What Counteracts Problematic Social Media Use in Adolescence? A Cross-National Observational Study.

PURPOSE: Social media use has increased rapidly during the past decade, raising concerns about adolescents who display problematic social media use (PSMU), as indicated by addiction-like symptoms (e.g., preoccupation, tolerance). We aimed to assess the extent to which an individual resource (health literacy), and social resources (friend support and family support), moderated the association between a range of individual characteristics (gender, age, family affluence, and depressive feelings) and PSMU; also the association between PSMU and health outcomes (self-rated health, life satisfaction, and sleep difficulties), both cross-nationally and nationally. METHODS: Our sample included 22,226 adolescents from six European countries. We used data from the Health Behaviour in School-aged Children cross-sectional survey (2017/2018). Random-effects models and moderator analyses were applied. RESULTS: Six moderations were found, with the resources moderating the association between individual characteristics and PSMU. One moderation emerged cross-nationally, namely that a higher level of family support was associated with a lower likelihood of PSMU, especially among adolescents who did not have frequent depressive feelings. In addition, five national moderations were identified. For example, a higher level of health literacy was associated with a lower likelihood of PSMU among Finnish girls. The resources were also found to moderate the association between PSMU and health outcomes, with two moderations emerging cross-nationally. For instance, a higher level of family support was related to higher self-rated health, especially among problematic users. In addition, nine national moderations were identified; these included a higher level of health literacy being associated with having less sleep difficulties, especially among problematic users in Germany. DISCUSSION: In adolescence, health literacy, family support, and friend support have the potential to moderate the association between individual characteristics and PSMU, and between PSMU and health outcomes, cross-nationally and nationally. We recommend the use of universal and targeted interventions to promote individual and social resources to counteract PSMU.

Encouraging greater empowerment for adolescents in consent procedures in social science research and policy projects.

The United Nations Convention on the Rights of the Child emphasizes the importance of allowing children and adolescents to influence decisions that are important to them following their age and maturity. This paper explores the principles, practices, and implications around using parental versus child/adolescent consent when participating in social science research and policy development. Experiences from two studies are presented: The Confronting Obesity: Co-creating policy with youth (CO-CREATE) and the Health Behaviour in School-aged Children (HBSC) study, a World Health Organization (WHO) Collaborative Cross-National study. Although parental consent may be an important gatekeeper for protecting children and adolescents from potentially harmful research participation, it may also be considered an obstacle to the empowerment of children and adolescents in case they want to share their views and experiences directly. This paper argues that evaluation of possible harm should be left to ethics committees and that, if no harm related to the research participation processes is identified and the project has a clear perspective on collaborating with the target group, adolescents from the age of 12 years should be granted the legal capacity to give consent to participate in the research project. Collaboration with adolescents in the development of the research project is encouraged.

Quality of life in 13-year-olds depending on health status, residential neighbourhood deprivation and social capital - results from the Polish HBSC Study 2010-2018.

INTRODUCTION AND OBJECTIVE: Health-related quality of life (HRQL) should be used more extensively in monitoring the health of school-aged children. The presented study aimed to evaluate trends in KIDSCREEN-10 indices, considering mean scores and the level of social inequalities. MATERIAL AND METHODS: 3,937 children aged 13 participated in three Health Behavior in School-aged Children (HBSC) cross-sectional surveys conducted in Poland between 2010-2018. Subgroups were distinguished according to gender, health status, and three social factors (family affluence, neighbourhood social capital, and local deprivation). RESULTS: The average KIDSCREEN-10 index value was equal to: 22.36±4.54; 25.41±6.75; and 24.74±6.53 in 2010, 2014, and 2018,respectively. However, in 2018 no deterioration was recorded in boys, in poorer families or in regions with high social capital. The improvement in HRQL in 2014 was accompanied by an increase in disparities in health status and family wealth, as well as a decrease in disparities in local deprivation. An especially high increase in Glass index values was recorded for neighbourhood social capital (increasing from 0.542 in 2010 to 0.938 in 2018). The multivariate general linear model revealed the main effect of the year of the study, gender, chronic disease status, and the three social factors, as well as six significant 2-way interactions. CONCLUSIONS: Changes in the well-being of adolescents should be tracked over time using HRQL indices with proven psychometric properties. The level of social inequalities faced by young people should be included in policies and when designing interventions. The relevant initiatives should be targeted at different populations in order to properly address the needs of different groups of children and adolescents.

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.

Similarities and Differences between Psychosocial Determinants of Bullying and Cyberbullying Perpetration among Polish Adolescents.

Despite the extensive literature on the psychosocial determinants of bullying and cyberbullying among adolescents, there is not sufficient comprehensive analysis of the differences between perpetrators. This study aims to assess the psychosocial similarities and differences between bullies and cyberbullies. Data of 3650 students from two grades, K9 and K11 (47% females, mean age = 16.53), were used from a survey conducted in Poland in 2018 as part of the Health Behaviour in School-aged Children study. Perpetration was measured by questions adapted from the Olweus Bully/Victim Questionnaire. The following predictors were analyzed: demographic, socioeconomic status measured with the Family Affluence Scale-III (FAS), and individual and social factors. Multiple binary logistic regression was applied. The random sampling design was based on stratification according to the local deprivation index of the region where the school was located. Male gender, younger age, and non-intact family were associated with a higher risk of bullying and cyberbullying. Family support, empathy, school performance, and school attachment had a protective effect against both aggressive behaviors. Life dissatisfaction and high FAS were revealed as determinants of cyberbullying and local deprivation of bullying only. Bullying and cyberbullying school prevention programs should take into account these psychosocial differences and consider the economic deprivation of the region.

Measurement Invariance of the WHO-5 Well-Being Index: Evidence from 15 European Countries.

(1) Background: The World Health Organization (WHO)-5 Well-Being Index has been used in many epidemiological studies to assess adolescent mental well-being. However, cross-country comparisons of this instrument among adolescents are scarce and, so far, no good-fitting, common invariant measurement model across countries has been reported. The present study aims to evaluate and establish a version of the WHO-5 Well-Being Index that allows for a valid cross-country comparison of adolescent self-reported mental well-being. (2) Methods: Using data from the 2018 Health Behaviour in School-aged Children study, we evaluated the measurement model and measurement invariance of the five items of the WHO-5 Well-Being Index. We used nationally representative samples of 11-, 13-, and 15-year-old adolescents (N = 74,071) from fifteen countries and regions in Europe. Measurement invariance of the WHO-5 was assessed using a series (country, gender, and age) of multi-group confirmatory factor analyses. In addition, we evaluated the convergent validity of the measure by testing its correlations with psychosomatic complaints, life satisfaction, and self-rated health. (3) Results: We found that WHO-5 does not show good psychometric properties or good measurement invariance fit. However, by excluding the first item of the scale ("I have felt cheerful and in good spirits"), the WHO-4, consisting of the other four original items, had good psychometric properties, and demonstrated good suitability for cross-national comparisons (as well as age and gender) in adolescent mental well-being. (4) Conclusions: The present study introduces the WHO-4-a revised version of the WHO-5-, that allows for a valid comparison of mental well-being across fifteen countries and regions in Europe. The WHO-4 proved to be a reliable and valid instrument to assess mental well-being in the adolescent population.

Who Is Able to Resist What Is Forbidden?-The Relationship between Health Literacy and Risk Behaviours in Secondary School Students in the Broader Social and Educational Context.

In the last Health Behaviour in School-Aged Children (HBSC) survey conducted in Poland in 2018, a group of 17-year-old adolescents (n = 1663; mean age 17.63 ± 0.36 years) was included outside the international protocol. This allowed an assessment to be made of their level of health literacy (HL) using the 10-point HBSC research tool. The aim of the study was to investigate the relationship between HL and risk behaviours (RB). A standardised index of RB in the last 30 days was considered as an outcome measure. This index was significantly higher in the group with low HL (0.318 ± 1.269) in comparison with the group with high HL (-0.083 ± 0.962). In a multivariate linear regression model, the strongest predictors of RB were gender, academic performance and level of regional deprivation, but the association with HL remained significant. This significant association persisted in general schools and in girls but disappeared in vocational schools and in boys. It was also shown that in rural areas, good academic performance has a less significant impact on RB if the HL level is low. The analyses led to the conclusion that when examining the relationship between HL and RB in older adolescents, it is advisable to take into account gender, the educational track and neighbourhood characteristics.

What factors do young people define as determinants of their well-being? findings from the improve the youth project.

BACKGROUND: The UN has recognised well-being as a main goal of The Global Strategy for Women's, Children's and Adolescents' Health (2016-2030). OBJECTIVE: The aim was to identify the areas of mental health that are the most significant to teenagers. MATERIAL AND METHODS: The mixed-method approach was applied. Quantitative research included adolescents aged 11-15 years (6,026 in Portugal; 4,545 in Poland). HBSC study results (2013/2014) were analysed in terms of the following variables: self-rated health, life satisfaction (Cantril Ladder, KIDSCREEN-10 Index), and psychosomatic complaints (SCL scale). Focus workshops took place in 2018, with 72 teenagers aged 14 to 16. RESULTS: 16.6% of the Polish participants and 12.7% of the Portuguese participants were concerned about their health. Polish participants were less satisfied with their life [KIDSCREEN score: 25.48 for Poland (SD=6.39), and 29.96 (SD=6.03) for Portugal]. Both nations associated mental health (MH) with the family setting and relationships with friends. An additional association among Portuguese teenagers involved social issues, whereas Polish adolescents were more focussed on relationships with various people in their environment, as well as on experiencing issues at school and in the family. CONCLUSIONS: Adolescent MH is determined by stress, environmental pressure and high expectations. The viewpoints of adolescents are the most valuable source of knowledge for specialists, researchers and youth institutions, who can benefit greatly from taking advantage of this resource.

Translation, cultural adaptation and validation of the basic psychological needs satisfaction in active commuting to and from school (BPNS-ACS) scale in Polish students.

BACKGROUND: To promote active commuting to and from school, it is pertinent to understand the motivational factors that influence the choice of this form of transportation. OBJECTIVE: Translation, cultural adaptation and analysis of the factor structure as well as psychometric properties of the Basic Psychological Needs and Satisfaction in Active Commuting to and from School (BPNS-ACS) scale among Polish students and examination of the distribution of the scale scores according to gender, mode of commuting to and from school and the frequency of using bicycle for this purpose. MATERIAL AND METHODS: Data from 475 Polish students aged 11-18, including 53.9% of girls were analysed. The Confirmatory Factor Analysis of the Polish version of the BPNS-ACS, U Mann-Whitney and Kruskal Wallis H tests were performed. RESULTS: The BPNS-ACS consists of 12 items forming three dimensions: autonomy, competence and relatedness need satisfaction. The scale has acceptable psychometric properties: χ2(51)=195.424 (p ˂ 0.001); χ2/df=3.832; CFI=0.944, TLI=0.927, RMSEA=0.077 (90%CI 0.066-0.089), AIC=249.424, BIC=361.833, GFI=0.937, AGFI=0.904. BPNC-ACS scores on factors corresponding to the three basic psychological needs differ based on gender, mode of commuting to and from school and the frequency of cycling to or from school. CONCLUSIONS: Further exploration of the function of basic psychological needs in active commuting to and from school among Polish adolescents may be conducted using an adapted version of the BPNS-ACS scale.

Adaptation of the Behavioural Regulation in Active Commuting to School (BR-ACS) Questionnaire in Portuguese Youth.

This study aimed to translate and adapt the psychometric properties of the Behavioural Regulation in Active Commuting to School (BR-ACS) questionnaire to young Portuguese students. This study had two stages: (1) translation and adaptation of the questionnaire; (2) evaluation of the psychometric properties. A sample of 338 participants (212 female, 126 male) aged 11 to 19 years (Mage = 15.6 ± 2.1) from 31 cities and Madeira island participated in this study. The confirmatory factor analysis suggested an acceptable fit to the data for the first-order and third-order measurement models. The composite reliability values ranged from 0.71 (identified regulation) to 0.90 (integrated regulation), demonstrating internal consistency. The AVE values ranged from 0.40 (amotivation) to 0.69 (integrated regulation), demonstrating an acceptable convergent validity for all constructs. The model estimation had an acceptable fit, with values akin to those of the first-order tested model. Finally, the results of the multigroup analysis for the successive restricted models (CFI < 0.010 and RMSEA < 0.015) point out that the null hypothesis of factor invariance between gender cannot be rejected. The psychometric properties demonstrates the suitability of this questionnaire among Portuguese youths aged 11 to 19. This questionnaire will help understand the motivation aspects that underpin active commuting to school and consequently help to increase physical activity among Portuguese adolescents.

Translation and Validation of the Basic Psychological Need Satisfaction in Active Commuting to and from School (BPNS-ACS) Scale in Young Portuguese Students.

Active commuting to and from school (ACS) is a strategy to enhance physical activity levels in youths. To promote ACS, it is important to understand the factors that lead to this behaviour. With this in mind, an adaptation of the Basic Psychological Needs in Exercise Scale for ACS was developed, named the Basic Psychological Need Satisfaction in Active Commuting to and from School (BPNS-ACS) scale. This study aimed to translate and evaluate the psychometric properties of the BPNS-ACS scale in young Portuguese students. A cross-sectional study was designed. A total of 338 students (212 girls, 126 boys), aged between 11 and 19 years old from 31 Portuguese cities participated in this study. To provide validity evidence based on the questionnaire's internal structure, confirmatory factor analyses were performed to test the three dimensions of the BNPS-ACS scale. The results of the confirmatory factor analysis indicated an acceptable fit to the data. The internal consistency of the measures was accepted as the composite reliability values ranged from 0.78 to 0.94. The evaluation of psychometric properties provided evidence of the adequacy of this questionnaire among Portuguese youth aged 11 to 19 years old.

Adolescent Health Literacy and Neighbourhood Features: HBSC Findings from Czech Republic, Poland, and Slovakia.

The role of supportive environments on health, wellbeing, and longevity has been widely recognized. However, there is no strong empirical evidence on the association between health literacy (HL) as a particular health-related competence and neighbourhoods. Therefore, the aim of the study was to assess the association between the features of neighbourhoods and the level of HL competencies of young people from three countries (Czech Republic, Poland, Slovakia). Self-reported data from an international sample of 11,521 students aged 13-15 years participating in the Health Behaviour in School-aged Children Study (HBSC) in the year 2018 were included in the analyses. The level of HL shows a strong positive relationship with family wealth, and a significant relationship is maintained in all studied countries. Both social and structural features of neighbourhoods turned out to have an impact on students' HL. However, HL is most clearly explained by the school environment. This study confirms the school effect on higher levels of HL competences in adolescents. This indicates the need to invest in schools located in less affluent areas to generally improve the level of education, implement modern health education combined with HL, and strengthen the social and health competencies of students.

Demographic analysis of difficulties related to remote education in Poland from the perspective of adolescents during the COVID-19 pandemic.

INTRODUCTION AND OBJECTIVE: Due to the COVID-19 pandemic all schools in Poland were closed and obliged to conduct lessons remotely. The aim of the study is to present the demographic analysis of difficulties with remote learning, as perceived by students during coronavirus pandemic in Poland. MATERIAL AND METHODS: In April 2020, a nationwide online survey was conducted among adolescents aged 11-18 (N=2408). Quantitative and qualitative data were used. Teenagers were asked about the problems connected with remote learning. In order to examine the overall level of remote learning difficulties, a scale of remote learning difficulties (RLD) was devised (range 0-23 points). Differences connected with gender, age and place of residence were analysed. RESULTS: More than a half of the teenagers surveyed rated the increased demands from teachers as a major problem. This answer appeared statistically more often among girls than boys (59.6% v. 53.2%). Almost every third adolescent saw the lack of consultation (31.6%) as a significant problem. Difficulties related to learning in the remote system were most often described as considerable by the oldest students (17-18-years-old) and those living in rural areas. The big problem for them was usually much higher requirements of teachers and poor organization of distance learning. The mean level on the scale of remote learning burden was M=11.9 (SD=7.1). Technical difficulties and insufficient skills in using software constituted additional problems most frequently mentioned by students. CONCLUSIONS: There is a need to pay particular attention to organizing appropriate technical conditions for remote learning, especially in rural areas, where students have complained more often than in cities about equipment and problems with access to the Internet during the pandemic.

Making the best out of youth-The Improve the Youth project.

Adolescents' mental health determines their general health and their mental health as adults. Improve the Youth project (ITY) was created and implemented among Polish and Portuguese adolescents. The aim of the project was to investigate the well-being of Portuguese and Polish adolescents, and to evaluate differences between them in self-rated health, life satisfaction and perceived psychosomatic health. A mixed-method approach was applied. The quantitative part was based on Health Behaviour in School-aged Children (HBSC) 2014 data, including adolescents aged 11-15 years (6026 in Portugal; 4545 in Poland). This study meets the issues raised by the HBSC results, regarding mental health in adolescence, and it is aimed to improve adolescents' social participation and active citizenship. In most study areas, findings in Poland were less favourable than in Portugal. The qualitative part was developed to recognize the main threats for adolescent's well-being. In this, they emphasised that every opportunity to talk about their feelings and needs resulted in improvement of their mental health. Elevated levels of stress were connected to environmental pressure and high expectations that they were often unable to cope with. Nervousness, perceiving that it was impossible to meet expectations, the desire to keep up with their peers, fatigue, and uncertainty of the future increased the feelings of frustration. The differences found between countries may be due to cultural roots, surfacing the relevance of assessing adolescents' mental health needs in the social context of family, school and peers. This study also aims to raise awareness among educators and stakeholders to the importance of youth engagement.

Active Transport to School May Reduce Psychosomatic Symptoms in School-Aged Children: Data from Nine Countries.

It is widely proven that being physically active and avoiding sedentary behaviour help to improve adolescents' well-being and keep them in better health in general. We aimed to investigate the relationship between modes of transport to school and subjective complaints among schoolchildren. Analyses were based on the HBSC (Health Behaviour in School-aged Children) surveys conducted in 2017/18 in nine countries (N = 55,607; mean age 13.43 ± 1.64 yrs.). The main outcome showed that health complaints consisted of somatic and psychological complaints. Transport to school was characterized by mode of getting there (walking, biking, or another passive mode). A total of 46.1% of students walked and 7.3% cycled to school; 46.6% commuted by passive means. Biking to school was more frequent in Denmark (37.9%), Norway (26.5%), and Germany (26.6%). The multivariate generalized linear model adjusted for age, gender, country, and school proximity showed that biking to school is protective against reports of health complaints. The beta parameters were equal to -0.498 (p < 0.001) for the general HBSC-SCL index, -0.208 (p < 0.001) for the somatic complaint index, and -0.285 (p < 0.001) for the psychological complaints index. Young people who actively commute to school are less likely to report health complaints, especially psychological symptoms.

Adolescents' Intense and Problematic Social Media Use and Their Well-Being in 29 Countries.

PURPOSE: This study examined (1) whether intense and problematic social media use (SMU) were independently associated with adolescent well-being; (2) whether these associations varied by the country-level prevalence of intense and problematic SMU; and (3) whether differences in the country-level prevalence of intense and problematic SMU were related to differences in mobile Internet access. METHODS: Individual-level data came from 154,981 adolescents (meanage = 13.5) from 29 countries that participated in the 2017/2018 Health Behaviour in School-aged Children (HBSC) survey. Intense SMU was measured by the time spent on social media, whereas problematic SMU was defined by symptoms of addiction to social media. Mental (life satisfaction and psychological complaints), school (school satisfaction and perceived school pressure), and social (family support and friend support) well-being were assessed. Country-level data came from aggregated individual-level data and data from the Organisation for Economic Co-operation and Development (OECD) on Internet access. RESULTS: Two-level regression analyses indicated that in countries with a lower prevalence of intense SMU, intense users reported lower levels of life satisfaction and family support and more psychological complaints than nonintense users. In contrast, in countries with a higher prevalence of intense SMU, intense users reported higher levels of family support and life satisfaction than nonintense users, and similar levels of psychological complaints. In all countries, intense users reported more friend support than nonintense users. The findings regarding problematic SMU were more consistent: In all countries, problematic users reported lower well-being on all domains than nonproblematic users. Observed differences in country-level prevalence rates of intense and problematic SMU could not be explained by mobile Internet access. CONCLUSIONS: Adolescents reporting problematic SMU are particularly at risk of lower well-being. In many countries, intense SMU may be a normative adolescent behavior that contributes positively to specific domains of their well-being.

Changes in physical activity of adolescent girls in the context of their perception of the Healthy Me programme.

BACKGROUND: An assumption was made that results of programme evaluation lead to better understanding for whom this intervention may work. The aim of the article is to compare the changes in physical activity of the intervention programme participants depending on subjective assessment of its impact. METHODS: The data were obtained from 14- to15-year-old Polish girls (N = 1120) from 48 random selected secondary schools participating in the 1-year Healthy Me programme in the 2017/2018. Schools were randomly assigned to one of two types of intervention or to a control (null) group. Satisfaction with the programme according to 21 criteria was measured retrospectively just after the intervention. Change in MVPA (moderate-to-vigorous physical activity) during the programme implementation was assessed in relation to satisfaction level, and adjusted for initial MVPA. RESULTS: In total, the MVPA did not change significantly comparing pre- and post-intervention surveys (3.94 ± 1.94 vs. 3.87 ± 1.93)-P = 0.093. However, the perceived notable improvement of functioning in 10 out of 21 areas was related to the unquestionable increase in MVPA (P ≤ 0.001). With respect to the four impact areas, an interaction was demonstrated between an intervention group and an improvement in the domain-specific functioning. The beneficial impact of the programme on these areas was associated with the improvement of physical activity only in case of full and null intervention. CONCLUSIONS: Indicators related to the implementation process and the results obtained during the Healthy Me programme evaluation could represent a change in motivational and environmental factors that indirectly affects adolescent girl's physical activity.

Family, school and neighborhood factors moderating the relationship between physical activity and some aspects of mental health in adolescents.

The impact of physical activity on mental health is widely described in literature. Less attention is given to factors which may modify this correlation, except for gender. The aim of this study was to conduct a qualitative assessment of such papers relating to children and young people. Selected papers were evaluated with regard to additional factors related to family, school and neighborhood. Attention was drawn to the definitions of these variables, the methods of analysis, and the content of the discussion. The starting point for this study included 7 systematic reviews published in 2006-2018. A total of 161 full articles described in detail in those reviews, and representing different research patterns, were selected for qualitative analysis. They met the criteria for the type of publication, mental health outcome, the direction of association, and the age group. A supplementary section of this paper contains a review of Polish literature from the Polish Medical Bibliography, and an analysis of national studies and some more recent papers not included in the analyzed reviews. It was demonstrated that 33 papers analyzed environmental variables to a greater degree than the characteristics of the sample. Twenty-three papers containing the results of statistical analyses were considered to be of particular interest. Almost 50% of these included both the socio-economic position of the family and the characteristics of the neighborhood. However, only 1 featured stratification of the sample with regard to contextual environmental variables. The obtained results are of great practical importance. Firstly, development of the research into environmental moderators should be advocated. Secondly, the social context in which adolescents grow up should be taken into account when designing intervention programs. Int J Occup Med Environ Health. 2019;32(4):423-39 .

Physical Activity, Sedentary Behaviours and Duration of Sleep as Factors Affecting the Well-Being of Young People against the Background of Environmental Moderators.

Mental health problems during adolescence are becoming increasingly frequent. The purpose of this study was to evaluate the total impact of selected behavioural and environmental factors on the variability of mental well-being indexes of young people aged 15 to 17 years. The survey, conducted as part of the last round of the Health Behaviour in School-Aged Children (HBSC) 2017/18 study, covered 3693 secondary school students in Poland at the average age of 16.53 years (SD = 1.09). Dependent variables: depression (CES-DC), stress (Cohen scale), satisfaction with life (Cantril's Ladder), and self-efficacy in social relations (Smith and Betz scale). Independent variables included: physical activity; sedentary behaviours; length of sleep; and perception of the environment in which the respondent was raised. The analyses were adjusted by gender, age, and occurrence of chronic disease. It was demonstrated that gender, duration of sleep, and perception of the surrounding environment proved to be significant predictors of all four mental health indicators. The protective influence of physical activity appeared to be a particular advantage in a less-supportive environment. The intervention programmes aimed at improving the mental well-being of young people should include promoting physical activity and sufficient sleep; furthermore, environmental moderators should be taken into consideration.