Video game addiction among Tunisian adolescents in Sousse: A cross-sectional study in high schools

Abstract Background Addiction to video games is a theme regularly mentioned and associated with the risks that concern adolescents. This study aimed to determine the prevalence of video game addiction (VGA) among adolescents and identify its associated factors. Methods We conducted a cross-sectional study within public high schools, in Sousse, Tunisia in 2019. The target population was high school students. A structured self-administered questionnaire was used to collect data about sociodemographic characteristics, lifestyle behaviors, and mental health disorders, and we used the 21-item Game Addiction Scale to objectify video game addiction. Statistical analysis was carried out using the program SPSS v.20. Results A total of 1342 participants were recruited for the study,36.8% of whom were boys. The average age was 17.5 ±1.44 years. The analysis of mental health disorders showed that 67% were anxious, 66.8% were alexithymic, 65.4% were depressed and 39% had low self-esteem. The analysis of lifestyle behaviors showed that a lack of physical activity was reported by 57.6% of participants. Problematic use of the Internet (>2 hours per day) was reported among 72.4% of the students. The prevalence of video game addiction was 13%. Boys were more prone to be addicted than girls (66.2% versus 33.8%, p < 0.001). ≥17 years old students had a higher rate of VGA than those aged<17 years old (57.3% vs 42.7%, p = 0.031). VGA was higher among students who follow the non-scientific study section (69.4%, p = 0.007). Students who had moderate depression had the highest percentages of VGA (35.7%, p = 0.005). Students who had problematic use of the internet were more addicted to video games (80.3%) than those not having problematic use (19.7%), p = 0.009. Conclusions This study allowed us to identify the students who are vulnerable to VGA. Also, a huge responsibility is accorded to school staff and parents to tackle this health problem by sensitizing their children and setting up some protective family rules. Key messages • Several factors were significantly associated with video game addiction, especially problematic internet use. • Further research is needed to understand the underlying mechanisms of video game addiction and to explore effective preventive or interventional strategies.

This study aimed to examine potential risk and protective factors for binge drinking among a cohort of 15-16-year-old adolescents in the West of Ireland. This study was a crosssectional secondary analysis of 4,473 15-16-year-olds who participated in the 2020 Planet Youth survey. Binge drinking was defined as ever consumption of five or more drinks in a two-hour period or less. Data were analysed using SPSS version 27. Multivariable logistic regression was used to examine independent associations between potential risk and protective factors and binge drinking. A p-value of < 0.05 was deemed statistically significant. The prevalence of binge drinking among participants was 34.1%. Female gender (aOR 0.55, 95% CI 0.46-0.67, p < 0.001) and non-White ethnicity (aOR 0.49, 95% CI 0.31-0.77, p = 0.002) were associated with reduced odds of ever binge drinking. Selfrated 'bad/very bad' mental health (aOR 1.61, 95% CI 1.26-2.06, p < 0.001), current cigarette use (aOR 4.06, 95% CI 3.01-5.47, p < 0.001) and current cannabis use (aOR 2.79, 95% CI 1.80-4.31, p < 0.001) were associated with increased odds of ever binge drinking. Parental supervision (aOR 0.80, 95% CI 0.73-0.88, p < 0.001) and negative parental reaction to adolescent drunkenness (aOR 0.51, 95% CI 0.42-0.61, p < 0.001) reduced the odds of ever binge drinking among participants. Getting alcohol from parents was associated with increased odds of ever binge drinking (aOR 1.79, 95% CI 1.42-2.25, p < 0.001). Adolescents with friends who drink alcohol had almost 5 times higher odds of ever binge drinking (aOR 4.59, 95% CI 2.65-7.94, p < 0.001). Participating in team sports was also associated with increased odds of ever binge drinking (aOR 1.30, 95% CI 1.07-1.57, p = 0.008 for 1-4 times/week, aOR 1.52, 95% CI 1.07-2.16, p = 0.020 for !5 times/week). This study highlights key influences of adolescents' social environment on their binge drinking, and a need for renewed public health efforts to protect adolescents from alcoholrelated harm.

Key messages:
This study identified a high prevalence of ever binge drinking among adolescents in the West of Ireland -this is highly concerning as adolescents are vulnerable to alcoholrelated harm. This study identified factors in the social environment of adolescents associated with binge drinking. This can inform public health action to protect adolescents from alcoholrelated harm.
Abstract citation ID: ckac129.520 Video game addiction among Tunisian adolescents in Sousse: A cross-sectional study in high schools

Background:
Addiction to video games is a theme regularly mentioned and associated with the risks that concern adolescents. This study aimed to determine the prevalence of video game addiction (VGA) among adolescents and identify its associated factors.

Methods:
We conducted a cross-sectional study within public high schools, in Sousse, Tunisia in 2019. The target population was high school students. A structured self-administered questionnaire was used to collect data about sociodemographic characteristics, lifestyle behaviors, and mental health disorders, and we used the 21-item Game Addiction Scale to objectify video game addiction. Statistical analysis was carried out using the program SPSS v.20.

Results:
A total of 1342 participants were recruited for the study,36.8% of whom were boys. The average age was 17.5 AE1.44 years. The analysis of mental health disorders showed that 67% were anxious, 66.8% were alexithymic, 65.4% were depressed and 39% had low self-esteem. The analysis of lifestyle behaviors showed that a lack of physical activity was reported by 57.6% of participants. Problematic use of the Internet (>2 hours per day) was reported among 72.4% of the students. The prevalence of video game addiction was 13%. Boys were more prone to be addicted than girls (66.2% versus 33.8%, p < 0.001). !17 years old students had a higher rate of VGA than those aged<17 years old (57.3% vs 42.7%, p = 0.031). VGA was higher among students who follow the non-scientific study section (69.4%, p = 0.007). Students who had moderate depression had the highest percentages of VGA (35.7%, p = 0.005). Students who had problematic use of the internet were more addicted to video games (80.3%) than those not having problematic use (19.7%), p = 0.009.

Conclusions:
This study allowed us to identify the students who are vulnerable to VGA. Also, a huge responsibility is accorded to school staff and parents to tackle this health problem by sensitizing their children and setting up some protective family rules.
Key messages: Several factors were significantly associated with video game addiction, especially problematic internet use.

Background:
The health and development of school-age children is a contemporary topic of various health policies and programs, which has become even more of a focus in critical situations such as the COVID-19 pandemic. The study aims to assess the prevalence of school-age children's participation in fights and bullying in Serbia, and to examine the relevance of students' socio-demographic characteristics and perceptions of school and relations with other students and professors for participation in fights and bullying.

Methods:
A secondary analysis of the original data of the 2017 HBSC study is performed on 3267 students in a nationally representative sample of primary and high schools in Serbia. Predictors of taking part in fights and taking part in bullying were examined by using univariate and multivariate logistic regression.

Results:
The main results show that 50.8% of boys and 17.1% of girls have taken part in fights, while 17.7% boys and 10.4% of girls have taken part in bullying. Students who felt a large and very large burden of school obligations were 1.43 times more likely to participate in bullying at least once, while they were 1.38 and 2.12 times more likely to participate in multiple fights and 4.04, 1.24, and 2.78 times more likely to participate multiple times in bullying. Fights among school-age children are significantly positively associated with living with relatives/ legal guardians and poor quality of life.

Conclusions:
The prevalence of participating in at least one fight/bullying is higher than in multiple fights/bullying. These associations suggest a necessity to enhance the monitoring and control of peer behavior among school-age children. The findings of the study imply key enablers of protection, such as building relationships based on team spirit and work, friendly behavior, empathy, and help, which should be included in the value system of school and family activities in programs to combat fights and bullying in school-age children.

Key messages:
In Serbia, every second boy and every fifth girl participated in fights, while less than every fifth boy and every tenth girl participated in bullying. Study results can inform school and healthcare actors' efforts to improve school-age children's development and health capacity for life.

Background:
Early childcare has been linked to child development in some countries. The aim of this study is to evaluate the impact of early childcare in the French context, where children can attend different types of childcare facilities prior to age 3 when they enter kindergarten, and development at age 3.5 years. Methods: 10,683 children from the ELFE French national birth cohort were classified into 4 groups depending on their main type of childcare between birth and age three: childminder (n = 5,014), centre-based childcare (n = 2,583), informal childcare (n = 777) and parents only (n = 2,465). Children's development was measured with the short form of the Child Development Inventory (CDI) via parents-reports at age 3.5 years. The CDI score was transformed into a Development Quotient (DQ) taking into account the child's age, and global developmental delay was defined as DQ < 90. Missing data was imputed by Fully Conditional Multiple Imputation with 10 imputations. Multinomial analyses were carried out adjusted by Inverse Probability Weighting based on Propensity Scores calculated using main selection and confounding variables.

Results:
Compared to children who were cared for by parents only, children who were cared for by a childminder or in a centrebased childcare had a higher DQ (103.0 and 104.8 respectively) as well as a lower likelihood of global developmental delay (propensity-score weighted OR = 0.84, [95% CI 0.70-1.01] and propensity-score weighted OR = 0.54, [95% CI 0.44-0.66]) respectively.

Conclusions:
In the French context, early centre-based childcare attendance is significantly associated with a lower risk of global child delay. Policies should make centre-based childcare more accessible to a broader number of children.

Key messages:
Early childcare type is linked to child development in France. Children in centre-based childhood had a lower likelihood of developmental delay compared to those looked after by parents only.