THE COMPARISON OF HEALTH-RELATED BEHAVIORS BETWEEN OVERWEIGHT AND NON-OVERWEIGHT ADOLESCENTS
Date Issued
2005
Date
2005
Author(s)
Chen, Mei-Yen
DOI
en-US
Abstract
Background: Adolescent overweight is increasing all over the developed and developing countries. However, previous studies have generally not looked at the impact of cultural elements and health promotion behaviors on adolescents’ body size. Overweight or obesity is defined as the presence of excess adipose tissue. Most of the literature on etiology of obesity addressed biologic and environmental factors. Although the cause of overweight is complex and involves both genetic and environmental determinants, overweight essentially results from an imbalance of energy intake via diet and energy expenditure. Until now, it is not clear how changes in dietary intake or activity levels and other factors have contributed to recent increases in obesity.
Aims: The purpose of this study was to examine the following questions: (1) to test the construct and discriminated validity of Adolescent Health Promoting behaviors between the overweight and non-overweight adolescents through factor and cluster analysis; (2) to compare the differences of adolescent health promoting behaviors among the overweight and non-overweight adolescents; (3) to find out the factors that associated with the overweight/non-overweight adolescents’ health-related behavior and their body sizes.
Methods: The conceptual framework for this study built on Orem’s self-care deficit theory and Pender’s health-promoting model. Both of these theories lead this study to explore the differences of daily self-care ability in practicing health promoting behaviors and their environmental influences among different body size adolescents. The study was conducted in five junior middle schools and two high schools in Tao-Yuan County, Taiwan. Four of them were located in rural areas, the other three were in urban areas. The study samples consisted of 660 subjects, 351 boys and 309 girls. The instruments included the AHP scale, the height and weight scales and a demographic data sheet. Hypothesis was tested using categorical data analysis, factor analysis, cluster and discriminated analysis, and SAS CATMOD procedure of log-linear and logit model testing.
Results: Findings indicated that AHP was a valid and reliable scale to measure the health promoting behaviors between overweight and non-overweight subjects. Kaiser-Meyer-Olkin (KMO) measures and Bartlett’s sphericity test showed that the samples met the criteria for factor analysis. Factor analysis yielded a six-factor instrument, which explained 50.62% of the variance in the 40 items. The six factors were social support, life appreciation, health responsibility, nutritional behaviors, exercise behaviors and stress management. The Cronbach’s alpha reliability coefficient for the total scale was 0.936. Hierarchical and k-means cluster analyse revealed two distinct patterns of these non-overweight and overweight adolescents: healthy and unhealthy groups. The result of discriminant analysis also supported the two clusters of AHP at construct and discriminant validity scale that the non-overweight adolescents tended to be healthy group and overweight adolescents tended to be the unhealthy group. Overweight adolescents practiced in general significantly less frequent of practicing health-relate behaviors such as exercise behavior, stress management, life appreciation, health responsibility, and social support. While in comparison of the time spent on watching TV and using computer, they gained significant of higher frequency than their counterpart. Interestingly, the longer the time spent on watching TV or using computer, the less they practiced health promoting behaviors. Further the overweight adolescents tended to claim worse health status. Besides for health promoting behavior, other factors related to the adolescent overweight were having overweight parents, male, 8th grader, living in urban area, and with non Christian-related religion background. However, significantly relationship between parental educational level, family structure, ethnics and adolescent’s body size was not found. The log-linear model suggests that there is a direct association between TV watching, living location, health-promoting behavior, and body size. The relative likelihood of being non-overweight in those watching less TV was 1.6 times more than in those overweight watching TV, 1.4 times more likely in those living in a rural area than in those from an urban area, and 1.3 times more likely in those practicing healthy behaviors.
Conclusions: This findings support the hypotheses that adolescent health promoting scale could discriminate participants into two clusters among overweight and non-overweight adolescents. Overweight adolescent was significantly associated with less health promoting behavior. The strongest variables associated with adolescent overweight were (1) a high level of TV watching, (2) living in an urban area, and (3) less health-promoting behavior. These findings can be used to help professionals further develop and refine the knowledge and strategies for adolescent overweight management. Suggestions for professionals in primary health care, ethical and methodological issues were discussed in this paper as well.
Subjects
集群分析
邏輯線性模型
類別資料分析
使用電腦
看電視
健康促進行為
過重青少年
overweight adolescents
health promoting behaviors
watching TV
categorical analysis
using computer
cluster analysis
log-linear model
logit model
SDGs
Type
other
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