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  • 1.
    Blank, J.
    et al.
    Department of Public Health and Community Health, Göteborg University, Sweden;.
    Nordin, P.
    Skaraborg Institute, Skövde, Sweden.
    Toivonen, Henri
    Children Health Care, Skaraborg, Sweden.
    Lindblad, Ulf
    Department of Public Health and Community Health, Göteborg University, Sweden.
    Nyholm, Maria
    Halmstad University, School of Social and Health Sciences (HOS), Centre of Research on Welfare, Health and Sport (CVHI).
    Prevalence of overweight and obesity among preschool children between 2004 and 2008, in a rural area of Sweden: The Skaraborg Evaluation Child Obesity Prevention Project (SECOPP)2010In: Special Issue: Abstracts of the 11th International Congress on Obesity, 11-15 July 2010, Stockholm, Sweden, Chichester, England: Wiley-Blackwell, 2010, p. 73-74Conference paper (Refereed)
    Abstract [en]

    Background: Childhood obesity is considered a serious public health problem and it has increased over the last two decades. The aim of this paper was to report 5-year change in prevalence of overweight and obesity among preschool children in a rural area of Sweden. Material and Method: Body height and weight were obtained in 2004, 2006 and 2008. A total of 1914 children (1014 boys and 900 girls), aged 4 years ± 4 months and were examined at Child Welfare Clinics in two municipalities in the Skaraborg area in Region of Västra Götaland, Sweden were included in the study. Body mass index (BMI) was calculated and categorized according to the International Obesity Task Force (IOTF) and WHO cut-off as reference methods in defining overweight and obesity, and GLM methods were used to estimate the change with age as a covariate. Result: Between 2004 and 2008, overweight increased in boys according to IOTF 2.0% (P = 0.048), whereas no such trend was seen when using WHO cut-offs. In girls, overweight increased significant according to the both definitions IOTF 9.1% (P < 0.001) and WHO 2.8% (P = 0.010). Obesity has decreased in both boys and girls, however not significant. According to IOTF obesity decreased with 1.1% in boys and 1.9% in girls, and WHO with 2.1% in boys and 1.5% in girls. Conclusion: This study shows that overweight has increased in both sexes and obesity rates remained rather steady. However, public health strategies targeting the whole population is still needed.

  • 2.
    Hutton, Katrin
    et al.
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI), Health promotion and disease prevention. Affecta Psychiatric clinic, Halmstad, Sweden.
    Nygren, Jens
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI), Health promotion and disease prevention.
    Nyholm, Maria
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI), Sport Health and Physical activity.
    Svedberg, Petra
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI), Health promotion and disease prevention.
    Low self-rated mental health among Swedish adolescent boys and its relationship to socioeconomic factors2013Conference paper (Refereed)
    Abstract [en]

    Background

    Adolescents mental health is a major public health concern and studies have shown that socioeconomic factors contribute to the experienced health of adolescents. Girls’ mental health, more than boys’ mental health, is often discussed. Therefore, the aim of this study was to investigate the association between self-rated mental health and socioeconomic factors among boys and we hypothesized that household wealth influences the association.

    Methods

    In 2011, a cross-sectional study was conducted at seven junior high schools in a medium sized town in south western Sweden. The data collected was based on a self-administrated questionnaire regarding socioeconomic factors, household wealth and health related quality of life (Minnesota Minneapolis Quality of Life Instrument (MMQL). In all, 235 boys between 11-13 years old and 254 boys between 14-16 years participated. The items from MMQL were summarized into a total score and dichotomized by the median and low self-rated mental health was defined as below median. Logistic regression analysis was used.

    Results

    Among younger boys no association between low self-rated mental health and socioeconomic factors were seen. Among older boys with divorced parents, an increased risk of low mental health rating was seen OR: 1.83 (95%CI, 1.04;3.23), however when adjusting for household wealth the association disappeared (OR;1.76, CI 0.98;3.15). Also, having one or two parents born outside Sweden implied increased risk of a low self-rated mental health OR: 2.0 (CI; 1.15;3.47), which remained when adjusting for household wealth variables (OR; 2.16 CI; 1.17;3.99). Furthermore, having two or more negative socioeconomic variables increased the risk of low rated mental health (OR;2.60, CI 1.15;5.90) the association remained after adjusting for household wealth (OR;2.38, CI 1.03;5.33).

    Conclusions

    Boys with divorced parents, boys from migrant backgrounds and boys with several negative socioeconomic factors constituted the identified subgroups at risk. More research in public health is essential to meet the special needs of different age groups and backgrounds among adolescent boys.

    Key messages

    • Among older boys (14-16 years old) with divorced parents, an increased risk of low mental health rating was seen, however when adjusting for household wealth the association disappeared.
    • Among older boys (14-16 years old) having two or more negative socioeconomic variables increased the risk of low rated mental health, the association remained after adjusting for household wealth.

    © The Author 2013. Published by Oxford University Press on behalf of the European Public Health Association. All rights reserved.

  • 3.
    Hutton, Katrin
    et al.
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI), Health promotion and disease prevention. Affecta psychiatric out-patients clinic, Halmstad, Sweden.
    Nyholm, Maria
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI), Sport Health and Physical activity.
    Nygren, Jens
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI), Health promotion and disease prevention.
    Svedberg, Petra
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI), Health promotion and disease prevention.
    Kadrija, Ibadete (Contributor)
    Halmstad University, School of Health and Welfare.
    Self-rated mental health and socio-economic background: a study of adolescents in Sweden2014In: BMC Public Health, ISSN 1471-2458, E-ISSN 1471-2458, Vol. 14, no 1, article id 394Article in journal (Refereed)
    Abstract [en]

    Background: Adolescents' mental health is a major public health issue. Previous research has shown that socio-economic factors contribute to the health status of adolescents. The present study explores the association between socio-economic status and self-rated mental health among adolescents.

    Methods: Cross sectional data from the Halmstad Youth Quality of Life cohort was collected in a town in Sweden. In all, 948 adolescents (11-13 younger age group and 14-16 older age group) participated. Information on self-rated mental health was collected from the subscale Psychological functioning in the Minneapolis Manchester Quality of Life instrument. The items were summarized into a total score and dichotomized by the mean. Indicators measuring socio-economic status (SES) were collected in a questionnaire using the Family Affluence Scale (FAS) and additional factors regarding parents' marital status and migration were added. Logistic models were used to analyze the data.

    Results: Girls were more likely to rate their mental health below the mean compared to boys. With regard to FAS (high, medium, low), there was a significantly increased risk of self-rated mental health below the mean among younger boys in the medium FAS score OR; 2.68 (95% CI 1.35;5.33) and among older boys in the low FAS score OR; 2.37 (1.02;5.52) compared to boys in the high FAS score. No such trend was seen among girls. For younger girls there was a significant protective association between having parents born abroad and self-rated mental health below mean OR: 0.47 (0.24;0.91).

    Conclusions: A complex pattern of associations between SES and self-rated mental health, divergent between age and gender groups, was shown. The total FAS score was only associated with boys' self-rated mental health in both age groups, whereas parents' migratory status influenced only the girls' self-rated mental health. Because of the different association for girls' and boys' self-rated mental health and SES, other factors than SES should also be considered when investigating and exploring the mental health of adolescents in affluent communities. © 2014 Hutton et al.; licensee BioMed Central Ltd.

  • 4.
    Häggström Westerberg, Katrin
    et al.
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI).
    Wilhsson, Marie
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI).
    Svedberg, Petra
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI).
    Nygren, Jens M.
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI).
    Antony, Morgan
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI). Glasgow Caledonian University, Glasgow, United Kingdom.
    Nyholm, Maria
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI).
    Exploring the role of optimism as a protective factor for adolescent quality of lifeManuscript (preprint) (Other academic)
    Abstract [en]

    This study attempts to understand the role that optimism could play in the context of a health asset approach to promote (and protect) adolescent health related quality of life (HRQOL).  Two hypotheses were formulated, a) there is an association between adolescents’ self-rated optimism and pessimism and their HRQOL, (b) age, gender and socio-demographic characteristics influence this association. We explore optimism and pessimism as a bi-dimensional construct and its impact on HRQOL among adolescents in two age groups (11-13 years and 14-16 years). Adolescents answered a self-report questionnaire consisting of two validated scales for measuring HRQOL and the concepts of optimism and pessimism. This study has shown that optimism is an important protective factor for HRQOL and low levels of pessimism were also seen to be protective of HRQOL in both age groups.  This infers the potential of an optimistic orientation about future goals might function as a health asset during adolescence that could be useful in the planning of health promotion strategies.

  • 5.
    Ljungkrona-Falk, Lena
    et al.
    Children Health Care, Skaraborg, Sweden.
    Brekke, Hilde
    Department of Clinical Nutrition, Sahlgrenska Academy at Göteborg University, Sweden.
    Nyholm, Maria
    Halmstad University, School of Social and Health Sciences (HOS), Centre of Research on Welfare, Health and Sport (CVHI).
    In order to prevent child obesity: New tool helps Nurses to talk about healthier habits to parents2010In: Special Issue: Abstracts of the 11th International Congress on Obesity, 11-15 July 2010, Stockholm, Sweden, Chichester, England: Wiley-Blackwell, 2010, p. 88-88Conference paper (Refereed)
    Abstract [en]

    Introduction: A new tool for nurses to communicate healthier habits to parents of children at 18 months and 3 years of age has been developed and implemented by a registered dietitian at the children’s health care centre (CHCC) in Skaraborg, Sweden. The tool contains questions and information about meal order, drinks, candy, snacks, fat and physical activity. Our aim was to describe the nurses’ experiences of the tool and supervision from the registered dietician at the CHCC. Methods: The tool was evaluated after 14 months in practice. In three focus groups 17 nurses participated. A structured interview guide was used and the interviews were transcribed verbatim. The transcripts were analyzed using qualitative content analysis. Findings were triangulated by a questionnaire within all nurses in Skaraborg (n = 76). Results: The nurses described their experiences in terms of comparison with the previous tool, practicability, parent’s reactions and improvement. Using the previous tool the nurses felt uncertain when talking about healthier habits. With the new tool the nurses expressed that they felt more confident. Parents were also more engaged in the dialogue. The discussion regarding physical activity was not satisfactory and the question needed improvement. The questionnaire showed, 98% of the nurses wanted to continue with the tool, and 86% found the question about physical activity needed revision. Conclusion: This is a new approach to prevent child obesity. The tool simplified the communication with parents and with supervision from dietitian, it lead to a higher quality in promoting healthier habits at CHCC.

  • 6.
    Ljungkrona-Falk, Lena
    et al.
    Primary Care, Child Health Care Centres of Skaraborg, Mariestad, Sweden.
    Brekke, Hilde
    Department of Clinical Nutrition, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
    Nyholm, Maria
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI). The Skaraborg Institute, Skövde, Sweden.
    Swedish nurses encounter barriers when promoting healthy habits in children2013In: Health Promotion International, ISSN 0957-4824, E-ISSN 1460-2245, Vol. 29, no 4, p. 730-738Article in journal (Refereed)
    Abstract [en]

    To increase the understanding of difficulties in promoting healthy habits to parents, we explore barriers in health-care provision. The aim of this study is to describe nurses' perceived barriers when discussing with parents regarding healthy food habits, physical activity and their child's body weight. A mixed method approach was chosen. Nurses (n = 76) working at 29 different Child Health Care Centers' in an area in west Sweden were included in the study. Three focus group interviews were conducted and 17 nurses were selected according to maximum variation. Data were categorized and qualitative content analysis was the chosen analysis method. In the second method, data were obtained from a questionnaire distributed to all 76 nurses. The latent content was formulated into a theme: even with encouragement and support, the nurses perceive barriers of both an external and internal nature. The results identified four main barriers: experienced barriers in the workplace-internal and external; the nurse's own fear and uncertainty; perceived obstacles in nurse-parent interactions and modern society impedes parents' ability to promote healthy habits. The nurses' perceived barriers were confirmed by the results from 62 of the nurses who completed the questionnaire. Despite education and professional support, the health professionals perceived both external and internal barriers in promoting healthy habits to parents when implementing a new method of health promotion in primary care. Further qualitative studies are needed to gain deeper understanding of the perceived barriers when promoting healthy habits to parents.

  • 7.
    Morgan, Antony
    et al.
    Glasgow Caledonian University, London, United Kingdom.
    Nygren, Jens M.
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI).
    Nyholm, Maria
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI).
    Svedberg, Petra
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI).
    Social capital as a theory of change for young people’s health: a scoping review preliminary findings2017In: European Journal of Public Health, ISSN 1101-1262, E-ISSN 1464-360X, Vol. 27, no Suppl. 3, p. 85-85, article id ckx187.217Article in journal (Refereed)
  • 8.
    Nyholm, Maria
    Department of Public Health and Community Medicine/Public Health Epidemiology, University of Gothenburg, BOX 454, SE-405 30 Göteborg, Sweden.
    Exploring dietary patterns, obesity and sources of bias: The Västerbotten Intervention Program (VIP)2013In: Public Health Nutrition, ISSN 1368-9800, E-ISSN 1475-2727, Vol. 16, p. 631-638Article in journal (Refereed)
  • 9.
    Nyholm, Maria
    Skaraborgsinstitutet, Skövde, Sverige.
    How to define obesity in preschool children: implication for enrolment in interventions2006Conference paper (Refereed)
  • 10.
    Nyholm, Maria
    Department of Community Medicine, Malmö University Hospital, S-205 02 Malmö, Sweden.
    Overweight and all-cause mortality in a Swedish rural population: Skaraborg Hypertension and Diabetes project. Scandinavian Journal of Public Health2005In: Scandinavian Journal of Public Health, p. 478-486Article in journal (Refereed)
  • 11.
    Nyholm, Maria
    Skaraborg Institute, Skövde, Sweden .
    What is the accurate prevalence of obesity in Sweden in the 21st century? Methodological experiences from the skaraborg project.2008In: Obesity, ISSN 1930-7381, E-ISSN 1930-739X, Vol. 16, no 4, p. 896-898Article in journal (Refereed)
  • 12.
    Nyholm, Maria
    et al.
    Department of Clinical Sciences, Malmö, Lund University, Malmö, Sweden.
    Gullberg, Bo
    Department of Clinical Sciences, Malmö, Lund University, Malmö, Sweden.
    Haglund, Bo
    Department of Public Health Sciences, Karolinska Institute, Stockholm, Sweden.
    Råstam, Lennart
    Department of Clinical Sciences, Malmö, Lund University, Malmö, Sweden.
    Lindblad, Ulf
    Department of Clinical Sciences, Malmö, Lund University, Malmö, Sweden.
    Higher education and more physical activity limit the development of obesity in a Swedish rural population: The Skaraborg Project2008In: International Journal of Obesity, ISSN 0307-0565, E-ISSN 1476-5497, Vol. 32, no 3, p. 533-540Article in journal (Refereed)
  • 13.
    Nyholm, Maria
    et al.
    Skaraborg Institute, Skövde, Sweden.
    Gullberg, Bo
    Department of Clinical Sciences, Malmö, Lund University, Sweden.
    Merlo, Juan
    Department of Clinical Sciences, Malmö, Lund University, Sweden.
    Lundqvist-Persson, Cristina
    Skaraborg Institute, Skövde, Sweden.
    Råstam, Lennart
    Department of Clinical Sciences, Malmö, Lund University, Sweden.
    Lindblad, Ulf
    Skaraborg Institute, Skövde, Sweden.
    The validity of obesity based on self-reported weight and height: Implications for population studies2007In: Obesity, ISSN 1930-7381, E-ISSN 1930-739X, Vol. 15, no 1, p. 197-208Article in journal (Refereed)
    Abstract [en]

    Objective: To validate self-reported information on weight and height in an adult population and to find a useful algorithm to assess the prevalence of obesity based on self-reported information. Research Methods and Procedures: This was a crosssectional survey consisting of 1703 participants (860 men and 843 women, 30 to 75 years old) conducted in the community of Vara, Sweden, from 2001 to 2003. Self-reported weight, height, and corresponding BMI were compared with measured data. Obesity was defined as measured BMI >= 30 kg/m(2). Information on education, self-rated health, smoking habits, and physical activity during leisure time was collected by a self-administered questionnaire. Results: Mean differences between measured and self-reported weight were 1.6 kg (95% confidence interval, 1.4; 1.8) in men and 1.8 kg (1.6; 2.0) in women (measured higher), whereas corresponding differences in height were -0.3 cm (-0.5; -0.2) in men and -0.4 cm (-0.5; -0.2) in women (measured lower). Age and body size were important factors for misreporting height, weight, and BMI in both men and women. Obesity (measured) was found in 156 men (19%) and 184 women (25%) and with self-reported data in 114 men (14%) and 153 women (20%). For self-reported data, the sensitivity of obesity was 70% in men and 82% in women, and when adjusted for corrected self-reported data and age, it increased to 81 % and 90%, whereas the specificity decreased from 99% in both sexes to 97% in men and 98% in women. Discussion: The prevalence of obesity based on self-reported BMI can be estimated more accurately when using an algorithm adjusted for variables that are predictive for misreporting.

  • 14.
    Rosenberg, David
    et al.
    Umeå University, Umeå, Sweden.
    Schön, Ulla-Karin
    Dalarna University, Falun, Sweden.
    Nyholm, Maria
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI), Health and Sport.
    Grim, Katarina
    Dalarna University, Falun, Sweden.
    Svedberg, Petra
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI), Health promotion and disease prevention. Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI), Health and Nursing.
    Shared decision making in community mental health services - an evaluation of three self-reporting instruments2017In: Journal of Mental Health, ISSN 0963-8237, E-ISSN 1360-0567, Vol. 26, no 2, p. 142-149Article in journal (Refereed)
    Abstract [en]

    Background: Despite the potential impact of shared decision making on users satisfaction with care and quality in health care decisions, there is a lack of knowledge and skills regarding how to work with shared decision making among health care providers.

    Aim: The aim of this study was to evaluate the psychometric properties of three instruments that measure varied dimensions of shared decision making, based on self-reports by clients, in a Swedish community mental health context.

    Method: The study sample consisted of 121 clients with experience of community mental health care, and involved in a wide range of decisions regarding both social support and treatment. The questionnaires were examined for face and content validity, internal consistency, test-retest reliability and construct validity.

    Results: The instruments displayed good face and content validity, satisfactory internal consistency and a moderate to good level of stability in test-retest reliability with fair to moderate construct correlations, in a sample of clients with serious mental illness and experience of community mental health services in Sweden.

    Conclusions: The questionnaires are considered to be relevant to the decision making process, user-friendly and appropriate in a Swedish community mental health care context. They functioned well in settings where non-medical decisions, regarding social and support services, are the primary focus. The use of instruments that measure various dimensions of the self-reported experience of clients, can be a key factor in developing knowledge of how best to implement shared decision making in mental health services. © Informa UK Limited, trading as Taylor & Francis Group.

  • 15.
    Svedberg, Petra
    et al.
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI), Health and Nursing.
    Morgan, Antony
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI). Glasgow Caledonian University, Glasgow, United Kingdom.
    Nygren, Jens M.
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI).
    Nyholm, Maria
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI).
    The association between social capital on health quality of life among adolescents2017In: European Journal of Public Health, ISSN 1101-1262, E-ISSN 1464-360X, Vol. 27, no Suppl. 3, p. 365-365, article id ckx189.162Article in journal (Refereed)
  • 16.
    Svedberg, Petra
    et al.
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI), Health and Nursing.
    Nygren, Jens M.
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI), Health and Nursing.
    Hutton, Katrin
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI), Health and Nursing.
    Nyholm, Maria
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI), Health and Sport.
    Self-reported objective and subjective indicators of socio-economic status and mental health between two adolescent age groups in Sweden2014In: European Journal of Public Health, ISSN 1101-1262, E-ISSN 1464-360X, Vol. 24, no Suppl. 2, p. 31-31Article in journal (Refereed)
    Abstract [en]

    Background: Research has shown that socio-economic status (SES) contributes to the mental health of adolescents; however the causality of this effect is debated. SES among adolescents is methodologically difficult to assess and SES indicators differ between age groups. The aim of this study was to evaluate objective and subjective indicators of SES and their relation to mental health in two adolescent age groups.

    Methods: This is a cross-sectional study based on data collected by self- report questionnaires from 11-13 years old n = 457 (younger age group) and 14-16 years old n = 462 (older age group) adolescents at schools in a rural town in south western Sweden. The Family Affluence Scale (FAS) (high, medium, low) and Perceived Wealth (PW) (high, medium, low) were used as measurement for objective and subjective socio-economic wealth. The domain psychological functioning health from the Minneapolis Manchester Quality of Life instrument (MMQL-PF) (continuous variable) was used to measure self-rated mental health.

    Results: When measuring SES using the two different scales, the proportion of adolescents in the younger age group stating a low SES was 28.1% using FAS and 12.1% using PW. In the older age group the proportion was 21.4% in FAS and 15.5% in PW. There was a positive significant relation between PW and self-rated mental health in both age groups, by 0.112 (95% CI.0.024; 0.199) in the younger age group and by 0.140 (95% CI.0.051; 0.223) in the older age group. This relation was not seen regarding FAS.

    Conclusion: In the search for SES’ relation to mental health, different aspects of adolescents’ socio-economic conditions should be considered. In this study we suggest that the subjective experiences of adolescents regarding the wealth of the family might be a stronger indicator of SES influencing mental health. This might be taken into consideration when planning for public health interventions and effective prevention programs suited for adolescents with lower SES. 

    Key message:

    • In the search for SES’ relation to mental health, different aspects of adolescents’ socio-economic conditions should be considered.

    © The Author 2014

  • 17.
    Svedberg, Petra
    et al.
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI), Health promotion and disease prevention.
    Nygren, Jens
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI), Health promotion and disease prevention.
    Staland Nyman, Carin
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI).
    Nyholm, Maria
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI).
    The validity of socioeconomic status measures among adolescents based on self-reported information about parents occupations, FAS and perceived SES; implication for health related quality of life studies2016In: BMC Medical Research Methodology, ISSN 1471-2288, E-ISSN 1471-2288, Vol. 16, article id 48Article in journal (Refereed)
    Abstract [en]

    Background

    Research has shown inconsistencies in results and difficulties in conceptualization of assessment of socioeconomic status (SES) among adolescents. The aim of this study was thus to test the validity of self-reported information on SES in two age-groups (11–13 and 14–16 years old) in an adolescent population and to evaluate its relationship to self-reported health related quality of life (HRQOL). Different measures of SES commonly used in research in relation to HRQOL were tested in this study; parent’s occupations status, family material affluence status (FAS) and perceived SES.

    Method

    A cross-sectional study, with a sample of 948 respondents (n = 467, 11–13 years old and n  = 481, 14–16 years old) completed questionnaires about SES and HRQOL. The adolescents’ completion rates were used, with chi2-test, to investigate differences between gender and age-group. Correlation was used for convergent validity and ANOVA for concurrent validity.

    Results

    We found a low completion rate for both fathers’ (41.7 %) and mothers' (37.5 %) occupation status, and a difference in completion rate between gender and age-groups. FAS had the highest completion rate (100 %) compared to parent's occupations status and perceived SES. The convergent validity between the SES-indicators was weak (Spearman correlation coefficient below 0.3), suggesting that the indicators measured different dimensions of SES. Both FAS and perceived SES showed a gradient in mean HRQOL between low and high SES in relation to HRQOL, this was significant only for perceived SES (p < 0.01, both age-groups).

    Conclusion

    This study indicates the need for considering different approaches to measures of SES among adolescences and when evaluating SES in relation to HRQOL. Further research is needed to investigate sustainable ways to measure SES, delineating the relevance of tangible measures of education, occupation and income in relation to the perceived socioeconomic status in comparison with others in immediate social networks and in society at large.

  • 18.
    Torsheim, Torbjørn
    et al.
    Department of Psychosocial Science, University of Bergen, Bergen, Norway.
    Nygren, Jens M.
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI), Health and Nursing.
    Rasmussen, Mette
    National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark.
    Arnarsson, Arsæll M.
    School of Humanities and Social Sciences, University of Akureyri, Akureyri, Iceland.
    Bendtsen, Pernille
    National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark.
    Schnohr, Christina W.
    Department of Public Health, University of Copenhagen, Copenhagen, Denmark.
    Nielsen, Line
    National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark.
    Nyholm, Maria
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI).
    Social inequalities in self-rated health: A comparative cross-national study among 32,560 Nordic adolescents2018In: Scandinavian Journal of Public Health, ISSN 1403-4948, E-ISSN 1651-1905, Vol. 46, no 1, p. 150-156Article in journal (Refereed)
    Abstract [en]

    AIMS: We aimed to estimate the magnitude of socioeconomic inequality in self-rated health among Nordic adolescents (aged 11, 13 and 15 years) using the Family Affluence Scale (a composite measure of material assets) and perceived family wealth as indicators of socioeconomic status.

    METHODS: Data were collected from the Health Behaviour in School-aged Children (HBSC) survey in 2013-2014. A sample of 32,560 adolescents from Denmark, Norway, Finland, Iceland, Greenland and Sweden was included in the study. Age-adjusted regression analyses were used to estimate associations between fair or poor self-rated health and the ridit scores for family affluence and perceived wealth.

    RESULTS: The pooled relative index of inequality of 2.10 indicates that the risk of fair or poor health was about twice as high for young people with the lowest family affluence relative to those with the highest family affluence. The relative index of inequality for observed family affluence was highest in Denmark and lowest in Norway. For perceived family wealth, the pooled relative index of inequality of 3.99 indicates that the risk of fair or poor health was about four times as high for young people with the lowest perceived family wealth relative to those with the highest perceived family wealth. The relative index of inequality for perceived family wealth was highest in Iceland and lowest in Greenland.

    CONCLUSIONS: Social inequality in self-rated health among adolescents was found to be robust across subjective and objective indicators of family affluence in the Nordic welfare states. © Author(s) 2017

  • 19.
    Wiman, Virginia
    et al.
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI).
    Lydell, Marie
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI).
    Nyholm, Maria
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI).
    Views of the workplace as a health promotion arena among managers of small companies2016In: Health Education Journal, ISSN 0017-8969, E-ISSN 1748-8176, Vol. 75, no 8, p. 950-960Article in journal (Refereed)
    Abstract [en]

    Introduction: Several studies have shown that workplace health promotion leads to better health, increased productivity, as well as reduced absenteeism and presenteeism among employees. The objective of this study was to describe how managers in small companies (10–19 employees) perceive their company as an arena for promoting employees’ health.

    Method: A sample of 10 managers (four women) was strategically selected. Semi-structured interviews were conducted with each person. Interviews were transcribed and analysed using qualitative content analysis. The analysis focused on both manifest and latent content.

    Results: Three main categories emerged from the analysis: the potential to promote employees’ health, responsibility as an employer and the need for external support. An arena for workplace health promotion is created when managers prioritise health at the workplace.

    Conclusion: Small companies often lack the knowledge and resources to manage health and safety problems and also have less access to occupational health services. This paper highlights the importance of the views of small company managers as resources for the development of health promotion. © 2016 by Health Education Journal

  • 20.
    Wiman, Virginia
    et al.
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI), Sport Health and Physical activity.
    Lydell, Marie
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI), Sport Health and Physical activity. Region Halland, Halmstad, Sweden.
    Nyholm, Maria
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI), Sport Health and Physical activity.
    Workplace health promotion; views from managers of small companies2012In: European Journal of Public Health, ISSN 1101-1262, E-ISSN 1464-360X, Vol. 22, no Suppl. 2, p. 129-129Article in journal (Other academic)
    Abstract [en]

    Background: Workplace health promotion leads to better health, high morale, increased productivity and reduced absenteeism among employees. The role of leadership is vital when creating strategies for workplace health promotion. Small companies (less than 50 employees) have increased need for health promotion, as they often lack knowledge and resources to manage health and safety problems. Moreover, small companies have less access to occupational health service. The aim of this study was to describe how managers at small companies perceive their company as an arena for health promotion. 

    Methods: A sample of ten managers (four females) was strategically selected using maximal variation in terms of branch of industry. Semi-structured interviews were conducted. The interviews were transcribed and analyzed using qualitative content analysis. The analysis comprised of both manifest and latent content and triangulation between the authors was used. 

    Results: Three main categories emerged from the analysis; sees the workplace as a possible arena, sees the opportunity to promote employees health and sees a need for external support. More in-depth analysis resulted in six subcategories. The latent content of these categories is described by the theme; Health promotion leadership in order to perceive the company as a health promotion arena. A key factor for workplace health promotion was the manager´s view of health promotion as a beneficial factor for the company. Furthermore, the managers expressed that they could promote employees´ health by organizing health promotion activities and promote a positive psychosocial work environment. The findings showed a need for easily accessible external support to assist managers in their work with health promotion. It is essential that the external support contributes with inspiration and knowledge of health promotion activities, for example by highlighting good practice from other small companies. 

    Conclusions: Using the manager´s view about the workplace as an arena for promoting health can be a step towards strategies for implementing workplace health promotion. However, for the development of healthy organizations it is necessary to have a comprehensive strategy in which employers, employees and society is pursuing the same goal.

  • 21.
    Östberg, Anna-Lena
    et al.
    Karlstad University, Karlstad, Sweden.
    Nyholm, Maria
    Halmstad University, School of Social and Health Sciences (HOS), Centre of Research on Welfare, Health and Sport (CVHI).
    Gullberg, Bo
    Lund University, Department of Clinical Sciences, Malmö, Sweden.
    Råstam, Lennart
    Lund University, Department of Clinical Sciences, Malmö, Sweden.
    Lindblad, Ulf
    Lund University, Department of Clinical Sciences, Malmö, Sweden.
    Tooth loss and obesity in a defined Swedish population2009In: Scandinavian Journal of Public Health, ISSN 1403-4948, E-ISSN 1651-1905, Vol. 37, no 4, p. 427-433Article in journal (Refereed)
    Abstract [en]

    Aims: To explore the association between tooth loss and obesity in an adult Swedish population, and to investigate the influence of socioeconomy, life-style, and co-morbidity.

    Methods: A cross-sectional population health survey conducted in 2001-2005 in 2816 randomly selected Swedish men and women (age: 30-74 years; participation rate 76%). Main measures were; tooth loss: < 20 remaining teeth (self-reported), general obesity: BMI[≥]30 kg m-2, abdominal obesity: waist circumference > 88 in women and > 102 cm in men. Adjustments were made for socioeconomy, life-style, and co-morbidity.

    Results: 420 individuals (21.2%) had < 20 remaining teeth: 30-59 years 6.0%, 60-74 years 53.5%. Mean BMI was similar in men and women (26.9 kg m-2), however, both general and abdominal obesity was still more frequent among women (both p < 0.001). There was a significant interaction between age and tooth loss in the association with both general (p = 0.004) and abdominal obesity (p < 0.011) in men. In participants below 60 years of age, the association between tooth loss and general obesity (OR 2.17 [95% CI 1.51 - 3.12]) and abdominal obesity (2.23 [1.58 - 3.15]), respectively, was statistically significant independent of age and gender, and remained so also when accounting for differences in socioeconomy, life-style, and co-morbidity. There was no similar association in those 60 years or older. The findings in men and women were robust and concordant.

    Conclusions: Common mechanisms for oral health and obesity should be explored more also including longitudinal designs. The findings are important for targeting comprehensive interventions against obesity and tooth loss, especially among younger adults.

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