School Children In Germany Research Articles

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.

Information-seeking behaviour and digital health literacy of schoolchildren in Germany during the COVID-19 pandemic

Zusammenfassung Hintergrund Während der Coronapandemie waren Schüler*innen mit einer Flut von Informationen zur Gesundheit und zur Coronapandemie konfrontiert. Der adäquate Umgang mit Gesundheitsinformationen setzt (digitale) Gesundheitskompetenz voraus. Ziel des Beitrags ist daher, das Informationssuchverhalten und das Ausmaß der digitalen Gesundheitskompetenz (dGK) von Schüler*innen in Deutschland während der Coronapandemie unter Berücksichtigung ihres sozialen Hintergrunds zu analysieren. Material und Methoden Die Online-Befragung wurde während des dritten Lockdowns, von März bis Juli 2021, in Hessen und anderen Bundesländern durchgeführt. Der Feldzugang erfolgte in weiterführenden Schulen, Verbänden und Sportvereinen. Der Online-Fragebogen wurde von N = 1096 Schüler*innen der Klassenstufe 6 bis 13 aufgerufen und n = 361 Schüler*innen vollständig ausgefüllt. Es wurden das gesundheitsbezogene Informationssuchverhalten (internetbasierte Quellen für Gesundheitsinformationen, [digitale] Quellen für Informationen zur Coronapandemie), die dGK (Digital Health Literacy Instrument [DHLI]) sowie soziodemografische und -ökonomische Hintergrundmerkmale (Geschlecht, Alter, zuhause gesprochene Sprache, Schulform, subjektiver Sozialstatus) erfasst und mittels uni-, bi- und multivariater Analysen mit SPSS ausgewertet. Ergebnisse Nach Gesundheitsinformationen zum Coronavirus im Internet suchten regelmäßig 75,6 % der Schüler*innen. Schwierigkeiten beim Umgang mit digitalen Gesundheitsinformationen gaben 52,6 % der Schüler*innen an. 49,8 % der Schüler*innen berichteten von Schwierigkeiten beim Bewerten der Zuverlässigkeit von digitalen Informationen zum Coronavirus. Die bi- und multivariaten Analysen weisen darauf hin, dass sich die dGK nach dem subjektiven Sozialstatus (SSS) dahingehend unterscheidet, dass Schüler*innen mit niedrigem bzw. mittlerem SSS (OR = 2,57, 95 %-KI: 1,30–5,06, p = 0,006) häufiger Schwierigkeiten im Umgang mit digitalen Gesundheitsinformationen zur Coronapandemie aufweisen als Gleichaltrige der Vergleichsgruppen. Die dGK unterscheidet sich nicht signifikant nach soziodemografischen (Geschlecht, Migrationshintergrund) und weiteren sozialen Merkmalen (besuchte Schulform, familiärer Wohlstand). Schlussfolgerung Die Förderung der dGK von Schüler*innen auf Schul- und Individualebene stellt ein wichtiges Anliegen der Prävention und Gesundheitsförderung dar. Durch bildungspolitische Maßnahmen (z. B. durch den „Medienkompetenzrahmen“ für die schulischen Medienbildung in den Bundesländern) sollte es den Schulen ermöglicht werden, die (d)GK im Rahmen der Medien- und Gesundheitsbildung in den Unterricht, Curricula und auf allen Ebenen von und bei allen Akteuren in Schulen (bspw. durch die organisationale Gesundheitskompetenz) zu berücksichtigen.

Mediation in the Relation of Orthographic Processing on the Lexical and Sublexical Level with Reading and Spelling Skills. A Large Cross-Sectional Study in Elementary School Children in Germany

ABSTRACT Purpose Two types of orthographic knowledge were examined: i) knowledge of permissible letter combinations (general orthographic knowledge) and ii) knowledge of whole words (word-specific orthographic knowledge), to gain further insights into the relationship of general and word-specific orthographic knowledge with literacy skills. Method Mediation models were estimated using a sample of 2,636 3rd and 4th grade children (50.6% female, ethnic backgrounds were not surveyed) to examine whether general orthographic knowledge predicts reading fluency and spelling performance and whether this path is mediated by word-specific orthographic knowledge. Using confirmatory factor analyses (CFA), we examined whether the responses to correctly spelled words/legal letter patterns and pseudohomophones/illegal letter patterns in word-specific and general orthographic knowledge tasks were generated by separate latent constructs. Results Our results confirm that word-specific orthographic knowledge is a facilitatory mediator in the relationship between general orthographic knowledge and literacy skills. The relationship of general and word-specific orthographic knowledge with literacy skills varies by item type, with a tendency toward higher correlations between literacy skills with pseudohomophones (vs words) and illegal (vs legal) pseudowords, which is in line with the two-factor solution of the CFA. Conclusion From a theoretical perspective, we conclude that general orthographic knowledge facilitates orthographic learning of words. From a methodological perspective, we encourage future researchers to distinguish between targets and foils in orthographic decision tasks.

Somatoform Symptoms and Functional Impairments During Middle Childhood

Abstract: Theoretical Background: Studies have shown that attachment is associated with somatoform symptoms in childhood, yet factors that mediate the association need to be explored. Objective: To examine emotion regulation strategies as a mediator between insecure attachment dimensions and somatoform symptoms and symptom-related impairments in quality of life (QoL). Method: A total of 221 fourth-grade school children in Germany completed the SOMS-KJ, FEEL-KJ, and ECR-RC. Results: In the path model, attachment-related anxiety was positively associated with social support seeking and emotional expression, while attachment-related avoidance was negatively associated with these, yet positively associated with emotional suppression. Both emotional suppression and social support seeking were positively associated with somatoform symptoms and symptom-related impaired QoL. Discussion and Conclusion: Differential pathways exist from insecure attachment dimensions to increased somatoform symptoms, indicating that children require specialized emotion competence training.

On the Role of Informal vs. Formal Context of Language Experience in Italian–German Primary School Children

This study focuses on the contexts of language experience in relation to language dominance in eighty-seven Italian–German primary school children in Germany using the MAIN narrative task. We compare current language experience in the heritage language (Italian) and the majority language (German) in both formal and informal settings, and we examine the respective impact on micro- and macrostructure measures, including different language domains. Some previous findings emphasized the importance of language experience in formal contexts. By contrast, our results suggest that, in particular, language experience in informal contexts determines vocabulary and fluency in the heritage and majority language, while there are no effects of exposure on syntactic complexity. Furthermore, while the younger children are relatively balanced, the older children are more dominant in the societal language. Our findings imply that the use of the minority language in informal contexts should be encouraged to promote its development and maintenance.

Determinants promoting and hindering physical activity in primary school children in Germany: a qualitative study with students, teachers and parents.

Determinants affecting children's physical activity (PA) at an early age are of particular interest to develop and strengthen strategies for increasing the levels of children's PA. A qualitative study was conducted to investigate the views of primary school-aged children, their teachers and parents regarding barriers and facilitators to engage in PA. Focus groups were conducted separately with primary school children, parents and teachers in a city in Northern Germany between October 2021 and January 2022. The semi- structured focus groups with children and teachers took part in person within school, whereas the focus groups with parents took place online. Data were transcribed verbatim and analysed using thematic analysis. During analysis, the socio-ecological model was identified as useful to map the determinants mentioned and was consequently applied to organize the data. Teachers (n = 10), parents (n = 18) and children (n = 46) of five primary schools in Germany participated in the focus groups. Participants of the three groups identified similar barriers and facilitators of PA in primary school-aged children, ranging across all four layers of the socio-ecological model. The barriers encountered were the preferences of children for sedentary activities (individual characteristics), the preference of parents to control their child's actions (microsystem), a lack of financial resources from parents and long sitting times in class (mesosystem), and barriers related to rainy weather and Covid-19 restrictions (exosystem). Facilitators mentioned were the childrens' natural tendency to be active (individual characteristics), involvement and co-participation of parents or peers in engaging in PA, support provided by teachers and the school (microsystem), living in rural areas, having sufficient facilities and favorable weather conditions (exosystem). A range of determinants promoting and hindering PA, ranging across all layers of the socio-ecological model were identified by children, parents and teachers in this study. These determinants need to be kept in mind when developing effective PA intervention programs for primary school-aged children. Future interventions should go beyond individual characteristics to also acknowledge the influence of childrens' social surrounding, including parents, peers and teachers, and the wider (school) environment.

Environmental attitude and affective-motivational beliefs towards sustainability of secondary school children in Germany and their associations with gender, age, school type, socio-economic status and time spent in nature.

There are warnings that human actions will lead to irreversible environmental damage if they continue at their current pace and scale. With regard to individual aspects, a pro-environmental attitude and positive affective-motivational beliefs towards sustainability represent fundamentals for a more sustainable future. However, there is little data regarding these constructs and relevant explanatory factors, especially with regard to young people. We examined environmental attitude (two-dimensional: utilization and preservation) and affective-motivational beliefs towards sustainability with regard to gender, age, socio-economic status, school type and time spent in nature in 484 adolescents (11-14 years) living in German cities by means of univariate and multiple regression analyses. Mean values were high in preservation and affective-motivational beliefs towards sustainability, and relatively low in utilization. Female adolescents had higher values compared to male students in affective-motivational beliefs towards sustainability. Age did not play a substantial role. Although being strongly correlated with each other, school type and socio-economic status each exhibited positive associations to environmental attitude and affective-motivational beliefs towards sustainability. Furthermore, multiple regression analyses identified time spent in nature as a significant predictor of incremental value, suggesting a tentative recommendation to spend at least half an hour per week in nature in order to promote positive attitudes towards the environment and sustainability. In sum, special needs for topic-related education seem to exist for male students, students with lower formal level of education, students with a lower socio-economic status and students who spend little time in nature.

11.L. Workshop: Digital health literacy of schoolchildren and teachers in Germany

Abstract Background Digital health literacy is an evolving concept and an interdisciplinary field of study. Digital health literacy describes the ability of people to find, understand, appraise, and apply digital health information and services. Recently, the concept has gained increased attention in European public health and health policy making. Digitalization of society and health care, the rise of digital communication technologies, the impact of digital health on public health, and the advent of artificial intelligence have all contributed significantly to the increasing uptake of digital health literacy. Children and adolescents frequently access health information sources on the Internet and Social Media these days and virtually interact with peers on health matters. Through digital health literacy, they can learn to better navigate these digital information environments and manage health information and services. In order for children and youth to become digitally health literate, it is important to address the development of digital health literacy as early as in schools. However, not only the competencies of schoolchildren matter but that of teachers are likewise important, and so are teaching and learning environments provided within schools. In Germany, digital education and literacy have become a mandatory requirement for schools and are addressed as cross-cutting topics in different school subjects. Both students and teachers are trained and educated in this new school topic. This new educational concept shares many similarities with digital health literacy and allows using these intersections to address digital health literacy in the school. However, evidence is scarce and not much is known about the state of digital health literacy in students and teachers, and even less is known about whether and to what extent digital health literacy is taught in schools. Objectives The goal of this workshop is to present first time findings from a unique German multi-centre, nation-wide school study on digital health literacy in students and teachers conducted in 16 federal states. (i) The first presentation will introduce an adaption of an instrument to measure digital health literacy of schoolchildren in Germany. (ii) The second presentation will introduce first time representative results of schoolchildren's digital health literacy. (iii) The third presentation will have its focus on the learning opportunities in schools concerning digital health literacy from the perspective of schoolchildren. (iv) The fourth presentation will illuminate evidence from the perspective of teaching digital health literacy in schools from the perspective of school teachers and associations with their own digital health literacy. The format of this workshop will be 4x8-minute presentations followed by a 20-minute panel discussion, reflecting the relevance of the results to public health research, practice and policy. Key messages • Digital health literacy has become an important public health topic, which must be addressed as early as in schools. • Targeted curriculum opportunities are important to effectively promote digital health literacy but interventions must address both students and teachers.

Sociodemographic differences in digital health literacy of schoolchildren: a representative study

Abstract Background The increasing amount, availability, and use of digital health information through the Internet, social media, and apps highlights the relevance of digital health literacy in schoolchildren. Children and youth need digital health literacy in order to find, understand, and appraise health information and to make health decisions in everyday live. However, there is only limited to none evidence available on child and youth digital health literacy. This study aims at investigating digital health literacy of schoolchildren in Germany and explore associations with sociodemographic differences. Methods Data were collected from a representative sample of N = 1,448 secondary schoolchildren employing a face-to-face survey (CAPI) (Oct-Nov 2022). In addition to sociodemographic information (age, gender, migration, family affluence, education level), digital health literacy was measured using an adapted and translated self-report tool for secondary schoolchildren in Germany. Descriptive statistics, chi-square tests, and internal consistency were calculated using SPSS. Results Cronbach's alpha indicated a good internal consistency (α=.82) for the overall scale and an acceptable-to-good reliability for the subscales (α=.735-.866). Digital health literacy was low in more than half of the participants (52.9%). While no differences were found for gender (X2 (1)=0.25, p=.618) and migration background (X2 (2)=2.34, p=.31), lower digital health literacy was more frequent among younger children aged 9-11 years (X2 (2)=34.69, p = <.001), children with low family affluence (X2 (4)=24.16, p = <.001), and lower parental education (X2 (2)=8.26, p=.016). Conclusions The results of the first study of its kind in Europe suggests an elevated need to promote digital health literacy in schoolchildren. Public health and education policies and interventions are needed that pay attention particularly to younger children's needs, to those from lower family affluence, and lower parental education.

Adaptation of the Digital Health Literacy Instrument and testing with German school-aged children

Abstract Background Children and adolescents in particular navigate in the digital space intensively and use the Internet, social media, and apps to seek health related information. From a public health perspective, the increasing amount of online-based information requires them to possess the abilities to find, understand, evaluate, and apply health information, making digital health literacy more and more important. The Digital Health Literacy Instruments (DHLI) is a psychometrically tested instrument for assessing digital health literacy in adults, which has been adapted for children and adolescents in the United States, using cognitive interviews. However, this version has not yet been adapted for Germany. Hence, the aim of this study is to adapt and test a German version of DHLI for secondary schoolchildren. Methods The pretest tool was translated into German by three native speakers. To test the translated version of the DHLI adapted for secondary schoolchildren, cognitive pretests were conducted with N = 12 children and adolescents aged 10-17 years. The thinking aloud method and probing questions were used during the pretests. The aim of the evaluation was to maximize usability and comprehensibility of the adapted version for schoolchildren in Germany. Results In order to adapt the instrument for a German target group, preferred synonyms were identified during the pretests, as well as a preferred word collocation for health information, namely ‘information about health,’ which was used consistently for all items. Furthermore, two explanations were added in one instruction and one item. Conclusions Based on the results of the pretest analysis, a German version of the DHLI for children and adolescents is now available. Psychometric properties and the methodological quality of the schoolchildren's version of the DHLI have been analyzed in a representative quantitative study, shown in the subsequent presentation.

Sedentary Behavior in Childhood, Lower Arterial Compliance and Decreased Endothelial Function-Cross Sectional Data From a German School Cohort.

BackgroundEndothelial function by flow-mediated dilatation assesses early markers of atherosclerotic progression. Greater amounts of physical activity and physical fitness in children are associated with cardiovascular health benefits. We aimed to explore factors, influencing endothelial function and arterial compliance in a cohort of healthy school children.MethodsThe 94 participants (41 girls, 53 boys) in the study were young, healthy children from a German school cohort. Anthropometric data, body composition and blood pressure were assessed. Blood was drawn (8 h overnight fast), assessing total cholesterol, high density lipoprotein and low density lipoprotein and triglycerides. Endothelial function was diagnosed by flow-mediated dilatation with ultrasonography (ALOKA/Hitachi, Prosound alpha 6). Tracking gates were set on the intima in B-mode. The waveform of diameter changes over the cardiac cycle was displayed in real time using the FMD-mode of the eTRACKING system. Changes in arterial diameter at baseline, ischaemia and vasodilatation were measured. A symptom limited pulmonary exercise test on a bicycle ergometer was performed to test cardiorespiratory fitness. Physical activity was assessed using GT3x accelerometers (Actigraph, USA), over 4 days (including 1 week-end day), with a minimum wear-time duration of 10 h.ResultsThe median age was 12.2 years (11.8–12.8). Children were normal weight, blood lipid profiles (cholesterol, high-density lipoprotein, low-density lipoprotein, triglyceride) were in normal range. Baseline measurements during the diagnostics of endothelial function revealed higher arterial compliance of the brachial artery in boys. Boys' cardiorespiratory fitness was higher than compared to girls. Boys met the recommendations of 60 min moderate to vigorous activity, whereas girls were significantly less active and did not meet current recommendations. More time spent in sedentary activity was the main predictor for lower arterial compliance (adjusted for age and sex), accounting for 14% of the variance. No significant model revealed, analyzing the influencing factors such as anthropometric data, blood lipids, physical activity and fitness on endothelial function.ConclusionThis is the first study on endothelial function in association to objectively measured physical activity and cardiorespiratory fitness in healthy school children in Germany. The study highlights the importance of reducing time spent being sedentary to maintain endothelial health.

Knowledge about Hand Hygiene and Related Infectious Disease Awareness among Primary School Children in Germany.

Hand hygiene is a cornerstone of infection prevention. However, few data are available for school children on their knowledge of infectious diseases and their prevention. The aim of the study was to develop and apply a standardized questionnaire for children when visiting primary schools to survey their knowledge about infectious diseases, pathogen transmission and prevention measures. Enrolling thirteen German primary schools, 493 questionnaires for grade three primary school children were included for further analyses, comprising 257 (52.1%) girls and 236 (47.9%) boys with an age range of 8–11 years. Out of 489 children, 91.2% participants indicated that they knew about human-to-human transmissible diseases. Of these, 445 children responded in detail, most frequently mentioning respiratory and gastrointestinal diseases, followed by childhood diseases. Addressing putative hygiene awareness-influencing factors, it was worrisome that more than 40.0% of the children avoided visiting the sanitary facilities at school. Most of the children (82.9%) noted that they did not like to use the sanitary facilities at school because of their uncleanliness and the poor hygienic behavior of their classmates. In conclusion, basic infection awareness exists already in primary school age children. Ideas about the origin and prevention of infections are retrievable, however, this knowledge is not always accurate and adequately contextualized. Since the condition of sanitary facilities has a strong influence on usage behavior, the child’s perspective should be given more consideration in the design and maintenance of sanitary facilities.

Intervention Effects of the Health Promotion Programme "Join the Healthy Boat" on Objectively Assessed Sedentary Time in Primary School Children in Germany.

Sedentary behaviour (SB) in children is related to negative health consequences that can track into adulthood. The programme “Join the Healthy Boat” promotes reduced screen time and a less sedentary lifestyle in schoolchildren. This study investigated the effects of the programme on children’s SB. For one year, teachers delivered the programme. A total of 231 children (7.0 ± 0.6 years) participated in the cluster-randomised study; there were 154 one year later at follow-up. Children’s SB was assessed using multi-sensor accelerometery, screen time via parental questionnaire. Effects were analysed using (linear) mixed effects regression models. At baseline, children spent 211 (±89) min daily in SB, at follow-up 259 (±109) min/day with no significant difference between the intervention (IG) and control group (CG). SB was higher during weekends (p < 0.01, for CG and IG). However, at follow-up, daily screen time decreased in IG (screen time of >1 h/day: baseline: 33.3% vs. 27.4%; follow-up: 41.2% vs. 27.5%, for CG and IG, respectively). This multi-dimensional, low-threshold intervention for one year does not seem to achieve a significant reduction in children’s SB, although screen time decreased in IG. Therefore, it should be considered that screen time cannot be the key contributor to SB and should not solely be used for changing children’s SB. However, if screen time is targeted, interventions should promote the replacement of screen time with active alternatives.

Comorbidities Between Specific Learning Disorders and Psychopathology in Elementary School Children in Germany.

Children with reading and/or spelling disorders have increased rates of behavioral and emotional problems and combinations of these. Some studies also find increased rates of attention-deficit/hyperactivity disorder (ADHD), conduct disorder, anxiety disorder, and depression. However, the comorbidities of, e.g., arithmetic disorders with ADHD, anxiety disorder, and depression have been addressed only rarely. The current study explored the probability of children with specific learning disorders (SLD) in reading, spelling, and/or arithmetic to also have anxiety disorder, depression, ADHD, and/or conduct disorder. The sample consisted of 3,014 German children from grades 3 and 4 (mean age 9;9 years) who completed tests assessing reading, spelling as well as arithmetic achievement and intelligence via a web-based application. Psychopathology was assessed using questionnaires filled in by the parents. In children with a SLD we found high rates of anxiety disorder (21%), depression (28%), ADHD (28%), and conduct disorder (22%). Children with SLD in multiple learning domains had a higher risk for psychopathology and had a broader spectrum of psychopathology than children with an isolated SLD. The results highlight the importance of screening for and diagnosing psychiatric comorbidities in children with SLD.

Objectively assessed physical activity and weight status of primary school children in Germany with and without migration backgrounds

ObjectivesMany children are insufficiently active, and children with a migration background appear to be even less active and at a higher risk of developing obesity. This study evaluated the weight status, and the frequencies and intensities of objectively assessed physical activity (PA) of children with and without a migration background. Study designCross-sectional study. MethodsPA was assessed objectively for 6 days in 273 children (aged 7.1 ± 0.6 years). In total, 74 children (27%) were classified as having a migration background. PA was grouped in light and moderate-to-vigorous (MVPA) intensities. Body mass index (BMI) percentiles (BMIPCT) were determined. ResultsChildren without a migration background spent more time in MVPA compared with children with a migration background (138.2 ± 62.6 vs 121.7 ± 54.9 min, respectively; P < 0.01). On weekends, time in MVPA decreased significantly for all children (112.3 ± 66.0 min, P < 0.01), especially for children with a migration background (97.7 ± 56.7 min, P < 0.01). Children with a migration background displayed significantly higher BMIPCT than children without a migration background (55.7 ± 29.6 vs 44.3 ± 26.8, respectively; P < 0.01) and were significantly more often overweight and/or obese (13.5% vs 8.5%, respectively; P < 0.02). ConclusionsChildren with a migration background are less physically active and more often overweight, resulting in higher risks of developing secondary diseases. The results of this study should be considered when designing interventions to increase PA in children with a migration background.Trial registration: German Clinical Trials Register (DRKS), DRKS-ID: DRKS00000494;

Caries Trends in the Primary Dentition of 6- to 7-Year-old Schoolchildren in Germany from 1994 to 2016: Results from the German National Oral Health Surveys in Children

Long-term nationally representative caries data in the primary dentition are rare, but nonetheless central to assess needs in caries prevention and treatment. This study evaluated the prevalence and trends of caries levels in the primary dentition of 6- to 7-year-olds in Germany as a whole and its federal states individually. In 2016, employing a randomized cluster selection, 6- to 7-year-old first graders were included in the National German Oral Health Survey performed regularly since 1994/95. Children were examined by 482 calibrated dentists in all 17 German regions using the WHO criteria for the decayed, missing, and filled teeth (dmft) including the assessment of initial carious lesions (it). In total, 151,555 6- to 7-year-olds were examined. Caries prevalence in the primary dentition dropped from 65% in 1994 to 44% in 2016, while the mean caries experience dropped from 2.89 to 1.73 dmft (dt = 0.74, mt = 0.19, ft = 0.80). When initial lesions were included, the mean caries experience increased to idmft = 2.12 (it = 0.38). In 2016, 49.7% of the examined 6- to 7-year-olds were caries-free including initial lesions. The Care Index at the tooth level was 57.5%, and the Significant Caries Index was 4.84 dmft. Depending on the German region, the mean dmft varied considerably, ranging from 1.37 to 2.31. In conclusion, despite the overall caries decline in 6- to 7-year-olds in Germany, only minor caries reductions were observed over the last decade, with a still existing high proportion of untreated dental decay. This calls for more effective preventive and restorative efforts with focus on the primary dentition in Germany.

Effectiveness of a school-based intervention to prevent child sexual abuse-Evaluation of the German IGEL program.

Child sexual abuse (CSA) is a problem with severe consequences for victimized children. A variety of interventions have been developed and implemented over the last decades to prevent CSA. However, most of them have not been systematically evaluated to determine their effectiveness. The IGEL program is a school-based intervention to prevent CSA in third-grade primary school children in Germany. This study was conducted using a quasi-experimental design, in which almost 300 children and their parents from eight intervention and four control schools were surveyed three times (pretest, posttest, 3 months later). In order to measure outcomes, a questionnaire was developed based on validated instruments to assess the knowledge, courses of action and self-protective skills of the children. Furthermore, increased anxiety and generalized touch aversion were examined as potentially harmful side effects of the program. The results clearly demonstrate increased CSA-related knowledge and courses of action in children from the intervention group compared to the control children. These effects were medium-sized and sustained for at least three months after the last session. No meaningful negative side effects were detected in the evaluation for either the children or parents. The outcome evaluation indicates that the IGEL program is an effective intervention in terms of knowledge about CSA and known courses of action, and may therefore contribute to the prevention of CSA in primary schools. Despite this positive core finding of the intermediate outcomes, some adaptations of the program to children with different cultural backgrounds were made prior to further dissemination.

Effectiveness of a “Grass Roots” Statewide Enrichment Program for Gifted Elementary School Children

ABSTRACTEnrichment programs provide learning opportunities for a broader or deeper examination of curricular or extracurricular topics and are popular in gifted education. Herein, we investigated the effectiveness of a statewide extracurricular enrichment program for gifted elementary school children in Germany. The program implemented a ”grass roots“ strategy by which local units developed and offered the enrichment courses, which spanned a broad array of topics. The courses targeted different outcomes, including students' cognitive abilities, school achievement, interests, creativity, self-control, self-concept, and social competencies. We compared third-grade students attending the enrichment program (N =423) with nonattending third-grade students (N = 2,328) by means of a propensity score analysis. Specifically, we controlled for potential selection effects and estimated the average causal effect of the enrichment program for children attending the program. The findings revealed positive program effects on academic achievement but not on the other targeted outcomes.

Acquiring a Taste: Alcohol Experiences of German Elementary School Children

Few data are available on alcohol experiences among elementary school children, although early onset and trying of alcohol use is known to be a risk factor for adolescent alcohol abuse. Until now, research leaves open the question on which factors encourage early trying behavior. In a cross-sectional study design, a written survey was conducted in 49 randomly selected elementary schools in Germany. The survey was carried out among 3rd and 4th graders with a median age of 9 years during class time in the school year 2010/2011. 1806 questionnaires were included in the study. The risk behavior of having tried alcohol was analyzed. A total of 37.7% (n = 681) of all children reported to have already tried alcohol. While grade and age had no significant influence in the final multivariate model, the gender effect stayed relevant (Male: aOR 1.2, 95%-CI 1.0–1.5), as did the question of whether the child liked going to school (No: aOR 1.4, 95%-CI 1.1–1.7), a lack of parental monitoring (aOR 1.5, 95%-CI 1.1–2.1), consistent parenting (Sometimes/never: aOR 1.5, 95%-CI 1.1–1.9), a regularly provided break-time snack (No: aOR 2.2, 95%-CI 1.3–3.8), as well as parents’ drinking (Yes: aOR 2.0, 95%-CI 1.6–2.6) and drinking among peers (Yes: aOR 8.5, 95%-CI 6.2–11.6). Our study shows that alcohol experiences can be highly prevalent among 3rd and 4th grade elementary school children in Germany. Our findings suggest that especially those variables which may be controlled by the parents are strongly associated with children’s alcohol experiences suggesting a starting point for preventative intervention measures. The results also indicate the need for innovative gender-sensitive approaches in the living environment of elementary school children.

ドイツにおける外国人児童生徒に対する「母語」教育の実際 : NRW州におけるトルコ語の「母語授業」を例に

ドイツにおける外国人児童生徒に対する「母語」教育の実際 : NRW州におけるトルコ語の「母語授業」を例に