Gymnastik- och idrottshögskolan, GIH

Abstract

Aim: The objective of the study was to investigate the energy expenditure with the use of dance mat respectively a traditional dance class.

The questions at issue were: What differences, in energy expenditure, an ordinary dance class and a session with dance mat? And: how do the two activities, dance mat and dance class, stand to the recommendations for daily physical activity?

Method: The test group that completed the study consisted of four men and four women in the ages 23-26 years old. The test subjects all have previous experience in mixed physical activity. The method was formed through the relation between heart rate (HR) and effect (w). The test group went through three different types of tests. In the first test a bicycle ergonometer were used and both HR and effect was recorded and formed into a linear equation. The second test was a session with dance mat to a given sample of music. During the test their average HR was recorded. In the third test the test group danced a premade choreography to the same sample of music and their average HR was recorded. The HR variables were set in the linear equation to establish their average effect during the two activities. Oxygen uptake (l/min) and energy expenditure (kcal) was calculated from these figures.

Results: The results of this study shows that dance class (7.4kcal/min) have 40 % higher energy expenditure than the session with dance mat (4.6kcal/min). The dance class reaches and exceeds the recommended lower limit of physical activity, while the session with dance mat does not.

Conclusions: It is possible to use dance mat as a replacement for a dance session, but the energy expenditure is depending on which technique you use in the different activities, despite that it could be used as a pedagogical instrument.

Ostörd handlar om att värna om, prioritera och förvalta dina mentala tillgångar. Då kan de användas där de behövs som mest och dessutom är roligast att tillämpa i utmanande, kreativt, koncentrerat arbete. 

Most work on activity-based working centers on the physical environment and digital technologies enabling flexible working. While important, we believe the key components for implementing activity-based working are employee and manager behaviors. To measure the degree of enactment of activity-based work, based on workshops with experienced practitioners as well as previous literature, we have developed and validated a behavior-focused measure of activity-based working behaviors. In our initial sample (Sample 1, N = 234), three subscales were identified: task - environment crafting, workday planning, and social needs prioritization. In the replication sample (Sample 2, N = 434), this model also showed adequate fit. Moreover, task - environment crafting was related to general health and lower stress in sample 1 (multi-organization sample), but not in the single-organization sample (sample 2). Workday planning was associated with higher concentration in both samples and in the second sample with general health and work engagement; the latter was also related to social needs prioritization.

Task-Environment fit, a special case of Person-Environment fit, has been suggested as the central mechanism through which Activity-Based Working (ABW) Environments support productivity and employee wellbeing, here operationalized as team functioning and concentration troubles. We extend previous work in this space by testing the asymmetric effect (where deficient supply is worse than excess supply) usually assumed, with a new statistical approach-cubic polynomial regression-capable of such tests. The complex models gained only partial support and none for a strict congruence effect. Results are more in line with previous work on P-E fit showing that higher levels of needs met are more valuable, and with previous ABW work showing that the supply of suitable environments has the largest impact on outcomes.

This explorative case study investigates health-promoting office design from an experience and meaning-making perspective in an activity-based flex-office (A-FO) in a headquarter building. This small case study (n = 11) builds using qualitative data (walk-through and focus group interviews). A reflexive thematic analysis (RTA) of the experience of design approach was performed on this from a health and sustainability perspective, including the physical, mental, and social dimensions of health defined by WHO. Results show a wide range in participants' experiences and meaning-making of the health-promoting office design of their office building. The control aspect plays a central role in participants' experiences, including factors such as surveillance and obeyance, related to status and power, in turn associated with experiences of pleasantness, symbolism, and inclusiveness. Three main themes are identified in participants' experiences: (1) comfort-non-comfort, (2) outsider-insider, and (3) symbolism. The major finding of the study is the ambiguity among participants about the health-supportive office design of the office building per se and its various environments. There is a sense that it is chafing, due to dissonance between the intention of the office and the applied design.

OBJECTIVES: This study aimed to investigate the reach of a large-scale health assessment delivered by the occupational health service in Sweden for almost 30 years.

METHODS: A total of 418 286 individuals who participated in a health assessment (Health Profile Assessment, HPA) between 1995-2021 were included. A comparative sample was obtained from Statistics Sweden, comprising the entire working population for each year (4 962 127-6 011 829 unique individuals per time period). Sociodemographic and work organization characteristics were compared between the HPA and comparative population for six different periods. Under- and overrepresented groups in the private and public sectors were identified using the most recent data (2015-2021).

RESULTS: With negative per cent indicating underrepresentation, the most notable changes over time in representation in the HPA population compared to the comparative were observed for women (-1.2% to -12.8%), private sector employees (-9.4% to 14.9%), individuals with ≥3 years of employment (14.5% to 0.9%), in personal care (0.8% to -8.8%) and manufacturing (0.7% to 6.4%) occupations. Consistently overrepresented groups (median representation across periods) included individuals who had a single income source (6.3%) and were middle-aged (10.8%), born in Sweden (5.9%), associate professionals (8.7%), and employed in companies with high operating profit (17.9%) and low staff turnover (14.3%). Conversely, individuals with low income (-34.0%) and employed in small companies/organizations (-10.9%) were consistently underrepresented. Middle-aged women in education occupations were most underrepresented in the public sector, while in the private sector, it was young women in service and shop sales occupations.

CONCLUSIONS: This health assessment has reached many professionals, including hard-to-reach groups, but did not fully represents the Swedish workforce throughout the years.

Den militärmedicinska forskningsgruppen vid Åstrandlaboratoriet, Gymnastik- och Idrottshögskolan, Stockholm, har som forskningsuppgift med stöd från Försvarsmakten att studera och föreslå insatser för att upprätthålla stridsvärdet för trupp under långvarigt fysiskt arbete. Forskningen har hitintills resulterat i åtta rapporter, där fysisk arbetsförmåga studerats under olika förhållanden. Föreliggande rapport sammanfattar de huvudsakliga resultaten från dessa undersökningar men omfattar också en diskussion gällande skillnader och likheter mellan kvinnors jämfört med mäns adaptation till långvarigt och tungt arbete samt ett kort avsnitt om fortsatta undersökningar, byggda på tidigare resultat.

Energistatus och förändring i fysiskt stridsvärde studerades i samband med en nästan 8 dygn långa grundmilitär slutövning (GMU) vid AMF-1 Berga Örlogsskolor i månadsskiftet oktober november 2013.

Totalt deltog 105 soldater i övningen, fördelat på 3 plutoner om vardera 35 soldater. En subgrupp på 24 soldater (8 kvinnor) bestående av 8 soldater från vardera pluton studerades mer ingående.

Medelhjärtfrekvensen för de 6 soldater (2 kvinnor) som hade i stort sett kompletta mätningar från den 187 timmar långa övningen, inklusive viloperioder, var 88 ± 7 slag/minut. Utifrån hjärtfrekvensdata beräknades den totala energiomsättningen till i genomsnitt 44 000 ± 6 600 kcal, vilket motsvarar 5 600 ± 840 kcal per dygn och 235 ± 35 kcal/tim. Total energiförbrukning var i genomsnitt 39 000 kcal för kvinnorna och 46 500 kcal för männen. I övrigt noterades inte några betydande skillnader mellan kvinnor och män. Däremot var det stora individuella variationer i energiutgift, vilka till ca hälften berodde på skillnader i kroppsvikt. Med hänsyn till kroppsvikt och buren vikt var energiförbrukningen ca 3,1 ± 0,23 kcal per timme per kg totalvikt. Den individuella variationen beror på skillnad i buren vikt, på olika uppgifter och på individuella fysiologiska skillnader.

Utifrån beräknat energiintag blev det totala energiunderskottet under övningen 12 000-15 000 kcal, vilket är ca 1 500-2 000 kcal per dygn. Viktminskningen under övningen var 2,9 kg för kvinnor och 3,7 kg för män. Denna viktminskning på >4 % leder troligen till försämrad uthållighetsförmåga.

Den maximala muskelstyrkan i armar och ben var i stort sett oförändrade efter övningen, liksom den beräknade maximala syreupptagningsförmågan. Däremot upplevdes ett lågintensivt cykelarbete som betydligt tyngre efter övningen. Muskeluthållighet mättes inte i denna studie.

Ett skjutprov om 5 skott i liggande på 100 m mot en tredjedelsfigur visade 64 deltagande soldater på en försämrad träffprocent från 90,5% före till 79,4 % efter övningen. Alla soldater hade minst en träff före medan 6 soldater hade alla bom efter övningen.

Slutsatsen från studien är att GMU-övningen resulterade i ett stort energiunderskott. Stridsvärdet, bedömt från skjutprovet var klart försämrat. Maximala fysiologiska parametrar var i stort sett oförändrade, medan skattad ansträngning och därmed uthållighetsförmåga, försämrades.

Syfte och frågeställning

Syftet med denna studie var att undersöka om det finns skillnader i upplevd hälsorelaterad livskvalitet, antalet sjukdagar samt fysisk aktivitet på fritiden mellan två olika yrkesroller med olika fysiska aktivitetsnivåer. Våra frågeställningar inför denna studie löd:

-          Hur skiljer sig den hälsorelaterade livskvaliteten mellan individer med ett fysisk aktivt arbete och individer med ett fysiskt inaktivt arbete?

-          Hur skiljer sig antalet sjukdagar år 2009 mellan individer med ett fysiskt aktivt arbete och individer med ett fysiskt inaktivt arbete?

-          Hur skiljer sig mängden fysisk aktivitet på fritiden mellan individer med ett fysiskt aktivt arbete och individer med ett fysiskt inaktivt arbete?

Metod

Vi använde oss av enkätundersökning för att besvara våra frågeställningar. Denna bestod SF-12 som är en sedan tidigare beprövad och validerad enkät och ett egenkomponerat frågeformulär med kompletterande bakgrundsfrågor. Materialet delades ut till 92 respondenter och besvarades av 79 av dessa, bortfallet blev 14 procent. Enkäterna hanterades anonymt, sammanställdes i Excel och bearbetades i SPSS. Som teoretisk utgångspunkt valdes KASAM.

Resultat

De viktigaste resultaten visar inte något signifikant resultat men en indikation på att det finns ett samband mellan den hälsorelaterade livskvaliteten och yrkesroll, i detta fall en högre hälsorelaterad livskvalitet hos de med administrativ tjänst. En skillnad mellan yrkesrollerna sågs även när det gäller antalet sjukdagar under år 2009. Majoriteten av respondenterna med administrativ tjänst hade 0 sjukdagar jämfört med 1-7 dagar hos orderexpeditörerna.

Slutsats

Undersökningen visade att det inte förekom några signifikanta skillnader mellan de två yrkesrollerna som vi valde att grunda vår studie på. Vi trodde att skillnaderna i den hälsorelaterade livskvaliteten, antalet sjukdagar samt mängden fysisk aktivitet på fritiden skulle vara större än vad de visade sig att vara. Vad skillnaderna kan bero på är svårt att säga då det förekommer många olika faktorer som kan påverka individerna.

Sjutton kvinnliga vältränade försökspersoner, åtta stycken med vana att bära tungt och nio stycken utan sådan vana, genomförde gång på löpband och mjukt underlag i hastigheterna 3 och 5 km/tim med bärvikter i ryggsäck på 20, 35 och 50 kg.Mjukt underlag i form av blå gymnastikmattor, indikerande gång i lätt terräng, ökade energiomsättningen under både hastigheterna mellan 10 och 15 %, jämfört med hårt underlag (löpband) med en grads lutning. Energiomsättningen ökade i genomsnitt lika mycket med ökad hastighet som med ökad bärvikt. Den individuella variationen vid en given bärvikt och hastighet är mycket stor. Beroende på bärvikt och hastighet kan energiomsättningen variera med 100 %. Dessa stora variationer i energiomsättning bör uppmärksammas vid beräkning av energitilldelning via kosten vid längre militära operationer.Energiomsättningen vid tyngsta belastningen – 50 kilo bärvikt och hastigheten 5 km/tim – belastade försökspersonerna på i genomsnitt 57 % av maximal syreupptagningsförmåga. I individuella fall var belastningen 72 % av maximal syreupptagningsförmåga. Dessa höga belastningar är oacceptabelt höga för transporter under längre tid och kan vara en orsak till belastningsskador.Förmågan att bära tungt sammanfaller med ökad kroppsvikt och benmuskelstyrka. Bärförmåga för mindre vikter, högst 35 kg, sammanfaller inte med någon av ovanstående faktorer. Således, för tyngre bärvikter vid förflyttningar bör selektion av soldater ske enligt de uppmätta parametrarna, medan vad gäller lättare vikter föreligger inte samma selektionskriterier.En slutsats från resultaten av denna undersökning är den ursprungliga uttagningen till tunga arbetsuppgifter inom försvaret bör genomföras med tunga arbetsbelastningar, motsvarande de i denna undersökning. I kommande rapport sammanfattas studierna på män och kvinnors bärförmåga, likheter och olikheter mellan könen, möjliga selektionskriterier samt rekommendationer med utgångspunkt från genomförda undersökningar och resultat från olika andra undersökningar.

Objectives The aim of this study was to examine the association between long-term sickness absence (LTSA) due to mental disorders and musculoskeletal disorders and all-cause disability pension (DP) among blue- and white-collar workers. A secondary objective was to examine the influence of familial factors on the associations. Methods This was a prospective twin cohort study of 42 984 individuals (21-64 years at baseline), 3017 of whom had a new LTSA spell (>14 days) due to mental or musculoskeletal disorders in 2005-2006. Average follow-up time was 5.4 years. Survey data on occupational class and register data on LTSA and DP were used. Cox proportional hazards regression was applied to calculate hazards ratios (HR) with 95% confidence intervals (CI). Results During follow-up, 989 participants went on disability. LTSA due to mental disorders and musculoskeletal disorders led to similar HR for DP among both white- and blue-collar workers when compared to white-collar workers not on LTSA (reference group). LTSA ≥6 months due to musculoskeletal disorders was associated with a higher risk of DP for white-collar (HR 31.50, 95% CI 20.45-48.52) than blue-collar (HR 17.64, 95% CI 13.08-23.78) workers when compared to the reference group. HR were lower in the discordant twin pair models for LTSA due to mental disorders than in the whole cohort. Conclusions White-collar workers on LTSA due to musculoskeletal disorders are especially vulnerable to all-cause DP. This pattern was not present for LTSA due to mental disorders. Familial factors seem to influence the association between LTSA due to mental disorders and all-cause DP.

Background: Sickness absence (SA) is becoming a major economic problem in many countries. Our aim was to investigate whether type of employment, including temporary employment or part-time employment, is associated with SA while controlling for familial factors (genetic and shared environment). Differences between men and women and across employment sectors were explored.

Methods: This is a prospective twin study based on 21 105 twins born in Sweden 1959-85. The participants completed a survey in 2005 with follow-up of SA (≥15 days), using register data, until end of 2013. The data were analyzed with logistic regression, with results presented as odds ratios (OR) with 95% confidence intervals (CI).

Results: Temporary employment involved higher odds of SA (OR=1.21 95% CI=1.04-1.40) compared to full-time employment. Both part-time workers (OR=0.84 95% CI=0.74-0.95) and the self-employed (OR=0.77 95%CI=0.62-0.94) had lower odds of SA. Stratifying by sex showed lower odds for part-timers (OR=0.82 95% CI=0.73-0.94) and self-employed women (OR=0.65 95% CI=0.47-0.90), but higher odds for men in temporary employment (OR=1.33 95% CI=1.03-1.72). Temporary employees in county councils (OR=1.73 95% CI=1.01-2.99) and municipalities (OR=1.41 95% CI=1.02-1.96) had higher odds while part-timers employed in the private sector had lower odds (OR=0.77 95% CI=0.64-0.93). Familial factors did not confound the association between employment type and SA.

Conclusions: Employment type is associated with SA, with temporary employment involving a higher risk compared to permanent full-time employment while both part-time employment and self-employment involved a lower risk. The associations vary between women and men and across sectors.

The context of retirement has changed over the last decades, but there is little knowledge on whether the quality of retirement adjustment has changed as well. Changes in retirement regulations and historical differences in resources may affect the quality of adjustment and increase inequalities between different socioeconomic groups. In the present study, we investigated historical differences in retirement adjustment by comparing cross-sectional samples of retirees from 1996, 2002, 2008, and 2014, based on the population-based German Ageing Survey. Adjustment was measured with three different indicators (perceived change in life after retirement, retirement satisfaction, adjustment difficulties). Retirement satisfaction was higher in later samples, but for the other two outcomes, there was no evidence for systematic increases or decreases in levels of retirement adjustment with historical time over the studied period. White-collar workers reported better adjustment than blue-collar workers did, and for two of three outcomes, this effect was stable over time. The white-collar workers’ advantage concerning retirement satisfaction, however, increased. We conclude that in Germany, at least for those who retire within the usual time window, adjustment quality has not changed systematically over the examined 18-year period. We only found mixed evidence for a growing social inequality in the retirement adjustment. However, as individual agency in choosing one’s retirement timing and pathway is increasingly restricted, social inequalities in well-being before retirement may increase.

Aim:

The aim of this graduate essay is to study if the health statement has brought any consequences to the sickness absence. Questions: How do the companies report the sickness absence? Do the companies comment on their chosen reporting and if so, how? How has the sickness absence changed since the introduction of obligatory reporting of sickness absence?

Method:

To study this, annual reports from 25 private companies have been analysed. The annual reports from 2003 have been compared with the corresponding annual reports of 2004. The companies come from five of the largest line of businesses in the Stockholm region. The companies have 50-249 employees which correspond to medium sized companies in Stockholm. The selection has been done from branches of industry and after that as a random pick in terms of drawing lots. The compilation that has been made is the total change of the sickness absence and the change of sickness absence in respective subgroup. This has been made both in branches of industry and totally. There has also been a compilation of the change of the total long-term sickness absence for all the companies, both in branches of industry and totally.

Results:

The sickness absence is reported by all the companies and on average in accordance with the law. Concerning the long-term sickness absence, 7 of the 25 companies probably have reported the total long-term sickness absence as per cent units of the total sickness absence instead of per cent of the total sickness absence. The sickness absence shows a tendency to have decreased or been unchanged in all the reported categories. None of the companies have commented the sickness absence in the annual report besides the comments that describes the numbers. 9 of the 25 companies have chosen not to report anything concerning some of the categories. Two of these companies have chosen to comment this.

Conclusions:

The health statement does not seem to have given any larger effects on the sickness absence. Nevertheless it shows no tendency to have increased which will have to been seen as positive. Since none of the companies has commented anything besides what the law says, one can assume that the health statement only has been received as an extra addition in the annual report. Since there is some uncertainty how the reporting should be done, the law should be clarified so that the aim with the health statement is achieved. To sum up, the health statement is a good thought that yet only get the companies aware of their sickness absence situation. For external interests the numbers still do not say much.

BACKGROUND: Total sitting time is associated with a higher risk for cardio metabolic disease and mortality, while breaks in prolonged sitting attenuate these effects. However, less is known about associations of different specific domains and breaks of sitting on general health, back/neck pain and if physical activity could influence these associations. The aim was to investigate how workplace sitting and frequency of breaking up workplace sitting is associated with self-reported general health and self-reported back/neck pain.

METHODS: 44,978 participants (42% women) from the Swedish working population, who participated in a nationwide occupational health service screening 2014-2019, were included in this cross-sectional study. Self-reported sitting duration and frequency of breaks from sitting at work, general health, back/neck pain, exercise, leisure time sitting, diet, smoking, stress and body mass index were assessed. Occupation was classified as requiring higher education qualifications or not. Logistic regression modelling was used to assess the association between workplace sitting/frequency of breaks in workplace sitting and poor general health and back/neck pain, respectively.

RESULTS: Compared to sitting all the time at work, sitting ≤75% of the time showed significantly lower risks for poor general health (OR range 0.50-0.65), and sitting between 25 and 75% of the time showed significantly lower risks (OR 0.82-0.87) for often reported back/neck pain. For participants reporting sitting half of their working time or more, breaking up workplace sitting occasionally or more often showed significantly lower OR than seldom breaking up workplace sitting; OR ranged 0.40-0.50 for poor health and 0.74-0.81 for back/neck pain.

CONCLUSIONS: Sitting almost all the time at work and not taking breaks is associated with an increased risk for self-reported poor general health and back/neck pain. People sitting almost all their time at work are recommended to take breaks from prolonged sitting, exercise regularly and decrease their leisure time sitting to reduce the risk for poor health.

BACKGROUND: Web-surveys are increasingly used in population studies. Yet, web-surveys targeting older individuals are still uncommon for various reasons. However, with younger cohorts approaching older age, the potentials for web-surveys among older people might be improved. In this study, we investigated response patterns in a web-survey targeting older adults and the potential importance of offering a paper-questionnaire as an alternative to the web-questionnaire.

METHODS: We analyzed data from three waves of a retirement study, in which a web-push methodology was used and a paper questionnaire was offered as an alternative to the web questionnaire in the last reminder. We mapped the response patterns, compared web- and paper respondents and compared different key outcomes resulting from the sample with and without the paper respondents, both at baseline and after two follow-ups.

RESULTS: Paper-respondents, that is, those that did not answer until they got a paper questionnaire with the last reminder, were more likely to be female, retired, single, and to report a lower level of education, higher levels of depression and lower self-reported health, compared to web-respondents. The association between retirement status and depression was only present among web-respondents. The differences between web and paper respondents were stronger in the longitudinal sample (after two follow-ups) than at baseline.

CONCLUSIONS: We conclude that a web-survey might be a feasible and good alternative in surveys targeting people in the retirement age range. However, without offering a paper-questionnaire, a small but important group will likely be missing with potential biased estimates as the result.

The ActiGraph has a high ability to measure physical activity, however, it lacks an accurate posture classification to measure sedentary behaviour. The aim of the present study was to develop an ActiGraph (waist-worn, 30Hz) posture classification to detect prolonged sitting bouts, and to compare the classification to proprietary ActiGraph data. The activPAL, a highly valid posture classification device, served as reference criterion.¹ Both sensors were worn by 38 office workers over a median duration of 9 days. An automated feature selection extracted the relevant signal information for a minute based posture classification. The machine-learning algorithm with optimal feature number to predict the time in prolonged sitting bouts (≥5 and ≥10 minutes) was searched and compared to the activPAL using Bland-Altman statistics. The comparison included optimised and frequently used cut-points (100 and 150 counts-per-minute (cpm), with and without low-frequency-extension (LFE) filtering). The new algorithm predicted the time in prolonged sitting bouts most accurate (bias ≤7 minutes/day). Of all proprietary ActiGraph methods, only 150 cpm without LFE predicted the time in prolonged sitting bouts non-significantly different from the activPAL (bias ≤18 minutes/day). However, the frequently used 100 cpm with LFE accurately predicted total sitting time (bias ≤7 minutes/day). To study the health effects of ActiGraph measured prolonged sitting, we recommend using the new algorithm. In case a cut-point is used, we recommend 150 cpm without LFE to measure prolonged sitting, and 100 cpm with LFE to measure total sitting time. However, both cpm cut-points are not recommended for a detailed bout analysis.

Sedentary Behavior (SB), defined as sitting with minimal physical activity, is an emergent public health topic. However, the measurement of SB considers either posture (e.g., activPal) or physical activity (e.g., ActiGraph), and thus neglects either active sitting or inactive standing. The aim of this study was to determine the true amount of active sitting and inactive standing in daily life, and to analyze by how much these behaviors falsify the single sensors' sedentary estimates. Sedentary time of 100 office workers estimated with activPal and ActiGraph was therefore compared with Bland-Altman statistics to a combined sensor analysis, the posture and physical activity index (POPAI). POPAI classified each activPal sitting and standing event into inactive or active using the ActiGraph counts. Participants spent 45.0% [32.2%-59.1%] of the waking hours inactive sitting (equal to SB), 13.7% [7.8%-21.6%] active sitting, and 12.0% [5.7%-24.1%] inactive standing (mean [5th-95th percentile]). The activPal overestimated sedentary time by 30.3% [12.3%-48.4%] and the ActiGraph by 22.5% [3.2%-41.8%] (bias [95% limit-of-agreement]). The results showed that sitting is not always inactive, and standing is not always active. Caution should therefore be paid when interpreting the activPal (ignoring active sitting) and ActiGraph (ignoring inactive standing) measured time as SB.

Mental disorders pose a significant global health challenge. To effectively address this challenge, mental health promotion must be included in various sectors, including workplaces. Various strategies for promoting mental health in the workplace have been suggested, including interventions aimed at improving movement behavior, i.e., sitting less and moving more. Physical activity (PA) and sedentary behavior (SED) are established determinants of mental health. However, there are aspects of the relationship between movement behavior and mental health that are not well understood, for example, the combined effects of all movement behaviors occurring throughout the daily 24-hour cycle, i.e., time in bed, SED, light-intensity physical activity, and moderate to vigorous physical activity (MVPA), on mental health. In addition, only a few well-designed workplace interventions for improving movement and mental health outcomes have been tested. Office workers often spend extensive amounts of time being sedentary and might particularly benefit from such interventions. The aims of this thesis were (1) to investigate cross-sectional associations between 24-hour movement behavior and mental health among office workers and (2) to evaluate the efficacy, acceptability, feasibility, and fidelity of two cluster randomized controlled trial (RCT) interventions for improving movement behavior and mental health using quantitative and qualitative methods.

In Paper I, we investigated cross-sectional associations between 24-hour movement behavior and mental health outcomes (symptoms of depression and anxiety, burnout, mental wellbeing, and stress) among office workers (N=345-370). Movement behavior was measured using accelerometers and sleep diaries. Mental health outcomes were assessed using validated questionnaires. Only the proportion of time spent in MVPA, relative to all other behaviors, was positively associated with mental wellbeing. 

Papers II-IV were based on a three-armed cluster RCT among office workers (N=263). During the 6-month intervention period, the iSED intervention group focused on reducing SED, and the iPA intervention group focused on increasing MVPA compared to a wait-list control group. The multi-level interventions were designed based on ecological models of health behavior, addressing the individual office workers as well as their physical, social, and organizational work environment. Paper II investigated intervention effects on accelerometer-measured 24-hour movement behavior and cardiorespiratory fitness. We considered overall 24-hour movement behavior and movement behavior during work versus non-work time. No intervention effects were found. Paper III was based on a qualitative study that was embedded in the RCT. It investigated the acceptability, feasibility, and fidelity of intervention components that addressed the individual, environmental and organizational level. Interviews and focus group discussions were performed with 38 key stakeholders after the 6-month intervention period. The study included office workers who received the interventions, health coaches who delivered counseling sessions, team leaders who were responsible for implementing group activities, and human resource and higher management staff who provided support at the organizational level. In general, the interventions were well appreciated, and components seemed to work as intended when delivered as intended. Many office workers experienced improvements in movement behavior and wellbeing and ascribed those to the interventions. Acceptability, feasibility, and fidelity of individual-level components were high but reduced for components depending on team leaders, mainly due to challenges associated with recruiting managers as team leaders and forming teams. Manager and team support were considered crucial for promoting more PA and less SED, yet many participants reported a lack of such support. Thus, identified challenges with these components might have reduced overall intervention efficacy. Paper IV investigated intervention effects on mental health outcomes (symptoms of depression or anxiety, mental wellbeing, and stress). In addition, we explored whether changes in mean PA intensity mediated or moderated intervention effects. The interventions improved mental wellbeing for the combined intervention groups and the iSED group but not for the iPA group compared to the control group. The interventions improved mean PA intensity, but mean PA intensity did not mediate intervention effects on any outcome. Mean PA intensity moderated intervention effects on mental wellbeing. Participants who reduced mean PA intensity reduced mental wellbeing compared to participants who did not change mean PA intensity. This highlights the importance of maintaining high levels of PA for mental wellbeing.

This thesis contributes to existing knowledge by applying a rigorous investigation of cross-sectional associations between 24-h movement behavior and mental health among office workers and by conducting a comprehensive analysis of intervention effects. It offers valuable insights and considerations that may inform occupational health practitioners, employers, policy makers, and researchers and may contribute to developing future effective interventions.

Background: We have previously reported on the design and efficacy of two cluster-randomized multi-level workplace interventions, attempting to decrease sedentary behavior (SED) or increase moderate to vigorous physical activity (MVPA) among office workers to improve mental health outcomes. The aim of this study was to investigate intervention effects on mental health outcomes, i.e., mental wellbeing, depression or anxiety symptoms, and stress immediately after the 6-month intervention period.

Methods: Teams of 263 office workers were cluster-randomized to one of two interventions or a waitlist control group. The PA intervention (iPA) focused on increasing MVPA and the SED intervention (iSED) on reducing SED. Both multi-level interventions targeted individual office workers and their social, physical, and organizational work environment, incorporating counseling based on cognitive behavioral therapy and motivational interviewing. Mental health outcomes were assessed using validated questionnaires before and immediately after the intervention. Intervention effects were analyzed using linear mixed effects models.

Results: Participants were mostly female and highly educated, with a mean age of 42 years and had favorable levels of mental health at baseline. Mental wellbeing improved for the iSED group (β = 8, 95% CI 1 to 15, p = 0.030) but not for the iPA group (β = 6, 95% CI -1 to 12, p = 0.072) compared to the control group. No effects were found for depression or anxiety symptoms or stress.

Conclusions: The multi-level interventions improved mental wellbeing among this population of office workers, reaching statistical significance in the iSED group. The size of the effect can be regarded meaningful, considering favorable mental health and high PA level at baseline. Thus, workplace interventions that provide support on multiple levels appear to have potential for improving mental wellbeing, but not reducing ill-health variables, among healthy office workers. More research is needed to understand the mechanisms through which such improvements can be achieved and to identify the most effective intervention components.

Intervention studies aiming at changing movement behavior have usually not accounted for the compositional nature of time-use data. Compositional data analysis (CoDA) has been suggested as a useful strategy for analyzing such data. The aim of this study was to examine the effects of two multi-component interventions on 24-h movement behavior (using CoDA) and on cardiorespiratory fitness among office workers; one focusing on reducing sedentariness and the other on increasing physical activity. Office workers (n = 263) were cluster randomized into one of two 6-month intervention groups, or a control group. Time spent in sedentary behavior, light-intensity, moderate and vigorous physical activity, and time in bed were assessed using accelerometers and diaries, both for 24 h in total, and for work and leisure time separately. Cardiorespiratory fitness was estimated using a sub-maximal cycle ergometer test. Intervention effects were analyzed using linear mixed models. No intervention effects were found, either for 24-h behaviors in total, or for work and leisure time behaviors separately. Cardiorespiratory fitness did not change significantly. Despite a thorough analysis of 24-h behaviors using CoDA, no intervention effects were found, neither for behaviors in total, nor for work and leisure time behaviors separately. Cardiorespiratory fitness did not change significantly. Although the design of the multi-component interventions was based on theoretical frameworks, and included cognitive behavioral therapy counselling, which has been proven effective in other populations, issues related to implementation of and compliance with some intervention components may have led to the observed lack of intervention effect.

The associations between 24 h movement behavior, i.e., the way people distribute their time in different movement-related behaviors, on mental health are not well understood. This study applied a compositional data analysis approach to explore cross-sectional associations between device-measured moderate to vigorous physical activity (MVPA), light intensity physical activity (LIPA), sedentary behavior (SED), self-reported time in bed and mental health outcomes, i.e., depression or anxiety symptoms, burnout, mental wellbeing and stress, in office workers. ActiGraph accelerometers were worn for 24 h for at least 4 days to assess MVPA, LIPA, and SED. Sleep diaries were used in addition to identify time in bed. Analytic sample sizes for the different outcomes ranged from N = 345-370 participants. In this population of office workers with high levels of MVPA, the entire movement behavior composition was not associated to any of the mental health outcomes, but MVPA relative to all other behaviors was positively associated with mental wellbeing. This confirms the importance of MVPA for health relative to other movement-related behaviors.

Purpose: This embedded qualitative study explored the acceptability, feasibility, and fidelity of two multi-level RCT interventions among office workers, aiming at improving movement behaviour to enhance mental health and cognition. The interventions addressed the organizational, environmental, and individual level.

Methods: Semi-structured interviews and focus group discussions were conducted with 38 stakeholders after completion of the interventions. Data were analysed using reflexive thematic analysis.

Results: The interventions were well appreciated, and office workers attributed improvements in movement behaviour and wellbeing to the interventions. Especially the cognitive behavioural therapy (CBT) based counselling and free gym access were appreciated, feasible and delivered as planned. Participants described existing workplace norms as barriers to more activity, particularly for reducing sitting. Support from managers and team support were considered crucial components. However, delivering these components was difficult.

Conclusions: The findings support the design of the multi-level interventions for changing movement behaviour. Results highlight the potential of CBT for this target group and the importance of manager and team support. Desired effects of similar multi-level interventions, including CBT, might be achieved in future studies that carefully address the issues with feasibility and acceptability and the resulting low fidelity of some intervention components that were identified in this study.

Sammanfattning

Syfte och frågeställningar

Syftet med uppsatsen var att undersöka genom ett test-retest, reliabiliteten hos fem stycken specifika fys- och styrketester för de muskelgrupper, som är mest utsatta i en ambulanssjukvårdares arbete.

- Är det en god reliabilitet i ett bellybacktest utan motstånd?

- Är det en god reliabilitet i ett balanstest?

- Är det en god reliabilitet i ett handstyrketest?

- Är det en god reliabilitet i ett aerobiskt steptest?

- Är det en god reliabilitet i ett marklyft i dragmaskin?

Metod

Ett test och retest utfördes på fem tester, bellybacktest utan motstånd, handstyrketest, aerobiskt steptest, marklyft i drargmaskin och balanstest. Försökspersonerna var 14 stycken, 11 män och 3 kvinnor, samtliga var studenter vid GIH i Stockholm.

Resultat

Varken bellybacktestet utan motstånd, handstyrketestet (höger samt vänster hand), aerobiska steptestet eller marklyftet i dragmaskinen visar några slumpmässiga eller systematiska statistisk signifikanta skillnader. Balanstestet däremot har bra värden på t-testet (p=0,89), som visar att det inte finns några systematiska signifikanta skillnader, men låga värden på övriga uträkningar som visar på de slumpmässiga skillnaderna.

Slutsats

Samtliga tester med undantag från balanstestet har hög reliabilitet. Balanstestet visar mindre tillförlitlighet än de övriga fyra testerna, vilket även tidigare forskning visar. Det är därför vår tanke att bellybacktestet, handstyrketesterna, aerobiska steptestet och marklyftet i dragmaskinen är tester som kan byggas vidare på inom arbetet att testa ambulanssjukvårdare. Balansen är fortfarande en viktig faktor att testa, men ett bättre test är nödvändigt för att få tillförlitliga resultat.

Objective: The purpose of the present study was to examine whether intraindividual changes in physical activity were correlated with intraindividual changes in mental health (depression, anxiety, and burnout) across four measurement time-points over 6 years, both from between-person and within-person perspectives. Methods: Health care workers (N = 3717; mean age = 46.9; SD = 10.0) were the target population in this study, which is part of a larger longitudinal survey that included questionnaires on physical activity levels and mental health (depression, anxiety, and burnout) at four time points across 6 years (2004-2010). Physical activity was assessed with an adapted version of the widely used 1-item, 4-level Saltin Grimby Physical Activity Level Scale (SGPALS). Depression, anxiety, and burnout were assessed using the Hospital Anxiety and Depression (HAD) scale and the Shirom-Melamed Burnout Questionnaire (SMBQ). Bivariate latent growth curve models were used to analyze the associations of change between physical activity and mental health. Results: Baseline levels of physical activity were moderately associated with baseline levels of mental health (rs = -.27 to -.40, ps < .01). Changes in physical activity were moderately to strongly associated (rs = -.57 to -.79, ps <. 01) with change in mental health at the between-person (correlated change) level and significantly, but weakly (rs = -.08 to -.14, ps <.01), associated with change at the within-person (coupled change) level of analysis. Conclusions: Changes in physical activity were associated with, and traveled together with, changes in depression, anxiety, and burnout across time. Changes in physical activity, and not only current or previous levels of activity, may be important to consider in preventive work linked to mental health within this population. (PsycINFO Database Record (c) 2014 APA, all rights reserved).

Aim and questions

The aim of our study was to increase knowledge about successful school managers' views on teachers' mental health and their own work regarding this subject.

• In what ways do the school manager work preventive with measures on teachers' mental health? 
• How does leadership affects teachers' mental health? 
• What factors create mental health among teachers?

Method

In order to answer the questions, we have chosen to use semi-structured interviews. To get in touch with schools that have been successful with their work with the teacher's mental health, we have made a targeted step wise sample where we contacted the primary managers of six randomly selected municipalities in Stockholms län. In total six school managers have been interviewed. The empiric data were thematized and analyzed based on the demand-control-support model.

Results

All the interviewed school managers agreed to that the concept of mental health is about feeling good, about balance in life and to feel safe. A clear, structured organization with clear responsibilities is of importantance for teachers in order to feel that they have control over their situation. A communicative and relationship-oriented leadership and support from both colleagues and school management can help teachers experience that they can master the demands placed on them. This support may include help to prioritize, to pay attention and be accessible as school management. The school managers also believe that to support the teachers´ self-confidence and let them take responsibility can help the teachers feel mentally well.

Conclusions

The school managers have a common view of how they work to make the teachers feel mentally well. The study showed that it is of importance for teachers' mental health, how they are able to respond to the demands placed on them. A clear organization and clear responsibilities increase the feeling of control. The managers have reflected much up on leadership and their way of organizing the school management. They have different strategies and approaches of how to show their support to the teachers, from supporting their self- confidence to showing them general appreciation.

Aim and questions: The aim of this survey was to study how the employees experienced their health, their work capacity, frequencies of injuries as well as exercise habits. The questions in the research were: How do different individuals experience health and working conditions in different professional areas within the same company? Could factors like exercise habits affect the physical work capacity within different professional areas?

Could smoking be a factor influencing how we experience health and exercise habits?

Method: The collection of data was performed by questionnaires, pedometer measuring and a step test for calculation of oxygen consumption. The survey included 48 persons from three different areas of work: administration, shop and restaurant. The group consisted of 31 women and 17 men between the ages of 19 to 63 years; the average age was 38 ± 14 years. In the pedometer testing there was a loss of five persons and in the step test there was a total loss of 11 persons.

Results: The participants declared that they experienced an important amount of joy/happiness, control/influence, and meaningfulness in their work. They valued their experienced health as fairly satisfactory or greater. Experienced physical performance and meeting the job requirements were relatively high estimated within all three areas of work. Within the administrative department the job was mostly sedentary. Test persons in the shop and the restaurant were more active which was confirmed by the pedometer testing and their work involved more lifting of things. The body bent forward or the back/neck twisted or flexed during work positions was occurring in all the studied areas. Seven persons described symptoms from back/hips and 12 persons described symptoms from neck/shoulders on a daily basis. On a total 12 persons said they were smokers, out of those, eight persons worked in the shop. The average test result of oxygen consumption during 37 step tests performed was 40 ± 6 ml/kg/min for women and 40 ± 5 ml/kg/min for men.

Conclusion: Within the three areas of work the test persons experienced a rather similar degree of health and physical capacity in spite of large differences in work conditions.

The prevalence of symptoms could not specifically be connected to any area of work.

Nevertheless there is a risk that the test persons working in the shop and the restaurant will show symptoms in the future predominantly from neck/ shoulders and back/hips.

Notwithstanding the fact that the pedometer measuring showed that people working in the shop and the restaurant walk almost twice as much as those within administration, the oxygen consumption is barely affected by a more active work situation. There is a probability that it requires a regular and higher level of physical activity in order to receive positive effects on a person's fitness status. The submaximal fitness test in this study does not provide a reliable conception of fitness status of the tested persons since they were too few. This study showed an obvious connection between smoking and low physical activity

OBJECTIVE: To investigate whether psychosocial work environment and health behaviors are risk factors for sick leave due to mental disorders, and whether familial confounding (genetics and shared environment) explains the associations.

METHODS: Respondents (n = 11,729), given to complete a questionnaire in 2004 to 2006, were followed up approximately 5 years for sick leave spells due to mental disorders, using national registry data. Data were analyzed using logistic regression, and conditional logistic regression for twin pairs discordant for sick leave (cotwin control).

RESULTS: High job demands, job strain, and iso-strain were independent risk factors for sick leave due to mental disorders. Familial factors seem to be of importance in the associations between job support, smoking, a combination of unhealthy behaviors and sick leave.

CONCLUSIONS: Improving the psychosocial work environment may be effective in preventing sick leave due to mental disorders.

Objectives: Aerobic exercise influence cognition in elderly, children, and neuropsychiatric populations. Less is known about the influence of aerobic exercise in healthy samples (particularly working age), and of different fitness levels on cognition. Two hypotheses were posed: 1) low fitness levels, compared to moderate and high, will be related to poorer cognitive performance, and 2) breakpoints for the beneficial relationship between VO2 and cognition will be observed within the moderate-to-high fitness span. Design and Methods: The sample consisted of n=362 office workers. A submaximal cycle ergometer test estimated maximal oxygen consumption (VO2max, mL•kg-1•min-1). Based on estimated VO2max participants were split into tertiles; low (n=121), moderate (n=119), and high (n=122). A cognitive test battery (9 tests), assessed processing speed, working memory, executive functions and episodic memory. Results: Both hypotheses were confirmed. Groups of moderate (≈40) and high (≈49) fitness outperformed the group of low (≈31) fitness for inhibition and episodic recognition, whereas no significant differences between moderate and high fitness were observed (ANCOVAs). Breakpoints between benefits fromVO2max for inhibition and recognition were estimated to ≈44/43 mL•kg-1•min-1 (multivariate broken line regressions). Conclusions: Results suggest that it is conceivable to expect a beneficial relationship between VO2max and some cognitive domains up to a certain fitness level. In a sample of healthy office workers, this level was estimated to 44 mL•kg-1•min-1. This has implications on organizational and societal levels; where incentives to improve fitness levels from low to moderate could yield desirable cognitive and health benefits in adults.

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.

Work metabolism (WM) can be accurately estimated by oxygen consumption (VO₂), which is commonly assessed by heart rate (HR) in field studies. However, the VO₂-HR relationship is influenced by individual capacity and activity characteristics. The purpose of this study was to evaluate three models for estimating WM compared with indirect calorimetry, during simulated work activities. The techniques were: the HR-Flex model; HR branched model, combining HR with hip-worn accelerometers (ACC); and HR + arm-leg ACC model, combining HR with wrist- and thigh-worn ACC. Twelve participants performed five simulated work activities and three submaximal tests. The HR + arm-leg ACC model had the overall best performance with limits of agreement (LoA) of -3.94 and 2.00 mL/min/kg, while the HR-Flex model had -5.01 and 5.36 mL/min/kg and the branched model, -6.71 and 1.52 mL/min/kg. In conclusion, the HR + arm-leg ACC model should, when feasible, be preferred in wearable systems for WM estimation. Practitioner Summary: Work with high energy demand can impair employees' health and life quality. Three models were evaluated for estimating work metabolism during simulated tasks. The model combining heart rate, wrist- and thigh-worn accelerometers showed the best accuracy. This is, when feasible, suggested for wearable systems to assess work metabolism.