Dobewall Henrik, Koivusilta Leena, Karvonen Sakari, Lindfors Pirjo, Kinnunen Jaana M, Vainikainen Mari-Pauliina, Rimpelä Arja
Faculty of Social Sciences, Unit of Health Sciences, Tampere University, Tampere, Finland.
PERLA-Tampere Centre for Childhood, Youth and Family Research, Tampere University, Tampere, Finland.
Eur J Public Health. 2020 Jun 1;30(3):438-443. doi: 10.1093/eurpub/ckz178.
The Finnish government has emphasized the need to expedite educational transitions. We study if a late start of upper secondary education is related to health-related selection, namely health-compromising behaviours in adolescence.
A large cohort of adolescents from the seventh (12-13 years) and ninth (15-16 years) grades answered online classroom surveys (total n = 10 873). They were followed to the start of upper secondary education, obtained from the Joint Application Registry. We compared those who continued studies directly from the ninth grade with later starters. We measured late bedtime, breakfast not every school day, tooth brushing less than twice-a-day, monthly alcohol consumption, weekly smoking, daily energy drinks, physical activity <6 days/week and excessive screen time. Multilevel logistic regressions and latent class analyses were conducted.
In gender and school adjusted models in the seventh grade, all behaviours except physical activity predicted the late start. The strongest predictor was smoking, OR = 2.96 (CI = 2.25-3.89). In the ninth grade, smoking, breakfast, tooth brushing and energy drinks, OR = 1.80, (CI = 1.36-2.39, strongest), were predictive. After controlling for sociodemographic background and academic achievement, associations for alcohol and screen time became non-significant in the seventh grade. In the ninth grade, only screen time remained significant, OR = 1.33 (CI = 1.04-1.71). Health-compromising behaviours formed clusters. Belonging to the unhealthy cluster predicted the late start in both grades, in adjusted models only in the seventh grade.
Students with health-compromising behaviours are less likely to start upper secondary education directly after the compulsory education. This may increase the risk for fragmentary educational trajectories and work careers.
芬兰政府强调了加快教育过渡的必要性。我们研究高中教育起步较晚是否与健康相关的选择有关，即青少年时期危害健康的行为。
一大群来自七年级（12 - 13岁）和九年级（15 - 16岁）的青少年回答了在线课堂调查问卷（总样本量n = 10873）。他们被追踪至高中教育开始，数据来自联合申请登记处。我们将直接从九年级继续学业的学生与起步较晚的学生进行了比较。我们测量了晚睡、并非每个上学日都吃早餐、每天刷牙少于两次、每月饮酒、每周吸烟、每天饮用能量饮料、每周体育活动少于6天以及过度使用电子设备的时间。进行了多水平逻辑回归和潜在类别分析。
在七年级的性别和学校调整模型中，除体育活动外，所有行为都能预测起步较晚。最强的预测因素是吸烟，比值比（OR）= 2.96（置信区间CI = 2.25 - 3.89）。在九年级，吸烟、早餐、刷牙和饮用能量饮料（OR = 1.80，CI = 1.36 - 2.39，最强）具有预测性。在控制了社会人口背景和学业成绩后，七年级中饮酒和使用电子设备时间的关联变得不显著。在九年级，只有使用电子设备时间仍然显著，OR = 1.33（CI = 1.04 - 1.71）。危害健康的行为形成了集群。属于不健康集群在两个年级都能预测起步较晚，在调整模型中仅在七年级显著。
有危害健康行为的学生在义务教育后直接开始接受高中教育的可能性较小。这可能会增加教育轨迹和职业生涯碎片化的风险。
