HBSC Study Overview

By supporting the Health Behaviour in School-Aged Children (HBSC) study, the government of Canada seeks to

  • collect data on school-aged young people to gain insights into their health attitudes, behaviours, and lifestyles; document trends; examine the effect of contextual factors; and draw international comparisons;
  • contribute to theoretical, conceptual, and methodological development; the knowledge base on health behaviour and the social contexts of health; establishment of international expertise; and a national information system on the health of young people in Canada;
  • disseminate findings to relevant audiences, including researchers, health and education policy-makers, health promotion practitioners, teachers, parents, and young people; and
  • promote and strengthen national and international research on health behaviour and the social context of health in youth.


In 1982, the HBSC study was initiated by researchers from England, Finland, and Norway to measure a range of youth health behaviours and a number of social and environmental variables. Shortly thereafter, the project was adopted by the WHO Regional Office for Europe as a WHO Collaborative study and the number of participants continued to grow. Canada participated in the 1989/90 survey cycle as an associate member and has since participated in all subsequent survey cycles as a full member.

A major goal of this international approach is to influence health promotion and health education policies and programs in schools and among young people in general. Data are collected through surveys among 11, 13 and 15 year olds. All participating countries use a common methodology and pool their data to form the cross-national data file. By analysing trends over time, it is possible to identify trends in health behaviours in a particular country.

The following countries and regions currently participate in the HBSC study:

  • Austria
  • Belgium (Flemish-speaking)
  • Canada
  • Czech Republic
  • England
  • Finland
  • Germany
  • Greenland
  • Iceland
  • Israel
  • Latvia
  • Luxembourg
  • Malta
  • Norway
  • Portugal
  • Russia
  • Slovak Republic
  • Spain
  • Switzerland
  • Ukraine
  • Wales
  • Belgium (French-speaking)
  • Bulgaria
  • Croatia
  • Denmark
  • Estonia
  • France
  • Greece
  • Hungary
  • Ireland, Republic of
  • Italy
  • Lithuania
  • TFYR Macedonia
  • Netherlands
  • Poland
  • Romania
  • Scotland
  • Slovenia
  • Sweden
  • Turkey
  • United States

Conceptual Framework

The HBSC study is rooted in the social and behavioural sciences rather than in classical medical epidemiology. Researchers with differing theoretical orientations are encouraged to use the data to examine different perspectives of young people's health-related behaviour and its determinants. A common conceptual framework, termed "the socialisation perspective", has been adopted for the development of HBSC. It describes the systematic exploration of the influence of various "settings" or "arenas" (e.g., the family, school, friends and media) on young people's health and health related behaviours.


Each country conducts the HBSC study according to quality standards set out in the international research protocol.

The survey sample population of students aged 11 to 15 is randomly selected from schools and/or classes to be nationally or regionally (with a population of at least one million) representative. The data is collected through anonymous self-completion questionnaires administered in the classroom under supervised conditions and are completed in one class period. An international standard questionnaire is used in all participating countries.

The international questionnaire retains a core of items on each survey to facilitate the monitoring of trends over time. Questions specific to Canada are added to reflect national interest and circumstance. The Canadian research team collects the data under a set of guidelines developed by the international network. The Canadian questionnaire for Grades 9 and 10 contains additional questions on risk behaviours. A questionnaire about the school itself has been included since 2001-02.

All HBSC data are cleaned and re-ordered to a consistent format for inclusion in an international data file held at the University of Bergen, Norway.

Core Topics

The core set of questions in each HBSC survey include

  • background factors — demographic characteristics such as age, gender, household composition and perceptions of socioeconomic circumstances;
  • individual and social resources — psycho-social adjustment, including mental health, peer and parental relationships, body image, and school environment;
  • health behaviours — physical activity, dietary habits, tobacco use, alcohol use, cannabis use, sexual behaviour, violence and bullying, injuries, and dental hygiene; and
  • health outcomes — general health, physical ailments, injury, life satisfaction, and medication use.

HBSC Findings

HBSC findings allow for the identification of trends in health behaviour among youth, indicate the effectiveness of youth health policy and programming initiatives, and provide a valuable comparative data source for developed, industrial countries with similar youth health issues. The findings are of interest to professionals in the Canadian health, education, and social services systems; non-governmental organizations; researchers; parents and caregivers; and young people themselves.

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