Ilze Kalnins

Adolescents with physical disabilities: some psychosocial aspects of health.

PURPOSE To examine the psychosocial issues related to growing up with a physical disability. METHODS Adolescents with physical disabilities aged 11-16 years were compared with a Canadian national sample of adolescents using the Health Behaviours in School-Aged Children (HBSC), a World Health Organization Cross-National Study survey. RESULTS Adolescents with physical disabilities reported good self-esteem, strong family relationships, and as many close friends as adolescents in the national sample. However, adolescents with physical disabilities participated in fewer social activities and had less intimate relationships with their friends. They had more positive attitudes toward school, teachers, and their fellow classmates than the national sample, but fewer had plans for postsecondary education. The majority of adolescents with physical disabilities reported that they had not received information on parenthood, birth control, and sexually transmitted diseases. CONCLUSIONS There are a number of critical areas of risk for adolescents with physical disabilities to which health promotion efforts should be directed. These include lower levels of peer integration, heightened adult orientation, low educational aspirations, and poor knowledge of sexuality.

Age-related health risk behaviors of adolescents with physical disabilities

SummaryObjective: To investigate age-related differences in health risk behaviors in 11–12-, 13–14-, and 15–16-year-old adolescents with physical disabilities. Method: Health survey data from 319 adolescents with physical disabilities were compared with the same data from 7 020 adolescents in a national sample. Results: Significant age-related differences were found for having tried smoking, smoking, having tasted an alcoholic drink, having been drunk, and using prescription drugs for recreational purposes. However, changes were modest and engagement of 15–16-year-old adolescents with physical disabilities was similar to 11–12-year-olds in the general population. Analysis of associations between disability status and health risk behaviors while controlling for age and sex showed that disability is associated with a lower likelihood of having tried smoking, smoking, having tasted an alcoholic drink, drinking, having been drunk, having used drugs, having used prescription drugs for recreational purposes, and eating sweets; a higher likelihood of not engaging in physical exercise, not eating fresh produce, and eating high-fat foods; and non-significant for seat-belt use. Conclusion: Health promotion programs about health risk behaviours designed for adolescents in the general population may not be appropriate for adolescents with physical disabilities.

Children's Concepts of Health and Illness— and Implications for Health Education: An Overview

Research on childrens concepts of health and illness has been dominated by two theoretical approaches. The first has been concerned with the delineation of age-related qualitative changes in childrens concepts of health and illness and the interpretation of these changes within a Piagetian framework. The second approach, based on expectancy theory from social psychology, has focused on childrens perceptions of vulnerability to health problems and the relationship of these to potential health behavior. Both approaches have emphasized childrens concepts of illness or of health problems. Thus, there is a dearth of literature on concepts of health per se.

Bullying and subjective health among adolescents at schools in Latvia and Lithuania.

SummaryObjectives:To investigate the prevalence of bullying among adolescents in Latvia and Lithuania and to study its association with self-rated health, health complaints, and life satisfaction.Methods:A total of 3417 students in Latvia and 5626 in Lithuania were surveyed using the Health Behaviour Study among School-aged Children 2001/2002 (HBSC) questionnaire and research protocol.Results:Being a victim, bully, or bully/victim was reported by 30.1% adolescents in Latvia and 52.3% in Lithuania with the highest proportion reporting being a victim. Bullying was associated with poor subjective health and low life satisfaction.Conclusions:The factors explaining the difference of bullying prevalence between both countries should be studied to develop effective anti-bullying interventions relevant to local conditions.

Individualist and structuralist perspectives on nutrition education for Canadian children

The controversy over the most efficacious approach to health education is presented as a debate between the individualist perspective which stresses lifestyle change and the structuralist perspective which emphasizes change in socio-political conditions. Within the context of nutrition education for Canadian children as a case study, the two perspectives are compared and contrasted with respect to their definitions of (1) the root causes of poor health, (2) the most appropriate strategies for health education programs and (3) the training and subsequent role of the health educator in health promotion. The authors discuss the conflict between the two perspectives and suggest that synthesis is needed for progressive health promotion for Canadian children to occur.

HEALTH PROMOTING SCHOOLS: A QUIET REVOLUTION IN YOUNG PEOPLE'S HEALTH AND EDUCATION IN LATVIA

Abstract The World Health Organization has operationalized health promotion in schools through a Health Promoting Schools (HPS) ideology that proposes that the entire school setting must support student well-being and health through the curriculum, the school environment, and links with family and community. In this paper we trace the development of HPS ideology in Latvia and evaluate its successes. We note that HPS has developed the required administrative infrastructure, a health education curriculum, and has successfully implemented health projects, particularly around lifestyle health issues. It has been less successful in establishing links with parents and the community.

Mental health and depression among adolescents in Latvia

Depression is a common sign of distress in the adult population. Its occurrence has been linked to life stress, poor interpersonal relationships, breakdown in social, emotional, and intellectual functioning, and suicide. Contrary to previously held beliefs, it has been found that youth and schoolage children also suffer from depressive symptoms. There is growing evidence that at any given time between 5% and 10% of the normal school population are depressed and that this percentage is even higher among adolescents, particularly girls1. Investigations with learning disabled children suggest that as many as 25% to 50% show signs of depression2. Depression is increasingly recognized as a serious problem among the young people; it contributes to poor social and academic functioning and is linked to risk of suicide. Thus, educators in Western countries are becoming more concerned about identification and intervention issues related to this

HEALTH FOR ALL YOUNG PEOPLE IN EUROPE: THE WORLD HEALTH ORGANIZATION CROSS-NATIONAL STUDY ON HEALTH BEHAVIOUR IN SCHOOL-AGED CHILDREN (HBSC) IN LATVIA

According to the World Health Organization, health is more than the absence of disease. Health encompasses physical, emotional and social well-being. It is a resource that allows people to realize their full potential.1 To better understand how this conception of health applies to young people, researchers in Europe and Canada have jointly collected information from eleven to sixteen-year-old children on their health behaviours, attitudes and health status. This international collaborative project is known as the Cross-National Study cmi Health Behaviour in School-Aged Children (HBSC). The project was initiated in 1982 as a collaborative pilot project involving researchers in England, Finland and Noway. Shortly thereafter it was adopted by the World Health Organization European Division as a collaborative study. In 1983-84 the first HBSC survey was conducted in the three original countries as well as in Austria. In 1985-86, eleven countries participated. In 1989-90 the HBSC survey was conducted in fourteen countries including Austria, Belgium, Canada, Finland, Hungary, Latvia, the Netherlands, Norway, Poland, Scotland, Spain, Sweden, Switzerland and Wales.2 The major objectives of this international comparative approach are first to increase understanding of the factors associated with health risk behaviours among young people within the social context of their lives and second, to contribute to the development of strategies and interventions that will reduce risk behaviours. Surveys are conducted at four-year intervals to show changes in health risk behaviours and to identify factors that might have contributed to these changes. The behaviours investigated are tobacco and alcohol use, nutrition, exercise, dental hygiene, safety, and sexual behaviours. The social context includes the family, peers and school. The HBSC survey in Latvia in 1990 was the first ever national health survey of young people. The information gained from it represents a valuable data base that is directly relevant to the formation of health policy, the