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Behavioral risk factor clusters among university students at nine universities in Libya

1 Department of Surgery, Hamad General Hospital, Hamad Medical Corporation, Doha, State of Qatar
2 College of Medicine, Qatar University, Doha, State of Qatar
3 School of Health and Education, University of Skövde, Skövde, Sweden
4 Faculty of Applied Sciences, University of Gloucestershire, Gloucester GL2 9HW, UK#
5 Faculty of Medical Technology, Misrata, Libya
6 Utrecht Centre for Child and Adolescent Studies, Utrecht University, Netherlands
7 Unit for Health Promotion Research, Institute of Public Health, University of Southern Denmark, Niels Bohrs Vej 9-10, 6700 Esbjerg, Denmark

topical section: Health Behavior, Health Promotion and Society

Objectives: This study identifies and describes the clustering of 5 behavioral risk factors (BRFs) among university students. We also investigated whether cluster membership is associated with the students’ self-rated academic performance and self-rated health. Material and methods: A sample of 1300 undergraduates at 6 universities and 3 colleges in Libya completed a self-administered questionnaire that assessed BRFs (nutrition, physical activity, alcohol consumption, smoking, illicit drug use, inadequate sleep). A two-step cluster analysis generated student clusters with similar lifestyles. Results: Two contrasting clusters of almost even size emerged (after exclusion of alcohol and illicit drug use due to very low prevalence). Cluster 1 comprised students with higher engagement in all forms of physical activity, higher levels of health consciousness, greater daily fruit/vegetable intake and better sleep patterns than students in cluster 2. Only as regards the consumption of sweets, cluster 1 students had less favorable practices than cluster 2 students. The prevalence of smoking was equally low in both clusters. Students in cluster 2, depicting a less healthy lifestyle, were characterized by a higher proportion of women, of students with less income and of higher years of study. Belonging to cluster 2 was associated with lower self-rated health (OR: 0.46, p < 0.001) and with lower self-rated academic performance (OR: 0.66, p < 0.001). Conclusion: Preventive programs should not address BRFs in isolation and should particularly target students with clustering of BRFs using specifically tailored approaches.
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