{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T07:56:17Z","timestamp":1791186977391,"version":"4.1.0"},"reference-count":30,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2026,9,11]],"date-time":"2026-09-11T00:00:00Z","timestamp":1789084800000},"content-version":"vor","delay-in-days":10,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T00:00:00Z","timestamp":1788220800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Health Science Reports"],"published-print":{"date-parts":[[2026,9]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Adolescence is a critical period for the formation of health behaviors, yet composite lifestyle data from rural districts of Pakistan are scarce. We described the healthy lifestyle profile of school\u2010going adolescents in Bahawalpur, South Punjab, and its association with socio\u2010demographic factors.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      This descriptive cross\u2010sectional study enrolled 319 adolescents aged 11\u201319 years from four public schools in one randomly selected tehsil during August 2024. Two over\u2010age records were excluded, leaving 317 eligible participants for descriptive tabulation; three of these had a missing item and were further excluded, leaving 314 participants for the complete\u2010case composite analysis. Lifestyle was measured with a nine\u2010item behavioral composite informed by the Adolescent Lifestyle Profile. We treated the composite as a formative index with a possible range of 0\u201338 and analyzed it mainly as a continuous score. We assessed associations with Mann\u2013Whitney U tests (reporting rank\u2010biserial effect sizes), Spearman correlation,\n                      <jats:italic>\u03c7<\/jats:italic>\n                      <jats:sup>2<\/jats:sup>\n                      tests with Cram\u00e9r's V, and multivariable linear regression with heteroscedasticity\u2010consistent (HC3) standard errors.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The mean composite score was 21.36 (SD 3.79; median 22, IQR 19\u201324; observed range 11\u201331). When scores were grouped into pragmatic descriptive bands, most adolescents fell in the middle of the distribution, and none reached the highest band. Girls scored modestly higher than boys (21.83 vs. 20.81; Mann\u2013Whitney\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.0075; rank\u2010biserial\n                      <jats:italic>r<\/jats:italic>\n                      \u2009=\u20090.175). In multivariable regression (\n                      <jats:italic>R<\/jats:italic>\n                      <jats:sup>2\u2009<\/jats:sup>\n                      =\u20090.073), grade was the only independent predictor of a higher score (\n                      <jats:italic>\u03b2<\/jats:italic>\n                      \u2009=\u20090.78, 95% CI 0.34\u20131.22,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). Age, sex, parental education, family size, and household income were not.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Adolescents attending these four schools reported largely mid\u2010range lifestyle behaviors. Screen time was high, fruit and vegetable intake low, sugary\u2010drink consumption frequent, and vigorous physical activity limited. School\u2010based health promotion that targets these specific behaviors and accounts for grade\u2010 and sex\u2010related differences is warranted. The findings apply to students of the four sampled schools and should not be generalized to all adolescents in the district.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/hsr2.73237","type":"journal-article","created":{"date-parts":[[2026,9,11]],"date-time":"2026-09-11T08:07:41Z","timestamp":1789114061000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Assessment of the Healthy Lifestyle Profile of Adolescents: A School\u2010Based Cross\u2010Sectional Study in Bahawalpur, Pakistan"],"prefix":"10.1002","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0009-0000-2456-6242","authenticated-orcid":false,"given":"Rameesha","family":"Shauket","sequence":"first","affiliation":[{"name":"Armed Forces Post Graduate Medical Institute National University of Medical Sciences Rawalpindi Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-0904-3903","authenticated-orcid":false,"given":"Anum","family":"Safeer","sequence":"additional","affiliation":[{"name":"Armed Forces Post Graduate Medical Institute National University of Medical Sciences Rawalpindi Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-8680-0743","authenticated-orcid":false,"given":"Rida","family":"Ali","sequence":"additional","affiliation":[{"name":"Armed Forces Post Graduate Medical Institute National University of Medical Sciences Rawalpindi Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2341-6431","authenticated-orcid":false,"given":"Humaira","family":"Mahmood","sequence":"additional","affiliation":[{"name":"Health Services Academy Islamabad Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4274-3756","authenticated-orcid":false,"given":"Farrah","family":"Pervaiz","sequence":"additional","affiliation":[{"name":"Rawalpindi Medical University Rawalpindi Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-8275-5713","authenticated-orcid":false,"given":"Inibehe Ime","family":"Okon","sequence":"additional","affiliation":[{"name":"Department of Research Medical Research Circle (MedReC) Bukavu DR Congo"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,9,11]]},"reference":[{"key":"e_1_2_14_2_1","doi-asserted-by":"publisher","DOI":"10.51250\/jheal.v3i3.66"},{"key":"e_1_2_14_3_1","unstructured":"World Health Organization \u201cNoncommunicable Diseases [Internet] \u201d (WHO 2025) https:\/\/www.who.int\/news-room\/fact-sheets\/detail\/noncommunicable-diseases."},{"key":"e_1_2_14_4_1","unstructured":"UNICEF \u201cAdolescents Statistics [Internet]\u201d New York: UNICEF Data 2024 https:\/\/data.unicef.org\/topic\/adolescents\/overview\/; UNICEF Pakistan \u201cAdolescents [Internet] \u201d Islamabad: UNICEF Pakistan 2021 https:\/\/www.unicef.org\/pakistan\/topics\/adolescents."},{"key":"e_1_2_14_5_1","volume-title":"Adolescent Health and Well\u2010Being","author":"UNICEF","year":"2018"},{"key":"e_1_2_14_6_1","volume-title":"Adolescent Development and Participation","author":"UNICEF","year":"2022"},{"key":"e_1_2_14_7_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjgh-2020-004448"},{"key":"e_1_2_14_8_1","doi-asserted-by":"publisher","DOI":"10.58398\/0001.000007"},{"key":"e_1_2_14_9_1","doi-asserted-by":"publisher","DOI":"10.47391\/JPMA.6735"},{"issue":"4","key":"e_1_2_14_10_1","first-page":"217","article-title":"Investigating the Impact of Socio\u2010Economic Factors on Agricultural Productivity: A Case Study of Bahawalpur, Pakistan","volume":"5","author":"Hussain K.","year":"2023","journal-title":"International Journal of Agricultural Sustainability"},{"key":"e_1_2_14_11_1","doi-asserted-by":"publisher","DOI":"10.18488\/journal.107\/2015.3.2\/107.2.29.48"},{"key":"e_1_2_14_12_1","doi-asserted-by":"publisher","DOI":"10.5539\/gjhs.v5n4p71"},{"issue":"2","key":"e_1_2_14_13_1","first-page":"1","article-title":"The Adolescent Lifestyle Profile: Development and Psychometric Characteristics","volume":"17","author":"Hendricks C.","year":"2006","journal-title":"Journal of National Black Nurses' Association: JNBNA"},{"key":"e_1_2_14_14_1","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2458-14-1106"},{"key":"e_1_2_14_15_1","doi-asserted-by":"publisher","DOI":"10.18231\/j.ijfcm.2023.017"},{"key":"e_1_2_14_16_1","doi-asserted-by":"publisher","DOI":"10.1037\/0033-2909.110.2.305"},{"key":"e_1_2_14_17_1","doi-asserted-by":"publisher","DOI":"10.1509\/jmkr.38.2.269.18845"},{"key":"e_1_2_14_18_1","doi-asserted-by":"publisher","DOI":"10.1207\/S15327752JPA8001_18"},{"key":"e_1_2_14_19_1","doi-asserted-by":"publisher","DOI":"10.3389\/fphys.2023.1131195"},{"key":"e_1_2_14_20_1","doi-asserted-by":"publisher","DOI":"10.1017\/S1368980020004334"},{"key":"e_1_2_14_21_1","doi-asserted-by":"publisher","DOI":"10.3389\/fpubh.2022.766101"},{"key":"e_1_2_14_22_1","doi-asserted-by":"publisher","DOI":"10.1186\/s40795-020-00343-w"},{"key":"e_1_2_14_23_1","doi-asserted-by":"publisher","DOI":"10.3389\/fnut.2024.1510183"},{"key":"e_1_2_14_24_1","doi-asserted-by":"publisher","DOI":"10.1146\/annurev-publhealth-031816-044628"},{"key":"e_1_2_14_25_1","doi-asserted-by":"publisher","DOI":"10.19141\/2237-3756.lifestyle.v10.n00.pe1583"},{"key":"e_1_2_14_26_1","doi-asserted-by":"publisher","DOI":"10.9734\/jpri\/2021\/v33i40A32223"},{"key":"e_1_2_14_27_1","doi-asserted-by":"publisher","DOI":"10.47028\/j.risenologi.2022.71a.325"},{"key":"e_1_2_14_28_1","doi-asserted-by":"publisher","DOI":"10.4103\/aihb.aihb_107_22"},{"key":"e_1_2_14_29_1","doi-asserted-by":"publisher","DOI":"10.34172\/aim.2020.54"},{"key":"e_1_2_14_30_1","doi-asserted-by":"publisher","DOI":"10.21101\/cejph.a6097"},{"key":"e_1_2_14_31_1","doi-asserted-by":"publisher","DOI":"10.60081\/SSHA.1.1.2023.31-35"}],"container-title":["Health Science Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/hsr2.73237","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/hsr2.73237","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/hsr2.73237","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T07:43:46Z","timestamp":1791186226000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/hsr2.73237"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9]]},"references-count":30,"journal-issue":{"issue":"9","published-print":{"date-parts":[[2026,9]]}},"alternative-id":["10.1002\/hsr2.73237"],"URL":"https:\/\/doi.org\/10.1002\/hsr2.73237","archive":["Portico"],"relation":{},"ISSN":["2398-8835","2398-8835"],"issn-type":[{"value":"2398-8835","type":"print"},{"value":"2398-8835","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9]]},"assertion":[{"value":"2026-01-22","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-09-04","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-09-11","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e73237"}}