Trends in high life satisfaction among adolescents in five Nordic countries 2002–2014

Life satisfaction is an important indicator when assessing positive mental health aspects in populations, including among adolescents. The aim of this study was to investigate trends over time in prevalence of high life satisfaction among adolescents from five Nordic countries: Denmark, Iceland, Finland, Norway and Sweden. We used data from four waves of the Health Behaviour in School-Aged Children study from 2002, 2006, 2010 and 2014 (n=109,847). HBSC is a school-based study examining social circumstances, health and health behaviour among 11-, 13- and 15-years olds every four years in many European and North American countries. The Cantril Ladder, an 11-step visual analogue scale, was used as the measure of life satisfaction, and was dichotomised into two groups: high life satisfaction (scoring 9 or 10 on the scale) and medium/low life satisfaction (scoring <9). Over the 12-year period studied, between 28.6 and 44.8% of adolescents in the five countries rated their life satisfaction as high. Relatively large changes in prevalence levels occurred at the country level over the period. Denmark and Finland showed a steady, significant decline in the prevalence of high life satisfaction over the years. Iceland showed the highest prevalence in 2010. Norway and Sweden showed similar development until 2010, followed by a clear increase for Norway and a sharp decline in adolescent high life satisfaction for Sweden up until 2014. In all countries, high life satisfaction was most prevalent in 11-year- olds and least prevalent in almost all surveys among 15-year-old girls.peerReviewe

Smoking trends among adolescents from 1990 to 2002 in ten European countries and Canada

BACKGROUND: Daily smoking adolescents are a public health problem as they are more likely to become adult smokers and to develop smoking-related health problems later on in their lives. METHODS: The study is part of the four-yearly, cross-national Health Behaviour in School-aged Children study, a school-based survey on a nationally representative sample using a standardised methodology. Data of 4 survey periods are available (1990–2002). Gender-specific daily smoking trends among 14–15 year olds are examined using logistic regressions. Sex ratios are calculated for each survey period and country. Interaction effects between period and gender are examined. RESULTS: Daily smoking prevalence in boys in 2002 ranges from 5.5% in Sweden to 20.0% in Latvia. Among girls, the daily smoking prevalence in 2002 ranges from 8.9% in Poland to 24.7% in Austria. Three daily smoking trend groups are identified: countries with a declining or stagnating trend, countries with an increasing trend followed by a decreasing trend, and countries with an increasing trend. These trend groups show a geographical pattern, but are not linked to smoking prevalence. Over the 4 surveys, the sex ratio has changed in Belgium, Switzerland, and Latvia. CONCLUSION: Among adolescents in Europe, three groups of countries in a different stage of the smoking epidemic curve can be identified, with girls being in an earlier stage than boys. In 2002, large differences in smoking prevalence between the countries have been observed. This predicts a high mortality due to smoking over 20–30 years for some countries, if no policy interventions are taken

Differential Item Functioning in Trend Analyses of Adolescent Mental Health - Illustrative Examples Using HBSC-Data from Finland

Although there is an increasing focus on trend analyses of adolescent mental health, yet too little attention is paid to the methodological challenges and pitfalls inherent in this type of analyses. The purpose of the study is to analyse the psychometric properties of a Finnish instrument on psychosomatic problems, with a major focus on Differential Item Functioning (DIF) across time. Questionnaire data collected in 1994, 1998, 2006 and 2014 among Finnish schoolchildren in grade 9 (15-year-olds) as part of the Health Behaviour in School-aged Children (HBSC) study were utilised. The polytomous Rasch model was used to examine the psychometric properties of a composite measure of psychosomatic problems. The results clearly indicate that the composite measure on psychosomatic problems consisting of nine items does not work invariantly over time. In particular, the item depressed shows DIF across years of investigations. This item works quite differently at the first year of investigation compared to the last year showing higher expected values 2014 (=less frequent problems) than 1994. This DIF affects the person measure of change in psychosomatic problems between 1994 and 2014. Resolving the item depressed for year of investigation DIF, or removing it, increases the difference in person mean values between the two years, implying increasing psychosomatic problems over time. Since the DIF affects the trend results, different options to address the problems need to be considered. Removing the item depressed would bring the Finnish measure of psychosomatic problems in better accordance with the content of the questions on psychosomatic problems in the international HBSC protocol in which the item depressed is not included.Peer reviewe

Subjective health, symptom load and quality of life of children and adolescents in Europe

Objectives: To examine cross-cultural differences in the prevalence of school children's subjective health types and the pattern of socio-demographic and socio-economic differences

Semantics bias in cross-national comparative analyses: is it good or bad to have "fair" health?

The Health Behavior in School-aged Children is a cross-national study collecting data on social and health indicators on adolescents in 43 countries. The study provides comparable data on health behaviors and health outcomes through the use of a common protocol, which have been a back bone of the study sine its initiation in 1983. Recent years, researchers within the study have noticed a questionable comparability on the widely used item on self-rated health. One of the four response categories to the item "Would you say your health is....?" showed particular variation, as the response category "Fair" varied from 20 % in Latvia and Moldova to 3-4 % in Bulgaria and Macedonia. A qualitative mini-survey of the back-translations showed that the response category "Fair" had a negative slant in 25 countries, a positive slant in 10 countries and was considered neutral in 9 countries. This finding indicates that there are what may be called semantic issues affecting comparability in international studies, since the same original word (in an English original) is interpreted differently across countries and cultures. The paper test and discuss a few possible explanations to this, however, only leaving to future studies to hold a cautious approach to international comparisons if working with the self-rated health item with four response categories