Gymnastik- och idrottshögskolan, GIH

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  • 1.
    Aronsson, Gunnar
    et al.
    Stockholms universitet.
    Blom, Victoria
    Stockholms universitet.
    Work conditions for workers with good long-term health2010In: International Journal of Workplace Health Management, ISSN 1753-8351, E-ISSN 1753-836X, Vol. 3, p. 160-172Article in journal (Refereed)
  • 2.
    Blom, Victoria
    Stockholms universitet.
    Contingent self-esteem, stressors and burnout in working women and men.2012In: Work: A journal of Prevention, Assessment and rehabilitation, ISSN 1051-9815, E-ISSN 1875-9270, Vol. 43, no 2, p. 123-131Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE:

    A high work involvement is considered central in the burnout process. Yet, research investigating how high work involvement and psychosocial stressors relate to burnout is scarce. High involvement in terms of performance-based self-esteem (PBSE) refers to individuals' strivings to validate self-worth by achievements, a disposition linked to poor health. The aim of the present study was to examine longitudinally PBSE in relation to burnout while also taking into account work- and private life stressors.

    PARTICIPANTS:

    The sample consisted of 2121 working women and men.

    METHODS:

    Main- and mediation effects were investigated using hierarchical regression analysis.

    RESULTS:

    The results showed performance-based self-esteem mediated partially between the stressors and burnout. Performance-based self-esteem was the strongest predictor of burnout over time, followed by private life stressors. Women experienced more work stress than did men. Men had stronger associations between work stressors and burnout, while women had stronger associations between performance-based self-esteem and burnout.

    CONCLUSIONS:

    Individual characteristics along with both private life and work stressors are important predictors of burnout. Factors associated with burnout differ somewhat between women and men.

  • 3.
    Blom, Victoria
    Stockholms universitet.
    Striving for self-esteem: Conceptualizations and role in burnout2011Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    When self-esteem is dependent on competence individuals invest a great deal of effort in their accomplishments in order to validate themselves. The aim of the present thesis was to develop a theoretically sound and valid concept and measure of contingent self-esteem dependent on competence, and examine its vulnerable implications and role in burnout. In Study I a concept and measure of contingent self-esteem dependent on competence, termed competence-based self-esteem (CBSE), was developed. Confirmatory factor analyses showed its distinctiveness from other sources of self-esteem and revealed two dimensions comprising behaviors referring to: i) Self-esteem conditional upon competence and ii) Frustrated self-critical strivings. The new scale showed high reliability and gained both convergent and discriminative validity through different methods in different samples. Study II set out to experimentally test the vulnerable implications of CBSE in a performance situation. The results showed that high, as compared to low, scorers on the scale exhibited stronger physiological reactivity and momentary exertion coupled with frustrated mood. Study III focused on the role of self-esteem contingent on competence in the burnout process and its association with work- and private-life stressors over time in working women and men. The analyses showed that contingent self-esteem was a predictor of burnout. In addition, women scored higher on both contingent self-esteem and burnout and reported higher general life stress than did men, whereas men showed stronger associations between work stressors and burnout. The results of the three studies suggest that contingent self-esteem, where outcomes of one’s acts and performance serve to compensate an impoverished basic self-worth, facilitates the understanding of stress-related vulnerability and ill-health.

  • 4.
    Blom, Victoria
    et al.
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences, Sport Psychology research group. Karolinska Insitutet.
    Bergström, Gunnar
    Karolinska institutet.
    Hallsten, Lennart
    Karolinska Institutet.
    Bodin, Lennart
    Karolinska Institutet.
    Svedberg, Pia
    Karolinska Institutet.
    Genetic susceptibility to burnout in a Swedish twin cohort.2012In: European Journal of Epidemiology, ISSN 0393-2990, E-ISSN 1573-7284, Vol. 27, p. 225-231Article in journal (Refereed)
    Abstract [en]

    Most previous studies of burnout have focused on work environmental stressors, while familial factors so far mainly have been overlooked. The aim of the study was to estimate the relative importance of genetic influences on burnout (measured with Pines Burnout Measure) in a sample of monozygotic (MZ) and dizygotic (DZ) Swedish twins. The study sample consisted of 20,286 individuals, born 1959–1986 from the Swedish twin registry who participated in the cross-sectional study of twin adults: genes and environment. Probandwise concordance rates (the risk for one twin to be affected given that his/her twin partner is affected by burnout) and within pair correlations were calculated for MZ and DZ same—and opposite sexed twin pairs. Heritability coefficients i.e. the proportion of the total variance attributable to genetic factors were calculated using standard biometrical model fitting procedures. The results showed that genetic factors explained 33% of the individual differences in burnout symptoms in women and men. Environmental factors explained a substantial part of the variation as well and are thus important to address in rehabilitation and prevention efforts to combat burnout.

  • 5.
    Blom, Victoria
    et al.
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences, Sport Psychology research group.
    Bodin, Lennart
    Bergström, Gunnar
    Hallsten, Lennart
    Svedberg, Pia
    The Importance of Genetic and Shared Environmental Factors for the Associations between Job Demands, Control, Support and Burnout.2013In: PloS one, ISSN 1932-6203, Vol. 8, no 9, p. e75387-Article in journal (Refereed)
    Abstract [en]

    Within occupational health research, one of the most influential models is the Job Demands-Control-Support model. Numerous studies have applied the model to different domains, with both physical and psychological health outcomes, such as burnout. The twin design provides a unique and powerful research methodology for examining the effects of environmental risk factors on burnout while taking familial factors (genetic and shared environment) into account. The aim of the present study was to investigate the impact of familial factors on the associations of burnout with job demands, control and support. A total of 14 516 individuals from the Swedish Twin Registry, who were born between 1959 and 1986, and who participated in the Study of Twin Adults: Genes and Environment (STAGE) by responding to a web-based questionnaire in 2005, were included in the analyses. Of these, there were 5108 individuals in complete same-sex twin pairs. Co-twin control analyses were performed using linear mixed modeling, comparing between-pairs effects and within-pair effects, stratified also by zygosity and sex. The results indicate that familial factors are of importance in the association between support and burnout in both women and men, but not between job demands and burnout. There are also tendencies towards familial factors being involved in the association between control and burnout in men. These results offer increased understanding of the mechanisms involved in the associations between work stress and burnout.

  • 6.
    Blom, Victoria
    et al.
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences, Sport Psychology research group.
    Bodin, Lennart
    Bergström, Gunnar
    Svedberg, Pia
    Applying the demand-control-support model on burnout in managers and non-managers.2016In: International Journal of Workplace Health Management, ISSN 1753-8351, E-ISSN 1753-836X, Vol. 9, no 1, p. 110-122Article in journal (Refereed)
    Abstract [en]

    Purpose – The purpose of this paper is to study the demand-control-support (DCS) model on burnout in male and female managers and non-managers, taking into account genetic and shared family environmental factors, contributing to the understanding of mechanisms of how and when work stress is related to burnout. Design/methodology/approach – A total of 5,510 individuals in complete same-sex twin pairs from the Swedish Twin Registry were included in the analyses. Co-twin control analyses were performed using linear mixed modeling, comparing between-pairs and within-pair effects, stratified by zygosity and sex. Findings – Managers scored higher on demands and control in their work than non-managers, and female managers seem to be particularly at risk for burnout facing more demands which are not reduced by a higher control as in their male counterparts. Co-twin analyses showed that associations between control and burnout as well as between demands and burnout seem to be affected by shared family environmental factors in male non-managers but not in male managers in which instead the associations between social support and burnout seem to be influenced by shared family environment. Practical implications – Taken together, the study offers knowledge that shared environment as well as sex and managerial status are important factors to consider in how DCS is associated to exhaustion. Originality/value – Using twin data with possibilities to control for genetics, shared environment, sex and age, this study offers unique insight into the DCS research, which focusses primarily on the workplace environment rather than individual factors.

  • 7.
    Blom, Victoria
    et al.
    Swedish School of Sport and Health Sciences, GIH, Department of Physical Activity and Health. Karolinska institutet, Stockholm, Sweden ; Stockholm University, Sweden.
    Drake, Emma
    Swedish School of Sport and Health Sciences, GIH, Department of Physical Activity and Health.
    Kallings, Lena
    Swedish School of Sport and Health Sciences, GIH, Department of Physical Activity and Health.
    Ekblom, Maria
    Swedish School of Sport and Health Sciences, GIH, Department of Physical Activity and Health.
    Nooijen, Carla F J
    Swedish School of Sport and Health Sciences, GIH, Department of Physical Activity and Health.
    The effects on self-efficacy, motivation and perceived barriers of an intervention targeting physical activity and sedentary behaviours in office workers: a cluster randomized control trial.2021In: BMC Public Health, E-ISSN 1471-2458, Vol. 21, no 1, article id 1048Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: The importance of physical activity on health is clear, but changing behaviour is difficult. Successful interventions aiming to improve physical activity and reduce sedentary behaviour is therefore of importance. The aim of this study was to evaluate effects on motivation, self-efficacy and barriers to change behaviour from two different behavioural intervention focusing either on reducing sedentary behaviour or on increasing physical activity as compared to a waiting list control group.

    METHODS: The study was designed as a cluster randomized control trial (RCT) within two private companies. Self-efficacy, motivation and perceived barriers were together with demographic variables assessed before and after a 6-month intervention. Participant cluster teams were randomly allocated to either the physical activity intervention (iPA), the sedentary behaviour intervention (iSED), or control group. The intervention was multi componential and included motivational counselling based on Cognitive behaviour therapy and Motivational interviewing, group activities and management involvement. Group differences were determined using Bayesian multilevel modelling (parameter estimate; credible interval (CI)), analysing complete cases and those who adhered to the protocol by adhering to at least 3 out of 5 intervention sessions.

    RESULTS: After the intervention, the complete cases analysis showed that the iPA group had significantly higher autonomous motivation (0.33, CI: 0.05-0.61) and controlled motivation (0.27, CI: 0.04-0.51) for physical activity compared with the control group. The iSED group scored less autonomous and controlled motivation compared to the iPA group (0.38, CI: - 0.69- -0.087 respectively - 0.32, CI: - 0.57-0.07) but no significant differences compared with the control group. Among individuals that adhered to the protocol, the results showed higher scores on Exercise (3.03, CI: 0.28-6.02) and Sedentary self-efficacy (3.59, CI: 0.35-7.15) for individuals in the iPA group and on Sedentary self-efficacy (4.77, CI: 0.59-9.44) for the iSED group compared to the control group.

    CONCLUSION: These findings indicate that the interventions were successful in increasing self-efficacy in each intervention group and autonomous motivation for exercise in the iPA group, in particular when actively participating in the motivational counselling sessions.

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  • 8.
    Blom, Victoria
    et al.
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences, Sport Psychology research group. Karolinska institutet.
    Kallings, Lena
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences, Åstrand Laboratory of Work Physiology.
    Ekblom, Björn
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences, Åstrand Laboratory of Work Physiology, Björn Ekblom's research group.
    Wallin, Peter
    HPI Health Profile Institute AB, Stockholm, Sweden.
    Andersson, Gunnar
    HPI Health Profile Institute AB, Stockholm, Sweden.
    Hemmingsson, Erik
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences.
    Ekblom, Örjan
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences, Åstrand Laboratory of Work Physiology.
    Söderling, Jonas
    Karolinska institutet.
    Ekblom Bak, Elin
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences, Åstrand Laboratory of Work Physiology.
    Self-Reported General Health, Overall and Work-Related Stress, Loneliness, and Sleeping Problems in 335,625 Swedish Adults from 2000 to 2016.2020In: International Journal of Environmental Research and Public Health, ISSN 1661-7827, E-ISSN 1660-4601, Vol. 17, no 2, article id E511Article in journal (Refereed)
    Abstract [en]

    The prevalence of poor health, in particular stress-related mental ill-health, is increasing over time and birth cohorts. As rapid societal changes have occurred in the last decade and still are occurring, there is an interest in investigating the trends in health-related factors. The aim of the present study was to investigate trends in self-reported general health, overall stress, work-related stress, feelings of loneliness, and sleeping problems in 335,625 Swedish adults across categories of gender, geographic regions, length of education, and age from 2000 to 2016. On population level, sleeping problems and poor general health have increased markedly and significantly, while experiences of work stress decreased between 2000 and 2016 (p < 0.05). Overall stress and level of loneliness were unchanged (p > 0.05). The risk of having ≥3 symptoms (any of poor or very poor general health, often or very often perceived overall stress, loneliness, or sleeping problems) has increased significantly from 2000 to 2016 (ß = 1034 (1027-1040)). This increase was significantly higher in young (ß = 1052 (1038-1065)) and individuals with lower education (ß = 1056 (1037-1076)) compared to older and high length of education.

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  • 9.
    Blom, Victoria
    et al.
    Swedish School of Sport and Health Sciences, GIH, Department of Physical Activity and Health.
    Lönn, Amanda
    Swedish School of Sport and Health Sciences, GIH, Department of Physical Activity and Health. Karolinska University Hospital, Solna, Sweden.
    Ekblom, Björn
    Swedish School of Sport and Health Sciences, GIH, Department of Physiology, Nutrition and Biomechanics.
    Kallings, Lena
    Swedish School of Sport and Health Sciences, GIH, Department of Physical Activity and Health.
    Väisänen, Daniel
    Swedish School of Sport and Health Sciences, GIH, Department of Physical Activity and Health.
    Hemmingsson, Erik
    Swedish School of Sport and Health Sciences, GIH, Department of Physical Activity and Health.
    Andersson, Gunnar
    HPI Health Profile Institute, Danderyd, Sweden.
    Wallin, Peter
    HPI Health Profile Institute, Danderyd, Sweden.
    Stenling, Andreas
    Umeå University, Umeå, Sweden; University of Agder, Kristiansand, Norway.
    Ekblom, Örjan
    Swedish School of Sport and Health Sciences, GIH, Department of Physical Activity and Health.
    Lindwall, Magnus
    Swedish School of Sport and Health Sciences, GIH, Department of Physical Activity and Health. University of Gothenburg, Gothenburg, Sweden.
    Salier Eriksson, Jane
    Swedish School of Sport and Health Sciences, GIH, Department of Physical Activity and Health.
    Holmlund, Tobias
    Swedish School of Sport and Health Sciences, GIH, Department of Physical Activity and Health. Karolinska Institute, Stockholm, Sweden.
    Ekblom Bak, Elin
    Swedish School of Sport and Health Sciences, GIH, Department of Physical Activity and Health.
    Lifestyle Habits and Mental Health in Light of the Two COVID-19 Pandemic Waves in Sweden, 20202021In: International Journal of Environmental Research and Public Health, ISSN 1661-7827, E-ISSN 1660-4601, Vol. 18, no 6, article id 3313Article in journal (Refereed)
    Abstract [en]

    The COVID-19 pandemic has become a public health emergency of international concern, which may have affected lifestyle habits and mental health. Based on national health profile assessments, this study investigated perceived changes of lifestyle habits in response to the COVID-19 pandemic and associations between perceived lifestyle changes and mental health in Swedish working adults. Among 5599 individuals (50% women, 46.3 years), the majority reported no change (sitting 77%, daily physical activity 71%, exercise 69%, diet 87%, alcohol 90%, and smoking 97%) due to the pandemic. Changes were more pronounced during the first wave (April–June) compared to the second (October–December). Women, individuals &lt;60 years, those with a university degree, white-collar workers, and those with unhealthy lifestyle habits at baseline had higher odds of changing lifestyle habits compared to their counterparts. Negative changes in lifestyle habits and more time in a mentally passive state sitting at home were associated with higher odds of mental ill-health (including health anxiety regarding one’s own and relatives’ health, generalized anxiety and depression symptoms, and concerns regarding employment and economy). The results emphasize the need to support healthy lifestyle habits to strengthen the resilience in vulnerable groups of individuals to future viral pandemics and prevent health inequalities in society.

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  • 10.
    Blom, Victoria
    et al.
    Stockholms universitet.
    Maarit, Johnson
    Stockholms universitet.
    Geoffrey, Patching
    Stockholms universitet.
    Physiological and behavioral reactivity when one's self-worth is staked on competence.2011In: Individual Differences Research, ISSN 1541-745X, E-ISSN 2169-3951, Vol. 9, p. 138-152Article in journal (Refereed)
  • 11.
    Blom, Victoria
    et al.
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences, Sport Psychology research group.
    Richter, Anne
    Hallsten, Lennart
    Svedberg, Pia
    The associations between job insecurity, depressive symptoms and burnout: The role of performance-based self-esteem2018In: Economic and Industrial Democracy, ISSN 0143-831X, E-ISSN 1461-7099, Vol. 39, no 1, p. 48-63Article in journal (Refereed)
    Abstract [en]

    Despite agreement on the negative effects of job insecurity, more knowledge needs to be generated on the health effects in terms of burnout and depressive symptoms and for whom job insecurity has these negative effects. The present study aims to investigate the associations between job insecurity and burnout and depressive symptoms respectively, by studying the moderation influences of performance-based self-esteem (PBSE), a form of contingent self-esteem. A population-based sample with 4145 twins was used. The results showed that job insecurity was significantly associated with both burnout and depressive symptoms, and that PBSE acted as a moderator, so that the associations were stronger for individuals with high PBSE than for individuals with low PBSE. The study contributes by including a personality characteristic to gain more knowledge about the mechanisms of job insecurity on mental ill-health, and by illustrating that job insecurity has an impact on severe health outcomes in terms of burnout and depressive symptoms.

  • 12.
    Blom, Victoria
    et al.
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences, Sport Psychology research group. Karolinska Inst, Dept Clin Neurosci, Stockholm, Sweden.;Stockholm Univ, Dept Psychol, Stockholm, Sweden.
    Svedberg, Pia
    Karolinska Inst, Dept Clin Neurosci, Stockholm, Sweden..
    Bergstrom, Gunnar
    Karolinska Inst, Div Intervent & Implementat Res, Inst Environm Med, Stockholm, Sweden..
    Mather, Lisa
    Karolinska Inst, Dept Clin Neurosci, Stockholm, Sweden..
    Lindfors, Petra
    Stockholm Univ, Dept Psychol, Stockholm, Sweden..
    Stress in paid and unpaid work as related to cortisol and subjective health complaints in women working in the public health care sector2017In: International Journal of Workplace Health Management, ISSN 1753-8351, E-ISSN 1753-836X, Vol. 10, no 4, p. 286-299Article in journal (Refereed)
    Abstract [en]

    Purpose - Focusing on 420 women employed within the woman-dominated health care sector, the purpose of this paper is to investigate how any variation in their total workload (TWL) in terms of paid and unpaid work relate to various subjective health complaints (SHC) (n = 420) and the neuroendocrine stress marker cortisol (n = 68). Design/methodology/approach - The authors explored how any variation in their TWL in terms of paid and unpaid work related cross-sectionally to SHC (n = 420), and the neuroendocrine stress marker cortisol (n = 68). Findings - Hierarchical regression analyses showed that stress of unpaid work was most strongly related to diurnal variations in cortisol. Both stress of paid and unpaid work as well as TWL stress, but not hours spent on TWL, were related to SHC. Practical implications - Taken together, objective measures of hours spent on various TWL domains were unrelated to outcome measures while perceptions of having too much TWL and TWL stress were linked to both cortisol and SHC, i.e. how individuals perceive a situation seem to be more important for health than the actual situation, which has implications for research and efforts to reduce individual TWL. Originality/value - This study is unique in showing that unpaid work and perceptions having too much TWL relate to stress markers in women working in the public health care sector.

  • 13.
    Blom, Victoria
    et al.
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences, Sport Psychology research group.
    Sverke, Magnus
    Bodin, Lennart
    Bergström, Gunnar
    Lindfors, Petra
    Svedberg, Pia
    Work-home interference and burnout: a study based on Swedish twins.2014In: Journal of Occupational and Environmental Medicine, ISSN 1076-2752, E-ISSN 1536-5948, Vol. 56, no 4, p. 361-6Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE: This study sets out to investigate the impact of work-home interference on burnout in women and men, while taking genetic and family environmental factors into account.

    METHODS: A total of 4446 Swedish twins were included in the study. The effects of work-home conflict (WHC) and home-work conflict (HWC) on burnout between and within pairs were analyzed with co-twin control analyses.

    RESULTS: Both WHC and HWC were significantly associated with burnout. Genetic factors may be involved in the association between HWC and burnout in women. Familial factors were not involved for WHC and burnout, neither for women nor for men.

    CONCLUSIONS: This study shows the importance to encounter WHC per se to prevent burnout. Because of genetic confounding in HWC and burnout in women, preventive efforts may also take into account individual characteristics.

  • 14.
    Bojsen-Møller, Emil
    et al.
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences, Åstrand Laboratory of Work Physiology.
    Boraxbekk, Carl-Johan
    Copenhagen University Hospital, Hvidovre, Denmark.
    Ekblom, Örjan
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences, Åstrand Laboratory of Work Physiology, Björn Ekblom's research group.
    Blom, Victoria
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences, Sport Psychology research group.
    Ekblom, Maria
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences, Laboratory for Biomechanics and Motor Control. Karolinska institutet.
    Relationships between Physical Activity, Sedentary Behaviour and Cognitive Functions in Office Workers.2019In: International Journal of Environmental Research and Public Health, ISSN 1661-7827, E-ISSN 1660-4601, Vol. 16, no 23, article id E4721Article in journal (Refereed)
    Abstract [en]

    Increasing evidence from animal experiments suggests that physical activity (PA) promotes neuroplasticity and learning. For humans, most research on the relationship between PA, sedentary behaviour (SB), and cognitive function has relied on self-reported measures of behaviour. Office work is characterised by high durations of SB combined with high work demands. While previous studies have shown that fitter office workers outperform their less fit colleagues in cognitive tests, the importance of PA and SB remains unknown. This study investigated associations between objectively measured PA and SB, using hip-worn accelerometers, and cognitive functions in 334 office workers. Time spent in moderate-to-vigorous PA (MVPA) was not associated with any cognitive outcome. However, time spent in SB tended to be positively associated with words recalled in free recall (β = 0.125). For the least fit participants, the average length of MVPA bouts was favourably related to Stroop performance (β = -0.211), while for the fitter individuals, a longer average length of MVPA bouts was related to worse recognition (β = -0.216). While our findings indicate that the length of MVPA bouts was associated with better Stroop performance in the least fit participants, our findings do not support the notion that more time spent in MVPA or less time in SB is associated with better cognitive function.

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  • 15.
    Drake, Emma
    et al.
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences.
    Ekblom, Maria
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences, Laboratory for Biomechanics and Motor Control.
    Ekblom, Örjan
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences, Åstrand Laboratory of Work Physiology.
    Kallings, Lena
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences, Åstrand Laboratory of Work Physiology.
    Blom, Victoria
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences, Sport Psychology research group.
    Cardiorespiratory Fitness and Device-Measured Sedentary Behaviour are Associated with Sickness Absence in Office Workers.2020In: International Journal of Environmental Research and Public Health, ISSN 1661-7827, E-ISSN 1660-4601, Vol. 17, no 2, article id E628Article in journal (Refereed)
    Abstract [en]

    Physical activity reduces the risk of several noncommunicable diseases, and a number of studies have found self-reported physical activity to be associated with sickness absence. The aim of this study was to examine if cardiorespiratory fitness, device-measured physical activity, and sedentary behaviour were associated with sickness absence among office workers. Participants were recruited from two Swedish companies. Data on sickness absence (frequency and duration) and covariates were collected via questionnaires. Physical activity pattern was assessed using ActiGraph and activPAL, and fitness was estimated from submaximal cycle ergometry. The sample consisted of 159 office workers (67% women, aged 43 ± 8 years). Higher cardiorespiratory fitness was significantly associated with a lower odds ratio (OR) for both sickness absence duration (OR = 0.92, 95% confidence interval (CI) 0.87-0.96) and frequency (OR = 0.93, 95% CI 0.90-0.97). Sedentary time was positively associated with higher odds of sickness absence frequency (OR = 1.03, 95% CI 0.99-1.08). No associations were found for physical activity at any intensity level and sickness absence. Higher sickness absence was found among office workers with low cardiorespiratory fitness and more daily time spent sedentary. In contrast to reports using self-reported physical activity, device-measured physical activity was not associated with sickness absence.

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  • 16.
    Eib, Constanze
    et al.
    Stockholm University.
    Schwarz, Ulrica von Thiele
    Stockholm University.
    Blom, Victoria
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences, Sport Psychology research group. Karolinska Institutet.
    Don't Let It Get to You! A Moderated Mediated Approach to the (In)Justice-Health Relationship2015In: Journal of Occupational Health Psychology, ISSN 1076-8998, E-ISSN 1939-1307, Vol. 20, no 4, p. 434-445Article in journal (Refereed)
    Abstract [en]

    The present study investigates the consequences of overall justice perceptions on employees' mental health and work-family conflict. While many studies have found that perceiving injustice at work is harmful, little is known about the underlying processes. Based on the allostatic load model, it is hypothesized that mental preoccupation with work, defined as a cognitive state, is a mediator linking overall justice perceptions to employee health. Moreover, we argue that locus of control is a moderator for the mediated relationship. We tested our hypotheses with panel data consisting of 412 Swedish office workers. Results support that mental preoccupation with work mediates the relationship between overall justice and mental health, and overall justice and work-family conflict. Results also reveal that mental preoccupation with work plays a greater mediating role for individuals with an external locus of control. Implications and suggestions for future studies on the emerging relationship between organizational justice and health are discussed.

  • 17.
    Ekblom Bak, Elin
    et al.
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences, Åstrand Laboratory of Work Physiology, Björn Ekblom's research group.
    Ekblom, Björn
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences, Åstrand Laboratory of Work Physiology, Björn Ekblom's research group.
    Söderling, J
    Börjesson, M
    Blom, Victoria
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences, Sport Psychology research group.
    Kallings, Lena
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences, Åstrand Laboratory of Work Physiology.
    Hemmingsson, Erik
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences.
    Andersson, G
    Wallin, P
    Ekblom, Örjan
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences, Åstrand Laboratory of Work Physiology.
    Sex- and age-specific associations between cardiorespiratory fitness, CVD morbidity and all-cause mortality in 316.137 Swedish adults2019Conference paper (Other academic)
  • 18.
    Ekblom Bak, Elin
    et al.
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences, Åstrand Laboratory of Work Physiology.
    Ekblom, Björn
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences, Åstrand Laboratory of Work Physiology, Björn Ekblom's research group.
    Söderling, Jonas
    Karolinska institutet.
    Börjesson, Mats
    University of Gothenburg.
    Blom, Victoria
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences, Sport Psychology research group.
    Kallings, Lena
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences, Åstrand Laboratory of Work Physiology.
    Hemmingsson, Erik
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences.
    Andersson, Gunnar
    HPI Health Profile Institute, Danderyd.
    Wallin, Peter
    HPI Health Profile Institute, Danderyd.
    Ekblom, Örjan
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences, Åstrand Laboratory of Work Physiology.
    Sex- and age-specific associations between cardiorespiratory fitness, CVD morbidity and all-cause mortality in 266.109 adults.2019In: Preventive Medicine, ISSN 0091-7435, E-ISSN 1096-0260, Vol. 127, article id 105799Article in journal (Refereed)
    Abstract [en]

    The aim was to investigate sex- and age-specific associations between cardiorespiratory fitness, all-cause and cause-specific mortality, and cardiovascular disease (CVD) morbidity. 266.109 participants (47% women, 18-74 years) free from CVD, participating in occupational health service screenings in 1995-2015 were included. CRF was assessed as estimated maximal oxygen consumption (estVO2max) using a submaximal cycle test. Incident cases of first-time CVD event and death from any cause were ascertained through national registers. There were 4244 CVD events and 2750 cases of all-cause mortality during mean 7.6 years follow-up. Male gender, higher age and lower estVO2max were associated with higher all-cause mortality and CVD morbidity incidence rates. Risk reductions with increasing estVO2max were present in all age-groups of men and women. No obvious levelling off in risk was identified in the total cohort. However, women and older age-groups showed no further reduction in higher aggregated estVO2max levels. CVD specific mortality was more associated with estVO2max compared to tumor specific mortality. The risk for all-cause mortality and CVD morbidity decreased by 2.3% and 2.6% per increase in 1 ml·min-1·kg-1 with no significant sex-differences but more pronounced in the three lower estVO2max categories for all-cause mortality (9.1%, 3.8% and 3.3%, respectively). High compared to lower levels of estVO2max was not related to a significantly elevated mortality or morbidity. In this large cohort study, CVD morbidity and all-cause mortality were inversely related to estVO2max in both men and women of all age-groups. Increasing cardiorespiratory fitness is a clear public health priority.

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  • 19.
    Ekblom Bak, Elin
    et al.
    Swedish School of Sport and Health Sciences, GIH, Department of Physical Activity and Health.
    Väisänen, Daniel
    Swedish School of Sport and Health Sciences, GIH, Department of Physical Activity and Health.
    Ekblom, Björn
    Swedish School of Sport and Health Sciences, GIH, Department of Physiology, Nutrition and Biomechanics.
    Blom, Victoria
    Swedish School of Sport and Health Sciences, GIH, Department of Physical Activity and Health.
    Kallings, Lena
    Swedish School of Sport and Health Sciences, GIH, Department of Physical Activity and Health.
    Hemmingsson, Erik
    Swedish School of Sport and Health Sciences, GIH, Department of Physical Activity and Health.
    Andersson, Gunnar
    HPI Health Profile Institute, Sweden.
    Wallin, Peter
    HPI Health Profile Institute, Sweden.
    Salier Eriksson, Jane
    Swedish School of Sport and Health Sciences, GIH, Department of Physical Activity and Health.
    Holmlund, Tobias
    Karolinska Institute, Stockholm, Sweden.
    Lindwall, Magnus
    Swedish School of Sport and Health Sciences, GIH, Department of Physical Activity and Health. University of Gothenburg, Sweden.
    Stenling, Andreas
    Umeå University, Sweden; University of Agder, Kristiansand, Norway.
    Lönn, Amanda
    Swedish School of Sport and Health Sciences, GIH, Department of Physical Activity and Health. Women's Health and Allied Health Professionals Theme Medical Unit Occupational Therapy and Physiotherapy, Stockholm, Sweden.
    Cardiorespiratory fitness and lifestyle on severe COVID-19 risk in 279,455 adults: a case control study.2021In: International Journal of Behavioral Nutrition and Physical Activity, E-ISSN 1479-5868, Vol. 18, no 1, article id 135Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: The impact of cardiorespiratory fitness (CRF) and other lifestyle-related factors on severe COVID-19 risk is understudied. The present study aims to investigate lifestyle-related and socioeconomic factors as possible predictors of COVID-19, with special focus on CRF, and to further study whether these factors may attenuate obesity- and hypertension-related risks, as well as mediate associations between socioeconomic factors and severe COVID-19 risk.

    METHODS: Out of initially 407,131 participants who participated in nationwide occupational health service screening between 1992 and 2020, n = 857 cases (70% men, mean age 49.9 years) of severe COVID-19 were identified. CRF was estimated using a sub-maximum cycle test, and other lifestyle variables were self-reported. Analyses were performed including both unmatched, n = 278,598, and sex-and age-matched, n = 3426, controls. Severe COVID-19 included hospitalization, intensive care or death due to COVID-19.

    RESULTS: Patients with more severe COVID-19 had significantly lower CRF, higher BMI, a greater presence of comorbidities and were more often daily smokers. In matched analyses, there was a graded decrease in odds for severe COVID-19 with each ml in CRF (OR = 0.98, 95% CI 0.970 to 0.998), and a two-fold increase in odds between the lowest and highest (< 32 vs. ≥ 46 ml·min-1·kg-1) CRF group. Higher BMI (per unit increase, OR = 1.09, 1.06 to 1.12), larger waist circumference (per cm, OR = 1.04, 1.02 to 1.06), daily smoking (OR = 0.60, 0.41 to 0.89) and high overall stress (OR = 1.36, 1.001 to 1.84) also remained significantly associated with severe COVID-19 risk. Obesity- and blood pressure-related risks were attenuated by adjustment for CRF and lifestyle variables. Mediation through CRF, BMI and smoking accounted for 9% to 54% of the associations between low education, low income and blue collar/low skilled occupations and severe COVID-19 risk. The results were consistent using either matched or unmatched controls.

    CONCLUSIONS: Both lifestyle-related and socioeconomic factors were associated with risk of severe COVID-19. However, higher CRF attenuated the risk associated with obesity and high blood pressure, and mediated the risk associated with various socioeconomic factors. This emphasises the importance of interventions to maintain or increase CRF in the general population to strengthen the resilience to severe COVID-19, especially in high-risk individuals.

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  • 20.
    Ekblom, Maria
    et al.
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences, Laboratory for Biomechanics and Motor Control.
    Blom, Victoria
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences, Sport Psychology research group.
    Ekblom, Örjan
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences, Åstrand Laboratory of Work Physiology.
    Kallings, Lena
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences, Åstrand Laboratory of Work Physiology.
    Nooijen, Carla F J
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences.
    Fysisk aktivitet och hjärnhälsa2018In: Fysioterapi, ISSN 1653-5804, no 5, p. 32-35Article in journal (Other (popular science, discussion, etc.))
    Abstract [sv]

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

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  • 21.
    Ekblom, Maria
    et al.
    Swedish School of Sport and Health Sciences, GIH, Department of Physical Activity and Health. Department of Neuroscience, Karolinska Institutet, Stockholm, Sweden..
    Bojsen-Møller, Emil
    Swedish School of Sport and Health Sciences, GIH, Department of Physical Activity and Health.
    Blom, Victoria
    Swedish School of Sport and Health Sciences, GIH, Department of Physical Activity and Health. Department of Psychology, Stockholm University, Stockholm, Sweden..
    Tarassova, Olga
    Swedish School of Sport and Health Sciences, GIH, Department of Physiology, Nutrition and Biomechanics.
    Moberg, Marcus
    Swedish School of Sport and Health Sciences, GIH, Department of Physiology, Nutrition and Biomechanics.
    Pontén, Marjan
    Swedish School of Sport and Health Sciences, GIH, Department of Physiology, Nutrition and Biomechanics.
    Wang, Rui
    Swedish School of Sport and Health Sciences, GIH, Department of Physical Activity and Health.
    Ekblom, Örjan
    Swedish School of Sport and Health Sciences, GIH, Department of Physical Activity and Health.
    Acute effects of physical activity patterns on plasma cortisol and brain-derived neurotrophic factor in relation to corticospinal excitability.2022In: Behavioural Brain Research, ISSN 0166-4328, E-ISSN 1872-7549, Vol. 430, article id 113926Article in journal (Refereed)
    Abstract [en]

    Brain-derived neurotrophic factor (BDNF) and cortisol are both capable of modulating synaptic plasticity, but it is unknown how physical activity-induced changes in their plasma levels relate to corticospinal plasticity in humans. Sixteen inactive middle-aged men and women participated in three separate interventions consisting of 3hours prolonged sitting (SIT); 3hours sitting interrupted every 30minutes with frequent short physical activity breaks (FPA); and 2.5hours prolonged sitting followed by 25minutes of moderate intensity exercise (EXE). These 3hour sessions were each followed by a 30min period of paired associative stimulation over the primary motor cortex (PAS). Blood samples were taken and corticospinal excitability measured at baseline, pre PAS, 5min and 30min post PAS. Here we report levels of plasma BDNF and cortisol over three activity conditions and relate these levels to previously published changes in corticospinal excitability of a non-activated thumb muscle. There was no interaction between time and condition in BDNF, but cortisol levels were significantly higher after EXE compared to after SIT and FPA. Higher cortisol levels at pre PAS predicted larger increases in corticospinal excitability from baseline to all subsequent time points in the FPA condition only, while levels of BDNF at pre PAS did not predict such changes in any of the conditions. Neither BDNF nor cortisol modified changes from pre PAS to the subsequent time points, suggesting that the increased corticospinal excitability was not mediated though an augmented effect of the PAS protocol. The relationship between cortisol and plasticity has been suggested to be U-shaped. This is possibly why the moderately high levels of cortisol seen in the FPA condition were positively associated with changes AURC, while the higher cortisol levels seen after EXE were not. A better understanding of the mechanisms for how feasible physical activity breaks affect neuroplasticity can inform the theoretical framework for how work environments and schedules should be designed. DATA AVAILABILITY: Data are available from the corresponding author upon reasonable request.

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  • 22.
    Heiland, Emerald G
    et al.
    Swedish School of Sport and Health Sciences, GIH, Department of Physical Activity and Health.
    Ekblom, Örjan
    Swedish School of Sport and Health Sciences, GIH, Department of Physical Activity and Health.
    Bojsen-Møller, Emil
    Swedish School of Sport and Health Sciences, GIH, Department of Physical Activity and Health.
    Larisch, Lisa-Marie
    Swedish School of Sport and Health Sciences, GIH, Department of Physical Activity and Health.
    Blom, Victoria
    Swedish School of Sport and Health Sciences, GIH, Department of Physical Activity and Health.
    Ekblom, Maria
    Swedish School of Sport and Health Sciences, GIH, Department of Physical Activity and Health.
    Bi-Directional, Day-to-Day Associations between Objectively-Measured Physical Activity, Sedentary Behavior, and Sleep among Office Workers.2021In: International Journal of Environmental Research and Public Health, ISSN 1661-7827, E-ISSN 1660-4601, Vol. 18, no 15, article id 7999Article in journal (Refereed)
    Abstract [en]

    The bi-directional, day-to-day associations between daytime physical activity and sedentary behavior, and nocturnal sleep, in office workers are unknown. This study investigated these associations and whether they varied by weekday or weekend day. Among 324 Swedish office workers (mean age 42.4 years; 33.3% men), moderate-to-vigorous physical activity (MVPA), and sedentary behaviors and sleep (total sleep time (TST) and sleep efficiency (SE)) were ascertained by using accelerometers (Actigraph GT3X) over 8 days. Multilevel linear mixed models were used to assess the bi-directional, day-to-day, within-person associations. Additional analyses stratified by weekend/weekday were performed. On average, participants spent 6% (57 min) of their day in MVPA and 59% (9.5 h) sedentary, and during the night, TST was 7 h, and SE was 91%. More daytime sedentary behavior was associated with less TST that night, and reciprocally, more TST at night was associated with less sedentary behavior on the following weekday. Greater TST during the night was also associated with less MVPA the next day, only on weekdays. However, daytime MVPA was not associated with TST that night. Higher nighttime SE was associated with greater time spent sedentary and in MVPA on the following day, regardless if weekday or weekend day. Sleep may be more crucial for being physically active the following day than vice versa, especially on weekdays. Nevertheless, sedentary behavior's relation with sleep time may be bi-directional. Office workers may struggle with balancing sleep and physical activity time.

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  • 23.
    Helgadóttir, Björg
    et al.
    Karolinska Institutet, Stockholm, Sweden.
    Mather, Lisa
    Karolinska Institutet, Stockholm, Sweden.
    Narusyte, Jurgita
    Karolinska Institutet, Stockholm, Sweden.
    Ropponen, Annina
    Karolinska Institutet, Stockholm, Sweden.
    Blom, Victoria
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences, Sport Psychology research group.
    Svedberg, Pia
    Karolinska Institutet, Stockholm, Sweden.
    Transitioning from sickness absence to disability pension - the impact of poor health behaviours: a prospective Swedish twin cohort study.2019In: BMJ Open, E-ISSN 2044-6055, Vol. 9, no 11, article id e031889Article in journal (Refereed)
    Abstract [en]

    OBJECTIVES: To investigate the association between three poor health behaviours (current smoker, high consumption of alcohol and low physical activity levels) and the transition to disability pension (DP) among individuals who have recently been sickness absent. Furthermore, we aimed to explore whether having multiple poor health behaviours increased the risk of transitioning from sickness absence (SA) to DP.

    DESIGN: Prospective twin cohort study.

    SETTING: Sweden.

    PARTICIPANTS: Twins aged 20-46 who had participated in a survey and been on SA (>14 days) in the year preceding baseline (date of answering the questionnaire).

    MAIN OUTCOME MEASURE: Incident DP during the follow-up which ended on 31 December 2012 (mean 5.2 years). A national register with full coverage provided data on DP.

    RESULTS: The Cox proportional-hazards regression analyses showed that current smokers had a higher risk of transitioning from SA to DP compared with never smokers (HR 1.76; 95% CI 1.08 to 2.84). Alcohol use and lack of physical activity as well as poor health behaviour sum score showed no significant associations.

    CONCLUSIONS: Being a current smoker influences the transition from SA to DP. Although non-significant, there were indications that more physical activity and fewer poor health behaviours could reduce the risk of exiting the labour market through DP. Improving health behaviours among people on SA could be a valuable tool for preventing the transition to DP.

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  • 24.
    Helgadóttir, Björg
    et al.
    Karolinska Institutet.
    Narusyte, Jurgita
    Karolinska Institutet.
    Ropponen, Annina
    Karolinska Institutet.
    Bergström, Gunnar
    Karolinska Institutet.
    Mather, Lisa
    Karolinska Institutet.
    Blom, Victoria
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences, Sport Psychology research group. Karolinska Institutet.
    Svedberg, Pia
    Karolinska Institutet.
    The role of occupational class on the association between sickness absence and disability pension: A Swedish register-based twin study.2019In: Scandinavian Journal of Work, Environment and Health, ISSN 0355-3140, E-ISSN 1795-990X, Vol. 45, no 6, p. 622-630, article id 3816Article in journal (Refereed)
    Abstract [en]

    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.

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  • 25.
    Helgadóttir, Björg
    et al.
    Karolinska Institutet.
    Svedberg, Pia
    Karolinska Institutet.
    Mather, Lisa
    Karolinska Institutet.
    Lindfors, Petra
    Stockholm University.
    Bergström, Gunnar
    Karolinska Institutet, University of Gävle.
    Blom, Victoria
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences, Sport Psychology research group. Karolinska Institutet.
    The association between part-time and temporary employment and sickness absence: a prospective Swedish twin study.2019In: European Journal of Public Health, ISSN 1101-1262, E-ISSN 1464-360X, Vol. 9, no 1, p. 147-153Article in journal (Refereed)
    Abstract [en]

    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.

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  • 26.
    Hemmingsson, Erik
    et al.
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences.
    Ekblom, Örjan
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences, Åstrand Laboratory of Work Physiology.
    Kallings, Lena
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences, Åstrand Laboratory of Work Physiology.
    Andersson, Gunnar
    Health Profile Institute, Stockholm, Sweden.
    Wallin, Peter
    Health Profile Institute, Stockholm, Sweden.
    Söderling, Jonas
    Department of Medicine, Karolinska Institutet, Stockholm, Sweden.
    Blom, Victoria
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences, Sport Psychology research group.
    Ekblom, Björn
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences, Åstrand Laboratory of Work Physiology, Björn Ekblom's research group. Swedish School of Sport and Health Sciences, GIH, Department of Physiology, Nutrition and Biomechanics.
    Ekblom Bak, Elin
    Swedish School of Sport and Health Sciences, GIH, Department of Physiology, Nutrition and Biomechanics.
    Prevalence and time trends of overweight, obesity and severe obesity in 447,925 Swedish adults, 1995–20172021In: Scandinavian Journal of Public Health, ISSN 1403-4948, E-ISSN 1651-1905, Vol. 49, no 4, p. 377-383Article in journal (Refereed)
    Abstract [en]

    Aims: The purpose of this research was to describe the current prevalence and historic trends in overweight, obesity and severe obesity in Sweden. Methods: Data on BMI, age, gender, education and geographic region were obtained in n=447,925 Swedish adults through a nationwide screening test (1995?2017). To account for sampling variations, we quantified prevalence estimates and time trends using standardized values (direct method) to all 18?74-year-old Swedes, using nationwide databases. Rates of overweight (BMI ?25 kg/m2), obesity (BMI ?30 kg/m2) and severe obesity (BMI ?35 kg/m2) were calculated across gender, age, education and geographic categories. Years were grouped into two-year sampling periods (except the first period where we used three years) for increased power. We used multivariable logistic regression to quantify independent associations between age, gender, education and region with obesity development and current prevalence rates. Results: In 2016/17 the unstandardized prevalence of overweight, obesity and severe obesity were 55.1%, 16.6% and 4.2%, respectively. Factors associated with a higher obesity prevalence were male gender, older age, lower education and residing in a rural region (all P<0.001). Between 1995 and 2017 the prevalence of severe obesity increased by 153%, compared to obesity (+86%) and overweight (+23%). While there were similar increases in obesity across gender and age groups, people with low education (vs high) and rural areas (vs urban) had a higher prevalence increase (both P<0.001). Conclusions: Rates of overweight, obesity and severe obesity have increased markedly in Swedish adults since 1995. Priority groups for prevention efforts include individuals with low education and those living in rural areas.

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  • 27.
    Hemmingsson, Erik
    et al.
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences.
    Ekblom, Örjan
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences, Åstrand Laboratory of Work Physiology.
    Kallings, Lena
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences, Åstrand Laboratory of Work Physiology.
    Andersson, Gunnar
    Wallin, Peter
    Söderling, Jonas
    Ekblom, Björn
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences, Åstrand Laboratory of Work Physiology, Björn Ekblom's research group.
    Blom, Victoria
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences, Sport Psychology research group.
    Ekblom Bak, Elin
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences, Åstrand Laboratory of Work Physiology.
    Objectively measured prevalence and time trends of obesity and severe obesity in 447 925 Swedish adults, 1995-20172019Conference paper (Other academic)
  • 28.
    Holmlund, Tobias
    et al.
    Swedish School of Sport and Health Sciences, GIH, Department of Physical Activity and Health.
    Blom, Victoria
    Swedish School of Sport and Health Sciences, GIH, Department of Physical Activity and Health.
    Hemmingsson, Erik
    Swedish School of Sport and Health Sciences, GIH, Department of Physical Activity and Health.
    Ekblom, Björn
    Swedish School of Sport and Health Sciences, GIH, Department of Physiology, Nutrition and Biomechanics.
    Andersson, Gunnar
    HPI Health Profile Institute, Sweden.
    Wallin, Peter
    HPI Health Profile Institute, Sweden.
    Ekblom Bak, Elin
    Swedish School of Sport and Health Sciences, GIH, Department of Physical Activity and Health.
    Change in cardiorespiratory fitness on self-rated health: prospective cohort study in 98 718 Swedish adults.2023In: Scandinavian Journal of Public Health, ISSN 1403-4948, E-ISSN 1651-1905, Vol. 51, no 4, p. 542-551Article in journal (Refereed)
    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.

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  • 29.
    Johnson, Maarit
    et al.
    Stockholms universitet.
    Blom, Victoria
    Stockholms universitet.
    Development and validation of two measures of contingent self-esteem2007In: Individual Differences Research, ISSN 1541-745X, E-ISSN 2169-3951, Vol. 5, p. 300-328Article in journal (Refereed)
  • 30.
    Kallings, Lena
    et al.
    Swedish School of Sport and Health Sciences, GIH, Department of Physical Activity and Health.
    Blom, Victoria
    Swedish School of Sport and Health Sciences, GIH, Department of Physical Activity and Health.
    Andersson, Gunnar
    HPI Health Profile Institute, Res Dept, Danderyd, Sweden..
    Wallin, Peter
    HPI Health Profile Institute, Res Dept, Danderyd, Sweden..
    Ekblom Bak, Elin
    Swedish School of Sport and Health Sciences, GIH, Department of Physical Activity and Health.
    O9-5 Workplace sitting associated with self-rated perceived global health2022In: EUROPEAN JOURNAL OF PUBLIC HEALTH, vol. 32, S2, 2022, Vol. 32Conference paper (Other academic)
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  • 31.
    Kallings, Lena
    et al.
    Swedish School of Sport and Health Sciences, GIH, Department of Physical Activity and Health. Uppsala University, Sweden.
    Blom, Victoria
    Swedish School of Sport and Health Sciences, GIH, Department of Physical Activity and Health.
    Ekblom, Björn
    Swedish School of Sport and Health Sciences, GIH, Department of Physiology, Nutrition and Biomechanics.
    Holmlund, Tobias
    Swedish School of Sport and Health Sciences, GIH, Department of Physical Activity and Health.
    Salier Eriksson, Jane
    Swedish School of Sport and Health Sciences, GIH, Department of Physical Activity and Health.
    Andersson, Gunnar
    HPI, Health Profile Institute, Stockholm, Sweden..
    Wallin, Peter
    HPI, Health Profile Institute, Stockholm, Sweden..
    Ekblom Bak, Elin
    Swedish School of Sport and Health Sciences, GIH, Department of Physical Activity and Health.
    Workplace sitting is associated with self-reported general health and back/neck pain: a cross-sectional analysis in 44,978 employees.2021In: BMC Public Health, E-ISSN 1471-2458, Vol. 21, no 1, article id 875Article in journal (Refereed)
    Abstract [en]

    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.

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  • 32.
    Kuster, Roman P
    et al.
    Karolinska Institutet, Stockholm, Sweden.
    Grooten, Wilhelmus J A
    Karolinska Institutet, Stockholm, Sweden.
    Baumgartner, Daniel
    ZHAW Zurich University of Applied Sciences, Winterthur, Switzerland..
    Blom, Victoria
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences, Åstrand Laboratory of Work Physiology. Karolinska Institutet, Stockholm, Sweden.
    Hagströmer, Maria
    Karolinska Institutet, Stockholm, Sweden.
    Ekblom, Örjan
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences, Åstrand Laboratory of Work Physiology.
    Detecting Prolonged Sitting Bouts with the ActiGraph GT3X.2020In: Scandinavian Journal of Medicine and Science in Sports, ISSN 0905-7188, E-ISSN 1600-0838, Vol. 30, no 3, p. 572-582Article in journal (Refereed)
    Abstract [en]

    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.

  • 33.
    Kuster, Roman P
    et al.
    Karolinska Institutet, Stockholm, Sweden.
    Grooten, Wilhelmus J A
    Karolinska Institutet, Stockholm, Sweden.
    Blom, Victoria
    Swedish School of Sport and Health Sciences, GIH, Department of Physical Activity and Health. Karolinska Institutet, Stockholm, Sweden.
    Baumgartner, Daniel
    ZHAW Zurich University of Applied Sciences, Winterthur, Switzerland.
    Hagströmer, Maria
    Karolinska Institutet, Stockholm, Sweden.
    Ekblom, Örjan
    Swedish School of Sport and Health Sciences, GIH, Department of Physical Activity and Health.
    How Accurate and Precise Can We Measure the Posture and the Energy Expenditure Component of Sedentary Behaviour with One Sensor?2021In: International Journal of Environmental Research and Public Health, ISSN 1661-7827, E-ISSN 1660-4601, Vol. 18, no 11, article id 5782Article in journal (Refereed)
    Abstract [en]

    Sedentary behaviour is an emergent public health topic, but there is still no method to simultaneously measure both components of sedentary behaviour-posture and energy expenditure-with one sensor. This study investigated the accuracy and precision of measuring sedentary time when combining the proprietary processing of a posture sensor (activPAL) with a new energy expenditure algorithm and the proprietary processing of a movement sensor (ActiGraph) with a published posture algorithm. One hundred office workers wore both sensors for an average of 7 days. The activPAL algorithm development used 38 and the subsequent independent method comparison 62 participants. The single sensor sedentary estimates were compared with Bland-Atman statistics to the Posture and Physical Activity Index, a combined measurement with both sensors. All single-sensor methods overestimated sedentary time. However, adding the algorithms reduced the overestimation from 129 to 21 (activPAL) and from 84 to 7 min a day (ActiGraph), with far narrower 95% limits of agreements. Thus, combining the proprietary data with the algorithms is an easy way to increase the accuracy and precision of the single sensor sedentary estimates and leads to sedentary estimates that are more precise at the individual level than those of the proprietary processing are at the group level.

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  • 34.
    Kuster, Roman P
    et al.
    ZHAW Zurich University of Applied Sciences, Switzerland.
    Grooten, Wilhelmus J A
    Karolinska institutet, Huddinge, Sweden.
    Blom, Victoria
    Swedish School of Sport and Health Sciences, GIH, Department of Physical Activity and Health. Karolinska institutet, Stockholm, Sweden.
    Baumgartner, Daniel
    ZHAW Zurich University of Applied Sciences, Switzerland.
    Hagströmer, Maria
    Karolinska institutet, Huddinge, Sweden.
    Ekblom, Örjan
    Swedish School of Sport and Health Sciences, GIH, Department of Physical Activity and Health.
    Is Sitting Always Inactive and Standing Always Active? A Simultaneous Free-Living activPal and ActiGraph Analysis.2020In: International Journal of Environmental Research and Public Health, ISSN 1661-7827, E-ISSN 1660-4601, Vol. 17, no 23, article id E8864Article in journal (Refereed)
    Abstract [en]

    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.

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  • 35.
    Larisch, Lisa-Marie
    et al.
    Swedish School of Sport and Health Sciences, GIH, Department of Physical Activity and Health.
    Blom, Victoria
    Swedish School of Sport and Health Sciences, GIH, Department of Physical Activity and Health. Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden..
    Hagströmer, Maria
    Division of Physiotherapy, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden.; Academic Primary Health Care Centre, Region Stockholm, Stockholm, Sweden.; Department of Health Promoting Science, Sophiahemmet University, Stockholm, Sweden.
    Ekblom, Maria
    Swedish School of Sport and Health Sciences, GIH, Department of Physical Activity and Health. Department of Neuroscience, Karolinska Institutet, Stockholm, Sweden..
    Ekblom, Örjan
    Swedish School of Sport and Health Sciences, GIH, Department of Physical Activity and Health.
    Nilsson, Jonna
    Swedish School of Sport and Health Sciences, GIH, Department of Physical Activity and Health.
    Kallings, Lena
    Swedish School of Sport and Health Sciences, GIH, Department of Physical Activity and Health. Division of Family Medicine and Preventive Medicine, Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden..
    Improving movement behavior in office workers: effects of two multi-level cluster-RCT interventions on mental health2024In: BMC Public Health, E-ISSN 1471-2458, Vol. 24, no 1, article id 127Article in journal (Refereed)
    Abstract [en]

    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.

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  • 36.
    Larisch, Lisa-Marie
    et al.
    Swedish School of Sport and Health Sciences, GIH, Department of Physical Activity and Health.
    Blom, Victoria
    Swedish School of Sport and Health Sciences, GIH, Department of Physical Activity and Health. Karolinska Institutet.
    Kallings, Lena
    Swedish School of Sport and Health Sciences, GIH, Department of Physical Activity and Health. Uppsala University.
    Effectiveness of two randomized and controlled multi-component interventions on 24-h movement behavior and mental health outcomes among office workers2022Conference paper (Refereed)
    Abstract [en]

    Background: To date it is unknown whether movement behavior change interventions among office workers are effective for improving mental health. Therefore, we designed a multi-component cluster RCT among office workers (N=263). One intervention group focused on reducing sedentary behavior (SED), the other on increasing moderate to vigorous physical activity (MVPA) compared to a wait-list control group. Based on ecological models of health behavior, intervention components addressed the individual (counseling using cognitive behavioral therapy (CBT) and motivational interviewing (MI)), the environmental (group activities such as lunch walks), and the organizational level (companies promoting the interventions internally). Primary outcomes were changes in accelerometer-measured and self-reported SED and MVPA, secondary outcomes were depression and anxiety symptoms, burnout, stress and mental well-being, assessed via validated, web- based questionnaires. Previous analyses using a compositional data analysis (CoDA) approach did not find intervention effects on 24-h movement behavior, i.e., SED, light intensity, moderate or vigorous physical activity. 

    Purpose: This study aims at investigating intervention effects on mental health, i.e., depression and anxiety symptoms, burnout, stress and mental well-being. Secondary aims are to describe those participants that achieved a significant change in accelerometer- and device-measured SED and MVPA in comparison to those that did not, and to investigate whether changes in movement behavior were associated with changes in mental well-being. 

    Methods: Linear mixed model analysis will be performed to analyze effects on mental health, according to the published study protocol. 

    Performing exploratory analyses, quartiles of participants, based on changes in MVPA and SED, will be described on demographic characteristics and compared across quartiles. Change change analyses will investigate whether changes in SED or MVPA are associated with changes in mental well-being. CoDA will be applied, taking the co-dependence of 24-h movement behaviors into account. 

    Implications: High sedentariness and sick-leave due to mental illness are challenges associated with office work. This RCT is the first among office workers that applies a multi-component approach to address several levels of health behavior, and that includes CBT and MI techniques. Results may inform occupational health and researcher efforts aiming at addressing the burden of sedentariness and its related consequences on mental health. 

  • 37.
    Larisch, Lisa-Marie
    et al.
    Swedish School of Sport and Health Sciences, GIH, Department of Physical Activity and Health.
    Blom, Victoria
    Swedish School of Sport and Health Sciences, GIH, Department of Physical Activity and Health. Karolinska Institutet.
    Kallings, Lena
    Swedish School of Sport and Health Sciences, GIH, Department of Physical Activity and Health. Uppsala University.
    Thedin Jakobsson, Britta
    Swedish School of Sport and Health Sciences, GIH, Department of Movement, Culture and Society.
    Changing movement behavior for improving mental health among office workers: A qualitative study on acceptability, feasibility and fidelity of two RCT interventions2022Conference paper (Refereed)
    Abstract [en]

    Background: Behavior change research suggests that interventions addressing not only the individual, but also the environmental and organizational level might be more effective than those addressing only one. However, few RCTs have tried to change movement behavior among office workers with the aim of improving mental health outcomes, using multi-component interventions that address several levels. Above that, researchers seldomly assess acceptability, feasibility and fidelity of such complex interventions, even though they are considered important moderators of study outcomes. 

    Purpose: This study aims at determining aspects of intervention acceptability, feasibility and fidelity of two multi-component cluster RCT interventions among office workers (N=263). Specifically, we want to answer: 

    1. How did participants experience specific intervention components as facilitating or hindering a movement behavior change? 

    2. Which factors in the work and non-work context did participants experience as facilitating or hindering a movement behavior change? 

    3. Were intervention components implemented and perceived as intended? 

    Methods The interventions addressed the individual level (counseling sessions based on cognitive behavior therapy and motivational interviewing), the environmental level (e.g. walking meetings or lunch walks organized by team leaders) and the organizational level (participation during work time, employers encouraging participation). One intervention focused on reducing sedentary behavior, the other on increasing physical activity, compared to a wait-list control group. After completion of the 6-month intervention period, audio-recorded interviews and focus group discussions were performed with participants, health coaches delivering the counseling sessions, team leaders and Human Resource staff). Verbatim transcribed data will be analyzed using thematic analysis (Braun&Clarke 2006). An initial codebook based on a-priori themes of interest will be created. Two researchers will apply it to a subset of transcripts, in an inductive fashion whilst allowing for new themes to emerge. Once agreement on a final version of the codebook will be achieved, remaining transcripts will be analyzed accordingly. 

    Implications: We expect that the results of this study may help to understand and interpret the results of the quantitative effectiveness evaluations. This study may generate valuable knowledge that can inform future similar studies or workplace health promotion efforts and make their conduct more efficient. 

  • 38.
    Larisch, Lisa-Marie
    et al.
    Swedish School of Sport and Health Sciences, GIH, Department of Physical Activity and Health.
    Bojsen-Møller, Emil
    Swedish School of Sport and Health Sciences, GIH, Department of Physical Activity and Health.
    Nooijen, Carla F J
    Swedish School of Sport and Health Sciences, GIH, Department of Physical Activity and Health.
    Blom, Victoria
    Swedish School of Sport and Health Sciences, GIH, Department of Physical Activity and Health. Karolinska institutet, Stockholm, Sweden.
    Ekblom, Maria
    Swedish School of Sport and Health Sciences, GIH, Department of Physical Activity and Health. Karolinska Institutet, Stockholm, Sweden.
    Ekblom, Örjan
    Swedish School of Sport and Health Sciences, GIH, Department of Physical Activity and Health.
    Arvidsson, Daniel
    University of Gothenburg, Sweden..
    Fridolfsson, Jonatan
    University of Gothenburg, Sweden..
    Hallman, David M
    University of Gävle, Sweden.
    Mathiassen, Svend Erik
    University of Gävle, Sweden.
    Wang, Rui
    Swedish School of Sport and Health Sciences, GIH, Department of Physical Activity and Health. Karolinska institutet, Stockholm, Sweden ; University of Wisconsin School of Medicine and Public Health, Madison, USA..
    Kallings, Lena
    Swedish School of Sport and Health Sciences, GIH, Department of Physical Activity and Health.
    Effects of Two Randomized and Controlled Multi-Component Interventions Focusing On 24-Hour Movement Behavior among Office Workers: A Compositional Data Analysis.2021In: International Journal of Environmental Research and Public Health, ISSN 1661-7827, E-ISSN 1660-4601, Vol. 18, no 8, article id 4191Article in journal (Refereed)
    Abstract [en]

    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.

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  • 39.
    Larisch, Lisa-Marie
    et al.
    Swedish School of Sport and Health Sciences, GIH, Department of Physical Activity and Health.
    Kallings, Lena
    Swedish School of Sport and Health Sciences, GIH, Department of Physical Activity and Health. Uppsala University, Sweden.
    Hagströmer, Maria
    Karolinska Institutet, Stockholm, Sweden.
    Desai, Manisha
    Stanford University, Palo Alto, USA.
    von Rosen, Philip
    Karolinska Institutet, Stockholm, Sweden.
    Blom, Victoria
    Swedish School of Sport and Health Sciences, GIH, Department of Physical Activity and Health. Karolinska Institutet, Stockholm, Sweden.
    Associations between 24 h Movement Behavior and Mental Health in Office Workers.2020In: International Journal of Environmental Research and Public Health, ISSN 1661-7827, E-ISSN 1660-4601, Vol. 17, no 17, article id E6214Article in journal (Refereed)
    Abstract [en]

    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.

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  • 40.
    Larisch, Lisa-Marie
    et al.
    Swedish School of Sport and Health Sciences, GIH, Department of Physical Activity and Health.
    Kallings, Lena
    Swedish School of Sport and Health Sciences, GIH, Department of Physical Activity and Health. Department of Public Health and Caring Sciences, Family Medicine and Preventive Medicine, Uppsala University, Uppsala, Sweden..
    Thedin Jakobsson, Britta
    Swedish School of Sport and Health Sciences, GIH, Department of Movement, Culture and Society.
    Blom, Victoria
    Swedish School of Sport and Health Sciences, GIH, Department of Physical Activity and Health. 4Department of Clinical Neuroscience, Karolinska Institutet, Division of Insurance Medicine, Stockholm, Sweden..
    “It depends on the boss”: A qualitative study of multi-level interventions aiming at office workers’ movement behavior and mental health2023In: International Journal of Qualitative Studies on Health and Well-being, ISSN 1748-2623, E-ISSN 1748-2631, Vol. 18, no 1, article id 2258564Article in journal (Other academic)
    Abstract [en]

    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.

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  • 41.
    Larsson, Kristina
    et al.
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences. Sophiahemmet University.
    Ekblom, Örjan
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences, Åstrand Laboratory of Work Physiology.
    Kallings, Lena
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences, Åstrand Laboratory of Work Physiology.
    Ekblom, Maria
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences, Laboratory for Biomechanics and Motor Control. Karolinska institutet.
    Blom, Victoria
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences, Sport Psychology research group. Karolinska institutet.
    Job Demand-Control-Support Model as Related to Objectively Measured Physical Activity and Sedentary Time in Working Women and Men.2019In: International Journal of Environmental Research and Public Health, ISSN 1661-7827, E-ISSN 1660-4601, Vol. 16, no 18, article id E3370Article in journal (Refereed)
    Abstract [en]

    A physically active lifestyle incurs health benefits and physically active individuals show reduced reactivity to psychosocial stressors. However, the findings are inconclusive and are based on self-reported physical activity and sedentary time. The present study aimed at studying the associations between psychological stressors (job demand, control, support, JD-C-S) and objectively measured physical activity (PA) on various intensities from sedentary (SED) to vigorous physical activity. The participants were 314 employees from a cross-sectional study. PA data were collected with the accelerometer ActiGraph GT3X (Pensacola, FL, USA), SED data with the inclinometer activPAL (PAL Technologies Ltd., Glasgow, Scotland, UK), and psychosocial stressors with a web questionnaire. Results showed that vigorous-intensity PA was negatively associated with demand (β -0.15, p < 0.05), even when adjusted for the covariates. SED was negatively associated to support (β -0.13, p < 0.05). Stress significantly moderated relations between support and sedentary time (β -0.12, p < 0.05). Moderate PA (MVPA) was negatively associated with demand, but only when controlling for overtime (β -0.13, p < 0.05). MVPA was also negatively associated with control (β -0.15, p < 0.05) but not when work engagement was included in the model. Being more physically active and spending less time sedentary may help to handle job situations with high demand and low support.

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  • 42.
    Larsson, Kristina
    et al.
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences.
    Ekblom, Örjan
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences, Åstrand Laboratory of Work Physiology.
    Kallings, Lena
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences, Åstrand Laboratory of Work Physiology.
    Ekblom, Maria
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences, Laboratory for Biomechanics and Motor Control.
    Blom, Victoria
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences, Sport Psychology research group.
    Job demands control model as related to objectively measured physical activity and sitting time in working women and men2019Conference paper (Other academic)
  • 43.
    Larsson, Kristina
    et al.
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences.
    Kallings, Lena
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences, Åstrand Laboratory of Work Physiology.
    Ekblom, Örjan
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences, Åstrand Laboratory of Work Physiology.
    Blom, Victoria
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences, Sport Psychology research group.
    Andersson, Eva
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences, Laboratory for Biomechanics and Motor Control.
    Ekblom, Maria
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences, Laboratory for Biomechanics and Motor Control.
    Criterion validity and test-retest reliability of SED-GIH, a single item question for assessment of daily sitting time.2019In: BMC Public Health, E-ISSN 1471-2458, Vol. 19, no 1, article id 19:17Article in journal (Refereed)
    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.

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  • 44. Mather, Lisa
    et al.
    Bergström, Gunnar
    Blom, Victoria
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences, Sport Psychology research group.
    Svedberg, Pia
    High Job Demands, Job Strain, and Iso-Strain Are Risk Factors for Sick Leave due to Mental Disorders: A Prospective Swedish Twin Study With a 5-Year Follow-Up.2015In: Journal of Occupational and Environmental Medicine, ISSN 1076-2752, E-ISSN 1536-5948, Vol. 57, no 8, p. 858-65Article in journal (Refereed)
    Abstract [en]

    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.

  • 45.
    Mather, Lisa
    et al.
    Karolinska institutet.
    Blom, Victoria
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences, Sport Psychology research group. Karolinska institutet, Stockholms universitet.
    Bergström, Gunnar
    Karolinska institutet.
    Svedberg, Pia
    Karolinska institutet.
    Adverse outcomes of sick leave due to mental disorders: A prospective study of discordant twin pairs.2019In: Scandinavian Journal of Public Health, ISSN 1403-4948, E-ISSN 1651-1905, Vol. 47, no 2, p. 127-136Article in journal (Refereed)
    Abstract [en]

    AIMS: The aim of this study was to investigate whether sick leave due to different mental disorders increased the risk of reoccurring sick-leave, disability pension and unemployment, taking genetics and shared environment into account.

    METHODS: This register-based cohort study contains 2202 discordant twin pairs 18-64 years old, where one twin had sick leave due to a mental disorder 2005-2006. The end of the sick-leave spell was the start of follow-up for both twins. The twins were followed up for reoccurring sick-leave, disability pension and unemployment (> 180 days in a year), until December 2012. Analyses were censored for disability pension, death, emigration and old-age pension. Cox proportional hazards models with time-varying covariates were used to calculate hazard ratios with 95% confidence intervals (CI).

    RESULTS: Those with sick leave due to mental disorders had a 3.64 (CI: 3.24-4.08) times higher risk of reoccurring sick-leave within the first two years; after that, hazard ratios were attenuated and explained by genetic factors. The first year, they had 12.24 (CI: 8.11-18.46) times the risk of disability pension. The risk was attenuated but remained at 2.75 (CI: 2.07-3.65) after one year. The risk of unemployment was 1.99 (CI: 1.72-2.31) during the whole follow-up period. The risk of unemployment and disability pension was lower for those with stress-related than other mental disorders, this was less clear for recurrent reoccuring sick-leave.

    CONCLUSIONS: Sick leave due to mental disorders increased the risk of reoccurring sick-leave within two years, disability pension and unemployment, independent of genetics and shared environment.

  • 46. Mather, Lisa
    et al.
    Blom, Victoria
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences, Sport Psychology research group.
    Bergström, Gunnar
    Svedberg, Pia
    An Underlying Common Factor, Influenced by Genetics and Unique Environment, Explains the Covariation Between Major Depressive Disorder, Generalized Anxiety Disorder, and Burnout: A Swedish Twin Study.2016In: Twin Research and Human Genetics, ISSN 1832-4274, E-ISSN 1839-2628, Vol. 19, no 6, p. 619-627Article in journal (Refereed)
    Abstract [en]

    Depression and anxiety are highly comorbid due to shared genetic risk factors, but less is known about whether burnout shares these risk factors. We aimed to examine whether the covariation between major depressive disorder (MDD), generalized anxiety disorder (GAD), and burnout is explained by common genetic and/or environmental factors. This cross-sectional study included 25,378 Swedish twins responding to a survey in 2005-2006. Structural equation models were used to analyze whether the trait variances and covariances were due to additive genetics, non-additive genetics, shared environment, and unique environment. Univariate analyses tested sex limitation models and multivariate analysis tested Cholesky, independent pathway, and common pathway models. The phenotypic correlations were 0.71 (0.69-0.74) between MDD and GAD, 0.58 (0.56-0.60) between MDD and burnout, and 0.53 (0.50-0.56) between GAD and burnout. Heritabilities were 45% for MDD, 49% for GAD, and 38% for burnout; no statistically significant sex differences were found. A common pathway model was chosen as the final model. The common factor was influenced by genetics (58%) and unique environment (42%), and explained 77% of the variation in MDD, 69% in GAD, and 44% in burnout. GAD and burnout had additive genetic factors unique to the phenotypes (11% each), while MDD did not. Unique environment explained 23% of the variability in MDD, 20% in GAD, and 45% in burnout. In conclusion, the covariation was explained by an underlying common factor, largely influenced by genetics. Burnout was to a large degree influenced by unique environmental factors not shared with MDD and GAD.

  • 47.
    Mather, Lisa
    et al.
    Karolinska Insitutet.
    Blom, Victoria
    Karolinska Insitutet.
    Pia, Svedberg
    Karolinska Institutet.
    Stressful and traumatic life-events are associated with burnout in a population of Swedish twins2014In: International Journal of Behavioral Medicine, ISSN 1070-5503, E-ISSN 1532-7558, Vol. 21, no 6, p. 899-907Article in journal (Refereed)
    Abstract [en]

    Background

    Most burnout studies focus on symptoms of burnout in relation to work-related stress. However, recent studies have found that familial factors and stress in the personal life may also be of importance. Stressful and traumatic life events influence how individuals cope with stress over the life course and may therefore be associated with burnout symptoms.

    Purpose

    This study aims to assess the associations between stressful and traumatic life events and burnout symptoms in a population-based sample of twins, adjusting for familial confounding.

    Methods

    In this cross-sectional questionnaire-based study of 25,378 Swedish twins, odds ratios (OR) with 95 % confidence intervals (CI) were calculated using logistic regression analysis. First, the whole sample was analysed. Secondly, a matched co-twin analysis was conducted of the same-sex twin pairs discordant on burnout, in order to adjust for familial factors.

    Results

    A history of traumatic life events was independently associated with burnout symptoms, with a cumulative effect with increasing number of events. ORs adjusted for familial confounding: 1–3 events OR 1.58 (CI = 1.21–2.07) 4 or more events OR 2.00 (CI = 1.45–2.75). Independent associations between the stressful life events: serious family problems OR 1.71 (CI = 1.36–2.15), physical illness OR 1.44 (CI = 1.17–1.77), divorce or separation OR 1.40 (CI = 1.15–1.70), and burnout symptoms were also found.

    Conclusions

    The results indicate that stressful and traumatic life events are of importance in the burnout process. This finding may have implications in efforts to prevent burnout.

  • 48.
    Mather, Lisa
    et al.
    Karolinska Insitutet.
    Gunnar, Bergström
    Karolinska Insitutet.
    Blom, Victoria
    Karolinska Insitutet.
    Pia, Svedberg
    Karolinska Institutet.
    The covariation between burnout and sick leave due to mental disorders is explained by a shared genetic liability: A prospective Swedish twin study with a five year follow-up.2014In: Twin Research and Human Genetics, ISSN 1832-4274, E-ISSN 1839-2628, Vol. 17, no 6, p. 535-544Article in journal (Refereed)
    Abstract [en]

    Background: This study aims to assess whether the associations between burnout and sick leave due to stress-related mental disorders, other mental disorders, and somatic conditions are influenced by familial (genetic and shared environmental) factors. Methods: In this prospective cohort study, 23,611 Swedish twins born between 1959 and 1985, who answered a web-based questionnaire, including the Pines Burnout Measure 2004–2006, were included. Registry data on sick leave spells from the response date until December 31, 2010 were obtained from the Swedish Social Insurance Agency. Logistic regression analysis was performed to assess odds ratios with 95% confidence intervals for the association between burnout and sick leave for the whole sample, while conditional logistic regression of the same-sex discordant twin pairs was used to estimate the association between burnout and sick leave, adjusting for familial confounding. The Bivariate Cholesky models were used to assess whether the covariation between burnout and sick leave was explained by common genetic and/or shared environmental factors. Results: Burnout was a risk factor for sick leave due to stress-related and other mental disorders, and these associations were explained by familial factors. The phenotypic correlation between burnout and sick leave due to somatic conditions was 0.07 and the association was not influenced by familial factors. The phenotypic correlations between burnout and sick leave due to stress-related (0.26) and other mental disorders (0.30) were completely explained by common genetic factors. Conclusions: The association between burnout and sick leave due to stress-related and other mental disorders seems to be a reflection of a shared genetic liability.

  • 49.
    Mather, Lisa
    et al.
    Karolinska Institutet.
    Narusyte, J
    Karolinska Institutet.
    Ropponen, A
    Karolinska Institutet.
    Bergström, G
    Karolinska Institutet.
    Blom, Victoria
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences, Sport Psychology research group. Karolinska Institutet.
    Helgadóttir, Björg
    Karolinska Institutet.
    Svedberg, P
    Karolinska Institutet.
    Sick leave due to mental disorders, morbidity and mortality: a prospective study of discordant twin pairs.2020In: Social Psychiatry and Psychiatric Epidemiology, ISSN 0933-7954, E-ISSN 1433-9285, Vol. 55, no 1, p. 25-32Article in journal (Refereed)
    Abstract [en]

    PURPOSE: To investigate if sick leave due to mental disorders increases the risk of morbidity measured by inpatient and specialized outpatient care, and mortality among women and men, independent of familial factors.

    METHODS: An open cohort study of 4979 twin pairs discordant for sick leave due to mental disorders was conducted in 2005-2013. Twins were followed up in the cause of death and national patient registries until the end of study, emigration, death, and inpatient and specialized outpatient care. Conditional Cox proportional hazard regression, adjusting for the familial factors shared by the twins, was used to calculate hazard ratios (HR) with 95% confidence intervals (CI). In case of non-proportional hazards, time-varying covariates were used.

    RESULTS: Sick leave due to mental disorders increased the risk for inpatient care among men (HR: 1.90, CI 1.66-2.17) and women (HR: 1.39, CI 1.27-1.51). For men, the risk of outpatient care was higher the first 2 years (HR: 2.08, CI 1.87-2.31), after which it was attenuated (HR: 1.32, CI 1.02-1.70). For women, the HR was 1.57 (CI 1.47-1.68) for the whole study time. There was an increased risk of death among men (HR: 2.91, CI 1.70-4.99), but not among women (HR: 0.84, CI 0.53-1.35).

    CONCLUSIONS: Sick leave due to mental disorders was a risk factor for mortality for men only, and increased the risk of inpatient and specialized outpatient care among both women and men, but the risks were higher for men when stratifying for sex.

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  • 50.
    Nooijen, Carla F J
    et al.
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences.
    Blom, Victoria
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences, Sport Psychology research group.
    Ekblom, Örjan
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences, Åstrand Laboratory of Work Physiology.
    Ekblom, Maria
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences, Laboratory for Biomechanics and Motor Control.
    Kallings, Lena
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences, Åstrand Laboratory of Work Physiology.
    Improving office workers' mental health and cognition: a 3-arm cluster randomized controlled trial targeting physical activity and sedentary behavior in multi-component interventions2019In: BMC Public Health, E-ISSN 1471-2458, Vol. 19, article id 266Article in journal (Refereed)
    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.

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