title: Factors associated with perceived health among 12-year-old school children. Relevance of physical exercise and sense of coherence.
abstract: BACKGROUND
  Poor perceived health during childhood may affect an individual's well-being throughout life. In adult studies, sense of coherence (SOC) has been shown to be associated with perceived health.
  
  
  OBJECTIVE
  The aim of this study was to determine which factors with an emphasis on SOC and physical exercise were associated with perceived health among 12-year-old children.
  
  
  METHODS
  A total of 1,231 12-year-old school children (83%) completed a questionnaire. Most of the 37 questions had multiple-choice types of response. The questions were largely based on those used in the Health Behaviour in School-aged Children (HBSC) study coordinated by the WHO. SOC was determined using the 13-item scale developed by Antonovsky. Factors used in calculating performance at school were marks (given by the teachers, range 4-10, 10 being the best) in mathematics, native language, and first foreign language. Statistical analysis involved the use of logistic regression models and the so-called generalized estimation technique because of the multi-level study design.
  
  
  RESULTS
  In a multivariate model adjusted for reported psychosomatic symptoms, insufficient physical exercise was clearly (OR 4.6) associated with poor perceived health. Other variables with significant associations (OR 1.4-1.7) were a mark below 9 in mathematics, belonging to the weakest SOC tertile, reporting of problems of perceived support from teachers, and reporting of various problems involving the class climate.
  
  
  CONCLUSIONS
  Among the studied variables physical exercise was the most strongly associated with perceived health, even when several social and psychological risk factors were included in the analysis. SOC and variables of social support were also of importance.
authors.affiliation: Turku Health Centre, 20100 Turku, Finland. paivi-leena.honkinen@turku.fi
authors.forename: Päivi-Leena K
authors.initials: PL
authors.lastname: Honkinen
authors.forename: Sakari B
authors.initials: SB
authors.lastname: Suominen
authors.forename: Raili S
authors.initials: RS
authors.lastname: Välimaa
authors.forename: Hans Y
authors.initials: HY
authors.lastname: Helenius
authors.forename: Päivi T
authors.initials: PT
authors.lastname: Rautava
mesh_terms: D000223:Adaptation, Psychological; D002648:Child; D015444:Exercise; D005387:Finland / Q000453:epidemiology; D015438:Health Behavior; D006304:Health Status; D006801:Humans; D011602:Psychophysiologic Disorders / Q000453:epidemiology; D012044:Regression Analysis; D012307:Risk Factors; D012649:Self Concept; D012944:Social Support; D011795:Surveys and Questionnaires