Dietary Advice on Prescription: A novel approach to dietary counseling

This article describes a novel approach to giving dietary advice, which is called “Dietary Advice on Prescription” (DAP; Matordning på Recept [MoR] in Swedish). It is the same principle as prescription on medicine and “Physical Activity on Prescription” (PAP; Fysisk aktivitet på Recept [FaR] in Swedish). The main idea is that a written prescription will strengthen the oral advice and emphasize certain aspects of the dietary recommendation. The DAP is on the brink of being tested in a planned study

Surveillance of compliance with tobacco regulations in Örebro County, Sweden: a mixed methods study after the ban of test purchases

<p>Abstract</p> <p>Background</p> <p>Tobacco has long been known to be one of the most common reasons for sickness and premature deaths in the world. An important aspect of tobacco use is the youth's access to tobacco, and surveillance visits are one way to make sure how retailers are complying with age limit in the tobacco law. In Örebro County, Sweden, a project to reinforce the tobacco legislation was carried out in 2009-2010. One part of the project was surveillance visits that were done according to three different themes, called thematic surveillance.</p> <p>Methods</p> <p>This study is an evaluation of the results from thematic surveillance and has a mixed methods approach. The quantitative analyses concerns protocols from 217 surveillance visits, where questions were asked about three themes (self-monitoring programs; marketing; labeling of products and pricing). In addition, questionnaires filled out by six tobacco administrators who worked within the project were analyzed qualitatively by content analysis in order to study their perceptions and opinions of the project.</p> <p>Results</p> <p>This study shows that half of the visited retailers had self-monitoring programs. Lack of self-monitoring programs was significantly more common in smaller stores/kiosks and at restaurants. Further, the tobacco administrators who worked within the project perceived thematic surveillance as a good method for accomplishing better structure in surveillance work, but not as effective as purchase attempts (mystery shopping).</p> <p>Conclusions</p> <p>Thematic surveillance was perceived as positive and the method was also regarded to be a good way to work with surveillance. However, the method could be developed further for optimal use and better effect at the retailers. It is clear that people who work with tobacco prevention at the local level in Örebro County want to use purchase attempts as a surveillance method, and that they believe that purchase attempts is the best way to make sure if store comply with the tobacco law.</p

Physical activity referrals in Swedish primary health care – prescriber and patient characteristics, reasons for prescriptions, and prescribed activities

<p>Abstract</p> <p>Background</p> <p>Over the past decade, practitioners in primary health care (PHC) settings in many countries have issued written prescriptions to patients to promote increased physical activity or exercise. The aim of this study is to describe and analyse a comprehensive physical activity referral (PAR) scheme implemented in a routine PHC setting in Östergötland County. The study examines characteristics of the PARs recipients and referral practitioners, identifies reasons why practitioners opted to use PARs with their clients, and discusses prescribed activities and prescriptions in relation to PHC registries.</p> <p>Methods</p> <p>Prospective prescription data were obtained for 90% of the primary health care centres in Östergötland County, Sweden, in 2004 and 2005. The study population consisted of patients who were issued PARs after they were deemed likely to benefit from increased physical activity, as assessed by PHC staff.</p> <p>Results</p> <p>During the two-year period, a total of 6,300 patients received PARs. Two-thirds of the patients were female and half of the patients were 45–64 years. Half of the patients (50.8%) who received PARs were recommended a home-based activity, such as walking. One third (33%) of the patients issued PARs were totally inactive, reporting no days of physical activity that lasted for 30 minutes, and 29% stated that they reached this level 1–2 days per week.</p> <p>The number of PARs prescribed per year in relation to the number of unique individuals that visited primary health care during one year was 1.4% in 2004 and 1.2% in 2005. Two-thirds of the combined prescriptions were issued by physicians (38%) and nurses (31%). Physiotherapists and behavioural scientists issued the highest relative number of prescriptions. The most common reasons for issuing PARs were musculoskeletal disorders (39.1%) and overweight (35.4%), followed by high blood pressure (23.3%) and diabetes (23.2%).</p> <p>Conclusion</p> <p>Östergötland County's PAR scheme reached a relatively high proportion of physically inactive people visiting local PHC centres for other health reasons. PAR-related statistics, including PAR-rates by individual PHC centres and PAR- rates per health professional category, show differences in prescribing activities, both by patient categories, and by prescribing professionals.</p

Monitoring the newly qualified nurses in Sweden: the Longitudinal Analysis of Nursing Education (LANE) study

BACKGROUND: The Longitudinal Analysis of Nursing Education (LANE) study was initiated in 2002, with the aim of longitudinally examining a wide variety of individual and work-related variables related to psychological and physical health, as well as rates of employee and occupational turnover, and professional development among nursing students in the process of becoming registered nurses and entering working life. The aim of this paper is to present the LANE study, to estimate representativeness and analyse response rates over time, and also to describe common career pathways and life transitions during the first years of working life. METHODS: Three Swedish national cohorts of nursing students on university degree programmes were recruited to constitute the cohorts. Of 6138 students who were eligible for participation, a total of 4316 consented to participate and responded at baseline (response rate 70%). The cohorts will be followed prospectively for at least three years of their working life. RESULTS: Sociodemographic data in the cohorts were found to be close to population data, as point estimates only differed by 0-3% from population values. Response rates were found to decline somewhat across time, and this decrease was present in all analysed subgroups. During the first year after graduation, nearly all participants had qualified as nurses and had later also held nursing positions. The most common reason for not working was due to maternity leave. About 10% of the cohorts who graduated in 2002 and 2004 intended to leave the profession one year after graduating, and among those who graduated in 2006 the figure was almost twice as high. Intention to leave the profession was more common among young nurses. In the cohort who graduated in 2002, nearly every fifth registered nurse continued to further higher educational training within the health professions. Moreover, in this cohort, about 2% of the participants had left the nursing profession five years after graduating. CONCLUSION: Both high response rates and professional retention imply a potential for a thorough analysis of professional practice and occupational health

Is there a demand for physical activity interventions provided by the health care sector? Findings from a population survey

<p>Abstract</p> <p>Background</p> <p>Health care providers in many countries have delivered interventions to improve physical activity levels among their patients. Thus far, less is known about the population's interest to increase their physical activity levels and their opinion about the health care provider's role in physical activity promotion. The aims of this paper were to investigate the self-reported physical activity levels of the population and intention to increase physical activity levels, self-perceived need for support, and opinions about the responsibilities of both individuals and health care providers to promote physical activity.</p> <p>Methods</p> <p>A regional public health survey was mailed to 13 440 adults (aged 18-84 years) living in Östergötland County (Sweden) in 2006. The survey was part of the regular effort by the regional Health Authorities.</p> <p>Results</p> <p>About 25% of the population was categorised as physically active, 38% as moderately active, 27% as somewhat active, and 11% as low active. More than one-third (37%) had no intentions to increase their physical activity levels, 36% had thought about change, while 27% were determined to change. Lower intention to change was mainly associated with increased age and lower education levels. 28% answered that physical activity was the most important health-related behaviour to change "right now" and 15% of those answered that they wanted or needed support to make this change. Of respondents who might be assumed to be in greatest need of increased activity (i.e. respondents reporting poor general health, BMI>30, and inactivity) more than one-quarter wanted support to make improvements to their health. About half of the respondents who wanted support to increase their physical activity levels listed health care providers as a primary source for support.</p> <p>Conclusions</p> <p>These findings suggest that there is considerable need for physical activity interventions in this population. Adults feel great responsibility for their own physical activity levels, but also attribute responsibility for promoting increased physical activity to health care practitioners.</p