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Health Risk Behaviors and Self-Esteem Among College Students: Systematic Review of Quantitative Studies

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Abstract

Background

Due to their impact on premature mortality and long-term disabilities, a better understanding of health risk behavior (HRB) determinants among college students is crucial in order to build the most appropriate prevention tools. Although self-esteem appears to be a relevant candidate, a clear picture summarizing its multiple links with HRB is lacking to guide clinicians and researchers. This study aims to provide a systematic review of the associations between health risk behavior and self-esteem among college students.

Methods

This search was performed in several databases on 02/02/17. Study eligibility criteria were original articles in peer-reviewed journals, in English; observational quantitative studies; among college students; and investigated the association between self-esteem and HRB. The PRISMA statements were complied with.

Results

One hundred fifteen articles were included: 46 on substance use, 35 on sexual behavior, 11 on nutritional habits, 27 on physical activity, and 5 on other HRB. Most studies reported an association between higher self-esteem and healthier behavior. For alcohol consumption and number of sexual partners, both negative and positive associations have been reported. Directionality was investigated in a few studies suggesting potential bidirectional effects.

Conclusions

This review points out the need for consensus for the definition of self-esteem and HRB. There was high heterogeneity in (1) the measurement of self-esteem either in the concept measured (global vs. domain) or in the way to implement validated tools; and (2) the definition of HRB. Self-esteem seems to be a relevant target to intervene on HRB, especially alcohol abuse and physical activity.

Trial Registration

Registration number: PROSPERO (ID = CRD42017056599).

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Acknowledgments

The authors are indebted to the staff of the libraries of the University of Bordeaux for their support to find all the references. We are grateful for the help provide by Emmanuelle Floch-Galaud and Coralie Thore Thibaud for their advices about search strategy and the algorithms.

Funding

The i-Share research project supported this research. It has received funding from the French National Research Agency (Agence Nationale de la Recherche, ANR) via the program ‘Investissements d’Avenir’ reference ANR-10-COHO-05. This study was further supported by a grant from the Excellence Cluster ‘Health Determinants in Societies’ HEADS of the University of Bordeaux, managed by the ANR, under the ‘Future Investments’ program in the framework of the Bordeaux ‘Initiatives d’excellence’ (IdEx) program, grant number (ANR-10-IDEX-03-02). Ministry of Higher Education, of Research and Innovation and the Public Health Doctoral Network are the funders of Julie Arsandaux’s PhD.

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Arsandaux, J., Montagni, I., Macalli, M. et al. Health Risk Behaviors and Self-Esteem Among College Students: Systematic Review of Quantitative Studies. Int.J. Behav. Med. 27, 142–159 (2020). https://doi.org/10.1007/s12529-020-09857-w

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