Abstract
BackgroundHigher prevalence rates of unhealthy behaviours among lower socioeconomic groups contribute substantially to socioeconomic inequalities in health in adults. Preventing the development of these inequalities in unhealthy behaviours early in life is an important strategy to tackle socioeconomic inequalities in health. Little is known however, about health promotion strategies particularly effective in lower socioeconomic groups in youth. It is the purpose of project TEENAGE to improve knowledge on the prevention of socioeconomic inequalities in physical activity, diet, smoking and alcohol consumption among adolescents in Europe. This paper describes the background, design and methods to be used in the project.Methods/designThrough a systematic literature search, existing interventions aimed at promoting physical activity, a healthy diet, preventing the uptake of smoking or alcohol, and evaluated in the general adolescent population in Europe will be identified. Studies in which indicators of socioeconomic position are included will be reanalysed by socioeconomic position. Results of such stratified analyses will be summarised by type of behaviour, across behaviours by type of intervention (health education, environmental interventions and policies) and by setting (individual, household, school, and neighbourhood). In addition, the degree to which effective interventions can be transferred to other European countries will be assessed.DiscussionAlthough it is sometimes assumed that some health promotion strategies may be particularly effective in higher socioeconomic groups, thereby increasing socioeconomic inequalities in health-related behaviour, there is little knowledge about differential effects of health promotion across socioeconomic groups. Synthesizing stratified analyses of a number of interventions conducted in the general adolescent population may offer an efficient guidance for the development of strategies and interventions to prevent socioeconomic inequalities in health early in life.
Highlights
Higher prevalence rates of unhealthy behaviours among lower socioeconomic groups contribute substantially to socioeconomic inequalities in health in adults
Studies conducted among adults have shown that unhealthy behaviours – physical inactivity, unhealthy eating habits, smoking, and alcohol consumption – are more prevalent in lower socioeconomic groups, and contribute to socio-economic inequalities in health [1,2,3,4,5]
Strategies to tackle inequalities in health-related behaviour are far mainly concentrated on the reduction of inequalities in unhealthy behaviours among adults [6], for example through community-based approaches [7] and/or through specific efforts to better reach lower socioeconomic groups with evidence-based interventions [8]
Summary
Socioeconomic inequalities in health-related behaviours are well described [18], but evidence of effective interventions and policies to prevent these inequalities is currently. Conclusions and recommendations will be mainly based on the direction of the difference in interventions across high and low socioeconomic groups in several studies, rather than on statistical significance Another potential limitation of the project is the presumable inability to pay sufficient attention to aspects which may eventually reduce inequalities community-wide. The framework and the general rules for analyses allow stratified analyses to be conducted in new or currently unidentified intervention studies Such additional information can strengthen the findings of the project. According to the principles of a "planned approach" of health promotion, descriptions of socioeconomic inequalities in health-related behaviours should be followed by studies investigating the explanation of these inequalities, before interventions can be developed.
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