ࡱ> kmj#` ^Pbjbj\.\. 7x>D>D^HTTTTTTTh0000l,h&L       %%%%%%%$&h")%Tw  ww%TT  %%%%wT T %%w%%%TT%  e0#%%%0&%)$^)%)T% >%    %%$   &wwwwhhh $hhh hhhTTTTTT Background paper on the Health Behaviour in School-Aged Children: WHO Collaborative Cross-National Study (HBSC) Prepared by Candace Currie HBSC International Coordinator Director, Child and Adolescent Health Research Unit University of Edinburgh For UNICEF IRC / OECD / European Commission Child Well-being Expert Consultation, May 25-27, 2009, OECD Paris The HBSC web-site gives detailed information on all aspects of the study at  HYPERLINK "http://www.hbsc.org" http://www.hbsc.org Origins and concept of the HBSC Study HBSC originated in 1982 when researchers from Norway, Finland and England, meeting to discuss the problems of lack of comparability of cross-national data on smoking among young people, agreed to collaborate on the development of a new cross-national survey using a common research protocol and research instrument so that data could be compared with confidence. This led to the conceptualisation of a study that would extend to include a range of important health related behaviours in the context of young peoples lifestyles. Health related behaviours were considered to form a set of interconnected patterns within adolescent lifestyles. The approach involved a broad understanding of how young people lived; both the wider society and the social domains that adolescents inhabited were considered important influences on behaviour. Health was conceptualised not merely as absence of illness or disease, but as both psychological and physical well-being. There was an implicit interest in understanding how behaviour related to health. Health related habits and psychosocial aspects of health were considered to be outcome variables, with personal and environmental factors in lifestyle as predictors. The importance of demographics and the macrosocial context as influences were also explicitly acknowledged. Methodological approaches and challenges The Health Behaviour in School-aged Children (HBSC) study was among the first international surveys on adolescent health. The challenges of producing valid and reliable data soon became apparent and included a range of structural and practical factors such as variation in the school systems in which fieldwork was conducted, compliance with a common research protocol, issues around language and translation, and the differing research capabilities within countries. The study has now grown to more than 40 countries and regions and its profile has increased dramatically. HBSC data are in demand to inform publications from a range of national and international agencies and from academics to access raw data for secondary analysis. This has led to an increased focus on methodological scrutiny and on continuous improvement. From the start, the conceptual approach dictated the survey content. Items relating to the social domains of family, peers, and school were included as were an array of relevant health promoting and health risk behaviours of contemporary public health concern. The survey design and content was and still is considered as innovative because it acknowledged, ahead of its time, that how young people feel is a valid aspect of their health (and that they can accurately report about it). In this respect it paid attention to young peoples everyday symptoms and health complaints, as well as their reflections on their health and well-being. The selected age groups - 11, 13 and 15 - represent the onset of adolescence, the time when young people face the challenges of physical and emotional changes; and the middle years, when young people start to consider important life and career decisions. They also mark increased of autonomy and choice around patterns of consumption; and were within the bounds of compulsory schooling in most European countries. HBSC survey methods For all surveys, a standardised research protocol providing a theoretical framework for the research topics and data collection and analysis procedures is developed. The protocol aims at securing comparable data. The HBSC Research Network members collaborate on the production of this international Research Protocol for each four-yearly survey. The Research Protocol includes detailed information and instructions covering the following: conceptual framework for the study; scientific rationales for each of the survey topic areas; international standard version of questionnaires and instructions for use (e.g., recommended layout, question ordering, and translation guidelines); comprehensive guidance on survey methodology, including sampling, data collection procedures, and instructions for preparing national datasets for export to the International Data Bank; and rules related to use of HBSC data and international publishing. Questionnaire content As HBSC is a school-based survey, data are collected through self-completion questionnaires administered in the classroom. The international standard questionnaire for each survey consists of three levels of questions which are used to create national survey instruments: core questions that each country is required to include to create the international dataset; optional packages of questions on specific topic areas from which countries can choose; and country-specific questions related to issues of national importance. Survey questions cover a range of health indicators and health-related behaviours as well as the life circumstances of young people. Questions are subject to validation studies and piloting at national and international levels, with the outcomes of these studies often being published. The core questions provide information on: demographic factors; social background (e.g., family structure and socio-economic status); social context (e.g., family, peer culture, school environment); health and well-being (e.g., self-rated health, life satisfaction, body image, overweight and obesity, injuries, symptoms); health behaviours (e.g., eating and dieting, physical activity and weight reduction behaviour); and risk behaviours (e.g., smoking, alcohol use, cannabis use, sexual behaviour, bullying). Data collection and file preparation In most countries, questionnaires are delivered to schools for teacher administration. Files from each country are prepared and exported to the HBSC International Data Bank at the University of Bergen, where they are cleaned and compiled into an international data set with support from the Norwegian Social Science Data Services (NSD), under the guidance of the study's Data Bank Manager and the support of the HBSC Methodology Development Group and International Coordinating Centre. With the increased demand for published HBSC data and requests for data for secondary analysis, it is necessary to ensure the quality of the data. All data processing, including consistency checks, age cleaning, derivation of variables, and imputation is therefore first handled centrally. When all national data have been received and accepted according to the Research Protocol by the Data Bank Manager, the files are merged and the combined dataset is made available to the Principal Investigators in each participating country. A period of checking of the international file then progresses as national teams first work with the datafile. From the time it is finalised the international data file is restricted for the use of member country teams for a period of three years, after which time access to the data may be requested for external use by agreement with Principal Investigators across the study. Details can be found at the HBSC homepage ( HYPERLINK "http://www.hbsc.org" http://www.hbsc.org). Access is allowed where there is no overlap with existing or planned analyses for publication by network members or where collaboration can be established. Discussions are currently underway to examine the scope for enhancing external access to HBSC data. Study organization The HBSC network membership currently comprises national teams from 43 countries in Europe and North America. A Principal Investigator (PI), who has been formally accepted by the study Assembly, leads each national team. The Assembly comprises the PI of every member country and is the decision making body of the study. Each member of a national team is automatically a member of the HBSC Research Network. The roles, responsibilities and rights of PIs and national team members have been collaboratively developed and agreed by the Assembly and form the studys Terms of Reference. The International Coordinating centre for the study is the Child and Adolescent Health Research Unit ( HYPERLINK "http://www.education.ed.ac.uk/cahru" www.education.ed.ac.uk/cahru) based at the University of Edinburgh and . the International Databank is based at the University of Bergen. Partnership with WHO The WHO Regional Office for Europe adopted HBSC soon after it was established and the study became a WHO Collaborative Study, and this has been an important driver of the success of the network. As HBSCs main partner, WHO plays an important role in many aspects of the governance of the study including providing support to a number of member countries and to the Assembly of Principal Investigators. Critically, WHO has been instrumental in helping to increase research capacity in some parts of the European Region through funding training workshops and enabling countries to make successful applications to join and participate in the study. Representatives from WHO have been vital members of the HBSC Policy Development Group and WHO has established a policy series of reports from the study: Health Policy for Children and Adolescents (HEPCA). Since 1998 the main international report from the HBSC study has been published by WHO as part of this series. WHO and HBSC have also in the last few years developed the WHO-HBSC Forum which has been an annual event to examine and showcase HBSCs contribution to policy and practice at international and national levels in the European region. The focus of each forum is the social and economic determinants of health among young people. Each Forum takes a special theme which has to date included health eating and physical activity; mental health and environment. Forum reports can be downloaded from the HBSC web-site and are listed below. While the main partnership is with WHO EURO, more recently HBSC has been identified by WHO Headquarters as a model study in the area of child and adolescent health. Data have been accessed for reports and the reports have been widely used and cited. Similarly UNICEF, OECD and EMCDDA have shown increasing interest in gaining information on HBSC and using the data in their own reports. This level of external interest in the data highlights the issues of data access. All HBSC products, including protocols and datasets are collaboratively developed, with funding granted from an increasing range of government and NGOs. Current mechanisms for sharing data and study resources and the principles underlying the approach of the network to these issues are under review to ensure that HBSC can best contribute to future scientific and policy development in the area of young peoples health HBSC dissemination activities The publication of scientific articles in peer reviewed international journals is a priority for the study and its network members. HBSC has fostered a collaborative and inclusive approach to this endeavour, designed explicitly to achieve greater output as well as to develop cooperation and capacity among the membership. A key aim of HBSC, throughout its history, has been to make a significant contribution to scientific knowledge and understanding of adolescent health through development of theory, production of empirical data, and innovation in survey methodology. The last 10 years have seen a range of successful efforts to increase scientific productivity and boost the studys contribution to the evidence base on young peoples health. New indicators have been developed and validation studies have been undertaken for new items and scales. The reading list below includes all the international reports from the study produced in the last decade as well a selection of key papers on international data and health and social indicators used and developed by HBSC. A full list of publications is available at  HYPERLINK "http://www.hbsc.org/publications.html" http://www.hbsc.org/publications.html ; there is also a forthcoming supplement to the International Journal of Public Health devoted to HBSC to be published later in 2009. Selection of recent international reports and journal articles relevant to topic of child well-being indicators Andersen A, Krlner R, Currie C, Dallago L, Due P, Richter M, rknyi , and Holstein B E (2008) High agreement on family affluence between children's and parents' reports: international study of 11-year-old children. Journal of Epidemiology & Community Health, 62(12), 1092-1094. DOI:10.1136/jech.2007.065169 Boyce W, Torsheim T, Currie C and Zambon A (2006) The Family Affluence Scale as a Measure of National Wealth: Validation of an Adolescent Self-reported Measure. Social Indicators Research, 78(3), 473-487. DOI:10.1007/s11205-005-1607-6 Cavallo F, Zambon A, Borraccino A, Ravens-Sieberer U, Torsheim T, Lemma P (2006) Girls growing through adolescence have a higher risk of poor health. Quality of Life Research, 15(10), 1577-1585. Currie C, Hurrelmann K, Settertobulte W, Smith R and Todd J (eds) (2000) 'Health and Health Behaviour Among Young People'[International Report from the 1997/98 HBSC survey]. WHO Policy Series: Health policy for children and adolescents. Issue 1. WHO Regional Office for Europe Currie C, Roberts C, Morgan A, Smith R, Settertobulte W, Samdal O, Barnekow Rasmussen V (eds) (2004) Young People's Health in Context, Health Behaviour in School-aged Children study: International Report from the 2001/2002 Survey. Health Policy for Children and Adolescents No.4, WHO Regional Office for Europe, Copenhagen, Denmark. Currie C, Molcho M, Boyce B, Holstein B, Torsheim T and Richter M (2008) Researching health inequalities in adolescents: The development of the Health Behaviour in School-Aged Children (HBSC) Family Affluence Scale. Social Science and Medicine, 66(6), 1429-1436. [DOI: 10.1016/j.socscimed.2007.11.024] Currie C et al (eds) (2008) Inequalities in young people's health: HBSC international report from the 2005/2006 Survey. Health Policy for Children and Adolescents No. 5, WHO Regional Office for Europe, Copenhagen, Denmark. Currie C, Nic Gabhainn S, Godeau E & the International HBSC Network Coordinating Committee (in press) The Health Behaviour in School-Aged Children: WHO Collaborative Cross- National (HBSC) Study: origins, concept, history and development 1982-2008. International Journal of Public Health. Due P, Holstein BE (2008) Bullying victimization among 13 to 15-year-old schoolchildren: results from two comparative studies in 66 countries and regions. Journal of Adolescent Medicine & Health, 20(2), 209-21. Due P, Merlo J, Harel-Fisch Y, Trab Damsgaard M, Holstein B, Hetland J, Currie C, Nic Gabhainn S, Gaspar de Matos M, Lynch J (2009) Socioeconomic inequality in exposure to bullying during adolescence: a comparative, cross-sectional, multilevel study in 35 countries. American Journal of Public Health, 99(5), 907-914. [DOI: 10.2105/AJPH.2008.139303] Godeau E, Vignes C, ter Bogt T, Nic Ghabhainn S, Navarro F (2006) Cannabis use in 15 year old students, results from 32 Western countries in the International HBSC/OMS survey. Alcoologie et Addictologie, 28(2), 135-142. Godeau E, Nic Gabhainn S, Vignes C, Ross J, Boyce W, Todd J (2008) Contraceptive use by 15 year old students at their last sexual intercourse. Results from 24 countries. Archives of Pediatrics & Adolescent Medicine, 162(1), 66-73 Hetland J, Torsheim T, Aar LE. (2002) Subjective health complaints in adolescence: dimensional structure and variation across gender and age. Scandinavian Journal of Public Health, 30 (3): 223-230. Hublet A, De Bacquer D, Valimaa R, Godeau E, Schmid H, Rahav G and Maes L (2006) Smoking trends among adolescents from 1990 to 2002 in ten European countries and Canada. BMC Public Health; 6: 280. DOI:10.1186/1471-2458-6-280 Janssen I, Boyce W, Simpson K, Pickett W (2006) Influence of individual- and area-level measures of socioeconomic status on obesity, unhealthy eating, and physical inactivity in Canadian adolescents. American Journal of Clinical Nutrition: 83: 139-145. Kuntsche E, Simons-Morton B, Fotiou A, ter Bogt T, & Kokkevi A (2009) Decrease in adolescent cannabis use from 2002 to 2006 and links to evenings spent out with friends in 31 European and North America countries and regions. Archives of Pediatrics and Adolescent Medicine, 163(2), 119-125. Ravens-Sieberer U, Erhart M, Torsheim T, Hetland J, Freeman J, Danielson M, Thomas C and the HBSC Positive Health Group (2008) An international scoring system for self-reported health complaints in adolescents.The European Journal of Public Health, 18(3), 294-9. DOI:10.1093/eurpub/ckn001 Richter M, Vereecken C, Boyce W, Maes L, Nic Gabhainn S, Currie C (2009) Parental occupation, family affluence and adolescent health behaviour in 28 countries. International Journal of Public Health, 54, 1-10. DOI: 10.1007/s00038-009-8018-4 Roberts C, Currie C, Samdal O, Currie D, Smith R & Maes L (2007) Measuring the health and health behaviours of adolescents through cross-national survey research: recent developments in the Health Behaviour in School-aged Children (HBSC) study. Journal of Public Health, 15(3), 179-186. Roberts C, Freeman J, Samdal O, Schnohr C, de Looze M, Nic Gabhainn S, Iannotti R, Rasmussen M & the International HBSC Study Group (in press) The Health Behaviour in School-aged Children (HBSC) study: methodological developments and current tensions. International Journal of Public Health. Simons-Morton B, Pickett W, Vollebergh W, Ter Bogt T, Boyce W (in press) Cross-national comparison of adolescent drinking and cannabis use in the United States, Canada, and the Netherlands. International Journal of Drug Policy. 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" "E"O"O""5666888NGG`H  8*urn:schemas-microsoft-com:office:smarttagsCity9*urn:schemas-microsoft-com:office:smarttagsplace=*urn:schemas-microsoft-com:office:smarttags PlaceType=*urn:schemas-microsoft-com:office:smarttags PlaceNameB*urn:schemas-microsoft-com:office:smarttagscountry-region guOW2#8#&&111111222233333333334444445555555566 77"8%88899 99:::;; ; ;;#;*;8;;;<;D;H;N;D<J<N<T<X<[<\<`<d<g<h<q<<<== =&=*=-=.=6=:=@===> >>>>!>>>>>>>>>>?? ???@@@@@@@@@@AAAAAAAAAABBBCCCCCC&CCCDDE E$E+E2E7E;E>E?EGEKESEEFOFSFVFWF[F`H5: """"e"h"##$$&&33,40444j5r5{66"8%8889:::<===EEF'FF G`H3333333333333333333333q;cT"j"++BB`H`Hw}le!os)r%I KnVrZ>cr_f]EivBMxpw.{#&~Q:a' {NA!^@#1#10 #1#1^H@UnknownGz Times New Roman5Symbol3& z Arial"qh"զ'զ =$ =$!24:H:H 2HX)?BMx2%Origins and concept of the HBSC StudyCandace Currieccurrie2Oh+'0 (4 T ` lx(Origins and concept of the HBSC StudyCandace CurrieNormal ccurrie23Microsoft Office Word@^в@E3@" =՜.+,D՜.+,P  hp|   $:H &Origins and concept of the HBSC Study Title 8@ _PID_HLINKSAT &http://www.hbsc.org/publications.html)<$http://www.education.ed.ac.uk/cahruYChttp://www.hbsc.org/YChttp://www.hbsc.org/  !"#$%&'()*+,-./0123456789:;<>?@ABCDFGHIJKLMNOPQRSTUVWXY[\]^_`acdefghilRoot Entry FnData =1TableE)WordDocument7xSummaryInformation(ZDocumentSummaryInformation8bCompObjq  FMicrosoft Office Word Document MSWordDocWord.Document.89q