Clustering of health-related behaviors and their determinants: possible consequences for school health interventions

Prev Sci. 2006 Jun;7(2):127-49. doi: 10.1007/s11121-005-0021-2. Epub 2006 Apr 5.


Characterizing school health promotion is its category-by-category approach, in which each separate health-related behavior is addressed independently. Such an approach creates a risk that extra-curricular activities become overloaded, and that teaching staff are distracted by continuous innovations. Within the health promotion sector there are thus increasing calls for an integrative approach to health-related behaviors. However, a meaningful integrative approach to different lifestyles will be possible only if there is some clustering of individual health-related behaviors and if health-related behaviors have a minimum number of determinants in common. This systematic review aims to identify to what extent the four health-related behaviors smoking, alcohol abuse, safe sex and healthy nutrition cluster; and how their determinants are associated. Potentially modifiable determinants that offer clues for an integrative approach of school health-promotion programs are identified. Besides, the direction in which health educators should look for a more efficient instructional design is indicated.

MeSH terms

  • Adolescent
  • Adult
  • Alcohol Drinking
  • Child
  • Cluster Analysis
  • Female
  • Health Behavior*
  • Humans
  • Male
  • Nutritional Physiological Phenomena
  • Safe Sex
  • School Health Services*
  • Smoking