Attachment and family systems theories provided a framework for examining parental structure and support and adolescent delinquency, substance abuse, peer relations, and self-esteem. Three parent scales: support, watchfulness and decidedness, and eight adolescent outcome variables assessing self-esteem, peer relations, and risk-behaviors were derived from the National Educational Longitudinal Study. The sample of 16,749 adolescents was diverse regarding race and ethnicity. All participants were in the tenth grade in the first wave and continued participation in the second wave two years later.</P> Parental support was hypothesized to be associated with increased self-esteem, positive peer relationships and reduced risk behaviors. Although the research findings support the hypothesis for each of the adolescent variables, support was most related to adolescent self-esteem and peer alienation, consistent with an attachment schema. The hypothesis that parental watchfulness is linked to a reduction in adolescent high-risk behaviors was not supported. Instead, watchfulness was linked to self-esteem and peer alienation. These findings indicate that watchfulness, similar to support, is more related to internal processes rather than a mechanism for controlling behavior. Parental decidedness is associated with lower risk behaviors along with lower self-esteem and greater susceptibility to peer alienation. This construct, in contrast to support and watchfulness, presents a different direction of influence depending on the adolescent outcome. The direction of influence of decidedness is negative for self-esteem and peer relations and positive for adolescent risk reduction. The overall research findings indicate that high amounts of support and watchfulness are related to the most positive outcomes for adolescent self-esteem and peer relations. In contrast, the effect of parental decidedness was less salutary for self-esteem and peer relations. In summary, conclusions from this research have implications for theory and practice. For theory, the understanding of specific linkages between these parenting constructs and adolescent outcomes is advanced in this research. These linkages have implication for extensions and modifications of attachment and family systems theories. For practice, the findings suggest refinement in contemporary parent education and clinical work with families. / Ph. D.

This thesis consists of a quantitative and a qualitative study. The quantitative study (articles I-III) aimed to examine how self-reported health in adolescence is associated with behavioral, parental, and school factors. Through a survey directed at all adolescents in grades 7-9, data were collected in 2005 in a region in northern Sweden (n=5060). Statistical methods were used to analyze the survey data: chi2tests, multivariate logistic regressions and multilevel logistic regressions. Results showed that even though most adolescents reported good health, there were also rather large proportions of adolescents who reported headaches, stomach aches and feelings of stress. Girls reported poor health to a higher extent than boys, a difference that was larger in grade 9 than in grade 7. The results also showed that being norm compliant was associated with good self-reported health. Furthermore, perceiving relations and communication with parents as poor was associated with poor self-reported health; however, this relationship could not explain gender differences in self-reported health. Continuing on, analyses showed that there exist greater variations in self-reported health between students (within a school) than between different schools. On an individual level, poor relations to teachers, bullying and truancy were associated with poor general health. The qualitative study  (article IV) sought to examine barriers to and facilitators of utilization of local school survey results within a school setting. In 2011, 21 school district managers and principals within a Swedish municipality were interviewed. Analyses were performed using a qualitative content analysis. The results from the qualitative study showed that the dissemination and utilization of school survey results appeared as two interrelated phases in one process. Barriers and facilitators differed qualitatively depending on the phase, dissemination or utilization. In conclusion, professionals as well as researchers need to consider the complexity of adolescent health and its social determinants. Adolescent health is a concern for multiple sectors in society, which highlights the need for further development of collaborations between professionals in relevant fields, such as health care, school and social services. / Den här avhandlingen består av en kvantitativ och en kvalitativ studie. Syftet med den kvantitativa studien (artikel I-III) var att undersöka sambandet mellan ungdomars självrapporterade hälsa och deras normrelaterade beteende samt föräldra- och skolfaktorer. Data samlades in under 2005, genom en enkät som riktade sig till alla ungdomar i årskurs 7-9 i en region i norra Sverige (n=5060). De statistiska metoder som användes i den kvantitativa studien var bland annat chi2- test, logistisk regression samt flernivåanalys. Resultaten visade att även om de flesta ungdomar rapporterade en god allmän hälsa, så var det också en relativt stor andel som rapporterade huvudvärk, magont samt upplevelser av stress. Flickor rapporterade sämre hälsa än pojkar, en skillnad som var större i åk 9 jämfört med åk 7. Resultaten visade också att normföljsamhet hade ett signifikant samband med god självrapporterad hälsa. De ungdomar som upplevde relationen och kommunikationen med sina föräldrar som dålig, rapporterade också dålig hälsa i högre utsträckning än övriga. Sambandet mellan självrapporterad hälsa och föräldrarelationer kunde inte förklara skillnaderna i ohälsa mellan pojkar och flickor. Vidare, analyser visade att det fanns större variationer i självrapporterad hälsa mellan ungdomar (inom en skola) än mellan olika skolor. Dåliga relationer med lärare, skolk, samt att bli utsatt för mobbning hade ett signifikant samband med dålig självrapporterad hälsa, på en individuell nivå. Syftet med den kvalitativa studien (artikel IV) var att undersöka vilka faktorer inom skolan som möjliggör och som utgör barriärer för användningen av enkätresultaten från en lokal skolenkät. 2011 genomfördes 21 intervjuer med skolområdeschefer och rektorer inom en kommun i Sverige. Analyser av intervjumaterialet genomfördes med hjälp av kvalitativ innehållsanalys. Resultaten från denna studie visade att spridningen och användningen av resultaten från skolenkäten kan beskrivas som två relaterade faser i en process. De faktorer som underlättade samt utgjorde barriärer för spridningen och användningen av enkätresultaten var kvalitativt olika varandra beroende på vilken fas i processen respondenterna hänvisade till. Dessa resultat illustrerar den mångfacetterade komplexitet som inryms i ungdomars hälsa och dess sociala determinanter, en komplexitet som både forskare och professionella behöver ta hänsyn till. Ungdomars hälsa angår ett flertal samhällssektorer, vilket visar på betydelsen av en fortsatt utveckling av samverkan mellan professionella inom exempelvis hälso- och sjukvården, skolan och socialtjänsten.