INTRODUCTION:

Teenage hood is a stage of acquiring good dietary habits which is essential to begin healthy behaviours related to consumption of food that is influencing adult morbidity and mortality. It is crucial period of life and family environment influence their food habits and sometimes influenced by the peer group also. Lack of awareness related to diet and healthy behaviours lead to poor habits and they tend to adopt unhealthy lifestyle. Adolescents may be influenced by their peer and mass media. In addition to this they may get exposure to nutritional education through school health program. Several studies have enlightened on importance of nutritional education on dietary habits of children.¹

Adolescent period is important for establishment of healthy lifestyle which may continue for adulthood. Healthy nutrition during teenage influences not only their health also their physical maturation and development. Increased incidence of overweight and diet related disorders emphasis on need for focusing on nutritional education at earlier age. Therefore, educating the children and teenagers regarding intake of balanced diet and good dietary habits is very much essential. Education of overall nutritional behaviour is important than education on single foods. Teenagers must be provided with guideline for nutritional intake and nutrient recommendations for different age groups, so that they are aware of food consumption. Nutrition and health are always interrelated factors and there is relationship between intake of food and healthy lifestyle.²

Health risk behaviours such as smoking, alcohol abuse, unhealthy dietary patterns, sedentary habits, and unsafe and aggressive behaviours have been found to have an important influence on morbidity and mortality. Health risk behaviours, which develop over time, can also contribute to an unhealthy lifestyle. Adolescent population and health of adolescents is a very special issue and is focus of attention globally for various reasons. An essential component in the prevention and management of diseases is the adoption of a healthy lifestyle that would include the promotion of non-smoking, eating a healthy balanced diet, and actively engaging in organized physical activities.³

There is urgent need to assess the healthy behaviours of teenagers and to give more focus on their lifestyle at earlier age. It is often difficult to change their unhealthy habits which adopted during their young age. Adolescents will have specific health need and that should be addressed during adolescence. Many studies showed correlation between health promoting relationship and quality of life.³

Obesity and overweight are emerging public health problems among adolescents which associated with loss of quality of life and social stigma which leads to expression, anxiety, feeling of low self esteem and guilty feeling. Incidence of obesity of obesity is increasing globally and especially in developing countries because of lack of physical activity and intake of foods rich in fat, sugar and less fibre. Nutritional habits are modifiable factors for obesity in childhood and adolescence. Many factors may cause the incidence of obesity and it is multi factorial and related to fast foods and snacking.⁴

Adolescence refers to the period of transition from childhood to adulthood when the person is not yet an adult, but no longer a child. As per World Health Organization, adolescence is a period of life that is extended from 10-19 years. Adolescents are the large segment of Indian population. Lifestyle choices adopted during this time continues into adulthood. Since adolescents are the future manpower of the nation, it is essential to know about their lifestyle practices so as to lay the foundation of healthy adult life. An exploratory study was undertaken with a view to explore the lifestyle of adolescent girls living in Dadu Majra Colony, Chandigarh. Sample size consisted of 128 adolescent girls in the age group 15-19 years of age selected through systematic random sampling technique among the total population of 640 adolescent girls. Data was collected through interview method using semi-structured interview schedule which was validated by experts in the field of Nursing, Community Medicine and Dietetics. The results of the study revealed that most of the subjects were leading sedentary life style. There were very few subjects involved in vigorous activities and most of them were engaged in indoor activities like doing household chores, watching TV and listening to music for as long as seven hours a day. Dietary habits of adolescents consisted of consumption of large amount of junk food items and inadequate consumption of pulses and fruits. They perceived themselves to be overweight in spite of having normal weight and carried on weight loss practices. In order to have healthy adolescents in future health professionals, school teachers, community leaders, social organizations and youth groups should focus on creating awareness among the adolescents on issues like dietary habits and physical activity.⁵

Female adolescents comprise 46.9 percent and male adolescents 53.1 percent of the total adolescent population. The adolescents in India suffer from various health problems like under nutrition, high risk behavior, sexually transmitted diseases, teenage pregnancy and anemia. Lifestyle choices have an impact throughout life and it can be measured by health behavior, leisure-time activities and social relations. Physical activity during adolescence takes a back seat as levels of physical activity decreases during this period. High uses of T.V. and video among adolescents have resulted in technology based sedentary behaviour. Another study on physical activities of adolescents reported that older girls spent most of their leisure time by watching TV, sewing, and gossiping. Insufficient physical activity results in higher B.M.I. in adolescents. In one of the studies in India, girls were found to have higher B.M.I. as compared to boys. There is another issue of poor dietary habits common among adolescents. Various studies have shown skipping of breakfast and lunch, more consumption of fast food items and less intake of fresh fruits and vegetables among adolescents. Young adults, in consideration of important lifestyle changes, are arranged to negatively modify their way of eating in terms of the variety, the consumption of fruit and vegetables, and the frequency and timing of intake. A study on adolescents reported that adolescents perceived themselves to be overweight as compared to their actual weight status and half of the girls belonging to all weight categories desired weight loss and were adopting weight loss measures like skipping meal, exercising, starving, binge eating and diet pills.

The above facts made the investigator to realize the importance of problem in current situation and created an intention to administer a integrated training program to assess behavioural outcome of adolescents regarding lifestyle pattern. Thereby enhancing their awareness on healthy lifestyle pattern and can prevent many lifestyle diseases in adolescents.⁶

OBJECTIVES:

1. To assess the knowledge level of adolescents regarding lifestyle pattern

2. To assess the attitude of adolescents regarding life style pattern.

3. To assess practice of adolescents regarding their lifestyle pattern

4. To design and develop Integrated Training Programme regarding life style pattern among adolescents

5. To determine the effectiveness of Integrated Training Programme regarding life style pattern among adolescents

6. To find the association between behavioural outcome of adolescents regarding lifestyle pattern and their selected demographic variables

HYPOTHESES:

H₁: There will be significant difference between mean pre test score and post test behavioural outcome scores of adolescents regarding lifestyle pattern

H₂: There will be significant association between behavioural outcome scores of adolescents regarding lifestyle pattern and selected demographic variables

METHODOLOGY:

Research approach:

Quantitative research approach

Research design: Pre-experimental one group pretest and post test design

Population: In this study, population consists of adolescents studying in selected schools of Mysuru city

Sampling technique: Non - probability convenient sampling technique.

Sample size: 500 of adolescents studying in selected schools of Mysuru city

Setting - The setting for the present study is selected high schools of Mysuru

Inclusion criteria:

1 Adolescents studying in selected schools of Mysuru city

2 Adolescents who are in the age group of 14-16 years

3 Adolescents who are able to understand read and write English/Kannada

Exclusion criteria:

1 Adolescents who are not willing to participate in the study.

2 Adolescents who are not available at the time of data collection.

Tool:

Section A - Demographic data of the subjects

Section B – Structured knowledge questionnaire to assess the knowledge of adolescents regarding lifestyle pattern

Section C - Self-administered Attitude scale to assess the attitude of adolescents regarding lifestyle pattern

Section D - Adolescent Lifestyle Practice scale to assess the practice of adolescents regarding lifestyle pattern

RESULTS:

Table No. 1: Frequency distribution of the subjects according to their demographic data n = 500

Parameters		Frequency	%
Age (Yrs)	14	194	38.8
	15	122	24.4
	16	184	36.8
Gender	Male	280	56
Gender	Female	220	44
Ordinal position	No sibling	215	43.0
	Eldest	102	20.4
	Middle	34	6.8
	Youngest	149	29.8
Class of study	8th standard	194	38.8
	9th standard	122	24.4
	10th standard	184	36.8
Religion	Hindu	453	90.6
	Muslim	20	4.0
	Christian	13	2.6
	Others	14	2.8
Type of family	Nuclear	406	81.2
Type of family	Extended	94	18.8
Father’s Education	No formal education	53	10.6
	Up to 10th Standard	40	8.0
	10+2 / JOC	236	47.2
	Graduate and above	96	19.2
	Technical	75	15.0
Mother’s Education	No formal education	20	4.0
	Up to 10th Standard	225	45.0
	10+2 / JOC	170	34.0
	Graduate and Above	62	12.4
Father's occupation	Unemployed	54	10.8
	Laborer	40	8.0
	Self employed	235	47.0
	Private employee	96	19.2
	Government Employee	75	15.0
Mothers occupation	Home maker	337	67.4
	Self employed	59	11.8
	Private employee	83	16.6
	Government employee	21	4.2
Family income per month	< Rs. 10000	81	16.2
	Rs.10001-Rs. 20000	141	28.2
	Rs. 20001-Rs. 30000	182	36.4
	> Rs. 30000	96	19.2
Type of diet	Vegetarian	216	43.2
	Mixed	284	56.8
Sources of information on lifestyle pattern	Parents	367	73.4
	Teacher	100	20
	Relatives	4	0.8
	Peer group	29	5.8
	Parents	367	73.4
How often do you use the internet?	Never	170	34.0
	Several times a day	260	52.0
	Daily or almost daily	70	14.0
How often do you engage in social media?	Never	143	28.6
	Several times a day	269	53.8
	At least weekly	44	8.8
	Daily or almost daily	44	8.8

Table No-2: Assessment of knowledge regarding lifestyle pattern of adolescents before and after Integrated Training Program n = 500

Knowledge score	Pretest		Post test
Knowledge score	Frequency	%	Frequency	%
0 – 16 (Poor)	27	5.4	0	0.0
17-32 (Average)	355	71.0	79	15.8
33-48 (Good)	118	23.6	421	84.2
Total	500	100.0	500	100.0

Table No-3: Association between knowledge scores of adolescents regarding lifestyle pattern and their age in years n=500

Age in years		Poor	Average	Good	Total	Chi square Value	df	P value
Pre test knowledge	14	9	141	44	194	5.691	4	0.223
	15	4	82	36	122
	16	14	131	39	184
	Total	27	354	119	500
Post test knowledge	14	0	29	165	194	1.136	2	0.567
	15	0	23	99	122
	16	0	27	157	184
	Total	0	79	421	500

Figure No-1: Area wise assessment of knowledge on lifestyle pattern of adolescents

Table No 4: Assessment of attitude score on lifestyle pattern of adolescents before and after Integrated Training Program n = 500

Attitude score	Pre test		Post test
Attitude score	Frequency	Percentage	Frequency	Percentage
30-75 (Negative attitude)	218	43.6	18	3.6
76-150 (positive attitude)	282	56.4	482	96.4
Total	500	100.0	500	100.0

Table No 5: Significance of difference between pretest and post test attitude scores and paired t value n = 500

Parameter	Pre test		Post test		Paired t Value	P Value
	Mean	SD	Mean	SD
Attitude score	78.80	16.587	105.74	15.213	-46.017	0.000

Table No 6: Association between attitude scores of adolescents regarding lifestyle pattern and their age in years n = 500

Age in years		Negative Attitude	Positive Attitude	Total	Chi square Value	df	P value
Pretest Attitude	14	93	101	194	2.872	2	0.238
	15	47	75	122
	16	78	106	184
	Total	218	282	500
Post test Attitude	14	10	184	194	2.466	2	0.291
	15	4	118	122
	16	4	180	184
	Total	18	482	500

Table No-7: Comparison of pre and post test practice score regarding lifestyle pattern of adolescents in study group n = 500

Practice score	Pretest		Post test
Practice score	Frequency	%	Frequency	%
40-100 (Inadequate practice)	144	28.8	0	0.0
101-200 (Adequate practice)	356	71.2	500	100.0
Total	500	100.0	500	100.0

Table No-8: Significance of difference between pretest and post test practice scores and paired t value n = 500

Parameter	Pretest		Post test		Paired t Value	P value
	Mean	SD	Mean	SD
Practice score	83.88	20.567	143.22	31.16	-38.773	0.000

Table No-9: Association between practice scores of adolescents regarding lifestyle pattern and their age in years n = 500

Age in years		Inadequate practice	Adequate practice	Total	Chi square Value	df	P value
Pretest Practice	14	55	139	194	0.452	2	0.798
	15	38	84	122
	16	51	133	184
	Total	144	356	500
Post test practice	14	0	194	194	-	-	-
	15	0	122	122
	16	0	184	184
	Total	0	500	500