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  • 1.
    Androutsos, O
    et al.
    Department of Nutrition and Dietetics, Harokopio University, Athens, Greec.
    Apostolidou, E
    Department of Nutrition and Dietetics, Harokopio University, Athens, Greec.
    Iotova, V
    Department of Pediatrics, Medical University Varna, Varna, Bulgaria.
    Socha, P
    The Children’s Memorial Health Institute, Warsaw, Poland.
    Birnbaum, J
    Dr. von Hauner Children’s Hospital, University of Munich Medical Centre, Munich, Germany.
    Moreno, L
    GENUD (Growth, Exercise, Nutrition and Development) Research Group, University of Zaragoza, Zaragoza, Spain; School of Health Science (EUCS), University of Zaragoza, Zaragoza, Spain .
    De Bourdeaudhuij, I
    Department of Movement and Sport Sciences, Ghent University, Ghent, Belgium.
    Koletzko, B
    Dr. von Hauner Children’s Hospital, University of Munich Medical Centre, Munich, Germany.
    Manios, Y
    Department of Nutrition and Dietetics, Harokopio University, Athens, Greece.
    Nilsen, Bente (Contributor)
    Oslo and Akershus University College of Applied Science, Oslo, Norway.
    Process evaluation design and tools used in a kindergarten-based, family-involved intervention to prevent obesity in early childhood: the ToyBox-study2014In: Obesity Reviews, ISSN 1467-7881, E-ISSN 1467-789X, Vol. 15, no Suppl 3, p. 74-80Article in journal (Refereed)
    Abstract [en]

    Process evaluation (PE) is used for the in-depth evaluation of the implementation process of health promotion programmes. The aim of the current paper was to present the PE design and tools used in the ToyBox-intervention. The PE design was based on a three-step approach, including the identification of ToyBox-specific PE elements (step 1), the development of PE tools and harmonization of procedures (step 2), and the implementation of PE using standardized protocol and tools across the intervention countries (step 3). Specifically, to evaluate the implementation of the intervention, teachers' monthly logbooks were recorded (dose delivered, fidelity, dose received); post-intervention questionnaires were completed by parents/caregivers and teachers (dose received); participation and attrition rates were recorded (recruitment, reach); and audit questionnaires and retrospective information on weather conditions were collected (physical and social environment within which the intervention was implemented). Regarding the teachers' training sessions, the researchers who performed the trainings completed evaluation forms and documented teachers' attendance after each training (dose delivered, fidelity, dose received) and teachers completed evaluation forms after each training (dose received). The PE performed in the ToyBox-intervention may contribute in the evaluation of its effectiveness, guide the revision of the intervention material and provide insights for future health promotion programmes and public health policy.

  • 2.
    Androutsos, O
    et al.
    Department of Nutrition and Dietetics, Harokopio University, Athens, Greece.
    Katsarou, C
    Department of Nutrition and Dietetics, Harokopio University, Athens, Greece.
    Payr, A
    Dr. von Hauner Children’s Hospital, University of Munich Medical Centre, Munich, Germany.
    Birnbaum, J
    Dr. von Hauner Children’s Hospital, University of Munich Medical Centre, Munich, Germany.
    Geyer, C
    Dr. von Hauner Children’s Hospital, University of Munich Medical Centre, Munich, Germany.
    Wildgruber, A
    State Institute of Early Childhood Research, Munich, Germany.
    Kreichauf, S
    State Institute of Early Childhood Research, Munich, Germany.
    Lateva, M
    Department of Pediatrics, Medical University Varna, Varna, Bulgaria.
    De Decker, E
    Department of Movement and Sports Sciences, Ghent University, Ghent, Belgium.
    De Craemer, M
    Department of Movement and Sports Sciences, Ghent University, Ghent, Belgium.
    Socha, P
    The Children’s Memorial Health Institute, Warsaw, Poland.
    Moreno, L
    GENUD (Growth, Exercise, Nutrition and Development) Research Group, University of Zaragoza, Zaragoza, Spain; School of Health Science (EUCS), University of Zaragoza, Zaragoza, Spain.
    Iotova, V
    Department of Pediatrics, Medical University Varna, Varna, Bulgaria.
    Koletzko, B V
    Dr. von Hauner Children’s Hospital, University of Munich Medical Centre, Munich, Germany.
    Manios, Y
    Department of Nutrition and Dietetics, Harokopio University, Athens, Greece.
    Nilsen, Bente (Contributor)
    Oslo and Akershus University College of Applied Science, Oslo, Norway.
    Designing and implementing teachers' training sessions in a kindergarten-based, family-involved intervention to prevent obesity in early childhood: the ToyBox-study2014In: Obesity Reviews, ISSN 1467-7881, E-ISSN 1467-789X, Vol. 15, no Suppl 3, p. 48-52Article in journal (Refereed)
    Abstract [en]

    Since school-based interventions are mainly delivered by the school staff, they need to be well-trained and familiarized with the programme's aims, procedures and tools. Therefore, the institute, research group, governmental or non-governmental body in charge of the coordination and implementation of the programme needs to devote time and resources to train the school staff before programme's implementation. This is particularly crucial in multi-centre studies where more than one research teams are involved. Both research teams and school staff need to be trained, using standard protocols and procedures, to ensure that the intervention will be delivered in a standardized manner throughout the intervention centres. The ToyBox-intervention, a multi-component, kindergarten-based, family-involved intervention, focusing on water consumption, snacking, physical activity and sedentary behaviours in preschool children, was implemented over the academic year 2012-2013 in six European countries. As part of this intervention, three teachers' training sessions were delivered to motivate and train teachers in implementing the intervention. The local researchers were trained centrally before delivering the training sessions for the teachers and followed a common protocol using standardized presentations and procedures. The aim of the current paper is to describe the protocol and methodological issues related to the teachers' training sessions conducted within the ToyBox-intervention.

  • 3.
    De Craemer, M
    et al.
    Department of Movement and Sport Sciences, Ghent University, Ghent, Belgium.
    De Decker, E
    Department of Movement and Sport Sciences, Ghent University, Ghent, Belgium.
    De Bourdeaudhuij, I
    Department of Movement and Sport Sciences, Ghent University, Ghent, Belgium.
    Verloigne, M
    Department of Movement and Sport Sciences, Ghent University, Ghent, Belgium.
    Duvinage, K
    Division of Metabolic and Nutritional Medicine, Dr. von Hauner Children’s Hospital, Ludwig-Maximilians-University of Munich, München, Germany.
    Koletzko, B
    Division of Metabolic and Nutritional Medicine, Dr. von Hauner Children’s Hospital, Ludwig-Maximilians-University of Munich, München, Germany.
    Ibrügger, S
    Division of Metabolic and Nutritional Medicine, Dr. von Hauner Children’s Hospital, Ludwig-Maximilians-University of Munich, München, Germany.
    Kreichauf, S
    State Institute of Early Childhood Research, Munich, Germany.
    Grammatikaki, E
    Department of Nutrition and Dietetics, Harokopio University, Athens, Greece.
    Moreno, L
    Growth, Exercise, Nutrition and Development Research Group, University of Zaragoza, Zaragoza, Spain.
    Iotova, V
    Department of Social Medicine and Health Care Organization, Medical University Varna, Varna, Bulgaria.
    Socha, P
    Children’s Memorial Health Institute, Warsaw, Poland.
    Szott, K
    Children’s Memorial Health Institute, Warsaw, Poland.
    Manios, Y
    Department of Nutrition and Dietetics, Harokopio University, Athens, Greece.
    Cardon, G
    Department of Movement and Sport Sciences, Ghent University, Ghent, Belgium.
    Nilsen, Bente (Contributor)
    Oslo and Akershus University College of Applied Science, Oslo, Norway.
    Applying the Intervention Mapping protocol to develop a kindergarten-based, family-involved intervention to increase European preschool children's physical activity levels: the ToyBox-study2014In: Obesity Reviews, ISSN 1467-7881, E-ISSN 1467-789X, Vol. 15, no Suppl 3, p. 14-26Article in journal (Refereed)
    Abstract [en]

    Although sufficient physical activity is beneficial for preschoolers' health, activity levels in most preschoolers are low. As preschoolers spend a considerable amount of time at home and at kindergarten, interventions should target both environments to increase their activity levels. The aim of the current paper was to describe the six different steps of the Intervention Mapping protocol towards the systematic development and implementation of the physical activity component of the ToyBox-intervention. This intervention is a kindergarten-based, family-involved intervention implemented across six European countries. Based on the results of literature reviews and focus groups with parents/caregivers and kindergarten teachers, matrices of change objectives were created. Then, theory-based methods and practical strategies were selected to develop intervention materials at three different levels: (i) individual level (preschoolers); (ii) interpersonal level (parents/caregivers) and (iii) organizational level (teachers). This resulted in a standardized intervention with room for local and cultural adaptations in each participating country. Although the Intervention Mapping protocol is a time-consuming process, using this systematic approach may lead to an increase in intervention effectiveness. The presented matrices of change objectives are useful for future programme planners to develop and implement an intervention based on the Intervention Mapping protocol to increase physical activity levels in preschoolers.

  • 4.
    De Craemer, Marieke
    et al.
    Department of Movement and Sport Sciences, Ghent University, Ghent, Belgium .
    De Decker, Ellen
    Department of Movement and Sport Sciences, Ghent University, Ghent, Belgium.
    Verloigne, Maïté
    Department of Movement and Sport Sciences, Ghent University, Ghent, Belgium.
    De Bourdeaudhuij, Ilse
    Department of Movement and Sport Sciences, Ghent University, Ghent, Belgium.
    Manios, Yannis
    Department of Nutrition and Dietetics, Harokopio University, Athens, Greece .
    Cardon, Greet
    Department of Movement and Sport Sciences, Ghent University, Ghent, Belgium.
    Nilsen, Bente (Contributor)
    Oslo and Akershus University College of Applied Science, Oslo, Norway.
    The effect of a kindergarten-based, family-involved intervention on objectively measured physical activity in Belgian preschool boys and girls of high and low SES: the ToyBox-study.2014In: International Journal of Behavioral Nutrition and Physical Activity, E-ISSN 1479-5868, Vol. 11, no 1, p. 38-Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: The ToyBox-study developed an evidence- and theory-based intervention to improve preschoolers' energy balance-related behaviours - including physical activity (PA) - by targeting the kindergarten environment and involving their parents/caregivers. The present study aimed to examine the effect of the ToyBox-intervention on increasing Belgian preschoolers' objectively measured PA levels.

    METHODS: A sample of 472 preschoolers (4.43 ± 0.55 years; 55.1% boys) from 27 kindergartens (15 intervention, 12 control kindergartens) in Flanders, Belgium were included in the data analyses. Preschoolers wore an ActiGraph accelerometer for six consecutive days and were included in the data analyses if they had a minimum of two weekdays and one weekend day, both at baseline and follow-up (one year later). Preschoolers' PA outcomes were estimated for an average day, weekday, weekend day, during school hours, and during after school hours. To assess intervention effects, multilevel repeated measures analyses were conducted for the total sample, and for sub-groups (according to sex, kindergarten levels of socio-economic status (SES) and risk groups (low levels of PA at baseline)) of preschoolers.

    RESULTS: Small intervention effects were found in the total sample. Most intervention effects were found in boys and in preschoolers from high SES kindergartens. Boys from the intervention group had an increase in vigorous PA (ß=1.47, p=0.03) and moderate-to-vigorous PA (ß=1.27, p=0.03) from baseline to follow-up, whereas PA levels in boys from the control group stagnated or decreased. In preschoolers from high SES kindergartens, the largest effects were found for PA outcomes during school hours and during after school hours.

    CONCLUSION: The results from the Belgian sample demonstrate that effects of the PA-component of the ToyBox-intervention on objectively measured PA were found in preschool boys and in preschoolers from high SES kindergartens, which means that the ToyBox-intervention was mainly effective in those sub-groups. Future interventions should search for alternative strategies to increase preschoolers' PA levels in preschool girls and preschoolers from low SES kindergartens, as these are the most important at-risk groups regarding PA.

  • 5.
    De Miguel-Etayo, P.
    et al.
    GENUD (Growth, Exercise, Nutrition and Development) Research Group, University of Zaragoza, Zaragoza, Spain; Department of Physiatry and Nursing, Faculty of Health Sciences, University of Zaragoza, Zaragoza, Spain; Department of Paediatrics, Faculty of Medicine, University of Zaragoza, Zaragoza, Spain.
    Mesana, M. I.
    GENUD (Growth, Exercise, Nutrition and Development) Research Group, University of Zaragoza, Zaragoza, Spain; Department of Physiatry and Nursing, Faculty of Health Sciences, University of Zaragoza, Zaragoza, Spain.
    Cardon, G.
    Department of Movement and Sport Sciences, Ghent University, Ghent, Belgium.
    De Bourdeaudhuij, I.
    Department of Movement and Sport Sciences, Ghent University, Ghent, Belgium.
    Góźdź, M.
    he Children’s Memorial Health Institute, Warsaw, Poland.
    Socha, P.
    he Children’s Memorial Health Institute, Warsaw, Poland.
    Lateva, M.
    Department of Paediatrics, Medical University Varna , Varna, Bulgaria.
    Iotova, V.
    Department of Paediatrics, Medical University Varna , Varna, Bulgaria.
    Koletzko, B. V.
    Division of Metabolic Diseases and Nutritional Medicine, Ludwig-Maximilians-University of Munich, Munich, Germany.
    Duvinage, K.
    Division of Metabolic Diseases and Nutritional Medicine, Ludwig-Maximilians-University of Munich, Munich, Germany.
    Androutsos, O.
    Department of Nutrition and Dietetics, Harokopio University, Athens, Greece.
    Manios, Y.
    Department of Nutrition and Dietetics, Harokopio University, Athens, Greece.
    Moreno, L. A.
    GENUD (Growth, Exercise, Nutrition and Development) Research Group, University of Zaragoza, Zaragoza, Spain; Department of Physiatry and Nursing, Faculty of Health Sciences, University of Zaragoza, Zaragoza, Spain.
    Nilsen, Bente (Contributor)
    Oslo and Akershus University College of Applied Science, Oslo, Norway.
    Reliability of anthropometric measurements in European preschool children: the ToyBox-study2014In: Obesity Reviews, ISSN 1467-7881, E-ISSN 1467-789X, Vol. 15, no Suppl 3, p. 67-73Article in journal (Refereed)
    Abstract [en]

    The ToyBox-study aims to develop and test an innovative and evidence-based obesity prevention programme for preschoolers in six European countries: Belgium, Bulgaria, Germany, Greece, Poland and Spain. In multicentre studies, anthropometric measurements using standardized procedures that minimize errors in the data collection are essential to maximize reliability of measurements. The aim of this paper is to describe the standardization process and reliability (intra- and inter-observer) of height, weight and waist circumference (WC) measurements in preschoolers. All technical procedures and devices were standardized and centralized training was given to the fieldworkers. At least seven children per country participated in the intra- and inter-observer reliability testing. Intra-observer technical error ranged from 0.00 to 0.03 kg for weight and from 0.07 to 0.20 cm for height, with the overall reliability being above 99%. A second training was organized for WC due to low reliability observed in the first training. Intra-observer technical error for WC ranged from 0.12 to 0.71 cm during the first training and from 0.05 to 1.11 cm during the second training, and reliability above 92% was achieved. Epidemiological surveys need standardized procedures and training of researchers to reduce measurement error. In the ToyBox-study, very good intra- and-inter-observer agreement was achieved for all anthropometric measurements performed.

  • 6.
    Duvinage, K
    et al.
    Division of Metabolic and Nutritional Medicine, Dr. von Hauner Children’s Hospital, Ludwig- Maximilians-University of Munich, München, Germany.
    Ibrügger, S
    Division of Metabolic and Nutritional Medicine, Dr. von Hauner Children’s Hospital, Ludwig- Maximilians-University of Munich, München, Germany.
    Kreichauf, S
    State Institute of Early Childhood Research, Munich, Germany.
    Wildgruber, A
    State Institute of Early Childhood Research, Munich, Germany.
    De Craemer, M
    Department of Movement and Sport Sciences, Ghent University, Ghent, Belgium.
    De Decker, E
    Department of Movement and Sport Sciences, Ghent University, Ghent, Belgium.
    Androutsos, O
    Department of Nutrition and Dietetics, Harokopio University, Athens, Greece.
    Lateva, M
    Department of Pediatrics and Medical Genetics, Medical University Varna, Varna, Bulgaria.
    Iotova, V
    Department of Pediatrics and Medical Genetics, Medical University Varna, Varna, Bulgaria.
    Socha, P
    Children’s Memorial Health Institute, Warsaw, Poland.
    Zych, K
    Children’s Memorial Health Institute, Warsaw, Poland.
    Mouratidou, T
    GENUD (Growth, Exercise, NUtrition and Development) Research Group, University of Zaragoza, Zaragoza, Spain.
    Mesana Graffe, M I
    GENUD (Growth, Exercise, NUtrition and Development) Research Group, University of Zaragoza, Zaragoza, Spain.
    Manios, Y
    Department of Nutrition and Dietetics, Harokopio University, Athens, Greece.
    Koletzko, B
    Division of Metabolic and Nutritional Medicine, Dr. von Hauner Children’s Hospital, Ludwig- Maximilians-University of Munich, München, Germany.
    Nilsen, Bente (Contributor)
    Oslo and Akershus University College of Applied Science, Oslo, Norway.
    Developing the intervention material to increase physical activity levels of European preschool children: the ToyBox-study2014In: Obesity Reviews, ISSN 1467-7881, E-ISSN 1467-789X, Vol. 15, no Suppl 3, p. 27-39Article in journal (Refereed)
    Abstract [en]

    Early childhood is an important period for adopting positive health-related behaviours. More than 95% of European preschool children attend kindergartens, making these settings ideal for the implementation of health promotion interventions. The ToyBox-intervention addressed preschool children, their parents/caregivers and teachers. The aim of the intervention was to improve four energy balance-related behaviours (i.e. healthy snacking, water consumption, physical activity and sedentary behaviour) by implementing a kindergarten-based, family-involved intervention in six European countries (Belgium, Bulgaria, Germany, Greece, Poland and Spain). The intervention material was developed following the intervention mapping protocol, taking into account local and cultural differences among the intervention countries. The present paper focuses on the development of the physical activity component of the intervention. Parental involvement was addressed by providing parents/caregivers with two newsletters, two tip cards and a poster. Teachers received a handbook with guidance on environmental changes in the classroom, 26 physical education sessions and suggestions for fun, interactive classroom activities aiming at total class participation to increase preschoolers' physical activity levels. The ToyBox-intervention material was distributed according to a standard time frame. Teachers received their material prior to the start of the intervention and parents/caregivers received their material during the intervention when each energy balance-related behaviour was implemented.

  • 7.
    González-Gil, E. M.
    et al.
    GENUD (Growth, Exercise, Nutrition and Development) Research Group, University of Zaragoza, Zaragoza, Spain; Faculty of Health Sciences, University of Zaragoza, Zaragoza, Spain.
    Mouratidou, T.
    GENUD (Growth, Exercise, Nutrition and Development) Research Group, University of Zaragoza, Zaragoza, Spain.
    Cardon, G.
    Department of Movement and Sport Sciences, Ghent University, Ghent, Belgium.
    Androutsos, O.
    Department of Nutrition and Dietetics, Harokopio University, Athens, Greece.
    De Bourdeaudhuij, I.
    Department of Movement and Sport Sciences, Ghent University, Ghent, Belgium.
    Góźdź, M.
    The Children’s Memorial Health Institute, Warsaw, Poland.
    Usheva, N.
    Department of Social Medicine and Health Care Organization, Medical University Varna, Varna, Bulgaria.
    Birnbaum, J.
    Division of Metabolic and Nutritional Medicine, Dr. von Hauner Children’s Hospital, Ludwig-Maximilians-University of Munich, München, Germany.
    Manios, Y.
    Department of Nutrition and Dietetics, Harokopio University, Athens, Greece.
    Moreno, L. A.
    GENUD (Growth, Exercise, Nutrition and Development) Research Group, University of Zaragoza, Zaragoza, Spain; Faculty of Health Sciences, University of Zaragoza, Zaragoza, Spain.
    Nilsen, Bente (Contributor)
    Oslo and Akershus University College of Applied Science, Oslo, Norway.
    Reliability of primary caregivers reports on lifestyle behaviours of European pre-school children: the ToyBox-study2014In: Obesity Reviews, ISSN 1467-7881, E-ISSN 1467-789X, Vol. 15, no Suppl 3, p. 61-66Article in journal (Refereed)
    Abstract [en]

    Reliable assessments of health-related behaviours are necessary for accurate evaluation on the efficiency of public health interventions. The aim of the current study was to examine the reliability of a self-administered primary caregivers questionnaire (PCQ) used in the ToyBox-intervention. The questionnaire consisted of six sections addressing sociodemographic and perinatal factors, water and beverages consumption, physical activity, snacking and sedentary behaviours. Parents/caregivers from six countries (Belgium, Bulgaria, Germany, Greece, Poland and Spain) were asked to complete the questionnaire twice within a 2-week interval. A total of 93 questionnaires were collected. Test-retest reliability was assessed using intra-class correlation coefficient (ICC). Reliability of the six questionnaire sections was assessed. A stronger agreement was observed in the questions addressing sociodemographic and perinatal factors as opposed to questions addressing behaviours. Findings showed that 92% of the ToyBox PCQ had a moderate-to-excellent test-retest reliability (defined as ICC values from 0.41 to 1) and less than 8% poor test-retest reliability (ICC < 0.40). Out of the total ICC values, 67% showed good-to-excellent reliability (ICC from 0.61 to 1). We conclude that the PCQ is a reliable tool to assess sociodemographic characteristics, perinatal factors and lifestyle behaviours of pre-school children and their families participating in the ToyBox-intervention.

  • 8.
    Holmen, Heidi
    et al.
    Department of Nursing and Health Promotion, Faculty of Health Sciences, Oslo Metropolitan University, 0130 Oslo, Norway; Intervention Centre, Oslo University Hospital, 4950 Oslo, Norway.
    Flølo, Tone
    Department of Nursing and Health Promotion, Faculty of Health Sciences, Oslo Metropolitan University, 0130 Oslo, Norway; Department of Surgery, Voss Hospital, Haukeland University Hospital, 5704 Voss, Norway.
    Tørris, Christine
    Department of Nursing and Health Promotion, Faculty of Health Sciences, Oslo Metropolitan University, 0130 Oslo, Norway.
    Løyland, Borghild
    Department of Nursing and Health Promotion, Faculty of Health Sciences, Oslo Metropolitan University, 0130 Oslo, Norway.
    Almendingen, Kari
    Department of Nursing and Health Promotion, Faculty of Health Sciences, Oslo Metropolitan University, 0130 Oslo, Norway.
    Bjørnnes, Ann Kristin
    Department of Nursing and Health Promotion, Faculty of Health Sciences, Oslo Metropolitan University, 0130 Oslo, Norway.
    Albertini Früh, Elena
    Department of Nursing and Health Promotion, Faculty of Health Sciences, Oslo Metropolitan University, 0130 Oslo, Norway.
    Grov, Ellen Karine
    Department of Nursing and Health Promotion, Faculty of Health Sciences, Oslo Metropolitan University, 0130 Oslo, Norway.
    Helseth, Sølvi
    Department of Nursing and Health Promotion, Faculty of Health Sciences, Oslo Metropolitan University, 0130 Oslo, Norway.
    Kvarme, Lisbeth Gravdal
    Department of Nursing and Health Promotion, Faculty of Health Sciences, Oslo Metropolitan University, 0130 Oslo, Norway.
    Malambo, Rosah
    Department of Nursing and Health Promotion, Faculty of Health Sciences, Oslo Metropolitan University, 0130 Oslo, Norway.
    Misvær, Nina
    Department of Nursing and Health Promotion, Faculty of Health Sciences, Oslo Metropolitan University, 0130 Oslo, Norway.
    Rasalingam, Anurajee
    Department of Nursing and Health Promotion, Faculty of Health Sciences, Oslo Metropolitan University, 0130 Oslo, Norway.
    Riiser, Kirsti
    Department of Nursing and Health Promotion, Faculty of Health Sciences, Oslo Metropolitan University, 0130 Oslo, Norway; Department of Rehabilitation Science and Health Technology, Faculty of Health Sciences, Oslo Metropolitan University, 0130 Oslo, Norway.
    Sandbekken, Ida Hellum
    Department of Nursing and Health Promotion, Faculty of Health Sciences, Oslo Metropolitan University, 0130 Oslo, Norway.
    Schippert, Ana Carla
    Department of Nursing and Health Promotion, Faculty of Health Sciences, Oslo Metropolitan University, 0130 Oslo, Norway.
    Nilsen, Bente B.
    Örebro University, School of Health Sciences. Department of Nursing and Health Promotion, Faculty of Health Sciences, Oslo Metropolitan University, 0130 Oslo, Norway.
    Sundar, Turid Kristin Bigum
    Department of Nursing and Health Promotion, Faculty of Health Sciences, Oslo Metropolitan University, 0130 Oslo, Norway.
    Sæterstrand, Torill
    Department of Nursing and Health Promotion, Faculty of Health Sciences, Oslo Metropolitan University, 0130 Oslo, Norway.
    Utne, Inger
    Department of Nursing and Health Promotion, Faculty of Health Sciences, Oslo Metropolitan University, 0130 Oslo, Norway.
    Valla, Lisbeth
    Department of Nursing and Health Promotion, Faculty of Health Sciences, Oslo Metropolitan University, 0130 Oslo, Norway; Regional Centre for Child and Adolescent Mental Health, Eastern and Southern Norway (RBUP), 0484 Oslo, Norway.
    Winger, Anette
    Department of Nursing and Health Promotion, Faculty of Health Sciences, Oslo Metropolitan University, 0130 Oslo, Norway.
    Torbjørnsen, Astrid
    Department of Nursing and Health Promotion, Faculty of Health Sciences, Oslo Metropolitan University, 0130 Oslo, Norway.
    Unpacking the Public Health Triad of Social Inequality in Health, Health Literacy, and Quality of Life-A Scoping Review of Research Characteristics2023In: International Journal of Environmental Research and Public Health, ISSN 1661-7827, E-ISSN 1660-4601, Vol. 21, no 1, article id 36Article, review/survey (Refereed)
    Abstract [en]

    Social inequalities in health, health literacy, and quality of life serve as distinct public health indicators, but it remains unclear how and to what extent they are applied and combined in the literature. Thus, the characteristics of the research have yet to be established, and we aim to identify and describe the characteristics of research that intersects social inequality in health, health literacy, and quality of life. We conducted a scoping review with systematic searches in ten databases. Studies applying any design in any population were eligible if social inequality in health, health literacy, and quality of life were combined. Citations were independently screened using Covidence. The search yielded 4111 citations, with 73 eligible reports. The reviewed research was mostly quantitative and aimed at patient populations in a community setting, with a scarcity of reports specifically defining and assessing social inequality in health, health literacy, and quality of life, and with only 2/73 citations providing a definition for all three. The published research combining social inequality in health, health literacy, and quality of life is heterogeneous regarding research designs, populations, contexts, and geography, where social inequality appears as a contextualizing variable.

  • 9.
    Manios, Y
    Department of Nutrition and Dietetics, Harokopio University, Athens, Greece.
    Nilsen, Bente (Contributor)
    Oslo and Akershus University College of Applied Science.
    Methodological procedures followed in a kindergarten-based, family-involved intervention implemented in six European countries to prevent obesity in early childhood: the ToyBox-study2014In: Obesity Reviews, ISSN 1467-7881, E-ISSN 1467-789X, Vol. 15 Suppl 3, p. 1-4Article in journal (Refereed)
  • 10.
    Manios, Y
    et al.
    Department of Nutrition and Dietetics, Harokopio University , Athens , Greece.
    Androutsos, O
    Department of Nutrition and Dietetics, Harokopio University , Athens , Greece.
    Katsarou, C
    Department of Nutrition and Dietetics, Harokopio University , Athens , Greece.
    Iotova, V
    Department of Pediatrics, Medical University Varna, Varna, Bulgaria.
    Socha, P
    The Children’s Memorial Health Institute, Warsaw, Poland.
    Geyer, C
    Dr. von Hauner Children’s Hospital, University of Munich Medical Centre, Munich, Germany.
    Moreno, L
    GENUD (Growth, Exercise, NUtrition and Development) Research Group, University of Zaragoza, Zaragoza, Spain; School of Health Science (EUCS), University of Zaragoza, Zaragoza, Spain.
    Koletzko, B
    Dr. von Hauner Children’s Hospital, University of Munich Medical Centre, Munich, Germany.
    De Bourdeaudhuij, I
    Department of Movement and Sport Sciences, Ghent University, Ghent, Belgium.
    Nilsen, Bente (Contributor)
    Oslo and Akershus University College of Applied Science, Oslo, Norway.
    Designing and implementing a kindergarten-based, family-involved intervention to prevent obesity in early childhood: the ToyBox-study2014In: Obesity Reviews, ISSN 1467-7881, E-ISSN 1467-789X, Vol. 15, no Suppl 3, p. 5-13Article in journal (Refereed)
    Abstract [en]

    The development of the ToyBox-intervention was based on the outcomes of the preliminary phase of the ToyBox-study, aiming to identify young children's key behaviours and their determinants related to early childhood obesity. The ToyBox-intervention is a multi-component, kindergarten-based, family-involved intervention with a cluster-randomized design, focusing on the promotion of water consumption, healthy snacking, physical activity and the reduction/ breaking up of sedentary time in preschool children and their families. The intervention was implemented during the academic year 2012-2013 in six European countries: Belgium, Bulgaria, Germany, Greece, Poland and Spain. Standardized protocols, methods, tools and material were used in all countries for the implementation of the intervention, as well as for the process, impact, outcome evaluation and the assessment of its cost-effectiveness. A total sample of 7,056 preschool children and their parents/caregivers, stratified by socioeconomic level, provided data during baseline measurements and participated in the intervention. The results of the ToyBox-study are expected to provide a better insight on behaviours associated with early childhood obesity and their determinants and identify effective strategies for its prevention. The aim of the current paper is to describe the design of the ToyBox-intervention and present the characteristics of the study sample as assessed at baseline, prior to the implementation of the intervention.

  • 11.
    Monteagudo, Celia
    et al.
    Örebro University, School of Hospitality, Culinary Arts & Meal Science. Department of Food, Nutrition and Dietetics, Uppsala University, Uppsala, Sweden; Research Group on Nutrition, Diet and Risk Assessment-AGR255, Department of Nutrition and Food Science, University of Granada, Granada, Spain.
    Scander, Henrik
    Örebro University, School of Hospitality, Culinary Arts & Meal Science.
    Nilsen, Bente
    Örebro University, School of Hospitality, Culinary Arts & Meal Science.
    Yngve, Agneta
    Örebro University, School of Hospitality, Culinary Arts & Meal Science. Department of Food, Nutrition and Dietetics, Uppsala University, Uppsala, Sweden.
    Folate intake in a Swedish adult population: Food sources and predictive factors2017In: Food & Nutrition Research, ISSN 1654-6628, E-ISSN 1654-661X, Vol. 61, article id 1328960Article in journal (Refereed)
    Abstract [en]

    Introduction: Folate plays an important role in cell metabolism, but international studies show that intake is currently below recommendations, especially among women. The study objective was to identify folate food sources by food group, gender, and age group, and to identify factors influencing folate intake, based on food consumption data for Swedish adults in the 2010-11 Riksmaten study.

    Methods: The sample included a representative Swedish population aged 18-80 years (n = 1657; 56.3% female). Food and nutrient intakes were estimated from self-reported food records during 4 consecutive days. Food consumption was categorized into 26 food groups. Stepwise regression was used to analyze food groups as folate sources for participants. Factors predicting the highest folate intake (third tertile) were determined by logistic regression analysis.

    Results: Vegetables and pulses represented the most important folate source for all age groups and both genders, especially in women aged 45-64 years (49.7% of total folate intake). The next folate source in importance was dairy products for the youngest group (18-30 years), bread for men, and fruit and berries for women. The likelihood of being in the highest tertile of folate intake (odds ratio = 1.69, 95% confidence interval 1.354-2.104) was higher for men. Influencing factors for folate intake in the highest tertile were low body mass index and high educational level in the men, and high educational level, vegetarian diet, organic product consumption, nonsmoking, and alcohol consumption within recommendations in the women.

    Conclusion: This study describes the folate intake per food group of Swedish adults according to the 2010-11 Riksmaten survey, identifying vegetables and pulses as the most important source. Data obtained on factors related to folate consumption may be useful for the development of specific nutrition education programs to increase the intake of this vitamin in high-risk groups.

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  • 12.
    Mouratidou, T
    et al.
    GENUD (Growth Exercise, NUtrition and Development) Research Group, University of Zaragoza, Zaragoza, Spain.
    Miguel, M L
    GENUD (Growth Exercise, NUtrition and Development) Research Group, University of Zaragoza, Zaragoza, Spain.
    Androutsos, O
    Department of Nutrition and Dietetics, Harokopio University, Athens, Greece.
    Manios, Y
    Department of Nutrition and Dietetics, Harokopio University, Athens, Greece.
    De Bourdeaudhuij, I
    Department of Movement and Sport Sciences, Ghent University, Ghent, Belgium.
    Cardon, G
    Department of Movement and Sport Sciences, Ghent University, Ghent, Belgium.
    Kulaga, Z
    The Children’s Memorial Health Institute, Warszawa, Poland.
    Socha, P
    The Children’s Memorial Health Institute, Warszawa, Poland.
    Galcheva, S
    Medical University Varna, Varna, Bulgaria.
    Iotova, V
    Medical University Varna, Varna, Bulgaria.
    Payr, A
    Dr von Hauner Children’s Hospital, University of Munich Medical Centre, Munich, Germany.
    Koletzko, B
    Dr von Hauner Children’s Hospital, University of Munich Medical Centre, Munich, Germany.
    Moreno, L A
    GENUD (Growth Exercise, NUtrition and Development) Research Group, University of Zaragoza, Zaragoza, Spain; Faculty of Health Science, University of Zaragoza, Zaragoza, Spain.
    Nilsen, Bente (Contributor)
    Oslo and Akershus University College of Applied Science, Oslo, Norway.
    Tools, harmonization and standardization procedures of the impact and outcome evaluation indices obtained during a kindergarten-based, family-involved intervention to prevent obesity in early childhood: the ToyBox-study2014In: Obesity Reviews, ISSN 1467-7881, E-ISSN 1467-789X, Vol. 15, no Suppl 3, p. 53-60Article in journal (Refereed)
    Abstract [en]

    The ToyBox-intervention is a kindergarten-based, family-involved intervention targeting multiple lifestyle behaviours in preschool children, their teachers and their families. This intervention was conducted in six European countries, namely Belgium, Bulgaria, Germany, Greece, Poland and Spain. The aim of this paper is to provide a descriptive overview of the harmonization and standardization procedures of the baseline and follow-up evaluation of the study (and substudies). Steps related to the study's operational, standardization and harmonization procedures as well as the impact and outcome evaluation assessment tools used are presented. Experiences from the project highlight the importance of safeguarding the measurement process to minimize data heterogeneity derived from potential measurement error and country-by-country differences. In addition, it was made clear that continuing quality control and support is an important component of such studies. For this reason, well-supported communication channels, such as regular email updates and teleconferences, and regular internal and external meetings to ensure smooth and accurate implementation were in place during the study. The ToyBox-intervention and its harmonized and standardized procedures can serve as a successful case study for future studies evaluating the efficacy of similar interventions.

  • 13.
    Nilsen, Bente B.
    Örebro University, School of Hospitality, Culinary Arts & Meal Science.
    Growth of schoolchildren: studies on somatic growth and deviant growth patterns such as weight loss and obesity and aspects of intake of breakfast and food items2018Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    The overall aim of this thesis is to explore somatic growth, and deviant growth patterns as episodes of weight loss and obesity development, including some aspects of meal patterns and food intake.

    Methods: The thesis includes four studies, two cross-sectional studies (Paper I and II), and two longitudinal studies (Paper III and IV).

    The first paper looks at assessment of BMI categories (underweight, overweight and obesity) prevalence and how the results relate to which growth reference that is used. Height and weight measurements of 4,518 Swedish schoolchildren aged 7–9 years were collected in 2008 using a standardised protocol from World Health Organization (WHO). Four growth references were used, from the WHO, the International Obesity Task Force (IOTF) and two Swedish growth references from Werner and Karlberg et al. (Paper I). Parts of the same data set plus a follow-up data set from 2010 was used to investigate correlations with deviances in BMI in relation to breakfast habits and selected food frequencies.

    For paper three and four, a longitudinal material from two nationally representative samples was used with height and weight data of 6,572 schoolchildren, born 1973 and 1981. Episodes of BMI reduction of 10% or more were identified and correlated to final height (Paper III). The same material was used for paper four to further investigate growth patterns on group level by use of weight for height, Tri-Ponderal Mass Index (TMI), apart from BMI. On individual level, weight at age 7 years and weight at 16 years for girls and 18 years for boys, were categorized in monthly values and expressed in standard deviation (from ≤ -2 to ≥ +3 SD) (Paper IV).

    Results: Depending on which growth reference we used, the prevalence of different degrees of thinness varied greatly. There were also significant gender differences depending on the growth reference we used (Paper I).

    The majority of parents reported that their children (95.4%) had breakfast every day. The odds of being OW/OB was higher among those not having breakfast every day (odds ratio (OR) 1.9, drinking diet soft drinks OR 2.6, 95% and skimmed/semi-skimmed milk OR 1.8), four days a week or more (Paper II).

    There was no statistically significant difference on group level in final height between individuals with and individuals without BMI reduction, independent of age and if the individuals were thin, normal weight, overweight or obese at the start of the BMI reduction episode (Paper III).

    Almost the same longitudinal growth patterns were found for the two cohorts, even if weight and BMI for all almost all ages were higher in 1981 cohort. Patterns for TMI differs from those of W/H and BMI. Three main longitudinal trajectories represent the description of weight development from 7–16 years for girls and 7–18 years for boys. These patterns were mainly the same in the 1981 cohort and the 1973 cohort. (Paper IV).

    List of papers
    1. Using different growth references to measure thinness and overweight among Swedish primary school children showed considerable variations
    Open this publication in new window or tab >>Using different growth references to measure thinness and overweight among Swedish primary school children showed considerable variations
    Show others...
    2016 (English)In: Acta Paediatrica, ISSN 0803-5253, E-ISSN 1651-2227, Vol. 105, no 10, p. 1158-1165Article in journal (Refereed) Published
    Abstract [en]

    Aim: The study compared how four different growth references determined the prevalence of thinness and overweight, based on height and weight measurements from a nationally representative sample of Swedish children from seven to nine years of age.

    Methods: The height and weight measurements of 4,518 Swedish schoolchildren aged seven to nine years were carried out in 2008 using a standardised protocol. The prevalence of different degrees of thinness and overweight were calculated using international growth references from the World Health Organization, the International Obesity Task Force and two Swedish growth references from Werner and Karlberg.

    Results: Depending on which growth reference we used, the prevalence of different degrees of thinness varied from 7.5%-16.9% for the boys and 6.9%-13.7% for the girls, while for the prevalence of overweight, including obesity and severe obesity, varied from 16.5%-25.7% for the boys and 18.2-25.2% for the girls. There were also significant gender differences depending on the growth reference we used.

    Conclusion: Using four different growth references, two international and two Swedish, produced wide variations in the prevalence of thinness and overweight, together with significant gender differences. In the absence of a global definition, we need both national and international growth references.

    Place, publisher, year, edition, pages
    Wiley-Blackwell Publishing Inc., 2016
    Keywords
    Body mass index cut-off levels, childhood, crowth surveillance, obesity, underweight
    National Category
    Nutrition and Dietetics Pediatrics
    Research subject
    Culinary Arts and Meal Science; Nutrition; Pediatrics
    Identifiers
    urn:nbn:se:oru:diva-50027 (URN)10.1111/apa.13400 (DOI)000383619400022 ()26991338 (PubMedID)2-s2.0-84987846807 (Scopus ID)
    Funder
    Forte, Swedish Research Council for Health, Working Life and Welfare, 2006-1624, 2006-1506Swedish Research Council, 7509, 2006-7777
    Note

    Funding Agencies:

    Örebro University, Sweden

    Oslo and Akershus University College, Norway

    The Swedish University Hospital (ALF)

    Karolinska Institut

    Region Västra Götaland

    Available from: 2016-04-28 Created: 2016-04-28 Last updated: 2020-01-29Bibliographically approved
    2. Reported habitual intake of breakfast and selected foods in relation to overweight status among seven-to nine-year-old Swedish children
    Open this publication in new window or tab >>Reported habitual intake of breakfast and selected foods in relation to overweight status among seven-to nine-year-old Swedish children
    Show others...
    2017 (English)In: Scandinavian Journal of Public Health, ISSN 1403-4948, E-ISSN 1651-1905, Vol. 45, no 8, p. 886-894Article in journal (Refereed) Published
    Abstract [en]

    Aim: The aim of this study was to examine the reported frequency of breakfast intake and selected food and beverages in the investigated group of Swedish children in comparison with recommended intakes. Furthermore, the study analyses these food habits and some demographic and lifestyle factors in relation to overweight and obesity.

    Methods: This cross-sectional study builds on data collected in 2008 and 2010. Measured anthropometric data and parent questionnaire data were collected. A total of 2620 Swedish children (52.1% boys) aged seven to nine years were included.

    Results: The majority of parents reported that their children (95.4%) had breakfast every day. The majority of children had fresh fruit (84.7%) and vegetables (83.9%) most days a week. Only 1.6% of the children were reported to have fast food and 6.0% to have sugar containing soft drinks, four days a week or more. The prevalence of overweight including obesity (OW/OB) was 17.8% for boys, 18.6% for girls. The odds of being OW/OB was higher among those not having breakfast every day (odds ratio (OR) 1.9, 95% confidence interval (CI) 1.20-2.96), drinking diet soft drink (OR 2.6, 95% CI 1.52-4.42) and skimmed/semi-skimmed milk (OR 1.8, 95% CI 1.37-2.36) four days a week or more. Parents being overweight and having low education levels were also related to a higher risk of their children being overweight.

    Conclusions: The parental reports of children's food habits pointed at favourable eating patterns for most investigated children. Breakfast skipping, diet soft drinks and low-fat milk consumption were more frequent among OW/OB children. Longitudinal studies are needed to determine the causal relationships.

    Place, publisher, year, edition, pages
    Sage Publications, 2017
    Keywords
    Child growth, breakfast, food habits, WHO Childhood Obesity Surveillance Initiative
    National Category
    Public Health, Global Health, Social Medicine and Epidemiology
    Identifiers
    urn:nbn:se:oru:diva-63801 (URN)10.1177/1403494817724951 (DOI)000418185200021 ()29160159 (PubMedID)2-s2.0-85038350923 (Scopus ID)
    Funder
    Forte, Swedish Research Council for Health, Working Life and WelfareThe Karolinska Institutet's Research Foundation
    Available from: 2018-01-03 Created: 2018-01-03 Last updated: 2020-01-29Bibliographically approved
    3. Do substantial BMI reduction episodes among Swedish schoolchildren have any impact on their final height?
    Open this publication in new window or tab >>Do substantial BMI reduction episodes among Swedish schoolchildren have any impact on their final height?
    2018 (English)In: Acta Paediatrica, ISSN 0803-5253, E-ISSN 1651-2227, Vol. 107, no 7, p. 1223-1229Article in journal (Refereed) Published
    Abstract [en]

    AIM: This study investigated whether substantial body mass index (BMI) reductions in Swedish schoolchildren aged 7-19 years, caused by disease, healthy or unhealthy behaviour, had any impact on their final height.

    METHODS: We used height and weight data on 6,572 subjects from two nationally representative longitudinal samples of Swedish children born in 1973 and 1981. These provided information on their final height and any BMI reduction episodes.

    RESULTS: Of the 6,572 subjects (50.9% boys), among individuals with information on final height, 1,118 had a BMI reduction of 5% and less than 10%, and 346 had at least one substantial BMI reduction of 10% of more. On a group level, there was no statistically significant difference in the final height of individuals with BMI reductions of 10% or more and those without. The findings were independent of age and the subject's BMI at the start of the reduction episode. However, there were a number of cases where a substantial BMI reduction probably had an impact on the subject's final height.

    CONCLUSION: Our study found no evidence that a substantial BMI reduction had any impact on final height on a group level, but further analyses of specific case studies are necessary to determine whether substantial BMI reduction might have an impact on final height.

    Place, publisher, year, edition, pages
    John Wiley & Sons, 2018
    Keywords
    Body Mass Index reduction, final height, longitudinal study, schoolchildren, weight loss
    National Category
    Pediatrics
    Identifiers
    urn:nbn:se:oru:diva-64913 (URN)10.1111/apa.14258 (DOI)000435258200018 ()29405369 (PubMedID)2-s2.0-85042559671 (Scopus ID)
    Available from: 2018-02-08 Created: 2018-02-08 Last updated: 2020-12-01Bibliographically approved
    4. The longitudinal development of body weight among individuals from age 7 to 18 years in Sweden
    Open this publication in new window or tab >>The longitudinal development of body weight among individuals from age 7 to 18 years in Sweden
    (English)Manuscript (preprint) (Other academic)
    National Category
    Social Sciences Interdisciplinary
    Research subject
    Culinary Arts and Meal Science
    Identifiers
    urn:nbn:se:oru:diva-65118 (URN)
    Available from: 2018-02-21 Created: 2018-02-21 Last updated: 2018-02-21Bibliographically approved
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    Growth of schoolchildren: studies on somatic growth and deviant growth patterns such as weight loss and obesity and aspects of intake of breakfast and food items
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  • 14.
    Nilsen, Bente B
    et al.
    Örebro University, School of Hospitality, Culinary Arts & Meal Science. Department of Nursing and Health Promotion, Oslo Metropolitan University, Oslo, Norway.
    Werner, Bo
    Örebro University, School of Medical Sciences.
    The longitudinal development of body weight among individuals from age 7 to 18 years in SwedenManuscript (preprint) (Other academic)
  • 15.
    Nilsen, Bente B.
    et al.
    Örebro University, School of Hospitality, Culinary Arts & Meal Science. Department of Nursing and Health Promotion, Oslo and Akershus University College, Oslo, Norway.
    Yngve, Agneta
    Örebro University, School of Hospitality, Culinary Arts & Meal Science. Department of Food, Nutrition and Dietetics, Uppsala University, Uppsala, Sweden.
    Monteagudo, Celia
    Department of Food, Nutrition and Dietetics, Uppsala University, Uppsala, Sweden; Research Group Nutrition, Diet and Risk Assessment, Department of Nutrition and Food Science, University of Granada, Granada, Spain.
    Tellström, Richard
    Örebro University, School of Hospitality, Culinary Arts & Meal Science.
    Scander, Henrik
    Örebro University, School of Hospitality, Culinary Arts & Meal Science.
    Werner, Bo
    Örebro University, School of Medical Sciences. School of Hospitality, Culinary Arts and Meal Sciences, Örebro University, Grythyttan, Sweden.
    Reported habitual intake of breakfast and selected foods in relation to overweight status among seven-to nine-year-old Swedish children2017In: Scandinavian Journal of Public Health, ISSN 1403-4948, E-ISSN 1651-1905, Vol. 45, no 8, p. 886-894Article in journal (Refereed)
    Abstract [en]

    Aim: The aim of this study was to examine the reported frequency of breakfast intake and selected food and beverages in the investigated group of Swedish children in comparison with recommended intakes. Furthermore, the study analyses these food habits and some demographic and lifestyle factors in relation to overweight and obesity.

    Methods: This cross-sectional study builds on data collected in 2008 and 2010. Measured anthropometric data and parent questionnaire data were collected. A total of 2620 Swedish children (52.1% boys) aged seven to nine years were included.

    Results: The majority of parents reported that their children (95.4%) had breakfast every day. The majority of children had fresh fruit (84.7%) and vegetables (83.9%) most days a week. Only 1.6% of the children were reported to have fast food and 6.0% to have sugar containing soft drinks, four days a week or more. The prevalence of overweight including obesity (OW/OB) was 17.8% for boys, 18.6% for girls. The odds of being OW/OB was higher among those not having breakfast every day (odds ratio (OR) 1.9, 95% confidence interval (CI) 1.20-2.96), drinking diet soft drink (OR 2.6, 95% CI 1.52-4.42) and skimmed/semi-skimmed milk (OR 1.8, 95% CI 1.37-2.36) four days a week or more. Parents being overweight and having low education levels were also related to a higher risk of their children being overweight.

    Conclusions: The parental reports of children's food habits pointed at favourable eating patterns for most investigated children. Breakfast skipping, diet soft drinks and low-fat milk consumption were more frequent among OW/OB children. Longitudinal studies are needed to determine the causal relationships.

  • 16.
    Nilsen, Bente B.
    et al.
    Örebro University, School of Hospitality, Culinary Arts & Meal Science. Department of Nursing and Health Promotion, Oslo and Akershus University College of Applied Science, Oslo, Norway.
    Yngve, Agneta
    Örebro University, School of Hospitality, Culinary Arts & Meal Science. Sophiahemmet University, Stockholm, Sweden.
    Sjöberg, Agneta
    Department of Food and Nutrition, and Sport Science, University of Gothenburg, Gothenburg, Sweden.
    Moraeus, Lotta
    Department of Food and Nutrition, and Sport Science, University of Gothenburg, Gothenburg, Sweden.
    Lissner, Lauren
    Department of Public Health and Community Medicine, University of Gothenburg, Gothenburg, Sweden.
    Werner, Bo
    Örebro University, School of Medical Sciences. School of Hospitality, Culinary Arts and Meal Science, Örebro University, Örebro, Sweden.
    Using different growth references to measure thinness and overweight among Swedish primary school children showed considerable variations2016In: Acta Paediatrica, ISSN 0803-5253, E-ISSN 1651-2227, Vol. 105, no 10, p. 1158-1165Article in journal (Refereed)
    Abstract [en]

    Aim: The study compared how four different growth references determined the prevalence of thinness and overweight, based on height and weight measurements from a nationally representative sample of Swedish children from seven to nine years of age.

    Methods: The height and weight measurements of 4,518 Swedish schoolchildren aged seven to nine years were carried out in 2008 using a standardised protocol. The prevalence of different degrees of thinness and overweight were calculated using international growth references from the World Health Organization, the International Obesity Task Force and two Swedish growth references from Werner and Karlberg.

    Results: Depending on which growth reference we used, the prevalence of different degrees of thinness varied from 7.5%-16.9% for the boys and 6.9%-13.7% for the girls, while for the prevalence of overweight, including obesity and severe obesity, varied from 16.5%-25.7% for the boys and 18.2-25.2% for the girls. There were also significant gender differences depending on the growth reference we used.

    Conclusion: Using four different growth references, two international and two Swedish, produced wide variations in the prevalence of thinness and overweight, together with significant gender differences. In the absence of a global definition, we need both national and international growth references.

  • 17.
    Nilsen, Bente B.
    et al.
    Örebro University, School of Hospitality, Culinary Arts & Meal Science. Department of Nursing and Health Promotion, Oslo Metropolitan University, Oslo, Norway.
    Yngve, Agneta
    Department of food, nutrition and dietetics, Uppsala University, Uppsala, Sweden.
    Werner, Bo
    Örebro University, School of Medical Sciences. Örebro University Hospital.
    Do substantial BMI reduction episodes among Swedish schoolchildren have any impact on their final height?2018In: Acta Paediatrica, ISSN 0803-5253, E-ISSN 1651-2227, Vol. 107, no 7, p. 1223-1229Article in journal (Refereed)
    Abstract [en]

    AIM: This study investigated whether substantial body mass index (BMI) reductions in Swedish schoolchildren aged 7-19 years, caused by disease, healthy or unhealthy behaviour, had any impact on their final height.

    METHODS: We used height and weight data on 6,572 subjects from two nationally representative longitudinal samples of Swedish children born in 1973 and 1981. These provided information on their final height and any BMI reduction episodes.

    RESULTS: Of the 6,572 subjects (50.9% boys), among individuals with information on final height, 1,118 had a BMI reduction of 5% and less than 10%, and 346 had at least one substantial BMI reduction of 10% of more. On a group level, there was no statistically significant difference in the final height of individuals with BMI reductions of 10% or more and those without. The findings were independent of age and the subject's BMI at the start of the reduction episode. However, there were a number of cases where a substantial BMI reduction probably had an impact on the subject's final height.

    CONCLUSION: Our study found no evidence that a substantial BMI reduction had any impact on final height on a group level, but further analyses of specific case studies are necessary to determine whether substantial BMI reduction might have an impact on final height.

  • 18.
    Payr, A
    et al.
    Dr. von Hauner Children’s Hospital, University of Munich Medical Centre, Munich, Germany.
    Birnbaum, J
    Dr. von Hauner Children’s Hospital, University of Munich Medical Centre, Munich, Germany.
    Wildgruber, A
    State Institute of Early Childhood Research, Munich, Germany.
    Kreichauf, S
    State Institute of Early Childhood Research, Munich, Germany.
    Androutsos, O
    Department of Nutrition and Dietetics, Harokopio University, Athens, Greece.
    Lateva, M
    Department of Pediatrics, Medical University Varna, Varna, Bulgaria.
    De Decker, E
    Department of Movement and Sports Sciences, Ghent University, Ghent, Belgium.
    De Craemer, M
    Department of Movement and Sports Sciences, Ghent University, Ghent, Belgium.
    Iotova, V
    Department of Pediatrics, Medical University Varna, Varna, Bulgaria.
    Manios, Y
    Department of Nutrition and Dietetics, Harokopio University, Athens, Greece.
    Koletzko, B
    Dr. von Hauner Children’s Hospital, University of Munich Medical Centre, Munich, Germany.
    Nilsen, Bente (Contributor)
    Oslo and Akershus University College of Applied Science, Oslo, Norway.
    Concepts and strategies on how to train and motivate teachers to implement a kindergarten-based, family-involved intervention to prevent obesity in early childhood: the ToyBox-study2014In: Obesity Reviews, ISSN 1467-7881, E-ISSN 1467-789X, Vol. 15, no Suppl 3, p. 40-47Article in journal (Refereed)
    Abstract [en]

    The key person for the implementation of kindergarten-based behavioural interventions is the kindergarten teacher. When conducting intervention studies in kindergartens, training sessions are needed to train and motivate kindergarten teachers for programme implementation. This paper presents the systematic development of the teachers' trainings executed in the ToyBox-intervention - a kindergarten-based and family-involved obesity prevention programme for children aged 4-6. Based on concepts for the education of kindergarten teachers, on general strategies for successful programme implementation and on the ToyBox programme-specific requirements, the aims of the teachers' trainings were defined and an overall concept was deduced. Regarding the concept for the ToyBox teachers' training sessions, it is concluded that the training modules should focus on presenting information on the practical implementation of the intervention. Furthermore, these modules should also include self-efficacy enhancing components and should give kindergarten teachers opportunities to share experiences. Regarding the didactic methods applied in the ToyBox teachers' training sessions, constructivist learning approaches that facilitate active participation, reflective thinking and personal involvement were implemented. Emphasis was put not only on the content but especially on the didactic methods of teachers' trainings in order to enhance devotion to, and quality and sustainability of the ToyBox-intervention.

  • 19.
    Pil, L
    et al.
    Department of Public Health, Ghent University, Ghent, Belgium.
    Putman, K
    Faculty of Medicine and Pharmacy, Vrije Universiteit Brussel, Brussels, Belgium.
    Cardon, G
    Department of Movement and Sports Sciences, Ghent University, Ghent, Belgium.
    De Bourdeaudhuij, I
    Department of Movement and Sports Sciences, Ghent University, Ghent, Belgium.
    Manios, Y
    Department of Nutrition and Dietetics, Harokopio University, Athens, Greece.
    Androutsos, O
    Department of Nutrition and Dietetics, Harokopio University, Athens, Greece.
    Lateva, M
    Clinic of Paediatric Endocrinology, Medical University of Varna, Varna, Bulgaria.
    Iotova, V
    Clinic of Paediatric Endocrinology, Medical University of Varna, Varna, Bulgaria.
    Zych, K
    Public Health Division, The Children’s Memorial Health Institute, Warsaw, Poland.
    Góźdź, M
    Public Health Division, The Children’s Memorial Health Institute, Warsaw, Poland.
    González-Gil, E M
    Growth, Exercise, Nutrition and Development (GENUD) Reseach Group, University of Zaragoza, Zaragoza, Spain.
    De Miguel-Etayo, P
    Growth, Exercise, Nutrition and Development (GENUD), University of Zaragoza, Zaragoza, Spain.
    Geyer, C
    Division of Metabolic and Nutritional Medicine, Dr. von Hauner Children’s Hospital, Ludwig-Maximilians-University of Munich, München, Germany.
    Birnbaum, J
    Division of Metabolic and Nutritional Medicine, Dr. von Hauner Children’s Hospital, Ludwig-Maximilians-University of Munich, München, Germany.
    Annemans, L
    Department of Public Health, Ghent University, Ghent, Belgium; Faculty of Medicine and Pharmacy, Vrije Universiteit, Brussels, Belgium.
    Nilsen, Bente (Contributor)
    Örebro University, School of Hospitality, Culinary Arts & Meal Science. Oslo and Akershus University College of Applied Science, Oslo, Norway.
    Establishing a method to estimate the cost-effectiveness of a kindergarten-based, family-involved intervention to prevent obesity in early childhood: the ToyBox-study2014In: Obesity Reviews, ISSN 1467-7881, E-ISSN 1467-789X, Vol. 15, no Suppl 3, p. 81-89Article in journal (Refereed)
    Abstract [en]

    Overweight and obesity in children are recognized as a major health problem. The ToyBox-intervention was developed with the aim of preventing obesity in pre-schoolers. Because it is increasingly important to inform policy makers not only on the effects of prevention interventions, but also on their costs and cost-effectiveness, our purpose was to establish a method to estimate the cost-effectiveness of the ToyBox-intervention. In order to estimate the long-term impact of the ToyBox-intervention on health and societal costs, extrapolations of the intervention effect will be conducted to predict children's weight status (based on the body mass index) at adult age. Effects of the adult weight status on the prevalence of obesity-related complications will be modelled through a Markov model, with a total time horizon of 70 years and a cycle length of 1 year. The model will be conducted in six European countries participating in the ToyBox-intervention, based on country-specific economic and epidemiological data. This study describes the methodological rationale and implementation of an analytic model to examine the cost-effectiveness of the ToyBox-intervention for six European countries, in order to inform decision-makers on the value for money of this intervention in the prevention of obesity in pre-schoolers.

  • 20.
    Schippert, Ana Carla S P
    et al.
    Institute of Nursing and Health Promotion, Oslo Metropolitan University, Oslo, Norway; Akershus University Hospital, Oslo, Norway.
    Dahl-Michelsen, Tone
    Institute of Physiotherapy, Oslo Metropolitan University, Oslo, Norway.
    Grov, Ellen Karine
    Institute of Nursing and Health Promotion, Oslo Metropolitan University, Oslo, Norway.
    Sparboe-Nilsen, Bente
    Örebro University, School of Health Sciences. Institute of Nursing and Health Promotion, Oslo Metropolitan University, Oslo, Norway; Faculty of Medicine and Health, Örebro University, Örebro, Sweden.
    Silvola, Juha
    Akershus University Hospital, Oslo, Norway; Institute of Clinical medicine, Campus Ahus, University of Oslo, Oslo, Norway; Norwegian University of Science and Technology, Gjøvik, Norway.
    Bjørnnes, Ann Kristin
    Institute of Nursing and Health Promotion, Oslo Metropolitan University, Oslo, Norway.
    Torture survivors' experiences of receiving surgical treatment indicating re-traumatization2023In: PLOS ONE, E-ISSN 1932-6203, Vol. 18, no 10, article id e0287994Article in journal (Refereed)
    Abstract [en]

    Due to the invasive nature of surgical procedures and the involvement of medical personnel, torture survivors may experience re-traumatization during surgical treatment. This study aimed to explore torture survivors' experiences of re-traumatization during surgical treatment as well as the process by which trauma-related emotions and responses are evoked during surgical treatment for torture survivors. Eight men, aged 45 to 72, from four different countries, who have lived in Norway for 6-40 years, were recruited. We assessed torture and surgical care experiences through in-depth interviews, and the data were analyzed using thematic analysis, resulting in five themes: (1) Interactions with healthcare providers, (2) Reactions during treatment, (3) Triggers causing re-experiences, (4) Avoidance, and (5) Suggestions to healthcare providers. In this study, survivors reported challenges receiving surgical treatment, indicating re-traumatization and difficulty returning to daily life following treatment. Participants reported little collaboration in care-related decision-making processes, lack of recognition of torture by healthcare providers involved in surgical care and experiencing healthcare professionals' attitudes as a source of perplexity, frustration, and despair. Exacerbation of torture memories throughout treatment and re-experiencing of trauma symptoms aggravated these difficulties. Our findings suggest that surgical treatment can remind torture survivors of the traumatic aspects of torture, eliciting strong reactions and feelings like those experienced during torture.

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