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  • 1.
    Savolainen, Eva
    et al.
    Luleå University of Technology, Department of Health, Education and Technology, Health, Medicine and Rehabilitation.
    Lindqvist, Anna-Karin
    Luleå University of Technology, Department of Health, Education and Technology, Health, Medicine and Rehabilitation.
    Mikaelsson, Katarina
    Luleå University of Technology, Department of Health, Education and Technology, Health, Medicine and Rehabilitation.
    Nyberg, Lars
    Luleå University of Technology, Department of Health, Education and Technology, Health, Medicine and Rehabilitation.
    Rutberg, Stina
    Luleå University of Technology, Department of Health, Education and Technology, Health, Medicine and Rehabilitation.
    Children’s active school transportation: an international scoping review of psychosocial factors2024In: Systematic Reviews, ISSN 2046-4053, Vol. 13, no 1, article id 47Article in journal (Refereed)
    Abstract [en]

    Background: Over the last decades, the prevalence of AST has decreased significantly. Barriers to active school transport (AST) have been extensively examined in the literature, while psychosocial factors that facilitate AST have received less attention. To our best knowledge, there are currently no reviews on this subject. Therefore, the objective of this review was to scope the literature and identify published research about psychosocial factors related to AST.

    Methods: Systematic searches conducted in PubMed, Web of Science, TRID, Scopus, and ERIC resulted in a total of 1933 publications, and 77 of them were considered eligible for this review.

    Results: The results of the included articles were categorised into four psychosocial factors: confidence in ability, attitudes, social support, and social norms, which were all generally positively related to AST, with a few exceptions.

    Conclusion: The findings of this review indicate that these psychosocial factors may be important to consider when developing interventions and highlight that both children and parents should be involved in the process. This knowledge can serve as a valuable guide for developing interventions to promote AST. However, the evidence base supporting these psychosocial factors requires further investigation to fully understand how and when to incorporate them to maximise AST efficacy.

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  • 2.
    Burgueño, Rafael
    et al.
    Department of Education, University of Almeria, Almeria, Spain.
    Lindqvist, Anna-Karin
    Luleå University of Technology, Department of Health, Learning and Technology, Health, Medicine and Rehabilitation.
    Nyberg, Lars
    Luleå University of Technology, Department of Health, Learning and Technology, Health, Medicine and Rehabilitation.
    Chillon, Palma
    PROFITH "PROmoting FITness and Health Through Physical Activity" Research Group, Sport and Health University Research Institute (iMUDS), Department of Physical Education and Sport, Faculty of Sport Sciences, University of Granada, Granada, Spain.
    Rutberg, Stina
    Luleå University of Technology, Department of Health, Learning and Technology, Health, Medicine and Rehabilitation.
    Basic psychological need satisfaction in active commuting to and from school BPNS-ACS(SWE)2023In: Journal of Transport and Health, ISSN 2214-1405, E-ISSN 2214-1405, Vol. 30, article id 101618Article in journal (Refereed)
    Abstract [en]

    Background

    The absence of appropriate Swedish-language instrumentation to assess active commuting to school has largely hampered the study of the individual factors of the children, such as autonomy, competence, and relatedness to active commuting to school.

    Purpose

    Building upon self-determination theory, the objective of this research was to gather evidence of the validity and reliability of the Swedish version of the Basic Psychological Need Satisfaction in Active Commuting to and from School (BPNS-ACS) tool.

    Methods

    The cross-sectional and purposive sample included 273 children (51.28% girls) from urban areas.

    Results

    Confirmatory factor analysis underpinned the three-factor correlated model, which was invariant across gender. Evidence in support of discriminant and convergent validity and reliability was gathered. Criterion validity evidence was met by positive and significant predictions of autonomy, competence, and relatedness satisfaction on active commuting to and from school.

    Conclusions

    The Swedish version of the BPNS-ACS is a psychometrically robust measure of children’s perceptions of autonomy, competence, and relatedness satisfaction in active commuting to school and could be used to assess the effects of school-based interventions on need satisfaction for active commuting to school.

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  • 3.
    Forsberg, Hanna
    et al.
    Luleå University of Technology, Department of Health, Learning and Technology, Health, Medicine and Rehabilitation.
    Rutberg, Stina
    Luleå University of Technology, Department of Health, Learning and Technology, Health, Medicine and Rehabilitation.
    Nyberg, Lars
    Luleå University of Technology, Department of Health, Learning and Technology, Health, Medicine and Rehabilitation.
    Lindqvist, Anna-Karin
    Luleå University of Technology, Department of Health, Learning and Technology, Health, Medicine and Rehabilitation.
    Children's intervention participation is associated with more positive beliefs towards active school transportation among parents2023In: Health Promotion International, ISSN 0957-4824, E-ISSN 1460-2245, Vol. 38, no 2, article id daad016Article in journal (Refereed)
    Abstract [en]

    Insufficient physical activity among children is a critical issue and health promoting initiatives are required to reverse this trend. In response to the current situation, a school-based intervention aiming to increase physical activity with the aid of active school transportation (AST) was implemented in one municipality in northern Sweden. By adopting the framework of the Theory of Planned Behavior, we aimed to analyse beliefs among parents whose children were or were not involved in the AST intervention. All municipality schools were included. There were 1024 responses from parents, comprising 610 who responded either 'yes' or 'no' to participating in the intervention. An adjusted linear regression analysis showed that children's intervention participation was significantly associated with more positive beliefs towards AST among parents. These results indicates that it is possible to influence beliefs that are important in the parental decision-making process by the use of an AST intervention. Therefore, to make children´s active transport to school the more favorable choice for parents, it seems to be worthwhile to not only give children the opportunity to participate but also to involve parents and address their beliefs when designing interventions.Not enough physical activity among children is an important issue and health promoting initiatives are needed to reverse this trend. In response to the current situation, a school-based intervention aiming to increase physical activity using active school transportation (AST) was implemented in one municipality in northern Sweden. Using the Theory of Planned Behaviour framework, we aimed to analyse beliefs among parents whose children were or were not involved in the AST intervention. Children’s participation in the intervention was significantly associated with more positive beliefs towards AST among parents. These results indicate that it is possible to influence beliefs that are important in the parental decision-making process by the use of an AST intervention. Therefore, to make children’s active transport to school the more favourable choice for parents, it seems to be worthwhile to not only give children the opportunity to participate but also to involve parents and address their beliefs when designing interventions.

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  • 4.
    Berg, Hans ten
    et al.
    Trafikanalys, Sweden.
    Klüft, Carolina
    Generation Pep, Sweden.
    Lindqvist, Anna-Karin
    Luleå University of Technology, Department of Health, Learning and Technology, Health, Medicine and Rehabilitation.
    Nilsson, Per
    Gymnastik- och idrottshögskolan, Sweden.
    Niska, Anna
    Statens väg- coh transportforskningsinstitut, Sweden.
    Rutberg, Stina
    Luleå University of Technology, Department of Health, Learning and Technology, Health, Medicine and Rehabilitation.
    Pellas, Maria
    Cykelfrämjandet, Sweden.
    Stigell, Erik
    Naturvårdsverket, Sweden.
    DN Debatt: Sluta skjutsa barnen till skolan - hälsa går före rädsla2023In: Dagens Nyheter. (DN), ISSN 1101-2447, no 2023-02-18Article in journal (Other (popular science, discussion, etc.))
    Abstract [sv]

    Våra barn blir alltmer stillasittande, vilket får livslånga konsekvenser. En av de enklaste lösningarna står föräldrar i vägen för – på grund av rädsla. Föräldrarnas välvilja är i själva verket ett tydligt hot mot barnens hälsa, både i trafiken och genom livet. Sverige behöver en ny nationell rekommendation för aktiva skolresor, skriver åtta forskare och organisationer.

  • 5.
    Klüft, Carolina
    et al.
    Generation Pep, Sweden.
    Lindqvist, Anna-Karin
    Luleå University of Technology, Department of Health, Learning and Technology, Health, Medicine and Rehabilitation.
    Rutberg, Stina
    Luleå University of Technology, Department of Health, Learning and Technology, Health, Medicine and Rehabilitation.
    Hasselberg, Per
    Cykelfrämjandet, Sweden.
    Föräldrar, våga låta era barn cykla till skolan: Debattörerna: Stå upp mot normen – riskerna är låga2023In: Aftonbladet, Vol. 09, no 03Article in journal (Other (popular science, discussion, etc.))
  • 6.
    Nyström, Michelle
    et al.
    Luleå University of Technology, Department of Health, Learning and Technology, Health, Medicine and Rehabilitation.
    Henriksson, Malin
    The Swedish National Road and Transport Research Institute, Sweden.
    Lindqvist, Anna-Karin
    Luleå University of Technology, Department of Health, Learning and Technology, Health, Medicine and Rehabilitation.
    Rutberg, Stina
    Luleå University of Technology, Department of Health, Learning and Technology, Health, Medicine and Rehabilitation.
    Making the right decision for our children's future: Parents' perceptions of active school travel in disadvantaged neighborhoods2023In: Journal of Transport and Health, ISSN 2214-1405, E-ISSN 2214-1405, Vol. 30, article id 101617Article in journal (Refereed)
    Abstract [en]

    Background

    Children's possibility to be physically active is linked to their parent's socioeconomic status. The use of active travel has the potential to increase daily physical activity among children. Parents are the gate-keepers to children using active school travel (AST) and their perceptions has shown to impact children's travel mode. Few studies have explored parents' perceptions about AST in disadvantaged neighborhoods and there is a lack of knowledge of their perceptions of the physical and social environment associated with school travel.

    Purpose

    To explore parents’ perceptions towards AST when living in disadvantaged neighborhoods.

    Methods

    Twelve parents participated in semi-structured interviews, and a qualitative content analysis was used to analyze the data.

    Results

    The findings show that parents faced dilemmas, striving to facilitate AST. Parents perceptions are presented as A, B, C categories that are likely to be important when promoting AST in disadvantaged neighborhoods, Acknowledging AST advantages, Balancing barriers, and Creating opportunities to use AST.

    Conclusions

    Despite having a positive attitude towards AST, insecure neighborhoods and social exclusion affect parents'descisions about AST. When promoting AST in disadvantaged neighborhoods, measures to enable AST should include efforts supporting community building, social participation, road safety and ways of promoting bicycling. Engaging children in AST could have a positive influence on their independent mobility, thereby impacting their development and preparing them for the future.

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  • 7.
    Lindqvist, Anna-Karin
    et al.
    Luleå University of Technology, Department of Health, Learning and Technology, Health, Medicine and Rehabilitation.
    Lugnet, Johan
    Luleå University of Technology, Department of Computer Science, Electrical and Space Engineering, Digital Services and Systems.
    Niska, Anna
    Department of Infrastructure Maintenance, Swedish National Road and Transport Research Institute, VTI, 581 95, Linköping, Sweden.
    Rutberg, Stina
    Luleå University of Technology, Department of Health, Learning and Technology, Health, Medicine and Rehabilitation.
    One should really be more worried about too little physical activity than injuries while walking or cycling to school. Parents’ perception of risk concerning active school transportation.2023In: Journal of Transport and Health, ISSN 2214-1405, E-ISSN 2214-1405, Vol. 29, article id 101573Article in journal (Refereed)
    Abstract [en]

    Introduction

    Active school transportation (AST) can be a powerful strategy to promote physical activity and improve children's health. Parents' perceptions of traffic risks are an important factor in their decision concerning their child's transport mode to school and addressing discordances between the percieved risks and actual incidents might contribute to promote children's AST. This study adopted a game originally designed for the context of information security to resonate with the context of Swedish AST and the aim of the study was to describe parent's experience of playing the game.

    Methods

    A qualitative approach was chosen and data was collected using focus groups with 16 parents for totally 29 children aged 7–12. The collected data were analyzed using qualitative content analysis.

    Results

    The results formed one main theme “Playing promotes parents' awareness and consideration of active school transportation” and three subthemes; “Fast, fun, and functional; Experiences from playing the game” showing that the parents perceived the game to be fun, easy, and time efficient to play. “Then and now. Own childhood experience vs being a parent” showing that parents' perception of risk can sometimes be barriers to their children's opportunity to use AST. “Personal perceptions vs statistical risk” showing that playing the game addressed the discordance between the parents' perceived risks and actual incidents, as well as promoted parents' awareness and consideration of AST.

    Conclusions

    Including an intervention component such as a game for parents and using schools as the arena for implementing projects promoting AST to improve children's physical activity levels, might be a fruitful avenue.

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  • 8.
    Rutberg, Stina
    et al.
    Luleå University of Technology, Department of Health, Learning and Technology, Health, Medicine and Rehabilitation.
    Lindqvist, Anna-Karin
    Luleå University of Technology, Department of Health, Learning and Technology, Health, Medicine and Rehabilitation.
    Henriksson, Malin
    Statens väg och trafikforskningsinstitut.
    Prövning och analys av barnets bästa när det gäller nationella rekommendationer för aktiva skolresor: en barnkonsekvensanalys2023Report (Other academic)
    Abstract [sv]

    I Sverige saknas en nationell rekommendation gällande aktiva skolresor. Samtidigt vet vi att barn och unga i Sverige rör på sig för lite. Aktiva resor till och från skolan är ett effektivt sätt att öka den fysiska aktiviteten och det är ett prioriterat område i WHO global action plan om fysisk aktivitet. Det aktiva resandet i dagens transportsystem har större positiva hälsoeffekter än de negativa effekterna av buller, luftkvalitet och trafiksäkerhet tillsammans. Det bidrar positivt till uppfyllelsen av flera mål i Agenda2030. Att barn själva så långt det är möjligt utifrån ålder, mognad och funktionsförmåga får ta ansvari sitt resande är en förutsättning för identitetsskapande och välbefinnande. Tyvärr förväntas de aktiva resorna minska ytterligare om inte riktade åtgärder sätts in.

    Barns aktiva resor är beroende av trafikmiljön och varierar mellan platser och situationer vilket gördet svårt att basera en rekommendation på ålder. Att det förekommer uttryck såsom ”att barn inteär mogna att cykla i trafikmiljöer förrän vid 12-års ålder” i olika policydokument ökar behovet av nyarekommendationer för att guida vårdnadshavare, skolor, samhällsplanerare och väghållare.

    I denna barnkonsekvensanalys prövas rekommendationen mot barns behov. En prövning och analys av barnets bästa är ett underlag för att synliggöra och stärka barnrättsperspektivet i beslut som fattas i frågor som rör barn direkt eller indirekt. För att säkerställa att barnets bästa tillgodoses ska en prövning göras inför varje beslut som berör barn. FN:s barnrättskommitté nämner bl.a. utarbetande av policyer och rekommendationer som exempel på sammanhang där en barnkonsekvensanalys ska göras. En barnkonsekvensanalys är ett verktyg för att omsätta barnrättslagen i handling och synliggöra barnets bästa.

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  • 9.
    Alexandrou, Christina
    et al.
    Department of Health, Medicine and Caring Sciences, Division of Society and Health, Linköping University, Linköping, Sweden; Department of Biosciences and Nutrition, Karolinska Institutet, NEO, Group MLÖ, Huddinge, Sweden.
    Rutberg, Stina
    Luleå University of Technology, Department of Health, Learning and Technology, Health, Medicine and Rehabilitation.
    Johansson, Linnea
    Department of Biosciences and Nutrition, Karolinska Institutet, NEO, Group MLÖ, Huddinge, Sweden.
    Lindqvist, Anna-Karin
    Luleå University of Technology, Department of Health, Learning and Technology, Health, Medicine and Rehabilitation.
    Müssener, Ulrika
    Department of Health, Medicine and Caring Sciences, Division of Society and Health, Linköping University, Linköping, Sweden.
    Löf, Marie
    Department of Health, Medicine and Caring Sciences, Division of Society and Health, Linköping University, Linköping, Sweden; Department of Biosciences and Nutrition, Karolinska Institutet, NEO, Group MLÖ, Huddinge, Sweden.
    User experiences of an app-based mHealth intervention (MINISTOP 2.0) integrated in Swedish primary child healthcare among Swedish-, Somali- and Arabic-speaking parents and child healthcare nurses: A qualitative study2023In: Digital Health, E-ISSN 2055-2076, Vol. 9Article in journal (Refereed)
    Abstract [en]

    Background: Preventive and scalable interventions, accessible to all, to counteract childhood obesity are urgently needed. We have recently developed a novel, digital parental intervention (MINISTOP 2.0 app) available in Swedish, Somali, Arabic and English. We have previously reported its positive effects on children's health behaviors and on parental self-efficacy. However, before introducing the app at scale in primary child healthcare, implementation aspects also need to be explored.

    Aim: This study aims to explore and describe user experiences as well as acceptability and feasibility of the MINISTOP 2.0 app-based intervention in a diverse group of parents (end-users) and Swedish child healthcare nurses (implementers).

    Methods: Individual interviews were conducted with Swedish- (n = 9), Somali- (n = 9), Arabic- (n = 5) and English-speaking (n = 1) parents as well as Swedish primary child healthcare nurses (n = 15). Data was analyzed using content analysis with an inductive latent approach.

    Results: Parents described how the app facilitated behavior change through increased awareness regarding current diet and physical activity behaviors. Furthermore, the evidence-based app content further facilitated trust and behavior change. Both parents and nurses acknowledged the app's preventive potential and the potential for reaching parents with diverse backgrounds or in need of extra support.

    Conclusion: The MINISTOP 2.0 app was perceived as a useful tool for health promotion both by parents and healthcare professionals, especially since it was adapted to several languages. These findings coupled with the previously shown beneficial effects on health behaviors support the large-scale implementation of the app in primary child healthcare.

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  • 10.
    Laine, Teemu H
    et al.
    Department of Digital Media, Ajou University, Suwon, Republic of Korea.
    Duong, Nhi
    Haaga-Helia University of Applied Sciences, Helsinki, Finland.
    Lindvall, Helena
    Luleå Municipality, Luleå, Sweden.
    Oyelere, Solomon
    Luleå University of Technology, Department of Computer Science, Electrical and Space Engineering, Computer Science.
    Rutberg, Stina
    Luleå University of Technology, Department of Health, Learning and Technology, Health, Medicine and Rehabilitation.
    Lindqvist, Anna-Karin
    Luleå University of Technology, Department of Health, Learning and Technology, Health, Medicine and Rehabilitation.
    A Reusable Multiplayer Game for Promoting Active School Transport: Development Study2022In: JMIR Serious Games, E-ISSN 2291-9279, Vol. 10, no 1, article id e31638Article in journal (Refereed)
    Abstract [en]

    Background: Most children and adolescents in Sweden do not meet the recommended daily physical activity levels of the World Health Organization. Active school transport (AST) and gamification are potential methods for increasing children’s daily physical activity. We previously developed a game named Tic-Tac-Training for promoting active transport at workplaces; however, the game has not been applied to AST.

    Objective: The objectives of this study are to investigate how Tic-Tac-Training functions to promote AST among schoolchildren in northern Sweden, improve the game to be more suitable for schoolchildren, and construct a road map for future development based on children’s ideas.

    Methods: First, we developed Tic-Tac-Training using the Scrum agile software development method. Second, we conducted a questionnaire-based formative evaluation of the game with schoolchildren (n=16; 9/16, 56% male; 6/16, 38% female; and 1/16, 6% other aged 11-12 years) in Luleå, Sweden. Third, we conducted focus group interviews with 33 children (13/33, 39% male and 20/33, 61% female aged 12-13 years) to gather ideas for gamifying AST. We mapped the interview results to the Octalysis gamification framework and established a road map for future development.

    Results: The formative evaluation revealed several issues, including a lack of interesting game features, lack of support for continuous engagement, disliked competitive features, and lack of incentives for discourse and participation. New features such as rewards, collectibles, and levels were implemented based on the results. The focus group interviews revealed additional ideas for gamifying AST, such as using avatars, in-game currency and trading, and context-sensitive tasks.

    Conclusions: The results have several potential impacts on how reusable, gamified AST interventions can be developed and what kind of gamification elements schoolchildren in northern Sweden wish to see. These results can interest game researchers and teachers who wish to apply gamification in school contexts. Finally, we aim to continue developing the game based on the road map.

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  • 11.
    Burgueño, Rafael
    et al.
    Faculty of Education, University of Zaragoza, Zaragoza, Spain; Health Research Centre, University of Almeria, Almeria, Spain.
    Rutberg, Stina
    Luleå University of Technology, Department of Health, Learning and Technology, Health, Medicine and Rehabilitation.
    Nyberg, Lars
    Luleå University of Technology, Department of Health, Learning and Technology, Health, Medicine and Rehabilitation.
    Pauelsen, Mascha
    Luleå University of Technology, Department of Health, Learning and Technology, Health, Medicine and Rehabilitation.
    Chillon, Palma
    PROFITH “PROmoting FITness and Health Through Physical Activity” Research Group, Sport and Health University Research Institute (iMUDS), Department of Physical Education and Sport, Faculty of Sport Sciences, University of Granada, Granada, Spain.
    Lindqvist, Anna-Karin
    Luleå University of Technology, Department of Health, Learning and Technology, Health, Medicine and Rehabilitation.
    Adapting the behavioral regulation in active commuting to and from school questionnaire in Sweden: BR-ACS(SWE)2022In: Transportation Research Interdisciplinary Perspectives, ISSN 2590-1982, Vol. 16, article id 100721Article in journal (Refereed)
    Abstract [en]

    Although growing attention has been paid to motivation in explaining active travel to school among young people at the international level, no measures of motivation for active commuting to school (ACS) were found in Sweden. Guided by self-determination theory, this research aimed to adapt the Behavioral Regulation in Active Commuting to and from School (BR-ACS) questionnaire to the Swedish context and test the resulting version’s psychometric properties. The purposive and cross-sectional sample included 273 students (58 % girls, aged 10–12 years) from four Swedish urban schools. Results from confirmatory factor analyses psychometrically supported the six-factor correlated model (intrinsic motivation, integrated regulation, identified regulation, introjected regulation, external regulation, and amotivation) and the hierarchical three-factor model (autonomous, controlled motivation, and amotivation), which were invariant across gender. Latent correlations underpinned a symplex-like pattern. Discriminant and convergent validity and reliability were gathered. Criterion validity evidence was met with positive associations from intrinsic motivation, integrated and identified regulation to ACS, and a negative relationship between amotivation and ACS. The Swedish version of the BR-ACS questionnaire is a valid and reliable measure of children’s motivation toward ACS.

  • 12.
    Oyelere, Solomon Sunday
    et al.
    Luleå University of Technology, Department of Computer Science, Electrical and Space Engineering, Computer Science.
    Berghem, Simon Malmström
    Luleå University of Technology, Department of Computer Science, Electrical and Space Engineering, Computer Science.
    Brännström, Robert
    Luleå University of Technology, Department of Computer Science, Electrical and Space Engineering, Computer Science.
    Rutberg, Stina
    Luleå University of Technology, Department of Health, Learning and Technology, Health, Medicine and Rehabilitation.
    Laine, Teemu H.
    Department of Digital Media, Ajou University, Suwon 16499, Korea.
    Lindqvist, Anna-Karin
    Luleå University of Technology, Department of Health, Learning and Technology, Health, Medicine and Rehabilitation.
    Initial Design and Testing of Multiplayer Cooperative Game to Support Physical Activity in Schools2022In: Education Sciences, E-ISSN 2227-7102, Vol. 12, no 2, article id 100Article in journal (Refereed)
    Abstract [en]

    ecent studies have shown that children are not adequately physically active and there is a need to increase children’s physical activity. This study describes new opportunities and solutions for using existing games and gamification to increase physical activity among children in Sweden. We adopted the principles of Tic-Tac-Training to redesign, build, and test a classical multiplayer cooperative game, Battleship, to create a PA game that children experience as fun and engaging. The low fidelity prototype of the game was developed using an iterative game development life cycle and tested with 13 young male children aged 8–11 in a real-world informal setting. A mixed-method research approach was used to understand the users’ experiences and the impact of the Battleship-PA game on behavior change regarding physical activity. Research data were collected through audio recordings of interactions, direct observation, and a user experience questionnaire. The results of this study indicate both positive and negative feedback that can be used to improve the game and user experiences. The results from the unfiltered recordings revealed that both teams were competitive, cooperated within their team, and became excited whenever they destroyed opponent’s ships or were close to winning. However, the children felt bored and exhausted when many gamification tasks were repeated several times in a game session. Direct observation indicated that the children enjoyed the physical activities resulting from playing the game. However, participants who had not previously played the classical version of Battleship were confused about the objectives and concept of the game. The analysis of the user experience questionnaire indicated that most children found the game easy to play, motivating, engaging, interactive, fun, cooperative, competitive, and visually appealing. Furthermore, most children agreed that the game helped them to be physically active and strongly agreed that they enjoyed performing the physical activities in the game. Future work is needed to improve the game user interface, gamification elements, and prepare additional physical activity tasks for a rewarding experience.

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  • 13.
    Forsberg, Hanna
    et al.
    Luleå University of Technology, Department of Health, Learning and Technology, Health, Medicine and Rehabilitation.
    Lindqvist, Anna-Karin
    Luleå University of Technology, Department of Health, Learning and Technology, Health, Medicine and Rehabilitation.
    Forward, Sonja
    Swedish Road and Transport Research Institute, VTI, 581 95 Linköping, Sweden.
    Nyberg, Lars
    Luleå University of Technology, Department of Health, Learning and Technology, Health, Medicine and Rehabilitation.
    Rutberg, Stina
    Luleå University of Technology, Department of Health, Learning and Technology, Health, Medicine and Rehabilitation.
    Development and Initial Validation of the PILCAST Questionnaire: Understanding Parents’ Intentions to Let Their Child Cycle or Walk to School2021In: International Journal of Environmental Research and Public Health, ISSN 1661-7827, E-ISSN 1660-4601, Vol. 18, no 21, article id 11651Article in journal (Refereed)
    Abstract [en]

    Children generally do not meet the recommendation of 60 min of daily physical activity (PA); therefore, active school transportation (AST) is an opportunity to increase PA. To promote AST, the involvement of parents seems essential. Using the theory of planned behavior (TPB), the aim was to develop and validate the PILCAST questionnaire to understand parents’ intentions to let their child cycle or walk to school. Cross-sectional sampling was performed, where 1024 responses were collected from parents. Confirmatory factor analysis indicated acceptable fit indices for the factorial structure according to the TPB, comprising 32 items grouped in 11 latent constructs. All constructs showed satisfying reliability. The regression analysis showed that the TPB explained 55.3% of parents’ intentions to let the child cycle to school and 20.6% regarding walking, increasing by a further 18.3% and 16.6%, respectively, when past behavior was added. The most influential factors regarding cycling were facilitating perceived behavioral control, positive attitudes, subjective and descriptive norms, and for walking, subjective and descriptive norms. The PILCAST questionnaire contributes to a better understanding of the psychological antecedents involving parents’ decisions to let their child cycle or walk to school, and may therefore provide guidance when designing, implementing and evaluating interventions aiming to promote AST.

  • 14.
    Sandborg, Johanna
    et al.
    Department of Biosciences and Nutrition, Karolinska Institutet, Huddinge, Sweden. Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden.
    Henriksson, Pontus
    Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden.
    Larsen, Erica
    Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden..
    Lindqvist, Anna-Karin
    Luleå University of Technology, Department of Health, Learning and Technology, Health, Medicine and Rehabilitation.
    Rutberg, Stina
    Luleå University of Technology, Department of Health, Learning and Technology, Health, Medicine and Rehabilitation.
    Söderström, Emmie
    Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden.
    Maddison, Ralph
    nstitute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Burwood, Melbourne, Australia.
    Löf, Marie
    Department of Biosciences and Nutrition, Karolinska Institutet, Huddinge, Sweden. Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden. Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Burwood, Melbourne, Australia.
    Participants’ Engagement and Satisfaction With a Smartphone App Intended to Support Healthy Weight Gain, Diet, and Physical Activity During Pregnancy: Qualitative Study Within the HealthyMoms Trial2021In: JMIR mhealth and uhealth, E-ISSN 2291-5222, Vol. 9, no 3, article id e26159Article in journal (Refereed)
    Abstract [en]

    Background:Excessive gestational weight gain (GWG) is common and associated with negative health outcomes for both mother and child. Mobile health–delivered lifestyle interventions offer the potential to mitigate excessive GWG. The effectiveness of a smartphone app (HealthyMoms) was recently evaluated in a randomized controlled trial. To explore the users’ experiences of using the app, a qualitative study within the HealthyMoms trial was performed.

    Objective:This qualitative study explored participants’ engagement and satisfaction with the 6-month usage of the HealthyMoms app.

    Methods:A total of 19 women (mean age: 31.7, SD 4.4 years; mean BMI: 24.6, SD 3.4 kg/m2; university degree attainment: 13/19, 68%; primiparous: 11/19, 58%) who received the HealthyMoms app in a randomized controlled trial completed semistructured exit interviews. The interviews were audiorecorded and fully transcribed, coded, and analyzed using thematic analysis with an inductive approach.

    Results:Thematic analysis revealed a main theme and 2 subthemes. The main theme, “One could suit many: a multifunctional tool to strengthen women’s health during pregnancy,” and the 2 subthemes, “Factors within and beyond the app influence app engagement” and “Trust, knowledge, and awareness: aspects that can motivate healthy habits,” illustrated that a trustworthy and appreciated health and pregnancy app that is easy to use can inspire a healthy lifestyle during pregnancy. The first subtheme discussed how factors within the app (eg, regular updates and feedback) were perceived to motivate both healthy habits and app engagement. Additionally, factors beyond the app were described to both motivate (eg, interest, motivation, and curiosity) and limit (eg, pregnancy-related complications, lack of time) app engagement. The second subtheme reflected important aspects, such as high trustworthiness of the app, increased knowledge, and awareness from using the app, which motivated participants to improve or maintain healthy habits during pregnancy.

    Conclusions:The HealthyMoms app was considered a valuable and trustworthy tool to mitigate excessive GWG, with useful features and relevant information to initiate and maintain healthy habits during pregnancy.

  • 15.
    Laine, Teemu H.
    et al.
    Department of Digital Media, Ajou University, Republic of Korea.
    Normark, Jörgen
    Luleå University of Technology, Department of Business Administration, Technology and Social Sciences, Humans and technology.
    Lindvall, Helena
    Luleå Municipality, Sweden.
    Lindqvist, Anna-Karin
    Luleå University of Technology, Department of Health Sciences, Health, Medicine and Rehabilitation.
    Rutberg, Stina
    Luleå University of Technology, Department of Health Sciences, Health, Medicine and Rehabilitation.
    A Distributed Multiplayer Game to Promote Active Transport at Workplaces: User-Centred Design, Implementation and Lessons Learned2020In: IEEE Transactions on Games, ISSN 2475-1502, Vol. 12, no 4, p. 386-397Article in journal (Refereed)
    Abstract [en]

    Recent decline in active transport and increase in motorised transport decreases physical activity and increases air pollution. Using games to motivate people to change their behaviour towards active transport can mitigate this. We proposed Tic-Tac-Training, a distributed, collaborative and competitive game for promoting active transport at workplaces. Tic-Tac-Training was developed through a multidisciplinary and iterative user-centred design (UCD) process in four stages: (i) paper prototype, (ii) low-fidelity prototypes, (iii) high-fidelity prototypes, (iv) digital prototype. User testing and playtesting (N=12) yielded a number of improvement suggestions. We also analysed how Tic-Tac-Training supports the eight core drives of gamification (Octalysis), and presented 17 lessons learned in four categories. Findings suggest that UCD can be useful for developing exergame interventions for workplaces. Moreover, the lessons learned can benefit exergame designers. More research is needed to measure the behaviour change effect of Tic-Tac-Training and its applicability to other use cases.

  • 16.
    Lindqvist, Anna-Karin
    et al.
    Luleå University of Technology, Department of Health Sciences, Health, Medicine and Rehabilitation.
    Löf, Marie
    Department of Biosciences and Nutrition, Karolinska Institutet, 141 83 Huddinge, Sweden. Department of Medical and Health Sciences, Linköping University, 581 85 Linköping, Sweden.
    Ek, Anna
    Department of Biosciences and Nutrition, Karolinska Institutet, 141 83 Huddinge, Sweden.
    Rutberg, Stina
    Luleå University of Technology, Department of Health Sciences, Health, Medicine and Rehabilitation.
    Addendum: Active School Transportation in Winter Conditions: Biking Together is Warmer2020In: International Journal of Environmental Research and Public Health, ISSN 1661-7827, E-ISSN 1660-4601, Vol. 17, no 5, article id 1524Article in journal (Other academic)
  • 17.
    Rutberg, Stina
    et al.
    Luleå University of Technology, Department of Health Sciences, Health and Rehabilitation.
    Nyberg, Lars
    Luleå University of Technology, Department of Health Sciences, Health and Rehabilitation.
    Castelli, Darla
    Department of Kinesiology and Health Education, The University of Texas at Austin, Austin, TX, USA.
    Lindqvist, Anna-Karin
    Luleå University of Technology, Department of Health Sciences, Health and Rehabilitation.
    Grit as Perseverance in Physical Activity Participation2020In: International Journal of Environmental Research and Public Health, ISSN 1661-7827, E-ISSN 1660-4601, Vol. 17, no 3, article id 807Article in journal (Refereed)
    Abstract [en]

    Childhood is a critical period for the acquisition of healthy behaviors, and the promotion of sustainable healthy behavior among children is greatly important. Therefore, an increased understanding of the relationship between grit and physical activity in a school context is needed. The purpose of this study is to describe and develop an understanding of students’ and teachers’ awareness and experiences concerning grit as a health-promoting factor. Fifty-five students and three teachers participated in the study. Data were collected through the Short Grit Scale and focus group interviews. There were weak to non-significant correlations between the three teachers’ ratings of their students’ grit and the children’s own ratings. The qualitative results show that children and teachers understood the construct of grit but had slightly different perceptions of it and that grit is not considered to be set in stone. The participants made an association between grit, motivation, meaningfulness, and setting goals. The findings indicate that grit might be an ideal target for making physical activity interventions sustainable.

  • 18.
    Forsberg, Hanna
    et al.
    Luleå University of Technology, Department of Health Sciences, Health, Medicine and Rehabilitation.
    Rutberg, Stina
    Luleå University of Technology, Department of Health Sciences, Health, Medicine and Rehabilitation.
    Mikaelsson, Katarina
    Luleå University of Technology, Department of Health Sciences, Health, Medicine and Rehabilitation.
    Lindqvist, Anna-Karin
    Luleå University of Technology, Department of Health Sciences, Health, Medicine and Rehabilitation.
    It’s about being the good parent: exploring attitudes and beliefs towards active school transportation2020In: International Journal of Circumpolar Health, ISSN 1239-9736, E-ISSN 2242-3982, Vol. 79, no 1, article id 1798113Article in journal (Refereed)
    Abstract [en]

    In recent decades, there has been a decline in active school transportation (AST). Parents play an important role as the key decision-makers of children’s AST, and there is a need of more knowledge about the decision-making process and parents’ beliefs towards AST. The overall aim of this study was to explore parents’ attitudes and beliefs towards AST in the northern part of Sweden. Twenty parents participated in semi-structured interviews, which was based on the theory of planned behaviour. Qualitative content analysis was used to analyse the interviews. The analysis yielded one main theme, “Parenting and active school transportation – making route choices in a changed landscape” and four subthemes, “Knowing that it is beneficial while struggling with daily life”, “Considering barriers and solutions to enable AST”, “Parenting is challenging and about balancing”, and “Reflecting and contemplating about what we and others do”. Winter conditions affect parents’ decisions, and this needs to be considered when facilitating AST in these regions. Overall better health, increased physical activity, time spent outdoors, and free play were revealed as positive outcomes of AST. Decisions were also influenced by social norms and how the idea of parenting has changed through generations. The findings of this study are likely to be important when promoting AST.

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  • 19.
    Savolainen, Eva
    et al.
    Luleå University of Technology, Department of Health Sciences, Health, Medicine and Rehabilitation.
    Rutberg, Stina
    Luleå University of Technology, Department of Health Sciences, Health, Medicine and Rehabilitation.
    Backman, Ylva
    Luleå University of Technology, Department of Arts, Communication and Education, Education, Language, and Teaching.
    Lindqvist, Anna-Karin
    Luleå University of Technology, Department of Health Sciences, Health, Medicine and Rehabilitation.
    Long-Term Perspectives of a School-Based Intervention to Promote Active School Transportation2020In: International Journal of Environmental Research and Public Health, ISSN 1661-7827, E-ISSN 1660-4601, Vol. 17, no 14, article id 5006Article in journal (Refereed)
    Abstract [en]

    There is a global need for sustainable interventions that increase physical activity among children, and active school transportation (AST) can promote physical activity among schoolchildren. Therefore, an intervention based on gamification, empowerment, and social cognitive theory was initiated in 2016 to promote AST. The aim of this study was to follow up on participants’ experiences one and two years after the AST intervention was initiated. Data were collected through focus groups and individual interviews which were analyzed using qualitative content analysis. Thirty-one pupils (2017), and forty pupils (2018) aged 9–10 years, two teachers (2017, 2018) and one principal (2018) participated in the study. The result is presented as one main theme; “Unity for an active community-An intervention towards making the active choice the easy choice” and three sub-themes; “Well begun is half done-Engagement sparks motivation”, “It takes two to tango-Keep moving with gamifications and togetherness” and “Jumping on the bandwagon–From project to everyday use.” The results show that the concept of the intervention was attractive to re-use and that it created a habit to use AST among the children. Interventions to promote AST can benefit from the use of engagement, togetherness, and gamification.

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  • 20.
    Mikaelsson, Katarina
    et al.
    Luleå University of Technology, Department of Health Sciences, Health and Rehabilitation.
    Rutberg, Stina
    Luleå University of Technology, Department of Health Sciences, Health and Rehabilitation.
    Lindqvist, Anna-Karin
    Luleå University of Technology, Department of Health Sciences, Health and Rehabilitation.
    Michaelson, Peter
    Luleå University of Technology, Department of Health Sciences, Health and Rehabilitation.
    Physically inactive adolescents’ experiences of engaging in physical activity2020In: European Journal of Physiotherapy, ISSN 2167-9169, E-ISSN 2167-9177, Vol. 22, no 4, p. 191-196Article in journal (Refereed)
    Abstract [en]

    Purpose: This study aimed to describe physically inactive adolescents’ experiences and reflections about engaging in physical activity. Methods: Nine graduate students from the third year of upper secondary school (six women and three men) participated in this study. Narrative interviews were used for data collection and qualitative content analysis was used to analyse the interviews. Results: The analysis revealed three themes ‘Acknowledging resistance and barriers to performing physical activity’, ‘Knowing that it is good is not enough’, and ‘Feeling included and accepted is fun and motivating’. These themes show that the adolescent’s experienced barriers, acknowledged pros and cons and identified possibilities to be physically active. Conclusions: Identifying experiences that impact on inactive adolescents’ attitude and willingness to perform physical activity can be useful to understand the needs of the individual. By relating these experiences to the different stages of the transtheoretical model, this study could provide valuable knowledge for designing future interventions to enhance physical activity in this target group.

  • 21.
    Lindqvist, Anna-Karin
    et al.
    Luleå University of Technology, Department of Health Sciences, Health, Medicine and Rehabilitation.
    Rutberg, Stina
    Luleå University of Technology, Department of Health Sciences, Health, Medicine and Rehabilitation.
    Söderström, Emmie
    Department of Health, Medical and Caring Sciences, Linköping University, Linköping, Sweden.
    Ek, Anna
    Department of Clinical Science Intervention and Technology, Karolinska Institutet, Huddinge, Sweden.
    Alexandrou, Christina
    Department of Health, Medical and Caring Sciences, Linköping University, Linköping, Sweden. Department of Clinical Science Intervention and Technology, Karolinska Institutet, Huddinge, Sweden.
    Maddison, Ralph
    Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Melbourne, Australia.
    Löf, Marie
    Department of Health, Medical and Caring Sciences, Linköping University, Linköping, Sweden. Department of Biosciences and Nutrition, Karolinska Institutet, Huddinge, Sweden.
    User Perception of a Smartphone App to Promote Physical Activity through Active Transportation: An Inductive Qualitative Content Analysis within the Smart City Active Mobile Phone Intervention (SCAMPI) Study2020In: JMIR mhealth and uhealth, E-ISSN 2291-5222, Vol. 8, no 8, article id e19380Article in journal (Refereed)
    Abstract [en]

    Background: Physical inactivity is globally recognized as a major risk factor for morbidity, particularly the incidence of non-communicable diseases, and mortality. Engaging in active transportation (AT) is a viable approach toward increasing physical activity (PA) on a daily basis. Mobile (mHealth) interventions enable promoting AT to a larger population. The Smart City Active Mobile Phone Intervention (SCAMPI) study is a randomized controlled trial designed to evaluate a smartphone application (app)’s ability to motivate participants to increase their PA by engaging in AT.

    Objective: This qualitative study examines the acceptance and usability of the SCAMPI app from the participants’ perspectives.

    Methods: Seventeen residents of Stockholm county (13 women; age range 25-61 years), who had completed the three-month, app-based behavioral change program in the SCAMPI randomized controlled trial during 2018 agreed to participate in a semi-structured telephone-based interview. These 17 participants were well representative of the whole intervention group (n = 127) in terms of baseline characteristics such as age, sex, and area of residence. The interviews were audio-recorded, transcribed verbatim, and analyzed using inductive qualitative content analysis.

    Results: The content analysis revealed two themes and four subcategories. The first theme “Main motivators: monitoring and messages” highlighted that monitoring AT and being able to set weekly goals using the app were the primary motivators reported among study participants. The second theme “Acceptable but modifiable” reflects that the app was well accepted and effectively encouraged many participants to use more AT. Nevertheless, there were functions in the app that require modification. For example, while the automated travel tracking feature was appreciated, participants found it time-consuming and unreliable at times.

    Conclusions: This study contributes novel insight into healthy adults’ experiences of using a mobile app to promote the use of AT. The results showed that the app was well-accepted and that self-monitoring and goal setting were the main motivators to engage in more AT. The automated tracking of AT was appreciated; however, it was also reported to be energy- and time-consuming when it failed to work. Thus, this feature should be improved going forward.

  • 22.
    Lindqvist, Anna-Karin
    et al.
    Luleå University of Technology, Department of Health Sciences, Health and Rehabilitation.
    Löf, Marie
    Karolinska Institutet; Linköping University, Linköping.
    Ek, Anna
    Karolinska Institutet.
    Rutberg, Stina
    Luleå University of Technology, Department of Health Sciences, Health and Rehabilitation.
    Active School Transportation in Winter Conditions: Biking Together Is Warmer2019In: International Journal of Environmental Research and Public Health, ISSN 1661-7827, E-ISSN 1660-4601, Vol. 16, no 2, article id 234Article in journal (Refereed)
    Abstract [en]

    There has been a decline in children’s use of active school transportation (AST) while there is also limited research concerning AST in winter conditions. This study aimed to explore the prerequisites and experiences of schoolchildren and parents participating in an empowerment- and gamification-inspired intervention to promote students’ AST in winter conditions. Methods: Thirty-five students, who were aged 12–13 years, and 34 parents from the north of Sweden participated in the study. Data were collected using photovoice and open questions in a questionnaire and analyzed using qualitative content analysis. Results: The results show that involvement and togetherness motivated the students to use AST. In addition, during the project, the parents changed to have more positive attitudes towards their children’s use of AST. The students reported that using AST during wintertime is strenuous but rewarding and imparts a sense of pride. Conclusion: Interventions for increasing students’ AST in winter conditions should focus on the motivational aspects for both children and parents. For overcoming parental hesitation with regards to AST during winter, addressing their concerns and empowering the students are key factors. To increase the use of AST all year around, targeting the challenges perceived during the winter is especially beneficial.

  • 23.
    Rutberg, Stina
    et al.
    Luleå University of Technology, Department of Health Sciences, Health and Rehabilitation.
    Lindqvist, Anna-Karin
    Luleå University of Technology, Department of Health Sciences, Health and Rehabilitation.
    Children’s motivation overcame parental hesitation: active school transportation in Sweden2019In: Health Promotion International, ISSN 0957-4824, E-ISSN 1460-2245, Vol. 34, no 6, p. 1149-1156Article in journal (Refereed)
    Abstract [en]

    Abstract

    To meet the recommendation of 60 min of daily physical activity, children can be encouraged to walk or bike to school, which is known as active school transportation (AST). The aim of this study was to describe parents’ attitudes to AST and to explore their experience when implementing interventions to promote it. To explore parent’s experiences, we collected pre- and post-intervention data via three questionnaires, using both closed and open questioning techniques. The pre-intervention questionnaire informed development of the intervention. Open-ended questions (pre- and post-) were analyzed with qualitative content analysis. In the intervention, there were 42 children, with 63 parents answering pre-intervention questionnaires and 44 answering a post-intervention questionnaire. The analysis resulted in one main theme: children’s motivation and active travel reduces parents’ perception of problems, along with three subthemes: parental concerns and suggestions for solutions, children’s motivation guides parental choice of transport mode, and trying it changes attitudes. In conclusion, it is beneficial to use the enthusiasm and motivation of children to overcome parental hesitation with AST. In addition, it is critical to acknowledge their concerns, as they are the gatekeepers to the children’s use of AST and it is valuable to empower parents when designing relevant interventions. Interventions to increase AST could preferably target changed behavior, and parents’ confidence in their children’s ability to use active transport in a safe and effective way, vs focusing on changing parental attitudes.

  • 24.
    Lindqvist, Anna-Karin
    et al.
    Luleå University of Technology, Department of Health Sciences, Health and Rehabilitation.
    Rutberg, Stina
    Luleå University of Technology, Department of Health Sciences, Health and Rehabilitation.
    Cykelväg till skolan kan vara vägen till framgång2019In: Skolledaren, ISSN 0037-6515, no 3Article in journal (Other (popular science, discussion, etc.))
  • 25.
    Ek, Anna
    et al.
    Department of Biosciences and Nutrition, The Innovative Use of Mobile Phones to Promote Physical Activity and Nutrition Across the Lifespan Research Group, Karolinska Institutet, Huddinge, Sweden. Division of Pediatrics, Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Huddinge, Sweden.
    Sandborg, Johanna
    Department of Biosciences and Nutrition, The Innovative Use of Mobile Phones to Promote Physical Activity and Nutrition Across the Lifespan Research Group, Karolinska Institutet, Huddinge, Sweden.Division of Community Medicine, Department of Medical and Health Sciences, Linköping University, Linköping, Sweden.
    Delisle Nyström, Christine
    Department of Biosciences and Nutrition, The Innovative Use of Mobile Phones to Promote Physical Activity and Nutrition Across the Lifespan Research Group, Karolinska Institutet, Huddinge, Sweden.
    Lindqvist, Anna-Karin
    Luleå University of Technology, Department of Health Sciences, Health and Rehabilitation.
    Rutberg, Stina
    Luleå University of Technology, Department of Health Sciences, Health and Rehabilitation.
    Löf, Marie
    Department of Biosciences and Nutrition, The Innovative Use of Mobile Phones to Promote Physical Activity and Nutrition Across the Lifespan Research Group, Karolinska Institutet, Huddinge, Sweden.Division of Community Medicine, Department of Medical and Health Sciences, Linköping University, Linköping, Sweden.
    Physical Activity and Mobile Phone Apps in the Preschool Age: Perceptions of Teachers and Parents2019In: JMIR mhealth and uhealth, E-ISSN 2291-5222, Vol. 7, no 4, article id e12512Article in journal (Refereed)
    Abstract [en]

    BACKGROUND:

    Physical activity (PA) is already beneficial at the preschool age. In many countries, young children spend most of their days in the preschool setting, making it a common arena for PA interventions. Mobile health tools are becoming increasingly popular to promote PA in different populations; however, little is known about the interest for and how the preschool setting could incorporate such a tool.

    OBJECTIVE:

    This study aimed to examine how teachers and parents perceive PA in preschool-aged children in general and their perceptions of how a mobile phone app could be used to promote PA in the preschool setting.

    METHODS:

    Semistructured interviews were conducted with 15 teachers (93%, [14/15] women, mean age 43.5 years, 47%, [7/15] with a university degree and 10 parents [91%, 9/10] women, mean age 38.9 years, all with a university degree) recruited from 2 urban preschools in central Sweden. The interviews were recorded, fully transcribed, coded, and analyzed using thematic analysis by means of an inductive approach.

    RESULTS:

    The analysis revealed 4 themes: (1) children are physically active by nature, (2) the environment as a facilitator or a barrier, (3) prerequisites of the adult world, and (4) an app in the preschool setting-challenges and possibilities. Parents and teachers perceived preschoolers as being spontaneously physically active; however, high-intensity PA was perceived as low. The PA was specifically performed during the day in the preschool. Identified facilitators of PA were access to safe and engaging outdoor environments such as forests, spacious indoor areas, and adult involvement. Adult involvement was considered especially important for children preferring sedentary activities. Identified barriers for PA were restricted indoor and outdoor space, rules for indoor activities, and lack of adult involvement because of time constraints. The teachers perceived that they had limited skills and experiences using apps in general, although they also acknowledged the increasing role of technological tools in the curriculum. Thus, the teachers expressed an interest for an app designed as a support tool for them, especially for situations when PA was limited because of perceived barriers. They suggested the app to include accessible information regarding the health benefits of PA in children linked to a library of activities for different settings and seasons. Parents suggested interactive app features including problem-solving tasks and music and dance, but not video clips as they made children passive.

    CONCLUSIONS:

    Vigorous PA was perceived as low in preschool-aged children. Future tailoring of interventions in the preschool setting should work around barriers and support facilitators to PA, especially PA of high intensity. In such work, an app could serve as a source of inspiration for PA in different ages, settings, and seasons and thus reduce environmental and structural inequalities in the preschool setting.

  • 26.
    Lindqvist, Anna-Karin
    et al.
    Luleå University of Technology, Department of Health Sciences, Health and Rehabilitation.
    Rutberg, Stina
    Luleå University of Technology, Department of Health Sciences, Health and Rehabilitation.
    The road to success - aktiva skoltransporter2019Conference paper (Other (popular science, discussion, etc.))
    Abstract [sv]

    Endast omkring 30% av svenska barn når rekommendationen för fysisk aktivitet och bara hälften av barnen använder aktiva skoltransporter (AST). Förutom den samhälleliga utmaningen som detta innebär för barns hälsa och kognitiv förmåga, har det också en negativ inverkan på klimatet och trafiksäkerhet nära skolorna. Dessutom följer barns fysiska vanor med in i vuxenlivet och därmed har den fysiska inaktiviteten på sikt en betydande hälsoekonomisk negativ effekt. Vi arbetar med ett skolbaserat koncept som bygger på empowerment och gamification. Det slutgiltiga målet är en innovativ digital lösning för en hållbar beteendeförändring avseende AST och att implementeringen av innovationen ökar användandet av AST bland svenska barn från dagens 52% till 80%.

  • 27.
    Rutberg, Stina
    et al.
    Luleå University of Technology, Department of Health Sciences, Health and Rehabilitation.
    Lindqvist, Anna-Karin
    Luleå University of Technology, Department of Health Sciences, Health and Rehabilitation.
    Active School Transportation is an Investment in School Health2018In: Health Behavior and Policy Review, ISSN 2326-4403, Vol. 5, no 2, p. 88-97Article in journal (Refereed)
    Abstract [en]

    Objective: In this study, we aimed to explore the experiences of schoolchildren and teachers participating in an empowerment- and gamification-inspired program to promote children's active school transportation. Methods: Data were collected using focus groups with 32 schoolchildren and 2 teachers. Content analysis revealed 2 themes and 5 subthemes. Results: Integrating learning into the program increased student engagement and enhanced learning outcomes. The program also created additional value beyond physical activity, such as togetherness, readiness to learn, and changed parental attitudes. Conclusions: Combining learning with physical activity through gamification is a promising method for promoting active school transportation. The time and energy spent increasing active school transportation enrich learning activities and health and are therefore well invested

  • 28.
    Kostenius, Catrine
    et al.
    Luleå University of Technology, Department of Health Sciences, Health and Rehabilitation.
    Hallberg, Josef
    Luleå University of Technology, Department of Computer Science, Electrical and Space Engineering, Computer Science.
    Lindqvist, Anna-Karin
    Luleå University of Technology, Department of Health Sciences, Health and Rehabilitation.
    Gamification of health education: Schoolchildren’s participation in the development of a serious game to promote health and learning2018In: Health Education, ISSN 0965-4283, E-ISSN 1758-714X, Vol. 118, no 4, p. 354-368Article in journal (Refereed)
    Abstract [en]

    Purpose

    The use of modern technology has many challenges and risks. However, by collaborating with schoolchildren, ideas to effectively promote health and learning in school can be identified. This study aimed to examine how a participatory approach can deepen the understanding of how schoolchildren relate to and use gamification as a tool to promote physical activity and learning.

    Design/methodology/approach

    Inspired by the concept and process of empowerment and child participation, the methodological focus of this study was on consulting schoolchildren. During a 2-month period, 18 schoolchildren (10–12-years-old) participated in workshops to create game ideas that would motivate them to be physically active and learn in school.

    Findings

    The phenomenological analysis resulted in one main theme, ‘Playing games for fun to be the best I can be’. This consisted of four themes with two sub-themes each. The findings offer insights on how to increase physical activity and health education opportunities using serious games in school.

    Originality/value

    The knowledge gained provides gamification concepts and combinations of different technological applications to increase health and learning, as well as motivational aspects suggested by the schoolchildren. The findings are discussed with health promotion and health education in mind.

  • 29.
    Kim, Jihoon
    et al.
    University of Texas, Austin.
    Castelli, Darla M.
    University of Texas, Austin.
    Lindqvist, Anna-Karin
    Luleå University of Technology, Department of Health Sciences, Health and Rehabilitation.
    Global Communication of Social Determinants of Health for Emerging Adults2018In: Research Quarterly for Exercise and Sport, ISSN 0270-1367, E-ISSN 2168-3824, Vol. 89, no Suppl. 1, p. A107-Article in journal (Refereed)
  • 30.
    Lindqvist, Anna-Karin
    et al.
    Luleå University of Technology, Department of Health Sciences, Health and Rehabilitation.
    Rutberg, Stina
    Luleå University of Technology, Department of Health Sciences, Health and Rehabilitation.
    One Step Forward: Development of a Program Promoting Active School Transportation2018In: JMIR Research Protocols, E-ISSN 1929-0748, Vol. 7, no 5, article id e123Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Physical activity promotes health and learning. However, up to 80% of the children in industrialized countries do not achieve the recommended level of daily physical activity. By encouraging children to use active school transportation (AST), it is possible to increase their overall physical activity.

    OBJECTIVE: The aim of this paper was to present the development of an AST intervention using Intervention Mapping (IM) to promote children's physical activity.

    METHODS: The principles of IM were applied to guide the development of the intervention. The process was divided into 3 phases. First, a literature review and collection of experiences of stakeholders were carried out to gain a broad perspective on the problem and possible solutions. Thereafter, an analysis of the critical environmental and behavioral factors affecting outcome was conducted, which guided the choice of tangible components of the intervention. Finally, a plan of evaluation and implementation was established.

    RESULTS: A structured program to increase AST among children was developed, consisting of 3 subsequent phases that are described in detail. Implementation took place, and evaluation of the intervention is being carried out.

    CONCLUSIONS: IM proved to be a valuable method to develop a structured AST intervention for children. By following the steps of the IM process, it became evident that empowerment and gamification are 2 promising avenues to consider when designing AST interventions in a school context. By engaging end users and including important agents, such as parents and teachers, who control the environmental factors, the possibility to design a sustainable program increases. In addition, gamification made it possible to integrate learning into AST, which could motivate schools to devote time and effort to implementing this program.

  • 31.
    Lindqvist, Anna-Karin
    et al.
    Luleå University of Technology, Department of Health Sciences, Health and Rehabilitation.
    Castelli, Darla
    Kinetic Kidz Lab, Department of Kinesiology and Health Education, University of Texas at Austin, Austin, TX, United States. .
    Hallberg, Josef
    Luleå University of Technology, Department of Computer Science, Electrical and Space Engineering, Computer Science.
    Rutberg, Stina
    Luleå University of Technology, Department of Health Sciences, Health and Rehabilitation.
    The Praise and Price of Pokémon GO: A Qualitative Study of Children's and Parents' Experiences.2018In: JMIR Serious Games, E-ISSN 2291-9279, Vol. 6, no 1, article id e1Article in journal (Refereed)
    Abstract [en]

    Background: Physical activity has multiple health benefits; however, the majority of children around the world do not attain the recommended levels of daily physical activity. Research has shown that the game Pokémon GO has increased the amount of physical activity of players and that the game has the potential to reach populations that traditionally have low levels of physical activity. Therefore, there is a need to understand which game components can promote initial and sustained physical activity. By using a qualitative research approach, it is possible to achieve rich descriptions and enhance a deep understanding of the components promoting physical activity among children in a game such as Pokémon GO.

    Objective: The objective of this study was to explore children’s and parents’ experiences playing Pokémon GO.

    Methods: Eight families comprising 13 children (aged 7-12 years) and 9 parents were selected using purposeful sampling. Data collected using focus groups were analyzed using qualitative latent content analysis.

    Results: The following three themes were revealed: (1) exciting and enjoyable exploration; (2) dangers and disadvantages; and (3) cooperation conquers competition. The first centers around the present and possible future aspects of Pokémon GO that promote physical activity. The second focuses on unwanted aspects and specific threats to safety when playing the game. The third shows that cooperation and togetherness are highly valued by the participants and that competition is fun but less important.

    Conclusions: Components from Pokémon GO could enhance the efficacy of physical activity interventions. Cooperation and exploration are aspects of the game that preferably could be transferred into interventions aimed at promoting children’s physical activity.

  • 32.
    Lindqvist, Anna-Karin
    Luleå University of Technology, Department of Health Sciences, Health and Rehab.
    Physiotherapists enabling school children's physical activity using social cognitive theory, empowerment and technology2017In: European Journal of Physiotherapy, ISSN 2167-9169, E-ISSN 2167-9177, Vol. 19, no 3, p. 147-153Article in journal (Refereed)
    Abstract [en]

    Aim: To contribute knowledge concerning how physiotherapists using social cognitive theory, empowerment and information and communication technology can promote children’s physical activity in a school context.

    Methodology: Four studies were conducted in the northern part of Sweden and a qualitative discourse analysis of the results from all four studies was performed to enable a more comprehensive understanding. Three of the studies involved children, and one study involved parents.

    Major findings: The findings formed three themes: A, Acknowledging empowerment; B, Bonded forces overcame barriers; and C, Competence and motivation enable change. The first theme includes the act of creating the intervention using an empowerment approach. The second theme concerns barriers to being physically active and social support from parents and peers regarding physical activity promotion. The third theme concerns motivation and associated personal factors, such as self-efficacy.

    Principal conclusion: This course of action might be a way for physiotherapists to promote children’s physical activity using social cognitive theory, empowerment and information and communication technology in a school context. An empowerment approach that includes the formation of partnerships with children is a promising avenue for developing physical activity interventions in schools. In addition, physical activity interventions should attempt to build on children’s self-efficacy and make physical activity opportunities fun and enjoyable.

  • 33.
    Kostenius, Catrine
    et al.
    Luleå University of Technology, Department of Health Sciences, Health and Rehab.
    Hallberg, Josef
    Luleå University of Technology, Department of Computer Science, Electrical and Space Engineering, Computer Science.
    Lindqvist, Anna-Karin
    Luleå University of Technology, Department of Health Sciences, Health and Rehab.
    A slice of the win-win game: Swedish schoolchildren’s ideas on gamification to promote physical activity and cognitive ability2016Conference paper (Other academic)
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  • 34.
    Lindqvist, Anna-Karin
    et al.
    Luleå University of Technology, Department of Health Sciences, Health and Rehab.
    Kostenius, Catrine
    Luleå University of Technology, Department of Health Sciences, Health and Rehab.
    Active@school: Promoting Physical Activity with Interactive Technology by Empowering Schoolchildren2015In: Empowering School eHealth Model in the Barents Region, Rovaniemi: Lapland University of Applied Sciences, 2015, p. 195-204Chapter in book (Refereed)
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  • 35.
    Lindqvist, Anna-Karin
    et al.
    Luleå University of Technology, Department of Health Sciences, Health and Rehab.
    Kostenius, Catrine
    Luleå University of Technology, Department of Health Sciences, Health and Rehab.
    Gard, Gunvor
    Luleå University of Technology, Department of Health Sciences, Health and Rehab.
    Rutberg, Stina
    Luleå University of Technology, Department of Health Sciences, Health and Rehab.
    Parent participation plays an important part in promoting physical activity2015In: International Journal of Qualitative Studies on Health and Well-being, ISSN 1748-2623, E-ISSN 1748-2631, Vol. 10, article id 27397Article in journal (Refereed)
    Abstract [en]

    Although physical activity (PA) is an important and modifiable determinant of health, in Sweden only 15% of boys and 10%of girls aged 15 years old achieve the recommended levels of PA 7 days per week. Adolescents’ PA levels are associated withsocial influence exerted by parents, friends, and teachers. The purpose of this study was to describe parents’ experiencesof being a part of their adolescents’ empowerment-inspired PA intervention. A qualitative interview study was performedat a school in the northern part of Sweden. A total of 10 parents were interviewed, and the collected data were analyzedwith qualitative content analysis. Three subthemes were combined into one main theme, demonstrating that parents are oneimportant part of a successful PA intervention. The life of an adolescent has many options and demands that make it difficultto prioritize PA. Although parents felt that they were important in supporting their adolescent, a successful PA interventionmust have multiple components. Moreover, the parents noted that the intervention had a positive effect upon not only theiradolescents’, but also their own PA. Interventions aimed at promoting PA among adolescents should include measures tostimulate parent participation, have an empowerment approach, and preferably be school-based.

  • 36.
    Lindqvist, Anna-Karin
    Luleå University of Technology, Department of Health Sciences, Health and Rehabilitation.
    Promoting adolescents' physical activity @ school2015Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    The overall aim of this thesis was to explore the development of a health-promoting intervention that uses empowerment and information and communication technology, to examine the impact of the intervention and to describe adolescents' and parents' experiences of the intervention. This thesis includes four studies, three of which used a qualitative approach (I, III and IV) and one of which used a mixed method approach (II). Three of the studies involved adolescents (I-III), and one study involved parents (IV).Data were generated using focus groups and analyzed using latent content analysis (study I). Physical activity, self-efficacy, social support, and attitude data were collected before and after the intervention and analyzed using descriptive and analytical statistics (study II). Adolescents were interviewed and the data were analyzed using latent content analysis (study III). The parents were interviewed and the data were analyzed using latent content analysis (study IV). The findings formed three themes: A, Acknowledging empowerment andphysical activity; B, Bonded forces overcame barriers; and C, Competence andmotivation enable change. The first theme concerns behavior regarding health promotion, specifically physical activity. That theme includes the act of creating the intervention using an empowerment approach and the physical activity behavior after the intervention. The second theme concerns barriers to being physically active and social support from parents and peers regarding physical activity promotion. The third theme concerns motivation and associated personal factors, such as knowledge and self-efficacy.The main conclusion of this thesis is that it is possible to develop anempowerment-inspired health-promoting intervention with a positive impact.Furthermore, interventions that aim to promote physical activity among adolescents should preferably include information and communication technology from the adolescents’ reality, involve actions that stimulate the participation of both parents and peers and be school-based.

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  • 37.
    Lindqvist, Anna-Karin
    et al.
    Luleå University of Technology, Department of Health Sciences, Health and Rehab.
    Kostenius, Catrine
    Luleå University of Technology, Department of Health Sciences, Health and Rehab.
    Gard, Gunvor
    Luleå University of Technology, Department of Health Sciences, Health and Rehab.
    Fun, feasible and functioning: Students’ experiences of a physical activity intervention2014In: European Journal of Physiotherapy, ISSN 2167-9169, E-ISSN 2167-9177, Vol. 16, no 4, p. 194-200Article in journal (Refereed)
    Abstract [en]

    Aim: The aim of this study was to describe students’ experiences of participating in a physical activity (PA) intervention. Methodology: A purposive sampling was used; 14 students (four boys and 10 girls) were interviewed and the collected data was analysed using qualitative content analysis. Major findings: One main theme was identified: fun, feasible and functioning. The following two subthemes also emerged: the multi-component intervention fits several, but not all, and manageable measuring can also be motivating. The main theme elucidates that fun was an important factor for joining the study; the students also experienced he empowerment-inspired intervention and the data collection to be fun and feasible. According to the students, the intervention was functioning since they experienced that it increased their PA. Principal conclusions: An empowerment approach that includes forming partnerships with students is a promising avenue for developing PA interventions for schools, regardless of whether the person concerned is a parent, teacher, school nurse or physiotherapist, but one size will never fit all.

  • 38.
    Lindqvist, Anna-Karin
    et al.
    Luleå University of Technology, Department of Health Sciences, Health and Rehab.
    Mikaelsson, Katarina
    Luleå University of Technology, Department of Health Sciences, Health and Rehab.
    Westerberg, Mats
    Luleå University of Technology, Department of Business Administration, Technology and Social Sciences, Innovation and Design.
    Gard, Gunvor
    Luleå University of Technology, Department of Health Sciences, Health and Rehab.
    Kostenius, Catrine
    Luleå University of Technology, Department of Health Sciences, Health and Rehab.
    Moving From Idea to Action: Promoting Physical Activity by Empowering Adolescents2014In: Health Promotion Practice, ISSN 1524-8399, E-ISSN 1552-6372, Vol. 15, no 6, p. 812-818Article in journal (Refereed)
    Abstract [en]

    Background. Physical activity provides fundamental health benefits for children and youth. The aim of the study was to explore the possibility of conducting an empowerment-inspired intervention and examine the impact of the intervention in promoting moderate and vigorous physical activity (MVPA) among adolescents. Method. A nonrandomized trial with a concurrent control group was carried out. Physical activity data were collected before and after the intervention with daily questions by short message service. Self-efficacy, social support, and attitude were also measured before and after the intervention since they were possible mediators. Results. The intervention was created by the students, the researchers, and the teachers using an empowerment-based approach. Students in the intervention group (n = 21) increased their MVPA on average by 4.9 (SD = 28.9) minutes per day, and students in the control group (n = 25) reduced their MVPA on average by 25.4 (SD = 23.0) minutes per day (p = .000). Conclusions. The intervention might have contributed to a promotion of physical activity among students in the intervention group. The most valuable contribution this study provides is the knowledge that it is possible to develop and conduct an empowerment-inspired intervention to promote adolescent physical activity.

  • 39.
    Kostenius, Catrine
    et al.
    Luleå University of Technology, Department of Health Sciences, Health and Rehabilitation.
    Bergmark, Ulrika
    Luleå University of Technology, Department of Arts, Communication and Education, Education, Language, and Teaching.
    Hertting, Krister
    Nyström, Lena
    Luleå University of Technology, Department of Arts, Communication and Education, Education, Language, and Teaching.
    Lögdberg, Ulrika
    Luleå University of Technology, Department of Health Sciences, Health and Rehabilitation.
    Lindqvist, Anna-Karin
    Luleå University of Technology, Department of Health Sciences, Health and Rehabilitation.
    Grape, Monica
    Project: ArctiChildren InNet2014Other (Other (popular science, discussion, etc.))
    Abstract [sv]

    Sedan 2003 har jag varit delaktig i Arctic Children, ett forsknings- och utvecklingsprojekt med övergripande mål att förbättra barn och ungdomars psykosocialahälsa och välbefinnande. Ett givande samarbete som inkluderar norra delarna av Sverige, Finland, Norge och Ryssland som sedan 2012 gått in i projektets tredje fas för att ta sig an gemensamma utmaningarna kopplat till barn och ungdomars psykiska, psykologiska, emotionella, sociala och andliga hälsa med hjälp av empowerment och informations-och kommunikationsteknik (IKT).

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  • 40.
    Kostenius, Catrine
    et al.
    Luleå University of Technology, Department of Health Sciences, Health and Rehab.
    Lindqvist, Anna-Karin
    Luleå University of Technology, Department of Health Sciences, Health and Rehab.
    Melander-Wikman, Anita
    Luleå University of Technology, Department of Health Sciences, Health and Rehab.
    From rocking horse to rocking chair in good health: research methods for intergenerational knowledge sharing in health promotion2013Conference paper (Refereed)
    Abstract [en]

    The overall purpose of this presentation is to discuss research methods for data collection togive voice throughout the lifespan including children, adults and elderly. More specifically,the aim is to present research methods to capture intergenerational experiences ofpsychosocial well-being, and transformation of knowledge between age groups. Subjectivewell-being is people’s positive evaluation of their lives including pleasant emotions,fulfillment and satisfaction. The methods are based on the concept of salutogenese, focusingon empowerment combining written and oral, individual and group methods to access variousforms of communication. The focus is on self-determination, ability to influence andparticipation as dimensions of empowerment, which lead us to an approach that is solutionfocusedwith a starting point in the participants’ own experiences of psychosocial well-being.First reflective narratives – open letters – are offered to the children, adults and elderly as away to share their experiences, thoughts and ideas on how to amplify health and well-being.Then participants meet in different constellations, focus groups, to share their healthpromoting experiences first with each homogeneous group; children, adults and elderly, thenin mixed age groups. The purpose of the heterogeneous focus groups are to develop the openletters, with health promotion ideas the individual participants have written, in order todeepen the understanding of how health promotion activities can be designed in differentcontexts. The purpose of the homogeneous focus groups are to make knowledgetransformation possible between different age groups, both as a way to enrich the discussionabout the topic as well as to empower the participants. Based on research showing thatpsychosocial well-being increase when people are listened to, taken seriously and have thepossibility to participate, these research methods may not only be ways to collect researchdata but promote health and well-being as well.

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  • 41.
    Kostenius, Catrine
    et al.
    Luleå University of Technology, Department of Health Sciences, Health and Rehab.
    Lindqvist, Anna-Karin
    Luleå University of Technology, Department of Health Sciences, Health and Rehab.
    Melander-Wikman, Anita
    Luleå University of Technology, Department of Health Sciences, Health and Rehab.
    From rocking horse to rocking chair in good health2012Conference paper (Refereed)
    Download full text (jpg)
    FULLTEXT01
  • 42.
    Lindqvist, Anna-Karin
    et al.
    Luleå University of Technology, Department of Health Sciences, Health and Rehab.
    Kostenius, Catrine
    Luleå University of Technology, Department of Health Sciences, Health and Rehab.
    Gard, Gunvor
    Luleå University of Technology, Department of Health Sciences, Health and Rehab.
    Peers, parents and phones: Swedish adolescents and health promotion2012In: International Journal of Qualitative Studies on Health and Well-being, ISSN 1748-2623, E-ISSN 1748-2631, Vol. 7, article id 17726Article in journal (Refereed)
    Abstract [en]

    Many unhealthy behaviors are created during adolescence and follow the individual into adulthood. In addition, health behaviors often occur in clusters as those who are inactive are more likely to eat unhealthy food and smoke. This makes the early foundation of healthy behaviors vital. The aim was to describe and develop an understanding of adolescents' awareness and experiences concerning health promotion. Data was collected using focus groups with a total of 28 seventh graders and was analysed with latent qualitative content analysis. One main theme was identified; being competent, ambivalent and creative at the same time. The following three subthemes also emerged: being a digital native for better and for worse, knowing what is healthy, and sometimes doing it, and considering change and having ideas of how change could be supported. The main theme elucidates how the majority of students were informed and able but they did not always prioritize their health. The concept of health promotion relies upon the engagement of the individual; however, although the students had clear ideas about how they would like to change their own behaviors, they felt a need for support. Interestingly, the students were able to make several suggestions about the kind of support that would make a difference to their adoption to more healthy modes of living. They suggested information and communication technology (ICT), for example encouraging text messages (SMS), and social support, for example parents setting rules and peers inspiring them to adhere to a healthy behavior. The knowledge gained from this study echoes our view of inclusion and this could be helpful for those who encounter the challenge of promoting health among adolescents

  • 43.
    Kostenius, Catrine
    et al.
    Luleå University of Technology, Department of Health Sciences, Health and Rehab.
    Lindqvist, Anna-Karin
    Luleå University of Technology, Department of Health Sciences, Health and Rehab.
    Hälsovägledning: från tanke till ord och handling2006Book (Other academic)
  • 44.
    Lindqvist, Anna-Karin
    et al.
    Luleå University of Technology, Department of Health Sciences, Health and Rehab.
    Kostenius, Catrine
    Luleå University of Technology, Department of Health Sciences, Health and Rehab.
    Hälsopedagogik2004Report (Other academic)
  • 45.
    Schenström, Ola
    et al.
    Primärvården, Luleå.
    Lindqvist, Anna-Karin
    Luleå University of Technology, Department of Health Sciences, Health and Rehab.
    Kostenius, Catrine
    Luleå University of Technology, Department of Health Sciences, Health and Rehab.
    Ett liv i balans2003Report (Other (popular science, discussion, etc.))
1 - 45 of 45
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