Health and health risk behaviour of adolescents—Differences according to family structure. Results of the German KiGGS cohort study

<div><p>Objective</p><p>This study’s aim was to investigate the association between family structure and different health-related outcomes in adolescence (self-rated health, emotional and behavioural problems, health-related quality of life, regular smoking, and heavy episodic drinking). Furthermore, we analysed the extent to which socio-economic status, family cohesion and the pre-transition health status explain family structure-related health disparities.</p><p>Methods</p><p>We used longitudinal data from the first two waves of the German KiGGS cohort study carried out by the Robert Koch Institute (baseline: 2003–2006, follow-up: 2009–2012). The sample comprised 4,692 respondents aged 11 to 17 years. Using data from both waves, effects of family structure on health status at follow-up were calculated applying linear and logistic regression models.</p><p>Results</p><p>We found that adolescents continuously living with both birth parents were in good health. Adolescents whose parents separated after the baseline survey, reported poorer health and were more likely to smoke. The transition from stepfamily to single parent family was also associated with a higher risk of regular smoking. Lower health-related quality of life as well as higher scores for emotional and behavioural problems occurred in almost all non-nuclear family structures, although not all effects were statistically significant. No significant effects of family structure on heavy episodic drinking were found. While family cohesion mediated the effects of family structure on adolescents’ health, the mediating effect of socio-economic status was small. After controlling for pre-transition health, the effects were even lower.</p><p>Conclusions</p><p>Because the direct effects of family structure on adolescents’ health were small and family cohesion was found to be an important mediator in the association between family structure and adolescents’ health, prevention programmes and interventions should be directed towards the parent–adolescent relationship rather than just the family structure, in order to minimize the psychosocial stress of adolescents during the period of family transition.</p></div

Sample characteristics.

<p>Sample characteristics.</p

Results from the linear regression models on self-rated health.

<p>Adolescents aged 11 to 17 years.</p

Results from the logistic regression models on heavy episodic drinking.

<p>Adolescents aged 14 to 17 years.</p

Mean values / proportions of the health outcomes according to family status.

<p>Mean values / proportions of the health outcomes according to family status.</p

Results from the linear regression models on health-related quality of life.

<p>Adolescents aged 11 to 17 years.</p

Results from the logistic regression models on regular smoking.

<p>Adolescents aged 14 to 17 years.</p

Additional file 1: Table S1. of Mixing modes in a population-based interview survey: comparison of a sequential and a concurrent mixed-mode design for public health research

Missing values for health indicators by survey design and mode of data collection. (PDF 26 kb

Data_Sheet_2_Mental health indicators for children and adolescents in OECD countries: a scoping review.docx

BackgroundThis scoping review is a further step to build up the Mental Health Surveillance System for Germany. It summarizes and analyzes indicators used or described in Organization for Economic Co-operation and Development (OECD) countries for public mental health monitoring in children and adolescents aged 0–18 years.MethodsWe searched PubMed-MEDLINE, PsycINFO, Cochrane Databases, and Google Scholar from 2000 to September 2022. The search used five general keyword categories: 1) “indicators/monitoring/surveillance” at the population level, 2) “mental/psychological,” 3) “health/disorders,” 4) “children and adolescents,” and 5) 38 OECD countries. The search was complemented with an extensive grey literature search, including OECD public health institutions and an internet search using Google. A predefined set of inclusion and exclusion criteria was applied.ResultsOver 15,500 articles and documents were screened (scientific search N = 10,539, grey literature search more than 5,000). More than 700 articles and documents have been full-text assessed, with 382 being ultimately included. Out of 7,477 indicators extracted, an initial set of 6,426 indicators met our inclusion criteria for indicators. After consolidating duplicates and similar content, this initial set was categorized into 19 topics, resulting in a final set of 210 different indicators. The analysis highlighted an increasing interest in the topic since 2008, but indicators for the younger age, particularly those aged 0 to 2 years, were less readily available.ConclusionOur research provides a comprehensive understanding of the current state of mental health indicators for children and adolescents, identifying both (1) indicators of public mental health noted in a previous scoping review on adults and (2) new indicators specific to this age group. These findings contribute to the development of effective public health surveillance strategies for children and adolescents and inform future research in this field.</p

Data_Sheet_1_Mental health indicators for children and adolescents in OECD countries: a scoping review.docx

BackgroundThis scoping review is a further step to build up the Mental Health Surveillance System for Germany. It summarizes and analyzes indicators used or described in Organization for Economic Co-operation and Development (OECD) countries for public mental health monitoring in children and adolescents aged 0–18 years.MethodsWe searched PubMed-MEDLINE, PsycINFO, Cochrane Databases, and Google Scholar from 2000 to September 2022. The search used five general keyword categories: 1) “indicators/monitoring/surveillance” at the population level, 2) “mental/psychological,” 3) “health/disorders,” 4) “children and adolescents,” and 5) 38 OECD countries. The search was complemented with an extensive grey literature search, including OECD public health institutions and an internet search using Google. A predefined set of inclusion and exclusion criteria was applied.ResultsOver 15,500 articles and documents were screened (scientific search N = 10,539, grey literature search more than 5,000). More than 700 articles and documents have been full-text assessed, with 382 being ultimately included. Out of 7,477 indicators extracted, an initial set of 6,426 indicators met our inclusion criteria for indicators. After consolidating duplicates and similar content, this initial set was categorized into 19 topics, resulting in a final set of 210 different indicators. The analysis highlighted an increasing interest in the topic since 2008, but indicators for the younger age, particularly those aged 0 to 2 years, were less readily available.ConclusionOur research provides a comprehensive understanding of the current state of mental health indicators for children and adolescents, identifying both (1) indicators of public mental health noted in a previous scoping review on adults and (2) new indicators specific to this age group. These findings contribute to the development of effective public health surveillance strategies for children and adolescents and inform future research in this field.</p