Publikationen

Heinz A, Sischka PE, Catunda C, Cosma A, García-Moya I [...] & Pickett W

Background: The Symptom Checklist (SCL) developed by the Health Behaviour in School-aged Children (HBSC) study is a non-clinical measure of psychosomatic complaints (e.g., headache and feeling low) that has been used in numerous studies. Several studies have investigated the psychometric characteristics of this scale; however, some psychometric properties remain unclear, among them especially a) dimensionality, b) adequacy of the Graded Response Model (GRM), and c) measurement invariance across countries. Methods: Data from 229,906 adolescents aged 11, 13 and 15 from 46 countries that participated in the 2018 HBSC survey were analyzed. Adolescents were selected using representative sampling and surveyed by questionnaire in the classroom. Dimensionality was investigated using exploratory graph analysis. In addition, we investigated whether the GRM provided an adequate description of the data. Reliability over the latent variable continuum and differential test functioning across countries were also examined. Results: Exploratory graph analyses showed that SCL can be considered as one-dimensional in 16 countries. However, a comparison of the unidimensional with a post-hoc bifactor GRM showed that deviation from a hypothesized one-dimensional structure was negligible in most countries. Multigroup invariance analyses supported configural and metric invariance, but not scalar invariance across 32 countries. Alignment analysis showed non-invariance especially for the items irritability, feeling nervous/bad temper and feeling low. Conclusion: HBSC-SCL appears to represent a consistent and reliable unidimensional instrument across most countries. This bodes well for population health analyses that rely on this scale as an early indicator of mental health status.

Reiß F, Kaman A, Napp A-K, Devine J, Li LY, Strelow L, Erhart M, Hölling H, Schlack R & Ravens-Sieberer U

Hintergrund: Ein kontinuierliches bundesweites Gesundheitsmonitoring ist wichtig, um das Wohlbefinden von Kindern und Jugendlichen im Blick zu behalten und Entwicklungsverläufe abzubilden. Anhand der Ergebnisse von 3 ausgewählten epidemiologischen Studien werden Entwicklungen zum kindlichen Wohlbefinden der letzten 20 Jahre vorgestellt. Methodik: Datengrundlage bilden (1.) die bevölkerungsbezogene BEfragung zum seeLischen WohLbefinden und VerhAlten (BELLA-Studie, 2003–2017, N = 1500–3000), die ein Modul der KiGGS-Studie ist, (2.) die COrona und PSYche Studie (COPSY, 2020–2022, N = 1600–1700), die auf der BELLA-Studie aufbaut, und (3.) die internationale Health-Behaviour in School-aged Children Studie (HBSC, 2002–2018, N = 4300–7300). Das Wohlbefinden wurde bei 7‑ bis 17-Jährigen mittels der Indikatoren gesundheitsbezogene Lebensqualität (KIDSCREEN-10), Lebenszufriedenheit (Cantril Ladder) und psychische Auffälligkeiten (Strenghts and Difficulties Questionnaire (SDQ), Screen for Child Anxiety Related Emotional Disorders (SCARED) und Center for Epidemiological Studies Depression Scale for Children (CES-DC)) erfasst. Ergebnisse: Insgesamt zeigen Kinder und Jugendliche präpandemisch (2002–2018) eine konstant hohe gesundheitsbezogene Lebensqualität und eine hohe allgemeine Lebenszufriedenheit, die sich mit Beginn der COVID-19-Pandemie 2020 zunächst verschlechterte. 2 Jahre später zeigen sich Verbesserungen, die jedoch noch nicht das Ausgangsniveau erreichen. Psychische Auffälligkeiten, ängstliche und depressive Symptome nahmen mit Pandemiebeginn um bis zu 12 Prozentpunkte zu und zeigen auch 2 Jahre nach Pandemiebeginn noch höhere Werte als präpandemische Studien. Diskussion: Die Epidemiologie kindlichen Wohlbefindens bietet eine notwendige Datengrundlage, um den Unterstützungsbedarf von Kindern und Jugendlichen zu erfassen und auf dieser Basis Maßnahmen der Gesundheitsförderung, Prävention und Intervention zu entwickeln.

Schütz R & Bilz L

Hintergrund: Einsamkeit ist sowohl im öffentlichen als auch im wissenschaftlichen Diskurs ein zunehmend präsentes Thema. Es liegen inzwischen zahlreiche Forschungsergebnisse zur Verbreitung und zu den gesundheitsbezogenen Zusammenhängen von Einsamkeit bei Erwachsenen vor. Zur Einsamkeit im Kindes- und Jugendalter gibt es für Deutschland nur wenige Erkenntnisse. Vor diesem Hintergrund stellt dieser Beitrag Befunde zur Verbreitung von Einsamkeit bei 11- bis 15-jährigen deutschen Schüler*innen vor und untersucht Zusammenhänge mit soziodemographischen Merkmalen. Methoden: Die Studie „Health Behaviour in School-aged Children“ (HBSC) ist eine globale Forschungskooperation unter Schirmherrschaft der Weltgesundheitsorganisation (WHO). In Brandenburg erfasste die Studie Daten von 3819 Kindern und Jugendlichen an allgemeinbildenden Schulen in den Klassenstufen 5, 7 und 9 (MAlter = 13,5, SD = 1,6). Einsamkeit wurde anhand der University of California, Los Angeles (UCLA) Loneliness Scale und eines Einzelitems erhoben. Ergebnisse: 13,2 % der Befragten gaben an, sich „meistens“ einsam zu fühlen, „immer“ einsam fühlten sich 3,6 %. Einsamkeit war stärker ausgeprägt bei Mädchen, bei Schüler*innen mit der Geschlechtszuschreibung „divers“ sowie bei älteren Heranwachsenden und bei Kindern und Jugendlichen mit niedrigerem sozioökonomischen Status. Diskussion: Die Befunde weisen darauf hin, dass Einsamkeit bei Kindern und Jugendlichen ein weit verbreitetes Phänomen ist. Dass sich Mädchen, ältere Schüler*innen sowie Kinder und Jugendliche mit geringerem familiären Wohlstand einsamer fühlen, stimmt mit Ergebnissen aus anderen Ländern überein und liefert Ansatzpunkte für die Planung von Präventionsmaßnahmen. Es bedarf in Deutschland weiterer Forschung zu möglichen gesundheitsbezogenen Zusammenhängen von Einsamkeit.

Richter M, Heilmann K & Moor I (2021)

Hintergrund: Die aktuell heranwachsende Generation verbringt mehr Zeit mit der Nutzung sozialer Medien als jede andere Altersgruppe. Über die gesundheitlichen Auswirkungen einer häufigen Nutzung sozialer Medien durch Heranwachsende ist bislang nur wenig bekannt. Ziel der Studie ist es, die Assoziation zwischen sozialer Mediennutzung, der Gesundheit und dem Risikoverhalten an einer großen repräsentativen Stichprobe für Deutschland zu untersuchen. Methode: Die Daten stammen aus dem deutschen Teilsurvey der internationalen WHO-Studie „Health Behaviour in School-aged Children (HBSC)“ aus dem Jahr 2013/14. Die Auswertung basiert auf Daten von 5.094 Schulkindern im Alter von durchschnittlich 11, 13 und 15 Jahren. Die soziale Mediennutzung wurde über einen Index aus 5 Items erhoben. Als Gesundheitsoutcomes werden Indikatoren des Gesundheitszustandes und des Risikoverhaltens betrachtet. Die Analysen wurden mithilfe von Kreuztabellen und log-binominaler Regressionsmodelle getrennt für Mädchen und Jungen berechnet. Ergebnisse: Die Ergebnisse zeigen, dass eine häufige Nutzung sozialer Medien bei Mädchen mit einer schlechteren subjektiven Gesundheit (OR=1,58, 95%-KI=1,17–2,15) sowie multiplen psychosomatischen Beschwerden (OR=1,56, 95%-KI = 1,22–1,98) assoziiert war. Bei Jungen traf dies für psychosomatische Beschwerden (OR=1,36, 95%-KI=1,03–1,80) und die Schulzufriedenheit (OR=1,39, 95%-KI=1,06–1,83) zu. Bezüglich des Risikoverhaltens zeigte sich unabhängig vom Geschlecht ein stärkerer Zusammenhang zwischen der häufigen Nutzung sozialer Medien und regelmäßigem Tabak- und Alkoholkonsum, alkoholbedingten Rauscherfahrungen sowie dem Mobben (Bullying-Täter) von Mitschülern. Die Ergebnisse blieben unter Kontrolle des Alters, Schultyps und Migrationshintergrunds bestehen. Schlussfolgerungen: Es konnte ein deutlicher Zusammenhang zwischen sozialer Mediennutzung und verschiedenen Indikatoren der Gesundheit und des Risikoverhaltens im Kindes- und Jugendalter festgestellt werden. Die Ergebnisse geben erste Hinweise auf mögliche gesundheitsabträgliche Effekte einer häufigen Nutzung sozialer Medien, die im Rahmen längsschnittlicher Studien bestätigt werden müssen.

Bucksch J, Häußler A, Schneider K, Finne E, Schmidt K, Dadaczynski K & Sudeck G (2020)

Numerous findings are known to exist between dietary habits, physical activity, and child and adolescent health. Here, we will use data from the most recent Health Behaviour in School-aged Children (HBSC) study to describe dietary habits and patterns of physical activity. Using the survey data for 11-, 13- and 15-year-old students from across Germany, we report findings for key indicators of diet and physical activity for the 2017/18 cycle. By comparing these findings with data from the 2009/10 and 2013/14 survey cycles, we also consider current trends. Results from the most recent cycle show that 10.0% of girls and 16.9% of boys meet the World Health Organization’s (WHO) physical activity recommendations. Across all HBSC cycles, this is the lowest figure so far. Concerning dietary habits, 50.6% of girls and 59.0% of boys reported having breakfast every morning. Data for daily fruit, vegetable and soft drink consumption emphasises the need to promote a healthy diet among adolescents. For all indicators of physical activity and diet, differences between girls and boys are apparent. Girls’ intake of fruit and vegetables is higher and they consume fewer soft drinks, yet boys are more physically active and have breakfast more regularly. For the majority of indicators of dietary habits and physical activity, considerable inequalities relating to family affluence are observed. An important implication of the study results for dietary habits and physical activity of older children and adolescents is the need to foster settings-based approaches to promote physical activity and a healthy diet that integrate a gender-sensitive perspective.

Fischer SM, John N, Melzer W, Kaman A, Winter K & Bilz L (2020)

Bullying is a specific form of violence that can potentially lead to numerous and long-term negative health implications. Despite consistent coverage in the media, particularly on cyberbullying, as of yet there are only few representative findings on the frequency of (cyber)bullying in Germany. This article analyses how widespread bullying and cyberbullying were at schools in Germany in 2018, what differences exist between girls and boys, age groups and various types of schools, and changes in bullying trends between 2002 and 2018. Our findings are based on an analysis of the data provided by the 2017/18 cycle (N=4,347 students, 53.0% female) and previous cycles of the German Health Behaviour in School-aged Children (HBSC) study. In the 2018 cycle, boys reported having bullied other children more frequently than girls, but were bullied just as often. 15-year-olds reported having bullied other children more frequently than 11- to- 13-year-olds but reported being bullied less frequently. Students at grammar schools (Gymnasium) least frequently reported any involvement in bullying. Only few children and adolescents reported cases of cyberbullying. Compared to all previous survey years, 2018 saw the lowest number of children that reported having bullied others. However, reports of having been bullied have remained almost stable. The findings highlight the need for evidence-based prevention and intervention anti-bullying programmes and measures across all types of general education schools and age groups.

Kaman A, Ottová-Jordan V, Bilz L, Sudeck G, Moor I & Ravens-Sieberer U (2020)

Subjective health is understood as a multidimensional construct that encompasses the physical, mental and social dimensions of a person’s well-being. Promoting the subjective health and well-being of children and adolescents has strong public health relevance because health impairments in childhood and adolescence are often associated with longterm health problems in adulthood. Therefore, it is very important to gain information about potential risk and resource factors involved. This article presents current prevalences for subjective health, life satisfaction and psychosomatic health complaints among children and adolescents in Germany aged 11, 13 and 15 years from the 2017/18 Health Behaviour in School-Aged Children (HBSC) study (N=4,347, 53.0% girls). It also examines the sociodemographic and psychosocial factors that influence subjective well-being. Most children and adolescents provided positive ratings of their health and life satisfaction. Nevertheless, about one third of girls and one fifth of boys were affected by multiple psychosomatic health complaints. Impairments in subjective well-being were particularly evident in girls, older adolescents, young people with low levels of family affluence and those under a lot of pressure at school. In contrast, high family support was associated with better subjective well-being. These results illustrate the need for target group-specific prevention and health promotion measures aimed at improving the subjective health and well-being of children and adolescents.

Moor I, Winter K, Bilz L, Bucksch J, Finne E, John N, Kolip P, Paulsen L, Ravens-Sieberer U, Schlattmann M, Sudeck G, Brindley C, Kaman A & Richter M (2020)

The Health Behaviour in School-aged Children (HBSC) study is an international research project in collaboration with the World Health Organization (WHO) for over 35 years. HBSC is the largest study on child and adolescent health and one of the most important sources of data for the WHO’s international comparative health monitoring. Every four years, data on the health and health behaviour of students aged 11, 13 and 15, as well as the social contexts and conditions for growing up healthy, are collected. A total of 50 countries belong to the HBSC network, with 45 countries taking part in the 2017/18 survey. Germany has contributed to the HBSC surveys since 1993/94. For the most recent 2017/18 cycle, students at 146 schools in Germany were interviewed (response rate of schools: 15.6%). A net sample of n = 4,347 girls and boys was achieved for Germany (response rate: 52.7%). Participation was voluntary and the survey was conducted in German school years five, seven and nine (corresponding to ages 11, 13 and 15). A weighting procedure was applied to allow for representative findings on the health of children and adolescents in Germany. HBSC offers a valuable contribution to health monitoring and provides numerous starting points to identify needs, risk groups and fields of action to initiate targeted and actual needs-based measures of prevention and health promotion in the school setting.

Moor I, Winter K, Rathmann K, Ravens-Sieberer U & Richter M (2020)

Tobacco, alcohol and cannabis are psychoactive substances that is often tried for the first time during adolescence and further continued in later life. Regular tobacco and cannabis use as well as alcohol abuse are associated with serious health consequences. According to the importance of health reporting, this article describes current prevalence of adolescent substance use and the associations between psychoactive substance use and specific social determinants. Representative data for Germany from the 2017/18 Health Behaviour in School-Aged Children (HBSC) study among schoolchildren aged 11, 13 and 15 years are used. The article analyses both, the lifetime and 30-day prevalence of tobacco, alcohol and cannabis use (in the latter case, data were only available for 15-year-olds) among adolescents as well as their experiences of alcohol-related misuse (binge drinking). Tobacco and alcohol are used comparatively rarely by 11- and 13-yearolds. However, the prevalence increases significantly among 15-year-olds. In addition, cannabis use is also quite common among this age group. Schoolchildren who do not attend grammar schools are at greater risk of smoking and those with high family affluence are at a greater risk of alcohol use, this applies particularly to girls. Finally, adolescents with a migration background are less at risk of regular alcohol use or binge drinking, but face an increased risk of cannabis use (girls with one-sided migration background). The results indicate that prevention measures should start early, as the prevalence of substance use is significantly higher among older schoolchildren. Depending on the substance, different risk groups can be identified that require particular consideration when drawing up preventive measures.