Turkish Adaptation of Healthy Habits Questionnaire for Adolescents: Diet, Physical Activity, Screen Time, and Sleep Habits
Year 2024,
Volume: 14 Issue: 2, 341 - 348, 28.06.2024
Tuğba Duygu Özmet
,
Ayşe Ergün
Abstract
Objective: The main purpose of this study was to adapt the adolescent Healthy Habits Questionnaire (HHQ) to the Turkish language and to test its validity and reliability. The study was also examined the diet, physical activity, screen time, and sleep habits of adolescents.
Methods: This study is a methodological and descriptive design. The sample of the research consists of 320 students. The validity of the HHQ was evaluated by the content validity index, the reliability by test-retest correlations, and the kappa coefficient of agreement. Number and percentage values were used for descriptive features.
Results: The content validity index of HHQ was found to be 0.96. The test-retest correlations of questions containing continuous variables were found to be between 0.44 and 0.91. Kappa values of questions containing categorical variables were between 0.7 and 0.94. It was found that 91.8% of the adolescents consumed less than three servings of vegetables, 76.9% of them consumed less than 2 servings of fruit,
and 80.5% of them consumed less than 2 glasses of milk. In addition, it was determined 40.2% of the adolescents used screen use more than two hours, 47.6% did less than one hour of physical activity and 30.2% slept less than eight hours.
Conclusion: HHQ was found as a valid and reliable measurement tool. It was determined that the adolescents did not consume enough vegetables, fruits, water, and milk and did not engage in sufficient physical activity.
Supporting Institution
The authors received no financial support for the research.
Thanks
We are grateful to the Maine Youth Overweight Collaborative (MYOC) group for allowing us to conduct our research, the administrators and teachers of the schools where we conducted our research, and the children who agreed to participate in our research.
References
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2020;59(11):978–987. DOI:10.1177/000.992.2820927030.
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a systems approach to address childhood obesity. J Health Care Poor Underserved.2013;24(2):80-96.
DOI:10.1353/hpu.2013.0107
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0711.100.0591
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Reducing pediatric overweight: Nurse-delivered motivational interviewing in primary care. J. Pediatr. Nurs.2013;28(6):536–547. DOI: /10.1016/j.pedn.2013.02.031
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- Centers for Disease Control and Prevention [CDC].Sleep in middle and high school 2020. Published [01 Jan 2018]. Updated[10 Sep 2020]. Accessed [10 Apr 2023]. https://www.cdc.gov/nccdphp/dnpao/multimedia/infographics/getmoving.html
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recommendations. Res Nurs Health. 2006;29(5):489-497. DOI:10.1002/nur.20147
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- Laska MN, Hearst MO, Forsyth A, Pasch KE, Lytle L. Neighbourhood food environments: are they associated
with adolescent dietary intake, food purchases and weight status?. Public Health Nutr. 2010;13(11):1757-1763.
DOI:10.1017/S136.898.0010001564
- Gur K, Erol S, Kadioglu H, Ergun A, Boluktas R. The impact on adolescents of a Transtheoretical Model-based
program on fruit and vegetable consumption. Public Health Nutr. 2019;22(13):2500–2508. DOI:10.1017/
S136.898.001900137X
- Mielgo-Ayuso J, Valtueña J, Huybrechts I, Breidenassel C, Cuenca-García M, De Henauw S, Stehle P, Kafatos A, Kersting M, Widhalm K, Manios Y, Azzini E, Molnar D, Moreno LA, González-Gross M.Fruit and vegetables consumption is associated with higher vitamin intake and blood vitamin status
among European adolescents. Eur J Clin Nutr. 2017;71(4):458–467. DOI:10.1038/ejcn.2016.232
- Sidoti E, Paolini G, Tringali G. A survey on lifestyle and attitudes on fruit and vegetable consumption and participation in physical activity in a sample of secondary school and university students from Palermo, Western Sicily. Ital J Public Health. 2010;7(2):85–93.DOI: 10.2427/5733
- Ndagire CT, Muyonga JH, Nakimbugwe D. Fruit and vegetable consumption , leisure – time physical activity, and sedentary behavior among children and adolescent students in Uganda. Food Sci Nutr. 2019;7(2):599-607.DOI:10.1002/fsn3.8832019:599–607.
- Wong RS, Tung KTS, Wong WHS, Ho FKW, Tso WWY, Yip PSF, Wong CKH, Fan SYS, Ip P. Associations of family meals
with adolescent perception of family relationship and compliance with parental guidance in hong kong : results of a representative cross-sectional survey. Int J Environ Res Public Health. 2021;18(10):1-11. DOI:10.3390/ijerph18105402
- Berge JM, Wall M, Hsueh T. The protective role of family meals for youth obesity: 10-year longitudinal associations. J Pediatr. 2015;166(2):296–301. DOI:10.1016/j.jpeds.2014.08.030
- Akman M, Tuzun S,Unalan P. Adolesanlarda sağlıklı beslenme ve fiziksel aktivite durumu. Nobel Med. 2012;8(1):24–29. (Turkish)
- Olatona FA, Oloruntola OO, Adeniyi OF, Amu EO. Association between breakfast consumption and anthropometrically determined nutritional status of secondary-school adolescents
in Lagos, Southwest Nigeria. Int J MCH AIDS. 2022;11(1): 1–10. DOI:10.21106/ijma.503
- Colak B, Ergun A. İstanbul’un bir ilçesinde okul çağı çocuklarındabeslenme alışkanlıkları ve sıvı tüketim durumunun
vücut kütle indeksi ile ilişkisi: Kesitsel bir çalışma.Halk Sağlığı Hemşireliği Dergisi 2020;2(3):197–212.(Turkish)
- Gökler ME, Buğrul N, Metintaş S, Kalyoncu C. Adolescent obesity and associated cardiovascular risk factors of rural
and urban life (Eskisehir, Turkey). Cent Eur J Public Health 2015;23(1):20-25.DOI:10.21101/cejph.a3958
- Li L, Sun N, Zhang L, Xu G, Liu J, Hu J, Zhang Z, Lou J, Deng H, Shen Z, Han L. Fast food consumption among young
adolescents aged 12–15 years in 54 low – and middleincome countries. Glob Health Action. 2020;13(1).DOI:
10.1080/16549.716.2020.1795438
- Koca B, Arkan G. The relationship between adolescents’ nutrition literacy and food habits, and affecting factors.
Public Health Nutr. 2020;24(2),1-12. DOI:10.1017/S136.898.0020001494
- American Academy Child & Adolescent Psychiatry [AACAP]. Screen Time and Children Published [01 Feb 2020]. Updated [01 Feb 2020]. Accessed [10 Apr 2023]. https://www.aacap.org/AACAP/Families_and_Youth/Facts_for_Families/FFFGuide/Children-And-Watching-TV-054.aspx
- Nagata JM, Cortez CA, Cattle CJ, Ganson KT, Iyer P, Bibbins-Domingo K, et al. Screen time use among us adolescents during the COVID-19 pandemic: Findings from the Adolescent Brain Cognitive Development (ABCD) study. JAMA Pediatr. 2022;176(1):94–96. DOI:10.1001/jamapediatrics.2021.4334
- Tezol O. Ergenlerde uyku hijyeni prensiplerine uyum: Mersin ili örneği.Sağlık ve Toplum.2020;(3):166–174.(Turkish)
- Gilbert-Diamond D, Li Z, Adachi-Mejia AM, McClure AC, Sargent JD. Association of a television in the bedroom with
increased adiposity gain in a nationally representative sample of children and adolescents. JAMA Pediatr. 2014;168(5):427–434. DOI:10.1001/jamapediatrics.2013.3921
- Hale L, Guan S. Screen time and sleep among school-aged children and adolescents: a systematic literature
review. SleepMed Rev. 2015;21(6):50–58. DOI:10.1016/j.smrv.2014.07.007
- Bay T, Ergun A. Uyku ve yaşam tarzı anketinin geçerlik ve güvenirliği. Türk Uyku Tıbbi Dergisi.2019;6(3):74–79.
DOI:10.4274/jtsm.galenos.2019.36855 (Turkish)
- Albrecht JN, Werner H, Rieger N, Widmer N, Janisch D, Huber R, Jenni OG.Association between homeschooling and adolescent sleep duration and health during covid-19 pandemic high school closures. JAMA Netw. Open. 2022;5(1):210-214. doi:10.1001/jamanetworkopen.2021.42100
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Year 2024,
Volume: 14 Issue: 2, 341 - 348, 28.06.2024
Tuğba Duygu Özmet
,
Ayşe Ergün
References
- World Health Organization [WHO]. Adolescent health. Published [2022]. Updated [2023].Accessed [10 Apr
2023]. https://www.who.int/health-topics/adolescenthealth#tab=tab_1
- Centers for Disease Control and Prevention [CDC] .Teenagers(15-17 years of age). Published [22 Feb 2021]. Updated [22 Feb 2021]. Accessed [10 Apr 2023]. https://www.cdc.gov/
ncbddd/childdevelopment/positiveparenting/adolescence2.html#:~:text=Adolescence (15-17 years old) %7C CDC
- World Health Organization [WHO]. Noncommunicable diseases: Childhood, overweight and obesity.Published [19
Oct 2020]. Updated [2023]. Accessed [10 Apr 2023]. https://www.who.int/news-room/questions-and-answers/item/noncommunicable-diseases-childhood-overweight-andobesity
- Centers for Disease Control and Prevention [CDC].Prevalence of overweight, obesity, and severe obesity among children and adolescents aged 2–19 years: United States, 1963–1965 through 2017–2018 2021. Published [29 Jan 2021]. Updated [8 Feb 2021]. Accessed [10 Apr 2023]. https://www.cdc.gov/nchs/data/hestat/obesity-child-17-18/obesity-child.htm
- Anderson E, Durstine JL. Physical activity, exercise, and chronic diseases: A brief review. Sport Med Heal Sci. 2019;1(1):3–10. DOI:https://doi.org/10.1016/j.smhs.2019.08.06
- American Academy Child & Adolescent Psychiatry [AACAP]. Obesity in children and teens.Published [01 Apr 2017]. Updated [2023]. Accessed [10 Apr 2023]. https://www.aacap.org/AACAP/Families_and_Youth/Facts_for_Families/FFFGuide/Obesity-In-Children-And-Teens-079.aspx
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- Camp NL, Robert RC, Kelly KP. Healthy Habits Questionnaire feasibility and utility for high-risk children. Clin Pediatr.
2020;59(11):978–987. DOI:10.1177/000.992.2820927030.
- Colorado Department of Education. Colorado Healthy Weight Toolkit. Empowering the school nurse to make a difference in addressing childhood obesity. Published December Published [01 Dec 2018]. Accessed [10 Apr 2023]. https://www.cde.state.co.us/healthandwellness/obesitytoolkitcomplete1-9-15
- Serpas S, Brandstein K, McKennett M, Hillidge S, Zive M, Nader PR. San Diego healthy weight collaborative:
a systems approach to address childhood obesity. J Health Care Poor Underserved.2013;24(2):80-96.
DOI:10.1353/hpu.2013.0107
- Gentile N, Kaufman, TK, Maxson J, Klein DM, Merten, S, Price, M, Swenson, L, Weaver AL, Brewer J, Rajjo T, Narr C, Ziebarth, S, Lynch, B. The effectiveness of a family-centered childhood obesity intervention at the YMCA: A pilot study. J Community Med Health Educ.2018;8(1):1-15. DOI:10.4172/2161-
0711.100.0591
- Polacsek M, Orr J, Letourneau L, Rogers V, Holmberg R, O’Rourke K, Hannon C, Lombard KA. Impact of a primary care intervention on physician practice and patient and family behavior: Keep ME healthy – The Maine Youth Overweight Collaborative. Pediatrics 2009;123(5):258-266. DOI:10.1542/peds.2008-2780C
- Tucker SJ, Ytterberg KL, Lenoch LM, Schmit TL, Mucha DI, Wooten JA, Lohse CM, Austin CM, Mongeon Wahlen KJ.
Reducing pediatric overweight: Nurse-delivered motivational interviewing in primary care. J. Pediatr. Nurs.2013;28(6):536–547. DOI: /10.1016/j.pedn.2013.02.031
- Lange SJ, Moore LV, Harris DM, Merlo CL, Lee SH, Demissie Z, Galuska DA. Percentage of Adolescents Meeting Federal Fruit and Vegetable Intake Recommendations — Youth Risk Behavior Surveillance System, United States, 2017. Morb Mortal Wkly Rep. 2021;70(3):69–74. DOI: 10.15585/mmwr.mm7003a1external icon.
- Centers for Disease Control and Prevention [CDC].Published [06 Jun 2022]. Water and Healthier Drinks.Updated [06 Jun 2022]. Accessed [10 Apr 2023]. https://www.cdc.gov/healthyweight/healthy_eating/water-and-healthier-drinks.html
- T.C Sağlık Bakanlığı Halk Sağlığı Genel Müdürlüğü. Yeterli ve dengeli beslenme nedir? Published [01 Jan 2020]. Updated [01 Jan 2022]. Accessed [10 Apr 2023]. https://hsgm.saglik.gov.tr/depo/birimler/saglikli-bebek-hareketli-hayat-db/Yeterlive-Dengeli-Beslenen/Yas-Doneminde-Beslenen/Ergenlik-Doneminde-Beslenen .pdf (Turkish)
- Centers for Disease Control and Prevention [CDC].Screen time and lean time infographic. Published [29 Jan 2018]. Updated [29 Jan 2018]. Accessed [10 Apr 2023]. https://www.cdc.gov/nccdphp/dnpao/multimedia/infographics/getmoving.html
- Centers for Disease Control and Prevention [CDC].Sleep in middle and high school 2020. Published [01 Jan 2018]. Updated[10 Sep 2020]. Accessed [10 Apr 2023]. https://www.cdc.gov/nccdphp/dnpao/multimedia/infographics/getmoving.html
- Centers for Disease Control and Prevention [CDC].Get the facts:Sugar sweetened beverages and consumption. Published [11 Apr 2022]. Updated [11 Apr 2022]. Accessed [10 Apr 2023]. https://www.cdc.gov/nutrition/data-statistics/sugarsweetened-beverages-intake.html
- Polit DF, Beck CT. The content validity index: are you sure you know what’s being reported? Critique and
recommendations. Res Nurs Health. 2006;29(5):489-497. DOI:10.1002/nur.20147
- Streiner DL, Norman GR, Cairney J. Health measurement scales: A practical guide to their development and use, 5th ed. New York, NY, US: Oxford University Press; 2015.
- Laska MN, Hearst MO, Forsyth A, Pasch KE, Lytle L. Neighbourhood food environments: are they associated
with adolescent dietary intake, food purchases and weight status?. Public Health Nutr. 2010;13(11):1757-1763.
DOI:10.1017/S136.898.0010001564
- Gur K, Erol S, Kadioglu H, Ergun A, Boluktas R. The impact on adolescents of a Transtheoretical Model-based
program on fruit and vegetable consumption. Public Health Nutr. 2019;22(13):2500–2508. DOI:10.1017/
S136.898.001900137X
- Mielgo-Ayuso J, Valtueña J, Huybrechts I, Breidenassel C, Cuenca-García M, De Henauw S, Stehle P, Kafatos A, Kersting M, Widhalm K, Manios Y, Azzini E, Molnar D, Moreno LA, González-Gross M.Fruit and vegetables consumption is associated with higher vitamin intake and blood vitamin status
among European adolescents. Eur J Clin Nutr. 2017;71(4):458–467. DOI:10.1038/ejcn.2016.232
- Sidoti E, Paolini G, Tringali G. A survey on lifestyle and attitudes on fruit and vegetable consumption and participation in physical activity in a sample of secondary school and university students from Palermo, Western Sicily. Ital J Public Health. 2010;7(2):85–93.DOI: 10.2427/5733
- Ndagire CT, Muyonga JH, Nakimbugwe D. Fruit and vegetable consumption , leisure – time physical activity, and sedentary behavior among children and adolescent students in Uganda. Food Sci Nutr. 2019;7(2):599-607.DOI:10.1002/fsn3.8832019:599–607.
- Wong RS, Tung KTS, Wong WHS, Ho FKW, Tso WWY, Yip PSF, Wong CKH, Fan SYS, Ip P. Associations of family meals
with adolescent perception of family relationship and compliance with parental guidance in hong kong : results of a representative cross-sectional survey. Int J Environ Res Public Health. 2021;18(10):1-11. DOI:10.3390/ijerph18105402
- Berge JM, Wall M, Hsueh T. The protective role of family meals for youth obesity: 10-year longitudinal associations. J Pediatr. 2015;166(2):296–301. DOI:10.1016/j.jpeds.2014.08.030
- Akman M, Tuzun S,Unalan P. Adolesanlarda sağlıklı beslenme ve fiziksel aktivite durumu. Nobel Med. 2012;8(1):24–29. (Turkish)
- Olatona FA, Oloruntola OO, Adeniyi OF, Amu EO. Association between breakfast consumption and anthropometrically determined nutritional status of secondary-school adolescents
in Lagos, Southwest Nigeria. Int J MCH AIDS. 2022;11(1): 1–10. DOI:10.21106/ijma.503
- Colak B, Ergun A. İstanbul’un bir ilçesinde okul çağı çocuklarındabeslenme alışkanlıkları ve sıvı tüketim durumunun
vücut kütle indeksi ile ilişkisi: Kesitsel bir çalışma.Halk Sağlığı Hemşireliği Dergisi 2020;2(3):197–212.(Turkish)
- Gökler ME, Buğrul N, Metintaş S, Kalyoncu C. Adolescent obesity and associated cardiovascular risk factors of rural
and urban life (Eskisehir, Turkey). Cent Eur J Public Health 2015;23(1):20-25.DOI:10.21101/cejph.a3958
- Li L, Sun N, Zhang L, Xu G, Liu J, Hu J, Zhang Z, Lou J, Deng H, Shen Z, Han L. Fast food consumption among young
adolescents aged 12–15 years in 54 low – and middleincome countries. Glob Health Action. 2020;13(1).DOI:
10.1080/16549.716.2020.1795438
- Koca B, Arkan G. The relationship between adolescents’ nutrition literacy and food habits, and affecting factors.
Public Health Nutr. 2020;24(2),1-12. DOI:10.1017/S136.898.0020001494
- American Academy Child & Adolescent Psychiatry [AACAP]. Screen Time and Children Published [01 Feb 2020]. Updated [01 Feb 2020]. Accessed [10 Apr 2023]. https://www.aacap.org/AACAP/Families_and_Youth/Facts_for_Families/FFFGuide/Children-And-Watching-TV-054.aspx
- Nagata JM, Cortez CA, Cattle CJ, Ganson KT, Iyer P, Bibbins-Domingo K, et al. Screen time use among us adolescents during the COVID-19 pandemic: Findings from the Adolescent Brain Cognitive Development (ABCD) study. JAMA Pediatr. 2022;176(1):94–96. DOI:10.1001/jamapediatrics.2021.4334
- Tezol O. Ergenlerde uyku hijyeni prensiplerine uyum: Mersin ili örneği.Sağlık ve Toplum.2020;(3):166–174.(Turkish)
- Gilbert-Diamond D, Li Z, Adachi-Mejia AM, McClure AC, Sargent JD. Association of a television in the bedroom with
increased adiposity gain in a nationally representative sample of children and adolescents. JAMA Pediatr. 2014;168(5):427–434. DOI:10.1001/jamapediatrics.2013.3921
- Hale L, Guan S. Screen time and sleep among school-aged children and adolescents: a systematic literature
review. SleepMed Rev. 2015;21(6):50–58. DOI:10.1016/j.smrv.2014.07.007
- Bay T, Ergun A. Uyku ve yaşam tarzı anketinin geçerlik ve güvenirliği. Türk Uyku Tıbbi Dergisi.2019;6(3):74–79.
DOI:10.4274/jtsm.galenos.2019.36855 (Turkish)
- Albrecht JN, Werner H, Rieger N, Widmer N, Janisch D, Huber R, Jenni OG.Association between homeschooling and adolescent sleep duration and health during covid-19 pandemic high school closures. JAMA Netw. Open. 2022;5(1):210-214. doi:10.1001/jamanetworkopen.2021.42100
- Kandola A, Lewis G, Osborn DPJ, Stubbs B, Hayes JF. Depressive symptoms and objectively measured physical activity and sedentary behavior throughout adolescence: a prospective cohort study. The Lancet Psychiatry 2020;7(3):262-271. DOI:10.1016/S2215-0366(20)30034-1
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