Use of emergency contraceptive pill by 15-year-old girls: results from the international Health Behaviour in School-aged Children (HBSC) study.

OBJECTIVE: To describe emergency contraceptive pill (ECP) use and variation across countries/regions; and to explore personal and contextual factors associated with ECP use and differences across countries/regions. DESIGN: Data were obtained from 11 countries/regions in the 2006 Health Behaviour in School-aged Children cross-sectional study. SETTING Data were collected by self-report questionnaire in school classrooms. POPULATION: The analysis is based on 2118 sexually active 15-year-old girls. METHODS: Contraceptive behaviours were compared across countries/regions by chi-square tests. Individual factors related to ECP use were investigated with separate logistic regression models. Multilevel random-intercept models allowed the investigation of individual and contextual effects, by partitioning the variance into student, school and country/region levels. MAIN OUTCOME MEASURES: ECP use at last sexual intercourse. RESULTS: ECP use rate varied significantly across countries/regions. Poor communication with at least one adult (odds ratio [OR] 1.62 [1.12-2.36], P = 0.011) and daily smoking (OR 1.46 [1.00-2.11], P = 0.048) were independently associated with ECP use in comparison with condom and/or birth-control pill use. Sexual initiation at 14 years or later (OR 2.02 [1.04-3.93], P = 0.039), good perceived academic achievement (OR 1.69 [1.04-2.75], P = 0.035) and daily smoking (OR 1.63 [1.01-2.64], P = 0.045) were associated with higher levels of ECP use in comparison with unprotected girls. The country-level variance remained significant in both comparisons. CONCLUSIONS: These data document the large heterogeneity in rates of ECP use between countries/regions. These differences could not be explained by individual or contextual factors, and raise further questions in relation to ECP access for adolescents and their education in its appropriate use.

Interpersonal relationships as predictors of positive health among Irish youth: the more the merrier?

To investigate positive health and its associations with supportive relationships with friends and family members, we conducted an analysis of data from the 2002 Irish Health Behaviour in School-Aged Children Study (HBSC); a cross-sectional survey of 8,424 Irish schoolchildren aged 10-18. 36.0% and 63.4% of the students reported lack of emotional and physical symptoms respectively, 56.1% reported high life satisfaction, 46.9% scored highly on positive life index and 44.2% reported that they are very happy with their life. Parent, sibling and friend relationships were independent predictors of positive health, with higher odds ratios for parents than those for siblings or friends. A greater number of supportive relationships was strongly associated with positive health. Gender and age variations are also reported. The data suggest that there are gains to be made in terms of adolescent health from assisting adolescents to build and maintain their interpersonal relationships, and independently to support parents in their relationships with their children.

Assessing the use of the Family Affluence Scale (FAS) among Irish schoolchildren.

The objective of this analysis was to examine the answering rates, internal reliability and external validity of the Family Affluence Scale (FAS) employing data from the 2002 Irish Health Behaviour in School-aged Children study HBSC; a cross-sectional survey of 8,424 Irish schoolchildren aged 10-18. Father's occupation was reported by 80.6% of the schoolchildren and 60.6% reported on mother's occupation, while over 96% reported on the FAS items. Lower answering rates on parental occupation were found among younger schoolchildren and among those with poorer material circumstances. Analysis of the FAS revealed a moderate internal reliability and FAS scores were significantly associated with reported parental occupation. The traditional SES measures suffer from poor answering rates that pose a serious methodological threat. The FAS has moderate internal reliability and does not capture the SES status in full, but it has high completion rates, and can be used as an additional measure of SES in late childhood and adolescence.

Correlates of increased risk of eating disorders in Irish school children.

Currently there are no large-scale data on the prevalence of disordered eating behaviours in Irish children and adolescents. We examined the 2002 Health Behaviour in School Aged Children (HBSC) study to estimate those Irish children who are potentially at risk of developing an eating disorder. Body Mass Index (BMI) data, based on self-reported height and weight were available for 2,469 pupils (29% of all participants). This analysis showed that 32.2% of adolescents were underweight (BMI < 18.5 kg m(-2)) and 10.7% of this group 'thought they were too fat'. These latter (n-86) were identified as the 'risk' group and compared with group 2 (n = 717) who reported they were underweight and had indeed a low BMI and group 3, (n = 856) those with a normal range BMI (18.5-25Kg/m2). Those at risk were significantly more likely to choose a large silhouette, be unhappy, poorly satisfied with life and perceive themselves as not good looking, to have diet concerns, be bullied at least twice per month and feel they were average/below average in their academic work (all p < 0.001). These data indicate psycho-social associations with an important potentially pathological population sub-group of at risk children.

Influence on self-rated health of socio-demographic, lifestyle and affluence factors: an analysis of the Irish and International Health Behaviours Among School-Aged Children (HBSC) datasets 1998.

In this analysis we employed the International Health Behaviour Among School Aged Children (HBSC) 1998 data, comprising 8326 Irish children and 115,327 children in the International dataset, to examine influences on self reported health among young people. Factors were similar for both boys and girls and between countries. Daily smokers, those reporting intoxication at least once, those taking infrequent exercise and those reporting difficulty in making friends were all predictive of poor self-rated health in adjusted odds ratio models. Disposable means, as measured by the Family Affluence Score was also a significant predictor of self-rated health but not as influential as reported lifestyle. In a multi-level between country comparison of 15 OECD countries, individual health behaviours explained much, but not all of the variability in poor self reported health (0.26, SE 0.08), and of various ecological level indicators considered in the final model only % voting and % males with minimum 2nd level of male education in the population were influential factors, with between-country variations still not fully explained (0.10, SE 0.03).