Fumo e alcol tra gli adolescenti nelle Regioni italiane: i dati della sorveglianza Health Behaviour in School-aged Children (HBSC) 2018

Introduction During adolescence, it is common to start experimenting with risky behaviours, such as using alcohol and cigarettes. Methods and materials We analysed these behaviours using data from the Health Behaviour in School-aged Children (HBSC) 2018 surveillance. Data were collected from every Italian region, with a national representative sample of 58,976 adolescents aged 11, 13, and 15 years. As an indicator of cigarette consumption, we considered the question of the surveillance that asked how many days the adolescent had smoked in the last month. As an indicator of alcohol consumption, we used the question that asked the adolescent if he had consumed more than 5 drinks on one occasion in the last year. Results Both indicators increased with age. For every age, on average girls smoked on more days, while a higher percentage of boys had experienced binge drinking. At 13 years, 8.0% of boys and 8.4% of girls smoked in the last month. For 15 years olds adolescent, frequencies were more than double, with 24.8% of boys and 31.9% of girls that smoked in the same period. 11.4% of eleven-year-old boys and 4.8% of same-age girls admitted drinking five or more drinks in a row during the last year. At thirteen, 19.1% of boys and 13.7% of girls were binge drinkers. At fifteen, more than four boys and three girls out of ten were binge drinkers. There were differences in both responses among the regions of Italy. Discussion and conclusions From the analyses, it emerges that prevention before adolescence is important, because the onset of these behaviours starts in this stage of life. As reported in other studies, smoking cigarettes appears more common among fifteen-year-old girls, and heavy drinking among boys at every age. The analyses reported that the behaviours are present in all the Italian regions with some regional differences

Unhealthy food consumption in adolescence : role of sedentary behaviours and modifiers in 11-, 13- and 15-year-old Italians

This work is part of the Project ‘Sistema di indagini sui rischi comportamentali in eta` 6-17 anni’ promoted and financed by the Ministry of Health (cap. 4393/2005-CCM).Backgrounds and aim. Unhealthy eating behaviours increase with age and have been associated with adverse health consequences in adulthood. We examined the influence of screen-based sedentary behaviours (SBs) on unhealthy food consumption, such as energy-dense foods and sweetened drinks, among a representative sample of nearly 60 000 adolescents and assessed the role of possible modifiers. Methods. Data come from the Italian 2009–10 Health Behaviour in School-aged Children (HBSC) survey. Data on Eating patterns, SBs, physical activity, peers network, BMI and socio-economic status (SES) were collected following the HBSC study protocol. Hierarchical logistic regression models were used. Results. Unhealthy food consumption was significantly associated with a lower intake of fruit and vegetables and with the increase of SBs in both sexes and in all ages. The risk was interestingly higher in normal weight adolescents, in those with wider relationships with peers and in low SES children. Conclusions. This study adds evidence to support the importance of investing more resources in educational initiatives both to increase parents’ awareness to support adolescents on dietary choices and on time spent in screen-based behaviours, independently of their adiposity status; and to develop youth’s ability to access and appropriately use media and technologies. Policy makers should also increase their attention on introducing regulatory policies on television food advertising to which youth are exposed.PostprintOtherOtherPeer reviewe

An international scoring system for self-reported health complaints in adolescents

Background: Aimed to develop a unitary scoring system for the 'Health Behaviour in school-aged Children' (HBSC) symptom checklist that would facilitate cross-national comparisons and interpretation. Rasch measurement analysis and investigation of differential item functioning (DIF) were conducted. Methods: Data were obtained from the 'WHO collaborative study HBSC 2001/2002'. A total of 162 305 students aged 11, 13 and 15 years from 35 European and North American Countries were surveyed. Unidimensionality of the items and local independence were tested using means of confirmatory factor analysis. DIF across countries, age groups and gender was investigated using a logistic regression procedure. Item and person parameters were estimated according to the Rating Scale Model (RSM). Results: All items proved to be unidimensional. One item displayed noticeable DIF across countries and was discarded. The remaining items were functioning equally across subgroups. The RSM analysis resulted in Rasch model conform item parameter estimation. Infit mean square values between 0.84 and 1.35 revealed acceptable item fit. Conclusion: The control of DIF enables comparable and unbiased assessment of subjective health complaints across countries, age groups and gender. A scoring algorithm could be developed which enables a cross-cultural comparable and interval-scaled assessment of subjective health complaints.publishersversionPeer reviewe

Establishing spirituality as an intermediary determinant of health among 42,843 children from eight countries

The World Health Organization (WHO) Commission on the Social Determinants of Health (CSDH) conceptual framework identifies socio-economic position as a structural determinant of health. Recognized intermediary determinants include biological, behavioural, and psychosocial factors. We examined whether connections afforded by a healthy spirituality potentially act as unrecognized intermediary determinants in adolescent populations, contributing to inequities in mental health. Reports from 42,843 children (21,007 boys, 21,836 girls) from eight countries who participated in the 2017–2018 Health Behaviour in School-aged Children (HBSC) study were used to describe correlations between family affluence and positive levels of mental health, using a cross-sectional design. Based on the CSDH conceptual framework and multivariable regression analyses, we then examined whether these associations were mediated by spiritual health. Connections afforded by a high level of spiritual health were universally correlated with positive mental health status. In three Western European nations (England, Scotland, and Wales) and Canada affluence was correlated with better mental health and this was partially mediated by spiritual health. Among the four Eastern European countries (Latvia, Lithuania, Moldova, Poland), our findings did not support aspects of the CSDH framework that focus on affluence as a direct determinant of health. Spiritual health potentially is an intermediary determinant of children's health in some Western countries, but not in Eastern countries. The universality of social determinants of health models and the measures used in their evaluation require careful assessment across cultures, political contexts, and health outcomes

Alcohol misuse and injury outcomes in young people aged 10-24: a cohort analysis using linked primary and secondary care data in England

Purpose: The burden of alcohol-attributable disease is a global problem. Young people often present to emergency health-care services with alcohol intoxication but little is known about how best to intervene at that point to improve future health outcomes. This study aimed to assess whether young people with an alcohol-specific hospital admission are at increased risk of injury following discharge. Methods: A cohort study was conducted using a general population of 10- to 24-year-olds identified using primary care medical records with linked hospital admission records between 1998 and 2013. Exposed individuals had an alcohol-specific admission. Unexposed individuals did not and were frequency matched by age (±5 years) and general practice (ratio 10:1). Incidence rates of injury-related hospital admission post discharge were calculated, and hazard ratios (HR) were estimated by Cox regression. Results: The cohort comprised 11,042 exposed and 110,656 unexposed individuals with 4,944 injury-related admissions during follow-up (2,092 in exposed). Injury rates were six times higher in those with a prior alcohol admission (73.92 per 1,000 person-years, 95% confidence interval (CI) 70.82–77.16 vs. 12.36, 11.91–12.81). The risk of an injury admission was highest in the month following an alcohol-specific admission (adjusted HR = 15.62, 95% CI 14.08–17.34), and remained higher compared to those with no previous alcohol-specific admission at 1 year (HR 5.28 (95% CI 4.97–5.60)) and throughout follow-up. Conclusions: Young people with an alcohol-specific admission are at increased risk of subsequent injury requiring hospitalization, especially immediately post discharge, indicating a need for prompt intervention as soon as alcohol misuse behaviors are identified