Changes from 1986 to 2006 in reasons for liking leisure-time physical activity among adolescents.

Reasons for participating in physical activity (PA) may have changed in accordance with the general modernization of society. The aim is to examine changes in self-reported reasons for liking leisure-time physical activity (LTPA) and their association with self-reported LTPA over a 20-year period. Data were collected among nationally representative samples of 13-year-olds in Finland, Norway, and Wales in 1986 and 2006 (N = 9252) as part of the WHO cross-national Health Behaviour in School-aged Children (HBSC) study. Univariate ANOVAs to establish differences according to gender, year, and country were conducted. In all countries, 13-year-olds in 2006 tended to report higher importance in terms of achievement and social reasons than their counterparts in 1986, while changes in health reasons were minor. These reasons were associated with LTPA in a similar way at both time points. Health reasons for liking LTPA were considered most important, and were the strongest predictor of LTPA. The findings seem robust as they were consistent across countries and genders. Health education constitutes the most viable strategy for promoting adolescents' motivation for PA, and interventions and educational efforts could be improved by an increased focus on LTPA and sport as a social activity.

Pre-pregnant body mass index and recreational physical activity: effects on perinatal mortality in a prospective pregnancy cohort.

OBJECTIVE: To examine the effect of maternal pre-pregnant body mass index (BMI) and recreational physical activity on perinatal mortality. DESIGN: A prospective cohort study. SETTING: The Norwegian Mother and Child Cohort (MoBa), 1999-2008. POPULATION: Singleton pregnancies without congenital anomalies (n = 77 246). METHODS: Pre-pregnant BMI was classified as underweight (<18.5), normal weight (18.5-24.9), overweight (25-29.9), obese (30-34.9) or morbidly obese (BMI ≥ 35). Risk estimates were obtained by logistic regression and adjusted for confounders. MAIN OUTCOME MEASURES: Perinatal death (stillbirth ≥ 22 weeks plus early neonatal death 0-7 days after birth). RESULTS: An increased risk of perinatal death was seen in obese [odds ratio (OR) 2.4, 95% CI (confidence interval) 1.7-3.4] and morbidly obese women (OR 3.3, 95% CI 2.1-5.1) as compared with normal weight women. In the group participating in recreational physical activity during pregnancy, obese women had an OR of 3.2 (95% CI 2.2-4.7) for perinatal death relative to non-obese women. In the non-active group the corresponding OR was 1.8 (95% CI 1.1-2.8) for obese women compared with non-obese women. The difference in perinatal mortality risk related to obesity between the active and non-active groups was statistically significant (P-value for interaction = 0.046, multiplicative model). CONCLUSIONS: Maternal obesity was associated with a two- to three-fold increased risk of perinatal death when compared with normal weight. For women with a BMI <30 the lowest perinatal mortality was seen in those performing recreational physical activity at least once a week.

Evaluation of the Coaches Educators training implementation of the PAPA project: A comparison between Norway and France.

This study cross-culturally compares the implementation process of the Empowering Coaching™ training program to grassroots coaches (GCs) by trained Coach Educators (CEs) from the Promoting Adolescent Physical Activity project in Norway and France. This program targets children's health through coach training to create a more positive environment. Using the RE-AIM framework, indicators of implementation processes at staff level were defined for adoption, implementation, and maintenance. CEs (n = 18) were interviewed about their professional use of the training, and video-filmed delivering the intervention trial workshops. GCs (n = 185) responded to a questionnaire after the workshops. Results showed that CEs were keen to participate in this project (16/18; 89%), to stay involved (12/16; 75%), and to diffuse the principles after the research project (12/12; 100%). CE training seemed effective as results indicated that CEs applied the principles of the program during the workshops and covered a high degree of the content (78%). Cross-cultural differences were found as the French Football Federation CE dropped out of the program, as Norwegian CEs delivered the content with higher fidelity and had higher enjoyment and pace scores than French CEs. More indicators are needed to use the RE-AIM framework for cross-cultural comparison.

Does socio-economic status moderate the associations between psychosocial predictors and fruit intake in schoolchildren? The Pro Children study.

This study tested whether socio-economic status (SES) moderated the association between the psychosocial constructs included in the attitude-social influence-self-efficacy (ASE) model and fruit intake in Norwegian schoolchildren. The sample consisted of 962 Norwegian sixth graders, mean age 11.3 years. They were split into three SES groups, and multi-group structural equation modeling (MSEM) was used. Children in the highest SES group reported eating fruit more frequently and reported more positive ASE variables than children in the lower SES groups. This was particularly true for social environmental factors, home availability of fruit and intention to eat fruit. MSEM showed that the relationships specified in the adapted ASE model were moderated by SES, as we did not find support for equal model structure across the three samples. Model modification for each SES group separately showed that the relation between home availability and fruit intake was not significant for the medium and low SES groups, and the relation between self-efficacy and intention to eat fruit was not significant for the medium SES group. Future interventions aiming at increasing fruit intake in children need to be sensitive to such SES-related differences and should in particular affect factors that may impede fruit intake in the lower SES groups.

The Health Behaviour in School-aged Children (HBSC) study: methodological developments and current tensions.

OBJECTIVES: To describe the methodological development of the HBSC survey since its inception and explore methodological tensions that need to be addressed in the ongoing work on this and other large-scale cross-national surveys. METHODS: Using archival data and conversations with members of the network, we collaboratively analysed our joint understandings of the survey's methodology. RESULTS: We identified four tensions that are likely to be present in upcoming survey cycles: (1) maintaining quality standards against a background of rapid growth, (2) continuous improvement with limited financial resources, (3) accommodating analysis of trends with the need to improve and adapt questionnaire content, and (4) meeting the differing requirements of scientific and policy audiences. CONCLUSIONS: While these challenges are not trivial, the structure of the HBSC network and its long-term experience in working through such challenges renders it likely that HBSC can provide a model of other similar studies facing these tensions.

Health Behaviour in School-aged Children (HBSC) study: international report from the 2001 / 2002 survey

This report covers the physical, emotional and psychological aspects of health, and the influences of the family, schools and peers on young people aged 11, 13 and 15 years in 35 countries and regions in the WHO European Region and North America, and gives comprehensive cross-national data on health and well-being, smoking, alcohol consumption, physical activity and sedentary behaviour, eating habits and body image, oral health, bullying and fighting, injuries, cannabis use, and sexual health. Document in pdf format; Acrobat Reader required.

[Psychological and somatic complaints among adolescents]. / Psykiske og somatiske plager blant ungdom.

BACKGROUND: Health promotion and disease prevention among adolescents should include efforts to reduce the burden of health complaints. In order to develop systematic preventive approaches, epidemiological research is needed. This study focuses on prevalence, gender differences, and intercorrelations among such complaints. MATERIAL AND METHODS: The data were drawn from a nationwide (Norwegian) survey among pupils in compulsory school grades 6, 8, and 10 (age 11, 13, and 15); response rate 79%. RESULTS: Among 15-year-olds, most health complaints were more prevalent among girls than among boys. A principal components analysis revealed a dimension from primarily psychological to primarily somatic complaints. Among 15-year-olds, 18% reported at least one daily psychological complaint and 14% reported at least one daily somatic complaint. Sum-scores for psychological and somatic complaints were constructed, the intercorrelation being 0.56 among 15-year-olds. Girls scored significantly higher than boys on both sum-scores. Among girls there was a marked increase in scores with age (particularly for somatic complaints). INTERPRETATION: The high prevalence of complaints among both genders and the increase with age among girls implies that preventive action is needed. The intercorrelations among complaints indicate common etiological processes.

Time trends in oral health behaviors among Norwegian adolescents: 1985-97.

The purpose of this study was to investigate 1) the temporal changes in oral health behaviors and 2) the development of the distribution of oral health behaviors on the basis of socioeconomic factors among Norwegian adolescents from 1985 to 1997. Large-scale national surveys to assess smoking, intake of sweets, soft drink consumption, and toothbrushing among Norwegian adolescents were conducted in November 1985, 1989, 1993, and 1997. The surveys were part of the World Health Organisation (WHO) international study, Health Behaviour in School-aged Children. A total of 3955 (1985), 5037 (1989), 4952 (1993), and 5026 (1997) 11-, 13-, and 15-year-old students completed anonymous questionnaires at school. The response rates varied from 79% to 90%. The results showed a strong increase in the percentages reporting ever smoking and daily intake of soft drinks and sweets with age from 11 to 15 years in each survey year. In 1997, at the age of 15 years, most students reported toothbrushing more than once a day (94% boys, 97% girls) and ever smoking (39% boys, 36% girls), whereas moderate proportions confirmed daily intake of soft drinks (28% boys, 19% girls). Comparison of the results across the survey years, from 1985 to 1997, showed an overall decrease in ever smoking (boys, 59% versus 39%; girls, 52%, versus 36%) and toothbrushing more than once a day (boys, 95% versus 94%; girls, 99% versus 97%). Contemporary increases occurred with regard to daily soft drink consumption. Inequalities in ever smoking and daily soft drink consumption between socioeconomic status groups decreased and increased, respectively, from 1983 to 1997. The sex disparities observed in 1985, with boys being more likely than girls to report ever smoking and daily soft drink consumption, leveled off in 1997.

Health-promoting schools in Australia: models and measurement.

Schools represent a very attractive setting for health promotion. Most children and young people attend school, professional educators are in place, and most school communities are microcosms of the larger community, providing opportunities for children to develop and practice the skills necessary to support a healthy life-style. In response to this opportunity, the precepts of contemporary health promotion have been synthesised into the 'health-promoting school' model, which is guided by a holistic view of health and by the principles of equity and empowerment. Although there are different conceptions of the model, the key components are: the formal curriculum; school ethos (the social climate); the physical environment; the policies and practices of the school; school health services; and the school-home-community interaction. The health-promoting school model offers a comprehensive, systematic approach to health promotion in the school setting, which is widely accepted internationally. There have been few studies in Australia that have attempted to determine the prevalence of activities related to the model or to evaluate interventions. Unfortunately, conceptual and practical advances have far outstripped the development of research and evaluation instruments. There is an urgent need to create valid research tools to support the development and implementation of this potentially fruitful health promotion model.