title: A longitudinal examination of the interrelationship of multiple health behaviors.
abstract: BACKGROUND
  Evaluating the interrelationship of health behaviors could assist in the development of effective public health interventions. Furthermore, the ability to identify cognitive mediators that may influence multiple behavioral changes requires evaluation.
  
  
  OBJECTIVE
  To evaluate covariation among health behaviors, specifically alcohol consumption, leisure-time physical activity, and smoking, and examine whether mastery acts as a mediating social-cognitive mechanism that facilitates multiple health behavior change in a longitudinal analysis.
  
  
  METHODS
  In 2010, secondary data analysis was conducted on the first seven cycles of the Canadian National Population Health Survey. Data collection began in 1994-1995 and has continued biennially. At the time of this analysis, only seven cycles of data (2006-2007) were available. Parallel process growth curve models were used to analyze covariation between health behaviors and the potential mediating effects of perceived mastery.
  
  
  RESULTS
  Increases in leisure-time physical activity were associated with reductions in tobacco use, whereas declines in alcohol consumption were associated with decreases in tobacco use. Covariation between alcohol consumption and leisure-time physical activity did not reach statistical significance. For the most part, mastery was unsuccessful in mediating the interrelationship of multiple behavioral changes.
  
  
  CONCLUSIONS
  Health behaviors are not independent but rather interrelated. In order to optimize limited prevention resources, these results suggest that population-level intervention efforts targeting multiple modifiable behavioral risk factors may not need to occur simultaneously.
authors.affiliation: Faculty of Kinesiology and Physical Education, University of Toronto, Toronto; Centre for Research on Employment and Workplace Health, Centre for Addiction and Mental Health, Toronto. Electronic address: wayne_deruiter@camh.net.
authors.forename: Wayne K
authors.initials: WK
authors.lastname: deRuiter
authors.affiliation: Department of Family Medicine, Psychiatry and Behavioural Neurosciences and Kinesiology, McMaster University, Hamilton.
authors.forename: John
authors.initials: J
authors.lastname: Cairney
authors.affiliation: School of Public Health and Health Systems, University of Waterloo, Waterloo.
authors.forename: Scott T
authors.initials: ST
authors.lastname: Leatherdale
authors.affiliation: Faculty of Kinesiology and Physical Education, University of Toronto, Toronto.
authors.forename: Guy E J
authors.initials: GE
authors.lastname: Faulkner
mesh_terms: D000328:Adult; D000368:Aged; D000428:Alcohol Drinking / Q000453:epidemiology*; D002170:Canada; D005260:Female; D015438:Health Behavior; D006306:Health Surveys; D006801:Humans; D007899:Leisure Activities; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D009043:Motor Activity; D012307:Risk Factors; D012907:Smoking / Q000453:epidemiology*; D055815:Young Adult