Norwegian Adolescents Research Articles

Pain and depressive symptoms among adolescents: prevalence and associations with achievement pressure and coping in the Norwegian Ungdata study.

This study investigated the prevalence of pain, depressive symptoms, and their co-occurrence in Norwegian adolescents. Additionally, we investigated if perceived achievement pressure and coping with pressure were associated with pain, depressive symptoms and co-occurrent pain and depressive symptoms. Cross-sectional data from the Norwegian Ungdata Survey (2017-2019) were analysed. Adolescents from across Norway completed an electronic questionnaire including questions on perceived achievement pressure, coping with pressure, pain, and depressive symptoms. Descriptive statistics presented prevalence rates, and multinominal regression reported in relative risk ratios (RR) was employed to estimate associations, adjusted for gender (boys/girls), school level, and socioeconomic status. The analyses included 209,826 adolescents. The prevalence of pain was 33%, 3% for depressive symptoms, and 14% reported co-occurring pain and depressive symptoms. The prevalence of co-occurring symptoms was higher in girls (22%) than boys (6%). Significant associations were found between perceived achievement pressure and pain (RR 1.11, 95% CI 1.10-1.11), depressive symptoms (RR 1.27, 95% CI 1.27-1.28), and co-occurring symptoms (RR 1.34, 95% CI 1.33-1.34). Struggling to cope with pressure was associated with pain (RR 2.67 95% CI 2.53-2.81), depressive symptoms (RR 16.68, 95% CI 15.60-17.83), and co-occurring symptoms (RR 27.95, 95% CI 26.64-29.33). The prevalence of co-occurring pain and depressive symptoms is high among Norwegian adolescents. Perceived achievement pressure and struggling to cope with pressure were associated with isolated and, more strongly, co-occurring pain and depressive symptoms. Enhancing adolescents' ability to cope with pressure could be a crucial target in treating pain and depressive symptoms.

Cyberbullying Among Adolescents in Norway: Time Trends and Factors Associated with Perpetration and Victimization

There is limited knowledge about time trends in cyberbullying involvement, and whereas previous studies have often focused on various mental health outcomes, possible outcomes of cyberbullying may concern a wide range of areas. A better understanding of cyberbullying development over time, as well as of the possible consequences, is needed for effective prevention and intervention efforts. The aims of this study were (i) to gain knowledge of time trends in cyberbullying among Norwegian adolescents, and (ii) to better understand how different forms of cyberbullying involvement is related to a variety of outcomes. Data from the Norwegian Ungdata surveys (2014–2016) were used to assess involvement in cyberbullying over time. Associations with cyberbullying involvement and four outcome variables (belief in a good and happy life, loneliness, school thriving, and depressive symptoms) were assessed using logistic regression analyses. Across years of study, the prevalence rates for cyberbullying involvement were 1.5% for perpetration, 3% for victimization, and 1% for perpetration-victimization. Compared with non-involvement, involvement in cyberbullying in any role was associated with poorer outcomes on all variables. Cyber-victims who were also perpetrators were less likely to have high levels of loneliness and depressive symptoms, compared to cyber-victims only. The prevalence of cyberbullying involvement among adolescents in Norway was relatively unchanged between 2014 and 2016. Cyberbullying involvement is associated with negative outcomes related to mental health, loneliness, school thriving, and beliefs in one’s personal future, and victims of cyberbullying appear to be the most vulnerable group.

Socioeconomic inequalities in substance use among Norwegian adolescents between 2014 and 2022

Abstract Background Increasing use of substances is observed among adolescents in recent years. Early onset of substance use dramatically increases the risk of substance use disorder, dependence, and poorer psychological, social, and physical health, and is thus a public health concern. We explore trends in socioeconomic inequalities in past year use of cannabis and other illicit drugs between 2014 and 2022 among Norwegian adolescents. Methods This study is based on data retrieved from five waves of the nationwide Norwegian Ungdata survey (2014-2022) among adolescents attending upper secondary education (N = 282,259; 51 % girls). Trends in socioeconomic inequalities were assessed using the Slope Index of Inequality (SII) and the Relative Index of Inequality (RII). Results The use of cannabis and other illicit drugs increased among boys (from 13% to 19%, and from 2% to 5%, respectively) and girls (from 8% to 14%, and from 1% to 3%, respectively) between 2014 and 2022. Higher prevalence’s was observed among the least affluence girls between 2020 and 2022, both in absolute and relative terms (SII: 0.01 to 0.06, RII: 0.97 to 1.52, p < 0.001). No inequalities were observed among boys during this time. While relative and absolute inequalities in use of other illicit drugs decreased in boys, absolute inequalities increased in girls. Boys were more likely than girls to have used cannabis and other illicit drugs, although the gender gap in cannabis use narrowed slightly during the study period. Conclusions Our data suggest increasing use of cannabis and other illicit drugs among Norwegian adolescent boys and girls between 2014 and 2022. Future studies should examine the potential causes of increasing substance use as a basis for understanding, and distinguishing between, the many intertwining factors that influence adolescent drug use behaviors. Key messages • The use of cannabis and other illicit drugs increased between 2014 and 2022 among Norwegian boys and girls. • While inequalities in the use of cannabis and ither illicit drug use increased in girls, small or no inequalities was observed among boys.

The association between electronic media use and quality of life (QoL) in Norwegian adolescents

Abstract Background The use of screens, especially mobile devices like tablets and smartphones have increased over the last years and have become an integrated part of modern life. Adolescents today spend a lot of their time using screens both at school and outside school. Identifying how screen use are related to QoL is necessary to plan effective policies and interventions in adolescence since it is the period where different behaviours are adopted. The purpose of this study is to examine the association between electronic media use and quality of life (QoL) among adolescents. Methods This study was based on self-reported cross-sectional data from the Young-Hunt4 study, conducted in 2017-2019. The target group comprised 8066 13-19 years old adolescents. QoL was measured with the Norwegian version of the Inventory of Life Quality (ILC). The ILC scale consists of seven items with four response alternatives. Electronic media use was measured using the two variables Social media use and Gaming. Multiple linear regression was used to analyse the association between gaming, social media use and QoL. Results Preliminary results showed an inverse association between gaming (>3 hours per day) after school and quality of life (β: -.07, p < 0.001) and social media use (>3 hours per day) after school and quality of life (β = -.06, p < 0.001). Similar inverse associations were observed between gaming (>3 hours per day) in the weekend and quality of life (β: -.09, p < 0.001) and social media use (>3 hours per day) in the weekend and quality of life (β = -.04, p = 0.002). These associations remained significant after controlling for gender, age, family economy, psychological distress and having friends. Conclusions More than three hours on screens per day after school was negatively associated with QoL. Hence, public health policy and practice should pay attention to consequences of screen time use in adolescence. Additional research is needed to further explore these associations. Key messages • More frequent use of electronic media is negatively associated with QoL. • Public health policy and practice should pay attention to screen time in adolescence and its association with QoL.

Use of Over-The-Counter Analgesics Is Associated with Pain, Stress, and Quality of Life in Norwegian Adolescents: A Cross-Sectional Study.

Introduction: Approximately 20% of Norwegian adolescents are frequently using Over-the-Counter Analgesics (OTCAs). The WHO emphasizes the need for research to identify the key determinants of health problems in adolescence. Thus, our aim was to describe and explore pain, stress, and Health-Related Quality of Life (HRQOL) in Norwegian adolescents and investigate possible associations upon high/low usage of OTCAs. Methods: This cross-sectional study included 315 adolescents (92 boys, 223 girls) with an average age of 14.1 years (13-15 years). All participants reported using OTCAs. Weekly usage was categorized as high and less than weekly as low. Using a validated questionnaire, we explored the following variables: pain, as measured using the Brief Pain Inventory, stress (Perceived Stress Questionnaire), and HRQOL (KIDSSCREEN-27). Binary logistic regression models were conducted using IBM SPSS Statistics (version 27). Results: Our descriptive findings reveal that high users of OTCAs reported higher pain intensity of 3.4 (SD = 1.9) and perceived stress of 0.38 (SD = 0.18) compared to low users, who reported 2.5 (SD = 1.9) and 0.32 (SD = 0.16), respectively. High OTCA users reported lower average scores than low users across all HRQOL subscales. Binary logistic regression revealed 30% higher odds for higher levels of pain intensity and 14 times higher odds of perceived stress associated with being a high user of OTCAs compared to a low user. Conclusions: Our study shows significantly higher odds for experiencing pain and stress among adolescents using OTCAs daily-to-weekly, compared to those seldom using such medicines. Health professionals should be aware of young people who have a high consumption of OTCAs and investigate whether the use is related to pain or stress. This might be important in designing a personalized and appropriate intervention. Parents and caregivers have an important responsibility in supporting adolescents' appropriate pain management. Longitudinal studies are needed to better explore predictive factors of OTCA use in adolescents, particularly in relation to psychological variables such as stress and quality of life.

The relationship between perceived school stress and satisfaction with life among Norwegian school-based adolescents and the moderating role of perceived teacher care: a cross-sectional study

BackgroundPerceived stress from schoolwork and perceived teacher care are shown to influence adolescents’ life satisfaction. However, there is a need to further explore how levels of perceived school stress affect life satisfaction of Norwegian adolescents across gender and school levels using nationwide data, and whether this association is moderated by perceived teacher care. Hence, this paper sought to: (1) describe perceived school stress, perceived teacher care and satisfaction with life in Norwegian adolescents stratified by gender and school level, (2) examine the association between perceived school stress and satisfaction with life by testing perceived teacher care as a possible moderator and (3) explore the association between perceived teacher care and adolescents’ satisfaction with life.MethodsWe utilized cross-sectional data from the Norwegian Ungdata Survey from 2021, encompassing adolescents from lower and upper secondary school. Two-thirds of all Norwegian adolescents participated in the Ungdata Survey from 2021. All data is anonymous. The study variables are presented according to lower and upper secondary school as well as gender. Linear regressions were conducted and adjusted for socioeconomic status (SES) by using SPSS.ResultsIn total, 139,841 adolescents were included. Girls exhibited higher perceived school stress, lower perceived teacher care, and lower life satisfaction than boys in both lower and secondary school (all p < 0.01). Strong inverse associations on satisfaction with life were found in both genders in lower and upper secondary school among those who reported very frequent perceived school stress, with perceived teacher care moderating the relationship (B= -0.67; 95% CI [-0.70 to -0.65], P < 0.01]). Moreover, robust associations were unveiled between high and low levels of perceived teacher care and life satisfaction across gender and school level.ConclusionsHigher perceived school stress was strongly inversely associated with life satisfaction in Norwegian adolescents, in both girls and boys, and in both lower and secondary school. Teacher care was identified as a moderator and seems to play a crucial part in the everyday life of Norwegian adolescents. These implications extend to teacher education, practice, and policy, which should be aware of the pivotal role of perceived teacher care on Norwegian school-based adolescents‘ life satisfaction.

Depressive symptoms, conduct problems and alcohol use from age 13 to 19 in Norway: evidence from the MyLife longitudinal study

BackgroundEven though mental health problems and alcohol use remain major challenges facing adolescents, our understanding of their developmental progressions primarily stems from cohorts coming 1 of age in the early 2000’s. We aimed to examine and describe normative developmental trajectories of depression, conduct problems, and alcohol use across adolescent years among more recent cohorts of Norwegian youth born in the 21st century.MethodsMultilevel mixed linear models for symptoms of depression and conduct disorder, and multilevel mixed logistic models for depressive disorder, conduct problems, any alcohol use, and risky drinking, were estimated with longitudinal data from a nationwide sample N = 3436 (55% girls) of Norwegian adolescents (mean age 14.3 [SD = 0.85] in 2017). We compared models with linear, quadratic, and cubic change with age, and models that tested moderation by sex and centrality (rural vs. urban communities).ResultsAverage symptoms and the rate of depressive disorder increased sharply from age 13 to age 19, but both the initial levels and the rates of change were greater for girls than for boys. Average symptoms of conduct disorder and the rate of conduct problems increased in early adolescence and were greater for boys than girls. The rates of any alcohol use and risky drinking both increased sharply from age 14, but there were no notable sex differences either in the initial levels or rates of change over time. Adolescents from more rural communities had greater rates of any drinking in mid-adolescence, but there were no other effects of centrality.ConclusionsThis study provides a much-needed update concerning normative developmental trajectories of depression, conduct problems, and alcohol use among millennium cohorts. Consistent with prior studies, we observed significant increases in all outcomes across adolescence, with depression being both greater and more prevalent among girls and conduct problems being both greater and more prevalent among boys. Consistent with the emerging evidence, we observed no sex differences in alcohol use. Finally, there were no differences in the examined developmental trajectories as a function of centrality. These findings underscore the importance of early prevention and treatment of mental health and substance use problems.

Validation of Rosenberg self-esteem scale among Norwegian adolescents – psychometric properties across samples

BackgroundSelf-esteem refers to the evaluative and affective dimensions of the self-concept and is important for positive mental health and overall functioning during adolescence. The Rosenberg Self-esteem scale (RSES) is one of the most frequently used and widely accepted instruments assessing self-esteem; however, the psychometric properties of the instrument have not been investigated in a Norwegian adolescent population. The present study’s aim is to investigate the factor structure, construct validity and reliability of the RSES among adolescents 14–21 years.MethodsThe study was based on two cross-sectional samples (n = 1,233/ n = 1,816) of adolescents from rural and urban areas in Mid-Norway. Concerning the dimensionality of the RSES, two measurement models were tested using Principal Component Analysis and Confirmatory Factor Analysis: a one-factor model and a two-factor-model.ResultsThe results show that a two-factor solution of positive and negative aspects of self-esteem representing “perceived personal competence” and “self-value” had the best fit across the two adolescent samples. The RSES also showed high reliability and correlated in expected directions with measures of life satisfaction, stress, and self-efficacy, supporting the convergent validity of the instrument.ConclusionThe psychometric properties of the RSES need to be further evaluated in Norwegian adolescent populations based on the dimensionality found in the present study; however overall, the results indicate that the instrument is appropriate for assessing self-esteem among Norwegian adolescents.

Trends in Norwegian adolescents’ substance use between 2014 and 2022: socioeconomic and gender differences

BackgroundSubstance use is a global health concern and early onset among adolescents increases health risks. We explore national overall trends in prevalence and trends in socioeconomic inequalities in past year alcohol intoxication, cannabis use, and use of other illicit drugs among Norwegian adolescents (ages ∼ 15–19 years of age) between 2014 and 2022.MethodThe present study builds on data from a nationwide repeated cross-sectional survey collected in 2014–2016 (T1), 2017–2019 (T2), 2021 (T3) and 2022 (T4). In total 415,560 adolescents (50.3% girls) completed the questionnaire during the study period. Trends in socioeconomic inequalities were assessed using the Slope Index of Inequality (SII) and the Relative Index of Inequality (RII).ResultsWhile the prevalence of alcohol intoxication remained fairly stable, the prevalence of cannabis and other illicit drug use increased between 2014 and 2022 among upper secondary school boys (13.3–17.6%, and 2.0–5.2%, respectively) and girls (8.8–12.8%, and 1.1–2.7%, respectively). Similar trends were observed among 10th-grade adolescents. Boys were more likely than girls to use cannabis or other illicit drugs, but the gender gap in cannabis use narrowed during the study period. Among upper secondary girls, use of cannabis and other illicit drugs was higher among those from less affluent backgrounds, with absolute and relative inequalities in cannabis use increasing between 2014 and 2022. Small inequalities in cannabis use and decreasing relative inequalities in the use of other illicit drug were observed among upper secondary boys.ConclusionsThe increasing use of cannabis and other illicit drugs among Norwegian adolescents is concerning. Future studies should explore the underlying causes of this rise and explore the complex factors influencing adolescent substance use behaviours. A comprehensive understanding of these factors is essential for developing targeted and effective interventions.

Prevalence and Characteristics of Female and Male Esports Players among Norwegian Youth: A General Population Study.

Electronic sports (esports) have evolved into a major cultural phenomenon in the 21st century, mirroring traditional sports with organized, competitive play. This study investigates the prevalence of esports participation and characteristics of esports players among Norwegian adolescents. Using data from the Ungdata survey, a comprehensive web-based survey of Norwegian adolescents that includes questions on demographics, health, physical activity, social relations, and leisure activities such as gaming and esports, we analyzed responses from 70,695 students aged 16-18 years collected during 2021-2023. We conclude that about one out of twenty in the age group of 16-18 years actively engage in esports. The figure conceals significant gender differences: only 0.7% of girls, compared to 8.8% of boys, actively participate in esports. While female esports players differ noticeably from non-players on almost all indicators included in our analyses, the picture among boys reflects more similarities between esports players and other boys, than differences. Among the esports players, females almost consistently reported more negative experiences than males, including less physical socialization, lower self-rated health, higher rates of loneliness and sleeping problems, and a greater difficulty fitting in at school. Despite these negative aspects, esports players maintain close friendships similar to their non-playing peers.

Socioeconomic inequality in breakfast skipping among Norwegian adolescents

BackgroundSkipping breakfast is associated with negative health-related and school-related outcomes. Breakfast is the most frequently skipped meal among adolescents. Thus, there is a need to explore the reasons for breakfast skipping across population subgroups to better inform policy makers. The purpose of this study was to present the prevalence of adolescents skipping breakfast on schooldays, analyse the reasons for skipping breakfast and assess associations between the prevalence of skipping breakfast and the reasons for skipping breakfast according to sociodemographic variables.MethodsThe data of a random sample of 10 000 upper secondary school students (aged 16–18 years) from Viken County, Norway, were collected. Students completed a questionnaire measuring breakfast skipping, reasons for skipping breakfast, and sociodemographic variables. Chi-square tests were used to assess differences between the independent groups (family affluence scale (FAS), parental education, and gender) and skipping breakfast and reasons for skipping breakfast.Results22% of adolescents reported that they usually skipped breakfast on all schooldays. Skipping breakfast was more prevalent among females, older students, students with lower socioeconomic status and students in vocational education programmes. The difference in breakfast skipping between students with low and high FAS scores was 31% versus 16%, respectively. The most common self-reported reasons for skipping breakfast were time (59%) and not wanting to eat breakfast (48%). Furthermore, 9% reported health issues, and 3% reported economic constraints as a reason for skipping breakfast. Not wanting to eat breakfast was related to a higher FAS score, health issues were more common among girls, and economic constraints were more common among those with low socioeconomic status.ConclusionsSkipping breakfast was common among Norwegian upper secondary school students. Lack of time and not wanting breakfast were clearly the most cited reasons for skipping breakfast. Health issues and economic constraints were also cited but were less common. The results showed diverging associations between different demographic characteristics and reasons for skipping breakfast. These results are important for developing effective programs to improve diet among adolescents.

Mental health in Norwegian children and adolescents exposed to childhood maltreatment: a comparison to a general population sample

The current study aimed to compare mental health outcomes of children and adolescents with maltreatment experiences to a general population sample. A secondary aim was to examine sex differences in mental health outcomes, and the association between polyvictimization and mental health. The two samples were age- and sex-matched, and data was collected from caregiver-reports and self-reports. 1378 participants aged 5 to 18 years were included in the study. Children and adolescents exposed to maltreatment had more mental health problems than the general population sample. Large effect sizes (d ≥ 0.8) were found for emotional problems (d = 1.19), hyperactivity problems (d = 0.88), peer problems (d = 0.86), and the impact score (d = 0.93). A moderate to large effect size was found on the conduct problems subscale (d = 0.68), and a small effect size was found on the prosocial subscale (d = −0.22). There was a dose-response relationship between cumulative maltreatment exposure and the severity of mental health problems. Childhood maltreatment was associated with considerably more emotional problems, hyperactivity problems, and peer problems, which in turn can impact the daily life of the exposed children and adolescents. Effective support measures for maltreated young people must be a priority.

Associations between digital health literacy and health system navigating abilities among Norwegian adolescents: validating the HLS19-DIGI scale using Rasch modeling

BackgroundDespite increasing global attention to health literacy and adolescents’ digital health information seeking, no unidimensional instruments measuring digital health literacy (DHL) in adolescents have reportedly been validated using Rasch modeling. Moreover, the evidence of adolescents’ abilities to navigate the health system (NAV-HL) in light of their DHL proficiency is still scarce. Therefore, our study aims to evaluate the psychometric properties of a DHL instrument (HLS19-DIGI scale) in order to investigate DHL in adolescents and young adults aged 16–25 and associations with abilities to navigate the health system.MethodsA population-based cross-sectional survey among 890 Norwegian adolescents was conducted during April–October 2020 using computer-assisted telephone interviewing. Rasch modeling, independent samples t-test, chi-square test, and binary regression models were used to analyze the data.ResultsThe HLS19-DIGI scale was sufficiently unidimensional, whereas no differential item functioning or disordered response categories were observed. However, relatively poor targeting was revealed indicating too many easy items for the target population. Yet, a high proportion (54%) of low DHL proficiency in adolescents was observed, as well as DHL was positively associated with the abilities to navigate the health system.ConclusionsThe HLS19-DIGI scale is considered a sufficiently unidimensional and valid instrument for measuring DHL in adolescents, which may be a useful tool for health authorities, public health workers, and health service providers. While DHL affects adolescents’ abilities to navigate the health system, future research should measure and examine their ability to utilize digital health services, separately.

Built for movement: Neighborhoods and adolescent physical activity behaviors, and the moderating role of socioeconomic position and gender

This study examined whether the built environment was associated with physical activity among adolescents in Oslo, Norway, and the role of socioeconomic position and gender as potential moderators of this association. We used data from 897 adolescents who participated in the TACKLE cross-sectional study conducted in 2020. Built environment features (recreational facilities, parks, forest, public transport, traffic calming devices, and schools) were assessed objectively using Geographical Information Systems. Physical activity data included device-measured moderate-to-vigorous physical activity, total physical activity, and self-reported active transportation to school. Using general linear models and logistic regression, we found that most built environment features were unrelated to the participants’ device-measured physical activity. Longer distances to school and to traffic calming devices were associated with decreased likelihood of participants reporting active transportation to school. Our moderated regression analysis showed that adolescents with low socioeconomic backgrounds seemed less affected by longer distances to school compared with their high socioeconomic counterparts. Furthermore, boys appeared to be more sensitive to traffic safety relative to girls. Implementing traffic calming devices may enhance active transportation to school and improve traffic safety for Norwegian adolescents.

Language learning and escapism: how five Norwegian adolescents escape reality through reading and/or gaming extramurally in L2 English

ABSTRACT Purpose This qualitative-dominant study focuses on five foreign/second language (L2) English learners in 10th grade (age 15) in Norway. The purpose is to provide insight into the processes underlying L2 English learning by looking at what escapist reading/gaming means for participants’ beliefs about their L2 English proficiency. Methodology Semi-structured interviews were conducted about learners’ engagement in reading/gaming in English outside of school, i.e. extramural English (EE). While other studies have explored EE reading/gaming, this study is innovative in that it contributes by additionally examining the role of escapism for L2 English learning. Escapism is the practice of temporarily escaping reality and everyday troubles. Purposive sampling was employed, and data were analyzed using inductive, reflexive thematic analysis. Findings and originality Three themes emerged: Relief: Students used escapism to temporarily escape stress, without losing their sense of reality. Personal changes: Students reported that escapism practices impacted their social skills and viewpoints positively. Language: Students perceived improvement in their English skills due to their escapism. L2 English was necessary to create distance from reality, and English reading/gaming material was associated with higher quality than material in other languages. These findings indicate that all participants experienced escapism similarly, as a positive outlet for stress. L2 English was necessary for escaping, which participants claimed to positively influence their English proficiency. Value The value of the present study lies in its attempt to shed new light on L2 English learning, by aiming to fill the research gap about the relationship between escapism and L2 English learning.

COVID-19 Pandemic Quarantines and Mental Health Among Adolescents in Norway

Adolescence is a critical developmental phase when mental health disorders, such as anxiety and depression, often emerge. Stringent public health measures and quarantine mandates during the COVID-19 pandemic could threaten adolescent mental health. To investigate the associations of public health measures and quarantine experiences with mental distress among Norwegian adolescents and to explore if certain vulnerability factors moderate these associations. This longitudinal cohort study used repeated measures to capture variations in mental distress explained by the stringency of public health measures and quarantine experiences. Data from the Norwegian Mother, Father, and Child cohort study were linked to national health registries and a national stringency index from April 1, 2020, to February 17, 2021. Participant included 7787 Norwegian adolescents aged 16 to 18 years. Data were analyzed from October 2022 to October 2023. Stringency index of public health measures and quarantine experiences including recent quarantine (within the last 2 weeks) and quarantine frequency (cumulative number of quarantine episodes). Mental distress was measured using the Hopkins Symptom Checklist across 6 data collection waves. In this study, 7787 participants were included in the analysis (4473 female [57%]; mean [SD] age, 17.0 [0.6] years). Stringent public health measures (β = 0.18; SE, 0.02; P < .001), recent quarantine (β = 0.11; SE, 0.02; P < .001), and frequent quarantine (β = 0.08; SE, 0.01; P < .001) were associated with higher levels of mental distress. The associations between public health measures and mental distress were not moderated by sex, age, prepandemic anxiety or depression, or genetic liability for mental health conditions. Frequency of quarantine appeared to be more strongly associated with mental distress among younger adolescents (β = -0.04; SE, 0.01; P = .008), those with parents with lower education (β = -0.04; SE, 0.01; P = .007), and those with lower genetic risk for depression (β = -0.03; SE, 0.01; P = .006). In this study, younger adolescents, those with parents with lower education, or those with low genetic liability for depression appeared more vulnerable when being quarantined several times. These findings emphasize the need for targeted support strategies to better protect adolescent well-being during future crises. Adolescents who experienced increased mental distress during the COVID-19 pandemic may be at risk of continued mental health problems and in need of ongoing support.

How have changes in accessibility and public funding influenced contraceptive use among Norwegian adolescents? A cohort study.

The Norwegian Government introduced in 2002 a reimbursement scheme for hormonal contraceptives to adolescents at the same time as public health nurses and midwives received authorization to prescribe hormonal contraceptives. This study examines the impact of increased accessibility and public funding on hormonal contraceptive use among adolescents. The Norwegian Prescription Database, Statistics Norway, and Norwegian Institute of Public Health served as data sources for this cohort study. The study population comprised 174 653 Norwegian women born 1989-1990, 1994-1995, and 1999-2000. We examined use of hormonal contraceptives through dispensed prescriptions from age 12 through age 19 with duration of first continuous use as primary outcome. The statistical analyses were done in SPSS using chi-squared test, survival analysis, and Joinpoint regression analysis with p-values < 0.05. By age 19, ~75% of the cohorts had used at least one hormonal method. The main providers of the first prescription were general practitioners and public health nurses. Starters of progestogen-only pills (POPs) have increased across the cohorts, while starters of combined oral contraceptives (COCs) have decreased. The use of long-acting reversible contraceptives (LARCs) has increased since its inclusion in the reimbursement scheme (2015). Most switchers shifted from COCs or POPs as a start method to implants after LARCs became part of the reimbursement scheme. There has been a significant increase across the cohorts in the number of women who continuously used hormonal contraceptives from start to the end of the calendar year they became 19 years with the same method and after switching methods. We could not correlate changes in decreasing trends for teenage births or induced abortions (Joinpoint analysis) to time for implementation or changes in the reimbursement of hormonal contraceptives from 2002. Primarily public health nurses and to a lesser extent midwives became soon after they received authorization to prescribe COCs important providers. The expansion of the reimbursement scheme to cover POPs, patches, vaginal ring, and depot medroxyprogesterone acetate in 2006 had minor impact on increasing the proportion of long-term first-time users. However, the inclusion of LARCs in 2015 significantly increased the proportion of long-term first-time hormonal contraceptive users.

Attitudes and doping prevalence among Norwegian youth across exercise activities

BackgroundUse of image and performance enhancing drugs (IPEDs), such as anabolic-androgenic steroids, has in the last decades spread from elite athletes to recreational exercisers seeking a shortcut to a lean and muscular physique. The drugs are associated with multiple potential negative health consequences, some of which may be particularly harmful for adolescents. To better develop adequate and targeted preventive measures, identifying individuals and groups at risk for using IPEDs are important. MethodsBy analyzing quantitative data extracted from Ungdata, a national data collection survey on adolescent health and well-being, this study describe self-reported physical activity and exercise habits, IPED prevalence, and attitudes and intentions towards IPEDs among 88 412 Norwegian adolescents aged 13–19 years. Results72 % participated in weekly sport or physical exercise. Young adolescents mostly exercised in sport clubs while older adolescents preferred training in gyms. Average lifetime IPED prevalence was 2.2 % (0.7 %–4.0 % depending on exercise activity). Respondents reported more favorable attitudes and higher intentions to use IPEDs when it was related to increasing muscle size (18 % and 5.8 %, respectively) and reducing weight (19 %, 8.1 %), compared to improving sport performance (5.6 %, 3.0 %). Large variations in attitudes and intentions were found between exercise groups, with individuals exercising in gyms having more favorable attitudes toward IPEDs than other groups. ConclusionThe study finds a low relative prevalence, but high acceptance for IPED use in certain exercise groups. Education and preventive measures should specifically target groups at risk for future use of these drugs.

Use of contraception during first sexual intercourse among Norwegian adolescents: a national cross-sectional study

BackgroundMost Norwegian adolescents experience their first sexual intercourse during late adolescence. Use of contraception is important to avoid unwanted pregnancy, while condoms can also protect against sexually transmitted diseases. There are few studies on the use of contraception at first sexual intercourse, most with varying results, and some studies have only examined the use of contraception among girls. In our study, we aimed to determine the use of contraception at first sexual intercourse, and to investigate associations between use of contraceptives at first sexual intercourse, sociodemographic factors, and alcohol and other substance use.MethodsThe study was based on data from the national electronic youth survey Ungdata, conducted in 2020–2022 among 113 049 upper secondary pupils (15–19 years) in Norway, which was around 65% of pupils attending upper secondary school during the study period. Descriptive analysis was used to estimate the prevalence of contraceptive use at first sexual intercourse, and multivariate logistic regression analyses to investigate the association between contraceptive use, sociodemographic factors, and alcohol intoxication and substance use.Result32% of Norwegian adolescents did not use contraception at first sexual intercourse. More girls (57.4%) than boys (42.6%) reported use of contraception. Factors associated with non-use of contraception during first sexual intercourse among boys were having parents with no college /university education (OR = 1.22: CI 1.13–1.32), perceived poor family finances (OR = 1.22: CI 1.06–1.40), alcohol intoxication, and use of cannabis or other narcotic substances during the past 12 months. The same factors were associated with non-use of contraception among girls. Additionally, being older than 16 years (OR = 1.13: CI 1.06–1.19) was also associated with non-use of contraception at first sexual intercourse.ConclusionMany adolescents did not use contraception at first sexual intercourse. Alcohol intoxication and use of cannabis or other narcotic substances were associated with a lower likelihood of using contraceptives. This highlights the importance of preventive efforts including earlier prevention education that focuses more on the consequences of not using contraception in order to prevent unwanted pregnancies and sexually transmitted infections.

The centrality of food in Norwegian adolescents' life; a photo elicitation study among Norwegian youth.

The purpose of the study was to explore how adolescents from a high school in Viken county define and interact with food systems in their immediate environments to understand if and how health and sustainability affect their food choices. A qualitative case study design and a participatory approach were employed. Data were collected through photo elicitation combined with group interviews. Pictures were analyzed in collaboration with participants, and the group interview through systematic text condensation. Results indicate that adolescents perceive food systems as being a substantial part of their everyday life, that they care about their health and that of the planet, and they wish to take sustainability and health into consideration when making food choices. Their food choices are affected by aspects such as family, friends, marketing, price, time, availability and accessibility. They perceive that their agency to influence their own diet and food systems is limited. Adolescents hold unique and important knowledge of their food-related behaviors and value their autonomy to make food choices. Future research and policies aiming to help adolescents make healthy and sustainable food choices should therefore actively include adolescents.