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Background: Digital transformation has influenced all areas of adolescents’ lives, including the ways adolescents maintain friendships. Interpersonal communication is one of the most common activities while online. Online communication may provide adolescents with opportunities to expand their social contacts, but these encounters can be risky, especially when the communication is with unknown people on the internet. This study examined the associations between different forms of online communication behavior and well-being. Materials and methods: Data were collected from Finnish adolescents as part of the Health Behavior in School-Aged Children (HBSC) study in 2018. The participants were 3,140 Finnish adolescents aged 11–15 years. Descriptive analyses were used to examine the frequency of different forms of online communication behaviors. The associations between online communications and individual factors were analyzed using the X2 test and 95% confidence intervals. Structural equation modeling (SEM) was used to analyze the extent to which adolescents’ online communication behavior explained the variance in adolescents’ well-being indicators. Results: Overall, 60% of the adolescents reported communicating intensively with close friends, with higher rates of intensive communication reported by girls, higher age groups, and the high health literacy group. 22% of adolescents reported intensive communication with friends they got to know through the internet (online friends), while intensive online communication with unknown people was reported by 13% of adolescents. Overall, around one-fourth of adolescents preferred sharing personal matters online rather than in face-to-face encounters, and 10% of adolescents reported using the internet daily to get to know new people, and to look for like-minded company. The SEM analysis showed that keeping online contact with offline friends was linked to a positive outcome in all the measured well-being indicators; however, intensive communication with people contacted only online (online friends and unknown people) was negatively associated with well-being indicators (lower self-rated health, lower life satisfaction, higher loneliness, and problematic social media use). Conclusion: Both positive and negative associations were observed between online communication and well-being, depending on the target and content of the communication. The results indicate that online communication has benefits for adolescents who have more offline social life. Overall, one should ensure that the impact of interventions is proportionately greater for adolescents at the bottom end of the health gradient. peerReviewed

Health literacy can help explain health inequalities in childhood and adolescence. However, suitable instruments for assessing health literacy in this age group are rare, especially in the German-speaking countries. One economical measure is the 10-item Health Literacy in School-Aged Children (HLSAC) scale, developed and reviewed as part of the WHO Child and Adolescent Health Study (HBSC, Health Behavior in School-Aged Children). In the present study, we tested dimensionality, measurement invariance, and associations with health-related measures of the German version of the scale (HLSAC–German), using data from the 2018 national German HBSC study (N = 4,347 students aged 11, 13, and 15 years). We also tested HLSAC–German with 11-year-olds, representing an expansion of the original scale. Exploratory and confirmatory factor analyses consistently demonstrated the unidimensionality of the scale (α = .88). Complete scalar measurement invariance was found for sex and partial scalar measurement invariance for age groups and school type, allowing for the comparison of means. Associations with indicators of health and health behavior further demonstrate the construct validity of the scale. The analyses show that the scale is suitable for the economic measurement of a general factor of health literacy in 11- as well as in 13- and 15-year-olds. Die 10-Item-Skala „Health Literacy in School-Aged Children“ (HLSAC) ist ein ökonomisches Verfahren zur Messung der Gesundheitskompetenz im Kindes- und Jugendalter, das im Rahmen der HBSC-Studie (Health Behavior in School-Aged Children) entwickelt und überprüft wurde. Im vorliegenden Beitrag werden die Dimensionalität und Messinvarianz der deutschen Version der Skala, HLSAC-German, sowie Zusammenhänge zu gesundheitsbezogenen Indikatoren anhand der Daten der deutschen HBSC-Studie 2018 (N = 4 347 Schülerinnen und Schüler im Alter von 11, 13 und 15 Jahren) überprüft. Der Einsatz in der Gruppe der 11-Jährigen stellt eine Erweiterung im Vergleich zur Originalskala dar. Explorative und konfirmatorische Faktorenanalysen belegen die Eindimensionalität der Skala (α = .88). Es zeigen sich vollständige skalare Messinvarianz bezüglich des Geschlechts und partielle skalare Messinvarianz bezüglich Altersgruppen und Schulform, welche Mittelwertvergleiche erlauben. Erwartungsgemäße Zusammenhänge zu Indikatoren der Gesundheit und des Gesundheitsverhaltens belegen weiter die Konstruktvalidität der Skala. HLSAC-German ist zur ökonomischen Messung eines allgemeinen Faktors der Gesundheitskompetenz sowohl bei 11- als auch bei 13- und 15-Jährigen geeignet, wobei die Dimensionalität in der jüngsten Altersgruppe weiter überprüft werden sollte.

Background and aims: There is currently no cross-national validation of a scale that measures problematic social media use (SMU). The present study investigated and compared the psychometric properties of the social media disorder (SMD) scale among young adolescents from different countries. Design: Validation study. Setting and participants: Data came from 222 532 adolescents from 44 countries participating in the health behaviour in school-aged children (HBSC) survey (2017/2018). The HBSC survey was conducted in the European region and Canada. Participants were on average aged 13.54 years (standard deviation = 1.63) and 51.24% were girls. Measurement: Problematic SMU was measured using the nine-item SMD scale with dichotomous response options. Findings: Confirmatory factor analyses (CFA) showed good model fit for a one-factor model across all countries (minimum comparative fit index (CFI) and Tucker–Lewis index (TLI) = 0.963 and 0.951, maximum root mean square error of approximation (RMSEA) and standardized root mean square residual (SRMR) = 0.057 and 0.060), confirming structural validity. The internal consistency of the items was adequate in all countries (minimum alpha = 0.840), indicating that the scale provides reliable scores. Multi-group CFA showed that the factor structure was measurement invariant across countries (ΔCFI = −0.010, ΔRMSEA = 0.003), suggesting that adolescents’ level of problematic SMU can be reliably compared cross-nationally. In all countries, gender and socio-economic invariance was established, and age invariance was found in 43 of 44 countries. In line with prior research, in almost all countries, problematic SMU related to poorer mental wellbeing (range βSTDY = 0.193–0.924, P < 0.05) and higher intensity of online communication (range βSTDY = 0.163–0.635, P < 0.05), confirming appropriate criterion validity. Conclusions: The social media disorder scale appears to be suitable for measuring and comparing problematic social media use among young adolescents across many national contexts.

This paper describes the development of an objective curriculum- and performance-based health literacy (HL) measurement instrument to assess Finnish 9th graders’ learning outcomes in the school subject termed Health Education (HE). There were four phases: (i) construction of the theoretical framework for the measurement, (ii) item generation, (iii) the field test (n = 252), and (iv) item analysis and item selection for the main study, in which 3652 ninth grade pupils (aged 15–16) participated. Initially, 303 HL test items were formulated, of which 107 were tested in two different field test versions. Both versions exhibited high reliability as measured by Cronbach’s alpha coefficient. The main study contained 55 items. Testing and item analysis enabled the development of a comprehensive competence- and curriculum-based HL measurement instrument for school-aged children. Measurement of HL in schools provides information for national policies, and for developing HE as a school subject. peerReviewed

nonPeerReviewed

(1) Background: Internet use has become an integral part of adolescents’ daily lives. It is important to understand how adolescents use the internet, and how this use is associated with demographic factors and health from a person-oriented perspective. (2) Methods: The study applied the Finnish nationally representative HBSC data (persons aged 11, 13, and 15, n = 3408), descriptive observation, latent class analysis, and multinomial logistic regression analysis. (3) Results: Entertainment activities (listening to music) and socially oriented activities (liking posts, talking online) were the most prevalent among adolescents, but gender differences emerged. Five different internet user profiles were identified (encompassing interest-driven, friendship-driven, abstinent, irregular, and excessive users). Interest-driven users participated in interest- and media-oriented activities. Adolescents in the interest-driven user group were more likely to be boys and participants with low academic achievement, high parental monitoring, and high problematic social media use. Friendship-driven users participated in socially oriented activities. Adolescents in the friendship-driven user group were more likely to be girls and participants aged 13 or 15, with high peer and family support. Abstinent users participated only in entertainment, while irregular users showed no particularly high involvement in any internet activity. Adolescents in the abstinent and irregular user groups were likely to be boys and participants aged 11 with high family support. Excessive users had high involvement in internet activities overall. Adolescents in the excessive user group were more likely to be participants with high problematic social media use and were most likely to feel low and tired on school mornings. (4) Conclusion: The study confirmed the prevalence of internet use. It identified five internet user profiles and differences between user profiles regarding individual and social factors and health outcomes. peerReviewed