Health Engagement Among Young Adults

The leading cause of death in America is cardiovascular disease (Martin et al., 2024), and almost all cardiovascular events can be linked to poor health behaviors (Kaminsky et al., 2022; Karr et al., 2017; Ning et al., 2024; Pocnet et al., 2017; Yusuf et al., 2004). To combat this disease burden, the American Heart Association operationalized the term cardiovascular health, and explained that ideal cardiovascular health is the simultaneous practice of four health behaviors (healthy diet, regular physical activity, never using tobacco or tobacco cessation for more than 12 months, and 7-9 hours of uninterrupted sleep per night) and four health factors such as (normal total cholesterol, blood pressure, blood sugar, and body mass index, with these factors being maintained without medication) (Kaminsky et al., 2022; Ning et al., 2023). College-age students may be a target population for cardiovascular health interventions, as they have developed a higher prevalence of poor cardiovascular health factors over time (Tromp et al., 2021) and exhibit poor cardiovascular health behaviors in collegiate settings (Goldstein et al., 2015). To understand what influences health behaviors in this population, the Social Cognitive Theory posits that health behaviors are shaped by factors such as self-efficacy, health goals, outcome expectations, and social determinants of health (Bandura, 1986). While evidence shows that these factors can impact health behaviors such as diet, physical activity, smoking, and sleep (Anderson et al., 2007; Anderson et al., 2010; Brooks et al., 2021; Marlatt et al., 1985; Young et al., 2014), more work is needed to fully understand how these factors influence young adults. The purpose of the current study is twofold: (1) to examine how the social cognitive model (self-efficacy, outcome expectations, goals, and social determinants of health) predicts four health behaviors (diet, physical activity, exercise, smoking, and sleep); and (2) to examine whether outcome expectations, goals, and social determinants of health directly affect self-efficacy. These findings could provide a novel way to assess the factors that shape cardiovascular health behaviors among young adults, ultimately strengthening our understanding of health behavior engagement in this population and improving health behavior interventions.