Food environments in and around post-primary schools in Ireland: Associations with youth dietary habits.

BACKGROUND: The food environment within and surrounding schools may influence children's diets. This study explored if the internal and external school food environments were associated with intake of specific food groups among adolescents. METHODS: Participants were a subset of 5344 post-primary school students that took part in the Health Behaviour in School-aged Children (HBSC) survey. Four school-level variables were created: urban/rural, disadvantaged status, percentage fast food premises within one kilometer of the school and food sold in the school. Logistic regression models were used to examine school-level influences on daily food consumption controlling for individual and family food environmental factors. RESULTS: For students in disadvantaged schools, the odds of having soft drinks (OR 1.79, 95% CI 1.30-2.47) or chips (OR 1.82, 95% CI 1.17-2.83) daily were larger and the odds of consuming fruits (OR 0.79, 95% CI 0.62-0.99) or vegetables (OR 0.73, 95% CI 0.60-0.88) daily were smaller than for students at other schools. Girls and those from higher socioeconomic classes also had healthier eating habits. Attending a school where more than 10% of the food premises within one kilometer of the school were fast food outlets was associated with a 0.78 (95% CI 0.64 to 0.94) and a 0.79 (95% CI 0.66 to 0.93) decreased odds of daily fruit and vegetable intake, respectively. CONCLUSIONS: Fast food environments around post-primary schools are associated with less fruit and vegetable intake. Children in disadvantaged schools and from lower social classes are more likely to report poorer dietary habits than children in other schools or from higher social classes, respectively. Multiple contexts influence diet, and children at an economic or social disadvantage are at most risk of poor dietary habits.

The Health Behaviour in School-aged Children (HBSC) study: methodological developments and current tensions.

OBJECTIVES: To describe the methodological development of the HBSC survey since its inception and explore methodological tensions that need to be addressed in the ongoing work on this and other large-scale cross-national surveys. METHODS: Using archival data and conversations with members of the network, we collaboratively analysed our joint understandings of the survey's methodology. RESULTS: We identified four tensions that are likely to be present in upcoming survey cycles: (1) maintaining quality standards against a background of rapid growth, (2) continuous improvement with limited financial resources, (3) accommodating analysis of trends with the need to improve and adapt questionnaire content, and (4) meeting the differing requirements of scientific and policy audiences. CONCLUSIONS: While these challenges are not trivial, the structure of the HBSC network and its long-term experience in working through such challenges renders it likely that HBSC can provide a model of other similar studies facing these tensions.

The mean age at menarche of Irish girls in 2006.

Strong evidence exists of a downward secular trend in the age at menarche; which appears to be associated with improved health and nutritional circumstances over the past two centuries. The aim of this study was to determine the mean age at menarche of Irish girls in 2006, as this has not been verified since 1986. A nationally representative sample of Irish girls (n = 4720, age 10-18 years) was obtained from the 2006 Irish Health Behaviour in School Aged Children survey and mean menarcheal age was calculated using the recall method. Mean age at menarche decreased from 13.52 years in 1986 to 12.53 years in 2006 and was lowest in cities and among manual groups. No significant differences were found between Irish-born and immigrant girls. Ongoing observation of this biological milestone is warranted to identify whether this secular trend will stabilise in Ireland and at what age. Consequences of earlier biological maturation on adolescent health behaviours and outcomes should also be monitored.

Self-esteem norms for Irish young people.

Self-esteem scores from the Rosenberg Self-esteem scale collected from a large sample of Irish young people are presented as norms for this population.

Socio-demographic predictors of self-rated health in the Republic of Ireland: findings from the National Survey on Lifestyle, Attitudes and Nutrition, SLAN.

Though Ireland continues to have a poor health profile compared with other European Union countries, previous research on social variations has been limited. For the first time in the Republic of Ireland, the influence on self-rated health of various socio-demographic indicators was assessed in a multi-variate logistic regression model, separately for men and women. Data were from the first National Survey of Lifestyles, Attitudes and Nutrition, SLAN, conducted by post in a multi-stage, cluster random sample across 26 counties. There were 6539 respondents (45.4% males). Mean self-rated health differed significantly according to age, marital status, tenure, educational status, social class, household size and eligibility for general medical services (GMS), but not according to gender or rurality. There were also differences if residing in a district with low level of affluence, or according to social cluster groupings. There were numerous significant correlations between the nine socio-demographic measures, but the most consistent pattern was between GMS eligibility and the various indicators, for both men and women. In the case of men, whether social class was included in the multi-variate model or not, education status remained predictive in the final model, (OR 2.36 CI 1.35-4.12) as did smoking status (OR 2.11 CI 1.47-3.02). Odds ratio for GMS eligibility was 3.33 (CI 2.61-4.26) attenuated to 1.70 (CI 1.12-2.56) in the final model. For women the pattern was somewhat different. Only GMS status (OR 2.64 CI 1.74-3.99) and level of education (2.25 CI 1.19-4.24) were predictive in the final model. A multi-level analysis showed that area level of affluence was not significantly predictive of self-rated health when individual level factors were taken into account.

Socio-demographic variations in perspectives on cardiovascular disease and associated risk factors.

Coronary heart disease (CHD) rates in Ireland are very high but little is known about attitudes to the disease. Qualitative attitudinal data were collected in focus group settings from 74 individuals across socio-demographic categories in order to assess knowledge of and attitudes to CHD and associated risk factors. Focus group questions were derived from group deconstruction of constructs from the Health Belief Model, Theory of Planned Behaviour, Protection Motivation Theory and Social Learning Theory. Participants were drawn from the personnel lists of local government and a health authority hospital. Eight types of groups were constructed according to the various permutations of the three variables: age, gender and occupational group. Analyses revealed good knowledge levels about risk factors among participants. However, participants exhibited mixed loci of control and low motivation to change behaviours. Men generally were less motivated to change than women; older men thought it too late and younger ones too soon. Though white and blue collar groups' views were similar, the discussion in white collar groups was more varied. Participants were sceptical about apparently contradictory medical advice which undermined motivation to change. The data complement earlier work and suggest preventative initiatives should be more focused.