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Health-promoting lifestyle profile and associated factors among medical students in a Saudi university
Open accessAbstract
Objectives: Health promotion is the main strategy for encouraging people to adopt a healthy lifestyle and for preventing non-communicable diseases. Medical students, in particular, are expected to have an important role in health promotion in their near future as physicians. The aim of this study was to determine and evaluate all six components of the Health-Promoting Lifestyle Profile and its sociodemographic determinants among medical students. Methods: A cross-sectional descriptive study was conducted in January 2018 in Jeddah, Saudi Arabia. The questionnaire used in this study consisted of two parts: the first part included sociodemographic questions and body mass index measurement and the second part consisted of questions from the Health-Promoting Lifestyle Profile II. Results: The study enrolled 243 medical students, of which 55.1% were male, 39.5% were in their fifth year, and more than half had a monthly family income above 20,000 Saudi Riyal. The mean body mass index of the respondents was 25.1 ± 5.2 (range = 13.7–43.8). The total mean score of the Health-Promoting Lifestyle Profile II was 123.8 ± 19.8 (range = 72–191). Study findings showed that health-promoting profiles differed by gender, particularly with respect to physical activity and interpersonal relationships. Factors were found to be associated with the Health-Promoting Lifestyle Profile II subscales, including income and year of study. Conclusions: University students, and in particular health science students, represent an appropriate area for health promotion interventions to be established.
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TL;DR
In a cross-sectional survey of 243 clinical-phase medical students at King Abdulaziz University, the mean Health-Promoting Lifestyle Profile II score was 123.8 ± 19.8, with spiritual growth highest and physical activity lowest. Gender, year of study, income, and BMI were variously associated with HPLP II subscales, though overall HPLP II did not differ significantly by most sociodemographic factors.
Key findings
- Among 243 medical students (55.1% male; mean age 21.6 ± 1.0 years; mean BMI 25.1 ± 5.2), the total HPLP II mean score was 123.8 ± 19.8 (range = 72–191), falling in the moderate range (91–129); Cronbach’s alpha was 0.91.
- The highest subscale mean was spiritual growth (25.5 ± 4.9), while the lowest was physical activity (16.7 ± 5.3).
- Male students had significantly higher physical activity scores than female students (17.67 ± 5.5 vs. 15.59 ± 4.8; p = 0.002) and significantly higher stress management scores (19.41 ± 3.5 vs. 18.33 ± 3.9; p = 0.03).
- Year of study was significantly associated with stress management (p = 0.03); higher monthly family income was significantly associated with higher interpersonal relationships scores (p = 0.03); BMI was negatively correlated with interpersonal relationships (r = −0.150, p = 0.020). No significant correlations were observed between total HPLP II score and BMI or age.
Methods
- A descriptive cross-sectional study was conducted in January 2018 among fourth-, fifth-, and sixth-year medical students at King Abdulaziz University, Jeddah, Saudi Arabia; students with chronic medical diagnoses or in an exam period were excluded.
- Using stratified sampling and proportional allocation, 243 of 1,100 clinical-phase students were enrolled; the questionnaire included sociodemographic items, BMI measurement, and the 52-item HPLP II with six subscales scored on a 1–4 Likert scale.
- Data were analyzed with SPSS version 23 using descriptive statistics, Cronbach’s alpha, independent samples t tests and ANOVA for gender, year of study, monthly income, and smoking status, and Pearson correlations for age and BMI.
Limitations
- The paper states that students were enrolled from one university only, that findings cannot be generalized to all medical students in the country or to students in other fields, and that the self-reported questionnaire may not reflect reality.
- Evident from the text: the cross-sectional design cannot establish causality or temporal ordering between associated factors and health-promoting behaviors.
- Evident from the text: some narrative results conflict with table values (for example, gender t statistics and the direction of the year-of-study association with stress management), so specific effect estimates should be interpreted cautiously.
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- Findingown data
Male medical students had significantly higher HPLP II physical activity scores than female students.
“Regarding gender, male students had significantly higher scores than female students in physical activity and stress management.”
Quote in the paperNot a substantial claim - Findingown data
Among medical students, the highest HPLP II subscale mean was spiritual growth (25.5 ± 4.9).
“the highest mean in the subscales was 25.5 ± 4.9 for spiritual growth and the lowest was 16.7 ± 5.3 for physical activity.”
- Also stated in: § Results · plain
“Spiritual growth | 25.5 | 4.9 | 10 | 36 | 9–36”
Quote in the paperNot a substantial claim - Also stated in: § Results · plain
- Findingown data
Among medical students, the lowest HPLP II subscale mean was physical activity (16.7 ± 5.3).
“the highest mean in the subscales was 25.5 ± 4.9 for spiritual growth and the lowest was 16.7 ± 5.3 for physical activity.”
- Also stated in: § Results · plain
“Physical activity | 16.7 | 5.3 | 8 | 32 | 8–32”
Quote in the paperNot a substantial claim - Also stated in: § Results · plain
- Findingown data
The total mean HPLP II score among medical students was 123.8 ± 19.8 (range 72-191).
“The total mean score of the Health-Promoting Lifestyle Profile II was 123.8 ± 19.8 (range = 72–191).”
- Also stated in: § Results · plain
“The HPLP II total mean score was 123.8 ± 19.8 (range = 72–191), and the highest mean in the subscales was 25.5 ± 4.9 for spiritual growth and the lowest was 16.7 ± 5.3 for physical activity.”
Quote in the paperNot a substantial claim - Also stated in: § Results · plain
- Findingown data
Higher monthly family income was significantly associated with higher interpersonal relationships scores among medical students.
“Higher income was significantly associated with a higher score on interpersonal relationships; BMI was negatively associated with interpersonal relationships.”
Quote in the paperNot a substantial claim
- Findingown data
BMI was negatively associated with interpersonal relationships scores among medical students.
“the Pearson’s correlation results showed a statistically significant negative correlation between students’ BMI and interpersonal relationships only.”
- Also stated in: § Results · plain
“BMI was negatively associated with interpersonal relationships.”
Quote in the paperNot a substantial claim - Also stated in: § Results · plain
- Findingown data
Male medical students had significantly higher HPLP II stress management scores than female students.
“Regarding gender, male students had significantly higher scores than female students in physical activity and stress management.”
Quote in the paperNot a substantial claim - Findingown data
Year of university study was significantly associated with stress management scores among medical students.
“There was a significant association between year of university study and stress management; fourth-year students had the highest scores.”
Quote in the paperNot a substantial claim - Findingown data
Fourth-year medical students had the highest stress management scores.
“There was a significant association between year of university study and stress management; fourth-year students had the highest scores.”
Quote in the paperNot a substantial claim - Findingown data
No significant correlations were observed between HPLP II total score and BMI or age among medical students.
“No significant correlations were observed between HPLP score and BMI or age.”
Quote in the paperNot a substantial claim - Findingown data
There was no significant difference between male and female medical students in overall HPLP II scores.
“the average score for male students was better than that for female students in the areas of health responsibility, nutrition, spiritual growth, stress management subscales, and overall HPLP II, but with no significant differences.”
Quote in the paperNot a substantial claim - Interpretationown data
Health-promoting behaviors differed by gender, particularly with respect to physical activity and interpersonal relationships.
“Study findings showed that health-promoting profiles differed by gender, particularly with respect to physical activity and interpersonal relationships.”
- Also stated in: § Conclusion · plain
“Health-promoting behaviors differed by gender, particularly with respect to physical activity and interpersonal relationships.”
Quote in the paperSubstantial claim - Also stated in: § Conclusion · plain
- Study design and conductown data
The HPLP II had excellent internal consistency in this sample, with Cronbach's alpha 0.91.
“Overall reliability was found to be excellent, with Cronbach’s alpha at 0.91.”
Quote in the paperNot a substantial claim - Premisecitation
There are no health-promoting proceedings directed to medical students.
“while medical students, who are expected to deal with rigorous study schedules, are taught about health, there are no health-promoting proceedings directed to them.11”
Quote in the paperSubstantial claim0 of 1 sources checked- cites [11] Chouhan S. Analysing health promoting life styles of medical students in Bhopal, Madhya Pradesh, India by HPLP-II. Int J Commun Med Public Health 2016; 4(1): 195– 199. source
- Interpretationown data
Theoretical learning may not always be reflected in behavior.
“These results suggest that theoretical learning may not always be reflected in behavior.”
Quote in the paperNot a substantial claim - Interpretationreasoning
The study's findings cannot be generalized to students in other fields because the study concerned only medical students.
“Furthermore, the study concerned only medical students; therefore, its findings cannot be generalized to students in other fields.”
Quote in the paperNot a substantial claim - Interpretationreasoning
The study's results cannot be generalized to the total population of medical students in the country because students were enrolled from one university only.
“Students were enrolled from one university only; thus, the results cannot be generalized to the total population of medical students in the country.”
Quote in the paperSubstantial claim
- It may state two separate claims as one. 5
- Probably not a substantial claim. 5
It may state two separate claims as one.
Findingown dataAge was negatively correlated with overall HPLP II and all six subscales, but the correlations were not significant.
“the Pearson’s correlation results showed negative correlations between the students’ age and the overall HPLP II scale and all six subscales, with no significant differences”
Quote in the paperNot a substantial claimIt may state two separate claims as one.
Findingown dataMarital status, nationality, parents' marital status, residency, living arrangements, number of rooms, and number of siblings were not significantly associated with HPLP II total or subscale scores.
“no significant difference was found in total HPLP II scores and the mean scores of the subscales related to marital status, nationality, parents’ marital status, residency, living arrangements, number of rooms, or number of brothers and sisters.”
Quote in the paperNot a substantial claimIt may state two separate claims as one.
Findingown dataFemale medical students had higher interpersonal relationships scores than male students, but the difference was not significant.
“the average score of female students was better than male students in interpersonal relationships, but also with no significant difference.”
Quote in the paperNot a substantial claimProbably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
Study design and conductown dataThe study used a calculated sample size of 243 out of 1100 eligible students, using stratified sampling and proportional allocation.
“Using a stratified sampling and proportional allocation, the calculated sample was 243 out of 1100 students in the clinical phase of the curriculum. This was calculated using Raosoft19 software (Raosoft, Seattle, WA, USA) and the single proportion method.”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites [19] Roasoft. Online Roasoft sample size calculator. 2016, http://www.raosoft.com/samplesize.html
Probably not a substantial claim. The paper’s conclusions may not depend on it.
InterpretationreasoningParticipants' responses to the self-reported questionnaire may not reflect reality.
“For data collection, a self-reported questionnaire was used; thus, participants’ responses may not reflect reality.”
Quote in the paperNot a substantial claimProbably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
PremisecitationThe original HPLP II overall scale had a Cronbach's alpha of 0.94, and its six subscales ranged from 0.79 to 0.87.
“The overall scale of the original version of the HPLP II reported a Cronbach’s alpha of 0.94, and for the six subscales, it ranged from 0.79 to 0.87.3”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites [3] Walker SN Sechrist KR Pender NJ. The health-promoting lifestyle profile: development and psychometric characteristics. Nurs Res 1987; 36(2): 76– 81. 3644262 source
Probably not a substantial claim. It may be too vague to check against evidence.
PremisecitationThe adoption and practice of a healthy lifestyle by medical students is critical for them to be role models and influence patients and the general population.
“The adoption and practice of a healthy lifestyle by medical students is critical for them to be role models and have the ability to influence their patients and the general population.10”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites [10] Rush KL Kee CC Rice M. Nurses as imperfect role models for health promotion. West J Nurs Res 2005; 27(2): 166– 183. 15695573
Probably not a substantial claim.
PremisecitationHealth-promoting behaviors include six components: health responsibility, physical activity, nutrition, stress management, self-actualization, and interpersonal relationships.
“Health-promoting behaviors include six components: health responsibility, physical activity, nutrition, stress management, self-actualization, and interpersonal relationships.3”
Quote in the paperSubstantial claim0 of 1 sources checked- cites [3] Walker SN Sechrist KR Pender NJ. The health-promoting lifestyle profile: development and psychometric characteristics. Nurs Res 1987; 36(2): 76– 81. 3644262 source
The paper relies on this without support.
Few studies have explored the Health-Promoting Lifestyle Profile (HPLP) among medical students, and literature from the Arab region for this particular group is even more scarce.
“Despite the importance of this issue, few studies have explored the Health-Promoting Lifestyle Profile (HPLP) among medical students, and literature from the Arab region for this particular group is even more scarce.”
The paper relies on this without support.
Medical students are expected to play a key role in health promotion in their near future as physicians.
“medical students are specifically expected to play a key role in health promotion in their near future as physicians.”
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
Evidence indicates differences in health-promoting behaviors by gender, with lower scores observed particularly among women.
“Studying measurement invariance based on sociodemographic characteristics is essential, as evidence indicates differences in the adoption of health-promoting behaviors between urban and rural contexts [37], as well as by gender, with lower scores observed particularly among women [40, 41].”
From Psychometric validation and measurement invariance of the Health-Promoting Lifestyle Profile II in Honduran university students (2025) · cites this paper as [40]
The Results report that male medical students scored significantly higher than female students on physical activity and stress management. This supports lower scores among women on those subscales, but not a general claim that women had lower health-promoting behavior scores overall; the Discussion notes that women scored slightly higher on interpersonal relationships, though the difference was not significant. (LLM, conf=0.85)
Experimental — accuracy not yet measured
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
Each contradiction between two passages listed here was confirmed by an independent check.
Claimed significant smoking difference conflicts with Table 4
MajorThe text claims a significant spiritual-growth difference by smoking status, but Table 4 reports p = 0.57 for that comparison.
“the results showed that non-smokers had significantly better mean scores than smokers and ex-smokers in the area of spiritual growth (t = 2.9; p\0.04)”
“| F | 0.9 | 0.9 | 1.1 | 0.6 | 1.9 | 0.4 | 1.2 | | p | 0.44 | 0.46 | 0.33 | 0.57 | 0.13 | 0.73 | 0.31 |”
Fourth-year students are called highest in stress management but score lowest
MajorThe results summary says fourth-year students had the highest stress-management scores, whereas Table 4 gives them 17.81, below fifth-year students' 18.93 and sixth-year students' 19.55.
“There was a significant association between year of university study and stress management; fourth-year students had the highest scores.”
“| Fourth | 17.43 ± 3.8 | 17.50 ± 5.3 | 21.30 ± 3.7 | 25.07 ± 5.3 | 22.92 ± 3.9 | 17.81 ± 3.8 | 122.06 ± 18.4 | | Fifth | 18.08 ± 4.8 | 16.00 ± 5.2 | 20.88 ± 3.9 | 25.38 ± 4.6 | 23.15 ± 4.0 | 18.93 ± 3.6 | 122.55 ± 19.3 | | Sixth | 18.19 ± 4.6 | 17.15 ± 5.3 | 21.55 ± 4.2 | 25.85 ± 5.1 | 23.95 ± 5.1 | 19.55 ± 3.7 | 126.26 ± 20.8 |”
Conclusion emphasizes a gender difference absent for interpersonal relationships
MajorThe conclusion identifies interpersonal relationships as a particular gender difference, but the discussion explicitly says its gender difference was not significant. Table 4 likewise reports p = 0.53 for that subscale.
“Health-promoting behaviors differed by gender, particularly with respect to physical activity and interpersonal relationships.”
“while the female students had a slightly higher score on this subscale, there was no significant difference in comparison with the male students”
Income-group interpersonal difference is described as non-significant
MajorThe text says the higher scores in the >30,000 income group, including interpersonal relationships, had no significant differences. Table 4 marks the income-group interpersonal-relationships comparison significant at p = 0.03.
“the participants from the group whose families earn more than 30,000 Saudi Riyal had better mean scores than other groups with regard to health responsibility, physical activity, spiritual growth, interpersonal relationships subscales, and overall HPLP scores, but with no significant differences (Table 4).”
“| p | 0.20 | 0.35 | 0.31 | 0.5 | 0.03* | 0.66 | 0.17 |”
Reported gender test statistics differ from Table 4
MinorThe prose gives t = 5.1 for stress management and t = 9.5 for physical activity; Table 4 instead gives t = 2.26 and t = 3.08, respectively.
“males had significantly higher scores than females in the areas of stress management (t = 5.1; p\0.03) and physical activity (t = 9.5; p\0.002).”
“| t | 1.52 | 3.08 | 0.95 | 1.05 | 0.63 | 2.26 | 1.92 |”
Age correlation is not negative for every subscale
MinorThe text describes negative age correlations for all six subscales, but Table 5 reports a positive correlation of 0.051 for physical activity.
“the Pearson’s correlation results showed negative correlations between the students’ age and the overall HPLP II scale and all six subscales”
“| Age | Age | Age | Age | Age | Age | Age | Age | | r | −0.083 | 0.051 | −0.025 | −0.019 | −0.096 | −0.080 | −0.036 |”
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The Health Behaviours of Students from Selected Countries—A Comparative Study
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Healthy lifestyle behaviors among teachers working in public primary schools and affecting factors
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Hemşirelik Öğrencilerinde Diyabet Riski ve Sağlıklı Yaşam Biçimi Davranışlarının Belirlenmesi
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Medical students’ hygiene training on healthy eating as part of classes at the department of hygiene
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The Relation Between Adverse Childhood Experiences and Health Behaviors in Adult Women
Tavares, K., & Tsotsoros, C. E. (2024) · American Journal of Health Promotion · doi:10.1177/08901171241229829 · Cited by 5
Healthy lifestyle behaviors among Omani undergraduates: a cross-sectional study
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Evaluating Health-promoting Lifestyle Profile among Menopausal Women: A Meta-analysis
Moshfeghy, Z., Riazi, H., Hajian, S., & Montazeri, A. (2023) · The Open Nursing Journal · doi:10.2174/18744346-v17-230720-2023-1 · Cited by 5
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Factors influencing health-promoting lifestyle among medical personnel: a systematic review protocol
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Predictors of Oral Health Behaviors among Dental Students
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The Relationship between Healthy Lifestyle Behaviors and Body Compositions in University Students
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Filipino Nursing Students’ Health Promoting Behaviors during Pandemic
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“While previous studies have explored sociodemographic differences in health-promoting behaviors [12, 40], to the best of our knowledge, this is the first study to provide empirical evidence of measurement invariance of the HPLP-II in a sample of Latin American university students.”
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Percepção dos estudantes sobre promoção da saúde no ensino superior e qualidade de vida
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Health Promoting Lifestyle Behaviors and Associated Factors among Sohag University Students
Mahmoud, R., Yousef, F. M. A., & Ali, R. A. E. (2024) · Sohag Medical Journal · doi:10.21608/smj.2024.254289.1432 · Cited by 3
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To Love Yourself: Psychological Approach to Predict Healthy Lifestyle Behaviour in Adolescents
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Abuadas, F. H. (2023) · The Open Nursing Journal · doi:10.2174/18744346-v17-e230404-2023-10 · Cited by 2
Healthy life-style behaviors and related factors among Turkish primary health care professionals
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Analysis of morbidity of medical university students
Kopylov, A. S., Popov, V. I., & Choporov, O. N. (2023) · Russian Medicine · doi:10.17816/medjrf609496 · Cited by 2
The Relationship between Lifestyle and The Incidence of Disrupted Fasting Blood Sugar
Jamil, A. M., Rezkitha, Y. A. A., Utama, M. R., Lutfiana, N. C., & Urrachman, S. K. (2024) · MAGNA MEDICA Berkala Ilmiah Kedokteran dan Kesehatan · doi:10.26714/magnamed.11.1.2024.29-37 · Cited by 2
Examining the Health-Promoting Lifestyle of College Students: A Quantitative Analysis
Dacay, N. J. B., Rañon, J. G., & Culajara, C. L. B. (2024) · American Journal of Human Psychology · doi:10.54536/ajhp.v2i1.2823 · Cited by 2
Medical students’ physical activity as an indicator of their commitment to healthy lifestyle
Ievleva, O. V. (2021) · doi:10.24075/rbh.2021.009 · Cited by 2
Olutende, O. M., Wamukoya, E. K., & Wanzala, M. (2019) · Saudi Journal of Nursing and Health Care · doi:10.36348/sjnhc.2019.v02i12.001 · Cited by 2
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Çelik, A., & Ersoy, P. (2022) · SDÜ Tıp Fakültesi Dergisi · doi:10.17343/sdutfd.1085671 · Cited by 2
Lifestyle behavior and mental health among nursing collegians at Baghdad University
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Health-promoting Lifestyle and Predicting Anxiety Caused by COVID-19 In Medical Sciences Students
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Metadata
- Authors
- Alzahrani, S. H., Malik, A. A., Bashawri, J., Shaheen, S. A., Shaheen, M. M., Alsaib, A. A., Mubarak, M. A., Adam, Y. S., & Abdulwassi, H. K.
- Affiliations
- King Abdulaziz University (SA)
- Corresponding author
- Alzahrani, Sami H
- Venue
- SAGE Open Medicine
- Publisher
- SAGE Publications
- Published
- 2019-01
- Volume
- 7
- Pages
- 2050312119838426-2050312119838426
- ISSN
- 2050-3121 (ISSN-L)
- PMC
- PMC6434441
- OpenAlex
- W2927863450
- Cited by
- 128
- References
- 36
- Citations by year
- 2026: 7 · 2025: 18 · 2024: 25 · 2023: 27 · 2022: 24 · 2021: 18 · 2020: 8 · 2019: 1
- FWCI
- 17.38
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Locations
- SAGE Open Medicine (publishedVersion, cc-by-nc)
- Europe PMC (PubMed Central) (publishedVersion, cc-by-nc)
- PubMed Central (publishedVersion, cc-by-nc)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion)
- Topics
- Health Sciences › Health Professions › General Health Professions › Health and Wellbeing Research
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Health and Lifestyle Studies
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › School Health and Nursing Education
- Keywords
- health-promoting lifestyle, Health-Promoting Lifestyle Profile II, medical students, physical activity, interpersonal relationships, body mass index, sociodemographic factors, gender differences, income, year of study, health promotion interventions, non-communicable disease prevention
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