Search

Introduction Body weight perception (BWP) is associated with health behaviors. Current evidence points to an increase over time in both actual and perceived weight status among adolescents, however there is limited evidence on time trends in BWP in cross-national samples of adolescents. Therefore, the aims of this study were to examine time trends in BWP between 2002 and 2018 among adolescents from 41 countries and regions, including gender and country differences and to explore the role of changes over time in country-level overweight/obesity prevalence in these trends. Methods Data were used from five cycles (2002, 2006, 2010, 2014, 2018) of the repeated cross-sectional Health Behavior in School-Aged Children (HBSC) study (n = 746,121; mean±standard deviation age 13.7 ± 1.6 years, 51.0% girls). Multilevel logistic models estimated cross-national linear time trends in adolescent BWP (correct perception, underestimation, or overestimation), adjusted for gender, age, and family affluence. Next, we tested whether country-level changes over time overweight/obesity prevalence could explain these trends in BWP among adolescents. Results Correct weight perception increased over time among girls, while it decreased among boys. Underestimation of weight status increased, and overestimation of weight status decreased over time among both genders, with stronger trends for girls. Furthermore, country differences in trends in both BWP and overweight/obesity were found. Changes over time in country-level overweight/obesity prevalence could not explain these trends. Conclusion The linear increase over time in correct weight perception and the decrease in overestimation may have a positive effect on unhealthy weight reduction behaviors among adolescents. However, the increase in underestimation could signal a need for interventions to strengthen correct weight perception among adolescents. Several implications for policy and practice are discussed. peerReviewed

Purpose: The purpose of the study was to examine the trends between 2002 and 2018 in school pressure and school satisfaction among 15-year-old students, across countries and by gender, in the WHO European region and North America, and explore whether there are variations between countries and by gender in the co-occurrence of school pressure and school satisfaction. Methods: Data from the 32 countries that participated in the Health Behaviour in School-aged Children study (HBSC) study between 2002 and 2018 were used. Statistical analyses included ttests, binary logistic regression analyses, and chi-square tests, as required by each of the study aims. Results: School satisfaction tended to increase over the period 2002e2018 among boys, whereas school pressure increased among girls. Also, gender differences tended to dissipate in school satisfaction and generally increase in school pressure. The co-occurrence of school satisfaction and school pressure in 2017/2018 shows that the majority of students are found in the “not pressured enot highly satisfied” and “pressuredenot highly satisfied” groups. There were more boys in the former group and more girls in the latter group. Conclusion: Few students in the 32 countries belonged to the “not pressuredehighly satisfied” group, which from a public health perspective may be seen as the most desirable group. The increases in school pressure in girls from 2002 to 2018 and their overrepresentation in the pressured groups require further attention. Ministerio de Ciencia, Innovación y Universidades RYC-2017e 21626

Purpose The purpose of this study was to analyze changes in the prevalence of weight reduction behaviors (WRBs) among European adolescents from 26 countries between 2001/2002 and 2017/2018. The impact of the perception of body weight on WLB was also analyzed, with particular attention being paid to overestimation. Methods The data of 639,194 European adolescents aged 11, 13, and 15 years who participated in the Health Behaviour in School-aged Children survey were analyzed. Age-standardized prevalence rates of WRB were estimated separately by survey round and gender for each country, using the overall 2017/2018 Health Behaviour in School-aged Children study population as the standard. Multivariate logistic regression analyses were used to assess WRB trends over time, adjusted for survey year, body mass index, body weight misperception, and family affluence and stratified by gender and age. Results In the 26 countries examined, the overall age-adjusted prevalence rates of WRB were 10.2% among boys and 18.0% among girls. The prevalence of WRB was higher for girls, but in the more recent surveys, gender differences in WRB decreased. There was a significant increase in the percentage of WRB among boys in most countries. Among girls, most countries did not experience significant changes. Increases in body mass index and overestimation of body weight were significant factors increasing the risk of WRB in both genders. Conclusions The change in the prevalence of WRB by gender warrants greater attention from researchers and practitioners alike. peerReviewed

Sleep has been found to be an important factor in adolescents’ mental and physical health. The aim of the present study was to examine trends in sleep difficulty (i.e., difficulty falling asleep more often than once a week) in the Nordic countries among 11- to 15-year-olds. We analysed Nordic data from the Health Behaviour in School-aged Children study (HBSC), which is conducted every four years, looking specifically at trends in sleep difficulty over a 12-year period from 2002 to 2014. The participants were aged 11 to 15 years. The total number of participants across these years was 113,447. A large percentage (17% to 31% in 2014) of adolescents in the Nordic countries experience sleep difficulty, and these difficulties increased from 2002 to 2014 in Denmark, Finland, Iceland, and Sweden. Only in Norway was there a decrease, mainly due to a reduction in sleep difficulty among 11-year-old boys and girls from 2010 to 2014. Sleep difficulty among boys and girls are prevalent and generally on the rise in the Nordic countries with the exception of Norway.

BACKGROUND: To analyse the psychometric properties of the HBSC Symptom Checklist (HBSC-SCL) on psychosomatic symptoms with a focus on the operating characteristics of the items, and on the impacts of measurement distortions on the comparisons of person measures across time and between countries.METHODS: Data were collected in 1993/94, 1997/98, 2001/02, 2005/06, 2008/09, 2013/14 in Denmark, Finland, Norway and Sweden as part of the Health Behaviour in School-aged Children (HBSC) study. Data comprised 116,531 students 11, 13 and 15 years old. Rasch analysis was conducted of the HBSC-SCL consisting of eight items with a focus on Differential Item Functioning (DIF) and item threshold ordering. The impacts of DIF and threshold disordering on trend analyses were analysed in a subsample consisting of 15 years old students.RESULTS: One item shows evidence of severe DIF and the categorisation of some items does not seem to work as intended. Analyses of changes based on proportions of psychosomatic symptoms show that bad item functioning affects some comparisons between countries across time: A four percentage point difference between 15 years old girls in Finland and Sweden concerning the rate of increase of psychosomatic symptoms from 1994 to 2014 disappears when the problems with DIF and disordered item thresholds are taken into account. Although the proportions of students with psychosomatic symptoms are clearly higher 2014 than 1994 in all four countries the shape of most trends is nonlinear.CONCLUSIONS: Some of the cross-country comparisons were distorted because of DIF and problems related to disordering of the item thresholds. The comparisons among girls between Finland and Sweden were affected by the problems pertaining to the original measure of psychosomatic symptoms, while the trend patterns among boys were not much affected. In addition to confirming increasing rates of adolescent mental health problems in the Nordic countries, the substantive analyses in the current study show that Finland is joining Sweden in having the sharpest increase among older adolescents, in particular among girls. To improve the functioning of the scale the DIF item could be removed or replaced and response categories collapsed in post hoc analyses.

Background: Excellent self-rated health (SRH) can be seen as an important component of positive health among adolescents. The aim of this paper is to examine time trends of excellent health among adolescents in five Nordic countries (Denmark, Finland, Iceland, Norway and Sweden) between 2002 and 2014, including differences between countries, gender and age. Methods: Nordic data from the Health Behaviour in School-aged Children (HBSC) survey (including 11-, 13- and 15-year-olds) from 2002 (n = 19,009), 2006 (n = 29,656), 2010 (n = 33,232) and 2014 (n = 31,540) were analysed by design-adjusted binomial logistic regression models. Results: The trend analysis of excellent SRH for Nordic adolescents indicates a small improvement between 2002 and 2006 but a stable trend in the following periods up until 2014. The time trends do, however, depend on the specific country. In general, a smaller proportion of girls compared to boys were found to rate their health as excellent. Over time, however, the proportion of boys rating their health as excellent decreased, while girls’ ratings improved. Conclusions: From a public health perspective, indications of a changing trend in adolescent health coinciding with the 2007–2008 global recession warrant further attention from researchers and policy-makers and should be closely monitored in the future.

Reasons for participating in physical activity (PA) may have changed in accordance with the general modernization of society. The aim is to examine changes in self-reported reasons for liking leisure-time physical activity (LTPA) and their association with self-reported LTPA over a 20-year period. Data were collected among nationally representative samples of 13-year-olds in Finland, Norway, and Wales in 1986 and 2006 (N = 9252) as part of the WHO cross-national Health Behaviour in School-aged Children (HBSC) study. Univariate ANOVAs to establish differences according to gender, year, and country were conducted. In all countries, 13-year-olds in 2006 tended to report higher importance in terms of achievement and social reasons than their counterparts in 1986, while changes in health reasons were minor. These reasons were associated with LTPA in a similar way at both time points. Health reasons for liking LTPA were considered most important, and were the strongest predictor of LTPA. The findings seem robust as they were consistent across countries and genders. Health education constitutes the most viable strategy for promoting adolescents' motivation for PA, and interventions and educational efforts could be improved by an increased focus on LTPA and sport as a social activity. publishedVersion

Aims: The aims of this study were to explore time-based trends of socioeconomic differences in alcohol use and drunkenness in Finnish adolescents from 1990 to 2014 and to investigate the significance of two indicators in detecting socioeconomic differences in alcohol use and drunkenness. Methods: Data were retrieved from seven surveys conducted as part of the Health Behaviour in School-aged Children (HBSC) study in Finland from 1990 to 2014. The alcohol use and drunkenness of 15-year-old students, as well as socioeconomic status, including educational aspiration and perceived family wealth, were assessed via a self-report questionnaire. Logistic regression models were used to investigate the relationships between alcohol use, drunkenness and indicators of socioeconomic status. Results: The study showed that the alcohol use and drunkenness of Finnish 15-year-old adolescents have decreased since the late 1990s. However, the level of decrease is not consistent among different socioeconomic groups and socioeconomic differences in drinking behaviour between two educational aspiration groups have persisted over two decades. Girls from the groups with low perceived family wealth were more likely to be frequently drunk in the time period 2006–2014. Conclusions: This study suggests that students with low educational aspiration should be the target population for interventions aiming at reducing the alcohol use and drunkenness of Finnish adolescents. In future interventions aimed at reducing heavier drinking, adolescents (especially girls) from less wealthy families should be the first priority. Further studies on trends in socioeconomic differences in alcohol use and drunkenness in adolescence should be conducted using different indicators of socioeconomic status and other social context factors should also be taken into account.

WHO:s skolelevsstudie (Health Behavior in School-aged Children (HBSC) Study) är internationellt en av de mest omfattande, långvariga och betydelsefulla undersökningarna om levnadsvanor bland skolungdomar. Undersökningen startade för drygt 30 år sedan och i detta nu deltar över 40 länder i Europa och Nordamerika. Nästa internationella datainsamling, som är den tionde i ordningen, genomförs år 2018. Nytt forskningsmaterial insamlas vart fjärde år. Forskare vid Jyväskylä universitets Forskningscenter för hälsofrämjande (Terveyden edistämisen tutkimuskeskus) ansvarar för WHO:s skolelevsstudie i Finland. För ungefär 20 år sedan började det givande samarbetet mellan Jyväskylä universitet och Samfundet Folkhälsan. Åren 1994, 1998, 2006 och 2014 har skilda datainsamlingar gjorts bland elever i svenskspråkiga skolor. WHO:s skolelevsstudie är till sitt forskningsgrepp en trendundersökning. Ju längre tidsperspektiv resultaten representerar, desto viktigare och intressantare blir en trendundersökning. Föreliggande rapport är den första i sitt slag att beskriva trender i upplevd hälsa, hälsobeteenden och skolupplevelser under de senaste 20 åren bland 11-, 13- och 15-åriga elever i svenskspråkiga skolor i Finland. Trendjämförelser med motsvarande resultat bland elever i finskspråkiga skolor har heller inte gjorts tidigare. Tidsperspektivet är imponerande, och resultaten är ytterst intressanta och viktiga då man överväger strategier och metoder att förbättra hälsa och välbefinnande bland ungdomar i skolåldern. Rapporten är speciellt viktig för det hälsofrämjandet arbetet i Svenskfinland – det är första gången man så här omfattande har kartlagt hälsa bland finlandssvenska ungdomar och gjort både en jämförelse mellan finlandssvenskar i olika regioner och samtidigt en jämförelse till finskspråkiga barn och ungdomar. Att färdigställa föreliggande rapport var möjligt genom att datainsamlingen i svenskspråkiga skolor kunde genomföras med hjälp av beviljade medel ur Anslaget för hälsofrämjande (Institutet för hälsa och välfärd, THL) och medel ur Utbildningsstyrelsens anslag, samt genom att Svenska kulturfonden beviljade understöd för bearbetning och analys av datamaterialet och skrivande av rapporten. Vårt varma tack för finansieringen. Analyser och rapportering har planerats och förverkligats av forskargrupper vid Folkhälsans forskningscentrum och Jyväskylä universitet. Vi vill tacka båda forskargrupperna, liksom Carola Ray och Åse Fagerlund som läst och kommenterat texten. Undersökningen kunde inte ha genomförts utan skolornas insatser, och vi vill rikta ett stort tack till alla deltagande skolor, rektorer och lärare. Ett särskilt varmt tack går till alla elever som så omsorgsfullt har besvarat frågeformulären.