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The experience of living with a chronic condition (CC) impacts adolescents' psychological and social adjustment and overall functioning. Considering the increased risk of psychosocial challenges among adolescents with CC, this study aimed to enhance our understanding of the psychological and social factors that impact their quality of life. It also compared the psychological and social variables among (a) adolescents with and without CC and (b) adolescents with CC who are and who are not victims of bullying. The results demonstrated that adolescents with CC showed more psychosocial difficulties than their peers, as they more frequently reported involvement in situations of violence, and demonstrated more difficulties at a psychological and emotional level. Further, being victims of bullying increased the psychosocial vulnerabilities of these adolescents. A better quality of life was associated with the following psychosocial factors: not being a victim of bullying or cyberbullying, having less anxiety and fewer depressive symptoms, liking school, receiving more support from family and friends, having better relationships with peers, and having fewer physical and psychological symptoms. These findings are significant for helping schools develop tools and strategies to address violence and support students with CC, who are at a higher risk of being involved in such situations and require a targeted response.

Sexual minority youth are at greater risk for bullying victimization than their heterosexual peers but data on perpetration and cybervictimization is limited. Using representative data from seven European countries and one region (N = 14,545), this study compared traditional bullying victimization and perpetration, and cyberbullying victimization among 15-year-old adolescents who reported ever being in love with same- or both- gender peers (sexual minority) versus opposite-gender peers (non-minority). Adolescents who have never been in love and non-respondents were also included. Analyses were stratified by gender and adjusted for country/region and family affluence. Compared to those attracted to opposite-gender peers, traditional bullying perpetration was more likely to be reported by both-gender attracted girls, while bullying victimization was more likely to be reported by both-gender attracted girls and both- and same-gender attracted boys. All sexual minority youth were more likely to report cybervictimization compared to their non-minority peers. Adolescents who have never been in love reported lower levels of bullying involvement than all other youth. Sexual minority stigma may contribute to higher risk of bullying involvement among adolescents. Interventions need to specifically address bullying involvement and associated health risks of sexual minority youth. Available evidence shows that explicit school policies and interventions tailored to local settings are particularly effective.

Introduction: The concept of the health promoting school offers a coherent approach to promoting health and well-being within a whole school community. This study sought to evaluate the health programmes and policies adopted by different Lebanese schools, and their appropriateness for this role as part of health promotion. Methods: Our research took the form of a prospective observational study involving 50 schools from different areas of Lebanon. Data were collected using a questionnaire based on the Health Assessment Tool for Schools (HATS). Data were analysed to describe school characteristics and to reveal differences in the health topics addressed. Results: Most of the schools included in the study came from Mount Lebanon (56%). Around 70% of the involved schools offered health-related courses in their curricula. Health-related seminars and workshops (60%) and health awareness campaigns took place at the studied schools, with 98% incorporating physical education into the curriculum. Dental health (74%), smoking cessation (72%) and physical activity (68%) were among other most addressed topics, while mental health was the least discussed (20%). The majority (70%) of schools had a shared vision of what promoting health involved and sought to promote the active involvement of community members in the life of the school (60%). Around two-thirds of the schools (66%) provided physical support and facilities, and had developed policies for health promotion. Less than half of these schools' health committees, however, had developed plans to improve health promotion and review data to ensure the effectiveness of their programmes. Conclusion: The study findings suggest that despite weaknesses, the majority of the sampled schools had either implemented or were in the process of implementing a health promoting school programme to improve health education and students' well-being.

Although most people in developed countries experience sexual initiation during adolescence, little is known about inter-country variability in the psychosocial correlates of early initiation. Population-based samples of 15-year-olds (n = 6,111, 52% female) who participated in the Health Behaviors in School-Aged Children Study (Finland, Scotland, France and Poland, 1997/1998) or the National Longitudinal Study of Adolescent Health (United States, 1996) self-reported sexual intercourse experience and physical (headaches, trouble sleeping) or psychological (unhappiness, loneliness, sadness, moodiness) symptoms. Analyses were conducted stratified by gender. Sexual initiation prevalence and symptoms scores varied significantly across nations. In adjusted models, sexual initiation was not related to symptoms among boys in any nation, but significantly positively related to symptoms among girls in Poland and the US. Results support variability by gender and nation in the relationship between adolescents' sexual initiation and physical/psychological symptoms. Empirically investigating specific features of national contexts that generate these differences should be explored further.

Aim: Although inclusive education of disabled children is now an accepted practice, it is often challenged by negative peer attitudes. We undertook an interventional study aimed at improving students' attitudes towards their disabled peers. Method: The participants were students from the 7th grade of twelve paired schools (1509 students from 62 classes; age 12-13y), randomly allocated to an intervention group (205 males, 285 females) or a control group (132 males, 165 females). The intervention consisted of a mandatory comprehensive educational project on disability. The Chedoke-McMaster Attitudes Towards Children with Handicaps Scale (CATCH) was used to assess children's attitudes before (T0) and after (T1) intervention. The hierarchical structure of the data was taken into account by adjusting standard deviations and using linear multilevel models. Results: Seven hundred and eighty-four students had at least one score on the three domains (cognitive, affective, behavioural) of the CATCH at T0 and T1. The final scores were higher than baseline scores (total scores, intervention group: baseline score 25.6 (SD=5.4), final score 26.8 (5.9), p less than 0.001; Control group: baseline 25.2 (5.4), final 26.0 (5.7), p less than 0.009) with no significant difference between the intervention and control groups. Individual score changes over time were associated with baseline score (p less than 0.001 for total and all sub-scores). Lower improvement in attitudes was found in students from schools with special units for their peers with cognitive impairment for total (p=0.013), affective (p less than 0.001), and behavioural (p=0.001) scores, while higher improvement existed for the cognitive domain (p=0.029). Interpretation: Although we found no effect of our intervention, we found an improvement in attitudes in the intervention and control groups that could be a result of the nature of the scales and questionnaires the students had to complete before the intervention.

Aim: To explore factors associated with students' attitudes towards their peers with disabilities. Method: All 7th grade students (aged 12-13y) from 12 schools in the Toulouse area were invited to participate (n = 1509). Attitudes were measured using the Chedoke-McMaster Attitudes Towards Children with Handicaps (CATCH) questionnaire (affective, behavioural, cognitive, and total scores). Personal characteristics, including KIDSCREEN quality of life scores, were recorded. Data regarding information about disabilities received from parents and the media and acquaintance with people with disabilities constituted the 'disability knowledge' factors. The characteristics of the schools were obtained from the local education authority. Multivariate multilevel linear regression analyses were conducted to explore the associations between CATCH scores and these three groups of factors. Results: Responses from 1135 students (612 females, 523 males; mean age 12y 8mo SD 7mo; age range 10y 8mo-15y) were studied (75.2% of the students approached). Factors independently associated with more positive attitudes were being a female, having a good quality of life, being friends with a child with disabilities, or having received information about disabilities from parents and the media. Presence in the school of a special class for children with cognitive disabilities was independently associated with more negative attitudes. Interpretation: This cross-sectional study identified different personal and environmental factors upon which interventions aimed at improving students' attitudes towards their peers with disabilities could be based.

This study aimed to identify instruments for measuring children's attitudes towards their peers with disabilities that are suitable for use in epidemiological studies and to report on their psychometric properties. A literature review was conducted to identify instruments measuring at least one of the three components of children's attitudes (affective, behavioural, or cognitive measures) towards peers with disabilities and which are intended for self-completion by children. Criteria used to appraise these instruments were appropriateness, acceptability, validity, reliability, internal consistency, and test-retest reliability. Of the 19 instruments matching the inclusion criteria, 16 measured only one attitude component (affective, n=4; behavioural, n=5; cognitive, n=7); one measured cognitive and behavioural components; and two (Acceptance Scale and Chedoke-McMaster Attitudes Towards Children with Handicaps Scale [CATCH]) measured all three components. The majority of instruments, and those most widely used, were developed in the 1970s and 80s and so do not cover some aspects relevant to current culture, although they are still being used in research. Acceptable levels of validity and reliability were reported. Detailed descriptions of the initial validation process were available for the Acceptance Scale, Adjective Checklist, CATCH, and Peer Attitudes Towards the Handicapped Scale. The Acceptance Scale and CATCH seem to be the most complete instruments among those identified as they include all three attitude components and have appropriate psychometric properties.