Gymnastik- och idrottshögskolan, GIH

AIM: Investigate the longitudinal relationship between physical activity, organised physical activity, fitness, screen time and academic performance among Swedish adolescents.

METHODS: Data from 1139 adolescents at age 13, included vigorous physical activity (accelerometry), fitness (submaximal ergometer test), screen time and organised physical activity participation (self-reported) and academic performance (math and Swedish grades at ages 13 and 16 from registry). Academic performance at age 16 was categorised as A-D (higher grades or pass) or E, F (fail or at-risk of failing). Multilevel logistic regression models were used to examine the relationships while adjusting for gender, parental education, parental country of birth and academic performance at age 13.

RESULTS: Higher fitness at age 13 was associated with increased odds of receiving A-D at age 16 (OR: 1.04 per mL, 99% CI 1.00, 1.07, p = 0.003). High screen time during weekdays was associated with reduced odds (OR: 0.40, 99% CI 0.20, 0.81, p = 0.001) compared to low screen time.

CONCLUSION: Academic performance at the end of compulsory school (age 16) was related to fitness and screen time 3 years earlier. These findings create a paradigm for future randomised controlled trials to explore how influencing these factors might affect academic performance.

De positiva effekterna av fysisk aktivitet på hälsa, välbefinnande och kognitiva funktioner är väl belagda i en rad publikationer och kunskapssammanställningar. Regelbunden daglig fysisk aktivitet kan främja psykisk hälsa och välbefinnande hos barn och ungdomar i alla skolåldrar.

Background: Families residing in disadvantaged communities encounter inequalities that restrict their engagement in physical activity. Family-based interventions and health coordinators have been proposed as promising approaches to encourage physical activity among parents and children. However, there is a paucity of knowledge regarding family experiences of such programmes and the ways health coordinators facilitate continued participation in programmes delivered in disadvantaged communities. The study aimed to explore parents’ perceptions of health coordinators in a family-based physical activity programme, Open Activities, delivered in disadvantaged communities in Sweden. Study design: An exploratory design with a qualitative ethnographic approach. Methods: Multiple methods, including 12 interviews, 15 observations and field notes, and prolonged researcher engagement between February 2022 and December 2023, were used to obtain complementary insights into parents’ perceptions and experiences in the Open Activities programme. Data was analysed using reflexive thematic analysis. Results: A main theme and three sub-themes emerged from the analysis. The sub-themes reflect participants’ perceptions of how health coordinators provide a sense of safety for parents and children, making them feel appreciated and motivated to continue participating in the programme. The sub-themes also reflect the struggles that families encounter with security and social disorders in their neighbourhoods and how these difficulties influence their participation in outdoor activities and trust in outside people, including health coordinators. This required health coordinators to demonstrate a deep commitment to their communities, cultivate trust and fairness, and take a more assertive role in enforcing rules and ensuring respect. Conclusion: The involvement of health coordinators, aware of the issues facing disadvantaged communities, could represent a promising avenue for advancing health equity through physical activity. Failure to consider the potential of health coordinators to promote safety can compromise programmes’ sustainability and even exacerbate existing disparities. © 2024 The Authors

Introduction: There is an association between physical activity and both health and academic performance. However, there is still a lack of consensus on how to engage adolescents in physical activity interventions in secondary schools. One approach to better understand the activities and strategies supporting effective implementation is to involve school staff and adolescents in the early stages of planning and preparing for interventions. Therefore, the aim of this study is to explore how multiple stakeholders, including school staff, students, and experts, perceive the barriers and facilitators for implementing a school-based intervention that extends the school day with additional physical activity in Sweden.

Material and methods: This inductive explorative qualitative study involved 16 participants. Three focus groups with school staff, including principals (n = 3), teachers (n = 6), and students (n = 4), and three interviews with experts were conducted. The planned intervention and its components were presented to the participants in the focus group and interviews to discuss them based on their previous experiences and thoughts of implementing physical activities or health promotion programmes in their schools or with adolescents. Data were analysed using qualitative content analysis.

Results: Three categories emerged: (1) “types of activities offered”, highlighting the importance of designing activities that are fun, inclusive and unusual; (2) “integration of the activities into school curriculum” to promote sustainability of the intervention and incorporate physical activity throughout the school day and across school subjects, and (3) “Management support and funding” referring to the funded time and facilities that teachers leading the activities need to facilitate implementation.

Conclusions: Before implementing extra physical activity in a school setting, it is important to understand what activities enhance students' motivation and the type of support teachers need from the school principal and administration. This includes funding for teachers' time, appropriate scheduling of the activities, and access to facilities.

BACKGROUND: Current evidence suggests that even in high-income countries such as Sweden, there are socioeconomic differences in children's participation in physical activity. While family-based programmes appear promising to encourage physical activity, there is a lack of knowledge on how to engage families in such programmes, particularly in socioeconomically disadvantaged areas. The Open Health-Promoting Activities programme was launched to promote physical activity outdoors and health equity for children and their families in these areas. This study aims to explore parents' experiences with the Open Health-Promoting Activities programme in socioeconomically disadvantaged areas, focusing on family engagement in physical activity and perceived changes in family dynamics.

METHODS: A qualitative design with an ethnographic approach was employed. In line with an ethnographic approach, the research team conducted 15 participant observations of the programme sessions on Saturdays during Spring 2022. Field notes were compiled during the observations, which provided contextual information for individual interviews with 12 programme participants. These interviews were conducted after the researchers attended the programme. The participants were adults/parents who participated in the programme with one or more of their children. An inductive reflexive thematic analysis was used to analyse the field notes and interviews.

RESULTS: The analysis identified three main themes: (1) prioritising children's equal engagement in physical activity, (2) helping parents promote children's healthy lifestyles, and (3) improving family dynamics through engagement in physical activity. Each theme captures an aspect of the programme that parents perceived as essential to facilitating their family's engagement in the programme. All the themes are interconnected and form the basis for improving family dynamics.

CONCLUSION: To develop tailored family-based programmes in socioeconomically deprived communities, it is crucial to understand parents' experiences and perceptions of aspects that facilitate their children's engagement in physical activity. The findings suggest that emphasising equal opportunities, a safe space approach and participation are essential for increasing family engagement in physical activity. These elements also supported increasing parents' awareness of their children's need to be active and have fun together.

Youth with neurodevelopmental disorders, such as attention-deficit/hyperactivity disorder (ADHD) and learning disabilities (LD), experience cognitive difficulties in their daily lives. Food insecurity, a public health problem, disproportionately affects youth with neurodevelopmental disorders and is associated with mental health and academic functioning. We examined the association between parent-reported food insecurity and cognitive difficulty among youth after adjusting for factors associated with cognitive difficulty.The 2022 National Survey of Children’s Health, conducted in the United States, is designed to provide parent-reported information on the health and well-being of children and adolescents. Associations between cognitive difficulty, food insecurity, adverse childhood experiences (ACEs), psychiatric conditions, flourishing, receiving federal assistance, and low socioeconomic status were analyzed using binary logistic regressions.There were 6422 youth (aged 6–17) with ADHD and/or LD (63.4% boys). Around half had parent-reported serious cognitive difficulties (50.5%). A third (31.9%) were reported to have mild food insecurity and 6.7% had moderate/severe food insecurity. In the multivariable model [χ2(6) = 1138.25, p < 0.001; Nagelkerke R2 = 0.22], food insecurity [Odds Ratio (OR) = 1.21; 95% confidence interval (CI) = 1.07–1.34)] was an independent predictor of serious cognitive difficulty, in addition to ACEs (OR = 1.121, 95%CI = 1.075–1.168), anxiety or depression (OR = 2.279, 95%CI = 2.041–2.545), flourishing (OR = 0.473, 95%CI = 0.442–0.505), and free or reduced school meals (OR = 1.244, 95%CI = 1.108–1.397).Food insecurity was independently associated with parent-reported cognitive problems among youth with ADHD and LD. Better understanding the mechanisms that underlie the associations between food insecurity, other social determinants of health, and cognitive difficulties can facilitate the development of targeted, evidence-informed interventions to bolster functional and academic outcomes for youth with neurodevelopmental disorders.

Food insecurity, a public health problem, is associated with worse academic and mental health outcomes in adolescents. Correlates of cognitive difficulty among adolescents include neurodevelopmental disorders, psychiatric conditions, and adverse childhood experiences (ACEs). We examined the association between parent-reported food insecurity and cognitive difficulties, after statistically adjusting for neurodevelopmental disorders, psychiatric conditions, and ACEs.The 2021 National Survey of Children’s Health is a parent-reported survey of youth in the United States that addresses their physical and emotional health. Associations between cognitive difficulty, food insecurity, neurodevelopmental and psychiatric conditions, and ACEs were examined using chi-squared tests and binary logistic regressions.Participants were 13,448 adolescents (aged 13–17; 48% girls), and 13.5% had parent-reported cognitive difficulties (14.7% of boys and 12.2% of girls). Among those with cognitive problems, 95% had a diagnosis of a neurodevelopmental or psychiatric condition. In the total sample, 21.7% were rated as having mild food insecurity and 3.4% had moderate–severe food insecurity. ACEs were associated with food insecurity and cognitive difficulties. Binary logistic regressions examined the associations between food insecurity and cognitive difficulties after statistically adjusting for sex, ACEs, and neurodevelopmental and psychiatric conditions [χ2(4) = 3941.339, p < 0.001; Nagelkerke R2 = 0.465]. Food insecurity was independently associated with cognitive difficulty (Odds Ratio = 1.28; 95% confidence interval = 1.15–1.42).Food insecurity was associated with serious cognitive difficulty among adolescents in the United States after adjusting for sex, neurodevelopmental or psychiatric conditions, and ACEs. It is important to better understand the correlates of cognitive difficulties among adolescents to bolster precision care designed to support youth with these difficulties.

It remains unknown whether dietary nitrate and breakfast may enhance working memory (WM) performance by augmenting physiological mechanisms and subjective psychological well-being. We performed a 3-arm randomised within-subject crossover study, with pretest-posttest comparisons, to test whether nitrate consumption via breakfast with a beetroot juice shot or regular breakfast compared to no breakfast improved WM (measured with n-back tests) and cognitive task-related changes in prefrontal cortical haemodynamic response (oxygenated- and deoxygenated-haemoglobin derived from functional near-infrared spectroscopy). In addition, effects on peripheral vascular function and self-reported psychological factors were assessed. In 60 adolescents (13-15 years old; 66% girls), WM improved in all conditions, with no intervention effects. Intervention effects were seen for oxygenated-haemoglobin changes, such that it increased after the breakfast with a nitrate shot during the WM tests and decreased after the regular breakfast. Thus, different neurophysiological mechanisms may be at play to preserve WM in adolescents depending on their breakfast composition. The trial was registered in the ISRCTN registry (ISRCTN16596056) on 21/02/2022.

INTRODUCTION AND AIM: Ethnically diverse neighborhoods encounter pronounced inequalities, including housing segregation and limited access to safe outdoor spaces. Residents of these neighborhoods face challenges related to physical inactivity, including sedentary lifestyles and obesity in adults and children. One approach to tackling health inequalities is through family-based programs tailored specifically to these neighborhoods. This study aimed to investigate parents' experiences and perceptions of the family-based Open Activities, a cost-free and drop-in program offered in ethnically diverse and low socioeconomic neighborhoods in Sweden.

METHODS: Researchers' engagement in 15 sessions of the Open Activities family-based program during the spring of 2022, and individual interviews with 12 participants were held. Data were analyzed using reflexive thematic analysis.

RESULTS: The analysis resulted in three main themes and seven sub-themes representing different aspects of the program's meaning to the participants as parents, their families, and communities. The main themes describe how parents feel valued by the program, which actively welcomes and accommodates families, regardless of cultural differences within these neighborhoods. The themes also show how cultural norms perceived as barriers to participation in physical activity can be overcome, especially by mothers who express a desire to break these norms and support girls' physical activity. Additionally, the themes highlight the importance of parents fostering safety in the area and creating a positive social network for their children to help them resist criminal gang-related influences.

CONCLUSIONS: The program's activities allowed parents to connect with their children and other families in their community, and (re)discover physical activity by promoting a sense of community and safety. Implications for practice include developing culturally sensitive activities that are accessible to and take place in public spaces for ethnically diverse groups, including health coordinators that can facilitate communication between groups. To enhance the impact of this program, it is recommended that the public sector support the creation of cost-free and drop-in activities for families who are difficult to reach in order to increase their participation in physical activity, outreach, and safety initiatives.

Health promotion from an early age is key to preventing unhealthy weight development in childhood, and parental involvement is essential. The school-based Healthy School Start intervention aims to promote healthy dietary and activity habits in the home environment and prevent child obesity through parental support. This study evaluated the effectiveness of the third iteration of the programme on children's dietary and activity behaviours, and body composition through a cluster-randomised controlled trial. The trial included 17 schools (8 intervention) in disadvantaged areas in mid-Sweden with 353 families with 5- to 7-year-old children. The primary outcomes were intake of selected healthy and unhealthy foods and beverages measured using photography. Secondary outcomes were physical activity and sedentary time measured by accelerometry, and measured weight and height. All outcomes were assessed at baseline and post-intervention (8 months). Linear multi-level regression showed significant favourable effects of the intervention for intake of sweet beverages (b =  - 0.17, p = 0.04), intake of healthy foods (b = 0.11, p = 0.04), and more time in moderate to vigorous physical activity during weekdays (b = 5.68, p = 0.02). An unfavourable sub-group effect of the intervention was found for children from families with low education regarding sedentary time on weekends (b = 23.04, p = 0.05). The results align with the previous two trials of the programme, indicating that school-based parental support is a useful approach for health promotion in young children in disadvantaged areas. Trial registration: ClinicalTrials.gov: No. NCT03390725, retrospectively registered on January 4, 2018, https://clinicaltrials.gov/ct2/show/NCT03390725 .