Factors Predicting Health Risk Prevention Behaviors among Adolescents in Urban Communities

Abstract

Introduction Adolescence is a developmental stage characterized by significant physical, psychological, and social changes. During this period, adolescents are more likely to engage in health risk behaviors, which constitute a critical concern with long-term implications for overall well-being. This issue is particularly marked in urban communities, where complex social, cultural, and environmental dynamics are rapidly evolving. Investigating the predictive factors of health risk prevention behaviors among adolescents can provide valuable insights for developing effective strategies to reduce health risk behaviors in this population. 

Objectives The objectives of this research were to study: 1) the health risk prevention behaviors among adolescents in urban communities; 2) the level of health literacy among adolescents in urban communities; and 3) the factors predicting health risk prevention behaviors among adolescents in urban communities.

Design This study employed a descriptive predictive correlational design, applying the concept of social determinants of health as its theoretical framework. The World Health Organization defines social determinants of health as the conditions in which individuals are born, grow, work, and live, as well as the broader systems that shape daily life, including economic policies, social norms, social policies, and political structures. This perspective highlights the complexity of health problems and emphasizes the need for new paradigms in healthcare, with three key aspects: 1) recognition that the causes of disease and illness extend beyond individual-level factors such as genetics, physiology, or behavior; 2) consideration of holistic influences that affect health across the lifespan; and 3) emphasis on strengthening disease prevention rather than focusing solely on medical treatment. Understanding the social determinants of health provides a foundation for more effective approaches to promoting and protecting individual and population health.

Methodology The sample comprised 382 adolescents enrolled in educational institutions located in the Lak Si district of Bangkok. Participants were selected through multistage random sampling. Inclusion criteria were: 1) being between 13 and 19 years of age, and 2) obtaining parental consent and providing voluntary assent to participate in the study. Data were collected using a self-administered questionnaire consisting of four sections: 1) demographic information, 2) school health service system, 3) a health literacy assessment, and 4) an assessment of health risk prevention behaviors. Data analysis was conducted using descriptive statistics and multiple regression analysis.

Results More than half of the participants were female (55.20%), with a mean age of 15.78 years (SD = 1.73). The majority were enrolled in lower secondary education (59.00%) and reported a grade point average between 3.00 and 4.00 (58.10%). Most adolescents lived with their parents (75.70%), and close friends were identified as the most influential figures in their life decisions (54.90%). Regarding school health service systems, most institutions had policies promoting student health (94.2%), including smoke-free school policies (68.4%), activities to strengthen schools (71.2%), supportive health environments (86.9%), safe and hygienic cafeterias (63.4%), and provision of health information to students (90.6%). Overall, health literacy among participants was at a good level (M = 2.65, SD = 0.15). When examined by domain, all aspects of health literacy were rated good, except for the domain of creating health-related information and activities, which was rated moderate (M = 2.38, SD = 0.13). In contrast, preventive health-risk behaviors were generally poor (M = 1.52, SD = 0.08). By specific domains, only the “3E behaviors” (exercise, eating, and emotional management) were rated moderate (M = 2.22, SD = 0.12), while three domains were rated poor: avoidance of harmful substances (M = 1.11, SD = 0.06), social behaviors (M = 1.37, SD = 0.08), and sexual risk reduction behaviors (M = 1.37, SD = 0.08). Multiple regression analysis using the Enter method revealed that health literacy, educational level, and academic performance significantly predicted health risk prevention behaviors (F = 21.580, p < .001), accounting for 21.5% of the variance (Adjusted R² = 0.215). Health literacy was the strongest positive predictor (β = .620, p < .001), while educational level showed a negative influence (β = –.100, p = .023), and academic performance demonstrated a weak positive influence (β = .090, p = .032).

Recommendation Relevant governmental and private sectors may utilize the findings of this study to develop programs that promote modifiable social determinants of health, with particular emphasis on enhancing health literacy related to risk prevention among urban adolescents. Such initiatives aim to foster more appropriate health risk prevention behaviors among adolescents residing in urban communities.