Clustering of health-related behaviours among Saudi Arabian adolescents.
Doctoral thesis, UCL (University College London).
Background: There are few studies on the patterns of clustering of health-related behaviours among adolescents. Most of the studies have not adequately explored the clustering of a wide range of health-related behaviours. The very few studies examining the determinants and variations in the clustering of health-related behaviours among adolescents merely assessed the variations in the clustering of health-related behaviours by socio-demographic factors. Moreover, they did not use rigorous statistical methods. Objectives: To assess the distribution of six health-related behaviours, namely, intake of fruits, intake of sweets, toothbrushing, physical activity, smoking, and physical fighting, in Saudi Arabian male adolescents. To identify the patterns of clustering of the six health-related behaviours in Saudi Arabian male adolescents. To assess the variations of the clustering count of the six health-related behaviours by demographic and socioeconomic status factors. To identify the role of psychosocial determinants of the clustering count of the six health-related behaviours. The psychosocial determinants assessed were self-confidence, future orientation, life satisfaction, and peer relationships. Methods: A representative stratified cluster random sample of 1335 Saudi Arabian male adolescents living in Riyadh city took part in this study. A modified WHO questionnaire was used to assess health-related behaviours. Hierarchical Agglomerative Cluster Analysis (HACA) was used as a first step to identify broad clusters of the six health-compromising behaviours (HCBs). Then clustering was assessed using an observed to expected ratio (O/E) method for possible combinations of the six HCBs. Poisson regression models were constructed to assess variations between selected explanatory variables and clustering count of the six HCBs. Results: About 85% of adolescents had low fruit consumption, 74% brushed their teeth less frequently, 64% had low physical activity, 51% had been involved in physical fighting, 43% ate more sweets, and 23% smoked tobacco. Hierarchical Agglomerative Cluster Analysis suggested two broad and stable clusters of the six health-compromising behaviours among Saudi male adolescents; 1. The first cluster included low fruit consumption, less frequent toothbrushing and low physical activity. 2. The second cluster included high sweets consumption, smoking and physical fighting. There were more than sixty patterns of health-compromising behaviours among both younger and older adolescent boys. Most patterns with the highest O/E ratio included smoking behaviour. Older adolescents (17-19 years) were more likely to have a greater clustering count of HCBs (RR: 1.06; 95% CI: 1.01-1.13) compared to younger adolescents (13-14 years). Adolescents whose fathers’ education was up to secondary school or lower had a greater rate for clustering count of HCBs (RR: 1.07; 95% CI: 1.01-1.16) compared to those whose fathers completed higher education. There were no significant differences in clustering count of HCBs in relation to adolescents’ perceived self-confidence (RR: 1.05; 95% CI: 0.99-1.12) and future orientation (RR: 1.05; 95% CI: 0.98-1.13). Adolescents who had low levels of life satisfaction (RR: 1.20; 95%CI: 1.10-1.31) and those who had middle levels of life satisfaction (RR: 1.07; 95% CI: 1.00-1.16) had a greater rate of clustering of HCBs compared to those with a high level of life satisfaction. The clustering rate of HCBs was higher for each extra evening meeting with friends (RR: 1.03; 95%CI: 1.01-1.04). Conclusions: The six health-compromising behaviours clustered into two broad clusters. Most of the clustering patterns with the highest O/E ratio included smoking behaviour. Adolescents’ father’s education level and life satisfaction were significantly negatively associated with clustering of health-compromising behaviours. Age of adolescents and evening meetings with friends were significantly positively associated with clustering of health-compromising behaviours. There were no significant variations in the clustering of health-compromising behaviours with adolescents’ self-confidence and future orientation, after adjusting for age and father’s education level.
|Title:||Clustering of health-related behaviours among Saudi Arabian adolescents|
|UCL classification:||UCL > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Epidemiology and Health Care|
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