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Purpose: The purpose of this paper is to explore Finnish adolescents' subjective health literacy (HL) in association to school achievement, learning difficulties, educational aspirations, and family affluence. Design/methodology/approach: Nationally representative data were collected in Finland as a part of the international Health Behaviour in School-aged Children study. The respondents consisted in total of 3,833 adolescents (7th and 9th graders) from 359 schools. The Health Literacy for School-aged Children instrument was applied to measure adolescents' subjective HL, while the Family Affluence Scale was used to measure adolescents' socioeconomic status. Information was gathered on school achievement, learning difficulties, and educational aspirations. Findings: Approximately one-third of the adolescents manifested a high level of HL, around 60 per cent had a moderate level of HL, and about one-tenth had low HL. The HL level was lower for boys than for girls, and lower for 7th graders than for 9th graders. In the total sample, the strongest explanatory variables for HL were school achievement in the first language, and educational aspirations. Originality/value: This study provides the first nationally representative examination of adolescents' subjective HL levels, and how these vary across age and gender groups. In drawing conclusions and presenting suggestions for HL interventions, it is important to verify the nature of the HL examined in any given study, and how it was researched.

Purpose: The purpose of this paper is to utilise the collective opinion of a group of Finnish experts to identify the most important learning outcomes of secondary-level school-based health education, in the specific domains of physical activity and nutrition. Design/ Methodology/ Approach: The study uses a Delphi survey technique to collect the opinions of a group (panel) of Finnish experts. A list of learning outcomes was compiled via an extensive literature review of documents from all levels of health education (physical activity and nutrition) policy development and implementation. A general inductive analysis method was conducted, resulting in education themes which were then compiled into health literacy-constructed learning outcomes to present to the panel in the two Delphi rounds. Findings: The study question is answered in the form of a ranked list of the 24 most important learning outcomes of physical activity and nutrition education in Finnish schools. The analysis of variance pair-wise comparisons with Bonferroni indicated that six items were statistically possibly more important than the 18 others. The three most important items being: first, understand the importance of a varied and balanced diet; second, the ability to analyse their own lifestyle; third, understand the link between physical activity and health. The study also identified topics/themes which could be either under-represented or over-represented in the current literature and teaching. Originality/Value: This study is the only one of its type, and researches an as yet unknown area of health education. The value of this study lies in its role in the further development of school health education, in terms of identifying the "most important" contemporary issues to teach in the classroom, and may also be used as a topic prioritisation and curriculum planning tool.

Purpose: This paper aims to clarify the extent to which youth sports clubs guide their coaches to recognise health promotion as a part of the coaching practice. The guidance activity of clubs is seen parallel to internal organisational communication. Design/methodology/approach: A survey of 93 (from 120, 78 per cent) youth sports clubs in Finland was carried out, and a total of 273 sports club officials acted as respondents. The clubs' guidance activity was examined under three domains: sports performance time, non performance sports club time, and health topics. Findings: In general, youth sports clubs were passive on guiding their coaches on health promotion. Guidance activity was evident concerning actual sports performance time, whereas non-performance sports club time received much less attention. Health topics were guided to a varying degree in that the clubs had been active in guiding the coaches on topics such as the risks of being physically active when ill, injury prevention, and sleep/rest, whereas topics such as nutrition and the use of various substances were much less acknowledged. Research limitations/implications: The study limitations relate to self-reported data, and the complexity of assessing sports clubs. As one of the first studies in the area, all the measurement instruments and methods were created from the outset. Therefore, further studies are required for validation purposes. Despite the limitations, this study provides pioneering baseline information. Practical implications: The results indicate that youth sports clubs are still discipline and competition oriented. Health promotion guidance especially regarding non-performance sports club time and several health topics needs to be addressed by the clubs in order to meet the clubs' own health-related intentions. Originality/value: These findings are unique in this relatively new setting for health promotion, and they can act as a baseline for research methodology development and further studies. (Contains 4 notes and 5 tables.)

The aim of this phenomenographic study was to identify student teachers' ways of experiencing the teaching of health education, and to determine the aspects that are educationally critical in gaining a deeper understanding of the teaching. Qualitative data (written essays, semi-structured interviews) were gathered twice during health education teacher training. Teaching was seen as transferring knowledge and skills, supporting the active processing of knowledge, supporting transformation of conceptions, supporting holistic personal growth and building a learning community with the students. The teaching was reflected through five themes: the nature of the knowledge, the source of the knowledge, the teacher's role, the pupil's role and the direction of the interaction. The findings support earlier studies but also bring new perspectives to discussions of teaching conceptions. The study also confirms that, although some conceptions seem to be parallel across different educational settings, other conceptions appear to vary over different contexts. (Contains 1 table.)

In this article we will present a reflexive way of producing a narrative analysis on teaching and learning that involves all participants of the pedagogical process. Our theoretical contribution rests on the concept "lived pedagogy", adapted from Max van Manen's term "lived experience". Like van Manen, we start by asking the key question of phenomenological-hermeneutical research: what is the nature of the phenomenon as meaningfully experienced? For us, the phenomenon is the pedagogical relationship; the interaction between the people involved in the pedagogical process. Thus, we will present how lived pedagogy is researched through the narratives told by the teacher-researcher, the students, and their parents, and how the analysis and interpretation is made with reference to three voices; "my voice" (teacher), "your voice" (pupils) and "their voice" (parents). (Contains 2 figures.)

The aim of this study was to describe students' perceptions of their psychosocial school environment and to examine the associations between such perceptions and students' perceived school performance. Our analyses were based on data from the Health Behaviour in School-Aged Children 2006 study, involving responses by Finnish students from grades 7 and 9. The results indicated that students' perceptions of their school environment were fairly positive, but that a remarkably large proportion of the students reported negative attitudes towards school. School engagement, school strain, and teacher-student relations were found to be the most influential predictors in the psychosocial school environment regarding perceived school performance; as were the grade and educational aspirations out of the selected background factors. The findings imply that despite good academic achievement in Finnish comprehensive schools, there is still a need to improve students' school engagement and their satisfaction with school. (Contains 6 tables.)

The purpose of this study was to investigate the dimensions of emotional health in two population-based groups (Finland and Canada) of adolescents (ages 13 and 15 years) who self-identify as having a disability or chronic condition, as conceptualized by the WHO International Classification of Functioning, Disability and Health. Data from the 2002 WHO Health Behaviour in School-aged Children survey were used to compare the prevalence of emotional health (items on feeling low, feeling nervous) within and between countries. Eighteen percent of the Canadian and Finnish samples indicated they had a long-time disability, illness or medical condition. Canadian adolescents with disability or chronic conditions felt low significantly more frequently than their classmates without disability or chronic conditions. In both countries, students with disabilities who had more than one functional difficulty were significantly more likely to report feeling low and nervous. These results illustrate that the severity of disability as measured by the number of functional difficulties, and not merely the presence of disability or chronic condition, or particular functional difficulties, may play an important role in the emotional health of adolescents. Health promotion programs may use this information to guide practice to support the emotional health of students with disabilities.

Background: Health literacy (HL) is an important determinant for maintaining and improving health throughout the lifespan. This underlines the need to monitor HL, including among adolescents, and to understand the factors explaining HL, with a view to decreasing differences in HL. The aim of this study was to objectively measure HL, and the relationship between HL and socio-demographic factors (gender, language of instruction, pupils' educational aspirations, parents' educational background and pupils' school achievement) among pupils (n = 3652) at the end of basic education in Finland. Methods: A nationally representative assessment, which included 55 items on HL, was conducted as a traditional paper-and-pencil test in schools. The data were analysed via descriptive statistics and a two-level hierarchical linear model to determine how the socio-demographic factors affected HL. Results: The pupils' average score on the HL test items was 58.9%, indicating a satisfactory HL level. A two-level hierarchical linear model showed that the variables (gender, language of instruction, pupils' educational aspirations, parents' educational background and pupils' school achievement) predicting the HL level had statistically significant effects. Conclusions: Among ninth graders (15–16 years old), almost one third of the boys and 8% of the girls exhibited an unsatisfactory HL level. The study also confirmed the importance of school-related factors in explaining HL differences. Since low HL has been linked to several unfavourable health indicators and has been viewed as an underestimated problem in times of pandemic and other health crises, the findings suggest that the HL level of Finnish ninth graders is a clear public-health issue. [ABSTRACT FROM AUTHOR]

The importance of intersectoral collaboration and partnership working in mental health promotion, together with the requisite competencies for effective collaboration, is widely acknowledged. This Delphi-based qualitative study examined how intersectoral collaboration and partnership work are constructed and adopted in mental health promotion practice. Descriptive data from a Delphi panel of mental health promotion practitioners working in the health sector (n  = 32) were used as a data source. Thematic analysis was used to analyze the data. Applying the theory of collaborative advantage, eight themes of collaboration advantage and the related competencies were identified: management structure, leadership, communication and language, common aims, working processes, resources, trust, and commitment and determination. The themes capture the competencies required to influence and work with others to improve the mental health and wellbeing of individuals and communities. The identified theme areas can be used to inform education and training and capacity building for professional practice in mental health promotion. Future research is needed to explore other possible collaborative advantage themes in mental health promotion practice and the competencies required to facilitate effective partnerships across sectors. Further investigations are also needed on the identified theme areas in order to develop and guide capacity building and training in mental health promotion. [ABSTRACT FROM AUTHOR]

Background: Adolescents' physical activity level is a major source of concern. For adolescents with long-term illnesses or disabilities (LTID), being physically active can prevent secondary conditions. This is one of the first studies reporting trends in physical activity of adolescents with LTID in relation to gender, age, and sports club membership. Methods: Data were collected from the Health Behavior in School-aged Children study in Finland during 2002, 2006, 2010, and 2014. In 13- and 15-year-olds (N = 2206), 17.1% reported having LTID. Daily physical activity recall was the dependent variable. Binary logistic regression analysis was conducted separately for sports club members (n = 936) and nonmembers (n = 1270). Results: The proportion of physically active adolescents with LTID in 2014 was higher than in 2002 for girls (15.6% vs 8.7%) and boys (26.6% vs 13.0%). Girl sports club members were 2 limes more likely to be physically active in 2014 than in 2002. The largest trend between 2014 and 2002 was among boy nonmembers (odds ratio: 4.62,95% confidence interval, 2.02-10.58). Conclusions: More adolescents with LTID took part in daily moderate-to-vigorous physical activity in 2014 than in 2002; however, physical activity levels still remain low. Sports club membership was similar to that of the general population. [ABSTRACT FROM AUTHOR]