| 1. |
- Bortes, Cristian, 1984-, et al.
(författare)
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A longitudinal effect study of contract signing for preventing alcohol use among Swedish school children
- 2015
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Ingår i: European Journal of Public Health. - Oxford, England : Oxford University Press. - 1101-1262 .- 1464-360X. ; 25:Suppl. 3
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Tidskriftsartikel (refereegranskat)abstract
- Background: Around 40% of the primary schools in Sweden have programs to prevent tobacco and alcohol use. One popular program is carried out by the Non-Governmental Organization SMART. The aim is to prevent or postpone alcohol, tobacco and other drug use among children through positive reinforcement and signing of contracts. The contract in this longitudinal study also contains items on good conduct behavior. Are there differences in youth problem behaviors between those who signed the contract all years versus those who signed the contract shorter time? What factors characterize those who signed the contract all the years compared to the others? Methods: Students in five schools in a middle-sized municipality in Sweden answered class-room questionnaires in three waves: 7th (n=432), 8th (n=458), and 9th (n=422) grade. Response rates were 88%. Students are divided into three groups, based on response at T3 on many years of contract signing: long-attendees, short-attendees, sporadic- or non-attendees. A repeated measure ANOVA was conducted to analyze changes over time. Binge drinking was the outcome measure in this analysis. Identifying predictors for duration of the contract signing will be analyzed with multiple logistic regressions. Results: Short-attendees, 40%, signed contract only two to four consecutive years starting in 4th grade. Long-attendees, 22.5%, signed contract five to six years. Sporadic- or non-attendees, 20.5%, signed contract only in some non-consecutive, or none of the years. 17.2% missing-response. Long-attendees have significant lower levels of binge drinking in 9th grade (M=1.72) compared to short-attendees (M=2.43) and sporadic- or non-attendees (M=2.41). F(2,408) = 9.52, p=<.001. Conclusion: Schools are an important setting for alcohol and tobacco prevention. Promising results were found regarding binge drinking for students that were long-attendees in the program. Further analysis of different outcomes and predictors, mediators and moderators is on-going. Key messages:Schools are an important setting for alcohol and tobacco prevention.There is a need for longitudinal evaluations of preventive programs in national contexts.
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| 2. |
- Bortes, Cristian, et al.
(författare)
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Associations between children’s diagnosed mental disorders and educational achievements in Sweden
- 2022
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Ingår i: Scandinavian Journal of Public Health. - : Sage Publications. - 1403-4948 .- 1651-1905. ; 50:8, s. 1140-1147
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
- Aims: To examine associations between multiple clinically diagnosed mental disorders among children in Sweden and educational achievements at the end of ninth grade.Methods: Data from Swedish administrative registers were utilised. Diagnoses of specific mental disorders (unipolar depression, mood, anxiety, obsessive compulsive, eating, attention deficit hyperactivity disorder) were used as exposure variables. Educational achievements were assessed in terms of teacher-assigned school grades and eligibility for upper secondary education. The sample comprised 266,664 individuals (49% females) born in 2000 to 2002 who were alive and resident in Sweden in 2017. Exposed and unexposed individuals were compared in terms of outcome variables by fitting linear and logistic regression models.Results: The results revealed negative associations between all the examined mental disorders and educational achievements, except for positive associations between eating disorders and grades among female students. Attention deficit hyperactivity disorder was the most strongly associated disorder in terms of non-successful completion of compulsory education, among both male and female students (odds ratio (OR): 3.58 (95% confidence interval (CI), 3.42 to 3.74) and 4.31 (95% CI, 4.07 to 4.57), respectively). This was followed by unipolar depression among males (OR: 2.92 (95% CI, 2.60 to 3.28)) and anxiety disorder among females (OR: 2.68 (95% CI, 2.49 to 2.88)). Obsessive compulsive disorder had the weakest negative association with educational achievements among both males (OR: 1.48 (95% CI, 1.01 to 2.17)) and females (OR: 1.38 (95% CI, 1.11 to 1.72)).Conclusions: Specific diagnosed mental disorders have varying, largely disadvantageous, associations with educational achievements of students in Sweden that differ between males and females.
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| 3. |
- Bortes, Cristian, et al.
(författare)
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Beyond academics: Links from teaching practices in Swedish schools to students’ achievements and mental health complaints
- 2024
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Ingår i: Learning and instruction. - : Elsevier. - 0959-4752 .- 1873-3263. ; 92
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Tidskriftsartikel (refereegranskat)abstract
- Background: Despite extensive research on the relationship between teaching practices and learning outcomes, limited attention has been given to their potential links with students’ mental health.Aims: This study investigates the relationships between three teaching practice types – teacher-centered, student-centered, and student-dominated – and both student mental health complaints and academic achievement. It furthers explores variations in these associations based on students’ socioeconomic status (SES).Sample: The analysis includes 4573 grade 9 students (aged 15–16 years) in the Swedish comprehensive school system.Methods: Employing structural equation modelling techniques, we analyze a dataset comprising students’cognitive test scores, their perceptions of classroom processes, self-reported mental health complaints, as well as register data on teacher-assigned grades and parental education.Results: Teacher-centered practices are positively associated with academic achievements but lack robust linkswith mental health complaints. Conversely, student-centered practices are positively associated with academicachievements and correlate with lower mental health complaint frequencies. However, student-dominated practices demonstrate poor relationships with both mental health and academic achievements. Limited variations based on students’ social background reveal only two differing associations between low and high SES students: teacher-centered teaching shows stronger academic achievement associations for low SES students, while student-dominated teaching is more adversely linked to low SES students’ mental health.Conclusions: The results affirm the benefits of both teacher- and student-centered teaching practices for academic achievement while cautioning against excessive self-directed teaching. Importantly, the study highlights the role of instructional approaches in shaping not only academic outcomes but also students’ mental health.
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| 4. |
- Bortes, Cristian, et al.
(författare)
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Evaluating the effectiveness of the SMART contract-signing strategy in reducing the growth of Swedish Adolescents’ substance use and problem behaviors
- 2016
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Ingår i: BMC Public Health. - London, United Kingdom : BioMed Central. - 1471-2458. ; 16:1
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Tidskriftsartikel (refereegranskat)abstract
- Background: In 2013, around 40 % of the schools in Sweden had structured programs to prevent tobacco and alcohol debut in compulsory school. There has unfortunately been a lack of scientific evidence to support most of the prevention methods focusing on primary prevention in schools in Sweden. The aim and purpose of the present study is to evaluate the effectiveness of the Non-Governmental Organization SMART contract-signing strategy in reducing the growth of youth substance use and other problem behaviors amongst Swedish adolescents.Methods: Students from five schools in a medium-sized Swedish municipality were surveyed in three waves from 7th to 9th grade of compulsory school. We used General Linear Model (GLM) repeated-measures ANOVA to test if the outcome measures smoking, use of snus and alcohol, drunkenness, delinquency, and bullying significantly changed different amounts over time in groups that had participated in the SMART program for long time, a short time, sporadically- or not at all. Groups were compared on demographic background variables, and outcome measures were assessed on all measurement occasions by a one-way ANOVA. The magnitude of group differences at the end of the study was estimated according to Cohen’s d.Results: Number of years with a contract has an effect on the levels of self-reported youth problems in 9th grade. We found small to medium-sized differences in measured outcomes between students who participated in the program for the longest period of time, 5 years, and who participated for the shortest time, 0–2 years.Conclusion: Findings suggests that the SMART program has preventive effects on adolescent substance use.
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| 5. |
- Bortes, Cristian, 1984-
(författare)
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Growing up with poor health and managing school : Studies on ill health and young people's educational achievements
- 2022
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Aim and objectives: The overall aim of this thesis was to empirically investigate consequences of poor health for children’s educational outcomes in Sweden. A central tenet is that health problems impact not only the afflicted individual but also people in their social and emotional proximity, in particular immediate family members. More specific objectives were to study: 1. The relationship between multiple clinically diagnosed mental disorders and children’s educational achievements in Sweden. 2. The bidirectional relationship between mental health problems and academic performance among Swedish adolescents, as well as heterogeneous patterns associated with gender and socioeconomic groups. 3. The effects of parental somatic and psychiatric health problems on the probability of youths leaving upper secondary education before completion in Sweden and potential gender differences in these effects. 4. The relationship between having a sibling with health problems and a healthy sibling’s school grades in the final year of compulsory education in Sweden and how socioeconomic background modifies this relationship.Theoretical framework: Key concepts applied in the thesis are health and illness. The ability to perform things in life, the ability to act, determines whether a person is healthy or ill. Illness (or poor health, treated as a synonymous term) entails a reduced ability to act in relation to one’s life situation and its demands. Family is viewed from a systems theory perspective. Poor health of a parent reduces his or her ability to maintain regular roles, which may require reorganisation of the family system. Siblings’ health problems can affect other children in the family by inducing concerns and occupying and diverting parents’ time and attention. All of this could be psychosocially stressful in many ways, not least for children in the family and their ability in relation to schooling.Data and methods: The research objectives were addressed by utilising social and medical microdata from Swedish administrative registers covering the entire population in Sweden. Data pertaining to different populations, collectively covering the period from 1987 to 2017, were used in four studies designated Studies I–IV. Educational achievement was measured in terms of teacher-assigned school grades awarded by the end of compulsory school and in upper secondary school, as well as completion (or non-completion) of an upper secondary education. Poor health was measured through data on outpatient visits to specialist healthcare facilities, psychotropic drug prescriptions and admissions/discharges from Swedish hospitals. Socioeconomic background was measured by parental level of education. The data were analysed by fitting linear and logistic regression models as well as cross-lagged path models.Results and conclusions: Empirical results of Study I showed that specific diagnosed mental disorders have varying, largely disadvantageous, associations with educational achievements of students that differ between boys and girls. Documentation of this in Sweden adds to evidence that mental disorders have a negative overall association with educational achievement, despite substantial variation in support and educational systems across countries. The results of Study II provided no support for a bidirectional relationship between mental health and academic performance of students aged 15-16 to 18-19 years. However, they support a unidirectional relationship, as a negative relationship was found between school grades at graduation from compulsory school and rates of subsequent psychotropic medication use in upper secondary school. The relationship was equal in size for both boys and girls but mainly among adolescents with the highest educated parents.Study III showed that having a mother or a father with psychiatric, but not somatic, illness that necessitated hospitalisation after completing compulsory schooling was associated with an increased probability of leaving upper secondary school before completion. No significant gender-based differences in this were found. Results presented in Study IV showed that having one or more siblings with health problems that necessitated recurrent hospitalisations was associated with lower grades. Children with ill siblings were also less likely to be eligible for an upper secondary education compared to children whose siblings did not have poor health. Socioeconomic background did not affect this educational disadvantage.Results presented in this thesis clearly corroborate the importance of health for children’s education. Children’s educational achievements at the end of compulsory school are inversely related to mental health problems in their adolescence. Thus, academic competence may have positive effects on certain aspects of young people’s mental health, which underscores the importance of promoting opportunities for youth to do as well as they can in school. The reciprocal aspect of the relationship between mental health and academic performance among school-aged children remains an important issue that requires further investigation. However, health is not just an individual issue; parents’ and siblings’ health problems can affect children and have negative ‘spillover’ effects on their schooling and educational achievements. This underlines the importance of a psychosocial perspective when identifying children’s difficulties in school. Taken together, health, and thus the school’s student health task, is highly associated with academic achievement and schools’ pedagogical responsibilities.
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| 6. |
- Bortes, Cristian, et al.
(författare)
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Health problems during childhood and school achievement : Exploring associations between hospitalization exposures, gender, timing, and compulsory school grades
- 2018
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Ingår i: PLOS ONE. - San Fransisco, CA, USA : Public Library Science. - 1932-6203. ; 13:12, s. 1-14
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Tidskriftsartikel (refereegranskat)abstract
- Aims To investigate while accounting for health at birth 1) associations between health problems during childhood, measured as hospitalizations, and school achievement in the final year of compulsory school, measured as overall grade points and eligibility for upper secondary education, 2) if and how gender moderates the association between health problems and school achievement, 3) if and how the timing of a health problem during childhood is associated with later school achievement. Methods Analyzes were performed on a population-based cohort (n = 115 196) born in 1990 in Sweden (51.3% boys, 48.7% girls) using data from several national registries. Multiple linear regression and logistic regression were used to analyze associations between study variables. Results Overall grade points and eligibility for continuation to upper secondary school were lower for individuals exposed to hospitalizations. Only the association between hospitalizations and overall grade points was moderated by gender and only for ages 13-16 years. Exposure close to actual grading had worst outcomes. Conclusions Health problems, measured through hospitalizations, was significantly associated with lower school achievements among Swedish children. Girls exposed to health problems requiring hospitalizations had relatively poorer school achievements as compared to boys. Health problems requiring hospitalization during junior high school had the greatest negative association with final achievement at compulsory school.
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| 7. |
- Bortes, Cristian, et al.
(författare)
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Is the effect of ill health on school achievement among Swedish adolescents gendered?
- 2019
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Ingår i: SSM - Population Health. - : Elsevier. - 2352-8273. ; 8, s. 1-8
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Tidskriftsartikel (refereegranskat)abstract
- This study investigates why the relationship between health problems requiring hospitalization between the ages of 13 and 16 and school achievement (school grades in 9th grade) in Sweden was stronger for girls than for boys. We reviewed previous research on gender differences in subjective health, health care utilization and medical drug treatment to identify mechanisms responsible for this gendered effect. The relationship was analysed using retrospective observational data from several national full-population registers of individuals born in 1990 in Sweden (n = 115 196), and ordinary least squares techniques were used to test hypotheses. We found that girls had longer stays when hospitalized, which mediated 15% of the interaction effect. Variability in drug treatment between boys and girls did not explain the gendered effect of hospitalization. The main mediator of the gendered effect was instead differences in diagnoses between boys and girls. Girls’ hospitalizations were more commonly related to mental and behavioural diagnoses, which have particularly detrimental effects on school achievement. © 2019 The Authors
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| 8. |
- Bortes, Cristian, et al.
(författare)
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Parental Illness and Young People's Education
- 2020
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Ingår i: Child Indicators Research. - : Springer. - 1874-897X .- 1874-8988. ; 13:6, s. 2069-2091
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Tidskriftsartikel (refereegranskat)abstract
- The purpose of the present study was to investigate the effects of parental health problems on the probability of youths leaving upper secondary education before completion in Sweden, and to investigate potential gender differences in these effects. Medical and social microdata from Swedish administrative registers were used. The study population consisted of individuals born between 1987 and 1990 (N = 398,748) who were still alive and residing in Sweden in 2010. We employed a quasi-experimental pre-test post-test study design. Logistic regression was used to analyse the relationships between indicators of parental illness and young people's early school leaving in relation to health and sociodemographic confounders. Having had a mother or father with psychiatric, but not somatic, illness that necessitated hospitalisation after completing compulsory schooling was significantly associated with an increased probability of leaving upper secondary education. We found no significant gender-specific interaction effects. The existence of these effects in Sweden, a country with an extensive institutional welfare system, suggests that similar but more pronounced effects may exist in regions lacking such systems.
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| 9. |
- Bortes, Cristian, 1984-, et al.
(författare)
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Preventing Alcohol Consumption During Pregnancy : A Randomized Controlled Trial
- 2015
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Ingår i: Health. - United States : Scientific Research Publishing. - 1949-4998 .- 1949-5005. ; 7:3, s. 289-299
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Tidskriftsartikel (refereegranskat)abstract
- The aim with this study is to report a brief alcohol intervention for preventing drinking during pregnancy. The Women’s Organizations Committee on Alcohol and Drug Issues (WOCAD) in Sweden developed a printed information material about alcohol in pregnancy, aiming to reach pregnant women before their first visit at a prenatal clinic. A randomized controlled trial was conducted between 2004 and 2005 to measure if the material had an effect. A total of 564 pregnant women are included in the study, between 17 and 46 years of age. Differences between intervention and control group were analyzed with cross-tabulations and chi-squared-tests. A logistic regression analysis was also conducted to determine predictors of abstention from alcohol at the first prenatal visit. Findings show that significantly more women who received the material did abstain completely from alcohol then those who did not receive the material (92% vs. 82%, p=.005). It is 2.6 times more likely that those who received the material did abstain completely from alcohol since pregnancy recognition at their first prenatal visit compared with those who did not receive it (OR=2,6, CI 1,3-5,1, p=. 005). The information brochure developed by WOCAD can be used in antenatal care to get more women to abstain from alcohol during pregnancy.
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| 10. |
- Bortes, Cristian, et al.
(författare)
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Psychotropic medication use and academic performance in adolescence : A cross-lagged path analysis
- 2021
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Ingår i: Journal of Adolescence. - : Elsevier. - 0140-1971 .- 1095-9254. ; 91, s. 25-34
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Tidskriftsartikel (refereegranskat)abstract
- Introduction: The study investigated the directionality of associations between mental health problems and school grades across two timepoints (T1 and T2) during mid to late adolescence; in school year 9 (ages 15-16) and school year 12 (ages 17-18). The study also investigated variation in the associations as a function of gender and across socioeconomic groups. Methods: Longitudinal data from several Swedish administrative registers were utilised. Information on prescribed psychotropic drugs was used as a proxy for mental health problems, and teacher-assigned school grades were used to measure academic performance. The study sample comprised 85 186 individuals (50.7% girls) born in 1991 who were alive and resident in Sweden in 2010. Directions of associations were analysed by estimating a series of cross-lagged path models. Results: The model with the best fit to data showed that higher school grades at T1 were associated with relatively lower rates of mental health problems by T2, for both boys and girls, mainly in socioeconomic groups with the highest educated parents. This association was equal in size across all of the socioeconomic groups that were explored. Conclusions: Performing well in school is equally important for boys' and girls' subsequent mental health, but only among adolescents in socioeconomic groups with the highest educated parents. The results underscore the importance of promoting opportunities for youth to do as well as they can in school.
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