Torbjørn Torsheim

The current study is the first to examine whether the positive effects of the School-Wide Positive Behavioral Interventions and Supports (SWPBIS) model, previously documented as effective in the school context, may generalize to the home context. Potential benefits for children and parents were investigated longitudinally. A randomly selected subsample of Norwegian students drawn from a larger dataset and considered at respectively low, moderate, and high risk of developing conduct problems was rated by their parents at five time points across four successive school years. Only the fourth graders were included in the analyses to follow a stable group of students over time. Data were analyzed using linear mixed models. The outcome variables examined were parent-rated problem behavior and social skills, monitoring, mental health, support to the child’s schooling, and school–home cooperation. The analyses revealed no significant benefits of SWPBIS in the home context, neither for the children nor the parents. Likewise, no differential effects for low-, moderate-, and high-risk groups were detected. To increase the odds of cross-domain effects of the SWPBIS model, the inclusion of additional intervention components to better inform, include, and support parents should be considered, particularly for parents of students with more severe behavior problems.

Objectives: Research questions about how and why health trends differ between populations require decisions about data analytic procedure. The objective was to document and compare the information returned from stratified, fixed effect and random effect approaches to data modelling for two prototypical descriptive research questions about comparative trends in toothbrushing.Methods: Data included five cycles of the Health Behaviour in School-aged Children 2006 to 2022, which provided a sample of 980192 11- to 15- year olds from 35 countries. Using logistic regression models and generalized linear mixed models, toothbrushing daily was regressed on time, following the three approaches to analysis of trends.Results: The stratified approach suggested a positive but non-linear trend in toothbrushing from 2006 to 2022 in most countries but provided no statistical inference on the variation. The fixed effect and the random effect approach converged on a positive but flattening overall trend, with a statistically significant country variation in trends.Conclusion: Only the fixed effect approach and the random effects approach provided clear answers to the research question. Additional methodological considerations for making an informed choice of analytical approach are discussed.

Background: Insufficient physical activity (PA) levels among adolescents and adults make promoting PA a public health priority. Although most people exhibit low or decreasing levels of PA, other groups increase or maintain high levels of activity. These different groups may engage differently in activity domains during their leisure time. This study aimed to identify distinct trajectories of leisure-time vigorous physical activity (LVPA) and to explore whether these trajectories are characterised by differences in four activity domains (participation in organised sports clubs, diversity in leisure-time activities, outdoor recreation, and peer PA) over the life course. Methods: Data were drawn from the Norwegian Longitudinal Health Behaviour Study. The sample of participants (n = 1103, 45.5% female) was surveyed 10 times from age 13 years in 1990 to age 40 years in 2017. LVPA trajectories were identified using latent class growth analysis, and mean differences in activity domains were studied using the one-step BCH approach. Results: Four trajectories were identified: active (9%), increasingly active (12%), decreasingly active (25%), and low active (54%). Overall, this analysis showed a declining tendency in LVPA from age 13 to 40 years except for the increasingly active trajectory. Belonging to a trajectory with a higher LVPA level was related to higher mean levels of the included activity domains. Compared with those in the increasing trajectory, people belonging to the decreasing trajectory reported higher mean participation levels in and age at becoming a member of sports clubs, diversity in leisure-time activities, and best friend’s activity level during adolescence. However, in young adulthood, people in the increasingly active trajectory reported significantly higher mean levels for the same variables. Conclusions: The development of LVPA from adolescence to adulthood is heterogeneous, suggesting the need for targeted health promotion initiatives. The largest trajectory group included more than 50 percent and was characterized by low levels of LVPA, less engagement in PA domains and fewer active friends. There seems to be little carry-over effect of engagement in organised sports in adolescence regarding level of LVPA later in life. Changes in social surroundings throughout the life span, such as having friends who are more or less engaged in PA, may assist or hinder health enhancing engagement in LVPA.

Bakgrunn: Denne artikkelen er en kunnskapsoppsummering og klassifisering av foreldreprogrammet De Utrolige Årene (DUÅ), rettet mot førskolebarn (3-6 år) og barn i skolealder (6-12 år). Foreldreprogrammene er rettet mot foreldre til barn med atferdsproblemer på et forebyggende, selektert, eller indikert nivå. Det vil si, programmene kan tilrettelegges som enten forebyggende tiltak eller behandlingstiltak. Foreldreprogrammene er utviklet av Carolyn Webster-Stratton, USA. I Norge er det Regionalt Kunnskapssenter for Barn og Unge – Nord (RKBU Nord) som er tiltaksleverandør og har det nasjonale ansvaret for opplæring. Metode: Kunnskapsoppsummeringen bygger på et systematisk litteratursøk fra ulike databaser (Embase, Medline, Psykinfo, NORART, Cochrane, Cristin, NORA, Scopus, SweMed, Bibsys, og Google Scholar), samt materiell gitt fra tiltakseier. Søket ble gjennomgått for å identifisere internasjonale, nordiske og norske effektstudier om tiltakene. Ni nordiske artikler (3 norske, 4 svenske,1 dansk og 1 finsk), samt tre internasjonale meta-analyser, er evaluert og inkludert i kunnskapsoppsummeringen. Resultater: Resultatene viser at DUÅs foreldreprogrammer er kunnskaps- og evidensbaserte tiltak med solid teoretisk forankring. De baserer seg på etablerte måleinstrumenter, og tiltakene har godt beskrevne implementeringsstrategier. Samtlige av de nordiske studiene viste positive resultater til fordel for de to programmene, det vil si en reduksjon i barns problematferd og en positiv endring i foreldre-barn samspill. Konklusjon: DUÅs foreldreprogrammer for førskole- og skolebarn klassifiseres på evidensnivå 5, det vil si tiltak med sterk dokumentasjon på effekt.

Adolescence is an important developmental period toward greater independence. However, the family is still very important in the life of young people. The aim of this study was to analyse changes over time in easy communication between adolescents and their parents in the Nordic countries. The study used the Nordic part of Health Behaviour in School-aged Children, carried out in four waves from 2002-2014. It included 109,446 adolescents. The adolescents were asked how easy it was to communicate with their mother or father about things that really bothered them. The results were analysed using descriptive statistics and binomial logistic regression. In all Nordic countries, the prevalence of easy communication between adolescents and their parents increased from 2002 to 2014. Although the positive change in parental communication was more pronounced among Nordic fathers, the data showed that mothers had markedly better communication with their adolescents than fathers did. In 2014, around three out of four adolescents found it easy to talk with their fathers, while four out of five found it easy to talk with their mothers. The results indicate that policies in the Nordic countries to support the role of both mothers and fathers in caring for their children are warranted.

Responsible gambling (RG) measures are methods aimed at reducing and preventing negative consequences associated with gambling. Some RG measures are set by authorities or gambling operators while others are available as features for gamblers to use themselves (e.g. budget tools where personal monetary limits are set prior to gambling). The present study is based on a general gambler population and investigates how RG measures with some specific RG features are assessed by the gamblers. The data was collected in 2013 and 2015. The samples were drawn from the Norwegian Population Registry. In total 9129 gamblers participated. Gamblers were asked to state to which degree they agreed that ten specific RG measures help or would help them controlling their gambling. Overall, between 35 and 42% neither agreed nor disagreed, but among those with an opinion, most agreed. A multiple regression analysis identified eleven variables as significant predictors of positive beliefs about RG measures: female gender, young age, playing random games only, being a moderate risk or problem gambler, reporting high impact from gambling advertisements as well as the personality traits agreeableness, openness and neuroticism. Playing low risk games only, reporting a high amount of spending on gambling and the personality trait extraversion were inversely related to positive beliefs about RG measures. The total explained variance was however only 7.1%. Positive beliefs about RG measures can relate to needs for external based countermeasures to minimize or reduce problems. Negative views may reflect a wish to play without obstacles, take risks or to trust in self-control.

To analyse the psychometric properties of the HBSC Symptom Checklist (HBSC-SCL) on psychosomatic symptoms with a focus on the operating characteristics of the items, and on the impacts of measurement distortions on the comparisons of person measures across time and between countries. Data were collected in 1993/94, 1997/98, 2001/02, 2005/06, 2008/09, 2013/14 in Denmark, Finland, Norway and Sweden as part of the Health Behaviour in School-aged Children (HBSC) study. Data comprised 116,531 students 11, 13 and 15 years old. Rasch analysis was conducted of the HBSC-SCL consisting of eight items with a focus on Differential Item Functioning (DIF) and item threshold ordering. The impacts of DIF and threshold disordering on trend analyses were analysed in a subsample consisting of 15 years old students. One item shows evidence of severe DIF and the categorisation of some items does not seem to work as intended. Analyses of changes based on proportions of psychosomatic symptoms show that bad item functioning affects some comparisons between countries across time: A four percentage point difference between 15 years old girls in Finland and Sweden concerning the rate of increase of psychosomatic symptoms from 1994 to 2014 disappears when the problems with DIF and disordered item thresholds are taken into account. Although the proportions of students with psychosomatic symptoms are clearly higher 2014 than 1994 in all four countries the shape of most trends is nonlinear. Some of the cross-country comparisons were distorted because of DIF and problems related to disordering of the item thresholds. The comparisons among girls between Finland and Sweden were affected by the problems pertaining to the original measure of psychosomatic symptoms, while the trend patterns among boys were not much affected. In addition to confirming increasing rates of adolescent mental health problems in the Nordic countries, the substantive analyses in the current study show that Finland is joining Sweden in having the sharpest increase among older adolescents, in particular among girls. To improve the functioning of the scale the DIF item could be removed or replaced and response categories collapsed in post hoc analyses.

The aims of this study were to assess the longitudinal trajectories of externalizing problem behavior during middle childhood among typically developing children and to examine subgroup differences in the effectiveness of the School-Wide Positive Behavior Support (SWPBS) model, called N-PALS in Norway. Participants were approximately 3000 students, and behavioral assessments were performed by class head teachers at four time points from the 4th or 5th grade through the 7th grade. Using a combination of latent class growth analyses (LCGA) and growth mixture modeling (GMM), four distinct trajectory classes were identified, i.e., persistent low (84.4%), persistent high (2.5%), decreasing (7.9%), and increasing (5.3%). An indication of a significant positive effect of the N-PALS model was found for students with a persistently high-risk trajectory. The current study adds to the evidence that this school-wide prevention model can moderate the development of externalizing behavior problems among children and youth.

Background Research into problematic tanning (or ‘tanning addiction’) has markedly increased over the past few years. Although several instruments exist to measure excessive tanning, most of these are psychometrically poor, are not theoretically anchored, and have been used mainly on small samples. Objectives To develop a new tanning addiction scale based on a specific theoretical approach utilizing core addiction criteria. Methods A scale comprising seven items (salience/craving, tolerance, mood modification, relapse/loss of control, withdrawal, conflict and problems) was administered online to a cross-sectional convenience sample of 23 537 adults (mean ± SD age 35·8 ± 13·3 years). There was also assessment of demographic factors, the five-factor model of personality, and symptoms of obsessive–compulsive disorder, anxiety and depression. Results A confirmatory factor analysis showed that a one-factor model gave an optimal fit with the data collected [root mean square error of approximation = 0·050, 90% confidence interval (CI) 0·047–0·053; comparative fit index = 0·99; Tucker–Lewis index = 0·99]. High factor loadings (0·78–0·91, all P < 0·001) and coefficient omega indicator of reliability (ω = 0·94, 95% CI 0·94–0·94) were also found using the new scale. In a multiple linear regression analysis, tanning addiction was positively associated with being female, not being in a relationship, extraversion, neuroticism, anxiety and obsessive–compulsiveness. It was also found that educational level, intellect/openness and depression were inversely associated with tanning addiction. Conclusions The new scale, the Bergen Tanning Addiction Scale (BTAS), showed good psychometric properties, and is the first scale to conceptualize tanning addiciton fully within a contemporary addiction framework. Given this, the BTAS may potentially assist future clinical practice in providing appropriate patient care, prevention and disease management.