Central European journal of public health最新文献

Objectives: This study examined trends in sexual behaviour and the timing of sexual initiation among 15-year-old adolescents in Czechia between 2002 and 2022, with a focus on the age of sexual debut (15 and older; early at 14; very early at 13 or younger). It also investigated trends in condom and hormonal contraceptive use at most recent intercourse.

Methods: Data were drawn from six nationally representative waves of the Czech Health Behaviour in School-aged Children study, which was conducted between 2002 and 2022. Only 15-year-olds were included (N = 19,384). Descriptive trend analyses were conducted using survey weights, with subgroup comparisons by gender and age at sexual initiation.

Results: The findings indicate a shift toward later sexual initiation, particularly among girls, with increasing proportions initiating at age 15 or older and declining initiation at age 14. A significant gender gap emerged in 2022, with fewer girls (13.9%) than boys (18.7%) reporting a sexual experience. The prevalence of very early initiation (age 13 or younger) remained stable over time, yet this group - especially boys - consistently accounted for a substantial minority of sexually active adolescents. Condom use declined from 81.2% to 69.9% across all initiation groups between 2014 and 2022, with the most persistent decline among very early initiators.

Conclusions: The findings suggest a modest postponement of sexual debut among Czech adolescents and highlight a growing gender disparity in sexual activity by age 15. Persistent early initiation and declining condom use highlight the need for differentiated sexual health education strategies, particularly for younger initiators.

Objectives: The present study aims to examine trends in adolescent alcohol use over the period from 2014 to 2022.

Methods: Data from the last three Health Behaviour in School-aged Children (HBSC) surveys conducted in 2014, 2018 and 2022 were used for this study. Three measures of adolescent alcohol use have been chosen for analyses: lifetime alcohol use, last 30 days alcohol use, and repeated lifetime drunkenness. The analyses comprised calculation of period-specific prevalence estimates and testing of the significance of between-period changes using survey-adjusted logistic regression models.

Results: Comparing prevalence rates between the periods, consistent decrease in adolescent alcohol use becomes apparent, particularly for drop of rates in 2018 compared to those in 2014. The corresponding data on the prevalence of lifetime alcohol use among 13-year-old boys was 59.7% in 2014 and 44.2% in 2018; and among 15-year-old boys 80.4% in 2014 and 74.9% in 2018. For 13-year-old girls, the estimated prevalence was 46.9% in 2014 and 41.1% in 2018; and for 15-year-old girls 83.7% in 2014 and 75.9% in 2018. This is the case for repeated lifetime drunkenness, and the decrease is consistent across boys and girls, as well as the respective age groups. In survey waves 2018 and 2022, we do not see a statistically significant decline, but rather a stabilisation of assessed prevalence at a level from the previous wave of the study.

Conclusions: The decline in alcohol use among Czech adolescents is part of a global trend of reducing alcohol drinking among young people, on the background of social mechanisms including the change of cultural status of alcohol and changes in young people's leisure preferences.

Objectives: Regular monitoring of health-related behaviours among vulnerable populations is of public health importance. This study examines recent trends in adolescent cigarette smoking in Czechia following the marked changes reported in the mid-2010s.

Methods: Data from three recent rounds of the Health Behaviour in School-aged Children (HBSC) study conducted in Czechia in 2014, 2018 and 2022 were analysed. Temporal trends were assessed for two indicators of adolescent cigarette use: lifetime cigarette use and cigarette use in the last 30 days. Survey-adjusted binary logistic regression models were used to test changes between survey periods. In 2022, the prevalence of electronic cigarette use was additionally estimated using the same indicators.

Results: A continued decline in adolescent cigarette use was observed for both indicators, extending the downward trends reported in the mid-2010s into the 2020s. The decline was most pronounced between 2014 and 2018, with smaller but persistent decreases thereafter, particularly among older adolescents. However, the findings also highlight the substantial prevalence of electronic cigarette use. In 2022, more than one-third of 15-year-olds in Czechia reported lifetime electronic cigarette use (35.1% among boys and 36.6% among girls), and approximately one in five reported use in the last 30 days (19.6% among boys and 23.0% among girls).

Conclusions: While conventional cigarette use among adolescents continues to decline, electronic cigarette use represents an important component of contemporary adolescent smoking-related behaviour. In the long term, the phenomenon of electronic cigarettes may counteract intended trends in nicotine-related harms. These findings underscore the need for continued surveillance and prevention efforts in Czechia that address both conventional and emerging smoking-related products.

Objectives: Sleep is vital for maintaining the health and wellbeing of people of all ages. However, for adolescents, sufficient sleep of adequate duration and quality is critical for profound mental, physical, social, and emotional development. This study aimed to describe trends in sleep duration and late bedtime during school and non-school days in representative cohorts of 11-, 13-, and 15-year-old adolescents from Czechia from 2014 to 2022, and to examine the current associations between late bedtimes/social jet lag and wellbeing indicators among adolescents in 2022.

Methods: The analysed sample of 42,101 adolescents aged 10.5-16.5 years was drawn from three nationally representative cohorts of Czech schoolchildren from the last three cycles of the Health Behaviour in School-aged Children study, conducted between 2014 and 2022.

Results: Mean sleep duration (hours:minutes) on school and non-school days significantly (p < 0.05) decreased for both boys (schooldays: 8:192014→7:592022; non-school days: 9:362018→9:232022) and girls (schooldays: 8:202014→7:552022; non-school days: 9:582018→9:412022) between 2014/2018 and 2022, while the prevalence of insufficient sleep significantly (p < 0.001) increased over the same period (boys schooldays: 35.4%2014→49.2%2022, boys non-school days: 14.9%2018→18.0%2022; girls schooldays: 35.1%2014→51.7%2022, girls non-school days: 9.8%2018→13.3%2022). Adolescents with late bedtimes or social jet lag (> 2 hours) had significantly higher odds (p < 0.001) of skipping breakfast daily, drinking energy drinks daily, being drunk at least twice in their lifetime, experiencing reduced psychological wellbeing and low life satisfaction, reporting irritability, and problematic social media use and internet gaming than those with earlier bedtimes or without social jet lag.

Conclusions: It is highly desirable that families, in close cooperation with schools and professional representatives, make efforts to ensure adherence to the recommended length and quality of sleep, as the trend results indicate worsening sleep patterns, deepening social jet lag, and a disturbing increase in adolescent risk behaviours and health complaints related to insufficient sleep.

Objectives: Adolescence is widely recognized as a critical developmental period marked by increased independence and risk-taking behaviours, which often result in medically attended injuries. The aim of the study is to present the trends analyses of self-reported HBSC data on medically attended injuries in Czech adolescents between the years 2002 and 2022 and complement other sources of injuries data in Czech adolescents. Additional objective is to outline the possible use of the above-mentioned data for research purposes by public health professionals and researchers so they can be used for injury prevention purposes.

Methods: The overall sample of 44,817 adolescents aged 11, 13 and 15 years (50.3% girls) from the last six cycles of the Health Behaviour in School-aged Children study data collections between 2002 and 2022 was analysed.

Results: An adjusted residual analysis of nationally representative data from 2002 to 2022 revealed a significant shift in the pattern of medically attended injuries among Czech adolescents. Across both sexes and all surveyed age groups, there was a notable increase in the prevalence of multiple (2 or more) injuries. Simultaneously, the proportion of adolescents reporting no injuries decreased significantly, particularly among girls, whose injury-free rate dropped from 61.2% in 2002 to 48.2% in 2022. While the rate of single injuries remained relatively stable - without significant change in many groups - the overall injury burden has shifted toward more frequent and potentially severe injury experiences. Logistic regression analysis revealed that the likelihood of reporting at least one injury was highest in 2022, after controlling for gender, age, and family affluence. Boys, 13-year-olds, and children from higher-income families were at increased risk.

Conclusions: Medically attended injuries have increased in both frequency and complexity over the last two decades among Czech adolescents. The shifting patterns underscore the urgent need for context-sensitive, age-appropriate, and equity-focused prevention strategies.

Objective: This study aimed to examine long-term trends in Czech adolescents' perceptions of school climate between 1994 and 2022, focusing on school satisfaction, perceived school pressure, and perceived social support from classmates and teachers.

Methods: Data were drawn from eight cycles of the Czech Health Behaviour in School-aged Children (HBSC) study, encompassing responses from 63,252 students aged 11, 13 and 15 years. Binary logistic regression analyses were conducted to assess temporal trends and associations between school climate indicators and demographic variables, including gender, age, and family affluence.

Results: Compared to 2022, students were significantly more likely to report liking school a lot in 2010 (OR = 2.14, 95% CI: 1.94-2.36) and 2014 (OR = 1.64, 95% CI: 1.52-1.76). Reports of school dissatisfaction were lowest in 2010 (OR = 0.53, 95% CI: 0.49-0.57) and 2014 (OR = 0.60, 95% CI: 0.57-0.63) relative to 2022. Perceived school pressure was highest in 2022, while in 2002 the odds of feeling pressure were less than half as likely (OR = 0.44, 95% CI: 0.41-0.47). Classmate support peaked in 2010 (OR = 2.04, 95% CI: 1.90-2.18) vs. 2022, and teacher support was highest in 2018 (OR = 1.32, 95% CI: 1.26-1.39). Girls and older students consistently reported greater school pressure and lower levels of support, while those from more affluent families reported more favourable perceptions of school climate.

Conclusions: Czech adolescents' school climate perceptions have deteriorated over the past three decades, marked by rising demands and weakening support at school. These trends may contribute to reduced school engagement and heightened psychological distress, emphasizing the need for systemic interventions that ensure that high school expectations are coupled with relational and emotional support in schools.

Objectives: Active school transport (AST), such as walking or cycling to and from school, represents an important source of daily physical activity for adolescents. In recent decades, however, many high-income countries have reported a steady decline in AST. The main objective of this study was to describe long-term trends in active travel to and from school among Czech adolescents aged 11, 13 and 15 years, using nationally representative data collected in five waves of the Health Behaviour in School-aged Children (HBSC) study between 2006 and 2022.

Methods: The analysis is based on a total sample of 50,813 adolescents (25,628 boys, 25,085 girls) aged 10.5-16.5 years, with valid self-reported data on travel modes to and from school. AST was defined as walking or cycling as the primary mode of transport. The prevalence of AST was analysed over time by gender and age category. Binary logistic regression was used to assess the associations between AST and survey year, gender, age group, socioeconomic status (Family Affluence Scale), and commuting time to school.

Results: Between 2006 and 2022, the prevalence of AST to school declined from 71.6% to 54.9% among boys and from 71.8% to 54.8% among girls. A similar trend was observed for AST from school, although participation remained consistently higher than in the morning. The strongest negative predictors of AST were longer commuting time and higher socioeconomic status. Girls had slightly lower odds of AST than boys, and older adolescents (only in fully adjusted models) were more likely to engage in AST.

Conclusions: The long-term decline in AST among Czech adolescents highlights the need for targeted public health and urban planning strategies. In particular, the lower rates of AST to school suggest potential opportunities for morning-focused interventions.

Objectives: Previous studies have identified four distinct patterns of adolescent social media use (SMU): non-active users abstain from social media or engage in online interactions only once a week or less; active users connect with others online daily without any functional impairments related to their SMU; intense users frequently engage with others online but do not meet criteria for problematic use; problematic users report six or more addiction-like symptoms. The following study aimed to assess the prevalence of these SMU patterns among Czech adolescent, examine changes between 2018 (pre-COVID-19) and 2022, and explore age and gender differences to identify at-risk subgroups.

Methods: Data were drawn from the Health Behaviour in School-aged Children (HBSC) study among 11-, 13- and 15-year-olds. The study analysed Czech data from the 2017/18 and 2021/22 waves (n = 26,450).

Results: Findings revealed marked changes in SMU patterns between 2018 and 2022 among Czech adolescents, which varied by gender and age category. Girls and older adolescents reported higher rates of problematic SMU. The share of non-active users declined, most notably among 11-year-olds.

Conclusions: The marked increase in both intense and problematic SMU among Czech adolescents highlights a growing public health concern. Given the established associations between problematic SMU and poorer mental health outcomes, these findings call for the integration of digital behaviour monitoring and education into school-based mental health and prevention programmes. Particular attention should be given to early adolescence and to gender-specific vulnerabilities.

Objectives: Planetary-health literacy (PHL), the knowledge, motivation and social support required to safeguard both human and environmental health, may help adolescents cope with climate-related distress and adopt sustainable behaviours. Evidence on the linkage between PHL and mental health from Central and Eastern Europe is lacking. The aim of the study was to describe PHL in Czech adolescents by sex, grade and family affluence, examine its association with mental-health indicators, and explore links with selected environment-relevant behaviours.

Methods: Cross-sectional data were drawn from the nationally representative Health Behaviour in School-aged Children (HBSC) 2022 survey (n = 4,195, 50.8% boys, ages 13 and 15 years). PHL was measured with an 11-item HBSC optional package yielding three sub-scales (knowledge, action, perceived pro-environmental social norms). Outcomes were wellbeing (WHO-5), life satisfaction (Cantril's ladder), and psychological complaints (HBSC symptom checklist). Fruit and vegetable intake plus cigarette and e-cigarette use served as behavioural correlates.

Results: Girls scored higher than boys on all PHL domains (Cohen d = 0.10-0.19). Thirteen-year-olds reported more action and stronger social norms than fifteen-year-olds (p < 0.001); socioeconomic gradients were small. In fully adjusted models, social norms were positively associated with wellbeing (β = 1.42, 95% CI: 1.12-1.72) and life satisfaction (β = 0.10, 0.08-0.13), and inversely with psychological complaints (β = -0.27, -0.33 to -0.21). Knowledge showed weak adverse relations with wellbeing and complaints, whereas action was associated with wellbeing only. Higher PHL related to daily fruit and vegetable consumption and inversely to intensive e-cigarette use; effect sizes were modest.

Conclusions: Perceived pro-environmental social norms appear most tightly related to adolescent mental health, while overall PHL is slightly associated with sustainable dietary patterns and lower use of e-cigarettes. School curricula that combine climate education with collaborative, action-oriented projects may therefore deliver co-benefits for planetary and psychological health in Central and Eastern Europe.

Objectives: Excess body weight and weight misperception in adolescents are associated with various physical and mental health risks. This study analysed trends in overweight, obesity, body image, and body weight perception among Czech adolescents between 2002 and 2022, considering gender, age and socioeconomic status (SES).

Methods: Data were retrieved from the questionnaire of the Health Behaviour in School-aged Children (HBSC) study conducted in 2002, 2006, 2010, 2014, 2018 and 2022 (N = 52,363; 49.9% girls). The difference test between two proportions was used to assess time trends in weight status (WS), body image and body weight perception across gender and SES groups. Logistic regression analysis was performed to examine the likelihood of being overweight/obese, and underestimating or overestimating WS.

Results: Between 2002 and 2022, overweight and obesity increased significantly, while non-overweight rates declined across both genders and SES groups, with a greater rise among boys and adolescents from low SES backgrounds. In 2022, more adolescents, regardless the gender and SES, perceived their body as "too thin" compared to 2002. Over the 20-year period, underestimation of WS increased while overestimation decreased among both girls and boys and across all SES groups. Accurate perception of WS rose among girls but worsened among boys. Girls were less likely than boys to be overweight/obese or to underestimate their WS but had higher odds of overestimating it.

Conclusions: The significant rise in overweight and obesity, especially in boys and adolescents from low SES backgrounds, during the last 20 years points out to socioeconomic disparities and should be taken into account when creating new policies. An improvement in correct perception of WS among girls and a decline in overestimating WS across genders and SES groups could help reduce risks of developing mental health problems/eating disorders. Conversely, an increase in underestimation of WS may contribute to weight-related health risks.