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Background: Variable-oriented analyses of time trends in the ease of communicating with mothers and fathers in the Swedish HBSC (Health and Behavior in School-aged Children) dataset show that communication problems with fathers, but not with mothers, positively predict mental health problems among adolescents. This similarity across years is likely to lead to high structural stability in person-oriented analyses across survey years, providing opportunities to uncover typical communication patterns in a robust way. A person-oriented method, cluster analysis, was used in this study to clarify these variable-oriented findings on the prediction of mental health problems. Methods: The Swedish HBSC dataset of 15-year-olds for 2002, 2006, 2010, 2014, and 2018, with a total of 9255 participants, was used for variable- and person-oriented analyses. Results: Person-oriented analyses of ease of communication with the mother and ease of communication with the father show that poor communication with both parents is associated with the worst mental health problems. They also show that when there is poor communication with mothers, in most cases, adolescents also have poor communication with fathers. The variable-oriented analyses do not show that mental health problems are highest when adolescents find it difficult to communicate with both parents. Conclusions: Person-oriented analyses offer the possibility of drawing more specific conclusions about family conditions that affect adolescents’ mental health. More generally, person-oriented analyses are likely to clarify the results of variable-oriented analyses in many other areas also.

Background: Studies of secular trends in mental unhealth indicate that adolescents in the Nordic countries, especially girls, have an increased reported prevalence of mental health problems the last decades. This increase needs to be seen in the light of the adolescents' assessments of their perceived overall health. Objective: To investigate whether a person-centered approach to research can enhance understanding of changes over time in the distribution of mental health problems among Swedish adolescents. Method: A dual-factor approach was used to study changes over time in mental health profiles among nationally representative 15-year-old adolescent samples from Sweden. Cluster analyses of subjective health symptoms (psychological and somatic) and perceived overall health from the Swedish Health Behavior in School-aged Children (HBSC) surveys of 2002, 2006, 2010, 2014, and 2018 were used to identify these mental health profiles (n = 9,007). Results: Four mental health profiles were identified by a cluster analysis which combined all five data collections-Perceived good health, Perceived poor health, High psychosomatic symptoms, and Poor mental health. There were no significant differences in the distributions of these four mental health profiles between the survey years 2002 and 2010, but substantial changes took place between 2010 and 2018. Here, particularly the High psychosomatic symptoms profile increased among both boys and girls. The Perceived good health profile decreased among both boys and girls, and the Perceived poor health profile decreased among girls. The profile involving the most pronounced mental health problems, the Poor mental health profile (perceived poor health, high psychosomatic problems), was stable from 2002 to 2018 among both boys and girls. Conclusion: The study shows the added value of using person-centered analyses to describe differences in mental health indicators between cohorts of adolescents over longer periods of time. In contra

Background: Studies that have examined time trends in adolescents’ mental health have frequently been based on analyses of adolescents’ psychosomatic symptoms. Adolescents’ reports of psychosomatic complaints need to be seen in the light of their overall evaluations of their health. The objectives of this study were to apply a person-centred approach to identifying adolescents’ mental-health profiles based on evaluations of their overall health and psychosomatic complaints. The relationships between these mental-health profiles and indicators of positive mental health and psychological and social-adjustment problems are examined. Methods: A dual-factor approach was used for nationally representative adolescent samples and examined adolescents’ self-rated psychosomatic complaints and perceived overall health simultaneously. Cluster analyses of data from the Swedish Health Behaviour in School-aged Children (HBSC) 2017/18 survey, including 3222 children aged 11, 13 and 15, were used to identify mental-health profiles. Results: Four mental-health profiles were identified by cluster analyses in all age groups. The profiles showed good construct validity in relation to mental well-being, life satisfaction and self-esteem. The poorest psychological adjustment was found among the adolescents with high levels of psychosomatic symptoms together with low levels of perceived overall health. Adolescents with high levels of psychosomatic symptoms only or with low levels of overall health only showed considerably better psychological adjustment. Conclusions: Cluster analyses identified distinct, valid and consistent mental-health profiles based on differing levels of perceived health and psychosomatic complaints. The dual-factor model in population health research may increase our potential to understand the mental health of adolescents better.

BackgroundStudies of secular trends in mental unhealth indicate that adolescents in the Nordic countries, especially girls, have an increased reported prevalence of mental health problems the last decades. This increase needs to be seen in the light of the adolescents' assessments of their perceived overall health. ObjectiveTo investigate whether a person-centered approach to research can enhance understanding of changes over time in the distribution of mental health problems among Swedish adolescents. MethodA dual-factor approach was used to study changes over time in mental health profiles among nationally representative 15-year-old adolescent samples from Sweden. Cluster analyses of subjective health symptoms (psychological and somatic) and perceived overall health from the Swedish Health Behavior in School-aged Children (HBSC) surveys of 2002, 2006, 2010, 2014, and 2018 were used to identify these mental health profiles (n = 9,007). ResultsFour mental health profiles were identified by a cluster analysis which combined all five data collections-Perceived good health, Perceived poor health, High psychosomatic symptoms, and Poor mental health. There were no significant differences in the distributions of these four mental health profiles between the survey years 2002 and 2010, but substantial changes took place between 2010 and 2018. Here, particularly the High psychosomatic symptoms profile increased among both boys and girls. The Perceived good health profile decreased among both boys and girls, and the Perceived poor health profile decreased among girls. The profile involving the most pronounced mental health problems, the Poor mental health profile (perceived poor health, high psychosomatic problems), was stable from 2002 to 2018 among both boys and girls. ConclusionThe study shows the added value of using person-centered analyses to describe differences in mental health indicators between cohorts of adolescents over longer periods of time. In contrast to the

Background: Studies that have examined time trends in adolescents’ mental health have frequently been based on analyses of adolescents’ psychosomatic symptoms. Adolescents’ reports of psychosomatic complaints need to be seen in the light of their overall evaluations of their health. The objectives of this study were to apply a person-centred approach to identifying adolescents’ mental-health profiles based on evaluations of their overall health and psychosomatic complaints. The relationships between these mental-health profiles and indicators of positive mental health and psychological and social-adjustment problems are examined. Methods: A dual-factor approach was used for nationally representative adolescent samples and examined adolescents’ self-rated psychosomatic complaints and perceived overall health simultaneously. Cluster analyses of data from the Swedish Health Behaviour in School-aged Children (HBSC) 2017/18 survey, including 3222 children aged 11, 13 and 15, were used to identify mental-health profiles. Results: Four mental-health profiles were identified by cluster analyses in all age groups. The profiles showed good construct validity in relation to mental well-being, life satisfaction and self-esteem. The poorest psychological adjustment was found among the adolescents with high levels of psychosomatic symptoms together with low levels of perceived overall health. Adolescents with high levels of psychosomatic symptoms only or with low levels of overall health only showed considerably better psychological adjustment. Conclusions: Cluster analyses identified distinct, valid and consistent mental-health profiles based on differing levels of perceived health and psychosomatic complaints. The dual-factor model in population health research may increase our potential to understand the mental health of adolescents better.

Background: Studies of secular trends in mental unhealth indicate that adolescents in the Nordic countries, especially girls, have an increased reported prevalence of mental health problems the last decades. This increase needs to be seen in the light of the adolescents' assessments of their perceived overall health. Objective: To investigate whether a person-centered approach to research can enhance understanding of changes over time in the distribution of mental health problems among Swedish adolescents. Method: A dual-factor approach was used to study changes over time in mental health profiles among nationally representative 15-year-old adolescent samples from Sweden. Cluster analyses of subjective health symptoms (psychological and somatic) and perceived overall health from the Swedish Health Behavior in School-aged Children (HBSC) surveys of 2002, 2006, 2010, 2014, and 2018 were used to identify these mental health profiles (n = 9,007). Results: Four mental health profiles were identified by a cluster analysis which combined all five data collections-Perceived good health, Perceived poor health, High psychosomatic symptoms, and Poor mental health. There were no significant differences in the distributions of these four mental health profiles between the survey years 2002 and 2010, but substantial changes took place between 2010 and 2018. Here, particularly the High psychosomatic symptoms profile increased among both boys and girls. The Perceived good health profile decreased among both boys and girls, and the Perceived poor health profile decreased among girls. The profile involving the most pronounced mental health problems, the Poor mental health profile (perceived poor health, high psychosomatic problems), was stable from 2002 to 2018 among both boys and girls. Conclusion: The study shows the added value of using person-centered analyses to describe differences in mental health indicators between cohorts of adolescents over longer periods of time. In contra

Background: Studies that have examined time trends in adolescents’ mental health have frequently been based on analyses of adolescents’ psychosomatic symptoms. Adolescents’ reports of psychosomatic complaints need to be seen in the light of their overall evaluations of their health. The objectives of this study were to apply a person-centred approach to identifying adolescents’ mental-health profiles based on evaluations of their overall health and psychosomatic complaints. The relationships between these mental-health profiles and indicators of positive mental health and psychological and social-adjustment problems are examined. Methods: A dual-factor approach was used for nationally representative adolescent samples and examined adolescents’ self-rated psychosomatic complaints and perceived overall health simultaneously. Cluster analyses of data from the Swedish Health Behaviour in School-aged Children (HBSC) 2017/18 survey, including 3222 children aged 11, 13 and 15, were used to identify mental-health profiles. Results: Four mental-health profiles were identified by cluster analyses in all age groups. The profiles showed good construct validity in relation to mental well-being, life satisfaction and self-esteem. The poorest psychological adjustment was found among the adolescents with high levels of psychosomatic symptoms together with low levels of perceived overall health. Adolescents with high levels of psychosomatic symptoms only or with low levels of overall health only showed considerably better psychological adjustment. Conclusions: Cluster analyses identified distinct, valid and consistent mental-health profiles based on differing levels of perceived health and psychosomatic complaints. The dual-factor model in population health research may increase our potential to understand the mental health of adolescents better.

Background: Studies that have examined time trends in adolescents’ mental health have frequently been based on analyses of adolescents’ psychosomatic symptoms. Adolescents’ reports of psychosomatic complaints need to be seen in the light of their overall evaluations of their health. The objectives of this study were to apply a person-centred approach to identifying adolescents’ mental-health profiles based on evaluations of their overall health and psychosomatic complaints. The relationships between these mental-health profiles and indicators of positive mental health and psychological and social-adjustment problems are examined. Methods: A dual-factor approach was used for nationally representative adolescent samples and examined adolescents’ self-rated psychosomatic complaints and perceived overall health simultaneously. Cluster analyses of data from the Swedish Health Behaviour in School-aged Children (HBSC) 2017/18 survey, including 3222 children aged 11, 13 and 15, were used to identify mental-health profiles. Results: Four mental-health profiles were identified by cluster analyses in all age groups. The profiles showed good construct validity in relation to mental well-being, life satisfaction and self-esteem. The poorest psychological adjustment was found among the adolescents with high levels of psychosomatic symptoms together with low levels of perceived overall health. Adolescents with high levels of psychosomatic symptoms only or with low levels of overall health only showed considerably better psychological adjustment. Conclusions: Cluster analyses identified distinct, valid and consistent mental-health profiles based on differing levels of perceived health and psychosomatic complaints. The dual-factor model in population health research may increase our potential to understand the mental health of adolescents better.

Background: Studies of secular trends in mental unhealth indicate that adolescents in the Nordic countries, especially girls, have an increased reported prevalence of mental health problems the last decades. This increase needs to be seen in the light of the adolescents' assessments of their perceived overall health. Objective: To investigate whether a person-centered approach to research can enhance understanding of changes over time in the distribution of mental health problems among Swedish adolescents. Method: A dual-factor approach was used to study changes over time in mental health profiles among nationally representative 15-year-old adolescent samples from Sweden. Cluster analyses of subjective health symptoms (psychological and somatic) and perceived overall health from the Swedish Health Behavior in School-aged Children (HBSC) surveys of 2002, 2006, 2010, 2014, and 2018 were used to identify these mental health profiles (n = 9,007). Results: Four mental health profiles were identified by a cluster analysis which combined all five data collections-Perceived good health, Perceived poor health, High psychosomatic symptoms, and Poor mental health. There were no significant differences in the distributions of these four mental health profiles between the survey years 2002 and 2010, but substantial changes took place between 2010 and 2018. Here, particularly the High psychosomatic symptoms profile increased among both boys and girls. The Perceived good health profile decreased among both boys and girls, and the Perceived poor health profile decreased among girls. The profile involving the most pronounced mental health problems, the Poor mental health profile (perceived poor health, high psychosomatic problems), was stable from 2002 to 2018 among both boys and girls. Conclusion: The study shows the added value of using person-centered analyses to describe differences in mental health indicators between cohorts of adolescents over longer periods of time. In contra

Background: Studies that have examined time trends in adolescents’ mental health have frequently been based on analyses of adolescents’ psychosomatic symptoms. Adolescents’ reports of psychosomatic complaints need to be seen in the light of their overall evaluations of their health. The objectives of this study were to apply a person-centred approach to identifying adolescents’ mental-health profiles based on evaluations of their overall health and psychosomatic complaints. The relationships between these mental-health profiles and indicators of positive mental health and psychological and social-adjustment problems are examined. Methods: A dual-factor approach was used for nationally representative adolescent samples and examined adolescents’ self-rated psychosomatic complaints and perceived overall health simultaneously. Cluster analyses of data from the Swedish Health Behaviour in School-aged Children (HBSC) 2017/18 survey, including 3222 children aged 11, 13 and 15, were used to identify mental-health profiles. Results: Four mental-health profiles were identified by cluster analyses in all age groups. The profiles showed good construct validity in relation to mental well-being, life satisfaction and self-esteem. The poorest psychological adjustment was found among the adolescents with high levels of psychosomatic symptoms together with low levels of perceived overall health. Adolescents with high levels of psychosomatic symptoms only or with low levels of overall health only showed considerably better psychological adjustment. Conclusions: Cluster analyses identified distinct, valid and consistent mental-health profiles based on differing levels of perceived health and psychosomatic complaints. The dual-factor model in population health research may increase our potential to understand the mental health of adolescents better.

Background: Studies of secular trends in mental unhealth indicate that adolescents in the Nordic countries, especially girls, have an increased reported prevalence of mental health problems the last decades. This increase needs to be seen in the light of the adolescents' assessments of their perceived overall health. Objective: To investigate whether a person-centered approach to research can enhance understanding of changes over time in the distribution of mental health problems among Swedish adolescents. Method: A dual-factor approach was used to study changes over time in mental health profiles among nationally representative 15-year-old adolescent samples from Sweden. Cluster analyses of subjective health symptoms (psychological and somatic) and perceived overall health from the Swedish Health Behavior in School-aged Children (HBSC) surveys of 2002, 2006, 2010, 2014, and 2018 were used to identify these mental health profiles (n = 9,007). Results: Four mental health profiles were identified by a cluster analysis which combined all five data collections-Perceived good health, Perceived poor health, High psychosomatic symptoms, and Poor mental health. There were no significant differences in the distributions of these four mental health profiles between the survey years 2002 and 2010, but substantial changes took place between 2010 and 2018. Here, particularly the High psychosomatic symptoms profile increased among both boys and girls. The Perceived good health profile decreased among both boys and girls, and the Perceived poor health profile decreased among girls. The profile involving the most pronounced mental health problems, the Poor mental health profile (perceived poor health, high psychosomatic problems), was stable from 2002 to 2018 among both boys and girls. Conclusion: The study shows the added value of using person-centered analyses to describe differences in mental health indicators between cohorts of adolescents over longer periods of time. In contra

Background: Studies that have examined time trends in adolescents’ mental health have frequently been based on analyses of adolescents’ psychosomatic symptoms. Adolescents’ reports of psychosomatic complaints need to be seen in the light of their overall evaluations of their health. The objectives of this study were to apply a person-centred approach to identifying adolescents’ mental-health profiles based on evaluations of their overall health and psychosomatic complaints. The relationships between these mental-health profiles and indicators of positive mental health and psychological and social-adjustment problems are examined. Methods: A dual-factor approach was used for nationally representative adolescent samples and examined adolescents’ self-rated psychosomatic complaints and perceived overall health simultaneously. Cluster analyses of data from the Swedish Health Behaviour in School-aged Children (HBSC) 2017/18 survey, including 3222 children aged 11, 13 and 15, were used to identify mental-health profiles. Results: Four mental-health profiles were identified by cluster analyses in all age groups. The profiles showed good construct validity in relation to mental well-being, life satisfaction and self-esteem. The poorest psychological adjustment was found among the adolescents with high levels of psychosomatic symptoms together with low levels of perceived overall health. Adolescents with high levels of psychosomatic symptoms only or with low levels of overall health only showed considerably better psychological adjustment. Conclusions: Cluster analyses identified distinct, valid and consistent mental-health profiles based on differing levels of perceived health and psychosomatic complaints. The dual-factor model in population health research may increase our potential to understand the mental health of adolescents better.

Background: Studies of secular trends in mental unhealth indicate that adolescents in the Nordic countries, especially girls, have an increased reported prevalence of mental health problems the last decades. This increase needs to be seen in the light of the adolescents' assessments of their perceived overall health. Objective: To investigate whether a person-centered approach to research can enhance understanding of changes over time in the distribution of mental health problems among Swedish adolescents. Method: A dual-factor approach was used to study changes over time in mental health profiles among nationally representative 15-year-old adolescent samples from Sweden. Cluster analyses of subjective health symptoms (psychological and somatic) and perceived overall health from the Swedish Health Behavior in School-aged Children (HBSC) surveys of 2002, 2006, 2010, 2014, and 2018 were used to identify these mental health profiles (n = 9,007). Results: Four mental health profiles were identified by a cluster analysis which combined all five data collections-Perceived good health, Perceived poor health, High psychosomatic symptoms, and Poor mental health. There were no significant differences in the distributions of these four mental health profiles between the survey years 2002 and 2010, but substantial changes took place between 2010 and 2018. Here, particularly the High psychosomatic symptoms profile increased among both boys and girls. The Perceived good health profile decreased among both boys and girls, and the Perceived poor health profile decreased among girls. The profile involving the most pronounced mental health problems, the Poor mental health profile (perceived poor health, high psychosomatic problems), was stable from 2002 to 2018 among both boys and girls. Conclusion: The study shows the added value of using person-centered analyses to describe differences in mental health indicators between cohorts of adolescents over longer periods of time. In contra

To the Editors: As the authors of the article, “Typologies of Joint Family Activities and Associations With Mental Health and Wellbeing Among Adolescents From Four Countries,” we would like to provide a statement in light of recent events taking place in Eastern Europe [1]. Following the tragic events surrounding the war in Ukraine which started on February 24, 2022, more than half the country’s 7.5 million children have now been displaced [2]. At the time of this paper’s acceptance, hundreds of thousands of refugees making up mostly women and children have travelled to Slovakia, Czechia, and even Russia [3]; countries of focus in the current study. Families have been separated, and the once familiar routines of school and leisure for many Ukrainian children have been replaced with ensuring survival coupled with trauma and unfamiliarity. Lack of housing, malnutrition/hunger, exposure to infectious disease but also deprivation of education, sport, and leisure, are just some of the devastating impacts from armed conflicts on young people’s health and wellbeing [4]. Families from Ukraine will add to the growing number of refugees in the world, a group of over 21 million people who can often struggle with sociocultural differences in the countries they take refuge, as well as accessing information due to language barriers [5]. Many of the most common family activities for the children in our study, such as eating a meal and talking together, will likely present differently or have very different meaning among the hundreds of children who have arrived and will continue to come to these countries. Similarly, the mental health and wellbeing of both those from Ukraine and those from countries geographically close to the conflict will almost certainly suffer following these terrible events. Júnior et al. [4] highlight the importance of addressing children’s psychosocial needs, recommending parents create a safe space that allows for listening to children. As demonstrated in

Purpose: This study aims to identify distinct typologies of joint family activities and the associations with mental health and wellbeing among adolescents across four countries from the World Health Organization European region. Methods: The 2017/2018 data from adolescents from Armenia (n = 3,977, Mage = 13.5 ± 1.6 years, 53.4% female), Czechia (n = 10,656, Mage = 13.4 ± 1.7, 50.1% female), Russia (n = 4,096, Mage = 13.8 ± 1.7, 52.4% female), and Slovakia (n = 3,282, Mage = 13.4 ± 1.5, 51.0% female) were collected in schools. The respondents self-reported their participation in joint family leisure-time activities, life satisfaction, psychological and somatic complaints, as well as a range of demographic and family situational factors. Stratified by countries, latent class analysis identified typologies of joint family activities, and logistic regression models explored cross-sectional associations with life satisfaction, and psychological and somatic complaints. Results: Three typologies were identified across each of the four countries, distinguished by low, moderate, and high levels of family engagement. Adolescents with higher family engagement generally reported greater life satisfaction and fewer psychological complaints compared to those with lower family engagement. Russian adolescents in the high family engagement typology reported fewer somatic complaints compared to those with low family engagement. In addition, adolescents from Czechia and Russia showing moderate family engagement also reported fewer psychological complaints compared to those in the low family engagement typology. Discussion: Our findings from four countries suggest that adolescents with high family engagement have greater life satisfaction and fewer psychological complaints, pointing toward a need for interventions to support family engagement among adolescents. Further research is needed to fully explore underlying mechanisms.

This study aimed to investigate how family structure varies and identify its time trends in European and North American countries using data from seven surveys conducted between 1994 and 2018 according to the Health Behaviour in School-aged Children (HBSC) study. The current family structure in 44 countries was described and time trend analysis of 28 countries was performed. Adolescents were asked whom they lived with in their home to describe family structures. Family structures showed distinct patterns and dynamics between countries. In 2018, in all countries, 73% of adolescents lived with both their mother and father; 14% and 5% of adolescents lived in a single-parent family and stepfamily, respectively; and around 9% of adolescents lived in another family type. In the period 1994-2018, the proportion of young people living in intact families decreased from 79.6% to 70.0%, on average about 10 percentage points. There were no significant changes in the prevalence of single-parent families and stepfamilies, but a significant increase in the number of adolescents living without either parent was revealed. The findings have implications for cross-national adjustment of adolescent health, well-being, and behaviours, and for critical analysis of socioeconomic family resources.

Background and Objectives: Despite the importance of life satisfaction for health and well-being, there is a paucity of cross-national comparative studies in life satisfaction related to the family environment. The present research examined the pathways of life satisfaction association with perceived family support and other family environment variables among adolescents aged from 11 to 15 years in 45 countries. Materials and Methods: Samples from the Health Behaviour in School-aged Children (HBSC) survey in 2017/2018 were analysed (n = 188,619). Path analysis was applied to evaluate the associations among the study variables. Results: A positive association between the life satisfaction score and high family support was identified in all 45 countries (standardized regression weight ranged from 0.067 to 0.420, p < 0.05). In majority of countries, living with both parents and higher levels of family affluence had a positive effect on adolescent life satisfaction both directly and indirectly through family support. In the described path model, the proportion of life satisfaction score variance that was accounted for by family support, family structure, family affluence, gender and age was up to 25.3%. The path models made it possible to group the participating countries into two clusters. In the first cluster (10 countries) the Eastern and Southern European countries dominated, while the second cluster (35 countries) united the countries of Western and Central Europe. Conclusions: There is evidence that countries with high level of adolescent life satisfaction differ in the high rate of intact family structure and the strong relation between family support and perceived life satisfaction.

Positive mental health is central to adolescent well-being. The present study examines the prevalence of loneliness and positive mental health indicators (mental well-being and self-esteem) in four Nordic countries and associations between loneliness, mental well-being, and high self-esteem. This study is based on data from the Health Behaviour in School-aged Children (HBSC) study which was conducted in 2018 in Denmark, Finland, Iceland, and Sweden. Participants were 5883 15-year-old boys and girls. To examine the associations between loneliness, mental well-being, and self-esteem, structural equation modeling (SEM) was applied. In the comparison of Nordic countries, the prevalence of loneliness was highest among Finnish and Icelandic adolescents. High mental well-being and high self-esteem were most prevalent in Denmark and Sweden. In general, boys scored higher on positive mental health indicators and girls on loneliness. Loneliness was also a strong indicator of low mental well-being and low self-esteem in all Nordic countries. Loneliness is not only associated with mental health problems such as anxiety and depression, but it is also a risk factor for adolescents' positive mental health. Positive mental health is important for healthy maturation and there is a need to develop initiatives to reduce adolescent loneliness and so support positive development.

Family support has a beneficial impact on protecting health-risk behaviour in adolescents. This study aimed to explore whether family support is associated with risk of smoking during transition from early (11 years) to late (15 years) adolescence across 42 countries. The data from the cross-national Health Behaviour in School-aged Children (HBSC) study in 2017/2018 were employed (N = 195,966). Family support was measured using the four-item Family dimension of the Multidimensional Scale of Perceived Social Support (sum score 20 or more was categorised as high family support). Smoking was defined as a reported cigarette smoking at least 1-2 days in the last 30 days. The association between smoking and family support was assessed using a prevalence ratio (PR) obtained from the multivariate Poisson regression. Over two thirds of adolescents reported high levels of support from their family. Family support was found to significantly decrease with age in most of the countries, with the boys reported high level of family support more often than girls. The adolescents who reported having low family support also were more likely to smoke compared to their peers who reported having high family support (PR = 1.81; 95% CI: 1.71-1.91 in boys, and PR = 2.19; 95% CI: 2.08-2.31 in girls). The countries with a stronger effect of family support in reducing smoking risk indicated lower rates of adolescent smoking as well as lower increases in the cigarette smoking prevalence during the age period from 11 to 15 years. This study reinforces the need for family support, which is an important asset helping adolescents to overcome the risk of smoking during their transition from early to late adolescence.

Education plays a particularly important role in explaining health outcomes in the Nordic countries. Our report aims to highlight knowledge gaps and describe the need for research to better understand the connections between education, health, and equality. The report School achievement and health development in the Nordic countries – Knowledge gaps and concerns about school-age children discusses a series of concerns regarding methodology, theoretical perspective, policy aspects, and ethical and political aspects. According to the report educational practice should be researched to uncover the mechanism behind gender-based and socio-economic inequalities in school achievement. This would include longitudinal studies over many years. The report states that school is a working environment for the children, teachers, and other school staff. Therefore, it would be important to close the knowledge gap on breaks, physical activity, and length of lessons in relation to school achievement and health development among school-age girls and boys.

Background: The context is highly relevant to the implementation of new health-related programs and is an implicit or explicit part of the major implementation models in the literature. The Resilience Curriculum (RESCUR) program was developed to foster the psychosocial development of children in early and primary education. RESCUR seeks specifically to decrease children's vulnerability. It aims to promote the emotional and social learning of children who may be at risk of leaving school pre-maturely, social exclusion and mental-health problems. The program is taught using a teachers' manual to support consistency of delivery, a parents' guide, and a resource package. This study aimed to examine the scaling-out of RESCUR to social services, and specifically to test if implementation differs between the school and social services sectors. Methods: RESCUR was implemented in schools and social services in Sweden 2017–2019. Data were collected via group leaders' self-reports and observation protocols for 3 months after implementation started. There were 34 self-reports from schools, and 12 from the social services sector; 30 observation protocols were collected from schools, and 10 from social services. We examined whether there were differences in implementation outcomes (in, for example, dosage, duration, fidelity, adaptation, quality of delivery) between the two delivery systems. Descriptive statistics were prepared and non-parametric tests of significance conducted to compare implementation-related factors across the two settings. Results: Analyses of both the observation protocols and group leaders' self-reports revealed that RESCUR was well-implemented in both schools and social services. The results showed a few significant differences in the outcomes of implementation between the sectors. First, regarding observations, school staff more often adapted the pace of RESCUR lessons to ensure that the children could understand than did social services staff (p < 0.0

Background: The context is highly relevant to the implementation of new health-related programs and is an implicit or explicit part of the major implementation models in the literature. The Resilience Curriculum (RESCUR) program was developed to foster the psychosocial development of children in early and primary education. RESCUR seeks specifically to decrease children's vulnerability. It aims to promote the emotional and social learning of children who may be at risk of leaving school pre-maturely, social exclusion and mental-health problems. The program is taught using a teachers' manual to support consistency of delivery, a parents' guide, and a resource package. This study aimed to examine the scaling-out of RESCUR to social services, and specifically to test if implementation differs between the school and social services sectors. Methods: RESCUR was implemented in schools and social services in Sweden 2017–2019. Data were collected via group leaders' self-reports and observation protocols for 3 months after implementation started. There were 34 self-reports from schools, and 12 from the social services sector; 30 observation protocols were collected from schools, and 10 from social services. We examined whether there were differences in implementation outcomes (in, for example, dosage, duration, fidelity, adaptation, quality of delivery) between the two delivery systems. Descriptive statistics were prepared and non-parametric tests of significance conducted to compare implementation-related factors across the two settings. Results: Analyses of both the observation protocols and group leaders' self-reports revealed that RESCUR was well-implemented in both schools and social services. The results showed a few significant differences in the outcomes of implementation between the sectors. First, regarding observations, school staff more often adapted the pace of RESCUR lessons to ensure that the children could understand than did social services staff (p < 0.0

Background: The context is highly relevant to the implementation of new health-related programs and is an implicit or explicit part of the major implementation models in the literature. The Resilience Curriculum (RESCUR) program was developed to foster the psychosocial development of children in early and primary education. RESCUR seeks specifically to decrease children's vulnerability. It aims to promote the emotional and social learning of children who may be at risk of leaving school pre-maturely, social exclusion and mental-health problems. The program is taught using a teachers' manual to support consistency of delivery, a parents' guide, and a resource package. This study aimed to examine the scaling-out of RESCUR to social services, and specifically to test if implementation differs between the school and social services sectors. Methods: RESCUR was implemented in schools and social services in Sweden 2017–2019. Data were collected via group leaders' self-reports and observation protocols for 3 months after implementation started. There were 34 self-reports from schools, and 12 from the social services sector; 30 observation protocols were collected from schools, and 10 from social services. We examined whether there were differences in implementation outcomes (in, for example, dosage, duration, fidelity, adaptation, quality of delivery) between the two delivery systems. Descriptive statistics were prepared and non-parametric tests of significance conducted to compare implementation-related factors across the two settings. Results: Analyses of both the observation protocols and group leaders' self-reports revealed that RESCUR was well-implemented in both schools and social services. The results showed a few significant differences in the outcomes of implementation between the sectors. First, regarding observations, school staff more often adapted the pace of RESCUR lessons to ensure that the children could understand than did social services staff (p < 0.0

Background: The context is highly relevant to the implementation of new health-related programs and is an implicit or explicit part of the major implementation models in the literature. The Resilience Curriculum (RESCUR) program was developed to foster the psychosocial development of children in early and primary education. RESCUR seeks specifically to decrease children's vulnerability. It aims to promote the emotional and social learning of children who may be at risk of leaving school pre-maturely, social exclusion and mental-health problems. The program is taught using a teachers' manual to support consistency of delivery, a parents' guide, and a resource package. This study aimed to examine the scaling-out of RESCUR to social services, and specifically to test if implementation differs between the school and social services sectors. Methods: RESCUR was implemented in schools and social services in Sweden 2017–2019. Data were collected via group leaders' self-reports and observation protocols for 3 months after implementation started. There were 34 self-reports from schools, and 12 from the social services sector; 30 observation protocols were collected from schools, and 10 from social services. We examined whether there were differences in implementation outcomes (in, for example, dosage, duration, fidelity, adaptation, quality of delivery) between the two delivery systems. Descriptive statistics were prepared and non-parametric tests of significance conducted to compare implementation-related factors across the two settings. Results: Analyses of both the observation protocols and group leaders' self-reports revealed that RESCUR was well-implemented in both schools and social services. The results showed a few significant differences in the outcomes of implementation between the sectors. First, regarding observations, school staff more often adapted the pace of RESCUR lessons to ensure that the children could understand than did social services staff (p < 0.0

Although previous research established a positive association between perceived social support and adolescent life satisfaction, little is known about the relative importance of different sources of support for adolescent life satisfaction and cross-country variations in this respect. Using large-scale representative samples from the 2017/18 Health Behaviour in School-aged Children (HBSC) study, this study examined to what extent the association between social support and life satisfaction in early adolescence varied across different social sources and countries. Also, it examined whether cross-country variations are explained by national-level generalized trust, a sociocultural factor that shapes adolescent socialization. National-level data were linked to data from 183,918 early adolescents (M-age = 13.56, SD = 1.63, 52% girls) from 42 European and North American countries/regions obtained from HBSC. Multilevel regression analyses yielded a positive association between support from different sources and life satisfaction. The strongest associations were found for support from families, followed by teachers and classmates, and weakest for support from friends. Associations varied across different countries/regions. National-level trust amplified the association between perceived classmate support and adolescent life satisfaction. The revealed cross-country differences open avenues for future cross-cultural research on explanations for cross-cultural differences in the association between social support from different sources and life satisfaction in early adolescence.

Education plays a particularly important role in explaining health outcomes in the Nordic countries. Our report aims to highlight knowledge gaps and describe the need for research to better understand the connections between education, health, and equality. The report School achievement and health development in the Nordic countries – Knowledge gaps and concerns about school-age children discusses a series of concerns regarding methodology, theoretical perspective, policy aspects, and ethical and political aspects. According to the report educational practice should be researched to uncover the mechanism behind gender-based and socio-economic inequalities in school achievement. This would include longitudinal studies over many years. The report states that school is a working environment for the children, teachers, and other school staff. Therefore, it would be important to close the knowledge gap on breaks, physical activity, and length of lessons in relation to school achievement and health development among school-age girls and boys.

Background: The context is highly relevant to the implementation of new health-related programs and is an implicit or explicit part of the major implementation models in the literature. The Resilience Curriculum (RESCUR) program was developed to foster the psychosocial development of children in early and primary education. RESCUR seeks specifically to decrease children's vulnerability. It aims to promote the emotional and social learning of children who may be at risk of leaving school pre-maturely, social exclusion and mental-health problems. The program is taught using a teachers' manual to support consistency of delivery, a parents' guide, and a resource package. This study aimed to examine the scaling-out of RESCUR to social services, and specifically to test if implementation differs between the school and social services sectors. Methods: RESCUR was implemented in schools and social services in Sweden 2017–2019. Data were collected via group leaders' self-reports and observation protocols for 3 months after implementation started. There were 34 self-reports from schools, and 12 from the social services sector; 30 observation protocols were collected from schools, and 10 from social services. We examined whether there were differences in implementation outcomes (in, for example, dosage, duration, fidelity, adaptation, quality of delivery) between the two delivery systems. Descriptive statistics were prepared and non-parametric tests of significance conducted to compare implementation-related factors across the two settings. Results: Analyses of both the observation protocols and group leaders' self-reports revealed that RESCUR was well-implemented in both schools and social services. The results showed a few significant differences in the outcomes of implementation between the sectors. First, regarding observations, school staff more often adapted the pace of RESCUR lessons to ensure that the children could understand than did social services staff (p < 0.0

Background: The context is highly relevant to the implementation of new health-related programs and is an implicit or explicit part of the major implementation models in the literature. The Resilience Curriculum (RESCUR) program was developed to foster the psychosocial development of children in early and primary education. RESCUR seeks specifically to decrease children's vulnerability. It aims to promote the emotional and social learning of children who may be at risk of leaving school pre-maturely, social exclusion and mental-health problems. The program is taught using a teachers' manual to support consistency of delivery, a parents' guide, and a resource package. This study aimed to examine the scaling-out of RESCUR to social services, and specifically to test if implementation differs between the school and social services sectors. Methods: RESCUR was implemented in schools and social services in Sweden 2017–2019. Data were collected via group leaders' self-reports and observation protocols for 3 months after implementation started. There were 34 self-reports from schools, and 12 from the social services sector; 30 observation protocols were collected from schools, and 10 from social services. We examined whether there were differences in implementation outcomes (in, for example, dosage, duration, fidelity, adaptation, quality of delivery) between the two delivery systems. Descriptive statistics were prepared and non-parametric tests of significance conducted to compare implementation-related factors across the two settings. Results: Analyses of both the observation protocols and group leaders' self-reports revealed that RESCUR was well-implemented in both schools and social services. The results showed a few significant differences in the outcomes of implementation between the sectors. First, regarding observations, school staff more often adapted the pace of RESCUR lessons to ensure that the children could understand than did social services staff (p < 0.0

QC 20201019

Background: Palestine, like other low-income countries, is confronting an increasing epidemic of non-communicable disease (NCD) and trend of war injury. The management of health problems often presents a critical challenge to the Palestinian health system (PHS). Understanding the perceptions of healthcare providers is essential in exploring the gaps in the health system to develop an effective healthcare intervention. Unfortunately, health research on management of NCD and war injury has largely been neglected and received little attention. Therefore, the study aimed to explore the perspectives of healthcare providers regarding NCD and war injury management in the PHS in the Gaza Strip. Methods: A qualitative study approach was used, based on four focus group discussions (FGDs) involving a purposive sampling strategy of 30 healthcare providers from three main public hospitals in Gaza Strip. A semi-structured topic guide was used, and the focus group interviews data were analyzed using manifest content analysis. The study was approved by the Palestinian Health Research Council (PHRC) for ethics approval. Results: From the healthcare providers perspective, four main themes and several subthemes have emerged from the descriptive manifest content analysis: functioning of healthcare system; system-related challenges; patients-related challenges; strategies and actions to navigating the challenges and improving care. Informants frequently discussed that despite some positive aspects in the system, fundamental changes and significant improvements are needed. Some expressed serious concerns that the healthcare system needs complete rebuilding to facilitate the management of NCD and war-related injury. They perceived important barriers to effective management of NCD and war injury such as poor hospital infrastructure and logistics, shortage of micro and sub-specialities and essential resources. Participants also expressed a dilemma and troubles in communication and interacti

Background: Palestine, like other low-income countries, is confronting an increasing epidemic of non-communicable disease (NCD) and trend of war injury. The management of health problems often presents a critical challenge to the Palestinian health system (PHS). Understanding the perceptions of healthcare providers is essential in exploring the gaps in the health system to develop an effective healthcare intervention. Unfortunately, health research on management of NCD and war injury has largely been neglected and received little attention. Therefore, the study aimed to explore the perspectives of healthcare providers regarding NCD and war injury management in the PHS in the Gaza Strip. Methods: A qualitative study approach was used, based on four focus group discussions (FGDs) involving a purposive sampling strategy of 30 healthcare providers from three main public hospitals in Gaza Strip. A semi-structured topic guide was used, and the focus group interviews data were analyzed using manifest content analysis. The study was approved by the Palestinian Health Research Council (PHRC) for ethics approval. Results: From the healthcare providers perspective, four main themes and several subthemes have emerged from the descriptive manifest content analysis: functioning of healthcare system; system-related challenges; patients-related challenges; strategies and actions to navigating the challenges and improving care. Informants frequently discussed that despite some positive aspects in the system, fundamental changes and significant improvements are needed. Some expressed serious concerns that the healthcare system needs complete rebuilding to facilitate the management of NCD and war-related injury. They perceived important barriers to effective management of NCD and war injury such as poor hospital infrastructure and logistics, shortage of micro and sub-specialities and essential resources. Participants also expressed a dilemma and troubles in communication and interacti

Background: Palestine, like other low-income countries, is confronting an increasing epidemic of non-communicable disease (NCD) and trend of war injury. The management of health problems often presents a critical challenge to the Palestinian health system (PHS). Understanding the perceptions of healthcare providers is essential in exploring the gaps in the health system to develop an effective healthcare intervention. Unfortunately, health research on management of NCD and war injury has largely been neglected and received little attention. Therefore, the study aimed to explore the perspectives of healthcare providers regarding NCD and war injury management in the PHS in the Gaza Strip. Methods: A qualitative study approach was used, based on four focus group discussions (FGDs) involving a purposive sampling strategy of 30 healthcare providers from three main public hospitals in Gaza Strip. A semi-structured topic guide was used, and the focus group interviews data were analyzed using manifest content analysis. The study was approved by the Palestinian Health Research Council (PHRC) for ethics approval. Results: From the healthcare providers perspective, four main themes and several sub-themes have emerged from the descriptive manifest content analysis: functioning of healthcare system; system-related challenges; patients-related challenges; strategies and actions to navigating the challenges and improving care. Informants frequently discussed that despite some positive aspects in the system, fundamental changes and significant improvements are needed. Some expressed serious concerns that the healthcare system needs complete rebuilding to facilitate the management of NCD and war-related injury. They perceived important barriers to effective management of NCD and war injury such as poor hospital infrastructure and logistics, shortage of micro and sub-specialities and essential resources. Participants also expressed a dilemma and troubles in communication and interact

Background Improving access to optimal quality of care is a core priority and ambitious health policy goal in spite of impediments, threats and challenges in Palestine. Understanding the factors that may impede quality of care is essential in developing an effective healthcare intervention for patient with non-communicable disease (NCD) or war-injured survivors. Methods Qualitative interviews were performed using a purposive sampling strategy of 18 political-key informants, 10 patients with NCD and 7 war-injured survivors from different health facilities in Gaza Strip. A semi-structured interview guide was developed for data collection. The interviews were audio recorded and transcribed verbatim. Important field notes of the individual interviews were also reported. Thematic-driven analytic approach was used to identify key themes and patterns. Results From the policy maker’s perspective, the following important barriers to accessing optimal healthcare for patients with NCD or war-injured survivors’ treatment were identified; 1) organizational/structural 2) availability 3) communication 4) personnel/lack of staff 5) financial and political barriers. Patient with NCD or war-injury had similar experiences of barriers as the policy makers. In addition, they also identified socioeconomic, physical and psychological barriers for accessing optimal healthcare and treatment. Conclusions The main perceived barriers explored through this study will be very interesting and useful if they are considered seriously and handled carefully, in order to ensure efficient, productive, cost-effective intervention and delivery of a high-standard quality of care and better disease management.

This scoping review was commenced as a collaboration within the NordicHealth Promotion Research Network (NHPRN). The overall aim was to explore how research under the label ‘health promotion’ was undertaken in a Nordic context. The search for dissertations published in Denmark, Finland, Iceland, Norway and Sweden was limited to the years 2008 to 2018. Manual searches of university websites, as well as different databases in the Nordic countries, were required for collecting dissertations from all universities. The collection of dissertations was more difficult than expected. There were 56 published PhD dissertations from 6 universities in Denmark, 51 from 8 universities in Finland, 0 from Iceland, 53 from 7 universities in Norway and 193 from 22 universities in Sweden. Almost half of the analysed dissertations combined qualitative and quantitative methods. About one-third of the dissertations had a settings approach, followed by a societal approach and individual approach. Finland and Sweden presented more intervention studies than the other countries. A majority of the intervention studies included individual lifestyle issues. Based on the analysis of the research approaches, more dissertations embracing societal perspectives and broader determinants of health may be recommended for future Nordic dissertations.

School achievement has increasingly come into focus during the last decades. The overall aim of this report is to highlight the need for knowledge for promoting health and development among school-aged children in the Nordic countries. Learning in school and for life is a key element for future well-being and quality of life. The present analysis did not have the resources nor time to do a systematic review. Therefore, a more selective approach was taken based on previous reviews and partly working as a scoping review. The different sections of the report conclude with a list of knowledge gaps and concerns. The research methodology in the relevant disciplinary fields are diverse and is also affected by the paradigm war, that is, difference scientific approaches do not share basic assumptions, research procedures and analytical methods. Therefore, an introductory section deals with this challenge. What is needed in this field is scientific knowledge as well as practical knowledge and practical wisdom to guide the further development of the school system. The school systems in the Nordic countries are similar but also different. We can learn from each other both from successes and failures, which merits a brief overview of the Nordic school systems follows. The school for all has been a joint characteristic of the Nordic school system, but it has been challenges by the neo-liberal policies such as school choices and privatisation. School achievement is a major focus in this report. However, in order to do multi-country comparison, the development of the international large-scale assessments has been of crucial as a research infrastructure. The report gives some recent results from the 2018 PISA study. This study concerns mainly three different aspects of inequality in school achievements. (i) Gender differences in school achievement are a universal finding. (i) Gender differences in school achievement are a universal finding. Boys are falling behind girls. What do we, Positive Mental Health among School-aged Children in the Nordic Countries

Forskning om utvecklingen av ungdomars psykiska hälsa är utmanande. Begreppets mångsidighet gör vetenskapsteoretiska och metodologiska reflektioner nödvändiga. Data ska samlas in som kan ge möjlighet att följa utvecklingen över tid, vilket kräver goda mätinstrument, god infrastruktur för datainsamling och kompetens att mäta och analysera. Det är en paradox att den självrapporterade psykiska hälsan försämras särskilt hos tonårsflickor i ett land som välfärdslandet Sverige. En översikt ges av tidigare forskning kring trender i ungdomars psykiska hälsa inom ramen för studien Skolbarns hälsovanor. Ytterligare multidisciplinär forskning med olika komplementande ansatser behövs för att bättre fylla kunskapsluckorna., Research on the development of adolescent mental health is challenging. The complexity of the phenomenon makes scientific and methodological reflections necessary. Data must be collected enhancing analysis of the developments over time, which requires good measuring instruments, infrastructure for data collection and competence in analysing and reporting. It is aparadox that the self-reported mental health deteriorates, especially among teenage girls in the Swedish welfare state. Previous research on trends in young people’s mental health in the Health Behaviour in School-aged Children study is reviewed. Further multidisciplinary research with different complementary approaches is needed to better fill the knowledge gaps., Positive Mental Health among School-children in the Nordic Countries

This scoping review was commenced as a collaboration within the NordicHealth Promotion Research Network (NHPRN). The overall aim was to explore how research under the label ‘health promotion’ was undertaken in a Nordic context. The search for dissertations published in Denmark, Finland, Iceland, Norway and Sweden was limited to the years 2008 to 2018. Manual searches of university websites, as well as different databases in the Nordic countries, were required for collecting dissertations from all universities. The collection of dissertations was more difficult than expected. There were 56 published PhD dissertations from 6 universities in Denmark, 51 from 8 universities in Finland, 0 from Iceland, 53 from 7 universities in Norway and 193 from 22 universities in Sweden. Almost half of the analysed dissertations combined qualitative and quantitative methods. About one-third of the dissertations had a settings approach, followed by a societal approach and individual approach. Finland and Sweden presented more intervention studies than the other countries. A majority of the intervention studies included individual lifestyle issues. Based on the analysis of the research approaches, more dissertations embracing societal perspectives and broader determinants of health may be recommended for future Nordic dissertations.

School achievement has increasingly come into focus during the last decades. The overall aim of this report is to highlight the need for knowledge for promoting health and development among school-aged children in the Nordic countries. Learning in school and for life is a key element for future well-being and quality of life. The present analysis did not have the resources nor time to do a systematic review. Therefore, a more selective approach was taken based on previous reviews and partly working as a scoping review. The different sections of the report conclude with a list of knowledge gaps and concerns. The research methodology in the relevant disciplinary fields are diverse and is also affected by the paradigm war, that is, difference scientific approaches do not share basic assumptions, research procedures and analytical methods. Therefore, an introductory section deals with this challenge. What is needed in this field is scientific knowledge as well as practical knowledge and practical wisdom to guide the further development of the school system. The school systems in the Nordic countries are similar but also different. We can learn from each other both from successes and failures, which merits a brief overview of the Nordic school systems follows. The school for all has been a joint characteristic of the Nordic school system, but it has been challenges by the neo-liberal policies such as school choices and privatisation. School achievement is a major focus in this report. However, in order to do multi-country comparison, the development of the international large-scale assessments has been of crucial as a research infrastructure. The report gives some recent results from the 2018 PISA study. This study concerns mainly three different aspects of inequality in school achievements. (i) Gender differences in school achievement are a universal finding. (i) Gender differences in school achievement are a universal finding. Boys are falling behind girls. What do we, Positive Mental Health among School-aged Children in the Nordic Countries

Forskning om utvecklingen av ungdomars psykiska hälsa är utmanande. Begreppets mångsidighet gör vetenskapsteoretiska och metodologiska reflektioner nödvändiga. Data ska samlas in som kan ge möjlighet att följa utvecklingen över tid, vilket kräver goda mätinstrument, god infrastruktur för datainsamling och kompetens att mäta och analysera. Det är en paradox att den självrapporterade psykiska hälsan försämras särskilt hos tonårsflickor i ett land som välfärdslandet Sverige. En översikt ges av tidigare forskning kring trender i ungdomars psykiska hälsa inom ramen för studien Skolbarns hälsovanor. Ytterligare multidisciplinär forskning med olika komplementande ansatser behövs för att bättre fylla kunskapsluckorna., Research on the development of adolescent mental health is challenging. The complexity of the phenomenon makes scientific and methodological reflections necessary. Data must be collected enhancing analysis of the developments over time, which requires good measuring instruments, infrastructure for data collection and competence in analysing and reporting. It is aparadox that the self-reported mental health deteriorates, especially among teenage girls in the Swedish welfare state. Previous research on trends in young people’s mental health in the Health Behaviour in School-aged Children study is reviewed. Further multidisciplinary research with different complementary approaches is needed to better fill the knowledge gaps., Positive Mental Health among School-children in the Nordic Countries

This scoping review was commenced as a collaboration within the NordicHealth Promotion Research Network (NHPRN). The overall aim was to explore how research under the label ‘health promotion’ was undertaken in a Nordic context. The search for dissertations published in Denmark, Finland, Iceland, Norway and Sweden was limited to the years 2008 to 2018. Manual searches of university websites, as well as different databases in the Nordic countries, were required for collecting dissertations from all universities. The collection of dissertations was more difficult than expected. There were 56 published PhD dissertations from 6 universities in Denmark, 51 from 8 universities in Finland, 0 from Iceland, 53 from 7 universities in Norway and 193 from 22 universities in Sweden. Almost half of the analysed dissertations combined qualitative and quantitative methods. About one-third of the dissertations had a settings approach, followed by a societal approach and individual approach. Finland and Sweden presented more intervention studies than the other countries. A majority of the intervention studies included individual lifestyle issues. Based on the analysis of the research approaches, more dissertations embracing societal perspectives and broader determinants of health may be recommended for future Nordic dissertations.

Forskning om utvecklingen av ungdomars psykiska hälsa är utmanande. Begreppets mångsidighet gör vetenskapsteoretiska och metodologiska reflektioner nödvändiga. Data ska samlas in som kan ge möjlighet att följa utvecklingen över tid, vilket kräver goda mätinstrument, god infrastruktur för datainsamling och kompetens att mäta och analysera. Det är en paradox att den självrapporterade psykiska hälsan försämras särskilt hos tonårsflickor i ett land som välfärdslandet Sverige. En översikt ges av tidigare forskning kring trender i ungdomars psykiska hälsa inom ramen för studien Skolbarns hälsovanor. Ytterligare multidisciplinär forskning med olika komplementande ansatser behövs för att bättre fylla kunskapsluckorna., Research on the development of adolescent mental health is challenging. The complexity of the phenomenon makes scientific and methodological reflections necessary. Data must be collected enhancing analysis of the developments over time, which requires good measuring instruments, infrastructure for data collection and competence in analysing and reporting. It is aparadox that the self-reported mental health deteriorates, especially among teenage girls in the Swedish welfare state. Previous research on trends in young people’s mental health in the Health Behaviour in School-aged Children study is reviewed. Further multidisciplinary research with different complementary approaches is needed to better fill the knowledge gaps., Positive Mental Health among School-children in the Nordic Countries

This scoping review was commenced as a collaboration within the NordicHealth Promotion Research Network (NHPRN). The overall aim was to explore how research under the label ‘health promotion’ was undertaken in a Nordic context. The search for dissertations published in Denmark, Finland, Iceland, Norway and Sweden was limited to the years 2008 to 2018. Manual searches of university websites, as well as different databases in the Nordic countries, were required for collecting dissertations from all universities. The collection of dissertations was more difficult than expected. There were 56 published PhD dissertations from 6 universities in Denmark, 51 from 8 universities in Finland, 0 from Iceland, 53 from 7 universities in Norway and 193 from 22 universities in Sweden. Almost half of the analysed dissertations combined qualitative and quantitative methods. About one-third of the dissertations had a settings approach, followed by a societal approach and individual approach. Finland and Sweden presented more intervention studies than the other countries. A majority of the intervention studies included individual lifestyle issues. Based on the analysis of the research approaches, more dissertations embracing societal perspectives and broader determinants of health may be recommended for future Nordic dissertations.

School achievement has increasingly come into focus during the last decades. The overall aim of this report is to highlight the need for knowledge for promoting health and development among school-aged children in the Nordic countries. Learning in school and for life is a key element for future well-being and quality of life. The present analysis did not have the resources nor time to do a systematic review. Therefore, a more selective approach was taken based on previous reviews and partly working as a scoping review. The different sections of the report conclude with a list of knowledge gaps and concerns. The research methodology in the relevant disciplinary fields are diverse and is also affected by the paradigm war, that is, difference scientific approaches do not share basic assumptions, research procedures and analytical methods. Therefore, an introductory section deals with this challenge. What is needed in this field is scientific knowledge as well as practical knowledge and practical wisdom to guide the further development of the school system. The school systems in the Nordic countries are similar but also different. We can learn from each other both from successes and failures, which merits a brief overview of the Nordic school systems follows. The school for all has been a joint characteristic of the Nordic school system, but it has been challenges by the neo-liberal policies such as school choices and privatisation. School achievement is a major focus in this report. However, in order to do multi-country comparison, the development of the international large-scale assessments has been of crucial as a research infrastructure. The report gives some recent results from the 2018 PISA study. This study concerns mainly three different aspects of inequality in school achievements. (i) Gender differences in school achievement are a universal finding. (i) Gender differences in school achievement are a universal finding. Boys are falling behind girls. What do we, Positive Mental Health among School-aged Children in the Nordic Countries

Forskning om utvecklingen av ungdomars psykiska hälsa är utmanande. Begreppets mångsidighet gör vetenskapsteoretiska och metodologiska reflektioner nödvändiga. Data ska samlas in som kan ge möjlighet att följa utvecklingen över tid, vilket kräver goda mätinstrument, god infrastruktur för datainsamling och kompetens att mäta och analysera. Det är en paradox att den självrapporterade psykiska hälsan försämras särskilt hos tonårsflickor i ett land som välfärdslandet Sverige. En översikt ges av tidigare forskning kring trender i ungdomars psykiska hälsa inom ramen för studien Skolbarns hälsovanor. Ytterligare multidisciplinär forskning med olika komplementande ansatser behövs för att bättre fylla kunskapsluckorna., Research on the development of adolescent mental health is challenging. The complexity of the phenomenon makes scientific and methodological reflections necessary. Data must be collected enhancing analysis of the developments over time, which requires good measuring instruments, infrastructure for data collection and competence in analysing and reporting. It is aparadox that the self-reported mental health deteriorates, especially among teenage girls in the Swedish welfare state. Previous research on trends in young people’s mental health in the Health Behaviour in School-aged Children study is reviewed. Further multidisciplinary research with different complementary approaches is needed to better fill the knowledge gaps., Positive Mental Health among School-children in the Nordic Countries