Swedish Youth Research Articles

Young people’s experiences of religious socialisation in Sweden and Finland

ABSTRACT The religious landscape in the Nordic countries has changed in recent decades. This article looks at what this means from the perspective of the religious socialisation experiences of Finnish and Swedish youth. Research has shown that the views and values of parents, family, friends, the youth culture and those that are prevalent in school and society as a whole are important for young people’s self-development. The intergenerational socialisation of religious traditions and values has diminished as societies have become more secularised. As this topic is scarcely researched, new studies are needed also on young people’s perspectives. This article aims to fill the research gap by investigating the kind of impact that parents, school and friends have on young people’s religious socialisation.

Attachment and trauma-informed programme to support forcibly displaced parents of youth in Sweden: feasibility and preliminary outcomes of the eConnect Online programme

ObjectivesTo assess the feasibility, acceptability and the impact of an online parenting programme for forcibly displaced parents of adolescents.DesignThe study was a single-arm feasibility study using pre-intervention post-intervention and follow-up...

The Swedish Youth with Obesity cohort: Profile of an ongoing prospective study.

As there is a lack of studies on adolescents and young adults with obesity, the Swedish Youth with Obesity cohort was set up to describe the long-term results of medical, as well as surgical, obesity interventions in youth. This article describes the study protocol. Since 2018, the study has continuously recruited patients aged between 16 and 25 years who have been admitted for obesity treatment at a specialist obesity clinic in Stockholm, Sweden. Participants provide data from blood tests, questionnaires, and anthropometric measurements. Data are collected longitudinally at enrollment and after 18 months and 3, 4, 5, and 10 years. In the first 500 participants (76% female), the mean age was 21 (SD 3.0) years and the mean BMI was 41.3 (SD 6.1) kg/m2 at enrollment. Almost half of the participants (44.4%) reported that both parents were born outside the Nordic countries. The proportion of participants who smoked at least sometimes was 28.4%. The longitudinally collected data from the Swedish Youth with Obesity cohort will become a valuable source for answering various research questions regarding long-term results of medical and surgical obesity treatment in adolescents and young adults with obesity.

Development and usability evaluation of an electronic health report form to assess health in young people: a mixed-methods approach

BackgroundElectronic Patient-Reported Outcomes (ePROs) have potential to improve health outcomes and healthcare. The development of health-technology applications, such as ePROs, should include the potential users and be theoretically grounded. Swedish Youth Health Clinics (YHCs) offer primarily sexual and psychological healthcare for young people aged 12 to 25 years old. Young people in healthcare settings are considered a vulnerable group. The development of a collection of Patient-Reported Outcomes (PROs) in an Electronic Health Report Form (eHRF) for identifying health and health-related problems in young people, was preceded by a qualitative interview study, exploring young people’s views on using an eHRF at YHCs and which questions about health an eHRF should contain. The aim of the current study was to develop and evaluate the usability of an eHRF prototype for identifying health and health-related problems in young people visiting YHCs.MethodsThis study used a participatory design. During the development, an expert panel consisting of eight researchers and one Information Technology worker, participated. A wide literature search was performed to find PROs to construct an eHRF prototype to cover health areas. A mixed methods usability evaluation included 14 participants (young people, healthcare professionals, and an expert panel).ResultsThe development resulted in an eHRF prototype, containing ten reliable and valid health questionnaires addressing mental-, physical-, and sexual health and social support, a self-efficacy question, and background questions, in total 74 items. The interviews in the usability evaluation resulted in three categories describing the usability of the eHRF: ‘Captures the overall health of young people but needs clarification’, ‘Fun, easy, and optional and will keep young people’s interest’, and ‘Potential contribution to improve the health consultation’. The quantitative results support the usability of the eHRF for YHCs.ConclusionsThe participatory approach contributed to development of the eHRF prototype to cover health areas adapted for the target population. The usability evaluation showed that the eHRF was usable and had the potential for self-reflection and contributions to cooperation between young people and healthcare professionals during the health consultation.

Melatonin use and the risk of self-harm and unintentional injuries in youths with and without psychiatric disorders.

Sleep disorders in youth have been associated with increased risks of injury, including suicidal behavior. This study investigated whether melatonin, which is the most common medication for sleep disturbances in youth in Sweden, is associated with a decreased risk of injury. This population-based cohort study included 25,575 youths who initiated melatonin treatment between ages 6 and 18. Poisson regression was used to estimate rate of injuries in the year prior to and following melatonin treatment initiation. A within-individual design was used to estimate relative risks by comparing injury risk in the last unmedicated month with injury risks in the 12 months after medication initiation. Analyses were stratified by sex, injury type, psychiatric comorbidities and age at melatonin-treatment initiation. While body injuries, falls and transport accident rates were comparable in the year before and after melatonin-treatment initiation, the risk of self-harm was highest in the months immediately prior to medication, and decreased thereafter. This was particularly prominent among adolescents with depression and/or anxiety, with females displaying greater absolute risks than males. Compared to the last unmedicated month, the 12 months post medication initiation had decreased relative risks for self-harm, with an IRR [95% CI] in the month following melatonin-treatment initiation of 0.46 [0.27-0.76] among adolescent females with psychiatric disorders, after excluding antidepressant users. Decreased risk of intentional self-harm was observed following melatonin-treatment initiation among females with depression and anxiety, suggesting that sleep interventions could be considered in an effort to reduce risk of self-harm in this population.

Sweden Against Apartheid: A Historical Overview

Sweden’s relations with the South African liberation movements date back to the 1960s, when the Swedish anti-apartheid movementarose. In addition to moral support and about $400 million dollars in financial support, Sweden became the first Western country to give official political support to the anti-apartheid movement. Such was the relationship between the African National Congress (ANC) and Sweden, that the latter became the first country outside of Africa to be visited by Nelson Mandela in 1990, after his release from decades of imprisonment. The aim of this contribution is therefore to provide a brief synopsis of the rich history of Sweden’s solidaritywith the South African liberation struggle and the role played by the Swedish youth, the Swedish antiapartheid movement, civil society, trade unions, and Olof Palme, former Swedish prime minister, who was one of the most committed allies of the liberation movements.

Associations between social factors and school belonging among newcomer and non-newcomer youth in Sweden.

Feeling a sense of belonging at school is associated with important positive outcomes for youth and requires youth to engage in positive social relationships. Yet there is a limited understanding of the social factors most associated with youths' school belonging and limited evidence about whether correlates of school belonging vary for marginalized groups like newcomers compared to majority groups. Sweden provides an important context for investigation of these issues because, over the past two decades, the country has experienced an influx of asylum seekers and educational reforms that have altered the composition and functioning of Swedish secondary schools. This study addresses these gaps by (1) investigating which of eight social factors are associated with school belonging among diverse Swedish youth, and (2) examining whether newcomer status moderates the relationship between social factors and school belonging. Hierarchical regression and moderation analyses were used to analyze data from 14 to 19 year-old (n = 233) newcomers and non-newcomers in Sweden. An exploratory factor analysis revealed that the school belonging measure contained two factors: positive perceptions and negative perceptions (reverse coded). For both, stronger school belonging was associated with lower perceived ethnic discrimination. Positive perceptions of school belonging were also associated with more prosocial behaviours and lower emotional problems. Negative perceptions of school belonging were associated with more peer problems. Notably, quantity and quality of peer relationships were not associated with school belonging. There was no consistent evidence of newcomer status moderating the relationship between social factors and school belonging. These results highlight factors associated with school belonging which are modifiable and amenable to intervention or impact by policy-ethnic discrimination, prosocial behaviour, and emotional and peer problems. The absence of moderation by newcomer status suggests that school belonging interventions or related policies are likely to affect newcomer and non-newcomer students similarly.

Be prepared and do the best you can: a focus group study with staff on the care environment at Swedish secure youth homes

ABSTRACT This study focuses on the care environment of secure youth homes run by the Swedish National Board of Institutional Care, where youths up to 21 years old are placed according to law due to extensive care needs or sentences. Purpose This study examined staff members’ experiences of the institutional care environment within secure youth homes. Methods Data were collected through three focus group discussions with 17 staff members at two secure youth homes. Subsequently, a thematic analysis was conducted. Results The analysis indicated two main themes: risk management and damage control in a restricted environment and compensating and reconstructing ordinariness—trying to make the best of it; each theme had three subthemes. The care environment seems to be experienced by staff as characterized by conflicting demands, thus constituting a gap between needs and what is possible to achieve—a balancing act that constitutes a constant struggle. Conclusions The staff members’ constant struggle could be interpreted as conflicting moral and instrumental demands; they know what the youths need, but the environment of the secure youth homes demands the decorous behaviour of sociomaterial control practices—rather than care practices.

Relapse Prevention Therapy for Problem Gaming or Internet Gaming Disorder in Swedish Child and Youth Psychiatric Clinics: Protocol for a Randomized Controlled Trial.

Although gaming is a common arena where children socialize, an increasing number of children are exhibiting signs of problem gaming or internet gaming disorder. An important factor to the development of problem gaming is parent-child relationships. A cognitive behavioral therapy-based form of treatment, labeled relapse prevention, has been developed as a treatment for child and adolescent problem gaming or internet gaming disorder. However, no study has evaluated the effect of this treatment among Swedish children and youth nor the role of the parent-child relationships in this treatment. This study aims (1) to evaluate a relapse prevention treatment for patients showing signs of problem gaming or internet gaming disorder recruited from child and youth psychiatric clinics and (2) to test whether the quality of parent-child relationships plays a role in the effect of relapse prevention treatment and vice versa-whether the relapse prevention treatment has a spillover effect on the quality of parent-child relationships. Moreover, we explore the carer's attitudes about parent-child relationships and child gaming, as well as experiences of the treatment among the children, their carers, and the clinicians who carried out the treatment. This study is a 2-arm, parallel-group, early-stage randomized controlled trial with embedded qualitative components. Children aged 12-18 years who meet the criteria for problem gaming or internet gaming disorder will be randomized in a 1:1 ratio to either intervention (relapse prevention treatment) or control (treatment as usual), with a total of 160 (80 + 80) participants. The primary outcomes are measures of gaming and gambling behavior before and after intervention, and the secondary outcomes include child ratings of parent-child communication and family functioning. The study is supplemented with a qualitative component with semistructured interviews to capture participants' and clinicians' experiences of the relapse prevention, as well as attitudes about parent-child relationships and parenting needs in carers whose children completed the treatment. The trial started in January 2022 and is expected to end in December 2023. The first results are expected in March 2023. This study will be the first randomized controlled trial evaluating relapse prevention as a treatment for child and adolescent problem gaming and internet gaming disorder in Sweden. Since problem behaviors in children interact with the family context, investigating parent-child relationships adjacent to the treatment of child problem gaming and internet gaming disorder is an important strength of the study. Further, different parties, ie, children, carers, and clinicians, will be directly or indirectly involved in the evaluation of the treatment, providing more knowledge of the treatment and its effect. Limitations include comorbidity in children with problem gaming and internet gaming disorder and challenges with the recruitment of participants. ClinicalTrials.gov NCT05506384 (retrospectively registered); https://clinicaltrials.gov/ct2/show/NCT05506384. DERR1-10.2196/44318.

Cultural Adaptation of Interventions and the a Priori Assessment of Intervention Fit: Exploring Measurement Invariance for American and Swedish Youth Leaving Care

ABSTRACT Purpose There is a growing literature on the importance of cultural adaptation of research-supported social work interventions. Few studies have however offered systematic methods for the a priori assessment of intervention fit in a new context. The current study explores the use of measurement invariance analyses to help identify whether key theoretical constructs in an intervention’s theory of change may fit differently in a new context. Methods We draw on data on 13 measures of key constructs in an intervention for youth leaving out-of-home care designed and trialed in the US context (N = 295; 53.1% girls, mean age 17.3) compared to Swedish adolescents (N = 104; 41% girls, mean age 17.5). Results In general, the results found all the measures to be invariant between US and Swedish samples. Discussion The original intervention (US) is likely to have a good fit in the new (Swedish) context in terms of the measurement and functionality of its key constructs. There are, however, some indications that certain aspects of the original key constructs may function differently in the Swedish context, highlighting a need to review either measurement or intervention design. A broader conclusion is that measurement invariance can provide a useful tool for research-supported social work practice, namely the systematic a priori assessment of the transferability of an intervention’s theory of change. Some limitations and methodological issues are discussed.

Among the swedish generation of adolescents who experience an increased trend of psychosomatic symptoms. Do they develop depression and/or anxiety disorders as they grow older?

BackgroundDespite an increase in mental health problems, with psychosomatic symptoms having been observed in new generations of Swedish youth, the extent to which these problems correspond to an increase in adult mental problems is unknown. The present study investigates whether Swedish adolescents with high levels of psychosomatic symptoms are at risk of developing depression and anxiety problems in adulthood and whether sex moderates any association. Moreover, we aim to understand whether different clusters of youth psychosomatic symptoms – somatic, psychological and musculoskeletal – have different impacts on adult mental health.MethodsOne thousand five hundred forty-five Swedish adolescents – aged 13 (49%) and 15 (51%) – completed surveys at baseline (T1) and 3 years later (T2); of them, 1174 (61% females) also participated after 6 years (T3). Multivariate logistic models were run.ResultsYouth with high levels of psychosomatic symptoms had higher odds of high levels of depressive symptoms at T2 and T3. Moreover, psychosomatic symptoms at T1 predicted a high level of anxiety symptoms and diagnoses of anxiety disorders at T3. When analyzed separately, musculoskeletal symptoms predicted higher odds of having high levels of depressive symptoms at T2 and T3 while somatic symptoms predicted high levels of anxiety symptoms at T2. Moreover, somatic symptoms at T1 predicted diagnoses of depression and anxiety disorders at T3. Sex did not moderate any of the relationships.ConclusionsThe study supports the idea that an increase in mental health problems, such as psychosomatic symptoms, can seriously impact the psychological health of new generations of young adults.

Ask me, listen to me, treat me well and I shall tell: a qualitative study of Swedish youths’ experiences of systematic assessment of sexual health and risk-taking (SEXIT)

Sexual ill health among young people, in terms of sexually transmitted infections (STIs), unintended pregnancy, transactional sex and sexual violence, is a global public health concern. To that end, the SEXual health Identification Tool (SEXIT) was developed. The purpose of this study was to explore the visitors’ experiences of a youth clinic visit when SEXIT was used. A purposively selected sample of 20 participants (16–24 years of age) was recruited from three Swedish youth clinics using SEXIT. Participants were interviewed individually in March and April 2016, and data were analysed using inductive qualitative content analysis. The analysis resulted in four main categories describing the participants’ experiences of using SEXIT: “Issues of concern” includes descriptions of the items in SEXIT as important; “Enabling disclosure” describes how SEXIT serves as an invitation to talk and facilitates disclosure of negative experiences; “Road to change” captures experiences of the conversation with the healthcare professional; and “Managing power imbalance” describes experiences regarding the response and attitudes of the healthcare professional as well as the participants’ fears of being judged. The categories are connected by the overarching theme “Ask me, listen to me, treat me well and I shall tell”. This study contributes knowledge on young people’s experiences of a tool-supported dialogue on sexual health and risk-taking initiated by the healthcare professional. Structured questions in a written format, as a basis for dialogue, are appreciated and experienced as a functioning way of addressing sexual ill health and risk-taking at Swedish youth clinics.

Utilization of antidepressants, anxiolytics, and hypnotics during the COVID-19 pandemic in Scandinavia

ObjectiveTo study patterns of antidepressant, anxiolytic, and hypnotic drug utilization in Denmark, Norway, and Sweden during the first year of the COVID-19 pandemic. MethodsThe monthly observed number of prescription fills of antidepressants, benzodiazepines and benzodiazepine-related hypnotics (BZ), and other anxiolytics and hypnotics (OAH) per population in 2020 were compared with predicted numbers based on analysis of covariance of prescription fills during 2015–2019. ResultsIn March 2020, there was an increased number of prescription fills for antidepressants, anxiolytics, and hypnotics in youths and adults aged 20–59 years in Denmark, Norway, and Sweden. Antidepressant prescription fills increased between 13.5 % and 31.3 % at the end of 2020 in all age groups in Denmark and 17.4 % in youths in Norway. BZ drug prescription fills increased by 20.8 % at the end of 2020 in the 20–59 year age group in Denmark and decreased by 16.7 % in youths in Sweden. A general increase of prescription fills of OAH at the end of 2020 was observed in all countries (range 24.0–80.0 % in Denmark, 11.5–30.8 % in Norway, and 9.1–12.1 % in Sweden). Increases of prescription fills of OAH occurred earlier in Denmark. LimitationsAggregated data with lack of information on indications. ConclusionsPeaks of utilization of antidepressants, anxiolytics, and hypnotics observed in March 2020 may reflect medication stock piling. Increased antidepressant drug utilization in Denmark and in Norwegian youths together with the general increase in OAH utilization in the Scandinavian countries in late 2020 may indicate an increase of symptoms of depression and anxiety, as well as disturbed sleep.

Supporting young women with menstrual pain – Experiences of midwives working at youth clinics

BackgroundMenstrual pain is relatively common among young girls. Many girls turn to youth clinics when seeking care for menstrual problems. ObjectiveThe objective of the study was to describe midwives’ experiences of supporting girls with menstrual pain. MethodsThis is a qualitative study with an inductive approach. Semi-structured interviews were conducted with 15 midwives working at Swedish youth clinics. Interviews were held inSeptember 2021. The recordings were transcribed and analyzed using thematic analysis. ResultsTwo main themes, consisting of three subthemes each, emerged: Guiding and educating young women about menstrual pain and Striving toward pain relief. It was important to the midwives to increase young women’s knowledge of menstrual pain and coping strategies, and to guide them in finding a method for menstrual pain relief. Hormonal contraceptives were often a natural choice and an effective method for pain relief, although the midwives occasionally faced resistance from young women or their mothers when recommending this. The midwives also referred to a gynecologist if needed. ConclusionThe results highlight that midwives working at youth clinics have an important role in the care of young women with menstrual pain. The midwives found it important to increase young women’s knowledge about menstrual pain and coping strategies, since they had noticed knowledge gaps in these areas. The results suggest a need to improve education about menstrual pain and coping strategies for young women, preferably in school and in cooperation with healthcare professionals.

Attitudes in motion: acculturation in views on family, sexuality and gender roles among immigrant-background youth in Sweden

ABSTRACT Swedes uphold progressive attitudes regarding family, sexuality, and gender norms. At the same time, Sweden has had generous immigration policies for decades. This leads to challenges for children of immigrants, who must navigate between expectations from their family and the surrounding society. Therefore, this study asks whether children of immigrants’ attitudes relating to family, sexuality and gender roles adapt and approach those of their Swedish-background peers, using the Swedish branch of the CILS4EU survey (n = 5434). We account for dynamics in three ways: We compare attitudes of first- and second-generation immigrants; compare attitudes of youth to those of their parents; and study change in youth’s attitudes over time. In favour of acculturation, we find that second-generation immigrants have more liberal attitudes than first-generation immigrants, that immigrant-background youth are closer to majority peers in attitudes than their parents are to majority parents, and that gender norms of immigrant-background youth move closer to those of Swedish-background youth over time. For attitudes relating to family and sexuality, however, we find a divergence in attitudes over time, but not because immigrant-background youth become less liberal: Their views do become more liberal, but majority youth see an even stronger change in the same direction.

Girls’ Responsibilities, Boys’ Needs: Sexual Health, Gender and Youth in Sweden 1970–1999

Abstract The present study explores medical views on sexual health, gender and youth in Sweden from 1970 to 1999. In terms of gender-based roles, the responsibility for sexual health at this time turned out to be closely linked to girls. First, there was a clear perception that girls should take responsibility for their own and the couple’s sexual health, manifested in counselling, contraception and the understanding of risk-taking. Secondly, there was an underlying notion that boys had greater sexual needs than girls. Boys were seen as irresponsible and uninterested in counselling and decisions on contraception. Medical experts hardly mentioned joint responsibility for sexual health and contraception before the 1990s. In addition, there was a widespread perception that it was the risk-taking of some girls that increased exposure to sexual ill-health. They presented girls who did not adhere to the female responsibility norm as problematic. The study also showed a solid heteronormative view of young people’s sexual health.

Mobile phone filmmaking in health promotion. Addressing problematic social media use in Swedish youth

Abstract Background Digital media is an important part in the everyday lives of young people. However, hate, threats, and harassment on social media is becoming a global public mental health issue among youth. To promote mental health in this age group, this issue needs to be addressed, and community-based health promotion, in particular participatory interventions, are needed to make measures taken meaningful for youth. The aim of the study was twofold; to teach participatory mobile phone filmmaking to Youth Community Center (YCC) staff; and to investigate how they assess this method regarding feasibility, relevance, costs, resources needed, and time considerations. Methods YCC staff participated in a two-day mobile phone filmmaking training. Group interviews that were recorded and transcribed verbatim were conducted and field notes were taken. Data was deductively analyzed in accordance with Elo and Kyngäs (2008). Results YCC staff found the technology was easily accessible and the method needs limited extra resources. It has the potential to promote creativity and can be used as a means to involve young people in describing the issue in their own words, and to find a solution to the issue at hand. The method also has the potential to reach and engage the whole community as organizing a mobile phone film event is part of the process. Time consumption was not perceived as an issue, as staff is free to plan activities as they see fit. Conclusions According to YCC staff, participatory mobile phone filmmaking has the potential to promote positive interactions on social media among youth. This in turn has the potential to promote wellbeing of young people. Recommendations are that this method is tested among young people and investigate if it is a helpful intervention to promote mental health in this age group. Key messages • Participatory mobile phone filmmaking may be useful in youth mental health promotion. • The method is cheap, easily accessible, and have the potential to involve the whole community.

Perceived Help and Support for Sex as Self-Injury: A Qualitative Study of a Swedish Sample

Earlier research has found that sexual acts could be used as a means of self-injury, with comparable functions to nonsuicidal self-injury (NSSI) such as cutting or burning the skin. However, no previous study has investigated the experience of help and support in relation to sex as a means of self-injury (SASI), which this study aims to investigate. The study was based on an anonymous open-ended questionnaire published from December 2016 to April 2017 on the websites of NGOs working with help and support for women and youths in Sweden. In total, 197 participants (mostly women, mean age 27.9 years, range 15–64 years) with self-reported experiences of SASI were included in the study. Three main themes were found concerning experiences of help and support for SASI. The need for: (1) Framing the behavior of SASI, to find a word for SASI—to know it exists, to get questions and information about SASI and its function; (2) Flexible, respectful, and professional help and support from an early age, to be listened to and confirmed in one’s experience of SASI; and (3) Help with underlying reasons to exit SASI such as finding one’s own value and boundaries through conventional therapy, through life itself, or through therapy for underlying issues such as earlier traumatic events, PTSD, dissociation, or anxiety. In conclusion, similar interventions could be helpful for SASI as for NSSI, irrespective of the topographical differences between the behaviors, but the risk of victimization and traumatization must also be addressed in SASI.

Co-occurrence of online and offline bullying and sexual harassment among youth in Sweden: Implications for studies on victimization and health a short communication

ABSTRACT Studies of co-occurrence of online and offline victimisation of bullying and sexual harassment and its associations to mental health outcomes among youth are scarce. To inform future study designs, the aim of this brief communication was to map co-occurrence of online and offline bullying and sexual harassment victimisation among adolescents. Data were collected in 2011 in nine schools in Northern Sweden, n = 1193 (boys = 566; girls = 627). Absolute and relative frequencies were calculated to find combinations of victimisation: one, two, three, or four forms. Reflecting a picture of the early days of online victimisation, in total fifty seven percent (57%) of adolescents were victimised. Single occurrence victimisation was 21.2% (offline sexual harassment was most common irrespective of gender), showing that most youths were victimised in a co-occurrence of two or more forms. Seven percent (7%) were victimised by all four forms of victimisation. Offline sexual harassment victimisation was present in the most common co-occurrences. Directions for future studies of victimisation and its associations to mental health outcomes are discussed.

S07 How do sports clubs contribute to health? From theory to interventions

Abstract The symposium presents last findings on health promotion interventions in sports clubs. After a short introduction about the health promoting sports clubs (HPSC), five presentations (France, Sweden, Ireland, Finland and Netherlands) will reflect upon how sports clubs can be health promoting: in theory, from youth perspectives, by increasing physical activity level as outcome or enhancing sustainability of interventions, before opening the discussion with academic experts. Presentation 1 describes an iterative international process, implicating three groups (French sport students, French and Swedish experts) to create an intervention theory, based on the HPSC model. Presentation 2 focuses on a cross-sectional study investigating 123 Swedish youth's representation of sports clubs' role towards health promotion, identifying social dimension, environment, coaches, amount and ambition of practice as key factors. Presentation 3 is a longitudinal study among 366 adolescents, followed from age 15 to age 19, questioning the participation to organised sport practice and their orientation (leisure or competitive). Results have shown that by the age of 19, 33% of boys and 43% of girls have dropped out of organised sport, where 45% of boys and 26% of girls continued participation. Adolescents with a competitive goal orientation were more likely to continue participation. Presentation 4 is a longitudinal study among 131 youth measuring objective physical activity before and in the middle of a sport season. Principal results showed a significant change across time point, as well as differences between gender (a decrease in moderate to vigorous physical activity during games for boys and an increase for girls). Presentation 5 examined factors that influenced the sustainability of 14 Dutch sporting program aimed at increasing physical activity among inactive people 6.5 years after their implementation. Interviews with representatives of Dutch National Sports Federations and sports clubs helped to identify facilitating and impeding factors, like program adaptation, evaluation, financing and factors related to human resources. Question and Answer will be organised around the key ingredients and challenges facing the development of HPSC interventions, such as implementation of theoretical background, sport participants need consideration, complexity of outcomes evaluation of HPSC and program sustainability.