Predictors and Associations of Healthy Lifestyle Beliefs with Sociodemographic, Behavioral, and Menstrual Characteristics in Adolescent Girls

Abstract

Background: It is reported that healthy lifestyle beliefs acquired during adolescence may influence future reproductive health behaviors and women’s health outcomes. This study was conducted to examine the association between healthy lifestyle beliefs and sociodemographic characteristics, healthy lifestyle behaviors, and menstrual characteristics among adolescent girls, and to determine whether these variables predict healthy lifestyle beliefs.

Method: This descriptive and cross-sectional study was conducted in five Family Health Centers located in a provincial center. The sample consisted of 336 adolescent girls. Data were collected using a Descriptive Information Form and the Healthy Lifestyle Beliefs Scale for Adolescents. Statistical significance was set at p<0.05.

Results: The mean age of the participants was 15.87±0.84 years, and 66.67% had a moderate socioeconomic status. The mean healthy lifestyle belief score of the adolescent girls was 60.82±8.14, with a relatively lower mean score observed in the nutrition subscale (14.71±2.70). There were statistically significant differences between the healthy lifestyle belief scale scores and red meat consumption, fruit and vegetable consumption, unsaturated fat intake, and exercise status (p<0.05). In the regression analysis, red meat consumption, fruit consumption, exercise status, and menstrual pain were identified as significant predictors of healthy lifestyle beliefs (p<0.05). The model explained 18.1% of the variance (R²=0.181).

Conclusion: Interventions aimed at promoting healthy lifestyle beliefs among adolescent girls should address nutrition, physical activity, and menstrual health holistically. 

Keywords

• Adolescent
• healthy lifestyle
• menstrual cycle
• belief
• health behavior

Adölesan Kızlarda Sağlıklı Yaşam Tarzı İnançlarının Sosyodemografik, Davranışsal ve Menstrüel Özelliklerle İlişkisi ve Yordayıcıları

Abstract

Giriş: Adölesan dönemde kazanılan sağlıklı yaşam inançlarının, gelecekteki üreme sağlığı davranışları ve kadın sağlığı sonuçları üzerinde etkili olabileceği bildirilmektedir. Bu çalışma, adölesan kızlarda sağlıklı yaşam tarzı inançlarının sosyodemografik özellikler, sağlıklı yaşam davranışları ve menstrüel özelliklerle ilişkisini incelemek ve bu değişkenlerin sağlıklı yaşam tarzı inançlarının yordayıcıları olup olmadığını belirlemek amacıyla yapılmıştır.

Yöntem: Tanımlayıcı ve kesitsel tipteki araştırma bir il merkezindeki beş Aile Sağlığı Merkezinde yürütülmüştür. Örneklem grubunu 336 adölesan kız oluşturmuştur. Veriler Tanıtıcı Bilgi Formu ve Adölesanlar İçin Sağlıklı Yaşam Tarzı İnanç Ölçeği ile toplanmıştır. İstatistiksel anlamlılık düzeyi p<0.05 olarak alınmıştır.

Bulgular: Katılımcıların yaş ortalaması 15.87±0.84 olup, %66.67’sinin sosyoekonomik durumu orta düzeydedir. Adölesan kızların sağlıklı yaşam tarzı inanç puan ortalaması 60.82±8.14 olup, görece daha düşük puan beslenme alt boyutunda elde edilmiştir (14.71±2.70). Sağlıklı yaşam tarzı inanç ölçeği puan ortalaması ile kırmızı et tüketimi, meyve ve sebze tüketimi, doymamış yağ tüketimi ve egzersiz yapma durumu arasında istatistiksel olarak anlamlı fark vardır (p<0.05). Regresyon analizinde kırmızı et tüketimi, meyve tüketimi, egzersiz yapma durumu ve menstrüel ağrının sağlıklı yaşam tarzı inançlarının anlamlı yordayıcıları olduğu saptanmıştır (p<0.05). Modelin açıklayıcılığı %18.1’dir (R²=0.181).
Sonuç: Adölesan kızlarda sağlıklı yaşam tarzı inançlarının geliştirilmesine yönelik girişimlerde beslenme, fiziksel aktivite ve menstrüel sağlığın bütüncül olarak ele alınması önemlidir.

Keywords

• Adölesan
• sağlıklı yaşam tarzı
• menstrüel siklus
• inanç
• sağlık davranışı

References

1. 1. Arafa A, Yasui Y, Kokubo Y, Kato Y, Matsumoto C, Teramoto M, et al. Lifestyle Behaviors of Childhood and Adolescence: Contributing Factors, Health Consequences, and Potential Interventions. Am J Lifestyle Med. 2024; 15598276241245941. doi:10.1177/15598276241245941
2. 2. Melnyk BM, Kelly S, Jacobson D, Belyea M, Shaibi G, Small L, et al. The COPE healthy lifestyles TEEN randomized controlled trial with culturally diverse high school adolescents: baseline characteristics and methods. Contemp Clin Trials. 2013;36(1):41–53. doi:10.1016/j.cct.2013.05.013
3. 3. Kudubes AA, Bektas M. Evaluating the psychometric properties of the Healthy Lifestyle Beliefs Scale on Turkish adolescents. J Pediatr Nurs. 2020;53:57–63. doi:10.1016/j.pedn.2020.03.019
4. 4. Ganguly M, Ganguly A, Chattaraj S, et al. A review on menstrual health in adolescent girls emphasizing multi-omics and machine learning strategies for preventing reproductive tract infections. Discov Public Health. 2025;22:105. doi:10.1186/s12982-025-00485-x
5. 5. Dhar S, Mondal KK, Bhattacharjee P. Influence of lifestyle factors with the outcome of menstrual disorders among adolescents and young women in West Bengal, India. Sci Rep. 2023;13:12476. doi:10.1038/s41598-023-35858-2
6. 6. Harvey J, Western MJ, Townsend NP, Francombe-Webb J, Sebire S, Malkowski OS, et al. Adolescents, menstruation, and physical activity: insights from a global scoping review. BMC Womens Health. 2025;25:281. doi:10.1186/s12905-025-03825-w
7. 7. Kim HW, Kang SY, Kim J. Factors influencing adolescents’ healthy pregnancy preparation behavior: a cross-sectional gender comparison applying the health belief model. Reprod Health. 2022;19:90. doi:10.1186/s12978-022-01392-z
8. 8. Chen HH, Hsieh PL. Applying the Pender's Health Promotion Model to identify the factors related to older adults' participation in community-based health promotion activities. Int J Environ Res Public Health. 2021;18(19):9985. doi:10.3390/ijerph18199985

9. 9. Bektas İ, Akdeniz Kudubes A, Ayar D, Bektas M. Predicting the healthy lifestyle behaviors of Turkish adolescents based on their health literacy and self-efficacy levels. J Pediatr Nurs. 2021;59:e20–e25. doi:10.1016/j.pedn.2021.01.016
10. 10. Karagözoğlu M, İlhan N. The effect of health literacy on health behaviors in a sample of Turkish adolescents. J Pediatr Nurs. 2024;77:e187–e194. doi:10.1016/j.pedn.2024.04.028
11. 11. Tatoglu N, Ayyildiz TK. Risk grubu ergenlerde sağlıklı yaşam biçimi davranışları ve benlik saygısı üzerine bir değerlendirme. YIU Saglik Bil Derg. 2022;3(3):53–61. doi:10.51261/yiu.2022.00053
12. 12. Babaoglu UT, Cevizci S, Ozdenk GD. Evaluation of healthy lifestyle behaviors of female students in a public accommodation center from Kirsehir, Turkey. Mater Sociomed. 2014;26(6):372–377. doi:10.5455/msm.2014.26.372-377
13. 13. Haapala EA, Leppänen MH, Kosola S, et al. Childhood lifestyle behaviors and mental health symptoms in adolescence. JAMA Netw Open. 2025;8(2):e2460012. doi:10.1001/jamanetworkopen.2024.60012
14. 14. Rajapakshe W, Wickramasurendra AK, Amarasinghe RR, et al. Application of the Health Belief Model (HBM) to explore the quality of sexual and reproductive health education in Sri Lanka. Int J Environ Res Public Health. 2024;21(12):1703. doi:10.3390/ijerph21121703
15. 15. Kelly SA, Melnyk BM, Jacobson DL, O’Haver JA. Correlates among healthy lifestyle cognitive beliefs, healthy lifestyle choices, social support, and healthy behaviors in adolescents. J Pediatr Health Care. 2011;25(4):216–223. doi:10.1016/j.pedhc.2010.03.002
16. 16. Tabrizi JS, Doshmangir L, Khoshmaram N, et al. Key factors affecting health promoting behaviors among adolescents: a scoping review. BMC Health Serv Res. 2024;24:58. doi:10.1186/s12913-023-10510-x
17. 17. Binay Ş, Yiğit R. Relationship between adolescents’ health-promoting lifestyle behaviors and self-efficacy. J Pediatr Res. 2016;3(4):180–186. doi:10.4274/jpr.18894
18. 18. Hawks M, Bratton A, Mobley S, Barnes V, Weiss S, Zadinsky J. Early adolescents' physical activity and nutrition beliefs and behaviours. Int J Qual Stud Health Well-being. 2022 Dec;17(1):2050523. doi: 10.1080/17482631.2022.2050523.
19. 19. Kaynak K, Koç K, Bayiroğlu GB, et al. Healthy lifestyle beliefs, nutritional behaviors, and physical activity of adolescents: A mediation analysis. Afr J Reprod Health. 2025;29(8 Suppl):83–93. doi:10.29063/ajrh2025/v29i8s.9
20. 20. McGovern CM, Militello LK, Arcoleo KJ, Melnyk BM. Factors associated with healthy lifestyle behaviors among adolescents. J Pediatr Health Care. 2018;32(5):473–480. doi:10.1016/j.pedhc.2018.04.002
21. 21. Yang, K., Xue, C., Xu, L. et al. The role of social and psychological factors in shaping health behaviors among rural adolescents: a cross-sectional study. Sci Rep 15, 25614 (2025). https://doi.org/10.1038/s41598-025-09314-2
22. 22. Ekici EM., Eroğlu FE, Mengi Çelik Ö. The relationship between exercise health beliefs, sustainable healthy eating behaviors, and adherence to the mediterranean diet in female university students. Discov Public Health 2025;22,327. doi: 10.1186/s12982-025-00727-y
23. 23. Martins C, Mitchell JJ, Hamer M, Blodgett JM. Associations between psychological distress in adolescence and menstrual symptoms across life: longitudinal evidence from the 1970 British Cohort Study. J Affect Disord. 2024;354:712-718. doi:10.1016/j.jad.2024.03.069.
24. 24. Yonkers KA, O'Brien PMS, Eriksson E. Premenstrual syndrome. Lancet. 2008;371(9619):1200-1210. doi:10.1016/S0140-6736(08)60527-9.
25. 25. Guzeldere HKB, Efendioglu EH, Mutlu S, et al. The relationship between dietary habits and menstruation problems in women: a cross-sectional study. BMC Womens Health. 2024;24:397. doi:10.1186/s12905-024-03235-4
26. 26. Wari SL, Siagian M, Wau H. Influence of nutritional status, physical activity and stress level on menstrual cycle. J Ilmu Kesehat Masy. 2024;15(2):195–208. doi:10.26553/jikm.2024.15.2.195-208
27. 27. Santi BD, Nogueira IS, Baldissera VDA. The nola pender model for adolescent health promotion: an integrative review. Rev Min Enferm. 2023;27:e-1507. doi: 10.35699/2316-9389.2023.40440
28. 28. Darabi F, Yaseri M. Intervention to improve menstrual health among adolescent girls based on the Theory of Planned Behavior in Iran: a cluster-randomized controlled trial. J Prev Med Public Health. 2022;55(6):595–603. doi:10.3961/jpmph.22.365
29. 29. Ghimire S, Gahatraj NR, Shrestha N, et al. Effects of health education intervention on menstrual hygiene knowledge and practices among adolescent girls in Nepal. PLoS One. 2024;19(9):e0291884. doi:10.1371/journal.pone.0291884
30. 30. Goyal A, Agarwal S. Enhancement of health-related quality of life among adolescent school girls via improvement in menstrual hygiene knowledge and practices. Arch Med Health Sci. 2024;12(1):73–77. doi:10.4103/amhs.amhs_112_23
31. 31. Mirghafourvand M, Ebadi A, Jahanfar S, et al. Exploring the practice of Iranian adolescent females during menstruation and related beliefs: a qualitative study. BMC Public Health. 2024;24:1145. doi:10.1186/s12889-024-18600-z