Examining student engagement and its influence in a social contextual model of adolescent health behavior change

Current theoretical models of health behavior change frequently serve as the theoretical backdrop to adolescent health promotion programs. Yet, despite that each main theory was developed with adults and for adults, appropriate and necessary changes for adolescents are often neglected. The unique values, priorities, and abilities of adolescents are important and therefore necessary to consider during health promotion efforts. The present study explored student engagement, a unique adolescent need that has been shown to facilitate achievement in academic environments. Evidence from the psychological and educational literatures suggests that engagement may uniquely influence the process of health behavior change for adolescents. Due to the paucity of related investigations, the current study first explored the structure of the student engagement construct, and second, tested student engagement as a predictor of behavioral intentions in three separate social contextual models of adolescent health behavior change. A mixed-method quasi-experimental design was used in the investigation. Data were gathered from a school-based randomized intervention program, Building a BRIDGE to Better Health (BRIDGE). BRIDGE was a 6 week life skills intervention program that was created to promote cancer-risk reduction among adolescents. It was based on a genealogy and health promotion/disease prevention model. An exploratory factor analysis (EFA) was performed to investigate the latent structure of the student engagement construct. Linear mixed models (LMM) were used to test student engagement as a novel predictor within social contextual models of health behavior change predicting student intentions to reduce fat consumption, conduct self-examinations, and exercise. The EFA yielded a one-factor solution that included six of the initial seven items. This finding did not support the hypothesis, which predicted that items would differentiate into behavioral, cognitive, and emotional types of student engagement. Results of the LMMs supported the hypotheses that student engagement would have a significant effect on student intentions to reduce fat consumption, conduct self-examinations, and exercise. Based on comparisons between student engagement and similar predictor variables, overall findings indicate mixed support for student engagement as a significant predictor in theoretically-based models of adolescent health behavior change.