Description

Health-promoting behaviors are an essential aspect of health promotion, especially for nursing students. However, studies to measure health-promoting behaviors among nursing students remain scarce. The Health-Promoting Lifestyle Profile-II questionnaire may be used to assess the HPB among nursing students. To determine psychometric properties of the Health-Promoting Lifestyle Profile-II scale among undergraduate nursing students.

As part of a major cross-sectional study regarding health-promoting behaviors of 866 undergraduate nursing students, exploratory and confirmatory factor analyses were conducted to assess the validity and reliability evidence of the Health-Promoting Lifestyle Profile-II questionnaire. The participants completed an online survey using the original 6-factor model Health-Promoting Lifestyle Profile-II.

Health-Promoting Lifestyle

The exploratory factor analysis provided a novel 12-factor model for Health-Promoting Lifestyle Profile-II. The 12-factor model demonstrates high internal consistency with a Cronbach's alpha of =.929. The confirmatory factor analysis demonstrates a goodness-of-fit index: χ2 (1208) =6939.04, p≤ .01, Root Mean Square Error of Approximation=.074, Goodness-of-fit Index = .76, Adjusted Goodness-of-fit Index=.72, the Parsimony Goodness-of-fit Index=.67 and the Comparative Fit Index .76, with χ2 and degrees of freedom ratio of 5.74. The 12-factor model shows a better fit compared to the original 6-factor Health-Promoting Lifestyle Profile-II.

Health Care Team

As emerging members of health care team, nursing students must project themselves to be models of health promotion. While the Health-Promoting Lifestyle Profile-II shows strong evidence of reliability and validity among nursing students, the researchers recommend conducting more studies on health-promoting behaviors using the 12-factor model on different population groups.

As preventive health is becoming more popular in today's healthcare settings, health-promoting behaviors (HPB) have a significant role in disease prevention. The primary purpose of health promotion is to improve health by changing people's health-related behaviors and preventing diseases. The Healthy People 2030 framework was developed by the U.S. Department of Health and Human Services with a vision to create communities where people can obtain health and wellness across their lifespan (Office of Disease Prevention and Health Promotion, 2014). HPB consists of a multidimensional pattern of self-initiated actions that improve or maintain an individual's health and wellness.

The study included a convenience sample of 866 undergraduate nursing students who are members of the National Student Nurses Association (NSNA). The participants received an email invitation from the NSNA executive director to participate in the study and a web-based survey link to the questionnaire. The sampling frame included 58,000 active NSNA members, who were students enrolled in the state-approved nursing programs (diploma, associate degree, generic, and baccalaureate) preparing for RN.

One of the priorities in the present healthcare system is the nurses’ role in health promotion (Bryer et al., 2013). A healthy society needs a healthy population; therefore, it is essential to help people develop and follow a healthy lifestyle at a young age, which will protect, sustain, and enhance their health and well-being. Evidence suggests that lifestyle choices make a difference in people's health and life expectancy. According to Mozaffarian et al. (2015), unhealthy behaviors and lifestyle-related risk factors are the primary causes of disability and death in the U.S. and worldwide. According to Tabish (2017), cardiovascular diseases (CVD), diabetes, cancer, and chronic respiratory diseases are four major lifestyle diseases. Based on the 2016 American Heart Association statistics, of the four major lifestyle diseases, CVD and stroke produce significant health and economic issues in the United States and globally.

The global impact of an unhealthy lifestyle is enormous. The leading causes of death are heart disease and stroke, which lead to about 17 million deaths every year. This number is projected to increase by more than 23.6 million by 2030. According to WHO (2021), 17.9 million people die every year due to CVD, which is nearly 32% of all global deaths, primarily due to heart attacks and strokes. The factors leading to these diseases include unhealthy diet, physical inactivity, tobacco use, and the harmful use of alcohol (WHO, 2021). Therefore, health promotion is a central strategy for improving health.

Although there are various studies on college students, research on HPB of nursing students are seldom. HPB plays an essential role in the health and wellness of nursing students. As health promoters and professional care providers, nursing students play an indispensable role in enhancing patients’ healthy lifestyle behaviors. As a result, nursing students adopting HPB is essential in providing better patient care. Although nursing students are exposed to health promotion and disease prevention concepts, adopting a healthy lifestyle can be challenging. Several factors affect students’ lifestyles, such as being away from family, having a busy schedule, the nature and amount of physical activities, missing meals, consuming fast foods, and dieting. According to Austin et al. Lack of time and inspiration are the most commonly reported obstacles to maintain a healthy lifestyle among undergraduate nursing students.

One of the most used instruments that measured HPB among adults is the Health-Promoting Lifestyle Profile (HPLP-II). HPLP-II represents a multi-dimensional approach to evaluate an individual's health behavior. It is an appropriate instrument for the sample in this study as it assesses the numerous domains of health behaviors which are applicable to the nursing student population. To our knowledge, no HPLP-II validation studies have been conducted on nursing student samples. We believe that understanding the factor structure of the HPLP-II help determine interventions to improve nursing students’ HPB.