HSBC Bank. HBSC (Health Behaviour in School-aged Children) HBCS (Helsinki Birth Cohort Study)

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1 HSBC HBSC HBCS

2 HSBC Bank HBSC (Health Behaviour in School-aged Children) HBCS (Helsinki Birth Cohort Study)

3 Health Behaviour in School-aged Children WHO Collaborative Cross-National Survey (HBSC) WHO-Koululaistutkimus Jorma Tynjälä

4 Broad aims of HBSC Research aims to increase understanding of young people's health and well-being and health behaviours in their social contexts (school, family, peers, ) To inform and influence policy and practice at national and international levels Health Behaviour in School-aged Children: WHO Collaborative Cross-National Study (HBSC)

5 Background HBSC initiated in 1982 by three countries (England, Finland, Norway), shortly afterwards adopted as a WHO collaborative study Since November 2017 has 48 member countries/regions in Europe and North America A collaborative project between national research teams in partnership with WHO Cross-sectional design: surveys conducted every 4 years using standard international questionnaire in all countries (latest survey 2013/2014) Health Behaviour in School-aged Children: WHO Collaborative Cross-National Study (HBSC)

6 Methods School based, pupil self-complete questionnaire, teacher or researcher administered Primary sampling unit (PSU) is class Three age groups with mean age 11.5, 13.5 and 15.5 years National surveys conducted at same time of year to obtain correct mean ages Sample size in each country: minimum of 4,500 (1,500 per age group) Research protocol (full version 870 pages in 2014 survey) Health Behaviour in School-aged Children: WHO Collaborative Cross-National Study (HBSC)

7 How HBSC works? Two annual research meetings Focus groups in different fields e.g. physical activity, school, Research methods work shops during meetings Research/writing groups in different fields e.g. health literacy, medicine use Country zones e.g. Nordic zone have had own meetings in positive mental health HBSC use Google Docs environment in all communication (protocols, meeting schedules, , news, ) HBSC International Coordinating Centre: Child and Adolescent Health Research Unit, University of St Andrews, Scotland AND HBSC Data Management Centre: Research Centre for Health Promotion, University of Bergen, Norway Health Behaviour in School-aged Children: WHO Collaborative Cross-National Study (HBSC)

8 Health and behaviour Survey instrument(s) Self-rated health, health complaints and life satisfaction Oral health Substance use: smoking, drinking and cannabis Physical activity and sedentary behaviour Eating behaviours Body image Obesity Weight reduction behaviour Sexual behaviour Bullying and fighting Injuries Social and developmental context Family structure and relationships School environment Peer relations and social behaviour Socioeconomic environment Pubertal development In the international protocol: - Mandatory question package, - Optional questions (several packages) In addition, each country can decide what questions it has in its national questionnaire. Health Behaviour in School-aged Children: WHO Collaborative Cross-National Study (HBSC)

9 Growth of HBSC study: countries by survey year 1983/ / / / / / / /10 1. England 2. Finland 3. Norway 4. Austria 5. Denmark *) *) Carried out the survey after schedule = national data 1. Finland 2. Norway 3. Austria 4. Denmark 5. Belgium 6. Hungary 7. Israel 8. Scotland 9. Spain 10. Sweden 11. Switzerland 12. Wales 13. Netherlands 1. Finland 2. Norway 3. Austria 4. Belgium (Fr) 5. Hungary 6. Scotland 7. Spain 8. Sweden 9. Switzerland 10. Wales 11.Denmark 12. Netherlands 13. Canada 14. Latvia 15. N. Ireland 16. Poland 1. Finland 2. Norway 3. Austria 4. Belgium (Fr) 5. Hungary 6. Israel 7. Scotland 8. Spain 9. Sweden 10. Switzerland 11. Wales 12. Denmark 13. Canada 14. Latvia 15. N..Ireland 16. Poland 17. Belgium (Fl) 18. Czech Republic 19. Estonia 20. France 21. Germany 22. Greenland 23. Lithuania 24. Russia 25. Slovakia 1. Finland 2. Norway 3. Austria 4. Belgium (Fr) 5. Hungary 6. Israel 7. Scotland 8. Sweden 9. Switzerland 10. Wales 11. Denmark 12. Canada 13. Latvia 14. N. Ireland 15. Poland 16. Belgium (Fl) 17. Czech Republic 18. Estonia 19. France 20. Germany 21. Greenland 22. Lithuania 23. Russia 24. Slovakia 25. England 26. Greece 27. Portugal 28. Ireland 29. USA 1. Finland 2. Norway 3. Austria 4. Belgium (Fr) 5. Hungary 6. Israel 7. Scotland 8. Spain 9. Sweden 10. Switzerland 11. Wales 12. Denmark 13. Canada 14. Latvia 15. Poland 16. Belgium (Fl) 17. Czech Republic 18. Estonia 19. France 20. Germany 21. Greenland 22. Lithuania 23. Russia 24. England 25. Greece 26. Portugal 27. Ireland 28. USA 29. tfyr Macedonia 30. Netherlands 31. Italy 32. Croatia 33. Malta 34. Slovenia 35. Ukraine 1. Finland 2. Norway 3. Austria 4. Belgium (Fr) 5. Hungary 6. Israel 7. Scotland 8. Spain 9. Sweden 10. Switzerland 11. Wales 12. Denmark 13. Canada 14. Latvia 15. Poland 16. Belgium (Fl) 17. Czech Republic 18. Estonia 19. France 20. Germany 21. Greenland 22. Lithuania 23. Russia 24. England 25. Greece 26. Portugal 27. Ireland 28. USA 29. tfyr Macedonia 30. Netherlands 31. Italy 32. Croatia 33. Malta 34. Slovenia 35. Ukraine 36. Luxembourg 37. Turkey 38. Slovakia 39. Romania 40. Iceland 41. Bulgaria 1 Finland 2 Norway 3 Austria 4 Belgium (French) 5 Hungary 6 Israel 7 Scotland 8 Spain 9 Sweden 10 Switzerland 11 Wales 12 Denmark 13 Canada 14 Latvia 15 Poland 16 Belgium (Flemish) 17 Czech Republic 18 Estonia 19 France 20 Germany 21 Greenland 22 Lithuania 23 Russia 24 Slovak Republic 25 England 26 Greece 27 Portugal 28 Rep. of Ireland 29 USA 30 tfyr Macedonia 31 Netherlands 32 Italy 33 Croatia 34 Malta 35 Slovenia 36 Ukraine 37 Bulgaria 38 Iceland 39 Luxembourg 40 Romania 41 Turkey 42 Albania 43 Armenia Health Behaviour in School-aged Children: WHO collaborative cross-national study

10 HBSC member countries 2017 Health Behaviour in School-aged Children: WHO Collaborative Cross-National Study (HBSC)

11 WHO-Koululaistutkimus Health Behaviour in Schoo-Aged Children (HBSC) HBSC is also in social media (Facebook and Twitter) Data visualisations International Report Journal Publications Factsheets and Briefing Papers

12 Publications: Academic papers International Report >750 peer reviewed articles ( ) Over 1000 citations (2012) Still 2 nd most downloaded publication from WHO website

13 Tulosten avaaminen: DATA VISUALISATIONS maiden välinen vertailu ja muutokset ajassa

14 Health literacy as a determinant of health Measuring health literacy within a HBSC- study: national and international data ENVIRONMENTAL FACTORS Family, friends, school, sport club, FAS PERSONAL FACTORS Age Gender School achievement Learning difficulties FAS Educational aspiration HEALTH LITERACY HEALTH & HEALTH BEHAVIOUR Perceived health Health complaints Weight Substance use Physical activity Sleep habits Eating habits Medicine use Paakkari L. & 0.

15 Description of Health Literacy in School-Aged Children (HLSAC) questions (age groups 13.5 & 15.5 yrs) I am confident that From the following options, choose the one that best describes your opinion: Not at all true Not completely true Somewhat true Absolutely true...i have good information about health when necessary I am able to give ideas on how to improve health in my immediate surroundings (e.g. a nearby place or area, family, friends) I can compare health-related information from different sources I can follow the instructions given to me by healthcare personnel (e.g. nurse, doctor) I can easily give examples of things that promote health I can judge how my own actions affect the surrounding natural environment when necessary I find health-related information that is easy for me to understand I can judge how my behaviour affects my health I can usually figure out if some health-related information is right or wrong I can give reasons for choices I make regarding my health (Paakkari O. et al., 2016)

16 Better Health Literacy, better health outcomes Less smoking BMI normal More moderate to vigorous physical activity Good perceived HL Less health complaints Less use of alcohol Better perceived health Paakkari L. et al., 2018b

17 Health Literacy julkaisut Paakkari L, Paakkari O. Health literacy as a learning outcome in schools. Health Education 2012;112: Paakkari O, Torppa M, Kannas L. Paakkari L. Subjective health literacy: development of a brief instrument for school-aged children. Scand J Public Health 2016;44: Paakkari O, Torppa M, Villberg J, Kannas L, Paakkari L. Subjective health literacy among school-aged children. Health Education 2018;118. Paakkari O ym. Työn alla mittarin kansainvälinen vertailu Suomen ja neljän muun maan (Itävalta, Slovakia, Puola, Belgia) välillä. Health Behaviour in School-aged Children: WHO Collaborative Cross-National Study (HBSC)

18 HBSC:n merkitys 1/2 WHO-Koululaistutkimus (HBSC) antaa tärkeää tietoa suomalaisten lasten ja nuorten terveydestä, terveyskäyttäytymisestä ja koulukokemuksista sekä terveyden sosioekonomisista eroista kyseisenä ajankohtana sekä vertailukelpoista trenditietoa useiden vuosikymmenten ajalta. WHO-Koululaistutkimuksen kiistaton arvo on kansainvälinen vertailtavuus. Tutkimus mahdollistaa maakohtaisten epäkohtien ja vahvuuksien tunnistamisen. Tutkimuksen yhteistyökumppaneita ovat WHO, Unicef esim. Unicef Innocenti Report Card 14 ( OECD. WHO käyttää tutkimustuloksia terveyspolitiikan työkaluna. Olennaista on Suomen paikantaminen WHO:n, Unicefin ja OECD raporteissa. Tutkimustulosten pohjalta rakennetaan lasten ja nuorten terveyssuosituksia. Health Behaviour in School-aged Children: WHO Collaborative Cross-National Study (HBSC)

19 HBSC:n merkitys 2/2 WHO Europe Health Stats -sovellus (esim. ipadille) perustuu nuorten osalta HBSC-tutkimukseen. Tutkimuksen tietoja käytetään indikaattorityössä. Indikaattorit kansainvälisesti validoituja. Tutkimuksen yhteys koulutukseen on vahva, sitä hyödynnetään Jyväskylän yliopiston Liikuntatieteellisen tiedekunnan liikunnan- ja terveystiedon opettajankoulutuksessa, terveystieteiden maisteriohjelmissa sekä täydennyskoulutuksessa. Tutkimuksen Suomen ryhmä on kehittänyt terveyden lukutaidon mittarin, HLSAC (Paakkari ym. 2016, 2017). WHO on nostanut terveyden lukutaidon tärkeäksi terveyden osoittimeksi. HLSAC - mittarin on valinnut kymmenen maata vuoden 2018 kansainvälisessä aineistonkeruussa. Health Behaviour in School-aged Children: WHO Collaborative Cross-National Study (HBSC)

20 HBSC Finland Lasse Kannas Jorma Tynjälä Raili Välimaa Kristiina Ojala Leena Paakkari Olli Paakkari Nelli Lyyra Sami Kokko Kwog Ng Tuula Aira Ilona Markkanen Sisko Honkala Finnish collaborators (outside JYU): Folkhälsan Finnish National Agency for Education (EDUFI eli Opetushallitus) Health Behaviour in School-aged Children: WHO Collaborative Cross-National Study (HBSC)

21 Further information Full list of scientific journal articles Downloadable copies of international reports: e.g report Adolescent obesity and related behaviours: trends and inequalities in the WHO European Region, See also: The next HBSC International report will be published in mid 2020