Search Results (168)

Purpose: Higher health literacy is associated with better health behaviors and better overall well-being; however, the contribution of relational and socio-economic factors to this association remains insufficiently explored. The present study aimed to examine the relationships between health literacy, well-being, social support, and stress among adolescents. In particular, the mediating roles of social support (family, peers, and teachers) and stress in the association between health literacy and well-being were analyzed. Participants and Methods: Data were drawn from the 2022 wave of the Health Behaviour in School-aged Children (HBSC) study, an international survey conducted every four years in collaboration with the World Health Organization (WHO) and implemented according to a standardized protocol. The sample comprised 7643 students from the 6th, 8th, 10th, and 12th grades of Portuguese public schools. Of the participants, 53.9% were female, and the mean age was 15.05 years (SD = 2.36). Gender-based comparisons indicated statistically significant differences for all study variables, with the exception of health literacy. Results: Mediation analysis reveals an effect of health literacy on well-being. After the inclusion of the mediating variables, the direct effect of health literacy on lack of well-being remained negative. All four mediators showed statistically significant indirect effects, accounting for the difference between the total and direct effects. These findings indicate that the association between health literacy and lack of well-being was partially mediated by family support, peer support, relationships with teachers, and stress. Health literacy influenced lack of well-being both directly and indirectly through these mediating pathways, with stress emerging as the strongest indirect contributor. Conclusions: The findings support an ecological interpretation of health literacy and well-being, as these constructs are embedded within multiple interacting systems. Individual adolescent characteristics, such as gender, age, and stress management, are interconnected with interpersonal contexts, including relationships with family members, peers, and teachers. In addition, adolescents’ socio-economic circumstances appear to play a relevant role in shaping both health literacy and perceptions of well-being. Full article

Background: The impact of the COVID-19 pandemic on temporal trends in peer violence and bullying deserves closer scrutiny. The aim of the present study was to examine temporal trends in peer violence and bullying among school-aged children before and after the COVID-19 pandemic. Methods: Data from the Health Behaviour in School-aged Children (HBSC) surveys (2013/2014–2021/2022) were analyzed to track changes in peer violence and bullying over time. The sample encompassed over 700,000 students aged 11, 13, and 15 from more than 40 countries across Asia, Europe, and North America. Results: Traditional (school) bullying perpetration and victimization did not change significantly over time. A significant decreasing trend in engagement in physical fighting between the 2013/2014 and 2021/2022 surveys was observed among male participants aged 15. In contrast, a significant increasing trend in engagement in physical fighting was observed among female participants aged 11 and 13 years. Following the pandemic, increases in cyberbullying perpetration and victimization were observed among students aged 11 and 13, a trend not evident among 15-year-olds. Conclusion: Except for cyberbullying, the pandemic did not appear to influence trends in peer violence and bullying, which remained largely stable or reflected trajectories that had begun prior to the pandemic. Full article

Background: This study examined the clustering of unhealthy lifestyle behaviours and their determinants among adolescents across Europe, Central Asia, and North America. Methods: The study included 210,713 adolescents aged 11 to 15 years from 45 countries who participated in the 2018 Health Behaviour in School-aged Children (HBSC) study. Lifestyle behaviours, including physical inactivity, inadequate fruit and vegetable consumption, frequent soft drink consumption, alcohol use, and smoking, were used to examine the clustering of unhealthy behaviours. Multilevel mixed-effects logistic regression was employed to assess the associations between unhealthy behaviour clustering (≥3 unhealthy behaviours) and contextual factors at the individual, family, and school levels. Results: A high prevalence of clustered unhealthy behaviours was observed among adolescents, with 51.5% engaging in three or more unhealthy lifestyle behaviours. The odds increased with age (AOR: 1.79, 95% CI: 1.75, 1.84 for those aged ≥ 15 years), among males (AOR: 1.26, 95% CI: 123, 1.28), and among those experiencing higher academic pressure (AOR: 1.13, 95% CI: 1.09, 1.17 for very high academic pressure). In contrast, the odds were lower among adolescents from a higher family affluence background (AOR: 0.62 95% CI: 0.60, 0.65 for high), among adolescents living with both parents (AOR: 0.83, 95 CI: 0.81, 0.85), those reporting higher family support (AOR: 0.62, 95% CI: 0.60, 0.63 for high), higher peer support at school (AOR: 0.87, 95% CI: 0.84, 0.89 for high), and those reporting higher school satisfaction (AOR: 0.50, 95% CI: 0.48, 0.52 for very high). Conclusions: The study reveals that one in two adolescents engages in three or more unhealthy lifestyle behaviours. It emphasises the need to tackle this public health challenge through multisectoral interventions targeting individual-level and contextual factors at the family and school levels. Full article

Background/Objectives: International physical activity (PA) questionnaires require a reliability and validity assessment in many countries to understand cross-cultural differences accurately. The current study examined the reliability and validity of the Japanese version of the WHO Health Behaviour in School-aged Children PA (HBSC-J) survey in adolescent students in Japan. Methods: The participants were 215 Japanese high school students. The HBSC-J was administered twice to measure reliability. The PA in the last week evaluated using the HBSC-J was compared with the PA evaluated using a triaxial accelerometer to measure the concurrent validity. Results: The intraclass correlation coefficients (ICCs) for reliability were 0.74 for the number of days, with 60 min/day or more of moderate-to-vigorous PA (MVPA). For the days with an MVPA of 60 min/day or more, ICCs were lower for girls (0.63 [0.49–0.74]) than boys (0.82 [0.75–0.87]). Positive correlations were observed between the accelerometry MVPA and the number of days, with at least 60 min/day of MVPA (r = 0.44). Conclusions: The HBSC-J questionnaire should be acceptable for evaluating MVPA in Japanese adolescents, with a reasonable reliability and validity. Full article

Introduction: Understanding adolescent maturational development and its impact on physical and psychological well-being is essential for supporting the academic and professional growth of undergraduate students in Health Sciences programs (Psychology, Medicine, and Nursing). This study aimed to assess and compare self-concept, self-perception, physical activity, and lifestyle among first-year Health Sciences students. Methods: A descriptive cross-sectional study was conducted with first-year students at the University of La Laguna, Tenerife, Spain. Data were collected using the Rosenberg Self-Esteem Scale (RSES), General Health Questionnaire (GHQ-12), Physical Activity Questionnaire for Adolescents (PAQ-A), and Health Behaviour in School-aged Children (HBSC). Variables included sex, age, study program, and body mass index (BMI). Statistical analyses included descriptive statistics, reliability assessment (Cronbach’s alpha), distribution tests, and chi-squared tests. Results: Among 190 participants, the RSES showed generally positive self-esteem, although 75% of students reported low self-confidence. Male Psychology students all scored in the fair range on self-perception. Physical activity was low, particularly among female students, with 20% classified as sedentary. HBSC results indicated the need for lifestyle improvements. SOC-13 scores showed that 80.5% of students had fair levels of sense of coherence. Conclusions: Health Sciences students exhibited low self-concept, emotional distress, sedentary habits, and inadequate lifestyle behaviors. Male Nursing students and female Psychology students had the poorest self-concept scores. The findings emphasize the need for interventions promoting healthy habits and emotional well-being among students entering health-related academic programs. Full article

Background: Italy was among the earliest countries globally to be heavily impacted by the outbreak of the new coronavirus (SARS-CoV-2). During this period, schools were closed to students, and distance learning was adopted. The school closure has changed children’s and adolescent’s everyday lives, affecting their emotional resilience and mental health overall. Objectives: The aim of this study was to provide evidence regarding the influence of the pandemic period and lockdown measures on the well-being of adolescents living in Italy. The effects of COVID-19 were evaluated. Methods: The Health Behaviour in School Aged-Children (HBSC) 2021/2022 Italian data were used to describe changes in different dimensions of adolescents’ lives (e.g., family and peer relationships, mental health, school performance, physical activity, eating behaviour, and life in general). Results: Data from a sample of 89,321 adolescents participating in the 2021/22 HBSC wave were analysed. The areas where adolescents reported the greatest positive perceived change due to the pandemic period were family relationships (54.0%) and relationships with friends (44.7%). In contrast, negative changes were noted on mental health (41.1%), physical activity practice (42.9%), and life expectancy in general (37.2%). The effects of the coronavirus measures on family finances (48.9%), eating behaviour (43.6%), and overall health (43.7%) were most frequently assessed as neutral, i.e., neither positive nor negative. Conclusions: These results, in particular the adverse COVID-19 effects, reinforce the idea that during a pandemic, in addition to containing the infectious agent, specific attention must be paid to adolescents’ well-being, preserving their mental health and overall health. Full article

Introduction: People with disabilities are characterized by suboptimal health and lower self-rating health. Their need for health care is greater, they often have a higher prevalence of health problems and they have more difficulty accessing health care. The aim of this study was to assess the health behaviors and health indicators of 12–18-year-old young people with intellectual disabilities and autism spectrum disorder, and to explore their school-related perceptions in the Northern Great Plain region of Hungary. Materials and Methods: A cross-sectional questionnaire survey was conducted with the participation of 185 young people. A custom questionnaire was used, based on the Health Behavior in School-aged Children (HBSC) survey, assessing eating habits, oral care, physical activity, mental well-being, and self-reported health status. The sample was categorized into three groups: the ID1 (Intellectual Disability level 1) group, encompassing young individuals with mild intellectual disability; the ID2 group, encompassing young people with moderate intellectual disability; and the ID+ASD group, encompassing young individuals affected by both intellectual disability and autism spectrum disorder. Results: Consumption of various food types was below optimal levels. Low intake of fruits and vegetables was common, with only 21.6% of the respondents consuming fruit daily and 23.8% consuming vegetables daily. ID1 group reported significantly higher rates of nervousness several times a week (17.8% vs. 5.6% and 6.9%, p < 0.001), sleep difficulties (28.8% vs. 7.4% and 15.5%, p = 0.032), and dizziness (9.6% vs. 1.9% and 3.4%, p = 0.022) compared to the other two groups. A third school-related factor, related to negative emotions, showed a near-significant difference (p = 0.064), suggesting that students with both autism spectrum disorder and intellectual disability perceive lower levels of acceptance from teachers. On school-free days, computer usage was significantly highest in the ID+ASD group; 50% of them used a computer for at least 4 h per day. Conclusions: To improve mental well-being among affected children, psychological support and the implementation of mental health programs are recommended. In addition to teaching stress management techniques and coping mechanisms, integrating relaxation techniques into comprehensive developmental programs—both individually and in groups—is advised. For teachers, it is recommended to acquire disability-specific communication strategies. Full article

Sickle-cell disease (SCD) is a group of inherited blood disorders in which a mutation in the β-globin (HBB) gene causes red blood cells to produce abnormal hemoglobin, known as Hb S. SCD is characterized by an autosomal-recessive pattern of inheritance, implying that for a child to manifest the condition, they must inherit an Hb S allele from both parents (HbSS) or one Hb S allele and another β-globin variant, such as Hb C or β-thalassemia (HbSC, HbS/β-thal). It has been observed that (heterozygote) carriers of one copy of the sickle-cell trait (HbAS) are typically healthy and can even gain partial protection from severe malaria. The term “severe and complicated malaria” is delineated based on specific clinical and laboratory characteristics in the presence of Plasmodium falciparum parasitemia. The prevalent forms of severe malaria among African children include cerebral malaria, respiratory distress, and severe malaria anemia. Cerebral malaria is a rare complication of malaria infection and is associated with a high mortality rate. Full article

Background: During childhood and adolescence, personality development is continuous. Younger people—defined in this study as high-school students aged 14 to 18—are particularly receptive to change. The health behaviors formed during this period can significantly influence health in later life. Therefore, families and schools play a crucial role in promoting a healthy lifestyle. In our research, we examined the relationship between psychosocial resources (social support and school resources) and the regularity and intensity of physical activity. Methods: In this study, “appropriate physical activity” refers to the level and intensity of activity recommended by the World Health Organization—namely, at least 60 min per day of moderate- to vigorous-intensity aerobic activity for adolescents. We conducted our cross-sectional research in Hungary, Western Transdanubia, using convenience sampling among high-school students (n = 331). Data collected with a self-edited and standardized questionnaire (MSPSS, HBSC school resources and school social support) were analyzed using the SPSS Statistics 22 program with a t-test, ANOVA and χ² test (p < 0.05). Results: In the case of the time spent on physical activities per week, boys (p < 0.05) and younger people (p < 0.05) showed a much more favorable picture. Examining the intensity of regular physical activity among students who belonged to the appropriate range, the average values of family social support were significantly higher (p < 0.05), but this association was not observed for social support from friends or significant others (p > 0.05). The amount of movement was not differentiated by support from others (p > 0.05). The level of attitude towards their school was higher among students who performed physical activity of the appropriate quality and quantity (p < 0.05). Teachers’ assessment of school performance and the quality of the relationship with teachers showed a correlation with physical activity performed at the appropriate intensity (p < 0.05). Conclusions: We found a positive effect of family and school resources on the regularity and intensity of physical activity, which draws attention to strengthening the partnership between family and school, improving the school atmosphere and social support within the school, increasing students’ attachment to their institution. The combination of these resources can help children lead a more active and healthier life, which has a beneficial long-term impact on their physical and mental well-being. The cooperation between parents and schools is crucial in supporting young people in adopting a healthy lifestyle. Full article

Objective: This study aimed to explore the association between adolescents’ health risk behaviours (excessive use of alcohol, (e)cigarette smoking, cannabis use) and familial factors. A special objective of this study was to compare findings between Bulgarian and Lithuanian adolescents aged 15 years. Material and Methods: National samples from the WHO Health Behaviour in School-aged Children (HBSC) survey in 2021/2022 were analysed. The focus was on adolescents aged 15 (n = 64,349), including those from Bulgaria (n = 793) and Lithuania (n = 1137). The set of outcome variables included drunkenness, smoked cigarettes, e-cigarettes, and used cannabis (all variables were measured during the last 30 days); their indicators were child’s talking separately to their father and separately to their mother, as well as the four-item family support scale. All variables were dichotomised and their associations were analysed using Structural Equation Modelling with a WLSMV estimator. Results: In the total sample, the prevalence of drunkenness was 14.9%, cigarette smoking at 12.6%, e-cigarette smoking at 18.4%, and cannabis use at 5.9%; while in Bulgaria, in contrast to Lithuania, these behaviours were much more prevalent, at 27.0%, 29.9%, 29.8%, and 11.1%, respectively. The use of substances was significantly associated with selected familial factors, which were more pronounced among girls than boys in most subsamples. Low family support showed the strongest association with increased substance use (in the total sample, regression weight B varied from 0.231 to 0.382). Adolescents’ difficulty in talking to mother was more pronounced (B = 0.123 to 0.204) than difficulty in talking to their father (B = 0.058 to 0.140). Comparison of data samples from Bulgaria and Lithuania showed stronger relationships in Bulgarian adolescents compared to other countries, which are more pronounced among boys. In addition, among Bulgarian adolescents, easy communication with their father had an inverse association (increasing prevalence) with cannabis use. Conclusions: Adolescent health risk behaviours, such as use of substances, are associated with familial factors, including parent–teen communication and family support. Generally, these associations are more pronounced among girls than boys, and more evident among Bulgarian adolescents than their Lithuanian counterparts. Identifying environmental factors in families helps to plan interventions to prevent development of multiple health risk behaviours in adolescents. Full article

Adolescents’ health risk behavior may have a longstanding impact on their later adult life and health. The aim of this cross-sectional study is to report on health risk behaviors and sexual attitudes in a sample of Mongolian adolescents (N = 312) in light of their levels of social support and well-being. Measurements were derived from the Health Behavior in School-aged Children (HBSC), including substance use and sexual behavior, whereas social support from parents and peers was measured with the Multidimensional Scale of Perceived Social Support (MSPSS). Student well-being was evaluated using the WHO Well-Being Questionnaire (WBI-5). The frequency of current smokers was 13.1% (boys: 18.9%, girls: 10.2%; χ² = 4.61, Phi = −0.12, p = 0.032). The prevalence rate of current alcohol consumption was 11.2% (boys: 14.2%, girls: 9.7%; χ² = 1.38, Phi = −0.07, p > 0.05), similar to the nationwide results. The percentage of students who have ever had sexual intercourse was 6.4 (12.4% of boys and 3.4% of girls, χ² = 9.33, Phi = 0.17, p = 0.006), similar to Central Asian countries included in the HBSC survey. Boys were more likely to associate sexual activity with self-esteem, intimacy with a partner, and positive perceptions among peers. Conversely, girls expressed greater concern about the negative consequences of sexual activity, such as STDs and pregnancy. Social support from the family played a protective role in frequencies of smoking and drinking. However, levels of the social support subscales did not differ by the students’ relationship status or previous sexual intercourse. These results suggest that there is a need for a complex prevention program to avoid increases in Mongolian adolescents’ smoking and drinking and promote their healthy sexual attitudes and behavior. Full article

Adolescents who possess environmental health literacy are more equipped to handle the effects of the environment on their health. This study uses data from Portugal’s 2022 HBSC survey to investigate the environmental health literacy (EHL) of teenagers. The Environmental Health Literacy Scale (EHLS) was verified by confirmatory component analysis. Within the framework of an ecosystem, this study investigates factors related to health and well-being. There are 7355 adolescents in the sample. EHLS_Social Norms and participation in volunteering activities were found to be significant predictors of EHL_Knowledge, which explained 25.2% of the variance in the final model. EHLS_Social Norms and EHLS_Knowledge accounted for 42.9% of the variance in EHL_Behaviors, while school grade was adversely connected with pro-environmental behavior. While actions and knowledge were major positive predictors, gender and school grades showed negative relationships, and EHL_Social Norms accounted for 46% of the variance. This study establishes a valid measure of environmental health literacy in adolescents, informing science education strategies and public health interventions. Full article

This study explored the association between ideal cardiovascular health behaviors (ICHBs) and mental health and well-being in Baltic adolescents using data from the 2018 HBSC survey. ICHBs included smoking status, body mass index, physical activity, and healthy diet adherence. Mental health included low mood, irritability, nervousness, and sleep difficulties, while well-being included life satisfaction and self-reported health. Multi-regression analyses were performed. The study included 12,934 adolescents (mean age: 13.6 ± 1.6 years). Non-smokers, non-overweight individuals, and physically active participants were more likely to report good mental health, higher life satisfaction, and better self-reported health. Adherence to a healthy diet was linked to improved self-reported health and greater life satisfaction. Compared to those with four ICHBs (reference), adolescents with only one ICHB had higher odds of feeling low (OR = 0.28, 95% CI: 0.13–0.62), irritability (OR = 0.35, 95% CI: 0.19–0.66), nervousness (OR = 0.26, 95% CI: 0.13–0.55), and sleep difficulties (OR = 0.29, 95% CI: 0.14–0.61). Adolescents with two ICHBs had higher odds of feeling low (OR = 0.45, 95% CI: 0.20–0.97) and nervousness (OR = 0.40, 95% CI: 0.19–0.83). These findings highlight the importance of promoting multiple ideal health behaviors to improve mental health and well-being among adolescents. Full article

Background: From a biopsychosocial perspective, health literacy is a key factor for healthy development and the development of more comprehensive interventions directed at health literacy determinants. The present study had the main goal of studying demographic, individual, social, and contextual variables related to health literacy in adolescents. Methods: The data used in this study are part of the Health Behavior in School-aged Children (HBSC) 2022 survey. The study included 7649 adolescents, 53.9% (n = 3961) female, with an average age of 15.05 years (SD = 2.36), in the 6th, 8th, 10th, and 12th grades, proportionally distributed across the five regions of the Portuguese mainland. Results: Health literacy was explained by factors related to physical, psychological, social, and environmental health. The factors with the higher explanatory value were the psychological variables, followed by social and lifestyle-related variables. Sociodemographic and environmental factors had a more modest explanatory value. These results point to the complexity of adolescents’ health literacy. Conclusions: These results are of the utmost importance for educators, professionals, and policymakers who can use this information to create friendly environments that promote health literacy and health-promoting activities according to a multidisciplinary, continuous, and consistent plan. Full article

Body image (BI) plays a critical role in mental health, with negative perceptions often linked to feelings of low mood. Physical activity (PA) has been shown to enhance self-acceptance and reduce negative emotions, suggesting it may help mitigate the impact of BI on low mood. This study examines the relationship between BI and low mood among adolescents, and explores the role of PA as a mediator in this relationship. The study had a cross-sectional design. Data were collected from 154,183 adolescents (average age 13.6 ± 1.6 years) across 43 countries, using the 2017/2018 Health Behaviour in School-aged Children (HBSC) survey. BI was assessed through self-perceived body size, low mood was measured on a scale from “about every day” to “rarely or never”, and PA was evaluated by the number of days per week participants engaged in at least 60 min of activity. The study used multinomial logistic regression and a mediation model to analyze the relationships of BI, PA, and BMI with low mood. The multinomial logistic regression showed that daily PA reduces the risk of low mood, especially with higher PA frequency, such as PA on 6 days (OR = 0.72) and PA on 5 days (OR = 0.86). Age, BMI, BI, and sex also influence low mood, with males showing lower odds (OR = 0.40 to 0.77), normal weight individuals having a reduced risk, and thinner individuals having lower odds of low mood (OR = 0.12 to 0.50), with PA partially mediating the relationship between BI and low mood (p < 0.001), contributing to 9% of the total effect. PA partially mediates the relationship between BI and low mood, with a direct negative impact of BI on low mood. In addition, girls, older adolescents, and those with negative BI and irregular PA have a higher risk of low mood. Full article