Frequency and effects of meeting health behaviour guidelines among adolescents.

BACKGROUND: To assess the relationship between overweight status and the concomitant adherence to physical activity, daily screen time and nutritional guidelines. METHODS: Data were derived from the Swiss Health Behaviour in School-aged Children Survey 2006. Participants (n = 8130, 48.7% girls) were divided into two groups: normal weight (n = 7215, 44.8% girls) and overweight (n = 915, 34.8% girls), using self-reported height and weight. Groups were compared on adherence to physical activity, screen time and nutritional guidelines. Bivariate analyses were carried out followed by multivariate analyses using normal-weight individuals as the reference category. RESULTS: Regardless of gender, overweight individuals reported more screen time, less physical activity and less concomitant adherence to guidelines. For boys, the multivariate analysis showed that any amount exceeding screen time recommendations was associated with increased odds of being overweight [>2-4 h: adjusted odds ratio (AOR) = 1.40; >4-6 h: AOR = 1.48; >6 h: AOR = 1.83]. A similar relation was found for any amount below physical activity recommendations (4-6 times a week: AOR = 1.67; 2-3 times a week: AOR = 1.87; once a week or less: AOR = 2.1). For girls, not meeting nutritional guidelines was less likely among overweight individuals (0-2 recommendations: AOR = 0.54). Regardless of weight status, more than half of the adolescents did not comply with any guideline and <2% met all three at the same time. CONCLUSIONS: Meeting current nutritional, physical activity and screen time guidelines should be encouraged with respect to overweight. However, as extremely low rates of concomitant adherence were found regardless of weight status, their achievability is questionable (especially for nutrition), which warrants further research to better adapt them to adolescents.

What is worse? A hierarchy of family-related risk factors predicting alcohol use in adolescence.

The aim of the present study was to determine if family structure, perception of excessive drinking in the family, and family bonding hold a graduated importance in predicting adolescent alcohol use and their association with peers who drink excessively. Three nested linear structural models were calculated separately for frequent and excessive drinking, based on a sample of 3,127 eighth and ninth graders in Switzerland (mean age 15.3, SD 0.8) surveyed in spring 2002 in the context of the "Health Behavior in School-Aged Children (HBSC)" study. The results confirm that the perception of excessive drinking in the family is more closely related to both frequent and excessive drinking than family structure, and family bonding is more closely related than drinking perception. Adjusting for both socio-demographic variables and the association with peers who drink excessively only slightly changed the results. To predict an association with the latter, family structure was more important than the perception of drinking, but family bonding remained the predominant predictor. The results stress the graduated importance of family-related risk factors: by listening to their children's worries, by spending their free time with them, and by providing help when needed, parents might have the possibility to actively minimize the risk of frequent and excessive drinking regardless of whether they are frequent excessive drinkers or live without a partner.

[Volume and profile of alcohol consumption among students and classmates as predictors of aggression and victimization: a multilevel analysis among Swiss adolescents]. / Volume et profil de consommation d'alcool des élèves et des camarades scolaires comme prédicteurs de l'agression et de la victimisation: une analyse multiniveaux auprès d'adolescents suisses.

OBJECTIVE: To test the effects of the volume of alcohol consumption and drinking patterns on alcohol-related aggression and victimization, both at the individual and class levels. METHODS: Representative sample drawn from the European School Survey Project on Alcohol and Other Drugs (ESPAD) of 6496 Swiss adolescents (13 to 16 years). Hierarchical multi-level models were used to simultaneously estimate individual and environmental influences. In addition to indicators of consumption of alcohol and other substances, age, sex, socioeconomic indicators and satisfaction with the relationship to parents were used as covariates. RESULTS: After controlling for confounding, both volume of alcohol consumption and the frequency of binge drinking occasions were associated independently with alcohol-related problems (aggression/victimization) on the individual level. On the aggregate level, there was colinearity between volume of drinking and frequency of heavy drinking occasions. When entered in the same model, however, only the effect of volume effect stayed in the same direction. CONCLUSIONS: Not only individual volume of drinking, but also the way alcohol is consumed influences individual problem levels. This includes individual patterns of drinking as well as environmental influences at school. These results open up important considerations for theory, research and prevention.

Do school surroundings matter? Alcohol outlet density, perception of adolescent drinking in public, and adolescent alcohol use.

The aim of the present study was to investigate the relationship between alcohol outlet density, perception of adolescent drinking in public (both assessed at the school level), and adolescent drinking and drunkenness at individual level. Hierarchical linear regression models were calculated based on data from 1194 ninth graders in Switzerland (mean age=15.3, S.D.=0.7) and their schoolmasters (n=61). Apart from the positive main effects, the results reveal a negative interaction of alcohol outlet density and perception of adolescent drinking in public in predicting individual alcohol use among adolescents. In regions with a high density of shops, it appears that the schoolmasters' perception reflects the general drinking norm of the area where the school is located rather than the actual drinking level of adolescents. More research is needed, particularly in Europe and among adolescent populations, to reach a better understanding of school level predictors of adolescent alcohol use.

Weapon-carrying at Swiss schools? A gender-specific typology in context of victim and offender related violence.

After reviewing prevalence rates, this work tries to identify gender specific groups in which weapon-carrying occurs in the context of victim and offender related violent behaviours. k-Means cluster and logistic regression analyses were calculated, based on a cross-sectional survey of a national representative sample of 1549 15-year-olds as part of the Health Behaviour in School-Aged Children (HBSC) international collaborative study. The victims and offenders of violence concern mainly female bullies and physically violent boys. In the male victim-offender group, 17% had already taken a weapon to school. Another male group emerged in which 95% had already taken a weapon to school. Members of this group revealed an elevated level of acting violently but a low level of being the victim. Among the minority girls who were offenders and victims of physical violence, everyone has already taken a weapon to school. Based on these results, homogenous risk groups can be targeted for violence prevention.

Progression of a general substance use pattern among adolescents in Switzerland? Investigating the relationship between alcohol, tobacco, and cannabis use over a 12-year period.

Many studies have shown that different risk or problem behaviors in adolescence are interrelated. Given the increased use of various substances among adolescents in the United States and in most European countries, the question emerges whether there are more substance use "specialists" or a progression of a general substance use pattern. If the latter is the case, the interrelatedness of the different substances should remain stable over time in a representative sample and among subgroups characterized by gender and language. Data from 4,146 15-year-olds in Switzerland surveyed in 1986, 1994 and 1998 were analyzed, using confirmatory factor analyses based on polychoric correlations. Smoking, drunkenness and cannabis use greatly increased over the 12-year period. However, in the different survey years, the factor structure did not differ for all 15-year-olds in general or for subgroups. This progression of a general pattern refers to an increased normalization of recreational substance use in general, not only of cannabis use. Favorable attitudes towards general substance use are a challenge to substance use prevention in adolescence, and reveal a need for more research on such a progression in other countries.

Hostility among adolescents in Switzerland? multivariate relations between excessive media use and forms of violence.

PURPOSE: To determine what kind of violence-related behavior or opinion is directly related to excessive media use among adolescents in Switzerland. METHODS: A national representative sample of 4222 schoolchildren (7th- and 8th-graders; mean age 13.9 years) answered questions on the frequency of television-viewing, electronic game-playing, feeling unsafe at school, bullying others, hitting others, and fighting with others, as part of the Health Behaviour in School-Aged Children (HBSC) international collaborative study protocol. The Chi-square tests and multiple logistic regression analyses were applied to high-risk groups of adolescents. RESULTS: For the total sample, all bivariate relationships between television-viewing/electronic game-playing and each violence-related variable are significant. In the multivariate comparison, physical violence among boys ceases to be significant. For girls, only television-viewing is linked to indirect violence. Against the hypothesis, females' electronic game-playing only had a bearing on hitting others. CONCLUSIONS: Experimental designs are needed that take into account gender, different forms of media, and violence to answer the question of whether excessive media use leads to violent behavior. With the exception of excessive electronic game-playing among girls, this study found that electronic media are not thought to lead directly to real-life violence but to hostility and indirect violence.

Emotional wellbeing and violence among social and solitary risky single occasion drinkers in adolescence.

OBJECTIVES: To classify adolescents according to risky single occasion drinking (RSOD) and their level of social integration, and to test whether these groups (social non-RSODs, social RSODs, solitary non-RSODs, solitary RSODs) differ in terms of emotional well-being and violence-related variables. METHOD: K-means cluster and multiple logistic regression analyses were performed based on a cross-sectional national representative sample of 3861 8th and 9th graders in Switzerland (mean age 15.3; SD = 0.88). RESULTS: Although RSODs in general appear to be more violent, social RSODs tend to be more violent than solitary RSODs. Although RSODs reveal a lower life satisfaction generally and tend to have more depressive moods, solitary RSODs are even less satisfied and more depressive. In addition, the latter tend to have lower self-esteem and are more often victims of bullying. CONCLUSIONS: RSODs are not a homogeneous group of adolescents and preventive efforts, such as competence-enhancing and social resistance programmes, should be applied in accordance with the constellation of associated problems: solitary RSODs appear to be socially inhibited, depressive and often victims of bullying, whereas social RSODs appear to be socially accepted but are prone to be violent offenders.