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Sökning: WFRF:(Müssener Ulrika)

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1.
  • Berman, A. H., et al. (författare)
  • Clinician experiences of healthy lifestyle promotion and perceptions of digital interventions as complementary tools for lifestyle behavior change in primary care
  • 2018
  • Ingår i: Bmc Family Practice. - : BMC. - 1471-2296. ; 19:139
  • Tidskriftsartikel (refereegranskat)abstract
    • Background: Evidence-based practice for healthy lifestyle promotion in primary health care is supported internationally by national policies and guidelines but implementation in routine primary health care has been slow. Referral to digital interventions could lead to a larger proportion of patients accessing structured interventions for healthy lifestyle promotion, but such referral might have unknown implications for clinicians with patients accessing such interventions. This qualitative study aimed to explore the perceptions of clinicians in primary care on healthy lifestyle promotion with or without digital screening and intervention. Methods: Focus group interviews were conducted at 10 primary care clinics in Sweden with clinicians from different health professions. Transcribed interviews were analyzed using content analysis, with inspiration from a phenomenological-hermeneutic method involving naive understanding, structural analysis and comprehensive understanding. Results: Two major themes captured clinicians' perceptions on healthy lifestyle promotion: 1) the need for structured professional practice and 2) deficient professional practice as a hinder for implementation. Sub-themes in theme 1 were striving towards professionalism, which for participants meant working in a standardized fashion, with replicable routines regardless of clinic, as well as being able to monitor statistics on individual patient and group levels; and embracing the future with critical optimism, meaning expecting to develop professionally but also being concerned about the consequences of integrating digital tools into primary care, particularly regarding the importance of personal interaction between patient and provider. For theme 2, sub-themes were being in an unmanageable situation, meaning not being able to do what is perceived as best for the patient due to lack of time and resources; and following one's perception, meaning working from a gut feeling, which for our participants also meant deviating from clinical routines. Conclusions: In efforts to increase evidence-based practice and lighten the burden of clinicians in primary care, decision-and policy-makers planning the introduction of digital tools for healthy lifestyle promotion will need to explicitly define their role as complements to face-to-face encounters. Our overriding hope is that this study will contribute to maintaining meaningfulness in the patient-clinician encounter, when digital tools are added to facilitate patient behavior change of unhealthy lifestyle behaviors.
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2.
  • Söderström, Emmie, et al. (författare)
  • Healthcare Professionals Perceptions of Promoting Healthy Lifestyle Behaviors in Pregnant Migrant Women and the Potential of a Digital Support Tool-A Qualitative Study
  • 2022
  • Ingår i: International Journal of Environmental Research and Public Health. - : MDPI. - 1661-7827 .- 1660-4601. ; 19:4
  • Tidskriftsartikel (refereegranskat)abstract
    • Eating healthily and being physically active during pregnancy are important for maternal and offspring health. Maternity healthcare is a key arena for health promotion; however, 20% of pregnant women in Sweden are foreign-born, which may reduce reach due to language and cultural barriers. The aims of this study were to explore healthcare professionals perceptions about (a) promoting health behaviors (i.e., healthy diet, physical activity, and weight gain) among Arabic- and Somali-speaking pregnant women and (b) how a translated version of the previously evaluated Swedish app (HealthyMoms) can be tailored and used as a tool in their clinical work. Healthcare professionals in Swedish maternity care (n = 14) were interviewed. Data were analyzed using inductive thematic analysis. Healthcare professionals expressed challenges in health promotion work, including cultural and educational aspects and low awareness of health behaviors among women themselves and their social environment. Further, a lack of resources within the clinical practice and a need for cultural awareness among healthcare professionals were highlighted. Finally, it was perceived that a translated app has potential to provide basic and culturally adjusted information, facilitate communication and thus has potential to become a helpful tool in maternity care to support healthy lifestyle behaviors in Arabic- and Somali-speaking pregnant women.
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3.
  • Alexandrou, Christina, et al. (författare)
  • Adapting a Parental Support App to Promote Healthy Diet and Physical Activity Behaviors (MINISTOP) for a Multi-Ethnic Setting : A Qualitative Study on the Needs and Preferences of Parents and Nurses within Swedish Child Health Care
  • 2021
  • Ingår i: Nutrients. - : MDPI. - 2072-6643 .- 2072-6643. ; 13:7
  • Tidskriftsartikel (refereegranskat)abstract
    • Early efforts for prevention of childhood overweight and obesity are needed. In order to adapt an app promoting healthy diet and physical activity behaviors in children (MINISTOP 1.0) for multi-ethnic communities, we explored: (1) needs and concerns among Somali-, Arabic-, and Swedish-speaking parents in terms of supporting healthy diet and activity behaviors in their children; (2) nurses perceptions of parental needs and concerns in relation to diet and physical activity behaviors; and (3) how the features and content of the MINISTOP 1.0 app could be refined to better support health behaviors in children, among both parents and nurses. Focus groups with Somali-, Arabic-, and Swedish-speaking parents (n = 15), and individual interviews with nurses (n = 15) were conducted. Parents expressed several challenges in supporting childrens health behaviors, the need for a tailored app, and alternative ways of accessing the content (audio/video). Nurses emphasized the need of supporting parents early, and the value of a shared platform in different languages, to facilitate communication. This study contributes valuable insights about parental needs and relevant adaptations to a parental support app, such as addition of audio/video files for increased accessibility. This adapted app version-MINISTOP 2.0, can be useful for childhood obesity prevention in multi-ethnic communities.
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4.
  • Bendtsen, Marcus, 1982-, et al. (författare)
  • mHealth intervention for multiple lifestyle behaviour change among high school students in Sweden (LIFE4YOUth) : Protocol for a randomised controlled trial
  • 2021
  • Ingår i: Public Health Nursing. - : BMC. - 0737-1209 .- 1525-1446. ; 21:1, s. 1406-
  • Tidskriftsartikel (refereegranskat)abstract
    • BackgroundNational surveys in Sweden demonstrate that the majority of young people do not engage in health promoting behaviours at levels recommended by the Public Health Agency of Sweden. The objective of this study is to estimate the effectiveness of a novel mHealth intervention named LIFE4YOUth, which targets multiple lifestyle behaviours (alcohol, diet, physical activity, and smoking) among high school students in Sweden.MethodsA 2-arm parallel groups single blind randomised controlled trial (1:1) will be employed to estimate the effectiveness of the novel mHealth intervention. Students will be recruited at high schools throughout Sweden, and will be included if they fulfil one of six criteria relating to unhealthy behaviours with respect to alcohol, diet, physical activity and smoking. Eligible participants will be randomised to either receive the novel intervention immediately, or to be placed on a waiting list for 4 months. The intervention consists of a combination of recurring screening, text messages, and an interactive platform which is adaptable to individual preferences. Outcome measures with respect to alcohol, diet, physical activity and smoking will be assessed through questionnaires at 2 and 4 months post randomisation.DiscussionThe findings of this trial could be generalised to a diverse high-school student population as our recruitment encompass a large proportion of schools throughout Sweden with various educational profiles. Furthermore, if effective, the mHealth intervention has good potential to be able to be scaled up and disseminated at high schools nationally.Trial registrationRegistered prospectively on 2020-05-20 in ISRCTN (ISRCTN34468623).
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5.
  • Bendtsen, Marcus, 1982-, et al. (författare)
  • The Mobile Health Multiple Lifestyle Behavior Interventions Across the Lifespan (MoBILE) Research Program : Protocol for Development, Evaluation, and Implementation
  • 2020
  • Ingår i: JMIR Research Protocols. - Toronto, Canada : JMIR Publications Inc. - 1929-0748 .- 1929-0748. ; 9:4
  • Tidskriftsartikel (refereegranskat)abstract
    • Background: Clustering of multiple lifestyle risk behaviors has been associated with a greater risk of noncommunicable diseases and mortality than one lifestyle risk behavior or no lifestyle risk behaviors. The National Board of Health and Welfare in Sweden reported in 2018 that it is important to provide additional support to individuals with multiple lifestyle risk behaviors, as risks from these behaviors are multiplicative rather than additive. However, the same report emphasized that there is a lack of knowledge regarding interventions that support changes to unhealthy lifestyle behaviors.Objective: The MoBILE (Mobile health Multiple lifestyle Behavior Interventions across the LifEspan) research program has brought together two Swedish research groups supported by international collaborators. Through this collaboration, we aim to design and evaluate a number of novel and tailored mobile health (mHealth) multiple lifestyle behavior interventions across the life span of different health care populations. In addition, the MoBILE research program will extend ongoing research to include mHealth interventions for migrant pregnant women and children.Methods: Each project within the MoBILE program will focus on a specific group: pregnant women, preschool children, high school and university students, and adults in primary and clinical care. All the projects will follow the same 4 phases: requirements, development, evaluation, and implementation. During the requirements phase, implementers and end users will aid the design of content and functionality of the interventions. In the development phase, findings from the first phase will be synthesized with expert domain knowledge and theoretical constructs to create interventions tailored to the target groups. The third phase, evaluation, will comprise randomized controlled trials conducted to estimate the effects of the interventions on multiple lifestyle risk behaviors (eg, alcohol, nutrition, physical activity, and smoking). The final phase will investigate how the interventions, if found effective, can be disseminated into different health care contexts.Results: The research program commenced in 2019, and the first results will be available in 2020. Projects involving pregnant women, preschool children, and high school and university students will be completed in the first 3 years, with the remaining projects being planned for the program’s final 3 years.Conclusions:The development of evidence-based digital tools is complex, as they should be guided by theoretical frameworks, and requires large interdisciplinary teams with competence in technology, behavioral science, and lifestyle-specific areas. Individual researchers or smaller research groups developing their own tools is not the way forward, as it means reinventing the wheel over and over again. The MoBILE research program therefore aims to join forces and learn from the past 10 years of mHealth research to maximize scientific outcomes, as well as the use of financial resources to expand the growing body of evidence for mHealth lifestyle behavior interventions. 
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6.
  • Henriksson, Hanna, et al. (författare)
  • MINISTOP 2.0: a smartphone app integrated in primary child health care to promote healthy diet and physical activity behaviours and prevent obesity in preschool-aged children: protocol for a hybrid design effectiveness-implementation study
  • 2020
  • Ingår i: BMC Public Health. - : BMC. - 1471-2458 .- 1471-2458. ; 20:1
  • Tidskriftsartikel (refereegranskat)abstract
    • BackgroundChildhood obesity is still a major health problem in many countries, including Sweden. Childhood obesity and obesity-related behaviours in childhood, such as low physical activity and unhealthy eating habits, tend to track into adulthood, which highlights the need for early prevention. Our aims are to evaluate whether a parent-oriented mobile health app (the MINISTOP 2.0 app) integrated into primary child health care can improve diet and physical activity behaviours and reduce the prevalence of overweight and obesity in preschool-aged children as well as to evaluate the implementation among child health care nurses and parents.MethodsThis trial uses a hybrid type 1 effectiveness-implementation design. Families (n=500) who attend a routine visit to one of 15-20 primary child health care centres throughout Sweden, when their child is 2.5years, are offered participation in a randomised controlled trial (effectiveness evaluation). After acceptance, families will be randomised (1:1) to control or intervention groups. The intervention group receives a 6-month parent-oriented smartphone intervention aimed at improving the dietary and activity behaviours of their child (the MINISTOP 2.0 app) and the control group receives routine child health care. Dietary habits, physical activity and screen time (primary outcomes), body weight and height in children, and parental self-efficacy (secondary outcomes) are measured at baseline and at 6months post randomisation. Implementation outcomes (i.e. perceived acceptability, appropriateness, and feasibility) of the intervention will be assessed among primary child health care nurses and parents in the trial through questionnaires and qualitative interviews.DiscussionThis trial will evaluate whether the MINISTOP 2.0 app can be used in primary child health care to improve diet and physical activity behaviours, and prevent overweight and obesity, in preschool-aged children. If effectiveness is proven, and the MINISTOP 2.0 app is considered acceptable, appropriate and feasible, it can be implemented nationally as part of the preventive strategies to combat childhood obesity provided by routine child health care.Trial registrationThe trial was registered at the Clinicaltrials.gov register platform (ID NCT04147039) on 31 October 2019.
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7.
  • Henstrom, Maria, et al. (författare)
  • The Need for an Evidence-Based Program in Sweden to Support Parents to Create Healthy Lifestyle Behaviors from the Start of Life-Parental Perceptions
  • 2020
  • Ingår i: Nutrients. - : MDPI. - 2072-6643 .- 2072-6643. ; 12:12
  • Tidskriftsartikel (refereegranskat)abstract
    • In Sweden, there have been no interventions promoting the development of healthy lifestyle behaviors starting in infancy. Thus this paper aims to: (i) investigate Swedish parents experiences regarding feeding of solid foods, screen time, and physical activity in healthy infants; (ii) investigate parents needs and perceptions regarding information/support provided in primary child healthcare (CHC) and (iii) explore whether a parenting program focused on child diet and active play would be relevant and utilized. Semi-structured interviews were conducted with 20 parents. These were recorded, transcribed verbatim and analyzed using thematic analysis. Seven themes emerged: Feeling excited to enter a new phase; Parents responsibility of doing it "right" can be stressful; Motivated to learn during specific time windows; Information to trust; The importance of social support from peers; Experiences of support received from CHC; and the Infant, Feeding, Activity, and Nutrition Trial (INFANT) for a Swedish context. Parents were excited to enter new phases in their childs development. However, this came with worry they were doing things "right", leading parents to want more information/support. Overall, Swedish parents were very positive about the prospects of engaging in a primary CHC delivered program to support them to promote healthy lifestyle behaviors from birth and felt this could complement the care currently provided.
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8.
  • Keurhorst, M., et al. (författare)
  • Strategies in primary healthcare to implement early identification of risky alcohol consumption: why do they work or not? A qualitative evaluation of the ODHIN study
  • 2016
  • Ingår i: Bmc Family Practice. - : BIOMED CENTRAL LTD. - 1471-2296. ; 17
  • Tidskriftsartikel (refereegranskat)abstract
    • Background: Screening and brief interventions (SBI) in primary healthcare are cost-effective in risky drinkers, yet they are not offered to all eligible patients. This qualitative study aimed to provide more insight into the factors and mechanisms of why, how, for whom and under what circumstances implementation strategies work or do not work in increasing SBI. Methods: Semi-structured interviews were conducted between February and July 2014 with 40 GPs and 28 nurses in Catalonia, the Netherlands, Poland, and Sweden. Participants were purposefully selected from the European Optimising Delivery of Healthcare Interventions (ODHIN) trial. This randomised controlled trial evaluated the influence of training and support, financial reimbursement and an internet-based method of delivering advice on SBI. Amongst them were 38 providers with a high screening performance and 30 with a low screening performance from different allocation groups. Realist evaluation was combined with the Tailored Implementation for Chronic Diseases framework for identification of implementation determinants to guide the interviews and analysis. Transcripts were analysed thematically with the diagram affinity method. Results: Training and support motivated SBI by improved knowledge, skills and prioritisation. Continuous provision, sufficient time to learn intervention techniques and to tailor to individual experienced barriers, seemed important T&S conditions. Catalan and Polish professionals perceived financial reimbursement to be an additional stimulating factor as well, as effects on SBI were smoothened by personnel levels and salary levels. Structural payment for preventive services rather than a temporary project based payment, might have increased the effects of financial reimbursement. Implementing e-BI seem to require more guidance than was delivered in ODHIN. Despite the allocation, important preconditions for SBI routine seemed frequent exposure of this topic in media and guidelines, SBI facilitating information systems, and having SBI in protocol-led care. Hence, the second order analysis revealed that the applied implementation strategies have high potential on the micro professional level and meso-organisational level, however due to influences from the macro-level such as societal and political culture the effects risks to get nullified. Conclusions: Essential determinants perceived for the implementation of SBI routines were identified, in particular for training and support and financial reimbursement. However, focusing only on the primary healthcare setting seems insufficient and a more integrated SBI culture, together with meso- and macro-focused implementation process is requested.
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9.
  • Müssener, Ulrika, et al. (författare)
  • Development of an Intervention Targeting Multiple Health Behaviors Among High School Students: Participatory Design Study Using Heuristic Evaluation and Usability Testing
  • 2020
  • Ingår i: JMIR mhealth and uhealth. - : JMIR PUBLICATIONS, INC. - 2291-5222. ; 8:10
  • Tidskriftsartikel (refereegranskat)abstract
    • Background: Mobile electronic platforms provide exciting possibilities for health behavior promotion. For instance, they can promote smoking cessation, moderate alcohol consumption, healthy eating, and physical activity. Young adults in Sweden are proficient in the use of technology, having been exposed to computers, smartphones, and the internet from an early age. However, with the high availability of mobile health (mHealth) interventions of varying quality, it is critical to optimize the usability of mHealth interventions to ensure long-term use of these health promotion interventions. Objective: This study aims to investigate the usability of an mHealth intervention (LIFE4YOUth) targeting health behaviors among high school students through heuristic evaluation and usability testing. Methods: A preliminary version of the LIFE4YOUth mHealth intervention, which was aimed at promoting healthy eating, physical activity, smoking cessation, and nonrisky drinking among high school students, was developed in early 2019. We completed a total of 15 heuristic evaluations and 5 usability tests to evaluate the usability of the mHealth intervention prototype to improve its functioning, content, and design. Results: Heuristic evaluation from a total of 15 experts (10 employees and 5 university students, both women and men, aged 18-25 years) revealed that the major usability problems and the worst ratings, a total of 17 problems termed usability catastrophes, concerned shortcomings in displaying easy-to-understand information to the users or technical errors. The results of the usability testing including 5 high school students (both girls and boys, aged 15-18 years) showed that the design, quality, and quantity of content in the intervention may impact the users level of engagement. Poor functionality was considered a major barrier to usability. Of the 5 participants, one rated the LIFE4YOUth intervention as poor, 2 rated as average, and 2 assessed it as good, according to the System Usability Scale. Conclusions: High school students have high expectations of digital products. If an mHealth intervention does not offer optimal functions, they may cease to use it. Optimizing the usability of mHealth interventions is a critical step in the development process. Heuristic evaluation and usability testing in this study provided valuable knowledge about the prototype from a users perspective. The findings may lead to the development of similar interventions targeting the high school population.
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10.
  • Müssener, Ulrika, et al. (författare)
  • Encouraging encounters : sick-listed persons’ experiences of interactions with rehabilitation professionals
  • 2007
  • Ingår i: Social work in health care. - 0098-1389 .- 1541-034X. ; 46:2, s. 71-87
  • Tidskriftsartikel (refereegranskat)abstract
    • Long-term sickness-absence has increased in many countries and more knowledge is warranted on factors that can promote return-to-work (RTW). Interactions with professionals might be one such factor and especially experiences of positive encounters. The purpose of the study was to identify and analyze sick-listed persons' experiences of positive encounters with professionals within social insurance and healthcare. An inductive and descriptive qualitative approach was used to analyze ttanscripts from 11 semi-structured interviews with persons with experience of long-term sickness absence. The following five categories of qualities of encounters were found to be of importance: being treated with respect, feeling supported, establishing a personal relationship, perceiving demands as well-balanced, and participating in decisions regarding rehabilitation measures. Several interviewees expressed the opinion that positive encounters with professionals can promote RTW. Further research is needed to elucidate the aspects of interactions that enhance empowerment and self-confidence in persons on sick leave, in order to develop professional treatment strategies that facilitate RTW.
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