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Published in: BMC Public Health 1/2014

Open Access 01-12-2014 | Research article

Patterns of clustering of six health-compromising behaviours in Saudi adolescents

Authors: Saeed G Alzahrani, Richard G Watt, Aubrey Sheiham, Maria Aresu, Georgios Tsakos

Published in: BMC Public Health | Issue 1/2014

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Abstract

Background

Clustering of multiple health-compromising behaviours is associated with an increased risk of various chronic diseases. There are few studies on patterns of clustering of multiple health-compromising behaviours in adolescents. Therefore, the aim of this study is to assess how six health-compromising behaviours, namely, low fruit consumption, high sweet consumption, less frequent tooth brushing, low physical activity, physical fighting and smoking, cluster among Saudi male adolescents.

Methods

A representative stratified cluster random sample of 1,335 Saudi Arabian male adolescents living in Riyadh city answered a questionnaire on health-related behaviours. Hierarchical Agglomerative Cluster Analysis (HACA) was used to identify cluster solutions of the six health-compromising behaviours.

Results

HACA suggested two broad and stable clusters for the six health-compromising behaviours. The first cluster included low fruit consumption, less frequent tooth brushing and low physical activity. The second cluster included high sweets consumption, smoking and physical fighting.

Conclusions

The six health-compromising behaviours clustered into two conceptually distinct clusters among Saudi Arabian male adolescents, one reflecting non-adherence to preventive behaviours and the second undertaking of risk behaviours. Clustering of health behaviours has important implications for health promotion.
Appendix
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Literature
1.
go back to reference Patton GC, Coffey C, Sawyer SM, Viner RM, Haller DM, Bose K, Vos T, Ferguson J, Mathers CD: Global patterns of mortality in young people: a systematic analysis of population health data. Lancet. 2009, 374: 881-892. 10.1016/S0140-6736(09)60741-8.CrossRefPubMed Patton GC, Coffey C, Sawyer SM, Viner RM, Haller DM, Bose K, Vos T, Ferguson J, Mathers CD: Global patterns of mortality in young people: a systematic analysis of population health data. Lancet. 2009, 374: 881-892. 10.1016/S0140-6736(09)60741-8.CrossRefPubMed
2.
go back to reference Pate RR, Heath GW, Dowda M, Trost SG: Associations between physical activity and other health behaviors in a representative sample of US adolescents. Am J Public Health. 1996, 86: 1577-1581. 10.2105/AJPH.86.11.1577.CrossRefPubMedPubMedCentral Pate RR, Heath GW, Dowda M, Trost SG: Associations between physical activity and other health behaviors in a representative sample of US adolescents. Am J Public Health. 1996, 86: 1577-1581. 10.2105/AJPH.86.11.1577.CrossRefPubMedPubMedCentral
3.
go back to reference Coulson NS, Eiser C, Eiser JR: Diet, smoking and exercise: interrelationships between adolescent health behaviours. Child Care Health Dev. 1997, 23: 207-216. 10.1111/j.1365-2214.1997.tb00964.x.CrossRefPubMed Coulson NS, Eiser C, Eiser JR: Diet, smoking and exercise: interrelationships between adolescent health behaviours. Child Care Health Dev. 1997, 23: 207-216. 10.1111/j.1365-2214.1997.tb00964.x.CrossRefPubMed
4.
go back to reference Steele JL, McBroom WH: Conceptual and empirical dimensions of health behavior. J Health Soc Behav. 1972, 13: 382-392. 10.2307/2136830.CrossRefPubMed Steele JL, McBroom WH: Conceptual and empirical dimensions of health behavior. J Health Soc Behav. 1972, 13: 382-392. 10.2307/2136830.CrossRefPubMed
5.
6.
go back to reference Terre L, Drabman RS, Meydrech EF: Relationships among children's health-related behaviors: a multivariate, developmental perspective. Prev Med. 1990, 19: 134-146. 10.1016/0091-7435(90)90015-C.CrossRefPubMed Terre L, Drabman RS, Meydrech EF: Relationships among children's health-related behaviors: a multivariate, developmental perspective. Prev Med. 1990, 19: 134-146. 10.1016/0091-7435(90)90015-C.CrossRefPubMed
7.
go back to reference Roysamb E, Rse J, Kraft P: On the structure and dimensionality of health-related behaviour in adolescents. Psychol Health. 1997, 12: 437-452. 10.1080/08870449708406721.CrossRef Roysamb E, Rse J, Kraft P: On the structure and dimensionality of health-related behaviour in adolescents. Psychol Health. 1997, 12: 437-452. 10.1080/08870449708406721.CrossRef
8.
go back to reference Jessor R, Jessor SL: Problem behavior and psychosocial development: A longitudinal study of youth New York: Academic Press. 1977, New York: Academic Press Jessor R, Jessor SL: Problem behavior and psychosocial development: A longitudinal study of youth New York: Academic Press. 1977, New York: Academic Press
9.
go back to reference van Nieuwenhuijzen M, Junger M, Velderman MK, Wiefferink KH, Paulussen TWGM, Hox J, Reijneveld SA: Clustering of health-compromising behavior and delinquency in adolescents and adults in the Dutch population. Prev Med. 2009, 48: 572-578. 10.1016/j.ypmed.2009.04.008.CrossRefPubMed van Nieuwenhuijzen M, Junger M, Velderman MK, Wiefferink KH, Paulussen TWGM, Hox J, Reijneveld SA: Clustering of health-compromising behavior and delinquency in adolescents and adults in the Dutch population. Prev Med. 2009, 48: 572-578. 10.1016/j.ypmed.2009.04.008.CrossRefPubMed
10.
go back to reference Ottevaere C, Huybrechts I, Benser J, De Bourdeaudhuij I, Cuenca-Garcia M, Dallongeville J, Zaccaria M, Gottrand F, Kersting M, Rey-Lopez J, Manios Y, Molnar D, Moreno L, Smpokos E, Widhalm K, De Henauw S, the HELENA Study Group: Clustering patterns of physical activity, sedentary and dietary behavior among European adolescents: The HELENA study. BMC Public Health. 2011, 11: 328-338. 10.1186/1471-2458-11-328.CrossRefPubMedPubMedCentral Ottevaere C, Huybrechts I, Benser J, De Bourdeaudhuij I, Cuenca-Garcia M, Dallongeville J, Zaccaria M, Gottrand F, Kersting M, Rey-Lopez J, Manios Y, Molnar D, Moreno L, Smpokos E, Widhalm K, De Henauw S, the HELENA Study Group: Clustering patterns of physical activity, sedentary and dietary behavior among European adolescents: The HELENA study. BMC Public Health. 2011, 11: 328-338. 10.1186/1471-2458-11-328.CrossRefPubMedPubMedCentral
11.
go back to reference Busch V, Van Stel H, Schrijvers A, de Leeuw J: Clustering of health-related behaviors, health outcomes and demographics in Dutch adolescents: a cross-sectional study. BMC Public Health. 2013, 13: 1118-10.1186/1471-2458-13-1118.CrossRefPubMedPubMedCentral Busch V, Van Stel H, Schrijvers A, de Leeuw J: Clustering of health-related behaviors, health outcomes and demographics in Dutch adolescents: a cross-sectional study. BMC Public Health. 2013, 13: 1118-10.1186/1471-2458-13-1118.CrossRefPubMedPubMedCentral
12.
go back to reference Patterson RE, Haines PS, Popkin BM: Health lifestyle patterns of U.S. adults. Prev Med. 1994, 23: 453-460. 10.1006/pmed.1994.1062.CrossRefPubMed Patterson RE, Haines PS, Popkin BM: Health lifestyle patterns of U.S. adults. Prev Med. 1994, 23: 453-460. 10.1006/pmed.1994.1062.CrossRefPubMed
13.
go back to reference Raitakari OT, Leino M, Rakkonen K, Porkka KV, Taimela S, Rasanen L, Viikari JS: Clustering of risk habits in young adults. The cardiovascular risk in young Finns study. Am J Epidemiol. 1995, 142: 36-44.PubMed Raitakari OT, Leino M, Rakkonen K, Porkka KV, Taimela S, Rasanen L, Viikari JS: Clustering of risk habits in young adults. The cardiovascular risk in young Finns study. Am J Epidemiol. 1995, 142: 36-44.PubMed
14.
go back to reference Neumark-Sztainer D, Story M, French S, Cassuto N, Jacobs DR, Resnick MD: Patterns of health-compromising behaviors among Minnesota adolescents: sociodemographic variations. Am J Public Health. 1996, 86: 1599-1606. 10.2105/AJPH.86.11.1599.CrossRefPubMedPubMedCentral Neumark-Sztainer D, Story M, French S, Cassuto N, Jacobs DR, Resnick MD: Patterns of health-compromising behaviors among Minnesota adolescents: sociodemographic variations. Am J Public Health. 1996, 86: 1599-1606. 10.2105/AJPH.86.11.1599.CrossRefPubMedPubMedCentral
15.
go back to reference Wiefferink CH, Peters L, Hoekstra F, Dam GT, Buijs GJ, Paulussen TG: Clustering of health-related behaviors and their determinants: possible consequences for school health interventions. Prev Sci. 2006, 7: 127-149. 10.1007/s11121-005-0021-2.CrossRefPubMed Wiefferink CH, Peters L, Hoekstra F, Dam GT, Buijs GJ, Paulussen TG: Clustering of health-related behaviors and their determinants: possible consequences for school health interventions. Prev Sci. 2006, 7: 127-149. 10.1007/s11121-005-0021-2.CrossRefPubMed
16.
go back to reference 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.1999.0538.CrossRefPubMed 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.1999.0538.CrossRefPubMed
17.
go back to reference Khaw KT, Wareham N, Bingham S, Welch A, Luben R, Day N: Combined impact of health behaviours and mortality in Men and women: the EPIC-Norfolk prospective population study. PLoS Med. 2008, 5: e12-10.1371/journal.pmed.0050012.CrossRefPubMedPubMedCentral Khaw KT, Wareham N, Bingham S, Welch A, Luben R, Day N: Combined impact of health behaviours and mortality in Men and women: the EPIC-Norfolk prospective population study. PLoS Med. 2008, 5: e12-10.1371/journal.pmed.0050012.CrossRefPubMedPubMedCentral
18.
go back to reference Kelder SH, Perry CL, Klepp KI, Lytle LL: Longitudinal tracking of adolescent smoking, physical activity, and food choice behaviors. Am J Public Health. 1994, 84: 1121-1126. 10.2105/AJPH.84.7.1121.CrossRefPubMedPubMedCentral Kelder SH, Perry CL, Klepp KI, Lytle LL: Longitudinal tracking of adolescent smoking, physical activity, and food choice behaviors. Am J Public Health. 1994, 84: 1121-1126. 10.2105/AJPH.84.7.1121.CrossRefPubMedPubMedCentral
19.
go back to reference Lawlor DA, O'Callaghan MJ, Mamun AA, Williams GM, Bor W, Najman JM: 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: 862-868. 10.1097/01.psy.0000188576.54698.36.CrossRefPubMed Lawlor DA, O'Callaghan MJ, Mamun AA, Williams GM, Bor W, Najman JM: 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: 862-868. 10.1097/01.psy.0000188576.54698.36.CrossRefPubMed
20.
go back to reference Pate RR, Pratt M, Blair SN, Haskell WL, Macera CA, Bouchard C, Buchner D, Ettinger W, Heath GW, King AC, Kriska A, Leon AS, Marcus BH, Morris J, Paffenbarger RSJ, Patrick K, Pollock ML, Rippe JM, Sallis J, Wilmore JH: Physical activity and public health: a recommendation from the centers for disease control and prevention and the American college of sports medicine. JAMA. 1995, 273: 402-407. 10.1001/jama.1995.03520290054029.CrossRefPubMed Pate RR, Pratt M, Blair SN, Haskell WL, Macera CA, Bouchard C, Buchner D, Ettinger W, Heath GW, King AC, Kriska A, Leon AS, Marcus BH, Morris J, Paffenbarger RSJ, Patrick K, Pollock ML, Rippe JM, Sallis J, Wilmore JH: Physical activity and public health: a recommendation from the centers for disease control and prevention and the American college of sports medicine. JAMA. 1995, 273: 402-407. 10.1001/jama.1995.03520290054029.CrossRefPubMed
21.
go back to reference Dallongeville J, Marecaux N, Fruchart JC, Amouyel P: Cigarette smoking is associated with unhealthy patterns of nutrient intake: a meta-analysis. J Nutr. 1998, 128: 1450-1457.PubMed Dallongeville J, Marecaux N, Fruchart JC, Amouyel P: Cigarette smoking is associated with unhealthy patterns of nutrient intake: a meta-analysis. J Nutr. 1998, 128: 1450-1457.PubMed
22.
go back to reference Currie C, Gabhainn SN, Godeau E, Roberts C, Smith R, Currie D, Picket W, Richter M, Morgan A, Barnekow V: Inequalities in Young People's health, HBSC International Report from 2005/2006 Survey. 2008, Copenhagen, Denmark: WHO Regoinal Office For Europe Currie C, Gabhainn SN, Godeau E, Roberts C, Smith R, Currie D, Picket W, Richter M, Morgan A, Barnekow V: Inequalities in Young People's health, HBSC International Report from 2005/2006 Survey. 2008, Copenhagen, Denmark: WHO Regoinal Office For Europe
23.
go back to reference Park Y, Patton L, Kim H: Clustering of oral and general health risk behaviors in Korean adolescents: a national representative sample. J Adolesc Health. 2010, 47: 277-281. 10.1016/j.jadohealth.2010.02.003.CrossRefPubMed Park Y, Patton L, Kim H: Clustering of oral and general health risk behaviors in Korean adolescents: a national representative sample. J Adolesc Health. 2010, 47: 277-281. 10.1016/j.jadohealth.2010.02.003.CrossRefPubMed
24.
go back to reference Torabi MR, Bailey WJ, Majd-Jabbari M: Cigarette smoking as a predictor of alcohol and other drug Use by children and adolescents: evidence of the "gateway drug effect". J Sch Health. 1993, 63: 302-306. 10.1111/j.1746-1561.1993.tb06150.x.CrossRefPubMed Torabi MR, Bailey WJ, Majd-Jabbari M: Cigarette smoking as a predictor of alcohol and other drug Use by children and adolescents: evidence of the "gateway drug effect". J Sch Health. 1993, 63: 302-306. 10.1111/j.1746-1561.1993.tb06150.x.CrossRefPubMed
25.
go back to reference Pickett W, Craig W, Harel Y, Cunningham J, Simpson K, Molcho M, Mazur J, Dostaler S, Overpeck MD, Currie CE, on behalf of the HBSC Violence and Injuries Writing Group: Cross-national study of fighting and weapon carrying as determinants of adolescent injury. Pediatrics. 2005, 116: e855-e863. 10.1542/peds.2005-0607.CrossRefPubMed Pickett W, Craig W, Harel Y, Cunningham J, Simpson K, Molcho M, Mazur J, Dostaler S, Overpeck MD, Currie CE, on behalf of the HBSC Violence and Injuries Writing Group: Cross-national study of fighting and weapon carrying as determinants of adolescent injury. Pediatrics. 2005, 116: e855-e863. 10.1542/peds.2005-0607.CrossRefPubMed
26.
go back to reference Sosin DM, Koepsell TD, Rivara FP, Mercy JA: Fighting as a marker for multiple problem behaviors in adolescents. J Adolesc Health. 1995, 16: 209-215. 10.1016/1054-139X(94)00093-T.CrossRefPubMed Sosin DM, Koepsell TD, Rivara FP, Mercy JA: Fighting as a marker for multiple problem behaviors in adolescents. J Adolesc Health. 1995, 16: 209-215. 10.1016/1054-139X(94)00093-T.CrossRefPubMed
27.
go back to reference Kuntsche EN, Gmel G: Emotional wellbeing and violence among social and solitary risky single occasion drinkers in adolescence. Addiction. 2004, 99: 331-339. 10.1111/j.1360-0443.2004.00653.x.CrossRefPubMed Kuntsche EN, Gmel G: Emotional wellbeing and violence among social and solitary risky single occasion drinkers in adolescence. Addiction. 2004, 99: 331-339. 10.1111/j.1360-0443.2004.00653.x.CrossRefPubMed
28.
go back to reference WHO: Adolescent Friendly Health Services. 2002, Geneva: World Health Organisation WHO: Adolescent Friendly Health Services. 2002, Geneva: World Health Organisation
29.
go back to reference Currie C, Samdal O, Boyce W, Smith B: Health Behaviour in School-Aged Children: a World Health Organisation Cross-National Study. Research Protocol for the 2001/02 Survey. 2002, Copenhagen: WHO Regional Office for Europe Currie C, Samdal O, Boyce W, Smith B: Health Behaviour in School-Aged Children: a World Health Organisation Cross-National Study. Research Protocol for the 2001/02 Survey. 2002, Copenhagen: WHO Regional Office for Europe
30.
go back to reference Peters TJ, Eachus JI: Achieving equal probability of selection under various random sampling strategies. Paediatr Perinat Epidemiol. 1995, 9: 219-224. 10.1111/j.1365-3016.1995.tb00135.x.CrossRefPubMed Peters TJ, Eachus JI: Achieving equal probability of selection under various random sampling strategies. Paediatr Perinat Epidemiol. 1995, 9: 219-224. 10.1111/j.1365-3016.1995.tb00135.x.CrossRefPubMed
31.
go back to reference Beaton DE, Bombardier C, Guillemin F, Ferraz MB: Guidelines for the process of cross-cultural adaptation of self-report measures. Spine. 2000, 25: 3186-3191. 10.1097/00007632-200012150-00014.CrossRefPubMed Beaton DE, Bombardier C, Guillemin F, Ferraz MB: Guidelines for the process of cross-cultural adaptation of self-report measures. Spine. 2000, 25: 3186-3191. 10.1097/00007632-200012150-00014.CrossRefPubMed
32.
go back to reference Honkala S, Honkala E, Al-Sahli N: Do life- or school-satisfaction and self-esteem indicators explain the oral hygiene habits of schoolchildren?. Community Dent Oral Epidemiol. 2007, 35: 337-347. 10.1111/j.1600-0528.2006.00326.x.CrossRefPubMed Honkala S, Honkala E, Al-Sahli N: Do life- or school-satisfaction and self-esteem indicators explain the oral hygiene habits of schoolchildren?. Community Dent Oral Epidemiol. 2007, 35: 337-347. 10.1111/j.1600-0528.2006.00326.x.CrossRefPubMed
33.
go back to reference Prochaska JJ, Sallis JF, Long B: A physical activity screening measure for Use with adolescents in primary care. Arch Pediatr Adolesc Med. 2001, 155: 554-559. 10.1001/archpedi.155.5.554.CrossRefPubMed Prochaska JJ, Sallis JF, Long B: A physical activity screening measure for Use with adolescents in primary care. Arch Pediatr Adolesc Med. 2001, 155: 554-559. 10.1001/archpedi.155.5.554.CrossRefPubMed
34.
go back to reference Brener ND, Collins JL, Kann L, Warren CW, Williams BI: Reliability of the youth risk behavior survey questionnaire. Am J Epidemiol. 1995, 141: 575-580.PubMed Brener ND, Collins JL, Kann L, Warren CW, Williams BI: Reliability of the youth risk behavior survey questionnaire. Am J Epidemiol. 1995, 141: 575-580.PubMed
35.
go back to reference Borgen FH, Barnett DV: Applying cluster analysis in counseling psychology research. J Couns Psychol. 1987, 34: 456-468.CrossRef Borgen FH, Barnett DV: Applying cluster analysis in counseling psychology research. J Couns Psychol. 1987, 34: 456-468.CrossRef
36.
go back to reference Everitt BS, Landau S, Leese M: Cluster Analysis. 2001, London: Arnold, 4 Everitt BS, Landau S, Leese M: Cluster Analysis. 2001, London: Arnold, 4
37.
go back to reference Clatworthy J, Buick D, Hankins M, Weinman J, Horne R: The use and reporting of cluster analysis in health psychology: a review. Br J Health Psychol. 2005, 10: 329-358. 10.1348/135910705X25697.CrossRefPubMed Clatworthy J, Buick D, Hankins M, Weinman J, Horne R: The use and reporting of cluster analysis in health psychology: a review. Br J Health Psychol. 2005, 10: 329-358. 10.1348/135910705X25697.CrossRefPubMed
38.
go back to reference Sanchez A, Norman GJ, Sallis JF, Calfas KJ, Cella J, Patrick K: Patterns and correlates of physical activity and nutrition behaviors in adolescents. Am J Prev Med. 2007, 32: 124-130. 10.1016/j.amepre.2006.10.012.CrossRefPubMed Sanchez A, Norman GJ, Sallis JF, Calfas KJ, Cella J, Patrick K: Patterns and correlates of physical activity and nutrition behaviors in adolescents. Am J Prev Med. 2007, 32: 124-130. 10.1016/j.amepre.2006.10.012.CrossRefPubMed
39.
go back to reference Alamian A, Paradis G: Clustering of chronic disease behavioral risk factors in Canadian children and adolescents. Prev Med. 2009, 48: 493-499. 10.1016/j.ypmed.2009.02.015.CrossRefPubMed Alamian A, Paradis G: Clustering of chronic disease behavioral risk factors in Canadian children and adolescents. Prev Med. 2009, 48: 493-499. 10.1016/j.ypmed.2009.02.015.CrossRefPubMed
40.
go back to reference Mistry R, McCarthy WJ, Yancey AK, Lu Y, Patel M: Resilience and patterns of health risk behaviors in California adolescents. Prev Med. 2009, 48: 291-297. 10.1016/j.ypmed.2008.12.013.CrossRefPubMed Mistry R, McCarthy WJ, Yancey AK, Lu Y, Patel M: Resilience and patterns of health risk behaviors in California adolescents. Prev Med. 2009, 48: 291-297. 10.1016/j.ypmed.2008.12.013.CrossRefPubMed
41.
go back to reference Pearson N, Atkin A, Biddle S, Gorely T, Edwardson C: Patterns of adolescent physical activity and dietary behaviours. Int J Behav Nutr Phys Act. 2009, 2009: 34-CrossRef Pearson N, Atkin A, Biddle S, Gorely T, Edwardson C: Patterns of adolescent physical activity and dietary behaviours. Int J Behav Nutr Phys Act. 2009, 2009: 34-CrossRef
42.
go back to reference Schou L, Currie C, McQueen D: Using a "lifestyle" perspective to understand toothbrushing behaviour in Scottish schoolchildren. Community Dent Oral Epidemiol. 1990, 18: 230-234. 10.1111/j.1600-0528.1990.tb00065.x.CrossRefPubMed Schou L, Currie C, McQueen D: Using a "lifestyle" perspective to understand toothbrushing behaviour in Scottish schoolchildren. Community Dent Oral Epidemiol. 1990, 18: 230-234. 10.1111/j.1600-0528.1990.tb00065.x.CrossRefPubMed
43.
go back to reference Jessor R: Risk behavior in adolescence: a psychosocial framework for understanding and action. J Adolesc Health. 1991, 12: 597-605. 10.1016/1054-139X(91)90007-K.CrossRefPubMed Jessor R: Risk behavior in adolescence: a psychosocial framework for understanding and action. J Adolesc Health. 1991, 12: 597-605. 10.1016/1054-139X(91)90007-K.CrossRefPubMed
44.
go back to reference Harris DM, Guten S: Health-protective behavior: an exploratory study. J Health Soc Behav. 1979, 20: 17-29. 10.2307/2136475.CrossRefPubMed Harris DM, Guten S: Health-protective behavior: an exploratory study. J Health Soc Behav. 1979, 20: 17-29. 10.2307/2136475.CrossRefPubMed
45.
go back to reference Brener ND, Billy JOG, Grady WR: Assessment of factors affecting the validity of self-reported health-risk behavior among adolescents: evidence from the scientific literature. J Adolesc Health. 2003, 33: 436-457. 10.1016/S1054-139X(03)00052-1.CrossRefPubMed Brener ND, Billy JOG, Grady WR: Assessment of factors affecting the validity of self-reported health-risk behavior among adolescents: evidence from the scientific literature. J Adolesc Health. 2003, 33: 436-457. 10.1016/S1054-139X(03)00052-1.CrossRefPubMed
46.
go back to reference MacCallum RC, Zhang S, Preacher KJ, Rucker DD: On the practice of dichotomization of quantitative variables. Psychol Methods. 2002, 7: 19-40.CrossRefPubMed MacCallum RC, Zhang S, Preacher KJ, Rucker DD: On the practice of dichotomization of quantitative variables. Psychol Methods. 2002, 7: 19-40.CrossRefPubMed
47.
go back to reference Nigg CR, Allegrante JP, Ory M: Theory-comparison and multiple-behavior research: common themes advancing health behavior research. Health Educ Res. 2002, 17: 670-679. 10.1093/her/17.5.670.CrossRefPubMed Nigg CR, Allegrante JP, Ory M: Theory-comparison and multiple-behavior research: common themes advancing health behavior research. Health Educ Res. 2002, 17: 670-679. 10.1093/her/17.5.670.CrossRefPubMed
48.
go back to reference de Vries H, van't Riet J, Spigt M, Metsemakers J, van den Akker M, Vermunt JK, Kremers S: Clusters of lifestyle behaviors: results from the Dutch SMILE study. Prev Med. 2008, 46: 203-208. 10.1016/j.ypmed.2007.08.005.CrossRefPubMed de Vries H, van't Riet J, Spigt M, Metsemakers J, van den Akker M, Vermunt JK, Kremers S: Clusters of lifestyle behaviors: results from the Dutch SMILE study. Prev Med. 2008, 46: 203-208. 10.1016/j.ypmed.2007.08.005.CrossRefPubMed
49.
go back to reference Sheiham A, Watt RG: The common risk factor approach: a rational basis for promoting oral health. Community Dent Oral Epidemiol. 2000, 28: 399-406. 10.1034/j.1600-0528.2000.028006399.x.CrossRefPubMed Sheiham A, Watt RG: The common risk factor approach: a rational basis for promoting oral health. Community Dent Oral Epidemiol. 2000, 28: 399-406. 10.1034/j.1600-0528.2000.028006399.x.CrossRefPubMed
Metadata
Title
Patterns of clustering of six health-compromising behaviours in Saudi adolescents
Authors
Saeed G Alzahrani
Richard G Watt
Aubrey Sheiham
Maria Aresu
Georgios Tsakos
Publication date
01-12-2014
Publisher
BioMed Central
Published in
BMC Public Health / Issue 1/2014
Electronic ISSN: 1471-2458
DOI
https://doi.org/10.1186/1471-2458-14-1215

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