| 1. |
- Häggström Westberg, Katrin, 1968-
(författare)
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Exploring mental health and potential health assets in young people
- 2021
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Young people in Sweden generally claim to have a good quality of life, but also report increasing mental health problems. It is a concern that only a minority of young people seek and/or access support when encountering mental health problems as mental health is a fundamental human right and integral to a positive development in both childhood and throughout the lifespan. There are uncertainties as to how to facilitate help-seeking and promote mental health among young people and previous studies have often focused on risk-reduction. A shift from a pathological view to a resource-based perspective of mental health can be achieved by adopting a health assets’ approach. This approach also ascribes due emphasis to the fact that mental health is developed within a social context, where both individual and structural health assets, such as the support system, are of importance. With this in mind, the overall aim of this thesis was to explore individual and structural health assets in relation to the mental health of young people.This thesis is based on four studies using both quantitative (Studies I and II) and qualitative (Study III) methods as well as a scoping review method with a qualitative synthesis (Study IV). Studies I and II had a cross-sectional design and utilized data from self-reported health-related ratings collected in schools in 2011. The association between socio-economic determinants and self-rated mental health in two age groups (11-13 and 14-16) was explored in Study I, and optimism and pessimism as a bi-dimensional construct, and its impact on health-related quality of life and potential to function as a health asset was explored in Study II. In Studies III and IV, the help- seeking process was explored from the perspective of young people, firstly with constructivist grounded theory in Study III based on interviews of young people seeking help for mental health problems within a local setting, and secondly, through a scoping review examination and qualitative synthesis of national and international literature on help-seeking in Study IV.The results identified potential health assets on both individual and structural levels. The explored health assets on an individual level were socio-economic status and socio-demographic factors (Study I), dispositional optimism (Study II) and individual resources for help-seeking (Studies III and IV), while health assets on a structural level were explored through the experience of and perceptions of young people’s help-seeking process(Studies III and IV). The individual health assets of socio-economic status and migratory background were seen to affect mental health differently for boys and girls with the boys being susceptible to an accumulation of socio-economic risk factors including family wealth affecting their mental health negatively, and the mental health of the young girls with a migratory background being affected positively (Study I).The individual health asset of optimism was found to be potentially supportive for help-seeking and mental health (Study II). Young people were optimistic about their future but there was a significant decrease in optimism and health-related quality of life, and a significant increase in pessimism, with age. Optimism was independently and positively associated with a high level of health-related quality of life among young people, even when adjusting for parents’ marital status, family country background and gender. Knowledge and a desire for self-reliance were identified as potential individual health assets mainly in regard to the help-seeking process (Studies III and IV). Young people expressed how their knowledge of mental health and the support system was inadequate, rendering a feeling of insecurity, however, they also expressed a strong desire for self-reliance in regard to their mental health. Help-seeking was characterised as a dynamic and psychosocial process without sequentially fixed stages. Potential health assets on a structural level were identified as support through social networks, and a responsive, collective and accessible support system. However, young people perceived the support system as unresponsive, focused on protocol instead of person, fragmented and spread, and lacking in accessibility. The results implied that equipping young people with sufficient knowledge would capitalize on the individual health assets of self-reliance and optimism, conducive to help-seeking and mental health, but that the support system needs to improve in order to meet the particular needs of young people.
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| 2. |
- Ahlborg, Mikael, 1985-, et al.
(författare)
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Current Conceptualization and Operationalization of Adolescents’ Social Capital : A Systematic Review of Self-Reported Instruments
- 2022
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Ingår i: International Journal of Environmental Research and Public Health. - Basel : MDPI. - 1661-7827 .- 1660-4601. ; 19:23
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Forskningsöversikt (refereegranskat)abstract
- There is a great heterogeneity in the conceptualization and operationalization of social capital in empirical research targeting adolescents. There has not yet been an attempt to systematically map and psychometrically evaluate the existing instruments for measuring social capital that have been developed and validated for adolescent samples. The aim of this systematic review was to identify and evaluate the design and psychometric properties of self-reported instruments for social capital, specifically developed and validated for use among adolescents. The design of this study was a systematic review guided by the COSMIN methodology for systematic reviews of Patient Reported Outcome Measures. The search included six electronic databases and no time frame was applied. Twenty studies were identified as describing the development and validation of a social capital instrument for adolescent samples. The results reveal common denominators, but also great variation in the design and validation of the instruments. Adolescents were only involved in the development procedures of four instruments. There is a lack of social capital instruments that cover both the multidimensionality of social capital and contextual relevance in relation to adolescents. Careful examination of instruments should thus precede a decision when designing studies and further instrument development involving the target group is encouraged. © 2022 by the authors.
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| 3. |
- Ahlborg, Mikael, 1985-
(författare)
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Social capital and inequalities in mental health among young adolescents in Sweden
- 2022
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- The aim of this thesis was to explore social capital and inequalities in mental health among young adolescents in Sweden. This is a compilation thesis comprising four studies. Studies I and II are quantitative studies of crosssectional data from the Swedish Health Behaviour in School-aged Children survey. The aim of Study I was to investigate socioeconomic inequalities in health using both a subjective and an objective measure of socioeconomic status among Swedish adolescents. The findings showed that subjective socioeconomic status robustly and independently predicted mental health problems, poor life satisfaction and poor general health perception. The association between objective socioeconomic status and mental health was weakened, and even reversed, when subjective socioeconomic status was accounted for in regression models. A Latent Profile Analysis was applied in Study II with the aim of identifying distinct profiles of family, school and peer social capital in a nationally representative sample of adolescents and to explore health outcomes in those profiles. The findings showed that five distinct profiles best represented the data for 11 and 15-year olds, while a four-profile model was optimal for 13-year olds. Significant inequalities were identified between profiles when these were examined in terms of mental health problems and life satisfaction. The design of Study III was a qualitative semi-structured interview study. The aim was to explore social capital from the perspective of adolescents in relation to mental health. Adolescents spoke of having access to a safe space, feeling connected to others and predictability as important aspects of social relationships and networks in relation to mental health. The aim of Study IV was to identify and evaluate the design and psychometric properties of instruments for assessing social capital specifically developed and validated for self-reporting among adolescents (10-19 years). The design was a systematic review, in which 20 instruments were identified. The results revealed a lack of instruments that covered both the multidimensionality of social capital and contextual relevance in relation to adolescents. The conclusion from this thesis is that social capital may be useful for identifying vulnerable individuals and for differentiating between the natural imbalance of adolescence and what may lead to serious illness. Longitudinal research and refinement of the operationalization of the concept are, however, needed to enhance the understanding of these findings.
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| 4. |
- Ahlborg, Mikael, 1985-, et al.
(författare)
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Socioeconomic inequalities in health among Swedish adolescents - adding the subjective perspective
- 2017
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Ingår i: BMC Public Health. - London : BioMed Central. - 1471-2458. ; 17
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Tidskriftsartikel (refereegranskat)abstract
- BackgroundSocioeconomic inequalities in adolescent health predict future inequalities in adult health. Subjective measures of socioeconomic status (SES) may contribute with an increased understanding of these inequalities. The aim of this study was to investigate socioeconomic health inequalities using both a subjective and an objective measure of SES among Swedish adolescents.MethodCross-sectional HBSC-data from 2002 to 2014 was used with a total sample of 23,088 adolescents aged 11–15 years. Three measures of self-rated health (dependent variables) were assessed: multiple health complaints, life satisfaction and health perception. SES was measured objectively by the Family Affluence Scale (FAS) and subjectively by “perceived family wealth” (independent variables). The trend for health inequalities was investigated descriptively with independent t-tests and the relationship between independent and dependent variables was investigated with multiple logistic regression analysis. Gender, age and survey year was considered as possible confounders.ResultsSubjective SES was more strongly related to health outcomes than the objective measure (FAS). Also, the relation between FAS and health was weakened and even reversed (for multiple health complaints) when subjective SES was tested simultaneously in regression models (FAS OR: 1.03, CI: 1.00;1.06 and subjective SES OR: 0.66, CI: 0.63;0.68).ConclusionsThe level of socioeconomic inequalities in adolescent health varied depending on which measure that was used to define SES. When focusing on adolescents, the subjective appraisals of SES is important to consider because they seem to provide a stronger tool for identifying inequalities in health for this group. This finding is important for policy makers to consider given the persistence of health inequalities in Sweden and other high-income countries. © The Author(s). 2017
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| 5. |
- Arnarsson, Arsaell, et al.
(författare)
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Cyberbullying and traditional bullying among Nordic adolescents and their impact on life satisfaction
- 2020
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Ingår i: Scandinavian Journal of Public Health. - London : SAGE Publications. - 1403-4948 .- 1651-1905. ; 48:5, s. 502-510
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Tidskriftsartikel (refereegranskat)abstract
- © Author(s) 2019. Aims: The aim of this study was to investigate the prevalence of cybervictimization in the six Nordic countries and to assess its overlap with traditional bullying. A further aim was to examine potential associations between life satisfaction, on the one hand, and traditional bullying and cyberbullying on the other. Methods: Analyses were based on data from the 2013⁄2014 Health Behaviour in School-aged Children study. It included 32,210 boys and girls, aged 11, 13, and 15, living in the six Nordic countries. Results: The prevalence of cyberbullying by both pictures and by messages was around 2% in all the Nordic countries except Greenland. There it was considerably higher. The prevalence of being bullied in a traditional manner varied widely by country. For boys, this type of bullying was most frequent in the youngest age group and then decreased steadily in the older age groups. Girls were on average more likely to be cyberbullied. Cyberbullying was more common among 13- and 15-year-olds than 11-year-olds. Higher family affluence was unrelated to the risk of cyberbullying. However, it was related to traditional bullying and combined forms of bullying. Compared with intact families, cybervictimization was commoner among single-parent families and stepfamilies. Adjusting for age, gender, family affluence, and family structure, those subjected to cyberbullying had lower life satisfaction than those who were not bullied. Conclusions: We found relatively little overlap between cyberbullying and traditional bullying, indicating that the two may be separate phenomena stemming from different mechanisms, at least in the Nordic context.
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| 6. |
- Blank, J., et al.
(författare)
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Prevalence of overweight and obesity among preschool children between 2004 and 2008, in a rural area of Sweden : The Skaraborg Evaluation Child Obesity Prevention Project (SECOPP)
- 2010
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Ingår i: Special Issue: Abstracts of the 11th International Congress on Obesity, 11-15 July 2010, Stockholm, Sweden. - Chichester, England : Wiley-Blackwell. ; , s. 73-74
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Konferensbidrag (refereegranskat)abstract
- Background: Childhood obesity is considered a serious public health problem and it has increased over the last two decades. The aim of this paper was to report 5-year change in prevalence of overweight and obesity among preschool children in a rural area of Sweden. Material and Method: Body height and weight were obtained in 2004, 2006 and 2008. A total of 1914 children (1014 boys and 900 girls), aged 4 years ± 4 months and were examined at Child Welfare Clinics in two municipalities in the Skaraborg area in Region of Västra Götaland, Sweden were included in the study. Body mass index (BMI) was calculated and categorized according to the International Obesity Task Force (IOTF) and WHO cut-off as reference methods in defining overweight and obesity, and GLM methods were used to estimate the change with age as a covariate. Result: Between 2004 and 2008, overweight increased in boys according to IOTF 2.0% (P = 0.048), whereas no such trend was seen when using WHO cut-offs. In girls, overweight increased significant according to the both definitions IOTF 9.1% (P < 0.001) and WHO 2.8% (P = 0.010). Obesity has decreased in both boys and girls, however not significant. According to IOTF obesity decreased with 1.1% in boys and 1.9% in girls, and WHO with 2.1% in boys and 1.5% in girls. Conclusion: This study shows that overweight has increased in both sexes and obesity rates remained rather steady. However, public health strategies targeting the whole population is still needed.
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| 7. |
- Hutton, Katrin, 1968-, et al.
(författare)
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Low self-rated mental health among Swedish adolescent boys and its relationship to socioeconomic factors
- 2013
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Ingår i: European Journal of Public Health. - Oxford : Oxford University Press. - 1101-1262.
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Konferensbidrag (refereegranskat)abstract
- BackgroundAdolescents mental health is a major public health concern and studies have shown that socioeconomic factors contribute to the experienced health of adolescents. Girls’ mental health, more than boys’ mental health, is often discussed. Therefore, the aim of this study was to investigate the association between self-rated mental health and socioeconomic factors among boys and we hypothesized that household wealth influences the association.MethodsIn 2011, a cross-sectional study was conducted at seven junior high schools in a medium sized town in south western Sweden. The data collected was based on a self-administrated questionnaire regarding socioeconomic factors, household wealth and health related quality of life (Minnesota Minneapolis Quality of Life Instrument (MMQL). In all, 235 boys between 11-13 years old and 254 boys between 14-16 years participated. The items from MMQL were summarized into a total score and dichotomized by the median and low self-rated mental health was defined as below median. Logistic regression analysis was used.ResultsAmong younger boys no association between low self-rated mental health and socioeconomic factors were seen. Among older boys with divorced parents, an increased risk of low mental health rating was seen OR: 1.83 (95%CI, 1.04;3.23), however when adjusting for household wealth the association disappeared (OR;1.76, CI 0.98;3.15). Also, having one or two parents born outside Sweden implied increased risk of a low self-rated mental health OR: 2.0 (CI; 1.15;3.47), which remained when adjusting for household wealth variables (OR; 2.16 CI; 1.17;3.99). Furthermore, having two or more negative socioeconomic variables increased the risk of low rated mental health (OR;2.60, CI 1.15;5.90) the association remained after adjusting for household wealth (OR;2.38, CI 1.03;5.33).ConclusionsBoys with divorced parents, boys from migrant backgrounds and boys with several negative socioeconomic factors constituted the identified subgroups at risk. More research in public health is essential to meet the special needs of different age groups and backgrounds among adolescent boys.Key messagesAmong older boys (14-16 years old) with divorced parents, an increased risk of low mental health rating was seen, however when adjusting for household wealth the association disappeared.Among older boys (14-16 years old) having two or more negative socioeconomic variables increased the risk of low rated mental health, the association remained after adjusting for household wealth.© The Author 2013. Published by Oxford University Press on behalf of the European Public Health Association. All rights reserved.
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| 8. |
- Hutton, Katrin, 1968-, et al.
(författare)
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Self-rated mental health and socio-economic background : a study of adolescents in Sweden
- 2014
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Ingår i: BMC Public Health. - London : BioMed Central. - 1471-2458. ; 14:1
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Tidskriftsartikel (refereegranskat)abstract
- Background: Adolescents' mental health is a major public health issue. Previous research has shown that socio-economic factors contribute to the health status of adolescents. The present study explores the association between socio-economic status and self-rated mental health among adolescents.Methods: Cross sectional data from the Halmstad Youth Quality of Life cohort was collected in a town in Sweden. In all, 948 adolescents (11-13 younger age group and 14-16 older age group) participated. Information on self-rated mental health was collected from the subscale Psychological functioning in the Minneapolis Manchester Quality of Life instrument. The items were summarized into a total score and dichotomized by the mean. Indicators measuring socio-economic status (SES) were collected in a questionnaire using the Family Affluence Scale (FAS) and additional factors regarding parents' marital status and migration were added. Logistic models were used to analyze the data.Results: Girls were more likely to rate their mental health below the mean compared to boys. With regard to FAS (high, medium, low), there was a significantly increased risk of self-rated mental health below the mean among younger boys in the medium FAS score OR; 2.68 (95% CI 1.35;5.33) and among older boys in the low FAS score OR; 2.37 (1.02;5.52) compared to boys in the high FAS score. No such trend was seen among girls. For younger girls there was a significant protective association between having parents born abroad and self-rated mental health below mean OR: 0.47 (0.24;0.91).Conclusions: A complex pattern of associations between SES and self-rated mental health, divergent between age and gender groups, was shown. The total FAS score was only associated with boys' self-rated mental health in both age groups, whereas parents' migratory status influenced only the girls' self-rated mental health. Because of the different association for girls' and boys' self-rated mental health and SES, other factors than SES should also be considered when investigating and exploring the mental health of adolescents in affluent communities. © 2014 Hutton et al.; licensee BioMed Central Ltd.
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| 9. |
- Häggström Westberg, Katrin, 1968-, et al.
(författare)
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Exploring the role of optimism as a protective factor for adolescent quality of life
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Annan publikation (övrigt vetenskapligt/konstnärligt)abstract
- This study attempts to understand the role that optimism could play in the context of a health asset approach to promote (and protect) adolescent health related quality of life (HRQOL). Two hypotheses were formulated, a) there is an association between adolescents’ self-rated optimism and pessimism and their HRQOL, (b) age, gender and socio-demographic characteristics influence this association. We explore optimism and pessimism as a bi-dimensional construct and its impact on HRQOL among adolescents in two age groups (11-13 years and 14-16 years). Adolescents answered a self-report questionnaire consisting of two validated scales for measuring HRQOL and the concepts of optimism and pessimism. This study has shown that optimism is an important protective factor for HRQOL and low levels of pessimism were also seen to be protective of HRQOL in both age groups. This infers the potential of an optimistic orientation about future goals might function as a health asset during adolescence that could be useful in the planning of health promotion strategies.
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| 10. |
- Häggström Westberg, Katrin, 1968-, et al.
(författare)
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Lost in Space - an exploration of help-seeking among young people with mental health problems : a constructivist grounded theory study
- 2020
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Ingår i: Archives of Public Health. - Brussels : Institut Scientifique de Sante Publique / Scientific Institut of Public Health. - 0778-7367 .- 2049-3258. ; 78
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Tidskriftsartikel (refereegranskat)abstract
- Background: Mental health problems among young people is a worldwide public health concern. There has been an increase in mental health problems among young people in the Nordic countries in the last 25 years, particularly in Sweden. Despite this increase, international research has repeatedly shown that young people do not access or receive support when encountering mental health problems. The purpose of this study was to explore the process of help-seeking for professional support among young people with mental health problems. Methods: The study used qualitative constructivist Grounded Theory and open-ended interviews. Thirteen young people between 15 and 23, recruited from two local support clinics, were interviewed. Results: Lost in space emerged as the core category, capturing aspects of both the experience of self and mental health problems as well as the process of seeking and acquiring help from professional support systems. The study identified several prominent barriers for seeking and acquiring professional help for mental health problems. The young people expressed a lack of knowledge on mental health issues and support services and substantial efforts were made to try to cope with problems on one’s own. Lost in space involved Drifting - trying to make sense of own experiences and struggling to cope with problems, Navigating - searching for help through multiple attempts and contacts and Docking - finding support with something/somebody that feels right. Conclusions: The theoretical model sheds light on how young people with mental health problems were met with fragmented support services. Society needs to provide encompassing, youth-friendly and flexible support services, so that attempts at help-seeking are not missed. © The Author(s). 2020
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