Aktiv på dagtid – et folkehelsetilbud

Mennesker som står helt eller delvis utenfor arbeidslivet møter store helsemessige utfordringer. Det finnes god dokumentasjon på at fysisk aktivitet har positiv innvirkning på helse. Myndighetene har rettet fokuset mot lavterskeltilbud for særlig utsatte grupper. Aktiv på dagtid, et lavterskeltilbud for personer som står helt eller delvis utenfor arbeidslivet og mottar en form for trygdeytelse, blir trukket fram som eksempel. Det etterlyses vitenskapelig baserte undersøkelser rundt lavterskeltilbud med fysisk aktivitet for utsatte grupper av befolkningen, slik at tiltak som settes inn er basert på forskning og utprøving. Hensikt: Hensikten med denne studien var å undersøke utvikling i helserelatert livskvalitet, fysisk aktivitet og trygdesituasjon hos en gruppe nye deltakere på Aktiv på dagtid i Oslo. Metode: Studien har et longitudinelt prospektivt design. Alle kvinner og menn som registrerte seg på Aktiv på dagtid i oktober 2004 ble spurt om å delta i studien. Utfylling av spørreskjema for å måle helserelatert livskvalitet, fysisk aktivitetsnivå og trygdesituasjon ble gjort ved registrering, etter tre måneder og etter syv måneder. Spørreskjemaene SF-36, WHOQOL-bref og IPAQ ble benyttet. Av de 60 som sa seg villige til å delta, svarte 45 personer på de tre datainnsamlingene, og disse utgjør materialet. Resultat: De kvinnelige respondentene (n=34) hadde signifikant bedring i helserelatert livskvalitet innen helsefaktorene fysisk funksjon, kroppslig smerte og vitalitet. Det var ingen signifikant endring i helserelatert livskvalitet hos de mannlige respondentene (n=11), eller i fysisk aktivitet og trygdesituasjon hos noen av kjønnene. Resultater ved studieslutt viser positiv sammenheng mellom fysisk aktivitetsnivå og helserelatert livskvalitet. Korrelasjonen er sterkest for fysisk funksjon, generell helse og emosjonell rollebegrensning. Ved studieslutt skåret de respondentene som fortsatt var deltakere på Aktiv på dagtid signifikant bedre i fysisk domene enn de som ikke lenger var deltakere. Konklusjon: Denne studien har viktige, men få signifikante funn. For helserelatert livskvalitet er det signifikant positiv endring for kvinnene. Det er ikke signifikante funn for mennene. For fysisk aktivitetsnivå og trygdesituasjon er det ikke signifikante funn for noen av kjønnene

National Trends in Cycling in Light of the Norwegian Bike Traffic Index

National and international strategies and recommendations are intended to increase physical activity in the general population. Active transportation is included in interdisciplinary strategies to meet these recommendations. Cycling seems to be more health enhancing than walking for transportation since cycling seems to reduce the risk of cardiovascular disease and associated risk factors. Furthermore, the health benefits of cycling are proven to outrun the risk of injuries and mortality. Politicians seem to approve costly infrastructure strategies to increase the amount of cycling in the population to improve public health and shift to more sustainable travel habits. A linear relationship between cycle-friendly infrastructure and the amount of commuter cycling has been demonstrated. However, in Norway and on a global level, there is a lack of robust evaluations of actions and sensitive monitoring systems to observe possible change. Therefore, we aimed to develop the Norwegian bike traffic index and describe the national, regional, and local trends in counted cycle trips. We used a transparent methodology so that the index can be used, developed, and adapted in other countries. We included 89 stationary counters from the whole country. Counters monitored cycling from 2018 onward. The index is organized at local, regional, and national levels. Furthermore, the index is adjusted for population density at the counter level and presented as ratio of counted cycle trips, comparing 2018 to subsequent years. The index is presented as a percentage change with 95% confidence intervals. In Norway, counted cycle trips increased by 11% from 2018 (100, 100–100) to 2020 (111.0, 106.2–115.1), with large geographical differences. In Southern Norway, there was a significant increase of 23%, and in Northern Norway, there was a nonsignificant decrease by 8% from 2018 to 2020. The indices may indicate possible related effects of local to national cycling strategies and how the COVID-19 pandemic has affected Norwegian travel habits in urban areas

Healthy Life Centres: a 3-month behaviour change programme's impact on participants' physical activity levels, aerobic fitness and obesity: an observational study

Objectives Individuals with low socioeconomic status and multimorbidity tend to have lower physical activity (PA) levels than the general population. Primary care is an important setting for reaching high-risk individuals to support behaviour change. This study aimed to investigate the impact of behaviour change interventions delivered by Norwegian Healthy Life Centres (HLCs) on participants’ PA levels, aerobic fitness and obesity, and furthermore to investigate possible predictors of change. Design An observational study with a pre–post design and a 3-month follow-up. Setting Thirty-two HLCs in Norway were included. Participants A total of 713 participants (72% of the participants included at baseline), 71% women, with a mean age of 51 (18–87 years) and body mass index (BMI) of 32 (SD 7) met to follow-up. Intervention Individual consultations and tailored individual and group-based exercise and courses organised by the HLCs and cooperating providers. Outcome measures The primary outcome was time spent in moderate to vigorous PA (MVPA, min/day) (ActiGraph GT3X+ accelerometer). The secondary outcomes were light PA (LPA, min/day), number of steps per day, time spent sedentary (SED, min/day), aerobic fitness (submaximal treadmill test, min), BMI (kg/m2) and waist circumference (WC, cm). Results There was no change in MVPA (B 1.4, 95% CI −0.4 to 3.1) after 3 months. The participants had improved LPA (4.0, 95% CI 0.5 to 7.5), increased number of steps (362, 95% CI 172 to 552), reduced SED (−5.6, 95% CI −9.8 to –1.3), improved fitness (0.8, 95% CI 0.6 to 1.0), reduced BMI (−0.2, 95% CI −0.1 to –0.3) and reduced WC (−1.7, 95% CI −2.0 to –1.3). Positive predictors of change were number of exercise sessions completed per week, duration of adherence to HLC offers and participation in exercise organised by HLC. Conclusion Participation in the HLC interventions had small positive impacts on participants’ PA levels, aerobic fitness and obesity. Further research to develop effective behaviour change programmes targeting individuals with complex health challenges is needed

Correlates of Commuter Cycling in Three Norwegian Counties

Globally, there is an increasing challenge of physical inactivity and associated diseases. Commuter cycling is an everyday physical activity with great potential to increase the health status in a population. We aimed to evaluate the association of self-reported factors and objectively measured environmental factors in residence and along commuter routes and assessed the probability of being a commuter cyclist in Norway. Our study included respondents from a web-based survey in three Norwegian counties and we used a Geographic Information Systems (GIS) to evaluate the natural and built environment. Of the 1196 respondents, 488 were classified as commuter cyclists. Self-reported factors as having access to an e-bike (OR 5.99 [CI: 3.71–9.69]), being physically active (OR 2.56 [CI: 1.42–4.60]) and good self-rated health (OR 1.92 [CI: 1.20–3.07]) increased the probability of being a cyclist, while being overweight or obese (OR 0.71 [CI: 0.54–0.94]) reduced the probability. Environmental factors, such as high population density (OR 1.49 [CI: 1.05–2.12]) increased the probability, while higher slope (trend p = 0.020), total elevation along commuter route (trend p = 0.001), and >5 km between home and work (OR 0.17 [CI: 0.13–0.23]) decreased the probability of being a cyclist. In the present study, both self-reported and environmental factors were associated with being a cyclist. With the exception of being in good health, the characteristics of cyclists in Norway, a country with a low share of cyclists, seem to be similar to countries with a higher share of cyclists. With better knowledge about characteristics of cyclists, we may design better interventions and campaigns to increase the share of commuter cyclists

Correlates of Commuter Cycling in Three Norwegian Counties

Globally, there is an increasing challenge of physical inactivity and associated diseases. Commuter cycling is an everyday physical activity with great potential to increase the health status in a population. We aimed to evaluate the association of self-reported factors and objectively measured environmental factors in residence and along commuter routes and assessed the probability of being a commuter cyclist in Norway. Our study included respondents from a web-based survey in three Norwegian counties and we used a Geographic Information Systems (GIS) to evaluate the natural and built environment. Of the 1196 respondents, 488 were classified as commuter cyclists. Self-reported factors as having access to an e-bike (OR 5.99 [CI: 3.71–9.69]), being physically active (OR 2.56 [CI: 1.42–4.60]) and good self-rated health (OR 1.92 [CI: 1.20–3.07]) increased the probability of being a cyclist, while being overweight or obese (OR 0.71 [CI: 0.54–0.94]) reduced the probability. Environmental factors, such as high population density (OR 1.49 [CI: 1.05–2.12]) increased the probability, while higher slope (trend p = 0.020), total elevation along commuter route (trend p = 0.001), and >5 km between home and work (OR 0.17 [CI: 0.13–0.23]) decreased the probability of being a cyclist. In the present study, both self-reported and environmental factors were associated with being a cyclist. With the exception of being in good health, the characteristics of cyclists in Norway, a country with a low share of cyclists, seem to be similar to countries with a higher share of cyclists. With better knowledge about characteristics of cyclists, we may design better interventions and campaigns to increase the share of commuter cyclists

Physical activity and cardiovascular risk factors in a 40- to 42-year-old rural Norwegian population from 1975–2010: repeated cross-sectional surveys

Background: Geographical differences in cardiovascular diseases (CVD) have been observed among Norwegian counties. Better long-term health status and higher physical activity (PA) levels have been documented in the county of Sogn & Fjordane compared with other counties. However, recent trends in CVD risk factors have not been documented. The aim of this study was to investigate the secular trends in leisure time physical activity (LTPA) and other CVD risk factors over a 35-year period in a rural population of 40- to 42-year-olds in western Norway and to compare these trends with national trends. Methods: Data from eight cross-sectional studies from 1975–2010 (n = 375,682) were obtained from questionnaires and physical examinations and were analyzed using mixed model regression analyses. Results: Decreasing trends were observed for sedentary behavior (for women), moderate PA, smoking, systolic blood pressure (SBP), diastolic blood pressure (DBP), high-density lipoprotein (HDL-c) and total cholesterol (TC), whereas increasing trends were observed for body mass index (BMI), triglycerides (TG), light PA, vigorous PA and sedentary behavior for men. Compared to the national trends, the trends in the 40-42-year-olds from Sogn & Fjordane were more beneficial in terms of TG, HDL-c and BMI but less beneficial in terms of SBP and DBP. Conclusions: Over a 35-year-period, this study indicates that the LTPA level has been relatively stable in the county of Sogn & Fjordane. Upward trends were observed in light and vigorous PA, whereas a downward trend was observed in moderate PA. For sedentary behavior, an upward trend was observed in men, whereas a downward trend was observed in women. For smoking, BP and cholesterol decreasing trends were found, but increasing trends were observed in BMI and TG. Compared with the national data, the trends in Sogn & Fjordane were more beneficial for TG, HDL-c and BMI but less beneficial for BP

Health-related quality of life and intensity-specific physical activity in high-risk adults attending a behavior change service within primary care.

ObjectivesHealth-related quality of life (HRQoL) is an important outcome for health interventions, such as physical activity (PA) promotion among high-risk populations. The aim of this study was to investigate levels of PA and HRQoL, and associations between PA and HRQoL, in participants attending a behavior change service within primary care in Norway.MethodsAdult participants (≥ 18 years) from 32 Healthy Life Centers (HLCs) in four regions of Norway, who provided valid data on HRQoL (SF-36) and PA (ActiGraph accelerometer) were included (N = 835). HRQoL scores were compared to normative data by independent sample t-tests. Associations between eight dimensions of HRQoL and time spent sedentary (SED), in light PA (LPA) or in moderate to vigorous PA (MVPA) were determined using general linear models adjusted for relevant confounders.ResultsNineteen percent of the participants (mean age 50; body mass index 32) met PA recommendations of > 150 min MVPA per week. SF-36 scores were 10 to 28 points lower than the norm (all p ConclusionsIndividuals attending a Norwegian behavior change service within primary care had low PA level and low HRQoL compared to the general population. Our study suggest there is a positive dose-response relationship between PA and HRQoL, and a negative relationship between SED and HRQoL. Furthermore, that specific PA intensities and SED are related to different dimensions of HRQoL

Health-related quality of life and physical activity level after a behavior change program at Norwegian healthy life centers: a 15-month follow-up

Purpose The long-term impact of primary care behavior change programs on health-related quality of life (HRQoL) and physical activity (PA) level is unknown. The aim of this study was to investigate changes in HRQoL and PA among participants after a 3-month behavior change intervention at Norwegian healthy life center (HLCs) and at a 15-month follow-up. Furthermore, we aimed to study associations between changes in PA and HRQoL. Methods We followed 524 adult participants (18–83 years), recruited from 32 HLCs in August 2016–January 2018, who provided data on HRQoL (SF-36) and PA (ActiGraph accelerometers) 12 months after a 3-month behavior change intervention. Changes in HRQoL and PA between baseline, 3-month and 15-month follow-ups, and associations between changes in PA and HRQoL were analyzed by linear mixed models. Results All HRQoL dimensions improved from baseline to 3-month follow-up, and the improvements maintained at 15-month follow-up (mean 3.1–13.1 points, p < 0.001). PA increased from baseline to 3 months (mean 418 steps/day, p < 0.001), but declined from 3 to 15 months (mean − 371 steps/day, p < 0.001). We observed positive associations between changes in PA and HRQoL (0.84–3.23 points per 1000 steps/day, p < 0.023). Conclusions Twelve months after completing a 3-month HLC intervention we found improved HRQoL, but not PA level. Still, there were positive associations between PA and HRQoL over this period, indicating that participants increasing their PA were more likely to improve their HRQoL

Health-related quality of life and physical activity level after a behavior change program at Norwegian healthy life centers: a 15-month follow-up

Purpose The long-term impact of primary care behavior change programs on health-related quality of life (HRQoL) and physical activity (PA) level is unknown. The aim of this study was to investigate changes in HRQoL and PA among participants after a 3-month behavior change intervention at Norwegian healthy life center (HLCs) and at a 15-month follow-up. Furthermore, we aimed to study associations between changes in PA and HRQoL. Methods We followed 524 adult participants (18–83 years), recruited from 32 HLCs in August 2016–January 2018, who provided data on HRQoL (SF-36) and PA (ActiGraph accelerometers) 12 months after a 3-month behavior change intervention. Changes in HRQoL and PA between baseline, 3-month and 15-month follow-ups, and associations between changes in PA and HRQoL were analyzed by linear mixed models. Results All HRQoL dimensions improved from baseline to 3-month follow-up, and the improvements maintained at 15-month follow-up (mean 3.1–13.1 points, p < 0.001). PA increased from baseline to 3 months (mean 418 steps/day, p < 0.001), but declined from 3 to 15 months (mean − 371 steps/day, p < 0.001). We observed positive associations between changes in PA and HRQoL (0.84–3.23 points per 1000 steps/day, p < 0.023). Conclusions Twelve months after completing a 3-month HLC intervention we found improved HRQoL, but not PA level. Still, there were positive associations between PA and HRQoL over this period, indicating that participants increasing their PA were more likely to improve their HRQoL

Long-term correlates of objectively measured physical activity and sedentary time in norwegian men and women.

Background: Sex, age, body mass index (BMI), perceived health and health behavior are correlates known to affect physical activity and sedentary time. However, studies have often been cross-sectional, and less is known about long-term correlates. Thus, the aims were to investigate 1) the associations between a set of characteristics (demographic, biological, psychological and behavioral) and objectively measured physical activity and sedentary time at 13 year follow-up, and 2) the association between changes in these characteristics over time and physical activity and sedentary time. Methods: Baseline characteristics were collected in 40-year-olds in 1996, and follow-up data on objectively measured physical activity and sedentary time were obtained in 2009 (n=240). Data were analyzed by multiple linear regressions. Results: Self-reported physical activity (p<0.001) and improved perceived health (p=0.046) were positively associated with moderate-to-vigorous physical activity (MVPA) whereas BMI (p=0.034) and increased BMI (p=0.014) were negatively associated with MVPA at follow-up. Women spent less time being sedentary than men (p=0.019). Education (p<0.001) was positively associated and improved perceived health (p=0.010) was negatively associated with sedentary time at follow-up. Conclusions: MVPA and sedentary time at follow-up were associated with behavioral, biological and demographic correlates. However, the nature of our analyses prevents us from inferring causality