Pilar Ramos

Physical activity and self-reported health status among adolescents: A cross-sectional population-based study

Objectives Little is known about the dose–response relationship between physical activity and health benefits among young people. Our objective was to analyse the association between the frequency of undertaking moderate-to-vigorous physical activity (MVPA) and the self-reported health status of the adolescent population. Design Cross-sectional study. Setting All regions of Spain. Participants Students aged 11–18 years participating in the Spanish Health Behaviour in School-aged Children survey 2006. A total of 375 schools and 21 188 students were selected. Main outcomes The frequency of undertaking MVPA was measured by a questionnaire, with the following four health indicators: self-rated health, health complaints, satisfaction with life and health-related quality of life. Linear and logistic regression models were used to analyse the association, adjusting for potential confounding variables and the modelling of the dose–response relationship. Results As the frequency of MVPA increased, the association with health benefits was stronger. A linear trend (p<0.05) was found for self-rated health and health complaints in males and females and for satisfaction with life among females; for health-related quality of life this relationship was quadratic for both sexes (p<0.05). For self-reported health and health complaints, the effect was found to be of greater magnitude in males than in females and, in all scales, the benefits were observed from the lowest frequencies of MVPA, especially in males. Conclusions A protective effect of MVPA was found in both sexes for the four health indicators studied, and this activity had a gradient effect. Among males, health benefits were detected from very low levels of physical activity and the magnitude of the relationship was greater than that for females.

Developmental contexts and sense of coherence in adolescence: A systematic review

The salutogenic model has led to revolutionary changes in the study of health. In recent years, a large amount of research has been carried out on the relationship between sense of coherence and health, but relatively little is known about sense of coherence in adolescence. This study is a systematic review of the studies that looked at sense of coherence in adolescent samples. Valuable information is provided regarding the characteristics of the samples, the reliability of the sense of coherence scale versions, the influence of demographic variables and how family, school, peers and neighbourhood impact sense of coherence development. Furthermore, future directions for the study of sense of coherence in adolescence are provided.

Eating habits and physical activity in dieter and non-dieter youth: A gender analysis of English and Spanish adolescents

Abstract A high prevalence of youth is overweight or obese, and a frequent lack of monitoring of their weight control strategies is observed. Consequently, this paper compares the eating habits and physical activities of male and female dieters and non-dieters. Data are obtained from the large cross-national WHO collaborative study “Health Behavior in School-aged Children 2010”. The current sample consists of 9,444 students aged 11, 13 and 15 years from England and Spain. Participants are asked about dieting, vigorous and moderate-to-vigorous physical activity, breakfast frequency and fruit, vegetable, sweet and soft drink consumption. A logistic regression is used to examine the differences between dieters and non-dieters with regard to the aforementioned eating and physical activity habits. Differences between genders, countries, and those associated with BMI (body mass index) are also considered. The results suggest that the reality of weight control differs from the major health promotion recommendations during adolescence.

Escuelas saludables y participativas: evaluación de una estrategia de salud pública

OBJECTIVE Lets foster health! is an intervention strategy in health promotion for use in primary and secondary schools and based on evidence, participation, consensus and the commitment of all members of the educational community. The aim of the present study was to evaluate this strategy according to the achievement of two specific aims: 1) the educational communitys opinion of the implementation process, and 2) changes due to the strategy. METHODS From 2010 to 2011, researchers conducted 1) a descriptive qualitative study to evaluate the implementation process by identifying facilitators, barriers, needs and suggestions using focus groups and in-depth interviews, and 2) a before-and-after quasi-experimental study with a comparison group using specific questionnaires aimed at evaluating participation and compliance with features of Health Promoting Schools. Both education and health professionals were used as information sources. RESULTS The main facilitators were the involvement of management structures and faculty during implementation. The most important barrier was lack of time and resources. Participating centers in Lets foster health! complied with the parameters defining Health Promoting Schools to a higher degree than the control group: these centers became more involved, carrying out more preventive actions and implementing health-related decisions in the curriculum and the centers policy. CONCLUSIONS Lets foster health! is a participative and community intervention strategy based on the characteristics of Health Promoting Schools that encourages health-promoting environments.

Analysis of social inequalities in health through an integrated measure of perceived and experienced health in Spanish and Portuguese adolescents

This article compares the self reported health of a sample of 9854 Spanish and Portuguese adolescents aged 11–15 years using an integrated measure of health, which takes account of positive and negative factors that affect overall feelings of health and wellbeing. This improved measure supports the emergence of health agendas that aim to make wellbeing improvements in populations through a combination of both the promotion of positive protective factors and the need to deal with those risk factors that inhibit individuals, communities and populations to attain good health.

How can parents obtain knowledge about their adolescent children

Abstract The aim of this study is to analyse the influence of family dimensions on parental knowledge of their adolescent children, based on the country, gender and age of adolescents. This study adopts two different perspectives—national and international—with data taken from the results of the 2006 edition of the Health Behaviour in School-aged Children (HBSC) study undertaken in Spain and other member countries of the international network, namely, Austria, Belgium, Bulgaria, Canada, Croatia, the Czech Republic, Denmark, Estonia, Finland, France, Germany and the United Kingdom. The results indicate that both fathers and mothers obtain knowledge about their adolescent children through the childrens disclosures, parental affection, parental solicitation and family activities. The discussion focuses on how these family dimensions promote parental knowledge.

Healthy and participative schools: evaluation of a public health strategy

OBJECTIVE Lets foster health! is an intervention strategy in health promotion for use in primary and secondary schools and based on evidence, participation, consensus and the commitment of all members of the educational community. The aim of the present study was to evaluate this strategy according to the achievement of two specific aims: 1) the educational communitys opinion of the implementation process, and 2) changes due to the strategy. METHODS From 2010 to 2011, researchers conducted 1) a descriptive qualitative study to evaluate the implementation process by identifying facilitators, barriers, needs and suggestions using focus groups and in-depth interviews, and 2) a before-and-after quasi-experimental study with a comparison group using specific questionnaires aimed at evaluating participation and compliance with features of Health Promoting Schools. Both education and health professionals were used as information sources. RESULTS The main facilitators were the involvement of management structures and faculty during implementation. The most important barrier was lack of time and resources. Participating centers in Lets foster health! complied with the parameters defining Health Promoting Schools to a higher degree than the control group: these centers became more involved, carrying out more preventive actions and implementing health-related decisions in the curriculum and the centers policy. CONCLUSIONS Lets foster health! is a participative and community intervention strategy based on the characteristics of Health Promoting Schools that encourages health-promoting environments.

Recent changes in school-based policies on physical activity and nutrition in Spain

BACKGROUND This study evaluates the changes in Spain between 2006 and 2012, of school-based policies encouraging healthy eating and the undertaking of physical activity (PA). METHODS A longitudinal study was undertaken comprising 277 representative schools from all the regions of Spain. The questionnaires were completed by the school management board. An indicator for school policies on PA was constructed (score 0-4) from the following indicators: (i) participation in PA programmes, (ii) existence of written PA guidelines, (iii) training of teachers about PA and (iv) organization of extracurricular PA activities. For nutrition, indicators similar to the first three for PA were evaluated, together with access to healthy foods (score 0-4). In addition to comparing the scores for 2006 and 2012, multivariate linear regression was used to study the association between the characteristics of the schools and the changes in the scores. RESULTS The indicators for school-based policies on nutrition and PA improved between 2006 and 2012: the average score for PA increased from 1.33 to 1.79 (P < 0.001) and that for nutrition from 1.28 to 1.92 (P < 0.001). The greatest changes were seen regarding the written guidelines for action and participation in PA and nutrition programmes as well as the training of teachers about nutrition. The schools with the least number of students had the highest changes in scores for policies on nutrition (P < 0.05). CONCLUSIONS There has been an increase of school-based policies on PA and nutrition, although there is still room for improvement.

A synthesis of research on effectiveness of school-based drug prevention programmes / Claves de eficacia de los programas de prevención de consumo de sustancias en el contexto escolar: una meta-revisión

Abstract Relevant information on effectiveness of school-based drug prevention programmes is available. Despite this, there is still contradictory evidence that makes it necessary to continue to shed light on this issue. Based on a synthesis research method, the aim of this study was to determine the relevant variables that enhance the efficacy of these programmes and to determine the weight of their empirical evidence. Furthermore, several features of the evaluation designs whose variables had been proven effective were examined. A systematic review of periodical literature was conducted, which led us to extract 1,622 papers, of which 17 studies were analysed. An in-depth analysis of these publications led us to identify 29 key variables associated with the efficacy of the programme, which were ranked according to the weight of their empirical evidence. Moreover, the characteristics of the studies included in the review highlighted the need to improve the rigorousness and quality of the evaluation designs in this field.

Key Variables in the Development of Eating Disorders During the Adolescence: Implications for Sex Differences

Eating disorders such as anorexia or bulimia are associated with unsuitable behavior, cognition and emotions, which could have negative consequences for a person’s well-being and health. These risks frequently appear during adolescence, as this developmental stage is characterized by physiological, emotional, cognitive, and above all, social changes that lead to a greater concern for physical appearances. The propensity of adolescents to be unhappy with their body image has been stated in many studies, in which case, the adolescent can go so far as to create distorted perceptions of his/her own body. In short, this population shows major discrepancy between the subjective measurements of their body shape (contributed by the subjects) and the real measurements assessed with objective methods, this leading to a larger proportion of eating disorders (Conley & Boardman, 2007; Gardner, 1996; Martin & Gentry, 1997). Perceiving oneself as «obese» when this is not the case indicates a cognitive problem that can be explained by learning imposed by social and cultural pressures. Thus, the self-perception of one’s body becomes a decisive factor for the development of an eating disorder, which is, in turn, more important than body weight itself (Barker & Galambos, 2003; Bessenoff & Snow, 2006; Cash & Deagle, 1997).