Adolescents In Scotland Research Articles

Associations Between Recent Contraceptive Use and First Sex Behaviors of Scottish Adolescents: A Brief Report

Objectives We examined associations between recent contraceptive use and first-sex behaviors (early initiation, substance use, contraceptive use) among adolescents in Scotland. Methods We used data from the Health Behavior in School-aged Children study. Results Controlling for early initiation and substance use, girls and boys who used contraceptives at first sex were 7.5 and 12.3 times more likely to use contraceptives at most recent sexual intercourse than adolescents who did not (p < .001). We also present preliminary evidence on contraceptive use of Scottish adolescents in 2022. Conclusions Experiences during adolescents’ first sex may have lasting implications for later sexual behavior.

Peer effects on health-related behaviours of adolescents in Scotland using social network analysis: a cross-sectional study

BackgroundPrevious research suggests that adolescent norms and behaviours may be influenced by peers. The aim of this study was to investigate social clustering of health outcomes among school friendship groups. MethodsCross-sectional surveys were collected from Oct 26, 2022, to March 30, 2023, in four secondary schools in Scotland's central belt, and all Secondary 2 (12–13 years) and Secondary 4 (14–15 years) students were invited to take part. Schools self-selected into the study, between 6% and 27% had a free school meal registration (Scotland average 25%). The survey asked about health and about friendships in school. The outcomes of interest were binary indicators of: mental health and self-esteem using validated scales, smoking, drinking without parents knowing (DWPK), and trying drugs. Ethics approval for the study was given by the University of Glasgow (200190035) and all participants gave consent via an online form. We used Auto-Logistic Actor Attribute Models (ALAAMs) to model the association between features of individuals’ social networks and their health outcomes. We specified a model for each health outcome separately including parameters: indegree, outdegree, and simple contagion, and combined using meta-analysis. FindingsResponse rate was 74% (n=1097; 50% boys, 46% girls, 4% other). Based on self-report measures, 40% participants had poor mental health, 15% had low self-esteem, 6% smoked regularly, 4% tried drugs, and 18% were drinking without parents knowing. Preliminary unadjusted analysis found evidence of social contagion for mental health. Odds of poor mental health for each additional friend with poor mental health was 1·15 (95% CI 1·05–1·26). There was no evidence of contagion for self-esteem (1·13, 0·95–1·34), smoking (1·14, 0·46–2·82), DWPK (0·88, 0·71–1·10), and having tried drugs (0·91, 0·38–2·19). Some networks had low or zero prevalence of the outcomes, increasing the uncertainty in the pooled estimate for the contagion parameter. InterpretationA cross-sectional study cannot differentiate between social contagion and selecting similar friends, and low prevalence and social desirability bias might have masked associations. However, the unique combination of social network data with advanced statistical modelling gives initial findings on the potential communicable nature of mental health and health behaviours in adolescence. Preliminary results indicate preventive approaches in schools could benefit from social network methods. FundingMedical Research Council (MRC) and Chief Scientist Office (CSO).

Inequalities in health complaints: 20-year trends among adolescents in Scotland, 1998-2018.

This study examined trends in inequalities in health complaints among early adolescents in Scotland from 1998 to 2018. We analysed data from the Health Behaviour in School-aged Children (HBSC) survey conducted in Scotland in 1998, 2002, 2006, 2010, 2014 and 2018. A self-report questionnaire was administered in schools to a nationally representative sample of 11-, 13-, and 15-year-olds (n = 29,250). Health complaints were measured using a scale comprising four psychological symptoms (feeling low, feeling nervous, irritability and sleep difficulties) and four somatic symptoms (headache, backache, stomachache and dizziness). Socio-economic status was measured using the Family Affluence Scale. Between 1998 and 2018, there were significant increases in the proportion of girls and boys reporting feeling low, feeling nervous, sleep difficulties and backache. Prevalence of the eight individual health complaints was higher among girls and adolescents from lower affluence families. Socio-economic inequalities increased over time, such that declines in mental health were greatest among low affluence adolescents. The data show worsening trends in health complaints among Scottish adolescents between 1998 and 2018, particularly for girls and adolescents from low affluence families. Increasing inequalities in mental health highlight the need to address the underlying social and structural determinants of adolescent mental health.

Vaccine effectiveness of two-dose BNT162b2 against symptomatic and severe COVID-19 among adolescents in Brazil and Scotland over time: a test-negative case-control study

BackgroundLittle is known about vaccine effectiveness over time among adolescents, especially against the SARS-CoV-2 omicron (B.1.1.529) variant. This study assessed the associations between time since two-dose vaccination with BNT162b2 and the occurrence of symptomatic SARS-CoV-2 infection and severe COVID-19 among adolescents in Brazil and Scotland.MethodsWe did test-negative, case-control studies in adolescents aged 12–17 years with COVID-19-related symptoms in Brazil and Scotland. We linked records of SARS-CoV-2 RT-PCR and antigen tests to national vaccination and clinical records. We excluded tests from individuals who did not have symptoms, were vaccinated before the start of the national vaccination programme, received vaccines other than BNT162b2 or a SARS-CoV-2 booster dose of any kind, or had an interval between their first and second dose of fewer than 21 days. Additionally, we excluded negative SARS-CoV-2 tests recorded within 14 days of a previous negative test, negative tests recorded within 7 days after a positive test, any test done within 90 days after a positive test, and tests with missing sex and location information. Cases (SARS-CoV-2 test-positive adolescents) and controls (test-negative adolescents) were drawn from a sample of individuals in whom tests were collected within 10 days of symptom onset. We estimated the adjusted odds ratio and vaccine effectiveness against symptomatic COVID-19 for both countries and against severe COVID-19 (hospitalisation or death) for Brazil across fortnightly periods.FindingsWe analysed 503 776 tests from 2 948 538 adolescents in Brazil between Sept 2, 2021, and April 19, 2022, and 127 168 tests from 404 673 adolescents in Scotland between Aug 6, 2021, and April 19, 2022. Vaccine effectiveness peaked at 14–27 days after the second dose in both countries during both waves, and was significantly lower against symptomatic infection during the omicron-dominant period in Brazil (64·7% [95% CI 63·0–66·3]) and in Scotland (82·6% [80·6–84·5]), than it was in the delta-dominant period (80·7% [95% CI 77·8–83·3] in Brazil and 92·8% [85·7–96·4] in Scotland). Vaccine efficacy started to decline from 27 days after the second dose for both countries, reducing to 5·9% (95% CI 2·2–9·4) in Brazil and 50·6% (42·7–57·4) in Scotland at 98 days or more during the omicron-dominant period. In Brazil, protection against severe disease remained above 80% from 28 days after the second dose and was 82·7% (95% CI 68·8–90·4) at 98 days or more after receiving the second dose.InterpretationWe found waning vaccine protection of BNT162b2 against symptomatic COVID-19 infection among adolescents in Brazil and Scotland from 27 days after the second dose. However, protection against severe COVID-19 outcomes remained high at 98 days or more after the second dose in the omicron-dominant period. Booster doses for adolescents need to be considered.FundingUK Research and Innovation (Medical Research Council), Scottish Government, Health Data Research UK BREATHE Hub, Fiocruz, Fazer o Bem Faz Bem programme, Brazilian National Research Council, and Wellcome Trust.TranslationFor the Portuguese translation of the abstract see Supplementary Materials section.

TeenCovidLife:a resource to understand the impact of the COVID-19 pandemic on adolescents in Scotland.

TeenCovidLife is part of Generation Scotland's CovidLife projects, a set of longitudinal observational studies designed to assess the psychosocial and health impacts of the COVID-19 pandemic. TeenCovidLife focused on how adolescents in Scotland were coping during the pandemic. As of September 2021, Generation Scotland had conducted three TeenCovidLife surveys. Participants from previous surveys were invited to participate in the next, meaning the age ranges shifted over time. TeenCovidLife Survey 1 consists of data from 5,543 young people age 12 to 17, collected from 22 May to 5 July 2020, during the first school closures period in Scotland. TeenCovidLife Survey 2 consists of data from 2,245 young people aged 12 to 18, collected from 18 August to 14 October 2020, when the initial lockdown measures were beginning to ease, and schools reopened in Scotland. TeenCovidLife Survey 3 consists of data from 597 young people age 12 to 19, collected from 12 May to 27 June 2021, a year after the first survey, after the schools returned following the second lockdown in 2021. A total of 316 participants took part in all three surveys. TeenCovidLife collected data on general health and well-being, as well as topics specific to COVID-19, such as adherence to COVID-19 health guidance, feelings about school closures, and the impact of exam cancellations. Limited work has examined the impact of the COVID-19 pandemic on young people. TeenCovidLife provides relevant and timely data to assess the impact of the pandemic on young people in Scotland. The dataset is available under authorised access from Generation Scotland; see the Generation Scotland website for more information.

TeenCovidLife: a resource to understand the impact of the COVID-19 pandemic on adolescents in Scotland

TeenCovidLife is part of Generation Scotland’s CovidLife projects, a set of longitudinal observational studies designed to assess the psychosocial and health impacts of the COVID-19 pandemic. TeenCovidLife focused on how adolescents in Scotland were coping during the pandemic. As of September 2021, Generation Scotland had conducted three TeenCovidLife surveys. Participants from previous surveys were invited to participate in the next, meaning the age ranges shifted over time. TeenCovidLife Survey 1 consists of data from 5,543 young people age 12 to 17, collected from 22 May to 5 July 2020, during the first school closures period in Scotland. TeenCovidLife Survey 2 consists of data from 2,245 young people aged 12 to 18, collected from 18 August to 14 October 2020, when the initial lockdown measures were beginning to ease, and schools reopened in Scotland. TeenCovidLife Survey 3 consists of data from 597 young people age 12 to 19, collected from 12 May to 27 June 2021, a year after the first survey, after the schools returned following the second lockdown in 2021. A total of 316 participants took part in all three surveys. TeenCovidLife collected data on general health and well-being, as well as topics specific to COVID-19, such as adherence to COVID-19 health guidance, feelings about school closures, and the impact of exam cancellations. Limited work has examined the impact of the COVID-19 pandemic on young people. TeenCovidLife provides relevant and timely data to assess the impact of the pandemic on young people in Scotland. The dataset is available under authorised access from Generation Scotland; see the Generation Scotland website for more information.

What do the potential recipients of disclosure of OSA say? Perspectives from adolescent residents in Scotland and Chile

BackgroundWith the increase in internet use, new forms of child victimization like Online Sexual Abuse (OSA) have emerged. Children and adolescents rarely disclose these incidents and most disclosure happens around peers. ObjectiveThis research addresses the perspective of adolescents (not victims of OSA), potential recipients of the disclosure, within the context of disclosure of OSA committed by either adult or peer perpetrators. MethodsThe study was performed in two stages. We interviewed adolescents in Scotland and then conducted focus groups with adolescents from Chile. Participants and setting51 adolescents (6 from Scotland and 45 from Chile) aged 15–20 years participated. ResultsDespite differences in age and cultural contexts, there were similarities in responses. Obstacles of disclosure included lack of clarity of OSA, prior levels of personal vulnerability, and gender factors (stereotypes and stigmatization). On the other hand, the disclosure process would be easier for adolescents with more personal resources (e.g. self-confidence) and when they have a supportive social environment, which includes parents, but especially peers. ConclusionDisclosure of OSA is considered similar to the disclosure of offline sexual abuse. However, differences such as a lack of clarity regarding the boundaries of the relationships on the Internet, and presence of a generational gap between adolescents and their parents or tutors in the use of internet makes early disclosure of OSA highly challenging. Plans to facilitate disclosure should consider different components: behavioral (risky behaviors), emotional (feelings of fear and shame) and cognitive (lack of information, self-blame, stigma). This should be focused on adolescents, potential recipients of disclosure (parents, authorities and peers) and society, where the prejudices and practices that prevent disclosure begin.

Reactions to, and trial intentions for, three dissuasive cigarette designs: A cross-sectional survey of adolescents in Scotland

Objectives There has been growing academic and policy interest in opportunities to decrease the appeal of cigarette sticks, such as making them an unattractive colour or requiring them to display a health warning. We therefore explored reactions to, and trial intentions for, three ‘dissuasive’ cigarette designs among adolescents in Scotland. Methods A cross-sectional survey with 12–17 year olds in Scotland (n=594) was conducted between November 2017 and November 2018. Participants were shown one ‘standard’ cigarette (imitation cork filter with white paper casing) and three dissuasive cigarettes: (1) a cigarette with the warning ‘smoking kills’; (2) a cigarette with the warning ‘toxic’ and a skull and cross-bones image and (3) a dark green cigarette. Participants rated each cigarette on nine five-point reaction measures (eg, appealing/unappealing or attractive/unattractive). A composite reaction score was computed for each cigarette, which was binary coded (overall negative reactions vs neutral/positive reactions). Participants also indicated whether they would try each cigarette (coded: Yes/No). Demographics, smoking status and smoking susceptibility were also measured. Results More participants had negative reactions to the dark green (93% of adolescents), ‘smoking kills’ (94%) and ‘toxic’ (96%) cigarettes, compared with the standard cigarette (85%). For all three dissuasive designs, Chi-square tests found that negative reactions were more likely among younger adolescents (vs older adolescents), never-smokers (vs ever smokers) and non-susceptible never-smokers (vs susceptible never-smokers). Most participants indicated that they would not try any of the cigarettes (range: 84%–91%). Conclusion Dissuasive cigarettes present an opportunity to further reduce the appeal of smoking among adolescents.

Reactions to standardised cigarette packs with varying structural designs, and the association with smoking susceptibility: A post-implementation cross-sectional survey with never-smoking adolescents in Scotland

INTRODUCTION From May 20, 2017, cigarettes in the United Kingdom must be sold in standardized (plain) packaging. We explore postimplementation reactions to standardized cigarette packaging among never-smokers in Scotland, whether reactions vary in relation to permitted variations in pack structure, and whether reactions are associated with susceptibility. AIMS AND METHODS A cross-sectional survey with 12-17-year-old never-smokers (n = 507) in Scotland, conducted November 2017-November 2018. Participants were shown one "regular" standardized cigarette pack (flip-top lid and straight-edged pack, similar to designs in Australia) and three standardized packs with varied pack structures (beveled-edges, slim pack, and shoulder box), which are permitted postimplementation in the United Kingdom. Participants rated each pack on eight five-point reaction measures (eg, attractiveness). Participants also indicated which pack, if any, they would choose. Smoking susceptibility was the outcome. RESULTS The mean reaction scores for all four packs were mostly negative, however the shoulder box was consistently rated less negatively than the regular, slim, or beveled-edge packs. Most participants (87%) said they would not select any of the four packs, although susceptible participants were more likely to select one than nonsusceptible participants (25% vs. 7%; χ 2 = 29.70; p < .001). For all four packs, not finding them off-putting was associated with susceptibility (Adjusted Odds Ratio range: 2.73-3.69), albeit only a minority of adolescents did not find each pack off-putting. CONCLUSIONS Adolescents have negative reactions to the standardized cigarette packs implemented in the United Kingdom, albeit permitted variations in structure can reduce the extent of negativity. Most reactions to standardized packaging had no association with susceptibility. IMPLICATIONS We provide the first empirical evidence that adolescents find the standardized cigarette packs implemented in the United Kingdom unappealing and that most pack reactions have no association with susceptibility among never-smokers, with the exception of the minority who did not think that they would put them off smoking. This suggests that the legislation is achieving one of its primary aims, to reduce the appeal of packaging. That permitted variations in pack structure (eg, shoulder boxes) somewhat reduce negative reactions suggests that the United Kingdom, and other countries introducing similar legislation, should ensure that all aspects of pack design are fully standardized.

Reactions to, and trial intentions for, three dissuasive cigarette designs: a cross-sectional survey of adolescents in Scotland

ObjectivesThere has been growing academic and policy interest in opportunities to decrease the appeal of cigarette sticks, such as making them an unattractive colour or requiring them to display a...

Reactions to Standardized Cigarette Packs With Varying Structural Designs, and the Association With Smoking Susceptibility: A Postimplementation Cross-Sectional Survey With Never-Smoking Adolescents in Scotland.

From May 20, 2017, cigarettes in the United Kingdom must be sold in standardized (plain) packaging. We explore postimplementation reactions to standardized cigarette packaging among never-smokers in Scotland, whether reactions vary in relation to permitted variations in pack structure, and whether reactions are associated with susceptibility. A cross-sectional survey with 12-17-year-old never-smokers (n = 507) in Scotland, conducted November 2017-November 2018. Participants were shown one "regular" standardized cigarette pack (flip-top lid and straight-edged pack, similar to designs in Australia) and three standardized packs with varied pack structures (beveled-edges, slim pack, and shoulder box), which are permitted postimplementation in the United Kingdom. Participants rated each pack on eight five-point reaction measures (eg, attractiveness). Participants also indicated which pack, if any, they would choose. Smoking susceptibility was the outcome. The mean reaction scores for all four packs were mostly negative, however the shoulder box was consistently rated less negatively than the regular, slim, or beveled-edge packs. Most participants (87%) said they would not select any of the four packs, although susceptible participants were more likely to select one than nonsusceptible participants (25% vs. 7%; χ 2 = 29.70; p < .001). For all four packs, not finding them off-putting was associated with susceptibility (Adjusted Odds Ratio range: 2.73-3.69), albeit only a minority of adolescents did not find each pack off-putting. Adolescents have negative reactions to the standardized cigarette packs implemented in the United Kingdom, albeit permitted variations in structure can reduce the extent of negativity. Most reactions to standardized packaging had no association with susceptibility. We provide the first empirical evidence that adolescents find the standardized cigarette packs implemented in the United Kingdom unappealing and that most pack reactions have no association with susceptibility among never-smokers, with the exception of the minority who did not think that they would put them off smoking. This suggests that the legislation is achieving one of its primary aims, to reduce the appeal of packaging. That permitted variations in pack structure (eg, shoulder boxes) somewhat reduce negative reactions suggests that the United Kingdom, and other countries introducing similar legislation, should ensure that all aspects of pack design are fully standardized.

Adolescents’ perceptions of tobacco accessibility and smoking norms and attitudes in response to the tobacco point-of-sale display ban in Scotland: results from the DISPLAY Study

BackgroundScotland implemented a ban on open display of tobacco products in supermarkets in April 2013, and small shops in April 2015. This study aimed to quantify changes in perceived tobacco...

Adolescents in Scotland: Challenges and Opportunities for Sexual Risk Reduction.

Sexually transmitted infections, HIV, and unplanned pregnancy challenge the health of Scottish teens. We conducted focus groups with teens (ages 16-19 years) recruited from an urban youth cafe in Edinburgh and assessed sexual risk-taking and protective behaviors. A trained facilitator, using a semi-structured interview guide, led the groups. We taped and transcribed data verbatim for coding and theming. The teens revealed similar concerns despite differences in gender and/or sexual histories. Despite school-based sex education, sex was rarely discussed with peers or adults outside classrooms; the ability to practice communication and negotiation skills was minimal. Much risky behavior occurred in public spaces and was often linked to drug or alcohol intake. There was a glaring lack of teen planning for, or contemplating, future adult lives. Findings highlight the challenges these teens faced in practicing safer sex and limited opportunities to tailor intervention strategies to address the cultural realities of their lives.

Assessing sectarian attitudes among Catholic adolescents in Scotland

ABSTRACT Sectarianism is perceived as a serious issue in Scotland despite a lack of concrete evidence, according to the Advisory Group on Tackling Sectarianism. This paper addresses one of the gaps in knowledge, the attitudes of Catholic school pupils. Our research was designed to profile sectarian attitudes among a sample of Catholic school pupils in Scotland, using our own newly designed Scale of Catholic Sectarian Attitudes. The research assessed the influence of five sets of factors on shaping individual differences in sectarian attitudes: personal factors (sex and age), psychological factors (personality), religious factors (identity, belief, and practice), theological factors (exclusivism), and contextual factors (Catholic schools). The study draws on data provided by 797 13- to 15-year-old school pupils from schools in Scotland who self-identified as Roman Catholic. We offer a new tool for measuring attitudes to sectarianism and also findings that demonstrate that sectarian attitudes exist within the young Catholic community in Scotland and that this has possibly become part of a wider problem generated by the public visibility of religious diversity within an increasingly secular society. Further we find that Sectarian attitudes are higher among males than among females and are higher among nominal Catholics than among practising Catholics.

Clustering of lifetime substance use and sexual intercourse among young people: Analysis of two school-based surveys

Adolescents commonly engage in substance use and sexual behaviors which pose risks for their health. Secondary data analysis of two school-based surveys explored the clustering of lifetime use of cigarettes, alcohol, cannabis, and engagement in sexual intercourse among 2,489 adolescents in Scotland and 1,405 adolescents in Northern Ireland. All four behaviors were clustered with substantially higher prevalence than expected (11 and 24 times higher, respectively). Multiple logistic regression models indicated associations of the four-behavior cluster with sociodemographic factors, with family structure operating as a predictor of clustering across the sample and deprivation operating as a predictor for the Scottish sample. This suggests a need to focus on the interdependence of risk behaviors and factors associated with engagement in risk clusters in distinct cultural settings.

Effect of seeing e-cigarettes in small shops on probability of e-cigarette experimentation by 1 year follow up in adolescents in Scotland, UK

Effect of seeing e-cigarettes in small shops on probability of e-cigarette experimentation by 1 year follow up in adolescents in Scotland, UK

Tobacco outlet density and tobacco knowledge, beliefs, purchasing behaviours and price among adolescents in Scotland

Despite long-term falls in global adult smoking prevalence and over 50 years of tobacco control policies, adolescent smoking persists. Research suggests greater densities of tobacco retail outlets in residential neighbourhoods are associated with higher adolescent smoking rates. Policies to reduce retail outlets have therefore been identified by public health researchers as a potential ‘new frontier’ in tobacco control. Better understanding of the pathways linking density of tobacco retailers and smoking behaviour could support these policies.In this study we use path analysis to assess how outlet density in the home environment is related to adolescent tobacco knowledge, beliefs, retail purchases and price in Scotland. We assessed 22,049 13 and 15 year old respondents to the nationally representative cross-sectional 2010 Scottish School Adolescent Lifestyle and Substance Use Survey. Outlet density was based on Scottish Tobacco Retailers Register, 2012, data. A spatially-weighted Kernel Density Estimation measure of outlet density within 400 m of respondents’ home postcode was grouped into tertiles. The analysis considered whether outlet density was associated with the number of cigarette brands adolescents could name, positive beliefs about smoking, whether smokers purchased cigarettes from shops themselves or through adult proxies and perceived cost of cigarettes. Models were stratified by adolescent smoking status.The path analyses indicated that outlet density was not associated with most outcomes, but small, significant direct effects on knowledge of cigarette brands among those who had never smoked were observed. With each increase in outlet density tertile the mean number of brands adolescents could name rose by 0.07 (mean = 1.60; SD = 1.18; range = 4). This suggests greater outlet densities may have affected adolescents' knowledge of cigarette brands but did not encourage positive attitudes to smoking, purchases from shops or lower cigarette prices. Exposure to tobacco outlets may influence adolescents’ awareness of tobacco products, a potential pathway to smoking behaviour.

Epidemiological trends and risk factors for tobacco, alcohol and drug use among adolescents in Scotland, 2002-13.

This study estimates trends in prevalence, and patterns, of individual and multiple substance use between 2002 and 2013 amongst adolescents in Scotland. The study uses data from 134 387 participants of the biennial national 'Scottish Schools Adolescent Lifestyle and Substance Use Survey' on smoking, alcohol and illicit drug use. Current regular use and current heavy use of smoking, alcohol, illicit drugs and multiple substances was measured. Time trends in the prevalence of each outcome were estimated using univariate and multivariate logistic regression. Regular smoking, alcohol, illicit drug and multiple substance use declined significantly amongst adolescents in Scotland. However, multivariate analyses that focussed upon high-risk levels of these behaviours revealed an upward linear trend in heavy alcohol (OR = 1.06; 95% CI: 1.04, 1.07) and heavy illicit drug (OR = 1.04; 95% CI: 1.00, 1.08) use (P < 0.05). Non-white pupils were more likely to be involved in individual and multiple substance use than ethnically white British pupils. In comparison to pupils from the least deprived socioeconomic quintile, pupils from the most deprived quintile had increased odds of 1.41 (95% CI: 1.02, 1.97; P < 0.05) and 1.62 (95% CI: 1.14, 2.29; P < 0.05) of being regular and heavy multiple substance users, respectively. Further effort is required to tackle heavy alcohol and heavy illicit drug use amongst adolescents in Scotland. Prevention strategies should be informed by the risk profiles of substance misusers and evidence around the clinical and cost-effectiveness of preventive interventions.

Results from Scotland's 2018 Report Card on Physical Activity for Children and Youth.

Previous Active Healthy Kids Scotland Report Cards from 2013 and 2016 (www.activehealthykidsscotland.co.uk) demonstrated that only a small minority of Scottish school-aged children and adolescents meet the recommended amount of daily moderate-tovigorous intensity physical activity (MVPA; ≥60 minutes). These low levels of MVPA occur despite a favorable physical and policy environment in Scotland. Previous report cards also identified major limitations in surveillance of physical activity and related behaviors in Scotland. The aim of this short paper is to (a) summarize the Scottish grades included in the Global Matrix 3.0 (www.activehealthykids.org) and (b) highlight the continuing limitations in surveillance of physical activity among children and adolescents in Scotland.

Time-trends in rates of hospital admission of adolescents for violent, self-inflicted or drug/alcohol-related injury in England and Scotland, 2005-11: population-based analysis.

Incidence of emergency admissions for violent injury in 10- to 18-year olds decreased in England and Scotland between 2005 and 2011, but more steeply in Scotland. To generate hypotheses about causes of these differences, we determined whether trends were consistent across admissions for three common types of adversity-related injury (violent, self-inflicted and drug/alcohol-related). Emergency admissions to NHS hospitals were captured using Hospital Episode Statistics and Scottish Morbidity Records. Adversity-related injury was defined using ICD-10 codes. Analyses were stratified by sex/age groups (10-12, 13-15 and 16-18 years) and adjusted for background trends in admissions for injury. During 2005-11, rates declined in all sex/age groups in Scotland (reductions adjusted for background trends ranged from -22.0 to -103.7/100 000) and in girls and boys aged <16 years in England (adjusted reductions -12.0 to -49.9/100 000). However, these rates increased in England for both sexes aged 16-18 years (adjusted increases, girls 71.8/100 000; boys 28.0/100 000). However, throughout 2005-11 overall rates remained relatively similar in England and Scotland for both sexes aged <16 years, and remained higher in Scotland for both sexes aged 16-18 years. A greater decline in the rates of emergency admissions for adversity-related injury for adolescents in Scotland compared with England could signal more effective policies in Scotland for reducing violence, self-harm, or drug/alcohol misuse, particularly for 16 to 18-year olds.