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  • 101.
    Stenling, Andreas
    et al.
    Umeå University, Umeå, Sweden.
    Ivarsson, Andreas
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI), Sport Health and Physical activity.
    Lindwall, Magnus
    Gothenburg University, Gothenburg, Sweden.
    Cross-lagged structural equation modeling and latent growth modeling2016In: An Introduction to Intermediate and Advanced Statistical Analyses for Sport and Exercise Scientists / [ed] Nikos Ntoumanis & Nicholas D. Myers, Chichester: John Wiley & Sons, 2016, 1, p. 131-154Chapter in book (Refereed)
  • 102.
    Svensson, Madeleine
    et al.
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI), Sport Health and Physical activity. Karolinska Institutet, Department of Medicine, Unit of Clinical Epidemiology, Stockholm, Sweden.
    Hult, Mari
    Karolinska Institutet, Department of Medicine, Unit of Clinical Epidemiology, Stockholm, Sweden.
    van der Mark, Marianne
    Karolinska Institutet, Department of Medicine, Unit of Clinical Epidemiology, Stockholm, Sweden.
    Grotta, Alessandra
    Karolinska Institutet, Department of Medical Epidemiology and Biostatistics, Stockholm, Sweden.
    Jonasson, Josefine
    Obesity Center Norrtull, Stockholm, Sweden .
    von Hausswolff-Juhlin, Yvonne
    Karolinska Institutet, Department of Neuroscience, Stockholm, Sweden.
    Rössner, Stephan
    Karolinska University Hospital, Department of Medicine, Stockholm, Sweden & Apple Bay Obesity Research Center, Stockholm, Sweden.
    Trolle Lagerros, Ylva
    Karolinska Institutet, Department of Medicine, Unit of Clinical Epidemiology, Stockholm, Sweden.
    The Change in Eating Behaviors in a Web-Based Weight Loss Program: A Longitudinal Analysis of Study Completers2014In: Journal of Medical Internet Research, ISSN 1438-8871, E-ISSN 1438-8871, Vol. 16, no 11, article id e234Article in journal (Refereed)
    Abstract [en]

    Background: Eating behaviors are essential components in weight loss programs, but limited research has explored eating behaviors in Web-based weight loss programs.

    Objectives: The aim was to evaluate an interactive Web-based weight loss program on eating behaviors using the 18-item Three-Factor Eating Questionnaire Revised (TFEQ-R18) which measures uncontrolled eating, emotional eating, and cognitive restrained eating. Our Web-based weight loss program is comprised of information about healthy lifestyle choices, weekly chats with experts, social networking features, databases for recipe searches, and features allowing members to self-report and track their weight, physical activity, and dietary intake on the website.

    Methods: On registering for the weight loss program, 23,333 members agreed to take part in the research study. The participants were then asked to complete the TFEQ-R18 questionnaire at baseline and after 3 and 6 months of participation. All data collection was conducted online, with no face-to-face contact. To study changes in TFEQ-R18 eating behaviors we restricted our study to those members who completed all 3 TFEQ-R18 questionnaires. These participants were defined as "completers" and the remaining as "noncompleters." The relationships between sex, change in eating behaviors, and total weight loss were studied using repeated measures ANOVA and Pearson correlation coefficient.

    Results: In total, 22,800 individuals participated (females: 19,065/22,800, 83.62%; mean age 39.6, SD 11.4 years; BMI 29.0 kg/m2; males: 3735/22,800, 16.38%; mean age 43.2, SD 11.7 years; BMI 30.8 kg/m2). Noncompleters (n=22,180) were younger and reported a lower score of uncontrolled eating and a higher score of cognitive restrained eating. Over time, completers (n=620) decreased their uncontrolled eating score (from 56.3 to 32.0; P<.001) and increased their cognitive restrained eating (from 50.6 to 62.9; P<.001). Males decreased their emotional eating (from 57.2 to 35.9; P<.001), but no significant change was found among females. The baseline cognitive restrained eating score was significantly and positively associated with weight loss for completers in both men (P=.02) and women (P=.002).

    Conclusions: To our knowledge, this is the largest TFEQ sample that has been documented. This Web-based weight loss intervention suggests that eating behaviors (cognitive restrained eating, uncontrolled eating, and emotional eating) measured by TFEQ-R18 were significantly changed during 6 months of participation. Our findings indicate differences in eating behaviors with respect to sex, but should be interpreted with caution because attrition was high.

  • 103.
    Tranaeus, Ulrika
    et al.
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI). Karolinska Institutet, Stockholm, Sweden.
    Ivarsson, Andreas
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI), Sport Health and Physical activity.
    Johnson, Urban
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI), Sport Health and Physical activity.
    Do psychological based intervention programs prevent sport injuries to occur?2015In: Proceedings: 14th European Congress of Sport Psychology, 14-19 July 2015 in Bern, Switzerland / [ed] Olivier Schmid, Roland Seiler, Annemarie Schumacher Dimech & André Klostermann, Bern: University of Bern , 2015, p. 174-174Conference paper (Refereed)
  • 104.
    Tranaeus, Ulrika
    et al.
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI), Sport Health and Physical activity. Karolinska Institutet, Stockholm, Sweden.
    Ivarsson, Andreas
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI), Sport Health and Physical activity.
    Johnson, Urban
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI), Sport Health and Physical activity.
    Evaluation of the effects of psychological prevention interventions on sport injuries: A meta-analysis2015In: Science & sports, ISSN 0765-1597, E-ISSN 1778-4131, Vol. 30, no 6, p. 305-313Article, review/survey (Refereed)
    Abstract [en]

    Objectives

    The purpose was to conduct a systematic review of published articles aiming to prevent sports injuries based on psychological interventions and to perform a meta-analysis of the effects in such interventions.

    News

    Different kinds of sport injury prevention strategies have been accomplished such as neuromuscular and warm-up programs. More recently, psychological intervention studies have been completed with the purpose of preventing sports injuries. The most evident predictor is stress. Consequently, most psychological injury prevention interventions incorporate stress management and other psychological skills training.

    Prospect and projects

    The electronic databases and suitable sport psychology journals were searched for published studies. Out of 560 screened articles, 15 were potentially eligible articles. Seven of these articles, with substantial information in the papers or the authors were able to provide us with data after request, were finally included.

    Conclusion

    The result, using a random effect model, showed a total Hedges’ g effect size of 0.82 (< .001), 95% CI (0.55–1.11). The result indicates that psychological injury prevention interventions have a large effect on reducing the number of injuries in sport population. © 2015 Elsevier Masson SAS.

  • 105.
    Tranaeus, Ulrika
    et al.
    Karolinska Institute, Stockholm Sports Trauma Research Center, Stockholm, Sweden.
    Johnson, Urban
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI), Sport Health and Physical activity.
    Psychosocial risk factors preceding overuse injury in floor-ball2011In: British Journal of Sports Medicine, ISSN 0306-3674, E-ISSN 1473-0480, Vol. 45, no 4, p. 377-377Article in journal (Refereed)
    Abstract [en]

    Background Previous research demonstrates an injury risk of traumatic and overuse injuries in floor-ball which is one of the major sports in Sweden with 1 24 000 licensed players. One important step to prevent overuse injuries to occur is to understand its psychosocial nature. Objective The aim of this study is to describe and structure athletes' experience of psychosocial risk factors preceding overuse injury. Design Elite floor-ball players were interviewed by the first author and based on a semi-structured interview guide. To uncover the underlying meaning in the transcribed interviews, a thematic content analysis was used. Setting Team doctors and physiotherapists in the highest floor-ball leagues (women and men), were contacted and asked to make contact with overuse injured players for interviews regarding their injury. Interviews were recorded at the interviewer's office or the floor-ball arena. The interviews were transcribed verbatim. Participants were informed about the purpose and the method of the study. That participation was voluntary, that their responses would be treated confidentially and that their identities would not be revealed in the reporting of the findings. Participants Nine male and one female elite floor-ball players diagnosed with a present overuse injury were recruited for voluntary participation. Main outcome measurements Psychosocial factors experienced by elite floor-ball players preceding overuse injuries. Assessment of risk factors Assessment is conducted through qualitative analysis. Results Three main themes evolved in the analysis; a) several players experienced pain while competing. However, it is difficult to separate normal/daily pain to warnings signals of an injury, b) many players experienced a culture in the team including not talking about their first symptoms, and, c) time for mental and physical recovery was not given during the season. Conclusion Players experienced a culture where it is not acceptable to talk about non traumatic pain. Periods of rest were limited leading to a need for mental recovery.

  • 106.
    Tranaeus, Ulrika
    et al.
    Karolinska Institutet, Stockholm, Sweden.
    Johnson, Urban
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI), Sport Health and Physical activity.
    Sports injury prevention: A psychological intervention program focusing floorball2012In: Book of Abstracts of the 17th Annual Congress of the European College of Sport Science: 4-7th July ECSS Bruges 2012 – Belgium / [ed] Meeusen, R., Duchateau, J., Roelands, B., Klass, M., De Geus, B., Baudry, S., Tsolakidis, E., Cologne: European College of Sport Science , 2012, p. 276-276Conference paper (Refereed)
    Abstract [en]

    Sports injuries are an obstacle in most athletes’ strive to achieve their goals. It is of importance to develop rehabilitation programmes and safe return to sport; also preventive intervention programmes are required. The aetiology of sports injuries shows multi-facetted natures. The results of psychological studies shows evidence that psycho-social factors affect the injury-risk exist (e.g. Johnson, 2011). One theoretical framework to intervention programme is Williams and Ander-sen’s stress-injury model (1998). The model provides psychosocial factors which are activated by the athletes’ cognitive and somatic stress-response. Over the years, psychological preventive intervention programmes have been evaluated, aiming to reduce the number of injuries through stress- management (e.g. Johnson et al., 2005). In our recently conducted study, the overall aim was to reduce the stress-response through a psycho-educational intervention and consequently lower the number of injuries. Out of the 22 participating Swedish elite male and female floorball teams, 10 teams were randomized to a preventive intervention programme. This programme was implemented during the first half of the season and consisted of six hour-long sessions with one whole team at a time, based on goal-setting, stress management, concentration, relaxation, self-confidence and emotions. The program was constructed to meet the cognitive and somatic reactions of stress. All sustained injures were recorded at the start of the study and registered as they occurred during the eight months season’s. The intervention-group sustained less injuries compared to the control-group. Reports of past and present research will be given at the seminar. References Johnson, U., Ekengren, J., & Andersen, M., B. (2005). Injury prevention in Swe-den. Helping soccer players at risk. Journal of Sport &. Exercise Psychology, 27, 32- 38. Johnson, U. (2011). Athletes’ experiences of psy-chosocial risk factors preceding injury, Qualitative Research in Sport, Exercise and Health, 3, 99-115. Williams, J. M., & Andersen, M. B. (1998). Psychosocial antecedents of sport injury: Review and critique of the stress and injury model. Journal of Applied Sport Psychology, 10, 5-25.

  • 107.
    Tranaeus, Ulrika
    et al.
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI), Sport Health and Physical activity. Stockholm Sports Trauma Research Center, Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden.
    Johnson, Urban
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI), Sport Health and Physical activity.
    Engström, Björn
    Stockholm Sports Trauma Research Center, Department of Molecular Medicine and Surgery, Karolinska Institutet, Capio Artro Clinic, Sophiahemmet, Stockholm, Sweden.
    Skillgate, Eva
    Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden & Scandinavian College of Napraphatic Manual Medicine, Stockholm, Sweden.
    Werner, Susanne
    Stockholm Sports Trauma Research Center, Department of Molecular Medicine and Surgery, Karolinska Institutet, Capio Artro Clinic, Sophiahemmet, Stockholm, Sweden.
    Psychological antecedents of overuse injuries in Swedish elite floorball players2014In: Athletic Insight: The Online Journal of Sport Psychology, ISSN 1536-0431, E-ISSN 1947-6299, Vol. 6, no 2, p. 155-172Article in journal (Refereed)
    Abstract [en]

    The epidemiology of sport injuries is well documented and the injuries can be divided into either traumatic or overuse injuries. So far, most research aiming to predict and prevent sport injures has focused on physical factors and traumatic sport injuries. The aim of this study was to identify psychological factors preceding overuse injuries. Eleven senior elite floorball players (men: n=9, women: n=2) were interviewed regarding their experiences of potentially stressful events before the onset of an overuse injury. Based on a thematic content analysis, five core themes were developed: history of stressors, person factors, psycho-physiological factors, psychosocial factors and ineffective coping. The results are discussed in the context of related research concerning subthemes and themes, such as stress, motivation, pain and social support; finally, recommendations are given for athletes and coaches. A working model is also suggested for future research. © 2014 Nova Science Publishers, Inc.

  • 108.
    Tranaeus, Ulrika
    et al.
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI), Sport Health and Physical activity. Department of Molecular Medicine and Surgery, Stockholm Sports Trauma Research Center, Karolinska Institutet, Stockholm, Sweden.
    Johnson, Urban
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI), Sport Health and Physical activity.
    Engström, Björn
    Department of Molecular Medicine and Surgery, Stockholm Sports Trauma Research Center, Karolinska Institutet, Stockholm, Sweden & Capio Artro Clinic, Sophiahemmet, Stockholm, Sweden.
    Skillgate, Eva
    Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden & Scandinavian College of Naprapathic Manual Medicine, Stockholm, Sweden.
    Werner, Suzanne
    Department of Molecular Medicine and Surgery, Stockholm Sports Trauma Research Center, Karolinska Institutet, Stockholm, Sweden & Capio Artro Clinic, Sophiahemmet, Stockholm, Sweden.
    A psychological injury prevention group intervention in Swedish floorball2015In: Knee Surgery, Sports Traumatology, Arthroscopy, ISSN 0942-2056, E-ISSN 1433-7347, Vol. 23, no 11, p. 3414-3420Article in journal (Refereed)
    Abstract [en]

    Purpose

    The main purpose of the study was to evaluate a psychological skills training intervention at group level aiming to prevent injuries, separated in traumatic and overuse, in male and female elite floorball players.

    Methods

    Twenty-three teams in the premiere leagues for males and females were volunteered, and the teams were allocated to an intervention group (n = 11, males n = 94, females n = 99) and a control group (n = 12, males n = 109, females n = 99). The teams in the intervention group participated in a psychological skills training programme consisting of six meetings with each team. The control group received no substitute. All injuries were registered and documented according to the time-loss definition and classified into either traumatic or overuse.

    Results

    In total, 142 players (35 %) out of the 401 players sustained 197 injuries, 0.49 injury/player: in the intervention group 0.45 injury/player and in the control group 0.53 injury/player. The analyses revealed no significant differences in injuries between intervention groups and control groups. The effect size of the influence of the psychological skills training in overuse injuries was considered to be small, Cohen’s d 0.2.

    Conclusions

    This study comprised the whole team for a group intervention and did not screen for at-risk athletes, e.g. scoring high in anxiety or low in coping skills, which might have influenced the result. A psychological injury prevention intervention forward to a whole team might not influence the injury occurrence significantly. Thus, this psychological intervention decreased the injury incidence which is of clinical interest.

    Level of incidence

    Level II.

    © Springer-Verlag Berlin Heidelberg 2014

  • 109.
    Tranaeus, Ulrika
    et al.
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI), Sport Health and Physical activity. Department of Molecular Medicine and Surgery, Stockholm Sports Trauma Research Center, Karolinska Institutet, Stockholm, Sweden & Capio Artro Clinic, Sophiahemmet, Stockholm, Sweden.
    Johnson, Urban
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI), Sport Health and Physical activity.
    Ivarsson, Andreas
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI), Sport Health and Physical activity.
    Engström, Björn
    Department of Molecular Medicine and Surgery, Stockholm Sports Trauma Research Center, Karolinska Institutet, Stockholm, Sweden & Capio Artro Clinic, Sophiahemmet, Stockholm, Sweden.
    Skillgate, Eva
    Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden & Scandinavian College of Naprapathic Manual Medicine, Stockholm, Sweden.
    Werner, Suzanne
    Department of Molecular Medicine and Surgery, Stockholm Sports Trauma Research Center, Karolinska Institutet, Stockholm, Sweden & Capio Artro Clinic, Sophiahemmet, Stockholm, Sweden.
    Sports injury prevention in Swedish elite floorball players: evaluation of two consecutive floorball seasons2015In: Knee Surgery, Sports Traumatology, Arthroscopy, ISSN 0942-2056, E-ISSN 1433-7347, Vol. 23, no 3, p. 899-905Article in journal (Refereed)
    Abstract [en]

    Purpose

    The objective was to evaluate the effect of a psychological group-based injury prevention, which was implemented throughout the first season, after the second season, in Swedish elite floorball teams (males and females). The secondary objective was to evaluate the effect of the intervention over the two consecutive floorball seasons as a whole.

    Methods

    Twenty-three teams in the premier leagues for males and females volunteered and were allocated to an intervention group, n = 175 players, and a control group n = 171 players. The intervention group participated in psychological skills training during the first season. The control group did not receive any alternative treatment. Neither of the groups received any intervention during the second season. All injuries were registered and documented according to time-loss definition and classified into either traumatic or overuse injuries.

    Results

    Ninety-three players (27 %) sustained 119 injuries during the second season. The intervention group 0.31 (95 % CI 0.22–0.39) and the control group 0.41 (95 % CI 0.29–0.53) injuries/player. The injury incidence decreased in the intervention group and was lower than the control group. The analysis showed no statistical differences when comparing the intervention group and the control group neither after the second season nor after the two seasons together, Cohen’s d 0.2.

    Conclusion

    This group-based training showed a small effect size after the second year resulting in fewer injuries, especially severe injuries, in the intervention group compared to the control group. It is, therefore, important not to overlook the potential of a group-based psychological injury prevention programme.

    Level of incidence: II.

    © 2014, European Society of Sports Traumatology, Knee Surgery, Arthroscopy (ESSKA).

  • 110.
    Weman Josefsson, Karin
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI), Sport Health and Physical activity. University of Gothenburg, Gothenburg, Sweden.
    Suggesting a Synergy between Self-Determination Theory and Person-Centred Care2016In: Jacobs Journal of Physical Rehabilitation Medicine, ISSN 2469-3103, Vol. 2, no 2, article id 023Article in journal (Refereed)
    Abstract [en]

    There seems to be interesting commonalities between self-determination theory (SDT) and person-centred care (PCC), especially when considering their respective value systems and foundations for practice. Both perspectives are based on the fundamental view of human beings as active and capable persons who will thrive if the social environment facilitates certain essential conditions. This short communication paper addresses potential synergy effects in combining these two perspectives in order to improve future applications and assessments of person-centred care. Opportunities for theoretical guidance, concept and measurement adoption along with practical implications are briefly discussed.

  • 111.
    Weman Josefsson, Karin
    et al.
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI).
    Ebbesson, Esbjörn
    Halmstad University, School of Information Technology, Halmstad Embedded and Intelligent Systems Research (EIS), Man and Information technology laboratory (MI-lab).
    Halila, Fawzi
    Halmstad University, School of Business, Engineering and Science, Centre for Innovation, Entrepreneurship and Learning Research (CIEL).
    Johnson, Urban
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI), Sport Health and Physical activity.
    Lund, Jesper
    Halmstad University, School of Information Technology, Halmstad Embedded and Intelligent Systems Research (EIS), Man and Information technology laboratory (MI-lab).
    Wickström, Nicholas
    Halmstad University, School of Information Technology, Halmstad Embedded and Intelligent Systems Research (EIS), CAISR - Center for Applied Intelligent Systems Research.
    Wärnestål, Pontus
    Halmstad University, School of Information Technology, Halmstad Embedded and Intelligent Systems Research (EIS), Man and Information technology laboratory (MI-lab).
    Application of self-determination theory in the e-health industry – promoting sustainable exercise motivation2015In: Proceeding: 14th European Congress of Sport Psychology: Sport Psychology: Theories and Applications for Performance, Health and Humanity: 14-19 July 2015, Bern, Switzerland / [ed] Olivier Schmid & Roland Seiler, Bern: University of Bern , 2015, p. 372-372Conference paper (Refereed)
    Abstract [en]

    Developing tailored digital interventions for exercise motivation by applying behavioral theory into existing web services in cooperation with the e-health industry could create a mutual base for experience exchange and practical implications. It could also add higher standards to e-health business by providing a scientifically sound and trustworthy foundation for digital solutions. This project aims to design an interactive tool grounded in sport and exercise psychology and combined with the latest expertise from information technology and innovation science, considering e-health industrial requirements and user needs. A main objective is to test the efficacy of using Self-Determination Theory (SDT) in designing, constructing and evaluating an exercise intervention. The digital intervention is based on a literature review mapping exercise motivation related to self-determination theory, complemented by qualitative cross-disciplinary interaction design methodologies, such as qualitative analysis of interviews and contextual observation capturing participant goals, behaviour, preferences, attitudes and frustrations. Intervention contents are essentially autonomy supportive structures, goal-setting support and relapse prevention, self-regulation structures, health information and web links. In February 2015 the intervention prototype will be pilot tested in a randomized controlled trial (RCT), involving existing members and clients (N > 10 000) of two health service companies. Outcomes relate to self-determined exercise motivation (The Basic Psychological Needs in Exercise Scale and The Behavioral Regulation in Exercise Questionnaire-2) and exercise behaviour, measured both by self-report measures (Godin Leisure-Time Exercise Questionnaire) and step counters. The RCT contains three measure points in order to allow advanced analyses of change and mechanisms based on the SDT-process model and motivational profiles. Latent growth curve and structural equation models will primarily be used to analyse data. This pilot study will create a baseline for elaboration into a second phase, were the digital tool will be further developed and longitudinally tested and evaluated over a nine months period. © 2015 University of Bern, Institut of Sport Science 

  • 112.
    Weman Josefsson, Karin
    et al.
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI).
    Halila, Fawzi
    Halmstad University, School of Business, Engineering and Science, Centre for Innovation, Entrepreneurship and Learning Research (CIEL).
    Johnson, Urban
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI), Sport Health and Physical activity.
    Wickström, Nicholas
    Halmstad University, School of Information Technology, Halmstad Embedded and Intelligent Systems Research (EIS), CAISR - Center for Applied Intelligent Systems Research.
    Wärnestål, Pontus
    Halmstad University, School of Information Technology, Halmstad Embedded and Intelligent Systems Research (EIS), Man and Information technology laboratory (MI-lab).
    Digital interventions in self-determined exercise motivation – interdisciplinary innovations2015In: ISBNPA 2015: Advancing Behavior Change Science : 3rd – 6th June 2015: Abstract Book, 2015, p. 592-592Conference paper (Refereed)
    Abstract [en]

    Purpose:There is a need for scientifically sound and theory based tools and services in e-health. In this project knowledge from the field of psychology will be complemented by expertise in information technology and innovation science in designing a digital intervention based on Self-determination theory (SDT) aiming to facilitate exercise motivation.

    Methods:The intervention will be tested by a three wave RCT design in a population of e-health clients (n = 200) in a web based exercise service. Sensors (step counters) and self-reports (Godin Leisure-Time Exercise Questionnaire) will be used to measure objective and subjective exercise behavior while instruments based on SDT (Basic Psychological Needs in Exercise Scale and Behavioral Regulation in Exercise Questionnaire-2 ) will measure factors related to motivation.  Advanced mediation variable analyses (MVA) and latent growth curve models (LGCM) will be used to explore motivational processes, changes and profiles in relation to exercise behavior.

    Expected Results:Based on the SDT process model, it is hypothesized that a (digital) environment supporting basic psychological need satisfaction will facilitate internalization and enhanced self-determined motivation, which in turn will have a positive effect on exercise behavior.

    Conclusions:Clarifying mechanisms and indirect effects provide knowledge of how intervention effects could be interpreted and understood. Combining high level research design like RCT and advanced analyses as MVA provides valuable contributions to the understanding of theoretical mechanisms of motivation that could inform the tailoring of effective interventions promoting healthy exercise behaviours.  In addition, the project might form a prosperous interdisciplinary fusion generating innovative and theory based digital solutions for e-health.

  • 113.
    Weman Josefsson, Karin
    et al.
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI), Sport Health and Physical activity.
    Lindwall, Magnus
    University of Gothenburg, Gothenburg, Sweden.
    Fröberg, Kristina
    University of Gothenburg, Gothenburg, Sweden.
    Karlsson, Sara
    University of Gothenburg, Gothenburg, Sweden.
    Exercise Motivation and Behaviour: A Brief Theory-based Intervention2014In: Book of Abstracts of the 19th Annual Congress of the European College of Sport Science – 2nd - 5th July 2014, Amsterdam – The Netherlands / [ed] De Haan, A., De Ruiter, C. J., Tsolakidis, E., Cologne: European College of Sport Science , 2014, p. 501-501Conference paper (Refereed)
    Abstract [en]

    Introduction

    The need for adequately designed and well-delivered interventions successfully increasing physical activity and exercise has long been highlighted [1]. Furthermore, interventions based on adequate theory and examined by proper analyses enable researchers to identify central mechanisms of change [2], important for successful intervention design [3].

    Methods

    The present study examined potential effects of a short theory based intervention on exercise motivation and behaviour in a randomized controlled trial design. Self-Determination Theory, Cognitive Behavioural Therapy, Motivational Interviewing and Relapse-Prevention Model were used as guiding frameworks. The research questions concerned whether the intervention would influence (a) exercise level and intensity, (b) motivation quality, (c) autonomy and competence need satisfaction, and (d) potential indirect effects of self-determined motivation on exercise were also examined. The participants (N=64) completed self-reported measures of exercise level and intensity (Leisure Time Exercise Questionnaire; LTEQ), of motivational quality (Behavioral Regulations in Exercise Questionnaire-2; BREQ-2) and of autonomy and competence need satisfaction (Psychological Needs in Exercise Scale; PNSE) at baseline and after the six weeks of intervention.

    Results

    The results showed significant intervention effects for both exercise level and intensity, as well as in motivation quality. Furthermore, the effect of the intervention on exercise was   mediated by motivational profile, in particular identified regulation.

    Discussion

    Despite the short-term and small scale nature of the intervention, effects were found on exercise behaviour and this effect was mediated by self-determined motivation. The results are generally in line with theoretical expectations from an SDT perspective. Furthermore, the study adds interesting findings of potential mechanisms behind exercise behaviour and motivation. Future research should further explore the theoretical mechanisms of behaviour change in order to facilitate tailoring of effective exercise interventions and enhancing motivation.

    References

    1. WHO, Global recommendations on physical activity for health. 2010, World Health Organization.: Geneva.
    2. Rhodes, R.E. and L.A. Pfaeffli, Mediators of physical activity behaviour change among adult non-clinical populations: a review update. Int J Behav Nutr Phys Act, 2010. 7: p. 37.
    3. Fortier, M.S., et al., Promoting physical activity: development and testing of self-determination theory-based interventions. International Journal of Behavioral Nutrition and Physical Activity 2012. 9(20).
  • 114.
    Weman Josefsson, Karin
    et al.
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI), Sport Health and Physical activity. University of Gothenburg, Gothenburg, Sweden.
    Lindwall, Magnus
    University of Gothenburg, Gothenburg, Sweden.
    Ivarsson, Andreas
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI).
    Considering moderators and mediators in self-determined motivation and exercise behaviour2014In: Association for Applied Sport Psychology – 2014 Conference Proceedings & Program / [ed] Daniel Weigand, Indianapolis, IN: Association for Applied Sport Psychology , 2014, p. 75-76Conference paper (Refereed)
    Abstract [en]

    In order to successfully enhance exercise motivation and behaviour change, it is of particular importance to explore and understand theoretical mechanisms underpinning exercise behaviours. Research based on adequate theory and using appropriate mediating variable analyses (MVA) could inform practice by identifying the active ingredients of successful exercise promotion intervention designs and distinguishing elements that could (or should) be excluded. Such an approach could not only promote cost-effectiveness, but also contribute to the understanding of sustainable behavior change and provide valuable practical implications for intervention design. This study aimed to examine the abovementioned mechanisms based on Self-Determination Theory (SDT; Deci & Ryan, 1985; 2000). Adult active members of an Internet-based exercise program (n = 1,091) between 18 and 78 years of age completed a test battery including the Basic Psychological Needs in Exercise Scale (BPNES); the Behavioural Regulation in Exercise Questionnaire-2 (BREQ-2) and Leisure Time Exercise Questionnaire (LTEQ). Data was analysed by structural equation modelling (SEM) and mediation analyses using bootstrapping resampling approach. Mplus version 7.1 was used to analyse the data with the maximum likelihood (ML) and robust maximum likelihood (MLM) estimators. Need satisfaction was found to predict self-determined motivation, which in turn predicted exercise, especially for women. Self-determined motivation mediated the association between need satisfaction and exercise, and these associations were moderated by gender and age. The results highlight the potential impact of considering moderating effects for a better understanding of how and for whom exercise interventions could influence behavioural outcomes. Future research would benefit practice by further exploration of underlying mechanisms in terms of mediating and moderating effects in order to be able to make adequate recommendations on how to tailor SDT intervention designs, e.g. by addressing age and gender issues.

  • 115.
    Weman Josefsson, Karin
    et al.
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI).
    Lindwall, Magnus
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI).
    Ivarsson, Andreas
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI), Sport Health and Physical activity.
    Examining patterns of change in self-determined exercise motivation using latent growth curve models2015Conference paper (Refereed)
    Abstract [en]

    Few previous studies have targeted how self-determined motivation changes within persons across shorter periods of time (e.g., weeks). Latent growth curve models allow study of within-person change and between-person differences in within-person change over time. The purpose of the study was to study within-person change and between-person differences in change in exercise and motivation in a sample of 2797 exercisers in a natural course of events (i.e. no intervention) over a period of eight weeks. Motivational variables related to self-determination theory were measured by the Basic Psychological Needs in Exercise Scale (BPNES) and the Behavioral Regulation in Exercise Questionnaire-2 (BREQ-2) and Godin Leisure-Time Exercise Questionnaire (GLTEQ) was used to assess self-reported exercise level and intensity. The data was analyzed by latent growth curve models in Mplus. The results show significant increase in the average change (mean slope) of psychological need satisfaction whereas there was significant decrease in amotivation. Furthermore, the slopes of variance were significant for all variables except for autonomy, competence and intrinsic motivation, indicating a pattern of heterogeneity in terms of within-person change. No significant changes were detected in exercise level or intensity (METS). The results will be used as reference data in a future intervention study aiming to enhance self-determined exercise motivation in a comparable population.

  • 116.
    Weman Josefsson, Karin
    et al.
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI), Sport Health and Physical activity.
    Lindwall, Magnus
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI).
    Sebire, Simon J.
    University of Bristol, Bristol, United Kingdom.
    Standage, Martyn
    University of Bath, Bath, United Kingdom.
    Viewing exercise goal content through a person-oriented lens: A self-determination perspective2016In: Psychology of Sport And Exercise, ISSN 1469-0292, E-ISSN 1878-5476, no 27, p. 85-92Article in journal (Refereed)
    Abstract [en]

    The present study examined profiles of exercise goal content and the associations with need satisfaction, motivation regulation and exercise behavior, combining variable-centered and person-centered analytical approaches. The participants were 1084 (279 men and 805 women) Swedish adults, aged between 18 and 78 years, that were all active members of an Internet-based exercise program. Latent profile analysis (LPA) and structural equation modeling (SEM) were used to analyze the data. In SEM analysis intrinsic goals were related to need satisfaction and autonomous motivation, whereas extrinsic goals were most strongly associated with controlled motivation. LPA revealed five unique latent classes of goal content. These five classes differed in need satisfaction, motivation regulation and exercise behavior, with classes being characterized by more intrinsic goal profiles reporting higher need satisfaction and autonomous motivation. The results are discussed from a self-determination theory perspective and the benefits of using both variable and person-centered analytical approaches are highlighted. © 2016 Elsevier Ltd. All rights reserved

  • 117.
    Weman-Josefsson, Karin Anna
    et al.
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI), Sport Health and Physical activity. University of Gothenburg, Gothenburg, Sweden.
    Halila, Fawzi
    Halmstad University, School of Business, Engineering and Science, Centre for Innovation, Entrepreneurship and Learning Research (CIEL).
    Johnson, Urban
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI), Sport Health and Physical activity.
    Wickström, Nicholas
    Halmstad University, School of Information Technology, Halmstad Embedded and Intelligent Systems Research (EIS), CAISR - Center for Applied Intelligent Systems Research.
    Wärnestål, Pontus
    Halmstad University, School of Information Technology, Halmstad Embedded and Intelligent Systems Research (EIS), Man and Information technology laboratory (MI-lab).
    Digital Innovations and Self-determined exercise motivation: an interdisciplinary approach2015In: Proceedings of The 6th International Multi-Conference on Complexity, Informatics and Cybernetics: IMCIC March 2015. Orlando, Florida., 2015Conference paper (Refereed)
    Abstract [en]

    In face of escalating health care costs, new technology holds great promise for innovative solutions and new, more sustainable health care models. Technology centers around the individual, allowing for greater autonomy and control in health issues and access to tailored information and customized health behavior interventions. While this offers good opportunities for both public health impact and improved well-being at individual levels, it also emphasizes the need for properly designed e-health models firmly based on scientific principles and adequate theoretical frameworks. Consequently, this project aims to design an interactive tool utilizing an interdisciplinary approach combining motivational theory with the fields of information technology and business model innovation. In collaboration with two companies from the e-health industry, the purpose is to design, apply and evaluate a person-centered interactive prototype for maintainable and self-determined exercise motivation.

  • 118.
    Weman-Josefsson, Karin Anna
    et al.
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI), Sport Health and Physical activity. University of Gothenburg, Gothenburg, Sweden.
    Lindwall, Magnus
    University of Gothenburg, Gothenburg, Sweden.
    Ivarsson, Andreas
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI), Sport Health and Physical activity.
    Need satisfaction, motivational regulations and exercise: moderation and mediation effects2015In: International Journal of Behavioral Nutrition and Physical Activity, ISSN 1479-5868, E-ISSN 1479-5868, Vol. 12, no 1, p. 1-11, article id 67Article in journal (Refereed)
    Abstract [en]

    Background: Based on the Self-determination theory process model, this study aimed to explore relationships between the latent constructs of psychological need satisfaction, autonomous motivation and exercise behaviour; the mediational role of autonomous motivation in the association of psychological need satisfaction with exercise behaviour; as well as gender and age differences in the aforementioned associations.

    Methods: Adult active members of an Internet-based exercise program (n = 1,091) between 18 and 78 years of age completed a test battery on motivational aspects based on Self-determination theory. The Basic Psychological Needs in Exercise Scale and the Behavioural Regulation in Exercise Questionnaire-2 were used to measure need satisfaction and type of motivation and the Leisure Time Exercise Questionnaire to measure self-reported exercise.

    Results: Need satisfaction predicted autonomous motivation, which in turn predicted exercise, especially for women. Autonomous motivation was found to mediate the association between need satisfaction and exercise. Age and gender moderated several of the paths in the model linking need satisfaction with motivation and exercise.

    Conclusions: The results demonstrated gender and age differences in the proposed sequential mechanisms between autonomous motivation and exercise in the process model. This study thus highlights a potential value in considering moderating factors and the need to further examine the underlying mechanisms between needs, autonomous motivation, and exercise behaviour. 

  • 119.
    Weman-Josefsson, Karin
    et al.
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI), Sport Health and Physical activity.
    Jonsson, Linus
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI), Sport Health and Physical activity.
    Johansson, Gunnar
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI), Sport Health and Physical activity.
    FaR har stor utvecklingspotential2014In: Läkartidningen, ISSN 0023-7205, E-ISSN 1652-7518, Vol. 111, no CZ77Article in journal (Other (popular science, discussion, etc.))
  • 120.
    Wiman, Virginia
    et al.
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI), Sport Health and Physical activity.
    Lydell, Marie
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI), Sport Health and Physical activity. Region Halland, Halmstad, Sweden.
    Nyholm, Maria
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI), Sport Health and Physical activity.
    Workplace health promotion; views from managers of small companies2012In: European Journal of Public Health, ISSN 1101-1262, E-ISSN 1464-360X, Vol. 22, no Suppl. 2, p. 129-129Article in journal (Other academic)
    Abstract [en]

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

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

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

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

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