Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2013 Jul 16;10(7):2944-78.
doi: 10.3390/ijerph10072944.

Distal and proximal factors of health behaviors and their associations with health in children and adolescents

Lena Lämmle  1 , Alexander Woll, Gert B M Mensink, Klaus Bös
Affiliations

Distal and proximal factors of health behaviors and their associations with health in children and adolescents

Lena Lämmle et al. Int J Environ Res Public Health. .

Abstract

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.

PubMed Disclaimer

Figures

Figure 1
Figure 1
Biopsychosocial model.
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. Hallal P.C., Victora C.G., Azevedo M.R., Wells J.C.K. Adolescent physical activity and health. Sports Med. 2006;36:1019–1030. doi: 10.2165/00007256-200636120-00003. - DOI - PubMed
    1. Hills A.P., King N.A., Armstrong T.P. The contribution of physical activity and sedentary behaviors to the growth and development of children and adolescents: Implications for overweight and obesity. Sports Med. 2007;37:533–545. doi: 10.2165/00007256-200737060-00006. - DOI - PubMed
    1. Spear B.A., Barlow S.E., Ervin C., Ludwig D.S., Saelens B.E., Schetzina K.E., Taveras E.M. Recommendations for treatment of child and adolescent overweight and obesity. Pediatrics. 2007;120:254–288. doi: 10.1542/peds.2007-2329F. - DOI - PubMed
    1. St-Onge M.P., Keller K.L., Heymsfield S.B. Changes in childhood food consumption patterns: A cause for concern in light of increasing body weights. Am. J. Clin. Nutr. 2003;78:1068–1073. - PubMed
    1. Whitaker R.C., Wright J.A., Pepe M.S., Seidel K.D., Dietz W.H. Predicting obesity in young adulthood from childhood and parental obesity. N. Engl. J. Med. 1997;337:869–873. doi: 10.1056/NEJM199709253371301. - DOI - PubMed

Publication types

LinkOut - more resources