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CANDACE CURRIE KATE LEVIN Child and Adolescent Health Research Unit (CAHRU)

Informing investment in adolescent health, the Health Behaviour in School-Aged Children Study A case study from Scotland. CANDACE CURRIE KATE LEVIN Child and Adolescent Health Research Unit (CAHRU) UNIVERSITY OF EDINBURGH.

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CANDACE CURRIE KATE LEVIN Child and Adolescent Health Research Unit (CAHRU)

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  1. Informing investment in adolescent health, the Health Behaviour in School-Aged Children Study A case study from Scotland CANDACE CURRIE KATE LEVIN Child and Adolescent Health Research Unit (CAHRU) UNIVERSITY OF EDINBURGH

  2. National health in international context: providing an evidence base for action Scottish Case Study • participation over 20 year period in international study • providing trends over time and international comparisons • research influencing policy agendas • knowledge transfer to develop practice • research informing the development of programmes, interventions and their evaluation • sharing national experiences in international forums

  3. The Health Behaviour in School-aged Children (HBSC) Study An international study that gathers data from young people about their health and well-being • Physical activity • Consumption of food & drinks/weight control • TV & computer use/electronic communication • Sexual health • Body image/BMI • Fighting/bullying/injuries • Self-rated health/health complaints/life satisfaction • Risk behaviours: tobacco/alcohol/cannabis

  4. The Health Behaviour in School-aged Children (HBSC) Study …and data on social and developmental factors • Family structure and relationships • Peer relations • School environment and social relations • Socioeconomic status of parents and family affluence

  5. HBSC: background • Initiated in 1982 by three countries and shortly afterwards became a WHO collaborative study • Now has 43 member countries in Europe and North America • International network of around 300 researchers from different disciplines

  6. HBSC: methods • Surveys conducted every 4 years using standard international questionnaire in all countries • School–based, pupil self-complete questionnaire, teacher or researcher administered • Class is sampling unit • Three age groups with mean age 11.5, 13.5 and 15.5 years • Sample size in each country: minimum of 4,500 (1,500 per age group)

  7. Scottish data: Mental health and well-being Prevalence:BoysGirls • Happiness: Very happy52 45 • Confidence: Always confident 2516 • Perception of looks: Good looking 3626 • Life satisfaction: High life satisfaction 8881 • Multiple Health complaints: MHC 2231 • Self-rated health: Poor/fair health 2416 Girls in Scotland doing worse than boys on all well-being outcomes

  8. Scottish data: 1994-2006 trends

  9. Scottish data: 1994-2006 trends

  10. Scottish data: Mental well-being • Happiness • Confidence • Perception of looks • Life satisfaction • Multiple Health complaints • Self-rated health

  11. Self rated health poor/fair at age 11 & 15 At age 11 Scotland: 13% (M) 14% (F) At age 15 Scotland: 18% (M) 34% (F)

  12. Scottish data: Risk behaviours (15 yrs) Prevalence:BoysGirls • Weekly smoking 14 23 • Weekly drinking 39 36 • Drunkeness (2+ times) 43 48 • Cannabis use (ever) 29 27 • Sexual intercourse (ever) 30 34 Higher rates of some of the most risky behaviours seen among girls

  13. Scottish data: 1990-2006 trends

  14. Weekly smoking at age 15: • Ranges from 8% to 48% • Scotland: 14% (M) 23% (F) Scotland: Girls rank 6th Boys rank 28th

  15. Scottish data: 1990-2006 trends

  16. Weekly drinking at age 11 & 15 At age 11 ranges from 1% to 22% Scotland: 8% (M) 3% (F) At age 15 ranges from 10% to 53% Scotland: 39% (M) 36% (F)

  17. Ever had sexual intercourse aged 15 Condom use at last intercourse aged 15 Ranges from 12% to 61% Scotland: 30% (M) 34% (F) Ranges from 61% to 95% Scotland: 82% (M) 74% (F)

  18. Scotland: key trends and international comparisons Positive long-term trends in emotional well-being Areas of concern: weekly smoking and drinking, particularly among girls Sexual risk taking, alcohol and cannabis use relatively high Gender inequalities placing girls at high risk

  19. Scotland: key trends and international comparisons HBSC has also identified Poor eating habits Low levels of physical activity Prevailing socioeconomic inequalities

  20. Scotland: HBSC research dissemination Dissemination strategy Feedback to schools, teachers and classrooms Reach health and education practitioners Inform policy makers Gain attention of media

  21. Scotland: HBSC research dissemination Impact in long term relationships with schools and education authorities which has enabled the study building partnerships with government departments who use the study findings invitations to government advisory groups use of study findings in policy development public visibility of study

  22. Policy developments related to children and young people’s health in Scotland HBSC findings have fed into a number of policy developments • National Programme for Improving Mental Health and Well-being (Scottish Executive, 2003) • Enhancing Sexual Wellbeing In Scotland: A Sexual Health & Relationship Strategy (Scottish Executive,2003) • Schools (Health Promotion and Nutrition) (Scotland) Act 2007 requires education authorities to ensure schools are health-promoting and meals meet nutritional standards

  23. Policy developments related to children and young people’s health in Scotland • ‘Creating confident kids’ programme • Equally Well: Report of the Ministerial Task Force on Health Inequalities (2008) aims to reduce health inequalities among children and young people • Curriculum for Excellence (2009) to take a holistic approach to health and wellbeing across the school curriculum to improve mental, emotional, social and physical health and to promote resilience, confidence, independent thinking and positive attitudes.

  24. HBSC findings informing health promotion practice ‘Growing Through Adolescence’ training resource • HBSC findings on physical activity, eating habits and mental health identifying gender and developmental issues related to puberty • we found that many teachers are challenged by topics such as body image, puberty and eating disorders • HBSC team and national health promotion agency collaborated on production of training resource for practitioners

  25. Growing Through Adolescence Book 1 Evidence and Overview

  26. Growing Through Adolescence in Europe • WHO commissioned European version of • Growing Through Adolescence • Disseminated widely through Europe • Uses HBSC international data • Translated into Russian and German

  27. Role of HBSC in programme development and evaluation HBSC in Scotland developed close links with Health Promoting Schools Programme helped identify areas for HPS action: eating habits, body image, physical activity, self-confidence .. provided tools for evaluation of HPS using adapted HBSC instrument for baseline and follow up

  28. Role of HBSC in programme development and evaluation evaluation of HPS stimulated new research on barriers to physical activity among girls provided evidence for new preventive programme to increase girls participation ‘Fit for Girls’ – being rolled out in all schools for 14-16 year old girls participative approach to develop physical activity among low active girls evaluation of preventive programme being undertaken at CAHRU

  29. HBSC International Forum sharing national experiences of study impact • WHO and HBSC jointly initiated an annual Forum • platform for countries share experiences of how HBSC research has had impact on health improvement policy and practice • main purpose is to have impact on social and economic determinants of adolescent health

  30. International Forum for sharing impact on policy and practice Forum topics to date • obesity prevention • mental health • environment • scaling up from national experiences to international platform • key messages from Forums feed into European Ministerial Conferences aiming to inform agendas

  31. Benefits of being part of HBSC international study • Gain broader perspective on national picture of health of adolescents • Cross-national comparisons highlight areas of concern and areas where doing well • Trends over time from survey every four years • Changes in relative health profile over time • Potential to have impact on policy • Lessons for practice

  32. Academic dissemination of HBSC research impact International Journal of Public Health HBSC Volume 54, Supplement 2. 2009 • Young I and Currie C (2009) The HBSC Study in Scotland: can the study influence policy and practice in schools • Koller et al (2009) Addressing the socioeconomic determinants of adolescent health: experiences from the WHO/HBSC Forum 2007

  33. Acknowledgements • Young people participating in HBSC Study internationally • International HBSC research network • HBSC national team in Scotland • WHO Regional Office for Europe • Organisations that fund HBSC

  34. Further information on HBSC HBSC International Coordinating Centre Child and Adolescent Health Research Unit University of Edinburgh Email:info@hbsc.org Website: www.hbsc.org

  35. Further information on HBSC Website: www.hbsc.org

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