Improving Adolescent Health: Translating Health Behaviour in School-aged Children Evidence Into Policy
The Health Behaviour in School-aged Children (HBSC) study has informed the development and implementation of policy for children and adolescents for over three decades. Every four years, the HBSC study provides evidence on health behaviors, health outcomes, and social environments of boys and girls across Europe and North America. The HBSC study has a working Policy Development Group that cultivates relationships with key stakeholders, disseminates widely HBSC research, and facilitates discussion and cross-fertilization of ideas and priorities. To date, HBSC data have been central to health promotion efforts and developments in practice, policy, and legislation at both national and international levels.
National policy impact
National governments and other national stakeholders have used HBSC data to identify priority areas for adolescent health, set targets for health improvement, and monitor the impact of policies and programs. Examples include the following:
System changes in health and education sectors in Wales
HBSC data supported the School Health Research Network led by Cardiff University with inputs from Welsh Government and Public Health Wales. All secondary schools in Wales are covered by the network and benefit from receiving individualized reports basedon their own data.
Reducing alcohol consumption in Israel, France, and the Netherlands
Together with the European School Survey Project on Alcohol and Other Drugs (ESPAD), HBSC had an important role in raising awareness about high levels of adolescent alcohol use and informing alcohol-related policy actions in Israel, France, and the Netherlands.
Following a considerable increase in binge alcohol use since 1994, Israel developed a national strategy to reduce alcohol consumption among children and youth. The strategy was implemented in 2010. In 2014, the HBSC survey reported a decrease of around 50% in “binge alcohol use” among young people in Israel, from 21% in 2009 to 11% in 2014, a trend sustained to this day.
The Netherlands responded to high levels of adolescent alcohol use with national public awareness campaigns, a set of targeted interventions for parents and adolescents, as well as more stringent policies on alcohol use, including increasing the legal alcohol use age from 16 to 18 years. Subsequent HBSC and ESPAD surveys revealed a significant decline in alcohol consumption among Dutch adolescents between 2005 and 2013, and a stable pattern afterward.
In France, the HBSC and ESPAD surveys have merged at the national level to monitor adolescent health behaviors and evaluate the impact of prevention programs aimed at secondary school students. The merged survey “EnCLASS” is now the main source of indicators on adolescents, used to monitor the impact of the new national policy plan to reduce drug consumption and addiction behavior in France.
Promoting healthy eating habits in Wales and Latvia
In Wales, HBSC data helped to strengthen the case for the Welsh Government’s Primary School Free Breakfast Initiative introduced in 2004.
In Latvia, HBSC findings helped shape national policies promoting healthy eating habits on two separate occasions. Latvia became one of the first European countries to introduce an excise tax on sweetened drinks in 2004, accompanied by a ban on soft drinks, sweets, and salty snacks in schools in 2006.
Improving sexual and reproductive health in Scotland
The HBSC study played a key role in the development of the first Scottish Strategy on pregnancy and parenthood among young people.
Promoting positive mental health in Nordic countries
Since the beginning of the 1990s, the Swedish HBSC study has highlighted an increase in multiple health complaints experienced by adolescents. In response, Sweden has invested heavily in schools and health care systems, held cross-sectoral consultations, and appointed a national coordinator to support the work of agencies, local authorities, regions, and nongovernmental organizations in the area of mental health.
Sweden is also contributing to a regional project, supported by the Nordic Council of Ministers, with the HBSC teams in Denmark, Finland, Iceland, and Norway. The “Nordic collaboration on positive mental health” aims to improve the well-being of adolescents in the region, identify best policy practices, and channel the HBSC research into effective prevention and intervention strategies.
International policy impact
The HBSC network is involved in a range of activities that impact international policy related to children and adolescent health. Through its partnership with the World Health Organization (WHO) Regional Office for Europe, the HBSC findings influence European-level policy-making, such as Investing in Children: the European Child and Adolescent Health strategy, monitoring, and country feedback on its implementation.
Topic-based reports that provide more in-depth analysis and highlight targeted priority areas are published separately. For example, recent reports on obesity and alcohol use have presented key trends and drawn attention to gender and socioeconomic inequalities across the WHO European Region.
By influencing the international policy arena, HBSC promotes progress toward achieving the United Nation’s Sustainable Development Goals and the supporting action plans such as the Accelerated Action for the Health of Adolescents.
Data from the HBSC study provide vital evidence to guide and monitor the effectiveness of health policies and programs overtime. As young people transition from childhood to adulthood, it is essential to foster their full potential and make their lives visible through policies and actions that are developmentally appropriate, evidence informed, rights based, and sustainable.