Repository hosted by TU Delft Library

Home · Contact · About · Disclaimer ·

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

Publication files not online:

Author: Wiefferink, C.H. · Peters, L. · Hoekstra, F. · Ten Dam, G. · Buijs, G.J. · Paulussen, T.G.W.M.
Institution: TNO Kwaliteit van Leven
Source:Prevention Science, 2, 7, 127-149
Identifier: 239297
doi: doi:10.1007/s11121-005-0021-2
Keywords: Health · Alcohol abuse · Clustering · Determinants · Health-related behaviors · School health interventions · Cluster analysis · Drinking behavior · Nutrition · Adolescent · Adult · Alcohol Drinking · Child · Cluster Analysis · Female · Health Behavior · Humans · Male · Nutrition Physiology · Safe Sex · School Health Services · Smoking


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. © 2006 Society for Prevention Research.