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Clustering of Health-Related Behaviors and Their Determinants: Possible Consequences for School Health Interventions

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Characterizing school health promotion is its category-by-category approach, in which each separate health-related behavior is addressed independently. Such an approach creates a risk that extra-curricular activities become overloaded, and that teaching staff are distracted by continuous innovations. Within the health promotion sector there are thus increasing calls for an integrative approach to health-related behaviors. However, a meaningful integrative approach to different lifestyles will be possible only if there is some clustering of individual health-related behaviors and if health-related behaviors have a minimum number of determinants in common. This systematic review aims to identify to what extent the four health-related behaviors smoking, alcohol abuse, safe sex and healthy nutrition cluster; and how their determinants are associated. Potentially modifiable determinants that offer clues for an integrative approach of school health-promotion programs are identified. Besides, the direction in which health educators should look for a more efficient instructional design is indicated.

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REFERENCES

  • Aarø, L. E., Laberg, J. C., & Wold, B. (1995). Health behaviors among adolescents: Toward a hypothesis of two dimensions. Health Education Research, 10(1), 83–93.

    Google Scholar 

  • Adalbjarnardottir, S., & Hafsteinsson, L. G. (2001). Adolescents’ perceived parenting styles and their substance use: Concurrent and longitudinal analyses. Journal of Research on Adolescence, 11(4), 401–423.

    Google Scholar 

  • Ajzen, I. (1991). The theory of planned behavior. Organizational Behavior and Human Decision Processes, 50, 179–211.

    Article  Google Scholar 

  • Amaro, H., Blake, S. M., Schwartz, P. M., & Flinchbaugh, L. J. (2001). Developing theory-based substance abuse prevention programs for young adolescent girls. Journal of Early Adolescence, 21(3), 256–293.

    Google Scholar 

  • Avenevoli, S., & Merikangas, K. R. (2003). Familial influences on adolescent smoking. Addiction, 98(Suppl 1), 1–20.

    Article  PubMed  Google Scholar 

  • Bachanas, P. J., Morris, M. K., Lewis-Gess, J. K., Sarett-Cuasay, E. J., Flores, A. L., Sirl, K. S., & Sawyer, M. K. (2002). Psychological adjustment, substance use, HIV knowledge, and risky sexual behavior in at-risk minority females: Developmental differences during adolescence. Journal of Pediatric Psychology, 27(4), 373–84.

    Article  PubMed  Google Scholar 

  • Backman, D. R., Haddad, E. H., Lee, J. W., Johnston, P. K., & Hodgkin, G. E. (2002). Psychosocial Predictors of Healthful Dietary Behavior in Adolescents. Journal of Nutrition Education and Behavior, 34, 184–193.

    PubMed  Google Scholar 

  • Bandura, A. (1986). Social foundations of thought and action: A social cognitive theory. Englewood Cliffs: Prentice—Hall.

    Google Scholar 

  • Bauman, K. E., & Ennet, S. T. (1996). On the importance of peer influence for adolescent drug use: Commonly neglected considerations. Addiction, 91(2), 185–198.

    Article  PubMed  CAS  Google Scholar 

  • Beal, A. C., Ausiello, J., & Perrin, J. M. (2001). Social influences on health-risk behaviors among minority middle school students. Journal of Adolescent Health, 28, 474–480.

    Article  PubMed  CAS  Google Scholar 

  • Becker, M. H. (1974). The health belief model and personal health behavior. Thorofare, NJ: Slack.

    Google Scholar 

  • Beckman, L. J., & Harvey, S. M. (1996). Factors affecting the consistent use of barrier methods of contraception. Obstetrics and Gynecology, 88(3 Suppl), 65S-71S.

    Google Scholar 

  • Belcher, H. M., & Shinitzky, H. E. (1998). Substance abuse in children: Prediction, protection, and prevention. Archives of Pediatrics and Adolescent Medicine, 152(10), 952–960.

    PubMed  CAS  Google Scholar 

  • Ben-Zur, H., Breznitz, S., Wardi, N., & Berzon, Y. (2000). Denial of HIV/AIDS and preventive behavior among Israeli adolescents. Journal of Adolescence, 23(2), 157–74.

    Article  PubMed  CAS  Google Scholar 

  • Berg, M. C., Jonsson, I., & Conner, M. T. (2000). Understanding choice of milk and bread for breakfast among Swedish children aged 11–15 years: An application of the theory of planned behavior. Appetite, 34, 5–19.

    Article  PubMed  CAS  Google Scholar 

  • Berg, M. C., Jonsson, I., Conner, M. T., & Lissner, L. (2002). Relation between breakfast food choices and knowledge of dietary fat and fiber among Swedish schoolchildren. Journal of Adolescent Health, 31, 199–207.

    Article  PubMed  Google Scholar 

  • Birch, L. L., & Fisher, J. O. (1998). Development of eating behaviors among children and adolescents. Pediatrics, 101, 539–549.

    PubMed  CAS  Google Scholar 

  • Blum, R. W., Beuhring, T., Shew, M. L., Bearinger, L. H., Sieving, R. E., & Resnick, M. D. (2000). The effects of race/ethnicity, income, and family structure on adolescent risk behaviors. American Journal of Public Health, 90(12), 1879–1884.

    PubMed  CAS  Google Scholar 

  • Boyer, C. B., Shafer, M. A., Wibbelsman, C. J., Seeberg, D., Teitle, E., & Lovell, N. (2000). Associations of sociodemographic, psychosocial, and behavioral factors with sexual risk and sexually transmitted diseases in teen clinic patients. Journal of Adolescent Health, 27(2), 102–11.

    Article  PubMed  CAS  Google Scholar 

  • Bronfenbrenner, M. (1986). Ecology of the family as a context for human development: Research perspectives. Developmental Psychology, 22, 723–742.

    Article  Google Scholar 

  • Brooks, T. L., Harris, S. K., Thrall, J. S., & Woods, E. R. (2002). Association of adolescent risk behaviors with mental health symptoms in high school students. Journal of Adolescent Health, 31, 240–246.

    Article  PubMed  Google Scholar 

  • Brown, J. S., Collins, A., & Duguid, P. (1989). Situated cognition and the culture of learning. Educational Researcher, 18, 32–42.

    Google Scholar 

  • Burke, V., Milligan, R. A. K., Beilin, L. J., Dunbar, D., Spencer, M., Balde, E., & Gracey, M. P. (1997). Clustering of health-related behaviors among 18-year-old Australians. Preventive Medicine, 26, 724–733.

    Article  PubMed  CAS  Google Scholar 

  • Carvajal, S. C., Wiatrek, D. E., Evans, R. I., Knee, C. R., & Nash, S. G. (2000). Psychosocial determinants of the onset and escalation of smoking: Cross-sectional and prospective findings in multiethnic middle school samples. Journal of Adolescent Health, 27(4), 255–265.

    Article  PubMed  CAS  Google Scholar 

  • Chassin, L., Presson, C. C., & Sherman, S. J. (2000). The natural history of cigarette smoking from adolescence to adulthood in a midwestern community sample: Multiple trajectories and their psychosocial correlates. Health Psychology, 19(3), 223–231.

    Article  PubMed  CAS  Google Scholar 

  • Choi, W. S., Ahluwalia, J. S., Harris, K. J., & Okuyemi, K. (2002). Progression to established smoking: The influence of tobacco marketing. American Journal of Preventive Medicine, 22(4), 228–233.

    Article  PubMed  Google Scholar 

  • Choi, W. S., Gilpin, E. A., Farkas, A. J., & Pierce, J. P. (2001). Determining the probability of future smoking among adolescents. Addiction, 96(2), 313–323.

    Article  PubMed  CAS  Google Scholar 

  • Coker, J. K., & Borders, L. D. (2001). An analysis of environmental and social factors affecting adolescent problem drinking. Journal of Counseling and Development, 79(2), 200–208.

    Google Scholar 

  • Colon, R. M., Wiatrek, D. E., & Evans, R. I. (2000). The relationship between psychosocial factors and condom use among African-American adolescents. Adolescence, 35(139), 559–69.

    PubMed  CAS  Google Scholar 

  • Contento, I. R., Michela, J. L., & Williams, S. S. (1995). Adolescent food choice criteria: Role of weight and dieting status. Appetite, 25, 51–76.

    Article  PubMed  CAS  Google Scholar 

  • Cooper, M. L. (2002). Alcohol use and risky sexual behavior among college students and youth: Evaluating the evidence. Journal of Studies on Alcohol, supplement, 14, 101–17.

    Google Scholar 

  • Cooper, M. L., Wood, P. K., Orcutt, H. K., & Albino, A.(2003). Personality and the predisposition to engage in risky or problem behaviors during adolescence. Journal of Personality and Social Psychology, 84(2), 390–410.

    PubMed  Google Scholar 

  • Croll, J. K., Neumark-Sztainer, D., & Story, M. (2001). Healthy eating: What does it mean to adolescents? Journal of Nutrition Education, 33, 193–198.

    PubMed  CAS  Google Scholar 

  • Crosby, R. A., & Yarber, W. L. (2001). Perceived versus actual knowledge about correct condom use among U.S. adolescents: Results from a national study. Journal of Adolescent Health, 28(5), 415–420.

    Article  PubMed  CAS  Google Scholar 

  • Crosby, R. A., DiClemente, R. J., Wingood, G. M., & Harrington, K. (2002a). HIV/STD prevention benefits of living in supportive families: A prospective analysis of high risk African-American female teens. American Journal of Health Promotion, 16(3), 142–145.

    PubMed  Google Scholar 

  • Crosby, R. A., DiClemente, R. J., Wingood, G. M., Cobb, B. K., Harrington, K., Davies, S. L., Hook, E. W., & Oh, M. K. (2002b). Condom use and correlates of African American adolescent females’ infrequent communication with sex partners about preventing sexually transmitted diseases and pregnancy. Health Education and Behavior, 29(2), 219–231.

    PubMed  Google Scholar 

  • Cullen, K. W., Koehly, L. M., Anderson, C., Baranowski, T., Prokhorov, A., Basen-Engquist, K., Wetter, D., & Hergenroeder, A. (1999). Gender differences in chronic disease risk behaviors through the transition out of high school. American journal of preventive medicine, 17, 1–7.

    Article  PubMed  CAS  Google Scholar 

  • D’Amico, E. J., Metrik, J., McCarthy, D. M., Appelbaum, M., Frissell, K. C., & Brown, S. A. (2001). Progression into and out of binge drinking among high school students. Psychology of Addictive Behaviors, 15(4), 341–349.

    Article  PubMed  CAS  Google Scholar 

  • Darling, N., & Cumsille, P. (2003). Theory, measurement, and methods in the study of family influences on adolescent smoking. Addiction, 98(Suppl 1), 21–36.

    Article  PubMed  Google Scholar 

  • De Bourdeaudhuij, I., & Van Oost, P. (1998). family members’ influence on decision making about food: Differences in perception and relationship with healthy eating. American journal of health promotion, 12, 73–81.

    Google Scholar 

  • Derzon, J. H., & Lipsey, M. W. (1999). Predicting tobacco use to age 18: A synthesis of longitudinal research. Addiction, 94(7), 995–1006.

    Article  PubMed  CAS  Google Scholar 

  • DiClemente, R. J., Wingood, G. M., Crosby, R., Sionean, C., Cobb, B. K., Harrington, K., Davies, S., Hook, E. W., & Kim Oh, M. (2001). Parental monitoring: Association with adolescents’ risk behaviors. Pediatrics, 107(6), 1363–1368.

    Article  PubMed  CAS  Google Scholar 

  • Dilorio, C., Dudley, W. N., Kelly, M., Soet, J. E., Mbwara, J., & Sharpe Potter, J. (2001). Social cognitive correlates of sexual experience and condom use among 13- through 15-year-old adolescents. Journal of Adolescent Health, 29(3), 208–216.

    Article  PubMed  Google Scholar 

  • DuRant, R. H., & Smith, J. A. (1999). Adolescent tobacco use and cessation. Primary Care, 26(3), 553–575.

    PubMed  CAS  Google Scholar 

  • Eertmans, A., Baeyens, F., & Wechsler, H. (2001). Food likes and their relative importance in human eating behavior: Review and preliminary suggestions for health promotion. health education research, 16, 443–456.

    Article  PubMed  CAS  Google Scholar 

  • Eissenberg, T., & Balster, R. L. (2000). Initial tobacco use episodes in children and adolescents: Current knowledge, future directions. Drug and Alcohol Dependence, 59(suppl 1), S41–S60.

    Article  PubMed  Google Scholar 

  • Ellickson, P. L., McGuigan, K. A., & Klein, D. J. (2001a). Predictors of late-onset smoking and cessation over 10 years. Journal of Adolescent Health, 29(2), 101–108.

    Article  PubMed  CAS  Google Scholar 

  • Ellickson, P. L., Tucker, J. S., Klein, D. J., & McGuigan, K. A. (2001b). Prospective risk factors for alcohol use in late adolescence. Journal of Studies on Alcohol, 62(6), 773–782.

    PubMed  CAS  Google Scholar 

  • Epstein, J. A., Griffin, K. W., & Botvin, G. J. (2000). A model of smoking among inner-city adolescents: The role of personal competence and perceived social benefits of smoking. Preventive Medicine, 31(2), 107–114.

    Article  PubMed  CAS  Google Scholar 

  • Fahs, P. S., Smith, B. E., Atav, A. S., Britten, M. X., Collins, M. S., Morgan, L. C., & Spencer, G. A. (1999). Integrative research review of risk behaviors among adolescents in rural, suburban, and urban areas. Journal of Adolescent Health, 24(4), 230–243.

    Article  PubMed  CAS  Google Scholar 

  • Ferdinand, R. F., Bluem, M., & Verhulst, F. C. (2001). Psychopathology in adolescence predicts substance use in young adulthood. Addiction, 96(6), 861–870.

    Article  PubMed  CAS  Google Scholar 

  • Flay, B. R. (2002). Positive youth development requires comprehensive health promotion programs. American Journal of Health Behavior, 26(6), 407–424.

    PubMed  Google Scholar 

  • Flay, B. R., & Petraitis, J. (1994). The theory of triadic influence: A new theory of health behavior with implications for preventive interventions. Advances in Medical Sociology, 4, 19–44.

    Google Scholar 

  • Flay, B. R., Phil, D., Hu, F. B., & Richardson, J. (1998). Psychosocial predictors of different stages of cigarette smoking among high school students. Preventive Medicine, 27(5 Pt 2), A9–A18.

    Article  PubMed  CAS  Google Scholar 

  • Flisher, A. J., Kramer, R. A., Hoven, C. W., King, R. A., Bird, H. R., Davies, M., Gould, M. S., Greenwald, S., Lahey, B. B., Regier, D. A., Schwab-Stone, M., & Shaffer, D. (2000). Risk behavior in a community sample of children and adolescents. Journal of American Academy of Child and Adolescent Psychiatry, 39(7), 881–887.

    Article  CAS  Google Scholar 

  • Gage, A. J. (1998). Sexual activity and contraceptive use: The components of the decision-making process. Studies in Family Planning, 29(2), 154–66.

    PubMed  CAS  Google Scholar 

  • Gillman, M. W., Frazier, A. L., Rockett, H. R., Camargo, C. A. J., Field, A. E., Berkey, C. S., & Colditz, G. A. (2000). Family dinner and diet quality among older children and adolescents. Archives of Family Medicine, 9, 235–240.

    Article  PubMed  CAS  Google Scholar 

  • Goldberg, J. H., Halpern-Felsher, B. L., & Millstein, S. G. (2002). Beyond invulnerability: The importance of benefits in adolescents’ decision to drink alcohol. Health Psychology, 21(5), 477–484.

    Article  PubMed  Google Scholar 

  • Greene, K., Krcmar, M., Walters, L. H., Rubin, D. L., Hale, J., & Hale, L. (2000). Targeting adolescent risk-taking behaviors: The contributions of egocentrism and sensation-seeking. Journal of Adolescence, 23, 439–461.

    Article  PubMed  CAS  Google Scholar 

  • Griffin, K. W., Scheier, L. M., Botvin, G. J., & Diaz, T. (2000). Ethnic and gender differences in psychosocial risk, protection, and adolescent alcohol use. Prevention Science, 1(4), 199–212.

    Article  PubMed  CAS  Google Scholar 

  • Gullone, E., & Moore, S. (2000). Adolescent risk-taking and the five-factor model of personality. Journal of Adolescence, 23, 393–407.

    Article  PubMed  CAS  Google Scholar 

  • Gutierrez, L., Oh, H. J., & Gillmore, M. R. (2000). Toward an understanding of (em)power(ment) for HIV/AIDS prevention with adolescent women. Sex Roles, 42(7–8), 581–611.

    Article  Google Scholar 

  • Halpern-Felsher, B., Millstein, S. G., & Ellen, J. M. (1996). Relationship of alcohol use and risky sexual behavior: A review and analysis of findings? Journal of Adolescent Health, 19(5), 331–336.

    Article  PubMed  CAS  Google Scholar 

  • Hanna, E. Z., Yi, H., Dufour, M. C., & Whitmore, C. C. (2001). The relationship of early-onset regular smoking to alcohol use, depression, illicit drug use, and other risky behaviors during early adolescence: Results from the youth supplement to the Third National Health and Nutrition Examination Survey. Journal of Substance Abuse, 13, 265–282.

    Article  PubMed  CAS  Google Scholar 

  • Henderson, M., Wight, D., Raab, G., Abraham, C., Buston, K., Hart, G., & Scott, S. (2002). Heterosexual risk behavior among young teenagers in Scotland. Journal of Adolescence, 25(5), 483–494.

    Article  PubMed  Google Scholar 

  • Hendrickx, K., Lodewijckx, E., Van Royen, P., & Denekens, J. (2002). Sexual behavior of second generation Moroccan immigrants balancing between traditional attitudes and safe sex. Patient Education and Counseling, 47(2), 89–94.

    Article  PubMed  Google Scholar 

  • Hine, D. W., McKenzie-Richer, A., Lewko, J., Tilleczek, K., & Perreault, L. (2002). A comparison of the mediational properties of four adolescent smoking expectancy measures. Psychology of Addictive Behaviors, 16(3), 187–195.

    Article  PubMed  Google Scholar 

  • Hoglund, D., Samuelson, G., & Mark, A. (1998). Food habits in Swedish adolescents in relation to socioeconomic conditions. European Journal of Clinical Nutrition, 52, 784–789.

    Article  PubMed  CAS  Google Scholar 

  • Irwin, C. E., & Millstein, S. G. (1986). Biopsychosocial correlates of risk-taking behaviors during adolescence: Can the physician intervene? Journal of Adolescence Health Care, 7, S82–S96.

    Google Scholar 

  • Irwin, C. E., Igra, V., Eyre, S., & Millstein, S. (1997). Risk-taking behavior in adolescents: The paradigm. Annals New York Academy Sciences, 28, 1–35.

    Google Scholar 

  • Jemmott, J. B., & Jemmott, L. S. (2000). HIV risk reduction behavioral interventions with heterosexual adolescents. AIDS, 14(Suppl 2), S40–S52.

    PubMed  Google Scholar 

  • Jessor, R. (1991). Risk behavior in adolescence: A psychosocial framework for understanding and action. Journal of Adolescent health, 2, 597–605.

    Article  Google Scholar 

  • Johnson, P. B., & Johnson, H. L. (1999). Cultural and familial influences that maintain the negative meaning of alcohol. Journal of Studies on Alcohol, 60(suppl. 13), 79–83.

    Google Scholar 

  • Karvonen, S., Abel, T., Calmonte, R., & Rimpelä, A. (2000). Patterns of health-related behavior and their cross-cultural validity—A comparative study on two populations of young people. Sozial- und Präventivmedizin, 45, 35–45.

    Article  PubMed  CAS  Google Scholar 

  • Kirby, D. (2002). Antecedents of adolescent initiation of sex, contraceptive use, and pregnancy. American Journal of Health Behavior, 26(6), 473–85.

    PubMed  Google Scholar 

  • Kobus, K. (2003). Peers and adolescent smoking. Addiction, 98(Suppl 1), 37–55.

    Article  PubMed  Google Scholar 

  • Kodjo, C. M., & Klein, J. D. (2002). Prevention and risk of adolescent substance abuse. The role of adolescents, families, and communities. Pediatric Clinics of North America, 49(2), 257–268.

    Article  PubMed  Google Scholar 

  • Koivisto Hursti, U. K. (1999). Factors influencing children’s food choice. Annals of Medicine, 31, 26–32.

    PubMed  Google Scholar 

  • Kotchick, B. A., Shaffer, A., & Forehand, R. (2001). Adolescent sexual risk behavior: A multi-system perspective. Clinical Psychology Review, 21(4), 493–519.

    Article  PubMed  CAS  Google Scholar 

  • Kremers, S. P. J., Brug, J., De Vries, H., & Engels, R. C. M. E. (2003) Parenting style and adolescent fruit consumption. Appetite, 41, 43–50.

    Article  PubMed  Google Scholar 

  • Kumpulainen, K. (2000). Psychiatric symptoms and deviance in early adolescence predict heavy alcohol use 3 years later. Addiction, 95(12), 1847–1857.

    Article  PubMed  CAS  Google Scholar 

  • La Greca, A. N., Prinstein, M. J., & Fetter, M. D. (2001). Adolescent peer crowd affiliation: Linkages with health-risk behaviors and close friendships. Journal of Pediatric Psychology, 26(3), 131–143.

    Article  PubMed  CAS  Google Scholar 

  • Laukkanen, E., Shemeikka, S., Notkola, I., Koivumaa-Honkanen, H., & Nissinen, A. (2002). Externalizing and internalizing problems at school as signs of health-damaging behavior and incipient marginalization. Health Promotion International, 17(2), 139–146.

    Article  PubMed  Google Scholar 

  • Li, X., Stanton, B., & Feigelman, S. (2000). Impact of perceived parental monitoring on adolescent risk behavior over 4 years. Journal of Adolescent Health, 27, 49–56.

    Article  PubMed  CAS  Google Scholar 

  • Little, L. A., Kelder, S. H., Perry, C. L., & Klepp, K. I. (1995). Covariance of adolescent health behaviors: A multivariate, developmental perspective. Preventive Medicine, 19, 134–146.

    Google Scholar 

  • Lonczak, H. S., Huang, B., Catalano, R. F., Hawkins, J. D., Hill, K. G., Abbott, R. D., Ryan, J. A., & Kosterman, R. (2001). The social predictors of adolescent alcohol misuse: A test of the Social Development Model. Journal of Studies on Alcohol, 62(2), 179–189.

    PubMed  CAS  Google Scholar 

  • Maes, L., & Lievens, J. (2003) Can the school make a difference? A multilevel analysis of adolescent risk and health behavior. Social Science and Medicine, 56, 517–529.

    Article  PubMed  Google Scholar 

  • Masui, R., Sallis, J. F., Berry, C. C., Broyles, S. L., Elder, J. P., & Nader, P. R. (2002). The relationship between health beliefs and behaviors and dietary intake in early adolescence. Journal of American Dietary Association, 102, 421–424.

    Article  PubMed  Google Scholar 

  • Maxwell, K. A. (2002). Friends: The role of peer influence across adolescent risk behaviors. Journal of Youth and Adolescence, 31(4), 267–277.

    Article  Google Scholar 

  • Mayhew, K., Flay, B. R., & Mott, J. A. (2000). Stages in the development of adolescent smoking. Drug and Alcohol Dependence, 59(suppl 1), S61–S81.

    Article  PubMed  Google Scholar 

  • McGee, R., & Williams, S. (2000). Does low self-esteem predict health-compromising behaviors among adolescents? Journal of Adolescence, 23, 569–582.

    Article  PubMed  CAS  Google Scholar 

  • Neumark-Sztainer, D., Hannan, P. J., Story, M., Croll, J., & Perry, C. (2003). Family meal patterns: Associations with sociodemographic characteristics and improved dietary intake among adolescents. Journal of the American Dietetic Association, 103, 317–322.

    Article  PubMed  Google Scholar 

  • Neumark-Sztainer, D., Story, M., Perry, C., & Casey, M. A. (1999). Factors influencing food choices of adolescents: Findings from focus-group discussions with adolescents. Journal of the American Dietetic Assocation, 99, 929–937.

    Article  CAS  Google Scholar 

  • Neumark-Sztainer, D., Story, M., Resnick, M. D., & Blum, R. W. (1996). Correlates of inadequate fruit and vegetable consumption among adolescents. Preventive medicine, 25, 497–505.

    Article  PubMed  CAS  Google Scholar 

  • O’dea, J. A. (2003). Why do kids eat healthful food? Perceived benefits of and barriers to healthful eating and physical activity among children and adolescents. Journal of the American Dietetic Association, 103(4), 497–501.

    Article  PubMed  Google Scholar 

  • Oman, R. F., McLeroy, K. R., Vesely, S., Aspy, C. B., Smith, D. W., & Penn, D. A. (2002). An adolescent age group approach to examining youth risk behaviors. American Journal of Health Promotion, 16(3), 167–176.

    PubMed  Google Scholar 

  • Orlando, M., Ellickson, P. L., & Jinnett, K. (2001). The temporal relationship between emotional distress and cigarette smoking during adolescence and young adulthood. Journal of Consulting and Clinical Psychology, 69(6), 959–970.

    Article  PubMed  CAS  Google Scholar 

  • Patton, L. H. (1995). Adolescent substance abuse: Risk factors and protective factors. Pediatric Clinics of North America, 42(2), 283–293.

    PubMed  CAS  Google Scholar 

  • Paulussen, T. G. W., Panis, R., Peters, L., Buijs, G., & Wijnsma, P. (1998). Stand van zaken schoolgezondheidsbeleid in Nederland: Een inventariserend onderzoek. Woerden: NIGZ.

    Google Scholar 

  • Petraitis, J., Flay, B. R., & Miller, T. Q. (1995). Reviewing theories of adolescent substance use: Organizing pieces in the puzzle. Psychological Bulletin, 117(1), 67–86.

    Article  PubMed  CAS  Google Scholar 

  • Pirouznia, M. (2001). The association between nutrition knowledge and eating behavior in male and female adolescents in the US. International Journal of Food Science and Nutrition, 52, 127–132.

    CAS  Google Scholar 

  • Pletcher, J. R., & Schwarz, D. F. (2000). Current concepts in adolescent smoking. Current Opinion in Pediatrics, 12, 444–449.

    Article  PubMed  CAS  Google Scholar 

  • Poikolainen, K., Tuulio-Henriksson, A., Aalto-Setala, T., Marttunen, M., & Lonnqvist, J. (2001). Predictors of alcohol intake and heavy drinking in early adulthood: A 5-year follow-up of 15–19-year-old Finnish adolescents. Alcohol and Alcoholism, 36(1), 85–88.

    Article  PubMed  CAS  Google Scholar 

  • Rogers, R. W. (1983). Cognitive and psychological processes in fear appeals and attitude change: A revised theory of Protection Motivation. In J. Cacioppo (Ed.), Social psychophysiology (pp. 153–176). New York: Guilford.

    Google Scholar 

  • Roos, E. B., Hirvonen, T., Mikkilä, V., Karvonen, S., & Rimpelä M. (2001). Household educational level as a determinant of consumption of raw vegetables among male and female adolescents. Preventive medicine, 33, 282–291.

    Article  PubMed  CAS  Google Scholar 

  • Rosengard, C., Adler, N. E., Gurvey, J. E., Dunlop, M. B. V., Tschann, J. M., Millstein, S. G., & Ellen, J. M. (2001). Protective role of health values in adolescents’ future intentions to use condoms. Journal of Adolescent Health, 29(3), 200–207.

    Article  PubMed  CAS  Google Scholar 

  • Rotheram-Borus, M. J., Mahler, K. A., & Rosario, M. (1995). AIDS prevention with adolescents. AIDS Education and Prevention, 7(3), 320–336.

    PubMed  CAS  Google Scholar 

  • Sasco, A. J., & Kleihues, P. (1999). Why can’t we convince the young not to smoke? European Journal of Cancer, 35(14), 1933–1940.

    Article  PubMed  CAS  Google Scholar 

  • Scaramella, L. V., & Keyes, A. W. (2001). The social contextual approach and rural adolescent substance use: Implications for prevention in rural settings. Clinical Child and Family Psychology Review, 4(3), 231–251.

    Article  PubMed  CAS  Google Scholar 

  • Schaalma, H., Bolman, C., de Nooyer, J., de Vries, H., Paulussen, Th., Aarts, H., & Willemse, G. (1997). Jongeren en de preventie van hart- en vaatziekten: Een leefstijl- en determinantenanalyse (Adolescents and the prevention of cardiac diseases: a lifestyle and determinant analysis). Den Haag/Woerden/Maastricht: Nederlandse Hartstichting, NIGZ, Universiteit Maastricht.

  • Scheier, L. M., Botvin, G. J., Griffin, K. W., & Diaz, T. (2000). Dynamic growth models of self-esteem and adolescent alcohol use. Journal of Early Adolescence, 20(2), 178–209.

    Google Scholar 

  • Schor, E. L. (1996). Adolescent alcohol use: Social determinants and the case for early family-centered prevention. Family-focused prevention of adolescent drinking. Bulletin of the New York Academy of Medicine, 73(2), 335–356.

    PubMed  CAS  Google Scholar 

  • Simantov, E., Schoen, C., & Klein, J. D. (2000). Health-compromising behaviors: Why do adolescents smoke or drink? Identifying underlying risk and protective factors. Archives of Pediatric and Adolescence Medicine, 154, 1025–1033.

    CAS  Google Scholar 

  • Soldz, S., & Cui, X. (2002). Pathways through adolescent smoking: A 7-year longitudinal grouping analysis. Health Psychology, 21(5), 495–504.

    Article  PubMed  Google Scholar 

  • Story, M., Neumark-Sztainer, D., & French, S. (2002). Individual and environmental influences on adolescent eating behaviors. Journal of the American Dietetic Association, 102, S40–S51.

    Article  PubMed  Google Scholar 

  • Swadi, H. (1999). Individual risk factors for adolescent substance use. Drug and Alcohol Dependence, 55(3), 209–224.

    Article  PubMed  CAS  Google Scholar 

  • Ten Dam, G. T. M. (2002). Effectiveness in health education. In I. Young (ed.), Education & health in partnership: A European conference on linking education with the promotion of health in schools (pp. 17–22). Woerden: NIGZ/International Planning Committee.

    Google Scholar 

  • Ten Dam, G., Volman, M., & Vernooij, F. (2000). New learning in social studies. In P. R. J. Simons, J. L. van der Linden, & T. M. Duffy (Eds.), New learning (pp. 141–156). Dordrecht: Kluwer.

    Google Scholar 

  • Topolski, T. D., Patrick, D. L., Edwards, T. C., Huebner, C. E., Connell, F. A., & Kiomi Mount, K. (2001). Quality of life and health-risk behaviors among adolescents. Journal of Adolescent Health, 29, 426–435.

    Article  PubMed  CAS  Google Scholar 

  • Tschann, J. M., Adler, N. E., Millstein, S. G., Gurvey, J. E., & Ellen, J. M. (2002a). Relative power between sexual partners and condom use among adolescents. Journal of Adolescent Health, 31(1), 17–25.

    Article  PubMed  Google Scholar 

  • Tschann, J. M., Flores, E., VanOss Marin, B., Pasch, L. A., Baisch, E. M., & Wibbelsman, C. J. (2002b). Interparental conflict and risk behaviors among Mexican American adolescents: A cognitive-emotional model. Journal of Abnormal Child Psychology, 30(4), 373–385.

    Article  PubMed  Google Scholar 

  • Tucker, J. S., Ellickson, P. L., & Klein, D. J. (2002). Five-year prospective study of risk factors for daily smoking in adolescence among early nonsmokers and experimenters. Journal of Applied Social Psychology, 32(8), 1588–1603.

    Google Scholar 

  • Tyas, S. L., & Pederson, L. L. (1998). Psychosocial factors related to adolescent smoking: A critical review of the literature. Tobacco Control, 7(4), 409–420.

    Article  PubMed  CAS  Google Scholar 

  • Wagner, E. F., & Atkins, J. H. (2000). Smoking among teenage girls. Journal of Child and Adolescent Substance Abuse, 9(4), 93–110.

    Article  Google Scholar 

  • Wang, M. Q. (2001). Social environmental influences on adolescents’ smoking progression. American Journal of Health Behavior, 25(4), 418–425.

    PubMed  CAS  Google Scholar 

  • Weber Cullen, K., Bartholomew, L. K., Parcel, G. S., & Koehly, L. M. (1998). Measuring stages of change for fruit and vegetable consumption in 9- to 12-year-old girls. Journal of behavioral medicine, 21, 241–254.

    Article  PubMed  Google Scholar 

  • Whaley, A. L. (1999). Preventing the high-risk sexual behavior of adolescents: Focus on HIV/AIDS transmission, unintended pregnancy, or both? Journal of Adolescent Health, 24(6), 376–82.

    Article  PubMed  CAS  Google Scholar 

  • White, H. R., Pandina, R. J., & Chen, P. H. (2002). Developmental trajectories of cigarette use from early adolescence into young adulthood. Drug and Alcohol Dependence, 65(2), 167–178.

    Article  PubMed  Google Scholar 

  • Wilcox, P. (2003). An ecological approach to understanding youth smoking trajectories: Problems and prospects. Addiction, 98(Suppl 1), 57–77.

    Article  PubMed  Google Scholar 

  • Williams, G. C., Cox, E. M., Hedberg, V. A., & Deci, E. L. (2000). Extrinsic life goals and health-risk behaviors in adolescents. Journal of Applied Social Psychology, 30(8), 1756–1771.

    Google Scholar 

  • Wills, T. A., Sandy, J. M., & Yaeger, A. M. (2002). Stress and smoking in adolescence: A test of directional hypotheses. Health Psychology, 21(2), 122–130.

    Article  PubMed  Google Scholar 

  • Wingood, G. M., DiClemente, R. J., Harrington, K., & Davies, S. L. (2002). Body image and African American females’ sexual health. Journal of Women’s Health and Gender-Based Medicine, 11(5), 433–439.

    Article  PubMed  Google Scholar 

  • Woodruff, S. I., Candelaria, J. I., Kaniado-Laborín, R., Sallis, J. F., & Villasenor, A. (2003). Availability of cigarettes as a risk factor for trial smoking in adolescents. American Journal of Health Behavior, 27(1), 84–88.

    PubMed  Google Scholar 

  • Woodward, D. R., Cumming, F. J., Ball, P. J., Williams, H. M., & Hornsby, H. (1996). Adolescents’ reported usage of selected foods in relation to their perceptions and social norms for those foods. Appetite, 27, 109–117.

    Article  PubMed  CAS  Google Scholar 

  • Yarcheski, T. J., Mahon, N. E., & Yarcheski, A. (2003). Social support, self-esteem, and positive health practices of early adolescents. Psychological reports, 92, 99–103.

    Article  PubMed  Google Scholar 

  • Young, E. M., & Fors, S. W. (2001). Factors related to the eating habits of students in grades 9–12. Journal of School Health, 71, 483–488.

    Article  PubMed  CAS  Google Scholar 

  • Zweig, J. M., Phillips, S. D., & Duberstein Lindberg, L. (2002). Predicting adolescent profiles of risk: Looking beyond demographics. Journal of Adolescent Health, 31, 343–353.

    Article  PubMed  Google Scholar 

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Wiefferink, C.H., Peters, L., Hoekstra, F. et al. Clustering of Health-Related Behaviors and Their Determinants: Possible Consequences for School Health Interventions. Prev Sci 7, 127–149 (2006). https://doi.org/10.1007/s11121-005-0021-2

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