HRQoL data
In total, we analysed KIDSCREEN data on 84 individuals from the intervention sample and 244 from the Norwegian reference sample. The proportion of girls compared to boys was higher in both samples (61% and 58% for Young & Active and the reference population, respectively). Statistically, findings from the Young & Active sample showed a significantly lower HRQoL on the subscale of physical well-being. The Norwegian reference population had a statistically significant lower HRQoL on the parent relations dimension (see Table 2).
Table 2
Comparison of median scores between study sample and reference sample on Kidscreen-52 domains
| Young & Active | Reference | |
| N | Median | 95% CI | N | Median | 95% CI | P- value |
Physical well-being | 67 | 55.00 | 50.00–60.00 | 244 | 70.00 | 67.50–70.00 | < 0.01 |
Psychological well-being | 72 | 77.09 | 70.83–85.42 | 244 | 79.17 | 75.00-79.17 | 0.85 |
Mood | 75 | 82.14 | 78.57–89.29 | 244 | 85.71 | 82.14–85.71 | 0.81 |
Self-perception | 72 | 62.50 | 47.50–75.00 | 244 | 70.00 | 67.50–75.00 | 0.46 |
Autonomy | 70 | 80.00 | 70.00–87.50 | 244 | 70.00 | 70.00–75.00 | 0.10 |
Parent relations | 70 | 83.33 | 75.00–91.67 | 244 | 75.00 | 75.00-79.17 | < 0.05 |
Financial resources | 72 | 100.00 | 87.50–100.0 | 244 | 83.33 | 75.00-87.50 | 0.06 |
Social support and peers | 70 | 83.33 | 77.09–87.50 | 244 | 70.83 | 68.75-75.00 | 0.19 |
School environment | 71 | 68.75 | 62.50–75.00 | 244 | 62.50 | 62.50-66.67 | 0.25 |
Social acceptance | 74 | 100.00 | 91.67–100.0 | 244 | 91.67 | 91.67–100.00 | 0.25 |
Further, all analyses were stratified by gender (data not shown in table). The subscale of physical well-being showed that both boys and girls from the Young & Active sample reported a statistically significantly lower HRQoL for this subscale compared to the reference population, with values ranging from 45.00–60.00 for girls and from 50.00–70.00 for boys. On the subscale of parent relations, the girls from the reference sample had statistically a significantly lower HRQoL score compared to the girls from the Young & Active sample, ranging from 70.83–81.20 in the reference sample and from 79.17–91.67 for Young & Active. Among the boys there were no statistically significant differences between the groups on this subscale. No other statistically significant differences were found for any of the remaining subscales.
Qualitative data
There were qualitative findings on all ten subscales, although the findings on the subscales of Physical Well-being and Self-Perception were the most prominent and will be treated in more detail than the other qualitative data. The findings in the remaining subscales will be presented in a summary. Quotes from the interviewees used in the text have been translated from Norwegian.
Statements about Physical Well-Being
Most of the adolescents stated that they felt increasingly fit and motivated to engage in PA after participating in Young & Active. However, they still described their health, fitness and energy level as being below average or lower than their peers. For example, one girl said: I’ve always struggled with physical activity because I’m not the strongest or the fastest person. I think my fitness level has increased but I haven’t noticed that much change (Inf. 10). When talking about their health, many adolescents expressed that their health was poor. They attributed this to weighing too much, not being active enough or liking food too much. A few talked about having health problems such as asthma, migraine, or complaints regarding neck, knees or heels. Other adolescents presumed that their health was ok, since they were not ill. Several adolescents emphasized that the extent to which they felt energetic, fit and healthy could vary significantly from week to week or even from day to day, depending on other factors such as amount of sleep, food intake, pain or disease – as one boy said: My health differs from day to day. Sometimes I feel less energetic, perhaps because I went to bed too late (Inf. 18). For some adolescents, feeling energetic was associated with the weather. One girl said: I feel I can have loads of energy if the weather’s nice, then I can go out and run around. But if it’s raining, I’ll lie on the sofa and play computer games (Inf. 5). When enjoying and mastering a physical activity, even pain seemed to be less significant, as one boy stated: I have some heel problems. I don’t notice it when I’m slalom skiing and slalom skiing is my favourite activity (Inf. 1). Other adolescents expressed similar opinions and stated that the extent to which they became involved in physical activities or felt energetic depended on their feelings about the physical activity they were thinking about engaging in, as this girl stated: I guess I have the energy, unless I don’t feel like it, and then I can be quite lazy (Inf. 4). This girl was regularly active in a sport that she enjoyed, had chosen by herself and which she mastered. When discussing other types of PA, she described herself as a person who didn’t like moving. Their feelings about PA also related to exercising together with friends, as this boy stated: I prefer to exercise with my friends because we push each other. Then I feel I'm getting more out of the exercise and enjoy it (Inf. 6).
Statements about Self-Perception
Most of the adolescents appeared to have a negative view of their bodies, as this girl stated: I’m not happy with my body. I feel I’ve grown too fast and that other people look at me. The problem is that all my friends are so thin, and here’s me with my large thighs and fat belly. I consider myself fat (Inf. 7). Another girl said that she often envied thin girls and wished she could have been like them: Sometimes I used to think, I want to look like her, and she’s so thin and beautiful (Inf. 2). For some, thoughts about weight were coupled with their perceptions of self, as this girl explained: I don’t think too highly of myself. It's a bit hard because I'm not used to talking about it, but I’m not happy about myself because I actually think that I weigh too much (Inf. 5). Most of the boys appeared to be more preoccupied with building muscles than getting thin, as this boy stated: I like bigger muscles; they make me feel good (Inf. 1). I’m not that attractive yet, but I will be when I’ve done some more training (Inf. 17). Some of the boys admitted that the main reason they exercised was to lose weight, as this boy stated: I think a lot about my weight and that’s the main reason why I do training (Inf. 3). However, like the other boys, he also wanted to achieve weight loss through training and building muscles. A number of the adolescents appeared to distinguish between negative thoughts about their bodies and how they viewed themselves as persons, as one girl said: I’m sort of satisfied with myself, but not with my body. I want to change my looks and lose weight. But I think my personality is ok (Inf. 11). The adolescents’ views about themselves were also associated with thoughts about how their friends viewed them, as this boy stated: I’m a happy person who makes friends easily. I’m satisfied with myself and I think other people like me and regard me as a kind and caring person (Inf. 15).
A summary of findings in the remaining subscales
Within the subscales of psychological well-being and mood, many adolescents stated that they felt happy most of the time but emphasised that this could vary considerably. Some of them said that eating too little could make them feel unhappy and irritable. Several of them stated that if their friends and family were happy, then they were happy, and vice versa. Most of them expressed that spending time with friends made them feel happy and put them in a good mood. They also said that good sleep was important for their moods. Some of them stated that they felt generally insecure about themselves, feeling pressure regarding how they should behave, how they should dress and how they should look.
Within the KIDSCREEN subscales of autonomy, parent relations, financial resources and social acceptance, a few adolescents expressed insufficiency, i.e. feeling a lack of freedom of choice, lack of parental support or too restrictive parents, lack of money to pay for sports activities because of their family’s financial situation, or being bullied at school. Most of the adolescents said that they received enough support from their parents and that they had not been bullied. Regarding family relations, they extended this to include siblings and other relatives. Many of them expressed that their feelings were influenced by other family events, such as loss of close family members etc., and not just their direct relationship to their parents.
All the adolescents affirmed that they had friends. Except for a couple of adolescents who told about being bullied at school, the majority said that they were friends with their classmates. All of them stated that they had friends outside school, although for some of them, these were mainly online friends.
Regarding the subscale of school environment, most of the adolescents stated that they liked their schools. The majority said that they felt increased pressure from their parents and teachers about achieving good grades and doing more homework. Several of them expressed that getting bad grades negatively impacted their self-confidence.