1. THE RELATIONSHIP ANDSELF-ESTEEM AND HEALTH-RELATED RISK BEHAVIORS
AMONG ADOLESCENTS IN BAGUIO CITY
___________
In partial fulfillment
Of the requirements
In the course
INTRODUCTION TO NURSING RESEARCH
__________
Submitted to
The Faculty of the
School of Nursing
Saint Louis University
Submitted by:
Names
August 2011
INTRODUCTION
adolescence
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Changes in adolescents
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Among the changes- Self-estem (reasons)- Males vs females, race/ethnicity
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2. Other than self-esteem- engage with health-related risk behaviors-common health-related
risk behaviors- statistics CDC, race or gender
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GAP
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Summary
Adolescence is a period of rapid and transformative physical, psychological,
sociocultural, and cognitive development. The physical changes of puberty — including growth
and maturation of multiple organ systems such as the reproductive organs and brain — lay a
biological foundation for the other developmental changes.Erik Erikson’s psychosocial theory
states that adolescence is the period of development during which an individual makes the
transition from childhood to adulthood, usually between 12-18 years old (Potter and Perry,
2006). Stanley Hall views adolescence as the “Storm and Stress” period (John W. Santrock,
1997).
During this period, the adolescent brain is rewired, with resulting maturation of cognitive
abilities in early adolescence. When these new cognitive abilities are combined with life
experiences, we often observe development of social judgment, including judgment about risk
and safety. Adolescence is also marked by critical transformation in the relationship of a young
person to the world, as the social circles of peers and the adult worlds of work, pleasure, and
social responsibility become more central and the family circle becomes somewhat less
prominent — at least temporarily. Adolescents must learn to deal with an expanding social
universe and must develop the social skills to find friendship, romance, employment, and social
standing within multiple social spheres. Finally, a critical task of adolescence is the
establishment of a stable sense of identity and the development of autonomy or agency. This
development of identity often occurs only after a period of exploration, of trial and error in social
roles and social behaviors. Although most adolescents navigate the often turbulent course from
childhood to adulthood to become healthy adults and productive citizens, many fail to do so
(Adolescents at risk: A Generation in Jeopardy, Crosby et.al). Adolescence is the agewhere
according to the Intrapsychic theory (also called psychodynamic) focuses on an individual’s
unconscious processes. Feelings, needs, conflicts and drives are considered to be motivators of
behavior, learning and development. Sigmund Freud and Erik Erikson are two major

3. Intraphysictheorist, it is the time where adolescents are given this perspective, it's not hard to
recognize that self-esteem plays a big part in the developing adolescent. It is important to
understand that not all theorists believe adolescence is characterized as a time of storm and
stress. It certainly may have its ups and downs, but much of this is a normal reaction to all of the
physical, emotional and social changes taking place. Latent growth curve analyses indicated
that self-esteem increases during adolescence and continues to increase more slowly in young
adulthood. Women and men did not differ in their self-esteem trajectories. In adolescence,
Hispanics had lower self-esteem than Blacks and Whites, but the self-esteem of Hispanics
subsequently increased more strongly, so that at age 30 Blacks and Hispanics had higher self-
esteem than Whites. At each age, emotionally stable, extraverted, and conscientious individuals
experienced higher self-esteem than emotionally unstable, introverted, and less conscientious
individuals. Moreover, at each age, high sense of mastery, low risk taking, and better health
predicted higher self-esteem (PubMed; Self-esteem development from age 14-30 years: A
longitudinal study; 2011) .Self-esteem issues are important throughout the teen years.
Self esteem is the one important factor required by anybody to succeed in life. It is a well
proven concept that if you can build self esteem at your adolescent period it will last all through
your life. Adolescence is one period in which boys and girls faces with many problems and
issues. It is necessary that adolescent self esteem to be at top to face the problems faced with
adolescent period because if not, this will lead to uncertain things that will definitely affect the
interaction of adolescents to their environment (Adolescent Self-esteem, Todd Koenig).
Webster defines self-esteem as "an objective respect for or favorable impression of
oneself, an inordinately or exaggeratedly favorable impression of oneself." This simply means
how you feel about yourself. Dr. Nathaniel Branden said, "Self-esteem is the experience of
being competent to cope with the basic challenges of life and of being worthy of
happiness".(Branden, N., 1994, The Six Pillars of Self-Esteem, New York: Bantam Books.)
Too many fall prey to social and behavior morbidities and mortality, and many fail to
achieve their full potential as workers, parents, and individuals. Many suffer substantial short -
term impairment and disability, and for many this impairment extends into adulthood. Many of
these failures of adolescent development are the result of preventable health risk behaviors.
Adolescence is marked by increasing involvement in health risk behaviors. Between the ages of
twelve and twenty - five, we observe the initiation of myriad health risk behaviors, including
alcohol and drug use, smoking, sexual behaviors, delinquency, and behaviors leading to
intentional and unintentional injuries — all of which can adversely influence health in the short

4. and long term. For example, alcohol and drug use are the proximate causes of unintentional
injuries during adolescence; they also can lead to adult addiction and social and health
impairment. Sexual behaviors often result in unplanned pregnancy and sexually transmitted
diseases, including HIV infection. Self-esteem of adolescents play an important role in their
engagement to health related risk behaviors such as physical harm, dietary behavior, physical
inactivity, sexual behavior, substance abuse (Charalampous, Ford, and Skinner; 1976;
Donnelly, 2000) which the Youth Risk Behavior Surveillance System (YRBSS) have
enumerated. Adolescents may engage in these health-related risk behaviors and may react on it
negatively or positively.There is a belief among many in the field of health promotion and health
education that a
high self-esteem is somehow protective against involvement in the so-called health risk
behaviours. The assumed protective
effect of self-esteem is derived from a 'deficit' or 'susceptibility' model of adolescent
behaviour (McGee & Williams, 2000; Moore, Laflin& Weis, 1996)
Some researches that were conducted outside the country revealed that there is a
significant difference among male and female adolescents when it comes to engaging in those
health-related risk behaviors whether they have a high or low self-esteem. In terms of sexual
behavior, self-esteem plays an apparent role in the sexual behaviors among adolescents,
according to a study by researchers at the Indiana University School of Medicine published in
the April 2002 issue of Pediatrics. Self-esteem had opposite effects on female adolescents and
male adolescents. Female adolescents with high self-esteem were less likely to engage in early
sexual activity, while male adolescents with high self-esteem were more likely to report being
sexually active.
In terms of physical harm, Johnson (1977) concluded
that juvenile delinquency prevention programs often fail because they are
based on incorrect assumptions about the sources of delinquency and overlook
the crucial roles of school failure and low self-esteem among adolescents either male or female.
Kelley (1978) reported a direct correlation between delinquency and low
self-esteem. He found evidence of a link between increased self-esteem and a
reduction of delinquent behavior. He found that as programs were implemented
to raise the level of self-esteem, the incidence of delinquent behavior was
reduced. Those with low self-esteem seem to rely more on group or collective
self-esteem than those with high personal self-esteem. Thus, some

5. individuals seek gang membership to compensate for feelings of low
self-esteem (Review of Self-esteem Research, Robert W. Reasoner).
In terms of substance abuse, low self-esteem can be one of the main indicators why
adolescents engage in using illegal drugs, drinking alcohol and the like. Moreover female
adolescents are less likely to engage in substance abuse than male adolescents (Women and
Children Treatment, 2010). In the book Alcoholism: A False Stigma: Low
Self-Esteem the True Disease, (1996) Candito reports, "Those who have
identified themselves as "recovered alcoholics" indicate that low self esteem
is the most significant problem in their lives. Low self-esteem is the true
problem and the true disease not because it will lead to alcoholism but also to other substance
abuse like marijuana, smoking and others.
In terms of dietary behaviors, Dr. Yellowlees (1996)
states that low self-esteem seems to operate as a predisposing and
contributory factor in the development of eating
disorders. In some cases, evidence for this
relationship is so strong that it is even thought by some researchers that
chronic low self-esteem is a necessary prerequisite for disordered eating. However more of the
female adolescents were being affected by their low self-esteem than the males.
In terms of physical inactivity, female and male adolescents who have a high self-
esteem are the ones who likely committed physical inactivity. Female and male adolescents
who have a low self-esteem are the ones engaging in physical activity such as exercise in order
to boost their low self-esteem (PubMed.Gov, 2009).
Since these researches were conducted outside the country, we would also like
to have a research about this in order to see if the results do vary here in the Philippines and
thus this factors affect the prevalence of committing certain attitudes that is why we come up
with this research entitled Self-esteem and Health-Related Risk Behaviors among Adolescents
in Baguio City.
In our research, Self-esteem is referred to as the overall evaluation or appraisal of one’s
own worth. Health-related risk behaviors are the actions, attitudes and perceptions that may
contribute to one’s engagement in activities which are hazardous or dangerous to their own

6. health. One of this is physical harm which is referred to as the intention or to cause damage to
self, others or property. Substance abuse is the maladaptive use(abuse) of tobacco, alcohol and
other drugs. Sexual behavior is the maladaptive sexual patterns or behaviors of adolescents
such as unsafe or premarital sex. Dietary behaviors are the dietary habits that are not
considered to be healthy. Physical inactivity is the behavior such as lack of exercise.
The research aims to understand the relationship of self-esteem and health risk behaviors.
Specifically, it seeks to answer the following questions:
1. What is the relationship between self-esteem and health-related risk behaviors of
adolescents?
2. What is the relationship betweenself-esteem and health-related risk behaviors
among adolescents whenthese behaviors are classified according to:
a. Physical harm
b. Substance abuse
c. Sexual behaviors
d. Dietary Behaviors
e. Physical inactivity
3. Is there a significant association between the relationship of self-esteem and health-
related risk behavior when grouped according to:
a. Gender
b. Ethnicity
METHODOLOGY
The study will utilize a correlational quantitative design. Give a short description in
relations to your study. (Poilt and Beck, 20?). The total population of adolescents in Baguio City
is 1,000,000 excluding those who are not enrolled. Adolescents who are out of school will not be
considered because the researchers were not able to know their exact number. The sample
size of 385 was determined by the formula for standard proportions.
The study will be conducted in Baguio City… {REASONS}
To answer the research questions, the researchers will utilize a questionnaire to gather
data. The questionnaire is composed of 3 parts. The first part comprises of a letter addressed to
the respondent. The letter explains the title of the study, the purpose of the study and ethical

7. considerations that shall be observed in the conduct of the study. The second part determines
the participants’ demographic data. The third part of the questionnaire consists of _ items to
determine the level of self-esteem and the level of health-related risk behaviors. The tool that
will be used in the study was adapted from Rosenberg’s Global Self-Esteem Inventory and
YRBSS ________. To assure validity of the tool, Expert- Content Validity Index CVI! {}
{Data Gathering Procedure}