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  • 1.
    Bergström, Göran
    et al.
    Göteborgs universitet.
    Börjesson, Mats
    Gymnastik- och idrottshögskolan, GIH, Institutionen för idrotts- och hälsovetenskap, Åstrandlaboratoriet, Björn Ekbloms och Mats Börjessons forskningsgrupp.
    Schmidt, Caroline
    Göteborgs universitet.
    Self-efficacy regarding physical activity is superior to self-assessed activity level, in long-term prediction of cardiovascular events in middle-aged men2015Ingår i: BMC Public Health, ISSN 1471-2458, E-ISSN 1471-2458, Vol. 15, artikel-id 820Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background

    Self-efficacy has been determined to be a strong predictor of who will engage in physical activity. We aimed to evaluate the associations between self-efficacy to perform physical activity, self-reported leisure-time physical activity and cardiovascular events in a population-based cohort of middle-aged Swedish men with no previous cardiovascular disease, or treatment with cardiovascular drugs.

    Methods

    Analyses are based on 377 men randomly selected and stratified for weight and insulin sensitivity from a population sample of 58-year-old men (n = 1728) and who had answered a question about their competence to perform exercise (as an assessment of physical self-efficacy). The Saltin-Grimby Physical Activity Level Scale was used to assess self-reported levels of leisure-time physical activity. Cardiovascular events were recorded during 13-years of follow-up.

    Results

    The group with poor self-efficacy to perform physical activity had a significantly higher incidence of cardiovascular events compared with the group with good physical self-efficacy (32.1 % vs 17.1 %, p < 0.01). Multivariate analyses showed that poor physical self-efficacy was associated with an increased relative risk of 2.0 (95 % CI 1.2 to 3.0), of having a cardiovascular event during follow-up also after adjustments for co-variates such as waist to hip ratio, heart rate, fasting plasma glucose, serum triglycerides, systolic blood pressure, apoB/apoA-I ratio and leisure-time physical activity.

    Conclusion

    Self-efficacy to perform physical activity was strongly and independently associated with cardiovascular events and was superior to self-assessed physical activity in predicting cardiovascular events during 13-years of follow-up in a group of middle-aged men, without known CVD or treatment with cardiovascular drugs.

  • 2.
    Ekblom, Örjan
    et al.
    Gymnastik- och idrottshögskolan, GIH, Institutionen för idrotts- och hälsovetenskap, Åstrandlaboratoriet, Björn Ekbloms forskningsgrupp.
    Ekblom-Bak, Elin
    Gymnastik- och idrottshögskolan, GIH, Institutionen för idrotts- och hälsovetenskap, Åstrandlaboratoriet, Björn Ekbloms forskningsgrupp.
    Bolam, Kate A
    Gymnastik- och idrottshögskolan, GIH, Institutionen för idrotts- och hälsovetenskap, Åstrandlaboratoriet, Björn Ekbloms forskningsgrupp.
    Ekblom, Björn
    Gymnastik- och idrottshögskolan, GIH, Institutionen för idrotts- och hälsovetenskap, Åstrandlaboratoriet, Björn Ekbloms forskningsgrupp.
    Schmidt, Caroline
    Söderberg, Caroline
    Bergström, Göran
    Börjesson, Mats
    Gymnastik- och idrottshögskolan, GIH, Institutionen för idrotts- och hälsovetenskap, Åstrandlaboratoriet, Björn Ekbloms forskningsgrupp.
    Concurrent and predictive validity of physical activity measurement items commonly used in clinical settings- data from SCAPIS pilot study.2015Ingår i: BMC Public Health, ISSN 1471-2458, E-ISSN 1471-2458, Vol. 15, artikel-id 978Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    BACKGROUND:

    As the understanding of how different aspects of the physical activity (PA) pattern relate to health and disease, proper assessment is increasingly important. In clinical care, self-reports are the most commonly used assessment technique. However, systematic comparisons between questions regarding concurrent or criterion validity are rare, as are measures of predictive validity. The aim of the study was to examine the concurrent (using accelerometry as reference) and predictive validity (for metabolic syndrome) of five PA questions.

    METHODS:

    A sample of 948 middle-aged Swedish men and women reported their PA patterns via five different questions and wore an accelerometer (Actigraph GT3X) for a minimum of 4 days. Concurrent validity was assessed as correlations and ROC-analyses. Predictive validity was assessed using logistic regression, controlling for potential confounders.

    RESULTS:

    Concurrent validity was low-to-moderate (r <0.35 and ROC AUC <0.7) with large misclassifications regarding time spent sitting/sedentary and in moderate-to vigorous PA. The predictive validity of the questions was good, and one question (PHAS) showed an 80 % decreased odds-ratio of having metabolic syndrome, after taking potential confounders into consideration.

    DISCUSSION:

    In this mixed sample of adults, both concurrent and predictive validity vaired between items and between measures of the physical activity pattern. The PHAS and WALK items are proposed for assessment of adherence to PA recommendations.

    CONCLUSION:

    Assessing PA patterns using self-report measures results in methodological problems when trying to predict individual risk for the metabolic syndrome, as the concurrent validity generally was low. However, several of the investigated questions may be useful for assessing risk at a group level, showing better predictive validity.

  • 3.
    Larsson, Kristina
    et al.
    Gymnastik- och idrottshögskolan, GIH, Institutionen för idrotts- och hälsovetenskap.
    Kallings, Lena
    Gymnastik- och idrottshögskolan, GIH, Institutionen för idrotts- och hälsovetenskap, Åstrandlaboratoriet.
    Ekblom, Örjan
    Gymnastik- och idrottshögskolan, GIH, Institutionen för idrotts- och hälsovetenskap, Åstrandlaboratoriet.
    Blom, Victoria
    Gymnastik- och idrottshögskolan, GIH, Institutionen för idrotts- och hälsovetenskap, Forskningsgruppen för idrottspsykologi.
    Andersson, Eva
    Gymnastik- och idrottshögskolan, GIH, Institutionen för idrotts- och hälsovetenskap, Laboratoriet för biomekanik och motorisk kontroll (BMC).
    Ekblom, Maria
    Gymnastik- och idrottshögskolan, GIH, Institutionen för idrotts- och hälsovetenskap, Laboratoriet för biomekanik och motorisk kontroll (BMC).
    Criterion validity and test-retest reliability of SED-GIH, a single item question for assessment of daily sitting time.2019Ingår i: BMC Public Health, ISSN 1471-2458, E-ISSN 1471-2458, Vol. 19, nr 1, artikel-id 19:17Artikel i tidskrift (Refereegranskat)
    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.

  • 4.
    Nooijen, Carla F J
    et al.
    Gymnastik- och idrottshögskolan, GIH, Institutionen för idrotts- och hälsovetenskap.
    Blom, Victoria
    Gymnastik- och idrottshögskolan, GIH, Institutionen för idrotts- och hälsovetenskap, Forskningsgruppen för idrottspsykologi.
    Ekblom, Örjan
    Gymnastik- och idrottshögskolan, GIH, Institutionen för idrotts- och hälsovetenskap, Åstrandlaboratoriet.
    Ekblom, Maria
    Gymnastik- och idrottshögskolan, GIH, Institutionen för idrotts- och hälsovetenskap, Laboratoriet för biomekanik och motorisk kontroll (BMC).
    Kallings, Lena
    Gymnastik- och idrottshögskolan, GIH, Institutionen för idrotts- och hälsovetenskap, Åstrandlaboratoriet.
    Improving office workers' mental health and cognition: a 3-arm cluster randomized controlled trial targeting physical activity and sedentary behavior in multi-component interventions2019Ingår i: BMC Public Health, ISSN 1471-2458, E-ISSN 1471-2458, Vol. 19, artikel-id 266Artikel i tidskrift (Refereegranskat)
    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.

  • 5.
    Olsson, Sven Johan Gustav
    et al.
    Gymnastik- och idrottshögskolan, GIH, Institutionen för idrotts- och hälsovetenskap, Åstrandlaboratoriet, Björn Ekbloms forskningsgrupp.
    Börjesson, Mats
    Gymnastik- och idrottshögskolan, GIH, Institutionen för idrotts- och hälsovetenskap, Åstrandlaboratoriet, Björn Ekbloms forskningsgrupp.
    Ekblom Bak, Elin
    Gymnastik- och idrottshögskolan, GIH, Institutionen för idrotts- och hälsovetenskap, Åstrandlaboratoriet, Björn Ekbloms forskningsgrupp.
    Hemmingsson, Erik
    Karolinska Institutet.
    Hellénius, Mai-Lis
    Karolinska Institutet.
    Kallings, Lena
    Gymnastik- och idrottshögskolan, GIH, Institutionen för idrotts- och hälsovetenskap, Åstrandlaboratoriet, Björn Ekbloms forskningsgrupp.
    Effects of the Swedish physical activity on prescription model on health-related quality of life in overweight older adults: a randomised controlled trial2015Ingår i: BMC Public Health, ISSN 1471-2458, E-ISSN 1471-2458, Vol. 15, artikel-id 687Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background

    The effects of physical activity on prescription (PAP) on health-related quality of life (HRQoL) in overweight adults are unclear. We therefore aimed to explore the effects of the Swedish PAP model on HRQoL in overweight older adults.

    Methods

    Participants were recruited from a cohort of men and women born between 1937 and 1938, and living in Stockholm County. Inclusion criteria were; insufficiently physically active, i.e. <30 min of at least moderate intensity physical activity (PA) per day; body mass index >25 kg/m 2 ; and waist circumference ≥102 cm (men) or ≥88 cm (women). Altogether, 101 individuals, aged 67 years, were randomly assigned to two parallel groups: intervention group (n = 47) receiving individualised PAP or control group (n = 54). The 36-item Short Form Health Survey (SF-36) was administered before and after the six months intervention. Main outcomes were the SF-36 physical component summary (PCS) and mental component summary (MCS) scores. Intention to treat analysis was utilised. Regression analysis was performed to assess whether changes in PA and body weight affected changes in HRQoL.

    Results

    At the six months follow-up, regarding the MCS score, the intervention group had improved significantly more (median: 4.4 [interquartile range (IQR): −2.4 to 23.3]) vs (median: 0.0 [IQR: −4.0 to 4.9]); p < 0.05) and a higher proportion of participants had attained relevant improvements (OR 2.43 (95 % CI 1.00–5.88) p < 0.05) compared to the controls. A within group improvement in the PCS score (median: 3.8 [IQR: −1.9 to 19.5] p < 0.05) was found in the intervention group. Changes in PA and body weight had a small, but significant, mediating effect on the changes in HRQoL.

    Conclusions

    PAP had a positive effect on HRQoL, measured by the SF-36 MCS, but no significant between group effect was seen on the PCS in overweight older adults. These effects were, to some extent, mediated by changes in PA and body weight. Our findings support clinical use of the Swedish PAP model.

    Trial registration

    ClinicalTrials.gov NCT02320760.

  • 6. Rödjer, Lars
    et al.
    Jonsdottir, Ingibjörg H
    Rosengren, Annika
    Björck, Lena
    Grimby, Gunnar
    Thelle, Dag S
    Lappas, Georgios
    Börjesson, Mats
    Gymnastik- och idrottshögskolan, GIH, Institutionen för idrotts- och hälsovetenskap.
    Self-reported leisure time physical activity: a useful assessment tool in everyday health care.2012Ingår i: BMC Public Health, ISSN 1471-2458, E-ISSN 1471-2458, Vol. 12, nr 1, s. 693-Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    BACKGROUND: The individual physical activity level is an independent risk factor for cardiovascular disease and death, as well as a possible target for improving health outcome. However, today's widely adopted risk score charts, typically do not include the level of physical activity. There is a need for a simple risk assessment tool, which includes a reliable assessment of the level of physical activity. The aim of this study was therefore, to analyse the association between the self-reported levels of physical activity, according to the Saltin-Grimby Physical Activity Level Scale (SGPALS) questionnaire, and cardiovascular risk factors, specifically focusing on the group of individuals with the lowest level of self-reported PA.

    METHODS: We used cross sectional data from the Intergene study, a random sample of inhabitants from the western part of Sweden, totalling 3588 (1685 men and 1903 women, mean age 52 and 51). Metabolic measurements, including serum-cholesterol, serum-triglycerides, fasting plasma-glucose, waist circumference, blood pressure and resting heart rate, as well as smoking and self-reported stress were related to the self-reported physical activity level, according to the modernized version of the SGPALS 4-level scale.

    RESULTS: There was a strong negative association between the self-reported physical activity level, and smoking, weight, waist circumference, resting heart rate, as well as to the levels of fasting plasma-glucose, serum-triglycerides, low-density lipoproteins (LDL), and self-reported stress and a positive association with the levels of high-density lipoproteins (HDL). The individuals reporting the lowest level of PA (SGPALS, level 1) had the highest odds-ratios (OR) for having pre-defined levels of abnormal risk factors, such as being overweight (men OR 2.19, 95% CI: 1.51-3.19; women OR 2.57, 95 % CI: 1.78-3.73), having an increased waist circumference (men OR 3.76, 95 % CI: 2.61-5.43; women OR 2.91, 95% CI: 1.94-4.35) and for reporting stress (men OR 3.59, 95 % CI: 2.34-5.49; women OR 1.25, 95% CI: 0.79-1.98), compared to the most active individuals, but also showed increased OR for most other risk factors analyzed above.

    CONCLUSION: The self-reported PA-level according to the modernized Saltin-Grimby Physical Activity Level Scale, SGPALS, is associated with the presence of many cardiovascular risk factors, with the most inactive individuals having the highest risk factor profile, including self-reported stress. We propose that the present SGPALS may be used as an additional, simple tool in a routine risk assessment in e.g. primary care, to identify inactive individuals, with a higher risk profile.

  • 7.
    Wahlgren, Lina
    et al.
    Gymnastik- och idrottshögskolan, GIH, Institutionen för idrotts- och hälsovetenskap, Åstrandlaboratoriet, FoU-gruppen för rörelse, hälsa och miljö.
    Schantz, Peter
    Gymnastik- och idrottshögskolan, GIH, Institutionen för idrotts- och hälsovetenskap, Åstrandlaboratoriet, FoU-gruppen för rörelse, hälsa och miljö.
    Exploring bikeability in a metropolitan setting: stimulating and hindering factors in commuting route environments2012Ingår i: BMC Public Health, ISSN 1471-2458, E-ISSN 1471-2458, Vol. 12, nr 168Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background

    Route environments may influence people’s active commuting positively and thereby contribute to public health. Assessments of route environments are, however, needed in order to better understand the possible relationship between active commuting and the route environment. The aim of this study was, therefore, to assess the potential associations between perceptions of whether the route environment on the whole hinders or stimulates bicycle commuting and perceptions of environmental factors.

    Methods

    The Active Commuting Route Environment Scale (ACRES) was used for the assessment of bicycle commuters’ perceptions of their route environments in the inner urban parts of Greater Stockholm, Sweden. Bicycle commuters (n = 827) were recruited by advertisements in newspapers. Simultaneous multiple regression analyses were used to assess the relation between predictor variables (such as levels of exhaust fumes, noise, traffic speed, traffic congestion and greenery) and the outcome variable (hindering – stimulating route environments). Two models were run, (Model 1) without and (Model 2) with the item traffic: unsafe or safe included as a predictor.

    Results

    Overall, about 40% of the variance of hindering – stimulating route environments was explained by the environmental predictors in our models (Model 1, = 0.415, and Model 2, = 0.435). The regression equation for Model 1 was: y = 8.53 + 0.33 ugly or beautiful + 0.14 greenery + (−0.14) course of the route + (−0.13) exhaust fumes + (−0.09) congestion: all types of vehicles (p ≤ 0.019). The regression equation for Model 2 was y = 6.55 + 0.31 ugly or beautiful + 0.16 traffic: unsafe or safe + (−0.13) exhaust fumes + 0.12 greenery + (−0.12) course of the route (p ≤ 0.001).

    Conclusions

    The main results indicate that beautiful, green and safe route environments seem to be, independently of each other, stimulating factors for bicycle commuting in inner urban areas. On the other hand, exhaust fumes, traffic congestion and low ‘directness’ of the route seem to be hindering factors. Furthermore, the overall results illustrate the complexity of a research area at the beginning of exploration.

  • 8.
    Wallman-Sperlich, Birgit
    et al.
    Institute of Health Promotion and Clinical Movement Science, German Sports University Cologne, Germany.
    Buksch, Jens
    WHO Collaborating Centre for Child and Adolescent Health Promotion, School of Public Health, Bielefeld University, Germany.
    Hansen, Sylvia
    Faculty of Health, Medicine and Life Sciences, Maastricht University, The Netherlands.
    Schantz, Peter
    Gymnastik- och idrottshögskolan, GIH, Institutionen för idrotts- och hälsovetenskap, FoU-gruppen för rörelse, hälsa och miljö.
    Froboese, Ingo
    Institute of Health Promotion and Clinical Movement Science, German Sports University Cologne, Germany.
    Sitting Time in Germany: An Analysis of Socio-demographic and Environmental Correlates2013Ingår i: BMC Public Health, ISSN 1471-2458, E-ISSN 1471-2458, Vol. 196, nr 13Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background: Sedentary behaviour in general and sitting time in particular is an emerging global health concern. The aim of this study was to provide data on the prevalence of sitting time in German adults and to examine socio-demographic and environmental correlates of sitting time.

    Methods: A representative sample of German adjults (n = 2000; 967 men, 1033 women; 49.3 ±17.6 years of age) filled in the Global Physical Activity Questionnaire, including one question on overall sitting time and answered questions about the neighbourhood environment, as well as concerning demographics. Daily sitting time was stratified by gender, age group, BMI, educational and income level, as well as physical activity (PA). To identify socio-demographic and environmental correlates of sitting time, we used a series of linear regressions.

    Results: The overall median was 5 hours (299 minutes) of sitting time/day and men sat longer than women (5 vs. 4 hours/day; p < 0.05). In both genders age and PA were negatively and the educational level positively associated with sitting time. The level of income was not a correlate of sitting time in multivariate analyses. Sitting time was significantly positively associated with higher neighbourhood safety for women. The variance ranged from 16.5% for men to 8.9% for women.

    Conclusions: The overall sitting time was unequally distributed in the German adult population. Our findings suggest implementing specific interventions to reduce sitting time for subgroups such as men, younger aged adults and adults with a higher education and lower PA. Future studies should enhance our understanding of the specific correlates of different types and domains of sitting in order to guide the development of effective public health strategies.

     

     

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