Title Page
Contents
LIST OF ABBREVIATIONS 13
ABSTRACT 14
Ⅰ. INTRODUCTION 16
A. Background of the Study 16
B. Purpose of the Study 41
C. Research Hypotheses 41
D. Definition of Terms 43
Ⅱ. REVIEW OF LITERATURE 46
A. Lifestyle Risk Factors that Impact Health 46
B. Major Risk Factors for NCDs 54
C. Empirical Literature on Available Healthy Lifestyle and Addiction Tools 58
Ⅲ. METHODOLOGY 67
A. Research Design 67
B. Research Process 67
C. Population and Sampling 68
D. Data Collection 68
E. Data Screening 71
F. Duration of the Study 72
G. Tools and Instruments 72
1. Socio-demographic Characteristics 72
2. Alcohol Use Disorders Identification Test (AUDIT) - Alcohol dependence 72
3. Fagerström Test for Cigarette Dependence - Nicotine Dependence 73
4. Healthy Lifestyle Screening Tool 74
H. Statistical Analysis 74
Ⅳ. RESULTS 77
A. Sociodemographic Characteristics 77
B. Content Reliability of the Healthy Lifestyle Screening Tool 80
C. Distribution of HLST scores among sociodemographic characteristics 83
1. Quartiles for the General Population 83
2. Quartiles for diagnosed and non-diagnosed groups 86
D. Determining the optimal cut-off score 92
E. Coordinates of the Curve 95
E. Relationship of lifestyle characteristics to alcohol and smoking addictions 103
Ⅴ. DISCUSSION 108
Ⅵ. CONCLUSION 122
REFERENCES 125
APPENDICES 153
Appendix 1. Institution Review Board (IRB) Approval 153
Appendix 2. Tools and Instruments 155
Table 1. Internal Consistency of the Healthy Lifestyle Screening Tool 80
Table 2. Intraclass Correlation Coefficient for Average Measures 82
Table 3. HLST Scores of Demographic Characteristics Per Quartile 84
Table 4. HLST Scores of Non-diagnosed and Diagnosed Groups Per Quartile 86
Table 5. Differences of HLST Scores among Healthy and Diagnosed Groups 87
Table 6. Differences of HLST Scores Among General and Diagnosed Groups 87
Table 7. Mean (SD) differences of HLST scores and HLST components among groups 89
Table 8. Area under the curve for healthy group vs. diabetic group 92
Table 9. Area under the curve for healthy group vs. hypertensive group 93
Table 10. Area under the curve for healthy group vs. hyperlipidemic group 94
Table 11. Coordinates of the curve for healthy group vs diabetic group 95
Table 12. Coordinates of the curve for healthy group vs hypertensive group 96
Table 13. Coordinates of the curve for healthy group vs hyperlipidemic group 97
Table 14. Association of HLST Risk and Diagnosed Groups 98
Table 15. Odds ratio and Relative Risk among Low Risk and Moderate Risk Groups 99
Table 16. Logistic regression analysis of HLST score among diagnosed groups 99
Table 17. Area Under the curve for the general group vs. the diabetic group 100
Table 18. Area under the curve for general group and hypertensive group 101
Table 19. Area under the curve for general group vs. hyperlipidemic group 102
Table 20. Performance of HLST in discriminating between alcohol and smoking addiction risks 103
Table 21. Summary of multiple linear regression analysis of the predictors of HLST components on alcohol addiction 104
Table 22. Predictors of HLST among nutrition and temperance items on alcohol addiction 105
Table 23. Summary of multiple linear regression analysis of the predictors of HLST items on smoking addiction 106
Table 24. Summary of multiple linear regression analysis of the predictors of HLST items on smoking addiction 107
Figure 1. Research Theoretical Framework of the Study 38
Figure 2. Research Conceptual Framework of the Study 40
Figure 3. Diagram of Data Collection 70
Figure 4. Diagram of Data Grouping 71
Figure 5. Distribution of participants' gender and age 77
Figure 6. Distribution of participants' marital status and education level 78
Figure 7. Distribution of participants' employment and income 79
Figure 8. Distribution of participants across regions of origin 79
Figure 9. General Population HLST mean and distribution of HLS scores per quartile 83
Figure 10. Trends of the distribution of scores per quartile 85
Figure 11. ROC curve for healthy group and diabetic group 92
Figure 12. ROC curve for healthy group and hypertensive group 93
Figure 13. ROC curve for healthy group and hyperlipidemic group 94
Figure 14. ROC curve for general group and diabetic group 100
Figure 15. ROC curve for general group and hypertensive group 101
Figure 16. ROC curve for general group and hyperlipidemic group 102