Psychosocial school factors and mental health of first grade secondary school students-Results of the Health Behaviour in School-aged Children Survey in Serbia.

This cross-sectional study aimed to investigate the association between psychosocial school factors and life satisfaction, symptoms of depression and psychosomatic health complaints among first grade secondary school students in Serbia. We analysed data from the 2018 Health Behaviour in School-aged Children (HBSC) study in the Republic of Serbia. Analyzed psychosocial school factors included satisfaction with school, schoolwork pressure, teacher support, classmate support and being bullied at school. Life satisfaction was assessed by the 11-step Cantril's ladder (cutoff >5). Symptoms of depression were measured by the Center for Epidemiologic Studies Depression Scale (CESD-10) and psychosomatic health complaints by using the HBSC symptom checklist. Univariable and multivariable binary logistic regression was used to determine independent predictors of students' life satisfaction, symptoms of depression and psychosomatic health complaints in the school environment, while also considering their socio-demographic characteristics and perceived family and friend support. The study included 1605 students (average age 15.26 ±0.44 years), of whom 50.3% were females. Results from the binary logistic regression analyses showed that life satisfaction was positively related to school satisfaction and classmate support, and negatively to being bullied at school. Symptoms of depression were positively associated with schoolwork pressure and being bullied at school, and negatively with teacher and classmate support. All analyzed factors of the school environment were significantly related to psychosomatic health complaints, whereby schoolwork pressure and being bullied at school were positively associated, while teacher and classmate support and satisfaction with school were negatively associated. Given the established association of psychosocial school factors with mental health, there is a need for targeted measures both at school and community level with the aim of improving social support in the school environment, reducing schoolwork burden and preventing bullying at school, potentially resulting in the overall improvement of mental health of the first grade secondary school students.

Encouraging greater empowerment for adolescents in consent procedures in social science research and policy projects.

The United Nations Convention on the Rights of the Child emphasizes the importance of allowing children and adolescents to influence decisions that are important to them following their age and maturity. This paper explores the principles, practices, and implications around using parental versus child/adolescent consent when participating in social science research and policy development. Experiences from two studies are presented: The Confronting Obesity: Co-creating policy with youth (CO-CREATE) and the Health Behaviour in School-aged Children (HBSC) study, a World Health Organization (WHO) Collaborative Cross-National study. Although parental consent may be an important gatekeeper for protecting children and adolescents from potentially harmful research participation, it may also be considered an obstacle to the empowerment of children and adolescents in case they want to share their views and experiences directly. This paper argues that evaluation of possible harm should be left to ethics committees and that, if no harm related to the research participation processes is identified and the project has a clear perspective on collaborating with the target group, adolescents from the age of 12 years should be granted the legal capacity to give consent to participate in the research project. Collaboration with adolescents in the development of the research project is encouraged.

Relationship between socioeconomic and nutritional status in the Serbian adult population: a cross-sectional study.

BACKGROUND: Socioeconomic status is a well-known risk factor for obesity. The aim of this study was to assess the relationship between socioeconomic and nutritional status in the Serbian adult population. DESIGN AND SETTING: Cross-sectional study on data from the 2013 National Health Survey performed in Serbia. METHODS: The study population consisted of adults aged ≥ 20 years. Face-to-face interviews and anthropometric measurements were conducted by trained staff. Associations between body mass index and sociodemographic variables were analyzed using multivariable logistic regression analyses. RESULTS: Out of 12,461 subjects of both sexes, 36.4% were overweight and 22.4% were obese. The prevalences of overweight and obesity differed significantly between the sexes, regarding all sociodemographic characteristics. Among women, educational attainment was associated with lower risk of being overweight (odds ratio, OR = 0.82; 95% confidence interval, CI: 0.69-0.98 for medium-level and OR = 0.77; CI: 0.62-0.97 for higher education) or obese (OR = 0.68; CI: 0.57-0.82 for medium-level and OR = 0.41; CI: 0.31-0.54 for higher education). In contrast, medium-level (OR = 1.28; CI: 1.08-1.52) and highly educated men (OR = 1.39; CI: 1.11-1.74) were more frequently overweight than were those with low education. Among men, grade I obesity was positively related to the richest wealth index group (OR = 1.27), while the opposite was true for grade II obesity among women (OR = 0.61). CONCLUSION: This study showed significant socioeconomic inequalities in nutritional status between men and women. Continuous monitoring of socioeconomic patterns relating to weight is important, especially with further exploration of the link between education and obesity.

Relationship between socioeconomic and nutritional status in the Serbian adult population: a cross-sectional study

ABSTRACT BACKGROUND: Socioeconomic status is a well-known risk factor for obesity. The aim of this study was to assess the relationship between socioeconomic and nutritional status in the Serbian adult population. DESIGN AND SETTING: Cross-sectional study on data from the 2013 National Health Survey performed in Serbia. METHODS: The study population consisted of adults aged ≥ 20 years. Face-to-face interviews and anthropometric measurements were conducted by trained staff. Associations between body mass index and sociodemographic variables were analyzed using multivariable logistic regression analyses. RESULTS: Out of 12,461 subjects of both sexes, 36.4% were overweight and 22.4% were obese. The prevalences of overweight and obesity differed significantly between the sexes, regarding all sociodemographic characteristics. Among women, educational attainment was associated with lower risk of being overweight (odds ratio, OR = 0.82; 95% confidence interval, CI: 0.69-0.98 for medium-level and OR = 0.77; CI: 0.62-0.97 for higher education) or obese (OR = 0.68; CI: 0.57-0.82 for medium-level and OR = 0.41; CI: 0.31-0.54 for higher education). In contrast, medium-level (OR = 1.28; CI: 1.08-1.52) and highly educated men (OR = 1.39; CI: 1.11-1.74) were more frequently overweight than were those with low education. Among men, grade I obesity was positively related to the richest wealth index group (OR = 1.27), while the opposite was true for grade II obesity among women (OR = 0.61). CONCLUSION: This study showed significant socioeconomic inequalities in nutritional status between men and women. Continuous monitoring of socioeconomic patterns relating to weight is important, especially with further exploration of the link between education and obesity.

Better noncommunicable disease outcomes: challenges and opportunities for health systems: Serbia country assessment

Despite positive trends, life expectancy in Serbia is well below the average for the WHO European Region.The probability of dying from one of the main noncommunicable diseases (NCDs) between the ages of30 and 69 years is 20%. This has significant socioeconomic consequences for the development of thecountry and calls for an immediate strengthening of the health system to respond to the growing burdenof NCDs. Despite significant progress and political commitment in Serbia, the outcomes of NCDs couldstill be improved. This report reviews the challenges and opportunities facing the health system in Serbiain scaling up core services for the prevention, early diagnosis and management of NCDs. The report alsoprovides examples of good practice in care. Policy recommendations are made for further action, based onthe assessment.

Attitudes on alcohol and drinking patterns among youth in Serbia.

INTRODUCTION: Alcohol is most abused psychoactive substance among youth. Analyzing attitudes on alcohol, patterns and consequences we are getting inputs important for implementing evidence based preventive measures. OBJECTIVE: The aim of this study was to analyze drinking patterns and expectations and alcohol risk perception by gender and region and determine correlation between attitudes and one year prevalence of drinking. METHODS: The study used data from the European School Survey on Alcohol and Other Drugs, which was then conducted in 2008 in Serbia on a sample of 6,553 students aged 16 years. For data analysis descriptive and analytical statistic were used. RESULTS: The results show that nine out often students have had at least one alcoholic beverage during life and 5% have at least one alcohol beverage on more than 20 occasions during the last month. Students in Serbia have mainly positive expectations from alcohol, and the strongest potential drinking predictors in the previous year are expectation of having fun and the wish to feel relaxed. According to the participants, drinking 4-5 drinks on weekends (34.6%) is less risky than trying cannabis (52.0%). Boys have experienced problems caused by alcohol drinking more often than girls, while students from Vojvodina have performed badly in school in higher percentage than students from Belgrade and Central Serbia. CONCLUSION: In Serbia, girls drink less and perceive drinking as more risky in comparison to boys, while 16-year-old students from Vojvodina have more positive expectations but also more prominent problems caused by alcohol drinking. Additional education of the young on alcohol risk is recommended.