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Objectives: Recent literature indicates a decline over time in adolescent mental wellbeing but results are inconsistent and rely mainly on data from Western societies. This study investigates time trends in adolescent mental wellbeing (psychological and somatic complaints, life satisfaction) among Czech adolescents and explores the moderating role of gender, age and socioeconomic status., Methods: Nationally representative data from 29,376 Czech adolescents (50.8% girls, mean age = 13.43; SD = 1.65) across five Health Behaviour in School-aged Children (HBSC) surveys (2002, 2006, 2010, 2014, 2018) were used. Hierarchical regression models estimated national trends in adolescent mental wellbeing and established the moderating role of gender, age and socioeconomic status., Results: From 2002 to 2018, an increase in the psychological complaints was observed. Life satisfaction decreased over time up to 2014 only, whereas somatic symptoms increased until 2010, followed by a decline in 2014 and 2018. Girls, older adolescents and those from low family affluence reported poorer mental wellbeing. Gender gap increased over time for psychological complaints and life satisfaction. Socioeconomic inequalities gap remained stable over the investigated timeframe., Conclusions: Our findings do not provide evidence for substantial temporal changes in mental wellbeing among adolescents in the Czech Republic. Yet, the increase in psychological complaints has been consistent which is an indicator of a small decline over time in adolescent mental wellbeing. Furthermore, the gender gap in mental wellbeing increased over time, whereas the age and socioeconomic differences remained relatively stable. This calls for the attention of public health professionals and policy makers from the Czech Republic.

Objective: Screen-based behaviours such as watching television or computer use are among the most prevalent sedentary behaviours adolescents spend time on. There is a lack of recent estimates on prevalence and changes in the amount of time spent on screen-based behaviour across Central and Eastern Europe. The main aim is to assess the trends in the prevalence of current recommendations for the screen time (≤2 hours per day) of school-aged children in the Czech Republic between 2002 and 2014., Methods: We used an internationally established methodology based on the Health Behaviour in School-aged Children (HSBC) study. Data was derived from Czech national representative samples of 11-, 13- and 15-year-olds collected in the years 2002 (N=4,065), 2006 (N=4,170), 2010 (N=3,962) and 2014 (N=4,338)., Results: The results indicated that the boys and girl surveyed in 2014 are up to two times more likely to meet the current recommendations for watching television in comparison with groups of schoolchildren of the same age surveyed in 2002. In contrast, computer use by adolescents increased markedly between 2006 and 2014. Taking total screen time into account, spending two hours per day or less on it decreased significantly among boys (OR=0.74, 95% CI=0.62-0.89) and girls (OR=0.80, 95% CI=0.70-0.92) between 2006 and 2014., Conclusions: As screen time is an important indicator of time spent in a sedentary way, our findings call for more interventions to reduce the time that school-aged children spend in front of screens., (Copyright© by the National Institute of Public Health, Prague 2017)

Objective: Active commuting (AC) is an important factor in increasing the total daily physical activity (PA) in children, which is significant for their health and positive physical behaviour in adulthood. The objective of the study was to describe trends in active commuting to school among Czech girls and boys aged 11-15 years from 2006 to 2014, using data from the Health Behaviour in School-aged Children (HBSC) study., Methods: To investigate trends in AC among Czech children of school age data obtained from the HBSC surveys carried out in 2006, 2010, and 2014 was used. The study sample comprised 12,273 respondents, out of whom 5,992 (48.8%) were boys and 6,281 (51.2%) girls. The overall trends in AC were evaluated using logistic regression analysis., Results: Compared with 2006, there was an overall decrease in AC among the 13-year-old boys and 13-year-old girls (boys - 1.8% in 2006 to 50.1% in 2014, girls - 69.3% in 2006 to 46.3% in 2014). The proportion of children AC (walking and cycling) to school significantly decreased from 74.3% in 2006 to 53.4% in 2014., Conclusion: This study demonstrated that AC to school decreased sharply among Czech children of school age from 2006 to 2014. However, walking was the most frequently used mode of travel. The boys were significantly more likely to cycle to school compared to the girls. PA interventions for youth should encourage participation in AC to school in the Czech Republic., (Copyright© by the National Institute of Public Health, Prague 2017)

The aim of the study is to present the theoretical background of trend studies in general, to characterize the international Health Behaviour in School-aged Children (HBSC) study and to describe its methodology and changes of the Czech HBSC study between 1994 and 2014. The first part describes various types of trend research studies including their advantages and disadvantages. The second part summarizes the history of the HBSC study in an international context and particularly in the Czech Republic. The final part presents the basic methodological data from six surveys conducted in the Czech Republic between 1994 and 2014., (Copyright© by the National Institute of Public Health, Prague 2017.)

Objective: Brushing one's teeth twice a day is the main self-care method to prevent the most prevalent non-communicable diseases. The aim of the study is to describe the trends in brushing teeth in 11-, 13-, and 15-year-old Czech children between 1994 and 2014., Methods: One question about oral health from the HBSC study protocol was used in the six surveys (1994, 1998, 2002, 2006, 2010, and 2014). Altogether, 21,170 answers from boys and girls were analyzed using statistical description and binominal logistic regression., Results: The findings showed that the prevalence of brushing their teeth more than once a day increased throughout the twenty years, more so in boys, but a preventive programme is still needed to educate the 21-38% of those who brush their teeth less than twice a day., Conclusion: Although the recommended frequency of brushing their teeth has increased among Czech school-aged children, it still lags far behind the recommended twice-a-day regularity, especially among boys., (Copyright© by the National Institute of Public Health, Prague 2017)

The Health Behaviour in School-aged Children (HBSC) study is now in its 34th year. It continues to grow not only as a source of reliable and valid data on the health behaviours of 11-, 13- and 15-year-olds, but also regarding its membership - 46 countries and regions across Europe and North America are now included. The HBSC study is a cohort cross-sectional questionnaire-based study focusing on health and health-related behaviours in adolescents in the context of their social environment. This age was selected because of the significant cognitive, psychological, and biological processes taking place in this period of the lifespan, as well as because of the fact that health-related behaviours adopted at this age are known to persist into adulthood. The findings from the HBSC study are used to monitor health, well-being, and health-related behaviours in school-aged children; deepen the understanding of the social determinants of health; and provide evidence-based data for policy makers and practitioners aiming to improve the lives of young people., (Copyright© by the National Institute of Public Health, Prague 2017.)

Objective: The aim of the study was to examine trends in the prevalence of lifetime cannabis use among the Czech 15-year old students., Methods: Data from the nationally representative Health Behaviour in School-aged Children Survey, conducted in the Czech Republic in 2002, 2006, 2010 and 2014, were used. Trends in cannabis use among both boys and girls were modelled through binary logistic regression with period as a predictor of the lifetime cannabis use., Results: The prevalence of lifetime cannabis use has significantly decreased among young Czechs, particularly among boys. Gender differences in cannabis use have been also gradually decreasing since 2002, with no significant differences between genders in recent period., Conclusions: Although there are positive changes in the prevalence of adolescent cannabis use, from the European perspective, Czech students still belong to those with significantly higher rates in this respect. Thus, alongside with the use of other substances, adolescent cannabis consumption remains an important challenge for the national public health policy., (Copyright© by the National Institute of Public Health, Prague 2017)

Objective: Due to the importance of surveillance of injuries and accidents in the Czech Republic, the purpose of this study was to report the temporal trends of injuries of Czech adolescents between 2002 and 2014., Methods: Adolescents (N=20,038) from the Czech Republic, that took part in the 2002, 2006, 2010 and 2014 HBSC study, reported the frequency of medically attended injuries in the past 12 months. Repeated binary logistic regressions with different years as reference categories were performed., Results: Less than half (44.7%) of all Czech adolescents reported they had experienced at least one medically attended injuries in the past 12 months, with boys experiencing more injuries than girls (p<0.001), and the injuries were more common in older adolescents. Fewer boys reported injury in 2014 when compared to 2002 (OR, CI: 0.81, 0.72-0.90), there was also a significant decrease in injuries among girls between 2014 and 2006 (OR, CI: 0.77, 0.69-0.86)., Conclusions: The trend was not linear amongst boys. Along with improved safety promotion education, the rate of injuries decreased among adolescents between the years 2002 and 2014., (Copyright© by the National Institute of Public Health, Prague 2017)

Objective: Overweight and obesity in adolescents is associated with many health risks and considerable direct and indirect healthcare costs. The purpose of this study is to examine trends in the prevalence of overweight and obesity in 11-, 13- and 15-year-old adolescents in the Czech Republic from 1998 to 2014., Methods: Data from five self-reported survey rounds (1998, 2002, 2006, 2010, and 2014) of the Health Behaviour in School-aged Children Study (HBSC) were used to assess trends in overweight and obesity among Czech adolescents. The total sample consisted of 19,103 adolescents (51.2% girls). A logistic regression analysis was used to assess trends in different age and gender categories., Results: From 1998 to 2014 a significant increase in the prevalence of overweight and obesity was observed among boys in all age categories (11 years old 22.2% 1998 - 28.3% 2014 ; 13 years old 17.9% 1998 - 26.7% 2014 ; 15 years old 9.8% 1998 - 20.8% 2014 ) and among 15-year-old girls (6.0% 1998 - 10.9% 2014 ). None of the age and gender categories showed an overall decrease over the 16-year period. In boys, the prevalence of overweight was significantly higher with steeper negative trends compared with girls. However, stabilization in overweight rates was observed between 2010 and 2014 in all age and gender groups., Conclusion: Nationally representative self-reported data show a significant increase in overweight (including obesity) prevalence among children from 1998 to 2014 in the Czech Republic. The results also suggest stabilization in overweight prevalence between 2010 and 2014. Continuing research is needed to determine future trends while interventions aimed at reducing overweight and obesity in children should be implemented on different levels of public policy., (Copyright© by the National Institute of Public Health, Prague 2017)

Objective: The aim of the study is to examine cross-sectional time trends of life satisfaction and self-rated health in a representative sample of Czech children aged 11, 13 and 15 years using the Health Behaviour in School-aged Children (HBSC) study data from the Czech Republic., Methods: Data from survey years 2002, 2006, 2010 and 2014 was used. The sample consisted of 16,357 participants (48.5% of boys). Life satisfaction (LS) was measured by Cantril's ladder; self-rated health was measured through the simple item "Would you say your health is: excellent, good, fair, poor"., Results: Most of the children were satisfied with their lives in all surveyed years (mean LS scores range from 7.21 to 7.51; maximum 10). LS was consistently significantly associated (p<0.001) with age and gender. Overall, children and adolescents in the Czech Republic also reported good health. In total, 87.6% of respondents from all samples reported their health as excellent or good. Gender was found to be significantly associated with self-rated health (p<0.05) in all surveyed years., Conclusions: No permanent trends in both followed indicators have been seen in the examined period., (Copyright© by the National Institute of Public Health, Prague 2017)

Objective: Bullying in school is a public health concern which continues to be a serious threat to physical and emotional health of children and adolescents. The purpose of this study is to examine trends in bullying behaviour among school-aged children in the Czech Republic., Methods: Data were obtained from cross-sectional self-report surveys in the years 1994-2014 as a part of the Health Behaviour in School-aged Children study (HBSC) from a representative sample of 11-, 13-, and 15-year olds., Results: The highest proportion of children who bullied others (20-47%) occurred during the years 1994 and 1998. The logistic regression models showed significant decreasing trends in bullying others and also in being bullied, regardless of age and gender., Conclusion: The decreasing trend in bullying may be the consequence of a preventive policy in the Czech Republic, but also a change in the understanding of the concept of bullying in society., (Copyright© by the National Institute of Public Health, Prague 2017)

Objective: The aim of this study is to monitor and analyze the influence of chosen family indicators related to alcohol consumption and experience of drunkenness in a representative sample of Czech children., Methods: Data for our work were obtained from the Health Behaviour in School Aged Children (HBSC) study - a World Health Organization (WHO) cross national study. The sample consisted of 4,293 children aged 11, 13 and 15 years. Data collection was conducted in June 2010 in 88 randomly selected schools in the Czech Republic using standardized questionnaires. Statistical analysis was performed in the program NCSS 9, methods of descriptive statistics, χ 2 test of independence in the contingency tables and logistic regression analysis were used., Results: Regular alcohol consumption (at least weekly) was reported by 7.4% of children aged eleven, 19.3% of children aged thirteen and 38.4% of children aged fifteen years. Drunkenness at least twice in their life was admitted by 3% of children aged eleven, 15% of children aged thirteen and 43% of children aged fifteen years. Both alcohol consumption and drunkenness were significantly associated (p<0.001) with age and gender. Formal structure of family was found to have significant effect on the experience of drunkenness, but no effect on alcohol consumption was recorded. Based on our results, neither the amount of time spent together, nor the children communication with parents had a statistically significant influence on alcohol consumption or drunkenness experience within each family type. However, statistically significant differences were observed between different family types (p<0.001)., Conclusions: These findings indicate a high degree of liberalism of Czech society towards alcohol. It appears that alcohol consumption will remain a serious problem in Czech society, therefore, more attention should be paid to this phenomenon in the future., (Copyright© by the National Institute of Public Health, Prague 2017)

Aim: Physical and screen-based activity in adolescents plays a crucial role in future health outcomes. Therefore, the aim of the study was to examine the associations of physical activity and screen-based activity with behavioural and psychosocial characteristics of school-aged children., Methods: Data on 11, 13 and 15 years old elementary school pupils (N=9,014; mean age=13.59) who participated in the cross-sectional Health Behaviour in School-aged Children 2009/2010 study in the Czech Republic and the Slovak Republic were analyzed. The associations of vigorous physical activity and screen-based activity with substance use, violent behaviour, eating habits and school-related outcomes adjusted for age were explored using logistic regression., Results: Vigorous physical activity was positively associated with some of the health-related behaviours (smoking, breakfast consumption, vegetable and fruit consumption) and school related outcomes (perceived school achievement and school pressure), with gender and country based differences. Screen-based activity was significantly associated with all examined health-related behaviours and school related outcomes with only some country and gender based differences., Conclusions: Vigorous physical activity is positively associated with healthy development of adolescents. Screen-based behaviour shows an inverse relationship with adolescents' healthy development, especially in the group of 11 and 13 years old children. Supporting physical activity conducive environments might lead to a reduction in screen-based behaviour in adolescents and should be highlighted in health-promoting strategies., (Copyright© by the National Institute of Public Health, Prague 2015.)

Aim: The prevalence of sedentary behaviour has increased, and physical activity (PA) levels have declined with increases in urbanisation and modernisation. Researchers need to find solutions to address this lack of PA. The main aim of this study was to identify the PA level and sedentary behaviour in a randomised sample of the Czech adult population in 2002 and 2011., Methods: To investigate PA in 20-64 year old adults, the International Physical Activity Questionnaire (IPAQ) (in 2002) and the Global Physical Activity Questionnaire (GPAQ) (in 2011) were applied. The randomised samples comprised 1,782 participants in 2002, and 1,359 participants in 2011., Results: The results showed a significant decrease (F=83.84; p<0.001; ω²=0.03) in the time spent sitting between the years 2002 and 2011. The proportion of individuals reporting low PA has increased (11.4% in 2002 vs. 27.9% in 2011). Individuals with college/university education were more likely to have low PA levels (OR=1.51, p<0.001, CI=1.21-1.68) compared with those with elementary or secondary education. Along with educational level, low PA levels are also associated with older age, spending more than four hours a day sitting, and the survey year., Conclusion: Sedentary behaviour, PA, and factors influencing this behaviour may differ across countries; therefore, more trend-related research should be performed on these issues, especially in Central and Eastern Europe, where these studies are scarce., (Copyright© by the National Institute of Public Health, Prague 2015.)

Objectives: Physical activity significantly contributes to overall health and the level of activity during adolescence has been associated with physical activity in adulthood. The aim of this paper was to analyse motives for young people undertaking leisure time physical activity in the Czech and Slovak Republics., Methods: Eleven to fifteen year old schoolchildren (N=9,014; mean age=13.59) participating in the Health Behaviour in School-aged Children 2009/2010 study in the Czech and Slovak Republics completed 12 items measuring physical activity motivations. To analyse the factor structure of motives for physical activity, Confirmatory Factor Analysis (CFA) was conducted using Principal Component Analysis (PCA) with varimax rotation., Results: Contrary to previous research that reported three main motives for physical activity (health, social, achievement), our study suggests four motives. The additional motive is a combination of internal and external motivations and was called the "Good Child Motive"., Conclusions: Better understanding of motives behind physical activity or inactivity of young people could significantly contribute to evidence based planning and development of national strategies for public health and active living., (Copyright© by the National Institute of Public Health, Prague 2015.)