Health perception, behavioral factors, and the formation of a healthy lifestyle among students: results of a cross-sectional observational study

Abstract

Over the past decade, the health status of young people in Ukraine has significantly deteriorated due to the full-scale war, socioeconomic instability, and increased psychological and educational burden. University students represent a particularly vulnerable population group, as they are exposed to high levels of stress, insufficient physical activity, disrupted sleep patterns, and limited awareness of effective health-preserving behaviors. In these conditions, understanding how students perceive health, which behavioral strategies they adopt, and how these patterns change throughout the course of higher education becomes critically important. Purpose. The purpose of this study was to conduct a comprehensive analysis of students’ health perceptions, behavioral factors, and the formation of a healthy lifestyle, as well as to identify differences between students at different stages of university education and the key factors influencing these changes. Materials and methods. A cross-sectional observational study was conducted in April 2025 at Dnipro Humanitarian University (Dnipro, Ukraine). The study sample consisted of 68 full-time undergraduate students majoring in Psychology, including 35 secondyear students and 33 fourth-year students aged 18–22 years. Participation was voluntary, anonymous, and approved by the university’s ethics committee in accordance with the Declaration of Helsinki. Data were collected using an author-developed questionnaire comprising 20 closed-ended questions. The questionnaire covered four thematic domains: (1) awareness of basic health concepts, (2) attitudes toward health-preserving practices, (3) personal behavioral habits related to a healthy lifestyle, and (4) expectations regarding health support within the educational environment. Statistical analysis was performed using the chi-square (χ²) test to compare response frequencies between groups, with statistical significance set at p < 0.05. Results. All respondents (100%) reported interest in their own health. However, significant differences were identified between second- and fourth-year students across multiple indicators. Fourth-year students were significantly more likely to undergo regular medical examinations (83.3%), rely on physicians and parents as primary sources of health information (p = 0.003), discuss healthrelated issues within the family (87.5%, p = 0.04), and consider themselves a role model for a healthy lifestyle (40.7%, p = 0.015). Older students also demonstrated more adaptive recovery strategies, more frequently identifying physical activity and engagement in favorite activities as key resources for restoring well-being (p = 0.001). They were more likely to feel rested in the morning (76.6% vs. 30%, p = 0.002), indicating better time management and sleep regulation. In contrast, second-year students more often relied on external role models, such as public figures, and demonstrated higher levels of stress and less stable health-related habits. Family context also played a significant role: fourth-year students were more likely to live in a complete family structure (80% vs. 40%, p = 0.003) and perceive their parents as examples of a healthy lifestyle (75% vs. 36.4%, p = 0.002). Conclusions. The findings indicate that students’ attitudes toward health and health-related behaviors undergo substantial transformation during the first four years of university education. Senior students demonstrate higher levels of health awareness, greater personal responsibility, increased reliance on credible information sources, and a preference for adaptive, health-promoting behaviors. At the same time, second-year students require targeted educational and psychological interventions aimed at stress management, habit formation, and health literacy. The results emphasize the need for a comprehensive, institution-wide approach to health promotion in higher education, integrating educational programs, family and social support, and supportive campus environments to foster sustainable healthy lifestyles among students.