Cross-national time trends in adolescent body weight perception and the explanatory role of overweight/obesity prevalence

ABSTRACTIntroduction Body weight perception (BWP) is associated with health behaviors. Current evidence points to an increase over time in both actual and perceived weight status among adolescents, however there is limited evidence on time trends in BWP in cross-national samples of adolescents. Therefore, the aims of this study were to examine time trends in BWP between 2002 and 2018 among adolescents from 41 countries and regions, including gender and country differences and to explore the role of changes over time in country-level overweight/obesity prevalence in these trends.Methods Data were used from five cycles (2002, 2006, 2010, 2014, 2018) of the repeated cross-sectional Health Behavior in School-Aged Children (HBSC) study (n = 746,121; mean±standard deviation age 13.7 ± 1.6 years, 51.0% girls). Multilevel logistic models estimated cross-national linear time trends in adolescent BWP (correct perception, underestimation, or overestimation), adjusted for gender, age, and family affluence. Next, we tested whether country-level changes over time overweight/obesity prevalence could explain these trends in BWP among adolescents.Results Correct weight perception increased over time among girls, while it decreased among boys. Underestimation of weight status increased, and overestimation of weight status decreased over time among both genders, with stronger trends for girls. Furthermore, country differences in trends in both BWP and overweight/obesity were found. Changes over time in country-level overweight/obesity prevalence could not explain these trends.Conclusion The linear increase over time in correct weight perception and the decrease in overestimation may have a positive effect on unhealthy weight reduction behaviors among adolescents. However, the increase in underestimation could signal a need for interventions to strengthen correct weight perception among adolescents. Several implications for policy and practice are discussed

Encouraging greater empowerment for adolescents in consent procedures in social science research and policy projects

The CO-CREATE project has received funding from the European Union's Horizon 2020 research and innovation programme under grant agreement No. 774210.The United Nations Convention on the Rights of the Child emphasizes the importance of allowing children and adolescents to influence decisions that are important to them following their age and maturity. This paper explores the principles, practices, and implications around using parental versus child/adolescent consent when participating in social science research and policy development. Experiences from two studies are presented: The Confronting Obesity: Co-creating policy with youth (CO-CREATE) and the Health Behaviour in School-aged Children (HBSC) study, a World Health Organization (WHO) Collaborative Cross-National study. Although parental consent may be an important gatekeeper for protecting children and adolescents from potentially harmful research participation, it may also be considered an obstacle to the empowerment of children and adolescents in case they want to share their views and experiences directly. This paper argues that evaluation of possible harm should be left to ethics committees and that, if no harm related to the research participation processes is identified and the project has a clear perspective on collaborating with the target group, adolescents from the age of 12 years should be granted the legal capacity to give consent to participate in the research project. Collaboration with adolescents in the development of the research project is encouraged.Publisher PDFPeer reviewe

Exposure to secondhand smoke in hospitality sector in Serbia

Exposure to secondhand smoke (SHS) is a threat to individual and population health. The prevalence of SHS exposure is higher in countries with higher adult smoking rates. In Serbia, 37% of adults are smokers which is above world average. Current Serbian legislation allows owners to decide whether the premises will be smoke-free in case cafe/restaurants is up to 80 m 2 . Оtherwise, they are obliged to provide smoke-free area but physical division between smoking and no-smoking areas is not requirement. Data regarding exposure and attitudes towards SHS exposure in hospitality sector in Serbia were collected in 2018 as cross-sectional study on representative sample of 1200 Serbian adults (18-64 years) that have visited hospitality sector in the last six months. Probability proportional sampling was applied aimed to include both smokers and non-smokers. Exposure to SHS in hospitality sector in Serbia is high (88% in cafes, 73% in restaurants). More than half (52%) of the cafes visitors (19% smokers, 86% non-smokers) and 63% restaurant visitors (26% of smokers, 89% non-smokers) stated that exposure to tobacco smoke bothers them. Almost half of the visitors (46%) said that they are always or frequently exposed to tobacco smoke when they are sitting in designated no-smoking area of the cafe/restaurant. Our data contribute to the current body of evidence that designated smoking areas in the hospitality sector do not protect visitors from the SHS. Therefore it is necessary to adopt 100% smoke-free law in Serbia

Challenges for building consensus for adoption and full compliance with 100% smoke free law in Serbia

In Serbia, 37% of adults smoke and more than half of the population is exposed to tobacco smoke in enclosed places. The hospitality sector is exempted from the smoking ban and compliance with current legislation is low. From March 2017, Institute of Public Health of Serbia implemented a project aimed at building consensus for adoption and full compliance with 100% smoke free law in Serbia. The project was funded by Bloomberg Philanthropies and managed by the International Union Against Tuberculosis and Lung Disease. Project supported conferences and other events, contributed to the continuous presence in the media and built up informational resources to advocate for the smoke free environment which will be useful in the next period. New partnerships were established leading to an increase in a number of partners who will further work in tobacco control field. Based on the findings from surveys, conclusions from the multisectorial events and media content analysis, next steps and challenges were identified. In the next period, together with advocacy measures aimed at decision makers, it is important to focus on the general public and health professionals so they accept and advocate for evidence based tobacco control measures. Social norms changes are needed due to strong correlation between social norms and policy implementation. Moreover, it is necessary to conduct campaigns to change the perception of economic benefits of tobacco. New challenges such as heated tobacco products amplify the importance of the provision of accurate information on tobacco control best practice to decision makers, general public and health professionals. Findings from 2018 survey conducted as part of the project showed that only 26% of smokers and 64% of nonsmokers think smoking in the hospitality sector violates right to smoke free air, indicating the need of incorporating human rights approaches into further actions

Waterpipe use and attitudes related to it among Serbian adult population

Introduction To analyze prevalence of water pipe use and attitudes related to it among Serbian adults. Methods Data were obtained through cross sectional survey conducted in December 2017. Three stage random nationally representative stratified sample was used. Data from 1045 Serbian adults were collected through computer assisted personal interviewing. Results Lifetime prevalence of waterpipe use is 6% (7% male, 5% female). In addition, 7% of population visited bars specialized for waterpipe use (waterpipe bars) but haven’t smoke waterpipe. The highest percentage of waterpipe lifetime users was in the 18-24 age group (15%), followed by age group 25-34 (12%). In the same age groups, additional 22% and 12% respectively have visited waterpipe bar, but haven’t smoke waterpipe. Almost every third citizen of Serbia (29%) thinks that waterpipe use is less harmful than cigarette use, 39% agree with the statement that waterpipe users can develop nicotine addiction and 36% think that waterpipe use is risk factor for malignant diseases. Young adults 18-24 years old are less aware of harmful consequences of waterpipe use. There are more citizens that agree that waterpipe use in hospitality sector should be banned than those who disagree with such measure (40% vs.24%). Younger population is less favorable to the waterpipe smoking ban in hospitality sector. Conclusions Waterpipe use and spending time in specialized waterpipe bars is popular in Serbia, especially among young adults. Insufficient number of citizens is aware of risks associated with waterpipe use. Findings indicate need of awareness raising on health effects associated with waterpipe smoking and exposure to waterpipe smoke

Psychosocial school factors and mental health of first grade secondary school students-Results of the Health Behaviour in School-aged Children Survey in Serbia.

This cross-sectional study aimed to investigate the association between psychosocial school factors and life satisfaction, symptoms of depression and psychosomatic health complaints among first grade secondary school students in Serbia. We analysed data from the 2018 Health Behaviour in School-aged Children (HBSC) study in the Republic of Serbia. Analyzed psychosocial school factors included satisfaction with school, schoolwork pressure, teacher support, classmate support and being bullied at school. Life satisfaction was assessed by the 11-step Cantril's ladder (cutoff >5). Symptoms of depression were measured by the Center for Epidemiologic Studies Depression Scale (CESD-10) and psychosomatic health complaints by using the HBSC symptom checklist. Univariable and multivariable binary logistic regression was used to determine independent predictors of students' life satisfaction, symptoms of depression and psychosomatic health complaints in the school environment, while also considering their socio-demographic characteristics and perceived family and friend support. The study included 1605 students (average age 15.26 ±0.44 years), of whom 50.3% were females. Results from the binary logistic regression analyses showed that life satisfaction was positively related to school satisfaction and classmate support, and negatively to being bullied at school. Symptoms of depression were positively associated with schoolwork pressure and being bullied at school, and negatively with teacher and classmate support. All analyzed factors of the school environment were significantly related to psychosomatic health complaints, whereby schoolwork pressure and being bullied at school were positively associated, while teacher and classmate support and satisfaction with school were negatively associated. Given the established association of psychosocial school factors with mental health, there is a need for targeted measures both at school and community level with the aim of improving social support in the school environment, reducing schoolwork burden and preventing bullying at school, potentially resulting in the overall improvement of mental health of the first grade secondary school students

Psychosomatic health complaints in relation to psychosocial school and other factors.

Psychosomatic health complaints in relation to psychosocial school and other factors.</p

STROBE statement—Checklist of items that should be included in reports of observational studies.

STROBE statement—Checklist of items that should be included in reports of observational studies.</p

Life satisfaction in relation to psychosocial school and other factors.

Life satisfaction in relation to psychosocial school and other factors.</p