Clustering of risk behaviours among African American adults

Objectives: Individuals may engage in more than one risk behaviour at any given time. The extent to which risk behaviours cluster among African American adults has been largely unexplored. This study examined the prevalence and clustering of three risk behaviours among African American church members: smoking; low moderate-to-vigorous intensity leisure time physical activity (leisure MVPA); and low fruit and vegetable consumption. Design: Cross-sectional study. Setting: African Methodist Episcopal churches in South Carolina. Method: Participants self-reported leisure MVPA, fruit and vegetable consumption and smoking. The prevalence of single and multiple risk behaviours was computed. To examine whether risk behaviours clustered, a series of hierarchical log-linear models (SAS CATMOD) were fitted to the observed counts. Results: Of the 1123 participants, 7.0% smoked, 56.0% engaged in <150 minutes/week of leisure MVPA and 76.8% consumed <5 servings/day of fruit and vegetables; 11.8% of the sample had no risk behaviours, 39.5% had one, 45.7% had two and 2.9% had all three. The most common risk behaviour cluster was low leisure MVPA and low fruit and vegetable consumption (42.1%). Results from the log-linear models showed dependence among low fruit and vegetable consumption and low leisure MVPA, independent of smoking status. Conclusions: Church members who engaged in low levels of leisure MVPA were more likely to have low fruit and vegetable consumption, regardless of smoking status. These findings suggest that these two behaviours should not be considered in isolation from one another when developing behaviour change interventions; interventions targeting both behaviours may be more effective.