Gymnastik- och idrottshögskolan, GIH

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Jayawickrama, R. S., Hill, B., O'Connor, M., Flint, S. W., Hemmingsson, E. & Lawrence, B. J. (2023). Assessing explicit weight bias among Australian health care students: Suitability of the Beliefs About Obese Persons Scale (BAOP) and the Antifat Attitudes Questionnaire (AFA).. Stigma and Health
Open this publication in new window or tab >>Assessing explicit weight bias among Australian health care students: Suitability of the Beliefs About Obese Persons Scale (BAOP) and the Antifat Attitudes Questionnaire (AFA).
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2023 (English)In: Stigma and Health, ISSN 2376-6972Article in journal (Refereed) Epub ahead of print
Abstract [en]

The aim of this study was to examine the suitability of the Beliefs About Obese Persons Scale (BAOP) and Antifat Attitudes Questionnaire (AFA) among Australian health care students. Specifically, we explored the factor structures of the two scales, their psychometric properties including internal consistency and convergent validity, and whether they were impacted by social desirability bias. Students studying health care courses at Australian universities (N = 900) responded to an online survey and completed the BAOP, AFA, 13-item Short Form Marlowe–Crowne Social Desirability Scale (MCSDS), Empathy for Obese Patients, and Confidence in Clinical Interaction With Obese Patients scales. Confirmatory factor analyses, Pearson’s correlations, and linear regressions were conducted to examine the factor structures of the BAOP and AFA, examine their convergent validity, and whether scores on these scales were associated with socially desirable responding. Confirmatory factor analyses confirmed the originally proposed factor structures of the BAOP (one factor) and AFA (three factors) and supported a relatively good model fit. Support for convergent validity of the two measures was shown when correlated with each other and the Empathy for Obese Patients and Confidence in Clinical Interaction With Obese Patients scales. The BAOP was not associated with socially desirable responding (p > .5). In contrast, all subscales of the AFA were associated with socially desirable responding (p < .5); as AFA scores increased, participants were less likely to respond in a socially desirable manner. The BAOP and AFA are considerably suitable measures to assess explicit weight bias among Australian health care students.Our findings indicate that the Beliefs About Obese Persons Scale (BAOP) and Antifat Attitudes Questionnaire (AFA) are considerably suitable measures to assess explicit weight bias among Australian health care students. Our findings support the continued assessment of explicit weight bias among health care students in order to quantify this construct within this population. Quantifying the extent to which explicit weight bias is present among health care students may assist in the development of novel weight bias reduction interventions to reduce students’ exhibited weight bias, with the goal of enabling future health care professionals to provide equitable treatment to people living with overweight. 

Place, publisher, year, edition, pages
American Psychological Association (APA), 2023
National Category
Applied Psychology
Research subject
Social Sciences/Humanities
Identifiers
urn:nbn:se:gih:diva-7923 (URN)10.1037/sah0000484 (DOI)001108460900001 ()
Funder
Australian Research Council, DE230100704
Available from: 2023-10-24 Created: 2023-10-24 Last updated: 2023-12-20
Holmlund, T., Blom, V., Hemmingsson, E., Ekblom, B., Andersson, G., Wallin, P. & Ekblom Bak, E. (2023). Change in cardiorespiratory fitness on self-rated health: prospective cohort study in 98 718 Swedish adults.. Scandinavian Journal of Public Health, 51(4), 542-551
Open this publication in new window or tab >>Change in cardiorespiratory fitness on self-rated health: prospective cohort study in 98 718 Swedish adults.
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2023 (English)In: Scandinavian Journal of Public Health, ISSN 1403-4948, E-ISSN 1651-1905, Vol. 51, no 4, p. 542-551Article in journal (Refereed) Published
Abstract [en]

Aim: To study how change in cardiorespiratory fitness over time is associated with the development of poor self-rated health in healthy Swedish adults, and whether this association varies with sex, age, body mass index and cardiorespiratory fitness at baseline. A secondary aim was to study the influence of other predictors of self-rated health. Methods: A total of 98,718 participants (45% women, mean age 42.2 years) with two assessments from occupational health service screenings between 1988 and 2019 (mean duration 4.3 years), with good self-rated health at baseline were included. Cardiorespiratory fitness was assessed as estimated maximal oxygen consumption using submaximal cycle testing. Change in cardiorespiratory fitness was expressed as percentage annual change. Poor self-rated health at follow-up was defined as percieving self-rated health as 'poor' or 'very poor'. Results: A large decrease in cardiorespiratory fitness (⩾-3%) was associated with a 34% higher risk of poor self-rated health compared to maintainers (-1 to +1%) after multi-adjustment including change in body mass index, back/neck pain, stress, exercise habits and sleep quality or sleep problems. The associations for decreasers were stronger with longer follow-up time (>10 years). Preserving, or changing to, risk level for body mass index, back/neck pain, stress, exercise and sleep quality/problems were associated with a higher risk of poor self-rated health. Conclusions: Preserving or increasing cardiorespiratory fitness is associated with a lower risk of poor self-rated health, independently of change in other health-related variables, which may act as a protection against future poor self-rated health. This is of high clinical value, and strategies for maintaining or improving cardiorespiratory fitness have the potential to influence both disease and mortality.

Place, publisher, year, edition, pages
Sage Publications, 2023
Keywords
Public health, cardiorespiratory fitness, exercise, pain, self-reported health, sleeping problems, stress
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Research subject
Medicine/Technology
Identifiers
urn:nbn:se:gih:diva-6831 (URN)10.1177/14034948211047140 (DOI)000713202300001 ()34664534 (PubMedID)
Funder
Forte, Swedish Research Council for Health, Working Life and Welfare, Dnr 2018-00384Swedish Heart Lung Foundation, 20180636Swedish Armed Forces, AF 922 0915
Available from: 2021-10-27 Created: 2021-10-27 Last updated: 2023-10-26
Jayawickrama, R. S., O'Connor, M., Flint, S. W., Hemmingsson, E. & Lawrence, B. J. (2023). Explicit and implicit weight bias among health care students: a cross-sectional study of 39 Australian universities.. eClinicalMedicine, 58, Article ID 101894.
Open this publication in new window or tab >>Explicit and implicit weight bias among health care students: a cross-sectional study of 39 Australian universities.
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2023 (English)In: eClinicalMedicine, E-ISSN 2589-5370, Vol. 58, article id 101894Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: Weight bias exhibited by health care students may continue into their future practice, compromising the provision of care that people living with overweight or obesity receive. This highlights the need to comprehensively examine the extent to which weight bias is present among health care students and the factors that may be associated with students' weight bias.

METHODS: In this cross-sectional study, Australian university students enrolled in health care courses were invited via social media advertisements, snowball and convenience sampling, and by making direct contact with universities to complete an online survey. Students provided demographic information including discipline of study, perceived weight status, and state of residence. Students then completed several measures which assessed their explicit and implicit weight bias, and empathy. Descriptive statistics established the presence of explicit and implicit weight bias, and ANCOVAs, ANOVA, and multiple regression analyses were conducted to examine the potential factors associated with students' exhibited weight bias.

FINDINGS: Between March 08, 2022, and March 15, 2022, 900 eligible health care students attending 39 Australian universities participated in the study. Students reported varying levels of explicit and implicit weight bias, with minimal differences between disciplines on most outcome measures. Students who identified as men (vs. women) exhibited higher of both explicit and implicit bias (Beliefs About Obese Persons (BAOP): p = 0.0002, Antifat Attitudes Questionnaire (AFA)-Dislike: p = 0.019, AFA Willpower p < 0.0001, Empathy for Obese Patients: p = 0.0011, Implicit Association Test: p = 0.022), and students who displayed greater (vs. less) empathic concern exhibited lower levels of explicit bias (BAOP, AFA Dislike and Willpower, and Empathy for Obese Patients: p < 0.0001). Having witnessed the enactment of weight stigma sporadically (vs. regularly) by role models was associated with greater attribution of the causes of obesity to willpower (a few times a month vs. daily: p = 0.020, a few times a year vs. daily: p = 0.022), and less time spent with people living with overweight or obesity outside of study was associated with more dislike (a few times a month vs. daily: p = 0.0048, once a month vs. daily: p = 0.0002) and less fear of fat (once a month vs. daily: p = 0.036, and once a month vs. a few times a week: p = 0.0028).

INTERPRETATION: Results demonstrate the presence of both explicit and implicit weight bias among Australian health care students. Several characteristics and experiences of students were associated with their weight bias. Validity of the exhibited weight bias should be established in practical interactions with people living with overweight or obesity and novel interventions should be developed to ameliorate weight bias.

FUNDING: Research Training Program (RTP) Scholarship, Australian Government, Department of Education.

Place, publisher, year, edition, pages
Elsevier, 2023
Keywords
Health care students, Overweight and obesity, Weight bias, Weight stigma
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Research subject
Medicine/Technology
Identifiers
urn:nbn:se:gih:diva-7640 (URN)10.1016/j.eclinm.2023.101894 (DOI)000994452700001 ()37181412 (PubMedID)
Available from: 2023-05-18 Created: 2023-05-18 Last updated: 2023-07-13
Hemmingsson, E., Nordenfelt, A. & Oljans, E. (2023). Mamma United: evaluation of a 12-week support program that promotes integration, autonomy, health and well-being for immigrant mothers and their families living in socially deprived areas. In: SIHI Sweden Conference 2023, Exploring Community Engagement for Social Innovation in Health: . Paper presented at 2nd annual SIHI Sweden Conference, Uppsala, 18-19 October 2023.
Open this publication in new window or tab >>Mamma United: evaluation of a 12-week support program that promotes integration, autonomy, health and well-being for immigrant mothers and their families living in socially deprived areas
2023 (English)In: SIHI Sweden Conference 2023, Exploring Community Engagement for Social Innovation in Health, 2023Conference paper, Poster (with or without abstract) (Other academic)
National Category
Social Work
Research subject
Social Sciences/Humanities
Identifiers
urn:nbn:se:gih:diva-7978 (URN)
Conference
2nd annual SIHI Sweden Conference, Uppsala, 18-19 October 2023
Available from: 2023-12-01 Created: 2023-12-01 Last updated: 2023-12-01Bibliographically approved
Väisänen, D., Kallings, L., Andersson, G., Wallin, P., Hemmingsson, E., Stenling, A. & Ekblom Bak, E. (2023). Mediation of lifestyle-associated variables on the association between occupation and incident cardiovascular disease. Preventive Medicine, Article ID 107411.
Open this publication in new window or tab >>Mediation of lifestyle-associated variables on the association between occupation and incident cardiovascular disease
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2023 (English)In: Preventive Medicine, ISSN 0091-7435, E-ISSN 1096-0260, article id 107411Article in journal (Refereed) Published
Abstract [en]

The main aim was to examine the association between occupational groups and incident cardiovascular disease (CVD), and to which extent associations are mediated by lifestyle-associated variables (cardiorespiratory fitness, smoking, BMI, exercise, and diet). A total of 304.702 participants (mean age 42.5 yrs., 47% women), who performed a health profile assessment in Sweden between 1982 and 2019, were included in the analyses. CVD incidence was obtained from national registers. All participants were free from CVD prior to the health profile assessment. Occupational group was defined using the Swedish Standard Classification of Occupations and analyzed separately (13 different occupational groups) as well as after aggregation into four occupational groups (white-collar high-skilled, white-collar low-skilled, blue-collar high-skilled and blue-collar low-skilled). Cardiorespiratory fitness, BMI, exercise, smoking, and diet were included as mediators and analyzed separately in single models and simultaneously in one multiple mediation model. All mediation analyses were adjusted for sex, age, length of education and calendar time. White-collar high-skilled was set as reference in all analyses. Blue-collar and low-skilled occupation had a higher risk of incident CVD compared to reference. Cardiorespiratory fitness, BMI, exercise, smoking, and diet mediated 48% to 54% of the associations between reference and the other aggregated occupational groups. In the single model, the strongest mediators were cardiorespiratory fitness, smoking and BMI. In conclusion, blue-collar and low skilled occupations had a significantly higher risk for incident CVD compared to white-collar high-skilled workers, with the association mediated to a large extent by variation in lifestyle-associated variables.

Place, publisher, year, edition, pages
Elsevier, 2023
Keywords
Cardiorespiratory fitness, mediation, mechanisms, occupation, white-collar, blue-collar, lifestyle
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Research subject
Medicine/Technology
Identifiers
urn:nbn:se:gih:diva-7463 (URN)10.1016/j.ypmed.2022.107411 (DOI)000993846700001 ()36592676 (PubMedID)
Available from: 2023-01-11 Created: 2023-01-11 Last updated: 2023-06-26Bibliographically approved
Väisänen, D., Johansson, P. J., Kallings, L., Hemmingsson, E., Andersson, G., Wallin, P., . . . Ekblom Bak, E. (2023). Moderating effect of cardiorespiratory fitness on sickness absence in occupational groups with different physical workloads. Scientific Reports, 13, Article ID 22904.
Open this publication in new window or tab >>Moderating effect of cardiorespiratory fitness on sickness absence in occupational groups with different physical workloads
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2023 (English)In: Scientific Reports, E-ISSN 2045-2322, Vol. 13, article id 22904Article in journal (Refereed) Published
Abstract [en]

Sickness absence from work has a large adverse impact on both individuals and societies in Sweden and the costs for sickness absence were calculated to 64.6 billion Swedish kronor (approx. 5.6 billion in Euros) in 2020. Although high cardiorespiratory fitness may protect against potential adverse effects of high physical workload, research on the moderating effect of respiratory fitness in the relation between having an occupation with high physical workload and sickness absence is scarce. To study the moderating effect of cardiorespiratory fitness in the association between occupation and psychiatric, musculoskeletal, and cardiorespiratory diagnoses. Data was retrieved from the HPI Health Profile Institute database (1988-2020) and Included 77,366 participants (mean age 41.8 years, 52.5% women) from the Swedish workforce. The sample was chosen based on occupational groups with a generally low education level and differences in physical workload. Hurdle models were used to account for incident sickness absence and the rate of sickness absence days. There were differences in sickness absence between occupational groups for musculoskeletal and cardiorespiratory diagnoses, but not for psychiatric diagnoses. In general, the association between occupation and musculoskeletal and cardiorespiratory diagnoses was moderated by cardiorespiratory fitness in most occupational groups with higher physical workload, whereas no moderating effect was observed for psychiatric diagnoses. The study results encourage community and workplace interventions to both consider variation in physical workload and to maintain and/or improve cardiorespiratory fitness for a lower risk of sickness absence, especially in occupations with high physical workload.

Place, publisher, year, edition, pages
Springer Nature, 2023
National Category
Occupational Health and Environmental Health Public Health, Global Health, Social Medicine and Epidemiology
Research subject
Medicine/Technology
Identifiers
urn:nbn:se:gih:diva-8032 (URN)10.1038/s41598-023-50154-9 (DOI)001136279200070 ()38129646 (PubMedID)
Projects
HPI-gruppen
Available from: 2024-01-08 Created: 2024-01-08 Last updated: 2024-03-06
Hemmingsson, E., Nowicka, P., Ulijaszek, S. & Sørensen, T. I. (2023). The social origins of obesity within and across generations.. Obesity Reviews, 24(1), Article ID e13514.
Open this publication in new window or tab >>The social origins of obesity within and across generations.
2023 (English)In: Obesity Reviews, ISSN 1467-7881, E-ISSN 1467-789X, Vol. 24, no 1, article id e13514Article in journal (Refereed) Published
Abstract [en]

We propose a model for obesity development that traces a considerable part of its origins to the social domain (mainly different forms of prolonged social adversity), both within and across generations, working in tandem with a genetic predisposition. To facilitate overview of social pathways, we place particular focus on three areas that form a cascading sequence: (A) social adversity within the family (parents having a low education, a low social position, poverty and financial insecurity; offspring being exposed to gestational stress, unmet social and emotional needs, abuse, maltreatment and other negative life events, social deprivation and relationship discord); (B) increasing levels of insecurity, negative emotions, chronic stress, and a disruption of energy homeostasis; and (C) weight gain and obesity, eliciting further social stress and weight stigma in both generations. Social adversity, when combined with genetic predisposition, thereby substantially contributes to highly effective transmission of obesity from parents to offspring, as well as to obesity development within current generations. Prevention efforts may benefit from mitigating multiple types of social adversity in individuals, families, and communities, notably poverty and financial strain, and by improving education levels.

Place, publisher, year, edition, pages
John Wiley & Sons, 2023
Keywords
chronic stress, genetics, social adversity, social transmission, weight stigma
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Research subject
Medicine/Technology
Identifiers
urn:nbn:se:gih:diva-7390 (URN)10.1111/obr.13514 (DOI)000877451100001 ()36321346 (PubMedID)
Available from: 2022-11-17 Created: 2022-11-17 Last updated: 2022-12-16
Hemmingsson, E., Väisänen, D., Andersson, G., Wallin, P. & Ekblom Bak, E. (2022). Combinations of BMI and cardiorespiratory fitness categories: trends between 1995 and 2020 and associations with CVD incidence and mortality and all-cause mortality in 471 216 adults.. European Journal of Preventive Cardiology, 29(6), 959-967
Open this publication in new window or tab >>Combinations of BMI and cardiorespiratory fitness categories: trends between 1995 and 2020 and associations with CVD incidence and mortality and all-cause mortality in 471 216 adults.
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2022 (English)In: European Journal of Preventive Cardiology, ISSN 2047-4873, E-ISSN 2047-4881, Vol. 29, no 6, p. 959-967Article in journal (Refereed) Published
Abstract [en]

AIMS: To describe time trends in combinations of cardiorespiratory fitness (CRF) and body mass index (BMI) status, and to analyse their associations with cardiovascular disease (CVD) incidence and mortality and all-cause mortality.

METHODS AND RESULTS: Prospective cohort study with data from occupational health screenings in Swedish employees, including n = 471 216 (aged 18-74 years) between 1995 and 2020, and n = 169 989 in risk analyses. Cardiorespiratory fitness was estimated from a submaximal cycle test. High CRF was defined as top quartile, and low CRF as bottom quartile. Body mass index was used to define normal weight (18.5-24.9 kg/m2), overweight (25.0-29.9 kg/m2), and obesity (≥30 kg/m2). Outcome data (CVD incidence and mortality, all-cause mortality) were obtained from national registers. From 1995 to 2020, the combination of obesity + low CRF increased from 2.1% to 5.3% (relative increase 154%) whereas the combination of normal weight + high CRF decreased from 13.2% to 9.3% (-30%) (both P < 0.001). Negative changes were more pronounced in men, younger ages, and non-university educated. At the end of the period, prevalence of obesity + low CRF were higher in men vs. women (3.1% vs. 2.2%), older vs. younger (3.7% vs. 1.7%), and in non-university vs. university educated (5.0% vs. 0.3%), all P-value <0.001. Having a high CRF attenuated the risk of all three outcomes in all BMI categories, especially in individuals with obesity (hazard ratio 3.90 vs. 6.67 for CVD mortality). Both a low BMI and a high CRF prolonged age of onset for all three outcomes.

CONCLUSIONS: The combination of obesity with low CRF has increased markedly since the mid-90s, with clear implications for increased CVD morbidity and mortality, and all-cause mortality.

Place, publisher, year, edition, pages
Oxford University Press, 2022
Keywords
BMI, Cardiorespiratory fitness, Cardiovascular disease, Mortality, Obesity
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Research subject
Medicine/Technology
Identifiers
urn:nbn:se:gih:diva-6826 (URN)10.1093/eurjpc/zwab169 (DOI)000790035000001 ()34669922 (PubMedID)
Projects
HPI-gruppen
Funder
Forte, Swedish Research Council for Health, Working Life and Welfare, 2018-00384Swedish Heart Lung Foundation, 20180636Swedish Armed Forces, AF 922 0915
Available from: 2021-10-22 Created: 2021-10-22 Last updated: 2022-05-19
Hemmingsson, E. & Wolter, S. (2022). Kriget mot kroppen. Stockholm: Bonnier
Open this publication in new window or tab >>Kriget mot kroppen
2022 (Swedish)Book (Other (popular science, discussion, etc.))
Abstract [sv]

Alldeles för många tvingas idag leva med vikthets och fettfobi i en dietkultur som stjälper mer än hjälper. Överviktsforskaren Erik Hemmingsson och konstnären Stina Wollter delar här chockerande vittnesmål om viktmobbning, både från samhället i stort och från sjukvården. De skärskådar en värld som tycks vara besatt av hälsa, men som varken gör människor lättare, friskare eller gladare.

Vad menas egentligen med hälsa? Är BMI ett bra verktyg? Vad säger aktuell forskning?

Författarna visar vägen mot en hälsosammare värld genom att ifrågasätta gamla sanningar och lyfta fram nya. Genom att utgå från vad just din kropp behöver och mår bra av istället för vad du väger, kan du uppnå bättre hälsa. Men framför allt, det är dags att sluta fred med kroppen! [Text från förlaget]

Place, publisher, year, edition, pages
Stockholm: Bonnier, 2022. p. 304
National Category
Health Sciences
Identifiers
urn:nbn:se:gih:diva-7365 (URN)9789178874002 (ISBN)
Available from: 2022-10-28 Created: 2022-10-28 Last updated: 2022-10-28
Väisänen, D., Kallings, L., Hemmingsson, E. & Ekblom Bak, E. (2022). P08-10 Clustering of unhealthy lifestyle factors in occupational groups in the Swedish workforce. In: EUROPEAN JOURNAL OF PUBLIC HEALTH, vol. 32, S2: . Paper presented at 11th Conference of HEPA Europe (Health Enhancing Physical Activity). 31 August - 2 September 2022, Nice, France. Oxford University Press, 32
Open this publication in new window or tab >>P08-10 Clustering of unhealthy lifestyle factors in occupational groups in the Swedish workforce
2022 (English)In: EUROPEAN JOURNAL OF PUBLIC HEALTH, vol. 32, S2, Oxford University Press, 2022, Vol. 32Conference paper, Oral presentation with published abstract (Other academic)
Place, publisher, year, edition, pages
Oxford University Press, 2022
Keywords
risk score, occupational groups, unhealthy lifestyle factors
National Category
Health Sciences
Research subject
Medicine/Technology
Identifiers
urn:nbn:se:gih:diva-7411 (URN)10.1093/eurpub/ckac095.123 (DOI)000848627100146 ()
Conference
11th Conference of HEPA Europe (Health Enhancing Physical Activity). 31 August - 2 September 2022, Nice, France
Available from: 2022-11-29 Created: 2022-11-29 Last updated: 2022-11-29
Projects
The WORK TOGETHER program: Using a systems approach to update an occupational health service and reduce the health gap [2023-01126]; Swedish School of Sport and Health Sciences, GIH
Organisations
Identifiers
ORCID iD: ORCID iD iconorcid.org/0000-0001-7335-3796

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