title: Clustering of health-related behaviors among early and mid-adolescents in Tuscany: results from a representative cross-sectional study.
abstract: A huge amount of literature suggests that adolescents' health-related behaviors tend to occur in clusters, and the understanding of such behavioral clustering may have direct implications for the effective tailoring of health-promotion interventions. Despite the usefulness of analyzing clustering, Italian data on this topic are scant. This study aimed to evaluate the clustering patterns of health-related behaviors.
  
  
  
  The present study is based on data from the Health Behaviors in School-aged Children (HBSC) study conducted in Tuscany in 2010, which involved 3291 11-, 13- and 15-year olds. To aggregate students' data on 22 health-related behaviors, factor analysis and subsequent cluster analysis were performed.
  
  
  
  Factor analysis revealed eight factors, which were dubbed in accordance with their main traits: 'Alcohol drinking', 'Smoking', 'Physical activity', 'Screen time', 'Signs & symptoms', 'Healthy eating', 'Violence' and 'Sweet tooth'. These factors explained 67% of variance and underwent cluster analysis. A six-cluster κ-means solution was established with a 93.8% level of classification validity. The between-cluster differences in both mean age and gender distribution were highly statistically significant.
  
  
  
  Health-compromising behaviors are common among Tuscan teens and occur in distinct clusters. These results may be used by schools, health-promotion authorities and other stakeholders to design and implement tailored preventive interventions in Tuscany.
authors.affiliation: Department of Molecular and Developmental Medicine, CREPS, University of Siena, 53100 Siena,Italy.
authors.forename: Giacomo
authors.initials: G
authors.lastname: Lazzeri
authors.affiliation: Department of Health Sciences, University of Genoa, 16126 Genoa, Italy.
authors.forename: Donatella
authors.initials: D
authors.lastname: Panatto
authors.affiliation: Department of Health Sciences, University of Genoa, 16126 Genoa, Italy.
authors.forename: Alexander
authors.initials: A
authors.lastname: Domnich
authors.affiliation: Department of Health Sciences, University of Genoa, 16126 Genoa, Italy.
authors.forename: Lucia
authors.initials: L
authors.lastname: Arata
authors.affiliation: Department of Molecular and Developmental Medicine, CREPS, University of Siena, 53100 Siena,Italy.
authors.forename: Andrea
authors.initials: A
authors.lastname: Pammolli
authors.affiliation: Department of Molecular and Developmental Medicine, CREPS, University of Siena, 53100 Siena,Italy.
authors.forename: Rita
authors.initials: R
authors.lastname: Simi
authors.affiliation: Department of Molecular and Developmental Medicine, CREPS, University of Siena, 53100 Siena,Italy.
authors.forename: Mariano Vincenzo
authors.initials: MV
authors.lastname: Giacchi
authors.affiliation: Department of Health Sciences, University of Genoa, 16126 Genoa, Italy.
authors.forename: Daniela
authors.initials: D
authors.lastname: Amicizia
authors.affiliation: Department of Health Sciences, University of Genoa, 16126 Genoa, Italy.
authors.forename: Roberto
authors.initials: R
authors.lastname: Gasparini
mesh_terms: D000293:Adolescent; D000294:Adolescent Behavior; D000428:Alcohol Drinking / Q000453:epidemiology; D058445:Bullying / Q000706:statistics & numerical data; D002648:Child; D016000:Cluster Analysis; D003430:Cross-Sectional Studies; D004032:Diet / Q000706:statistics & numerical data; D005163:Factor Analysis, Statistical; D005260:Female; D015438:Health Behavior; D006801:Humans; D007558:Italy / Q000453:epidemiology; D008297:Male; D057185:Sedentary Behavior; D012907:Smoking / Q000453:epidemiology; D014754:Violence / Q000706:statistics & numerical data