Gymnastik- och idrottshögskolan, GIH

Aim

To investigate physical activity (PA), sedentary time, and screen time by age, sex, and parental education in a national sample of young children.

Method

This cross-sectional study, conducted 2021–2024, of Swedish children recruited via their parents, included 1078 children aged 18 months, mean 1.5 ± 0.1 years, and 750 aged four, mean 4.1 ± 0.1 years. PA, sedentary time, and screen time were measured with accelerometry and questionnaire.

Results

PA guidelines were met by 94% of the 18-month-old children and 51% of those 4 years old. Among 18-month-old children, 22% met screen time guidelines on weekdays and 17% on weekends; corresponding percentages among children 4 years old were 60% and 28%. Device-measured PA levels were consistently lower for girls than boys at age four, but sex differences were small among 18-month-old children. More children whose parents were highly educated participated in organised activities and used active transport modes; they also had lower screen time than children whose parents had low education.

Conclusion

Nearly all 18-month-old children met PA guidelines, versus only half of those aged 4 years. Many children in both age groups exceeded screen time guidelines. Age, sex, and parental education were associated with children's PA and screen time, suggesting targeted interventions.

PURPOSE: Mental health problems are increasingly prevalent during adolescence. Nutritional factors, particularly antioxidants, are of interest due to their potential to reduce oxidative stress and inflammation linked to mental health issues. However, the relationship between dietary antioxidants and adolescent mental health remains unclear. This study aimed to investigate this association in Swedish adolescents and explore potential gender differences.

METHODS: Cross-sectional data were gathered among Swedish boys and girls aged 13-14 years (n = 1139). Participants reported their dietary intake using a detailed web-based method and mental health outcomes, including anxiety, psychosomatic symptoms, and health-related quality of life (HRQoL) using self-report scales. Multiple linear regression analysis, adjusted for confounders, was used to investigate the associations between mental health outcomes and tertiles of dietary intake of vitamin C, E and β-carotene.

RESULTS: Adolescents in the highest tertile of β-carotene intake reported lower anxiety (β=-1.23, 95% CI=-2.34, -0.12), fewer psychosomatic symptoms (β=-0.91, 95% CI=-1.69, -0.13), and better HRQoL (β = 0.89, 95% CI = 0.11, 1.68). Similarly, higher vitamin C intake was associated with fewer psychosomatic problems (β=-1.00, 95% CI=-1.79, -0.21). Vitamin E intake showed no associations. Significant gender interactions were observed on the multiplicative scale analysis and limited to the middle tertiles of β-carotene and vitamin C for anxiety and psychosomatic symptoms, respectively.

CONCLUSION: Our findings underscore the potential role of dietary antioxidants, particularly β-carotene and vitamin C, in adolescent mental health. Further research including diverse populations and employing prospective designs could deepen the understanding and inform public health interventions.

AIM: Investigate the longitudinal relationship between physical activity, organised physical activity, fitness, screen time and academic performance among Swedish adolescents.

METHODS: Data from 1139 adolescents at age 13, included vigorous physical activity (accelerometry), fitness (submaximal ergometer test), screen time and organised physical activity participation (self-reported) and academic performance (math and Swedish grades at ages 13 and 16 from registry). Academic performance at age 16 was categorised as A-D (higher grades or pass) or E, F (fail or at-risk of failing). Multilevel logistic regression models were used to examine the relationships while adjusting for gender, parental education, parental country of birth and academic performance at age 13.

RESULTS: Higher fitness at age 13 was associated with increased odds of receiving A-D at age 16 (OR: 1.04 per mL, 99% CI 1.00, 1.07, p = 0.003). High screen time during weekdays was associated with reduced odds (OR: 0.40, 99% CI 0.20, 0.81, p = 0.001) compared to low screen time.

CONCLUSION: Academic performance at the end of compulsory school (age 16) was related to fitness and screen time 3 years earlier. These findings create a paradigm for future randomised controlled trials to explore how influencing these factors might affect academic performance.

De positiva effekterna av fysisk aktivitet på hälsa, välbefinnande och kognitiva funktioner är väl belagda i en rad publikationer och kunskapssammanställningar. Regelbunden daglig fysisk aktivitet kan främja psykisk hälsa och välbefinnande hos barn och ungdomar i alla skolåldrar.

Background: Families residing in disadvantaged communities encounter inequalities that restrict their engagement in physical activity. Family-based interventions and health coordinators have been proposed as promising approaches to encourage physical activity among parents and children. However, there is a paucity of knowledge regarding family experiences of such programmes and the ways health coordinators facilitate continued participation in programmes delivered in disadvantaged communities. The study aimed to explore parents’ perceptions of health coordinators in a family-based physical activity programme, Open Activities, delivered in disadvantaged communities in Sweden. Study design: An exploratory design with a qualitative ethnographic approach. Methods: Multiple methods, including 12 interviews, 15 observations and field notes, and prolonged researcher engagement between February 2022 and December 2023, were used to obtain complementary insights into parents’ perceptions and experiences in the Open Activities programme. Data was analysed using reflexive thematic analysis. Results: A main theme and three sub-themes emerged from the analysis. The sub-themes reflect participants’ perceptions of how health coordinators provide a sense of safety for parents and children, making them feel appreciated and motivated to continue participating in the programme. The sub-themes also reflect the struggles that families encounter with security and social disorders in their neighbourhoods and how these difficulties influence their participation in outdoor activities and trust in outside people, including health coordinators. This required health coordinators to demonstrate a deep commitment to their communities, cultivate trust and fairness, and take a more assertive role in enforcing rules and ensuring respect. Conclusion: The involvement of health coordinators, aware of the issues facing disadvantaged communities, could represent a promising avenue for advancing health equity through physical activity. Failure to consider the potential of health coordinators to promote safety can compromise programmes’ sustainability and even exacerbate existing disparities. © 2024 The Authors

Tackling inequities and inequalities related to adolescents' engagement in physical activity and sport is highlighted in recent research. However, rarely addressed are the issues of intersecting hierarchal systems of power that interlocks on both micro and macro levels, affecting how physical activity patterns express social memberships across several contexts. Therefore, this study aimed to explore how adolescents' physical activity during leisure and school hours expressed intersecting social positions and institutional school segregation, using a critical intersectionality approach. Nested in a larger study, a cross-sectional design was applied, including a total of 1139 adolescents in grade 7 (age 13-14) from Swedish school settings. Data was retrieved from surveys, accelerometers, and national registries. Descriptive statistics and stratified analyses were performed to examine levels of moderate-to-vigorous physical activity (MVPA) during school and leisure hours connected to intersecting social positions and school segregation contexts. The statistical analysis indicated that MVPA, to varying extents, expressed both individual social position and school segregation across the sub-groups explored. Inequalities in MVPA were closer connected to intercategorical gendered social positions in school contexts, rather than during leisure hours. However, there were significant intracategorical differences among girls during leisure hours across segregated contexts. Our results suggest that the power structures of school segregation together with educational and sport logics intertwined seem to 'disadvantage' especially girls with a non-ethnically Swedish background. Yet, it also highlights a need to problematize 'the absent minority girl' in equity focused physical activity research. This study emphasizes how an intersectionality approach can shed light on social (dis)advantages connected to adolescents' MVPA from two poles of power, contributing to a more comprehensive and critical understanding of social inequities in physical activity and health research.

Aim: Insufficient physical activity among adolescents, combined with poorer well-being and mental health, are worrying societal problems. Adolescents with ADHD encounter daily challenges and are more prone to experiencing mental and physical health issues compared to their peers. The aim was to investigate associations between moderate-to-vigorous physical activity, sedentary time, screen-time, psychosomatic problems, and ADHD symptoms in adolescents. Method: Data came from a cross-sectional study. Participants (N = 1139) were seventh-grade students who answered questionnaires on screen-time, psychosomatic problems, hyperactivity, and ADHD and were assigned an accelerometer, worn for seven consecutive days. Data were analyzed using linear regression. Results: A negative association was found between moderate to vigorous physical activity and psychosomatic problems in the entire sample. Moderate-to-vigorous physical activity was more strongly associated with psychosomatic problems for adolescents with self-reported ADHD symptoms (B = -0.14 (-0.24, -0.04)) than adolescents without ADHD symptoms (B: -0.03 (-0.05, -0.01)). Conclusions: Moderate-to-vigorous physical activity, sedentary time, and screen-time were all significantly associated with psychosomatic problems among all participants. Moderate-to-vigorous physical activity showed a stronger association with psychosomatic problems among participants with ADHD. This indicates that this group may be particularly responsive to interventions attempting to promote mental health through physical activity.

Introduction: There is an association between physical activity and both health and academic performance. However, there is still a lack of consensus on how to engage adolescents in physical activity interventions in secondary schools. One approach to better understand the activities and strategies supporting effective implementation is to involve school staff and adolescents in the early stages of planning and preparing for interventions. Therefore, the aim of this study is to explore how multiple stakeholders, including school staff, students, and experts, perceive the barriers and facilitators for implementing a school-based intervention that extends the school day with additional physical activity in Sweden.

Material and methods: This inductive explorative qualitative study involved 16 participants. Three focus groups with school staff, including principals (n = 3), teachers (n = 6), and students (n = 4), and three interviews with experts were conducted. The planned intervention and its components were presented to the participants in the focus group and interviews to discuss them based on their previous experiences and thoughts of implementing physical activities or health promotion programmes in their schools or with adolescents. Data were analysed using qualitative content analysis.

Results: Three categories emerged: (1) “types of activities offered”, highlighting the importance of designing activities that are fun, inclusive and unusual; (2) “integration of the activities into school curriculum” to promote sustainability of the intervention and incorporate physical activity throughout the school day and across school subjects, and (3) “Management support and funding” referring to the funded time and facilities that teachers leading the activities need to facilitate implementation.

Conclusions: Before implementing extra physical activity in a school setting, it is important to understand what activities enhance students' motivation and the type of support teachers need from the school principal and administration. This includes funding for teachers' time, appropriate scheduling of the activities, and access to facilities.

AIM: Evidence on physical activity (PA), sedentary time, and fitness in adolescents with impairments has been limited. We aimed to compare outcomes in Swedish adolescents with and without impairments and between impairment types.

METHODS: This cross-sectional study, from September to December 2019, comprised of adolescents from 34 mainstream schools within 3 h' drive of Stockholm, Sweden. Parents reported impairment status. PA and sedentary time were measured with accelerometers during school and leisure time on weekdays and weekends. Fitness was estimated using the Ekblom-Bak submaximal cycle test, sports participation was self-reported and multilevel mixed models were used for analyses.

RESULTS: We enrolled 972 adolescents (51% girls), with a mean age of 13.4 ± 0.3 years. Just under a third (31%) had impairments. Adolescents with impairments showed lower PA levels, less adherence to recommendations, lower fitness and less participation in organised sports than those without impairments. Those with learning or visual impairments engaged in less vigorous activity and the former had lower fitness levels.

CONCLUSION: Adolescents with impairments were less physically active, more sedentary and had lower fitness than peers without impairments. This emphasises the need for equitable opportunities for PA, to support long-term health and well-being in adolescents with impairments.

BACKGROUND: Current evidence suggests that even in high-income countries such as Sweden, there are socioeconomic differences in children's participation in physical activity. While family-based programmes appear promising to encourage physical activity, there is a lack of knowledge on how to engage families in such programmes, particularly in socioeconomically disadvantaged areas. The Open Health-Promoting Activities programme was launched to promote physical activity outdoors and health equity for children and their families in these areas. This study aims to explore parents' experiences with the Open Health-Promoting Activities programme in socioeconomically disadvantaged areas, focusing on family engagement in physical activity and perceived changes in family dynamics.

METHODS: A qualitative design with an ethnographic approach was employed. In line with an ethnographic approach, the research team conducted 15 participant observations of the programme sessions on Saturdays during Spring 2022. Field notes were compiled during the observations, which provided contextual information for individual interviews with 12 programme participants. These interviews were conducted after the researchers attended the programme. The participants were adults/parents who participated in the programme with one or more of their children. An inductive reflexive thematic analysis was used to analyse the field notes and interviews.

RESULTS: The analysis identified three main themes: (1) prioritising children's equal engagement in physical activity, (2) helping parents promote children's healthy lifestyles, and (3) improving family dynamics through engagement in physical activity. Each theme captures an aspect of the programme that parents perceived as essential to facilitating their family's engagement in the programme. All the themes are interconnected and form the basis for improving family dynamics.

CONCLUSION: To develop tailored family-based programmes in socioeconomically deprived communities, it is crucial to understand parents' experiences and perceptions of aspects that facilitate their children's engagement in physical activity. The findings suggest that emphasising equal opportunities, a safe space approach and participation are essential for increasing family engagement in physical activity. These elements also supported increasing parents' awareness of their children's need to be active and have fun together.