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Aim This study assessed the association between exposure to alcohol adverts on social media and alcohol use among university students in Uganda since alcohol consumption has severe effects, especially in countries with weak regulations for alcohol marketing.Methods In total, 996 undergraduate students at Makerere University responded to a questionnaire assessing exposure to alcohol advertising on social media (independent variable) and alcohol use (dependent variable). Adjusted multinomial logistic regression was used to analyse data.Results One in ten students reported hazardous drinking, while three in ten students were low-risk drinkers. Most students (70.1%) reported low exposure to alcohol adverts on social media, followed by high exposure (12.1%), and 17.8% reported no exposure. A key finding was that exposure to alcohol adverts on social media was significantly associated with alcohol use, especially the high exposure and hazardous drinking (odds ratio = 12.62, 95% confidence interval: 4.43-35.96). Students reporting high exposure to alcohol adverts on social media also had higher odds of low-risk drinking (odds ratio = 3.70, 95% confidence interval: 1.88-7.27) than those with low exposure (odds ratio = 1.77, 95% confidence interval: 1.09-2.87), in reference to no exposure.Conclusion Among Ugandan university students, exposure to alcohol adverts on social media is common and associated with alcohol use, in a dose-response manner. These findings suggest a need for a design and implementation of alcohol interventions for students using social media. Short Summary: Forty percent of students reported using alcohol, including hazardous alcohol drinking (10%). Most students were exposed to alcohol adverts on social media to some degree (low exposure, 70.1%; and high exposure, 12.1%). The exposure to alcohol adverts on social media was significantly associated with alcohol use. The association was strong for high exposure in relation to hazardous drinking.

News and media reports on social work have had policy and legislative consequences for social work practice in Sweden. Generally, it is often argued that media reports have negative implications for public perception and public trust towards social services. However, empirical studies supporting such claims are rare. Going back to the classic theory of cultivation regarding media effects, this study investigates possible associations between news media use, public trust in news, and public trust towards social services in Sweden. Analyses are based on survey data from a representative sample of Swedish adults and young adults (n = 1 697) and linear regressions have been applied. In contrast to assumptions in the existing literature, no associations were identified between the level of news use, preferred news outlet and public trust towards the social services, whereas trust in news predicted trust in social services. The findings challenge dominating notions on the implications of news media use and public trust in social services. In short, news reports of the social services do not simply translate into public (dis)trust. This also enable, linear regressions has been applied. In contrast to assumptions in existing literature, no associations., Nyheter och massmediala rapporter har haft betydelse för policy och lagstiftning inom det sociala området i Sverige, inte minst i relation till exempelvis inrättandet av Lex Sarah. Ofta hävdas också att rapporter i massmedia har negativa konsekvenser för allmänhetens uppfattningar om, och förtroende för socialtjänsten. Empiriska studier av liknande påståenden är emellertid sällsynta. Med utgångspunkt i kultiveringsteori undersöker vi i denna studie möjliga samband mellan användning av nyhetsmedier, allmänhetens förtroende för nyheter och allmänhetens förtroende för socialtjänsten i Sverige. Studien bygger på enkätdata från ett representativt urval av svenska vuxna och unga vuxna (n = 1697). Data har analyserats deskriptivt och med hjälp av linjär regressions analys. I motsats mot tankar om medias påverkan visar resultatet inget samband mellan nivå av nyhetsanvändning, föredragen nyhetskanal och förtroende för socialtjänsten. Däremot hade förtroende för nyheter ett samband med högre tillit till socialtjänsten. Dessa fynd tyder på att det är dags att omvärdera tidigare dominerande idéer om kopplingen mellan nyhets – och medierapporter och allmänhetens förtroende för socialtjänsten. Vi menar att nyhetsrapporter om socialtjänsten inte per automatik leder till ett allmänt missförtroende för socialtjänsten, något som dessutom skapar möjligheter för socialarbetare att närma sig nyhetsbevakningen av socialtjänsten på ett annat sätt.

Teachers in preschools and schools have a central role in detecting children at risk of maltreatment. The aim of this study was to provide a longitudinal understanding of teachers’ temporary and prolonged concerns for children's home situations (CCHS), from preschool (age 3–5 years) to year 1–3 of elementary school (age 8–10 years). Teacher- and parent reports from an ongoing prospective longitudinal study was used (baseline n = 2,113; 5-year follow-up n = 1,829). The study applied the bio-ecological systems framework by assessing how teachers’ CCHS were associated with person-, process-, and context-related factors. Both temporary and prolonged CCHS were primarily associated with teachers’ concern for different aspects of the children’s development, poor contact with parents and low parental SES, while school-related factors were less prominent. The longitudinal pattern indicates three risk levels and highlights the importance of the contact between teachers and parents in understanding when CCHS arises, ceases, or persists over time.

Background News media reports have been accredited by practitioners and academics as being, at least partly, responsible for distrust towards social workers and social services – undermining legitimacy. Through negative representations news media contribute to a skepticism within the public. However, even if it is a possibility that news media representations create distrust, it is yet to be empirically substantiated. The aim of the paper was to explore associations between patterns in news media use- and trust, and individuals trust in the Swedish social services. This paper draws on survey data (n= 1697). Latent profile analysis (LPA) was used to create empirically derived subgroups concerning use. One-way analysis of variance (ANOVA) and linear regression were used to assess associations between news use- and trust and trust in the social services. Findings Via LPA classes with basis in level of use and preferred type of news medium was identified. No significant associations between classes and trust in the social services was found. However, trust in news media content was positively associated with trust in the social services. The association was statistically significant also when covariates previously shown to be of importance for trust was included in analysis. Applications The findings presented in the paper provide empirical insights concerning the role of news for public trust in the social services. On contrary to what has been assumed – news affects trust negatively­ – the findings suggest the opposite. For academics and practitioners alike, this enhances the understanding of news media’s role in public trust and legitimacy.

BACKGROUND: Globally, alcohol use significantly contributes to the disease burden. Alcohol consumption in Uganda is related to several health consequences among young people, including university students. Social media is commonly used by students to share academic information and create social networks. Among young people in high-income countries, previous studies have also shown that social media use can have negative health outcomes related to alcohol use, and associated problems. To date, similar studies conducted in low- and middle-income countries are largely missing. OBJECTIVE: To assess the prevalence of and associations between social media use and alcohol consumption among university students in Uganda. METHOD: This was a cross-sectional study among 996 undergraduate students at Makerere University. Data were collected using a questionnaire. Alcohol use in the previous 12 months was the dependent variable. The independent variable was social media use categorised as general use, alcohol-related use, and social media lurking/passive participation. Multinomial logistic regression was used to assess associations. Crude and adjusted odds ratios were reported. RESULTS: Nearly all students (97%) used social media and 39% reported alcohol use. Regular alcohol use was significantly associated with moderate (OR = 2.22, CI: 1.35-3.66) and high level general social media use (OR = 2.45, CI: 1.43-4.20). Regular alcohol use was also associated with alcohol-related social media (OR = 6.46, CI: 4.04-10.30), and alcohol-related lurking (OR = 4.59, CI: 2.84-7.39). Similar, although weaker associations were identified for occasional alcohol use. CONCLUSIONS: Approximately four in ten students reported alcohol use in the past year, and almost all students used social media. Alcohol-related social media use was associated with occasional and regular alcohol use, with stronger associations for regular use. These findings may guide further research and present an opportunity fo

The relationship with place has been recognized as a significant dimension of rural youth leisure, both through the discursive constructions of place, but also as affective and embodied dimensions. This study captures these processes by applying the concept of place-making as a set of recurrent discursive processes, analyzing how girls in Northern Sweden engage in place-making alongside, beyond, and in contrast to dominant discourses on leisure, rurality and wellbeing. The study draws on data from photo-elicited focus groups with girls from two sports organizations. The discursive psychology analysis resulted in three interpretative repertoires. The first repertoire describes the sharp contrast between discourses of the ‘rural dull’ and how stressful the participants constructed their own places of leisure. The second illustrates the gendered discourses around what is considered to be productive and respectable leisure. The third shows how the participants are made responsible for the survival of their leisure. Through place-making, the participants shape places of leisure, affecting both themselves and their rural community. They engage in, conform to, and challenge place-making within discourses of responsibility and precariousness, creating space for their own initiatives, which are simultaneously shaped by the material conditions under which these practices take place.

Public trust towards social workers is essential for legitimacy and accessibility of the social services, as well as for help-seeking behaviour. However, research on public trust towards the social services is lacking. The aim of this study was to describe the extent to which Swedish citizens trust social workers who work within the social services, and to explore patterns in level of trust based on demographic factors and history of service use. The analysis draws on survey data from 2010, 2014, and 2018 (total n = 4975). Logistic regressions were conducted to assess associations between predictor variables and trust. Findings On average, 40 percent of the general public reported a high level of trust regardless of year. Approximately 20 percent reported a low level of trust. The results indicate a slight decrease in trust between 2010 and 2014 but not between 2014 and 2018. No gender or age differences were identified. Low income level, being related to a service user, and low level of education were all associated with low level of trust. Applications Our findings provide new insights regarding variations in levels of trust in the general population. Economically and educationally disadvantaged groups as well as those related to a service user are more likely to report low trust than their more advantaged counterparts. To strengthen legitimacy and accessibility, these groups should be prioritised in trust-enhancing efforts. Still, reports of high trust were predominant, indicating that social workers are generally perceived as trusted providers of social support.

The aim of this qualitative study was 2-fold: to explore, in the context of young people’s civic engagement in Sweden, (i) how adult leaders perceive social factors of youth mental health and (ii) how adult leaders handle such social factors within their organizations. Interviews were conducted with leaders engaged in various civic organizations that provide leisure activities for young people. Using thematic analysis, three themes were constructed. Firstly, the social landscape of youth mental health described how adult leaders perceived the social factors of youth mental health within the context of civic engagement. Secondly, the organizational structures developed by adult leaders illustrated the organizing forms that leaders created for young people’s civic engagement. Thirdly, adult leaders’ strategies for addressing the social factors of youth mental health reflected the strategies developed to handle e.g. stress and achievement pressure. The adult leaders recognized the importance of their organizations and their huge potential to have a positive impact on youth mental health. However, some participants also saw limitations in terms of their own resources and competence. They found themselves having to address the complex issue of social factors of youth mental health regardless of whether they felt competent and prepared to do this or not. Our findings contribute to the existing knowledge on youth and community development via the role of adult leaders in promoting young people’s mental health by highlighting the organizational structures and leadership strategies developed by them.

Purpose: Stress and achievement pressure constitute factors affecting young people's mental health, especially among girls. Leisure participation holds the potential to be a collective space where young people can respond to stressors together. This study explores how girls collectively construct responses to daily stressors within the context of leisure participation. Methods: Nine focus groups were conducted with 16 girls aged 14-21 who were active members in two sport organizations in northern Sweden. Data was collected by using participatory observations and photo-elicited focus group discussions. Results: Our findings from the inductive thematic analysis were interpreted by combining the stress process model with social practice theory, resulting in three subthemes or responses: sharing sites of responsibility, resisting norms related to (gendered) youth and focused distraction. The subthemes were abstracted into the central theme of trustful belonging as a resource for collective responses, representing what pre-conditions need to be in place to make the responses possible. Conclusion: Leisure participation is an important relational space for young people to respond to stressors by making use of everyday routines, and the agency these social practices hold. However, the effort needed to respond to these stressors brought additional pressure in terms of responsibilities, and achievements.

Introduction: Violence in a broad sense among youth is common and there is some evidence that there are groups of youth who are victims of more than one form of violence. More knowledge is needed in terms of patterning of subgroups of poly-victimization. The aim was to explore if there are distinct subgroups of youth with particular patterns of violence victimization. Method: Survey data from a Swedish sample (n = 1,569) of 14-16-year-olds were used (females 48.4%). Measures were physical violence, threat of physical violence, bullying, sexual harassment, and cyber bullying and harassment in the past six months as well as lifetime physical violence. Latent Class Analysis (LCA) was used to identify subgroups of youth with particular violence victimization patterns. Model fit assessment was based on model parsimony, theoretical justification and fit indices criteria (the Akaike information criterion and the Bayesian information criterion). Result: A three-latent-class model was selected: 1. Poly-victims with high probabilities of being victimized by a multitude of different types of violence (girls 47.6%). 2. Overall low probabilities of violence victimization (girls 47.5%). 3. High probabilities of victimization of sexual harassment off- and online as well as bullying online (girls 65.6%). Discussion: Three distinct subgroups of violence victimization in youth was evident in the data. There was a greater representation of girls in the purely sexualized violence sub-group. Further research and preventive programs should acknowledge that young people who are victims of one type of violence are likely also to be victims of other types of violence.

ObjectiveTo date, no longitudinal, community-based studies have examined the association between disordered eating emerging in adolescence and long-term physical well-being. This study sought to explore the longitudinal associations between risk for restrictive disordered eating (DE-R; those not presenting with binge-purge symptoms) in adolescence and trajectories of functional somatic symptoms (FSS) and body mass index (BMI), and several indicators of poor physical well-being across early- to mid-adulthood, including medication, number of doctor visits, and sick leave. DesignData were obtained from the Northern Swedish Cohort Study (N=1,001), a prospective longitudinal study including four time points from age 16 to 42years. MethodsA cumulative measure of DE-R risk was computed. Latent class growth analysis was used to identify subpopulation trajectories of FSS and BMI. The three-step method for auxiliary variables and logistic regressions were used to assess associations between DE-R and the trajectory classes as well as indicators of poorphysical well-being. ResultsThree trajectories were identified for FSS. A gender by BMI interaction led to a classification of four BMI trajectories in men, but three in women. The presence of DE-R risk in adolescence increased odds of unfavourable FSS development, increasing BMI in women, and continually low BMI in men. Indicators of poor physical well-being at ages 21, 30, and 42years were associated with DE-R risk in adolescence. ConclusionsData spanning nearly three decades suggest that physical well-being impairment is related to DE-R risk measured earlier in life, underscoring the urgency for targeted, gender-sensitive preventive interventions for teenagers. What is already known on this subject? Disordered eating is linked to poor physical and mental well-being and quality of life. No longitudinal studies have examined long-term physical well-being consequences of adolescent disordered eating risk. What does this study add

Disadvantaged circumstances in youth tend to translate into poor health development. However, the fact that this is not always the case has been seen as indicative of differential resilience. The current study highlights factors outside the context of the family with the potential to counteract the long-term negative influences of social and material adversity in adolescence on general health status. This study was based on two waves of questionnaire data from the Northern Swedish Cohort. From the wave in 1981 (age 16), indicators of social and material conditions as well as factors related to school, peers, and spare time were derived. From the wave in 2008 (age 43), information about self-rated health was used. Ordinal logistic regression models (n = 908) showed that adversity in youth was associated with poorer self-rated health in midlife among men and women alike, net of health status at baseline. However, having an advantaged situation with regard to school, peers, or spare time appeared to protect against the detrimental influences of disadvantaged circumstances in the family context on subsequent health. This suggests that health-promoting interventions may benefit from focusing on contexts outside the family in their effort to strengthen processes of resilience among disadvantaged youths.

Background: Violence among youth is common and has been linked to poor mental health outcomes. There is some evidence that there are groups of youth who are victims of more than one form of violence but more knowledge is needed in terms of patterning of subgroups of multiple violence victimization. Aim: To explore if there are distinct subgroups of youth with particular patterns of violence victimization. Methods: Survey data from a Swedish sample (n = 1,569) of youth 14-16 years old were used (females 48.4%). Using a broad definition of violence, respondents indicated if they had experienced physical violence, threat of physical violence, bullying, sexual harassment, cyber bullying, online sexual victimizayion, and other adverse sexual experience in the past six months as well as lifetime physical violence victimization. Distinct subgroups of youth within the data set with particular patterns of violence victimization were identified using Latent Class Analysis (LCA). Model fit was assessed using the Akaike information criterion (AIC) and the Bayesian information criterion (BIC), with smaller values indicating better model fit. Results: Preliminary results show three distinct subgroups: 1. Sexualized violence off- and online (girls 66.6%), 2. Bullying only (girls 47.5%) and 3. Multi-victimization including threat of physical violence, violence in the past six months and lifetime, sexual harassment on- and offline, bullying on- and offline as well as other adverse sexual experience (girls 47.6%). Conclusions: Three distinct subgroups of violence victimization in a sample of 14-16 year old youth was evident in the data. There was a greater representation of girls in the sexualized violence sub-group. Further research as well as preventive programs should acknowledge that many young people are victims of several types of violence. Future research should also investigate the implications of multi-victimization on mental health outcomes. Key messages: Three distinct sub, Supplement 4

Background: Cigarette smoking is a major public health threat. In high income countries, smoking is most prevalent in disadvantaged groups. Little is known about complex inequalitites in smoking based on multiple axes of social positions which would be necessary in designing interventions aiming at reducing smoking rates. The study aimed to describe the prevalence of daily smoking in the adult Swedish population across combinations of the social positions gender and occupational class, and to examine smoking differences attributed to the intersection of gender/occupational class Methods: The study sample (N = 61 316, age 26 – 84) was pooled from seven years of the annual cross sectional Swedish national public health surveys (2010 to 2016). The outcome was current daily smoking. Binary variables of gender (man/woman) and occupational class (blue collar/white collar) were used to construct the four category intersection meausure of gender/class. Complex inequalities in daily smoking were estimated by joint-, referent- and excess disparities. Survey year and age were used as covariates. Results: The overall daily smoking prevalence was 10.21%. The smoking rates in the categories of gender and occupational class were as follows: white collar men: 6.70%; white collar women: 7.79%; blue collar men: 13.75% and blue collar women: 16.63%. The absolute joint disparity was 9.96 percentage points (CI: 9.14 – 10.79) and that the main contributor to this inequality was occupational class (70.66%). The results of excess disparity further showed that blue collar women were particularly exposed regarding smoking. Conclusions: Acknowledging the complexity of disadvantage and privilege regarding daily smoking contributes to an understanding of the situation for multiply marginalised groups, for example blue collar women. The findings may inform future public health interventions to reduce smoking habits. Key messages: Acknowledging the complexity of disadvantage and privilege contrib, Supplement 4

Violence among youth is common and has been linked to poor mental health outcomes. There is some evidence that there are groups of youth who are victims of more than one form of violence but more knowledge is needed in terms of patterning of subgroups of multiple violence victimization. Aim: To explore if there are distinct subgroups of youth with particular patterns of violence victimization. Method: Survey data from a Swedish sample (n = 1,569) of youth 14-16 years old were used (females 48.4%). Using a broad definition of violence, respondents indicated if they had experienced physical violence, threat of physical violence, bullying, sexual harassment, cyber bullying, online sexual victimization, and other adverse sexual experience in the past six months as well as lifetime physical violence victimization. Distinct subgroups of youth within the data set with particular patterns of violence victimization were identified using Latent Class Analysis (LCA). Model fit was assessed using the Akaike information criterion (AIC) and the Bayesian information criterion (BIC), with smaller values indicating better model fit. Results: Preliminary results show three distinct subgroups: 1. Sexualized violence off- and online (girls 66.6%), 2. Bullying only (girls 47.5%) and 3. Multi-victimization including threat of physical violence, violence in the past six months and lifetime, sexual harassment on- and offline, bullying on- and offline as well as other adverse sexual experience (girls 47.6%). Conclusions: Three distinct subgroups of violence victimization in a sample of 14-16 year old youth was evident in the data. There was a greater representation of girls in the sexualized violence sub-group. Further research as well as preventive programs should acknowledge that many young people are victims of several types of violence. Future research should also investigate the implications of multi-victimization on mental health outcomes.

BACKGROUND: Numerous studies have demonstrated an association between social support and health, almost regardless of how social support and health have been conceptualised or measured. Even so, the issue of causality has not yet been sufficiently addressed. This issue is particularly challenging for mental health problems such as depressive symptoms. The aim of the present study is to longitudinally assess structural and functional aspects of social support in relation to depressive symptoms in men and women, through a series of competing causal models that, in contrast to many other statistical methods, allow for bi-directional effects. METHODS: Questionnaire data from the Northern Swedish Cohort (n = 1001) were utilised for the years 1995 (age 30) and 2007 (age 42). Associations were analysed by means of gender-specific structural equation modelling, with structural and functional support modelled separately. RESULTS: Both structural and functional support were associated with depressive symptoms at ages 30 and 42, for men and women alike. A higher level of support, particularly functional support, was associated with a decrease in depressive symptoms over time among men. Among women, there were bi-directional effects of social support and depressive symptoms over time. CONCLUSION: Concerning social support and health, the social causation hypothesis seems relevant for men whereas, for women, the associations appear to be more complex. We conclude that preventive and health promoting work may need to consider that the presence of depressive symptoms in itself impedes on women's capability to increase their levels of social support.