Comparable data on socioeconomic position (SEP) is essential to international studies on health i... more Comparable data on socioeconomic position (SEP) is essential to international studies on health inequalities. The Health Behaviour in School-aged Children (HBSC) has used the Family Affluence Scale (FAS) on material assets. The present study used data collected from adolescents in eight countries in 2002, 2006 and 2010, and examined the construct validity of the FAS, by focusing on changes in item responses over time. The analyses reported the changes in means in item responses, and fitted models which estimated differential item functioning (DIF), and local dependency (LD) between items. DIF and LD were analysed by Graphical Log-Linear Rasch Models (GLLRMs), and changes in the measurement properties of the FAS over time and between countries were assessed. The results showed that the FAS items have changed their measurement properties between 2002 and 2010, and caution is warranted in studies comparing the FAS between different time points.
Increasing numbers of migrant youth around the world mean growing numbers of heterogeneous school... more Increasing numbers of migrant youth around the world mean growing numbers of heterogeneous school environments in many countries. Contradictory findings regarding the relationship between immigrant school composition (the percentage of immigrant versus non-immigrant students in a school) and adolescent peer violence necessitate further consideration. The current study examined the relationship between immigrant school composition and peer violence, considering classmate support as a potential moderator among 51,636 adolescents (50.1 % female) from 11 countries. The findings showed that a higher percentage of immigrant adolescents in a school was related to higher levels of physical fighting and bullying perpetration for both immigrant and non-immigrant adolescents and lower levels of victimization for immigrants. In environments of low classmate support, the positive relationship between immigrant school composition and fighting was stronger for non-immigrants than in environments w...
We sought to determine whether social capital at the individual-, school-and community-level can ... more We sought to determine whether social capital at the individual-, school-and community-level can explain variance in adolescent smoking and accounts for social inequalities in smoking. We collected data as part of the 2005/6 Health Behavior in School-aged Children survey, a nationally representative survey of the health and well-being of high school pupils in Belgium (Flanders). Social capital was assessed by structural and cognitive components of family social capital, a four-factor school social capital scale and a cognitive community social capital scale. We fitted non-hierarchical multilevel models to the data, with 8453 adolescents nested within a cross-classification of 167 schools and 570 communities. Significant variation in adolescent regular smoking was found between schools, but not between communities. Only structural family social capital and cognitive school social capital variables negatively related to regular smoking. No interactions between socio-economic status and social capital variables were found. Our findings suggest that previously observed community-level associations with adolescent smoking may be a consequence of unmeasured confounding. Distinguishing nested contexts of social capital is important because their associations with smoking differ.
Clays, E., Casini, A., Kittel, F., Godin, I., Janssens, H., De Clercq, B., Braeckman, L., et al. ... more Clays, E., Casini, A., Kittel, F., Godin, I., Janssens, H., De Clercq, B., Braeckman, L., et al. (2012). Psychosocial characteristics at work as risk factors for long-term cause-specific sick leave. European Academy of Occupational Health Psychology, 10th Conference, Abstracts (pp. 151–151). Presented at the 10th Conference of the European Academy of Occupational Health Psychology (EAOHP). ... Clays E, Casini A, Kittel F, Godin I, Janssens H, De Clercq B, et al. Psychosocial characteristics at work as risk factors for long-term cause-specific ...
Previous research on the links between income inequality and health and socioeconomic differences... more Previous research on the links between income inequality and health and socioeconomic differences in health suggests that relative differences in affluence impact health and well-being more than absolute affluence. This study explored whether self-reported psychosomatic symptoms in adolescents relate more closely to relative affluence (i.e., relative deprivation or rank affluence within regions or schools) than to absolute affluence. Data on family material assets and psychosomatic symptoms were collected from 48,523 adolescents in eight countries (and Ukraine) as part of the 2009/10 Health Behaviour in School-aged Children study. Multilevel regression analyses of the data showed that relative deprivation (Yitzhaki Index, calculated in regions and in schools) and rank affluence (in regions) (1) related more closely to symptoms than absolute affluence, and (2) related to symptoms after differences in absolute affluence were held constant. However, differences in family material assets, whether they are measured in absolute or relative terms, account for a significant variation in adolescent psychosomatic symptoms. Conceptual and empirical issues relating to the use of material affluence indices to estimate socioeconomic position are discussed.
Although it is widely acknowledged that community social capital plays an important role in young... more Although it is widely acknowledged that community social capital plays an important role in young people's health, there is limited evidence on the effect of community social capital on the social gradient in child and adolescent health. Using data from the 2005-2006 Flemish (Belgium) Health Behavior among School-aged Children survey (601 communities, n = 10,915), this study investigated whether community social capital is an independent determinant of adolescents' perceived health and well-being after taking account of individual compositional characteristics (e.g. the gender composition within a certain community). Multilevel statistical procedures were used to estimate neighborhood effects while controlling for individual level effects. Results show that individual level factors (such as family affluence and individual social capital) are positively related to perceived health and well-being and that community level social capital predicted health better than individual social capital. A significant complex interaction effect was found, such that the social gradient in perceived health and well-being (i.e. the slope of family affluence on health) was flattened in communities with a high level of community social capital. Furthermore it seems that socioeconomic status differences in perceived health and well-being substantially narrow in communities where a certain (average) level of community social capital is present. This should mean that individuals living in communities with a low level of community social capital especially benefit from an increase in community social capital. The paper substantiates the need to connect individual health to their meso socioeconomic context and this being intrinsically within a multilevel framework.
The Relation between Presenteeism and Different Types of Future Sickness Absence: Heidi JANSSENS,... more The Relation between Presenteeism and Different Types of Future Sickness Absence: Heidi JANSSENS, et al. Department of Public Health, Ghent University, Belgium-Objectives:
Background: The aim was to study the impact of psychosocial risk factors on long-term sickness ab... more Background: The aim was to study the impact of psychosocial risk factors on long-term sickness absence due to mental health problems (LSA-MH) or musculoskeletal disorders (LSA-MSD) in 2983 Belgian middle-aged workers. Methods: Data were collected from 1372 male and 1611 female workers in the Belstress III study. Considered psychosocial risk factors were job demands, job control, social support, job strain, efforts, rewards, effort-reward imbalance and bullying. Prospective registered sickness absence data were collected during 12 months follow-up; the causes for long-term sickness absence episodes of at least 15 consecutive days were obtained by contacting the general practitioner of the worker. Multiple logistic regression models were used to investigate the relationship between the psychosocial risk factors and LSA-MH and LSA-MSD. Results: Higher levels of rewards at baseline were independently and significantly associated with a lower risk for LSA-MH. Higher levels of control were associated with a lower risk for LSA-MSD during follow-up. Higher job demands and efforts were significantly related to a lower risk for LSA-MSD. Finally, bullying was significantly and independently related to both LSA-MH and LSA-MSD during the follow-up period. Conclusions: These results suggest that psychosocial risk factors are related to LSA-MH and LSA-MSD, of which especially bullying seems to be a potent stressor.
The interplay of occupational and leisure time physical activity (LTPA) in affecting cardiovascul... more The interplay of occupational and leisure time physical activity (LTPA) in affecting cardiovascular health is subject to debate. This study aimed to examine the independent and interacting associations of leisure time and occupational physical activity (OPA) with the incidence of coronary events within the BELSTRESS cohort. The study included 14,337 middle-aged men free from coronary heart disease at baseline. Standardized questionnaires and clinical examinations were used to assess socio-demographic factors, level of physical activity, job strain and classical coronary risk factors. The incidence of clinical coronary events was monitored during a mean follow-up time of 3.15 years. Results demonstrated overall a beneficial relation of LTPA and an adverse relation of physical work demands with cardiovascular health. However, an interaction effect between both physical activity types was observed, showing that men with high physical job demands who also engaged in physical activity during leisure time had an almost four times increased incidence of coronary events after adjusting for socio-demographic and classical coronary risk factors (HR 3.82; 95 % CI 1.41-10.36). Stratified analyses revealed that moderate to high physical activity during leisure time was associated with a 60 % reduced incidence rate of coronary events in men with low OPA (age adjusted HR 0.40; 95 % CI 0.21-0.76), while this protective association was not observed in workers being exposed to high physical work demands (age adjusted HR 1.67; 95 % CI 0.63-4.48). These findings suggest that recommendations regarding LTPA should be tailored according to the level of occupational physical activity.
Janssens, H., Clays, E., Casini, A., Kittel, F., De Clercq, B., Braeckman, L., & De Bacquer, D. (... more Janssens, H., Clays, E., Casini, A., Kittel, F., De Clercq, B., Braeckman, L., & De Bacquer, D. (2012). The prospective relation between presenteeism and different types of sickness absence. European Academy of Occupational Health Psychology, 10th Conference, Abstracts (pp. 178–179). Presented at the 10th Conference of the European Academy of Occupational Health Psychology (EAOHP). ... Janssens H, Clays E, Casini A, Kittel F, De Clercq B, Braeckman L, et al. The prospective relation between presenteeism and different types of sickness ...
Janssens, H., Clays, E., De Clercq, B., Kittel, F., Casini, A., Braeckman, L., & De Bacquer, D. (... more Janssens, H., Clays, E., De Clercq, B., Kittel, F., Casini, A., Braeckman, L., & De Bacquer, D. (2012). Relation between job strain, bullying and depression. European Academy of Occupational Health Psychology, 10th Conference, Abstracts (pp. 132–132). Presented at the 10th Conference of the European Academy of Occupational Health Psychology (EAOHP). ... Janssens H, Clays E, De Clercq B, Kittel F, Casini A, Braeckman L, et al. Relation between job strain, bullying and depression. European Academy of Occupational Health Psychology, 10th Conference, ...
Journal of Occupational and Environmental Medicine, 2013
Objectives: Self-efficacy is defined as a person's beliefs in his or her abilities to successfull... more Objectives: Self-efficacy is defined as a person's beliefs in his or her abilities to successfully complete a task, and has been shown to influence student motivation and academic achievement. The purpose of this study was to evaluate the impact of a new European teaching module in occupational medicine on undergraduate students' self-efficacy and knowledge in the subject matter. Methods: Pre-, in-between, and posttraining tests were used to assess self-efficacy and knowledge building of 261 third-year medical students on occupational health issues. Determinants of self-efficacy and knowledge were also identified. Repeated measurement data were analyzed with multilevel statistical procedures. Results: The level of self-efficacy and knowledge in occupational medicine increased after the training. Students who frequently attended the lectures scored significantly higher than sporadic attendees. There was no relation between the level of self-efficacy and the final knowledge score. Conclusions: Teaching with the new occupational medicine module was effective. Lecture attendance is an important determinant of self-efficacy and performance. Self-efficacy was not associated with knowledge score. Encouraging classroom participation may enhance student achievement.
Comparable data on socioeconomic position (SEP) is essential to international studies on health i... more Comparable data on socioeconomic position (SEP) is essential to international studies on health inequalities. The Health Behaviour in School-aged Children (HBSC) has used the Family Affluence Scale (FAS) on material assets. The present study used data collected from adolescents in eight countries in 2002, 2006 and 2010, and examined the construct validity of the FAS, by focusing on changes in item responses over time. The analyses reported the changes in means in item responses, and fitted models which estimated differential item functioning (DIF), and local dependency (LD) between items. DIF and LD were analysed by Graphical Log-Linear Rasch Models (GLLRMs), and changes in the measurement properties of the FAS over time and between countries were assessed. The results showed that the FAS items have changed their measurement properties between 2002 and 2010, and caution is warranted in studies comparing the FAS between different time points.
Increasing numbers of migrant youth around the world mean growing numbers of heterogeneous school... more Increasing numbers of migrant youth around the world mean growing numbers of heterogeneous school environments in many countries. Contradictory findings regarding the relationship between immigrant school composition (the percentage of immigrant versus non-immigrant students in a school) and adolescent peer violence necessitate further consideration. The current study examined the relationship between immigrant school composition and peer violence, considering classmate support as a potential moderator among 51,636 adolescents (50.1 % female) from 11 countries. The findings showed that a higher percentage of immigrant adolescents in a school was related to higher levels of physical fighting and bullying perpetration for both immigrant and non-immigrant adolescents and lower levels of victimization for immigrants. In environments of low classmate support, the positive relationship between immigrant school composition and fighting was stronger for non-immigrants than in environments w...
We sought to determine whether social capital at the individual-, school-and community-level can ... more We sought to determine whether social capital at the individual-, school-and community-level can explain variance in adolescent smoking and accounts for social inequalities in smoking. We collected data as part of the 2005/6 Health Behavior in School-aged Children survey, a nationally representative survey of the health and well-being of high school pupils in Belgium (Flanders). Social capital was assessed by structural and cognitive components of family social capital, a four-factor school social capital scale and a cognitive community social capital scale. We fitted non-hierarchical multilevel models to the data, with 8453 adolescents nested within a cross-classification of 167 schools and 570 communities. Significant variation in adolescent regular smoking was found between schools, but not between communities. Only structural family social capital and cognitive school social capital variables negatively related to regular smoking. No interactions between socio-economic status and social capital variables were found. Our findings suggest that previously observed community-level associations with adolescent smoking may be a consequence of unmeasured confounding. Distinguishing nested contexts of social capital is important because their associations with smoking differ.
Clays, E., Casini, A., Kittel, F., Godin, I., Janssens, H., De Clercq, B., Braeckman, L., et al. ... more Clays, E., Casini, A., Kittel, F., Godin, I., Janssens, H., De Clercq, B., Braeckman, L., et al. (2012). Psychosocial characteristics at work as risk factors for long-term cause-specific sick leave. European Academy of Occupational Health Psychology, 10th Conference, Abstracts (pp. 151–151). Presented at the 10th Conference of the European Academy of Occupational Health Psychology (EAOHP). ... Clays E, Casini A, Kittel F, Godin I, Janssens H, De Clercq B, et al. Psychosocial characteristics at work as risk factors for long-term cause-specific ...
Previous research on the links between income inequality and health and socioeconomic differences... more Previous research on the links between income inequality and health and socioeconomic differences in health suggests that relative differences in affluence impact health and well-being more than absolute affluence. This study explored whether self-reported psychosomatic symptoms in adolescents relate more closely to relative affluence (i.e., relative deprivation or rank affluence within regions or schools) than to absolute affluence. Data on family material assets and psychosomatic symptoms were collected from 48,523 adolescents in eight countries (and Ukraine) as part of the 2009/10 Health Behaviour in School-aged Children study. Multilevel regression analyses of the data showed that relative deprivation (Yitzhaki Index, calculated in regions and in schools) and rank affluence (in regions) (1) related more closely to symptoms than absolute affluence, and (2) related to symptoms after differences in absolute affluence were held constant. However, differences in family material assets, whether they are measured in absolute or relative terms, account for a significant variation in adolescent psychosomatic symptoms. Conceptual and empirical issues relating to the use of material affluence indices to estimate socioeconomic position are discussed.
Although it is widely acknowledged that community social capital plays an important role in young... more Although it is widely acknowledged that community social capital plays an important role in young people's health, there is limited evidence on the effect of community social capital on the social gradient in child and adolescent health. Using data from the 2005-2006 Flemish (Belgium) Health Behavior among School-aged Children survey (601 communities, n = 10,915), this study investigated whether community social capital is an independent determinant of adolescents' perceived health and well-being after taking account of individual compositional characteristics (e.g. the gender composition within a certain community). Multilevel statistical procedures were used to estimate neighborhood effects while controlling for individual level effects. Results show that individual level factors (such as family affluence and individual social capital) are positively related to perceived health and well-being and that community level social capital predicted health better than individual social capital. A significant complex interaction effect was found, such that the social gradient in perceived health and well-being (i.e. the slope of family affluence on health) was flattened in communities with a high level of community social capital. Furthermore it seems that socioeconomic status differences in perceived health and well-being substantially narrow in communities where a certain (average) level of community social capital is present. This should mean that individuals living in communities with a low level of community social capital especially benefit from an increase in community social capital. The paper substantiates the need to connect individual health to their meso socioeconomic context and this being intrinsically within a multilevel framework.
The Relation between Presenteeism and Different Types of Future Sickness Absence: Heidi JANSSENS,... more The Relation between Presenteeism and Different Types of Future Sickness Absence: Heidi JANSSENS, et al. Department of Public Health, Ghent University, Belgium-Objectives:
Background: The aim was to study the impact of psychosocial risk factors on long-term sickness ab... more Background: The aim was to study the impact of psychosocial risk factors on long-term sickness absence due to mental health problems (LSA-MH) or musculoskeletal disorders (LSA-MSD) in 2983 Belgian middle-aged workers. Methods: Data were collected from 1372 male and 1611 female workers in the Belstress III study. Considered psychosocial risk factors were job demands, job control, social support, job strain, efforts, rewards, effort-reward imbalance and bullying. Prospective registered sickness absence data were collected during 12 months follow-up; the causes for long-term sickness absence episodes of at least 15 consecutive days were obtained by contacting the general practitioner of the worker. Multiple logistic regression models were used to investigate the relationship between the psychosocial risk factors and LSA-MH and LSA-MSD. Results: Higher levels of rewards at baseline were independently and significantly associated with a lower risk for LSA-MH. Higher levels of control were associated with a lower risk for LSA-MSD during follow-up. Higher job demands and efforts were significantly related to a lower risk for LSA-MSD. Finally, bullying was significantly and independently related to both LSA-MH and LSA-MSD during the follow-up period. Conclusions: These results suggest that psychosocial risk factors are related to LSA-MH and LSA-MSD, of which especially bullying seems to be a potent stressor.
The interplay of occupational and leisure time physical activity (LTPA) in affecting cardiovascul... more The interplay of occupational and leisure time physical activity (LTPA) in affecting cardiovascular health is subject to debate. This study aimed to examine the independent and interacting associations of leisure time and occupational physical activity (OPA) with the incidence of coronary events within the BELSTRESS cohort. The study included 14,337 middle-aged men free from coronary heart disease at baseline. Standardized questionnaires and clinical examinations were used to assess socio-demographic factors, level of physical activity, job strain and classical coronary risk factors. The incidence of clinical coronary events was monitored during a mean follow-up time of 3.15 years. Results demonstrated overall a beneficial relation of LTPA and an adverse relation of physical work demands with cardiovascular health. However, an interaction effect between both physical activity types was observed, showing that men with high physical job demands who also engaged in physical activity during leisure time had an almost four times increased incidence of coronary events after adjusting for socio-demographic and classical coronary risk factors (HR 3.82; 95 % CI 1.41-10.36). Stratified analyses revealed that moderate to high physical activity during leisure time was associated with a 60 % reduced incidence rate of coronary events in men with low OPA (age adjusted HR 0.40; 95 % CI 0.21-0.76), while this protective association was not observed in workers being exposed to high physical work demands (age adjusted HR 1.67; 95 % CI 0.63-4.48). These findings suggest that recommendations regarding LTPA should be tailored according to the level of occupational physical activity.
Janssens, H., Clays, E., Casini, A., Kittel, F., De Clercq, B., Braeckman, L., & De Bacquer, D. (... more Janssens, H., Clays, E., Casini, A., Kittel, F., De Clercq, B., Braeckman, L., & De Bacquer, D. (2012). The prospective relation between presenteeism and different types of sickness absence. European Academy of Occupational Health Psychology, 10th Conference, Abstracts (pp. 178–179). Presented at the 10th Conference of the European Academy of Occupational Health Psychology (EAOHP). ... Janssens H, Clays E, Casini A, Kittel F, De Clercq B, Braeckman L, et al. The prospective relation between presenteeism and different types of sickness ...
Janssens, H., Clays, E., De Clercq, B., Kittel, F., Casini, A., Braeckman, L., & De Bacquer, D. (... more Janssens, H., Clays, E., De Clercq, B., Kittel, F., Casini, A., Braeckman, L., & De Bacquer, D. (2012). Relation between job strain, bullying and depression. European Academy of Occupational Health Psychology, 10th Conference, Abstracts (pp. 132–132). Presented at the 10th Conference of the European Academy of Occupational Health Psychology (EAOHP). ... Janssens H, Clays E, De Clercq B, Kittel F, Casini A, Braeckman L, et al. Relation between job strain, bullying and depression. European Academy of Occupational Health Psychology, 10th Conference, ...
Journal of Occupational and Environmental Medicine, 2013
Objectives: Self-efficacy is defined as a person's beliefs in his or her abilities to successfull... more Objectives: Self-efficacy is defined as a person's beliefs in his or her abilities to successfully complete a task, and has been shown to influence student motivation and academic achievement. The purpose of this study was to evaluate the impact of a new European teaching module in occupational medicine on undergraduate students' self-efficacy and knowledge in the subject matter. Methods: Pre-, in-between, and posttraining tests were used to assess self-efficacy and knowledge building of 261 third-year medical students on occupational health issues. Determinants of self-efficacy and knowledge were also identified. Repeated measurement data were analyzed with multilevel statistical procedures. Results: The level of self-efficacy and knowledge in occupational medicine increased after the training. Students who frequently attended the lectures scored significantly higher than sporadic attendees. There was no relation between the level of self-efficacy and the final knowledge score. Conclusions: Teaching with the new occupational medicine module was effective. Lecture attendance is an important determinant of self-efficacy and performance. Self-efficacy was not associated with knowledge score. Encouraging classroom participation may enhance student achievement.
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Papers by Bart Clercq