Pirjo Lindfors

Pirjo Lindfors
Tampere University | UTA · Faculty of Social Sciences

Doctor of Social Sciences, Title of Docent on Health Promotion

About

71
Publications
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Introduction
Pirjo Lindfors currently works at the Faculty of Social Sciences, Health Sciences, University of Tampere, Finland. She is currently involved in the projects: RELE- Redefining Adolescent Learning: A Multi-level Longitudinal Cohort Study of Adolescent Learning, Health, and Well-being in Educational Transitions in Finland. Consortium with University of Helsinki Centre for Educational Assessment. SILNE-R (Horizon 2020, 2015–2018) Enhancing the Effectiveness of Programs and Strategies to Prevent Youth Smoking – A Comparative Realist Evaluation of 7 European Countries and Adolescent Health and Lifestyle Survey

Publications

Publications (71)
Article
Teachers play a crucial role in students’ learning and in the development of health literacy. Hence, the aim of this study was to identify the core competencies needed for teachers of health education in supporting student learning. A three-round Delphi study was carried out over an 8-week period, through consultation with 25 Finnish experts in hea...
Article
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Online health information-seeking behaviour has increased since the World Health Organization declared COVID-19 a global pandemic in March 2020. This study examined whether health-related information on COVID-19 searched on the internet was associated with mental well-being among higher education students. A cross-sectional internet survey was cond...
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Itsearvioitu terveydentila on monipuolinen mittari, jossa sosiokulttuuriset tekijät yhdistyvät yksilötasoiseen kokemukseen. Monipuolisuutensa vuoksi se on tärkeä väline lasten terveysseurannassa. Suomalaisten lasten itsearvioitu terveydentila näyttää huonontuneen viime vuosina. Lisää tietoa lasten terveyskokemuksesta ja siihen yhteydessä olevista t...
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Opettajien yhteisöllisen pystyvyyden ja yhteistyötä rakentavasta vuorovaikutuksesta muodostuvan yhteisöllisyyden tiedetään auttavan opettajia suoriutumaan työstään, mutta suomalaisten koulujen opettajien yhteisöllisyydessä ilmeneviä eroja ja niiden heijastumista oppilaiden oppimiseen ja hyvinvointiin on tutkittu vähemmän. Tarkastelemme koronapandem...
Article
Pitkittynyt työttömyys voidaan katkaista lyhytkestoisella tukityöllistämisellä, jolla voi olla vaikutusta työttömien hyvinvointiin, terveyteen ja toimintakykyyn. Työllistäminen voi vaikuttaa myös perusterveydenhuollon avopalvelujen käyttöön esimerkiksi tuomalla näkyväksi piilevää palvelutarvetta. Artikkelissa tutkitaan harvaan asutun kunnan tukityö...
Article
Full-text available
Background School staff members’ consistent enforcement of school tobacco policies (STPs) is needed to decrease adolescent smoking and exposure to tobacco smoke. Staff’s confidence, indicating their perceived ability to cope with students’ negative responses, explains variations in staff’s STPs enforcement, yet understanding of the determinants for...
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Background: To address social inequalities in adolescent substance use and consequent disparities in health, it is important to identify the mechanisms of the association between substance use and academic performance. We study the role of health literacy (HL) in the association between academic performance and weekly smoking, monthly alcohol use...
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The COVID-19 pandemic enforced countries to close schools and rapidly transfer to distance teaching without preparation. Little is known about how different distance teaching practices influenced students’ wellbeing. We studied this during the period of school closures in Finland. Wellbeing was measured by health complaints and perceived loneliness...
Article
Background During the COVID-19 pandemic, Internet and social media became important and fast sources of health information, leading to overabundance of both valid and invalid information. Digital health literacy (DHL) is a core competency for navigating web- and social media based COVID-19 information. This study is part of the global COVID-HL surv...
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Background: Studies comparing adolescent e-cigarette use in different countries are scarce. We study students' e-cigarette and conventional cigarette ever-use, their social correlates and e-liquid use in seven EU countries. Methods: SILNE-R data (N=12 167, response rate 79.4%) of 14-17-year-olds from Amersfoort (NL), Coimbra (PT), Dublin (IR), H...
Article
Background Adolescents' images of the future emerge from knowledge built on experiences of the past and present and their age-related developmental tasks. Images of the future direct adolescents' decision-making, choices, and behavior. The images of the future can act as a mirror of our times, reflecting the political values and ethos of society. T...
Article
Background Serious long-term diseases like asthma, diabetes or epilepsy in adolescence means extra efforts to cope everyday life in school, hobbies or at home. These also set extra challenges on adolescents to go through the developmental tasks of that age. We study here, if adolescents with a long-term disease have lower chances for an academic ed...
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Existing literature on recent trends in adolescent gambling is scarce. The rapidly changing landscape of gambling, together with the generally applied legal age limits, calls for the continuous monitoring of gambling also among the adolescent population. In Finland, the legal gambling age is 18. We examined changes in adolescents’ gambling, gamblin...
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The long-term effects of sleep on adolescent psychosocial well-being are mostly unknown, although insufficient sleep has been associated with emotional and behavioral difficulties in cross-sectional studies. With a five-year follow-up of Finnish adolescents (Time 1: n = 8834; Mean age = 13 years, 51.1% female, Time 2: n = 5315, Mean age = 15 years,...
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Peer networks at school and students’ position in these networks can influence their academic well-being. We study here individual students’ network position (isolation, popularity, social activity) and peer network structures at the school level (centralization, density, clustering, school connectedness) and their relations to students’ academic w...
Article
Background Advocacy, resources and intersubjective reasonable arguments are known as factors that contribute to smoke-free (SF) adoption and implementation in Chinese and Anglo-Saxon places. Less is known about how the implementation of smoking bans differs across European places. The aim of this qualitative comparative study is to identify and cl...
Article
School tobacco policies (STPs) are a crucial strategy to reduce adolescents smoking. Existing studies have investigated STPs predominantly from a school-related 'insider' view. Yet, little is known about barriers that are not identified from the 'schools' perspective', such as perceptions of local stakeholders. Forty-six expert interviews from seve...
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Background: The health selection hypothesis suggests that poor health leads to low educational attainment during the life course. Adolescence is an important period as poor health might prevent students from making the best educational choices. We test if health in adolescence is associated with educational aspirations and whether these associatio...
Article
Background Adolescents’ alcohol use and binge drinking decreased in Finland since 2001 while the proportion of those who did not drink, increased until 2017. The 2018 Alcohol Act (entered 1 March) allowed retail stores sell all alcoholic beverages containing up to 5.5% alcohol by volume (previously 4.7%, beer and cider). Alcopops, assumed popular a...
Article
Background We studied the associations of health-compromising behaviours with a transition into secondary education by following a large cohort of Finnish adolescents. Students with a direct (successful) transition into secondary education after the 9th grade (73%) and those with a late transition (7%) were compared. Methods We analysed the follow...
Conference Paper
Background Beliefs about smoking have been found to be associated with smoking behaviour. Similarly, health literacy (HL) as a competence to make health-related decisions has been identified as an independent factor to explain differences in smoking. However, little is known about adolescents’ HL in different countries, and how HL is associated wit...
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Secondary schools in European countries increasingly implement comprehensive smoke-free school policies (SFSPs) that prohibit most or even all adolescents from smoking during school hours. Consistent enforcement of SFSPs is essential for realizing optimum effectiveness. A main challenge represents adolescents who persistently violate the rules. We...
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Background: The Finnish government has emphasized the need to expedite educational transitions. We study if a late start of upper secondary education is related to health-related selection, namely health-compromising behaviours in adolescence. Methods: A large cohort of adolescents from the seventh (12-13 years) and ninth (15-16 years) grades an...
Article
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Introduction: Bans on smoking in public places and on sales to minors have been widely implemented across the globe. However, many countries have either adopted non-comprehensive (i.e., partial) bans and/or weakly enforce those bans. Little is known, from the adolescents' perspective, how this affects their smoking-related perceptions and behavior...
Article
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Background: School tobacco policies (STPs) that aim to achieve a tobacco-free environment require consistent enforcement by school staff. However, little is known about why staff choose whether or not to enforce STPs. Therefore, we investigated staff members' responses to STPs that determine enforcement. Furthermore, we examined how these response...
Article
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Background: Several studies indicate an association between e-cigarette use and subsequent smoking among youth. However, most previous studies lack measures of the nicotine content of e-liquid and have not usually measured regular smoking. Methods: We tested the association between e-cigarette use, with and without nicotine, and subsequent daily...
Article
Abstract Background Previous research suggests that parental knowledge of the child’s activities and whereabouts prevents adolescents’ alcohol use. However, evidence on whether the positive effects of maternal and paternal knowledge are distinctive for boys’ and girls’ alcohol use is inconclusive. We examined whether perceived parental knowledge at...
Article
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Background: Low academic achievement has been associated with smoking but factors behind this association are poorly known. Such factors could include schoolwork disengagement and schoolwork difficulties. To assess the extent to which they contribute to the explanation of how health inequalities emerge, we study in a longitudinal design whether th...
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Little is known of the predictors of electronic cigarette (e-cigarette) use among adolescents, even though the use is increasing. We studied here the predictors for e-cigarette experimentation (tried and tried more than twice) and compared them with predictors for conventional smoking. A baseline school survey was conducted in the Helsinki metropol...
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Research on the associations between family and school social capital, school burnout and academic achievement in adolescence is scarce and the results are inconclusive. We examined if family and school social capital at the age of 13 predicts lower school burnout and better academic achievement when graduating at the age of 16. Using data from 446...
Article
BACKGROUND: Studies have shown a relationship between students’ health and their academic achievements, but whether health of classmates and schoolmates impacts individual students’ school achievement is less known. We studied these effects on students in lower secondary school in Finland. METHODS: Students (seventh grade, age 12-13 years., N=7779,...
Conference Paper
Background Low academic performance has been associated with poor health but less so in longitudinal studies. We examined whether psychosocial health and health complaints at the beginning of lower secondary school predicts academic performance when leaving basic education. Our research hypothesis included micro and macro level contributions of psy...
Article
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Electronic cigarettes are quite a new potential source of nicotine addiction among youth. More research is needed, particularly on e-liquid use and socioeconomic factors as potential determinants. We studied changes from 2013 to 2015 in adolescent e-cigarette awareness and ever-use, types of e-liquids, and determinants in Finland. In 2015, we studi...
Conference Paper
Background Low academic performance has been associated with poor health but less so in longitudinal studies. We examined whether psychosocial health and health complaints at the beginning of lower secondary school predicts academic performance when leaving basic education. Our research hypothesis included micro and macro level contributions of psy...
Chapter
Koulun oppilasmäärällä ei ollut yhteyttä koulutusvalintaan ja sen onnistumiseen, kun taas maahanmuuttajataustaisten oppilaiden suhteellisella määrällä sekä koulussa annetun erityisopetuksen määrällä oli yhteyttä koulutusvalintaan. Maahanmuuttajataustaisten oppilaiden suhteellinen määrä koulussa sekä osa-aikaisen erityisopetuksen määrä koulussa ennu...
Chapter
Oppilaiden hyvinvointiin liittyvät tekijät, koulu-uupumus ja tupakointi, ennustivat toisen asteen koulutusvalintaa ja sen onnistumista, vaikka samaan aikaan kontrolloitiin koulumenestys ja taustamuuttujat. Koulu-uupumus ja tupakointi yläkoulussa olivat myös vastavuoroisessa yhteydessä oppilaan koulumenestykseen. Tulokset vahvistavat aiempia tuloksi...
Chapter
Tarkasteltaessa oppilaiden hyvinvoinnin ja terveyskäyttäytymisen muutoksia 7. luokalta 9. luokalle kouluryppäittäin, havaittiin negatiivista kehitystä lähes kaikissa indikaattoreissa: päivittäinen tupakointi ja humalajuominen lisääntyivät, välittömän psykososiaalisen tuen tarve lisääntyi, päivittäinen oireilu lisääntyi, säännöllisen aamupalan syömi...
Chapter
Koulujen välillä on suuria eroja oppilashuoltopalvelujen resursseissa. Noin kaksi kolmasosaa kouluista yltää kuraattoriresurssien osalta suositukseen ja noin kolme neljästä kouluterveydenhoitajaresurssien osalta. Psykologiresurssien osalta pääsee suositukseen vain noin kolmasosa kouluista ja lääkärien osalta noin joka kymmenes. Niissä kouluissa, jo...
Chapter
Koulujen yhtenäistä toimintakulttuuria rakentavat käytännöt kuten oppilaiden ja huoltajien osallisuus vaihtelivat koulujen välillä, ja useimmissa toimintakäytännöissä vain osassa kouluja oppilaat voivat osallistua toiminnan suunnitteluun, kehittämiseen ja arviointiin. Viime vuosina myös lapsi- ja nuorisopolitiikassa on ryhdytty erityisesti painotta...
Article
Full-text available
It is well established that poor academic performance is related to smoking, but the association between academic well-being and smoking is less known. We measured academic well-being by school burnout and schoolwork engagement and studied their associations with smoking among 14- to 17-year-old schoolchildren in Belgium, Germany, Finland, Italy, t...
Conference Paper
Abstract: Objectives The purpose was to study if students’ academic well-being, measured by school burn-out, and health-compromising behavior, measured by smoking, as well as classroom climate during the lower secondary school (grades 7th to 9th) predict the choice of educational track at the upper secondary school (academic vs. vocational) after t...
Book
Learning and well-being have been largely treated as separate entities in research and legislation regarding children and youth, and in the daily practices of the school. In 2011, a new research project was launched to study in unison the learning and well-being of approximately 10 000 seventh graders in the 14 municipalities of the Helsinki Metrop...
Book
Learning and well-being have been largely treated as separate entities in research and legislation regarding children and youth, and in the daily practices of the school. In 2011, a new research project was launched to study in unison the learning and well-being of approximately 10 000 seventh graders in the 14 municipalities of the Helsinki Metrop...
Article
Full-text available
The influence of parents’ smoking on children’s smoking is well known, but few studies have examined the association between grandparents’ and grandchildren’s smoking. We studied the association between paternal and maternal grandparents’ smoking and their grandchildren’s tobacco use and assessed whether parents’ smoking is a mediator in this proce...
Article
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Monolingual Web survey is a common tool for studying adolescent health. However, national languages may cause difficulties for some immigrant-origin youths, which lower their participation rate. In national surveys, the number of ethnic minority groups is often too small to assess their well-being. We studied the feasibility of a multilingual Web s...
Article
Background: Monolingual Web survey is a common tool for studying adolescent health. However, national languages may cause difficulties for some immigrant-origin youths, which lower their participation rate. In national surveys, the number of ethnic minority groups is often too small to assess their well-being.
Article
Purpose Physical activity is a key to independent functional ability among older adults but few interventions have been conducted in assisted‑living residences. A pedometer has been stated to be ‘a good-enough’ measuring device for the assessment of walking activity in older populations. Research has, however, focused more on community dwelling old...
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Background Burnout is usually regarded as a work-related disorder. For school-aged children, school-related burnout could be defined correspondingly consisting of exhaustion due to school demands, cynical attitude toward school, and sense of inadequacy at school. Little is known about the variance between school systems, as well as its associatio...
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Early support has been acknowledged to be needed in the phase of transition to parenthood, and increasing knowledge is available on the factors enhancing this transition. The issue is to translate the knowledge into practices of preventive care. In this article, our aim is to map out recent research on supporting parents in maternity and child heal...
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This study introduces Finnish girls’ views on and explanations for the factors contributing to their decisions concerning their first sexual intercourse. The data consists of personal interviews with girls aged 16–19, and stories produced through process drama. The analysis was conducted by narrative methods. Two model story categories of the first...
Article
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A wide range of electronic cigarettes (e-cigarettes) are now on the market. We studied e-cigarette awareness and use, determinants and sources of e-cigarettes, the e-liquids used in them and exposure to e-cigarette advertisements among adolescents in Finland. Among smokers, we studied the association of e-cigarette use and interest in smoking cessa...
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We aimed to develop and evaluate the effectiveness of an individualized, long-term support lifestyle counseling approach in promoting healthy physical activity, improving dietary and sleeping behaviors, and preventing weight gain in young females. The counseling approach's intensity was designed to be low enough to be implementable in primary healt...
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We examined whether the occurrence of violence changed among Finnish adolescents between 1999 and 2009. The study was based on the nationwide Adolescent Health and Lifestyle Survey from samples of 12- to 18-year-olds. The number of respondents was 8136 in 1999 and 5516 in 2009. The proportion of adolescents reporting violence was 7.9% in 1999 and 6...
Article
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Background Cyberbullying, threatening or harassing another via the internet or mobile phones, does not cause physically harm and thus the consequences are less visible. Little research has been performed on the occurrence of cyberbullying among adolescents or the perception of its seriousness. Only a few population-based studies have been published...
Article
Wireless and mobile phone technology as a method of data collection will increase alongside conventional methods. The aim of the present study was to evaluate the use of a mobile phone application for recording symptoms and physical activity exertion during an experimental physical exercise study. An experimental study on the effects of physical ex...
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We examined how Finnish adolescents' fears for their future changed over a quarter of a century and how these changes reflect transformations of the adolescents' key contexts from the late-modernist perspective. Nationally representative samples of 12-, 14-, 16-, and 18-year-olds in 1983, 1997, and 2007 were surveyed using mailed questionnaires reg...
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In health care encounters, complaining is usually discussed in terms of written and filed customer or patient complaints against negligence or malpractice within the medical institution. Less attention has been paid to complaining as a co-constructed activity that may emerge in various ways, depending on the institutional and structural context in...
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The aim of the study was to examine the construct validity of the Three-Factor Eating Questionnaire -R18 (TFEQ-R18), a measure of eating behaviour, and to evaluate cognitive restraint, uncontrolled eating and emotional eating in a sample of adolescent and young adult females of different weights. Subjects were 2 997 females, aged 17 to 20 years, wh...
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We explore the variety of practices professionals and patients use whilst discussing patients' eating and drinking habits in general practice and in homeopathic consultations. Our aim is to show how the interaction is shaped, on the one hand, by the professionals' theories and goals and, on the other hand, by the participants' orientations to other...

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