Grocery purchase data in the study of alcohol use - A validity study.

BACKGROUND: Alcohol use epidemiology is facing challenges as survey response rates decline. In addition, population surveys fail to capture a large proportion of alcohol consumed and are expensive to conduct. This study aims to aid in complementing traditional epidemiological methods by validate grocery purchase data in the research on population alcohol use. METHODS: The LoCard study subjects were loyalty card holders of a grocery retail co-operative, which possessed more than 45 % market share in Finland. One third of those who consented to the analyses of their grocery purchases were presented a questionnaire including a Food Frequency Questionnaire on the web; N = 11,818 responded. The relationship between beer purchase frequency and self-reported beer drinking frequency was studied for association and agreement in different subgroups using crosstabulations and Poisson regression modeling. RESULTS: The association between beer purchase frequency and self-reported beer drinking frequency was good (Gamma = .556). The agreement between beer purchase frequency and drinking frequency was only fair (Kappa = .189). Limiting the data to those single adult households that reported making at least 61 % of their grocery purchases from this grocery retailer and collapsing the frequency categories to three instead of six increased the agreement to good (Kappa = .463). CONCLUSIONS: Information on beer purchase frequency from the loyalty card database can be used to rank people according to their drinking frequency and to estimate beer drinking frequency with fair to good accuracy, depending on what share of grocery purchases they make from the grocery retailer in question.

Hepatitis A, B, C and HIV infections among Finnish female prisoners--young females a risk group.

OBJECTIVES: Previous prison studies have shown that the female gender is associated with higher hepatitis C prevalence. However, there are few prison studies of gender differences concerning the risk factors of hepatitis C infections. We studied the prevalence of hepatitis and HIV infections and the risk factors among Finnish female prisoners. METHODS: The material consisted of 88 females and 300 male prisoners as controls. RESULTS: The prevalence of hepatitis C virus antibodies was 52%, hepatitis B surface antigen 0%, hepatitis A virus antibodies 38% and HIV antibodies 1% among women, and 44%, 0.7%, 4% and 0.7% respectively among men. Among women, 71% of the age group 16-24 had HCV. There was no significant association between gender and HCV. Women were more commonly sharing syringes/needles and had unsafe sexual habits. Among women, HCV was associated only with IDU and syringe/needle sharing whereas among men also with tattoos, cumulative years in prison and age. CONCLUSIONS: Especially young females had a high prevalence of HCV. The study showed that the risk factors are differentiated by gender. This should be taken into account when assessing earlier studies which mainly concentrate on men.

Information technology in health promotion.

eHealth, the use of information technology to improve or enable health and health care, has recently been high on the health care development agenda. Given the vivid interest in eHealth, little reference has been made to the use of these technologies in the promotion of health. The aim of this present study was to conduct a review on recent uses of information technology in health promotion through looking at research articles published in peer-reviewed journals. Fifteen relevant journals with issues published between 2003 and June 2005 yielded altogether 1352 articles, 56 of which contained content related to the use of information technology in the context of health promotion. As reflected by this rather small proportion, research on the role of information technology is only starting to emerge. Four broad thematic application areas within health promotion were identified: use of information technology as an intervention medium, use of information technology as a research focus, use of information technology as a research instrument and use of information technology for professional development. In line with this rather instrumental focus, the concepts 'ePromotion of Health' or 'Health ePromotion' would come close to describing the role of information technology in health promotion.

Theory-based survey analysis of well-being in secondary schools in Finland.

Frameworks concerning school health and well-being, like the Health Promoting School and the Coordinated School Health Programme, have been available for some time. However, the indicators of well-being studies and the comprehensive frameworks have not met. The main aim of the present study was to test the use of the theoretically based School Well-being Profile to clarify the aspects of well-being in schools and to test if the Profile could be used to identify differences in well-being between classes in school. The data were collected in connection with the Koulumiete Project in Finland; 1346 pupils and 69 classes from grades seven to nine were included in the present data. In the school conditions category, the physical conditions that most needed improvement were ventilation, toilet facilities and temperature. Time pressure was also reported widely. Concerning social relationships, teachers' interest in how pupils are doing and teachers' fair treatment were the aspects calling for attention. In the means for self-fulfillment category pupils' participation in school development was a key area for reform. The most prevalent psychosomatic symptoms in the health status category were headache and feeling tired or weak. The School Well-being Profile seemed to work well when evaluating well-being differences between classes. By utilizing the results locally, the school personnel can act to develop their own school. The Profile could be used as a tool when planning and evaluating well-being and mental health promotion interventions in schools.

Use of information and communication technology and prevalence of overweight and obesity among adolescents.

BACKGROUND: The prevalence of overweight and obesity has increased among children and adolescents, as well as among adults, and television viewing has been suggested as one cause. Playing digital games (video, computer and console games), or using computer may be other sedentary behaviors related to the development of overweight and obesity. OBJECTIVE: To study the relationships of times spent on viewing television, playing digital games and using computer to overweight among Finnish adolescents. DESIGN: Mailed cross-sectional survey. SUBJECTS: Nationally representative samples of 14-, 16-, and 18-y-old (N=6515, response rate 70%) in 2001. METHODS: Overweight and obesity were assessed by body mass index (BMI). The respondents reported times spent daily on viewing television, playing digital games (video, computer and console games) and using computer (for e-mail, writing and surfing). Data on timing of biological maturation, intensity of weekly physical activity and family's socio economic status were taken into account in the statistical analyses. RESULTS: Increased times spent on viewing television and using computer were associated with increased prevalence of overweight (obesity inclusive) among girls: compared to girls viewing television <1 h daily, the adjusted odds ratio (OR) for being overweight was 1.4 when spending 1-3 h, and 2.0 when spending > or =4 h daily on viewing television. In girls using computer > or =1 h daily, the OR for being overweight was 1.5 compared to girls using computer <1 h daily. The results were similar in boys, although not statistically significant. Time spent on playing digital games was not associated with overweight. CONCLUSION: Overweight was associated with using information and communication technology (ICT), but only with certain forms of ICT. Increased use of ICT may be one factor explaining the increased prevalence of overweight and obesity at the population level, at least in girls. Playing digital games was not related to overweight, perhaps by virtue of game playing being less sedentary or related to a different lifestyle than viewing television and using computer.

The misperceived social norm of drunkenness among early adolescents in Finland.

Adolescents tend to overestimate peer drinking; the resulting misperception of the social norm predicts the child's own future drinking. This study examined the misperception's relatedness to a person's drinking pattern in order to facilitate the segmentation of the audience for health education interventions. Adolescent Health and Lifestyle Survey (Finland) data on 14 year olds' drinking patterns and perceptions of peer drinking were gathered using self-administered mailed questionnaires in 1989 (N = 3105, response rate 77%), 1995 (N = 8382, 79%) and 2001 (N = 7292, 70%). The perceptions of peer drinking were significantly related to respondents' drinking patterns. Non-drinkers and those drinking recurrently until drunkenness held reasonably correct views of their peers' drinking. However, the segment between these two extremes comprising around half of the cohort incorrectly thought that their peers drank more; they misperceived the normative drinking pattern to be drunkenness. From health education perspective, three different target audiences can be identified: non-drinkers, moderate drinkers and heavy drinkers. The intermediate group, drinkers not normally getting drunk, holds the view most influenced by the social norm misperception and are likely to feel pressured to increase their drinking. The social norms marketing approach to health education should find this group the most viable target.

Factors associated with schoolchildren's general subjective well-being.

Based on a conceptual model of well-being in school, this study was aimed at exploring factors associated with schoolchildren's general subjective well-being. Classroom data for the School Health Promotion Survey were gathered in 1998 (n = 39 886) and in 1999 (n = 47 455) among eighth and ninth graders (aged 14.3-16.2 years) from 458 secondary schools in different parts of Finland. The dependent variable was the General Subjective Well-being Indicator (GSWI), based on the Raitasalo-modified 13-item Beck Depression Inventory. The independent variables (total 56) included background (grade, socioeconomic status, social cohesion, recreation and health behaviors) and school context (school conditions, social relationships, means for self-fulfillment and health status). The analysis utilized multivariate linear regression modeling. The final model accounted for 22% of boys' and 25% of girls' GSW variation. 'Means for self-fulfillment' (R2 = 0.11 boys, R2 = 0.15 girls), and social relationships in school (R2 = 0.09 boys, R2 = 0.10 girls) and outside school (R2 = 0.09 boys, R2 = 0.11 girls) were the categories showing the strongest correlations with GSW. Grade and socioeconomic status showed only a weak correlation with GSW (R2 = 0.01) among both genders. The study indicated that the school context has a major influence on pupils' general subjective well-being.

Factor structure of the School Well-being Model.

The aim of this study was to confirm empirically the factor structure of the School Well-being Model. In this Model well-being was divided into school conditions, social relationships, means for self-fulfillment and health status. Data for this study were collected by the School Health Promotion Survey in Finland with 40147 respondents from Grades 8 and 9. The 43 variables from the Survey were fitted into the School Well-being Model using confirmatory factor analysis. The Goodness of Fit Index (GFI) for the four-factor model was 0.93 and GFI Adjusted for Degrees of Freedom was 0.93. The correlations between factors varied from 0.30 to 0.78 and internal consistencies (Cronbach's alphas) from 0.62 to 0.84. The categories school conditions and health status had a good variety of variables. However, the social relationships and the means for self-fulfillment categories would have benefited from additional questions. The School Well-being Model can be utilized to construct school well-being profiles both for groups of pupils and for schools as a whole. The school well-being profile could highlight the area or areas in which schools could make improvements in order to promote the well-being of its pupils.

Trends in drinking habits among Finnish adolescents from 1977 to 1999.

AIMS: Trends in adolescent drinking habits in Finland from 1977 to 1999 are studied with special attention to the onset of problem use and gender differences. DESIGN AND SETTING: Biennial cross-sectional mailed surveys (Adolescent Health and Lifestyle Survey). PARTICIPANTS: Representative samples of 12, 14, 16 and 18-year-olds. The number of respondents varied from 2832 to 8390 and the response rate from 88% to 76%. MEASUREMENTS: The frequencies of alcohol use and perceived drunkenness obtained from self-administered questionnaires. FINDINGS: Alcohol use remained rare among 12-year-olds. The overall trends in the frequencies of alcohol use and drunkenness increased considerably over time among the 14-18-year-olds. Age-adjusted monthly drunkenness among 14, 16 and 18-year-olds rose from 13% (1981) to 27% (1999) among boys and 6% to 22% among girls. Throughout the study period, the drinking style among boys became more drunkenness-orientated with age, but the opposite was true among girls. Birth cohort investigation showed that the onset of drunkenness moved towards an earlier age. Earlier onset predicted higher prevalence of problem use at the age of 18. Boys developed a regular pattern of drunkenness steadily increasing between ages 14-18 while among girls the increase of drunkenness started to level off between ages 16 and 18. CONCLUSIONS: Alcohol use among 12-year-olds remained rare, but became more prevalent and drunkenness-orientated among 14-18 year-olds. Gender differences in problem use diminished. Nevertheless, notable differences persist in the onset and development of drunkenness-orientated use.

The effect of societal changes on drunkenness trends in early adolescence.

Increased adolescent drunkenness in Finland has called for research to explore the background of this development. This study seeks to find out to what extent the societal level changes have contributed to the increased drunkenness among 14 year olds in Finland from 1981 to 1997. The data set is drawn from a nationally representative bi-annual mail study, the Adolescent Health and Lifestyle Survey, conducted since 1981 (N = 792-2533, response rate 77-90% per year). Logistic regression analysis was used to study the effect of several background factors on the drunkenness prevalence trend. Family structure, parental education, residence urbanization, weekly allowance and timing of biological maturation were associated with drunkenness. Changes within the distribution of these factors, especially in increased weekly allowance and earlier timing of biological maturation, appeared to account for a considerable part of the increased drunkenness from 1981 to 1997. The findings suggest that increased adolescent drunkenness is significantly associated with societal changes outside the scope of health and alcohol policies.