Health promotion behaviors in adolescents: prevalence and association with mental health status in a statewide sample.

The purpose of this study is to estimate the proportion of adolescents meeting Healthy People 2020 health behavior recommendations for the prevention of chronic disease and to determine the association between mental health status (depression and/or conduct problems) and the likelihood of meeting these recommendations. The data used for this study are from the 2010 Washington State Healthy Youth Survey. Descriptive statistics and linear regression were utilized to estimate the proportion of adolescents meeting recommendations and associations between youth mental health status indicators and health-promoting behaviors. A small minority (5.8 %) of youth met all six recommendations in domains of tobacco abstinence, substance use abstinence, daily physical activity, breakfast consumption, weight below obese levels, and adequate sleep, though most (84.3 %) met at least three. At the aggregate level, the proportion of Washington State youth who met Healthy People 2020 guidelines exceeded targets, with the exception of substance use abstinence. A minority of youth reported guideline levels of daily physical activity (23.3 %) and sleep (39.8 %). Mental health status was strongly associated with the number of health-promoting behaviors adolescents endorsed. Interventions to increase the adoption of sleep hygiene and exercise habits should be added to an integrative positive youth development framework within school-, community-, and primary care-based adolescent health initiatives. Attention to adolescent mental health and shared risk factors may be critical for reducing barriers to healthy behavior.