Health-Promoting and Health-Risk Behaviors: Theory-Driven Analyses of Multiple Health Behavior Change in Three International Samples

Lippke, Sonia; Nigg, Claudio R.; Maddock, Jason E. (2012). Health-Promoting and Health-Risk Behaviors: Theory-Driven Analyses of Multiple Health Behavior Change in Three International Samples. International journal of behavioral medicine, 19(1), pp. 1-13. Springer 10.1007/s12529-010-9135-4

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Background: Co-occurrence of different behaviors was investigated using the theoretical underpinnings of the Transtheoretical Model, the Theory of Triadic Influence and the concept of Transfer.

Purpose: To investigate relationships between different health behaviors' stages of change, how behaviors group, and whether study participants cluster in terms of their behaviors.

Method: Relationships across stages for different behaviors were assessed in three studies with N = 3,519, 965, and 310 individuals from the USA and Germany by telephone and internet surveys using correlational analyses, factor analyses, and cluster analyses.

Results: Consistently stronger correlations were found between nutrition and physical activity (r = 0.16-0.26, p < 0.01) than between non-smoking and nutrition (r = 0.08-0.16, p < 0.03), or non-smoking and physical activity (r = 0.01-0.21). Principal component analyses of investigated behaviors indicated two factors: a "health-promoting" factor and a "health-risk" factor. Three distinct behavioral patterns were found in the cluster analyses.

Conclusion: Our results support the assumption that individuals who are in a higher stage for one behavior are more likely to be in a higher stage for another behavior as well. If the aim is to improve a healthy lifestyle, success in one behavior can be used to facilitate changes in other behaviors--especially if the two behaviors are both health-promoting or health-risky. Moreover, interventions should be targeted towards the different behavioral patterns rather than to single behaviors. This might be achieved by addressing transfer between behaviors.

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