title: The association between medical students' lifestyles and their attitudes towards preventive counseling in different countries.
abstract: BACKGROUND
  Preventive counselling is an effective approach to reducing the prevalence of non-communicable diseases. Studies have shown that there is a positive association between healthy behaviors of Colombian medical students and favorable attitudes towards preventive counselling. However, there is limited research that explores this relationship in different countries. The current study aimed to determine how the health behaviors of medical students from China, U.S., and Australia, are associated with attitudes towards preventive counseling.
  
  
  METHODS
  Students from five Chinese medical schools, Duke University in the U.S., and the University of Queensland in Australia, completed a 32-item, self-reported online survey. The survey was used to examine the prevalence of healthy behaviors and their association with attitudes towards preventive counseling. The target sample size was 150 students from each grade, or 450 students in total from different medical universities. Logistic regression analyses were used to assess the association between health behaviors and attitudes towards preventive counseling, stratified by grade and adjusted by gender.
  
  
  RESULTS
  A positive association was found between healthy behaviors and attitudes towards preventive counseling for all medical students. There are significant differences among medical students' self-reported health behaviors and their attitudes towards preventive counselling from three different countries (P < 0.05). Chinese medical students were more positive in stress control (OR > 1) and more passive in limiting their smoking and alcohol behaviors compared to medical students in Duke University. However, compared to medical students in University of Queensland, five Chinese medical students were more passive in stress control (OR < 1).
  
  
  CONCLUSIONS
  Based on the finding that healthy behaviors are positively related to favorable attitudes towards preventative counselling, medical students should adopt targeted courses and training in preventive counseling and develop healthy lifestyles.
authors.affiliation: Xi'an Jiaotong University School of Medicine, No.76#, West Yanta Road, Xi'an, 710061, Shaanxi, China. yuyan11@126.com.
authors.forename: Yan
authors.initials: Y
authors.lastname: Yu
authors.affiliation: Xi'an Jiaotong University School of Medicine, No.76#, West Yanta Road, Xi'an, 710061, Shaanxi, China. yangyuxuanmm@126.com.
authors.forename: Yuxuan
authors.initials: Y
authors.lastname: Yang
authors.affiliation: Changzhi Medical College, Changzhi, Shanxi Province, China. lizhifangseu@163.com.
authors.forename: Zhifang
authors.initials: Z
authors.lastname: Li
authors.affiliation: First Hospital of China Medical University, Shenyang, Liaoning Province, China. Zhoubo@163.com.
authors.forename: Bo
authors.initials: B
authors.lastname: Zhou
authors.affiliation: Ningxia Medical University, Yinchuan, Ningxia Hui Autonomous Region, China. zhaoyi1989@gmail.com.
authors.forename: Yi
authors.initials: Y
authors.lastname: Zhao
authors.affiliation: Xi'an Jiaotong University School of Medicine, No.76#, West Yanta Road, Xi'an, 710061, Shaanxi, China. yuanshen10@126.com.
authors.forename: Shen
authors.initials: S
authors.lastname: Yuan
authors.affiliation: Xi'an Jiaotong University School of Medicine, No.76#, West Yanta Road, Xi'an, 710061, Shaanxi, China. zhangruijuan12@gmail.com.
authors.forename: Ruijuan
authors.initials: R
authors.lastname: Zhang
authors.affiliation: Duke Global Health Institutesss, Duke University, Durham, USA. sebranek11@gmail.com.
authors.forename: Matthew
authors.initials: M
authors.lastname: Sebranek
authors.affiliation: School of Public Health, the University of Queensland, St Lucia, Brisbane, Australia. l.veerman@sph.uq.edu.au.
authors.forename: Lennert
authors.initials: L
authors.lastname: Veerman
authors.affiliation: School of Public Health, the University of Sydney, Sydney, Australia. muyang@163.com.
authors.forename: Mu
authors.initials: M
authors.lastname: Li
authors.affiliation: Children's Hospital Los Angeles, Los Angeles, CA, USA. gongenying66@seu.edu.
authors.forename: Enying
authors.initials: E
authors.lastname: Gong
authors.affiliation: Children's Hospital Los Angeles, Los Angeles, CA, USA. chenshumail@gmail.com.
authors.forename: Shu
authors.initials: S
authors.lastname: Chen
authors.affiliation: Children's Hospital Los Angeles, Los Angeles, CA, USA. Estellehappy@gmail.com.
authors.forename: Wenjie
authors.initials: W
authors.lastname: Ma
authors.affiliation: School of Public Health, the University of Sydney, Sydney, Australia. polly@hotmail.com.
authors.forename: Liping
authors.initials: L
authors.lastname: Huang
authors.affiliation: Children's Hospital Los Angeles, Los Angeles, CA, USA. kaiwing.cho@gmail.com.
authors.forename: KaWing
authors.initials: K
authors.lastname: Cho
authors.affiliation: Menzies Centre for Health Policy, School of Public Health, the University of Sydney, Sydney, Australia. stephenleeder@hotmail.com.
authors.forename: Stephen
authors.initials: S
authors.lastname: Leeder
authors.affiliation: Duke Global Health Institutesss, Duke University, Durham, USA. 15098512013@163.com.
authors.forename: Lijing
authors.initials: L
authors.lastname: Yan
mesh_terms: D000328:Adult; D001291:Attitude of Health Personnel; D001315:Australia; D002681:China; D003376:Counseling / Q000706:statistics & numerical data*; D005260:Female; D015438:Health Behavior; D006801:Humans; D008019:Life Style; D016015:Logistic Models; D008297:Male; D015995:Prevalence; D011322:Primary Prevention / Q000379:methods*; D057566:Self Report; D013337:Students, Medical / Q000523:psychology*; D011795:Surveys and Questionnaires; D014481:United States; D055815:Young Adult