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Jackisch J, Noor N, Raitakari OT, Lehtimäki T, Kähönen M, Cullati S, Delpierre C, Kivimäki M, Carmeli C. Does the effect of adolescent health behaviours on adult cardiometabolic health differ by socioeconomic background? Protocol for a population-based cohort study. BMJ Open 2024; 14:e078428. [PMID: 38806419 PMCID: PMC11138306 DOI: 10.1136/bmjopen-2023-078428] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Accepted: 05/08/2024] [Indexed: 05/30/2024] Open
Abstract
INTRODUCTION Adolescence is a sensitive period for cardiometabolic health. Yet, it remains unknown if adolescent health behaviours, such as alcohol use, smoking, diet and physical activity, have differential effects across socioeconomic strata. Adopting a life-course perspective and a causal inference framework, we aim to assess whether the effects of adolescent health behaviours on adult cardiometabolic health differ by levels of neighbourhood deprivation, parental education and occupational class. Gaining a better understanding of these social disparities in susceptibility to health behaviours can inform policy initiatives that aim to improve population health and reduce socioeconomic inequalities in cardiometabolic health. METHODS AND ANALYSIS We will conduct a secondary analysis of the Young Finns Study, which is a longitudinal population-based cohort study. We will use measures of health behaviours-smoking, alcohol use, fruit and vegetable consumption, and physical activity-as exposure and parental education, occupational class and neighbourhood deprivation as effect modifiers during adolescence (ages 12-18 years). Eight biomarkers of cardiometabolic health (outcomes)-waist circumference, body mass index, blood pressure, low-density lipoprotein cholesterol, apolipoprotein B, plasma glucose and insulin resistance-will be measured when participants were aged 33-40. A descriptive analysis will investigate the clustering of health behaviours. Informed by this, we will conduct a causal analysis to estimate effects of single or clustered adolescent health behaviours on cardiometabolic health conditional on socioeconomic background. This analysis will be based on a causal model implemented via a directed acyclic graph and inverse probability-weighted marginal structural models to estimate effect modification. ETHICS AND DISSEMINATION The Young Finns study was conducted according to the guidelines of the Declaration of Helsinki, and the protocol was approved by ethics committees of University of Helsinki, Kuopio, Oulu, Tampere and Turku. We will disseminate findings at international conferences and a manuscript in an open-access peer-reviewed journal.
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Affiliation(s)
- Josephine Jackisch
- Population Health Laboratory (#PopHealthLab), University of Fribourg, Fribourg, Switzerland
| | - Nazihah Noor
- Population Health Laboratory (#PopHealthLab), University of Fribourg, Fribourg, Switzerland
- Swiss School of Public Health (SSPH+), Zürich, Switzerland
| | - Olli T Raitakari
- Centre for Population Health Research & Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland
- Department of Clinical Physiology and Nuclear Medicine, TYKS Turku University Hospital, Turku, Finland
| | - Terho Lehtimäki
- Department of Clinical Chemistry, Tampere University, Tampere, Finland
| | - Mika Kähönen
- Department of Clinical Physiology, Tampere University Hospital, Tampere, Finland
- Finnish Cardiovascular Research Center, Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland
| | - Stéphane Cullati
- Population Health Laboratory (#PopHealthLab), University of Fribourg, Fribourg, Switzerland
- Swiss School of Public Health (SSPH+), Zürich, Switzerland
- Quality of Care Service, University of Geneva, Geneve, Switzerland
| | - Cyrille Delpierre
- CERPOP, UMR1295, Inserm, Toulouse III University-Paul Sabatier, Toulouse, France
| | - Mika Kivimäki
- UCL Brain Sciences, University College London, London, UK
- Clinicum, University of Helsinki Faculty of Medicine, Helsinki, Finland
| | - Cristian Carmeli
- Population Health Laboratory (#PopHealthLab), University of Fribourg, Fribourg, Switzerland
- Swiss School of Public Health (SSPH+), Zürich, Switzerland
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Powell-Wiley TM, Martinez MF, Heneghan J, Weatherwax C, Osei Baah F, Velmurugan K, Chin KL, Ayers C, Cintron MA, Ortiz-Whittingham LR, Sandler D, Sharda S, Whitley M, Bartsch SM, O’Shea KJ, Tsintsifas A, Dibbs A, Scannell SA, Lee BY. Health and Economic Value of Eliminating Socioeconomic Disparities in US Youth Physical Activity. JAMA HEALTH FORUM 2024; 5:e240088. [PMID: 38488779 PMCID: PMC10943408 DOI: 10.1001/jamahealthforum.2024.0088] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2023] [Accepted: 01/08/2024] [Indexed: 03/18/2024] Open
Abstract
Importance There are considerable socioeconomic status (SES) disparities in youth physical activity (PA) levels. For example, studies show that lower-SES youth are less active, have lower participation in organized sports and physical education classes, and have more limited access to PA equipment. Objective To determine the potential public health and economic effects of eliminating disparities in PA levels among US youth SES groups. Design and Setting An agent-based model representing all 6- to 17-year-old children in the US was used to simulate the epidemiological, clinical, and economic effects of disparities in PA levels among different SES groups and the effect of reducing these disparities. Main Outcomes and Measures Anthropometric measures (eg, body mass index) and the presence and severity of risk factors associated with weight (stroke, coronary heart disease, type 2 diabetes, or cancer), as well as direct and indirect cost savings. Results This model, representing all 50 million US children and adolescents 6 to 17 years old, found that if the US eliminates the disparity in youth PA levels across SES groups, absolute overweight and obesity prevalence would decrease by 0.826% (95% CI, 0.821%-0.832%), resulting in approximately 383 000 (95% CI, 368 000-399 000) fewer cases of overweight and obesity and 101 000 (95% CI, 98 000-105 000) fewer cases of weight-related diseases (stroke and coronary heart disease events, type 2 diabetes, or cancer). This would result in more than $15.60 (95% CI, $15.01-$16.10) billion in cost savings over the youth cohort's lifetime. There are meaningful benefits even when reducing the disparity by just 25%, which would result in $1.85 (95% CI, $1.70-$2.00) billion in direct medical costs averted and $2.48 (95% CI, $2.04-$2.92) billion in productivity losses averted. For every 1% in disparity reduction, total productivity losses would decrease by about $83.8 million, and total direct medical costs would decrease by about $68.7 million. Conclusions and Relevance This study quantified the potential savings from eliminating or reducing PA disparities, which can help policymakers, health care systems, schools, funders, sports organizations, and other businesses better prioritize investments toward addressing these disparities.
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Affiliation(s)
- Tiffany M. Powell-Wiley
- Social Determinants of Obesity and Cardiovascular Risk Laboratory, Cardiovascular Branch, Division of Intramural Research, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland
- Intramural Research Program, National Institute on Minority Health and Health Disparities, National Institutes of Health, Bethesda, Maryland
| | - Marie F. Martinez
- Public Health Informatics, Computational, and Operations Research (PHICOR), CUNY Graduate School of Public Health and Health Policy, New York, New York
- Center for Advanced Technology and Communication in Health (CATCH), CUNY Graduate School of Public Health and Health Policy, New York, New York
- Artificial Intelligence, Modeling, and Informatics, for Nutrition Guidance and Systems (AIMINGS) Center, New York, New York
| | - Jessie Heneghan
- Public Health Informatics, Computational, and Operations Research (PHICOR), CUNY Graduate School of Public Health and Health Policy, New York, New York
- Center for Advanced Technology and Communication in Health (CATCH), CUNY Graduate School of Public Health and Health Policy, New York, New York
- Artificial Intelligence, Modeling, and Informatics, for Nutrition Guidance and Systems (AIMINGS) Center, New York, New York
| | - Colleen Weatherwax
- Public Health Informatics, Computational, and Operations Research (PHICOR), CUNY Graduate School of Public Health and Health Policy, New York, New York
- Center for Advanced Technology and Communication in Health (CATCH), CUNY Graduate School of Public Health and Health Policy, New York, New York
- Artificial Intelligence, Modeling, and Informatics, for Nutrition Guidance and Systems (AIMINGS) Center, New York, New York
| | - Foster Osei Baah
- Social Determinants of Obesity and Cardiovascular Risk Laboratory, Cardiovascular Branch, Division of Intramural Research, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland
- Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, Georgia
| | - Kavya Velmurugan
- Public Health Informatics, Computational, and Operations Research (PHICOR), CUNY Graduate School of Public Health and Health Policy, New York, New York
- Center for Advanced Technology and Communication in Health (CATCH), CUNY Graduate School of Public Health and Health Policy, New York, New York
- Artificial Intelligence, Modeling, and Informatics, for Nutrition Guidance and Systems (AIMINGS) Center, New York, New York
| | - Kevin L. Chin
- Public Health Informatics, Computational, and Operations Research (PHICOR), CUNY Graduate School of Public Health and Health Policy, New York, New York
- Center for Advanced Technology and Communication in Health (CATCH), CUNY Graduate School of Public Health and Health Policy, New York, New York
- Artificial Intelligence, Modeling, and Informatics, for Nutrition Guidance and Systems (AIMINGS) Center, New York, New York
| | - Colby Ayers
- Social Determinants of Obesity and Cardiovascular Risk Laboratory, Cardiovascular Branch, Division of Intramural Research, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland
- Intramural Research Program, National Institute on Minority Health and Health Disparities, National Institutes of Health, Bethesda, Maryland
| | - Manuel A. Cintron
- Social Determinants of Obesity and Cardiovascular Risk Laboratory, Cardiovascular Branch, Division of Intramural Research, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland
- Intramural Research Program, National Institute on Minority Health and Health Disparities, National Institutes of Health, Bethesda, Maryland
| | - Lola R. Ortiz-Whittingham
- Social Determinants of Obesity and Cardiovascular Risk Laboratory, Cardiovascular Branch, Division of Intramural Research, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland
- Intramural Research Program, National Institute on Minority Health and Health Disparities, National Institutes of Health, Bethesda, Maryland
| | - Dana Sandler
- Social Determinants of Obesity and Cardiovascular Risk Laboratory, Cardiovascular Branch, Division of Intramural Research, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland
- Intramural Research Program, National Institute on Minority Health and Health Disparities, National Institutes of Health, Bethesda, Maryland
| | - Sonal Sharda
- Social Determinants of Obesity and Cardiovascular Risk Laboratory, Cardiovascular Branch, Division of Intramural Research, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland
- Intramural Research Program, National Institute on Minority Health and Health Disparities, National Institutes of Health, Bethesda, Maryland
| | - Meredith Whitley
- Ruth S. Ammon College of Education and Health Sciences, Adelphi University, Garden City, New York
- Maties Sport, Centre for Sport Leadership, Stellenbosch University, Stellenbosch, South Africa
| | - Sarah M. Bartsch
- Public Health Informatics, Computational, and Operations Research (PHICOR), CUNY Graduate School of Public Health and Health Policy, New York, New York
- Center for Advanced Technology and Communication in Health (CATCH), CUNY Graduate School of Public Health and Health Policy, New York, New York
- Artificial Intelligence, Modeling, and Informatics, for Nutrition Guidance and Systems (AIMINGS) Center, New York, New York
| | - Kelly J. O’Shea
- Public Health Informatics, Computational, and Operations Research (PHICOR), CUNY Graduate School of Public Health and Health Policy, New York, New York
- Center for Advanced Technology and Communication in Health (CATCH), CUNY Graduate School of Public Health and Health Policy, New York, New York
- Artificial Intelligence, Modeling, and Informatics, for Nutrition Guidance and Systems (AIMINGS) Center, New York, New York
| | - Alexandra Tsintsifas
- Public Health Informatics, Computational, and Operations Research (PHICOR), CUNY Graduate School of Public Health and Health Policy, New York, New York
- Center for Advanced Technology and Communication in Health (CATCH), CUNY Graduate School of Public Health and Health Policy, New York, New York
- Artificial Intelligence, Modeling, and Informatics, for Nutrition Guidance and Systems (AIMINGS) Center, New York, New York
| | - Alexis Dibbs
- Public Health Informatics, Computational, and Operations Research (PHICOR), CUNY Graduate School of Public Health and Health Policy, New York, New York
- Center for Advanced Technology and Communication in Health (CATCH), CUNY Graduate School of Public Health and Health Policy, New York, New York
- Artificial Intelligence, Modeling, and Informatics, for Nutrition Guidance and Systems (AIMINGS) Center, New York, New York
| | - Sheryl A. Scannell
- Public Health Informatics, Computational, and Operations Research (PHICOR), CUNY Graduate School of Public Health and Health Policy, New York, New York
- Center for Advanced Technology and Communication in Health (CATCH), CUNY Graduate School of Public Health and Health Policy, New York, New York
- Artificial Intelligence, Modeling, and Informatics, for Nutrition Guidance and Systems (AIMINGS) Center, New York, New York
| | - Bruce Y. Lee
- Public Health Informatics, Computational, and Operations Research (PHICOR), CUNY Graduate School of Public Health and Health Policy, New York, New York
- Center for Advanced Technology and Communication in Health (CATCH), CUNY Graduate School of Public Health and Health Policy, New York, New York
- Artificial Intelligence, Modeling, and Informatics, for Nutrition Guidance and Systems (AIMINGS) Center, New York, New York
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Reuter M, Diehl K, Richter M, Sundmacher L, Hövener C, Spallek J, Dragano N. A longitudinal analysis of health inequalities from adolescence to young adulthood and their underlying causes. ADVANCES IN LIFE COURSE RESEARCH 2024; 59:100593. [PMID: 38340523 DOI: 10.1016/j.alcr.2024.100593] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/26/2022] [Revised: 12/04/2023] [Accepted: 01/08/2024] [Indexed: 02/12/2024]
Abstract
Research suggests that children of low-educated parents face greater health burdens during the passage from adolescence to young adulthood, as they are more likely to become low-educated themselves, establish behavioural and psychosocial disadvantages, or being exposed to unhealthy working conditions. However, studies examining the development and drivers of health inequalities during this particular life stage are limited in number and have produced varied results. This study investigates trajectories of self-rated health and overweight from 14 to 25 years of age, stratified by parental education, and explores the role of potential mediators (educational achievement, health behaviours, psychosocial factors, working conditions). We rely on prospective cohort data from the National Educational Panel Study (NEPS), a representative sample of 14,981 German ninth graders interviewed yearly from 2011 to 2021 (n = 90,096 person-years). First, we estimated random-effects growth curves for self-rated health and overweight over participants' age and calculated the average marginal effect of high versus low parental education. Second, a series of simulation-based mediation analyses were performed to test how much of health inequalities were explained by children's educational attainment (years of school education, years in university), health behaviours (smoking, alcohol, physical inactivity), psychosocial factors (number of grade repetitions, years in unemployment, chronic stress, self-esteem) and working conditions (physical and psychosocial job demands). We accounted for potential confounding by controlling for age, sex, migration background, residential area, household composition, and interview mode. Results show that higher parental education was related to higher self-rated health and lower probabilities of being overweight. Interaction between parental education and age indicated that, after some equalisation in late adolescence, health inequalities increased in young adulthood. Furthermore, educational attainment, health behaviours, psychosocial factors, and early-career working conditions played a significant role in mediating health inequalities. Of the variables examined, the level of school education and years spent in university were particular strong mediating factors. School education accounted for around one-third of the inequalities in self-rated health and one-fifth of the differences in overweight among individuals. Results support the idea that the transition to adulthood is a sensitive period in life and that early socio-economic adversity increases the likelihood to accumulate health disadvantages in multiple dimensions. In Germany, a country with comparatively low educational mobility, intergenerational continuities in class location seem to play a key role in the explanation of health inequalities in youth.
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Affiliation(s)
- Marvin Reuter
- Junior Professorship for Sociology, esp. Work and Health, Department of Sociology, University of Bamberg, Bamberg, Germany.
| | - Katharina Diehl
- Department of Medical Informatics, Biometry and Epidemiology, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| | - Matthias Richter
- Chair for Social Determinants of Health, Department of Sport and Health Sciences, Technical University of Munich, Munich, Germany
| | - Leonie Sundmacher
- Chair of Health Economics, Department of Sport and Health Sciences, Technical University of Munich, Munich, Germany
| | - Claudia Hövener
- Department of Epidemiology and Health Monitoring, Robert Koch-Institute, Berlin, Germany
| | - Jacob Spallek
- Department of Public Health, Brandenburg University of Technology Cottbus-Senftenberg, Senftenberg, Germany
| | - Nico Dragano
- Institute of Medical Sociology, Centre for Health and Society, Medical Faculty and University Hospital Düsseldorf, Heinrich-Heine-University Duesseldorf, Duesseldorf, Germany
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Jørgensen M, Smith ORF, Wold B, Haug E. Social inequality in the association between life transitions into adulthood and depressed mood: a 27-year longitudinal study. Front Public Health 2024; 12:1286554. [PMID: 38476482 PMCID: PMC10929615 DOI: 10.3389/fpubh.2024.1286554] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2023] [Accepted: 01/31/2024] [Indexed: 03/14/2024] Open
Abstract
Background Few studies have considered the life-course development of depressive symptoms in relation to life transitions in early-adulthood and whether these might affect depressive trajectories differently depending on specific indicators of parental socioeconomic status (SES). In the present work, we explore these questions using the adolescent pathway model as a guiding framework to test socially differential exposure, tracking and vulnerability of the effects of life transitions on depressed mood across different socioeconomic backgrounds. Methods Latent growth modeling was used to estimate the associations between indicators of parental SES (parental education and household income) and depressed mood from age 13 to 40 with life transitions (leaving the parental home, leaving the educational system, beginning cohabitation, attaining employment) as pathways between the two. Our analyses were based on a 27-year longitudinal dataset (n = 1242) of a Norwegian cohort with 10 time points in total. To make socioeconomic comparisons, three groups (low, mid, and high) were made for parental education and income respectively. Results Depressed mood decreased from age 13 to 40. The low and high parental education groups showed a stable difference in depressed mood during early adolescence, which decreased in young adulthood and then increased slightly in mid-adulthood. The low household income group showed higher depressed mood across young adulthood compared to the medium and higher household income groups. For life transitions, leaving the parental home and beginning cohabitation was associated with an added downturn of the trajectory of depressed mood when adjusting for other transitions. However, adolescents with high parental education showed a relatively stronger decrease in depressed mood when leaving the parental home. Similarly, adolescents with a high household income showed a relatively stronger decrease in depressed mood when leaving the educational system. Conclusions Depressed mood decreased over time and developed differently depending on parental education and household income. Life transitions were generally associated with reductions in depressed mood across time, but lower SES youths were not found to be more socially vulnerable these effects.
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Affiliation(s)
- Magnus Jørgensen
- Department of Health Promotion and Development, Faculty of Psychology, University of Bergen, Bergen, Hordaland, Norway
| | - Otto R. F. Smith
- Department of Health Promotion, Division of Mental and Physical Health, Norwegian Institute of Public Health (NIPH), Bergen, Hordaland, Norway
- Department of Teacher Education, NLA University College, Bergen, Hordaland, Norway
| | - Bente Wold
- Department of Health Promotion and Development, Faculty of Psychology, University of Bergen, Bergen, Hordaland, Norway
| | - Ellen Haug
- Department of Health Promotion and Development, Faculty of Psychology, University of Bergen, Bergen, Hordaland, Norway
- Department of Teacher Education, NLA University College, Bergen, Hordaland, Norway
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Dhawan D, McCloud R, Pinnamaneni R, Arora G, Kadam R, Dutt A, Biswas-Ramchandran N, Viswanath K. Communication and Social Determinants of Cancer Preventive Behaviors in Adolescents From Low Socio-Economic Backgrounds in India: A Cross-Sectional Study. Cancer Control 2024; 31:10732748241255538. [PMID: 38736171 PMCID: PMC11089949 DOI: 10.1177/10732748241255538] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2023] [Revised: 04/17/2024] [Accepted: 05/01/2024] [Indexed: 05/14/2024] Open
Abstract
PURPOSE Promoting cancer preventive behaviors among adolescents, especially those from lower socioeconomic backgrounds, is crucial due to the significant impact of health behaviors in adolescence on disease risk in adulthood. With India witnessing a rise in cancer incidence and mortality, adolescence becomes a pivotal stage for establishing healthy habits, emphasizing the need for early cancer prevention efforts. METHODS This cross-sectional study used survey data from 2242 adolescents attending public schools of Mumbai, India. Multiple logistic regression was conducted to determine the associations between cancer preventive behaviors and: (1) the individual and social determinants of health, and (2) media exposure. FINDINGS Merely 21.5% of the adolescents ate fruits and vegetables daily, 50% of the adolescents exercised 3 or more times a week, and 20% of the adolescents admitted having used tobacco and/or supari. Girls were found to have lower odds of exercising, as well as using tobacco and/or supari. Wealth and father's education were positively associated with all 3 cancer preventive behaviors. Media exposure was negatively associated, with television exposure linked to reduced fruits and vegetables consumption, while movies and social media exposure were associated with increased tobacco and/or supari use. INTERPRETATION Our findings suggest that individual and social determinants of health and media exposure can influence cancer preventive health behaviors in low socio-economic status (SES) adolescents. Efforts to increase awareness to promote cancer preventive behaviors among the adolescents, particularly low SES adolescents, a population more vulnerable to poor health outcomes, is critical.
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Affiliation(s)
| | | | | | | | | | | | | | - K. Viswanath
- Dana-Farber Cancer Institute, Boston, MA, USA
- Harvard T.H. Chan School of Public Health, Boston, MA, USA
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Nielsen T, Pontoppidan M, Pettersson M, Donstrup CH, Kreiner S, Rayce SB. Measuring child and adolescent well-being in Denmark: Validation and norming of the Danish KIDSCREEN-10 child/adolescent version in a national representative sample of school pupils in grades five through eight. PLoS One 2023; 18:e0291420. [PMID: 37683029 PMCID: PMC10490965 DOI: 10.1371/journal.pone.0291420] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2023] [Accepted: 08/27/2023] [Indexed: 09/10/2023] Open
Abstract
KIDSCREEN-10 is a generic instrument for measuring global health-related quality of life among 8-18-year-old children and adolescents. This study examines the criterion-related construct validity and psychometric properties of the Danish language version of the KIDSCREEN-10 using Rasch models. A further aim was to construct Danish norms based on the resulting person parameter estimates from the Rasch models. Data consists of a nationally representative cross-sectional survey of 8171 children in the 5th to 8th grade of primary school in Denmark. No adequate fit to the Rasch model or a graphical loglinear Rasch model could be established for the KIDSCREEN-10 in the full sample of children (n = 8171). Results based on analyses with increasing samples sizes showed that even with the smallest sample item 3 (Kid3) of the KIDSCREEN-10 did not fit the Rasch model. After elimination of Kid3, substantial local dependence and differential item functioning relative to gender and grade level was still present. Already with a sample size of 630 fit to the Rasch model or a graphical loglinear Rasch model adjusting for local dependence and differential item functioning was not established. Therefore, generation of Danish norms was not realizable, as this requires valid sum scores and estimates of the person parameters for an adequate number of cases. Thus, the Danish language version of the child/adolescent self-report KIDSCREEN-10 questionnaire cannot be recommended for use in population-level studies. Neither can use in small sample be recommended as adjustment for differential item functioning and local dependence is ambiguous.
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Affiliation(s)
- Tine Nielsen
- Department of Applied Research in Education and Social Sciences, UCL University College, Odense, Denmark
| | - Maiken Pontoppidan
- VIVE Health, VIVE—The Danish Center for Social Science Research, Copenhagen, Denmark
| | - Morten Pettersson
- Department of Applied Research in Education and Social Sciences, UCL University College, Odense, Denmark
| | - Christina H. Donstrup
- Department of Applied Research in Education and Social Sciences, UCL University College, Odense, Denmark
| | - Svend Kreiner
- Biostatistics Unit, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Signe Boe Rayce
- VIVE Health, VIVE—The Danish Center for Social Science Research, Copenhagen, Denmark
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Jørgensen M, Smith OR, Wold B, Bøe T, Haug E. Tracking of depressed mood from adolescence into adulthood and the role of peer and parental support: A partial test of the Adolescent Pathway Model. SSM Popul Health 2023; 23:101440. [PMID: 37691980 PMCID: PMC10492161 DOI: 10.1016/j.ssmph.2023.101440] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2023] [Revised: 04/28/2023] [Accepted: 05/25/2023] [Indexed: 09/12/2023] Open
Abstract
•Adolescent depressed mood predicts adult depressed mood.•Peer acceptance during adolescence is not associated with adult depressed mood.•Household income moderates the effect of parental closeness on adult depressed mood.
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Affiliation(s)
- Magnus Jørgensen
- Department of Health Promotion and Development, University of Bergen, Bergen, Norway
| | - Otto R.F. Smith
- Norwegian Institute of Public Health, Bergen, Norway
- Department of Teacher Education, NLA University College, Bergen, Norway
| | - Bente Wold
- Department of Health Promotion and Development, University of Bergen, Bergen, Norway
| | - Tormod Bøe
- Department of Psychosocial Science, University of Bergen, Bergen, Norway
- Regional Centre for Child and Youth Mental Health and Child Welfare, NORCE Norwegian Research Centre, Bergen, Norway
| | - Ellen Haug
- Department of Health Promotion and Development, University of Bergen, Bergen, Norway
- Department of Teacher Education, NLA University College, Bergen, Norway
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Madsen KM, Holstein BE, Madsen KR. Recurrent headache, stomachache, and backpain among adolescents: association with exposure to bullying and parents' socioeconomic status. Scand J Pain 2023; 23:563-570. [PMID: 37277906 DOI: 10.1515/sjpain-2022-0144] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2022] [Accepted: 05/09/2023] [Indexed: 06/07/2023]
Abstract
OBJECTIVES Recurrent pain is a prevalent and severe public health problem among adolescents and is associated with several negative health outcomes. In a representative sample of adolescents this study examined 1) whether exposure to bullying and low socioeconomic status (SES) were associated with recurrent headache, stomachache and backpain, 2) the combined effect of exposure to bullying and low SES on recurrent pain and 3) whether SES modified the association between bullying and recurrent pain. METHODS Data derived from the Danish contribution to the international collaborative study Health Behaviour in School-aged Children (HBSC). The study population was students in three age groups, 11-, 13- and 15-year-olds from nationally representative samples of schools. We pooled participants from the surveys in 2010, 2014 and 2018, n=10,738. RESULTS The prevalence of recurrent pain defined as pain 'more than once a week' was high: 11.7 % reported recurrent headache, 6.1 % stomachache, and 12.1 % backpain. The proportion who reported at least one of these pains 'almost every day' was 9.8 %. Pain was significantly associated with exposure to bullying at school and low parental SES. The adjusted odds ratio (AOR, 95 % CI) for recurrent headache when exposed to both bullying and low SES was 2.69 (1.75-4.10). Equivalent estimates for recurrent stomachache were 5.80 (3.69-9.12), for backpain 3.79 (2.58-5.55), and for any recurrent pain 4.81 (3.25-7.11). CONCLUSIONS Recurrent pain increased with exposure to bullying in all socioeconomic strata. Students with double exposure, i.e., to bullying and low SES, had the highest OR for recurrent pain. SES did not modify the association between bullying and recurrent pain.
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Affiliation(s)
- Klara Merrild Madsen
- University of Southern Denmark, National Institute of Public Health, Copenhagen, Denmark
| | - Bjørn E Holstein
- University of Southern Denmark, National Institute of Public Health, Copenhagen, Denmark
| | - Katrine Rich Madsen
- University of Southern Denmark, National Institute of Public Health, Copenhagen, Denmark
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Livingstone KM, Olstad DL, McNaughton SA, Nejatinamini S, Dollman J, Crawford D, Timperio A. Do food-related capabilities, opportunities and motivations of adolescents mediate the association between socioeconomic position in adolescence and diet quality in early adulthood? Int J Behav Nutr Phys Act 2023; 20:70. [PMID: 37308957 DOI: 10.1186/s12966-023-01477-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Accepted: 06/01/2023] [Indexed: 06/14/2023] Open
Abstract
BACKGROUND Socio-economic position (SEP) in adolescence may influence diet quality over the life course. However, knowledge of whether individual and environmental determinants of diet quality mediate the longitudinal association between SEP and diet quality is limited. This study examined whether and to what extent food-related capabilities, opportunities and motivations of adolescents mediated the longitudinal association between SEP in adolescence and diet quality in early adulthood overall and by sex. METHODS Longitudinal data (annual surveys) from 774 adolescents (16.9 years at baseline; 76% female) from ProjectADAPT (T1 (baseline), T2, T3) were used. SEP in adolescence (T1) was operationalized as highest level of parental education and area-level disadvantage (based on postcode). The Capabilities, Opportunities and Motivations for Behaviour (COM-B) model was used as a framework to inform the analysis. Determinants in adolescence (T2) included food-related activities and skills (Capability), home availability of fruit and vegetables (Opportunity) and self-efficacy (Motivation). Diet quality in early adulthood (T3) was calculated using a modified version of the Australian Dietary Guidelines Index based on brief dietary questions on intake of foods from eight food groups. Structural equation modelling was used to estimate the mediating effects of adolescents' COM-B in associations between adolescent SEP and diet quality in early adulthood overall and by sex. Standardized beta coefficients (β) and robust 95% confidence intervals (CI) were generated, adjusted for confounders (T1 age, sex, diet quality, whether still at school, and living at home) and clustering by school. RESULTS There was evidence of an indirect effect of area-level disadvantage on diet quality via Opportunity (β: 0.021; 95% CI: 0.003 to 0.038), but limited evidence for parental education (β: 0.018; 95% CI: -0.003 to 0.039). Opportunity mediated 60.9% of the association between area-level disadvantage and diet quality. There was no evidence of an indirect effect via Capability or Motivation for either area-level disadvantage or parental education, or in males and females separately. CONCLUSIONS Using the COM-B model, the home availability of fruit and vegetables (Opportunity) of adolescents explained a large proportion of the association between area-level disadvantage in adolescence and diet quality in early adulthood. Interventions to address poor diet quality among adolescents with a lower SEP should prioritize environmental determinants of diet quality.
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Affiliation(s)
- Katherine M Livingstone
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, VIC, 3220, Australia.
| | - Dana Lee Olstad
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Canada
| | - Sarah A McNaughton
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, VIC, 3220, Australia
| | - Sara Nejatinamini
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Canada
| | - James Dollman
- Alliance for Research in Exercise, Nutrition and Activity, University of South Australia, Adelaide, 5000, Australia
| | - David Crawford
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, VIC, 3220, Australia
| | - Anna Timperio
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, VIC, 3220, Australia
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Richardson AS, Nugroho A, Dubowitz T, Schultz D, Martin CK. Students' consumption of high and low nutrition foods and reduced plate waste by schools' wellness-related policies and garden program participation. J Hum Nutr Diet 2023; 36:864-874. [PMID: 36890709 PMCID: PMC10853945 DOI: 10.1111/jhn.13167] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2022] [Accepted: 02/25/2023] [Indexed: 03/10/2023]
Abstract
BACKGROUND Participation in school-based programs that may support children's nutritious dietary behaviours varies across schools. We examined school participation in wellness-related policies, school-based garden programs and students' dietary behaviours. METHODS Among matching schools who did and did not participate in school-based garden programs, we analysed the lunches of 80 Pittsburgh Public Schools (PPS) students in 1st, 2nd, 6th and 7th grades during Autumn 2019 using digital food photography. We also acquired school wellness policy data. Using cross-sectional linear regression, we estimated the association between school-based garden programming, wellness-related policies and dietary outcomes, adjusting for grade. RESULTS School's implementation of nutrition services policies was negatively associated with energy wasted from lunch (β = - 44.7 , p = 0.01 ${\rm{\beta }}=-44.7,{p}=0.01$ ). The number of semesters the students' school had participated in the garden program was positively associated with students' whole grain consumption (β = 0.07 , p < 0.001 ${\rm{\beta }}=0.07,{p}\lt 0.001$ ). CONCLUSIONS Cross-sectional associations suggest that schools that are more engaged in wellness policies and garden programs may provide environments that are more supportive of students' nutrition than in other schools.
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Affiliation(s)
- Andrea S Richardson
- Department of Behavioral and Policy Sciences, RAND Corporation, Pittsburgh, PN, USA
| | - Alvin Nugroho
- Department of Behavioral and Policy Sciences, RAND Corporation, Pittsburgh, PN, USA
| | - Tamara Dubowitz
- Department of Behavioral and Policy Sciences, RAND Corporation, Pittsburgh, PN, USA
| | - Dana Schultz
- Department of Behavioral and Policy Sciences, RAND Corporation, Pittsburgh, PN, USA
| | - Corby K Martin
- Pennington Biomedical Research Center, Louisiana State University, Baton Rouge, LA, USA
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Klapp T, Klapp A, Gustafsson JE. Relations between students’ well-being and academic achievement: evidence from Swedish compulsory school. EUROPEAN JOURNAL OF PSYCHOLOGY OF EDUCATION 2023. [DOI: 10.1007/s10212-023-00690-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/29/2023]
Abstract
AbstractThe study aimed to investigate students’ psychological, cognitive, and social well-being in 6th Grade and the relations to academic achievement in compulsory school, as measured by grades in 9th Grade. Due to reports from Swedish authorities and research, students’ self-reported well-being has decreased during the last decade. Data from the Swedish longitudinal project Evaluation Through Follow-up was analyzed with confirmatory factor analysis and structural equation modelling. By using data from two birth cohorts (1998: N = 7 684 and 2004: N = 9 437), differences in well-being across the two cohorts could be investigated. Cognitive ability, parental education, and gender were also accounted for. Statistically significant cohort and gender differences were found, where cohort 2004 was disadvantaged in all three well-being dimensions, and girls were disadvantaged in psychological and social well-being. Psychological well-being was negatively related to academic achievement, indicating that students who experienced more school-related stress performed higher than students who experienced less stress. Cognitive well-being was positively related to academic achievement. Possible causes of the decrease in well-being may be changes in the educational and assessment system, which meant that cohort 2004 went through compulsory school with a stronger focus on results and grades than earlier cohorts.
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Deindl C, Diehl K, Spallek J, Richter M, Schüttig W, Rattay P, Dragano N, Pischke CR. Self-rated health of university students in Germany-The importance of material, psychosocial, and behavioral factors and the parental socio-economic status. Front Public Health 2023; 11:1075142. [PMID: 36844838 PMCID: PMC9950386 DOI: 10.3389/fpubh.2023.1075142] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2022] [Accepted: 01/16/2023] [Indexed: 02/12/2023] Open
Abstract
Introduction Health inequalities start early in life. The time of young adulthood, between late teens and early twenties, is especially interesting in this regard. This time of emerging adulthood, the transition from being a child to becoming an adult, is characterized by the detachment from parents and establishing of an own independent life. From a health inequality perspective, the question about the importance of the socio-economic background of parents is important. University students are an especially interesting group. Many students come from a privileged background and the question of health inequality among university students has not yet been properly studied. Methods Based on the National Educational Panel Study (NEPS), we analyzed health inequalities among 9,000 students in Germany (∅ 20 years in the first year of their studies) over a period of 8 years. Results We found that most university students (92%) in Germany reported a good and very good health. Yet, we still found substantial health inequalities. Students whose parents had a higher occupational status reported less health problems. Additionally, we observed that health inequalities had indirect impact on health via health behavior, psychosocial resources, and material conditions. Discussion We believe our study is an important contribution to the understudied subject of students' health. We see the impact of social inequality on health among such a privileged group like university students as an important sign of the importance of health inequality.
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Affiliation(s)
- Christian Deindl
- Department of Social Sciences, TU Dortmund University, Dortmund, Germany,*Correspondence: Christian Deindl ✉
| | - Katharina Diehl
- Department of Medical Informatics, Biometry and Epidemiology, Chair of Epidemiology and Public Health, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Jacob Spallek
- Department of Public Health, Brandenburg University of Technology Cottbus-Senftenberg, Senftenberg, Germany
| | - Matthias Richter
- Department of Sport and Health Sciences, Technical University of Munich, Munich, Germany
| | - Wiebke Schüttig
- Department of Sport and Health Sciences, Technical University of Munich, Munich, Germany
| | - Petra Rattay
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany
| | - Nico Dragano
- Institute of Medical Sociology, Centre for Health and Society, University Hospital and Medical Faculty, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany
| | - Claudia R. Pischke
- Institute of Medical Sociology, Centre for Health and Society, University Hospital and Medical Faculty, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany
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Stamates AL, Linden-Carmichael AN, Lau-Barraco C. Daily Exercise and Alcohol Use Among Young Adult College Students. EMERGING ADULTHOOD (PRINT) 2022; 10:572-580. [PMID: 37476026 PMCID: PMC10358348 DOI: 10.1177/21676968211047028] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/22/2023]
Abstract
The present study examined associations between exercise and alcohol use at the between- and within-person levels, including temporal sequencing and the impact of gender. Participants were 221 college students that completed an online survey and 14 daily surveys assessing their daily exercise and alcohol use. Individuals who reported higher exercise scores also consumed more alcohol, on average. On days when individuals reported consuming fewer drinks than usual, they also reported greater exercise scores. Individuals reported lower exercise scores following a day with heavier alcohol use than usual or a day with heavy episodic drinking. Exercise was unassociated with next-day alcohol use. There were mixed findings on the impact of gender. Exercise may have a more proximal influence on drinking. Exercise interventions for alcohol use could target days with higher probabilities of drinking to reduce levels of alcohol use among college students.
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Affiliation(s)
- A L Stamates
- University of Rhode Island, 142 Flagg Road, Chafee Hall, Department of Psychology, Kingston, RI, 02881, USA
| | - A N Linden-Carmichael
- The Pennsylvania State University, 320E Biobehavioral Health Building, Edna Bennett Pierce Prevention Research Center, University Park, PA 16802, USA
| | - C Lau-Barraco
- Old Dominion University, 5115 Hampton Boulevard., Mills Godwin Building, Department of Psychology, Norfolk, VA, 23529, USA
- Virginia Consortium Program in Clinical Psychology, 555 Park Avenue, Norfolk, VA, 23504, USA
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Kohoutek J, Maráček M, Ng K, Hamrik Z. Test-retest reliability of selected HBSC items in Vietnam: well-being, physical and sedentary activities, and eating behaviours. BMC Med Res Methodol 2022; 22:135. [PMID: 35549896 PMCID: PMC9097099 DOI: 10.1186/s12874-022-01624-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2021] [Accepted: 05/04/2022] [Indexed: 11/17/2022] Open
Abstract
Background Valid and reliable research tools to assess children’s and adolescent’s health-related behaviour are highly needed across the globe. Rapid economic development, globalization, and associated lifestyle challenges observed in most countries support the need for high-quality evidence in adolescents to target health-promoting policies and interventions. This study aims to examine the test–retest reliability of selected well-being, physical and screen-time related siting activities, and eating behaviour items of the Health Behaviour in School-Aged Children (HBSC) questionnaire in a sample of Vietnamese adolescents. Methods Data were collected in autumn 2018 in Vietnam (3-week interval). The sample consisted of 410 adolescents (41.0% of boys; mean age = 12.61; SD = 1.24).Test–retest reliability was evaluated using the single measure Intraclass Correlation Coefficients (ICC) and Cohen’s kappa statistic stratified by sex, grade and place of residence (urban or rural). Results The reliability analyses of the well-being items were poor to good ICC values (0.43–0.79) and moderate to large Cohen’s kappa values (0.33–0.77). The physical activity and eating behaviour items were moderate (ICC = 0.54–0.65; Cohen’s kappa = 0.38–0.57). The screen-time related siting activities items were moderate to large (ICC = 0.51–0.72; Cohen’s kappa = 0.42–0.53). There was more item stability among females than males. The social media item was not as stable for 6th graders (ICC = 0.45) compared with older adolescents (ICC 0.68–0.77). Conclusions The findings show that with regards to age, sex and place of residence, self-reported health, life satisfaction, physical and screen-time related siting activities, as well as eating behaviour items of the HBSC questionnaire have a sufficient test–retest reliability to be used in national self-report surveys for Vietnamese adolescents while health complaints items showed borderline reliability.
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Affiliation(s)
- Jaroslav Kohoutek
- Department of Recreation and Leisure Studies, Faculty of Physical Culture, Palacký University Olomouc, 77147, Olomouc, Czech Republic.
| | - Marek Maráček
- Department of Recreation and Leisure Studies, Faculty of Physical Culture, Palacký University Olomouc, 77147, Olomouc, Czech Republic
| | - Kwok Ng
- Physical Activity for Health Research Cluster, Department of Physical Education and Sport Sciences, University of Limerick, Limerick, V94 T9PX, Ireland.,School of Educational Sciences and Psychology, University of Eastern Finland, Joensuu, 80101, Finland
| | - Zdenek Hamrik
- Department of Recreation and Leisure Studies, Faculty of Physical Culture, Palacký University Olomouc, 77147, Olomouc, Czech Republic
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Dierckens M, Richter M, Moor I, Elgar FJ, Clays E, Deforche B, De Clercq B. Trends in material and non-material inequalities in adolescent health and health behaviours: A 12-year study in 23 European countries. Prev Med 2022; 157:107018. [PMID: 35283161 DOI: 10.1016/j.ypmed.2022.107018] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/05/2021] [Revised: 12/29/2021] [Accepted: 03/06/2022] [Indexed: 11/18/2022]
Abstract
Information on trends in adolescent health inequalities is scarce but the available evidence suggests that inequalities are increasing. Prior studies describe associations between material resources of socioeconomic status (SES) and health, while information on non-material SES resources and inequalities in health behaviours is lacking. To improve current understandings of evolutions in adolescent health inequalities, we examined how material and non-material SES resources were associated with changes in selected health outcomes (life satisfaction, physical and psychological symptoms) and health behaviours (physical activity, screen time, breakfast, fruit, vegetables, sweets and soft drinks consumption and alcohol and tobacco use) over a 12-year period. Repeated cross-sectional data came from the 2002, 2006, 2010 and 2014 waves of the Health Behaviour in School-aged Children (HBSC) survey from 23 European countries (n = 480,386). Measures of family affluence and occupational social class were used as indicators of material and non-material SES resources respectively. Regression-based slope indices of inequality indicated that absolute material and non-material inequalities remained stable from 2002 to 2014 in all health outcomes, except for life satisfaction for which a decrease in material inequalities was found between the highest and lowest affluence group (0.81 to 0.68 difference; p < 0.001). In terms of health behaviours, material inequalities decreased in screen time between highest and lowest affluence groups (0.53 to 0.34 h/day difference; p < 0.001), fruit (odds ratio [OR] 1.89 to 1.72 lower odds; p = 0.0088) and soft drinks consumption (OR 1.36 to 1.13 lower odds; p < 0.001) and remained stable in all others. Non-material inequalities increased in all health behaviours (except for sweets consumption) between highest and lowest occupational social class groups: physical activity (0.16 to 0.24 h/day difference; p = 0.0071), screen time (-0.41 to -0.58 h/day difference; p < 0.001), breakfast (0.21 to 0.51 day/week difference; p < 0.001), fruit (OR 1.23 to 1.48 higher odds; p < 0.001), vegetables (OR 1.39 to 1.74 higher odds; p < 0.001) and soft drinks consumption (OR 0.59 to 0.43 lower odds; p < 0.001) and alcohol (OR 0.99 to 0.85 lower odds; p = 0.0420) and tobacco use (OR 0.71 to 0.59 lower odds; p = 0.0183). In summary, non-material inequalities in most health behaviours increased, whereas material inequalities in adolescent health and health behaviours remain stable or decreased. Policies and interventions may consider non-material SES components as these can help in reducing future health inequalities.
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Affiliation(s)
- Maxim Dierckens
- Department of Public Health and Primary Care, Ghent University, Corneel Heymanslaan 10, B-9000 Ghent, Belgium.
| | - Matthias Richter
- Institute of Medical Sociology, Martin Luther University Halle-Wittenberg, Magdeburger Straße 8, 06112 Halle (Saale), Germany
| | - Irene Moor
- Institute of Medical Sociology, Martin Luther University Halle-Wittenberg, Magdeburger Straße 8, 06112 Halle (Saale), Germany
| | - Frank J Elgar
- Institute for Health and Social Policy, McGill University, 2001 McGill College Avenue, Suite 1200, Montreal, Quebec, Canada
| | - Els Clays
- Department of Public Health and Primary Care, Ghent University, Corneel Heymanslaan 10, B-9000 Ghent, Belgium
| | - Benedicte Deforche
- Department of Public Health and Primary Care, Ghent University, Corneel Heymanslaan 10, B-9000 Ghent, Belgium; Movement and Nutrition for Health and Performance Research Group, Department of Movement and Sports Sciences, Faculty of Physical Education and Physical Therapy, Vrije Universiteit Brussel, Pleinlaan 2, B-1050 Brussels, Belgium
| | - Bart De Clercq
- Department of Public Health and Primary Care, Ghent University, Corneel Heymanslaan 10, B-9000 Ghent, Belgium
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Chronic backpain among adolescents in Denmark: trends 1991-2018 and association with socioeconomic status. Eur J Pediatr 2022; 181:691-699. [PMID: 34529135 DOI: 10.1007/s00431-021-04255-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2021] [Revised: 08/31/2021] [Accepted: 09/01/2021] [Indexed: 10/20/2022]
Abstract
Chronic backpain among adolescents is important because the prevalence is high, above 10%, and more than 10% of all adolescents experience impacts on important day-to-day activities. Chronic backpain tracks into adulthood and is associated with several health problems. The objective was to study trends in the prevalence of chronic backpain among adolescents 1991-2018, to examine the association with socioeconomic status (SES), and whether this association changed over time. The study used data from eight comparable cross-sectional school surveys of nationally representative samples of 11-15-year-olds in 1991, 1994, 1998, 2002, 2006, 2010, 2014, and 2018, which constitute the Danish arm of the international Health Behaviour in School-aged Children (HBSC) study. The participation rate was 74.6% of the eligible study population, n = 29,952. Chronic backpain was defined as self-reported backpain daily or several days a week during the last 6 months. The prevalence of chronic backpain was 11.1%, significantly increasing from 8.9% in 1991 to 11.7% in 2018. The OR for chronic backpain was 1.20 (95% CI: 1.10-1.31) in middle, and 1.56 (95% CI: 1.41-1.73) in low compared to high SES. Sensitivity analyses with two other cut-points for backpain frequency showed similar associations.Conclusion: Chronic backpain is common among adolescents and the prevalence increased from 1991 to 2018. The prevalence was highest in lower SES families. We recommend increased efforts to prevent chronic backpain. What is Known: • Chronic backpain among adolescents is common, has a high burden of disability, is associated with several health problems, and tracks into adulthood. What is New: • The prevalence of chronic backpain among adolescents in Denmark increased from 8.9% in 1991 to 11.7% in 2018. • The prevalence was highest among adolescents from lower SES families.
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Oke S, Tan M. Techniques for Advertising Healthy Food in School Settings to Increase Fruit and Vegetable Consumption. INQUIRY: THE JOURNAL OF HEALTH CARE ORGANIZATION, PROVISION, AND FINANCING 2022; 59:469580221100165. [PMID: 35511550 PMCID: PMC9081710 DOI: 10.1177/00469580221100165] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Background Childhood obesity rates in Western developed countries are rapidly increasing. While research shows that eating more fruits and vegetables (FV) is a preventive measure, children do not eat adequate amounts of FV. Marketing of high salt, fat, and sugar foods influences children’s eating behaviors, decreases FV consumption, and is prevalent in children’s surroundings. Garnering the power of ads on children, a potential solution for increasing FV consumption is FV marketing/advertising. Schools can serve as a viable option for testing this advertising because a significant amount of children’s time is spent in school settings. However, research surrounding the use of FV advertising in schools is lacking in a consensus on the most effective methodologies. Objective This paper reviewed existing research on FV advertising in schools and proposed directions for future research surrounding methodology and experimental design. Study Design, Setting, Participants PubMed and PsycINFO databases were searched with variations of the terms “vegetable,” “marketing,” “advertisements,” “consumption,” and “schools” (eg, “vegetable consumption AND advertisements AND schools”. Study inclusion criteria were: conducted in school settings, used FV marketing as primary intervention, and measured change in FV consumption or preference. Measurable Outcome/Analysis This review qualitatively compared the studies’ participant demographics, methodologies, and measures of success, and evaluated the studies’ strengths and weaknesses. Results Of the 38 articles reviewed, 8 met the inclusion criteria. Five studies examined elementary school populations; 4 were conducted in cafeterias. Major forms of advertising/interventions were print media, video media, and classroom education interventions, of which print media was the most widely used. Three articles utilized change in consumption of FV as a measure of success, while others measured change in preference. All studies reported increased consumption/preference in at least 1 intervention during or immediately after the intervention. However, only 4 studies conducted follow-up testing. Conclusion FV advertisements in schools appear to be effective in increasing FV consumption among children. To develop implementable advertising, future studies should maintain cohesive methodologies by controlling for novelty effects, conducting follow-up testing, and measuring actual FV consumption rather than preference.
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Affiliation(s)
- Shariwa Oke
- Department of Public Health Sciences, University of Chicago, Chicago, IL, USA
| | - Marcia Tan
- Department of Public Health Sciences, University of Chicago, Chicago, IL, USA
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Setiawan AS, Indriyanti R, Suryanti N, Rahayuwati L, Juniarti N. Neonatal stunting and early childhood caries: A mini-review. Front Pediatr 2022; 10:871862. [PMID: 35923789 PMCID: PMC9339654 DOI: 10.3389/fped.2022.871862] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2022] [Accepted: 06/29/2022] [Indexed: 11/13/2022] Open
Abstract
The nutritional status of pregnant women greatly determines their newborn outcome. Deficiencies of several micronutrients are associated with stunting in early childhood, affecting health into adulthood. However, apart from the systemic disease that has been a concern so far, fetal undernutrition can also be associated with dental caries in a child's early life, especially since the primary teeth begin to form during the mother's gestation period. The important thing to underline regarding the intrauterine formation of primary teeth is especially in terms of enamel formation. One of the causes of developmental enamel defects that will contribute to the emergence of early childhood caries is the malnutrition of the pregnant mother. This mini-review aims to understand the linkage mechanism behind neonatal stunting to early childhood caries. This concept is expected to generate further research to help prevent both growth stunting and early childhood caries. In addition, with some evidence-based research, the importance of the first dental visit can be further promoted.
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Affiliation(s)
- Arlette Suzy Setiawan
- Department of Pediatric Dentistry, Faculty of Dentistry, Universitas Padjadjaran, Sumedang, Indonesia
| | - Ratna Indriyanti
- Department of Pediatric Dentistry, Faculty of Dentistry, Universitas Padjadjaran, Sumedang, Indonesia
| | - Netty Suryanti
- Department of Community Dentistry, Faculty of Dentistry, Universitas Padjadjaran, Sumedang, Indonesia
| | - Laili Rahayuwati
- Department of Community Nursing, Faculty of Nursing, Universitas Padjadjaran, Sumedang, Indonesia
| | - Neti Juniarti
- Department of Community Nursing, Faculty of Nursing, Universitas Padjadjaran, Sumedang, Indonesia
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Zaborskis A, Kavaliauskienė A, Eriksson C, Klemera E, Dimitrova E, Melkumova M, Husarova D. Family Support as Smoking Prevention during Transition from Early to Late Adolescence: A Study in 42 Countries. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:12739. [PMID: 34886464 PMCID: PMC8656923 DOI: 10.3390/ijerph182312739] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/19/2021] [Revised: 11/21/2021] [Accepted: 11/28/2021] [Indexed: 11/16/2022]
Abstract
Family support has a beneficial impact on protecting health-risk behaviour in adolescents. This study aimed to explore whether family support is associated with risk of smoking during transition from early (11 years) to late (15 years) adolescence across 42 countries. The data from the cross-national Health Behaviour in School-aged Children (HBSC) study in 2017/2018 were employed (N = 195,966). Family support was measured using the four-item Family dimension of the Multidimensional Scale of Perceived Social Support (sum score 20 or more was categorised as high family support). Smoking was defined as a reported cigarette smoking at least 1-2 days in the last 30 days. The association between smoking and family support was assessed using a prevalence ratio (PR) obtained from the multivariate Poisson regression. Over two thirds of adolescents reported high levels of support from their family. Family support was found to significantly decrease with age in most of the countries, with the boys reported high level of family support more often than girls. The adolescents who reported having low family support also were more likely to smoke compared to their peers who reported having high family support (PR = 1.81; 95% CI: 1.71-1.91 in boys, and PR = 2.19; 95% CI: 2.08-2.31 in girls). The countries with a stronger effect of family support in reducing smoking risk indicated lower rates of adolescent smoking as well as lower increases in the cigarette smoking prevalence during the age period from 11 to 15 years. This study reinforces the need for family support, which is an important asset helping adolescents to overcome the risk of smoking during their transition from early to late adolescence.
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Affiliation(s)
- Apolinaras Zaborskis
- Faculty of Public Health, Medical Academy, Lithuanian University of Health Sciences, LT-44307 Kaunas, Lithuania
| | - Aistė Kavaliauskienė
- Faculty of Odontology, Medical Academy, Lithuanian University of Health Sciences, LT-44307 Kaunas, Lithuania;
| | - Charli Eriksson
- Department of Public Health Sciences, Stockholm University, SE-10691 Stockholm, Sweden;
| | - Ellen Klemera
- Centre for Health Services Studies, Division of Low, Society and Social Justice, University of Kent, Canterbury CT2 7NS, UK;
| | - Elitsa Dimitrova
- Institute for Population and Human Studies, Bulgarian Academy of Sciences & Plovdiv University Paisii Hilendarski, 1000 Sofia, Bulgaria;
| | - Marina Melkumova
- Arabkir Medical Centre-Institute of Child and Adolescent Health, National Institute of Health, Yerevan 0014, Armenia;
| | - Daniela Husarova
- Department of Health Psychology and Methodology Research, Faculty of Medicine, Pavol Jozef Šafárik University in Košice, 04011 Kosice, Slovakia;
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Wells L, Östberg V. How do educational disparities in smoking develop during early life? A Swedish longitudinal study. SSM Popul Health 2021; 15:100859. [PMID: 34286059 PMCID: PMC8274329 DOI: 10.1016/j.ssmph.2021.100859] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2021] [Revised: 06/28/2021] [Accepted: 06/28/2021] [Indexed: 11/23/2022] Open
Abstract
Smoking contributes to health inequalities, but how social inequalities in smoking develop in early life remains unclear. This study examines how measures of education attained over the early life course (representing socioeconomic position of origin, socioeconomic position of destination, and in-between) contribute to smoking behavior in a Swedish longitudinal sample. We used data obtained from the Swedish Level-of-Living Surveys in addition to national register data. Young adults (aged 20-28, n = 749) self-reported their educational attainment and smoking behavior (initiation and cessation) in 2010. Ten years earlier, their parents self-reported their own education and smoking behavior. We used linked register data on school performance in adolescence (in grade 9). Logistic regression models showed that lower parental education, lower adolescent school performance, and low young adult educational attainment were respectively associated with young adult smoking initiation. The association between parental education and young adult smoking initiation was explained by adolescent school performance and not parental smoking. Young adult smoking cessation was associated with high parental education and high adolescent school performance (marks in the top quartile), but only school performance remained significant in the final model, which included all measures of education and parental smoking. Results suggest that school performance in adolescence (which connects adolescents' socioeconomic position of origin with their destination) may play an important role in how educational disparities in smoking form over the life course.
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Affiliation(s)
- Laura Wells
- Department of Public Health Sciences, Stockholm University, SE-106 91, Stockholm, Sweden
| | - Viveca Östberg
- Department of Public Health Sciences, Stockholm University, SE-106 91, Stockholm, Sweden
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Stassen G, Grieben C, Hottenrott N, Rudolf K, Froböse I, Schaller A. Associations between health-related skills and young adults' work ability within a structural health literacy model. Health Promot Int 2021; 36:1072-1083. [PMID: 33319224 PMCID: PMC8405247 DOI: 10.1093/heapro/daaa099] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Young adults have a high societal relevance but are still an under-represented target group in health promotion. Health literacy is widely acknowledged as one of the strongest predictors and key determinant of health, so its influence on work ability is of great interest. The purpose of the study was to examine the associations between health-related skills and work ability within the structural model of health literacy of Lenartz, Soellner and colleagues, which explains health behaviour and health through the indirect and direct influence of six 'advanced skills' ('self-perception', 'proactive approach to health', 'dealing with health information', 'self-control', 'self-regulation' and 'communication and cooperation'). The cross-sectional study was based on baseline data of a health literacy promotion intervention (495 vocational school students, 59.0% female, age span 18-25 years). Structural equation modelling with partial least squares was used to examine the associations between the six constructs of the model and the Work Ability Index (WAI). Mean WAI score was 39.7 ± 4.5 (51.1% categorized 'moderate'/'poor'). Five out of six constructs of the model showed a statistically significant indirect or direct effect, respectively, on work ability. The model explained 24.8% of the WAI score variance. Our findings show associations between the health literacy model and the work ability among young employees. In view of demographic change, it is crucial to develop and analyse target group-specific health literacy interventions. The model offers new facets in the modelling of health literacy.
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Affiliation(s)
- Gerrit Stassen
- Working Group Physical Activity-Related Prevention Research, Institute of Movement Therapy and Movement-Oriented Prevention and Rehabilitation, German Sport University Cologne, Cologne, Germany
| | - Christopher Grieben
- Department 1: Movement-Oriented Prevention and Rehabilitation Sciences, Institute of Movement Therapy and Movement-Oriented Prevention and Rehabilitation, German Sport University Cologne, Cologne, Germany
| | - Nina Hottenrott
- Working Group Physical Activity-Related Prevention Research, Institute of Movement Therapy and Movement-Oriented Prevention and Rehabilitation, German Sport University Cologne, Cologne, Germany
| | - Kevin Rudolf
- Department 1: Movement-Oriented Prevention and Rehabilitation Sciences, Institute of Movement Therapy and Movement-Oriented Prevention and Rehabilitation, German Sport University Cologne, Cologne, Germany
| | - Ingo Froböse
- Department 1: Movement-Oriented Prevention and Rehabilitation Sciences, Institute of Movement Therapy and Movement-Oriented Prevention and Rehabilitation, German Sport University Cologne, Cologne, Germany
| | - Andrea Schaller
- Working Group Physical Activity-Related Prevention Research, Institute of Movement Therapy and Movement-Oriented Prevention and Rehabilitation, German Sport University Cologne, Cologne, Germany
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Serdà BC, Planas-Lladó A, delValle A, Soler-Masó P. Health promotion in secondary schools: participatory process for constructing a self-assessment tool. Health Promot Int 2021; 37:6338059. [PMID: 34343304 DOI: 10.1093/heapro/daab123] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
This article presents the process of constructing an effective self-assessment tool for monitoring health promotion in secondary schools (SS). The ultimate aim is to improve adolescents' well-being and quality of life in their reference environment. The design and validation of the instrument were based on participatory action research (involving students, professors, parents, health professionals, youth workers, youth directors, youth managers). A mixed quantitative and qualitative approach was adopted. The construction process included the following five consecutive stages: (i) steering-group creation and definition of objectives; (ii) diagnosing students' health and well-being in SS (case study); (iii) initial design and construction of health promotion indicators; (iv) validation based on expert judgement and (v) validation by means of a pilot test. The final construction of the self-assessment tool included 5 areas (healthy habits, affectivity and socialization, emotional well-being, safety and risks, and specific health situations), 9 objectives and 18 indicators deployed through a rubric. Each indicator is discussed in depth, specifying the most appropriate resources and health promotion activities for its application. The final self-assessment tool is designed to be sensitive to and effective for self-assessment of health promotion in SS. It contributes to improving adolescent health on an individual basis and also has an impact on the school environment. Finally, it also promotes analysis of the health content on the curriculum and the teaching-learning method(s) employed at the school. The self-assessment tool has been published open access and its implementation will continue to increase health promotion in SS in Catalonia.
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Affiliation(s)
- Bernat-Carles Serdà
- Health Sciences Research, Faculty of Nursing, University of Girona, Catalonia, Spain
| | - Anna Planas-Lladó
- Department of Pedagogy, Research Institute of Education, University of Girona, Catalonia, Spain
| | - Arantza delValle
- Psychology Department, University of Girona, Edifici Centre C/ Emili Grahit, 77 Campus Centre 17003 Girona, Catalonia, Spain
| | - Pere Soler-Masó
- Department of Pedagogy, Research Institute of Education, University of Girona, Catalonia, Spain
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Khan RJ, Needham BL, Advani S, Brown K, Dagnall C, Xu R, Gibbons GH, Davis SK. Association of Childhood Socioeconomic Status with Leukocyte Telomere Length Among African Americans and the Mediating Role of Behavioral and Psychosocial Factors: Results from the GENE-FORECAST Study. J Racial Ethn Health Disparities 2021; 9:1012-1023. [PMID: 33948907 PMCID: PMC9061663 DOI: 10.1007/s40615-021-01040-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2020] [Revised: 04/04/2021] [Accepted: 04/05/2021] [Indexed: 11/26/2022]
Abstract
Purpose We examined if childhood socioeconomic status (SES) was related to adult leucocyte telomere length (TL) using the data of 361 African American (AA) participants from the GENE-FORECAST Study. We also assessed the mediating role of behavioral and psychosocial factors in the association between childhood SES and adult TL. Methods Childhood SES was assessed individually by using participant’s mother’s education and occupation, father’s education and occupation, parental home ownership, and family structure. TL was assessed using the quantitative polymerase chain reaction method. Information on potential confounders and mediators were collected. The associations of childhood SES with TL were assessed using multivariable linear regression models. We used path analysis to quantify and test the share of these associations that was statistically explained by each of the mediators (participant’s educational attainment, smoking status, physical activity, dietary habit, perceived stress, and depressive symptoms). Results Mother’s education was associated with longer average TL (β: 0.021; 95% CI: 0.001, 0.04, p=0.038) in confounder adjusted models. Once mediators were introduced in the model, the estimates were reduced and remained marginally significant (β: 0.017; 95% CI: −0.003, 0.038, p=0.061). According to path model, approximately 19% of the effect of mother’s education on TL (β: 0.004; 95% CI: −0.001, 0.01, p < 0.10) was mediated through participant’s own education level. No significant mediation effect was observed for any other mediators. Conclusions These data provide evidence that participant’s mother’s education was positively linked to adult TL in AA population. Participant’s own educational level partially explained this association. Supplementary Information The online version contains supplementary material available at 10.1007/s40615-021-01040-5.
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Affiliation(s)
- Rumana J Khan
- Cardiovascular Section, Social and Behavioral Research Branch, National Human Genome Research Institute, National Institutes of Health, 10 Center Drive, Room 7N316 MSC 1644, Bethesda, MD, USA.
| | - Belinda L Needham
- Department of Epidemiology, School of Public Health, University of Michigan, 1415, Ann Arbor, Washington Heights, MI, USA
| | - Shailesh Advani
- Cardiovascular Section, Social and Behavioral Research Branch, National Human Genome Research Institute, National Institutes of Health, 10 Center Drive, Room 7N316 MSC 1644, Bethesda, MD, USA
| | - Kristen Brown
- Cardiovascular Section, Social and Behavioral Research Branch, National Human Genome Research Institute, National Institutes of Health, 10 Center Drive, Room 7N316 MSC 1644, Bethesda, MD, USA
| | - Casey Dagnall
- Cancer Genomics Research Laboratory, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD, USA
| | - Ruihua Xu
- Cardiovascular Section, Social and Behavioral Research Branch, National Human Genome Research Institute, National Institutes of Health, 10 Center Drive, Room 7N316 MSC 1644, Bethesda, MD, USA
| | - Gary H Gibbons
- Cardiovascular Disease Section, Metabolic, Cardiovascular and Inflammatory Disease, Genomics Branch, National Human Genome Research Institute, National Institutes of Health, Bethesda, MD, USA
- National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD, USA
| | - Sharon K Davis
- Cardiovascular Section, Social and Behavioral Research Branch, National Human Genome Research Institute, National Institutes of Health, 10 Center Drive, Room 7N316 MSC 1644, Bethesda, MD, USA
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Bast LS, Lund L, LauemØller SG, Kjeld SG, Due P, Andersen A. Socio-economic differences in smoking among adolescents in a school-based smoking intervention: The X:IT II study. Scand J Public Health 2021; 49:961-969. [PMID: 33863260 DOI: 10.1177/14034948211007683] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Aims: Socio-economic inequalities in health behaviour may be influenced by health interventions. We examined whether the X:IT II intervention, aiming at preventing smoking in adolescence, was equally effective among students from different occupational social classes (OSC). Methods: We used data from the multi-component school-based smoking preventive intervention X:IT II, targeting 13- to 15-year-olds in Denmark. The intervention was tested in 46 schools with 2307 eligible students at baseline (response rate=86.6%) and had three main intervention components: smoke-free school time, smoke-free curriculum and parental involvement. We used a difference-in-difference design and estimated the change in current smoking after the first year of implementation in high versus low OSC. Analyses were based on available cases (N=1190) and imputation of missing data at follow-up (N=1967). Results: We found that 1% of the students from high OSC and 4.9% from low OSC were smokers at baseline (imputed data), and 8.2% of the students from high OSC and 12.2% from low OSC were smokers at follow-up. Difference-in-difference estimates were close to zero, indicating no differential trajectory. Conclusions: As intended, the X:IT II intervention, designed to apply equally to students from all socio-economic groups, did not seem to create different trajectories in current smoking among adolescents in high and low socio-economic groups. To diminish social inequality in health, future studies should carefully consider the ability to affect all socio-economic groups equally, or even to appeal mainly to participants from lower socio-economic groups, as they are often the ones most in need of intervention.
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Pedron S, Schmaderer K, Murawski M, Schwettmann L. The association between childhood socioeconomic status and adult health behavior: The role of locus of control. SOCIAL SCIENCE RESEARCH 2021; 95:102521. [PMID: 33653585 DOI: 10.1016/j.ssresearch.2020.102521] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/06/2020] [Revised: 11/20/2020] [Accepted: 12/20/2020] [Indexed: 06/12/2023]
Abstract
The socioeconomic environment in childhood is a powerful determinant for health behavior in adulthood, subsequently influencing health outcomes. However, the underlying mechanisms are insufficiently understood. This study assesses locus of control (LOC) as a mediator linking childhood socioeconomic status (SES) with health behavior (smoking, regular alcohol consumption, unhealthy diet and low physical activity). Drawing on a representative sample from Germany (SOEP), we investigated these relations using structural equations modelling. Results show that externally oriented LOC explains up to 6% of the relationship between childhood SES and health behavior in adulthood, independently from adult SES. Stratification indicates that these results hold in women but not in men, in younger and middle-aged individuals but not in older ones. Hence, control beliefs play a modest yet significant role in shaping the socioeconomic gradient in health behavior and might have far-reaching consequences on how morbidity and mortality arise and persist across generations.
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Affiliation(s)
- Sara Pedron
- Institute of Health Economics and Health Care Management, Helmholtz Zentrum München, German Research Center for Environmental Health, Ingolstädter Landstr. 1, 85764, Neuherberg, Germany; German Center for Diabetes Research, Ingolstädter Landstr. 1, 85764, Neuherberg, Germany; Institute for Medical Information Processing, Biometry, and Epidemiology (IBE), Ludwig-Maximilians-University Munich, Marchioninistr. 15, 81377, Munich, Germany; Pettenkofer School of Public Health, Munich, Germany.
| | - Katharina Schmaderer
- Institute of Health Economics and Health Care Management, Helmholtz Zentrum München, German Research Center for Environmental Health, Ingolstädter Landstr. 1, 85764, Neuherberg, Germany
| | - Monika Murawski
- Institute of Health Economics and Health Care Management, Helmholtz Zentrum München, German Research Center for Environmental Health, Ingolstädter Landstr. 1, 85764, Neuherberg, Germany; IFT Institut für Therapieforschung, Leopoldstr. 175, 80804, Munich, Germany
| | - Lars Schwettmann
- Institute of Health Economics and Health Care Management, Helmholtz Zentrum München, German Research Center for Environmental Health, Ingolstädter Landstr. 1, 85764, Neuherberg, Germany; Department of Economics, Martin Luther University Halle-Wittenberg, Große Steinstraße 73, 06108, Halle (Saale), Germany
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26
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Bast LS, Andersen S, Glenstrup S, Damsgaard MT, Andersen A. Assessing Differences in the Implementation of Smoke-Free Contracts-A Cross-Sectional Analysis from the School Randomized Controlled Trial X:IT. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:2163. [PMID: 33672151 PMCID: PMC7926470 DOI: 10.3390/ijerph18042163] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/20/2021] [Revised: 02/16/2021] [Accepted: 02/17/2021] [Indexed: 12/04/2022]
Abstract
OBJECTIVE The X:IT study is a school-based smoking preventive intervention that has previously been evaluated in a large randomized controlled trial (RCT) with good effects. However, the actual effect for participating students depends on the individual implementation. The aim of this study was to examine the implementation of smoke-free contract, which is one of the three main intervention components. Specifically, we examined whether it was implemented equally across family occupational social class (OSC), separately for boys and girls, the joint effect of OSC and gender, and the participants' own reasons for not signing a contract. RESULTS Overall, the smoke-free contract was well implemented; 81.8% of pupils (total N = 2.015) signed a contract (girls 85.1, boys 78.6%). We found a social gradient among girls; more than 90% were in OSC group I vs. 75% in group VI. Among boys, however, we found no difference across OSC. Boys in all the OSC groups had about half the odds (i.e., medium OSC boys: OR = 0.48 (95% CI: 0.32-0.72) of having a smoke-free contract compared to girls from a high OSC. CONCLUSION future interventions should include initiatives to involve families from all OSC groups and allow for different preferences among boys and girls.
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Affiliation(s)
- Lotus Sofie Bast
- National Institute of Public Health, University of Southern Denmark, Studiestraede 6a, 1455 Copenhagen, Denmark; (S.A.); (S.G.); (M.T.D.)
| | - Susan Andersen
- National Institute of Public Health, University of Southern Denmark, Studiestraede 6a, 1455 Copenhagen, Denmark; (S.A.); (S.G.); (M.T.D.)
| | - Stine Glenstrup
- National Institute of Public Health, University of Southern Denmark, Studiestraede 6a, 1455 Copenhagen, Denmark; (S.A.); (S.G.); (M.T.D.)
| | - Mogens Trab Damsgaard
- National Institute of Public Health, University of Southern Denmark, Studiestraede 6a, 1455 Copenhagen, Denmark; (S.A.); (S.G.); (M.T.D.)
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Li J, Shan D, Liu P, Liu H, Cai L, Zhang H, Zhang L, Zhang D. Sex-seeking on the internet and mobile-based applications among young people in China: An online survey. Int J STD AIDS 2021; 32:403-410. [PMID: 33612032 DOI: 10.1177/0956462420971940] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
The aim of this study was to investigate young people's risk behaviors in use of social network applications for sexual purposes. Snowball sampling technique was used to recruit participants online. Logistic regressions were performed to examine interrelationships among risk behaviors and sex-seeking platforms (A, B, C, D, and others). The prevalence of online sex-seeking was 22.2% (1156/5199) among people with sexual experience, and the most debut online sex-seeking happened in 15-24 years old in both men and women (79.8%, 590/739 vs 86.1%, 359/417). The risk behaviors varied in different platforms among 730 young people age 15-24 years. Among men, participants seeking sex via B were more likely to engage in concurrent sexual partnership (aOR: 1.64; 95% CI: 1.01-2.66). Participants seeking sex via C were more likely to engage in drug use (aOR: 1.74; 95% CI: 1.01-3.02) and condomless sex (aOR: 1.75; 95% CI: 1.04-2.95). Participants seeking sex via A, C, or D were all less likely to have homosexual behaviors. Among women, participants seeking sex via B were more likely to have condomless sex (aOR: 2.06; 95% CI: 1.10-3.86). The study indicated that emerging of the HIV epidemic in young people might be driven by risk behaviors during online sex-seeking. Effective intervention programs need to target on different social network platforms.
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Affiliation(s)
- Jian Li
- National Center for AIDS/STD Control and Prevention196543, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Duo Shan
- National Center for AIDS/STD Control and Prevention196543, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Peng Liu
- Chinese Association of STD and AIDS Prevention and Control, Beijing, China
| | - Hui Liu
- National Center for AIDS/STD Control and Prevention196543, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Lingping Cai
- China HIV/AIDS Information Network, Beijing, China
| | | | - Lei Zhang
- China HIV/AIDS Information Network, Beijing, China
| | - Dapeng Zhang
- National Center for AIDS/STD Control and Prevention196543, Chinese Center for Disease Control and Prevention, Beijing, China
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Semsarian CR, Woodforde A, Cheung JMY, Rigney G, Blunden S, Cistulli PA, Bin YS. The need for sleep and circadian education in Australian high schools: incidental results from a survey of university students. Health Promot J Austr 2021; 33:170-175. [PMID: 33544942 DOI: 10.1002/hpja.462] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2020] [Revised: 01/25/2021] [Accepted: 01/31/2021] [Indexed: 11/06/2022] Open
Abstract
ISSUE ADDRESSED To describe the need for high school sleep education from the perspective of undergraduate university students. METHODS Undergraduate students who completed an online course on sleep and circadian health were surveyed 6 months after course completion. Students were asked whether a similar course would have benefited them as high school students, and about the need for sleep education in high schools. Thematic analysis of this qualitative data was carried out. RESULTS Eighty-nine students who had attended 71 unique high schools provided responses. Eight-one per cent thought they would have benefitted from a similar course during high school and identified domains of sleep knowledge particularly relevant to high school students. They cited environmental barriers to healthy sleep present during high school and believed that sleep education could improve students' lifestyle, sleep and performance. Nineteen per cent of students said they would not have benefited, because they perceived sleeping patterns during high school to be nonmodifiable or believed that previous sleep education was sufficient. Of the respondents who did not think students would benefit, 53% would still tell their high school principal that there was a need for sleep education. CONCLUSIONS The findings support the need for engaging sleep education for high school students. Future studies should examine the perspectives of students in high school directly, rather than undergraduate students who have already shown an interest in sleep health. SO WHAT?: Sleep health is missing from the Australian school curriculum. Online courses may be an engaging method of promoting sleep and circadian health to high school students.
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Affiliation(s)
| | - Alisha Woodforde
- Sleep Research Group, Charles Perkins Centre, University of Sydney, Sydney, Australia
| | - Janet M Y Cheung
- School of Pharmacy, Faculty of Medicine and Health, University of Sydney, Sydney, Australia
| | - Gabrielle Rigney
- Appleton Institute of Behavioural Science, Central Queensland University, Wayville, Australia
| | - Sarah Blunden
- Appleton Institute of Behavioural Science, Central Queensland University, Wayville, Australia
| | - Peter A Cistulli
- Sleep Research Group, Charles Perkins Centre, University of Sydney, Sydney, Australia
| | - Yu Sun Bin
- Sleep Research Group, Charles Perkins Centre, University of Sydney, Sydney, Australia
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Martin-Gutierrez G, Wallander JL, Yang YJ, Depaoli S, Elliott MN, Coker TR, Schuster MA. Racial/Ethnic Differences in the Relationship Between Stressful Life Events and Quality of Life in Adolescents. J Adolesc Health 2021; 68:292-299. [PMID: 32747050 DOI: 10.1016/j.jadohealth.2020.05.055] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/27/2019] [Revised: 05/26/2020] [Accepted: 05/29/2020] [Indexed: 10/23/2022]
Abstract
PURPOSE Stressful life events (SLEs) increase allostatic load and require adaptation. Experiencing SLEs has been associated with decreased health-related quality of life (HRQOL) among adolescents. This study examined racial/ethnic and developmental differences in the relationship between SLEs and HRQOL from preadolescence to midadolescence. METHODS Data were from 4,824 participants in the Healthy Passages project, a population-based prospective longitudinal survey of fifth, seventh, and 10th grade adolescents in the U.S. HRQOL was measured with Pediatric Quality of Life Inventory and SLEs with items addressing family-related SLEs (e.g., the parent's death, separation, and divorce; family member's injury/illness; residential change; new child in the household). RESULTS Adolescents, regardless of race/ethnicity, reported the highest SLEs and the lowest HRQOL in early adolescence. Analysis of an autoregressive model with cross-lagged effects showed that the concurrent relationships between SLEs and HRQOL were significantly negative across preadolescence, early adolescence, and midadolescence in African-American, Latinx, and white groups. Furthermore, adolescents had a negative cross-lagged association from SLEs in early adolescence to HRQOL in pre adolescence, but this was not the case among the other racial/ethnic groups. CONCLUSIONS Because the negative relationship between family-related SLEs and HRQOL persisted throughout stages of adolescent development, health services targeting adolescents should provide comprehensive family-centered care to alleviate the impact of family-related life stress. Relationships between family life stress and HRQOL varied by racial/ethnic groups, which should be considered by health professionals, teachers, and parents, and in prevention efforts. Latinx adolescents may be particularly vulnerable to time-lagged effects of such family-related stress.
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Affiliation(s)
- Geraldy Martin-Gutierrez
- Psychological Sciences and Health Sciences Research Institute, University of California, Merced, Merced, California
| | - Jan L Wallander
- Psychological Sciences and Health Sciences Research Institute, University of California, Merced, Merced, California.
| | - Yuzhu June Yang
- Psychological Sciences and Health Sciences Research Institute, University of California, Merced, Merced, California
| | - Sarah Depaoli
- Psychological Sciences and Health Sciences Research Institute, University of California, Merced, Merced, California
| | | | - Tumaini R Coker
- Department of Pediatrics, University of Washington School of Medicine, Seattle, Washington; Seattle Children's Research Institute, Seattle, Washington
| | - Mark A Schuster
- Kaiser Permanente Bernard J. Tyson School of Medicine, Pasadena, California
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30
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Lange SJ, Moore LV, Harris DM, Merlo CL, Lee SH, Demissie Z, Galuska DA. Percentage of Adolescents Meeting Federal Fruit and Vegetable Intake Recommendations - Youth Risk Behavior Surveillance System, United States, 2017. MMWR-MORBIDITY AND MORTALITY WEEKLY REPORT 2021; 70:69-74. [PMID: 33476311 PMCID: PMC7821769 DOI: 10.15585/mmwr.mm7003a1] [Citation(s) in RCA: 37] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Matos Fialho PM, Dragano N, Reuter M, Metzendorf MI, Richter B, Hoffmann S, Diehl K, Wachtler B, Sundmacher L, Herke M, Pischke C. Mapping the evidence regarding school-to-work/university transition and health inequalities among young adults: a scoping review protocol. BMJ Open 2020; 10:e039831. [PMID: 33268415 PMCID: PMC7713198 DOI: 10.1136/bmjopen-2020-039831] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
INTRODUCTION School-to-work/university transition is a sensitive period that can have a substantial impact on health and health behaviour over the life course. There is some indication that health and health behaviour is socially patterned in the age span of individuals in this transition (16-24 years) and that there are differences by socioeconomic position (SEP). However, evidence regarding this phenomenon has not been systematically mapped. In addition, little is known about the role of institutional characteristics (eg, of universities, workplaces) in the development of health and possible inequalities in health during this transition. Hence, the first objective of this scoping review is to systematically map the existing evidence regarding health and health behaviours (and possible health inequalities, for example, differences by SEP) in the age group of 16-24 years and during school-to-work transition noted in Germany and abroad. The second objective is to summarise the evidence on the potential effects of contextual and compositional characteristics of specific institutions entered during this life stage on health and health behaviours. Third, indicators and measures of these characteristics will be summarised. METHODS AND ANALYSIS We will systematically map the evidence on health inequalities during school-to-work-transitions among young adults (aged 16-24 years), following the methodological framework proposed by Arksey and O'Malley. The literature search is performed in Ovid MEDLINE, Web of Science, International Labour Organization and National Institute for Occupational Safety and Health, using a predetermined search strategy. Articles published between January 2000 and February 2020 in English or German are considered for the review. The selection process follows a two-step approach: (1) screening of titles and abstracts, and (2) screening of full texts, both steps by two independent reviewers. Any discrepancies in the selection process are resolved by a third researcher. Data extraction will be performed using a customised data extraction sheet. The results will be presented in tabular and narrative form. ETHICS AND DISSEMINATION Ethical approval is not required for this scoping review. The results will be published in a peer-reviewed scientific journal and presented at international conferences and project workshops.
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Affiliation(s)
- Paula Mayara Matos Fialho
- Institute of Medical Sociology, Centre for Health and Society, Medical Faculty, University of Duesseldorf, Duesseldorf, Germany
| | - Nico Dragano
- Institute of Medical Sociology, Centre for Health and Society, Medical Faculty, University of Duesseldorf, Duesseldorf, Germany
| | - Marvin Reuter
- Institute of Medical Sociology, Centre for Health and Society, Medical Faculty, University of Duesseldorf, Duesseldorf, Germany
| | - Maria-Inti Metzendorf
- Cochrane Metabolic and Endocrine Disorders Group, Institute of General Practice (ifam), Centre for Health and Society, Medical Faculty, University of Duesseldorf, Duesseldorf, Duesseldorf, Germany
| | - Bernd Richter
- Cochrane Metabolic and Endocrine Disorders Group, Institute of General Practice (ifam), Centre for Health and Society, Medical Faculty, University of Duesseldorf, Duesseldorf, Duesseldorf, Germany
| | - Stephanie Hoffmann
- Department of Public Health, Faculty for Social Work, Health, and Music, Brandenburg University of Technology Cottbus-Senftenberg, Senftenberg, Germany
| | - Katharina Diehl
- Mannheim Institute of Public Health, Social and Preventive Medicine, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Benjamin Wachtler
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany
| | - L Sundmacher
- Department of Health Services Management, Ludwig Maximilians University Munich, Munich, Germany
| | - Max Herke
- Institute of Medical Sociology, Medical Faculty, Martin-Luther-Universitat Halle-Wittenberg, Halle (Saale), Germany
| | - Claudia Pischke
- Institute of Medical Sociology, Centre for Health and Society, Medical Faculty, University of Duesseldorf, Duesseldorf, Germany
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Mehrotra S. Indian higher education and youth mental health: Challenges and opportunities. J Glob Health 2020; 10:020307. [PMID: 33110511 PMCID: PMC7535075 DOI: 10.7189/jogh.10.020307] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Affiliation(s)
- Seema Mehrotra
- National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, India
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Tauriello S, Bowker J, Wilding G, Epstein L, Anzman-Frasca S. Examining associative conditioning with a positive peer context as a strategy to increase children's vegetable acceptance. Pediatr Obes 2020; 15:e12660. [PMID: 32548907 DOI: 10.1111/ijpo.12660] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2020] [Revised: 05/03/2020] [Accepted: 05/06/2020] [Indexed: 01/05/2023]
Abstract
BACKGROUND Children's vegetable acceptance increases following repeated exposure and associative conditioning pairing a target vegetable with a well-liked food. Yet traditional pairings may increase energy intake when well-liked foods are calorie-rich. OBJECTIVES To examine whether pairing a non-food stimulus with target vegetables increases children's vegetable acceptance and whether effects exceed those of repeated exposure. METHODS Twenty-three 6-to-8-year-old children participated in twice-weekly sessions across 6 weeks of a summer camp serving children from low-income families. First- and second-grade camp classrooms were randomly assigned to associative conditioning and repeated exposure groups, respectively. Liking and preference were assessed for seven vegetables at pre/post-test. For each child, two non-preferred vegetables were randomly assigned as the target or control. During exposures, associative conditioning group children experienced a positive peer context (involving group games) paired with tasting their target vegetable. The repeated exposure group received only taste exposures; target vegetable liking was assessed. RESULTS Preferences for target vegetables increased from pre- (Median = 6.00) to post-test (Median = 3.00) overall (P = .007), but did not differ by group (P = .59). Group, time and interaction effects on vegetable liking were non-significant overall (P ≥ .29), with some evidence of group differences when examining select time points. CONCLUSIONS Findings can inform future research aiming to increase vegetable preferences in community settings.
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Affiliation(s)
- Sara Tauriello
- Department of Pediatrics, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, New York, USA
| | - Julie Bowker
- Department of Psychology, College of Arts and Sciences, University at Buffalo, Buffalo, New York, USA
| | - Gregory Wilding
- Department of Biostatistics, School of Public Health and Health Professions, University at Buffalo, Buffalo, New York, USA
| | - Leonard Epstein
- Department of Pediatrics, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, New York, USA.,Center for Ingestive Behavior Research, University at Buffalo, Buffalo, New York, USA
| | - Stephanie Anzman-Frasca
- Department of Pediatrics, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, New York, USA.,Center for Ingestive Behavior Research, University at Buffalo, Buffalo, New York, USA
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Evaluation of a program targeting sports coaches as deliverers of health-promoting messages to at-risk youth: Assessing feasibility using a realist-informed approach. PLoS One 2020; 15:e0236812. [PMID: 32877443 PMCID: PMC7467304 DOI: 10.1371/journal.pone.0236812] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2020] [Accepted: 07/15/2020] [Indexed: 11/26/2022] Open
Abstract
Unequal access to health promotion resources and early prevention services is a major determinant of health inequity among youth. Initiatives that improve the access to and adoption of health promotion messages are important undertakings, e.g., sport. Sport-for-development (SFD) programs are seen as valuable delivery tools, in which coaches are used as change agents to increase health awareness and behavior among at-risk youth. The delivery of such messages requires specific knowledge and skills that can be attained through training; however, the effectiveness of such training requires assessment. In this study, we evaluated the feasibility of such a training program for SFD coaches using process evaluation from a realist perspective, and views from multiple stakeholders, among other sources. We also clarified the inner workings of the training and investigated how context shaped the training outcomes. Increased health awareness and a sense of responsibility from acting as a role model for at-risk youth were among the perceived training outcomes. Building a safe environment for learning, engagement, and bonds of trust increased the confidence to learn, and resulted in a sense of critical self-reflection and self-development of SFD coaches towards health and prevention messages. Importantly, the unique situations (or context) of SFD coaches and SFD in general presented challenging variables, e.g., a precarious life history or living conditions, mental health issues, or low educational skills, that hampered the impact of the mechanisms put in place by the training. Here, we present a process in which the development of the ‘right mind-set,’ engagement and bonds of trust, in combination with the right settings are key elements for SFD coaches to learn how to convey health-promoting messages and take responsibility as role models for at-risk youth.
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Lorimer K, Knight R, Shoveller J. Improving the health and social wellbeing of young people: exploring the potential of and for collective agency. CRITICAL PUBLIC HEALTH 2020. [DOI: 10.1080/09581596.2020.1786501] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Affiliation(s)
- Karen Lorimer
- School of Health & Life Sciences, Glasgow Caledonian University, Glasgow, Scotland
| | - Rod Knight
- British Columbia Centre on Substance Use, Vancouver, British Columbia, Canada
| | - Jean Shoveller
- School of Population & Public Health, University of British Columbia, Vancouver, British Columbia, Canada
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Patterns of Health-Related Gender Inequalities-A Cluster Analysis of 45 Countries. J Adolesc Health 2020; 66:S29-S39. [PMID: 32446606 DOI: 10.1016/j.jadohealth.2020.02.011] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/04/2019] [Revised: 02/06/2020] [Accepted: 02/07/2020] [Indexed: 11/22/2022]
Abstract
PURPOSE The paper explores gender inequalities between 45 countries across 10 health indicators among adolescents and whether those differences in health correlate with gender inequality in general. METHODS Data from 71,942 students aged 15 years from 45 countries who participated in the 2018 Health Behaviour in School-aged Children survey were analyzed. For this purpose, 10 indicators were selected, representing a broad spectrum of health outcomes. The gender differences in the countries were first presented using odds ratios. Countries with similar risk profiles were grouped together using cluster analyses. For each of the 10 indicators, the correlation with the Gender Inequality Index was examined. RESULTS The cluster analysis reveals systematic gender inequalities, as the countries can be divided into seven distinct groups with similar gender inequality patterns. For eight of the 10 health indicators, there is a negative correlation with the Gender Inequality Index: the greater the gender equality in a country, the higher the odds that girls feel fat, have low support from families, have low life satisfaction, have multiple health complaints, smoke, drink alcohol, feel school pressure, and are overweight compared with boys. Four indicators show a divergence: the higher the gender equality in a country in general, the larger the differences between boys and girls regarding life satisfaction, school pressure, multiple health complaints, and feeling fat. CONCLUSIONS Countries that are geographically and historically linked are similar in terms of the health risks for boys and girls. The results challenge the assumption that greater gender equality is always associated with greater health equality.
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Engagement with a Web-Based Health Promotion Intervention among Vocational School Students: A Secondary User and Usage Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17072180. [PMID: 32218251 PMCID: PMC7177298 DOI: 10.3390/ijerph17072180] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/05/2020] [Revised: 03/11/2020] [Accepted: 03/17/2020] [Indexed: 12/27/2022]
Abstract
Engagement with web-based interventions is both generally low and typically declining. Visits and revisits remain a challenge. Based on log data of a web-based cluster randomized controlled trial conducted in vocational schools, the present secondary analysis aimed to identify influencing factors on initially logging in to a health promotion platform among young adults and to examine the engagement over the course of an eight-week intervention. Data of 336 students (62.2% female, age span 18–25) from two intervention arms (web-based intervention and web-based intervention with an additional initial face-to-face contact) was included. Binary logistic regression and log-data visualization were performed. An additional initial face-to-face contact (odds ratio (OR) = 2.971, p = 0.005), female sex (OR = 2.237, p = 0.046) and the health-related skill “dealing with health information” (OR = 2.179, p = 0.030) significantly increased the likelihood of initially logging in. Other variables showed no influence. 16.6% of all potential users logged in at least once, of which 57.4% revisited the platform. Most logins were tracked at the beginning of the intervention and repeated engagement was low. To increase the engagement with web-based interventions, health-related skills should be fostered. In addition, a strategy could be to interlink comparable interventions in vocational schools more regularly with everyday teaching through multi-component interventions.
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Jensen JD, Andersen JH, Winding TN. Psychological resources in adolescence and the association with labour market participation in early adulthood: a prospective cohort study. BMC Public Health 2020; 20:386. [PMID: 32209059 PMCID: PMC7092559 DOI: 10.1186/s12889-020-08531-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2019] [Accepted: 03/16/2020] [Indexed: 11/25/2022] Open
Abstract
Background Young adults at the age of 25–29 in Denmark have the highest unemployment rate and are at higher risk of labour market marginalization. Exclusion from the labour market may have negative individual consequences on mental and physical health and can lead to increasing societal expenditures due to social benefits. It is important to understand what factors determine or protect against early labour market marginalization. The aim of the present study was to investigate the association between psychological resources in adolescence and labour market participation in early adulthood, and whether the associations differed by gender. Methods This prospective cohort study used questionnaire data collected through the West Jutland Cohort study in 2004 and 2007. The study population (N = 2982) consisted of people born in 1989 and living in the county of Ringkjoebing at baseline in 2004. Outcome was dichotomized as +/− 12 months of passive labour market participation during the age of 25–29. Psychological resources were measured as self-esteem, sense of coherence and mastery. Logistic regression analyses were performed to investigate the associations between psychological resources and labour market participation. Results Results indicated associations between high levels of mastery or sense of coherence in adolescence and high labour market participation in early adulthood. The strongest associations were observed for females with a medium (OR: 1.9, 95% CI: 1.3–2.8) or high level (OR: 1.6, 95% CI: 1.0–2.4) of mastery or a high level of sense of coherence (OR: 1.6 95% CI: 1.0–2.4) at age 15 and for males with a medium (OR: 2.7, 95% CI: 1.5–3.8) or high (OR: 1.9, 95% CI: 1.1–3.5) level of mastery or a high level of sense of coherence (OR: 1.7, 95% CI: 0.9–3.1) at age 18. Conclusion The results of the present study indicate associations between a high level of sense of coherence or mastery in adolescence and high labour market participation in early adulthood in a Danish context. Psychological resources seemed to play a bigger role for females in early adolescence compared to males, for whom a larger impact was seen in late adolescence.
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Affiliation(s)
- Jacob Devantie Jensen
- Ramboll Management Consulting, Stakeholder Intelligence, Olof Palmes Allé 22, 8200, Aarhus, Denmark
| | - Johan Hviid Andersen
- Department of Occupational Medicine, Danish Ramazzini Centre, University Research Clinic, Regional Hospital West Jutland, Gl. Landevej 61, 7400, Herning, Denmark
| | - Trine Nøhr Winding
- Department of Occupational Medicine, Danish Ramazzini Centre, University Research Clinic, Regional Hospital West Jutland, Gl. Landevej 61, 7400, Herning, Denmark.
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Hoffman S, Rueda HA, Beasley L. Health-Related Quality of Life and Health Literacy among Mexican American and Black American Youth in a Southern Border State. SOCIAL WORK IN PUBLIC HEALTH 2020; 35:114-124. [PMID: 32248757 DOI: 10.1080/19371918.2020.1747584] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Among adults, health literacy and health-related quality of life are highly correlated constructs that are associated with tangible health outcomes. While the connection between these concepts and health outcomes among youth is still unclear, studying these factors among at-risk adolescent populations can provide researchers, policy-creators, and educators a quantifiable summary of the challenge they face in their efforts to reduce health disparities. The purpose of this study was to better understand the health of minority youth living in a Southern state near the US-Mexico border. Specifically, we sought to describe their health literacy and health-related quality of life, and identify how those concepts may be interrelated. Results indicated that our sample of primarily Mexican American and Black American youth living along the US-Mexico border may be struggling more than other known high-risk groups in terms of health literacy and health-related quality of life. Practical implications for families, schools, and border communities are discussed.
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Affiliation(s)
- Steven Hoffman
- School of Social Work, Brigham Young University, Provo, Utah, USA
| | - Heidi Adams Rueda
- Department of Social Work, University of Texas at San Antonio, San Antonio, Texas, USA
| | - Lauren Beasley
- Knoxville Department of Kinesiology, Recreation and Sport Studies, University of Tennessee, Knoxville, Tennessee, USA
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Meilstrup C, Holstein BE, Nielsen L, Due P, Koushede V. Self-efficacy and social competence reduce socioeconomic inequality in emotional symptoms among schoolchildren. Eur J Public Health 2020; 30:80-85. [PMID: 31329865 DOI: 10.1093/eurpub/ckz058] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Many adolescents experience mental health problems which may have serious consequences for short- and long-term health and wellbeing. This study investigates socioeconomic inequality in emotional symptoms, self-efficacy and social competence. Further, whether self-efficacy and social competence reduce socioeconomic inequalities in emotional symptoms. METHODS Data stem from the cross-sectional Danish Health Behaviour in School-aged Children Methodology Development Survey 2012. Data were collected among all schoolchildren in grades 5-9 (11-15-year-olds) in 23 public schools in two municipalities. Participation rate was 76.8% (n = 3969). Analyses of the associations between daily emotional symptoms, occupational social class, self-efficacy and social competence were performed through logistic regression analyses using SAS version 9.3. Multilevel logistic regression analyses were used to study effect modification. RESULTS Schoolchildren from lower socioeconomic positions have higher odds for daily emotional symptoms and lower levels of high self-efficacy and high social competence compared to schoolchildren from higher socioeconomic positions. High self-efficacy and high social competence buffer the association between socioeconomic position and emotional symptoms, i.e. they seem to protect children and adolescents from lower socioeconomic strata against the higher risk of daily emotional symptoms. CONCLUSIONS High self-efficacy and high social competence buffer the negative effects of low socioeconomic status on emotional symptoms among schoolchildren. Self-efficacy and social competence can be promoted e.g. through school-based initiatives and may be an effective way to improve mental health and reduce socioeconomic inequality in emotional symptoms among children and adolescents.
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Affiliation(s)
- Charlotte Meilstrup
- National Institute of Public Health, University of Southern Denmark, Copenhagen K, Denmark
| | - Bjørn E Holstein
- National Institute of Public Health, University of Southern Denmark, Copenhagen K, Denmark
| | - Line Nielsen
- The Council on Health and Disease Prevention, Copenhagen Ø, Denmark
| | - Pernille Due
- National Institute of Public Health, University of Southern Denmark, Copenhagen K, Denmark
| | - Vibeke Koushede
- National Institute of Public Health, University of Southern Denmark, Copenhagen K, Denmark
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Bonnesen CT, Toftager M, Madsen KR, Wehner SK, Jensen MP, Rosing JA, Laursen B, Rod NH, Due P, Krølner RF. Study protocol of the Healthy High School study: a school-based intervention to improve well-being among high school students in Denmark. BMC Public Health 2020; 20:95. [PMID: 31969134 PMCID: PMC6977303 DOI: 10.1186/s12889-020-8194-y] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2019] [Accepted: 01/10/2020] [Indexed: 12/05/2022] Open
Abstract
BACKGROUND The prevalence of low well-being, perceived stress and unhealthy behaviours is high among high school students, but few interventions have addressed these problems. The aim of this paper is to present a study protocol of a cluster randomised controlled trial evaluating the Healthy High School (HHS) intervention programme. The intervention programme is designed to improve well-being (primary outcome) by preventing 1) stress and promoting 2) sleep, 3) sense of community, 4) physical activity (PA) and 5) regular and healthy meals among high school students in Denmark. METHODS The development of the HHS study was guided by the Intervention Mapping protocol. The intervention comprises four components: 1) a teaching material, 2) a smartphone app, 3) a catalogue focusing on environmental changes, and 4) a peer-led innovation workshop aiming at inspiring students to initiate and participate in various movement activities. The HHS study employs a cluster-randomised controlled trial design. Thirty-one high schools across Denmark were randomly allocated to intervention (16 schools) or control (15 schools) groups. The study included all first-year students (~ 16 years of age) (n = 5976 students). Timeline: Intervention: August 2016 - June 2017. Collection of questionnaire data: Baseline (August 2016), 1st follow-up (May 2017) and 2nd follow-up (April 2018). All students were invited to participate in a monthly sub-study about perceived stress using text messages for data collection (September 2016 - June 2017). PA was objectively assessed among a sub-sample of students using accelerometers (Axivity, AX3) in August 2016 and May 2017. PRIMARY OUTCOME MEASURES Student well-being measured by the Cantril Ladder and the five item World Health Organisation Well-being Index (individual level outcomes). SECONDARY OUTCOME MEASURES Stress (10-item Perceived Stress Scale), sleep (quantity and quality), PA (hours of moderate-to-vigorous PA per week, hours of daily sedentary time and average daily PA), meal habits (daily intake of breakfast, lunch, snacks and water), and strong sense of community in class and at school, respectively (individual level outcomes). The study encompasses process and effect evaluation as well as health economic analyses. TRIAL REGISTRATION ISRCTN ISRCTN43284296, 28 April 2017, retrospectively registered.
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Affiliation(s)
- Camilla Thørring Bonnesen
- Centre for Intervention Research in Health Promotion and Disease Prevention, National Institute of Public Health, University of Southern Denmark, Studiestræde 6, 1455 Copenhagen, Denmark
| | - Mette Toftager
- Centre for Intervention Research in Health Promotion and Disease Prevention, National Institute of Public Health, University of Southern Denmark, Studiestræde 6, 1455 Copenhagen, Denmark
| | - Katrine Rich Madsen
- Centre for Intervention Research in Health Promotion and Disease Prevention, National Institute of Public Health, University of Southern Denmark, Studiestræde 6, 1455 Copenhagen, Denmark
| | - Stine Kjær Wehner
- Centre for Intervention Research in Health Promotion and Disease Prevention, National Institute of Public Health, University of Southern Denmark, Studiestræde 6, 1455 Copenhagen, Denmark
| | - Marie Pil Jensen
- Centre for Intervention Research in Health Promotion and Disease Prevention, National Institute of Public Health, University of Southern Denmark, Studiestræde 6, 1455 Copenhagen, Denmark
| | - Johanne Aviaja Rosing
- Centre for Intervention Research in Health Promotion and Disease Prevention, National Institute of Public Health, University of Southern Denmark, Studiestræde 6, 1455 Copenhagen, Denmark
| | - Bjarne Laursen
- Centre for Intervention Research in Health Promotion and Disease Prevention, National Institute of Public Health, University of Southern Denmark, Studiestræde 6, 1455 Copenhagen, Denmark
| | - Naja Hulvej Rod
- Section of Epidemiology, Department of Public Health, University of Copenhagen, Bartholinsgade 6Q, 1356 Copenhagen, Denmark
| | - Pernille Due
- Centre for Intervention Research in Health Promotion and Disease Prevention, National Institute of Public Health, University of Southern Denmark, Studiestræde 6, 1455 Copenhagen, Denmark
| | - Rikke Fredenslund Krølner
- Centre for Intervention Research in Health Promotion and Disease Prevention, National Institute of Public Health, University of Southern Denmark, Studiestræde 6, 1455 Copenhagen, Denmark
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Holstein BE, Damsgaard MT, Due P, Krølner RF, Pedersen TP, Rasmussen M. Intake of sugar sweetened soft drinks among adolescents: Trends and social inequality in Denmark 2002-2018. Nutr Health 2020; 26:3-8. [PMID: 31965902 DOI: 10.1177/0260106019900742] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
BACKGROUND Intake of sugar sweetened soft drinks (SSSD) has decreased among adolescents, but trends in social inequality in SSSD intake are unknown. AIM Examine trends in social inequality in SSSD intake among adolescents in Denmark during 2002-2018. METHODS Five Health Behaviour in School-aged Children surveys with data on SSSD intake and parents' occupational social class (OSC) from nationally representative samples of 11, 13 and 15 year olds, n =20,112. RESULTS The overall prevalence of daily SSSD intake decreased from 10.1% in 2002 to 6.4% in 2018. The prevalence decreased in both high OSC (from 8% to 5%) and middle OSC (from 10% to 6%) but remained around 12% in low OSC. The odds ratio (OR) estimates of low compared with high OSC increased over the years around an overall OR of 2.01 (1.74-2.34). CONCLUSIONS Danish adolescents' SSSD intake decreased during 2002-2018 and was higher the lower the parents' OSC. Thus, social inequality increased during 2002-2018.
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Affiliation(s)
- Bjørn E Holstein
- University of Southern Denmark, National Institute of Public Health, Copenhagen, Denmark
| | - Mogens Trab Damsgaard
- University of Southern Denmark, National Institute of Public Health, Copenhagen, Denmark
| | - Pernille Due
- University of Southern Denmark, National Institute of Public Health, Copenhagen, Denmark
| | | | - Trine Pagh Pedersen
- University of Southern Denmark, National Institute of Public Health, Copenhagen, Denmark
| | - Mette Rasmussen
- University of Southern Denmark, National Institute of Public Health, Copenhagen, Denmark
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Poulsen PH, Biering K, Winding TN, Aagaard Nohr E, Andersen JH. Influences of childhood family factors on depressive symptoms in adolescence and early adulthood: A Danish longitudinal study. Scand J Public Health 2020; 48:715-725. [PMID: 31960768 DOI: 10.1177/1403494819870056] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
Aims: The study examined the timing of family socio-economic factors during early (aged 0-8 years) and late (aged 9-14 years) childhood, as well as psychosocial variables in relation to depressive symptoms at the ages of 15, 18 and 21. Methods: This prospective cohort study included 3014 young people from western Denmark. Exposure variables were equivalised household income (income), mother's educational level and mother's labour market participation (LMP), derived from registers and self-reported variables family functioning, subjective social status and negative life events. The outcome variable was depressive symptoms. Associations were analysed using logistic regression, adjusted for other exposure variables and sex. Results: In early childhood, mother's low LMP was associated with higher risk of depressive symptoms at the age of 15, whereas mother's low educational level and lower income was associated with higher risk of depressive symptoms at the age of 21. In late childhood, lower income, mother's low educational level and mother's low LMP was associated with higher risk of depressive symptoms at the ages of 15 and 21. Poorer family functioning was associated with depressive symptoms at the age of 15-21, with estimates ranging from 1.8 to 2.6. Reporting two or more negative life events were associated with depressive symptoms at the ages of 15 and 18. Conclusions: Timing of low income, mother's low educational level and mother's low LMP during childhood in relation to future depressive symptoms in the offspring appears to be of some importance in this Danish youth cohort. Family functioning and negative life events were the most stable risk factors for depressive symptoms. Results should, however, be interpreted with caution due to the risk of reverse causality.
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Affiliation(s)
- Per Hoegh Poulsen
- Danish Ramazzini Centre, Department of Occupational Medicine, University Research Clinic, Regional Hospital West Jutland, Denmark
| | - Karin Biering
- Danish Ramazzini Centre, Department of Occupational Medicine, University Research Clinic, Regional Hospital West Jutland, Denmark
| | - Trine Nøhr Winding
- Danish Ramazzini Centre, Department of Occupational Medicine, University Research Clinic, Regional Hospital West Jutland, Denmark
| | - Ellen Aagaard Nohr
- Institute of Clinical Research, University of Southern Denmark, Department of Obstetrics and Gynaecology, Odense University Hospital, Denmark
| | - Johan Hviid Andersen
- Danish Ramazzini Centre, Department of Occupational Medicine, University Research Clinic, Regional Hospital West Jutland, Denmark
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Al-Azri M, Al-Saadi WI, Al-Harrasi A, Murthi Panchatcharam S. Knowledge of Cancer Risk Factors, Symptoms, and Barriers to Seeking Medical Help among Omani Adolescents. Asian Pac J Cancer Prev 2019; 20:3655-3666. [PMID: 31870107 PMCID: PMC7173372 DOI: 10.31557/apjcp.2019.20.12.3655] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2019] [Indexed: 12/24/2022] Open
Abstract
Objective: Raising cancer awareness among adolescents should lead to early diagnosis and improve their survival rate into adulthood. This study aims to identify knowledge of cancer risk factors, symptoms and barriers to seek medical help among Omani adolescents. Methods: A cross-sectional study with Omani adolescents (aged 15-17 years) has been conducted in six schools in Muscat, the capital of Oman. The general Cancer Awareness Measure questionnaire was used to collect the data. Results: A total of 481 adolescents participated. The average recognition of cancer risk factors and symptoms was low (36.8% and 39.6%, respectively). Cancer risk factors and/or symptoms significantly recognised more in girls compared to boys (χ2 = 10.136; Odds ratio [OR] = 2.13 ; 95% confidence interval [CI]= 0.33-3.41; P = 0.001); older (age 17 year) versus younger (aged 15 and 16 years) (χ2 = 6.075; OR = 11.68; 95% CI: 1.11-2.53; P = 0.014); those with existing co-morbidities compared to those without (χ2 = 4.955; OR = 0.41; 95% CI: 0.18-0.92; P = 0.026); and those who knew someone with cancer compared to those who did not (χ2 = 15.285; OR 2.70; 95% CI: 1.62-4.49; P <0.001). The majority of adolescents (88.8%) would seek medical help within the first two weeks of noting cancer symptoms. The most notable barriers to seek medical help were “emotional”. Girls were experienced “emotional barriers” significantly more than the boys (χ2 = 11.617; OR = 1.89; 95% CI: 1.31-2.72; P = <0.001). Conclusion: Adolescents in Oman showed poor cancer awareness with several “emotional” barriers. There is a need to establish and integrate effective cancer educational programs in school curriculums to raise the cancer awareness, address emotional barriers and encourage seeking early medical help. The program could potentially have a life-long impact on encouraging early cancer diagnosis and improving the cancer survival rate.
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Affiliation(s)
- Mohammed Al-Azri
- Department of Family Medicine and Public Health, College of Medicine and Health Sciences, Sultan Qaboos University, Sultanate of Oman
| | - Waleed Ibrahim Al-Saadi
- Department of Family Medicine and Public Health, College of Medicine and Health Sciences, Sultan Qaboos University, Sultanate of Oman
| | - Abdulaziz Al-Harrasi
- Department of Family Medicine and Public Health, College of Medicine and Health Sciences, Sultan Qaboos University, Sultanate of Oman
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Van der Veken K, Willems S, Lauwerier E. Health Promotion in Socially Vulnerable Youth: Sports as a Powerful Vehicle? Health Promot Pract 2019; 22:275-286. [PMID: 31583905 DOI: 10.1177/1524839919874751] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Community sport has emerged in the past decades and uses sports as a lever to improve health and well-being among socially disadvantaged youth. Despite this premise, we do not know whether and to what extent health promotion aims are achieved within community sports practice. Measurable actions are needed, but it can be hard for researchers or practitioners to know how to approach this. This study aimed at developing a health-promoting intervention targeting youth attending community sports. To this aim, we used a planned approach for intervention design within a community-based participatory research design. The result is a group-based program promoting health-supportive behavior among community sport coaches, as we found coaches to be quintessential in fostering motivation toward health behavior change in vulnerable youth attending community sports. The design of such a complex intervention is difficult, yet tractable, when using a planned approach. Of importance, community engagement was the core of our work and we provide the reader with detailed examples on the combined use of participatory research and planned intervention design. This article provides an exemplar of how to approach the development of a health-promoting intervention in hard-to-reach populations.
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Socio-economic inequality in unhealthy snacks consumption among adolescent students in Iran: a concentration index decomposition analysis. Public Health Nutr 2019; 22:2179-2188. [PMID: 31199208 DOI: 10.1017/s1368980019000740] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
OBJECTIVE The present study aimed to assess and decompose the socio-economic inequality in unhealthy snacks consumption among adolescent students in Kerman, Iran. DESIGN The data were obtained from a cross-sectional study. Principal component analysis was done to measure the socio-economic status (SES) of the adolescents' families and the normalized concentration index (NCI) was used to measure the inequality in unhealthy snacks consumption among adolescent students of different SES. The contributions of environmental and individual explanatory variables to inequality were assessed by decomposing the concentration index. SETTING Forty secondary schools of Kerman Province in Iran in 2015. PARTICIPANTS Eighth-grade adolescent students (n 1320). RESULTS The data of 1242 adolescent students were completed for the current study. Unhealthy snacks consumption was unequally distributed among adolescent students and was concentrated mainly among the high-SES adolescents (NCI = 0·179; 95 % CI 0·056, 0·119). The decomposition showed that higher SES (62 %) and receiving pocket money allowance (31 %), as environmental variables, had the highest positive contributions to the measured inequality in unhealthy snacks consumption. Taste and sensory perception (7 %) as well as cost sensitivity (5 %), as individual variables, followed them in terms of their contribution importance. CONCLUSIONS It is highly suggested that both environmental and individual factors should be addressed at different settings including schools, families and suppliers of unhealthy snacks. These findings can help future health promotion strategies in Iran to tackle the observed inequality in unhealthy snacks consumption.
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Bast LS, Due P, Lauemøller SG, Kjær NT, Christiansen T, Andersen A. Study protocol of the X:IT II - a school-based smoking preventive intervention. BMC Public Health 2019; 19:497. [PMID: 31046721 PMCID: PMC6498574 DOI: 10.1186/s12889-019-6805-2] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2018] [Accepted: 04/11/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The X:IT intervention, conducted in 2010 to 2013, showed overall smoking preventive effect. However, parts of the intervention appeared less appealing to children from families with lower socioeconomic backgrounds. Therefore, the intervention components were modified and an evaluation of the amended intervention X:IT II is needed to show the effect of this revised intervention and whether children from different social backgrounds benefits equally from the current intervention. METHODS Main intervention components are smoke free schools, a curricular component, and parental involvement (smoke free agreements and talks about tobacco). Components have been revised from the first version; 1) previously, schools should be smoke free on the school ground and were encouraged to hide smoking so that it wasn't visible to pupils from the school ground. Now they are encouraged to tighten the rules so that no pupils or teachers smoke during the school day, no matter where they are; 2) the specifically developed educational material (Up in Smoke) has been revised so that all materials are online and all texts has a ARI; 3) the parental involvement is now targeted multiple groups of parents, e.g. parents that are smokers, and parents of children that smoke. Language used is simpler and the website for parents presents very specific examples. X:IT is implemented in 46 Danish public schools from fall 2017 until summer 2020. Data is collected through electronic questionnaires to students and coordinators four times (fall 2017, spring/summer 2018, 2019 and 2020). Further, qualitative interviews and observations are conducted. DISCUSSION Prevalence of smoking among Danish adolescents is high compared to other Nordic countries and there is social inequality in smoking, leaving individuals from the lowest social backgrounds at higher risk. Although there has been an overall decline in smoking among Danish adolescents over the last decades, a recent levelling of this development indicates an urgent need for smoking prevention in Denmark. The X:IT intervention has the potential to prevent uptake of smoking among adolescents. However, there is a particular need for evaluating the effectiveness of the revised X:IT intervention, X:IT II, with focus on the effect across socioeconomic groups of adolescents. TRIAL REGISTRATION Current Controlled Trials ISRCTN31292019 , date of registration 24/10/2017. Retrospectively registered.
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Affiliation(s)
- Lotus Sofie Bast
- National Institute of Public Health, University of Southern Denmark, Studiestreade 6, 1455 Copenhagen, Denmark
| | - Pernille Due
- National Institute of Public Health, University of Southern Denmark, Studiestreade 6, 1455 Copenhagen, Denmark
| | - Stine Glenstrup Lauemøller
- National Institute of Public Health, University of Southern Denmark, Studiestreade 6, 1455 Copenhagen, Denmark
| | - Niels Them Kjær
- Danish Cancer Society, Strandboulevarden 49, 2100 Copenhagen, Denmark
| | | | - Anette Andersen
- National Institute of Public Health, University of Southern Denmark, Studiestreade 6, 1455 Copenhagen, Denmark
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Thomsen EL, Khoury LR, Møller T, Boisen KA. Parents to chronically ill adolescents have ambivalent views on confidential youth consultations - a mixed methods study. Int J Adolesc Med Health 2019; 33:/j/ijamh.ahead-of-print/ijamh-2018-0226/ijamh-2018-0226.xml. [PMID: 31026223 DOI: 10.1515/ijamh-2018-0226] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2018] [Accepted: 12/20/2018] [Indexed: 06/09/2023]
Abstract
BACKGROUND Confidential youth consultations aiming at enhancing adolescent autonomy are a cornerstone of transitional care. At the same time, parental support is essential. These conflicting considerations result in a clinical dilemma. OBJECTIVE The aim of this study was to examine the attitudes of parents to chronically ill adolescents regarding confidential youth consultations and to explore the underlying reasons. METHODS A sequential explanatory mixed methods design consisting of a cross-sectional questionnaire survey (n = 117) and three focus group interviews among parents (n = 12) to chronically ill adolescents (12-19 years) was used. Quantitative data were analyzed descriptively. Qualitative data were analyzed using King's template method. RESULTS The parents preferred independent youth consultations starting around the age of 14-15 years. Around 60% of the parents had one or more concerns regarding independent youth consultations. Although 64% of the parents supported conditional or full confidentiality during adolescence, 95% wanted information even though their child did not consent. In the qualitative analysis, the parents described caring for a child with chronic disease as a term of life perceiving themselves as an "octopus" with numerous roles related to daily care and treatment and at the same time with thoughts and worries regarding the future. We found four themes: 'a life with chronic disease', 'responsibility', 'protection' and 'apprenticeship'. The parents' attitudes were influenced by their roles and their perception of the adolescent's competences as well as their experience with the healthcare system. CONCLUSIONS Our findings suggest that parents need transitional care too.
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Affiliation(s)
- Ena L Thomsen
- Center of Adolescent Medicine, Department of Pediatrics and Adolescent Medicine, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - Lina R Khoury
- Department of Dermatology and Allergy, Herlev and Gentofte Hospital, University of Copenhagen, Copenhagen, Denmark
| | - Tom Møller
- University Hospitals Centre for Health Research (UCSF), Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - Kirsten A Boisen
- Center of Adolescent Medicine, Department of Pediatrics and Adolescent Medicine, Copenhagen University Hospital, Rigshospitalet, Blegdamsvej 9, 2100 Copenhagen, Denmark
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McAloney-Kocaman K, Rogon PJ, Ireland L. Clustering of lifetime substance use and sexual intercourse among young people: Analysis of two school-based surveys. JOURNAL OF CHILD & ADOLESCENT SUBSTANCE ABUSE 2019. [DOI: 10.1080/1067828x.2019.1602090] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
| | - Paul J.S. Rogon
- Scottish Children’s Reporter Administration (SCRA), Stirling, UK
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Waldhauer J, Kuntz B, Mauz E, Lampert T. Intergenerational Educational Pathways and Self-Rated Health in Adolescence and Young Adulthood: Results of the German KiGGS Cohort. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:E684. [PMID: 30813568 PMCID: PMC6427741 DOI: 10.3390/ijerph16050684] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/12/2018] [Revised: 02/20/2019] [Accepted: 02/20/2019] [Indexed: 11/19/2022]
Abstract
Health differences in social mobility are often analysed by income differences or different occupational positions. However, in early adulthood many young people still have very diffuse income situations and are not always fully integrated into the labour market despite many having finished school. This article focusses on the link between intergenerational educational pathways and self-rated health (SRH) among young adults considering their SRH in adolescence. The data source used is the German KiGGS cohort study. The analysis sample comprises 2175 young people at baseline (t0: 2003⁻2006 age 14⁻17) and first follow-up (t1: 2009⁻2012 age 19⁻24). Combining parent's and young people's highest school degree, the data can trace patterns of intergenerational educational pathways (constant high level of education, upward mobility, downward mobility, constant low level of education). Young people's SRH was recorded at t0 and t1. During adolescence and young adulthood, participants were less likely to report poor SRH if they had a constant high intergenerational education or if they were upwardly mobile. The differences were particularly striking among young adults: average marginal effects (AME) for poor SRH showed much higher risk among downwardly mobile compared to peers with an intergenerational constant high education (AME: 0.175 [0.099; 0.251]), while the upwardly mobile had a significantly lower risk for less than good SRH than peers with an intergenerational constant low level of education (AME: -0.058 [-0.113; -0.004]). In the context of great societal demands and personal developmental needs, educational differences in health tend to increase in young adulthood. Public Health should pay more attention to educational and health inequalities in young adulthood.
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Affiliation(s)
- Julia Waldhauer
- Robert Koch Institute, Department of Epidemiology and Health Monitoring, Berlin, Germany.
| | - Benjamin Kuntz
- Robert Koch Institute, Department of Epidemiology and Health Monitoring, Berlin, Germany.
| | - Elvira Mauz
- Robert Koch Institute, Department of Epidemiology and Health Monitoring, Berlin, Germany.
| | - Thomas Lampert
- Robert Koch Institute, Department of Epidemiology and Health Monitoring, Berlin, Germany.
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