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Patterns of health-related behaviours among adolescents: a cross-sectional study based on the National Survey of School Health Brazil 2012
  1. Catarina Machado Azeredo1,
  2. Renata Bertazzi Levy2,
  3. Maria Fernanda Tourinho Peres2,
  4. Paulo Rossi Menezes2,
  5. Ricardo Araya3
  1. 1School of Medicine—Federal University of Uberlandia (Faculdade de Medicina—Universidade Federal de Uberlândia), Uberlandia, Brazil
  2. 2School of Medicine—University of Sao Paulo (Faculdade de Medicina—Universidade de São Paulo), Sao Paulo, Brazil
  3. 3Department of Population Health, London School of Hygiene and Tropical Medicine, Centre for Global Mental Health, London, UK
  1. Correspondence to Professor Catarina Machado Azeredo; catarina{at}


Objectives The aim of this study was to analyse the clustering of multiple health-related behaviours among adolescents and describe which socio-demographic characteristics are associated with these patterns.

Design Cross-sectional study.

Setting Brazilian schools assessed by the National Survey of School Health (PeNSE, 2012).

Participants 104 109 Brazilian ninth-grade students from public and private schools (response rate=82.7%).

Methods Exploratory and confirmatory factor analyses were performed to identify behaviour clustering and linear regression models were used to identify socio-demographic characteristics associated with each one of these behaviour patterns.

Results We identified a good fit model with three behaviour patterns. The first was labelled ‘problem-behaviour’ and included aggressive behaviour, alcohol consumption, smoking, drug use and unsafe sex; the second was labelled ‘health-compromising diet and sedentary behaviours’ and included unhealthy food indicators and sedentary behaviour; and the third was labelled ‘health-promoting diet and physical activity’ and included healthy food indicators and physical activity. No differences in behaviour patterns were found between genders. The problem-behaviour pattern was associated with male gender, older age, more developed region (socially and economically) and public schools (compared with private). The ‘health-compromising diet and sedentary behaviours’ pattern was associated with female gender, older age, mothers with higher education level and more developed region. The ‘health-promoting diet and physical activity’ pattern was associated with male gender and mothers with higher education level.

Conclusions Three health-related behaviour patterns were found among Brazilian adolescents. Interventions to decrease those negative patterns should take into account how these behaviours cluster together and the individuals most at risk.

  • health-risk behaviours
  • adolescents
  • factor analysis
  • multiple risk behaviours

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  • Twitter Follow Maria Fernanda Peres at @none

  • Contributors CMA, RA, RBL, MFTP and PRM conceptualised the study. CMA, RA and RBL performed statistical analysis. CMA drafted the manuscript. All authors participated in the interpretation of the results and revised critically the manuscript. All authors read and approved the final manuscript.

  • Funding This work was supported by the Brazilian National Council of Scientific and Technological Development (Centro Nacional de Desenvolvimento Científico e Tecnológico—CNPq) no. 473502/2013-5 awarded to PRM.

  • Competing interests None declared.

  • Ethics approval National Commission of Research Ethics—Conep, record no. 16,805.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data sharing statement The original PeNSE data set is publicly available in:

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