Heike Hölling

The challenge of comprehensively mapping children's health in a nation-wide health survey: Design of the German KiGGS-Study

BackgroundFrom May 2003 to May 2006, the Robert Koch Institute conducted the German Health Interview and Examination Survey for Children and Adolescents (KiGGS). Aim of this first nationwide interview and examination survey was to collect comprehensive data on the health status of children and adolescents aged 0 to 17 years.Methods/DesignParticipants were enrolled in two steps: first, 167 study locations (sample points) were chosen; second, subjects were randomly selected from the official registers of local residents. The survey involved questionnaires filled in by parents and parallel questionnaires for children aged 11 years and older, physical examinations and tests, and a computer assisted personal interview performed by study physicians. A wide range of blood and urine testing was carried out at central laboratories. A total of 17 641 children and adolescents were surveyed – 8985 boys and 8656 girls. The proportion of sample neutral drop-outs was 5.3%. The response rate was 66.6%.DiscussionThe response rate showed little variation between age groups and sexes, but marked variation between resident aliens and Germans, between inhabitants of cities with a population of 100 000 or more and sample points with fewer inhabitants, as well as between the old West German states and the former East German states. By analysing the short non-responder questionnaires it was proven that the collected data give comprehensive and nationally representative evidence on the health status of children and adolescents aged 0 to 17 years.

German health interview and examination survey for adults (DEGS) - design, objectives and implementation of the first data collection wave

BackgroundThe German Health Interview and Examination Survey for Adults (DEGS) is part of the recently established national health monitoring conducted by the Robert Koch Institute. DEGS combines a nationally representative periodic health survey and a longitudinal study based on follow-up of survey participants. Funding is provided by the German Ministry of Health and supplemented for specific research topics from other sources.Methods/designThe first DEGS wave of data collection (DEGS1) extended from November 2008 to December 2011. Overall, 8152 men and women participated. Of these, 3959 persons already participated in the German National Health Interview and Examination Survey 1998 (GNHIES98) at which time they were 18–79 years of age. Another 4193 persons 18–79 years of age were recruited for DEGS1 in 2008–2011 based on two-stage stratified random sampling from local population registries. Health data and context variables were collected using standardized computer assisted personal interviews, self-administered questionnaires, and standardized measurements and tests. In order to keep survey results representative for the population aged 18–79 years, results will be weighted by survey-specific weighting factors considering sampling and drop-out probabilities as well as deviations between the design-weighted net sample and German population statistics 2010.DiscussionDEGS aims to establish a nationally representative data base on health of adults in Germany. This health data platform will be used for continuous health reporting and health care research. The results will help to support health policy planning and evaluation. Repeated cross-sectional surveys will permit analyses of time trends in morbidity, functional capacity levels, disability, and health risks and resources. Follow-up of study participants will provide the opportunity to study trajectories of health and disability. A special focus lies on chronic diseases including asthma, allergies, cardiovascular conditions, diabetes mellitus, and musculoskeletal diseases. Other core topics include vaccine-preventable diseases and immunization status, nutritional deficiencies, health in older age, and the association between health-related behavior and mental health.

Der Kinder- und Jugendgesundheitssurvey (KiGGS): Studienmanagement und Durchführung der Feldarbeit

UNLABELLED From May 2003 to May 2006, the Robert Koch Institute conducted the German Health Interview and Examination Survey for Children and Adolescents (KiGGS). Nationwide data collection in 167 cities and municipalities was carried out by 4 survey teams, each consisting of a physician, centre interviewer, examiner, medical laboratory technician, environmental interviewer. Regional and seasonal factors were excluded by systematised route planning. Invitation of the participants and appointments for examinations were handled by a survey office with subsidised service telephone. Data processing in the survey office was performed using an SQL data base system programmed in the RKI. One central and several regional members of staff performing preparatory field visits were responsible for finding suitable examination rooms and for subject recruitment respectively. To further increase the response rate, continuous public relation actions were established. The survey involved questionnaires filled in by parents and parallel questionnaires for children from the age of 11 years onwards, physical examinations and tests and a computer assisted personal interview performed by the physician. The wide range of blood and urine testing carried out at central laboratories required standardised transport logistics. To achieve a high degree of standardisation of the survey, the examination teams were initially trained and then underwent continuous further training. The concept of quality management covered action of internal and independent external quality control monitoring each data collecting and data processing step as well as the training courses. CONCLUSION Dedicated public relations activities and the deployment of staff performing preparatory field visits increased the willingness of the subjects to participate. Intensive personnel care and continuous quality checks contribute to increased job satisfaction and data quality. By bindingly defining all laboratory diagnostic processes as well as transport logistics, high-quality laboratory test results are ensured. The conduct of the study from design via conduct to data processing and analysis by one institution guarantees complete control of all steps of the survey.ZusammenfassungVon Mai 2003 bis Mai 2006 führte das Robert Koch-Institut (RKI) den Kinder- und Jugendgesundheitssurvey (KiGGS) durch. Zur Datenerhebung waren bundesweit in 167 Städten und Gemeinden insgesamt 4 Untersuchungsteams – bestehend aus Arzt, Zentrumsinterviewern, Untersucherin, MTA, Umweltinterviewer – im Einsatz. Regionale und saisonale Einflüsse wurden mit einem systematisierten Routenplan ausgeschlossen. Die Einladung der Teilnehmer und die Vergabe von Untersuchungsterminen erfolgten über eine Survey-Geschäftsstelle mit kostensubventioniertem Service-Telefon. Die Datenverarbeitung in der Geschäftsstelle geschah mit Hilfe eines im RKI programmierten SQL-Datenbanksystems. Für die Beschaffung geeigneter Untersuchungsräume sowie zur Probandenwerbung wurden ein Zentraler bzw. mehrere Regionale Feldvorbegeher beschäftigt. Um die Ausschöpfungsquote zusätzlich zu erhöhen, wurde eine kontinuierliche Öffentlichkeitsarbeit eingerichtet. Im Rahmen der Untersuchung kamen schriftliche Selbstausfüllfragebogen für Eltern und zusätzlich für Kinder ab 11 Jahren körperliche Untersuchungen und Tests und ein computergestütztes ärztliches Interview zum Einsatz. Für die in zentralen Labors durchgeführte umfangreiche Blut- und Urindiagnostik war eine standardisierte Transportlogistik erforderlich. Zwecks weitgehender Standardisierung der Erhebung wurden die Untersuchungsteams initial geschult und kontinuierlich nachgeschult. Das Qualitätsmanagementkonzept umfasste Maßnahmen der internen und externen Qualitätskontrolle, die sich auf alle datenerhebenden und -verarbeitenden Schritte sowie die Schulungen erstreckte. Fazit: Engagierte Öffentlichkeitsarbeit und der Einsatz von Feldvorbegehern erhöhen die Teilnahmebereitschaft. Intensive Personalbetreuung und kontinuierliche Qualitätskontrollen tragen zu einer Erhöhung der Arbeitszufriedenheit und der Datenqualität bei. Eine verbindliche Festlegung sämtlicher labordiagnostischer Arbeitsabläufe und der Transportlogistik sichert eine hohe Qualität der Labormessdaten. Die Durchführung der Studie vom Design über die Durchführung bis zur Datenaufbereitung und -auswertung in einer Hand ermöglicht eine lückenlose Kontrolle aller Arbeitsschritte.AbstractFrom May 2003 to May 2006, the Robert Koch Institute conducted the German Health Interview and Examination Survey for Children and Adolescents (KiGGS). Nationwide data collection in 167 cities and municipalities was carried out by 4 survey teams, each consisting of a physician, centre interviewer, examiner, medical laboratory technician, environmental interviewer. Regional and seasonal factors were excluded by systematised route planning. Invitation of the participants and appointments for examinations were handled by a survey office with subsidised service telephone. Data processing in the survey office was performed using an SQL data base system programmed in the RKI. One central and several regional members of staff performing preparatory field visits were responsible for finding suitable examination rooms and for subject recruitment respectively. To further increase the response rate, continuous public relation actions were established. The survey involved questionnaires filled in by parents and parallel questionnaires for children from the age of 11 years onwards, physical examinations and tests and a computer assisted personal interview performed by the physician. The wide range of blood and urine testing carried out at central laboratories required standardised transport logistics. To achieve a high degree of standardisation of the survey, the examination teams were initially trained and then underwent continuous further training. The concept of quality management covered action of internal and independent external quality control monitoring each data collecting and data processing step as well as the training courses. Conclusion: Dedicated public relations activities and the deployment of staff performing preparatory field visits increased the willingness of the subjects to participate. Intensive personnel care and continuous quality checks contribute to increased job satisfaction and data quality. By bindingly defining all laboratory diagnostic processes as well as transport logistics, high-quality laboratory test results are ensured. The conduct of the study from design via conduct to data processing and analysis by one institution guarantees complete control of all steps of the survey.

Prevalence of mental health problems among children and adolescents in Germany: results of the BELLA study within the National Health Interview and Examination Survey.

BackgroundOver the past decades the public health relevance of mental health conditions in children and adolescents has been of growing concern. However, so far no detailed epidemiological data has been available for a representative national sample in Germany.ObjectivesThe present paper reports prevalence rates of general and specific mental health problems among children and adolescents in Germany and describes the link between symptoms and impairment as well as the treatment situation.MethodsThe mental health module (BELLA study) examines mental health problems in a representative sub-sample of 2,863 families with children aged 7–17 from the National Health Interview and Examination Survey among Children and Adolescents (KiGGS). Mental health problems were determined using the extended version of the strengths and difficulties questionnaire (SDQ). Further standardised screening measures were employed to screen for anxiety disorders (SCARED), conduct disorder (CBCL), attention deficit-/hyperactivity disorder (FBB-HKS, Conners’ Scale) and depressive disorders (CES-DC). Furthermore, substance abuse and suicidal tendencies were assessed. Health-related quality of life (HRQoL) and health care use were determined.ResultsOverall, 14.5% of the children and adolescents aged 7–17 fulfilled the criteria for at least one specific mental health problem associated with impairment, or had an overall mental health problem indicated by an abnormal SDQ score and present impairment. However, high comorbidity was found in the children concerned. Symptoms of overall mental health problems were present in 8.6% of the children and 6.6% of the adolescents. This number was reduced to prevalence rates of 6.3 and 4.9% when additional impairment was taken as a criterion. Irrespective of the type of disorder, fewer than half of the children affected were reported as receiving treatment. However, for those suffering from mental health problems, large impairments in HRQoL were observed.ConclusionsThe observed prevalence of mental health problems as well as their large impact on well-being and functioning calls for early prevention. This is especially important with regard to the large decrease in HRQoL in the children and adolescents affected.

Gesundheitsmonitoring am Robert Koch-Institut

Since January 2008, the Robert Koch Institute (RKI) has been administrating a Health Monitoring System, i.e., health examination surveys and health interview surveys with longitudinal components being alternatingly performed. These surveys are continuously accompanied by annual cross-sectional interview surveys of the population living in Germany. The content and structure of the Health Monitoring System is explained and the actual on-going surveys are described in this paper. An overview of future surveys and their integration within the European context demonstrates the new quality in utilizing the data obtained by longitudinal and cross-sectional analyses for health reporting, health policies and health sciences.ZusammenfassungSeit Januar 2008 gibt es am Robert Koch-Institut (RKI) ein Gesundheitsmonitoring, das auf alternierend durchzuführenden Untersuchungs- beziehungsweise Befragungssurveys mit Längsschnittkomponenten beruht und kontinuierlich durch jährliche Querschnittsbefragungen der in Deutschland lebenden Bevölkerung begleitet wird. Das inhaltliche und strukturelle Konzept dieses Monitoringsystems wird erläutert, die aktuell laufenden Surveys werden vorgestellt. Ein Ausblick auf künftige Erhebungen und die Einordnung in den europäischen Kontext verdeutlicht die qualitativ neuen Nutzungsmöglichkeiten der im Längsschnitt und Querschnitt erhobenen Daten für die Gesundheitsberichterstattung, die Gesundheitspolitik und die Gesundheitswissenschaften.AbstractSince January 2008, the Robert Koch Institute (RKI) has been administrating a Health Monitoring System, i.e., health examination surveys and health interview surveys with longitudinal components being alternatingly performed. These surveys are continuously accompanied by annual cross-sectional interview surveys of the population living in Germany. The content and structure of the Health Monitoring System is explained and the actual on-going surveys are described in this paper. An overview of future surveys and their integration within the European context demonstrates the new quality in utilizing the data obtained by longitudinal and cross-sectional analyses for health reporting, health policies and health sciences.

Verhaltensauffälligkeiten bei Kindern und Jugendlichen - Erste Ergebnisse aus dem Kinder- und Jugendgesundheitssurvey (KiGGS)

ZusammenfassungPsychische Probleme im Kindes- und Jugendalter stellen gesundheitliche Beeinträchtigungen mit zum Teil schwerwiegenden Konsequenzen für das individuelle Wohlbefinden sowie die alltägliche und soziale Funktionsfähigkeit dar. Häufig sind diese Probleme auch mit starken Belastungen für das soziale Umfeld verbunden. Im Rahmen des Kinder- und Jugendgesundheitssurvey (KiGGS) beantworteten die Eltern von 14.478 Kindern und Jugendlichen im Alter von 3–17 Jahren den Strengths and Difficulties Questionnaire (SDQ), der Verhaltensauffälligkeiten und Stärken in den Bereichen emotionale Probleme, Hyperaktivität, Verhaltensprobleme, Probleme mit Gleichaltrigen und prosoziales Verhalten erfasst. Nach dem SDQ-Gesamtproblemwert sind 11,5 % der Mädchen (M) und 17,8 % der Jungen (J) verhaltensauffällig bzw. grenzwertig auffällig. 92,5 % der Mädchen bzw. 86,3 % der Jungen verfügen über ein adäquates prosoziales Verhalten. Die häufigsten Problembereiche sind Verhaltensprobleme (M = 11,9 %, J = 17,6 %) emotionale Probleme (M = 9,7 %, J = 8,6 %) und Hyperaktivitätsprobleme (M = 4,8 %, J = 10,8 %). Etwa 8,1 % der Befragten mit hohem sozioökonomischem Status, 13,4 % der mit mittlerem und 23,2 % der mit niedrigem Sozialstatus zeigen Hinweise auf psychische Probleme. Kinder mit Migrationshintergrund sind häufiger betroffen als Kinder von Nicht-Migranten. Die Resultate betonen die Notwendigkeit, beginnende psychische Probleme frühzeitig zu erkennen und ihnen präventiv zu begegnen. Insbesondere nur schwer erreichbare Gruppen wie z. B. sozial Benachteiligte oder Kinder mit Migrationshintergrund müssen hierbei berücksichtigt werden.AbstractMental health problems in children and adolescents constitute health impairments with major implications regarding individual wellbeing as well as daily and social functioning. In addition, these problems often burden the social partners of the individual. Within the German Health Interview and Examination Survey for Children and Adolescents (KiGGS), the parents of 14478 children and adolescents aged 3–17 answered the Strengths and Difficulties Questionnaire (SDQ) which assesses behavioral problems and strengths in the areas emotional problems, hyperactivity, behavioral problems, peer problems and prosocial behavior. According to the results of the Total Difficulties Score (SDQ) 11,5 % girls (G) and 17,8 % boys (B) are classified borderline or abnormal, respectively. 92,5 % (G) and 86,3 % (B) display an adequate pro social behavior. Most prevalent problem areas are behavioral problems (G = 11,9 %, B = 17,9 %), emotional problems (G = 9,7 %, B = 8,6 %) and hyperactivity problems (G = 4,8 %, B = 10,8 %). The test-data of approximately 8,1 % of the respondents with high socio-economic status (SES), 13,4 % of those with middle SES and 23,2 % of those with low SES hinted at mental health problems. Migrants are more frequently affected than non-migrants. Results point at the need for early detection and prevention of commencing mental health problems. Especially the noneasily accessible groups like those with low socioeconomic status or migrants have to be considered.

[The German Health Interview and Examination Survey for Children and Adolescents (KiGGS): study management and conduct of fieldwork].

UNLABELLED From May 2003 to May 2006, the Robert Koch Institute conducted the German Health Interview and Examination Survey for Children and Adolescents (KiGGS). Nationwide data collection in 167 cities and municipalities was carried out by 4 survey teams, each consisting of a physician, centre interviewer, examiner, medical laboratory technician, environmental interviewer. Regional and seasonal factors were excluded by systematised route planning. Invitation of the participants and appointments for examinations were handled by a survey office with subsidised service telephone. Data processing in the survey office was performed using an SQL data base system programmed in the RKI. One central and several regional members of staff performing preparatory field visits were responsible for finding suitable examination rooms and for subject recruitment respectively. To further increase the response rate, continuous public relation actions were established. The survey involved questionnaires filled in by parents and parallel questionnaires for children from the age of 11 years onwards, physical examinations and tests and a computer assisted personal interview performed by the physician. The wide range of blood and urine testing carried out at central laboratories required standardised transport logistics. To achieve a high degree of standardisation of the survey, the examination teams were initially trained and then underwent continuous further training. The concept of quality management covered action of internal and independent external quality control monitoring each data collecting and data processing step as well as the training courses. CONCLUSION Dedicated public relations activities and the deployment of staff performing preparatory field visits increased the willingness of the subjects to participate. Intensive personnel care and continuous quality checks contribute to increased job satisfaction and data quality. By bindingly defining all laboratory diagnostic processes as well as transport logistics, high-quality laboratory test results are ensured. The conduct of the study from design via conduct to data processing and analysis by one institution guarantees complete control of all steps of the survey.ZusammenfassungVon Mai 2003 bis Mai 2006 führte das Robert Koch-Institut (RKI) den Kinder- und Jugendgesundheitssurvey (KiGGS) durch. Zur Datenerhebung waren bundesweit in 167 Städten und Gemeinden insgesamt 4 Untersuchungsteams – bestehend aus Arzt, Zentrumsinterviewern, Untersucherin, MTA, Umweltinterviewer – im Einsatz. Regionale und saisonale Einflüsse wurden mit einem systematisierten Routenplan ausgeschlossen. Die Einladung der Teilnehmer und die Vergabe von Untersuchungsterminen erfolgten über eine Survey-Geschäftsstelle mit kostensubventioniertem Service-Telefon. Die Datenverarbeitung in der Geschäftsstelle geschah mit Hilfe eines im RKI programmierten SQL-Datenbanksystems. Für die Beschaffung geeigneter Untersuchungsräume sowie zur Probandenwerbung wurden ein Zentraler bzw. mehrere Regionale Feldvorbegeher beschäftigt. Um die Ausschöpfungsquote zusätzlich zu erhöhen, wurde eine kontinuierliche Öffentlichkeitsarbeit eingerichtet. Im Rahmen der Untersuchung kamen schriftliche Selbstausfüllfragebogen für Eltern und zusätzlich für Kinder ab 11 Jahren körperliche Untersuchungen und Tests und ein computergestütztes ärztliches Interview zum Einsatz. Für die in zentralen Labors durchgeführte umfangreiche Blut- und Urindiagnostik war eine standardisierte Transportlogistik erforderlich. Zwecks weitgehender Standardisierung der Erhebung wurden die Untersuchungsteams initial geschult und kontinuierlich nachgeschult. Das Qualitätsmanagementkonzept umfasste Maßnahmen der internen und externen Qualitätskontrolle, die sich auf alle datenerhebenden und -verarbeitenden Schritte sowie die Schulungen erstreckte. Fazit: Engagierte Öffentlichkeitsarbeit und der Einsatz von Feldvorbegehern erhöhen die Teilnahmebereitschaft. Intensive Personalbetreuung und kontinuierliche Qualitätskontrollen tragen zu einer Erhöhung der Arbeitszufriedenheit und der Datenqualität bei. Eine verbindliche Festlegung sämtlicher labordiagnostischer Arbeitsabläufe und der Transportlogistik sichert eine hohe Qualität der Labormessdaten. Die Durchführung der Studie vom Design über die Durchführung bis zur Datenaufbereitung und -auswertung in einer Hand ermöglicht eine lückenlose Kontrolle aller Arbeitsschritte.AbstractFrom May 2003 to May 2006, the Robert Koch Institute conducted the German Health Interview and Examination Survey for Children and Adolescents (KiGGS). Nationwide data collection in 167 cities and municipalities was carried out by 4 survey teams, each consisting of a physician, centre interviewer, examiner, medical laboratory technician, environmental interviewer. Regional and seasonal factors were excluded by systematised route planning. Invitation of the participants and appointments for examinations were handled by a survey office with subsidised service telephone. Data processing in the survey office was performed using an SQL data base system programmed in the RKI. One central and several regional members of staff performing preparatory field visits were responsible for finding suitable examination rooms and for subject recruitment respectively. To further increase the response rate, continuous public relation actions were established. The survey involved questionnaires filled in by parents and parallel questionnaires for children from the age of 11 years onwards, physical examinations and tests and a computer assisted personal interview performed by the physician. The wide range of blood and urine testing carried out at central laboratories required standardised transport logistics. To achieve a high degree of standardisation of the survey, the examination teams were initially trained and then underwent continuous further training. The concept of quality management covered action of internal and independent external quality control monitoring each data collecting and data processing step as well as the training courses. Conclusion: Dedicated public relations activities and the deployment of staff performing preparatory field visits increased the willingness of the subjects to participate. Intensive personnel care and continuous quality checks contribute to increased job satisfaction and data quality. By bindingly defining all laboratory diagnostic processes as well as transport logistics, high-quality laboratory test results are ensured. The conduct of the study from design via conduct to data processing and analysis by one institution guarantees complete control of all steps of the survey.

Behavioural problems in children and adolescents. First results from the German Health Interview and Examination Survey for Children and Adolescents (KiGGS)

ZusammenfassungPsychische Probleme im Kindes- und Jugendalter stellen gesundheitliche Beeinträchtigungen mit zum Teil schwerwiegenden Konsequenzen für das individuelle Wohlbefinden sowie die alltägliche und soziale Funktionsfähigkeit dar. Häufig sind diese Probleme auch mit starken Belastungen für das soziale Umfeld verbunden. Im Rahmen des Kinder- und Jugendgesundheitssurvey (KiGGS) beantworteten die Eltern von 14.478 Kindern und Jugendlichen im Alter von 3–17 Jahren den Strengths and Difficulties Questionnaire (SDQ), der Verhaltensauffälligkeiten und Stärken in den Bereichen emotionale Probleme, Hyperaktivität, Verhaltensprobleme, Probleme mit Gleichaltrigen und prosoziales Verhalten erfasst. Nach dem SDQ-Gesamtproblemwert sind 11,5 % der Mädchen (M) und 17,8 % der Jungen (J) verhaltensauffällig bzw. grenzwertig auffällig. 92,5 % der Mädchen bzw. 86,3 % der Jungen verfügen über ein adäquates prosoziales Verhalten. Die häufigsten Problembereiche sind Verhaltensprobleme (M = 11,9 %, J = 17,6 %) emotionale Probleme (M = 9,7 %, J = 8,6 %) und Hyperaktivitätsprobleme (M = 4,8 %, J = 10,8 %). Etwa 8,1 % der Befragten mit hohem sozioökonomischem Status, 13,4 % der mit mittlerem und 23,2 % der mit niedrigem Sozialstatus zeigen Hinweise auf psychische Probleme. Kinder mit Migrationshintergrund sind häufiger betroffen als Kinder von Nicht-Migranten. Die Resultate betonen die Notwendigkeit, beginnende psychische Probleme frühzeitig zu erkennen und ihnen präventiv zu begegnen. Insbesondere nur schwer erreichbare Gruppen wie z. B. sozial Benachteiligte oder Kinder mit Migrationshintergrund müssen hierbei berücksichtigt werden.AbstractMental health problems in children and adolescents constitute health impairments with major implications regarding individual wellbeing as well as daily and social functioning. In addition, these problems often burden the social partners of the individual. Within the German Health Interview and Examination Survey for Children and Adolescents (KiGGS), the parents of 14478 children and adolescents aged 3–17 answered the Strengths and Difficulties Questionnaire (SDQ) which assesses behavioral problems and strengths in the areas emotional problems, hyperactivity, behavioral problems, peer problems and prosocial behavior. According to the results of the Total Difficulties Score (SDQ) 11,5 % girls (G) and 17,8 % boys (B) are classified borderline or abnormal, respectively. 92,5 % (G) and 86,3 % (B) display an adequate pro social behavior. Most prevalent problem areas are behavioral problems (G = 11,9 %, B = 17,9 %), emotional problems (G = 9,7 %, B = 8,6 %) and hyperactivity problems (G = 4,8 %, B = 10,8 %). The test-data of approximately 8,1 % of the respondents with high socio-economic status (SES), 13,4 % of those with middle SES and 23,2 % of those with low SES hinted at mental health problems. Migrants are more frequently affected than non-migrants. Results point at the need for early detection and prevention of commencing mental health problems. Especially the noneasily accessible groups like those with low socioeconomic status or migrants have to be considered.

Der Kinder- und Jugendgesundheitssurvey (KiGGS): Risiken und Ressourcen für die psychische Entwicklung von Kindern und Jugendlichen

ZusammenfassungMit dem salutogenetischen Ansatz in den Gesundheitswissenschaften hat neben der Betrachtung von Risikofaktoren zunehmend auch die Frage nach Schutzfaktoren an Bedeutung gewonnen, die sich protektiv auf die psychische Entwicklung und die Gesundheit auswirken. Insgesamt 6691 Kinder und Jugendliche im Alter von 11–17 Jahren beantworteten im Rahmen des Kinder- und Jugendgesundheitssurvey (KiGGS) Fragebögen zu personalen, sozialen und familiären Ressourcen. Kinder aus Familien mit einem niedrigen sozioökonomischen Status weisen häufiger Defizite in ihren personalen, sozialen und familiären Ressourcen auf. Auch unter Kindern mit Migrationshintergrund findet sich ein größerer Prozentsatz mit schwach ausgeprägten personalen und sozialen Schutzfaktoren. Ältere Kinder berichten geringere familiäre, aber mehr soziale Ressourcen als jüngere, Mädchen verfügen im Vergleich zu Jungen über mehr soziale, aber weniger personale und familiäre Ressourcen. Deutliche Zusammenhänge sind zwischen Schutzfaktoren und gesundheitlichem Risikoverhalten zu erkennen. Defizite in personalen und familiären Ressourcen gehen mit einem erhöhten Risiko für Rauchen einher. Bei ausgeprägten sozialen Ressourcen lässt sich zwar ein erhöhter Anteil an rauchenden und Alkohol konsumierenden Kindern und Jugendlichen finden, das Risiko für Drogenerfahrungen ist jedoch nicht erhöht. Die Ergebnisse belegen die Notwendigkeit, Schutzfaktoren präventiv zu stärken. Insbesondere bei Kindern und Jugendlichen mit schwachen Schutzfaktoren bei gleichzeitigem Vorliegen von Belastungen muss von einem erhöhten Risiko für psychische Probleme ausgegangen werden.AbstractAlong with the salutogenetic approach in health sciences, the quest for factors exerting a protective effect on mental development and health has increasingly gained importance, complementing the study of risk factors. A total of 6,691 children and adolescents aged 11 to 17 years answered questionnaires on personal, social and family resources as part of the German Health Interview and Examination Survey for Children and Adolescents (KiGGS). Children with low socioeconomic status (SES) more frequently show deficits in their personal, social and family resources. Similarly, in children with migration background a higher percentage with poorly developed personal and social protective factors is found. Older children report less family resources but more social resources than younger children; in comparison to boys, girls have more social but less personal resources at their disposal. Clear connections are observed between protective factors and health-related risk-taking behaviour. Deficits in personal and family resources are associated with an increased risk for smoking. Although an increased percentage of smoking and alcohol consuming children and adolescents is found to be associated with well-developed social resources, the risk for drug experiences is not increased. The results prove the necessity to build up protective factors as a preventative measure. Especially in children and adolescents with weak protective factors, an increased risk of mental health problems can be expected in the presence of stressful events.

Psychische Auffälligkeiten und psychosoziale Beeinträchtigungen bei Kindern und Jugendlichen im Alter von 3 bis 17 Jahren in Deutschland – Prävalenz und zeitliche Trends zu 2 Erhebungszeitpunkten (2003–2006 und 2009–2012)

Child and adolescent mental health problems burden not only the individual, but also their families and their social environment and may, therefore, be regarded as a highly relevant public health issue. The data on mental health problems of children and adolescents from the KiGGS Wave 1 study (sample period 2009-2012) make it possible to report on both current prevalence rates and time trends over the 6-year period beginning with the KiGGS baseline survey (2003-2006). The assessment of emotional and behavioral problems in KiGGS Wave 1 was carried out with the symptoms questionnaire of the Strengths and Difficulties Questionnaire (SDQ) in a telephone interview with 10,353 guardians of children and adolescents aged 3-17 years. Moreover, using the SDQ impact supplement, the KIGGS Wave 1 data provide information on psychosocial impairment following child and adolescent mental health problems. Subjects with a borderline or abnormal SDQ score, according to German normative data, were considered at risk. A total of 20.2% (95% CI: 18.9-21.6%) of the study subjects were identified as being at risk for a mental health disorder, compared with 20.0% (19.1-20.9%) during the KiGGS baseline study (age-standardized based on population from 12 December 2010). Thus, no significant changes over time in the prevalence of mental health problems were detected. Also, there were no statistically significant differences in prevalence by sex, age group, or socioeconomic status between the KiGGS baseline survey and KiGGS Wave 1. The statistical comparison of the subscale mean values for both girls and boys showed higher values with respect to the subscales for emotional problems, behavioral problems, and prosocial behavior and lower mean values for the peer problems subscale in KiGGS Wave 1. These partly small temporal trends, however, may be due to possible mode effects (written questionnaire in the KiGGS baseline study versus telephone interview in KiGGS Wave 1). The hyperactivity subscale remained stable across the two sample periods. Regarding impairments following mental health problems at the second sample period, boys were more affected in the areas of chronicity, family burden, and impact score. The high and stable prevalence rates and magnitude of emotional and behavioral problems should prompt increased preventive efforts.