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1.
  • Alexandrou, Christina, et al. (författare)
  • 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
  • Ingår i: Digital Health. - : Sage Publications. - 2055-2076. ; 9
  • 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)
  • DN Debatt: Sluta skjutsa barnen till skolan - hälsa går före rädsla
  • 2023
  • Ingår i: Dagens Nyheter. (DN). - Stockholm : Bonnier. - 1101-2447. ; :2023-02-18
  • 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)
  • Adapting the behavioral regulation in active commuting to and from school questionnaire in Sweden: BR-ACS(SWE)
  • 2022
  • Ingår i: Transportation Research Interdisciplinary Perspectives. - : Elsevier. - 2590-1982. ; 16
  • 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)
  • Basic psychological need satisfaction in active commuting to and from school BPNS-ACS(SWE)
  • 2023
  • Ingår i: Journal of Transport & Health. - : Elsevier. - 2214-1405 .- 2214-1413. ; 30
  • 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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  • Ek, Anna, et al. (författare)
  • Physical Activity and Mobile Phone Apps in the Preschool Age: Perceptions of Teachers and Parents
  • 2019
  • Ingår i: JMIR mhealth and uhealth. - : JMIR Publications. - 2291-5222. ; 7:4
  • Tidskriftsartikel (refereegranskat)abstract
    • BACKGROUND:Physical activity (PA) is already beneficial at the preschool age. In many countries, young children spend most of their days in the preschool setting, making it a common arena for PA interventions. Mobile health tools are becoming increasingly popular to promote PA in different populations; however, little is known about the interest for and how the preschool setting could incorporate such a tool.OBJECTIVE:This study aimed to examine how teachers and parents perceive PA in preschool-aged children in general and their perceptions of how a mobile phone app could be used to promote PA in the preschool setting.METHODS:Semistructured interviews were conducted with 15 teachers (93%, [14/15] women, mean age 43.5 years, 47%, [7/15] with a university degree and 10 parents [91%, 9/10] women, mean age 38.9 years, all with a university degree) recruited from 2 urban preschools in central Sweden. The interviews were recorded, fully transcribed, coded, and analyzed using thematic analysis by means of an inductive approach.RESULTS:The analysis revealed 4 themes: (1) children are physically active by nature, (2) the environment as a facilitator or a barrier, (3) prerequisites of the adult world, and (4) an app in the preschool setting-challenges and possibilities. Parents and teachers perceived preschoolers as being spontaneously physically active; however, high-intensity PA was perceived as low. The PA was specifically performed during the day in the preschool. Identified facilitators of PA were access to safe and engaging outdoor environments such as forests, spacious indoor areas, and adult involvement. Adult involvement was considered especially important for children preferring sedentary activities. Identified barriers for PA were restricted indoor and outdoor space, rules for indoor activities, and lack of adult involvement because of time constraints. The teachers perceived that they had limited skills and experiences using apps in general, although they also acknowledged the increasing role of technological tools in the curriculum. Thus, the teachers expressed an interest for an app designed as a support tool for them, especially for situations when PA was limited because of perceived barriers. They suggested the app to include accessible information regarding the health benefits of PA in children linked to a library of activities for different settings and seasons. Parents suggested interactive app features including problem-solving tasks and music and dance, but not video clips as they made children passive.CONCLUSIONS:Vigorous PA was perceived as low in preschool-aged children. Future tailoring of interventions in the preschool setting should work around barriers and support facilitators to PA, especially PA of high intensity. In such work, an app could serve as a source of inspiration for PA in different ages, settings, and seasons and thus reduce environmental and structural inequalities in the preschool setting.
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7.
  • Forsberg, Hanna (författare)
  • Active school transportation : Understanding the parental decision-making process
  • 2024
  • 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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8.
  • Forsberg, Hanna, et al. (författare)
  • Children's intervention participation is associated with more positive beliefs towards active school transportation among parents
  • 2023
  • Ingår i: Health Promotion International. - : Oxford University Press. - 0957-4824 .- 1460-2245. ; 38:2
  • 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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9.
  • Forsberg, Hanna, et al. (författare)
  • Development and Initial Validation of the PILCAST Questionnaire : Understanding Parents’ Intentions to Let Their Child Cycle or Walk to School
  • 2021
  • Ingår i: International Journal of Environmental Research and Public Health. - : MDPI. - 1661-7827 .- 1660-4601. ; 18:21
  • 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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11.
  • Forsberg, Hanna, et al. (författare)
  • It’s about being the good parent : exploring attitudes and beliefs towards active school transportation
  • 2020
  • Ingår i: International Journal of Circumpolar Health. - : Taylor & Francis. - 1239-9736 .- 2242-3982. ; 79:1
  • 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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12.
  • Jingili, Nuru, et al. (författare)
  • A Two-Stage co-Design Process of Battleship-AST Persuasive Game for Active School Transportation in Northern Sweden
  • 2024
  • Ingår i: International Journal of Human-Computer Interaction. - : Taylor & Francis. - 1044-7318 .- 1532-7590.
  • 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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14.
  • Laine, Teemu H., et al. (författare)
  • A Distributed Multiplayer Game to Promote Active Transport at Workplaces : User-Centred Design, Implementation and Lessons Learned
  • 2020
  • Ingår i: IEEE Transactions on Games. - : IEEE. - 2475-1502 .- 2475-1510. ; 12:4, s. 386-397
  • Tidskriftsartikel (refereegranskat)abstract
    • Recent decline in active transport and increase in motorised transport decreases physical activity and increases air pollution. Using games to motivate people to change their behaviour towards active transport can mitigate this. We proposed Tic-Tac-Training, a distributed, collaborative and competitive game for promoting active transport at workplaces. Tic-Tac-Training was developed through a multidisciplinary and iterative user-centred design (UCD) process in four stages: (i) paper prototype, (ii) low-fidelity prototypes, (iii) high-fidelity prototypes, (iv) digital prototype. User testing and playtesting (N=12) yielded a number of improvement suggestions. We also analysed how Tic-Tac-Training supports the eight core drives of gamification (Octalysis), and presented 17 lessons learned in four categories. Findings suggest that UCD can be useful for developing exergame interventions for workplaces. Moreover, the lessons learned can benefit exergame designers. More research is needed to measure the behaviour change effect of Tic-Tac-Training and its applicability to other use cases.
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15.
  • Laine, Teemu H, et al. (författare)
  • A Reusable Multiplayer Game for Promoting Active School Transport: Development Study
  • 2022
  • Ingår i: JMIR Serious Games. - : JMIR Publications Inc.. - 2291-9279. ; 10:1
  • Tidskriftsartikel (refereegranskat)abstract
    • Background: Most children and adolescents in Sweden do not meet the recommended daily physical activity levels of the World Health Organization. Active school transport (AST) and gamification are potential methods for increasing children’s daily physical activity. We previously developed a game named Tic-Tac-Training for promoting active transport at workplaces; however, the game has not been applied to AST.Objective: The objectives of this study are to investigate how Tic-Tac-Training functions to promote AST among schoolchildren in northern Sweden, improve the game to be more suitable for schoolchildren, and construct a road map for future development based on children’s ideas.Methods: First, we developed Tic-Tac-Training using the Scrum agile software development method. Second, we conducted a questionnaire-based formative evaluation of the game with schoolchildren (n=16; 9/16, 56% male; 6/16, 38% female; and 1/16, 6% other aged 11-12 years) in Luleå, Sweden. Third, we conducted focus group interviews with 33 children (13/33, 39% male and 20/33, 61% female aged 12-13 years) to gather ideas for gamifying AST. We mapped the interview results to the Octalysis gamification framework and established a road map for future development.Results: The formative evaluation revealed several issues, including a lack of interesting game features, lack of support for continuous engagement, disliked competitive features, and lack of incentives for discourse and participation. New features such as rewards, collectibles, and levels were implemented based on the results. The focus group interviews revealed additional ideas for gamifying AST, such as using avatars, in-game currency and trading, and context-sensitive tasks.Conclusions: The results have several potential impacts on how reusable, gamified AST interventions can be developed and what kind of gamification elements schoolchildren in northern Sweden wish to see. These results can interest game researchers and teachers who wish to apply gamification in school contexts. Finally, we aim to continue developing the game based on the road map.
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16.
  • Lindqvist, Anna-Karin, et al. (författare)
  • Active School Transportation in Winter Conditions: Biking Together Is Warmer
  • 2019
  • Ingår i: International Journal of Environmental Research and Public Health. - : MDPI. - 1661-7827 .- 1660-4601. ; 16:2
  • Tidskriftsartikel (refereegranskat)abstract
    • There has been a decline in children’s use of active school transportation (AST) while there is also limited research concerning AST in winter conditions. This study aimed to explore the prerequisites and experiences of schoolchildren and parents participating in an empowerment- and gamification-inspired intervention to promote students’ AST in winter conditions. Methods: Thirty-five students, who were aged 12–13 years, and 34 parents from the north of Sweden participated in the study. Data were collected using photovoice and open questions in a questionnaire and analyzed using qualitative content analysis. Results: The results show that involvement and togetherness motivated the students to use AST. In addition, during the project, the parents changed to have more positive attitudes towards their children’s use of AST. The students reported that using AST during wintertime is strenuous but rewarding and imparts a sense of pride. Conclusion: Interventions for increasing students’ AST in winter conditions should focus on the motivational aspects for both children and parents. For overcoming parental hesitation with regards to AST during winter, addressing their concerns and empowering the students are key factors. To increase the use of AST all year around, targeting the challenges perceived during the winter is especially beneficial.
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  • Lindqvist, Anna-Karin, et al. (författare)
  • One should really be more worried about too little physical activity than injuries while walking or cycling to school. Parents’ perception of risk concerning active school transportation.
  • 2023
  • Ingår i: Journal of Transport & Health. - : Elsevier. - 2214-1405 .- 2214-1413. ; 29
  • Tidskriftsartikel (refereegranskat)abstract
    • IntroductionActive school transportation (AST) can be a powerful strategy to promote physical activity and improve children's health. Parents' perceptions of traffic risks are an important factor in their decision concerning their child's transport mode to school and addressing discordances between the percieved risks and actual incidents might contribute to promote children's AST. This study adopted a game originally designed for the context of information security to resonate with the context of Swedish AST and the aim of the study was to describe parent's experience of playing the game.MethodsA qualitative approach was chosen and data was collected using focus groups with 16 parents for totally 29 children aged 7–12. The collected data were analyzed using qualitative content analysis.ResultsThe results formed one main theme “Playing promotes parents' awareness and consideration of active school transportation” and three subthemes; “Fast, fun, and functional; Experiences from playing the game” showing that the parents perceived the game to be fun, easy, and time efficient to play. “Then and now. Own childhood experience vs being a parent” showing that parents' perception of risk can sometimes be barriers to their children's opportunity to use AST. “Personal perceptions vs statistical risk” showing that playing the game addressed the discordance between the parents' perceived risks and actual incidents, as well as promoted parents' awareness and consideration of AST.ConclusionsIncluding an intervention component such as a game for parents and using schools as the arena for implementing projects promoting AST to improve children's physical activity levels, might be a fruitful avenue.
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20.
  • Lindqvist, Anna-Karin, et al. (författare)
  • One Step Forward : Development of a Program Promoting Active School Transportation
  • 2018
  • Ingår i: JMIR Research Protocols. - : JMIR Publications. - 1929-0748. ; 7:5
  • Tidskriftsartikel (refereegranskat)abstract
    • BACKGROUND: Physical activity promotes health and learning. However, up to 80% of the children in industrialized countries do not achieve the recommended level of daily physical activity. By encouraging children to use active school transportation (AST), it is possible to increase their overall physical activity.OBJECTIVE: The aim of this paper was to present the development of an AST intervention using Intervention Mapping (IM) to promote children's physical activity.METHODS: The principles of IM were applied to guide the development of the intervention. The process was divided into 3 phases. First, a literature review and collection of experiences of stakeholders were carried out to gain a broad perspective on the problem and possible solutions. Thereafter, an analysis of the critical environmental and behavioral factors affecting outcome was conducted, which guided the choice of tangible components of the intervention. Finally, a plan of evaluation and implementation was established.RESULTS: A structured program to increase AST among children was developed, consisting of 3 subsequent phases that are described in detail. Implementation took place, and evaluation of the intervention is being carried out.CONCLUSIONS: IM proved to be a valuable method to develop a structured AST intervention for children. By following the steps of the IM process, it became evident that empowerment and gamification are 2 promising avenues to consider when designing AST interventions in a school context. By engaging end users and including important agents, such as parents and teachers, who control the environmental factors, the possibility to design a sustainable program increases. In addition, gamification made it possible to integrate learning into AST, which could motivate schools to devote time and effort to implementing this program.
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21.
  • Lindqvist, Anna-Karin, et al. (författare)
  • Parent participation plays an important part in promoting physical activity
  • 2015
  • Ingår i: International Journal of Qualitative Studies on Health and Well-being. - : Informa UK Limited. - 1748-2623 .- 1748-2631. ; 10
  • Tidskriftsartikel (refereegranskat)abstract
    • Although physical activity (PA) is an important and modifiable determinant of health, in Sweden only 15% of boys and 10%of girls aged 15 years old achieve the recommended levels of PA 7 days per week. Adolescents’ PA levels are associated withsocial influence exerted by parents, friends, and teachers. The purpose of this study was to describe parents’ experiencesof being a part of their adolescents’ empowerment-inspired PA intervention. A qualitative interview study was performedat a school in the northern part of Sweden. A total of 10 parents were interviewed, and the collected data were analyzedwith qualitative content analysis. Three subthemes were combined into one main theme, demonstrating that parents are oneimportant part of a successful PA intervention. The life of an adolescent has many options and demands that make it difficultto prioritize PA. Although parents felt that they were important in supporting their adolescent, a successful PA interventionmust have multiple components. Moreover, the parents noted that the intervention had a positive effect upon not only theiradolescents’, but also their own PA. Interventions aimed at promoting PA among adolescents should include measures tostimulate parent participation, have an empowerment approach, and preferably be school-based.
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22.
  • Lindqvist, Anna-Karin, et al. (författare)
  • The Praise and Price of Pokémon GO : A Qualitative Study of Children's and Parents' Experiences.
  • 2018
  • Ingår i: JMIR Serious Games. - : JMIR Publications. - 2291-9279. ; 6:1
  • Tidskriftsartikel (refereegranskat)abstract
    • Background: Physical activity has multiple health benefits; however, the majority of children around the world do not attain the recommended levels of daily physical activity. Research has shown that the game Pokémon GO has increased the amount of physical activity of players and that the game has the potential to reach populations that traditionally have low levels of physical activity. Therefore, there is a need to understand which game components can promote initial and sustained physical activity. By using a qualitative research approach, it is possible to achieve rich descriptions and enhance a deep understanding of the components promoting physical activity among children in a game such as Pokémon GO.Objective: The objective of this study was to explore children’s and parents’ experiences playing Pokémon GO.Methods: Eight families comprising 13 children (aged 7-12 years) and 9 parents were selected using purposeful sampling. Data collected using focus groups were analyzed using qualitative latent content analysis.Results: The following three themes were revealed: (1) exciting and enjoyable exploration; (2) dangers and disadvantages; and (3) cooperation conquers competition. The first centers around the present and possible future aspects of Pokémon GO that promote physical activity. The second focuses on unwanted aspects and specific threats to safety when playing the game. The third shows that cooperation and togetherness are highly valued by the participants and that competition is fun but less important.Conclusions: Components from Pokémon GO could enhance the efficacy of physical activity interventions. Cooperation and exploration are aspects of the game that preferably could be transferred into interventions aimed at promoting children’s physical activity.
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23.
  • Lindqvist, Anna-Karin, et al. (författare)
  • The road to success - aktiva skoltransporter
  • 2019
  • Konferensbidrag (populärvet., debatt m.m.)abstract
    • Endast omkring 30% av svenska barn når rekommendationen för fysisk aktivitet och bara hälften av barnen använder aktiva skoltransporter (AST). Förutom den samhälleliga utmaningen som detta innebär för barns hälsa och kognitiv förmåga, har det också en negativ inverkan på klimatet och trafiksäkerhet nära skolorna. Dessutom följer barns fysiska vanor med in i vuxenlivet och därmed har den fysiska inaktiviteten på sikt en betydande hälsoekonomisk negativ effekt. Vi arbetar med ett skolbaserat koncept som bygger på empowerment och gamification. Det slutgiltiga målet är en innovativ digital lösning för en hållbar beteendeförändring avseende AST och att implementeringen av innovationen ökar användandet av AST bland svenska barn från dagens 52% till 80%.
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24.
  • Lindqvist, Anna-Karin, et al. (författare)
  • User Perception of a Smartphone App to Promote Physical Activity through Active Transportation : An Inductive Qualitative Content Analysis within the Smart City Active Mobile Phone Intervention (SCAMPI) Study
  • 2020
  • Ingår i: JMIR mhealth and uhealth. - : JMIR Publications. - 2291-5222. ; 8:8
  • Tidskriftsartikel (refereegranskat)abstract
    • Background: Physical inactivity is globally recognized as a major risk factor for morbidity, particularly the incidence of non-communicable diseases, and mortality. Engaging in active transportation (AT) is a viable approach toward increasing physical activity (PA) on a daily basis. Mobile (mHealth) interventions enable promoting AT to a larger population. The Smart City Active Mobile Phone Intervention (SCAMPI) study is a randomized controlled trial designed to evaluate a smartphone application (app)’s ability to motivate participants to increase their PA by engaging in AT.Objective: This qualitative study examines the acceptance and usability of the SCAMPI app from the participants’ perspectives.Methods: Seventeen residents of Stockholm county (13 women; age range 25-61 years), who had completed the three-month, app-based behavioral change program in the SCAMPI randomized controlled trial during 2018 agreed to participate in a semi-structured telephone-based interview. These 17 participants were well representative of the whole intervention group (n = 127) in terms of baseline characteristics such as age, sex, and area of residence. The interviews were audio-recorded, transcribed verbatim, and analyzed using inductive qualitative content analysis.Results: The content analysis revealed two themes and four subcategories. The first theme “Main motivators: monitoring and messages” highlighted that monitoring AT and being able to set weekly goals using the app were the primary motivators reported among study participants. The second theme “Acceptable but modifiable” reflects that the app was well accepted and effectively encouraged many participants to use more AT. Nevertheless, there were functions in the app that require modification. For example, while the automated travel tracking feature was appreciated, participants found it time-consuming and unreliable at times.Conclusions: This study contributes novel insight into healthy adults’ experiences of using a mobile app to promote the use of AT. The results showed that the app was well-accepted and that self-monitoring and goal setting were the main motivators to engage in more AT. The automated tracking of AT was appreciated; however, it was also reported to be energy- and time-consuming when it failed to work. Thus, this feature should be improved going forward.
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25.
  • Mikaelsson, Katarina, et al. (författare)
  • Physically inactive adolescents’ experiences of engaging in physical activity
  • 2020
  • Ingår i: European Journal of Physiotherapy. - : Taylor & Francis. - 2167-9169 .- 2167-9177. ; 22:4, s. 191-196
  • Tidskriftsartikel (refereegranskat)abstract
    • Purpose: This study aimed to describe physically inactive adolescents’ experiences and reflections about engaging in physical activity. Methods: Nine graduate students from the third year of upper secondary school (six women and three men) participated in this study. Narrative interviews were used for data collection and qualitative content analysis was used to analyse the interviews. Results: The analysis revealed three themes ‘Acknowledging resistance and barriers to performing physical activity’, ‘Knowing that it is good is not enough’, and ‘Feeling included and accepted is fun and motivating’. These themes show that the adolescent’s experienced barriers, acknowledged pros and cons and identified possibilities to be physically active. Conclusions: Identifying experiences that impact on inactive adolescents’ attitude and willingness to perform physical activity can be useful to understand the needs of the individual. By relating these experiences to the different stages of the transtheoretical model, this study could provide valuable knowledge for designing future interventions to enhance physical activity in this target group.
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26.
  • Nyman, Anneli, et al. (författare)
  • The Process of Using Participatory Action Research when Trying out an ICT Solution in Home-Based Rehabilitation
  • 2022
  • Ingår i: International Journal of Qualitative Methods. - : Sage Publications. - 1609-4069. ; 21
  • Tidskriftsartikel (refereegranskat)abstract
    • This article describes the process of using PAR and discusses the strengths and challenges of adopting it as a methodology. With a pilot project “the rehabilitation journey” as a showcase, we share experiences of how we co-created knowledge and illustrate the actions taken and participants’ involvement in the process. This pilot project aimed to explore how ICT solutions can create new ways to deliver home-based rehabilitation that meet the needs of the organization, rehabilitation professionals, and older persons. Our experience is that using PAR as a research method had several strengths. Our project stemmed from demographic and epidemiological trends in society viewed as a “real life problem” experienced on different levels in the organization of home-based rehabilitation. At the same time, PAR was a challenging research method to use, as it was time-consuming and required the commitment and contribution over time of the different participants involved. There were also specific challenges that had to be considered regarding routines and regulations, as the pilot project was conducted in a health care context. This article aspires to offer methodological guidelines by using a six-step method to illustrate a PAR process. We propose that these guidelines can act as a tool to guide researchers in carrying out PAR.
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27.
  • Nyström, Michelle, et al. (författare)
  • Making the right decision for our children's future: Parents' perceptions of active school travel in disadvantaged neighborhoods
  • 2023
  • Ingår i: Journal of Transport & Health. - : Elsevier. - 2214-1405 .- 2214-1413. ; 30
  • Tidskriftsartikel (refereegranskat)abstract
    • BackgroundChildren's possibility to be physically active is linked to their parent's socioeconomic status. The use of active travel has the potential to increase daily physical activity among children. Parents are the gate-keepers to children using active school travel (AST) and their perceptions has shown to impact children's travel mode. Few studies have explored parents' perceptions about AST in disadvantaged neighborhoods and there is a lack of knowledge of their perceptions of the physical and social environment associated with school travel.PurposeTo explore parents’ perceptions towards AST when living in disadvantaged neighborhoods.MethodsTwelve parents participated in semi-structured interviews, and a qualitative content analysis was used to analyze the data.ResultsThe findings show that parents faced dilemmas, striving to facilitate AST. Parents perceptions are presented as A, B, C categories that are likely to be important when promoting AST in disadvantaged neighborhoods, Acknowledging AST advantages, Balancing barriers, and Creating opportunities to use AST.ConclusionsDespite having a positive attitude towards AST, insecure neighborhoods and social exclusion affect parents'descisions about AST. When promoting AST in disadvantaged neighborhoods, measures to enable AST should include efforts supporting community building, social participation, road safety and ways of promoting bicycling. Engaging children in AST could have a positive influence on their independent mobility, thereby impacting their development and preparing them for the future.
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28.
  • Oyelere, Solomon Sunday, et al. (författare)
  • Initial Design and Testing of Multiplayer Cooperative Game to Support Physical Activity in Schools
  • 2022
  • Ingår i: Education Sciences. - : MDPI. - 2227-7102. ; 12:2
  • Tidskriftsartikel (refereegranskat)abstract
    • ecent studies have shown that children are not adequately physically active and there is a need to increase children’s physical activity. This study describes new opportunities and solutions for using existing games and gamification to increase physical activity among children in Sweden. We adopted the principles of Tic-Tac-Training to redesign, build, and test a classical multiplayer cooperative game, Battleship, to create a PA game that children experience as fun and engaging. The low fidelity prototype of the game was developed using an iterative game development life cycle and tested with 13 young male children aged 8–11 in a real-world informal setting. A mixed-method research approach was used to understand the users’ experiences and the impact of the Battleship-PA game on behavior change regarding physical activity. Research data were collected through audio recordings of interactions, direct observation, and a user experience questionnaire. The results of this study indicate both positive and negative feedback that can be used to improve the game and user experiences. The results from the unfiltered recordings revealed that both teams were competitive, cooperated within their team, and became excited whenever they destroyed opponent’s ships or were close to winning. However, the children felt bored and exhausted when many gamification tasks were repeated several times in a game session. Direct observation indicated that the children enjoyed the physical activities resulting from playing the game. However, participants who had not previously played the classical version of Battleship were confused about the objectives and concept of the game. The analysis of the user experience questionnaire indicated that most children found the game easy to play, motivating, engaging, interactive, fun, cooperative, competitive, and visually appealing. Furthermore, most children agreed that the game helped them to be physically active and strongly agreed that they enjoyed performing the physical activities in the game. Future work is needed to improve the game user interface, gamification elements, and prepare additional physical activity tasks for a rewarding experience.
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29.
  • Riekkola Carabante, Jenni, et al. (författare)
  • Spousal caregivers’ experiences of participation in everyday life when living in shifting contexts
  • 2019
  • Ingår i: Scandinavian Journal of Occupational Therapy. - : Taylor & Francis. - 1103-8128 .- 1651-2014. ; 25:6, s. 457-465
  • Tidskriftsartikel (refereegranskat)abstract
    • Background: To promote health and well-being, and to meet the desires of the growing elderly population to age in place, elderly spousal caregivers need adequate support such as respite care services. More knowledge is needed about elderly spousal caregivers’ experiences in relation to participation, which is an aspect of health that remains relatively unexplored for this group.Aim: To explore and describe how elderly spousal caregivers experience and discuss participation in everyday life when living in shifting contexts due to the use of respite care.Method: A grounded theory approach was used during data generation and analysis, which involved repeated focus group interviews with 12 spousal caregivers.Results: Complexity and ambiguity was understood to imbue participation in everyday life. Being in charge of everyday life was challenging for spousal caregivers, and created a need for personal time. Respite care and home care service gave them time, although when interacting with social contexts other issues arose that influenced their own recovery.Conclusions: A holistic ‘situation centered’ approach that focuses on the elderly couple’s life story and needs might capture a wider perspective and enable adequate support that influences their health, well-being, and participation in everyday life.
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30.
  • Riekkola, Jenni, et al. (författare)
  • Healthcare professionals’ perspective on how to promote older couples’ participation in everyday life when using respite care
  • 2019
  • Ingår i: Scandinavian Journal of Caring Sciences. - : John Wiley & Sons. - 0283-9318 .- 1471-6712. ; 33:2, s. 427-435
  • Tidskriftsartikel (refereegranskat)abstract
    • AimsThe aim is to describe healthcare professionals’ perspectives on how they understand and promote older couples’ participation in everyday life when using residential respite care.Design and MethodsEighteen healthcare professionals with varying degrees of competence and from one residential respite care facility participated in four focus group interviews. Data were analysed through qualitative latent content analysis.FindingsThe findings revealed a broad, multifaceted view of participation and ways in which participation in everyday life is promoted by these professionals. Trustworthy relationships between professionals, spousal caregivers and clients were implicated. Promoting participation also necessitated that clients have access to meaningful activities. In addition, participation entailed an environment that supported various needs.ConclusionPromoting participation for older couples that are using respite care involves multifaceted perspectives that consider social–relational aspects including both the client and their spouse. Furthermore, attention is needed to the meaning a change of context between home and the respite care facility has on relationships, environments and activities in everyday life. Such an approach could benefit the couples’ shared everyday life situation and in a wider perspective, also influence their health and well‐being when ageing in place together.
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31.
  • Riekkola, Jenni (författare)
  • Older couples' participation in everyday life - when living in changing and shifting contexts
  • 2019
  • Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
    • The overall aim of this thesis was to explore and develop an understanding about older couples’ participation in everyday life when living in shifting contexts. To achieve the aim, multiple perspectives were sought and a variety of qualitative methods were applied. Data were generated through interviews and observations with older couples and through focus groups with spousal caregivers, healthcare professionals, and other stakeholders and those data were analyzed through a constant comparative method, content analysis, and narrative analysis.From the perspective of spousal caregivers, the findings in study I revealed the complexity and ambiguity that influences participation in everyday life. Being in charge of everyday life was described as challenging in many ways and produced a need for recovery and own time. Interacting with social contexts and being confident with the provided social services, such as respite care, was described as complex. The partner’s wellbeing and participation had an impact on the spousal caregiver’s own participation when living in shifting contexts. The perspective of healthcare professionals related to residential respite care was captured in study II. They described a broad and multifaceted picture of participation in everyday life and how promoting participation for older couples involved building trustworthy relationships, enabling meaningful activities, and arranging a comfortable shared environment. Both of the partners in the older couples needed to be considered by the professionals. In study III, the perspectives of the older couples were explored. In order to understand how meaning and togetherness is created in older couples’ everyday life, the focus has to be on the couples’ whole situation, including their relationship. The results showed that the couples strived to continue living their lives in togetherness. Strategies used by the couples were shifting responsibilities, doing more things together than before, using residential respite care, and rearranging social interactions with family and friends. Study IV offered the perspectives of multiple stakeholders. The findings suggested that the focus has to be on older couples through maintaining abilities and creating comfort. Support is also required from both an engaged civil society and healthcare professionals that are motivated and have both competence and time. Further, social services need to work together to ensure that resources are properly available.Overall, this thesis contributes to a deeper understanding about older couples’ participation in everyday life when living in shifting contexts. The findings showed that acknowledging the couples’ relationship, seeing beyond the client and the spousal caregiver, was vital for supporting their participation. Furthermore, living in shifting contexts was multifaceted and the couples strived to continue living their lives in togetherness. The meaning that the change of life situation and context has on a couple’s participation in everyday life is important to consider when supporting aging in place. In light of demographic changes and challenges, bringing together the interests of older couples, professionals, systems of services, and civil society is vital for a sustainable future. Systems and situations that are both closely and remotely related to the older couples’ daily life need to be addressed in an ideal situation of aging in place. Knowledge from this thesis could be valuable for occupational therapists and other healthcare professionals, as well as social services that are supporting older couples to age in place. Consequently, this knowledge could be used to benefit the situations of older couples and their health and wellbeing when aging in place.
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32.
  • Riekkola, Jenni, et al. (författare)
  • ‘Possibilities and challenges for older couples to continue ageing in place’
  • 2024
  • Ingår i: Journal of Aging Studies. - : Elsevier. - 0890-4065 .- 1879-193X. ; 69
  • Tidskriftsartikel (refereegranskat)abstract
    • Ageing in place is an imminent concern for both older couples and communities. Identifying ways to support ageing in place is required to meet the needs and challenges of older couples and social services systems. Through focus groups with a total of 46 participants and a constant comparative methodology, this study aimed to explore and describe the experiences and reasoning of spousal carers, healthcare professionals, and stakeholders regarding possibilities for older couples to age in place. The findings consisted of one main category, ‘Facilitating ageing in place is a win-win situation with challenges’ and four interrelated categories, ‘Focus on older couples – building relationships and providing adequate services’, ‘Engaged civil society as a source of care and social inclusion,’ ‘Motivated professionals with competence and time,’ and ‘Services working together for a sustainable society,’ that present possibilities and challenges for ageing in place. This study suggests that facilitating ageing in place is possible but involves a complex series of challenges that can be linked to different contexts ranging from individuals and couples to civil society, services provided, organisational systems, and existing resources. All these aspects need to be considered and balanced to achieve a situation that contributes to older couples' possibilities to age in place as well as to a sustainable society.
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33.
  • Riekkola, Jenni, et al. (författare)
  • Strategies of older couples to sustain togetherness
  • 2019
  • Ingår i: Journal of Aging Studies. - : Elsevier. - 0890-4065 .- 1879-193X. ; 48, s. 60-66
  • Tidskriftsartikel (refereegranskat)abstract
    • The aim of this study was to explore how elderly couples, who are in need of social services in the community, act and reason over time regarding their everyday togetherness. Data were generated through repeated interviews and participant observations with three older couples. A narrative method was used for data generation and analysis. The findings present four parallel narratives illustrating how the couples, over time, strove to continue living their lives in togetherness despite the many challenges that had emerged. These narratives show the complexity and variety of strategies that the couples adopted to handle different situations of everyday life and the couples’ experiences and feelings connected to these situations. The strategies that the couples used resulted, for example, in performing more activities together in another way, using respite care and reorganizing their social interactions. The spousal caregiver had a leading role to manage day-to-day life and to initiate and perform the strategies. Simultaneously, an important reciprocity existed in their relationship that gave meaning to their efforts of sustaining togetherness. These findings give a deeper understanding of the complexity of their situation and of how meaning is created in their everyday life through enacted togetherness. The findings highlight the need for professionals within social services in the community to embrace a couple's whole situation, involving both partners. 
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34.
  • Rutberg, Stina, et al. (författare)
  • Active School Transportation is an Investment in School Health
  • 2018
  • Ingår i: Health Behavior and Policy Review. - : Paris Scholar Publishing. - 2326-4403. ; 5:2, s. 88-97
  • Tidskriftsartikel (refereegranskat)abstract
    • Objective: In this study, we aimed to explore the experiences of schoolchildren and teachers participating in an empowerment- and gamification-inspired program to promote children's active school transportation. Methods: Data were collected using focus groups with 32 schoolchildren and 2 teachers. Content analysis revealed 2 themes and 5 subthemes. Results: Integrating learning into the program increased student engagement and enhanced learning outcomes. The program also created additional value beyond physical activity, such as togetherness, readiness to learn, and changed parental attitudes. Conclusions: Combining learning with physical activity through gamification is a promising method for promoting active school transportation. The time and energy spent increasing active school transportation enrich learning activities and health and are therefore well invested
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35.
  • Rutberg, Stina, et al. (författare)
  • Children’s motivation overcame parental hesitation: active school transportation in Sweden
  • 2019
  • Ingår i: Health Promotion International. - : Oxford University Press. - 0957-4824 .- 1460-2245. ; 34:6, s. 1149-1156
  • Tidskriftsartikel (refereegranskat)abstract
    • To meet the recommendation of 60 min of daily physical activity, children can be encouraged to walk or bike to school, which is known as active school transportation (AST). The aim of this study was to describe parents’ attitudes to AST and to explore their experience when implementing interventions to promote it. To explore parent’s experiences, we collected pre- and post-intervention data via three questionnaires, using both closed and open questioning techniques. The pre-intervention questionnaire informed development of the intervention. Open-ended questions (pre- and post-) were analyzed with qualitative content analysis. In the intervention, there were 42 children, with 63 parents answering pre-intervention questionnaires and 44 answering a post-intervention questionnaire. The analysis resulted in one main theme: children’s motivation and active travel reduces parents’ perception of problems, along with three subthemes: parental concerns and suggestions for solutions, children’s motivation guides parental choice of transport mode, and trying it changes attitudes. In conclusion, it is beneficial to use the enthusiasm and motivation of children to overcome parental hesitation with AST. In addition, it is critical to acknowledge their concerns, as they are the gatekeepers to the children’s use of AST and it is valuable to empower parents when designing relevant interventions. Interventions to increase AST could preferably target changed behavior, and parents’ confidence in their children’s ability to use active transport in a safe and effective way, vs focusing on changing parental attitudes.
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36.
  • Rutberg, Stina, et al. (författare)
  • Experiences of acupuncture among women with migraine
  • 2009
  • Ingår i: Advances in Physiotherapy. - : Informa UK Limited. - 1403-8196 .- 1651-1948. ; 11:3, s. 130-136
  • Tidskriftsartikel (refereegranskat)abstract
    • The aim of this study was to describe experiences of acupuncture treatment among women with migraine. The study was based on narrative interviews with 10 women in the northern part of Sweden. The interview text was analysed using qualitative content analysis and the results were grouped into two categories: "experiences during acupuncture treatment" and "experiences after acupuncture treatment" and five subheadings. The experience of acupuncture during treatment varied between women, over time, and depending on external circumstances. Women stated that the patient-therapist relationship affected the experience both during and the outcome after acupuncture treatment. The results showed that acupuncture relieved pain, decreased the use of pharmaceuticals and increased emotional strength. When the migraine disappeared or was lessened, women felt that they could live life to the fullest again and felt that family and work did not suffer, as they did before the acupuncture treatment. Women felt a feeling of control over migraine and experienced safety in the effect of acupuncture. In conclusion, acupuncture seems to relieve the consequences of migraine and can be viewed as an alternative for physiotherapists in treating persons with migraine.
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37.
  • Rutberg, Stina, et al. (författare)
  • Grit as Perseverance in Physical Activity Participation
  • 2020
  • Ingår i: International Journal of Environmental Research and Public Health. - : MDPI. - 1661-7827 .- 1660-4601. ; 17:3
  • Tidskriftsartikel (refereegranskat)abstract
    • Childhood is a critical period for the acquisition of healthy behaviors, and the promotion of sustainable healthy behavior among children is greatly important. Therefore, an increased understanding of the relationship between grit and physical activity in a school context is needed. The purpose of this study is to describe and develop an understanding of students’ and teachers’ awareness and experiences concerning grit as a health-promoting factor. Fifty-five students and three teachers participated in the study. Data were collected through the Short Grit Scale and focus group interviews. There were weak to non-significant correlations between the three teachers’ ratings of their students’ grit and the children’s own ratings. The qualitative results show that children and teachers understood the construct of grit but had slightly different perceptions of it and that grit is not considered to be set in stone. The participants made an association between grit, motivation, meaningfulness, and setting goals. The findings indicate that grit might be an ideal target for making physical activity interventions sustainable.
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38.
  •  
39.
  • Rutberg, Stina, et al. (författare)
  • Migraine − more than a headache : women's experiences of living with migraine
  • 2012
  • Ingår i: Disability and Rehabilitation. - : Informa UK Limited. - 0963-8288 .- 1464-5165. ; 34:4, s. 329-336
  • Tidskriftsartikel (refereegranskat)abstract
    • Purpose: In this qualitative study the aim was to explore the meaning of living with migraine. Method: In-depth interviews were conducted with ten women about their experience of living with migraine. Halfway through the interview, the women drew a picture of what living with migraine is like, and the interview continued with the conversation being guided by the picture. The interviews were analyzed using a hermeneutic phenomenological method inspired by van Manen. Results: The analysis revealed an essence “Being obliged to endure a life accompanied by an unpredictable and invisible disorder” and three themes “Being besieged by an attack”, “Struggling in a life characterized by uncertainty” and “Living with an invisible disorder.” Conclusion: Migraine is a debilitating disorder which accompanies life in the sense that it or the threat of its return is always present, and yet invisible to others. The struggle of enduring life with migraine is worsened by the feeling of having an invisible disorder and of being doubted. There is a need to increase the knowledge among healthcare professionals about what it means to live with migraine, something this qualitative study offers. Read More: http://informahealthcare.com/eprint/dMX3Yk2JskPHanvF8JyK/full
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40.
  • Rutberg, Stina, et al. (författare)
  • My Way to School Through a Camera Lens: Involving Children to Inform a Policy Recommendation on Active School Travel
  • 2024
  • Ingår i: Health Promotion Practice. - : Sage Publications. - 1524-8399 .- 1552-6372.
  • Tidskriftsartikel (refereegranskat)abstract
    • Active school travel (AST) is an effective approach for increasing children’s physical activity and independent mobility, but policy supporting AST is lacking. This study aims to explore children’s experiences of AST to inform a policy recommendation. Photovoice methodology with a qualitative approach was applied, with children taking pictures on their way to school. This was followed by focus groups where the children explored their experiences of AST based on their photos. The data were analyzed using qualitative content analysis. The results show that the children valued independent mobility and wanted to be involved in decisions about their travels; they also expressed feelings of increased responsibility and personal growth as a consequence. Although the children recognized areas of improvement regarding infrastructure, especially regarding heavy traffic that jeopardized travel safety, they continued using AST. Finally, the children talked about the value of the health and environmental benefits of AST. Opportunities for friendship, play, and making decisions about their own time were highlighted as important incentives. The benefits from AST are many for children, as well as for society. The result has informed policy recommendations for AST, and the children’s input will be used to communicate the recommendations. Listening to the voices of children could be a steppingstone toward forming future healthy mobility initiatives. In that process, it is key to include children’s perspectives when formulating the AST policy for successful adoption and implementation.
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41.
  • Rutberg, Stina, et al. (författare)
  • Professional tools and a personal touch : experiences of physical therapy of persons with migraine
  • 2013
  • Ingår i: Disability and Rehabilitation. - : Informa UK Limited. - 0963-8288 .- 1464-5165. ; 35:19, s. 1614-1621
  • Tidskriftsartikel (refereegranskat)abstract
    • Purpose: The aim was to explore the lived experience of physical therapy of persons with migraine. Method: Data were collected by conducting narrative interviews with 11 persons with migraine. Inspired by van Manen, a hermeneutic phenomenological method was used to analyse the experiences of physical therapy which these persons had. Results: Physical therapy for persons with migraine meant making an effort in terms of time and energy to improve their health by meeting a person who was utilising his or her knowledge and skill to help. Being respected and treated as an individual and having confidence in the physical therapist were highlighted aspects. The analysis revealed a main theme, “meeting a physical therapist with professional tools and a personal touch”. The main theme included four sub-themes, “investing time and energy to feel better”, “relying on the competence of the physical therapist”, “wanting to be treated and to become involved as an individual” and “being respected in a trustful relationship”. Conclusions: The therapeutic relationship with the physical therapist is important and the findings of this study can increase awareness about relational aspects of physical therapy and encourage thoughtfulness among physical therapists and other healthcare professionals interacting with persons with migraine. Implications for Rehabilitation •Physical therapists use both professional tools and a personal touch in their interaction with persons with migraine and this article can increase physical therapists’ awareness and encourage thoughtfulness in their professional practice.•Being respected and treated as an individual and having confidence in the physical therapist are important aspects of the therapeutic relationship and indicate a need for patient-centred care.•By making the effort of spending the time and energy required, physical therapy could be a complement or an alternative to medication to ease the consequences of migraine.
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42.
  • Rutberg, Stina, et al. (författare)
  • Prövning och analys av barnets bästa när det gäller nationella rekommendationer för aktiva skolresor : en barnkonsekvensanalys
  • 2023
  • Rapport (övrigt vetenskapligt/konstnärligt)abstract
    • I Sverige saknas en nationell rekommendation gällande aktiva skolresor. Samtidigt vet vi att barn och unga i Sverige rör på sig för lite. Aktiva resor till och från skolan är ett effektivt sätt att öka den fysiska aktiviteten och det är ett prioriterat område i WHO global action plan om fysisk aktivitet. Det aktiva resandet i dagens transportsystem har större positiva hälsoeffekter än de negativa effekterna av buller, luftkvalitet och trafiksäkerhet tillsammans. Det bidrar positivt till uppfyllelsen av flera mål i Agenda2030. Att barn själva så långt det är möjligt utifrån ålder, mognad och funktionsförmåga får ta ansvari sitt resande är en förutsättning för identitetsskapande och välbefinnande. Tyvärr förväntas de aktiva resorna minska ytterligare om inte riktade åtgärder sätts in.Barns aktiva resor är beroende av trafikmiljön och varierar mellan platser och situationer vilket gördet svårt att basera en rekommendation på ålder. Att det förekommer uttryck såsom ”att barn inteär mogna att cykla i trafikmiljöer förrän vid 12-års ålder” i olika policydokument ökar behovet av nyarekommendationer för att guida vårdnadshavare, skolor, samhällsplanerare och väghållare.I denna barnkonsekvensanalys prövas rekommendationen mot barns behov. En prövning och analys av barnets bästa är ett underlag för att synliggöra och stärka barnrättsperspektivet i beslut som fattas i frågor som rör barn direkt eller indirekt. För att säkerställa att barnets bästa tillgodoses ska en prövning göras inför varje beslut som berör barn. FN:s barnrättskommitté nämner bl.a. utarbetande av policyer och rekommendationer som exempel på sammanhang där en barnkonsekvensanalys ska göras. En barnkonsekvensanalys är ett verktyg för att omsätta barnrättslagen i handling och synliggöra barnets bästa.
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43.
  • Rutberg, Stina (författare)
  • Striving for control and acceptance to feel well : experiences of living with migraine and attending physical therapy
  • 2013
  • Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
    • The overall aim of this doctoral thesis was to describe and develop an understanding ofpersons’ experiences of living with migraine and managing their lives to feel well, andto elucidate their experiences of physical therapy. Qualitative, narrative interviews (IIV)were conducted with individuals to explore and describe their experiences ofliving with migraine. The persons with migraine were asked to draw a picture of theirexperiences to support their narration and the interview continued after the drawingwas complete (II, III). To interpret the meaning of living with migraine, the transcribedtext was analyzed using a hermeneutical-phenomenological approach (I, II, IV), andthe interviews were analyzed using qualitative content analysis (IV) to describe theexperiences of acupuncture.The findings show that living with migraine meant living with the uncertaintyabout having an attack and striving to control the migraines (I, II, IV). To increasetheir sense of control, the persons with migraine tried to identify and manage theirmigraine triggers and they tried to find effective ways of alleviating the attacks (I, II).They also attempted to amplify the good things in life, which increased both theirsense of control and their well-being (II). Living with migraine meant living with thefear of being misunderstood and doubted. When persons with migraine made peacewith being afflicted, they received an inner sense of security from which they couldview more possibilities than limitations in life (I, II). When the person with migraineattended physical therapy, they invested their time and energy towards feeling well,and it was important that the intervention rewarded their effort with increased health.The interaction with the physical therapist was an important aspect of physicaltherapy. The persons with migraine emphasized the need to be trusted and to receiveindividual attention, and they also wanted to feel confident in their physical therapist(III, IV).In conclusion, knowledge about the meaning of living with migraine isimportant for physical therapists and other healthcare professionals who encounterpersons with migraine. By listening to persons’ experiences of migraine, their abilityto control their migraine, their acceptance of their migraine and their general sense ofwell-being, new possibilities for individually adapted interventions and empoweringactions can be revealed. In addition, physical therapists should consider the need fortrust and confidence as important aspects of treating persons with migraine to improvetheir practice.
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44.
  • Rutberg, Stina, et al. (författare)
  • Travelling along a road with obstacles : Experiences of managing life to feel well while living with migraine
  • 2013
  • Ingår i: International Journal of Qualitative Studies on Health and Well-being. - : Informa UK Limited. - 1748-2623 .- 1748-2631. ; 8
  • Tidskriftsartikel (refereegranskat)abstract
    • Living a life with migraine can impair one’s sense of feeling well, and migraine is a disorder that is associated with substantial disability. Earlier research on how people manage their migraine has given important insight into these people’s preventive actions and how they handle their attacks, but there is still a lack of knowledge of how persons with migraine manage their lives to feel well from a more holistic viewpoint. Therefore, the aim of this study was to explore lived experiences of managing life to feel well while living with migraine. Nineteen persons with migraine were interviewed. A hermeneuticphenomenological approach was used to explore their lived experiences. The findings reveal that persons with migraine not only used preventive strategies to abort and ease the consequences of migraine but also tried to amplify the good in life through increasing their energy and joy and through reaching peace with being afflicted with migraine. The findings of this study can encourage healthcare providers, as well as persons with migraine, to consider channeling their efforts into strategies aiming to amplify the good in life, including reaching peace of mind despite being afflicted.
  •  
45.
  • Sandborg, Johanna, et al. (författare)
  • Participants’ Engagement and Satisfaction With a Smartphone App Intended to Support Healthy Weight Gain, Diet, and Physical Activity During Pregnancy : Qualitative Study Within the HealthyMoms Trial
  • 2021
  • Ingår i: JMIR mhealth and uhealth. - : JMIR publications. - 2291-5222. ; 9:3
  • Tidskriftsartikel (refereegranskat)abstract
    • Background:Excessive gestational weight gain (GWG) is common and associated with negative health outcomes for both mother and child. Mobile health–delivered lifestyle interventions offer the potential to mitigate excessive GWG. The effectiveness of a smartphone app (HealthyMoms) was recently evaluated in a randomized controlled trial. To explore the users’ experiences of using the app, a qualitative study within the HealthyMoms trial was performed.Objective:This qualitative study explored participants’ engagement and satisfaction with the 6-month usage of the HealthyMoms app.Methods:A total of 19 women (mean age: 31.7, SD 4.4 years; mean BMI: 24.6, SD 3.4 kg/m2; university degree attainment: 13/19, 68%; primiparous: 11/19, 58%) who received the HealthyMoms app in a randomized controlled trial completed semistructured exit interviews. The interviews were audiorecorded and fully transcribed, coded, and analyzed using thematic analysis with an inductive approach.Results:Thematic analysis revealed a main theme and 2 subthemes. The main theme, “One could suit many: a multifunctional tool to strengthen women’s health during pregnancy,” and the 2 subthemes, “Factors within and beyond the app influence app engagement” and “Trust, knowledge, and awareness: aspects that can motivate healthy habits,” illustrated that a trustworthy and appreciated health and pregnancy app that is easy to use can inspire a healthy lifestyle during pregnancy. The first subtheme discussed how factors within the app (eg, regular updates and feedback) were perceived to motivate both healthy habits and app engagement. Additionally, factors beyond the app were described to both motivate (eg, interest, motivation, and curiosity) and limit (eg, pregnancy-related complications, lack of time) app engagement. The second subtheme reflected important aspects, such as high trustworthiness of the app, increased knowledge, and awareness from using the app, which motivated participants to improve or maintain healthy habits during pregnancy.Conclusions:The HealthyMoms app was considered a valuable and trustworthy tool to mitigate excessive GWG, with useful features and relevant information to initiate and maintain healthy habits during pregnancy.
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46.
  •  
47.
  • Savolainen, Eva, et al. (författare)
  • Children’s active school transportation : an international scoping review of psychosocial factors
  • 2024
  • Ingår i: Systematic Reviews. - : Springer Nature. - 2046-4053. ; 13:1
  • Tidskriftsartikel (refereegranskat)abstract
    • Background: Over the last decades, the prevalence of AST has decreased significantly. Barriers to active school transport (AST) have been extensively examined in the literature, while psychosocial factors that facilitate AST have received less attention. To our best knowledge, there are currently no reviews on this subject. Therefore, the objective of this review was to scope the literature and identify published research about psychosocial factors related to AST.Methods: Systematic searches conducted in PubMed, Web of Science, TRID, Scopus, and ERIC resulted in a total of 1933 publications, and 77 of them were considered eligible for this review.Results: The results of the included articles were categorised into four psychosocial factors: confidence in ability, attitudes, social support, and social norms, which were all generally positively related to AST, with a few exceptions.Conclusion: The findings of this review indicate that these psychosocial factors may be important to consider when developing interventions and highlight that both children and parents should be involved in the process. This knowledge can serve as a valuable guide for developing interventions to promote AST. However, the evidence base supporting these psychosocial factors requires further investigation to fully understand how and when to incorporate them to maximise AST efficacy.
  •  
48.
  • Savolainen, Eva, et al. (författare)
  • Feasibility of a school-based intervention to promote active school transportation – The school personnel's perspective
  • 2024
  • Ingår i: Journal of Transport & Health. - : Elsevier. - 2214-1405 .- 2214-1413. ; 38
  • Tidskriftsartikel (refereegranskat)abstract
    • BackgroundThere is a growing need to invest in interventions that promote physical activity, such as active school transportation. Ideally, these interventions should be school-based to reach as many children as possible. However, school personnel have a heavy workload, and interventions must be feasible and sustainable. This study aims to explore the feasibility of a school-based intervention from the school personnel's perspective and increase knowledge about what makes an intervention in a school context feasible.MethodsA qualitative design was applied with individual interviews with 19 participants, including principals, teachers, project coordinators, one school nurse, and one operation manager. The data were analyzed with qualitative content analysis.ResultsThe result were formulated into one main theme “Crossing the threshold – enter and you might feel at home” and three subthemes “Flexibility for integration in the school context”, “Sensing meaningfulness is essential for being worth the effort” and “A supportive design to enhance enthusiasm”. These themes indicate that schools have a heavy workload and that there is a threshold for schools to invest time and effort into health promoting intervention. Flexibility, meaningfulness, and support were thus crucial elements for making an intervention in the school context feasible.ConclusionThe results of this study outline a promising strategy to meet the needs of school personnel and can serve as a valuable guide for further research concerning school-based interventions aiming to promote health.
  •  
49.
  • Savolainen, Eva, et al. (författare)
  • Long-Term Perspectives of a School-Based Intervention to Promote Active School Transportation
  • 2020
  • Ingår i: International Journal of Environmental Research and Public Health. - : MDPI. - 1661-7827 .- 1660-4601. ; 17:14
  • Tidskriftsartikel (refereegranskat)abstract
    • There is a global need for sustainable interventions that increase physical activity among children, and active school transportation (AST) can promote physical activity among schoolchildren. Therefore, an intervention based on gamification, empowerment, and social cognitive theory was initiated in 2016 to promote AST. The aim of this study was to follow up on participants’ experiences one and two years after the AST intervention was initiated. Data were collected through focus groups and individual interviews which were analyzed using qualitative content analysis. Thirty-one pupils (2017), and forty pupils (2018) aged 9–10 years, two teachers (2017, 2018) and one principal (2018) participated in the study. The result is presented as one main theme; “Unity for an active community-An intervention towards making the active choice the easy choice” and three sub-themes; “Well begun is half done-Engagement sparks motivation”, “It takes two to tango-Keep moving with gamifications and togetherness” and “Jumping on the bandwagon–From project to everyday use.” The results show that the concept of the intervention was attractive to re-use and that it created a habit to use AST among the children. Interventions to promote AST can benefit from the use of engagement, togetherness, and gamification.
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50.
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