A model for HTA priority setting: experience in Lithuania.

OBJECTIVES: To promote the further development of HTA, this study aims to design a model for HTA priority setting, which would address national needs for a country with little experience in the field of HTA, and assess its feasibility for the health system. METHODS: Literature search and review, as well as qualitative research have been used in the design and testing of the model for HTA priority setting. To test the model and the methodology, a three-round Delphi study was conducted in 2011 in the form of an electronic questionnaire, which was distributed to the panel of eleven national experts. The panel was composed of experts representing various fields of the health care sector: policy-makers, health care service professionals and academics, with diverse professional roles. RESULTS: The designed model consists of four stages: (i) selection of experts for the panel, (ii) indication and selection of health policy topics, (iii) identification of health technologies, and (iv) priority setting. Three rounds of the Delphi study were performed to test the model and reach expert consensus on a list of health technologies for assessment, including pharmaceuticals, vaccines, medical devices, diagnostic methods, public health interventions, organizational systems, etc. CONCLUSIONS: Based on the Delphi technique as a method for consensus building, the model for HTA priority setting was developed for Lithuania; however, it could also be used for other countries with little experience in the field of HTA.

Motivations for adolescent participation in leisure-time physical activity: international differences.

BACKGROUND: Although there are substantial international differences in adolescent physical activity (PA), cross-country motivational differences have received limited attention, perhaps due to the lack of measures applicable internationally. METHODS: Identical self-report measures assessing PA and motivations for PA were used to survey students ages 11, 13, and 15 from 7 countries participating in the 2005-2006 Health Behavior in School-Aged Children (HBSC) study representing 3 regions: Eastern Europe, Western Europe and North America. Multigroup comparisons with Confirmatory Factor Analysis and Structural Equation Modeling examined the stability of factors across regions and regional differences in relations between PA and motives for PA. RESULTS: Three PA motivation factors were identified as suitable for assessing international populations. There were significant regional, gender, and age differences in relations between PA and each of the 3 PA motives. Social and achievement motives were positively related to PA. However, the association of PA with health motivations varied significantly by region and gender. The patterns suggest the importance of social motives for PA and the possibility that health may not be a reliable motivator for adolescent PA. CONCLUSION: Programs to increase PA in adolescence need to determine which motives are effective for the particular population being targeted.

The influence of individual and regional factors on association between leisure time physical activity and psychological complaints among adolescents in Europe.

The aim of this study was to examine the association between leisure time physical activity and psychological complaints among adolescents and to determine to what extent this association is mediated by individual and regional factors. Data from the 2005/06 Health Behaviour in School-aged children (HBSC) survey, composed of 106,319 respondents aged 11, 13 and 15 from 20 European countries was analysed. Multilevel modeling showed that individual factors (gender, age and family socioeconomic status) were significant mediators of the association between leisure time physical activity and psychological complaints. The mediating effect of individual factors differed in the magnitude of the association. Regional differences in this association were not found. The findings suggest that individual factors contribute in explaining the association between leisure time physical activity and psychological complaints among adolescents. Future research should examine country specific characteristics which may influence this association.

Body image and weight control among adolescents in Lithuania, Croatia, and the United States in the context of global obesity.

AIM: To compare body image and weight control behavior among adolescents in Lithuania, Croatia, and the United States (US), the countries with striking contrasts in the prevalence of overweight among adolescents. METHOD: The study was carried out according to the methodology of the Health Behavior in School-aged Children collaborative survey. Nationally-representative samples of students, aged 13 and 15, were surveyed in Lithuania (3778 respondents), Croatia (2946 respondents), and the US (3546 respondents) in the 2001/2002 school year. RESULTS: In all three countries, girls perceived themselves as being "too fat" more frequently than boys (37.0% vs 19.7%, P<0.001, z test). The prevalence of this perception increased with age among girls (32.7% vs 41.1%, P<0.001, z test) and decreased among boys (21.4% vs 17.9%, P=0.005, z test). Lithuanian adolescents were least likely to perceive themselves as "too fat;" this perception was significantly more frequent in Croatia and the US (24.2%, 27.5%, and 34.3%, respectively; P<0.001, chi(2) test). With the exception of 15-year-old Lithuanian boys, in all respondents the proportion of adolescents with body mass index (BMI) > or =85th percentile who perceived themselves as "too fat" was significantly higher (up to 3.13 times among 15-year-old US girls) than the proportion of adolescents with BMI < or =15th percentile who perceived themselves as "too thin." The highest proportion of overweight boys and girls on a diet or doing something else to lose weight was found in the US. Boys in Lithuania were most likely to be satisfied with their weight regardless of their weight status. CONCLUSION: Perceived body image and weight control behavior differ among adolescents in Lithuania, Croatia, and the US. Cross-cultural, age, and sex influences moderate body image and weight control behavior in underweight and overweight adolescents.

Risk factors for alcohol use among youth and main aspects of prevention programs.

Increasing alcohol consumption becomes more relevant social and health problem among youth. There is no reason to believe that this problem will decrease or be solved in the future. In such situation, it is necessary to build on the experience and conclusions of research performed by other countries. In this article, the risk factors for alcohol consumption among youth and preventive programs, in which family, school, and community play the main role, are analyzed. Such programs may attract the attention of public health specialists and public health politicians and can be not only declared, but also really implemented.