• health-promoting lifestyle;
  • health promotion model;
  • health-related quality of life;
  • path analysis


Predicting the significant determinants of health-related quality of life through the application of structural equation modeling in adolescents has received little attention in the health education and health promotion literature. The purpose of this study was to investigate the relationships between self-efficacy, barriers, social support, health-promoting lifestyle, and health-related quality of life among Iranian adolescent girls. Pender's health promotion model guided this study. This was a cross-sectional survey of 500 students who were recruited in Kashan, Iran. Their health-related quality of life was measured by using the Short Form Health Survey. A path analysis was conducted to predict the health-related quality of life determinants. The results indicated that 71% of the variance in health-related quality of life could be predicted by the variables. The results affirmed that self-efficacy was the most significant predictor of the students' health-related quality of life. It was concluded that interventions that are aimed at improving self-efficacy can lead to the enhancement of health-related quality of life among adolescent girls in the developing country of Iran.