Predictors of adolescents' health-promoting behaviors guided by primary socialization theory.

Although the major threats to health and life during adolescence are related to a few preventable health-risk behaviors (e.g., smoking, drinking alcohol, using illicit drugs), engaging in health-promoting behaviors can lead to a number of immediate and long-term positive health outcomes (Pender, Murdaugh, & Parsons 2010). Health-promoting behaviors such as physical activity and eating foods low in fat have been shown to protect adolescents from adverse health outcomes (Hayman & Reineke, 2003; Johnson, Li, Galati, Pedersen, Smyth, & Parcel, 2003) and contribute to a healthy lifestyle over time (Kelder et al., 2003). Engaging in a healthy lifestyle during adolescence may prevent cardiovascular disease and cancer later in life (Grunbaum, Lowry, & Kann, 2001). The influence of friends on adolescents’ unhealthy behaviors is well-established, as are the protective effects of parent connectedness against risky behaviors, but the influence of friends and parents on adolescents’ health-promoting behaviors is examined less frequently. In the present study, we focus on the influence of parents’ and peers’ health behaviors and social connectedness of caring adults and friends on health-promoting behaviors in adolescents, and we provide evidence that should facilitate the development of health-promoting behaviors through family-focused interventions. Although parents may provide verbal messages about the inherent dangers of engaging in risky health behaviors (Ford, Davenport, Meier, & McRee, 2011), their own actions often model behaviors that their children then imitate (Griesler & Kandel, 1998). Pender and colleagues’ (2010) conceptualization of health-promoting behavior posits that behavior is learned from observing and interacting with other people in one’s social environment. These nurse scientists (2010) proposed that a person is more likely to engage in health-promoting behaviors when significant people such as family members and peers model that behavior and provide social support to facilitate such behaviors. Parents, by virtue of their central position in the social environment of the developing adolescent, play an important role in modeling health-promoting or health-risking behaviors. Parental monitoring, which includes knowing where children are when not in school, and parental religious practices have been shown to protect young adolescents from dating violence (Howard, Qiu, & Boekeloo, 2003). Parenting style, which includes parents’ responsiveness to and demandingness of their children, has been shown to protect adolescents from engaging in health-risk behaviors (Stephenson, Quick, Atkinson, & Tschida, 2005). Peers also influence adolescents’ health behaviors (Dornelas et al., 2005; Wills, Gibbons, Gerrard, Murry, & Brody, 2003). For example, positive peer influences and social connectedness are related to adolescents’ positive health behaviors (Bruening et al., 2012). Less is understood, however, concerning the influence of parents’ own health behaviors and their parenting styles on their children’s health behaviors. Some have suggested that authoritative parenting styles (Milevsky, Schlechter, Netter, & Keehn, 2007) and engaging in organized religious activities (Haglund & Fehring, 2010; Manlove, Terry-Humen, Ikramullah, & Moore, 2006) may protect adolescents from engaging in health-risk behaviors. Protective factors within the family such as warmth, caring, and appropriate supervision have been cited as the most potent forms of protection, particularly within the Latino culture (Prado et al, 2007). How parenting style and parents’ monitoring and health-related behaviors influence their adolescent children’s participation in developing specific health-promoting behaviors therefore remains unclear. Few studies have examined parents as role models of health-promoting or self-care behaviors for their adolescent child’s health-related behaviors. The present study was undertaken (a) to determine the influence of parents’ self-care behaviors and parenting behavior on health-promoting behaviors of their adolescent children and (b) to determine the influence of selected parenting behaviors (i.e., parenting style, parental monitoring, and parents’ religious commitment) as well as adolescents’ perceptions of other influences (i.e., social connectedness, peers, and religious commitment) on the adolescents’ health-promoting behaviors.