@incollection{BuckschFinneGohresetal., author = {Bucksch, Jens and Finne, Emily and Gohres, Hannah and Bilz, Ludwig and Moor, Irene and Richter, Matthias and Kolip, Petra}, title = {Die Methodik des HBSC-Surveys 2013/14}, series = {Schule und Gesundheit : Ergebnisse des WHO-Jugendgesundheitssurveys "Health behaviour in school-aged children"}, booktitle = {Schule und Gesundheit : Ergebnisse des WHO-Jugendgesundheitssurveys "Health behaviour in school-aged children"}, editor = {Bilz, Ludwig and Sudeck, Gorden and Bucksch, Jens and Klocke, Andreas and Kolip, Petra and Melzer, Wolfgang and Ravens-Sieberer, Ulrike and Richter, Matthias}, publisher = {Beltz Juventa}, address = {Weinheim}, isbn = {978-3-7799-1991-9}, pages = {35 -- 46}, language = {de} } @misc{MoorSpallekRichter, author = {Moor, Irene and Spallek, Jacob and Richter, Matthias}, title = {Explaining socioeconomic inequalities in self-rated health - A systematic review of the relative contribution of material, psychological and behavioural factors}, series = {Journal of Epidemiology \& Community Health}, volume = {71}, journal = {Journal of Epidemiology \& Community Health}, number = {6}, issn = {1470-2738}, doi = {10.1136/jech-2016-207589}, language = {en} } @misc{MoorLampertRathmannetal., author = {Moor, Irene and Lampert, Thomas and Rathmann, Katharina and Kuntz, Benjamin and Kolip, Petra and Spallek, Jacob and Richter, Matthias}, title = {Explaining educational inequalities in adolescent life satisfaction: Do health behaviour and gender matter}, series = {International Journal of Public Health}, volume = {59}, journal = {International Journal of Public Health}, number = {2}, issn = {1661-8564}, pages = {309 -- 317}, language = {en} } @misc{MoorRathmannStronksetal., author = {Moor, Irene and Rathmann, Katharina and Stronks, Karien and Levin, Kate and Spallek, Jacob and Richter, Matthias}, title = {Psychosocial and behavioural factors in the explanation of socioeconomic inequalities in adolescent health. A multilevel analysis in 28 European and North American countries}, series = {Journal of epidemiology and community health}, volume = {68}, journal = {Journal of epidemiology and community health}, number = {10}, issn = {1470-2738}, doi = {10.1136/jech-2014-203933}, pages = {912 -- 921}, language = {en} } @misc{KamanOttovaJordanBilzetal., author = {Kaman, Anne and Ottov{\´a}-Jordan, Veronika and Bilz, Ludwig and Sudeck, Gorden and Moor, Irene and Ravens-Sieberer, Ulrike}, title = {Subjective health and well-being of children and adolescents in Germany - Cross-sectional results of the 2017/18 HBSC study}, series = {Journal of Health Monitoring}, volume = {5}, journal = {Journal of Health Monitoring}, number = {3}, issn = {2511-2708}, doi = {10.25646/6899}, pages = {7 -- 20}, abstract = {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 long- term 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.}, language = {en} } @misc{MoorWinterBilzetal., author = {Moor, Irene and Winter, Kristina and Bilz, Ludwig and Bucksch, Jens and Finne, Emily and John, Nancy and Kolip, Petra and Paulsen, Lisa and Ravens-Sieberer, Ulrike and Schlattmann, Marina and Sudeck, Gorden and Brindley, Catherina and Kaman, Anne and Richter, Matthias}, title = {The 2017/18 Health Behaviour in School-aged Children (HBSC) study - Methodology of the World Health Organization's child and adolescent health study}, series = {Journal of Health Monitoring}, volume = {5}, journal = {Journal of Health Monitoring}, number = {3}, issn = {2511-2708}, doi = {10.25646/6904}, pages = {88 -- 102}, abstract = {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.}, language = {en} } @misc{HerkeMoorWinteretal., author = {Herke, Max and Moor, Irene and Winter, Kristina and Hoffmann, Stephanie and Spallek, Jacob and Hilger-Kolb, Jennifer and Pischke, Claudia R. and Dragano, Nico and Novelli, Anna and Richter, Matthias}, title = {Role of contextual and compositional characteristics of schools for health inequalities in childhood and adolescence: protocol for a scoping review}, series = {BMJ Open}, volume = {10}, journal = {BMJ Open}, number = {12}, issn = {2044-6055}, doi = {10.1136/bmjopen-2020-038999}, pages = {7}, abstract = {Introduction Childhood and adolescence are crucial life stages for health trajectories and the development of health inequalities in later life. The relevance of schools for health and well-being of children and adolescents has long been recognised, and there is some research regarding the association of contextual and compositional characteristics of schools and classes with health, health behaviour and well-being in this population. Little is known about the role of meso-level characteristics in relation to health inequalities. The aim of this scoping review is to retrieve and synthesise evidence about the mediating or moderating role of compositional or contextual characteristics of schools for the association between students' socioeconomic position and health in primary and secondary education. Methods and analysis We will conduct a systematic search of electronic databases in PubMed/Medline, Web of Science and Education Resources Information Center. Studies must meet the following inclusion criteria: (1) The population must be students attending primary or secondary schools in developed economies. (2) The outcomes must include at least one indicator for individual health, health behaviour or well-being. (3) The study must include at least one contextual or compositional characteristic of the school context and one individual determinant of socioeconomic position. (4) The study must also examine the mediating or moderating role of the contextual or compositional characteristic of the school context for the associations between socioeconomic position and health, health behaviour or well-being. (5) The study must be published since 1 January 2000 in English or German language. We will provide a narrative synthesis of findings. Ethics and dissemination We will not collect primary data and only include secondary data derived from previously published studies. Therefore, ethical approval is not required. We intend to publish our findings in an international peer-reviewed journal and to present them at national and international conferences.}, language = {en} } @misc{NovelliSchuettigSpalleketal., author = {Novelli, Anna and Sch{\"u}ttig, Wiebke and Spallek, Jacob and Wachtler, Benjamin and Diehl, Katharina and Moor, Irene and Richter, Matthias and Dragano, Nico and Sundmacher, Leonie}, title = {Correlation of mesolevel characteristics of the healthcare system and socioeconomic inequality in healthcare use: a scoping review protocol}, series = {BMJ Open}, volume = {11}, journal = {BMJ Open}, number = {2}, issn = {2044-6055}, doi = {10.1136/bmjopen-2020-044301}, pages = {7}, abstract = {Introduction Although the impact of macrolevel characteristics of health systems on socioeconomic inequity in health has been studied extensively, the impact of access characteristics on a smaller scale of health systems has received less attention. These mesolevel characteristics can influence access to healthcare and might have the potential to moderate or aggravate socioeconomic inequity in healthcare use. This scoping review aims to map the existing evidence of the association of socioeconomic inequity in healthcare use and mesolevel access characteristics of the health system. Methods and analysis In conducting the scoping review, we follow the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols Extension for Scoping Reviews. The search will be carried out in four scientific databases: MEDLINE (via PubMed), Web of Science, Scopus and PsycINFO. Main eligibility criteria are inclusion in the analysis of a measure of socioeconomic position, a measure of individual healthcare use and a mesolevel determinant of access to healthcare services. The selection process consists of two consecutive screening stages (first: title/abstract; second: full text). At both stages, two reviewers independently assess the eligibility of studies. In case of disagreement, a third reviewer will be involved. Cohen's kappa will be calculated to report inter-rater agreement between reviewers. Results are synthesised narratively, as a high heterogeneity of studies is expected. Ethics and dissemination No primary data are collected for the presented scoping review. Therefore, ethical approval is not necessary. The scoping review will be published in an international peer-reviewed journal, and findings will be presented on national and international conferences.}, language = {en} } @misc{BlumeRattayHoffmannetal., author = {Blume, Miriam and Rattay, Petra and Hoffmann, Stephanie and Spallek, Jacob and Sander, Lydia and Herr, Raphael and Richter, Matthias and Moor, Irene and Dragano, Nico and Pischke, Claudia R. and Iashchenko, Iryna and H{\"o}vener, Claudia and Wachtler, Benjamin}, title = {Health Inequalities in Children and Adolescents: A Scoping Review of the Mediating and Moderating Effects of Family Characteristics}, series = {International Journal of Environmental Research and Public Health}, volume = {18}, journal = {International Journal of Environmental Research and Public Health}, number = {15}, issn = {1660-4601}, doi = {10.3390/ijerph18157739}, pages = {33}, abstract = {This scoping review systematically mapped evidence of the mediating and moderating effects of family characteristics on health inequalities in school-aged children and adolescents (6-18 years) in countries with developed economies in Europe and North America. We conducted a systematic scoping review following the PRISMA extension for Scoping Reviews recommendations. We searched the PubMed, PsycINFO and Scopus databases. Two reviewers independently screened titles, abstracts and full texts. Evidence was synthesized narratively. Of the 12,403 records initially identified, 50 articles were included in the synthesis. The included studies were conducted in the United States (n = 27), Europe (n = 18), Canada (n = 3), or in multiple countries combined (n = 2). We found that mental health was the most frequently assessed health outcome. The included studies reported that different family characteristics mediated or moderated health inequalities. Parental mental health, parenting practices, and parent-child-relationships were most frequently examined, and were found to be important mediating or moderating factors. In addition, family conflict and distress were relevant family characteristics. Future research should integrate additional health outcomes besides mental health, and attempt to integrate the complexity of families. The family characteristics identified in this review represent potential starting points for reducing health inequalities in childhood and adolescence.}, language = {en} } @misc{HerkeMoorWinteretal., author = {Herke, Max and Moor, Irene and Winter, Kristina and Hack, Miriam and Hoffmann, Stephanie and Spallek, Jacob and Hilger-Kolb, Jennifer and Herr, Raphael and Pischke, Claudia R. and Dragano, Nico and Novelli, Anna and Richter, Matthias}, title = {Role of contextual and compositional characteristics of schools for health inequalities in childhood and adolescence: a scoping review}, series = {BMJ Open}, volume = {12}, journal = {BMJ Open}, number = {2}, issn = {2044-6055}, doi = {10.1136/bmjopen-2021-052925}, pages = {16}, abstract = {Objectives: To synthesise the evidence on the role of compositional or contextual characteristics of schools in the association between students' socioeconomic position and their health in primary and secondary education in developed economies. Design: Scoping review. We included studies examining the role of at least one school or class characteristic on students' health inequalities and was published since 1 January 2000, in English or German. We searched PubMed/Medline, Web of Science and Education Resources Information Center. We provided a narrative synthesis and an overview of findings. School characteristics were grouped into five broad categories: school composition, school climate, school policies and organisation, food environment and facilities. Results: Of 8520 records identified, 26 studies were included. Twelve studies found a moderating and 3 a mediating effect. The strongest evidence came from studies examining the moderating effect of school composition, that is, the negative impact of a low individual socioeconomic position on mental health and well-being was aggravated by a low average socioeconomic position of schools. Evidence concerning the role of school climate, school stratification (eg, performance base tracking) and sponsorship, food environment and sport facilities and equipment was generally weak or very weak and mostly based on singular findings. Overall, favourable meso-level characteristics mitigated the negative impact of low individual socioeconomic position on health outcomes. Conclusions: School characteristics affect health inequalities in children and adolescents to some degree, but future research is necessary to strengthen the existing evidence and address under-represented aspects in school characteristics and health outcomes.}, language = {en} } @misc{IashchenkoSchuettigBammertetal., author = {Iashchenko, Iryna and Sch{\"u}ttig, Wiebke and Bammert, Philip and Spallek, Jacob and Rattay, Petra and Schneider, Sven and Moor, Irene and Pischke, Claudia R. and Sundmacher, Leonie}, title = {The role of regional health policy for socioeconomic inequality in health services utilization}, series = {European Journal of Public Health}, volume = {32}, journal = {European Journal of Public Health}, number = {Supplement_3}, issn = {1101-1262}, doi = {10.1093/eurpub/ckac129.584}, pages = {1}, abstract = {Background "J1" is a preventative routine examination in Germany recommended for adolescents at the age of 12-14 years. In contrast to the well-established U1-U9 examinations for younger children, with participation rates above 90\%, the attendance of the J1 examination is approximately only 40\%. The most frequent reason for not attending J1 is the unawareness of this examination. "Ticket to J1" is an intervention including an information leaflet introduced in Bavaria in 2017 to inform adolescents about J1. The aims of the present analysis are to investigate (1) if the regional policy was effective in increasing the attendance in J1, (2) if the effects vary by family socioeconomic status (SES), and (3) which meso-level characteristics of the healthcare system correlate with attendance rates in J1. Methods We used anonymised data of a large statutory health insurance in Germany for the timeframe of 2016-2018. To investigate the effect of the policy, a difference-in-differences design at the individual level was used. Assuming a parallel trend at the level of federal states, the likelihood of attendance in J1 of 13- and 14-year-olds was compared between Bavaria and other federal German states before and after policy introduction. All analyses were additionally stratified by SES. Results The introduction of "Ticket to J1" increased participation in J1 by 1\% after controlling for all confounders. Furthermore, the effect was stronger for children from families with lower SES (an increase of 5\%). Density of pediatricians was positively significantly correlated with participation in J1. Discussion Regional health policy intervention had a significant positive impact on attendance of J1 and appears to have the potential to reduce socioeconomic inequalities in healthcare utilization. Informing adolescents about J1 seems to increase the attendance, in particular for children from families with lower SES.}, language = {en} } @misc{HoffmannRattayBlumeetal., author = {Hoffmann, Stephanie and Rattay, Petra and Blume, Miriam and H{\"o}vener, Claudia and Schneider, Sven and Moor, Irene and Pischke, Claudia R. and Sch{\"u}ttig, Wiebke and De Bock, Freia and Spallek, Jacob}, title = {Do family characteristics explain a social gradient in overweight in early childhood?}, series = {European Journal of Public Health}, volume = {32}, journal = {European Journal of Public Health}, number = {Supplement_3}, issn = {1101-1262}, doi = {10.1093/eurpub/ckac129.581}, pages = {1}, abstract = {Background Children's overweight is associated with many factors, including their living situation, in particular their family's socioeconomic position (SEP) and family characteristics. Research on the extent to which family characteristics account for a social gradient in overweight in early life is scarce. This study evaluated whether family characteristics explain SEP differences in the risk of overweight in early childhood. Methods The study used baseline data of 3-6 year-old children (n = 1,116) from the intervention 'Ene mene fit' conducted at kindergartens in Baden-W{\"u}rttemberg, Germany. Data included overweight (body mass index > 90 percentile) and parents' reports on their education and family characteristics associated with overweight (child consumes: sweets in front of TV, soft drinks; family joined time: outdoor, breakfast, sports; cooking; child sets table; role model). Model-based single mediation analyses decomposed the total effect of highest parental education on overweight into direct (unmediated) and indirect (mediated) effects (OR, 95\% CI). Results Girls and boys with low parental education had higher odds for overweight than children with high/medium education. Among boys, low education influenced the risk of overweight via indirect effects of i. 'sweets consumption in front of TV' (OR = 1.31, 1.05-1.59) and ii. 'no joined sports' (OR = 1.14, 1.00-1.44). The direct effect of low education only remained significant when 'no joined sports' was considered (OR = 2.19, 1.11-5.19). Among girls, family characteristics measured here did not explain SEP differences in overweight. Conclusions The family characteristics 'sweets consumption in front of TV' and 'no joined sports' contribute to inequalities in overweight among boys, but not among girls. Therefore, more gender-sensitive research is needed to identify family risk and protective characteristics that explain health inequalities among both boys and girls.}, language = {en} } @misc{ReissBehnErhartetal., author = {Reiß, Franziska and Behn, Steven and Erhart, Michael and Strelow, Lisa and Kaman, Anne and Ottov{\´a}-Jordan, Veronika and Bilz, Ludwig and Moor, Irene and Ravens-Sieberer, Ulrike}, title = {Subjective health and psychosomatic complaints of children and adolescents in Germany: Results of the HBSC study 2009/10 - 2022}, series = {Journal of Health Monitoring}, volume = {9}, journal = {Journal of Health Monitoring}, number = {1}, issn = {2511-2708}, doi = {10.25646/11868}, pages = {7 -- 22}, abstract = {Background: Subjective health and well-being are important health indicators in childhood and adolescence. This article shows current results and trends over time between 2009/10 and 2022. Methods: The Health Behaviour in School-aged Children (HBSC) study examined subjective health, life satisfaction and psychosomatic complaints of N = 21,788 students aged 11 to 15 years in the school years 2009/10, 2013/14, 2017/18 and in the calendar year 2022. Multivariate regression analyses show the associations between sociodemographic characteristics and well-being in 2022, as well as trends since 2009/10. Results: The majority of children and adolescents indicate a good subjective health and high life satisfaction. About half of the girls and one third of the boys report multiple psychosomatic health complaints, with a clear increase over time. Older adolescents, girls and gender diverse adolescents are at an increased risk of poor well-being. Subjective health and life satisfaction varied between 2009/10 and 2022, with a significant deterioration between 2017/18 and 2022. Conclusions: The high proportion of children and adolescents with psychosomatic complaints, as well as the observed gender and age differences, underline the need for target group-specific prevention, health promotion and continuous health monitoring.}, language = {en} } @misc{MoorHerkeMarkertetal., author = {Moor, Irene and Herke, Max and Markert, Jenny and B{\"o}hm, Marie and Reiß, Franziska and Bilz, Ludwig and Sudeck, Gorden and Winter, Kristina}, title = {Trends in health inequalities in childhood and adolescence in Germany: Results of the HBSC study 2009/10 - 2022}, series = {Journal of Health Monitoring}, volume = {9}, journal = {Journal of Health Monitoring}, number = {1}, issn = {2511-2708}, doi = {10.25646/11876}, pages = {79 -- 98}, abstract = {Background: Many studies have identified health inequalities in childhood and adolescence. However, it is unclear how these have developed in recent years, particularly since the COVID-19 pandemic. Methods: Analyses are based on the German data from the international Health Behaviour in School-aged Children (HBSC) study from 2009/10 (n = 5,005), 2013/14 (n = 5,961), 2017/18 (n = 4,347), and 2022 (n = 6,475). A total of 21,788 students aged approximately between 11 and 15 years were included. Socioeconomic status (SES) was assessed using the Family Affluence Scale (FAS). Several health indicators were analysed stratified by gender using bivariate and multivariate analysis methods. Results: In 2022, there are clear socioeconomic inequalities in life satisfaction, self-rated health, fruit and vegetable consumption, and physical activity. These inequalities remained largely constant or increased between 2009/10 and 2022. Between 2017/18 and 2022, no significant changes in inequalities were found. Conclusions: Health inequalities are persistent and reduce the chances of growing up healthy. There is no evidence that inequalities in the analysed outcomes have changed during the pandemic period (between 2017/18 and 2022). Rather, the changes in the health indicators seem to affect all adolescents in a similar way.}, language = {en} } @misc{WinterMoorMarkertetal., author = {Winter, Kristina and Moor, Irene and Markert, Jenny and Bilz, Ludwig and Bucksch, Jens and Dadaczynski, Kevin and Fischer, Saskia M. and Helmchen, Ronja M. and Kaman, Anne and M{\"o}ckel, Juliane and Rathmann, Katharina and Ravens-Sieberer, Ulrike and Reiß, Franziska and Schierl, Theresa and Sch{\"u}tz, Raphael and Sendatzki, Saskia and St{\"u}rmer, Elisabeth and Sudeck, Gorden and Richter, Matthias}, title = {Concept and methodology of the Health Behaviour in School-aged Children (HBSC) study - Insights into the current 2022 survey and trends in Germany}, series = {Journal of Health Monitoring}, volume = {9}, journal = {Journal of Health Monitoring}, number = {1}, issn = {2511-2708}, doi = {10.25646/11878}, pages = {99 -- 117}, abstract = {Background: Health Behaviour in School-aged Children (HBSC) is one of the largest international studies on child and adolescent health and cooperates with the World Health Organization (WHO). In Germany, adolescents aged 11, 13 and 15 are surveyed every four years about their health, health behaviour and social conditions. This article describes the HBSC study and in particular the methodology of the current 2022 survey and prior surveys conducted between 2009/10 and 2017/18. Method: 174 schools with a total of 6,475 students participated in the 2022 survey. The survey was conducted using questionnaires and covered a wide range of topics (including mental health, physical activity, bullying experiences, social determinants of health and experiences related to COVID-19). The 2022 survey was complemented by a school principal survey (N = 160). In addition to the current sample, the samples of the three previous surveys with representative data for Germany are presented: 2009/10 (N = 5,005), 2013/14 (N = 5,961) and 2017/18 (N = 4,347). Discussion: The health of children and adolescents is of great public health importance. The HBSC study makes a substantial contribution by providing internationally comparable results, analysing trends, and providing stakeholders with comprehensive and representative health monitoring data.}, language = {en} } @misc{BammertSchuettigNovellietal., author = {Bammert, Philip and Sch{\"u}ttig, Wiebke and Novelli, Anna and Iashchenko, Iryna and Spallek, Jacob and Blume, Miriam and Diehl, Katharina and Moor, Irene and Dragano, Nico and Sundmacher, Leonie}, title = {The role of mesolevel characteristics of the health care system and socioeconomic factors on health care use - results of a scoping review}, series = {International Journal for Equity in Health}, volume = {23}, journal = {International Journal for Equity in Health}, number = {1}, issn = {1475-9276}, doi = {10.1186/s12939-024-02122-6}, abstract = {Background: Besides macrolevel characteristics of a health care system, mesolevel access characteristics can exert influence on socioeconomic inequalities in healthcare use. These reflect access to healthcare, which is shaped on a smaller scale than the national level, by the institutions and establishments of a health system that individuals interact with on a regular basis. This scoping review maps the existing evidence about the influence of mesolevel access characteristics and socioeconomic position on healthcare use. Furthermore, it summarizes the evidence on the interaction between mesolevel access characteristics and socioeconomic inequalities in healthcare use. Methods: We used the databases MEDLINE (PubMed), Web of Science, Scopus, and PsycINFO and followed the 'Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols extension for scoping reviews (PRISMA-ScR)' recommendations. The included quantitative studies used a measure of socioeconomic position, a mesolevel access characteristic, and a measure of individual healthcare utilisation. Studies published between 2000 and 2020 in high income countries were considered. Results: Of the 9501 potentially eligible manuscripts, 158 studies were included after a two-stage screening process. The included studies contained a wide spectrum of outcomes and were thus summarised to the overarching categories: use of preventive services, use of curative services, and potentially avoidable service use. Exemplary outcomes were screening uptake, physician visits and avoidable hospitalisations. Access variables included healthcare system characteristics such as physician density or distance to physician. The effects of socioeconomic position on healthcare use as well as of mesolevel access characteristics were investigated by most studies. The results show that socioeconomic and access factors play a crucial role in healthcare use. However, the interaction between socioeconomic position and mesolevel access characteristics is addressed in only few studies. Conclusions: Socioeconomic position and mesolevel access characteristics are important when examining variation in healthcare use. Additionally, studies provide initial evidence that moderation effects exist between the two factors, although research on this topic is sparse. Further research is needed to investigate whether adapting access characteristics at the mesolevel can reduce socioeconomic inequity in health care use.}, language = {en} } @misc{KamanOttovaJordanBilzetal., author = {Kaman, Anne and Ottov{\´a}-Jordan, Veronika and Bilz, Ludwig and Sudeck, Gorden and Moor, Irene and Ravens-Sieberer, Ulrike}, title = {Subjektive Gesundheit und Wohlbefinden von Kindern und Jugendlichen in Deutschland - Querschnittergebnisse der HBSC-Studie 2017/18}, series = {Journal of Health Monitoring}, volume = {5}, journal = {Journal of Health Monitoring}, number = {3}, issn = {2511-2708}, doi = {10.25646/6891}, pages = {7 -- 21}, abstract = {Subjektive Gesundheit wird als multidimensionales Konstrukt verstanden, welches k{\"o}rperliche, seelische und soziale Dimensionen des Wohlbefindens einer Person umfasst. Die F{\"o}rderung der subjektiven Gesundheit und des Wohlbefindens von Kindern und Jugendlichen ist von hoher Public-Health-Relevanz, da gesundheitliche Beeintr{\"a}chtigungen oftmals mit langfristigen Gesundheitsproblemen im sp{\"a}teren Erwachsenenalter einhergehen. Informationen {\"u}ber m{\"o}gliche Risikofaktoren und Ressourcen sind daher von zentraler Bedeutung. In diesem Beitrag werden aktuelle Pr{\"a}valenzen zum subjektiven Gesundheitszustand, zur Lebenszufriedenheit und zu psychosomatischen Beschwerden von 11-, 13- und 15-j{\"a}hrigen Kindern und Jugendlichen in Deutschland aus der „Health Behaviour in School-Aged Children (HBSC)"-Studie 2017/18 berichtet (N=4.347, 53,0 \% M{\"a}dchen). Zudem werden soziodemografische und psychosoziale Einflussfaktoren des subjektiven Wohlbefindens untersucht. Die meisten Kinder und Jugendlichen sch{\"a}tzten ihre Gesundheit und Lebenszufriedenheit positiv ein. Dennoch litt etwa ein Drittel der M{\"a}dchen und ein F{\"u}nftel der Jungen unter mehreren (multiplen) psychosomatischen Beschwerden. Beeintr{\"a}chtigungen im subjektiven Wohlbefinden zeigten sich vor allem bei M{\"a}dchen, {\"a}lteren Jugendlichen, Jugendlichen mit niedrigerem famili{\"a}ren Wohlstand sowie bei hoher schulischer Belastung. Eine hohe famili{\"a}re Unterst{\"u}tzung war hingegen mit einem besseren subjektiven Wohlbefinden assoziiert. Die Ergebnisse verdeutlichen die Notwendigkeit zielgruppenspezifischer Angebote der Pr{\"a}vention und Gesundheitsf{\"o}rderung, um die subjektive Gesundheit und das Wohlbefinden von Kindern und Jugendlichen zu f{\"o}rdern.}, language = {de} } @misc{MoorWinterBilzetal., author = {Moor, Irene and Winter, Kristina and Bilz, Ludwig and Bucksch, Jens and Finne, Emily and John, Nancy and Kolip, Petra and Paulsen, Lisa and Ravens-Sieberer, Ulrike and Schlattmann, Marina and Sudeck, Gorden and Brindley, Catherina and Kaman, Anne and Richter, Matthias}, title = {Die Health Behaviour in School-aged Children (HBSC)-Studie 2017/18 - Methodik der Kinder- und Jugendgesundheits­studie der Weltgesundheitsorganisation}, series = {Journal of Health Monitoring}, volume = {5}, journal = {Journal of Health Monitoring}, number = {3}, issn = {2511-2708}, doi = {10.25646/6896}, pages = {93 -- 108}, abstract = {Die „Health Behaviour in School-Aged Children (HBSC)"-Studie ist ein international kooperatives Forschungsprojekt, das von der Weltgesundheitsorganisation (WHO) seit {\"u}ber 35 Jahren unterst{\"u}tzt wird. HBSC ist die weltweit gr{\"o}ßte Studie zur Kinder- und Jugendgesundheit und f{\"u}r die WHO eine der wichtigsten Datengrundlagen zur international vergleichenden Gesundheitsberichterstattung. Im vierj{\"a}hrigen Turnus werden Daten zur Gesundheit und zum Gesundheitsverhalten von Sch{\"u}lerinnen und Sch{\"u}lern im Alter von 11, 13 und 15 Jahren sowie zu den Rahmenbedingungen f{\"u}r ein gesundes Aufwachsen erhoben. Insgesamt geh{\"o}ren 50 L{\"a}nder dem HBSC-Netzwerk an, an dem Survey 2017/18 beteiligten sich insgesamt 45 L{\"a}nder. Deutschland beteiligt sich seit 1993/94 an der HBSC-Studie. F{\"u}r die aktuelle Erhebung 2017/18 in Deutschland wurden Sch{\"u}lerinnen und Sch{\"u}ler an 146 Schulen befragt (Responserate Schulen: 15,6 \%). Insgesamt konnte f{\"u}r Deutschland eine Netto-Stichprobe von n=4.347 M{\"a}dchen und Jungen (Responserate: 52,7 \%) erzielt werden. Die freiwillige Teilnahme an der Befragung erfolgte in ganzen Schulklassen der Jahrgangsstufen f{\"u}nf, sieben und neun. Mit Hilfe einer Gewichtung sind repr{\"a}sentative Aussagen zur gesundheitlichen Lage von Kindern und Jugendlichen in Deutschland m{\"o}glich. Die HBSC-Studie leistet einen wichtigen Beitrag f{\"u}r die Gesundheitsberichterstattung und bietet wichtige Ansatzpunkte f{\"u}r die Identifikation von Bedarfen, Risikogruppen und Handlungsfeldern, um gezielte und bedarfsorientierte Maßnahmen zur Pr{\"a}vention und Gesundheitsf{\"o}rderung im Setting Schule zu initiieren.}, language = {de} } @misc{WinterMoorMarkertetal., author = {Winter, Kristina and Moor, Irene and Markert, Jenny and Bilz, Ludwig and Bucksch, Jens and Dadaczynski, Kevin and Fischer, Saskia M. and Helmchen, Ronja M. and Kaman, Anne and M{\"o}ckel, Juliane and Rathmann, Katharina and Ravens-Sieberer, Ulrike and Reiß, Franziska and Schierl, Theresa and Sch{\"u}tz, Raphael and Sendatzki, Saskia and St{\"u}rmer, Elisabeth and Sudeck, Gorden and Richter, Matthias}, title = {Konzept und Methodik der Studie Health Behaviour in Schoolaged Children (HBSC) - Einblicke in den aktuellen Survey 2022 und die Entwicklung in Deutschland}, series = {Journal of Health Monitoring}, volume = {9}, journal = {Journal of Health Monitoring}, number = {1}, issn = {2511-2708}, doi = {10.25646/11877}, pages = {108 -- 127}, abstract = {Hintergrund: „Health Behaviour in School-aged Children (HBSC)" ist eine der gr{\"o}ßten internationalen Kinder- und Jugendgesundheitsstudien und kooperiert mit der Weltgesundheitsorganisation (WHO). In Deutschland werden im vierj{\"a}hrigen Turnus jeweils Heranwachsende im Alter von 11, 13 und 15 Jahren zur Gesundheit, zum Gesundheitsverhalten und zu sozialen Rahmenbedingungen befragt. Der Beitrag widmet sich der Beschreibung der HBSC-Studie und speziell der Methodik des aktuellen Surveys 2022 sowie der vorherigen Erhebungen von 2009/10 bis 2017/18. Methode: Am Survey 2022 beteiligten sich 174 Schulen mit insgesamt 6.475 Sch{\"u}lerinnen und Sch{\"u}lern. Die Erhebung erfolgte mittels Fragebogen und erfasst ein breites Themenspektrum (u. a. mentale Gesundheit, Bewegungsverhalten, Mobbingerfahrungen, soziale Determinanten der Gesundheit sowie Erfahrungen im Zusammenhang mit COVID-19). Erg{\"a}nzt wurde die Erhebung 2022 um eine Schulleitungsbefragung (N = 160). Neben der aktuellen Stichprobe werden auch die Stichproben der vorangegangenen drei Surveys mit repr{\"a}sentativen Angaben f{\"u}r Deutschland vorgestellt: 2009/10 (N = 5.005), 2013/14 (N = 5.961) und 2017/18 (N = 4.347). Diskussion: Die Kinder- und Jugendgesundheit hat eine hohe Public-Health-Relevanz. Dazu leistet die HBSC-Studie einen elementaren Beitrag, denn sie liefert international vergleichbare Ergebnisse, erm{\"o}glicht die Analyse von Trendentwicklungen und stellt umfangreiche, repr{\"a}sentative Daten zum Gesundheitsmonitoring f{\"u}r Stakeholder bereit.}, language = {de} } @misc{ReissBehnErhartetal., author = {Reiß, Franziska and Behn, Steven and Erhart, Michael and Strelow, Lisa and Kaman, Anne and Ottov{\´a}-Jordan, Veronika and Bilz, Ludwig and Moor, Irene and Ravens-Sieberer, Ulrike}, title = {Subjektive Gesundheit und psychosomatische Beschwerden von Kindern und Jugendlichen in Deutschland: Ergebnisse der HBSC-Studie 2009/10 - 2022}, series = {Journal of Health Monitoring}, volume = {9}, journal = {Journal of Health Monitoring}, number = {1}, issn = {2511-2708}, doi = {10.25646/11867}, pages = {7 -- 24}, abstract = {Hintergrund: Die subjektive Gesundheit und das Wohlbefinden stellen wichtige Gesundheitsindikatoren im Kindes- und Jugendalter dar. Der vorliegende Beitrag zeigt aktuelle Ergebnisse sowie zeitliche Trends zwischen 2009/10 und 2022. Methode: Die „Health Behaviour in School-aged Children (HBSC)"-Studie erfasste in den Schuljahren 2009/10, 2013/14, 2017/18 und im Kalenderjahr 2022 bei N = 21.788 Sch{\"u}lerinnen und Sch{\"u}lern im Alter von 11 bis 15 Jahren deren subjektive Gesundheit, Lebenszufriedenheit und psychosomatische Beschwerden. Multivariate Regressionsanalysen zeigen die Zusammenh{\"a}nge zwischen soziodemografischen Merkmalen und dem Wohlbefinden f{\"u}r 2022 sowie Trendverl{\"a}ufe seit 2009/10. Ergebnisse: Der Großteil der Kinder und Jugendlichen berichtet eine gute subjektive Gesundheit und eine hohe Lebenszufriedenheit. Etwa die H{\"a}lfte der M{\"a}dchen und ein Drittel der Jungen berichten multiple psychosomatische Gesundheitsbeschwerden, mit einem deutlichen Anstieg im zeitlichen Verlauf. {\"A}ltere Jugendliche, M{\"a}dchen und Genderdiverse haben ein erh{\"o}htes Risiko f{\"u}r ein geringes Wohlbefinden. Zwischen 2009/10 und 2022 variierten die subjektive Gesundheit und die Lebenszufriedenheit mit einer deutlichen Verschlechterung von 2017/18 zu 2022. Schlussfolgerungen: Der hohe Anteil von Kindern und Jugendlichen mit psychosomatischen Beschwerden sowie die aufgezeigten Geschlechts- und Altersdiskrepanzen verdeutlichen den Bedarf an zielgruppenspezifischer Pr{\"a}vention, Gesundheitsf{\"o}rderung und einem kontinuierlichen Gesundheitsmonitoring.}, language = {de} } @misc{MoorHerkeMarkertetal., author = {Moor, Irene and Herke, Max and Markert, Jenny and B{\"o}hm, Marie and Reiß, Franziska and Bilz, Ludwig and Sudeck, Gorden and Winter, Kristina}, title = {Die zeitliche Entwicklung gesundheitlicher Ungleichheit im Kindes- und Jugendalter in Deutschland: Ergebnisse der HBSC-Studie 2009/10 - 2022}, series = {Journal of Health Monitoring}, volume = {9}, journal = {Journal of Health Monitoring}, number = {1}, issn = {2511-2708}, doi = {10.25646/11875}, pages = {86 -- 107}, abstract = {Hintergrund: Viele Studien berichten von gesundheitlichen Ungleichheiten im Kindes- und Jugendalter. Unklar ist, wie sich diese in den letzten Jahren, insbesondere vor dem Hintergrund der COVID-19-Pandemie, entwickelt haben. Methode: Die Analysen basieren auf den deutschen Daten der internationalen HBSC-Studie (Health Behaviour in Schoolaged Children) von 2009/10 (n = 5.005), 2013/14 (n = 5.961), 2017/18 (n = 4.347) und 2022 (n = 6.475). Insgesamt wurden 21.788 Sch{\"u}lerinnen und Sch{\"u}ler im Alter von ca. 11 bis 15 Jahren ber{\"u}cksichtigt. Der sozio{\"o}konomische Status (SES) wurde mithilfe der Family Affluence Scale (FAS) erhoben. Verschiedene Gesundheitsindikatoren wurden mittels bi- und multivariaten Analysemethoden stratifiziert nach Geschlecht ausgewertet. Ergebnisse: 2022 zeigen sich deutliche sozio{\"o}konomische Ungleichheiten in der Lebenszufriedenheit, der subjektiven Gesundheit, im Obst- und Gem{\"u}sekonsum sowie im Bewegungsverhalten. Diese Ungleichheiten sind im Zeitverlauf von 2009/10 bis 2022 {\"u}berwiegend konstant geblieben oder haben sich vergr{\"o}ßert. Zwischen 2017/18 und 2022 sind keine signifikanten {\"A}nderungen bez{\"u}glich der betrachteten Ungleichheiten zu erkennen. Schlussfolgerungen: Gesundheitliche Ungleichheiten zeigen sich kontinuierlich und reduzieren die Chancen auf ein gesundes Aufwachsen. Es gibt keine Hinweise darauf, dass sich die Ungleichheiten w{\"a}hrend des Pandemie-Zeitraums (zwischen 2017/18 und 2022) ver{\"a}ndert haben. Die Ver{\"a}nderungen in den betrachteten Gesundheitsindikatoren betreffen vielmehr alle Heranwachsende in {\"a}hnlicher Weise.}, language = {de} } @misc{DadaczynskiMoorBuckschetal., author = {Dadaczynski, Kevin and Moor, Irene and Bucksch, Jens and Winter, Kristina and Schierl, Theresa and Bilz, Ludwig and Reiß, Franziska}, title = {Gesundheitsverhalten und Gesundheit von Kindern und Jugendlichen in Deutschland. Ergebnisse der Health Behaviour in School-aged Children (HBSC) Studie 2022}, series = {Gesundheit - gemeinsam. Kooperationstagung der Deutschen Gesellschaft f{\"u}r Medizinische Informatik, Biometrie und Epidemiologie (GMDS), Deutschen Gesellschaft f{\"u}r Sozialmedizin und Pr{\"a}vention (DGSMP), Deutschen Gesellschaft f{\"u}r Epidemiologie (DGEpi), Deutschen Gesellschaft f{\"u}r Medizinische Soziologie (DGMS) und der Deutschen Gesellschaft f{\"u}r Public Health (DGPH). Dresden}, journal = {Gesundheit - gemeinsam. Kooperationstagung der Deutschen Gesellschaft f{\"u}r Medizinische Informatik, Biometrie und Epidemiologie (GMDS), Deutschen Gesellschaft f{\"u}r Sozialmedizin und Pr{\"a}vention (DGSMP), Deutschen Gesellschaft f{\"u}r Epidemiologie (DGEpi), Deutschen Gesellschaft f{\"u}r Medizinische Soziologie (DGMS) und der Deutschen Gesellschaft f{\"u}r Public Health (DGPH). Dresden}, publisher = {German Medical Science GMS Publishing House}, address = {D{\"u}sseldorf}, doi = {10.3205/24gmds888}, language = {de} } @misc{BlumeSchienkiewitzWollgastetal., author = {Blume, Miriam and Schienkiewitz, Anja and Wollgast, Lina and Hoffmann, Stephanie and Sander, Lydia and Spallek, Jacob and Herr, Raphael and Moor, Irene and Pischke, Claudia R. and Iashchenko, Iryna and H{\"o}vener, Claudia and Rattay, Petra}, title = {Association between socioeconomic position of the family and adolescent obesity in Germany - analysis of the mediating Role of familial determinants}, series = {Journal of Obesity}, volume = {2024}, journal = {Journal of Obesity}, number = {1}, publisher = {Wiley}, issn = {2090-0708}, doi = {10.1155/2024/7903972}, pages = {9}, abstract = {Background. Obesity's negative impact on young people's health has long been known. The family and its socioeconomic position (SEP) are key determinants in adolescent obesity. However, understanding which familial determinants explain the association remains limited. Method. The analyses are based on data from the "German Health Interview and Examination Survey for Children and Adolescents" (KiGGS) (1,384 females and 1,332 males aged 11 to 17 years). Logistic regression models explored how familial determinants (family stress, family cohesion, parental smoking, parental sporting activity, and parental overweight) mediated the association between family SEP (parental education, occupational status, and household income) and adolescent obesity. Results. Significant total effects for the associations between family SEP in childhood and adolescent obesity were found. Splitting the total effect of the family SEP on obesity into direct and indirect effects, all direct effects turned out to be significant. However, all associations involved also indirect effects of familial determinants, except for household income for female adolescents. Parental smoking and overweight were the most relevant mediators for males and females. For male adolescents, parental sporting activity additionally mediated the association between SEP and obesity. Conclusion. A low SEP in childhood was associated with adolescent obesity. Parental health and health behaviors partly explained the association. For increasing health equality in adolescent health, the consideration of parental health behavior in the planning and implementation of health promotion programs seem to be important.}, language = {en} } @misc{BlumeRattayHoffmannetal., author = {Blume, Miriam and Rattay, Petra and Hoffmann, Stephanie and Spallek, Jacob and Sander, Lydia and Herr, Raphael and Moor, Irene and Pischke, Claudia R. and Iashchenko, Iryna and H{\"o}vener, Claudia}, title = {Zusammenhang zwischen der sozio{\"o}konomischen Position der Familie und Adipositas bei Jugendlichen in Deutschland - welche Rolle hat die Familie?}, series = {Gesundheitswesen}, volume = {84}, journal = {Gesundheitswesen}, number = {08/09}, doi = {10.1055/s-0042-1753866}, pages = {826}, abstract = {Einleitung Die gesundheitlichen Folgen von Adipositas f{\"u}r junge Menschen k{\"o}nnen schwerwiegend sein. Bei der Entwicklung verschiedener Gesundheitsoutcomes wie Adipositas spielt f{\"u}r junge Menschen die Familie als auch ihre sozio{\"o}konomische Position (SEP) eine große Rolle. In dieser Analyse wird untersucht, welche famili{\"a}re Determinanten den Zusammenhang zwischen SEP der Familie und Adipositas bei Jugendlichen erkl{\"a}ren. Methoden Die vorliegende Analyse wurde mit Daten der "Studie zur Gesundheit von Kindern und Jugendlichen in Deutschland" (KiGGS) (Basiserhebung, Welle 1 und 2) durchgef{\"u}hrt (1301 weibliche und 1232 m{\"a}nnliche 11- bis 17-J{\"a}hrige). Mittels logistischer Regressionsmodelle (KHB-Methode) wurden f{\"u}r den Zusammenhang zwischen der SEP der Familie (Einkommen, berufliche Stellung, Bildung, SES-Index) und Adipositas (Ja/Nein) bei Jugendlichen die mediierenden Effekte von famili{\"a}ren Determinanten (elterliches Rauchen, elterliche sportliche Aktivit{\"a}ten, elterliches {\"U}bergewicht, famili{\"a}rer Stress und famili{\"a}rer Zusammenhalt) analysiert. Ergebnisse Die Pr{\"a}valenz von Adipositas betrug 7,9 \% bei den weiblichen und 8,4 \% bei den m{\"a}nnlichen Jugendlichen. Es zeigen sich signifikante Zusammenh{\"a}nge zwischen Adipositas und SEP zu Ungunsten von jenen mit niedriger sozio{\"o}konomischer Position. Famili{\"a}re Determinanten erkl{\"a}ren teilweise oder vollst{\"a}ndig den Zusammenhang zwischen SEP und Adipositas bei Jugendlichen. Es wurden geschlechtsspezifische Unterschiede im Ausmaß der Mediation der Familie gefunden. Bei Jungen erkl{\"a}ren famili{\"a}re Determinanten vollst{\"a}ndig den Zusammenhang zwischen Adipositas und Einkommen sowie zwischen Adipositas und der beruflichen Stellung der Eltern. Bei m{\"a}nnlichen Jugendlichen l{\"a}sst sich der indirekte Effekt abh{\"a}ngig von der jeweiligen SEP-Variable zu 20,8 - 27,9 \% auf das elterliche Rauchen, zu 14,8 - 26,3 \% auf die elterliche sportliche Aktivit{\"a}t und zu 42,6 - 63,6 \% auf das elterliche {\"U}bergewicht zur{\"u}ckf{\"u}hren. Bei M{\"a}dchen wurde der Zusammenhang zwischen der SEP und Adipositas teilweise durch famili{\"a}re Determinanten erkl{\"a}rt. Bei weiblichen Jugendlichen l{\"a}sst sich der indirekte Effekt abh{\"a}ngig von der jeweiligen SEP-Variable zu 26,0 - 52,2 \% auf das elterliche Rauchen und zu 41,6 - 67,6 \% auf das elterliche {\"U}bergewicht zur{\"u}ckf{\"u}hren. Schlussfolgerung Die Adipositas-Pr{\"a}valenz von Jugendlichen variiert nach dem SEP. Famili{\"a}re Determinanten sind wichtige mediierende Faktoren f{\"u}r gesundheitliche Ungleichheiten bei Adipositas von Jugendlichen. Es zeigt sich, dass sich Unterschiede in der Adipositas nach SEP insbesondere durch das elterliche Gesundheitsverhalten (v.a. elterliches Rauchen, elterliches {\"U}bergewicht und elterliche sportliche Aktivit{\"a}t) erkl{\"a}ren lassen. Die Ber{\"u}cksichtigung und Einbindung der Familie bei der Planung und Umsetzung von Gesundheitsf{\"o}rderungs- und Pr{\"a}ventionsprogrammen f{\"u}r gesundheitliche Chancengleichheit bei Jugendlichen ist essentiell.}, language = {de} } @misc{HerkeReuterMayeretal., author = {Herke, Max and Reuter, Marvin and Mayer, A. and Spallek, Jacob and Rattay, Petra and Moor, Irene and Richter, Matthias}, title = {Wie wirkt sich die sozio{\"o}konomische Komposition der Schule auf Ungleichheiten im subjektiven Wohlbefinden von Sch{\"u}lerinnen und Sch{\"u}lern in Deutschland aus?}, series = {Gesundheitswesen}, volume = {84}, journal = {Gesundheitswesen}, number = {08/09}, publisher = {Georg Thieme Verlag}, doi = {10.1055/s-0042-1753867}, pages = {826}, abstract = {Einleitung Zielsetzung des Beitrags ist es, zu untersuchen, inwiefern die sozio{\"o}konomische Komposition von Schulen mit dem Wohlbefinden von Sch{\"u}lerinnen und Sch{\"u}lern in Deutschland assoziiert ist. Konkret wurden die Assoziationen der Bildung, des Einkommens und des beruflichen Status der Eltern auf Individualebene und aggregiert auf Schulebene sowie die Interaktionen zwischen diesen Ebenen auf das subjektive Wohlbefinden von Sch{\"u}lern der Sekundarstufe I untersucht. Methoden Es wurden Daten der Startkohorte „Klasse 5" des Nationalen Bildungspanels (NEPS) herangezogen. Die Kohorte startete 2010 mit einer repr{\"a}sentativen Stichprobe von F{\"u}nftkl{\"a}sslern in Deutschland, welche j{\"a}hrlich nachverfolgt wurden. Es wurden Erhebungswellen von der f{\"u}nften bis zur neunten Klasse zusammengefasst. Damit konnten 14.265 Beobachtungen mit vollst{\"a}ndigen Angaben von 3.977 Sch{\"u}lerinnen und Sch{\"u}lern in 218 Schulen in den Analysen ber{\"u}cksichtigt werden. Mit Mixed-Models wurde getestet, ob die sozio{\"o}konomische Position auf individueller und/oder schulischer Ebene und die ebenen{\"u}bergreifende Interaktion dieser Indikatoren mit dem Wohlbefinden (adaptierter Personal Well-Being - School Children-Index) der Jugendlichen assoziiert ist. Es wurde f{\"u}r Alter, Geschlecht, Migrationshintergrund, Familienform, Schultyp und Notendurchschnitt kontrolliert. Ergebnisse Auf individueller Ebene war das elterliche Einkommen mit h{\"o}herem Wohlbefinden verbunden. Der berufliche Status der Eltern zeigte keine signifikanten Assoziationen. Auf Schulebene fanden wir einen geringen, positiven Zusammenhang zwischen dem durchschnittlichen elterlichen Einkommen und dem individuellen Wohlbefinden, aber auch einen m{\"a}ßig negativen Einfluss eines hohen Anteils hoch gebildeter Eltern auf das Wohlbefinden. In Sensitivit{\"a}tsanalysen blieben diese Zusammenh{\"a}nge auch bei separater Betrachtung dieser Indikatoren bestehen. Die Zusammenh{\"a}nge auf Individualebene wurden nicht durch die sozio{\"o}konomische Komposition von Schulen moderiert, es konnten keine signifikanten ebenen{\"u}bergreifende Interaktionen festgestellt werden. Schlussfolgerung Es wurde ein Zusammenhang der sozio{\"o}konomischen Zusammensetzung der Schule mit dem subjektiven Wohlbefinden der Jugendlichen gefunden. Internationale Befunde einer Moderation der Zusammenh{\"a}nge auf individueller Ebene durch sozio{\"o}konomische Charakteristika auf Schulebene konnten jedoch nicht repliziert werden. Die Zusammenh{\"a}nge zwischen individueller SEP und Wohlbefinden variieren somit nicht in Abh{\"a}ngigkeit von der SEP auf Schulebene. Es zeigen sich vielmehr in Teilen additive Effekte f{\"u}r die individuelle und schulische SEP.}, language = {de} } @misc{IashchenkoSchuettigBammertetal., author = {Iashchenko, Iryna and Sch{\"u}ttig, Wiebke and Bammert, Philip and Spallek, Jacob and Rattay, Petra and Schneider, Sven and Moor, Irene and Pischke, Claudia R. and Sundmacher, Leonie}, title = {Die Rolle der regionalen Gesundheitspolitik f{\"u}r die sozio{\"o}konomische Ungleichheit in der Inanspruchnahme der Gesundheitsleistungen}, series = {Gesundheitswesen}, volume = {84}, journal = {Gesundheitswesen}, number = {08/09}, publisher = {Georg Thieme Verlag}, doi = {10.1055/s-0042-1753865}, pages = {825}, abstract = {Einleitung Die J1 ist eine Vorsorgeuntersuchung, die f{\"u}r Kinder zwischen 12 und 14 Jahren empfohlen ist. Im Gegensatz zu den etablierten U1- bis U9-Untersuchungen f{\"u}r j{\"u}ngere Kinder mit Teilnahmeraten {\"u}ber 90\% liegt die Teilnahme bei der J1 bei etwa 40\%. Ein Grund f{\"u}r die mangelnde Teilnahme an der J1 ist die geringe Bekanntheit bei Eltern und Kindern. Mehrere Bundesl{\"a}nder haben Einladungswesen eingef{\"u}hrt, um Jugendliche zur Teilnahme an der J1 zu motivieren. Die Einladung „Dein Ticket zur J1" wurde Mitte 2017 in Bayern eingef{\"u}hrt. Das „Ticket" ist ein Informationsflyer {\"u}ber die J1 in einer jugendgerechten Gestaltung. Die vorliegende Analyse untersuchte, ob die regionale Informationskampagne zu einer Steigerung der Teilnahme an der J1 gef{\"u}hrt hat, ob die Effekte mit dem sozio{\"o}konomischen Status der Familie (SES) variieren und welche Meso-Ebene-Merkmale des Gesundheitssystems mit der J1-Teilnahme korrelieren. Methoden Um die Wirkung der Intervention zu untersuchen, wurden bundesweite anonymisierte Routinedaten der Techniker Krankenkasse aus den Jahren 2016-2018 sowie ein Difference-in-Differences-Design auf individueller Ebene verwendet. Unter der Annahme eines parallelen Trends auf Bundesl{\"a}nderebene wurde die J1-Teilnahme von 13- und 14-J{\"a}hrigen in Bayern mit anderen Bundesl{\"a}ndern vor und nach der Intervention verglichen. Zus{\"a}tzlich wurde die Analyse f{\"u}r die verschiedenen SES-Gruppen durchgef{\"u}hrt. Wir untersuchten auch, ob Faktoren auf Mesoebene des Gesundheitssystems mit der Teilnahme an der J1 korrelierten. Ergebnisse Die Einf{\"u}hrung von „Dein Ticket zur J1" erh{\"o}hte die Teilnahme an der J1 um 1 \%. Obwohl eine h{\"o}here Bildung und berufliche Stellung der Eltern positiv mit der J1-Teilnahme korrelierten, war der Effekt der Intervention bei Kindern aus Familien mit niedrigerem SES st{\"a}rker (Anstieg um 5 \%). Die Kinderarztdichte auf Kreisebene korrelierte zudem positiv mit der Teilnahme an der J1. Schlussfolgerung Die Intervention hat das Potenzial, die sozio{\"o}konomische Ungleichheit bei der Inanspruchnahme von Gesundheitsleistungen zu verringern, da die Effekte f{\"u}r Kinder aus Familien mit niedrigerem SES st{\"a}rker waren. Es bedarf jedoch weiterer Maßnahmen, um Jugendliche {\"u}ber die J1 und die damit verbundenen gesundheitlichen Vorteile zu informieren. Zuk{\"u}nftige Studien sollten untersuchen, von welchen weiteren Faktoren die Wirksamkeit der Intervention abh{\"a}ngt, wie z. B. die Art und Anzahl der Kommunikationskan{\"a}le.}, language = {de} } @misc{ReissOttovaJordanBilzetal., author = {Reiß, Franziska and Ottov{\´a}-Jordan, Veronika and Bilz, Ludwig and Moor, Irene and Dadaczynski, Kevin and Helmchen, Ronja M. and Schierl, Theresa and Sendatzki, Saskia and Rathmann, Katharina and Kaman, Anne and Study Group Germany, HBSC and Ravens-Sieberer, Ulrike}, title = {Effects of the corona measures on the life of children and adolescents : results of the German HBSC study 2022}, series = {Journal of Health Monitoring}, volume = {2025}, journal = {Journal of Health Monitoring}, number = {10 (1)}, issn = {2511-2708}, doi = {10.25646/13002}, pages = {16}, abstract = {Background: The containment measures of the COVID-19 pandemic have changed many people's daily lives. The study examines how children and adolescents assess the impact of the coronavirus measures on various areas of life. Methods: Overall, N = 6,475 students (11 -15 years) in Germany took part in the representative 'Health Behavior in School-aged Children (HBSC)' study in 2022. Logistic regressions were performed to investigate the relationships between the perceived impact of the coronavirus measures on various areas of their lives by age, gender and family wealth. Results: Two years after the onset of the pandemic, children and adolescents reported both, positive and negative effects of the coronavirus measures. About a half of those surveyed perceived positive effects regarding social relationships. In contrast, approximately one in three respondents reported a deterioration in mental health and school performance. In particular, 11-year-olds, boys and wealthy students reported more often positive effects. Conclusions: The positive effects of the pandemic on the lives of children and adolescents in individual areas and the resilience (resistance) that is emerging here, as well as the results on more negative assessments of adolescents, girls and respondents with lower family wealth, can be used as a starting point for a needs-oriented and target group-specific health promotion in times of crisis. Future research should focus on the pandemic's long-term effects on young people's development.}, language = {en} } @misc{ReissOttovaJordanBilzetal., author = {Reiß, Franziska and Ottov{\´a}-Jordan, Veronika and Bilz, Ludwig and Moor, Irene and Dadaczynski, Kevin and Helmchen, Ronja M. and Schierl, Theresa and Sendatzki, Saskia and Rathmann, Katharina and Kaman, Anne and Deutschland, HBSC-Studienverbund and Ravens-Sieberer, Ulrike}, title = {Auswirkungen der Corona-Maßnahmen auf das Leben von Kindern und Jugendlichen: Ergebnisse der bundesweiten HBSC-Studie 2022}, series = {Journal of Health Monitoring}, volume = {10}, journal = {Journal of Health Monitoring}, number = {1}, organization = {Robert Koch-Institut, Berlin}, issn = {2511-2708}, doi = {10.25646/12954}, pages = {17}, abstract = {Hintergrund: Die Eind{\"a}mmungsmaßnahmen der COVID-19-Pandemie haben den Alltag vieler Menschen ver{\"a}ndert. Untersucht wird, wie Kinder und Jugendliche die Auswirkungen der Corona-Maßnahmen auf verschiedene Lebensbereiche einsch{\"a}tzen. Methode: An der repr{\"a}sentativen „Health Behaviour in School-aged Children (HBSC)"-Studie haben 2022 bundesweit N = 6.475 Sch{\"u}lerinnen und Sch{\"u}ler (11 -15 Jahre) teilgenommen. Mittels logistischer Regressionen wurden Zusammenh{\"a}nge zwischen den wahrgenommenen Auswirkungen der Corona-Maßnahmen auf verschiedene Bereiche ihres Lebens und den Faktoren Alter, Geschlecht und famili{\"a}rer Wohlstand untersucht. Ergebnisse: Zwei Jahre nach Pandemiebeginn berichteten Kinder und Jugendliche sowohl positive als auch negative Auswirkungen der Corona-Maßnahmen. Bei den sozialen Beziehungen nahm etwa die H{\"a}lfte der Befragten positive Auswirkungen wahr. Dagegen gab etwa jede bzw. jeder dritte Befragte Verschlechterungen bei der seelischen Gesundheit und den schulischen Leistungen an. Vor allem 11-J{\"a}hrige, Jungen und Befragte mit hohem famili{\"a}ren Wohlstand berichteten von positiven Auswirkungen. Schlussfolgerungen: Die in Einzelbereichen positiven Auswirkungen der Pandemie auf das Leben von Kindern und Jugendlichen und die sich hier abzeichnende Resilienz (Widerstandskraft) sowie die Ergebnisse zu negativeren Einsch{\"a}tzungen von Jugendlichen, M{\"a}dchen und Befragten mit niedrigerem famili{\"a}ren Wohlstand k{\"o}nnen als Ausgangspunkt f{\"u}r eine bedarfsorientierte und zielgruppenspezifische Gesundheitsf{\"o}rderung in Krisenzeiten genutzt werden. Gegenstand zuk{\"u}nftiger Forschung sollten die Langzeitfolgen der Pandemie auf die Entwicklung junger Menschen sein.}, language = {de} } @misc{IashchenkoSchuettigBammertetal., author = {Iashchenko, Iryna and Sch{\"u}ttig, Wiebke and Bammert, Philip and Schneider, Udo and Spallek, Jacob and Rattay, Petra and Schneider, Sven and Moor, Irene and Pischke, Claudia and Sundmacher, Leonie}, title = {Can invitation systems increase participation in preventive health screening among adolescents? : an evaluation of a state-wide intervention in Germany using a difference-in-differences analysis of claims data}, series = {European Journal of Public Health}, volume = {35}, journal = {European Journal of Public Health}, number = {2}, publisher = {Oxford University Press}, address = {Oxford}, issn = {1464-360X}, doi = {10.1093/eurpub/ckaf026}, pages = {312 -- 318}, abstract = {In Germany, routine screenings are used to monitor the health and development of children and adolescents, enabling timely discovery and treatment of health issues. One such screening, called J1, is recommended for adolescents aged 12-14 years, but participation is only 43\%. In the state of Bavaria, a lack of awareness is the main reason cited for not attending. 'Your Ticket to J1' was an invitation system implemented across the state to inform adolescents about the screening. Our study investigated whether this intervention increased J1 participation and if its effects varied by family socioeconomic position (SEP). We used pseudonymized data from a large statutory health insurer from 2016 to 2018 and containing 267 650 observations. To investigate the effect of the intervention, we employed a difference-in-differences analysis at the individual level. Assuming parallel trends at the state level, we compared J1 participation rates between Bavaria and other German states before and after the intervention. We additionally stratified analyses by SEP. The intervention led to an increase in J1 participation by about 1\%. In the stratified regressions, the effect size was larger for children from families with a lower SEP. J1 participation increased by about 4\% among adolescents whose primary insured parent had the lowest occupational status. A state-wide invitation system had a small but statistically significant positive impact on J1 participation and might reduce socioeconomic inequities in healthcare utilization. Informing adolescents about J1 appears to increase participation, particularly among those from families with a lower SEP.}, language = {en} } @misc{MoorBuckschFischeretal., author = {Moor, Irene and Bucksch, Jens and Fischer, Saskia M. and Reiß, Franziska and Schierl, Theresa and Sch{\"u}tz, Raphael and Sendatzki, Saskia and Winter, Kristina and HBSC Studienverbund, and Dadaczynski, Kevin}, title = {Die Gesundheit von Sch{\"u}ler:innen in Deutschland : Ergebnisse der HBSC-Studie}, series = {Public health forum}, volume = {33}, journal = {Public health forum}, number = {2}, publisher = {De Gruyter}, address = {Berlin ; Boston, Massachusetts}, issn = {0944-5587}, doi = {10.1515/pubhef-2025-0010}, pages = {126 -- 130}, abstract = {Die HBSC-Studie ist die weltweit gr{\"o}ßte Studie zur Kinder- und Jugendgesundheit und erfasst alle vier Jahre die Gesundheit und das Gesundheitsverhalten im Schulkontext. Die aktuellen Ergebnisse in Deutschland weisen auf Handlungsbedarf in den Bereichen psychische Gesundheit, (Cyber-)Mobbing, Einsamkeit, k{\"o}rperliche Aktivit{\"a}t, Gesundheitskompetenz und gesundheitliche Chancengleichheit hin. Vor allem M{\"a}dchen, gender-diverse, {\"a}ltere und sozio{\"o}konomisch benachteiligte Heranwachsende sollten adressiert werden.}, language = {de} } @misc{SchuetzReissMooretal., author = {Sch{\"u}tz, Raphael and Reiss, Franziska and Moor, Irene and Kaman, Anne and Bilz, Ludwig}, title = {Lonely children and adolescents are less healthy and report less social support : a study on the effect of loneliness on mental health and the moderating role of social support}, series = {BMC public health}, volume = {25}, journal = {BMC public health}, publisher = {BioMed Central (BMC)}, address = {London}, issn = {1471-2458}, doi = {10.1186/s12889-025-23247-5}, pages = {1 -- 21}, abstract = {Background Loneliness among children and adolescents has been increasingly recognized as a public health issue, for example, because of its associations with mental health problems. Nevertheless, there is a lack of evidence regarding the links between loneliness and mental health and the potential buffering role of social support. Thus, this study aims to investigate the prevalence of loneliness among children and adolescents in Germany and its associations with mental health. Furthermore, we analyze whether social support is negatively correlated with loneliness and mental health problems and whether it acts as a moderator of the association between loneliness and mental health issues. Methods This study analyzed data from the Health Behavior in School-aged Children (HBSC) survey in Germany in 2022, which included 6,475 students aged 11, 13, and 15 years (girls: 50,6\%, Mage = 13,4, SD = 1,7). Loneliness was measured via the University of California-Los Angeles Scale (UCLA) and a single-item measure. The mental health indicators included subjective health, life satisfaction, and multiple psychosomatic complaints. Social support from family, teachers, and classmates was assessed. Chi-square tests, t tests, logistic regressions, and moderation analyses were conducted. Results A total of 17.2\% of the students reported high levels of loneliness. Compared with boys, girls and gender-diverse students reported higher rates of loneliness. High levels of loneliness were strongly linked to poorer subjective health (OR = 5.56, p <.001), lower life satisfaction (OR = 7.32, p <.001), and increased psychosomatic complaints (OR = 7.38, p <.001). High social support from family, teachers, and students was associated with reduced loneliness and better mental health outcomes. Teacher support in grades 7 and 9 buffered the effect of loneliness on multiple psychosomatic complaints. Conclusion The findings highlight that loneliness is a prevalent phenomenon among children and adolescents and is strongly associated with mental health issues. Greater social support is linked to reduced loneliness and better mental health, so targeted interventions to promote social support in schools and families are needed to address loneliness. Future research should explore longitudinal relationships and further elucidate the mechanisms underlying these associations.}, language = {en} } @book{SchuetzBilzMooretal., author = {Sch{\"u}tz, Raphael and Bilz, Ludwig and Moor, Irene and Kaman, Anne and Reiß, Franziska and HBSC Study Group Germany,}, title = {Einsamkeit bei Kindern und Jugendlichen in Deutschland : schulische und gesundheitsbezogene Zusammenh{\"a}nge}, publisher = {Institut f{\"u}r Sozialarbeit und Sozialp{\"a}dagogik e.V. - Kompetenznetz Einsamkeit}, address = {Berlin ; Frankfurt am Main}, isbn = {978-3-88493-301-5}, pages = {80}, abstract = {Hintergrund: Einsamkeit ist bei Kindern und Jugendlichen weit verbreitet und steht mit zahlreichen physischen, psychischen und schulischen Faktoren im Zusammenhang. F{\"u}r Deutschland liegen dazu jedoch erst wenige empirische Erkenntnisse vor. Ziel dieser Expertise ist es daher, einen {\"U}berblick des Forschungsstandes zum Thema zu liefern und mit Hilfe aktueller Daten zu untersuchen, inwieweit Einsamkeit bei Kindern und Jugendlichen mit schulischen Aspekten (Schulform, Schulzufriedenheit, schulischen Belastungen und schulischer Unterst{\"u}tzung) in Verbindung steht. Methodik: Die HBSC-Studie ist eine internationale Forschungskooperation unter Schirmherrschaft der Weltgesundheitsorganisation (WHO) und wird seit {\"u}ber 40 Jahren in einem Vierjahresrhythmus in mittlerweile {\"u}ber 50 L{\"a}ndern durchgef{\"u}hrt. Deutschland ist seit 1993 Partner des internationalen HBSC-Konsortiums und seit 2009 regelm{\"a}ßig mit einer bundesweit repr{\"a}sentativen Stichprobe an den Erhebungen beteiligt. In der aktuellen Befragung in Deutschland wurden erstmals die optionalen Fragen zum Thema Einsamkeit aufgenommen. Somit zielt die vorliegende Expertise darauf ab, aktuelle Daten zur Einsamkeit, zur Gesundheit und zu sozialen Beziehungen sowie soziodemografischen Faktoren von Sch{\"u}lerinnen und Sch{\"u}lern zu analysieren und einem breiten Publikum zur Verf{\"u}gung zu stellen. Ergebnisse: Gemessen mit der UCLA-Skala sind 11,8 \% der Sch{\"u}ler*innen als einsam einzustufen. Hierbei f{\"a}llt auf, dass M{\"a}dchen in h{\"o}herem Maße einsam sind (14,8 \%) als Jungen (7,4 \%). Eine m{\"o}gliche Erkl{\"a}rung f{\"u}r eine st{\"a}rkere Einsamkeit bei M{\"a}dchen kann eine erh{\"o}hte Bereitschaft sein, nicht erf{\"u}llte emotionale Bed{\"u}rfnisse zu kommunizieren. Schlussfolgerung: Einsamkeit in der Kindheit und Jugend spielt auch im schulischen Kontext eine wichtige Rolle. Sch{\"u}ler*innen sollten in ihren emotionalen und sozialen Kompetenzen gest{\"a}rkt werden. Lehrkr{\"a}fte k{\"o}nnen zu einem positiven Schulklima und einer sozialen Unterst{\"u}tzung der Lernenden beitragen und so Einsamkeit begegnen.}, language = {de} }