Patterns of health behavior in U.S. adults
Abstract
Background Associations between health-related behaviors are important for two reasons. First, disease prevention and health promotion depend on understanding both prevalence of health behaviors and associations among such behaviors. Second, behaviors may have synergistic effects on disease risk.Methods We document patterns of adherence to recommendations concerning five behaviors (physical activity, tobacco use, alcohol consumption, fruit and vegetable consumption, and dietary fat intake) in U.S. adults (n = 15,425) using data from the Third National Health and Nutrition Examination Survey. Division of individuals into categories associated with adherence or nonadherence to lifestyle recommendations results in 32 patterns of adherence/nonadherence.Results Proportions of U.S. adults with 21 of 32 behavior patterns characterized here deviated from proportions expected if health behaviors are independent of each other. The two extreme patterns, all adherence (5.9%) and all nonadherence (4.9%), were found in about double the proportion expected. Age, gender, race/ethnicity, education, and income were associated with a number of patterns, including the two extremes.Conclusions This analysis of behavior patterns highlights population subgroups of public health importance, provides a benchmark for studies of multivariate associations between health behaviors, and supports a multidimensional model of health behavior.
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Health-risk behaviors cluster within people and groups.
“these highly prevalent HRBs are known to cluster within individuals and populations.27–29”
From Early life adversity and health-risk behaviors: Proposed psychological and neural mechanisms (2018) · cites this paper as [27]
Low adherence can skew interpretations of efficacy if it is not clearly measured and reported.
“Low adherence has clear implications for research and clinical practice, as it can: (i) skew interpretations of efficacy if not clearly measured and reported, and (ii) moderate intervention outcomes, with longer exposure to an intervention yielding greater benefits [20, 23-26].”
From Uptake and adherence to an online intervention for cancer-related distress: older age is not a barrier to adherence but may be a barrier to uptake (2017) · cites this paper as [25]
Low adherence can moderate intervention outcomes, with longer exposure to an intervention yielding greater benefits.
“Low adherence has clear implications for research and clinical practice, as it can: (i) skew interpretations of efficacy if not clearly measured and reported, and (ii) moderate intervention outcomes, with longer exposure to an intervention yielding greater benefits [20, 23-26].”
From Uptake and adherence to an online intervention for cancer-related distress: older age is not a barrier to adherence but may be a barrier to uptake (2017) · cites this paper as [25]
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- Authors
- Berrigan, D., Dodd, K., Troiano, R. P., Krebs-Smith, S. M., & Barbash, R. B.
- Affiliations
- National Institutes of Health (US)
- Corresponding author
- Berrigan, David
- Venue
- Preventive Medicine
- Publisher
- Elsevier BV
- Published
- 2003-05
- Volume
- 36
- Issue
- 5
- Pages
- 615-623
- ISSN
- 0091-7435 (ISSN-L)
- OpenAlex
- W2026395256
- Cited by
- 382
- References
- 52
- Citations by year
- 2026: 2 · 2025: 2 · 2024: 7 · 2023: 15 · 2022: 14 · 2021: 10 · 2020: 24 · 2019: 11 · 2018: 19 · 2017: 13 · 2016: 27 · 2015: 27 · 2014: 24 · 2013: 27 · 2012: 19
- FWCI
- 34.70
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Preventive Medicine (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Cancer Institute
- Topics
- Health Sciences › Health Professions › General Health Professions › Health and Lifestyle Studies
- Health Sciences › Health Professions › General Health Professions › Health and Wellbeing Research
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Health and Risk Factors
- Keywords
- health behavior patterns, lifestyle adherence, physical activity, tobacco use, alcohol consumption, fruit and vegetable intake, dietary fat intake, disease prevention, health promotion, sociodemographic differences
- MeSH terms
- Smoking Prevention, Adult, Alcohol Drinking, Demography, Ethnicity, Female, Fruit, Health Surveys, Humans, Life Style, Male, Patient Compliance, United States, Vegetables, Health Behavior, Exercise, Diet, Fat-Restricted
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