How 15- to 16-year-old Swedish adolescents experience social relationships and health-related behaviours: A qualitative study.

Aims: Health-related behaviours are associated with social relationships. Adolescence is a time when healthy and unhealthy behaviours are established. There is a need to investigate adolescents' views on how social relationships are related to health-related behaviours of adolescents in the Scandinavian welfare system. This study aimed to explore Swedish adolescents' experiences and thoughts of how social relationships in different social environments are related to health-related behaviours. Methods: A total of 36 adolescents aged 15-16 years were interviewed in seven focus-group sessions. Qualitative content analysis was used for analysis of the transcribed interviews. Results: Two themes - social context and personal management - emerged. Swedish adolescents describe that their health-related behaviours as being partly shaped by their own personal management but mainly by the social contexts that surround them. Social contexts were expressed as playing a role in the adolescents' health-related behaviours, as they provide fellowship, pressure, dependability and engagement. Fellowship with friends and family was expressed as providing healthy behaviours and high levels of well-being. Fellowship with friends was particularly important for physical activity. Close relationships were stated to influence health-related behaviours. Pressure from friends, teachers and social media were described as mainly influencing unhealthy behaviours and, to some extent, low levels of well-being. However, adolescents' personal ability illustrated how adolescents shaped their own health-related behaviours. Conclusions: The study results contribute to the understanding of Swedish adolescents' views on how social relationships can shape their health-related behaviours. The findings may be useful to school professionals in supporting adolescents to improve well-being and healthy behaviours.

Psychosocial vulnerability underlying four common unhealthy behaviours in 15-16-year-old Swedish adolescents: a cross-sectional study.

BACKGROUND: Factors that influence unhealthy behaviours in adolescents may have different impacts in different sociocultural settings. There is lack of research on the association between psychosocial vulnerability and unhealthy behaviours in adolescents, particularly outside the United States. The aim was to investigate both direct and indirect relationships between psychosocial conditions (subjective well-being, social relationships and self-esteem) and four health-related behaviours (smoking, alcohol consumption, meal frequency and physical activity) in Swedish adolescents aged 15-16 years. Socio-demographic variables (socio-economic status, gender and age) were also investigated. METHODS: To study these associations, a hypothesised model was tested using structural equation modelling. In the hypothesised model, interrelated psychosocial conditions (low well-being, poor social relationships and low self-esteem) and socio-demographic factors (low self-perceived socio-economic status, being female and higher age) together represented a vulnerability underlying smoking, alcohol consumption, irregular meal frequency and low level of physical activity. In this cross-sectional study, self-report questionnaires were used to collect data from 492 adolescents. RESULTS: Hypothesised pathways between psychosocial conditions, socio-demographic factors and the four unhealthy behaviours were confirmed. Low well-being was strongly associated with unhealthy behaviours, and poor social relationships showed a strong indirect association with the unhealthy behaviours. Low self-esteem, low self-perceived socio-economic status and female gender were also vulnerability factors for the unhealthy behaviours. CONCLUSIONS: Vulnerability for four common unhealthy behaviours was found in Swedish adolescents. This study presents the interrelationships of psychosocial and socio-demographic factors and how they were related with unhealthy behaviours. The results bring new insight into how psychosocial factors are related to unhealthy behaviours in adolescents living in northern Europe.

Vulnerability to unhealthy behaviours across different age groups in Swedish Adolescents: a cross-sectional study.

Purpose: There is lack of evidence on the effects of health-promoting programmes among adolescents. Health behaviour models and studies seldom compare the underlying factors of unhealthy behaviours between different adolescent age groups. The main objective of this study was to investigate factors including sociodemographic parameters that were associated with vulnerability to health-damaging behaviours and non-adoption of health-enhancing behaviours in different adolescent age groups. Methods: A survey was conducted among 10,590 pupils in the age groups of 13-14, 15-16 and 17-18 years. Structural equation modelling was performed to determine whether health-damaging behaviours (smoking and alcohol consumption) and non-adoption of health-enhancing behaviours (regular meal habits and physical activity) shared an underlying vulnerability. This method was also used to determine whether gender and socio-economic status were associated with an underlying vulnerability to unhealthy behaviours. Results: The findings gave rise to three models, which may reflect the underlying vulnerability to health-damaging behaviours and non-adoption of health-enhancing behaviours at different ages during adolescence. The four behaviours shared what was interpreted as an underlying vulnerability in the 15-16-year-old age group. In the youngest group, all behaviours except for non-participation in physical activity shared an underlying vulnerability. Similarly, alcohol consumption did not form part of the underlying vulnerability in the oldest group. Lower socio-economic status was associated with an underlying vulnerability in all the age groups; female gender was associated with vulnerability in the youngest adolescents and male gender among the oldest adolescents. Conclusions: These results suggest that intervention studies should investigate the benefits of health-promoting programmes designed to prevent health-damaging behaviours and promote health-enhancing behaviours in adolescents of different ages. Future studies should examine other factors that may contribute to the underlying vulnerability in different age groups.