Being Equal Is Not the Same: The Need for Gender-Specific Drug Abuse Prevention for Youth

Die Notwendigkeit einer geschlechtsspezifischen Differenzierung von Suchtpräventionsprogrammen wird diskutiert. Dabei wird zum einen auf empirische Befunde eingegangen, die belegen, daß Mädchen und Jungen sich in der Qualität und Intensität des Konsums von Alkohol und Tabak nach wie vor unterscheiden. Zum anderen werden theoretische Überlegungen dargestellt, die von einer differentiellen Funktionalität des Risikoverhaltens und von unterschiedlichen strukturellen Rahmenbedingungen der Bewältigung jugendspezifischer Entwicklungsaufgaben ausgehen. In diesem Zusammenhang werden auch die Ergebnisse einer Sekundäranalyse empirischer Daten aus einer Befragung von insgesamt 2330 Jugendlichen zwischen 12 und 16 Jahren vorgestellt, die die strukturellen Gegebenheiten auf der Ebene subjektiver Unsicherheiten und Belastungen untersuchte. Es zeigten sich deutliche Geschlechtsunterschiede hinsichtlichh Zukunftsunsicherheit und Ablöseproblematik. Abschließend werden Konsequenzen für die schulische Suchtprävention aufgezeigt. (DIPF/Orig.

Sexuelle Gesundheit braucht Daten – und Ideen zur Gestaltung einer positiven Sexualkultur

Kolip P. Sexuelle Gesundheit braucht Daten – und Ideen zur Gestaltung einer positiven Sexualkultur!. Journal of Health Monitoring. 2022;7(2):3-6

Social, health-related, and environmental factors influencing sleep problems of children, adolescents and young adults

Sleep is a relevant factor for functioning and well-being of young people. The paper provides a differentiated description of sleep difficulties in this population group including social, health-related, and environmental factors. The analyses included n=6,728 11- to 17-year-olds of the KiGGS baseline study (2003–2006) and 6,072 young adults (age 18–31), who provided information relating sleep in the survey KiGGS Wave 2 (2014–2017). Information from 3,567 people was evaluated at two survey points. 22.0% of the 11- to 17-year-olds reported sleep difficulties. A significant impact for the sex (female), living with a single parent, and with siblings is reflected in the logistic regression. The risk for sleep difficulties increases significantly in the case of mental problems and pain. Among the 18- to 31-year-olds, 19.6% complained of difficulties falling asleep and sleeping through the night. In addition to sex, noise exposure, a low level of education, the professional situation, and living with children were reflected as important influencing factors in the logistic regressions. Over one third of those, who suffered from sleep problems as children and adolescents, also indicated sleep difficulties almost ten years later. The high prevalence of sleep problems and the associated health risks illustrate the high public health relevance of the topic. In addition to sex, health-related and environmental variables also turned out to be significant and need to be considered in the development of interventions

Does a decision aid improve informed choice in mammography screening? Results from a randomised controlled trial

Reder M, Kolip P. Does a decision aid improve informed choice in mammography screening? Results from a randomised controlled trial. PLOS ONE. 2017;12(12): e0189148.Background Decision aids can support informed choice in mammography screening, but for the German mammography screening programme no systematically evaluated decision aid exists to date. We developed a decision aid for women invited to this programme for the first time based on the criteria of the International Patient Decision Aids Standards Collaboration. Objective To determine whether a decision aid increases informed choice about mammography screening programme participation. Methods A representative sample of 7,400 women aged 50 was drawn from registration offices in Westphalia-Lippe, Germany. Women were randomised to receive usual care (i.e., the standard information brochure sent with the programme’s invitation letter) or the decision aid. Data were collected online at baseline, post-intervention, and 3 months follow-up. The primary outcome was informed choice. Secondary outcomes were the constituents of informed choice (knowledge, attitude, intention/uptake), decisional conflict, decision regret, and decision stage. Outcomes were analysed using latent structural equation models and χ2-tests. Results 1,206 women participated (response rate of 16.3%). The decision aid increased informed choice. Women in the control group had lower odds to make an informed choice at post-intervention (OR 0.26, 95% CI 0.18-0.37) and at follow-up (OR 0.66, 95% CI 0.46-0.94); informed choices remained constant at 30%. This was also reflected in lower knowledge and more decisional conflict. Post-intervention, the uptake intention was higher in the control group, whereas the uptake rate at follow-up was similar. Women in the control group had a more positive attitude at follow-up than women receiving the decision aid. Decision regret and decision stage were not influenced by the intervention. Conclusion This paper describes the first systematic evaluation of a newly developed decision aid for the German mammography screening programme in a randomised controlled trial. Our decision aid proved to be an effective tool to enhance the rate of informed choice and was made accessible to the public

Does a decision aid improve informed choice in mammography screening? Study protocol for a randomized controlled trial

Reder M, Kolip P. Does a decision aid improve informed choice in mammography screening? Study protocol for a randomized controlled trial. BMC Women's Health. 2015;15(1): 53.Background When invited for the first time at age 50, most women in Germany have to decide whether they wish to participate in the German mammography screening programme. For ethical reasons, screening decisions should be informed choices, but this is rarely the case with mammography screening. Decision aids are interventions with the potential to support informed choice by improving the following factors: knowledge, clarity of personal attitude, and implementation of an intention. Currently, no systematically evaluated decision aid exists for the German mammography screening programme. Therefore, the objective of this randomized controlled trial is to assess the effectiveness of a decision aid for first-time mammography screening programme invitees. Methods/Design We have developed a decision aid for women invited to the mammography screening programme for the first time based on the criteria of the International Patient Decision Aids Standards Collaboration. The effectiveness of the decision aid will be evaluated in a randomized controlled trial with a 3-month follow-up. We will invite 7400 women aged 50 years from the district of Westfalen-Lippe, Germany, to participate. This sample will be drawn from registration office data. The primary outcome will be informed choice. The secondary outcomes will be the components of informed choice (knowledge, attitude, decision/implementation). Decisional conflict, decision regret, eHealth literacy, health behaviours, perceived behavioural control, subjective norms, invitation status, and demographic variables will be assessed. Data will be collected online at baseline, post-intervention, and at the 3-month follow-up. Participants will be randomized to receive either the decision aid or usual care (invitation and standard leaflet of the mammography screening programme). Discussion This paper describes the evaluation of a decision aid for the German mammography screening programme in a randomized controlled trial. If the decision aid proves to be an effective tool to enhance the rate of informed choice, it will be made accessible to the public and the use of this decision aid for first-time invitees will be recommended. The long-term effect could be an improvement in informed choices in women invited to the mammography screening programme. Trial registration German Clinical Trials Register DRKS00005176

Age, puberty, body dissatisfaction, and physical activity decline in adolescents. Results of the German Health Interview and Examination Survey (KiGGS)

Finne E, Bucksch J, Lampert T, Kolip P. Age, puberty, body dissatisfaction, and physical activity decline in adolescents. Results of the German Health Interview and Examination Survey (KiGGS). International Journal of Behavioral Nutrition and Physical Activity. 2011;8(1): 119.Background: Physical activity (PA) shows a marked decline during adolescence. Some studies have pointed to pubertal status or timing as possible PA determinants in this age group. Furthermore, it was supposed that the impact of pubertal changes on PA might be mediated by psychological variables like body dissatisfaction (BDS). Methods: The 11- to 17-year-old subsample of the German Health Interview and Examination Survey (KiGGS) was used (n = 6 813; 51.3% male, response rate = 66.6%). Through sex-specific sequential multinomial logistic regressions we analysed the univariate and independent associations of chronological age, absolute pubertal status, relative pubertal timing, and BDS with the frequency of PA. Results: Chronological age showed a significantly negative association with PA in both sexes, independent of puberty. The odds of inactivity in contrast to nearly daily PA increased about 70% in boys and 35% in girls for each year of age, respectively. Adjusted for age and other possible confounders, inactivity was significantly less likely for boys in late pubertal stages (OR = 0.27, 95% CI = 0.09-0.78). The risk of inactivity was more than doubled in boys maturing earlier than peers in terms of relative pubertal timing (OR = 2.20, 95% CI = 1.36-3.56). No clear significant puberty effects were found in girls, but the inactivity was more likely for those with irregular menstruation (OR = 1.71, 95% CI = 1.06-2.75). BDS also contributed to the prediction of PA in both sexes. It partially mediated puberty effects in boys but not in girls. Conclusions: Overall, chronological age was a far more important predictor of PA in German adolescents than absolute pubertal status or relative pubertal timing. Further possible explanatory variables like sociocultural influences, social support or increasing time requirements for education should be analysed in conjunction with chronological age in future studies

Wohin mit der Wut? Eine geschlechtsspezifische Analyse zum Zusammenhang zwischen aggressiven Gefühlen, Gewalt und psychosomatischen Beschwerden im Jugendalter

'Die Sozialisationsforschung hat immer wieder auf geschlechtsspezifische Unterschiede der Aggressivität hingewiesen. So wird vielfach davon ausgegangen, daß Frauen eher mit nach innen gerichteten Verhaltensformen auf Belastungen reagieren und von daher eher als Männer psychosomatische Beschwerden entwickeln. Demgegenüber reagieren Männer auf Belastungen häufiger als Frauen mit Aggressivität, der eine entlastende Funktion zugeschrieben wird. In dieser repräsentativen Studie an Schülern und Schülerinnen der Sekundarstufe II wird der Zusammenhang zwischen aggressiven Gefühlen, aggressiven Verhaltensweisen und psychosomatischen Beschwerden untersucht. Es zeigt sich, daß aggressives Verhalten weder bei den Jungen noch bei den Mädchen zu einem Spannungsabbau führt, sondern Gesundheitsbeeinträchtigungen eher verstärkt.' (Autorenreferat)'Research on processes of socialisation repeatedly refers to gender differences in aggressiveness. It is often assumed that women more likely react to stress with an internalising behaviour and develop psychosomatic symptoms more easily than men. In contrast to this men react more likely with aggressiveness, which is said to have a release function on stress. This representative study of pupils analyses the connections between aggressive feelings, aggressive behaviour and psychosomatic symptoms. It shows that aggressive behaviour neither for girls nor for boys leads to a release of stress, but more likely to an increase in health impairments.' (author's abstract)

Gender inequality and sex differences in physical fighting, physical activity, and injury among adolescents across 36 countries

Purpose: Sex differences in adolescent health are widely documented, but social explanations for these sex differences are scarce. This study examines whether societal gender inequality (i.e., men’s and women’s unequal share in political participation, decision-making power, economic participation and command over resources) relates to sex differences in adolescent physical fighting, physical activity, and injuries. Methods: National-level data on gender inequality (i.e. the United Nations Development Program’s Gender Inequality Index) were linked to health data from 71,255 15-year olds from 36 countries in the 2009/10 Health Behavior in School-aged Children (HBSC) study. Using multilevel logistic regression analyses, we tested the association between gender inequality and sex differences in health while controlling for country wealth (GDP per capita). Results: In all countries, boys reported more physical fighting, physical activity, and injuries than girls, but the magnitude of these sex differences varied greatly between countries. Societal gender inequality positively related to sex differences in all three outcomes. In more gender unequal countries, boys reported higher levels of fighting and physical activity, compared to boys in more gender equal countries. In girls, scores were consistently low for these outcomes, however injury was more common in countries with less gender inequality. Conclusions: Societal gender inequality appears to relate to sex differences in some adolescent health behaviors and may contribute to the establishment of sex differences in morbidity and mortality. To reduce inequalities in the health of future generations, public health policy should target social and cultural factors that shape perceived gender norms in young people

Do Women With High eHealth Literacy Profit More From a Decision Aid on Mammography Screening? Testing the Moderation Effect of the eHEALS in a Randomized Controlled Trial

Reder M, Soellner R, Kolip P. Do Women With High eHealth Literacy Profit More From a Decision Aid on Mammography Screening? Testing the Moderation Effect of the eHEALS in a Randomized Controlled Trial. Frontiers in Public Health. 2019;7: 46.Background: Our decision aid on mammography screening developed according to the criteria of the International Patient Decision Aids Standards Collaboration increases knowledge compared to usual care. However, it remains unclear whether this decision aid is more effective in women with higher eHealth literacy. Our objective was to test whether the positive effect of the decision aid on knowledge is moderated by eHealth literacy. Methods: A total of 1,206 women aged 50 from Westphalia-Lippe, Germany, participated (response rate of 16.3%) in our study and were randomized to usual care (i.e., the standard information brochure sent with the programme's invitation letter) or the decision aid. eHealth literacy was assessed at baseline with the Electronic Health Literacy Scale (eHEALS); knowledge was assessed at baseline and post-intervention. First, we compared the 2-factor model of the German eHEALS (information-seeking and information-appraisal) found in previous research and the 3-factor model we hypothesized for decision aid use to the originally proposed 1-factor model. Second, we modeled the measurement model according to the superior factor model found in step one and tested whether the eHEALS moderated the effect of the decision aid on knowledge. Results: The 3-factor model of the eHEALS had a better model fit than the 1-factor or 2-factor model. Both information-seeking, information-appraisal, and information-use had no effect on knowledge post-intervention. All three interactions of the decision aid with information-seeking, information-appraisal, and information-use were not significant. Equally, neither education nor its interaction with the decision aid had an effect on knowledge post-intervention. Conclusion: The decision aid developed in this project increases knowledge irrespective of level of eHealth literacy. This means that not only women with high eHealth literacy profit from the decision aid but that the decision aid has been successfully conceptualized as a comprehensible information tool that can be used by women of varying eHealth literacy levels