Secondary School Research Articles

Metacognitive reading strategies: gender, locality, and age differences among secondary school students

This study ascertained the influence of gender, locality and age on metacognitive reading strategies of secondary school students. The sample size consists of 440 students randomly selected from 23 secondary schools. An adopted questionnaire tagged “metacognitive reading strategies questionnaire,” was used as the data gathering instrument, with a logical validity of 0.88 and Cronbach alpha of 0.73 as internal consistency. The data collected were analysed statistically using descriptive statistics and t-tests. Data analysis revealed that females' reading strategies outnumber males'; females' global strategies ranked highest, while females' problem-solving strategies ranked lowest; and students in urban secondary schools tended to utilise metacognitive reading strategies more frequently than their rural counterparts. This study also shows that students with higher age brackets make more use of metacognitive reading strategies than lower-age students. Therefore, it is recommended that educators should be prepared to educate students how to effectively utilise various components of metacognitive reading strategies.

Workshop training to facilitate parental involvement in their children’s mathematics education: parents’ perceptions

This study investigated the effectiveness of workshops on parental involvement in their children’s mathematical education. The study employed a quasi-experimental with a pre-test-post-test design. This study involved 76 parents from one senior secondary school in the Kweneng Region, Botswana. The study included three steps for data analysis: thematic content analysis, hypothesis testing, and descriptive statistical analysis. The results showed that the parental involvement level before and after the intervention marked a difference with a significant increase. Parental involvement variables such as parenting style, parental expectations, home rules, parental supervision, communication between parents and children, children’s home mathematics activities, and parental attitude toward school all improved significantly. The findings further indicated that parental involvement in their child's general and mathematical learning can be improved. As a result, the study recommended that all basic education schools reach out to parents through parent education programs that can assist parents in understanding the value of being active in their children’s mathematics education, which will probably affect their education performance positively.

“Our earth, it's like it's in a toaster”: Creative, figurative and narrative interactions in interviews with lower secondary school students about climate activism

Previous studies have identified the use of metaphor and metonymy in contexts of youth-led climate protests and social media activism. In this study, we conducted semi-structured interviews to investigate how secondary school students in England make sense of different creative uses of metaphor and metonymy in a sample of slogans shared on social media for the Global Climate Strikes and #FridaysForFuture. For analysing students' responses, we produced a coding scheme to unpack the relationship between figurative interpretation and narrative. The findings suggest that different creative uses (e.g. twice-true, juxtaposition and personification) prompted different kinds of thinking about climate change and its relevance to students’ personal lives. The study has implications for research on figurative creativity, narrative, and climate change education.

Effect of problem-solving teaching methods on students' interest and academic performance in animal husbandry in secondary schools for sustainable development in Nigeria

This study investigated the effects of Problem-solving teaching method on Animal Husbandry Students' interest and academic performance in Senior secondary schools in Benin City, Edo State, Nigeria. The Theory of experiential learning was used to explain how learning by active participation in the learning process can increase interest in the learning process. Quasi-experimental. Specially, the pre-test post-test control group were used to collect data from 251 students using an intact class. The results showed that students interest increase as the result of the treatment. The study found that students. performance also increases as a result of their interest in studying Animal Husbandry. The study concludes that teaching using problem solving can increase students interest in studying Animal Husbandry and also improve their performance in the subject for sustainable development in Nigeria. Recommendations include that animal Husbandry teachers should constantly use problem solving teaching methods in teaching animal Husbandry to encourage students to learn animal Husbandry effectively in secondary schools.

Parenting behaviour and student discipline in public boarding secondary schools in Western region of Kenya

Discipline in schools is an issue that especially concerns educators, parents, and other stakeholders. In an environment that lacks order and discipline, it is impossible for students to learn effectively. Thus, order and discipline are indispensable for achieving positive educational results. The family assumes a pivotal role in shaping the early years of an individual. The purpose of this research was to investigate the influence of parenting behaviour on student discipline in public boarding secondary schools in Western region of Kenya. Family composition and structural-functionalism theories served as guiding principles for the research. The investigation was conducted using an ex post facto design. The study's target population consisted of 5583 class teachers and 369 deputy principals (administrators-in-charge) from 369 public boarding secondary institutions. The sample included 123 deputy Principals and 558 class teachers from the 123 randomly selected schools. Simple random sampling was used to select 558 class teachers while purposive sampling was used to select 123 deputy Principals. For the purpose of data collection from the participants, a questionnaire and an interview schedule were employed. The assessment of the instruments' reliability was conducted using the test-retest method, results of the pilot study reveal that all scales were trustworthy because their reliability values were more than the required threshold of 0.7. Data was analyzed using frequency, percentages, weighted averages, correlations and multi-regression analysis. The study concluded that parenting behavior influence the discipline of students in public secondary schools. Therefore, it was recommended that school management boards should organize for the sensitization meetings on effective parenting behaviour, this will enable curb indiscipline among students.

Compliance with weekly iron folic acid supplementation and associated factors among secondary school adolescent girls, in Jimma Arjo District, West Ethiopia, 2022: A mixed method cross-sectional Study

Background: Iron deficiency anemia is a prevalent and major public health problem in low- and middle-income countries among adolescent girls. The risk of Iron deficiency anemia and its consequences are prevented by taking and complying with a weekly iron-folic acid supplement. However, there was no information regarding compliance and its associated factors in Ethiopia. The study aimed to determine the magnitude of compliance with weekly Iron-folic acid supplementation and associated factors among Jimma Arjo secondary school adolescent girls. Methods: Institutional-based cross-sectional study was conducted on 417 adolescent girls in three secondary schools of Jimma Arjo, West Ethiopia from March 1st to 31st, 2022 using interviewer-administered structured and semi-structured questionnaires. Bivariable and multivariable logistic regression analyses were used to determine the association of variables. Results: Compliance with iron-folic acid supplementation was 29.3% with 95% CI (24.9, 33.3). Mother`s secondary level of education (AOR=4.94 (95% CI:2.45,9.94)), awareness of anemia (AOR=4.23 (95% CI:2.35,7.61)), good knowledge about iron-folic acid supplementation (AOR=3.96 (95% CI:2.17,7.22)), lack of iron-folic acid supplementation (AOR=0.42 (95% CI:0.23,0.75)), and iron-folic acid supplementation side effects (AOR=0.17 (95% CI:0.08,0.37)) were factors significantly associated with iron-folic acid supplementation compliance. Misconceptions about iron-folic acid supplementation, forgetfulness of tablet, lack of access to drinking water, and irregularity of school weekly iron-folic acid supplementation days were identified as the main barriers to adolescent girls' compliance with iron-folic acid supplementation in a qualitative study. Conclusions: Weekly iron-folic acid supplementation compliance was low at 29.3%. Scheduled health education, parental participation in the program, access to drinking water, refresher training for school focal persons, and fixed weekly iron-folic acid supplementation days can improve compliance with iron-folic acid supplementation and are recommended.

Influence of Teachers’ Experience in Information Communication Technology and Students’ Academic Performance in Mathematics in Public Secondary Schools of Rwanda: A Case of Kayonza District

The study evaluated the impact of teachers' ICT experience on students' math performance in public secondary schools in Kayonza District, Rwanda. Involving 259 participants (223 teachers and 36 head teachers), data were gathered through questionnaires, interviews, and observations, and analyzed using SPSS Version 20.0. Findings revealed that 83.5% of respondents strongly agreed that teachers skilled in MS Excel, 85.9% in PowerPoint, and 83.9% in preparing teaching materials with ICT tools positively influenced students' performance. Additionally, 82.3% noted that teachers trained in exam preparation with ICT tools demonstrated their ICT experience. Improved student outcomes were reported, with 79.4% noting better numeracy, 80.2% improved grades, and 78.3% enhanced skills in experimenting with MS Excel. A significant positive correlation was found between teachers' ICT expertise and students' math performance. The study suggests that proficiency in ICT tools enhances students' academic performance. The Ministry of Education should support ICT integration to boost academic achievement, with superintendents and head teachers optimizing ICT training and lab usage. Teachers should share ICT skills to improve instruction and student outcomes. Future research should investigate the broader effects of ICT in education on academic achievement in mathematics.

Teacher support as antecedent of students’ academic achievement in EFL learning: Mediating role of academic buoyancy

Teachers’ academic support has been empirically shown to positively influence academic performance through both case studies and quantitative research. However, the mechanisms underlying this relationship remain inadequately explored. This gap is particularly evident in the domain of teaching English as a foreign language (EFL), where the integration of positive psychology warrants investigation into how teachers’ academic support fosters students’ academic buoyancy, subsequently enhancing academic performance. To address this issue, the present study engaged 610 secondary school English learners (292 females, representing 47.5%) in a questionnaire survey. A structural equation modeling analysis was conducted, controlling for variables such as age, gender, and family resources. The findings reveal two key insights: first, both teachers’ academic support and academic buoyancy exert significant positive effects on academic performance; second, academic buoyancy serves as a partial mediator between classroom academic support and academic performance. These results underscore the importance of understanding the nuanced roles that teacher support and psychological factors play in educational outcomes. Implications, limitations and direction for further research are discussed.

Relationship between Student-Teachers’ Academic Interaction and Academic Self-Esteem in Public Secondary Schools in Nakuru County, Kenya

The learners’ academic self-esteem and academic interaction shape the learning environment of students. The purpose of this study was to examine students’ academic interaction and academic self-esteem relationships in public secondary schools in Nakuru County, Kenya. Correlational research design and both quantitative and qualitative research approaches were used in the study. The population of the study comprised 23,309 that is 11,938 boys and 11,371 girls form three students from 294 public secondary schools in Nakuru County. A total of 29 public secondary schools and 378 form three students were selected using stratified random sampling. The study used purposive sampling to sample 29 class teachers from the selected public secondary schools in Nakuru County. The total sample size for this study was therefore 407 respondents. The study used closed-ended questionnaires to collect data from students and interview schedule to collect data from class teachers. To ensure content validity of the research instruments, the researcher developed questionnaires and an interview schedule in line with the objectives of the study in consultation with experts on counseling and educational foundations. To test the reliability of the questionnaire, a pilot study was done on one secondary school that was not part of the actual study. Cronbach’s Alpha test of internal consistency was established whereby the items had reliability coefficients of 0.871 (for the student-teacher academic interactions tool) and 0.873 (for student academic self-esteem tool) which were considered acceptable. Quantitative data was analyzed using the Statistical Package for Social Sciences (SPSS) version 24 while qualitative data was analyzed using NVivo version 12. The study established that there was a statistically significant relationship between student-teachers’ academic interaction and academic self-esteem in public secondary schools in Nakuru County, Kenya. The study recommends Kenyan teachers training institutions to advance teaching methods that seeks to improve student-teachers’ academic interaction and academic self-esteem for better academic achievement.

Implementation of Active Learning Methods in Islamic Religious Education to Improve Students' Critical Thinking Skills in Schools

This research aims to examine the effectiveness of implementing active learning methods in Islamic Religious Education (PAI) as an effort to improve students' critical thinking skills at school. This research uses a quantitative approach with a quasi-experimental design, involving students from several secondary schools as samples. Data was collected through critical thinking skills tests before and after implementing active learning methods. The research results show that the application of active learning methods significantly improves students' critical thinking skills in the PAI context. These findings indicate that this method is effective in creating a learning environment that supports the development of students' analytical, evaluation and reflection skills on religious values, as well as their relevance in everyday life.

Influence of Organizational Technology on Administrative Performance of Public Secondary Schools in Nakuru County, Kenya

The purpose of this study was to assess the influence of organizational technology on administrative performance in public secondary schools in Nakuru County, Kenya. The study adopted a mixed-method research design. The study targeted 352 principals in public secondary schools and 11 Sub-County Quality Assurance and Standards Officers in Nakuru County. Using stratified random sampling, a sample size of 106 principals and 4 Sub-County Quality Assurance and Standards Officers (30 % of the population) was selected. Data collection methods included questionnaires administered to principals and interviews conducted with Sub-County Quality Assurance and Standards Officers (SCQASO). Quantitative data were analyzed using descriptive and inferential statistics, including Pearson’s correlation and regression analysis, while qualitative data underwent thematic analysis. A pre-test involving 11 schools in Nyandarua County confirmed the reliability of the research instruments, yielding a Cronbach’s alpha of 0.805. The findings reveals a strong and significant correlation between organizational technology and administrative performance (r = 0.876, p = 0.004). It was concluded that organizational technology, significantly influenced the administrative performance of principals, ultimately enhancing school effectiveness. To improve public secondary school administration, it is recommended that operational efficiency be enhanced, and technology be integrated.

Influence of Organizational Roles on Administrative Performance of Public Secondary Schools in Nakuru County, Kenya

The purpose of this study was to assess the influence of organizational roles on administrative performance in public secondary schools in Nakuru County, Kenya. The study adopted a mixed-method research design. The study targeted 352 principals in public secondary schools and 11 Sub-County Quality Assurance and Standards Officers in Nakuru County. Using stratified random sampling, a sample size of 106 principals and 4 Sub-County Quality Assurance and Standards Officers (30 % of the population) was selected. Data collection methods included questionnaires administered to principals and interviews conducted with Sub-County Quality Assurance and Standards Officers (SCQASO). Quantitative data were analyzed using descriptive and inferential statistics, including Pearson’s correlation and regression analysis, while qualitative data underwent thematic analysis. A pre-test involving 11 schools in Nyandarua County confirmed the reliability of the research instruments, yielding a Cronbach’s alpha of 0.805. The study found that the correlation coefficients between organizational roles and administrative performance in public secondary schools in Nakuru County, Kenya (r = 0.567, p = 0.002) was strong and significant. Organizational role significantly influenced the administrative performance of principals, ultimately enhancing school effectiveness. To improve public secondary school administration, it is recommended that clearly defined administrative roles be established.

Extensiveness of Teachers’ Workload in Determining the Acquisition of Kiswahili Reading Skills Among Pupils in Public Primary Schools in Tanga City Council, Tanzania

The study investigated the extensiveness of teachers’ workload in determining the acquisition of Kiswahili reading skills among public primary school pupils in Tanga City Council, Tanzania. The study employed a convergent design under mixed methods research approach to collect both quantitative and qualitative data simultaneously and compare the results to obtain a more complete understanding of the research problem. The study targeted 80 public primary schools, 80 head teachers, 264 Kiswahili subject teachers, 24 Ward Education Officer and 1 City Council Primary Education Officer. Both probability and non-probability sampling techniques were employed to obtain respondents who participated in this study. The study involved 8 public primary schools, 8 head teachers, 88 Kiswahili reading skills teachers, 8 WEO and 1 CCPEO. Data were collected using questionnaires, and interview guide. Data collection instruments were validated by Mwenge Catholic University research experts. A pilot study was conducted in two public secondary schools. The reliability of questionnaires for Likert scale items was determined using Cronbach's Alpha Coefficient where reliability coefficient r= 0.892 for Kiswahili subject teachers questionnaire was obtained. The reliability for qualitative data was established through peer debriefing and triangulation. The study adhered to research ethical principles throughout the research process. Quantitative data were analyzed using descriptive statistics particularly using frequencies, percentages and mean with the aid of SPSS Version 22. The study concludes that due to their overwhelming responsibilities, teachers find it challenging to give students timely and insightful feedback on their reading progress. Teachers find it challenging to plan and implement enjoyable reading activities that would greatly enhance their pupils Kiswahili reading skills. Teachers are unable to give each pupils the individualized support and attention they need to improve their reading skills in Kiswahili, leaving them with little time and energy. The study recommends that heads of public primary schools can support teachers in working less by making sure that teachers have enough time to plan, organize, assign reading tasks, and help pupils who are failing with learning. The administration of public primary school should make sure that the school has enough teaching and learning resources for Kiswahili reading instruction.

The relationship between mindfulness and childhood trauma with suicide: The mediating role of cognitive bias

The purpose of this study is to investigate the relationship between mindfulness, childhood trauma, and suicide, specifically focusing on the mediating role of cognitive bias. Suicide is a pressing issue that poses a significant threat to public health in society, and understanding the factors that contribute to it is crucial. The research design employed in this study is a correlation-based structural equation model. A total of 370 students from the second level of secondary school in Iran city were selected as participants using an available sampling method during the academic year of 2023. To gather data, several questionnaires were utilized, including the Kentucky Mindfulness Questionnaire, Bernstein et al.'s Childhood Trauma Questionnaire (1994), Hammachi and Ozturk's Cognitive Bias Questionnaire (2004), and the Multi-attitude Suicidal Tendency Questionnaire (MAST). Data analysis was conducted using SPSS-23 and Amos software, encompassing both descriptive and inferential levels. The findings of this research revealed several significant relationships. Firstly, there is a positive and significant direct path from childhood trauma to cognitive bias. Secondly, mindfulness has a negative and significant direct path to cognitive bias. Thirdly, childhood trauma has a direct and significant path to suicide. Additionally, cognitive bias has a positive and significant path to suicidality, while mindfulness has a negative and significant path to suicide. Moreover, there are positive and significant indirect paths from suicide to childhood trauma and negative and significant indirect paths from suicide to mindfulness. In conclusion, this study highlights the importance of mindfulness and cognitive bias as variables related to adolescent suicide. Adolescents who have experienced childhood trauma are more likely to consider suicide as a solution when faced with life problems. These findings emphasize the need for interventions and support systems that address mindfulness, cognitive bias, and childhood trauma to prevent and mitigate the risk of suicide among adolescents.

11.K. Scientific session: Roots of public health: school health literacy to enhance population health outcomes in Europe

Abstract This workshop will present empirical results from three representative studies on health literacy and digital health literacy conducted in primary and secondary schools in Wales and Germany: (1) Digital Health Literacy in Schools, (2), HLCA HL-Kids, (3) WHO HBSC Wales. While research on child and adolescent health literacy has gained traction in the past decade, only a few studies focus on health literacy in schools. While the European Commission and WHO, as well as most European governments, highlight the importance of schools to support children’s health literacy, schools remain neglected as a research context. With only little evidence available, it is difficult to derive strategies and programs to promote health literacy in schools. We aim to provide practical novel knowledge and contribute to closing the school health literacy gap that is prevalent in Europe. In turn, this will also contribute to European public health development and population health outcomes. Levels of health literacy in child and adolescent populations across European countries and age groups are alarmingly low, making low health literacy a severe risk factor for health outcomes. Low health literacy is associated with worse health conditions and unhealthy behaviours, and in turn, impacts school attainment and educational outcomes. Evidence suggests that health literacy acts as a determinant of health and itself is influenced by other social determinants of health, such as education, intertwining health and education. All studies conducted so far provide evidence that low health literacy follows a social gradient, with children from less affluent families being more likely to have lower health literacy, widening preexisting health inequities observed in almost all health domains within Europe. While effective interventions on the individual and system levels are needed to enhance health literacy, implementation and evaluation research concerning children’s health literacy is rare. Workshop objectives The aim of this workshop is to present findings from three representative studies on health literacy and digital health literacy in primary and secondary schools: (i) The 1st speaker will introduce a study on health literacy and health behaviours of children aged 8-11 (ii) The 2nd speaker will discuss the influence of living environments on health literacy in 4th-grader school kids (iii) The 3rd presentation will have its focus on navigating the infodemic through digital health literacy in adolescent students (iv) The 4th speaker will show links between digital health literacy and health behaviour in adolescent students The format of this workshop will be 4x10-minute presentations followed by a 20-minute panel discussion with the audience, reflecting the relevance of the results to public health research, practice, and policy. The chairs will provide a brief introduction to the concept and moderate the presentations and panel discussion. Key messages • Our results show that health literacy should be addressed as early as in primary schools and that the places, households, and environments children grow up are critical social determinants of health. • Digital health literacy has proven to be a valid learning topic in secondary schools and is linked to digital and media literacy, allowing us to define it as a targeted curriculum item.

Comprehensive sexuality education: indicators to evaluate interventions in Italian schools

Abstract Background Comprehensive sexuality education (CSE) is globally acknowledged as the most effective approach to promoting sexual health and preventing Sexually Transmitted Infections (STIs). However, in Italy, CSE is not consistently part of the school curriculum. The EduForIST project, funded by the Ministry of Health, introduced and tested a unique CSE model in a sample of secondary schools across six Italian regions, aiming to develop an evaluation model for potential nationwide implementation. Methods The EduForIST partnership, comprising experts from various institutions, devised a framework for monitoring and evaluating CSE interventions. Through monthly focus group discussions from April 2023 to February 2024, they established indicators for short-, medium-, and long-term evaluation of clinical and behavioral outcomes, as well as process indicators to assess intervention implementation. Results A total of 35 indicators were developed, including clinical and behavioral ones for medium and long-term outcomes, short-term behavioral outcomes, and process indicators. Data for clinical and behavioral indicators can be obtained from administrative sources like the Ministry of Health and Regional Health Authorities. The National Institute of Health provides data from relevant surveillance programs. However, many process indicators require specific data collection and calculations. Challenges such as under-reporting and underestimation persist, especially in regions with limited CSE implementation. Conclusions Creating an effective monitoring system for CSE interventions necessitates integrating diverse data sources, including health records, administrative data, and behavioral assessments. The proposed model’s effectiveness will be fully assessed by comparing pre- and post-intervention after widespread implementation in secondary schools. Meanwhile, the selected indicators serve as a foundation for evaluating baseline status of STIs and behaviors in Italy. Key messages • The EduForIST project establishes a robust framework for evaluating Comprehensive Sexuality Education (CSE) interventions in secondary schools, addressing gaps in nationwide implementation. • By devising indicators encompassing several measures, the project lays the groundwork for a comprehensive monitoring system, vital for assessing the effectiveness of CSE interventions in Italy.

Sexual health education in Italian schools: preliminary results of EduForIST3 national project

Abstract Background School-based comprehensive sexuality education (CSE) is the best approach to disseminate scientific evidence and promote healthier sexual behaviours among young people. However, in Italy, CSE is not included in schools curricula. This study, funded by the Ministry of Health, seeks to investigate information uptake and attitudes towards sexuality among adolescents included in a pilot CSE intervention in 6 Italian regions, from December 2023 to June 2024. Methods A 10-hours education intervention was implemented in a convenient sample of 26 upper and lower secondary schools (U/LSS), covering topics such as changes in adolescence, relationships and consent, sexual identity, sexually transmitted infections (STIs), contraception and sexual health services. Students’ evaluation comprised pre/post tests assessing knowledge, attitudes towards sexuality and satisfaction. A Solomon 4-group design study was used to compare intervention and control classes. A follow-up test will be conducted 4-6 months post-intervention. Results Preliminary analysis of available data as of 30 April, 510 pre-tests and 266 post-tests, showed incremented correct answers in all items. A significant increase (p<.05) was found in 12/21 items for USS and in 9/19 items for LSS, especially in the domain STIs symptoms and prevention, among those mostly appreciated. Over 90% of students considered schools as suitable setting to receive CSE, preferably by external experts. Ongoing qualitative and long-term analysis will provide further insights of the overall impact of the activity. Conclusions The pilot CSE intervention increased the knowledge and attitudes of the students involved. Additional insights will be available after study completion. Findings from this study will contribute to evaluate the effects of CSE initiatives on sexual health knowledge and attitudes among Italian secondary schools students, as well as the effectiveness of such programs in fostering healthier behaviours. Key messages • Providing evidence-based, relevant information and education on sexual health to young people in secondary schools increases their knowledge and improves attitudes towards sexuality. • CSE should be included in Italian school curricula in order to promote an incremental uptake of information and to improve young people’s sexual health.

The influence of education on antenatal care and nutrition of newborns in Croatia

Abstract Background Previous studies indicate differences in the nutrition of newborns. Great efforts are invests in public health education of expectant mothers in order to improve the health of their offspring. Methods An analytical study of data on the influence of social factors and the level of education of mothers on the nutrition of newborns, habits of pregnant women and antenatal care in the City of Zagreb was conduct in 2022. The paper shows analytical results expressed in percentages of the prevalence and 95% confidence interval (CI). Results The survey covered 6,358 women giving birth in the City of Zagreb in 2022. Most mothers fed their newborns in the hospital with breast milk (48.6%) or a combination of breast milk and artificial nutrition (45.8%), and only 1.4% with artificial nutrition. The share of mothers who fed their newborns exclusively with breast milk is slightly higher among highly educated women (52.4%). The majority of women had their newborn’s first feeding within one hour (81.4%), also more often in highly educated women. The first breastfeeding is most often ten (10.1%) or 15 minutes after birth (8.2%). Only 1.1% of pregnant women smoked during pregnancy, of which the largest share was women with a high school diploma (62.1%). With the increase in education, the share of women with 5 or less antenatal checks decreases (completed college 3.3%, higher school 4.6%, secondary school 6.6%, primary school 12.7%). The largest share of pregnant women who had their first antenatal examination only after 10 weeks of pregnancy is among women with a high school diploma (11.3%). Conclusions The education of pregnant women influenced their adoption of positive lifestyle habits, the need for timely and regular antenatal care and the benefits of feeding newborns with breast milk. Additional education through public health campaigns aimed at pregnant women and future parents as well as breastfeeding support groups need to be continuously implement. Key messages • The education of pregnant women influenced their adoption of positive lifestyle habits, the need for timely and regular antenatal care and the benefits of feeding newborns with breast milk. • Additional education through public health campaigns aimed at pregnant women and future parents as well as breastfeeding support groups need to be continuously implement.

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

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

The cohort trends of social connectedness in secondary school students in Finland between 2017 and 2021.

The aim was to investigate the cohort trends of the experienced social connectedness in secondary school students between 2017 and 2021 and whether these trends vary by gender, school level and sociodemographic background. We used nationally representative Finnish data of 450,864 students in lower and upper secondary education. Social connectedness was measured by number of close friends, feelings of loneliness and sense of belonging at school. Adjusted regression analyses included year, gender, school level and sociodemographic factors (parental education, immigrant status of the student and urban-rural area of the school). The results showed that social connectedness declined from 2017 to 2021: 11% decline in having 3+ close friends, 15% increase in loneliness and 8% decline in belonging at school. The decline was especially large in girls and upper secondary school. Although some socio-demographically disadvantaged groups showed lower levels of social connectedness, there were differences by gender, school level and year. Many differences diminished because the more advantaged groups declined faster, i.e. moved towards the less advantaged groups. Declining social connectedness in young people is a worrying trend that requires a public health focus on the whole cohort while accommodating the variation by the individual and environmental context.