title: Internet and game behaviour at a secondary school and a newly developed health promotion programme: a prospective study.
abstract: BACKGROUND
  This study investigated the Internet and game use of secondary school children, the compulsiveness of their use and the relationship with other health behaviours. It also evaluated the preliminary results of a recently developed school health promotion programme, implemented at a secondary school in the Netherlands in January 2008. This programme is one of the first to combine seven health behaviours in one educational programme and is a pilot project for a case-control study.
  
  
  METHODS
  A total of 475 secondary school children completed an extensive questionnaire before and a year after starting the programme. Of these children, 367 were in first, second and third grade; the grades in which the lessons about internet and game behaviour were implemented. Questionnaires contained questions about personal information, Internet and game use (Compulsive Internet Use Scale), and other health behaviours (alcohol use, physical activity, psychosocial wellbeing and body mass index).
  
  
  RESULTS
  Heavy Internet use was significantly associated with psychosocial problems, and heavy game use was significantly associated with psychosocial problems and less physical activity. No relationship was found with alcohol use or body mass index. The time spent on Internet (hours/day) and the number of pathological Internet users increased during the study. The number of game users decreased but heavy game use increased.
  
  
  CONCLUSIONS
  The association between heavy Internet use and psychosocial problems and between game use and psychosocial problems and less physical activity emphasizes the need to target different health behaviours in one health education programme. A case-control study is needed to further assess the programme-induced changes in Internet and game behaviour of school children.
authors.affiliation: Julius Center, Division of Public Health, Utrecht University, Utrecht, The Netherlands. j.r.j.deleeuw@umcutrecht.nl
authors.forename: J Rob J
authors.initials: JR
authors.lastname: de Leeuw
authors.forename: Marieke
authors.initials: M
authors.lastname: de Bruijn
authors.forename: Gerdien H
authors.initials: GH
authors.lastname: de Weert-van Oene
authors.forename: August J P
authors.initials: AJ
authors.lastname: Schrijvers
mesh_terms: D000293:Adolescent; D000294:Adolescent Behavior; D002648:Child; D002652:Child Behavior; D005260:Female; D015438:Health Behavior; D006293:Health Promotion; D006801:Humans; D020407:Internet; D008297:Male; D009426:Netherlands; D010988:Play and Playthings; D011446:Prospective Studies; D011795:Surveys and Questionnaires; D014584:User-Computer Interface; D018910:Video Games