| 1. |
- Alexandrou, Christina, et al.
(författare)
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User experiences of an app-based mHealth intervention (MINISTOP 2.0) integrated in Swedish primary child healthcare among Swedish-, Somali- and Arabic-speaking parents and child healthcare nurses: A qualitative study
- 2023
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Ingår i: Digital Health. - : Sage Publications. - 2055-2076. ; 9
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Tidskriftsartikel (refereegranskat)abstract
- Background: Preventive and scalable interventions, accessible to all, to counteract childhood obesity are urgently needed. We have recently developed a novel, digital parental intervention (MINISTOP 2.0 app) available in Swedish, Somali, Arabic and English. We have previously reported its positive effects on children's health behaviors and on parental self-efficacy. However, before introducing the app at scale in primary child healthcare, implementation aspects also need to be explored.Aim: This study aims to explore and describe user experiences as well as acceptability and feasibility of the MINISTOP 2.0 app-based intervention in a diverse group of parents (end-users) and Swedish child healthcare nurses (implementers).Methods: Individual interviews were conducted with Swedish- (n = 9), Somali- (n = 9), Arabic- (n = 5) and English-speaking (n = 1) parents as well as Swedish primary child healthcare nurses (n = 15). Data was analyzed using content analysis with an inductive latent approach.Results: Parents described how the app facilitated behavior change through increased awareness regarding current diet and physical activity behaviors. Furthermore, the evidence-based app content further facilitated trust and behavior change. Both parents and nurses acknowledged the app's preventive potential and the potential for reaching parents with diverse backgrounds or in need of extra support.Conclusion: The MINISTOP 2.0 app was perceived as a useful tool for health promotion both by parents and healthcare professionals, especially since it was adapted to several languages. These findings coupled with the previously shown beneficial effects on health behaviors support the large-scale implementation of the app in primary child healthcare.
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| 2. |
- Berg, Hans ten, et al.
(författare)
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DN Debatt: Sluta skjutsa barnen till skolan - hälsa går före rädsla
- 2023
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Ingår i: Dagens Nyheter. (DN). - Stockholm : Bonnier. - 1101-2447. ; :2023-02-18
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Tidskriftsartikel (populärvet., debatt m.m.)abstract
- Våra barn blir alltmer stillasittande, vilket får livslånga konsekvenser. En av de enklaste lösningarna står föräldrar i vägen för – på grund av rädsla. Föräldrarnas välvilja är i själva verket ett tydligt hot mot barnens hälsa, både i trafiken och genom livet. Sverige behöver en ny nationell rekommendation för aktiva skolresor, skriver åtta forskare och organisationer.
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| 3. |
- Burgueño, Rafael, et al.
(författare)
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Adapting the behavioral regulation in active commuting to and from school questionnaire in Sweden: BR-ACS(SWE)
- 2022
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Ingår i: Transportation Research Interdisciplinary Perspectives. - : Elsevier. - 2590-1982. ; 16
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Tidskriftsartikel (refereegranskat)abstract
- Although growing attention has been paid to motivation in explaining active travel to school among young people at the international level, no measures of motivation for active commuting to school (ACS) were found in Sweden. Guided by self-determination theory, this research aimed to adapt the Behavioral Regulation in Active Commuting to and from School (BR-ACS) questionnaire to the Swedish context and test the resulting version’s psychometric properties. The purposive and cross-sectional sample included 273 students (58 % girls, aged 10–12 years) from four Swedish urban schools. Results from confirmatory factor analyses psychometrically supported the six-factor correlated model (intrinsic motivation, integrated regulation, identified regulation, introjected regulation, external regulation, and amotivation) and the hierarchical three-factor model (autonomous, controlled motivation, and amotivation), which were invariant across gender. Latent correlations underpinned a symplex-like pattern. Discriminant and convergent validity and reliability were gathered. Criterion validity evidence was met with positive associations from intrinsic motivation, integrated and identified regulation to ACS, and a negative relationship between amotivation and ACS. The Swedish version of the BR-ACS questionnaire is a valid and reliable measure of children’s motivation toward ACS.
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| 4. |
- Burgueño, Rafael, et al.
(författare)
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Basic psychological need satisfaction in active commuting to and from school BPNS-ACS(SWE)
- 2023
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Ingår i: Journal of Transport & Health. - : Elsevier. - 2214-1405 .- 2214-1413. ; 30
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Tidskriftsartikel (refereegranskat)abstract
- BackgroundThe absence of appropriate Swedish-language instrumentation to assess active commuting to school has largely hampered the study of the individual factors of the children, such as autonomy, competence, and relatedness to active commuting to school.PurposeBuilding upon self-determination theory, the objective of this research was to gather evidence of the validity and reliability of the Swedish version of the Basic Psychological Need Satisfaction in Active Commuting to and from School (BPNS-ACS) tool.MethodsThe cross-sectional and purposive sample included 273 children (51.28% girls) from urban areas.ResultsConfirmatory factor analysis underpinned the three-factor correlated model, which was invariant across gender. Evidence in support of discriminant and convergent validity and reliability was gathered. Criterion validity evidence was met by positive and significant predictions of autonomy, competence, and relatedness satisfaction on active commuting to and from school.ConclusionsThe Swedish version of the BPNS-ACS is a psychometrically robust measure of children’s perceptions of autonomy, competence, and relatedness satisfaction in active commuting to school and could be used to assess the effects of school-based interventions on need satisfaction for active commuting to school.
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| 5. |
- Forsberg, Hanna
(författare)
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Active school transportation : Understanding the parental decision-making process
- 2024
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Few children and adolescents reach the recommended levels of daily physical activity. This trend is evident in the countries examined in this thesis: Sweden and Spain. In efforts to reverse the current trend, active school transportation (AST) and independent mobility (IM) have been suggested as opportunities to increase levels of physical activity. Unfortunately, AST and IM have decreased during recent decades; consequently, initiatives promoting such behaviors have been called for. Parents are the main decision-makers on a child’s use of AST and IM, and thus, understanding their decisions is important in efforts to promote such behaviors. The overarching aim of this thesis was to increase the understanding of the parental decision-making process concerning their children’s active transport to school.This thesis applied an exploratory sequential design, with both interview (qualitative) and cross-sectional (quantitative) designs used to attain the overall aim. Data was collected through interviews with 20 parents (I) and two surveys: the PILCAST (Parents intentions to let their child use AST) questionnaire (II-III) and the PACO (Pedalea y Anda COlegio [Cycle and walk to school]) family questionnaire (IV). In total, 1024 responses from parents were collected with the PILCAST questionnaire (II). In paper III, a sub-sample of 610 was extracted from the 1024, based on parents responding “yes” or “no” to participation in an AST intervention. In paper IV, a total of 573 parents were included in the study. Data was analyzed with content analysis (I), descriptive statistics (II-IV), confirmatory factor analysis (II), linear regression analysis (II-IV), and logistic regression analysis (IV).The main findings showed that parents’ decisions regarding AST and IM were influenced by social norms, which was reflected in appearing to be a good parent and by what significant others do in their vicinity and neighborhood (I, II, IV). The importance of social norms applied to both Swedish and Spanish parents when it comes to AST. Some, gender differences were found, showing that they might play a more important role for parents of girls when it comes to AST and IM. Further, the findings showed that attitudes influence decisions, which was reflected in how parents master everyday life by sometimes choosing what is most convenient, even though they are aware of the benefits of AST (I-II). Parents identified factors both impeding and facilitating the use of AST, while safety and trusting the child were found to be important (I-II). The findings also indicate that the intervention within the Sustainable Innovation for Children Transporting Actively (SICTA) project might positively influence parents’ beliefs about AST (III). In addition, there seems to be a habitual factor involved in the parental decision-making process (II). Differences were found between parents’ decisions to let their child cycle to school compared to letting their child walk to school (II). Finally, the parental decision-making process seems to be influenced by the child’s age and the distance between home and school (I, II, IV). The PILCAST questionnaire showed acceptable validity and reliability.In conclusion, the findings show that when aiming to promote AST and IM, social acceptance is important. This concerns both other people’s judgments of parenting and what other important referent groups are doing, encompassing the visibility of AST and IM in the parents’ vicinity and neighborhoods. Attention given to gender differences could be beneficial as well. Further, it is also important to understand the prerequisites of modern family life. It is likely that strengthening positive attitudes in parents could promote AST, but the practice also needs to be in line with their everyday life tasks. Efforts should also be made to strengthen the factors that facilitate AST. From a parental perspective, this includes safety and being supported in gaining trust in their children and their children’s capabilities with respect to the age of the children. Habit seems to play an important role, and to encourage parents to form new habits, it might be beneficial to launch AST interventions along with contextual changes, as these might open a window for change, which could occur in the transition between preschool and primary school. It could be beneficial to consider cycling and walking as different behaviors because walking seems to be more dependent on the distance to school than cycling. Further, the PILCAST questionnaire was valid and reliable, providing an increased understanding of these behaviors from a parental perspective. Finally, to make children’s use of active transport to school the more favorable choice, it seems worthwhile not only to give children the opportunity to participate but also to involve parents and address their beliefs when designing interventions.
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| 6. |
- Forsberg, Hanna, et al.
(författare)
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Children's intervention participation is associated with more positive beliefs towards active school transportation among parents
- 2023
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Ingår i: Health Promotion International. - : Oxford University Press. - 0957-4824 .- 1460-2245. ; 38:2
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Tidskriftsartikel (refereegranskat)abstract
- Insufficient physical activity among children is a critical issue and health promoting initiatives are required to reverse this trend. In response to the current situation, a school-based intervention aiming to increase physical activity with the aid of active school transportation (AST) was implemented in one municipality in northern Sweden. By adopting the framework of the Theory of Planned Behavior, we aimed to analyse beliefs among parents whose children were or were not involved in the AST intervention. All municipality schools were included. There were 1024 responses from parents, comprising 610 who responded either 'yes' or 'no' to participating in the intervention. An adjusted linear regression analysis showed that children's intervention participation was significantly associated with more positive beliefs towards AST among parents. These results indicates that it is possible to influence beliefs that are important in the parental decision-making process by the use of an AST intervention. Therefore, to make children´s active transport to school the more favorable choice for parents, it seems to be worthwhile to not only give children the opportunity to participate but also to involve parents and address their beliefs when designing interventions.Not enough physical activity among children is an important issue and health promoting initiatives are needed to reverse this trend. In response to the current situation, a school-based intervention aiming to increase physical activity using active school transportation (AST) was implemented in one municipality in northern Sweden. Using the Theory of Planned Behaviour framework, we aimed to analyse beliefs among parents whose children were or were not involved in the AST intervention. Children’s participation in the intervention was significantly associated with more positive beliefs towards AST among parents. These results indicate that it is possible to influence beliefs that are important in the parental decision-making process by the use of an AST intervention. Therefore, to make children’s active transport to school the more favourable choice for parents, it seems to be worthwhile to not only give children the opportunity to participate but also to involve parents and address their beliefs when designing interventions.
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| 7. |
- Forsberg, Hanna, et al.
(författare)
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Development and Initial Validation of the PILCAST Questionnaire : Understanding Parents’ Intentions to Let Their Child Cycle or Walk to School
- 2021
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Ingår i: International Journal of Environmental Research and Public Health. - : MDPI. - 1661-7827 .- 1660-4601. ; 18:21
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Tidskriftsartikel (refereegranskat)abstract
- Children generally do not meet the recommendation of 60 min of daily physical activity (PA); therefore, active school transportation (AST) is an opportunity to increase PA. To promote AST, the involvement of parents seems essential. Using the theory of planned behavior (TPB), the aim was to develop and validate the PILCAST questionnaire to understand parents’ intentions to let their child cycle or walk to school. Cross-sectional sampling was performed, where 1024 responses were collected from parents. Confirmatory factor analysis indicated acceptable fit indices for the factorial structure according to the TPB, comprising 32 items grouped in 11 latent constructs. All constructs showed satisfying reliability. The regression analysis showed that the TPB explained 55.3% of parents’ intentions to let the child cycle to school and 20.6% regarding walking, increasing by a further 18.3% and 16.6%, respectively, when past behavior was added. The most influential factors regarding cycling were facilitating perceived behavioral control, positive attitudes, subjective and descriptive norms, and for walking, subjective and descriptive norms. The PILCAST questionnaire contributes to a better understanding of the psychological antecedents involving parents’ decisions to let their child cycle or walk to school, and may therefore provide guidance when designing, implementing and evaluating interventions aiming to promote AST.
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| 8. |
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| 9. |
- Forsberg, Hanna, et al.
(författare)
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It’s about being the good parent : exploring attitudes and beliefs towards active school transportation
- 2020
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Ingår i: International Journal of Circumpolar Health. - : Taylor & Francis. - 1239-9736 .- 2242-3982. ; 79:1
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Tidskriftsartikel (refereegranskat)abstract
- In recent decades, there has been a decline in active school transportation (AST). Parents play an important role as the key decision-makers of children’s AST, and there is a need of more knowledge about the decision-making process and parents’ beliefs towards AST. The overall aim of this study was to explore parents’ attitudes and beliefs towards AST in the northern part of Sweden. Twenty parents participated in semi-structured interviews, which was based on the theory of planned behaviour. Qualitative content analysis was used to analyse the interviews. The analysis yielded one main theme, “Parenting and active school transportation – making route choices in a changed landscape” and four subthemes, “Knowing that it is beneficial while struggling with daily life”, “Considering barriers and solutions to enable AST”, “Parenting is challenging and about balancing”, and “Reflecting and contemplating about what we and others do”. Winter conditions affect parents’ decisions, and this needs to be considered when facilitating AST in these regions. Overall better health, increased physical activity, time spent outdoors, and free play were revealed as positive outcomes of AST. Decisions were also influenced by social norms and how the idea of parenting has changed through generations. The findings of this study are likely to be important when promoting AST.
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| 10. |
- Jingili, Nuru, et al.
(författare)
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A Two-Stage co-Design Process of Battleship-AST Persuasive Game for Active School Transportation in Northern Sweden
- 2024
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Ingår i: International Journal of Human-Computer Interaction. - : Taylor & Francis. - 1044-7318 .- 1532-7590.
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Tidskriftsartikel (refereegranskat)abstract
- This research delves into the dynamics of active school transport (AST) by utilizing a two-stage co-design process and leveraging persuasive technology within a game for promoting AST called Battleship-AST. The primary aim of this research is to thoroughly investigate the two-stage game co-design process employed in creating a Battleship-AST game. Moreover, our research aims to evaluate participants’ perceptions regarding the motivating and engaging potential of the persuasive technology and gamification features embedded within the final iteration of the game. This evaluation aims to understand how these features influence participants’ motivation to increase their usage of AST through gameplay. In pursuit of these objectives, the research builds upon the existing Battleship-AST prototype and actively engages school children in a collaborative two-stage co-design process. Their valuable insights and preferences were harnessed in refining the game, which was subsequently tested during a tech event in Skellefteå, Sweden. The findings shed light on various aspects of the game’s impact, from its reception to the gamification features integrated within. Notably, the research highlights the positive impact of the co-design process, with increased motivation and engagement observed among the participants. Their involvement in shaping the game’s design resulted in a more engaging and enjoyable experience. The persuasive technology features, encompassing competition, collaboration, auditory cues, a virtual reward system, and an emphasis on similarity, played a pivotal role in sustaining engagement and motivating players. Elements such as rewards, leaderboard progression, and badges proved highly effective in encouraging continued participation and fostering a positive feedback loop. However, the study also identifies areas for potential improvement, including the need to measure real-life progress and refine the game’s levelling system. The research indicates that refining feedback mechanisms and tailoring game content to individual preferences could create an even more engaging experience. Additionally, long-term playtesting is proposed to assess the game’s extended impact. The findings offer promising avenues for enhancing motivation and engagement in AST, which can contribute to the promotion of healthier and more sustainable transportation choices among school children.
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