| 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, 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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| 3. |
- 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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