We wanted to study if and how students become motivated and stimulated towards a permanent interest for regular physical activity, from a pedagogical perspective. Our goal was to examine how physical education teachers create motivation for the students and how you, as a physical education teacher, can motivate those students who are physically inactive due to obesity or other various kinds of problems. In the theoretical background, we have made a summary of sports and development of the physical education subject over the years. We also describe society´s perspective on public health. The motivation concept is definded and we explain different motivational theories. The study shows how teachers can help motivate their students and we discuss earlier research concerning motivation. The examination consisted of semi-structured interviews interpreted on the basis of research questions. When it comes to creating motivation for physical activity among students, the result shows that physical education teachers are of utmost importance. The students´ motivation can be influenced in a positive way if teachers encourage and praise all children and vary the education, adapting it to needs of the students.

<p>The increasing prevalence of obesity in both developed and developing countries and its associated health risks have brought the issue of obesity prevention and management a public health debate. Health care professionals have been identified to have a role to play in directing the future of obesity management. However, among the numerous barriers for effective management of obesity is lack of knowledge of causes of obesity and negative attitudes towards obese patients by health care professionals. With limited or no studies available for the physiotherapy setting, the aim of the study was to determine the knowledge and attitudes of students of Physiotherapy at the University of the Western Cape, South Africa towards obese individual. A descriptive quantitative research design using a cross-sectional survey was used. One hundred and seventy five (175) students of Physiotherapy took part in the study using a convenience sampling technique. Data was collected by means of a structured, self-administered questionnaire adopted from the Obesity Risk Knowledge-10 scale, Beliefs About Obese Person scale and the Fat Phobia Scale. A response rate of 77.3% was obtained. Descriptive and inferential statistics were employed to describe the relationship and association between variables. Alpha level was set at 0.05. The mean age of the sample was 21.54 (SD = 4.903). Females constituted 73.5% and males 26.5% of the sample. The results showed that majority of the students of Physiotherapy (85%) reported having received no formal education regarding obesity.</p>

Aim:  To describe health professional's treatment of pregnant overweight or obese women at an antenatal clinic in Nairobi, Kenya. Method: A descriptive qualitative method was used including interviews with 11 health professionals at an antenatal clinic in Nairobi, Kenya. The interviews were semi-structured and consisted of five open-ended question. The result was then analysed through a systematic content analyse. Result: Four categories were identified. The methods used to state gestational overweight or obesity were weighting and assessing from the previous weight. BMI was also measured. The most common intervention is counselling on diet and lifestyle. Some respondents mentioned referral to nutritionist and also multidisciplinary involvement. Many of the respondents stated however that gestational overweight and obesity is very rare and that they don't have any specific routines or interventions. Conclusion: The basic measures used to survey  pregnant women´s weight are  pre- pregnant weight, continuously weighting and measuring BMI are used. There are also basic interventions such as counselling on diet and exercise. However, gestational overweight or obesity is not a prioritised issue at Kenyatta National Hospital and few routines and interventions exist. This study demonstrates the necessity for training and educating the staff to raise awareness about the risks gestational overweight or obesity implies. It also highlights the need of clear guidelines on how manage gestational overweight and obesity. / Syfte: Att beskriva hälso- och sjukvårdspersonals behandling av överviktiga eller feta gravida kvinnor. Metod: Beskrivande kvalitativ metod där intervjuer med 11 vårdpersonal utfördes på en mödravårdscentral i Nairobi, Kenya. Intervjuerna var semi- strukturerade och bestod av fem öppna frågor. Resultatet analyseras sedan genom en systematisk innehållsanalys. Resultat: Fyra kategorier identifierades. De metoder som användes för att fastställa övervikt eller fetma under graviditet var vägning, jämförelse med tidigare vikt samt BMI. Den vanligaste insatsen var rådgivning om kost och livsstil. Några respondenter nämnde att de vid behov remitterar patienter till en dietist och att de arbetar tvärvetenskapligt. Många av respondenterna uppgav dock att övervikt och fetma under graviditet är mycket ovanligt och att inga särskilda rutiner eller interventioner finns. Slutsats: Den vanligaste åtgärden för att förebygga graviditetsdiabetes övervikt och fetma är rådgivning om kost och motion. Kvinnornas vikt, kontinuerligt vägning och mätning av BMI är de grundläggande redskapen för att hålla en god kontroll på gravida kvinnors vikt. Övervikt och fetma hos gravida kvinnor är dock inte en prioriterad fråga på Kenyatta National Hospital och mycket få rutiner och åtgärder finns. Studien belyser behovet av att utbilda personal för att öka medvetenheten om vilka risker övervikt och fetma hos gravida kvinnor kan medföra. Det finns även ett behov av tydliga riktlinjer för hur man identifierar, behandlar och följer upp överviktiga eller feta gravida kvinnor.

Övervikt och fetma anses vara ett globalt folkhälsoproblem, vars omfattning tycks ha ökat de senaste årtiondena. Förklaringen till det anses ofta vara en västerländsk livsstil bestående av kaloririk kost och bristande fysisk aktivitet. Att lyckas med en livsstilsförändring tycks därmed viktigt, men svårt. Syftet med studien var att identifiera framgångsfaktorer som bidragit till initierande och vidmakthållande av en livsstilsförändring. Enskilda intervjuer, med tre kvinnor och tre män, genomfördes därför med individer som vidmakthållit en livsstilsförändring i minst två år. Studien visade att gemensamma framgångsfaktorer för initiering och vidmakthållande var en vändpunkt som resulterat i motiv och mål, samt omgivande förutsättningar. Specifikt för initieringen var bestämdhet viktigt, medan vidmakthållandet gynnades av strategier och upplevd belöning. Respondenterna hade överlag många gemensamma framgångsfaktorer, och inga tydliga skillnader mellan könen kunde urskiljas.

Övervikt och fetma är ett hälsoproblem bland barn och ungdomar idag och beror främst på att vårt kaloriintag är större än vår energiförbrukning. Syftet med denna studie var att belysa och sammanställa forskning som beskriver olika omvårdande insatser som främjar hälsa hos överviktiga och feta barn och ungdomar. Metoden som användes var litteraturöversikt. Elva artiklar analyserades och sammanställdes och resultatet visades genom fyra teman som benämndes; att identifiera ohälsa, att vara en vägledare, att arbeta med motivation och att stödja familjen. Resultaten visade att identifiering av barn med fetma är viktig för att barnet ska få hjälp på ett tidigt stadium. Barn och ungdomar behöver stöd i form av hälsovägledning och motiverande samtal. Föräldrars deltagande är viktigt för barn och ungdomar långsiktigt och därför är det viktigt att även stödja föräldrar. Resultaten visade även att det finns omvårdande insatser riktade mot feta barn och ungdomar som ger positiva effekter på deras hälsa. / Overweight and obesity is a health problem among children and adolescents today and is mainly due to our caloric intake being greater than our energy consumption. The purpose of this study was to highlight and summarize research that describes the various nursing interventions that promote health for obese children and adolescents. The method used was literature review. Eleven articles were analyzed and the results were shown in four themes named; to identify health problems, being a guide, to work with motivation and to support the family. The result showed that identification of obese children is important for the child to get help at an early stage. The result also showed that children and adolescents need support in terms of health counseling and motivational interviewing. Parental involvement is important for children and young people long term and therefore it is important to also support the parents. In conclusion there are nursing interventions targeting obese children and adolescents that have a positive impact on their health.

Syftet med föreliggande studie var att beskriva hur skolsköterskor upplever problematiken kring övervikt/fetma hos barn i låg- och mellanstadiet och att undersöka vilka strategier skolsköterskorna har för att förebygga/hjälpa dessa barn. Ännu ett syfte med studien var att undersöka hur skolsköterskorna ser på samarbetet med föräldrar, lärare och andra skolsköterskor i detta problem. Metoden var att intervjua sju skolsköterskor på låg- och mellanstadiet i två kommuner i Mellansverige. Intervjuerna spelades in på band och transkriberades ordagrant. Meningsbärande enheter plockades ut och materialet kategoriserades och resulterade i tre huvudkategorier och tio subkategorier. Resultatet visade att de sju intervjuade skolsköterskorna ansåg att det är ett problem med övervikt/fetma hos skolbarn. Skolsköterskorna hade inte några särskilda strategier för att förebygga övervikt/fetma och riktlinjerna från skolhälsovården är oklara, men fyra av skolsköterskorna höll på att arbeta fram en förebyggande strategi på egen hand. Alla skolsköterskor hade mer eller mindre en strategi för att hjälpa överviktiga/feta skolbarn genom att prata kost och motion på hälsosamtalen. Fyra av skolsköterskorna hade arbetat fram eget material. Materialet användes sedan för att hjälpa barnen att få ett annat tankesätt och en förändrad livsstil. Alla sju skolsköterskor ansåg att ett fungerande samarbete med föräldrar, lärare och andra skolsköterskor underlättar arbetet med de överviktiga barnen. / The aim of the existing study was to describe how school nurses experience the complex of problems about obesity among primary school and middle school children, also to examine which strategies school nurses use to prevent/help these children. Amongst other aims, this study examines how school nurses experience cooperation with parents, teachers and other school nurses within this area. The method used was to interview seven school nurses in primary school and middle school from two school regions in the middle of Sweden. The interviews were recorded on tape and transcribed in verbatim. Sense bearing units were picked out and the material was categorized, which resulted in three main categories with ten subcategorise. The results showed that the seven interviewed school nurses considered that there is a problem with obesity in school children. The school nurses didn’t have any specific strategies to prevent obesity and the guidelines from the school health board were indistinctive, but four of the school nurses were working on preventive strategies on their own hand. All of the school nurses more or less had a strategy for helping obese school children, by meens of talking about nutrition and fysical exercise in health sessions. Four of the school nurses had created their own material. The material was then used to help the children with another way of thinking and change in lifestyle. All seven school nurses considered that a working cooperation with parents, teachers and other school nurses facilitated the work with the obese children.

Syftet med denna studie var att beskriva vilka behandlingsformer det finns för överviktiga barn och barn med fetma samt vilka effekter de har på kroppsvikten. Metoden som användes var en litteraturstudie av deskriptiv ansats och sökningen av vetenskapliga artiklar skedde via databaserna PubMed och High Wire Press. Det var 19 stycken studier som svarade mot studiens syfte och frågeställning och inkluderades i studien. Av de behandlingsformer som presenterades i studien hade kirurgi- och läkemedelsbehandling den största effekten på barn med fetma. Studien påvisade att de kombinerade behandlingsformerna inriktade på beteende och kostförändringar tillsammans med fysisk aktivitet och som involverade hela eller delar av familjen hade den största effekten på barn med övervikt. Pågick den kombinerade behandlingen mer är ett år kunde man se en positiv viktutveckling med en minskning av BMI på de barn med övervikt som deltog. De övriga behandlingsformerna som presenteras visar var och en av dem en god effekt under behandlingstiden men avtar efter avslutad behandling. Slutsatsen författaren drar av denna studie var att de barn som behandlas tillsammans med familjen under en längre tid och lär sig hur man förhåller sig till kost och fysisk aktivitet, har störst chans att slippa gå in i vuxenvärlden som överviktig. / The objective for this study was to describe what available treatments there is for overweight children and children with obesity and what effect the treatments have on the bodyweight. The Method used was a descriptive literature study and the search of articles was made in PubMed and High Wire Database. There were 19 articles included in the study who all answered to the aim and questions of this study. Of all treatments that were presented in the study, surgery- and drug treatment had the largest effect on children with obesity. The study proved that the combined treatments with behavior and nutrition changes combined with physical activity that involved whole or parts of the family was the most effective treatment for overweight children. If the combined treatment lasted for more than a year, a reduction of weight and BMI was shown among the overweight children that participated in the study. The rest of the treatments found shows god results during the treatment, but the effect decreases after completed treatment. The authors’ conclusion was that the children treated along with their family for a long period of time and learns how to behave with food and physical activities will have the largest chance to escape an overweight life as an adult

An estimated 50% of mortality from the 10 leading causes of death is due to behaviour. Individuals can make important contributions to their own health by adopting health-related behaviours and avoiding others. Motivational interviewing (MI) has emerged as a counselling approach for behavioural change that builds on a patient empowerment perspective by supporting autonomy and self-efficacy. The overall aim of this thesis is to contribute to improved understanding of the different factors that impact on general health care professionals’ learning and practice of MI. Specific aims are; study I was to identify barriers, facilitators and modifiers to use MI with pharmacy clients in community pharmacies; study II was to identify barriers and facilitators to use MI with overweight and obese children in child welfare and school health services; study III was to evaluate the attitudes towards MI and clinical use of MI with children´s weight issues one year after child health care nurses’ participation in MI training; study IV was to systematically review studies that have evaluated the contents and outcomes of MI training for general health care professionals. Participants in study I were 15 community pharmacy pharmacists in Östergötland, Sweden. Participants in study II were five child welfare centre nurses from the county council and six municipally-employed school health service nurses, all from Östergötland, Sweden. Data for both studies were obtained through focus group interviews. Study III, participants were 76 nurses from child health care centres in Östergötland, Sweden. 1-year after MI training they answered a survey. Study IV, the material was 10 empirical studies that have evaluated different aspects of MI training. MI training for general health care providers is generally of short duration and tends to focus on specific topics such as diabetes, smoking, and alcohol. The training seems to contain more training on phase I elements, such as clients’ inner motivation, than on phase II, which involves strengthening clients’ commitment to change. MI is seen as practical and useful in work with lifestyle and health promotion issues, especially with issues that may be perceived as sensitive, such as alcohol and obesity. General health care providers have positive attitudes to MI and view MI as being compatible with their values and norms about how they want to work. Clients’ resistance reactions are difficult to handle in the first stages of learning MI, and may lead to frustration. Strategies to avoid resistance are including in the final stages of learning MI. Learning and clinical use of MI for general health care providers is influenced by interactions with their environment (colleagues, staff and organization). Unlearning of old knowledge can be a problem for general health care providers in the learning and clinical use of MI.

Background Overweight and obesity in childhood is associated with physical, psychological and social consequences. Physical inactivity is regarded as one of the main factors that have contributed to the increase in childhood obesity through out the world. Overweight and obesity as well as physical activity level are shown to track from childhood to adolescence and adulthood, thereby influencing not only the current health status but also long-term health. The general purpose of this thesis was to evaluate the effect of a 2-year family-based lifestyle intervention on physical activity and metabolic health among children with overweight and obesity. Methods Children with overweight or obesity living in northern Sweden were recruited to the study. In total 105 children, mean age 10.5 years (SD±1.09), were randomized into either an intervention or a control group. The intervention group was offered as a 2-year family-based lifestyle intervention; the 1st year consisted of 14 group sessions and during the 2nd year the intervention was web-based. The control group did not participate in any intervention sessions, but performed all measurements. Physical activity was measured in all children using SenseWear Pro2 Armband (SWA) during 4 consecutive days before, in the middle and after the intervention, data regarding anthropometrics and blood values were collected in the same periods. Twenty-two of the children wore SWA during 14 days before the intervention in order to validate energy expenditure (EE) estimated by SWA against EE measured with double labelled water. Results The SWA, together with software version 5.1, proved to be a valid device to accurately estimate EE at group level of overweight and obese children. There were no statistically significant differences between the groups neither before nor after the intervention regarding physical activity and screen-time. All children significantly decreased their time being active ≥3 METs during the study period. After the study period, significantly fewer in the control group achieved the national physical activity recommendation, and they had significantly increased their screen-time. However, these changes were not seen within the intervention group. The intervention group had a significantly lower apolipoprotein B/A1 compared to the control group at 1-year measurement; no other significant differences were found regarding metabolic markers. No statistical difference was found between the groups regarding body mass index after the 2-year study period. Conclusion Even though a comprehensive program, the 2-year family-based lifestyle intervention had limited effects on physical activity and metabolic health in overweight and obese children. SWA is a device that can be used in future studies to measure energy expenditure among free-living overweight or obese children. / SELFH

Obesity and overweight is the worst public health related disease today, and it is a constantly increasing problem in societies all over the world. In Sweden the number of overweight persons has been doubled in the last 20 years. Today about 500 000 persons suffer from obesity and overweight.The aim of this study was to investigate obese and overweight people´s thoughts and wishes regarding what support they would like, in order to be able to successfully manage a weightreduction. The study is qualitative and conducted through six interviews, the material was analysed with content analysis. The result of the analysed interviews led to four categories:offered support, wished support, are you strong enough to find support by your own and mental wellbeing.The conclusion of this study is that overweight person’s biggest wish is to get continuous and personal support from the health care system. Sometimes the support needs to be life long. This is what all the interviewed persons think is most important in order to be able to handle a weight reduction. A common understanding among the participants was also that the society needs to take more responsibility in order to prevent more people from getting overweight,and to help people who already are overweight. A feeling of stigmatization is something that all the interviewed feels on a daily basis.