Gender-specific social and environmental correlates of active travel to school in four European countries: the HBSC Study.

Introduction: Despite the health benefits, a large proportion of girls and boys in Europe do not travel to school actively. A better understanding of the correlates associated with this behavior could guide interventions. This study examines perceived social and environmental correlates of active travel to school (ACTS) from the 2017/18 Health Behavior in School-Aged Children (HBSC) survey in four European countries, with a special emphasis on gender differences (n = 22,023). Methods: Logistic regression was conducted to analyze associations between the perceived importance of each correlate and ACTS behavior for 11-, 13-, and 15-year-old girls and boys from Germany, Czechia, Poland, and Slovakia. All models were adjusted for age, family affluence, and meeting World Health Organization recommendations for moderate-to-vigorous physical activity. Results: Rates of ACTS significantly differed between girls and boys. In Czechia, 65% of girls and boys traveled to school actively, followed by Slovakia (61.4% girls and 58.4% boys), Poland (57.7% girls and 60.2% boys), and Germany (42.6% girls and 48.6% boys). Girls were less likely to actively travel to school compared to boys (odds ratio [OR]: 0.92, 95% confidence interval [CI]: 0.87-0.97). Increasing age (OR: 0.95, 95% CI: 0.93-0.97) and a greater distance to school index (OR: 0.89, 95% CI: 0.88-0.90) were both negatively associated with ACTS. The perceived importance of living closer to school and of road and neighborhood safety was positively associated with ACTS, with a stronger association in boys than in girls for neighborhood safety. On the contrary, the perceived importance of having people to walk with was negatively associated with ACTS, with a stronger association in girls (OR: 0.74, 95% CI: 0.65-0.84) than in boys (OR: 0.77, 95% CI: 0.66-0.88). Discussion: This study provides insights into perceived social and environmental correlates associated with ACTS behavior. Future research should include gender-specific perceptions and more in-depth investigations of correlates encouraging ACTS, especially considering social aspects, safety issues, and the structuring of the environment in different cultural settings.

The Czech Republic's 2022 Report Card on Physical Activity for Children and Youth: A rationale and comprehensive analysis.

Background/Objective: The second edition of the Czech Republic's Report Card on Physical Activity for Children and Youth was released in 2022. This paper describes the development of the Report Card and presents a comprehensive summary of the main findings. Methods: The multi-level search strategy was developed by the national expert panel to identify the available sources that provide data related to the physical activity of Czech children and adolescents. The data were used to assign grades to ten core and two additional indicators. Results: A total of 28 sources provided data that allowed grades to be assigned to 11 out of the 12 indicators. Grade B was assigned to six indicators (School: B+, Community and Environment: B, Organized Sport and Physical Activity: B-, Active Transportation: B-, Family and Peers: B-, Sleep: B-), grade C to three indicators (Overall Physical Activity: C+, Active Play: C, Physical Literacy: C), and grade D to two indicators (Government: D+, Sedentary Behaviors: D). No grade for the "Physical Fitness" indicator could be assigned due to a lack of data collected in the reference period 2018-2019. Conclusions: Although the family, school, and built environment provided a variety of opportunities to be physically active, a high proportion of children and adolescents did not meet the current physical activity guideline and were exposed to excessive sedentary behavior. A multisectoral and multidisciplinary response is required to reduce the health and economic burden of physical inactivity and excessive sedentary behavior among Czech children and adolescents.

Organized Sport Activities of 11 to 15-Year-Old Adolescents: Trends from 2010-2018 and Socioeconomic Context.

The aim of this paper was to analyse the trends in the participation of Czech adolescents in organized sport activities in relation to the socioeconomic status (SES) of their families. The sample consisted of 11, 13 and 15-year-old children (N = 4425 (2010), 10,361 (2014) and 13,377 (2018)); the data were collected as part of the HBSC Study in the Czech Republic. The findings suggest that adolescents from affluent families tend to participate more often in organized sports-both team activities and individual activities. Fifteen-year-old adolescents from families with a high SES are 3.01 times more likely to participate in individual organized sports than adolescents from low-SES families. The gap between participation in sport activities increases with the children's age but does not change significantly during the observed period. The findings suggest that public health policy should be oriented towards children from less-affluent families.

Test-retest reliability of selected HBSC items in Vietnam: well-being, physical and sedentary activities, and eating behaviours.

BACKGROUND: Valid and reliable research tools to assess children's and adolescent's health-related behaviour are highly needed across the globe. Rapid economic development, globalization, and associated lifestyle challenges observed in most countries support the need for high-quality evidence in adolescents to target health-promoting policies and interventions. This study aims to examine the test-retest reliability of selected well-being, physical and screen-time related siting activities, and eating behaviour items of the Health Behaviour in School-Aged Children (HBSC) questionnaire in a sample of Vietnamese adolescents. METHODS: Data were collected in autumn 2018 in Vietnam (3-week interval). The sample consisted of 410 adolescents (41.0% of boys; mean age = 12.61; SD = 1.24).Test-retest reliability was evaluated using the single measure Intraclass Correlation Coefficients (ICC) and Cohen's kappa statistic stratified by sex, grade and place of residence (urban or rural). RESULTS: The reliability analyses of the well-being items were poor to good ICC values (0.43-0.79) and moderate to large Cohen's kappa values (0.33-0.77). The physical activity and eating behaviour items were moderate (ICC = 0.54-0.65; Cohen's kappa = 0.38-0.57). The screen-time related siting activities items were moderate to large (ICC = 0.51-0.72; Cohen's kappa = 0.42-0.53). There was more item stability among females than males. The social media item was not as stable for 6th graders (ICC = 0.45) compared with older adolescents (ICC 0.68-0.77). CONCLUSIONS: The findings show that with regards to age, sex and place of residence, self-reported health, life satisfaction, physical and screen-time related siting activities, as well as eating behaviour items of the HBSC questionnaire have a sufficient test-retest reliability to be used in national self-report surveys for Vietnamese adolescents while health complaints items showed borderline reliability.

Typologies of Joint Family Activities and Associations With Mental Health and Wellbeing Among Adolescents From Four Countries.

PURPOSE: This study aims to identify distinct typologies of joint family activities and the associations with mental health and wellbeing among adolescents across four countries from the World Health Organization European region. METHODS: The 2017/2018 data from adolescents from Armenia (n = 3,977, Mage = 13.5 ± 1.6 years, 53.4% female), Czechia (n = 10,656, Mage = 13.4 ± 1.7, 50.1% female), Russia (n = 4,096, Mage = 13.8 ± 1.7, 52.4% female), and Slovakia (n = 3,282, Mage = 13.4 ± 1.5, 51.0% female) were collected in schools. The respondents self-reported their participation in joint family leisure-time activities, life satisfaction, psychological and somatic complaints, as well as a range of demographic and family situational factors. Stratified by countries, latent class analysis identified typologies of joint family activities, and logistic regression models explored cross-sectional associations with life satisfaction, and psychological and somatic complaints. RESULTS: Three typologies were identified across each of the four countries, distinguished by low, moderate, and high levels of family engagement. Adolescents with higher family engagement generally reported greater life satisfaction and fewer psychological complaints compared to those with lower family engagement. Russian adolescents in the high family engagement typology reported fewer somatic complaints compared to those with low family engagement. In addition, adolescents from Czechia and Russia showing moderate family engagement also reported fewer psychological complaints compared to those in the low family engagement typology. DISCUSSION: Our findings from four countries suggest that adolescents with high family engagement have greater life satisfaction and fewer psychological complaints, pointing toward a need for interventions to support family engagement among adolescents. Further research is needed to fully explore underlying mechanisms.

12-Year Trends in Active School Transport across Four European Countries-Findings from the Health Behaviour in School-Aged Children (HBSC) Study.

Active school transport (AST) is a source of daily physical activity uptake. However, AST seems to have decreased worldwide over recent decades. We aimed to examine recent trends in AST and associations with gender, age, family affluence, and time to school, using data from the Health Behaviour in School-Aged Children (HBSC) study collected in 2006, 2010, 2014, and 2018 in the Czech Republic, Norway, Scotland, and Wales. Data from 88,212 students (11, 13 and 15 years old) revealed stable patterns of AST from 2006 to 2018, apart from a decrease in the Czech Republic between 2006 and 2010. For survey waves combined, walking to and from school was most common in the Czech Republic (55%) and least common in Wales (30%). Cycling was only common in Norway (22%). AST differed by gender (Scotland and Wales), by age (Norway), and by family affluence (everywhere but Norway). In the Czech Republic, family affluence was associated with change over time in AST, and the effect of travel time on AST was stronger. The findings indicate that the decrease in AST could be levelling off in the countries considered here. Differential associations with sociodemographic factors and travel time should be considered in the development of strategies for AST.

After the bell: adolescents' organised leisure-time activities and well-being in the context of social and socioeconomic inequalities.

BACKGROUND: Previous research has linked adolescents' participation in organised leisure-time activities (OLTAs) to better health and well-being. It remains unclear whether these associations can be observed consistently across social and socioeconomic strata and countries. METHODS: The present study used nine nationally representative samples of adolescents aged 11, 13 and 15 years (total n=55 429) from the 2017/2018 Health Behaviour in School-aged Children survey from Europe and Canada. Regression models with mixed effects to account for nested nature of data were applied to estimate: (1) the associations of social and socioeconomic factors with OLTA participation; (2) strengths of the associations between breadth and pattern of OLTA participation with health and well-being indicators, after adjustment for the social and socioeconomic factors. RESULTS: Rates of OLTA participation varied by age, sex and country of adolescents. Participants from lower socioeconomic classes and non-nuclear families were less likely to participate in OLTAs across each of the nine countries. Moreover, breadth of OLTA participation was associated with higher well-being independent of socioeconomic status or family structure. All of the participation patterns were associated with higher life satisfaction, but sports (either alone or in combination with a non-sport OLTA) were also associated with fewer psychological complaints and excellent self-rated health. CONCLUSION: Adolescents' engagement in OLTAs was associated with adolescents' subjective well-being regardless of country, age, sex and variance in social and socioeconomic factors. Policies aimed at increasing adolescents' subjective well-being and OLTA participation should focus on adolescents from low socioeconomic classes and non-nuclear families.

Vigorous physical activity in relation to family affluence: time trends in Europe and North America.

OBJECTIVES: The aim of the study was to determine secular trends in vigorous physical activity (VPA) among adolescents in relation to family affluence across 34 countries. METHODS: This study used data from the Health Behaviour in School-aged Children (HBSC) study from 34 countries in Europe and North America. Adolescents (N = 501,647) aged 11, 13 and 15 years across three survey cycles (2006, 2010, 2014) self-reported data on VPA and a family affluence scale (FAS) using standardized questionnaires. RESULTS: A significant increase in VPA was found in low-FAS boys (girls) in four (10) countries and a decrease in four (three) countries. In high-FAS boys (girls), a significant increase was observed in nine (11) countries and a decrease in two(three) countries. An overall significant increase in meeting the VPA recommendations was found in high-FAS boys (OR 1.11; 95% CI 1.06-1.16) and in all FAS groups in girls, with the largest effect being found among high-FAS girls (OR 1.24; 95% CI 1.18-1.30). CONCLUSIONS: A country-specific increase in VPA was observed primarily in the medium- and high-FAS categories. This study suggests a need to focus on increasing VPA efforts, especially in low- and medium-FAS boys.

Unhealthy eating habits and participation in organized leisure-time activities in Czech adolescents.

A healthy lifestyle habits in adolescents consist of healthy eating patterns and active ways of spending leisure time. This study aimed to examine the relationship between organized leisure-time activities (OLTA) and eating habits in adolescence. Data from the 2013/2014 Health Behaviour in School-aged Children (HBSC) study on 10,494 Czech adolescents aged 11-15 years was used. The associations of participation in OLTA with ten specific eating habits were analyzed using logistic regression. Involvement in any type of OLTA was associated with higher consumption of daily breakfast, fruit, and vegetables and a lower intake of soft drinks. Participants in non-sport and sport and other activity reported lower rates of unhealthy eating habits (e.g., lower rates of eating crisps and eating in front of the TV or computer). Participation only in sport was related to more frequent eating at fast food restaurants but less frequent snacking in front of the computer and intake of crisps. CONCLUSION: Participation in OLTA was associated with healthier eating habits (e.g., consumption of fruit and vegetables) and a lower occurrence of unhealthy eating habits (e.g., consumption of soft drinks). Alternatively, our findings indicate that non-participation in OLTA can serve as an indicator of an unhealthy lifestyle in adolescence. What is Known • Unhealthy eating habits in youth tend to persist into adulthood and are related to adverse health consequences later in life. • The type of the leisure-time activity (participation in sport, non-sport, sport, and other activities) affects the strength of developmental outcomes in adolescents. What is New • Youth participating in non-sport activity and sport and other activity concurrently reported lower rates of unhealthy eating habits (e.g., eating junk food, eating in front of the TV/computer). • Non-participation in OLTA could be viewed as a potential risk factor for an unhealthy lifestyle in adolescents.

Trends and correlates of overweight/obesity in Czech adolescents in relation to family socioeconomic status over a 12-year study period (2002-2014).

BACKGROUND: This study examined a) trends in overweight/obesity, moderate-to-vigorous physical activity (MVPA), and screen time (ST) among Czech adolescents over a 12-year study period (2002-2014) in relation to family affluence (FA) and b) correlates of adolescent overweight/obesity from different FA categories. METHODS: A nationally representative sample of 18,250 adolescents (51.4% girls) aged 10.5-16.5 years was drawn from the Czech Health Behaviour in School-aged Children questionnaire-based surveys in 2002, 2006, 2010, and 2014. Using the FA scale, the socioeconomic status (SES) of the respondents' families was assessed. SES-stratified trends in the prevalence of overweight/obesity meeting the MVPA (≥60 min/day), and ST (≤2 h/day) recommendations were assessed using logistic regression. RESULTS: A trend-related significant increase (p < 0.05) in the prevalence of overweight/obesity was observed in low-/medium-FA boys and medium-/high-FA girls. Unlike in high-FA adolescents, a significant decrease was revealed in the rates of meeting the MVPA recommendation in low-FA boys (28.9%2002 → 23.3%2014, OR = 0.75, 95% CI = 0.59-0.95, p < 0.05) and girls (22.3%2002 → 17.3%2014, OR = 0.73, 95% CI = 0.57-0.92, p < 0.01). A significant (p < 0.001) trend-related increase in excessive ST was evident in adolescents regardless of gender and FA category. Generally, girls and older adolescents had lower odds of overweight/obesity than boys and 11-year-old adolescents. While in the high-FA category of adolescents, achieving 60 min of MVPA daily and the absence of excessive ST on weekdays significantly (p < 0.01) reduced their odds of being overweight/obese, in low-FA adolescents this was not the case. CONCLUSIONS: High rates of overweight/obesity and a poor level of daily MVPA among low-FA children provide disturbing evidence highlighting the necessity of public health efforts to implement obesity reduction interventions for this disadvantaged population.

Trends in Overweight and Obesity in Czech Schoolchildren from 1998 to 2014.

OBJECTIVE: Overweight and obesity in adolescents is associated with many health risks and considerable direct and indirect healthcare costs. The purpose of this study is to examine trends in the prevalence of overweight and obesity in 11-, 13- and 15-year-old adolescents in the Czech Republic from 1998 to 2014. METHODS: Data from five self-reported survey rounds (1998, 2002, 2006, 2010, and 2014) of the Health Behaviour in School-aged Children Study (HBSC) were used to assess trends in overweight and obesity among Czech adolescents. The total sample consisted of 19,103 adolescents (51.2% girls). A logistic regression analysis was used to assess trends in different age and gender categories. RESULTS: From 1998 to 2014 a significant increase in the prevalence of overweight and obesity was observed among boys in all age categories (11 years old 22.2%1998- 28.3%2014; 13 years old 17.9%1998- 26.7%2014; 15 years old 9.8%1998- 20.8%2014) and among 15-year-old girls (6.0%1998- 10.9%2014). None of the age and gender categories showed an overall decrease over the 16-year period. In boys, the prevalence of overweight was significantly higher with steeper negative trends compared with girls. However, stabilization in overweight rates was observed between 2010 and 2014 in all age and gender groups. CONCLUSION: Nationally representative self-reported data show a significant increase in overweight (including obesity) prevalence among children from 1998 to 2014 in the Czech Republic. The results also suggest stabilization in overweight prevalence between 2010 and 2014. Continuing research is needed to determine future trends while interventions aimed at reducing overweight and obesity in children should be implemented on different levels of public policy.

Trends in Screen Time Behaviours in Czech Schoolchildren between 2002 and 2014: HBSC Study.

OBJECTIVE: Screen-based behaviours such as watching television or computer use are among the most prevalent sedentary behaviours adolescents spend time on. There is a lack of recent estimates on prevalence and changes in the amount of time spent on screen-based behaviour across Central and Eastern Europe. The main aim is to assess the trends in the prevalence of current recommendations for the screen time (≤2 hours per day) of school-aged children in the Czech Republic between 2002 and 2014. METHODS: We used an internationally established methodology based on the Health Behaviour in School-aged Children (HSBC) study. Data was derived from Czech national representative samples of 11-, 13- and 15-year-olds collected in the years 2002 (N=4,065), 2006 (N=4,170), 2010 (N=3,962) and 2014 (N=4,338). RESULTS: The results indicated that the boys and girl surveyed in 2014 are up to two times more likely to meet the current recommendations for watching television in comparison with groups of schoolchildren of the same age surveyed in 2002. In contrast, computer use by adolescents increased markedly between 2006 and 2014. Taking total screen time into account, spending two hours per day or less on it decreased significantly among boys (OR=0.74, 95% CI=0.62-0.89) and girls (OR=0.80, 95% CI=0.70-0.92) between 2006 and 2014. CONCLUSIONS: As screen time is an important indicator of time spent in a sedentary way, our findings call for more interventions to reduce the time that school-aged children spend in front of screens.

Trends in Active Commuting to School among Czech Schoolchildren from 2006 to 2014.

OBJECTIVE: Active commuting (AC) is an important factor in increasing the total daily physical activity (PA) in children, which is significant for their health and positive physical behaviour in adulthood. The objective of the study was to describe trends in active commuting to school among Czech girls and boys aged 11-15 years from 2006 to 2014, using data from the Health Behaviour in School-aged Children (HBSC) study. METHODS: To investigate trends in AC among Czech children of school age data obtained from the HBSC surveys carried out in 2006, 2010, and 2014 was used. The study sample comprised 12,273 respondents, out of whom 5,992 (48.8%) were boys and 6,281 (51.2%) girls. The overall trends in AC were evaluated using logistic regression analysis. RESULTS: Compared with 2006, there was an overall decrease in AC among the 13-year-old boys and 13-year-old girls (boys - 1.8% in 2006 to 50.1% in 2014, girls - 69.3% in 2006 to 46.3% in 2014). The proportion of children AC (walking and cycling) to school significantly decreased from 74.3% in 2006 to 53.4% in 2014. CONCLUSION: This study demonstrated that AC to school decreased sharply among Czech children of school age from 2006 to 2014. However, walking was the most frequently used mode of travel. The boys were significantly more likely to cycle to school compared to the girls. PA interventions for youth should encourage participation in AC to school in the Czech Republic.

Trends in Lifetime Cannabis Use among Czech School-aged Children from 2002 to 2014.

OBJECTIVE: The aim of the study was to examine trends in the prevalence of lifetime cannabis use among the Czech 15-year old students. METHODS: Data from the nationally representative Health Behaviour in School-aged Children Survey, conducted in the Czech Republic in 2002, 2006, 2010 and 2014, were used. Trends in cannabis use among both boys and girls were modelled through binary logistic regression with period as a predictor of the lifetime cannabis use. RESULTS: The prevalence of lifetime cannabis use has significantly decreased among young Czechs, particularly among boys. Gender differences in cannabis use have been also gradually decreasing since 2002, with no significant differences between genders in recent period. CONCLUSIONS: Although there are positive changes in the prevalence of adolescent cannabis use, from the European perspective, Czech students still belong to those with significantly higher rates in this respect. Thus, alongside with the use of other substances, adolescent cannabis consumption remains an important challenge for the national public health policy.

Trends in Medically Attended Injuries in Czech Adolescents.

OBJECTIVE: Due to the importance of surveillance of injuries and accidents in the Czech Republic, the purpose of this study was to report the temporal trends of injuries of Czech adolescents between 2002 and 2014. METHODS: Adolescents (N=20,038) from the Czech Republic, that took part in the 2002, 2006, 2010 and 2014 HBSC study, reported the frequency of medically attended injuries in the past 12 months. Repeated binary logistic regressions with different years as reference categories were performed. RESULTS: Less than half (44.7%) of all Czech adolescents reported they had experienced at least one medically attended injuries in the past 12 months, with boys experiencing more injuries than girls (p<0.001), and the injuries were more common in older adolescents. Fewer boys reported injury in 2014 when compared to 2002 (OR, CI: 0.81, 0.72-0.90), there was also a significant decrease in injuries among girls between 2014 and 2006 (OR, CI: 0.77, 0.69-0.86). CONCLUSIONS: The trend was not linear amongst boys. Along with improved safety promotion education, the rate of injuries decreased among adolescents between the years 2002 and 2014.

The Family Affluence Scale as an Indicator for Socioeconomic Status: Validation on Regional Income Differences in the Czech Republic.

The Health Behaviour in School-Aged Children study (HBSC) uses the Family Affluence Scale (FAS) as a tool to identify the socioeconomic status of children and adolescents. Even though it is now widely applied in research studies, the external criterion validation of FAS has not been verified in terms of objective economic indicators in Central Europe. The aim of this study is to validate FAS in terms of disposable income per capita in 14 Czech administrative regions. Regional differences in the FAS score were analyzed using Pearson correlation and linear regression to measure the dependency of the aggregated mean of the FAS index at the regional level on data from the Czech HSBC survey carried out from April to June 2014 (n = 10,361). The data analysis has shown an overall positive correlation between the FAS index and regional disposable income (R = 0.77, p < 0.01). The regional disposable income per person could explain 59.7% of the variance in the FAS index (p < 0.01). By validating individual items, the authors identified three items with a significant correlation (p < 0.01): number of computers, dishwasher at home, and number of holidays. FAS seems to be a valid instrument to measure adolescents' socioeconomic status.