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20.17: Adolescent Lifestyle Choices

Skills to Develop

Research conducted by

Ka He, Ellen Kramer, Robert F. Houser, Virginia R. Chomitz, and Karen A. Hacker

Case study prepared by

Robert F. Houser, Alyssa Koomas, and Georgette Baghdady


Teen pregnancy, sexually transmitted disease, drug abuse, and suicide are some of the behaviorally-mediated negative health outcomes that can occur during adolescence.  Identifying the characteristics of adolescents who are able to make healthy lifestyle choices is imperative toward understanding positive health behaviors in this age group.  This information could be used to develop targeted interventions that support at-risk adolescents in making healthy lifestyle choices, and hopefully prevent such negative outcomes.

This study collected survey data from \(1487\) high school students in an urban Massachusetts community.  The survey assessed health-related behaviors, stressful events, demographics, familial characteristics, perceptions of peer and parental support, and academic performance.  In collaboration with community stakeholders and parents, the researchers selected six health-related behaviors and developed two sets of criteria to define positive health behaviors.  One set used “strict” definitions, namely, not drinking alcohol in the last \(30\) days, no attempted suicide in the past \(12\) months, and no experience at all with tobacco, hard illegal drugs, marijuana, and sexual partners.  The second set used “broad” definitions that allowed for mild use and safe experimentation (except for suicidal behavior).  Students who adhered to all six health-related behaviors according to the “strict” definitions formed one subgroup for analysis, and those who reported behaviors in accordance with the “broad” definitions formed another subgroup.  These two lifestyle subgroups were analyzed separately in relation to the personal and social-environmental factors assessed by the survey.

Questions to Answer

What personal and social-environmental characteristics are associated with adolescents who practice healthy lifestyle behaviors according to the “strict” definitions?  How much more likely are adolescents with these characteristics to be practicing healthy behaviors than adolescents without these characteristics?

Design Issues

The results of this study may not be applicable to adolescents in non-urban schools, as the sample was drawn from a diverse, urban school.  As well, the definitions that make up positive health behaviors may vary by region and social group.  Adolescents self-reported their health-related behaviors and other information via the survey.  Missing responses may have caused bias in the results.

Descriptions of Variables

Table \(\PageIndex{1}\): Description of Variables

Variable Description
Healthy behaviors based on the “strict” definitions

Whether or not the adolescent practices all 6 health-related behaviors according to the “strict” definitions

Immigration status

Whether the adolescent was born in the US or is an immigrant

Stress score

An index from 0 to 14 assessing 14 possible stressful events in the adolescent’s life, such as failing grades, moving, death in the family, divorce in the family, abuse, and violence

Stress index

Whether the adolescent’s stress score is at or above the median stress score of 2, or below

Academic performance

The adolescent’s average academic letter grade (A, B, C, D, F)


  • He, K., Kramer, E., Houser, R. F., Chomitz, V. R., Hacker, K. A. (2004). Defining and understanding healthy lifestyles choices for adolescents. Journal of Adolescent Health, 35, 26-33.


  • Online Statistics Education: A Multimedia Course of Study ( Project Leader: David M. Lane, Rice University.