| 1. |
- Buli, Benti Geleta, et al.
(author)
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Trends in adolescent mental health problems 2004–2020 : do sex and socioeconomic status play any role?
- 2023
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In: Scandinavian Journal of Public Health. - 1403-4948 .- 1651-1905.
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Journal article (peer-reviewed)abstract
- Aims: This study aims to investigate trends in four types of adolescent mental health problems; that is, psychosomatic symptoms, depressive symptoms, suicidal ideations, and suicide attempts 2004–2020. A second aim is to investigate the moderating roles of socioeconomic status and sex in these trends.Methods: The analysis is based on repeated cross-sectional data 2004–2020 among grade 9 students in secondary schools in a Swedish county. In total, data from 19,873 students were included in the analysis. We fitted linear and logistic regression equations and used survey-years’ coefficients to estimate the trends. We also estimated the moderating effects of socioeconomic status and sex using interactions between survey year and socioeconomic status and sex, respectively.Results: The trends in all mental health problems declined over time. Through its interaction with survey year, socioeconomic status moderated the trends; psychosomatic symptoms (B = −0.115, P<0.001), depressive symptoms (B = −0.084, P<0.001) and suicidal ideations (odds ratio 0.953, confidence interval 0.924–0.983) significantly declined over time among those with high socioeconomic status. However, socioeconomic status did not have an association with the trend in suicide attempts. Interaction between sex and year of survey was associated with significant decreasing trends in depressive symptoms and suicidal ideations only among girls.Conclusions: Adolescent mental health problems have decreased over time, but only for adolescents with high socioeconomic status, or only in depressive symptoms and suicidal ideations for girls. The results shed light on the growing inequalities in health outcomes across levels of socioeconomic status.
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| 2. |
- Buli, Benti Geleta, et al.
(author)
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Trends in mental health problems among Swedish adolescents : Do school-related factors play a role?
- 2024
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In: PLOS ONE. - 1932-6203. ; 19:3
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Journal article (peer-reviewed)abstract
- AimThe aim of this study is to investigate the extent to which school-related factors, such as school liking, participation in decision-making, school-related parental support, teachers’ support, and school physical environment, explain trends in mental health problems. The problems considered are psychosomatic symptoms (PSS), depressive symptoms (DS), suicidal ideations (SI), and suicide attempts (SA) among Swedish adolescents of varying socioeconomic status (SES) from 2004 to 2020.MethodsWe analyzed data collected through repeated cross-sectional surveys from 19,873 15-year-old students at schools in a county in Sweden. Boys and girls each constituted 50% of the participants. We fitted linear and logistic regression models to investigate associations between the school-related factors and trends in mental health problems.ResultsIncreased school-related parental support and school liking were cross-sectionally associated with decreased PSS, DS and SI, with school liking also associated with decreased SA. Conducive school physical environment was also found to be cross-sectionally associated with lower PSS and DS scores. Over time, mental health problems have shown a general increase among adolescents in the low SES group and a decrease among those in the high SES group. While school-related factors explained the improvement in mental health in the high SES group, we found such association only between parental support trends in PSS and DS, along with participation and trends in SA over time among adolescents in the low SES group.ConclusionsThe results show that school-related factors play significant roles in influencing adolescent mental health. The influence, however, varied across SES gradients over time. This suggests that working against inequities in school-related factors would help address inequities in mental health.
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| 3. |
- Buli, Benti Geleta, et al.
(author)
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Trends in psychosomatic symptoms among adolescents and the role of lifestyle factors
- 2024
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In: BMC Public Health. - 1471-2458. ; 24
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Journal article (peer-reviewed)abstract
- Background Adolescent mental health problems are on the rise globally, including in Sweden. One indicator of this trend is increased psychosomatic symptoms (PSS) over time. Lifestyle factors such as physical activity (PA), diet, smoking, and alcohol consumption may influence the time trends in PSS; however, the evidence base is scarce. The aim of this study was to investigate associations between time trends in PSS and lifestyle factors.Methods The study was based on data collected from a nationally representative sample of 9,196 fifteen-year-old boys and girls in Sweden using the Health Behavior in School-aged Children (HBSC) symptom checklist. The sample comprised nearly equal proportions of girls (50.5%) and boys. The lifestyle factors examined in this study included PA, regular breakfast intake, consumption of fruits, vegetables, sweets, or soft drinks, smoking, and alcohol drunkenness. We used data from 2002 to 2018 and stratified by family affluence scale (FAS) to demonstrate how the associations varied among the FAS groups. We fitted separate regression models for the high- and low-FAS groups, where interaction terms between the year of survey and each lifestyle factor were used to estimate the level and direction of associations between the factors and trends in PSS.Results There was a generally increasing trend in PSS mean scores from 2.26 in 2002 to 2.49 in 2018 (p <.001). The changes in each survey year compared to the average mean scores during the preceding years were significant in all years except 2010. Regular breakfast intake, daily fruit and vegetable consumption, and higher PA were associated with lower PSS mean scores, while smoking and drunkenness had opposite associations with PSS. The only significant interaction between survey year and the lifestyle factors was observed regarding drunkenness in the high FAS group, suggesting that the association between trends in PSS and the experience of getting drunk at least twice got stronger over time (B = 0.057; CI:0.016, 0.097; p <.01).Conclusions The results indicate increasing trends in PSS among young people in Sweden from 2002 to 2018, with a significant increase observed among adolescents in the high FAS group who reported getting drunk on at least two occasions.
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| 4. |
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| 5. |
- Giannotta, Fabrizia, 1978-, et al.
(author)
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Anxiety, Sleep Problems, and Vigorous Physical Activity : Bidirectional Associations from Early Adolescence to Early Adulthood in Swedish Adolescents
- 2024
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In: Journal of Youth and Adolescence. - 0047-2891 .- 1573-6601. ; 53:6, s. 1355-1369
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Journal article (peer-reviewed)abstract
- Anxiety symptoms and sleep problems typically emerge during adolescence and are frequently intertwined. However, there is a dearth of knowledge concerning their reciprocal influence and whether physical activity might play a protective role in this relationship. The present study aims at filling this gap exploring also the moderating role of sex. 915 13-year-old Swedish adolescents (56% girls) answered a survey conducted four times: at ages 13 (T1), 16 (T2), 19 (T3), and 22 (T4). A random intercept cross-lagged panel model was used. At within-levels, sleep problems and anxiety symptoms had a bidirectional positive association in middle adolescence. Vigorous physical activity and anxiety symptoms showed a reciprocal negative association from middle adolescence. Vigorous physical activity and sleep problems were reciprocally associated only in late adolescence. Associations were the same for girls and boys. This study demonstrated that the relations between anxiety symptoms, sleep problems, and vigorous physical activity cannot be understood without adopting a developmental perspective and that middle adolescence is a crucial period to plan interventions to reduce anxiety symptoms and sleep problems.
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| 6. |
- Giannotta, Fabrizia, 1978-, et al.
(author)
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Frequency of vigorous physical activity and depressive symptoms across adolescence : Disentangling the reciprocal associations between different groups and subtypes of symptoms
- 2023
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In: Mental Health and Physical Activity. - : Elsevier BV. - 1755-2966 .- 1878-0199. ; 25
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Journal article (peer-reviewed)abstract
- Physical activity has a demonstrated positive effect on youth depressive symptoms. However, very few studies have explored the bi-directionality of the links between physical activity and depression. The present study aims at filling this gap and tests whether any associations are moderated by sex. Moreover, the role of subtype of depressive symptoms, vegetative (i.e., lack of energy, poor sleep) or non-vegetative (i.e., mood-related), is explored. Participants were 910 12-13 year-old Swedish adolescents (56% girls) who answered a three-wave survey at ages 12-13 (T1), 15-16 (T2), and 18-19 (T3). Using a cross-lagged structural model, depression predicted decreased frequency of vigorous physical activity (VPA) from T1 to T2 (& beta; = -0.09, p < .05) and from T2 to T3 (& beta; = -0.10, p < .01), while frequency of VPA at T2 decreased depression at T3 (& beta; = -0.12, p < .05). Associations did not differ between boys and girls. Non-vegetative symptoms predicted decreased frequency of VPA from T1 to T2 (& beta; = -0.10, p < .05), while frequency of VPA at T2 predicted decreased non-vegetative symptoms at T3 (& beta; = -0.15, p < .05). Vegetative symptoms predicted decreased frequency of VPA from T1 to T2 (& beta; = -0.09, p < .05), while have a reciprocal influence with VPA from T2 to T3. Overall, our results highlight an association across adolescence between VPA and depression. The association becomes stronger and reciprocal in middle adolescence, which suggests this period as an effective developmental time to plan physical-activity-based interventions to decrease youth depressive symptoms.
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| 7. |
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| 8. |
- Giannotta, Fabrizia, 1978-, et al.
(author)
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Problem gambling, risk behaviours, and mental health in adolescence : A person oriented study
- 2022
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In: Journal of Gambling Issues. - : Journal of Gambling Issues. - 1910-7595. ; 49, s. 90-107
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Journal article (peer-reviewed)abstract
- Adolescent gambling is becoming a public health problem. While comorbidities with other externalizing behaviours have been ascertained, few studies focus on adolescents with a multi-problem behaviour pattern, i.e., alcohol and tobacco use, in addition to antisocial behaviour, which includes problem gambling. The purpose of this study was to identify adolescents with multi-problem behaviours, i.e., alcohol abuse, daily smoking, antisocial behaviour, and problem gambling and to investigate the differences in relation to gender. Unlike most studies on this topic, we adopted a person-oriented approach to identify groups of adolescent boys and girls who reported multi-problem risk behaviours, i.e., alcohol abuse, daily smoking, antisocial behaviour, and problem gambling. Moreover, we explored to what extent these adolescents exhibited mental health problems, i.e., depressive, psychosomatic, and ADHD symptoms, as well as sleep problems. The sample consisted of 1,526 adolescents from two age cohorts, 15- to 16-year-olds (n = 711, 47%) and 17- to 18-year-olds (n = 815, 53%). Latent Variable Mixture Modeling (LVMM) revealed one group with low rates of all risk behaviours and three groups with multi-problem behaviours. Among the latter three groups, two reported problem gambling and had higher levels of mental health problems. These results suggest that gambling can be added to the constellation of risk behaviours in adolescence and might be more associated with mental health problems than other externalizing behaviours.
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| 9. |
- Giannotta, Fabrizia, 1978-, et al.
(author)
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Short-Term Mediating Factors of a School-Based Intervention to Prevent Youth Substance Use in Europe
- 2014
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In: Journal of Adolescent Health. - New York : Elsevier. - 1054-139X .- 1879-1972. ; 54:5, s. 565-573
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Journal article (peer-reviewed)abstract
- Purpose: To investigate factors mediating the effects of a European school-based intervention (Unplugged) based on a social influence approach to youths' substance use.Methods: Schools in seven European countries (n = 143, including 7,079 pupils) were randomly assigned to an experimental condition (Unplugged curriculum) or a control condition (usual health education). Data were collected before (pretest) and 3 months after the end of the program (posttest). Multilevel multiple mediation models were applied to the study of effect mediation separately for tobacco, alcohol, and cannabis use. Analyses were conducted on the whole sample, and separately on baseline users and nonusers of each substance.Results: Compared with the control group, participants in the program endorsed less positive attitudes toward drugs; positive beliefs about cigarettes, alcohol, and cannabis; and the normative perception of peers using tobacco and cannabis. They also increased in knowledge about all substances and refusal skills toward tobacco. Decreased positive attitudes toward drugs, increase in refusal skills, and reappraisal of norms about peer using tobacco and cannabis appeared to mediate the effects of the program on the use of substances. However, mediating effects were generally weak and some of them were only marginally significant.Conclusions: This study lends some support to the notion that school-based programs based on a social influence model may prevent juvenile substance use through the modification of attitudes, refusal skills, and normative perceptions. (C) 2014 Society for Adolescent Health and Medicine. All rights reserved.
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| 10. |
- Giannotta, Fabrizia, 1978-, et al.
(author)
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The role of threat appraisal in the relation between peer victimization and internalizing problems in early Italian adolescents
- 2012
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In: Journal of Applied Social Psychology. - : Wiley-Blackwell. - 0021-9029 .- 1559-1816. ; 42:9, s. 2077-2095
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Journal article (peer-reviewed)abstract
- Appraisals are a key, but understudied part of the coping process. In the current study, the mediating role of threat appraisals in the relation between relational and physical victimization by peers and internalizing and externalizing problems was investigated in a sample of 155 Italian adolescents (52% female; M age = 12.2 years) using a cross-sectional design. Structural equation modeling revealed that appraisals of threat (negative self-evaluation, negative evaluation by others, loss of relationship) mediated associations between peer victimization and internalizing problems. Moreover, peer victimization affected externalizing behaviors, but this link was not mediated by threat appraisal. Implications for interventions with youth are discussed.
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| 11. |
- Graziano, Federica, et al.
(author)
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Drinking motives and alcoholic beverage preferences among Italian adolescents
- 2012
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In: Journal of Adolescence. - : Academic Press. - 0140-1971 .- 1095-9254. ; 35:4, s. 823-831
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Journal article (peer-reviewed)abstract
- Although drinking motives have been largely studied, research taking into account the Mediterranean drinking culture and focusing on motives specifically associated to adolescents' developmental tasks is lacking. For these reasons the study investigates drinking motives in a group of Italian adolescents and their relationships with drunkenness and high levels of alcohol consumption (wine, beer, spirits and alcopops). A self-report questionnaire on drinking motives and amount of alcohol use was administered to 784 adolescents, boys (46%) and girls, ages 15-19. Using confirmatory factor analysis and stepwise logistic regressions, we found that: 1) motives for drinking were coping, conformity, self-affirmation and experimentation-transgression; 2) coping motives were positively related to the high consumption of all alcoholic beverages and to drunkenness; 3) conformity motives were negatively related to high beer consumption and drunkenness, while experimentation-transgression motives were positively related to high alcopops consumption. Implications for prevention are discussed.
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| 12. |
- Larm, Peter, et al.
(author)
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Do non-drinking youth drink less alcohol in young adulthood or do they catch up? : Findings from a Swedish birth cohort
- 2023
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In: European Journal of Public Health. - : Oxford University Press. - 1101-1262 .- 1464-360X. ; 33:4, s. 640-644
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Journal article (peer-reviewed)abstract
- Background Alcohol consumption among adolescents has declined considerably during the last two decades. However, it is unknown if these adolescents' alcohol consumption will remain low as they grow older. To our knowledge, this is one of the first studies that uses longitudinal data to examine if non-drinking adolescents have a lower alcohol consumption in young adulthood or if they catch up. Methods A self-report survey was distributed to a birth cohort (n = 794) born in 1997 in a Swedish region when cohort members attended ninth grade (age 14-15 years) in 2012. Responders were divided into non-drinkers and alcohol users and assessed again in their late teens (17-18 years) and young adulthood (20-21 years). Results In their late teens (17-18 years), non-drinkers at baseline consumed less alcohol and had a lower probability of harmful use compared with their alcohol-using peers. In young adulthood (20-21 years), these effects disappeared when adjustment was made for covariates. However, a stratified analysis showed that non-drinking adolescents low in conduct problems consumed less alcohol and had a lower probability of harmful use in young adulthood than alcohol-using peers. Conclusions This study suggests that the decline in alcohol use among adolescents in the past decades may be associated with a lower alcohol consumption in the late teens and young adulthood among those low in conduct problems. This may have promising implications for alcohol-related morbidity and mortality.
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| 13. |
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| 14. |
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| 15. |
- Ortega, Enrique, et al.
(author)
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Cultural adaptation of the strengthening families program 10-14 to Italian families
- 2012
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In: Child and Youth Care Forum. - : Springer. - 1053-1890 .- 1573-3319. ; 41:2, s. 197-212
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Journal article (peer-reviewed)abstract
- The family context has proven to be a useful target in which to apply prevention efforts aimed at child and adolescent health risk behaviors. There are currently a variety of cultural adaptation models that serve to guide the international adaptation of intervention programs.The cultural adaptation process and program reception of the Strengthening Families Program 10-14 (SFP 10-14) was described in this article. The implementation context is one in which strong family bonds and high family communication are the norm.We described our cultural adaptation process comparing our efforts to the recommended stages of the main current cultural adaptation models. We pilot tested and implemented the adapted version of our program with a total of 35 families in the city of Turin Italy.This study showed that the SFP 10-14 may indeed be quite suitable for Italian families given the particularities of Italian society regarding strong family bonds and extended social networks. We described the language translation, cultural adaptation process for program materials, staff training, onsite supervision, and the process evaluation feedback that were undertaken as part of the adaptation efforts.The field of prevention could greatly benefit from the identification of tools and techniques that are applicable to populations with diverse social and cultural backgrounds. The family is extremely important for Italians and represents a rich context in which prevention efforts could be addressed.
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| 16. |
- von Thiele Schwarz, Ulrica, 1975-, et al.
(author)
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Professionals’ management of the fidelity–adaptation dilemma in the use of evidence-based interventions—an intervention study
- 2021
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In: Implementation Science Communications. - : Springer Science and Business Media LLC. - 2662-2211. ; 2:1
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Journal article (peer-reviewed)abstract
- Background: Evidence-based interventions (EBIs) can be effective tools for the prevention of disease and healthpromotion. However, their implementation often requires a delicate balance between the need to adjust theintervention to the context in which it is implemented and the need to keep the core components that make theintervention effective. This so-called dilemma between fidelity and adaptation is often handled by healthprofessionals in the sustainment phase of an implementation (i.e., once the intervention has been adopted andinstitutionalized in an organization), but not much is known about how and to what extent health professionals areaffected by this dilemma. Focusing on the sustainment phase, this project aims to study (1) how fidelity andadaptation are managed by professionals using an EBI, (2) how the fidelity–adaptation dilemma affectsprofessionals’ psychosocial working conditions, and (3) how a structured decision support influences professionals’management of the dilemma and their psychosocial working conditions.Methods: The study is set in Sweden, and the EBI in focus is a parental program (All Children in Focus). Alongitudinal within-person intervention design is used, combined with a cross-sectional survey design. Data sourcesinclude web-based questionnaires, brief interviews, fidelity ratings, paper-and-pen questionnaires, and writtendocumentation, collected at multiple time points with both group leaders and parents as respondents.Discussion: This project approaches fidelity and adaptation from the perspective of the professionals that manageEBIs during the sustainment phase of implementation. Although it is well known that EBIs continue to change overtime, it remains to be understood how the fidelity–adaptation dilemma can be managed so that the effectivenessof interventions is retained or improved, not diluted. Moreover, the project adds to the literature by presenting anoccupational health perspective on the fidelity–adaptation dilemma. It is acknowledged that fidelity and adaptationmay have consequences for not only clients but also the occupational wellbeing of the professionals managing thedilemma, and subsequently, their willingness and ability to deliver EBIs in a sustainable way.
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| 17. |
- von Thiele Schwarz, Ulrica, 1975-, et al.
(author)
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Understanding the value of adhering to or adapting evidence-based interventions : a study protocol of a discrete choice experiment
- 2021
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In: Implementation Science Communications. - : Springer Science and Business Media LLC. - 2662-2211. ; 2:1
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Journal article (peer-reviewed)abstract
- Background: Whereas the value of an evidence-based intervention (EBI) is often determined by its effect on clinicaloutcomes, the value of implementing and using EBIs in practice is broader, reflecting qualities such asappropriateness, equity, costs, and impact. Reconciling these value conflicts involves a complicated decision processthat has received very limited scholarly attention. Inspired by studies on decision-making, the objective of thisproject is to explore how practitioners appraise the values of different outcomes and to test how this appraisalinfluences their decisions surrounding the so-called fidelity–adaptation dilemma. This dilemma is related to thebalance between using an EBI as it was designed (to ensure its effectiveness) and making appropriate adaptations(to ensure alignment with constraints and possibilities in the local context).Methods: This project consists of three sub-studies. The participants will be professionals leading evidence-basedparental programs in Sweden and, in Sub-study 1, parents and decision-makers. Sub-study 1 will use sequentialfocus groups and individual interviews to explore parameters that influence fidelity and adaptation decisions—thedilemmas encountered, available options, how outcomes are valued by practitioners as well as other stakeholders,and value trade-offs. Sub-study 2 is a discrete choice experiment that will test how value appraisals influencedecision-making using data from Sub-study 1 as input. Sub-study 3 uses a mixed-method design, with findingsfrom the two preceding sub-studies as input in focus group interviews to investigate how practitioners make senseof findings from optimal decision situations (experiment) and constrained, real-world decision situations.Discussion: The project will offer unique insights into decision-making processes that influence how EBIs are usedin practice. Such knowledge is needed for a more granular understanding of how practitioners manage thefidelity–adaptation dilemma and thus, ultimately, how the value of EBI implementation can be optimized. Thisstudy contributes to our knowledge of what happens once EBIs are adopted—that is, the gap between the way inwhich EBIs are intended to be used and the way in which they are used in practice.
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| 18. |
- Özdemir, Metin, 1977-, et al.
(author)
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Improving dissemination of evidence‐based programs through researcher–practitioner collaboration
- 2014
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In: New Directions for Youth Development. - : Wiley. - 1533-8916 .- 1537-5781. ; 141, s. 107-116
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Journal article (peer-reviewed)abstract
- Prevention field has achieved major advances in developing, implementing, and testing the efficacy of preventive interventions in controlled settings. Nevertheless, there is still a gap in translating the success of programs in efficacy trials into real-life settings. Dissemination of evidence-based programs is a major challenge. The authors argue that promoting adoption of evidence-based programs requires further improvements in three areas, and collaboration between researchers and practitioners. First, there is a need to develop a holistic assessment system encompassing both risk/need and readiness assessments. Second, there is need for new methods for improving implementation quality. Third, prevention research needs to focus more on identifying the mechanisms that explain how programs work and the core elements of the program. Both researchers and practitioners have roles and opportunities to collaborate to achieve developments in these areas.
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