Patterns and Preventive Strategies for Health Risk Behaviours Among in-School Adolescents in Ado Ekiti, Ekiti State, Nigeria

Background: Health risk behaviours acquired during adolescence are a leading driver of preventable morbidity and mortality among young people worldwide, yet context-specific evidence to guide school-based prevention remains scarce in many Nigerian settings, including Ado Ekiti, Ekiti State. This study examined the prevalence and patterns of health risk behaviours, awareness of and attitudes toward preventive strategies, associated factors, and the perceived effectiveness of existing interventions among in-school adolescents in Ado Ekiti. Methods: A descriptive cross-sectional survey was conducted among 248 in-school adolescents aged 10-19 years, selected from public and private secondary schools in Ado Ekiti through multi-stage sampling combining purposive school selection with systematic random selection of students. Data were collected using a structured, self-administered questionnaire and analysed with SPSS version 27 using descriptive statistics, chi-square tests, Pearson correlation, and independent-samples t-tests, with significance set at p < 0.05. Results: Nearly half of respondents (49.2%) had engaged in at least one health risk behaviour, most commonly unhealthy dietary practices (55.6%) and physical inactivity (46.8%), and 29.8% reported two or more concurrent behaviours. Only 25.8% demonstrated adequate awareness of preventive strategies, although 64.5% held positive attitudes toward prevention. Health risk behaviours were significantly associated with age, gender, school type, and socioeconomic status (p < 0.05). They were significantly and inversely correlated with awareness (r = -0.412), attitude (r = -0.387), and perceived effectiveness of existing strategies (r = -0.356), all p < 0.001. Conclusion: Health risk behaviours cluster at high prevalence among in-school adolescents in Ado Ekiti and are shaped by an interconnected set of individual, interpersonal, and contextual determinants that existing school-based interventions have not adequately addressed. Comprehensive, skills-based, peer-led, and family-inclusive prevention strategies are urgently required.