The correlation between family function and health-promoting lifestyle among female adolescents in Iran


1 1 Nursing and Midwifery Care Research Center, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran

2 2 Department of Community Health and Geriatric Nursing, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran

3 3 Nursing Care Research Center, Iran University of Medical Sciences, Tehran, Iran


Background: Health-promoting lifestyle (HPL) is a major health concern among adolescents. Family function (FF) has potential effects on adolescents’ lifestyle and health. Objectives: This study aimed to evaluate the correlation between FF and HPL among female adolescents. Methods: This correlational study was conducted from January to February 2020 on 356 female adolescent students randomly recruited through multistage cluster sampling from four public junior high schools in the south of Tehran, Iran in 2020. Data were collected using a personal characteristics questionnaire, the Adolescent Health Promotion Short Form, and the McMaster Family Assessment Device. Data analysis was performed through Pearson’s correlation coefficient, the one-way analysis of variance, the independent-samples t test, and the linear regression analysis. Results: The average age of adolescents was 14.16 ± 0.76 years. The total mean scores of participants’ HPL and FF were 75.36 ± 12.43 (in the possible range of 21–105) and 3.02 ± 0.37 (in the possible range of 1–4), respectively. There was a significant positive correlation between FF and HPL (r = 0.399, P < 0.001). Among demographic characteristics, adequacy of family income, and among dimensions, the problem-solving, behavioral control, roles, and affective involvement dimensions of FF were significant predictors of HPL, explaining 24.5% of its total variance. Conclusion: The mean HPL and FF were greater than the possible median scores. Also, adequacy of family income and FF were significant predictors of HPL among female adolescents. Healthcare authorities and policymakers are recommended to pay greater attention to FF in developing health-promoting programs for adolescents.


1. World Health Organization. Adolescent Health. [Online].
Available from: [Last accessed on 2020 Mar 13].
2. Statistical Center of Iran. [Online]. Available from: https://www.
[Last accessed on 2020 Apr 5].
3. Stanhope  M, Faan  RD, Lancaster  J, Faan  RP. Public
Health Nursing E-book: Population-Centered Health Care
in the Community. Amsterdam: Elsevier Health Sciences;
4. Nies  MA, McEwen  M. Community/Public Health NursingE-Book: Promoting the Health of Populations. Amsterdam:
Elsevier Health Sciences; 2014.
5. Chen  MY, Lai  LJ, Chen  HC, Gaete  J. Development and
validation of the short-form adolescent health promotion scale.
BMC Public Health 2014;14:1106.
6. Balali Meybodi F, Hasani M, Mehdinejad M. Evaluating healthpromoting life style and its related factors among adolescent
girls of Kerman in 2015. Health Develop J 2017;6:85-96.
7. Heshmati  H, Alizadeh  Sh, Adib-Moghaddam  S, Khajavi  S,
Rafiee N, Behnampour N. Self-care pattern related to life style
and its related factors among female high school students
in Gorgan in 2013. J Torbat Heydariyeh Univ Med Sci
8. Yekefallah L, Vaezi A, Pazokian M, Yekefallah F, Samieefard F.
Study of lifestyle and preventive behaviors of osteoporosis
among adolescents in Qazvin. J Shahid Sadoughi Univ Med
Sci 2012;20:259-68.
9. Trask  BS, Hamon  RR. Cultural diversity and families:
Expanding perspectives. J Family Commun 2008;8:96-100.
10. Zhang  T, Wang  Z. The effects of family functioning and
psychological suzhi between school climate and problem
behaviors. Front Psychol 2020;11:212.
11. Sharma  R. The family and family structure classification
redefined for the current times. J Family Med Prim Care
12. Halliday  JA, Palma  CL, Mellor  D, Green  J, Renzaho  AM.
The relationship between family functioning and child and
adolescent overweight and obesity: A systematic review. Int J
Obes (Lond) 2014;38:480-93.
13. Matejevic  M, Todorovic  J, Jovanovic  AD. Patterns of family
functioning and dimensions of parenting style. Procedia-Soc
Behav Sci 2014;141:431-7.
14. Yoosefi  N. An investigation of the psychometric properties
of the McMaster clinical rating scale (MCRS). Educ Meas
15. Akbari  Zardkhaneh  S, Mahmoodi  M. The efficacy of
adolescent development training program to parent on parentchild relationship and family function. J Child Ment Health
16. Lima-Serrano  M, Guerra-Martín  MD, Lima-Rodríguez  JS.
[Relationship between family functioning and lifestyle in
school-age adolescents]. Enferm Clin 2017;27:3-10.
17. Fleming  MS. Associations between family functioning and
adolescent health behaviors. 2015. Available from: http://
18. Velders FP, Dieleman G, Henrichs J, Jaddoe VW, Hofman A,
Verhulst  FC, et  al. Prenatal and postnatal psychological
symptoms of parents and family functioning: The impact on
child emotional and behavioural problems. Eur Child Adolesc
Psychiatry 2011;20:341-50.
19. Sim L, Matthews A. The role of maternal illness perceptions in
family functioning in adolescent girls with anorexia nervosa. J
Child Family Stud 2013;22:541-50.
20. Amani R. The role of family function in teenagers anxiety and
depression. Biannual J Clin Psychol Personal 2016;13:77-84.
21. Bujang MA, Baharum N. Sample size guideline for correlation
analysis. World J Soc Sci Res 2016;3:468-78.
22. Cohen J. Statistical Power Analysis for the Behavioral Sciences.
2nd ed. New York: Lawrence Erlbaum Associates; 2013.
23. Sarkhani  N, Negarandeh  R, Pashaeypoor  S. The effects of
face-to-face education for student health ambassadors on
the health-promoting lifestyle of adolescent female students:
A randomized controlled trial. J Public Health 2021:1-7.
24. Epstein NB, Baldwin LM, Bishop DS. The McMaster family
assessment device. J Marital Fam Ther 1983;9:171-80.
25. Zadehmohmmadi  A, Malekkhosravi  GH. Preliminary study
of psychometric properties and validation of the Family
Functioning Scale (FAD). J Family Res 2013;2:69-89.
26. Mohammad-Alizadeh-Charandabi  S, Mirghafourvand  M,
Tavananezhad  N, Karkhaneh  M. Health promoting lifestyles
and self-efficacy in adolescent boys. J Mazandaran Univ Med
Sci 2014;23:152-62.
27. Yesilfidan  D, Adana  F. The impact of health behaviours
development training on healthy lifestyle behaviours amongst
adolescents with obesity risk: A  school example in a city in
western turkey. J Pak Med Assoc 2017;67:1698-703.
28. Wei  CN, Harada  K, Ueda  K, Fukumoto  K, Minamoto  K,
Ueda  A. Assessment of health-promoting lifestyle profile
in Japanese university students. Environ Health Prev Med
29. Zhang  SC, Tao  FB, Ueda  A, Wei  CN, Fang  J. The influence
of health-promoting lifestyles on the quality of life of retired
workers in a medium-sized city of northeastern china. Environ
Health Prev Med 2013;18:458-65.
30. Baheiraei  A, Mirghafourvand  M, Charandabi  SM,
Mohammadi E. Facilitators and inhibitors of health-promoting
behaviors: The experience of Iranian women of reproductive
age. Int J Prev Med 2013;4:929-39.
31. Louthrenoo  O, Aurpibul  L, Oberdorfer  P, Sirisanthana  V.
Family functioning in adolescents with perinatal HIV
infection. J Int Assoc Provid AIDS Care 2018;17:
32. Berge JM, Wall M, Larson N, Loth KA, Neumark-Sztainer D.
Family functioning: Associations with weight status, eatingbehaviors, and physical activity in adolescents. J Adolesc Health
33. Hosseini M, Sarbakhsh P, Mollaei S. The relationship between
the family functions and health-promoting behaviors of nursing
students in Tehran, Iran. World Family Med J 2018;99:1-4.
34. Jiang SS, Shen LP, Ruan HF, Li L, Gao LL, Wan LH. Family
function and health behaviours of stroke survivors. Int J Nurs
Sci 2014;1:272-6.
35. Amiri M. The relationship between familial performance, social
support and demographic variables with parenting stress and
mental health among parents of deaf children. J Res Psychol
Health 2017;10:63-75.
36. Nacar  M, Baykan  Z, Cetinkaya  F, Arslantas  D, Ozer  A,
Coskun  O, et  al. Health promoting lifestyle behaviour in
medical students: A multicentre study from turkey. Asian Pac J
Cancer Prev 2014;15:8969-74.
37. Unalan  D, Senol  V, Ozturk  A, Erkorkmaz  U. A research
on the relation between the healthy life style behaviors and
selfcare levels of the students in health and social programs of
vocational collages. Ann Med Res 2007;14:101-9.
38. Soleimani M, Hafeznia M, Masodi S, Moradi M, Ordobadi S.
Comparison of dimensions of psychopathology, lifestyle and
family functioning in female students with eating disorders.
Nurs Midwifery J 2016;14:371-79.
39. Santesteban-Echarri O, MacQueen G, Goldstein BI, Wang J,
Kennedy  SH, Bray  S, et  al. Family functioning in youth
at-risk for serious mental illness. Compr Psychiatry 2018;87:
Volume 10, Issue 4
October 2021
Pages 249-256
  • Receive Date: 14 September 2022
  • Accept Date: 14 September 2022
  • First Publish Date: 14 September 2022