Distal and Proximal Factors of Health Behaviors and Their Associations with Health in Children and Adolescents

International Journal of Environmental Research and Public Health

Lena Lämmle³  Alexander Woll¹  Gert B. M. Mensink² 

[1] Karlsruhe Institute of Technology, Engler-Bunte-Ring 15 Geb. 40.40, Karlsruhe 76131, Germany; E-Mails:;Robert Koch Institute Berlin, Postfach 650261, Berlin 13302, Germany; E-Mail:;Technische Universität München, Georg-Brauchle-Ring 60/62, München 80992, Germany

关键词: psychosocial determinants;    health behavior;    objective health;    health complaints;    subjective health;   

DOI  :  10.3390/ijerph10072944

来源: mdpi

【 摘 要 】

Objective: The aim of the present paper was to analyze factors affecting distal and proximal health behavior within a biopsychosocial model for examining their interactions and associations with respect to health. Methods: Path analysis was based on the nationwide, cross-sectional German Health Interview and Examination Survey for Children and Adolescents (2003 to 2006). The data was collected from 4,529 participants with an average age of 9.45 years (SD = 4.01). Socio-demographic data, psychosocial factors and health behavior were assessed via questionnaire. Participants also underwent physical fitness tests and a medical examination. Results: Over the five levels of the model analyzed with socioeconomic status, immigration background, and rural-urban differences on the first level; physical activity of relatives and peers, intrinsic motivation, and quality of life on the second level; eating patterns, sedentary behavior, and physical activity on the third level; physical fitness and objective health on the fourth level; and health complaints and subjective health on the fifth level; direct, moderation, and mediation effects could be shown. Conclusions: Several distal and proximal factors are needed to take account of the multivariate complexity of health: e.g., immigration background affected health behaviors only indirectly and the effect of physical activity on objective health was mediated by physical fitness.

【 授权许可】

CC BY   
© 2013 by the authors; licensee MDPI, Basel, Switzerland.