{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,7]],"date-time":"2026-05-07T17:16:02Z","timestamp":1778174162778,"version":"3.51.4"},"reference-count":45,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2022,7,5]],"date-time":"2022-07-05T00:00:00Z","timestamp":1656979200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100003329","name":"Ministerio de Econom\u00eda y Competitividad","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100003329","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["European Journal of Pain"],"published-print":{"date-parts":[[2022,9]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Previous research has shown that chronic back pain amongst European adolescents is increasing. Determining the factors associated with this increasing trend is crucial for developing prevention strategies. In this study, we used data from the Health Behaviour in School\u2010aged Children (HBSC) survey to examine whether increases in screen time and\/or obesity between 2002 and 2014 were associated with the increase in the prevalence of chronic back pain amongst European adolescents during the 12\u2010year period.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Data from 423,092 adolescents from 27 European countries\/regions were drawn from the HBSC questionnaire\u2010based surveys conducted in 2002, 2006, 2010 and 2014. The Karlson\u2013Holm\u2013Breen method was used to examine the explanatory role of increases in screen time and obesity on the increase in the prevalence of chronic back pain whilst controlling for sex and age.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Increases in both screen time and obesity between 2002 and 2014 were associated with increases in the prevalence of chronic back pain (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001). The percent of chronic back pain prevalence increase accounted for by screen time and obesity was 3.98% and 1.65%, respectively.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The increase in the prevalence of chronic back pain amongst European adolescents may be explained, in part, by the rising trends in both sedentary screen time and obesity. The fact that screen time and obesity only accounted for a small part of the increase in the prevalence of chronic back pain indicates that other unmeasured factors also play a role.<\/jats:p><\/jats:sec><jats:sec><jats:title>Significance<\/jats:title><jats:p>More screen time and obesity are slightly associated with more chronic back pain (CBP) prevalence in adolescents across the WHO European Region. The findings may be used to identify ways to prevent or reduce the rising trend of CBP in adolescents.<\/jats:p><\/jats:sec>","DOI":"10.1002\/ejp.2003","type":"journal-article","created":{"date-parts":[[2022,6,28]],"date-time":"2022-06-28T05:29:46Z","timestamp":1656394186000},"page":"1781-1789","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":22,"title":["The explanatory role of sedentary screen time and obesity in the increase of chronic back pain amongst European adolescents: The <scp>HBSC<\/scp> study 2002\u20132014"],"prefix":"10.1002","volume":"26","author":[{"given":"Josep","family":"Roman\u2010Juan","sequence":"first","affiliation":[{"name":"Universitat Rovira i Virgili Unit for the Study and Treatment of Pain \u2013 ALGOS Research Center for Behavior Assessment (CRAMC) Department of Psychology  Catalonia Spain"},{"name":"Institut d'Investigaci\u00f3 Sanit\u00e0ria Pere Virgili Universitat Rovira i Virgili  Catalonia Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rub\u00e9n","family":"Roy","sequence":"additional","affiliation":[{"name":"Universitat Rovira i Virgili Unit for the Study and Treatment of Pain \u2013 ALGOS Research Center for Behavior Assessment (CRAMC) Department of Psychology  Catalonia Spain"},{"name":"Institut d'Investigaci\u00f3 Sanit\u00e0ria Pere Virgili Universitat Rovira i Virgili  Catalonia Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mark P.","family":"Jensen","sequence":"additional","affiliation":[{"name":"Department of Rehabilitation Medicine University of Washington  Seattle Washington USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1998-6653","authenticated-orcid":false,"given":"Jordi","family":"Mir\u00f3","sequence":"additional","affiliation":[{"name":"Universitat Rovira i Virgili Unit for the Study and Treatment of Pain \u2013 ALGOS Research Center for Behavior Assessment (CRAMC) Department of Psychology  Catalonia Spain"},{"name":"Institut d'Investigaci\u00f3 Sanit\u00e0ria Pere Virgili Universitat Rovira i Virgili  Catalonia Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2022,7,5]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13104\u2010015\u20101587\u20109"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.107.2.423"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00586\u2010004\u20100785\u20102"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jped.2019.07.008"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12998\u2010019\u20100280\u20109"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00038\u2010014\u20100628\u20109"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejpain.2003.08.001"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1177\/0049124113494572"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1111\/jcpp.12372"},{"key":"e_1_2_9_11_1","unstructured":"Currie C. 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