Abstract
Objectives
The paper aims to study the relationships between psychosocial school environment and health risk behaviours (cigarette smoking, alcohol consumption, drunkenness, bullying perpetration and early start of sexual life) in a representative sample of Bulgarian adolescents.
Methods
We apply multilevel analysis, using data from the Bulgarian 2017/2018 “Health Behaviour in School-aged Children (HBSC)” Study.
Results
There is a significant variation between schools in Bulgaria in the proportions of students who smoke cigarettes, drink alcohol, get drunk and have an early start of sexual life. Lower school satisfaction is significantly associated with higher odds of smoking and drunkenness. The effect of school pressure differs for smoking and bullying perpetration. The effect of student support also differs for certain types of health risk behaviours. Higher student support is positively associated with frequent alcohol consumption and drunkenness. The relationship between teacher support and alcohol abuse is negative.
Conclusions
There is a significant association between characteristics of psychosocial school environment and Bulgarian adolescents’ risk health behaviours (cigarette smoking, alcohol consumption, drunkenness, bullying perpetration). Comprehensive and effective health promotion policies in Bulgarian schools are needed in order to facilitate healthy lifestyles.
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Funding
The survey was conducted in Bulgaria by a research team from the Institute of Population and Human Studies at the Bulgarian Academy of Sciences with the financial support of the Ministry of Education and Science of Bulgaria.
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The authors declare that they have no conflicts of interest.
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Ethical approval to conduct the survey was obtained by the Ministry of Education and Science of Bulgaria.
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The study complies with the ethical standards for research with human participants as laid down in the 1964 Declaration of Helsinki and its later amendments or comparable ethical standards.
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Participation in the study was anonymous and voluntary. Active consent was sought from school principals and parents. Only children whose parents gave their written informed consent participated in the study. All the survey procedures for each data collection cycle were documented and can be downloaded from http://www.hbsc.org/methods/index.html.
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This article is part of the special issue “Adolescent health in Central and Eastern Europe”.
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Dimitrova, E., Kotzeva, T. & Alexandrova-Karamanova, A. Psychosocial school environment and health risk behaviours of adolescents in Bulgaria: results from multilevel analysis. Int J Public Health 65, 1331–1344 (2020). https://doi.org/10.1007/s00038-020-01482-4
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DOI: https://doi.org/10.1007/s00038-020-01482-4