Maes Lea, Lievens John
Department of Public Health, University Hospital, Ghent University, Block A, De Pintelaan 185, 9000, Gent, Belgium.
Soc Sci Med. 2003 Feb;56(3):517-29. doi: 10.1016/s0277-9536(02)00052-7.
The main aim of this article is to assess the relationship between the structural and (health) policy variables of the school and characteristics of the individual on the risk and health behaviour of adolescents. Individual and school level effects on seven health-related behaviours are simultaneously estimated, using multilevel modelling. The data are from the Flemish health behaviour in school-aged children study in Belgium. Data are used from 29 Flemish schools in which students (N=3225), school administrators (N=29) and teachers (N=1132) were surveyed with anonymous written questions. The analysis confirms previous findings concerning individual level effects. Although differences between schools in risk and health behaviour were found to originate mainly from differences in pupil characteristics, substantial variation between schools remained with regard to regular smoking, drinking habits and tooth brushing after controlling for individual effects. A wide range of school structure and policy variables were taken into account, but only few of them were found to influence the health and risk behaviour of young people. Moreover, the study could not detect an effect of health promotion policy at school. The analysis therefore only partially confirms the hypothesis that the school has an impact on the health behaviour of young people. The findings demonstrate the need for a more thorough examination of the paths by which schools can influence the health behaviour of their pupils.
本文的主要目的是评估学校的结构和（健康）政策变量与个体特征对青少年风险和健康行为的关系。利用多层次模型同时估计个体和学校层面因素对七种与健康相关行为的影响。数据来自比利时弗拉芒地区学龄儿童健康行为研究。数据取自29所弗拉芒学校，对学生（N = 3225）、学校管理人员（N = 29）和教师（N = 1132）进行了匿名书面问卷调查。分析证实了先前有关个体层面影响的研究结果。虽然发现学校在风险和健康行为方面的差异主要源于学生特征的差异，但在控制个体因素后，学校在经常吸烟、饮酒习惯和刷牙方面仍存在显著差异。考虑了广泛的学校结构和政策变量，但发现其中只有少数变量会影响年轻人的健康和风险行为。此外，该研究未能发现学校健康促进政策的效果。因此，该分析仅部分证实了学校对年轻人健康行为有影响这一假设。研究结果表明，有必要更深入地研究学校影响学生健康行为的途径。
