Prevention Science

, 7:127 | Cite as

Clustering of Health-Related Behaviors and Their Determinants: Possible Consequences for School Health Interventions

  • Carin H. Wiefferink
  • Louk Peters
  • Femke Hoekstra
  • Geert Ten Dam
  • Goof J. Buijs
  • Theo G. W. M. Paulussen

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.


health-related behaviors clustering determinants school health interventions smoking alcohol abuse safe sex nutrition 


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Copyright information

© Society for Prevention Research 2006

Authors and Affiliations

  • Carin H. Wiefferink
    • 1
    • 4
  • Louk Peters
    • 2
  • Femke Hoekstra
    • 1
  • Geert Ten Dam
    • 2
  • Goof J. Buijs
    • 3
  • Theo G. W. M. Paulussen
    • 1
  1. 1.TNO Quality of LifeLeidenThe Netherlands
  2. 2.University of AmsterdamAmsterdamThe Netherlands
  3. 3.Netherlands Institute For Health Promotion and Disease PreventionWoerdenThe Netherlands
  4. 4.TNO Quality of LifeLeidenThe Netherlands

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