| 1. |
- Nilsen, Bente B., 1960-, et al.
(författare)
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Reported habitual intake of breakfast and selected foods in relation to overweight status among seven- to nine-year-old Swedish children.
- 2017
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Ingår i: Scandinavian Journal of Public Health. - : SAGE Publications. - 1403-4948 .- 1651-1905. ; 45:8, s. 886-894
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Tidskriftsartikel (refereegranskat)abstract
- AIM: The aim of this study was to examine the reported frequency of breakfast intake and selected food and beverages in the investigated group of Swedish children in comparison with recommended intakes. Furthermore, the study analyses these food habits and some demographic and lifestyle factors in relation to overweight and obesity.METHODS: This cross-sectional study builds on data collected in 2008 and 2010. Measured anthropometric data and parent questionnaire data were collected. A total of 2620 Swedish children (52.1% boys) aged seven to nine years were included.RESULTS: The majority of parents reported that their children (95.4%) had breakfast every day. The majority of children had fresh fruit (84.7%) and vegetables (83.9%) most days a week. Only 1.6% of the children were reported to have fast food and 6.0% to have sugar containing soft drinks, four days a week or more. The prevalence of overweight including obesity (OW/OB) was 17.8% for boys, 18.6% for girls. The odds of being OW/OB was higher among those not having breakfast every day (odds ratio (OR) 1.9, 95% confidence interval (CI) 1.20-2.96), drinking diet soft drink (OR 2.6, 95% CI 1.52-4.42) and skimmed/semi-skimmed milk (OR 1.8, 95% CI 1.37-2.36) four days a week or more. Parents being overweight and having low education levels were also related to a higher risk of their children being overweight.CONCLUSIONS: The parental reports of children's food habits pointed at favourable eating patterns for most investigated children. Breakfast skipping, diet soft drinks and low-fat milk consumption were more frequent among OW/OB children. Longitudinal studies are needed to determine the causal relationships.
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| 2. |
- Androutsos, O, et al.
(författare)
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Designing and implementing teachers' training sessions in a kindergarten-based, family-involved intervention to prevent obesity in early childhood : the ToyBox-study
- 2014
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Ingår i: Obesity Reviews. - : Wiley. - 1467-7881 .- 1467-789X. ; 15:Suppl 3, s. 48-52
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Tidskriftsartikel (refereegranskat)abstract
- Since school-based interventions are mainly delivered by the school staff, they need to be well-trained and familiarized with the programme's aims, procedures and tools. Therefore, the institute, research group, governmental or non-governmental body in charge of the coordination and implementation of the programme needs to devote time and resources to train the school staff before programme's implementation. This is particularly crucial in multi-centre studies where more than one research teams are involved. Both research teams and school staff need to be trained, using standard protocols and procedures, to ensure that the intervention will be delivered in a standardized manner throughout the intervention centres. The ToyBox-intervention, a multi-component, kindergarten-based, family-involved intervention, focusing on water consumption, snacking, physical activity and sedentary behaviours in preschool children, was implemented over the academic year 2012-2013 in six European countries. As part of this intervention, three teachers' training sessions were delivered to motivate and train teachers in implementing the intervention. The local researchers were trained centrally before delivering the training sessions for the teachers and followed a common protocol using standardized presentations and procedures. The aim of the current paper is to describe the protocol and methodological issues related to the teachers' training sessions conducted within the ToyBox-intervention.
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| 3. |
- Androutsos, O, et al.
(författare)
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Process evaluation design and tools used in a kindergarten-based, family-involved intervention to prevent obesity in early childhood : the ToyBox-study
- 2014
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Ingår i: Obesity Reviews. - : Wiley. - 1467-7881 .- 1467-789X. ; 15:Suppl 3, s. 74-80
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Tidskriftsartikel (refereegranskat)abstract
- Process evaluation (PE) is used for the in-depth evaluation of the implementation process of health promotion programmes. The aim of the current paper was to present the PE design and tools used in the ToyBox-intervention. The PE design was based on a three-step approach, including the identification of ToyBox-specific PE elements (step 1), the development of PE tools and harmonization of procedures (step 2), and the implementation of PE using standardized protocol and tools across the intervention countries (step 3). Specifically, to evaluate the implementation of the intervention, teachers' monthly logbooks were recorded (dose delivered, fidelity, dose received); post-intervention questionnaires were completed by parents/caregivers and teachers (dose received); participation and attrition rates were recorded (recruitment, reach); and audit questionnaires and retrospective information on weather conditions were collected (physical and social environment within which the intervention was implemented). Regarding the teachers' training sessions, the researchers who performed the trainings completed evaluation forms and documented teachers' attendance after each training (dose delivered, fidelity, dose received) and teachers completed evaluation forms after each training (dose received). The PE performed in the ToyBox-intervention may contribute in the evaluation of its effectiveness, guide the revision of the intervention material and provide insights for future health promotion programmes and public health policy.
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| 4. |
- De Craemer, M, et al.
(författare)
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Applying the Intervention Mapping protocol to develop a kindergarten-based, family-involved intervention to increase European preschool children's physical activity levels : the ToyBox-study
- 2014
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Ingår i: Obesity Reviews. - : Wiley. - 1467-7881 .- 1467-789X. ; 15:Suppl 3, s. 14-26
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Tidskriftsartikel (refereegranskat)abstract
- Although sufficient physical activity is beneficial for preschoolers' health, activity levels in most preschoolers are low. As preschoolers spend a considerable amount of time at home and at kindergarten, interventions should target both environments to increase their activity levels. The aim of the current paper was to describe the six different steps of the Intervention Mapping protocol towards the systematic development and implementation of the physical activity component of the ToyBox-intervention. This intervention is a kindergarten-based, family-involved intervention implemented across six European countries. Based on the results of literature reviews and focus groups with parents/caregivers and kindergarten teachers, matrices of change objectives were created. Then, theory-based methods and practical strategies were selected to develop intervention materials at three different levels: (i) individual level (preschoolers); (ii) interpersonal level (parents/caregivers) and (iii) organizational level (teachers). This resulted in a standardized intervention with room for local and cultural adaptations in each participating country. Although the Intervention Mapping protocol is a time-consuming process, using this systematic approach may lead to an increase in intervention effectiveness. The presented matrices of change objectives are useful for future programme planners to develop and implement an intervention based on the Intervention Mapping protocol to increase physical activity levels in preschoolers.
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| 5. |
- De Miguel-Etayo, P., et al.
(författare)
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Reliability of anthropometric measurements in European preschool children : the ToyBox-study
- 2014
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Ingår i: Obesity Reviews. - : Wiley. - 1467-7881 .- 1467-789X. ; 15:Suppl 3, s. 67-73
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Tidskriftsartikel (refereegranskat)abstract
- The ToyBox-study aims to develop and test an innovative and evidence-based obesity prevention programme for preschoolers in six European countries: Belgium, Bulgaria, Germany, Greece, Poland and Spain. In multicentre studies, anthropometric measurements using standardized procedures that minimize errors in the data collection are essential to maximize reliability of measurements. The aim of this paper is to describe the standardization process and reliability (intra- and inter-observer) of height, weight and waist circumference (WC) measurements in preschoolers. All technical procedures and devices were standardized and centralized training was given to the fieldworkers. At least seven children per country participated in the intra- and inter-observer reliability testing. Intra-observer technical error ranged from 0.00 to 0.03 kg for weight and from 0.07 to 0.20 cm for height, with the overall reliability being above 99%. A second training was organized for WC due to low reliability observed in the first training. Intra-observer technical error for WC ranged from 0.12 to 0.71 cm during the first training and from 0.05 to 1.11 cm during the second training, and reliability above 92% was achieved. Epidemiological surveys need standardized procedures and training of researchers to reduce measurement error. In the ToyBox-study, very good intra- and-inter-observer agreement was achieved for all anthropometric measurements performed.
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| 6. |
- Duvinage, K, et al.
(författare)
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Developing the intervention material to increase physical activity levels of European preschool children : the ToyBox-study
- 2014
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Ingår i: Obesity Reviews. - : Wiley. - 1467-7881 .- 1467-789X. ; 15:Suppl 3, s. 27-39
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Tidskriftsartikel (refereegranskat)abstract
- Early childhood is an important period for adopting positive health-related behaviours. More than 95% of European preschool children attend kindergartens, making these settings ideal for the implementation of health promotion interventions. The ToyBox-intervention addressed preschool children, their parents/caregivers and teachers. The aim of the intervention was to improve four energy balance-related behaviours (i.e. healthy snacking, water consumption, physical activity and sedentary behaviour) by implementing a kindergarten-based, family-involved intervention in six European countries (Belgium, Bulgaria, Germany, Greece, Poland and Spain). The intervention material was developed following the intervention mapping protocol, taking into account local and cultural differences among the intervention countries. The present paper focuses on the development of the physical activity component of the intervention. Parental involvement was addressed by providing parents/caregivers with two newsletters, two tip cards and a poster. Teachers received a handbook with guidance on environmental changes in the classroom, 26 physical education sessions and suggestions for fun, interactive classroom activities aiming at total class participation to increase preschoolers' physical activity levels. The ToyBox-intervention material was distributed according to a standard time frame. Teachers received their material prior to the start of the intervention and parents/caregivers received their material during the intervention when each energy balance-related behaviour was implemented.
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| 7. |
- Holmen, Heidi, et al.
(författare)
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Unpacking the Public Health Triad of Social Inequality in Health, Health Literacy, and Quality of Life-A Scoping Review of Research Characteristics
- 2023
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Ingår i: International Journal of Environmental Research and Public Health. - : Journal Issues. - 1661-7827 .- 1660-4601. ; 21:1
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Forskningsöversikt (refereegranskat)abstract
- Social inequalities in health, health literacy, and quality of life serve as distinct public health indicators, but it remains unclear how and to what extent they are applied and combined in the literature. Thus, the characteristics of the research have yet to be established, and we aim to identify and describe the characteristics of research that intersects social inequality in health, health literacy, and quality of life. We conducted a scoping review with systematic searches in ten databases. Studies applying any design in any population were eligible if social inequality in health, health literacy, and quality of life were combined. Citations were independently screened using Covidence. The search yielded 4111 citations, with 73 eligible reports. The reviewed research was mostly quantitative and aimed at patient populations in a community setting, with a scarcity of reports specifically defining and assessing social inequality in health, health literacy, and quality of life, and with only 2/73 citations providing a definition for all three. The published research combining social inequality in health, health literacy, and quality of life is heterogeneous regarding research designs, populations, contexts, and geography, where social inequality appears as a contextualizing variable.
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| 8. |
- Manios, Y, et al.
(författare)
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Designing and implementing a kindergarten-based, family-involved intervention to prevent obesity in early childhood : the ToyBox-study
- 2014
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Ingår i: Obesity Reviews. - : John Wiley & Sons. - 1467-7881 .- 1467-789X. ; 15:Suppl 3, s. 5-13
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Tidskriftsartikel (refereegranskat)abstract
- The development of the ToyBox-intervention was based on the outcomes of the preliminary phase of the ToyBox-study, aiming to identify young children's key behaviours and their determinants related to early childhood obesity. The ToyBox-intervention is a multi-component, kindergarten-based, family-involved intervention with a cluster-randomized design, focusing on the promotion of water consumption, healthy snacking, physical activity and the reduction/ breaking up of sedentary time in preschool children and their families. The intervention was implemented during the academic year 2012-2013 in six European countries: Belgium, Bulgaria, Germany, Greece, Poland and Spain. Standardized protocols, methods, tools and material were used in all countries for the implementation of the intervention, as well as for the process, impact, outcome evaluation and the assessment of its cost-effectiveness. A total sample of 7,056 preschool children and their parents/caregivers, stratified by socioeconomic level, provided data during baseline measurements and participated in the intervention. The results of the ToyBox-study are expected to provide a better insight on behaviours associated with early childhood obesity and their determinants and identify effective strategies for its prevention. The aim of the current paper is to describe the design of the ToyBox-intervention and present the characteristics of the study sample as assessed at baseline, prior to the implementation of the intervention.
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| 9. |
- Mouratidou, T, et al.
(författare)
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Tools, harmonization and standardization procedures of the impact and outcome evaluation indices obtained during a kindergarten-based, family-involved intervention to prevent obesity in early childhood : the ToyBox-study
- 2014
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Ingår i: Obesity Reviews. - : Wiley-Blackwell. - 1467-7881 .- 1467-789X. ; 15:Suppl 3, s. 53-60
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Tidskriftsartikel (refereegranskat)abstract
- The ToyBox-intervention is a kindergarten-based, family-involved intervention targeting multiple lifestyle behaviours in preschool children, their teachers and their families. This intervention was conducted in six European countries, namely Belgium, Bulgaria, Germany, Greece, Poland and Spain. The aim of this paper is to provide a descriptive overview of the harmonization and standardization procedures of the baseline and follow-up evaluation of the study (and substudies). Steps related to the study's operational, standardization and harmonization procedures as well as the impact and outcome evaluation assessment tools used are presented. Experiences from the project highlight the importance of safeguarding the measurement process to minimize data heterogeneity derived from potential measurement error and country-by-country differences. In addition, it was made clear that continuing quality control and support is an important component of such studies. For this reason, well-supported communication channels, such as regular email updates and teleconferences, and regular internal and external meetings to ensure smooth and accurate implementation were in place during the study. The ToyBox-intervention and its harmonized and standardized procedures can serve as a successful case study for future studies evaluating the efficacy of similar interventions.
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| 10. |
- Nilsen, Bente B., 1960-, et al.
(författare)
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Do substantial BMI reduction episodes among Swedish schoolchildren have any impact on their final height?
- 2018
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Ingår i: Acta Paediatrica. - : John Wiley & Sons. - 0803-5253 .- 1651-2227. ; 107:7, s. 1223-1229
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Tidskriftsartikel (refereegranskat)abstract
- AIM: This study investigated whether substantial body mass index (BMI) reductions in Swedish schoolchildren aged 7-19 years, caused by disease, healthy or unhealthy behaviour, had any impact on their final height.METHODS: We used height and weight data on 6,572 subjects from two nationally representative longitudinal samples of Swedish children born in 1973 and 1981. These provided information on their final height and any BMI reduction episodes.RESULTS: Of the 6,572 subjects (50.9% boys), among individuals with information on final height, 1,118 had a BMI reduction of 5% and less than 10%, and 346 had at least one substantial BMI reduction of 10% of more. On a group level, there was no statistically significant difference in the final height of individuals with BMI reductions of 10% or more and those without. The findings were independent of age and the subject's BMI at the start of the reduction episode. However, there were a number of cases where a substantial BMI reduction probably had an impact on the subject's final height.CONCLUSION: Our study found no evidence that a substantial BMI reduction had any impact on final height on a group level, but further analyses of specific case studies are necessary to determine whether substantial BMI reduction might have an impact on final height.
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| 11. |
- Nilsen, Bente B., 1960-
(författare)
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Growth of schoolchildren : studies on somatic growth and deviant growth patterns such as weight loss and obesity and aspects of intake of breakfast and food items
- 2018
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- The overall aim of this thesis is to explore somatic growth, and deviant growth patterns as episodes of weight loss and obesity development, including some aspects of meal patterns and food intake.Methods: The thesis includes four studies, two cross-sectional studies (Paper I and II), and two longitudinal studies (Paper III and IV).The first paper looks at assessment of BMI categories (underweight, overweight and obesity) prevalence and how the results relate to which growth reference that is used. Height and weight measurements of 4,518 Swedish schoolchildren aged 7–9 years were collected in 2008 using a standardised protocol from World Health Organization (WHO). Four growth references were used, from the WHO, the International Obesity Task Force (IOTF) and two Swedish growth references from Werner and Karlberg et al. (Paper I). Parts of the same data set plus a follow-up data set from 2010 was used to investigate correlations with deviances in BMI in relation to breakfast habits and selected food frequencies.For paper three and four, a longitudinal material from two nationally representative samples was used with height and weight data of 6,572 schoolchildren, born 1973 and 1981. Episodes of BMI reduction of 10% or more were identified and correlated to final height (Paper III). The same material was used for paper four to further investigate growth patterns on group level by use of weight for height, Tri-Ponderal Mass Index (TMI), apart from BMI. On individual level, weight at age 7 years and weight at 16 years for girls and 18 years for boys, were categorized in monthly values and expressed in standard deviation (from ≤ -2 to ≥ +3 SD) (Paper IV).Results: Depending on which growth reference we used, the prevalence of different degrees of thinness varied greatly. There were also significant gender differences depending on the growth reference we used (Paper I).The majority of parents reported that their children (95.4%) had breakfast every day. The odds of being OW/OB was higher among those not having breakfast every day (odds ratio (OR) 1.9, drinking diet soft drinks OR 2.6, 95% and skimmed/semi-skimmed milk OR 1.8), four days a week or more (Paper II).There was no statistically significant difference on group level in final height between individuals with and individuals without BMI reduction, independent of age and if the individuals were thin, normal weight, overweight or obese at the start of the BMI reduction episode (Paper III).Almost the same longitudinal growth patterns were found for the two cohorts, even if weight and BMI for all almost all ages were higher in 1981 cohort. Patterns for TMI differs from those of W/H and BMI. Three main longitudinal trajectories represent the description of weight development from 7–16 years for girls and 7–18 years for boys. These patterns were mainly the same in the 1981 cohort and the 1973 cohort. (Paper IV).
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| 12. |
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| 13. |
- Nilsen, Bente B., 1960-, et al.
(författare)
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Using different growth references to measure thinness and overweight among Swedish primary school children showed considerable variations
- 2016
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Ingår i: Acta Paediatrica. - West Sussex, United Kingdom : Wiley-Blackwell Publishing Inc.. - 0803-5253 .- 1651-2227. ; 105:10, s. 1158-1165
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Tidskriftsartikel (refereegranskat)abstract
- Aim: The study compared how four different growth references determined the prevalence of thinness and overweight, based on height and weight measurements from a nationally representative sample of Swedish children from seven to nine years of age.Methods: The height and weight measurements of 4,518 Swedish schoolchildren aged seven to nine years were carried out in 2008 using a standardised protocol. The prevalence of different degrees of thinness and overweight were calculated using international growth references from the World Health Organization, the International Obesity Task Force and two Swedish growth references from Werner and Karlberg.Results: Depending on which growth reference we used, the prevalence of different degrees of thinness varied from 7.5%-16.9% for the boys and 6.9%-13.7% for the girls, while for the prevalence of overweight, including obesity and severe obesity, varied from 16.5%-25.7% for the boys and 18.2-25.2% for the girls. There were also significant gender differences depending on the growth reference we used.Conclusion: Using four different growth references, two international and two Swedish, produced wide variations in the prevalence of thinness and overweight, together with significant gender differences. In the absence of a global definition, we need both national and international growth references.
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| 14. |
- Payr, A, et al.
(författare)
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Concepts and strategies on how to train and motivate teachers to implement a kindergarten-based, family-involved intervention to prevent obesity in early childhood : the ToyBox-study
- 2014
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Ingår i: Obesity Reviews. - : Wiley. - 1467-7881 .- 1467-789X. ; 15:Suppl 3, s. 40-47
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Tidskriftsartikel (refereegranskat)abstract
- The key person for the implementation of kindergarten-based behavioural interventions is the kindergarten teacher. When conducting intervention studies in kindergartens, training sessions are needed to train and motivate kindergarten teachers for programme implementation. This paper presents the systematic development of the teachers' trainings executed in the ToyBox-intervention - a kindergarten-based and family-involved obesity prevention programme for children aged 4-6. Based on concepts for the education of kindergarten teachers, on general strategies for successful programme implementation and on the ToyBox programme-specific requirements, the aims of the teachers' trainings were defined and an overall concept was deduced. Regarding the concept for the ToyBox teachers' training sessions, it is concluded that the training modules should focus on presenting information on the practical implementation of the intervention. Furthermore, these modules should also include self-efficacy enhancing components and should give kindergarten teachers opportunities to share experiences. Regarding the didactic methods applied in the ToyBox teachers' training sessions, constructivist learning approaches that facilitate active participation, reflective thinking and personal involvement were implemented. Emphasis was put not only on the content but especially on the didactic methods of teachers' trainings in order to enhance devotion to, and quality and sustainability of the ToyBox-intervention.
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| 15. |
- Scander, Henrik, 1976-, et al.
(författare)
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Food and beverage dinner combinations, patterns among Swedish adults
- 2018
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Ingår i: International Journal of Gastronomy and Food Science. - : Elsevier. - 1878-450X .- 1878-4518. ; 14, s. 20-26
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Tidskriftsartikel (refereegranskat)abstract
- Introduction: Since the taste preferences of food and beverage combinations are considered subjective properties and have been studied in several different ways, mainly within the field of sensory science, this study contributes to the field of food and beverage combination studies by using self-reported eating habits.Objective: This article explores the relationships between food and beverage combinations, recorded by a Swedish adult population.Method: Analyses were made using data from the national dietary survey, Riksmaten (2010–2011), performed by the Swedish National Food Agency. A total of 1753 Swedish adults (53% women) aged 18–80 contributed dietary intake data during four consecutive days. All dinner choices were categorized into beverage categories and food categories. Combinations between beverage and food categories were analyzed by using cross tabulation. Correlation coefficients for non-parametric variables were used to determine the association power. Predictive factors for more important beverage and food combinations were explored by logistic regression analysis.Results: Water was the most frequent choice in combination with all food categories. The results also showed that alcoholic beverages are present in two of the three strongest food and beverage correlations, the spirits drinks and white wine. The most important predictive factors were where the dinner took place for non-alcoholic combinations (OR: 4.33; 95% CI: 2.28–8.21) and age and employment for alcoholic combinations (OR > 2; p < 0.05).Conclusion: Our results show correlations in reported consumption of food and beverage, which explain the occurrences of specific patterns of combinations of food and beverage. More studies on choice of beverage are needed to describe the patterns of intake, in order to understand the mechanisms behind beverage choice, in different settings, cultural situations and lifestyle backgrounds. Combinations in everyday life are described here and these are not always so sophisticated, rather building on availability than on optimal taste combinations. Our findings can offer an understanding of some common every-day choices to culinary professionals, useful for their guidance of food and beverage pairing, to enhance restaurant experiences.
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| 16. |
- Schippert, Ana Carla, et al.
(författare)
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Preventing retraumatisation in torture survivors during surgical care : results of a guideline-development project and qualitative study exploring healthcare providers' experiences
- 2024
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Ingår i: BMJ Open. - : BMJ Publishing Group Ltd. - 2044-6055. ; 14:8
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVES: Insufficient training and the absence of guidelines increase the risk of retraumatisation in torture survivors during surgical procedures. This study aims to develop guidelines to mitigate this risk and gather healthcare professionals' experiences treating torture survivors and insights on the guideline's feasibility and acceptability.DESIGN: The study was conducted in two phases. Phase 'a' involved developing guidelines based on reviews of torture survivors' encounters in somatic care and potential retraumatisation triggers, as well as a qualitative study on survivors' experiences during surgical interventions. The development process adhered to the Grading of Recommendations Assessment, Development and Evaluation (GRADE) principles and the Appraisal of Guidelines for Research and Evaluation (AGREE II) instrument for methodological rigour. Phase 'b' involved focus groups and individual interviews with healthcare professionals to explore challenges in caring for torture survivors and to evaluate the guidelines.SETTING: The study, conducted from May to August 2023, involved participants from surgical departments in three hospitals in southern and southeastern Norway. PARTICIPANTS: Twenty-one healthcare professionals, including surgeons, anaesthesiologists, nurses and a dentist, participated in the study. Both focus group interviews and individual interviews were conducted.RESULTS: Phase 'a': guidelines comprising six sections were developed: an introduction, general guidelines and four sections covering the preoperative, perioperative and postoperative surgical stages. Phase 'b': healthcare professionals struggled to understand torture's complexities and identify survivors' unique needs. They faced challenges using interpreters and assisting patients with strong reactions. While the guidelines were viewed as practical and useful for raising awareness, their length was questioned.CONCLUSIONS: We provide recommendations for preventing retraumatisation in torture survivors undergoing surgical treatment. The guidelines may serve as a starting point for offering safe and individualised care to torture survivors. Teaching institutions and hospitals may incorporate the guidelines into healthcare professionals' education.
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