France: data collection helps policy-makers devise careful prevention strategies to improve adolescent health
In France, researchers working on adolescent health found that merging 2 major surveys could innovate the collection of public health data on young people and deliver more accurate insights on which to build policies.
The Health Behaviour in School-aged Children (HBSC) and the European School Project on Alcohol and other Drugs (ESPAD) were merged into 1 survey called EnCLASS. EnCLASS is co-coordinated by Dr Emmanuelle Godeau, Principal Investigator for HBSC, and Dr Stanislas Spilka, Principal Investigator for ESPAD.
“From 2010, the 2 research teams in charge of each survey decided to cooperate instead of competing for funding, access to schools and publications,” Dr Godeau explains. This has led to smoother monitoring and heightened cost–effectiveness. In 2018, EnCLASS was conducted under a unified framework for the first time, streamlining the 2 monitoring systems into 1.
“It is important to identify ‘pivotal’ grades when experimenting [with substance use] starts or increases throughout the whole secondary school period,” Dr Spilka says. The depth of data is truly enlightening. For example, EnCLASS can identify the already high proportion of children in Grade 6 who have tried alcohol. This prompts the question of whether alcohol prevention initiatives should begin in primary school. Observed experimentation with tobacco from Grade 8 onwards, and daily smoking in Grade 10, shows how early interventions can have huge benefits.
EnCLASS’s monitoring shows the evolution of health behaviours and provides a temporal framework for intervention. It can provide a much wider range of data on health among young people than the 2 surveys conducted separately.
During the unified survey, 20 000 11- to 18-year-olds were asked a common set of questions on health determinants, drug use, sexuality and sleep. They also responded to the mandatory questionnaires of both HBSC and ESPAD. EnCLASS also tracks specific information about key trends in early drug use and provides an image of the spread of use throughout early adolescence.
Ultimately, the aim of public health monitoring is for data to impact policies and programmes. The more comprehensive the survey is, the more tailored interventions can be and the more health will improve for all.
EnCLASS is radical in its provision of comparable data on an international scale as well as targeted national statistics. By merging the 2 surveys, HBSC and ESPAD have created a win–win situation: the Government gets better data more frequently, and the survey is now a key part of the national drug prevention plan for 2018–2022.
This monitoring system, particularly as it collects data grade by grade, is not just a cost-effective way to reach adolescents – it also helps policy-makers devise careful prevention strategies. “EnCLASS data helps to target key grades to reduce substance use by implementing ad hoc programmes,” Dr Godeau explains. “The results of the EnCLASS survey can guide or support certain choices in terms of programming school-based prevention.”
Mass monitoring of this kind for substance use is unparalleled in the WHO European Region. It will have a significant impact on France’s 2018–2022 drug prevention plan, and in turn ameliorate health among young people across France. By swapping rivalry for cooperation, HBSC and ESPAD have produced a valuable, centralized system that has real influence on the well-being of young people.
The HBSC study in France is led by Emmanuelle Godeau and Mariane Sentenac from the École des Hautes Études en Santé Publique in Rennes. For more information, contact emmanuelle.godeau@hbsc.org or mariane.sentenac@hbsc.org.