• Hedwig Hofstetter, Elise Dusseldorp, Pepijn van Empelen, and Theo W G M Paulussen.
• TNO (Netherlands Organization for Applied Scientific Research), Expertise Group Life Style, The Netherlands. Electronic address: hedwig.hofstetter@tno.nl.
• Prev Med. 2014 Oct 1; 67: 141-6.

ObjectiveThe aim of this paper is to provide a guideline to a universal understanding of the analysis of co-occurrence of risk behaviors. The use of cluster analysis and factor analysis was clarified.MethodA theoretical introduction to cluster analysis and factor analysis and examples from literature were provided. A representative sample (N=4395) of the Dutch population, aged 16-40 and participating from fall 2005 to spring 2006, was used to illustrate the use of both techniques in assessing the co-occurrence of risk behaviors.ResultsWhereas cluster analysis techniques serve to focus on particular clusters of individuals showing the same behavioral pattern, factor analysis techniques are used to assess possible groups of interrelated health-risk behaviors that can be explained by an unknown common source. Choice between the techniques partly depends on the research question and the aim of the research, and has different implications for inferences and policy.ConclusionBy integrating theory and results from an illustrative example, a guideline has been provided that contributes towards a systematic approach in the assessment of co-occurrence of risk behaviors. Following this guideline, a better comparison between outcomes from various studies is expected, leading to improved effectiveness of multiple behavior change interventions.Copyright © 2014 Elsevier Inc. All rights reserved.

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