Project details

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Pattern and predictors of health care utilization related to involvement in bullying in secondary education

Keywords:
Health care utilization bullying adolescents

Researchers:
Dr. D.E.M.C. Jansen
Prof. dr. S.A. Reijneveld

Nature of the research:
Cohort study

Fields of study:
epidemiology health sciences

Background / introduction
Bullying can be defined as repeated verbal, psychological or physical aggression conducted by an individual or group against others. Bullying is a problem that affects millions of children and adolescents of all races and classes; it can lead to physical injury, social problems and emotional problems. Involvement in bullying and the mental health consequences of it can easily lead to an increased use of medication and/or mental health care. There are however only a few of studies examining this possible association. Of these studies, only the study of Sourander et al. (2009) is a prospective study following children over a long period of time. The study reveals that girls who are frequently victimized at age 8 years were more likely to receive psychiatric hospital treatment and use of different psychiatric drugs in adolescence and early adulthood. However, by restricting their research to psychiatric medication and health care use, this study only yields limited insight into the actual health care utilization.
Research question / problem definition
To assess whether involvement in bullying leads to an increased use of health care and if yes, which patterns of health care utilization (HCU) adolescents have who are involved in bullying vs. not. Second, to assess mediators of this association, primarily in an exploratory fashion.
Workplan
Shortly review the literature on this topic. The next step is to analyse TRAILS-data. The TRAILS-data consists of a population cohort (N = 2230) and a clinical cohort (N = 543), both of which were followed from about age 11 years onwards. To date, the population cohort has been assessed five times over a period of 11 years, with retention rates ranging between 80% and 96% (Oldehinkel et al, 2015). Data will be analyzed using logistic regression analysis, with being HCU as outcome and being bullied, family structure, school involvement, social well-being, parenting stress and mental health problems as determinants. This analysis will be repeated by adjusting for gender, adolescent and parental educational level, parental occupational level and status, degree of urbanization, ethnicity and physical health status.
References
Oldehinkel AJ, Rosmalen JGM, Buitelaar JK, Hoek HW, Ormel J, Raven D, Reijneveld SA, Veenstra R, Verhulst FC, Vollebergh WAM, and CA Hartman. Cohort Profile Update: The TRacking Adolescents’ Individual Lives Survey (TRAILS). Int J Epidemiol. 2015 Feb; 44(1): 76–76n.

Sourander A, Ronning J, Brunstein-Klomek A, Gyllenberg D, Kumpulainen K, Niemelä S, Helenius H, Sillanmäki L, Ristkari T, Tamminen T, Moilanen I, Piha J, Almqvist F: Childhood bullying behavior and later psychiatric hospital and psychopharmacologic treatment: Findings from the Finnish
1981 Birth Cohort Study. Arch Gen Psychiatry 2009, 66(9): 1005-1012.

Due P, Hansen EH, Merlo J, Andersen A, Holstein BE: Is victimization from bullying associated with medicine use among adolescents? A nationally representative cross-sectional survey in Denmark. Pediatrics 2007, 120(1): 110-117.

Jansen DEMC, Wiegersma PA, Ormel J, Verhulst FC, Vollebergh WAM & Reijneveld SA. Need for mental health care in adolescents and its determinants: The TRAILS Study. Eur J Public Health 2012, 23: 236-241.

Reijneveld SA, Wiegersma PA, Ormel J, Verhulst FC, Vollebergh WA & Jansen DEMC. Adolescents’ use of care for behavioral and emotional problems: types, trends, and determinants. PLoS One. 2014, 9.
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