Pernille Bendtsen

Decreases in adolescent weekly alcohol use in Europe and North America: evidence from 28 countries from 2002 to 2010

BACKGROUND This study examined trends in adolescent weekly alcohol use between 2002 and 2010 in 28 European and North American countries. METHODS Analyses were based on data from 11-, 13- and 15-year-old adolescents who participated in the Health Behaviour in School-Aged Children (HBSC) study in 2002, 2006 and 2010. RESULTS Weekly alcohol use declined in 20 of 28 countries and in all geographic regions, from 12.1 to 6.1% in Anglo-Saxon countries, 11.4 to 7.8% in Western Europe, 9.3 to 4.1% in Northern Europe and 16.3 to 9.9% in Southern Europe. Even in Eastern Europe, where a stable trend was observed between 2002 and 2006, weekly alcohol use declined between 2006 and 2010 from 12.3 to 10.1%. The decline was evident in all gender and age subgroups. CONCLUSIONS These consistent trends may be attributable to increased awareness of the harmful effects of alcohol for adolescent development and the implementation of associated prevention efforts, or changes in social norms and conditions. Although the declining trend was remarkably similar across countries, prevalence rates still differed considerably across countries.

Perceived problems with computer gaming and internet use among adolescents: measurement tool for non-clinical survey studies.

BackgroundExisting instruments for measuring problematic computer and console gaming and internet use are often lengthy and often based on a pathological perspective. The objective was to develop and present a new and short non-clinical measurement tool for perceived problems related to computer use and gaming among adolescents and to study the association between screen time and perceived problems.MethodsCross-sectional school-survey of 11-, 13-, and 15-year old students in thirteen schools in the City of Aarhus, Denmark, participation rate 89%, n = 2100. The main exposure was time spend on weekdays on computer- and console-gaming and internet use for communication and surfing. The outcome measures were three indexes on perceived problems related to computer and console gaming and internet use.ResultsThe three new indexes showed high face validity and acceptable internal consistency. Most schoolchildren with high screen time did not experience problems related to computer use. Still, there was a strong and graded association between time use and perceived problems related to computer gaming, console gaming (only boys) and internet use, odds ratios ranging from 6.90 to 10.23.ConclusionThe three new measures of perceived problems related to computer and console gaming and internet use among adolescents are appropriate, reliable and valid for use in non-clinical surveys about young people’s everyday life and behaviour. These new measures do not assess Internet Gaming Disorder as it is listed in the DSM and therefore has no parity with DSM criteria. We found an increasing risk of perceived problems with increasing time spent with gaming and internet use. Nevertheless, most schoolchildren who spent much time with gaming and internet use did not experience problems.

Adolescent Alcohol Use Reflects Community-Level Alcohol Consumption Irrespective of Parental Drinking

PURPOSE Risk factors for adolescent alcohol use are typically conceptualized at the individual level, and school- and community-level risk factors have received little attention. Based on the theoretical understanding of youth alcohol consumption as a reflection of community social practice, we analyzed whether adolescent drunkenness was related to community-level adult alcohol use (AAC), when taking individual and school-level risk factors for drunkenness into account. Furthermore, we investigated whether the association between community-level AAC and adolescent drunkenness was attenuated after inclusion of parental drinking. METHODS We used data from three sources: data about adolescent drunkenness from the Health Behavior in School-Aged Children 2010 survey (N = 2,911; 13- to 15-year-olds nested in 175 school classes and 51 schools); data about community-level AAC derived from the Danish National Health Survey 2010 (177,639 participants); and data on school-level variables from Health Behavior in School-Aged Children School Leader Survey 2010. We performed multilevel logistic regression analysis with data from students nested within school classes and schools. RESULTS Overall, 33.5% of students had been drunk twice or more. High community-level AAC was significantly associated with adolescent drunkenness (odds ratio [95% confidence interval], 1.94 [1.21-3.11]). Parental drinking was strongly related to adolescent drunkenness but did not attenuate the relationship between community-level AAC and adolescent drunkenness. We found no association between adolescent drunkenness and school-level variables (youth friendly environment, alcohol education, and exposure to alcohol outlets). CONCLUSIONS Adolescent drunkenness was associated with community-level AAC and was not explained by parental drinking.

Emotional symptoms among adolescents: epidemiological analysis of individual-, classroom- and school-level factors

BACKGROUND Large proportions of schoolchildren suffer from emotional symptoms and there are large variations across schools. It is unknown to what degree this variation is due to composition of schoolchildren in each school or to contextual factors. Objectives are to identify factors at individual, classroom and school levels associated with emotional symptoms. METHOD Data stem from the Danish contribution to the international Health Behaviour in School-aged Children study 2010 including 4922 schoolchildren aged 11-15-years from a random sample of schools and including data from school leaders. Emotional symptoms are defined as daily presence of at least one of four symptoms: feeling low, irritable or bad tempered, nervous and having difficulties falling asleep. Multilevel multivariable logistic regression analyses are applied to identify and quantify factors at individual, classroom and school level. RESULTS Schoolchildren from low (odds ratio (OR) 1.70, 95% CI: 1.33-2.17) and medium (OR 1.50, 95% CI: 1.22-1.85) occupational social class (OSC), girls (OR 1.32, 95% CI: 1.13-1.56) and schoolchildren exposed to bullying (OR 3.82, 95% CI: 2.71-5.40), had increased odds for emotional symptoms. A negative classroom climate was associated with emotional symptoms (OR 1.29, 95% CI: 0.99-1.69) and so was being part of classrooms with a high prevalence of bullying (OR 1.28, 95% CI: 1.0-1.60). CONCLUSION Female sex, low OSC, single parent family, exposure to bullying and a high prevalence of bullying within a class are all associated with emotional symptoms. Most variation across schools is explained by individual-level factors but psychosocial aspects of the classroom environment also play a role.

Social inequalities in self-rated health: A comparative cross-national study among 32,560 Nordic adolescents

Aims: We aimed to estimate the magnitude of socioeconomic inequality in self-rated health among Nordic adolescents (aged 11, 13 and 15 years) using the Family Affluence Scale (a composite measure of material assets) and perceived family wealth as indicators of socioeconomic status. Methods: Data were collected from the Health Behaviour in School-aged Children (HBSC) survey in 2013–2014. A sample of 32,560 adolescents from Denmark, Norway, Finland, Iceland, Greenland and Sweden was included in the study. Age-adjusted regression analyses were used to estimate associations between fair or poor self-rated health and the ridit scores for family affluence and perceived wealth. Results: The pooled relative index of inequality of 2.10 indicates that the risk of fair or poor health was about twice as high for young people with the lowest family affluence relative to those with the highest family affluence. The relative index of inequality for observed family affluence was highest in Denmark and lowest in Norway. For perceived family wealth, the pooled relative index of inequality of 3.99 indicates that the risk of fair or poor health was about four times as high for young people with the lowest perceived family wealth relative to those with the highest perceived family wealth. The relative index of inequality for perceived family wealth was highest in Iceland and lowest in Greenland. Conclusions: Social inequality in self-rated health among adolescents was found to be robust across subjective and objective indicators of family affluence in the Nordic welfare states.

The Danish National Youth Study 2014: Study design, population characteristics and non-response analysis:

Aims: This paper aims to give a description of the Danish National Youth Study 2014 in terms of study design, study population and questionnaire content. The differences between participants and non-participants regarding socioeconomic characteristics are also described. Methods: The Danish National Youth Study 2014 was a web-based survey with data collected through self-completion questionnaires administered in the classroom. There were two questionnaires: one for students, with >250 core questions; and one for school leaders on the school environment. Data collection took place at 119 high schools and 10 vocational schools. Results: A total of 75,853 students participated (70,674 high school students and 5179 vocational school students). In the participating schools, 85% of high school students and 69% of vocational school students took part in the survey. A total of 166 school leaders responded. Among the high school students, 61% were girls, and among vocational school students, 24% were girls. The average age was 17.9 years for high school students and 20.9 years for vocational school students. Participants were more likely than non-participants to be of Danish origin and to have parents with higher educational levels and a higher disposable income. Conclusions: The Danish National Youth Study 2014 contributes to knowledge on adolescent health behaviour, health and well-being. It is unique in its size, diversity of questionnaire content, high participation rate and possibility of linkage to various national registers through the Danish Civil Registration System. The study offers great opportunities for health planning and a wide range of future research projects.

Sunbed use among 64,000 Danish students and the associations with demographic factors, health-related behaviours, and appearance-related factors

Sunbed use is associated with an increased risk for skin cancer and is particularly dangerous for younger persons. The objective of this study was to assess how demographic factors, health-related behaviours and appearance-related factors are associated with sunbed use. Cross-sectional data from the Danish National Youth Study collected by the National Institute of Public Health during 2014 was used. A total of 64,382 students aged 15-25years were included in the present study. Multilevel logistic regression analyses were used to determine associations. Sunbed use during the past 12months was reported by 22% of students, with a higher proportion among females (29%) than males (12%). Factors associated with sunbed use were older age, studying at a vocational college or a higher preparatory examination school compared to upper secondary school, and lower parental education. Furthermore, being a smoker, been binge-drinking, longer duration of exercise and been dieting were also associated with sunbed use. For females, poor dietary habits were also associated with sunbed use. Feeling overweight was associated with lower odds for sunbed use for males, but with higher odds for females. Lower body satisfaction was associated with higher odds of sunbed use, except for overweight males. Students who were underweight had lower odds for sunbed use, than normal weight students. Conclusively, we found evidence of associations between demographic factors, health-related behaviours and appearance-related factors and sunbed use. Understanding these relations could help to identify high-risk groups and guide preventive strategies for sunbed use and skin cancer prevention.