Gaming Behaviors and the Association with Sleep Duration, Social Jetlag, and Difficulties Falling Asleep among Norwegian Adolescents

The relationship between gaming and sleep is mostly informed by studies of addictive gaming behavior, thus limiting our understanding of sleep in the context of nonproblematic engaged gaming. The present study investigated whether addicted, problem, and engaged gaming behavior was associated with sleep duration, social jetlag, and difficulties falling asleep. The sample consisted of 13- and 16-year-old Norwegian adolescents (n = 3228) participating in the Health Behavior in School-Aged Children (HBSC) survey in 2018. Participants were categorized into addicted, problem, engaged, and normal/non-gaming behavior groups according to which GAS-7 criteria they fulfilled. Robust generalized linear mixed models with a random intercept for class ID were used to examine the association between the sleep variables and gaming behavior. Addicted gaming behavior was unfavorably associated with all sleep parameters. The findings for engaged gaming and problem gaming behavior were somewhat mixed. Engaged gamers slept less on weekends, less on weekdays for those aged 16, and experienced greater social jetlag compared to the normal/non-gaming group. Problem gamers experienced greater social jetlag and had higher odds of experiencing difficulties falling asleep. Overall, the results suggest that all types of gaming behaviors might harm sleep health, but to a greater extent for the addicted gamers.publishedVersio

Satisfaction With Life, Mental Health Problems and Potential Alcohol-Related Problems Among Norwegian University Students

Objective: Recent studies have shown that today's college students more than ever are struggling with mental health and alcohol problems. While poor satisfaction with life and mental health problems have been linked to higher alcohol consumption, there is still a lack of studies examining in detail the shape and nature of the relationship between mental health and alcohol consumption. Aim: To investigate the associations between satisfaction with life, mental health problems and potential alcohol-related problems among Norwegian university students. The shape of the associations was also examined. Methods: Data were drawn from a 2018 national survey of students in higher education in Norway (the SHoT-study). Associations between satisfaction with life, mental health problems and potential alcohol-related problems (AUDIT; risky and harmful alcohol use) were investigated using logistic regression. Both crude models and models adjusted for age, gender and marital status were conducted. To investigate the shape of the associations, logistic regression with quadric and cubic terms was tested. Results: Decreased satisfaction with life and increased mental health problems were associated with potential alcohol-related problems. For satisfaction with life, a curvilinear association with risky alcohol use and a linear association with harmful alcohol use was identified. For mental health problems, curvilinear associations were found for both risky and harmful alcohol use. Conclusion: Many students report potential alcohol-related problems. Students with harmful alcohol use seem to be more at risk of reduced satisfaction with life and increased mental health problems than students with risky alcohol use. Educational institutions may be an ideal setting for raising awareness of mental health issues and responsible alcohol consumption among students. The present study contributes with important information about the shape of the associations between satisfaction with life, mental health problems and potential alcohol-related problems in the student population.publishedVersio

Lessons Learned from an Intersectoral Collaboration between the Public Sector, NGOs, and Sports Clubs to Meet the Needs of Vulnerable Youths

The Norwegian Government emphasizes intersectoral collaboration to achieve health goals such as reducing social health differences. However, research shows that achieving fruitful collaboration between different organizations and the public sector is challenging. The sports sector is one potential partner for such collaboration. Although the Government calls for intersectoral collaboration that includes the sports sector, there are few concrete guidelines for how this may be implemented in practice. Guided by The Bergen Model of Collaborative Functioning, the purpose of this study was to explore factors that promote or inhibit collaboration in an intersectoral project involving the sports sector, NGOs, and public sector. The current project aimed to work towards creating health promoting activities aimed at vulnerable youths. Methods: A qualitative case study of the Sports Project with interviews of eleven collaborative partners. Results: Factors promoting collaboration amongst the different partners were having a common mission, an appreciation of the partners’ complementary skills and knowledge, and a consistent user perspective. Conclusions: By orienting the collaboration towards the users’ needs, the partners have succeeded in creating tailored health-promoting activities for vulnerable youths. However, a challenge remains in transforming the collaborative project into a sustainable structure.publishedVersio

Long-term outcomes at 24- and 36-month follow-up in the intervention arm of the randomized controlled trial of Prompt Mental Health Care

Background: Whether long-term symptom improvement is maintained after treatment in services such as the Norwegian Prompt Mental Health Care (PMHC) and the English Improving Access to Psychological Therapies is not yet known. In this prospective study, we investigate whether improvements observed at 6-month follow-up are maintained at 24- and 36-month follow-up among clients who received PMHC. Method: Data from the treatment arm of the randomized controlled trial of PMHC were used (n = 459). The main outcomes were (reliable) recovery rate and symptoms of depression (PHQ-9) and anxiety (GAD-7). Primary outcome data at 24- and 36-months follow-up were available for 47% and 39% of participants, respectively. Secondary outcomes were work participation, functional status, health-related quality of life, and positive mental well-being. Sensitivity analyses with regard to missing data assumptions were conducted for the primary continuous outcomes. Results: Improvements were maintained at 24- and 36-month follow-up for symptoms of depression and anxiety, (reliable) recovery rate, and health-related quality of life. Small linear improvements since 6-month follow-up were observed for work participation, functional status, and positive mental well-being. Sensitivity analyses did not substantially alter the findings for symptoms of depression and anxiety mentioned above. Conclusions: Our findings support the long-term effectiveness of PMHC, but results should be interpreted with caution due to lacking follow-up data at 24- and 36-month in the control group, and substantial attrition.publishedVersio

Tracking of depressed mood from adolescence into adulthood and the role of peer and parental support: A partial test of the Adolescent Pathway Model

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Quality of life among young people in Norway during the COVID‑19 pandemic. A longitudinal study

In this study, we aimed to examine health-related quality of life during the COVID-19 pandemic among a general sample of young people in Norway aged 11–19 years. More specifically, we examine: (1) Change over 2 time-points in five health-related quality of life dimensions, (2) Whether sociodemographic- and COVID-19-related factors contributed to change in these five dimensions, (3) Whether parental stress and socioeconomic status at T1 interacted with change in health-related quality of life across T1 and T2. Data collection lasted from April 27th to May 11th, 2020 (T1), and from December 16th, 2020, to January 10th, 2021 (T2). Youth aged 11–19 years (N = 2997) completed the KIDSCREEN-27, COVID-19 related and sociodemographic items. Parents (N = 744) of youth aged 15 years and younger completed the parental stress scale and sociodemographic items. Physical and psychological wellbeing declined significantly from March to December 2020. Subscale scores for social support and peers increased. Controlling for a broad number of sociodemographic and COVID-19-related factors did not make an overall impact on the estimates. Those worried about infection, older aged, girls, and youth born outside Norway had a steeper decline in health-related quality of life subdimensions from T1 to T2. In the wake of the COVID-19 pandemic, we warrant special attention to the recovery of youth's physical and psychological wellbeing.publishedVersio

Increased gaming during COVID-19 predicts physical inactivity among youth in Norway a two-wave longitudinal cohort study

Background: A concern for the COVID-19 measures and the potential long-term consequences the measures may have on physical inactivity and gaming among youth. Objectives: Examine the stability and change in internet and offline gaming and the association with physical inactivity among adolescents in Norway during the pandemic. Methods: A total of 2940 youth (58% girls) aged 12–19 years participated in an online longitudinal two-wave survey during the first Norwegian national lockdown in April 2020 (t1) and in December 2020 (t2). Gaming behavior and physical activity status were assessed at both time points. Age, gender, and socioeconomic status were included as covariates. Results: Among boys, 41% reported gaming a lot more and 35% a little more at t1 compared to before the national lockdown. The corresponding numbers for girls were 14 and 23%, respectively. In fully adjusted analysis, a pattern of increased gaming at t1 followed by an additional increase in gaming reported at t2 was associated with physical inactivity at t1 (OR = 2.10, p < 0.01) and t2 (OR = 2.45, p < 0.001). Participants gaming more at t1 followed by a reduction at t2 had higher odds of inactivity at t1 (OR = 1.88, p < 0.01). Youth reporting no gaming at t1 had lower odds for inactivity at this time point (OR = 0.67, p < 0.05). Conclusions: Increased gaming among many youths and a relationship with physical inactivity was observed during the first phase of the COVID-19 pandemic. To counteract the negative long-term impacts of COVID-19 restrictions, public health initiatives should emphasize the facilitation of physical activity in youth and develop effective strategies to prevent problematic gaming.publishedVersio

Parental stress during the COVID-19 pandemic: A one-year follow-up

Objective This two-wave longitudinal study aimed at increasing knowledge about levels of parental stressors and rewards among mothers and fathers of children aged 1–18 during the first year of the COVID-19 pandemic in Norway. Background The COVID-19 pandemic and infection-control measures have caused changes to family life. Managing homeschooling or caring for younger children while working from home may have posed significant strain on parental stress, negatively impacting the quality of parent-child relationships and parents’ sensitivity to their children’s needs. Method We employed data collected in April 2020 and April 2021 from the longitudinal population-based survey in Bergen/Norway (Bergen in ChangE-study). 7424 parents participated (58.6% mothers and 41.5% fathers). Results The overall levels of parental stressors and rewards did not change significantly. Over the two time points, the factors associated with decreased parental stressors were being male, aged 40–49 years, having a relatively high income, and reporting initial difficulties with closed kindergartens or schools. For parents aged 18–29 years, the level of parental stressors increased. Conclusion The study suggests that the overall levels of parental stress remained unchanged during the first year of the pandemic. Even so, the study also uncovered that younger parents represented a vulnerable subgroup.publishedVersio

The association between psychological distress and alcohol consumption and physical activity: a population-based cohort study

Introduction: The COVID-19 pandemic and infection control measures caused changes to daily life for most people. Heavy alcohol consumption and physical inactivity are two important behavioral risk factors for noncommunicable diseases worldwide. The COVID-19 pandemic, with its social distancing measures, home office policies, isolation, and quarantine requirements may have an impact on these factors. This three-wave longitudinal study aims to investigate if psychological distress and worries related to health and economy were associated with levels and changes in alcohol consumption and physical activity during the two first years of the COVID-19 pandemic in Norway. Methods: We used data collected in April 2020, January 2021, and January 2022 from an online longitudinal population-based survey. Alcohol consumption and physical activity status were assessed at all three measuring points via the Alcohol Use Disorder Identification Test (AUDIT-C) and the International Physical Activity Questionnaire (IPAQ-SF). COVID-19-related worries, home office/study, occupational situation, age, gender, children below 18 years living at home, and psychological distress (measured with the Symptom Checklist (SCL-10)) were included as independent variables in the model. A mixed model regression was used and presented with coefficients with 95% confidence intervals (CI). Results: Analysis of data from 25,708 participants demonstrates that participants with substantial symptoms of psychological distress more often reported higher alcohol consumption (1.86 units/week, CI 1.48–2.24) and lower levels of physical activity [−1,043 Metabolic Equivalents of Task (METs) per week, CI −1,257;−828] at baseline. Working/studying from home (0.37 units/week, CI 0.24–0.50) and being male (1.57 units/week, CI 1.45–1.69) were associated with higher alcohol consumption. Working/studying from home (−536 METs/week, CI −609;−463), and being older than 70 years (−503 METs/week, CI −650;−355) were related to lower levels of physical activity. The differences in activity levels between those with the highest and lowest levels of psychological distress reduced over time (239 METs/week, CI 67;412), and similarly the differences in alcohol intake reduced over time among those having and not having children < 18 years (0.10 units/week, CI 0.01–0.19). Conclusion: These findings highlight the substantial increases in risks related to inactivity and alcohol consumption among those with high levels of psychological distress symptoms, and particularly during the COVID-19 pandemic, and increase the understanding of factors associated with worries and health behavior.publishedVersio

Cross-national variation in the association between family structure and overweight and obesity: Findings from the Health Behaviour in School-aged children (HBSC) study

Background Trends of increased complexity in family structure have developed alongside increasing prevalence of overweight and obesity. This study examines cross-national variations in the likelihood of living with overweight and obesity among adolescents living with one parent versus two parents, as well as the influence of living with stepparents, grandparents and siblings. Furthermore, the study explores how these associations relate to age, gender and individual-level socioeconomic status (SES) and country-level SES. We hypothesised that adolescents living in one-parent versus two-parents families, were more likely to live with overweight and obesity. Methods The study is based on nationally representative data from 41 countries participating in the 2013/14 Health Behaviors in School-Aged Children study (n = 211.798). Multilevel logistic regression analysis was used to examine the associations between family structure and overweight and obesity by age, gender, SES, and geographic region, among adolescents aged 11, 13 and 15 years. Results Living with one versus two parent(s) was associated with a higher likelihood of overweight and obesity (ORadj.1.13, 95%CI 1.08,1.17). Age, gender, individual-level SES, and living with grandparents were also associated with a higher likelihood of overweight and obesity, whereas living with siblings was associated with a lower likelihood of overweight and obesity. The effect of family structure varied also by age and gender with no significant associations found between living with one parent and overweight and obesity in the 15-year-old age group. Some cross-national variation was observed, and this was partly explained by country-level SES. The effect of family structure increased by a factor 1.08 per one-unit change in country-level SES (OR 1.08, 95%CI1.03, 1.12). Conclusion The study indicates that living in a one-parent family, as well as living together with grandparents, are associated with overweight and obesity among adolescents, particularly in the Nordic European region. Existing welfare policies may be insufficient to eliminate inequalities related to family structure differences.publishedVersio