Italiano - Home page

Istituto Superiore di Sanità
EpiCentro - Epidemiology for public health
Epidemiology for public health - ISS

General information

Health Behaviour in School-aged Children (HBSC) is an international multicentre study conducted in over 40 countries across Europe and North America, in partnership with the Regional Office for Europe of the World Health Organization (WHO). The population selected for sampling consists of adolescents aged 11, 13 and 15 years.


The study aims to gain greater insight into determinants of health and well-being in adolescents so as to better guide (national and international) prevention and health promotion policies targeting young people.



Data collection is conducted under a multidisciplinary protocol developed, and updated over the years, by the international surveillance group made up of researchers from all of the participating countries. The protocol sets out the rules and procedures for carrying out the surveys and coding the data collected, thus allowing comparison between information gathered by different countries.


The survey is based on a closed-ended questionnaire administered to adolescents in the sampled schools, which consists of a common section for all countries and optional in-depth sections that each participating country can decide to include based on specific national interests.


The questionnaire comprises a number of questions investigating:

  • Health behaviours
  • Health and well-being
  • Social context
  • Environmental context for the development of social competencies

With regard to health behaviours, which constitute the core part of the questionnaire, the following areas are investigated:

  • Nutrition (e.g. consumption of fruit, vegetables, sweets, sugary drinks)
  • Oral hygiene
  • Physical activity and sedentary behaviour (regularly engaging in physical activity during the week, time spent watching TV, playing video games, or on a computer)
  • Risk behaviours (tobacco and alcohol use, cannabis use, gambling, problematic use of social media)
  • Sexual behaviour (age of first sexual intercourse, use of contraceptive methods)
  • Violence and injuries (bullying/cyber-bullying peers or being bullied/cyber-bullied by peers, frequency of injuries)
  • Perceived well-being.

The school environment is also examined and further investigated. A questionnaire addressed to headmasters/principals allows gathering useful information about schools in terms of both health promotion initiatives/programmes and adequacy of their infrastructure.


HBSC in Italy

Since 2002, Italy has been involved in the HBSC multicentre study, taking part in 5 surveys and contributing to continued monitoring of the investigated topics (2002 survey, 2006 survey, 2010 survey, 2014 survey, 2018 survey).


The Prime Ministerial Decree (DPCM) of 3 March 2017, “Identification of surveillance systems and registries of mortality, tumours and other diseases, implementing Decree-Law n. 179 of 2012”, included the “Surveillance system for risk behaviours in 11-17 year-olds” among those of national and regional significance, and identified the Istituto Superiore di Sanità (ISS) as its national reference body. By virtue of the mandate laid down in the DPCM, the ISS agreed with the Ministry of Health that this surveillance should be extended to include adolescents aged 17 years.


In our country, HBSC data collection has been coordinated by a multidisciplinary team of researchers from the Universities of Turin, Siena and Padua. The ISS has been part of this research group since the 2010 survey (except for the 2014 survey), and in 2018 directly coordinated the fifth data collection in cooperation with the Universities of Turin, Siena and Padua.


Publication date: 25 August 2020