Adolescent vegetable consumption: the role of socioemotional family characteristics

Objective: To describe associations between adolescents’ frequency of vegetable consumption, food parenting practices and socioemotional family characteristics, and to explore potential mediated relationships that may contribute to an understanding of the family processes involved. Design: Cross-sectional survey among adolescents aged 13–15 years. Setting: A survey questionnaire including self-report measures on adolescents’ frequency of vegetable consumption, perceived food parenting practices (i.e. family dinner frequency, maternal/paternal healthy eating guidance (HEG), maternal/paternal social support for vegetable consumption) and socioemotional family characteristics (i.e. general family functioning and level of cohesion and conflict within the family) was distributed in a convenience sample of secondary school students. Participants: Four hundred forty students from five secondary schools in eastern Norway completed the questionnaire. Results: Results from multiple linear regression analysis revealed positive and statistically significant associations between adolescents’ frequency of vegetable consumption, maternal HEG and family cohesion. A partial indirect (mediated) association between family cohesion and adolescents’ frequency of vegetable consumption, working through maternal HEG, was also found. Conclusions: Results from the present study suggest that perceived family cohesion may influence adolescents’ frequency of vegetable consumption both directly and indirectly. However, there is a need for continued investigation of family-related factors influencing adolescent eating. In particular, the role of socioemotional family characteristics should be further scrutinised in future studies.acceptedVersio

Injury-Free Children and Adolescents: Towards Better Practice in Swedish Football (FIT project)

This interdisciplinary research project will produce evidence-based recommendations on how injuries in Swedish youth football (soccer) can be prevented. Fewer injuries will positively impact athlete health, performance and career longevity and have the potential to promote life-long physical activity and wellbeing. Injury pattern research demonstrates that injuries are a significant problem in (Swedish) youth sport. Football has a higher traumatic and overuse injury rate than many contact/collision sports (e.g., field hockey, basketball). In research on youth football, the incidence of overuse training injuries was measured as high as 15.4 injuries per 1000 training hours, and the incidence of traumatic and overuse match injuries was 47.5 injuries per 1000 match hours. The injury frequency is alarming and applies to the 54% of children aged 7-14 and the 39% of youths aged 15-19 years who participate in Swedish organised sports. A large body of research identifies injury risk factors and preventative strategies; however, as the recent IOC consensus statement on youth athletic development points out, the existing, mostly bio-medical knowledge does not provide effective evidence-based injury prevention strategies. To address this deficit, interdisciplinary and context-driven knowledge on injury development in youth sport is needed. The proposed project will produce scientific evidence through four consecutive studies: a) Questionnaire to register the types, frequency and management of injuries; b) Laboratory testing of biomechanical, clinical and training-specific parameters to establish individual physical and sport-specific dispositions; c) Observation of sporting contexts to understand sporting cultures, coaching methods and coach-athlete relationships; and d) Interviews with coaches and players to recognize knowledge that shapes coaching and training. The sample of youth players will be recruited from Sweden’s most popular and injury-prone sport: football. Each of the four studies will conduct its own data production and analyses, and a collective analysis will produce integrated evidence. Concrete recommendations for best sporting practice will be developed, which will serve sporting federations, sport education institutions, coaches, sport support staff and players

The reliability of the general functioning scale in Norwegian 13–15-year-old adolescents and association with family dinner frequency

Background Family environment is crucial to the development of health behaviors into adolescence and adulthood. The aims of this study were (1) to explore the reliability of the General Functioning Scale (GFS) among Norwegian 13-15-year-olds, and (2) to assess whether family functioning reported by adolescents was associated with family dinner frequency. Methods In total 440 secondary-school students were invited to participate in this cross-sectional web-based questionnaire survey, with 54 participating in the test-retest study. Test-retest and internal consistency were assessed for the 12-item GFS-scale. Associations between family functioning and family dinner frequency were tested using multiple logistic regression. Results The GFS had high internal consistency (corrected item-total correlations ranging from 0.40 to 0.65, Cronbach’s α = 0.85), and excellent test–retest reliability (intra-class correlation coefficient = 0.83). In the logistic regression model, a higher score on GFS (poorer family functioning) was associated with a reduced likelihood of having dinner together on a daily basis (i.e., 6–7 times per week, OR = 0.36, CI = 0.20–0-64) after adjusting for age, gender, ethnicity, living situation and parental education level. Conclusions The GFS had high reliability. As poorer family functioning was associated with less frequent family dinners, the family environment may be an important (contextual) target to influence adolescent health behaviors. It would be of interest to further explore the role of family functioning in relation to adolescents’ dietary habits, besides shared family meals, and to reveal the mechanisms underlying such relationships.publishedVersio

Alkoholforbruk og beruselsesfrekvens hos menn og kvinner over 40 år : alders- og livsfaseeffekter

Alkoholforbruket i dagens norske befolkningen over 40 år har økt de siste tiårene og mye tyder på at forbruket blant eldre voksne vil øke mer i årene som kommer. En slik økning kan føre til utfordringer og belastninger for den enkelte, familie og helsemyndigheter. Med utgangspunkt i datamaterialet fra studien ”Livsløp, generasjon og kjønn, 2007/2008” (LOGG), ble derfor aldersvariasjoner i alkoholforbruk og beruselsesfrekvens hos de over 40 år undersøkt nærmere. Det ble også undersøkt om typiske livsfasefaktorer som sivilstatus, arbeidssituasjon og barnas bosituasjon kunne påvirke alkoholforbruket og beruselsesfrekvensen, samt forklare aldersvariasjonene. De overordnede resultatene viste at det var variasjoner i alkoholforbruk og beruselsesfrekvens i de forskjellige aldersgruppene. Disse variasjonene kunne bare delvis forklares ut i fra livsfasefaktorene, samt deltakernes utdannings- og inntektsnivå, noe som indikerer at andre eller flere faktorer kan forklare variasjonene bedre. Videre forsking bør inkludere andre forklaringsfaktorer, blant annet faktorer som omhandler det sosiale nærmiljøet, for å få et mer nyansert bilde av hva som kan være årsaken til variasjoner i alkoholforbruk i siste halvdel av livsløpet. Det trengs også longitudinell forskning som kan undersøke kausale sammenhenger og kohorteffekter, slik at man bedre kan fange opp kompleksiteten av midtlivsfasen. Økt kunnskap omkring hvilke aldersgrupper i den eldre befolkningen som drikker mest, samt hvorfor noen aldersgrupper drikker mer enn andre, kan være til hjelp i å utvikle spesifikk forebygging rettet mot alder, livsfase og kjønn

Pårørendes perspektiv på egne erfaringer og behov ved palliativ sykepleie i hjemmet

Bakgrunn Flere pasienter ønsker å tilbringe den palliative fasen hjemme, og de pårørendes innsats er avgjørende for at dette skal la seg gjøre. Ønsket har vært å lære mer om de pårørendes erfaringer med palliasjon i hjemmet, for å få en økt forståelse av de pårørendes perspektiv. Hensikt Hensikten med denne oppgaven er å belyse pårørendes perspektiv på egne erfaringer og behov ved palliativ sykepleie i hjemmet. Metode Det er gjort en litteraturbasert analyse av kvalitative artikler, ettersom kvalitative artikler har som hovedmål å skape økt forståelse. Oppgaven er en deskriptiv metasyntese, som innebærer at de pårørendes erfaringer beskrives og sette sammen til en større helhet. Resultater Artiklenes resultater ble plassert i fire hovedkategorier og 13 underkategorier. Pårørendes rolle omhandler de pårørendes ansvar, forventinger de møtte og at de ofte bidro så mye at deres egne behov ble tilsidesatt. Omsorgsrollens utfordringer omhandler ulike utfordringer og konsekvenser de pårørende følte på, både fysiske og psykiske. Forventinger til sykepleier trekker frem de pårørendes møte med sykepleier og behov som kom til uttrykk i denne relasjonen. Verdifull tid viser til de mer verdifulle aspektene ved å være hjemme, som normalitet og ny intimitet. Konklusjon Pårørendes erfaringer og behov kan oppsummeres med tre ord: ansvarlig, avhengig og anerkjent. De er ansvarlige for praktiske oppgaver og pleien som gis, men er på samme tid også avhengige av helsepersonell, tid til egenomsorg og normalitet. De pårørende trenger å anerkjennes både for sitt ansvar og for sin avhengighet. Som omsorgsgiver og som pårørende

Methodological implications of adapting and applying a web-based questionnaire on health problems to adolescent football players

Background The Oslo Sport Trauma Research Centre Questionnaire on Health Problems (OSTRC-H) has become a popular tool to monitor health status in athletes. Originally developed for adult athletes, the tool is today also being used in adolescent athletes. However, little is known on the suitability of the questionnaire for the adolescent age group and the methodological implications of applying the tool to prospectively monitor illness and injury. To address this gap in methodological knowledge, the aim of this study is to outline and discuss the adaption and application process of the OSTRC-H to adolescent football players. Method The adaption process included a slightly modified back-translation method to translate the questionnaire. The application process included a web-based version of the Swedish OSTRC-H sent out once a week over 23 weeks to 115 adolescent football players aged 10-19 attending two football schools in Sweden. The response rate and prevalence of health problems over 23 weeks were calculated as feasibility indicators. Additionally, comprehensibility questions were added to the questionnaire in the end of the study. Result No major disagreement was found between the original and translated versions of the questionnaire. However, significant changes to the wording of the questions and answer categories were necessary to adapt it to adolescents. A visual body figure was also added. The average weekly response rate was 38% (SD 13.5). To increase this rate, questionnaire data was gathered retrospectively through telephone and email contact with the participants and their parents, elevating the response rate to 53% (SD 15.5). The adolescents experienced the questionnaire as easy to understand and to cover all relevant health problems. Conclusion Our study demonstrates the importance of adapting the questionnaire to the adolescent target group through translation, pre-tests, adjustments of wording and the facilitation of answering the questionnaire using a visual body figure. The study further shows the importance of keeping close and personal contact with the participants, their parents, teachers, and coaches throughout data collection. Future studies should take into account the age group and study context when adapting and applying the OSTRC-H to adolescents

Perceived rules and accessibility: measurement and mediating role in the association between parental education and vegetable and soft drink intake

Background: The existence of socioeconomic differences in dietary behaviors is well documented. However, studies exploring the mechanisms behind these differences among adolescents using comprehensive and reliable measures of mediators are lacking. The aims of this study were (a) to assess the psychometric properties of new scales assessing the perceived rules and accessibility related to the consumption of vegetables and soft drinks and (b) to explore their mediating role in the association between parental education and the corresponding dietary behaviors. Methods: A cross-sectional survey including 440 adolescents from three counties in Norway (mean age 14.3 years (SD = 0.6)) was conducted using a web-based questionnaire. Principal component analysis, test-retest and internal reliability analysis were conducted. The mediating role of perceived accessibility and perceived rules in the association between parental education and the dietary behaviors was explored using linear regression analyses. Results: Factor analyses confirmed two separate subscales, named “accessibility” and “rules”, both for vegetables and soft drinks (factor loadings >0.60). The scales had good internal consistency reliability (0.70 – 0.87). The test–retest reliability of the scales was moderate to good (0.44 – 0.62). Parental education was inversely related to the consumption of soft drinks and positively related to the consumption of vegetables. Perceived accessibility and perceived rules related to soft drink consumption were found to mediate the association between parental education and soft drink consumption (47.5 and 8.5 % of total effect mediated). Accessibility of vegetables was found to mediate the association between parental education and the consumption of vegetables (51 % of total effect mediated). Conclusion: The new scales developed in this study are comprehensive and have adequate validity and reliability; they are therefore considered appropriate for use among 13 – 15 year-olds. Parents, in particular those with a low educational background, should be encouraged to increase the accessibility of vegetables and to decrease the accessibility of soft drinks, in particular during dinner. Enforcing parental rules limiting soft drink intake in families with low parental education also appears relevant

Changes in adolescents’ and parents’ intakes of sugar-sweetened beverages, fruit and vegetables after 20 months: results from the HEIA study – a comprehensive, multi-component school-based randomized trial

Background: Interventions conducted in school-aged children often involve parents, but few studies have reported effects on parents’ own behaviour as a result of these interventions. Objective: To determine if a multi-component, cluster randomized controlled trial targeting 11–13 year olds influenced their consumption of fruit, vegetables, sugar-sweetened soft drinks and fruit drinks, and to explore whether the results varied by gender, adolescent weight status or parental educational level. A final aim was to assess whether the parents’ intakes were affected by the intervention. Design: Participants were 1,418 adolescents, 849 mothers and 680 fathers. Baseline and post-intervention data from the 20 months intervention study HEIA (HEalth In Adolescents) were included. Data were collected assessing frequency (and amounts; beverages only). Results: No significant differences were found at baseline between the intervention and control groups, except for the parental groups (educational level and intakes). At post-intervention, the adolescents in the intervention group consumed fruit more frequently (P<0.001) and had a lower intake of sugar-sweetened fruit drinks compared to the control group (P=0.02). The parental educational level moderated the effect on intake of sugar-sweetened fruit drinks in adolescents. The intake was less frequent in the intervention groups compared to the control groups (P=0.02) for those who had parents with low and medium educational level. Furthermore, the intervention may have affected mothers’ fruit intake and the vegetable intake in higher educated fathers. Conclusion: Favourable effects in favour of the intervention group were found for intake of fruit and sugar-sweetened fruit drinks among the adolescents in the HEIA study. Our results indicate that it is possible to reduce adolescents’ intake of sugar-sweetened fruit drinks across parental education, and potentially affect sub-groups of parents

Perceived rules and accessibility: measurement and mediating role in the association between parental education and vegetable and soft drink intake

Background The existence of socioeconomic differences in dietary behaviors is well documented. However, studies exploring the mechanisms behind these differences among adolescents using comprehensive and reliable measures of mediators are lacking. The aims of this study were (a) to assess the psychometric properties of new scales assessing the perceived rules and accessibility related to the consumption of vegetables and soft drinks and (b) to explore their mediating role in the association between parental education and the corresponding dietary behaviors. Methods A cross-sectional survey including 440 adolescents from three counties in Norway (mean age 14.3 years (SD = 0.6)) was conducted using a web-based questionnaire. Principal component analysis, test-retest and internal reliability analysis were conducted. The mediating role of perceived accessibility and perceived rules in the association between parental education and the dietary behaviors was explored using linear regression analyses. Results Factor analyses confirmed two separate subscales, named “accessibility” and “rules”, both for vegetables and soft drinks (factor loadings >0.60). The scales had good internal consistency reliability (0.70–0.87). The test–retest reliability of the scales was moderate to good (0.44–0.62). Parental education was inversely related to the consumption of soft drinks and positively related to the consumption of vegetables. Perceived accessibility and perceived rules related to soft drink consumption were found to mediate the association between parental education and soft drink consumption (47.5 and 8.5 % of total effect mediated). Accessibility of vegetables was found to mediate the association between parental education and the consumption of vegetables (51 % of total effect mediated). Conclusion The new scales developed in this study are comprehensive and have adequate validity and reliability; they are therefore considered appropriate for use among 13–15 year-olds. Parents, in particular those with a low educational background, should be encouraged to increase the accessibility of vegetables and to decrease the accessibility of soft drinks, in particular during dinner. Enforcing parental rules limiting soft drink intake in families with low parental education also appears relevant