Transcript PowerPoint-presentation

Health-related empowerment
predicts self-rated health
among adolescent girls in Sweden
Lars Jerdén
6th Nordic Health Promotion Research Conference
2009-08-21
Lars Jerdén
Family physician, Jakobsgårdarna, Borlänge
Centre for Clinical Research Dalarna
Public Health Sciences, Umeå University
Swedish National Institute of Public Health
VIP
project
(Very
Interesting
Person)
Intervention
N=339
Control
N=707
Pilot study
N=150
Q1
Q2
Q3
I
Q4
Q1
Q2
Q3
I
Q4
Q1
Qx
2002
2003
Qy
2004
2005
2006
2007
2008
2009
Self-rated health
Three problems during adolescence:
Gets worse
A gender difference evolves
Declining since mid-1980s
Self-rated health
”How do you consider your well-being most of
the time?
High:
Medium:
Low:
Very good
Rather good
Nor good nor bad + rather bad +
very bad
GIRLS
7th grade
9th grade
HIGH
47.4%
HIGH
29.8%
76
39
4
101
MEDIUM
45.1%
MEDIUM
56.1%
114
9
12
LOW
7.5%
17
27
LOW
14.0%
BOYS
7th grade
9th grade
HIGH
56.1%
HIGH
45.8%
122
47
4
MEDIUM
38.1%
MEDIUM
44.2%
79
79
9
18
LOW
5.8%
9
11
LOW
10.1%
Empowerment: our choices
A state, measured longitudinally
Individual level
Three dimensions: self-efficacy,
competence, and social interaction
Self-efficacy and competence measured
in the domain of health
7th grade
9
8
7.56
Self-rated
health
7.49
7.01
7
6.81
High
6.15
5.52
6
Medium
Low
5
4
3
Boys
Girls
9th grade
9
8
7.75
7.80
7.26
7
Self-rated
health
6.90
High
6.10
5.99
6
Medium
Low
5
4
3
Boys
Girls
Association between variables 7th grade and self-rated
health 9th grade. Ordinal multivariate regression
Variables 7th grade
Empowerment
Self esteem:
Yes, most often
Yes, sometimes
No, seldom
School experience
Positive
Negative
Physical exercise
Mood in family
Support from family:
Yes, most often
Yes, sometimes
No, seldom
Self-rated health 9th grade
Boys
Girls
OR
CI 95%
OR
CI 95%
1.13
0.82-1.56
1.38
1.02-1.88
1.00
0.51
0.43
ref
0.27-0.94
0.09-1.88
1.00
0.60
0.54
ref
0.34-1.04
0.20-1.39
1.00
1.16
1.16
0.60
ref
0.61-2.17
0.97–1.38
0.41-0.87
1.00
0.34
1.10
0.83
ref
0.13-0.85
0.90-1.34
0.58-1.16
1.00
0.75
0.21
ref
0.35-1.59
0.03-1.46
1.00
0.63
0.57
ref
0.29-1.38
0.06-4.97
Association between variables 7th grade and self-rated
health 9th grade. Ordinal multivariate regression
Variables 7th grade
Empowerment
Self esteem:
Self-rated health 9th grade
Boys
Girls
OR
CI 95%
OR
CI 95%
1.13
0.82-1.56
1.38
1.02-1.88
Yes, most often
Yes, sometimes
No, seldom
1.00
0.51
0.43
ref
0.27-0.94
0.09-1.88
1.00
0.60
0.54
ref
0.34-1.04
0.20-1.39
Positive
Negative
1.00
1.16
1.16
0.60
ref
0.61-2.17
0.97–1.38
0.41-0.87
1.00
0.34
1.10
0.83
ref
0.13-0.85
0.90-1.34
0.58-1.16
Yes, most often
Yes, sometimes
No, seldom
1.00
0.75
0.21
ref
0.35-1.59
0.03-1.46
1.00
0.63
0.57
ref
0.29-1.38
0.06-4.97
School experience
Physical exercise
Mood in family
Support from family:
Self-esteem:
”Do you like yourself?”
School experience:
”How do you like school?”
Mood in family:
”How do you consider the mood in your
family?”
Association between variables 7th grade and self-rated
health 9th grade. Ordinal multivariate regression
Variables 7th grade
Self-rated health 9th grade
Boys
Girls
OR
CI 95%
OR
CI 95%
Empowerment
1.13
0.82-1.56
1.38
1.02-1.88
Yes, most often
1.00
0.51
0.43
ref
0.27-0.94
0.09-1.88
1.00
0.60
0.54
ref
0.34-1.04
0.20-1.39
1.00
1.16
1.16
0.60
ref
0.61-2.17
0.97–1.38
0.41-0.87
1.00
0.34
1.10
0.83
ref
0.13-0.85
0.90-1.34
0.58-1.16
1.00
0.75
0.21
ref
0.35-1.59
0.03-1.46
1.00
0.63
0.57
ref
0.29-1.38
0.06-4.97
Self esteem:
Yes, sometimes
No, seldom
School experience
Positive
Negative
Physical exercise
Mood in family
Support from family:
Yes, most often
Yes, sometimes
No, seldom
Association between variables 7th grade and self-rated
health 9th grade. Ordinal multivariate regression
Variables 7th grade
Empowerment
Self esteem:
Yes, most often
Yes, sometimes
No, seldom
School experience
Positive
Negative
Physical exercise
Mood in family
Support from family:
Yes, most often
Yes, sometimes
No, seldom
Self-rated health 9th grade
Boys
Girls
OR
CI 95%
OR
CI 95%
1.13
0.82-1.56
1.38
1.02-1.88
1.00
0.51
0.43
ref
0.27-0.94
0.09-1.88
1.00
0.60
0.54
ref
0.34-1.04
0.20-1.39
1.00
1.16
1.16
0.60
ref
0.61-2.17
0.97–1.38
0.41-0.87
1.00
0.34
1.10
0.83
ref
0.13-0.85
0.90-1.34
0.58-1.16
1.00
0.75
0.21
ref
0.35-1.59
0.03-1.46
1.00
0.63
0.57
ref
0.29-1.38
0.06-4.97