Predictors of healthy behaviours in Swedish school children

Rural-urban differences in health among youth in northern Sweden: an outcome-wide epidemiological approach

The aim of this research was to contribute knowledge about rural–urban differences in health among young northern Swedish women and men. This study was based on the 2014 “Health on Equal Terms” survey, distributed in the four northernmost counties of Sweden, with complementary information on areas of residence classified as rural, semi-urban and urban from total population registers. The analytical sample included 2,691 individuals who were selected using a probabilistic sampling method. Prevalence ratios were calculated in multivariable log-binomial regression analyses to measure the association between place of residence and nine outcomes covering three health dimensions (general, mental and lifestyle behaviours). The results indicated that daily smoking and being overweight were more common, while feelings of stress and psychological distress were less prevalent, among youths in rural as compared to urban areas. After including covariates, this pattern appeared stronger for young women, although the direction of the results also applied to young men, albeit without revealing significant differences. In conclusion, the findings from this study indicate that for youths – particularly young women – the rural setting may imply an increased risk of poor general health and lifestyle behaviours, while simultaneously playing a partially protective role for mental health.

Vulnerability to unhealthy behaviours across different age groups in Swedish Adolescents: a cross-sectional study

Purpose: There is lack of evidence on the effects of health-promoting programmes among adolescents. Health behaviour models and studies seldom compare the underlying factors of unhealthy behaviours between different adolescent age groups. The main objective of this study was to investigate factors including sociodemographic parameters that were associated with vulnerability to health-damaging behaviours and non-adoption of health-enhancing behaviours in different adolescent age groups. Methods: A survey was conducted among 10,590 pupils in the age groups of 13-14, 15-16 and 17-18 years. Structural equation modelling was performed to determine whether health-damaging behaviours (smoking and alcohol consumption) and non-adoption of health-enhancing behaviours (regular meal habits and physical activity) shared an underlying vulnerability. This method was also used to determine whether gender and socio-economic status were associated with an underlying vulnerability to unhealthy behaviours. Results: The findings gave rise to three models, which may reflect the underlying vulnerability to health-damaging behaviours and non-adoption of health-enhancing behaviours at different ages during adolescence. The four behaviours shared what was interpreted as an underlying vulnerability in the 15-16-year-old age group. In the youngest group, all behaviours except for non-participation in physical activity shared an underlying vulnerability. Similarly, alcohol consumption did not form part of the underlying vulnerability in the oldest group. Lower socio-economic status was associated with an underlying vulnerability in all the age groups; female gender was associated with vulnerability in the youngest adolescents and male gender among the oldest adolescents. Conclusions: These results suggest that intervention studies should investigate the benefits of health-promoting programmes designed to prevent health-damaging behaviours and promote health-enhancing behaviours in adolescents of different ages. Future studies should examine other factors that may contribute to the underlying vulnerability in different age groups.

Family- and school-based correlates of energy balance-related behaviours in 10-12-year-old children: a systematic review within the ENERGY (EuropeaN Energy balance Research to prevent excessive weight Gain among Youth) project

OBJECTIVE

To identify family- and school-based correlates of specific energy balance-related behaviours (physical activity, sedentary behaviour, breakfast consumption, soft drink consumption) among 10-12-year-olds, using the EnRG framework (Environmental Research framework for weight Gain prevention).

DESIGN

A literature review to identify observational studies exploring at least one family- or school-based correlate of the specific behaviours, resulting in seventy-six articles.

SETTING

Eighteen studies were conducted in Europe, forty-one studies in North America and seventeen studies in Australasia.

SUBJECTS

Healthy children aged 10-12 years.

RESULTS

Parental and maternal physical activity, doing physical activities with parents and parental logistic support were identified as the most important, positive correlates of physical activity. Parental rules was the most important correlate of sedentary behaviour and was inversely related to it. School socio-economic status was positively related to physical activity and inversely related to sedentary behaviour. The available studies suggested a positive relationship between soft drink availability at home and consumption. Soft drink availability and consumption at school were the most important school-based correlates of soft drink consumption. A permissive parenting style was related to more soft drink consumption and less breakfast consumption.

CONCLUSIONS

An important role has been awarded to parents, suggesting parents should be involved in obesity prevention programmes. Despite the opportunities a school can offer, little research has been done to identify school-environmental correlates of energy balance-related behaviours in this age group. Obesity prevention programmes can focus on the most important correlates to maximize the effectiveness of the programme. Future research should aim at longitudinal studies.

Correlates among healthy lifestyle cognitive beliefs, healthy lifestyle choices, social support, and healthy behaviors in adolescents: implications for behavioral change strategies and future research

INTRODUCTION

The foundation for healthy lifestyle behaviors begins in childhood. As such, the relationships among cognitive beliefs, healthy lifestyle choices, and healthy lifestyle behaviors in adolescents have been explored. The purpose of this study was to assess the relationships among cognitive variables, social support, and healthy lifestyle behaviors in adolescents.

METHOD

A descriptive correlational design was used for this study. Students from two high schools in the Southwest United States were recruited to participate (N = 404).

RESULTS

Significant correlations existed among cognitive variables, social support, behavioral skills, and health lifestyle behaviors.

DISCUSSION

This study demonstrated that cognitive beliefs about leading a healthy lifestyle, including attitudes and intended choices, are related to physical activity as well as the intake of fruits and vegetables. In working with adolescents on healthy lifestyle behavior change, it is important to implement strategies to strengthen their cognitive beliefs about their ability to make healthy choices and engage in healthy lifestyle behaviors. Strengthening these beliefs should lessen their perception that these behaviors are difficult to perform, which ultimately should result in healthy behaviors.

Determinants of health-promoting lifestyle behaviour in the rural areas of Hungary

Today chronic non-communicable diseases are the major cause of death and disability worldwide. Chronic diseases are determined by common risk factors (e.g. smoking). The purpose of this study was to develop a health-promoting behaviour index, and to evaluate the impact of the social and the demographic characteristics of the individuals, self-rated health and certain features of settlements on the score of this index. A population-based, cross-sectional health survey was conducted. Altogether 91 settlements with various sizes of population, and at various stages of social, economic and infrastructural development took part in the survey. The survey was based on interviewer-administered questionnaires, 3380 subjects filled in the questionnaires correctly, and the response rate was 82.4%. Questions on lifestyle factors referred to smoking, nutritional habits and physical activity. Low level (5.5%) of people have achieved the 'complete' health-promoting behaviour, including non-smoking, healthy nutrition and physical activity. There were significant associations between health-promoting behaviour and demographic, social and economic characteristics of the individuals and their dwelling place. The lower prevalence of healthy lifestyle activities among lower educated, lower income and aged people living in small settlements call the attention to the higher risk of these people. On planning interventions, special attention should be paid to the geographically, infrastructurally, socially and demographically disadvantaged population groups to provide equal opportunities for them, to live a healthy way of life. The application of the health-promoting index might be used to monitor the effects of interventions to alter lifestyle at community level.

Systematic review of multicomponent interventions with overweight middle adolescents: implications for clinical practice and research

BACKGROUND

Being overweight is a global epidemic that occurs in more than 10% of school-aged children (age 5-17) worldwide. The rate of adolescents being overweight continues to rise despite numerous public health campaigns and programs to increase awareness and modify unhealthy lifestyle patterns.

AIMS

The purpose of this systematic review was to determine the most efficacious intervention for treating overweight adolescents. Evidence from this systematic review could guide clinical practice and future research with this high-risk population in youth.

METHODS

In adolescents of 13-17 years of age who are above ideal body weight, are multicomponent interventions that integrate nutrition, activity, and behavioral components more efficacious than any type of comparison group in improving weight, body mass index (BMI), percentage body fat, or behaviors of dietary intake or activity level? Literature searches were completed in Cochrane Library, MEDLINE, the Cumulative Index to Nursing and Allied Health Literature (CINAHL), and PsycINFO databases as well as hand searching.

RESULTS

Due to a lack of consistency among the studies regarding methods and rigor of the studies, the evidence is not entirely clear on the best multicomponent program for addressing overweight in middle adolescents. The success of an intervention was associated with the dose of the intervention received by the adolescent and parent.

CONCLUSIONS

A structured program addressing nutrition, physical activity, and behavioral skills appears to be efficacious in reducing weight and cardiovascular risk factors. Primarily, interventions have included the individual and varying degrees of parental participation. In the past few years, more research has addressed the multiple levels of the ecological model. Further research addressing the five levels of the ecological model will assist in illuminating the impact of the environment on behavior change in adolescents.