Family Child Care Homes (FCCHs) are the second largest provider of non-relative care in the U.S. However, despite providing care for nearly 1.9 million children under the age of 5, little is known about the physical activity levels of children attending FCCHs. This dissertation sought to provide new information with regards to physical activity in children attending FCCHs. The purpose of the first study was to objectively measure physical activity in children attending FCCHs. 114 children (60 boys and 54 girls) 3.7 �� 1.1 years of age from 47 FCCHs wore an ActiGraph GT1M accelerometer for the duration of child care attendance during a randomly selected week. Counts were classified as sedentary (SED), light (LPA), or moderate-to-vigorous (MVPA) using the cut-points developed by Pate et al. (2006). Total physical activity was calculated by summing time spent in LPA and MVPA. Non-wear time was estimated by summing the number of consecutive zero counts accumulated in strings of 10 minutes or longer. Children were included in the analyses if they had 2 or more monitoring days in which wear time was ���75% of the attendance time. On average, children accumulated 25.9 �� 5.7 min of SED, 10.1 �� 4.2 min of MVPA, and 34.1 �� 5.7 min of total physical activity per hour of attendance. Further analysis revealed that among healthy weight children, 4 year-olds exhibited significantly lower levels of SED and significantly higher levels of MVPA and total physical activity than 2- and 3- year-olds. Among 4-year-olds, overweight and obese children exhibited significantly higher levels of SED and significantly lower levels of MVPA and total PHYSICAL ACTIVITY than healthy weight counterparts. The results from this study indicated that preschool-aged children attending FCCHs are mostly sedentary and accumulate low levels of MVPA during the child care day. The purpose of the second study was to assess the validity of two proxy report instruments designed to measure physical activity in children attending FCCHs. Valid self-report measures are needed for large scale intervention studies and/or population-based surveillance studies in which more burdensome objective measures are not feasible. In Year 1 of the study, FCCH Providers (N=37) completed the Burdette parent proxy report, modified for the family child care setting, for 107 children aged 3.4 �� 1.2 years. In Year 2, 42 Providers completed the Harro parent and teacher proxy report, modified for the family child care setting, for 131 children aged 3.8 �� 1.3 years. Both proxy-reports were assessed for validity using objectively measured physical activity as a criterion measure (accelerometry). Significant positive correlations were observed between scores from the modified Burdette proxy report and objectively measured total physical activity (r = 0.31, p < 0.01) and MVPA (r = 0.33, p < 0.01). Across levels of Provider-reported activity, both total physical activity and MVPA increased significantly in a linear dose-response fashion. Provider-reported MVPA scores from modified Harro proxy report were not associated with objectively measured physical activity. These findings suggested that the modified Burdette proxy report may be a useful measurement tool in larger-scale physical activity studies involving FCCHs in which objective measures, such as direct observation or accelerometry, are not practical. The purpose of the third study was to evaluate the effects of two strategies to increase the use of portable play equipment in FCCHs ��� a community-based train-the-trainer physical activity intervention (INT), and the same trainer-the-trainer intervention supplemented with monthly emails promoting the use of portable play equipment (INT+). We hypothesized that Providers completing the standard train-the-trainer intervention would report significantly greater portable play equipment use than Providers completing the food allergy control training (CON). We further hypothesized that Providers completing the supplementary email intervention would report significantly greater portable play equipment use than Providers completing standard train-the-trainer intervention or the food allergy control training. A total of 50 FCCH Providers from Marion, Linn, Benton, Washington, and Lane County, Oregon were randomized to the INT or CON conditions. Twelve Providers from Lincoln County were assigned to the (INT+). The type, variety, and frequency of portable play equipment use was measured by means of self-report via a checklist and two items from the previously validated NAP-SACC Self-Assessment instrument. FCCH Providers who completed the INT reported significantly greater use of portable play equipment than Providers completing the CON training. However, portable play equipment use among Providers completing the INT+ was not significantly different from that reported by Providers in the INT or CON. Notably, neither intervention had a significant impact on the amount or variety of portable play equipment. The results showed that a comprehensive trainer-the-trainer intervention to increase physical activity in FCCHs could successfully increase the use of portable play equipment in the home. However, supplementing the intervention with monthly emails encouraging the use of PPE was not effective. / Graduation date: 2013

L'athérosclérose est une maladie cardiovasculaire complexe affectant la paroi artérielle où le développement et la progression de la plaque sont fortement favorisés par une inflammation chronique. L'instabilité de la plaque carotidienne peut conduire à de potentiels évènements ischémiques majeurs tels que l'accident vasculaire cérébral (AVC) dont le caractère imprévisible rend la prévention primaire très compliquée. Ainsi, il n'existe pas à l'heure actuelle de biomarqueurs prédictifs efficaces de la rupture de plaque. Néanmoins, il est maintenant clairement établi que l'hémorragie intraplaque (IPH), la néovascularisation et l'accumulation excessive de macrophages sont les principaux facteurs d'instabilité de la plaque. Sur la base de travaux précédents, l'objectif de cette thèse était d'évaluer de manière indépendante les effets de l'activité physique (AP) et de la sédentarité, premièrement sur les paramètres histologiques d'instabilité de plaque, et deuxièmement, sur les facteurs de risque secondaires de l'athérosclérose, que sont l'inflammation, le stress oxydant et le profil hémorhéologique de patients asymptomatiques à risque d'AVC traités chirurgicalement. La 1ère étude a montré que l'AP régulière était associée à une prévalence d'IPH diminuée, et était l'unique facteur protecteur de l'IPH. Cette étude a également suggéré un effet bénéfique de l'AP sur le stress oxydant, ainsi que sur l'accumulation de macrophages. Dans une 2ème étude, nous avons caractérisé l'état fonctionnel de protéines potentiellement impliquées dans les dysfonctions du système immunitaire, et l'implication des cellules inflammatoires dans ces mécanismes. Nous avons alors identifié une cytokine pro-inflammatoire jouant un rôle déterminant dans les processus inflammatoires de déstabilisation de plaque. L'étude 3 nous a permis de caractériser l'effet du niveau d'AP sur la réponse monocytaire chez des patients avec plaque d'athérosclérose, et d'identifier une chimiokine qui pourrait avoir un rôle dans la modulation de la réponse monocytaire par l'AP. Enfin, la 4ème étude démontre l'altération de paramètres hémorhéologiques chez des patients atteints de maladie carotidienne sévère, et comment l'AP permet de limiter cette altération via la diminution de l'agrégation érythrocytaire. Ce travail de thèse apporte des informations quant à la pratique de l'AP dans la prévention primaire de l'athérosclérose. Des études complémentaires seront toutefois nécessaires afin de confirmer ces résultats, en proposant notamment une approche interventionnelle en activité physique / Atherosclerosis is a complex cardiovascular disease that affects the arterial wall where plaque development and progression are severely promoted by chronic inflammation. Carotid plaque destabilization could lead to potential major ischemic events such stroke which is still unpredictable, making primary prevention very complex. Thus, there is still currently no suitable predictive biomarker of plaque rupture. Nevertheless, it is now clearly established that intraplaque hemorrhage (IPH), neovascularization and excessive macrophage accumulation are the three main risk factors of plaque instability. Based on previous studies, the aim of this work was to evaluate independently the impact of physical activity (PA) and sedentary behavior, first on histological parameters of plaque instability, and secondly on secondary risk factors of atherosclerosis, such as inflammation, oxidative stress and hemorheological profile of asymptomatic patients at high-risk of stroke who underwent endarterectomy surgery. The first study shows that regular PA was associated to a decreased occurrence of IPH, and was the only protective factor for IPH. This study also suggested a beneficial effect of PA on macrophage accumulation as well as on oxidative stress. Then, in the 2nd study, we have characterized the functional state of proteins potentially implicated in immune system dysfunctions, and the implication of inflammatory cells in these mechanisms. We have identified a pro-inflammatory cytokine as a key driver of disrupting inflammatory process of plaque. In the same way, we have characterized in the 3rd study, the effect of PA on the monocytic response in atherosclerosis patients, and identified a chemokine associated that could explain the modulation of this monocytic response by PA. Finally, the 4th study demonstrates the hemorheological parameters alteration in carotid artery disease patients, and how PA could limit this alteration via red blood cell aggregation. This PhD thesis provided information regarding regular PA in primary prevention of atherosclerosis. However, additional studies are required to confirm these results, using in particular PA interventional approach

Syfte Syftet med studien var dels att kartlägga stillasittandet hos högskoleanställda lärare under arbetsdagen. Vidare syftade studien till att undersöka faktorer som bidrog till att vara stillasittande. Metod I studien användes en blandad metodansats. Datainsamling genomfördes via 4 enskilda intervjuer samt en enkät med 49 lärare på Högskolan Dalarna. Resultat Medelvärdet för deltagarnas tid i stillasittande per arbetsdag var 6,62 (±1,97) timmar och antal avbrott i stillasittandet var i genomsnitt 1,6 (±0,89) per timme. Det fanns ingen statistiskt signifikant skillnad i stillasittande tid ( p= 0,22) eller antal avbrott i stillasittandet (p= 0,21) under arbetsdagen mellan kvinnor och män. Relationsvärdet (r= -0,34) indikerade att det fanns ett svagt samband som visade att deltagare som var mer stillasittande också gjorde färre avbrott i sitt stillasittande. Den främsta anledning som angavs till att sitta ner var att stillasittandet förbättrade koncentrationsförmågan vid arbetsuppgifter som krävde mycket fokus. Andra framträdande faktorer som påverkade ett intagande av stillasittande var tidspress och hög arbetsbelastning. Individen själv uppgavs vara det största hindret för att minska sitt eget stillasittande, där det invanda beteendet att sitta vid vissa arbetsmoment hade stor påverkan. Deltagarnas kunskap kring stillasittandets konsekvenser var bristfällig och det var inte heller ett samtalsämne som diskuterades i större utsträckning på arbetsplatsen. Slutsatser Högskoleanställda lärare är en riskgrupp för stillasittandets negativa hälsoeffekter. Engagemang och ökad kunskap på individ-, interpersonell- och organisationsnivå krävs för att uppnå förändringar i det stillasittande beteendet. / Purpose The purpose of the study was to map the sedentary behavior of college-faculty teachers during the working day. Furthermore, the study aimed at investigating factors that contributed to being sedentary. Method The study used a mixed method approach. Data collection was conducted through 4 individual interviews and a questionnaire with 49 teachers at Högskolan Dalarna. Results The average of the participants' sedentary time per working day was 6,62 (±1.97) hours. The number of interruptions from being sedentary was in average 1,6 (±0.89) per hour. There was no statistically significant difference in sedentary time (p= 0,22) or number of interruptions (p= 0,21) during the working day between men and women. Relationship value (r= -0,34) indicated that there was a weak relationship that showed that participants who were more sedentary also made fewer interruptions in their sitting time. The main reason for being sedentary was that sitting improved the ability to concentrate on tasks requiring a lot of focus. Other prominent factors that affected the intake of sedentary behavior were time pressure and high workload. The individual himself was said to be the biggest obstacle to reducing his own sedentary behavior, where the habitual behavior of sitting when doing certain tasks in the workplace had a major impact. Participants' knowledge of sedentary behavior and consequences was inadequate, and it was not a discussion topic that was discussed in greater detail at the workplace. Conclusions Higher education teachers are a risk group for negative health effects caused by sedentary behavior. Engagement and increased knowledge at individual, interpersonal and organizational levels are required to achieve changes in sedentary behavior.

Inledning: I dagens moderna, välutvecklade och allt mer digitaliserade samhälle ges människor en ökad möjlighet till att leva sina liv betydligt mer stillasittande än tidigare. Allt mer forskning pekar idag på att långvarigt stillasittande som enskild riskfaktor är en bidragande orsak till utvecklingen av ohälsa samt vällevnadssjukdomar såsom diabetes, hjärt- och kärlsjukdomar samt fetma. Syfte: Syftet med litteraturöversikten är att undersöka hur ett stillasittande beteende som enskild riskfaktor påverkar vuxna människors hälsa samt belysa vilka faktorer som bidrar till ett stillasittande beteende. Metod: För att besvara syftet har en litteraturöversikt gjorts utifrån tio vetenskapliga originalartiklar. Sökningarna har gjorts via databaserna Pubmed, Cinahl och PsycARTICLES. Artiklarna granskades och analyserades sedan med hjälp av Whittemore och Knafl (2005) analysmetod. Resultat: Längre stunder av stillasittande hade en tydlig koppling mellan flera fysiologiska effekter i kroppen. När pauser togs genererade det i flera hälsofrämjande effekter så som ett ökat upptag av glukos i blodet, ökad kaloriförbrukning samt minskat BMI. Hos de personer som var mindre stillasittande sågs även en minskad risk av att dö i t.ex. hjärt- och kärlsjukdomar. Riskfaktorer så som en dålig arbetsmiljö, vart en bor samt ett förhöjt BMI sågs ha negativa effekter som ledde till ett ökat stillasittande. Slutsats: Att så mycket som 60 % av den vakna tiden spenderas stillasittande kan ses som en riskfaktor för att i förlängningen kunna utveckla vällevnadssjukdomar. Viktiga aspekter som sågs för att motverka detta var att regelbundet ta kortare pauser för att avbryta längre stunder av stillasittande.Trots att en hälsosam nivå av fysisk aktivitet uppnås är det inte tillräckligt om resten av dagen spenderas stillasittande. Detta utgör ett behov av nya tydligare och uppnåeliga riktlinjer för hur personer bör begränsa sitt stillasittande. / Introduction: In today's modern, well-developed and increasingly digitized society, people are given the opportunity to live much more sedentary lives than before. More research today indicates that long-term sedentary as a single risk factor is a contributing factor in developing illness and public health diseases such as diabetes, cardiovascular disease and obesity. Aim: The aim of the literature review is to investigate how sedentary behavior as an individual risk factor affects adult human health as well as highlight the factors that contributes to sedentary behavior. Method: In order to respond to the aim, an integrated literature survey has been conducted based on ten scientific original articles. The searches have been made through the databases Pubmed, Cinahl and PsycARTICLES. The articles were then examined and analyzed using the Whittemore and Knafl (2005) analytical method. Results: Longer moments of sedentary had a clear connection between several physiological effects in the body. When breaks were taken, it generated several health-promoting effects such as increased blood glucose absorption, increased calorie consumption, and reduced BMI. In those who were less seated, there was also a reduced risk of dying in e.g. Heart disease. Risk factors such as a poor work environment, where one lives, and an elevated BMI, were found to have adverse effects that led to increased sedentary behaviors. Conclusion: As much as 60% of the waking time is spent sedentary this is considered a risk factor in order to develop public health diseases in the long run. Important aspects that were seen to counteract this were to regularly take shorter breaks to interrupt longer moments of sedentary. Although a healthy level of physical activity is achieved, it is not enough if the rest of the day is spend sedentary. This constitutes a need for new, clearer and achievable guidelines for how people should limit their sedentary behavior.

Prevalence of physical inactivity in children and adolescents and the associated epidemic of obesity are increasing concerns. U.S. national health statistics indicate early adolescence (i.e., 10-14 years) appears to be a period of importance regarding physical activity, sedentary behavior, health-related physical fitness, and obesity trends. Considering a significant portion of their waking hours are spent in school, it is widely held that schools' should play a significant role in increasing students' physical activity and health-related physical fitness. To do this, physical education in schools focus on providing quality physical education programs that produce physically literate individuals who have the knowledge, skills, and confidence to enjoy a lifetime of health-producing physical activity. In effect, a call for developing a comprehensive and valid measure of physical literacy has been aptly expressed. Thus, the purpose of this dissertation was to test the psychometric properties of proposed models of physical literacy, examine correlates of the physical literacy factor, and investigate the significance of the relationship between physical literacy and interscholastic sport intention via structural equation modeling. Participants were 400 (231 female, 169 male) sixth-grade physical education students who completed three brief surveys assessing maturation, self-efficacy, self-esteem, knowledge and understanding, motivation, physical activity and sport participation, and interscholastic sport intention. In addition, students completed a sedentary behavior log, a health-related physical fitness assessment, and an overhand throwing skill assessment. Analyses offered overall support for the proposed physical literacy measurement models. Results also supported positive relationship Physical literacy was statistically significantly positively related physical activity and sport team participation, and significantly negatively related and screen-time sedentary behavior. Results also supported a positive path between physical literacy and interscholastic sport intention. The implications of promoting physical literacy within physical education are discussed in light of the three higher-order underlying factors of physical literacy.

Sammanfattning: Bakgrund: Stillasittande och fysisk inaktivitet har ökat bland barn och ungdomar i Sverige. Detta skapar storakonsekvenser för både den fysiska och psykiska hälsan. Fysioterapeuter som arbetar med barn och ungdomar hargod erfarenhet kring barn och ungdomars fysiska och psykisk hälsa. Därför vill vi undersöka dessa fysioterapeuterssyn på stillasittande samt vilka behov av fysioterapi de upplever hos barn och ungdomar. Syfte: Syftet med denna studie var att belysa fysioterapeuters erfarenheter av barn och ungdomars stillasittandeoch fysisk inaktivitet samt fysioterapeuternas tankar om behovet av fysioterapi i skolan. Metod: Kvalitativ intervjustudie med induktiv ansats. Fem enskilda intervjuer utfördes med fysioterapeutersom arbetar med barn och ungdomar. Intervjuerna analyserades genom kvalitativ innehållsanalys. Resultat: Analysen resulterade i fyra kategorier: “Fysisk aktivitet är ingen självklarhet för barn”, “Barn hamnarutanför vården”, “Skolfysioterapeuten skulle kunna ha ett dynamiskt samarbete medvården” och “Skolfysioterapeutens kompetens kan öka barns hälsa”. Fysioterapeuterna som intervjuades sågstillasittande och fysisk inaktivitet som ett betydande problem för barn och ungdomars hälsa. Resultatet visade påatt fysioterapi som profession har god kunskap för att arbeta hälsofrämjande via skolan. Slutsats: Barn och ungdomars ohälsa ökar, i takt med ett ökat stillasittande och fysisk inaktivitet. Enskolfysioterapeut skulle kunna utföra behandling av motoriska svårigheter och psykisk ohälsa samt bidra till attutveckla det hälsofrämjande arbete i skolan.

Background: “Targeted health dialogues” is a preventive method that aims to reduce the risk of cardiovascular disease and type 2 diabetes. It includes a health-survey containing physical activity (PA)-questions. Health region Skåne introduced the method 2020 and decided to add additional questions about PA and sedentary behavior (SB). With the wish to replace current validated PA-questions with new validated questions and describe SB. Aim: Analyze concurrent validity between the answers of the original PA-questions (kcal/week) in the method and new answers (activity-minutes/last 7-days) and describe SB (hours/day). Method: Quantitative cross-sectional study with non-random, appropriate selection. Participants were 40-year-old health dialogue-participants that consented to research. Data on kcal/week, activity-minutes/last 7-days, sedentary hours/day and basic characteristics were retrieved from digital health-survey. Agreement between PA-questions was analyzed by Cohen´s weighted kappa and intraclass correlation-coefficient (ICC). SB was presented with descriptive statistics and analyzed by Chi2-test, Fisher's-exact-test and independent t-test. Result: Weak agreement between the PA-questions was found (Kw=0,378; ICC=0,273). Participants born in Sweden were more sedentary than those born outside Sweden (p&lt;0.001) and participants with high education were more sedentary compared with lower education (p=0.014). Significant associations were found between SB and BMI (p=0.028; dichotomized analysis). Sedentary participants (&gt;9 hours/d) also had higher mean BMI compared to those who were less sedentary (29,0(SD5,7) and 26,7(SD5,2) respectively; p=0,008). Conclusion: Current PA-questions cannot be replaced in favor of new questions in their current form. Further validation studies are warranted, preferably using objective PA-measures. SB was significantly associated with country of birth, education level and BMI. / Bakgrund: Riktade hälsosamtal är en preventiv metod med syfte att minska risken för hjärt-kärlsjukdom och diabetes typ 2. Metoden innehåller frågor om fysisk aktivitet (FA). Region Skåne införde 2020 metoden och valde att lägga till ytterligare frågor om FA samt stillasittande. Önskemålet var att ersätta tidigare validerade frågor om FA med nya validerade frågor och kartlägga stillasittandet. Syfte: Att undersöka samtidig validitet mellan svaren på de ursprungliga frågorna om FA (kcal/vecka) och svaren på de nya frågorna (aktivitetsminuter/senaste 7-dagarna) samt kartlägga stillasittandet (timmar/dag). Metod: Kvantitativ tvärsnittsstudie med icke-slumpmässigt, ändamålsenligt urval. Deltagarna utgjordes av 40-åringar som haft hälsosamtal samt lämnat forskningssamtycke. Data om kcal/vecka, aktivitetsminuter/senaste 7 dagarna, stillasittande timmar/dag samt bakgrundsinformation inhämtades från den digitala hälsoenkäten. Samstämmighet mellan svaren om FA analyserades genom beräkning av Cohens viktade kappa samt intraklass-korrelationskoefficient (ICC). Stillasittande beskrevs deskriptivt och jämförelseanalyser gjordes med Chi2-test, Fishers exakta-test och oberoende t-test. Resultat: Svag samstämmighet och överensstämmelse sågs mellan FA-frågorna (Kw =0,378; ICC=0,273). Deltagare födda i Sverige var mer stillasittande jämfört med dem födda utanför Sverige (p&lt;0.001) och deltagare med eftergymnasial utbildning var mer stillasittande jämfört med dem utan eftergymnasial utbildning (p=0,014). Signifikant samband sågs mellan stillasittande och BMI (p=0,028; dikotomiserad analys). Medelvärdet för BMI var högre i gruppen som var stillasittande &gt;9h/dag jämfört med ≤9 h/dag (29,0(SD5,7) respektive 26,7(SD5,2); p=0,008). Slutsats: Nuvarande frågor om FA kan inte rakt av bytas ut till förmån för de nya frågorna. Ytterligare valideringsstudier, företrädesvis med objektiva FA-mått, behövs. Nivån av stillasittande hade signifikanta samband med födelseland, utbildningsnivå och BMI.

No description available.

Sedentary behavior and an inactive lifestyle are a risk factor for chronic diseases and an increasing number of people are affected. Technologies and smartphone applications can help to support and increase awareness of sedentary behavior and thus, help users change their lifestyle and create a balance between sedentary time and physically active time. Based on Self-Determination Theory, this study aimed to identify user preferences and design features in technologies to support the awareness of sedentary behavior and explored the influence of design implementations towards motivation on sedentary behavior change. Data was collected and analyzed via a survey that was made available online. Participants were drawn from social media platforms and company email addresses. The survey was distributed to 97 people through a web-based tool which resulted in complete data from 84 responses. Results of the survey based on Self-Determination Theory indicated a positive influence of competition among users in screen-based sedentary behavior applications. These findings contribute to our understanding of how individuals can be motivated to use awareness-based sedentary behavior technologies by the implementation of design features.

Background: Pandemic caused due to the coronavirus (SARS-COV-2) has contributed to changes in everyday life among people around the world and also in Sweden. This has led to unusual circumstances regarding work, school, daily routines and also leisure and physical activity. Aim: The aim of the study is to compare levels of physical activity and sedentary life among students at Malmö University before and during the pandemic caused by Covid-19. Method: Random selection was made for the study. The study compared different levels of physical activity and sedentary behavior before and during the pandemic. The IPAQ survey was used twice. In addition, there were 5 estimation questions about how the pandemic has affected life in general. A total of 341 questionnaires were sent and a total of (n = 83) participants participated. The gender distribution was 42 percent men (n = 35) and 58 percent women (n = 48). Results: The results showed a significant reduction in the students' level of physical activity during the pandemic compared with before the pandemic (p &lt;0.05). In addition, the results of the study showed a significant increase in the time spent sitting still during the pandemic compared to before the pandemic (p &lt;0.05). Conclusion: The pandemic has affected students' activity habits and sitting still. On average, students spend less time on physical activities during the pandemic and sedentary life has increased among students during the pandemic compared to before the pandemic began.