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Background The transition of young people from school to university has many health implications. Food choice at the university can differ because of childhood food consumption patterns, sex and the living arrangements. Food consumption may change especially if students are living away from home. We aimed to assess food consumption patterns among university students from four European countries and how they differ by their living arrangements. Methods We analysed data from a cross-country survey assessing health and health behaviours of students. The sample comprised a total of 2402 first year undergraduate students from one university in each of the countries of Germany, Denmark, Poland and Bulgaria. Food consumption was assessed by means of a food frequency questionnaire with 9 food groups (indicators). Results Students’ food consumption patterns differed across the countries. Frequent consumption of unhealthy items was common. Bulgarian students reported most often frequent consumption of sweets and cakes and snacks (e.g. chips and fast food). Polish students reported the least frequent consumption of vegetables and a low consumption of fruits. Across all countries except Bulgaria, men reported substantially more often frequent consumption of snacks than women. Students living at parental home consumed more fruit, vegetables, and meat than those who resided outside of their family home in all studied countries. There was more variation with regard to cakes and salads with more frequent consumption of cakes among Bulgarian female students and Danish male students and more frequent consumption of salads among Danish female students not living at parental home, compared to students from other countries. Conclusions Nutrition habits of university students differed across countries and by sex. Students living at parental home displayed more healthy nutrition habits, with some exceptions.

Background Adolescence is a stage of life characterised by significant biological, social, and emotional changes, making it a particularly challenging period for mental health. Young people face these challenges within environments shaped by social, cultural, and economic dynamics, often rooted in structural inequality. In urban contexts such as the megacity of Bogotá, many adolescents live in conditions of social inequality. The COVID-19 pandemic intensified pre-existing issues and introduced new challenges to adolescent mental health. This study explores the mental health of adolescents living in an urban setting characterised by social inequality, including both the benefits and challenges associated with the COVID-19 pandemic. Methods Using a qualitative approach, direct observations were conducted in public schools and socially vulnerable neighbourhoods in Bogotá. Complementary problem-centred interviews were carried out with adolescents and school counsellors at three public schools in these areas. The interviews focused on topics related to social inequality, mental health, and key experiences during the COVID-19 pandemic. A reflexive thematic analysis was conducted. The research adhered to national and international ethical guidelines. Results A total of 95 h of field observation were conducted, alongside 42 interviews with adolescents aged 12–18 (57% female) and six school counsellors, most of whom were female psychologists. The findings are presented through the the Critical Ecological Model of Adolescents’ Mental Health, which illustrates adolescents’ mental health and its changes concerning the pandemic across four levels: (a) personal: self-care, life plans, emotional distress, and post-pandemic coping; (b) interpersonal: family and peer relationships; (c) community: support networks, disadvantage, and violence; and (d) organisational/media: school-based support and mental health promotion and care. Conclusions In urban settings marked by social inequality, supportive environments within families, schools, communities, and institutions are essential. Engaging with adolescents’ perspectives highlights both their needs and their capacities to navigate challenges and support mental health across different contexts. Structural strategies are required to confront social inequalities and promote both individual and collective actions to support adolescent mental health, particularly in post-pandemic contexts.

VR FestLab is a virtual reality party simulation application. The tool allows users to make decisions while experiencing a virtual party where they are offered alcohol. This study examines the user experience, game satisfaction, and engagement of 181 adolescent users (aged 15–18) with VR FestLab involving seven schools in Denmark. All user experience factors of the short user experience questionnaire were rated positively or neutral, and 66% of the students liked the VR experience. Neither the user experience score nor a score for game satisfaction and engagement were associated with sex, age, perceived family affluence, school performance, alcohol consumption and attitudes or mental health of students. Overall, positive user experiences and game satisfaction of VR FestLab were found not to differ according to student characteristics. We conclude that virtual simulations offer new ways for developing drinking refusal skills that are attractive and acceptable for adolescent users.

Background Student life offers many opportunities for personal development; however, this transitional phase often also poses challenges to mental health. Various factors associated with university life, such as academic stress and financial burdens, have been found to exacerbate psychological distress and contribute to increased alcohol and substance use among students. Our aim is to closely examine (i) components of available digital public health interventions (DPHIs), (ii) to evaluate their effectiveness for promoting well-being, health behaviors, and reducing symptoms of mental disorders among university students and (iii) to rate the quality of the evidence identified in this rapid review. Methods We conducted a rapid review to capture the evidence on DPHIs for university students. We adhered to the methodological criteria recommended by the Cochrane Rapid Reviews Methods Group and PRISMA. The literature search was performed in Ovid MEDLINE to look for articles related to university students, mental well-being, mental health, and DPHIs published between June 2018 - June 2023. The selection was carried out in two steps: Screening of titles and abstracts and screening of full texts. Results One thousand one hundred thirty-two articles were screened, of which 24 met the inclusion criteria for data extraction. (i) Of the intervention components in the included studies, 18 used web-based platforms, while six used smartphone applications. The interventions were aimed at improving mental health (68%), reducing substance use (28%), promoting physical activity (PA) (36%) and changing eating habits (16%). (ii) 42% of the included studies were able to demonstrate significant effects in the intended direction for mental health, 4% for substance use, 25% for PA and 8% for eating behavior. (iii) The quality assessment revealed that 58% of the studies were classified with ‘some concerns’, indicating moderate bias, while 29% were classified as ‘high risk’, suggesting considerable bias affecting the validity of the results. Conclusion This rapid review comprehensively summarized intervention components of DPHIs. Further, the findings of this review provide significant insights into the effectiveness of DPHIs targeting mental well-being and health behaviors among university students. The studies included in the analysis demonstrate varying degrees of success across different domains, highlighting both the potential and limitations of DPHIs.

Background Violence related injury is a serious public health issue all over the world. This study aims to assess the association between several socio-economic factors and intimate partner violence (IPV) in Nepal. Methods A cross-sectional study was conducted among 236 women working in carpet and garment factories in Kathmandu, Nepal. Interviews were conducted to collect quantitative data on three forms of IPV, namely physical violence, psychological violence and sexual violence, as well as on a number of potentially associated factors. Results Twenty-two percent of women experienced sexual IPV, 28% physical IPV and 35% psychological IPV at least once in the last 12 months. The variables independently associated with at least one form of IPV were: age of the woman >29 years [OR = 4.23, p  = 0.025 for physical IPV; OR = 6.94, p  = 0.008 for sexual IPV; OR = 3.42, p  = 0.043 for psychological IPV], alcohol consumption of the husband [OR = 9.97, p  < 0.001 for physical IPV; OR = 3.76, p  = 0.004 for sexual IPV; OR = 4.85, p < 0.001 for psychological IPV], education of the husband above primary level [OR = 0.43, p  = 0.013 for physical IPV; OR = 0.51, p  = 0.033 for psychological IPV], and economic dependency of the woman on the husband [OR = 3.04, p  = 0.021 for physical IPV; OR = 2.97, p  = 0.008 for psychological IPV]. Conclusions This study identified various factors associated with IPV and showed that economic dependence of wives on their husband was among the most important ones. Thus, for the prevention of IPV against women, long term strategies aiming at livelihood and economic empowerment as well as independence of women would be suggested.

We assessed associations between educational achievement and alcohol consumption. We employed five alcohol consumption measures (length of time of and amount consumed during most recent drinking occasion, frequency of alcohol consumption, heavy episodic drinking, problem drinking); and three educational achievement indicators (students' subjective importance of achieving good grades, students' appraisal of their academic performance in comparison with peers, students' actual module mark). Males were positively associated with all five alcohol consumption measures. Age was negatively associated with three alcohol consumption measures. While students´ importance of good grades was negatively associated with three alcohol consumption measures, academic performance in comparison with peers was negatively associated with heavy episodic drinking. Actual module mark was not associated with any alcohol consumption measure. Alcohol consumption showed negative associations with motivation for and subjectively achieved academic performance. University alcohol prevention activities might have positive impact on students' academic success.

Discrimination poses a threat to the mental health of university students, especially those affected by social inequality, yet understanding its intersectional impact remains limited. This study examines the intersection of social inequalities with perceived discrimination to explore differences in mental health among students in Germany. Data from the cross-sectional project \"Survey on study conditions and mental health of university students\" (n = 14,592) were analysed using Multilevel Analysis of Individual Heterogeneity and Discriminatory Accuracy (MAIHDA). Depressive symptoms, cognitive stress symptoms, and exhaustion were examined across 48 intersectional strata based on gender, first academic generation, family care tasks, and perceived discrimination. The MAIHDA analysis revealed substantial between strata variance, with most of it explained by additive rather than intersectional interaction effects. Perceived discrimination, diverse or female gender, first academic generation, and family care tasks (for exhaustion only) were associated with worse mental health outcomes. The profound associations between perceived discrimination and the mental health among university students call for urgent attention and intervention within university settings. Adopting an intersectional lens is key to identifying and addressing inequalities.

Background Health literacy enables people to cope efficiently with health threats, such as the COVID-19 pandemic. However, little is known about health literacy among adolescents in general and especially in the context of pandemics. This study aimed to explore pandemic-related health literacy among adolescents by addressing cognitive, behavioral, conative, and affective components of the multidimensional health literacy construct. Methods Four online focus groups with 24 adolescents aged 13-17 years from four German federal states were conducted during the COVID-19 pandemic in May and June 2021. Data were analyzed using qualitative content analysis. Results Regarding the cognitive and behavioral components of pandemic-related health literacy, adolescents reported to use a broad range of traditional and digital media and personal information sources. The adolescents considered pandemic-related information to be good and easy to understand, when the information is presented in a concise and structured manner. The participants stated difficulties in finding, understanding, and evaluating pandemic-related information regarding particular protective measures. The adolescents described themselves to be critical when evaluating pandemic-related information and reported a high level of adherence to protective measures. Regarding the conative and affective components of health literacy, the adolescents explained that their wish to protect their loved ones from getting infected was the predominant motive for adherence to protective measures. They were convinced that people of their age play a role in pandemic containment. The adolescents reported sometimes making exceptions from adhering to protective measures to cope with negative feelings they experienced during the pandemic. Conclusions This study provides insights on how measures to improve pandemic-related health literacy among adolescents may be tailored to their needs. Prompt, concise, structured, and comprehensible preparation and communication of pandemic-related information in addition to educational efforts to strengthen health-related cognitive skills and critical health literacy may be supportive to reduce barriers in finding, understanding, and evaluating pandemic-related content.

Background It is currently unknown if school-based social norms interventions are effective in preventing harmful alcohol consumption and other drug use among adolescents in Denmark. This paper describes the social norms-based programme The GOOD life and the design of a cluster-randomized controlled trial to test its effectiveness. Methods/Design The intervention The GOOD life is composed of three social norms components representing three different communication channels, namely face-to-face communication (normative feedback session), print communication (posters) and interactive media (web application). The intervention period of 8 weeks is preceded and followed by data collection, with the follow-up taking place 3 months after baseline. Public schools in the Region of Southern Denmark with grades 8 and 9 are invited to participate in the study and participating schools are randomly allocated to either intervention or control schools. The aim is to recruit a total of 39 schools and a sample of 1.400 pupils for the trial. An online questionnaire is conducted to examine the use of alcohol, tobacco and marijuana as well as the perceived frequency of use among peers of their own grade, which is measured before and after the intervention. Baseline data is used to develop social norms messages which are included in the three intervention components. Primary outcomes are binge drinking (more than 5 units at one occasion) and perceived frequency of binge drinking among peers, while smoking, marijuana use and alcohol-related harm will be assessed as secondary outcomes. Discussion The GOOD life study will provide necessary insights on descriptive and injunctive norms regarding alcohol and other drug use among Danish adolescents. In addition, it will provide new knowledge and insight on the feasibility, implementation context and effectiveness of a newly developed social norms intervention in the Danish school context. Trial registration Date of registration: 17 February 2016 (retrospectively registered) at Current Controlled Trials with study ID ISRCTN27491960

Virtual Reality-simulations offer new opportunities for alcohol prevention in adolescents. As an innovative medium, Virtual Reality can be attractive for the target group, and avatar-based pathways allow tailoring prevention in a gender-specific manner. However, tailoring may reproduce gender stereotypes and be exclusive. Therefore, this systematic review aims to summaries existing evidence regarding Virtual Reality-simulations for alcohol prevention targeting adolescents and to examine how gender is considered. A systematic search was conducted in seven databases. Two reviewers independently performed screening, data extraction, and quality assessment. Out of 224 search hits, four publications derived out of an Australian, a Danish, and a US-American project met the inclusion criteria. Research designs included qualitative (2), quantitative (1), and mixed-method approaches (1). Qualitative methods focused on development, evaluation, and participatory methods in the creation process, demonstrating adolescents’ involvement in Virtual Reality design. Adolescents appreciated the realism and the exposure to peer pressure and to negative alcohol consequences. Quantitative designs focused mainly on measuring alcohol-related outcomes (e.g., attitude and behavioral intentions towards binge drinking), and positive changes were found. In all studies, gender was assessed in the male-female dichotomy. Further gender-sensitive research is needed to develop and test the possibilities and pitfalls of tailoring Virtual Reality-simulations.