Assessment of the Healthy Lifestyle Profile of Adolescents: A School‐Based Cross‐Sectional Study in Bahawalpur, Pakistan

Vollständiger Abstract

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ABSTRACT Background Adolescence is a critical period for the formation of health behaviors, yet composite lifestyle data from rural districts of Pakistan are scarce. We described the healthy lifestyle profile of school‐going adolescents in Bahawalpur, South Punjab, and its association with socio‐demographic factors. Methods This descriptive cross‐sectional study enrolled 319 adolescents aged 11–19 years from four public schools in one randomly selected tehsil during August 2024. Two over‐age records were excluded, leaving 317 eligible participants for descriptive tabulation; three of these had a missing item and were further excluded, leaving 314 participants for the complete‐case composite analysis. Lifestyle was measured with a nine‐item behavioral composite informed by the Adolescent Lifestyle Profile. We treated the composite as a formative index with a possible range of 0–38 and analyzed it mainly as a continuous score. We assessed associations with Mann–Whitney U tests (reporting rank‐biserial effect sizes), Spearman correlation, χ 2 tests with Cramér's V, and multivariable linear regression with heteroscedasticity‐consistent (HC3) standard errors. Results The mean composite score was 21.36 (SD 3.79; median 22, IQR 19–24; observed range 11–31). When scores were grouped into pragmatic descriptive bands, most adolescents fell in the middle of the distribution, and none reached the highest band. Girls scored modestly higher than boys (21.83 vs. 20.81; Mann–Whitney p = 0.0075; rank‐biserial r = 0.175). In multivariable regression ( R 2 = 0.073), grade was the only independent predictor of a higher score ( β = 0.78, 95% CI 0.34–1.22, p < 0.001). Age, sex, parental education, family size, and household income were not. Conclusion Adolescents attending these four schools reported largely mid‐range lifestyle behaviors. Screen time was high, fruit and vegetable intake low, sugary‐drink consumption frequent, and vigorous physical activity limited. School‐based health promotion that targets these specific behaviors and accounts for grade‐ and sex‐related differences is warranted. The findings apply to students of the four sampled schools and should not be generalized to all adolescents in the district.