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      The methodology of the Italian Health Behaviour in School-aged Children (HBSC) 2018 study and its development for the next round

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          Summary

          Introduction

          The Italian “Health Behaviour in School-aged Children” (HBSC) is a national surveillance system that collects data on health and well-being among adolescents aged 11, 13 and 15 years attending school. It is part of the HBSC Research Network, an international alliance of researchers from 45 European and North American countries and regions started in 1982.

          Methods

          All countries and regions participating in HBSC must adhere to a common international standard protocol developed and systematically updated by the entire HBSC Network. Data collection occurs every four years. Italy joined the international Network in 2000 and, to date, five waves (in 2002, 2006, 2010, 2014 and 2018) have been carried out. From 2010 the Italian HBSC is representative at regional level and in 2017 the base of the “Surveillance system for risk behaviours in 11-17 year-olds” became part of the Prime Ministerial Decree “Identification of surveillance systems and registries of mortality, tumours and other diseases”. Cluster sampling is used, with school class as primary sampling unit, and two validated questionnaires are used to collect the information.

          Results

          In 2018, the Italian HBSC involved 3,608 classes and 58,976 students. The average response rates were 86% of sampled classes and 97% of students achieving a national and regional representative sample for youths of all age groups (19,504 eleven-year-old, 20,554 thirteen-year-old and 18,918 fifteen-year-old). The national coordination group prepared a standardized format for disseminating the results locally and indicating areas for intervention A national report and some articles have been published. The next round, which will take place in the 2021-2022 school year, will also involve a representative sample of students of grade four of secondary schools (adolescents aged 17 years) and use on line questionnaires.

          Conclusions

          Over 3 decades at international and 2 decades at national level 35 years have demonstrated that HBSC methodology and its results are useful for monitoring and deepening the knowledge on the most critical issues of adolescents’ well-being.

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          Most cited references43

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          A future for the world's children? A WHO–UNICEF–Lancet Commission

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            A simplified general method for cluster-sample surveys of health in developing countries.

            General guidelines are presented for the use of cluster-sample surveys for health surveys in developing countries. The emphasis is on methods which can be used by practitioners with little statistical expertise and no background in sampling. A simple self-weighting design is used, based on that used by the World Health Organization's Expanded Programme on Immunization (EPI). Topics covered include sample design, methods of random selection of areas and households, sample-size calculation and the estimation of proportions, ratios and means with standard errors appropriate to the design. Extensions are discussed, including stratification and multiple stages of selection. Particular attention is paid to allowing for the structure of the survey in estimating sample size, using the design effect and the rate of homogeneity. Guidance is given on possible values for these parameters. A spreadsheet is included for the calculation of standard errors.
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              Health of the world's adolescents: a synthesis of internationally comparable data.

              Adolescence and young adulthood offer opportunities for health gains both through prevention and early clinical intervention. Yet development of health information systems to support this work has been weak and so far lagged behind those for early childhood and adulthood. With falls in the number of deaths in earlier childhood in many countries and a shifting emphasis to non-communicable disease risks, injuries, and mental health, there are good reasons to assess the present sources of health information for young people. We derive indicators from the conceptual framework for the Series on adolescent health and assess the available data to describe them. We selected indicators for their public health importance and their coverage of major health outcomes in young people, health risk behaviours and states, risk and protective factors, social role transitions relevant to health, and health service inputs. We then specify definitions that maximise international comparability. Even with this optimisation of data usage, only seven of the 25 indicators, covered at least 50% of the world's adolescents. The worst adolescent health profiles are in sub-Saharan Africa, with persisting high mortality from maternal and infectious causes. Risks for non-communicable diseases are spreading rapidly, with the highest rates of tobacco use and overweight, and lowest rates of physical activity, predominantly in adolescents living in low-income and middle-income countries. Even for present global health agendas, such as HIV infection and maternal mortality, data sources are incomplete for adolescents. We propose a series of steps that include better coordination and use of data collected across countries, greater harmonisation of school-based surveys, further development of strategies for socially marginalised youth, targeted research into the validity and use of these health indicators, advocating for adolescent-health information within new global health initiatives, and a recommendation that every country produce a regular report on the health of its adolescents. Copyright © 2012 Elsevier Ltd. All rights reserved.
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                Author and article information

                Journal
                J Prev Med Hyg
                J Prev Med Hyg
                JPMH
                Journal of Preventive Medicine and Hygiene
                Pacini Editore Srl
                1121-2233
                2421-4248
                31 January 2022
                December 2021
                : 62
                : 4
                : E926-E933
                Affiliations
                [1 ] Dipartimento di Medicina Molecolare e dello Sviluppo, Università degli studi di Siena , Siena, Italy
                [2 ] Dipartimento di Psicologia dello Sviluppo e della Socializzazione, Università degli Studi di Padova , Padua, Italy
                [3 ] Dipartimento di Scienze della Sanità Pubblica e Pediatriche, Università degli Studi di Torino , Turin, Italy
                [4 ] Centro Nazionale per la Prevenzione delle Malattie e la Promozione della Salute, Istituto Superiore di Sanità , Rome, Italy
                [5 ] Ministero della Salute, Direzione generale della prevenzione sanitaria , Rome, Italy
                Author notes
                Correspondence: Giacomo Lazzeri, Dipartimento di Medicina Molecolare e dello Sviluppo, Università degli Studi di Siena, Siena, Italy
                Article
                10.15167/2421-4248/jpmh2021.62.4.2343
                9104679
                35603245
                8b748625-5d04-4d78-8ec9-b16759a3048c
                ©2021 Pacini Editore SRL, Pisa, Italy

                This is an open access article distributed in accordance with the CC-BY-NC-ND (Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International) license. The article can be used by giving appropriate credit and mentioning the license, but only for non-commercial purposes and only in the original version. For further information: https://creativecommons.org/licenses/by-nc-nd/4.0/deed.en

                History
                : 01 October 2021
                : 26 October 2021
                Page count
                Figures: 0, Tables: 2, Equations: 0, References: 46, Pages: 8
                Categories
                Health Promotion

                healthy behavior,epidemiological surveillance,adolescents,italy

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