Search

Objectives To assess the long-term effects on weight reduction and health of a group-based behavioral weight intervention over six months focusing eating for fulfillment as compared to a control regime with brief intervention. Method Overweight or obese adults (n = 176, 80% female, mean BMI 33.8 ± 4.7 kg/m2, mean age 55.2 ±10.1 years) were randomized to a group treatment or control receiving a brief intervention. Ninety-three participants (53% of original sample) completed the 5-year follow-up. Anthropometrics, blood pressure and biochemical measurements, self-rated lifestyle habits, quality of life and medication were obtained at baseline, at the end of the 6-month intervention, and once a year for five years following randomization. Results A per-protocol analysis, performed due to a high drop-out rate, found that weight reduction was small and similar in the two groups after five years. Reduction of waist/hip ratio, total-cholesterol and triglycerides were somewhat larger in the control group than in the treatment group. No changes regarding blood pressure, quality of life or medication use between the treatment and control groups were found. Conclusions No effect on weight reduction of the group intervention was found as compared to brief intervention but both groups achieved small weight loss over time. Findings indicate that any intervention or merely regular follow-ups might be promotive for weight maintenance in middle age.

The effectiveness of counsellor support in addition to physical activity on prescription (PAP) from health care professionals has rarely been evaluated. This observational follow-up study investigated differences in physical activity levels and health-related quality of life (HRQoL) one year after PAP regarding patients use of counsellor support in addition to PAP in routine care. The study was conducted in a Swedish health care region in which all patients receiving PAP from health care professionals were offered counsellor support. Data were collected from medical records and questionnaires (baseline and follow-up). Of the 400 study participants, 37% used counsellor support. The group of counsellor users attained a higher level of physical activity one year after receiving PAP compared to the group of non-users (p< 0.001). The level of physical activity was measured by a validated index (score 3-19) calculated from weekly everyday activity and exercise training. Comparison of the change in scores between baseline and follow-up showed a significant difference between the two groups, (p< 0.001). The median difference in the PAP + C group was 2.0 (interquartile range, 7.0) and 0.0. among non-users (interquartile range, 4.0). Significant differences in HRQoL were due to positive improvements among counsellor users, with the main improvement in general health. The conclusion is that patients using counsellor support after receiving PAP from health care professionals had higher physical activity and better HRQoL one year after compared with patients who did not use this support., Funding Agencies|Department of Research and Development, Region Kronoberg [4896]

Background: Public health gains from physical activity on prescription (PAP) depend on uptake in routine care. We performed an evaluation of the implementation, in a Swedish county council, of counsellors who give personalized support to PAP recipients aimed at facilitating PAP delivery. The aim was to compare characteristics between PAP recipients and the health care population as well as between PAP recipients who used and did not use counsellor support. We also investigated professional belonging and health care setting of health care professionals who prescribed PAP. Methods: All patients’ ≥18 years who received PAP during 2009–2012 in primary and secondary care in the County Council of Kronoberg were included (n = 4879). Data were retrieved from electronic medical records. Main outcome measures were patient and professional characteristics. Results: A third of the PAP recipients had diseases in ≥5 diagnostic groups and more than half had ≥11 office visits the year before receiving PAP. Counsellor support was used by one-third and PAP recipients who used counsellor support had more multiple diagnoses and office visits compared with non-users. Physicians issued 44% of prescriptions and primary care was the predominant setting. The amount of PAP did not change over time, but the proportion of physicians’ prescriptions decreased while the proportion of nurses’ prescriptions increased. Conclusions: PAP recipients had high morbidity and were frequent health care attenders, indicating that PAP was predominantly used for secondary or tertiary prevention. PAP rates did not increase as intended after the implementation of counsellor support. View Full-Text

Background: Smoking among teenagers and young people is still common and about every third young smoker states that they want to quit smoking. There are no obvious evidence-based methods for tobacco cessation for young people, and therefore, the same methods are used for young people as well as adults. The aim was to study young people's views about what support they would like for quit smoking, with the intention of developing a model for tobacco cessation for young people through interviews with the target groups. Methods: A qualitative study using a descriptive and exploratory design was conducted. Young smokers 16 - 29 years old (n=25) were interviewed in five focus groups in southern Sweden. Data were analyzed by content analysis. Results: The results illuminate young people's suggestions to develop a model for tobacco cessation. Four main categories emerged; Existing support rejected - existing apps, support- by SMS, and self-help brochures did not appeal to young people. Agreement between friends - To sign an agreement between two friends which included a fee on relapse. Adult support - To organize the model with duo groups and give adapted support. Celebrate and competition - Lift the positive with the freedom of smoke and create the opportunity to win simple prizes to celebrate the achieved interim goals. Conclusions: The young people suggested that the model for tobacco cessation would contain adult support and involves an agreement between friends and has elements of celebration and competition. The challenge will be to implement this model into environments where young people live.

Objective The aim of this study was to identify how fathers-to-be used the Internet as a source of information during their partners' pregnancy and how it affected them. Design and setting A descriptive cross-sectional study was conducted. Data were collected through a questionnaire and distributed at a maternity clinic in south of Sweden. The data were analysed descriptively. Participants Ninety-two Swedish fathers participated in the study, and the response rate was 98.9%. Findings Of all the fathers-to-be, 76% sought pregnancy-related information on the Internet. One sought information on a daily basis, 40.6% every week and 58% every month or more rarely. The fathers-to-be who participated at all/most visits at antenatal care searched for information on the Internet more often than those who only attended few/no visits (p = 0.012). A total of 33.4% of fathers-to-be had been recommended a web page by the midwife at the antenatal care. The main reason for using the Internet was to find information about pregnancy related subjects and read about people in similar situations. More than half of the fathers-to-be (61.8%) had at some point been worried by something they read online. These concerns were commonly addressed by asking the midwife at their next appointment (33.9%). Almost 26% of the fathers-to-be chose not to take any action at all to address their concerns. Conclusion The majority of all fathers-to-be searched for information on the Internet, and more than half of the fathers were, at some point, worried about the information they read on the Internet. One way to address questions and concerns could be for the fathers-to-be to ask and discuss with the midwives what they read online so that midwives can recommend appropriate and credible websites. To achieve this, there must be opportunities for midwives to gain knowledge on how best to use the Internet as a tool.

Aims: To identify factors, which were related to being smoke-free and snus-free, respectively, among adolescents in relation to adolescents who were smoking and/or using snus, and de-termine if there were any sex differences. Me- thods: A questionnaire study was performed among students in year two in upper secondary schools (17-years-old) in southern Sweden in 2009. More than 2200 students completed the questionnaire regarding health and living habits anonymously. The variables were tested by χ²-test, before selection into the logistic model. Because of the salutogenic approach in the study, the results of the logistic regression analyses were expressed as Positive Odds Ratio (POR). Results: The prevalence of being smoke- free was 75.6 percent for girls and 70.2 percent for boys, whilst the prevalence of being snus- free was 95.1 percent for girls and 70.2 percent for boys. Having a tobacco-free best friend was the most important factor that correlated with being smoke- and snus-free as an adolescent, for both boys and girls. Good living habits, such as drinking less alcohol, were also central to being smoke-free and snus-free. Conclusions: The results show that a tobacco-free environ-ment has a great influence on whether or not adolescents stay tobacco-free. As the environ-ment has a big impact, the school has a big challenge to work with the school environment and policies but also with family responsibility, norms and attitudes to tobacco.

BACKGROUND:The teenage years are the years when adolescents seek their identity, and part of this involves experimenting with tobacco. The use of tobacco as such, and norms among their friends, is more important to the adolescents than the norms of parents when it comes to using tobacco or not. The aim was to explore the significance of using snus for adolescents, and attitudes to snus, as well as the reasons why they began using snus and what maintained and facilitated the use of snus.METHODS:Adolescents who use snus were interviewed in focus groups. The material was analysed using content analysis.RESULTS:Four groups of boys and one group of girls were interviewed, a total of 27 students from the upper secondary vocational program. Three themes related to the students' opinions on and experiences of using snus were found: Circumstances pertaining to snus debut indicate what makes them start using snus. Upholding, which focuses on the problem of becoming addicted and development of identity, and approach, where the adolescents reflect on their snus habits in relation to those around them. A number of factors were described as relevant to behaviour and norm building for the development into becoming a snus user. Attitudes and actions from adults and friends as well as - for the boys - development of an identity as a man and a craftsman influenced behaviour.CONCLUSIONS:The results showed that development of identity was of major importance when adolescents start using snus. The adolescents were initially unable to interpret the early symptoms of abstinence problems, but subsequently became well aware of being addicted. Once they were stuck in addiction and in the creation of an image and identity, it was difficult to stop using snus. These factors are important when considering interventions of normative changes and tobacco prevention in schools as well as among parents.

Bakgrund: Ett tidigt stöd till föräldrar kan främja barns hälsa och utveckling samt hjälpa föräldrarna att möta det väntade och nyfödda barnet. Därför anordnas bl.a. föräldragrupper för föräldrar som väntar barn. För att garantera att föräldragruppernas utvecklas i takt med de riktlinjer som finns och efter föräldrarnas behov behövs ständiga utvärderingar. Syfte: Syfte med studien var att göra en utvärdering av föräldragrupperna inom mödrahälsovården i norra Kalmar län bland förstagångsföräldrar. Metod: Retrospektiv tvärsnittstudie med kvantitativt ansats. Data samlades in genom ett frågeformulär med strukturerade frågor och resultatet framställdes med hjälp av beskrivande statistik. Resultat: Tvåhundrafemtiotvå föräldrar deltog i studien. Av dessa hade 135 föräldrar deltagit i alla träffar. Resultatet visar på att föräldrarna tyckte att grupperna var meningsfulla (84,5 %) och att de uppfyllde deras behov (85,9 %). Föräldragrupperna ansågs vara en bra förlossningsförberedelse (85,1 %) och kunde stärka dem i föräldraskapet (75,5 %). Främst mödrar skapade kontakter och gemenskap med andra föräldrar. Det ämne som ej tagits upp i tillräcklig grad var parrelationen. Föräldrarna önskade att tidpunkten för träffarna skulle anpassas mer efter deras behov. Slutsats: Föräldrar upplevde de genomförda föräldragrupperna positivt. De förbättringar som angavs var att tidpunkten kunde anpassa mer efter föräldrarnas behov samt att parrelationen kunde diskuteras mera., Stöd i föräldraskapet