Health Behaviour In School-aged Children Research Articles

Adolescents perception of the COVID-19 pandemic restrictions and associated mental health and well-being: gender, age and socioeconomic differences in 22 countries

BackgroundThe COVID-19-pandemic has had a profound impact on the lives of adolescents worldwide. This study examined the subjective perception of the COVID-19 pandemic measures and its association with mental health and well-being (i.e., loneliness, life satisfaction and multiple health complaints) among 13- and 15-years-old adolescents from 22 countries.MethodsData from the cross-national Health Behaviour in School-aged Children (HBSC) 2021/22 study were used from representative samples of 22 countries (N = 67,544; 51.9% girls). The self-perceived impact of COVID-19 measure comprised 10 items asking about the impact on several dimensions of adolescent lives (e.g., relationships with family and friends, health, or eating behaviours). Measures of loneliness, multiple health complaints, and life satisfaction were included as indicators of mental health and well-being. A non-parametric multilevel latent class analysis considering individual and country-levels was conducted to identify classes of self-perceived impact of the COVID-19 measures. Multilevel logistic regression models adjusted by age and socioeconomic status were applied to assess the association between COVID-19 measure impact classes and mental health.ResultsThree classes were identified on individual level encompassing a neutral (51%), positive (31%), or negative (18%) perception of COVID-19 measures. A third of the adolescents reported a positive impact of the pandemic measures. The distribution of classes was heterogeneous within and across countries. Within the positive COVID-19 measure impact class, social relationships were the most important dimension, whereas mental health problems were mostly represented within the negative COVID-19 measure impact class. Girls with a negative perception of pandemic measures showed higher levels of loneliness and multiple health complaints and lower life satisfaction. 15-year-old adolescents and those with a low socioeconomic status reported higher levels of loneliness and lower life satisfaction.ConclusionsThe majority of adolescents perceived the pandemic measures as neutral or positive. Girls, 15-year-old adolescents, and those with low socioeconomic status were at higher risk of suffering from pandemic measures and associated problems of loneliness, multiple health complaints, and low life satisfaction. We conclude that adolescent’s mental health and well-being should be considered in the decision-making process by ensuring that the unique challenges of adolescents are adequately addressed in policies.

School pressure and psychosomatic complaints among Swedish adolescents: does physical activity play a buffering role?

School pressure is a significant stressor in the lives of adolescents, recognised to be associated with psychosomatic complaints. Therefore, the exploration of potential buffering factors is a relevant task. This study aimed to examine the association between school pressure and psychosomatic complaints and the potentially moderating role of physical activity in a Swedish national sample of adolescents. Data were derived from the 2017/2018 Swedish Health Behaviour in School-aged Children (HBSC) survey, involving 3,745 participants aged 11-15 years. School pressure and physical activity were measured using single items. Psychosomatic complaints were assessed through an additive index based on the frequency of eight complaints. Covariates included gender, grade, and family affluence. Linear regression analyses demonstrated a positive graded association between school pressure and psychosomatic complaints, while an inversely graded association was observed between physical activity and psychosomatic complaints. Physical activity did, however, not moderate the link between school pressure and psychosomatic complaints. Even though physical activity did not serve as a buffer, the direct effects of school pressure and physical activity on psychosomatic complaints suggest that supporting young people in managing school demands and promoting their engagement in physical activities could be effective measures in alleviating psychosomatic complaints.

School socioeconomic status and psychological complaints among adolescents in 44 countries: The mediating role of schoolwork pressure and classmate support and the moderating role of family SES and country-level income inequality

Previous research has reported both positive and negative associations between school socioeconomic status (SES) and internalizing problems among adolescents. Little is known about cross-national differences in this association, as well as potential mediators and moderators. Therefore, this study investigated this association using representative cross-national samples of adolescents whilst exploring the mediating role of schoolwork pressure and classmate support, and the moderating role of family SES and country-level income inequality. Using data from adolescents aged 11–15 from 44 countries, participating in the 2017/2018 Health Behaviour in School-aged Children (HBSC) study (N = 202,202), we employed multilevel regression models with cross-level interactions. School SES was operationalized as the average family affluence of adolescents within a school and psychological complaints (e.g., feeling low/depressed) were used as an indication of internalizing problems. On average across countries, adolescents in higher SES schools reported more psychological complaints, with a large effect size. However, differences in this association were observed across countries, with a positive association in 19 out of 44 countries, a negative association in one country, and nonsignificant associations in the remaining countries. Schoolwork pressure partially mediated the average association between school SES and psychological complaints, as school SES was positively associated with schoolwork pressure which was associated with more psychological complaints. Our results did not support the mediating role of classmate support. Also, we found a moderating effect of family SES, indicating a stronger positive association between school SES and psychological complaints for those with a below average family SES compared to those with an average and above average family SES. No moderating effect was observed for country-level income inequality. These findings suggest that adolescents with low family SES attending higher SES schools are especially at risk for psychological complaints, and may therefore require tailored support. A promising strategy to reduce psychological complaints entails addressing schoolwork pressure.

Social media threats and health among adolescents: evidence from the health behaviour in school-aged children study

BackgroundSocial media are immensely popular among adolescents. Thus, concerns have been raised about the threats adolescents encounter on social media and the possible negative health consequences, such as depressive symptoms and anxiety. This study investigated the prevalence of nine social media threats: (1) cyberbullying, (2) sexual harassment, (3) racism, (4) unauthorized distribution of sensitive material, (5) phishing attempts, (6) misinformation, (7) the sale or distribution of drugs, (8) harmful or dangerous social media challenges, (9) content causing appearance pressures. The study also investigated how individual and social factors, problematic social media use (PSMU), and online communication with strangers are associated with social media threat exposure, as well as the association between social media threats and self-rated health, depressive feelings, and anxiety symptoms.Methods and findingsNationally representative Health Behaviour in School-aged Children (HBSC) data from Finland were obtained from 2288 respondents aged 11, 13, and 15 years. Fixed effects regression models were applied. The most common threat, encountered daily and weekly, was misinformation. Regression models showed that individual and social factors, PSMU, and online communication with strangers explained adolescent exposure to social media threats in differing ways. Furthermore, certain factors (e.g., emotional intelligence, family support) were associated with encountering social media threats less frequently, whereas other factors (e.g., PSMU, online communication with strangers) were associated with more frequent encounters. Daily and weekly exposure to social media threats was systematically associated with poor self-rated health, frequent depressive feelings, and anxiety symptoms.ConclusionsOur study highlights the need for intervention and health promotion efforts to mitigate adolescent exposure to social media threats and ensuing negative health consequences.

Is family meal frequency associated with obesity in children and adolescents? A cross-sectional study including 155 451 participants from 43 countries.

This study tried to examine the association between the frequency of family meals and excess weight using large and representative samples of children and adolescents from 43 countries. This cross-sectional study used data from the Health Behaviour in School-aged Children (HBSC), which included nationally representative samples of children and adolescents aged 10-17 years, involving a total of 155 451 participants (mean age = 13.6 years; standard deviation [SD] = 1.6; 51.4% girls). Family meal frequency was gauged through the following question: 'How frequently do you and your family typically share meals?' The possible responses were: 'never', 'less often', 'approximately once a week', 'most days' and 'every day'. The body weight and height of the participants were self-reported and utilized to calculate body mass index (BMI). Subsequently, BMI z-scores were computed based on the International Obesity Task Force criteria, and the prevalence of excess weight was defined as +1.31 SD for boys and + 1.24 SD for girls, with obesity defined as +2.29 SD for boys and + 2.19 SD for girls. Generalized linear mixed models were conducted to examine the associations between the frequency of family meals and excess weight or obesity. The lowest predicted probabilities of having excess weight and obesity were observed for those participants who had family meals every day (excess weight: 34.4%, 95% confidence interval [CI] 31.4%-37.5%; obesity: 10.8%, 95% CI 9.0%-13.0%). A higher frequency of family meals is associated with lower odds of having excess weight and obesity in children and adolescents.

The Social Self-Efficacy Scale for Spanish and Portuguese (13–18-Year-Olds) Adolescents: Psychometric Properties and Measurement Invariance

Introduction: Social self-efficacy refers to peoples’ beliefs about their ability to establish effective social relationships. During adolescence, it has been related to positive social relationships, skills to cope with adverse experiences, and health. While prior research has focused on the general dimension of self-efficacy, this study aims to examine the reliability and validity of the subscale social self-efficacy in Spanish and Portuguese adolescents across gender, age, and country. Method: The sample, selected from the 2018 Health Behaviour in School-aged Children (HBSC) study, was composed of 20,691 13–18-year-old adolescents from Spain and Portugal (48.2% boys and 51.8% girls). The scale’s reliability and internal and external validity were examined systemically across sex, age, and country, as well as testing measurement invariance according to these variables. Results: Data showed adequate evidence of reliability ( α = 0.85), as well as internal and external validity, thus demonstrating the scale’s stability and applicability in similar research contexts. Conclusions: Social self-efficacy fosters individual and social well-being in youth, as well as healthy and positive development. Use of this subscale in evaluation and intervention programs could further our understanding about different dimensions of adolescent development.

Associations of Eating Habits with Self-Rated Health and Life Satisfaction in Adolescents: A 42-Country Cross-Sectional Study.

The aim of this study was to explore the associations of eating habits with self-rated health and life satisfaction in adolescents using a multiple-country sample. Cross-sectional data from the Health Behavior in School-Aged Children (HBSC) 2013/2014 wave was used in this study. A self-reported questionnaire was used to collect data on independent variables including breakfast on weekdays, breakfast at weekends, and consumption of fruits, vegetables, sweets, and soft dirks. Outcomes included self-rated health and life satisfaction. Regression models were used to assess the associations between the independent variables and the two outcomes, separately, after controlling for covariates. Results were presented using odds ratios (ORs) and 95% confidence intervals (CIs). Of all the study participants (aged 11-15 years), 50.8% were girls. Compared with no consumption of breakfast on weekdays, eating breakfast for five days had 1.22 times greater likelihood for improved self-rated health (OR = 1.22, 95% CI: 1.19-1.25, p < 0.001). Participants who ate breakfast for both days (OR = 1.41, 95% CI: 1.36-1.46, p < 0.001) and one day (OR = 1.12, 95% CI = 1.08-1.17, p < 0.001) were more likely to experience improved self-rated health compared to never eating breakfast at weekends. Five or more days for fruit and vegetable consumption resulted in better self-rated health (all p < 0.001). Similar results were found in terms of the associations of breakfast, fruit, and vegetable consumption with life satisfaction. For example, a higher frequency of fruit intake was associated with enhanced self-rated health (e.g., OR for more than once daily = 1.42, 95% CI: 1.34-1.51, p < 0.001) compared to no fruit consumption. Similarly, a higher-frequency vegetable intake, such as more than once daily (OR = 1.33, 95% CI: 1.26-1.39, p < 0.001), was associated with improved self-rated health. Healthy eating habits, especially regular breakfast and a higher consumption of vegetables and fruit, are associated with better self-rated health and life satisfaction in school-aged children. Of note, the consumption of fruit would have the greatest impact on health and wellbeing outcomes. This study offers evidence that healthy eating habits can play a vital role in school-aged children's health and wellbeing, highlighting the practical significance of educating adolescents to develop healthy eating habits.

Dose-Dependent Association Between Body Mass Index and Mental Health and Changes Over Time

Overweight and obesity affect 340 million adolescents worldwide and constitute a risk factor for poor mental health. Understanding the association between body mass index (BMI) and mental health in adolescents may help to address rising mental health issues; however, existing studies lack comprehensive evaluations spanning diverse countries and periods. To estimate the association between BMI and mental health and examine changes over time from 2002 to 2018. This was a repeated multicountry cross-sectional study conducted between 2002 and 2018 and utilizing data from the Health Behaviour in School-aged Children (HBSC) survey in Europe and North America. The study population consisted of more than 1 million adolescents aged 11 to 15 years, with all surveyed children included in the analysis. Data were analyzed from October 2022 to March 2023. Mental health difficulties were measured by an 8-item scale for psychological concerns, scoring from 0 to 32, where a higher score reflects greater psychosomatic issues. BMI was calculated using weight divided by height squared and adjusted for age and sex. Data were fitted by multilevel generalized additive model. Confounders included sex, living with parents, sibling presence, academic pressure, the experience of being bullied, family affluence, screen time, and physical activity. Our analysis of 1 036 869 adolescents surveyed from 2002 to 2018, with a mean (SD) age of 13.55 (1.64) years and comprising 527 585 girls (50.9%), revealed a consistent U-shaped association between BMI and mental health. After accounting for confounders, adolescents with low body mass and overweight or obesity had increased psychosomatic symptoms compared to those with healthy weight (unstandardized β, 0.14; 95% CI, 0.08 to 0.19; unstandardized β, 0.27; 95% CI, 0.24 to 0.30; and unstandardized β, 0.62; 95% CI, 0.56 to 0.67, respectively), while adolescents with underweight had fewer symptoms (unstandardized β, -0.18; 95% CI, -0.22 to -0.15). This association was observed across different years, sex, and grade, indicating a broad relevance to adolescent mental health. Compared to 2002, psychosomatic concerns increased significantly in 2006 (unstandardized β, 0.19; 95% CI, 0.11 to 0.26), 2010 (unstandardized β, 0.14; 95% CI, 0.07 to 0.22), 2014 (unstandardized β, 0.48; 95% CI, 0.40 to 0.56), and 2018 (unstandardized β, 0.82; 95% CI, 0.74 to 0.89). Girls reported significantly higher psychosomatic concerns than boys (unstandardized β, 2.27; 95% CI, 2.25 to 2.30). Compared to primary school, psychosomatic concerns rose significantly in middle school (unstandardized β, 1.15; 95% CI, 1.12 to 1.18) and in high school (unstandardized β, 2.12; 95% CI, 2.09 to 2.15). Our study revealed a U-shaped association between adolescent BMI and mental health, which was consistent across sex and grades and became stronger over time. These insights emphasize the need for targeted interventions addressing body image and mental health, and call for further research into underlying mechanisms.

National Dietary Survey on the children population

Abstract The national food consumption survey on the children population in Poland was conducted from August 2019 to February 2020 and was funded by EFSA under the EU Menu project. It aimed at collecting food consumption data of a representative sample of children living in Poland and followed the EFSA EU Menu methodology. Altogether 2605 subjects aged three months to nine years old were invited to participate in the study out of which participants were 1,574 children (780 boys and 794 girls) with a response rate of 60%. An additional group of 300 vegetarians aged six to nine years old was also recruited. After verifying the collected data, EFSA accepted the data from 1565 subjects (777 boys, 788 girls) in the main group and 294 subjects (147 boys, 147 girls) in the group of vegetarians. Data on food consumption was collected by means of two non‐consecutive food dietary record method using a web‐based tool intended for 24‐hour dietary recall method. In addition, a food propensity questionnaire was used. Anthropometric measurements of height, weight, waist and hip circumferences were made to assess the nutritional status of the participants. The level of physical activity was assessed with a short questionnaire, using questions from HBSC (Health Behaviour in School‐aged Children) Polish Study. Before the main study the pilot study was conducted for verifying the feasibility of the study organization. The collected data will be used to update the Comprehensive European Food Consumption Database, which is regulated and administered by EFSA. The results will allow the evaluation of diet and nutritional status of children in Poland, including the prevalence of underweight, overweight and obesity.

Problematic social media use mediatesthe effect of cyberbullying victimisation on psychosomatic complaints in adolescents.

Adolescent psychosomatic complaints remain a public health issue globally. Studies suggestthat cyberbullying victimisation, particularly on social media, could heighten the risk of psychosomatic complaints. However, the mechanisms underlying theassociationsbetween cyberbullying victimisationandpsychosomatic complaints remain unclear. This cross-cultural study examines the mediating effect of problematic social media use (PSMU) on the association between cyberbullying victimisation and psychosomatic complaints among adolescents in high income countries. We analysed data on adolescents aged 11-16.5years (weighted N = 142,298) in 35 countries participating in the 2018 Health Behaviour in School-aged Children(HBSC) study. Path analysis using bootstrapping technique tested the hypothesised mediating role of PSMU. Results from the sequential binary mixed effects logit models showed that adolescents who were victims of cyberbullying were 2.39 times significantly morelikely to report psychosomatic complaints than those who never experienced cyberbullying (AOR = 2.39; 95%CI = 2.29, 2.49). PSMU partially mediated the association between cyberbullying victimisation and psychosomatic complaints accounting for 12% ( =0.01162, 95%CI = 0.0110, 0.0120) of the total effect. Additional analysis revealed a moderation effect of PSMU on the association between cyberbullying victimisation and psychosomatic complaints. Our findings suggest that while cyberbullying victimisation substantially influences psychosomatic complaints, the association is partially explained by PSMU. Policy and public health interventions for cyberbullying-related psychosomatic complaints in adolescents should target safe social media use.

Country-level sociocultural context and socioeconomic inequalities in adolescent dietary behaviours: A multilevel analysis in 21 European countries

Studies to date have predominantly focused on countries' socioeconomic conditions (e.g., income inequality) to explain cross-national differences in socioeconomic inequalities in adolescent health (behaviours). However, the potential explanatory role of sociocultural contexts at country-level remains underexamined. This study examined whether the country-level sociocultural context and changes thereof were associated with adolescent socioeconomic inequalities in dietary behaviours. International comparative data of 344,352 adolescents living in 21 countries participating in 2002, 2006, 2010 and 2014 waves of the Health Behaviour in School-aged Children (HBSC) survey were combined with aggregated levels of openness-to-change from the European Social Survey (ESS). Four dietary behaviours (i.e., fruit, vegetable, sweets and soft drink consumption) and two measures of socioeconomic status (SES) on the individual level (i.e., family affluence scale [FAS] and occupational social class [OSC]) were studied. Multilevel logistic regression analyses returned contrasting results for the two SES measures used. In countries with higher levels of openness-to-change, smaller FAS inequalities in daily fruit, sweets and soft drink consumption were observed, but no such inequalities were found for vegetable consumption. Conversely, in these countries, larger OSC inequalities in soft drink consumption were found. Country-specific changes in openness-to-change over time were not associated with the magnitude of adolescent dietary inequalities. Findings underscore the importance of including country-level sociocultural contexts to improve the understanding of cross-national differences in socioeconomic inequalities in adolescents’ diets. Future studies, spanning a longer timeframe, are required to examine whether such associations exist within countries over time since our timeframe might have been too small to capture these long-term trends.

Problematic social media use and psychological symptoms in adolescents.

This study examined time trends in significant child and adolescent psychological symptoms and explored the association of frequent and problematic social media use with these symptoms. Time trends in psychological symptoms were assessed using data from five waves of the international survey of Health Behavior in School-aged Children (HBSC), conducted between 2001 and 2018 (N = 1,036,869). The associations of frequent and problematic social media use with significant psychological symptoms were assessed by hierarchical multinomial logistic regression using data from 2001-2002 and the 2017-2018 survey waves. The direction of effect between social media use variables and psychological symptoms was explored using Linear Non-Gaussian Acyclic Models (LiNGAM). Prevalence of more severe psychological symptoms increased from 6.7% in 2001-2002 to 10.4% in the 2017-2018 survey waves. The increase was especially large among 15-year old and older girls: from 10.9 to 19.1%. The higher prevalence of more severe psychological symptoms in 2017-2018 compared with 2001-2002 was eliminated after adjusting the model for problematic social media use. LiNGAM analysis supported the direction of effect going from social media use and problematic social media use to psychological symptoms. The findings suggest that frequent and problematic use of social media contribute to the increasing trend of psychological symptoms in adolescents in recent years.

Depression, stress, and anxiety versus internet addiction in early and middle adolescent groups: the mediating roles of family and school environments

BackgroundFamily and school environment play a crucial role across the different developmental stages of adolescence. This paper investigates the potential mediating role of family and school environments in the relationship between the three psychosocial predictors of depression, anxiety, stress, and Internet addiction (IA). Specifically, it focuses on the two stages of early and middle adolescence.MethodsThe study involved a survey of 407 adolescents from Qatar, comprising 250 early adolescents and 157 middle adolescents. Inclusion criteria for the study included adolescents between the ages of 10 to 17 years old, residents of Qatar and studying in a Qatar-based school. To assess the constructs of the three psychosocial predictors, IA, family environment, the study utilized the Depression, Stress, and Anxiety Scale (DASS), the Internet Addiction Diagnostic Questionnaire (IADQ), and the Brief Family Relationship Scale, respectively. School environment was measured using questions from the “Health Behavior in School-aged Children: WHO Collaborative Cross-National survey/study (HBSC) 2013–2014. The study applied standard mediation analysis between the DASS components and IA with family and school environment as the mediators.ResultsResults from the mediation analysis reveal insights into the relationships between psychosocial predictors and IA. The findings indicate that family and school environments partially mediated the relationship with regards to depression, stress, and anxiety in early adolescents. In middle adolescents, family environment partially mediated the relationship with depression and stress and fully mediating the relationship with anxiety. Meanwhile, school environment only exhibited partial mediation in the relationship with anxiety in middle adolescence.ConclusionsThese results highlight the crucial role parents and schools play in addressing problematic technology usage that develops as a response to depression, anxiety, and stress among adolescents. Moreover, the study reveals nuances in the mediating role of family and school environment in early and middle adolescence. This highlights the evolving nature of these influences across the different stages of development. Notably, this study contributes to the literature by moving beyond the conventional focus on the so-called WEIRD population, and offering valuable insights from a region that is underrepresented in current research.

Associations between dietary behaviours and the mental and physical well-being of Swedish adolescents

AimsThis study aims to investigate the association between dietary behaviours, overweight/obesity, and mental health and well-being among Swedish adolescents.MethodsData from the 2017/2018 Health Behaviour in School-aged Children (HBSC) survey of 3692 adolescents aged ≈11, ≈13, and ≈15 years was analysed. We evaluated the prevalence and association of dietary behaviours, characterised by daily intake of fruits and vegetables, consumption of sugar-sweetened beverages (SSBs) and sweets once per week, and daily consumption of family meals and breakfast, with socioeconomic and demographic factors. Multivariate logistic regression models (adjusted and unadjusted) were then used to examine the relationship between dietary behaviours, overweight/obesity, and mental health and well-being including psychosomatic complaints, life satisfaction, and school-related pressure.ResultsBoys were more likely to eat breakfast and have meals together with their family than girls, but their fruit and vegetable intake was lower compared to girls. Adolescents with lower socioeconomic status (low family affluence, families perceived ’not well-off’ and two unemployed parents), single-parent households and twoforeign born parents were more likely to engage in poorer dietary behaviours. Daily breakfast, family meals, fruit and vegetable intake were positively associated with mental health and well-being. Specifically, daily family meals were linked to higher life satisfaction, fewer psychosomatic complaints, and reduced school-related pressure. Breakfast emerged as a beneficial dietary habit, associated with higher life satisfaction, and a lower likelihood of psychosomatic complaints, school-related pressure, and overweight/obesity. Fruit and vegetable consumption was consistently associated with better mental health and well-being while associations between SSBs and sweets were mixed.ConclusionsImproving mental health and well-being, along with tackling the rising rates of mental illness and challenges related to overweight/obesity in adolescents constitute key public health priorities. Implementing policies that promote the intake of fruits and vegetables, reducing the consumption of SSBs and sweets, and emphasizing the value of having breakfast and sharing family meals could offer a cost-effective public health intervention.

Bullying at School, Cyberbullying, and Loneliness: National Representative Study of Adolescents in Denmark.

The aim was to examine how loneliness was associated with bullying victimization at school and online. We used data from the Danish arm of the international Health Behavior in School-aged Children (HBSC) study from 2022. The study population was a nationally representative sample of 11-15-year-olds who completed the internationally standardized HBSC questionnaire at school, n = 5382. Multilevel logistic regression was applied to study the associations between bullying victimization and loneliness. The prevalence of reporting loneliness often or very often was 9.0%; 6.3% of the sample experienced habitual bullying victimization at school, and 4.8% incurred cyberbullying. There was a strong and graded association between loneliness and bullying victimization at school and cyberbullying. The associations were significant for boys and girls, and the association between exposure to bullying at school and loneliness was steeper for boys than girls. The gradients were steeper for physical bullying than for cyberbullying. Students exposed to habitual bullying in both contexts had an adjusted OR (95% CI) of 11.21 (6.99-17.98) for loneliness. Exposure to bullying at school and cyberbullying are strongly associated with loneliness. It is important to reduce bullying at school and on the internet and to promote effective interventions to reduce continuing loneliness.

Trends in psychosomatic symptoms among adolescents and the role of lifestyle factors

BackgroundAdolescent mental health problems are on the rise globally, including in Sweden. One indicator of this trend is increased psychosomatic symptoms (PSS) over time. Lifestyle factors such as physical activity (PA), diet, smoking, and alcohol consumption may influence the time trends in PSS; however, the evidence base is scarce. The aim of this study was to investigate associations between time trends in PSS and lifestyle factors.MethodsThe study was based on data collected from a nationally representative sample of 9,196 fifteen-year-old boys and girls in Sweden using the Health Behavior in School-aged Children (HBSC) symptom checklist. The sample comprised nearly equal proportions of girls (50.5%) and boys. The lifestyle factors examined in this study included PA, regular breakfast intake, consumption of fruits, vegetables, sweets, or soft drinks, smoking, and alcohol drunkenness. We used data from 2002 to 2018 and stratified by family affluence scale (FAS) to demonstrate how the associations varied among the FAS groups. We fitted separate regression models for the high- and low-FAS groups, where interaction terms between the year of survey and each lifestyle factor were used to estimate the level and direction of associations between the factors and trends in PSS.ResultsThere was a generally increasing trend in PSS mean scores from 2.26 in 2002 to 2.49 in 2018 (p <.001). The changes in each survey year compared to the average mean scores during the preceding years were significant in all years except 2010. Regular breakfast intake, daily fruit and vegetable consumption, and higher PA were associated with lower PSS mean scores, while smoking and drunkenness had opposite associations with PSS. The only significant interaction between survey year and the lifestyle factors was observed regarding drunkenness in the high FAS group, suggesting that the association between trends in PSS and the experience of getting drunk at least twice got stronger over time (B = 0.057; CI:0.016, 0.097; p <.01).ConclusionsThe results indicate increasing trends in PSS among young people in Sweden from 2002 to 2018, with a significant increase observed among adolescents in the high FAS group who reported getting drunk on at least two occasions.

There is a correlation between nutritional status, Self-Rated Health and Life Satisfaction? Evidence from 2018 Health Behaviour in School-aged Children cross sectional study in a sample of Italian adolescents living in Tuscany Region.

Overweight has been associated with several social and phycological problems and is perceived as one of the major health care challenges to focus on in the future. The purpose of the study is to investigate the correlations among nutritional status, assessed by the Body Mass Index, the perception of one's own health status and Life Satisfaction, detected in Italian adolescents living in Tuscany Region, and to investigate the influence of gender on them. A statistically representative sample of 2760 Tuscan adolescents aged 11, 13 and 15 was involved in the 2018 Health Behaviours at School-aged Children survey. The participants were divided into three nutritional status class: underweight, normal weight and overweight (overweight + obese). The results show that there is a statistically significant difference in all categories between boys and girls aged 13 and 15 years; in girls aged 11 and 13 years, the Life Satisfaction of the overweight group is statistically lower than that of normal and underweight groups; Self-Rated Health is statistically lower in all age groups for overweight individuals compared to normal weight children, except for 11-year-old females. Viewing the psychosocial problems related to overweight, more attention and care must be placed on adolescents to ensure their healthier development.

Physical activity of older children and adolescents in Germany - Results of the HBSC study 2022 and trends since 2009/10.

Physical activity is central to health, beginning in childhood and adolescence, and regular monitoring provides important information for strategic decisions on promoting physical activity in Germany. The current survey cycle of the Health Behaviour in School-aged Children (HBSC) study gives an insight into the prevalence of the indicators daily recommended physical activity, high and low physical activity, and sporting activity among students aged between 11 and 15 for 2022. In addition, the data is compared to the survey cycles of the 2009/10, 2013/14, and 2017/18 school years and analysed over time. The results of the current survey cycle show that 10.8 % of girls, 20.9 % of boys, and 12.4 % of gender diverse adolescents fulfil the daily physical activity recommendation. There are also major gender-specific differences for the other indicators. The group of gender diverse adolescents needs to be analysed further. The changes over time between 2009/10 and 2022 are relatively small. While girls' physical activity habits decreased slightly for the various indicators between 2009/10 and 2022, boys' prevalence remained relatively stable over the same period. Overall, in part due to the effects of the various COVID-19 lockdowns, the need for effective and population-based measures to promote physical activity in childhood and adolescence remains high.

Traditional bullying and cyberbullying at schools in Germany: Results of the HBSC study 2022 and trends from 2009/10 to 2022.

Bullying is a form of violence that is carried out repeatedly, with the intention of causing harm and with an imbalance of power between those involved. Bullying has serious negative effects on the mental health of adolescents and thus represents a significant health risk in childhood and adolescence. Based on data from the Health Behaviour in School-aged Children (HBSC) study from the survey year 2022 in Germany (N = 6,475), the prevalence of school bullying and cyberbullying among 11-, 13- and 15-year-olds in Germany was analysed. In addition, the prevalence of school bullying and cyberbullying was analysed as a trend from 2009/10 to 2022 (bullying) and from 2017/18 to 2022 (cyberbullying). Around 14 % of the learners surveyed reported direct experience of bullying at school, and around 7 % reported cyberbullying experiences as bullied and/or bullying victims. Adolescents who identified as gender diverse were particularly likely to report bullying experiences. School bullying decreased over time, but remained stable between 2017/18 and 2022. Cyberbullying, on the other hand, increased in 2022 compared to 2017/18. Experiencing bullying at school and online is an everyday experience for many children and young people, so there is still a need for the broad implementation of effective anti-bullying measures in schools.

Trends in health inequalities in childhood and adolescence in Germany: Results of the HBSC study 2009/10 - 2022.

Many studies have identified health inequalities in childhood and adolescence. However, it is unclear how these have developed in recent years, particularly since the COVID-19 pandemic. Analyses are based on the German data from the international Health Behaviour in School-aged Children (HBSC) study from 2009/10 (n = 5,005), 2013/14 (n = 5,961), 2017/18 (n = 4,347), and 2022 (n = 6,475). A total of 21,788 students aged approximately between 11 and 15 years were included. Socioeconomic status (SES) was assessed using the Family Affluence Scale (FAS). Several health indicators were analysed stratified by gender using bivariate and multivariate analysis methods. In 2022, there are clear socioeconomic inequalities in life satisfaction, self-rated health, fruit and vegetable consumption, and physical activity. These inequalities remained largely constant or increased between 2009/10 and 2022. Between 2017/18 and 2022, no significant changes in inequalities were found. Health inequalities are persistent and reduce the chances of growing up healthy. There is no evidence that inequalities in the analysed outcomes have changed during the pandemic period (between 2017/18 and 2022). Rather, the changes in the health indicators seem to affect all adolescents in a similar way.