Health Behaviour In School-aged Children Research Articles

How Family Structure Can Influence Adolescents’ Eating Habits: An Italian Health Behaviour in School-Aged Children (HBSC) 2022 Sample

Background/Objectives: Adolescence is an important period of psychophysical development. In this phase of life people acquire greater self-awareness and adopt behaviors that will later shape their lifestyle in adulthood. This study aimed to assess whether family structure can influence adolescents’ eating habits. Methods: Data were acquired from a survey titled ‘Italian Health Behaviour in School-aged Children’ (HBSC) given to a representative sample of Tuscan adolescents aged 11, 13, 15 and 17 years of age. Participants (3210) filled out a validated questionnaire answering questions about their eating habits and family structure. After adjusting for covariates, some interesting trends were highlighted in the survey results. Results: Adolescents living in single-mother families reported a lower intake of fruits (OR 0.68, 95% CI = 0.55–0.83) and vegetables (OR 0.66, 95% CI = 0.53–0.81) and a higher intake of sugar-added soft drinks (OR 1.33, 95% CI = 1.08–1.64). Living in a mother and stepfather family was associated with a higher intake of sugar-added soft drinks (OR 1.53, 95% CI = 1.02–2.28), whereas living in a father and stepmother family was associated only with a lower intake of fruits (OR 0.48, 95% CI = 0.26–0.87). Participants living with other family types reported a lower intake of vegetables (OR 0.68, 95% CI = 0.47–0.98). Conclusions: The results of this study show a correlation between family structure and adolescents’ eating habits.

Weight status and psychosomatic complaints in Swedish adolescent boys and girls: does family support play a buffering role?

BackgroundPsychosomatic complaints have increased among adolescents in recent decades, as have overweight and obesity rates. Both of these trends are regarded as public health concerns. However, the associations between weight status and psychosomatic complaints are not yet clear, necessitating further research. The aim of the present study was to investigate the associations between weight status and psychosomatic complaints in Swedish adolescent boys and girls, as well as to explore the potential buffering effect of family support.MethodsThe data was obtained from the cross-sectional Swedish Health Behaviour in School-aged Children (HBSC) study conducted in 2017/18, which involved 3,135 students aged 11, 13, and 15 years. Weight status was based on self-reported information on weight and height, which allowed for the calculation of body mass index (BMI) and the categorisation of participants into three groups: non-overweight, overweight, and obese. Psychosomatic complaints were assessed based on information regarding the frequency of eight different complaints, which were summed into an index. Family support was measured using three items describing the level of perceived emotional support, and an index was created, which was dichotomised into low and high family support. Gender stratified linear regression models were run to examine the associations between weight status and psychosomatic complaints. Age and family affluence were included as covariates. Interaction terms were included to evaluate whether family support moderated the main association.ResultsObesity was associated with higher levels of psychosomatic complaints in both boys and girls when compared to being non-overweight (boys: b = 2.56, 95% CI 0.32, 4.79; girls: b = 3.35, 95% CI 0.77, 5.94), while being overweight did not show any statistically significant associations with the outcome (boys: b = 0.21, 95% CI -0.72, 1.15; girls: b = 0.78, 95% CI -0.42, 1.98). In girls, a statistically significant interaction effect between family support and weight status was observed (p = 0.031), indicating that family support buffered against psychosomatic complaints in girls with obesity. No statistically significant interaction was found for boys (p = 0.642).ConclusionsThe findings of this study highlight the importance of public health initiatives aimed at preventing childhood obesity. They also underscore the significant role of family support in reducing psychosomatic complaints among adolescents with obesity. Further research is necessary to gain a deeper understanding of these relationships.

Digital health literacy and health behaviour of schoolchildren: A representative study in Germany

Abstract Background Health information is increasingly available and plays a crucial role in making health decisions and developing healthy behaviours. Digital health literacy (DHL) enables one to distinguish between true and false health information online. Studies have found higher health literacy to be associated with healthier behaviour. However, there is no research on child DHL and health behaviour. This study aims to investigate the relationship between DHL and selected health behaviour of schoolchildren in Germany. Methods This cross-sectional study is based on a representative sample of (N = 1448) secondary schoolchildren (aged 9-18 years) in Germany across all 16 federal states and school forms. DHL was assessed using the child and adolescent version of the Digital Health Literacy Instrument developed and pretested in this study. Selected health behaviours (eating, teeth brushing, smoking, and alcohol consumption) were measured using self-report scales. Chi-square tests were conducted to measure differences between DHL and health behaviour. Results Associations were found between DHL and all eating behaviours (fruits; vegetables and salad; whole-grain products; other animal-based products; chocolate or other sweets; sugary drinks; fast food), except for eating meat and sausages. Schoolchildren with higher levels of DHL reported more often about regular consumption of fruits and vegetables (X2 (2)=17.06, p = <.001). salads (X2 (2)=56.54 p = <.001) and whole-grain-products (X2 (2)=98.81 p = <.001). While DHL was associated with teeth brushing (X2 (2)=44.46, p = <.001), no differences were observed for smoking (X2 (2)=1.93, p=.381) and drinking alcohol within the last 30 days (X2 (2)=2.62, p=.270). Conclusions These findings indicate that most health behaviours of schoolchildren may benefit from enhancing DHL in schools. Programs should build around these topics. However, more research is needed to investigate associations between DHL and health behaviours comprehensively.

Sleep difficulties as a universal risk factor for injury among adolescents in 46 countries

Abstract Background Poor sleep is common among adolescents and associated with unintentional injuries. The current evidence base is limited by differences in measures of sleep and injury implemented across studies. We examined the potential universality of the relationship between poor sleep and injury cross-nationally using self-reports from 229,589 adolescents in 46 countries that were collected using common procedures and measures. Methods A cross-sectional study was conducted using records from the 2017/18 Health Behaviour in School-aged Children (HBSC): World Health Organization cross-national study. The prevalence of sleep indicators (difficulties in falling asleep, insufficient sleep, social jet lag) and medically treated injuries (overall, multiple) were described across countries and by gender. Multivariable modified Poisson regression analyses were conducted within and across countries to test the consistency of the association between poor adolescent sleep and injuries. Results Overall, indicators of poor sleep were reported by nearly half of adolescents, and varied by gender and across countries. Country-level analyses found consistently positive associations between indicators of poor sleep and injuries. Pooled (multi-country) analyses further demonstrated a universality of these relationships across sleep indicators and injury outcomes. The strength of relationships varied by gender, with more robust associations detected among girls compared to boys. Conclusions Poor sleep is a robust and mainly consistent risk factor for injury among adolescents across countries and regions. Public health officials and policymakers should therefore recognize adolescent sleep as a health priority. The promotion of sleep hygiene may represent a novel target for injury prevention at regional and national levels. Key messages • Poor sleep, in the form of sleep difficulties, insufficient sleep, and social jet lag, were robust and mainly consistent injury risk factors among adolescents across 46 countries. • Public health officials should recognize sleep hygiene as a novel focus for adolescent injury prevention.

Are answers affected by data collection on paper or online? The case of Belgian adolescents

Abstract Background In the early 2000s, the prevalence estimations were compared in relation with the mode of data collection, i.e. paper or online. Following the widely spread routine use of connected devices, especially in adolescents, such a monitoring is of interest. Within the 2022 “Health Behaviour in school-aged children” survey in French-speaking primary and secondary schools of Belgium, those participating could choose between paper and online collection. Our objective was to compare a large set of indicators between the two modes after adjusting for the students’ characteristics. Methods After a two-stage random selection of schools and classes, 11,751 10-to-20-year-old adolescents completed the questionnaire either on paper or online. Descriptive analysis and comparisons were conducted using chi2 and multiple logistic regressions adjusted for the students’ sociodemographic characteristics that may vary according to the questionnaire mode. Results Overall, 54.9% of the questionnaires were completed online. The choice of the collection mode provided to the schools’ headteachers was associated with the adolescents’ characteristics. Those who completed the questionnaire online were more likely to be in secondary schools, in Wallonia, and of a more favourable socioeconomic profile. After adjustments, no difference in the indicators regarding health, well-being, substance use, or sleep duration was observed. Conversely, a difference was observed for screen time (internet ≥2h/weekday: 70.4% on paper vs. 72.3% online; adjusted P-value: 0.02), some food groups (daily vegetables: 51.2% vs. 58.0%; P-value<0.001) and body weight status (overweight including obesity: 16.7% vs. 14.0%; P-value<0.001). Conclusions In some circumstances such as data collection in the school setting, mixed modes are still necessary due to operational issues. While most indicators did not show a difference between online and paper collection, potential implications for others need to be further understood. Key messages • Collecting data through online or paper questionnaires does not lead to major differences in prevalence estimates. • With the rise of online surveys, further assessment is required to understand the potential declaration biases.

Unlocking adolescent dietary behaviours: the causal role of social contexts

Abstract Background Using a causal inference framework, our study aimed to extend previous work in providing a comprehensive understanding of the role various social contexts across different levels can play in predicting adolescent dietary behaviours. Methods Data came from the 2017/18 Health Behaviour in School-aged Children (HBSC) survey in Flanders (Belgium). The sample included representative data from 8,702 adolescents in 165 schools. Social factors at individual-level (family meals, family, peer, student and teacher support) and at contextual-level (school culture of student and teacher support and school-level socioeconomic status [SES]) were considered. Multilevel logistic regression analyses were performed. Results At individual-level, family meals and family and student support were positively associated with fruit and vegetable consumption, family meals with sweet consumption too. Student and teacher support showed positive associations solely with fruit consumption. At contextual-level, adolescents attending schools with a lower school-SES demonstrated lower vegetable consumption. Culture of teacher support was negatively associated with sweets but also vegetable consumption. For culture of student support no associations were found. Conclusions The study mainly provide cues for strengthening family social ties as dietary health promotion initiatives, with some evidence supporting the role of beneficial peer and school social factors. Mixed results for contextual school-level social factors warrant further research to identify additional school-related influences on adolescent dietary behaviours to advance current understandings. Key messages • Family meals and support promote healthy eating in adolescents, emphasising the health promoting role of family social ties in dietary habits. • Mixed findings on school-level social factors call for more research on school health policies.

Risk of eating disorders and body image in adolescents in Belgium: is migration status a modifier?

Abstract Background The risk of eating disorders (ED) has been linked to body image (BI) dissatisfaction in adolescents. In addition, the origin and host country culture may influence BI dissatisfaction. Our objective was to assess the modifying effect of migratory status on the association between BI and risk of ED in Belgium, a setting characterized by a large proportion of migrant adolescents. Methods In the 2022 cross-sectional “Health Behaviour in School-aged Children” (HBSC) study in French-speaking schools, 7,267 adolescents aged 12 to 20 self-completed questionnaires. Risk of ED was determined by an Eating Attitude Test (EAT-7), score ≥5. BI was categorised into 3 groups: “too thin”, “about the right size” and “too fat”. Migratory status was divided into “native”, “2nd generation” and “1st generation” migrants. The association between BI and ED was estimated using logistic regressions adjusted for socioeconomic and psychosocial characteristics. After the inclusion of the “migration*BI” interaction term, migration-stratified logistic regressions were conducted. Results Overall, 13.0% of students were at risk of ED. Percentages of ED were 15.7% among those who perceived themselves as “too fat” (vs. “about the right size”: aOR=1.67 [95%CI: 1.34-2.08]) and 19.4% in the “too thin” group (aOR=3.36 [2.54-4.45]). Despite non-significant interaction terms, perceiving themselves as “too fat” (vs. “about the right size”) was not associated with the risk of ED in 1st generation migrants (aOR: 1.24 [0.67-2.29]). Compared with the overall estimation, it was lower in 2nd generation migrants (aOR: 1.43 [1.00-2.03]) while it was slightly higher in natives (aOR: 1.95 [1.45-2.62]). Conclusions These findings suggest complex interrelations between BI and risk of ED according to migratory status in adolescents with potential underlying mechanisms involving cultural norms. Promoting positive BI as a possible way for preventing the development of eating disorders need to be further investigated. Key messages • This study shows differences of body image dissatisfaction according to the migratory status in adolescents, inducing potential impacts on the risk of eating disorders. • Better understanding differences in body perception related to cultural background could help prevent risk of eating disorders in adolescents, by promoting positive body image for example.

Leveraging epidemiological data for the development of interventions to promote healthy nutrition and physical activity among adolescents from disadvantaged backgrounds

Abstract ePro-Schools is a public health initiative designed to promote healthy nutrition and physical activity among adolescents from socially disadvantaged backgrounds using a targeted e-health intervention to be deployed in the school context. A central theme of ePro-Schools is its robust cross-sectoral collaboration, involving stakeholders from academia, healthcare, education, and local communities. This cooperative approach not only enhances the intervention’s relevance and efficacy but also ensures its cultural, social, and economic adaptability to the needs of the target population. The project embodies a truly interdisciplinary effort, integrating insights from epidemiology, behavioural science, public health, and digital technology to innovate and improve health promotion strategies. This presentation will explore how data from epidemiological studies, such as the Health Behaviour in School-aged Children (HBSC) study, are used to support the development of the ePro-Schools intervention. Utilizing high-quality epidemiological data, the project identifies key determinants of physical activity, dietary habits, and sedentary behaviour amongst adolescents growing up in low-SES contexts, allowing to craft tailored strategies to promote healthier lifestyles within this vulnerable population.

Tobacco and nicotine products use among adolescents in Serbia – Latent class analysis

Abstract Background In parallel with a decline in cigarette smoking in the previous decade, other tobacco and nicotine products (TNPs), that are often used concurrently, have gained popularity among adolescents. The purpose of this study was to identify patterns of tobacco and nicotine product use among Serbian adolescents. Methods Data for this study were obtained from Health Behavior in School-aged Children (HBSC), a WHO collaborative cross-national study of adolescent health and well-being, that was conducted in Serbia in 2022 on a sample of 3713 students 11,13 and 15 years old. Descriptive statistics was used as well as latent class analysis to classify students based on their past-month use of cigarettes, e-cigarettes, heated tobacco products, waterpipes, and oral tobacco/nicotine products. Results Among students 11,13 and 15 years old, 10.2% smoke cigarettes, 13% use e-cigarettes, 11.1% waterpipes, 3.7% oral tobacco/nicotine products, and 4.5% heated tobacco products with differences by age and sex. We found high percentages of dual use of TNPs among cigarette smokers. Among students who smoke cigarettes, 61.6% also use e-cigarettes, 36.2% smoke waterpipes, 30.2% heated tobacco products, and 24.1% oral tobacco/nicotine products. Latent class analysis identified three classes as optimal solution: (1) dual e-cigarette and cigarette users (6.9%); (2) minimal/non-users (83.2%) and (3) poly tobacco and nicotine products users (9.9%). Statistically significant differences between classes were found in age and sex. Conclusions Dual and poly-tobacco and nicotine use is common among Serbian adolescents and presents a challenge for monitoring and public health response. Findings contribute to a better understanding of patterns and heterogeneity of TNPs use among adolescents and might have implications for prevention and cessation interventions for youth. Key messages • Among students 11,13 and 15 years old, tobacco and nicotine products, other than cigarettes is gaining popularity and with the e-cigarettes being the most popular product. • Dual and poly tobacco and nicotine products use is new challenged that should be taken into account in tobacco and nicotine monitoring, cessation and prevention.

Impact of loneliness and social support on leisure physical activity in adolescents in Luxembourg

Abstract Background Healthy lifestyle includes a regular practice of vigorous physical activity in adolescents’ leisure time. Engaging in physical activity (PA) depends on individual, social and environmental factors. Previous literature has showed that social support and loneliness can influence the practice of PA. The study aims to analyse the relation between PA during leisure time and social support and loneliness among adolescents in Luxembourg. Methods The study includes 7049 adolescents from the Health Behaviours in School-aged Children (HBSC) Luxembourg 2022 survey. PA in leisure time was categorised according to WHO recommendations for vigorous physical activity. Perceived social support (friends, family, teacher, and classmate) was dichotomised in high support and in low/medium and loneliness in feel often lonely and not feel often lonely. It was executed a binomial logistic regression to analyse the PA levels in leisure time by loneliness and social support, controlling by age, migration background, perceived wealth, and family structure, split by gender. Results In Luxembourg, boys who perceived high support from most of the sources and didn’t feel often lonely had higher chances to reach WHO recommendations for PA during leisure time (e.g. loneliness: OR = 1.38, CI95%[1.11-1.74]; family support: OR = 1.31, CI 95%[1.10-1.56]), except for teacher support (OR = 0.79, CI95%[0.67-0.93]). In contrast, girls who only perceived high support from classmates (OR = 1.21, CI95%[1.05-1.4]) and teachers (OR = 1.19, CI95%[1.01-1.38]) had higher chances to be physically active. Conclusions This is the first study to investigate the impact of social support and loneliness among adolescents in Luxembourg. Future research should investigate social-related barriers and facilitators of PA during leisure time. Key messages • Understanding adolescents social support can guide towards effective strategies that promote physical activity during leisure time. • Boys benefit from several social support sources, while girls thrive with encouragement from classmates and teachers to stay physically active in leisure time.

Inequities in child health in Luxembourg

Abstract Background In Luxembourg, despite its economic prosperity, 28.6 % of children are estimated to be at the risk of poverty. Research has shown that growing up with socioeconomic disadvantage is associated with worse physical and mental health in childhood. We explore the association of socioeconomic status with health, health behaviours and access to healthcare in Luxembourg for children up to age twelve. Methods We used data from 2014 to 2022 for 11-12 year old children from the Health Behaviour in School-aged Children (HBSC) survey as well as social security data from Luxembourg for a similar time period and children 0 to 12 years old. To assess socioeconomic status, we used information on self-perceived household wealth for the HBSC results and stratified health and health behaviours by well-off, average, or less well-off households. For the social security data, we stratified access to care indicators by equivalized household income quintiles. Results We found that physical activity levels, nutritional quality and daily routines such as eating breakfast and brushing teeth are significantly lower in children from less affluent families. For example, 61% of 11-12-year-old children from well-off families reported eating breakfast every day, but only 41% of children from less well-off families. Only 23% of 11-12 year olds from less affluent families rated their health as excellent, compared to 52% of children from affluent families. There were similarly large differences for multiple health complaints, with 63% of children from less affluent families reporting this indicator for psychosomatic problems, compared to 34% of children from affluent families. We did not find differences in the use of pre- and postnatal care visits. Conclusions Socioeconomic differences in child health, mental health and health behaviours are large, with children from poorer households being in worse physical and mental health and less likely to report positive health behaviours. Key messages • Many children in Luxembourg face socioeconomic challenges that are adversely associated with health and health behaviours. The underlying reasons require further attention to improve child health. • Children from poorer backgrounds are in significantly worse mental health than children from better off families in Luxembourg.

The Impact of Parental Monitoring on Exposure to Multiple Substances and Bullying in Croatian Students

Background/Objectives: Adolescence is a critical period for experimenting with a wide range of risky behaviors, which are often influenced by family dynamics, including parental monitoring. This study aims to analyze the patterns of exposure to multiple substances and bullying among Croatian students by age and gender in 2022 and examine the association of exposure to multiple substances and bullying with maternal and paternal monitoring. Methods: The data were obtained from the 2022 Health Behaviour in School-aged Children (HBSC) study conducted in Croatia among students aged 11, 13, and 15. Two multinomial logistic regressions were performed separately by age and gender. Results: Exposure to multiple instances of bullying is more common among boys than girls in all three age groups, while exposure to multiple substances varies depending on age. The analysis revealed the strong protective effect of maternal monitoring against both substance use and bullying. Paternal monitoring showed less consistent effects but still indicated that lower paternal monitoring was associated with higher exposure to multiple substances and bullying, particularly at age 13. Conclusions: The patterns of multiple substance use and bullying vary by gender and age, emphasizing the need for tailored intervention strategies. Programs that strengthen parental monitoring, particularly maternal monitoring, should be prioritized.

Increasing loneliness among German children and adolescents from 2018 to 2022: A cross-sectional survey before and after the onset of the COVID-19 pandemic

Abstract Aim Loneliness is an increasingly present topic in scientific and public discourse, and has gained relevance due to the COVID-19 pandemic. Nevertheless, there is a lack of representative studies examining the prevalence of loneliness among children and adolescents before and after the pandemic. Accordingly, the present study aimed to determine the prevalence of loneliness among 11- to 15-year-old students before (2018) and after (2022) the onset of the COVID-19 pandemic and to investigate subgroup differences. Subject and methods In this cross-sectional Health Behaviour in School-aged Children (HBSC) study, the prevalence of loneliness was compared in two representative samples from the German federal state of Brandenburg from 2018 and 2022. In 2018, data were collected from 3,057 (51.8% girls, Mage = 13.1, SD = 1.7) and, in 2022, from 3,801 (52.6% girls, Mage = 13.5, SD = 1.6) students in general education schools. Loneliness was assessed using a single item from the Center for Epidemiologic Studies Depression Scale (CES-D). Chi-square test and logistic regressions were performed. Results In total, 11.8% of the students reported being lonely in 2018, and 19.3% reported being lonely in 2022. Loneliness was more prevalent among girls, nonbinary, older adolescents, and students with lower family affluence. The increase in loneliness did not differ depending on age, gender, or family affluence. Conclusion The findings highlight that loneliness among children and adolescents is a widespread phenomenon that has increased significantly from 2018 to 2022. There is a need for prevention measures and further research into health-related associations of loneliness.

Oral hygiene predicts lower life satisfaction and subjective health: experience of post-Soviet countries

Oral diseases are among the most common non-communicable diseases around the globe and become a public health challenge that considerably impact general health and well-being in all ages across the lifespan. Oral health is an integral part of general health, where poor oral health and other lifestyle-related chronic diseases have a common risk factor background. The underlying causes of oral health inequalities are often complex and related to country-specific historical, economic, cultural, social, or political factors. For more than a decade, data from the Health Behavior in School-aged Children (HBSC) survey showed that tooth brushing rates are very low in post-Soviet countries. The general aim of our study was to focus on a more detailed profile of schoolchildren from post-Soviet countries, who have poor habits of teeth brushing, in terms of their family, social support, physical activity, nutrition, and other health-related behaviors. Data for this study was extrapolated from the Health Behavior in School-aged Children study, a World Health Organization collaborative cross-national study, conducted every 4 years since 1983/1984. For this study, the post-Soviet countries from Eastern Europe and Central Asia were selected: Armenia, Azerbaijan, Estonia, Georgia, Kazakhstan, Kyrgyzstan, Lithuania, Latvia, Moldova, Tajikistan, Ukraine, and Uzbekistan. Data from all countries (some exceptions for Kyrgyzstan, Tajikistan, and Uzbekistan) were collected within 2017–2018 HBSC study, following international research protocol. The sample consisted of 44,760 schoolchildren, aged 11, 13, and 15 years from 12 countries. Irregular tooth brushing is more common among boys, elder adolescents, and schoolchildren from less affluent families. Low own health measures, low life satisfaction, low physical activity, and low FAS relate to poorer adolescent dental hygiene in post-Soviet countries. Adolescents characterized by irregular tooth brushing were more likely to assess their health as fair or poor rather than excellent or good (OR = 1.22), and also had greater odds of reporting low life satisfaction (OR = 1.36). Individual mental health complaints—feeling low, being irritable, being nervous, and having sleep difficulties—were assessed as a possible outcome of irregular tooth brushing. However, irregular tooth brushing was not associated with poorer mental health outcomes (p > 0.05). Conclusions: Oral hygiene in post-Soviet countries is still a major public health challenge and have to be addressed properly.What is Known:• Oral health strongly affects the overall health of children and adolescents in the future.• Oral diseases often share common determinants and risk factors with other chronic diseases.• The underlying causes of oral health inequalities are often complex and related to country-specific historical, economic, cultural, social, or political factors.What is New:• Irregular tooth brushing was more common among adolescents with low life satisfaction and poor or fair health as well as in less affluent families.• Irregular tooth brushing was not found to be associated with poorer mental health among post-Soviet countries adolescents.

Variation in health and well-being parameters: cross-country and temporal aspects

BACKGROUND: The coronavirus epidemic has stimulated large-scale structural and socio-economic changes throughout the world and led to increased attention to the problem of health in general. But has the epidemic affected the change in the attitude of people of different ages to their health, the perception of various parameters of subjective well-being? The article presents a comparative analysis of a number of assessments (about the level of happiness, satisfaction with income, healthcare, safety, communication, life, attitude towards people, etc.) of respondents from Europe and Central Asia for the period 2006–2021. AIM: The goal is to assess changes that have occurred over a 15-year time interval in relation to health and social determinants of well-being, to determine possible directions for changing the current situation. METHODS: To achieve this goal, the results of the tenth wave of the international comparative European Social Survey, conducted in 2021 (32 countries), were used in comparison with data from the third wave, conducted in 2006 (25 countries). The impact of the pandemic on the health of children and adolescents aged 11–15 years was based on materials from the international Health Behavior in School-Aged Children 2021–2022 in 44 countries in Europe and Central Asia. RESULTS: Despite the difficulties, dictated by the coronavirus, over the period 2006–2021 in most European countries stability in the perception of the world of work and the healthcare institution has been maintained, the psychological situation related to the safety of living has improved, and life satisfaction has increased. According to most of the parameters considered, Russians are outsiders among European countries; however, Russians’ responses to 7 indicators of health and well-being (out of 12) show positive changes. The results of studies of the health of children and adolescents during the pandemic and post-pandemic periods indicate significant negative consequences, mainly related to mental health. CONCLUSION: It is necessary to increase the attention of Russian government bodies to the health and well-being of Russians, first of all, to children and adolescents.

Adolescents’ health literacy is directly associated with their physical activity but indirectly with their body composition and cardiorespiratory fitness: mediation analysis of the Slovak HBSC study data

BackgroundHealth literacy is a core public health issue in relation to children and adolescents associated with multiple health behaviours and health outcomes. The aim of the study is to test the direct associations between health literacy, physical activity behaviour, health outcomes of body composition and cardiorespiratory fitness among Slovak adolescents and possible indirect effect of health literacy on health outcomes of body composition and cardiorespiratory fitness mediated by adolescents’ physical activity behaviour.MethodsData from the Slovak Health Behaviour in School-aged Children (HBSC) study conducted in 2022 were used. For the purposes of this study, a subsample of the adolescents (n = 508; mean age = 14.50; SD = 0.82; 54.3% boys) which provided HBSC questionnaire data on health literacy, moderate-to-vigorous physical activity and vigorous physical activity and participated in body composition (InBody 230) and cardiorespiratory fitness (20-m shuttle run test) measurements. Data were analysed using linear regression analysis.ResultsThe findings showed that higher health literacy of the adolescents was directly associated with higher frequency of physical activity represented by moderate-to-vigorous physical activity and vigorous physical activity and only with the visceral fat area in the crude model. Furthermore, there was an indirect effect of health literacy on cardiorespiratory fitness and most of the body composition variables (except the Body Mass Index) which was mediated by physical activity of the respondents.ConclusionsHealth literacy is indirectly associated to body composition and cardiorespiratory fitness through higher frequency of physical activity. It seems that health literacy as cognitive and social competencies need behavioural components to be involved in the proposed causal pathway between health literacy and health outcomes. Our findings may contribute to the process of creating a framework for future health literacy interventions in adolescents.

Mental Health and Medicine Use for Headache: A Nationally Representative Study of Adolescents in Denmark.

This study examined the prevalence of headache medicine use among Danish adolescents and explores the link between mental health, frequent headaches, and medicine use for headache. We hypothesized that poor mental health increases headache occurrence, leading to greater medicine use. The 2022 Danish Health Behaviour in School-aged Children (HBSC) study surveyed 5292 students aged 11, 13, and 15. Self-reported data included headache frequency, medicine use for headache, and five mental health indicators: life satisfaction, emotional symptoms, loneliness, self-efficacy, and self-esteem. Multivariate logistic regression analyses assessed the association between mental health indicators and headache medicine use, adjusting for headache frequency. Weekly headaches were reported by 33.1%, and 43.6% used headache medicine in the past month. Poor mental health correlated with higher headache and medicine use rates. Analyses adjusted for sex, age group, and occupational social class found significantly increased odds ratios (95% confidence interval) for medicine use for headache among students with low life satisfaction (2.27; 1.88-2.75), among students with 2+ emotional symptoms (2.28; 1.92-2.69), students who often felt lonely (2.08; 1.69-2.55), students with low self-efficacy (1.37; 1.16-1.61) and students with low self-esteem (1.59; 1.36-1.85). When accounting for headache frequency, the association between poor mental health and medicine use diminished and became nonsignificant. Poor mental health was linked to increased medicine use for headache. The findings suggest that frequent headaches may explain the association between poor mental health and the use of headache medicine. Promoting rational medicine use and enhancing mental health among adolescents is essential.

Associations between eating habits and mental health among adolescents in five nordic countries: a cross-sectional survey

BackgroundThe role of eating habits in adolescent mental health has become a growing area of interest for researchers and health professionals. Recent studies suggest that healthy eating habits may play a role in the development and management of mental health. However, existing literature is largely based on clinical populations, and comparisons are challenged by sociocultural differences and methodological issues. The aim of the present study was to use nationally representative data based on standardized procedures, to explore associations between adolescents eating habits and mental health, considering the importance of age, gender, socioeconomic factors, and country.MethodsThe study was based on data from Nordic adolescents (age 11, 13 and 15 years) who participated in the 2017/2018 Health Behavior in School-aged Children (HBSC) study (n = 22384). General linear modelling and multigroup regression analysis were used to examine the relationship between food habits (intake of fruit, vegetables, sweets, soft drinks), meal habits (intake of breakfast and having family meals together), and mental health (life satisfaction and subjective health complaints). The analyses were weighted and adjusted for age, gender, socio-economic status, and country.ResultsOverall, healthier eating habits were associated with better mental health. The strongest associations were found between meal habits (breakfast consumption and having family meals together) and mental health. Gender and country differences were seen, with weaker associations found among Danish boys.ConclusionEating habits should be considered when promoting mental health in the adolescent population. While gender differences and cross-country variations exist, even minor enhancements in eating behaviors could yield meaningful benefits.

Gender differences in adolescents' life satisfaction: A replication study in Kazakhstan.

Whether adolescents' life satisfaction varies with gender is unclear. In a recently published study, Brisson et al. found unadjusted mean scores of life satisfaction to be higher in boys than in girls in Luxembourg, a country ranking high in gender-equality indexes. However, gender was no longer predictive of life satisfaction when well-identified predictors of life satisfaction were included in the model. The present work aimed to replicate Brisson et al.'s study in Kazakhstan, a less gender-equal country than Luxembourg, and test the gender-equality-paradox hypothesis. We used cross-sectional data from the Health-Behavior in School-aged Children study conducted in 2022 to mirror Brisson et al.'s study design. We relied on a nationally representative sample of 7369 school attendees in Kazakhstan (MAGE = 13.4; SDAGE = 1.7; 52.3% female). We performed general linear modeling analyses to achieve our research goals. In keeping with Brisson et al.'s study, we found unadjusted mean scores of life satisfaction to be higher in boys than in girls. The magnitude of the gender gap was lower in Kazakhstan than in Luxembourg. In contrast to Brisson et al.'s study, controlling for well-identified predictors of life satisfaction did not annul the gap in question but changed its sign. This result suggests that, ceteris paribus, girls were more satisfied with their life than boys. Overall, our replication study supports the gender-equality-paradox hypothesis. Future studies may investigate whether this paradox stems from gendered criteria of life satisfaction assessment and/or sociobiological differences in health profiles.

90 The association between risk of depression and combined vigorous physical activity and screen time behaviours in French-speaking Belgian adolescents

Abstract Purpose While there is a clear consensus on the positive effect of physical activity on reducing the risk of depression, the literature on the association between screen time and risk of depression is rather conflicting. Also, no clear consensus has been reached on whether being sufficiently active could alleviate the negative effects of being sedentary on mental health. The purpose of this study was to investigate the association of combined vigorous physical activity (VPA) and screen time (ST) behaviours with the risk of depression (RD) in Belgian adolescents. Methods The analysis used data collected through self-reported questionnaires from 8412 adolescents aged 10 to 20 included in the 2022 “Health Behaviour in School-aged Children” (HBSC) study in French-speaking schools. RD was measured using the World Health Organisation Five Well-being Index (WHO-5), with scores ≤28/100 indicating RD. VPA and ST behaviours were identified by combining data on ST (TV, video games and internet use) and VPA in three categories: (1) low ST (total weekly ST < 4hours/day), independently of VPA; (2) high VPA-high ST (VPA≥3 times/week and total weekly ST ≥ 4hours/day) and (3) low VPA-high ST (VPA<3 times/week and total weekly ST ≥ 4hours/day). The association between RD and VPA-ST behaviours was measured using adjusted binary logistic regression. Results In 2022, 15.4% had low ST, 40.6% high VPA-high ST, and 44.0% low VPA-high ST behaviours. Moreover, 13.2% were at risk of depression. This prevalence was eight times higher in low VPA-high ST (62.9%) and four times higher in high VPA-high ST (29.5%) than in low ST (7.6%) adolescents. After adjusting for sociodemographic characteristics, body mass index and sleep duration, adolescents with low VPA-high ST behaviours were more likely to be at risk of depression (aOR=1.17, 95%CI: 1.31-2.35) compared to those with low ST, but this was not the case for those who had high VPA-high ST (aOR=1.18, 95%CI: 0.81-1.71). Conclusion These findings suggest that having either low ST or sufficient VPA may be protective for RD in adolescents. With ST increasing and PA remaining low in French-speaking Belgian adolescents, health promotion initiatives should continue to promote both PA and the reduction of sedentary behaviours in adolescents.