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Larsson, K., Kallings, L., Ekblom, Ö., Blom, V., Andersson, E. & Ekblom, M. (2019). Criterion validity and test-retest reliability of SED-GIH, a single item question for assessment of daily sitting time.. BMC Public Health, 19(1), Article ID 19:17.
Open this publication in new window or tab >>Criterion validity and test-retest reliability of SED-GIH, a single item question for assessment of daily sitting time.
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2019 (English)In: BMC Public Health, ISSN 1471-2458, E-ISSN 1471-2458, Vol. 19, no 1, article id 19:17Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: Sedentary behaviour has been closely linked to metabolic and cardiovascular health and is therefore of importance in disease prevention. A user-friendly tool for assessment of sitting time is thus needed. Previous studies concluded that the present tools used to assess a number of sedentary behaviours are more likely to overestimate sitting than single-item questions which often underestimate sitting time, and that categorical answering options are recommended. In line with this, the single-item question with categorical answering options, SED-GIH, was developed. The aim of this study was to investigate the criterion validity of the SED-GIH question using activPAL3 micro as the criterion measure. The second aim was to evaluate the test-retest reliability of the SED-GIH questionnaire.

METHOD: In the validity section of this study, 284 middle-aged adults answered a web questionnaire, which included SED-GIH, wore activPAL and filled in a diary log for one week. Spearman's rho assessed the relationship between the SED-GIH answers and the daily average sitting time as monitored by the activPAL (activPAL-SIT), a Weighted Kappa assessed the agreement, ANOVA assessed differences in activPAL-SIT between the SED-GIH answer categories, and a Chi2 compared the proportions of hazardous sitters between the different SED-GIH answer categories. In the reliability section, 95 elderly participants answered the SED-GIH question twice, with a mean interval of 5.2 days. The reliability was assessed with ICC and a weighted Kappa.

RESULTS: The SED-GIH question correlated moderately with activPAL-SIT (rho = 0.31), with a poor agreement (weighted Kappa 0.12). In total, 40.8% underestimated and 22.2% overestimated their sitting time. The ANOVA showed significant differences in activPAL-SIT between the different SED-GIH answer categories (p < 0.001). The Chi2 showed a significant difference in proportion of individuals sitting more than 10 h per day within each SED-GIH answer category. ICC for the test-retest reliability of SED-GIH was excellent with ICC = 0.86, and the weighted Kappa showed an agreement of 0.77.

CONCLUSIONS: The unanchored single item SED-GIH question showed excellent reliability but poor validity in the investigated populations. Validity and reliability of SED-GIH is in line with other questionnaires that are commonly used when assessing sitting time.

Place, publisher, year, edition, pages
BioMed Central, 2019
Keywords
Adults, Office-based work, Older adults, Reliability, Sedentary behaviour, Sitting, Validity, activPAL
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Research subject
Medicine/Technology
Identifiers
urn:nbn:se:gih:diva-5520 (URN)10.1186/s12889-018-6329-1 (DOI)30611226 (PubMedID)
Available from: 2019-01-08 Created: 2019-01-08 Last updated: 2019-01-08
Nooijen, C. F., Blom, V., Ekblom, Ö., Ekblom, M. & Kallings, L. (2019). Improving office workers' mental health and cognition: a 3-arm cluster randomized controlled trial targeting physical activity and sedentary behavior in multi-component interventions. BMC Public Health, 19, Article ID 266.
Open this publication in new window or tab >>Improving office workers' mental health and cognition: a 3-arm cluster randomized controlled trial targeting physical activity and sedentary behavior in multi-component interventions
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2019 (English)In: BMC Public Health, ISSN 1471-2458, E-ISSN 1471-2458, Vol. 19, article id 266Article in journal (Refereed) Published
Abstract [en]

Background

Physically inactive and sedentary lifestyles are negatively related to both mental health and cognition. For office-workers, who spend two-thirds of their workday sitting, it is important to improve these lifestyles. The aim of this study is to assess the effectiveness of multi-component interventions, incorporating individual, environmental and organizational changes, to increase physical activity or reduce sedentary behavior among office-workers in order to improve mental health and cognition.

Methods

a 3-arm, clustered randomized controlled trial (RCT) with waiting list control group amongst adult office-workers of two large Swedish companies. Cluster teams will be randomized into 6-month interventions or to a passive waiting list control group which will receive the allocated intervention with a 6-month delay. Two multicomponent interventions will be studied of which one focuses on improving physical activity and the other on reducing sedentary behavior. Both interventions include 5 sessions of motivational counselling. In the physical activity intervention persons also get access to a gym and team leaders will organize lunch walks and encourage to exercise. In the sedentary behavior intervention standing- and walking meetings will be implemented and team leaders will encourage to reduce sitting. The recruitment target is 110 office-workers per arm (330 in total). Measurements will be repeated every 6months for a total intended duration of 24months. Proximal main outcomes are physical activity measured with accelerometers and sedentary behavior with inclinometers. Distal outcomes are self-reported mental health and a cognition test battery. Additional outcomes will include cardiovascular fitness, body composition, sleep, self-reported physical activity and sedentary behavior, other health habits, physical health, and working mechanisms from blood samples and questionnaires.

Discussion

This cluster RCT will contribute to the currently available evidence by comparing the effectiveness of multi-component interventions targeting physical activity or sedentary behavior with the end goal of improving mental health and cognition. This study is strong in its cluster randomized design, numerous objective outcome measures and long-term follow-up. The exact content of the interventions has been defined by combining theory with results from a larger research project as well as having a continuous dialogue with the involved companies.

Place, publisher, year, edition, pages
Springer, 2019
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Research subject
Medicine/Technology
Identifiers
urn:nbn:se:gih:diva-5646 (URN)10.1186/s12889-019-6589-4 (DOI)000460405200003 ()30836957 (PubMedID)
Available from: 2019-03-19 Created: 2019-03-19 Last updated: 2019-03-19
Nooijen, C. F., Kallings, L., Blom, V., Ekblom, Ö., Forsell, Y. & Ekblom, M. (2018). Common Perceived Barriers and Facilitators for Reducing Sedentary Behaviour among Office Workers.. International Journal of Environmental Research and Public Health, 15(4), Article ID E792.
Open this publication in new window or tab >>Common Perceived Barriers and Facilitators for Reducing Sedentary Behaviour among Office Workers.
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2018 (English)In: International Journal of Environmental Research and Public Health, ISSN 1661-7827, E-ISSN 1660-4601, Vol. 15, no 4, article id E792Article in journal (Refereed) Published
Abstract [en]

Qualitative studies identified barriers and facilitators associated with work-related sedentary behaviour. The objective of this study was to determine common perceived barriers and facilitators among office workers, assess subgroup differences, and describe sedentary behaviour. From two Swedish companies, 547 office workers (41 years (IQR = 35–48), 65% women, 66% highly educated) completed questionnaires on perceived barriers and facilitators, for which subgroup differences in age, gender, education, and workplace sedentary behaviour were assessed. Sedentary behaviour was measured using inclinometers (n = 311). The most frequently reported barrier was sitting is a habit (67%), which was reported more among women than men (X2 = 5.14, p = 0.03) and more among highly sedentary office workers (X2 = 9.26, p < 0.01). The two other most reported barriers were that standing is uncomfortable (29%) and standing is tiring (24%). Facilitators with the most support were the introduction of either standing- or walking-meetings (respectively 33% and 29%) and more possibilities or reminders for breaks (31%). The proportion spent sedentary was 64% at the workplace, 61% on working days, and 57% on non-working days. This study provides a detailed understanding of office workers’ ideas about sitting and means to reduce sitting. We advise to include the supported facilitators and individualized support in interventions to work towards more effective strategies to reduce sedentary behaviour.

Keywords
barriers, facilitators, office workers, sedentary behaviour, workplace
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Research subject
Medicine/Technology
Identifiers
urn:nbn:se:gih:diva-5262 (URN)10.3390/ijerph15040792 (DOI)000434868800231 ()29670047 (PubMedID)
Projects
Fysisk aktivitet och hälsosamma hjärnfunktioner: Delprojekt 1, Tvärsnittsstudie
Available from: 2018-05-25 Created: 2018-05-25 Last updated: 2018-11-22
Nooijen, C. F., Kallings, L., Blom, V., Ekblom, Ö., Forsell, Y. & Ekblom, M. (2018). Common perceived barriers and facilitators for reducing sedentary behaviour among office-workers. In: Journal of Physical Activity & Health, Volume 15, Issue 10, Pages S94-S95 Supplement 1: . Paper presented at 7th International Society for Physical Activity and Health Congress, London, England, October 15 to October 17, 2018 (pp. S94-S95). Canadian Consortium on Human Security, 15(10)
Open this publication in new window or tab >>Common perceived barriers and facilitators for reducing sedentary behaviour among office-workers
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2018 (English)In: Journal of Physical Activity & Health, Volume 15, Issue 10, Pages S94-S95 Supplement 1, Canadian Consortium on Human Security, 2018, Vol. 15, no 10, p. S94-S95Conference paper, Oral presentation with published abstract (Other academic)
Place, publisher, year, edition, pages
Canadian Consortium on Human Security, 2018
National Category
Occupational Health and Environmental Health
Research subject
Medicine/Technology
Identifiers
urn:nbn:se:gih:diva-5513 (URN)000446516100316 ()
Conference
7th International Society for Physical Activity and Health Congress, London, England, October 15 to October 17, 2018
Available from: 2018-12-21 Created: 2018-12-21 Last updated: 2018-12-21Bibliographically approved
Ekblom, M., Blom, V., Ekblom, Ö., Kallings, L. & Nooijen, C. F. (2018). Fysisk aktivitet och hjärnhälsa. Fysioterapi (5), 32-35
Open this publication in new window or tab >>Fysisk aktivitet och hjärnhälsa
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2018 (Swedish)In: Fysioterapi, ISSN 1653-5804, no 5, p. 32-35Article in journal (Other (popular science, discussion, etc.)) Published
Abstract [sv]

Psykisk ohälsa är den vanligaste orsaken till sjukskrivning. Fysisk aktivitet kan förebygga många former av ohälsa, men vilka fysiska aktivitetsmönster som gynnar psykisk hälsa och kognitiva förmågor är fortfarande okänt. Denna typ av forskning är komplex och kräver samarbete med många olika aktörer i samhället.

National Category
Sport and Fitness Sciences
Research subject
Medicine/Technology
Identifiers
urn:nbn:se:gih:diva-5452 (URN)
Available from: 2018-10-18 Created: 2018-10-18 Last updated: 2018-11-22Bibliographically approved
Ek, A., Ekblom, Ö., Hambraeus, K., Cider, Å., Kallings, L. & Börjesson, M. (2018). Physical inactivity and smoking after myocardial infarction as predictors for readmission and survival: results from the SWEDEHEART-registry.. Clinical Research in Cardiology
Open this publication in new window or tab >>Physical inactivity and smoking after myocardial infarction as predictors for readmission and survival: results from the SWEDEHEART-registry.
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2018 (English)In: Clinical Research in Cardiology, ISSN 1861-0684, E-ISSN 1861-0692Article in journal (Refereed) Epub ahead of print
Abstract [en]

BACKGROUND: Physical activity (PA) and smoking cessation are included in the secondary prevention guidelines after myocardial infarction (MI), but they are still underutilised. This study aims to explore how PA level and smoking status (6-10 weeks post-MI) were associated with 1-year readmission and mortality during full follow-up time, and with the cumulative 5-year mortality.

METHODS: A population-based cohort of all hospitals providing MI-care in Sweden (SWEDEHEART-registry) in 2004-2014. PA was expressed as the number of exercise sessions of ≥ 30 min in the last 7 days: 0-1 (low), 2-4 (medium) and 5-7 (high) sessions/week. Individuals were categorised as smokers, former smokers or never-smokers. The associations were analysed by unadjusted and adjusted logistic and Cox regressions.

RESULTS: During follow-up (M = 3.58 years), a total of 1702 deaths occurred among 30 644 individuals (14.1 cases per 1000 person-years). For medium and high PA, the hazard ratios (HRs) for mortality were 0.39 and 0.36, respectively, compared with low PA. For never-smokers, the HR was 0.45 and former smokers 0.56 compared with smokers. Compared with low PA, the odds ratios (ORs) for readmission in medium PA were 0.65 and 0.59 for CVD and non-CVD causes, respectively. For high PA, the corresponding ORs were 0.63 and 0.55. The association remained in adjusted models. There were no associations between smoking status and readmission.

CONCLUSIONS: The PA level and smoking status are strong predictors of mortality post-MI and the PA level also predicts readmission, highlighting the importance of adherence to the secondary prevention guidelines.

Keywords
Hospitalisation, Myocardial ischaemia, Physical activity, Survival, Tobacco
National Category
Cardiac and Cardiovascular Systems
Research subject
Medicine/Technology
Identifiers
urn:nbn:se:gih:diva-5405 (URN)10.1007/s00392-018-1360-x (DOI)30167806 (PubMedID)
Available from: 2018-09-04 Created: 2018-09-04 Last updated: 2018-09-04
Kallings, L. (2018). The Swedish PAP Physical activity on prescription(FaR®). In: : . Paper presented at Meeting on implementing the transfer of best practices selected by the Steering Group on Promotion and Prevention under the 2018 work plan of the Health Programme, Directorate-General For Health And Food Safety, European Commission. 8 February 2018, Luxemburg..
Open this publication in new window or tab >>The Swedish PAP Physical activity on prescription(FaR®)
2018 (English)Conference paper, Oral presentation only (Other academic)
Keywords
Physical activity on prescription, FaR
National Category
Medical and Health Sciences Health Sciences
Research subject
Medicine/Technology
Identifiers
urn:nbn:se:gih:diva-5537 (URN)
Conference
Meeting on implementing the transfer of best practices selected by the Steering Group on Promotion and Prevention under the 2018 work plan of the Health Programme, Directorate-General For Health And Food Safety, European Commission. 8 February 2018, Luxemburg.
Available from: 2019-01-11 Created: 2019-01-11 Last updated: 2019-01-15Bibliographically approved
Gustavsson, C., Nordqvist, M., Bröms, K., Jerdén, L., Kallings, L. & Wallin, L. (2018). What is required to facilitate implementation of Swedish physical activity on prescription? - interview study with primary healthcare staff and management.. BMC Health Services Research, 18(1), Article ID 196.
Open this publication in new window or tab >>What is required to facilitate implementation of Swedish physical activity on prescription? - interview study with primary healthcare staff and management.
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2018 (English)In: BMC Health Services Research, ISSN 1472-6963, E-ISSN 1472-6963, Vol. 18, no 1, article id 196Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: The method, Swedish Physical Activity on Prescription (SPAP), has been launched in Swedish healthcare to promote physical activity for prevention and treatment of lifestyle related health disorders. Despite scientific support for the method, and education campaigns, it is used to a limited extent by health professionals. The aim of the study was to describe the views of health professionals on perceived facilitators, barriers and requirements for successful implementation of SPAP in primary healthcare.

METHODS: Eighteen semi-structured interviews with stakeholders in SPAP, i.e. ten people working in local or central management and eight primary healthcare professionals in two regional healthcare organisations, were analysed using qualitative content analysis.

RESULTS: We identified an overarching theme regarding requirements for successful implementation of SPAP: Need for knowledge and organisational support, comprising four main categories: Need for increased knowledge and affirmative attitude among health professionals; Need for clear and supportive management; Need for central supporting structures; Need for local supporting structures. Knowledge of the SPAP method content and core components was limited. Confidence in the method varied among health professionals. There was a discrepancy between the central organisation policy documents declaring that disease preventive methods were prioritised and a mandatory assignment, while the health professionals asked for increased interest, support and resources from management, primarily time and supporting structures. There were somewhat conflicting views between primary healthcare professionals and managers concerning perceived barriers and requirements. In contrast to some of the management's beliefs, all primary healthcare professionals undisputedly acknowledged the importance of promoting physical activity, but they lacked time, written routines and in some cases competence for SPAP counselling.

CONCLUSION: The study provides knowledge regarding requirements to facilitate the implementation of SPAP in healthcare. There was limited knowledge among health professionals regarding core components of SPAP and how to practise the method, which speaks for in-depth training in the SPAP method. The findings highlight the importance of forming policies and guidelines and establishing organisational supporting structures, and ensuring that these are well known and approved in all parts of the healthcare organisation.

Keywords
Disease prevention, Health professionals, Health promotion, Implementation, Non-communicable disease prevention, Physical activity, Primary healthcare, Qualitative research method, Sweden
National Category
Other Health Sciences
Research subject
Medicine/Technology
Identifiers
urn:nbn:se:gih:diva-5231 (URN)10.1186/s12913-018-3021-1 (DOI)000428198500005 ()29562922 (PubMedID)
Available from: 2018-03-27 Created: 2018-03-27 Last updated: 2018-05-17
Olsson, S. J., Ekblom, Ö., Andersson, E., Börjesson, M. & Kallings, L. (2016). Categorical answer modes provides superior validity to open answers when asking for level of physical activity: A cross-sectional study. Scandinavian Journal of Public Health, 44(1), 70-76, Article ID 1403494815602830.
Open this publication in new window or tab >>Categorical answer modes provides superior validity to open answers when asking for level of physical activity: A cross-sectional study
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2016 (English)In: Scandinavian Journal of Public Health, ISSN 1403-4948, E-ISSN 1651-1905, Vol. 44, no 1, p. 70-76, article id 1403494815602830Article in journal (Refereed) Published
Abstract [en]

AIMS:

Physical activity (PA) used as prevention and treatment of disease has created a need for effective tools for measuring patients' PA level. Our aim was therefore to assess the validity of two PA questions and their three associated answer modes.

METHODS:

Data on PA according to the PA questions and Actigraph GT3X+ accelerometers, aerobic fitness (VO2max), cardiovascular biomarkers, and self-rated general health were collected in 365 Swedish adults (21-66 years). The PA questions ask about weekly PA via categories (Categorical), an open-ended answer (Open), or specified day by day (Table).

RESULTS:

The Categorical mode, compared with the Open mode, correlated (Spearman's rho) significantly more strongly (p<0.05) with accelerometer PA (0.31 vs. 0.18) and VO2max (0.27 vs. 0.06), and the level of BMI (-0.20 vs. -0.02), waist circumference (-0.22 vs. -0.03), diastolic blood pressure (-0.16 vs. 0.08), glucose (-0.18 vs. 0.04), triglycerides (-0.31 vs. -0.07), and general health (0.35 vs. 0.19). The validity of the Categorical and Table modes were similar regarding VO2max and accelerometry, but the Categorical mode exhibited more significant and stronger correlations with cardiovascular biomarkers. The capacity of the PA questions to identify insufficiently physically active individuals ranged from 0.57 to 0.76 for sensitivity and from 0.47 to 0.79 for specificity.

CONCLUSIONS:

The Categorical mode exhibits the strongest validity and Open mode the weakest. The PA questions may be used on a population level, or as a tool for determining patents' appropriateness for treatment.

National Category
Medical and Health Sciences
Research subject
Medicine/Technology
Identifiers
urn:nbn:se:gih:diva-3958 (URN)10.1177/1403494815602830 (DOI)000369969000011 ()26392418 (PubMedID)
Available from: 2015-08-04 Created: 2015-08-04 Last updated: 2017-12-04Bibliographically approved
Kallings, L. (2016). Hur ska vi fråga om fysisk aktivitet?. Idrottsmedicin, 35(3), 20-23
Open this publication in new window or tab >>Hur ska vi fråga om fysisk aktivitet?
2016 (Swedish)In: Idrottsmedicin, ISSN 2001-3302, Vol. 35, no 3, p. 20-23Article in journal (Other academic) Published
Place, publisher, year, edition, pages
Svensk förening för fysisk aktivitet och idrottsmedicin, 2016
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Research subject
Medicine/Technology
Identifiers
urn:nbn:se:gih:diva-4599 (URN)
Available from: 2016-10-03 Created: 2016-10-03 Last updated: 2016-10-03Bibliographically approved
Organisations
Identifiers
ORCID iD: ORCID iD iconorcid.org/0000-0002-3185-9702

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