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Article History

Received: 27 September 2024

Accepted: 25 February 2025

First Online: 12 March 2025

Declarations

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: The study adhered to the Guidelines of the Declaration of Helsinki. In Denmark, according to the Danish Scientific Ethical Committees Act, no ethics approval are needed for population-based questionnaire surveys. Approval was received from the school principal, the school board representing the parents, and the board representing the schoolchildren in every participating school. The participants were informed orally and in writing about the purpose and confidentiality of the study and that participation was voluntary. The parents also received written information and an electronic link to a short information video as well as an electronic link by which they could reject their child’s participation in the study. In Finland, the University of Jyväskylä Ethics Committee reviewed the study and approved ethical clearance. The committee considered that the study was not a medical research project as defined in the Act on Medical Research and therefore did not require ethical review. Approval was collected from participating municipalities before approaching the schools and principals. At school-level, principals permitted school classes to participate in the study. In Iceland, the study received approval from the National Data Protection Agency and the University of Iceland Ethics Committee (Ethics approval number S7522). Additionally, permissions were obtained from educational authorities in each municipality as well as from the principals of all participating schools. In Norway, the Privacy Ombudsman at the University of Bergen verified that the study conformed to privacy and confidentiality standards, and the Regional Committee for Medical Research Ethics of South East Norway provided ethical approval (Ethics approval number 346737) including permission of applying informed (passive) consent. In Sweden, the study was reviewed by the Regional Ethical Review Board in Stockholm and classified as exempt from human subjects research (2023–05117-01). Participants were provided with both oral and written information regarding the confidentiality of their responses, ensuring that participation remained confidential and voluntary. All countries employed a passive consent approach.

: The authors declare no competing interests.