MSS.0000078924.61453.FBSearch in Google Scholar PubMed
46. Hall JN, Moore S, Harper SB, Lynch JW. Global variability in fruit and vegetable consumption. Am J Prev Med 2009;36: 402–9.e5.10.1016/j.amepre.2009.01.029Search in Google Scholar PubMed
47. Kim JH, Lau CH, Cheuk KK, Kan P, Hui HL, et al. Brief report: predictors of heavy Internet use and associations with health-promoting and health risk behaviors among Hong Kong university students. J Adolesc 2010;33:215–20.10.1016/j.adolescence.2009.03.012Search in Google Scholar PubMed
48. Lesieur HR, Blume SB. The South Oaks Gambling Screen (SOGS): a new instrument for the identification of pathological gamblers. Am J Psychiatry 1987;144:1184–8.10.1176/ajp.144.9.1184Search in Google Scholar PubMed
49. CDC. Questionnaire – CDC Global School-based Student Health Survey, 2009. Retrieved at www.cdc.gov/gshs/questionnaire/index.htm, accessed 15 September 2012.Search in Google Scholar
50. Hublin C, Partinen M, Koskenvuo M, Kaprio J. Sleep and mortality: a population-based 22 year follow-up study. Sleep 2007;30:1245–53.10.1093/sleep/30.10.1245Search in Google Scholar PubMed PubMed Central
51. WHO Expert Consultation. Appropriate body-mass index for Asian populations and its implications for policy and intervention strategies. Lancet 2004;363:157–63.10.1016/S0140-6736(03)15268-3Search in Google Scholar
52. Brock D, Sarason I, Sarason B, Pierce G. Simultaneous assessment of perceived global and relationship-specific support. J Soc Pers Relationships 1996;13:143–52.10.1177/0265407596131008Search in Google Scholar
53. Koenig HG, Meador K, Parkerson G. Religion index for psychiatric research: a 5-item measure for use in health outcome studies. Am J Psychiatry 1997;154:885–6.10.1176/ajp.154.6.885bSearch in Google Scholar
54. Koenig HG, Büssing A. The Duke University Religion Index (DUREL): a five-item measure for use in epidemological studies. Religions 2010;1:78–85.10.3390/rel1010078Search in Google Scholar
55. Lachman ME, Weaver SL. The sense of control as a moderator of social class differences in health and well-being. J Pers Soc Psychol 1998;74:763–73.10.1037/0022-3514.74.3.763Search in Google Scholar
56. Andresen EM, Malmgren JA, Carter WB, Patrick DL. Screening for depression in well older adults: evaluation of a short form of the CES-D (Center for Epidemiologic Studies Depression Scale). Am J Prev Med 1994;10:77–84.10.1016/S0749-3797(18)30622-6Search in Google Scholar
57. Mulrow CD, Williams JW Jr, Gerety MB, Ramirez G, Montiel OM, et al. Case-finding instruments for depression in primary care settings. Ann Intern Med 1995;122:913–21.10.7326/0003-4819-122-12-199506150-00004Search in Google Scholar PubMed
58. Kilbourne A, Justice A, Rollman B, McGinnis K, Rabeneck L, et al. Clinical importance of HIV and depressive symptoms among veterans with HIV infection. J Gen Intern Med 2002;17:512–20.10.1046/j.1525-1497.2002.10803.xSearch in Google Scholar PubMed PubMed Central
59. Kimerling R, Ouimette P, Prins A, Nisco P, Lawler C, et al. Brief report: Utility of a short screening scale for DSM-IV PTSD in primary care. J Gen Intern Med 2006;21:65–7.10.1111/j.1525-1497.2005.00292.xSearch in Google Scholar PubMed PubMed Central
60. Sikkema KJ, Watt MH, Meade CS, Ranby KW, Kalichman SC, et al. Mental health and HIV sexual risk behavior among patrons of alcohol serving venues in Cape Town, South Africa. J Acquir Immune Defic Syndr 2011;57:230–7.10.1097/QAI.0b013e3182167e7aSearch in Google Scholar PubMed PubMed Central
61. Banwell C, Lim L, Seubsman SA, Bain C, Dixon J, et al. Body mass index and health-related behaviours in a national cohort of 87,134 Thai open university students. J Epidemiol Community Health 2009;63:366–72.10.1136/jech.2008.080820Search in Google Scholar
62. Kanter R, Caballero B. Global gender disparities in obesity: a review. Adv Nutr 2012;3:491–8.10.3945/an.112.002063Search in Google Scholar
63. Doshi D, Baldava P, Anup N, Sequeira PS. A comparative evaluation of self-reported oral hygiene practices among medical and engineering university students with access to health-promotive dental care. J Contemp Dent Pract 2007;8:68–75.10.5005/jcdp-8-1-68Search in Google Scholar
64. Khosla V, Thankappan KR, Mini GK, Sarma PS. Prevalence and predictors of alcohol use among college students in Ludhiana, Punjab, India. Indian J Med Res 2008;128:79–81.Search in Google Scholar
65. Parikh R, Chakraborthy N, Sonawalla S, Mehra G, Dracas S, et al. Depression in college students in Bombay: A study of 2273 individuals. European Neuropsychopharmacology 2002;12(Suppl 3):247.10.1016/S0924-977X(02)80313-3Search in Google Scholar
66. Potdar R, Koenig MA. Does Audio-CASI improve reports of risky behavior? Evidence from a randomized field trial among young urban men in India. Stud Fam Plann 2005;36:107–16.10.1111/j.1728-4465.2005.00048.xSearch in Google Scholar PubMed
67. Von Ah D, Ebert S, Ngamvitroj A, Park N, Kang DH. Predictors of health behaviours in college students. J Adv Nurs 2004;48:463–74.10.1111/j.1365-2648.2004.03229.xSearch in Google Scholar PubMed
©2014 by De Gruyter
