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Lifestyle and Risk Behaviors Among a Group of College Students in

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					     Lifestyle and Risk Behaviors
     Among College Students in
                Erbil City

                                       By

           Lecturer                Assist. Professor   Assist. Professor
      Hoshyar Amin Ahmed         Sadia Ahmed Khuder    Namir G. Al-Tawil
Ph.D. Community Health Nursing     Ph.D. NURSING         FICMS/CM.
• Introduction
  –   Definitions
  –   Background
  –   Components of a healthy lifestyle
  –   Lifestyle changes
  –   Objectives
• Subjects and Methods
• Results and Discussion
• Conclusions and Recommendations
                     Lifestyle
Theoretical definition:
A pattern of individual practices and personal behavioral
choices that are related to elevated or reduced health
risk.(Health line dictionary, 2009).
The way of living that lowers the risk of being seriously ill or
dying early. It is also about physical, mental, and social
wellbeing (WHO, 1999)

Operational definition:
The self reported responses of 1000 college students (who
participated in this study) regarding 104 health habits in
term under six lifestyle domains including physical
activity, dietary, self care and safety, stress, social and
emotional wellness, and sleep patterns.
             Risk behaviors

Theoretical definition:
Behavioral pattern associated with a high risk of
developing a chronic illness (Payne et al, 2007).

Operational definition:
The self reported unhealthy behavioral patterns by 1000
students who participated in this study with respect to
physical activity, dietary, self care and safety, stress,
social and emotional wellness, and sleep patterns.
            College students
Theoretical definition:
  A student enrolled in a college or university (Wordweb
  dictionary, 2009).

Operational definition:
  One thousand students in the first and final years of 8
  colleges who participated in this study and have been
  selected from the total population.
           WHO STEPS approach to risk factor assessment

                                                 Levels
  Module                                              Step 2:           Step 3:
                         Step 1:
                                                     Physical        Biochemical
                   Questionnaire-based
                                                   measurements        analyses
               Socio-economic and                 Measured          Fasting blood
               demographic variables,             weight and        sugar, total
               tobacco use, alcohol               height, waist     cholesterol
Core
               consumption, physical              circumference,
               inactivity, fruit and vegetable    blood pressure
               consumption
               Fat consumption education,         Hip               HDL,
Expanded
               household indicators               circumference     cholesterol,
core                                                                triglycerides
               Other health-related               Timed walk,       Oral glucose
Optional       behaviours, mental health,         pedometer, skin   tolerance test,
(examples)     disability, injury                 fold thickness,   urine
                                                  pulse rate.       examination
WHO 2003
                  Background
• “The recipe for a long life is correct nutrition, rest,
  emotional balance, and physical activity”.
• In the early 1960s “Lifestyle” had been used for
  advertising and marketing.
• This usage was taken up in epidemiology
• Lifestyle has moved from being a symptom of illness to
  a cause of disease
• With the rise of lifestyle drugs lifestyle is no longer seen
  as symptom or cause.
    Health determinants

1. Genetics
2. Lifestyle
3. Chance
Components of a good health
             Healthful lifestyle
•   Habits such as wearing a seat belt
•   Healthy diet
•   Enough physical exercise
•   Wearing sunscreen
•   Avoidance of smoking
•   Vaccinatiom
•   Screening
•   Drug therapy
           Lifestyle diseases
•   Atherosclerosis
•   Hypertension
•   Heart and lung diseases
•   Stroke
•   Obesity
•   Type 2 diabetes
•   Liver diseases
•   Cancers
•   Diseases associated with smoking,
    alcohol, and drug abuse.
          Leading causes of death
           Whole US Population
       1890s                  1990s
Flu                   Heart disease
Pneumonia             Cancer
TB                    Stroke
Digestive diseases    Chronic lung disease
Bronchitis            Accidents
Scarlet fever         Pneumonia/flu
Stroke                Suicide
Kidney diseases       Diabetes
                      HIV infection
                      Liver disease
             RESEARCHERS
Diseases are the result of modifiable lifestyle factors,
not the inevitable consequences of modern society
   PREVENTION




CHANGES IN BEHAVIOR
 GOOD MEDICAL CARE
LIFESTYLE CHANGES
Discontinuation of unhealthy
         behaviors
Modification of unhealthy
       behaviors
    Initiation of healthy behaviors
It appears the hunter-gatherer of
the Late Paleolithic era has evolved
into today’s couch potato, seeing
that the inhabitants of modern
societies have adopted a
predominantly sedentary lifestyle.
Humans are genetically
predisposed to live a highly active
lifestyle, deviation from that may
have contributed to the rise in
obesity rates and subsequent
development of chronic diseases
(O’Keefe and Cordain, 2004)
             Aims and objectives
• College students do not take into account the seriousness
  of their health behaviors.
• Their lives are very busy.
• Unhealthy behaviors affect academic performance.
• They encounter mental problems as well.
• Massive input of stresses include inside and outside
  pressures to succeed.
• University students form a high number of the young
  population.
• Healthy lifestyle behaviors will improve their health in order
  to live longer.
• Healthy, well educated young people contribute to the
  health and wealth of the population at large.
                 Aims and objectives cont.




General objective:
This study aimed to assess the lifestyle and risk behaviors
among college students in Erbil city.
           Specific objectives
     This study aimed to:
1.   Assess the lifestyle domains of college students in
     term of physical activity, dietary, self care and safety,
     stress, social and emotional wellness, and sleep
     patterns.
2.   Assess the risk behaviors practicing by college
     students in term of obesity, blood pressure, smoking,
     and alcohol use.
3.   Find out the association between lifestyle domains and
     risk behaviors with some of the variables such as
     gender, age, college type, and students' grades.
4.   Identify the association between Body Mass Index
     (BMI), and waist circumference with some of the
     studied variables such as gender, age, college type,
     and students' grades.
        Subjects and Methods
Study design
  This is a descriptive cross-sectional quantitative study
  carried out from 1st of May 2008 to 31st of August 2009.
Study setting
  This study was carried out at Hawler Medical University
  and Salahaddin University located in Erbil city, Iraqi
  Kurdistan region.
                  Subjects and Methods cont.

     Erbil city
Erbil city is the capital of Kurdistan Region and the central
district of Erbil governorate, which is located in the northern
part of Iraq, exactly between upper and lower Zab River,
bounded by Turkey and part of Duhok governorate at the
north, Kirkuk governorate at the south, Iran and part of the
Sulaimaniya governorate at the east, and Ninevah
governorate at the west. Erbil city is located at about 350 km
north of Baghdad, on latitude 36.11 and longitude 42.2 and
covering an area of about 60 km², while the governorate is
covering about 17981 km² (UNICEF, 2000).
Erbil governorate had a population of 1438482 with a male:
female ratio of 1.02:1; adolescents and young adults (15-49
years) constitute 51.2% of the total population. The Erbil city
had a population of 868145 with 437586 males and 430559
females giving a male: female ratio of 1.01:1 (KRSO, 2006).
              Subjects and Methods cont.


B. Data collection:
1. The questionnaire
      • Socio-demographic information
      • Biophysical measurements
      • Lifestyle patterns
2. Biophysical measurements:
   Blood Pressure (B.P.)
   Body mass Index (BMI)
   Waist Circumference
   Waist-hip Ratio (WHR)

   According to the WHO guides.
           Subjects and Methods cont.



                   Blood pressure
Normal                 90–119/60–79 mmHg
Prehypertensive        120–139/80–89 mmHg
Hypertensive           ≥ 140/ ≥ 90 mmHg
Hypotensive            < 90/60 mmHg
Hariharan (2006)
International Classification of adult underweight,
    overweight and obesity according to BMI


       Classification                BMI (kg/m2)
     Underweight               <18.5
     Normal range              18.5 - 24.99
     Overweight                ≥25
     Obese                     ≥30
     Adapted from WHO, 2004.
             Subjects and Methods cont.


               Waist circumference
                      Male                Female

Normal              < 94 cm               < 80 cm
Overweight      94 – 101.9 cm       80 – 87.9 cm
Obesity             ≥102 cm               ≥88 cm
             Subjects and Methods cont.


                  Waist-hip ratio
                      Male                 Female

Normal                < 0.9                 < 0.8
Overweight          0.9 – 0.99            0.8 – 0.84
Obesity                ≥1                  ≥ 0.85
                Subjects and Methods cont.



C. Participation in this study was not compulsory.
D. Statistical analysis:
  SPSS and Microsoft Excel
  The P value of ≤ 0.05 was considered as statistically
  significant.
                  Subjects and Methods cont.

            Scores of the behavioral variables

                                Number of        Maximum
    Behavioral variable
                                  items           Score
Physical activity patterns            5             10
Dietary patterns                     12             24
Self care and safety patterns        20             40
Stress patterns                      13             26
Social and emotional patterns        46             92
Sleep patterns                        8             16
             Total                  104            208
         Limitations of the study
1.   This study lacks measurement of the sexual patterns
     of the students due to socio-cultural barriers which
     leaded to obscure personal information about sexual
     behaviors.
2.   Including the College of Sport in the study which
     affected the results of the study with respect to
     physical activity, while this result had an advantage in
     comparison of lifestyle patterns of the students of this
     college with the other 7 colleges.
Results
               Distribution of sample by college and grade

           Grade        First grade     Final grade     Total

College                No.        %     No.     %     No.       %
Medical colleges:
Medicine               102       20.4   100     20    202    20.2
Dentistry              53        10.6   42      8.4    95       9.5
Pharmacy               49        9.8    77     15.4   126    12.6
Nursing                46        9.2    31      6.2    77       7.7
Non-medical colleges:
Human sciences         59        11.8   63     12.6   122    12.2
Sport                  37        7.4    30       6     67       6.7
Basic education        60         12    77     15.4   137    13.7
Arts                   94        18.8   80      16    174    17.4
       Total           500       100    500    100    1000   100
    Demographic characteristics of the sample
                               Frequency
       Variables                           %
                                n=1000
Age (years):
17 – 19                           270      27
20 – 22                           347      34.7
23 – 25                           317      31.7
≥ 26                              66       6.6
Gender:
Male                              488      48.8
Female                            512      51.2
Marital status:
Single                            898      89.8
Married                           102      10.2
Permanent residency:
Urban                             684      68.4
Sub-urban                         249      24.9
Rural                             67       6.7
Self reported family income:
Sufficient                        648      64.8
Not sufficient                    249      24.9
Exceeds the needs                 103      10.3
Distribution of the sample (1000 students) by engagement in fitness
                  activities according to college type
                                          Fitness activities
               College         YES                NO                 Total
                          No.        %      No.        %       No.           %
       Medicine           81     40.1       121    59.9        202       100
       Dentistry          27     28.4       68     71.6        95        100
       Pharmacy           38     30.2       88     69.8        126       100
       Nursing            23     29.9       54     70.1        77        100
       Human sciences     18     14.8       104    85.2        122       100
       Sport              63         94      4         6       67        100
       Basic education    46     33.6       91     66.4        137       100
       Arts               53     30.5       121    69.5        174       100
                Total     349    34.9       651    65.1    1000          100
       X2 = 132.77               d.f. = 7                            P < 0.001
  Distribution of sample by sources of information about health and lifestyle
                              Medical colleges   Non-medical colleges     Total
               College type       n=500                n=500             n=1000

Source of information          No.       %         No.         %        No.   %

TV                             445       89        415         83       860   86
Friends                        355       71        355         71       710   71
Textbooks                      353       70.6      353        70.6      706   70.6
Family                         369       73.8      325         65       694   69.4
Teachers                       348       69.6      302        60.4      650   65
Newspapers                     339       67.8      293        58.6      632   63.2
Magazines                      310       62        313        62.6      623   62.3
Radio                          301       60.2      268        53.6      569   56.9
Internet                       244       48.8      241        48.2      485   48.5
Relatives                      225       45        187        37.4      412   41.2
Workshops and seminars         126       25.2      163        32.6      289   28.9
Conferences                    105       21         94        18.8      199   19.9
  Measurement of
health risk behaviors
            Prevalence of smoking among the study sample
                                  First grade               Final grade
                                           Non-                     Non-           Total
                            Smokers                    Smokers
    College        Gender                 smokers                  smokers
                                          N            N           N
                            No.    %            %           %             %      No.   %
                                          o.           o.          o.
                  Male      11    16.7   55     83.3   14   25.9   40     74.1   120   20.8
Medicine
                  Female    0       0    36     100    0     0     46     100    82     0
                  Male      3      8.8   31     91.2   4    17.4   19     82.6   57    12.3
Dentistry
                  Female    0       0    19     100    0     0     19     100    38     0
                  Male      6     22.2   21     77.8   4    13.8   25     86.2   56    17.9
Pharmacy
                  Female    0       0    22     100    2    4.2    46     95.8   70    2.9
                  Male      1      5.3   18     94.7   5    26.3   14     73.7   38    15.8
Nursing
                  Female    0       0    27     100    0     0     12     100    39     0
                  Male      3     10.7   25     89.3   6    25     18     75     52    17.3
Human sciences
                  Female    1      3.2   30     96.8   0     0     39     100    70    1.4
                  Male      1       5    19     95     2    15.4   11     84.6   33    9.1
Sport
                  Female    0       0    17     100    0     0     17     100    34     0
                  Male      0       0    13     100    12   29.3   29     70.7   54    22.2
Basic education
                  Female    0       0    47     100    2    5.6    34     94.4   83    2.4
                  Male      4      9.1   40     90.9   10   29.4   24     70.6   78    17.9
Arts
                  Female    0       0    50     100    0     0     46     100    96     0
   Distribution of smokers by gender and college type
                     Male students      Female students          Total
      College
                      n    No.   %        n    No. %       n     No.     %
Medical colleges     251   29    11.6    249    1   0.4   500     30      6
Non-medical colleges 237   57    24.1    263    4   1.5   500     61     12.2
       Total         488   86    17.6    512    5    1    1000    91     9.1

P = 1 (by Fisher's Exact Test)


    Poreba et al (2007) Wroclaw universities in Poland : 23.9% .
    Nazari (2002); 14.4% among the medical college students.
Distribution of the sample by alcohol use

                    Users, 47,
                     4.7%




      Non-users, 953,
          95.3%
            Alcohol consumption by grade and college type

                                First grade               Final grade
               Grade                                                Alcohol
                             Alcohol      Alcohol        Alcohol
                                                                     Non-
                              users      Non-users        users
                        n                            n               users

      College                No.    %    No.   %         No.   %   No.   %
Medical colleges       250   17    6.8   233 93.2 250    18    7.2 232 92.8
Non-medical colleges 250     4     1.6   246 98.4 250     8    3.2 242 96.8
       Total           500   21    4.2   479 95.8 500    26    5.2 474 94.8
                       X2=8.4      d.f.=1 P=0.003    X2=4.06   d.f.=1 P=0.04


 Significant difference were seen between alcohol consumption of the
 medical and non-medical students regarding their grades (P<0.001).
Percentage of alcohol user students by currency of alcohol use

                    Daily; 2.40%
                   Every other
                   day; 2.40%
           Once a week;
             17.20%




                                      On occasions;
                                           78%
Distribution of the sample by reporting feeling of being healthy or unhealthy
                             Feeling          Feeling
                                                               Total
         College             healthy        unhealthy
                          No.     %         No. %           No.       %
  Medicine                168 83.2           34 16.8        202      100
  Dentistry                86    90.5         9    9.5       95      100
  Pharmacy                100 79.4           26 20.6        126      100
  Nursing                  63    81.8        14 18.2         77      100
  Human sciences           76    62.3        46 37.7        122    100
  Sport                    52    77.6        15 22.4         67    100
  Basic education         103 75.2           34 24.8        137    100
  Arts                    139 79.9           35 20.1        174    100
         Total            787 78.7          213 21.3       1000    100
    X2 = 31.6                    d.f. = 7                   P < 0.001
                                Past medical history of the sample


             12.00%   11.1%

             10.00%
Percentage




             8.00%


             6.00%


             4.00%


             2.00%                   1.4%
                                                     0.7%              0.7%
                                                                                   0.1%      0.1%
             0.00%

                      Obesity     Hypertension   Heart diseases Thyroid disease   Diabetes   Cancer
                                                            Diseases
                Distribution of the sample by families' medical history



             35.00%
                         29.5%
             30.00%
             25.00%
Percentage




                                      19.1%
             20.00%                              17.5%
                                                            15%
             15.00%
             10.00%                                                  6.9%     6.8%
                                                                                        5.2%
             5.00%
             0.00%
                      Hypertension   Diabetes     Heart    Obesity   Cancer   Stroke   Thyroid
                                                diseases                               disease
                                                           Disease
 Biophysical
measurements
Distribution of the sample by their B.P. in mm. Hg.


           B.P.                No.           %
  Hypotensive                   4            0.4          Gan et al
                                                          (2003) on the
  Normal                       523          52.3          17-23 years
                                                          Singapore,
  Prehypertensive              434          43.4          hypertension
                                                          was 1.6%.
  Hypertensive                 39            3.9
          Total               1000          100

  Note: None of the students was under antihypertensive
  medication.
            Association between BMI, waist circumference, and WHR
        Physical                BMI                 Waist Circumference               WHR
        measurement
                        Male          Female          Male       Female        Male       Female

Classification        No.     %      No.   %        No.   %      No.   %      No.   %     No.   %
Underweight           29      5.9    36    7.0

Normal                343     70.3   375   73.2     430   88.1   371   72.5   380   77.9 247    48.2

Overweight            98      20.1   87        17   44     9     103   20.1   92    18.9 155    30.3

Obese                 18      3.7    14    2.7      14    2.9    38    7.4    16    3.3   110   21.5

        Total         488     100    512   100      488   100    512   100    488   100   512   100

                           X2=2.75    d.f.=3          X2=38.55    d.f.=2       X2=113.9   d.f.=2
                               P = 0.43                   P <0.001                 P <0.001


   •   USA CDC : 1 in 5 college students are overweight.
        Half of them perceive themselves as being overweight (Garside, 2009).
   •   Middle Eastern countries: obesity exceeding 40% worse in women than in men
       (Uwaifo, 2009).
 Distribution of the sample by Waist Circumference and age

                Age    17 – 19      20 – 22     23 – 25
                                                            ≥ 26 years
                        years        years       years

   Classification     No.   %      No.   %     No.   %      No.   %
Underweight           30    11.1   19    5.5   15    4.7    1     1.5
Normal                196 72.6     256   73.8 229 72.2      37    56.1
Overweight            41    15.2   59    17    63    19.9   22    33.3
Obese                 3     1.1    13    3.7   10    3.2    6     9.1
        Total         270   100    347   100   317   100    66    100
X2 = 37.3                     d.f. = 9                       P < 0.001

Janghorbani et al, 2007 higher prevalence of obesity among females
than males in Iranian adults.
      Prevalence of obesity assessed by Waist Circumference according
                          to grades of the students

            Grade                  First grade                                   Final grade
                     Male              Female        Total          Male           Female         Total
Classification
of Waist
Circumference       No.      %        No.   %      No.    %       No.     %      No.    %       No.       %
Normal              231      92       190   76.3   421    84.2    199     84      181   68.8    380       76
Overweight          17       6.8      47    18.9   64     12.8    27      11.4    56    21.3    83    16.6
Obese                3       1.2      12    4.8    15         3   11      4.6     26    9.9     37        7.4
       Total        251      100      249   100    500    100     237     100     263   100     500       100
                         X2 = 23.45                d.f. = 2             X2 = 15.76             d.f. = 2
                                      P < 0.001                                   P < 0.001
            Prevalence of overweight and obesity by waist
             circumference according to the college type


          Physical
          measurement      Normal         Overweight             Obese          Total


College                   No.    %       No.         %      No.      %      No.     %
Medicine                  169   83.66     26        12.87   7       3.47    202    100
Dentistry                 78    82.11     10        10.53   7       7.36    95     100
Pharmacy                  102   80.95     19        15.08   5       3.97    126    100
Nursing                   47    61.04     23        29.87   7       9.09    77     100
Human sciences            86    70.49     23        18.85   13      10.66   122    100
Sport                     58    86.57      6        8.95    3       4.48    67     100
Basic Education           116   84.67     15        10.95   6       4.38    137    100
Arts                      145   83.33     25        14.37   4        2.3    174    100
            X2 = 38.806                 d.f. = 14                   P < 0.001
Distribution of physical activity patterns of the sample
                  by the college type
               College type                  Non-
                                Medical
                                            medical      Total
                                colleges
                                            colleges                P
                                                                  value
                                 n=500       n=500      N=1000
         Physical
     Activity Patterns         No.    %    No.    %    No.   %
     Engage in sweat-
     producing physical
1.   activity for 20-30        158 31.6 215       43   373 37.3 < 0.001   Abolfotouh et
     minutes, three times                                                 al (2007)
     per week
                                                                          College
     Engage in individual,                                                students living
2.   family, or team           214 42.8 308 61.6 522 52.2 < 0.001
     activities                                                           in Alexandria
     Stretch for at least 5
                                                                          university
3.
     minutes every day         158 31.6    61    12.2 219 21.9 < 0.001    hostels; 67.2%
     Walk or bicycle
4.
     whenever possible         331 66.2 323 64.6 654 65.4         0.59
     Avoid watching TV or
5.   use computer at least 2   125   25    92    18.4 217 21.7    0.01
     hours daily
                                      Dietary patterns
                             College type         Medical       Non-medical
                                                                                      Total
                                                  colleges        colleges
                                                                                                     P
                                                      n=500          n=500           n=1000        value
Dietary patterns                                No.       %     No.           %     No.       %

     Limit the number of beverages
1    containing caffeine (coffee, tea, cacao)   316      63.2   351          70.2   667   66.7     0.01
     not more than two cups per day

     Eat or drink at least two servings of
2    milk products every day
                                                104      20.8   50           10     154   15.4     0.01

3    Avoid eating foods that are high in fat    182      36.4   161          32.2   343   34.3     0.16
4    Avoid eating between meals                 151      30.2   158          31.6   309   30.9     0.63
     Try to eat regular meals, rather than
5    skip of meals
                                                316      63.2   344          68.8   660       66   0.06

6    Eat salad with meal                        414      82.8   403          80.6   817   81.7     0.37
     Try to balance energy intake with
7    physical activity
                                                276      55.2   281          56.2   557   55.7     0.75

8    Eat fruits at least 2 times daily          293      58.6   273          54.6   566   56.6     0.2
9    Eat sweets at least once a day             290       58    306          61.2   596   59.6     0.3

10   Drink at least 8 cups of fluids daily      305       61    306          61.2   611   61.1     0.95
     Avoid drinking two cans of soda or
11   more daily
                                                372      74.4   372          74.4   744   74.4      1

12   Limit the amount of salt and sugar         281      56.2   264          52.8   545   54.5     0.28
                     Self care and safety patterns
                College type      Medical     Non-medical
                                                               Total
                                  colleges      colleges
                                                                            P
                                   n=500        n=500         n=1000      value
Self care and
safety patterns                  No.    %     No.       %    No.   %
     Avoid places with
1    cigarette smoking
                                 374   74.8   427    85.4    801   80.1   < 0.001
     Get 6 - 8 hours of sleep
2    every night
                                 380    76    416    83.2    796   79.6   0.005

3    Avoid smoking narghile      450    90    464    92.8    914   91.4   0.114
     Avoid using alcohol or
     other drugs as a way of
4    handling stressful
                                 472   94.4   459    91.8    931   93.1   0.105
     situations or problems
     Protect skin from sun
     damage by using
5    sunscreen and wearing
                                 268   53.6   336    67.2    604   60.4   < 0.001
     hats
     Wear glasses at summer
6    times
                                 212   42.4   167    33.4    379   37.9   0.003

     Examine breasts or testes
7    on a monthly basis
                                 94    18.8    33     6.6    127   12.7   < 0.001

8    Clean teeth every day       452   90.4   452    90.4    904   90.4     1
     Avoid using steroidal
9    drugs to gain weight
                                 482   96.4   484    96.8    966   96.6   0.727

     Avoid drinking alcoholic
10   beverages
                                 369   73.8   405       81   774   77.4   0.006
                                Self care and safety patterns cont.
                                          Medical colleges   Non-medical colleges         Total
                       College type
                                                                                                         P
Self care and                                   n=500                n=500            n=1000
                                                                                                       value
safety patterns
                                          No.           %      No.           %      No.           %
      Do annual routine health
11    checkup
                                          93        18.6        86           17.2   179       17.9     0.563

12    Got hepatitis vaccination           297       59.4        91           18.2   388       38.8     < 0.001

13    Got Tetanus Toxoid vaccination      221       44.2       115           23     336       33.6     < 0.001
      Avoid self medications when
14    getting sick
                                          222       44.4       326           65.2   548       54.8     < 0.001

      Read and follow the label
15    directions when using               432       86.4       411           82.2   843       84.3     0.068
      prescribed drugs
      Wear a seat belt when traveling
16    in a vehicle
                                          241       48.2       209           41.8   450           45   0.042

      Know how to respond in the
17    event of an emergency situation
                                          380           76     382           76.4   762       76.2     0.882

      Avoid riding with drivers who
18    are under the influence of          405           81     429           85.8   834       83.4     0.041
      alcohol or other drugs

      Use safety measures in the
19    bathroom or wear masks,             251       50.2       225           45     476       47.6     0.099
      helmets, lifejacket in activities

      Avoid driving under the
20    influence of alcohol and other      425           85     468           93.6   893       89.3     < 0.001
      drugs
                                 Stress patterns
                                                            Non-
                                              Medical
                     College type             colleges
                                                           medical       Total
                                                           colleges                   P
                                                                                    value
                                              n=500         n=500       n=1000
Stress patterns                              No.    %     No.    %     No.   %
     Have a job or do other enjoyable
1    work
                                             159   31.8   150    30    309   30.9   0.538

2    Easy to express feelings freely         268   53.6   273   54.6   541   54.1   0.751
     Recognize early, and prepare for,
3                                            374   74.8   383   76.6   757   75.7   0.507
     events or stressful situations
     Have friends and relatives to help
4                                            376   75.2   367   73.4   743   74.3   0.515
     when being stressed
5    Do not feel overstressed at college     218   43.6   299   59.8   517   51.7   < 0.001
6    Do not feel overstressed at home        382   76.4   369   73.8   751   75.1   0.342
     Participate in enjoyable group
7                                            267   53.4   252   50.4   519   51.9   0.342
     activities
     Practice relaxation technique when
8                                            292   58.4   334   66.8   626   62.6   0.006
     feeling distressed
     Avoid drinking a cup of tea or coffee
9                                            288   57.6   302   60.4   590   59     0.368
     when feeling distressed
     Listen to music when feeling
10                                           361   72.2   337   67.4   698   69.8   0.098
     distressed
11   Walk when feeling distressed            291   58.2   319   63.8   610   61     0.069
                          Social and emotional wellness
                                                                                   Non-
                                                 College type       Medical
                                                                                  medical       Total
                                                                    colleges
                                                                                  colleges                   P
Social and emotional                                                                                       value
                                                                     n=500        n=500        N=1000
wellness patterns                                                   No.   %      No.   %      No.   %

1    Keep informed about social, political and/or current issues    275   55     238   47.6   513   51.3   0.019

2    Participate in campus events that help community               292   58.4   357   71.4   649   64.9   < 0.001

3    Share in community charity activities                          335   67     370   74     705   70.5   0.015

4    Take action to correct something that is dangerous to others   443   88.6   443   88.6   886   88.6     1

5    Resolve conflict                                               456   91.2   480   96     936   93.6   0.002

6    Go out with the family or friends at least once a week         331   66.2   328   65.6   659   65.9   0.841

7    Find all of friends that they are college students             326   65.2   363   72.6   689   68.9   0.011

8    Belong to a club or organization                               156   31.2   117   23.4   273   27.3   0.006
9    Invest in a mutual bond fund                                   87    17.4   72    14.4   159   15.9    0.22
10   Have a hobby                                                   425   85     456   91.2   881   88.1   0.002
                 College type       Medical     Non-medical
                                                                Total
                                    colleges      colleges
                                                                             P
                                                                           value
Emotional                            n=500         n=500       N=1000
management                         No.    %     No.    %      No.    %

    Take into consideration the
1   age, gender, and position of   378   75.6   343   68.6    721   72.1   0.014
    people
2   Cry easily                     251   50.2   323   64.6    574   57.4 < 0.001
3   Learn from the mistakes        462   92.4   484   96.8    946   94.6   0.002
4   Set realistic goals            457   91.4   460    92     917   91.7   0.731
    Accept responsibility for
5                                  449   89.8   455    91     904   90.4   0.52
    own actions
    Interested in
6   understanding the views of     449   89.8   478   95.6    927   92.7   0.835
    others
                                            Medical     Non-medical
                      College type          colleges      colleges
                                                                        Total
                                                                                       P
                                             n=500        n=500        N=1000        value
Professionalism                            No.    %     No.    %      No.       %

1   Have professional goals                423   84.6   417    83.4   840       84   0.024

2   Subscribe to journals                  64    12.8   39     7.8    103   10.3      0.01
3   Belong to professional organizations   83    16.6   49     9.8    132   13.2     0.001

    Use appropriate personal protective
4                                          298   59.6   374    74.8   672   67.2     < 0.001
    equipments

    Follow standards of care when
5                                          411   82.2   407    81.4   818   81.8     0.743
    handling dangerous substances

    Try to perform daily duties without
6                                          383   76.6   396    79.2   779   77.9     0.322
    delay

    Take advantage of opportunities to
7                                          451   90.2   467    93.4   918   91.8     0.065
    learn new skills

    Strive to develop dependability in
8                                          460    92    486    97.2   946   94.6     < 0.001
    work

9   Strive to develop initiative in work   450    90    473    94.6   923   92.3     0.006
                     College type           Medical     Non-medical
                                                                        Total
                                            colleges      colleges
                                                                                       P
                                                                                     value
Spirituality                                 n=500        n=500        N=1000

and values                                 No.    %     No.    %      No.       %

1   Feel that the life is purposeful       443   88.6   443    88.6   886   88.6       1

    Have leisure time activities
2                                          302   60.4   276    55.2   578   57.8     < 0.001
    consistent with values
    Maintain the trust of the family
3                                          465    93    480    96     945   94.5     0.037
    and friends
    Tolerating the values and beliefs of
4                                          435    87    431    86.2   866   86.6      0.71
    others
5   Pray or meditate every day             422   84.4   458    91.6   880       88   < 0.001

6   Believe in a higher power              466   93.2   475    95     941   94.1     0.227

    Attend meetings at a place of
7                                          292   58.4   348    69.6   640       64   < 0.001
    worship regularly
8   Read spiritual books                   292   58.4   305    61     597   59.7     0.402

9   Listen to spiritual audiotapes         262   52.4   326    65.2   588   58.8     < 0.001
                                             Medical     Non-medical
                                                                         Total
                   College type              colleges      colleges
                                                                                      P
                                              n=500        n=500        N=1000      value
Intellectuality                             No.    %     No.    %      No.   %


1   Having no difficulty in concentrating   313   62.6   280    56     593   59.3   0.034


2   Do not forget easily                    250    50    224   44.8    474   47.4   0.112

    Learn about different interesting
3   topics from books, magazines,           427   85.4   438   87.6    865   86.5   0.309
    newspapers, and the internet

4   Gather facts before making decisions    443   88.6   459   91.8    902   90.2   0.089


5   Read at least one book a month          184   36.8   275    55     459   45.9   < 0.001

    Do not use drugs for elevation of
6                                           464   92.8   390    78     854   85.4   < 0.001
    concentration level
    Make a plan to learn new things
7                                           324   64.8   370    74     694   69.4   0.002
    every day
    Prefer manual math calculations
8                                           308   61.6   310    62     618   61.8   0.896
    rather than using calculator
                   College type          Medical
                                         colleges
                                                     Non-medical
                                                       colleges
                                                                     Total

                                                                                   P
                                          n=500        n=500        N=1000
                                                                                 value

                                        No.    %     No.    %      No.       %
Body image
1   Worry about weight                  322   64.4   370    74     692   69.2    0.001
2   Like to be attractive               366   73.2   319   63.8    685   68.5    0.001

    Having no difficulty in accepting
3   compliments about appearance        307   61.4   288   57.6    595   59.5    0.221
    from others

    Ask other people how to be
4                                       245    49    252   50.4    497   49.7    0.658
    looked

    Feel more anxious about body in
5                                       207   41.4   246   49.2    453   45.3    0.013
    the summer time

6   Proud of body feature               310    62    314   62.8    624   62.4    0.794
                            Sleep patterns
                                              Non-
                 College type    Medical
                                             medical        Total
                                 colleges
                                             colleges                     P
                                                                        value
                                  n=500       n=500        N=1000
Sleep patterns
                                No.   %      No.   %      No.   %

1 Sleep 6 - 8 hours at night    339   67.8   346   69.2   685   68.5   0.634

    Wake up refreshed most
2                               205   41     219   43.8   424   42.4    0.37
    mornings
    Sleep soundly without
3   waking up during the        255   51     196   39.2   451   45.1   < 0.001
    night
    Do not wake up
4   suddenly during the         343   68.6   273   54.6   616   61.6   < 0.001
    night

5   Go to bed before 10 PM      124   24.8   136   27.2   260   26     0.387

    Take a shower before
6                               108   21.6   125   25     233   23.3   0.203
    bedtime
    Put off the lights before
7                               419   83.8   425   85     844   84.4   0.601
    going to bed
    Go to toilet before going
8                               431   86.2   443   88.6   874   87.4   0.253
    to bed
                  Overall lifestyles mean scores



             50                               47.2%
             45
             40
             35
Percentage




             30                     24.2%
             25                                          21.1%
             20
             15
             10           5.6%
              5   0.4%                                           1.5%
              0
                  < 70    70-74     75-79     80-84      85-89   90+
                                  Lifestyle mean score
          Mean scores of the lifestyle patterns according to
                            college type
         Lifestyle                                                 Social and
                         Physical
                                    Diet    Self care     Stress   emotional       Sleep    Total*
                         activity
pattern College                                                     patterns


Mean scores of the medical college students:
Medicine                  72.03     76.90    81.27        78.94      83.42         80.07    80.89
Dentistry                 70.74     78.20    82.76        81.21      84.38         76.71    81.72
Pharmacy                  71.98     78.14    82.76        79.82      84.92         75.55    81.96
Nursing                   78.57     77.11    85.52        78.67      86.97         76.70    83.32
    P value              <0.001     0.34    <0.001        0.126     <0.001        <0.001    0.078
Mean scores of the non-medical college students:
Human
                                                                                            80.67
sciences                  73.52     77.08    80.82        81.43      82.85         75.92
Sport                     83.88     78.36    82.65        81.80      87.36         79.85    83.98
Basic
                                                                                            81.96
Education                 77.52     77.40    81.90        79.76      85.20         76.73
Arts                      76.61     76.70    82.41        80.02      85.77         76.94    82.29
    P value              < 0.001    0.423    0.081        0.182    < 0.001         0.016    0.117
       Total              74.93     77.35    82.25        80.04      84.82         77.40    80.89
                     F = 7.44                        d.f. = 7                   P < 0.001
       Note: ANOVA test was used
Lifestyle mean scores according to college grade


                                 Grade
                                                        P
  Lifestyle pattern   Mean scores /   Mean scores /   value
                      First grade     Final grade
 Physical activity        75.7           74.16        0.055
 Diet                     77.4            77.3        0.827
 Self care                82.2            82.3        0.786
 Stress                  80.62           79.46        0.028
 Social and
                         85.18           84.46        0.032
 emotional patterns
 Sleep                   77.86           76.94        0.09
  Conclusions
     and
Recommendations
                      Conclusions
     Based on the findings of the study and their
   interpretations, the following conclusion can be driven:
1. Nearly one third of the college students who participated in
   this study reported negative health habits.
2. No significant differences were noted between the lifestyle
   patterns of the medical and non-medical college students
   on one hand and between the first grade and final grade
   college students on other hand.
3. Nearly one quarter of the college students reported that
   they are unhealthy.
4. Only one third of the college students were engaged in the
   fitness activities.
5. Students of the College of Sport had reported the highest
   overall lifestyle mean score than the other 7 colleges
   including highest mean scores in physical activity, dietary,
   stress, social and emotional patterns, with exception of self
   care and sleep patterns.
                  Conclusions cont.

6. Abdominal obesity was much common among females
   than male students nearly by 3 times. It was lower among
   students of the College of Sport than the students of the
   other colleges and it was increasing with age.
7. The WHR based obesity was higher among females than
   male students by nearly 6 times.
8. Smoking habit was much prevalent among male college
   students than females.
9. Alcohol consumption was eight times higher among male
   college students than females and 3 times higher among
   medical college students than non-medical college
   students.
10. About half of the participants of the study suffered from
   abnormal blood pressure including 43.4%
   prehypertensives and 3.4% hypertensives.
Recommendations
                Recommendations

1. Further studies are recommended in order to;
    a. Set a cut off point below which the risk of diseases significantly
       increases.
    b. Identify the factors behind the prehypertension conditions
       among college students.
    c. Determine the association of different lifestyle patterns with the
       grade point average of the college students.
2. Establishment of committees in the university to address the health
    needs and try to help them in monitoring their health behaviors through
    measurement of their health lifestyle and receive advices for changing
    their health behaviors to desirable ones.
3. Integrating physical education into the university curriculum in order to
    promote the physical activity of the college students.
4. Integration of healthy lifestyle education into the formal primary and
    secondary school educational program.
Thank You

				
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