Adolescent Health Research Articles

Research on structural determinants and mental health in adolescents

Research on structural determinants and mental health in adolescents

Remember Darwin: Individualism, Neuroscience and Language

Individualism has been a constant theme of the development of child and adolescent mental health since at least 1870. Freud’s Scientific Project is an exercise in neurological individualism as have many subsequent neuroscience projects. Just because bodies contain neurological and chemical circuits, it does not mean that mammalian animals are discrete. Mammals live in communication networks and humans have evolved to make those networks linguistic. It is species adaptations that are manifest in the lives of single members of a species and provide for fitness to environment. The many biological scientists that call themselves neurologists have been prone to misunderstand this Darwinian premise.

Capturing authentic academic ability: The role of mental health in youths’ academic lives

Capturing authentic academic ability: The role of mental health in youths’ academic lives

Evaluation of beverage consumption patterns and oral health in Korean adolescents and young adults

Objectives: This study aimed to investigate the beverage consumption patterns and analyze the relationship between the frequency of beverage consumption and oral health in Korean adolescents and young adults who consumed large amounts of sugar from beverages. Methods: Data from the 8th Korea National Health and Nutrition Examination Survey (2019–2021) were analyzed, and 2,787 individuals aged 12-29 years were selected as the study subjects. A complex sample general linear model was used to assess the associations of subject general characteristics and oral health with the frequency of beverage consumption. Results: Both adolescents and young adults frequently consumed carbonated beverages 2.04 and 2.12 times per week, respectively. The most commonly consumed volume per drink was 200 cc. In both groups, the lower the average number of times teeth were brushed daily, the higher was the frequency of fizzy drink consumption. When teeth were brushed less than once daily, the frequency of carbonated drink consumption was 2.63 in adolescents and 2.22 in young adults. Conclusions: This study highlights the need for oral health education of adolescents and young adults on diet and beverage intake. Additionally, information should be provided on oral diseases associated with beverage consumption, such as dental caries and erosion.

Factors related to oral health and subjective health among Korean adolescents: the 18th Korea Youth Risk Behavior Survey (KYRBS)

Objectives: This study was conducted to investigate factors related to oral health and subjective health in Korean adolescents, a total of 51,850 people. Methods: Subjective health by general characteristics, subjective health by oral health characteristics, and subjective health by oral health symptoms were analyzed by a cross-analysis. Factors influencing subjective health were analyzed using multiple regression analysis. Results: As a factor influencing subjective health, the number of times teeth were brushed 0.62 times lower (p<0.001) for 0 times, and 0.91 times lower (p<0.05) for 1-2 times. The risk was 1.33 times higher (p<0.001) if teeth were brushed before going to bed, and 1.10 times higher (p<0.05) if an intrdental brush was used, In cases where oral health education was not received, subjective health was 0.86 times lower (p<0.001). In cases where there was no pain subjective health was 1.44 times higher (p<0.001), gingival bleeding was 1.51 times higher (p<0.001), or malodor was 1.53 times higher (p<0.001). Conclusions: Based on the above results, the relationship between oral health and subjective health was confirmed, and it is thought that opportunities to develop preventive programs to promote youth health should be expanded.

Examining the impact of health insurance and socioeconomic factors on children’s hospitalization in Indonesia: an empirical analysis

ABSTRACT The purpose of this research is to examine the impact of different types of healthcare and insurance on the health of Indonesian youth. The study employs logistic regression, a statistical method used to analyze relationships between variables and predict outcomes. Data were collected through an Indonesia’s National Socio-Economic Survey, which gathers information from individuals within a household. The findings reveal that Indonesia’s National Health Insurance (with or without subsidies) reduces the likelihood of children being hospitalized. Families enrolled in the program, often from low- to middle-income backgrounds with limited access to healthcare, benefit significantly from this initiative, which provides affordable and essential health services. This program allows these families to access healthcare that would otherwise be unaffordable. However, private and employer-sponsored insurance did not reduce hospitalization rates, likely because families in these plans already benefit from better overall health, nutrition and access to health-promoting activities. In contrast, children without insurance are more likely to be hospitalized due to their location and economic and financial constraints. Other determinant factors affecting children’s health included age, sex, parent’s education, smoking behavior and house location. The results showed that older children were generally healthier, children of well-educated and non-smoking parents were less likely to be hospitalized and those living in urban areas had a higher likelihood of hospitalization than those in rural areas. This study highlights the importance of expanding access to health insurance and promoting parental education and non-smoking behavior to improve children’s overall health. Failing to address these issues could create challenges for the future, given that the current young generation will eventually become the nation’s leaders.

A personalised nutrition intervention for adolescent depression: a mixed-methods feasibility pilot study.

Randomised controlled trials have demonstrated the benefit of diet modification to improve diet quality in the treatment of adult major depressive disorder (MDD). However, research examining nutritional interventions for adolescents with MDD is sparse. This pilot study examined the feasibility of a personalised nutrition intervention for adolescents with MDD. Ten adolescents with MDD and their parents recruited from a tertiary care setting participated in an 8-week, single-arm mixed-methods study. Feasibility was assessed using five criteria (demand, acceptability, implementation, adaptation and limited efficacy testing) alongside qualitative interviews. The intervention involved four bi-weekly virtual nutrition counselling sessions with a stepped approach to dietary change, menu planning, grocery delivery and educational eHealth messages. Study participants sought positive changes in diet, health and lifestyle for adolescents and family-wide benefits. Recruitment challenges included concerns about managing mood fluctuations, anticipated dietary restrictions and the potential time and effort required for diet adherence. Feedback based on interviews emphasised moderate to high acceptability, satisfaction with menu planning and counselling and recognition of the benefits of trying new foods and sustaining positive dietary changes beyond the study. Improvements in depression symptoms (Cohen's d = 0·36, 95 % CI (-0·24, 3·36)), parent food modeling (Cohen's d = 0·24, 95 % CI (-0·43, 1·16) and the family food environment (Cohen's d = 0·61, 95 % CI (-0·04, 2·61)) were observed. This nutrition intervention was feasible for adolescents with MDD and was acceptable to both parents and depressed adolescents. These preliminary data suggest that further examination of the intervention and its potential benefits on depression symptoms and family food dynamics are warranted.

Dose-response associations between physical activity and mental health among USA adolescents

Abstract Background Adolescent mental health is a critical public health concern. Physical activity has been shown to reduce risk of negative mental health outcomes. However, in adolescents little is known about the dose-response nature of this relationship. This study aims to fill this gap by examining the association between varying levels of self-reported physical activity and the odds of reporting depressive symptoms and poor mental health, among US high school students. Methods This is a cross-sectional study using data from the 2021 Youth Risk Behavior Survey. Physical activity exposure was assessed as students’ self-reported weekly frequency of ≥ 60min moderate-to-vigorous physical activity (MVPA), as well as frequency of participation in muscle-strengthening activities, sports teams, and physical education (PE) classes. For the dose-response analysis three categories were created for each item. Depressive symptoms and poor mental health were measured using established survey items. Multivariate logistic regression risk models were used. Results A total of 8,015 high-school students were included. Depressive symptoms were reported by 43% of students, and 28% reported poor mental health. Moderate doses (1-4 days) of muscle-strengthening activities reduced the odds of depressive symptoms by 23% and the odds of poor mental health by 38% compared to low doses (0 days). Higher reductions were observed for higher doses (5-7 days). Similar results were observed for sports teams (1 vs 0 teams). Moderate doses (1-4 days) of MVPA ≥60min showed a significant reduction in the odds for poor mental health (38%) but not depressive symptoms compared to low doses (0 days). No effect was observed for any dose of PE attendance. Conclusions The findings suggest a dose-response pattern in the association between physical activity and mental health in adolescents. Any increase in physical activity levels among young adults would be valuable in preventing poor mental health. Key messages • A dose-response pattern was observed between self-reported mental health and physical activity exposure in adolescents. • Moderate levels of physical activity significantly reduced the risk of self-reported poor mental health among adolescents.

Resilience and mental and physical health of higher and lower educated youth during COVID-19

Abstract Background COVID-19 had a considerable impact on the mental and physical health of youth. To limit the impact of this crisis on their health, resilience was required. This study aims to discover how resilient, in terms of mastery, emotional reactivity and social support, groups of youth with different SES were during COVID-19, and what risk and protective factors they experienced. Methods Two qualitative datasets were analyzed. One dataset included 10 interviews of university students during April-May 2020, and the other dataset included 8 interviews with pre-vocational secondary education adolescents during October 2021 to March 2022. Interviews were held in person or online. Data were analyzed with thematic analysis in Atlas.ti. Results In general, university students displayed resilience despite the tumultuous beginning of the pandemic, and their mental and physical health was positive. Protective factors that helped them during COVID-19 were spending time with friends and family, being healthy and having a healthy lifestyle, and being able to avoid stressful situations. Risk factors that impacted their resilience were loneliness, COVID-19 anxiety, and missing stability and routine. Adolescents receiving pre-vocational secondary education showed mixed resilience later in the COVID-19 period, and they made negative observations about their health. Protective factors that helped them were achieving good results in school, hobbies, and avoiding stressful situations. Risk factors they experienced were lack of motivation and having difficulties at school. They experienced worry about school progress during COVID-19. Conclusions University students and lower educated adolescents seemed to have differing resilience during the impactful stages of COVID-19, possibly due to differences in their psychological development. To protect their well-being, it is important that policy makers consider the protective and risk factors that impact the health of youth during crises. Key messages • Resilience differs among the two different age groups and education levels. • Policy makers should consider the protective and risk factors that impact the health of youth during crises.

Promoting Equity: Child & Adolescent Health Service

Abstract The health and well-being of children and adolescents face significant challenges, particularly in times of social instability. In response to these challenges, the Norwegian government allocated funding in 2021 to establish a national center for Child and Adolescent Health Promotion Services. Situated within the Norwegian Institute of Public Health, this center focuses on enhancing expertise, professional development, and research within municipal maternity and child health clinics, school health services, and youth health clinics. This presentation delves into the crucial role of Universal Health Promoting Services (UHPS) in mitigating the adverse effects of social inequality on child and adolescent health. By leveraging evidence-based practices and identifying knowledge gaps in health promotion and disease prevention in primary care settings, UHPS serve as catalysts for reducing health disparities and enhancing outcomes among expecting parents, children, and adolescents. Moreover, UHPS plays a vital role in addressing the underlying determinants of health inequality, including social network, lifestyle factors, promotion of health literacy and ensuring accessible health care services for all. UHPS empowers individuals and communities to actively participate in health promotion efforts, fostering a culture of health equity and resilience. Through targeted health education programs, early intervention strategies, and community empowerment initiatives the UHPS work both at a systems and individual level to address social inequality in health. This presentation contextualizes UHPS within a broader picture aimed at promoting child and adolescent health while addressing social inequality in health. By highlighting effective approaches and areas requiring further research, it aims to contribute to the ongoing discourse on optimizing health outcomes for young populations.

How does family support mitigate the impact of childhood adversity on adolescent mental health?

Abstract Background Childhood adversity is associated with increased risk of developing mental health problems over the life course. We investigated how family emotional support in adolescence may mitigate the impact of childhood adversity on adolescent mental health. Methods We used longitudinal data from the UK Millennium Cohort Study on 9,269 children followed to age 17 years. Individuals were assigned to exposure trajectories characterised using group-based trajectory models that included measures of poverty and family adversities (parental mental ill health, parental alcohol misuse and domestic violence) up to age 14 years. Using counterfactual causal mediation analysis and four-way decomposition modelling approach, we evaluated how perceived family emotional support at age 14 (measured using the three-item Short Social Provisions Scale) influences the association of childhood adversity trajectories on mental health at ages 14 and 17, assessing the relative contributions of mediation and interaction simultaneously. Results Compared with children experiencing low adversity and poverty, those exposed to childhood adversity were almost three times more likely to experience poor mental health (RR 2·99, 95% CI 2 ·41 to 3·57) at age 14 and age 17 (RR 2·58, 95% CI 2·09 to 3·06). Perceived emotional support mitigates up to 18% (95% CI: 9% to 26%) of this effect at age 14, and 13% (95% CI: 5% to 22%) at age 17, mainly due to interactive mechanisms. Conclusions Childhood adversity has a strong effect on mental health, which is partially mitigated by perceived family support in adolescence. Policies that support positive family functioning may be particularly beneficial for children who have experienced adversity. Key messages • Socio-economic – associated mental health problems in adolescence differed based on levels of family support. • Approximately 20% of the social inequality in mental health outcomes in adolescence may be mitigated or reduced by improving levels of family support.

The changing association between pandemic-related stressors and child and adolescent mental health during the waning phase of the COVID-19 pandemic

This study examined the relation between pandemic-related stressors and mental health among young people (YP) in India during two time points in the waning phase of the pandemic. We use data from two cross-sectional waves of over 20,000 YP aged 5–19 in February 2022, during the peak of the Omicron wave, and October 2022, during a reduction in infections and easing of restrictions. COVID illness/death in the family’s social network, current lockdown stringency, and significant change in household income were examined in relation to adult respondents’ reports of YP internalizing symptoms. Internalizing symptoms declined slightly from February to October 2022. COVID-19 illness/death in the family’s network was generally associated with more internalizing symptoms. Higher lockdown stringency was associated with lower levels of internalizing symptoms. YP in households with increases in income tended to have more internalizing symptoms. Many associations were driven by older adolescents and were stronger during the earlier (Feb-2022) than later (Oct-2022) data collection time-points. The findings illustrate the importance of anchoring results within a study’s specific geographic context, including concurrent events during the study period. Importantly, findings that may initially seem counterintuitive ultimately illuminate the dynamic and complex processes underlying child and adolescent mental health.

The association between screen use, psychological distress and sleep among adolescents in Norway

Abstract Background Today’s adolescents dedicate a significant portion of their time to screens. Concerns have arisen regarding the lasting impact of screen use on adolescent health, making it a crucial public health topic. Previous studies have presented both positive and negative outcomes associated with screen use. Further insight is required into various forms of screen use and the influence on adolescent health. The objective of this study is to examine the relationship between gaming, social media use, psychological distress, and sleep among adolescents. Methods This study is based on cross-sectional data from the Ung-HUNT4-study, a health study conducted among adolescents 13-19 years old in Trøndelag municipality in Norway from 2017-2019 (n = 8066). Binomial logistic regression was used to analyse the association between gaming, social media, psychological distress and sleep. Analysis was controlled for gender, age, family economy and having friends. Results Preliminary results showed that the odds for having psychological distress were higher for those who spent more than 3 hours on social media after school (OR: 1.31, 95% CI: 1.10-1.57), and on weekends (OR: 1.45, 95% Cl: 1.22 - 1.73), and on gaming in weekends (OR:1.30 Cl: 1.08-1.55) compared to those who spent 3 hours and less. The odds for sleeping < 8 hours per day on weekdays were higher for those who spent more than 3 hours on gaming after school (OR: 1.27 Cl:1.07-1.52), and more than 3 hours on social media after school, (OR:1.41 Cl:1.20-1.67) or on weekends (OR:1.39 Cl: 1.19-1.62), compared to those who spent 3 hours or less. Conclusions More than 3 hours spent on social media after school and on weekends was associated with significantly higher odds for psychological distress and less sleep on weekdays. More knowledge about the impact of different types of screen use on adolescents’ health is needed, and new public health strategies to secure safe screen use should be developed. Key messages • Screen use is associated with psychological distress and less sleep. • Awareness on various types of screen use and its influence on health in adolescence, is important in public health policy and practice.

9.N. Practice session: From Data to Action – Joining forces to close the inequity gap in adolescent health

Abstract Persistent adolescent health inequalities exist in Europe, necessitating interventions that address both individual and societal factors, especially those pertinent to youths in unfavourable contexts. Collaborative efforts involving cross-sectoral partnerships and adolescent engagement are crucial in identifying and mitigating these disparities. Three case studies exemplify this approach. Case study 1: Effective intervention development hinges upon the translation of epidemiological insights into tangible actions. Heiko Schmengler will discuss how individual and contextual-level data is made actionable for the development of ePro-schools, an e-health intervention to promote healthy dietary habits and physical activity amongst adolescents in socially disadvantaged settings. ePro-schools brings together stakeholders from academia, the health sector, the education system, and local communities. This collaborative approach ensures that the intervention is not only grounded in solid scientific evidence but also fits the specific cultural, social, and economic contexts of the adolescents it aims to serve. Case study 2: Adolescents are not passive consumers of interventions, but active agents who frequently understand best what they need to improve regarding their health. Lourdes Cantarero Arevalo will share innovative methodologies and best practices for involving adolescents in data collection, intervention design, and policy development processes with the final aim to empower the voices of adolescents in vulnerable situations while addressing problems that are relevant for them. Case study 3: Filipa Alves da Costa will draw attention to the health concerns of adolescents resulting from incarceration. This talk will outline the development of a policy brief derived from UN global study data, which highlights the importance of cross-sectoral collaboration in developing actions to safeguard access to high quality healthcare for adolescents within the criminal justice system. A cross-sectoral approach is critical given that criminal justice systems typically fall outside the direct oversight of health ministries. The goal is to encourage policymakers, practitioners, and advocates to consider inter-sectoral strategies to address the complex health challenges these adolescents face. Following the presentations, we will facilitate a dynamic discussion with the audience, encouraging an exchange of ideas on strategies to address adolescent health inequalities from a multilevel perspective. This discussion aims to draw on the collective expertise of participants from diverse backgrounds, including practitioners, researchers, and policymakers. This dialogue aims to identify common barriers and opportunities, fostering a collaborative approach to tackling inequalities. The goal is to emerge from the workshop with a richer understanding of effective strategies that can be leveraged to close the gap in adolescent health across Europe. Key messages • Health inequalities among adolescents must be tackled collaboratively across different sectors and with participation of adolescents. • Participants will gain valuable insights on innovative solutions and effective methodologies from the case studies to inform their own efforts in addressing adolescent health inequalities.

Empowering youths through citizen science to address health inequalities in adolescence

Abstract Citizen Science (CS) stands as a beacon of hope in the fight against inequalities in adolescent health, revolutionizing scientific research by involving individuals from diverse backgrounds. Unlike traditional methods, CS transcends academic boundaries, fostering inclusivity and collaboration irrespective of age, nationality, or social status. This approach has gained momentum in adolescent health research, empowering young people as co-researchers from project inception, thereby reducing disparities in health knowledge and access. Studies demonstrate its efficacy in enhancing empowerment and health literacy among participants. YouthChronic is an example of how CS can mitigate health inequalities among adolescents. The project ensures active participation in every research stage by engaging adolescents with chronic conditions as citizen scientists. Open-ended questions facilitate detailed responses, while participation in analysis and dissemination enhances their research involvement and sense of ownership. Through initiatives like YouthChronic, CS is reshaping the research landscape, making it more relevant and impactful to bridge the inequality gap. Young Citizen Scientists’ views on their participation: “As part of YouthChronic, we felt like our experiences with chronic conditions were finally being heard. The researchers were cool-they listened to us, let us be flexible with our participation, and even taught us some research skills. Learning from other peers’ experiences made us feel less alone and gave us new insights. But it’s frustrating that we’re limited by resources. We have big ideas, like running an advocacy campaign, but we need funding to make them happen”. In conclusion, by actively involving adolescents in the scientific process through CS initiatives like YouthChronic, we can reduce inequalities in adolescent health, empower marginalized voices, and pave the way for a brighter, more inclusive future in scientific exploration and discovery.

Family-based sexual health intervention for adolescents; A systematic review and meta-analysis

Abstract Background Family-based interventions are important in promoting adolescent sexual health outcomes. However, the effectiveness of these interventions in promoting adolescent sexual and reproductive health (ASRH) in Lower and middle-income countries (LMIC) has not been empirically evaluated. This review aimed to summarise the effectiveness of family-based sexual and reproductive health interventions in promoting ASRH in LMIC. Methods We conducted a systematic search for studies published in English from 2000 to October 2023 using MEDLINE, PsyINFO, CINAHL, Web of Science, and EMBASE databases. Studies were included if they involved adolescents aged 10-19 years, included family members in a key intervention component, evaluated the effectiveness of the interventions using an experimental or quasi-experimental design, assessed ASRH outcomes reported by adolescents and were conducted in LMIC setting. Standardized mean difference (SMD) and 95% confidence intervals were computed and meta-analyses were conducted using random effect models. Results Ten articles involving 2,246 participants were included in the review. The studies were nostly conducted in Africa. Across studies, there was no significant impact of family-based interventions in improving adolescent sexual health knowledge (SMD=0.5, 95%CI: -1.98 to 2.98), attitudes (SMD= -0.05, 95%CI: -1.92 to 1.82), practices (SMD=0.53, 95%CI: -0.69 to 1.75), or sexual communication with their family (SMD= 0.14, 95%CI: -0.42 to 0.7). Although individual studies reported a mixed effect of family-based interventions in improving sexual health outcomes, the pooled results from the meta-analysis showed no significant impact of family-based interventions. Conclusions Our review did not find any significant impact of family-based interventions in improving ASRH in LMIC. We recommend interventions using innovative approaches and novel strategies to align with the socio-cultural and economic background of the study setting. Key messages • This study found no significant impact of family-based interventions in improving ASRH in LMIC. • Additional studies, particularly from Asia, using culturally relevant interventions is required in this area.

Exploring the association between low birthweight and adolescent mental health in the United Kingdom

Abstract Low birthweight (LBW) is associated with a range of medical conditions including behavioural and emotional problems over the life course. This study aimed to explore the association between LBW and internalising and externalising mental health problems (MHP) in adolescents born in the United Kingdom between 2000 and 2002. Data were analysed for 10,485, 9,228, and 8,402 Millennium Cohort Study participants at ages 11, 14 and 17, respectively. Internalising and externalising MHP were measured using the Strengths and Difficulties Questionnaire (SDQ). LBW was subcategorised by size for gestational age and prematurity. Crude and adjusted associations between LBW subgroup and internalising and externalising MHP were estimated using binary logistic regression. Internalising MHP were more prevalent in LBW than NBW participants at ages 11 (14.2% vs 10.3%, p < 0.001), 14 (19.4% vs 13.7%, p < 0.001), and 17 (parent-report: 20.3% vs 14.8%, p < 0.001; self-report: 25.7% vs 20.1%, p < 0.001), respectively. Externalising MHP were more common amongst LBW participants at ages 11 (9.4% vs 7.3%, p = 0.02) and 14 (9.0% vs 6.6%, p = 0.01). Compared with NBW peers, the odds of internalising (males: aOR 2.18, 95% CI 1.21-3.73, p = 0.007; females: aOR 2.17, 95% CI 1.22-3.66, p = 0.005) and externalising MHP (males: aOR 2.01, 95% CI 1.05-3.60, p = 0.014; females: aOR 2.58, 95% CI 1.14-5.24, p = 0.016) were significantly increased in male and female premature small for gestational age (SGA) participants at age 11. Externalising MHP were significantly increased amongst premature SGA females aged 14 (aOR: 2.53, 95% CI 1.01-5.66, p = 0.016). Internalising MHP were significantly increased in premature SGA females at age 17 based on parent (aOR: 2.41, 95% CI 1.38-4.22, p = 0.005) and self-report (aOR: 1.95, 95% CI 1.14-3.31, p = 0.014). Amongst LBW individuals, premature SGA females have the greatest risk of internalising and externalising MHP during adolescence, thus identifying an important target group for intervention. Key messages • This study provides evidence for the longitudinal association between low birth weight and mental health in adolescents born in the United Kingdom in the 21st century. • Stratification of low birth weight individuals by size for gestational age and prematurity enabled the identification of a subgroup of adolescents for mental health promotion.

The Icehearts Europe Implementation Guide to promote a mentoring programme for youth mental health

Abstract Issue/problem In Europe, 9 million young people (10-19) suffer from mental disorders and 70% of children and adolescents with mental health problems do not receive appropriate interventions at a sufficiently early age. Moreover, during the Covid-19 pandemic a high prevalence of depressive symptoms, anxiety and sleep disorders was observed in the population aged 4-19 years. The Icehearts Europe project (funding: EU4Health 2022 Programme) aims to disseminate at EU level a long-term programme for supporting health and wellbeing of disadvantaged children and adolescents. It is inspired by the Finnish best practice Icehearts, a 12-year long mentoring programme. Five pilot countries (Italy, Denmark, Spain, Slovenia, Estonia) will test the model to raise European awareness of how it works and to get more countries and organisations involved. Description of the problem Icehearts Europe is a preventive mentoring programme based on team sports, recreation and school support activities, with a child-centred community approach. To facilitate its implementation, a practical guide has been developed for grassroots sport and social promotion organisations to help them implement the model in their own contexts. The guide is the result of both a multisectoral cooperation between grassroots sport, health, universities, NGOs, and qualitative study activities (bibliographic research, study visit, group work, analysis of the situation and needs of local contexts). Results From February 2024 the Icehearts Europe Implementation Guide is available in six languages at https://www.icehearts.eu/resources. It is now being adapted by the Icehearts Europe partners into an online training programme for managers. Lessons The guide has incorporated lessons learnt from the Finnish model, considered as an evidence-based approach. It contains several operational tools to implement Icehearts Europe and can be adopted using different approaches: there is no one-size-fits-all solution. Key messages • Developed as a support to the Icehearts Europe piloting partners and as a basis for a fully-fledged online training programme for future Icehearts Europe managers. • To facilitate the implementation of early interventions to promote health and wellbeing of children and adolescents and enable them to cope with disadvantaged conditions.

Adolescent mental health literacy and help-seeking behaviours. Cross-Sectional survey in Barcelona

Abstract Background Adolescents’ mental health information and help-seeking is critical for preventing the development of mental disorders. This study aims to examine the relationship between mental health literacy and information and help-seeking behaviours, as well as the effects of age and gender. Methods A cross-sectional online survey on a representative sample of 2,240 secondary school students in Barcelona from 11 randomly selected schools. Participants are evenly distributed by age (25% each course) and gender. Results Most adolescents show good recognition of mental disorders and knowledge of mental health (M = 6.39/10; SD = 1.97 and M = 7.75/10; SD = 1.21 respectively). They report having good literacy (M = 3.25/5; SD = 0.71) to search and manage online health information (eHealth literacy), and around half of them affirm having enough knowledge about mental health for them. Search engines (35.7%) and talking to family/friends (31.8%) are preferred for mental health information-seeking, but 19.8% chose not to engage in active information-seeking behaviour. When having mental health concerns, they prefer seeking help (“I would not ask for help” M = 2.4/7; SD = 1.93), and turning to family (M = 4.7/7; SD = 2.4) and friends (M = 4/7; SD = 2.1), instead of health professionals (M = 2.5/7; SD = 3.5). Chi-square test reveals that: lower recognition of mental disorders is associated with not help-seeking; lower mental health knowledge is associated with beliefs that information for mental health promotion, prevention, and care is unnecessary; and higher eHealth literacy is related to information searching in social media, but not to active searching. The ANOVA test reveals a significant gender-age interaction in certain variables, particularly in the recognition of mental disorders, which is higher in girls and increases with age. Conclusions Higher eHealth literacy is related to information-seeking on social media, but not to active search. Girls have a higher level of recognition of mental disorders. Key messages • Adolescents need a support network to seek mental health help, as they often avoid seeking professional help. • Mental health promotion activities would benefit from further exploration of gender differences.

1.Y.2. Children’s mental health problems explode. Can exposome research offer a solution?

Abstract Background A week-long, multidisciplinary workshop at the Lorentz Institute explored the expectations of exposome research on child health. Exposome research investigates how combined exposures affect health. Currently we see an increase in adolescent mental health problems in Europe. We explore at the workshop if and how exposome research can be part of the solution to tackle this health issue. Findings The workshop aims were to analyze how monitoring data from exposome research can be best used for improving health policy in relation to improving (environmental) health policy in relation to children’s health. By taking a deep dive into solution-finding, we explored creative solutions to better utilize existing exposome data from digital data platforms, such as cohort data. And to facilitate working across disciplines using innovative tools of working transdisciplinary across research, policymakers and other professionals. Furthermore, we study how to enhance, harmonize and interpretation of data on child health. Furthermore, we look how child health depends not only on the quality of a healthcare system, but also on the magnitude of negative or positive influencing factors, such as social and environmental factors. Identifying such stressors and reducing their impact through adequate policies can improve child health on local, national, or even global scales. One innovative way of identifying such stressors is the exposome approach. The exposome approach is the characterization of the non-genetic drivers of health and disease. The exposome comprises aspects of the Built environment (characteristics of where we live); the Social environment (with whom we interact, social networks and income); the Physio-Chemical environment (chemical and environmental factors exposure) and the Lifestyle/Food environment (what we eat, how much we exercise) over the entire life-course. Workshop aims: - Provide a background on the urgency of adolescent mental health problems in Europe. - Compare approaches of stakeholders and researchers: stakeholders’ input from the practical field can shape the approach of the research process. The second benefit is to derive implications for creating effective interventions and policies to prevent adverse effects of environmental exposures and to foster positive health in children and later in life. - Explore existing interventions on child health for issues, experiences and possible solutions to the governance and organization of health adaptation in urban and social planning. - How to act in the process of research to intervention to public policies. The workshop consists of three short presentations followed by interactive panel discussions. We end with the audience actively engaging in the debate, as well as entering their questions. The workshop will end by identifying the current and future necessary roles, responsibilities, capacities of the public health researchers, policymakers, and professionals for child health protection in complicated exposure settings. Key messages • Child mental health issues are increasing in an unexplainable way. • Engaging stakeholders into an exposome research process can help to form a child health strategy in Europe.