Perceived Barriers to Healthy Lifestyle Practices among School-going Youth in a Rural Block of Varanasi, India: An Institution-based Cross-sectional Study

Abstract

Background: Healthy lifestyle behaviours established during adolescence and early adulthood strongly shape later non-communicable disease risk. In rural settings, young people often face constraints that go beyond awareness such as academic pressure, limited opportunities for structured physical activity, and practical challenges related to diet. Objectives: To estimate the prevalence of perceived barriers across key lifestyle domains and to examine their association with selected sociodemographic characteristics among rural youth. Methods: An analytical study was conducted among 15–24 years students. Participants were selected using multistage sampling from educational institutions. Perceived barriers were assessed using a validated “Barriers to a Healthy Lifestyle” questionnaire covering nutrition, physical activity, and psychosocial stress domains, with responses recorded on a five-point Likert scale. Determinants were examined using multivariable logistic regression, and adjusted odds ratios (aOR) with 95% confidence intervals (CI) were reported. Results: High perceived barriers were reported by 49.0% of participants in the psychosocial stress domain, 47.0% in nutrition, and 45.3% in physical activity. Examination-related stress (68.0%) and lack of healthy food availability within institutions (55.0%) were the most frequently endorsed barriers. Male students had significantly higher odds of reporting lower perceived barriers across nutrition (aOR 2.15; 95% CI 1.25–3.67), physical activity (aOR 2.41; 95% CI 1.40–4.14), and psychosocial stress (aOR 2.53; 95% CI 1.47–4.36). Students in 12th grade and college demonstrated significantly higher perceived stress barriers compared to those in 10th–11th grade. Conclusion: Nearly half of rural, school-going youth reported high perceived barriers to healthy lifestyle practices, particularly related to psychosocial stress, diet, and physical activity.