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  • 1.
    Beckman, Linda
    et al.
    Faculty of Medicine and Health, School of Health Sciences, Örebro University, Örebro, Sweden; Department of Public Health, Karlstad University, Karlstad, Sweden.
    Svensson, Mikael
    Health Metrics, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
    Geidne, Susanna
    Örebro universitet, Institutionen för hälsovetenskaper.
    Eriksson, Charli
    Örebro universitet, Institutionen för hälsovetenskaper.
    Effects on alcohol use of a Swedish school-based prevention program for early adolescents: a longitudinal study2017Inngår i: BMC Public Health, ISSN 1471-2458, E-ISSN 1471-2458, Vol. 17, artikkel-id 2Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Background: The aim of the study was to address the lack of evaluations of school-based substance use prevention programs and to conduct a quasi-experimental evaluation of the alcohol use part of the Triad intervention.

    Methods: Eleven Swedish intervention schools (285 pupils) and three control schools (159 pupils) participated in the evaluation. Baseline measurements were conducted in 2011 before the alcohol part in the prevention program was implemented in the intervention schools (school year 6, ages 12–13). We estimated an Intention-To-Treat (ITT) Difference-in-Difference (DD) model to analyze the effectiveness of the intervention on subsequent alcohol use measured in grades 7, 8 and 9.

    Results: The main results show no effect on the likelihood of drinking alcohol or drinking to intoxication.

    Conclusions: The lack of positive effects highlights the need for policy-makers and public health officials need to carefully consider and evaluate prevention programs in order to ensure that they are worthwhile from school, health, and societal perspectives.

  • 2.
    Bergström, Gunnar
    et al.
    Division of Intervention and Implementation Research in Worker Health, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden; Centre for Occupational and Environmental Medicine, Stockholm County Council, Stockholm, Sweden.
    Lohela-Karlsson, M.
    Division of Intervention and Implementation Research in Worker Health, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.
    Kwak, L.
    Division of Intervention and Implementation Research in Worker Health, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.
    Bodin, Lennart
    Division of Intervention and Implementation Research in Worker Health, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.
    Jensen, I.
    Division of Intervention and Implementation Research in Worker Health, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.
    Torgén, Margareta
    Department of Medical Science, Uppsala University, Uppsala, Sweden.
    Nybergh, L.
    Division of Intervention and Implementation Research in Worker Health, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden..
    Preventing sickness absenteeism among employees with common mental disorders or stress-related symptoms at work: Design of a cluster randomized controlled trial of a problem-solving based intervention versus care-as-usual conducted at the Occupational Health Services2017Inngår i: BMC Public Health, ISSN 1471-2458, E-ISSN 1471-2458, Vol. 17, nr 1, artikkel-id 436Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Background: Common mental disorders (CMDs) are among the leading causes of sick leave in Sweden and other OECD countries. They result in suffering for the individual and considerable financial costs for the employer and for society at large. The occupational health service (OHS) can offer interventions in which both the individual and the work situation are taken into account. The aim of this paper is to describe the design of a study evaluating the effectiveness of an intervention given at the OHS to employees with CMDs or stress-related symptoms at work. In addition, intervention fidelity and its relation to the outcome will be assessed in a process analysis.

    Methods: The study is designed as a cluster randomized trial in which the participating OHS consultants are randomized into either delivering the intervention or performing care as usual. Employees with CMDs or stress-related symptoms at work are recruited consecutively by the OHS consultants. The intervention aims to improve the match between the employee and the job situation. Interviews are held individually with the employee and the nearest supervisor, after which a joint meeting with both the employee and the supervisor takes place. A participatory approach is applied by which the supervisor and the employee are guided by the OHS consultant and encouraged to actively take part in problem solving concerning the work situation. Outcomes will be assessed at baseline and at six and 12 months. A long-term follow-up at 3 years will also be performed. The primary outcome is registered sickness absence during a 1-year period after study inclusion. Secondary outcomes are mental health and work ability. The intervention's cost effectiveness, compared to treatment as usual, both for society and for the employer will be evaluated. A process evaluation by both the OHS consultants and the employee will be carried out.

    Discussion: The study includes analyses of the effectiveness of the intervention (clinical and economic) as well as an analysis of its implementation at the participating OHSs. Possible methodological challenges such as selection bias and risk of contamination between OHS consultants delivering the experimental condition and consultants giving usual care are discussed.

  • 3.
    Bortes, Cristian
    et al.
    School of Health and Medical Sciences, Örebro University, Örebro, Sweden.
    Geidne, Susanna
    Örebro universitet, Institutionen för hälsovetenskaper.
    Eriksson, Charli
    Örebro universitet, Institutionen för hälsovetenskaper.
    Evaluating the effectiveness of the SMART contract-signing strategy in reducing the growth of Swedish Adolescents’ substance use and problem behaviors2016Inngår i: BMC Public Health, ISSN 1471-2458, E-ISSN 1471-2458, Vol. 16, nr 1, artikkel-id 519Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Background: In 2013, around 40 % of the schools in Sweden had structured programs to prevent tobacco and alcohol debut in compulsory school. There has unfortunately been a lack of scientific evidence to support most of the prevention methods focusing on primary prevention in schools in Sweden. The aim and purpose of the present study is to evaluate the effectiveness of the Non-Governmental Organization SMART contract-signing strategy in reducing the growth of youth substance use and other problem behaviors amongst Swedish adolescents.

    Methods: Students from five schools in a medium-sized Swedish municipality were surveyed in three waves from 7th to 9th grade of compulsory school. We used General Linear Model (GLM) repeated-measures ANOVA to test if the outcome measures smoking, use of snus and alcohol, drunkenness, delinquency, and bullying significantly changed different amounts over time in groups that had participated in the SMART program for long time, a short time, sporadically- or not at all. Groups were compared on demographic background variables, and outcome measures were assessed on all measurement occasions by a one-way ANOVA. The magnitude of group differences at the end of the study was estimated according to Cohen’s d.

    Results: Number of years with a contract has an effect on the levels of self-reported youth problems in 9th grade. We found small to medium-sized differences in measured outcomes between students who participated in the program for the longest period of time, 5 years, and who participated for the shortest time, 0–2 years.

    Conclusion: Findings suggests that the SMART program has preventive effects on adolescent substance use.

  • 4.
    Börnhorst, Claudia
    et al.
    Department of Biometry and Data Management, Leibniz Institute for Prevention Research and Epidemiology, BIPS GmbH, Bremen, Germany .
    Wijnhoven, Trudy M. A.
    Division of Noncommunicable Diseases and Life-course, WHO Regional Office for Europe, UN City, Denmark.
    Kunesova, Marie
    Obesity Management Centre, Institute of Endocrinology, Prague 1, Czech Republic .
    Yngve, Agneta
    Örebro universitet, Restaurang- och hotellhögskolan.
    Rito, Ana I.
    National Health Institute Doutor Ricardo Jorge, Lisbon, Portugal .
    Lissner, Lauren
    Section for Epidemiology and Social Medicine (EPSO), Department of Public Health and Community Medicine, University of Gothenburg, Gothenburg, Sweden .
    Duleva, Vesselka
    Department of Food and Nutrition, National Center of Public Health and Analyses, Sofia, Bulgaria.
    Petrauskiene, Ausra
    Department of Preventive Medicine, Lithuanian University of Health Sciences, Kaunas, Lithuania .
    Breda, Joao
    Department of Biometry and Data Management, Leibniz Institute for Prevention Research and Epidemiology, BIPS GmbH, Bremen, Germany .
    WHO European Childhood Obesity Surveillance Initiative: associations between sleep duration, screen time and food consumption frequencies2015Inngår i: BMC Public Health, ISSN 1471-2458, E-ISSN 1471-2458, Vol. 15, nr 1, artikkel-id 442Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Background: Both sleep duration and screen time have been suggested to affect children's diet, although in different directions and presumably through different pathways. The present cross-sectional study aimed to simultaneously investigate the associations between sleep duration, screen time and food consumption frequencies in children.

    Methods: The analysis was based on 10 453 children aged 6-9 years from five European countries that participated in the World Health Organization European Childhood Obesity Surveillance Initiative. Logistic multilevel models were used to assess associations of parent-reported screen time as well as sleep duration (exposure variables) with consumption frequencies of 16 food items (outcome variables). All models were adjusted for age, sex, outdoor play time, maximum educational level of parents and sleep duration or screen time, depending on the exposure under investigation.

    Results: One additional hour of screen time was associated with increased consumption frequencies of 'soft drinks containing sugar' (1.28 [1.19; 1.39]; odds ratio and 99% confidence interval), 'diet/light soft drinks' (1.21 [1.14; 1.29]), 'flavoured milk' (1.18 [1.08; 1.28]), 'candy bars or chocolate' (1.31 [1.22; 1.40]), 'biscuits, cakes, doughnuts or pies' (1.22 [1.14; 1.30]), 'potato chips (crisps), corn chips, popcorn or peanuts' (1.32 [1.20; 1.45]), 'pizza, French fries (chips), hamburgers' (1.30 [1.18; 1.43]) and with a reduced consumption frequency of 'vegetables (excluding potatoes)' (0.89 [0.83; 0.95]) and 'fresh fruits' (0.91 [0.86; 0.97]). Conversely, one additional hour of sleep duration was found to be associated with increased consumption frequencies of 'fresh fruits' (1.11 [1.04; 1.18]) and 'vegetables (excluding potatoes)' (1.14 [1.07; 1.23]).

    Conclusion: The results suggest a potential relation between high screen time exposure and increased consumption frequencies of foods high in fat, free sugar or salt whereas long sleep duration may favourably be related to children's food choices. Both screen time and sleep duration are modifiable behaviours that may be tackled in childhood obesity prevention efforts.

  • 5.
    Granbom, Marianne
    et al.
    Department of Health Sciences, Lund University, Lund, Sweden.
    Iwarsson, Susanne
    Department of Health Sciences, Lund University, Lund, Sweden.
    Kylberg, Marianne
    Department of Health Sciences, Lund University, Lund, Sweden.
    Pettersson, Cecilia
    Department of Health Sciences, Lund University, Lund, Sweden.
    Slaug, Björn
    Department of Health Sciences, Lund University, Lund, Sweden.
    A public health perspective to environmental barriers and accessibility problems for senior citizens living in ordinary housing2016Inngår i: BMC Public Health, ISSN 1471-2458, E-ISSN 1471-2458, Vol. 16, nr 1, artikkel-id 772Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    BACKGROUND: Housing environments that hinder performance of daily activities and impede participation in social life have negative health consequences particularly for the older segment of the population. From a public health perspective accessible housing that supports active and healthy ageing is therefore crucial. The objective of the present study was to make an inventory of environmental barriers and investigate accessibility problems in the ordinary housing stock in Sweden as related to the functional capacity of senior citizens. Particular attention was paid to differences between housing types and building periods and to identify environmental barriers generating the most accessibility problems for sub-groups of senior citizens.

    METHODS: Data on environmental barriers in dwellings from three databases on housing and health in old age was analysed (N = 1021). Four functional profiles representing large groups of senior citizens were used in analyses of the magnitude and severity of potential accessibility problems. Differences in terms of type of housing and building period were examined.

    RESULTS: High proportions of one-family houses as well as multi-dwellings had substantial numbers of environmental barriers, with significantly lower numbers in later building periods. Accessibility problems occurred already for senior citizens with few functional limitations, but more profound for those dependent on mobility devices. The most problematic housing sections were entrances in one-family houses and kitchens of multi-dwellings.

    CONCLUSIONS: Despite a high housing standard in the Swedish ordinary housing stock the results show substantial accessibility problems for senior citizens with functional limitations. To make housing accessible large-scale and systematic efforts are required.

  • 6.
    Hagberg, Lars A.
    et al.
    Örebro universitet, Institutionen för hälsovetenskap och medicin. Region Örebro län. Centre for Health Care Science, Örebro University, Örebro, Sweden.
    Brekke, Hilde K.
    Dept Internal Med & Clin Nutr, Sahlgrenska Acad, Univ Gothenburg, Gothenburg, Sweden.
    Bertz, Fredrik
    Dept Internal Med & Clin Nutr, Sahlgrenska Acad, Univ Gothenburg, Gothenburg, Sweden.
    Winkvist, Anna
    Dept Internal Med & Clin Nutr, Sahlgrenska Academy, Univ Gothenburg, Gothenburg, Sweden.
    Cost-utility analysis of a randomized controlled weight loss trial among lactating overweight/obese women2014Inngår i: BMC Public Health, ISSN 1471-2458, E-ISSN 1471-2458, Vol. 14, artikkel-id 38Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Background: Overweight and obesity among young, adult women are increasing problems in Sweden as in many other countries. The postpartum period may be a good opportunity to improve eating habits and lose weight in a sustainable manner. The aim was to make a cost-utility analysis of a dietary behavior modification treatment alongside usual care, compared to usual care alone, among lactating overweight and obese women.

    Methods: This study was a cost-utility analysis based on a randomized controlled and longitudinal clinical diet intervention. Between 2007-2010, 68 women living in Sweden were, after baseline measurement at 8-12 weeks postpartum, randomly assigned to a 12-week dietary behavior modification treatment or control group.

    Inclusion criteria were: self-reported pre-pregnancy body mass index (BMI) 25-35 kg/m(2), non-smoker, singleton term delivery, birth weight > 2500 g, intention to breastfeed for 6 mo and no diseases (mother and child). The women in the intervention group received 1.5 hour of individual counseling at study start and 1 hour at follow-up home visits after 6 weeks of intervention, with support through cell phone text messages every two wk. Dietary intervention aimed to reduce dietary intake by 500 kcal/day. The control group received usual care. Weight results have previously been reported. Here we report on analyses carried out during 2012-2013 of cost per quality adjusted life years (QALY), based on the changes in quality of life measured by EQ-5D-3 L and SF-6D. Likelihood of cost-effectiveness was calculated using Net Monetary Benefit method.

    Results: Based on conservative assumptions of no remaining effect after 1 year follow-up, the diet intervention was cost-effective. Costs per gained QALY were 8 643 - 9 758 USD. The likelihood for cost-effectiveness, considering a willingness to pay 50 000 USD for a QALY, was 87-93%.

    Conclusions: The diet intervention is cost-effective.

  • 7.
    Hagberg, Lars
    et al.
    Örebro universitet, Institutionen för hälsovetenskaper. Region Örebro län.
    Winkvist, Anna
    Department of Internal Medicine and Clinical Nutrition, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
    Brekke, Hilde K.
    Department of Internal Medicine and Clinical Nutrition, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; Department of Nutrition, Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway.
    Bertz, Fredrik
    Department of Internal Medicine and Clinical Nutrition, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
    Johansson, Else Hellebö
    Närhälsan Research and Development Primary Health Care, Region Västra Götaland, Borås, Sweden.
    Huseinovic, Ena
    Department of Internal Medicine and Clinical Nutrition, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
    Cost-effectiveness and quality of life of a diet intervention postpartum: 2-year results from a randomized controlled trial2019Inngår i: BMC Public Health, ISSN 1471-2458, E-ISSN 1471-2458, Vol. 19, artikkel-id 38Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Background: Pregnancy has been identified as a contributor to obesity. We have shown that a diet intervention postpartum produced a 2-y weight loss of 8%. Here, we present the impact of the diet intervention on cost-effectiveness and explore changes in quality of life (QOL).

    Methods: A total of 110 postpartum women with overweight/obesity were randomly assigned to diet (D-group) or control (C-group). D-group received a 12-wk diet intervention within primary health care followed by monthly emails up to the 1-y follow-up. C-group received a brochure. Changes in QOL were measured using the 36-item Short Form Health Survey and EQ-5D. The analysis of cost-effectiveness was a cost-utility analysis with a health care perspective and included costs of intervention for stakeholder, quality-adjusted life-years (QALYs) gained and savings in health care. The likelihood of cost-effectiveness was examined using the net monetary benefit method.

    Results: The D-group increased their QOL more than the C-group at 12 wk. and 1 y, with pronounced differences for the dimensions general health and mental health, and the mental component summary score (all p<0.05). Cost per gained QALY was 1704-7889 USD. The likelihood for cost-effectiveness, based on a willingness to pay 50,000 USD per QALY, was 0.77-1.00.

    Conclusions: A diet intervention that produced clinically relevant postpartum weight loss also resulted in increased QOL and was cost-effective.

    Trial registration: Clinical trials, NCT01949558, 2013-09-24

  • 8.
    Hugelius, Karin
    et al.
    Örebro universitet, Institutionen för hälsovetenskaper.
    Semrau, Maya
    Center for Global Health Research, Brighton and Sussex Medical School, Brighton, UK.
    Holmefur, Marie
    Örebro universitet, Institutionen för hälsovetenskaper.
    HESPER web - development and reliability evaluation of a web-based version of the humanitarian emergency settings perceived needs scale2020Inngår i: BMC Public Health, ISSN 1471-2458, E-ISSN 1471-2458, Vol. 20, nr 1, artikkel-id 323Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Background: The Humanitarian Emergency Settings Perceived Needs Scale (HESPER) assesses a wide range of physical, psychological and social perceived needs across 26 questions, and can be used in humanitarian emergencies and disasters for needs assessment or research studies. The original HESPER collects data through individual interviews. Today, a large number of people have access to the internet, including in humanitarian emergencies and disasters. Therefore, this paper aimed to report the development, reliability evaluation and feasibility evaluation of the HESPER Web.

    Methods: First, the original HESPER was developed into a web based survey. Thereafter, alternate forms reliability between the HESPER and HESPER Web, and test-retest reliability for the HESPER Web, was evaluated using a study sample of 85 asylum seekers in Sweden in total.

    Results: The alternate forms reliability evaluation showed that the HESPER Web was a reliable instrument to assess perceived needs. Intraclass correlation coefficient (ICC) for total number of serious needs was 0.96 (CI 0.93–09.98, p < 0.001). Cohen’s κ was used to analyse the alternate forms reliability between the HESPER and HESPER Web item per item; the correspondence between HESPER and HESPER Web varied between 0.54 and 1.0 for the 26 questions. There was a strong nominal association in first priority need between the HESPER and HESPER Web (Cramer’s V 0.845, p < 0.001). In the test-retest reliability evaluation of HESPER Web, ICC was 0.98 (CI 0.97–0.99, p < 0.001), and Cohen’s κ varied between 0.53 and 1.0. There was a strong nominal association in first priority need between test and re-test (Cramer’s V 0.93, p < 0.001). The HESPER Web was experienced as easy and safe to use and was found less time consuming than the original HESPER interview, according to the study participants.

    Conclusion: The HESPER Web is a reliable and usable instrument to assess perceived needs. It can reduce a number of practical challenges both for needs assessment in disasters or humanitarian emergencies as well as in research.

  • 9.
    Kumakech, Edward
    et al.
    Örebro universitet, Institutionen för hälsovetenskap och medicin. Department of Pathology, Makerere University, College of Health Sciences, Kampala, Uganda.
    Andersson, Sören
    Region Örebro län. Department of Laboratory Medicine, Örebro University Hospital, Örebro, Sweden.
    Wabinga, Henry
    Department of Pathology, Makerere University, College of Health Sciences, Kampala, Uganda.
    Berggren, Vanja
    Division of Health Sciences, Lund University, Lund, Sweden.
    Integration of HIV and cervical cancer screening perceptions of healthcare providers and policy makers in Uganda2014Inngår i: BMC Public Health, ISSN 1471-2458, E-ISSN 1471-2458, Vol. 14, artikkel-id 810Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Background: HIV-positive women have an increased risk of developing cervical cancer (CC) compared to the HIV-negative women. Despite this, HIV and CC screening programs in many developing countries have remained disintegrated. Therefore, the objective of the study was to explore perceptions of healthcare providers (HCP) and policy makers (PM) about integration of HIV and CC screening services in Uganda.

    Methods: This was a qualitative study conducted among 16 participants comprising of 12 healthcare providers and 4 policy makers in Uganda. Data were collected through individual interviews. Participants were purposively selected from different level of health facilities with clinics for HIV and CC screening services. Content analysis method was used to analyze the data.

    Results: Three themes emerged from the data, namely appreciating benefits of integration, worrying about the limited health system capacity and potential consequences of integration and feeling optimistic about integration under improved health system conditions. The benefits embraced the women - particularly the HIV-positive women- but also men, healthcare providers and the health system or the government. There were worries that HIV stigma and shortage of healthcare workers would affect the effective delivery of the integrated program.

    Conclusion: Integration of HIV and CC screening can offer manifold benefits to all stakeholders in the health system, more so to the women. However, its feasibility in developing countries such as Uganda will most likely be hampered by weak and inefficient health systems. Therefore, when considering HIV and CC screening integration, it is important not to only recognize the benefits but also take into account resources requirements for addressing the existing weaknesses and inefficiencies in the health systems such as limited infrastructure, insufficient drugs and supplies, inadequate and poorly motivated healthcare workers.

  • 10. Lannerstrom, Linda
    et al.
    Wallman, Thorne
    Holmström, Inger K.
    Örebro universitet, Institutionen för hälsovetenskap och medicin.
    Losing independence: the lived experience of being long-term sick-listed2013Inngår i: BMC Public Health, ISSN 1471-2458, E-ISSN 1471-2458, Vol. 13, nr 745, s. 1-10Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Background: Sickness absence is a multifaceted problem. Much is known about risk factors for being long-term sick-listed, but there is still little known about the various aftermaths and experiences of it. The aim of this qualitative study was to describe, analyze and understand long-term sickness-absent people's experiences of being sick-listed.

    Methods: The design was descriptive and had a phenomenological approach. Sixteen long-term sickness-absent individuals were purposively sampled from three municipalities in Sweden in 2011, and data were collected through semi-structured, individual interviews. The interview questions addressed how the participants experienced being sick-listed and how the sick-listing affected their lives. Transcribed interviews were analysed using Giorgi's phenomenological method.

    Results: The interviews revealed that the participants' experiences of being sick-listed was that they lost their independence in the process of stepping out of working society, attending the mandatory steps in the rehabilitation chain and having numerous encounters with professionals. The participants described that their life-worlds were radically changed when they became sick-listed. Their experiences of their changing life-worlds were mostly highly negative, but there were also a few positive experiences. The most conspicuous findings were the fact that stopping working brought with it so many changes, the participants' feelings of powerlessness in the process, and their experiences of offensive treatment by and/or encounters with professionals.

    Conclusions: Sick-listed persons experienced the process of being on long-term sickness absent as very negative. The negative experiences are linked to consequences of stopping to work, consequences of social insurance rules and to negative encounters with professionals handling the sickness absence. The positive experiences of being sick-listed were few in the present study. There is a need to further examine the extent of these negative experiences are and how they affect sick-listed people's recovery and return to work. Long-term sickness absence; sick leave; experiences; interviews; phenomenology; Sweden.

  • 11.
    Larsson, Madelene
    et al.
    Örebro universitet, Institutionen för hälsovetenskaper.
    Pettersson, Camilla
    Örebro universitet, Institutionen för hälsovetenskaper.
    Skoog, Therése
    Örebro universitet, Institutionen för juridik, psykologi och socialt arbete.
    Eriksson, Charli
    Örebro universitet, Institutionen för hälsovetenskaper.
    Enabling relationship formation, development, and closure in a one-year female mentoring program at a non-governmental organization: a mixed-method study2016Inngår i: BMC Public Health, ISSN 1471-2458, E-ISSN 1471-2458, Vol. 16, nr 1, artikkel-id 179Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Background: Mental health problems among young women aged 16-24 have increased significantly in recent decades, and interventions are called for. Mentoring is a well-established preventative/promotive intervention for developing adolescents, but we have yet to fully understand how the relationship between the mentor and the protégé forms, develops, and closes. In this study, we focused on a female mentoring program implemented by a Swedish non-governmental organization, The Girls Zone. First, we examined the psychological and social characteristics of the young women who chose to take part in the program as protégés. Second, we investigated adolescent female protégés’ own experiences of the relationship process based on a relational-cultural theory perspective.

    Methods: The mixed-method study included 52 questionnaires and five semi-structured interviews with young women aged 15–26 who had contacted The Girls Zone between 2010 and 2012 in order to find a mentor. Their experience of the mentoring relationships varied in duration. Data were analysed statistically and with inductive qualitative content analysis.

    Results: The group of protégés was heterogeneous in that some had poor mental health and some had good mental health. On the other hand, the group was homogenous in that all its members had shown pro-active self-care by actively seeking out the program due to experiences of loneliness and a need to meet and talk with a person who could listen to them. The relationships were initially characterized by feelings of nervousness and ambivalence. However, after some time, these developed into authentic, undemanding, non-hierarchical relationships on the protégés’ terms. The closure of relationships aroused feelings of both abandonment and developing strength.

    Conclusions: Mentorships that are in line with perspectives of the relational-cultural theory meet the relationship needs expressed by the female protégés. Mentor training should focus on promoting skills such as active listening and respect for the protégé based on an engaged, empathic, and authentic approach in a non-hierarchical relationship. These insights have the potential to inform interventions in several arenas where young women create authentic relationships with older persons, such as in school, in traditional health care contexts, and in youth recreation centres. 

  • 12.
    Linden-Bostrom, Margareta
    et al.
    Dept Community Med & Publ Hlth, Örebro Cty Council, Örebro, Sweden.
    Persson, Carina
    Dept Community Med & Publ Hlth, Örebro Cty Council, Örebro, Sweden.
    Eriksson, Charli
    Örebro universitet, Hälsoakademin.
    Neighbourhood characteristics, social capital and self-rated health - A population-based survey in Sweden2010Inngår i: BMC Public Health, ISSN 1471-2458, E-ISSN 1471-2458, Vol. 10, s. 628-Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Background: In previous public health surveys large differences in health have been shown between citizens living in different neighbourhoods in the Orebro municipality, which has about 125000 inhabitants. The aim of this study was to investigate the determinants of health with an emphasis on the importance of neighbourhood characteristics such as the influence of neighbourhood social cohesion and social capital. The point of departure in this study was a conceptual model inspired by the work of Carpiano, where different factors related to the neighbourhood have been used to find associations to individual self-rated health. Methods: We used data from the survey 'Life & Health 2004' sent to inhabitants aged 18-84 years in Orebro municipality, Sweden. The respondents (n = 2346) answered a postal questionnaire about living conditions, housing conditions, health risk factors and individual health. The outcome variable was self-rated health. In the analysis we applied logistic regression modelling in various model steps following a conceptual model. Results: The results show that poor self-rated health was associated with social capital, such as lack of personal support and no experience of being made proud even after controlling for strong factors related to health, such as age, disability pension, ethnicity and economic stress. Also the neighbourhood factors, housing area and residential stability were associated with self-rated health. Poor self-rated health was more common among people living in areas with predominately large blocks of flats or areas outside the city centre. Moreover, people who had lived in the same area 1-5 years reported poor health more frequently than those who had lived there longer. Conclusions: The importance of the neighbourhood and social capital for individual health is confirmed in this study. The neighbourhoods could be emphasized as settings for health promotion. They can be constructed to promote social interaction which in turn supports the development of social networks, social support and social capital - all important determinants of health.

  • 13.
    Lundqvist, Stefan
    et al.
    Department of Health and Rehabilitation, Unit of Physiotherapy, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; Närhälsan Göteborg centrum för fysisk aktivitet, Region Västra Götaland, Gothenburg, Sweden.
    Börjesson, Mats
    Department of Food and Nutrition and Sport Science, Faculty of Education, University of Gothenburg, Gothenburg, Sweden; Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; Sahlgrenska University Hospital/Östra, Gothenburg, Sweden.
    Larsson, Maria E. H.
    Department of Health and Rehabilitation, Unit of Physiotherapy, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; Närhälsan Research and Development Primary Health Care, Region Västra Götaland, Gothenburg, Sweden.
    Cider, Åsa
    Department of Health and Rehabilitation, Unit of Physiotherapy, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
    Hagberg, Lars
    Örebro universitet, Institutionen för hälsovetenskaper. Region Örebro län. University Health Care Research Center.
    Which patients benefit from physical activity on prescription (PAP)?: A prospective observational analysis of factors that predict increased physical activity2019Inngår i: BMC Public Health, ISSN 1471-2458, E-ISSN 1471-2458, Vol. 19, nr 1, artikkel-id 482Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    BACKGROUND: There is robust evidence that regular physical activity (PA) has positive health effects. However, the best PA methods and the most important correlates for promoting PA remain unclear. Physical activity on prescription (PAP) aims to increase the patient's motivation for and level of PA. This study investigated possible predictive baseline correlates associated with changes in the PA level over a 6-month period of PAP treatment in order to identify the primary care patients most likely to benefit from a PAP intervention.

    METHODS: The study included 444 patients with metabolic risk factors who were aged 27 to 85 years and physically inactive. The patients received PAP treatment that included individual counseling plus an individually-tailored PA recommendation with a written prescription and individualised structured follow-up for 6 months. Eight baseline correlates of PA were analysed against the PA level at the 6-month follow-up in a predictor analysis.

    RESULTS: Five baseline correlates predicted the PA level at the 6-month follow-up: self-efficacy expectations for changing PA; the patient's preparedness and confidence regarding readiness to change PA; a BMI <  30; and a positive valued physical health. The proportion of patients increasing the PA level and achieving a PA level that was in accordance with public health recommendations was higher with a positive valued baseline correlate. The odds of achieving the recommended PA level increased substantially when 2 to 4 predictive correlates were present. PA levels increased to a greater extent among patients with low PA at baseline than patients with high PA at baseline, especially in combination with 2 to 4 positively-valued correlates (87-95% vs. 62-75%).

    CONCLUSIONS: This study identified potential predictive correlates of an increased PA level after a 6-month PAP intervention. This contributes to our understanding of PAP and could help individualise PAP support. The proportion of patients with the lowest PA level at baseline increased their PA level in a higher extent (84%) and thus may benefit the most from PAP. These results have clinical implications for behavioural change in those patients having the greatest health gains by increasing their PA level.

    TRIAL REGISTRATION: ClinicalTrials.gov ; NCT03586011 . Retrospectively registered on July 17, 2018.

  • 14.
    Mazaheri, Monir
    et al.
    School of Health, Care and Social Welfare, Mälardalen University, Eskilstuna, Sweden; Department of Neurobiology, Care Science and Society, Karolinska Institutet, Stockholm, Sweden; Faculty of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran.
    Eriksson, Lars E.
    Department of Neurobiology, Care Science and Society, Karolinska Institutet, Stockholm, Sweden; Department of Infectious Diseases, Karolinska University Hospital, Stockholm, Sweden; School of Health Sciences, City University London, London, United Kingdom .
    Nasrabadi, Alireza Nikbakht
    Faculty of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran.
    Sunvisson, Helena
    Örebro universitet, Institutionen för hälsovetenskap och medicin.
    Heikkila, Kristiina
    Department of Neurobiology, Care Science and Society, Karolinska Institutet, Stockholm, Sweden; Department of Health and Care Sciences, Faculty of Life and Health Sciences, Linnaeus University, Kalmar, Sweden .
    Experiences of dementia in a foreign country: qualitative content analysis of interviews with people with dementia2014Inngår i: BMC Public Health, ISSN 1471-2458, E-ISSN 1471-2458, Vol. 14, s. 794-Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Background: Dementia is a worldwide health concern of epidemic proportions. Research in the field of subjective experience of dementia suffers from a lack of diversity of their participants including immigrants. Different portraits of life with dementia could help us understand how people with dementia conceptualise their experiences of dementia and how they live. Our study aimed to explore the subjective experiences of living with dementia among Iranian immigrants in Sweden.

    Methods: Qualitative content analysis of interviews with fifteen people with dementia from Iranian immigrant backgrounds were conducted (8 females and 7 males).

    Results: Three themes and seven associated sub-themes were revealed. The themes included: Being a person with dementia means living with forgetfulness (personal sphere), living with forgetfulness in the private sphere means feeling incompetent but still loved, living with forgetfulness in the public sphere means feeling confident and secure but also isolated.

    Conclusions: Living with dementia for the participants meant living with forgetfulness. They experienced feeling incompetent but still loved within their families and feeling confident and secure but also isolated in the society. Educating people with dementia and their families about the course and process of dementia may help them understand the changes better and adjust their expectations. Our study can provide a basis for healthcare workers to understand the experiences of living with dementia from this specific perspective.

  • 15. Molarius, Anu
    et al.
    Berglund, Kenneth
    Eriksson, Charli
    Örebro universitet, Hälsoakademin.
    Eriksson, Hans G.
    Linden-Bostrom, Margareta
    Nordstrom, Eva
    Persson, Carina
    Sahlqvist, Lotta
    Starrin, Bengt
    Ydreborg, Berit
    Mental health symptoms in relation to socio-economic conditions and lifestyle factors: a population-based study in Sweden2009Inngår i: BMC Public Health, ISSN 1471-2458, E-ISSN 1471-2458, Vol. 9, s. 302-Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Background: Poor mental health has large social and economic consequences both for the individual and society. In Sweden, the prevalence of mental health symptoms has increased since the beginning of the 1990s. There is a need for a better understanding of the area for planning preventive activities and health care. Methods: The study is based on a postal survey questionnaire sent to a random sample of men and women aged 18-84 years in 2004. The overall response rate was 64%. The area investigated covers 55 municipalities with about one million inhabitants in central part of Sweden. The study population includes 42,448 respondents. Mental health was measured with self-reported symptoms of anxiety/depression (EQ-5D, 5th question). The association between socio-economic conditions, lifestyle factors and mental health symptoms was investigated using multivariate multinomial logistic regression models. Results: About 40% of women and 30% of men reported that they were moderately or extremely anxious or depressed. Younger subjects reported poorer mental health than older subjects, the best mental health was found at ages 65-74 years. Factors that were strongly and independently related to mental health symptoms were poor social support, experiences of being belittled, employment status (receiving a disability pension and unemployment), economic hardship, critical life events, and functional disability. A strong association was also found between how burdensome domestic work was experienced and anxiety/depression. This was true for both men and women. Educational level was not associated with mental health symptoms. Of lifestyle factors, physical inactivity, underweight and risk consumption of alcohol were independently associated with mental health symptoms. Conclusion: Our results support the notion that a ground for good mental health includes balance in social relations, in domestic work and in employment as well as in personal economy both among men and women. In addition, physical inactivity, underweight and risk consumption of alcohol are associated with mental health symptoms independent of socio-economic factors.

  • 16.
    Nilsing Strid, Emma
    et al.
    Department of Medical and Health Sciences, Division of Physiotherapy, Linköping University, Linköping, Sweden.
    Söderberg, Elsy
    Linköping University, Linköping, Sweden.
    Öberg, Birgitta
    Linköping University, Linköping, Sweden.
    Sickness certificates in Sweden: did the new guidelines improve their quality?2012Inngår i: BMC Public Health, ISSN 1471-2458, E-ISSN 1471-2458, Vol. 12, artikkel-id 907Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Background: Long-term sickness absence is high in many Western countries. In Sweden and many other countries, decisions on entitlement to sickness benefits and return to work measures are based on information provided by physicians in sickness certificates. The quality demands, as stressed by the Swedish sick leave guidelines from 2008, included accurate sickness certificates with assessment of functioning clearly documented. This study aims to compare quality of sickness certificates between 2007 and 2009 in Ostergotland County, Sweden. Quality is defined in terms of descriptions of functioning with the use of activity and participation according to WHOs International Classification of Functioning, Disability and Health (ICF), and in prescriptions of early rehabilitation.

    Methods: During two weeks in 2007 and four weeks in 2009, all certificates had been collected upon arrival to the social insurance office in Ostergotland County, Sweden. Four hundred seventy-five new certificates were included in 2007 and 501 in 2009. Prolongations of sick leave were included until the last date of sick listing. Free text on functioning was analysed deductively using the ICF framework, and placed into categories (body functions/structures, activity, participation, no description) for statistical analysis.

    Results: The majority of the certificates were issued for musculoskeletal diseases or mental disorders. Text on functioning could be classified into the components of ICF in 65% and 78% of sickness certificates issued in 2007 and 2009, respectively. Descriptions according to body components such as "sensations of pain" or "emotional functions" were given in 58% of the certificates from 2007 and in 65% from 2009. The activity component, for example "walking" or "handling stress", was more frequent in certificates issued in 2009 compared with 2007 (33% versus 26%). Prescriptions of early rehabilitation increased from 27% in 2007 to 35% in 2009, primarily due to more counseling.

    Conclusions: An improvement of the quality between certificates collected in 2007 and 2009 was demonstrated in Ostergotland County, Sweden. The certificates from 2009 provided more information linkable to ICF and incorporated an increased use of activity limitations when describing patients functioning. Still, activity limitations and prescriptions of early rehabilitation were only present in one-third of the sickness certificates.

  • 17.
    Nilsson, Andreas
    et al.
    Örebro universitet, Hälsoakademin.
    Andersen, Lars Bo
    Ommundsen, Yngvar
    Froberg, Karsten
    Sardinha, Luis B.
    Piehl-Aulin, Karin
    Örebro universitet, Hälsoakademin.
    Ekelund, Ulf
    Örebro universitet, Hälsoakademin.
    Correlates of objectively assessed physical activity and sedentary time in children: a cross-sectional study (The European Youth Heart Study)2009Inngår i: BMC Public Health, ISSN 1471-2458, E-ISSN 1471-2458, Vol. 9, artikkel-id 322Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Background

    Identifying leisure time activities performed before and after school that influence time in physical activity (PA) and/or time spent sedentary can provide useful information when designing interventions aimed to promote an active lifestyle in young people. The purpose of this study was to examine associations between mode of transportation to school, outdoor play after school, participation in exercise in clubs, and TV viewing with objectively assessed PA and sedentary behaviour in children.

    Methods

    A total of 1327 nine- and 15-year-old children from three European countries (Norway, Estonia, Portugal) participated as part of the European Youth Heart Study. PA was measured during two weekdays and two weekend days using the MTI accelerometer, and average percent of time in moderate-to-vigorous PA (MVPA) and time spent sedentary were derived. Potential correlates were assessed by self-report. Independent associations between self-reported correlates with percent time in MVPA and percent time sedentary were analysed by general linear models, adjusted by age, gender, country, measurement period, monitored days and parental socio-economic status.

    Results

    In 9-year-olds, playing outdoors after school was associated with higher percent time in MVPA (P < 0.01), while participation in sport clubs was associated with higher percent time in MVPA (P < 0.01) in 15-year-olds. No associations with percent time sedentary were observed in either age group.

    Conclusion

    Frequency of outdoor play after school is a significant correlate for daily time in MVPA in 9-year-olds, while this correlate is attenuated in favour of participation in sport and exercise in clubs in 15-year-olds. Targeting walking to school or reduced TV viewing time in order to increase time in daily MVPA in children is unlikely to be sufficient. Correlates related to time spent sedentary need further examination.

  • 18.
    Pettersson, Camilla
    et al.
    Örebro universitet, Hälsoakademin.
    Lindén-Boström, Margareta
    Department of Community Medicine, Örebro County Council .
    Eriksson, Charli
    Örebro universitet, Hälsoakademin.
    Reasons for non-participation in a parental program concerning underage drinking: a mixed-method study2009Inngår i: BMC Public Health, ISSN 1471-2458, E-ISSN 1471-2458, Vol. 9, artikkel-id 478Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Background: Alcohol consumption among adolescents is a serious public health concern. Research has shown that prevention programs targeting parents can help prevent underage drinking. The problem is that parental participation in these kinds of interventions is generally low. Therefore, the aim of the present study is to examine non-participation in a parental support program aiming to prevent underage alcohol drinking. The Health Belief Model has been used as a tool for the analysis.

    Methods: To understand non-participation in a parental program a quasi-experimental mixed-method design was used. The participants in the study were invited to participate in a parental program targeting parents with children in school years 7-9. A questionnaire was sent home to the parents before the program started. Two follow-up surveys were also carried out. The inclusion criteria for the study were that the parents had answered the questionnaire in school year 7 and either of the questionnaires in the two subsequent school years (n = 455). Multinomial logistic regression analysis was used to examine reasons for non-participation. The final follow-up questionnaire included an opened-ended question about reasons for non-participation. A qualitative content analysis was carried out and the two largest categories were included in the third model of the multinomial logistic regression analysis.

    Results: Educational level was the most important socio-demographic factor for predicting non-participation. Parents with a lower level of education were less likely to participate than those who were more educated. Factors associated with adolescents and alcohol did not seem to be of significant importance. Instead, program-related factors predicted non-participation, e.g. parents who did not perceive any need for the intervention and who did not attend the information meeting were more likely to be non-participants. Practical issues, like time demands, also seemed to be important.

    Conclusion: To design a parental program that attracts parents independently of educational level seems to be an important challenge for the future as well as program marketing. This is something that must be considered when implementing prevention programs.

  • 19.
    Pettersson, Camilla
    et al.
    Örebro universitet, Hälsoakademin.
    Özdemir, Metin
    Örebro universitet, Akademin för juridik, psykologi och socialt arbete.
    Eriksson, Charli
    Örebro universitet, Hälsoakademin.
    Effects of a parental program for preventing underage drinking: the NGO program Strong and Clear2011Inngår i: BMC Public Health, ISSN 1471-2458, E-ISSN 1471-2458, Vol. 11, artikkel-id 251Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Background

    The present study is an evaluation of a 3-year parental program aiming to prevent underage drinking. The intervention was implemented by a non-governmental organization and targeted parents with children aged 13-16 years old and included recurrent activities during the entire period of secondary school. The program consisted of four different types of group and self-administered activities: parent meetings, family dialogues, friend meetings, and family meetings.

    Methods

    A quasi-experimental design was used following parents and children with questionnaires during the three years of secondary school. The analytic sample consisted of 509 dyads of parents and children. Measures of parental attitudes and behaviour concerning underage drinking and adolescents' lifetime alcohol consumption and drunkenness were used. Three socio-demographic factors were included: parental education, school, and gender of the child. A Latent Growth Modelling (LGM) approach was used to examine changes in parental behaviour regarding youth drinking and in young people's drinking behaviour. To test for the pre-post test differences in parental attitudes repeated measures ANOVA were used.

    Results

    The results showed that parents in the program maintained their restrictive attitude toward underage drinking to a higher degree than non-participating parents. Adolescents of participants were on average one year older than adolescents with non-participating parents when they made their alcohol debut. They were also less likely to have ever been drunk in school year 9.

    Conclusion

    The results of the study suggested that Strong and Clear contributed to maintaining parents' restrictive attitude toward underage drinking during secondary school, postponing alcohol debut among the adolescents, and significantly reducing their drunkenness

  • 20.
    Reineholm, Cathrine
    et al.
    HELIX VINN Excellence Centre, Linköping University, Linköping, Sweden; National Centre for Work and Rehabilitation, Department of Medical and Health Sciences, Linköping University, Linköping, Sweden.
    Gustavsson, Maria
    HELIX VINN Excellence Centre, Linköping University, Linköping, Sweden; Department of Behavioural Sciences and Learning, Linköping University, Linköping, Sweden.
    Liljegren, Mats
    Örebro universitet, Institutionen för juridik, psykologi och socialt arbete. HELIX VINN Excellence Centre, Linköping University, Linköping, Sweden.
    Ekberg, Kerstin
    HELIX VINN Excellence Centre, Linköping University, Linköping, Sweden; National Centre for Work and Rehabilitation, Department of Medical and Health Sciences, Linköping University, Linköping, Sweden.
    The importance of work conditions and health for voluntary job mobility: a two-year follow-up2012Inngår i: BMC Public Health, ISSN 1471-2458, E-ISSN 1471-2458, Vol. 12, artikkel-id 682Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Background: Changing jobs is part of modern working life. Within occupational health, job mobility has mainly been studied in terms of employees' intentions to leave their jobs. In contrast to actual turnover, turnover intentions are not definite and only reflect the probability that an individual will change job. The aim of this study was to determine what work conditions predict voluntary job mobility and to examine if good health or burnout predicts voluntary job mobility.

    Methods: The study was based on questionnaire data from 792 civil servants. The data were analysed using logistic regressions.

    Results: Low variety and high autonomy were associated with increased voluntary job mobility. However, the associations between health and voluntary job mobility did not reach significance. Possible explanations for the null results may be that the population was homogeneous, and that the instruments for measuring global health are too coarse for a healthy, working population.

    Conclusions: Voluntary job mobility may be predicted by high autonomy and low variety. The former may reflect that individuals with high autonomy have stronger career development motives; the latter may reflect the fact that low variety leads to job dissatisfaction. In contrast to our results on job content, global health measurements are not strong predictors of voluntary job mobility. This may be because good health affects job mobility through several offsetting channels, involving the resources and ability to seek a new job. Future work should use more detailed measurements of health or examine other work settings so that we may learn more about which of the offsetting effects of health dominate in different contexts.

  • 21.
    Sandmark, Helene
    Örebro universitet, Hälsoakademin.
    Work and family: associations with long term sick-listing in Swedish women2007Inngår i: BMC Public Health, ISSN 1471-2458, E-ISSN 1471-2458, nr 7, s. 287-Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Background: The number of Swedish women who are long-term sick-listed is high, and twice ashigh as for men. Also the periods of sickness absence have on average been longer for women thanfor men. The objective of this study was to investigate the associations between factors in work and family life and long-term sick-listing in Swedish women.

    Methods: This case-control study included 283 women on long-term sick-listing ≥90 days, and 250 female referents, randomly chosen, living in five counties in Sweden. Bivariate and multivariate logistic regression analyses with odds ratios were calculated to estimate the associations between long-term sick-listing and factors related to occupational work and family life.

    Results: Long-term sick-listing in women is associated with self-reported lack of competence for work tasks (OR 2.42 1.23–11.21 log reg), workplace dissatisfaction (OR 1.89 1.14–6.62 log reg), physical workload above capacity (1.78 1.50–5.94), too high mental strain in work tasks (1.61 1.08–5.01 log reg), number of employers during work life (OR 1.39 1.35–4.03 log reg), earlier part-time work (OR 1.39 1.18–4.03 log reg), and lack of influence on working hours (OR 1.35 1.47–3.86 log reg). A younger age at first child, number of children, and main responsibility for own children was also found to be associated with long-term sick-listing. Almost all of the sick-listed women (93%) wanted to return to working life, and 54% reported they could work immediately if adjustments at work or part-time work were possible.

    Conclusion: Factors in work and in family life could be important to consider to prevent women from being long-term sick-listed and promote their opportunities to remain in working life. Measures ought to be taken to improve their mobility in work life and control over decisions and actions regarding theirs lives.

  • 22.
    Sandmark, Helene
    et al.
    Örebro universitet, Hälsoakademin. Dept Med Sci Occupat & Environm Med, Uppsala Univ, Uppsala, Sweden.
    Renstig, Monica
    Womens Business Res Inst, Stockholm, Sweden.
    Understanding long-term sick leave in female white-collar workers with burnout and stress-related diagnoses: a qualitative study2010Inngår i: BMC Public Health, ISSN 1471-2458, E-ISSN 1471-2458, Vol. 10, s. 210-Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Background: Sick leave rates in Sweden have been significant since the end of the 1990s. In this paper we focus on individual female white-collar workers and explore various factors and setting-based sources of ill health in working life and in private life, in order to understand impaired work ability, leading ultimately to long-term sick leave. Methods: A qualitative methodology was chosen, and thematic, open-ended interviews were carried out with 16 women. The interviewees were strategically selected from a cohort of 300 women in full-time white-collar jobs in high-level positions, living in three urban areas in Sweden, and on long-term sick leave >= 90 days. A qualitative content analysis was carried out. Results: The informants in the study were generally well educated, but a few had surprisingly little formal education considering their salary level and position on the labour market. The women were in professional positions more commonly held by men, either as specialists with some degree of managerial role or as executives with managerial responsibilities. Both external and internal stressors were identified. The analysis indicated that being in these gender-typed jobs could have induced sex discrimination and role conflicts. The women expressed strong agreement regarding success in working life, but emphasised the lack of competence matching in their present jobs. They also lacked the sense of having a rewarding job, saw leadership as weak, and disliked their present workplace and colleagues. Impaired health may have hindered them from changing jobs; conversely, their locked-in positions could have resulted in deterioration in their health status. The women displayed personal overcommitment, both at work and in private life, and had difficulties in setting limits. Conclusions: Factors in working life, as well as in private life, played an important role in the informants' deteriorated health and long-term sick leave. Job and workplace mismatching, problems in connection with company profitability, and poor leadership contributed to stress-related symptoms, resulting in reduced working capacity. On the basis of these findings, attention should be paid to identification of early indicators of exhaustion, and measures should be taken in work settings and in working life as a whole to promote retained work ability.

  • 23. Sherar, Lauren B.
    et al.
    Griew, Pippa
    Esliger, Dale W.
    Cooper, Ashley R.
    Ekelund, Ulf
    Örebro universitet, Hälsoakademin.
    Judge, Ken
    Riddoch, Chris
    International children's accelerometry database (ICAD): design and methods2011Inngår i: BMC Public Health, ISSN 1471-2458, E-ISSN 1471-2458, Vol. 11, s. 485-Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Background: Over the past decade, accelerometers have increased in popularity as an objective measure of physical activity in free-living individuals. Evidence suggests that objective measures, rather than subjective tools such as questionnaires, are more likely to detect associations between physical activity and health in children. To date, a number of studies of children and adolescents across diverse cultures around the globe have collected accelerometer measures of physical activity accompanied by a broad range of predictor variables and associated health outcomes. The International Children's Accelerometry Database (ICAD) project pooled and reduced raw accelerometer data using standardized methods to create comparable outcome variables across studies. Such data pooling has the potential to improve our knowledge regarding the strength of relationships between physical activity and health. This manuscript describes the contributing studies, outlines the standardized methods used to process the accelerometer data and provides the initial questions which will be addressed using this novel data repository. Methods: Between September 2008 and May 2010 46,131 raw Actigraph data files and accompanying anthropometric, demographic and health data collected on children (aged 3-18 years) were obtained from 20 studies worldwide and data was reduced using standardized analytical methods. Results: When using >= 8, >= 10 and >= 12 hrs of wear per day as a criterion, 96%, 93.5% and 86.2% of the males, respectively, and 96.3%, 93.7% and 86% of the females, respectively, had at least one valid day of data. Conclusions: Pooling raw accelerometer data and accompanying phenotypic data from a number of studies has the potential to: a) increase statistical power due to a large sample size, b) create a more heterogeneous and potentially more representative sample, c) standardize and optimize the analytical methods used in the generation of outcome variables, and d) provide a means to study the causes of inter-study variability in physical activity. Methodological challenges include inflated variability in accelerometry measurements and the wide variation in tools and methods used to collect non-accelerometer data.

  • 24.
    Wahlgren, Lina
    et al.
    The Research Unit for Movement, Health and Environment, The Åstrand Laboratory, GIH - The Swedish School of Sport and Health Sciences, Stockholm, Sweden; School of Health and Medical Sciences, Örebro University, Örebro, Sweden.
    Schantz, Peter
    The Research Unit for Movement, Health and Environment, The Åstrand Laboratory, GIH - The Swedish School of Sport and Health Sciences, Stockholm, Sweden; Department of Health Sciences, Mid Sweden University, Östersund, Sweden.
    Exploring bikeability in a metropolitan setting: stimulating and hindering factors in commuting route environments2012Inngår i: BMC Public Health, ISSN 1471-2458, E-ISSN 1471-2458, Vol. 12, s. 168-Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Background: Route environments may influence people's active commuting positively and thereby contribute to public health. Assessments of route environments are, however, needed in order to better understand the possible relationship between active commuting and the route environment. The aim of this study was, therefore, to assess the potential associations between perceptions of whether the route environment on the whole hinders or stimulates bicycle commuting and perceptions of environmental factors. Methods: The Active Commuting Route Environment Scale (ACRES) was used for the assessment of bicycle commuters' perceptions of their route environments in the inner urban parts of Greater Stockholm, Sweden. Bicycle commuters (n = 827) were recruited by advertisements in newspapers. Simultaneous multiple regression analyses were used to assess the relation between predictor variables (such as levels of exhaust fumes, noise, traffic speed, traffic congestion and greenery) and the outcome variable (hindering stimulating route environments). Two models were run, (Model 1) without and (Model 2) with the item traffic: unsafe or safe included as a predictor. Results: Overall, about 40% of the variance of hindering - stimulating route environments was explained by the environmental predictors in our models (Model 1, R-2 = 0.415, and Model 2, R-2 = 0.435). The regression equation for Model 1 was: y = 8.53 + 0.33 ugly or beautiful + 0.14 greenery + (-0.14) course of the route + (-0.13) exhaust fumes + (-0.09) congestion: all types of vehicles (p <= 0.019). The regression equation for Model 2 was y = 6.55 + 0.31 ugly or beautiful + 0.16 traffic: unsafe or safe + (-0.13) exhaust fumes + 0.12 greenery + (-0.12) course of the route (p <= 0.001). Conclusions: The main results indicate that beautiful, green and safe route environments seem to be, independently of each other, stimulating factors for bicycle commuting in inner urban areas. On the other hand, exhaust fumes, traffic congestion and low 'directness' of the route seem to be hindering factors. Furthermore, the overall results illustrate the complexity of a research area at the beginning of exploration.

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