Caring Climate and Support, Mental Health, and Academic Adjustment: Effects from a Cluster Randomized Controlled Trial in Upper Secondary Schools in Norway.

This cluster randomized controlled trial (RCT) examined the effect of a three year follow up of a multi-tier intervention aiming at improving the psychosocial environment in upper secondary schools in Norway. Two intervention conditions were tested: a universal single-tier intervention focused on improving the psychosocial school climate, the dream school program (DSP), and a multi-tier intervention combining the DSP with a targeted measure, the mental health support team (MHST). A total of 2203 students responded to the baseline survey. Of the 2203 pupils, 1884 responded to the first follow-up survey (year 1), 1287 pupils to the second (year 2), and 756 pupils to the third (year 3). The direct and indirect effects on school completion were analyzed using a multi-level linear mixed model. The results showed no significant effects of either the DSP or the DSP and MHST in combination on support, the school climate, mental health, or academic adjustment. We found no significant effect of the interventions on the proportion who had completed school or were in training (the three groups varied between 76.6% and 77.8%). Future similar studies should be attentive to the potential challenges of implementing RCTs in the school setting. Furthermore, the long-term effects of school interventions on the constructs included in this study could be difficult to capture due to the complexity of the phenomena. The implications of these findings are discussed.

Adolescent determinants of life-course leisure-time vigorous physical activity trajectories: a 27-Year longitudinal study.

BACKGROUND: Adolescence is regarded as formative years for building the foundations for life-long health and well-being, and adolescent determinants of physical activity (PA) development is particularly interesting. Novel approaches for the study of PA development, such as group-based trajectory modelling, opens for the possibility of identifying different patterns in the relationship among several known determinants of PA. This study aimed to explore how demographic, psychological and social factors in early adolescence determine membership in four distinct leisure-time vigorous physical activity (LVPA) trajectories from 13 to 40 years. METHODS: This study is based on data from the Norwegian Longitudinal Health Behaviour Study, following a cohort born in 1977 from Western Norway. Four trajectories identified using latent class growth analysis, based on self-reposted LVPA (n = 1103, 45.5% women) measured ten times from age 13 to age 40 and 17 different adolescent determinants, were used in a multivariate multinomial logistic regression. RESULTS: We found that gender (male), VPA intentions the next year and athletic identity associated with belonging to the two trajectories reporting the highest levels of LVPA in adolescence, while VPA intentions in ten years were associated with belonging to the active trajectory compared to the decreasingly active and low active trajectories Enjoyment increased the odds of belonging to the increasingly and decreasingly active trajectories compared to the low active trajectory. In addition, two of the social determinants, mother's PA and emotional support from father, were associated with belonging to the increasingly active trajectory when compared to the low active trajectory. Higher family income increased the odds of belonging to the increasingly active compared to the decreasingly active trajectory. CONCLUSIONS: Both demographic, psychological, and social factors were identified as determinants of LVPA trajectory membership, and the findings support previous research related to the importance of intentions, but also indicate that enjoyment, role modelling and emotional support in PA can be of great importance to LVPA promotion among adolescents.

Leisure-time physical activity trajectories from adolescence to adulthood in relation to several activity domains: a 27-year longitudinal study.

BACKGROUND: Insufficient physical activity (PA) levels among adolescents and adults make promoting PA a public health priority. Although most people exhibit low or decreasing levels of PA, other groups increase or maintain high levels of activity. These different groups may engage differently in activity domains during their leisure time. This study aimed to identify distinct trajectories of leisure-time vigorous physical activity (LVPA) and to explore whether these trajectories are characterised by differences in four activity domains (participation in organised sports clubs, diversity in leisure-time activities, outdoor recreation, and peer PA) over the life course. METHODS: Data were drawn from the Norwegian Longitudinal Health Behaviour Study. The sample of participants (n = 1103, 45.5% female) was surveyed 10 times from age 13 years in 1990 to age 40 years in 2017. LVPA trajectories were identified using latent class growth analysis, and mean differences in activity domains were studied using the one-step BCH approach. RESULTS: Four trajectories were identified: active (9%), increasingly active (12%), decreasingly active (25%), and low active (54%). Overall, this analysis showed a declining tendency in LVPA from age 13 to 40 years except for the increasingly active trajectory. Belonging to a trajectory with a higher LVPA level was related to higher mean levels of the included activity domains. Compared with those in the increasing trajectory, people belonging to the decreasing trajectory reported higher mean participation levels in and age at becoming a member of sports clubs, diversity in leisure-time activities, and best friend's activity level during adolescence. However, in young adulthood, people in the increasingly active trajectory reported significantly higher mean levels for the same variables. CONCLUSIONS: The development of LVPA from adolescence to adulthood is heterogeneous, suggesting the need for targeted health promotion initiatives. The largest trajectory group included more than 50 percent and was characterized by low levels of LVPA, less engagement in PA domains and fewer active friends. There seems to be little carry-over effect of engagement in organised sports in adolescence regarding level of LVPA later in life. Changes in social surroundings throughout the life span, such as having friends who are more or less engaged in PA, may assist or hinder health enhancing engagement in LVPA.

12-Year Trends in Active School Transport across Four European Countries-Findings from the Health Behaviour in School-Aged Children (HBSC) Study.

Active school transport (AST) is a source of daily physical activity uptake. However, AST seems to have decreased worldwide over recent decades. We aimed to examine recent trends in AST and associations with gender, age, family affluence, and time to school, using data from the Health Behaviour in School-Aged Children (HBSC) study collected in 2006, 2010, 2014, and 2018 in the Czech Republic, Norway, Scotland, and Wales. Data from 88,212 students (11, 13 and 15 years old) revealed stable patterns of AST from 2006 to 2018, apart from a decrease in the Czech Republic between 2006 and 2010. For survey waves combined, walking to and from school was most common in the Czech Republic (55%) and least common in Wales (30%). Cycling was only common in Norway (22%). AST differed by gender (Scotland and Wales), by age (Norway), and by family affluence (everywhere but Norway). In the Czech Republic, family affluence was associated with change over time in AST, and the effect of travel time on AST was stronger. The findings indicate that the decrease in AST could be levelling off in the countries considered here. Differential associations with sociodemographic factors and travel time should be considered in the development of strategies for AST.

Vigorous physical activity in relation to family affluence: time trends in Europe and North America.

OBJECTIVES: The aim of the study was to determine secular trends in vigorous physical activity (VPA) among adolescents in relation to family affluence across 34 countries. METHODS: This study used data from the Health Behaviour in School-aged Children (HBSC) study from 34 countries in Europe and North America. Adolescents (N = 501,647) aged 11, 13 and 15 years across three survey cycles (2006, 2010, 2014) self-reported data on VPA and a family affluence scale (FAS) using standardized questionnaires. RESULTS: A significant increase in VPA was found in low-FAS boys (girls) in four (10) countries and a decrease in four (three) countries. In high-FAS boys (girls), a significant increase was observed in nine (11) countries and a decrease in two(three) countries. An overall significant increase in meeting the VPA recommendations was found in high-FAS boys (OR 1.11; 95% CI 1.06-1.16) and in all FAS groups in girls, with the largest effect being found among high-FAS girls (OR 1.24; 95% CI 1.18-1.30). CONCLUSIONS: A country-specific increase in VPA was observed primarily in the medium- and high-FAS categories. This study suggests a need to focus on increasing VPA efforts, especially in low- and medium-FAS boys.

Leisure-time physical activity and participation in organized sports: Changes from 1985 to 2014 in Finland and Norway.

Participation in organized sports is a popular and important part of the lives of children and adolescents and is associated with improved psychological and social health, as well as an increased likelihood of meeting physical activity (PA) recommendations. Changes in modern society, including increased car ownership and use of technology and electronic media, have led to an additional focus on the importance of health-enhancing PA among children and adolescents. The aim of this article was to study the secular changes in self-reports of participation in organized sports clubs and leisure-time vigorous physical activity (LVPA), and whether the relationship between participation in organized sports clubs and LVPA has changed from 1985 to 2014. Questionnaire data were collected in two cross-sectional samples of Finnish and Norwegian 11-, 13- and 15-year-olds in 1985/1986 (n = 7137) and 2014 (n = 9218). Overall, participation in organized sports clubs and level of LVPA appears to have changed in the same direction in the two Nordic countries. The proportion of 11-year-olds reporting to be participants in organized sports clubs increased from 1985/1986 to 2014. There was an overall increase in self-reported LVPA. The association between participation in sports clubs and LVPA was stronger in 2014 than in 1985/1986. The findings indicated subgroup differences, in particular with regard to a steeper increase in LVPA and participation in sports clubs among Finnish girls. We suggest that attention should be given to the role of organized sports to better understand secular changes in PA.

Trends in Active Commuting to School among Czech Schoolchildren from 2006 to 2014.

OBJECTIVE: Active commuting (AC) is an important factor in increasing the total daily physical activity (PA) in children, which is significant for their health and positive physical behaviour in adulthood. The objective of the study was to describe trends in active commuting to school among Czech girls and boys aged 11-15 years from 2006 to 2014, using data from the Health Behaviour in School-aged Children (HBSC) study. METHODS: To investigate trends in AC among Czech children of school age data obtained from the HBSC surveys carried out in 2006, 2010, and 2014 was used. The study sample comprised 12,273 respondents, out of whom 5,992 (48.8%) were boys and 6,281 (51.2%) girls. The overall trends in AC were evaluated using logistic regression analysis. RESULTS: Compared with 2006, there was an overall decrease in AC among the 13-year-old boys and 13-year-old girls (boys - 1.8% in 2006 to 50.1% in 2014, girls - 69.3% in 2006 to 46.3% in 2014). The proportion of children AC (walking and cycling) to school significantly decreased from 74.3% in 2006 to 53.4% in 2014. CONCLUSION: This study demonstrated that AC to school decreased sharply among Czech children of school age from 2006 to 2014. However, walking was the most frequently used mode of travel. The boys were significantly more likely to cycle to school compared to the girls. PA interventions for youth should encourage participation in AC to school in the Czech Republic.

The assessment of ongoing community-based interventions to prevent obesity: lessons learned.

BACKGROUND: The assessment of real-life, community-based interventions to tackle obesity is an important step in the development of effective policies. Especially multi-level interventions have a high likely effectiveness and potential reach in counteracting the obesity epidemic. Although much can be learned from these initiatives, performing an evaluation of such interventions is challenging. The aim of the current article is to provide a descriptive overview of the data collection process and general results of an assessment of ongoing multi-level obesity prevention community interventions for adults in Europe, and the lessons learned from this effort. METHODS: The data collection was divided into two main phases: a) finding the ongoing obesity prevention interventions by contacting key informants in each of the European Union countries and the European Economic Area, and searching existing databases; and b) collecting detailed information (including the reach, effectiveness, adoption, implementation and maintenance (RE-AIM)) of the selected interventions using questionnaires for informants in each of the interventions. RESULTS: A total of 78 interventions from 24 European countries were included in the final sample. The number of identified interventions varied greatly per country. The interventions covered various implementation levels (national, regional or local) and determinants (physical, sociocultural, economic, political), mostly addressing both nutrition and physical activity behaviours. CONCLUSIONS: We found that many multi-level obesity prevention interventions among adults are currently active in Europe, although we found relatively few in Southern and Eastern Europe. Identifying interventions and obtaining detailed information proved to be a difficult, time consuming and painstaking process. We discuss some of the reasons why this might be the case and present recommendations based on our experiences. We suggest that future research uses a step-wise approach, keeping participant burden to a minimum. The use of personalised and tailored strategies is recommended, led by researchers who exercise flexibility, tact and patience during the data collection process.