Document Type : Original Article


1 Metabolic Diseases Research Center, Research Institute for Prevention of Non-Communicable Diseases, Qazvin, University of Medical Sciences, Qazvin, Iran

2 Department of Educational Psychology, Kharazmi University

3 Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences

4 Department of Epidemiology and Biostatistics, Knowledge Utilization Research Center, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran


BACKGROUND: Health promotion of adolescents requires appropriate evidences of its determinants.
The aim of this study was to investigate predictors of self-rated health (SRH) among adolescents
in Qazvin, Iran.
MATERIALS AND METHODS: In this descriptive cross-sectional study, with a multistage sampling
method, we recruited 1740 adolescents aged 12–19 years from 53 schools in Qazvin, Iran (2018). We
used the Strengths and Difficulties Questionnaire and Adolescents’ Academic Stress Questionnaire
for data collection. The analysis was conducted using a multilevel logistic regression model. Gender,
educational period, and socioeconomic status were considered as confounders.
RESULTS: Almost 21% of the adolescents reported their SRH suboptimal. Suboptimal SRH was
higher in girls and older adolescents. Mental health disorders and academic stress had a positive
association with SRH. However, this association was negative for academic achievement and
physical activity. The interaction between mental health disorders and academic stress with SRH
had a significant association in a crud regression model.
CONCLUSION: Mental health, academic stress, academic achievement, and physical activity were
important predictors for SRH. Interventions that focus on promoting mental health, academic stress,
academic achievement, and physical activity such as physical activity for 1 h and each day for 3 days
per week can improve SRH in adolescents. Hence, policymakers should pay more attention to this
issue in health promotion programs of adolescents.


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