Distal and Proximal Factors of Health Behaviors and Their Associations with Health in Children and Adolescents

Lena Lämmle, Alexander Woll, Gert B. M. Mensink and Klaus Bös
Additional contact information
Lena Lämmle: Technische Universität München, Georg-Brauchle-Ring 60/62, München 80992, Germany
Alexander Woll: Karlsruhe Institute of Technology, Engler-Bunte-Ring 15 Geb. 40.40, Karlsruhe 76131, Germany
Gert B. M. Mensink: Robert Koch Institute Berlin, Postfach 650261, Berlin 13302, Germany
Klaus Bös: Karlsruhe Institute of Technology, Engler-Bunte-Ring 15 Geb. 40.40, Karlsruhe 76131, Germany

IJERPH, 2013, vol. 10, issue 7, 1-35

Abstract: Objective : The aim of the present paper was to analyze factors affecting distal and proximal health behavior within a biopsychosocial model for examining their interactions and associations with respect to health. Methods : Path analysis was based on the nationwide, cross-sectional German Health Interview and Examination Survey for Children and Adolescents (2003 to 2006). The data was collected from 4,529 participants with an average age of 9.45 years ( SD = 4.01). Socio-demographic data, psychosocial factors and health behavior were assessed via questionnaire. Participants also underwent physical fitness tests and a medical examination. Results : Over the five levels of the model analyzed with socioeconomic status, immigration background, and rural-urban differences on the first level; physical activity of relatives and peers, intrinsic motivation, and quality of life on the second level; eating patterns, sedentary behavior, and physical activity on the third level; physical fitness and objective health on the fourth level; and health complaints and subjective health on the fifth level; direct, moderation, and mediation effects could be shown. Conclusions : Several distal and proximal factors are needed to take account of the multivariate complexity of health: e.g., immigration background affected health behaviors only indirectly and the effect of physical activity on objective health was mediated by physical fitness.

Keywords: psychosocial determinants; health behavior; objective health; health complaints; subjective health (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2013
References: View references in EconPapers View complete reference list from CitEc
Citations: View citations in EconPapers (2)

Downloads: (external link)
https://www.mdpi.com/1660-4601/10/7/2944/pdf (application/pdf)
https://www.mdpi.com/1660-4601/10/7/2944/ (text/html)

Related works:
This item may be available elsewhere in EconPapers: Search for items with the same title.

Export reference: BibTeX RIS (EndNote, ProCite, RefMan) HTML/Text

Persistent link: https://EconPapers.repec.org/RePEc:gam:jijerp:v:10:y:2013:i:7:p:2944-2978:d:27230

Access Statistics for this article

IJERPH is currently edited by Ms. Jenna Liu

More articles in IJERPH from MDPI
Bibliographic data for series maintained by MDPI Indexing Manager ().