Effectiveness of interventions used to prepare preschool children and their parents for day surgery: A systematic review and meta-analysis of randomised controlled trials.

BACKGROUND: To evaluate how effective preparatory interventions for paediatric day surgery are at reducing parents' anxiety and stress and children's pain and fear. METHODS: A systematic review was conducted according to Joanna Briggs Institute (JBI) guidelines and reported using the PRISMA 2020 checklist. PubMed, CINAHL (EBSCO), Scopus, Medic and Web of Science were screened for original research published up until December 2020, while Mednar and EBSCO Open Dissertations were used to identify any relevant grey literature. The methodological quality and risks of bias were evaluated according to JBI guidelines by two authors. The eligibility criteria were parents of a preschool (2- to 6-year-old) child going through day surgery with preparatory interventions, outcomes measured anxiety, stress (parent), fear and pain (child), and randomised controlled trial (RCT). RESULTS: Two thousand and three hundred and fourteen RCTs were screened. Fifteen studies (including 1514 participants) were chosen for narrative synthesis of parental anxiety and stress and children's fear and pain. Nine studies underwent a meta-analysis of parental anxiety (n = 970). The interventions were categorised as functional, informative or a combination of both. Four interventions reduced parents' anxiety while two significantly alleviated children's postoperative pain. The interventions found to be effective combined various ways of providing information. The meta-analysis did reveal a statistically significant impact on parents' anxiety (SMD =0.22, 95% Cl [0.03, 0.41], z = 2.28, p = .023). None of the studies dealt with parental stress or fear in children. CONCLUSIONS: The studied interventions used various preparatory approaches, some of which were effective at reducing parental anxiety. More RCT studies are needed to find the most effective methods for preparing parents and their children for day surgery. RELEVANCE TO CLINICAL PRACTICE: Preparation for day surgery through appropriate interventions can reduce anxiety among parents and postoperative pain in children.

The association of problematic gaming characteristics with dietary habits among Finnish vocational school students.

Digital gaming is a popular pastime among young people, but its links to dietary habits have been little studied. The purpose of the study was to describe dietary habits and to examine their associations to problematic gaming behavior with regard to the degree of daily digital gaming time and the overall levels of disordered-like gaming behavior among students in vocational education in the Oulu region of Finland. This cross-sectional study consisted of a total of 773 first-year vocational school students who had played digital games regularly. Data was collected by using an online survey measuring sociodemographic information, dietary habits, amount of digital gaming time, and symptoms of problematic gaming behavior. Most prevalent weekly consumed food types were chicken (90.1%), chips (87.7%), and sausages/cold cuts (85.4%). Around one-fourth of students skipped breakfast on weekdays and at weekends. A higher amount of digital gaming time was associated with skipping breakfast on weekdays. More elevated levels of disordered gaming behavior were particularly associated with the use of a group of food types encompassing carbohydrate-dense and fast food. Current research provides indications that digital gaming may have an impact on youths' dietary habits, while at the same time, however, emphasizing that the issue can be affected by several interrelated and complex factors.

The association between the social environment of childhood and adolescence and depression in young adulthood - A prospective cohort study.

BACKGROUND: Good social relationships with parents and peers protect children and adolescents from developing mental disorders in adulthood while several negative experiences increase the risk of depression in later life. METHODS: We used population-based cohort data from the Northern Finland Birth Cohort (NFBC) 1986. Participants (n = 6147), their teachers and parents reported factors associated with the social environment of children and adolescents. Diagnoses of depression of cohort members were derived from Finnish nationwide registers. We conducted regression analyses to assess which factors of the social environment of childhood and adolescence were associated with depression in young adulthood. RESULTS: Bullying victimization in adolescence was the strongest predictor of depression in young adulthood among girls (OR 2.23: 95% CI 1.47-3.39) and boys (OR 2.44: 95% CI 1.49-4.00). Loneliness and bullying behavior in childhood were associated with depression in boys only. Loneliness in adolescence (OR 1.63: 95% CI 1.30-2.04) was associated with depression among both genders. Spending with the family seemed to protect against the negative impact of bullying and loneliness. LIMITATIONS: We used single-item study questions to measure social relationships. These questions do not necessarily describe the phenomena as accurately as the measures validated for them. CONCLUSION: Problems in social relationships with peers in childhood and adolescence are associated with depression in young adulthood. Time spent with the family is emphasized in situations in which adolescents have problems in peer-relationships.

Lower parental socioeconomic status in childhood and adolescence predicts unhealthy health behaviour patterns in adolescence in Northern Finland.

OBJECTIVES: To determine the association between parental socioeconomic status in childhood and adolescence and unhealthy health behaviour patterns among adolescents in Northern Finland. METHODS: The sample, drawn from the Northern Finland Birth Cohort 1986 Study, consisted of 15- to 16-year-old adolescents (n = 4305). Data on socioeconomic status and health behaviours were based on questionnaires collected from cohort members and their parents during the former's childhood and adolescence. Logistic regression served to assess the association. RESULTS: Controlling for all other factors in the model, several socioeconomic factors were found to be significant predictors of unhealthy health behaviour patterns. In childhood, father's low and medium education for boys, and mother's low or medium education as well as fathers' unemployment for girls predicted greater likelihood of engaging in unhealthy behaviour patterns. For both genders, having a stay-at-home mother in childhood (and for boys also in adolescence) protected from unhealthy health behaviour patterns. For boys, mother's and for girls, fathers' low occupational education in adolescence increased the risk of developing unhealthy patterns. CONCLUSIONS: In the development of effective health prevention strategies, it is important to identify children and adolescents who are at risk of developing lifestyle diseases.

Associations between Childhood and Adolescent Emotional and Behavioral Characteristics and Screen Time of Adolescents.

The correlations between emotional and behavioral problems and increased screen time among young people has been highlighted in the literature. This study examined both longitudinal and cross-directional associations between the degree of childhood and adolescent emotional and behavioral problem characteristics and a higher level of daily screen time in adolescence using an extensive population study. Questionnaires providing data on a representative cohort sample (the Northern Finland Birth Cohort 1986 Study, NFBC 1986; n = 6479; 3101 males) were completed at birth, in childhood, and in adolescence. Male gender, and self-reported behavioral issues (such as a higher degree of hyperactivity/distractibility problems at the beginning of formal schooling and adolescent rule-breaking problems), predicted higher daily screen time in adolescence, after controlling for confounding factors. Higher levels of anxious-depression symptoms among adolescents were inversely related to them having elevated daily digital screen time. Individual behavioral tendencies at the start of formal schooling and later in adolescence may predict higher screen time among young people.

Parental socioeconomic status, adolescents' screen time and sports participation through externalizing and internalizing characteristics.

The socioeconomic status of parents is reportedly closely related to the digital screen usage and physical inactivity levels of children and adolescents. Internalizing and externalizing behavior characteristics may be linked to these associations and explain them. The purpose of the present study was to investigate the effects of parents' socioeconomic status (SES) on youths' total screen time along with physical inactivity through internalizing and externalizing behavior characteristics. Thus, we examined associations between parents' socioeconomic status (using scores based on several indicators) and adolescents' total digital screen exposure and physical inactivity level, together with the potentially predicting role of the adolescents' internalizing and externalizing behavior. For this, we assessed the internalizing and externalizing problem characteristics, total screen time exposure, physical inactivity level and parental socioeconomic status of a large cohort sample of Finnish adolescents (the Northern Birth Cohort, 1986 comprised 2899 males and 3059 females). The present study includes data collected in two phases, in 1985-1986 and 2000-2001. Path modeling suggests that a low SES of parents was directly associated with adolescents' physical inactivity level, while externalizing characteristics were a significant and additional contributing factor in adolescents' level of screen exposure in both genders. Gender moderated the relationship between adolescents' internalizing and externalizing characteristics and physical inactivity levels. The results also suggest that parents' socioeconomic status constitutes a risk factor in relation to media screen exposure only in female adolescents. Implications of the findings are discussed.

Association Between Psychosocial Problems and Unhealthy Health Behavior Patterns Among Finnish Adolescents.

The aim of the study was to investigate how psychosocial problems in childhood and adolescence associate with an unhealthy health behavior pattern among adolescents in Northern Finland. The study population consisted of 4350 participants, drawn from the Northern Finland Birth Cohort 1986 Study. Health behavior patterns were assessed in adolescence and psychosocial problems in childhood and adolescence. Logistic regression analyses were performed to determine the associations. Several psychosocial problems predicted greater likelihood of engaging in unhealthy health behavior pattern. Externalizing problems in childhood predicted greater likelihood of engaging in unhealthy behavior patterns for girls. For both genders, externalizing problems and inattention in adolescence were associated with unhealthy health behavior patterns. Boys and girls with externalizing problems both in childhood and adolescence had an increased risk of unhealthy patterns. Psychosocial problems contribute to unhealthy lifestyles and should therefore be acknowledged when designing and targeting health promotion strategies aimed at adolescents.

Problematic gaming behaviour and health-related outcomes: A systematic review and meta-analysis.

This systematic review and meta-analysis aimed to investigate the interplay between problematic gaming behaviour and health-related outcomes at different developmental stages. A total of 50 empirical studies met the specified inclusion criteria, and a meta-analysis using correlation coefficients was used for the studies that reported adverse health implications regarding the impact of problematic gaming behaviour on depression, anxiety, obsessive-compulsive disorder and somatisation. Overall, the results suggested that problematic gaming behaviour is significantly associated with a wide range of detrimental health-related outcomes. Finally, the limitations of this review alongside its implications were discussed and considered for future research.

How mentoring education affects nurse mentors' competence in mentoring students during clinical practice - A quasi-experimental study'.

BACKGROUND: Mentors need diverse competencies, sources of motivation and characteristics to successfully mentor nursing students and support students' learning processes. Effective mentoring education can benefit future nursing professionals, students' satisfaction and learning, as well as the general perception of the nursing profession. OBJECTIVE: The purpose of this study was to evaluate how an educational intervention affects nurse mentors' competence in mentoring nursing students during clinical practice. DESIGN: A quasi-experimental study design with pre- and post-tests was used. SETTINGS: Educational interventions were conducted in one university hospital and two central hospitals in Finland between 2013 and 2017. The intervention was conducted twice per year with a duration of 3 months for each group. The inclusion criteria for the participants were as follows: volunteer participation to mentor education employment at the university hospital or central hospitals in Northern Finland. METHODS: The intervention aimed to increase Registered Nurses' competence in mentoring nursing students. The education lasted 3 months and included online learning as well as three face-to-face teaching sessions. A total of 120 nurse mentors completed the Mentor Competence Instrument (MCI), which includes 10 subscales that describe various competence areas, before and after the education. RESULTS: Nurse mentors' mentoring competence increased across all mentoring competence areas after the educational intervention. More specifically, the participating nurses showed a statistically significant increase in their competence regarding knowledge of mentoring practices in the workplace, student-centred evaluation, identifying student needs, mentoring practices between mentor and student, supporting students' learning processes, goal orientation in mentoring and constructive feedback. CONCLUSIONS: On an international level, nurse mentors are not typically required to have completed mentoring education prior to the mentoring of nurse students. Since mentoring education increased nurses' competence at mentoring nursing students, we recommend that all nurse degree programs include mentoring education to prepare future nurses for the important future role in mentoring.

Clusters of health behaviours and their relation to body mass index among adolescents in Northern Finland.

AIMS: To identify clusters of health behaviours among Finnish adolescents and examine whether these clusters are associated with body mass index (BMI). METHODS: The data, drawn from the prospective population-based Northern Finland Birth Cohort 1986, comprised a total of 7182 adolescents who replied to a follow-up postal questionnaire at the age 15 to 16. The adolescents were asked about multiple health behaviours, such as physical activity, screen time, cigarette smoking, alcohol use and diet. Adolescents who answered the questions concerning all of these variables were included in the study, yielding a final sample of 4305 subjects. K-means cluster analysis was performed to identify group of adolescents with similar health behaviours. Chi-squared tests were performed to analyse the association between the clusters and BMI. RESULTS: Two clusters - Healthy Lifestyle and Unhealthy Lifestyle - were identified for both genders. The values of all the studied variables differed significantly between the clusters identified for both boys and girls. No significant relationship between the identified clusters and BMI was found for either boys or girls. CONCLUSIONS: It is important to consider multiple lifestyle-related behaviours and trying to identify groups that present probability for developing lifestyle diseases.

Nurses' experiences of their competence at mentoring nursing students during clinical practice: A systematic review of qualitative studies.

Aim To identify and synthesize the best available evidence on nurse mentors' experiences of their competence in mentoring nursing students during clinical practice. DESIGN: The research employed a systematic literature review that followed the guidelines of the Joanna Briggs Institute (JBI). DATA SOURCES: The databases CINAHL, Medline Ovid, Scopus, Eric, Web of Science, Medic, and OATD were systemically searched from 2000 to 2017. REVIEW METHODS: The identified studies were screened by title, abstract (n = 3080) and full-text (n = 91) using the following inclusion criteria: registered nurses, nurses' experiences of competence in mentoring nursing students, acute and primary care organizations providing clinical practice for nursing students, qualitative study. Quality appraisal was performed, data extracted and findings from the included studies (n = 21) were pooled using meta-aggregation with the Qualitative Assessment and Review Instrument (JBI-QARI). RESULTS: A total of 92 extracted findings were aggregated into 21 categories and then further grouped into five synthesized findings: 1) creating an interactive relationship with the student; 2) developing mentor's characteristics and cooperation with stakeholders; 3) providing goal-oriented mentoring; 4) supporting students' development to nurse profession; 5) supporting the student's learning process. CONCLUSIONS: This review demonstrated that multifaceted mentoring competence is essential to supporting students' learning processes and helping them become confident professionals. For this reason, the findings suggest that healthcare organizations which provide clinical practice for students should emphasize developing the mentoring competence of nurses by offering nurse mentors adequate education, ensuring that the organizational structure affords them sufficient support, and creating a receptive learning atmosphere.

Psychometric properties of the Internet Gaming Disorder Test (IGDT-10) and problematic gaming behavior among Finnish vocational school students.

This study was conducted to investigate the psychometric properties of the Finnish version of the Internet Gaming Disorder Test (IGDT-10), identify the proportion displaying problematic gaming behavior (PGB) among Finnish vocational school students, and characterize the relationships between sociodemographic factors and gaming characteristics predicting PGB in this population. This cross-sectional study involving 773 students (mean age 17.5 years). Socio-demographic and gaming behavior characteristics were established using a web-based survey. A confirmatory factor analysis (CFA) showed that the IGDT-10 test has appropriate psychometric properties. The proportion of students exhibiting PGB based on the DSM-5 cut-off threshold was 1.3%. Regression analysis showed that male gender, preference for gaming on a personal computer, gaming time, poor self-perceived health status, and a preference for the solo and multiplayer online battle arenas (MOBA) game genres related positively to PGB scores. These findings demonstrate the appropriateness of the IGDT-10 test for the assessment of problematic gaming among adults, and support further research on PGB in Finland.

Competence areas of health science teachers - A systematic review of quantitative studies.

BACKGROUND: In the face of rapid digitalisation and ever-higher educational requirements for healthcare professionals, it is important that health science teachers possess the relevant core competences. The education of health science teachers varies internationally and there is no consensus about the minimum qualifications and experience they require. OBJECTIVE: The aim of this systematic review was to describe the health science teachers' competences and the factors related to it. DESIGN: Systematic review of original quantitative studies. DATA SOURCES: Four databases were selected from which to retrieve original studies: Cinahl (Ebsco), PubMed, Medic, Eri (ProQuest). REVIEW METHODS: The systematic review used PICOS inclusion criteria. Original peer-reviewed quantitative studies published between 1/2007 and 1/2018 were identified. Screening was conducted by two researchers separately reading the 1885 titles, 600 abstracts, and 63 full-texts that were identified, and then agreed between them. Critical appraisal was performed using the JBI MAStARI evaluation tool. The data was extracted and then analysed narratively. RESULTS: The core competences of health science teachers include areas of knowledge, skills and attitudes. Health science teachers evaluate their own competence as high. Only in relation to entrepreneurship and leadership knowledge was evaluated to be average. The most common factors influencing competence were teachers' title/position, healthcare experience, research activities, age, academic degree and for which type of organisation they work. CONCLUSION: It is important to identify the core competencies required by health science teachers in order to train highly competent healthcare professionals. Based on the findings of this systematic review we suggest that teachers should be encouraged to gain university education and actively participate in research, and that younger teachers should have opportunities to practice the relevant teaching skills to build competence.

The competence of nurse mentors in mentoring students in clinical practice - A cross-sectional study.

BACKGROUND: Nurses play an important role in developing the competence of nursing students and acting as role models for students during clinical practice placements. Nurses need diverse competence to successfully mentor nursing student. OBJECTIVES: This study aimed to describe and explain nurse mentor competence in mentoring nursing students in clinical practice settings based on self-evaluation, as well as identify different mentor profiles. DESIGN: This study employed a cross-sectional, descriptive design involving a self-administered electronic version of the Mentor Competence Instrument. SETTINGS: The study population included nurse mentors from all five university hospitals in Finland. PARTICIPANTS: Through random sampling, 3355 nurse mentors were invited to take part in the study in 2016. METHODS: Data was collected using Mentors Competence Instrument, which consists of 63 items structured in 10 mentoring competence categories. RESULTS: Mentors (n = 576) evaluated their level of competence in various categories as middle- to high-level. They evaluated reflection during mentoring and identifying a student's need for mentoring the highest, whereas student-centered evaluation and supporting a student's learning process were rated lowest. Three distinct profiles of mentor competence were identified. These profiles differed in evaluation of mentoring competence level, previous participation in mentoring education, and time spent on reflective discussions with students. CONCLUSIONS: According to their profiles, mentors have diverse needs for support in building their mentoring competence. We suggest that healthcare organizations should provide nursing mentors with education that is based on their individual levels of mentoring competence. Nurses should also be encouraged to use time for reflective discussion with students during clinical practice.

Development and psychometric testing of the nursing student mentors' competence instrument (MCI): A cross-sectional study.

BACKGROUND: Mentors require competence at a diverse array of skills to mentor students during clinical practice. According to the latest evidence, competence at mentoring includes: knowledge, skills and attributes of individual students' learning objectives, core elements of nursing, learning processes, a reciprocal and trustful relationship, feedback, evaluation, cooperation with stakeholders, and the mentor's personal qualities. OBJECTIVE: The purpose of the study was to test psychometric properties of a mentor's competence instrument developed to self-evaluate mentors' competence at mentoring nursing students in clinical practice. DESIGN: A cross-sectional, descriptive, explorative study design was used. SETTINGS: Data were collected from mentors at five university hospitals in Finland in 2016. PARTICIPANTS: A total of 576 mentors participated in this study. METHODS: The instrument was developed through systematic review, experts' evaluations, and pilot versions of the instrument tested in previous studies. The construct validity and reliability of the instrument were tested using exploratory factor analysis (EFA) with promax rotation and Cronbach's alpha. RESULTS: A 10-factor model showed that the instrument has acceptable construct validity. Cronbach's alpha values for the subscales observed ranged from 0.76 to 0.90. CONCLUSIONS: The instrument exhibited acceptable psychometric properties, thereby proving itself a valuable tool for evaluating mentors' competence at mentoring students. Further assessments of its reliability, validity and generality for measuring mentor's competence for mentoring students in different contexts and cultures are recommended.

Healthcare students' evaluation of the clinical learning environment and supervision - a cross-sectional study.

BACKGROUND: The purpose of clinical placements and supervision is to promote the development of healthcare students´ professional skills. High-quality clinical learning environments and supervision were shown to have significant influence on healthcare students´ professional development. OBJECTIVES: This study aimed to describe healthcare students` evaluation of the clinical learning environment and supervision, and to identify the factors that affect these. DESIGN: The study was performed as a cross-sectional study. METHODS: The data (n = 1973) were gathered through an online survey using the Clinical Learning Environment, Supervision and Nurse Teacher scale during the academic year 2015-2016 from all healthcare students (N = 2500) who completed their clinical placement at a certain university hospital in Finland. The data were analysed using descriptive statistics and binary logistic regression analysis. RESULTS: More than half of the healthcare students had a named supervisor and supervision was completed as planned. The students evaluated the clinical learning environment and supervision as 'good'. The students´ readiness to recommend the unit to other students and the frequency of separate private unscheduled sessions with the supervisor were the main factors that affect healthcare students` evaluation of the clinical learning environment and supervision. Individualized and goal-oriented supervision in which the student had a named supervisor and where supervision was completed as planned in a positive environment that supported learning had a significant impact on student's learning. CONCLUSIONS: The clinical learning environment and supervision support the development of future healthcare professionals' clinical competence. The supervisory relationship was shown to have a significant effect on the outcomes of students' experiences. We recommend the planning of educational programmes for supervisors of healthcare students for the enhancement of supervisors' pedagogical competencies in supervising students in the clinical practice.

Problematic Gaming Behavior Among Finnish Junior High School Students: Relation to Socio-Demographics and Gaming Behavior Characteristics.

Multiplatform digital media use and gaming have been increased in recent years. The aim of this study was to examine associations between sociodemographics and digital gaming behavior characteristics (i.e., gaming time, medium, and genres) with problematic gaming behavior in adolescents. A convenience sample of Finnish junior high school students (n = 560; mean age 14 years, ranging from 12 to 16 years) participated in the cross-sectional survey, of which, 83% (n = 465) reported having played digital games regularly. Sociodemographic data, different forms of digital media use, gaming behavior characteristics and problematic gaming behavior was assessed. Study participants spent on average one hour per day playing digital games; casual games (23.9%), shooting games (19.8%), and sport games (12.9%), were the most popular games among participants. By using regression analysis, a blended family structure and gaming time related positively to problematic gaming behavior. Preferences for game genres such as solo, Massively Multiplayer Online Role-Playing and strategy-management games were also positively associated with problematic use of digital games. These findings provide knowledge that can be utilized in the prevention of the possible negative consequences of digital gaming.

Mentors' competence in mentoring culturally and linguistically diverse nursing students during clinical placement.

AIMS: To describe mentors' competence in mentoring culturally and linguistically diverse nursing students during clinical placement and identify the factors that affect mentoring. BACKGROUND: Healthcare education is confronted by several challenges in a time characterized by globalization and increasing international migration. Nursing students from diverse backgrounds continue to experience difficulties during clinical placement. Students can overcome these difficulties and assume responsibility for their learning when mentored by supportive and competent mentors. DESIGN: A cross-sectional, descriptive explorative study design was used. METHODS: Data were collected during spring 2016 through a survey sent to mentors (n = 3,355) employed at five university hospitals in Finland. Mentors' competence in mentoring culturally and linguistically diverse nursing students was measured with the self-assessment Mentors' Competence Instrument and the Cultural and Linguistic Diversity in Mentoring scale. The analysis included descriptive statistics, non-parametric tests and binary logistic regression analysis. RESULTS: Mentors with experience mentoring nursing students from diverse backgrounds rated their overall competence in mentoring as good. However, the results show continued challenges related to competence in linguistic diversity in mentoring. Seven factors that affect mentors' competence in linguistic diversity were identified. Despite high evaluations by mentors of competence related to cultural diversity in mentoring, there are still opportunities for improvement in this area. CONCLUSION: Innovative and effective strategies are needed to develop mentors' competence in mentoring culturally and linguistically diverse nursing students. Educational and healthcare organizations should strive to enhance collaboration and increase the competence of both mentors and nursing students to work in increasingly diverse healthcare environments.

Adolescents' evaluations of the quality of lifestyle counselling in school-based health care.

BACKGROUND: Adolescents need effective lifestyle counselling precisely because health problems are so common. Good-quality lifestyle counselling can prevent the problems from becoming worse and decrease the costs of health care. Nurse practitioners in schools are well positioned to promote adolescent health. AIM: This study describes adolescents' evaluations of the quality of lifestyle counselling and factors related to it in school-based health care. METHODS: The data were collected from seventh- to ninth-grade adolescents (n = 846) using the Counselling Quality Instrument, from two junior high schools in northern Finland. The study employed a web-based survey. Response rate was 67% (n = 563). The data were analysed via descriptive statistics. RESULTS: Most adolescents (84%) reported that the counselling resources related to school-based health care are quite good. Most of them reported that nutrition (70%) and physical activity (63%) related to lifestyle counselling are sufficient. Approximately half of adolescents (51%) considered the counselling related to substance abuse as being sufficient. Most (80%) felt that the level of interaction during counselling is good. Overall, the majority of adolescents reported that goal-oriented lifestyle counselling (67%) and adolescent-centred counselling (69%) are good. Finally, most adolescents (72%) reported that they have benefitted from lifestyle counselling. Gender and health status were significantly related to resources, interaction and benefits of lifestyle counselling. Girls evaluated that counselling were more adolescent-centred than boys. Adolescents with very good health status evaluated content of lifestyle counselling better than adolescents with poorer health status. CONCLUSION: The adolescents evaluated the quality of lifestyle counselling in school-based health care as mainly being good. School nurses should pay particular attention when providing counselling to boys and those who are in poorer health.

Effectiveness of Facebook-Delivered Lifestyle Counselling and Physical Activity Self-Monitoring on Physical Activity and Body Mass Index in Overweight and Obese Adolescents: A Randomized Controlled Trial.

Background. The aim was to evaluate the effects of a 12-week, Facebook-delivered lifestyle counselling intervention, with or without physical activity self-monitoring, on physical activity and body mass index (BMI) in overweight and obese 13-16-year-old adolescents. Methods. Three-arm randomized controlled trial. Participants (n = 46) were randomly assigned to intervention and control groups: one group received Facebook-delivered lifestyle counselling and monitoring of their physical activity (Fb + Act, n = 15), whereas a second experimental group received the same Facebook-delivered lifestyle counselling without self-monitoring (Fb, n = 16) and a third group served as the control group (n = 15). Objective and self-reported physical activity assessment were used. Nonparametric statistical tests were used. Results. There were no significant intervention effects in terms of changes in physical activity levels or BMI from baseline to the 12-week postintervention measurements between the intervention and control groups. The Fb + Act group had lower sedentary time on weekdays compared to the control group during postintervention measurements (p = 0.021), but there was no interaction between time and group. Conclusions. Interventions were not effective at increasing physical activity in overweight and obese adolescents. Before implementing such interventions, more evaluations on their effectiveness are needed. This trial is registered with ClinicalTrials.gov identifier NCT02295761 (2014-11-17).