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Measuring the health and health behaviours of adolescents through cross-national survey research: recent developments in the Health Behaviour in School-aged Children (HBSC) study


Cross-national surveys have the potential to make a significant contribution to the study of adolescent health. The Health Behaviour in School-aged Children (HBSC) study was among the first international studies established in three countries in 1983 and growing to more than 40 countries for the seventh wave of fieldwork in 2005/06. The original aim of the study has remained largely the same since its inception, to increase understanding of adolescent health behaviours, health and well being in their social context and to collect high quality comparable data to achieve this. The challenges to producing valid and reliable data from cross-national, school-based research were recognised from the outset and reflected in the methodological development of the study. The paper sets out how these challenges were addressed, examining key aspects of the methodology, including study design, questionnaire content, data collection and file preparation. These methods are still in place, but HBSC has had to recognise the social and political change of recent years. The challenges that were recognised 20 years ago are magnified today, with the study embracing a variety of cultures across Europe and North America. As demand for HBSC data has grown from the scientific and policy communities, greater attention has been paid to scrutiny of the data produced, matched by a sharper focus on continuous improvement in data quality. Key developments of recent years are summarised in the paper, focusing on study organisation, review of the international Research Protocol, strengthening support for sampling, greater attention to translation and improvements in data processing and documentation. It is concluded that the HBSC study has evolved over the last 20 years and continues to do so, recognising the importance of data quality, but also the constraints of cross-national survey research. Looking to the future, some outstanding issues for consideration are touched upon, including the opportunities and challenges for expanding our knowledge on the possibilities for gathering cross-national and cross-cultural data, with the HBSC study being used to build capacity in understanding the health needs of young people in other regions of the world.

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The authors would like to acknowledge principal investigators of the HBSC International Research Network: Dr. Wolfgang Dür, University of Vienna, Austria; Prof Lea Maes, University of Gent, Belgium; Dr Danielle Piette, Université Libre de Bruxelles, Belgium; Dr Lidiya Vasileva, Bulgarian Academy of Sciences, Bulgaria; Dr Will Boyce, Queen’s University, Canada; Dr Marina Kuzman, Croatian National Institute of Public Health, Croatia; Dr Ladislav Csémy, Prague Psychiatric Centre, Czech Republic; Associate Prof Pernille Due, University of Copenhagen, Denmark; Mr Antony Morgan, National Institute for Health and Clinical Excellence (NICE), England; Dr Katrin Aasvee, National Institute for Health Development, Estonia; Dr Jorma Tynjälä, University of Jyväskylä, Finland; Dr Emmanuelle Godeau, Service médical du Rectorat de Toulouse, France; Prof Klaus Hurrelmann, University of Bielefeld, Germany; Associate Prof Anna Kokkevi, University Mental Health Research Institute (UMHRI), Greece; Dr Birgit Niclasen, Lægeklinikken (District Medical Centre), Greenland; Dr Ágnes Németh, National Institute of Child Health, Hungary; Dr Thoroddur Bjarnason, University of Akureyri, Iceland; Dr Saoirse Nic Gabhainn, National University of Ireland, Republic of Ireland; Dr Yossi Harel, Bar-Ilan University, Israel; Prof Franco Cavallo, Universita degli Studi di Torino, Italy; Dr. Iveta Pudule, Health Promotion State Agency, Latvia; Dr Apolinaras Zaborskis, Kaunas University of Medicine, Lithuania; Dr Yolande Wagener, Ministère de la Santé, Luxembourg ; Ms Lina Kostarova Unkovska, Center for Psychosocial and Crises Action (CPCA), tfyr Macedonia; Ms Marianne Massa, Health Promotion Department, MALTA; Prof Wilma A.M. Vollebergh, the Netherlands Institute of Mental Health and Addiction, the Netherlands; Dr Oddrun Samdal, University of Bergen, Norway; Dr Joanna Mazur, Mother and Child National Research Institute, Poland; Dr Margarida Gaspar de Matos, Universidade Tecnica de Lisboa, Portugal; Prof. Adriana Baban, Babes-Bolyai University, Romania; Dr Alexander Komkov, SPb Research Institute of Physical Culture, Russia; Prof Candace Currie, University of Edinburgh, Scotland; Dr Elena Morvicová, Public Health Authority of the Slovak Republic, Slovak Republic; Ms Helena Jericek, Institute of Public Health of the Republic of Slovenia, Slovenia; Dr Carmen Moreno Rodriguez, University of Seville, Spain; Dr Ulla Marklund, National Institute of Public Health, Sweden; Dr Holger Schmid, Swiss Institute for the Prevention of Alcohol and Drug problems, Switzerland; Prof Oya Ercan, Istanbul University, Turkey; Dr. Ron Ianotti, National Institute of Child Health and Human Development, USA; Dr Olga Balakireva, Ukranian Institute for Social Research, Ukraine; Mr Chris Roberts, Welsh Assembly Government, Wales.

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Roberts, C., Currie, C., Samdal, O. et al. Measuring the health and health behaviours of adolescents through cross-national survey research: recent developments in the Health Behaviour in School-aged Children (HBSC) study. J Public Health 15, 179–186 (2007).

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  • Adolescents
  • Health behaviour
  • Cross-national survey research
  • Methodology