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.

Background

Recent reports of increasing prevalence of frequent health complaints and mental health problems among adolescents call for directing more attention on determinants of adolescent health. The relationship between health and social capital has gained increased attention since the early 2000’s and research at review level confirms the importance of social capital for health outcomes, despite methodological heterogeneity. The aim of this study was to identify distinct profiles of family, school and peer social capital in a nationally representative sample of adolescents and to explore health outcomes in those profiles.

Method

Cross-sectional data from the Swedish Health Behaviour of School-aged Children 2013/14 was used for this study. The analytical sample consisted of 7,804 adolescents aged 11-, 13- and 15-years. Items representing sense of belonging and emotional support were assessed in three contexts; family, school and among peers. Latent profile analyses (LPA) were run to determine social capital profiles. Health outcomes included frequent health complaints and life satisfaction, while socioeconomic status and genders were included as predictors.

Results

The results show that five distinct profiles best represent the data for 11- and 15-year olds, while a four-profile model was optimal for 13-year olds. Some profiles were recurrent between age groups but unique profiles were also found. Health outcomes were significantly different between profiles depending on levels of social capital in the different contexts.

Conclusions

This study provides novel insight into how social capital co-occurs among adolescents within the contexts of family, school and peers and how this translates into differences in health outcomes. The national representativeness of the sample increases the implications of the results and contributes to meaningful insights that help explain the interactions of social capital in multiple contexts, complementing what is previously known about the relationship with adolescent health. © 2019 Ahlborg et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Background

Socioeconomic 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.

Method

Cross-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.

Results

Subjective 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).

Conclusions

The 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

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.

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.

Background

Adolescents 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.

Methods

In 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.

Results

Among 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).

Conclusions

Boys 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 messages

• Among 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.

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.

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

Young people’s mental health is a public health priority, particularly as mental health problems in this group seem to be increasing. Even in countries with supposedly good access to healthcare, few young people seek support for mental health problems. The aim of this study was twofold, firstly to map the published literature on young people’s experiences of seeking help for mental health problems and secondly to validate whether the Lost in Space model was adaptable as a theoretical model of the help-seeking process described in the included articles in this scoping review. A scoping review was conducted in which we searched for literature on mental health help-seeking with a user perspective published between 2010 and 2020 in different databases. From the 2905 studies identified, we selected 12 articles for inclusion. The review showed how young people experience unfamiliarity and insecurity with regard to issues related to mental health and help-seeking. A strong wish for self-reliance and to safe-guard one’s own health were consistent among young people. Support structures were often regarded as inaccessible and unresponsive. There was a high level of conformity between the model on help-seeking and the analysed articles, reinforcing that help-seeking is a dynamic and psychosocial process. © 2022 by the authors.

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.

This study aims to understand the role that optimism could play in the context of a health asset approach to promote adolescent health-related quality of life (HRQOL). Adolescents (n = 948), between 11 and 16 years old from a medium-sized rural town in Sweden, answered questionnaires measuring optimism, pessimism, and HRQOL. The findings indicate a significant decrease in optimism and a significant increase in pessimism between early and mid adolescence. The study has allowed us to present associational evidence of the links between optimism and HRQOL. This infers the potential of an optimistic orientation about the future to function as a health asset during adolescence and by implication may provide additional intervention tools in the planning of health promotion strategies. © 2017 The Authors

Children with disabilities engage less in physical activity and sports during their spare time compared to their peers without disabilities. Modern sports, contextual factors, and parents’ fear of discrimination have been discussed as barriers to participation. The aim of this study is to describe parents’ experiences of their child with neurodevelopmental disorders (NDD) participating in a PAP intervention. The intervention involved a Child and Adolescent Psychiatry outpatient clinic (CAP), the Regional Sport Federation, and local sport clubs in the southwestern region of Sweden. A sample of 13 parents took part in semi-structured interviews, and qualitative content analysis was used for data analysis. The analysis resulted in three main categories, including sub-categories. By being part of a collaboration, the parents experienced two different worlds coming together, the CAP and the sport world, and they were also aware of the collaboration’s organisation and need for resources. In growing with sports, the parents described that treating the children with respect involved learning sports from the child’s condition and creating a social space for them. Regarding individual motivation for participating in sports, the parents expressed that the children felt proud to be part of the PAP intervention and experienced a sense of belonging in the group with the other children. The study highlights perspectives for developing sports for all in local sport clubs and improving sports as part of the CAP care for children with NDD. © 2023 by the authors.

Introduction: A new tool for nurses to communicate healthier habits to parents of children at 18 months and 3 years of age has been developed and implemented by a registered dietitian at the children’s health care centre (CHCC) in Skaraborg, Sweden. The tool contains questions and information about meal order, drinks, candy, snacks, fat and physical activity. Our aim was to describe the nurses’ experiences of the tool and supervision from the registered dietician at the CHCC. Methods: The tool was evaluated after 14 months in practice. In three focus groups 17 nurses participated. A structured interview guide was used and the interviews were transcribed verbatim. The transcripts were analyzed using qualitative content analysis. Findings were triangulated by a questionnaire within all nurses in Skaraborg (n = 76). Results: The nurses described their experiences in terms of comparison with the previous tool, practicability, parent’s reactions and improvement. Using the previous tool the nurses felt uncertain when talking about healthier habits. With the new tool the nurses expressed that they felt more confident. Parents were also more engaged in the dialogue. The discussion regarding physical activity was not satisfactory and the question needed improvement. The questionnaire showed, 98% of the nurses wanted to continue with the tool, and 86% found the question about physical activity needed revision. Conclusion: This is a new approach to prevent child obesity. The tool simplified the communication with parents and with supervision from dietitian, it lead to a higher quality in promoting healthier habits at CHCC.

To increase the understanding of difficulties in promoting healthy habits to parents, we explore barriers in health-care provision. The aim of this study is to describe nurses' perceived barriers when discussing with parents regarding healthy food habits, physical activity and their child's body weight. A mixed method approach was chosen. Nurses (n = 76) working at 29 different Child Health Care Centers' in an area in west Sweden were included in the study. Three focus group interviews were conducted and 17 nurses were selected according to maximum variation. Data were categorized and qualitative content analysis was the chosen analysis method. In the second method, data were obtained from a questionnaire distributed to all 76 nurses. The latent content was formulated into a theme: even with encouragement and support, the nurses perceive barriers of both an external and internal nature. The results identified four main barriers: experienced barriers in the workplace-internal and external; the nurse's own fear and uncertainty; perceived obstacles in nurse-parent interactions and modern society impedes parents' ability to promote healthy habits. The nurses' perceived barriers were confirmed by the results from 62 of the nurses who completed the questionnaire. Despite education and professional support, the health professionals perceived both external and internal barriers in promoting healthy habits to parents when implementing a new method of health promotion in primary care. Further qualitative studies are needed to gain deeper understanding of the perceived barriers when promoting healthy habits to parents.

Children with autism spectrum disorder (ASD) or attention-deficit/hyperactivity disorder (ADHD) have a higher risk of inactivity, and efforts to promote physical activity among this population have been limited. Physical activity on prescription (PAP) may be a suitable tool for motivating participation in physical activity among children with these diagnoses. However, PAP calls for synergy and partnership between health care and other sectors of the community. The aim of this study was to describe a health promotion partnership for physical activity targeting children with ASD or ADHD. Data were obtained through individual interviews with professionals at CAP (n = 11) and three focus-group interviews with coaches from local sports clubs. We used the Bergen Model of Collaborative Functioning as the theoretical framework and used qualitative content analysis as the method of analysis to study partnerships between professionals from the Child and Adolescent Psychiatry outpatient clinic (CAP) and coaches from local sport clubs. The findings demonstrate that the partnerships included both positive and negative processes. Although the two partners shared values regarding the project, such as working for a good cause for the children and seeing the potential in the collaboration, there were doubts about sharing common resources and uncertainties about the sustainability of the PAP project. Challenges remain and further research is needed into developing, monitoring and evaluating health promotion partnerships when promoting physical activity for all. © The Author(s) 2022. Published by Oxford University Press.

Inequalities in young people's mental health have been documented according to social class but less is known about determinants that can buffer or mediate the relationship. Social capital has the potential to contribute to alleviating observed health inequalities. However, clarity about how it can be understood and measured in relation to mental health among younger populations remains inconsistent. This scoping review examined published literature to investigate how social capital has been researched for young people's mental health. An established framework was used to guide the methodology. Studies were included: on age (10-19 years); publication year (since 2000); language (English). Only studies using social capital as a central theme were included. No restriction was placed on mental health outcomes. Nine bibliographic databases were interrogated. Articles (1541) were screened, 793 retained for analysis and 73 articles were included. Most studies were conducted in North America and Europe. Twenty per cent provided insights into how social capital should be described in relation to young people. A majority of the studies provided links between varying social capital indicators and a range of mental health outcomes (70%), however such evidence was associational. Only few studies inferred the causal direction between social capital and health (10%) and there were no dedicated studies on measurement. Findings suggest that literature on social capital and young people's mental health has grown but continues to be variously described and measured. It requires better utilization of existing knowledge and new research to improve its application in practice. © The Author(s) 2020. Published by Oxford University Press. All rights reserved.

Objective: To validate self-reported information on weight and height in an adult population and to find a useful algorithm to assess the prevalence of obesity based on self-reported information. Research Methods and Procedures: This was a crosssectional survey consisting of 1703 participants (860 men and 843 women, 30 to 75 years old) conducted in the community of Vara, Sweden, from 2001 to 2003. Self-reported weight, height, and corresponding BMI were compared with measured data. Obesity was defined as measured BMI >= 30 kg/m(2). Information on education, self-rated health, smoking habits, and physical activity during leisure time was collected by a self-administered questionnaire. Results: Mean differences between measured and self-reported weight were 1.6 kg (95% confidence interval, 1.4; 1.8) in men and 1.8 kg (1.6; 2.0) in women (measured higher), whereas corresponding differences in height were -0.3 cm (-0.5; -0.2) in men and -0.4 cm (-0.5; -0.2) in women (measured lower). Age and body size were important factors for misreporting height, weight, and BMI in both men and women. Obesity (measured) was found in 156 men (19%) and 184 women (25%) and with self-reported data in 114 men (14%) and 153 women (20%). For self-reported data, the sensitivity of obesity was 70% in men and 82% in women, and when adjusted for corrected self-reported data and age, it increased to 81 % and 90%, whereas the specificity decreased from 99% in both sexes to 97% in men and 98% in women. Discussion: The prevalence of obesity based on self-reported BMI can be estimated more accurately when using an algorithm adjusted for variables that are predictive for misreporting.

Background: Despite the potential impact of shared decision making on users satisfaction with care and quality in health care decisions, there is a lack of knowledge and skills regarding how to work with shared decision making among health care providers.

Aim: The aim of this study was to evaluate the psychometric properties of three instruments that measure varied dimensions of shared decision making, based on self-reports by clients, in a Swedish community mental health context.

Method: The study sample consisted of 121 clients with experience of community mental health care, and involved in a wide range of decisions regarding both social support and treatment. The questionnaires were examined for face and content validity, internal consistency, test-retest reliability and construct validity.

Results: The instruments displayed good face and content validity, satisfactory internal consistency and a moderate to good level of stability in test-retest reliability with fair to moderate construct correlations, in a sample of clients with serious mental illness and experience of community mental health services in Sweden.

Conclusions: The questionnaires are considered to be relevant to the decision making process, user-friendly and appropriate in a Swedish community mental health care context. They functioned well in settings where non-medical decisions, regarding social and support services, are the primary focus. The use of instruments that measure various dimensions of the self-reported experience of clients, can be a key factor in developing knowledge of how best to implement shared decision making in mental health services. © Informa UK Limited, trading as Taylor & Francis Group.

This study aimed to describe parents’ experiences of communication with school nurses concerning the growth data and weight development of their children aged 8 and 10 years old in Sweden. Eighteen interviews with parents were conducted and analyzed through qualitative content analysis. The result showed a need for improved dialogue where the parents viewed the health visit's purpose as unclear and lacked feedback. The parents desired access to their child's growth data and described the need for an improved channel for receiving information. The parents moreover experienced the lack of a child-centered perspective, described the child's context as not in focus, and desired collaboration around their child. This study shows the need for the development of evidence-based methods for communicating growth data and weight development between School Health Service (SHS) and parents, as well as the need for a reformed SHS perspective towards parents and children. © The Author(s) 2023.

Background: Research has shown that socio-economic status (SES) contributes to the mental health of adolescents; however the causality of this effect is debated. SES among adolescents is methodologically difficult to assess and SES indicators differ between age groups. The aim of this study was to evaluate objective and subjective indicators of SES and their relation to mental health in two adolescent age groups.

Methods: This is a cross-sectional study based on data collected by self- report questionnaires from 11-13 years old n = 457 (younger age group) and 14-16 years old n = 462 (older age group) adolescents at schools in a rural town in south western Sweden. The Family Affluence Scale (FAS) (high, medium, low) and Perceived Wealth (PW) (high, medium, low) were used as measurement for objective and subjective socio-economic wealth. The domain psychological functioning health from the Minneapolis Manchester Quality of Life instrument (MMQL-PF) (continuous variable) was used to measure self-rated mental health.

Results: When measuring SES using the two different scales, the proportion of adolescents in the younger age group stating a low SES was 28.1% using FAS and 12.1% using PW. In the older age group the proportion was 21.4% in FAS and 15.5% in PW. There was a positive significant relation between PW and self-rated mental health in both age groups, by 0.112 (95% CI.0.024; 0.199) in the younger age group and by 0.140 (95% CI.0.051; 0.223) in the older age group. This relation was not seen regarding FAS.

Conclusion: In the search for SES’ relation to mental health, different aspects of adolescents’ socio-economic conditions should be considered. In this study we suggest that the subjective experiences of adolescents regarding the wealth of the family might be a stronger indicator of SES influencing mental health. This might be taken into consideration when planning for public health interventions and effective prevention programs suited for adolescents with lower SES. 

Key message:

• In the search for SES’ relation to mental health, different aspects of adolescents’ socio-economic conditions should be considered.

© The Author 2014

Background

Research has shown inconsistencies in results and difficulties in conceptualization of assessment of socioeconomic status (SES) among adolescents. The aim of this study was thus to test the validity of self-reported information on SES in two age-groups (11–13 and 14–16 years old) in an adolescent population and to evaluate its relationship to self-reported health related quality of life (HRQOL). Different measures of SES commonly used in research in relation to HRQOL were tested in this study; parent’s occupations status, family material affluence status (FAS) and perceived SES.

Method

A cross-sectional study, with a sample of 948 respondents (n = 467, 11–13 years old and n  = 481, 14–16 years old) completed questionnaires about SES and HRQOL. The adolescents’ completion rates were used, with chi2-test, to investigate differences between gender and age-group. Correlation was used for convergent validity and ANOVA for concurrent validity.

Results

We found a low completion rate for both fathers’ (41.7 %) and mothers' (37.5 %) occupation status, and a difference in completion rate between gender and age-groups. FAS had the highest completion rate (100 %) compared to parent's occupations status and perceived SES. The convergent validity between the SES-indicators was weak (Spearman correlation coefficient below 0.3), suggesting that the indicators measured different dimensions of SES. Both FAS and perceived SES showed a gradient in mean HRQOL between low and high SES in relation to HRQOL, this was significant only for perceived SES (p < 0.01, both age-groups).

Conclusion

This study indicates the need for considering different approaches to measures of SES among adolescences and when evaluating SES in relation to HRQOL. Further research is needed to investigate sustainable ways to measure SES, delineating the relevance of tangible measures of education, occupation and income in relation to the perceived socioeconomic status in comparison with others in immediate social networks and in society at large.

AIMS: We aimed to estimate the magnitude of socioeconomic inequality in self-rated health among Nordic adolescents (aged 11, 13 and 15 years) using the Family Affluence Scale (a composite measure of material assets) and perceived family wealth as indicators of socioeconomic status.

METHODS: Data were collected from the Health Behaviour in School-aged Children (HBSC) survey in 2013-2014. A sample of 32,560 adolescents from Denmark, Norway, Finland, Iceland, Greenland and Sweden was included in the study. Age-adjusted regression analyses were used to estimate associations between fair or poor self-rated health and the ridit scores for family affluence and perceived wealth.

RESULTS: The pooled relative index of inequality of 2.10 indicates that the risk of fair or poor health was about twice as high for young people with the lowest family affluence relative to those with the highest family affluence. The relative index of inequality for observed family affluence was highest in Denmark and lowest in Norway. For perceived family wealth, the pooled relative index of inequality of 3.99 indicates that the risk of fair or poor health was about four times as high for young people with the lowest perceived family wealth relative to those with the highest perceived family wealth. The relative index of inequality for perceived family wealth was highest in Iceland and lowest in Greenland.

CONCLUSIONS: Social inequality in self-rated health among adolescents was found to be robust across subjective and objective indicators of family affluence in the Nordic welfare states. © Author(s) 2017

Introduction: Several studies have shown that workplace health promotion leads to better health, increased productivity, as well as reduced absenteeism and presenteeism among employees. The objective of this study was to describe how managers in small companies (10–19 employees) perceive their company as an arena for promoting employees’ health.

Method: A sample of 10 managers (four women) was strategically selected. Semi-structured interviews were conducted with each person. Interviews were transcribed and analysed using qualitative content analysis. The analysis focused on both manifest and latent content.

Results: Three main categories emerged from the analysis: the potential to promote employees’ health, responsibility as an employer and the need for external support. An arena for workplace health promotion is created when managers prioritise health at the workplace.

Conclusion: Small companies often lack the knowledge and resources to manage health and safety problems and also have less access to occupational health services. This paper highlights the importance of the views of small company managers as resources for the development of health promotion. © 2016 by Health Education Journal

Background: Workplace health promotion leads to better health, high morale, increased productivity and reduced absenteeism among employees. The role of leadership is vital when creating strategies for workplace health promotion. Small companies (less than 50 employees) have increased need for health promotion, as they often lack knowledge and resources to manage health and safety problems. Moreover, small companies have less access to occupational health service. The aim of this study was to describe how managers at small companies perceive their company as an arena for health promotion. 

Methods: A sample of ten managers (four females) was strategically selected using maximal variation in terms of branch of industry. Semi-structured interviews were conducted. The interviews were transcribed and analyzed using qualitative content analysis. The analysis comprised of both manifest and latent content and triangulation between the authors was used. 

Results: Three main categories emerged from the analysis; sees the workplace as a possible arena, sees the opportunity to promote employees health and sees a need for external support. More in-depth analysis resulted in six subcategories. The latent content of these categories is described by the theme; Health promotion leadership in order to perceive the company as a health promotion arena. A key factor for workplace health promotion was the manager´s view of health promotion as a beneficial factor for the company. Furthermore, the managers expressed that they could promote employees´ health by organizing health promotion activities and promote a positive psychosocial work environment. The findings showed a need for easily accessible external support to assist managers in their work with health promotion. It is essential that the external support contributes with inspiration and knowledge of health promotion activities, for example by highlighting good practice from other small companies. 

Conclusions: Using the manager´s view about the workplace as an arena for promoting health can be a step towards strategies for implementing workplace health promotion. However, for the development of healthy organizations it is necessary to have a comprehensive strategy in which employers, employees and society is pursuing the same goal.

Aims: To explore the association between tooth loss and obesity in an adult Swedish population, and to investigate the influence of socioeconomy, life-style, and co-morbidity.

Methods: A cross-sectional population health survey conducted in 2001-2005 in 2816 randomly selected Swedish men and women (age: 30-74 years; participation rate 76%). Main measures were; tooth loss: < 20 remaining teeth (self-reported), general obesity: BMI[≥]30 kg m-2, abdominal obesity: waist circumference > 88 in women and > 102 cm in men. Adjustments were made for socioeconomy, life-style, and co-morbidity.

Results: 420 individuals (21.2%) had < 20 remaining teeth: 30-59 years 6.0%, 60-74 years 53.5%. Mean BMI was similar in men and women (26.9 kg m-2), however, both general and abdominal obesity was still more frequent among women (both p < 0.001). There was a significant interaction between age and tooth loss in the association with both general (p = 0.004) and abdominal obesity (p < 0.011) in men. In participants below 60 years of age, the association between tooth loss and general obesity (OR 2.17 [95% CI 1.51 - 3.12]) and abdominal obesity (2.23 [1.58 - 3.15]), respectively, was statistically significant independent of age and gender, and remained so also when accounting for differences in socioeconomy, life-style, and co-morbidity. There was no similar association in those 60 years or older. The findings in men and women were robust and concordant.

Conclusions: Common mechanisms for oral health and obesity should be explored more also including longitudinal designs. The findings are important for targeting comprehensive interventions against obesity and tooth loss, especially among younger adults.