Prevalence of behavioral health risk factors and their simultaneous occurrence among students at a public university in Pelotas, state of Rio Grande do Sul, Brazil, 2017

Crespo, Pedro Augusto; Machado, Adriana Kramer Fiala; Nunes, Bruno Pereira; Wehrmeister, Fernando César

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Epidemiologia e Serviços de Saúde

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Original article • Epidemiol. Serv. Saúde 30 (4) • 2021 • https://doi.org/10.1590/S1679-49742021000400027 copy

Prevalence of behavioral health risk factors and their simultaneous occurrence among students at a public university in Pelotas, state of Rio Grande do Sul, Brazil, 2017^* * Article derived from the Master's degree dissertation entitled ‘Simultaneity of behavioral health risk factors among students at a public university in southern Brazil’, submitted by Pedro Augusto Crespo da Silva to the Postgraduate Program in Epidemiology of the Universidade Federal de Pelotas, on January 24, 2019. The study received financial support from the Academic Excellence Program of the Coordenação de Aperfeiçoamento de Pessoal de Nível Superior, an organ of the Ministry of Education (Proex-CAPES/MEC): Process No. 0185/2017/23038.000288/2017-47

Authorship SCIMAGO INSTITUTIONS RANKINGS

Abstract

Objective:

To estimate the prevalence of behavioral health risk factors and investigate clusters of simultaneous occurrences of these factors among students at a public university in Pelotas, state of Rio Grande do Sul, Brazil.

Methods:

This was a cross-sectional study among university students in the second semester of 2017. Physical inactivity, excessive sedentary behavior, inadequate sleep duration and smoking were the factors studied. Simultaneity of risk factors was evaluated using cluster analysis, through the ratio between observed and expected prevalence, and those that did not include the unit were considered clusters.

Results:

Among 1,716 students, the prevalence of inadequate sleep duration, physical inactivity, excessive sedentary behavior and smoking were 45.2% (95%CI 42.9;47.6), 44.4% (95%CI 42.7;47.2), 39.8% (95%CI 37.7;42.2) and 10.6% (95%CI 9.6;12.5) respectively. More than 80% of the students presented at least one risk factor. The clusters identified were related to inadequate sleep duration (O/E=1.15) and physical inactivity associated with sedentary behavior (O/E=1.24).

Conclusion:

High prevalence of the four risk factors studied and only two clusters were observed.

Keywords:
Students; Physical Activity; Sedentary Behavior; Sleep; Smoking; Cross-sectional Studies

Variables		Total		Male		Female
Variables		n	%	n	%	n	%
Age (in years)
	18-19	713	41.9	304	39.8	409	43.7
	20-22	552	32.4	252	32.9	299	31.9
	≥23	438	25.7	209	27.3	229	24.4
Race/skin color
	White	1,241	72.4	559	72.4	681	72.2
	Black	217	12.7	93	12.1	124	13.2
	Brown	228	13.3	104	13.5	124	13.2
	Asian/indigenous/other	28	1.6	15	2.0	13	1.4
Marital Status
	Single	1,545	90.1	68	8.8	76	8.1
	Married or in stable union	144	8.4	695	90.0	849	90.1
	Separated, divorced or widowed	26	1.5	9	1.2	17	1.8
Type of school attended in high school
	Public school	1,235	72.0	550	71.3	684	72.5
	Private school	480	28.0	221	28.7	259	27.5
Economic status ^a a Variable with the highest amount of missing data (n=73); (ABEP ^b b ABEP: Associação Brasileira das Empresas de Pesquisa; criteria)
	A	252	15.3	128	17.6	124	13.6
	B	734	44.7	329	45.1	405	44.3
	C	586	35.7	240	32.9	345	37.8
	D-E	71	4.3	32	4.4	39	4.3
Maternal education
	Illiterate or incomplete elementary education	377	22.1	156	20.4	221	23.5
	Complete elementary school or incomplete high school education	204	12.0	84	11.0	120	12.8
	Complete high school education (technical course) or incomplete higher education	539	31.5	237	31.0	301	31.9
	Complete higher education (or technologist course)	388	22.7	186	24.3	202	21.5
	Complete postgraduate education	199	11.7	102	13.3	97	10.3
Major areas of study (CNPq ^c c CNPq: Conselho Nacional de Desenvolvimento Científico e Tecnológico of the Ministry of Science, Technology and Innovations. criteria)
	Exact and land/agricultural sciences and engineering	495	28.9	274	35.5	220	23.3
	Health and biological sciences	317	18.5	126	16.3	191	20.3
	Applied social sciences and humanities	588	34.2	238	30.8	350	37.1
	Linguistic, letters and arts	316	18.4	134	17.4	182	19.3
Body mass index – BMI
	Underweight	91	5.4	22	2.9	69	7.4
	Eutrophic	1,072	63.0	493	64.4	578	61.7
	Overweight	370	21.7	181	23.7	189	20.2
	Obesity	169	9.9	69	9.0	100	10.7

Variable		Physical inactivity (%)	Sedentary behavior (%)	Inadequate sleep (%)	Smoking (%)	0 factor (%)	1 factor (%)	2 factors (%)	3 or 4 factors (%)
Variable		n=762	n=683	n=775	n=181	n=282	n=681	n=554	n=199
Age (years)
	18-19	43.2	44.7	44.3	8.4	16.3	39.2	33.1	11.4
	20-22	45.1	40.4	42.0	9.8	17.8	39.3	31.7	11.2
	≥23	45.2	31.3	49.3	15.1	15.5	40.9	31.3	12.3
	p-value^a a Pearson's chi-square test; b) Fischer's exact test;	0.725	<0.001	0.068	0.001	0.621	0.844	0.780	0.844
Race/skin color
	White	44.6	39.1	44.1	10.2	17.3	39.5	31.9	11.3
	Black	43.3	44.7	46.5	10.1	17.5	33.6	36.5	12.4
Age (years)
	Brown	46.5	39.5	49.6	11.4	11.0	45.1	30.7	13.2
	Asian/indigenous/other	28.6	35.7	46.4	25.0	10.7	53.6	28.6	7.1
	p-value^a a Pearson's chi-square test; b) Fischer's exact test;	0.337	0.449	0.465	0.085	0.088	0.037	0.531	0.716
Marital status
	Single	43.9	41.6	44.9	10.4	16.5	39.0	32.8	11.7
	Married or in stable union	50.0	23.6	43.8	11.8	18.8	44.4	25.7	11.1
	Separated, divorced or widowed	46.2	23.1	73.1	15.4	0	50.0	42.3	7.7
	p-value^a a Pearson's chi-square test; b) Fischer's exact test;	0.363	<0.001	0.015	0.623	0.058	0.247	0.122	0.802
Type of school attended in high school
	Public school	45.8	39.6	45.5	10.1	16.0	39.3	33.3	11.4
	Private school	41.0	40.2	44.2	11.7	17.7	40.6	29.6	12.1
	p-value^a a Pearson's chi-square test; b) Fischer's exact test;	0.083	0.826	0.627	0.381	0.384	0.660	0.150	0.737
Economic status (ABEP ^c c Variable with higher amount of missing data (n=38). criteria)
	A	39.7	42.1	45.6	13.1	17.9	36.5	33.3	12.3
	B	43.7	40.1	43.7	10.1	17.7	40.6	29.3	12.4
	C	48.0	38.2	46.1	10.2	15.7	38.0	35.0	11.3
	D-E	45.1	45.1	46.5	8.5	11.3	42.2	36.6	9.9
	p-value^a a Pearson's chi-square test; b) Fischer's exact test;	0.148	0.578	0.837	0.513	0.440	0.579	0.127	0.868
Major area of study (CNPq ^c c Variable with higher amount of missing data (n=38). criteria)
	Exact and land/agricultural sciences and engineering	42.8	38.2	58.4	8.5	13.3	39.2	34.6	12.9
	Health and biological sciences	40.1	31.2	53.0	6.3	21.1	38.2	30.6	10.1
	Applied social sciences and humanities	47.1	44.2	34.7	12.8	16.2	41.8	30.1	11.9
	Linguistic, letters and arts	46.2	42.7	36.1	13.9	17.1	38.0	34.5	10.4
	p-value^a a Pearson's chi-square test; b) Fischer's exact test;	0.166	0.001	<0.001	0.002	0.034	0.598	0.314	0.568
Body mass index – BMI
	Underweight	52.8	46.2	40.7	7.7	16.5	36.2	30.8	16.5
	Eutrophic	44.7	39.5	44.1	9.6	16.1	40.9	32.6	10.4
	Overweight	43.2	38.4	50.3	10.8	16.8	36.7	34.3	12.2
	Obesity	41.4	40.2	43.8	16.6	17.8	39.0	28.4	14.8
	p-value^a a Pearson's chi-square test; b) Fischer's exact test;	0.333	0.594	0.155	0.039	0.958	0.473	0.577	0.135

Factors					Total			Male			Female
N	PI^a a PI: Physical inactivity;	SB^b b SB: sedentary behavior;	ISD^c c ISD: inadequate sleep duration;	S^d d S: tobacco use;	O^e e O: observed value; (%)	E^f f E: expected value; (%)	O/E^g g O/E: ratio between observed/ expected values; (95%CI^h h 95%CI: 95% confidence interval; )	O (%)	E (%)	O/E (95%CI^h h 95%CI: 95% confidence interval; )	O (%)	E (%)	O/E (95%CI^h h 95%CI: 95% confidence interval; )
0	–	–	–	–	16.4	16.4	1.00 (0.91;1.10)	18.6	17.2	1.09 (0.95;1.24)	14.5	15.3	0.95 (0.82;1.09)
1	+	–	–	–	12.3	13.1	0.94 (0.83;1.06)	7.4	9.1	0.81 (0.64;1.03)	16.4	16.8	0.97 (0.85;1.10)
1	–	+	–	–	10.0	10.9	0.92 (0.81;1.06)	9.3	11.0	0.85 (0.69;1.05)	10.6	10.4	1.02 (0.85;1.21)
1	–	–	+	–	15.5ⁱ i clustering.	13.5	1.15 (1.04;1.27)	18.7	17.4	1.08 (0.95;1.23)	12.8ⁱ i clustering.	10.7	1.20 (1.03;1.40)
1	–	–	–	+	1.9	1.9	0.96 (0.68;1.35)	2.6	2.6	0.98 (0.64;1.51)	1.3	1.4	0.92 (0.52;1.61)
2	+	+	–	–	10.8ⁱ i clustering.	8.7	1.24 (1.09;1.41)	8.3ⁱ i clustering.	5.8	1.42 (1.13;1.78)	12.8	11.5	1.12 (0.96;1.30)
2	+	–	+	–	10.1	10.8	0.93 (0.82;1.07)	8.7	9.2	0.94 (0.76;1.17)	11.2	11.7	0.96 (0.81;1.13)
2	+	–	–	+	1.2	1.6	0.76(0.49;1.17)	0.8	1.4	0.55 (0.25;1.23)	1.5	1.5	0.97 (0.58;1.64)
2	–	+	+	–	7.3ⁱ i clustering.	8.9	0.81 (0.69;0.96)	9.2	11.1	0.83 (0.67;1.02)	5.7	7.3	0.79 (0.61;1.02)
2	–	+	–	+	1.3	1.3	1.05 (0.70;1.57)	1.8	1.7	1.07 (0.64;1.80)	1.0	0.9	1.01 (0.53;1.94)
2	–	–	+	+	1.6	1.6	1.02 (0.71;1.47)	2.9	2.7	1.07 (0.71;1.61)	0.6	1.0	0.67 (0.30;1.47)
3	+	+	+	–	7.1	7.1	0.99 (0.84;1.17)	6.4	5.9	1.08 (0.83;1.40)	7.6	8.0	0.96 (0.77;1.18)
3	+	+	–	+	0.9	1.0	0.91 (0.56;1.48)	0.9	0.9	1.01 (0.49;2.12)	1.0	1.0	0.92 (0.48;1.76)
3	+	–	+	+	1.2	1.3	0.96 (0.63;1.47)	1.3	1.4	0.92 (0.50;1.69)	1.2	1.1	1.11 (0.62;1.99)
3	–	+	+	+	1.5	1.1	1.44 (0.99;2.11)	2.1	1.7	1.21 (0.75;1.97)	1.1	0.7	1.62 (0.87;3.01)
4	+	+	+	+	0.9	0.8	1.03 (0.62;1.71)	1.0	0.9	1.15 (0.58;2.28)	0.7	0.7	1.03 (0.49;2.15)

Secretaria de Vigilância em Saúde e Ambiente - Ministério da Saúde do Brasil SRTVN Quadra 701, Via W5 Norte, Lote D, Edifício P0700, CEP: 70719-040, +55 61 3315-3464, Fax: +55 61 3315-3464 - Brasília - DF - Brazil
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[1] Correspondence: Pedro Augusto Crespo da Silva – Rua Marechal Deodoro, No. 1160, 3º andar, Pelotas, RS, Brasil. CEP: 96020-220, E-mail: pedroacrespo@hotmail.com